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JOB STRESS

Job stress and associated conditions

Job stress is the harmful physical and emotional responses that occur when the requirements of the job do not match the capabilities, resources, or needs of the worker.

Job stress matters to our health and our work.

When we feel stressed, our bodies respond by raising the concentration of stress hormones in our blood. When our bodies continually respond to constant demands or threats, coping mechanisms stay in overdrive, which can be damaging to health over time

Stressful working conditions can also impact health indirectly by limiting our ability or motivation to participate in other health promoting behaviors such as eating well and exercising.

Definitions

Stress: a (perceived) substantial imbalance between demand and response capability under conditions where failure to meet demand has important (perceived) consequences.
Stressor: environmental event or condition that results in stress.
Stressful: pertaining to an environment that has many stressors.
Strain (or stress reaction): short-term physiological, psychological or behavioral manifestations of stress.

Types of stress

Stress is not always bad.

Stress in the form of a challenge energizes us psychologically and physically, and it motivates us to learn new skills and master our work.

When a challenge is met, we feel relaxed and satisfied. This is good stress or eustress. However, sometimes a challenge is turned into job demands that cannot be met. This is negative stress, or distress, which sets the stage for illness, injury, and job failure.

There are several types of stress, including:

Acute stress
Episodic acute stress
Chronic stress

Acute stress

An acute stress reaction occurs when symptoms develop due to a particularly stressful event. The word ‘acute’ means the symptoms develop quickly but do not usually last long.

The events are usually very severe and an acute stress reaction typically occurs after an unexpected life crisis. This might be, for example, a serious accident, sudden bereavement, or other traumatic events. Acute stress reactions may also occur as a consequence of sexual assaults or domestic violence. Acute stress can also come out of something that you actually enjoy. It’s the somewhat-frightening, yet thrilling feeling you get on a roller coaster or when skiing down a steep mountain slope. These incidents of acute stress don’t normally do you any harm. They might even be good for you. Stressful situations give your body and brain practice in developing the best response to future stressful situations.

Once the danger passes, your body systems should return to normal.

Episodic acute stress

Episodic Stress occurs when we experience acute stress too frequently.

It often hits those who take on too much―those who feel they have both self-imposed pressure and external demands vying for their attention.

In such cases, hostility and anger frequently result. Episodic stress also commonly afflicts those who worry a lot of the time, in turn resulting in anxiety and depression.

This might also happen if you’re often anxious and worried about things you suspect may happen e.g. certain professions, such as law enforcement or firefighters, might also lead to frequent high-stress situations.

Chronic stress

Chronic Stress leads to serious health problems, because it disrupts nearly every system in your body. Part of what makes chronic stress so insidious is its ability to become a “normal” feeling. This pattern of enduring is what makes chronic stress such a serious health issue.

Poverty, trauma, general pressure from the demands of life, and more can all cause chronic stress. When you have high-stress levels for an extended period of time, you have chronic stress. Long-term stress like this can have a negative impact on your health. It may contribute to:

Anxiety
Cardiovascular disease
Depression
High blood pressure
A weakened immune system

Common Stressors at the Workplace

I. Job-related Stressors

A. Job Structure

Overtime: Excessive work hours beyond regular working hours can lead to fatigue, reduced work-life balance, and increased pressure.
Shift work: Irregular work schedules, such as rotating shifts or night shifts, can disrupt sleep patterns and negatively impact physical and mental well-being.
Machine pacing: When the speed of machines or equipment sets the pace of work, employees may feel pressured to keep up, leading to stress and potential health issues.
Piecework: Being paid based on the number of tasks completed can create pressure to work quickly, potentially compromising quality and increasing stress levels.

B. Job Content

Quantitative overload: Having excessive work demands, such as high workloads or tight deadlines, can result in stress, time pressure, and difficulty maintaining quality work.
Qualitative underload: Experiencing tasks that lack challenge or do not fully utilize one’s skills and abilities can lead to boredom, dissatisfaction, and reduced motivation.

II. Physical Conditions

Unpleasant Odor: Working in an environment with unpleasant smells can be distracting, uncomfortable, and contribute to overall dissatisfaction.
Threat of physical or toxic hazards: Fear of potential accidents, injuries, or exposure to toxic substances can create anxiety and stress among employees.

III. Organizational Factors

Role Conflict: Conflicting expectations or demands from different roles or job responsibilities can create stress and uncertainty.
Competition: An environment that fosters excessive competition among employees may lead to heightened stress levels and strained relationships.
Rivalry: Unhealthy competition or rivalries between individuals or teams within the organization can create tension and stress.

IV. Extra-organizational Stressors

Job Insecurity: Uncertainty about job stability or fear of losing employment can significantly impact an individual’s well-being and increase stress levels.
Career Development: Lack of opportunities for growth, advancement, or training can lead to frustration and a sense of stagnation.
Commuting: Long and stressful commutes can contribute to fatigue, reduced work-life balance, and overall stress levels.

V. Other Sources of Stress

Personal: Personal issues, such as financial problems, health concerns, or relationship difficulties, can affect an individual’s ability to cope with workplace stressors.
Family: Family-related challenges, including conflicts, caregiving responsibilities, or major life events, can add to overall stress levels.
Community: Factors outside of work, such as social or environmental issues within the community, can impact an individual’s well-being and contribute to stress.

VI. Organizational Stressors

Change: Periods of organizational change, such as restructuring or mergers, can create uncertainty, resistance, and stress among employees.
Inadequate Communication: Poor communication channels or lack of information flow within the organization can lead to misunderstandings, conflict, and increased stress levels.
Interpersonal Conflict: Disagreements, tensions, or hostile relationships among colleagues can create a stressful work environment.
Conflict with Organizational Goals: Misalignment between personal values and organizational objectives can result in job dissatisfaction and increased stress.

VII. Role-related Stressors

Role Conflict: Conflicting expectations or demands within a specific job role can lead to stress, confusion, and difficulty prioritizing tasks.
Role Ambiguity: Unclear or undefined job responsibilities and expectations can cause anxiety, frustration, and reduced job satisfaction.
Inadequate Resources to Accomplish Job: Insufficient tools, equipment, or support to perform job tasks effectively can lead to stress and hinder job performance.
Inadequate Authority to Accomplish Job: Having limited decision-making power or authority to address work-related issues can create frustration and hinder productivity.

VIII. Task-related Stressors

Quantitative and Qualitative Overload: Having excessive quantitative (amount) or qualitative (complexity) demands within job tasks can lead to stress, reduced performance, and potential burnout.
Quantitative and Qualitative Underload: Insufficient task demands or lack of challenging work can result in boredom, disengagement, and reduced motivation.
Responsibility for the Lives and Well-being of Others: Jobs that involve the safety and well-being of others, such as healthcare or emergency services, can create significant stress due to the high level of responsibility.
Low Decision-making Latitude: Limited autonomy or control over decision-making processes can lead to feelings of disempowerment, frustration, and increased stress.

IX. Work Environment Stressors

Poor Aesthetics: Unpleasant or uncomfortable workspaces lacking visual appeal or ergonomic design can contribute to stress and reduced well-being.
Physical Exposures: Exposure to physical factors like extreme temperatures, inadequate lighting, or poor air quality can impact health and increase stress levels.
Ergonomic Problems: Poor ergonomics, such as uncomfortable workstations or repetitive strain injuries, can cause physical discomfort and contribute to stress.
Noise: Excessive noise levels in the workplace can disrupt concentration, impair communication, and lead to irritation and stress.
Odors: Strong or unpleasant odors in the work environment can create discomfort, distraction, and negatively affect overall well-being.
Safety Hazards: Presence of potential workplace hazards or lack of safety measures can generate anxiety, fear, and stress among employees.
Shift Work: Irregular work schedules, especially night shifts, can disrupt sleep patterns, affect circadian rhythms, and increase stress levels.

X. Outcomes of Workplace Stress

A. Physiological

Short-term:

Catecholamines: Stress hormones released in response to acute stress situations.
Cortisol: Stress hormone involved in regulating various physiological processes.
Increased Blood Pressure: Elevated blood pressure as a physiological response to stress.

Long-term:

Hypertension: Prolonged high blood pressure resulting from chronic stress can lead to cardiovascular problems.
Heart Disease: Chronic stress can contribute to the development of heart-related conditions.
Ulcers: Chronic stress may increase the risk of developing ulcers or worsening existing ones.
Asthma: Stress can exacerbate symptoms and trigger asthma attacks.

B. Psychological (Cognitive and Affective)

Short-term:

Anxiety: Feeling of unease, worry, or fear associated with stressors.
Dissatisfaction: Feeling unsatisfied or discontented with one’s job or work environment.
Mass Psychogenic Illness: A phenomenon where stress or anxiety spreads among a group, resulting in physical symptoms.

Long-term:

Depression: Prolonged exposure to chronic stress can increase the risk of developing depression.
Burnout: Extreme exhaustion, cynicism, and reduced efficacy resulting from chronic workplace stress.
Mental Disorders: Chronic stress can contribute to the development or exacerbation of various mental health conditions.

C. Behavioral

Short-term:

Job: Absenteeism, Reduced Productivity, and Participation: High levels of stress can lead to increased absenteeism, decreased productivity, and reduced engagement in work-related activities.
Community: Decreased Friendships and Participation: Stress can negatively impact social relationships and reduce engagement in community activities.
Personal: Excessive Use of Alcohol and Drugs, Smoking: Individuals may engage in unhealthy coping mechanisms, such as substance abuse or excessive smoking, to manage stress temporarily.

Signs and Symptoms of Job Stress

Headache: Persistent or recurrent headaches can be a physical manifestation of stress and tension.
Sleep disturbances: Difficulty falling asleep, staying asleep, or experiencing restless sleep patterns can be indicators of job-related stress.
Stomach Upset: Stress can contribute to digestive issues such as stomachaches, indigestion, or gastrointestinal discomfort.
Difficulty concentrating: High levels of stress can make it challenging to concentrate and focus on tasks.
Short temper: Increased irritability and a short temper may arise due to the cumulative effects of job stress, leading to strained relationships with colleagues and patients.
Fatigue: Chronic fatigue and low energy levels can result from prolonged exposure to job stress.
Muscle aches and pains: Stress-induced muscle tension and strain can cause body aches, particularly in the neck, shoulders, and back.
Over- and under-eating: Job stress can disrupt normal eating patterns, leading to changes in appetite and potentially resulting in unhealthy eating habits.
Chronic mild illness: Long-term job stress may weaken the immune system, making workers more susceptible to frequent minor illnesses such as colds or infections.
Anxiety: Feelings of worry, apprehension, or unease are common symptoms of job-related stress and can significantly impact any workers emotional well-being.
Irritability: Nurses experiencing job stress may become easily annoyed or frustrated, leading to increased interpersonal conflicts.
Depression: Prolonged exposure to high levels of stress can contribute to feelings of sadness, hopelessness, and a loss of interest or pleasure in activities.
Gastrointestinal problems: Stress can manifest as gastrointestinal symptoms, such as stomach cramps, diarrhea, or constipation.
Angry outbursts: Intense emotions resulting from job stress can lead to episodes of anger or emotional outbursts.
Accidents: Reduced concentration and impaired cognitive function due to job stress can increase the risk of accidents or errors at work.
Substance use and abuse: Some nurses may turn to substances like alcohol or drugs as unhealthy coping mechanisms in response to job stress.
Isolation from co-workers: Excessive stress may cause employees to withdraw from social interactions with colleagues, leading to feelings of isolation or disengagement.
Job dissatisfaction: Job stress can contribute to feelings of dissatisfaction or disillusionment with the nursing profession, potentially impacting overall job satisfaction.
Low morale: Prolonged exposure to job stress can erode morale, affecting their motivation and commitment to work.
Marital and family problems: Job stress can spill over into personal relationships, leading to conflicts, strained family dynamics, or difficulty maintaining work-life balance.

Prevention and Control of Stress

To effectively prevent and control stress in the workplace, a comprehensive approach that addresses both the individual and organizational factors is necessary. The following strategies can be implemented:

I. Treat the Individual

A. Medical Treatment

Hypertension: Providing medical treatment and management for employees with hypertension to reduce the physiological effects of stress.
Backache: Offering appropriate medical interventions, such as physical therapy or pain management, for employees experiencing backaches caused by stress-related factors.
Depression: Identifying and treating individuals with depression through therapy, counseling, or medication.

B. Counseling Services and Employee Assistance Programs

Providing access to counseling services and employee assistance programs to help individuals cope with stressors and develop effective coping mechanisms.
Addressing addictive behaviors such as smoking, alcohol consumption, and drug abuse through counseling and support programs.

C. Reduce Individual Vulnerability

Conducting counseling sessions or offering individual and group programs to help individuals build resilience, develop coping skills, and enhance their ability to manage stress effectively.
Providing training programs that focus on relaxation techniques, medication management, and biofeedback to equip individuals with stress management tools.

D. General Support

Implementing exercise programs and recreational activities to promote physical and mental well-being, as regular exercise has been shown to reduce stress levels.

II. Treat the Organization

A. Diagnosis

Conducting attitude surveys and rap sessions to gather feedback and identify sources of stress within the organization.
Creating opportunities for open and honest communication to address concerns and challenges that contribute to workplace stress.

B. Develop Flexible and Responsive Management Style

Improving internal communications to ensure clear and effective information flow, promoting transparency and reducing uncertainty.
Implementing measures to reduce organizational stress, such as fostering a supportive work culture, providing recognition and rewards, and promoting work-life balance.
Offering variable work schedules that allow employees flexibility in managing their workload and personal commitments.

C. Job Restructuring

Job Enlargement: Redesigning job roles to provide employees with a broader range of tasks and responsibilities, reducing monotony and increasing job satisfaction.
Job Enrichment: Enhancing job content by incorporating meaningful and challenging tasks, granting employees a sense of accomplishment and autonomy.
Increased Control: Allowing employees to have more control and decision-making authority over their work, reducing feelings of powerlessness and stress.

Principles of a good job design

Work schedule: A work schedule should be designed to avoid conflicts with demands and responsibilities outside the job. When rotating shift schedules are used, the rate of rotation should be stable and predictable.
Participation/control: Workers should be able to provide input into decisions or actions affecting their jobs and the performance of their tasks.
Workload: Demands should not exceed the capabilities of individuals. Work should be designed to allow recovery from demanding physical or mental tasks.
Content: Work tasks should be designed to provide meaning, stimulation, a sense of completeness and an opportunity for the use of skills.
Work roles: Roles and responsibilities at work should be well defined.
Social environment: Opportunities should be available for social interaction, including emotional support and actual help as needed in accomplishing tasks.
Job future: Ambiguity should be avoided in matters of job security and career development opportunities.

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WASTE MANAGEMENT

Waste is any material – solid, liquid, or gas – that is unwanted and/or unvalued, and has been discarded or discharged by its owner.

Healthcare Waste refers to all types of waste from all health care activities; waste generated by the health care facilities, research facilities and laboratories.

Healthcare waste is also known as biomedical waste, infectious waste or medical waste. Healthcare waste is also known as biomedical waste, infectious waste or medical waste.

The large volumes of health care waste if not managed properly can lead to a global hazard. This could not only lead to the spread of highly contagious diseases but the hazardous chemical waste produced by the use of items can cause considerable damage to the ecosystem and the environment.

Classification of wastes

Classification according to matter state (properties)

Solid waste includes common household waste (including kitchen and garden waste), commercial and industrial waste, sewage sludge, construction and demolition waste, waste from agriculture and food processing, and mine and quarry tailings.
Liquid waste includes domestic waste water (liquid kitchen, laundry, and bathroom waste), storm water, used oil, and waste from industrial processes.
Gaseous waste comprises gasses and small particles emitted from open fires, incinerators, and vehicles, or produced by agricultural and industrial processes.

Classification of wastes- general according to their degradability

Bio-degradable : Whether they can be degraded by physical or biological means (paper, wood, fruits and others)
Non-biodegradable; These cannot be degraded easily by physical or biological means (plastics, bottles, old machines, cans, Styrofoam containers and others)

Classification according to their Effects on Human Health and the Environment

Hazardous wastes: Substances unsafe to use commercially, industrially, agriculturally, or economically that are shipped, transported to or brought from the country of origin for dumping or disposal in, or in transit through, any part of the world.
Non-hazardous: Substances safe to use commercially, industrially, agriculturally, or economically that are shipped, transported to or brought from the country of origin for dumping or disposal in, or in transit through, any part of the world.

Type of Waste	Percentage
Non-infectious Waste	80%
Pathological and Infectious Waste	15%
Sharps Waste	1%
Chemical or Pharmaceutical Waste	3%
Pressurized Cylinders, Broken Thermometers	Less than 1%

SOURCES OF HEALTHCARE WASTE

Major Sources		Minor Sources
Hospitals	Clinics	Dental Clinics	Physician’s Office
Laboratories	Research Centers	Home Health-care	Nursing Homes
Animal Research	Blood Banks	Acupuncturists	Psychiatric Clinics
Nursing Homes	Mortuaries	Cosmetic Piercing and Tattooing	Funeral Services
Autopsy Centers		Paramedic Services	Institutions for Disabled Persons

Sources of health care waste

Major sources

Hospitals
Clinics
Laboratories
Research centers
Animal Research
Blood banks
Nursing Homes
Mortuaries
Autopsy centers

Minor sources

Dental clinics
Physician’s office
Home health-care
Nursing homes
Acupuncturists
Psychiatric clinics
Cosmetic piercing and tattooing
Funeral services
Paramedic services
Institutions for disabled persons

WASTE MANAGEMENT HIERARCHY

Waste management hierarchy is a structured approach to prioritize and manage waste by minimizing its environmental impact.

It consists of several key steps, listed in descending order of priority

Waste management hierarchy is defined as the order of preference for action to reduce and manage waste and is usually presented diagrammatically in the form of a pyramid.

The aim of waste hierarchy is to extract the maximum practical benefits from products and to generate a minimum amount of waste.

Prevention/avoidance: This concept focuses on the measures to be taken so as not to create any type of wastes in the first place e.g. avoiding to eat from the ward. This is given the top priority in the waste management program.
Reduction of Wastes/minimization: According to this concept, the health care setting should reduce or minimize the amount of waste or the toxicity of wastes e.g. avoiding to use gloves in procedures that don’t necessary need one to use gloves and companies should take action to make changes in the type of materials that are being used for the production of the specific products, so as to ensure that the by-products are of the least toxicity.
Reuse: Reuse is another effective Solid waste management strategy, in which the waste is not allowed to enter into the disposal system. The wastes are collected in the middle of the production phase and are again fed along with the source to aid in the production process e.g. Autoclaving metal instruments or sterilization of medical equipment.
Recycle: In the recycling strategy, the waste materials are implemented in the production of a new product. In this process, the waste materials of various forms are collected and then processed. Post processing, they enter into the production lines to give rise to new products. This process prevents pollution and saves energy.
Energy Recovery: The energy recovery process is also called waste to energy conversion. In this process; the wastes that cannot be recycled are being converted into usable forms of energy such as heat, light and electricity etc. This helps in the saving of various natural resources. Various processes such as combustion, anaerobic digestion, landfill gas recovery, pyrolization and gasification are being implemented to carry out the conversion process.
Treatment and Disposal: The disposal process holds the last position in the waste management hierarchy. Landfills are the common form of waste disposal.

Waste Management Steps/Waste Stream

Waste stream refers to the systemic steps followed in health care solid waste management from its generation to its final disposal.

1. Generation:

Non-Hazardous waste/General waste: Office, Kitchen, Administrative, Municipal/Public Areas, Hostels, Store Authorities, Restrooms, etc.

Hazardous (Infectious & toxic waste): Wards, Treatment Rooms, Dressing Rooms, OT ICU, Labour Room, Laboratory, Dialysis Room, CT Scan, Radio-imaging, etc.

WHO Classification	Description of Waste	Examples
1. General Waste	No risk to human health	Office paper, wrappers, kitchen waste, general sweeping, etc.
2. Pathological Waste	Human tissue or fluid	Body parts, blood, body fluids, etc.
3. Sharps	Sharp waste	Needles, scalpels, knives, blades, etc.
4. Infectious Waste	May transmit bacterial, viral, or parasitic diseases	Laboratory culture, tissues (swabs), bandages, etc.
5. Chemical Waste	Chemical waste	Laboratory reagents, disinfectants, film developer, etc.
6. Radioactive Waste	Radioactive waste	Unused liquid from radiotherapy or lab research, contaminated glassware, etc.
7. Pharmaceutical Waste	Expired or outdated drugs/chemicals	Expired medications and chemicals
8. Pressurized Container	Waste from pressurized containers	Gas cylinders, aerosol cans, etc.

2. Segregation:

Waste segregation is the practice of separating different types of waste at the source to ensure proper handling and disposal.

Done at the point of waste generation and placed in separate colored bags. Color coding may vary by nation or hospital.

Type of Waste Category	Examples	Type of Bin
Non-Infectious Waste	Discarded paper, packing material, empty bottles or cans, food peelings, paper boxes, plastic bags, used tissues, food scraps	Two Black Bins Wet Waste Dry Waste
Infectious Waste	Used gauze or dressing, used IV fluid lines, used giving sets	Yellow Bin
Highly Infectious	Sputum containers, used test tubes, extracted teeth, all anatomical waste (e.g., placenta) Pathological Waste; Anatomical parts	Red bin
Toxic Waste	Pharmaceutical waste like expired drugs., Laboratory wastes like expired laboratory reagents	Brown Bin
Sharp Waste	Used syringe needles, needle cuts, cut from used infusion sets, used scalpels, blades, and broken glass	Safety Box

3. Collection or Handling of Waste:

Waste collection is the systematic gathering of various types of medical waste.

Handling concerns the collection, weighing and storing conditions.

Trained sanitation personnel, often supervised by nursing staff and sanitation supervisors, manage this process. They ensure waste is correctly segregated at the point of generation into appropriate color-coded bins.

Proper documentation is maintained in a register to track waste quantity and type. Regular cleaning and disinfection of garbage bins are essential for maintaining hygiene.

The waste collection process is conducted in compliance with safety regulations and guidelines, ensuring the protection of personnel and the environment. This systematic collection is a crucial step in the safe and efficient management of medical waste.

Waste should not be stored in the generation area for more than 4-6 hours. Waste collected in various areas is prepared for transport or disposal/treatment.

4. Transportation:

Hospitals should have a separate corridor and lift dedicated to carrying and transporting waste.

General waste is deposited at municipal dumps.

Waste designated for autoclaving and incineration is disposed of at a separate site for external transport (using distinct colored plastic bags).
Transportation is carried out in sealed containers to prevent leakage.

5. Treatment & Disposal:

Waste disposal in hospitals is the final phase in the systematic management of medical waste.

It involves the safe and environmentally responsible removal or destruction of waste, ensuring it no longer poses health risks to patients, staff, and the community.

General waste is dumped at municipal dumping sites.
The sanitation officer is responsible for coordinating with municipal authorities for proper disposal.
Use of labels/symbols helps in identifying waste for treatment (e.g., Risk of Corrosion, Danger of Infection, Toxic Hazards, Glass Hazards, Radioactive Materials, etc.).

TREATMENT AND DISPOSAL TECHNIQUE FOR HEALTH CARE WASTE

Incineration
Chemical disinfection
Wet & dry thermal treatment (Autoclave)
Microwave irradiation
Land disposal
Inertization

Technique

Description

Incineration

– High temperature dry oxidation process of over 800 °C.

– Reduces organic and combustible waste to inorganic and incombustible waste

– Used for most hazardous waste and waste that can’t be recycled

– Results in significant reduction of waste volume and weight

Disinfection

Chemical

– Kills or inactivates pathogens contained in waste

– Suitable for liquid waste like urine, blood, stool, and hospital sewage

Wet and Dry Thermal Treatment

– Wet Thermal Treatment: Steam autoclave sterilization process, and any waste contaminated with microorganisms.

– Dry Thermal Treatment: Non-burn, dry thermal disinfection process suitable for infectious waste and sharps, not to be used for pathological, cytotoxic, or radioactive waste

Microwave Irradiation

– Most organisms destroyed by microwaves of specific frequency and wavelength

– Efficiency checked through bacteriological and virological tests

Land Disposal

Burial

– Used when hazardous healthcare waste cannot be treated or disposed elsewhere

– Investigate more suitable treatment methods

– May include land open dumps and sanitary landfills

Inertization OR

Encapsulation

– Mixing waste with cement and other substances before disposal

– Inhibits waste from migrating into surface and groundwater

– Mixture proportions: 65% pharmaceutical waste, 15% lime, 15% cement, 5% water

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PERSONAL PROTECTIVE EQUIPMENT (PPE)

Personal protective equipment – known as ‘PPE’ – is used to protect health care workers while performing specific tasks that might involve them coming into contact with blood or body fluids that may contain some infectious agents (germs).

Personal protective equipment is special equipment you wear to create a barrier between you and germs. This barrier reduces the chance of touching, being exposed to, and spreading germs. Personal protective equipment (PPE) helps prevent the spread of germs in the hospital. This can protect people and health care workers from infections.

It includes many of the items often associated with health care by the public – gowns, gloves and masks. These items will be for single use only – that is, you MUST use them once and then discard them – while others are retained, cleaned and reused.

All hospital staff, patients, and visitors should use PPE when there will be contact with blood or other bodily fluids.

Types of PPE

These are mainly categorized under the following classes;

Masks
Eye Protection PPE
Clothing PPE

Masks

It is defined as the protective covering for the face or part of the face. i.e. they cover your mouth and nose.

Types of masks

There are two types of masks on the Ugandan market namely:

Medical masks
Non- Medical masks

Medical masks

Medical masks should be preserved for health workers in health facilities and are not reusable There are 2 main types of masks used to prevent respiratory infection namely

Surgical masks also called the face masks
Respirators e.g. N95 and KN95

Surgical masks

Definition: A surgical mask is a loose-fitting, disposable device that creates a physical barrier between the mouth and nose of the wearer and potential contaminants in the immediate environment. These are sometimes referred to as face masks, as described above, although not all face masks are regulated as surgical masks.

Note:

Surgical masks are made in different thicknesses and with different ability to protect you from contact with liquids.
These properties may also affect how easily you can breathe through the face mask and how well the surgical mask protects you.
Surgical masks are not intended to be used more than once.
Surgical masks are not to be shared and may be labeled as surgical, isolation, dental, or medical procedure masks.

While a surgical mask may be effective in blocking splashes and large-particle droplets, a face mask, by design, does not filter or block very small particles in the air that may be transmitted by coughs, sneezes, or certain medical procedures.

Respirators

A respirator is a respiratory protective device designed to achieve a very close facial fit and very efficient filtration of airborne particles.

Note that the edges of the respirator are designed to form a seal around the nose and mouth. Types of respirators

N95 (commonly used in Uganda)
KN95

General Respirator Precautions

People with chronic respiratory, cardiac, or other medical conditions that make breathing difficult should check with their health care provider before using an N95 respirator because the N95 respirator can make it more difficult for the wearer to breathe.
Some models have exhalation valves that can make breathing out easier and help reduce heat build up. Note that N95 respirators with exhalation valves should not be used when sterile conditions are needed.
All respirators are labeled as “single-use,” disposable devices. If your respirator is damaged or soiled, or if breathing becomes difficult, you should remove the respirator, discard it properly, and replace it with a new one. To safely discard your N95 respirator, place it in a plastic bag and put it in the trash. Wash your hands after handling the used respirator.
N95 respirators are not designed for children or people with facial hair. Because a proper fit cannot be achieved on children and people with facial hair, the N95 respirator may not provide full protection.

Comparison between a surgical mask and a respirator

A surgical mask is a loose-fitting, disposable device that creates a physical barrier between the mouth and nose of the wearer and potential contaminants in the immediate environment whereas a respirator is a respiratory protective device designed to achieve a very close facial fit and very efficient filtration of airborne particles.

Wear medical masks with

A proper fit over your nose and mouth to prevent leaks
Multiple layers of non-woven material
Disposable masks are widely available.

Do NOT wear medical masks with

Wet or dirty material

Ways to have better fit and extra protection with medical masks

Wear two masks (disposable mask underneath AND cloth mask on top)
Combine either a cloth mask or disposable mask with a fitter or brace
Knot and tuck ear loops of a 3-ply mask where they join the edge of the mask
Use masks that attach behind the neck and head with either elastic bands or ties (instead of ear loops)

Non-medical masks

The non-medical masks are made out of fabric (cloth)

They are sometimes called reusable masks because one can wash and iron then wear them again The community in Uganda is encouraged to use non-medical masks (masks made out of fabrics e.g. cotton masks

A 2 layered cotton mask with a filter material e.g. paper towel or coffee filter or polypropylene (the material often used for non-plastic shopping bags placed between the 2 layers may improve the mask . This material acts as a filter and can be removed before washing. Polypropylene is washable and reusable Cloth Masks can be made from a variety of fabrics and many types of cloth masks are available.

Wear cloth masks with

A proper fit over your nose and mouth to prevent leaks
Multiple layers of tightly woven, breathable fabric
Fabric that blocks light when held up to bright light source mask considerations tightly woven Do NOT wear cloth masks with
Gaps around the sides of the face or nose
Exhalation valves, vents, or other openings (see example)
Single-layer fabric or those made of thin fabric that don’t block light

Who should wear masks

All adults
Children aged 6 years and above
Children aged 2- 6 years are very active and cannot take care of their masks and observe hygiene. They should only put on masks under close supervision

NB: Children below 2 years should not wear a mask as they have a small lung capacity Places to where masks in this COVID 19 pandemic

When going to public places – e.g. work, public transport, markets, supermarkets, shops, classrooms, places of worship, healthcare facilities etc
When acceptable social distancing is not possible
When one has a cough, cold or sore throat even when at home
When at home and visited by a person who is not part of the household
When in any congested area
At work places, especially when with colleagues

NB: Do NOT wear a mask when running, jogging, or doing other physical activities

It is not necessary to wear a mask when you are alone in the car but have it ready in case of another passenger or when you step out

Precautions of wearing the masks pandemic

To put on the mask, hold onto the straps or loops and place it over the nose and mouth all the way to the chin
Avoid touching the front and inner sides of the mask
The mask should be kept on even when talking
In case of need to remove the mask like for eating or drinking, the mask should be removed completely by holding on to the straps and folded with the inner side in and placed in a clean container such as an envelope. It may also be hanged on nails, hooks e.t.c, in such a way that it does not touch any surfaces
Wash hands with soap and water or use a hand sanitizer whenever one touches the front or inside of the mask

How well should one care the mask

Ensure the mask covers the nose, mouth and chin when wearing it.
Keep the mask hanging in a clean area or in a clean envelope/container when not wearing it
Wash and dry reusable fabric (cotton) masks daily.
Remove the filter before washing the mask.
If the filter is washable (e.g. polypropylene) wash and dry it separately

Eye protection PPE

These PPE protect mainly the eyes. They includes

Face shields
Goggles.

These protect the mucous membranes in your eyes from blood and other bodily fluids. If these fluids make contact with the eyes, germs in the fluid can enter the body through the mucous membranes.

Clothing PPE

These are often used during surgery to protect you and the patient.

They are also used during surgery to protect you when you work with bodily fluids. Visitors wear gowns if they are visiting a person who is in isolation due to an illness that can be easily spread. They include

Gowns
Aprons
Head covering
Shoe covers.

Aprons/Disposable aprons

Aprons must always be changed after you finish care activities with each person.

These aren’t needed to carry out many normal aspects of Day today care with patients/clients, such as helping them to go for short walks, but you will need one when you are:

Performing or assisting in a procedure that might involve splashing of body fluids
Performing or helping the patient/client with personal hygiene tasks
Carrying out cleaning and tidying tasks in the patient’s/client’s living space, such as bed making. You must always perform hand hygiene before putting a disposable gown on and after taking it off and placing it in the correct clinical waste bin.

Note that different organizations have different colored aprons for different tasks – you should always check your workplace’s local policy.

Putting on

Pull the apron over your head and fasten at the back of your waist.

Taking off

Unfasten (or break) the ties.
Pull the apron away from your neck and shoulders, lifting it over your head and taking care to touch the inside only, not the contaminated outer side.
Fold or roll the apron into a bundle with the inner side outermost.
Dispose of the apron in the clinical waste bin.
Perform hand hygiene.

Gloves/Disposable gloves

This is a type of clothing that covers the hand thereby preventing the spread of infection through the hands Disposable gloves should only be worn if you’re performing or assisting in a procedure that involves a risk of contact with body fluids, broken skin, dirty instruments and harmful substances such as chemicals and disinfectants.

Types of glove

Examination gloves: These are used by health workers during examination of the patient or non invasive procedures e.g. general body examinations, taking vital observations.
Surgical gloves: These are worn during surgeries, wound dressing and while performing any invasive procedure

Gloves should not be routinely used or put on ‘just in case’. This is dangerous for the patient/client as you will not be able to wash your hands when you are wearing gloves.

Gloves need to be used in specific circumstances only i.e. procedures that involve:

A risk of being splashed by body fluids (blood, saliva, sputum, vomit, urine or faeces, for instance)
Contact with the patient’s/client’s eyes, nose, ears, lips, mouth or genital area, or any instruments that have been in contact with these areas.
Contact with an open wound or cut .
Handling potentially harmful substances, such as disinfectants.

Note: that disposable gloves are NOT necessary for many parts of routine day care, like helping a patient/client to wash and dress or bed making.

Gloves should:

Fit you comfortably (not be too tight or too loose)
Be changed between patients/clients and between different tasks with the same patient/client
Never be washed or reused.

When you’ve finished the procedure, you should take the gloves off, avoid touching the outer surfaces (which are likely to be contaminated with germs), and dispose of them in the correct waste disposal system. You must then perform hand hygiene.

Putting on gloves

Select the correct glove size and type.
Perform hand hygiene.
Pull to cover wrists.

Taking off gloves

Grasp the outside of the glove with the opposite gloved hand and peel off.
Hold the removed glove in the gloved hand.
Slot your finger under the lip of the remaining glove and peel it off, taking care not to touch the contaminated outer surface.
Dispose of the gloves in the clinical waste bin.
Perform hand hygiene.

Warning!

Some gloves have a substance called ‘latex’ that can cause serious allergies. If you know you have an allergy to latex, you must tell your employer so that alternative gloves can be supplied.
Some nursing staff experience sore hands as a result of their job, usually caused by a mixture of things such as wet work (bathing, washing patients), using wipes and alcohol hand gel, wearing gloves and not drying their hands properly.
If you have sore hands you should tell your manager and report it to your occupational health department or lead.

Benefits of using PPE in the health care facility

It prevents the transmission of infection between

Patient to patient
Health worker to patient and vice versa
Health worker to health worker
It motivates health workers to provide care to patients with infectious diseases comfortably

FIRE EXTINGUISHERS

A fire extinguisher is an active fire protection device used to extinguish or control small fires, often in emergency situations.

Elements of fire

Actually, it’s a tetrahedron, because there are four elements that must be present for a fire to exist.

There must be oxygen to sustain combustion
Heat to raise the material to its ignition temperature,
Fuel to support the combustion
Chemical reaction between the other three elements. It is summarized in the picture below which is the fire triangle.

NB: Remove any one of the four elements to extinguish the fire.

Types of fire

Most household fires fall into one of the following categories:

Class A: These are fires in ordinary combustibles such as wood, paper, cloth, rubber, and many plastics.
Class B: These are fires in flammable liquids such as gasoline, petroleum greases, tars, oils, oil-based paints, solvents, alcohols. Class B fires also include flammable gases such as propane and butane. Class B fires do not include fires involving cooking oils and grease.
Class C: These are fires involving energized electrical equipment such as computers, servers, motors, transformers, and appliances. Remove the power and the Class C fire becomes one of the other classes of fire.
Class D: These are fires in combustible metals such as magnesium, titanium, zirconium, sodium, lithium, and potassium.
Class K: These are fires in cooking oils and greases such as animal and vegetable fats.

NB: Some types of fire extinguishing agents can be used on more than one class of fire. Others have warnings where it would be dangerous for the operator to use on a particular fire extinguishing agent.

Classification of fire extinguishers

Classification according to the type of fire they extinguish

There are four classes of fire extinguishers – A, B, C and D – and each class can put out a different type of fire.

Class A extinguishers will put out fires in ordinary combustibles such as wood and paper
Class B extinguishers are for use on flammable liquids like grease, gasoline and oil
Class C extinguishers are suitable for use only on electrically energized fires
Class D extinguishers are designed for use on flammable metals

Classification of fire extinguishers according to chemical composition

Water and Foam fire extinguishers: They extinguish the fire by taking away the heat element of the fire triangle.

(a). Foam agents also separate the oxygen element from the other elements.
(b).Water extinguishers are for Class A fires only – they should not be used on Class B or C fires. The discharge stream could spread the flammable liquid in a Class B fire or could create a shock hazard on a Class C fire.

Carbon Dioxide fire extinguishers: They extinguish fire by taking away the oxygen element of the fire triangle and also by removing the heat with a very cold discharge. Carbon dioxide can be used on Class B & C fires. They are usually ineffective on Class A fires.
Dry Chemical fire extinguishers: They extinguish the fire primarily by interrupting the chemical reaction of the fire triangle. Today’s most widely used type of fire extinguisher is the multipurpose dry chemical that is effective on Class A, B, and C fires. This agent also works by creating a barrier between the oxygen element and the fuel element on Class A fires.
Wet Chemical fire extinguishers: This is a new agent that extinguishes the fire by removing the heat of the fire triangle and prevents re-ignition by creating a barrier between the oxygen and fuel elements. Wet chemicals of Class K extinguishers were developed for modern, high efficiency deep fat fryers in commercial cooking operations. Some may also be used on Class A fires in commercial kitchens.

Halogenated or Clean Agent extinguishers: They include the halon agents as well as the newer and less ozone depleting halocarbon agents. They extinguish the fire by interrupting the chemical reaction and/or removing heat from the fire triangle. Clean agent extinguishers They are effective on Class A, B and C fires.
Dry Powder extinguishers: Dry Powder extinguishers are similar to dry chemicals except that they extinguish the fire by separating the fuel from the oxygen element or by removing the heat element of the fire triangle. However, dry powder extinguishers are for Class D or combustible metal fires, only. They are ineffective on all other classes of fires.
Water Mist extinguishers: They are a recent development that extinguish the fire by taking away the heat element of the fire triangle. They are an alternative to the clean agent extinguishers where contamination is a concern. Water mist extinguishers are primarily for Class A fires, although they are safe for use on Class C fires as well.

Rules for fighting fire

They are 3 A’s

ACTIVATE the building alarm system or notify the fire department by calling 911. Or, have someone else do this for you.
ASSIST any persons in immediate danger, or those incapable on their own, to exit the building, without risk to yourself.
Only after these two are completed should you ATTEMPT to extinguish the fire.

Only fight fire if:

The fire is small and contained
You are safe from toxic smoke
You have a means of escape
Your instincts tell you it’s OK

Fire extinguisher use

It is important to know the locations and the types of extinguishers in your workplace prior to actually using one.

Fire extinguishers can be heavy, so it’s a good idea to practice picking up and holding an extinguisher to get an idea of the weight and feel.
Take time to read the operating instructions and warnings found on the fire extinguisher label. Not all fire extinguishers look alike.
Practice releasing the discharge hose or horn and aiming it at the base of an imagined fire. Do not pull the pin or squeeze the lever. This will break the extinguisher seal and cause it to lose pressure
When it is time to use the extinguisher on a fire, just remember PASS!

(a). Pull the pin.
(b).Aim the nozzle or hose at the base of the fire from the recommended safe distance.
(c). Squeeze the operating lever to discharge the fire extinguishing agent.
(d). Starting at the recommended distance, Sweep the nozzle of hose from side to side until the fire is out. Move forward or around the fire area as the fire diminishes. Watch the area in case of re ignition.

Maintenance of a Fire extinguisher

In addition, fire extinguishers must be maintained annually in accordance with local, state, and national codes and regulations. This is a thorough examination of the fire extinguisher’s mechanical parts, fire extinguishing agent, and the expellent gas.

Your fire equipment professional is the ideal person to perform the annual maintenance because they have the appropriate servicing manuals, tools, recharge materials, parts, lubricants, and the necessary training and experience.

Inspection of a fire extinguisher

Like any mechanical device, fire extinguishers must be maintained on a regular basis to ensure their proper operation. You, the owner or occupant of the property where the fire extinguishers are located, are responsible for arranging your fire extinguishers’ maintenance.

Fire extinguishers must be inspected or given a “quick check” every 30 days.

For most extinguishers, this is a job that you can easily do by locating the extinguishers in your workplace and answering the three questions below.

Is the extinguisher in the correct location?
Is it visible and accessible?
Does the gauge or pressure indicator show the correct pressure?

Precautions of Fire extinguishers

Don’t Ignore the Instructions: Thoroughly read the operating instructions that came with your fire extinguisher. Make sure all able members of your home read and understand the instructions. Review them regularly when you conduct fire drills and go over your evacuation plan.
Don’t Use the Wrong Type of Fire Extinguisher: Never use a fire extinguisher for a class of fire that is not indicated on the label. Most importantly, extinguishers that are labeled for Class A fires only cannot be used on electrical or grease fires. However, it is safe to use an extinguisher labeled for Class B and C fires on a Class A fire. While Class K fires are technically a subset of Class B fires, other contents in Class B extinguishers can make Class K fires worse, so it’s best to get a separate extinguisher for cooking fires.
Don’t Let Your Extinguisher Go Bad: Fire extinguishers come with an expiration date, after which the extinguishing agent is no longer effective. Know the dates on your fire extinguishers and replace them as needed.
Don’t Forget about Exits: When you decide where to keep your fire extinguisher, make sure it is in an easily accessible location near exterior doors. Also, consider the most common places where fires occur in a home
Don’t Keep It a Secret: Make sure that everyone in your home knows where the fire extinguishers are kept. Share the location, along with your entire fire escape plan, with babysitters, house sitters, and any long-term visitors.

PERSONAL PROTECTIVE EQUIPMENT (PPE) Read More »

OCCUPATIONAL HEALTH SERVICE PROGRAM

Occupational health programs offer health services which correspond to the aims of ILO/WHO.

Such OHS programs contain preventive, control, curative, treatment, rehabilitation and promotion activities for the improvement of working conditions, protection of health and for the maintenance and promotion of working capacity.

Objectives/aims of Occupational Health programs at the workplace

To promote and maintain the highest degree of positive health and welfare of workers in all aspects of occupations.
To prevent health declination (sickness and accidents) due to working occupations.
To protect workers from factors that affect their health during employment
To assist the injured and disabled for rehabilitation.
To improve human efficiency in his work by applying ergonomics
To provide a self-occupational environment in order to safeguard the health of the workers and to set up industrial production.

Principles of occupational Health and Safety programs

The basic principles for the development of occupational health and safety services are as follows:

The service must optimally be preventive oriented and multidisciplinary.
The service provided should integrate and complement the existing public health service.
The service should address environmental considerations
The service should involve participation of social partners and other stakeholders
The service should be delivered on criticized approach
The service should base up to date information, education, training, consultancy, advisory services and research findings
The service should be considered as an investment

Benefits of OHS service program

Reduce injuries and disability
Control and prevention of infections
Improved quality of life
Saves money lost due to diseases, injuries and insurance compensations
Improves productive labour force.

OSH committees

In order to implement OSH policy, the MOH in conjunction with the Ministry of Gender, Labor and Social Development has instituted OSH committees at different levels. These include the following

National OSH committee (has 9 members)
District OSH committee (9 members)
HSD OSH committee (7 members)
Health unit OSH committee (5 members) each committee has specific roles and responsibilities.

Roles and responsibilities of health unit committee

Coordinate consultation and risk management implementation.
Evaluate the hazards, and make recommendations for prevention.
Compile and analyze injury data for appropriate action.
Regular reviews and analyze data from the exposure incidents within the institution.
Ensure appropriate follow up and post exposure prophylaxis.

Role of a Nurse in Occupational Health Programs

The responsibility of occupational health nurse is threefold e.g.

a) To the worker
b) To the employer
c) To his or her professional colleagues

The following are nursing functions in occupational health programs

To participate in the health assessment (physical and Psychological assessment) of workers to facilitate proper recruitment (selection and placement).
Prevention of occupational and non-occupational illnesses through health education, training, health surveillance and screening.
Provisions for treatment/provide nursing care to workers with both occupational and non occupational illnesses.
Provision of referral services to those who require advanced care.
Counsel workers regarding personal and family health problems i.e. conduct health education and counseling.
Advocate and or advise on occupational sanitation or industrial hygiene and safety education activities.
Participate in planning for occupational health activities by establishing mutual goals and objectives of OHP.
Work cooperatively (collaborate, communicate and consult) with other professional and non professional staff.
Maintains accurate and complete health records of the workers.
Participate in rehabilitation and resettlement of those who have been disabled as a result of the occupations.
Participate in evaluation of health programs and activities.

Multiple Choice Questions (MCQs):

Occupational health programs aim to:
a) Improve working conditions
b) Enhance worker efficiency
c) Prevent health decline due to work
d) All of the above
Answer: d) All of the above

Explanation: Occupational health programs encompass activities that improve working conditions, protect workers’ health, enhance their efficiency, and prevent health decline resulting from work-related factors.

Which of the following is not an objective of an occupational health program?
a) Promoting positive health and welfare of workers
b) Preventing accidents and illnesses in the workplace
c) Maximizing profits for the employer
d) Assisting injured and disabled workers in rehabilitation
Answer: c) Maximizing profits for the employer

Explanation: Occupational health programs prioritize the well-being of workers and focus on preventing accidents and illnesses. Maximizing profits, although important for employers, is not a specific objective of occupational health programs.

Which principle is crucial for the development of occupational health and safety services?
a) Prevention-oriented and multidisciplinary approach
b) Sole reliance on the existing public health service
c) Neglecting environmental considerations
d) Excluding social partners and stakeholders
Answer: a) Prevention-oriented and multidisciplinary approach

Explanation: The development of occupational health and safety services should have a preventive orientation and involve a multidisciplinary approach to address the various aspects of worker health and safety.

What is a benefit of implementing an occupational health service program?
a) Reduced injuries and disability
b) Increased healthcare costs
c) Decreased productivity
d) Higher insurance compensations
Answer: a) Reduced injuries and disability

Explanation: Implementing an occupational health service program helps in reducing injuries and disability among workers, leading to improved overall health and well-being.

What are the roles and responsibilities of a health unit OSH committee?
a) Coordinate consultation and risk management
b) Evaluate hazards and make prevention recommendations
c) Conduct health education and counseling
d) All of the above
Answer: d) All of the above

Explanation: The roles and responsibilities of a health unit OSH committee include coordinating consultation and risk management, evaluating hazards, making prevention recommendations, and conducting health education and counseling.

Fill in the Blanks (FIBs):

The aim of occupational health programs is to promote and maintain the ________ degree of positive health and welfare of workers.
Answer: highest
Explanation: Occupational health programs strive to promote and maintain the highest degree of positive health and welfare of workers.

Occupational health nurses play a vital role in the ________ assessment of workers to ensure proper recruitment.
Answer: health
Explanation: Occupational health nurses are involved in conducting health assessments of workers to facilitate appropriate recruitment, which includes selection and placement processes.

Occupational health programs focus on the prevention of both ________ and non-occupational illnesses through various interventions.
Answer: occupational
Explanation: Occupational health programs aim to prevent both occupational and non-occupational illnesses among workers by implementing health education, training, health surveillance, and screening activities.

Nurses in occupational health programs are responsible for providing nursing care to workers with ________ illnesses.
Answer: occupational and non-occupational
Explanation: Nurses in occupational health programs are responsible for providing nursing care to workers who experience both occupational and non-occupational illnesses.

One of the responsibilities of occupational health nurses is to participate in the ________ and resettlement of workers who have been disabled due to their occupations.
Answer: rehabilitation
Explanation: Occupational health nurses play a role in the rehabilitation and resettlement process of workers who have been disabled as a result of their work-related activities.

OCCUPATIONAL HEALTH SERVICE PROGRAM Read More »

Workers Compensation Act

Workers’ compensation is a system that provides cash and non-cash payments to individuals who have suffered loss, suffering, or injury while on the job.

Impairment and Disability:

Impairment refers to the loss of function of an organ or part of the body compared to its previous state.

Disability, on the other hand, considers the impact of impairment on societal or work functions. It takes into account the loss of function and the patient’s work requirements and home situation. Disability evaluations assess both impairment and its effect on occupational or societal functioning.

Certain agencies use a more restrictive definition of disability such as “inability to perform any substantial gainful work“

Others define it as an “inability to perform the essential tasks of the usual employment.” However the determination of disability is always predicted on an assessment of impairment followed by a determination of the loss of occupational or societal functioning that result from the impairment

Compensation may be used to;

Recruit and retain qualified employees.
Increase or maintain morale/satisfaction.
Reward and encourage peak performance.
Achieve internal and external equity.
Reduce turnover and encourage company loyalty.
Modify practices of unions through negotiations.

Types of Compensation:

Base Pay: Base pay refers to the fixed amount of money an employee receives for their work before any additional payments or deductions. It is the regular salary or wage agreed upon between the employer and the employee.
Commissions: Commissions are additional payments that employees receive based on a percentage of sales or revenue they generate. This type of compensation is common in sales or business development roles, where employees earn a commission based on the value of the products or services they sell.
Overtime Pay: Overtime pay is the additional compensation provided to employees for working beyond their regular working hours. Typically, employees receive a higher rate of pay, often called “time-and-a-half” or “double-time,” for the extra hours worked beyond the standard workweek.
Bonuses, Profit Sharing, Merit Pay: Bonuses are one-time payments given to employees as a reward for achieving specific goals or exemplary performance. Profit sharing involves distributing a portion of the company’s profits among employees. Merit pay, also known as performance-based pay, is given to employees based on their individual performance or merit.
Stock Options: Stock options are a form of compensation that grants employees the right to purchase company stock at a predetermined price within a specified time period. This provides employees with the opportunity to share in the company’s success and potentially benefit from an increase in stock value.
Travel/Meal/Housing Allowance: Travel, meal, and housing allowances are additional payments or reimbursements provided to employees to cover the expenses incurred during work-related travel, meals, or housing accommodations when working away from their usual place of employment.
Benefits: Benefits refer to non-cash compensation provided to employees as part of their overall compensation package. They can include dental, insurance (such as health insurance or life insurance), medical coverage, vacation and leave entitlements, retirement plans, and tax-related benefits.

Worker’s Compensation

Workers’ compensation act is an ACT to provide for compensation to workers for injuries suffered and scheduled diseases incurred in the course of their employment.

The Worker’s Compensation Act is a legal written document, which establishes the liability of employers for injuries to workers while on the job or illnesses due to the employment, and requiring insurance to protect the workers.

Workers’ compensation is not based on negligence of the employer, but is absolute liability for medical coverage, a percentage of lost wages or salary, costs of rehabilitation and retraining, and payment for any permanent injury (usually based on an evaluation of limitation).

Compensation can be made for weekly payments in place of wages (functioning in this case as a form of disability insurance), compensation for economic loss (past and future), reimbursement or payment of medical and like expenses (functioning in this case as a form of health insurance). and benefits payable to the dependents of workers killed during employment.

N.B: General damage for pain and suffering, and punitive damages for employer negligence are generally not available in workers’ compensation plans, and negligence is generally not an issue in this case.

The constitution of Uganda (15 February 2006) highlights the following articles as far as work is concerned.

I. Article 25(1): No person shall be held in slavery or servitude
II. Article 25(2): No person shall be required to perform forced labour
III. Article 29(1): Every person has a right to, Freedom of association which shall include the freedom to form or join associations or unions including trade unions and political and other civic organizations
IV. Article 34 (4): Children are entitled to be protected from social or economic exploitation and shall not be employed in or required to perform work that is likely to be hazardous or to interfere with their education or to be harmful to their health or physical, metal, spiritual, moral or social development
V. Article 39: Every person has a right to a clean and healthy environment
VI. Article 40(1): Parliament shall enact laws-
a) To provide for the right of persons to work under satisfactory, safe and healthy conditions
b) To ensure equal pay for equal work without discrimination and;
c) To ensure that every worker is accorded rest and reasonable working hours and periods of holidays with pay, as well as remuneration for public holidays
VII. Article 40(2): Every person in Uganda has a right to practice his or her profession and to carry on any lawful occupation, trade or business
VIII. Article 40(3): Every worker has a right to-
a) To form or join a trade union of his or her choice for promotion and protection of his or her economic and social interests
b) For collective bargaining and representation, and
c) To withdraw his or her labour according to the law
IX. Article 40(4): The employer of every woman worker shall accord her protection during pregnancy and after birth, in accordance with the law.

Instances for compensation

1. Employer’s liability (an obligation to be fulfilled by an institution)

2. Fatal injuries. A serious workplace injury is an accident at work that:

Is or may be fatal
Results in a loss of a limb
Produces unconsciousness
Results in a substantial loss of blood
Involves a fracture
Involves the amputation of a leg, arm, hand, or foot
Consists of burns to a large portion of the body
Causes the loss of sight in an eye

3. Permanent total or partial or temporary incapacity
4. Agreement as to compensation
5. Appeals
6. Insurance
7. Bankruptcy of employer
8. Contracting out

Terms used in compensation

Permanent total incapacity – the worker is permanently incapacitated for any employment which he/she was capable of undertaking at the time when an accident occurred.
Permanent partial incapacity – capacity to perform has been reduced by a percentage.
Temporary incapacity – worker is able to regain capacity to perform after sometime.

Computation for Compensation

Permanent total incapacity; Total monthly earnings x 60 months x percentage of incapacitation awarded by medical officer/practitioner. In case the injured worker requires assistance (wheel chair, feeding, dressing, etc. The pay is increased by 25% of amount computed
Permanent partial incapacitation: Total monthly earnings x 60 months x percentage of incapacitation awarded by medical practitioner.
Temporary incapacity: Daily earnings x number of days of incapacitate x percentage of incapacity
NB: In case of death, settlement for claims is made through the Administrator general.

Example for Permanent Incapacitation.

Let’s assume that an injured worker’s total monthly earnings are Shs. 3,000,000/= and they have been determined to have a permanent total incapacity with an incapacitation percentage of 70%.

To compute the compensation for permanent total incapacity, we use the formula: Total monthly earnings x 60 months x percentage of incapacitation.

Using the given values, the computation would be as follows:
3,000,000/= (total monthly earnings) x 60 (months) x 0.70 (70% incapacitation) = Shs. 126,000,000/=

However, in this case, the injured worker requires assistance for daily activities, such as using a wheelchair, feeding, and dressing. Therefore, the pay is increased by 25% of the computed amount.

25% of Shs.126,000,000/= Shs. 31,500,000/=

So, the total compensation for permanent total incapacity, considering the additional assistance required, would be Shs.126,000,000 + Shs. 31,500,000 = Shs.157,500,000/=

This calculation ensures that the injured worker receives appropriate compensation based on their incapacitation and the impact it has on their ability to work.

Factors that determine compensation claims of employees

1. Years of experience and education level.
It probably goes without saying, but the more experience and education candidates have, the more money they can command.
2. Industry/nature of job.
Depending on the industry, you may have to pay vastly different wages for the same skill sets.
3. Location.
Location can drive compensation rates up or down, depending on the cost of living.
4. Skill sets.
When it comes to determining compensation, it might seem like second nature to search by job title; however, searching by job title can be unreliable. After all, a product manager at one company could have a vastly different role – and require a different set of skills – from a product
manager at another company.
5. Supply and demand.
It’s crucial to be aware of the availability of talent for the position for which you’re recruiting. If you’re recruiting in an area where the supply of talent outweighs the demand, you should expect to pay more in order to lure talent.

Eligibility criteria for compensation

Typically, there are four basic eligibility requirements for workers’ comp benefits:

You must be an employee. In particular, independent contractors (like freelancers, consultants, or volunteers) typically aren’t entitled to workers’ compensation benefits
Your employer must carry workers’ compensation insurance.
You must have a work-related injury or illness.
You must meet your state’s deadlines for reporting the injury and filing a workers’ compensation claim.

OVERVIEW OF THE ACT

The Act addresses matters such as:

Assisting injured or disabled workers and their dependants,
Assessing employers
The rights and responsibilities of employers and workers with respect to occupational health and safety
Setting and enforcing occupational health and safety regulations and standards
Inspecting workplaces, issuing orders, and imposing penalties.

Steps to claiming compensation

Support a workplace where there is trust and mutual respect. A negative work environment almost invites workers’ compensation losses and can inevitably make them worse. Injured workers can often lack motivation to get better because they don’t want to go back to a workplace environment they feel is unfriendly, unwelcoming or distrustful.
Inform employees of the injury reporting process. The process should be part of the employee rules of conduct and provide clear step-by-step rules for employees to follow in the event of an injury. Employees should know to inform their supervisor of an injury as soon as possible, get emergency help if needed or at least see a doctor if necessary. Employees also need to know where to find easily accessible information about how to fill out a claim form, benefits available and the importance of rehabilitation and returning to work.
Establish procedures to ensure that injured employees get prompt medical attention in the most appropriate ways. This should include establishing:
✔ relationships with occupational medicine practitioners who understand your business
operations
✓ referral program to appropriate medical specialists
Maintain a policy of reporting claims to your workers’ compensation carrier the same day they occur. If a claims adjuster is able to quickly respond, this will minimize the sense of uncertainty that often results when someone is injured and confused about whether their claim will be handled promptly and equitably.
Investigate the accident thoroughly. This is essential not only to quickly resolve the immediate claim and mitigate the loss but to prevent future losses. Your accident investigation should include;
✓ Written statements from the employee-claimant and any co-workers or witnesses at the accident site.
✓ Written statement from the supervisor.
✓ Supporting documentation such as photographs of the accident site.
Maintain clear communications with the injured employee throughout the claims process. Help them understand the process, what to expect in terms of medical treatment, payments for their medical treatment and status of their pay. Remind them that you support them and want to see them back on the job as soon as possible.
Have an early return-to-work program. They help employees recover faster by allowing them to quickly return to feeling like useful contributors. And they reduce the costs of temporary total disability. Arrange for employee to return to work in light duty/modified duty
Consider the value of;
✓ Future medical treatment
✓ Rehabilitation
✓ Vocational training
✓ Value of death and funeral benefits

Workers Compensation Act Read More »

HAZARD PREVENTION AND CONTROL

Hazard prevention is any workplace-specific program designed to stop the occupancy or occurrence of work-related injuries and diseases.

Hazard control refers to the implementation of policies, standards, procedures and physical changes to eliminate or minimize adverse risks.

Hazards are anything that can cause harm to workers, such as injuries, illnesses, or accidents.

Hazard Identification: This is the initial step in the risk assessment process. It involves recognizing and listing potential hazards that may exist in a given environment.

Hazard identification is the process of identifying, locating, and documenting anything that could cause harm, damage, injury, or adverse effects. This step is more qualitative and involves recognizing what hazards could be present.

Methods of hazard control/Hierarchy of Controls at the workplace

There are different methods of hazard prevention and control, which can be ranked according to a hierarchy of effectiveness. The higher the level in the hierarchy, the more effective the method is. The hierarchy of controls is as follows:

Elimination: Eliminating the Risk (Level One): This is the most effective method, as it removes the hazard completely from the workplace. For example, cleaning spills from the floor immediately or replacing worn-out equipment or wires eliminates the risk of slips, trips, or electric shocks.
Substitution: Substituting the Risk (Level Two): This is the second most effective method, as it replaces a hazard with a less hazardous one. For example, using single-use syringes instead of re-usable ones reduces the risk of infection. However, substitution may introduce new hazards, so a new risk assessment should be done after the change.
Isolation: Isolate the Risk (Level Three): This is the third most effective method, as it separates workers from the hazard by using barriers or distance. For example, placing dangerous machinery in a separate room and installing remote control systems isolates workers from the risk of injury. Another example is using isolation rooms for patients with contagious diseases.
Engineering controls: Engineering Controls (Level Four): Engineering risk control is the process of designing and installing additional safety features to workplace equipment. These are physical modifications or additions to equipment or the work environment that reduce exposure to hazards. For example, installing ventilation systems in areas with harmful gasses or dust or guardrails on raised walkways reduces the risk of respiratory problems or falls.
Administrative controls: Administrative Controls (Level Five): These are rules, policies, procedures, or training that aim to change workers’ behavior or work practices to avoid or reduce hazards. For example, providing safety training on how to use equipment properly or arranging work schedules to limit exposure time in hazardous areas reduces the risk of human error or fatigue.
Personal protective equipment (PPE): Personal Protective Equipment (Level Six): These are items that workers wear or use to protect themselves from hazards, such as hard hats, ear plugs, gloves, masks, etc. This is the least effective method in the hierarchy, as it does not remove or reduce the hazard itself. It only protects workers from harm if an incident occurs. Therefore, PPE should always be used in combination with other methods and as a last resort.

Considerations for Effective Control and Prevention of Hazards

Involve workers in the process. Workers often have the best understanding of the hazards in the workplace and how they can be controlled.
Identify and evaluate options for controlling hazards. Use a “hierarchy of controls” to select the most effective and permanent controls. The hierarchy of controls prioritizes engineering controls (such as eliminating or substituting hazards) over administrative controls (such as work practices) and personal protective equipment (PPE).
Use a hazard control plan to guide the selection and implementation of controls. The hazard control plan should describe how the selected controls will be implemented and who is responsible for their implementation.
Develop plans to protect workers during non-routine operations and emergencies. These plans should include procedures to control hazards that may arise during non-routine operations, such as maintenance and repair, and during emergencies, such as fires and explosions.
Implement selected controls in the workplace. Implement the controls according to the hazard control plan and track progress to ensure that they are effective.
Follow up to confirm that controls are effective. Track progress in implementing the controls, inspect and evaluate the controls once they are installed, and follow routine preventive maintenance practices.

Prevention of Occupational Health Hazards

There are three levels of prevention of occupational health hazards: primary prevention, secondary prevention, and tertiary prevention.

Primary Prevention

Primary prevention aims to prevent the exposure to hazards in the first place. This can be done through a variety of measures, including:

Health education: Educating workers about the hazards in their workplace and how to protect themselves.
Pre-employment medical screening: Screening workers for health conditions that may make them more susceptible to hazards.
Establishing and enforcing health and safety regulations: Ensuring that workplaces are safe and that workers are following safe work practices.
Providing personal protective equipment: Providing workers with personal protective equipment (PPE) to protect them from hazards.
Engineering controls: Designing workplaces to reduce or eliminate hazards.

Secondary Prevention

Secondary prevention aims to identify and treat health problems early, so that they do not become more serious. This can be done through a variety of measures, including:

Health surveillance: Regularly monitoring workers’ health for signs of occupational health problems.
Health screening: Testing workers for specific health problems that may be related to their work.
Treatment: Providing workers with treatment for occupational health problems.

Tertiary Prevention

Tertiary prevention aims to minimize the effects of occupational health problems that have already occurred. This can be done through a variety of measures, including:

Rehabilitation: Helping workers who have been injured or disabled by occupational health problems to return to work.
Compensation: Providing financial compensation to workers who have been injured or disabled by occupational health problems.
Prevention of further injury or disability: Taking steps to prevent workers from being injured or disabled again.

Occupational hazard assessment

Occupational hazard assessment is the routine examination of; sites, equipment and human resource to ensure prevention of occurrence of an occupational hazard

Importance of Occupational Hazard Assessment.

This assessment is of importance to;

Employer
Employees
And community

Employer:

Compliance with regulations: Occupational hazard assessment helps employers comply with legal and regulatory requirements related to workplace safety. By identifying and mitigating hazards, employers demonstrate their commitment to providing a safe working environment.
Risk management: Assessing occupational hazards enables employers to identify potential risks and implement appropriate control measures. This proactive approach reduces the likelihood of workplace accidents, injuries, and related financial liabilities.
Enhanced productivity: A safe and healthy work environment promotes employee well-being, job satisfaction, and morale. By conducting hazard assessments, employers can address risks and create a conducive workplace, leading to improved productivity and efficiency.
Reputation and credibility: Employers who prioritize occupational hazard assessment showcase their commitment to employee safety and welfare. This enhances their reputation, builds trust among employees and stakeholders, and helps attract and retain talented workers.

Example: A manufacturing company conducts regular hazard assessments in its production facility. During one assessment, they identify potential risks associated with outdated machinery. As a result, the employer invests in upgrading the equipment to improve worker safety and efficiency. This approach not only minimizes the risk of accidents and injuries but also demonstrates the employer’s commitment to employee well-being and compliance with safety regulations.

Employee:

Personal safety: Occupational hazard assessments prioritize employee safety by identifying and addressing potential workplace hazards. Employees can work with peace of mind, knowing that their well-being is valued, and appropriate measures are in place to mitigate risks.
Health and well-being: Identifying and controlling hazards through assessments promotes employee health and well-being. By reducing exposure to occupational risks, employees are less likely to develop work-related illnesses or injuries, leading to improved overall health and quality of life.
Empowerment and involvement: Involving employees in hazard assessments empowers them to actively participate in maintaining a safe work environment. It allows them to contribute their insights and concerns, fostering a culture of safety and ownership within the organization.
Confidence and job satisfaction: Employees who feel safe and protected in their work environment experience higher job satisfaction and are more engaged in their roles. Occupational hazard assessments contribute to this sense of confidence, leading to increased employee retention and loyalty.

Example: In a construction company, hazard assessments are conducted before each new project. During one assessment, potential fall hazards are identified, leading to the implementation of safety measures such as providing harnesses and guardrails. By involving employees in the assessment process and addressing their safety concerns, the company empowers its workers, instilling confidence and job satisfaction.

Community:

Public safety: Occupational hazard assessment benefits the community by ensuring that workplaces operate in a manner that does not pose risks to public safety. Preventing accidents and incidents at work contributes to the overall well-being of the community.
Environmental protection: Hazard assessments often include evaluating the environmental impact of work processes. By identifying and controlling hazards that could harm the environment, occupational hazard assessments contribute to sustainable and responsible practices.
Community perception: Companies that prioritize occupational hazard assessments demonstrate their commitment to responsible business practices. This positive perception enhances community trust and goodwill toward the organization, fostering positive relationships and potentially attracting community support.

Example: An oil refinery conducts regular hazard assessments to ensure the safety of its operations. During an assessment, they identify potential risks related to chemical spills that could harm the surrounding environment and nearby communities. The refinery invests in advanced containment systems and implements stringent protocols to prevent such incidents. By prioritizing occupational hazard assessment, the company safeguards the community from environmental harm and builds trust and goodwill.

Methods of Hazard Identification, Prevention, and Control

Human Resource

Pre-placement/pre-employment medical examination: This examination has three aims:
- To determine the suitability of an applicant for a particular job, from the viewpoints of both the risk to the applicant’s health and safety, and the risk to other workers and members of the community.
- To detect untreatable pathological conditions and asymptomatic diseases.
- To provide a baseline record against which any future findings or routine examinations can be compared.
Periodic examinations: These examinations are conducted to detect adverse trends caused by work.
Special physical examinations: Every worker should have a physical examination before being allowed to return to work following an illness, and also following signs of difficulty to cope with work, and among those with chronic illnesses.

Equipment and Workplace/Site

Routine maintenance and servicing of equipment: This helps to identify and correct potential hazards before they cause an accident.
Repair and replacement of equipment: This ensures that equipment is in good working order and does not pose a hazard to workers.
Provision of standard operating protocols: These protocols provide clear instructions on how to operate equipment safely.
Routine drills to employees: These drills help employees to learn how to respond to emergencies in a safe and effective manner.
Provision of protective wears: This includes items such as safety glasses, hard hats, and gloves, which can help to protect workers from injury.
Installation of warning posters in work environment and restriction of access to some areas: This helps to keep workers safe by warning them of potential hazards and restricting access to areas where there is a risk of injury.
Standard training of employees before employment and handling of new machinery: This training helps employees to learn how to operate equipment safely and to identify and avoid hazards.
Installation of fire extinguishers: This helps to prevent the spread of fire and to protect workers from burns.
Provision of sanitary points such as hand washing equipment: This helps to prevent the spread of infection.
Assembly points: These points are designated areas where workers can gather in the event of an emergency.

Steps in Occupational Hazard Assessment and Identification

Occupational hazards are any sources of potential damage, harm or adverse effects on the health and safety of workers or the environment. Occupational hazard assessment and identification is the process of finding, recognizing, and describing the hazards that exist in the workplace, and analyzing and evaluating the risks associated with these hazards. The purpose of this process is to prevent or reduce the occurrence and severity of work-related injuries, illnesses, and fatalities.

The following are some steps that can be followed to conduct occupational hazard assessment and identification:

1. Collect existing information about workplace hazards

Before inspecting the workplace for hazards, it is useful to gather and review any information that may already be available from both internal and external sources. This can include:

Inspecting the work place for safety: Records of previous incidents, injuries, illnesses, near misses, complaints, or suggestions related to workplace hazards
Identify hazards: Safety data sheets , labels, manuals, or instructions for hazardous products or equipment used in the workplace.
Conducting incident investigations: Regulations, standards, codes of practice, or guidelines that apply to the workplace or the industry
Reports or publications from professional associations, research institutions, government agencies, or other organizations that provide information on workplace hazards
Input from workers, supervisors, managers, health and safety committees, unions, or other stakeholders who have knowledge or experience of the workplace hazards

The collected information should be organized and reviewed with workers to determine what types of hazards may be present and which workers may be exposed or potentially exposed. This can help identify areas or activities that need more attention during the inspection.

2. Inspect the workplace for safety hazards

Even if some information on workplace hazards is already available, it is still important to inspect the workplace regularly for any new or existing hazards that may have been overlooked or introduced over time. Hazards can arise from changes in workstations, processes, equipment, tools, materials, or environment. They can also result from poor maintenance, housekeeping, or training practices.

A workplace inspection involves observing the physical conditions and work activities in the workplace, and identifying any hazards that could cause harm to workers or the environment. Some common methods of inspecting the workplace are:

Walking around the workplace and looking for any obvious signs of hazards, such as spills, leaks, broken equipment, exposed wires, blocked exits, etc.
Talking to workers and asking them about any concerns or issues they have regarding their work environment, tasks, equipment, tools, materials, etc.
Using checklists or forms to guide the inspection process and ensure that all relevant aspects of the workplace are covered
Taking notes, photos, videos, measurements, samples, or other records of the observed hazards and their locations

Workers can be a very useful internal resource for inspecting the workplace for hazards, especially if they are trained in how to identify and assess risks. Workers have firsthand knowledge of their work conditions and tasks, and may be aware of some hazards that are not obvious to others. Involving workers in the inspection process can also increase their awareness and participation in health and safety matters.

3. Identify hazards associated with emergency and non-routine situations

In addition to inspecting the workplace for regular hazards that occur during normal operations, it is also necessary to identify any hazards that may arise during emergency or non-routine situations. These are situations that are not part of the usual work activities or procedures, but may occur unexpectedly or occasionally due to various factors. Some examples of emergency or non-routine situations are:

Fire
Explosion
Chemical spill
Power outage
Natural disaster
Equipment failure
Maintenance work
New project
Temporary assignment

Emergency or non-routine situations can pose different or additional risks to workers or the environment than those encountered during normal operations. Therefore, it is important to identify these risks beforehand and prepare appropriate measures to prevent or respond to them effectively.

Some ways to identify hazards associated with emergency or non-routine situations are:

Reviewing past incidents or near misses that involved emergency or non-routine situations
Consulting with experts or specialists who have knowledge or experience of dealing with emergency or non-routine situations
Conducting scenario analysis or simulation exercises to anticipate potential outcomes and consequences of emergency or non-routine situations
Developing emergency plans or procedures that outline the roles and responsibilities of workers and other parties in case of emergency or non-routine situations

4. Characterize the nature of identified hazards, identify interim control measures, and prioritize the hazards for control

After identifying all the possible hazards in the workplace, it is necessary to characterize their nature, identify interim control measures, and prioritize them for control.

Characterizing the nature of identified hazards means describing their sources, forms, effects, and severity. This can help determine how likely they are to cause harm, and how serious the harm could be. Some factors that can be used to characterize the nature of identified hazards are:

Frequency: how often the hazard occurs or is encountered
Duration: how long the hazard lasts or is exposed
Magnitude: how large or intense the hazard is
Probability: how likely the hazard is to cause harm
Severity: how serious the harm could be

Identifying interim control measures means taking temporary actions to reduce or eliminate the risk of harm from the identified hazards until permanent solutions can be implemented. Interim control measures can include:

Isolating or removing the hazard from the workplace or workers
Providing personal protective equipment (PPE) or other safety devices to workers
Posting warning signs or labels to alert workers of the hazard
Implementing administrative controls, such as limiting access, exposure, or work hours to the hazard
Providing training, information, or instruction to workers on how to avoid or handle the hazard

Prioritizing the hazards for control means ranking the identified hazards according to their level of risk and urgency of action. This can help allocate resources and plan interventions more effectively and efficiently. Some criteria that can be used to prioritize the hazards for control are:

Legal requirements: whether the hazard violates any laws, regulations, standards, or codes of practice that apply to the workplace or the industry
Worker concerns: whether the hazard affects a large number of workers or causes significant distress or dissatisfaction among workers
Cost-benefit analysis: whether the benefits of controlling the hazard outweigh the costs of doing so
Hierarchy of controls: whether the hazard can be controlled by using more effective and reliable methods, such as elimination, substitution, engineering controls, administrative controls, or PPE

Note: Many hazards can be identified using common knowledge and available tools. For example, you can easily identify and correct hazards associated with broken stair rails and frayed electrical cords. Workers can be a very useful internal resource, especially if they are trained in how to identify and assess risks

Good safety Practices

Good safety practices are the actions that can be taken to prevent accidents and injuries in the workplace. They can help to create a safe and healthy environment for employees

Provide regular safety training. This training should cover all aspects of workplace safety, including how to identify and avoid hazards, how to use personal protective equipment (PPE), and how to respond to emergencies.
Encourage employees to report hazards. Employees should feel comfortable reporting any hazards they see, no matter how small they may seem. Employers should have a system in place for employees to report hazards and should investigate all reports promptly.
Provide PPE. The right PPE can help protect employees from injury. Employers should provide PPE that is appropriate for the hazards in the workplace and should ensure that employees know how to use it properly.
Maintain equipment and facilities. Equipment and facilities should be regularly inspected and maintained to ensure that they are safe to use. Employers should also have a system in place for reporting and correcting unsafe conditions.
Create a culture of safety. Employers should create a culture of safety in the workplace where employees feel valued and respected. This means creating a workplace where employees feel comfortable speaking up about safety concerns and where they are not afraid to take risks.
Hold regular safety meetings. These meetings should be used to discuss safety issues and to remind employees of the importance of safety. They should also be used to share information about new hazards or changes to safety procedures.
Enforce safety rules. Safety rules are in place to protect employees. Employers should enforce these rules consistently and fairly.
Provide incentives for safety. Employers should provide incentives for safety, such as rewards for employees who have a good safety record. This can help to encourage employees to be more safety conscious.
Celebrate safety successes. When employees do something to improve safety, employers should celebrate their success. This can help to reinforce the importance of safety and to encourage employees to continue to work safely.
Make safety a priority. Safety should be a top priority for employers. This means providing the resources and support necessary to create a safe workplace.

HAZARD PREVENTION AND CONTROL Read More »

OCCUPATIONAL HEALTH HAZARDS

In the field of occupational health, it is important to understand the concept of hazards and risks associated with the workplace. The following definitions and processes help in identifying and controlling these hazards:

Hazard: A hazard refers to a situation in the workshop that has the potential to cause harm, such as personal injury, disease, or even death.
Risk: Risk is the probability or chance of a hazard leading to actual injury, disease, or death.
Hazard identification: This process involves actively identifying all possible situations in the workplace where individuals may be exposed to risks of injury, disease, or death.
Hazard control: Hazard control entails implementing policies, standards, procedures, and making physical changes to the workplace to eliminate or minimize the adverse risks.

Classification of Workplace Hazards

Workplace hazards can be categorized into different types.

Physical Hazards: These hazards are associated with physical factors in the workplace, such as noise, vibration, radiation, temperature extremes, and ergonomic stressors. They can cause direct harm to workers’ physical well-being.
Mechanical Hazards: Mechanical hazards arise from machinery, equipment, or processes that can lead to injuries, such as crushing, cutting, or shearing. Examples include unguarded machinery, faulty equipment, or inadequate machine maintenance.
Chemical Hazards: Chemical hazards encompass exposure to hazardous substances in the workplace, including toxic chemicals, gases, fumes, or flammable materials. Exposure can occur through inhalation, ingestion, or skin contact, potentially resulting in poisoning, respiratory issues, or chemical burns.
Biological Hazards: Biological hazards are associated with exposure to living organisms or their byproducts, such as bacteria, viruses, fungi, or parasites. These hazards are common in healthcare settings, laboratories, or agricultural environments, and can lead to infectious diseases or allergic reactions.
Ergonomic Hazards: Ergonomic hazards arise from work tasks, equipment, or the workplace layout that can cause musculoskeletal disorders or physical strain. Poor posture, repetitive movements, lifting heavy objects, or poorly designed workstations can contribute to ergonomic hazards.
Psychosocial Hazards: Psychosocial hazards involve factors related to the social and psychological aspects of work. They include stress, work-related violence, bullying, harassment, or excessive workload, which can have detrimental effects on mental and emotional well-being.

Physical Hazards

Physical hazards in the workplace are associated with elements that can cause harm due to their physical characteristics. Examples of physical hazards include:

Work at Height: Working at elevated levels without proper fall protection measures.
Vibration: Exposure to excessive vibrations, such as from handheld tools or machinery, leading to musculoskeletal disorders.
Noise: Excessive levels of noise that can result in hearing loss or other hearing-related issues.
Heat: Extreme temperatures in the workplace that can lead to heat stress, heat stroke, or cold stress.
Trip Hazards: Objects or conditions that can cause individuals to trip and fall, such as uneven surfaces or cluttered walkways. (when you trip or slip but do not actually fall is called near miss)
Poor Illumination: Insufficient lighting that can lead to reduced visibility and potential accidents.
Radiation:
a. Non-ionizing radiation:

Ultraviolet radiation: Exposure in welding, metal cutting, or carbon arc can cause skin erythema, burns, and eye-related issues. Protection with special face shields and goggles is necessary.
Infrared radiation: Exposure in front of furnaces, steel mills, or glass industry settings can lead to eye and skin problems. Special goggles can provide complete eye protection.

b. Ionizing radiation: Sources include radioactive isotopes and X-ray machines, posing risks such as increased probabilities of certain cancers and cataracts.

Effects of Physical Hazards on Individuals in the Workplace

1. Extreme temperatures:

Lassitude, irritability, and discomfort.
Reduced work performance and lack of concentration.
Heat rash, heat exhaustion, and heat stroke.

2. Noise pollution: Noise-induced hearing loss.

3. Vibration: Vascular disorders in the arms and bony changes in the wrist bones.

4. Radiation exposure: Increased risks of mutation, certain cancers, and cataracts.

5. Poor illumination: Loss of sight due to poor light adaptation.

6. Atmospheric pressure: Increased pressure underwater can cause aseptic bone necrosis around the knee, hip, and shoulder.

7. Occupational exposure to physical factors (e.g., ionizing radiation) can affect reproductive functions, leading to dysfunction, increased incidence of miscarriage, stillbirth, neonatal death, and defects in newborn babies.

Prevention of Physical Hazards

Controls to reduce the risk of slips, trips, and falls include:

Keeping hallways clear of obstructions.
Using non-slippery surfaces on stairs or at least on the leading edges.
Regular maintenance to keep stairs in good repair, ensuring no protruding objects.
Maintaining proper lighting levels.
Utilizing angular lighting and color contrast to improve depth perception.
Educating workers and enforcing the use of proper footwear.
Promptly cleaning up spills.
Eliminating tripping hazards such as extension cords.
Keeping walkways free of clutter.

Preventing Electrical Hazards Considerations for using extension cords:

Protect cords from damage.
Unplug extension cords when not in use.
Avoid using damaged extension cords.
Never modify extension cord plugs.
Do not chain multiple extension cords together; use a single cord of sufficient length.

Sharp Hazards

Use safety cutters as bag and box openers.
Proper storage and disposal of sharp objects like in safety boxes.

Measures to Control Noise in the Workplace:

Design and maintain machinery to reduce noise levels.
Segregate and disperse noise sources.
Use soundproofing materials for floors, walls, and ceilings.
Rotate workers to minimize exposure.
Reduce work exposure hours.
Provide personal protective devices such as earplugs, earmuffs, and helmets.

Control of Exposure to External Radiation Sources:

Control of exposure to external radiation sources rests on three general principles:

Maintain sufficient distance between the source and workers.
Minimize time of exposure.
Implement containment and shielding measures.

Conduct environmental monitoring and provide alarm systems.
Perform pre-placement and periodic medical examinations with emphasis on eyes, skin, and blood.
Provide personal protective clothing.
Use personal monitoring badges, pocket dosimeters, and whole-body counters.

Chemical Hazards

Chemical hazards are substances that can cause harm due to their chemical composition characteristics. These hazards can exist in the form of gasses or liquids.

Types of Chemical Hazards.

Asphyxiants: These gasses can cause asphyxia by displacing oxygen or by affecting the respiratory tract system.
Irritant gasses: Gasses that can cause irritation or inflammation of the mucous membranes upon contact.
Organo-metallic compounds (e.g., Nickel carbonyl Ni (CO)4): Volatile liquids produced during nickel extraction. Exposure to these compounds can result in hemolysis, anemia, jaundice, and severe cases may lead to anuria.
Anesthetic vapors: Many of these substances have systemic effects and tend to accumulate in low, poorly ventilated spaces.
Metals: Examples include lead, mercury, manganese, and arsenic.
Dust: Fine particles that can be hazardous when inhaled.

Effects of Chemical Hazards

Silicosis: Caused by inhalation of respirable particles of free crystalline silica.
Asbestosis: Resulting from the inhalation of asbestos fibers, a material once widely used in building materials.
Lung cancer: Many chemicals are known to cause lung cancer, including asbestos and some types of silica.
Chronic obstructive pulmonary disease (COPD): This is a group of lung diseases that cause airflow blockage and breathing difficulties.
Asphyxiation: Some chemicals can prevent the body from getting enough oxygen, leading to suffocation.
Systemic intoxication:This is a general poisoning of the body.
Carcinogens: Chemicals that can cause cancer.
Irritation: Some chemicals can irritate the skin, eyes, or respiratory system.
Mutagenicity: Chemicals that can cause mutations (changes) in DNA, which can lead to cancer or other health problems.

Occupational exposure to certain chemicals or physical factors (like ionizing radiation) has been found to have certain effects on reproductive functions:

Dysfunction in males (sterility or defective spermatozoa) and females (anovulation, implantation defects in the uterus)
Increased incidence of miscarriage, stillbirth and neonatal death
Induction of structural and functional defects in newborn babies

Prevention of Chemical Hazards

To prevent chemical hazards, safe work procedures should be implemented:

Limit the worker’s exposure time.
Reduce contact with the hazardous substance through any route of exposure.
Ensure safe disposal of substances and disposable equipment that come into contact with harmful substances.
Ensure safe handling and decontamination of reusable equipment.

Precautions for potential exposure to noxious gasses include:

Ventilation of workplaces.
Provision of gas masks if there is a likelihood of noxious gasses or insufficient oxygen.
Proper training of workers, working in teams with designated observers at a safe distance.
Availability of first aid equipment and trained rescuers.
Prompt removal of affected workers from exposure, providing warmth and rest. Artificial respiration should be administered if breathing stops.

Dust control measures include:

Segregation of dusty jobs.
Enclosure of dusty operations.
General and local exhaust ventilation.
Proper housekeeping and cleanliness.
Use of water for dust suppression.
Personal cleanliness, washing facilities, changing work clothes, separate areas for eating, drinking, and smoking in the case of toxic dust.
Health education.
Pre-placement medical examination.
Use of personal protective equipment.

Mechanical Hazards

Mechanical hazards in the workplace encompass unshielded machinery, unsafe structures, and dangerous, unprotected tools. These factors pose risks to the safety of individuals.

Effects of Mechanical Hazards

Occupational accidents, primarily due to contact with machinery or tools.
Bruises on different parts of the body.
Subcutaneous cellulitis, an infection of the skin and underlying tissues.

Prevention of Mechanical Hazards

Machine Guarding: Install appropriate guards on machinery to protect workers from moving parts, rotating equipment, and other hazardous components.
Safety Training: Provide training programs for employees to educate them about the potential mechanical hazards in their work environment. Train them on safe work practices, proper use of tools and equipment, and the importance of following safety protocols.
Regular Equipment Maintenance: Establish a regular maintenance schedule to inspect and maintain machinery and equipment. This includes checking for wear and tear, loose parts, and any potential hazards. Promptly address any identified issues to prevent accidents.
Personal Protective Equipment (PPE): Ensure that appropriate PPE, such as gloves, safety glasses, hard hats, is provided to workers. Train employees on the correct use and maintenance of PPE and enforce its consistent usage.
Hazard Identification and Risk Assessment: Conduct regular hazard assessments to identify potential mechanical hazards in the workplace.
Safe Work Practices: Establish and enforce safe work practices and standard operating procedures (SOPs) for tasks involving machinery and equipment. These practices should include guidelines for proper use, maintenance, and storage of tools and machinery.
Emergency Preparedness: Develop and communicate emergency procedures in the event of mechanical hazards, such as equipment malfunctions or unexpected incidents. Ensure workers are aware of emergency exits, evacuation routes, and emergency contact information.
Regular Inspections: Conduct routine inspections of work areas to identify potential mechanical hazards. Encourage workers to report any hazards or concerns they observe and address them.
Employee Engagement(Safety Culture): Foster a culture of safety by involving employees in the identification and resolution of mechanical hazards.

Biological Hazards

Biological hazards involve viruses, bacteria, fungi, parasites, or any living organisms capable of causing diseases in humans.

Transmission of Biological Hazards

Inhalation: Breathing in airborne pathogens.
Injection: Entry of pathogens through puncture wounds or contaminated sharps.
Ingestion: Swallowing pathogens through contaminated food, water, or objects.
Contact with the skin: Direct contact with infected materials or surfaces.

Effects of Biological Hazards

Infections: Contracting diseases caused by pathogens.
Diseases: Developing specific illnesses due to exposure to biological hazards.
Reduced productivity at work: Illnesses can result in decreased work performance and absenteeism.
Disability: Severe cases of diseases caused by biological hazards can lead to long-term impairments.

The Contract of Biohazard: The severity of exposure to biological hazards depends on:

The concentration or number of organisms present in the environment.
The virulence of these organisms, which refers to their ability to cause disease.
The susceptibility of the individual to the pathogens.
Concurrent physical or chemical stresses in the environment, which can enhance the effects of biological hazards.

Ergonomic Hazards

Ergonomic hazards refer to the stress and strain placed on the body through posture and movement, such as frequent repetitive handling of small boxes.

Ergonomics, also known as human engineering or human factors, focuses on designing machines, products, and systems to maximize the safety, comfort, and efficiency of the people who use them.

The ergonomics triad emphasizes that for work to be safe and efficient, the worker/human, the task, and the environment should be in harmony. By considering these three elements in combination, ergonomics aims to optimize the interaction between workers and their work settings, which can lead to increased productivity, reduced risk of injuries, and enhanced well-being for employees.

Principles of Ergonomics

There are 10 fundamental principles of ergonomics which are:

1. Work in neutral postures

Proper posture maintenance is necessary
Working too long with “C” curve can cause strain
Keeping the proper alignment of neck hands wrist are also necessary

2. Reduce excessive force

Excessive pressure or force at the joints can cause injury
Better to minimize the work that requires more physical labor

3. Keep everything in reach

Keeping everything in reach would help in avoiding unneeded stretching and strain
More or less this principle is related to maintaining good posture.

4. Work at proper height

Working at right makes things way easier
Sometimes height can be maintained by adding extensions or avoiding extensions on the chair or tables

5. Reduce excessive motions

Repetitive motion needs to be avoided
This can cause disorder and numbness in long run
Motion scan be reduced by the use of power tools

6. Minimize fatigue and static load

Fatigue is common in strenuous work
Having to hold things for longer period is example of static load
Fatigue can be reduced by the intervals and the breaks between the works.

7. Minimize pressure points

One needs to be aware of pressure points
Almost everyone has to sit on chairs that have cushioning, one of the pressure points is behind the knees, which happens if air is too high or when you dangle your legs. Pressure point is also created in between your thigh and the bottom of a table when you sit.
Anti-fatigue mats or insole can be used

8. Provide clearance

Work area should have enough clearance
Let the worker not worry about the bumps that they have to encounter on a daily basis.

9. Move, exercise and stretch

Move and stretch when you can
It better to take intervals between the works and stretch and move along
Stretching technique may differ and depend on the work one does

10. Maintain a comfortable environment

This principle is focused on the other components of the working environment.
It is concerned about lightning, space, cool air and many more.

Causes of Ergonomic Hazards

Many ergonomic problems arise from technological changes or poorly designed job tasks. The following conditions can contribute to ergonomic hazards:

Repetitive Motions: Performing the same motion repeatedly, like typing or using a mouse, can strain muscles, tendons, and nerves.
Awkward Postures: Maintaining uncomfortable positions for extended periods, such as reaching overhead or bending at the waist, can cause muscle imbalances and pain.
Forceful Exertion: Applying excessive force, such as lifting heavy objects or using tools with high resistance, can lead to injuries like muscle strains and tendonitis.
Static Posture: Holding the same position for long periods, like sitting at a desk or standing in one spot, can restrict blood flow and cause discomfort and pain.
Vibration: Exposure to excessive vibration, like from using power tools or operating machinery, can damage nerves, tendons, and bones.
Improper Workstation Design: Workstations that are not properly designed to fit the individual worker’s needs can contribute to many ergonomic hazards. This includes factors like desk height, chair adjustments, and monitor placement.
Poor Lighting: Inadequate or improper lighting can strain the eyes and lead to headaches and fatigue.
Insufficient Work Breaks: Lack of adequate rest breaks allows fatigue to build up, increasing the risk of injury.
Heavy Lifting: Lifting heavy objects improperly or frequently can put strain on the back, shoulders, and knees.
Lack of Training: Employees who are not properly trained on how to perform their tasks safely and ergonomically are more likely to be exposed to hazards.

Repetitive motions or shocks over prolonged periods, such as those involved in jobs like sorting, assembling, and data entry, can lead to irritation and inflammation of the tendon sheath in the hands and arms, known as carpal tunnel syndrome.

Effects of Ergonomic Hazards

Tenosynovitis: This condition affects the tendons and the sheaths that surround them. Repetitive motions, especially those involving the wrist and hand, can cause inflammation and pain within the tendon sheath. This can lead to stiffness, swelling, and difficulty moving the affected area.
Bursitis: This involves inflammation of the bursa, a fluid-filled sac that cushions and lubricates joints. Ergonomic hazards like repetitive motions, awkward postures, and forceful exertion can irritate the bursa, causing pain, swelling, and tenderness.
Carpal Tunnel Syndrome: This condition occurs when the median nerve, which runs through the carpal tunnel in the wrist, is compressed. Repetitive hand movements, awkward postures, and prolonged pressure on the wrist can all contribute to this nerve compression, leading to numbness, tingling, and weakness in the hand and fingers.
Raynaud’s Syndrome (“White Fingers”): This condition affects blood circulation in the fingers, causing them to turn white, then blue, and finally red. Exposure to cold temperatures and vibrations can trigger Raynaud’s syndrome, often seen in workers who operate vibrating tools or work in cold environments.
Back Injuries: Ergonomic hazards like poor posture, heavy lifting, and repetitive bending can strain the muscles, ligaments, and discs in the back. This can lead to pain, stiffness, and even herniated discs.
Muscle Strain: Overusing muscles or straining them through awkward postures can lead to muscle strain, resulting in pain, tenderness, and limited range of motion. This is common in workers who perform repetitive tasks or lift heavy objects improperly.

Prevention of Ergonomic Hazards

To prevent ergonomic hazards, the following control measures should be implemented:

1. Ergonomic Design & Engineering:

Workstation Optimization: Design workstations with adjustable heights, comfortable seating, and proper monitor placement to promote neutral postures and minimize strain.
Equipment Selection: Choose tools, equipment, and furniture that are ergonomically designed to reduce strain and fatigue. This includes computer workstations, chairs, and lifting devices.
User Input: Involve workers in the selection and testing of new equipment to ensure it meets their needs and reduces ergonomic risks.

2. Work Practices & Training:

Proper Lifting Techniques: Provide training on safe lifting techniques to minimize back strain and injuries. Encourage the use of lifting aids for heavy objects.
Task Rotation: Rotate workers among different tasks to avoid prolonged exposure to repetitive motions or static postures.
Work Breaks & Rest: Encourage frequent breaks to stretch and move around, reducing muscle fatigue and stiffness.
Ergonomics Education: Train workers to recognize biomechanical risk factors, understand the signs and symptoms of ergonomic injuries, and implement safe work practices.

3. Administrative Controls:

Work Shift Scheduling: Optimize work schedules to minimize extended work hours and overtime, reducing the risk of fatigue-related injuries.
Workload Management: Ensure workloads are manageable and avoid excessive demands that could lead to ergonomic hazards.
Job Design: Evaluate tasks and consider alternative methods to minimize repetitive motions, awkward postures, and forceful exertions.

4. Personal Protective Equipment:

When Necessary: Provide and mandate the use of personal protective equipment (PPE) when it can help prevent injuries, such as gloves for tasks involving vibrations or hand tools.

5. Continuous Improvement & Monitoring:

Self-Assessments: Provide workers with self-assessment tools to identify potential ergonomic hazards in their work areas.
Regular Reviews: Conduct periodic ergonomic assessments of workplaces, work processes, and equipment to identify areas for improvement.
Incident Reporting: Encourage workers to report any incidents or discomfort related to ergonomic hazards. This data can be used to make adjustments and improve safety.

Ergonomics, or the proper design of work systems based on human factors, offers several advantages, including more efficient operations, fewer accidents, reduced training time, lower operational costs, and more effective use of personnel.

Psychosocial Hazards

Psychosocial hazards are factors in the workplace that can cause psychological stress and strain on individuals.

These hazards have become more prevalent in recent years, with issues such as time pressure, hectic work environments, and the risk of unemployment contributing to psychological stress. Jobs with heavy responsibility, monotonous work, and constant concentration requirements can also have adverse psychological effects.

Types of Psychosocial Hazards

Poor vocational guidance: Lack of clear career paths, training opportunities, or support for professional development can lead to frustration and demotivation.
Poor arrangement of working hours: Inconsistent or unpredictable schedules can disrupt sleep patterns and contribute to work-life imbalances.
Poor job design and work methods: Repetitive, monotonous tasks, lack of autonomy, and unclear job responsibilities can contribute to burnout and dissatisfaction.
Poor management: Lack of support, unclear expectations, ineffective communication, and inconsistent leadership styles can create a stressful and toxic work environment.
Abusive patients: Exposure to aggressive or abusive patients can lead to emotional distress and stress for healthcare workers.
Long working hours: Excessive work hours without adequate breaks can lead to fatigue, stress, and burnout
Sexual harassment: Unwanted sexual advances, requests for sexual favors, or other verbal or physical harassment based on sex can create a hostile work environment.
Workplace violence: Threats, harassment, or physical violence in the workplace can create a climate of fear and anxiety.
Unfriendly work shifts: Such as chronic night duties can lead to stress.
Technostress: The constant pressure to keep up with new technologies, manage a growing volume of information, and remain connected can lead to stress and burnout
Substance abuse as a response to excessive workplace stressors
Work-Life Conflict: Balancing work demands with family responsibilities and personal commitments can lead to stress and anxiety.
Exposure to Stressors: Noise, poor air quality, and other environmental factors can contribute to stress and affect mental well-being.
Exposure to poor indoor air quality that induces stress

Control Strategies for Psychosocial Hazards Work Shift Issues

Engage workers in the design and planning of shift schedules.
Avoid scheduling demanding, dangerous, or monotonous tasks during the night shift, especially during early morning hours when alertness is lowest.
Limit permanent night shifts and offer a choice between permanent and rotating shifts.
Use forward-rotating schedules for rotating shifts when possible.
Arrange shift start/end times to correspond to public transportation or provide transport for workers on specific shifts.
Limit shifts to a maximum of 12 hours (including overtime) and consider the needs of vulnerable workers.
Limit night shifts to 8 hours for demanding, dangerous, or monotonous work.
Encourage regular breaks away from the workstation and discourage saving up break time for the end of the workday.
Limit consecutive working days to a maximum of 5-7 days.
Limit consecutive shifts to 2-3 days for long work shifts, night shifts, and shifts with early morning starts.
Design shift schedules to ensure adequate rest time between successive shifts.
Provide a minimum of 2 nights’ full sleep when switching from day to night shifts.
Incorporate regular free weekends into the shift schedule.

Technostress (Stress Resulting from New Technologies)

Select user-friendly technology.
Involve workers in technology selection, trial, and implementation, and gather feedback on its use.
Provide sufficient training to ensure workers feel confident and competent in using the technology.

Work-Life Balance and Reduction of Excessive Workloads

Offer flexible time arrangements, such as alternative work schedules, compressed work weeks, reduced hours/part-time work, and phased retirement.
Allow flexible work locations through telecommuting and satellite offices.
Implement flexible job design through job redesign and job sharing.
Provide wellness programs.
Offer flexible benefits including paid and unpaid leaves for maternity, parental care, education, and sabbatical.
Support employer-sponsored childcare and eldercare services.

Workplace Violence

Establish management policies and procedures with a zero-tolerance approach to violence or abuse.
Provide worker education on violence awareness, avoidance, and de-escalation procedures.
Establish liaison and response protocols with local police.
Enable workers to request support.
Offer counseling services.

Work-Related Stress

Provide training to increase awareness of signs and symptoms of critical incident stress.
Establish a critical incident stress team to respond to incidents, with clear communication and call procedures.

Work-Related Substance Abuse

Provide problem-solving resources and support for workers.
Involve workers in the development of substance abuse policies and procedures.
Educate workers about substance abuse.
Implement procedures to limit individual access to narcotics.
Offer counseling services and return-to-work plans.

Conditions Likely to Be Sources of Workplace Hazards

Ensure proper access routes, such as ramps.
Address hazardous tasks in the workplace, such as repetitive lifting of patients.
Ensure correct installation and use of equipment/machines.
Maintain and repair equipment adequately.
Address exposure to hazardous substances, such as blood and other body fluids.

The Epidemiologic Triangle

The Epidemiologic Triangle is a model that helps us understand infectious diseases. It has three parts:

Agent: The microbe that causes the disease.
Host: The organism that is infected with the disease.
Environment: The surroundings that allow the disease to spread.

Agent

The agent is the cause of the disease. When studying the epidemiology of most infectious diseases, the agent is a microbe—an organism too small to be seen with the naked eye. Disease-causing microbes are bacteria, viruses, fungi, and protozoa (a type of parasite).

Bacteria: Single-celled organisms that can reproduce themselves.
Viruses: Tiny particles that contain genetic material but cannot reproduce on their own.
Fungi: Multicellular organisms that live off other organisms.
Protozoa: Single-celled organisms that live off other organisms.

Host

The host is the organism that is infected with the disease. The host can be a human, animal, or insect. The host’s immune system plays a role in determining whether or not the disease will develop.

Environment

The environment includes the physical surroundings, such as temperature and humidity, as well as the presence of other organisms. The environment can also play a role in the spread of disease. For example, mosquitoes can transmit malaria, and contaminated water can transmit cholera.

Conclusion

The Epidemiologic Triangle is a useful tool for understanding how infectious diseases spread. By understanding the three parts of the triangle, we can better prevent the spread of disease.

Here are some additional points to consider:

The Epidemiologic Triangle can be used to understand a variety of infectious diseases.
The three parts of the triangle are interconnected.
By breaking one of the links in the triangle, we can help to prevent the spread of disease.

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Occupational Health and Safety

OCCUPATIONAL HEALTH AND SAFETY

Occupational health is an area of work in public health to promote and maintain the highest degree of physical, mental and social well-being of workers in all occupations. According to WHO

Occupational health is also defined as the overall well-being—physically, mentally, and socially—of individuals in relation to their work and working environment.

Occupational Health and Safety: This discipline is dedicated to preventing workers from contracting diseases or sustaining injuries as a result of their work. According to the World Health Organization (WHO, 1995), occupational safety and health encompass the following multidisciplinary activities:

Protection and promotion of workers’ health by eliminating hazardous occupational factors and conditions that pose risks to their well-being and safety at work.
Enhancement of workers’ physical, mental, and social well-being, supporting the development and maintenance of their working capacity, as well as their professional and social growth within their work environment.
Development and promotion of sustainable work environments and organizations.

Occupational health is also defined as the overall well-being—physically, mentally, and socially—of individuals in relation to their work and working environment.

It involves both the individual’s adjustment to work and the adaptation of work to the individual (Forsman, 1976). The WHO defines occupational health as the “promotion and maintenance of the highest degree of physical, mental, and social well-being of workers in all occupations.” Furthermore, the WHO considers occupational health services responsible for the well-being of workers and, whenever possible, their families as well.

Definition of Terms

Occupational Epidemiology: This field focuses on studying the occurrence of diseases in relation to work-related factors.
Occupational Biostatistics: It serves as a vital tool for quantitatively studying morbidity and mortality in humans, particularly in relation to workplace exposure.
Ergonomics: This discipline involves tailoring the job to fit the workers, encompassing the design of machines, tools, equipment, work layouts, methods, and environments. Its objective is to enhance human efficiency and well-being, thereby reducing industrial accidents and improving overall worker health and productivity.
Risk Assessment: The process of identifying and evaluating potential risks and hazards in the workplace to determine appropriate preventive measures. Example: Conducting a risk assessment to identify potential hazards associated with a chemical substance used in a laboratory.
Hazard Control: Implementing measures to eliminate or minimize workplace hazards and reduce the risk of accidents or injuries. Example: Installing safety guards on machinery to prevent workers from coming into contact with moving parts.
Personal Protective Equipment (PPE): Equipment worn by workers to protect themselves from potential workplace hazards. Example: Safety goggles, gloves, and helmets used to protect workers from eye injuries, hand injuries, or head injuries.
Safety Training: Providing education and training to workers on occupational health and safety practices, procedures, and emergency protocols. Example: Conducting regular safety training sessions to ensure workers are aware of fire evacuation procedures and know how to respond in an emergency.
Incident Investigation: The process of examining workplace incidents, accidents, or near-miss events to identify their causes and implement corrective measures to prevent future occurrences. Example: Investigating a workplace fall to determine whether it was caused by inadequate safety measures or improper equipment usage.
Workplace Ergonomics: Designing and arranging workspaces, equipment, and tasks to fit the capabilities and limitations of the workers, promoting comfort, safety, and efficiency. Example: Adjusting the height and position of computer monitors to reduce neck strain and prevent musculoskeletal disorders.
Safety Culture: The shared values, beliefs, attitudes, and behaviors regarding workplace safety within an organization. Example: Encouraging open communication about safety concerns, recognizing and rewarding safe practices, and fostering a proactive approach to safety among employees.

Aims/Objectives of Occupational Safety and Health

Promoting and maintaining the highest level of physical, mental, and social well-being for workers in all occupations. Example: Ensuring that workers have a safe and healthy work environment that contributes to their overall well-being.
Preventing workers from being affected by harmful working conditions that can negatively impact their health. Example: Implementing measures to protect workers from exposure to hazardous substances or dangerous equipment.
Protecting workers from work-related risks and hazards that may arise in their employment. Example: Establishing safety protocols and providing personal protective equipment (PPE) to minimize workplace accidents and injuries.
Creating and maintaining an occupational environment that is tailored to meet workers’ physiological and psychological needs. Example: Adapting workstations to ergonomic standards to prevent musculoskeletal disorders and promote comfort.
Ensuring that work is adjusted to suit individuals and that individuals are well-suited for their jobs. Example: Assigning tasks that match workers’ skills and capabilities, allowing them to perform their duties effectively and safely.

Alice’s First Day at Nurses Revision Hospital

Alice was happy to start her new job as a nurse at Nurses Revision Hospital. She was healthy and excited about her new role.

Promoting and Maintaining Well-Being: When Alice arrived, she noticed the hospital had a welcoming environment. The management prioritized the well-being of all employees. They ensured everyone had regular health check-ups, access to mental health resources, and social activities to foster a supportive community.

Preventing Harmful Conditions: On her first day, Alice attended a training session where she learned about the importance of preventing harmful working conditions. The hospital had strict protocols to protect staff from exposure to hazardous substances, such as proper handling of chemicals and safe disposal of medical waste.

Protecting from Risks and Hazards: Alice was provided with personal protective equipment (PPE), including gloves, masks, and gowns, to protect her from potential risks and hazards. The hospital also had safety protocols in place, like emergency evacuation plans and regular fire drills, to ensure everyone knew how to respond in case of an incident.

Creating an Enabling Environment: Alice’s workstation was ergonomically designed. She had a comfortable chair, a properly adjusted computer screen, and a supportive mat to stand on. This setup helped prevent musculoskeletal disorders and promoted her comfort while working long shifts.

Adjusting Work to Suit Individuals: The hospital management made sure that Alice’s tasks matched her skills and capabilities. They provided continuous training to help her develop her skills and assigned her tasks she was confident in handling. This approach ensured that Alice could perform her duties effectively and safely.

Principles of Occupational Health and Safety

Protecting and promoting workers’ health by preventing and controlling occupational diseases and accidents and eliminating hazardous factors and conditions at work. Example: Implementing safety protocols and providing training to prevent accidents, as well as monitoring and addressing any potential occupational health hazards.
Developing and promoting healthy and safe work environments and organizations by adapting working conditions to meet the needs of workers. Example: Modifying workplace layouts or processes to reduce physical strain and improve worker well-being.
Enhancing workers’ physical, mental, and social well-being, supporting their professional and social development, and maintaining their capacity to work. Example: Offering health and wellness programs, promoting work-life balance, and providing opportunities for skill development and career growth.
Enabling workers to lead productive lives and contribute to sustainable development. Example: Supporting initiatives that foster a healthy work-life balance, job satisfaction, and employee engagement, which ultimately benefits both individuals and the organization.
Providing curative and rehabilitative services to address any health issues or injuries that may occur in the workplace. Example: Offering medical treatment, rehabilitation programs, and support for workers who experience work-related injuries or illnesses.
Ensuring immediate response through first aid and emergency measures for victims. Example: Establishing protocols for first aid training and having emergency response systems in place to provide prompt medical assistance when accidents occur.

Components of Occupational Health and Safety in the Workplace

Availability of Regulations: Have occupational health and safety regulations within the workplace to ensure compliance and worker safety.
Safety Committee: Establishing an active and effective occupational health and safety committee to address and manage safety concerns and initiatives.
Hazard Control: Monitoring and managing workplace hazards to prevent potential health risks for employees.
Hygiene Maintenance: Overseeing cleanliness and sanitation facilities to maintain worker health and well-being.
Protective Device Standards: Regularly inspecting the health and safety standards of protective devices used in the workplace to ensure they meet requirements.
Health Examinations: Conducting various health assessments, including pre-employment, periodic, and special health examinations for workers.
Ergonomics: Tailoring work conditions to accommodate individual needs and enhance worker well-being.
First Aid Services: Providing access to first aid services to address injuries and illnesses promptly.
Training and Education: Offering health education and safety training to workers to increase awareness and knowledge.
Incident Reporting: Reporting incidents such as occupational deaths, diseases, injuries, disabilities, hazards, and their prevention measures to enhance workplace safety and prevent future occurrences.

Elements of the work

The worker: The individual who performs the work or job e.g. a health worker
The tool: The machine the person doing a job uses e.g. injection syringe
The process: The steps the person who does a job takes to do the job e.g. steps of administering an IM injection.
The work environment: The place or situation in which a person who does the work lives in e.g. hospital, health care place.

The elements of work encompass the worker, the tool they utilize, the process they follow to perform the job, and the work environment they operate within. For example, a health worker (the worker) administers an intramuscular injection using an injection syringe (the tool) by following a specific set of steps (the process), typically in a hospital or healthcare facility (the work environment).

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Ethics in Research

Research Ethics

Ethics refers to the discipline of distinguishing between what is good and bad, involving moral duty and obligation.

It encompasses a set of moral principles or values that guide behavior and conduct.
Ethics establishes the principle of conduct governing individuals or groups.
In research, ethics provides guidelines for the responsible conduct of biomedical research. It ensures that research is conducted in an ethical manner, with a focus on protecting the welfare and rights of research participants. In addition, research ethics educates and monitors scientists conducting research to ensure a high ethical standard.

History of Research ethics

The development of modern research ethics began from the need to protect human subjects involved in research projects.
The first significant attempt to establish regulations occurred during the Doctors Trial of 1946-1947 in Germany, which took place after World War II.
The Doctors Trial was part of the Nuremberg Trials for Nazi war criminals, where the accused violated basic ethical principles.
The Nuremberg Code emerged from this trial and comprised ten ethical guidelines that emphasized the importance of voluntary consent, societal benefits, scientific basis, avoidance of unnecessary suffering, and the prohibition of research with potential harm or death as outcomes.
The Nuremberg Guidelines laid the foundation for subsequent initiatives, such as the Helsinki Declaration, which aimed to promote responsible research with human subjects.
Another significant document is The Belmont Report, published in 1978 by the U.S. National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research, which further defined ethical principles in research.

The Nuremberg Code consisted of ten basic ethical principles that the accused violated.

The 10 guidelines were as follows

Research participants must voluntarily consent to research participation
Research aims should contribute to the good of society
Research must be based on sound theory and prior animal testing
Research must avoid unnecessary physical and mental suffering
No research projects can go forward where serious injury and/or death are potential outcomes
The degree of risk taken with research participants cannot exceed anticipated benefits of results
Proper environment and protection for participants is necessary
Experiments can be conducted only by scientifically qualified persons
Human subjects must be allowed to discontinue their participation at any time
Scientists must be prepared to terminate the experiment if there is cause to believe that continuation will be harmful or result in injury or death.

Why study research ethics

Studying research ethics is a reflection of respect for individuals who participate in research studies.
It ensures that researchers do not make unreasonable, unsafe, or thoughtless demands on participants.
Research ethics ensures the sharing of sufficient knowledge among all concerned parties.
It establishes a common standard for ethical conduct, which has become the norm and an expectation in research activities.
Research ethics is a professional requirement in disciplines like nursing.
It is also necessary for accessing participants in health-related research.

Major concerns in research ethics

PLAGIARISM

Plagiarism is the act of passing off somebody else’s ideas, thoughts, pictures, theories, words, or stories as your own.

If a researcher plagiarizes the work of others, they are bringing into question the integrity, ethics, and trustworthiness of their research.

Forms of plagiarism

Intentionally taking a passage word-for-word without proper credit
Unintentionally (or simply lazy) paraphrased and fragmented texts the author has pieced together from several works without properly citing the original sources
NOTE: No form of plagiarism is tolerated by the scientific community, including unintentional plagiarism.

How to handle plagiarism:

- Cite all ideas and information that are not your own and / or is not common knowledge.
- Use quotation marks when using someone else’s words.
- Clearly indicate the origin of paraphrased sections and provide proper citations.
- At the beginning of a paraphrased section, show that what comes next is someone else’s original idea (example: these bullet points start out by saying the information originated ……….),
- At the end of a paraphrased section, place the proper citation

AUTHORSHIP

Authorship is the process of deciding whose names belong on a research paper.

Research often involves collaboration and assistance between experts and colleagues.
Responsible authorship practices require acknowledging contributions and determining joint authorship when necessary, therefore responsible authorship practices are an important part of research.

How is authorship is achieved

Authorship credit should be based only on

1. substantial contributions to conception and design, or acquisition of data, or analysis and interpretation of data;
2. drafting the article or revising it critically for important intellectual content; and
3. final approval of the version to be published.
4. Conditions 1, 2, and 3 must all be met.
5. Acquisition of funding, data collection, or general supervision of the group alone does not justify authorship.

“Can I be a co-author?”

“Sure! But only if you…

Contribute substantially to the research, AND…
Write or revise all or part of the manuscript, AND…
Approve the final version of the entire article.”

Co-authorship requires substantial contribution to the research, writing or revising the manuscript, and approval of the final version.

RESEARCH MISCONDUCT

Research misconduct is the process of identifying and reporting unethical or unsound research.

Research misconduct is defined as fabrication, falsification, or plagiarism in proposing, performing, or reviewing research, or in reporting research results.

Fabrication is making up or recording false data or results.
Falsification is manipulating research materials, equipment, processes, or omitting data to misrepresent the research.
Plagiarism is appropriating another person’s ideas, processes, results, or words without giving appropriate credit.

Research misconduct does not include honest error or differences of opinion.

General ethical principles

Research with human subjects involves various ethical considerations relevant to nursing practice. Understanding and applying the following principles is crucial for conducting ethical research in Uganda:

Respect for Persons
- Individuals have the right to make autonomous decisions, and their choices should be respected.
- People who cannot make autonomous decisions should receive appropriate protection.
- Voluntary subjects should receive adequate information for decision-making.
- Example: In a study on informed consent for pediatric patients, nurses must ensure that parents or guardians understand the research purpose, potential risks, benefits, and their right to withdraw their child from participation.
Informed Consent
- Informed consent ensures that research participants have a clear understanding of the research and voluntarily agree to participate.
- Information provided to participants should be comprehensive, understandable, and adapted to their abilities and language needs.
- Participants should not be coerced or manipulated into participating.
- Example: Before conducting a study on elderly patients’ experiences with pain management, nurses must explain the study purpose, procedures, potential benefits, and risks to the participants, allowing them to make an informed decision to participate or not.
- Requirements for Informed Consent
- 1. When obtaining informed consent from research participants, the information disclosed should include:
  1. Research procedure,
  2. Purpose of the research,
  3. Risks and anticipated benefits associated with participation,
  4. Alternative procedures (especially in therapeutic research),
  5. A statement providing the opportunity for participants to ask questions and withdraw from the research at any time.
  2. Comprehension: To ensure comprehension, researchers must adapt the information to be understandable for every participant. This requires considering factors such as:
  1. Different abilities,
  2. Intelligence levels,
  3. Maturity,
  4. Language needs.
  3. Voluntariness: , informed consent must be voluntary and free from coercion or improper pressure. Participants should have the freedom to make their own decision regarding participation.
Privacy and Confidentiality
- Privacy and confidentiality are vital in research to protect participants’ sensitive information.
- Participants have the right to control and keep private information about themselves.
- Researchers must ensure that data collected during research participation are anonymized and stored securely.
- Example: In a study on mental health stigma, nurses must guarantee that participants’ identities and personal information are kept confidential to protect their privacy and prevent potential harm.
Beneficence
- Beneficence is a principle used frequently in research ethics. It means, “doing good”
- Beneficence means maximizing potential benefits and minimizing potential harm to research participants.
- Researchers should strive to conduct studies that offer a favorable balance of potential benefits and risks.
- Participants should not be subjected to unnecessary risks or harm beyond what is necessary for the research.
- Be prepared to cease research if it is causing harm, and never put participants at a level of risk disproportionate to the anticipated benefits.
- Example: When conducting a study on the effectiveness of a new nursing intervention for wound care, nurses should ensure that the potential benefits outweigh any potential discomfort or inconvenience experienced by the participants.
Justice
- This principle means treating people with “fairness”
- This principle aims at preventing the overburdening of some populations in order to apply research findings to other groups.
- Researchers should avoid overburdening vulnerable populations and ensure equitable access to research opportunities.
- Examples of vulnerable populations in nursing research may include marginalized communities, children, pregnant women, or individuals with mental health conditions.
- Example: When conducting a study on healthcare access in rural areas, nurses should ensure that participants from underserved communities have an equal opportunity to participate and benefit from the research findings.
- Another Example: let’s consider a research study on the effectiveness of a new medication for managing a chronic disease. To uphold the principle of fairness, the study should aim to include a diverse population that represents various demographic groups. This ensures that the research findings can be applied to a wide range of individuals who may benefit from the medication, without excluding or disproportionately burdening any specific group.
  Like a drug should be tested on pregnant mothers, elderly, so that when it is out, both groups can benefit from it, not carrying out research on only the elderly and yet even pregnant mothers would benefit from it.

The Institutional Review Board (IRB)

These are bodies mandated by state, institutions and organizations to review research proposals in which there are human participants to ensure ethical research. Also called Research and Ethics committees(REC). In Uganda, researchers, including nursing students, should engage with the Research and Ethics committees(REC) to ensure ethical research practices, and prominent institutions in Uganda have Institutional based Research Ethics Committees e.g. The Uganda Christian University REC(UCU-REC), Mengo Hospital-REC, e.t.c.

The IRB is a mandated body that reviews research proposals involving human participants to ensure ethical standards are met.
The roles of the IRB include balancing potential risks and benefits,
protecting participants from unnecessary harm,
offering proportional compensation, and
ensuring the research is conducted by qualified scientists.
The IRB also ensures that informed consent and other research-related documents are readable, understandable, and promote voluntary participation.
Example: As nursing students, when planning a research study involving human participants, it is important to submit the research proposal to the IRB for review and obtain ethical clearance before commencing the study. This ensures that the study adheres to ethical principles and safeguards the welfare of the participants.

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Gender Based Violence (GBV)

Gender based violence is any act that results in physical, sexual or psychological harm or suffering to women, men and children

Key terms related to Gender-based Violence

Gender;

This refers to the social and cultural construct of the roles, responsibilities, characteristics, opportunities, privileges, status and access to and control over resources and benefits between men and women, boys and girls in a given society.

Men and female are sex categories while masculine feminine are gender Aspect of sex will not vary substantially between different human societies while aspect of gender will vary greatly.

Example of gender characteristics

In developed countries women earn significantly less money than men for similar work.
In many society, many more men smoke tobacco than women as female smoking has not traditionally been considered appropriate.
In some countries, men are allowed to drive while women don’t.

2. Gender-based violence;

This is any act that results in physical, sexual or psychological harm or suffering to women, men and children. It also includes threats of such acts; coercion and deprivations of liberty whether occurring in public or in private life.

3. Violence against women;

Refers to any act of gender-based violence that results in or is likely in physical, sexual and psychological harm to women and girls whether occurring in private or in public. Violence against women is a form of gender-based violence and includes sexual violence.

4. Sexual violence, exploitation and abuse.

This refers to any act, attempt or threat of sexual nature.

5. Gender equality

This is the state or condition that awards men and women equal engagement of human rights, socially valued goods, opportunities and resources.

6. Gender blind

Refers to a policy or plan that is silent on relevant gender issues

7. Gender responsiveness

This is a policy or plan with actionable strategy that seeks to reduce inequality and ensures equal distribution of the benefits associated with a particular service.

8. Sexual and gender-based violence is a serious form of discrimination, particularly against women and children and as such contravenes the principle of no It is both a public health problem and a human right issue.

9. Sex

It’s defined as biological characteristics of male and females. The characteristics are congenital and their differences are limited to physiological reproductive functions.

10. Violence

This is any act that causes injury, harm, intimidation, fear, damage or humiliation to s person. It is a mean of control and oppression that can include emotional, social and economic force or pressure as physical harms. Examples like; threatening someone with a weapon, intimidation, physical assaults etc. The person targeted by this kind of violence is to behave as expected or act against his/her will out of fear.

11. Sex typing

This refers to the differential treatment for people according to their biological sex.

12. Gender equity

This is when women and men, boys and girls have equal opportunities of receiving services which are equally accessible to all.

13. Gender sensitive

This refers to being aware that women and men perform different roles and have different needs which must be planed for accordingly.

14. Gender neutrality

This refers to planning for men and women as if they are homogenous i.e. without taking consideration of their different needs and roles. Such programs are usually not effective because they fail to response to gender specific needs of individual. Treatment care and services do not favor women and men e.g. women to be examined by male and vice versa.

15. Gender roles

These are the different task and responsibilities that society, defines and allocates to women and men, girls and boys. They are not necessarily determined by their biological make up and therefore change according to situation, time and society.

16. Coercion;

This is forcing or attempting to force another person to engage in behavior against this/her will by using threats, verbal insistence, manipulation, deception, cultural expectations or economic power.

17. Sexual preference/orientation

This refers to a person’s preference for the same or opposite partner e.g. homosexual, heterosexual.

18. Gender role stereotype

This is socially determining model which contain the cultural beliefs about what gender role should be.

Examples

– Girls should be obedience and cute, and allow to cry while boys are expected to be brave. However, women are better house keeper and boys strong, good at machinery similarly, boys are better at mathematics and girls are good at language differs from gender role in that it tends to be the way people fill adult others should behave.

Forms of violence in Uganda

Domestic violence such as wife battering, oppression, intimidation
Sexual abuse g. Rape, defilement and incest.
Harmful cultural practices like female genital mutilation and widow
Forced marriages: Girl children are married off early for economic purposes in form of bride Others are married off early because the girl child culturally is destined for marriage instead of advancing in education.
Others;
- Sexual harassment and intimidation at work places, religious institutions and schools
- Coercion or arbitrary deprivation of
- Belief in large families
- Men having forced sex with
- Violence perpetrated or condoned by the

Setting where Gender-based violence can occur

Family; i.e. battering of women, sexual abuse of children and incest
Community; sexual abuse, sexual harassment and intimidation, trafficking and forced prostitution
State; poorly drafted or unenforceable laws, presence of law enforcement agents who violate people, lack of facilities and education for prevention and treatment of people exposed to violence.

Predisposing factors of sexual and gender violence

Low socio- economic status (topical) in the Women‘s low status in the community and their dependence on men to make decisions increase inequality and vulnerability to violence.
Infertility leading to the husbands and relatives blaming, battering or abandoning wife for this inability.
Fear of reporting because the perpetuators are not reprimanded and can easily come back to revenge.
Cultural definitions of gender roles e.g. Girls are made to fetch water, fire wood, cultivate and cook for the family. It is through execution of these duties that they meet men who defile them or boys grow up not knowing that they can help in performing some of the activities like cooking, washing utensils, clothes etc.
Some cultural practices like female genital mutilation, promoting early marriages of the girl child so as to earn bride pride for financial gains.
Physical and mental disabilities leading to rejection, discrimination and stigmatization. For instance people with blindness, deafness,
Ill health especially from HIV/AIDS.
Poverty making parents to force their daughters to be defiled or married so as to get some money as compensation.
Idleness and redundancy leading to over consumption of alcohol, drug abuse e.t.c.
Abduction of children exposing them to rape, defilement and assaults.
Land wrangles especially after a loss of a husband; the wife is denied ownership of property.
Conflict and camp environment resulting in congestion and loss of good morals.
Poor role modeling for boys and girls

Risk groups for Sexual Gender-based Violence

All children and women
Adolescents
Displaced persons including refugees
People with disabilities
Prisoners
Men in particular as they fear reporting acts of violence because they fear being embarrassed.
Pregnant mothers

Reasons for staying in an abusive relationship

Hope for change
Total love to the partner
Fear of losing the marriage
Purpose of the children
Shame
Poverty- fear of returning the bride price
Security purpose

Characteristics of those who are abused

They believe that violence give them immediate result
They are insecure, extremely jealous and possessive
They are emotionally dependent on other partner
They deny that their action are violence
They have poor impulse control

Impacts of Sexual Gender-based Violence

These may be physical and or psychological

Various forms of injury, physical, mental and psychosocial to the body of the victim/survivor.
Reduced quality of life and low self esteem
Sexually transmitted infections including HIV/AIDS
Unwanted pregnancies resulting into unsafe abortion which can result in the lifelong health effects and death/suicide
Poverty and loss of means of livelihood
School dropout and unknown paternity of children
Psychological and behavioral problems in children
Rejection of survivors by society/stigmatization
Divorce
Child neglect
Loss of friends
Spiritual shame
Prostitution
Alcoholism
Early marriage
Suicidal attempt and ideation

8Ways through which Sexual Gender-based Violence can be reduced in Uganda

Sexual and gender-based violence should be recognized as an important public health matter. Therefore, everyone in the community can contribute tremendously to reducing the acts of sexual gender-based violence by actively doing the following:

Leaders should spearhead sensitization of communities on the impacts of sexual gender-based violence throughout the country.
Reporting all acts of violence to the health centers, police, and other relevant authorities.
Ensuring that those who commit these acts are punished appropriately.
Some of the current measures to punish the perpetrators should be revised and made stronger to deter people from committing acts of violence.
Communities should be encouraged to stop the culture of silence which hampers victims from reporting fearing the repercussions e.g. imprisonment and stigmatization.
Advocacy to reduce sexual and gender-based violence must be intensified at all levels.
Review the legal systems to improve the court relationship between the legal officers and the victims.
Improve the relationship between the legal and other practitioners during court session.
Health workers should be supported to undertake their roles to manage and care for survivors of Sexual Gender-based Violence.

Roles of leaders on SGBV in their community

The following ways can be used by leaders to fight Sexual Gender-based Violence by:

Speaking out against Sexual Gender-based Violence at every opportunity for instance during community meetings, campaigns, fundraising, funerals, drinking places.
Leaders should strive to act as role models by avoiding being perpetrators of SGBV.
Assisting victims to get help and to see that the culprits such as defilers, rapists, men who batter their wives are reported to the police and punished appropriately.
Leaders can form counseling groups to help men, children and women who are perpetrators of Sexual Gender-based Violence.

Control and prevention of Sexual Gender-based Violence

Improve girl child education at all level.
Reducing the high level of poor socio-economic status will in long run reduce women vulnerability to violence.
Increasing awareness of women‘s rights and responsibilities related to owning property and assets.
Reviewing and amending laws that safeguard women‘s rights.
Strengthening nationwide/community wide efforts to challenge the widespread tolerance and acceptance of violence against women.
Encouraging parents to bring up children who respect the rights of individuals as men or women, boys or girls
Supporting parents to bring up their boys and girls as equal partners

Reasons why the community and leaders be concerned about SGBV

Damages social bonds if women and girl who are sexually abused isolate themselves or are isolated by their families and communities.
Places a substantial health burden on the health care Example, victims often present with vague complaints that are difficult to diagnose and to treat.
Brings economic loss to households and communities when victims of Sexual Gender-based Violence due to physical injury or emotional stress are unable to undertake their roles in the households and the workplace (in many Uganda villages, women are among the key bread winners in their homes).
Bring a legacy of bitterness especially in conflict situation towards the group from which the perpetrators came. This will have a negative long term impacts on reconciliation and community reconstruction.

Roles of health workers in managing victims and addressing gender-based violence

This is important to note that health workers play instrumental roles in ensuring that families and victims of gender-based violence are professionally attended and see that the victims get justice. Therefore, the following cited are some of roles of health worker in gender-based violence management;

Offering psychosocial support and counseling services to the affected families and individuals.
Liaising with people and other stakeholders to see that the perpetrator (culprits) is brought to book to prevent possibility of reoccurrences.
Collecting victim‘s medical information and performing required medical examination to promote continuity of care.
Creating a friendly and confidential environment (shelter) where victims needs are addressed.
Offering timely and appropriate referral services as needed.
Establishing and promoting strict reporting of all gender-based violence related cases to responsible authority and ensure victims get fair justice.
Ensuring and maintaining constant follow-up care of all affected families or victims.

Sources of help for victims of SGBV

Police
Probation officers
Child and family protection unit.
Local leaders/elders
Trusted person or family members
Counselors etc

Note: In some African cultures, beating a woman or girls is part of the disciplining process; in fact some women even willingly accept to be beaten

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