8/4/2021

Introduction of
Occupational health,
Medical and
Biological Monitoring

Objective
At the end of this session, the participants would be able to:

Discuss medical surveillance and Discuss importance of

4
1 biological monitoring to identify Occupational Health
medical condition of workers.

Differentiate medical and

5 Discuss Biological hazards
2 biological monitoring.

To identify the importance of

33 medical surveillance in the
workplace.

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DUTIES OF EMPLOYER
Equip a place of employment for workers free from
hazardous conditions that are causing or are likely to
cause death, illness, or physical harm

Ensure that the chemical, physical and biological

substances and agents, and ergonomic and psychosocial
stresses under control are without risk to health

Comply with OSHS including training, medical

examination, and where necessary, provisions on
protective and safety devices such as PPE and machine
guards

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OCCUPATIONAL HEALTH DEFINITION (WHO/ILO)

• Promotion and maintenance of the highest degree of

physical, mental & social well-being of workers of all occupations
• Prevention among its workers of departures from health
caused by their working conditions
• Protection of workers in their employment from risks usually
from factors adverse to health
• Placing & maintenance of the worker in an occupational
environment adapted to his/her physiological ability.

OCCUPATIONAL HEALTH PERSONNEL AND

FACILITIES
The number of health personnel, which may be classified as full time (FT) or part-
time (PT), equipment and facilities, and the amount of supplies shall be
proportionate to the total number of workers and the risk or hazard involved in the
workplace, the ideal ratio of which shall be as follows:
Covered workplaces
shall have qualified
occupational health
personnel such as
certified first-aiders,
nurses, dentists, and
physicians duly
complemented with the
required medical
supplies, equipment and
facilities.

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Every employer covered by this Rules shall provide his/her workers

medical services and facilities and shall not be an excuse by employer
from maintaining in his/her workplace a first aid treatment room or clinic
for workers which shall be as follows:

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OCCUPATIONAL HEALTH PERSONNEL AND

FACILITIES
The employer may not establish a hospital or dental clinic in the
workplace where there is a hospital or dental clinic which is
located not more than five (5) kilometers away from the
workplace, accessible in not more than twenty-five (25) minutes
travel time, and the employer has facilities readily available for
transporting workers to the hospital or dental clinic in cases of
emergency.

For this purpose, the employer shall enter into a written contract
with the hospital for the use of such hospital for the treatment
of workers in cases of emergency.

OCCUPATIONAL HEALTH PERSONNEL

TRAINING
a) All safety and health personnel shall undergo the mandatory
orientation or training on OSH as prescribed by DOLE.
The following are the minimum prescribed training or
orientation for all safety and health personnel:

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OCCUPATIONAL HEALTH HAZARDS

SAFETY HAZARDS HEALTH HAZARDS

-Working conditions where harm to the worker -Working conditions which results in an illness
is of an immediate and violent nature

-Result in broken bones, cuts, bruises,

sprains, loss of limbs, etc. -Exposure to dangerous substances and
conditions, such as chemicals, gases,
-The harm results in some kind of injury to the
worker
-Often, latency between exposure and
-Associated with poorly guarded or dangerous
disease.
equipment and machinery

OCCUPATIONAL HEALTH HAZARDS

Biological Ergonomics

Viruses, Exhaustive Physical Exertions

Bacteria, Prolonged standing
fungi, Lifting heavy loads
Parasites, Job Monotony
Insects Workplace stress

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Will exposure to hazards in

workplace ALWAYS cause injury,
illnessm or adverse health effects?

Bernardino Ramazzini
1633 – 1714

Hazards Exposure in the Workers’ Health Practices

Working Environment • Individual risk taking
• Physical behaviors
• Chemical • Physical activity
• Biological • Nutrition
• Ergonomics

Personal-Social Factors
• Occupational status
Access to Health Services
• Employment conditions
• Preventive OH services
• Income
• Specialized curative care
• Inequities in sex, age,
& rehabilitation
race,
• Health & accident
etc.
insurance
• Medical history
• Family history

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Will exposure to hazards in

workplace ALWAYS cause injury,
illnessm or adverse health effects?

NO
Bernardino Ramazzini
1633 – 1714

BIOLOGICAL HAZARDS
Microbes Sources

Bacteria Soil
Insects
Fungi
Plants
Parasites Birds
Other animals
viruses Humans

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SELECTED BIOLOGICAL AGENTS / DISEASES AND

ASSOCIATED HIGH RISK GROUP
Agent/Disease Occupation

Tuberculosis Silica workers, people exposed to heat

and organic dusts, & medical personnel

Tetanus Handling jute (spores in soil mixed with

jute) or anyone in contact with manure

Psittacosis (in parrots, parakeets, Pet shop personnel, gardeners,

pigeons, ducks, turkeys, chickens, housewives, veterinary surgeons, &
etc.) researchers
Rabies (e.g., dogs, bats, rats, pigs, Veterinarians, letter carriers, laboratory
cats) research workers, agricultural workers

BIOLOGICAL HAZARDS
HIV and AIDS
Prevention and control of HIV RA 8504

•HIV
oHuman Immunodeficiency Virus
oVirus that causes AIDS

•AIDS
oAcquired Immunodeficiency Syndrome

oSerious & usually fatal condition in which the body’s immune system
is severely weakened & can’t fight off infection

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BODY FLUIDS WITH HIGH VIRAL LOAD

•Blood
•Semen
•Vaginal & cervical mucus
•Breast milk
•Amniotic fluid
•Cerebrospinal fluid

MODE OF TRANSMISSION

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AM I AT
RISK FOR HIV
OR AIDS?

PREVENTION & CONTROL OF HIV INFECTION

REMEMBER SAVE!

 Safer practices
 Access to treatment, care & support, & other
services
 Voluntary counseling & testing
 Empowerment, education, early detection of STI

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PREVENTION & CONTROL OF HIV INFECTION

• ABCDs of SAVE

 Abstinence
 Be faithful to partner
 Consistent & proper condom use
 Don’t inject drugs

TETANUS
• A neurological disorder
characterized by increased
muscle tone & spasms that is
caused by tetanospasmin, a
protein toxin elaborated by
the organism Clostridium
tetani.
• Clinical Manifestations
oIncreased tone in the masseter muscle (lockjaw)
oSustained contraction of the facial muscles (risus
sardonicus) & back muscles (opisthotonus)
• Prevention
oActive immunization with tetanus toxoid
oCareful wound management

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TUBERCULOSIS
P R EV E NTI O N AND CO NTR O L O F T B EO 18 7 -0 3

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REFERENCE: BIOLOGICAL HAZARDS DR. REYNOLD STA ANA

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WHAT IS HEPATITIS?
PREVENTION AND CONTROL OF DOLE DA 05-2010

•Inflammation of the liver

•Can be caused by viruses, drugs, or toxins

HAV HBV HCV HDV

Source Feces • Blood • Blood • Blood
• Body fluids • Body fluids • Body fluids
• Needles
• Childbirth • Needles • Sex
Route of • Needles • Blood • Blood
transmission Fecal-oral • Sex transfusion transfusion
• Blood (sex, (requires
transfusion childbirth) HBV co-
infection)
Chronicity No Yes Yes Yes
• Blood
Active & Active & donor
Prevention passive passive screening HBV vaccine
vaccination vaccination • Risk mgt
• Education

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IMPACT OF HEPATITIS B

•1 of 8 Filipinos is infected with hepatitis B virus

oConsidered as the silent Asian epidemic
oMost don’t even know they’re infected

•Chronic hepatitis B is a major public health concern

•70% – 80% of those infected with hepatitis B can lead

healthy & productive lives if diagnosed early & monitored
regularly by a physician

Monitoring
Ongoing process by
which stakeholders
obtain regular feedback
on the progress being
made towards achieving
their goals and
objectives.
-UNDP

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Health Hazards

 working conditions which result in an illness

 exposure to dangerous substances or conditions, such as

chemicals, gases, dusts, noise etc.

 often, latency between exposure and disease

Health monitoring

This collects early reports of any symptoms workers may have. In law,
you do not have to do health monitoring. But it is often useful to
collect this information so that you are aware of any health issues your
workers have and to monitor trends.

Reference: hse

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Role of Health Monitoring

Genetic Multiplicity of
factors exposure
Lifestyle
Duration of
Age exposure
Workers’
Susceptibility WORK- Workplace
Physical
RELATED Factors
properties
Race
DISEASE
Magnitude of
Gender exposure
Medical Timing of
history exposure

Role of Monitoring

• To inspect that control measures are working

• To have early detection of job-related health
problems
• To check that health and safety procedures are
understood and followed.

HSE Science and Research Centre

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Types of monitoring

1 Ambient / Environmental Monitoring

2
Biologic

3 Medical Surveillance

Biological
Monitoring

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Biological Monitoring - Biological monitoring is the measurement

and assessment of chemicals or their metabolites (substances the body
converts the chemical into) in exposed workers. These measurements
are made on samples of breath, urine or blood, or any combination of
these.

The relationship between environmental, biological and exposure

monitoring, and health surveillance

Source : ILO http://www.ilocis.org/documents/chpt27e.htm

1 Monitoring of exposure
-Assessment health risk
Biological through the evaluation of
monitoring internal dose
can be
divided into 2 Monitoring of
two: effect

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Role of Safety Officer in

Biological Monitoring
1 Acts in an advisory capacity on all matters pertaining
to health for the guidance of the employer and the
workers.
2 Conducts investigation of accidents as member of the
health and safety committee and submits his separate
report and analysis of accidents to the employer.
3 Conducts health inspection
inspection.

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Participation in analysis of occupational accidents
and occupational diseases.
Reference : Rule 1047 Duties of Safety Man
Rule 1961.03 Occupational Health Services

Medical
Surveillance
Medical surveillance describes
activities that target health events
or a change in a biologic function of
an exposed person or persons.

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• The analysis of health information to look for problems that may be occurring in the
workplace that require targeted prevention.

• Surveillance serves as a feedback loop to the employer.

• May be based on a single case or sentinel event, but more typically uses screening
results from the group of employees being evaluated to look for abnormal trends in
health status.

• The fundamental purpose of surveillance is to detect and eliminate

the underlying causes such as hazards or exposures of any discovered
trends and thus has a prevention focus.

• The purpose of medical surveillance is to prevent work-related

illnesses through early recognition of problems, such as abnormal
laboratory results that may be associated with the early stages of a
disease.

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1. Hazard and Exposure Assessment

2. Identification of Target Organ Toxicities for Each Hazard
3. Selecting Medical Screening Test
4. Interpretation of data and recommendation
5. Communication of results
6. Record keeping

1. Hazard and Exposure Assessment

oTypes of substances
oProcess involved
oExposure pathways
oExposed population
oEstimate intensity, frequency and duration of
exposure to toxic agent.

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2. Identification of Target Organ Toxicities for Each Hazard

Causative agent Industry/process Diseases

Inorganic dusts Mining,sandblasting, Pneumococoniosis
construction, Silicosis
manufacturing Asbestosis

Molds Agriculture Farmer’s lung

3. Selecting Medical Screening Test

Causative agent Diseases Screening Test

Inorganic dusts Pheumococoniosis Chest X-ray
Silicosis CT scan
Asbestosis Lung Function test

Molds Farmer’s lung Chest X-ray

Blood test

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Physical Examination

All workers, irrespective of age and sex, shall undergo physical

examination:

a)before entering employment for the first time;

b)periodically, or at such intervals as may be necessary on account of
the conditions or risks involved in the work;
c)when transferred or separated from employment; and
d)when injured or ill

Physical Examination

All examinations shall:

a)be complete and thorough;
b)be rendered free of charge to the workers; and
c)include X-ray or special laboratory examinations
when necessary due to the peculiar nature of the
employment.

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Physical Examination

Results are recorded carefully and legibly on appropriate

forms by the health service personnel

Records of physical examinations and all information

obtained by the health personnel shall be considered
strictly confidential

Health Examinations:

Entrance;
Periodic;
Special examination;
Transfer examination;
Separation examination.

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ENTRANCE/PREPLACEMENT (PRE-
EMPLOYMENT)

a. to determine the physical condition of the prospective employee

at the time of hiring.

b. to prevent the placement of a worker on a job where, through

some physical or mental defects, he/she may be dangerous to his
fellow workers or to property.

PERIODIC: ANNUAL PHYSICALS

Conducted in order to:

a. Follow-up previous findings,
b. To allow early detection of occupational and non-occupational
diseases,
c. To determine the effect of exposure of employees to health
hazards.

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SPECIAL MEDICAL EXAMINATION

May be required where there is undue exposure to health

hazards, such as lead, mercury, hydrogen sulfide, sulfur dioxide,
nitro glycol and other similar substances

TRANSFER EXAMINATION

Applicants examined for employment and accepted for specific

work or job shall not be transferred to another work or job until
they have been examined by the physician and certified that the
transfer is medically advisable.

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SEPARATION/EXIT MEDICAL
EVALUATION
An employee leaving the employment of the company shall, if necessary,
be examined by the OH physician:
a. To determine if the employee is suffering from any occupational disease;

b. To determine’ whether he is suffering from any injury or illness which

has not completely healed

c. To determine whether he has sustained an injury

4. INTERPRETATION OF DATA AND RECOMMENDATION

• Group pattern
• What to do if a group of workers have poorer lab results?
- Determine relation between exposure and test results
-Was there overexposure?
-Ineffective control measures?

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5 Communication of results

oAll information must communicated properly according to

protocol so effective measures can be immediately
planned and implemented
oMedical information is handled with strict confidentiality

6. Record Keeping
oMedical recordkeeping – test results, interpretations, records of
notifications
oRequirements, procedures, and interpretations of findings for health
surveillance as specified by national legislation.
oPhysical Examination
Complete system review
oOccupational History
Descriptions of all jobs held
Work exposure
Symptoms or illness at previous at previous jobs
Personal protective equipment uses

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STANDARDS, POLICIES AND GUIDELINES FOR MEDICAL

SURVEILLANCE AND BIOLOGICAL MONITORING

OSHS RULE 1050 – Notifications and Keeping record of accidents and/or

Occupational Illness
Employers work accident/illness report IP6
Annual work accident report exposure data report IP6-B
Annual Medical Report Form-47-A

OSHS RULE 1070 – Occupational Health and Environmental Control

Threshold Limit Values (TLVS)
Permissible exposure
Work Environment Measurement

OSHS Rule 1960 – Occupational Health Services

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Basic Components of Company OSH Program and Policy

(DO 198-18, Chapter IV, Section 12)

1. Commitment to Comply with OSH Requirements

2. General Safety and Health Programs
3. Promotion of Occupational
c Health Program
4. Prevention/Control of HIV-AIDS,
c Tuberculosis, Hepatitis B
5. Health and Safety
c Committee
6. OSH Personnel c and Facilities
7. Safety and Health Promotion,
c Training and Education
8. Toolbox/Safety Meetings, job safety analysis
9. Accident/Illness Investigation, Recording and Reporting
10. Personal Protective Equipment (PPE)
11. Safety signages
12. *Dust control and management
13. Welfare Facilities
c
14. Emergency/ disaster preparedness and response plan
15. Solid waste management system
16. Reportorial Government
c Requirement
17. Control and Management of Hazards
18. *Prohibited Acts and Penalties for Violations
19. *Cost of OSH program

COMPANY’S PROFILE

Company’s Name
Date Established
Company Address
Contact information
Company Owner/President
Total Employee
Type of Industry
Type /Description of Services

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COMPANY’S OSH POLICY

Commitment to comply with the requirements of:

1. R.A. 11058
2. DOLE D.O. 198-18
3. Other Applicable OSH Standards

COMPANY’S OSH PROGRAM

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COMPANY’S OSH PROGRAM

2.3 First aid and emergency medical services

Treatment, clinic, hospital requirement at work site based on
numbers of workers per site and risk category of the company

3.0 Promotion of
3.1 Drug free workplace RA9165
3.2 Mental Health RA11036
3.3 Healthy Lifestyle

4.0 Prevention and Control of

4.1 HIV RA 8504
4.2 TB EO 187-03
4.3 HEPA DOLE DA 05-2010

5.0 Safety & Health Committee Composition based on number

of employee and company’s risk category

COMPANY’S OSH PROGRAM

5.0 Composition of Joint Coordinating Safety & Health

Committee(if applicable)
6.0 OSH Personnel and Facilities
6.1 Safety Officer and Mandated Training Acquired
SO1 - 10HR SO1
SO2 - BOSH/COSH
SO3 - LCM
First Aider- FA/BLS
OH - OHNAP

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COMPANY’S OSH PROGRAM

COVID WAIR
6.2 Emergency OH Personnel FORM
and Facilities
7.0 Safety and Health Promotion,
Training and Education
8.0 Toolbox / Safety Meeting
9.0 Workplace Injury Illness
Investigation and Reporting

WAIR FORM WAIR MULTI WORKER

INVOLVED

COMPANY’S OSH PROGRAM

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COMPANY’S OSH PROGRAM

9.0 Workplace Injury Illness

Investigation and Reporting

10.0 PPE Provisions

11.0 Safety Signage

12.0 Dust Control and Management

COMPANY’S OSH PROGRAM

13.0 Worker’s Facility

14.0 Emergency and Disaster Preparedness
Drill Conducted
15.0 Waste Management Proc. & PCO
16.0 Reportorial Requirement
17.0 HIRAC Document
18.0 Prohibited Acts, Penalties, sanctions
for violations on OSH

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COMPANY’S OSH PROGRAM

19.0 Cost of implementing OSH Program

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GOVERNMENT WORKPLACE POLICY

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Summary:

• The purpose of health monitoring/ surveillance is the prevention of illnesses

• There are various of health effects for every health hazard in the workplace
• Medical surveillance and biological monitoring are strategies done to check
for any abnormalities or physiologic changes of the workers
• Data results from all monitoring (environmental, biological, medical
surveillance) must be used comparatively and not as a stand alone
reference
• All monitoring must be followed by preventive/ mitigating actions followed by
evaluation of effectiveness

REFERENCE:

REFERENCE: POWERPOINT PRESENTATIONBIOLOGICAL HAZARDS DR.

REYNOLD STA ANA

CDC

ILO

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Thank you!

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