Occupational hygiene

Hygiene is defined in the Concise Oxford English Dictionary as: "the principles of maintaining health; practice of these."

By definition it therefore follows that there is an unequivocal relationship between the theory and practice of occupational health and hygiene and the concepts of promoting health in the workplace.

A professional definition from the International Occupational Hygiene Association states that, "Occupational Hygiene is the discipline of anticipating, recognising, evaluating and controlling health hazards in the working environment with the objective of protecting worker health and well-being and safeguarding the community at large."

A range of pressures and lobbying, including outcries from the public, the workers or their advocates, the media, some politicians, scientists, medical practitioners and others contributed in the last century towards a slow but progressive reform in relation to the health of workers.

In spite of some shortcomings, activities such as those of Robert Owen in New Lanark in Scotland showed the way, within the context of their times, to improving the health of the workforce (Murray 1987). Historically, the main thrust of occupational hygiene has been to promote organisational and environmental change in the workplace in the first instance, before attempting to promote change in individual behaviour. The practice of occupational hygiene has contributed significantly to the promotion of health in the workplace in addressing concerns ranging from cancer to stress (Harrington 1994).

While it is important to consider, as a whole, all the determinants of health and well being of the worker, it is essential to realise that it is work itself that often determines the health of the worker. Work can make a substantial and specific positive or negative contribution to health and well being. In attempting to improve health an assessment of needs is of prime importance: "Health Promotion in the Workplace must start with the correct assessment of the risks to health arising from work, communication of information about them and appropriate control measures" (Seaton et al 1994). Several past and recent laws are of relevance and value.

The current legal status is exemplified by the Management of Health and Safety at Work Regulations (HMSO 1992) which require all employers and self employed persons to assess the risk to workers and any others who may be affected by their undertaking. This assessment should identify the significant risks arising out of work, should enable the employer to identify and prioritise the measures that need to be taken and it should be timely and appropriate to the nature of the work. The risk assessments must ensure that all groups of employees who might be affected are considered and must identify groups of workers who by virtue of their age, experience or disability might be particularly at risk - in other words individual needs are taken into account at a health-promoting preventive level (as well as through rehabilitation).

Occupational hygiene involves a hierarchical sequence of several methods, starting by planning a systematic approach based on identified priorities and set objectives. Risks are eliminated, or reduced substantially by organisational change and by careful selection and design of relevant facilities e.g. enclosure, segregation, local exhaust ventilation etc. Organisational measures and education, with the aim of ensuring a progressive improvement in health (and safety) go hand-in-hand with the technical solutions. Steps are taken to ensure implementation of the risk control measures. Thus, monitoring and review of the organisational aspects and of the work environment (e.g. by measuring noise, dust etc) together with appropriate indices of workers= health ensure that the feedback loop is closed. Consultation is enshrined in legislation regarding safety committees and safety representatives, although in many workplaces the opportunities for workers’ and employers’ involvement presented by this are not fully exploited, in parallel with the advisory role of occupational health and hygiene professionals.

There are several challenges and opportunities for debate. These include the need for strategies to promote health in small workplaces, which classically have had less commitment of occupational hygiene resource than the larger establishments. Changing patterns of work (in relation to hours worked, job security, etc) need further study and attention, so as to attenuate risks and to promote health. Novel hazards and problems must be pre-empted and risks reduced, using the continually improving and diverse methods in occupational hygiene.

• Seaton A, Agius R, McCloy and D'Auria D. Practical Occupational Medicine Arnold publishers. London. 1994. Chapter 9 Health Promotion in the Workplace; pp.211-30.
• Harrington J M. Improving the Health of People at Work; Ann.Occup.Hyg.38,811-813, 1994.
• Health and Safety Commission. Management of Health and Safety at Work; Management of Health and Safety at Work Regulations 1992. Approved Code of Practice. London:HMSO 1992.
• Murray R. Social Reforms in the 19th Century; in Raffle PAB, Lee WR, McCallum RI, Murray R. Hunter's Diseases of Occupations 6th ed. 1987. Edward Arnold, London. Ch.3. pp. 93-155.