EVERY year, April 28 is celebrated as World Day for Safety and Health at Work. Led by the International Labour Organisation (ILO), the celebration aims to raise public awareness of the importance of health and safety at work globally.
This year, the focus is on safety and health and the future of work, and it also marks the ILO’s centenary. Discussions would also focus on ways of managing the challenges posed by new technology, changing demographics and climate change.
Workers comprise half of the world’s population and are the major contributors to economic and social development. In Malaysia, data from the Department of Statistics show that the number of employed persons in this country is about 15 million as of February 2019.
According to the ILO, approximately 2.3 million women and men around the world die from work-related accidents or diseases annually. This equates to over 6,000 deaths every day.
While the safety aspect of workplaces receives much attention, occupational diseases or disorders are underestimated as these are under-diagnosed due to ignorance among medical doctors and also the challenges of recognising them.
As such, the World Health Organisation (WHO) Global Plan of Action on Workers’ Health has called for improving the diagnosis, reporting and registration of occupational diseases and building capacities for estimating the occupational burden of diseases.
Occupational safety seems to take precedence in Malaysia, as seen in how issues like collapsing scaffoldings at the workplace or death of workers due to accidents at the work site are reported.
Occupational diseases have a long latent period (the time that passes between being exposed to something that can cause disease, such as radiation, asbestos and cancer-causing agents, and developing the symptoms).
The time can stretch to decades before one realises that he or she is suffering from an occupational disease.
This is what makes it challenging for physicians to diagnose, as doctors who do not specialise in occupational diseases generally do not have the index of suspicion to probe into the patient’s current and past occupations and recognising the culprit agent. Hence, occupational disease remains a hidden problem.
Occupational physicians would know how to perform workplace visits and identify the hazards like chemical, biological, physical, ergonomic or psychosocial hazards. One example is occupational asthma. If the chemical or other implicating agent is not identified as the asthma-causing agent, one can expect the patient’s asthma to keep recurring. The patient will end up “doctor hopping” in the quest to seek a cure for the illness.
It is time for our government to pay special attention to occupational health. The World Medical Association (WMA) is urging physicians, medical associations and countries to work together to develop systems to ensure that healthcare services and professionals are aware of high-risk industrial accidents when they occur, and receive timely and accurate information on the management of these emergencies.
It also recommends that occupational and environmental medicine be made a core theme in medical education to train sufficient specialists in occupational medicine and environmental health.
In this aspect, our Health Ministry would need to create a pathway for specialist occupational physicians to be gazetted to work in hospitals. The adage that prevention is better than cure also holds true for occupational diseases.
People spend at least eight to 10 hours daily in their workplace where there are many types of occupational hazards. But it is challenging to diagnose occupational diseases without visiting a workplace to identify these hazards.
The Occupational Safety and Health Act 1994 (OSHA 1994) is in the process of being amended. Kudos to the government for taking proactive steps to institute amendments to this Act!
OSHA imposes a statutory duty upon all employers to ensure, as far as is practicable, the safety, health and welfare at work of all employees. The government, employers and employees have a legal and moral responsibility to ensure a healthy and safe working place. Healthy and safe workplaces increase workers’ productivity, which in turn generates great economic benefits for employers and the country in general.
ASSOCIATE PROFESSOR DR JAYAKUMAR GURUSAMY
Perdana University Graduate School of Medicine
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