FAMCOMM

Dr. Hora January 18 2014

ENVIRONMENTAL HEALTH
MAINTAINING A HEALTHY LIFESTYLE
DIET and EXERCISE
* A 12oz soda contain 10 tsp of sugar
* Some Indian farmers claim that coke is an insecticide
HEALTHY ENVIRONMENT
Over the past 50 years we have all been
unwitting participants in a vast, uncontrolled,
worldwide chemistry experiment involving the
oceans, air, soils, plants, animals, and human
beings.
You are not the same as our grandparents
were. You are partly synthetic

Those of us living in the early 21st

century inhabit a world where synthetic
chemicals, introduced as far back as
the 1920s, have been around for
decades.

Now these chemicals are everywhere

including in the tissues of every human
being on earth.

There are traces within you of several

hundred man-made chemicals.

Some of these may cause cancer and

damage
the
nervous
systems,
reproductive
systems,
immune
systems, or livers of animals.

Mounting evidence confirms the same

in human beings.
*Silent Spring by Rachel Carson: Book about DDT
hazards: insecticide for the control of Malaria
> brought about regulations in insecticide use
*Our stolen future Colborn, et al.
Large outbreaks of cancer in fish had been
reported only since the chemical revolution of
the past half century. The fish cancers showed
up below discharge pipes from industrial
operations.
ENDOCRINE DISRUPTORS: Why crocodile
penises are shrinking and why male sperm
counts worldwide are decreasing
UNDER-RECOGNITION
OF
ENVIRONMENTLA
DISEASES
Doses are at concentrations far below those
experienced by workers
Longer exposure time before symptoms appear
There is no one-to-one correspondence
between symptoms and toxins
Lack of routine data on air and water pollution
Lack of awareness among health practitioners
**Environmental Hazards are hard to prove in regards
with its correlation
**Large study populations needed
**Testing of 1 heavy metal in a sample: 1,000+ PhP

PRECAUTIONARY PRINCIPLE
Whenever there is a serious threat to health and
environment, lack of scientific certainty should not
postpone cost-effective measures to prevent harm
CHEMICAL PESTICIDES

No.1 culprit in the cordilleran region

Uncertainty on the quality and safety of
highland vegetables
**Pesticides used by farmers at Happy Hollow, Baguio
City 2002:
Shows that Dithane, Tamaron and Thiodan (which
is banned) are the 3 most widely used fertilizers
GMOs
Also
called
genetically
modified
organisms/foods
Involves the insertion of DNA from one
organism into another OR modification of an
organisms DNA in order to achieve a desired
trait
**ie: Arctic fish DNA + Strawberry = A
strawberry resistant to frost
Golden rice
Rice that contains beta-carotene (Vit.
A), which is not fopund in regular rice
Bt Corn
Corn that contains a chemical normally
found
in
a
bacterium
(Bacillus
thuringiensis) that is toxic to insects
but not to man
Herbicide resistant plants
GMO poultry
Earlier harvesting time of chickens and
other poultries
rBST (Bovine growth hormone)
Increased incidence of mastitis and
raised pus cell counts in milk
Herbicide Resitance: Round-up Ready
Crops
Herbicide resistant transgenic crops
May evolve into resistant weeds
Increase pesticide use
Unanticipated physiologic effects on
the plant..
** Labelling of GMO foods are not mandatory
**UK Field Trials: GM crop field vs non-GM crop field
Similar total weed densities
Fewer broad-leaved floering weeds (leaves
provide food for insects and seeds provide food
for other wildlife)
50% less ees and 33% less butterflies in GM
crop field
**Designer Crops: Golden Rice (Vit A. Fortified rice):
Gene from daffodil + promoter segment from bacteria
Infects rice embryo crossed with local rice strains
Q: Is Vit A fortified rice the answer?
Non polished vs Polished rice
Other nutritional deficiencies accompany Vit A
deficiency
Need to eat 9kg of cooked rice to fulfill the
RDA for Vit. A
POTENTIAL HUMAN HEALTH RISKS
a. Allergens
Genetic engineering could potentially
introduce or create allergens
For example, inserting genes from a
nut into another plant could be
dangerous for people who are allergic
to nuts
b. Unknown health risks
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Dr. Hora January 18 2014

Insertion of foreign gene may disrupt

biological processes that may be
critical to maintain normal biologic
function
Disruption of gene ecology of recipient
organism may result in unpredictable
adverse interaction.
ECONOMIC HAZARDS
1. Corporate monopoly control
GM seeds are patented
2. Suicide seeds (Terminator genes)
No crop rotations
Plants with sterile seeds that are infertile
are created
Farmers are forced to buy seeds every year
BIRTH OF LIFE SCIENCES
Chemical companies, Pharmaceutical companies
Agri-business gener revolution Life sciences
*TOP 10 Global Chemical Companies: Top ten
comes from developed countries
PERSISTENT ORGANIC POLLUTANTS (POPs)
- Substances that are not degraded immediately,
remains for a very long time (as long as 50 years)
Pesticides: aldrin, DDT, dieldrin, endrin,
heptachlor, chlordane, mirex, and toxaphene
Industrial compounds: hexachlorobenzene
and polychlorinated biphenyls (PCBs)
Undesired
by-products
emerging
in
various processes: dioxins, furans
*POPs evaporate and travel long distances through air
and through water
they are literally everywhere in the world, even
in the Arctic, Antartica, and remote islands
They accumulate in the food chain
**POPs gradually start to concentrate as
organisms consume other organisms as they
move up the food chain
What are the effects of POPs on wildlife?
Population decline
Reproductive organ anomalies
Eggshell thinning in bird species
Sex reversals
Birth deformities
Metabolic changes
Hormone system dysfunction
Behavioral changes
Immune supression
LARGE SCALE MINING STUDIES:
Prevalence of Symptoms associated with mine
drainage, Upper vs Lower Paalaban. Cabitin and
Camay:
Shows that people at the upland have lower prevalence
of symptoms than the people residing at th e lower
areas where mine refuse flows to (Skin symptom, Eye
irritation, Diziness, Cough etc.)
Water analysis:
Way beyond the DENR standards (which are lax as
compared to International Standards)
1. Blood testing of locals in the affected
community :
15 CASES
15 CONTROLS

Cyanide
Lead
Copper

Increased
Increased
Increased

Decreased
Decreased
Decreased

2. Neurological exam = all are normal

3. Mental Status exam =
Most are with
problems in recent memory and repeat phase
**Cyanide was found to be present in the
blood of all 34 Itogon SSM tested
This was attributed not only to work
exposure
but
to
environmental
exposure as weel since the SSM live
and work in the same area

CYANIDE
Cyanide affects body organs that have a high oxygen requir
heart and brain
Short term effects
Long term effects
1. Irritation
of
mucous
1.
Eye irritation
membranes
5. Skin Ulceration
2. Difficulty of breathing
6. Thyroid enlargem
3. Headache
7. Damage to the
4. Nausea and Vomiting
brain
LEAD
Damage to the nervous system occur in children at blood lead le
previously considered safe or normal
Short term effects
Long term effects
1. Seizures
1. Pallor
2. Headache
2. Seizures
3. Dizziness
3. Memory Loss
4. Memory deficit
4. Wrist/ Foot Dro
5. Epigastric
discomfort,
5. Renal failure
6. Miscarriage
nausea
MERCURY
1. Respiratory Problems
1. Kidney disease
2. Personality chang
3. Tingling/ Numbne
COPPER
1. Metal-fume fever (flu-like)
4. Kidney diseases a
2. Eye and skin discoloration/
5. Liver diseases an
6. Lung diseases an
irritation
**Minamata Disease in Japan: Factory refuse drains
in the river where locals get their fish
**Small-scale Mining in the Cordilleras
Before the main industry of Cordillerans is
focused in farming and agriculture
The introduction of small-scale mining shifted
the industry paradigm
More are into small-scale mining
EFFECTS ON THE ENVIRONMENT
PHILIPPINE CONCERNS:
1. Toxic waste from abandoned and former US
bases (Asbestos in base camps)
2. Oil spils: Guimaras oil spill
August 11 2006: Petron tanker carrying
2M liters of low-grade bunker oil sank
Living in areas exposed to the crude oil
spillage was significantly associated
with higher anxiety and depression,

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FAMCOMM
Dr. Hora January 18 2014

worsening mental health, headache,

sore eyes and sore throat
Many symptoms emerged after the
beginning of cleanup activities. The
principal symptoms are: Low back pain
and leg pain, headache, and symptoms
of eye and throat

Q: What does all this mean to me?

A healthy lifestyle doesnt just mean DIET and
EXERCISE after all..
A healthy lifestyle = maintaining a Healthy
Environment
The biggest threat to a healthy environment =
globalization
The chemical war is never won and we are all caught
in the crossfire Rachel Carson
OCCUPATIONAL MEDICINE
Job/Occupation = Hanap Buhay (ideal) but in
reality Hanap Patay
Dead men walking at work every day: Occupational
safety is too often a forgotten right in developing
countries
OCCUPATIONAL MEDICINE

The diagnosis and treatment of human

pathology caused in whole or in part by an
individuals work environment.

Occupational health should aim at:

The promotion and maintenance of the
highest degree of physical, mental and
social well-being of workers in all
occupations
The
prevention
among
workers
of
departures from health caused by their
working conditions
The protection of workers in their
employment from risks resulting from
factors adverse to health
The placing and maintenance of workers in
an occupational environment adapted to
his physiological and psychological ability
HISTORY OF OCCUPATIONAL HEALTH (Bold prints in
reds are discussed by Doc Hora)
Ancient Times
Aristotle: Diseases of runners. Made a special
diet for gladiators
Plato: Artisans body deformed due to exercise
of their profession
Galen: Pathology of lead poisoning
Hippocrates: Lead colic in miners
15th-16th Centuries
Agricola: Account of occupational ill-health
among miners
17th 19th Centuries
Bernardino Ramazinni:
Father of Occupational Medicine (1700)
Discussed 54 groups of workers

Ask each patient: What is your

occupation?
Percival Potts
Noted high incidence of scrotum cancer
among child chimney sweepers
After 1980
Skilled steelworkers machines
Rapid development of productive techniques
Huge investment in new equipment
Large increases in productivity per worker
**Increase in worker injury and death slowdown in
production Safety programs:
a. Welfare programs
b. Compensation over prevention
c. Safety over health
d. Accident-proneness concept
**Phossy Jaw
Distressing form of industrial disease.
The phosphorus penetrates into a
defective tooth and down through the
roots to the jawbone, killing the tissue
cells which then become the prey of
suppurative germs from the mouth,
and abscesses for
**Dead Fingers
The condition of which the men
complained is a spastic anemia of
certain fingers, the ones most tightly
cramped around the tool.
It is caused by three factors -- cramped
muscles driving the blood from the
fingers, cold which contracts the
vessels, and the rapid vibration which
sets up vasomotor disturbances.
1930s
The Great Depression - people were
desperate for jobs (even without safety precautions in
the workplace)
1940s
-

World War
Labor shortage
Influx of inexperienced workers
Higher accident rates
US federal grants for safety
programs

and

health

1960s
coal miners strike vs Black Coal Lung Disease
resulted in:
a. 1969 Coal Mine Health and Safety Act
b. 1972 Black Lung Benefits Act
1970s
different organizations that tackle Occupational
Health
Occupational Safety and Health Act (OSHA)
National Institute for Occupational Safety and
Health (NIOSH)
Setbacks:

low budget

influence/lobbying of companies in setting

of standards
LESSONS:
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FAMCOMM
Dr. Hora January 18 2014

What contributes to advances in OSH?

Labor shortages
Workers mass actions
Physicians who are pro-workers
TRENDS:
Occupational Medicine as a Specialization
Expansion into environmental Medicine
Focus away from acute injuries towards:
Chronic conditions (eg: pneumoconiosis)
Ergonomics
Effects of new solvents
HISTORY OF THE FILIPINO WORKER (Bold prints in
reds are discussed by Doc Hora)
Spanish Colonization
Spanish colonizers organized the first labor
corps in the country
Mostly Filipino or Chinese male mestizos, 16 to
60 years old
Obligated to give personal service to
community projects
** Polo/Polistas official pay = 1 real
daily, real pay = 0.75 real
American Colinization
Philippines as source of cheap raw agricultural
materials
Wages of Filipino workers (male) = 10-15x
lower than in the USA
Wages of women and child workers = 30-75x
lower than in the USA

a.
b.
c.
d.
e.

Biological (6%)
Chemical (34%)
Physical (25%)
Psychological
Ergonomic (35%)

Hazards vs Risk
Hazard: potential to cause harm
Risk: Likelihood of harm
Eg: Cook: Hazard : Knife Risk: Nonuse of personal
protective equipment (apron, gloves etc)
Eg: Potassium Dichromate is a highly carcinogenic
material. It is used to analyze exhaled breath for
alcohol content. For this purpose it is sealed in a tube,
and does not become airborne when air is drawn over
it

Q: Is it a highly hazardous substance?

Q: Does it present a high risk to the user?

Factors affecting risk:
a. Duration
b. Chronicity
c. Frequency
d. Magnitude
e. Other routes of exposure
f. Exposure to many substances at the same time
What harm can it do? (illustrations not thoroughly
discussed)

First Labor Leaders:

Isabelo de los Reyes and Crisanto Evangelista:
Main issue: Low Wages
Who are the Filipino workers?
Overseas Filipino Workers
2004 1.06 million
2006 9-10 million
2004 Survey on Overseas Filipinos

Of the 1.06 million OFWs, 49.3 percent were

males while 50.7 percent were females.

The bulk of the female OFWs belonged to the

25-29 age group. On the other hand, most of
the male OFWs were 45 years old and over.
Philippines is the NO.2 EXPORTER of DOCTORS in
the world

MD-NURSES: More than 9,000 MDs have

already left as nurses in 2002-2005.

Around 80% of public health physicians have

taken up or are enrolled in nursing.

Obstetricians and anesthesiologists are fast

depleting, followed by pediatricians and
surgeons.
Patients are workers and workers are patients

OCCUPATIONAL HAZARDS
Occupational Hazards can be classified as:

Threshold Limit values

- Level at which nearly all workers may be exposed
repeatedly, day after day, without adverse effects
- (?) Effects of combined exposures
- (?) Unknown adverse effects
Heirarchy of Controls
1. Elimination
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FAMCOMM
Dr. Hora January 18 2014

2.
3.
4.

5.

- Control of the hazard at the source

- Ban, restrict, and isolate
Process or equipment modification
- Replacement of a substance or activity with a
less hazardous one (eg: use of cyanide)
Engineering
- Isolation or enclosure of hazardous materials
- Local exhaust ventilation
Administrative
Policies and procedures for safe work
practices
- Health education
PPE

BIOLOGIC HAZARDS
SARS: Which occupational groups at risk? health
practitioners
Corona virus is a group of virus that have a
halo or crown like appearance when viewed
under the microscope
In view of the disproportionate association of
SARS cases with people working in the food
industry, a detailed analysis of the exotic
animals sold in Chinese food markets was
carried out. A virus was found in civet cats a
species eaten as a delicacy in China.
How did it affect the workplace?
Directly linked to work and workplaces

Persons most affected are those in the

productive age group
Lost business

Absenteeism (illness, quarantine, fear)

Travel restrictions (Tourism)

No customers (Small-scale service

industries)

No trading
Employees doubts about managements ability
to handle the situation
How can we control this hazard?
The routine use of Use of PPEs such as: Caps,
N-95 mask, Gown, Goggles, Gloves, Shoe
covers
Routine use of PPEs is currently not
recommended in the general workplace
(outside the health-care setting)
Other

Biological Hazards
Tuberculosis
Hepatitis B
HIV/AIDS
Extrinsic allergic alveolitis
Leptospirosis
Rabies
Organic dust toxic syndrome

Animal laboratory personnel

Biotechnology personnel
Veterinarians
Health care workers
Textile production workers

CHEMICAL HAZARDS
Over 4 million hazardous chemicals
70,00 chemicals used for commercial purposes
1-3.5% tested for carcinogenicity
5-10% carcinogenic to humans
Less than 10% have been studied for reproductive
effects
Heavy metals: Lead, Mercury, Nickel, Cadmium,
Arsenic
Pesticides:
Organophosphates,
Carbamates,
Organochlorines
Solvents: Benzene, Toulene, Xylene
Gases: Hydrogen sulfide, Carbon monoxide
SOLVENTS
Paint
Ink
Adhesives
Pesticides
Cleaners
-

Paint strippers
Degreaser
Refrigerants
Anesthetics
Dry Cleaning Fluids

Used to dissolve other substances

Organic
Lipophilic: Affects the following organs and
organ system
a) Skin
b) Liver
c) Peripheral nervous system
d) Central nervous system
Liquiod or Gas
Volatile with or without odor

Effects:
LOW
LEVEL
EXPOSURE
mild skin irritation
headache
dizziness
feeling of intoxication
nausea
eye,
nose,
throat
irritation
visual disturbances
Long term effect
Toulene
Trichloroethylene

Occupational Hazards
Animal handlers
Agricultural workers
Wood and paper workers
Waste management workers
Sewage workers
Food production workers

Benzene
Ethanol
Glycol Ethers

HIGHER
LEVEL
EXPOSURE
disorientation
confusion
difficulty
in
concentrating
diarrhea
vomiting
shortness of breath

Skin rash
Memory loss, confusion
Facial numbness
Aplastic anemia
Leukemia
Fetal Alcohol Syndrome
Reproductive toxicity

GASES AND AEROSOLS

JethroDomengDumbsky2014

VERY HIGH

Seizures
Cardiac arr
CNS depres
Coma and D

FAMCOMM
Dr. Hora January 18 2014

Gases
salivation
Cytogenetic/immunotoxic eff
Solubility in water
Integument: Rashes, sweating
If highly soluble: Irritation of upper airways
Chlorine
PHYSICAL HAZARDS
Chlorine dioxide
Ammonia
Can be classified as:
Sulfur dioxide
a) Extremes of temperature: Heat and Cold
b) Pressure
Hydrogen chloride
c) Vibration
Hydrogen fluoride
d) Radiation
Sulfuric acid
e) Noise
Less water soluble irritants cause lower
respiratory tract injury
Extreme Heat
Ozone
Heat rash
Nitrogen dioxide
Heat cramps: sweating, salt loss
Phosgene
Transient heat fatigue
Asphyxiants

Decline
in
task
performance,
Inhalants
that
act
by
oxygen
coordination,
alertness,
and
vigilance
deprivation
Heat exhaustion

Simple asphyxiants: Displace

Sweating,
weakness
or
fatigue,
oxygen from inspired air
giddiness,
nausea,
or
headache,

Toxic asphyxiants: Interfere

vomiting or unconsciousness
with delivery of oxygen at the
Heat stroke
cellular level

hyperthermia,
anhydrosis,
CNS
SIMPLE
Methane from: confined spaces, mining and
disturbances,
(confused,
delirious,
ASPHYXIANTS
sewage
convulsions, or unconscious), death
Carbon
dioxide
from:
combustion
and
can occur.
fermentation
Where it could happen:
TOXIC
Carbon monoxide
Outdoor operations in hot weather,
ASPHYXIANTS
Odorless by-product of combustion
including surface mining, roofing, road
Leading cause of death due to gas
repair and construction, dam building,
and other construction
inhalation
Farming operations
Hemoglobin impairment (COHb)
Iron, steel and nonferrous foundries
Cyanide
brick-firing
and
Bitter almond smell, metal plating, Manufacturing:
ceramics,
glass
products,
rubber
mining, fishing, fires
products
Mitochondrial impairment
Electrical utilities (particularly boiler
Hydrogen sulfide
rooms)
Rotten egg smell
Bakeries
From breakdown of organic materials
Confectioneries
Mitochondrial impairment
Restaurant kitchens
Laundries
PESTICIDES
Food canneries
Prevalent use in the cordilleras.
Mines
Dithane
(fungicide),
Tamaron
Smelters
(organophosphate), and Thoidan (banned
Steam tunnels
organochloride) is still being used in Baguio
Control of extreme Heat
and Benguet
Mechanization of work
Toxicity rating:
Isolate workers from heat
a) RED: Danger! Poison Extremely
toxic
Ventilation: windows, fans, exhaust ventilation
b) YELLOW: Warning! Harmful
Modify work-rest schedule
Highly toxic
Schedule outdoor work
c) BLUE: Caution Moderately toxic
Gradual exposure
d) GREEN: Least toxic
Provide cool rest area
Make liquids available (not alcohol!)
Health effects of exposure:
Wear clothing allowing better heat loss
ACUTE
CHRONIC
CNS:
Dizziness,
headache, Endocrine
disruption Vibration
(thyroid,
Transmission of mechanical energy from oscillating
tremors, seizures, coma CVS: reproductive)
sources
Cardiac
irregularities, Cardiovascular (hypertension)
hypertension
CNS and PNS Disease (neuropathies)
A. Whole body vibration
Respiratory:
Difficulty
of Cancer
Transport fixed machinery can cause:
breathing
Bone marrow effects
a) Disc displacement
GIT: Nausea, vomiting, diarrhea, Skin lesions
b) Degenerative spinal changes
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FAMCOMM
Dr. Hora January 18 2014

B. Local Vibaration
Power tools:
Hand-arm vibration syndrome: Dead hand
or Vibration White Finger

With
vascular,
neurologic,
musculoskeletal components

When exposed to cold environment will

manifest as blanching, parasthesias,
Numbness, Cyst formation in carpal
bones
Control of Vibration
For every hour of work using vibrating tools, rest for 10
minutes
Noise
Unwanted sounds
A form of vibration conducted through solids,
liquid and air
It is probably too noisy if:

You need to speak loudly to be

understood

You have ringing in the ears at the end

of the day

Measured sound levels, are greater

than 80dB
**Arms length rule:

If conversation is difficult at arms

length, the noise level is >85 dB.
Noise
-

effects:
Noise-induced hearing loss
Acoustic Trauma ~160 dB
Temporary Threshold Shift (TSS) ~120 dB
Permanent Threshold Shift (PSS)
Interference with communication - safety
hazard
Psychological effects (stress, annoyance, loss
of concentration

Noise Evaluation: Sound level surveys and personal

noise dosimeter

Noise control

Generate less noise

Acoustical engineering
Isolation of vibration
Acoustical insulation

Work processes
Remote operations

Look into personal habits

Ear plugs and muffs

PSYCHOLOGICAL HAZARDS
DAILY MINIMUM WAGES (including Cost of Living
Allowance COLA)
*Wages could be a psychological hazard

How stressful is your job?

Miner
8.3
Police Officer
7.7
Prison Officer
7.5
Airline Pilot
7.5
Dentist
7.3
Actor
7.2
Doctor
6.8
Nurse
6.5
Ambulance personnel
Musician
Firefighter
Social worker
6.0

6.3
6.3
6.3

Occupational Stress
Recent promotion beyond capacity
Conflicts due to multiple responsibilities
Too many demands on time
A tiring shift pattern, excess overtime
Too little or boring work
New technology
A new or unreasonable boss
Increased productivity targets
Threat of redundancy
Sexual harassment or bullying
High sickness absence in colleagues
Effects:
Hypertension
Heart Disease
Alcoholism
Mental illness
Immune System alterations
Occupational Stress Control
Primary Prevention: Promote teamwork and Involve
members in decision making
ERGONOMICS
The science of making the work environment safer and
more comfortable for workers using design and
anthropometric data
Workers who are exposed to:
a) repetition
b) prolonged trunk/upper limb intensive activities
c) forceful exertions
d) awkward posture
e) static posture
f) whole body or segmental vibration
g) temperature extremes
h) localized mechanical stress
Occupational Hazards
Epicondylitis
Tendinitis
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Dr. Hora January 18 2014

Reynauds phenomenon
Carpet layers knee
Herniated spinal disc
Low back pain
Carpal tunnel syndrome
Rotator cuff syndrome
De Quervains disease
Trigger finger
Tarsal tunnel syndrome
Sciatica
Engineering controls
Recent advancement to prevent
ergonomics includes chanes in:
a) Machines
b) Tools
c) Work station lay-out

hazards

1998: 13.3M Pesos worth of losses due

to accidents
2000: 4,831 cases of accidents
involving about 123,125 workers

from

*Anthropometry: The branch of the human sciences

that deals with body measurements
A. Chair
support back
feet contact with ground
thighs parallel to floor
close to work surfaces
arm rests optional (no pressure on
arms)
B. Monitor
top of screen is at or slightly below
eye level
directly in front
correct lighting
no glare
2 feet away
C. Keyboard and mouse
in front and close
elbow 90 degrees or sli
ghtly greater
straight wrists
Administrative Controls
Changes:
work practices
policies
shift length
amount of work
kind of work
rotation
training and education
OCCUPATIONAL HAZARDS CAN LEAD TO:
a) Accidents at work
At least one out of every 48 workers in
the country meets accidents in
workplaces

Occupational Injuries: Agents

Machines/ Equipment
30.0 %

Materials/ Objects
21.5

Hand Tools
20.7

Conveying/ Transport/ 7.5

Packaging Equipment or Vehicles

Building Structures
5.2

Distribution Systems
1.2
Occupational Injuries: Causes
Stepping on, striking against or being struck
by objects
Being caught in or between objects
Struck by falling objects
Falls of persons
Over-exertion or strenuous movements
Exposure to or contact with extreme
temperatures

34.8%
17.3%
9.8%
6.8%
12.1%
7.1%

b) Occupational Disease
An abnormal condition or disorder
other than one resulting from an
occupational
injury
caused
by
exposure over a period of time to risk
factors
associated
with
work
activity
OCCUPATIONAL HISTORY
1. Complete work history
2. Work walk-through
Tasks and sub-tasks
Hazards and sources of accidents per
sub-task
The future of occupational health is perhaps to know
how to resolve the conflict between the right to health
and the right to work at the level both of the individual
and all workers, with the aim of protecting health and
allowing employment.- G. Coppee, 24th ICOH, 1993

JethroDomengDumbsky2014