INTRODUCTION

What is OSH?

As defined by the World Health Organization (WHO) occupational health deals with all aspects of health and safety in the workplace and has a strong focus on primary prevention of hazards. 

The main focus in occupational health is on three different objectives: 

• Concerned with preserving and protecting human and facility resources in the workplace to preventing them from being injured or becoming ill due to hazards in their workplaces. Practitioners in the field try to prevent needless deaths and injuries to workers. It involves more than first aid activities and is far reaching in both scope and practice.
• A field where professionals attempt to prevent catastrophic losses. When they conduct pre-inspections, safety professionals may prevent explosions or fires that could destroy entire buildings.

• The management function in an organization concerned with improving its quality and efficiency. Safety professionals consider the way products are moved from place to place and are concerned with reducing lifting injury exposures, while minimizing product movement. They attempt to eliminate property and facility damage, waste, and costs that lessen an organization’s ability to operate profitably.

Work Accident Prevention

1. Rules
2. Standardization
3. Supervision
4. Research Technique
5. Medical Research
6. Psychological Research
7. Statistical research
8. Education
9. Training
10. Persuasion
11. Insurance
12. Implementation 1 to 11

Those who in the field of occupational health come from a wide range of disciplines and professions including 

• medicine
• psychology
• epidemiology
• physiotherapy and rehabilitation
• occupational therapy
• occupational medicine
• human factors and ergonomics

Professionals advise on a broad range of occupational health matters. These include how to avoid particular pre-existing conditions causing a problem in the occupation, correct posture for the work, frequency of rest breaks, preventative action that can be undertaken,

and so forth.

Occupational health should aim at: 

• the promotion and maintenance of the highest degree of physical, mental and social well-being of workers in all occupations
• the prevention among workers of departures from health caused by their working conditions
• the protection of workers in their employment from risks resulting from factors adverse to health
• the placing and maintenance of the worker in an occupational environment adapted to his physiological and psychological capabilities
• to summarize, the adaptation of work to man and of each man to his job.

Definitions

Health has been defined as a state of complete physical, mental and social well being and not merely the absence of disease or infirmity.

Occupational health is a multidisciplinary field of healthcare concerned with enabling an individual to undertake their occupation, in the way that causes least harm to their health. 

Safety is the control of accident loss and the ability to identify and eliminate unacceptable risks.

Safe is a condition in which or when the emergence of the source of danger has been controlled to an adequate level, and this is the opposite of danger.

Incident is an undesirable event, when at the moment if there is a little change it can lead to an accident.

Accident is an unplanned, undesirable event, disruption to work that results in human injury, property damage, and pollution.

Danger is a liability or exposure to harm or injury; risk; peril.

Harm is a damage or loss in the form of death, injury, physical or mental illness, property damage, production loss, environmental damage or any combination of such losses.

Hazard is a potential source of danger that can cause harm. Hazard may be chemicals, machine parts, energy forms, work methods or work situations.

Risk is a measure of possible losses that will arise from a particular hazard that occurs. To determine risk requires calculations between consequences / impacts that may arise and probability, which is usually called the level of risk. 

Laws and Regulations (click on the law for details)

1. Law no. 1 of 1970 on Occupational Safety
2. Law no. 3 of 1951 concerning Labor Inspection
3. Law no. 13 of 2003 on Manpower.
4. Law no. 50 of 2012 on the Implementation of OSH Management System
5. Ministerial Regulation No. Per 04/ Men/ 1987 on P2K3 and OSH Expert.
6. Ministerial Regulation No. Per 04/ Men/ 1995 on OSH Service Company.
7. Ministerial Regulation No.18/ Men/ 2016 on the Occupational Safety and Health Council.
8. Ministerial Regulation No. 37/ Men/ 2016 on OSH Pressure and Tank Pressure Tank
9. Ministerial Regulation No. 38/ Men/ 2016 on OSH Aircraft Power and Production

Type of OSH (click on the link for details)

1. Mechanical Work Safety
2. Steam and Pressure Vessels Safety
3. Construction Work Safety
4. Electrical Safety
5. Fire Safety
6. Safety of Toxic Substances and Dangerous Chemicals
7. Safety of Work Environment

Occupational Illness

• Biological factors (infection of animals, viruses, bacteria, fungi, worms)
• Chemical factors (dust, gas, steam, liquids)
• Physical factors (noise, vibration, temperature)
• Physiological factors of work (attitude / way of working, machine construction)
• Psychological factors (routine / working atmosphere / working relationship uncomfortable)
• Mechanical factors (heavy machinery / equipment)

Health Care Examination:

1. Initial Health Check - Health checks done before labor or at the time of recruitment.
2. Regular Health Check - Labor inspection for a period of time periodically during work (6 months / 1 year).
3. Specific Health Check - Medical examination to assess the effect of certain jobs on labor.

Compensation:

Direct cost

• compensation costs 
• cost of care / treatment 
• equipment repair costs 
• Wage fee STMB  

Indirect Costs 

• Work time loss from worker friends because work stalled 
• Loss of working time because other employees help the victim 
• Loss from damage to machinery, tools and other equipment 
• Other inquiry and social costs

Hazard Identification and Assessment

One of the "root causes" of workplace injuries, illnesses, and incidents is the failure to identify or recognize hazards that are present, or that could have been anticipated. A critical element of any effective safety and health program is a proactive, ongoing process to identify and assess such hazards.

To identify and assess hazards, employers and workers:

• Collect and review information about the hazards present or likely to be present in the workplace.
• Conduct initial and periodic workplace inspections of the workplace to identify new or recurring hazards.
• Investigate injuries, illnesses, incidents, and close calls or near misses to determine the underlying hazards, their causes, and safety and health program shortcomings.
• Group similar incidents and identify trends in injuries, illnesses, and hazards reported.
•  Consider hazards associated with emergency or non-routine situations.
• Determine the severity and likelihood of incidents that could result for each hazard identified, and use this information to prioritize corrective actions.

Some hazards, such as housekeeping and tripping hazards, can and should be fixed as they are found. Fixing hazards on the spot emphasizes the importance of safety and health and takes advantage of a safety leadership opportunity.

Steps of action to be taken in order to control and prevent hazards:

1. Collect existing information about workplace hazards
2. Inspect the workplace for safety hazards
3. Identify health hazards
4. Conduct incident investigations
5. Identify hazards associated with emergency and non-routine situations
6. Characterize the nature of identified hazards, identify interim control measures, and prioritize the hazards for control

1. Collect existing information about workplace hazards

Information on workplace hazards may already be available to employers and workers, from both internal and external sources.

How to accomplish it:

Collect, organize, and review information with workers to determine what types of hazards may be present and which workers may be exposed or potentially exposed. Information available in the workplace may include:

• Equipment and machinery operating manuals.
• Safety Data Sheets (SDS) provided by chemical manufacturers.
• Self-inspection reports and inspection reports from insurance carriers, government agencies and consultants.
• Records of previous injuries and illnesses, such as Occupational Safety and Health Administrator (OSHA) 300 and 301 logs and reports of incident investigations.
• Workers' compensation records and reports.
• Patterns of frequently-occurring injuries and illnesses.
• Exposure monitoring results, industrial hygiene assessments, and medical records (appropriately redacted to ensure patient/worker privacy).
• Existing safety and health programs (lockout/tagout, confined spaces, process safety management, personal protective equipment, etc.).
• Input from workers, including surveys or minutes from safety and health committee meetings.
• Results of job hazard analyses, also known as job safety analyses.

Information about hazards may be available from outside sources, such as:

• OSH, National Institute for Occupational Safety and Health (NIOSH), and Centers for Disease Control and Prevention (CDC) websites, publications, and alerts.
• Trade associations.
• Labor unions, state and local occupational safety and health committees and coalitions ("COSH groups"), and worker advocacy groups.
•  Safety and health consultants.

2. Inspect the workplace for safety hazards

Hazards can be introduced over time as workstations and processes change, equipment or tools become worn, maintenance is neglected, or housekeeping practices decline. Setting aside time to regularly inspect the workplace for hazards can help identify shortcomings so that they can be addressed before an incident occurs.

How to accomplish it:

• Conduct regular inspections of all operations, equipment, work areas and facilities. Have workers participate on the inspection team and talk to them about hazards that they see or report.
• Be sure to document inspections so you can later verify that hazardous conditions are corrected. Take photos or video of problem areas to facilitate later discussion and brainstorming about how to control them, and for use as learning aids.
• Include all areas and activities in these inspections, such as storage and warehousing, facility and equipment maintenance, purchasing and office functions, and the activities of on-site contractors, subcontractors, and temporary employees.
• Regularly inspect both plant vehicles (e.g., forklifts, powered industrial trucks) and transportation vehicles (e.g., cars, trucks).
• Use checklists that highlight things to look for. Typical hazards fall into several major categories, such as those listed below; each workplace will have its own list:

Ø  General housekeeping

Ø  Slip, trip, and fall hazards

Ø  Electrical hazards

Ø  Equipment operation

Ø  Equipment maintenance

Ø  Fire protection

Ø  Work organization and process flow (including staffing and scheduling)

Ø  Work practices

Ø  Workplace violence

Ø  Ergonomic problems

Ø  Lack of emergency procedures

• Before changing operations, workstations, or workflow; making major organizational changes; or introducing new equipment, materials, or processes, seek the input of workers and evaluate the planned changes for potential hazards and related risks.

Many hazards can be identified using common knowledge and available tools. For example, you can easily identify and correct hazards associated with broken stair rails and frayed electrical cords. Workers can be a very useful internal resource, especially if they are trained in how to identify and assess risks.

3. Identify health hazards

Identifying workers' exposure to health hazards is typically more complex than identifying physical safety hazards. For example, gases and vapors may be invisible, often have no odor, and may not have an immediately noticeable harmful health effect. Health hazards include chemical hazards (solvents, adhesives, paints, toxic dusts, etc.), physical hazards (noise, radiation, heat, etc.), biological hazards (infectious diseases), and ergonomic risk factors (heavy lifting, repetitive motions, vibration). Reviewing workers' medical records (appropriately redacted to ensure patient or worker privacy) can be useful in identifying health hazards associated with workplace exposures.

How to accomplish i:

• Identify chemical hazards – review SDS and product labels to identify chemicals in your workplace that have low exposure limits, are highly volatile, or are used in large quantities or in unventilated spaces. Identify activities that may result in skin exposure to chemicals.
• Identify physical hazards – identify any exposures to excessive noise (areas where you must raise your voice to be heard by others), elevated heat (indoor and outdoor), or sources of radiation (radioactive materials, X-rays, or radiofrequency radiation).
• Identify biological hazards – determine whether workers may be exposed to sources of infectious diseases, molds, toxic or poisonous plants, or animal materials (fur or scat) capable of causing allergic reactions or occupational asthma.
• Identify ergonomic risk factors – examine work activities that require heavy lifting, work above shoulder height, repetitive motions, or tasks with significant vibration.
• Conduct quantitative exposure assessments – when possible, using air sampling or direct reading instruments.
• Review medical records – to identify cases of musculoskeletal injuries, skin irritation or dermatitis, hearing loss, or lung disease that may be related to workplace exposures.

Identifying and assessing health hazards may require specialized knowledge. Small businesses can obtain free and confidential occupational safety and health advice services, including help identifying and assessing workplace hazards, through OSHA's On-site Consultation Program.

4. Conduct incident investigations

Workplace incidents including injuries, illnesses, close calls or near misses, and reports of other concerns provide a clear indication of where hazards exist. By thoroughly investigating incidents and reports, you will identify hazards that are likely to cause future harm. The purpose of an investigation must always be to identify the root causes (and there is often more than one) of the incident or concern, in order to prevent future occurrences.

How to accomplish it:

• Develop a clear plan and procedure for conducting incident investigations, so that an investigation can begin immediately when an incident occurs. The plan should cover items such as:

Ø  Who will be involved

Ø  Lines of communication

Ø  Materials, equipment, and supplies needed

Ø  Reporting forms and templates

• Train investigative teams on incident investigation techniques, emphasizing objectivity and open-mindedness throughout the investigation process. 
• Conduct investigations with a trained team that includes representatives of both management and workers. 
• Investigate close calls or near misses.
• Identify and analyze root causes to address underlying program shortcomings that allowed the incidents to happen.
• Communicate the results of the investigation to managers, supervisors, and workers to prevent recurrence.

Effective incident investigations do not stop at identifying a single factor that triggered an incident. They ask the questions "Why?" and "What led to the failure?" For example, if a piece of equipment fails, a good investigation asks: "Why did it fail?" "Was it maintained properly?" "Was it beyond its service life?" and "How could this failure have been prevented?" Similarly, a good incident investigation does not stop when it concludes that a worker made an error. It asks such questions as: "Was the worker provided with appropriate tools and time to do the work?" "Was the worker adequately trained?" and "Was the worker properly supervised?"

OSHA has special reporting requirements for work-related incidents that lead to serious injury or a fatality (29 CFR 1904.39). OSHA must be notified within 8 hours of a work-related fatality, and within 24 hours of an amputation, loss of an eye, or inpatient hospitalization.

5. Identify hazards associated with emergency and non-routine situations

Emergencies present hazards that need to be recognized and understood. Non-routine or infrequent tasks, including maintenance and start up or shut down activities, also present potential hazards. Plans and procedures need to be developed for responding appropriately and safely to hazards associated with foreseeable emergency scenarios and non-routine situations.

How to accomplish it: 

• Identify foreseeable emergency scenarios and non-routine tasks, taking into account the types of material and equipment in use and the location within the facility. Scenarios such as the following may be foreseeable:

Ø  Fires and explosions

Ø  Chemical releases

Ø  Hazardous material spills

Ø  Start-ups after planned or unplanned equipment shutdowns

Ø  Non-routine tasks, such as infrequently performed maintenance activities

Ø  Structural collapse

Ø  Disease outbreaks

Ø  Weather emergencies and natural disasters

Ø  Medical emergencies

Ø  Workplace violence

6. Characterize the nature of identified hazards, identify interim control measures, and prioritize the hazards for control

The next step is to assess and understand the hazards identified and the types of incidents that could result from worker exposure to those hazards. This information can be used to develop interim controls and to prioritize hazards for permanent control.

How to accomplish it:

• Evaluate each hazard by considering the severity of potential outcomes, the likelihood that an event or exposure will occur, and the number of workers who might be exposed.
• Use interim control measures to protect workers until more permanent solutions can be implemented.
• Prioritize the hazards so that those presenting the greatest risk are addressed first. Note, however, that employers have an ongoing obligation to control all serious recognized hazards and to protect workers.

"Risk" is the product of hazard and exposure. Thus, risk can be reduced by controlling or eliminating the hazard or by reducing workers' exposure to hazards. An assessment of risk helps employers understand hazards in the context of their own workplace and prioritize hazards for permanent control.

Personal Protective Equipment (PPE)

To ensure the greatest possible protection for employees in the workplace, the cooperative efforts of both employers and employees will help in establishing and maintaining a safe and healthful work environment.

In general, employers are responsible for:

1. Performing a “hazard assessment” of the workplace to identify and control physical and health hazards.
2. Identifying and providing appropriate PPE for employees.
3. Training employees in the use and care of the PPE.
4. Maintaining PPE, including replacing worn or damaged PPE.
5. Periodically reviewing, updating and evaluating the effectiveness of the PPE program.

In general, employees should:

1. Properly wear PPE,
2. Attend training sessions on PPE,
3. Care for, clean and maintain PPE, and
4. Inform a supervisor of the need to repair or replace PPE.

Specific requirements for PPE are presented in many different Occupational Safety and Health Administration (OSHA) standards, published in 29 CFR. Some standards require that employers provide PPE at no cost to the employee while others simply state that the employer must provide PPE. Appendix 

In a final rule on employer-paid PPE published in November 2007, all PPE, with a few exceptions, will be provided at no cost to the employee. The Nov. 2007 final rule also clarified OSHA’s requirements regarding payment for employee-owned PPE and for replacement PPE. The final rule is published at 72 Fed. Reg. 64341-64430 (Nov. 15, 2007).

PPE selection:

1. Should be of safe design and construction
2. Should be maintained in a clean and reliable fashion
3. Fit and comfort should be taken into consideration when selecting
4. Make sure PPE types are compatible if worn together
5. Must meet standards developed by American National Standards Institute (ANSI) 

Types of PPE:

• Eye and face
• Head
• Foot and leg
• Hand and arm
• Ears
• Lungs