EHS 100, Chapter 13 (Occupational Health)

Threshold Limit Value (TLV)

"Refers to *airborne concentrations of substances* and represents conditions under which it is believed that nearly all workers may be unaffected." The Am Conference of Governmental Industrial Hygienists (ACGIH) publish these guidelines annually.

Biological exposure indices (BEIs)

"a measure of the amt of chemical absorbed into the body"

Maximum allowable concentrations (MACs)

"define permissible levels of exposure to chemicals.

Job Stress

"defined as the harmful physical and emotional responses that occur when the requirements of the job do not match the capabilities, resources, or needs of the worker."

3 industries w the largest #s of deaths

1. Construction 2. Transportation + warehousing 3. Agriculture, forestry, fishing, and hunting

2 employment categories affected greatly by noise

1. Construction industry - bulldozers, heavy trucks, loading machines 2. Healthcare industry - high-speed bone cutting drills and suctioning devices

Prevention of occupational disease PRIMARY prevention

1. Engineering controls: quieter machinery, improved building ventilation 2. Modification of work practices: safety education and training programs 3. Administrative controls: organization of work shifts and rotation of employees

Distribution of injuries and illnesses by nature, 2008

1. Sprains and strains - 38.6% 2. All other natures - 16.6% 3. Cuts, lacerations, punctures - 9.3% 4. Bruises, contusions - 8.7% 5. Fractures - 8.3% 6. Soreness, pain (except back) - 7.1% 7. Multiple traumatic injuries - 4.1% 8. Back pain - 3.4%

2 historically significant occupational accidents

1. Triangle Shirtwaist Company Fire -- 1911, NYC.. 146 women died within 15 minutes. Doors were locked and fire escapes were nonfunctional. 2. Gauley Bridge Disaster -- 1931, WV. Tunneling project caused exposure of unprotected workers to high levels of silica dust. Resulted in about 1,500 cases of silicosis and 1,000 deaths.`

Nonfatal Occupational Injuries and Illnesses (private industry)

2002 = 4.7 million newly reported cases. Since 2002, the # of cases has continued to decline. 2008 = 3.7 million cases. Leading causes of injuries were *sprains and strains* from repeated trauma.

COPD and Asthma

About 30% of cases of COPD and asthma can be linked to occupational exposures. COPD is related to workplace exposure to dusts. It can lead to loss of work time, economic losses, morbidity and mortality. Asthma has become the most frequently diagnosed occupational respiratory disease in the U.S. Occupational exposure may exacerbate pre-existing asthma.

Carbon Monoxide (CO)

An odorless, hazardous, toxic gas. Causes death by depriving the body of oxygen. Persons with conditions such as lung disease, heart disease, and anemia are at increased risk of the effects of CO.

Conditions assc w Job Stress

Anxiety, stress, and neurotic disorders "Going postal" Critical incident stress Note: Of 6 job categories, the classification of *technical, sales, and adm support* had the highest %of cases of anxiety, stress, and neurotic disorders in 2001.

Personal Protective Equipment (PPE)

Apparatuses "designed to protect employees from serious workplace injuries or illnesses resulting from contact with chemical, radiological, physical, electrical, mechanical, or other workplace hazards." Examples = goggles, coveralls, gloves, vests, earplugs.

Microbial Agents

Are a source of health risks for workers in many occupational categories. For example, health care workers, workers exposed to sewage, and agricultural workers may be exposed to bacteria, viruses, and disease-carrying insects. Bloodborne pathogens = HBV, HCV, HIV Bacteria = TB, anthrax Virus = influenza

Work-related stress

Chronic stress has been implicated in a range of somatic conditions (e.g., coronary heart disease) and mental disorders including depression. Term *going postal* refers to employees who react to stressful conditions of their environment by committing violent acts.

Costs of occupational injuries, illnesses, and fatalities (2002)

Direct costs = $45.8 billion. Indirect costs = $229 billion.

Fertility and pregnancy abnormalities

Examples are birth defects, prematurity, low birth weight, sp abortions, and developmental disabilities. A total of 4 million chemicals in use commercially have not been tested for their reproductive effects. Most of the 1,000 chemicals used in the work env that have been demonstrated to cause adverse reproductive effects among animals have not been tested with humans.

Exposure limits

Guidelines and regulations for limitation of workplace exposures to hazardous agents.

Occupational Disease

Health outcomes that are "caused or influenced by exposure to general conditions or specific hazards encountered in the work environment."

Infectious diseases: workers at risk

Healthcare workers Public utility workers Agricultural workers Social service workers and corrections personnel Clinical laboratory specialists Mortuary workers Adult film industry workers

US agencies the conduct surveillance

NIOSH = National Institute for Occupational Safety and Health NCHS = National Center for Health Statistics BLS = Bureau of Labor Statistics OSHA = Occupational Safety and Health Administration MSHA = Mine Safety and Health Administration

Surveillance programs operated by NIOSH

NSSPM = National Surveillance System of Pneumoconiosis Mortality NTOF = National Traumatic Occupational Fatalities Surveillance System SENSOR = State-based Sentinel Event Notification System for Occupational Risks

Low back disorders

Nursing profession is one of the occupations w a high risk of back injuries. ~38% of nurses report to have sustained back injuries.

Origin of occupational health

Recognition of occupational risks from mining occurred during Greek and Roman times.

Permissible noise levels in the workplace, set by NIOSH

Recommended exposure limit (REL) for noise exposure in the workplace during an 8-hour shift is *85 dBA*. dBA refers to "A-weighting", meaning that exposure is an 8-hour time weighted avg.

Critical incidence stress (CIS)

Refers to intense reactions that arise from witnessing violent behavior or from dealing w traumatic incidents such as those experienced by paramedics or first-responders.

Noteworthy figures in history

Rhazes (ca. 850-923) - used occupational classifications (i.e. goldsmith) in medical case descriptions. Paracelsus (1493-1541) - one of the founders of toxicology, used to examine the effects of chemicals found in workplace. Bernardino *Ramazzini* (1633-1714) - "father of occupational medicine". Described manifestations of occupational diseases. His book highlighted risks of hazardous chemicals, dusts and metals used in workplace. Sir Percival Pott - first person to describe an envtal cause of cancer, scrotal CA in chimney sweeps. Dr. Hamilton - described "phossy jaw", phosphorus necrosis of the jaw among workers who manufactured matches.

Nature of sound and hearing

Sound is produced by oscillating waves of various *frequencies*. The term Hertz (Hz) denotes the number of cycles per second associated with the oscillation of a given sound wave. The range of human hearing is 20-20,000Hz.

Common MSD in the workplace

Sprains, strains, tears Soreness, pain, hurt, except the back Back pain, hurt back Hernia Carpal tunnel syndrome Tendonitis

PH Surveillance

Surveillance systems include the collection of information about occupational injuries and illnesses and maintenance of databases on exposures to occupational hazards.

The 3 methods of primary prevention are preferred over other methods for protecting workers such as the use of PPE.

TRUE!!!!

Sound Pressure Level (SPL) and Decibels (dB)

The SPL is a measure of the *intensity* of sound. The SPL is reported on a logarithmic scale that uses decibels (dBs). An increase of 10dB represents a *10-fold* increase in sound intensity. dBs are advantageous for characterizing the large variability in the range of sounds that the human ear can perceive.

Hearing loss caused by noise

The second most-commonly self-reported occupational injury or illness. As many as 10 million workers in U.S. suffer from noise-induced hearing loss. Prolonged exposure to noise may result in psychological reactions that adversely impact the immune system and physical well-being. As many as 30 million persons in the US face the risk of hearing loss due to excessive noise.

Allergic and irritant dermatitis

The skin is one of the most common sites of contact with chemicals in the workplace. Manufacturing, construction, food production, and activities such as metal plating and engine service put workers at highest risk for skin diseases.

Noise

The term ototoxic refers to agents that can produce hearing loss. Ototoxic agents include very loud sounds and several classes of drugs and chemicals used in the work environment.

Toxic heavy metals and their fumes

Toxic heavy metals (arsenic, lead, mercury, cadmium, chromium and nickel) are potential hazards to human health. Processing and milling of heavy metals put workers at risk of breathing fumes and dusts that contain toxic levels of these metals.

Sources of Job stress

Work overload Job dissatisfaction Job insecurity Lack of control of work env Inadequate compensation Lack of benefits

Work-related injuries and fatalities

Work-related traumatic injuries are serious injuries from causes such as vehicle collisions, workplace violence, and falls. In 2007, approximately 15 workers died every day in the US from traumatic injuries. The BLS reported a total of 5,214 fatal occupational injuries in 2008.