hi

1. Occupational Health I
Group A3

2. Occupational Safety and Health Act
Praveenash

3. Occupational Safety and Health Act
• The Occupational Safety and Health Act 1994 is a piece
of Malaysian legislation which was gazetted on 25 February 1994 by
the Malaysian Parliament.
• The principle of the Act is "To make further provision for securing that
safety, health and welfare of persons at work, for protecting others
against risks to safety or health in connection with the activities of
persons at work, to establish the National Council for Occupational
Safety and Health and for matters connected therewith."

4. The purposes of Act 514 are:
1. to secure the safety, health and welfare of persons at work against
hazards and risks arising out of the activities of person at work
2. to protect person at a place of work, other than persons at work,
against risks arising out of the activities of persons at work
3. to promote an occupational environment for persons at work which
is adapted to their physiological and psychological needs
4. to provide the means whereby the associated occupational safety and
health legislation may be progressively replaced by a system of
regulations and approved industry codes of practice operating in
combination with the provisions of this Act designed to maintain or
improve the standards of safety and health.

5. The Occupational Safety and Health Act 1994, in its current form (1 January 2006), consists
of 15 Parts containing 67 sections and 3 schedules :
• Part I: Preliminary
• Part II: Appointment of Officers
• Part III: National Council for Occupational Safety and Health
• Part IV: General Duties of Employers and Self-Employed Persons
• Part V: General Duties of Designers, Manufacturers and Suppliers
• Part VI: General Duties of Employees
• Part VII: Safety and Health Organizations
• Part VIII: Notification of Accidents, Dangerous Occurrence, Occupational Poisoning and
Occupational Diseases, and Inquiry
• Part IX: Prohibition against Use of Plant or Substance
• Part X: Industry Codes of Practice
• Part XI: Enforcement and Investigation
• Part XII: Liability for Offences
• Part XIII: Appeals
• Part XIV: Regulations
• Part XV: Miscellaneous

6. Role of occupational health physician,
List the components of occupational
health and explain the importance of
occupational history
Chung Yee Jiat

7. Role of occupational health physician
• An occupational health physician (OHP) is a medical doctor who diagnoses
and treats occupational diseases, work-related illnesses and injuries of
employees, and conducts fitness-for-work physical examinations.
• Under certain regulations, employers have a duty to ensure workers are
placed under statutory medical surveillance by an appointed doctor. An
appointed doctor is a registered medical practitioner appointed by the
Health and Safety Executive to undertake statutory medical surveillance.
• Apart from medical surveillance, Occupational Health Doctors are also
responsible for carrying out health surveillance for employees who work in
confined spaces to ensure the health of workers involved is in the optimum
condition both physically and mentally.

8. • Conduct the pre-employment and pre-placement medical examination
(baseline medical data) of employees to assess fitness for work, taking
into consideration the hazards and risk assessment in the workplace.
• Determination of the ability to work while wearing the Personal
Protective Equipment (PPE).
• Maintain the medical records of employees during the course of
employment and post termination.
• Documentation of employee exposure to hazards at workplace.

9. • Analysis of Occupational Diseases & Poisoning and co-relate with
Chemical Health Risk Assessment.
• Investigation of the cause of the Occupational Disease / Poisoning.
Visit work place and recommend remedial actions.
• Notification of Occupational Diseases & Poisoning to Department of
Occupational Safety and Health（DOSH）and employer.
• Assist in Implementation of Occupational Health Programme in the
workplace.

10. List the components of occupational health
Part 1. Exposure Survey
A. Exposures
• Current and past exposure to chemicals, biologic, or physical hazards
• Typical workday (job tasks, location, materials, and agents used)
• Changes in routines or processes
• Other employees or household members similarly affected
B. Health and Safety Practices at Work Site
• Ventilation
• Medical and industrial hygiene surveillance
• Employment exams
• Personal protective equipment
• Personal habits (Smoke and/or eat in work area? Wash hands with solvents?)

11. Part 2. Work History
• Description of all previous jobs including short-term, seasonal, and
part-time employment and military service
• Description of present jobs
Part 3. Environmental History
• Present and previous home locations
• Home cleaning agents, Pesticide exposure
• Water supply, Recent renovation/remodeling
• Air pollution, indoor and outdoor - Hobbies

12. Importance of occupational history
• Most environmental and occupational diseases either manifest as common medical
problems or have nonspecific symptoms.
• Etiology distinguishes a disorder as an environmental illness. Unless an exposure history
is pursued by the clinician, the etiologic diagnosis might be missed, treatment may be
inappropriate, and exposure can continue.
• A missed diagnosis that is occupationally related could impact not only the patient but
also their co- workers, and failure to appreciate an occupational link can lead to reduced
efficacy of medical treatment.
• Taking a good occupational history can help primary care physicians prevent the onset
and progression of illness and potential disability in their patients, as well as help protect
others in the same workplace.

13. OCCUPATIONAL
DISEASES
TAN KER SHING

14. 1. Dermatitis
- Allergic and irritant dermatitis (also known as ‘contact dermatitis’) is the most important cause of
occupational skin diseases.
- It is an itchy rashes caused by direct contact with a substance or an allergic reaction to it
- Contact dermatitis is caused by a wide array of physical, biological or chemical agents such as
cosmetics, fragrances, jewelry or plants.
2. Respiratory illnesses
- This can include asthma, disease of the lung and chronic obstructive pulmonary diseases (COPD).
- Asthma considered to be the most common occupational lung disease.
- There are over 300 chemicals in the workplace that are known to cause asthma, in foam or plastic
manufacturing industries.
- Most of the work-related asthma caused by inhaling irritants in the workplace, such as dusts, gases,
fumes, and vapors.

15. 3. Musculoskeletal disorders (MSDs)
- A group of painful disorders of muscles, tendons, and nerves.
- MSDs are prevalent in most workplaces, even in office settings.
- Indeed, office workers may be at risk of repetitive strain injuries (RSI) such as carpal tunnel syndrome or
tendonitis.
- Most work-related MSDs develop over time and can be caused by repetitive movements, awkward
positions, handling loads, high work demands, lack of breaks, etc.
4. Hearing loss
- It can occur when workers are exposed to loud noise or ototoxic chemicals.
- Noise is considered loud (hazardous) when it reaches 85 decibels or higher.
- Workers who had higher occupational noise exposures than the general population have higher
chances of getting hearing loss.
- Workers in the mining, construction and manufacturing industries need better hearing conservation
strategies.
- Hearing loss and auditory issues are also a problem in hospitality and healthcare settings.

16. 5. Cancer
- Occupational cancers occur when workers are in contact with carcinogenic substances in their
workplace.
- Certain substances are associated with different cancers, and certain carcinogens can be especially
prevalent in certain industries.
- Asbestos-related diseases are now some of the most well-known incidences of occupational
- These include cancers such as lung cancer, gastro-intestinal cancer, cancer of the larynx or pharynx
and mesothelioma.
6. Stress and mental health disorders
- Multiple sources state that mental health disorders can also be considered as occupational
in certain contexts.
- Post traumatic stress disorder (PTSD) is most commonly cited.
- PTSD can affect workers in high pressure workplaces, such as the military or law enforcement.

17. 5. Infectious diseases.
- Healthcare workers run the risk of contacting infectious diseases such as hepatitis B and C,
tuberculosis (TB) and even the human immunodeficiency virus (HIV).
- It also notes that TB is also a risk for workers in social services or correctional facilities as they are in
constant contact with high-risk populations. This is also the case for lab workers.
- Bloodborne and airborne pathogens represent a significant class of exposures for the health care
workers.

18. Strategies to prevent
occupational diseases
By Shaktish Letchumanan M19090984

19. (A) Elimination of hazards in the workplace
The ideal way to prevent occupational diseases is to
eliminate the hazards in the work environment. It is thus
appropriate not to adopt work processes that will generate
hazards. Without hazards in the work environment,
employees will not suffer from occupational diseases.
Example
In compliance with relevant legislation, prohibiting asbestos
spraying or the use of any type of asbestos insulation
material for the purpose of thermal, acoustic or other
insulation can prevent employees from contracting asbestos-
related diseases such as asbestosis and mesothelioma
through inhalation of asbestos during the work processes
Avoiding hand-dug caisson work which exposes
employees to exceptionally
high concentration of silica dust can minimise
employees' risk of contracting
silicosis.

20. (B) Substitution by alternative materials, tools or machines
● Substituting fiberglass for asbestos
prevent employees from contracting
asbestos-related diseases.
● Using toluene instead of benzene as a
solvent, employees will not contract
leukaemia caused by benzene.
Substituting water-soluble cleansing
agents for organic solvents can reduce
dermatitis among employees.
● Replacing sand which contains a high
level of free silica with metal shots in
sandblasting processes to prevent
employees from contracting silicosis.
● Substituting low-noise machines for noisy
ones can reduce employees' risk of
suffering occupational deafness.
● Replacing manual can-openers with
automatic ones can save employees from
repetitive upper limb movements and
forceful exertion, thus preventing them
from having musculoskeletal disorders.

21. (C) Engineering control measures
If the hazards in the work environment cannot be completely
eliminated or substituted by using safer alternative materials, tools
or machines, other control measures should be used to reduce
employees' exposure to such hazards. Controlling the hazards at
source by engineering methods is an effective measure widely
adopted. Engineering control measures include:

22. C(I). Enclosure
Enclosure of the hazardous work processes to
reduce employees' exposure to the hazards,
thus minimising the adverse health effects.
For example:
1. Enclosing the process of rock crushing
in a quarry can prevent employees from
contracting silicosis by the inhalation of
silica dust.
2. Using enclosed machines for disinfecting
endoscopes can prevent employees from
developing occupational asthma due to
inhalation of glutaraldehyde.

23. C (II.) Isolation
Employees should be isolated from hazards or work
processes which cause hazards. Automation or remote
control of operation may be used where necessary to
minimise employees' exposure to the hazards.
For example:
1. When removing materials or plants
containing asbestos, isolating the removal
area from other work areas to minimise
the spread of asbestos through air can
prevent employees from contracting
asbestosis and mesothelioma.
2. Using insulating materials to isolate heat
sources such as hot water pipes or steam
pipes in kitchens or cabins to lower the
ambient temperature of the workplace
can help protect employees from heat
stroke.

24. C (Ill.) Wet method
Hazards such as dusts or fibres in the air can be
reduced by water spraying to
lower the risk of inhaling these substances by
employees.
2. Using wet wiping method properly in
construction and demolition works to
suppress asbestos dust production can
prevent workers from contracting
asbestosis and mesothelioma.
For example:
1. Spraying water in construction sites
when vehicles pass through to reduce
the suspension of silica dust in air can
protect employees from silicosis.

25. C (IV.) Good ventilation system
A good ventilation system not only brings fresh air into a
workplace and provides a comfortable work
environment, but also helps extract harmful substances
from the environment to safeguard employees' health.
Ventilation in the workplace can be effected by natural
or mechanical means
For example:
1. The negative pressure ventilation system adopted
in isolation wards for infectious patients can prevent
the spread of pathogenic micro-organisms to infect
health care workers and other patients outside the
wards.
2. Placing the exhaust hood of a local exhaust
system near the fume-producing source during
welding processes can prevent employees from
poisoning through breathing in hazardous
fumes.

26. (D) Health surveillance
Environmental monitoring can measure the level of hazards at
the workplace and indicate whether the health of employees will
be at risk. However, health surveillance is important for early
detection of any deviance in employees' health due to work, so
that they can seek appropriate treatment as early as possible and
take corresponding preventive measures at the workplace.
For example:
The law stipulates that employees engaged in
mines, quarries or compressed air work should
undergo pre-employment and periodic medical
examinations and receive chest-X ray examination
if necessary to prevent silicosis and compressed
air illnesses, eic.

27. (E) Personal hygiene and vaccination
Personal hygiene is very important in the prevention of occupational
diseases. Employees should follow relevant working guidelines,
and refrain from eating, drinking or smoking at the workplace, and
should wash their hands thoroughly after work and before eating to
avoid chemicals, bacteria or other harmful substances from getting
into the body through eating and drinking. Furthermore, abrasions or cut wounds
should be managed immediately to reduce the risk of occupational infections.
Vaccination can minimise employees* risks of getting infections, but not all
infections can be prevented by immunisation.

28. (F) Administrative measures
I. Formulation, provision and monitoring of safety management system and quidelines
II. Provision of appropriate tools and mechanical aids
Ill. Regular repair and maintenance
IV. Job rotation and appropriate rest breaks
V. Provision of information and training
VI. Formulating contingency plan
Every organisation should formulate a contingency plan according to its operational needs and conduct drills regularly
so that employees can properly react in a timely manner to minimise the impacts of the incidents in case of
emergencies.

29. (G) Personal protective equipment
Although controlling hazards at source is an ideal way to prevent occupational diseases, the use of
appropriate personal protective equipment (PPE) will be the last resort if different control measures cannot
eliminate or reduce the hazards to meet relevant standards. PPE should be used to complement other control
measures since PPE alone is not sufficient for safeguarding the health of employees. In using PPE, one
should pay attention to the correct way of wearing such equipment, regular checking of its effectiveness,
cleanliness and hygiene as well as proper storage atter use.

30. (H) Environmental monitoring
Environmental monitoring not only indicates the levels of hazards in the work environment but also reflects the
effectiveness of existing control measures. If the level of hazards exceeds the relevant standards, then the
health of employees working in or near such environment may be at risk. Therefore, regular environmental
monitoring is an important step for preventing occupational diseases.
For example
1. Taking air samples regularly in firing ranges for lead analysis can help prevent
employees from lead poisoning

31. (I) Healthy lifestyle
Employees should adopt a healthy lifestyle to maintain a strong physique to meet the needs of their daily work
irrespective of the industry they belong to. A healthy lifestyle includes adequate rest and sleep, a balanced
diet, regular exercise, a cheerful mind, and abstinence from alcohol and smoking, etc,
1. Using self-relaxation to relieve work stress and maintain a cheerful mind, and seeking assistance from
colleagues or supervisors when there are problems at work.
2. Abstaining from smoking and alcohol, as smoking can increase the risk of
occupational diseases such as Legionnaires' disease.

32. Hazard and Risk
Anuthra Devaraj M18090926

33. Definition of Hazard and Risk
Hazard
➢A source, situation, or act with a potential for harm in terms of human injury or ill health and damage to
property.
Risk
➢A combination of the likelihood of an occurrence of a hazardous event or exposure with specified period or
in specified circumstances and the severity of injury or damage to the health of people, property, environment
or any combination of these caused by the event or exposure.

34. Physical Hazards
1) Heat and Cold
Heat exposure
1.Direct Effects: Burns, heat stoke, heat exhaustion,
heat cramp
2.Indirect effects: Decreased efficiency, increased
fatigue and enhanced accident rates.
Cold exposure
3.Hazards: Chilblains, erythrocyanosis, immersion foot
and frostbite due to cutaneous vasoconstriction
2) Light
Poor illumination
•Acute effects: Eye fatigue, headache, eye pain,
congestion around cornea
•Chronic effect: Miner’s nystagmus
Excessive brightness
•Effects: Discomfort, annoyance and visual fatigue
•Intense direct glare may result blurring of vision and
lead to accidents

35. Physical Hazards
3) Noise
Auditory effects:
•Temporary / permanent hearing loss
Non-auditory effects:
•Nervousness
•Interference with communication by speech
•Decreased efficiency
•Annoyance
4) Vibration
•Encountered in work with pneumatic tools such
as drills & hammers.
•Usually affects hands and arms.
•After some month of exposure, fine blood
vessels of fingers may become increasingly
sensitive to spasm.
•May also produce injuries to joints of hands,
elbows and shoulders.

36. Physical Hazards: Radiation
1) Ultraviolet radiation
•Occurs mainly in arc welding.
•Mainly affects eyes, causing intense
conjunctivitis, keratitis
2) Ionizing radiation
•Occurs in medicine and industry (E.g.: X-ray)
•Radiation hazards: genetic changes, cancer,
leukemia, sterility, and in extreme cases death

37. Chemical Hazards
1) Local action
•Some chemicals cause dermatitis, eczema,
ulcers.
2) Ingestion
•E.g.: Lead, mercury, arsenic, chromium
•Usually swallowed through contaminated
hands, food
•Much of the ingested material is excreted
through faeces
3) Inhalation
Dust:
•Inorganic dust: Silica, coal, asbestos dust
•Organic dust: cotton
•Most common dust diseases: Silicosis, anthracosis
Gas:
•Carbon monoxide hazard is frequently reported in coal-gas
manufacturing plants and steel industry
Metals and their compound
•E.g.: Lead, antimony, arsenic, mercury, chromium, beryllium

38. Biological Hazards
➢Exposed to infective and parasitic
agents at workplace
➢Diseases: Leptospirosis, tapeworm
infection, tetanus, fungal infections
➢E.g. : Persons working among
animal products (hair, wool) and
agricultural workers

39. Mechanical Hazards
➢Hazards: Centre round machinery,
protruding and moving parts
➢10% of the industry accidents due to
mechanical causes.

40. Psychosocial Hazards
Factors
oFrustration
oLack of job satisfaction
oPoor human relationships
oInsecurity
oEmotional tension
Health effects
oAnxiety
oDepression
oAlcoholism
oDrug abuse
oHeadache
oPeptic ulcer.
oHypertension
oHeart disease
oRapid aging.

42. ● Most effective hazard control.
● Eg: if employees must work high above the ground, the hazard can be eliminated by moving the piece they
are working on to ground level to eliminate the need to work at heights
ELIMINATION

43. ● Involves replacing something that produces a hazard (similar to elimination) with something that does not
produce a hazard
● Eg: Replacing lead-based paint with acrylic paint.
● To be an effective control, the new product must not produce another hazard. Because airborne dust can
be hazardous, if a product can be purchased with a larger particle size, the smaller product may
effectively be substituted with the larger product
SUBSTITUTION

44. ● Effective means of controlling hazards is engineered controls
● Eg: A crew might build a work platform rather than purchase, replace and maintain fall arrest equipment.
● “Enclosure and isolation” creates a physical barrier between personnel and hazards, such as using
remotely controlled equipment.
● Fume hoods can be used to remove airborne contaminants as a means of engineering control
ENGINEERING CONTROLS

45. ● Changes to the way people work
● Eg: procedure changes, employee training, and installation of signs and warning labels (such as those in
the Workplace Hazardous Materials Information System).
● Administrative controls do not remove hazards, but limit or prevent people's exposure to the hazards,
such as completing road construction at night when fewer people are driving
ADMINISTRATIVE CONTROLS

46. ● Personal protective equipment (PPE) includes gloves, respirators, hard hats, safety glasses, high-visibility
clothing, and safety footwear.
● High potential for damage to render PPE ineffective.
● Eg: Some PPE, such as respirators, increase physiological effort to complete a task and, therefore, may
require medical examinations to ensure workers can use the PPE without risking their health.
PPE

47. Discuss medical
surveillance for
occupational health
By: Ching Soo Xuan

48. Definition of medical surveillance
● Monitoring of a person for the
purpose of identifying changes in
the health status due to occupational
exposure to chemicals which are
hazardous to health
● This is for early identification of
conditions, if any, which could
present an increased risk of adverse
health effects related to the task
being performed.

49. Components of medical surveillance
● Pre-employment and pre-placement medical examination
● Biological monitoring and biological effect monitoring
● Health effects monitoring
● Investigation of occupational diseases and poisoning
including workplace inspections
● Notification of occupational disease and poisoning
● Assist in disability assessment
● Return to work examination after medical removal
protection
● Record keeping and monitoring
● Maintenance and analysis of records

50. (A) Duties of Occupational
Health Doctors (OHD)
● Conducting pre-employment and pre-placement medical
examination of employees to assess the fitness for work, take
consideration on the hazards and risk assessment in the
workplace.
● Determination of ability to work while wearing Personal
Protective Equipment (PPE)
● Maintain medical records of employees during employment
and post termination
● Documentation of employee exposure to hazards at workplace
● Analysis of occupational diseases and poisoning correlate with
chemical health risk assessment
● Reinforce value of education or training in occupational health
to both employer and employee

51. (B) Duties of Employer
● Carry out health surveillance programme as required by the assessment report under Use of
Standard of Exposure Chemical Hazardous to Health (USECHH )Regulations.
● Health surveillance programme shall be conducted during the working hours and the costs shall
be borne by the employer.
● Appoint an Occupational Health Doctor, (OHD) to conduct occupational medical surveillance
programme.
● Allow and assist the OHD to visit the workplace to investigate and manage occupational disease
and poisoning including access to relevant monitoring and other health related data.
● Co-operate with the OHD in medical removal protection of the worker.
● During the period of medical removal the worker may be allowed to do other work that will not
expose him to the hazardous chemical.
● Notify occupational disease and poisoning to DOSH .

52. ● Notify the workers concerned regarding monitoring of exposure levels of chemicals hazardous to health
including occupational disease and poisoning.
● Allow the employee access to occupational medical surveillance records.
● Ensure the workplace hygiene is improved, is safe and healthy and does not place the worker at increased
risk of material impairment to health from exposure to chemical hazardous to health before allowing the
worker to work in the same place so as to ensure the disease or poisoning does not reoccur.
● Record Keeping of diseases and accidents.
● Provide Employee Medical Book.

53. (C) Duties of Employee
● Undergo training on importance of preventing
occupational poisoning and disease.
● Report early symptoms and signs of disease
(including self-examination) to the OHD and
management
● Comply and co-operate in the Occupational
Medical Surveillance Programme, as required
under USECHH.
● To take proper care of the Employee Record
Book and to present it to OHD for
Occupational Medical Surveillance record
purposes.

54. Personal Protection
Equipment
Daniel Chieng Kai Kiong

55. What is PPE?
• A protective gear used to safeguard the health of frontline workers by
minimizing the exposure to infections.
• Components of PPE includes face shield, masks, gloves, coveralls,
gowns, respirators, protective hearing devices and etc.

56. OSHA’s PPE general requirements
• Provide adequate protection against the particular hazards for which they
are designed
• Be of safe design and construction for the work to be performed
• Be reasonably comfortable when worn under the designated conditions
• Fit snugly and not unduly interfere with the movements of the wearer
• Be durable
• Be capable of being disinfected
• Be easily cleanable
• Be distinctly marked to facilitate identification only of the manufacturer

57. Categories of PPE
1. Head protection
- Required for all employees working in areas where there is potential
danger of head injury from impact, electrical shock or burns or falling or
flying objects
- Examples: helmets, hard hats, bump caps, guards
2. Hearing protection
- Vital for those working is an environment with high sounds levels where it’s
not possible to reduce the level of noise or duration of exposure
- Example: earplugs, noise meters, acoustic foam and communication sets

58. 3. Eye and face protection
- Necessary when workers are exposed to eye or face hazards from liquid
chemicals, acids, chemical gases, molten metal, light radiation and flying
particles
- Examples: visors, over specs, eye and face shields , eyewear accessories,
safety glasses and googles
4. Respiratory protection
- Used when workers may come into contact into large amount of harmful
dusts, fogs, mists, fumes, vapors, powders or gases.
- Examples: face masks, detectors, protective hoods, respirators, helmets

59. 5. Hand protection
- Necessary to protect your workers against cuts, lacerations,
punctures, abrasions, chemical burns, thermal burns and harmful
temperature extremes
- Examples: leather, canvas, metal, coated fabric and chemical-
resistant gloves

60. THANK you