Occupational disease | |
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Other names | Occupational illnesses [1] |
An occupational disease or industrial disease is any chronic ailment that occurs as a result of work or occupational activity. It is an aspect of occupational safety and health. An occupational disease is typically identified when it is shown that it is more prevalent in a given body of workers than in the general population, or in other worker populations. The first such disease to be recognised, squamous-cell carcinoma of the scrotum, was identified in chimney sweep boys by Sir Percival Pott in 1775[ citation needed ]. Occupational hazards that are of a traumatic nature (such as falls by roofers) are not considered to be occupational diseases.
Under the law of workers' compensation in many jurisdictions, there is a presumption that specific diseases are caused by the worker being in the work environment and the burden is on the employer or insurer to show that the disease came about from another cause. Diseases compensated by national workers compensation authorities are often termed occupational diseases. However, many countries do not offer compensations for certain diseases like musculoskeletal disorders caused by work (e.g. in Norway). Therefore, the term work-related diseases is utilized to describe diseases of occupational origin. This term however would then include both compensable and non-compensable diseases that have occupational origins.
In a landmark study published by the World Health Organization and the International Labour Organization in 2021, 745,000 fatalities from coronary artery disease and stroke events in 2016 were attributed to exposure to long working hours. [2] With these UN estimates, the global burden of work-related cardiovascular diseases has been quantified for the first time.
Occupational disease is expected to be reported less than actual figure. Neither educational material nor educational meeting increase the report of occupational disease. However, reminders on the legal obligation to report the occupational disease seem to increase physician reporting. [3]
Some well-known occupational diseases include:
Occupational lung diseases include asbestosis among asbestos miners and those who work with friable asbestos insulation, as well as black lung (coalworker's pneumoconiosis) among coal miners, silicosis among miners and quarrying and tunnel operators and byssinosis among workers in parts of the cotton textile industry.
Occupational asthma has a vast number of occupations at risk.
Bad indoor air quality may predispose for diseases in the lungs as well as in other parts of the body.
Occupational skin diseases are ranked among the top five occupational diseases in many countries. [4]
Occupational skin diseases and conditions are generally caused by chemicals and having wet hands for long periods while at work. Eczema is by far the most common, but urticaria, sunburn and skin cancer are also of concern. [5]
Contact dermatitis due to irritation is inflammation of the skin which results from a contact with an irritant. [6] It has been observed that this type of dermatitis does not require prior sensitization of the immune system. There have been studies to support that past or present atopic dermatitis is a risk factor for this type of dermatitis. [7] Common irritants include detergents, acids, alkalies, oils, organic solvents and reducing agents. [8]
The acute form of this dermatitis develops on exposure of the skin to a strong irritant or caustic chemical. This exposure can occur as a result of accident at a workplace. The irritant reaction starts to increase in its intensity within minutes to hours of exposure to the irritant and reaches its peak quickly. After the reaction has reached its peak level, it starts to heal. This process is known as decrescendo phenomenon. [9] The most frequent potent irritants leading to this type of dermatitis are acids and alkaline solutions. [10] The symptoms include redness and swelling of the skin along with the formation of blisters.
The chronic form occurs as a result of repeated exposure of the skin to weak irritants over long periods of time. [11]
Clinical manifestations of the contact dermatitis are also modified by external factors such as environmental factors (mechanical pressure, temperature, and humidity) and predisposing characteristics of the individual (age, sex, ethnic origin, preexisting skin disease, atopic skin diathesis, and anatomic region exposed. [12]
Another occupational skin disease is Glove related hand urticaria. It has been reported as an occupational problem among the health care workers. This type of hand urticaria is believed to be caused by repeated wearing and removal of the gloves. The reaction is caused by the latex or the nitrile present in the gloves. [13]
High-risk occupations include: [5]
The List of Occupational Diseases of the International Labour Organization (ILO) [15] also includes "mental and behavioral disorders associated with exposure to risk factors", [16]
Donald Hunter in his classic history of occupational diseases discusses many example of occupational diseases. [17] They include:
Bernardino Ramazzini in his book, dated 1700, De Morbis Artificum Diatriba, outlined the health hazards of chemicals, dust, metals, repetitive or violent motions, odd postures, and other disease-causative agents encountered by workers in more than fifty occupations.
Prevention measures include avoidance of the irritant through its removal from the workplace or through technical shielding by the use of potent irritants in closed systems or automation, irritant replacement or removal [18] and personal protection of the workers.
In order to better prevent and control occupational disease, most countries revise and update their related laws, most of them greatly increasing the penalties in case of breaches of the occupational disease laws. Occupational disease prevention, in general legally regulated, is part of good supply chain management and enables companies to design and ensure supply chain social compliance schemes as well as monitor their implementation to identify and prevent occupational disease hazards.
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Dermatitis is inflammation of the skin, typically characterized by itchiness, redness and a rash. In cases of short duration, there may be small blisters, while in long-term cases the skin may become thickened. The area of skin involved can vary from small to covering the entire body. Dermatitis is often called eczema, and the difference between those terms is not standardized.
Contact dermatitis is a type of acute or chronic inflammation of the skin caused by exposure to chemical or physical agents. Symptoms of contact dermatitis can include itchy or dry skin, a red rash, bumps, blisters, or swelling. These rashes are not contagious or life-threatening, but can be very uncomfortable.
Latex allergy is a medical term encompassing a range of allergic reactions to the proteins present in natural rubber latex. It generally develops after repeated exposure to products containing natural rubber latex. When latex-containing medical devices or supplies come in contact with mucous membranes, the membranes may absorb latex proteins. In some susceptible people, the immune system produces antibodies that react immunologically with these antigenic proteins. Many items contain or are made from natural rubber, including shoe soles, pen grips, hot water bottles, elastic bands, rubber gloves, condoms, baby-bottle nipples, and balloons; consequently, there are many possible routes of exposure that may trigger a reaction. People with latex allergies may also have or develop allergic reactions to some fruits, such as bananas.
Hives, also known as urticaria, is a kind of skin rash with red, raised, itchy bumps. Hives may burn or sting. The patches of rash may appear on different body parts, with variable duration from minutes to days, and does not leave any long-lasting skin change. Fewer than 5% of cases last for more than six weeks. The condition frequently recurs.
Atopic dermatitis (AD), also known as atopic eczema, is a long-term type of inflammation of the skin (dermatitis). It results in itchy, red, swollen, and cracked skin. Clear fluid may come from the affected areas, which can thicken over time. AD may also simply be called eczema, a term that generally refers to a larger group of skin conditions.
A needlestick injury is the penetration of the skin by a hypodermic needle or other sharp object that has been in contact with blood, tissue or other body fluids before the exposure. Even though the acute physiological effects of a needlestick injury are generally negligible, these injuries can lead to transmission of blood-borne diseases, placing those exposed at increased risk of infection from disease-causing pathogens, such as the hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV). In healthcare and laboratory settings globally, there are over 25 distinct types of blood-borne diseases that can potentially be transmitted through needlestick injuries to workers. In addition to needlestick injuries, transmission of these viruses can also occur as a result of contamination of the mucous membranes, such as those of the eyes, with blood or body fluids, but needlestick injuries make up more than 80% of all percutaneous exposure incidents in the United States. Various other occupations are also at increased risk of needlestick injury, including law enforcement, laborers, tattoo artists, food preparers, and agricultural workers.
Perioral dermatitis, also known as periorificial dermatitis, is a common type of skin rash. Symptoms include multiple small (1–2 mm) bumps and blisters sometimes with background redness and scale, localized to the skin around the mouth and nostrils. Less commonly the eyes and genitalia may be involved. It can be persistent or recurring and resembles particularly rosacea and to some extent acne and allergic dermatitis. The term "dermatitis" is a misnomer because this is not an eczematous process.
Allergic contact dermatitis (ACD) is a form of contact dermatitis that is the manifestation of an allergic response caused by contact with a substance; the other type being irritant contact dermatitis (ICD).
Irritant contact dermatitis is a form of contact dermatitis that can be divided into forms caused by chemical irritants and those caused by physical irritants.
Occupational asthma is new onset asthma or the recurrence of previously quiescent asthma directly caused by exposure to an agent at workplace. It is an occupational lung disease and a type of work-related asthma. Agents that can induce occupational asthma can be grouped into sensitizers and irritants.
An occupational exposure limit is an upper limit on the acceptable concentration of a hazardous substance in workplace air for a particular material or class of materials. It is typically set by competent national authorities and enforced by legislation to protect occupational safety and health. It is an important tool in risk assessment and in the management of activities involving handling of dangerous substances. There are many dangerous substances for which there are no formal occupational exposure limits. In these cases, hazard banding or control banding strategies can be used to ensure safe handling.
A barrier cream is a topical formulation used in industrial applications and as a cosmetic to place a physical barrier between the skin and contaminants that may irritate the skin. There are many other terms for creams designed to protect skin from harmful substances, including skin protective creams, pre-work creams, antisolvent gels, protective ointments, and shielding lotions. Three classes of barrier creams are used: water repellent creams, water-soluble creams, and creams designed for special applications. Barrier creams may contain substances such as zinc oxide, talc or kaolin to layer over the skin. For hand care they are designed to protect against the harm from detergents and other irritants.
Contact stomatitis is inflammation or pain of the oral mucosa caused by external stimuli. It is characterized by cutaneous lesions that may be located where the offending agent contacts the mucosa for a prolonged time. Oftentimes it presents in the mouth after contact with hot food or from ill-fitted dentures or other irritant. Consequently, patients may seek resolve from their dentist rather than a dermatologist. Unlike with allergic contact stomatitis, the skin requires no previous exposure to a stimulant before crafting an immune reaction.
Garlic allergy or allergic contact dermatitis to garlic is a common inflammatory skin condition caused by contact with garlic oil or dust. It mostly affects people who cut and handle fresh garlic, such as chefs, and presents on the tips of the thumb, index and middle fingers of the non-dominant hand. The affected fingertips show an asymmetrical pattern of fissure as well as thickening and shedding of the outer skin layers, which may progress to second- or third-degree burn of injured skin.
Exposure to ionizing radiation is known to increase the future incidence of cancer, particularly leukemia. The mechanism by which this occurs is well understood, but quantitative models predicting the level of risk remain controversial. The most widely accepted model posits that the incidence of cancers due to ionizing radiation increases linearly with effective radiation dose at a rate of 5.5% per sievert; if correct, natural background radiation is the most hazardous source of radiation to general public health, followed by medical imaging as a close second. Additionally, the vast majority of non-invasive cancers are non-melanoma skin cancers caused by ultraviolet radiation. Non-ionizing radio frequency radiation from mobile phones, electric power transmission, and other similar sources have been investigated as a possible carcinogen by the WHO's International Agency for Research on Cancer, but to date, no evidence of this has been observed.
Occupational skin diseases are ranked among the top five occupational diseases in many countries.
Occupational cardiovascular diseases (CVD) are diseases of the heart or blood vessels caused by working conditions, making them a form of occupational illness. These diseases include coronary heart disease, stroke, cardiomyopathy, arrythmia, and heart valve or heart chamber problems. Cardiovascular disease is the leading cause of death in the United States and worldwide. In the United States, cardiovascular diseases account for one out of four deaths. The 6th International Conference on Work Environment and Cardiovascular Diseases found that within the working age population about 10-20% of cardiovascular disease deaths can be attributed to work. Ten workplace stressors and risk factors were estimated to be associated with 120,000 U.S. deaths each year and account for 5-8% of health care costs.
Lip licker's dermatitis is a type of skin inflammation around the lips due to damage by saliva from repetitive lip licking and is classified as a subtype of irritant contact cheilitis. The resulting scaling, redness, chapping, and crusting makes a well-defined ring around the lips. The rash may extend as far as the tongue can reach and usually does not occur at the corners of the mouth. It commonly occurs during winter months but some people can have it year-round if lip licking is a chronic habit.
The intense contact between a musical instrument and skin may exaggerate existing skin conditions or cause new skin conditions. Skin conditions like hyperhidrosis, lichen planus, psoriasis, eczema, and urticaria may be caused in instrumental musicians due to occupational exposure and stress. Allergic contact dermatitis and irritant contact dermatitis are the most common skin conditions seen in string musicians.
Dermatoses induced by Personal Protective Equipment are skin lesions that occur due to the use of personal protective equipment (PPE). Personal Protective Equipment such as masks, face shields, goggles, gloves and gowns can cause abrasion in the skin and retain moisture in body parts, particularly the face. During the COVID-19 pandemic, healthcare workers and general public need to use personal protective equipment, sometimes for extended duration, which may result in skin problems due to friction, pressure, long-term sealing and moisture retention.
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