Occupational diseases dr usama

transcript

Dr. Osama Zeinalabidin

Master/Occupational Diseases

17/07/2011 2Occupational Health

1. Silicosis

It is the major cause of permanent disability and mortality

Caused by inhalation of Silicon Dioxide (SiO2) Found among construction workers, foundries .. The particles are ingested by the phagocytes,

accumulate and block the lymph channels Pathologically characterized by a dense nodular

fibrosis 3x4 mm

cont. silicosis

Onset insidious Early manifestations:

Irritant cough Dyspnoea on exertion and, Chest pain

Advanced cases Impairment of total lung capacity (TLC)

X-Ray shows “snow-storm) Prone to tuberculosis (silicotuberculosis) No effective treatment

2. Anthracosis

Disease of coal miners 1st phase after 12 years exposure (simple

pneumoconiosis) 2nd phase progressive massive fibrosis (PMF) The risk of death among coal miners is twice

that of general population

3. Byssinosis

It is due to inhalation of cotton fiber dust over > 10 years

Symptoms: Chronic cough Progressive Dyspnoea Ending in chronic bronchitis Affects about 10% of spinning workers Characterized by Monday syndrome

4. Bagassosis

Caused by inhalation of bagasse (sugar cane) dust

Symptoms: Cough Breathlessness Haemoptysis Untreated may lead to diffuse fibrosis,

emphysema and bronchiectasis

5. Asbestosis

Asbestos is a silica combine with magnesium, iron, calcium and aluminum

It had 2 types: Serpentine (chrysolite) 90% of used asbestos Amphibole

Asbestos fibers are of 20 -500 μ Used in roofs, pipes, break lining ….

cont. asbestos

Insoluble fibers Enters the body by inhalation and deposited in the alveoli

Asbestos is carcinogenic Appear after 5-10 years Symptoms:

Respiratory Cardiac Clubbing fingers Sputum shows asbestos bodies X-Ray shows a ground glass in the lower lung

fields

6. Farmer’s Lung

It is due to the inhalation of grain dust 30 % of moisture of grain contains bacteria

and fungi Symptoms:

Respiratory Fibrosis Corpulmonale

Lead Poisoning

Lead: Low boiling point Mixes easily with other metals Anticorrosive

Used in more than 200 industries Non-occupational sources (gasoline)

cont. lead poisoning

Mode of absorption: Inhalation (common) Ingestion (rare) Skin (only organic lead tetraethyl lead) Normal absorption 0.2 – 0.3 mg per day

Distribution in the body: 90% excreted 10% stored in the bones

Symptoms of organic lead (CNS): Insomnia Headache Mental confusion Delirium …. Etc

Organic Lead is rarely used (Gasoline)

Clinical Picture of Inorganic Lead Poisoning:Abdominal colicConstipationLoss of appetiteBlue line on the gumsAnaemiaWrist drop

Diagnosis of lead poisoning

History Clinical picture Laboratory tests: Diagnosis and treatment of lead exposure are

based on blood lead level WHO state that a blood lead level of

>10 μg/dL is a cause for concern

X ray demonstrating the characteristic

finding of lead poisoning

Preventive measures of Lead Poisoning

Substitution Isolation Local exhaust ventilation Personal protection, hygiene, health education Good housekeeping Working atmosphere (should not exceed 2.0 -10 mg

per 10 cu meters of air Periodic medical examination

1. Skin Cancers

75% of skin cancers are occupational Main causes:

Tar X-Rays Oils and dyes

2. Lung Cancers

10% of lung cancer are occupational It is a hazard in:

Gas industry Asbestos industry Radio-active substances (a large number of

industries are using radioactive substances) Arsenic and Beryllium ??

3. Cancer of bladder

Rubber industry Aromatic amines Electric cable industries Gas industries Naphthylamines ?

4. Leukaemia

Benzol (solvent)

Roentgen rays, Radioactive substances

Characteristics of Occupational Leukaemia: Appear after a long exposure (10 -15 years) The disease develop even after cessation of

exposure The average age is earlier

Occupational Hazards of Agricultural Workers

Zoonotic diseases Accidents Insecticides, fertilizers Physical hazards (heat, cold …) Respiratory diseases (farmer’s lung …) Occupational-related diseases

(Schistosomiasis, malaria …)

Accidents in industry

Human factors: Physical Psychosocial Sex (males ↑) Age (young age ↑) Time Experience Carelessness, overconfidence Slow cerebration

Environmental factors of Accidents in industry

Unsafe machines (10 -20 %) Noise Poor illumination Poor housekeeping Unsafe tools

Sickness absenteeism

It is the sick absence due to occupational diseases (10%), non-occupational diseases or other causes: Economic Social

Prevention: Good factory management Adequate pre-placement examination Good human relations Application of ergonomics

17/07/2011 Occupational Health 27

Diseases/disorders due to biological hazards

= Diseases related to occup. caused by living organisms: Brucellosis, Leptospirosis, Anthrax, Tetanus RVF Wild animal, snakes, scorpions .. etc.

Heat Hyperpyrexia (Heat stroke):

Severe and sometimes fatal condition

Due to failure of the body to regulate temperature.

Caused by prolonged exposure to the sun or to high temperatures..

Symptoms of Health Stroke

Lessening or lack of sweating

Body temperature of 105 F or higher,

Fast pulse rate,

Hot and dry skin, >>

Heat Exhaustion:

Weakness, muscle cramps, fainting. Caused by ↓ levels of body fluid & salts Temperature is nearly normal Skin cool, and pale Recovers with rest, replacement of

water and salt.

Prickly heat

Blisters and pimples, often red.

Caused by blockage of sweat ducts

Frost bite: Narrowing and damage to blood vessels

Results in oxygen starvation and

Tissue death.

Occupational cataract.

Miner’s nystagmus.

PressureCaisson disease: Caused by nitrogen bubbles forming in the

body tissue.

Affects deep-sea divers and aviators,

Caused by moving too quickly from different levels of pressure

Disorientation, severe pain, and fainting

Occupational deafness

Vibration

White fingers

Arthritis

Ultraviolet

Conjunctivitis

Keratitis (Welder’s flash).

Ionizing radiation Genetic changes

Cancer (Leukemia)

Sterility

Aplastic anaemia

Electricity

Burns,

Electrical shocks

Types of Occupational Accidents disorders

1. Injuries due to falls, cuts, abrasions …..

2. Ergonomic Disorders (Muscular-skeletal)

Ergonomic disorders

Ergonomics

Ergonomics: Adjustment of Man & Machine”

Ergo-friendly tools: Tools which reduce the stresses or problems resulting work

Causes of accidents

Human factors: Inadequate visual or hearing acuity Use of drugs and alcohol Carelessness .. Fatalism Poor training Overconfidence Working hours

cont. causes of accidents

2. Environmental factors: Noise Poor light

Factors Leading to Psychosocial hazards

Lack of job satisfaction Insecurity Poor interpersonal relations Work pressure Poor management Poor incentives

Psychological & behavioural changes

Hostility, Aggressiveness, Anxiety, Depression, Addiction Sickness absenteeism.

Organic disorders

Hypertension, headache, body-ache, peptic ulcers, asthma, diabetes, heart disorders, etc.

Occupational dermatitis1. 75% of occup. cancers are skin cancers,

mainly among oil refiners, road makers

2. Irritants are due to long exposure to acids, alkaline, dyes and solvents

3. Eczema

4. Note: Occupational diseases affect groups

Occupational Hazards of agricultural workers

1. Infectious diseases

2. Pesticides poisoning

3. Accidents

4. Biological Hazards

Thank you

Ref:• Park’s Textbook of Preventive and

Social Medicine

Occupational diseases dr usama

Health & Medicine