Prevention and Control Measures of Occupational Health Hazards

GENERAL MEASURES FOR HEALTH PROTECTION OF WORKERS

1. Nutrition

• Malnutrition is an important factor contributing to poor health and low work output in developing countries
• It can also affect the metabolism of toxic agents and tolerance mechanisms
• Under the Indian Factories Act, canteens are mandatory in establishments with more than 250 employees
• Aim: provide balanced diets at reasonable cost under sanitary control
• Food brought from home should be stored in a safe, uncontaminated place; a separate area from the workroom should be available for meals

2. Communicable Disease Control

• Industry provides an excellent opportunity for early diagnosis, treatment, prevention, and rehabilitation
• Goal: detect cases of communicable disease and render them non-infectious by treatment or removal from the working environment
• Important diseases in India: tuberculosis, typhoid fever, viral hepatitis, amoebiasis, intestinal parasites, malaria, and STDs
• An adequate immunization programme against preventable communicable diseases is essential
• Occupational communicable diseases (anthrax, undulant fever, Q fever) require special sanitary measures in handling working materials

3. Environmental Sanitation

• (1) Water Supply: Sufficient wholesome drinking water must be available; common glass tumblers for drinking should be abandoned (spreads infection); water fountains at convenient points should be encouraged
• (2) Food: Sanitary preparation, storage, and handling are essential; education of food handlers to prevent gastro-intestinal outbreaks
• (3) Toilets: Sufficient latrines and urinals of sanitary type, separate for males and females; at least 1 sanitary convenience per 25 employees (first 100 employees), then 1 per every 50; proper garbage and waste disposal to avoid fly breeding
• (4) General Plant Cleanliness: Walls, ceilings, passages should be painted with water-washable paint and repainted at least once in 3 years, washed at least once in 6 months; dust on floors/machinery should be removed by vacuum cleaners or wetting agents; high standard of cleanliness is fundamental for accident prevention
• (5) Sufficient Space: Minimum 500 cu.ft. of space per worker (space above 14 ft not counted); prevents respiratory infections and ensures comfortable working environment
• (6) Lighting: Sufficient and suitable lighting (natural, artificial, or both) is required; precision work requires 50-75 foot candles; general work areas require 6-12 foot candles; poor illumination causes eye fatigue, accidents, decreased production, and permanent impairment of vision
• (7) Ventilation: Ventilating openings of 5 sq.ft per worker; rooms where dust is generated must have efficient exhaust ventilation; controls airborne hazards

4. Medical Care

• Occupational health service should provide diagnostic, curative, and rehabilitative services including first-aid and emergency treatment
• A referral system to specialist services and hospitals is important
• Workers returning from medical leave should be specially assessed for fitness

5. Special Protection for Women Workers

• Maternity leave: 26 weeks (up to 8 weeks before confinement); after 2 children, 12 weeks
• Free antenatal, natal, and postnatal services
• Factories Act (Section 66): prohibits night work (7 pm - 6 am)
• Section 34: prohibits carrying excessive weights
• Mines Act (1923): prohibits work underground for women
• Maternity Benefit Act, 2017: mandates creches where 50+ women workers are employed

6. Health Education

• Should be envisaged at all levels: management, supervisory staff, workers, trade union leaders, and community
• Content: personal hygiene, protection, and participation in planning the health service programme

7. Family Planning

• Recognized as a decisive factor for quality of life; workers are encouraged to adopt the small family norm

A. MEDICAL MEASURES

1. Pre-placement Examination

• Foundation of an efficient occupational health service
• Done at time of employment; includes medical, family, occupational, and social history; thorough physical examination; chest X-ray, ECG, vision testing, urine/blood examination, and special tests for endemic diseases
• Purpose: "place the right man in the right job" (ergonomics) so the worker performs duties without detriment to health
• A fresh recruit may be totally rejected or assigned a job suited to their abilities
• Pre-placement examination serves as a useful benchmark for future comparison

2. Periodical Examination

• Many occupational diseases take months or years to develop and are not recognized early
• Frequency depends on the type of occupational exposure
• Ordinarily: once a year
• Lead, toxic dyes, radium exposures: monthly examinations
• Irritant chemicals like dichromates: daily examination may be needed
• May be supplemented by biological and radiological examinations
• Special care for workers returning from medical leave

3. Treatment

• Early and adequate treatment prevents full development of occupational disease
• First-aid treatment is essential and should be available within the factory

4. Biological Monitoring

• Monitor body burdens of toxic substances (e.g., blood lead levels, urinary metabolites)
• Helps detect subclinical exposure before overt disease develops

5. Rehabilitation

• Physical, mental, and vocational rehabilitation for workers with occupational disabilities
• Redeployment to alternative suitable work if the original job is no longer safe

6. Record Keeping

• Worker's health record and occupational disability record must be maintained
• Review enables: watching over workers' health, assessing hazards, and devising/improving preventive measures

7. Health Education and Counselling

• Ideally should start before the worker enters the factory
• Workers should be educated on:
  • All risks involved in their industry
  • Measures for personal protection
  • Correct use of protective devices (masks, gloves)
  • Simple hygiene rules (handwashing, nail paring, cleanliness)
• Reminders through charts, posters, and hand bills
• Purpose: assist workers in adjusting to the working, home, and community environment

B. ENGINEERING MEASURES

1. Design of Building

• Prevention of occupational diseases should commence at the blue-print stage
• Type of floor, walls, height, ceiling, roof, doors, windows, and cubic space should be planned by the industrial architect
• Alterations after construction are difficult and expensive

2. Good House-keeping

• Covers general cleanliness, ventilation, lighting, washing facilities, food arrangements, and general maintenance
• Fundamental requirement for control or elimination of occupational hazards
• Walls and ceilings: white-washed at least once a year
• Dust on floors, ledges, beams, machinery removed by vacuum cleaners or wetting agents
• Protective equipment (masks, gloves, aprons) kept clean and in good repair
• Outside of the plant should also be kept clean

3. General Ventilation

• Ventilating openings at 5 sq.ft per worker
• Rooms where dust is generated: efficient exhaust ventilation system
• Indian Factories Act: minimum 500 cu.ft of air space per worker

4. Mechanization

• Replacing manual operations with machines reduces direct worker exposure to toxic agents and hazardous processes
• Reduces risk of injuries and chemical exposure

5. Substitution

• Replacing a dangerous substance with a safer alternative (e.g., substituting a toxic solvent with a non-toxic one)
• One of the most effective methods of hazard control

6. Isolation / Enclosure

• Isolating dangerous processes from the general work environment
• Enclosing toxic processes so that contamination is contained

7. Local Exhaust Ventilation (LEV)

• Extracting toxic dusts, fumes, and gases at the point of origin before they can contaminate the workroom air
• Used for grinding, welding, polishing operations

8. Wet Methods

• Using water to suppress dust (e.g., wet drilling in mines, wet grinding)
• Prevents dust from becoming airborne

9. Personal Protective Equipment (PPE)

• Used when engineering controls are insufficient
• Includes: dust respirators, gas masks, protective clothing (overalls, aprons), gloves, eye protectors, ear plugs/ear muffs, safety helmets, safety footwear
• PPE is the last line of defense - not a substitute for engineering controls

C. STATUTORY (LEGISLATIVE) MEASURES

The Factories Act, 1948 (Amended 1987)

• Defines factory as an establishment employing 10+ workers (with power) or 20+ workers (without power)
• Key provisions:
  • Chapter III, IV, IVA, V: Health, Safety, and Welfare
  • Cleanliness, lighting, ventilation, treatment of wastes
  • Minimum 500 cu.ft space per worker
  • Precautions for dangerous fumes, explosive/inflammable substances
  • Casing of machinery; devices for cutting off power; hoists and lifts
  • Protection of eyes

The Employees' State Insurance (ESI) Act, 1948

• Provides medical care, sickness benefits, maternity benefits, disability benefits
• Unemployment allowance (Rajiv Gandhi Shramik Kalyan Yojana)

Other Important Acts:

• The Mines Act: protection specific to mining industry; prohibits underground work for women
• The Plantation Act: occupational health provisions for plantation workers
• The Minimum Wages Act: ensures economic security for workers
• The Maternity Benefit Act, 2017: maternity leave of 26 weeks, creche facilities
• Child Labour (Prohibition and Regulation) Amendment Rules, 2017: prohibits employment of children under 14 in factories, mines, or hazardous work (Article 24, Indian Constitution)

National Programme for Control and Treatment of Occupational Diseases

1. Prevention, control, and treatment of silicosis and silico-tuberculosis in agate industry
2. Occupational health problems of tobacco harvesters and their prevention
3. Hazardous process documentation and database generation

Summary Framework (for exam purposes)

Park's Textbook of Preventive and Social Medicine, Chapter on Occupational Health - "PREVENTION OF OCCUPATIONAL DISEASES" section, pp. 915-917