News Publications Basic Occupational Health Services

Basic Occupational Health Services in Bangladesh, the MSF Dhaka model

To diagnose and treat work-related diseases among tannery, metal, plastics and garment workers and families, part of a population of 600 000 working people in heavily polluted areas of Dhaka, Bangladesh, Médecins Sans Frontiérs (MSF) started four clinics as basic occupational health services. Workers were exposed to many high risks, among these chemical substances such as chromium, cadmium, lead, mercury, asbestos; they were also exposed to noise, vibration, electric shock, heat and ionizing radiation. Of the original cohort of 5000 workers, 3200 (64%) came for at least 1 consultation (6-month data) . From these workers 14.6% were diagnosed with suspected work-related diseases using protocols. As some equipment arrived very late, such as an audiometer, this is an underestimation of the true figures. Follow-up consultation was performed for 1447 cases of occupational diseases and work-related injuries.
The report clearly shows the need for such services in densely populated urban areas in low-income nations like Bangladesh and India. In most low-income countries no specialty occupational health clinics exist in primary care. Existing occupational health clinics on factory premises are exclusive to formal industry employees and are not accessible for communities or for informal workers.
Replication of basic occupational health clinics in a primary health care context, is recommended in densely populated urban areas in low-income countries. The article is Open Access, published in BMJ Case Rep. 2017 Mar 20;2017. First author is Muralidhar V.  PMID: 28320759 (PubMed).

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