Case 4 EPH2022 Flashcards
What is occupational health (OH)?
Promotion & maintenance of physical, mental & social wellbeing of workers in all occupations & extends to improvement of working environment & work to be good for safety & health
What are the main components for OH?
- OH legislation & policies to protect health of workforce
- Reduction of risks from exposure to workplace hazards
- Health promotion for those at work
What considerations must OH practice include?
Environmental health considerations & holistic management of workforce.
E.g. hazardous waste management & disposal in chemical plant, prevention of outbreaks of occupational infections, emergency preparedness & response.
What does a holistic approach mean?
To provide support that looks at the whole person, not just their mental needs.
What are occupational exposures that can have negative health effects?
- Safety: objects, substances that injure worker e.g. working heights, spills, confined spaces, electrical wiring
- Chemical: environmental smoke, acids, pesticides, carbon monoxide, flammable liquids, paints, etc
- Biological: e.g farms, zoos, hospitals, vets exposed to biological hazards (blood, fungi, virus, insect bites, etc)
- Physical: harm body without touching e.g. radiation, sunlight, noise, extreme high/low temperatures
- Ergonomic: hazard put strain on body over time. E.g. sedentary lifestyle, repeated movements, vibrations
- Work organisation hazards: WP violence, discrimmination, harrassment, etc
- Psychological: stress, burnout, etc
What are the major types of occupational diseases & injuries?
- Occupational lung diseases
- Occupational cancers
- Occupational & work-related skin diseases
- Occupational reproductive disorders
- Occupational noise-induced hearing loss
- Occupational infections
- Occupational traumatic injuries
Explain occupational lung diseases
- Respiratory system easily accessible for airborne toxic agents
- Common: occupational asthma, LC, bronchitis, pulmonary infections, dust disease
Explain occupational cancers
- Occupational carcinogens include chemical substances, e.g. benzene, asbestos, radiation, viruses
- Most common cancers due to workplace exposures: lung, bladder, skin & liver
Explain occupational & work-related skin diseases
- Workers in agriculture, forestry, manufacturing (e.g. metal workers), florists, hairdressers, etc higher risk due to range of irritants or alergens exposed to skin.
- Most common are dermatitis & skin cancer
Explain occupational reproductive disorders
- Limited researh
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Exposures in females: menstrual cycle irregularities, infertility, early menopause, cross placenta to baby.
* Foetal & developmental effects from maternal exposures: peterm delivery, prenatal death, low birth weight, hearing dysfunction
Explain occupational noise-induced hearing loss
- Workers in manufacturing, mining, transportation, agriculture & military at high risk
Explain occupational infections
- Blood-borne diseases (hep B,C, HIV) & droplet-borne infections (measels, TB, varicella) can be transmitted from patients to healthcare workers (HCW).
- Also vector-borne diseases (malaria, dengue, Lyme disease), water & food-borne diseases (from poor sanitation & unsafe water = cholera & typhoid), zoonoses among veterinarians, farmers, agricultural & forestry workers (rabies, lepospirosis)
What are 2 examples of work-related diseases?
- Work-related MSDs
- Stress-related ill-health
Explain work-related MSDs
- Physical risk factors: rapid work pace, repetivie motion, vibration, sedentary lifestyle
- Pyschosocial factors: high job demands, lack of job control, boring (monotous) work = increased risk
- Interventions such as stretching exercises, implementation fo ergnomic measures = help prevent MSDs
What are MSDs?
injuries & disorders that affect body’s movement or musculoskeletal system (i.e. muscles, tendons, ligaments, nerves, discs, blood vessels, etc.)
What is work related stress?
‘Harmful physical & emotional responses that occur when the requirements of the job do not match the capabilities, resources or needs of the worker’
Explain work-related stress
- New forms of work organisation & employment patterns (more temporary & independent contracting) bring job flexibility but also lower control & increase job insecurity.
- Present as: emotion lability, anxiety, depression, insomnia, suicide.
- Adverse health outcomes: risk of CVD, MSDs symptoms, impaired immune functions, gastrointestinal disorders
What are the most common occupational diseases?
Lung & skin cancer coz of substantial surface area in direct contact with toxic substances
NIHL & MSDs from physical factors in workplace.
Why are occupational & work-related diseases underdiagnosed?
- Difficulty in establishing cause-and-effect relationships (skin cancer can be due to exposure of hydrocarbons or excessive sunlight exposure)
- Long latency between occupational exposure & onset of illness
- Lack of good understanding among health practitioners about hazards at work
- Limited ability of workers to provide an accurate report of (past) exposures. Many developing countries, not required to inform workers of hazards.
- Financial liability associated with finding a disease of occupational origin - employers maybe reluctant to recognize disease
Technological evolutions & changees in employment patterns = new occupational disease, making even more complicated
What are special populations of workers?
- Child labour
- Female workers
- Disabled workers
- Migrant workers
- Shift workers
Why is child labour a special population of workers?
- Greater exposure to hazards than adults coz tend to do menial jobs & involve high exposures of toxins
- Using hand tools designed for adults = higher risk of fatigue & injury
Why are female workers a special population of workers?
- Work for smaller industries/organisations & have less opportunity for work control
- More likely to work in informal sectors (domestic work, street vending, sex work) with accompanying low social status and lack of legislative protection.
Why are disabled workers a special population of workers?
- Reasonable accomodations are: changes made to work environment, job responsibilities, etc
- Aim is to ensure disabled people have same access to everything involved in performing & keeping a job as a non-disabled person.
Why are migrant workers a special population of workers?
*
* many perform 3D (dirty, dangerous, demanding) jobs
What are some problems for migrant workers?
- Affected by poor nutrition & endemic diseases, often have lower educational backgrounds, inadequately trained to deal with potential hazards.
- Language barriers
- Often not familiar with local health & safety practices & regulations.
- Accomodation available often temporary & crowded with limited shared facilities, restricted access to medical care & other social services.
- May encounter racism, xenophobia & exploitation coz of legal status
Why are shift workers a special population of workers?
- Can take form of fixed shifts (work same shift period) or rotating shifts (shifts differ over time)
- Consequences: sleep deficits, minimal work performance, psychological health effects, reproductive disorders, metabolic disorders, gastrointestinal disorders, cancer, CVDs
- Shift work-related ill health can increase with time of exposure.
What occupational factors impact well-being?
- Workload
- Duration
- Intensity
- Psychological stress
- Access to WHP resources
- Why is well-being, safety & physical health important for OH?
which model check doc
- Contributes to changing paradigm that besides safety issues, good workplace health (physical & psychosocial health) is equally important coz impacts work capacity. & performance of organiation.
- More holistic approach to understanding of occupational & work-related diseases, prevention & management.
What is toxicology?
Study of nature & mechanisms of toxic effects of substances on living organisms & ther biological systems
What are toxic substances?
- Poison
- Ability to cause harm/damage to living organisms
How can chemicals cause ill-health to exposed populations?
- Entry of chemicals in water supplies
- Effects of toxic vapours contaminating environment of public places & housing complexes
- Presence of chemicals in land where buildings or rereational activities are planned = land contamination
- Deliberate release of toxic chemicals, either during war or act of terrorism.
What are the exposure routes of chemicals in the body?
- Ingestion (oral)
- Injection
- Dermal (skin)
- Inhalation
- Mucous membranes
Explain the exposure route of ingestion & how chemicals are distributed in the body
- Absorption of administered dose in gastrointestinal tract (Gastrointestinal tract - stomach, intenstines, liver,etc)
- Sometimes absorption through mucous membrane of mouth (under toungue = sublingual)
Explain the exposure route of injection & how chemicals are distributed in the body
- Direct administration into bloodstream
- usually given into vein (intraveous) but sometimes (rarely) into artery & into muscle (intramuscular)
- Substance distributed slower after intramuscular injection than intravenous injection & rate depends on blood flow to muscle.
Explain the exposure route of dermal & how chemicals are distributed in the body
- One of most common routes of exposure
- Certain dry material (pesticide dusts, powders, liquid pesticides, etc) enter body through quick skin absorption
- Skin absopriton pattern vs rate of entry through skin = different for different parts of body
What factors infleunce the rate of dermal exposure of a chemical?
- toxicity of chemical on skin
- Rate of absorption
- Size of skin area contamined
- Length of time chemical is in contact with skin
- Amount. ofchemical present on skin
Explain the exposure route of inhalation & how chemicals are distributed in the body
- inhaled via nose & breathing tubes (trachea, bronchi & bronchioles) into lungs and into thinly lined air cells (alveoli) surrounded by blood vessels.
- Very quick to body & short blood route to lungs & brain which is why you faint, dizzy & long blood route to rest of body (feel fatigue) but skin could get a rash, irrtated, etc.
Explain the exposure route of inhalation & how chemicals are distributed in the body
- inhaled via nose & breathing tubes (trachea, bronchi & bronchioles) into lungs and into thinly lined air cells (alveoli) surrounded by blood vessels.
- Very quick to body & short blood route to lungs & brain which is why you faint, dizzy & long blood route to rest of body (feel fatigue) but skin could get a rash, irrtated, etc.
Short & long blood route?
Very quick to body & short blood route lungs to brain which is why faint, fatigue, dizzy & long blood route to rest of body (why you might feel fatigue) but skin e.g. maybe a rash, irritation.
Explain the exposure route of mucous membranes & how chemicals are distributed in the body
Substances enter body following absoprtion through mucous membrane of rectum or vagina.
Describe the toxicodynamic phase
look at image!
- How toxic substance affects the cells and organs of human body
- Effect (reversible/irreversible)
- Effects depend on: concentration & half-life
Define dose
- determines potential toxicity of a substance.
- Amount of harmful substance that enters living organism at one time.
- No substance is poisonby itself: dose that makes substance poison.
What is important for assessment of harmful effects of a substance entering the body?
Quantity of substance & duration of exposure
How is toxic dose determined?
- Dose which reachs the body by inhalation, ingestion, skin, etc.
- Processes that take place once toxic substance is within body