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occupational disease,illness incurred because of the conditions or environment of employment. Unlike with accidents, some time usually elapses between exposure to the cause and development of symptoms. In some instances, symptoms may not become evident for 20 years or more.
Sources of Occupational Disease
Among the environmental causes of occupational disease are subjection to extremes of temperature (leading to heatstroke or frostbite), unusual dampness (causing diseases of the respiratory tract, skin, or muscles and joints) or changes in atmospheric pressure (causing decompression sicknessdecompression sickness,
physiological disorder caused by a rapid decrease in atmospheric pressure, resulting in the release of nitrogen bubbles into the body tissues. It is also known as caisson disease, altitude sickness, and the bends.
..... Click the link for more information. , or the bends), excessive noise (see noise pollutionnoise pollution,
human-created noise harmful to health or welfare. Transportation vehicles are the worst offenders, with aircraft, railroad stock, trucks, buses, automobiles, and motorcycles all producing excessive noise. Construction equipment, e.g.
..... Click the link for more information. ), and exposure to infrared or ultraviolet radiation or to radioactive substances. The widespread use of X rays, radium, and materials essential to the production of nuclear power has led to an especial awareness of the dangers of radiation sicknessradiation sickness,
harmful effect produced on body tissues by exposure to radioactive substances. The biological action of radiation is not fully understood, but it is believed that a disturbance in cellular activity results from the chemical changes caused by ionization (see
..... Click the link for more information. ; careful checking of equipment and the proper protection of all personnel are now mandatory.
In addition there are hundreds of industries in which metal dusts, chemical substances, and unusual exposure to infective substances constitute occupational hazards. The most common of the dust- and fiber-inspired disorders are the lung diseases caused by silica, beryllium, bauxite, and iron ore to which miners, granite workers, and many others are exposed (see pneumoconiosispneumoconiosis
, chronic disease of the lungs. Primarily an occupational disease of miners, sandblasters, and metal grinders, it is a result of repeated inhalation of dusts, including iron oxides (e.g., rust and filings), silicates (e.g.
..... Click the link for more information. ) and those caused by asbestosasbestos,
common name for any of a variety of silicate minerals within the amphibole and serpentine groups that are fibrous in structure and more or less resistant to acid and fire.
..... Click the link for more information. .
Fumes, smoke, and toxic liquids from a great number of chemicals are other occupational dangers. Carbon monoxide, carbon tetrachloride, chlorine, creosote, cyanides, dinitrobenzene, mercury, lead, phosphorus, and nitrous chloride are but a few of the substances that on entering through the skin, respiratory tract, or digestive tract cause serious and often fatal illness.
Occupational hazards also are presented by infective sources. Persons who come into contact with infected animals in a living or deceased state are in danger of acquiring such diseases as anthraxanthrax
, acute infectious disease of animals that can be secondarily transmitted to humans. It is caused by a bacterium (Bacillus anthracis) that primarily affects sheep, horses, hogs, cattle, and goats and is almost always fatal in animals.
..... Click the link for more information. and tularemiatularemia
or rabbit fever,
acute, infectious disease caused by Francisella tularensis (Pasteurella tularensis). The greatest incidence is among people who handle infected wild rabbits.
..... Click the link for more information. . Doctors, nurses, and other hospital personnel are prime targets for the tuberculosis bacillus and for many other infectious organisms.
Recognition of the effects of working under deleterious conditions and with harmful substances has resulted in efforts to protect workers from exposure to them. Legislation to prevent or limit the occurrence of occupational disease dates from the Factory Act in England in 1802. Prevention of unhealthy or unsafe working conditions and oversight of healthy and safe workplaces are the responsibility in the United States of the federal Occupational Safety and Health AdministrationOccupational Safety and Health Administration
(OSHA), U.S. agency established (1970) in the Dept. of Labor (see Labor, United States Department of) to develop and enforce regulations for the safety and health of workers in businesses that are engaged in interstate commerce.
..... Click the link for more information. (OSHA) and Environmental Protection AgencyEnvironmental Protection Agency
(EPA), independent agency of the U.S. government, with headquarters in Washington, D.C. It was established in 1970 to reduce and control air and water pollution, noise pollution, and radiation and to ensure the safe handling and disposal of toxic
..... Click the link for more information. , as well as many state agencies. Many occupational abuses have been redressed by litigation and legislation in the United States, and workers' compensationworkers' compensation,
payment by employers for some part of the cost of injuries, or in some cases of occupational diseases, received by employees in the course of their work.
..... Click the link for more information. takes care, by a system of insurance, of those who suffer from occupational diseases.
a disease caused by occupational hazards.
Occupational diseases are brought on by dust and certain kinds of toxic substances, such as benzene, lead, and mercury, or by physical factors in the place of employment, for example, vibration, loud noise, high or low air temperatures, high or low atmospheric pressure (decompression sickness, altitude sickness), and various types of ionizing radiation (radiation sickness). Persons whose work involves contact with infectious patients or infected animals, materials, or products may contract a contagious or parasitic disease, for example, brucellosis, anthrax, and tularemia. The clinical forms of occupational diseases vary; the factor responsible for the disease largely determines the organs and systems affected, which may include the respiratory, nervous, cardiovascular, or hematopoietic systems or the bones, joints, liver, eyes, ears, or skin.
In the USSR, workers and employees who suffer from occupational diseases are eligible for such benefits as social security and insurance. Temporary disability payments are always paid at the rate of 100 percent of the wages previously earned. Pensions for invalidism or the loss of a breadwinner are granted without requiring a minimum length of time on the job or a minimum age and are paid at the rate of more than 100 percent of the wages previously earned. Workers or employees disabled by a form of pneumoconiosis (silicosis, anthracosis, silicosiderosis) receive especially large disability pensions. Victims of occupational disorders, except pneumoconioses, may present their claims to the enterprise and receive compensation for damages.
Occupational therapy is concerned with the causes, mechanism of development, symptoms, and treatment of occupational diseases. Occupational hygiene is the study of the prophylaxis of these diseases.
References to the effects that poor working conditions have on the body can be found in the writings of ancient Greek and Roman authors, such as Aristotle, Hippocrates, Pliny the Elder, and Galen. The first studies specifically on occupational diseases appeared in the 16th century; the occupational diseases of miners were discussed in Agricola’s De re metallica (1556) and in Paracelsus’ On Miner’s Phthisis and Other Mining Diseases (1567). B. Ramazzini was the founder of occupational therapy and hygiene as an independent branch of medicine. The Russian physician A. N. Nikitin published Workers’ Diseases and Means of Prevention (1847), the first original Russian textbook on the subject. F. F. Erisman’s Occupational Hygiene, or Hygiene of Mental and Physical Work (1877) dealt with the effects of working conditions on the physical development of workers.
In the USSR, the incidence rate of many occupational diseases and poisonings has declined sharply. A network of research institutes specializing in occupational hygiene and disorders has been established; the first such institute was founded in Moscow in 1923. In 1974 there were 15 functioning research institutes in the USSR, in such cities as Moscow, Leningrad, Gorky, Sverdlovsk, Angarsk, Kiev, Kharkov, and Karaganda. Research in occupational therapy is carried on in many clinical and hygiene subdepartments of medical institutes and in institutes for the advanced training of physicians.
Important contributions to the study of occupational diseases have been made by I. G. Gel’man, V. A. Levitskii, N. A. Vigdorchik, E. M. Tareev, A. A. Letavet, E. Ts. Andreeva-Galanina, K. P. Molokanov, and E. A. Drogichina. Discussions on the subject are held at meetings of the Problem Commission of the Academy of Medical Sciences of the USSR on the Scientific Bases of Occupational Hygiene and Therapy. Medical societies, whose membership includes internists, hygienists, and health officials, have meetings on preventive medicine, where occupational diseases are also discussed. The journal Gigiena truda i professional’nye zabolevaniia (Occupational Hygiene and Occupational Diseases) has been published since 1957.
In 1910, Europe’s first specialized clinic for occupational diseases was founded in Milan. By 1974 there were institutes of industrial medicine with occupational disease clinics in such countries as France, Great Britain, the USA, Finland, Spain, and the Federal Republic of Germany. Research is also conducted in university departments, clinics, and special centers subsidized by private companies. Specialized scientific clinical institutes, modeled after those in the USSR, have been established in other socialist countries.
Among those whose research in occupational diseases is well known are L. Teleky, A. Lehman, and F. Koelsch (Germany), T. Oliver and A. Hill (Great Britain), E. Vigliani (Italy), A. Hamilton and C. Drinker (USA), H. Schlipköter and J. Hagen (Federal Republic of Germany), E. Holstein (German Democratic Republic), and W. Zakorsky (Polish People’s Republic). More than 30 specialized journals on occupational diseases are published abroad.
REFERENCEProfessional’nye bolezni, 3rd ed. Moscow, 1973. (Bibliography.)
N. N. SHATALOV