SITUATION OF

OCCUPATIONAL HEALTH

SURVEILLANCE IN

MALAYSIA DR PRIYA RAGUNATH

FFOM(IRE), MPH(MAL), MPH[OH] (MAL), CMIA(MAL), CAOCH(USA)

MINISTRY OF HEALTH, MALAYSIA

18.12.17

Contents

• Introduction

• Functions and Authority

• Statistics in Occupational health

• Safety Measures and Legislation

• Health Surveillance

MALAYSIA

Malaysian Scenario 2016

• 13 States and 3 Federal Territories

• 330,803 square kilometres

• Population 32.2 million

• Labour force 15.06 million

• Unemployment Rate 3.4%

• Outside labour force (housewives, disabled) 7.12 million

• Foreign labour force 2.1 million

Major Industries

Manufacturing :

Electronics

Automotive Others:

• Petroleum and LNG

• Wood

• Palm Oil

• Rubber

OCCUPATIONAL HEALTH SERVICES

NATIONAL COUNCIL OF

OCCUPATIONAL SAFETY AND HEALTH

MIN OF HUMAN

RESOURCES

DEPARTMENT OF

OCCUPATIONAL

SAFETY AND

HEALTH

(DOSH)

OCCUPATIONAL

HEALTH UNIT

MIN OF HEALTH

SOCIAL

SECURITY

ORGANIZATION

(SOCSO)

NIOSH

OTHER

AGENCIES

UNIVERSITIES SOCIETIES

Functions of MOH

• To provide health preventive & promotive services, treatment, rehabilitation

• To provide human resources : trained healthcare personnel, occupational health doctors, occupational health nurses

• To complement the services of the Department of Occupational Safety and Health, Social Security Organization-joint activities

• Regional and global networking

Activities of MOH concerned with occupational

health

Preventive programs – Immunization

Promotive programs - workplace NCD’s, Occ health

Training of personnel -health care personnel

Treatment and rehabilitation -clinical

Notification

Safety and health audits

Medical surveillance

Compensation : Ex Gratia & SOCSO

Investigations of outbreaks at the workplace

Roles of the other Agencies AGENCY ROLES

DOSH Setting standards, enforcement, OSH promotion, data analysis

NIOSH Training, consultancy, information dissemination, research

SOCSO Compensation, rehabilitation, OSH promotion in private sector

Ministry of Finance Compensation for Govt sector

Universities Academic training

Societies Training, promotion

OCCUPATIONAL DISEASE STATISTICS

Accidents and Injuries 2016 Industry Accidents

Manufacturing 11,943

Mining 238

Construction 4,269

Agriculture 2,359

Utilities 620

Transportation 2,038

Trade 5,377

Hotel 941

Finance 3,677

Civil Service 9,543

Total 41,005

Legislation

• Occupational Safety and Health Act 1994

• Factories and Machinery Act 1967

• Social Security Act 1969

• Pesticides Act 1974

• Environmental Quality Act 1974

•Employment Act 1955

•Workman's Compensation Act 1952

Safety and Health Policy

Notification

Safety and

Health Audit

Workplace Health

Promotion

Investigations

Medical Surveillance

OH Activities to be carried out by law

Activities under OSHA

1994

Health Surveillance 1. Surveillance of occupational diseases and accidents:

By the Occ Health practitioners OHD, OHN • Notification System

• Medical surveillance

• Compensation

2. Work environment assessment

By the Hygienists, safety officers, other competent persons • Audits

• Risk assessments

• Investigations

Health Surveillance : Occupational Diseases and Accidents

• DOSH reporting system

Includes : MOH reporting

Medical Surveillance data

• Complementary systems: Compensation systems • SOCSO

• Ex Gratia

Health surveillance procedure for occupational

health

OSHA Act 1994

• NADOPOD Regulations 2004: Notification of Occupational Diseases and Accidents • USECHH Regulations 2000: Medical Surveillance for chemicals

Factories and Machinery Act 1967 • Noise regulations 1989: Medical Surveillance • Mineral Dust regulations 1989: Medical Surveillance • Asbestos regulations 1986: Medical Surveillance • Lead Regulations 1984: Medical Surveillance

NADOPOD ACT 2004

• Occupational Safety and Health (Notification of Accident, Dangerous Occurrence, Occupational Poisoning and Occupational Disease Regulations) 2004

• Enforced by DOSH

• Reporting by government and private doctors

NADOPOD 2004

Objectives:

a. To comply with the act

b. To standardize reporting

c. To establish valid and

reliable statistics

Guidelines on Occupational Safety And Health (Notification Of Accident, Dangerous Occurrence,

Occupational Poisoning And Occupational Disease Regulations) 2004

LEGAL REQUIREMENTS UNDER OCCUPATIONAL SAFETY AND HEALTH ACT

(OSHA) 1994

Section 32(1) require employer to notify the nearest OSH office if any of the following has occurred or is likely to occur:-

Accident

Dangerous Occurrence

Occupational Poisoning

Occupational Disease

LEGAL REQUIREMENTS UNDER OCCUPATIONAL SAFETY AND HEALTH ACT

(OSHA) 1994

Section 32(2) require every registered medical practitioner attending or visiting a patient whom he believes to be suffering from any diseases listed under FMA 1967 or any regulation made under OSHA 1994 to report the matter to Director General

A registered medical practitioner or medical

officer attending to a patient suffering from any

one of the OP or OD listed in the 3rd Schedule

shall within 7 days report to DG and notify the

employer of the patient

LEGAL REQUIREMENTS UNDER OCCUPATIONAL SAFETY AND HEALTH ACT (OSHA) 1994

LIST OF REPORTABLE

DISEASES

Record Keeping

• Every employer shall record and maintain a

register, in approved form of all occupational

poisonings or occupational diseases which have

occurred, arising out of or in connection with work

under his control, whether or not the occupational

poisonings and diseases have been reported

• The record is to be kept at the place of work or

business for 5 years

• The extract from the registry for a period of 1 year

to be sent to DOSH at the end of the year

PENALTY

Any person who contravenes any provision of these Regulations commits an offence and

shall on conviction be liable to a fine not exceeding ten thousand ringgit (RM10,000) or to imprisonment for a term not exceeding one

year or to both.

Medical Surveillance As per relevant regulations :

• Chemicals

Including: • Mineral dusts • Asbestos • Lead

• Noise

• Guidelines on Medical Surveillance : 36 Chemicals

Reported Medical Surveillance 2016: 3040 reports

Compensation claims data

• SOCSO : Data from the private sector

• Ex Gratia : Data from the government sector

( Includes disability, disease and death)

OH Resources MOH

• Registered Occupational Health Doctors (Govt & Private) : 1113

• Govt doctors in health care facilities: trained to report occupational diseases through MOH

• Paramedics in the health care facilities trained to report occupational accidents

Capacity Building

Training Courses:

NIOSH/ MOH Occupational Health Doctor –certification

Occupational Health Nurse – certification

Universities Masters in Public Health(Occupational Health)

Masters in Occupational Medicine -overseas

Issues in occupational health surveillance

• Limited trained Occ Health personnel

• OHD do not have power of entry to workplaces

• No central lab, various accreditation bodies, limited availabilities for certain tests

• OHD stuck in btw legislation and employer; reporting, cases with infectious diseases like HIV, company policies

Future Prospects : in progress

• Migration of FMA and the OSHA

• Requirements for in-house OHD and OHN

• Updated medical surveillance guidelines

• Integrated online surveillance system

• Registration of overseas Occupational Medicine degrees on the National Specialist Register

TERIMA KASIH