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\begin{document}

\title{Seven concepts of occupational health}



\author[1]{Arindam Basu}%
\affil[1]{University of Canterbury}%


\vspace{-1em}



  
  \date{May 04, 2024}


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\sloppy


\subsection*{Definition, background, and
challenges}

{\label{909285}}

X used to work at a firm that dealt with asbestos. He took precautions
he knew about his exposure to asbestos. Every day he would bring back
home the clothings he used to wear in his workplace and get them washed.
Thirty years later, Y, his wife was diagnosed with mesothelioma. Can you
guess what happened?

Z was a university lecturer. The university introduced open plan office
spaces in the university. A few weeks after the open plan office system
was installed, Z was diagnosed with severe depression and missed several
classes. What could have caused his depression?

\par\null\selectlanguage{english}
\begin{figure}[h!]
\begin{center}
\includegraphics[width=0.70\columnwidth]{figures/occhlth/occhlth}
\caption{{Occupational Health can be studied from many angles
{\label{111991}}%
}}
\end{center}
\end{figure}

Occupational health deals with the principles of public health in
workplace settings; it is the study of the exposures and health outcomes
in workplaces to ensure that the~\textbf{\emph{work has to be fitted for
the workers and the workers are fitted for the job}}s, and that, the
risk to health due to occupations are minimised or
prevented~\cite{guidotti_GlobalOccupationalHealth_2011} . A broad range of disciplines contribute
to Environmental health, such as occupational epidemiology, industrial
hygiene, occupational medicine, and others. The
\href{https://www.ilo.org/safework/lang--en/index.htm}{ILO/WHO
definition}~is as follows:

\begin{quote}
Occupational health should aim at the promotion and maintenance of the
highest degree of physical, mental and social well-being of workers in
all occupations; the prevention amongst workers of departures from
health caused by their working conditions; the protection of workers in
their employment from risks resulting from factors adverse to health;
the placing and maintenance of the worker in an occupational environment
adapted to his physiological and psychological capabilities and; to
summarize: the adaptation of work to man and of each man to his job.~
\end{quote}

\subsection*{Concept 1:
protect-adapt-promote-care}

{\label{352142}}

\emph{\textbf{Protect workers from illnesses and prevent illnesses among
workers}}. -- This is the core business of occupational health and
consists of four elements:

\begin{quote}
\begin{quote}
(1) we must be able to identify hazardous exposure,~ we must be able to
tell when a worker has work overload or adverse work conditions that
will potentially lead to poor health;

(2) in the shop floor, we must be able to assess what the worker is
exposed to and measure the level of exposure ;

(3) we must be able to assess risks to health of the worker as a result
of exposure;

(4) we must be able to prevent illnesses and establish control measures
so that we can ensure the worker's health and safety
\end{quote}
\end{quote}

\textbf{\emph{Adapt the work to the worker and the worker to the work}}.
-- We~ must acknowledge that different workers based on their age,
gender, mental capacity, physical capacity, health histories are best
suited to different types of jobs; similarly, different types of jobs
demand different types of working ability. We~ must be able to determine
what these are and enable people to adapt to those situations.~

\emph{\textbf{Promote health and well-being of all workers}}. --We must
study how people work best, and how we can make proper adjustment of
work environment.

\textbf{\emph{Arrange for curative and rehabilitative services when they
are available, and we must be able to rehabilitate workers when
needed}}. --- While primary care or primary prevention is the best way
to ensure workers will enjoy good health, often prevention and promotion
of health is not enough. People often work in scaffolds and have
protective helmets but even then, they may fall over and injure
themselves. Occupational health specialists should then arrange to have
the worker assessed as soon as possible and arrange for his or her
rehabilitation if needed.

\textbf{\emph{Establish primary care services}}. -- Primary care
services mean that medical care where a doctor or nurse will be
available in the workplace to diagnose and provide medical treatment in
the first instance. For example, if a worker feels dizzy, a medical
doctor must be available to diagnose the cause of the dizziness: is it
because of some exposure in the workplace, is it because the person has
problems with his or her spine, or is it because the person may have an
aura of migraine? What needs to be done?~

\subsection*{Concept 2: environmental health is different from
occupational
health}

{\label{795325}}

We use the principles of environmental health to occupational settings
as we can argue that occupations or workplaces are specific
environments. So the basic principles that in working environment too,
\textbf{workers or objects that change the conditions} of the
environment affect our health applies. We need to understand that there
are~\textbf{exposures} to which workers are exposed to in their
workplaces, and the exposures lead to \textbf{high doses} of specific
agents that can affect them. We need to be aware of the potential
hazards and we must know the risks such hazards can cause. For example,
an x-ray technician is exposed to harmful ionizing radiation and must be
protected from the source. A university lecturer is exposed to
\textbf{hazards of sitting} all day in a desk~\cite{owen2008too}. Also,
working at a computer keyboard using repetitive tasks would predispose
such a person to carpal tunnel syndrome. Therefore, we can use the
principles of environmental epidemiological studies to explore what
hazards exist that lead to health risks. We can also conduct health risk
assessment of the workers or people employed in different occupations to
further characterise the risk.

Having said that, we must be aware that there are some differences
between people who are exposed to agents in the general environment
(indoor or outdoors) and workers who are exposed to specific
environments in their workplaces.

First,~\textbf{\emph{workers tend to be exposed for longer duration and
higher intensity of exposure}} to whatever they are exposed to in their
workplaces. Consider yourself as a ``worker'' and say you are exposed to
dusts in a classroom to which you are allergic. Your average level of
exposure will be higher during the term time than during other times of
the year. The same logic applies to any worker who is working in a
workplace where he is exposed to a hazardous substance or risky
behaviour that he or she is about to undertake. A bus driver for example
is exposed to longer hours of diesel exhausts when he is on duty than
when he is not.~ Second, we can argue that~\textbf{\emph{Workers tend to
be healthier and younger~}}than the members of the general public. The
average work age starts in young adulthood and most people retire from
work around the age of 60+, whereas the general age range of the members
of the public are wider. More people in the younger age band would be
working than older age bands and there may be difference in the nature
and style of work and therefore exposure. We need to keep this in mind.~
Third, for environmental health,~\textbf{\emph{there are different
regulatory agencies for environmental and occupational health}} that
look for exposure in the overall environment. For occupational health
issues, there are rights and claims processes, hence there are
specialised government agencies are different for Environmental health
and occupational health issues. This distinction is not trivial as this
tells us that the priorities are different to the governments for people
in the general environmnental settings and people who are in work
settings. Fourth,~ \textbf{\emph{insights gained in occupational health
settings helped to solve problems in environmental health settings and
each other}}. For example, lead exposure leading to health effects and
neurological effects led to control of environmental lead.~ Similarly,
knowledge from environmental exposure can lead to investigation of
occupational exposure; for example agricultural work, work in forestry
and logging, etc are practices where work conducted in an outdoor
environmental setting is also associated with occupational issues.~

\subsection*{Concept 3: occupational hazards are unique to
occupations}

{\label{224783}}

Every occupation and workplace is associated with hazards. As we
discussed earlier, hazards are those that can cause potential harm and
when that harm is ``realised'', the health effects are risks. As in all
occupations and workplaces, we work with some exposures that have their
own physical and chemical properties, we exposed ourselves in many ways
to physical forces that impact on us. For example, imagine a waiter
carrying a tray of food to patrons in a restaurant and walks on a floor
that has slippery surface. He slips on the floor, falls, and injures
himself, and also in the process some food items and spices in the food
hit his eyes. Now, several things occurred: (1) he slipped but because
the surface was slippery and the friction forces were so low that he
could not hold himself; (2) the impact of his fall was enough to injure
his hip, but that was a health hazard; (3) the spices in the food that
were uncovered led to splashing of hot liquid and spices to his eyes. So
here is a case of mix between what is referred to as safety hazards and
health hazards in this particular case. In safety hazard, we talk of
energy transfer (friction, hitting a surface, hot surface, etc); in
health hazard we talk about risk of health effects due to exposure to
some other exposure.~

\textbf{Safety hazards}. -- In an unsafe workplace, energy gets
transferred from the source to the recipient, the worker. For example,
the waiter who slipped on the slippery floor had loss of friction force
and his movement disrupted his balance and he crashed on the floor. In
other situations, other forms of energy such as chemical energy get
transferred from a chemical body to the humans. For example,
firefighters who fight chemical fires such as that resulting from acid
fires should not aim to douse the fire with water, if they do, they may
get burnt from the acid fumes; an electrician wears insulated materials
to work and turns off electric current sources to avoid electrical
shock. From the source, uncontrolled transfer of energy (physical,
chemical, electrical, thermal, kinetic, radiation) happens to vulnerable
recipients. Example: electric shock, touching a hot plate, lead from
battery units, radiation from Xray units, hit by a moving part in a car
manufacturing unit, etc. A safety hazard and the resulting health effect
(fractured bones, or electrocution, or burn) are unique to occupational
health.

\textbf{Health hazards}. -- In contrast to safety hazard that is largely
preventable, a health hazard is one that occurs after a latent period. A
worker is exposed to a health hazard for some time and the hazard
accrues for some time before manifesting in health effects. We discuss
five types of hazards: chemical hazards, where specific chemical
compounds will lead to either acute or chronic health effects. For
example sudden exposure to high concentrations of carbon monoxide can
lead to death due to increased accumulation of carboxyhaemoglobin that
prevents transfer of oxygen to cells; continued exposure to asbestos can
lead to mesothelioma. Physical hazards are the ones where persistent
exposure to physical agents (such as noise or vibration) can lead to
illnesses. For example, if gardeners do not take precaution while
operating chainsaws or hedge trimmers using gloves, or ear muffs, then
they risk damages to the median nerve in hand, or hearing loss (noise
induced hearing loss). Clerks and writers, if they sit for long time at
a place risk developing a number of health effects (sitting is the new
smoking).

1. Chemical hazards. -- exposed to chemical agents at work and develops
disease

2. Physical hazards. -- Noise, pressure, vibration, non-ionizing
radiation

3. Biomechanical. -- Heavy weight lifting, repeated movements (carpal
tunnel syndrome)

4. Biological. -- infection from infected syringes, HIV, Hepatitis B,
etc

5. Psychosocial. -- Job loss, stress

\subsection*{Concept 4: Statistics of NZ occupational
health}

{\label{842005}}

Driscoll, Pearce and colleagues (2004) have tabulated and discussed
several disease conditions that occur due to workers are exposed to
specific objects and agents in the workplace~\cite{driscoll2004burden}. Other
sources of data to understand the burden of occupational diseases in New
Zealand are from Worksafe website data section and from the ACC
(see~\url{https://www.acc.co.nz/about-us/statistics/}); Here, see a part
of the picture of the occupational health issues in New Zealand. What do
you think?

Prevalence of Hepatitis B among New Zealand workforce:

\par\null\selectlanguage{english}
\begin{table}[h!]
\centering
\normalsize\begin{tabulary}{1.0\textwidth}{CCCCCCC}
Occupation & Hepatitis Antibody &  &  &  &  &  \\
Psychopaedic workers & 16 &  &  &  &  &  \\
Psychopaedic nurses & 12 &  &  &  &  &  \\
European school dental nurses & 26 &  &  &  &  &  \\
Non-Europeans school dental nurses & 68 &  &  &  &  &  \\
Dentists & 14 &  &  &  &  &  \\
Dental Assistants & 7 &  &  &  &  &  \\
School Dental Assistants & 7 &  &  &  &  &  \\
Laboratory workers & 20 &  &  &  &  &  \\
Medical workers & 22 &  &  &  &  &  \\
Nurses & 10 &  &  &  &  &  \\
Dental Staff & 36 &  &  &  &  &  \\
General Staff & 13 &  &  &  &  &  \\
Police Officers & 12 &  &  &  &  &  \\
Customs officers & 6 &  &  &  &  &  \\
Prison officers & 23 &  &  &  &  &  \\
 &  &  &  &  &  &  \\
 &  &  &  &  &  &  \\
 &  &  &  &  &  &  \\
 &  &  &  &  &  &  \\
 &  &  &  &  &  &  \\
 &  &  &  &  &  &  \\
\end{tabulary}
\caption{{Hepatitis B seroprevalence, indicates the extent of Hepatitis B
infection (past or~ present) by occupation. What do you think?
{\label{476608}}%
}}
\end{table}Risk of liver cancer among New Zealand work groups\selectlanguage{english}
\begin{table}[h!]
\centering
\normalsize\begin{tabulary}{1.0\textwidth}{CCCCC}
Work\_group & Relative Risk &  &  &  \\
Woodworkers & 1.87 &  &  &  \\
Sawmill workers & 3.55 &  &  &  \\
Wood workers & 4.24 &  &  &  \\
Performing Artists or composers & 25.1 &  &  &  \\
Transport Operators & 3.05 &  &  &  \\
 &  &  &  &  \\
 &  &  &  &  \\
 &  &  &  &  \\
 &  &  &  &  \\
\end{tabulary}
\caption{{Risk of liver cancer among working groups in NZ%
}}
\end{table}Risk of lung cancer among New Zealand working population\selectlanguage{english}
\begin{table}[h!]
\centering
\normalsize\begin{tabulary}{1.0\textwidth}{CCCCC}
Workgroup & RelativeRisk &  &  &  \\
Bricklayers & 1.25 &  &  &  \\
Carpenters & 1.27 &  &  &  \\
Asbestos-exposed workers & 1.2 &  &  &  \\
Machine tool operators & 2.18 &  &  &  \\
Sawmillers & 1.76 &  &  &  \\
Welders & 1.4 &  &  &  \\
Pulpmill workers & 1.33 &  &  &  \\
Meat workers & 1.79 &  &  &  \\
Cooks & 2.23 &  &  &  \\
Hairdressers & 2.54 &  &  &  \\
Fishermen & 2.06 &  &  &  \\
Food and beverage processors & 1.29 &  &  &  \\
\end{tabulary}
\caption{{Risk of lung cancer among New Zealand workers
{\label{553576}}%
}}
\end{table}Risk of health effects due to exposure to Environmental tobacco smoke
among New Zelaand workers\selectlanguage{english}
\begin{table}[h!]
\centering
\normalsize\begin{tabulary}{1.0\textwidth}{CCCCC}
Workgroup & Relative Risk & 95\% CI & PAF &  \\
IHD for men & 1.21 & 1.04-1.41 & 0.06 &  \\
IHD for women & 1.21 & 1.04-1.41 & 0.04 &  \\
Lung Cancer for men & 1.24 & 1.13-1.36 & 0.08 &  \\
Lung Cancer for women & 1.24 & 1.13-1.36 & 0.05 &  \\
Stroke for men & 2.1 & 1.33-3.32 & 0.24 &  \\
Stroke for women & 1.66 & 1.07-2.57 & 0.11 &  \\
 &  &  &  &  \\
 &  &  &  &  \\
 &  &  &  &  \\
\end{tabulary}
\caption{{This is a caption
{\label{803676}}%
}}
\end{table}\subsection*{Concept 5: occupational epidemiology: sentinel surveillance,
healthy worker effect, retrospective cohort
study}

{\label{522609}}

Occupational epidemiology as the discipline of study that deals with the
distribution and determinants of workplace related illnesses and use of
that knowledge to prevent harm and promote wellness of the workers has
two distinctions:

\begin{itemize}
\tightlist
\item
  The exposure or environment is workplace related: therefore knowledge
  of the toxins in the workplace and toxicology is essential for the
  epidemiologist
\item
  Although the outcomes can be varied and the population is restricted
  within the workplace, similar to the exposure variables: therefore a
  few study designs are better suited than others to study the health
  effects of exposures: these include prospective and retrospective
  cohort studies, nested case control studies, and surveillance or case
  series. We will discuss these concepts.
\end{itemize}

As workers within a workplace setting are relatively readily
identifiable, therefore many epidemiological studies can rely on all
members of the population. A common study design to assess the
distribution of diseases in workplace is surveillance or workplace
surveillance. This is a variation in the case series study design where
an epidemiologist:

\begin{itemize}
\tightlist
\item
  Would draw up a precise definition of the disease under study
\item
  Observe every worker periodically and watch for the signs of the
  disease occurring having known the time of exposure.
\item
  All workers in workplaces usually undergo an initial pre-employment
  examination so that a baseline health status record for each worker is
  available for review.
\item
  Any new cases of the disease can be identified through periodic
  examination and recorded for surveillance.
\end{itemize}

The cases are then recorded and reported to the disease surveillance
units or occupational surveillance units for further analysis to
identify causes of the diseases and risk factor. For assessment of
occupational risk factors, epidemiologists rely on cross-sectional
surveys, case control studies, and retrospective or prospective cohort
studies. Cross-sectional surveys are where employees are assessed for a
specific disease condition or health condition. For example, if 100
employees work in a an enterprise and they are surveyed for high blood
pressure, this type of study is a cross-sectional survey. A limitation
of cross-sectional survey in workplaces to identify true rates of
disease is healthy worker effect. If some employees are absent on the
day the survey is conducted due to an illness, say for example for the
blood pressure, then the epidemiologists would not be able to measure
the true prevalence of hypertension in this workforce. Instead, the
epidemiologists would only be able to measure the prevalence of
hypertension among those workers who were healthy to attend work on that
particular day. This phenomenon is referred to as "\textbf{healthy
worker effect}" and therefore a remedy to that would be to repeatedly
survey the workplace for the particular disease or health state that
investigators are interested to study.

Because workplace settings provide opportunities for pre-employment
examination and thereafter periodic examinations, therefore, workplaces
are ideal settings for conducting retrospective cohort studies.
Retrospective cohort studies are those where the investigators would
start with a group of exposed and non-exposed individuals, all of whom
are free of the health outcomes they are interested to study. Some
workers are exposed to specific toxins due to their natural exposure as
a result of their work, others would not be exposed, or exposed to less
extent, again, due to the nature of their work. For example, if you were
to study nurses and orderlies in a hospital where they were required to
lift heavy weights and patients such as operation theatres, and compare
them with nurses and workers in other parts of the hospital such as
chronic disease wards where they were required to tend to only
occcasionally patients who would require heavy lifting of equipments and
then wanted to study the association between certain shifts and the risk
of low back pain, you could use a retrospective cohort study. In a
retrospective cohort study like this, you would start with the health
records of all healthy workers in the hospitals who were free of low
back pain complaints in the beginning of their work and then you would
follow different sets of workers in different work contexts to find out
their relative risks of developing low back pain.

Retrospective cohort studies would also enable the epidemiologist to set
up a nested case control study design within this setting and this too
is used in occupational health setting. Imagine you are interested to
study whether exposure to certain chemical (let's call it ``Ch'') is
associated with increased risk of high blood pressure among a group of
employees. The investigator might take blood samples of all employees
during their pre-employment physical examination to measure the dose of
Ch in blood and then follow up employees over the years. After a few
years, when sufficient numbers of employees have developed high blood
pressure and others have not developed blood pressures, then, within
this cohort that are being followed up over the years, the researchers
would set up a case control study; in this case control study for
instance, where they would test the association between presence of Ch
in the blood sample many years earlier and the risk of blood pressure,
they would be able to use an odds ratio of the the presence or absence
and indeed various levels of Ch in the body.~

So these are the opportunities and costs of conducting epidemiological
studies within the workplace.

\subsection*{Concept 6: history of occupational health, from Hippocrates
to Percival
Pott}

{\label{342415}}

The history of occupational health is as old as that of modern medical
science. Hippocrates in 5th century BC in his work, airs, waters, and
places wrote about the importance of places and occupations in health
states and advices to the doctors.\selectlanguage{english}
\begin{figure}[h!]
\begin{center}
\includegraphics[width=0.70\columnwidth]{figures/Hippocrates-rubens/Hippocrates-rubens}
\caption{{Hippocrates, the father of medicine, wrote Airs, Waters, and Places --
the earliest work on occupational health
{\label{397919}}%
}}
\end{center}
\end{figure}

Georgius Agricola

\par\null\selectlanguage{english}
\begin{figure}[h!]
\begin{center}
\includegraphics[width=0.70\columnwidth]{figures/agricola/agricola}
\caption{{Georgius Agricola is widely considered as the father of mining and he
described the problem of diseases among miners in his text ``De re
metallica''. He described a case where a widow was survived by seven
husbands who were miners in the Erz mountains of Czech border
{\label{612519}}%
}}
\end{center}
\end{figure}

\par\null\par\null

Bernadino Ramazzini

\par\null\par\null\selectlanguage{english}
\begin{figure}[h!]
\begin{center}
\includegraphics[width=0.70\columnwidth]{figures/Screenshot-2018-08-04-21-47-02/Screenshot-2018-08-04-21-47-02}
\caption{{Anthony Stones is a New Zealander who drew this picture of Bernadino
Ramazzini who is considered as the father of occupational health and
medicine.
{\label{305894}}%
}}
\end{center}
\end{figure}

Bernadino Ramazzini was an Italian doctor and he introduced the concept
of asking for what work one does that doctors ask routinely in their
clinical examination. In de Morbius diatriba, he wrote the following
passage.

Bernadino Ramazzini's famous quote,

\par\null

\begin{quote}
" When a doctor visits a working-class home, he should be content to sit
on a three-legged stool if there isn't a gilded chair, and he should
take time for his examination: and to the questions recommended by
Hippocrates, he should add one more - ``What is your occupation?''
\end{quote}

Percival Pott and chimney sweeps cancer: Sir Percival Pott discovered
the first occupational cancer where he identified scrotal cancer among
men who worked as chimney sweeps in London. As chimneys were crusted
with coal combustion byproducts and the chimney sweeps were to climb up
the chimneys to clean them up, this activity exposed them to high
concentration of coal combustion products that led to cancer of scrotum
in these group of workers.

\par\null\selectlanguage{english}
\begin{figure}[h!]
\begin{center}
\includegraphics[width=0.70\columnwidth]{figures/percival-pott/percival-pott}
\caption{{Sir Percival Pott, who is credited to identify the first occupational
cancer - cancer of the scrotum among chimney sweeps in England.
{\label{741135}}%
}}
\end{center}
\end{figure}

\subsection*{}

{\label{541231}}\par\null

\textbf{Concept 7: study and prevent occupational accidents using the
Haddon Matrix}

So far we have seen that occupational health is related to how we can
protect the health of the worker and how we can fit the worker to the
job and the job to the worker; we have also seen that in occupational
health, our role is to identify if an exposure is causing harm to the
worker, and to promote the worker's health, prevent illnesses, and if
the worker falls ill, then arrange for treatment and rehabilitate if
needed. One of the issues with occupational health is not just
identifying and mitigating health hazards or those which can affect
health states after a certain lag period, but also, to mitigate the
effects of physical hazards that impact the lives of workers. Such
physical hazards involve accidents, and impacts with physical, chemical,
biological forces that have health impacts due to transfer of energy
from source to the recipient. Injuries are a special case, where a
systematic approach can minimize the risk of injuries in workplaces.

William Haddon provided a workflow and a framework for injury prevention
with motor vehicle accidents, but this has been used for injury
prevention in a wide range of applications. Instead of focusing only on
human behaviours, Haddon hypothesised that the end result of an injury
could be minimised in three phases: before the event occurred, during
the event occurred, and after the event occurred. For example, in a
motor vehicle crash related injury prevention scenario, one could think
in terms of human factors, agent (vehicle in this case), the physical
environment, and the social environment all could be thought of. The
pre-event (before even the crash were to occur), one could think of the
human factor as wearing a seat belt and educating people to ensure 100\%
seat belt use. The agent or vehicle could be fitted with warning signs
and sounds till the person were to wear seat belts (or technology would
be such that the car would not start if the seat belts were not worn).
The physical environment before the crash could be made safer by
creating speed breakers, and the social environment could include, for
example, by police patroling. During the event, the human factor might
include ejection from the car, the vehicle factor might include design
to resist the impact through design, the physical environment might
include wide medians on the highway so that instead of crashing into a
median divider, the car would find itself on a median grassy land, and
so on. The post event human factors might include prompt action by
rescue trauma team (human factor), deployment of airbags (vehicle/agent
factor), clear visibility (physical environmental factor), and creating
safe passageways for the ambulance to arrive or a rescue helicopter can
take the passengers and the drive away from the scene to a nearby
hospital for treatment.

For a range of occupational injuries, particularly those with physical
hazards, one can think of constructing similar Haddon Matrices.

\par\null

\subsection*{Haddon Matrix:}

{\label{656648}}\par\null\selectlanguage{english}
\begin{figure}[h!]
\begin{center}
\includegraphics[width=0.70\columnwidth]{figures/haddon-matrix/haddon-matrix}
\caption{{Haddon Matrix of workplace injuries
{\label{940657}}%
}}
\end{center}
\end{figure}

Pre-event phase:

Introduce injury education programme

Think about everything that has led to the disease or injury and
everything that happened after the injury

\par\null

Table. Haddon Matrix\selectlanguage{english}
\begin{longtable}[]{@{}lllll@{}}
\toprule
Phase & Human Factor & Agent & Physical & Social\tabularnewline
\midrule
\endhead
Pre-event & x & x & x & x\tabularnewline
Event & y & y & y & y\tabularnewline
Post-event & z & z & z & z\tabularnewline
\bottomrule
\end{longtable}

Epidemiology of accidents

Falls, motor vehicle accidents, and being struck by objects

Epidemiology of violence at workplace

Homicide

Workplaces have instituted anger management programmes and have led to
reduction in workplace homicides.~

suicide

assault

Better developed surveillance systems to avoid assaults or assualt
related injuries.

child abuse

\par\null

\subsection*{Summary}

{\label{572940}}

\subsection*{}

{\label{370213}}

This was a quick tour of seven principles of occupational health.
Occupational health refers to the application of the principles of
public health to prevent illnesses and injuries and promote health in
workplaces for all workers. It is about fitting the work to the worker
and the worker to the job. Occupational health differs from
environmental health in a number of different ways, most importantly,
with occupational health, the intensity and duration of exposure to
agents is higher or greater than what is expected in an environmental
health setting. New Zealand statistics show that some professions are
more susceptible to occupational health related diseases than others,
and occupational epidemiology has some distinct properties such as a
more or less captive population that allows for surveillance and
retrospective cohort studies easier to conduct than in the community.
Finally, while many different ways to control exposures through
legislation, technology modification, and human behavioural
modifications exist, injury prevention through Haddon matrix provides a
useful framework that can be applied widely in the context of
occupational health.

\par\null\par\null\par\null

\subsection*{}

{\label{951835}}\par\null\par\null

\selectlanguage{english}
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