Care Without Scare!

Occupational Health for Health Care Workers

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OCCUPATIONAL HEALTHPHYSICAL, MENTAL & SOCIAL WELL BEING IN RELATION TO WORK AND WORK ENVIRONMENT.

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What is Occupational Health?Occupation (work)HealthAccidentsEnvironmentDifferent Definitions:Health problems arising from or pertaining to workHealth of people at workThe Health of the gainfully employedRelationship between Occupation (work) & Health

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Occupational diseases have a long latent period.Most occupational diseases cannot be treated.All occupational diseases can be prevented.Occupational Diseases

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What the mind does not know, the eyes do not see

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OCCUPATIONAL HAZARDSPhysical HazardsChemical HazardsBiological HazardsMechanical HazardsPsychosocial Hazards

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OCCUPATIONAL HEALTH DISORDERS

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Primary irritants, Allergy, Systemic toxicityGas, Vapour, Aerosol, Dust, Fume, Smoke, Mist, FogEating, SmokingINHALATIONINGESTIONSKIN ABSORBTIONROUTE OF EXPOSURE

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FOUR TYPESDiseases 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)

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OCCUPATIONAL HAZARDSPhysical HazardsChemical HazardsBiological HazardsMechanical HazardsPsychosocial Hazards

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OCCUPATIONAL DISEASESDiseases due to Physical AgentsHeat - Heat stroke, BurnsCold - Frost biteLight - Miners Nystagmus, CataractPressure - Caisson disease, Air embolism

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Diseases due to Physical AgentsNoise - NIHL, Hypertension, IrritabilityVibration - Neuromuscular diseases, Peripheral vascular diseasesRadiation - Leukemia, Aplastic anaemiaMechanical - Injuries, AccidentsElectricity - Electric shock, Burns OCCUPATIONAL DISEASES

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OCCUPATIONAL DISEASESDiseases due to Chemical AgentsGases - CO, CO2, HCN, H2S,CS2Dusts - PneumoconiosisMetals - Lead, Mercury, Chromium, ManganeseChemicals - Acids, AlkaliesSolvents - Benzene, Trichloroethylene

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Chemical HazardsMetals (lead, mercury, arsenic, cadmium, chromium, zinc, beryllidum, tin, silver, etc)Carbon compounds (organic solvents)Benzine, Toluene, ZylenePhenol, Nitrate, Napthalene, Isocyanates, Carbon tetrachloride, Carbon disulphide, Vinyl chloride monomer, etcPesticides & toxic gases (amonia phosgene, carbon monoxide)

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Lung Diseases Caused by DustDepends on chemical composition, particulate size, concentration, shape, specific gravity & bodys reactionPneumoconiosisAsbestosisSilicosisCoal workers pneumoconiosisLung diseases caused by dust of organic originByssinois (exposure to cotton dust)Mushroom workers lungSuberrosis (Cork dust)Bird breeders lung (chickens, parrots, pigeons)Man made fibresOccupational asthma Flour insects and pollens: linseed, soya beans, teak wood, hair, fur, etc: isocyanates, poly urethane, amines, metals

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Diseases due to Biological Agents Hepatitis B, Rabies, AIDS, Leptospirosis, Occupational CancersCancer of Skin, Lungs, BladderOccupational DermatosisDermatitis, EczemaPsychosocial DiseasesNeurosis, Peptic ulcer, Hypertension OCCUPATIONAL DISEASES

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Musculo-skeletal problemsDue 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).

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Common sites for Musculo-skeletal problemsNeckForearmWristFingersBackKnee

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COMPUTERS / VDU

RSI / CTD Tenosynovitis, Tendinitis, Tennis Elbow, Carpal Tunnel Syndrome, Trigger FingerMusculoskeletal Problems in Neck, Shoulder & Upper LimbsVisual Fatigue & Eye ProblemsBifocals & ComputersSkin DiseasesLow Back PainEffects of Shift Work

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Occupational health & Computer workMusculo-skeletal problemsOcular problemsReproductive problemsSkin problemsPsychosocial problemsLifestyle problems

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

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Common RSIsCarpal tunnel syndromeCervical radiculopathyEpicondylitisGanglion cystTendonitis

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New PathologiesAIDSStress GeriatricsSpace MedicineGenetic Aberrations (longevity!)CancerRobotics-related InjuriesMigrant Global Workers

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Elements of Occupational Health ServicesMedical treatmentAssessment and control of work environmentGeneral preventive health measuresPreventive medical examinations

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Prevention of Occupational Health HazardsAdministrative MeasuresEngineering MeasuresErgonomicsMedical Measures

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ErgonomicsThe 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.

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Goals Of ErgonomicsImprove quality of working environment engineered to the capabilities of the human bodyIncrease efficiency and productivity by reducing fatigue. Prevention of Occupational injury & illness.Work quality improvement.

Proactive Ergonomics Vs Reactive Ergonomics

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

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Pre-employment Medical ExaminationTo 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.

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Pre-placement Medical Examination

HAZARD

UNDESIRABLE CONDITIONS

Lead

Anaemia, Hypertension, Peptic ulcer

Dyes

Asthma, Skin & Kidney disease

Solvents

Liver & Kidney disease, Alcoholism

Silica

Tuberculosis, Chronic lung disease

X rays / Radium

Blood diseases

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Periodic Medical ExaminationEvaluation 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.

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OSH IN HEALTHCARE

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Who is a Health Care Worker?Doctor DentistNurseLab technicianRadiology technicianPhysiotherapistAaya, WardboyPharmacistLaundry workerMaintenance staff ..

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Occupational Risks in Various Areas

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Common Concerns Shift Work Emotional Stress Ergonomic Slips, trips, falls Violence ?

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Preventive Measures

Universal Precautions Training & Education Medical Surveillance Immunization Identify, Monitor & Control exposures Stress Management Violence Prevention Program

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Hippocrates Refusing Gift from Alexander

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Thank YouPrepared by Dr. Shyam R. Pingle

*******Ergonomics is the scientific study of people at work. The goal of ergonomics is to create jobs, tools, equipment and workplaces that fit people, rather than making people adapt to fit them. An important part of ergonomics is making sure that the demands of the job do not go beyond what a worker can do safely. Lets take a look at an example of what can happen on a job where the demands created a problem and ergonomics was used to solve it.*Ergonomics is the scientific study of people at work. The goal of ergonomics is to create jobs, tools, equipment and workplaces that fit people, rather than making people adapt to fit them. An important part of ergonomics is making sure that the demands of the job do not go beyond what a worker can do safely. Lets take a look at an example of what can happen on a job where the demands created a problem and ergonomics was used to solve it.*