Occupational Health

Repeated often

"Repetition is the mother of all learning" - Increase availability of information - Increases positive feelings about the message - Truth sometimes loses out to repetition Beneficial to convey a message through multiple modes e.g., news media, talk radio, social media, community forums, trusted leaders, social influencers...

workers exposed "first and worst"

"first" one to be exposed and "worst" because of the longer duration of exposure

Forms of airborne matter

Gas: air-like state of matter - e.g., oxygen Vapor: matter in a gaseous state below critical temperature - e.g., water vapor Mist: liquid droplets suspended in air - e.g., paint mist Fume: solids generated by condensation of gas after volatilization of molten metal -e.g., from welding Dust: particulate matter -e.g., coal just Fiber: particulates with length-to-width ratio > 3:1 -e.g., asbestos

global trends around occupational-related injuries

Global burden (1990-2016) - Greatest burden (deaths) : carcinogens, particulate matter, gases and fumes, risk factors for injury - Greatest burden (DALYs) : Ergonomic exposures associated with low back pain, injury risk factors, and noise - Both deaths and DALYs greater in men than women - Overall reduction in both over time

Examples of Psychosocial Hazards

Psychosocial risk - arise from poor work design, organization and management, as well as a poor social context of work, and they may result in negative psychological, physical and social outcomes such as work-related stress, burnout or depression - workplace bullying, discrimination and harassment - fatigue - burnout - remote/isolated work - workplace violence/customer aggression - mental stress - workplace change

recommendations vs. regulations

Recommendation: NIOSH sets recommended exposure limits (RELs) Regulation: OSHA sets permissible exposure limits (PELs) - OSHA recognizes that many of its PELs are outdated and inadequate for ensuring protection of workers' health - Most of the OSHA's PELs were issued shortly after adoption of the Occupational Safety and Health Act in 1970 and have not been updated since then - OSHA inspects workers complaints - Fatality or serious injury or high-hazard industry - penalties generally low - worker fatality rate down to 3.3/100,000 - Fix the workplace not the worker - focus on risk modification - hierarchy of controls - address hazards at the source

Risk characterization

Synthesis of risk level for a particular health effect of a particular contaminant in a particular population - summarizes scope and assumptions - expresses and interprets results - separates policy from science - provides a judgment of risk - can be expressed using a hazard index (HI): relationship between actual exposure and reference dose (RfD) - characterizes uncertainty where it exists

occupational health terminology and abbreviations

Threshold limit values (TLVs) - for chemical hazards such as airborne particles - levels at which no adverse health effects are expected in workers - daily exposures acceptable Time-weighted averages (TWAs) - acceptable daily exposures for workers, assuming a 40-h work week Short-term exposure limits (STELs) - concentrations workers can be exposed to over a short period of time - usually 15 min, not more than 4 per day, with at least 60 min between exposures TLV-ceiling (C) - absolute limit that should never be exceeded for workers Example: Aerosolized benzene vapor 1 ppm, TWA 5 ppm, STEL 25 ppm, ceiling

Transmission of Covid + prevention

Transmission: - Infected people can transmit virus for several days before symptoms - Virus is expelled in respiratory droplets or aerosols, or, less commonly, can survive on touched surfaces (fomites) - Without precautions, basic reproduction number is >4.0; one infected person transmits infection to >4 other people - Risk of severe illness and high transmission were the basis for most public health countermeasures in COVID-19 pandemic Prevention: Physical/social distancing - Limit non-essential in-person work - Limit crowded indoor gatherings - Advise distancing between persons PPE: Mask-wearing Vaccination - Originally hoped to protect against all SARS-CoV-2 infections - Evolution of pathogens revealed that reinfection was common and vaccine value was focused on reducing severe illness - Vaccine composition and vaccination recommendations are expected to evolve

Transmission of flu + at risk

Transmission: - via respiratory transmission from symptomatic people - After ~2 days incubation, classic symptoms include fever, headache, muscle/joint pain, sore throat, cough -Complications can result in death for 0.1% of cases -Average annual cases in US estimated at 20,000,000, with 20,000 deaths. Statistics vary year-to-year due to changes in circulating influenza viruses.

blood-borne pathogens + at risk + prevention

Transmission: - after exposure to infected blood or body fluids via break in skin (e.g., needle stick) or mucus membrane exposure - occupational transmission in US is much much lower Workers at risk: first-responders and healthcare professionals Prevention: OSHA Bloodborne Pathogen Standard requires employers to: - offer HBV vaccine to at-risk workers; no vaccines are currently available for HCV or HIV - Apply 'universal precautions' to all blood and body fluids - Apply engineering controls, such as retractable needles, whenever possible - Provide training to workers at least annually - Require workers to wear PPE (gowns, gloves, face shields) - Medically evaluate all exposures promptly

Examples of Mental Health Hazards

Vets High Suicide Rates - women: 3.5 times as likely - male: 2.1 times as likely EMTs - 5.2% of deaths among EMTs between 2009 and 2015 were from suicide -40% of EMTs could suffer from high-risk drug and alcohol use Construction - men working in construction had the highest rate of suicide in 2012 and 2015 Military - Mental health appointments among active-duty troops accounted for roughly 16% of all military medical appointments - 22 veterans die by suicide every day - 30% of active duty and reserve military personnel have a diagnosed mental health condition

occupational health

an area of work in public health to promote and maintain highest degree of physical, mental and social well-being of workers in all occupations

category of occupational hazards

i) By hazard category - physical, chemical, biologic, psychological ii) By health effects - pulmonary, dermatologic, neurologic, etc iii) By specific hazard - asbestos, noise, hepatitis infection, violence iv) By occupation - miners, construction workers, firefighters

occupational melanoma and who does it affect most

occupational skin cancer Jobs with the highest rates of melanoma - construction - agriculture - indoor offices - drivers - airline pilots - lifeguards - Occupational exposure is responsible for about 34,000 cases of skin cancer each year in Australia -These jobs were found to have 9 times the amount of dangerous UV radiation exposure than those working in any other capacity

Industrial Hygiene

the discipline of anticipating, recognizing, evaluating, and controlling health hazards in the working environment with the objective of protecting workers' heath and well-being, and safeguarding the community at large

occupational vibration

whole-body vibration - affected occupations - Bulldozer drivers - Transport drivers - Machinery operators Hand-transmitted vibration: vibration entering the body through the hands - from hand-held power tools - hand-arm Vibration Syndrome may contribute to low-back pain arthritis inflammation upper extremity injuries/pain chronic use injuries

Risk Management

Process of identifying, evaluating, prioritizing, and choosing among policy options Incorporates science and non-science factors - Acceptable levels of risk - Existing legislation - Economic cost and benefits - Administrative considerations - Stakeholder perceptions Aims to define decisions and actions to follow Rests with decision makers rather than risk assessors

Types of PPE respiratory protection and fields each one might be used in

- Air-purifying respirators filter or neutralize contaminants - Air-supply respirators are used in low-O2 situations or when the hazard is unknown or undetectable Particulate Respirators - simplest, least expensive, and least protective of the respirator types - only protect against particles (e.g., dust) - filters out dusts, fumes and mists Chemical Cartridge/Gas Mask Respirator - "air-purifying respirators"; filter or clean chemical gases out of the air as you breathe - includes a facepiece or mask, and a cartridge or canister Powered Air-Purifying Respirator (PAPR) - use a fan to draw air through the filter to the user - easier to breathe through - need a fully charged battery to work properly - use the same type of filters/cartridges as other air-purifying respirators. Self-Contained Breathing Apparatus (SCBA) - commonly used by firefighters - use air tank to supply clean air, so you don't need to worry about filters -also protect against higher concentrations of dangerous chemicals

Simple and Clear Messaging

- Difference in internal and external communication - Identify and share the most important information first - What is the risk? How serious is it? Who is affected? What causes the risk? How can risk be managed? -The less we say, the more we are heard

Histoplasmosis

- Fungal spores found in bird and bat droppings - When contaminated dust is inhaled by workers, fungi can cause lung infection - More than 90% of infections are asymptomatic, but few develop pulmonary disease, which must be treated by anti-fungal medications Workers at risk: Ohio River Valley of central US, in demolition, construction, roofing, hunting, and farming jobs (exposure to certain bird and bat droppings) Prevention: - avoiding exposures - wetting down contaminated dust - sometimes disinfecting dust ( with formaldehyde or other agent) - worker training - PPE with respirators

Valley fever

- Fungal spores found in dust in San Joaquin Valley of CA and other areas of southwest US - When contaminated dust is inhaled by workers, can cause infection, called "Valley Fever" - More than 60% of infections are asymptomatic; others develop flu-like symptoms, and few (<5%) develop severe disease (fever, pneumonia, joint pain, rash), which must be treated by anti-fungal medications Workers at risk: southwest US, in demolition, construction, archeology, farming, or military jobs (i.e., exposed to desert dust) - High rates were found in CA solar energy farm constructors Prevention: - avoiding exposures - wetting down contaminated dust - sometimes disinfecting dust (with formaldehyde or other agent) - worker training - PPE with respirators

healthy worker effect and relevance to studying occupational health

- a form of selection bias in almost all studies of occupational health that may make investigators underestimate the true risks of exposure -Working populations are healthier than the general population so rates of illness are not easily compared -Some workers (e.g., military and firefighters) are much healthier than the general population

Tuberculosis (TB) + prevention

- a slow-growing bacteria that causes human infection via respiratory transmission - Most infections result in latent TB (asymptomatic); <5% of latent TB infection progress to active TB - Only active pulmonary TB cases can transmit infection to others - Pulmonary TB is challenging to treat, requiring multiple antibiotics taken over at least 6 months - TB vaccines prevent severe illness in children, not overall infection; not recommended for adults; not an occupational protection option -Global burden of TB is enormous, with more than one-third of world population affected and >1M deaths each year; TB burden in US is much lower -Multi-drug-resistant TB adds to public health challenges Work at risk: those who work with refugees, prisoners, and patients Prevention of TB in hospital workers: - Eliminating some exposure by isolating suspect-TB patients and/or putting surgical masks on patients -Engineering controls ensure that suspect-TB patients remain in negative-pressure isolation rooms -Administrative controls include training and restricting exposure of some workers (e.g., immune-compromised) -PPE includes N95 respirators for workers who care for TB patients -Secondary prevention (screening) for latent TB through skin testing or blood testing - Higher-risk hospitals screen workers annually - Workers with evidence of new latent TB can be treated with antibiotics (e.g., isoniazid for several months) to reduce their risk of developing active TB

Hierarchy of control and its importance

- address hazards at the source; relay on personal protective equipment as a last resort Elimination - physically remove the hazard Substitution - replace the hazard Engineering Controls - isolate people from the hazard Administrative Controls - change the way people work PPE - protect the worker with Personal Protective Equipment - Industry/task specific - e.g., helmets, ear protection, goggles, gloves - puts the burden of control on the individual workers - least controllable and most likely to fail - always considered the last resort in the hierarchy

Hantavirus

- can be transmitted from exposure to rodent droppings - First id in southwest US; the virus is similar to a pathogen found in Hantan area of South Korea in 1950s - Infection is rare, but can cause flu-like symptoms or severe Hantavirus Pulmonary Syndrome with >30% fatality rate Workers at risk: those in southwest US, in excavation, construction, farming, park service, grounds keeping, house cleaning, or pest control (i.e., exposed to rodent droppings) Prevention: - avoiding exposures (excluding or trapping rodents) - using only wet cleaning - disinfecting droppings before cleaning - worker training -PPE with gloves and respirators

Workplace burnout

- specific work-related chronic stress - emotional and physical exhaustion that leads to job dissatisfaction and loss of personal happiness Causes - a feeling of little control. Not being able to make decisions about your schedule or workload can lead to job burnout - a poor work culture - a lack of work-life balance - high engagement with your work - over-worked - lack of breaks Physical/Mental Health Consequences - Fatigue/Chronic Stress - Increased likelihood for heart disease, high blood pressure, type 2 diabetes, respiratory issues -Depression, anger, irritability, anxiety, alcohol or substance abuse -Isolation from family and friends -Decrease in work productivity

Notes about illness and injury lost-days

- workplace illnesses are more difficult to quantify than deaths/injury; difficult of latent period between exposures and disease development - healthcare workers (nursing aides, orderlies, etc): musculoskeletal injuries > 7X the average for all industries

Rabies

- zoonotic infection, affects animals and humans - can be transmitted to workers from the bite or scratch of an infected carnivore, such as a dog, cat, skunk, raccoon, fox, or bat - After exposure, virus incubates in human for 4-8 weeks before causing neurologic disease - Neurologic disease is characterized by fever, anxiety, excess salivation, and difficulty swallowing - After progression to neurologic disease, rabies is nearly 100% fatal! Work at risk: animal handlers, wildlife workers, tour guides (e..g, spelunkers), vets Prevention: - pre-exposure vaccination, or post-exposure vaccination plus immune globulin (rabies antibodies) injections - vaccination of domestic animals in the US has reduced rabies risk to many occupations - Workers who still incur risk of rabies exposure should receive human rabies vaccine - After a high-risk exposure additional vaccine doses are needed

Fishing Industry (highest mortality rates in 2019)

-145 deaths per 100,000 people -A sample of 187 medically treated injuries among fishermen was the basis for this study. -Nearly half the injuries occurred while shooting or hauling fishing gear. The most common injuries were the upper extremities (48.7%) -22% of the injuries occurred while working with winches ropes and wires -30% were caused by falls or slips -75% of accidents occurred on trawlers, where the trawl doors (other boards) are a special hazard. -Medical treatment ashore was delayed for more than 24 hours in 35% of the injuries, showing the need for providing optimal treatment facilities on board

Semi-Truck Drivers

-20% of fatal accidents were due to fatigue -26% of heavy truck crashes resulting in an injury of fatality were due to environmental conditions such as ice on the roadway -Higher rates of obesity, cancer, cardiovascular disease and lung disease -higher rates of skin cancer on left side of face -In 2018, there were around 499,000 automobile accidents involving large trucks in the U.S. - 107,000 injuries - 4119 fatalities -Texas, California and Florida have the highest crash rates in the U.S.

seasonal cycle of flu + prevention

-Infection rates vary seasonally, peaking in winter in northern hemisphere - Global pandemics include 1918 (killed > 50M) and 2009 (sickened > 500M) Workers at risk: exposure to general public; highest risk jobs include public service, teachers, and healthcare professionals Prevention: - avoiding exposures (e.g., isolating patients) - administrative controls (e.g., training to cover cough) - vaccination must generally be repeated annually to protect against emerging influenza viruses

Risk communication primary objectives

-Inform and educate people about risks -Build, strengthen, or repair trust -Encourage people to take appropriate actions Must address risk perception - Subjective, with influences of personal, social, cultural, and other factors - Requires listening and learning

Top 5 causes of injury and total annual costs

1) Overexertion (includes injuries related to lifting, pushing, pulling, holding, carrying, or throwing objects) -> 24.4% 2) Falls (same level) -> 16.4% 3) Falls (lower level) -> 8.7% 4) Being struck by object or equipment -> 8.6% 5) Other exertions or bodily reactions -> 6.7%

Categorizing Occupational Hazards and examples

1. By hazard category - physical, chemical, biologic, psychological 2. By health effects - respiratory, carcinogenic, dermatologic, etc 3. By exposure route - inhalation, ingestion, dermal, etc 4. By specific hazard - asbestos, diacetyl 5. By occupation - miners, construction workers, firefighters

Exposure assessment

1. Concentration - expressed in units of mass per mass, volume per volume, mass per volume Example: Air contaminants - Particulate matter: units of mass per volume - Gases: units of a mixing ratio - Contaminant per total volume of air - typically Parts per Million (PPM) or Parts per Billion (PPB) 2. Exposure - a contact between the contaminant and a boundary interface of a person with the environment - different than concentration: to be exposed, a person must come into contact with a contaminant - Boundary interfaces -Tissues - skin, alveolar surfaces, gastrointestinal lining - requires the simultaneous presence of a contaminant in the environment and contact at the human boundary interface - the function of both the CONCENTRATION (exposure intensity) and time - expressed as units of concentration x time duration 3. Dose - the mass of contaminant that crosses the tissue barrier and gets inside the body - potential dose: product of CONCENTRATION, duration of EXPOSURE, and the rate at which the material reaches the appropriate boundary - Evaluators often stop at potential dose, but absorption is typically not all of the potential dose -Toxicologists, physicians, and health scientists focus on the ABSORBED dose to understand the relationship between exposure and health effects -DOSE RATE affects the health outcome: - Exposure profile matters - some contaminants easily clear at low exposure levels, but toxic at higher levels - Focus on INTENSITY of exposure and DURATION of exposure

Important figures in occupational health

1. Crystal Eastman, Work Accidents and the Law (1906-1907) - First systematic investigation of accidents occurring during one year in Allegheny County, Pennsylvania - 526 men killed by work accidents in county 84% < 40 years old 58% < 30 years old 2. Alice Hamilton Described - lead poisoning in bathtub enamellers - Carbon monoxide poisoning in steel workers - Heart disease in munitions workers - "Dead fingers" in jack hammer users - Neurologic disease in rayon workers - Cancer after benzene exposure

Most common workplace accidents resulting in time missed from work

1. Overexertion - lifting, lowering, bending, and repetitive stress 2. Contact with objects and equipment - including being struct by, caught or compressed between, or crushed by machinery, falling objects, and collapsing structures and equipment 3. Slips, trips, and falls - falls can cause a variety of types of traumatic injuries, whether they involve slipping on a wet floor or falling from height due to a ladder failure of faulty handrail

Hierarchy of Controls

Elimination - remove a chemical from the manufacturing process (e.g., lead in paint) Substitution - replacement of a hazardous chemical or process with a less hazardous one (e.g., benzene replaced by toluene) Engineering controls (isolation) - containing or limiting exposure to hazardous materials (e.g., ventilation hoods for chemicals) Administrative controls - policies and procedures to reduce risk (e.g., limiting time each worker spends with a hazard) Protective devices and PPE - machine design and equipment worn to reduce hazards (e.g., reducing access of hands to hazards, respirators)

5 steps in the Silver Book for risk assessment

1. Problem formulation - What health effects are of concern? - What policy and management options are available to reduce risk? -What types of analyses are needed? - What are the roles of partners? 2. Hazard identification -Observational human studies -Experimental animal evidence -In vitro studies -In silico studies 3. Dose-response assessment : relationship between dose of a chemical and resulting incidence or severity of an adverse effect - carcinogen = cancer causing agent ---no threshold for how much you have to be exposed to it due to exposure over time (difficult to measure) - noncarcinogen: NOAEL (or LOAEL)/uncertainty factors -> reference dose - assumption of non-threshold vs. threshold 4. Exposure assessment - Difference in exposures - Route (inhalation, ingestion, etc) - Acute/chronic - Continuous/intermittent - Quantity/concentration - Stage of life Exposure setting (who) Exposure pathways (how) Exposure magnitude, frequency, duration (time period, when, how often) Exposure intake (how much) : focus on "internal dose" (amount of chemical taken into the body as opposed to amount one comes into contact with) 5. Risk characterization

top 5 occupations with disabling injuries and associated health risks

1. Service (including firefighters and police officers) 2. Transportation and shipping 3. Manufacturing and production 4. Installation, maintenance, and repair 5. Construction Rates of work-related deaths 2019 - Transportation and material moving: 1,481 - Construction and extraction: 1,066 - Service: 762 - Installation, maintenance and repair: 438 - Management, business, financial operations: 409

brief history on occupational health

1. Survey (July 1906-1907) in Allegheny County, Pennsylvania - 526 deaths in work accidents; 195 deaths of steelworkers - Bureau of Labor Statistics (1913) estimated 61 death per 100,000 U.S. workers (20X current rate) 2. Radium Girls

Most common workplace injuries resulting in time missed from work

1. sprains, strains, and tears - injuries to muscles, ligaments, and tendons that can result from twisting, stretching, overuse, or overexertion 2. soreness or pain - chronic pain is one of the most-common complaints among workers whose jobs require them to sit in an office chair for hours a day. 3. cuts, lacerations, and punctures - from band aids to sutures, the injuries can range in severity, and they can cause a variety of different types of physical limitations

Three objectives of occupational health

1. the maintenance and promotion of workers' health and working capacity 2. the improvement of working environments 3. the development of work organizations and working cultures to support health and safety

global child labor trends and the Fair Labor Standards Act

152 million children were working on any given day in 2016 - children aged 5-17 years 4.3 million children aged below 18 years in forced labor, representing 18% of the 24.8 million total forced labor victims worldwide More than two-thirds of all children in child labor work as contributing family laborers, while paid employment make up 27% United States - Fair Labor Standards Act (FLSA) - "To protect the educational opportunities of youth and prohibit their employment in jobs that are detrimental to their health and safety. FLSA restricts the hours that youth under 16 years of age can work and lists hazardous occupations too dangerous for young workers to perform" -Children ages 5-17 who live and work on farms suffer an average of 104 fatal injuries and 22,287 nonfatal injuries each year -The FSLA loophole - still permits children as young as 12 to work unlimited hours on a farm outside of school - Children of any age can work on small farms, with their parents' permission -child agricultural workers are also permitted to perform hazardous work at age 16, while hazardous work is strictly reserved for adults in all other sectors

Types of Exposure

Acute Exposure - occurs by ingestion, skin absorption, or breathing for 24 hours or less - when ACUTE EXPOSURE occurs at high levels = poisoning or other immediate responses Chronic Exposure - repeated episodes that occur by the same routes for more than approximately 10% of the lifespan -CHRONIC EXPOSURE at lower levels = linked to cancers, chronic lung damage, etc Subchronic Exposure - repeated exposure by one or more routes for more than 30 days, up to appx. 10% of the lifespan - Between ACUTE and CHRONIC = may be episodic or recurring

3 most common workplace injuries resulting from accidents

Back and neck injuries - Bulging discs (herniated discs), whiplash, and other back and neck injuries Bone fractures and dislocations - bone fractures also result in long-term absences for many workers. Dislocations, while generally less serious than fractures, also leave many workers in need of short-term disability benefits Concussions and Other Traumatic Brain Injuries (TBI) - more common than many people realize. You do not need to lose consciousness to suffer a concussion. can cause long term effects

Most common repetitive stress injuries at work

Carpal Tunnel Syndrome: repetitive stress injury that is common among office workers Tennis Elbow: repetitive stress injury that is common among workers - job-related tasks such as painting, operating tools, cutting, welding, operating, and performing dental and medical exams Injuries caused by inflammation: the most-common causes of repetitive stress injuries - tendonitis - trigger finger

desk occupational hazards and prevention strategies

Carpal tunnel syndrome - 70% of all Carpal Tunnel Syndrome cases are work related Arthritis - prolonged periods of working in awkward or unnatural postures at a desk Eye Strain - Migraines/Headaches Neck Strain/Pain - Holding a phone - Prolonged sitting Back Pain - Poor posture - Prolonged sitting-tight hip muscles Physical inactivity - Obesity Prevention - walking on breaks - five-minute walks throughout the workday can lift moods, reduce lethargy and improve overall health, increase productivity -preferably every hour -Stretching - Neck, wrists, back, shoulders -Standing Desks -Blue Light Glasses - Mixed evidence -Yoga -Reduce glare on computer screen -Bluetooth headsets

ways to protect workers against noise

Dosimetry - use of body-worn instruments (dosimeters) to monitor an employee's noise exposure over the work-shift Engineering Modifications - assessment of options for applying engineering controls to noisy machinery Ear protection

High-risk occupations in the U.S.

Fatal accidents - farming, fishing, forestry - transportation - construction - production - service Illness and injury lost-days - production workers - hand laborers - truck drivers - health aides - housekeepers - all others Distribution of Fatal and Nonfatal injury and illness in the U.S. Fatal: Transportation incidents Nonfatal: overexertion and bodily reaction

Examples of professionals at risk of chemical hazard exposures + how they are exposed

Hair Stylists - hair dyes, hair sprays, keratin treatments - absorb chemicals thorugh skin and breathe them in as fumes built up in the air Nail Technicians - nail polishes, polish removers, fingernail glue, nail primer, nail hardener, etc - exposed to higher levels of volatile organic compounds (VOCs) than encountered in most homes or urban environments - Health problems including headaches, respiratory irritation, and reproductive complications and cancer Textile Workers - chemicals including dyes, solvents, optical brighteners, finishing agents and natural and synthetic fibers - Dyes and solvents have mutagenic and carcinogenic properties - Respiratory difficulties, skin irritation, risk of cancers

Temperature Stress High Temperature

In 2014, 2,630 workers suffered from heat illness, and 18 died from heat stroke and related causes on the job -Heat rash -Heat cramps: painful, intermittent muscle spasms that occur during or following hard physical work under hot conditions -Heat exhaustion: caused by the loss of body fluids through sweating, the loss of salt, or both -Heat stroke: occurs when the body's heat regulation mechanisms break down. The characteristics of heat stroke are a high body temperature (105F or more), little or no sweating , and hot, dry, flushed skin

Temperature Stress Low Temperature

In 2017, there were over 20,000 occupational injuries related to ice, sleet and snow, 14% (2,890 cases) of which occurred in New York State Hypothermia - occurs when body heat is lost from being in a cold environment faster than it can be replaced -slurred speech, lack of coordination and memory loss develop and unconsciousness Frostbite - Typically affects the extremities, particularly the face, ears, fingers and toes. Initial symptoms vary, but typically include skin that looks waxy and feels numb - occurs more readily from touching cold metal objects because heat is rapidly transferred from skin to metal Solutions -The "work warm-up schedule," as developed by Saskatchewan Occupational Health and Safety Division shows the warm-up breaks required for working in cold conditions and the normal breaks to be provided every two hours. -protective clothing -machine engineering - can wear gloves/mittens

Use trusted sources

Little trust, little learning - communication mistakes (e.g., unclear messages, evasive answers, lack of empathy) can undermine public trust and reduce your impact Value in partnering with people known personally or by reputation to the target audience - Ultimately, you want members of the target audience to convey a message to one another

Key agencies

National Institute for Occupational Safety and Health (NIOSH) - Under the CDC, Dept of HHS - Scientific authority - makes recommendations Occupational Safety and Health Administration (OSHA) - under the Dept of Labor - regulatory authority - sets permissible exposure limits Mine Safety and Health Administration, Dept of Labor Offshore oil and gas workers, Dept of the Interior Truck drivers and railroad workers, Dept of Transportation

Obstructive Lung Disease vs. Restrictive Lung Disease + examples + how someone contracts each

Obstructive lung disease - obstruction in air movement through bronchial tubes - patients feel air hunger or short of breath; may wheeze or cough -Lungs become "hyper-inflated" due to air-trapping -Exposures: dust, chemicals and gases -Occupations at risk: construction workers - includes chronic obstructive pulmonary disease (COPD) and asthma Restrictive lung disease (Pneumoconioses) - restriction of alveoli expansion due to fibrosis and scarring - restricts lung expansion, resulting in a decreased lung volume, an increased work of breathing, and inadequate ventilation and/or oxygenation Asbestos: natural fiber with high durability, tensile strength, and heat resistance - used to insulate buildings, ships, brakes, and wiring - use peaked in 1950s, but now banned in 52 countries - Breathing asbestos fibers can cause a buildup of scar-like tissue in the lungs called asbestosis and result in loss of lung function that often progresses to disability and death -Asbestos also causes cancer of the lung and mesothelioma Coal Workers Pneumoconiosis (CWP) or Black Lung Disease - Long term exposure to coal dust - Coal dust accumulates in airways - Symptoms: Shortness of breath - In 2013 CWP resulted in 25,000 deaths - down from 29,000 deaths - Regulations - The Federal Mine Safety and Health Act (Mine Act) requires that the U.S. Dept of Labor's Mine Safety and Health Administration (MSHA) inspect all mines each year to ensure safe and healthy work environments for miners Silicosis - Silica is the primary component of sand and quartz - Occupational exposures come from masonry, stonework, glass work, mining - ~1M workers exposed inUS

Key legislation

Occupational Safety and Health Act of 1970 - created right to safe workplace and worker rights - OSHA and NIOSH founded - states can establish their own OSHA programs - Approximately half of states have done so - must be as effective as federal OSHA Policy instruments - Regulations and inspections - Limited budgets; focus is on bad actors instead of inspections for all Employers 1) shall furnish employment free from recognized hazards that are causing or are likely to cause death or serious physical harm to employees 2) shall comply with occupational safety and health standards promulgated under this Act

occupations at risk for viral skin infection + prevention

Occupations at risk: Veterinarians and zookeepers Prevention: avoiding skin contact with infected animals, wearing globes, and washing hands

occupations at risk for bacterial skin infection + prevention

Occupations at risk: all who work with tools, food preparers, landscapers, construction workers, many others Prevention: avoiding cuts and abrasions e.g., using safety devices on tools, wearing gloves or other PPE, and seeking prompt treatment for cuts and abrasions

occupations at risk for fungal skin infection + prevention

Occupations at risk: dishwashers, laundry workers, and others Prevention: keeping skin clean and dry; gloves, if wet inside, are counterproductive

Oscillatory vibration and what are atmosphere variations

Oscillatory vibrations - noise (unwanted sound) - physical vibrations of the body Atmosphere variations - extreme temperatures - high and low air pressures

Occupational health is multidisciplinary

Physicians (Board-certified specialty) Nurses (Certification-based specialty) Industrial hygienists (Certification-based specialty) Safety specialists Toxicologists Epidemiologists Audiologists, microbiologists, etc Exposure scientists - quantify exposure in general populations for use in risk assessments Industrial hygienists - conduct environmental sampling in the workplace - field has evolved from measuring exposures/risks to controlling risks

occupational health relationship with health equity

workers generally healthier than the general population - people who are sick or injured are more likely to leave employment - unemployment is associated with poorer health status than employment People with high incomes typically live longer and have better health indicators than those with lower incomes Underemployment (being paid too little) can lead to working multiple jobs, fatigue, greater risk of injury - Overlapping vulnerabilities - workers who are immigrants, and particularly those who are undocumented, are at increased risk of injury and illness - higher risk occupations, less access to information and care - Temporary workers show disproportionate injury/illness - less stability, may have less familiarity with safety protocols - Most costs are borne by workers and their families and by taxpayer-supported programs - Relatively little borne by employers