1. EOH3202 Occupational Health
Dr. Emilia Zainal Abidin, PhD or
(response time < 24 hours)
Office:
13 April 2014
PJJ Bac Sc. Human Resource Dev 2nd Semester 2nd Meeting

2. Were there any problems we need to discuss?
Module – everyone has a copy?
Other reference books – Kesihatan di Tempat Kerja
Assignments OK?
Emilia Zainal Abidin

3. Questions on Individual Assignment 1?
Describe the 4 objectives of the Occupational Safety and Health Act 1994 Malaysia.
Compare and describe the differences between the Occupational Safety and Health Act 1994 and the Factory and Machinery Act 1967.
Use and Standard of Exposure to Chemicals Hazardous to Health Regulations 2000 requires workers being exposed to solvents to undergo medical surveillance at regular intervals. True/False
What are the main functions of Department of Occupational Safety and Health, Malaysia?
Please explain particle size fractions of dust.
Please explain the aerodynamic behavior of particles in airstream and particle deposition in human lung system.
Emilia Zainal Abidin

4. Questions on Individual Assignment 1?
Explain the noise regulation being used in Malaysia.
Please describe the steps to control dust exposure in a construction site.
Please explain the roles of professionals in the field of occupational health.
Define the term ergonomic hazard.
List four acts that are enforced by the Ministry of Human Resources Malaysia.
Define radiation. Discuss two types of radiation by giving appropriate examples.
Alpha radiation cannot travel far through air. How far does it go? What material will absorb alpha radiation? State two safety precautions for handling radioactive sources.
Discuss how Malaysian workers are compensated for occupational injuries.
Explain 3 major incidents which occurred globally and in Malaysia that lead to the establishment of the Occupational Safety and Health Act 1994.
Emilia Zainal Abidin

5. Questions on Individual Assignment 2?
Identify the impact of sickness absence to the employee and employer.
Explain the mechanism by which organophosphate poisoning occurs. Include 2 diagrams to describe normal muscle function and muscle function with neurotoxic agent.
Give the steps in control and management of pesticide exposure in a paddy farming agricultural setting.
Pesticides are categorised into different groups. Explain the classification of pesticides.
Use and Standard of Exposure to Chemicals Hazardous to Health Regulations 2000 requires workers being exposed to pesticides to undergo medical surveillance at regular intervals. True/False
Emilia Zainal Abidin

6. Questions on Individual Assignment 2?
Using the hierarchy of control concept, explain how a safety and health manager could manage psychosocial hazard related at the workplace.
Give examples of personal protective equipment suitable to protect workers from exposure to chemicals in a chemical manufacturing factory.
Why personal protective equipment is considered as a “last resort” for use in the hierarchy of control to protect workers from hazardous substances?
List the effects of chronic pesticide poisoning. Describe briefly each type of effect.
Define occupational stress and list common occupational stressors. List the diseases associated with occupational stress and as a manager of human resource, please describe the management of occupational stress.
Emilia Zainal Abidin

7. Cont.
Describe the group of workers at risk for biological hazard exposure. Elaborate on the classification of infective microorganism by risk group.
Describe 2 models to explain the cause of occupational stress.
Define and describe Material Safety Data Sheet or Chemical Safety Data Sheet.
Describe the different work compensation scheme available in Malaysia for private employees, civil servants and foreign workers.
Define biological monitoring. Describe the role of biological monitoring and describe how biological monitoring is done.
Emilia Zainal Abidin

8. Cont.
Please define what sexual harassment is and please describe the different forms of sexual harassment that might occur at the workplace.
What are the potential hazards of working underwater?
What should be included in Medical Emergency Response Plan? What are the elements of Emergency Response Plan?
What is the required number of first aider in a workplace? What is the content of a First Aid Box?
What is the definition of risk communication and what are the 3 goals of risk communication?
Emilia Zainal Abidin

9. Your Recent Mid-Semester Examination
Chapter 1 to 11 from module
2 hours examination
50 objectives
5 out of 8 short answer questions
How well did you do?
Comments or feedback to improve the type of questions
a._____________________________________________
b._____________________________________________
c._____________________________________________
Emilia Zainal Abidin

10. Our Coming Final Exam in May 2014
Chapter 12 to 22
2.00 hours?
50 objectives?
5/8 short answer questions?
Any requests?
Emilia Zainal Abidin

11. Responsibility to protect the safety health and welfare of workers and visitors
Duties of an Employer - OSHA 1994 Section 15 – 19
To ensure the safety, health and welfare at work of all his employees and visitors.
To formulate safety and health policy. Extra protection for the disabled etc.
There are seven regulations under OSHA 1994 that enforced by DOSH.
Employers’ Safety and Health General Policy Statements (Exception) Regulations, 1995
Control of Industrial Major Accident Hazards Regulations, 1996
Classification, Packaging and Labelling of Hazardous Chemicals Regulations, 1997
Safety and Health Committee Regulations, 1996
Safety and Health Officer Regulations, 1997
Use and Standards of Exposure of Chemicals Hazardous to Health Regulations, 2000
Notification of Accident, Dangerous Occurrence, Occupational Poisoning and Occupational Disease Regulations, 2004
Emilia Zainal Abidin

12. Duties of Safety and Health Officer
to advise employer on the safety and health measures;
to inspect and determine the safety of work place;
to investigate any accident which has happened in the work place;
to assist employer in organizing and implementing OSH programme;
to become secretary to the committee;
to assist the committee in any inspection of the work place;
to collect, analyze and maintain statistics on any accident, dangerous occurrence, occupational poisoning and disease which have occurred at the work place;
to assist any officer in carrying out his duty under the Act;
to carry out other instruction made by the employer on any matters pertaining to OSH.
Emilia Zainal Abidin

13. Stress, boredom, burnout
OCCUPATIONAL HAZARDS
PSYCHOLOGICAL
Stress, boredom, burnout
CHEMICAL AGENTS
Solvents, gases, vapors,
fumes, mists, pesticides etc.
PHYSICAL AGENTS
noise, vibration, radiation,
defective illumination,
temperature extremes, dusts
BIOLOGICAL AGENTS
viruses, bacteria, fungi,
parasites, insects, etc.
LACK OF ERGONOMIC PRINCIPLES
exhaustive physical exertions, excessive standing, improper motions, lifting heavy load, job monotony, etc.

14. Occupational health is about identifying hazards and controlling it
Emilia Zainal Abidin

15. Identify the hazard and suggest control methods…
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16. Identify the hazard and suggest control methods…
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17. Identify the hazard and suggest control methods…
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18. Identify the hazard and suggest control methods…
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19. What to focus on? Chapter 12: Chemical hazards – Pesticides
Based on chapter in module
Classification of pesticides – use?, toxicity, chemical prop.,
Occupational exposures of pesticides
Toxic effects from exposure
Neurotoxic effect – acetyl cholinesterase function diagram ??
How to control and manage pesticide use in the workplace
Emilia Zainal Abidin

20. Agricultural workers Farmers
Handling pesticide with bare hands
Wear short pants and short sleeves without proper PPE

21. Apply most of the protection but without proper mask
No boots and poor work practices

22. Exposure to Organophosphate pesticide
May result in:
build-up of acetylcholine
cholinesterase inhibition
constant firing of electrical messages
potential symptoms of: DUMBELSS
-Diarrhoea
-Urination
-Miosis/Muscle weekness
-Excitation of skeleton muscles of CNS
-Lacrimation
-Sweating
-Salivation
Emilia Zainal Abidin

23. What to focus on?
Chapter 13: Bio hazard management
Based on lecture notes
What is biohazard? - A substance derived from an organism, that poses a threat to (primarily) human health.
Divided into:
Body fluids pathogen – Bacteria, Viruses, Fungi, Protozoa, Parasites
Animal – insects, birds
Recombinant DNA – genetic engineering, cloning
Nano-technology
Classification of infective microorganism by risk group?
References are made to the relative hazards of infective microorganisms by World Health Organization Risk Groups 1, 2, 3 & 4.
Emilia Zainal Abidin

24. What to focus on? Chapter 14: Occupational Psychosocial Hazards
Based on chapter in module and lecture
Scope of occupational psychosocial hazards
Work-related stress
Workplace violence
Bullying
All types of harassment
Work-life imbalance
Type of psychosocial hazards
Questionnaires
Emilia Zainal Abidin

25. Examples from Leka et al. 2003
Psychosocial hazards
Examples from Leka et al. 2003
Job content
Lack of variety or short work cycles, fragmented or meaningless work, under use of skills, high uncertainty, continuous exp to people through work
Workload and work pace
Work overload or underload, machine pacing, high level of time pressure, continually subject to deadlines
Work schedule
Shift work, night shifts, inflexible work schedules, unpredictable hours and long or unsociable hours
Control
Low participation in decision making, lack of control over workload
Environment and equipment
Inadequate equipment, poor environmental conditions such as lack of space, poor lighting, noise
Organisational culture and function
Poor communication, low level of support for problem solving and personal development, lack of definition of organisational objectives
Interpersonal relationship at work
Social or physical isolation, poor relationships with superiors, interpersonal conflict, lack of support, bullying and harassment
Role in organisation
Role ambiguity, role conflict and responsibility of people
Career development
Career stagnation and uncertainty, under promotion or over promotion, poor pay, job insecurity, low social value to work
Home-work interface
Conflicting demands of work and home, low support at home, dual career problems

26. ACUTE AND CHRONIC EFFECT
Work environment
Conceptual Frame Work of Stress
Home environment
FAMILY & SOCIO
DEMOGRAPHIC
STRESSORS
OCCUPATIONAL
STRESSORS
Work load
Work environment
Health status
Family Conflict
Financial
Time and System Management
ACUTE AND CHRONIC EFFECT
1. Physiological
2. Psychological
3. Behavioral
OUTCOMES OF STRESS
Organizational relationship
Personality
Training
MODYFYING
VARIABLES
SUPPORT
Knowledge
Skill
Social Interaction
Coping mechanism
Emotional support
PERCEIVED STRESS
Emilia Zainal Abidin

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30. What to focus on? Elimination Substitution Isolation or Enclosure
Chapter 15: Prevention and Control principles
Based on module
Prevention and control according to the hierarchy of control
Elimination
Substitution
Isolation or Enclosure
Engineering Controls e.g Local Exhaust Ventilation
Administrative Controls/Safe Work Practices
Personal Protective Equipment
Effectiveness
Emilia Zainal Abidin

31. What to focus on? Chapter 16: Workers’ compensation
Based on the module and half of lecture
Work compensation scheme in Malaysia
Private – SOCSO or Perkeso
Civil servants – Ex-Gratia Scheme
Foreign workers – Insurance from the Workmen Compensation Act
Self-employed – None
Emilia Zainal Abidin

32. SKIM PERKESO SKIM FAEDAH PERKESO SKIM PENCEN ILAT
SKIM INSURANS BENCANA PEKERJAAN Bencana pada seseorang pekerja sendiri disebabkan oleh kemalangan atau suatu penyakit khidmat terbit daripada dan dalam masa menjalankan pekerjaan dalam sesuatu perusahaan.
SKIM PENCEN ILAT
Skim ini memberi perlindungan 24 jam kepada pekerja terhadap keilatan atau kematian akibat sebarang sebab yang tidak berkaitan dengan pekerjaan.

33. Faedah yang disediakan
SKIM INSURANS BENCANA PEKERJAAN
Faedah Perubatan
SKIM PENCEN ILAT
Faedah Hilangupaya Sementara
Pencen Ilat
Bantuan Ilat
Faedah Hilangupaya Kekal
Elaun Layanan Sentiasa
Pencen Penakat
Faedah Orang Tanggungan
Faedah Pengurusan Mayat
Faedah Pemulihan
Faedah Pendidikan
Emilia Zainal Abidin

34. What to focus on? What is biological monitoring
Chapter 17: Biological monitoring
Based on the module and notes
What is biological monitoring
Biological monitoring is the measurement of a substance or its metabolite in biological material in order to provide a quantitative estimate of its uptake into the body by all routes of exposures
What are the objectives of biological monitoring?
To ensure that current or past exposure of worker is not harmful to his/her health by detecting potential excessive exposure before overt adverse health effects occur
Emilia Zainal Abidin

35. Exposure, absorption and effects*
Ukur pendedahan di persekitaran contoh: ukur debu atau bunyi bising di persekitaran selama 8 jam
Ambient monitoring
Ukur dos yang diserap dalam badan pekerja (bentuk tidak berubah) contoh: ukur plumbum dalam darah
Exposure
Ukur kesan perubahan yang berlaku dari dos terdedah contoh: ukur Cholinesterase enzyme akibat organofosfat
Internal
dose
Adverse
effects
Biological monitoring
Biological effect monitoring
*Adapted from Cassarett & Doull’s Toxicology 5th Edition, ed. Klassen CD pp995. McGraw Hill, 1995
Emilia Zainal Abidin

36. What to focus on? Chapter 18: Stress and Violence and the workplace
Based on the module and lecture
Definition
Scope and characteristics
Any action, incident or behaviour that departs from reasonable conduct in which a person is assaulted, threatened, harmed, injured in the course of, or as a direct result 1 of, his or her work.
Internal workplace violence
is that which takes place between workers, including managers and supervisors.
External workplace violence
is that which takes place between workers (and managers and supervisors) and any other person present at the workplace.
Emilia Zainal Abidin

37. What to focus on? Chapter 19: Cause and effect of sick leave
Based on the module and lecture
What is sick leave?
The benefit of sick leave
Human right
Protect the worker
Cost of losing an employee is greater than the cost of providing sick days to retain existing employees
Emilia Zainal Abidin

38. Absenteeism in business case
Unhealthy and unsafe workplace
Accidents and injuries
Work related illness
Job dissatisfaction
Lack of job commitment
Depression
Violence
Work related stress
Unhealthy personnel behaviour which will bring to non communicable disease
Heavy Smoking and drinking drugs
Increased cost, decreased productivity, decreased quality of product, fines, imprisonment
Absenteeism
Short and long term disability
Health insurance
Workers compensation and claims
Turnover
Union grievance
Business failure!
Sources: WHO (2010). WHO Healthy Workplace Framework and Model: Background and Supporting Literature and Practices.
Emilia Zainal Abidin

39. Example: Tools for tackling short term absence
Rigorous notification procedure
Return to work interviews
Should all short term absences be counted?
Medical evidence?
Withholding sick pay
Employee health initiatives
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Emilia Zainal Abidin 39

40. Example: Tools for tackling long term absence
Keep in touch
Early intervention 4-6 weeks
Consider temporary adjustments
Be proactive in asking for medical advice
Preferably Occupational Health Practitioner
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Emilia Zainal Abidin 40

41. What to focus on? Chapter 20: Water and Air Decompression
Based on the module and lecture
Gas laws – Boyle and Henry
Hyperbaric work environment (kerja di persekitaran bertekanan tinggi)
The effects of hyperbaric work environments
Decompression sickness and other symptoms – kesan seperti bends
Emilia Zainal Abidin

42. Boyle’s Law
The mechanical responses to changes in pressure are in accordance with Boyle's Law, which states that a volume of gas is inversely proportional to the pressure to which it is subjected, temperature remaining constant.

43. Henry’s Law
The amount of gas in solution is proportional to the partial pressure of that gas over the solution
As the pressure of the gas above a solution increases, the amount of that gas dissolved in the solution increases
Reverse is also true, as the pressure of the gas above a solution decreases, the amount of gas dissolved in the solution decreases and forms a “bubble” of gas within the solution

44. Henry’s Law Illustration
Low pressure equilibrium
Low concentration
Double the pressure equilibrium
Double the concentration

45. How does the increased pressure at depth affect gas in the body?
The increased pressure of each gas component at depth means that more of each gas will dissolve into the blood and body tissues, a physical effect predicted by Henry's Law
Inhaled gases are in close contact with blood entering the lungs
Hence, the greater the partial pressure of any inhaled gas, the more that gas will diffuse into the blood.

46. Symptoms of decompression sickness
Bends -
DCS Type
Bubble Location
Signs & Symptoms (Clinical Manifestations)
BENDS
Mostly large joints of the body (elbows, shoulders, hip, wrists, knees, ankles)
Localized deep pain, ranging from mild (a "niggle") to excruciating. Sometimes a dull ache, but rarely a sharp pain.
Active and passive motion of the joint aggravates the pain.
The pain may be reduced by bending the joint to find a more comfortable position.
If caused by altitude, pain can occur immediately or up to many hours later.

47. Symptoms of decompression sickness
CHOKES
Lungs
Burning deep chest pain
Pain is aggravated by breathing
Shortness of breath
Dry constant cough
SKIN BENDS
Skin
Itching usually around the ears, face, neck arms, and upper torso
Sensation of tiny insects crawling over the skin
Mottled or marbled skin usually around the shoulders, upper chest and abdomen, with itching
Swelling of the skin, accompanied by tiny scar-like skin depressions

48. Symptoms of decompression sickness
NEUROLOGIC
Brain
Confusion or memory loss
Headache
Spots in visual field, tunnel vision, double vision, or blurry vision
Unexplained extreme fatigue or behaviour changes
Seizures, dizziness, vomitting and unconsciousness may occur
Spinal Cord
Abnormal sensations such as burning, stinging, and tingling around the lower chest and back
Symptoms may spread from the feet up and may be accompanied by ascending weakness or paralysis
Girdling abdominal or chest pain
Peripheral Nerves
Urinary and rectal incontinence
Abnormal sensations, such as numbness, burning, stinging and tingling
Muscle weakness for twitching

49. What to focus on?
Chapter 21: Emergency Response Plan (ERP) and First Aid
Based on the module
ERP should include
Procedures
Emergency medical equipment
Internal and external contact and support
Management of injury and triage
Evacuation plan
Training to those involved
Local facilities
Give knowledge to all workers
Elements of ERP – evacuation plan, area custodian/damage control team, fire brigade, emergency medical facility
What is in First Aid Box?
Emilia Zainal Abidin

50. What to focus on? Chapter 22: Risk Communication Based on module
Definition of risk communication
Primary goals of risk communication
Risk communication strategies
Principles of risk communication
Emilia Zainal Abidin

51. Thank you. Any questions?
Emilia Zainal Abidin