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
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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
1995 1996 1997 1998 1999 2000 2001 2002 2003 2004Socso Annual Report
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
1995 1996 1997 1998 1999 2000 2001 2002 2003 2004Socso Annual Report
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
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What we have done?
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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
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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
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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
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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
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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
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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
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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
37
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