Injury&disjjrev

Injury and Disease Prevention
Prepared by Dr. Julian Jolly
Ph.D (UK) SSIRSM (UK) IGC (NEBOSH, UK)
TTT (NIOSH)

Ministry of Health (MOH) Malaysia
Description of The Occupational Health Unit
Vision
Towards a healthy nation and healthy workers
through promotion of healthy environment and
workplace in order to achieve sustainable basic
of health for all.
Mission
To promote healthy and quality of life by
preventing and controlling diseases, injuries and
disabilities related to the interaction between
people and their working environment.

MOH Objectives
• To promote and maintain the highest possible
degree of physical, mental and social wellbeing of
workers in all occupations.
• To promote the safety and health at workplace
which includes work environment and process.
• To increase awareness among employers,
employees and communities on occupational
safety and health aspects.
• To prevent occupational related health problems
arising from the work environment and work
process amongst workers.
• To reduce the morbidity and mortality due to
occupational diseases ( injuries and poisoning).

Ministry of Human Resources
Malaysia
• The Department of Occupational
Safety and Health (DOSH) is under
this ministry.
(Jabatan Keselamatan dan Kesihatan
Perkerjaan - JKKP)
• ACT 514 – Occupational Safety and Health
Act 1994.

Occupational
INJURY and DISEASE
The Department of Occupational Safety and Health,
Ministry of Human Resources Malaysia describes
INJURY and DISEASE as follows:
1. Occupational Injury
Any injury such as a cut, fracture, sprain, amputation
etc., which results from a work accident or from a single
instantaneous exposure to a hazard in the work
environment.
2. Occupational Disease
A disease arising out of or in connection with work. It
includes acute and chronic disease or poisoning which
may be caused by inhalation, absorption, ingestion, or
direct contact with a hazard at the workplace.

Notification of Accident, Dangerous
Occurrence, Occupational Poisoning and
Occupational Disease Regulations 2004
• The above must also be addressed as it is
part and parcel of the related legal
requirements of Occupational Safety and
Health.
• It is known as NADOPOD Regulations
2004.

Levels of Disease
SporadicSporadic
EndemicEndemic
EpidemicEpidemic
PandemicPandemic
Increasing amount of diseaseIncreasing amount of disease

Natural History of Disease
Stage ofStage of
susceptibilitysusceptibility
Stage ofStage of
SubclinicalSubclinical
DiseaseDisease
Stage ofStage of
Clinical DiseaseClinical Disease
Stage of Recovery,Stage of Recovery,
Disability, or DeathDisability, or Death
ExposureExposure
PathologicalPathological
ChangesChanges Onset ofOnset of
SymptomsSymptoms
Usual TimeUsual Time
of Diagnosisof Diagnosis

Environmental Issues and Impacts
ISO14001
• Health of workers are affected by the
environment.
• ISO 14000 addresses various aspects of
environmental management.
• It provides practical tools for companies
and organizations looking to identify and
control their environmental impact and
constantly improve their environmental
performance.

Environmental Quality ACT, 1974
Malaysia
ACT 127
It assists companies to take effective
measures to CURB, CONTROL or
ERADICATE pollution problems so as not
to be prosecuted under the Law.

Intentional and Unintentional
Injuries
1. Intentional
The term "intentional" is used to refer to
injuries resulting from purposeful human
action, whether directed at oneself or
others. Intentional injuries include self
inflicted and interpersonal acts of violence
intended to cause harm.
2.Unintentional
Injuries that were unplanned or considered
accidental, not intended to happen, such
as motor vehicle crashes, falls, fires and
drowning.

WHO International Classification of
External Causes of Injury (ICECI)
Purpose/Definition
It is designed to help researchers and
prevention practitioners to describe,
measure and monitor the
occurrence of injuries and to
investigate their circumstances of
occurrence using an internally agreed
classification.

Criteria underlying the
Classification
As a separate coding axis for each
main concept, usefulness for injury
prevention, usability in many types of
settings in many parts of the world e.g.
hospitals and other places where data
are collected, and complementing the
ICD-10.

Classification Structure
ICECI has a multi-axial and hierarchical structure:
1.Core module including seven items (mechanism
of injury, objects/substances producing injury,
place of occurrence, activity when injured, the role
of human intent, use of alcohol, use of (other)
psycho-active drugs) and
2.Five (5) additional modules
To enable collection of additional data on special
topics (violence, transport, place, sports,
occupational injury).

The Meaning of DISEASE
• A pathological condition of a part, organ,
or system of an organism resulting from
various causes, such as infection, genetic
defect, or environmental stress, and
characterized by an identifiable group of
signs or symptoms.
• A condition or tendency, as of society,
regarded as abnormal and harmful.

Classifying Diseases
They can be divided into three (3) categories:
1. Intrinsic (non-infectious)
Coming from within the body, normally not
contagious or communicable.
e.g. stress related diseases, autoimmune
diseases, cancers, hereditary diseases.
2. Extrinsic (infectious)
Emerging from outside the body and
contagious,
e.g. infections derived from viruses, bacterium
or parasites.
3. Unknown Origin
Diseases for which there is no known cause.

Occupational Disease
An occupational disease is a
health problem experienced by the
worker caused by exposure to a
health hazard at the workplace.

HAZARDS causing DISEASES
• dust, gases, or fumes
• noise
• toxic substances (poisons)
• vibration
• radiation
• infectious germs or viruses
• extreme hot or cold temperatures
• extremely high or low air pressure.

World Health Organization
Classifications of diseases have been
developed by WHO mainly for two
purposes:
(1) notification for labour safety and health
surveillance &
(2) compensation.

International Classification of
Diseases (ICD)/History
• ICD-10 was endorsed by the Forty-third (43rd
) World
Health Assembly in May 1990.
• Came into use in WHO Member States as from 1994.
• The classification is the latest in a series which has its
origins in the 1850s.
• The first edition, known as the International List of
Causes of Death, was adopted by the International
Statistical Institute in 1893.
• WHO took over the responsibility for the ICD at its
creation in 1948 when the Sixth Revision, which included
causes of morbidity for the first time, was published.

Types of Classification
The WHO-FIC (Family of International Classification) is
comprised of:
1. Reference Classifications: Main classifications on basic
parameters of health. These classifications have been
prepared by the World Health Organization and approved
by the Organization's governing bodies for international
use
- International Classification of Diseases (ICD)
- International Classification of Functioning, Disability
and Health (ICF)
- International Classification of Health Interventions (ICHI)
2. Derived Classifications
Derived Classifications are based on the reference
classifications( i.e. ICD and ICF).

Chapters and Titles of the ICD
IA00-B99 Certain infectious and parasitic diseases
IIC00-D48 Neoplasms
IIID50-D89 Diseases of the blood and blood-forming organs
and certain disorders involving the immune
mechanism
IVE00-E90 Endocrine, nutritional and metabolic diseases
VF00-F99 Mental and behavioural disorders
VIG00-G99 Diseases of the nervous system
VIIH00-H59 Diseases of the eye and adnexa
VIIIH60-H95 Diseases of the ear and mastoid process
IXI00-I99 Diseases of the circulatory system
XJ00-J99 Diseases of the respiratory system
XIK00-K93 Diseases of the digestive system
XIIL00-L99 Diseases of the skin and subcutaneous tissue

Chapters and Titles of the ICD
XIIIM00-M99 Diseases of the musculoskeletal system and
connective tissue
XIVN00-N99 Diseases of the genitourinary system
XVO00-O99 Pregnancy, childbirth and the puerperium
XVIP00-P96 Certain conditions originating in the perinatal
period
XVIIQ00-Q99 Congenital malformations, deformations and
chromosomal abnormalities
XVIIIR00-R99 Symptoms, signs and abnormal clinical and
laboratory findings, not elsewhere classified
XIXS00-T98 Injury, poisoning and certain other
consequences of external causes
XXV01-Y98 External causes of morbidity and mortality
XXIZ00-Z99 Factors influencing health status and contact
with health services
XXIIU00-U99 Codes for special purposes.

Workplace Health Hazards
Workplace health hazards can cause three (3)
kinds of reactions in the body:
• Immediate or acute reactions, like shortness of breath
or nausea, can be caused by a one-time event, (e.g. a
chemical spill). These reactions are not usually
permanent.
• Gradual reactions, like asthma or dermatitis (skin
rashes), can get worse and persist when you are exposed
over days, weeks or months. These reactions tend to last
for a longer time.
• Delayed reactions or diseases that take a long time to
develop, like lung cancer or loss of hearing, can be
caused by long-term exposure to a substance or work
activity. These reactions can be noticed long after the job
is over.

Hazards are often built Into or
brought Into the Workplace

Breaking Rules – A BIG Hazard!

Chronic Respiratory Diseases
Chronic respiratory diseases are chronic
diseases of the airways and other structures
of the lung. Some of the most common are:
• Asthma
• Chronic Obstructive Pulmonary Disease (COPD)
• Respiratory Allergies
• Occupational Lung Diseases and
• Pulmonary Hypertension.

ASTHMA
• Asthma is a chronic disease characterized
by recurrent attacks of breathlessness and
wheezing, which vary in severity and
frequency from person to person.
• During an asthma attack, the lining of the
bronchial tubes swells, causing the
airways to narrow and reducing the flow of
air into and out of the lungs.

Causes of Asthma
• The causes of asthma are not completely
understood. However, risk factors for
developing asthma include inhaling
asthma “triggers”, such as allergens,
tobacco smoke and chemical irritants.
• Asthma cannot be cured, but appropriate
management can control the disorder and
enable people to enjoy a good quality of
life.

Asthma
Asthma is a disease in which
inflammation of the airways causes
airflow into and out of the lungs to be
restricted.

Occupational Lung Diseases
• Silicosis (silica/cement dusts)
• Brucellosis (brucella bacteria)
• Anthrax (anthrax bacteria)
• Asbestosis (asbestos dust)
• Lung Cancer (viral)
• Black Lung Disease (coal dust)
• Occupational Bronchitis
(allergens/bacteria)
• Pneumonia (viral/chemicals/dusts)

Anthrax Bacteria or
Bacillus anthracis

CRD Risk Factors
The most important risk factors for
preventable chronic respiratory
diseases are:
• Tobacco smoking
• Indoor air pollution
• Outdoor pollution
• Allergens
• Occupational risks and vulnerability.

AIR POLLUTION (Indoors)
• Indoor air pollution is contamination of the air
inside buildings.
• The most common cause is smoke from open
fires or stoves that burn solid fuels, such as coal,
wood, dung or crop waste.
• This smoke contains a range of health-damaging
pollutants, in particular fine particles.
• It can lead to respiratory diseases and chronic
obstructive pulmonary disease in adults.

Examples of Indoor Air Pollution
(the “Sick-Building” syndrome)

RADON Gas
 Radon is a radioactive gas that occurs
naturally in the environment. It comes from
the natural breakdown of uranium in soils
and rocks.
 In the open air, the amount of radon gas is
very small and does not pose a health
risk.
 In some confined spaces like basements
and underground mines, radon can
accumulate to relatively high levels and
become a health hazard.

RADON Gas
 After smoking, radon is the next leading cause of
lung cancer.
 Radon gas can move through small spaces in
the soil and rock upon which a house is built. It
can seep into a home through dirt floors, cracks
in concrete, sumps, joints, basement drains,
under the furnace base and jack posts if the
base is buried in the floor.
 Concrete-block walls are particularly porous to
radon and radon trapped in water from wells can
be released into the air when the water is used.

Blood borne Pathogens
Blood borne Pathogens are
pathogenic microorganisms that are
present in human blood and can
cause disease in humans. These
pathogens include, but are not limited
to, Hepatitis B virus (HBV) and
Human Immunodeficiency virus (HIV).

The Blood borne Pathogens Standard
based on the U.S. Department of
Labour, OSHA Regulations 29CFR,
provides requirements to protect
employees from exposure to blood or
other potentially infectious materials
that may contain blood borne
pathogens.

There are many blood borne
pathogens, but the main infections
that pose the greatest risk to workers
are the Human Immunodeficiency
virus (HIV), Hepatitis B virus (HBV),
and Hepatitis C virus (HCV).

Costs of Occupational Injury
or Illness
Work-related accidents or diseases are very costly
and can have many serious direct and indirect
effects on the lives of workers and their families.
For workers some of the direct costs of an injury
or illness are:
• the pain and suffering of the injury or illness
• the loss of income
• the possible loss of a job
• health-care costs.

or Illness
For employers, some of the direct costs are:
• payment for work not performed
• medical and compensation payments
• repair or replacement of damaged machinery
and equipment
• reduction or a temporary halt in production
• increased training expenses and administration
costs
• possible reduction in the quality of work
• negative effect on morale in other workers.

or Illness
Some of the indirect costs for employers are:
• the injured/ill worker has to be replaced
• a new worker has to be trained and given time to
adjust
• it takes time before the new worker is producing
at the rate of the original worker
• time must be devoted to obligatory investigations,
to the writing of reports and filling out of forms

or Illness
• accidents often arouse the concern of
fellow workers and influence labour
relations in a negative way.
• poor health and safety conditions in the
workplace can also result in poor public
relation.

Worker’s Compensation Act 1952
(covering foreign workers)
This Act provides for the
compensation payment to an
injured employee or worker arising
out of and in the course of
employment or contracting
occupational disease.

Important Information on the ACT
• Where the employee or worker dies in the event
of fatal accident or contracting an occupational
disease or in the course and arising out of
performing his duty or work, the Workmen's
Compensation Act 1952 provides for the
compensation payment to the worker's
dependants.
• This Act is administered by the Department of
Labour and applies throughout Malaysia.
• Only foreign workers are covered under this Act.
• Effective from 1st July 1992, local workers are
covered under the Employees Social Security Act
1969.

Social Security Organization
(for Malaysian workers only)
The Social Security Organization (SOCSO)
is an organization set up to administer,
enforce and implement the following:
The Employees' Social Security Act, 1969
and
The Employees' Social Security (General)
Regulations 1971

More about SOCSO
• It is commonly known in the Malay term as
PERKESO or Pertubuhan Keselamatan
Sosial.
• The Social Security Organization provides
social security protection by social
insurance including medical and cash
benefits, provision of artificial aids and
rehabilitation to employees to reduce the
sufferings and to provide financial
guarantees and protection to the family.

Who is compulsory to contribute to
SOSCO?
• An employee employed under a contract
of service or apprenticeship and earning a
monthly wages of RM2,500 and below
must compulsorily register and contribute
to SOCSO regardless of the employment
status whether it is permanent, temporary
or casual in nature.
• An employee must be registered with the
SOCSO irrespective of the age.

SOCSO does NOT cover the
following categories of persons
• A person whose wages exceed RM2,000 a
month and has never been covered before.
• Government employees.
• Domestic servants employed to work in a private
dwelling house which includes a cook,
gardeners, house servants, watchman, washer
woman and driver.
• Employees who have attained the age of 55
only for purposes of invalidity but if they
continue to work they should be covered under
the Employment Injuries Scheme.
• Self-employed persons.
• Foreign workers.

Compensation and Claims
SOCSO provides coverage to eligible
employees through two (2) Schemes namely:
1.Employment Injury Insurance Scheme
2.Invalidity Pension Scheme.
These schemes provide the benefits of,
• Invalidity pension
• invalidity grant survivors
• pension rehabilitation
• funeral benefit,
• constant attendance allowance and
• educational loan.

Compensation and Claims
These schemes are classified into 2 categories :
• First Category - Employment Injury Insurance
Scheme and Invalidity Pension Scheme. The
contribution payment is made by both the
employer and employee
• Second Category - Employment Injury
Insurance Scheme Only. The contribution is paid
by the employer only. An employee who is not
eligible for coverage under the Invalidity Pension
Scheme is protected under this category.

LEGISLATIVE FRAMEWORK
in Malaysia
Occupational and Safety Health Act 1994
ACT 514
(Exercise – via the INTERNET/Download
the ACT 514 and report on your findings.)

Some Points we ought to know
about the OSHA Act
• All employers (in Malaysia) with more than 5
employees are required by the legislation to
formulate a written Safety and Health Policy.
• The object of the Safety and Health Policy is to
demonstrate the company's commitment and
concern to ensure safety and health at place of
work.
• Among the provisions of the OSHA Act 1994 is
the establishment of the safety and health
committee, the appointment of a safety and
health officer and the enforcement, investigation
and offenses.

OSHA Standards
(often referred to as the General Duty Clause)
(a) Each employer --
(1) shall furnish to each of his employees employment
and a place of employment which are free from
recognized hazards that are causing or are likely to
cause death or serious physical harm to his employees
(2) shall comply with occupational safety and health
standards promulgated under the Act
(b) Each employee shall comply with occupational safety
and health standards and all rules, regulations, and
orders issued pursuant to the Act which are applicable
to his own actions and conduct.

HEALTH and SAFETY PROGRAM
The best Safety and Health Programs
involve every level of the
organization, instilling or promoting a
safety culture that reduces accidents
for workers and improves the bottom
line for managers. When Safety and
Health are part of the organization
and a way of life, everyone wins.

The First OBJECTIVE
Overview of System Components
• A system is an established arrangement
of components that work together to attain
a certain objective, in this case to
prevent injuries and illnesses in
the workplace.
• Within a system, all parts are
interconnected and affect each other.

The four (4) main Components
1. Worksite Analysis (involving
thorough inspection)
2. Hazard Prevention and Control
3. Management Leadership and
Employee Involvement
4. Safety and Health Training

In reality we are talking of
Workplace Safety For ALL

Worksite Analysis
 Worksite analysis involves a variety of
worksite examinations to identify not
only existing hazards, but also
conditions and operations in which
changes might create hazards.
 Effective management actively
analyzes the work and the worksite, to
anticipate and prevent harmful
occurrences.
The next slide is an acceptable plan to identify all worksite
hazards:

Plan to Identify Worksite Hazards

Identify the Hazards
HAZARD IDENTIFICATION demonstrates
a simple but effective way to eliminate or
control safety hazards. By highlighting
unsafe workplaces, processes, and
machinery, it shows you how to list the
hazards thus RECONIZING them,
eliminate those you are responsible for,
and request action to remove those
hazards outside your authority.

Major Action Points
1. Conduct a comprehensive, baseline survey for
safety and health and ensure periodic surveys
are carried out as well to monitor any new
facility, processes, materials, and equipment.
2. Perform routine job hazard analysis.
3. Develop and introduce new controls and
update inventories (in line with new
technologies).
4. Conduct periodic and daily safety and health
inspections of the workplace.
.

What we are looking for is -
Actions to form the basis
from which good hazard
prevention and control can
be developed.

Hazard and Prevention Control
After detection, all current and potential hazards must
be prevented, corrected or controlled. Systems used to
prevent and control hazards include:
• Engineering Controls
• Safe Work Practices
• Administrative Controls
• Personal Protective Equipment (PPE)
• Systems to Track Hazard Correction
• Preventive Maintenance Systems
• Emergency Preparation
• Medical Programs

Engineering Controls
• The first and best strategy is to control the
hazard at its source.
Engineering controls do this, unlike
other controls that generally focus on the
employee exposed to the hazard.
The basic concept behind engineering
controls is that, to the extent feasible, the
work environment and the job itself should be
designed to eliminate hazards or reduce
exposure to hazards.

Safe Work Practices
Safe work practices include the company’s
general workplace rules and other operation-
specific rules. Through established safe work
practices, employee exposure to hazards can be
further reduced.
Some of these specific areas include:
• Respiratory Protection
• Lockout/Tagout
• Confined Space Entry
• Hazard Communication
• Blood borne Pathogens
• Hearing Conservation
• Laboratory Chemical Hygiene

Administrative Controls
 While safe work practices can be considered
forms of administrative controls, OSHA uses the
term administrative controls to mean other
measures aimed at reducing employee
exposure to hazards.
 These measures include additional relief
workers, exercise breaks and rotation of
workers. These types of controls are normally
used in conjunction with other controls that more
directly prevent or control exposure to the
hazard.

Personal Protective Equipment
 When exposure to hazards cannot be engineered
completely out of normal operations or
maintenance work, and when safe work practices
and other forms of administrative controls cannot
provide sufficient additional protection, a
supplementary method of control is the use of
protective clothing or equipment. This is
collectively called personal protective
equipment, or PPE.
 PPE may also be appropriate for controlling
hazards while engineering and work practice
controls are being installed.

Systems to Track Hazard Correction
 An essential part of any safety and health
system is the correction of hazards that
occur despite the overall prevention and
control program.
 Many companies use the form that
documents the original discovery of a
hazard to track its correction.
 Frequently, companies will computerize
their hazard tracking system which can be
as simple as adding a few items to an
existing database, such as work order
tracking.

Preventive Maintenance Systems
Good preventive maintenance plays a major role
in ensuring that hazard controls continue to
function effectively. It also keeps new hazards
from arising due to equipment malfunction.
Reliable scheduling and documentation of maintenance
activity is necessary. The scheduling depends on
knowledge of what needs maintenance and how often.
The point of preventive maintenance is to get the work
done before repairs or replacement is needed.
Documentation is not only a good idea, but is a necessity
in larger companies. Certain OSHA standards also
require that preventive maintenance be done.

Emergency Preparation
During emergencies, hazards that normally are not found in
the workplace, may appear. These may be the result of
natural causes (floods, typhoons, etc.), events caused by
humans but beyond control (train or plane accidents,
terrorist activities, etc.), or those within an organization’s
own systems.
We must become aware of possible emergencies and plan
the best way to control or prevent the hazards they present.
Some of the steps in emergency planning include:
• Survey of possible emergencies
• Planning actions to reduce impact on the workplace
• Employee information and training
• Emergency drills as needed.

Medical Programs
A company’s medical program is an important
part of the safety and health system. It can
deliver services that prevent hazards which may
cause illness and injury, recognize and treat
illness and injury, and limit the severity of work-
related injury and illness. The size and complexity
of a medical program will depend on many
factors, including the:
• Type of processes and materials and the related hazards
• Type of facilities
• Number of workers
• Characteristics of the workforce
• Location of each operation and its proximity to a health
care facility.

Medical Programs
• May consist of everything from a basic
First Aid to CPR response.
• Either in-house or through arrangements
made with a local medical clinic (GH).
• It is important to use medical specialists
with occupational health training.
(Note: CPR or Cardiopulmonary Resuscitation is a
technique designed to temporarily circulate oxygenated
blood through the body of a person whose heart has
stopped.)

Management Leadership
• Management leadership and employee
involvement are complementary.
• Management leadership provides the motivating
force and the resources for organizing and
controlling activities within the organization.
• Management regards worker safety and health
as a fundamental value.
• Employer involvement provides the means
through which workers express their own
commitment to safety and health, for themselves
and their fellow workers.

Visible Leadership from Managers
Successful top managers use a variety of techniques
that visibly involve them in the safety and health
protection of their workers. Managers should look for
methods that fit their style and workplace. Some methods
include:
• Getting out where you can be seen, informally or
through formal inspections.
• Being accessible.
• Being an example, by knowing and following the
rules employees are expected to follow.
• Being involved by participating on the workplace
Safety and Health Committee.

Employee Involvement
OSHA is aware that the growing recognition of
the value of employee involvement and the
increasing number and variety of employee
participation arrangements can raise legal
concerns. It makes good sense to consult your
labor relations advisor (or HR Dept) to ensure
that any employee involvement program
conforms to current legal requirements.

Why should employees be
involved?
• Rank and file workers are the persons
most in contact with potential safety and
health hazards. They have a vested
interest in effective protection programs.
• Group decisions have the advantage of
the group’s wider range of experience.
• Employees are more likely to support and
use programs in which they have input.

What can employees do to be involved?
Examples of employee participation include:
• Participating on joint labor-management
committees and other advisory or specific
purpose committees.
• Conducting site inspections.
• Analyzing routine hazards in each step of a job or
process, and preparing safe work practices or
controls to eliminate or reduce exposure.
• Developing and revising the site safety and
health rules.
• Training both current and newly hired employees.
• Providing programs and presentations at safety
and health meetings.

What can employees do to be involved?
• Conducting accident/incident investigations.
• Reporting hazards.
• Fixing hazards within your control.
• Supporting your fellow workers by providing
feedback on risks and assisting them in
eliminating hazards.
• Participating in accident/incident investigations.
• Performing a pre-use or change analysis for new
equipment or processes in order to identify
hazards up front before use.

Accountability from Managers and
Employees
When managers and employees are held
accountable for their safety and health
responsibilities, they are more likely to
press for solutions to safety and health
problems than to present barriers. By
implementing an accountability system,
positive involvement in the safety and
health program is created.

Accountability – Making it Effective
Any accountability system should have the
following elements to be effective:
• Established standards in the form of company
policies, procedures or rules that clearly convey
standards of performance in safety and health to
employees.
• Resources needed to meet the standards, such as
a safe and healthful workplace, effective training,
and adequate oversight of work operations.
• A measurement system which specifies acceptable
performance e.g. consequences, both positive and
negative.
• Application at all levels.

Review of Program Operations
• The last action recommended under management
leadership and employee involvement is an
annual review of program operations to
evaluate success in meeting the goal and
objectives.
• A comprehensive program audit is needed to
evaluate the safety and health management
means, methods, and processes, to ensure they
are protecting against worksite hazards.

Review of Program Operations
• The audit determines whether the policies
and procedures are implemented as
planned and whether they have met the
objectives set for the program. This allows
for the identification of opportunities for
improvement and can drive the following
year's planning process.

Employee Recognition Program
In the US, the Department of Labor operates an
Employee Recognition Program to encourage
employees to participate fully in improving
operations and to recognize and reward
employees whose contributions and day-to-day
input merit special attention. OSHA fully endorses
this program and encourages maximum
participation of all personnel.

Letters of Commendation
Commendation of employees via letters of
recognition for excellent compliance to
safety and health or some other matters
related to safety at workplace can also be
made by management to all levels of
employees as a gesture of work well done.

Safety and Health Training
We cannot assume that everyone in the
workplace knows the hazards around them.
Some of the QUESTIONS asked are:
• What are the workplace plan in case of a fire or
other emergency?
• When and where PPE is required?
• What are the types of chemicals used in the
workplace?
• What are the precautions when handling them?
• Can Training help to develop the knowledge and
skills needed to understand workplace hazards
and safe procedures?

OSHA considers Safety and Health
Training vital to every workplace
It is most effective when integrated into a
company’s overall training in performance
requirements and job practices.
Identification of needs is an important
early step in training design. Involving
everyone in this process and in the
subsequent teaching can be highly
effective.

The Five (5) Principles
The five (5) principles of teaching and learning should
be followed to maximize program effectiveness.
They are:
• Trainees should understand the purpose of the training.
• Information should be organized to maximize
effectiveness.
• People learn best when they can immediately practice
and apply newly acquired knowledge and skills.
• As trainees practice, they should get feedback.
• People learn in different ways, so an effective program
will incorporate a variety of training methods.

Who needs Training?
Training should target new hires, contract workers,
employees who wear personal protective equipment,
and workers in high risk areas.
Managers and supervisors should also be included in the
training plan. Training for managers should emphasize
the importance of their role in visibly supporting the
safety and health program and setting a good example.
Supervisors should receive training in company policies
and procedures, as well as hazard detection and control,
accident investigation, handling of emergencies, and
how to train and reinforce training.
The long-term worker whose job changes as a result of
new processes or materials should not be overlooked.
And the entire workforce needs periodic refresher
training in responding to emergencies.

Plan to EVALUATE the Training
If the evaluation is done right, it can identify your
program’s strengths and weaknesses, and
provide a basis for future program changes.
Keeping training records will help ensure that
everyone who should get training does. A simple
form can document the training record for each
employee.
OSHA has developed voluntary training
guidelines to assist in the design and
implementation of effective training programs.

Types of Training
• Orientation Training for site workers and contract
personnel.
• JSAs (Joint Service Agreement), SOPs
(Standard Operating Procedures), and other
hazard recognition training.
• Training required by OSHA standards, including
the Process Safety Management standard.
• Training for emergency response people.
• Accident investigation training.
• Emergency drills.

PPE Hazard Assessment and
Training
The basic element of any management program for PPE
should be an in depth evaluation of the equipment needed
to protect against the hazards at the workplace. The
evaluation should be used to set a standard operating
procedure for personnel, then train employees on the
protective limitations of the PPE, and on its proper use and
maintenance.
Using PPE requires hazard awareness and training on the
part of the user. Employees must be aware that the
equipment does not eliminate the hazard. If the equipment
fails, exposure will occur. To reduce the possibility of
failure, equipment must be properly fitted and maintained
in a clean and serviceable condition.

MITIGATION
Mitigation is any sustained action taken to reduce
or eliminate long-term risk to life and property from
a hazard event. This process has four (4) steps:
1. Organizing resources.
2. Assessing risks.
3. Developing a mitigation plan.
4. Implementing the plan and monitoring
progress.

Safety Inspection
Safety Inspection of workplaces (The Walk Round – look and
check at/for) must be carried out on a periodical basis i.e.
regularly. A Safety Inspection Check list must be used and the
following should be included:
1. Poor housekeeping causing hazards e.g. trips, obstructions, fire
risks
2. Trip hazards - wires, cables, damaged flooring, items stored on
floor
3. Electrical equipment - not PAT tested, defective, unauthorized
fires, toasters etc, overloaded sockets,
extension leads and adaptors.
4. Safety signage - missing damaged, obscured
5. Fire and/or office- damaged, gaps in, missing closers, not closing
properly;
6. Smoking - in no smoking areas
7. Fire extinguishers - missing, used, not checked in last 12 months
8. Junk in fire escape routes
9. Ladders - check for any defects - bends, bashes, missing feet or
rungs, wobbly etc.
10. Staff complaints/comments - ask staff if they have any.
11. First Aid - are all boxes reasonably stocked?

Unscheduled Safety Inspection
• In addition to scheduled safety inspections, it is useful for
senior members of an organization to undertake periodic
unscheduled safety tours to ensure that, for example,
standards of house-keeping are acceptable, fire
protection precautions are being maintained and that
personal protective equipment is being correctly used. In
addition to being a useful extra check, this will
demonstrate their commitment to safety.
• The term "safety audit" should be reserved for the
systematic critical examination of all areas of an
organization's activities, including for example
management policy, attitudes, training, processes,
personal protection needs and emergency procedures,
with the object of minimizing injury and loss.

Accident Reporting
Reasons to investigate a workplace accident
include:
• most importantly, to find out the cause of
accidents and to prevent similar accidents in the
future.
• to fulfill any legal requirements.
• to determine the cost of an accident.
• to determine compliance with applicable safety
regulations.
• to process workers' compensation claims.

The Process
The accident investigation process involves the
following steps:
• Report the accident occurrence to a designated person
within the organization
• Provide first aid and medical care to injured person(s)
and prevent further injuries or damage
• Investigate the accident
• Identify the causes
• Report the findings
• Develop a plan for corrective action
• Implement the plan
• Evaluate the effectiveness of the corrective action
• Make changes for continuous improvement.

Accident reporting
A preliminary investigation includes noting
information such as the following:
– - Where did the accident or incident occur?
– - What time did it occur?
– - What people were present?
– - What was the employee doing at the time of
the accident or incident?
– - What happened during the accident or
incident?

Accident Causation Models
• Many models of accident causation have
been proposed, ranging from Heinrich's
Domino Theory to the sophisticated
Management Oversight and Risk Tree
(MORT).
• The causes of any accident can be
grouped into five categories - task,
material, environment, personnel, and
management.

The Five (5) categories
1. Task – e.g. work procedure, appropriate tools,
safety devices.
2. Material – e.g. equipment failure, materials
used, use of PPE.
3. Environment – e.g. weather conditions, poor
housekeeping, noise.
4. Personnel – e.g. training, status of health,
stress.
5. Management – e.g. safety rules, adequate
supervision, regular safety inspection.

Occupational EPIDEMIOLOGY
• Occupational epidemiology involves the
application of epidemiologic methods to
populations of workers.
• Occupational epidemiologic studies may involve
looking at workers exposed to a variety of
chemical, biological or physical (e.g. noise, heat,
radiation) agents to determine if the exposures
result in the risk of adverse health outcomes.
• Alternatively, epidemiologic studies may involve
the evaluation of workers with a common
adverse health outcome to determine if an agent
or set of agents may explain their disease.

The Epidemiologic Triangle
(Triad)
• Disease is the result of complex interactions
(imbalance) between the triad of the agent (toxic
or infectious), the host and the environment.
• Recognizing the different components of this
triad is important because they are the source of
opportunities to reduce disease at multiple
points in the transmission cycle.
• A common mistake is to focus on only one
aspect of the triad for disease control or
prevention and to overlook the others.

Epidemiologic Triad
AgentAgent
HostHost EnvironmentEnvironment

Agent Factor Examples
– Dose
– Environmental hardiness
– Virulence (microbial)
– Infectivity (microbial)
– Toxicity (poisons).

Host Factor Examples
– Innate resistance (e.g. gastric barrier, mucocilliary
transport mechanism)
– Previous exposure
– Vaccination status and response
– Age
– Gender
– Behavior (e.g. mutual grooming, dominance)
– Production status (e.g., lactating vs. non-lactating)
– Reproductive status (e.g., pregnant vs. non-pregnant
sterile vs. intact)
– Genetics
– Intrinsic (non-changeable in the individual).

When evacuating the Building
(Egress)
1.Leave by the nearest staircase. DO NOT use
the elevators unless under police or fire
department supervision. Floor plans should be
posted at various areas around the building for
route of quickest egress.
2.Assemble at least 100 feet away from the
building for a head count conducted by your
local Fire Marshall or Warden. Quickly identify
any individuals whom you suspect might still be
in the building and alert fire or police
department personnel.

When evacuating the Building
(Egress)
3.Disabled Occupants - If a disabled
occupant is unable to exit the building
unassisted, the Fire Marshall or Warden
must notify the emergency response
personnel of the person's location.
Transporting of disabled individuals up or
down stairwells should be avoided until
emergency response personnel have
arrived.

OCCUPATIONAL HEALTH AND
SAFETY COORDINATOR (Officer)
TASKS and RESPONSIBILITIES:
• plans, organizes, directs and coordinates the
Occupational Health and Safety Program.
• plans, develops, implements, and monitors programs,
policies and procedures to ensure compliance of
workplace safety and health laws and regulations.
• identifies program needs and sets program priorities.
• conducts field (workplace) inspections.
• distributes pertinent safety information to employees and
management.
• requests for technical assistance e.g. training where
required.

Safety Monitors (Wardens)
The Safety Monitors are responsible for:
• Familiarizing personnel with emergency
procedures.
• Acting as liaison between management and their
work area.
• Ensuring that occupants have vacated the premise
in the event of an evacuation, and for checking
assigned areas.
• Knowing where their Designated Meeting Site is
and for communicating this information to
occupants.

Safety Monitors (Wardens)
• Having a list of personnel in their area of
coverage, so a head count can be made at the
assembly point.
• Ensuring that disabled persons and visitors are
assisted in evacuating the building.
• Evaluating and reporting problems to the
Emergency Coordinator after an emergency
event.
• Posting the "Area Evacuation Plan" in their work
areas, communicating plan to occupants, and
updating the plan annually.

Biostatistics
(Useful information)
1. The science of statistics applied to the
analysis of biological or medical data.
2.Biostatistics in the public health context
consists primarily of developing descriptive
statistics describing the overall health and
well being of a population.

Exercise via Internet
Biostatistics
Look up for Biostatistics and report your
findings in the next class. Group discussion.

Responsibility of an
OSHA personnel
Do NOT compromise on SAFETY,
it is your duty to ensure a
SAFE and HEALTHY
work environment!

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