HEALTH OF THE WORKER

Industrial workers constitute only a segment of the general population, and the factors that
influence the health of the population also apply equally to industrial workers, i.e., housing, water,
sewage and waste disposal, nutrition, and education. A detailed consideration of these factors can
be found in Chapter 2. In addition to these factors, the health of the industrial workers, in a large
measure, will also be influenced by conditions prevailing in their work place. One of the declared
aims of occupational health is to provide a safe ‘occupational environment’ in order to safeguard the
health of the workers and to step up industrial production.

Occupational environment

By “occupational environment” is meant the sum of external conditions and influences which prevail
at the place of work and which have a bearing on the health of the working population. The
industrial worker today is placed in a highly complicated environment which is getting more
complicated as man is becoming more ingenious. Basically, there are three types of interaction in a
working environment:

(a) Man and physical, chemical and biological agents

(b) Man and machine

(c) Man and man.

MAN AND PHYSICAL, CHEMICAL AND BIOLOGICAL AGENTS

(1) Physical agents: The physical factors in the working environment which may be adverse to health
are heat, cold, humidity, air movement, heat radiation, light, noise, vibrations and ionizing radiation.
The factors act in different ways on the health and efficiency of the workers, singly or in different
combinations. The amount of working and breathing space, toilet, washing and bathing facilities are
also important factors in an occupational environment.

(2) Chemical agents: These comprise a large number of chemicals, toxic dusts and gases which are
potential hazards to the health of the workers. Some chemical agents cause disabling respiratory
illnesses, some cause injury to skin and some may have a deleterious effect on the blood and other
organs of the body.

(3) Biological agents: The workers may be exposed to viral, rickettsial, bacterial and parasitic agents
which may result from close contact with animals or their products, contaminated water, soil or
food.
MAN AND MACHINE

An industry or factory implies the use of machines driven by power with emphasis on mass
production. The unguarded machines, protruding and moving parts, poor installation of the plant,
lack of safety measures are the causes of accidents which is a major problem in industries, Working
for long hours in unphysiological postures is the cause of fatigue, backache, diseases of joints and
muscles and impairment of the worker's health and efficiency.

MAN AND MAN

There are numerous psychosocial factors which operatd at the place of work. These are the human
relationships amongst workers themselves on the one hand, and those in authority over them on the
other. Examples of psychosocial factors include the type and rhythm of work, work stability, service
conditions, job satisfaction, leadership style, security, workers participation, communication, system
of payment, welfare conditions, degree of responsibility, trade union activities, incentives and a host
of similar other factors, all entering the field of human relationships. In modern occupational health,
the emphasis is upon the people, the conditions in which they live and work, their hopes and fears
and their attitudes towards their job, their fellowworkers and employers (2).

The occupational environment of the worker cannot be considered apart from his domestic
environment. Both are complementary to each other. The worker takes his worries home, and brings
to his work disturbances which arise in his domestic environment. Stress at work may disturb his
sleep, just as stress at home may affect his work. Severe prolonged stress, no matter where it has
been aroused, may produce serious physical or mental symptoms which do not allow man to work
efficiently. According to ecological approach, occupational health represents a dynamic equilibrium
or adjustment between the industrial worker and _ his occupational environment.

OCCUPATIONAL HAZARDS

An industrial worker may be exposed to five types of hazards, depending upon his occupation:

(a) Physical hazards

(b) Chemical hazards

(c) Biological hazards

(d) Mechanical hazards

(e) Psychosocial hazards.

(1) HEAT AND COLD: The common physical hazard in most industries is heat. The direct effects of
heat exposure are burns, heat exhaustion, heat stroke and heat cramps; the indirect effects are
decreased efficiency, increased fatigue and enhanced accident rates. Many industries have local “hot
spots” - ovens and furnaces, which radiate heat. Radiant heat is the main problem in foundry, glass
and steel industries, while heat stagnation is the principal problem in jute and cotton textile industry
(7). High temperatures are also found in mines for instance in the Kolar Gold Mines of Mysore which
is the second deepest mine of the world (11,000 feet), temperatures as high as 65 deg. C are
tecorded (8). Physical work under such conditions is very stressful and impairs the health and
efficiency of the workers. For gainful work involving sustained and repeated effort, a reasonable
temperature must be maintained in each work room. The Indian Factories Act has not laid down any
Specific temperature standard. However, the work of Rao (1952, 1953) and Mookerjee et al. (1953)
indicate that a corrected effective temperature of 69 to 80 deg. F(2ZO°C to 27°C) is the comfort zone
in this country and temperatures above 80 deg F (27°C) cause discomfort (7).

Important hazards associated with cold work are chilblains, erythrocyanosis, immersion foot, and
frostbite as a result of cutaneous vasoconstriction. General hypothermia is not unusual (9).

(2) LIGHT: The workers may be exposed to the risk of poor illumination or excessive brightness The
acute effects of poor illumination are eye strain, headache, eye pain, lachrymation, congestion
around the cornea and eye fatique. The chronic effects on health include “miner's nystagmus”.
Exposure to excessive brightness or “glare” is associated with discomfort, annoyance and visual
fatigue. Intense direct glare may also result tn blurring of vision and lead to accidents. There should
be sufficient and suitable lighting, natural or artificial, wherever persons are working

(3) NOISE: Noise is a health hazard in many industries. The effects of noise are of two types: (i)
Auditory effects which consist of temporary or permanent hearing lioss (ii) Non-auditory effects
which consist of nervousness, fatique, interference with communication by speech, decreased
efficiency and annoyance. The degree of injury from exposure to noise depends upon a number of
factors such as intensity and frequency range, duration of exposure and individual susceptibility.

(4) VIBRATION: Vibration, especially in the frequency range 10 to 500 Hz, may be encountered in
work with pneumatic tools such as drills and hammers. Vibration usually affects the hands and arms.
After some months or years of exposure, the fine blood vessels of the fingers may become
increasingly sensitive to spasm (white fingers). Exposure to vibration may also produce injuries of the
joints of the hands, elbows and shoulders (9).

(5) ULTRAVIOLET RADIATION : Occupational exposure to ultraviolet radiation occurs mainly in arc
welding. Such radiation mainly affects the eyes, causing intense conjunctivitis and keratitis (welder’s
flash). Symptoms are redness of the eyes and pain, these usually disappear ina few days with no
permanent effect on the vision or on the deeper structures of the eye (9).
(6) IONIZING RADIATION : Ionizing radiation is finding increasing application in medicine and
industry, e.g., X-rays and radio-active isotopes. Important radio-isotopes are cobalt 60 and
phosphorus 32. Certain tissues such as bonemarrow are more sensitive than others and from a
genetic standpoint, there are special hazards when the gonads are exposed. The radiation hazards
comprise genetic changes, malformation, cancer, leukaemia, depilation, ulceration, sterility and in
extreme cases death. The International Commission of Radiological Protection has set the maximum
permissible level of occupational exposure at 5 rem per year to the whole body (10).

b. Chemical hazards

There is hardly any industry which does not make use of chemicals. The chemical hazards are on the
increase with the introduction of newer and complex chemicals. Chemical agents act in three ways :
local action, Inhalation and ingestion. The _ ill effects produced depend upon the duration of
exposure, the quantum of exposure and individual susceptibility.

(1) LOCAL ACTION : Some chemicals cause dermatitis, eczema, ulcers and even cancer by primary
trritant action; some cause dermatitis by an allergic action. Somechemicals, particularly the aromatic
nitro and amino compounds such as TNT and aniline are absorbed through the skin and cause
systemic effects. Occupational dermatitis ts a big problem in industry. Rao and Banerji (1952) were
the first to draw attention in India to the prevalence of occupational dermatitis due to machine oil,
rubber, X-rays, caustic alkalies and lime (7).

(2) INHALATION : (i) DUSTS : Dusts are finely divided solid particles with size ranging from 0.1 to 150
microns. They are released into the atmosphere during crushing, grinding, abrading, loading and
unloading operations. Dusts are produced in a number of industries — mines, foundry, quarry,
pottery, textile, wood or stone working industries. Dust particles larger than 10 microns settle down
from the air rapidly, while the smaller ones remain suspended indefinitely. Particles smaller than 5
microns are directly inhaled into the lungs and are retained there. This fraction of the dust is called
“respirable dust”, and is mainly responsible for pneumoconiosis. Dusts have been classified into
inorganic and organic dusts; soluble and Insoluble dusts. The inorganic dusts are silica, mica, coal,
asbestos dust, etc.; the organic dusts are cotton, jute and the like. The soluble dusts dissolve slowly,
enter the systemic circulation and are eventually eliminated by body metabolism. The insoluble
dusts remain, more or less, permanently in the Jungs. They are mainly the cause of pneumoconiosis.
The most common dust diseases in this country are silicosis and anthracosis. (ii) GASES : Exposure to
gases is a common hazard in industries. Gases are sometimes classified as simple gases (e.g., oxygen,
hydrogen), asphyxiating gases (e.g. carbon monoxide, cyanide gas, sulphur dioxide, chlorine) and
anaesthetic gases (e.g., chloroform, ether, trichlorethylene). Carbon monoxide hazard is frequently
reported in coal-gas manufacturing plants and steel industry. (iii) METALS AND THEIR COMPOUNDS:
A large number of metals, and their compounds are used throughout the industry. The chief mode of
entry of some of them is by inhalation as dust or fumes. The industrial physician should be aware of
the toxic effects of lead, antimony, arsenic, beryllium, cadmium, cobalt, manganese, mercury,
phosphorus, chromium, zinc and others. The ill-effects depend upon the duration of exposure and
the dose or concentration of exposure. Unlike the pneumoconiosis, most chemical intoxications
respond favourably to cessation, exposure and medical treatment.

(3) INGESTION: Occupational diseases may also result from ingestion of chemical substances such as
lead, mercury, arsenic, zinc, chromium, cadmium, phosphorus etc. Usually these substances are
swallowed in minute amounts through contaminated hands, food or cigarettes. Much of the
ingested material is excreted through faeces and only a small proportion may reach the general
blood circulation.

c. Biological hazards

Workers may be exposed to infective and parasitic agents at the place of work. The occupational
diseases in this category are brucellosis, leptospirosis, anthrax, hydatidosis, psittacosis, tetanus,
encephalitis, fungal infections, schistosomiasis and a host of others. Persons working among animal
products (e.g., hair, wool, hides) and agricultural workers are specially exposed to biological hazards.

d. Mechanical hazards

The mechanical hazards in industry centre round machinery, protruding and moving parts and the
like. About 10 per cent of accidents in industry are said to be due to mechanical causes.

e. Psychosocial hazards

The psychosocial hazards arise from the workers fa:hwe to adapt to an alien psychosocial
environment. Frustration lack of job satisfaction, insecurity, poor human relationship . emotional
tension are some of the psychosocial factor which may undermine both physical and mental hearth
of the workers. The capacity to adapt to different working environments is influenced by many
factors such a education, cultural background, family life, social habits and what the worker expects
from employment.

The health effects can be classified in two maa categories: (a) Psychological and behavioural changes
- including hostility, aggressiveness, anxiety, depression, tardiness, alcoholism, drug abuse, sickness,
absenteeism, (b) Psychosomatic illhealth : including fatigue, headache. pain in the shoulders, neck
and back; propensity to pepac ulcer, hypertension, heart disease and rapid aging.

Reports from various parts of the world indicate that physical factors (heat, noise, poor lighting) also
play a major role in adding to or precipitating mental disorders among workers. The increasing stress
on automation, electronc operations and nuclear energy may introduce newer psychosocial health
problems in industry. Psychosocial hazards are therefore, assuming more importance than physical
or chemical hazards.