During an occupational health surveillance program in an Indian steel manufacturing plant, the occupational health physician reviews preventive measures for occupational diseases. All of the following are recognized primary prevention strategies for occupational health hazards EXCEPT:

Question

Accepted Answer

A. Periodic medical surveillance and spirometry screening of exposed workers to detect early lung disease. ## Levels of Prevention in Occupational Health

**Key Point:** Periodic medical surveillance and screening (spirometry, audiometry) are **secondary prevention** measures—they detect disease early in asymptomatic workers. Primary prevention aims to eliminate or reduce exposure to the hazard before disease occurs.

### Three Levels of Occupational Health Prevention

| Level | Timing | Goal | Examples |
|-------|--------|------|----------|
| **Primary** | Before exposure/disease | Eliminate or reduce hazard exposure | Substitution, engineering controls, PPE, ergonomic redesign |
| **Secondary** | Early disease stage | Early detection in asymptomatic workers | Medical surveillance, spirometry, audiometry, chest X-ray screening |
| **Tertiary** | Established disease | Rehabilitation, prevent complications | Occupational therapy, vocational retraining, disability management |

**High-Yield:** The **hierarchy of occupational hazard control** (in order of effectiveness) is:
1. **Elimination** — remove the hazard entirely
2. **Substitution** — replace with less hazardous material
3. **Engineering controls** — isolate worker from hazard (ventilation, enclosure)
4. **Administrative controls** — reduce exposure time, job rotation
5. **Personal protective equipment (PPE)** — last resort

All of these are **primary prevention**. Medical surveillance is **secondary prevention**.

**Clinical Pearl:** In a worker with silicosis detected on routine spirometry screening, the spirometry itself is secondary prevention (early detection). However, installing local exhaust ventilation in the foundry to reduce silica dust exposure is primary prevention (hazard reduction).

**Mnemonic:** **PRIMARY = Prevent exposure** (Substitution, Engineering, Ergonomics, Elimination). **SECONDARY = Screen early** (Surveillance, Spirometry, Screening).

Answer

B. Substitution of hazardous substances with less toxic alternatives in the workplace

Answer

C. Engineering controls such as local exhaust ventilation and enclosure of dust-generating processes

Answer

D. Ergonomic redesign of workstations to reduce repetitive strain injury and musculoskeletal disorders

During an occupational health surveillance program in an Indian steel manufacturing plant, the occupational health physician reviews preventive measures for occupational diseases. All of the following are recognized primary prevention strategies for occupational health hazards EXCEPT:

Explanation

Practice similar questions