Occupational diseases. PhD Kamil Barański PhD Anna Korczyńska

Transcription

1 Occupational diseases PhD Kamil Barański PhD Anna Korczyńska

2 History of occupational diseases Hippocrates of KOS Bernardino Ramazzini

3 workplace health and safety (WHS) = occupational safety and health (OSH) = occupational health and safety (OHS) is an area concerned with the safety, health and welfare of people engaged in work or employment

4 General exposure sources at work Physical exposures (noise, radiation, heat, cold, inadequate lighting, lack of oxygen, ect.) Chemical exposures (solvents, cleaning agents, degreasing agents, etc.) Biological exposures (viruses, bacteria, flour, animal blood, leather, ect.) Psychological exposures (changing working hours, threat of violence, work in isolation etc.) 4

5 Risk factors at work Posture Repetitive movements Vibration (local vibration-holding a vibrating tool) Work organization (rest periods, breaks) Psychological and social faktors Individual factors Encyclopaedia of Occupational Health and Safety. Geneva

6 Threshold limit value (TLV) Chemical substances Physical agents Risk factors at work The TLV for chemical substances is defined as a concentration in air (for inhalation or skin exposure) for gases (in ppm) for particulates eg. dust, mist, smoke (in mg/m³) TLVs for physical agents include noise exposure, vibration, ionizing and non-ionizing radiation exposure heat and cold stress. 6

7 Three types of Threshold limit value for chemical substances Threshold limit value - Time weighted average (TLV-TWA): average exposure on the basis of a 8h/day, 40h/week work schedule Threshold limit value - Short-term exposure limit (TLV-STEL): spot exposure for a duration of 15 minutes, that cannot be repeated more than 4 times per day with at least 60 minutes between exposure periods Threshold limit value - Ceiling limit (TLV-C): absolute exposure limit that should not be exceeded at any time 7

8 Definition an occupational disease is any disease contracted primarily as a result of an exposure to risk factors arising from work activity. Work-related diseases have multiple causes, where factors in the work environment may play a role, together with other risk factors, in the development of such diseases.

9 Definition of occupational disease in Poland Regulated by labour law An occupational disease is considered as occupational disease when it s listed on the list of occupational diseases.

10 Four criteria 1. On the list 2. Notification under a specified time (on the list) 3. It is a result of environment at work 4. Unqestionable exposure factors (or high probability)

11 European definition of occupational disease The case of occupational disease is defined as a case recognized by the national institutions responsible for recognition of occupational diseases. Occupational diseases and other health problems have to be related to work

12 List of occupational diseases POLAND 1. Acute and chronic intoxications with chemical substances and their sequels 2. Metallic fever 3. Pneumoconioses 1) silicosis 2) coal workers pneumoconiosis 3) pneumoconiosis associated with tuberculosis 4) welders pneumoconiosis 5) asbestosis and other pneumoconioses due to silicates 6) pneumoconiosis due to talc 7) graphite fibrosis 8) pneumoconioses due to metal dusts

13 4. Diseases of pleura or pericardium induced by asbestos dust 1) diffuse thickening of pleura 2) diffuse plaques of pleura or pericardium 3) pleural exudate 5. Chronic obstructive bronchitis which causes airflow limitation (FEV1 < 60% of predicted value) induced by exposure to dusts and irritant gases, if an excess of TLV was documented within the last 10 years in at least 30% measurements of occupational exposure 6. Bronchial asthma 7. Extrinsic allergic alveolitis: 1) acute or sub-acute form 2) chronic form

14 8. Acute general allergic reactions 9. Byssinosis 10. Berylliosis 11. Lung diseases induced by hard metals dust 12. Allergic rhinitis 13. Oedematous laryngitis induced by allergy 14. Nasal septum perforation induced by irritant and corrosive agents 15. Chronic voice disorders due to excessive vocal effort lasting at least 15 years: 1) hard vocal nodules 2) secondary hypertrophic changes of vocal folds 3) paresis of internal muscles of larynx with fusiform insufficiency of glottis and persistent hoarseness

15 16. Diseases caused by ionizing radiation: 1) acute generalised radiation sickness as a consequence of whole body, or greater part of body, irradiation 2) acute radiation sickness of the type of inflammatory or inflammatory-necrotic changes of skin or subcutaneous tissue 3) chronic dermatitis due to radiation 4) chronic lesion of bone marrow 5) cataract due to radiation

16 17. Malignant neoplasms induced by human carcinogens present in work environment: 1) lung cancer, bronchus cancer 2) pleural or peritoneal mesothelioma 3) neoplasms of haematopoietic system 4) skin cancer 5) bladder cancer 6) malignant neoplasms of liver 7) larynx cancer 8) malignant neoplasms of nose and accessory sinuses 9) malignant neoplasms for which the probability of induction by radiation is greater than 10%

17 18. Skin diseases: 1. allergic contact dermatitis 2. irritant contact dermatitis 3. oil acne, chloroacne, coal tar acne of diffuse nature 4. candida infections: hand intertrigo, nail dystrophy with paronychia due to working conditions 5. dermatophyte infections due to contact with biological material from animals 6. contact urticaria 7. occupational photodermatoses 19. Chronic diseases of locomotor system related to the way the job is performed: 1. tendovaginitis 2. bursitis 3. chronic lesion of meniscus due to the job performed in kneel or squat position 4. periarticular inflammation of shoulder joint 5. epicondylitis of shoulder bone 6. fatigue-induced bone fracture

18 21. Bilateral permanent noise-induced hearing loss of cochlear or sensoneural type, amounting to at least 45 db in better ear as a pure tone average for 1, 2 and 3 khz audiometric frequencies 22. Vibration syndrome 1) vibratory angioneuropathy 2) osteoarticular form 3) mixed form: angioneuropathy and osteoarticular disorders 23. Diseases induced by work under increased atmospheric pressure 1) decompression sickness 2) barotrauma 3) sequels of compressed air breathing 24. Diseases induced by high or low temperature of environment 1) heat stroke and its sequels 2) heat exhaustion and its sequels 3) frostbites

19 25. Diseases of visual system induced by physical, chemical or biological agents: 1. allergic conjunctivitis 2. acute conjunctivitis induced by ultraviolet radiation 3. epidemic viral conjunctivitis or keratitis 4. keratopathy induced by irritant agents 5. cataract induced by infrared or long-wave ultraviolet radiation 6. central retinal and choroidal degeneration induced by short-wave infrared radiation or visible radiation of blue spectrum 26. Infectious and parasitic diseases or their sequels

20 ILO List of Occupational Diseases (revised 2010) Source safework/documents/publication/wcms_ pdf

21 International Labour Organistation 1. Diseases caused by external factors 1.1. Diseases caused by chemical substances 1.2. Diseases caused by physical agents 1.3. Diseases caused biological agents 2. Diseases Systems main bodies 2.1. Occupational diseases respiratory systems 2.2. Occupational Skin Diseases 2.3. Occupational musculo skeletal diseases 2.4 Psychosocial Diseases 3. Occupational Cancer 4. Other Diseases 4.1. Nystagmus Miners 4.2 Other Diseases

22 PROBLEMS AND CHALLENGES 22

23 Pneumoconioses Exposure to silica, coal, asbestos and various mineral dust in mining, quarring, construction and other manufacturing processes. Long latency periods Often undiagnosted and unreported Associated illnesses: Chronic obstructive pulmonary disease (COPD) Silicotuberculosis Silica- and asbestos-related cancers 23

24 Asbestos-related diseases Until the 1970s asbestos was widely used in many industries across different countries to insulate pipes, boilers and ships, make brakes, strengthen cement and many fireproof materials. 24

25 People who worked with asbestos during that time are now at risk of developing an asbestos-related lung cancer and mesothelioma. It generally takes from 10 to 40 years for ARDs to develop after exposure. France, Germany, Italy, Netherlands, Switzerland,UK deaths from Masothelioma

26 Problems and challenges 26

27 globalization changes in workplace emerging risks new challenges new technologies: nanotechnologies biotechnologies poor ergonomic conditions exposure to electromagnetic radiation psychosocial risks 27

28 Musculoskeletal disorders Musculoskeletal disorders are among the most important occupational health problems in both developed and developing countries In most cases, it is not possible to point to one casual factor for musculoskeletal diseases (in most cases-several factors) The muscles are the most common site of pain Work-related muscle pain is reported most frequently in the neck and shoulder area, the forearm and the low back 28

29 LOCAL MUSCLE DISORDERS Muscular rheumatism Fibrosis Myostis Muscle pain Myalgia Fibromyalgia Tenderpoint Triggerpoint REGIONAL SYNDROMES Myofascial pain syndrome Tension neck Rotator cuff syndrome Compartment syndrome GENERAL SYNDROMES Fibrosis syndrome Fibromyalgia syndrom Primary fibromyalgia Polymyalgia Polymyositis Encyclopaedia of Occupational Health and Safety. Geneva

30 Carpal tunnel syndrome 59% of all recognized diseases (European Occupational Diseases Statistic, 2005) 10% of all years lost to disability (WHO raport, 2009) 30

31 Mental disorders Work-related stress and its health consequences have emerged as a matter of great concern Enterprises are increasingly confronted with psychological harassment, mobbing, bullying, sexual harassment other forms of violence Problems with stress (unhealthy behaviours-abuse of alcohol or drugs) 31

32 Prevention 32

33 Prevention - organization International labour organization Occupational Safety & Health Administration (OSHA) European Agency for Safety & Health at Work (EU OSHA) NAPO

34 Prevention Qualification tests for work Periodic tests for work 34

35 Prevention at work General protection Personal protective equipment (PPE) PPE is equipment that will protect the user against health or safety risks at work. Protected: the lungs (eg from breathing in contaminated air) the head and feet (eg from falling materials) the eyes (eg from flying particles or splashes of corrosive liquids) the skin (eg from contact with corrosive materials) the body (eg from extremes of heat or cold) 35

36 Allergic occupational diseases in health services workers Allergic rhinitis Allergic angioedema of the larynx Bronchial asthma Allergic contact dermatitis Contact urticaria

37 Allergic diseases of the skin (dermatitis) and respiratory diseases The most common allergens in professional medical staff: metals (nickel, cobalt, chromium, mercury) gum nurses, doctors specialty treatment, orderlies (release of chromium and nickel from cleaning fluids and disinfectants, contact with metal tools, surgical thread) the most common additions or such vulcanization accelerators (thiram ) - basic contact allergen latex gloves

38 natural rubber latex, acrylates dentists aids, dental technicians and orthodontists. medicines the most common cause allergy : neomycin and other antibiotics aminoglycosides, PNC and its synthetic products, benzocaine, sedative drugs, cytostatics. disinfectants flavoring

39 MBT (mercaptobenzothiazole) natural rubber latex, Acrylates dentists aids, dental technicians and orthodontists. Drugs the most common cause allergy : neomycin and other antibiotics aminoglycosides, PNC and its synthetic products, benzocaine, sedative drugs, cytostatics. Disinfectants

40 Epidemiology of occupational diseases in Poland

41 Number of cases Incidence rate on hired Number of reported occupational diseases and incidence rate on hired in Poland Lata Source: Based on data from IOM in Łódź

42 Incidnace rate on (hired) 180 Incidence rate on (hired) of women and men Source: Based on data from IOM in Łódź

43 Europe - findings Frequency of fatigue or painful and long sitting positions SOURCE: -and-statistics-osh/esener/2014

44 Reported moving or lifting heavy objects SOURCE: -and-statistics-osh/esener/2014

45 Reported noise SOURCE: -and-statistics-osh/esener/2014

46 Workplace health and safety.

47 workplace health and safety (WHS) = occupational safety and health (OSH) = occupational health and safety (OHS) is an area concerned with the safety, health and welfare of poeple engaged in work or employment 47

48 Risk factors at work Posture Repetitive movements Vibration (local vibration-holding a vibrating tool) Work organization (rest periods, breaks) Psychological and social faktors Individual factors Encyclopaedia of Occupational Health and Safety. Geneva

49 Ergonomics 49

50 Definition Ergonomics is the systematic study of people at work with the objective of improving the work situation, the working conditions and the tasks performed. The aim of ergonomics is to ensure that the working situation is in harmony with the activities of the worker. Encyclopaedia of Occupational Health and Safety. Geneva

51 The International Ergonomics Association defines ergonomics: Ergonomics (or human factors) is the scientific discipline concerned with the understanding of interactions among humans and other elements of a system, and the profession that applies theory, principles, data and methods to design in order to optimize human well-being and overall system performance. 51

52 Workstation ergonomics 52

53 Poor ergonomic conditions Muscular and psychological disturbances Visual fatigue Eye strain, sore eyes Headaches Fatigue Muscle sorenes Cumulative trauma disorders Back disorders Psychological tension Anxiety and depression 53