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Status and future tasks of OHS in Malaysia
International Congress Series 1294 (2006) 65 – 68
www.ics-elsevier.com
Status and future tasks of OHS in Malaysia Mohd Nizam Jemoin * Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jln Yaakob Latif, Bandar Tun Razak 56000 Cheras Kuala Lumpur, Malaysia
Abstract. The purpose of this paper is to describe the evolution and future tasks of occupational health services (OHS) in Malaysia. The initiatives to develop a more systematic and comprehensive OHS have become more prominent after Occupational Safety and Health Act 1994 with appointment of competent persons to conduct specific task. Various professional groups have been identified and their roles are clearly outlined in the Guidelines on Occupational Health Services which was recently launched. Collaboration and coordination by all the OHS providers, both government and private agencies is essential to ensure efficient OHS delivery. However, more need to be done to enhance OHS in the country particularly to develop a better system of OHS delivery and participation from the industry and other stakeholders. In conclusion, comprehensive, well designed and accessible occupational health services are important to ensure the health and safety of the workforce. D 2006 Published by Elsevier B.V. Keywords: Occupational health service; Legislation framework; Developing country; Malaysia
1. Introduction Workers’ access to occupational health services is limited to only 5–10% in developing countries. In Malaysia, there has been an urgent need to coordinate and further enhance the occupational health services (OHS) in order to deal with current and future challenges arising from the workplace. Comprehensive, systematic and accessible OHS are particularly essential to cater for nearly 10.5 million Malaysian workforces engaging in wide range of work i.e. from traditional agriculture activities to high technology industry.
* Tel.: +60 3 91702531; fax: +60 3 91737825. E-mail addresses: [email protected], [email protected]. 0531-5131/ D 2006 Published by Elsevier B.V. doi:10.1016/j.ics.2006.01.075
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M.N. Jemoin / International Congress Series 1294 (2006) 65–68
2. OHS: from legislation framework to practice In the last 40 years, the occupational safety and health legislation has undergone massive transformation. With the Occupational Safety and Health Act 1994 (OSHA 1994) the philosophy of ensuring safety and health in the workplace changed from one that was very prescriptive and containing detailed technical provisions under the Factory and Machinery Act (FMA) 1967 to one that is more flexible and encourages self-regulation [1]. OSHA 1994 was promulgated based on philosophy that bthe responsibility to ensure safety and health lies with those who create the risk and those who work with the riskQ [2].The initiatives to develop a more systematic and comprehensive OHS have become more prominent after OSHA 1994 with appointment of competent persons to conduct specific task. These include the occupational health doctors who are responsible to conduct medical surveillance program for workers who are exposed to specified hazardous chemicals. The current legislation framework also requires chemical health risk assessment (CHRA) to be performed by the qualified CHRA assessor. Hygiene technicians are responsible to conduct evaluation on engineering control equipment. It is also recognized that occupational health involves various disciplines to provide comprehensive protection of the health of all persons at work. Major components of OH include Occupational medicine, Occupational health nursing, Occupational hygiene and Ergonomics. These professional groups have been identified and their roles are clearly outlined in the Guidelines on Occupational Health Services which was recently launched early this year. The guidelines are developed to assist employers and occupational health practitioners in the implementation of appropriate levels of OHS in their respective organizations [3]. Functions and mechanism on how to implement OHS were also outlined. It is hoped that this important step will improve the delivery and organization of OHS in the country. 3. Current system and the main providers Currently, occupational health services are mainly provided by general practitioners in private practice who act as panel doctors to various companies. Their tasks are mainly to conduct pre-employment medical examination and medical surveillance and provide primary health care to the workers. To date there are 560 trained occupational health doctors in the country and most of them are general practitioners. The National Institute of Occupational Safety and Health (NIOSH) Malaysia provides a comprehensive 72 h training program for medical doctors before being certified as occupational health doctors (OHD). Training in occupational safety and health is also conducted by several universities in the country mainly as post graduate programs. The Department of Occupational Safety and Health (DOSH) under the Ministry of Human Resources is the agency responsible to enforce the occupational safety and health law. In recent years, the agency has undergone institutional strengthening by enhancing its manpower competencies to deal with current challenges. DOSH has also increased promotional activities in collaboration with other stakeholders. The Social Security Organization (SOCSO) is the one that traditionally provides compensation for injured workers. However, SOCSO has expanded its health promotion activities and enhancing the clinical services. It introduced certified training for disability
M.N. Jemoin / International Congress Series 1294 (2006) 65–68
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assessment i.e. Certified Medical Impairment Assessor (CMIA), developed Guidelines for assessment of traumatic injuries and occupational diseases and embarked on smart partnership with a private institution to provide rehabilitation for work related injuries. The Occupational Health Unit, Ministry of Health has been instrumental in conducting surveillance activities for the country. Most of the notification of occupational poisoning, injuries and diseases are provided by hospitals and health clinics under the Ministry of Health. Apart from that, it conducts regular occupational safety and health training for its employee. There are also various other agencies who provide assistance and support to the OHS in the country that include relevant ministries, professional associations, employer organizations and employee unions. 4. Challenges and the way forward It is realized that more need to be done to enhance OHS in the country particularly to develop a better system of OHS delivery and participation from the industry and other stakeholders. Transforming Malaysia into a developed country by the year 2020 has its own cost to be born by the workforce. Rapid industrialization has led to influx of not only state-ofthe-art technology but also numerous new hazards in the work environment. Workplaces in the country are subjected to the phenomenon of globalization with introduction of new technologies, work organizations, work processes and substances [4]. Numerous emerging occupational health issues such as chemical exposure, infectious diseases and mental health need to be attended and managed in appropriate manner. Other outstanding issues including lack of trained personnel, deficiency in enforcement, and the small and medium industries not having the proper infrastructure in place has posed a problem in efficient delivery of OHS [5]. A good OHS delivery is in need to deal with all these pressing challenges. Well designed Occupational Health Services should have the following functions that include surveillance of the work environment, initiatives on the control of hazards at work, surveillance of health of employees, adaptation of work and the work environment to the worker, organization of first aid and emergency response, health promotion and provision of curative services for occupational diseases. In the private sector, the responsibility for the provision of OHS lies with the employer. To this end, the employer has to make the necessary arrangements within its organization to ensure that there is the budgetary (both financial and human resource) provisions for the implementation of the appropriate type of OHS. In the Government sector, adequate arrangements should also be made to provide the appropriate protection for the health of employees. This is no different from the private sector which requires the expertise of OH practitioners to help identify the hazards, evaluate their risks, implement control measures, conduct medical surveillance and reevaluates the effectiveness of the control measures. Collaboration and coordination by all the OHS providers, both government and private agencies is essential to ensure efficient OHS delivery. In conclusion, comprehensive, well designed and accessible occupational health services are important to ensure the health and safety of the workforce.
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M.N. Jemoin / International Congress Series 1294 (2006) 65–68
Acknowledgements I would like to thank the officers from the Department of Occupational Safety and Health, National Institute of Occupational Safety and Health and Social Security Organization for their valuable assistance. References [1] Singh Harminder, Decades of Occupational Safety and Health in Malaysia, National Institute of Occupational Safety and Health (Malaysia), Bangi, Malaysia, 2004. [2] C.M. Abu Bakar, Perspective of occupational safety and health legislation in Malaysia, in: K.G. Rampal, I. Noorhassim (Eds.), Occupational Safety and Health in Malaysia, National Institute of Occupational Safety and Health (Malaysia), Bangi, Malaysia, 1996, pp. 1 – 13. [3] Department of Occupational Safety and Health (DOSH), Guidelines on Occupational Health Services, 2005. [4] K.G. Rampal, Current developments and future directions of occupational health in Malaysia, Med. J. Malays. 55 (3) (2000) 295 – 298. [5] Onn Abed, Occupational safety and health in the chemical industry, in: K.G. Rampal, I. Noorhassim (Eds.), Occupational Safety and Health in Malaysia, National Institute of Occupational Safety and Health (Malaysia), Bangi, Malaysia, 1996, pp. 95 – 100.
www.ics-elsevier.com
Status and future tasks of OHS in Malaysia Mohd Nizam Jemoin * Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jln Yaakob Latif, Bandar Tun Razak 56000 Cheras Kuala Lumpur, Malaysia
Abstract. The purpose of this paper is to describe the evolution and future tasks of occupational health services (OHS) in Malaysia. The initiatives to develop a more systematic and comprehensive OHS have become more prominent after Occupational Safety and Health Act 1994 with appointment of competent persons to conduct specific task. Various professional groups have been identified and their roles are clearly outlined in the Guidelines on Occupational Health Services which was recently launched. Collaboration and coordination by all the OHS providers, both government and private agencies is essential to ensure efficient OHS delivery. However, more need to be done to enhance OHS in the country particularly to develop a better system of OHS delivery and participation from the industry and other stakeholders. In conclusion, comprehensive, well designed and accessible occupational health services are important to ensure the health and safety of the workforce. D 2006 Published by Elsevier B.V. Keywords: Occupational health service; Legislation framework; Developing country; Malaysia
1. Introduction Workers’ access to occupational health services is limited to only 5–10% in developing countries. In Malaysia, there has been an urgent need to coordinate and further enhance the occupational health services (OHS) in order to deal with current and future challenges arising from the workplace. Comprehensive, systematic and accessible OHS are particularly essential to cater for nearly 10.5 million Malaysian workforces engaging in wide range of work i.e. from traditional agriculture activities to high technology industry.
* Tel.: +60 3 91702531; fax: +60 3 91737825. E-mail addresses: [email protected], [email protected]. 0531-5131/ D 2006 Published by Elsevier B.V. doi:10.1016/j.ics.2006.01.075
66
M.N. Jemoin / International Congress Series 1294 (2006) 65–68
2. OHS: from legislation framework to practice In the last 40 years, the occupational safety and health legislation has undergone massive transformation. With the Occupational Safety and Health Act 1994 (OSHA 1994) the philosophy of ensuring safety and health in the workplace changed from one that was very prescriptive and containing detailed technical provisions under the Factory and Machinery Act (FMA) 1967 to one that is more flexible and encourages self-regulation [1]. OSHA 1994 was promulgated based on philosophy that bthe responsibility to ensure safety and health lies with those who create the risk and those who work with the riskQ [2].The initiatives to develop a more systematic and comprehensive OHS have become more prominent after OSHA 1994 with appointment of competent persons to conduct specific task. These include the occupational health doctors who are responsible to conduct medical surveillance program for workers who are exposed to specified hazardous chemicals. The current legislation framework also requires chemical health risk assessment (CHRA) to be performed by the qualified CHRA assessor. Hygiene technicians are responsible to conduct evaluation on engineering control equipment. It is also recognized that occupational health involves various disciplines to provide comprehensive protection of the health of all persons at work. Major components of OH include Occupational medicine, Occupational health nursing, Occupational hygiene and Ergonomics. These professional groups have been identified and their roles are clearly outlined in the Guidelines on Occupational Health Services which was recently launched early this year. The guidelines are developed to assist employers and occupational health practitioners in the implementation of appropriate levels of OHS in their respective organizations [3]. Functions and mechanism on how to implement OHS were also outlined. It is hoped that this important step will improve the delivery and organization of OHS in the country. 3. Current system and the main providers Currently, occupational health services are mainly provided by general practitioners in private practice who act as panel doctors to various companies. Their tasks are mainly to conduct pre-employment medical examination and medical surveillance and provide primary health care to the workers. To date there are 560 trained occupational health doctors in the country and most of them are general practitioners. The National Institute of Occupational Safety and Health (NIOSH) Malaysia provides a comprehensive 72 h training program for medical doctors before being certified as occupational health doctors (OHD). Training in occupational safety and health is also conducted by several universities in the country mainly as post graduate programs. The Department of Occupational Safety and Health (DOSH) under the Ministry of Human Resources is the agency responsible to enforce the occupational safety and health law. In recent years, the agency has undergone institutional strengthening by enhancing its manpower competencies to deal with current challenges. DOSH has also increased promotional activities in collaboration with other stakeholders. The Social Security Organization (SOCSO) is the one that traditionally provides compensation for injured workers. However, SOCSO has expanded its health promotion activities and enhancing the clinical services. It introduced certified training for disability
M.N. Jemoin / International Congress Series 1294 (2006) 65–68
67
assessment i.e. Certified Medical Impairment Assessor (CMIA), developed Guidelines for assessment of traumatic injuries and occupational diseases and embarked on smart partnership with a private institution to provide rehabilitation for work related injuries. The Occupational Health Unit, Ministry of Health has been instrumental in conducting surveillance activities for the country. Most of the notification of occupational poisoning, injuries and diseases are provided by hospitals and health clinics under the Ministry of Health. Apart from that, it conducts regular occupational safety and health training for its employee. There are also various other agencies who provide assistance and support to the OHS in the country that include relevant ministries, professional associations, employer organizations and employee unions. 4. Challenges and the way forward It is realized that more need to be done to enhance OHS in the country particularly to develop a better system of OHS delivery and participation from the industry and other stakeholders. Transforming Malaysia into a developed country by the year 2020 has its own cost to be born by the workforce. Rapid industrialization has led to influx of not only state-ofthe-art technology but also numerous new hazards in the work environment. Workplaces in the country are subjected to the phenomenon of globalization with introduction of new technologies, work organizations, work processes and substances [4]. Numerous emerging occupational health issues such as chemical exposure, infectious diseases and mental health need to be attended and managed in appropriate manner. Other outstanding issues including lack of trained personnel, deficiency in enforcement, and the small and medium industries not having the proper infrastructure in place has posed a problem in efficient delivery of OHS [5]. A good OHS delivery is in need to deal with all these pressing challenges. Well designed Occupational Health Services should have the following functions that include surveillance of the work environment, initiatives on the control of hazards at work, surveillance of health of employees, adaptation of work and the work environment to the worker, organization of first aid and emergency response, health promotion and provision of curative services for occupational diseases. In the private sector, the responsibility for the provision of OHS lies with the employer. To this end, the employer has to make the necessary arrangements within its organization to ensure that there is the budgetary (both financial and human resource) provisions for the implementation of the appropriate type of OHS. In the Government sector, adequate arrangements should also be made to provide the appropriate protection for the health of employees. This is no different from the private sector which requires the expertise of OH practitioners to help identify the hazards, evaluate their risks, implement control measures, conduct medical surveillance and reevaluates the effectiveness of the control measures. Collaboration and coordination by all the OHS providers, both government and private agencies is essential to ensure efficient OHS delivery. In conclusion, comprehensive, well designed and accessible occupational health services are important to ensure the health and safety of the workforce.
68
M.N. Jemoin / International Congress Series 1294 (2006) 65–68
Acknowledgements I would like to thank the officers from the Department of Occupational Safety and Health, National Institute of Occupational Safety and Health and Social Security Organization for their valuable assistance. References [1] Singh Harminder, Decades of Occupational Safety and Health in Malaysia, National Institute of Occupational Safety and Health (Malaysia), Bangi, Malaysia, 2004. [2] C.M. Abu Bakar, Perspective of occupational safety and health legislation in Malaysia, in: K.G. Rampal, I. Noorhassim (Eds.), Occupational Safety and Health in Malaysia, National Institute of Occupational Safety and Health (Malaysia), Bangi, Malaysia, 1996, pp. 1 – 13. [3] Department of Occupational Safety and Health (DOSH), Guidelines on Occupational Health Services, 2005. [4] K.G. Rampal, Current developments and future directions of occupational health in Malaysia, Med. J. Malays. 55 (3) (2000) 295 – 298. [5] Onn Abed, Occupational safety and health in the chemical industry, in: K.G. Rampal, I. Noorhassim (Eds.), Occupational Safety and Health in Malaysia, National Institute of Occupational Safety and Health (Malaysia), Bangi, Malaysia, 1996, pp. 95 – 100.