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Transcript of Introduction to Occupational Health.pdf
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Introduction toOccupational Health
Victor Hoe Chee WaiMBBS, MPH (Malaya), MPH (Occupational Health) (Malaya),
CMIA, OHD, CHRA
Lecturer Occupational and Environmental Health Unit
Department of Social and Preventive Medicine
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Outline of Lecture
History and Definition Objective of OH
Occupational health laws in Malaysia Occupational health in Malaysia
Occupational history
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08/01/2008 MBBS-OH01 Introduction to OH 3
History Ramazini - 18th
Century Father occupationalmedicine.
Publish first systemicaccount of occupational
disease (“De Morbis Artificum”/ Disease andOccupation)
Emphasize obtaining
occupational history Introduce practice of
doctors visit workplace.
Statue of Ramazini at the OEHU
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When a doctor visits a working class homehe should be contended to sit on a threelegged stool, if there isn’t a guilded chair,
and he should take time for hisexamination; and to the questionsrecommended by Hippocrates he should
add one more What is your occupation?
Bernadino Ramazzini (1633-1714)
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In Malaysia, Occupational Health is
not a new field, medical students
have been looking at occupation
and effect on health since the
beginning of the MBBS programmein University of Malaya, Kuala
Lumpur
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Definition of OH
“The Promotion and Maintenance of the HighestDegree of Physical, Mental and Social Well
Being of Workers in All Occupations;
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The prevention among workers of departures from health
caused by their working conditions;
The protection of workers in their employment from risks
resulting from factors adverse to health;
The placing and maintenance of the worker in anoccupational environment adapted to his physiological and
psychological equipment;
and, to summarize: The adaptation of work to man and each man to his
job”
Joint ILO/WHO Committee (1950)
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That branch of medicine which deal with therelationship of man and his occupation,
for the purposes of prevention of disease and
injury, and
the promotion of optimal health, productivity
and social adjustment
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Objective of OH
Active appreciation of social, economic and administrative needs and
Responsibilities
of the worker and company
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Why Occupational Health?
The overall picture that emerges from all parts of the developing world is one of increased health
and safety risks in all occupations.
Dramatic changes in the global labour force willoccur as globalisation and population growth
continue to be affected by global economy.
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Legislation
To understand the legislation we must firstunderstand the way laws are formulated in
this country
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Act Main Law Enacted by Parliament
Regulation Details for enforcing the Act Gazette by Minister
Code of Practice
Guidelines No legal binding
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Act
Factory and Machinery Act 1967 (FMA) Occupational Safety and Health Act 1994
(OSHA)
Department of Occupational Safety and Health
Ministry of Human Resource
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Others Legislation
Pesticides Act 1984 Department of Agricultural
Atomic Energy Licensing Act 1984
Atomic Energy Licensing Board
Employees’ Social Security Act 1969
Social Security Organisation
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FMA (1967)
Covers safety, health and welfare of workers infactories and working with machinery.
“Factory” is defined as workplaces where 5 or
more persons are employed and any premiseswhere machinery is used.
List of occupational Diseases where Notification
is required – Section 35 of the parent act referringto Third Schedule – Notification must be directedto the DG of DOSH
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Regulations under FMA related tohealth
FM (Safety, Health & Welfare) 1970 FM (Leads) 1984
FM (Asbestos) 1984 FM (Mineral Dust) 1989
FM (Noise Exposure) 1989
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OSHA (1994)
The Occupational Safety & Health Act 1994is enacted to complement the FMA 1967.
Where there is any areas of conflict
between the two Acts, OSHA 1994 will
over-rule FMA 1967.
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Occupational Safety & Health Act1994
Philosophy and Guiding Principles: “Responsibilities to ensure safety and health at the
workplace lies with those who create the risk and withthose who work with the risk.”
Stress on self-regulation
workers cooperation and participation Covers all persons at work except on
board ships and the armed forces
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OSHA regulations OSH (Employers’ Safety and Health General Policy
Statement)(Exception) 1995 OSH (Control of Industrial Major Accident Hazards (CIMA)) 1996
OSH (Safety and Health Committee) 1996
OSH (Classification, Packaging and Labeling of Hazardous
Chemicals) Regulation 1997 OSH (Safety and Health Officer) 1997
OSH (Prohibition of Use of Substance) Order 1999
OSH (Use and Standards of Exposure to Chemical Hazardous toHealth) 2000
OSH (Notification of Accident, Dangerous Occurrence, OccupationalPoisoning and Disease) Regulation 2004
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FMA vs OSHA
FMA OSHA
Limited to factories Covers most work
placesPrescriptive General Principle
Government
Enforcement
Self-regulation
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Providers of OccupationalHealth in Malaysia
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Occupational Health Providers
National Level. Government Agencies.
Department of Public Health (DPH)
Department of Occupational Safety and Health (DOSH)
Social Security Organisation (SOCSO)
National Instituite of Occupational Safety and Health (NIOSH)
Universities
State Level. State Health Departments
State Departments of Occupational Safety and Health (DOSH)
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District Level. District Health Office
Hospital
Occupational Health Clinics in Primary Health Care Facilities
Private Occupational Health Doctors (Specialist/OHD)
Enterprise Level
Employers Occupational Health Doctor (Company Doctors/Company
Appointed Doctors)
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Non-Governmental Organisation Union
Malaysian Trade Union Congress
Professional Organisation
Society of Occupational and Environmental Health
Malaysian Occupational Health Nurses Association Malaysian Industrial Hygienist Association
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Ministry of Health
Have no legislative power under theOSHA1994
Main functions
As an employer – should provide a safe and
healthy work environment for all its workers
As the custodian of the Nations health toprovide the curative and preventive service for
the Malaysian population
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Ministry of Human Resource
National Council of Occupational Safetyand Health (NCOSH)
Departments of Occupational Safety and
Health (DOSH)
National Institute of Occupational Safety
and Health (NIOSH)
Social Security Organisation (SOCSO)
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National Council for OccupationSafety and Health (NCOSH)
Formed in 1995 15 members representing the government,
employers, employees and non-
governmental or professionalsorganizations, each serving three-year terms
Chaired by the Deputy Minister of HumanResources
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NCOSH
Duties is to Discuss,
Analyse and
Investigate through the process of tripatism and
subsequently forward suggestions to the
Minister on matters which is in line with theaims of the Occupational Safety andHealth Act 199408/01/2008 MBBS-OH01 Introduction to OH 28
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Department of Occupational Safety &Health (DOSH)
Begun in 1878 with the appointment of thefirst Machinery Inspector
Machinery Department (Machinery
Ordinance 1953) Factories and Machinery Department
(Factories and Machinery Act 1967)
Department of Occupational Safety andHealth (DOSH) (Occupational Safety andHealth Act 1994 (OSHA 1994))
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DOSH
Responsible for ensuring the Safety,
Health and
Welfare of persons at work and
Protections of other people from hazards to
safety and health arising from the activities of persons at work
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Major Activities
Standard setting relevant legislation, codes of practice,
guidelines
Enforcement
regional branch offices in every state
Promotion enhance OSH consciousness
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National Institute Occupation SafetyHealth (NIOSH)
Founded in December 1, 1992 as aCompany Limited by Guarantee, under the
Malaysian companies Act, 1965 to
spearhead the safety and health culture atthe workplace in Malaysia
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NIOSH
The Board of Directors is a tripartiterepresentation of the Government, thePrivate Sectors and the Workers Unions,provides autonomy in decision making.
NIOSH was set up on a Launching Grantfrom the Government and the SocialSecurity Organization (SOCSO) of Malaysia.
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Function of NIOSH
Teaching Research
Consultancy
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Social Security Organisation(SOCSO)
Set up in 1971 To implement, administer and enforce
The Employees’ Social Security Act, 1969 and
The Employees’ Social Security (General
Regulations), 1971.
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Insurance Scheme
Injury Scheme Contribution by the employers only
All workers with salary of RM3000 or less are required
to contribute. Exception: Self employed, public servant
Invalidity Pension Scheme Contribution by both the worker and employer
It is an optional scheme
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Employment Injury InsuranceScheme
The scheme provides workers withprotection for accidents that occur while:
Traveling (Commuting accident)
Arising out of and in the course of employment
Occupational disease
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Invalidity Pension Scheme
24 hours coverage to an employee against
invalidity or death due to any cause notconnected with his employment.
The benefits provided are: Invalidity Pension Invalidity Grant
Constant Attendance Allowance
Survivors Pension
Funeral Benefit Rehabilitation
Educational Loan
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Occupational History
“When a doctor visits a working-class home he
should be content to sit on a three-legged stool,
if there isn’t a gilded chair, and he should take
time for his examination; and to the questionsrecommended by Hippocrates, he should add
one more – What is your occupation?”
Bernardino Ramazzini
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The most important diagnostic skill in thepractice of occupational medicine is the
taking of a comprehensive occupational
history.
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Definition
Occupy vt inhibit, fill; employ; take possession of (-pied, -plying)
Occupation n employment, pursuit; fact of occupying; seizure
Job n
Piece of work, task; post, office Coll ins Gem pocket English Dictionary
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Chronology of Jobs
Exposure Survey At work
At home
Current Job Description of a typical day
Clinical clues
Exploration of the temporal link Job and symptoms
“Does other at work have similar problems?”
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