1. Care Without Scare…! Occupational Health for Health Care Workers

2. IAOH - 2013 2 OCCUPATIONAL HEALTH PHYSICAL, MENTAL & SOCIAL WELL BEING IN RELATION TO WORK AND WORK ENVIRONMENT.

3. IAOH - 2013 3 What is Occupational Health? Occupation (work) Health Accidents Environment Different Definitions: F Health problems arising from or pertaining to work F Health of people at work F The Health of the gainfully employed F Relationship between Occupation (work) & Health

4. IAOH - 2013 4  Occupational diseases have a long latent period.  Most occupational diseases cannot be treated.  All occupational diseases can be prevented. Occupational Diseases

5. IAOH - 2013 5 “ What the mind does not know, the eyes do not see”

6. IAOH - 2013 6 OCCUPATIONAL HAZARDS  Physical Hazards  Chemical Hazards  Biological Hazards  Mechanical Hazards  Psychosocial Hazards

7. IAOH - 2013 7 OCCUPATIONAL HEALTH DISORDERS

8. IAOH - 2013 8 Primary irritants, Allergy, Systemic toxicity Gas, Vapour, Aerosol, Dust, Fume, Smoke, Mist, Fog Eating, Smoking  INHALATION  INGESTION  SKIN ABSORBTION ROUTE OF EXPOSURE

9. IAOH - 2013 9 FOUR TYPES Diseases only occupational in origin (pneumoconiosis) Where occupation as one of the causal factors (bronchogenic carcinoma) Occupation as A contributary factor (chronic bronchitis) Occupation aggrevating pre-existing condition (asthma)

10. IAOH - 2013 10 OCCUPATIONAL HAZARDS  Physical Hazards  Chemical Hazards  Biological Hazards  Mechanical Hazards  Psychosocial Hazards

11. IAOH - 2013 11 OCCUPATIONAL DISEASES Diseases due to Physical Agents  Heat - Heat stroke, Burns  Cold - Frost bite  Light - Miners Nystagmus, Cataract  Pressure - Caisson disease, Air embolism

12. IAOH - 2013 12 Diseases due to Physical Agents  Noise - NIHL, Hypertension, Irritability  Vibration - Neuromuscular diseases, Peripheral vascular diseases  Radiation - Leukemia, Aplastic anaemia  Mechanical - Injuries, Accidents  Electricity - Electric shock, Burns OCCUPATIONAL DISEASES

13. IAOH - 2013 13 OCCUPATIONAL DISEASES Diseases due to Chemical Agents  Gases - CO, CO 2, HCN, H 2 S,CS 2  Dusts - Pneumoconiosis  Metals - Lead, Mercury, Chromium, Manganese  Chemicals - Acids, Alkalies  Solvents - Benzene, Trichloroethylene

14. IAOH - 2013 14 Chemical Hazards  Metals (lead, mercury, arsenic, cadmium, chromium, zinc, beryllidum, tin, silver, etc)  Carbon compounds (organic solvents)  Benzine, Toluene, Zylene  Phenol, Nitrate, Napthalene, Isocyanates, Carbon tetrachloride, Carbon disulphide, Vinyl chloride monomer, etc  Pesticides & toxic gases (amonia phosgene, carbon monoxide)

15. IAOH - 2013 15 Lung Diseases Caused by Dust  Depends on chemical composition, particulate size, concentration, shape, specific gravity & body’s reaction  Pneumoconiosis  Asbestosis  Silicosis  Coal workers pneumoconiosis  Lung diseases caused by dust of organic origin  Byssinois (exposure to cotton dust)  Mushroom workers lung  Suberrosis (Cork dust)  Bird breeders lung (chickens, parrots, pigeons)  Man made fibres  Occupational asthma  Flour insects and pollens: linseed, soya beans, teak wood, hair, fur, etc: isocyanates, poly urethane, amines, metals

16. IAOH - 2013 16 Diseases due to Biological Agents  Hepatitis B, Rabies, AIDS, Leptospirosis…, Occupational Cancers  Cancer of Skin, Lungs, Bladder Occupational Dermatosis  Dermatitis, Eczema Psychosocial Diseases  Neurosis, Peptic ulcer, Hypertension OCCUPATIONAL DISEASES

17. IAOH - 2013 17 Musculo-skeletal problems  Due to Excessive load on the muscles, ligaments, tendons and bone.  Due to Insufficient circulation to the Musculoskeletal system.  Work that requires activity of a small group of relatively weak muscles (such as continuous use of fingers of the dominant hand in data entry).

18. IAOH - 2013 18 Common sites for Musculo-skeletal problems  Neck  Forearm  Wrist  Fingers  Back  Knee

19. IAOH - 2013 19 COMPUTERS / VDU  RSI / CTD – Tenosynovitis, Tendinitis, Tennis Elbow, Carpal Tunnel Syndrome, Trigger Finger  Musculoskeletal Problems in Neck, Shoulder & Upper Limbs  Visual Fatigue & Eye Problems  Bifocals & Computers  Skin Diseases  Low Back Pain  Effects of Shift Work

20. IAOH - 2013 20 Occupational health & Computer work F Musculo-skeletal problems F Ocular problems F Reproductive problems F Skin problems F Psychosocial problems F Lifestyle problems

21. IAOH - 2013 21 Repetitive Strain Injury F Muscular stress caused by the frequent, repetitive use of the same muscle throughout the day. F Accustomed and unaccustomed repetitive work with hands. F Work that involves repeated wrist flexion or extreme extension, particularly in combination with forceful pinching. F Repeated forces on the base of the palm or wrist.

22. IAOH - 2013 22 Common RSIs F Carpal tunnel syndrome F Cervical radiculopathy F Epicondylitis F Ganglion cyst F Tendonitis

23. IAOH - 2013 23 New Pathologies  AIDS  Stress  Geriatrics  Space Medicine  Genetic Aberrations (longevity!)  Cancer  Robotics-related Injuries  Migrant Global Workers

24. IAOH - 2013 24 Elements of Occupational Health Services Medical treatment Assessment and control of work environment General preventive health measures Preventive medical examinations

25. IAOH - 2013 25 Prevention of Occupational Health Hazards  Administrative Measures  Engineering Measures  Ergonomics  Medical Measures

26. IAOH - 2013 26 Ergonomics The IEA divides ergonomics broadly into three domains:  Physical ergonomics: working postures, materials handling, repetitive movements, work related musculoskeletal disorders, workplace layout, safety and health.  Cognitive ergonomics : mental workload, decision-making, skilled performance, human-computer interaction, human reliability, work stress and training as these may relate to human-system design.  Organizational ergonomics: communication, crew resource management, work design, design of working times, teamwork, community ergonomics, cooperative work, new work programs, virtual organizations, telework, and quality management.

27. IAOH - 2013 27 Goals Of Ergonomics  Improve quality of working environment engineered to the capabilities of the human body  Increase efficiency and productivity by reducing fatigue.  Prevention of Occupational injury & illness.  Work quality improvement.  Proactive Ergonomics Vs  Reactive Ergonomics

28. IAOH - 2013 28 MEDICAL MEASURES  Pre-employment medical check up  Periodic medical examination  Health promotion  Health education  Specific protection  Assessment of risk by supervision of working environment

29. IAOH - 2013 29 Pre-employment Medical Examination  To determine the physical and emotional capacity of the individual to perform the job.  To provide base line health data for epidemiological and legal purposes.  To counsel the person for correction of diseases / habits which may harm later.  Assessment of pre-existing toxicity / impairment due to past exposure, if any.

30. IAOH - 2013 30 Pre-placement Medical Examination

31. IAOH - 2013 31 Periodic Medical Examination  Evaluation of general health status.  Earliest detection and prevention of work related disorders.  Early detection, control and prevention of any health disorder which may affect the ability to perform the job.  To detect deviation in health status from base line data.  Detection of infectious / communicable diseases which may affect others.

32. IAOH - 2013 32 OSH IN HEALTHCARE

33. IAOH - 2013 33 Who is a Health Care Worker? Doctor Dentist Nurse Lab technician Radiology technician Physiotherapist Aaya, Wardboy Pharmacist Laundry worker Maintenance staff ………..

34. IAOH - 2013 34 Occupational Risks in Various Areas Clinical Surgical Laboratory Radiology Physiotherapy CSSD Maintenance Housekeeping Laundry Food Handlers Others

35. IAOH - 2013 35 Common Concerns Shift Work Emotional Stress Ergonomic Slips, trips, falls Violence ?

36. IAOH - 2013 36 Preventive Measures Universal Precautions Training & Education Medical Surveillance Immunization Identify, Monitor & Control exposures Stress Management Violence Prevention Program

37. IAOH - 2013 37 Hippocrates Refusing Gift from Alexander

38. IAOH - 2013 38 Thank You Prepared by Dr. Shyam R. Pingle