The factories act 1948, The Employees state insurance act 1948- spm from park textbook

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The Factories Act, 1948 - SPM Notes (Park's Textbook)

(Park's Textbook of Preventive and Social Medicine, p. 919)

Historical Background

  • The first Indian Factories Act dates back to 1881
  • The Act was revised and amended several times
  • Latest amendment: Factories (Amendment) Act, 1987

1. SCOPE

  • Factory is defined as an establishment employing:
    • 10 or more workers where power is used
    • 20 or more workers where power is not used
  • No distinction between perennial and seasonal factories
  • 1976 amendment: expanded definition of "worker" to include contract labour employed in the manufacturing process
  • Applies to the whole of India except Jammu & Kashmir (at the time)
  • State Governments appoint: Chief Inspector, Additional Chief Inspectors, Joint Chief Inspectors, Deputy Chief Inspectors, and Inspectors

2. HEALTH, SAFETY AND WELFARE (Chapters III, IV, IVA & V)

Health Provisions

  • Cleanliness, lighting, ventilation
  • Treatment and disposal of wastes and effluents (render innocuous)
  • Elimination of dusts and fumes
  • Provision of spittoons
  • Control of temperature
  • Supply of cool drinking water during summer
  • Employment of cleaners for water closets
  • Minimum space per worker:
    • 500 cu. ft per worker (factories set up after 1948 Act)
    • 350 cu. ft per worker (factories installed before the 1948 Act)

Safety Provisions

  • Casing of new machinery
  • Devices for cutting off power
  • Hoists, lifts, cranes and lifting devices
  • Protection of eyes
  • Precautions against dangerous fumes, explosive and inflammable materials
  • No worker shall be required to lift/carry loads likely to cause injury
  • State Governments empowered to prescribe maximum weights for men, women, and children
  • 1976 amendment (Section 40B): Appointment of Safety Officers in every factory employing 1,000 or more workers

Welfare Provisions (Chapter V)

FacilityThreshold
Canteen>250 workers ordinarily employed
Creche>30 women workers (1976 amendment)
Welfare OfficerEvery factory (implied by the Act)
Washing facilities, facilities for storing/drying clothes, facilities for sitting, first-aid, shelters, rest rooms, lunch roomsApplicable provisions

3. EMPLOYMENT OF YOUNG PERSONS

  • Prohibited: Employment of children below 14 years
  • Adolescents: Persons aged 15-18 years
    • Must be certified as fit by Certifying Surgeons
    • Allowed to work only between 6 AM and 7 PM
  • Restrictions on employment of women and children in certain dangerous occupations

4. HOURS OF WORK

  • Maximum: 48 hours per week, not exceeding 9 hours per day
  • Rest: At least 1/2 hour after every 5 hours of continuous work
  • For adolescents: hours reduced to 4.5 hours per day
  • 1976 amendment: Spread-over period (including rest intervals) increased to 12 hours (from 10.5 hours)
  • Total hours per week including overtime: shall not exceed 60

5. LEAVE WITH WAGES

  • Entitlement after 12 months' continuous service:
    • Adults: 1 day leave for every 20 days of work
    • Children: 1 day leave for every 15 days of work
  • Leave accumulation limit:
    • Adults: up to 30 days
    • Children: up to 40 days

6. OCCUPATIONAL DISEASES

  • Management must notify specified accidents causing death, serious bodily injury, or occupational disease
  • Act gives a schedule of notifiable diseases
  • 1976 amendment added to the list:
    • Byssinosis
    • Asbestosis
    • Occupational dermatitis
    • Noise-induced hearing loss
  • Provision for enquiry in every case of a fatal accident
  • Safety and occupational health surveys in factories/industries

7. EMPLOYMENT IN HAZARDOUS PROCESSES

  • New Chapter IV-A added by Factories (Amendment) Act, 1987
  • Site Appraisal Committee to be constituted: Chief Inspector + not more than 14 members total
  • Reviews service conditions of employees in factories involving hazardous processes
  • Specific responsibilities of occupier in relation to hazardous processes
  • Workers' participation in safety management
  • List of hazardous industries: 1st Schedule of the Act


The Employees' State Insurance (ESI) Act, 1948 - SPM Notes (Park's Textbook)

(Park's Textbook of Preventive and Social Medicine, pp. 919-921)

Background

  • Passed in 1948; amended in 1975, 1984, 1989, 2010, and 2019
  • Important measure of social security and health insurance
  • Provides cash and medical benefits in case of sickness, maternity, and employment injury
  • First introduced the principle of contribution by both employer and employee in India

SCOPE

Originally covered: All power-using factories (excluding seasonal factories, mines, railways, defence establishments) employing 10 or more persons
Extended to:
  • Small factories employing 10 or more persons (whether or not power is used)
  • Shops
  • Hotels and restaurants
  • Cinemas and theatres
  • Road-motor transport establishments
  • Newspaper establishments
  • Private medical and educational institutions employing 20 or more persons (in some states)
Wage limit for coverage:
  • From 1.5.2010: employees getting up to Rs. 15,000/month
  • Revised to Rs. 21,000/month (w.e.f. 6.9.2016)

ADMINISTRATION

  • Entrusted to an autonomous body: ESI Corporation (ESIC)
  • Chairman: Union Minister for Labour
  • Vice-Chairman: Secretary, Ministry of Labour, Govt. of India
  • Members: Central & State Governments, employers, employees' organizations, medical profession, Parliament
  • Standing Committee acts as executive body
  • Chief Executive Officer: Director General, assisted by 4 Principal Officers:
    1. Insurance Commissioner
    2. Medical Commissioner
    3. Financial Commissioner
    4. Actuary
  • Medical Benefit Council headed by Director General of Health Services, GOI
Infrastructure (as of 31.3.2020):
  • 1526 ESI dispensaries
  • 1753+ panel clinics
  • 307 diagnostic centres
  • 159 ESI hospitals + 42 hospital annexes
  • 22,600 beds
  • 559 branch offices, 185 cash offices

FINANCE

ContributorRate
Employer3.25% of total wage bill
Employee0.75% of wages
State Government1/8 of total cost of medical care
ESI Corporation7/8 of total cost of medical care
  • (Revised rates w.e.f. 1.7.2019)
  • Employees getting daily wages below Rs. 176 are exempted from employee contribution

BENEFITS TO EMPLOYEES (7 Benefits)

1. Medical Benefit

  • Full medical care (including hospitalization) - free of cost - in sickness, employment injury, and maternity
  • Services include:
    • Out-patient care
    • Supply of drugs and dressings
    • Specialist services (all branches)
    • Pathological and radiological investigations
    • Domiciliary services
    • Antenatal, natal, postnatal services
    • Immunization and family planning services
    • Emergency and ambulance services
    • Health education
    • In-patient treatment
  • Delivered via direct pattern (ESI dispensaries/hospitals) or indirect/panel system (Insurance Medical Practitioners)
  • Also extended to family members of workers (restricted or expanded medical care)

2. Sickness Benefit

  • Cash payment for duly certified sickness
  • Payable for a maximum of 91 days in any continuous period of 365 days
  • Daily rate: approximately 70% of average daily wages
  • Worker protected from dismissal/discharge during sickness period
Extended Sickness Benefit:
  • For 34 specified long-term diseases (e.g., TB, leprosy, AIDS, malignancies, COPD, cirrhosis, renal failure, schizophrenia, etc.)
  • Requires 2 years' continuous employment
  • Extended up to 2 years
Enhanced Sickness Benefit (sterilization):
  • For tubectomy (women): 14 days at double standard rate (full wages)
  • For vasectomy (male IPs): 7 days at double standard rate

3. Maternity Benefit

  • Cash payment at approximately full wages
  • Confinement: 26 weeks
  • Miscarriage: 6 weeks
  • Sickness arising out of confinement: 30 days
  • Confinement expenses: Rs. 7,500 per confinement

4. Disablement Benefit

  • Cash payment + free medical treatment for employment injury / occupational disease
  • Temporary disablement: ~90% of wages for duration of disablement
  • Total permanent disablement: Life pension based on loss of earning capacity (determined by medical board)
  • Partial permanent disablement: Proportionate life pension

5. Dependant's Benefit

  • In case of death due to employment injury, dependants receive periodic payments
  • Rate: 90% of wages shared by dependants in fixed ratio
  • Eligible son/daughter: benefit up to age 18 (withdrawn on daughter's marriage if earlier)

6. Funeral Expenses

  • Cash payment towards funeral expenses of insured person
  • Amount: not exceeding Rs. 15,000/-

7. Rehabilitation Allowance

  • On monthly payment of Rs. 10, insured person and family continue to get medical treatment after:
    • Permanent disablement, or
    • Retirement

BENEFITS TO EMPLOYERS

  1. Exemption from Workmen's Compensation Act, 1923
  2. Exemption from Maternity Benefit Act, 1961
  3. Exemption from providing/paying for medical care of employees and dependants
  4. Rebate under Income Tax Act on contribution deposited in ESI Account
  5. Healthy workforce

RAJIV GANDHI SHRAMIK KALYAN YOJNA (w.e.f. 1st April, 2005)

  • Scheme for unemployed workers covered under ESI
  • Covers involuntary unemployment due to retrenchment/closure of factory
  • Eligibility: Insurable employment for 5 or more years with contributions
  • Unemployment allowance: Maximum 6 months during entire service (in one spell or multiple spells of ≥1 month)

Coverage (as of 31.3.2020)

  • 309 lakh employees covered (including 62.6 lakh women)
  • Total beneficiaries: ~1324 lakhs
  • Covers ~7.83 lakh factories/establishments in 34 States/Union Territories

Source: Park's Textbook of Preventive and Social Medicine, 26th edition, pp. 919-921

Lead poisoning -Spm from park textbook

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LEAD POISONING - SPM Notes (Park's Textbook)

(Park's Textbook of Preventive and Social Medicine, p. 911)

Introduction

  • More industrial workers are exposed to lead than to any other toxic metal
  • Properties of lead that make it widely used:
    1. Low boiling point
    2. Mixes with other metals easily to form alloys
    3. Easily oxidised
    4. Anticorrosive
  • All lead compounds are toxic
    • Most dangerous: lead arsenate, lead oxide, lead carbonate
    • Least toxic: lead sulphide

Industrial Uses

  • Over 200 industries use lead, including:
    • Manufacture of storage batteries
    • Glass manufacture
    • Ship building
    • Printing and potteries
    • Rubber industry, and several others

Non-Occupational (Environmental) Sources

  • Greatest source: Gasoline (thousands of tons of lead exhausted from automobiles every year)
  • Lead is one of the few trace metals abundantly present in the environment
  • Other sources:
    • Drinking water from lead pipes
    • Children chewing lead paint on window sills or toys

Mode of Absorption (3 Routes)

RouteDetails
1. InhalationMost common route in industrial lead poisoning - inhalation of fumes and dust of lead or its compounds
2. IngestionLess common; small quantities trapped in upper respiratory tract may be swallowed; also via contaminated hands touching food/drink
3. SkinOnly for organic compounds (especially tetraethyl lead); inorganic compounds are NOT absorbed through skin

Body Stores & Distribution

  • Body store of lead in average adult: 150-400 mg
  • Normal blood level: ~25 μg/100 ml
  • Blood level of 70 μg/100 ml is associated with clinical symptoms
  • Normal daily ingestion: 0.2-0.3 mg/day (from food and beverages)

Distribution in Body:

  • 90% of ingested lead is excreted in faeces
  • Absorbed lead enters circulation → 95% enters erythrocytes
  • Transported to liver and kidneys → finally deposited in bones (laid down with other minerals)
  • Bone lead is 'metabolically inactive' but may be released under conditions of bone resorption

Mechanism of Toxicity:

  • Combines with essential -SH (sulphydryl) groups of certain enzymes
  • Particularly those involved in porphyrin synthesis and carbohydrate metabolism
  • Effect on membrane permeability - potassium leakage demonstrated from erythrocytes exposed to lead

Clinical Picture (Plumbism)

Inorganic Lead Poisoning:

  • Abdominal colic
  • Obstinate constipation
  • Loss of appetite
  • Blue line on gums (Burton's line - classic sign)
  • Stippling of red cells (basophilic stippling)
  • Anaemia
  • Wrist drop and foot drop (peripheral neuropathy)

Organic Lead Poisoning (e.g., tetraethyl lead):

  • Toxic effects mostly on CNS:
    • Insomnia
    • Headache
    • Mental confusion
    • Delirium

Diagnosis

Diagnosis is based on:

1. History

  • History of lead exposure

2. Clinical Features

  • Loss of appetite, intestinal colic, persistent headache, weakness, abdominal cramps, constipation, joint and muscular pains, blue line on gums, anaemia

3. Laboratory Tests

TestNormal ValueSignificance
(a) Coproporphyrin in urine (CPU)<150 μg/litre in non-exposedUseful screening test
(b) Amino levulinic acid in urine (ALAU)-Exceeds 5 mg/litre = clear lead absorption; >10 mg/litre = significant
(c) Lead in bloodNormal: ~25 μg/100 ml≥70 μg/100 ml = clinical symptoms
(c) Lead in urineNormal: 0.2-0.8 mg/litre>0.8 mg/litre = lead exposure and absorption
(d) Basophilic stippling of RBC-Sensitive parameter of haematological response

Preventive Measures (9 Points)

  1. Substitution - Replace lead compounds with less toxic materials wherever possible
  2. Isolation - All processes generating harmful concentrations of lead dust or fumes should be enclosed and segregated
  3. Local exhaust ventilation - Adequate system to remove fumes and dust promptly
  4. Personal protection - Workers protected by approved respirators
  5. Good housekeeping - Floors, benches, machines kept clean by wet sweeping (not dry, to avoid re-suspension of dust)
  6. Working atmosphere - Lead concentration kept below 2.0 mg per 10 cubic metres of air (permissible limit/threshold value)
  7. Periodic medical examination - All workers must undergo:
    • Urinary lead estimation
    • Blood lead estimation
    • Red cell count
    • Haemoglobin estimation
    • Coproporphyrin test (urine)
    • Basophilic stippling estimation
    • (WHO Expert Committee: not only the average blood lead level matters, but also the number of subjects whose blood level exceeds 70 μg/ml or ALA in urine exceeds 10 mg/litre)
  8. Personal hygiene - Handwashing before eating; adequate washing facilities; prohibition on taking food in work places
  9. Health education - Workers educated on risks and personal protection measures

Management

Major objectives:
  1. Prevention of further absorption
  2. Removal of lead from soft tissues
  3. Prevention of recurrence
Steps:
  • Early recognition → remove worker from further exposure
  • Saline purge to remove unabsorbed lead from the gut
  • D-penicillamine (chelating agent) - promotes lead excretion in urine
  • Ca-EDTA (chelating agent) - promotes lead excretion in urine

Important Legal Point

  • Lead poisoning is a notifiable and compensatable disease in India since 1924

Source: Park's Textbook of Preventive and Social Medicine, 26th edition, p. 911
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