Issues and Challenges of Medical Surveillance Implementation in Small and Medium Industries in Malaysia discusses the key challenges that small and medium enterprises (SMEs) in Malaysia face in implementing medical surveillance programs. Some of the main challenges identified include limited resources to dedicate to health and safety, lack of awareness of legal obligations, managerial factors like business priorities taking precedence over health, and social dynamics within SMEs that can discourage safety. The document recommends strategies to address these challenges, such as promoting guidelines and standards, empowering workers, incentivizing SMEs for good surveillance programs, and enhancing enforcement of regulations.

1. Issues and Challenges of Medical
Surveillance Implementation in Small and
Medium Industries in Malaysia
WAN NUR INSYIRAH BINTI WAN RAMZAN
KGJ 150040
NOR ILLIANI BINTI RAMZI
KGJ 150050
MARINA BINTI MUHAMAD
KQD 160022

2. Medical Surveillance
The monitoring of a
person for the purpose
of identifying changes in
health status due to
occupational exposure to
chemicals hazardous to
health
Component
of medical
surveillance
Pre-employment
and pre-
placement
medical
examination
Biological
monitoring and
biological effect
monitoring
Health effects
monitoring
Investigation of
occupational
disease and
poisoning
Notification of
occupational
disease and
poisoning
Assist in disability
assessment
Return to work
examination after
medical removal
protection

3. Small and Medium
Enterprise (SME)
• Manufacturing: Sales turnover not
exceeding RM 50 million or full time
employees not exceeding 200 workers
• Services and other sectors: Sales
turnover not exceeding RM 20 million
or full time employees not exceeding
75 workers.
SME is one of biggest economic
contribution in Malaysia

4. Despite the high amount of SME in Malaysia, standards of occupational
safety and health culture that surpass the legal requirement were not
widely practiced by SME.
Research by Baba et al. (2012) shows that,
• Overwhelming majority (92.7%) of the respondents from SMEs are
likely not conforming to the basic requirement of Occupational Safety
and Health Act (1994).
• Only 3.1% of the management personnel can be considered
competent in terms of knowledge, skill and ability in carrying out
occupational safety and health regulation within their respective
organization.
• 96.9% of the respondents that participated in the survey can be
considered not competent.

5. • This happen due to:

6. ISSUES AND CHALLENGES

7. SMEs recognize the potential benefits of good occupational health. However, the
nature of these enterprises is such that they are unlikely to be able to support
dedicated health and safety staff regardless of good intentions to protect the people
and processes at work.
Training and bespoke advice from consultants available to assist in compliance
with the existing regulations.
SME often experiences a potential organizational conflict between the pressures
of generating income and aim of protecting staff from occupational hazards.
SME often appear to be unaware of their legal obligations, do not realize the dangers
of poor practice, do not think about the benefits of good health and safety practice
and have insufficient resource to devote to health and safety.
ISSUES:

8. Challenges
Managerial
Factors
Suspicion of
Interventions
Legislation
SME Social
Characteristics
& Dynamics
Stress
Worker
Representation
within the SME

9. Suspicion of Interventions:
1. Perceptions:
a) Health and safety seminars offered free of charge may be vulnerable to the suspicion
that they are of low value, and these may negatively affect their uptake by SMEs.
b) The perception that moves to improve heath and safety may not produce any
improvement or benefit in real term
c) The fact that early interventions were modelled on what appeared to be good practice
in larger firms, rather than as a result of research findings among smaller enterprises.
d) That such systems are a cause of bureaucratization and an obstacle to the flexibility of
SMEs.
2. Interventions which incur charges for services may have reduced uptake because of limited
resources available to small businesses.
3. Also, smaller businesses may be less likely to have measures of performance, staff morale,
sickness absence, and time lost through accidents in order to make objective and calculated
evaluations of any intervention.
4. Lack of human resources, managerial capacity, limited capital resources, a reactive
approach, tacit knowledge and little attention given to the formalization of processes.

10. Legislation:
1. Lack of awareness of what specific health and safety legislation is relevant to their business
and unsure of their statutory requirements.
2. Small firms tend to see their own ability to interpret regulations as limited and therefore
they require more specific advice to tell them exactly what to do (E.g. An organization that
delivers foodstuffs may consider itself to be in the retail sector rather than transport one)
Managerial Factors:
1. The characteristic size or structure of the SME (Totally dependable on the owner’s willingness
to implement / support medical surveillance at the workplace)
2. Lack of interest from the staff / difficulty in coordinating people to discuss health and safety
skills.
3. Lack of coordination and communication within a company.
4. Management/business style (E.g.: Owner/manager-led companies tended to engage less in
health and safety activities than those companies adopting participatory management style.)
5. Lack of management training or understanding of good management practice.

11. SME Social Characteristics & Dynamics:
1. Positive relations with owner/managers may encourage employees to accept riskier work
conditions, ignoring personal requirements in favor of the perceived economic interests of
the enterprise.
2. Negative employment relations may intensify difficulties surrounding health and safety
issues.
3. The employees may have unique understanding of their risks but are still unwilling to
compromise the discomfort from some personal protective equipment, for example, hearing
defenders and visors adopted in forestry.
4. Religious issues may also be relevant, for example, supplying appropriate protective head
gear to Sikhs.
5. Family labor / family-employee - More inclined to engage in activities potentially
detrimental to safety and wellbeing (E.g. Extended working hours or safety shortcuts.)
6. Language barriers – Create problems both in understanding legislation and also in managers
communicating risks to employees.

12. Worker Representation within the SME:
1. The level of worker representation on health and safety issues within the SME.
2. Workforce involvement / direct participation is rare in small businesses.
3. It is less straightforward for employees to employ legal rights to refuse dangerous work or
obtain information concerning the risks of their work.
4. Difficult to persuade the employees to take health and safety precautions:-
a) Lack of effective communication between employer and employees
b) The perception that relations may be strained if employers attempt to enforce
unpopular procedures
c) Lack of interest in the health and safety of the employees
d) Not enough time to spend on addressing issues of health and safety when faced with
other more immediate challenges.
Stress:
1. SMEs are not on the whole generally well-equipped to manage stress.
2. Small businesses saw all business as good business and worked very long hours, often for
small returns, without a strategic understanding of the means of controlling workload.

13. AWARENESS
Promotions of Guidelines on
Medical Surveillance, Department
of Occupational Safety and Health
DOSH 2015
Workforce empowerment on their
roles and rights to health risk
management
Holistic management and learning
culture on Occupational Health
(SOHELP Program)
ENFORCEMENT
Liaising between relevant agencies
and departments for enforcement
of Occupational Safety and Health
(Use and Standards of Exposure of
Chemical Hazardous to Health)
Regulation 2000 -USECHH
Implementations of Chemical
Health Risk Assessment (CHRA) by
all SMEs employer
Enhance of Information Technology
usage through Portal SMILE
(www.smile-pks.com.my)
INCENTIVES
Organizing OSH award on Medical
Surveillance Excellence to
recognize SMEs effort towards OSH
implementation
Tax exemptions/reduction for
SMEs with good record of medical
surveillance
Provide SME Compliance Support
Program for medical surveillance
RECCOMMENDATIONS AND STRATEGIES

14. Systematic Occupational Health
Enhancement Level Program

15. References
1. Baba Md Deros, Ahmad Rasdan Ismail, Mohd Yusri Mohd Yusof. 2012.
Conformity To Occupational Safety and Health Regulations In Small and
Medium Enterprises. Journal Of Occupational Safety and Health. 9: 1-6
2. Press Release Small and Medium Enterprises 2015. Department of
Statistics Malaysia
3. Guidelines on Medical Surveillance, Department of Occupational Safety
and Health, Ministry of Human Resources. Malaysia. 2015
4. Buku Panduan Keselamatan dan Kesihatan Pekerjaan di Tapak Projek
Perusahaan Kecil dan Sederhana – Sektor Kemudahan, Department of
Occupational Safety and Health, Ministry of Human Resources
5. Presentation slides from National Seminar on Occupational Safety and
Health 2015
http://www.dosh.gov.my/index.php/en/presentation-slides