OCCUPATIONAL HEALTH

promotion

and maintenance of the highest

degree of physical, mental and social well-being
of workers in all occupations,

 the

prevention among workers of departures from

health caused by their working condition;

 the

protection of workers in their employment

from risks resulting from factors adverse to
health;

 placing

and maintenance of the worker in an

occupational environment adapted to his
physiological and psychological

to summarize,
the adaptation of work to man and of each man to
work.

 Occupational

health nurse
She functions independently and
caries the responsibility for the administration of
the occupational health programmes

 American

Association of Occupational Health

Nurse (AAOHN, 1999), occupational health
nursing means the specialty practice

 It

is an autonomous specialty, and nurses make

independent nursing judgments in providing
health care.

The components of the

occupational health nursing are:
To carry

on a significant, positive health

programmes
To provide therapeutic care for the worker;
To establish meaningful interpersonal relationship
To ensure that nursing activities are compatible

Objectives of occupational health

Function of occupational health

Plans

and develops nursing care

Research to improve delivery of nursing services.

Principles of occupational
health
occupational

safety and health.

interdisciplinary team effort.
qualified, professional personnel,
Quality of work environment
Workers participation
Occupational health & community health, they are
interrelated and independent.

Scope of Services: Occupational

Health Programme
Health/medical

surveillance
Workplace monitoring/surveillance
Health assessments

Scope of Services: Occupational

Health Programme
Health assessments
Preplacement
Periodic, mandatory, voluntary
Transfer
Retirement/termination
Executive
Return to work

Scope of Services: Occupational

Health Programme
Health

promotion
Health screening
Employee assistance programs
Case management
Primary health care for workers and dependents

Legislation related to occupational health

The

Factories Act, 1948

The Employees State Insurance Act, 1948
The Workmans Compensation Act, 1923
The Maternity Benefit Act, 1961
The Atomic Energy Act, 1973
The Fatal Accident Act, 1855
The Personal Injuries (Compensation Act), 1963
The Biomedical Waste (Management and Handing)
Rules, 1988

Legislation related to occupational health

The

Mines Act, 1952

The Plantation Labour Act, 1951
The Motor Transport Worker Act, 1961
The Shops and Commercial Establishment Act (State
Act)
The Employment of Children Act, 1938
The Bids and Cigar Workers (Condition of
employment) Act, 1966

The Occupational Health Team

ERGONOMICS
The term ergonomics is derived from the Greek
ergon, meaning work and
nomos, meaning law.
It simply means: fitting the job to the worker.

 designing

of machines, tools, equipment and

manufacturing processes,
lay-out of the places of work,
methods of work and environment
For-greater efficiency of both man and machine.

to achieve the best mutual adjustment of man and

his work, for the improvement of human efficiency
and well-being.
reducing industrial accidents and
to the overall health and efficiency of the workers.

What to do?
Warm

up and stretch before activities

Take frequent breaks
Recognize early signs
Maintain erect position
Keep feet flat on floor, upper body weight resting on
sits bones
Avoid bending neck forward for prolonged
Avoid repetitive or prolonged grip activities.

 Use

the largest joints & muscles to do the job

Use 2 hands to lift rather than one
Slide or push and pull objects instead of lifting

OCCUPATIONAL ENVIRONMENT

OCCUPATIONAL HAZARDS

 Physical

hazards:
radiation,
electricity,
extreme temperatures, and
noise

 Chemical

hazards:
medications,
solutions,
gases,
vapors,
aerosols, and
particulate matter

 Biological
bacteria,
viruses,
fungi,

or
parasites

and infectious hazards:

 mechanical

hazards:

accidents,
injuries,
strain,

or
unsafe/inadequate equipment
lifting devices,
slippery floors

 Psychosocial

hazards:

stress,
emotional

strain,
interpersonal problems.

PHYSICAL HAZARDS
Heat
burns, heat exhaustion, heat stroke, heat cramps.
Hot spots ovens and furnaces
Radiant heat glass and steel industry
Heat stagnation jute and cotton textile industry,
mines
The indirect effects are decreased efficiency, increased
fatigue, enhanced accident rate, stress, impaired health.

PHYSICAL HAZARDS
Cold
cutaneous vasoconstriction
Light
eye strain, headache, eye pain, corneal congestion ,
eye fatigue.
Excessive brightness or glare discomfort,
annoyance, visual fatigue, blurring of vision and
leads to accident.

Noise
Auditory effects temporary or permanent hearing
loss.
Non auditory effects nervousness, fatigue,
interference with communication by speech,
decreased efficiency, annoyance.
Vibration
drills and hammers (10 to 500 Hz).

Ultraviolet Radiation
conjunctivitis and keratitis
Ionizing Radiation
X-rays, radioactive isotopes (cobalt 60).
Affects bone marrow and gonads.
cancer, leukemia, depilation, ulceration, sterility

CHEMICAL HAZARDS
Local Action
Dermatitis, eczema, ulcers, allergic actions, cancer.
Inhalation
Dusts
Gases, oxygen, hydrogen, asphyxiating gases
Anesthetic gases chloroform, ether
Ingestion:lead, mercury, cadmium,

BIOLOGICAL HAZARDS
brucellosis,
leptospirosis,
anthrax,
hydatidosis,
tetanus,
encephalitis,
fungal

infections, etc.

MECHANICAL HAZARDS
accidents

PSYCHOSOCIAL HAZARDS
Frustrations,
lack

of job satisfaction,
insecurity,
poor human relationships, and emotional tension

 Psychological

and behavioral changes:

including hostility, aggressiveness, anxiety,
depression, alcoholism, drug abuse, sickness,
absenteeism.
Psychosomatic ill health: including fatigue,
headache, pain in the shoulders, neck and back,
peptic ulcer, hypertension, heart disease and rapid
aging.

OCCUPATIONAL DISEASES AND

DISORDERS
diseases arising out of or in the course of
employment.
Each occupation has its own hazards.

OCCUPATIONAL DISEASES
Diseases

due to physical agents:

Diseases due to chemical agents:
Diseases due to biological agents:
Occupational cancers:
Occupational dermatosis:
Disease of psychological origin:

PNEUMOCONIOSIS:
SILICOSIS:
ANTHRACOSIS:
BYSSINOSIS:
BAGASSOSIS:
ASBESTOSIS:
FARMERS LUNG:
OCCUPATIONAL CANCER
RADIATION HAZARDS:
LEAD POISONING:

PNEUMOCONIOSIS
It is a lung disease caused due to the inhalation of
dust particles (0.5 3 micron),
which may gradually reduce the work capacity of
a man due to lung fibrosis and other
complications.
The important dust diseases are:

Silicosis:
It is caused by inhalation of dust containing free
silica silicon dioxide.
The incidence of silicosis depends upon the chemical
composition of the dust, size of the particles,
duration of exposure and individual susceptibility.
the incubation period vary from a few months to 6
years of exposure.

 mica

mines (34.1%),
ceramic and pottery industry (15.7%),
sand blasting,
metal grinding,
building and construction,
rock mining etc.

 Pathology:
Particles

reach the interior of the lungs are

ingested by the phagocytes which accumulate and
block the lymph channels.
It is characterized by a dense nodular fibrosis
ranging from 3 to 4 mm in diameter.

 irritant

cough,
dyspnoea and
chest pain;
finally impairment of total lung capacity (TLC).

 Diagnosis:

Chest X-ray

Silicosis is prone to pulmonary tuberculosis

(silicotuberculosis).

Treatment:
there is no effective treatment.
The control measures are:
Dust control measures complete enclosure,
isolation, hydroblasting, good housekeeping,
personal protective measures.
Regular physical examination of workers.

Anthracosis (coal miners pneumoconiosis):

It is caused due to coal dust.
Simple pneumoconiosis caused due to minimum
of 12 years of work exposure which leads to little
ventilatory impairment.
Progressive massive fibrosis (PMF) causes
severe respiratory disability.

Byssinosis
It is due to inhalation of cotton fibre dust over
long periods of time.
chronic cough and progressive dyspnoea,
ending in chronic bronchitis and emphysema.

 Bagassosis
It

is the disease of lung caused by inhalation of

bagasse or sugar cane dust.
sugar cane fibre waste was used in the
manufacture of paper, cardboard
breathlessness, cough, haemoptysis, and slight
fever further leading to impairment of pulmonary
function.

Preventive Measures
Dust control exhaust ventilation, enclosed
apparatus.
Personal protection mask, respirators with
mechanical filters.
Medical control periodic health check up.
Bagasse control moisturizing spraying 2%
propionic acid, fungicide.

 Asbestosis

Asbestos are silicates of varying composition

(magnesium, iron, calcium, sodium, aluminium).
Asbestos is used in the manufacture of asbestos
cement, fire proof textiles, roof tiling, brake
lining, etc.

 Asbestos

enters the body by inhalation, and

fine dust may be deposited in the alveoli.
The disease is characterized by dyspnoea, clubbing
of fingers, cardiac distress and cyanosis.
It

causes pulmonary fibrosis leading to respiratory

insufficiency and carcinoma of the bronchus and
gastro intestinal tract, death.

Preventive Measures
Use of safer types of asbestos(chrysolite and amosite)
Substitution of other insulants glass fiber, mineral
wood, calcium silicate, plastic foams.
Dust control and biological monitoring(x-ray, lung
function)
Periodic examination of workers and continuing
research.

Farmers Lung
It is due to the inhalation of mouldy hay or grain
dust
The disease is characterized by respiratory
symptoms and finally leads to pulmonary fibrosis
and pulmonary damage.

LEAD POISONING
manufacture
of
storage
batteries,
glass
manufacture, ship building, printing and potteries,
rubber industry etc.
All lead components are toxic lead oxide, lead
carbonate, lead arsenate, etc.
Mode of absorption is of 3 ways inhalation,
ingestion and absorption through skin.

 abdominal

colic,
constipation,
loss of appetite,
blue-line on the gums,
anemia,
wrist drop and foot drop.
CNS- insomnia, headache, mental confusion, delirium,
etc.

Preventive measures:
Substitution of lead with less toxic materials.
Isolation
Local exhaust ventilation.
Personal protection, personal hygiene and good
housekeeping
Periodic examination
Medical management- saline stomach washes if ingested

OCCUPATIONAL CANCER
The characteristics of occupational cancer are:
They appear after prolonged exposure
The period between exposure and development of
disease may be 10 to 25 years.
The disease may develop even after cessation of
exposure.

 Skin

Cancer: gas workers, oven workers, tar

distillers, oil refiners, dye-stuff makers, road
makers
Lung Cancer: gas industry, asbestos industry,
nickel and chromium work
Bladder Cancer: dye-stuffs and dyeing industry,
rubber, gas, and the electric cable industries.
Leukaemia

Control of Industrial Cancer

Elimination or control of industrial carcinogens
well-designed building or machinery, closed system
of production.
Medical examinations and Inspection of factories.
Notification and licensing of establishments
Personal hygiene measures
Education of workers and management and research.

RADIATION HAZARDS
acute burns, dermatitis malignancies, genetic effects etc.
Preventive measures:
Shielding of workers in x-ray field
Suitable protective clothing
Adequate ventilation
Pregnant women should not be allowed to work in risky
areas.

OCCUPATIONAL HAZARDS OF
AGRICULTURAL WORKERS:
Zoonotic

diseases:brucellosis,
anthrax,
leptospirosis, tetanus, Q fever.
Accidents:- use of agricultural machinery.
Toxic hazards:- fertilizers, insecticides, pesticides.
Physical hazards:- extremes of climatic conditions,
excessive noise and vibration.
Respiratory diseases:- exposure to dusts of grains,
rice husks, coconut fibers, etc. The common diseases
are byssinosis, bagassosis, occupational asthma.

OCCUPATIONAL ACCIDENTS:
1. HUMAN FACTORS:
2. ENVIRONMENTAL FACTORS:

HUMAN FACTORS:
Physical factors :- impaired vision, hearing
problems.
Physiological factors :- age, sex, fatigue, etc.
Psychological factors :- level of confidence,
concentration, emotional stress, dissatisfaction,
non interestedness etc.
1.

ENVIRONMENTAL FACTORS:
extreme temperature, humidity, noise, vibrations,
unsafe machines etc.
2.

ACCIDENT PREVENTION PRINCIPLES:

Adequate preplacement examination and job training.

Continuing examination
Ensuring safe working environment
Establishing a safety department in the organization
under a competent safety engineer.
Periodic surveys for finding out hazards.
Careful reporting, maintenance of records and
publicity.

Health Problems due to Industrialization:

Environmental

sanitation problems housing,

water pollution, air pollution, sewage disposal.
Communicable diseases
Food sanitation
Mental health.
Accidents and Social problems.
Morbidity and mortality.

MEASURES FOR HEALTH

PROMOTION OF WORKERS
Prevention

and

control

of

occupational

diseases,
disability limitations and rehabilitation

MEASURES FOR HEALTH

PROMOTION OF WORKERS
Nutrition
Communicable

Disease Control
Environmental Sanitation
Mental Health
Measures for Women and Children
Health Education
Family Planning

Nutrition
poor health among workers - low work
productivity.
Indian Factories Act, canteen -exceeds 250.
education -balanced diet.

Communicable Disease Control

immunization program against preventable
communicable diseases.
special importance in India - tuberculosis, typhoid
fever, viral hepatitis, amoebiasis, intestinal
parasites, malaria and venereal diseases.

Environmental Sanitation:
Water supply
Food
Rest rooms
Sufficient space
Lighting , ventilation , temperature
Protection against hazards
Housing

Mental Health
To promote the health and happiness of the workers
To detect the signs of emotional stress and strain
and to secure relief
The treatment of employees suffering from mental
illness
Rehabilitation of those who become ill

Measures for Women and Children

Expectant mothers are given maternity leave for 12
weeks, of which 6 weeks precede the expected date of
confinement they are allowed maternity benefit with
cash payment.( ESI act, 1948)
Provision of free antenatal, natal and postnatal services.
Night work between 7 pm to 6 am is prohibited.
(Factories Act)

Measures for Women and Children

Provide crches in factories where more than 30
women workers are employed.
The Indian Mines Act 1923, prohibits work under
ground.
No child below the age of 14 shall be employed to
work in any factory or mine or engaged in any
other hazardous employment.

Health Education
management,
supervisory staff,
workers,
trade union leaders and
community.

Family Planning
quality of life,
small family norm.

PREVENTION OF OCCUPATIONAL
DISEASES
Medical

measures
Engineering measures
Legislative or statutory measures

1. Medical Measures
Pre-placement examination
Periodical examination
Medical and health care services
Notification
Supervision of working environment
Maintenance and analysis of records
Health education and counseling

2. Engineering Measures
Design of building
Good housekeeping
General ventilation
Mechanization
Substitution
.
Dust
Enclosure

Isolation
Local

exhaust
ventilation
Protective device
Environmental
monitoring
Statistical monitoring
Research

3. Legislation
The Factory Act, 1948
The Employees State Insurance Act, 1948
The Mines Act, The Plantation Act, The
Minimum Wages Act, The Maternity Benefit Act,
etc.

VOILENCE AT WORKPLACE
act

of aggression, physical assault, or threatening

behavior that occurs in a work setting and causes
physical or emotional harm to customers,
coworkers, or managers.

three forms:
Non-physical violence (intimidation, abuse, threats
etc)
Physical violence (punching, kicking, pushing etc)
Aggravated physical violence (use of weapons, e.g.
guns, knives, syringes, pieces of furniture, bottles,
glasses, etc)

Causes of Work Place Violence

Occupational Groups at Higher Risk

from Workplace Violence
health

care employees
social services employees
teachers
municipal housing inspectors
public works employees

Measures
Maintain

and disseminate detailed policies on

workplace behavior:
Maintain and disseminate workplace violence
prevention programs:
Recognize warning signs:
Counseling:
Regular meetings with managers: comment boxes
or surveys.

CHILD LABOUR
children

will be forced to work

International labor organization- ILO

Improve

labor conditions and living standards

through international action.
Promote economic and social stability.

Factories act-1948
The

Factories Act, is a social legislation which has

been enacted for occupational safety, health and
welfare of workers at work places.
This legislation is being enforced by technical officers
i.e. Inspectors of Factories, Dy. Chief Inspectors of
Factories who work under the control of the Chief
Inspector of Factories and overall control of the
Labour Commissioner, Government of National
Capital Territory of Delhi

APPLICABILITY
The

industries in which ten (10) or more than ten

workers are employed on any day of the preceeding
twelve months and are engaged in manufacturing
process being carried out with the aid of power or
twenty or more than twenty workers are employed
in manufacturing process being carried out without
the aid of power, are covered under the provisions
of this Act.

SALIENT FEATURES OF THE ACT ARE :-

Approval

of Factory Building Plans before

construction/extension, under the Delhi Factories
Rules, 1950 .
Grant of Licences under the Delhi Factories Rules,
1950, and to take action against factories running
without obtaining Licence.
Renewal of Licences granted under the Delhi Factories
Rules, 1950, by the Dy. Chief Inspectors of Factories .

SALIENT FEATURES OF THE ACT ARE :-

Inspections

of factories by District Inspectors of

Factories, for investigation of complaints,
serious/fatal accidents
inspections to check compliance of provisions of
this Act relating to :- Health, Safety, Welfare
facilities, Working hours, Employment of young
persons , Annual Leave with wages etc.

 Administrative

Machinery : The enforcement of this legislation is being

carried out on district basis by the district
Inspectors of Factories.
After inspection, Improvement Notices are issued
to the defaulting managements and ultimately
legal action is taken against the defaulting
managements.

 Administrative

Machinery : The Inspectors of Factories file Challans against

the defaulters, in the Courts of Metropolitan
Magistrates.
The work of Inspectors of Factories is supervised
by the Dy. Chief Inspector of Factories on district
basis.

 Penalties: This

Act provides for a maximum punishment up

to two years and or a fine up to Rs. one lakh or
both.

The Act does not permit the employment of

women and young in dangerous process or
operation.

 Section

11 to 20 deal with provision of

environmental sanitation that protect the worker
from hazardous environment.
Cleanliness of the working place, privy, benches,
stairs, wall etc. is explained.
Disposal of wastes and effluents should be
without any risk.

 Ventilation,

temperature inside factory, dust and

fumes emission, lighting, artificial humidification,
overcrowding (minimum of 50 cubic metres per
person) are specified.
There should be a provision for safe and cool
drinking water and provision of water in the
latrine and urinal.

 One

latrine for 25 female workers but one for 25

male workers up to 100 and one for 50 thereafter.
One urinal for 50 people up to 500 men and after
that one for every 100 more.

 Safety

measures like fencing of machines,

protection of eyes by use of goggles, precautions
against fire, dangerous fumes, etc. are defined.

 Facilities

for washing, and sitting, canteens,

creche (one for more than 30 women) and first aid
appliances are provided.
One Welfare Officer for 500 or more workers is
suggested.

 There

is provision for one weekly holiday, and not more

than 48 hours in a week an adult worker should work.
There is at least half an hour rest after a stretch of 5
hours of continuous work.
No women should be employed between 7 p.m. and 6
a.m.
No person less than 14 years of age should work in the
factory.

 No

child should work more than 4 hours a day

and should not work in the night between 10 p.m.
to 6 a.m.
One full wage leave should be given to an adult
worker for every 20 days of work and one for
every 15 days to the child worker.
12 weeks of maternity leave should be given to a
woman.

 If

an accident occurs in any factory causing death

or bodily injury or prevents a worker from
working for more than 48 hours, the manager
must immediately send notice to the prescribed
authority (i.e. Labor commissioner).

Following are the Notifiable Diseases:

Lead

poisoning
Phosphorus poisoning
Mercury poisoning
Manganese poisoning
Arsenic poisoning
Poisoning by nitrous fumes
Carbon bisulphate poisoning
Benzene and its derivatives poisoning
Chrome ulceration

Following are the Notifiable Diseases:

Anthrax
Silicosis
Poisoning

by halogens or its derivatives of hydrocarbons

Pathological manifestation due to radium
Toxic anemia
Toxic jaundice due to poisonous substances
Byssinosis
Asbestosis

 Employees

State Insurance Scheme of India, is a

multidimensional social security system tailored
to provide socio-economic protection to worker
population and their dependants covered under
the scheme.

 Besides

full medical care for self and dependants,

that is admissible from day one of insurable
employment, the insured persons are also entitled
to a variety of cash benefits
in times of physical distress due to sickness,
temporary or permanent disablement etc. resulting
in loss of earning capacity,
the confinement in respect of insured women,

 dependants

of insured persons who die in

industrial accidents or because of employment
injury or occupational hazard are entitled to a
monthly pension called the dependants benefit.

 The

promulgation of Employees' State Insurance

Act, 1948(ESI Act), by the Parliament was the
first major legislation on social Security for
workers in independent India.

lighted lamp which is the logo of ESIC truly

symbolises the spirit of the Scheme, lighting up
lives of innumerable families of workers by
replacing despair with hope and providing help in
times of distress, both physical and financial.

Coverage under the ESI Act, 1948

APPLICABILITY
Under Section 2(12) the Act is applicable to nonseasonal factories employing 10 or more persons.
Under Section 1(5) of the Act, the Scheme has
been extended to shops, hotels, restaurants,
cinemas including preview theatres, road-motor
transport
undertakings
and
newspaper
establishments employing 20* or more persons.

Coverage under the ESI Act, 1948

APPLICABILITY
Further under section 1(5) of the Act, the Scheme
has been extended to Private Medical and
Educational institutions employing 20* or more
persons
in
certain
States/UTs.
The

existing wage limit for coverage under the Act

is Rs. 15,000/- per month ( w.e.f. 01/05/2010).

*Note: 14 State Govts. / UTs have reduced the

threshold limit for coverage of shops and other
establishments from 20 to 10 or more persons.
Remaining State Governments/UTs are in the
process
of
reducing
the
same.

AREAS COVERED
The ESI Scheme is being implemented area-wise by
stages.
STATES
All the States except Manipur, Sikkim, Arunachal
Pradesh and Mizoram.
UNION TERRITORIES
Delhi and Chandigarh

Coverage(As on 31st March, 2013)

No. of Insured Person family units-1.85 Crores
No. of Employees-1.65 Crores
Total No. of Beneficiaries-7.20 Crores
No. of Insured women-0.26 Crores
No. of Employers, etc6.66 Lacs

ADMINISTRATION
The

comprehensive and multi-pronged social

security programme is administered by an apex
corporate
body
called
the
Employees' State Insurance Corporation.
It comprises members representing vital interest
groups, including, employees, employers, the
Central and State Government, representatives of
Parliament and medical profession.

 The

Corporation is headed by the Union Minister of

Labour, as its Chairman,
whereas the Director General, appointed by the Central
Government functions as its Chief Executive Officer.
The broad based corporate body is, primarily,
responsible for coordinated policy planning and
decision making for growth, development and efficacy
of the scheme.

 A Standing

Committee, constituted from among

the members of the Corporation, acts as an
Executive Body.
The Medical Benefit Council, constituted by the
Central Government, is yet another Statutory
Body that advises the Corporation on matters
related to effective delivery of medical services to
the Beneficiary Population.

 Central

Headquarters - New Delhi, operates through a

network of 52 Regional, Sub- Regional and Divisional
Offices located in various States.
The administration of Medical Benefit is taken care of
by the respective State Government except in case of
Delhi and Noida
The Corporation has taken over the administration of 23
ESI Hospitals in various States for developing them as
ESIC Model Hospitals.

Finance
ESI

Scheme, like most of the Social Security

Schemes the world over, is a self financing health
insurance scheme.
Contributions are raised from covered employees
and their employers as a fixed percentage of wages.
As of now, covered employees contribute 1.75% of
the wages, whereas, the employers contribute
4.75% of the wages, payable to their employees.

Finance
Employees

earning upto Rs.100/- a day are

exempted from payment of their share of
contribution.
The State Governments, as per provisions of the
Act, contribute 1/8th of the expenditure of
medical benefit within a per capita ceiling of Rs.
1500/- per Insured Person per annum.

Contribution
all

the employees
employer's
contribution
and
employee's
contribution at a specified rate.
The rates are revised from time to time.
Currently, the employee's contribution rate (w.e.f.
1.1.97) is 1.75% of the wages and that of
employer's is 4.75% of the wages paid/payable in
respect of the employees in every wage period.

Contribution
Employees

in receipt of a daily average wage

upto Rs.100/- are exempted from payment of
contribution.
Employers will however contribute their own
share in respect of these employees.

Contribution
Collection
of
Contribution
deduct employees contribution from wages bill
and shall pay these contributions at the above
specified rates to the Corporation within 21 days
of the last day of the Calendar month in which the
contributions fall due.

Contribution Period and Benefit Period

There are two contribution periods each of six
months duration and
two corresponding benefit periods also of six
months
duration
as
under.

Benefits
The section 46 of the Act envisages following six social
security benefits :(a) Medical Benefit
(b) Sickness Benefit(SB)
(c) Maternity Benefit (MB)
(d) Disablement Benefit
(e) Dependants' Benefit(DB)
(f) Other Benefits : Funeral Expenses & Confinement
Expenses

other need based benefits to insured workers.

Vocational Rehabilitation
Physical Rehabilitation
Old Age Medical Care
Rajiv Gandhi Shramik Kalyan Yojana
Incentive to employers in the Private Sector

(a) Medical Benefit :

Full medical care is provided to an Insured person
and his family members from the day he enters
insurable employment.
Medical care is also provided to retired and
permanently disabled insured persons and their
spouses on payment of a token annual premium of
Rs.120/-

System of Treatment
Scale of Medical Benefit
Benefits to Retired IPs
Administration of Medical Benefit in a State
Domiciliary treatment
Specialist consultation
In-Patient treatment
Imaging Services
Artificial Limbs & Aids
Special Provisions
Reimbursement

System of Treatment
Generally, the allopathic system of medicine is
used for providing Medical Benefit.
treatment facilities may be provided under the
ISM & H as well.

Scale of Medical Benefit

The beneficiaries are entitled to reasonable medical,
surgical and obstetric treatment.
To Insured Persons:- IPs are entitled to avail
treatment in ESI Dispensary/Hospital/Diagnostic
Centre and recognised institutions
Outpatient treatment
Domiciliary treatment by visits at their residences.

Scale of Medical Benefit

Specialists Consultation.
In-patient treatment(Hospitalisation)
Free supply of drugs dressings and artificial limbs,
aids and appliances.
Imaging and laboratory services.
Integrated family welfare, immunisation and MCH
Programme and other national health programme etc.

Scale of Medical Benefit

Ambulance service or re-imbursement of conveyance
charges for going to hospitals, diagnostic centres etc.
Medical Certification and
Special provisions.
To Family Members of Insured Persons:- FULL"
Medical Care i.e., all facilities as for IPs including
hospitalisation.

(b) Sickness Benefit(SB) :

Sickness Benefit in the form of cash compensation
at the rate of 70 per cent of wages is payable to
insured workers during the periods of certified
sickness for a maximum of 91 days in a year.
Extended Sickness Benefit(ESB)
Enhanced Sickness Benefit

 Extended

Sickness Benefit(ESB) : SB extendable

upto two years in the case of 34 malignant and
long-term diseases at an enhanced rate of 80 per
cent of wages.
Enhanced Sickness Benefit : Enhanced Sickness
Benefit equal to full wage is payable to insured
persons undergoing sterilization for 7 days/14
days for male and female workers respectively.

(c) Maternity Benefit (MB) :

Maternity Benefit for confinement/pregnancy is
payable for three months, which is extendable by
further one month on medical advice at the rate of
full wage subject to contribution for 70 days in
the
preceding
year.

(d) Disablement Benefit

Temporary disablement benefit (TDB)
Permanent disablement benefit (PDB)

Temporary disablement benefit (TDB) :

From day one of entering insurable employment
& irrespective of having paid any contribution in
case of employment injury.
Temporary Disablement Benefit at the rate of
90% of wage is payable so long as disability
continues.

Permanent disablement benefit (PDB) :

The benefit is paid at the rate of 90% of wage in
the form of monthly payment depending upon the
extent of loss of earning capacity as certified by a
Medical Board

(e) Dependants' Benefit(DB) :

DB paid at the rate of 90% of wage in the form of
monthly payment to the dependants of a deceased
Insured person in cases where death occurs due to
employment injury or occupational hazards.

(f) Other Benefits :

Funeral Expenses : An amount of Rs.10,000/- is payable
to the dependents or to the person who performs last
rites from day one of entering insurable employment.
Confinement Expenses : An Insured Women or an I.P.in
respect of his wife in case confinement occurs at a place
where necessary medical facilities under ESI Scheme
are
not
available.

 Vocational

Rehabilitation :To permanently

disabled Insured Person
Physical Rehabilitation : In case of physical
disablement due to employment injury.
Old Age Medical Care :For Insured Person retiring
on attaining the age of superannuation to leave
service due to permanent disability insured person
& spouse on payment of Rs. 120/- per annum.

 Rajiv

Gandhi Shramik Kalyan Yojana :

This scheme of Unemployment allowance was
introduced w.e.f. 01-04-2005.
An Insured Person who become unemployed after
being insured three or more years, due to closure of
factory/establishment, retrenchment or permanent
invalidity are entitled to :-Unemployment Allowance
equal to 50% of wage for a maximum period of upto
one year.

 Rajiv

Gandhi Shramik Kalyan Yojana :

Medical care for self and family from ESI
Hospitals/Dispensaries during the period IP
receives unemployment allowance.
Vocational Training provided for upgrading skills
- Expenditure on fee/travelling allowance borne
by ESIC.

ROLE OF THE OCCUPATIONAL HEALTH

NURSE IN WORKPLACE HEALTH
MANAGEMENT
several,

inter related and complimentary

Clinician
Primary prevention
Emergency care
Treatment services
Nursing diagnosis
Individual and group care plan.
General Health advice and health assessment

Specialist
Occupational health policy, and practice development,
implementation and evaluation
Occupational health assessment
Health surveillance
Rehabilitation
Health and safety
Hazard identification
Risk assessment

Manager
Management
Administration
Budget planning
Marketing
Quality assurance
Professional audit
Continuing professional development

Co-ordinator
Occupational health team
Worker education and training
Environmental health management

Adviser
To management and staff on issues related to
workplace health management
to other external health or social agencies

Health Educator
Workplace Health promotion
Counselor
Counseling and reflective listening skills
Problem solving skills
Researcher
Research skills
Evidence based practice
Epidemiology