OccupationalHealth

Dr.SireenAlkhaldi,BDS,MPH,DrPHCommunityHealth/SecondSemester 2018/2019DepartmentofFamilyandCommunityMedicineFacultyofMedicine/TheUniversityof Jordan

Editedby: يداھلا دبع انیل

profession

occupation

Position

Job

Thelevelsoflabor:

Thehighestlevelbecauseitrequiresaparticular

qualificationsandcertainlevelof

educationalskills.

Whyisoccupationalhealthandsafetyimportant?

•Workplaysacentralroleinpeople'slives,sincemostworkersspendatleasteighthoursadayintheworkplace,whetheritisinanofficeorinthefactory,etc.•Workersrepresenthalftheworld’spopulationandarethemajorcontributorstoeconomicandsocial development.

• Therefore,workenvironmentsshouldbesafeandhealthy.Yetthisisnotthecaseformany workers.

Whyisoccupationalhealthandsafetyimportant?• Everydayworkersallovertheworldarefacedwithamultitudeofhealthhazards,such as: dusts; gases; noise; vibration; &extreme temperatures.

• Occupationalhazardscauseorcontributetotheprematuredeathofmillionsofpeopleworldwideandresultintheillhealthordisablementofhundredsofmillionsmoreeach year.

• TheInternationalLaborOrganization(ILO)andtheWorldHealthOrganizationestimatethat5–7%ofglobalfatalitiesattributabletowork-relatedillnessesandoccupational injuries.

Whyisoccupationalhealthandsafety important?

TheILOandWHOalsoestimatethatgloballythereare2.3millionoccupationallyrelateddeathseachyearattributabletowork.

Overall,cancerformsthelargestcomponent(32%) *(workersthatareexposedtoradioactiveandchemicalmaterials) followedbywork-relatedcirculatorydiseases (23%),communicablediseases(17%) *(workersinthemedicalfield:nursesandphysicians)andoccupationalaccidents(18%)withthelattertwobeingfarmoreprevalentindevelopingandrapidlyindustrializing countries.

Over313millionnonfataloccupationalaccidents(withatleast4days absence)

So,whatistheproblemwithoccupational health?

• Unfortunatelysomeemployersassumelittleresponsibilityfortheprotectionofworkers'healthand safety.

• Infact,someemployersdonotevenknowthattheyhavethemoralandoftenlegalresponsibilitytoprotect workers.• Asaresultofthehazardsandalackofattentiongiventohealthandsafety,work-relatedaccidentsanddiseasesarecommoninallpartsofthe world.

DefinitionSince1950,theInternationalLabourOrganization (ILO)andtheWorldHealthOrganization (WHO)havesharedacommondefinitionofoccupational health.

OccupationalHealthisthepromotionandmaintenanceofthehighestdegreeofphysical,mentalandsocialwell-beingofworkersinalloccupationsbypreventingdeparturesfromhealth,controllingrisksandtheadaptationofworktopeople,andpeopletotheirjobs.(ILO/WHO 1950)

IdentifyingSafetyandHealth HazardsTheterminologyusedinOccupationalSafetyandHealth(OSH)varies,butgenerally speaking:• Ahazardissomethingthatcancauseharmifnot controlled.

• Theoutcomeistheharmthatresultsfromanuncontrolledhazard.• Ariskisacombinationoftheprobabilitythataparticularoutcomewilloccurandtheseverityoftheharm involved.• Thecalculationofriskisbasedonthelikelihoodorprobability oftheharmbeingrealizedandthe severity oftheconsequences.

• Forexample,repetitivelycarryingout manualhandling ofheavyobjectsisa hazard.• Theoutcomecouldbea musculoskeletaldisorder(MSD)oranacutebackorjointinjury.• Theriskcanbeexpressednumerically(e.g.a0.5or50/50chanceoftheoutcomeoccurringduringayear),inrelativeterms(e.g. "high/medium/low").

IdentifyingSafetyandHealth Hazards

Commonworkplacehazard groups1 Mechanical hazards.

Bytypeof agent:• Fallingdownfroma height (construction workers)• Confined Space• Impact force• Slipsand trips• Fallingonapointed object• Compressedair/high pressure• Entanglement• Equipment-related injuryBytypeof damage:Crushing,Cutting,Friction andabrasion,Shearing ,

Stabbing and puncture

2. physicalhazards .• Noise *(cancause headache,elevatedlevels of stress,hearing problemsPhysicalandbiologicaldiseases)• Vibration *(cancausemusculoskeletaldiseases)• Barotrauma(hypobaric/hyperbaric pressure)• Ionizing radiation• Electricity• Asphyxiation• Coldstress (hypothermia)*(can causeRheumatoidarthritis)• Heatstress (hyperthermia)

3- Biological Hazards:BacteriaVirusFungie.g.Blood-borne pathogense.g. Tuberculosis

4- Chemical hazardsinclude:AcidsBasesHeavy metalsSolventsParticulates:Fumes(noxiousgases/vapors),silicaparticles (pneumoconiosis)Highly-reactivechemicals

Fire, explosionhazards.

5- Psychosocialissues include• Work-related stress,whosecausalfactorsincludeexcessiveworkingtimeand overwork .•Violence fromoutsidetheorganization .•Bullying,whichmayinclude emotional and verbalabuse• Sexual harassment•Burnout• Exposuretounhealthyelementsduringmeetingswithbusinessassociates,e.g. tobacco,uncontrolled alcohol

6.Musculoskeletal DisordersMusculoskeletaldiseasesareamajorindustrialproblemintermsofbothdisabilityand cost.• Thesediseasescausealargenumberofpermanentdisabilityratingsandaburdentomedical services.• Lowbackpainoccursin50%ofworkersinheavy industries.•Repetitiveloadingsappeartofatigueandweakensthe tissues.

• Avoidedbytheemploymentofgood ergonomic design•Theneedtoreducemusculoskeletalinjuriesintheworkplacehasbecome acute.

*If youwanttoliftaheavy

objectjustbendyourknees(don’t

keepthemextended).J

Risk assessmentModernoccupationalsafetyandhealthlegislationusuallydemandsthatariskassessment becarriedoutpriortomakingan intervention.Itshouldbekeptinmindthatriskmanagementrequiresrisktobemanagedtoalevelwhichisaslowasisreasonably practical.Thisassessment should:• Identifythe hazards• Identifyallaffectedbythehazardand how• Evaluatethe risk• Identifyandprioritizeappropriatecontrol measures

Risk Assessment

• Thecalculationofriskisbasedonthelikelihoodorprobability oftheharmbeingrealizedandthe severity ofthe consequences.

• Thiscanbeexpressedmathematicallyasa quantitativeassessment(byassigninglow,mediumandhighlikelihoodand severity

• Theassessmentshouldberecordedandreviewedperiodicallyandwheneverthereisasignificantchangetowork practices

Risk Assessment

• Theassessmentshouldinclude practicalrecommendationstocontrolthe risk.

•Oncerecommendedcontrolsareimplemented, theriskshouldbere-calculatedtodetermineifithasbeenloweredtoanacceptable level.

• Generally speaking, newly introduced controlsshould lower risk by one level, i.e., from high tomedium or frommedium to low.

OccupationalHealthinHealth WorkersAhealthcarefacilityisaworkplaceaswellasaplaceforreceivingandgivingcare.Healthcarefacilitiesaroundtheworldemployover59millionworkerswhoareexposedtoacomplexvarietyofhealthandsafetyhazardseveryday including:

• biologicalhazards,suchasTB,Hepatitis,HIV/AIDS, SARS• chemicalhazards,suchas,glutaraldehyde,ethyleneoxide• physicalhazards,suchasnoise,radiation,slipstripsand falls• ergonomichazards,suchasheavy lifting• psychosocialhazards,suchasshiftwork,violenceand stress• fireandexplosionhazards,suchasusingoxygen,alcoholsanitizing gels• electricalhazards,suchasfrayedelectrical cords.

OccupationalHealthHazardsamongDoctorsand NursesInfectious Diseases: Tuberculosis: Common among health care workers,HepatitisB,HepatitisC,HIV, Influenza,Risksrelatedtostressandoverwork:Depression,suicide,hopelessness,Burnout,Restrictedsociallife,pronetoalcohol/drugabuse/drug exposure.StressofbalancingFamilylife:Kindofworkandnightdutieseffectfamilylifeveryadversely, Specially female doctors. Completing familywilleffecttheircareers,mostoftime.Highratesofdivorces,Stressrelated diseasesLifestylediseases:mainlysedentaryworkandlonghoursofworking,makesthempronetolifestylediseaseslikeischemicheartdisease,hypertension etc.Exposuretoradiations:speciallyinradiologyandoncology.femaledoctorsaremore affected.Lackofexposuretosunlight:effectsbones,deficiencyofvitDandpredisposesto depression

OccupationalHealthHazardsamongDoctorsand Nurses

Risk of catching resistant infections and sometimes there is risk that they carrythese deadly bacteria to their homes. So their family members and children areat risk.Risk of working in disaster areas, floods, earthquakes.

Change in natural bio flora of doctors and nurses. It is replaced by hospital bioflora. If they get infection, it is difficult to treat.

Risksbecauseoflegalproblemsand violent patients: Legaltroubleaddstofurther stress.Verbalabuseandthreateningisverycommon.Fear of physical assaultcanreallyharmdoctorsandfamilymembers.Excessiveandunilateralregulationputsdoctorsatthereceivingendofthediscontent(doctorsalways blamed).

RulestoRememberWhenWorkingWith RadiationEveryonemusttakeradiationoverexposureseriously.Hence, preventivemeasuresandrulesmustbestrictlyfollowedtoavoidcriticalhealthconditions.• Acquireadequatetrainingtobetterunderstandthenatureofradiationhazards.

• Reducehandlingtimeofradioactivematerialsand equipment.• Bemindfulofyourdistancefromsourcesofradiation.Increasedistanceasmuchas possible.

• Usepropershieldingforthetypeof radiation.• Isolateorcontainharmfulradioactivematerials properly.• Armoryourselfwithappropriateprotectiveclothingand dosimeters.• Conductcontaminationsurveysinthework area.• Donoteat,drink,smoke,orapplycosmeticsinanareawhereunsealedradioactivesubstancesare handled.

• Observeproperradioactivewaste disposal.