Occupational Safety and Health in Agriculture- The BOHS
ApproachPrepared in Public InterestByIndian Association of
Occupational HealthApril, 2013
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DEFINATION OF AGRICULTURE
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INTRODUCTION An estimated 1.3 billion workers are engaged in
agricultural production worldwide. This represents half of the
total world labour force. Almost 60% of them are in developing
countries. A great majority of agricultural workers are found in
Asia, which is the most densely populated region of the world, with
more than 40% of the world's agricultural population concentrated
in China and more than 20% in India.
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SPECIFIC FEATURES OF AGRICULTUREmost tasks are carried out in
the open air, exposing workers to climatic conditions;the seasonal
nature of the work and the urgency of certain tasks in specific
periods;a wide variety of tasks are performed by the same
person;the type of working postures and the length of the tasks
performed;
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contact with animals and plants exposing workers to bites,
poisoning, infections, parasitic diseases, allergies, toxicity and
other health problems;the use of chemicals and biological products
;the considerable distances between living quarters and
workplaces.
SPECIFIC FEATURES OF AGRICULTURAL WORK
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LABOUR FORCE IN AGRICULTURE Lack of clear-cut distinctions
between different categories of workers.Numerous types of labour
relations and different forms of labour force participation.
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PRINCIPLES OF BOHSThe following principles will be applied in
the organization of Basic Occupational Health Services:Available to
all working peopleAddressing to local needsAdapted to local
conditionsAffordable to providers and clientsOrganized by the
employer for employeesProvided by the public sector for the
self-employed and the informal sectorSupported by intermediate
level services
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BOHS MODEL
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ORIENTATION AND PLANNINGAnalysis of the type of production
indicating the risks and problems typical of the branch or
occupation in concern.Agriculture involves a wide range of
different types of machinery, animals, plants and products, working
in both indoor and outdoor environmentsIn India labour-intensive
farming is much more common.Review of problems that have been
identified previously in the companyReview of the characteristics
of the workforce of the companychild labour , migrant workers ,
seasonal, migratory and casual labour.
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ORIENTATION AND PLANNINGAvailable data on occupational diseases
and accidentsData on working methods, chemical substances, etc.The
knowledge by employers and employees of occupational health
problemsPlans for changes in production systems, e.g. installation
of new facilities, machinery and equipment
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SURVEILLANCE OF THE WORK ENVIRONMENTIdentification and
evaluation of ergonomic factors which may affect the workers'
healthErgonomic factors affecting the health outcomes of
agricultural workers include:the nature of the physical work
environment (noise, heat, lighting, thermal comfort), the
agricultural tasks to be performed;the technology applied to the
prescribed tasks (including workplace design, facility design, and
agricultural material handling);the manner in which tasks are
organized (including use of shift work); andWorker characteristics
(including demographics, physiology, human error, and
identification and treatment of injured workers).
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SURVEILLANCE OF THE WORK ENVIRONMENTAssessment of conditions of
occupational hygiene and factors, such as physical, chemical, and
biological exposures which may generate risks to the health of
workersAssessment, where appropriate, of exposure of workers to
adverse psychological factors and aspects of work
organizationAssessment of risk of occupational accidents and major
hazardsAssessment of collective and personal protective
equipmentAssessment of control systems designed to eliminate,
prevent or reduce exposureAssessment of general hygiene and
sanitary facilities
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Occupational Health Problems in Agriculture
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Occupational Health Problems in Agriculture
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EXPOSUREHEALTH EFFECT Physical work stress, fatigue Numerous
types of (largely unreported) musculoskeletal disorders,
particularly soft-tissue disorders, e.g., back painWeather,
climateDehydration, heat cramps, heat exhaustion, heat stroke, skin
cancer. Dusts, fumes, gases, particulatesIrritation of the eyes and
respiratory tract, allergic reactions, respiratory diseases such as
asthma, chronic obstructive pulmonary disease, and hypersensitivity
pneumonitisPesticides Acute poisonings, chronic effects such as
neurotoxicity, reproductive effects, and cancerBiologicalagents
andvectors of diseaseSkin diseases such as fungal infections,
allergic reactions, and dermatosesParasitic diseases such as
schistosomiasis, malaria, bilharziasis, facioliasis, sleeping
sickness, leishmaniasis, ascariasis, and hookworm, zoonoses such as
anthrax, bovine tuberculosis, brucellosis, and rabies (at least 40
of the 250 zoonoses are occupational diseases in
agriculture)Cancers, contact with wild and poisonous animals:
insects, spiders, scorpions, snakes, certain wild mammals.machinery
Injuries
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SURVEILLANCE OF WORKERS' HEALTHThe following types of health
examinations are carried out either on the basis of regulations or
as a part of good occupational health practice:1. Pre-assignment
(pre-employment) health examinations2. Periodic health
examinations3. Return to work health examinations4. General health
examinations5. Health examinations at termination or after ending
of serviceA new type of health examination has recently been
introduced for assessment of work ability of ageing workers.
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SURVEILLANCE OF WORKERS' HEALTHIn the case of exposure of
workers to specific hazards, medical and health surveillance should
include, where appropriate, any examination and investigations
which may be necessary to detect exposure levels and early effects
and responses which also bear in mind the biological difference
between women and men. Example, in pesticide
handlers.Pre-employment screening should ensure that those with
inherently low-level cholinesterase do not undertake work with
organophosphate or carbamate pesticidesbaseline samples, periodic
samples,
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ASSESSMENT OF HEALTH AND SAFETY RISKSA hazard is anything with
the potential to do harm, whereas a risk is the likelihood of
potential harm from that hazard being realised. The identification
of hazards in the workplace should take into account:(a) the
situation or events or combination of circumstances that have the
potential to give rise to injury or illness;(b) the nature of
potential injury or illness relevant to the activity, product or
service;(c) those likely to be harmed (e.g. young workers, older
workers, temporary workers, pregnant workers); and(d) past
injuries, incidents and illness.
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ASSESSMENT OF HEALTH AND SAFETY RISKSThe steps in an
occupational health risk assessment include:Identification of
occupational health hazards (as a result of surveillances)
Hazards Description Mechanical hazard Poorly designed and/or
guarded agricultural machinery is a major cause of fatalities and
accidents. Injuries from cutting tools are another major
risk.Psycho social hazards low pay, sexual and other harassment,
job insecurity, poor promotion mechanisms, delay in payment of
salaries.Work organisation hazards badly organised shift work and
working hours, excessive overtime, lone working, lack of control
over work.Ergonomic hazards These hazards can cause permanent
injuries and disablement. For example: badly designed machinery,
prolonged static working positions, repetitive work, unsuitable
tools used by workers, poor seatingOthers - Physical hazards ,
Biological hazards, chemical hazards, environmental
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ASSESSMENT OF HEALTH AND SAFETY RISKSIdentification of workers
or groups of workers exposed to specific hazards for e.g. in tea
plantation workers the hazards are different for pruners, pluckers,
sprayersAnalysis of how the hazard may affect the worker (ways of
entry and type of exposure, threshold limit values, dosage/
response relationships, adverse health effects it may cause, etc.in
case of sprayers who are in constant contact with the
pesticides)Determination of intensity (level) and magnitude
(volume) of risk
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ASSESSMENT OF HEALTH AND SAFETY RISKS5. Identification of
individuals and groups with special vulnerabilities, e.g. young
workers, old workers, pregnant workers, temporary workers6.
Evaluation of available hazard prevention and control measures7.
Making conclusions and recommendations for the management and
control of risks
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ASSESSMENT OF HEALTH AND SAFETY RISKSHierarchy of control
measures for reducing risks in the work place.Elimination
SubstitutionOthers technical and engineering control- enclosure,
isolation, ventilationSafe systems of work- changing work
schedules, extending rest periods, training and informationIssuing
Personal Protective Equipment (PPE)8. Documenting the findings of
the assessment9. Periodic review and, if necessary, reassessment of
risks
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INFORMATION AND EDUCATION ON RISKS AND ADVICE ON THE NEED FOR
PREVENTIVE AND CONTROL ACTIONSThe information and education include
the following aspects:Workers in agriculture should have the right
to be informed and consulted on OSH matters including risks from
new technologies; andThe workers have a right to know and get
continuously information on hazards related to their own work and
the workplace.The employer is responsible for training the workers
on safe and healthy work practices.
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The workers have a duty to follow the safety instructions and
safe and healthy work practices.Confidential health information of
an individual worker is subject to special legislation and
practices and to informed consent.The advice provided by OHS
personnel must be given in a form which is easily understood by
employers and workers.Information given to various partners should
be documented.
INFORMATION AND EDUCATION ON RISKS AND ADVICE ON THE NEED FOR
PREVENTIVE AND CONTROL ACTIONS
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PREVENTIVE ACTIONS FOR THE MANAGEMENT AND CONTROL OF HEALTH AND
SAFETY HAZARDS AND RISKSControl measures should be monitored and
reviewed at regular intervals and if necessary revised, especially
when circumstances change or if new information becomes available
about the risks posed or the suitability of existing control
measures. Control measures should also be reviewed and if necessary
revised following an accident.
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The risk management actions may comprise: Control of hazards at
the source Ventilation or control technology Dust control Ergonomic
measures Use of personal protective equipment Regulation of thermal
conditions, etc.
PREVENTIVE ACTIONS FOR THE MANAGEMENT AND CONTROL OF HEALTH AND
SAFETY HAZARDS AND RISKS
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PREVENTION OF ACCIDENTS1. Safe planning of facilities,
machinery, etc.The employer should not permit the use of any unsafe
or faulty equipment.The employer should ensure the provision of
adequate information, instruction and training for those using
equipment, and that their skill levels are periodically
evaluated.2. Good housekeeping, order and cleanlinessThe employer
should ensure that workers are clearly instructed and supervised in
good housekeeping measures that can prevent slips, trips and
falls.
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Making walkways and other structures safe (e.g. scaffolds,
fences)The employer shall ensure that: walking surfaces and stairs
inside facilities are equipped with adequate lighting; stairs and
ladders are maintained in good condition with handrails in place;
.4. Guarding dangerous machines- by providing enclosures, safety
symbols surrounding such places. Unauthorized persons should not be
allowed to operate machinery. In particular, children should be
kept away from all agricultural equipment.
PREVENTION OF ACCIDENTS
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Technical aids for moving and lifting heavy loadsWith regard to
the use and maintenance of ladders, the employer should ensure that
appropriate, well-maintained equipment is available and is
appropriate to the task at hand. the use of mechanical means to
lift or lower heavy objects; and other practices appropriate to the
task at hand.Safe tools and safety equipment for workersWorkers
should use handholds when mounting and dismounting
equipment.Analysis of major hazard risks and provision of
"redundant safety"
PREVENTION OF ACCIDENTS
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MAINTAINING PREPAREDNESS TO FIRST AID AND PARTICIPATION IN
EMERGENCY PREPAREDNESS1. Providing first aid services at the
workplace when appropriate2. Introducing and training first aid
practices to workers and supervisors3. Maintaining and periodically
inspecting the first aid readiness and facilities4. Participating
from the health point of view in emergency planning and organizing
the health elements in emergency response
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MAINTAINING PREPAREDNESS TO FIRST AID AND PARTICIPATION IN
EMERGENCY PREPAREDNESS
Emergency preparedness Date______________ Checklist Self-audit
Step 1 Step2 Step 3 Planning N/A Yes No Priority for action What
action is required 1. Does the workplace have an emergency response
plan? 2. Does the workplace have established emergency escape
routes and procedures? 3. Does the workplace have a trained
first-aider(s)? 4. Does the workplace have basic rescue equipment
and are workers trained to use it?
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DIAGNOSIS OF OCCUPATIONAL AND WORK-RELATED DISEASES1.
Identification of exposure which may cause the disease2.
Examination of clinical findings which are known to be associated
with the specific exposure (lists of occupational diseases)3.
Exclusion of non-occupational factors as a possible cause of
disease4. Conclusion on existence or non-existence of occupational
disease (diagnosis)5. Statement on occupational disease for
workmen's compensation6. Proposals for preventive actions to the
workplace of the worker in concern7. Notification of occupational
diseases to authorities
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GENERAL HEALTH CARE, CURATIVE AND REHABILITATION SERVICES1.
Immunizations and other preventive measures2. Participation in
public health actions and programmes3. GP-level general health
services4. Inspection and advice on canteens, sanitary facilities5.
Advice and education in general personal and community hygiene6.
Actions for rehabilitation and adjustment of work for workers after
injuries, diseases, reduced work ability and on return to work from
long sick leaves7. General health promotion and introduction of
healthy lifestyles
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RECORD KEEPING1. General health record, if the workers are
treated as patients or health service clients2. Data on surveyed,
detected and measured occupational exposures and risk assessments
made3. Statistics on occupational diseases and injuries4. Data on
health examinations5. Documents on proposals for preventive and
control measures
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EVALUATION1. Evaluation is carried out as an inbuilt part of
BOHS activity, at least annually2. Evaluation is made when the
working methods, production structures or other aspects at work are
substantially changed3. Evaluation is made if the methods or
conditions of operation of services are substantially changed
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EVALUATION4. The following questions are answered through
evaluation:a) Do the services respond to the needs of the
workplace?b) Are the activities directed to priority problems?c) Is
good occupational health practice followed?d) Are the resources,
human and technical, sufficient?e) Are the services effective in
elimination of health problems?f) What can be improved?
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ROVISION OF BOHSPrimary health services modelBig company model
with in-company servicesGroup services organized jointly, e.g. by
several SMEsSocial security institution as a service
providerPrivate physician who has special competence in
occupational healthPrivate health centre either providing
occupational health services only or occupational health as a part
of its servicesLocal or regional outpatient clinic of hospitals
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AIMING FOR THIS CHANGE
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REFERENCES BOHS. a response to the Joint ILO/WHO Committee on
Occupational Health priority area for ILO/WHO/ICOH collaboration,
with support of the Finnish Institute of Occupational Health
(FIOH). Author: Professor Jorma Rantanen. 3rd, revised edition,
Helsinki 28 September 2007Safety and health in agriculture.
Programme on safety, health and the environment. Labour Protection
Department. ILO.Code of practice on safety and health in
agriculture .2010. INTERNATIONAL LABOUR OFFICE GENEVA.Top on the
agenda: Health and safety in agriculture. Labour Education 2000/
1-2 Nos. 118/119. ILOHealth, Safety and Environment: A Series of
Trade Union Education Manuals for Agricultural Workers Written by:
Peter Hurst & Peter Kirby. ILO.
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CONTRIBUTORSDr. Shwetha Marali, Senior Resident, Department of
Community Health, St. Johns Medical College
Dr. Bobby Joseph, Professor and Head, Division of Occupational
Health Services of the same Department..
In the Convention, however, the term agriculture does not cover:
subsistence farming; industrial processes that use agricultural
products as raw material and the related services; and the
industrial exploitation of forests.
IAOH-2013*With more than a third of the worlds labour force
employed in the sector, agriculture is the second greatest source
of employment worldwide after services. It is also the most
important sector for female employment in many countries,
especially in Africa and Asia, and a major proportion of
agricultural workers are women.Agriculture is in fact one of the
most hazardous of all sectors and many agricultural workers suffer
occupational accidents and ill-health each year.
IAOH-2013*The BOHS cycle follows the conventional action model:
identification of needs > assessment of problems > management
of actions > evaluation of effect > revision of the
programme.
The various steps indicated in Figure have a dual target: The
work environment-oriented activities (outside the action cycle) or
the worker-oriented activities (inside the action cycle), and often
both simultaneously. It is important to see BOHS as a functional
process instead of a number of separate actions.
IAOH-2013*6. The wide-ranging profiles in agriculture both in
terms of employment and of enterprise have a significant bearing on
levels of risk awareness and on attitudes towards preventing
accidents and diseases within the sector.
IAOH-2013*such as tractors, trucks and harvesters, and cutting
and piercing tools;
This slide supplements the previous slide, if
neededIAOH-2013*Medical surveillance includes, where appropriate,
pre-assignment and periodical medical examinations. It also
includes, where appropriate, medical examinations following an
incident, when workers report symptoms of poisoning, upon
resumption of work after a prolonged absence for health reasons,
and upon and after termination of work involving exposure to
chemicals.
IAOH-2013*For example, the hazard associated with power-driven
agricultural machinery might be getting trapped or entangled by
moving parts. The risk may be high if guards are not fitted and
workers are in close proximity to the machine. If however, the
machine is properly guarded, regularly maintained and repaired by
competent staff, then the risk will be lower.
IAOH-2013*Evaluation of risk takes into consideration both the
likelihood of the hazard causing harm to persons and the severity
of such harm if it were to occur.
IAOH-2013*(6) As part of the risk-assessment process, the
employer, in consultation with workers and their representatives,
should chart the flow of raw materials, intermediate and finished
products, mobile equipment and workers in the course of operations,
noting the hazards that pertain to each step.Control measuresAsk
whether the hazard can be eliminated. For example, remove the need
to use a toxic pesticide by using organic farming methods2. If the
hazard cannot be prevented or eliminated, consider substitution
with a less risky process or substance in the case of chemicals
IAOH-2013*Employers should provide training to all personnel at
no cost to the worker and training should take place during working
hours. The timing and other arrangements should be agreed upon
between the employer and workers representatives, taking into
account childcare and family responsibilities.
IAOH-2013*IAOH-2013*EXAMPLE OF PESTICIDE CAN BE GIVEN
IAOH-2013*2. These include having walking aisles or pathways
clearly identified; keeping stairs and passageways clear of tools,
buckets, slippery substances, etc.; and keeping buildings free of
accumulations of trash and other objects not needed in the
workspace.
IAOH-2013*walkways that are exposed to wet or slippery
substances are roughened; damaged floor boards and concrete defects
are repaired, as needed; and ladder openings, hay chutes and animal
house clean-out openings are protected with railings and
toe-boardsIAOH-2013*Workers should be properly instructed in the
use of ladders and supervised when using them. Safe work practices
include the presence of a second person at the base of the ladder;
the avoidance of work on ladders in windy or stormy conditions;
IAOH-2013*Many occupational diseases can be diagnosed in the BOHS
service but many of them need to be referred to specialized
occupational medicine clinicsIAOH-2013*the workplace can be an
important source of information for workers of both genders on
wellness, and how to maintain a healthy lifestyle, through a proper
diet, personal hygiene, rest and recreation. Employers should
consider establishing an enterprise wellness programme as well as
establishing clear policies with regard to alcohol- and
drug-related problems, HIV/aids, workplace violence, harassment and
bullying, and smoking.
IAOH-2013*The investigation of the origin and underlying causes
of work-related injuries, ill health, diseases and incidents should
identify any failures in the OSH management system and should be
documented.The corrective action resulting from such investigations
should be implemented in order to avoid repetition of work-related
injuries, ill health, diseases and incidents.
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