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BREATHING EASY AT WORK

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Title: BREATHING EASY AT WORK


1
BREATHING EASY AT WORK
  • OCCUPATIONAL LUNG HEALTH

2
OUTLINE
  • The Facts
  • Your lungs
  • Workplace exposures
  • Lung health impact/ Occupational Health trends
  • Research
  • Acts Regulations
  • Workplace Interventions
  • The Lung Association

3
THE FACTS
  • Every 20 minutes a Canadian dies from lung
    disease
  • One in five Canadians (six million) have a
    breathing problem
  • More than 2.8 million Canadians have asthma
  • Asthma is the number one reason for work /school
    absenteeism
  • More than 750,000 Canadians have chronic
    obstructive pulmonary disease (COPD) - estimated
    only half of these people have been diagnosed and
    treated.

4
THE FACTS
  • Lung disorders are the number one cause of short
    term disability
  • 4th leading cause of death (2004)
  • 13 of all hospitalizations
  • Decreased quality of life for patients with COPD
  • High health service resource use economic
    burden to society
  •  

5
THE RESPIRATORY SYSTEM
  • No oxygen -live only minutes
  • Every cell needs constant supply of oxygen
  • Lungs link to supply of life-giving oxygen
  • From American Lung Association Occupational Lung
    Diseases An Introduction. New York, NY.
    Macmillan. 1979 pp 10. (5).
  •  
  •  

6
THE RESPIRATORY SYSTEM
  • Susceptible to damage from inhaled toxic
    materials irritants surface area exposed to
    air is so large and bodys need for oxygen so
    great.great impact on body.leading to disease
    of other vital organs

7
THE RESPIRATORY SYSTEM
  • NATURAL MECHANISMS against airborne hazards
  • Fine hairs in nose
  • -front-line barrier
  • -filter
  • -exercise/hard work
  • Cough reflex clears trachea main bronchi
  • Special cells-destroy bacteria viruses
  • Ciliary cells-few hrs to expect foreign material
  • Innermost areas of lungs- much longer to clear
    out

8
THE RESPIRATORY SYSTEM
  • Lungs that receive prolonged /or repeated
    exposure to air contaminants eventually cannot
    keep up with the rate of deposition /or constant
    irritation. Result contaminants accumulate
    contributing to the development of Occupational
    Lung Diseases.

Diagram- black asbestos fibers- exposure
standards to be less than 1 fibre/cm3 for 8 hr
exposure
9
THE RESPIRATORY SYSTEM
  • PARTICLES

10
OCCUPATIONAL LUNG HAZARDS
  • TYPES OF LUNG HAZARDS (AIRBORNE)
  • Occupational Pulmonary Contaminants
  • come in many forms
  • Seen, smelled, felt as irritants in nose or
    throat
  • Only detected with special equipment
  • Short tem exposure- immediate, acute damage
  • Most take repeated or constant exposure over
    months or years to cause disease or permanent
    harm
  • Influenced by air pollution, age, smoking
    history, nutritional status as well as genetics
    and stress

11
OCCUPATIONAL LUNG HAZARDS
  • Several contaminants -same time lead to additive
    or worse, synergistic consequences to health
  • Essential to know what materials processes used
    so appropriate monitoring control of potential
    lung hazards can take place
  • Exposures to airborne hazards can be greatly
    reduced or eliminated through engineering
    controls such as improving ventilation and good
    work practices such as the use of personal
    protective equipment (properly selected
    maintained respirators) Legislated Workplace
    Safety and Health Act, W210

12
MINERAL DUSTS
Particles formed from inorganic dusts.
13
AIRBORNE HAZARDS
  • MINERAL DUSTS
  • Dusts mineral fibres from stones, rocks, ores
  • Sources Mining, quarrying, tunnelling, blasting,
    smelting, grinding, milling, processing,
    drilling, abrading
  • Industries mines, quarries, foundries
  • Lung effects pneumoconiosis (asbestosis,
    silicosis, black lung) chronic bronchitis,
    emphysema, fibrosis, cancer

14
ORGANIC DUSTS
Particles formed from organic materials.
15
AIRBORNE HAZARDS
  • ORGANIC DUSTS
  • Dusts formed from living materials-micro-organisms
    , plants, animals natural products like
    wood/leather.
  • Sources Wood, cereal grains (planting,
    harvesting, storing, transporting, processing),
    animal husbandry (droppings, dander, feathers)
  • Industries Agriculture, manufacturers
    (furniture/ drugs), millers, bakers, chemists
  • Lung effects Hypersensitivity reactions-occupatio
    nal asthma or hypersensitivity pneumonitis-permane
    nt obstructive disease, diffuse lung fibrosis.
    Wood dusts -cancer

16
CHEMICAL DUSTS
Dusts from synthetic materials.
17
AIRBORNE HAZARDS
  • CHEMICAL DUSTS
  • Synthetic chemicals (powder form)-pesticides,
    pharmaceuticals, dyes, bleaching agents,
    detergents, paints
  • Sources Any contact from making, packaging,
    applying, weathering
  • Industries aircraft building, autobody, pulp
    mills, chemical, breweries, foundries,
    hairdressing, health care, labs, manufacturing
    (paints), paint sprayers
  • Lung effects Depends on toxic properties of
    specific chemicals-irritants, allergens, lungs-
    cause cancer

18
FUMES
Metals and polymers.
19
AIRBORNE HAZARDS
  • FUMES
  • Very small solid particles formed when hot vapors
    cool rapidly condense
  • Can give off hazardous gases
  • Act like very fine mineral dust in lungs
  • Sources High heat processes
  • Industries Smelting, arc-welding, furnace work
  • Lung effects Difficult to assess effects of
    separate materials since several hazards present
    at same time. Can lead to emphysema lung
    cancer.

20
MISTS and SPRAYS
Liquid droplets and other propellant gas.
21
AIRBORNE HAZARDS
  • MISTS SPRAYS
  • Liquid droplets suspended in air or other
    propellant gas.
  • Sources Cleaning products, pesticides, paints,
    cosmetic products, rust removers, by-products
    from other processes (cutting oils in machine
    shops)
  • Industries Cutting, grind, spraying and pickling
    operations, electroplating
  • Lung effects The finer the spray the deeper
    into the lungs it goes. Effect depends on
    material, concentration and temperature.

22
GASES
Natural or Manmade chemical reactions phosgene,
nitrogen oxides or methane ammonia, bromine,
sulfur dioxide, chlorine nitrogen, carbon
monoxide cyanide, or radioactive, vinyl
chloride gas, nickel carbonyl.
23
AIRBORNE HAZARDS
  • GASES
  • Fluids that expand to fill the space containing
    them
  • Can travel quickly, be highly flammable,
    explosive when mixed with air, chemically or
    physiologically reactive. Some colorless
    odorless.
  • Sources Natural chemical reactions (fermenting
    silage), Manmade chemical reactions (high-heat
    processes-welding)
  • Industries Agriculture, foundries, manufacturing
  • Lung effects suffocation, interference with
    oxygen use, immediate irritation, airway
    constriction, existing lung disease aggravation,
    cancer (takes years)

24
VAPORS
Ketones, aromatic hydrocarbons, alcohols,
acetates and mercury.
25
AIRBORNE HAZARDS
  • VAPORS
  • Gaseous form of liquid always found over that
    liquid-more vapors form as liquid heats. Affect
    lungs similar to gases. Vapors hang out with
    parent liquids-gases dont always stick with
    liquid forms.
  • Sources Inorganic-high boiling points, dont
    vaporize at room temp.-arent usually assoc. with
    lung disease Organic-many vaporize at room
    temp.-used as solvents (ketones, alcohols,
    acetates, aromatic hydrocarbons)
  • Lung effects enter body through lungs- damage to
    other organs more so than lungs-pulmonary edema
    tracheobronchitis.

26
RADIATION
Ionizing (electromagnetic waves) and non-ionizing
radiation.
27
AIRBORNE HAZARDS
  • RADIATION
  • Non-ionizing radiation (electromagnetic
    waves-infrared, ultraviolet, microwave, laser,
    radar, radio frequency) Ionizing radiation
    (alpha, beta, gamma rays, neutron particles
    x-rays)
  • Sources Mining radioactive ores
  • Industry Medicine, power plants, equipment used
    in industry (high energy electrical equip.,
    lasers, microwaves, radar)
  • Lung effects Electromagnetic waves can cause
    thermal burns. Ionizing radiation can cause
    cancer.

28
BIOLOGICAL HAZARDS
Bacteria, viruses, fungi, ricketsia, Chlamydia
parasites.
29
AIRBORNE HAZARDS
  • BIOLOGICAL
  • Bacteria, viruses, fungi, rickettsial, chlamydial
    parasitic agents
  • Sources Health care child care facilities,
    poorly maintained ventilation systems, biological
    research labs, animal care processing
    facilities
  • Lung effects Depends on type of hazard. Can be
    minor allergies resp. infections to cancer.
    Vaccinations for some.

30
CONFINED SPACES
Oxygen deficient atmosphere.
31
AIRBORNE HAZARDS
  • CONFINED SPACES
  • Oxygen deficient atmosphere-oxygen content below
    19.5 by volume.
  • Sources Storage tanks, drums, sewers, septic
    tanks, manholes, pits, underground utility
    tunnels.
  • Lung effects irritation to extreme ( immediate
    death)- dependant on material/activity in
    confined area- RESPIRATORS REQUIRED.

32
LUNG HEALTH IMPACT
  • OCCUPATIONAL HEALTH TRENDS
  • Occupational respiratory (lung) diseases
  • workplace exposure to irritating or toxic
    substances- may cause acute or chronic
    respiratory ailments.

33
PNEUMONCONIOSES
Lung disease from inhaling inorganic dust in
mines other workplaces has declined over past
30 years.
34
PNEUMOCONIOSES
  • Pneumonconioses includes silicosis, black lung
    (coal miners), asbestosis (most common)

35
MESOTHELIOMA
  • Stats only available as of 2001 when the ICD
    codes were introduced and then only in all
    provinces in 2006 so national estimates are no
    available. Ca Care Ontario has stats that show a
    marked rise of mesothelioma associated with
    asbestos exposure decades earlier.

36
CONDITIONS DUE TO INHALATION OF CHEMICALS, FUMES
OR GASES
  • Hospital admissions for lung conditions due to
    inhalation of chemicals, fumes or gases remained
    steady from 1979 to 2004. 7 deaths 2000-2004.
    Specific causes not identified.

37
OCCUPATIONAL ASTHMA
  • Most common lung disease compensated for by
    workers compensation. National data not
    available on rates of confirmed occupational
    asthma.

38
OCCUPATIONAL ASTHMA
  • INDUSTRY/JOB at risk
  • AGENT
  • Printers/paper products
  • Grain handlers
  • Lumber/wood workers
  • Leather workers
  • Paint sprayers
  • Plastics
  • Rubber industry
  • Bakers
  • Veterinarians
  • Vegetable gums, natural glues
  • Grain dust
  • Wood dust
  • Formalin, chromium
  • Diisocyanates, dimet ethanalamine
  • Epoxy resin, polyurethane
  • Ethylene diamine, diisocyanates
  • Flour, insect, mite debris
  • Animal dander

39
OCCUPATIONAL ASTHMA
  • INDUSTRY/JOB
  • AGENT
  • Laboratory workers
  • Vegetable oil production
  • Beauticians/cosmetologists
  • Health care workers
  • Pharmaceutical workers
  • Solders, electronic fabricators
  • Animal dander
  • Flax seed, castor bean
  • Diamines, potassium persulfate
  • Formaldehyde, medication, latex
  • Various drugs, enzymes
  • Colophony resin, ethanalamine

40
OTHER OCCUPATIONAL LUNG DISEASES
  • ICD codes not available for other Occupational
    lung diseases include occupational lung cancer
    from agents such as asbestos, chromium, radon
    (photo), other occupational chronic obstructive
    lung disease. (15 to Occupational exposures).
    WCB numbers likely markedly underestimated.

41
Occupational Lung Disease DeathsMB WCB-2005
42
Occupational Disease Fatalities- MB
43
Acute-Hazard Occupational Disease Deaths- MB
WCB
44
SMOKING OCCUPATIONAL LUNG DISEASE
  • Smoking contributes to lung disease
  • Impairs lungs natural defense mechanisms
    irritates airways inhibits work of ciliary
    cells
  • Smoking is leading cause of serious lung disease
    certain types of cancer
  • Synergistic effect with other pulmonary
    carcinogens (asbestos, chromium/uranium
    compounds, arsenic)
  • Increases lung cancer risk by 15 chronic
    asbestos exposure 4 60 risk NOT 29
  • Smokers develop lung disease cancer more
    readily diseases progress more rapidly

45
OCCUPATIONAL LUNG DISEASE
  • Pulmonary Diseases
  • Occupational Asthma
  • Reactive Airways Dysfunction Syndrome (RADS)
  • Emphysema
  • Chronic Bronchitis (repeated infections and/or
    exposure to irritants such as fumes/dusts, oil
    aerosols, gases, smoke)
  • Pneumoconioses (from particles less than 5
    microns in size)
  • Hypersensitivity Pneumonitis (organic
    dusts-fungi, animal proteins, vegetable proteins)

46
OCCUPATIONAL LUNG DISEASE
  • Granulomatous Disease (TB, toxins-Berylliosis
    best known occupational example)
  • Pneumonias- toxic process or more commonly
    infections (health care, child care animal care
    workers)-fungi, bacteria, viruses, other
    microorganisms
  • Occupational Lung Cancer- smoking,
    bis-chloromethyl ether, coal tar, pitch
    volatiles, mustard gas, arsenic, asbestos,
    radium, petroleum, chromates, uranium

47
REGULATIONS ACTS
  • Labour Immigration of Manitoba
  • Workplace Safety Health Division
  • Workplace Safety Health Act of Manitoba
    (C.C,S,M.c.W210) updated to April 8,2008
  • Effective Feb.1, 2007 a new WSH regulation was
    consolidated into one The Workplace Safety and
    Health Regulation 217/2006
  • Certain industries regulated- exposure to
    asbestos silica (Fibrogenic Dust Exposure
    Guideline-revised released Dec.2008)
  • Other industries- Due diligence

48
REGULATIONS ACTS
  • DUE DILIGENCE
  • In occupational health safety employers shall
    take all reasonable precautions under the
    particular circumstances, to prevent injuries or
    accidents in the workplace. Applies to situations
    that arent addressed elsewhere in the OHS
    legislation.
  • Bill C-45- federal legislation that amends the
    Canadian Criminal Code- became law 2004-applies
    legal duty to workplace health and safety.

49
RESPIRATORY SURVEILLANCE
  • Employment settings where workers use or are
    potentially exposed to lung hazards
  • Lung diseasemost significant due to severity
  • Human economic toll
  • Significant causes of morbidity, disability,
    early retirement death
  • Entirely preventable once causes recognized
  • HIGH PRIORITY -Recognition of Occupational Lung
    Disease hazards prevention of exposure

50
RESPIRATORY SURVEILLANCE
  • Reduce human suffering economic impact of
    occupational disease.
  • Detect occupational non-occupational lung
    diseases in earliest stages when reduction of
    exposure is likely to be most effective.
  • Identify working conditions that are hazardous so
    that improvements in industrial hygiene can be
    made.
  • Establish baseline function for new employees
    to identify job applicants with pre-existing lung
    damage so that they can be placed in positions
    that do not jeopardize their health.

51
WORKPLACE INTERVENTIONS
  • Workplace Inspections
  • Workplace Safety Health reps/committees
  • Engineering controls
  • Workplace design
  • Equipment selection
  • Modification of existing equipment/processes
  • Ventilation system
  • Work Practices Procedures
  • Housekeeping
  • Maintenance

52
WORKPLACE INTERVENTIONS
  • Personal Hygiene
  • Air-monitoring
  • Replace toxic products for safer/ less toxic
    products
  • Medical surveillance examinations Act/Reg. 50
    (1)
  • Education training
  • Personal protective equipment
  • Smoking cessation programs
  • Workplace wellness programs

53
THE LUNG ASSOCIATION
  • OCCUPATIONAL LUNG HEALTH
  • Perform occupational lung health screening
  • Prevention early detection
  • On-site or office appointments
  • Questionnaires
  • Lung function tests (spirometry)
  • Chest x-rays
  • Fitness to wear respirator testing
  • Medical surveillance reports
  • Lung health trending
  • Retention of health records for 40 years
  • Presentations/displays

54
THE LUNG ASSOCIATION
  • TOBACCO CESSATION PREVENTION
  • Lungs are for Life (school program)
  • N.O.T. on Tobacco (teens)
  • Smoke Free Car Home Campaign
  • World No Tobacco Day (May)
  • National Non-Smoking Week (Jan)
  • Workplace Smoking Cessation project MANTRA/HC
  • Smoking Cessation Forums (universities- target)
  • Presentations, Displays, Print /video resources

55
THE LUNG ASSOCIATION
  • ENVIRONMENT
  • Bye Bye Beaters-vehicle scrappage program
  • Partnership with Science, Technology, Energy
    Mines to promote clear air quality messaging
  • Member of Crop Residue Burning
  • Advisory Committee
  • Air Quality issues

56
THE LUNG ASSOCIATION
  • THE SANATORIUM BOARD -1904
  • THE LUNG ASSOCIATION, MANITOBA
  • (Non-profit health charity -division of the
    Sanitorium Board of MB in 1975)
  • MISSION
  • To improve lung health of Manitobans

57
  • For more information contact
  • PHONE
  • Winnipeg (204) 774-5501
  • Brandon (204) 725-4230
  • Toll free1-888-566-5864
  • info_at_mb.lung.ca
  • www.mb.lung.ca
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