History of occupational health

Global Perspective:
The first book on occupational medicine, De Morbis Artificum Diatriba (meaning
Diseases of Workmen), was published in 1700 in Italy by the father of occupational
medicine Bernardino Ramazzini (1633-1714). It contained accurate descriptions of
occupational diseases linked to various types of jobs.
Then came the Industrial Revolution in England (1760-1830), which gave pace to the
occupational health movement. Dr. Alice Hamilton played a great role in the
development of industrial hygiene in America during the early part of the 20th century.
The Office of Industrial Hygiene and Sanitation was established in 1914 in the USA. In
1919, the ILO came into being in Geneva, Switzerland, with a Department of
Occupational Safety, Health and Welfare. Subsequently, the WHO in Geneva,
Switzerland, also set up a Department of Occupational Medicine.
Indian Perspective:
The first Factories Act was passed in 1881 in British India. The act was amended in
1891, 1911, 1923, 1934 and 1948 to bring the legislation in line with that of the British
Factory Act. The Bhopal Gas tragedy (1984) was a turning point towards legislation
pertaining to occupational health and safety in India. The Factories Act was amended
(1987) and stipulated the qualifications/strength of occupational health staff in
hazardous industries. At present 29 diseases have been included as notifiable
occupational diseases under this Act.
There is a dearth of qualified occupational health physicians in our country. Awareness
about occupational health is at a low level even in the organised sector. Most affected is
the unorganised and small-scale sector. The Indian Association of Occupational Health
is the leading NGO in the field of occupational health in India.
Occupational health
Occupational health should aim at the promotion and maintenance of
the highest degree of physical, mantal and social wellbeing of the workers in all
occupations; the prevention among workers of departures from health caused by there
working conditions; the protection of workers in their employement from risks resulting
from factors adverse to health; the placing and maintenance of the workers in an
occupational environment adapted to his physiological and psychological equipment,
and, to summarize, the adaptation of work to man and of each man to his job
(JOINT ILO & WHO SESSION IN
1950)
Health of the worker

The factors that influence the health of the population also apply
equally to the industrial workers, i:e biological, behavioral, environmental,
socioeconomic, health system, sociocultural, aging of population, science and
technology, information and communication, gender, equity, social justice and human
rights ( determinants of health ). in addition to these factors the health of the workers is
also influenced by conditions prevailing in the work place. (i:e occupational
environment)
Occupational environment
Occupational environment can be defined as the sum of external conditions and
influences which prevail at the work place and which has bearing on the health of the
working population. Basically there are three type of interaction in a working
environment
a) Man and physical, chemical biological
b) Man and machine
c) Man and man
Man and physical, chemical, biological
a) 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
radiations. The amount of working and breathing space, toilet, washing and bathing
facilities are also important factors in an occupational environment.
b) Chemical agents
These comprises a large number of chemicals, toxic dust and gases which are
potential hazard to the health of the workers
c) Biological agents
d) The workers may also get exposed TO viral bacterial, ricketcial and paracitic 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.
Man and man
There are numerous psychosocial factors which operate at the place of work. These are
the human relationships that exist among the workers and also between the workers and
the their superiors. The many psychosocial factors which influence the workers are work
rhythm and stability, service condition, job satisfaction, leadership style security,workers
participation , communication, system of payment, welfare conditions, degree of

responsibilities, trade union acitivities, incentieves etc. the occupational health of the
worker is also affected by his domestic environment.
Occupational hazard
There are five type of hazard that an industrial worker may be exposed to.
1) Physical hazard
2) Chemical hazard
3) Biological hazard
4) Mechanical hazard
5) Psychological hazard
Physical hazard
a) Heat and cold
The direct effect of heat exposure are burns, heat exhaustion, heat stroke, and heat
cramps, the indirect effect are decreased efficiency, increased fatigue, and enhanced
accident rates. Many industries have local hot spots oven and furnaces which radiates
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. Indian factories act
have not laid down any specific temperature standard, but work of rao and mookerjee
(1953) indicate that a temperature of 20 to 27 c is the comfort zone in the country and
the tempratur above it causes discomfort. Apart from these hazards accosiated with
cold are chilblains, erythrocynosis, immersion foot and frostbite.
b) Light
The workers may be exposed to poor illumination or excessive light, the hazards of poor
illumination are eye strain, headache, eye pain, lachrymation, congestion around the
cornea eye fatigue, and miners nystagmus. Exposure to intense light may lead to visual
fatigue, annoyance and discomfort. It may also lead to blurring vision and may lead to
accidents.
c) Noise
Noise is a health hazard in many industries. There are two type of auditory hazards
these are 1) auditory effects such as temporary or permanent hearing loss and 2) non
auditory effects such as nervousness, fatigue, interference with communication by
speech. Decreased efficiency and annoyance
d) Vibration
Vibrations especially in the frequency of 10 to 500 hz may be encountered in work with
pneumatic tools such as drills and hammers. Vibrations usually affects the hands and
arms. After a prolonged period of exposure the worker may experience white
finger(fingers may become increasingly sensitive to spasm), injuries to to joints of hands,
elbows and shoulders.
e) Ultraviolet radiation

Welders are commonly affected by this kind of radiation (welders flash), the
results are conjunctivitis and keratitis
f) Ionizing radiation
Medicine and others industries are at risk of exposure to ionizing radiation, x-rays and
radioactive isotopes play a major role, important radio isotopes are cobalt 60 &
phosphorous 32, bone marrows and gonads are the tissues which are affected by such
kind of radiation. The hards may include, genetic changes, cancer, leukemia, depilation,
ulceration, sterility and in extreme cases death. The maximum permissible radiation is 5
rem /year to the whole body.
Chemical hazards
The chemical hazards which occur in the industries occur by three ways local action,
inhalation and ingestion
1. Local action : the local action are dermatitis, eczema, and ulcers some even cause
cancers, some chemicals particularly the aromatic nitro and amino compounds such
as TNT and analine are absorbed through the skin and causes systemic effects
2. Inhalation :Dusts :-dusts are finely divided solid particles with size ranging from 0.1 to 150 microns
those that are greater than 10 microns settle down faser and those that are less than 10
micron remain suspended in the air and those that are less than 5 microns are directly
absorbed into the lungs and is a cause of pneumoconiosis the dust may be classified as
organic, inorganic, soluble and insoluble, organic dusts are from cotton jute etc and
inorganic is from coal, mica etc. soluble are those that are absorbed in to the systemic
circulation and excreted from the body and insoluble are those that are absorbed into the
lungs and are unable to get eliminated and are the main causes of pneumoconiosis
Gases:- exposure to gases is a common hazard in industries, gases may be classified as
simplegases (oxygen, hydrogen) , asphyxiating gases (carbon mono oxide, cyanide gas)
and anesthetic gases ( chloroform, ether, trichloroethelene).
Metals and other compounds:- a large number of metals are and their compounds
are used throughout the industries. the chief mode of entry of some of them is through
inhalation. The adverse effect of these depend on the duration of exposure and also the
dose or concentration of exposure. The metals that have adverse effect are lead,
mercury, antimony, zinc, chromium, cadmium etc
3. Ingestion :Occupational disease may also result from the ingestion of chemical substances, usually
the ingestion takes place through contaminated hands and cigarettes but large amount
are excreted through the feces and only a small amount is absorbed into the systemic
circulation.
Biological hazard

Workers may be exposed to infective and parasitic agents at the place of work. The
occupational disease in this category are brucellocis, leptospirosis, anthrax, hydatidosis,
psittacosis, tetanus, encephalitis, fungal infection, schistomosis and a host of others.
Persons working among animal products and agricultural workers are exposed to
biological hazard
Mechanical hazard
The mechanical hazard are due to protruding and moving parts about 10 percent of the
accidents in industries are said to be due to mechanical causes
Psychosocial hazards
The psychosocial hazards arise from workers adaptation to new environment.
Frustration , lack of job satisfaction, poor human relationships, emotional tension are
some of the psychosocial factors which undermines the efficiency of the health and
efficiency of the workers. The psychosocial hazards can be manifested in the form of
psychological and behavioual changes such as hostility, aggressiveness, anxiety,
depression, tardiness, alchoholism, drug abuse, absenteeism and psychosomatic ill
health such as fatigue, headache, pain in the shoulders,neck and back, propensity to
peptic ulcers hypertension, heart disease and rapid aging.
Ergonomics
Definition : Ergonomics, also known as human factors, is the scientific discipline that
seeks to understand and improve human interactions with products, equipment,
environments and systems. Drawing upon human biology, psychology, engineering and
design, ergonomics aims to develop and apply knowledge and techniques to optimise
system performance, whilst protecting the health, safety and well-being of individuals
involved. The attention of ergonomics extends across work, leisure and other aspects of
our daily lives
It may also be defined as fitting the job to the worker. The application of
ergonomics has contributed to the reduction in accidents and overall achievement of
health and efficiency of the workers.
MEASURES FOR HEALTH PROTECTION OF WORKERS
The joint committee of ILO/WHO has recommended following heath protection for
workers
1. NUTRITION
In many countries malnutrition of workers is a major problem. The malnourishment
among workers causes poor health and low work outout, it may also affect the
metabolism of toxic agents and also the tolerance mechanisms. Inorder to avoid this
problem the Indian factories act has provided a provision to provide canteen for the
workers where the number of the workers exceed 250, where a balanced diet will be
provided and food will be served under sanitary conditions. Apart from these if a worker

brings his tiffin from home arrangements should be made to have his food in a room
other than the work room under sanitary conditions.
2. COMMUNICABLE DISEASE CONTROL
The industry provides an excellent opportunity for the diagnosis, treatment, prevention
and rehabilitation of many diseases prevalent among the workers. It is a general
objective of the industries to detect the communicable disease among the workers and
prevent or treat it so as to render it non infectious to others. The communicable disease
of special interest in india are TB, malaria, intestinal parasites, hepatitis, amoebiasis.
Immunization programmes are also available in industries
3. ENVIRONMENTAL SANITATION
Under environmental sanitation following factors are considered
a) Water supply
Sufficient amount of wholesome water supply is a basic requirement of all
industries, the old way of water tumblers should be avoided as it spreads
infection. Water fountains at different points should be established
b) Food
Education about safe and hygienic way of preparation, handling and storage
of food should be given to the food handlers inorder to avoid the outbreak
of gastro- intestinal diseases
c) Toilet
There should be sufficient number of toilets for the male and female
workers sepeately. According to the norm there should be 1 toilet for every
25 workers (separate for males and females) till 100 workers and then 1
tolit for every 50 workers thereafter. Garbage disposal system should be
such as to prevent breeding of flies and vermin.
d) General plant cleanliness
The walls cellings and passages should be adequately painted with water
washable paints and repainted atleast every 3 years and washed every 6
months. Dust which gets settled after the wok should be promptly cleaned
with wet cloths and vacuum cleaners.
e) Sufficient space
Sufficient floor space and cubic space are essential not only to prevent
respiratory infection but also to ensure a comfortable working environment.
The recommended atandard is a 500cu.ft of space for every worker.
f) Lighting
There should be sufficient amount of light at the place where the workers
work and also where the workers pass by. The standards are 50-75 foot
candles for the job requiring high degree of accuracy, 6 to 12 foot candles
may be sufficient for place where people work regularly and 0.5 foot
candles for the corridors
g) Ventilation, temperature
Poor ventilation not only brings respiratory diseases but also affects the
mental and physical efficiency of the workers. Effective and suitable
provision should be made for the proper exit of noxious fumes and gases
and provisions should be made such that fresh air is circulated in all room

where the workers are working. Adequate temperature at the work place is
also recommended.
h) Protection against hazard
There should be a adequate measures for protection of workers against
dust, fumes and toxic hazards.
4. MENTAL HEALTH
The objective of occupational health service is not only to keep the workers
physically fit and healthy but also mentally and psychologically stable. The
goals of mental health in industries are
1) Promote the health and happiness of the workers
2) To detect signs of emotional stress and strain and to secure relief of
stress and strain where possible.
3) The treatment of employees suffering from mental illness
4) Rehabilitation of those who become ill.
5. MEASURES FOR WOMEN AND CHILDREN
Women are susceptible to many health hazards than men and also pregnant
women can face many problems as the hazards at the work place may
threaten the development of the growing fetus. Following protective
measures are available for women workers in india.
a) Expectant mothers are given maternity leave for 12 weeks, of which the
6 weeks precede the expected maternity benefit, which is a cash
benefit under the ESI act 1948.
b) Provision of free antenatal, natal and postnatal services
c) The factories act prohibit night work between 7pm and 6 am. And also
prohibits carrying of excessive weight beyond a certain schedule which
has been laid down.
d) The Indian mines act prohibits work underground
e) The factories act provide crches facilities where more than 30 women
are employed and also prohibits employment of certain women and
children in certain dangerous occupations
f) The constitution of india dosent allow any children below 14 years of
age to work in any factories or hazardous environment.
6. HEALTH EDUCATION
Health education is a basic health need and should be provided to the
various levels such as managerial, supervisory, trade union, workers etc
according to their needs
7. FAMILY PLANNING
Family planning is a decisive factor for the quality of life and this applies to
industrial workers also. Workers must adopt small family norm.

PREVENTION OF OCCUPATIONAL DISEASES

The various measures of prevention of occupational disease may be grouped under three
headings as medical, engineering and statutory or legislative

1. Medical
a) Preplacement examination
Preplacement examination as the name suggest is done before the
placement of the workers, it comprises of workers through medical,
family, occupational and social history. It consist of through physical
examination and also an array of biological and radio examination like x
ray, ECG, blood and urine test etc. the main aim of the preplacement
examination is to place the right person in the right job.
b) Periodical examination
Many occupational diseases require a months or even years to develop.
The slow development will often leads non recognition in the early
stages and this is harmful for the workers and so periodic medical
examination becomes necessary. The frequency of medical examination
depends on the type of occupational exposure, ordianarily the workers
are examined once a year but in certain occupational exposure monthly
or even daily examination is required.
c) Medical and health care services
Medical and health care service is a notable function of occupational
health. In india employee state insurance corporation provides medical
benefit to not only the worker but also his family. The first aid to the
worker at the work place and immunization is also an important
function
d) Notification
National laws and regulation require the notification of cases and
suspected of cases of occupational diseases. The prime aim of
notification is to initiate measures for prevention and protection and
ensuring their effective application. And to investigate the working
conditions and other circumstances which have caused or suspected to
have caused occupational diseases. In the factories act a list of 22
diseases is included while in mines act 3 diseases and in dock
regulations 8 diseases are involved for which the the workers may
receive compensation.
e) Supervision of working environment
Periodic inspection to the working environment provides physician with
sufficient data to prevent occupational diabilities. The physician should
visit the occupational environment and look after the working
environment such as the temperature, ventilation, lighting etc. he
should also study the products such as the raw materials used and its
effect on the workers in the due course of processing, handling and
dispensing. After collecting sufficient data the physician should notify
the authority concerned to make improvement in the occupational
health of the workers.
f) Maintenance and analysis of records
proper maintenance of records are essential for the formulation,
planning and operation of occupational health in industries. The

workers health record and disability record should be maintained

strictly
g) Health education and counseling
The process of health education should begin before the worker enters
the occupation, he should be made aware about the situation he is
going to handle and the threats he is going to face in the occupation, as
soon as he enters the job the workers should be instructed regarding
the personal safety and hygienic measures that he should ensue
inorder to have a health occupational and social life. Apart from these
he must also be reminded with the help of media about the hazards he
could face during the occupation if or otherwise he dosent take safety
measures
2. Engineering measures
a) Design of building
Measures for the prevention of occupational diseases should commence
in the blueprint stage. The type of roof, celing, doors and cubic space
are all matters which should recieve attention during the plan because
once the building is constructed it is difficult to bring about the change.
b) Good house keeping
Good housekeeping is a term often applied to industries and means
much the same as when used domestically. It covers general
cleanliness, washing, ventilation, lighting, washing, food arrangements
and general maintenance good housekeeping is a fundamental
requirement for the control or elimination of the occupational hazard.
The walls, ceilings and passages should be white washed once a year.
The dust which settles down on thefloor, ledges, beams, machinery
should be promptly cleaned. Not only inside but also outside of the
building must be kept clean.
c) General ventilation
There should be a good general ventilation in factories, the
recommendation is to provide a ventilation opening of 5sqft for each
worker in a working room and where abundant amount of dust is
generated an exhaust ventilation is recommended. The Indian factories
act has prescribed a air space of 500cu.ft for each worker.
d) Mechanization
Mechanization is recommended completely as much as in the plant as
possible, this will reduce the human contact with the harmful chemicals
and thus hazards can be reduced to much extent. For example if hand
mixing is replaced by machines contact dermatitis can be prevented.
Acids and other chemicals can be conveyed from one place to others
through pipes.
e) Substitution
Substitution means replacement of harmful chemical by the less
harmful one. For example the white phosphorous in the match industry
is replaced by phosphorous sesquisulphide which has reduced the
necrosis of jaw (phossy jaw) to much extent. zinc and iron paints can be
used instead of harmful lead paints.

f) Dusts
Dusts can be controlled at the point of origin by the water sprays.eg:
wet drilling of rocks, inclusion of little moisture in the materials will
make the process of grinding, sieving and mixing comparatively dust
free.
g) Enclosure
Enclosing the harmful material and processes will prevent the escape of
dust into the factory atmosphere. For example grinding machinery can
be completely enclosed. Such enclosed units are generally combined
with exhaust ventilation
h) Isolation
Sometimes some process of the industry can be done in isolation so
that the workers who are not in direct contact with the process can be
protected from the hazard. The isolation is not only done in space but
also in the time, as some process are carried out in night hours so that
the workers are not affected
i) Local exhaust ventilation
Local exhaust ventilation traps the dusts , fumes and noxious gases at
the point of origin and makes the breathing environment clean for the
workers. In this process the hood of the ventilator is placed at the
source of origin of dust and dust is sucked up into the hood through
suction method and is collected into the collector thus making the
breathing environment clean for the workers
j) Protective devices
The workers use many protective devices such as respirators,
gumboots, gloves, goggles, protective creams etc. respirators are one
of the oldest method for protection. Respirators are of two types that is
one which filter the harmful material and one to which fresh air is
supplied.the workers should know when to use and how to use the
respirator devices, respirators should not be substituted with other
control measures
k) Environmental monitoring
An important aspect of occupational health is environmental
monitoring. it is concerned with periodical environmental surveys
especially the factory atmosphere to determine whether the dust and
gases escaping into the atmosphere is under permissible level or not.
l) Statistical monitoring
Statistical monitoring comprises review at regular intervals of collected
data on health and environmental exposure of occupational groups. The
main objective of these review is to evaluate the adequacy of
preventive measures and occupational health criteria , including
permissible exposure
m) Research
Research in occupational health provides a fertile ground for study
which can provide a better understanding of the industrial health
problems. There are two kind of research, pure research and research

for the improvement of, or in connection with a manufactured product.

Both are important from the occupational health point of view
3. Legislation
Society has obligation towards the workers, society has claimed the
worker to be more important than the machine that he runs therefore
society has come forward with certain laws and benefit in favor of the
workers. There are many acts and laws which are prominent among which
the
1) THE FACTORIES ACT 1948
The first Indian factories act dates as far back as 1881. The act was
revised and amended several times. The latest amendment was done
in 1987. Description of the act is as follows
a) Scope
The act defines factory as an establishment with 10 or more workers
without power and 20 or more workers with power
There is no distinction between seasonal and perennial factories
The applies to all the country except to the state of Jammu and Kashmir
b) Health safety and welfare
Elaborate provisions have made for the health safety and welfare of the workers

The act provides for the treatment of waste and effluents so as to render
them innoccous, and for their disposal, the elimination of dust and fumes,
provision of spittoons, control of temperature, supply of cool drinking water
during summer and for the employment of cleaners to keep the water closets
clean.
A minimum of 500 cu ft of space for each worker has been prescribed
For factories installed before 1948act a minimum of 350 cu ft of space has
been prescribed
Many safety provisions related to casing of machinery, cranes, hoists and lifts,
protection of eyes and precaution against dangerous fumes, explosives and
inflammable materials.
The act requires that no worker shall be required to lift or carry loads which
are likely to cause him injury.
The 1976 ammendment provides for the appointment of safety officers in
every factory wherein 1000 or more workers are ordinarily employed.
The act contains a separate chapter for the welfare of the workers eg:
washing facilities, facilities for storing and drying clothes, facilities for sitting,
first aid appliances, shelters and rest rooms , canteens and crches. The act
specifies that wherein more than 250 employees are employed a canteen
shall be provided. The 1976 amendment provides for crches in every factory
wherein more than 30 women workers are ordinarily employed.
In every factory wherein more than 500 workers are employed a welfare
officer should be employed
c) Employment of young persons

The act prohibits the working of children below 14 years of age

Those between the age group of 15 to 18 years are called as adolescents
and they should be certified by surgeons and physicians to be medically fit
for doing the job
Adolescent employee is allowed to work only from 6am to 7pm
Women and children are restricted to do certain jod which may prove them
hazardous
d) Hours of work
The act has prescribed 48 hours of work per week with not more than 9
hours per day and half an hour rest after a continuous work of 5 hours
The adolescents are allowed to work only four and hours per day
The total number of hours in a week should not exceed 60 along with
overtime
e) Leave with wages
The act has provision for leaves that after one year of continous service in an institution
the worker is eligible for leave as under ( the leave that are mentioned below are leave
apart from weekly holidays)

An adult worker is permitted to take one leave for every 20 days of work and
the leave can be accumulated up to 30 days.
An adolescent worker is allowed to take a leave for every 15 days and the
leave can be gathered for 40 days.
f) Occupational diseases
It is obligatory on the part of factory management to inform the workers
regarding the accidents that can cause death, serious bodily injuries, and
diseases contracted by the workers.
The act has certain scheduled diseases like asbestosis, bysinosis, occupational
dermatitis and noise induced hearing loss.
Provision has also been made for the occupational health and safety surveys
in factories and industries.
g) Employment in hazardous process
The central government has incorporated a new chapter iv A by factories
amendment act 1987, relating to hazardous processes. Site appraisal
committee consisting of chief inspector and other members not more
than 14 in number for examination of service condition in a factory
involving hazardous processes is to be constituted for recommendations
2) EMPLOYEES STATE INSURANCE ACT 1948
The ESI act passed in 1948 is an important measure of social security and health
insurance in the country it provides for certain cash and medical benefits for the
employees in case of sickness, maternity and employment injury
a) Scope
the act extends to the whole of india. The ESI act of 1948 covered all the power using
factories other than the seasonal factories wherein 20 or more persons were employed

(excluding mines, railways and defense establishments). The provision of ESI act of 1975
were extended to the following new class of establishments
a. Small power using factories employing 10 to 19 persons and non power using
factories employing 20 or more persons
b. Shops
c. Hotels and restaurants
d. Cinemas and theaters
e. Road motor transport establishments
f. News paper establishments
b) Administration
The administration of ESI scheme under the act is entrusted to an autonomous body
called the ESI corporation. The union minister for the labor is the chairman and the
secretary to government of india, ministry of labor is the vice chairman of this
cooperation. It consist of members representing, central and state governments,
employers and employees organizations, medical proffesion and parliament. There is a
standing committee constituted from the members of the cooperation, which act as an
executive body for the administration of the scheme. The chief executive officer is the
director general who is assisted by four principal officers. I:e insurance commissioner,
medical commissioner, financial commissioner, and actuary. There is a medical benefit
council which is headed by the director general of health services, government of india
who is assisted by medical commissioner in all matters relating to medical relief.
c) Finance
The scheme is run by contributions from the employers and employees and
grants from central and state governments
d) Benefits to employees
The act has made following benefits
a) Medical benefits
Medical benefit consist of full medical care including hospitalization free of
coast to the insured persons in case of sickness, employment injury and
maternity. The service comprises
Out patient care
Supply of drugs and dressings
Specialist services in all branches of medicine
Pathological and radiological investigations
Domiciliary services
Antenatal and post natal services
Immunization services
Family planning services
Emergency services
Ambulance services
Health education
Inpatient treatment
b) Sickness benefits

It consist of periodical cash payment to an insured person in case of sickness, if his

sickness is duly certified by an insurance medical officer. The benefit is payable for
maximum period of 91 days in any continuous period of 365 days. The daily rate being
about 50% of the average daily wages. A person receiving the sickness benefit is
required to remain under medical treatment provided under the act. In addition to 91
days of sickness benefit, insured person suffering from certain long term diseases are
entitled to extend sickness benefit
c) Maternity benefit
The benefit is payable in cash to an insured women for confinement / miscarriage or
sickness arising out of pregnancy/ confinement or premature birth of child or
miscarriage. For confinement the duration of benefit is 12 weeks, for miscarriage 6
weeks and for sickness arising out of confinement 30 days. The benefit is allowed at
about full wages.
d) Disablement benefits
The act provides for cash payment, besides free medical treatment, in the event of
temporary or permanent disablement as a result of employment injury as well as
occupational diseases. The rate of temporary disablement benefit is about 70 % of the
wages as long as the temporary disablement lasts. In case of total permanent
disablement, the insured person is given life pension worked out on the basis of earning
capacity determined by a medical board, while in case of partial permanent disablement
a portion of it is granted as life pension.
e) Dependent benefits
In case of death of an insured person while in an occupation the dependent of the
insured person shall receive the dependent benefits. The benefit will be 70 percent of the
wages every month in the name of dependent. If an eligible son or daughter is the
dependent then the benefits could be received by them till the age of 18
f) Funaral expenses
In case of death of an insured person the scheme provides for the funeral of the not
more than rs.2500
g) Rehabilitation allowance
On monthly payement of rs. 10 the insured person and his family members continue to
get medical treatment after permanent disablement or retirement.
Legal permission to start factory
Following are the legal requirements to start a factory

Make a plan for factory with map and get it approved from factories dept and take
licence
Take SSI certificate and polution NOc

ESI and PF codes are also regd.

Prepare standing orders and get them certified from DLC
Take fire NOC
Take air and wter consent from polution dept.
Take sale tax number
Permission from Explosive Dept.( If storing of HSD)
PAN No.
TIN No.
Certificate of Labour employing by Labour Dept.( It's for once time)
Building Permission from Local Panchayat(Lay out approal)
License from Local Panchayat
NOC from Local Panchayat
Police Clearance
Permission to take from Electrical Dept. for advance to applying Electrical
connection
Agriculture Land should be convert to Non Agriculture from DC concerned District

Occupational safety and health(OSH) management system.

The protection of workers against work-related sickness, disease and injury forms part of
the historical mandate of the ILO. Disease and injury do not go with the job nor can
poverty justify disregard for workers' safety and health. The ILO's primary goal is to
promote opportunities for women and men to obtain decent and productive work in
conditions of freedom, equity, security and human dignity. We have summarized this as
"decent work". Decent work is safe work. And safe work is also a positive factor for
productivity and economic growth.
Taking these factors into consideration the ILO has developed occupational
safety and health management systems

Elements of ocuupational safety and health management systems

Action
Planning
for
Evaluation
& IMPROVRMENT Organizing
CONTINOUS
improvement
implimentation Policy

A.
B.
C.
D.
E.
F.

Policy
Organizing
Planning and implementation
Evaluation
Action for improvement

A. Policy
The employer, in consultation with workers and their representatives,
should set out in writing an OSH policy
The OSH policy should include, as a minimum, the following key
principles and objectives to which the organization is committed:
(a) protecting the safety and health of all members of the organization by
preventing
work-related injuries, ill health, diseases and incidents;
(b) complying with relevant OSH national laws and regulations, voluntary
programmes, collective agreements on OSH and other requirements to which the
organization subscribes;
(c) ensuring that workers and their representatives are consulted and encouraged
to

participate actively in all elements of the OSH management system; and

(d) continually improving the performance of the OSH management system.

The OSH management system should be compatible with or integrated in

other management systems in the organization.
Worker participation is an essential element of the OSH management
system in the organization.
The employer should ensure that workers and their safety and health
representatives are consulted, informed and trained on all aspects of OSH,
including emergency arrangements, associated with their work.
The employer should make arrangements for workers and their safety and
health representatives to have the time and resources to participate actively
in the processes of organizing, planning and implementation, evaluation and
action for improvement of the OSH management system.
The employer should ensure, as appropriate, the establishment and
efficient functioning of a safety and health committee and the recognition of
workers'safety and health representatives, in accordance with national laws
and practice.
B. ORGANIZING
The employer should have overall responsibility for the protection of
workers' safety and health, and provide leadership for OSH activities in the
organization.

The employer and senior management should allocate responsibility,

accountability and authority for the development, implementation and
performance of the OSH management system and the achievement of the
relevant OSH objectives.
A person or persons at the senior management level should be appointed,
where appropriate, with responsibility, accountability and authority
The necessary OSH competence requirements should be defined by the
employer, and arrangements established and maintained to ensure that all
persons are competent to carry out the safety and health aspects of their
duties and responsibilities.
The employer should have, or should have access to, sufficient OSH
competence to identify and eliminate or control work-related hazards and
risks, and to implement the OSH management system.
Training should be provided to all participants at no cost and should take
place during working hours, if possible.
OSH records should be established, managed and maintained locally and
according to the needs of the organization. They should be identifiable and
traceable,and their retention times should be specified.
Workers should have the right to access records relevant to their working
environment and health, while respecting the need for confidentiality.
C. PLANNING AND IMPLIMENTATION
The organization's existing OSH management system and relevant
arrangements should be evaluated by an initial review, as appropriate. In the
case whereno OSH management system exists, or if the organization is

newly established, the initial review should serve as a basis for establishing
an OSH management system.
The initial review should be carried out by competent persons, in
consultation with workers and/or their representatives, as appropriate.
Arrangements should be made for adequate and appropriate OSH planning,
based on the results of the initial review, subsequent reviews or other
available data.These planning arrangements should contribute to the
protection of safety and health at work
The OSH planning arrangements of the organization should cover the
development and implementation of all the OSH management system
elements,
Consistent with the OSH policy and based on the initial or subsequent
reviews, measurable OSH objectives should be established,
. Hazards and risks to workers' safety and health should be identified and
assessed on an ongoing basis. Preventive and protective measures should be
implemented
The impact on OSH of internal changes (such as those in staffing or due
to new processes, working procedures, organizational structures or
acquisitions) and of external changes (for example, as a result of
amendments of national laws and regulations, organizational mergers, and
developments in OSH knowledge and technology) should be evaluated and
appropriate preventive steps taken prior to the introduction of changes.
A workplace hazard identification and risk assessment should be carried
out before any modification or introduction of new work methods, materials,
processes or machinery. Such assessment should be done in consultation
with and involving workers and their representatives, and the safety and
health committee, where appropriate.
The implementation of a "decision to change" should ensure that all affected
members of the organization are properly informed and trained.
Emergency prevention, preparedness and response arrangements should
be established and maintained. These arrangements should identify the
potential for accidents and emergency situations, and address the
prevention of OSH risks associated with them. The arrangements should be
made according to the size and nature of activity of the organization.
Emergency prevention, preparedness and response arrangements should
be established in cooperation with external emergency services and other
bodies where applicable.
Arrangements should be established and maintained for ensuring that the
organization's safety and health requirements, or at least the equivalent, are
applied to contractors and their workers
.
D. EVALUATION
Procedures to monitor, measure and record OSH performance on a regular
basis should be developed, established and periodically reviewed.
Responsibility,

accountability and authority for monitoring at different levels in the

management
structure should be allocated.
The selection of performance indicators should be according to the size and
nature of activity of the organization and the OSH objectives
Both qualitative and quantitative measures appropriate to the needs of
theorganization should be considered.
The investigation of the origin and underlying causes of work-related injuries,
ill health, diseases and incidents should identify any failures in the OSH
management system and should be documented.
Such investigations should be carried out by competent persons, with the
appropriate participation of workers and their representatives.
The results of such investigations should be communicated to the safety and
health committee, where it exists, and the committee should make appropriate
recommendations.
The results of investigations, in addition to any recommendations from the
safety and health committee, should be communicated to appropriate persons
for
corrective action, included in the management review and considered for
continual
improvement activities.
The corrective action resulting from such investigations should be
implemented in order to avoid repetition of work-related injuries, ill health,
diseases and incidents.
Reports produced by external investigative agencies, such as inspectorates
and social insurance institutions, should be acted upon in the same manner as
internal investigations, taking into account issues of confidentiality.
Arrangements to conduct periodic audits are to be established in order to
determine whether the OSH management system and its elements are in
place, adequate, and effective in protecting the safety and health of workers
and preventing incidents.
An audit policy and programme should be developed, which includes a
designation of auditor competency, the audit scope, the frequency of audits,
audit
methodology and reporting.
The audit includes an evaluation of the organization's OSH management
system elements or a subset of these, as appropriate.
Audits should be conducted by competent persons internal or external to
the organization who are independent of the activity being audited.
The audit results and audit conclusions should be communicated to those
responsible for corrective action.
Consultation on selection of the auditor and all stages of the workplace
audit, including analysis of results, are subject to worker participation, as
appropriate.

E. ACTION FOR IMPROVEMENT

Arrangements should be established and maintained for preventive and

corrective action resulting from OSH management system performance

monitoring and measurement, OSH management system audits and
management reviews.
When the evaluation of the OSH management system or other sources
show that preventive and protective measures for hazards and risks are
inadequate or likely to become inadequate, the measures should be addressed
according to the
recognized hierarchy of prevention and control measures, and completed and
documented, as appropriate and in a timely manner.
The safety and health processes and performance of the organization
should be compared with others in order to improve health and safety
performance.

AN EXAMPLE OF OCCUPATIONAL HAZARD

The great Bhopal gas tragedy
Introduction
The Bhopal disaster was the world's worst industrial catastrophe. It occurred on the night of December 23,
1984 at the Union Carbide India Limited (UCIL) pesticide plant in Bhopal, Madhya Pradesh, India. A leak of
methyl isocyanate gas and other chemicals from the plant resulted in the exposure of hundreds of thousands of
people. Estimates vary on the death toll. The official immediate death toll was 2,259 and the government of
Madhya Pradesh has confirmed a total of 3,787 deaths related to the gas release.[1] Other government agencies
estimate 15,000 deaths.[2] Others estimate that 3,000 died within weeks and that another 8,000 have since died
from gas-related diseases.[3][4] A government affidavit in 2006 stated the leak caused 558,125 injuries including
38,478 temporary partial and approximately 3,900 severely and permanently disabling injuries.[5]

The cause of tragedy

It emerged in 1998, during civil action suits in India, that the plant was not prepared for problems. No action
plans had been established to cope with incidents of this magnitude. This included not informing local
authorities of the quantities or dangers of chemicals used and manufactured at Bhopal.[3][4][13][20]

The MIC tank alarms had not worked for four years.[3][4][13][25]

There was only one manual back-up system, compared to a four-stage system used in the US.[3][4][13][25]

The flare tower and the vent gas scrubber had been out of service for five months before the disaster.
The gas scrubber therefore did not treat escaping gases with sodium hydroxide (caustic soda), which
might have brought the concentration down to a safe level.[25] The maximum pressure the scrubber could
handle, provided it had been operating, was only a quarter of the pressure during the leak. The flare
tower could only hold a quarter of the gas that leaked in 1984.[3][4][13][26]

To reduce energy costs, the refrigeration system was idle. The MIC was kept at 20 degrees Celsius, not
the 4.5 degrees advised by the manual. [3][4][13][25]

The steam boiler, intended to clean the pipes, was out of action for unknown reasons.[3][4][13][25]

Slip-blind plates that would have prevented water from pipes being cleaned from leaking into the MIC
tanks through faulty valves were not installed. Their installation had been omitted from the cleaning
checklist.[3][4][13]

The water pressure was too weak to spray the escaping gases from the stack. They could not spray high
enough to reduce the concentration of escaping gas.[3][4][13][25]

According to the operators the MIC tank pressure gauge had been malfunctioning for roughly a week.
Other tanks were used rather than repairing the gauge. The build-up in temperature and pressure is
believed to have affected the magnitude of the gas release.[3][4][13][25] UCC investigation studies have
disputed this hypothesis.

Carbon steel valves were used at the factory, even though they corrode when exposed to acid.[20]

UCC admitted in their own investigation report that most of the safety systems were not functioning on
the night of December 3, 1984.[17]

The design of the MIC plant, following government guidelines, was "Indianized" by UCIL engineers to
maximize the use of indigenous materials and products. Mumbai based Humphreys and Glasgow
Consultants PVT. Ltd. were the main consultants, Larsen and Toubro fabricated the MIC storage tanks,
and Taylor of India Ltd. provided the instrumentation. [27]

previous warnings

A series of prior warnings and MIC-related accidents had occurred:

In 1976, the two trade unions reacted because of pollution within the plant.[4][21]

In 1981, a worker was splashed with phosgene. In panic he ripped off his mask, thus inhaling a large
amount of phosgene gas; he died 72 hours later.[4][21]

In January 1982, there was a phosgene leak, when 24 workers were exposed and had to be admitted to
hospital. None of the workers had been ordered to wear protective masks.

In February 1982, an MIC leak affected 18 workers.[4][21]

In August 1982, a chemical engineer came into contact with liquid MIC, resulting in burns over 30
percent of his body.[4][21]

In October 1982, there was a leak of MIC, methylcarbaryl chloride, chloroform and hydrochloric acid.
In attempting to stop the leak, the MIC supervisor suffered intensive chemical burns and two other
workers were severely exposed to the gases.[4][21]

During 1983 and 1984, leaks of the following substances regularly took place in the MIC plant: MIC,
chlorine, monomethylamine, phosgene, and carbon tetrachloride, sometimes in combination.[4][21]

Reports issued months before the incident by UCC engineers warned of the possibility of an accident
almost identical to that which occurred in Bhopal. The reports never reached UCC's senior management.
[4][20]

UCC was warned by American experts who visited the plant after 1981 of the potential of a "runaway
reaction" in the MIC storage tank. Local Indian authorities warned the company of problems on several
occasions from 1979 onwards. [4][20]

short term health effects

The leakage caused many short term health effects in the surrounding areas. Apart from MIC, the gas cloud may
have contained phosgene, hydrogen cyanide, carbon monoxide, hydrogen chloride, oxides of nitrogen,
monomethyl amine (MMA) and carbon dioxide, either produced in the storage tank or in the atmosphere.[4]
The gas cloud was composed mainly of materials denser than the surrounding air, stayed close to the ground
and spread outwards through the surrounding community. The initial effects of exposure were coughing,
vomiting, severe eye irritation and a feeling of suffocation. People awakened by these symptoms fled away
from the plant. Those who ran inhaled more than those who had a vehicle to ride. Owing to their height,
children and other people of shorter stature inhaled higher concentrations. Many people were trampled trying to
escape.[4]
Thousands of people had succumbed by the morning hours. There were mass funerals and mass cremations as
well as disposal of bodies in the Narmada river. 170,000 people were treated at hospitals and temporary
dispensaries. 2,000 buffalo, goats, and other animals were collected and buried. Within a few days, leaves on
trees yellowed and fell off. Supplies, including food, became scarce owing to suppliers' safety fears. Fishing
was prohibited as well, which caused further supply shortages.[4]
A total of 36 wards were marked by the authorities as being "gas affected", affecting a population of 520,000.
Of these, 200,000 were below 15 years of age, and 3,000 were pregnant women. In 1991, 3,928 deaths had been
certified. Independent organizations recorded 8,000 dead in the first days. Other estimations vary between
10,000 and 30,000. Another 100,000 to 200,000 people are estimated to have permanent injuries of different
degrees.[4]
The acute symptoms were burning in the respiratory tract and eyes, blepharospasm, breathlessness, stomach
pains and vomiting. The causes of deaths were choking, reflexogenic circulatory collapse and pulmonary
oedema. Findings during autopsies revealed changes not only in the lungs but also cerebral oedema, tubular
necrosis of the kidneys, fatty degeneration of the liver and necrotising enteritis.[28] The stillbirth rate increased
by up to 300% and neonatal mortality rate by 200%.[4]

long term health effects

It is estimated 100,000 to 200,000 people have permanent injuries. Reported symptoms are eye problems,
respiratory difficulties, immune and neurological disorders, cardiac failure secondary to lung injury, female

reproductive difficulties and birth defects among children born to affected women. [4] The Indian Government
and UCC deny permanent injuries were caused by MIC or the other gases.
solutions for the improvement of occupational health in india
According to a scientific paper strategies and policies deteriorate occupational health situation in india : a
review based on social determinant framework presented by ashish kumar mandal, department of ergonomics,
occupational health, kolkata. Following recommendation were pressed forward for the improvement of
occupational health in india
improvement of occupational health requires strengthened organization and appropriate leadership
in trade unions, concious workers, who are able to control the work process and generation of
unbiased information about occupational health risks. Strategies and steps for the improved
conditions of occupational health status include

India urgently requires a mordern occupational health safety (OHS) legislation with adequate
enforcement, machinery , laws, occupational medicine and a proper awareness programme to catch
up with the rest of the world

Health awareness and factors to measure the safety analysis of laborers working in particular
industry

Empowering positive trade union so that they can play a key role in demanding occupational health
improvements

Making proffesionals available through training and development and enabling them to play an
active role in the generation of information and knowledge through proper research.

Work should be given depending upon two principles, which are worker fit for the job and job fit
for the worker, so that the employer generates interest on the work avoids lack of attention

Need for policymakers to change their attitude towards occupational health and recognize the
occupational health improvement is a vehicle for socio economic development.

Impose a strict vigilance upon hazardous materials by investigators. The government should also
weigh the pros and cons between environment and health cost of our people and cost of importing
them from elsewhere

Survillance of diseases in industrial belts, maintanance of death certificates, and using record
linkage techniques between various resources may also potentially improve the research on
occupational health

Quality assurance, crating awareness, accrediation and capacity building, will be needed in the field
of occupational health. Model programmes and pilot projects / surveys may be undertaken with the
support from ILO/ WHO and different NGOS like the indian association of occupational health
(IAOH) for unorganized sector.