MODULE 1

SYLLABUS
• Introduction to Occupational Health And Toxicology: Safety at work – Socio – Economic
reasons.
• Introduction to health and safety at various industries.
• occupational related diseases Musculoskeletal disorders, hearing impairment,
carcinogens, silicosis, asbestosis, pneumoconiosis
• Toxic materials and substances used in work, exposure limits, toxicological
investigation
• Industrial Hygiene
• Arrangements by organisations to protect the workers.

Occupational health
The joint international labor organization committee on occupational health, 1950 defined
occupational health as “the highest degree of physical, mental and social well-being of
workers in all occupations.”
• Occupational health and safety is the discipline concerned with preserving and
protecting human resources in the workplace.
• Occupational health deals with all aspects of health and safety in the workplace and
has a strong focus on primary prevention of hazards.
OBJECTIVES OF OCCUPATIONAL HEALTH
• To prevent occupational diseases and injuries.
• To adapt the work place and work environment to the needs of the workers i.e
application of ergonomics principle.
• To be preventive rather than curative.
• To reduce industrial accidents and reduce sick absenteeism.
• To achieve maximum human efficiency and machine efficiency.
components.
• Promotion and maintenance of the highest degree of physical, mental and social well
being of workers in all occupations;
• Prevention among workers of departures from health caused by their working
conditions;
• Protection of workers in their employment from risks resulting from factors adverse
to health; and
• Placing and maintenance of a worker in an occupational environment adapted to his
physiological and psychological equipment
OCCUPATIONAL TOXICOLOGY
 • Toxicology is the study of how natural or man-made poisons cause undesirable effects
in living organisms
• concerned with health effects from exposure to chemicals in the workplace.
• application of the principles and methodology of toxicology toward chemical and
biologic hazards encountered at work.
• toxicity” describes the degree to which a substance is poisonous or can cause injury
• to establish acceptable exposure levels
TOXICOLOGY HAS A NUMBER OF USES IN OCCUPATIONAL HEALTH
• determining whether a substance is toxic, through laboratory investigation.
• predicting hazard (risk) of a substance which has not been studied
• basis of biological monitoring.
• interpret the meaning of biological sampling results and to determine the correct
timing of sampling.
• understanding clinical effects.
• basis for worker education.
• asked about how the chemical gets into and out of the body, how long it affects them
Safety at work
• Workplace safety refers to the limitation of elements that can cause harm, accidents,
and other negative outcomes in the workplace.
• represents a culmination of policies, behaviors, and precautions that work to limit
hazards, accidents, and other kinds of harm in a work environment.
Benefits of a safe and healthy work environment
• produce more output in less time, reducing operational costs.
• promotes the wellness of employees and employers alike.
• very few accidents in a safe working environment.
• less downtime for safety investigations and reduces costs for worker’s compensation.
• Damage to industrial equipment creates costs for replacement and repair.
• absenteeism rates drop, and employees are more focused on doing their tasks
• Prevent workplace injuries and illnesses
• Improve compliance with laws and regulations
• Reduce costs, including significant reductions in workers' compensation premiums
• Engage workers
• Enhance their social responsibility goals
• Increase productivity and enhance overall business operations

Social and economic factors

Occupational diseases
 • An occupational disease is a health condition or disorder (e.g., cancer, musculoskeletal
disorders, post-traumatic stress, etc.) that is caused by work environment or activities
related to work.
• Exposure to chemical, physical or biological hazards
• Occupational diseases are acute or chronic (gradual or delayed) reactions and are very
diverse.
• To avoid occupational diseases the exposure should be prohibited, regulated,
restricted, limited or controlled by industrial hygiene practices & IH -programs.
Agents
• Biological agents- bacteria, viruses, fungi, parasites, insects, plants, birds, animals,
humans, etc.
• Chemical agents- beryllium, lead, benzene, isocyanates, etc.
• Ergonomic issues- repetitive movements, improper set up of workstation, poor
lighting, poor design of tools, etc.
• Physical agents - ionizing and non-ionizing radiation, magnetic fields, pressure
extremes (high pressure or vacuum), extreme temperatures, noise, vibration, etc.
• Psychosocial issues- stress, violence, bullying, harassment, lack of recognition, etc.
Occupational health hazards
• Immediate or acute reactions, like shortness of breath or nausea, can be caused by a
one-time event, (e.g., A chemical spill) (usually no permanent reactions).
• Gradual reactions, like asthma or dermatitis (skin rashes), can get worse and persist
when there is exposure over longer periods (reactions tend to last for a longer time).
• Delayed reactions or diseases that take a long time to develop, like lung cancer or loss
of hearing, can be caused by long-term exposure. These reactions can be noticed long
after the job is over.
Types of occupational disease
• Musculoskeletal disorders
• Hearing impairment
• Carcinogens
• Silicosis
• Asbestosis
• Pneumoniocosis

Musculoskeletal disorders

• Work-related musculoskeletal disorders (WMSDs) are a group of painful disorders of

muscles, tendons, nerves, joints, cartilage and spinal discs.
• Musculoskeletal disorder (MSD) is an injury or disorder of the muscles, nerves,
tendons, joints, cartilage, and spinal discs.
 • It is not an acute injury, rather a chronic disease which develops over time.
• MDS is related to manual tasks
• It has been recognized as a source of significant pain, disability and disadvantage for
the injured person and a substantial burden on modern societies.
• more than 30% of all occupational injuries are musculoskeletal injuries associated with
manual tasks
• Musculoskeletal disorders are associated with high costs to employers such as
absenteeism, lost productivity, and increased health care, disability, and worker’s
compensation costs.
• Repetition/duration/rest – short cycle time (<30 sec)
• Static work
• Joint deviations – awkward postures
• Velocity and acceleration- speed of movement
• Internal forces on joints
• Vibration
• Coldness
• Non occupational factors – fitness level, mental stress, smoker, hobby
Arthritis
• more than 100 rheumatic diseases and conditions that affect joints, the tissues which
surround the joint and other connective tissue.
• occupations are associated with increased prevalence of arthritis, specifically
osteoarthritis, most often of the knee and/or hip are mining, construction,
agriculture, and sectors of the service industry.
• Common features of these occupations are physically demanding/heavy labor tasks,
lifting or carrying heavy loads, exposure to vibration, high risk of joint or tissue
injury, and prolonged periods of working in awkward or unnatural postures such as
kneeling and crawling.
Carpal tunnel syndrome
• Also called median nerve compression
• Carpal tunnel syndrome is a common condition that causes numbness, tingling, and
pain in the hand and forearm.
• Carpal tunnel syndrome is a condition in which the median nerve, which runs from the
forearm into the palm of the hand, becomes compressed at the wrist.
• To prevent permanent damage, surgery to take pressure off the median nerve
• If left untreated, carpal tunnel syndrome can leadto weakness and lack of
coordination in fingers and thumb

caused by swollen and inflamed tissue that puts pressure on the median nerve, which
provides sensation to all fingers of the hand except the little finger.
 Symptoms usually start gradually with a vague ache in the wrist that runs into the hand
or up the forearm. Eventually, there can be:
Tingling or numbness in the hand or fingers, especially the thumb, index, middle or
ring fingers, but not the little finger.
This sensation often occurs while sleeping or after using the hand.
Pain radiating or extending from the wrist up the arm to the shoulder or down into
the palm or fingers, especially after forceful or repetitive use.
A sense of weakness in the hands; dropping objects.
A loss of feeling in some fingers.
Tendonitis
• A tendon is a fibrous connective tissue that attaches muscle to bone.
• Tendinitis is inflammation or irritation of a tendon — the thick fibrous cords that
attach muscle to bone.
• The condition causes pain and tenderness just outside a joint.
• most common around shoulders, elbows, wrists, knees and heels.
• symptom is pain at the site of the injured tendon, especially during use.
• The pain may be chronic or it may come on suddenly and feel sharp.
• Other symptoms include swelling, warmth, tenderness, and redness.
Thoracic outlet syndrome (TOS
• TOS is a group of disorders that occur when blood vessels or nerves in the space
between collarbone and first rib (thoracic outlet) are compressed.
• This can cause shoulder and neck pain and numbness in fingers
• Collar bone- either of the pair of bones joining the breastbone to the shoulder blades
1. Physical therapy is typically the first treatment.
2. Botulinum toxin injections are sometimes effective when physical therapy doesn't
completely relieve symptoms.
3. surgery may be recommended.
Hernias
• Hernias can be directly caused by work activities.
• This can relate to either a specific or cumulative trauma.
• Hernias can be caused by a specific lifting incident that causes a tear of the muscle
of the abdominal wall.
• A hernia is an injury that occurs when an organ or fatty tissue is pushed through a
weak spot or a tear in surrounding muscle tissue.
• Hernias can also be caused by repetitive lifting over time
1. Avoid heavy lifting when you can. Lifting puts stress on the groin.
2. When you must lift, don't bend over. Lift objects by using the legs, not the back.
3. Eat high-fiber foods and drink plenty of water.
4. Maintain a healthy body weight.
Hearing impairment
• Hearing impairment occur when workers are exposed to loud noise or ototoxic
chemicals.
• Noise is considered loud (hazardous) when it reaches 85 decibels or higher, or if a
person has to raise his/her voice to speak with someone 3 feet away (arm's length).
• Industrial workers.
• Construction workers.
• Farmers.
• Maintenance crews.
• Entertainment workers
• Ambulance drivers.
• Airline workers.
• Music and sports industry employees.
Carcinogens
• caused by substances, or mixtures of substances, called 'carcinogens’.
• caused through prolonged exposure to carcinogens in the workplace.
Such exposures include:
• a wide range of different industrial chemicals, dusts, metals and combustion products
(e.g. asbestos or diesel engine exhaust)
• forms of radiation (e.g. ultraviolet or ionising radiation)
• entire professions and industries (e.g. working as a painter, or in aluminium
production)
• Asbestos, second hand smoke, and benzene are the carcinogens that people are most
commonly exposed to at work.
• Lung cancer-most common and common cause of death cancer in the world for
several decades.
• Malignant mesothelioma is a very rare, but invariably fatal form of cancer that arises
from the mesothelium, the protective lining that covers many internal organs.
• More than 80 % of the cases are related to asbestos exposure
• Sino-nasal cancer due to chemical exposure
• Leukemia is a cancer that starts in the blood-forming tissue such as bone marrow
causes large numbers of abnormal blood cells to be produced.
• The cancer cells interfere with the body’s production of healthy cells, making the body
unable to fight off infections.
• either chronic (slowly progressing) or acute (rapidly progressing).
• Acute myelogenous leukemia has been associated with occupational exposures such
as benzene and ionizing radiation.
• weakness and fatigue
• weight loss, anxiety
 • loss of appetite
• unexplained muscle or body pain
• shortness of breath or persistent cough
• difficulty in swallowing
• altered bowel habits
• appearance of lumps on the body
• night sweats, reddish or scaly patchy skin and abnormal bleeding
• well-known carcinogens are asbestos, nickel, cadmium, radon, vinyl chloride,
benzidene, and benzene.
• carcinogens may act alone or with another carcinogen to increase risk.
• Early warning signs of cancer are often similar to other common illnesses, making
them easy to overlook.
• No symptom should be ignored, especially if it has persisted or gotten worse over
time.
PNEUMOCONIOSIS
Pneumoconiosis is a generic name covering the group of lung disorders which result from
the inhalation of “inorganic dust”
Classification
1.Major pneumoconiosis 2.Minor pneumoconiosis 3. Benign pneumoconiosis
1.Major pneumoconiosis
• Inhalation of some dusts results in “major fibrosis” of the lungs, which results in
interference of lung architecture or lung function tests.
• As: Silica  silicosis , Asbestos  asbestosis , Talc  talcosis
Coal  coal workers pneumoconiosis (anthracosis)

2.Minor pneumoconiosis
• Inhalation of some dusts results in “minor fibrosis” of the lungs
• There is minimal fibrosis of the lungs without interference of lung architecture or lung
function tests.
• These dusts include:
o Clay
o Koalin
o MicaFeldspar (non-fibrous silicates)
Major pneumoconiosis and Minor pneumoconiosis are called Fibrotic Pneumoconiosis
3.Benign pneumoconiosis
• There isn't any reaction in the lungs, but dust deposition casts a shadow in x-ray of the
lung.
• There is no fibrosis and no disturbance of lung functions
Examples of Benign pneumoconiosis:
  It can result from the inhalation of:
o Iron dust sidrosis
o Tin dust stannosis
o Calcium dust chalicosis
• They are characterized by the presence of small rounded dense opacities on a chest
film due to perivascular collections of dusts.
• Hilar lymph nodes may be prominent.
• The deposits in the lung disappear when exposure is discontinued.
SILICOSIS
• Silicosis occur when workers are consistently exposed to silica particles of respirable
size (0.2–5.0 μm in diameter) at levels exceeding those recognized to be safe.
• OSHA permissible exposure limit (PEL) is 100 μg/m3 for an 8-hour work exposure.
• caused by the inhalation of respirable size silica particles, and can be categorized by
recognizable findings on the chest radiograph.
• Most forms of silicosis develop slowly, 10 to 30 years are required from the beginning
of exposure to the onset of clinical manifestations
• The risk of lung cancer is highest in workers with silicosis who also smoke.
• The dust particles settle in the lungs and cause small nodules of fibrosis that
progressively become more numerous, enlarge and coalesce causing fibrosis and
progressive loss of lung function and disability.
PREVENTION
• Product substitution of silica with less toxic particles in abrasive blasting.
• Control of air-borne dust concentration through engineering interventions.
• Appropriate use of respiratory protective devices.
• Medical screening of silica-exposed workers is generally recommended, using chest
x-rays, spirometry & PPDlung transplantation for workers with extensive silicosis.
MANAGEMENT
• Once a diagnosis of silicosis is made the worker should be removed from further silica
exposure.
• Corticosteroid therapy : in patients with acute and chronic forms especially when
silicosis is associated with auto immune disease.
• Isoniazid prophylaxis is appropriate when corticosteroid therapy is prescribed.
• Tetrandrine, a plant alkaloid with antioxidant and anti inflammatory properties ,has
been shown to arrest the progression of silicosis
ASBESTOSIS
• Asbestosis is defined as a type of pneumoconiosis caused by the inhalation of asbestos
fibers. It is a hydrated magnesium silicate which is resistant to heat and many
chemicals.
 • Occurs in mining and extraction, making of asbestos cloth, in the manufacture of
asbestos cement pipes and other products, vinyl floor tiles and in brake and cloth
lining.
• Progressive cough, shortness of breath, weakness, fatigue develop over time.
• Exposure to asbestos can cause lung cancer, pleural cancer, and pulmonary
fibrosis.The early symptoms include progressive dyspnoea on exertion, cough,
,expectoration, chest pain, cyanosis and clubbing of the fingers.
• Early detection depends on symptoms and signs and the X-ray picture
Prevention
• Guidelines on the handling of Asbestos Materials published by MOM(Ministry of
manpower) should be followed
• Work area should be segregated and sealed to prevent the escape of asbestos dust to
other spaces
• Workers should use PPEs
• Signs boards should be kept near work area
• air conditioning systems must be shut down as they can circulate asbestos dust to
other parts of buildings
• worker education is an essential part of administrative control to reduce asbestos
exposure.
• regular dust monitoring is required when asbestos work is in progress
• efficient local exhaust systems should be installed whenever mechanical cutting,
sawing or machining of soft asbestos insulating boards or hard asbestos cement
building boards takes place
• all exhaust air from the asbestos work area must pass through a high efficiency
particulate air (HEPA) filter before release into the environment
• Spray method, soaking method and dry methods can be used for asbestos removal
• dampening of asbestos waste to reduce dustiness before disposal is highly
recommended
Toxic materials and substances used in work
• The degree of hazard depends on the concentration of the chemical.

Common hazardous substances in the workplace include:

• acids
• caustic substances
• disinfectants
• glues
• heavy metals, including mercury, lead, cadmium and aluminium
• paint
• pesticides
 • petroleum products
• solvents.
• Hazardous substances are substances that can have a harmful effect on health
• Examples:
• Chemicals - organic solvents, acids, pharmaceutical ingredients…
• Dust - metal dust, wood dust, flour…
• Fumes - welding, soldering…
• Fibers - asbestos
Health effects
• Health effects depend on the type of hazardous substance and the level of exposure
(concentration and duration).
• A hazardous substance can be inhaled, splashed onto the skin or eyes, or swallowed.
Some of the possible health effects can include:
• poisoning
• nausea and vomiting
• headache
• skin rashes, such as dermatitis
• chemical burns
• birth defects
• disorders of the lung, kidney or liver
• nervous system disorders.
MEASUREMENT OF TOXICITY

 PARTS PER MILLION - ppm

 PARTS PER BILLION - ppb
 PARTS PER TRILLION - ppt
 LETHAL DOSE - LD50
 LETHAL CONCENTRATION - LC50
 THRESHOLD LIMIT VALUE - TLV
 IMMEDIATELY DANGEROUS TO
LIFE AND HEALTH - IDLH
The TLV is the upper limit of a toxin concentration to which an average healthy person may
be repeatedly exposed on an all-day, everyday basis without suffering adverse health effects.
TLV is Typically used for workplace exposure determinations.
• Gaseous substances in air, are usually express in:
parts per million (ppm).
• Fumes or mists in air, are expressed in:
milligrams per cubic meter (mg/m3).
The OEL is the concentration in the air to which nearly all workers may be repeatedly exposed
day after day without adverse health effects to themselves or their children.
 1. 8 hour reference period –ACGIH descriptor TLV-TWA – the 8 hour TWA
exposure to which it is believed that nearly all workers may be
repeatedly exposed, day after day, for a working lifetime, without
adverse effect
2. 15 minute reference period – called short term exposure limit (stel)-
the 15 minute twa exposure that should not be exceeded at any time
during a work day, even if the 8 hour twa is within the tlv-twa.
Exposures (re. 15 mins) above the TLV-TWA but below the TLV-STEL
should not occur more than 4 times a day, with 60 minutes at least
between successive exposures
3. Ceiling (tlv-c) – the concentration that should not be exceeded during
any part of the working exposure

Industrial hygiene
• Definition Industrial Hygiene: (fundamentals of IH, 4th edition)
“Industrial Hygiene is that science and art devoted to the anticipation, recognition,
evaluation and control of those environmental factors or stresses arising in or from
the workplace that may cause sickness, impaired health and well-being, or significant
discomfort among workers or among citizens of the community”
Toxicological investigation
• Toxicology is the study of how natural or man-made poisons cause undesirable effects
in living organisms
• Toxicological Investigation is the analysis of biological samples for the presence of
toxins, including drugs.
• The toxicology report can provide key information as to the type of substances
present in an individual and if the amount of those substances is consistent with a
therapeutic dosage or is above a harmful level.
Arrangements by organisations to protect the workers
• Provide flexible work arrangements for workers to avoid exposure to risks in industries
especially chemical industries.
• Flexible working arrangements allow employees to negotiate a less rigid working
arrangement to improve work-life balance and their overall contribution to their
company.
• Ensuring working conditions are met for workers
• Provide periodical medical checks for the workers who work in risk environment.
• Provide personal protective equipments to all workers.
• Check the exposure limit of various chemical parameters especially in chemical
industries.
• Warnings/alarms to be given within industry incase of emergencies
• Proper communication facilities to be given especially for workers who work in
construction ,mining and petroleum industries
• Check whether the PPE’s provided to workers are safe to use without any wear or tear.
• Workers have to wear hard hats especially in construction industry.
• Risky areas within the industry should be cordorned / barricaded
• Eliminate the potential hazards within the industry
• Provide visual safety aids and measurements.