BSC – SEM 7 – UNIT 1 – COMMUNITY HEALTH NURSING – II

Occupational Diseases

Definition

Occupational diseases are illnesses or health conditions caused by prolonged exposure to specific risk factors in the workplace. These diseases develop due to the nature of the work, workplace environment, or exposure to hazardous substances. They can be physical, chemical, biological, ergonomic, or psychological in origin.

Types of Occupational Diseases and Their Causes

1. Respiratory Diseases

Occupational respiratory diseases are caused by inhaling dust, fumes, gases, or biological agents at the workplace.

🔹 Examples:

Pneumoconiosis – Caused by inhaling dust particles (e.g., coal dust in miners, silica in construction workers, asbestos in factory workers).
Occupational Asthma – Triggered by chemicals, dust, or allergens (e.g., flour dust in bakers, animal dander in veterinary workers).
Chronic Obstructive Pulmonary Disease (COPD) – Linked to long-term exposure to air pollutants, fumes, and tobacco smoke in workplaces.
Byssinosis (“Brown Lung Disease”) – Affects textile workers exposed to cotton, flax, or hemp dust.
Hypersensitivity Pneumonitis – Caused by inhaling organic dust (e.g., mold in farmers, wood dust in carpenters).

🔹 Prevention:
✅ Use of masks and respirators
✅ Ventilation systems to reduce dust exposure
✅ Regular medical check-ups for lung health

2. Skin Diseases

These diseases occur due to prolonged exposure to chemicals, biological agents, or irritants at the workplace.

🔹 Examples:

Contact Dermatitis – Caused by exposure to irritants (e.g., detergents, oils, cement, solvents, pesticides).
Eczema – Develops from chemical irritants in industries like hairdressing, healthcare, and construction.
Occupational Urticaria (Hives) – Caused by allergens in latex gloves, seafood processing, or chemicals.
Skin Cancer – Associated with prolonged sun exposure (e.g., outdoor workers, farmers) or exposure to carcinogens like arsenic and coal tar.

🔹 Prevention:
✅ Use of gloves, protective clothing, and barrier creams
✅ Avoid direct contact with harmful chemicals
✅ Proper workplace hygiene and washing after exposure

3. Musculoskeletal Disorders (MSDs)

MSDs result from repetitive movements, poor posture, or manual labor over time.

🔹 Examples:

Carpal Tunnel Syndrome – Common in office workers, typists, and factory workers using vibrating tools.
Tendonitis & Bursitis – Affects workers in construction, sports, and manufacturing due to repetitive motions.
Lower Back Pain – Common in nurses, factory workers, and heavy lifters.
Repetitive Strain Injury (RSI) – Seen in office workers, assembly line employees, and musicians.

🔹 Prevention:
✅ Ergonomic workstations with proper chairs and desks
✅ Regular stretching and exercise
✅ Proper lifting techniques

4. Noise-Induced Hearing Loss (NIHL)

Prolonged exposure to loud noise damages hearing.

🔹 Common Causes:

Factory workers exposed to heavy machinery
Construction workers using drills and jackhammers
Airport ground staff working near aircraft engines
Musicians and nightclub workers exposed to loud music

🔹 Symptoms:

Gradual hearing loss
Ringing in the ears (tinnitus)
Difficulty understanding conversations

🔹 Prevention:
✅ Use of earplugs or noise-canceling earmuffs
✅ Regular hearing tests
✅ Reducing exposure to loud environments

5. Occupational Cancer

Long-term exposure to carcinogens in the workplace leads to different types of cancer.

🔹 Examples:

Lung Cancer – Caused by asbestos, silica, radon gas, and arsenic exposure.
Mesothelioma – A rare cancer caused by asbestos exposure (common in shipyard workers, construction workers).
Skin Cancer – Develops in outdoor workers exposed to ultraviolet (UV) radiation.
Bladder Cancer – Linked to exposure to aromatic amines (found in dye and rubber industries).
Leukemia – Caused by exposure to benzene (used in petroleum, rubber, and chemical industries).

🔹 Prevention:
✅ Use of personal protective equipment (PPE)
✅ Substituting hazardous substances with safer alternatives
✅ Regular health screenings for early detection

6. Occupational Infectious Diseases

Workers in healthcare, agriculture, and waste management are at higher risk of infections.

🔹 Examples:

Tuberculosis (TB) – Common in healthcare workers, laboratory technicians, and prison staff.
Hepatitis B & C – Spread through needlestick injuries in healthcare workers.
HIV/AIDS – Risk in medical professionals due to accidental exposure to infected blood.
Leptospirosis – Caused by water contaminated with animal urine, affecting sewer workers and farmers.
Brucellosis – Affects farmers and veterinarians who handle infected animals.

🔹 Prevention:
✅ Vaccination (Hepatitis B, Influenza, COVID-19)
✅ Proper hand hygiene and use of gloves
✅ Safe disposal of medical waste

7. Cardiovascular Diseases (CVDs)

Work-related stress, long working hours, and exposure to chemicals contribute to heart diseases.

🔹 Risk Factors:

Workplace stress – Increases blood pressure and risk of heart attack.
Exposure to carbon monoxide – Leads to heart problems in firefighters, miners, and industrial workers.
Sedentary jobs – Prolonged sitting increases obesity and heart disease risk.

🔹 Prevention:
✅ Stress management programs
✅ Healthy diet and exercise for workers
✅ Work-life balance policies

8. Psychological & Mental Health Disorders

Workplace stress and poor mental health conditions can lead to various psychological disorders.

🔹 Examples:

Depression and Anxiety – Caused by high workload, job insecurity, and workplace bullying.
Burnout Syndrome – Affects healthcare workers, teachers, and IT professionals due to excessive workload.
Post-Traumatic Stress Disorder (PTSD) – Common in soldiers, police officers, and firefighters exposed to traumatic events.
Sleep Disorders – Common in shift workers and airline crew due to irregular work hours.

🔹 Prevention:
✅ Mental health counseling at workplaces
✅ Flexible work hours and stress management programs
✅ Creating a supportive work environment

General Prevention and Control of Occupational Diseases

Workplace Risk Assessment – Identifying hazards and implementing safety measures.
Use of Personal Protective Equipment (PPE) – Masks, gloves, goggles, ear protection, etc.
Engineering Controls – Improving ventilation, soundproofing, and chemical safety systems.
Regular Health Check-ups – Screening workers for early detection of diseases.
Workplace Policies & Regulations – Enforcing occupational safety laws like OSHA (Occupational Safety and Health Administration).
Employee Training Programs – Educating workers about hazards and safe work practices.

Occupational diseases are preventable through proper safety measures, regular health monitoring, and employee education. Employers and employees must work together to create a safe work environment and reduce occupational health risks.

Employees’ State Insurance (ESI) Act, 1948.

1. Introduction

The Employees’ State Insurance (ESI) Act, 1948, is a social security and health insurance scheme implemented by the Government of India to provide medical and financial benefits to workers and their dependents. It aims to protect employees from health-related risks such as sickness, maternity, disability, and employment-related injuries.

The Employees’ State Insurance Corporation (ESIC), under the Ministry of Labour and Employment, is responsible for administering the scheme.

2. Objectives of the ESI Act

To provide medical benefits to employees and their families.
To offer cash benefits during sickness and maternity.
To ensure financial support in case of employment-related disabilities.
To provide dependents’ benefits in case of the insured worker’s death.
To offer vocational rehabilitation in case of permanent disability.
To ensure welfare measures for industrial workers and improve their health and economic well-being.

3. Applicability of the ESI Act

The Act applies to factories and establishments with 10 or more employees (in some states, it is applicable to units with 20 or more employees).
It covers organized sector employees earning a gross salary of up to ₹21,000 per month (₹25,000 for persons with disabilities).
It applies to shops, hotels, restaurants, cinemas, road transport, educational institutions, hospitals, and newspaper establishments.

🔹 Exemptions:

Seasonal factories operating for less than 7 months in a year.
Employees earning above ₹21,000 per month are not covered under ESI but can avail of other insurance schemes.

4. Contributions under the ESI Act

Employee and Employer Contribution

Contributor	Contribution (% of Gross Wages)
Employer	3.25%
Employee	0.75%
Total Contribution	4.00%

Employees earning less than ₹176 per day are exempted from the employee’s share of contribution, but the employer must still contribute.

5. Benefits Under the ESI Act

1. Medical Benefits

Free medical treatment for the insured person and their dependents.
Includes hospitalization, specialist consultation, and surgery if required.
No upper limit on medical expenses for insured persons.
Covers super-specialty treatments like heart surgery, kidney transplant, and chemotherapy.

2. Sickness Benefits

Cash compensation of 70% of wages for 91 days per year during medical leave.
Extended sickness benefits up to 2 years (80% of wages) for specific diseases like tuberculosis, cancer, and mental illness.

3. Maternity Benefits

100% of wages paid for 26 weeks during maternity leave.
Extendable by 1 month on medical advice.
Benefits also applicable in case of miscarriage (6 weeks leave) or tubal ligation (14 days leave).

4. Disability Benefits

Temporary Disability Benefit (TDB):
- 90% of wages paid till the employee recovers.
Permanent Disability Benefit (PDB):
- Monthly pension based on disability percentage assessed by a medical board.

5. Dependents’ Benefits

In case of death due to employment injury, 90% of wages is paid as a monthly pension to dependents (spouse, children, and parents).
Widow receives a pension for life, children up to 25 years, and dependent parents for life.

6. Funeral Expenses

A lump sum of ₹15,000 is paid towards funeral expenses of the insured worker.

7. Unemployment Allowance (Rajiv Gandhi Shramik Kalyan Yojana – RSBKY)

50% of wages for 2 years if the worker loses their job due to factory closure, retrenchment, or permanent disability.
Medical care for self and family during this period.

6. Administration of ESI Scheme

Employees’ State Insurance Corporation (ESIC)

The ESIC is a statutory body under the Ministry of Labour & Employment, which manages the ESI scheme.

🔹 ESIC Functions:

Formulating policies and regulations.
Running hospitals, dispensaries, and medical colleges.
Collecting contributions from employers and employees.
Ensuring proper use of funds for the benefit of insured persons.

7. Registration Under the ESI Act

For Employers

Employers must register under ESIC within 15 days of becoming eligible.
They must submit Form 01 and other relevant documents.

For Employees

Employees receive an ESI Card (Pehchan Card), which provides access to medical facilities.

8. Penalties for Non-Compliance

Employers who fail to register or do not contribute to ESI face strict penalties:

🔹 Fines & Legal Actions

Non-payment of contributions – Imprisonment up to 2 years and fine up to ₹5,000.
False statements to evade ESI contribution – Imprisonment up to 1 year or fine up to ₹5,000.
Non-maintenance of records – Fine of ₹10,000 per instance.

9. Recent Amendments & Updates

Threshold limit increase: Increased from ₹15,000 to ₹21,000 for employee coverage.
Reduction in contribution rate (2019): Employee contribution reduced from 1.75% to 0.75% and employer contribution from 4.75% to 3.25%.
ESI coverage expansion: Inclusion of more districts under ESIC hospitals and dispensaries.
Online services: Digital registration, e-challans, and claim submission via the ESIC online portal.

10. Comparison: ESI Act vs. EPF Act

Criteria	ESI Act	EPF Act (Provident Fund)
Objective	Health & Social Security	Retirement Benefits
Applicability	Factories, shops, establishments with 10 or more employees	Organizations with 20 or more employees
Salary Limit	₹21,000 per month	₹15,000 per month
Contribution (%)	Employer: 3.25%, Employee: 0.75%	Employer: 12%, Employee: 12%
Benefits	Medical, maternity, disability, dependent pension	Provident fund, pension, insurance
Governing Body	Employees’ State Insurance Corporation (ESIC)	Employees’ Provident Fund Organization (EPFO)

The ESI Act, 1948 is a crucial social security scheme that ensures health protection and financial support for workers in case of sickness, maternity, disability, or employment-related injuries. It plays a vital role in improving the quality of life for industrial workers and their families. Employers must comply with ESI regulations to provide better healthcare and social security benefits to their employees.

National & State Occupational Health Programs

Occupational health programs in India are designed to prevent and control occupational diseases, injuries, and hazards among workers in various industries. These programs are implemented at the national and state levels to ensure safe working conditions and health coverage for employees.

1. National Occupational Health Programs in India

1.1. National Programme for Occupational Health and Safety (NPOHS)

🔹 Objective:
To ensure the health and safety of workers by identifying occupational hazards, preventing work-related diseases, and promoting workplace health.

🔹 Key Components:

Strengthening occupational health services in industries.
Conducting health surveillance of workers exposed to hazardous environments.
Implementing workplace safety regulations and training programs.
Encouraging employers to adopt preventive measures like PPE (Personal Protective Equipment) and regular medical check-ups.

🔹 Target Sectors:

Construction industry
Manufacturing and chemical industries
Mining and quarrying
Agriculture sector
Healthcare workers

1.2. Employees’ State Insurance (ESI) Scheme

🔹 Objective:
To provide medical and financial benefits to employees facing occupational health issues due to workplace-related injuries or illnesses.

🔹 Coverage:

Factories and establishments with 10 or more employees.
Workers earning up to ₹21,000 per month.
Provides medical care, disability compensation, and maternity benefits.

🔹 Services Provided:

Free medical treatment in ESI hospitals and dispensaries.
Cash benefits for sick and disabled workers.
Rehabilitation services for permanently disabled workers.

1.3. The Factories Act, 1948 (Amended in 1987)

🔹 Objective:
To ensure safe working conditions and health protection for workers in factories.

🔹 Provisions Related to Occupational Health:

Cleanliness and ventilation in workplaces.
Occupational disease surveillance for workers exposed to hazards like chemicals, radiation, and dust.
Mandatory health check-ups for workers in hazardous industries.
Provision of clean drinking water, restrooms, and canteens for workers.

1.4. The Mines Act, 1952

🔹 Objective:
To regulate occupational safety and health standards in the mining industry.

🔹 Key Provisions:

Ensures ventilation, dust control, and proper lighting in mines.
Mandates medical examinations for miners exposed to dangerous conditions.
Provides compensation for mine accidents and occupational lung diseases (e.g., pneumoconiosis).

1.5. The Dock Workers (Safety, Health, and Welfare) Act, 1986

🔹 Objective:
To protect port and dock workers from occupational hazards.

🔹 Provisions:

Safety training and protective measures for dock workers.
First aid and medical facilities at ports.
Accident prevention measures to reduce injuries at docks.

1.6. The Building and Other Construction Workers (Regulation of Employment and Conditions of Service) Act, 1996

🔹 Objective:
To provide health, safety, and welfare measures for construction workers.

🔹 Benefits for Workers:

Free health check-ups and medical insurance.
Maternity benefits for female construction workers.
Compensation in case of accidents and disabilities.
Provision for drinking water, restrooms, and safety gear at construction sites.

1.7. The Workmen’s Compensation Act, 1923

🔹 Objective:
To compensate workers injured or disabled due to occupational accidents.

🔹 Provisions:

Employers must pay compensation for work-related injuries, permanent disability, or death.
The amount of compensation depends on the severity of the disability.
Coverage includes industrial workers, construction laborers, and transport workers.

1.8. National Policy on Safety, Health, and Environment at Workplace (2009)

🔹 Objective:
To promote a safe and healthy work environment across all industries.

🔹 Key Focus Areas:

Developing safety training programs for workers.
Ensuring strict enforcement of occupational health laws.
Promoting the use of modern technology to reduce workplace hazards.

1.9. National Rural Health Mission (NRHM) & Urban Health Mission (NUHM) – Occupational Health Component

🔹 Objective:
To provide basic healthcare services to workers in unorganized sectors such as agriculture and construction.

🔹 Services:

Free medical check-ups for rural and urban workers.
Mobile health units for migrant and seasonal laborers.
Awareness programs on occupational diseases and prevention.

1.10. Occupational Health Programs by NIOH (National Institute of Occupational Health)

🔹 Objective:
To conduct research and training on occupational diseases and workplace hazards.

🔹 Key Activities:

Study of occupational diseases (silicosis, asbestosis, pesticide poisoning).
Development of guidelines for workplace safety.
Conducting training workshops for industrial workers and healthcare providers.

2. State-Level Occupational Health Programs in India

Many states have customized occupational health programs based on regional industries and health concerns. Some notable state programs include:

2.1. Gujarat Occupational Health Programme

Special focus on textile, diamond polishing, and chemical industries.
Free silicosis screening for workers exposed to silica dust.
Occupational health awareness campaigns for workers.

2.2. Rajasthan Silicosis Prevention Program

Financial compensation and health benefits for workers suffering from silicosis.
Free medical check-ups and disability pensions for affected workers.
Strict enforcement of dust control measures in mining areas.

2.3. Maharashtra Industrial Health and Safety Program

Medical camps for workers in automobile, textile, and chemical industries.
Regular workplace inspections to ensure compliance with safety laws.
Training programs for workers and supervisors on occupational safety.

2.4. Karnataka Occupational Health and Safety Scheme

Focus on agriculture and plantation workers.
Mobile medical units for tea and coffee estate workers.
Implementation of strict pesticide safety norms.

2.5. Tamil Nadu Industrial Health Program

Special initiatives for leather, textile, and fireworks industry workers.
Free health check-ups and safety training for factory workers.
Strict implementation of hazardous chemical handling rules.

3. Challenges in Implementing Occupational Health Programs

🚫 Lack of Awareness – Many workers are unaware of occupational health risks and available benefits.
🚫 Poor Compliance – Many small industries do not follow safety regulations due to lack of enforcement.
🚫 Inadequate Health Facilities – Many rural and unorganized sector workers lack access to proper medical care.
🚫 Limited Coverage – The unorganized sector (agriculture, construction, domestic workers) is not fully covered under occupational health programs.

4. Recommendations for Improving Occupational Health Programs

✅ Strict enforcement of occupational safety laws.
✅ Expansion of ESI coverage to all unorganized sector workers.
✅ Awareness campaigns for workers about occupational diseases.
✅ More research and data collection on workplace hazards.
✅ Adoption of advanced technology to reduce workplace risks.

India’s national and state-level occupational health programs play a crucial role in protecting workers’ health and safety. However, there is a need for stronger implementation, better awareness, and expanded coverage to ensure that all workers, including those in the unorganized sector, receive adequate healthcare and protection.

Role of a Nurse in Occupational Health Services

Occupational health nurses (OHNs) play a crucial role in preventing, identifying, and managing occupational health problems. Their responsibilities include screening, diagnosing, managing, and referring clients with work-related health issues. They work in industries, hospitals, factories, and corporate settings to promote health and safety in the workplace.

1. Screening for Occupational Health Problems

🔹 Objective:

Early detection of occupational diseases, injuries, and health hazards in workers.
Identifying risk factors before they cause serious health complications.

🔹 Nurse’s Role in Screening:
✅ Conduct pre-employment health check-ups to assess workers’ fitness for specific jobs.
✅ Perform periodic health assessments to monitor long-term effects of workplace exposure.
✅ Administer specific screening tests based on occupational risk factors:

Type of Screening	Example of Workplace Exposure	Test Used
Respiratory Screening	Silica dust, asbestos, fumes	Pulmonary Function Test (PFT), Chest X-ray
Hearing Screening	Loud noise in factories	Audiometry Test
Skin Screening	Chemical exposure, latex	Skin Patch Test
Ergonomic Assessment	Repetitive work, lifting heavy loads	Musculoskeletal Screening
Vision Screening	Computer operators, welders	Snellen’s Eye Test
Blood Tests	Lead, mercury, pesticide exposure	Blood Lead Level (BLL), Liver Function Tests (LFT)

✅ Educate workers on self-monitoring for early symptoms of occupational diseases.
✅ Identify workers at higher risk (pregnant women, elderly, immunocompromised individuals) and provide preventive counseling.

2. Diagnosing Occupational Health Problems

🔹 Objective:

Identify occupational diseases early to prevent complications.
Differentiate between work-related illnesses and other medical conditions.

🔹 Nurse’s Role in Diagnosis:
✅ Take a detailed occupational history, including:

Type of work and duration of exposure.
Symptoms related to workplace conditions.
Use of protective equipment (PPE).
Past medical history and pre-existing conditions.

✅ Conduct clinical examinations to assess symptoms related to occupational hazards.
✅ Order and interpret diagnostic tests to confirm occupational diseases:

Lung function tests (Spirometry) for occupational asthma or pneumoconiosis.
Hearing tests (Audiometry) for noise-induced hearing loss.
Blood tests for lead, mercury, or pesticide poisoning.
Urinalysis for heavy metal toxicity.

✅ Use OSHA (Occupational Safety and Health Administration) & NIOH (National Institute of Occupational Health) guidelines to diagnose work-related conditions.

3. Management of Occupational Health Problems

🔹 Objective:

Provide first aid and emergency care for occupational injuries and illnesses.
Offer long-term health management and rehabilitation for affected workers.

🔹 Nurse’s Role in Management:
✅ Emergency Care for Workplace Injuries:

Treat burns, chemical exposures, fractures, cuts, and electrocution injuries.
Provide cardiopulmonary resuscitation (CPR) and oxygen therapy in case of emergencies.
Remove workers from hazardous environments and initiate decontamination if exposed to toxic chemicals.

✅ Chronic Disease Management:

Monitor workers with chronic occupational illnesses (e.g., silicosis, asbestosis, noise-induced hearing loss).
Provide medications, inhalers, or oxygen therapy for respiratory conditions.
Manage ergonomic-related musculoskeletal disorders (MSDs) with physical therapy, exercise, and proper posture training.
Offer mental health support for stress, burnout, and workplace anxiety.

✅ Health Promotion & Disease Prevention:

Educate workers on proper use of personal protective equipment (PPE).
Conduct vaccination programs (e.g., Hepatitis B for healthcare workers, Tetanus for factory workers).
Train workers in hygiene, workplace safety, and first aid.
Organize yoga, exercise, and stress management programs.

✅ Workplace Modifications for High-Risk Workers:

Recommend better ventilation, ergonomic chairs, and protective barriers.
Advise on job modifications for pregnant workers, disabled employees, or those with pre-existing conditions.

4. Referral of Clients with Occupational Health Problems

🔹 Objective:

Ensure workers receive specialized medical treatment if needed.
Provide rehabilitation and disability support.

🔹 Nurse’s Role in Referral:
✅ Refer workers to specialists for further evaluation and treatment:

Pulmonologist for occupational lung diseases (e.g., silicosis, COPD).
Dermatologist for occupational skin disorders (e.g., dermatitis, chemical burns).
Audiologist for hearing loss due to noise exposure.
Neurologist for nerve-related injuries (e.g., carpal tunnel syndrome, heavy metal poisoning effects).
Oncologist for work-related cancers (e.g., mesothelioma, leukemia due to benzene exposure).

✅ Coordinate with ESI hospitals, occupational health centers, and government schemes for financial assistance.
✅ Support rehabilitation programs for disabled workers to help them regain employment or receive disability benefits.
✅ Guide workers in filing compensation claims under the ESI Act and Workmen’s Compensation Act.

5. Legal & Ethical Responsibilities of Occupational Health Nurses

🔹 Ensure Workplace Safety Compliance:

Conduct workplace audits for safety violations.
Report unsafe working conditions to employers and health authorities.

🔹 Maintain Confidentiality:

Protect workers’ medical records and health status.

🔹 Advocate for Workers’ Rights:

Promote healthy work policies and mental well-being programs.

6. Summary: Nurse’s Role in Occupational Health Services

Function	Nurse’s Responsibilities
Screening	Conduct health check-ups, risk assessments, and workplace monitoring.
Diagnosing	Identify occupational diseases using medical history and diagnostic tests.
Management	Provide emergency care, chronic disease management, and health education.
Referral	Refer workers to specialists, rehabilitation centers, and legal aid.

Occupational health nurses bridge the gap between healthcare and workplace safety, ensuring that workers receive timely diagnosis, proper management, and necessary referrals for occupational health problems.

Published February 14, 2025By mynursingapp

Categorized as BSC - SEM 7 - COMMUNITY HEALTH NURSING – II, Uncategorised

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