occupational diseases- the malaysian scenario

OCCUPATIONAL DISEASES-THE MALAYSIAN SCENARIO

DR. MOHAMMED AZMAN BIN AZIZ MOHAMMEDMBBS (MALAYA), LFOMRCP (IRELAND)

CIME ABIME (USA), CMIA(NIOSH)

General Manager,Department

Medical & Rehabilitation Social Security Organisation (SOCSO)

Malaysia

1

CONTENTS1. Introduction to Occupational Diseases in

Malaysia2. Legal aspects – Acts & Regulations3. Statistics of Occupational Diseases4. What has been done?5. Obstacles in early detection, diagnosis

notification6. What we plan to do?

- Role of doctor, employers & employee7. Conclusion

2

QUESTIONS

1. How is the occupational diseases list system organised in your country?

2. Which occupational diseases are included in the list?

3. When was the list first established and last updated?

4. Who is responsible for amending lists?

3

How is the list system organised?

At the national level the list of occupational diseases is determined by:-

1. Department of Occupational Safety & Health, Ministry of Human Resource – (Notification)

2. Social Security Organisation-(Compensation)3. Workmen Compensation-(Compensation)4. Occupational Health Unit.Min. of Health-

(Treatment, monitoring & coding according to International Classification Disease (ICD-10)

4

Which occupational diseases are included in the list?

This is detemined by the Acts & Regulations that govern:-

1. Notification of occupational diseases• Factories & Macheinery Act 1967• Occupational Safety and Health Act 19942. Compensable occupational diseases

Employees Social Security Act 1969-Malaysian worker

3. Workmen’s compensation Act 1952- Foreign worker

5

LAWS RELATED TO OCCUPATIONAL DISEASES & POISONING

1. FACTORIES & MACHINERY ACT 1967Poisoning or disease arising out of or in connectionwith work and is of a class specified in Schedule 3...\My Documents\OdhFMA3rdSch.doc15 DISEASES

- Lead regulations 1984- Asbestos Process 1986- Mineral Dust 1989- Noise Exposure 1989

6

Abstract from

FACTORIES & MACHINERIES ACT 1967 THIRD SCHEDULE

(Section32 )NOTIFIABLE INDUSTRIAL DISEASES

1. Dust diseases of the lungs(a) Silicosis – inhalation of (Sio2) silica containing dust(b) Stannosis- inhalation of tin dusts or fumes (c) Siderosis or Sidero-silicosis inhalation of dust containing

iron, silica & haematitie

7

Occupational Disease

Defined in

OCCUPATIONAL SAFETY AND HEALTH ACT 1994Poisoning or disease arising out of or in connection with work and is of a class specified in Schedule

Declaration of Occupational Diseases (OSHA)...\My Documents\OdOshaDeclaration.doc

8

Abstract from

OCCUPATIONAL SAFETY HEALTH ACT 1994DECLARATION OF OCCUPAIONAL DISEASES

SCHEDULELIST OF OCCUPATIONAL DISEASES

Description of occupational diseasesA. POISONING1. Poisoning by:

(a) Acrylamide monomer;(b) Alcohols, glycols, ketones or aldehydes(c) Antimony(d) Arsenic

9

COMPENSABLE OCCUPATIONAL DISEASES formulated in 1969

Employees Social Security Act 1969 Section 28Section 28

If an employee who is employed in any occupation described If an employee who is employed in any occupation described in the in the 5 5 thth ScheduleSchedule contracts any contracts any diseasedisease or injury shown in or injury shown in the said Schedule to be related that occupation , or if an the said Schedule to be related that occupation , or if an employee who has been employed in such occupation employee who has been employed in such occupation contacts such a disease or injury within contacts such a disease or injury within 60 months60 months after after ceasing to be employed, the contacting of the disease or ceasing to be employed, the contacting of the disease or injury shall, unless the contrary is proved , to be deemed to beinjury shall, unless the contrary is proved , to be deemed to bean employment injury arising out of & in the course of an employment injury arising out of & in the course of employmentemployment..\My Documents\OdESSASch5.doc

10

Abstract from EMPLOYEE’S SOCIAL SECURITY ACT 1969

FIFTH SCHEDULE OCCUPATIONAL DISEASES

(Section 28)

Description of occupational diseases or injuryPoisoning by:(a) Lead or compound

of lead

Nature of occupationAny occupation involving –the use or handling of, or exposure to, the fumes, dust or vapour of lead or a compound of lead substancecontaining

11

12

OCCUPATIONAL DISEASE

194183189216204278

192178

832

1089

1247

0

200

400

600

800

1000

1200

1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005

Total CasesSocso Annual Report 1995-2005

13

502

2,942

1,0261,145

1,2481,089

832

178 192 278 204 216 189 185 194

0

500

1000

1500

2000

2500

3000

1991 1993 1995 1997 1999 2001 2003 2005

Ocuupational Diseases

ALL TYPES OCCUPATIONAL DISEASES

Occupational Diseases from DOSH

41

40

170

134

57

Occupational Lung Disease skin disease noise induced hearing loss

chemical poisoning other

14

15

CASES OF OCCUPATIONAL LUNG DISEASE1995-2004

29 29

1714

33

12

6

9

13

17

0

5

10

15

20

25

30

35

1995 1996 1997 1998 1999 2000 2001 2002 2003 2004Socso Annual Report

16

Occupational lung disease ‘95 ‘96 ‘97 ‘98 ‘99 ‘00 ‘01 ‘02 ‘03 ‘04

1 Pneumoconiosis 6 3 0 1 2 4 5 1 7 7

2

Brochopulmonarydisease due toHard metal dust 0 0 1 1 2 3 2 1 2 2

3BrochopulmonaryCotton,falx,hemp 1 4 3 2 1 3 2 1 1 1

4 Occupational asthma 2 0 3 1 4 5 0 6 6 6

5Extrinsic allergicalveolitis 1 2 1 1 2 6 0 2 2 2

6 Siderosis 0 0 0 0 0 1 0 0 0 0

7Chr. ObstructivePulmonary Disease 0 2 0 0 0 4 0 2 0 0

8Lung diseases due to Aluminium 0 1 0 0 0 0 0 0 0 0

9 Upper airway disorder 1 1 0 0 1 4 0 0 4 4

10 Others 6 0 1 0 2 3 5 4 7 7

TOTAL 17 13 9 6 14 33 14 17 29 29

CHEMICALS CAUSING OCCUPATIONAL DISEASES 1995-2004

90

113

1712

35 37

1

12

54

11

0

20

40

60

80

100

120

1995 1996 1997 1998 1999 2000 2001 2002 2003 2004

17Socso Annual Report Year

18

NOISE INDUCED HEARING LOSS CASES 1995-2004

65

24

46

58

4

26

59

1

48

0

10

20

30

40

50

60

70


19

OCCUPATIONAL DISEASES DUE TO BIOLOGICAL AGENTS 1995-2003

1

6

1 1 1

3

4 4

2

0

1

2

3

4

5

6

7

1995 1996 1997 1998 1999 2000 2001 2002 2003

Socso Annual Report

20

OCCUPATIONAL CANCER 1995-2004

33

194

57 61 5386

18

65

115

464

0

50

100

150

200

250

300

350

400

450

500


8438 52

82

0 109

328

541

600

151030 0 1 1 20

100

200

300

400

500

600

700

1995 1996 1997 1998 1999 2000 2001 2002 2003 2004

Occupational skin disease due to Physica, Chemical & Biological agents and cases of vitiligo

Vitiligo

21Socso Annual Report

22

MUSCULO-SKELETAL DISORDERS 1995-2004

8

3

8

3

00

22

5

0

1

2

3

4

5

6

7

8

9

1995 1996 1997 1998 1999 2000 2001 2002 2003 2004

Socso Annual Report

Reasons for poor reporting

• No anticipation of diseases in various sectors

• No surveillance of exposures to hazards• Unrecognised & undiagnosed by doctor• Unrecognised by the worker as they are

not aware of the hazards has long effect / outcome

23

What we have done?

24

1. In collaboration with other agencies produced Guidelines on occupational diseases:-

• Criteria for the diagnosis of Occupational Lung Disease

• Criteria for the diagnosis of the Occupational Skin Disease

• Criteria for the diagnosis of occupational Noise Included Hearing Loss

• Criteria for the diagnosis of Occupational Pesticide Poisoning and early treatment

2. Compulsory Training of 4,000 SOCSO panel doctors in occupational health in collaboration with National Institute of Occupational Safety & Health (NIOSH)

What we have done?

3. Train doctors of the Medical and Appellate Medical Board in occupational diseases using the Guidelines on Impairment and Disability Assessment of Traumatic Injuries, Occupational Diseases 2006

4. Support Continuous Medical Educationa of doctors to identify and notify occupational diseases in collaboration with Society of Occupational & Environment Medicine and other no government organisations

26

What we have done?

5. Social Security Organisation gives grants for promotion of Occupational Safety and Health activities & publications

6. Drafted the amendments to the list of compensable occupational diseases under the Employees, Social Security Act 1967 according to the International Classification of Diseases ICD-10

..\My Documents\OdEssa5thAmend.doc27

New format of occupational disease according to ICD 10

Agent Disease Occupation/IndustryChemical

agentsMetals & its compounds

Any occupation involving the use or handling (manufacture, transport, storage, disposal ) or exposure ( > PEL) to, the metal & its toxic fumes, dust vapour or the material

Aluminum Respiratory irritant, chronic bronchitis, pulmonary fibrosis, pneumoconiosis, dermatitis

Used as phosphor binders. Includes cans, containers and wrappings manufacture; welding jobs, ceramic making (aluminum oxide); antiperspirant production; aluminum reduction plants; and in industries making pigments, paints and catalysts

28

OCCUPATIONAL DISEASES

PROBLEMS & SOLUTIONS

29

Occupational Diseases reported do not cover :-

1. Foreign workers - legal

2. Illegal foreign workers -1.2 million

3. Informal sector -Self employed, work from home, familybusiness

4. Contract workers, seasonal workers, part-time esp.agriculture

30

Occupational Diseases reported do not cover:-continue

5. Public / Government sector

6. Those earning RM > 3,000

7. Illegal workplaces

8. Those diseases with long latent period and no comprehensive follow-up

31

REFUSAL TO NOTIFY DISEASES

• Fear visits by agencies, closure of operations / stop work order / seal equipment

• Foreign workers will be deported – loss of workforce & money spent to bring them

• Fear dismissal / discrimination by employer

Employers

Employees

32

REASONS FOR POOR REPORTING BY SOCSO DOCTORS

1. Fear termination of contract if doctors report poisoning / disease to Government agencies

2. Frequent movement of workers3. Reluctance of employers to comply or adhere to

certain health examination criteria4. Limited payment for total comprehensive tests

discourage doctors from carrying out the necessary tests for diagnosis of occupational diseases

33

348

TOTAL OF CONTRIBUTION & BENEFIT PAYMENT

1,380,972,917

1,213,709,000

1,095,136,0001,047,728,000

990,051,000

898,726,000878,532,000

879,435,000

237,629,000290,287,000

366,951,000

499,086,000

573,670,000

672,988,000757,512,000

1,143,628,000

890,210,00

754,000,000

638,384,660585,788,000

506,477,000

383,906,000

316,184,310

100,216,000

120,177,425

139,379,955

214,975,390 211,905,426288,981,198

629,640,000 722,400,000

830,176,000

0

200,000,000

400,000,000

600,000,000

800,000,000

1,000,000,000

1,200,000,000

1,400,000,000

1,600,000,000

1990

1991

1992

1993

1994

1995

1996

1997

1998

1999

2000

2001

2002

2003

2004

2005

Contribution Benefit Payment

SOCSO’S O.S.H. FUTURE STRATEGIES

• No occupational disease /injury is our major aim.• Minimal occupational diseases & injuries is secondary

aim.1. SOCSO is making amendments in the 5th Schedule of

compensable occupational diseases according to International Classification of Diseases (ICD10 ). Please see the

2. SOCSO has produced the Guidelines for the Diagnosis of Occupational Diseases 2006

3. Investigate & Study Occupational Injury & Diseases to establish Data Base for sharing especially for prevention of occupational diseases.

35

36

CONCLUSION

More comprehensive notification ofoccupational diseases is needed so that:-1.Surveillance & identification of risk

factors to enable holistic preventive actions can be implemented

2.Compensation can be given to those who really deserve it

Dr. Mohammed Azman Bin Aziz Mohammed

General ManagerMedical & Rehabilitation Department

Social Security Organization, Malaysia

[email protected]

37

mailto:[email protected]