occupational health

OCCUPATIONAL OCCUPATIONAL HEALTHHEALTH

JAIME A. BARRON, JAIME A. BARRON, M.D.,M.P.H.,M.H.A.M.D.,M.P.H.,M.H.A.

ASSOCIATE PROFESSOR VIIASSOCIATE PROFESSOR VIIUniversity of Perpetual Help System, LagunaUniversity of Perpetual Help System, Laguna

DOCTORSDOCTORSARE MEN WHO PRESCRIBE MEDICINES ARE MEN WHO PRESCRIBE MEDICINES OF WHICH THEY KNOW LITTLE, TO CURE OF WHICH THEY KNOW LITTLE, TO CURE DISEASES OF WHICH THEY KNOW LESS, DISEASES OF WHICH THEY KNOW LESS, FOR HUMAN BEINGS OF WHICH THEY FOR HUMAN BEINGS OF WHICH THEY KNOW NOTHING!!KNOW NOTHING!!

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Definitions:Definitions:

1.1. Industrial Hygiene: science and art of preserving health through Industrial Hygiene: science and art of preserving health through the recognition, evaluation, and control of environmental causes the recognition, evaluation, and control of environmental causes and sources of illness in industry.and sources of illness in industry.

2. Industrial Health: specialized form of medical and public health 2. Industrial Health: specialized form of medical and public health practice, combining elements of med., eng., chem., toxicology, practice, combining elements of med., eng., chem., toxicology, psychology, sociology, statistics, and the principle of disease and psychology, sociology, statistics, and the principle of disease and health promotion, to the end result that the physical and mental health promotion, to the end result that the physical and mental efficiency of the worker is increased and production bettered in efficiency of the worker is increased and production bettered in QUAL and QUAN and permanence.QUAL and QUAN and permanence.

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3. Industrial Medicine: broad field which is concerned with all of the 3. Industrial Medicine: broad field which is concerned with all of the health problems of employed persons; and ind, health as the health problems of employed persons; and ind, health as the objective of ind. Medicine. In other words, ind. Health is the END objective of ind. Medicine. In other words, ind. Health is the END and the practice of ind. Med. Is the MEANSand the practice of ind. Med. Is the MEANS

4. Occupational Medicine: deals with the restoration and 4. Occupational Medicine: deals with the restoration and conservation of health in relation to work, the working conservation of health in relation to work, the working environment and maximum efficiency.environment and maximum efficiency.

5. OCCUPATIONAL HEALTH: sum total of all efforts to improve the 5. OCCUPATIONAL HEALTH: sum total of all efforts to improve the health of workers.health of workers.

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Objectives of O.H.

1.1. Prevent the occurrence of occupational diseases Prevent the occurrence of occupational diseases and injuries.and injuries.

2.2. To minimize the progression of any disease or To minimize the progression of any disease or injury.injury.

3.3. To utilize maximally residual capacities.To utilize maximally residual capacities.

4.4. To promote the optimum health and well being of To promote the optimum health and well being of the workerthe worker

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Aims of Occupational HealthAims of Occupational Health

1.1. Promotion and maintenance of the highest degree of Promotion and maintenance of the highest degree of physical, mental and social well being of workers in all physical, mental and social well being of workers in all occupations.occupations.

2.2. Prevention among workers of departures from health caused Prevention among workers of departures from health caused by their working conditions.by their working conditions.

3.3. Protection of Workers in their Protection of Workers in their employment from risks resulting from employment from risks resulting from factors adverse to health.factors adverse to health.

4.4. Placing and maintenance of the Placing and maintenance of the worker in an occupational worker in an occupational environment adapted to his environment adapted to his physiological and psychological physiological and psychological make-upmake-up

5. Adaptation of work to man and of each man to his job.5. Adaptation of work to man and of each man to his job.

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Aims of Occupational HealthAims of Occupational Health

1.1. Inadequate controlled occupational hazardsInadequate controlled occupational hazards

2.2. Illnesses:Illnesses:

a.a. parasiticparasitic

b.b. zoonoticzoonotic

c.c. respiratoryrespiratory

d.d. GITGIT

e.e. OthersOthers

3.3. MalnutritionMalnutrition

4.4. PoisoningPoisoning

5.5. Occupational Injuries/AccidentsOccupational Injuries/Accidents

6.6. Poor law enforcementPoor law enforcement

7.7. Poor LegislationPoor Legislation

8.8. Health CareHealth Care

9. Psychosocial9. Psychosocial

10. Few labor Inspectors10. Few labor Inspectors

11.11. Occupational Health ManpowerOccupational Health Manpower

12.12. Child LaborChild Labor

13.13. UnderemploymentUnderemployment

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OCCUPATIONAL HEALTH FUNCTIONOCCUPATIONAL HEALTH FUNCTION

Some of the major activities included in the occupational Some of the major activities included in the occupational health function are:health function are:

(A)(A) Ability to recognize occupational disease signs symptoms;Ability to recognize occupational disease signs symptoms;

(B)(B) Collection of morbidity statistics for workers;Collection of morbidity statistics for workers;

(C)(C) Visits to plants;Visits to plants;

(D)(D) Immunization of workers;Immunization of workers;

(E)(E) Recommendation of environmental control measure;Recommendation of environmental control measure;

(F)(F) Industrial hygiene assessment;Industrial hygiene assessment;

(G)(G) Pre employment and periodic medical examinations of Pre employment and periodic medical examinations of workers exposed to know, e.g. lead, silica, dust etc.;workers exposed to know, e.g. lead, silica, dust etc.;

(H)(H) Evaluation of physical fitness for work;Evaluation of physical fitness for work;

(I)(I) Respiratory function test and chest x-ray workers;Respiratory function test and chest x-ray workers;

(J)(J) Treatment of occupational injuries.Treatment of occupational injuries.Dr.

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OCCUPATIONAL HEALTH PROGRAMOCCUPATIONAL HEALTH PROGRAM1) Meaning1) Meaning:

Program provided by management to deal constructively Program provided by management to deal constructively with the health of employees in relation to their works.with the health of employees in relation to their works.

2) Objectives2) Objectives:

a)a) To facilitate the placement and insure the suitability of To facilitate the placement and insure the suitability of individuals according to their physical capacities, mental individuals according to their physical capacities, mental abilities, and emotional make-up in work which they can abilities, and emotional make-up in work which they can perform with an acceptable degree of efficiency and without perform with an acceptable degree of efficiency and without endangering their own health and safety and that of their endangering their own health and safety and that of their co-workers.co-workers.

b)b) To protect employees against health hazards in their work To protect employees against health hazards in their work environment.environment.

c)c) To ensure adequate medical care and rehabilitation of the To ensure adequate medical care and rehabilitation of the occupationally ill and injured; occupationally ill and injured;

d)d) To encourage personal health maintenance, e.g. physical To encourage personal health maintenance, e.g. physical fitness activities.fitness activities.

e)e) Provisions for first aid, emergency services and treatment Provisions for first aid, emergency services and treatment depending on the nature of the industry.depending on the nature of the industry.

f)f) Provide guidance, information and service for family Provide guidance, information and service for family planning programs.planning programs.3) Activities:3) Activities: a) Maintenance of healthful work environmenta) Maintenance of healthful work environment Dr.

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FUNCTION OF AN OCCUPATIONAL FUNCTION OF AN OCCUPATIONAL HEALTH SERVICEHEALTH SERVICE

1)1) Placing people in suitable work.Placing people in suitable work.

2)2) Maintaining people in suitable workMaintaining people in suitable work

3)3) Provision of treatmentProvision of treatment

4)4) Controlling recognize hazardsControlling recognize hazards

5)5) Identifying unrecognized hazardIdentifying unrecognized hazard

6)6) Avoiding potential risksAvoiding potential risks

7)7) Screening for early evidence of non-occupational diseaseScreening for early evidence of non-occupational disease

8)8) Supervision of vulnerable groupsSupervision of vulnerable groups

9)9) CounselingCounseling

10)10) Surveillance of sanitary, catering and welfare amenitiesSurveillance of sanitary, catering and welfare amenities

11)11) Environmental control outside the work placeEnvironmental control outside the work placeDr.

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OBJECTIVE OF OCCUPATIONAL PHYSICIAN; OBJECTIVE OF OCCUPATIONAL PHYSICIAN; (WHO)(WHO)

1)1) Promotion and maintenance of highest degree of Promotion and maintenance of highest degree of physical, mental and social well being of workers in all physical, mental and social well being of workers in all occupations.occupations.

2)2) Prevention among workers of workers of departures Prevention among workers of workers of departures from health caused by their working conditions.from health caused by their working conditions.

3)3) Protection of workers in their employment from risk Protection of workers in their employment from risk resulting from factors adverse to health.resulting from factors adverse to health.

4)4) Placing and maintenance of workers in an occupational Placing and maintenance of workers in an occupational environment adapted to their physiological equipment.environment adapted to their physiological equipment.

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DUTIES OF PHYSICIANS:DUTIES OF PHYSICIANS:The Physician whether part-time or full-time shall be The Physician whether part-time or full-time shall be

responsible of promoting and maintaining the physical and responsible of promoting and maintaining the physical and mental well-being of the workers. It shall be the duty and mental well-being of the workers. It shall be the duty and function of the physicians to:function of the physicians to:1)1) Organize and administer a health service program integrating Organize and administer a health service program integrating

there in occupational safety program.there in occupational safety program.2)2) Conduct studies on occupational healthConduct studies on occupational health3)3) Prevent disease or injury in the workplace by establishing Prevent disease or injury in the workplace by establishing

proper medical supervision over substances used, process, proper medical supervision over substances used, process, work environment;work environment;

4)4) Converse the health of the workers through physical Converse the health of the workers through physical examinations, proper advice for placement and health examinations, proper advice for placement and health education;education;

5)5) Providing medical and surgical care to restore health and Providing medical and surgical care to restore health and earning capacity of injured worker;earning capacity of injured worker;

6)6) Maintain and analyze records of all medical cases and to Maintain and analyze records of all medical cases and to prepare and submit the reports required by this standardsprepare and submit the reports required by this standards

7)7) Continually monitor the work environment for health hazards Continually monitor the work environment for health hazards through periodic inspection of the workplace;through periodic inspection of the workplace;

8)8) Act as adviser to management and labor on all health matters; Act as adviser to management and labor on all health matters; andand

9)9) Report directly to top management in order to be effectiveReport directly to top management in order to be effective Dr. J

Figure I. CAUSATIVE MODEL OF OCCUPATIONAL HEALTH PROBLEMFigure I. CAUSATIVE MODEL OF OCCUPATIONAL HEALTH PROBLEM

Undetected/Unchecked

Occupational Diseases

Inadequate Industrial Health Service Program

Increased Exposure of Workers to Health

Hazards

Inadequate Health

Manpower

Inadequate Health

Facilities

Increased Health Needs of Workers

Ignorance on Safety

Precautionary Measures

Poor Institutional Health Hazards

Control Measures

Unstable Employment Status

Lack of Occupational Health &

Safety Program Training

Preference for Private

Medical Care

Susceptibility to Community

Health Problems (pollution,

malnutrition etc.)

Low Enforcement of Labor Laws on

Working Conditions

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PhysicalPhysical ChemicalChemical

BiologicBiologic ErgonomicErgonomic

OCCUPATIONAL OCCUPATIONAL HEALTH HAZARDSHEALTH HAZARDS

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MEDICAL AND DENTAL SERVICESMEDICAL AND DENTAL SERVICESAS AMENDED BYAS AMENDED BY

ADMINISTRATIVE ORDER # III-S, 1991ADMINISTRATIVE ORDER # III-S, 1991

OF P.D. 856OF P.D. 856

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HAZARDOUS WORKPLACESHAZARDOUS WORKPLACES

A. Exposure to dangerous environmental elements, A. Exposure to dangerous environmental elements, contaminants,contaminants,i.i. RadiationRadiation

ii.ii. ChemicalsChemicals

iii.iii. FireFire

iv.iv. Flammable and Noxious substancesFlammable and Noxious substances

B. WorkersB. Workersi.i. ConstructionConstruction

ii.ii. LoggingLogging

iii.iii. Fire fightingFire fighting

iv.iv. StevedoringStevedoring

v.v. Deep sea divingDeep sea diving

vi.vi. Mechanized workingMechanized working

vii.vii. Mining quarryingMining quarrying

viii.viii.BlastingBlasting

C.C. Explosives / pyrotechnicExplosives / pyrotechnic

D. Exposure to Biological D. Exposure to Biological agentsagents

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What are Work Hazards?What are Work Hazards? Work hazards are negative factors in the workplace that affect man Work hazards are negative factors in the workplace that affect man and the work environment and can cause illnesses, injuries or deaths.and the work environment and can cause illnesses, injuries or deaths.

What are the most common work hazards What are the most common work hazards and what are their effects on the workers and what are their effects on the workers health?health? There are four major categories of work hazard that can affect the There are four major categories of work hazard that can affect the workers health and safety. Below are the examples of these and their workers health and safety. Below are the examples of these and their possible effects on the workers health.possible effects on the workers health.

PHYSICAL HAZARDSPHYSICAL HAZARDSNoiseNoiseVibrationsVibrationsPoor LightingPoor LightingAbnormal TemperatureAbnormal Temperature

Inadequate VentilationInadequate VentilationRadiationsRadiations

CHEMICAL CHEMICAL HAZARDSHAZARDSSolvents, vapors, gases, Solvents, vapors, gases, dust, particulates, heavy dust, particulates, heavy metals, fumes, toxic metals, fumes, toxic gases, etc.gases, etc.

Effect on Workers Effect on Workers (Risk)(Risk)Hearing lossHearing lossJoint StrainJoint StrainVisual problems/accidentsVisual problems/accidentsLeg cramps, dizziness,Leg cramps, dizziness,UnconsciousnessUnconsciousnessLung/respiratory problemsLung/respiratory problemsSkin irritations, visualSkin irritations, visualDisturbanceDisturbance

May cause diseases of lungs, May cause diseases of lungs, skin, liver, heart & blood system. skin, liver, heart & blood system. They can also cause poisoning.They can also cause poisoning. Dr.

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BIOLOGICAL HAZARDSBIOLOGICAL HAZARDSBacteria, virus, fungi, Bacteria, virus, fungi, enzymes, enzymes, microorganisms, microorganisms, molds, etc.molds, etc.

ERGONOMIC ERGONOMIC HAZARDSHAZARDSImproperly designed tools Improperly designed tools or work area, improper or work area, improper lifting, poor visual lifting, poor visual condition, repeated condition, repeated motions in awkward motions in awkward positionspositions

Can cause ailments like Can cause ailments like TB, Tetanus, Viral TB, Tetanus, Viral HepatitisHepatitisHIV/AIDS, etc.HIV/AIDS, etc.

Can lead to low back Can lead to low back pain, accidentpain, accident

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How can employees help employers in the prevention or removal How can employees help employers in the prevention or removal of work hazard at the workplace?of work hazard at the workplace?

• By assisting in good housekeepingBy assisting in good housekeeping

All sources of harmful or unsafe condition must be All sources of harmful or unsafe condition must be eliminated. Work environment must be clean, spotless if eliminated. Work environment must be clean, spotless if possible.possible.

Layout of work areas should be well-planned, with materials Layout of work areas should be well-planned, with materials properly stored or piled, aisles and passageways should be properly stored or piled, aisles and passageways should be clear and accessible.clear and accessible.

Waste materials should be removed as soon as possible and Waste materials should be removed as soon as possible and properly disposed.properly disposed.

Materials should be handled and stored properly.Materials should be handled and stored properly. Signages must be properly placed and must serve as Signages must be properly placed and must serve as

reminders/warnings on the presence of hazards.reminders/warnings on the presence of hazards. Walking surfaces should be free from contaminants like Walking surfaces should be free from contaminants like

water and oil.water and oil. A proper maintenance system is part of good housekeeping. A proper maintenance system is part of good housekeeping.

Workplace cleaning should be scheduled and done Workplace cleaning should be scheduled and done regularly.regularly.

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• By being safety consciousBy being safety conscious Observe proper posture when performing tasks such as Observe proper posture when performing tasks such as

reaching, bending and lifting.reaching, bending and lifting. Don’t smoke near combustible materials.Don’t smoke near combustible materials. Pay attention and be alert at all times.Pay attention and be alert at all times. Don’t operate machines when under the influence of drugs Don’t operate machines when under the influence of drugs

or alcohol.or alcohol. Use the right tool for the jobUse the right tool for the job

• By observing fire/electrical safetyBy observing fire/electrical safety Use insulated toolsUse insulated tools Always replace a fuse with the same kind and rating. Never Always replace a fuse with the same kind and rating. Never

bridge a fuse (using wire, metal, etc.)bridge a fuse (using wire, metal, etc.) When working with any part of electrical circuit, make sure When working with any part of electrical circuit, make sure

that there is someone to look after you.that there is someone to look after you. Observe proper maintenance schedules of electrical Observe proper maintenance schedules of electrical

equipment, loads and wires.equipment, loads and wires. Strictly follow established regulations and rulesStrictly follow established regulations and rules

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• By observing machine safetyBy observing machine safety Use machine guards and safety devicesUse machine guards and safety devices Always follow safe lock-out/tag-out proceduresAlways follow safe lock-out/tag-out procedures Follow safety procedures – keep hands away from moving Follow safety procedures – keep hands away from moving

parts, and keep all guards in placeparts, and keep all guards in place

• By wearing Personal Protective Equipment (PPE) or By wearing Personal Protective Equipment (PPE) or equipment used to isolate the worker from the hazardous equipment used to isolate the worker from the hazardous environment.environment. Use of protective mask or face shields in the case of Use of protective mask or face shields in the case of

welders.welders. Use of safety belts or cable harness in the case of workers Use of safety belts or cable harness in the case of workers

perched on posts, extended stairs or scaffoldings.perched on posts, extended stairs or scaffoldings. Use of buoyant work vest if there is a danger of falling into Use of buoyant work vest if there is a danger of falling into

water while working.water while working. Use of helmets and safety shoes in the case of construction Use of helmets and safety shoes in the case of construction

workers.workers. Use of electrical safety helmets, rubber gloves, insulation Use of electrical safety helmets, rubber gloves, insulation

garments, sleeve cover and insulation tube in the case of garments, sleeve cover and insulation tube in the case of electricians and firemanelectricians and fireman

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Republic of the PhilippinesRepublic of the PhilippinesDEPARTMENT OF LABOR AND EMPLOYMENTDEPARTMENT OF LABOR AND EMPLOYMENT

Employees’ Compensation CommissionEmployees’ Compensation Commission

List of Occupational and Compensable DiseasesList of Occupational and Compensable Diseasesunder theunder the

Employees’ Compensation ProgramEmployees’ Compensation Program

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Occupational DiseasesOccupational Diseases

The ECC, in consultation with the Philippine Medical The ECC, in consultation with the Philippine Medical Association, the Philippine Hospital Association and specialist Association, the Philippine Hospital Association and specialist on occupational health and safety, has listed ailments which on occupational health and safety, has listed ailments which may be deemed work-connected and subject to certain may be deemed work-connected and subject to certain conditions in the work environment, under P.D. 626, as conditions in the work environment, under P.D. 626, as amended, a disability arising from an ailment may be deemed amended, a disability arising from an ailment may be deemed work-connected if the illness is contracted due to the worker’s work-connected if the illness is contracted due to the worker’s nature of employment. This is so if all the following conditions nature of employment. This is so if all the following conditions are present.are present.1)1) The employee’s work must involve the risks or conditions The employee’s work must involve the risks or conditions

described;described;2)2) The disease was contracted as a result of the employee’s The disease was contracted as a result of the employee’s

exposure to the described risks;exposure to the described risks;3)3) The disease was contracted within a period of exposure The disease was contracted within a period of exposure

and under such other factors necessary to contract it; andand under such other factors necessary to contract it; and4)4) There was no notorious negligence on the part of the There was no notorious negligence on the part of the

employee.employee. The employer who has failed to provide adequate The employer who has failed to provide adequate protection and safety devices shall be subjected to the protection and safety devices shall be subjected to the penalty imposed by Article 200 of the Labor Code. penalty imposed by Article 200 of the Labor Code. Where he has provided adequate protective and safety Where he has provided adequate protective and safety devices, there shall be a determination as to whether or devices, there shall be a determination as to whether or not the employee has been notoriously negligent.not the employee has been notoriously negligent.

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The following diseases are considered as occupational The following diseases are considered as occupational when contracted under working conditions involving the risks when contracted under working conditions involving the risks described herein:described herein:


1.1. Cancer of the epithelial Cancer of the epithelial lining of the bladder. lining of the bladder. (Papilloma of the bladder)(Papilloma of the bladder)

2.2. Cancer, epitheliomatous or Cancer, epitheliomatous or ulceration of the skin or of ulceration of the skin or of the corneal, surface of the the corneal, surface of the eye due to tar, pitch, eye due to tar, pitch, bitumen, mineral oil or bitumen, mineral oil or paraffin, or any compound paraffin, or any compound product or residue of these product or residue of these substances.substances.

3.3. Cataract produced by Cataract produced by exposure to the glare of, or exposure to the glare of, or rays from molten glass or rays from molten glass or molten or red hot metalmolten or red hot metal

Nature of EmploymentNature of Employment

Work involving exposure to alpha-Work involving exposure to alpha-naphthylamine, betanaphthylamin or naphthylamine, betanaphthylamin or benzidine or any part of the salts; and benzidine or any part of the salts; and auramine or magentaauramine or magentaThe use or handling of, exposure to The use or handling of, exposure to tar, pitch, bitumen, mineral oil tar, pitch, bitumen, mineral oil (including paraffin) soot or any (including paraffin) soot or any compound product or residue of any compound product or residue of any of these substances.of these substances.

Frequent and prolonged Frequent and prolonged exposure to the glare of or exposure to the glare of or rays from molten glass or rays from molten glass or red hot metal.red hot metal.

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4. 4. DeafnessDeafness


Any industrial operation having to the glare of Any industrial operation having to the glare of or rays from molten glass or red hot metal.or rays from molten glass or red hot metal.

5.5. Decompression sicknessDecompression sickness(a) Caissons disease(a) Caissons disease(b) Aeroembolism(b) Aeroembolism

Any process carried on in compressed or Any process carried on in compressed or rarefied air.rarefied air.Any process carried on in rarefied air.Any process carried on in rarefied air.

6.6. Dermatitis due to Dermatitis due to irritants and irritants and sensitizers.sensitizers.

The use or handling of chemical agents which The use or handling of chemical agents which are skin irritants and sensitizers.are skin irritants and sensitizers.

7.7. InfectionsInfections(a) Anthrax(a) Anthrax

(b) Brucellosis(b) Brucellosis

(c) Glanders(c) Glanders

(d) Rabies(d) Rabies

Work in connection with animals infected with Work in connection with animals infected with anthrax, handling of animal carcasses or parts anthrax, handling of animal carcasses or parts of such carcasses including hides, hoofs and of such carcasses including hides, hoofs and horns.horns.Any occupation involving handling of Any occupation involving handling of contaminated food and drink particularly milk, contaminated food and drink particularly milk, butter and cheese of infected goats and cows.butter and cheese of infected goats and cows.Any occupation involving rabid dogs, or Any occupation involving rabid dogs, or equine animals or carcasses.equine animals or carcasses.Any occupation involving rabid dogs.Any occupation involving rabid dogs.

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Occupational DiseasesOccupational Diseases Nature of EmploymentNature of Employment

(e) Tuberculosis(e) Tuberculosis

(f) Tularemia(f) Tularemia

(g) Weill’s disease(g) Weill’s disease

(h) Q. Fever or (h) Q. Fever or equineequine encephalomyelitisencephalomyelitis(i) Mite dermatitis(i) Mite dermatitis

Any occupation involving close and frequent Any occupation involving close and frequent contact with source or sources of tuberculosis contact with source or sources of tuberculosis infection by reason of employment: (a) in the infection by reason of employment: (a) in the medical treatment or nursing of person or medical treatment or nursing of person or persons suffering from tuberculosis, (b) as a persons suffering from tuberculosis, (b) as a laboratory worker, pathologist or postmortem laboratory worker, pathologist or postmortem worker, where occupation involves working worker, where occupation involves working with material which is a source of tuberculosis with material which is a source of tuberculosis infectioninfectionAny occupation involving handling of rabbits, Any occupation involving handling of rabbits, ground squirrels, mice or other rodents.ground squirrels, mice or other rodents.Any occupation involving handling of rats, Any occupation involving handling of rats, mice, swine and dogs.mice, swine and dogs.Any occupation involving handling of horse, Any occupation involving handling of horse, cattle and sheep, or their slaughter and meat cattle and sheep, or their slaughter and meat packing.packing.Any occupation involving handling of flows or Any occupation involving handling of flows or pigeons.pigeons.

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8.8. Ionizing radiation disease, Ionizing radiation disease, inflammation, ulceration or inflammation, ulceration or malignant disease of skin or malignant disease of skin or subcutaneous tissues of the subcutaneous tissues of the bones or leukemia, or anemia bones or leukemia, or anemia of the aplastic type due to X-of the aplastic type due to X-rays, ionizing particle, radium rays, ionizing particle, radium or other radioactive or other radioactive substances.substances.(a) Acute radiation syndrome(a) Acute radiation syndrome

(b) Chronic radiation (b) Chronic radiation syndromesyndrome

(c) Glass blower’s cataract(c) Glass blower’s cataract


Exposure to X-rays, ionizing particles of Exposure to X-rays, ionizing particles of radium or other radioactive substance or radium or other radioactive substance or other forms of radiant energy.other forms of radiant energy.

Short duration of exposure to large doses Short duration of exposure to large doses of X-rays, gamma rays, alpha rays and of X-rays, gamma rays, alpha rays and beta rays.beta rays.Chronic over-exposure to X-rays with a Chronic over-exposure to X-rays with a long latent period affecting the skin, long latent period affecting the skin, blood and reproduction organ.blood and reproduction organ.These are workers exposed to infrared These are workers exposed to infrared rays.rays.

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9. Poisoning and its sequelae 9. Poisoning and its sequelae caused by:caused by:


All work involving exposure to the risk All work involving exposure to the risk concerned.concerned.

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a)a) AmmoniaAmmoniab)b) Arsenic or its toxic compoundArsenic or its toxic compoundc)c) Benzene or its toxic homologues; nitro Benzene or its toxic homologues; nitro

and aminotoxic derivatives of benzene or and aminotoxic derivatives of benzene or its homologue compoundits homologue compound

d)d) Beryllium or its-toxic compoundsBeryllium or its-toxic compoundse)e) Brass, zinc or nickelBrass, zinc or nickelf)f) Carbon dioxideCarbon dioxideg)g) Carbon bisulfideCarbon bisulfideh)h) Carbon monoxideCarbon monoxidei)i) ChlorineChlorinej)j) Chrome of its toxic compoundsChrome of its toxic compoundsk)k) Dinitrophenol or its homologueDinitrophenol or its homologuel)l) Halogen derivatives of hydrocarbon of Halogen derivatives of hydrocarbon of

the aliphatic seriesthe aliphatic seriesm)m) Lead or its toxic compoundsLead or its toxic compoundsn)n) Manganese or its toxic compoundsManganese or its toxic compoundso)o) Mercury of its toxic compoundsMercury of its toxic compoundsp)p) Nitrous fumesNitrous fumesq)q) PhosgenePhosgener)r) Phosphorous of its toxic compoundsPhosphorous of its toxic compoundss)s) Sulfur dioxideSulfur dioxide

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10. Pneumoconiosis10. Pneumoconiosis


Exposure to coal dustExposure to coal dustExposure to cotton dust causing weaver’s Exposure to cotton dust causing weaver’s cough or mill fevercough or mill feverExposure to sugar cane dustExposure to sugar cane dustAny occupation involving handling of parrots, Any occupation involving handling of parrots, parakeets and other species of birds.parakeets and other species of birds.Exposure to particles of silica, quartz or slateExposure to particles of silica, quartz or slateExposure to asbestos particles.Exposure to asbestos particles.

a)a) Coal minersCoal minersb)b) BysinosisBysinosis

c)c) BagassosisBagassosisd)d) PsittacosisPsittacosis

e)e) SilicosisSilicosisf)f) AsbestosisAsbestosis

11. Diseases caused by 11. Diseases caused by abnormalities in abnormalities in temperature and temperature and humidity. humidity.

Any occupation involving exposure to Any occupation involving exposure to excessive heat.excessive heat.Any occupation involving exposure to Any occupation involving exposure to excessive cold.excessive cold.Any occupation involving exposure to Any occupation involving exposure to excessive cold.excessive cold.

a)a) Heat Heat stroke/cramps/exhaustionstroke/cramps/exhaustion

b)b) Chilblain/frostbite/freezingChilblain/frostbite/freezingc)c) Immersion foot/generalImmersion foot/general

hypothermiahypothermia

Any occupation involving exposure to Any occupation involving exposure to excessive heat or cold.excessive heat or cold.

12. Vascular disturbance in 12. Vascular disturbance in the upper extremities the upper extremities due to continuous due to continuous vibration from vibration from pneumatic tools or pneumatic tools or power drills, riveting power drills, riveting machines or hammers.machines or hammers.

Any occupation causing repeated motions, Any occupation causing repeated motions, vibrations and pressure of upper extremities.vibrations and pressure of upper extremities.

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13.13.Viral Hepatitis *Viral Hepatitis *

14.14.Poisoning by cadmium *Poisoning by cadmium *

15.15.Leukemia and Leukemia and lymphoma *lymphoma *

16.16.Cancer of stomach and Cancer of stomach and other lymphatic and other lymphatic and blood forming vessels; blood forming vessels; nasal cavity and sinuses nasal cavity and sinuses **

17.17.Cancer of the lungs, Cancer of the lungs, liver and brain * liver and brain *


Among workers in close and frequent Among workers in close and frequent contact with (a) human blood products and contact with (a) human blood products and (b) a source of vital hepatitis by reason of (b) a source of vital hepatitis by reason of employment in the medical treatment or employment in the medical treatment or nursing of a person suffering from viral nursing of a person suffering from viral hepatitis, or in a service ancillary to such hepatitis, or in a service ancillary to such treatment or nursing.treatment or nursing.

Among workers in battery factories who are Among workers in battery factories who are exposed to cadmium fumes.exposed to cadmium fumes.

Among operating room personnel due to Among operating room personnel due to exposure to anestheticsexposure to anesthetics

Among woodworkers, wood products Among woodworkers, wood products industry carpenters, loggers and employees industry carpenters, loggers and employees in pulp and paper mills and plywood mills.in pulp and paper mills and plywood mills.

Among vinyl chloride workers, plasticAmong vinyl chloride workers, plastic workers.workers.

18. CARDIO-VASCULAR DISEAS. ** All of the following conditions-18. CARDIO-VASCULAR DISEAS. ** All of the following conditions-

a.a. If the heart disease was known to have been present during If the heart disease was known to have been present during employment, there must be proof that an acute exacerbation was employment, there must be proof that an acute exacerbation was clearly precipitated by the unusual strain by reason of the nature clearly precipitated by the unusual strain by reason of the nature of his work.of his work.

b.b. The strain of work that brings about an acute attack must be of The strain of work that brings about an acute attack must be of sufficient severity and must be followed within 24 hours by the sufficient severity and must be followed within 24 hours by the clinical signs of a cardiac insult to constitute causal relationship.clinical signs of a cardiac insult to constitute causal relationship.

c.c. If a person who was apparently a symptomatic before being If a person who was apparently a symptomatic before being subjected to strain at work showed signs and symptoms of cardiac subjected to strain at work showed signs and symptoms of cardiac injury during the performance of his work and such symptoms and injury during the performance of his work and such symptoms and signs persisted, it is reasonable to claim a causal relationship.signs persisted, it is reasonable to claim a causal relationship.

Dr. J

Dr. J

19. CEREBRO-VASCULAR ACCIDENTS. **All of the following conditions-19. CEREBRO-VASCULAR ACCIDENTS. **All of the following conditions-

a.a. There must be a history which should be proved, or trauma at There must be a history which should be proved, or trauma at work (to the head specially) due to unusual and extraordinary work (to the head specially) due to unusual and extraordinary physical or mental strain or event, or undue exposure to noxious physical or mental strain or event, or undue exposure to noxious gases in industry.gases in industry.

b.b. There must be a direct connection between the trauma or There must be a direct connection between the trauma or execution in the course of the employment and the worker’s execution in the course of the employment and the worker’s collpase.collpase.

c.c. If the trauma or exertion then and there caused a brain If the trauma or exertion then and there caused a brain hemorrhage, the injury may be considered as arising from work.hemorrhage, the injury may be considered as arising from work.

Dr. J

20. MALARIA AND SCHISTOSOMIASIS. ** All of the following conditions-20. MALARIA AND SCHISTOSOMIASIS. ** All of the following conditions-

a.a. Through the knowledge of the respective incubation periods of the Through the knowledge of the respective incubation periods of the different types of the diseases, the physician determining the different types of the diseases, the physician determining the causal relationship between the employment and the illness or causal relationship between the employment and the illness or malaria or schistosomiasis should be able to tell whether the malaria or schistosomiasis should be able to tell whether the disease of the afflicted employee manifested itself while he was disease of the afflicted employee manifested itself while he was so employed.so employed.

b.b. Compensability should be based on the principle of greater risk Compensability should be based on the principle of greater risk acquiring the disease in the place of work than in the place of acquiring the disease in the place of work than in the place of usual residence of the afflicted worker.usual residence of the afflicted worker.

c.c. The place of work of employment has to be verified as a malarial The place of work of employment has to be verified as a malarial or schistosomal work area.or schistosomal work area.

Dr. J

21. PNEUMONIA. ** All of the following conditions-21. PNEUMONIA. ** All of the following conditions-

a.a. There must be an honest and definite history of wetting and There must be an honest and definite history of wetting and chilling during the course of employment and also, of injury to the chilling during the course of employment and also, of injury to the chest wall with or without rib fracture, or inhalation of noxious chest wall with or without rib fracture, or inhalation of noxious gases, fumes and other deleterious substances in the place of gases, fumes and other deleterious substances in the place of work.work.

b.b. There must be direct connection between the offending agent or There must be direct connection between the offending agent or event and the worker’s illness.event and the worker’s illness.

c.c. The signs of consolidation should appear soon (within a few hours) The signs of consolidation should appear soon (within a few hours) and the symptoms of initial chilling and fever should at least be and the symptoms of initial chilling and fever should at least be 24 hours after the injury or exposure.24 hours after the injury or exposure.

d.d. The patient must manifest any of the following symptoms within a The patient must manifest any of the following symptoms within a few days of the accident: (1) sever chill and fever; (2) headache few days of the accident: (1) sever chill and fever; (2) headache and pain, agonizing in character, in the side of the body; (3) short, and pain, agonizing in character, in the side of the body; (3) short, dry painful cough with blood – tinged expectorations; and (4) dry painful cough with blood – tinged expectorations; and (4) physical signs of consolidation, with fine rales.physical signs of consolidation, with fine rales.

Dr. J

22. HERNIA. ** All of the following conditions-22. HERNIA. ** All of the following conditions-

a.a. The hernia should be of recent origin.The hernia should be of recent origin.

b.b. Its appearance was accompanied by pain, discoloration and Its appearance was accompanied by pain, discoloration and evidence of a tearing of the tissues.evidence of a tearing of the tissues.

c.c. The disease was immediately preceded by unique or severe strain The disease was immediately preceded by unique or severe strain arising out of and in the course of employment.arising out of and in the course of employment.

d.d. A protrusion of mass should appear in the area immediately A protrusion of mass should appear in the area immediately following the alleged strain.following the alleged strain.

Dr. J

23. BRONCHIAL ASTHMA. ** All of the following conditions-23. BRONCHIAL ASTHMA. ** All of the following conditions-

a.a. There is no evidence of history of asthma before employment.There is no evidence of history of asthma before employment.

b.b. The allergen is present in the working conditions.The allergen is present in the working conditions.

c.c. Sensitivity test to allergens in the working environment should Sensitivity test to allergens in the working environment should yield positive results.yield positive results.

d.d. A provocative test should show positive results.A provocative test should show positive results.

Dr. J

24. OSTEOARTHRITIS. *** Any occupations involving -24. OSTEOARTHRITIS. *** Any occupations involving -

a.a. Joint strain from carrying heavy loads, or unduly heavy physical Joint strain from carrying heavy loads, or unduly heavy physical labor, as among laborers and mechanics.labor, as among laborers and mechanics.

b.b. Minor or major injuries to the joint.Minor or major injuries to the joint.

c.c. Excessive use or constant strenuous usage of a particular joint, as Excessive use or constant strenuous usage of a particular joint, as among sportsmen, particularly those who have engaged in the among sportsmen, particularly those who have engaged in the more active sports activities.more active sports activities.

d.d. Extreme temperature changes (humidity, heat and cold Extreme temperature changes (humidity, heat and cold exposures), andexposures), and

e.e. Faulty work posture or use of vibratory tools.Faulty work posture or use of vibratory tools.

Dr. J

25. VIRAL ENCEPHALITIS. *** Any occupations involving -25. VIRAL ENCEPHALITIS. *** Any occupations involving -

a.a. Contact with an infected person, as in areas of poor sanitation, Contact with an infected person, as in areas of poor sanitation, with a high density of schoolchildren, who are the most frequent with a high density of schoolchildren, who are the most frequent virus spreaders;virus spreaders;

b.b. Rural exposure, primarily in picnics, camping activities, fishing or Rural exposure, primarily in picnics, camping activities, fishing or hunting in, or adjacent to, woods or subtropical vegetation, or as hunting in, or adjacent to, woods or subtropical vegetation, or as among agricultural or forest workers; andamong agricultural or forest workers; and

c.c. Contact with other sources of infection, such as birds and animals, Contact with other sources of infection, such as birds and animals, as among veterinarians and abattoir workers.as among veterinarians and abattoir workers.

26. PEPTIC ULCER. ***26. PEPTIC ULCER. ***

Any occupation involving prolonged emotional, or physical stress, Any occupation involving prolonged emotional, or physical stress, as among professional people, transport workers and the like.as among professional people, transport workers and the like.

Dr. J

27. PULMONARY TUBERCULOSIS. ***27. PULMONARY TUBERCULOSIS. ***

In addition to working conditions already listed under P.S. 626, as In addition to working conditions already listed under P.S. 626, as amended, any occupation involving constant exposure to harmful amended, any occupation involving constant exposure to harmful substances in the working environment, in the form of gases, fumes, substances in the working environment, in the form of gases, fumes, vapors and dust, as in chemical and textile factories: overwork or vapors and dust, as in chemical and textile factories: overwork or fatigue; and exposure to rapid variation in temperature, high degree of fatigue; and exposure to rapid variation in temperature, high degree of humidity and bad weather conditions.humidity and bad weather conditions.

28. VIRAL HEPATITIS. ***28. VIRAL HEPATITIS. ***

In addition to working conditions already listed under P.S. 626, as In addition to working conditions already listed under P.S. 626, as amended, any occupation involving: exposure to a source of infections amended, any occupation involving: exposure to a source of infections through ingestion of water, milk, or other foods contaminated with through ingestion of water, milk, or other foods contaminated with hepatitis virus; hepatitis virus; Provided, that,Provided, that, the physician determining the causal the physician determining the causal relationship between the employment and the illness should be able to relationship between the employment and the illness should be able to indicate whether the disease of the afflicted worker manifested itself indicate whether the disease of the afflicted worker manifested itself while he was so employed, knowing the incubation period thereof.while he was so employed, knowing the incubation period thereof.

29. ESSENTIAL HYPERTENSION. ****29. ESSENTIAL HYPERTENSION. ****

Hypertension classified or essential is considered compensable Hypertension classified or essential is considered compensable if it causes impairment of function of body organs like kidneys, if it causes impairment of function of body organs like kidneys, heart, eyes and brain, resulting in permanent disability: heart, eyes and brain, resulting in permanent disability: Provided, that,Provided, that, the following documents substantiate it: (a) the following documents substantiate it: (a) chest x-ray report, (b) ECG report, © blood chemistry report, chest x-ray report, (b) ECG report, © blood chemistry report, (d) funduscopy report, and (f) C-T scan.(d) funduscopy report, and (f) C-T scan.

Dr. J

30. ASBESTOSIS. ***** All of the following conditions -30. ASBESTOSIS. ***** All of the following conditions -

a.a. The employee must have been exposed to asbestos dust in the The employee must have been exposed to asbestos dust in the work place, as duly certified to by the employer, or by a medical work place, as duly certified to by the employer, or by a medical institution, or competent medical practitioner acceptable to or institution, or competent medical practitioner acceptable to or accredited by the Systems:accredited by the Systems:

b.b. The chest x-ray report of the employee must show findings of The chest x-ray report of the employee must show findings of asbestos, or asbestos – related disease. E.G. pleural plaques, asbestos, or asbestos – related disease. E.G. pleural plaques, pleural thickening, effusion, neoplasm and interstitial fibrosis; andpleural thickening, effusion, neoplasm and interstitial fibrosis; and

c.c. In case the ailment is discovered after the employees’ In case the ailment is discovered after the employees’ retirement/separation from the service, the claim therefore must retirement/separation from the service, the claim therefore must be filled with the System within three (3) years from discovery.be filled with the System within three (3) years from discovery.

** Approved under ECC Resolution No. 247-A, dated April 13, 1977Approved under ECC Resolution No. 247-A, dated April 13, 1977**** Approved under ECC Resolution No. 432, dated July 20, 1977. Approved under ECC Resolution No. 432, dated July 20, 1977.

Although notAlthough notconsidered occupational diseases, they are nevertheless work-considered occupational diseases, they are nevertheless work-

related and related and thus compensable too.thus compensable too.

****** Approved under ECC Resolution No. 1676, dated Jan. 29, 1981Approved under ECC Resolution No. 1676, dated Jan. 29, 1981******** Approved under ECC Resolution No. 92-07-0031, dated July 8, Approved under ECC Resolution No. 92-07-0031, dated July 8,

1992.1992.********** Approved under ECC Resolution No. 96-08-0372, dated Aug. 1, Approved under ECC Resolution No. 96-08-0372, dated Aug. 1,

19961996

COMMON OCCUPATIONAL CARCINOGENS COMMON OCCUPATIONAL CARCINOGENS

Agent Organ Affected Occupation

Wood Nasal cavity and Sinuses

Woodworkers

Leather Nasal cavity and sinuses, Urinary Bladder

Leather and Shoe workers

Iron Oxide Lung, Larynx Iron ore miners, metal grinders and polishers, silver finishers, iron

foundry workers

Nickel Nasal sinuses, Lung Nickel smelters, mixers and roasters, electrolysis workers

Arsenic Skin, Lung, Liver Miners, smelters, mixers and roasters, electrolysis workers

Chromium Nasal cavity and sinuses, lung larynx

Chromium producers and users, acetylene and aniline workers, bleachers, glass, pottery and linoleum workers, and battery

workers


Asbestos Lung (pleural and peritoneal

mesothelioma)

Miners, millers textile, insulation and shipyard workers

Petroleum, coke, wax, creosol anthracene,

paraffin, shale mineral oil

Nasal avity, larynx, lung, skin, scrotum

Contact with lubricating, cooling, paraffin or wax fuel oils or coke

rubber filters, textile weaver, diesel jet testers

Mustard gas Larynx, Lung, trachea, bronchia

Mustard gas workers

Vinyl chloride Lung, brain Plastic workers

Bis-chlo romethyl ether, chloromethyl methyl

ether

Lung Chemical workers

Isopropyl oil Nasal cavity Isopropyl oil producers

Coal soot, coal tar, other products of coal

combustion

Lung, larynx, skin, scrotum, urinary

bladder

Gashouse workers, stokers and producers, asphalt, coal, tar, and pitch workers, coke oven workers,

miners, steel cleaners


Benzene Bone marrow Explosives and benzene makers, distillers, cement workers, dye users, painters, shoemakers

Auramine, Benzidine, Napthalamine, Beta-

Nathalamine, magenta 4-Aminodiphenyl, 4-

Nitrodiphenyl

Urinary Bladder Dye Stuff manufacturers and users. Rubber workers, filter man textile

dyers, paint manufacturer

Maraming Salamat Maraming Salamat Po!Po!

.

i JAIME A. BARRON, M.D., M.P.H., M.H.A.

Associate Professor VIIUniversity of Perpetual Help System, Laguna

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