Transcript Slide 1

Country Presentation
OCCUPATIONAL MEDICINE AND
MEDICAL PRACTITIONERS IN INDIA
Hong Kong, October 28-29, 2013
Jagdish Patel
Ashish Mittal
Labour Force in the country
• Total Population (2011 Census): 1.21 billion
(Rural – 830 Million, Urban – 380 Million)
• Working Population (2001 Census): 402
million (39% of total population)
(Rural ~ 310 Million, Urban ~ 92 Million)
Male Workers – 275 million
Female workers – 127 million
Industry-wise Classification of
Workers in India (in millions)
Place of
Residence
Cultivators Agricultural
labourers
Household
industry
workers
Other
workers
Total
Total
workers
(Main +
Marginal)
402
127
107
16
151
Rural
310
124
103
11.5
71
Urban
92
3
4
4.5
80
Source: Census of India, 2001
Statistics of Factories (2009)
Registered Factories
Working Factories
Employment
Safety Officers
Welfare Officers
Factory Med. Officers
Total Injuries
Fatal Injuries
324,761
270,294
13,100,129
2,642
3,096
6,809
33,093
1,509
Data on Burden of Occupational
Diseases
Total Injuries
Fatal Injuries
Occupational Diseases
Occ. Disease Death
Economic Burden
Global
100 million
0.1 million
11 million
0.7 million
2-14 % of GNP for
various countries
Indian Proportion
17 million (17%)
45,000 (45%)
1.9 million (17%)
0.12 million (17%)
186 million INR in 1997
(8 million INR in 1961)
Source: NATIONAL PROGRAMME FOR CONTROL & TREATMENT OF OCCUPATIONAL DISEASES,
NIHFW Website
No information or breakup on the above categories is available
Data on Burden of Occupational
Diseases
• Under the Right to Information Act, ESIC gave information
in 2010 that it has the reports of 1576 cases of
occupational diseases,15 which occurred between 1997
and 2009. Diseases include Silicosis, Asbestosis (Total 47,
Maharashtra-36, W.Bengal-10), Byssinosis, other lung
diseases (70), Noise-induced hearing loss (total 471,
Gujarat 39, Maharashtra 432) and few cases of mercury,
lead and chromium poisoning (97 altogether), Dermatitis
(7), COPD (6).
• Occupational asthma following exposure to soldering
fumes as well as chromium. One case of liver damage due
to Chromium.
• Indian Labour Year Book 2005 and 2006 (P.167) reports only
7 suspected cases of occupational diseases.
Labour laws
• The Factory Act, 1948
• Mines Act 1952, and 1957 and Mines Rules 1957.
• Dock Workers (Safety, Health and Welfare) Act,
1986,
• Building and other Construction Workers
(Regulation and the Employment and Conditions
of Service) Act, 1996,
• Child labour (Prohibition and Regulation) Act
1986,
• Insecticides Act, 1968
Government institutions and agencies
• Ministry Of Labour And Employment
• Directorate General Of Factory Advice Service
& Labour Institutes (DGFASLI) / CLI / RLI
• Directorate General Of Mines Safety (DGMS)
• State Factories Directorates/ Chief Inspector
Of Factories
• State Mines Inspectorate
• Labour Bureau
• Various sectoral Labour Welfare Boards
Government institutions and agencies
• Employee State Insurance Corporation (ESIC)
• National Institute of Occupational Health
(NIOH)
• National Institute of Miner’s Health (NIMH)
• National Safety Council of India (NSC)
• Indian Toxicology Research Centre (ITRC)
Inter-sectoral Linkages in Occupational health in India
Workers
Union
Ministry of Health
and Family
welfare
NGO’s
Ministry of
Industries
Ministry of
Environment
Corresponding
Departments of
the respective
State
Governments
Ministry of
Agriculture
Ministry of
Law
Industry
Ministry of
Labour
International
Organizations
Public health, medical and laboratory
services overview
• In 335 Medical Colleges ~ 40,000 Graduates
are being trained (2011-12) for Primary Health
Care.
• 12000 Govt. Hospitals with 0.8 million beds
with 72,000 Doctors. 0.8 million registered
doctors.
• General Nursing Midwives – 1.2 million,
Auxiliary Nursing Midwives – 0.6 million
• Health Visitors/Supervisors – 53,000
Laws related for Occupational
Medicine and Medical Practitioners
• Appointment of Certifying Surgeon / Inspector
Medical u/s 10 of Factories Act and 11 of
Mines Act.
• Any Medical graduate can be appointed
without OHS qualification
• Inspector of Factories (Medical)/ Certifying
Surgeon, can also suo-moto carry out medical
examination of workers engaged in hazardous
processes.
Laws related for Occupational
Medicine and Medical Practitioners
• NOTICE OF CERTAIN DISEASES (Factories and Mines
Act)
• If any medical practitioner attends on a person who is
or has been employed in a factory, and who is, or is
believed by the medical practitioner to be, suffering
from any disease, specified in the Third Schedule the
medical practitioner shall without delay send a report
in writing to the office of the Chief Inspector.
• If any medical practitioner fails to comply with the
provisions of above sub-section, he shall be punishable
with fine.
• Similar provisions in BOCW Act. List may be different
Process of Diagnosis for Occupational
Disease
• Pre-employment and periodic medical
examination of workers under Factories Act and
Mines Act
• Workers covered under ESIC Act, ESI dispensaries
and Hospitals provide the diagnostic services to
the covered employees. Have 4 referral centres
for Occ. Diseases, remained non-functional.
• Any qualified medical practitioner can diagnose
OD
Current Curriculum – Industrial Health
Institute
Course
Duration
No. Of Students
Eligibility
CLI, Mumbai
AFIH
3 months
50
MBBS
RLI, Kolkata
AFIH
3 months
25
Do
State Factory
Inspectorate, Goa
AFIH
3 months
25
Do
BHEL, Trichy
AFIH
3 months
25
Do
LMRC, Pune
AFIH
3 months
25
Do
COEH, New Delhi
AFIH
3 months
25
Do
NIOH, Ahmedabad AFIH
PhD
3 months
3 years
15-20
MBBS
MD
AIIHPH, Kolkata
DIH
2 years
2-3
MBBS
AFMC, Pune
Diploma in
Industrial
Health
2 years
1
MBBS
AIMS, Kochi
PhD
3 years
-
MD
SRMC, Chennai
PG Cert.
1 yrs
20
MBBS
Current Curriculum – Industrial Safety
Institute
Course
Duration
No. Of
Eligibility
Students
RLI, Mumbai
Advance
Diploma
1 year fulltime
50
Recognized Degree or
Diploma in Tech.
/Engineering or in
Physics or Chemistry
RLI, kolkata
PGD Industrial
Safety
1 year fulltime
50
Do
RLI, Chennai
Diploma
Industrial
Safety
1 year fulltime
50
Research, training
education in the field
of Industrial Safety
RLI, Kanpur
PGD Industrial
Safety
1 year fulltime
50
Department in
administration, or in
construction industry
ITRC, Lucknow
Summer
Training
3-6 months
-
M. Sc. Students
SRMC, Chennai
M.Sc (Distance) 3 yrs
20
B.E/B.Tech/MBBS
Current Curriculum – Industrial Safety
Institute
Course
Duration
No. Of
Students
Eligibility
ISTAR, Anand
Masters in
Industrial
Hygiene
2 year fulltime
15
Any Science Graduate
British Safety
Council, London
Diploma
1 month
-
Appropriate role in
Health & Safety
NITIE, Mumba1
PEDISEM
DErg
2 year
9 months
-
-
Annamalai
University,
Chennai
Diploma in
Industrial
Hygiene
2 years
(distance)
-
Any Science Graduate
Mahatma
Gandhi Labour
Institute,
Diploma in
Industrial
Safety
2 y ears
Full time
15 - 20
Any Science Graduate
Pramukhswami
Medical college
Diploma in
Industrial
Hy giene
2 y ears
Full time
01
MBBS
Expectations from this meeting
• Developing training curriculum for all relevant
stakeholders.
• Training for Health Workers at PHC level.
• Support for more emphasis on OHS in Medical
graduation.
• Support for training of Practitioners in the
endemic area on specific issues.
• Developing Orientation training curriculum for
future managers (HR, Engineers, Safety).
Chrome Nasal Perforation
Bilateral Wrist Drop (Lead)
Machine Oil Contact Dermatitis
Awareness Session of Workers
Eye Examination of workers
Thank you