OCCUPATIONAL

HEALTH HAZARDS
Leonardo DG. Macam Jr., RMT, MPH
 PHYSICAL
HAZARD

ERGONOMIC CHEMICAL
HAZARD HAZARD

BIOLOGICAL
HAZARD
OBJECTIVES:
 Discuss and explain common hazards in the
workplace and their effects to workers’
health.

 Recommend appropriate measures to

prevent occupational and work-related
illnesses.
OCCUPATIONAL HEALTH
(WHO )
 Promote and maintain the highest degree of physical,
mental & social well-being of workers of all occupations

 Prevent workers from departures due to health caused

by their working conditions

 Protect workers in their working environment from

hazards and risks usually causing adverse health effects

 Place & maintain a worker in an occupational

environment adapted to his/her physiological ability
HAZARD AND RISK
 HAZARD  RISK
- any source of - the chance or
potential damage, probability that a
harm or adverse person will be
health effects on harmed or
something or experience an
someone under adverse health
certain conditions at effect if exposed to
work. a hazard.
WORKPLACE HAZARDS
Safety Hazards Health Hazards

 working conditions where  working conditions which

harm to the workers is of an result in an illness
immediate and violent nature
 result in broken bones, cuts,  exposure to dangerous
bruises, sprains, loss of substances or conditions,
limbs, etc. such as chemicals, gases,
 the harm results in some kind dusts, noise etc.
of injury to the worker
 associated with poorly  often, latency between
guarded or dangerous exposure and disease
equipment and machinery
 Genetic Multiplicity of
factors exposure
Lifestyle
Duration of
Age exposure

Workers’ WORK- Workplace

Susceptibility Factors Physical
RELATED properties
Race DISEASE
Magnitude of
Gender exposure
Medical Timing of
history exposure
CHEMICAL HAZARDS
Chemical Hazards
Routes of entry into the body
Inhalation Skin Contact

Ingestion
 Chemical Hazards
Routes of excretion

Gastro-intestinal Renal (urine) Respiratory Skin (sweat, hair, nails)

(feces) (exhalation)
LD 50 - Dose lethal to 50% of test animals
Threshold:
•point at which toxicity first appears
•occurs at the point where the body's ability to
detoxify or repair toxic injury has been exceeded. 
Chemical Hazards
Measures of concentration of toxic substances

 Threshold Limit Value (TLV)- average concentration

of an airborne substance to which most workers
could be safely exposed over an eight-hour working
day or forty-hour working week throughout a
working lifetime

 Maximal Allowable Concentration (MAC)- peak or

maximum concentration of an airborne to which
most workers could be safely exposed.
Chemical Hazards
Classification of Toxic Effects

 Local toxicity- occurs at the site of chemical contact

 Systemic toxicity- occurs distant from point of contact,

may involve many organ systems

 Acute toxicity- occurs almost immediately (hours/days)

after an exposure

 Chronic toxicity- represents cumulative damage to

specific organ systems; occurs many months or years to
have recognizable clinical disease
Chemical Hazards
Health Effects
 Renal Diseases
 Respiratory Diseases
 Skin Diseases
 Hematologic Diseases
 Cardiovascular Diseases
 Neurologic Diseases
 Carcinogenic
 Teratogenic
Chemical Hazards
Effects Chemical Agent Industry/Process

Renal Diseases: Battery, chemical

acute/chronic renal Mercury, cadmium, industries,
failure chloroform pesticide
Respiratory Diseases:
Irritation, inflammation Solvents, ammonia Chemical industries

Pneumoconiosis Inorganic dust Mining, construction,

sandblasting, coal

Cancer Chromium Plating, metal refining

Chemical Hazards
Blood Diseases:
Anemia Lead Battery mfg., lead
smelting

Aplastic anemia Benzene Solvent & soap mfg.

Skin Diseases:
Allergic/contact Plastic epoxides Plastic, varnish
dermatitis

Acne Cutting oils, grease Machine-tool

operators
Skin Cancer Arsenic, tar Petroleum refinery
Chemical Hazards
Liver Disease:
Acute liver toxicity Carbon Cleaning fluids, dry
tetrachloride cleaners
Liver cancer Vinyl chloride Plastics & vinyl
chloride mfg.

Cardiovascular Disease:
Hypertension Lead, Cadmium Battery mfg. &
recycling
Atherosclerosis Carbon disulfide Degreasing, dry
cleaning
Arrythmias Fluorocarbon, Refrigeration, solvent
trichloroethylene workers
PHYSICAL HAZARDS
Physical Hazards
 Noise

 Vibration

 Extreme Temperature

 Illumination

 Radiation
Ear Anatomy
NOISE
Types of Noise-Induced Hearing Loss

 Temporary Threshold Shift (auditory fatigue)

 temporary loss of hearing acuity after exposure to
loud noise
 recovery within 16-48 hrs

 Permanent Threshold Shift

 irreversible loss of hearing
NOISE
Early Signs of Hearing Loss
• Difficulty in understanding spoken words in a
noisy environment
• Need to be near or look at the person
speaking to help understand words
• Familiar sounds are muffled
• Complaints that people do not speak clearly
• Ringing noises in the ears (tinnitus)
Other Harmful Effects of
Noise

• Hypertension
• Hyperacidity
• Palpitations
• Disturbs relaxation and sleep
VIBRATION
 Physical factor which affects man by
transmission of mechanical energy from
oscillating sources

 Types
 Segmental vibration

 Whole body vibration

Segmental Vibration:
• Health Effects:
— Hand Arm Vibration Syndrome (HAVS)

— tingling, numbness, blanching of fingers

— pain
Whole Body Vibration:
 Health effects:
 Fatigue

 Irritability

 Headache

 Disorders of the spine

EXTREME TEMPERATURE

 Sources of heat stress:

 Natural Conditions
 Hot work processes related to furnaces, kilns,
boilers and smelting
 Health Effects of Heat Stress
Disorders Clinical features

Prickly Heat (Miliaria rubra) Pruritic rash

Heat cramps Cramps in the body,

usually legs

Heat exhaustion Dizziness, fainting attack,

blurring of vision, cold,
clammy and sweaty skin
Heat stroke Cyanosis, muscle
twitchings, disorientation,
delirium, convulsions
EXTREME TEMPERATURE

 Sources of Cold Environment:

 Ice plants and freezers in the food industry

Health Effects of Cold Temperature

 Frostbite: reddening of skin,

localized burning pain and
numbness. Fingers, toes, cheeks,
nose, ears are most susceptible.

 trench foot or immersion foot:

numbness, pain, cramps,
ulceration and gangrene.
ILLUMINATION
Recommended Illumination Levels
Area of Operation Min Lighting Level (lux)

Cutting Cloth  2000

Fine machining
Transcribing handwriting 1000
Drafting
Welding 500
First Aid station
Lunch Room 300
Rest Room
Inadequate Illumination
Health Effects
 Visual Fatigue

 Double Vision

 Headaches

 Painful irritation

 Lacrimation

 Conjunctivitis
 Electromagnetic Spectrum

Source Frequency in hertz (Hz)

X-rays, about

IONIZING RADIATION
1 billion Gamma rays 22
billion Hz 10
20
can penetrate
10
the body and damage X-rays 18
internal organs and tissues 10
by damaging important 16
molecules like DNA.
Ultraviolet radiation 10
14
This is called “ionization.” Visible light 10
12
Microwaves, several billion Hz, Infrared radiation 10
can have “thermal” or hearing 10

effects on body tissues Microwaves 10

8
Power frequency EMFs 50 or 10
60 Hz carry very little energy, Radio waves 6
10
have no ionizing effects 800 - 900 MHz
4
Very low frequency (VLF)
and usually no thermal 15 - 30 Hz &
50 - 90 Hz 3,000 - 30,000 Hz
10
effects. They can, however, 2
cause very weak electric
Extremely low frequency 10
(ELF) 3 - 3,000 Hz 60 Hz
currents to flow in the body. Direct current 0
 RADIATION
Types Sources Health Effects
Ionizing X-rays Cancer, congenital
Gamma rays defects, death

Non-ionizing Ultraviolet skin redness, premature

skin ageing, and skin
cancer
corneal and conjunctival
Infrared
burns, retinal injury,
cataract
Laser Skin and eye problem
BIOLOGICAL HAZARDS
BIOLOGICAL HAZARDS

VIRUSES FUNGI

BACTERIA PARASITES
Selected Infectious Diseases
and Occupations

Agent / Disease Occupation

Colds, influenza, scarlet fever, May be contracted anywhere
diphtheria, smallpox
Tuberculosis Silica workers, people exposed
to heat and organic dusts, and
medical personnel
Anthrax Animal handlers and handlers
of carcasses, skins, hides, or
hair of infected animals,
including wool carpet
processors and handlers.
Selected Infectious Diseases
and Occupations

Agent / Disease Occupation

Ringworm (in horses, cattle, Pet shop salesmen, stockmen,

deer, pigs, cats, dogs, birds) breeders of cats and dogs, and
other animal handlers

Tetanus Farmers (spores in soil) or

anyone in contact with manure.
Selected Infectious Diseases
and Occupations

Agent / Disease Occupation

Psittacosis (in parrots, Pet shop personnel, gardeners,
parakeets, pigeons, ducks, housewives, veterinary
turkeys, chickens, etc.) surgeons, and researchers.

Hookworm Miners, agricultural laborers,

planters of sugar, tobacco, tea,
rice and cotton, and brick and
tunnel workers.
Selected Infectious Diseases
and Occupations

Agent / Disease Occupation

Rabies (e.g. dogs, bats, rats, Veterinarians, letter carriers,
pigs, cats) laboratory research workers,
agricultural workers.

Fungus Farmers, outdoor workers,

animal handlers
HIV and AIDS
A- Acquired
H- Human

I- Immunodeficiency I- Immune

V- Virus D- Deficiency
 virus which causes
AIDS
S- Syndrome
 serious and usually fatal
condition in which the body’s
immune system is severely
weakened and cannot fight
off infection.
 Body Fluids with High Viral Load
 Blood
 Semen
 Vaginal and cervical mucus
 Breastmilk
 Amniotic fluid
 Cerebrospinal fluid
Modes of Transmission
• Unprotected penetrative sex
— semen, blood, vaginal secretions
• Blood transfusion on infected blood and blood products
• Sharing needles among
I.V. drug users
• Vertical/perinatal
— mother to infant
• Breastfeeding
 HIV is NOT transmitted…
• through casual contact in any setting– schools, homes,
hospitals

• through insect, food, water, clothes, toilets, swimming

pools, and drinking and eating utensils
Prevention of HIV Infection
REMEMBER ABCDE!
 Abstinence
 Be Faithful
 Condom
 Do not inject Drugs/no
sharing of needles

 Education
TETANUS
 A neurological disorder
characterized by increased
muscle tone and spasms, that is
caused by tetanospasmin, a
protein toxin elaborated by the
organism Clostridium tetani.

 It arises from the contamination

of wounds with Clostridium
spores.
 TETANUS
 Clinical Manifestations
 Increased tone in the
masseter muscle
(lockjaw)
 Sustained contraction of
the facial muscles (risus
sardonicus) and back
muscles (opisthotonus)

 Prevention
 Active immunization with
tetanus toxoid
 Careful wound
management
TUBERCULOSIS
 caused by the bacteria,
Mycobacterium tuberculosis
 caused by droplet nuclei
released when sneezing and
coughing
 Symptoms: weight loss, low
grade afternoon fever,
persistent cough and
sometimes, blood-streaked
expectoration or hemoptysis
DOTS Strategy…the Solution!
Directly Observed Therapy Short Course
With DOTS
90% CURE RATE
ERGONOMIC HAZARDS
ERGONOMICS
Human Biological Science
+
Engineering Science
____________________________________
MAXIMUM SATISFACTION AND INCREASE
PRODUCTIVITY

“ fitting the job to the worker”

ERGONOMICS
the task
(job content &
context)

the the
organization tool

the the
environment workstation
ERGONOMICS

 Goal
 to reduce work-related musculoskeletal
disorders (MSDs) developed by workers

 MSDs are injuries and illnesses that affect

muscles, nerves, tendons, ligaments, joints
or spinal discs.
ERGONOMICS
Common Symptoms of MSDs

 Painful joints
 Pain, tingling, numbness in hands, wrists,
forearms, shoulders, knees and feet
 Shooting or stubbing pains
 Swelling or inflammation
ERGONOMICS
Common Symptoms of MSDs

 Fingers or toes turning white

 Back or neck pain
 Stiffness
Risk Factor: ERGONOMICS

Static
posture
Risk Factor: ERGONOMICS

Forceful exertion
Risk Factor: ERGONOMICS

Repetitive movement
Risk Factor: ERGONOMICS

Extreme range of motion

Risk Factor: ERGONOMICS

Awkward posture
ERGONOMICS
STRESS
STRESS

The harmful physical and emotional responses

that occurs when the requirements of the job
do not match the capabilities, resources or
needs of the worker.
STRESS: Effects
 STRESS
Manifestations of Stress
PSYCHOLOGICAL PHYSIOLOGICAL BEHAVIORAL
 Fatigue  Heart rate  Drug use
 Anxiety  Blood pressure  Alcohol intake
 Tension  Indigestion  Heavy smoking
 Irritability  Impulsive emotional
 Depression
behavior
 Boredom
 Inability to
concentrate
 Low esteem
 Poor work & family
relationship
 Social isolation
 Family abandonment
 Sleep problems
MONITORING

• Systematic, continuous, repetitive health-

related activities that should lead to
corrective action

• Types of monitoring
1. Ambient / Environmental
2. Biological
3. Medical Surveillance
BIOLOGICAL
MONITORING
Biological Monitoring

 Measurement of a substance, its metabolites

or its effects in body tissues, fluids or exhaled
air of exposed person

 Assess exposure and health risk of workers

 Complements exposure assessment by air

sampling
Biological Monitoring

Chemical / Sampling Time BEI

Determinant
LEAD
Lead in Blood Not critical 30ug/100ml
MERCURY
Total inorganic in urine Prior to shift 35ug/g
Total inorganic in blood End of shift at end of 15ug/L
workweek
CARBON MONOXIDE
Carboxyhemoglobin in End of shift 3.5% of Hgb
blood
 MEDICAL
SURVEILLANCE
Medical Surveillance

 Identify cases

 Analyze Trends and Patterns in the Workforce

to Guide Prevention Efforts

 Meet Regulatory Requirements

Medical Surveillance
 Know the hazard - How worker is exposed
- How worker is affected

 Characterize the hazard - Exposure levels

- Exposure duration

 Know the worker - Susceptibilities

 Obtain information on - Directed towards specific

medical examinations organ system

 Analyze Medical Data - Disease, recovery, rehab

- Effectiveness or failure of
control measures
 PREVENTION AND CONTROL OF
OCCUPATIONAL HAZARDS
Monitoring Activity Workplace-Related Events Health Effects

Exposure at the workplace

Environmental monitoring - Chemicals None
- Physical agents

Biologically significant exposure

Biological monitoring and - Chemicals absorbed Early
surveillance - Early (reversible) changes

Clinical diagnosis
Treatment and surveillance - measurable health effects
- Morbidity Late
- Mortality

End effects
- diseases
- unfavorable events (spontaneous
abortion)
 OCCUPATIONAL
HEALTH PROGRAMS
Key Elements of the
Occupational Health Program

Health Protection

Health Promotion

Health Rehabilitation
 Health and Safety Programs
Hazards/ Source Health Effect Health Program
Disease
Chemical
Solvents Paints, Irritant, Surveillance for chemical
Thinners Multisystem exposure
effects Exposure monitoring
(Biologic Monitoring)

Physical
Noise Woodwork Hearing Hearing Conservation
Operations Impairment Program
 Health and Safety Programs
Hazards/ Source Health Effect Health Program
Disease
Biologic
Tetanus Dirty Nails, soil Lockjaw, rigidity, Immunization
death
Ergonomic
Stresses Awkward Musculoskeletal Management or
Cumulative postures, Heavy Disorders personnel methods;
Trauma loads Workplace
Disorder modification
Worker education
and training;
Back Care Program
Health Promotion
 Physical activity, Nutrition, Weight reduction

 Immunization
 OSHS, RULE 1960

 Smoking cessation
 RA 9211 Tobacco Regulation Act of 2003

 HIV/AIDS
 RA 8504 Philippine AIDS Prevention and Control Act of
1998
 National Workplace Policy on STD/HIV/AIDS initiated by
DOLE - 1997
Health Promotion
 Drug Abuse Prevention and Control
 RA 9165 Comprehensive Drugs Act of 2002
 Department Order No. 53-03: Guidelines for the
Implementation of a Drug-Free Workplace Policy and
Program for the Private Sector

 Tuberculosis Prevention and Control

 Executive Order No. 187, Instituting a Comprehensive
and Unified Policy for Tuberculosis Control in the
Philippines (CUP) (March 2003)
 Department Order No. 73-05: Guidelines for the
Implementation of Policy and Program on Tuberculosis
(TB) Prevention and Control in the Workplace
DEPARTMENT ORDER NO. 56-03
RATIONALIZING THE IMPLEMENTATION OF THE FAMILY
WELFARE PROGRAM (FWP) IN DOLE
SECTION 2. New Priorities of the Family Welfare Program
a) Reproductive Health and Responsible Parenthood
b) Education/Gender Equality
c) Spirituality or Value Formation
d) Income Generation/Livelihood/Cooperative
e) Medical Health Care
f) Nutrition
g) Environmental Protection, Hygiene and Sanitation
h) Sports and Leisure
i) Housing
j) Transportation
Approach in Ensuring
Well-Being of Workers
 Looking at
developmental
 Looking at regulatory
strategies requirements

 Information
 Education
 Relevant laws,
 Training standards, issuances
 Campaigns and guidelines
 Good practices  Enforcement
 Successful cases  Implementation
 Competitions
 Demonstrations
 Inspection
 Interventions  Evaluation
Participatory Approach
 Participation and involvement from stakeholders
 Coordinated intervention
 Learning from
 specifications/guidelines,

 scientific data

 best practice
Benefits to the workers
 Enhanced worker motivation and job satisfaction
 Added problem-solving capacity
 Greater acceptance of change
 Greater knowledge of work and organization
 Reduces the extent and severity of work related
injuries and illnesses
 Improves employee morale and productivity
 Reduces workers’ compensation costs
END OF THE PRESENTATION

BOSH Training 2009 OSHC

 Epidemiology of HIV and AIDS
Demographic Data Feb 2009 Jan – Feb 2009 Cumulative Data
1984 – 2009
Total Reported Cases 47 112 3,701
Asymptomatic Cases 45 107 2,893
AIDS Cases 2 5 808
Males 38 95 2,595*
Females 9 17 1,095*
Youth 15-24 y/o 12 31 537
Children <15 y/o 1 2 52
Reported deaths due to 0 0 317
AIDS
Source: HIV / AIDS Registry, Department of Health, Philippines * Note: No data available on sex for eleven (11) cases.
Modes of HIV Transmission
Reported Mode of Feb Jan-Feb Cumulative Data:
Transmission 2009 2009 1984—2009
n=47 n= 112 N=3,701
Sexual Contact 43 107 3,297
Heterosexual contact 13 36 2,034 (62%)
Homosexual contact 14 37 872 (26%)
Bisexual contact 16 34 391 (12%)
Blood / Blood Products 0 0 19
Injecting Drug Use 0 1 8
Needle Prick Injury 0 0 3
Mother-to-Child 1 2 49
No data available 3 3 325
 Ten Leading Causes of Death by Sex
Number, Rate/100,000 Population &
Percentage, Philippines, 2004
Both Sexes
Cause Male Female
No. Rate Percent*
1. Heart Diseases 40,361 30,500 70,861 84.8 17.6
2. Vascular System Diseases 28,930 22,750 51,680 61.8 12.8
3. Malignant Neoplasm 21,395 19,129 40,524 48.5 10.1
4. Accidents** 28,041 6,442 34,483 41.3 8.6
5. Pneumonia 15,822 16,276 32,098 38.4 8.0
6. Tuberculosis, all forms 17,841 8,029 25,870 31.0 6.4
7. Ill-defined and unknown causes of
10,941 10,362 21,278 25.5 5.3
mortality
8. Chronic lower respiratory diseases 13,084 5,891 18,975 22.7 4.7
9. Diabetes Mellitus 7,970 8,582 16,552 19.8 4.1
10. Certain conditions from perinatal
7,809 5,371 13,180 15.8 3.6
period
Source: 2004 Philippine Health Statistics, Last Update: February 11, 2008
* percent share from total deaths, all causes, Philippines ** External Causes of Mortality
BOSH Training 2009 OSHC
 “I still need more healthy rest in
order to work at my best. My health
is the main capital I have and I want
to administer it intelligently.”
---Ernest Hemmingway
Nobel Prize winner for literature

THANK YOU FOR YOUR ATTENTION!