Occupational Health

Coal Worker’s Pneumoconiosis (CWP)

Occupational exposure to coal dust leads to Coal Worker's Pneumoconiosis (CWP), which has enormous social, medical and economic importance of many countries in the world where coal mining is a major industry. About 10% of the workers in a coal mine are having Coal Worker's Pneumoconiosis who are working in coal mine for more than 20 years, that can be diagnosed by simple X-ray and if more sophisticated equipments are used than it is much higher. The anthracite miners have more grave situation, they have more than 50% positive X-rays on plain radiography. The prevalence of Coal Worker's Pneumoconiosis is much lower in bituminous mines and in US and most western nations the mines are of bitumen so Coal Worker's Pneumoconiosis is less prevalent in those countries.

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Silicosis

Among all the occupational diseases and pneumoconiosis, silicosis is the commonest and causes most sufferings in terms of morbidity, mortality and permanent disability. Silicosis is caused by inhalation of free silica or crystalline quartz or silicon dioxide (SiO2). The important causes of occupational exposure include mining, stone cutting, working in abrasive industries like stone, clay, glass and cement factories or working with cement; packing of silica flour, foundry work or quarrying of granite. Commonly pulmonary fibrosis occur in silicosis inn a dose dependent manner after exposure to silica for many years.

Some workers are heavily exposed to silica (sandblasting in confined spaces, tunneling in the area where quartz content is very high at 15-25%), manufacture of abrasive soaps and they can develop silicosis in less than a year of exposure. The worst thing about silicosis and other occupational lung diseases is that the progression of the disease continues even after discontinuation of exposure.

Simple silicosis develops if there is long duration and less intense exposure to silica. There appears small rounded opacities in the upper lobe of lung that can give “eggshell” appearance in simple silicosis.

The nodular fibrosis can be progressive in the absence of further exposure, with formation of non segmental conglomerates of irregular masses more than 1 cm in diameter (complicated silicosis). These masses can become very large and when this occurs it is called progressive massive fibrosis (PMF). Significant functional impairment with restrictive and obstructive components are associated with this form of silicosis.

Silica is toxic to the macrophages of alveoli and due to that patients with silicosis are more prone to respiratory infections like tuberculosis, fungal infection and infection by atypical mycobacterium. Due to high risk of active tuberculosis the treatment of tuberculosis is given for longer duration in silicosis patient than usual. Another complication of silicosis is autoimmune connective tissue disorder like rheumatoid arthritis.

International Agency for Research on Cancer includes silica as a carcinogen (causes cancer) for lung and it is supported by epidemiological data.

Other less harmful silicates are kaolin, mica, Fuller’s earth, diatomaceous earths, silica gel, soapstone, carbonate dusts, and cement dusts etc. Fibrosis is produced in the persons exposed to these dusts depends on the content of free silica in these dusts or due to heavy load of dust where free silica is absent.

There is no effective treatment available for silicosis. Only treatment is prevention by further exposure and sadly this is also not much helpful because the progression of disease continues even after exposure is stopped. Whole-lung lavage may provide symptomatic relief and slow progression.

Occupational Health Hazards of Agricultural Worker

Occupational health and occupational health hazards are new concept in case of agriculture. This is due to the fact of misconception that, occupational health is only in relation to industry and factories and in industrialized countries. agricultural workers have a multitude of health problems due to working conditions in the field of agriculture. The following type of health problems arise due to working conditions in agriculture:

1. Physical Hazards: the agriculture worker may be exposed to extreme heat, cold, high humidity, solar radiation from direct and prolonged exposure to sun all of which imposes stress to the worker. There may also be excess of vibration, noise or there may be necessity of working in uncomfortable, non physiological posture for long duration.
2. Zoonotic Diseases: The agricultural worker may be in close contact with animals or animal products, which increases the chance of contacting zoonotic diseases like anthrax, tetanus, brucellosis, leptospirosis, bovine tuberculosis (transmission of tuberculosis from animals mainly through milk of cows), and Q fever and other rickettsial diseases. But the extent the agricultural worker is exposed to such zoonotic diseases is different in different parts of the world.
3. Accidents: Accidents are becoming increasingly more frequent in agriculture in many parts of the world due to increase in use of agriculture machinery. Other accidents like snake bite, insect bite and accidental injury from agriculture equipment is also not uncommon.
4. Respiratory Diseases: Agriculture worker is exposed to many type of dusts like grain dust, rice husk, tea, cotton fiber, coconut fiber, tobacco, wood dust and hay fiber, depending on the products they grow and the region they live in. exposure to the above dusts can give rise to diseases like farmer’s lung, byssinosis, bagassosis, occupational asthma, occupational acne etc.
5. Toxic Hazards: there has been increase use of chemicals in agriculture as fertilizers, insecticides or pesticides. And agriculture workers are exposed to such compounds which can enter the body through intact skin like organophosphorus insecticides. So, unless agriculture worker is educated in that and take appropriate measure to protect himself there is a high risk of poisoning. Suicide by consuming organophosphorus compound is very common among agricultural workers due to its easy availability. There are many agricultural regions in the world where pesticide residue is more than acceptable level in drinking water, which is harmful to not only agriculture worker but to the entire population living in that area. If there is associated malnutrition than agriculture worker is at higher risk of developing poisoning at relatively lower level of pesticide in the drinking water.

Pneumoconiosis: What is It?

Pneumoconiosis is a group of diseases of respiratory system caused due to inhalation of respirable particle. The dust particle size, if it is between 0.5 micron to 3 micron, is a health hazard and can produce lung disease called pneumoconiosis, after a variable period of exposure to the dust particles. Pneumoconiosis gradually cripple working capacity of worker by producing lung fibrosis (formation of fibrous tissue in lung with lesser capacity to expand) and other complications. Many factors are responsible for the health hazards of the dust particles like fineness, chemical composition of the dust particle, period of exposure to the dust particle, concentration of dust in the air and health and nutrition status of the worker or exposed person. That’s why there are different threshold values for different dust particles. Superimposed lung infections like tuberculosis and other chronic lung diseases can multiply the toxic effects of dust particles. This is particularly true in the developing countries where lung infections like tuberculosis is common health problem.

Silicosis, anthracosis, byssinosis, bagasosis, asbestosis and farmer’s lung are some common and important examples of pneumoconiosis.

Treatment of Pneumoconiosis is not helpful and not successful. Once developed it can not be cured nor the progression stopped. So it is very much essential to prevent the disease from arising at the place of work, may it be in factories, mines, agricultural field or in any business establishments.

In case of Pneumoconiosis preventive medicine is the main not curative form. “Prevention is better than cure” is more truer in case of Pneumoconiosis than any other disease.

Occupational Health Hazards

Depending on the type of employment the worker may be exposed to physical hazard, chemical hazard, biological hazard, mechanical hazard and psychosocial hazard.

Physical Hazards: physical hazards may be heat & cold, noise, ionizing radiation, ultraviolet radiation, vibration and light.

1. Heat & cold: Heat is a common health hazard in industries. Direct effects of heat are heat stroke (sun stroke), burns, heat exhaustion and heat cramps. Indirect effects of heat are decreased efficiency, increased fatigue and increased chances of accidents. Ovens and furnaces radiate heat and in textile and jute industries causes heat stagnation. High temperature is also seen in deep mines where it may go up to as high as 65 deg. C. work under such condition is extremely difficult, stressful and health & efficiency of worker is diminished.

Important hazards due to cold are chilblain, frost bite and immersion foot or trench foot and erythrocyanosis. Cold injuries are commonly seen in the oilfields near the polar regions. Hypothermia is also an important health hazard in some industries.

2. Noise: noise is a health hazard in many workplaces and its effects can be auditory and non auditory. Auditory effect is temporary or permanent hearing loss. Non auditory effects are fatigue, nervousness, decreased efficiency and annoyance and interference with speech communication. The degree of injury due to noise depend on intensity and frequency range, duration of exposure and susceptibility of the individual.

3. Ionizing radiation: ionizing radiation from X-rays and radioactive isotopes are health hazards cobalt 60 and phosphorus 32 are commonly used now and cause radiation. Some tissues like bone marrow. Radiation can lead to genetic changes, cancers, leukemia, sterility and malformation. The International Commission on Radiological protection has set the maximum permissible level of occupational exposure to 5 rem per year to the whole body.

4. Ultraviolet radiation: ultraviolet radiation in industries like welding can the eyes and can cause conjunctivitis and keratitis known as “welder’s flash”. Symptoms of welder’s flash are redness of eyes and pain, but disappear in a few days without any permanent damage to the eyes.

5. Vibration: 10 to 500 Hz vibration can be seen in industries using pneumatic drills and hammers. Vibration usually affects arms and after months and years of exposures small blood vessels of fingers can become sensitive to vibration and cause spasm known as “white fingers”. Exposure to vibration can injure joints of hands, elbow joints and shoulder joints.

6. Light: worker may be exposed to poor or excess illumination. The acute effects of poor illumination include eye strain, eye pain, headache, tearing, eye fatigue and congestion around cornea. The effects of chronic exposure to poor illumination is “miner’s nystagmus”. Exposure to excess illumination or glare causes discomfort, visual fatigue and annoyance. Sudden intense direct glare can cause blurring of vision and accidents. Don’t forget, weight loss also has relation to your health. Therefore, try to learn weight loss pills review.

Occupational Environment

Occupational Environment means, the external condition and influence of place of work and has a bearing on the health of the worker. The workers are placed today in a highly complicated environment and it is becoming more complicated day by day. There are mainly three types of interaction in a working environment:

• • Man and man.
  • Man and machine.
  • Man and physical, chemical and biological agents.
    1. Man and man: There are many factors like social, psychosocial etc. which play a role in working environment. There is also human relationship among the workers and with superiors. Psychosocial factors are job satisfaction, service condition, leadership, type of work, communication, payment, welfare state, trade union activity, incentives etc. In modern occupational health, importance is given to the condition in which people work, their attitude toward their job, there hopes and fear etc. The occupational environment of a worker can not be separated from his domestic environment. They are complementary to each other. They take worries of work place to home and from home he brings domestic problems. Stress at work can disturb sleep the same way stress at home can disturb work. Occupational health is a dynamic equilibrium between the worker and his occupational environment.
    2. Man and Machines: The following are the causes of industrial accident: unguarded machines, poor installation of machines, protruding and moving parts and lack of safety measures and employee education. Other causes are fatigue due to long working hours, bad postures which cause backache, joint disease etc.
    3. Man and physical, Chemical and Biological agents:
       • Physical factors: Physical factors that effect health of worker are, heat, cold, noise, vibration, ionizing radiation, light, air movement (ventilation), humidity and heat radiation. These factors acts singly or in combination. The washing & bathing facility, toilet facility as well as amount of working space effect health of a worker.
       • Chemical factors: These are harmful chemicals toxic dusts, toxic gases and are harmful to the health of the worker. Some chemicals are irritant to skin, some causes respiratory problems and some maybe highly poisonous.
       • Biological agents: Workers may be exposed to bacterial, viral, rickettsial and parasites. All these are health hazards may arise due to close contact with animals, contaminated water, contaminated soil, contaminated food etc.

Occupational Health

The joint ILO/WHO (international labor organization and world health organization) on occupational health, gave the definition of occupational health as follows “Occupational health should aim at the promotion and maintenance of the highest degree of physical, mental and social well being of workers in all occupations; the prevention among the workers of departures from health caused by their working conditions; the protection of workers in their employment from the risks resulting from factors adverse to health; the placing and maintenance of the workers in an occupational environment adapted to his physiological and psychological equipment and to summarize the adaptation of work to man and of each man to his job”.

The aim of occupational health is essentially preventive; i.e. the prevention of disease and maintenance of highest degree of health (highest degree of physical, mental and social well being) of workers in all occupations. These are attained by-health promotion, specific protection, early diagnosis and treatment, disability limitation and rehabilitation. Tools used for attaining goals are screening , health education, health statistics and epidemiological approach. Therefore, occupational health is application of preventive medicine in all places of employment.

In the older time occupational health used to mean in relation to factories and mines, but nowadays it is applied to all types of employment including agriculture.

Ergonomics (study of human engineering) is the term used for study of man and his working environment. The term ergonomics is derived from Greek words, ergon meaning work and nomos meaning law. Ergonomics in its simplest form means “fitting the job to the worker”. Ergonomics include designing of machines, tools, equipments, layout of the places of work, method of work in order to achieve greatest efficiency of man and machine. The aim of ergonomics is to achieve the best results and also maintain best health of the worker. By applying ergonomics to all areas of employment the number of accidents have reduced and the efficiency of worker and overall health condition has improved.

The modern concept of occupational health now cover all types of employment like commercial enterprises, trade, service sector, information technology sector, forestry and agriculture. It also include subject of industrial hygiene, industrial diseases, industrial and other accidents (road, railway and air accidents), toxicology, industrial rehabilitation and occupational psychology.