OCCUPATIONAL

HEALTH
 Occupational Health

Objectives:
At the end of the session, the participants will be able to:

 Determine how to establish an appropriate

occupational health control management system.
 Enumerate steps in providing health mishap
prevention programs.
 Discuss on how health hazard abatement
programs are implemented.
 Occupational Health

Promotion and maintenance of the highest degree of

physical, mental & social well-being of workers of all
occupations
Prevention among its workers of departures from health
caused by their working conditions
Protection of workers in their employment from risks usually
from factors adverse to health
Placing & maintenance of the worker in an occupational
environment adapted to his/her physiological ability.
 Occupational Health

Global Estimates
 Occupational Health

based on 2001 Data (2005)

Work-related accidents: 270 million/year

Work-related illnesses: 160 million/year

Deaths: 2.2 million/year

 Occupational Health

(32%)

(0.4%)

(1%)
 Occupational Health

Philippine Data
 Occupational Health

Sources
Administrative submission of annual accident and
medical reports (Work Accident and illness Report
WAIR and Annual Medical Report AMR)
Nationwide Sampling Survey (Integrated Survey –
Bureau of Labor and Employment Statistics BITS)
Database of compensation claims
Research and case studies
 Occupational Health

Specific Hazard
Type of Hazard
(with highest exposure)
Physical Noise

Chemical Unclassified

Ergonomics Prolonged standing

Excessive physical load

Biological Viral
 Occupational Health

1996 1997 1998 1999 2000

1.colds
1. colds 1.tension
1.colds 2.Tonsillo-
1.colds 2. diarrhea headache
2.tension pharyngitis
2.tension 3. tension 2.colds
headache 3.diarrhea
headache headache 3.diarrhea
3.diarrhea 4.tension
3.diarrhea 4. gastritis 4.influenza
4.influenza headache
4.Tonsillo- 5. Tonsillo- 5.vertigo
5.gastritis 5.gastritis
pharyngitis pharyngitis 6.gastritis
6.Tonsillo- 6.influenza
5.gastritis 6. Conjunc-tivitis 7.error of
pharyngitis 7.Dysmenor-
6.influenza 7. influenza refraction
7.hypertension rhea
7.Hyperten-sion 8. allergy 8.amoebiasis
8.Dysmenor- 8.urinary tract
8.allergy 9. Dysmenor- 9.Tonsillo-
rhea infection
9.Conjunc-tivitis rhea pharyngitis
9.bronchitis 9.bronchitis
10.gingivitis 10.Hyperten- 10.Dysmenor-
10.arthritis 10.Conjunc-
sion rhea
tivitis
n = 1,048 n = 2,068 n = 1,929 n = 3,028 n = 2,097
 Occupational Health

Data on Occupational Illnesses and

Injuries in the Philippines

Bureau of Labor and Employment Statistics (BLES)

 BLES Integrated Survey (BITS) 2007 - 2008
 Nationwide sampling survey
 Sample
 Around 24,000 non-agricultural establishments employing 20 or

more
 Occupational Health

Data on Occupational Illnesses and

Injuries in the Philippines
Type of Disease Number Percent
Total 43,235 100.0
Work-related musculoskeletal 13,296 31.0
diseases
Bronchial asthma 8,759 20.0
Infections 6,517 15.0
Essential hypertension 6,152 14.0
Occupational dermatitis 5,965 14.0
Peptic ulcers 4,135 10.0
 Occupational Health

Database of Employees Compensation Claims

Review and analysis of EC claims filed with the social security
system
 Occupational Health

YEAR FILED
DISEASES Total Rank
1997 1998 1999 2000
Diseases of the genito- urinary system 110 111 23 13 257 1
Diseases of the circulatory 72 123 13 14 222 2
Infectious and Parasitic Diseases 66 85 16 11 178 3
Diseases of the skin 58 54 18 13 143 4
Diseases of the musculoskeletal
45 63 5 2 115 5
system
Disease of the Eye 18 19 6 1 44 6
Diseases of the respiratory 11 24 3 3 41 7
Diseases of the nervous system 9 8 3 - 20 8
Symptoms, signs, not classified 1 8 1 2 12 9
Diseases of the digestive system 3 6 - - 9 10
TOTAL 400 515 91 64 1070
 Occupational Health

Surveillance of Occupational Illnesses and Injuries in the

National Capital Region (NCR)
Survey of Occupational and Work-related Illnesses in
Establishments with Company Physicians affiliated with PCOM
 Occupational Health

No. of Reporting Estab with

DISEASES Occurrence of Disease
Low back pain 32 (97%)
Hypertension 30 (91%)
Allergic dermatitis 16 (48%)
Neck/Shoulder Pain 13 (39%)
Other kidney disease* 9 (27%)
Other lung disease 9 (27%)
Carpal tunnel syndrome 8 (24%)
Anemia 7 (21%)
Hand-wrist tenosynovitis 5 (15%)
Other due to physical hazards** 1 (3%)
Occupational Health
 Occupational Health
Safety Hazards
working conditions where harm
to the workers is of an
immediate and violent nature
result in broken bones, cuts,
bruises, sprains, loss of limbs,
etc.
the harm results in some kind of
injury to the worker
associated with poorly guarded
or dangerous equipment and
machinery
Health Hazards
working conditions which
result in an illness
exposure to dangerous
substances or conditions,
such as chemicals, gases,
dusts, noise etc.
often, latency between
exposure and disease
 Occupational Health

A hazard is any source of potential damage, harm or

adverse health effects on something or someone
under certain conditions at work

Risk is the chance or probability that a person will be

harmed or experience an adverse health effect if
exposed to a hazard.
 Occupational Health

Chemical Physical
hazards hazards

Ergonomic Biological
stresses hazards
 Occupational Health

Workplace factors

+
Workers’ susceptibility
___________________________________
 Occupational Health

Physical properties
Frequency of exposure
Duration of exposure
Magnitude of exposure
Timing of exposure
Multiplicity of exposure
 Occupational Health

Age
Gender
Genes
Race
Personal Hygiene
Health Habits (Smoking, alcohol, drugs)
Medical History
Occupational Health
Occupational Health
 Skin absorption
 Inhalation
 Ingestion
 Injection
 Degree of exposure/ severity
of effect is determined by:
nature of type of
materials/ substance
duration-length of
exposure
Intensity-amount of
exposure
individual susceptibility
Occupational Health
 Occupational Health

General Classification of Toxic

Effects
 Local toxicity: Occurs at the site of chemical contact
 Irritation of skin, eyes, upper respiratory tract, lungs
 Systemic toxicity: Distant site from point of contact,
may involve many organ systems
 Most chemicals produce systemic toxicity
 Occupational Health
Toxicity Acute vs Chronic
Acute
• occurs almost immediately
(hours/days) after an exposure
Skin Absorption
Absorption of phenol through the
skin creating a chemical burn
Inhalation
Inhalation of formaldehyde causing
irritation to mucus membranes
Chronic
• represents cumulative damage to
specific organ systems
• many months or years to have
recognizable clinical disease.
Inhalation
Consumption of lead causing
damage to the kidneys
Inhalation
Inhalation of asbestos causing
cancer to the lungs
 Occupational Health
Occupational Kidney Diseases
Causative Agents Industry Diseases

Mercury, Lead Battery., Chronic renal failure,

Cadmium Chemical Ind, Renal stones
Battery Mfg. (Cadmium)
Nephrotic Syndrome
(Mercury)

Chloroform, Solvents, chemical Acute renal

Carbon tetrachloride industries failure

Ethylene glycol Solvents, cosmetics

Carbon disulfide Solvent, pesticide Chronic renal failure
 Occupational Health

pulmonary irritation
asthma/bronchitis
reactive airway disease
emphysema
allergic alveolitis
fibrotic lung disease
pneumoconiosis
lung cancer
 Occupational Health

dermal irritation due to skin exposure to gasoline

dermal corrosion due to skin exposure to sodium
hydroxide (lye)
dermal hypersensitivity due to skin exposure to poison
ivy
skin cancer due to ingestion of arsenic or skin exposure
to UV light
 Occupational Health

Occupational Hematologic (Blood)

Diseases
Causative Agents Industry/Process Disease

Lead Battery manufacturing Anemia

Lead Smelting

Benzene Solvent Aplastic

Soap manufacturing anemia

Arsine gas Chemical industries Destruction of

red blood
cells
 Occupational Health

Occupational Heart Diseases

Causative Agents Industry/Process Disease

Lead, Cadmium (?) Battery mfg. Hypertension

Recycling

Carbon disulfide Degreasing, Dry Atherosclerosis

Cleaning

Fluorocarbons Refrigeration, Abnormal heart

Trichloroethylene solvent workers rhythm

Nitrates Explosives Angina, heart attack

 Occupational Health
Occupational Liver Diseases
Causative Agents Industry/Process Disease

Carbon Cleaning fluids, Acute liver

tetrachloride Dry cleaners toxicity

Arsenic Smelting, Insecticides Cirrhosis

Chlorinated Chemical industry
hydrocarbons

Epoxy resins Rubber, synthetic Acute

fabric manufacturing hepatitis

Vinyl chloride Plastics, Vinyl chloride Liver Cancer

monomer manufacturing
 Occupational Health

acids and strong alkalis may cause severe corneal

corrosion

methanol (wood alcohol) may damage the optic nerve

 Occupational Health

neuronopathies (neuron injury)

Organic mercury
axonopathies (axon injury)
Inorganic lead
n-hexane
demyelination (loss of axon insulation)
Tricholoroethylene
interference with neurotransmission
Organophosphates
 Occupational Health

Hypersensitivity
allergy and autoimmunity
Immunodeficiency, and uncontrolled proliferation
Leukemia (benzene)
 Occupational Health

decreased libido and impotence

infertility
interrupted pregnancy (abortion, fetal death, or 
premature delivery)
infant death or childhood morbidity
altered sex ratio and multiple births
chromosome abnormalities and birth defects
childhood cancer
Occupational Health
 Occupational Health

Noise
Extremes of Temperature
Inadequate Illumination
Vibration
Radiation
Ionizing
Non-ionizing
Occupational Health
 Occupational Health

Acute: from loud noise such as blasts

(140-160 dB damages the eardrum)

Chronic: Due to long-term exposure to hazardous noise levels

Major risk Factor: Prolonged exposure to unprotected levels of noise (> 85 dB)
 Occupational Health

Permanent hearing loss when exposed to

more than 85 dB(A) of noise for an extended
period

Lowered work efficiency from added stress

and fatigue
 Occupational Health

Temporary threshold shift (auditory fatigue)

temporary loss of hearing acuity after exposure to loud
noise
recovery within 16-48 hrs.

Permanent threshold shift

irreversible loss of hearing
difficulty in understanding spoken words
familiar sounds are muffled
frequent tinnitus
 Occupational Health

Periodic hearing tests should be carried out

 Occupational Health

Hearing Damage
Interfere with work performance
Disturbs relaxation and sleep
Hypertension
Hyperacidity
Palpitations
Stress-related disorders
Occupational Health
 Occupational Health

Definition
Physical factor which affects man by transmission of
mechanical energy from oscillating sources

Types
Whole body vibration
Segmental vibration.
 Occupational Health

Hand Arm Vibration Syndrome (HAVS)

(secondary Raynaud’s Syndrome)
tingling, numbness, blanching of fingers
pain
Occupational Health
 Occupational Health

Usual Complaints
Visual Fatigue
Double Vision
Headaches
Painful irritation,
Lacrimation,
Conjunctivitis
Occupational Health

Loss of productivity
Increased Accident Rate
More Mistakes
Lowering of Quality
Visual Complaints
 Occupational Health

Area of Operation Min Lighting Level (lux)

Cutting Cloth  2000
Fine machining
Transcribing handwriting 1000
Drafting
Welding 500
First Aid station
Lunch Room 300
Rest Room
Occupational Health
 Occupational Health

DISORDERS CAUSES MAIN CLINICAL TREATMENT PROGNOSIS

FEATURES
Miliaria rubra Malfunction of Pruritic rash Symptomatic Good
sweat glands
Heat cramps Loss of water and Cramps in limbs Rest, fluids with Complete recovery
electrolytes added salt

Heat exhaustion Physical exertion, Dizziness, blurring of Rest, cooling in Complete recovery
loss of water & vision with cold and well-ventilated usual
electrolytes clammy skin surroundings

Heat stroke Failure of Convulsions, muscle Stripping down High mortality;

temperature twitch, delirium with and vigorous Sequelae: poor
control center in hot and dry skin; cooling with ice memory &
brain Temp > 41°C baths concentration,
headache
Occupational Health
 Occupational Health

Radiation Sources Effects

Non-Ionizing
Ultraviolet Sunlight, Arc flash erythema, skin
Welding cancer, sunburn
Microwaves Radar, Ovens Can interfere with
pacemaker & medical
devices
Infrared Glass Blowing, Cataracts
Furnaces
Ionizing X-rays, Gamma Cancer, congenital
Radiation rays defects, death
Occupational Health
 Occupational Health

Anything of biological nature

Has potential to cause harm to humans
Viruses, bacteria, fungi, parasites
Occupational Health
 Occupational Health

HIV is the virus which causes AIDS.

AIDS is a serious and usually fatal condition in which the

body’s immune system is severely weakened and cannot
fight off infection.
 Occupational Health
HIV & AIDS:
The Philippine Scenario
Reported Mode of Feb. Jan-Feb Cumulative Data:
Transmission 2011 2011 1984—2011
n=159 n=311 N=6,326
Sexual Contact 155 306 5,712
Heterosexual contact 33 (21%) 61(20%) 2,546 (45%)
Homosexual contact 70 (45%) 144 (47%) 1,993 (35%)
Bisexual contact 52 (34%) 101 (33%) 1,173 (21%)
Blood / Blood Products 1 1 20
Injecting Drug Use 0 0 155
Needle Prick Injury 0 0 3
Mother-to-Child 0 0 52
No data available 3 4 384
 Occupational Health

Blood
Semen
Vaginal fluids
Breast milk
 Occupational Health
HIV can enter the bloodstream:
• During unprotected sex
• Through transfusions of
contaminated blood or
blood products

• Puncturing of the skin by

needle or sharps infected
with HIV
• From an HIV positive
mother to her baby
 Occupational Health

through casual contact in any setting– schools,

homes, hospitals

through insect, food, water, clothes, toilets,

swimming pools, and drinking and eating utensils
 Occupational Health

REMEMBER!
Abstinence
Be Faithful
Condom
Do not inject Drugs/ no sharing of needles
Education
 Occupational Health

A neurological disorder characterized by increased muscle

tone and spasms, that is caused by tetanospasmin, a
protein toxin elaborated by the organism Clostridium
tetani.

It arises from the contamination of wounds with

Clostridium spores.
 Occupational Health

Clinical Manifestations
Increased tone in the masseter muscle (lockjaw)
Sustained contraction of the facial muscles (risus
sardonicus) and back muscles (opisthotonus)
Prevention
Active immunization with tetanus toxoid
Careful wound management
 Occupational Health

caused by the bacteria, Mycobacterium tuberculosis

caused by droplet nuclei released when sneezing and
coughing
Symptoms: weight loss, low grade afternoon fever,
persistent cough and sometimes, blood-streaked
expectoration or hemoptysis
 Occupational Health

Both Sexes
Cause Male Female
No. Rate Percent*
1. Heart Diseases 40,361 30,500 70,861 84.8 17.6
2. Vascular System Diseases 28,930 22,750 51,680 61.8 12.8
3. Malignant Neoplasm 21,395 19,129 40,524 48.5 10.1
4. Accidents** 28,041 6,442 34,483 41.3 8.6
5. Pneumonia 15,822 16,276 32,098 38.4 8.0
6. Tuberculosis, all forms 17,841 8,029 25,870 31.0 6.4
7. Ill-defined and unknown causes of
10,941 10,362 21,278 25.5 5.3
mortality
8. Chronic lower respiratory diseases 13,084 5,891 18,975 22.7 4.7
9. Diabetes Mellitus 7,970 8,582 16,552 19.8 4.1
10. Certain conditions from perinatal
7,809 5,371 13,180 15.8 3.6
period
 Occupational Health

With DOTS
90% CURE RATE
 Occupational Health

“Fitting the job to the worker”

 Occupational Health

Goal
to reduce work-related musculoskeletal
disorders (MSDs) developed by workers

MSDs are injuries and illnesses that affect muscles, nerves,

tendons, ligaments, joints or spinal discs.
 Occupational Health
ERGONOMICS

Painful joints

Pain, tingling, numbness in hands, wrists, forearms, shoulders, knees and feet

Shooting or stubbing pains

Swelling or inflammation

Fingers or toes turning white

Back or neck pain

Stiffness

Less strength for gripping or hand grasping

Less range of motion

Loss of muscle function

Inability to do everyday tasks.
 Occupational Health

ERGONOMICS
Risks Factors

Heavy lifting
Twisting at the waist
Reaching and Lifting
Working in odd and uncomfortable positions
Sitting or standing too long in one position
Repetitive movements
 Occupational Health

Occupational Non-Occupational
Factors Factors

Lifting Age
Pushing/pulling Severe postural
deformities
Prolonged sitting Smoking
Whole body vibration Sports (golf, bowling,
jogging, etc.)
Work dissatisfaction Hypochondriasis
 Occupational Health

•Identify cases

•Analyze Trends and Patterns in the Workforce to Guide

Prevention Efforts

•Meet Regulatory Requirements

 Occupational Health

Know the hazard - How worker is exposed

- How worker is affected

Characterize the hazard - Exposure levels

- Exposure duration

Know the worker - Susceptibilities

Obtain information on - Directed towards affected appropriate

medical organ system
examination

Analyze medical data - Disease, recovery,

rehabilitation
- Effectiveness or failure
of control measures
 Occupational Health

Entrance (Baseline) Examinations

Can They do the Job?
Do They Have Medical Conditions?
Do They Need Accommodation?
Periodic Screening (Specific, Job Related)
Fitness for Duty (Specific Cause)
Exit Examination
 Occupational Health

 Biological monitoring
Blood – routine examination
Biomarkers of exposure
Urine – metabolites
Hair/nails – chronic exposure
 Complete physical examination
 Neurological examination
 Occupational Health

Occupational Safety and Health Standards

Rule 1050
Notification and Keeping of Records of Accidents and/or
Occupational illnesses

Rule 1070
Occupational Health and Environmental Control

Rule 1960
Occupational Health Services
 Occupational Health
Rule 1960: Occupational Health Services
1961: General Provisions
1. Every employer shall establish in his place of
employment occupational health services in
accordance with the regulation and guidelines
provided for under this rule.
2. The employer, workers, and their representatives,
where they exist, shall cooperate and participate
in the implementation of the organizational and
other measures relating to occupational health
services.
 Occupational Health

Rule 1960: Occupational Health

Services

1963: Emergency Health Services

1963.01: Medicines and Facilities

1963.02: Emergency Medical and Dental Services

 Occupational Health

Health Programs shall include:

Entrance
Periodic
Special examination
Transfer examination
Separation examination
 Occupational Health

Prescribed Minimum Standards for Periodic Medical

Examinations Designed for the Early Detection of
Occupational Diseases:

Exposure to occupational hazards enumerated in the “list of

Occupational Diseases” is a requirement to undergo:

Periodic medical examinations :

< than 3 mos. - exposure to: Benzene or its homologues, Ionizing
Radiation and Organophosphates
> than 3 months: Lead, Mercury, Manganese, Chromium and Carbon
disulfide
 Occupational Health

For diseases not listed above: periodic examinations

not exceeding one year
Specific examinations depending on exposure
(examples):
Audiometric exam with exposure to noise
Examination of Urine and urinary bladder: alpha
naphthylamine, benzidine
Examination of the skin: irritants and sensitizers
Examination of the eyes and respiratory tract: chlorine
and sulfur dioxide
 Occupational Health
Health Promotion
Drug Abuse Prevention and Control
RA 9165 Comprehensive Drugs Act of 2002
Department Order No. 53-03: Guidelines for the
Implementation of a Drug-Free Workplace Policy and
Program for the Private Sector

Tuberculosis Prevention and Control

Executive Order No. 187, Instituting a Comprehensive
and Unified Policy for Tuberculosis Control in the
Philippines (CUP) (March 2003)
Department Order No. 73-05: Guidelines for the
Implementation of Policy and Program on Tuberculosis
(TB) Prevention and Control in the Workplace
 Occupational Health
Health Promotion
HIV and AIDS Prevention and Control
RA 8504 Philippine AIDS Prevention and Control Act of
1998
National Workplace Policy on STD/HIV/AIDS initiated
by DOLE – 1997
Department Order 102-10: Guidelines for the
Implementation of HIV and AIDS Prevention and
Control in the Workplace

Hepatitis B Prevention and Control

Department Advisory No. 05: Guidelines for the
Implementation of Workplace Policy and Program on
Hepatitis B
 Occupational Health
DEPARTMENT ORDER NO. 56-03
RATIONALIZING THE IMPLEMENTATION OF THE FAMILY
WELFARE PROGRAM (FWP) IN DOLE
SECTION 2. New Priorities of the Family Welfare Program
a) Reproductive Health and Responsible Parenthood
b) Education/Gender Equality
c) Spirituality or Value Formation
d) Income Generation/Livelihood/Cooperative
e) Medical Health Care
f) Nutrition
g) Environmental Protection, Hygiene and Sanitation
h) Sports and Leisure
i) Housing
j) Transportation
 Occupational Health

Sec. 6. Designated Smoking And Non-Smoking Areas

In all enclosed places that are open to the general public,
private workplaces, and other places not covered under the
preceding section, where smoking may expose a person to
the other than the smoker to tobacco smoke, the owner,
proprietor, possessor, manager or administrator of such
places shall establish smoking areas.

Such areas may include a designated smoking area within the

building, which may be in an open space or separate area
with proper ventilation, but shall not be located within the
same room that has been designated as a non-smoking area.
ANY QUESTIONS?
 END OF THE
PRESENTATION

Thank you!