Subject: Community Health Nursing I
The various measures for the prevention of occupational diseases may be grouped under three heads: medical, engineering and statutory or legislative.
Pre-placement Examination:
Pre-placement examination is the foundation of an efficient occupational health service. It is done at the time of employment and includes the worker's medical, family, occupational and social history; a through physical examination and a battery of biological and radiological examinations, e.g. Chest x-ray, electro- cardiogram, vision testing, urine and blood examination, special tests for endemic disease.
Periodical Examination:
Many diseases of Occupational origin require months or even years for their development. Their slow development, very often, leads to their non- recognition in the early stages and this is harmful to the worker. This is the reason why a periodical medical check- up of workers is very necessary when they handle toxic or poisonous substances.
Medical and Health Care Services:
The medical care of occupational diseases is a basic function of an occupational health service. Within the factory, first aid services should be made available. Properly applied first aid can reduce suffering and disability and hasten recovery. Immunization is another accepted function of an occupational health service.
Notification:
The main purpose of notification in industry is to initiate measures for prevention and protection and ensuring their effective application; and to investigate the working conditions and other circumstances which have caused or suspected to have caused occupational diseases
Supervision of Working Environment:
Periodic inspection of working environment provides information of primary importance in the prevention of occupational disabilities. The physician should pay frequent visits to the factory in order to acquaint himself with the various aspects of the working environment such as temperature, lighting, ventilation, humidity, noise, cubic space, air pollution and sanitation which have an important bearing on the health and welfare of the workers.
Maintenance and Analysis of Records:
Proper records are essential for the planning. development and efficient operation of an occupational health service. The worker's health record and occupational disability record must be maintained. Their compilation and review should enable the service to watch over the health of the workers, to assess the hazards inherent in certain types of work and to devise or improve preventive measures.
Design of Building: Measures for the prevention of occupational diseases should commence in the blue - print stage. The type of floor, walls, height, ceiling, roof, doors and windows, cubic space are all matters which should receive attention in the original plan of the building is constructed, it would be difficult to introduce alterations without much trouble and expense.
Good House Keeping: Good house keeping is a term often applied to industry and means much the same as when used domestically. It Covers general cleanliness, ventilation, lighting, washing, food arrangements and general maintenance. Good housekeeping is a fundamental requirement for the control or elimination of occupational hazards.
General Ventilation: There should be good general ventilation in factories. It has been recommended that in every room of a factory, ventilating openings shall beprovided in the promotion of 5 sq. feet for each worker employed in such room, and the openings shall be such as to admit of a continued supply of fresh air.
Mechanization: The plant should be mechanized to the fullest possible extent to reduce the hazard of contact with harmful substances. Dermatitis can be prevented if hand- mixing is replaced by mechanical devices. Acids can be conveyed from one place to another through pipes. There may be other similar situations where mechanization can be substituted to hand operation.
Substitution: By substitution is meant the replacement of a harmful material by a harmless one, or one of lesser toxicity. A classical example is the substitution of white phosphorus by phosphorus sesquisulphide in the match industry, which resulted in the elimination of necrosis of jaw (phossy jaw). Zinc or iron paints can be used in place of mercury salts; acetone can be used in place of benzene. But substitution is not always possible in industry. Where possible, it should be used to the fullest possible extent.
Dusts: Dusts can be controlled at the point of origin by water sprays, e.g. wet drilling of rock. Inclusion of a little moisture in the materials will make the processes of grinding, sieving and mixing comparatively dust free.
Enclosure: Enclosing the harmful materials and processes will prevent the escape of dust and fumes into the factory atmosphere. For example, grinding machinery can be completely enclosed. Such enclosed units are generally combined with exhaust ventilation.
Isolation: Sometimes it may be necessary to isolate the offensive process in a separate building so that workers not directly connected with the operation are not exposed to the hazard. Isolation may not be only in space, but also in the fourth dimension of time. Certain operations can be done at night in the absence of the usual staff.
Local Exhaust Ventilation: By providing local exhaust ventilation dusts, fumes and other injurious substances can be trapped and extracted "at source" before they escape into the factory atmosphere. The heart of the local exhaust ventilation is the hood which is placed as near as possible to the point of origin of the dust or fume or other pollution. Dusts, gases and fumes are drawn into the hood by suction and are conveyed through ducts into collecting units. In this way, the breathing zone of workers may be kept free of dangers dust and poisonous fumes.
Research: Research in occupational health affords fertile ground for study which can provide a better understanding of the industrial health problems. There are two kinds of research - pure research and research for the improvement of, or in connection with a manufactured product. Both are important. Study of the permissible limits of exposure to dusts and toxic fumes. occupational cancer, accident prevention, industrial fatigue and vocational psychology are some aspects of research in Occupational health.
Society has an obligation to protect the health of the worker engaged in diverse occupations. It has grown out of the realization that the worker is more important than the machine which he operates. The worker can not be permitted to endanger his life and limb in an occupation, while the employer makes a chance. Labour act, therefore, have been framed to govern the conditions in industry and to safeguard the health and welfare of the worker.
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