EOH3202 Occupational Health

Dr. Emilia Zainal AbidinEnvironmental & Occupational Health

Faculty of Medicine and Health SciencesUniversity Putra of Malaysia

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Basic concept of Occupational HealthRoles of ProfessionalsCompetenciesKnowledge areas and skillsChallengesDiscussion: What went wrong?

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Definition 1: Occupational Health is the promotion and maintenance of the highest degree of physical, mental and social well-being of workers in all occupations by preventing departures from health, controlling risks and the adaptation of work to people, and people to their jobs (ILO-WHO 1950)

Definition 2 - Occupational Health is the maintenance and promotion of workers’ health and working capacity, improvement of working environment and work to become conducive to safety and health and the Development of work organisation and working culture – safe, healthy and enhance productivity (ILO-WHO Committee on Occupational Health 1955)

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But not limited to:Occupational physiciansNursesPsychologist Industrial hygienistEpidemiologistEngineerToxicologistMicrobiologistChemist Information technicianStatisticianHealth promotion specialist

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Hazard: A hazard is any source of potential damage, harm or adverse health effects on something or someone under certain conditions at work

Risk: Risk is the chance or probability that a person will be harmed or experience an adverse health effect if exposed to a hazard. It may also apply to situations with property or equipment loss.

Surveillance: ?Control measures: ?Health promotion: ?

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Identify and assess the risks from health hazard in environment/workplace

Protect and promote public/workers’ healthCarry out surveillance of factors which may affect

healthImprove the conditions that might harm health

through sound control measuresMaintain health and achieve the highest possible

standards of health in the interest of the workersStrengthen health promotion and ensure continuous

improvementsDevelop safe and healthy culture and management

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Primary preventionRisk assessment – determine whether the risk

is high or lowHazard controlHealth promotion

Secondary preventionTreatment for injuries and diseases

Tertiary preventionRehabilitation, therapy

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Adviser – individual, group, organisationalAgent of change – worker, environment,

processExpert – evaluation, risk assessmentCounsellorTrainerSource of knowledge – disseminating relevant

informationSkill development resource

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Identify the problemsTreat or fix the problemsAssess the effectiveness of the programs and

interventions or in other words, to evaluate the programs

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Identification and assessment of the risks from health hazardsHealth risk assessment – carry out assessment

on hazards that may arise from operation, e.g. machinery

Advise for control methodsDiagnosing ill-health related to environment or

occupationAssessment by multidisciplinary team

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Physical Hazards– are in the form of energy or force Chemical Hazards – Chemical hazards can appear as

gasses, vapours, liquids, solids, dust, fumes, or mists which can be flammable, toxic, corrosive, reactive or explosive

Biological Hazards – can cause disease and are found in living organisms

Ergonomic Hazards – results from poorly designed equipment, work processes or work stations

Psychosocial Hazards – affect the psychological well-being

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Pre-employment and pre-placement examination – medical check-up to obtain base line health data

Periodical medical monitoring – auditory status, blood lead level, lung function

Examination after illness or injury – to determine whether worker is able to work

Termination examination – start work disease free, should stop work disease free

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Advising of occupational healthAssessing control systems designed to

eliminate or reduce exposure and ensure it is working

Selecting appropriate personal protective equipment – but this is the last resort

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Why walk-through survey is important? To enable the visualisation of the possibility

for injury to occurTo enable OH professionals to observe

workers in order to give effective advice

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Advising on the planning and organisation of work/projectProviding safe operating procedures to be used

by workers for existing work systemProvide information, instruction guidance and

trainingAdvising on introduction of new working

systems/techniqueIncluding human factors in the process design

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Participating in formulating safety, health and environment policiesPolicies based on ethical principles – identify

who formulate the policy? Sometimes the policy formulated by management is not in line with the occupational health aspiration

Public/workers fully informed of the policy and their right

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Collaborating in providing information and trainingDissemination of information and skill

developmentParticipating in relevant committees – MIHA,

DOSH, NIOSHEvaluation of work-related diseases – lung

cancer

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Contributing to scientific knowledge regarding hazards to healthRecognising and investigate ill-health

determinantsAnalysing routinely collected data – statistical

analysis to identify pertinent risk factorsConducting scientific investigation –

collaborate with research organisations

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Advising and supporting the implementation of relevant legislationApplication and implementation of relevant

laws and regulations – e.g. certificate of fitness is obtained for specific machinery before it is used

Formulating a Health policy in the workplaceAdvising workers and management of their

legal obligation

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Participation in health promotion programsNeeds analysis – based on the evidences

obtainedCost-benefit analysisSeeking participation from various relevant

groupsEvaluating and auditing health promotion

programs

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Management of health and safety - ISOPolicy Organising Planning and implementationEvaluationAction for improvement

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Working as part of a multidisciplinary servicesPromoting multidisciplinary scientific work on

exposure data gathering – e.g University of Manchester developed THOR (The Health and Occupation Network) and SWORD (Surveillance of Work-Related and Occupational Respiratory Disease)

Planning the efficient use of multidisciplinary resources

Coordinating health surveillance, environmental surveillance and other risk assessment

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Medical sciences – diagnosis, treatment, risk assessment/analysis

Laboratory sciences – monitoringRelevant legislation and policiesHealth promotionEducation, training and communication skillsScientific research – epidemiology and

biostatisticsGenetics

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Surveillance – disease, exposure and behaviour

Toxicology – study of agents that produce adverse responses in the biological system with which they interact

Public health ethics – human right, confidentiality, equity

Risk communication – exchange of information of health risks

Management – planning, effective evaluation, cost benefit analysis, capacity building

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Need for focused national and international leadershipLack of disease exposure tracking, training of relevant

professionals, developing strategic partnership and financial support

Focus on health promotion, trained professionals, developing national performance standards and best practice and providing technical assistance

Emerging threatsRapid industrialisation, globalisation, natural disasters,

terrorist attacks, epidemics, under reporting of diseasesPreventive approach, coordination of multidiscipline

agencies

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Photo: View at lower ground floor which was covered with blood

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What improvements would you suggest as an Occupational Health professional?

The incident involved a machine that has been fabricated and installed in a furniture store.

It has the characteristic of a hoisting machine which had resulted in a worker being crushed to death by a drum motor which had fallen down.

The victim body was discovered at the lower ground of the building and covered with blood with his head smashed.

From the initial investigation, it was found that the incident was due to hook installation on the cross beam structure at the top level which is used to hang the drum motor.

The hook cannot withstand the load, which was being lifted. The victim was believed to have started work after the

holiday. He is likely to have not received any safety training on use of the machinery, which was newly fitted in that furniture store, and it is not yet completely installed and tested properly.

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What would you suggest as an Occupational Health professional

What improvements would you suggest as an Occupational Health professional?

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Around 8.45 am on February 24, 2012 a fatal accident occurred at Port Klang, Selangor involving a Bangladeshi employee who worked with the cleaning contractor

During the accident, the victim was collecting mill scale that has spilled on the pier floor under the path of the wharf crane (capacity 20 tons), which, at the time was unloading the mill scale from vessels into the hopper on the pier (Figure 1).

While the grab bucket used to transport the mill scale passing through the area where the victim was working, grab bucket had opened suddenly and cause the load carried to fall and buried the victim below (Figure 2).

Victim died on the way to the hospital.

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