Occupational and Work-related Diseases - Workplace Safety and …bedoksafetygroup.wsh.sg/attachments/articles/Occupational... · 2010-11-30 · Work-related musculoskeletal disorders

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Occupational and Work-related Diseases

Dr. Lim J WMB Bch (UK), MPH (Singapore)

Centre for Environmental and Occupational HealthCentre for Environmental and Occupational Health Research (CEOHR)

Department of Epidemiology and Public HealthNational University of Singapore

21 October 2010

Presentation Outline:1. Introduction2. Definitions of occupational and work-2. Definitions of occupational and work

related diseases3. Statistics in Singapore4. Management and Prevention5. Example of Occupational disease: Skinp p6. Example of Work-related disease:

Musculoskeletal disease7. Conclusion

Bedok Safety Group Seminar on Industrial Health - 21 October 2010

Occupational and Work-Related Diseases - by Dr Lim John Wah

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Work can be GOOD for your health

Financial rewardinga c a e a d gAffords opportunities to express creativity and broaden outlookProvide avenue for social interactionSense of self worth- contribution to the society

Source: Health at work : a handbook for people who work / editors: David Koh ...[et al.].

Work can also be BAD for your health

Hazardous working conditions can cause ill health

DeafnessNoise

Dust Lung disease



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Diseases at the workplace

Definition – Occupational diseases

– Having a specific or a strong relation to occupation generally with only one causal agent

E.g. asbestos causes asbestosis

– Occur as a result to exposure to physical, chemical, biological or psychological factors in the workplace



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Characteristics of Occupational Diseases

• Usually chronic• No symptoms in early stages• Symptoms may appear at work and

disappear when away from work• Other workers may also be affected• Usually incurable but preventable

Definition – Work-related diseases

– With multiple causal agents, where factors in the work environment may play a role, together with other risk factors, in the development of such diseases, which have a complex etiology (i.e. multifactorial)

– Work may be associated with their causation or may aggravate a pre-existing condition

E.g. Hypertension, ischaemic heart disease, musculoskeletal disorders



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Definition –Diseases affecting working populations

– Without causal relationship with work butWithout causal relationship with work but which may be aggravated by occupational hazards to health

ILO List of Occupational Diseases (revised 2010)

1. Occupational diseases caused by exposure to agents arising from work activities

1 1 Ch i l1.1 Chemical1.2 Physical1.3 Biological

2. Occupational diseases by target organ systems 2.1. Respiratory diseases 2.2. Skin diseases 2.3. Musculoskeletal disorders2.4. Mental and behavioural disorders

3 Occupational cancer3. Occupational cancer 4. Other diseases

Source:http://www.ilo.org/safework/info/meetingdocs/lang--en/docName--WCMS_125137/index.htm



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In Singapore:

Source: Occupational Safety and Health Division Annual Report 2009



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Number of confirmedOccupational Diseases by typeDiseases by type,2008 and 2009



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Recognition Of Occupational Diseases

Most illnesses go unrecognized:R tiReportingLatencySimilarity to non-occupational diseaseEducation and training of doctors

Why early recognition of Occupational Diseases is important?

• Reduce morbidity (the incidence of disease )• Prevent permanent disability• Treat the cause, not just symptoms• Identify high risk workplace or work• Protect other workers at risk• Workmen’s compensation



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Management of Occupational Diseases

• Medical managementg

• Patient education

• Discussion with patient and managementp g

• Removal from exposure (if indicated)

Respiratory

Dermatologist

Multidisciplinary Input

Occupational Physician

Respiratory Physician

Rheumatologists/

Allied health‐Physiotherapist

Occupational therapist

Orthopedic surgeons

AudiologicalPhysicians

Psychiatrists



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Prevention of Occupational Diseases

• OD are caused by exposure to a specific health hazards at the workplacehealth hazards at the workplace

• OD accounts for a relatively small percentage of overall morbidity

• The exposure can be maintained at safe level

Occurrence of OD = Failure of prevention

Levels of Prevention

• Primary Prevention

• Secondary Prevention

• Tertiary Prevention



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Primary Prevention

• Aims to reduce the occurrence of a disease by eliminating the cause of thedisease by eliminating the cause of the disease or to prevent it from causing damage

Control



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Secondary Prevention

• Aims at detection of and taking corrective action in early effects of a disease before they y ymanifest clinicallyScreening for diseasePeriodic examinationStatutory medical examinations

E.g. Blood lead levelsAudiogram

Tertiary Prevention

• To minimise the consequences in persons h h l d t t d th diwho have already contracted the disease

CurativeRehabilitation

E.g.First aid after an injury- First aid after an injury

- Treatment for severe heavy metal poisoning



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Prevention of Work-related Diseases

• Work-related diseases are diseases that are multifactorialare multifactorial

• Related to presence of one or two sets of factors:

1.) Adverse workplace factors2 ) Non-occupational factors2.) Non occupational factors

Adverse Workplace Factors

• May be partially caused by adverse

E.g.Psychosomatic illness:y

working conditions• Or aggravated,

accelerated or exacerbated by adverse workplace exposure

- Psychosomatic illness:work overloadShift workRole conflict

- Locomotor disorders:exposureweight bearingtraumapoor posture



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Non-occupational Risk Factors

For example:H t iHypertension

high salt diet and poor weight controlCorrection of these will bring the pressure towards normal

Chronic non-specific respiratory diseaseChronic non specific respiratory disease aggravated by smoking ameliorated by control of dust and irritants

OCCUPATIONAL SKIN DISEASE

Contact Dermatitis (CD)

Irritant CD Allergic CDRedness, swelling and water blistersUntreated, the skin may darken and become leathery and U t eated, t e s ay da e a d beco e eat e y a d

cracked



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IRRITANT Contact Dermatitis

- When the skin contact with an “irritant”- Almost any substance can act as an irritant

Examples: acid, alkali, solvent, soap or detergent.

- Can produce a reaction on anyone's skin• the symptoms can occur within a few hours if expose to

a strong irritant=> Burning or stinging early in the early course> Burning or stinging early in the early course

• With prolonged contact, the skin becomes continually inflamed=> itching

Irritant Contact Dermatitis



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What to do?

• The mainstay of treatment: avoiding as many of the irritants as possible. y p

Other helpful measures include: • Reduce water exposure• Moisturize

P t ti• Protection

• Topical steroids

Allergic Contact Dermatitis

- Body's sensitive reaction to “something” that directly contacts the skin. - “Allergen”: Nickel, rubber, chromates, plastics, cobalt, epoxy resins, etc.

- Usually no trouble for most people- Once skin becomes allergic to the substance, any exposure will produce a rashexposure will produce a rash.



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Allergic Contact Dermatitis ToNickel

What to do?

• Avoid the allergen, and materials that cross-react with it.

• Substitute products made of materials that do not cause reactions.

Patch testing by a skin specialistPatch testing by a skin specialist can alert worker to which substances to avoid.



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Other Occupational Skin Diseases• Contact urticaria - Immediate Wheals and flares on skin

e.g.: Latex allergy – Caused by latex rubber products

Other Occupational Skin Diseases

Occupational acne • Simple acne: caused by contact with greases, oils,

creosote or coal tar pitch• Chloracne : caused by chlorinated aromatic hydrocarbons

such as dioxins, furans, possibly PCBs



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Work-related musculoskeletal disorders (WRMSD)

• When a muscle, tendon, nerve or joint is stressed and traumatized on a repeated basis for days, months or years, those body tissues eventually become damaged.

Repetitive Strain InjuriesCumulative Trauma Disorders Overuse Injuries

Body parts where WRMSDs occur:

Also affect the low back, knees, ankles and feet.



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Symptoms of WRMSD

1. Pains and aches2. Numbness or tingling 3. Swelling, as tissues become irritated3. Stiffness and loss of range of motion of

surrounding joints4. Inability to work and function at home

What Factors May Contribute To WRMSD?

Physical factors Organisational and h i l f t

Force applicationRepetition of movementsAwkward and static posturesLocal compression of tools and surfacesVibrationCold or excessive heat

psychosocial factors

Demanding work, lack of control over the tasks performed,and low levels of autonomyLow levels of job satisfactionRepetitive, monotonous work, at a

high paceL k f t f llLack of support from colleagues,

supervisors and managersIndividual factors

Prior medical historyPhysical capacity AgeObesitySmoking



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WRMSDs are a problem for pemployers as well as workers

Workers with WRMSDs tend to h d d d ti ithave reduced productivity and increased absenteeism

How to treat WRMSD?

• A combination of approaches:Use of medication for pain reliefUse of medication for pain reliefApplication of heat or coldServices of health professionals, such asphysiotherapists or occupational therapistsSurgeryExercise programExercise programJob modifications/More frequent break

Make sure your doctor has a description of your job and understands how your job affects your body.



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BUT, most effective way…

Ergonomics in the work place:Fitting the task, tools, materials and equipment in the workplace to the worker

WMSDs are preventable instead of treatable

Adjustable seating

AngledAngled hand tools

Work pace



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Working with the arms above shoulder height increases the risk of developing shoulder injuries.Awkward postures can be reduced by raising the worker on a platform and/or lowering the work piece.

By supporting the weight of the tool and reducing overhead work, the risk of shoulder injury is reduced.



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Conclusion

• Occupational and work-related diseasesOccupational and work related diseases can be prevented

• Early diagnosis is essential• Identify and assess health hazards• Implement measures to eliminate hazards p

and protect workers

Th k YTh k YThank You Thank You For For

Your AttentionYour AttentionYour AttentionYour Attention



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Occupational and Work-related Diseases - Workplace Safety and …bedoksafetygroup.wsh.sg/attachments/articles/Occupational... · 2010-11-30 · Work-related musculoskeletal disorders