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OCCUPATIONAL HEALTH

Marnie Alfar
HSE International Consultancy OSH Practitioner
HEALTH SAFETY & ENVIRONMENT
Occupational Health
• Defines as the promotion and maintenance of the
highest degree of physical, mental and social well-
being of workers in all occupations.
• People at work can be exposed to risks to their
health and may contract a range of occupational
diseases and conditions.
• Some people may die as a result of a contact;
others may be permanently incapacitated, etc.

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AIMS of Occupational Health:
• Promotion & maintenance of the physical,
mental and social well-being of workers;
• Prevention of illness;
• Protection of workers from ‘risks’ at work;
• Placement and maintenance of workers in an
occupational environment appropriate to his
capacity.

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PHYSICAL HAZARDS CHEMICAL HAZARDS BIOLOGIC HAZARDS ERGONOMIC HAZARDS

 Noise Forms:  Bacteria  Improper tools and


 Vibration Liquids  Viruses equipment design
 Extremes of Solids  Fungi  Unnecessary and
temperature Gas  Insects/ Parasites unusual design
 Illumination Route of entry  Repetitive Motions
 Pressure Inhalation  Stress at work
Ingestion
Injection
Skin
Eye Contamination

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Physical Hazards

Noise- An unwanted sound; Noise can block, distort, change or interfere


with the meaning of a message in both human and electronic
communication.

Three Characteristics of Sound:


•Frequency- is the number of occurrences of a repeating event per unit
time; measured in Hertz cycles per second.
•Loudness- Intensity of the sound; measured in Decibel (dB)
•Duration- Continuous, intermittent, burst, waxing/ waning

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Permissible Noise Exposure (OSHA 1981)

TABLE G-16 - PERMISSIBLE NOISE EXPOSURES (1)


______________________________________________________________
Duration per day, hours Sound level dBA slow response
____________________________________________________________
8...........................| 90
6...........................| 92
4...........................| 95
3...........................| 97
2...........................| 100
1 1/2 ......................| 102
1...........................| 105
1/2 ........................| 110
1/4 or less................| 115
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Adverse Health Effects Of Noise:
• Acute Effects:
1. Acoustic Trauma (explosion, Gunshot); acoustic trauma refers to permanent
cochlear damage from a one-time exposure to excessive sound pressure.
2. Temporary Threshold Shift (Disco)
3. Poor Communication

• Chronic or Long Term Effects:


Permanent Threshold Shift (Noise Induced Hearing Loss); Noise-induced hearing
loss (NIHL) is an increasingly prevalent disorder that results from exposure to
high-intensity sound, especially over a long period of time.

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Control of Noise
Engineering methods
•Purchase new equipment
•Preventive maintenance
•Isolation/damping

Administrative Control
•Job rotation / breaks
PPE
•Ear plugs / ear muffs

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2. Heat Stress- (Hyperthermia)
occurs when the body produces or absorbs more heat than it
can dissipate.

•High Temperature
•High Humidity
•Poor Ventilation
•Multiple Heat Source

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Acute Health Effects of Heat
• Prickly Heat- is a skin disease marked by small and itchy
rashes
• Heat Fatigue-bad mood, water loss
• Heat Cramps- muscle spasm (water + salt)
• Heat Exhaustion- fatigue, dehydration, diaphoresis, nausea,
vomiting (water + salts + electrolytes )
• Heat Stroke- overheating, seizure, coma (failure of
thermoregulatory system); a temperature of greater than
40.6 °C (105.1 °F) due to environmental heat exposure

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Control of Heat Problems
Engineering control
–Ventilation
–Water sources (fountains/showers)

Administrative control
–Job rotation/breaks

PPE
–Cotton clothes, multiple changes

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3. Cold Stress- (Hypothermia)
is a condition in which core temperature drops below that
required for normal metabolism and body functions which is
defined as 35.0 °C (95.0 °F).

Acute Health Effects of Cold


•Hypothermia
•Frostbite- is the medical condition where localized damage is
caused to skin and other tissues due to extreme cold.
•Trench Foot- is a medical condition caused by prolonged
exposure of the feet to damp, unsanitary and cold conditions.

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Chronic Health Effects of Cold

• Bradycardia- ("heart slowness"), as applied to adult


medicine, is defined as a resting heart rate of under 60
beats per minute, though it is seldom symptomatic
until the rate drops below 50 beat/min.

• Skin Scaling- due to dryness of the skin.

• Callous Formation

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Control Methods
Engineering Control
Isolation / enclosure / insulation

Administrative Control
Shift work, rest periods
Warm food and drinks / medical exams

PPE
Thermal clothing / electric blanket
Gloves / cap / jacket / wool lined shoes

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4. Vibration
• Vibration- refers to mechanical oscillations about an
equilibrium point.
The oscillations may be periodic such as the motion of a
pendulum or random such as the movement of a tire on a
gravel road; continuous low frequency oscillation that is
more likely felt than heard; affects the body through direct
contact.

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Health Effects of Vibration
• Inflammation of wrist, elbows,
shoulders
• Carpal Tunnel syndrome
• Tenosynovitis
• Fatigue

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Prevention & Treatment

Engineering
Tool re-design
Isolation
Administrative
Shifting
PPE
gloves

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Illumination
• is the deliberate application of light to achieve
some aesthetic or practical effect.
• Lighting includes use of both artificial light sources
such as lamps and natural illumination of interiors
from daylight.
• Day lighting (through windows, skylights, etc.) is
often used as the main source of light during
daytime in buildings given its low cost.
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The importance of Illumination or
Lighting
• 1915.92(a) of OSH Standards - all means of access and
walkways leading to working areas as well as the working areas
themselves shall be adequately illuminated.
– A minimum of 50 lux – passageway, corridor, warehouse
– A minimum of 100 lux – engine and boiler rooms; toilets and
washrooms
– A minimum of 200 lux – canning and preserving; planing of lumber
– A minimum of 300 lux – medium inspection; office deskwork with
intermittent reading and writing for filing and mail sorting
– A minimum of 500 lux – fine inspection, fine woodworking, accounting,
drafting, stenographic work.
– A minimum of 1000 lux – extra fine assembling; jewelry and watch mfg;
proofreading in printing plants

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Acute effects of low illumination

• Eye Strain- is an ophthalmological condition that manifests itself


through nonspecific symptoms such as fatigue, pain in or around the eyes,
blurred vision, headache and occasional double vision. Symptoms often
occur after reading, computer work, or other close activities that involve
tedious visual tasks.
• Dizziness, Headache, Neck Pains, Teary Eyes

Control Methods:
• Improve illumination by adding:
– artificial light sources
– natural light sources
• Reduce by- Isolation or enclosure
• PPE

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• Pressure- Pressure is an effect which
occurs when a force is applied on a
surface. Pressure is the amount of
force acting on a unit area; is the
atmospheric force that is constantly
applied on the body, as a result of
normal changes in altitude or
artificially induced conditions;
Pressure changes cause body stress.

Work in compressed air, for example in pressurized caissons


and diving bells, and in diving operations, may expose people
to the risk of decompression sickness.

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Acute Effects of Pressure:
• Fatigue Dizziness Depressed Reduced Oxygen
• Incoordination Headaches Sensorium Lowered Temperature
• Apprehension Disorientation Narcosis Paresthesia's
• Excitability Tremors Pulmonary Edema / Death

Control methods

Pre-employment screening
Training (Pre-event)
Scheduled work duration
Exercise (During event)
Medical monitoring
Medications
Pressure vessels / chamber
Rehabilitation (Post-event)
Pressurized suits

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Chemical Hazards

•Chemical Hazard is the danger caused by chemicals to the


environment and people.

•A chemical hazard arises from contamination with harmful or


potentially harmful chemicals.

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The Routes of Entry of Chemicals
• Skin Absorption- Skin acts as a protective barrier.
Health Effects:
1. Local irritation
2. Generalized Reaction (sensitization or allergic reaction)
3. Absorption is increased with high temperature and perspiration

• Eye Contamination-enters thru contamination of the eye.


Health Effects:
1. Irritation
2. Blindness
3. Swelling

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The Routes of Entry of Chemicals
• Ingestion- enters thru mouth; accidental swallowing from eating in
contaminated area; smoking on the job with contaminated fingers and
hands; ingestion of inhaled materials.

Health Effects: Vomiting and Dizziness

• Inhalation- most important route of chemical exposure; concentration in


the air; duration of exposure; amount of air inhaled.

Health Effects: Lack of oxygen and Difficult to breathe

• Injection

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Organs in that body that may be
affected by chemicals:

•Skin
•Lungs
•CNS
•Kidney
•Liver
•Blood
•Heart

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General Health effects

• Disorientation
• Euphoria
• Light headedness
• Confusion
• Unconsciousness
• Headache
• Nausea, vomiting
• Paralysis, convulsion, death

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Control of Chemical Hazards
Engineering
•Initial selection / substitution
•Chemical hood
•Redesign the process

Administrative
•APE / SOP / shiftwork / housekeeping
•MSDS review
•Environmental monitoring

PPE

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Biological Hazards
• Also known as biohazards, refer to
biological substances that pose a threat
to the health of living organisms,
primarily that of humans.
• This can include medical waste or
samples of a microorganism, virus or
toxin (from a biological source) that can
impact human health; these are the
factors that cause infectious and
contagious diseases.
• These are common problems among
health care workers and laboratory
personnel handling biologic specimens.

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Some Biologic Hazards that can are
Contiguous or can lead to Death

• Tuberculosis
• AIDS
• Hepatitis A,B,C,E
• Chicken Pox
• URTI- Upper respiratory tract infections, (URI or URTI),
• Sore Eyes
• Sexually Transmitted Disease
• Other Skin Diseases

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Ergonomic Hazards
• It is a technique that brings together several disciplines to solve
problems at work.
Job
• the task needed to achieve a result
• governed by guidelines designed to prevent muscle overload
• requires learning, training and skill
Workstation
• place of deployment
• where duties are carried out
• where equipment are located
• machines are the tools
• 8 hours are spent
• most accidents happen

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Ergonomic Hazards

Tool
•integral part of the man-machine system
•powerful, fast, tireless
•enables man to accomplish his job with reduced effort

Man
•Integral part of the man-machine-system.
•intelligent, adaptive and versatile
•the basis of existence - survival

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Ergonomic Hazards

Workplace Design
•Fit the workplace to the worker; not the worker to the
workplace

Tool Design
•Fit the tool to the worker; not the worker to the tool

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Ergonomics
• Ergonomics is the study of designing equipment and
devices that fit the human body, its movements and its
cognitive abilities.
“Fitting the Job to the Person rather than Fitting the
Person to the Job.”

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Five aspects of ergonomics
• Safety
• Comfort
• Ease of use
• Productivity/performance
• Aesthetics

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Risk Factors on Ergonomics
• Position
– Wrist straight, shoulders relaxed
– Back and neck as close to their natural alignment as possible
– Elbows near the side, bent at a 90º angle to reach the work
– Keep materials close to the body when carrying
– Don’t twist, bend, reach
• Force
– Use as little effort as allowable
– Push a cart, don’t pull
– Seek assistance from others
– Don’t exceed 25kgs when lifting
• Frequency
– Reduce the repetitions of movements in activities
– Rest Breaks

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Sample of Correct Positioning in Using the
Computer

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The Necessary Health Personnel in the
Workplace: Rule 1960

1. First Aider
2. Nurse
3. Physician
4.Dentist

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Occupational Health
Program of DOLE

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DOLE Department Order no. 73-05

Guidelines for the


implementation of
policies and programs
on tuberculosis
prevention and
control in the
workplace.

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Tuberculosis

Is caused by bacteria Mycobacterium


Tuberculosis

It usually affects the lungs but other part of


the body may also be infected: bones, brains
and its covering joints, kidneys, liver, intestines
and heart.

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How do people get TB?

Easily spread through the air from one person


to another.

When a person breathes in TB bacteria, the


bacteria can live in the lungs and begin to
grow.

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FORMS OF TB

TB infection
TB Disease
Multidrug-resistant TB (MDR-TB
Extensive resistant TB (XDR-TB)

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Signs and Symptoms:
 Chest and Back pains
 Productive cough for two
or more weeks
 Easy fatigability
 Night sweats
 Blood in sputum or
phlegm
 Fever
 Weight loss

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TREATMENT

The current strategy for TB is the DOTS which


stands for Direct Observed Treatment Short
Course.
- SUPERVISED treatment of TB patients by a treatment
partner
3 to 4 Anti TB drugs / 6 months treatment
program

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How can the spread of TB be
prevented workplace?
 Have a tuberculosis prevention and control policy program
 Practice good hygiene such as covering the mouth when
coughing or sneezing to prevent the spread of TB Bacteria.
 Be conscious of TB disease symptoms for early diagnosis and
treatment.
 Consult with doctors in clinics or nearby health centers.
 Minimize the crowding of workplaces.
 Ensure proper ventilation in the workplace.
 Encourage workers to strengthen their immune system
through healthy lifestyle.

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SIGNS OF GETTING WELL FROM TB

Less productive cough


Good appetite
Weight gain
Increase in body strength and stamina

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DOLE Department Advisory no.05-2010

Guidelines for the Implementation of a


Workplace Policy and Program on Hepatitis B

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 Potential life threatening liver infection caused by the
Hepatitis B Virus (HBV).

 There are approximately 7.3 million or 16 % of Filipino


adults infected with chronic hepatitis B.

 Most people infected acquired it from birth or in early


childhood.

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How HBV is transmitted?

From an infected mother to baby during


pregnancy or at birth
Unsafe blood transfusion
Unsafe injection practices
Unprotected sexual intercourse

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Yellowing of skin and
eyes
Vomiting
Nausea
Dark urine
Extreme fatigue
Liver cirrhosis/Liver
cancer

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Protecting yourself and others:
KNOW YOUR HEPATITIS B STATUS- Get tested
With HBV infection
-Regular follow up
1. For blood test to know the condition of the liver
2. To get proper medical advice and treatment
Without HBV infection
-Get vaccinated
-3 Separate vaccination over a 6-month period (last 20 years or lifelong)

PRACTISE STANDARD PRECUATIONS


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PRACTICE HEALTHY LIFESTYLE:
Have healthy meals
Avoid smoking and dangerous drinking habit
Practice safe sex
Reduce stress
Avoid drugs and sharing needles
Be physically active
Plan pregnancy and have regular prenatal
check up.
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FREQUENTLY ASKED
QUESTIONS FOR HEPA B
IN THE WORKPLACE:
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HEPATITIS B AND THE WORKPLACE
1. Should HIV Screening be part of pre-employment medical exam?
2. Should job applicants and workers be required to disclose their Hepatitis
B status?
3. Are Hepatitis B virus-infected workers fit to work?
4. Can I be terminated from employment if I am infected with Hepatitis B
Virus?
5. How can my company help in preventing and controlling HBV infection in
the workplace?
6. What can my company do to eliminate discrimination against Hepatitis B
positive worker?
7. Are hospitals required to implement HBV immunizations for their
workers?
8. I am an employer of a manufacturing company. Am I required to provide
HBV vaccination to my employees?
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OBSERVE NON- DISCRIMINATORY
PRACTISE IN THE WORKPLACE
Department Advisory No. 05-2010-
• Prohibits discrimination of any form against
workers on the basis of their Hepatitis B Status
• Hepa B Status shall not be used for denying
employment, promotion or training

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DOLE Department order no. 53-03

Guidelines for
implementation of a
Drug free workplace
Policies and Programs
for the private sector.

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• Drugs are chemicals that affect a person in
such a way as to bring about physiological,
emotional, or behavioral change.
• Dangerous drugs are those that have high
tendency for abuse and dependency, these
substances may be organic or synthetic, and
pose harm to those who use them.
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• Drug abuse exists when a person continually uses a
drug other than its intended purpose. This continued
use can lead to drug dependence, a state of physical
and psychological dependence or both on a
dangerous drug.
• Drug addiction is a complex, and open chronic, brain
disease. It is characterized by excessive drug craving,
seeking, and use. Addiction is caused by brain
changes by constant drug use.

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• Dependence is the state of physical and
psychological dependence, or both, on a dangerous
drug, or drugs, experienced by a person following the
use of that substance on a periodic or continuous
basis. A person dependent on drugs will experience
withdrawal reactions (also known as “cold turkey”,
symptoms that occur after long-term use of a drug is
reduced or stopped abruptly )after abstaining from
drugs.
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Current Philippine Drug Situation
Profile of a Filipino Drug Abuser
Age: 29 Years old
Sex: Male to female 10:1
Civil Status: Single/ 52.11 %
Educational Attainment: College level 32.22%
Status of Employment: Unemployed: 38.67 %
Economic status: Average Family Monthly Income of P15,789
Place of residence: Urban, specifically NCR 47.70 %
Duration of Drug taking: More than 6 years
Nature of Drug use: Poly Drug use
Drug of abuse: Methamphetamine Hydrochloride (Shabu)
Canabis Sativa ( Marijuana), Inhalants (Contact Cement adhesives)

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Most commonly abused drugs

1. Methamphetamine Hydrocloride- 2,167


cases
2. Cannabis or Marijuana- 934 cases
3. Contact cement/rugby- 129 cases

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Signs of Drug abuse
• Declining interest in work or school
• Suddenly changes friends
• Becomes pessimistic, irritable and anxious all the time
• Asks to be left alone a lot
• Is always tired (or makes it as an excuse to be left alone
• Becomes careless and often involved accidents
• Becomes implicated in a lot of fights
• Frequent mood swings
• Loss of interest in hobbies and sports
• Exhibits poor judgment
• Finds it difficult to concentrate
• Sudden changes in appearance (red or puffy eyes, weight changes,
constant complaints of head aches or stomach aches, shaking, incessant
cough, brown stains or finger tips, stumbling or a constant runny nose)
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Substance abuse as a workplace issue
Studies indicate that the rate of drug use are higher among
workers who:
1. Work in high stress job-
Manager, sales staff, physicians, lawyers, bartenders,
entertainers
1. Work in unsupervised situation
-long distance driver, travelling, sales persons
3. Work under extreme temperature
- Army personnel, mining industry workers
4. Work round the clock in different time zones
- Call centers and information technology services

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Workplace provisions of existing laws
on substance abuse in the workplace
• R.A 9165: Comprehensive dangerous drug act
of 2002
- This act provides for the enforcement of the
law, control of dangerous drugs, treatment
and rehabilitation of drug dependent, drug
abuse prevention in schools, workplace and
communities

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Workplace provisions of existing laws
on substance abuse in the workplace
• DOLE Department Order No. 53-03Guidelines for the
Implementation of a Drug-free Workplace Policies
and Programs for the Private Sector
• It emphasizes the importance of preventing
substance abuse in the workplace.
• The guideline serve as a basis for the formulation
and implementation of company policies in private
companies

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OUTLINE OF D.O. 53-03

• The DO mandates that all companies with 10 o r


more workers to formulate its own drug abuse
policies and programs.
• It includes for the components for formulation,
information and education, and the implementation
of random drug testing
• The guidelines shall apply to all private
establishments, including contractor and
concessionaires

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Formulations and policies and
programs
• Prepared Jointly by the employer and the workers
• Assist maybe sought from the tripartite task force
• Integrated to OSH Programs or similar programs
• In organized task force, should be part of Collective
bargaining agreement

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DOLE Department Order No. 102- 10
Series 2010
Guideline for the implementation of HIV and
AIDS prevention and control in the workplace
program

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What is HIV?
HIV- Human Immunodeficiency Virus
•This virus attacks the body’s immune system, the system which
gives our body the ability to fight infections.
•HIV Weakens the body’s ability to fight even the most simple
disease.

HIV Infection- is the successful entry of HIV in the human body,


weakening the immune system and leading to variety of disease.

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What is AIDS?

AIDS- Acquired Immunodeficiency Syndrome


•AIDS is the final stage of HIV infection characterized by signs
and symptoms.

•Having AIDS means that the virus has weakened the immune
system to the point at which the afflicted individual becomes
susceptible to the life threatening infections.

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How many are infected in the
Philippines?

2015: 22 Filipinos newly diagnosed with HIV per day


2014: 17 Filipinos newly diagnosed with HIV per day
2012: 13 Filipinos newly diagnosed with HIV per day
2010: 9 Filipinos newly diagnosed with HIV per day
2008: 4 Filipinos newly diagnosed with HIV per day

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How can a person be infected?
• Specific body fluids (blood, semen, vaginal secretions, breast)
milk from HIV infected person can transmit HIV.
• Saving unprotected sexual intercourse
• Having injection or transfusion with infected blood or blood
products.
• From a mother who is infected to her baby; this can occur
during pregnancy at birth and through breast feeding

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How to be protected from HIV/AIDS?
• Practice Safe Sex
• Remain faithful in a relationship with an uninfected equally faithful
partner
• Ensure that any blood or blood products that you might need are tested
for HIV and blood safety standards are implemented
• Practice universal precautions
• Always use new disposable needles and syringes for injections
• For drug dependent, it is best to enter a drug treatment program’
• Do not expose your body to needles infection like tattooing parts of your
body or piercing your ears
• Take antiretroviral drugs- reduce the risk of transmission to unborn child

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Why should workers and employers be
concerned about HIV and AIDS?
• Global and local statistics shows that most HIV- infected and
IADS cases are men and women in their most economically
productive ages of 20 to 20 years like the workers.

• The workplace is an ideal venue for communicating correct


and updated information on HIV and AIDS, with workers and
employers as captured audience

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Why is education and training
important in the workplace?
• The International Labor Organizations (2008) estimates that 9
out of 10 people living with HIV are working. Effective HIV and
AIDS education can help prevent new infections by equipping
individuals with the knowledge to protect themselves from
becoming infected with the virus.
• Providing education in the workplace is also important to
protect and help HIV positive workers to live healthily and stay
in work.

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What does R.A. 8504 require
workplaces?
• R.A 8504 requires that all offices, both government and
private, implement HIV and AIDS awareness and prevention
programs.
• Under the law, DOLE in collaboration with DOH is to oversee
the anti HIV and AIDS campaign in all companies in the private
sector
• The civil service commission is responsible for all government
offices and agencies

HSE International Consultancy


HEALTH SAFETY & ENVIRONMENT