Penyakit-penyakit Pekerjaan dalam
operasi Kerajaan Tempatan
Hak-Hak Pekerja dan Orang lain.
Occupational Safety and Health
Awareness Course- Minsistry of Housing and Local
Government
Dr. Avinash K. Chand
MBBS, LFOM, DMO, CMIA
Occupational Health Doctor
KESAN KEMALANGAN
KESAN KEMALANGAN
OH : DEFINITION BY WHO/ILO
1. Promotion and maintenance of the highest
degree of physical, mental and social well-
being of workers in all occupations;
2. Prevention of workers of departures from
health caused by their working conditions;
3. Protection of workers in their employment
from risks resulting from factors adverse to
health;
4. Placing and maintenance of the worker in
an occupational environment adapted to
physiological and psychological ability
5. Summary : the adaptation of work to man
and of each man to his job.”
CLASSIFICATION OF OCCUPATIONAL
HAZARDS
Hazards at work may be classified into Acute or Chronic:
Acute
These cause immediate health effects such as by corrosive, irritant, poisonous, inflammable and volatile gases, liquids, and solids.
Chronic
The effect take a long term to manifest (latency period), and may be difficult to identify, e.g. occupational cancers.
TYPES OF OCCUPATIONAL HAZARDS
1. PHYSICAL (including
ERGONOMIC)
2. CHEMICAL
3. BIOLOGICAL
4. PSYCHOSOCIAL
Chemical Dusts, metals, organic solvents, acids,
alkalis, pesticides, etc.
Physical Noise, vibration, ionizing radiation,
heat, cold, lighting, physically
demanding work, e.g. Repetitive
strain injuries, etc.
Biological Viruses, bacteria,
fungi, worms etc.
Psychosocial
Stress – shift work, overworks,
boredom, lack of motivation,
monotony, insufficient
training, Poor organization.
Personal threat – sexual
harassment, abuse,
discrimination.
ROUTES OF ENTRY
• Ingestion Toxic substances may be ingested orally
through contaminated food or drink, during smoking, or through swallowing of contaminated mucus from the respiratory tract. Significant absorption may then occur via the intestinal tract. However, oral toxicity is generally lower than inhalation toxicity for a particular substance because of poorer absorption, dilution from food and drinks and detoxication by the liver.
• Inhalation
This is the most important route of entry for most
substances. The upper respiratory tract
(nose,throat,larynx,trachea and main bronchi)
acts as an important filtration and drainage
system through mucus and cilia to remove
much of the inhaled substances. Particles
smaller than 5 microns are deposited in the
lower respiratory tree (alveoli) but may be
engulfed and cleared by macrophage cells or
absorbed through the alveolar-capillary
membrane.
• Skin absorption
This is an important route for
pesticides,solvents and organic chemicals,
and for microbiological organisms.
Absorption may occur through intact or
especially damaged skin, and is higher at
warm temperatures due to sweating and
vasodilation.
Ionizing and ultraviolet radiation are also
absorbed through the skin.
Skin Structure
Epidermis
Muscle fibers
Subcutaneous
Dermis
METABOLISM
After absorption, the substances are transported in the blood, either in plasma or bound to red blood cells, to other organs or tissues in the body. Some substances are deposited and metabolized in the liver to non toxic compounds which are then excreted through the kidneys.
Others may accumulate in special affinity sites or target organs such as bones(e.g. lead,fluorine,radium), hair(arsenic,cadmium), nerve or fatty tissue (organochlorines).
PHYSICAL HAZARD
Silica (SiO2)
A former tunneling worker
suffered from silicosis
54 y.o. 61 y.o.
Tunneling from18 to 38 years old
Lung changes
Construction materials
including asbestos
Asbestos fibre
A carpenter suffered from
asbestosis
56 y.o. 59 y.o.
Working as a carpenter from 23 to 56 years old
Lung changes
ERGONOMIC
History of MSD’s (England 19th & 20th Century
BEFORE
AFTER
BEFORE
AFTER
Old New
Mechanical Aids
Victorian WorkCover Authority 39
BIOLOGICAL HAZARD
BIOLOGICAL
HAZARD
eg : HIV/AIDS
VIRUS HIV
WASTING IN
AIDS PATIENT
110101
KARPOSI SARCOMA IN AIDS PATIENT
110101
110101
110101
VIRUS SARS
Typical
Pneumonia Atypical
Pneumonia
Pneumonia
ZOONOTIC DISEASES
Examples :
Nipah virus
Anthrax
Brucellosis
Psittacosis
Leptospirosis
An infection or infectious disease
transmissible under natural conditions
from vertebrate animals to human
NIPAH VIRUS
CHEMICAL HAZARD
n-Hexane polyneuropathy
The 1st patient in the world who was diagnosed to be n-hexane polyneuropathy
19 y.o. Polyethylene lamination (Aug. 1962-Dec. 1962) Sept 1962 : Easy fatigability Oct. 1962 : Body weight loss Nov.1962 : Tingling sensation Dec.1962 : Gait disturbance Jan. 1963 : Grip power 0kg
Organic Solvent
Mass outbreak
of n-hexane
polyneuropathy
among
footwear
manufacturers
disclosed in
1967
Organic Solvent
Stevens-Johnson syndrome due to
trichloroethylene (TCE)
Symptoms and Signs :
Fever & headache
Serious form of Erythema
multiforme
Mucous membrane
involvement :
conjunctivitis, rhinitis,
vesicobullous eruption
Eyes : keratitis, iritis,
uveitis, panopthalmitis
Organic Solvent
Stevens-Johnson syndrome due to
trichloroethylene (TCE)
Organic Solvent
Reproductive disorder and bone marrow damage
due to 2-bromopropane
Organic Solvent
Brain damage of a thinner sniffer
Normal brain (MRI) Brain damage of a thinner sniffer (MRI)
Contents of thinner
Toluene 68%
Ethyl acetate 18%
Methyl isobutyl ketone 9%
Isopropyl alcohol 3%
Butyl acetate 3%
Organic Solvent
ALLERGIC CONTACT DERMATITIS (ACD)
DERMATITIS DUE TO DETERGENT EXPOSURE
PESTICIDES
PREVENTION AND CONTROL
The hierarchy of controls is a list of measures in order of priority or desirability:
Elimination
Substitution
Isolation
Engineering Controls
Work Practices
Personal Protective Equipment
Other preventive measures are:
Environmental monitoring (Industrial Hygiene)
Ventilation Housekeeping Health Education Health Surveillance and Biological
Monitoring
Health Surveillance is the examination of
individual workers on a regular basis for
early diagnosis or identification of changes
or deviations in health status due to
workplace exposure to hazardous
substances.
This may include biological monitoring, which is the measurement of a hazardous substance or its metabolite, or other biological parameters such as enzymes in body tissues, fluids or exhaled air.
BIOLOGICAL EXPOSURE INDICES (BEIs)
These are measurements of the concentration of a chemical determinant in the biological media of those exposed.
Examples - Acetone in urine
- Hippuric acid in urine
- Cholinesterase activity in rbc
- Lead in blood
MEDICAL SURVEILLANCE
MONITORING of a person for the
purpose of identifying CHANGES IN
HEALTH STATUS DUE TO
OCCUPATIONAL EXPOSURE TO CHEMICALS HAZARDOUS TO HEALTH
REPORTING OF OCCUPATIONAL DISEASES
Underreporting :
ICEBERG PHENOMENON
Occupational Lung Disease
Occupational Skin Disease
Occupational Cancers
Zoonoses
NIHL
Neurological Disorders 2o solvents
Poisoning 2o Inorganic and Organic poisons
Ergonomic problems/ Stress
Reported cases
Gross underreporting
NOTIFICATION OF OCCUPATIONAL DISEASES
Legal Requirement
1) Section 32 of Act 139 FMA 1967
(Notification on Industrial Diseases)
~ Duty to report by Medical Practitioner
~ List of notifiable industrial diseases in Third
Schedule
2) Section 32 of Act 514 OSHA 1994
~ Duty to report by employer and Medical
Practitioner
Hak- hak pekerja dan orang lain
Dijelaskan dalam OSHA 1994
OTHER PROVISIONS TO…
73
Ensure the safety, health and welfare of the people at work
Protect others from the safety and health risks arising from the activities of people at work
Establishment of the National Council for OSH
Other related matters
OSHA 1994: CONTENTS
74
The 15 Parts of OSHA 1994:
1. Preliminary
2. Appointment of Officers
3. National Council for OSH
4. General Duties of Employers and Self-Employed Persons
75
5. General Duties of Designers, Manufacturers and Suppliers
6. General Duties of Employees
7. Safety and Health Organisations
OSHA 1994: CONTENTS
OSHA 1994: CONTENTS
76
8. Notification of Accidents, Dangerous Occurrence, Occupational Poisoning and Occupational Diseases and Inquiry
9. Prohibition Against Use of Plant or Substance
10. Industry Codes of Practice
OSHA 1994: CONTENTS
Copyright@NIOSH 2005 77
11. Enforcement and Investigation
12. Liability for Offences
13. Appeals
14. Regulations
15. Miscellaneous
PART I: PRELIMINARY
Copyright@NIOSH 2005 78
Section 1(2)&(3) - SHORT TITLE &
APPLICATION
Persons at work
In all sectors of the economy as in the First Schedule including
public services and authoritative bodies
Exceptions: work on board ships, and the Armed Forces
FIRST SCHEDULE
Subsection 1(2)
Copyright@NIOSH 2005 79
Manufacturing
Mining and quarrying
Construction
Agriculture, forestry and
fisheries
Utilities
Electricity, Gas, Water &
Cleaning services
Transportation, storage and
communications
Commercial – wholesale and
retail
Hotel and restaurant
Financial, insurance, properties
and business services
Public services and authoritative
bodies
PART I: PRELIMINARY
80
Section 2 - PREVAILING LAWS
(1) Additional provisions to any other written law related to
OSH
(2) The OSHA provisions will supersede any conflict or
inconsistencies with previous laws
PART I: PRELIMINARY
81
Section 3 - INTERPRETATION
Industry – public service, or local authorities,
or any activities in the First Schedule
Plant – any machinery, equipment, appliance,
implement or tool, any component thereof and
anything fitted, connect to it
PART I: PRELIMINARY
82
Section 3 - INTERPRETATION
Employer - the immediate employer or the principle
employer or both
Immediate employer – employer that employs the employee
directly, by or through him
Principle employer - the owner of an industry including
manager, the occupier, the legal representative, government,
local authority or statutory body
PART I: PRELIMINARY
83
Section 3 - INTERPRETATION
Worker - a person who is employed for wages under a contract of service
Occupier - a person who has the management or control of the place of work
Place of work- premises where persons work or premises used for the storage of plant or substance
PART I: PRELIMINARY
84
Section 3 - INTERPRETATION Premise – includes any: land, building or part of any building
vehicle, vessel or aircraft
installation whether on land, shores, or floating on any water or
underwater
tent or mobile structure
PART I: PRELIMINARY
85
Section 3(2) - INTERPRETATION
Risk arising - the risk that may come due to
activities of persons at work including:
the work processes
the plant or substances used
the condition of premises used
PART I: PRELIMINARY
86
Section 3(3) - INTERPRETATION
Work – Work as an employee or as a self-employed person
An employee is deemed to be at work throughout the time
when he is at his place of work
A self-employed is at work throughout such time as he devoted to work as a self-employed person
87
Part I: Section 3 Practicable should take into account: the severity of the risk or hazard or risk
the state of knowledge about the hazard or risk and any way of removing or migitate the hazards or risk
the availability and suitability of methods to remove or mitigate the hazard or risk
the cost of removing or mitigating the hazard or risk
PRACTICABLE INTEPRETATION
PART I: PRELIMINARY
88
Section 4 - OBJECTIVES OF THE ACT
To ensure the safety, health and welfare of persons
at work
To protect person at a place of work other than
persons at work
PART I: PRELIMINARY
89
Section 4 - OBJECTIVES OF THE ACT
To promote an occupational environment for persons at work which is adapted to their physiological and psychological needs
To provide the means towards a system of regulations and approved industry codes of practice
PART IV:
GENERAL DUTIES OF EMPLOYERS AND SELF-
EMPLOYED PERSONS
90
Section 18
Responsibility of an occupier of a non-domestic premise is
to ensure the place of work is free from risks to the safety
and health of those other than his workers
Case Discussion…
Kisah Benar