PHLT611: Special Issues in Public Health – I
Unit 03: - Occupational Health and Healthcare Legislation in India: Law, Legislation
and Program, the Medical Termination of Pregnancy Act, the Transplantation of
Human Organs Act, PCPNDT Act, the Registration of Birth and Death Act.
Occupational Health in India
Occupational health is defined as the highest degree of physical, mental and social well-being of workers in
all occupations. It is the branch of healthcare which deals with all aspects of health and safety at the
workplace. It lays strong emphasis on the prevention of hazards at a primary level. Occupational health is
essentially preventive medicine. Consider the following facts from India: total population is 1.324 billion
(2016); gross national per capita income (PPP) is 6490$; life expectancy at birth (Male/Female) is 67.3/69.8
years; probability of dying under the age of five (per 1000 live births) is 48; total expenditure on health per
capita is 75$; and total expenditure on health as a percentage of GDP is 4.7
Occupational Health Legislation in India
There are presently 16 laws related to working hours, conditions at work and employment. There are two
acts containing the main provisions for legal measures for the protection of health and safety of workers;
they are the Factories Act (1948) and the Mines Act (1952). The Factories Act was amended in 1987 and
stipulates pre-employment examination as a pre-placement procedure, statutory periodic medical
examination for job in hazardous areas. In India, occupational health is under two ministries: 1) Labour and
2) Health and Family Welfare. The Ministry of Labour and the labour departments of the states and union
territories are mainly responsible for health and safety of workers. The Ministry of Health and Family
Welfare is responsible for providing health and medical care to workers through its facilities. The DGMS
(Directorate General of Mines Safety) and the DGFASLI (Directorate General – Factory Advisory Services
and Labour Institutes) assist the Ministry in technical aspects of occupational health and safety in mines,
ports, and factories respectively.
Occupational Health Institutions
The National Institute of Occupational Health (NIOH) was established in 1970 at Ahmedabad, Gujarat, as a
WHO collaborative and reference centre for occupational health, and it works closely with the Ministries of
Labour, Health and Family Welfare, Environment and Forests, Agriculture etc. Some thrust areas of the
Institute are occupational and environmental epidemiology, toxicology, environmental pollution, women’s
health, agricultural health, and human resource development. The objectives of NIOH are to promote
intensive research to evaluate environmental stresses/factors at the workplace, to promote the highest quality
of occupational health through fundamental and applied research, to develop control technologies and health
programmes through basic and fundamental research and to generate human resources in the field. Two
Regional Occupational Health Centres (ROHCs) have been set up in Bangalore and Calcutta. The National
Safety Council of India (NSCI) was established to promote safety consciousness among workers to prevent
accidents, minimise dangers and risks and arrange related education and awareness programmes. The three
main activities of the NSCI are: road transportation safety; safety of health in the construction sector; safety,
health, and environment in small – to medium-scale enterprises (SMEs). Other public institutes include the
Central Labour Institute (and its associated institutes) and the All-India Institute of Hygiene and Public
Health. The Indian Association of Occupational Health (IAOH) is an association of over 3000 members
comprising health professionals, industrial hygienists, safety professionals, social workers, and others. It
aims to promote occupational health by various measures including conducting training courses, workshops,
and conferences, producing a journal with scientific articles, conducting research activities, collaborating
with international agencies in the field and preparing a national registry of occupational health.
, Occupational Health Statistics (India)
National Institute of Miners’ Health (NIMH), an autonomous Institute under the Ministry of Mines,
Government of India, conducts applied research in occupational health and hygiene and specializes in
providing technical support services to mining and mineral-based Industry with special reference to the
metalliferous sector and endeavours for safe mines and healthy miners through research and development.
As per NIMH, the prevalence of pneumoconiosis opacities in chest radiographs in open cast mine workers in
2005 and 2011 were 5.7% to 12% and 5.3% to 13%, respectively. In 2011, out of 101 workers in a stone
mining area suffering from respiratory diseases, 73 suffered from silicosis, of whom 16 had silicosis with
progressive massive fibrosis (PMF). A survey conducted in an underground metal mine has shown that
almost 75% of mine workers had evidence of noise-induced hearing loss. In a recent survey conducted by
NIMH in various mines, out of 117 HEMM (Heavy earth moving machinery), 100% dozers, 95% loaders,
90% dumpers and tippers, 15% excavators and 8% shovelers showed moderate to high health risks to
operators due to whole-body vibrations. Of 48 HEMM operators, 85% complained of various
musculoskeletal disorders related to back, shoulder, neck, and knees. In India, major occupational diseases
are pneumoconiosis (including silicosis, bagassosis, anthracosis and byssinosis), asbestosis, other chronic
lung diseases, musculoskeletal injuries, noise-induced hearing loss, pesticide poisoning and accidents.
Occupations related to construction, mining and agriculture have high levels of related diseases.
Occupational health nurses are the largest single group of health professionals involved in delivery of health
services at the workplace. They are at the front line in helping to protect and promote the health of working
population. The concept of occupational health nursing is new to India. It is non-existent in unorganised
sectors. Even the public sector and private employers have not yet realized its importance. There is a need to
create awareness about this issue amongst all stakeholders.
National Policy on Occupational Health
The Ministry of Labour and Employment, Government of India, approved the national policy on safety,
health, and environment at workplaces in February 2009. It provides guidelines for developing and
maintaining safety culture and environment at workplaces for all stakeholders. It also deals with provision of
a statutory framework, administrative and technical support services, providing incentives (both financial
and non-financial) to employers and employees, developing research and development capabilities,
prevention strategies and their monitoring and providing required technical manpower and inclusion of
safety, health, and environment improvement in other national policies.
An action programme for policy implementation is part of the documented policy. It includes eight specific
working areas for action – enforcement, development of national standards, ensuring compliance, increasing
awareness, promoting research and development, occupational safety, health skills development and data
collection. The government of India is committed to implementing the national policy on safety, health, and
environment at workplaces through tripartite consultations and mobilisation of resources and expertise of all
concerned stakeholders. The guidelines of the policy are helpful since it envisages total commitment and
demonstration by all concerned stakeholders such as governments and social partners through well-set goals
and objectives. Through dedicated and concerted efforts, India will steadily march towards economic
prosperity consistent with the requirements of OSHE, thereby improving the people’s standards of living.
A policy review was done initially to determine the status of health, safety, and environment at the
workplace. Subsequent reviews of the policy and action programme is planned for once in five years.
Assistance was taken from the report of the working group on occupational safety and health for the 11th
and 12th five-year plans under the Ministry of Labour and Environment, Government of India. As per the
data available, the number of working factories for the years 2003 to 2007 has increased by about 46% with
the increase in average daily employment from 4.92 million to 8.02 million. The number of injuries also
decreased by about 7% i.e., from 16,432 to 15,290; however, the fatalities during the period increased from
525 to 821. It may be noted that the frequency rate of injuries significantly reduced by about 30% during the
above period. The number of reportable accidents in major ports from 2003–2007 decreased from 191 to
158 thus registering a decrease of about 17%. The number of fatal accidents also decreased from 29 to 23,
Unit 03: - Occupational Health and Healthcare Legislation in India: Law, Legislation
and Program, the Medical Termination of Pregnancy Act, the Transplantation of
Human Organs Act, PCPNDT Act, the Registration of Birth and Death Act.
Occupational Health in India
Occupational health is defined as the highest degree of physical, mental and social well-being of workers in
all occupations. It is the branch of healthcare which deals with all aspects of health and safety at the
workplace. It lays strong emphasis on the prevention of hazards at a primary level. Occupational health is
essentially preventive medicine. Consider the following facts from India: total population is 1.324 billion
(2016); gross national per capita income (PPP) is 6490$; life expectancy at birth (Male/Female) is 67.3/69.8
years; probability of dying under the age of five (per 1000 live births) is 48; total expenditure on health per
capita is 75$; and total expenditure on health as a percentage of GDP is 4.7
Occupational Health Legislation in India
There are presently 16 laws related to working hours, conditions at work and employment. There are two
acts containing the main provisions for legal measures for the protection of health and safety of workers;
they are the Factories Act (1948) and the Mines Act (1952). The Factories Act was amended in 1987 and
stipulates pre-employment examination as a pre-placement procedure, statutory periodic medical
examination for job in hazardous areas. In India, occupational health is under two ministries: 1) Labour and
2) Health and Family Welfare. The Ministry of Labour and the labour departments of the states and union
territories are mainly responsible for health and safety of workers. The Ministry of Health and Family
Welfare is responsible for providing health and medical care to workers through its facilities. The DGMS
(Directorate General of Mines Safety) and the DGFASLI (Directorate General – Factory Advisory Services
and Labour Institutes) assist the Ministry in technical aspects of occupational health and safety in mines,
ports, and factories respectively.
Occupational Health Institutions
The National Institute of Occupational Health (NIOH) was established in 1970 at Ahmedabad, Gujarat, as a
WHO collaborative and reference centre for occupational health, and it works closely with the Ministries of
Labour, Health and Family Welfare, Environment and Forests, Agriculture etc. Some thrust areas of the
Institute are occupational and environmental epidemiology, toxicology, environmental pollution, women’s
health, agricultural health, and human resource development. The objectives of NIOH are to promote
intensive research to evaluate environmental stresses/factors at the workplace, to promote the highest quality
of occupational health through fundamental and applied research, to develop control technologies and health
programmes through basic and fundamental research and to generate human resources in the field. Two
Regional Occupational Health Centres (ROHCs) have been set up in Bangalore and Calcutta. The National
Safety Council of India (NSCI) was established to promote safety consciousness among workers to prevent
accidents, minimise dangers and risks and arrange related education and awareness programmes. The three
main activities of the NSCI are: road transportation safety; safety of health in the construction sector; safety,
health, and environment in small – to medium-scale enterprises (SMEs). Other public institutes include the
Central Labour Institute (and its associated institutes) and the All-India Institute of Hygiene and Public
Health. The Indian Association of Occupational Health (IAOH) is an association of over 3000 members
comprising health professionals, industrial hygienists, safety professionals, social workers, and others. It
aims to promote occupational health by various measures including conducting training courses, workshops,
and conferences, producing a journal with scientific articles, conducting research activities, collaborating
with international agencies in the field and preparing a national registry of occupational health.
, Occupational Health Statistics (India)
National Institute of Miners’ Health (NIMH), an autonomous Institute under the Ministry of Mines,
Government of India, conducts applied research in occupational health and hygiene and specializes in
providing technical support services to mining and mineral-based Industry with special reference to the
metalliferous sector and endeavours for safe mines and healthy miners through research and development.
As per NIMH, the prevalence of pneumoconiosis opacities in chest radiographs in open cast mine workers in
2005 and 2011 were 5.7% to 12% and 5.3% to 13%, respectively. In 2011, out of 101 workers in a stone
mining area suffering from respiratory diseases, 73 suffered from silicosis, of whom 16 had silicosis with
progressive massive fibrosis (PMF). A survey conducted in an underground metal mine has shown that
almost 75% of mine workers had evidence of noise-induced hearing loss. In a recent survey conducted by
NIMH in various mines, out of 117 HEMM (Heavy earth moving machinery), 100% dozers, 95% loaders,
90% dumpers and tippers, 15% excavators and 8% shovelers showed moderate to high health risks to
operators due to whole-body vibrations. Of 48 HEMM operators, 85% complained of various
musculoskeletal disorders related to back, shoulder, neck, and knees. In India, major occupational diseases
are pneumoconiosis (including silicosis, bagassosis, anthracosis and byssinosis), asbestosis, other chronic
lung diseases, musculoskeletal injuries, noise-induced hearing loss, pesticide poisoning and accidents.
Occupations related to construction, mining and agriculture have high levels of related diseases.
Occupational health nurses are the largest single group of health professionals involved in delivery of health
services at the workplace. They are at the front line in helping to protect and promote the health of working
population. The concept of occupational health nursing is new to India. It is non-existent in unorganised
sectors. Even the public sector and private employers have not yet realized its importance. There is a need to
create awareness about this issue amongst all stakeholders.
National Policy on Occupational Health
The Ministry of Labour and Employment, Government of India, approved the national policy on safety,
health, and environment at workplaces in February 2009. It provides guidelines for developing and
maintaining safety culture and environment at workplaces for all stakeholders. It also deals with provision of
a statutory framework, administrative and technical support services, providing incentives (both financial
and non-financial) to employers and employees, developing research and development capabilities,
prevention strategies and their monitoring and providing required technical manpower and inclusion of
safety, health, and environment improvement in other national policies.
An action programme for policy implementation is part of the documented policy. It includes eight specific
working areas for action – enforcement, development of national standards, ensuring compliance, increasing
awareness, promoting research and development, occupational safety, health skills development and data
collection. The government of India is committed to implementing the national policy on safety, health, and
environment at workplaces through tripartite consultations and mobilisation of resources and expertise of all
concerned stakeholders. The guidelines of the policy are helpful since it envisages total commitment and
demonstration by all concerned stakeholders such as governments and social partners through well-set goals
and objectives. Through dedicated and concerted efforts, India will steadily march towards economic
prosperity consistent with the requirements of OSHE, thereby improving the people’s standards of living.
A policy review was done initially to determine the status of health, safety, and environment at the
workplace. Subsequent reviews of the policy and action programme is planned for once in five years.
Assistance was taken from the report of the working group on occupational safety and health for the 11th
and 12th five-year plans under the Ministry of Labour and Environment, Government of India. As per the
data available, the number of working factories for the years 2003 to 2007 has increased by about 46% with
the increase in average daily employment from 4.92 million to 8.02 million. The number of injuries also
decreased by about 7% i.e., from 16,432 to 15,290; however, the fatalities during the period increased from
525 to 821. It may be noted that the frequency rate of injuries significantly reduced by about 30% during the
above period. The number of reportable accidents in major ports from 2003–2007 decreased from 191 to
158 thus registering a decrease of about 17%. The number of fatal accidents also decreased from 29 to 23,
