Abstract

Insulin-dependent diabetes have become a major challenge for professionals who have to demonstrate great courage and efforts to save lives of citizens. This dissertation example is offered as a free dissertation sample to help students write any kind of academic papers following the same pattern and the research work. Click here for more dissertation examples on various topics close to your research area. 

Occupational health and safety is a key issue in today’s world of industrial development and revolution of technology. To safeguard health of workers and general public health and safety act 1974 was introduced. Occupational health and safety is implied in law proceedings and is a standard for safe administration at work place. The workers have right to be protected against risks and dangers to life resulting from workplace environment. All the monitoring and implementation of law regarding public health and health and safety at work is the responsibility of Health and Safety Commission, which include looking after the health, safety and well being of people at work place, and to protect others, mostly members of the community, who may be harmed in any way from the method work is being done. HSC’s legislative tasks include recommending new or modernized laws and standards, carrying out research, and offer required information and advice.

This study aims at evaluating the case of firefighter who was found to be having insulin-dependent diabetes. He was checked by an occupational health doctor on work place so that his disease may be treated and arrangements are made for him to go back to work. When he could show that his diabetes was stable and it proved by different tests and his trial at work by some key tasks such as using breathing apparatus etc so as to assess he could securely use it. Further his blood tests also showed that levels of his sugar were established and he was an end to risk of in hazard than any other firefighter.

Introduction

Emerging Health Issue:  insulin-dependent Diabetes

Diabetes mellitus is defined as the dysregulation of glucose metabolism characterized by chronic hyperglycemia resulting from defects in insulin secretion, decreased insulin sensitivity or a combination of both. The clinical symptoms are polydipsia, polyuria, and unexplained loss of body weight, weakness and susceptibility to certain infections.

According to etiopathogenic criteria, diabetes mellitus is subdivided into four major groups. The diagnosis should be made according to guidelines such as those of the German Diabetes Society using fasting blood glucose levels or 2-h postload glucose levels (glucose load containing 75 g glucose dissolved in water) at some stage in an oral glucose tolerance test (oGTT)

The reason for Type 1 diabetes is a particular devastation of the b-cells which produce insulin in the pancreas. The disease is diagnosed when specific types of auto antibodies against islet cell antigens appear. Auto antibodies to insulin, glutamic acid decarboxylase, tyrosine phosphatase IA-2 and cytoplasmic islet cell antibodies are helpful indicators for the disparity diagnosis of type 1 diabetes when medical and metabolic criterion alone do not allow exact categorization. The clinical symptoms are polydipsia, polyuria, and unexplained loss of body weight, weakness and susceptibility to certain infections.

Type2 diabetes mellitus is characterized by insulin resistance, often in association with the other features of IRS, and a partial failure of insulin secretion triggered or exacerbated by the insulin resistance. Pancreatic islet dysfunction associated with type 2 diabetes mellitus results in failure of _ cells to secrete an adequate quantity of insulin to maintain normoglycemia. At the same time, inappropriately high hepatic glucose output results from continued glucagon production by cells, which contributes to fasting hyperglycemia. Normal glucose metabolism is maintained by the two counterregulatory hormones, insulin and glucagon. The incretins, GIP and GLP-1, are released in response to oral glucose and act together to promote the insulin response and decrease glucagon. Insulinogenic activity of GLP-1 and GIP is due to interaction with their respective receptors. The GLP-1 receptor is articulated on _ and _ cells of the pancreas, as well as in peripheral tissues such as the heart, nervous system, lung, kidney, , and gastrointestinal tract, whereas the GIP receptor is mainly expressed on islet _ cells and to some level in adipose tissue and the main nervous system

According to NFPA reports; “In 1996, 92 death of firefighter while they were on-duty were recorded. Out of these, cause of 50 percent deaths was stress resulting in heart attack. The firefighters who died during duty were in the ages ranging from 41 to 55 were 69 percent of the total. When we see the record of hearth attack deaths of fire fighters for the last twenty years, the figures are as under;

Total heart attach deaths are 532
Out of these almost 50 percent had had gone through heart attacks or bypass surgery in past
Among these 33 percent were those who had previous history of arteriosclerotic heart disease,
And 12 percent were those who had hypertension or diabetes”..

Keeping this in view, diabetes if not managed properly can also cause heart attack and ultimately death. Diabetes is among the top rapidly growing persistent disease in the United States. Out of total population in the United States, almost 20.8 million which is seven percent of the total population, cover diabetes. Whereas there is an estimate that about 14.6 million have been confirmed that they have diabetes, about 6.2 million people which is almost one-third of the total are ignorant of the presence of the disease (A report from National Diabetes Information Clearinghouse, 2005). 4 percent of the firefighters who replied to the NVFC Foundation questionnaire informed of having been identified with diabetes. In Diabetes human body either does not produce or appropriately use insulin. In human body Insulin plays the role to make easy the elimination of blood glucose from the blood and convey it into cells for the body so that they can use it as energy. When blood glucose is not removed and remains in the blood flow, this state is called “hyperglycemia.”

Protracted hyperglycemia is a cause of many systematic complications concerning many tissues of the human body. Some of the complications of Type-2 diabetic disease are;  heart disease which is termed as cardiovascular disease, nerve damage , blindness which is called retinopathy, (neuropathy), and kidney damage which is called nephropathy.

HSC Policy

Health and safety commission has developed policy to implement health and safely law at work place and for individual other than workers who may be affected by the workplace activities. The purpose of HSC policy is to establish rules and principles for authorities responsible to follow. These authorities include health and safety commission itself and local authorities. Local authority and staff or health and safety executive are responsible to follow this policy. Normally, the staff includes inspectors, who monitor the implementation of health and safety laws at work place.

The purpose and procedures

The aim of enforcement is to make sure that staff on duty get going to deal instantly with somber risks, encourage and achieve continued fulfillment with the law, make sure that the responsible staff is working to monitor if there is a violation of health and safety necessities, and company boss or supervisor who do not perform their duties and fail to comply with the law are asked about their failure and appropriate punishment is given, which may encompass bringing supposed offenders previous to the courts

Enforcement is different from civil alleges for reimbursement and is not carried out in all situations where civil alleges may be pursue, or to assist these alleges.

The implementing authorities have a variety of apparatus at their discarding to seek safe fulfillment of the law and to make sure a fair response to illegal offences. It is on inspector’s choice to give instructions to their staff face to face of in writing. This may comprise issuance of a warning to the on duty staff (inspector or other staff) that he is not satisfied with their work and in his opinion; they have failed to fulfill the law. Where suitable, inspectors can also give out development and ban notices, remove approvals, show a discrepancy in license conditions or exceptions, issue official cautions, and they may put on trial

The main ways which are used by the inspectors to achieve their aim of compliance of law are; advising the managers and directors , issuing them notices of  improvement or ban, and removal or discrepancy of licenses or other authorizations of handling serious dangers, securing fulfillment with health and safety law and avoiding harm. By issuance a ban notice inspector can ask to stop work so that serious personal injury is avoided.

An improvement notice consists of a statement that according to the view of an inspector a violation of law has been committed. These ban or advice notices, , can also be used in court dealings.

Official cautions and trials are significant ways to bring duty holders to explanation for supposed violations of the law. Where it is suitable to do so in accord with this strategy, implementing authorities can use any of the actions in addition to giving them an improvement or ban notice.

Health and safety law in UK

The purpose of the Health and Safety at Work place Act 1974 is to protect people along with those at work to protect against risks arising out with the activity of person at work. Section 3 of HSWA imposes general duties on employers and the self-employed towards persons other than their employees.

Disability Discrimination Act and Fire Fighter

According to disability discrimination Act 1995 (DDA), the said fire fighter is counted to be a disable person as it defines disable person as “an individual as disabled if he / she has a physical or mental impairment which has caused a substantial and long-term unfavorable effect on their capability to continue their routine work activities”. That means a disable person cannot do his routine work like normal people like reading books, writing, and using the telephone ,difficulty in talking to others and traveling by public transportation.

Fire fighter has developed diabetes and it is’ Long-term’ impairment as he will have to depend on insulin his disease has no permanent treatment. Insulin-Dependent Diabetes can be called substantial.

As per HSC policy, employing company ought to treat job-seekers and disabled employees in a just way to avoid:

the three kinds of disability discrimination
victimization; and
Harassment.

Disability discrimination

The three kinds of illegal discrimination are;

Direct discrimination;
Do not succeed in making a reasonable adjustment; and discrimination related to disability.
Direct’ discrimination cannot be justified and it occurs when a company manager or employer treats the disabled not as much favorably as he treats the normal person, whose applicable circumstances are the similar or not significantly different; and the behavior is on basis of disability.

An example of disability discrimination is that a firm totally bans to employ a person with a particular disability. In the case of fire fighter with diabetes will be the firm ban him to employ or restrict on his bonuses or prefer other on him. Because as per disability-related discrimination definition, a disabled person is not treated as favorably for the reason of his or her disability associated cause and this behavior cannot be justified.

Victimization

Victimization is anywhere somebody is treated less favorably since, for example, they have protested at work place or used their lawful rights or has supported somebody to do this. For instance, a co-worker of a disabled employee takes part in a tribunal investigation to provide verification, in good faith, in favor of a disability discrimination allege. Because of his participation in the trial and giving evidence he is called a troublemaker’ by the employer and employer withholds his bonus. This will be considered victimization. Victimization of fire fighter will be if he complains he is not being provided with the facilities of regular check ups at workplace or is frequently posted on an emergency vehicle or there is no facility of fridge at work place to store his insulin and for that complaint his employer withholds his bonus.

Harassment

Harassment is any form of undesirable and unwanted behavior with the purpose to violate the disabled person’s dignity; or to create a threatening, antagonistic, humiliating, embarrassing or unpleasant environment. For example, a worker having schizophrenia is over and over again teasingly called by colleagues as ‘a bit off the wall’. Although the colleague have no intention to tease him but the victimized person feels that and this may at times involve their performance at work or in other settings. However, in spite of of the fact that co-workers may not have wished-for any offence, the disabled person feels that these comments make them anxious about the job environment. The colleagues’ behavior will be considered harassment and manager or employing company must have to resolve the matter. The same is the matter with the fire fighter, if he is criticized at work place and he feels that, he may complain and the employer will have to take notice and deal accordingly.

Making reasonable adjustments

As per law, employers are obligatory to put together ‘reasonable adjustments’ to work and workplaces for disabled workers. The reasonable adjustments mean, that disable person have equivalent opportunity to apply for any job and employer does not distinct him with other and he is treated in the same way as the other candidates or employees are treated and no discrimination is made toward him on ground of his disability.

Privacy and data protection Act

If a disabled individual desires an employer to make a reasonable adjustment, then he or she will have to make available the employer with sufficient information to complete that adjustment. Further disabled people also preserve the right to privacy and their manager or employer ought to not reveal secret details about disabled persons without their open permission.

According to the Data Protection Act 1998, it is the duty of employers to make sure to keep the sensitive and personal information about a disable employee confidential; this includes data about a worker’s health. This Act also gives disabled persons or other workers the right to see their private data and information detained or processed about them, with the condition they ask for it in writing. This condition is significant in accessing individual information involving to a risk assessment.

U.S Health and Safety Legislation

US Health and safety laws put duties on everybody concerned with work activities i.e employer, employee etc to ensure safety of health of related individuals. According to HSW Act; that set out the basic duties of employers, self-employed persons, producer and suppliers to defend the healthiness and safety of employees and individual of the public who may be exaggerated by work activities:  The fire fighter who has developed insulin-independent diabetes should return to work with the following reasonable adjustments:

For his safety and to avoid any risk to his health limits on the emergency vehicles he has to drive;
The employer has the responsibility to facilitate provide him facility of regular check ups by the doctor provided by employer at work  and
The employer has the responsibility to provide a fridge to store his insulin.

If these adjustments are not made and the fire fighter is not provided with the facilities as mentioned above it will be the violation of HSW Act section 2 to 6, and the matter can referred to court and employer can be fined by lower court utmost £20 000 and by Higher court it is up to Unlimited fine

The other violations of the HSW Act and violations of ‘applicable legitimate provisions’ under this Act; comprise all health and safety rules. These oblige both universal and more particular requirements, like requirements to carry out an appropriate and adequate risk evaluation or to give proper personal protective equipment to the workers:

The punishment for violation of the law is up to £5000 fine by lower court and unlimited fine by higher court

If director commit a violation concerned to the management of a company and it is proved in court then in addition to the above punishment the firm or company can be disqualified by court for maximum five years period (Sections 36 and 37 of HSW Act), and its directors may also be giving a ineligibility order (Disqualification Act 1986 related to Company Directors, sections 1 and 2). The courts have used this authority following health and safety certainty. Health and safety inspectors illustrate this power to the court’s notice whenever it is required and appropriate. According to disqualification act the disqualification cab be for 5 years’ by lower court and for a maximum of 15 years’ by

Higher court maximum

International Standards for safe fire fighter  

NFPA 1500, A Standard for Fire department Occupational Safety and Health

NFPA 1500

This standard demands for fire departments to set up and uphold a training and education program to stop work-related deaths, damages, and disease. In addition, the fire fighter departments must have to design and comply with training and education for all members of the department as per the requirement of nature of their work and duties that they are likely to do. Training ought to be conventional to the individual necessities for each fire department function for example for firefighter according to his job requirement, for driver or operator according to his job requirement, for fire officer according to his job nature, and for fire instructor keeping in view his function and duty.

NFPA 1403, Standard on Live Fire Training

NFPA 1403 was created following a training occurrence in 1982, in which two firefighters died during duty. Fulfillment with 1403 (in addition to development in personal protective equipment) has assisted pick up safety throughout live fire training division has diverged from the standard.

Resources used for this study

The resources listed below have been used for this study. These include mainly focusing US Health & Safety legislation, reports about health and safety specifically firefighting incidents and comprising the data about diabetes disease and its impact on fire fighters. HSC commission reports and policy has also been used. These resources helped to evaluate the position of fire fighter, his requirements at work place and his rights to get job without any difficulty. HSC enforcement policy and HSW Act helped to know exactly what could be done with the disable persons at work and what duties imply on the employer. The reports about different incident and hazards regarding fire fighting departments also helped to evaluate the exact picture and suggestion for the betterment of the individuals working with these departments. Further standards for fire fighting personal have been studied and these help better work place conditions in the departments.

Searches related to insulin-dependent diabetes

difference between type 1 and type 2 diabetes, type 1 diabetes life expectancy. diabetes type 1 diet. type 1 diabetes in children. type diabetes 2, type 1 diabetes causes. diabetes type 1 treatment. diabetes type 1 symptoms

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