Occupational Health Seminar: How to Sell Occupational Health

Dr Faridah Amin, Department of Occupational Safety and Health

Dr Faridah begins by explained that the role and function of the Department of Occupational Safety and Health (DOSH) is to ensure the safety, health and welfare of persons at work and to protect other people from the safety and health hazards arising from the activities at work.

She continues by mentioning that DOSH has come out with several guidelines to assist companies and occupational safety and health professionals to ensure that they meet the requirement of the Occupational Safety and Health Act 1994 and DOSH (The guidelines are available at any State DOSH Offices and at National Institute of Occupational Safety and Health (NIOSH) Malaysia ).

One of the guidelines that are in the process is the guideline for setting up Occupational Health Services (OHS) at the workplace. She explains that according to the First Joint ILO/WHO Committee on Industrial Hygiene 1959 and ILO Occupational Health Services Convention 1985 the OHS should be set up near a place of employment and should be a service entrusted with essentially preventive functions.

Dr Faridah then gives examples of the experience in the European region, Finland, and Japan. She also touches on the legal provision, mechanism on how to implement OHS, Function of OHS, the flow chart for OHS and flow chart for identification hazard at the workplace.

Dr Abu Hasan Samad, ExxonMobil Malaysia

The topic covered by Dr Abu Hasan in the presentation included

• What is Occupational Health,
• OH Services,
• OH Resource Person (Capacity Building),
• OSH Management System,
• OSH Legislation,
• OSH Behavior and Values,
• Interaction between OH and
• Environment and Challenges/Issues.

In the What is OH, he touches on the Focus of OH, the Relationship between Work and Health, Worker & Influences around him, and factors affecting worker’s health. In Occupational Health Service and OH Resource Person, he touches on the responsibilities of OH personnel, the differences of healthcare professionals and industrial hygienist, the individual roles of OH doctors and OH nurses.

OSH management system should be an integrated approach involving all departments or unit within the organisation, and professionals and agencies outside the organisations. He compared the two management systems ILO OSH-MS and OH Management System (OHMS) which is being used by his company, and he explained in detail the OHMS.

He points out the changes in the concept of safety at the workplace; the difference between the traditional safety pyramid and the new behaviour-based safety pyramid, which look into values, prevention and control, causes (behaviour) and consequences (fatalities, injuries and illnesses, property damage and near misses).

OH Challenges in Malaysia

Why Industrial accidents and occupational diseases continue to increase?

• Rapid industrialisation, transfer-in of hazardous industry, young inexperienced workers
• Megaprojects, tight deadlines
• Round the clock operation, shift work
• Rural-urban migration and migrant workers
• Poor workplace OSH practices, lack of HSE culture
• Too few OH-trained or competent persons
• Increased reporting for social security claims

Challenges/Issues

• Ensuring compliance and effective enforcement
• Difficulty with SMI: costs vs responsibilities
• Prompt/early reporting, goof record keeping
• Multifactorial causation, subtle presentation of occupational diseases
• Psychosocial issues: stress and violence at the workplace
• Compensation vs rehabilitation
• Declining fertility in the general population?
• Continuing environmental/ecosystem degradation
• Emerging issues: globalisation, long working hours, work-life balance, ergonomics, travel health, infectious diseases.

What is next?

• Enhanced public awareness on OSH and the environment
• OSH awareness/education at young/schooling age
• Behavioural change towards OSH and Environment
• OH Service Guidelines – multi-stakeholders involvement
• OSH Management System – more widespread acceptance
• Training – Universities, NIOSH, Ministry of Health, Malaysian Society of Occupational Safety and Health, and Society of Occupational Safety and Health.
• Enforcement by DOSH and Department of Environment
• Emphasis on rehabilitation and early return to work

Dr Abdul Rahim Rahman Hamzah, Petronas Malaysia

Dr Rahim explains that compensation is the last resort in the progress of Occupational Disease or Injuries. The “Prevention” model in epidemiology and HSE in the workplace start with Primary presentation, Secondary prevention, “cure”, tertiary prevention and then only compensation.

He then explains the avenues of compensation available for an injured and/or diseased worker; it includes civil claims and prescribed claims. The prescribed claims are benefits included in the legislation. He then went on to outline the history of compensation in the world, which all started in Germany in 1838 by Chancellor Otto von Bismarck, then England in 1880 with the Employer’s Liability Act and 1897 the Workmen’s Compensation Act, in the USA it started in 1908 with the Federal Employer’s Liability Act in 1908 and the latest is the Major Reform Act; Independent Medical Examiners.

In Malaysia, we have the Workmen’s Compensation Act 1952 and the Employees’ Social Security Act 1969. The Workmen’s Compensation Act has been superseded when the ESSA came into effect in 1969, the Workmen’s Compensation Act is now only applicable for foreigners when the Workmen’s Compensation (Foreign Workers’ Compensation Scheme)(Insurance) Order 1998 was issued.

Associate Professor Siti Zaharah, Lecturer from Faculty of Law, University of Malaya

In the presentation, Assoc Prof Siti Zahrah focuses on what are the protection available for workers who found himself with problems in relation to safety at work, either because he met with an accident, suffered occupational disease or being terminated or dismissed by his employer, for raising issues on safety and health at his workplace.

She explain the various Acts that are important to a worker:

• Workmen’s Compensation Act 1952
• Employees’ Social Security Act 1969
• Employment Act 1955
• Industrial Relation Act 1967

In case of accident or occupational disease Occupational Safety and Health Act, 1994 (OSHA) did not provide for the worker any right to sue the employer or to be given compensation if the employer was found guilty of non-compliance with the Act.

In case of termination or dismissal, under Section 27 of the OSHA, no employer can dismiss an employee just because he raises an issue from the OSHA or function as a member of a committee required under the same Act.

She also discussed the issue of termination or dismissal, where she explains the various methods of termination by an employer or resignation of an employee:

• Termination with notice
• Termination without notice
• Termination of special reasons
• Termination because of redundancy or retrenchment
• Termination because of change of ownership of business, and
• Constructive dismissal

She also discussed the issues and methods of bringing up a case to the Industrial Court for wrongful dismissal. The burden of proof in the Industrial Court lies with the employer, in the case of the Civil court the burden of proof lies with the plaintiff.

She concluded by indicating that OSHA does not give any additional rights to the worker in terms of compensation for injury or occupational disease suffered by him. At the same time, OSHA does not guarantee that the worker will not lose his job if he raises issues on OSHA. To know your right as a worker will be the best way to protect oneself. Even though OSHA is 10 years old, its provision has yet to be tested by the court

Dr Nirmal Singh, Polykilinik Sri Muda, Shah Alam

Dr Nirmal explain from his experience that to sell occupational health is a difficult issue, you will need a balance between the carrot and the stick. If you use the stick and report all that you find at the workplace to the authority, sometimes you will find that the company would not need your service the next time around. The carrot is an important tool for selling occupational health, to look at how OH will benefit the company bottom line, but there are still lack of data to show it. So the best way is to employ a balance approach and also knowledge of how to sell oneself.

Assoc Prof Dato S Noor Ghani, Head of the Department of Social and Preventive Medicine

Dato brought up the issue that each year, in the world an estimated two million women and men die as a result of occupational accidents and work-related disease. Across the globe, there are some 270 million occupational accidents and 160 million work-related diseases each year. Experience has shown that a strong safety culture is beneficial for workers, employers and governments alike. Various prevention techniques have proven themselves effective, both in avoiding workplace accidents and illness and improving business performance.

Dato mentions that employee is our most important asset and the responsibility for ensuring the workers’ health, work environment and welfare lies with the Human Resource Manager and the Occupational Health Physicians. The HR has the right to hire, fire, promote, demote, develop, compensate and welfare the workers. HR are the people who decide how they would like to treat the workers; i.e. Roman Galley, Sweatshop or Asset.

Dato mention few behavioural schools of thought on an employee; Elton Mayo – “Hawthorne Studies”, Maslow’s – Hierarchy of Needs and Mc Gregor’s – Theory X and Theory Y.

Dato concluded with some Questions to ponder:

• Concept of investing in the health of workers
• Occupational health physician input to HR Department – a greater role
• What saving accrue
• A more conducive employer-employee relationship
• More committed faithful workforce
• Would productivity, efficiency and quality improve

Dr BJ Singh, Society of Occupational and Environmental Medicine

Dr Singh started by defining Occupational Health, Management, and Issues. He further lists down some of the issues related to the topic of Occupational Health Management:

• Perception/attitude of Employer vs perception/expectation of employees
• Perception of OH Practitioner to OH and Health in General
• Expectation and Actions of OSH Legislators
• Expectation/Culture of Employers for Legislative enforcement and knee-jerk action
• Historical legislative emphasis – on Safety with little mention to OH
• Not all Business enterprises run profitably all the time
• OH and Health – side issues, left for HR to resolve
• The success rate of Marketing, Sales, Promotion strategies, usually in the region of 2-5%
• Current OH/OSH promotion programme seen to be expensive especially no visible short term gain
• a dire need for leadership from Authorities and Institutions.

He discussed the role of ILO OSH-MS, which he described as a new approach, which includes the elements of Policy, Organization, Planning and Implementation, Evaluation and Action for Improvement. The majority of local Small and Medium Enterprises has lack know-how and find documenting and procedures too “overpowering”, they are satisfied with their own old ways, lack manpower resources, prefer ad-hoc or as & when management style and always looking at the bottom line.

He suggested the possible approach for Local SME

• Work through and with trade Organisation and Guilds on OH issues
• Implement simple 5 steps of risk management programme
• Introduction of WISE (Work Improvement in Small Enterprises)

WISE Programme

• WISE Programme has been very successful in Japan, China, Philippines, Thailand, Cambodia and Vietnam
• It Build on local practices
• Focus on Achievement and Improvement
• Link line working conditions with other Management and OSH Goals
• Use-Learning-by-Doing approach
• Encourage exchange of Experience
• Encourage and Have Workers involvement
• Programme authorities or institution supported
• Low cost programme for participants

The way to convince the Management is to do Need Assessment and compute the costs; i.e. Measurable costs and hidden costs vs the benefits. In summary, Dr Singh put it Managing OH needs an Enlightened Management and a multi-disciplinary approach, non-enlightened employers need a friendly and low-cost approach to promote the idea of OH and work improvement programmes must be an integral part of company OH enhancement efforts.

Dr G. Jayakumar, Melaka-Manipal Medical College

Dr Jaya remind us that communicable disease is one of the oldest public health problem, and it has now impact on the work place. During the SARS outbreak in 2003, Singapore Airlines has to retrench plan, the outbreak of Nipah devastated the Pig Industry in Malaysia and now the Flu Virus have effect on both the birds and the workers. He also touch on the other communicable diseases found in the hospitals and among health care workers; i.e. HIV, Malaria, Hepatitis B, Hepatitis C and Syphilis. Communicable disease has become an issue at the workplace and we should protect all the workers from this .