Topic: Occupational Health Performance

Indicator
Dr. Mohamed Neezar Mahadzir Bin Aris
Occupational Health Doctor
15 March 2023
 Background
● Dr Mohamed Neezar Mahadzir Bin Aris
● DOSH registered Occupational Health Doctor since 2005
● Occupational Health Doctor at PETRONAS Pengerang Industrial Complex Industrial
Clinic(2017-2022)
● PETRONAS AME, MPM Offshore and OEUK Approved Medical Examiner
● Diving Medical Examiner
● Medical Review Officer for Drug Free Workplace Program
● Initial and Advanced Ergonomic Risk Assessor
● Train the Trainor NIOSH
● Certified Medical Impairment Assessor
● MD(UKM), OHD(NIOSH),Master in Safety Health Environment(UMP)
 Outline of Presentation

1. Occupational Health Services: Definition & Overview, Mechanism

2. OH Performance Indicators(OHPI) Definition
3. Why OHPI
4. Mechanism on how to assess OHS
 Objectives

● OYK have an idea on OHS

Program at workplace
● Guide OYK. How to set up an
OHS Program at workplace
● Guide OYK on using current
government initiative to comply
with OHS compliance
● How to maximize government
initiative for OHS to comply with
OSH
OSH Malaysia Plan 25 (OSHMP25)

6
 EMPOWERING OCCUPATIONAL HEALTH

● Providing Competent OH Practitioners at the workplace to increase

performance and access to OHS
● Comprehensive OH Risk management
● Awareness and information sharing to OH and Occupational
Diseases
● Empowering Industrial Hygiene towards occupational quality
improvement
● Integrating Occupational Health Risk assessment
OSH(Amendment) Act 2022: Occupational Health Services
DEFINITION
 OCCUPATIONAL HEALTH SERVICES(OHS)

● preventive functions
● advising and assisting the
employer, the workers
● maintaining a safe and
healthy working environment
● optimal physical and mental
health in relation to work
● the adaptation of work to the
capabilities of workers in light
of their state of physical and
mental health.
 Why OHS Performance?
1. Legislation Compliance Requirement
Health Surveillance for Workers Exposed to Hazards
1. Operational Requirement
Fitness to Work for Safety Sensitive Task/Job Specific
Periodic Health screening to have baseline health data
Drug Free Workplace Program
1. Business Requirement
Service Provider Operational Improvement
Client HSSE Requirement
 Legal Provision For Occupational Health Services
The Occupational Safety and Health Act (OSHA) 1994 and its Regulations
USECHH Regulations 2000
Occupational Safety and Health (Noise Exposure) Regulations 2019.
FMA 1967 ((Lead) Regulations 1984, (Asbestos) Regulations 1986, (Mineral Dust)
Regulations 1989)
There are other legal provisions for OH stated in the Factories and Machinery Act
1967, Food Act 1983, Atomic Energy Licensing Act 1984
Why? OHS
 Methods to Implement OHS

Each organisation may provide OHS by utilising;

a. In-house resources;

b. External resources i.e. acquiring the services needed from another unit or
persons entitled; or

c. A combination of the above.

OHS needs a team working together

 OCCUPATIONAL HEALTH PRACTITIONERS

1. Occupational Health Doctor (OHD).

2. Occupational Health Nurse (OHN).
3. Occupational Hygienist (OHyg).
4. Hygiene Technician.
5. Ergonomist.
6. Safety and Health Officer
 OHS Management

1. Management of workplace occupational health risks.

2. Structured Program for the Year, Quarter of the year
3. Commitment from CEO and HR and Approved Budget for the year and next
year
4. Management of Exposure Assessment Records and recommendations.
5. Managing, Evaluating and Improvement of Occupational Health Controls
 Factors To Consider to plan for OHS
a. The nature of its operations, hazards involved and their associated risks

b. The number of employees who are potentially exposed to these hazards

c. The duration of its operations (e.g. one eight-hour shift or three eight-hour shifts
or two twelve-hour shifts, etc).

The Ball Is In Your Court

Management of OH Hazards at Workplace
OH Management On Workers’ Fitness To
Work
● Pre-employment, Pre-
placement, Health Surveillance
and Medical Removal
● Rehabilitation. Return To Work
● Follow up on vulnerable group
● Occupational disease
investigation
● Health Promotion
● Medical Emergency Response
Services
● Outpatient clinic services
● Occupational Health Data
Management and Analysis
OCCUPATIONAL HEALTH PERFORMANCE INDICATOR(OHPI)
Indicators are designed to provide different stakeholders with information in order
to

● Set benchmark
● Assess performance on improving health
● Measure effectiveness or efficiency of the occupational health services (OHS)
● Measure and review company OHMS
● Set new target for continuous improvement, progress, review and quality
assurance
SMART
Ref: Good Practice in Occupational Health Services, A Contribution to Workplace Health WHO Regional
Office for Europe
The five components of the BASF OHPI
Assessing performance qualitatively
Conceptual spectrum of leading to lagging indicators –

Adapted from www.hse.gov.uk/research/rrpdf/rr734.pdf

 Leading Indicators

Measurement preceding or indicating a future event

Measurement of activities to prevent and control injury.
Examples include:
● Health Promotion
● Communication of Occupational Disease and Injury
● Management of Workers Health: CHRA & Medical Surveillance
● Management of Ergonomic Risk Factors
● Reduction of Muscle and Skeletal work related injury

Why use leading indicators?

It focused on future safety performance and continuous improvement and are

proactive in nature.
 Leading Indicators

Examples of level 1 occupational health leading performance indicators include:

● A health and safety policy
● A health plan has been developed to meet regulatory requirements
● Health related risk assessments and reassessments as required by legislation
● Program to control health risks
● Medics and first-aiders refreshers are done in time
● Necessary health surveillance is in place.
 Leading Indicators

● % of planned training courses completed

● % reduction in exposure hours for hazardous activities (e.g. reduction in
exposure to noise, vibration or chemicals)
● % reduction in the use of PPE (RPE and HP) as control at source improves
● % of tool box talks with a health element
● % of permits to work reviewed and controls found to meet health
requirements
● Commitment of top enterprise manager to implement OHSMS
● Financial investment in OHSMS as percentage of the enterprise total budget
or gross income
● Numbers and qualifications of in house occupational health specialists
● Inclusion of risk assessment activities in job specifications of workers
 Leading Indicators
● Health surveillance activities
● Work environment surveillance including surveys and monitoring programmes
● New employment health examination
● Risk assessments of occupational health hazards
● Assessments of environmental health hazards and their health impact
● Needs assessment
● Ergonomic assessments
● Workplace Health Promotion Programmes
● Sickness absence management;
● Rehabilitation programme
● Vaccination programmes
● Curative (primary medical care) services
● Training programmes on Occupational Health subjects
● Employee Assistance Program
 Lagging Indicators
Lagging indicators measure a company’s incidents in the form of past accident
statistics.
Examples include:
● JKKP 6,7, 8
● SOCSO Compensation
Why use lagging indicators?

Traditional safety metrics used to indicate progress toward compliance with safety
rules.

These are the bottom-line numbers that evaluate the overall effectiveness of
safety at your facility.

They tell you how many people got hurt and how badly.
 The drawbacks of lagging indicators.

how many people got hurt and how badly,

but not how well your company is doing at preventing incidents and accidents.

a poor gauge of prevention

For example, when managers see a low injury rate, they may become complacent
and put safety on the bottom of their to-do list

there are numerous risk factors present in the workplace that will contribute to
future injuries.
 “The wealth of
business depends on
the health of
workers.”
- Dr Maria Neira, WHO

Workplace Health Promotion

 Health Promotion

“A healthy workplace is one which workers and managers collaborate to use a

continual improvement process to protect and promote the health, safety and
wellbeing of all workers and the sustainability of the workplace”
 Health Promotion

Non-communicable diseases (NCDs), including heart disease, stroke, cancer,

diabetes and chronic lung disease, are collectively responsible for almost 70% of
all deaths worldwide.

The three most common NCD categories – namely cardiovascular disease,

diabetes and cancer – are estimated to have cost the Malaysian economy RM
12.88 billion (high estimate) in terms of productivity losses arising from
absenteeism, presenteeism or premature death in persons of working age
(Source: Ministry of Health).
 Ill health
burden

Medical care

Health protection (OHD)

Health promotion( OHD)

Wellness

Productivity
Wellness -defined as optimal health, a positive state that exceeds the absence
of
disease
Health Promotion: OH Performance Collection Database

Workers Demography

Baseline Health Surveillance

- BMI, High Blood Pressure, Waist: Hip Ratio

- Coronary Artery Disease risk assessment e.g Framingham Risk Score
- Psychosocial Assessment: Depression, Anxiety, Stress Scale
- Ergonomic Risk Screening: Musculoskeletal Disorder
 MECHANISM ON HOW TO ASSESS OHS PERFORMANCES

A number of different indicators may be used to assess the effectiveness and

benefits of OHS in an organization. Compliance

1. Occupational health related legislation

2. Company safety and health policy and occupational performance data.
3. No of training and education is to improve awareness of safety and health
hazards, knowledge of the causes of occupational illness and injury

These data are used to observe trends in the management of OH in the

workplace:
ANMS: Agenda Nasional Malaysia Sihat
 ANMS- OH Performance & Compliance to OHS

Nama Program Yang Telah

Dijalankan. Lokasi Program
Dijalankan.

Aturcara Dan Pengisian Sepanjang

Program Berlangsung.

Jumlah Pekerja & Bilangan Pekerja

Terlibat (Senarai Kehadiran Pekerja
Atas Pilihan).

Laporan Rumusan Hasil Saringan

Kesihatan Yang Telah Dijalankan.
(Rujukan Julat Di Bahagian Lampiran
D) vii. Bilangan Pekerja Yang Telah
Dirujuk viii. Maklumat Program
Ceramah Kesihatan. ix. Gambar
Sepanjang Aktiviti Berlangsung.
ANMS: Agenda Nasional Malaysia Sihat
ANMS- OH Performance & Compliance to OHS
ANMS- Free Government Initiatives
Ergonomic Risk Assessment an OHPI
Ergonomic at Workplace
Ergonomic at Workplace
 OH Performance to comply with OSH(USECHH) Regulations 2000

Regulations 27(1) & 27(2)

1. Exposure to Chemical Hazardous to Health(CHH) and based on CHRA

requirement to have medical surveillance program.
2. No of workers screened and summary of medical surveillance. USECHH IV
3. No of workers Medically Removed and Management of workers. USECHH V
4. Return To Work of MRP and Pre placement

Reference:Guidelines on Control of Chemicals Hazardous to Health.

OH Performance on Management of Hearing Conservation

5 components of Hearing Conservation Program

I. Identification of exposure to excessive noise

II. Exposure Assessment. Noise Risk Assessment
III. Audiometry Program
IV. Information, Instruction and Training
V. Record Keeping
OH Performance on Management of Hearing Conservation
OH Performance on Management of Hearing Conservation
OH Performance on Management of Hearing Conservation
 OH Performance on Management of Occupational Noise
Exposure and Hearing Conservation
Audiometry Program
1. Numbers of screening audiometry normal
2. Numbers of diagnostic audiometry for abnormal
audiometry
3. Numbers of abnormal audiometry require work
relatedness investigation
4. Established Occupational Noise Related Hearing
Disorder reported to DOSH
5. Numbers of workers attending Hearing Conservation
Program
6. List of workers in process of Occupational Disease
SOCSO Compensation Program
 2: Compliance with Company Safety and Health Policy

Management audit to assess the compliance with company or corporate safety

and health policy should also be conducted.

Examples of such measures include:

a) Number of OH-related training programmes planned

b) Number of OH-related training programmes conducted

c) Number of employees attending OH-related training programmes

 3 Occupational Health Performance Data

Percentage of completion of the activities planned for the year

(e.g. number of statutory medical surveillance planned for compared with the
number of such assessments completed successfully by the end of the year in
question).

This is an indicator of how realistic and serious the organization and its OH
practitioners are in their planning and implementation of the programmes.
 MECHANISM ON HOW TO ASSESS OHS EFFECTIVENESS

No. of new cases of occupational diseases and/or poisonings reported. In fact, the
report of any such case indicates the failure of the OHS in its preventive activity.

This data is also useful to focus improvement efforts on specific parts of the work
process or group of employees who may not fully appreciate the risks they are facing.

Examples of such measures include no/incidence:

a) occupational/work related diseases reported

b) occupational/work related poisonings reported

c) of areas required for noise reduction and completion status

d) Employee exposure (i.e noise, chemicals) monitoring data.

 MECHANISM ON HOW TO ASSESS OHS EFFECTIVENESS

c) of areas required for noise reduction and completion status

d) Employee exposure (i.e noise, chemicals) monitoring data.

 OH Performance: Lagging Indicator

No of Occupational Disease
Reported to SOCSO

Examples of Occupational
Disease

Occupational Noise Related

Hearing Disorder

Hearing Impairment
 Experience in an Industrial Clinic in Pengerang
Integrated Complex
During Covid-19 Pandemic Client: Ensuring Business Continuity Plan: Leading
Indicators
- Numbers of workers performing self declaration through My Sejahtera
Platform: 100% prior to entry of site
- Green Bubble Concept: Workers quarantined from outside and allowed work
and remained quarantined area for a period of 2 weeks.
- Risk Communication through designated communication channel.
- Contract tracing of workers diagnosed with Covid-19
- Return to Work Program for Post Covid
- Work from home
- Competent person whom is OHD and Approved Medical Examiner to manage
RTW and EAP for returning workers post covid
- Fitness To Work Program for Job Specific
OSH Malaysia Plan 25 (OSHMP25)

67
Mental Health at Workplace
Penyakit mental boleh ditakrifkan sebagai
gangguan dalam fungsi kognitif, tingkah laku, dan
emosi seseorang dan interaksi dengan orang lain.
Secara umumnya, penyakit mental dikaitkan
dengan kemurungan, kebimbangan, dan tekanan
(Hassan et al., 2018).
Contoh keadaan penyakit mental termasuk tekanan
(Hassan et al., 2018), kemurungan, gangguan
kecemasan, skizofrenia, gangguan makan dan
tingkah laku ketagihan (Azmi et al., 2021).
Faktor yang menyebabkan peningkatan tekanan di
tempat kerja termasuk beban kerja, tugas yang tidak
menyenangkan, dan konflik antara tuntutan peribadi
dan profesional (Maulik, 2017).
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REFERENCES

1. Guidelines on Occupational Health Services Department of OCCUPATIONAL

SAFETY AND HEALTH MINISTRY OF HUMAN RESOURCES MALAYSIA 2005
JKKP GP (BI) 04/2005
2. Occupational Health Services – an Overview; WHO Regional Publications;
European Series No. 26
3. ILO Occupational Health Services Convention, 1985
4. ILO Occupational Health Services Recommendations, 1985
5. American Association of Occupational Health Nurses Inc. Fact Sheet
6. Encyclopedia of Occupational Health and safety, 4th edition., ILO
7. Good Practice in Occupational Health Services, A Contribution to Workplace
Health WHO Regional Office for Europe
8. Health Performance Indicators A guide for the oil and gas industry IPIECA
THANK YOU
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