1. Health
The World Health Organization – in its constitution – defined health as a state of complete physical, mental and social well-being and not just the absence of disease or infirmity.
2. Occupational health:
The Joint Occupational Health Committee of the International Labor Organization and the World Health Organization, at its first meeting in 1950, defined “occupational health as the branch of health that aims to improve the health of workers in all professions and maintain them at the highest levels of physical, psychological and social well-being, and prevent health deviations.” Which may cause workers from working conditions, as well as protecting workers from all health risks in the workplace, and placing the worker – and keeping him – in a working environment suitable for his physiological and psychological capabilities.This is summarized in adapting the work in order to suit the worker and adapting each worker to his work. .
3- The environment is the space in which a person lives and performs his activities. And in this area there are:
A- Groups of plant and animal organisms of different sizes, some huge and some microscopic.
B- Groups of liquid substances such as water, gaseous substances such as air, and solid substances such as earth and rocks
C- Groups of conditions and forces loaded with energy, such as sunlight, stormy winds, water flow, and sea waves
D- Groups of physical, chemical and biological interactions linking the components of the three previous groups in bonds built on balance known as environmental systems or Ecosystems.
The environment in its broadest context is the biosphere. It is the framework for life on planet Earth.
It consists of the lower layers of the atmosphere (air), the surface layers of the Earth (land), and the surface layers of the water mass. And there is wild life in this space
Limited.
The Egyptian law defines the environment as “the biosphere that includes living organisms and the materials they contain and the air, water and soil that surrounds them, and what man builds.”
Facilities “.
The environment in which a person lives is divided into:
* The external environment or the general environment: Ambient Environment, Out-door Environment It is the environment in which all humans live and move as they like between open spaces.
Indoor Environment: It is the environment inside closed places, such as the work environment, the home environment, the school environment, indoor play areas, and other closed places. And depending on the types of activities that are practiced inside these places, it is possible to identify several internal environments, the most important of which is the work environment.
However, it must be taken into account when talking about the work environment that not all types of work are practiced inside closed places. And that although factory and workshop workers practice their work inside buildings, and miners also practice their work inside mine tunnels, the work environment in agricultural professions – for the most part – is open places, and the same applies to many other professions such as traffic police and workers in public transport. And sailors and street vendors, and these are affected – in addition to the specific risks of their work – by everything that others are affected by in the external environment. In these cases, the risks of the external environment are considered among the qualitative risks of this business.
4. The worker:
The Labor Law defines a worker as “every natural person who works for a wage for an employer and under his management or supervision.”
However, this “legal” definition does not cover all workers, as there are workers who work for themselves in self-employment, and there are juveniles who work for their families and do not receive specific wages, and some may consider housewives as workers. All of these are exposed to working conditions and some risks specific to the work they practice.
In a general view, school students – especially industrial and agricultural schools – are exposed to some risks in the places of study … which are considered workplaces.
5. Occupational diseases and work injuries:
Occupational disease is the disease that afflicts the worker as a result of exposure to some harmful factors that are part of the nature of work.
And some of these harmful factors do not exist – in most cases – only in the work environment, and therefore the diseases that arise from them are found only among exposed workers. An example of this is the lung disease (silicosis) that affects miners.
However, there are some diseases that affect some workers in certain professions, but they can also affect individuals who are not working in those professions. An example of this is tuberculosis, which is considered an occupational disease when it affects workers in tuberculosis hospitals or in medical analysis laboratories, and is considered a normal disease in other cases. Some other infectious diseases such as brucellosis in animal husbandry workers and viral hepatitis B and C in surgeons are considered occupational diseases in those professions and common diseases in the general public.
The relationship between the causative agent and the disease must be clear in order for the disease to be considered an occupational disease. Therefore, the injury of a worker to any of the common diseases during his work in a place is not considered an occupational disease unless there is a clear direct causal relationship between the disease and the disease. working conditions.
The Egyptian law defines a work injury as “injury to one of the occupational diseases shown in Table No. 1 accompanying the Social Insurance Law No. 79 of 1975, or injury as a result of an accident that occurred during or because of the performance of work. An injury resulting from stress or exhaustion from work is considered a work injury when It fulfills the conditions and rules for which a decision is issued by the Minister of Insurance in agreement with the Minister of Health.
Every accident that occurs while the insured worker is going to start his work or returning from it is considered under the rule of work injury, provided that the going or returning is without stopping, lagging behind, or deviating from the normal route (road injury).
It is noted that Table 1 referred to specifically includes:
It contains 35 groups of occupational diseases, which – of course – are not comprehensive of all known occupational diseases, or that may affect workers in Egypt.
6. Diseases related to work:
The work environment contributes – in addition to other risk factors – to the occurrence of some diseases that have multiple causes that may or may not be occupational factors among them. Therefore, it often infects the general public, but when it infects workers under certain circumstances, occupational factors may contribute – to varying degrees – with other factors in causing the disease. These multi-causal diseases are called “work-related diseases”.
Examples of these diseases are high blood pressure, stomach and duodenal ulcers, diabetes mellitus, locomotor system diseases, chronic obstructive pulmonary diseases, some behavioral disorders, and some psychosomatic disorders.
7. Non-occupational diseases that worsen as a result of exposure to certain working conditions:
It is known that some common non-occupational diseases – such as bronchial asthma – worsen when exposed to many types of dust in the work atmosphere, and the severity of non-occupational liver diseases increases among workers exposed to some organic solvents.
In addition, some occupational diseases increase the possibility of the infected worker contracting some other diseases, for example, pulmonary stone disease increases the possibility of contracting pulmonary tuberculosis.
Also, some factors related to the worker himself, such as hereditary traits, nutritional status, and infection with parasites, increase the worker’s susceptibility to some occupational diseases. Pneumonia upon exposure to silica dust (sand).
8. Work accidents and injuries:
An accident can be defined as an unexpected, unplanned event that may result in losses or injuries
The International Labor Organization defines a work injury as “an injury that occurs as a result of an accident that occurs in the workplace and results in death, personal injury or acute illness.”
However, it should be noted that the definition of work injury as stated in the Egyptian legislation differs from the aforementioned definition, as it – for reasons related to compensating the injured worker – includes more general cases such as road injury or injuries that occur as a result of work, but which occur outside the workplace.
9. Fatigue
It is difficult to give a specific definition of stress. There were several definitions, including the following:
A- “Stress is all the changes that can be observed in the performance of the work and which are due to the continuation of the performance of this work for a long period under normal conditions, and which result – immediately or after a period – a deterioration in the performance of the work or undesirable aspects in this performance. “.
b- “Exhaustion is a state of feeling tired or boredom, physical and/or mental, that negatively affects a person’s ability to perform work, and this feeling is either for a real reason or a person imagines it.”
C- In the case of performing muscular work, stress can be expressed and its degree measured by expressing the extent of the physiological changes that occur as a result of the work, such as an increase in the pulse rate, the volume of breathing air, changes in blood pressure, the level of lactic acid in the blood, and so on. .
It is noted that stress can affect some body systems without others and without affecting all body systems. For example, eyestrain, mental stress, or straining a group of muscles that perform limited muscular work, such as straining an arm.
10. Health Promotion: Health promotion is defined as “enabling individuals to increase their control over, and their ability to improve, their health condition. In order for an individual, or a group, to reach a state of complete physical, psychological and social well-being, he must be able to Recognizing his aspirations and achieving them, and to meet his needs, or change – for the better – the environment in which he lives, or to have the ability to bear it.So health promotion was not only the responsibility of the health sector, but it extends beyond changing lifestyles to achieving the well-being of the individual. .
Interaction between the worker and the work environment
The worker represents the first building block in the way of economic and social development, and it is the most important side of the triangle of production that consists of the worker, work and its equipment, and the work environment.
And when the work is suitable for the worker’s abilities, goals, and potential limits, and the work risks and environment are under full control, then the work often plays a positive role in securing the worker’s physical and psychological health and developing his physical capabilities, and reaching the desired goals of the work is an important source of satisfaction. And self respect.
However, sometimes work tools and the work environment are a source of many risks, including physical, chemical, mechanical, biological, psychological and social, which – when they exceed safe limits – are an important source of negative effects on the worker’s physical and psychological health and are a cause of death. Occupational diseases and work injuries, or may contribute, with other factors from inside or outside work, to the incidence of work-related diseases, or may exacerbate some other diseases that are not causally related to work.
And in the workplace, workers meet with each other, and this limited meeting in the work environment is an opportunity for the transmission of some communicable diseases that are not related to work or the work environment, from the sick to the healthy.
It is worth noting that the design of work, workplace, machines and work equipment to suit the worker’s capabilities and capabilities are among the important factors in increasing production in quantity and quality. And it – although ignoring it may not lead directly to an increase in the incidence of occupational diseases – but it certainly increases the rates of stress, accidents and injury.
t work.
Environmental factors that may affect the health of the working person.
Work accidents: psychological and social factors:
The machines and the equipments . Fire stress. Work in shifts
and bang. Means of transportation. pay. Human relationships . the support
The nature of the building. The cleanliness of the place … the social and the prisoners …
physical factors: biological factors:
Heat, humidity and cold viruses. bacteria
Poor lighting. Parasite electricity
radiations. the noise .
vibration. pressure changes
The air.
Chemicals :
Toxic metals. Gases and vapors. dirt
solvents pesticides
There are some personal characteristics of workers that make them affected by occupational risks differently. Examples of these characteristics include age, gender, nutritional status, health status, personality type, and genetic factors.
Personal characteristics that determine a person’s vulnerability to factors
different environmental.
Gender is genetic factors
age, nutritional status
Disease health condition
personality type
Occupational factors and risks affecting the health of workers
In many workplaces, workers are not exposed to any risks that may affect an individual’s health or his ability to perform work efficiently. However, in other locations, there are various risks in the workplace that differ according to the nature of the occupational activity, affecting the health status of workers and thus affecting production efficiency, causing diseases and increasing rates of accidents and work injuries.
And because occupational risks are – in most cases – known in advance, it is possible – and even necessary – to work to control them and reduce their risks to the health of workers.
Occupational factors affecting workers in the work environment are divided into several groups
• Physical factors and risks
• Chemical hazards
• Biological hazards
• Mechanical hazards and work accidents and injuries
• Psychological and social factors.
Occupational health and safety services system
First: health and safety programs in the workplace
To achieve health and safety in the work environment in the face of occupational and non-occupational risks to which workers are exposed, it was necessary to develop specific programs to reach this
the goal . Occupational health and safety activity has arisen in keeping with the development of industry in the industrially developed countries. The first law to protect workers appeared in England in 1802. In the year 1830, the first factory inspection body was established, then occupational health and safety legislation appeared in the year 1840 in Switzerland and Denmark, and in the year 1877 in the United States. This was followed by the enactment of similar laws in many other countries.
In Egypt, for the first time, Law No. 64 of 1936 was issued for insurance against work injuries, and the worker had to prove the employer’s fault in order to have the right to compensation for the injury, which was very difficult. In the year 1942, Law No. 86 was issued regarding compulsory insurance against work injuries to guarantee the rights of workers, and the insurance companies assumed this task until the year 1955, when the Insurance and Savings Corporation was established, which was then transformed into the General Organization for Social Insurance.
And the development of work injury insurance through many amendments, so occupational diseases were added to work injuries in 1955 by Law No. 117, and the various amendments ended up with the current Law No. 79 of 1975 and its amendments.
In the year 1959, Labor Law No. 91 was issued, of which Chapter Five was concerned with caring for the health of workers and organizing occupational health and safety procedures. It was later amended by Law No. 137 of 1981, which was later replaced by Labor Law No. 12 of 2003, which entered into force on July 7, 2003.
And within the framework of the interest of international organizations in the health and safety of workers, and in order to achieve the objectives of occupational health and safety, the International Labor Organization issued Recommendation No. 112 of 1959, which aims – not only to protect workers from occupational hazards – but also to improve their health level, the matter which is reflected in the production efficiency.
The occupational health and safety program includes the following activities:
1 . Primary medical examination: It takes place upon entering the service, and aims to assess the health status of the applicant and record it at the start of work, and assess his physical and psychological capabilities so that the appropriate worker can be placed in the appropriate work. The examination also helps to discover diseases that were not known to the applicant, so that the necessary treatment can be provided.
The examination also helps to avoid employing the applicant in a job in which he may be a source of danger to his colleagues (if he is ill with an infectious disease, for example) or to himself (for example, if he is ill with heart disease or epilepsy….).
2. Conducting a survey and assessment of the work environment to identify existing or potential risks. This is the responsibility of the occupational health doctor, the industrial hygiene specialist and the occupational safety specialist, who make recommendations on the need for engineering or other means to control risks and protect workers, as well as develop a program for occupational safety and health and industrial security.
In fact, the efforts being made to control the work environment must begin from the first moment of planning for the establishment of the workplace. Taking measures to control the work environment is easier and less costly at this stage than if it was delayed to a next stage.
3. Periodic medical examination: The aim of the periodic medical examination is the early detection of occupational diseases at a stage that can be cured or their damage can be minimized.
The type of examination and its periodicity varies according to the type of exposure and its severity. The periodicity of the examination ranges from a few weeks – or less – to a year or two.
The periodic medical examination includes a clinical examination with some examinations and medical analyzes that depend on the nature of exposure. And the examination focuses on the organs and systems of the body that are affected by the exposure that the worker faces (such as a chest x-ray for those exposed to A
Soil, measuring hearing acuity for those exposed to noise, measuring the level of lead concentration in the blood for those exposed to lead fumes…. ).
And since the periodic medical examinations include large numbers of workers, it is – usually – that screening tests are sufficient to discover the infected or those suspected of having the disease, provided that the discovered cases are then examined comprehensively. Screening examinations are simple, quick, inexpensive, and do not take as much time as comprehensive medical examinations, and are sufficiently accurate and sensitive to the purpose for which they are used.
And the discovery of occupational diseases in some workers means that the means of prevention are not sufficient.
4. Other medical examinations conducted on different occasions, such as:
• Medical examination for returnees after a long sick leave to ensure complete recovery, and for the worker’s condition to be re-evaluated to ensure that it is still suitable to do the same work that he was performing before his illness, otherwise – if he suffers from partial inability to work – it becomes necessary to rehabilitate him for work Appropriate .
• Medical examination upon promotion or transfer to another job to ensure that the worker’s abilities are commensurate with the requirements of his new job.
• Medical examination upon reaching retirement age.
• Periodic medical examination for senior management personnel, since they have reached the age at which rates of infection with some diseases such as diseases of the circulatory system, heart, diabetes mellitus and tumors are high. Likewise, they are exposed to work pressures to a greater degree than others, and their absence from work due to illness causes more confusion than what happens if those in a lower administrative rank are absent.
• Periodic medical examination for those over a certain age (45 years, for example), as rates of infection with some diseases rise.
5. Emergency treatment and first aid:
In addition to the traditional first aid kits, which should be available at every site
However, there are special equipment and antibiotics for certain types of exposures, depending on the type of exposure.
In all cases, those responsible for first aid must be trained and retrained, and ensure that the required equipment and medicines are still sufficient and usable.
6. Although preventive activities constitute an important part of occupational health and safety programmes, medical care must be provided to workers, including outpatient clinic services, specialist services and hospitals, as well as mental and dental health services, and testing capabilities. medical, x-ray examination, and provision of the necessary medication.
7. Food safety in the workplace: ensuring that health conditions are met in places for preparing, preserving and eating food, and supervising health workers in preparing and serving food.
One of the duties of the occupational health doctor is to provide advice to the management of the establishment with regard to the quality of food that is provided to the workers, and the need to provide additional nutrition to some workers in special professions in which the body’s need for calories, proteins, mineral salts, or water and table salt increases. when working in hot weather) or some vitamins.
8. Diagnosing and treating occupational diseases and work injuries, rehabilitating them, and estimating the rates of disability resulting from these cases in order to compensate them. And in cases where there is a partial disability, the occupational health doctor will reassess the health condition and capabilities of the injured person, and recommend assigning him a suitable job if necessary.
9. In the workplace, a sufficient amount of potable water for washing and washing must be provided, and toilets of the appropriate number must be provided, and healthy places for preserving and eating food must be provided. Care should also be taken to dispose of waste in proper ways, including industrial waste. Attention should also be paid to controlling insects and rodents.
10. Combating and controlling infectious and endemic diseases, including providing the necessary vaccinations.
11. Health education:
All members of the occupational health and safety team must participate in health education for workers at all levels, including senior management, as workers must be fully aware of the risks of their professions, safe ways to perform work, and participate positively in the accident prevention program And that they also participate in monitoring the proper performance of control and prevention equipment from work hazards, including personal protective equipment, and that they are committed to using them where necessary, and that they ensure their maintenance in a way that leads to their efficient performance.
Workers should also be aware of the early symptoms of occupational diseases, first aid methods in the event of injuries, as well as the principles of personal hygiene. Personal meetings, posters, films, slides, lectures, seminars, and training programs are used in health education. otherwise.
12. A special medical file should be created for each of the employees, in which personal data, type of work and nature of occupational exposure, if any, the result of the primary medical examination, the results of the periodic medical examination, and complete data on visits to the facility’s clinic and visits shall be recorded. For specialists, hospital admissions, medical examination results, medical procedures, sick leaves, work accidents and injuries, and occupational diseases. And the medical files of the workers must be treated in complete confidentiality. Collected reports are prepared at intervals, on the state of health in the facility and its trends, in the facility as a whole, and in different departments, and at different times of the year, and its relationship to any change in industrial processes and materials In addition, there should be a daily record of the medical services activity showing the numbers of frequent workers, the departments in which they work, their health problems, and the measures taken to deal with them. A record of the measurements that are conducted to evaluate the work environment should be established periodically, As well as a record of accidents and injuries. Also, records are established for the primary and periodic medical examination.
Second: Occupational Health Team
which insulted
As he mentioned about occupational health and safety programmes, it is clear that work in this field cannot be the work of one individual, but rather requires an integrated team of specialists. This team consists of specialists in the following branches:
1. Occupational Health Doctor: He performs medical examinations and environmental health work.
And preventive medicine, supervising food safety and those working in preparing and serving food. It performs primary and periodic medical examinations, treatment of occupational diseases and work injuries, rehabilitation, estimation of disability rates, treatment of non-occupational diseases, and first aid. It also participates in health education and in completing and maintaining medical and environmental records.
2. The nurse and her role in occupational health and safety: The nurse helps the doctor in
The work of medical examination and keeping medical records, and it performs traditional nursing work, in addition to being an important element in carrying out health education, as it is closely related to workers, as it spends more time in the workplace than the doctor, and it can document its relationship with workers in an efficient manner.
3. Occupational Hygiene Specialist: and performs
Basically, he inspects the work environment to identify real or potential risks, and for this he uses various techniques in evaluating the work environment, comparing the results of measurements with the permissible standards, and making a decision on the need for means of controlling occupational risks.
4. Occupational Safety Specialist: and performs
Inspection of the work environment with regard to occupational safety, particularly in terms of mechanical, electrical, other physical and chemical safety. It prepares and implements a program to prevent accidents, as well as conducts an investigation when accidents occur and analyzes them to find out the causes. He also actively participates in health education and in the work of the occupational safety and health committee in the facility.
5. Occupational Physicist: In special cases, where
In the workplace, there are sources of exposure to physical hazards, such as radioactive sources. The situation in these cases requires special skills to measure radiation and control its sources.
6. Environmental Control Engineer: Occupational risk control requires engineering skills to design
Control equipment, ventilation and containment systems, etc. are in place
the job . These are skills that require a precise engineering specialization.
7. Other disciplines such as psychology, human engineering, toxicology, and nutrition. And physiology, statistics and community medicine, according to the nature of work, the number of workers, types of exposure, problems resulting from industrial processes, the psychological environment in the workplace, and the extent that the institution allows for research and investigation.
8. All this is in addition to doctors who specialize in different branches of medicine, to whom patients are referred from the general practitioner’s clinic.
