Risk Groups & Occupational Toxicology

Prof. A. Gurhan Fisek MD., PhD 
Fisek Institute Science & Foundation for Child Labour
Ankara University Faculty of Political Sciences

ABSTRACT:

It is important to put out risk analysis and risk groups when struggle strategies are being formed. If a subject like ?toxicology? is concerned with an ?occupational? aspects it is important to get help from group dynamics and to choose priorities.

The classical risk groups are formed on the basis of age-sex; the most known ones are children, women and elders. All three groups carry risks of occupational toxicology and form special concern areas like; child labour, reproductive health and geriatrics.

Besides all these, there are some groups which concern occupational toxicology by their work or industrial branch. Agriculture, chemical industry and metal industry are risky branches of industry and determine the work done unconsciously and not taking safety-health precautions in small-closed spaces with hazardous working conditions.

In studies directed to these groups, the workers and working environment must both be examined carefully and the risks must be decreased to minimum and also it should be aimed to remove the risks totally.

PRESENTATITON:

For a healthy and safe life to be sustained, risks should be identified, measured and grouped, also their priorities should be assessed and the strategies struggling with these priorities should be outlined.

Occupational toxicology has come on the scene as an outcome of these necessities. It has a crucial place among occupational risks and for social groups.

It is already known that people who are required to work with toxic substances due to their occupational responsibilities are exposed to toxic substances at various degrees and recurrently for every new day. Requiring a priority given to these people, it is their basic difference from the one who are not employed in such occupations. The risks can also be arranged in a descending order in regard to the priorities of the toxicity levels. What has an utmost priority is the ones that cause people to die most, that disable people physically most, and that is the most commonly encountered with.

Yet, it is not only these specific employees that are exposed to occupational toxic substances. Potentially, these substances can infiltrate through the walls of workplaces by means of toxic wastes. Transferred through water, air, products or employees, these toxic agents appear as a risk for the exposed human groups.

Among these exposed human groups, there are more sensitive and special ones. These disadvantageous groups can be enumerated as children, women, elders, disabled people, chronically sick people and substance addicts like alcoholics. In regard to the risk groups, these are the ones that are commonly classified and mostly underlined.

These groups carry a great significance in terms of occupational toxicology as well. All these groups are exposed to toxic agents in two ways:
1. As an employee,
2. As a victim of environmental pollution.

The necessary conditions should be organised in order to withdraw working children immediately from these kind of working environments. Basically, these conditions are economic and social ones. However, it is such a shame that these two factors do not allow these conditions to be organised immediately: the fact of widespread poverty and the insufficiencies in regard to access to educational facilities. For this reason, elimination of ?worst forms? of child labour in the short-run has been put forth for consideration.
Hazardous works are also counted among these ?worst forms? of child labour. On that ground, children?s being exposed to toxic agents during their work should be hindered. In order to achieve this, we should keep in mind the fact that the standards applied on adults can not be applied on children in the same way. As a solid justification, we may remind the fact that children?s skin is more delicate than of the adults and they are highly sensitive to dermatological absorptions.
Besides, these may also come along with respect to the toxicity of an exposed substance: chromosomal aberrations among children and young people who are employed in mechanics, increases in the ?urinary 1-hydroxypyrene (1-OHP) level? or in ?some genotoxicity parameters (sister-chromatid exchange, SCE; micronucleus, MN).

If it is to be approached from the perspective of exposure limits, the same sensitivity is under consideration as well. Therefore, working hours of children, who are exposed to these toxic substances, should be reduced undoubtedly and unequivocally.

Regarding the working environments in which toxic substances are worked with, people should be provided with collective health and safety precautions. For this reason, aiming at the provision of necessary health and safety servicesfor the small-scale workplaces in which child workers are employed, a model study has been devised by Fisek Institute-Science and Action Foundation for Child Labour and developed through the contributions of ILO/IPEC.

Among the special conditions that increase the sensitivity of women to be exposed to toxic substances, ?pregnancy? has an utmost importance. It is acknowledged that toxic substances affecting a pregnant woman do also affect the foetus, and they cause miscarriages and birth defects to occur. Because, germ cells are much more sensitive towards toxic substances in comparison with the other cells of the human body.i The affects of toxic substances in relation with women are not only limited with foetus. Exposed to toxic agents, mothers may transfer these substances to their children by breast-feeding. Trichloroethylene is an example for this. Reproductive problems do not only come along with women?s exposure to occupational toxic agents. When men are occupationally exposed to these substances, the libido is affected as well; and it may result to various defects over an embryo through chromosomal influences. For example, it is observed that substances like dibromochloropopane pave a way for sterility among men.

Occupations, in which chemicals cause to reproductive problems to occur, can be classified as in Table-1

TABLE-1
CHEMICALS CAUSING REPRODUCTIVE PROBLEMS & OCCUPATIONAL GROUPS IN WHICH THEY ARE EMLOYED

OCCUPATIONAL GROUP

SUSPECTED GROUPS OF CHEMICALS

Employees in the pharmaceutical industry

Medicines and drugs

Anaesthetists and intensive care staff (health and medical care)

Liquid anaesthetics, medicines

Cancer nursing staff

Tumoricidal medicines

(mostly cytostatics)

Various kinds of industrial and laboratory work

Organic solvents

The rubber industry

Rubber chemicals

Others

Wend killers and insecticides

Additionally, as an example for the reproductive problems arisen out of toxic exposures,

Table-2
presents 7 toxic substances and their effects on the reproductive system:i

Chemical name

Teratogen

Reduced fertility or sterility

Miscarriageor foetal damage

Birth defects, foetal damage

Cancer ofreproductiveorgans

Menstrual problems

Antimony

A

H/A

H

?

H

Carbon disulfide

H A si

H/A

H/A

Ethylene dibromide

H A s

H/A

H/A

?

Chlorobenzene

A

A

?

Cadmium

H A si

H

H

H

Lead

H A si

H

H

?

H

Toluen

A

A

H

H= evidence for humans
A= evidence for animals
H/A= evidence for humans and animals
s= reported to cause sterility
i= associated with male impotence
?= known to cause cancer in other parts of the body

For this risks and risk groups about which various studies have been carried out, there are various information to be cited.

The most important indicator of a risk is stress. Stress becomes intensified as the exposed individual cannot overcome this. It is the main objective that people and risks should not be brought in each other?s presence. Yet, there are various reasons which impedes the attainment of “zero risk” approach that is the main objective:

The limits of human thinking;
The limits of science;
Insufficient “health-safety-environmental” researches on the products that are newly put for sale; not being able to achieve to replace a toxic substance with the relatively less toxic one;
Not being able to prevent risk at the source.Not being able to get favourable results from collective or personal precautions.The limits of economy;
Not being able to afford the cost of “zero risk” and sustainability;
Competitive inequalities between the ones who want to achieve “zero risk” and who do not.Nonconformity of the whole production chain with the “zero risk” approach. Cultural obstacles and unawareness;
Individual variations.

In that case, it is just after the achievement of “zero risk” has been determined as the main objective, minimisation of these should be emphasised as an objective having a secondary importance. The strategy for struggling with occupational toxic agents is just in order accomplish these two objectives.

In this circumstance, another significant indicator specifying the priorities is the assessment of risk causing hazards? magnitude. The magnitude of a hazard is put forth for consideration through biological and environmental assessments. Through the identification of exposure limits and a continuous monitoring, it is aimed that the risks that are not “resetable to zero” cause to a minimum loss over people.

Exposure limits and holding employers accountable for monitoring in practice are one of the leverage points of occupational disease related laws. “Give me a leverage point, so that I move the world”, it is just as Archimed stated, the application of exposure limits allows us to progress forward in regard to the struggle with occupational toxic agents. Now that the time seems ripe, it is better to underline to what extent the reflection of our approach on risk groups over the relevant laws is important.

The outlined struggle strategy should be put into practice and be applied in all workplaces in an equitable way. For this to be achieved, national and international laws have a crucial place. These laws, on the one hand, explicate the necessary precautions required to be taken by the employers; on the other hand, they charge the state and trade unions with the duty of supervising the applications. Concerning with the risk groups, these three actors of working life, as the main actors, play a part in the assessment of priorities and preservation and improvement of the human life.

Sectorial grouping is one of the most important groupings that should be emphasised during the evaluation of occupational risks, and outlining the strategies in struggling with them. It is not only the industrial or mining sector where occupational toxic agents are encountered with; agricultural sector is subject to various risks to a great extent as well. It is such an extent that not only the agricultural employees or their families, but also the large segments of societies that use these agricultural products are exposed to these hazards. It is in such a way that increase in agricultural production is aimed to be achieved through the utilisation of chemical fertilisers and through the use of chemical pesticides in order to control the agricultural pests. However, this unawareness maximises the hazards of agricultural risks. During the process passing from the storage of these toxic substances till their utilisation, major dangers can be encountered with, if the necessary precautions are not taken. Such unaware and insensitive farmers do not chose a pesticide that cause minimum hazards both for themselves and their environments, while supposing that the more the amount of these chemicals, the more the efficiency of the results. The same unawareness and insensitivity are also valid for consumers.

Beside the above mentioned risky sectors, risky works and workplaces can also be touched upon. For instance, works performed in confined spaces like boilers or in negative health and safety conditions are considered among the risky works. Workers performing their jobs in such working conditions are considered among the risk groups with the definitions like ?heavy and hazardous works?, ?flammable-explosive hazardous works? and ?exhaustive works?. All these require the necessary precautions to be taken and the monitoring the health of the employees with a great care.

In addition to worker and consumer based causes, the interest groups that benefit from the production and marketing of these toxic agents should also be taken into account. Their endeavours to profit more is a striking danger for all; and they have a tendency to form pressure groups in order to make the precautionary strategies unimplemented. All these should not be neglected by policy-makers and beneficiaries.

Specifically, insofar as occupational toxicology and all kind of social spheres are concerned, it is one of the most indispensable steps of risk groups oriented policies that awareness of people should be raised and their reactions should be organised. In my opinion, our coming together here and today is a meeting for serving for this specific objective.

References:

  • ILO: Eliminating The Worst Forms of Child Labour ? ILO Publication 2002, p.25-26).
  • Mc Guigan M.A.: Toxic Exposures: Incentives for Action, in ?Child Health and Child Labour: From Information to Intervention?, Netherlands Foundation for International Child Health, Amsterdam 1998 p.23
  • Karahalil B., Burgaz S., Karakaya A.E., Fisek A.G.: Biological Monitoring of Young Workers Exposed to Polycyclic Aromatic Hydrocarbons in Engine Repair Workshops, Mutation Research, 412: 261-269, 1998.
  • http://www.fisek.org/childlabour/fisekmodel
  • WHO: Women and Occupational Health ? Issues and policy paper for the Global Commission on Women?s Health, Geneva 1999 p.60.
  • Westerholm P.: Pregnancy and the Working Environment, Joint Industrial Safety Council, Sweden 1994.
  • ILO: Health and Safety for Women and Children, Bureau for Workers? Activities, Geneva 1996.