WORKPLACE HAZARDS AND THEIR ILL EFFECTS

I. INTRODUCTION:

Goals of Occupational Health (Joint ILO/WHO Committee on Occupational Health)

• the promotion and maintenance of the highest degree of physical, mental and social
well-being of workers in all occupations;
• the prevention among its workers of departures from health caused by their working
conditions; the protection of workers in their employment from risks usually from
factors adverse to health;
• the placing and maintenance of the worker in an occupational environment adapted
to his/her physiological and psychological ability; and
• the adaptation of work to the worker and each worker to his/her job.

II. CLASSIFICATION OF HAZARDS

Occupational hazards - factors found in the workplace that can cause diseases,
injuries or deviations from health and may be classified as physical, chemical, biological and
ergonomic hazards.

1. Physical agents include excessive levels of noise, vibration, extremes of

temperature and pressure and ionizing and non-ionizing radiation.

2. Biologic agents cause diseases through infection or by affecting the immune

mechanism.

3. Chemical hazards are caused by gases, vapors or aerosols workers come in

contact with through the performance of their tasks.

4. Ergonomic stressors include improperly designed tools or work areas, improper

lifting or reaching, poor visual conditions and other conditions in the workplace that
may lead to accidents and illness or discomfort on the part of the workers.

Factors That Influence Workers’ Response to Hazards

• Genetic or Heredity
• Age
• Gender
• Medical History

Variables that Influence Effects of Hazards to the Workers

• Physical properties of the hazards
• Multiplicity of exposure to the hazards

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 • Duration of exposure to the hazards
• Timing of exposure
• Magnitude of exposure
*An immediate response may be produced due to intense exposure to the hazard
or the response may result from longer exposure at a lower intensity.

III. CHEMICAL HAZARDS

Chemical Agents May Occur As:

• Gas – e.g. carbon monoxide, hydrogen sulfide, carbon dioxide
• Vapors – e.g. solvents, acids
• Aerosols – dusts, fumes, smoke, mist, fog

Examples of the Patterns of Effects from Exposure to Chemical Hazards

• Acute – immediate effect from high dose exposure
o e.g. pesticide poisoning
• Chronic – effects from low dose long term exposure
o e.g. lead poisoning, cancer from benzene
• Carcinogenic effect
• Allergic reaction/ effects, etc

Routes of Entry of Chemical Hazards into the Human Body

• Through the skin (absorption)
• Through the gastrointestinal tract (ingestion)
• Through the respiratory tract/ lungs (inhalation)
*In the occupational setting, the most frequent and most important route of absorption
is through the lungs or inhalation

Routes by Which the Body Excretes the Chemical Hazards

• Gastrointestinal tract – through the feces
• Kidneys – through the urine
• Lungs – as one exhales
• Secretory structures – through the sweat glands, breast milk, etc.

Factors which affect absorption of chemical hazards

• Water solubility
• Particle size
• Defense mechanisms of the host/ human body

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Table 1. Renal Diseases That May Arise From Chemical Exposure in the Workplace
Causative Agents Industry Diseases
M ercury, Lead Battery, chemical industries, Battery Chronic Renal Failure
Cadmium manufacturing Renal Stones (cadmium)
Nephrotic Syndrome (mercury)
Chloroform, Carbon Solvents, chemical industries Acute Renal Failure
tetrachloride
Carbon disulfide Solvents, pesticides Chronic renal failure

Table 2. Respiratory Diseases That May Arise From Chemical Exposure in the Workplace
Causative Agents Industry/ Process Diseases
Inorganic Dust Mining, sandblasting, construction, Pneumoconiosis (silicosis,
coal workers asbestosis, coal workers’
pneumoconiosis
Hemp, flax Textile, cotton, Byssinosis
Molds Agriculture Farmers’ Lung, bagassosis
Solvents, ammonia, Chemical processes/ industries, pulp Irritation, inflammation, edema
formaldehyde & paper production, laboratories
Diisocyanates, vanish Plastics, platinum jewellers, Asthma
electroplating
Nickel, arsenic, Pigments, plating processes, metal Cancer
chromium refining

Table 3. Occupational Hematologic (Blood) Diseases

Causative Agent Industry/Process Disease
Lead Battery manufacturing, lead Anemia
smelting
Benzene Solvent, soap manufacturinf Aplastic anemia
Arsine gas Chemical industries Hemolysis of red blood cells

Table 4. Skin Diseases That May Arise From Chemical Exposure in the Workplace
Causative Agent Industry/Process Disease
Plastics. Epoxies Plastic, Varnish Allergic Contact Dermatitis
Sodium Hydroxide, Acids Chemical industry, laundering Irritant Contact Dermatitis

Cement Construction, Cement Burns, irritation, contact

manufacturing dermatitis
Cutting oils, grease Machine tools operations Acne
Chlorinated hydrocarbons Chemical processes Chloracne
Arsenic, tar, polycyclic Petroleum refinery, asphalt Skin cancers
hydrocarbons workers
Table 5. Occupational Liver Diseases
Causative Agent Industry/Process Disease

Carbon tetrachloride Cleaning fluids, dry cleaners Acute Hepatotoxicity

Arsenic, Chlorinated Smelting, Insecticides, Chemical Cirrhosis
Hydrocarbons industry
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Epoxy resins Rubber, synthetic fabrics Acute cholestatic hepatitis
Vinyl chloride, aflatoxins Plastics, vinyl chloride monomer Liver cancer

Table 6. Occupational Cardiovascular Diseases

Causative Agent Industry/Process Disease

Lead, cadmium Battery manufacturing/ Hypertension

recycling
Carbon disulfide Degreasing, dry cleaning Atherosclerosis
Flourocarbons, trichloroethylene Refrigeration, solvent workers Arrythmias
Nitrates Explosives Angina, Myocardial infarction

Table 7. Occupational Lead Exposure: Risk Factors

INCREASED RISK DECREASED RISK
The process itself • High processing temperature (esp. 1000ºc) • Low temperature (500ºc)
• Extensive fume, dust or aerosol formation. • Low dust exposure
• Primitive working methods • Automation
General hygienic • Poor housekeeping • Efficient local and general
level of the • Poor personal hygiene ventilation
workplace • Ignorance (e.g when protective equipment • Prevention of spread of lead
is required but not used) dust (for example,
• Smoking and eating in the workplace moistening the floor)

Effects of Lead Poisoning:

• Hypertension
• Decreased hearing acuity
• Nephropathy/ Renal failure
• Infertility (men)
• Frank anemia
• Peripheral Neuropathy
• Encephalopathy – seizures

IV. PHYSICAL HAZARDS

• Noise
• Extremes of Temperatures (Very warm & very cold)
• Inadequate Illumination
• Radiation (Ionizing & Non-ionizing)
• Vibration

A. NOISE
• Any unwanted or undesirable sound
• Effects of noise depend on
o intensity (loudness)
o duration of the sound
o frequency of the sound

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Approximate Decibel Level
Decibels (dB) Examples
0 The quietest sound you can hear
30 Whisper, quiet library
60 Normal conversation, sewing machine, typewriter
70-80 Television
90 Lawnmower, shop tools, truck traffic,
8 hours per day is the maximum exposure
100 Chainsaw, pneumatic drill, snowmobile;
115 Sandblasting, loud rock concert, auto horn
140 Gun muzzle blast, jet engine

*Permissible Noise Exposure

Duration/day (hrs) Sound Level (dB)
8 90
6 92
4 95
3 97
2 100
1 1/2 102
1 105
1/2 110
1/4 or less 115

*(from the Department of Labor & Employment: Occupational Safety & Health Standards)

Harmful Effects of Noise

• Hearing damage
• Interfers with work performance
• Disturbs relaxation and sleep
• Hypertension
• Hyperacidity
• Palpitations
• Stress-related disorders

Patterns of Hearing Damage From Noise Exposure

Acute Effects: From loud/ excessive noise such as blasts

(140-160 dB, damages the eardrums)

Chronic Effects: Due to long term exposure to hazardous noise levels

Types of Noise Induced hearing Loss

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 1. Temporary Threshold Shift (Auditory Fatigue)
• Temporary loss of hearing acuity after exposure to loud noise
• Recovery within 16-48 hours

2. Permanent Threshold Shift

• Irreversible loss of hearing
• Usually after prolonged unprotected exposure to noise greater than the
permissible limit

Early Signs of Hearing Loss

• Difficulty in understanding spoken words in a noisy environment

• Need to be near or look at the person speaking to help understand words
• Familiar sounds are muffled
• Complaints that people do not speak clearly
• Ringing noises in the ears (tinnitus)
B. VIBRATION

Definition
• physical factor which affects man by transmission of mechanical energy from
oscillating sources
Subdivisions
• Wholebody vibration
• Segmental vibration

POTENTIAL OCCUPATIONAL EXPOSURES

Whole Body Vibration Segmental Vibration

truck drivers chain sawyers

bus drivers pneumatic tool operators
(chippers, staple gun operators, construction & road
operations)
heavy equipment operators mining (jack leg & hand tool)
farm vehicle and tractor operators electrical grinder operators
foundry workers (mold shakeout, metal extrusion operators
forklift trucks, overhead cranes) wood products manufacturing
railroads (engineers, conductors,
track repair workers)
forklift operators

HEALTH EFFECTS: VIBRATION

Whole Body Vibration Segmental Vibration (Hand-Arm)

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General stressor Localized stressor to the fingers and hand –
can cause damage to the bones and joints of the
upper extremities
Changes in the central nervous system
Hand-Arm Vibration Syndrome
- Raynaud’s phenomenon or “white fingers” –
fingers blanch or turn white especially when vibration
exposure is also accompanied by exposure to cold
weather
Damage in bone structure tenosynovitis
Disturbance in nerve conduction Dupuytren’s contractures
Disturbances in vision and gastrointestinal function
Increase in oxygen consumption
Increase in pulmonary ventilation

Prevention of Vibration injuries:

• Information and training of workers
• Proper work schedule: rotation of workers, adequate rest
• Proper job and production design
• Minimize smoking and use of drugs which affect circulation
• Use of personal protection such as vibration dampening gloves or shock absorbers

Medical Surveillance: Pre-employment and Periodic Exams

> clearances from an otolaryngologist, neuropathologist,
therapist, gynecologist, and radiologist
Special Tests > general: blood tests
> x-ray of the hand bones or spinal column

C. INADEQUATE ILLUMINATION

Evaluation for illumination shall consider:

1. Quantity - depends on task (too much too little)
2. Quality - shadows, silhouettes, overcasts, reflections, glares

Recommended Illumination Levels

Area of Operation Min Lighting Level (lux)
Cutting Cloth =2000
Fine machining
Transcribing handwriting 1000
Drafting
Welding 500
First Aid station
Lunch Room 300
Rest Room

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Recommended Illumination Levels at VDT Workstations
Working Conditions Illumination Level (lux)
Conversational Tasks 300
- well printed source documents
- reduced readability of source 300-400
documents

Data Entry Tasks 500-700

Usual Complaints of Inadequate Illumination:

• Visual Fatigue
• Double Vision
• Headaches
• Painful irritation
• Lacrimation, Conjunctivitis

Occupational Effects of Visual Fatigue

• Loss of productivity
• Increased Accident Rate
• More Mistakes
• Lowering of Quality
• Visual Complaints
D. HEAT

Definition Heat is a form of thermal energy which may come from:

• body metabolism
• increase physical activities
• radiation from hot surfaces/ objects or from the sun and byproducts of
industrial processes.

Table 8. Summary of Disorders due to heat stress

Disorder Cause Main Clinical Features Treatment Prognosis
Milaria Rubra Malfunction of Pruritic rash Symptomatic Good
sweat glands
Heat Cramps Loss of water Cramps in limbs Rest, fluids with Complete is
and electrolytes added salt/saline recovery usual
Heat Physical exertion. Dizziness, blurring of Rest, cooling in well- Complete
exhaustion Loss of water vision, clammy, sweaty, ventilated recovery is
and electrolytes. cold skin. surroundings usual
Heat stroke Failure of Convulsions; muscle Stripping down, High mortality,
temperature twitching. delirium. hot cooling with ice- sequelae may
control center in dry skin, cyanosis, body baths, corticosteroids include poor
brain temperature 41.1º C or memory and
higher. concentration,
headache.

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Recommendations For Working In Hot Conditions
1. Acclimatization is necessary
2. Encourage drinking small amount of fluids at frequent intervals
3. The greater the heat and physical load, the more frequent the cooling periods.
4. Source of drinking water should be made available and if possible near the workers.
5. Proper clothing should be worn, clothing adequate enough to shield workers from the heat
source.

COLD STRESS

Occupational Exposures
• cooling room workers
• dry ice workers
• ice makers
• out of door workers during cold weather
• cold storage workers

Cold Induced Injuries

Frostbite
• fingers, toes, cheeks, nose, and ears are most susceptible
• characterized by reddening of the skin, localized burning pain, and numbness

Trench Foot (Immersion Foot)

• results from prolonged exposure of the lower extremities to cold and moisture
o 32o F to 50o F or Oo to 10o C
• neurovascular damage, and tissue anoxia follows
• characterized by numbness, painful paresthesias, followed by leg cramps, vesiculation,
ulceration and gangrene

General Hypothermia
• results from being in cold weather or submerged in cold water
• characterized by dizziness, fatigue
• can lead to unconsciousness and death

Control MeasuresProvide adequate clothing including insulated gloves, footwear and

headgear
• Build barriers around the worksite to block the wind
• Supply workers with warm beverages

RADIATION

Ionizing Radiation – any electromagnetic or particulate radiation capable of producing ion pairs by
interaction with matter, particularly important biologically since media can be altered
•Ionized atom in DNA molecule may be altered causing:
–cell death
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 –change in cell reproduction and division
–mutation

Examples of Ionizing Radiation: General Population Exposure

• Alpha particles Medical
• Beta particles Radon
• Neutrons Terrestrial
• X and Gamma rays Cosmic
Fallout
Industrial
Internal

Acute Effects of Ionizing Radiation (within days,4 weeks to 3 months)

1. Skin – erythema
2. Bone Marrow – depressed white cell count, impaired immune system
3. Intestines – depletion of intestinal villi, can result in fatal dysentery like syndrome
4. Testes – decreased sperm count, sterility
5. Lungs – Pneumonitis, respiratory failure
6. Lens of the Eye – opacities, cataracts

Delayed Effects – probability of an effect is proportional to the dose; severity is independent of the
dose
1. Skin cancer
2. Leukemias
3. Effects on Prenatal Irradiation
a. Pre-implantation - embryonic death
b. Development and formation of organs – congenital abnormalities

Non-Ionizing Radiation

Sources and Effects of Non-Ionizing Radiation

• Ultraviolet rays – erythema, premature aging of the skin, skin cancers, cataracts, retinal
injury, welder’s flash
• Infrared – corneal and conjunctival burns, cataracts, retinal injury
• Lasers – Potential hazards to the skin and eyes
• Microwave – Current conduction, heat
• Radiofrequency - Current conduction, heat
• Extremely low frequency – current conduction
• Static fields – static electric shock

V. BIOLOGIC HAZARDS

Biological hazards - caused by living organisms which include insects, molds, fungi, viruses and
bacterial contamination; from defects in sanitation and housekeeping procedures, such as in the
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provision of potable water, removal of industrial waste and sewage, food handling and personal
cleanliness.

Common Health Problems From Biologic Hazards:

Tuberculosis (TB)
- chronic bacterial infection that is characterized by formation of granulomas (scarring
of tissues) in infected tissues.
- In 1993, was the 5th leading cause of death in the Philippines
- 60% of deaths occur among the 15-64 years of age (productive age group)
- readily transmitted by an infected person through respiratory secretions during
coughing, sneezing, vocalizing
- easily treated with antimicrobials, preventable

Tetanus
- caused by a bacteria, Clostridium tetani, usually from contaminated wounds
- affects the nervous system
- manifests as muscle spasm, lock jaw, sustained contraction of muscles in the face &
back, convulsions/ seizures.
- can be prevented through active immunization with tetanus vaccine
and careful wound management

Viral Hepatitis
- systemic infection caused by a virus affecting the liver
- route of infection
§ Hepatitis A – fecal-oral route (contaminated food & water)
§ Hepatitis B – blood, sexual, perinatal
§ Hepatitis C – transfusion-associated, intravenous drug injection
§ Hepatitis D – endemic among those with HB
§ Hepatitis E – ingestion of virus
- patients suffering from hepatitis usually manifest similar signs and symptoms
- fever, nausea, vomiting, fatigue, body weakness, jaundice (yellow skin
discoloration)

HIV/ AIDS

Acquired Immunodeficiency Syndrome (AIDS)

- a chronic and fatal illness
- affects the body’s immune system making it unable to combat infection.
- caused by the Human Immunodeficiency Virus (HIV)
- to be transmitted, the virus must enter the blood stream in large enough quantities
- modes of transmission:
§ during unprotected sex
§ through transfusion with infected blood and blood products
§ from an HIV(+) mother to her baby

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 - of importance to the working population because the statistics of those infected are
increasing
- for the prevention and control of HIV/ AIDS, the Philippine National AIDS Prevention
and Control Act of 1998 was established for the provision of the following:
§ basic information on HIV/ AIDS
§ non-mandatory testing
§ confidentiality of results
§ prohibition of discrimination and termination from work

Diseases caused by viruses:

1. Upper Respiratory Tract Infections- are due to a huge number of viruses and account for a very
large proportion of sickness absence among workers. Studies have shown the possibility of
such viruses being transmitted through air conditioning systems.

2. Hepatitis B Infection- it is widespread in many parts of the world especially in developing

countries. Health personnel have occasionally been infected by accidentally pricking
themselves with infected needles or surgical or dental instruments. In areas of high endemicity, it
is often advisable for all susceptible health personnel to be immunized against this infection.

3. Acquired Immune Deficiency Syndrome (AIDS)- this disease was first reported in the USA in mid-
1981. The disease is characterized by a defect in the whole immune system. It is caused by
infection with a virus called human immunodeficiency virus (HIV). Sexual intercourse
contaminated injection, needles and less commonly through transfused blood or its components
spread AIDS.

4. Rabies- this disease occurs among dogs, bats and many other wild animals. Trappers and other
animal handlers may get infected. Nervous system involvement is severe and often fatal.

Diseases caused by bacteria

1. Leptospirosis can be transmitted to man from rodents, pigs, cattle, dogs and wild animals usually
through the urine of infected animals but sometimes by direct contact. The leptospira enter the
body through cuts or abrasions in the skin or through the intact mucous membranes of the
conjunctivae, nose or mouth. Occasionally, the infection may be foodborne. Wading through
contaminated water in sewers, puddles, streams and paddy fields are common ways of getting
infected. The handling of infected animals in animal husbandry or laboratories has also led to the
disease.

3. Tetanus is an acute disease caused by Clostridium tetani, a bacillus that is very common in soil
and the feces of man and many animals. The tetanus organism forms spores that gain access
into the human body through any break in the skin or mucous membranes. Industrial and
agricultural workers constitute a group especially vulnerable to tetanus because of the
penetrating and contaminated with soil or road dust.

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4. Tuberculosis is a leading cause of morbidity and mortality in many hospitals and other
developing countries. The disease is caused by Mycobacterium tuberculosis. The most
common form is pulmonary infection. However, this organism can cause disease virtually
anywhere in the body. Extrapulmonary infection is particularly common in HIV- infected
individuals. Tuberculosis adenitis, pleural effusion, urinary tract infection, peritonitis, bone and
joint infection and meningitis are the most commonly encountered extrapulmonary infection.

VI. ERGONOMICS

The International Labour Organization defines ergonomics as the application of human

biological science in conjunction with the engineering sciences to achieve optimum mutual
adjsutment of human to the work, the benefits being measured in terms of efficiency and well-being.
To summarize, ergonomics can be defined as "fitting the job to the worker". The different fields of
expertise needed for the application of ergonomics include biomechanics, physiology,
anthropometry, psychological/behavioral sciences and engineering, among others. Biomechanics
describes motion of various body parts and determines forces acting on these body parts.
Physiology is concerned with the function and actions of the different organ systems. Anthropometry
is concerned with the size and form of the human body. Psychology/Behavioral Sciences is
concerned with motivations, attitudes. Finally, engineering aims to design the tools, workstations and
systems in the workplace.

Ergonomic stressors commonly seen in the workplace are improperly designed tools or
work areas, improper lifting or reaching, poor visual conditions or repeated motions in an awkward
position that may be responsible for fatigue, stress and strain and may lead to accidents in the
occupational environment. Outcomes of ergonomic problems on performance include low
productivity, high rate of errors, material wastage and equipment damage. Musculoskeletal, vascular,
visual, hearing, skin and psychological problems are some of the perceived health problems
resulting from ergonomic problems.

REFERENCES:

1. Phoon, WO. Practical Occupational Health, 1988.

2. Zenz, C. (ed) Occupational Medicine. Principles and Practical Applications. 3 rd Edition 1994.

3. ILO Encyclopedia of Occupational Health and Safety, 4 th Edition, 1999.

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