occupational hazards

1. Occupational Hazards/injuries
and other infectious diseases:
Who cares for the care giver?
Seth Oppong
Sam Jonah School of Business
African University College of Communications
WAHO Day Celebration, July 9, 2014, GRNA Conference Room, Shiashie, Accra

2. Presentation Outline
• Overview – accidents, occupational hazards (health &
safety)
• Occupational hazards associated with infectious diseases
• Current Institutional Framework
– Safety culture - employer
– Laws & Policies
– Union
• New Institutional Framework: Gap analysis & What it
should look like
– Laws & policies
– Employer – safety culture
– Union
– Individuals

3. Why Accidents?
• Accident is:
– an unplanned or uncontrolled event in which
action or reaction of an object, material, or person
results in ill-health, personal injury or property
damage, or both.

4. Why Accidents? Domino Theory

5. Occupational Hazards
• Hazards are:
– aspects of the workplace (human and nonhuman) that
have the potential to cause gradual deterioration in a
worker’s health and/or have the potential to cause
injuries, death, and/or damage to property (Oppong,
2011).
• Hazards can take the form of:
– Objects
– Materials
– Condition
– Practice

6. Occupational Hazards: Types
• Health Hazards
– Conditions in the workplace that may gradually or
progressively hurt the health of workers.
• Safety hazards
– Conditions in the workplace that may lead to
injuring causing accidents or death.

7. Occupational Hazards: Types (Cont’d.)
Health hazards
• Physical hazards (noise,
radiation, etc)
• Chemical hazards present in
dusts, fumes, and gases
(lead, benzene, tobacco
smoke, etc)
• Biological hazards (bacteria,
virus, etc)
• Psychosocial hazards
(stressful work conditions
such as work overload
Safety hazards
• Unsafe acts
• Unsafe conditions
• Ergonomic hazards

8. Common Health & Safety Hazards in
Ghana’s Health Sector
• Biological hazards #
– Virus, bacteria, and parasites exposing workers to
infections
• Ergonomic hazards (#) generates musculoskeletal
diseases (MSDs)
– In a study among female nurses at Korle Bu Teaching
Hospital and Mamprobi Polyclinic, it was reported
that 65.4%, 63%, and 37% suffered from lower back,
neck, and upper back MSDs respectively.
– Caused by lifting of patients, poor work postures,
stress, and slips & falls.

9. Common Health & Safety Hazards in
Ghana’s Health Sector
• Psychosocial hazards (#)
– Stress is identified as the third most important
health hazards and is associated with various
diseases suffered by health workers in Ghana such
as hypertension.
• Chemical hazards
– Exposure to chemicals and chemical vapour such
as cytotoxic drugs and disinfectant.
• Physical hazards
– X-ray radiation, poor lighting and noise.

10. Oppong’s Risk Chain Process Model
Faulty Risk
Perceptions
Human Error/Risky
Behaviour
Risk
Exposure
Incidents/
Accidents
Individual
Factors
Organizational
Factors
National
Culture
Source: Adapted from Oppong, S. (2015, In press). Risk Chain Process Model:
Linking Risk Perception to Occupational Accidents. SIGURNOST (SAFETY).
•Job stress
•Perceived risk
•Job satisfaction
•Personality
•Eyes-not-on-task(s)
•Mind-not-on-task(s)
•Being in the line-of-fire
•Poor balance/grip.

11. Current Institutional Framework
• OSH Constitutional Provisions
– Article 24(1) provides that “Every person has the
right to work under satisfactory, safe and healthy
conditions,...”
– Article 36(10) states “The State shall safeguard the
health, safety and welfare of all persons in
employment, and shall establish the basis for the
full deployment of the creative potential of all
Ghanaians”.

12. Institutional Framework (Cont’d)
• A national OSH policy for Ghana has been drafted
and laws exist but scattered.
– Factories, Offices and Shops Act, 1970, (ACT 328)
– Mining Regulations, 1970, (L.I. 665)
– Radiation Protection Instrument, 1993, (LI 1559)
– Workmen’s Compensation Law 1987 (P.N.D.C. 187)
– Part XV of Labour Act, 2003, (ACT 651)
– Sections 18 to 20 of Labour Regulations, 2007 (L.I.
1833)

13. Institutional Framework (Cont’d.)
• Factories, Offices and Shops Act, 1970, (ACT 328) which is
the mainstay of the occupational safety, health and
employee’s welfare legislation in Ghana does not cover
the service sector.
• Other Agencies Providing OSH Services
— National Road Safety Commission, (NRSC),
— Occupational Health Unit of the Ministry of Health
(MoH)/Ghana Health Service (GHS)
— Plant Protection and Regulatory Services Directorate, (PPRSD) of
the Ministry of Food and Agriculture
— Environmental Protection Agency (EPA).

14. Occupational Health Unit of the Ministry of
Health (MoH)/Ghana Health Service (GHS)
• The Occupational Health Unit:
– plays an advisory role
– develops guidelines for occupational health
practice and employee well-being programmes
– conducts research into national OSH problems.

15. Employer-Level
• Safety Culture is the way safety is perceived,
valued and prioritized in an organisation.
• There is poor safety culture in Ghana Health
Service; evidence?
– Studies carried out by the Occupational and
Environmental Health Programme of the GHS
show that not only do workers work under
conditions that are hazardous to their health, but
the staffs are also not sensitized to Occupational
Health and Safety (OHS) issues (GHS, 2010, p.1)

16. Employer-Level (Cont’d)
• Health and Safety survey in health care
institutions carried out between July 1999 and
April 2002 in Ghana documented that:
– Only 6% of health workers reported that the OSH
measures put in place at the time of the survey
adequate
– 48% of the respondents considered the measures
to be poor
– 33% said OSH measures required improvement

17. Employer-Level (Cont’d.)
• There exists the Occupational Health and Safety
Policy and Guidelines for the Health Sector
which, among objectives seeks, to
– Achieve and maintain the overall well-being, quality of
life and work performance of health sector staff in
order to minimize the impact of work on their physical
and mental health.
• Others include:
– Workplace HIV/AIDS Policy and Guidelines of the MOH
– Infection Control Policy of the MOH
– Health Care Waste Management Policy and Guidelines
of the MOH

18. Occupational Health and Safety Policy and
Guidelines for the Health Sector
• Preventive activities aimed at preventing the
occurrence of injury and disease.
– Hazard assessment: Key elements of this include
identification, evaluation and control of hazards.
• Promotional activities: provision of
information and education to employees.
• Curative activities that offer treatment and
advice in respect of injuries and diseases.

19. Occupational Health and Safety Policy and
Guidelines for the Health Sector (Cont’d.)
• Rehabilitation activities in case of disability
due to an injury or disease
—Objective
• To help the affected persons regain their skills or
acquire new ones that will enable them return to work.
• Research activities: studies on the work
environment as well as occupational diseases
and injuries.

20. Occupational Health And Safety Policy And
Guidelines For the Health Sector (Cont’d.)
• Financing Occupational Health Services
– Medical surveillance and rendering of medical care for
injuries and disease suffered by the worker should be
at no cost to the worker. The cost should be borne by
the employer through arrangements made in
accordance with national conditions and practice
(GHS, 2010, p.31).
• Sources of funding
– National Health Insurance Scheme
– An endowment fund with contributions from both
employer and employee.
– Group insurance for workers
– Provisions in Workmen’s Compensation Law1987
(P.N.D.C. 187)

21. Union-Level
• Currently, Health Service Workers Union
(HSWU), Ghana and Ghana Registered Nurses’
Association (GRNA) do not have
comprehensive guidelines on occupational
health and safety.
• However, attempts are being made via this
symposium.

22. New Institutional Framework: What
should it look like?
• Adoption of the draft Policy on OSH and
preparation of a new OSH legislation.
– Combine workmen compensation & control of
hazards
– Recognize psychosocial hazards
– Include psychological assessment in addition to
medical examinations
– Strict enforcement of existing laws until the new
law is enacted.

23. New Institutional Framework: What
should it look like? (Cont’d.)
• Employer responsibility
– Undertake risk/hazard assessment and share with
employees and their unions
– Policy in response to pandemics and epidemics
– Educate employees and patients
– Outline procedure for accessing OSH services:
who, where, and how?
– Outline procedure for seeking reimbursement :
who, where, and how?

24. New Institutional Framework: What
should it look like? (Cont’d.)
• Unions
– Push for the adoption of the draft Policy on OSH
and preparation of a new OSH legislation (and
seek to be part of the process)
– Educate members about OSH
– Make OSH a key point of negotiations for CBAs
and ensure their implementation
– Set up Endowment Fund, which among other
things, will provide additional compensation for
affected employees.

25. New Institutional Framework: What
should it look like? (Cont’d.)
• Individuals
– Be aware of hazards one is exposed to at work
– Be educated in ways to prevent exposure
– Require that one is supplied with all the necessary
PPEs
– Obey all OSH regulations at work (failure to do so
is a violation of Section 78 of Factories, Offices
and Shops Act, 1970).
– Report unsafe conditions to the appropriate
authorities

26. Education on OSH: Accident Ratio
Triangle
Source: UK HSE (2000)
Ghana’s Accident Ratio Triangle
based on DFI Data
Accident Ratio Triangle (UK)
Source: Oppong (2011, p.64)

27. Thank You
oppon.seth@gmail.com
+233 243 361 991