- 1. pageOCCUPATIONAL HEALTH SURVEILLANCEGOOD HEALTH IS GOOD
BUSINESS Pakistan Petroleum Limited
2. OVER VIEW
- What is an Occupational Health?
- Importance of Occupational Health
- Health Surveillance of Staff at risk.
- Use of drugs & alcohol at workplace.
- General housekeeping of residence blocks, dining halls (messes)
& sanitation
3. CONTROLLING HEALTH RISKS AT WORK
- Occupational health is concerned withprotecting the health of
people engaged in work or employment.
- The goal of occupational health and safety program is to foster
a safe & healthy work environment
4. HEALTH HAZARDS
- Health hazardshave potential to adversely affect the health of
individuals or groups and potential to cause occupational diseases
which may be (acute, delayed or chronic) with varying degrees of
disability and even death
- Noise induced hearing loss
- Irritant Contact Dermatitis
5. SAFETY HAZARDS
- Safety hazards have the potential to cause sudden injury
- Working with Grinders with out guards
6. LIFTING
- Lifting heavy items or lifting items incorrectly, can cause
serious back Injury , Hernia and Crushing injuries
7. HERNIA 8. LIFTING 9. UPPER LIMB DISORDERS 10. WHO AND
OCCUPATIONAL HEALTH
- It is the fundamental right of each worker to get higher
attainable standard of health and occupational health services
should be ensured for all workers.
- When work is fully adapted to human goals, capacities, and
limitations, and occupational health hazards are under control,
work often plays a role in promoting both physical and mental
health.
11.
- 270 million occupational accidents and 160 million work-related
diseases occur annually world wide.
- 6,000 (on an average) people die as a result of
work-relatedaccidents or diseases, making it 2.2 million fatalities
annually:
-
- 1.7 million deaths due to work related diseases
-
- 0.35 million fatalities due to workplace accidents
-
- 0.15 million fatalities due to accidents during commuting
- 4% (approximately) of the worlds gross domestic product is lost
with the cost of injury, death and disease through absence from
work, sickness treatment, disability and survivor benefits.
ILO STATISTICSOCCUPATIONAL HEALTH AND SAFETY 12. ILO
OCCUPATIONAL HEALTH ANDSAFETY COVENTION C155 (1981)
- Sets out broad requirements for member states to follow to
ensure health and safety requirements are set into national
laws.
- The employers are responsibleso far as reasonably practicable ,
the workplaces, machinery equipment and process under their control
aresafe and without risk to healthand
- Appropriatemeasures of protectionare taken.
- The employers must also providemeasures to deal with
emergencies and accidents.
13. ILO OCCUPATIONAL HEALTH SERVICESCONVENTION (C.161) 1985
- Each member state shall formulate implement and periodically
review national policy on occupational Health services
- Each member state undertakes to develop progressively
occupational health services for all workers including those in the
public sector
- The provision made should be adequate and appropriate to the
specific risks of undertaking
14. LAGISLATION REGARDINGOCCUPATIONAL HEALTHAND SAFETYIN
PAKISTAN
- West Pakistan Hazardous Operations Rules 1963
- Workman's Compensation act 1923 and Rules 1961
- Provincial Employees social Security Regulations 1967
- The Oil and Gas (safety in drilling and production) Regulations
1974
- Hazardous Substances Rule 2003
15. BENEFITS OF OCCUPATIONAL HEALTH PROGRAMME
- Prevents cost of absence and ill-health redundancy
- Reduction in re-training and recruitment costs.
- Helps in retention of staff and build employee loyalty
- Increased productivity leading to increased profits
- Compliance with Legislation
- Decrease employer liability
- Reduced risk and cost of litigation
- Rise in public profile of the company
- Helps to prevent occupational diseases like deafness, cancers,
asthma, etc
- Protection of both physical and economic well being of
employees
- Corporate social responsibility
16. OBJECTIVEOF OCCUPATIONAL HEALTH SURVEILLANCE PROGRAM
- Occupational health programme helps to ensure that people can
be as effective as possible in their work and their health is
protected
- Occupational health risks are addressed at work place
- Medical checks to ensure that employees remain in good health
and not being harmed by their work
- Compliance with Occupational health and safety legislation
17.
- HEALTH SURVEILLANCE PROGRAMME
- Identifying the occupational injury / illness
- Assessment of Occupational health hazards
- Implementation of controls to eliminate root causes of health
hazards
- Managing treatment in systematic manner
- Managing Sickness absence
- Optimizing business performance and reputation
18. SCOPE OF OCCUPATIONAL HEALTH PROGRAMME
- deals with following areas of Occupational Health:
- Health Surveillance of Staff at risk.
- Use of drugs & alcohol at workplace.
- Fumigation & pest control.
- General housekeeping of residence blocks, dining halls (messes)
& sanitation etc.
19. HEALTH RISK ASSESSMENT (HRA)
- The identification of health hazards in the workplace and the
subsequent assessment of risk to health due to these hazards.
- This assessment takes into account existing control measures
and where required additional measures are adopted to reduce risks
to ALARP .
- HRA must be carried out for
- All new activities and developments
- Changes in existing activities
- For post-operating activities
Danger 20. OCCUPATIONAL HEALTH SURVEILLANCE PROGRAMME
- Organize a competent team
-
- Dept / Section Head Team Leader
-
- Field HSE Representative Member
-
- Site MedicalOfficer Member
- Break down areas for HRA into Assessment Units (AU)
- Workshop, Store, Control room, Plant, Well Head etc
21. OCCUPATIONAL HEALTH SURVEILLANCEPROGRAMME
- Step-3 : Exposure Categorization
- Identify the Performance Standards
-
- National / International standards
- benchmark against accepted standards.
S.No. HAZARD CATEGORY ASSOCIATED HAZARDS 1 Geographical /
Location Temperature & climate Humidity & air quality
Potential for catastrophes etc 2 Biological Wildlife Epidemic
disease Hygiene Occupational illness (due to virus, bacteria, fungi
etc) 3 Physical Noise Vibration Ergonomic Pressure Radiation
(Ionizing / Non ionizing) etc 4 ChemicalToxic chemical Dust, mist
& fumes Acid, alkalis, carcinogens etc 5 Psychological Stress
factors Smoking etc 22. OCCUPATIONAL HEALTH
SURVEILLANCEPROGRAMME
- Step-4 : Effectiveness ofExisting controls
- Ensure that existing controls are effective and maintained
- The effectiveness of control measures can be ensured by
-
- Routine exposure monitoring
23.
- Step-5: Health Risk Assessment:
- A health risk is generally defined as the likelihood that
exposure to a hazard will result in occupational illness,
disability or death (Severity).
- The risk is obtained by combining the probability with
severity
- Risk (R) = Probability / Likelihood (P)X Severity (S)
- RAM Categorizes Health hazards as Very High, High, Medium,
low
24. HEALTH RISK ASSESSMENT MATRIX 25. SETTING PRIORITIES
- The priorities to hazards depends upon the hazards caused by
them
Risk Risk Rating 20-25 Intolerable / Very High (VH) 12 - 16 High
(H) 8-10 Medium (M) < 8 Low (L) 26. HEALTH RISK ASSESSMENT
MATRIX Severity Likelihood / Probability (P) Rating Consequence
Very Unlikely (Could happen but probably will not) Unlikely (Could
happen but very rarely) Often Likely (Could happen at some time)
Likely (Could happen once in a year) Extremely likely (Could happen
at any time) 1 2 3 4 5 1 No health effect Low 2 Minor /
slighthealth effect Medium 3 Major health effect 4 Single
fatalities High 5 Multiple fatalities Very High 27. HEALTH RISK
ASSESSMENT MATRIX Severity Likelihood / Probability (P) Rating
Consequence Very Unlikely (Could happen but probably will not)
Unlikely (Could happen but very rarely) Often Likely (Could happen
at some time) Likely (Could happen once in a year) Extremely likely
(Could happen at any time) 1 2 3 4 5 1 No health effect No
Immediate Action Required 2 Minor / slighthealth effect Third
Priority 3 Major health effect 4 Single fatalities Second Priority
5 Multiple fatalities First Priority 28. OCCUPATIONAL HEALTH
SURVEILLANCEPROGRAMME
- Step-7 Determine the additional control measures
- If Control Measures are not enough to control Risks
- Identify the additional controls to limit risk to ALARP
- Compare the additional controls with existing controls and
identify gaps
- Identify and agree remedial actions to address the
29. PRIORITOIES TO CONTROL HAZARDS
- Notify management immediately
- Implement immediate control improvements, e.g. introduce use of
Personal Protective Equipment as a short term measure until other
more robust controls are in place
- Consider need for exposure measurement
- Identify and implement work practice and control improvements -
consider hierarchy of controls
- Review HRA, including measurements, after improvements are
made
30. PRIORITOIES TO CONTROL HAZARDS
- Reduce exposure to below NEQS
- Introduce use of Personal Protective Equipment as a short term
measure until other more robust controls are in place
- Identify and implement work practice and control improvements -
consider hierarchy of controls
- Consider need for exposure measurement
- Review HRA, including measurements, after improvements are
made
31. PRIORITOIES TO CONTROL HAZARDS
- Identify and implement work practice and control improvements -
consider hierarchy of controls
- Consider need for exposure measurement
- Review HRA, including measurements, after improvements are
made
32. HIERARCHY OF CONTROLS 33. NOISE REDUCING CONTROLS Re-design
or maintain Acoustic Guard Absorb or Shield Enclose the person
Shadow Noise 34. OCCUPATIONAL HEALTH SURVIELLANCEPROGRAMME
- Step 8: Remedial Action Plan
- Remedial action Plan should state the Additional control and
recovery measures.
- Remedial action plan should be SMART.
- This plan should include priorities, responsible person and
target dates for actions.
35. OCCUPATIONAL HEALTH SURVEILLANCEPROGRAMME
- Step-9: Documenting Health Risk Assessments
- The record of HRA is kept and retrievable for Audits and
periodic reviews.
- For chronic health risks records should be kept for long period
to allow the evaluation of individual health effects.
- Include exposure monitoring and health surveillancerecord
- Itmay act as insurance against possible future
liabilities.
- Findings of HRAs should be communicated
36. PRE -EMPLOYEMENT HEALTH SCREENING
- To determine the pre-existing health conditions of individuals
prior to commencement of work
- To make sure that he / she is physically and mentally fit for
the type of activity he / she is employed for.
- At the time of employment , HR/ IR arrange pre-employment
medicalexamination in liaison with Medical Dept.
- General physical Examination
37.
- Specialized testswill be conducted for staff deputed on
specialized jobs or they have special requirements as part of their
job like crane or fork lift operators , drives, Electrical
Technicians
- Pre employment Medical Record will be maintained in personal
file of individual by Medical Dept. at HO
38. PREIODIC HEALTH SURVEILLIENCE
- Periodic Health Surveillance will be conductedfor staff:
- At risk from workplace exposure
- In compliance with regulatory requirement
- To detect early, reversible health affects
- Periodic Surveillance Record will be maintained at Field /
Location level.
39. OCCUPATIONAL HEALTH SURVEILLANCE PROGRAM
- At initial stages the Occupational Health Surveillance Program
is focused on
- Fork Lift and crane operators
- Any case identified by Dept. Head / Field Incharge
40. S. No Cadre Occupational Exposures Possible Hazards
Surveillance Required Frequency ScreeningVaccination 1 Production/
Maintenance TechniciansNoise level above 85 for 8 - hrs a day
Hearing loss Color blindness Audiometric Test -- Annual Color
Blindness (Only for electrical technicians) --- Initially / Upon
entry 2 Vehicle Drivers Driving for company business Vision &
hearing loss Eye Test -- Annual Audiometric Test -- Initially /Upon
entry Color Blindness --- Initially / Upon entry 3 Fork Lift /
Crane Operators Loading / unloading driving Vision & hearing
loss Eye Test -- Annual Audiometric Test -- 2 - Yearly Color
Blindness --- Initially / Upon entry 41. S. No Cadre Occupational
Exposures Possible Hazards Surveillance Required Frequency
ScreeningVaccination 4 SF Hospitals Staff Infectious agents in
blood and other body fluids, while handling the
patients.Transmission of contagious diseases from patients -
Hepatitis B Complete Course - Tetanus 5 Yearly 5 Canteen Staff
Preparation of food for PPL Staff Transmission of contagious
diseases e.g. Typhoid, Hepatitis A and parasitic infections. X Ray,
SGPT and Stool D / R ---- Upon entry ---- HepatitisA Upon entry
----- Typhoid Upon entry Medical Review by Company Doctor / CMA
based on medical screening results of SGPT and Stool D / R ----
Annually 6 Janitorial Staff Exposure to effluent & hazardous
wastes Susceptible to diseases like Typhoid, Hepatitis etc---
Hepatitis B Complete Course --- Tetanus 5 - Yearly 42. S. No Cadre
Occupational Exposures Possible Hazards Surveillance Required
Frequency ScreeningVaccination 7 Janitorial Staff Exposure to
effluent & hazardous wastes Susceptible to diseases like
Typhoid, Hepatitis etc--- Tetanus 5 - Yearly 8 Radiology Lab Staff
Radiation CBC Urine Chest X-Ray --- Annually 9 Firemen Use of
breathing apparatus in Smokey conditions of fire. Emergency Sirens
of high pitch during emergency. Susceptible to cardio-respiratory
distress and syncope.Vision & hearingMedical fit test for use
of Breathing Apparatus as per checklist provided in HSE SOP on PPE
--- Annually Vision --- Annual for Staff above 45 yrs. Two yearly
for Staff below 45 yrs. Audiometric --- Two yearly for all Staff
43. EXECUTION OF HEALTH SURVEILLANCE PROGRAM 44. HEALTH
SURVEILLANCE OF CONTRACTORS
- The relevant concerned Dept. shallincorporate Health
Surveillance Requirements in Contracts with third party
- Health Surveillance of Contractor staffis responsibility of
Contractor . However itwill also be recorded by PPL
- If Health Surveillance is not covered in work Contract than PPL
will arrange for Health Surveillance.
- Initially Health Surveillance will be focused on
45. HEALTH SURVEILLANCE OF CONTRACTORS
- Admin. Dept. HO shall incorporate the Health Surveillance
requirements into the Contract Document with the Catering /
Janitorial Service / Transport Contractors and extend necessary
coordination with Medical & HSE Dept.at HO for monitoring
implementation by these contractors.
- The actions taken by Field Management in response to
recommendations of OHS for the implementation of additional control
measures are recorded in template (PPL HSE / FM / HS / 02 &
03).
- Dept. Head / FieldIncharge will acquire record(s) of
vaccination and health surveillance of contractors Staff and
forward to Medical Dept. for necessary review and
recommendations.
- Any new entry into the record shall be maintained at contract
executing Dept.'s end.
46. DISEASE STATISTICS
- At Fields Site Company Medical Advisor (CMA) in coordination
with Field HSE Representative develops and forwards the Disease
Analysis Record Sheet (PPL - HSE / FM / HS / 04) on monthly basis
to OHS with copy to HSE Dept. HO through respective Field /
Location Incharge for their record and onward maintaining
statistical data.
- At Sui the sickness and illnesses data of PPL Staff is
centrally consolidated and forwarded through Sui Hospital.
- At HO the same is developed and maintained by Medical
Dept.
- For any contagious diseases, immediate actions may be taken on
CMA's recommendations. However, the detailed guidelines may be
obtained from OHS.
47.
- First aid is the immediate application of first line treatment
following an injury or sudden illness using facilities &
material available in order to
- Prevent deterioration in an existing condition.
FIRST AID 48.
- Provided at desired places on location of Head Office and
Fields and Messes
- Field In charges to nominate individuals for inspection and
Replenishment of First Aid Boxes
- At HO, WW & PPL owned Huts, Geological Survey Teamsfirst
aid boxes are inspected & maintained by Medical Dept. HO
- Emergency cabinets are provided at each floor at HO are
maintained by Admin Dept. and verified by HSE Dept.
FIRST AID BOXES 49.
- Department Head / Field Incharge are responsible for Nomination
and arrangements for training of Emergency Response Team Members
(ERTMs)
- Refresher training every two years for first aiders.
- List of names, telephone numbers of First Aiders will be
maintained in all Dept. / Field / Locations
- List of First aiders will be posted on notice boards
- List of ERTMswill be forwarded to
- SMMS / CMO / CMA for necessary
- assessment and clearance before
- The assessment is recorded on form
- (PPL - HSE /FM /HS / 09).
FIRST AID TEAM 50.
- Proper ambulance shall be available at Fields / Locations
equipped with necessary first aid accessories.
- At project sites any appropriate vehicle may be dedicated on
emergency duty during job in progress.
- Vehicle must contain first aid box and Stretcher for onward
shifting patient to nearby hospital.
- The ambulance should be checked on daily basis and records
maintained in Ambulance Inspection Checklist (PPL - HSE / FM / HSH
/ 05).
-
- Vehicle Check-listmaintained by drivers
-
- First Aid equipment by Field / Location Medical Technician /
Medical Dept. Representative.
- Review of report by Field HSE Representative / Coordinator
AMBULANCE 51. BLOOD BORNE PATHOGENS & HEALTH HAZARDS
- Hospital Staff are exposed to following Major Health
Risks..
- Precautionary Measures shall be taken to avoid exposure to
health risks
52. FATIGUE MANAGEMENT
- Fatiguerefers tomental or physical exhaustion that reduces work
efficiency.
- However fatigue is more thansimply feeling tired or
drowsy.
- Fatigue is caused by prolonged periods of physical and or
mental exertion without enough time to rest and recover.
- PPL Fields / Locations are provided with facilities to balance
out work requirement and medical fitness for staff to appropriately
prevent / manage fatigue.
- Recreational activities, social events / functions /
gathering.
- Working in Shift, avoiding prolonged exposures.
- Annual leaves / holidays.
- Ergonomically designed work stations
53. KITCHEN HYGIENE & DINNING
- Appropriate Kitchen and Food Safety standards shall be
maintained at PPL Head Office and all PPL Locations
- HSE Representatives / Coordinators along withAdministration
Dept. / Section responsible quarterly inspection of kitchen &
dining areas as per checks provided in Kitchen Hygiene Inspection
Checklist (PPL - HSE / FM / HS / 06).
54. PERSONAL HYGIENE
- Appropriate personal hygiene standards shall be
maintained(Detailsare Given in procedure)
- Food handlers shall be assessed for their healthCMA / CMO Sui /
Medical Dept. at HO.
- The assessment / physical examination is carried out by
Occupational Health Specialist at HO, CMA at Field / Location and
suitable nominated doctor by CMO Sui Hospital.
- Assessment is recorded on Form Food Handlers Initial Assessment
(PPL - HSE / FM / HS / 07) .
55. FOOD MANAGEMENT
- Food Storage / Refrigeration
- Prevention from Contamination
- Food waste must be stored in completely covered containers as
per guidelines provided in SOP on Waste Management (PPL - HSE / PR
/ 14) for onward safe disposal.
- Field HSE Representative / HSE Coordinator shall provide
awareness and training to all food handlers on food safety &
personal hygiene for effective implementation of standards outlines
in this procedure.
56. WATER QUALITY
- Water utilized for drinking and cooking purpose at Fields /
Locations shall be from approved sources
- comply with the chemical and bacteriological limits specified
in Quality Drinking Water Standards specified by Ministry of
Health, Govt. of Pakistan.
- PPL Occupational health specialist shall approve the source
based on certain testing from external laboratories or certificate
submitted from the supplier.
- Water used for dish washing, lavatories etc. shall be stored in
aboveground tanks. All underground and above ground tanks are
internally cleaned at least annually to avoid chances of
microbiological accumulation.
- Fields / Location where water is supplied through tankers /
bowzers,
- It will beensured that tankers / bowzers are internally clean
and in good physical condition.
- CMA / Field HSE Representative / HSE Coordinator shall carry
out random inspections of tankers / bowzers and address this
requirement in work contract.
57.
- PPL views alcohol and drugs abuse very seriously.
- Alcohol in any form is prohibited at all PPL work sites, Any
employee proved to be in possession of alcohol will be summarily
dismissed.
- Any member of Staff arriving at a workplace under the influence
of alcohol will not be permitted to enter the premises.
- The use of drugs, except under medical advice, is prohibited at
all locations.
- Any employee proven to be under the influence of or in
possession of controlled drugs will be summarily dismissed and the
facts reported to the police.
USE OF DRUGS & ALCOHOL 58. HOUSE KEEPING
- Appropriate House Keepingshall be maintained at all work sites
( Details are given in procedure)
- HSE Field Representatives / Coordinators in consultation
withmedical Staff / Admin. Dept. shall carry out spot checks of
rooms & toilets and recommend remedial measure for continuous
improvement.
- Residential Areas, Dinning halls shall be maintained
appropriately
- HSE Field Representatives / Coordinators in consultation
withmedical Staff / Admin. Dept. shall carry out spot checks of
rooms & toilets and recommend remedial measure for continuous
improvement.
59.
- MONITORING AND RECORD KEEPING
- The overall performance of this program is monitored by HSE
Dept. HO through HSE Internal Audits and relevant record is
maintained at Field / Location / Admin. Dept. at HO.
- HSE & Medical Dept. will evaluate the overall performance
of this procedure on annual basis.
- Field HSE Representative / Coordinator shall identify the
training need as per TNA in coordination with Occupational Health
Specialist.
60. RESPONSIBILITIES
- Overall Co-ordination of managing Health Surveillance
Program
- Monitoring of implementation
- Recommend preventive measures to
- Departmental Head / Field Incharges
- in close liaison with Occupational Health Specialist
- Review on annual basis and update
- Implement Health Surveillance Program across PPL.
- Carry out Assessment of nature, severity, extend of injury /
illness.
- Recommendstreatment of individual and preventive measures to
avoid re-occurrence.
- Seek all budgetary approval required for execution of this
program.
- Nominate Occupational Health Specialist (OHS) for execution of
this program.
61. RESPONSIBILITIES
- . Occupational Health Specialist
- Carrying out assessment, suggest treatment plans &
recommend actions for prevention of occupational injury / illness
and follow up through periodic checks.
- Provide training to Field HSE Representatives / Coordinators
for the identification & preliminary assessment of occupational
injuries and illnesses.
62. RESPONSIBILITIES
- Dept. Head / Field / Location Incharge
- Ultimately responsible for implementation of Occupational
Health Procedure on his location
- Reporting occupational injuries / illnesses to Medical Dept. HO
along with initial findings of risk assessment for onward
action.
- Implementing the recommendation of Medical & HSE Depts.
HO.
- Regularly monitoring the compliance of recommendations.
- Inspection and maintenancegood housekeeping and hygiene
standards.
- Nominating and training designated ERTMs on First Aid.
- Updating all First Aid boxes
- Report incidents to HSE Dept. HO
- Arranginghygienic inspection of kitchen on quarterly
basis.
- Ensuring compliance of local regulations pertaining to
fumigation activity by the contractor.
- Providing vehicle at project sites for shiftinginjured person
to nearby identified hospital.
63. RESPONSIBILITIES
- HSE Representative / Coordinator
- Carrying out initial risk assessment
- Identification of persons at risk
- Carrying out inspection of Kitchen along with Admin. Dept. /
Section Rep.
- Extending necessary assistance to Field / Location Incharge in
implementing requirements of procedure
- Coordinating medical screening of newly appointed Staff through
Medical Dept. at HO and / or Field / Location.
- It will be ensured that Electrical Technicians, Fork Lift /
Crane Operators and Vehicle Drivers are assessed for color
blindness and audiometric in addition to other specified routine
pre employment test.
64. ATTACHMENTS
- Basic Occupational Health Surveillance Program Annexure A
- Occupational Health Risk Assessment GuidelinesAnnexure B
- List of First Aid Box InventoryAnnexure C
- Ambulance Inspection Guidelines Annexure D
- Occupational Health Risk Assessment PPL - HSE / FM / HS /
01
- Occupational Health Surveillance RecordPPL - HSE / FM / HS /
02
- Occupation Health Surveillance Record - Contractor PPL - HSE /
FM / HS / 03
- Disease Analysis Record Sheet PPL - HSE / FM / HS / 04
- Ambulance Inspection Checklist PPL - HSE / FM / HS / 05
- Kitchen Hygiene Inspection Checklist PPL - HSE / FM / HS /
06
- Food Handler Initial Health Assessment FormPPL - HSE / FM / HS
/ 07
- List of First Aid Boxes PPL - HSE / FM / HS / 08
- Nomination Form for ERTM PPL - HSE / FM / HS / 09
65. OCCUPATIONAL HEALTH SURVEILLANCEPROGRAMME Safe and Healthy
return from Workplace to Home 66. OCCUPATIONAL HEALTH
SURVIELLANCEPROGRAMME We must be the change we wish to see in the
world 67. OCCUPATIONAL HEALTH SURVIELLANCEPROGRAMME