Occupational Health: Importance and Strategies
Jun 18, 2024

Occupational health aims to promote and maintain the highest level of occupational physical, mental, and social well-being of workers. The occupational environment compromises external conditions that prevail and affect the health of the worker. There are three types of interaction in the occupational environment.
- Man with physical, chemical, and biological agents.
- Man with a machine.
- Man with man.

Classification Of Occupational Hazards
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Diseases Due to Physical Agents/Physical Hazards |
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Chemical hazards (inhalation of gases) |
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Biological hazards (Animal products, Agricultural sector) |
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Mechanical hazards |
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Occupational cancer |
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Occupational dermatosis |
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Psychological hazards |
Let us begin by discussing each of these in detail, as occupational health is an important topic for NEET-PG, INI-CET, and FMGEexamination.
1. Heat hazards
It is mainly seen among soldiers, security guards, and field workers.
| Heat stroke | The heat regulating mechanism fails when the body is exposed to 108-110 ℉. It can be treated by rapid cooling. |
| Heat hyperpyrexia | The impairment of the heat-regulating mechanism occurs when the body is exposed to 104-106 ℉. It can be treated by rapid cooling. |
| Heat exhaustion | Water-salt imbalance causes water loss, which leads to dehydration. It occurs when the body is exposed to less than 102 ℉ |
| Heat cramps | It occurs due to excessive salt loss - and can be fixed by rehydration. |
| Heat syncope | Vasodilation and pooling of blood in lower limbs with inadequate cardiac filling. |

2. Cold injuries
Trench foot Immersion of the foot in very cold water or ice– leads to vasospasm leading to swelling of legs Frost bite Crystallization of body fluids in extremities
- Treatment – Rewarm the body parts at 40 - 42℃ for 15-20 mins.
3. Pneumoconiosis
- It occurs due to inhalation of dust particles.
- The most dangerous size is 0.5-3 microns, as it goes to the lower respiratory tract, causing maximum damage.
- Causes- Restrictive lung diseases
- Pathogenesis of pneumoconiosis:
- Prolonged dust exposure causes a local inflammatory reaction in the lung parenchyma.
- This leads to fibrosis, which causes restrictive lung diseases.
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Particle Size And Behavior
The behavior of the particle is decided by the particle size. The biggest particles are usually >10 microns, and they will be settled by themselves. The very small particle will show Brownian movement. It is the middle-sized particles that are notorious and will actually cause different issues.
| Particle size | Behavior |
| >10 micron | Settle down by gravity |
| 5-10 micron | Arrested in the Upper Respiratory Tract |
| 3-5 micron | Deposited in Mid-Respiratory Tract |
| 1-3 micron | Enter Alveoli and settle there |
| <1 micron | Brownian movement |
Types of Pneumoconiosis
Pneumoconiosis Dust particle (Inorganic Mineral Dust) Asbestos Asbestos fibers (Cement factory, fireproof industry, construction, airplanes) Anthracosis Coal dust (coal dust) Aluminosis Aluminium Silicosis Silica dust (Sandstone industry, granite industry. Pottery industry, ceramic industry, gold, mica, steel industry, glass factory, building and construction work, rock mining) Siderosis Iron (Iron mines, Iron, and steel industry) Baritosis Barium (Photography, printing, barium diagnostic works) Lithosis Stone Industry Pneumoconiosis Organic or soluble dust Byssinosis Cotton dust (textile industry) Bagassosis Sugar cane dust (Cane sugar factories, paper and cardboard factories) Tobaccosis Tobacco Farmer’s Lung Moldy hay/ grain dust (Agricultural industry) Bird Fancier Lung Bird droppings
Also Read: Water: Sources, Diseases and Quality
Factors Influencing Pneumoconiosis
There are many factors that influence pneumoconiosis. They are:
- Composition of dust
- Concentration of dust
- Size of the dust particle
- Duration of exposure
- Individual susceptibility
X-ray Changes In Pneumoconiosis
It is very important to understand the x-ray changes as they help us to diagnose the type of pneumoconiosis:
- Ground glass — seen in Asbestosis
- Black lung – Anthracosis
- Mottling — Bagassosis
- Fine nodular opacity – Farmer’s lung
- Snowstorm — Silicosis
- SILICOSIS
- Discovered in India in Kolar mines.
- Inhalation of silica dust
- Components of silica dust–free silica or silicon dioxide
| Occupation | Sandblasting, Pottery, etc. |
| Time To Develop | A few months to 6 years for development |
| Diagnosis | Snowstorm appearance X-ray |
| The portion of Lung Affected | The upper part of the lung |
| Fibrosis | Dense Nodular fibrosis |
Clinical Symptoms
- First stage – Mild dyspnea on exertion, unproductive cough.
- Second stage – Marked dyspnea impaired patient's ability to work
- Third stage– Patient incapacitated with signs of right heart failure
- Silicosis is a notifiable disease under the Factories Act.
- Those who are occupationally exposed to silica dust have a chance of developing the disease of silico-tuberculosis.
- Sputum will not show AFB bacilli
- Postmortem will not show the presence of bacilli
- Treatment – No treatment
- ASBESTOSIS
| Exposure | Asbestos fiber |
| Occupation | Cement industry |
| Time To Develop | 5-10 years of exposure |
| Diagnosis | X-ray shows ground glass appearanceSputum contains asbestos bodies (Asbestos fiber-coated fibroid) |
| The portion of the lung affected | The basal portion of the lung field |
| Fibrosis | Diffuse Fibrosis |
| Notifiable disease | Yes |
- Asbestos fibers are of two types:
- Serpentine or chrysolite variety, which is hydrated magnesium silicate. It is the most commonly implicated form – 95%: curly fibers
- Amphibole variety — dangerous form - needle-like – less magnesium silicate
| Most common manifestation | Plural plaques (thickening and calcification of parietal pleura) |
| The most common site of calcification | Along lower lung fields, diaphragm and cardiac border |
| Diseases caused | Asbestos may lead to pulmonary fibrosis, carcinoma of the bronchus, mesothelioma of the peritoneum, and cancer of the GIT |
| Most specific manifestation | Mesothelioma |
| Most common presentation | Adenocarcinoma of lungs |
| Symptoms | Dyspnea, Clubbing of fingers, cardiac distress and cyanosis, respiratory failure |
| Treatment | Symptomatic management — Anti-asthmatic given. Lung transplant |
Also Read: Asha: Accessibility, Functions, Obligations, Compensation, Benefits And Facilitators of Asha
Difference Between Silicosis and Asbestosis
These two topics have always confused young doctors. This table will help you learn some facts that would be really important for last-minute revision for NEET PG/ FMGE and INI-CET.
| Basis of difference | Silicosis | Asbestosis |
| Cause | Silica dust | Asbestos fibers |
| The Portion Of the Lung Affected | The upper part of the lung | The basal part of the lung |
| X-Ray Appearance | Snowstorm appearance | Ground glass appearance |
| Fibrosis | Nodular fibrosis | Diffused fibrosis |
| Disease | Alveolitis | Bronchiolitis |
| Malignancy | Not pre-malignant | More malignant |
| Disease | Silico TB | Cancers and mesothelioma |
- Bagassosis
- Caused by Inhalation of sugar cane fibers, Cardboard industry, and paper industry
- Infested by a fungus known as Thermoactinomyces sacchari.
- Reported in India by Ganguly and Pal
- X-ray findings: Mottling of lung fields
- Bagasse control: Keep the moisture content more than 20% and also spray the bagasse with 2% propionic acid.
- Byssinosis
- Caused: Inhalation of cotton fibers
- It is mostly seen in the jute and textile industry
- It predominantly affects the lower part of the lungs.
- Farmer’s Lung
- Cause: inhalation of moldy hay /grain dust
- Infested by fungus – Thermophilic actinomycetes / Micropolyspora faeni
- Occurs when the moisture content has been kept more than 30%
- Caplan’s syndrome
- Combination of rheumatoid arthritis and pneumoconiosis with intrapulmonary nodules
- Miners working in mines, asbestosis, silicosis.
- Also associated with genetic predisposition and smoking
4. Lead Poisoning
- The most common route of infection in adults is Inhalation
- The most common route in children is ingestion.
- Other names: Plumbism, Saturnism, Painter’s colic
- Sources :
| Industrial | Non-industrial |
| Manufacturing storage batteries, printing, paint, shipbuilding, lead pipes, dyes, glass manufacture, potteries | Gasoline from automobile exhaust (most common), drinking water through lead pipes, ingestion of led paints from wooden toys by children |

- The Burtonian line indicates chronic lead poisoning.
- Deposition of lead sulfite on the gums
Also Read: Prevention Strategies: Levels of Prevention
Screening And Diagnose The Lead Poisoning
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Coproporphyrin levels in Urine (CPU) |
Shows Lead exposure
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Aminolaevulinic acid in Urine (ALA) |
More reliable – More specific and sensitivity
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Lead in Urine |
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Confirmatory test |
Lead Levels in Blood
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Treatment of Lead Poisoning
Treatment is done using Chelating agents like:
- EDTA
- D- Penicillamine
- Dimercaprol
5. Metal Fume Fever
- It is a Temporary occupational disease
- Due to the Inhalation of fresh metallic oxide fumes of zinc and magnesium
- Clinical Features may include:
- Fever
- Sweating
- Chills
- Dryness of throat
- Cough
- Breathlessness
- Does not cause permanent changes, and recovery takes place within 24 hours
- People at risk: Metal welders, galvanizing, heavy metal molting factories
6. Occupation- Related Cancers
- The most common cancer related to occupation is Skin cancer (Squamous cell carcinoma)
- Bladder cancer –
- Exposure to dyes – ?- naphthylamine, Auramine and magenta dyes, and Benzidine
- Benzidine leads to leukemia.
- The most common presentation is hematuria.
| TYPES OF CARCINOMA | PREDISPOSING OCCUPATIONAL EXPOSURE |
| Lung carcinoma | Arsenic, beryllium, cadmium, chromium, asbestosis, silica, radon, nickel, aromatic hydrocarbons |
| Liver carcinoma | Vinyl chloride, arsenic |
| Bladder carcinoma | Benzidine, auramine, beta naphthylamine, paramino-diphenyl, magenta |
| Leukemia carcinoma | Benzene, ethylene oxide, Roentgen rays, and radioactive substances |
| Skin carcinoma | Arsenic, ionizing radiations, polycyclic aromatic hydrocarbons |
| Scrotum carcinoma | Polycyclic aromatic hydrocarbons (chimney sweepers cancer, mule spinners cancer) |
Also Read: Entomology: Mosquitoes, Flies, Louse, Flea
Prevention of Occupational Diseases
Since these occupations cause a great deal of diseases, including cancers, they must be prevented at all costs.
| Ergonomics | Application of psychological, medical, and engineering principles for making the workplace more suitable for enhancing the proficiency of workers and maintenance of the health of workers (putting the right man in the right job) |
| Emporiatrics | Application Of psychological and medical understanding for protecting health and preventing disease in people with different external environments due to more than usual long-distance traveling. |
| Medical | Engineering | Legislative |
| Pre-placement examination | User-friendly machine | Factories act — implementation |
| Post-placement examination | Ventilation should be adequate | ESI Act |
| Notification of disease (Bagassosis is not notifiable) | Housekeeping should be proper | |
| Maintaining health records | Protective equipment availability |
Sickness Absenteeism
- It is a way to measure the overall health state of workers
- Sickness Absenteeism Rate
SAR= Total number of workers remaining absent in a year/ total worker x 100
- High SAR indicates low occupational health.
- Rate of sickness absenteeism in India = 8-10 days/person/year
- Causes
- Medical
- Social
- Economic
Pre-Placement vs. Post-Placement Examination
There are some pre-placement and post-placement examinations that must be done before and after hiring an employee. This is done to ensure a perfect work environment and to prolong the employment.
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PRE-PLACEMENT |
POST-PLACEMENT |
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Before the person is employed
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After the person is employed
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The primary level of prevention |
The Secondary level of prevention |
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Done only once |
Done periodically.
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We hope that this blog will give you a better understanding of all the health disorders, including cancers, that might happen if the job environment is not regulated.
Also Read: Important MCQs on National Health Programs
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Classification Of Occupational Hazards
1. Heat hazards
2. Cold injuries
3. Pneumoconiosis
Particle Size And Behavior
Types of Pneumoconiosis
Factors Influencing Pneumoconiosis
X-ray Changes In Pneumoconiosis
Clinical Symptoms
Difference Between Silicosis and Asbestosis
4. Lead Poisoning
Screening And Diagnose The Lead Poisoning
Treatment of Lead Poisoning
5. Metal Fume Fever
6. Occupation- Related Cancers
Prevention of Occupational Diseases
Sickness Absenteeism
Pre-Placement vs. Post-Placement Examination
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