Occupational Health: Importance and Strategies

Occupational health aims to promote and maintain the highest level of occupational physical, mental, and social well-being of workers. The occupational environment compromises external conditions that prevail and affect the health of the worker. There are three types of interaction in the occupational environment.

1. Man with physical, chemical, and biological agents.
2. Man with a machine. 
3. Man with man.   

Classification Of Occupational Hazards

Let us begin by discussing each of these in detail, as occupational health is an important topic for NEET-PG, INI-CET, and FMGEexamination.

1. Heat hazards

It is mainly seen among soldiers, security guards, and field workers.

2. Cold injuries

• Treatment – Rewarm the body parts at 40 - 42℃ for 15-20 mins.

3. Pneumoconiosis

• It occurs due to inhalation of dust particles.
• The most dangerous size is 0.5-3 microns, as it goes to the lower respiratory tract, causing maximum damage.
• Causes- Restrictive lung diseases
• Pathogenesis of pneumoconiosis:
  • Prolonged dust exposure causes a local inflammatory reaction in the lung parenchyma.
  • This leads to fibrosis, which causes restrictive lung diseases.

Particle Size And Behavior

The behavior of the particle is decided by the particle size. The biggest particles are usually >10 microns, and they will be settled by themselves. The very small particle will show Brownian movement. It is the middle-sized particles that are notorious and will actually cause different issues. 

Types of Pneumoconiosis

Also Read: Water: Sources, Diseases and Quality

Factors Influencing Pneumoconiosis

There are many factors that influence pneumoconiosis. They are:

• Composition of dust
• Concentration of dust
• Size of the dust particle
• Duration of exposure 
• Individual susceptibility

X-ray Changes In Pneumoconiosis

It is very important to understand the x-ray changes as they help us to diagnose the type of pneumoconiosis:

• Ground glass — seen in Asbestosis 
• Black lung – Anthracosis
• Mottling — Bagassosis
• Fine nodular opacity – Farmer’s lung
• Snowstorm — Silicosis

1. SILICOSIS 

• Discovered in India in Kolar mines.
• Inhalation of silica dust
• Components of silica dust–free silica or silicon dioxide 

Clinical Symptoms

• First stage – Mild dyspnea on exertion, unproductive cough.
• Second stage – Marked dyspnea impaired patient's ability to work
• Third stage– Patient incapacitated with signs of right heart failure
• Silicosis is a notifiable disease under the Factories Act.
• Those who are occupationally exposed to silica dust have a chance of developing the disease of silico-tuberculosis.

• Sputum will not show AFB bacilli
• Postmortem will not show the presence of bacilli
• Treatment – No treatment

2. ASBESTOSIS

• Asbestos fibers are of two types:
  • Serpentine or chrysolite variety, which is hydrated magnesium silicate. It is the most commonly implicated form – 95%: curly fibers
  • Amphibole variety — dangerous form - needle-like – less magnesium silicate 

Also Read: Asha: Accessibility, Functions, Obligations, Compensation, Benefits And Facilitators of Asha

Difference Between Silicosis and Asbestosis

These two topics have always confused young doctors. This table will help you learn some facts that would be really important for last-minute revision for NEET PG/ FMGE and INI-CET.

3. Bagassosis

• Caused by Inhalation of sugar cane fibers, Cardboard industry, and paper industry
• Infested by a fungus known as Thermoactinomyces sacchari.
• Reported in India by Ganguly and Pal
• X-ray findings: Mottling of lung fields
• Bagasse control: Keep the moisture content more than 20% and also spray the bagasse with 2% propionic acid.

4. Byssinosis

• Caused: Inhalation of cotton fibers 
• It is mostly seen in the jute and textile industry
• It predominantly affects the lower part of the lungs.

5. Farmer’s Lung

• Cause: inhalation of moldy hay /grain dust
• Infested by fungus – Thermophilic actinomycetes / Micropolyspora faeni
• Occurs when the moisture content has been kept more than 30%

6. Caplan’s syndrome 

• Combination of rheumatoid arthritis and pneumoconiosis with intrapulmonary nodules
• Miners working in mines, asbestosis, silicosis.
• Also associated with genetic predisposition and smoking

4. Lead Poisoning

• The most common route of infection in adults is Inhalation
• The most common route in children is ingestion.
• Other names: Plumbism, Saturnism, Painter’s colic
• Sources : 

• The Burtonian line indicates chronic lead poisoning.
  • Deposition of lead sulfite on the gums

Also Read: Prevention Strategies: Levels of Prevention

Screening And Diagnose The Lead Poisoning

Treatment of Lead Poisoning

Treatment is done using Chelating agents like:

• EDTA
• D- Penicillamine
• Dimercaprol

5. Metal Fume Fever

• It is a Temporary occupational disease 
• Due to the Inhalation of fresh metallic oxide fumes of zinc and magnesium
• Clinical Features may include:
  • Fever
  • Sweating
  • Chills
  • Dryness of throat
  • Cough
  • Breathlessness
• Does not cause permanent changes, and recovery takes place within 24 hours
• People at risk: Metal welders, galvanizing, heavy metal molting factories

6. Occupation- Related Cancers

• The most common cancer related to occupation is Skin cancer (Squamous cell carcinoma)
• Bladder cancer – 
  • Exposure to dyes – ?- naphthylamine, Auramine and magenta dyes, and Benzidine
  • Benzidine leads to leukemia.
  • The most common presentation is hematuria.

Also Read: Entomology: Mosquitoes, Flies, Louse, Flea

Prevention of Occupational Diseases

Since these occupations cause a great deal of diseases, including cancers, they must be prevented at all costs. 

Sickness Absenteeism

• It is a way to measure the overall health state of workers
• Sickness Absenteeism Rate

              SAR= Total number of workers remaining absent in a year/ total worker x 100 

• High SAR indicates low occupational health.
• Rate of sickness absenteeism in India = 8-10 days/person/year
• Causes
  • Medical
  • Social
  • Economic

Pre-Placement vs. Post-Placement Examination

There are some pre-placement and post-placement examinations that must be done before and after hiring an employee. This is done to ensure a perfect work environment and to prolong the employment.

We hope that this blog will give you a better understanding of all the health disorders, including cancers, that might happen if the job environment is not regulated.

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