Occupational Health

Aiko A. Salorsano
Objectives :

Define Occupational Health and its aims

Identify the types of hazards encountered in the work
place
Discuss the common occupational and work – related
diseases
Discuss Philippine programs in relation to Occupational
Health
What is Occupational Health ?

deals with all aspects of health

and safety in the workplace
and has a strong focus on
primary prevention of hazards.
-WHO
 Occupational Health is a
Multidisciplinary activity aimed at:

 the protection and promotion of the health of

workers by preventing and controlling
occupational diseases and accidents and by
eliminating occupational factors and conditions
hazardous to health and safety at work
The development and promotion of the healthy
and safe work, work environment and work
organizations
-WHO
 Occupational Health is a
multidisciplinary activity aimed at:

The enhancement of the physical, mental and

social well being of workers and support for the
development and maintenance of their working
capacity , as well as professional and social
development at work
Enabling workers to conduct socially and
economically productive lives and to contribute
positively to sustainable development
-WHO
 Workers

 The worker stands to benefit from health promotion

programmes by having a safe and healthy work
environment, a convenient location to learn about
and put into practice a healthy lifestyle, readily
available opportunities for screening and health care
and an opportunity ultimately to achieve optimal
health.
 Health has an all-encompassing impact on the
worker’s life, by affecting his or her ability to interact
with others, to work and to be self-reliant.
-WHO
Health Determinants of the workers

risk factors at the workplace leading to

Cancers
 accidents
musculoskeletal diseases
respiratory diseases, hearing loss
 circulatory diseases, stress related disorders
communicable diseases
-WHO
 Health Determinants of the workers

Employment and working conditions in the formal

or informal economy embrace other important
determinants, including,
working hours
Salary
 workplace policies concerning maternity leave
health promotion and protection provisions
-WHO
 Work-related diseases

“Work-related diseases” have multiple causes,

where factors in the work environment may
play a role, together with other risk factors, in
the development of such diseases. -WHO
Work-related diseases

disorders other than/in addition to the recognized

occupational diseases
Work environment and performance = significant
contributors
factors in the work environment
may cause, aggravate, accelerate or exacerbate the
condition
more common than occupational disease
 Occupational disease

is any disease contracted primarily as

a result of an exposure to risk factors
arising from work activity. –WHO
Any abnormal condition or disorder ,
other that one resulting from
occupational injury, caused by
factors associated with employment.
Included the acute or chronic
diseases that result from cumulative
or repetitive exposures to workplace
hazards. –(Mckenzie et.al.,1999)
 Occupational disease

factors in the work and

environment are the essential
causation of the disease
affects working population
exclusively
Having a specific or a strong
relation to occupation
generally with only one casual
agent
 General Diseases

Diseases among the general population

which workers may be equally or more
susceptible
Weak or unclear relationship with factors in
the work environment
 Occupational Health Issues in Developing
Countries according to John Hopkin’s Bloomberg School of Public Health (2008)
 Worker training and education
levels of workers may be lower
than in developed countries „
 Child labor more prevalent in
some countries „
 Pre-existing levels of health may
be lower
 Less-developed surveillance
systems „
 Fewer laws in some countries „
 Strong laws in other countries, but
poor enforcement
 Nature of occupational health
problems
− Overt occupational diseases—
chemical poisonings,
pneumoconioses—more
common; pesticide poisoning
particularly problematic
− Poorly controlled
occupational health hazards
Disability Evaluation

 Classification
 Permanent Partial Disability (PPD) o Employee loses a body part
and loss of use of that body part
 Temporary Total Disability (TTD) o Inability to work for a
continuous period not exceeding 120 days
 Permanent Total Disability (PTD) o Inability to work more than 240
days o Loss of vision, limb (2), brain injury or insanity caused by
work
 30 disease lists as “occupational disease”
Compensation

1. Temporary Total Disability (TTD)

 The amount of daily income benefit shall be ninety percent (90%) of the employee’s
average daily salary credit as determined by the Systems.
2. Permanent Total Disability (PTD)
 The amount of monthly income benefit for PTD shall be determined by the Systems based
on the average monthly salary credit or average monthly compensation (AMSC/AMC).
3. Permanent Partial Disability (PPD)
 A monthly income benefit is granted for disabilities that result in physical loss (amputation)
or functional loss of a body part. The number of monthly pensions is based on the
corresponding body part loss or functional loss, as provided under Article 193 of PD No.

626, as amended, and EC schedule of Compensation .

Phil. Program: Employee Compensation
Program

 The Employee Compensation Program

 Gov’t program designated to provide a compensation
package to public and private employees or their
dependents in the event of work-related sickness, injury or
death.
Who?
o All workers in the formal sector enjoying employer-
employee relationship are covered
 SSS
GSIS
What are compensable?

o Any work related sickness, injury, or death shall

be compensated under ECP
 Sickness is considered work-connected if it is in
ECC list o Accident may be considered work-
connected if it arises out or in the course of
employment
What are compensable?

Accident such as:

 Employee in injured in workplace/ performing official
function
 Occurred outside the company premise but executing
an order of his employer
 Occurred while going to or coming from work While
on board of a company vehicle
 Occurred in a company sponsored activity
Not Compensable

o Injury sustained
 Due to intoxication
 Notorious negligence
 Deliberate act
BENEFITS:

 Loss of income benefits – cash benefits given to workers to

compensate for the lost income due to his inability to work
 Medical benefit – reimbursement of cost and medical
services limited to ward service of an accredited hospital
 Rehabilitation – obj. is to develop workers mental, vocational,
and social potential to help them remain productive members
of society.
 Death- (PTD) primary beneficiaries shall receive 80% monthly
income plus 10% for every dependent child not exceeding
five
Government Service Insurance System

 The employees’ compensation benefit (or disability benefit) is a

compensation package for public and private sector employees
and their dependents in the event of work-related injury, sickness,
disability or death.
 Employees compensation is a purely employer-based contribution
benefit. Thus, employees do not contribute any amount to the
program. GSIS administers the employees compensation (EC) fund
as provided for under Presidential Decree No. 626.
Benefits :GSIS

Medical services, appliances and supplies;

Rehabilitation services;
Temporary total disability benefit;
Permanent total disability benefit;
Permanent partial disability benefit;
Death benefit; and
Funeral Benefit
 Beneficiaries

 In case of death and funeral benefits, the beneficiaries may either be one of the following:
 1. Primary
 Legitimate spouse until he or she remarries
 Dependent children (legitimate, legitimated or adopted, and illegitimate):
 Below 18 years old, unmarried, not gainfully employed; or
 More than 18 years old but incapacitated and incapable of self-support due to mental or
physical defect acquired prior to age of majority.
 2. Secondary
 Dependent parents
 Legitimate descendants
 Eligibilities

 The conditions for payment are as follows:

Injury must be the result of accident arising out of and in the
course of employment
Sickness must be listed /considered an “occupational disease”; or
even if not listed as one, it must be shown that the risk of
contracting the sickness is increased by the working conditions
Disability/Death is caused by work-connected injury or sickness
Exceptions.

When any of these is due to the employee’s:

Intoxication or drunkenness
Willful intention to injure or kill himself or another
Notorious negligence
Not work-related
 List of Occupational Diseases (under PD
626)
 Papilloma of the bladder
 Cancer, epithellomatous or ulceration of the skin or of the
corneal surface of the eye
 Cataract
 Deafness
 Decompression sickness
 Caisson disease
 Aeroembolism
 Dermatitis due to irritants and sensitizers
 Infections: Anthrax, Brucellosis, Glanders, Rabies, Tuberculosis, Tularemia, Weill’s disease,Q Fever or equine
encephalomyelitis, Mite dermatitis
 Ionizing radiation disease, inflammation, ulceration or malignant disease of the skin or subcutaneous tissues of the
bones or leukemia or anemia of the aplastic type due to X-rays, ionizing particles, radium or other radioactive
substances Acute radiation syndrome: Chronic radiation syndrome and Glass blower’s cataract.
 List of Occupational Diseases (under PD
626)
 Poisoning
 Pneumoconiosis
 Diseases caused by abnormalities in temperature and humidity
 Vascular disturbance in the upper extremities due to continuous vibration from pneumatic tools or
power drills, riveting machines or hammers
 Viral hepatitis
 Poisoning by cadmium
 Leukemia and lymphoma
 Cancer of the stomach and other lymphatic and blood forming vessels, nasal cavities and sinuses
 Cancer of the lungs, liver and brain
 Cardio-vascular diseases
 Cerebro-vascular accidents
 List of Occupational Diseases (under PD
626)

 Malaria and schistosomiasis

 Pneumonia
 Hernia
 Bronchial asthma
 Osteoarthritis
 Viral encephalitis
Peptic ulcer
 Pulmonary tuberculosis
 Viral hepatitis
 Essential hypertension
 Asbestosis
No claim for compensation will be
given due course unless said claim is
filed with the GSIS within three years
from the time the cause of action
accrued. (ECC Resolution No. 2799, July
25, 1984)
Increase in EC Benefits

On 26 May 2014, President Benigno Simeon Aquino

III issued Executive Order 167 which approved the
increase of Employees’ Compensation Funeral Benefit
from Php10,000 to Php20,000 for both the employees in
the private and public sectors and a 10% across-the-
board increase in EC pension for all EC permanent partial
disability, permanent total disability and survivorship
pension in the private sector.
Sick Leave: Twelve (12) days for the first two
years of service and additional 1 day every
year starting on the 3 rd year. Maximum total
sick leave is 15 days. All unused leave are
convertible to cash at the end of the year.
Maternity and Paternity leave

 The recently-signed Republic Act (RA) No. 11210 or the

Expanded Maternity Leave Act - gives mothers up to 105 days or
3 months of maternal leave, it also entitles fathers to 14 days of
paid leave.

 Article II, Section 6, of the new law allows any female worker who
will avail of maternity leave to transfer up to 7 of her 105 days of
paid leave to the child’s father, whether they are married or not
SSS Employment Compensation benefit

Types of Cash Benefits for Disabled SSS Members

 Monthly disability pension - For members who have paid a minimum of 36 monthly SSS contributions before
the semester of disability
 Lump sum payment - For members who have paid less than 36 monthly contributions before the semester of
disability and those whose approved disability period is payable for less than a year
Other SSS Disability Benefits
 In addition to the monthly pension, a disability pensioner can receive the following benefits:
 PHP 500 monthly supplemental allowance
 PHP 1,150 additional benefit (granted by Executive Order 54 effective January 2017)
 13th month pension paid every December
 PhilHealth hospitalization benefits for the ff: - SSS members who became total disability pensioners and their
dependents before RA 7875 took effect on March 4, 1995 - SSS members who became total disability
pensioners and their dependents after RA 7875 took effect on March 4, 1995, are at least 60 years old, and
have paid 120 monthly Medicare contributions
 Who Can Get Disability Pension from SSS?
- Permanently Disabled SSS Members
- An SSS member with partial or total permanent disability must have paid at least one-month
SSS contribution before the semester of disability.

Partial Disabilities That Qualify for a Pension

 SSS defines partial disability as a complete and permanent loss of a certain body part. The
condition doesn't totally prevent a person from doing his or her job. Partial disabilities that
qualify for SSS benefits include the loss of any of these parts and senses:
 One finger
 One hand
 One arm
 One foot
 One leg
 Both ears
 Hearing of one ear or both ears
 Sight of one eye
Total Disabilities That Qualify for a Pension
 Complete loss of sight of both eyes
 Loss of two limbs at or above the wrists or ankles
 Permanent complete paralysis of two limbs
 Brain injury that leads to incurable imbecility or insanity
 Other cases of total disability approved by the SSS

Who Can Receive a Lifetime Monthly Disability Pension?

 Only SSS members who are totally and permanently disabled are entitled to a monthly disability pension
for life. However, SSS stops paying the pension in the following cases:
 Recovery from total permanent disability
 Resumption of employment
 Failure to report for the annual physical examination when notified by the SSS
 Dependents of SSS Disability Pensioners
 Up to five of a disability pensioner's children below age 21 (conceived on or before disability) may
receive PHP 250 or 10% of the SSS member's monthly pension, whichever is higher. When a pensioner
dies, his or her primary beneficiaries will get the full monthly disability pension except for the supplemental
allowance.
 List of Occupational Disease

• Diseases caused by agents

- Physical, Chemical, Biological
• Diseases by target organ system
-Respiratory, Skin, Musculoskeletal
• Occupational cancer
-Cancer caused by the following agents
Source :International Labour Organization ( 2010)
 Hazard

 any source
of potential damage, harm or
adverse health effects on
something or someone.
 a potential source of harm to a
worker.

Harm - physical injury or damage

to health.

Source: Canadian Centre for Occupational Health & Safety (2017)

 Hazard

Source: Canadian Centre for Occupational Health & Safety (2017)

RECOGNITION OF HEALTH HAZARDS
Inspection

Inspection of the workplace is the

best source of directly relevant
data about health hazards.
There is no substitute for
observation of work practices, use
of chemical and physical agents,
and the apparent effectiveness of
control measures. -WHO
Potential health hazards
Chemical hazards

 in the form of solids, liquids, gases, mists, dusts,

fumes and vapours
 exert toxic effects by inhalation (breathing),
absorption (through direct contact with the
skin) or ingestion (eating or drinking).
 The degree of worker risk from exposure to any
given substance depends on the nature and
potency of the toxic effects and the magnitude
and duration of exposure.
 Gases and vapours

These can be classified according

to their physiological action into:
 asphyxiants
 irritant gases
organometallic compounds
 anaesthetic vapours
 Asphyxiants

 Can cause asphyxia either by replacing oxygen or by some other mechanism.

 They are classified into:
simple asphyxiants
- replace oxygen, e.g. nitrogen, methane, hydrogen and carbon
dioxide.
chemical asphyxiants
- interfere through some chemical action with the respiratory function of
the blood, tissue cells or respiratory centre, e.g. carbon monoxide (CO),
hydrogen sulfide and hydrocyanic acid.
 Simple asphyxiants
 Nitrogen:
 a simple asphyxiant used in the fertilizer industry and present in mines when O2 is consumed. In mines it
can be detected by the safety lamp which is extinguished at O2 concentration of 17%. At 12% O2
there is dyspnea, cyanosis, unconsciousness, loss of motor power, convulsions and death.
 Methane (marsh gas)
 results from decomposition of organic matter and is present in marshes, sewers and mines. It is a
simple asphyxiant, inflammable and lighter than air.
 Carbon dioxide (CO2):
 results from combustion of fuels; it is a colourless gas, heavier than air. It can be found in mines, wells,
caves and close to furnaces and brick kilns. It is also present in the manufacture of soft drinks, beer, in
the sugar industry and is used as dry ice. In addition it can be used to extinguish fires. CO 2 is a simple
asphyxiant but in low concentrations stimulates rapid respiration. Resuscitation calls for O2 inhalation,
warmth, cardio-respiratory stimulants and if respiration stops, artificial respiration.
 Carbon monoxide (CO)

 a colourless, odourless gas which results from incomplete combustion of fuel.

 It is a product of coal distillation plants, steel furnaces, fuel boilers and
furnaces and home heating appliances. It is also present in vehicle exhaust
fumes
 CO has a great affinity to haemoglobin (HbCO) (210 times that of O2) and
thus interferes with O2 transport.
 Exposure causes headaches, dizziness, chest oppression, loss of motor
power, unconsciousness, convulsions, cardiovascular effects, coma and
death (depending on the percentage of HbCO in the blood).
CO poisoning

Prevention of CO poisoning depends on proper design,

maintenance and regular inspection of home appliances
and industrial sources and also on control measures in
garages.
In a case of poisoning, O2 inhalation is indicated (with 5%
CO2), with warmth, stimulants and artificial respiration
provided if needed; the worker should be removed from
exposure first.
 Hydrogen sulfide (H2S)

 Hydrogen sulfide (H2S): a colourless gas, heavier than air; it has the odour of
rotten eggs. Exposure occurs in oil fields and refineries, tanneries, sewers and in
the manufacture of rayon and artificial rubber.
 It can be detected by its smell and causes paralysis of the olfactory nerve after
a short while.
 it has an irritant effect on the eyes and upper respiratory centre; it also causes
asphyxia by combining with cytochrome oxidase enzyme and preventing tissue
respiration.
 If respiratory paralysis occurs artificial respiration is indicated.
 Nitrites (sublingual and intravenous) serve to break the combination between
the gas and cytochrome oxidase enzyme by forming methaemoglobin.
 Hydrocyanic acid (HCN)

 a colourless gas that has the odour of bitter almonds.

 HCN is used in fumigation of ships as a pesticide and its salts are used in
photography, metal hardening, electroplating and in extraction of gold from
ore.
 The gas can be absorbed through the skin and its inorganic salts are among
the most potent poisons.
 They produce their effects through inhibiting cytochrome oxidase enzyme
thus interfering with tissue respiration. Signs and symptoms appear within
minutes in the form of dizziness, oppression of the chest, cardio-respiratory
manifestations, unconsciousness and death which, in severe cases, occurs
within minutes. Organic salts are not as toxic
 Hydrocyanic acid (HCN)

First aid includes the inhalation of amyl nitrite and intravenous

injection of sodium nitrite followed by sodium thiosulfate. Cobalt
EDTA and hydroxocobalamin are also used in the treatment of
cyanide poisoning. Cardio-respiratory stimulants, warmth and
artificial respiration may also be indicated.
Since HCN is a very rapid poison, the first ai
d equipment should be very close to the work site and a well-
trained first aid attendant available at all work shifts.
Metals (source: Arif et.al.,2015)
 Biological hazards

 These exist in exposures to bacteria, viruses, fungi and

other living organisms that can cause acute and
chronic infections by entering the body either directly
or through breaks in the skin.
 Occupations that deal with plants or animals or their
products, or with food and food processing may
expose workers to biological hazards.
 Laboratory and medical personnel also can be
exposed to biological hazards. Any occupations that
result in contact with bodily fluids expose workers to
biological hazards.
 Biological hazards

 Effective personal hygiene, particularly proper attention

to minor cuts and scratches especially on the hands
and forearms, helps keep worker risks to a minimum. In
occupations where there is potential exposure to
biological hazards, workers should practice proper
personal hygiene, particularly hand washing.
 Hospitals should provide proper ventilation, proper
personal protective equipment such as gloves and
respirators, adequate infectious waste disposal systems
and appropriate controls including isolation in instances
of particularly contagious diseases, e.g. tuberculosis.
 Physical hazards

These include excessive levels of

 noise
Vibration
illumination
Temperature
ionizing and non-ionizing
electromagnetic radiation
 Noise can be controlled by:

 installing equipment and systems that have been engineered, designed and built to
operate quietly
 enclosing or shielding noisy equipment
 making certain that equipment is in good repair and is properly maintained with all worn or
unbalanced parts replaced
 mounting noisy equipment on special mounts to reduce vibration
 installing silencers, mufflers or baffles
 substituting quiet work methods for noisy ones, e.g. welding parts rather than riveting them
 treating floors, ceilings and walls with acoustic material to reduce reflected or reverberant
noise
 erecting sound barriers at adjacent workstations around noisy operations to reduce worker
exposure to noise generated at adjacent workstations
 Ionizing radiation can be controlled by:

 Reducing exposure time: danger from radiation increases with the

amount of time one is exposed to it. The shorter the time of exposure
the smaller the radiation danger.
 Increasing distance: a valuable tool in controlling exposure to both
ionizing and non-ionizing radiation. Radiation levels from some sources
can be estimated by comparing the squares of the distances
between the worker and the source.
 Shielding: the greater the protective mass between a radioactive
source and the worker, the lower the radiation exposure. Similarly,
shielding workers from non-ionizing radiation can also be an effective
control method.
In some instances, however, limiting exposure to or
increasing distance from certain forms of non-ionizing
radiation, e.g. lasers, is not effective. An exposure to laser
radiation that is faster than the blinking of an eye can be
hazardous and would require workers to be miles from the
laser source before being adequately protected.
Radiant heat exposure can be controlled by

 installing reflective shields

providing protective clothing in factories
such as steel mills.
Psychosocial factors

These may include

 boring
repetitive tasks
production pressure
Stress
 low pay and lack of recognition
Accident factors

The main causes of accidents

include:
unsafe mechanical and physical
conditions
unsafe act
unsafe personal factors
OCCUPATIONAL HEALTH PROGRAMS

PHILIPPINES
 The program addresses the incidence of occupational diseases and work-related diseases
and injuries among workers through health promotion and protection in all workplaces.

It initially focuses on public health workers and informal sector workers including, but not
limited to those in agriculture, transport,
and small-scale mining.

It aims to improve workers’ access to basic occupational health services at the local level.
 Objective/Goal:
 By 2022, reduce the number of occupational diseases and injuries by 30% from the 2015
baseline as identified in the Occupational Health and Safety Profile of the Philippines.
Policies and Laws
 1961, Administrative Order No. 63 “Industrial Hygiene Code”
 1975, Presidential Decree No. 856 Code on Sanitation of the Philippines (Chapter VII
– Industrial Hygiene)
 1987, Philippine Constitution of 1987 (Article II, Section 15)
 2008, Joint Administrative Order between DTI-DENR-DA-DOF-DOH-DILG-DOLE-DOTC
No. 01 “The Adoption and Implementation of the Globally Harmonized System of
Classification and Labelling of Chemicals (GHS)”
 2012, DOH Administrative Order No. 2012-0020 “Guidelines Governing the
Occupational Health and Safety of Public Health Workers”
 2013, DOH Administrative Order No. 2013-0018 “National Occupational Health Policy
for the Informal Mining, Transport and Agricultural Sectors”
 2013, DOH Administrative Order No. 2013-0009 “National Chemical Safety
Management and Toxicology Policy
 2013, DOH Department Personnel Order No. 2013-3584 “Designation of
Undersecretaries and Assistant Secretaries as Heads of Technical and Operations
Cluster for Kalusugang Pangkalahatan, the Occupational Health and Safety
Committee for the Department of Health and other Attached Agencies” and its
Reconstitution DPO No. 2014-2282 and 2014-2282-A “Reconstitution of the
Occupational Health and Safety Committee for the Department of Health and other
Attached Agencies”