OCCUPATIONAL HEALTH & OH PROGRAMME IN INDIA

WELCOME TO OCCUPATIONAL HEALTH IN INDIA

DR.MAHESWARI JAIKUMAR

ROLE OF A OCCUPATIONAL HEALTH NURSE.

OCCUPATIONAL HEALTH.

DEFINITION

“OCCUPATIONAL HEALTH is the promotion & maintenance of the highest degree of physical, mental & social wellbeing of the workers in all occupations”.

CONCEPT OF OCCUPATIONAL HEALTH.

INCLUDES:

INDUSTRIAL HYGIENE.

INDUSTRIAL DISEASE.

INDUSTRIAL ACCIDENTS.

INDUSTRIAL HAZARDS.

INDUSTRIAL REHABILITATION.

OCCUPATIONAL PSYCHOLOGY.

OBJECTIVES OF OCCUPATIONAL HEALTH

Prevention among workers of departure from health caused by their working conditions.

Protection of workers from risk resulting from factors adverse to health.

Placing & maintenance of workers in an occupational environment adapted to his/her physiological & psychological equipment.

Adaptation of worker to man & each man to his job.

ILO RECOMMENDATION.

Focus on providing the following to promote health of the employees as follows.

Nutrition.

Prevention & control of communicable disease.

Environmental sanitation.

--------Water supply.

--------Food.

---------Toilet facilities.

General Plant cleanliness.

Floor Space.

Wastage & Garbage disposal.

Lighting & Ventilation.

Protection against hazards.

Housing.

Maternity benefit.

First Aid.

Crèches.

Family Planning.

Mental Health.

Health Education.

DIRECTIVE PRINCIPLES OF STATE POLICY.

INDIAN CONSTITUTION.

States; “The state shall in particular direct it’s policy towards security that the health & strength of the workers, man, woman, & the tender age of children are not abused & that citizens are not forced by economic necessity to enter avocations unsuited to their strengths”.

The state shall make provisions for securing just & humane conditions of work

DEVELOPMENT OF OCCUPATIONAL HEALTH IN INDIA.

1930– All India Inst of Hygiene & Public Health.

1945 – Adarkar’s report on Health Insurance foe Industrial workers.

1945- Directorate of General Factory Inspection & Advisory Service established.

1946 – Bhore Committee report.

1946 – Thomas Badford – Report on Health of Industrial workers.

1947 – Report on the health of workers PLANTATION.

1881 – The first Indian Factories Act.

1947 – Coal Mines Labour Welfare Act.

1948 – ESI Act.

1948 – Indian Factories Act.

1960 – Central Labour Institute – Mumbai.( 3 Regional Institutes _ Chennai.).

Research Institutions--- Central Mining & Research Station. – Dhanbad.

The Industrial Toxicology & Research Centre.- Lucknow.

Occupational Health research Institute. – Ahemedhabad.

National Environment Engineering Research Institute – Nagpur.

All India Institute of Hygiene & Public Health. – Calcutta.

Indian Institute of Technology – Kanpur.

Museums of Industrial Health, training sections.

COUNCILS: Council of Scientific & Industrial Research.

Indian Council of Medical research.

1984 – The ESI Amendment Bill.

1984 – The Workman’s Compensation Amendment Act.

1987 – Factories Amendment Act.( Operated to protect employees exposed to hazardous process.)

1989 – ESI Amendment Act. (Employee, dependents, Family, definitions).

OCCUPATIONAL HAZARDS

Physical Chemical

Biological

Mechanical

Psychosocial

Heat.

cold.

Light.

Noise.

Vibration

UV rays

Ionizing R

Local action.

Inhalation.

Ingestion.

Bacteria.

Virus.

Fungi.

Parasites.

Protozoon's

Accidents Psycho social conditions.

PHYSICAL HAZARDS.

HEAT: Burns, heat exhaustion, heat stroke, heat cramps, decreased efficiency, increased fatigue, & enhanced accident rates.

COLD: Chill blains, erythrocyanosis, immersion cyanosis, frost bite, hypothermia.

LIGHT: Eye strain, headches, Eye pain, lacrymation, congestion around cornea, eye fatigue, miner’s nystagmus, discomfort, annoyance, visual fatigue, blurring of vision leading to accidents.

NOISE: Temporary / permanent hearing loss, nervousness, fatigue, interference with communication, decreased efficiency, annoyance.

VIBRATION: White fingers, injuries to joints.

ULTRA VIOLET RADIATION: Conjunctivitis, keratitis, (welder’s flash), redness of eyes & pain.

IONIZING RADIATION: Genetic changes, malformations, cancer, leukemia, depilation, ulceration, sterility, death.

CHEMICAL HAZARDS

LOCAL ACTION : Dermatitis, eczema, ulcers, cancer, allergy, systemic effects (TNT, Aniline dyes).

INHALATION : DUST: (.1 – 150 microns ),< 5 microns, directly inhaled into the lungs.Pnuemoconiosis.(silicosis, anthracosis, byssinosis, bagassosis,asbestosis, farmer’s lung).

GASES: Poisoning. Eg ; CO poisoning, anesthetic gases, - ether & chloroform.

METALS & THEIR COMPOUNDS: Toxic effects of the corresponding metals.

BIOLOGICAL HAZARDS.

Exposure & effect of parasitic agents,--- brucellosis, leptospirosis, anthrax, hydatidosis, psittacosis, tetanus, encephalitis, fungal infections, schistosomiasis.

MECHANICAL HAZARDS.

10% of accidents in industries are due to mechanical hazards.

PSYCHOSOCIAL HAZARDS

Frustration, loss of job satisfaction, insecurity, poor human relationships, emotional tensions, depression, sickness, absenteeism, peptic ulcer, rapid ageing, heart disease,

OCCUPATIONAL DISEASES.

DISEASES DUE TO PHYSICAL AGENTS.

DISEASES DUE CHEMICAL AGENTS.

DISEASES DUE TO BIOLOGICAL AGENTS.

OCCUPATIONAL CANCERS.

OCCUPATIONAL DERMATITIS.

DISEASES OF PSYCHOLOGICAL ORIGIN.

DISEASES DUE TO PHYSICAL AGENTS.

HEAT : Heat hyperpyrexia, heat exhaustion, heat syncope, heat cramps, burns, prickly heat.

COLD : Trench foot, frost bite, chilblains.

LIGHT : Occupational cataract, miner’s nystagmus.

PRESSURE : Air embolism.

NOISE : Occupational deafness.

MECHANICAL FACTORS : Injuries & accidents.

ELECTRICITY : Burns.

DISEASES DUE TO CHEMICAL AGENTS.

POISONING – CO,CO2,NH3,N2, H2S,SO2.

DUST : Pneumoconiosis.

INORGANIC DUST : Coal dust : Anthracosis.

Silica : Silicosis.

Asbestos : Asbestosis.

Iron : Siderosis.

ORGANIC DUST

CANE FIBRE : Bagassosis.

COTTON DUST : Byssinosis.

TOBACCO : Tobacossis.

HEY/ GRAIN DUST : Farmer’s lung.

DISASES DUE TO BIOLOGICAL AGENTS

Brucellosis, leptospirosis, anthrax, actinomycosis, psittacosis, tetanus, encephalitis, fungal infections.

OCUPATIONAL CANCERS.

Cancer of lungs, skin, & bladder.

OCCUPATIONAL DERMATOSIS.

Dermatitis, eczema.

DISEASES OF PSYCHOLOGICAL ORIGIN.

Industrial neurosis, hypertension, peptic ulcer.

HEALTH ACTS & HEALTH MEASURES IN OHP

THE FACTORIE’S ACT.1948.

THE EMPLOYEES STATE INSURANCE ACT.1948.

THE FACTORIE’S ACT- 1948.(1987 – Amended).

SCOPE : DEF OF ESTABLISHMENT.

10 or more workers where power is used & 20 or more workers where power is not used.

HEALTH SAFETY & WELFARE.

The act addresses matters as cleanliness, lighting, ventillation, treatment of waste & effluents, disposal & elimination of dust, fumes – provision of spittoons, control of temperature, supply of cool drinking water during summer, employment of cleaners.

OTHER RECOMMENDATIONS INCLUDE :

500 cu ft space for each worker.

Precautions regarding the safety of the workers.

Appointment of safety officers 1976 ammendment.(1000 or more workers.).

Specific welfare measures.– washing facilities, facilities for drying & storing, facilities for sitting, first aid appliances, rest rooms, lunch rooms, canteens, crèches, welfare officer – 500 employees.(200 worker – canteen, 30 women – crèche.)

EMPLOYMENT OF YOUNG PERSONS.

The act prohibits employment of children below the age of 14 yrs.,

15 – 18 yrs – Adolescents for employment should be certified by surgeon for fitness of work.(6AM-7PM).

The act prohibits employment of women & children in dangerous occupations.

HOURS OF WORK.

The act prescribes a maximum of 48 hrs/wk not exceeding 9 hrs / day with half an hour rest after continuous work.

Work – The act promotes spread over work – 10 -12 hrs work.

The total working hours must not exceed incl OT- 60 hrs.

LEAVE WITH WAGES.

Workers are entitled for a leave with wages after 12 months continuous service.

1 day / 20 days – adults.

1 day / 15 days – children.

The leave can be accumulated up to 30 days in adults, 40 days in children.

OCCUPATIONAL DISEASES.

The act enlists the schedule of notifiable diseases.

The act includes for provision for occupational health surveys in factories & industries.

EMPLOYMENT IN HAZARDOUS PROCESS.

The amendment act specifies procedures relating to hazardous process.

The site appraisal committees is to be involved in examining the service conditions of employees involved in the hazardous process.

THE ESI ACT - 1948THE ACT WAS AMMENDED IN 1975, 84 & 89.The ESI act is an important measure of social security & health insurance.

SCOPE : The act covers whole of India.

The act covers all factories using power.

The following are the areas that the act extends.

Small power using factories.(10 -19 workers).

Factories having 20 workers without power.

Shops.

Hotels & Restaurants.

Cinemas & theatres.

Road – motor transport establishments.

News paper establishments.

The act involves employees of all cadres ( manual, clerical, supervisory, technical drawing up to 7500/mo.

ORGANIZATIONAL PATTERN – ESI DELIVERY. ESI CORPORATION

Representatives of central & state Govt employers, employees, medical professionals & parliament.

Min for labour Vice chairman –Sec to Govt of India, ministry of labour

DGI -ESIInsurance commissioner.

Medical commissioner.

Financial commissioner.

Actuary.Medical benefit council chairman.DGHS

Medical Sickness Maternity Disablement Dependants

Benefits

EXTRA BENEFITS

Extended sickness' benefit.

Artificial limbs/dentures/family planning.

Family medical care.

Protection against dismissal / discharge from service.

Funeral expenses.

Rehabilitation allowances.

Medical facilities to dependants.

FINANCE --- ESI.

The ESI scheme is run by contributions of employers, employees & grant from central & state govt.

Employee – 4.75 % of the total wage bill.

Employer – 1.75 % (1.1.97).

Employees getting wages below Rs 15/day are exempted from contribution.

BENEFITS.

MEDICAL BENEFITS : Full medical care, out patient care, supply of drugs & dressings, specialist services in all specialties –(pathological & radiological services), ambulance services, immunization, family planning, AN,PN services, H/E, & in- patient care.

ESI dispensaries : & insurance for medical practitioners in having 1000 employees. out patient & inpatient services available.

Dentures , spectacles, hearing aids, artificial limbs & special appliances.

SICKNESS BENEFITCash payment to injured sick person(91 days) on certification by insurance medical officer.

( 365 Days – at daily rate – 50 % of the daily wages.).

EXTENDED SICKNESS BENEFIT : for TB, leprosy,chronic empyema, AIDS, payable upto 309 days.

NEOPLASMS : malignant diseases.

EDOCRINE : DM – retinopathy, nephropathy,

MATERNITY : Confinement services for insured women, miscarriage or sickness arising out of pregnancy

Maternity leave – 12 wks., miscarriage – 6 wks., sickness – 30 days.

DISABLEMENT BENEFIT : Pension at partial & at full rate.

DEPENDENT’S BENEFIT : Pension at the rate of 40 % to widows & children.

Rs 14 / day – for children up to the age of 18 or marriage.

FUNERAL EXPENSES – Rs 2500 cash payment.

REHABILITATION : on payment of RS 10 insured person & his family members continue to avail treatment.