UNDERSTANDING

OCCUPATIONAL SAFETY & HEALTH

STANDARDS

JEHREMIAS M. FLORANTE, MD, DPCOM

Occupational Health Officer
Health Control Division
Occupational Safety & Health Center
 Objectives
Discuss the core provisions of the OSHS.
Describe the scope & components of the different
OSH-related DOLE issuance that form part of the Labor
Laws Compliance Checklist
Legal basis
Review the basic info, statistics, management, &
prevention of HIV & AIDS, hepatitis B, TB, & drugs; &
Discuss the different DOLE issuance on drug-free
workplace, TB, HIV & AIDS, & hepatitis B including the
key principles in the implementation of policies &
programs in the workplace.
 OSH Legislations

PD 442, Book IV, Title I

Chapter I: Medical & Dental

Services

Chapter II: Occupational Health &

Safety
 OSH Legislations
PD 442, Book IV, Title I, Chapter II
Art. 168: Safety & Health Standards
The SOLE shall, by appropriate order, set & enforce
mandatory OSHS to eliminate or reduce OSH hazards in
all workplaces, & institute new & update existing
programs to ensure safe & healthful working conditions
in all places of employment.
Art. 171: Administration of Safety & Health Laws
DOLE shall be solely responsible for the administration,
enforcement of laws, policies & programs on OSH.
Chartered cities may be allowed to conduct TSI of
establishments within their respective jurisdiction.
 OSH Legislations

Book IV, Title I: Medical, Occupational Safety &

Dental, & Occupational Health Standards (OSHS)
Safety
 OSH Standards
A set of mandatory
rules on OSH which
codifies all safety orders
issued prior to its
promulgation

Patterned after the

Standards of other
developed countries
 Rules of OSHS
1000 Gen. Provisions
1010 Other Safety Rules
1020 Registration
1030 Training & Accreditation
1040 OSH Committee
1050 Notification & Keeping of
Occupational Illnesses & Injuries
1060 Premises of Establishments
1070 Environmental Control
1080 PPE
1090 Hazardous Materials
1100 Gas & Electric Welding & Cutting
Operations
1120 Hazardous Work Processes
1140 Explosives
1150 Materials Handling & Storage
1160 Boiler
1170 Unfired Pressure Vessels
1180 Internal Combustion Engines
1200 Machine Guarding
1210 Electrical Safety
1220 Elevators & Related Equipment
1230 Identification of Piping System
1240 Power Piping Lines
1410 Construction Safety
1420 Logging
1940 Fire Protection & Control
1950 Pesticides & Fertilizers
1960 OH Services
1970 Fees
1980 Authority of LGUs
1990 Final Provisions
Rule 1005 Duties of Employer
Furnish his workers a place of employment free
from hazardous conditions.
Give complete job safety instructions to all his
workers.
Comply with the requirements of the OSHS.
Use only approved devices & equipment in his
workplace.
 Rule 1005 Duties of Workers
Cooperate with the employer in carrying out the
provisions of the OSHS.

Report any work hazard in the workplace.

Make proper use of all safeguards & safety devices

furnished in accordance with the provisions of OSHS
for his protection & the protection of others.

Follow all instructions by the employer in compliance

with the OSHS provisions.

A
 Rule 1020 - Registration
Every employer shall register his business
with the DOLE RO to provide DOLE with
information as guide in its enforcement
activities
Free of charge
Valid for lifetime, except when there is change
in name, location, ownership, opening after
previous closing
Lay-out plan, IP Form 3
 Rule 1030 Training &
Accreditation of Personnel in OSH
The BWC, either directly or through accredited
organizations, shall conduct continuing training
programs to increase the supply & competence of
personnel qualified to carry out the provision of this
Standards.
Employer to appoint a SO on a full-time or part-time
basis depending on the type of workplace (whether
hazardous or non-hazardous) & number of workers
in the workplace.
*Based on DO 16-01
 Required No. of SO in the Workplace
(OSHS, 1978)
Number of Workers Highly Hazardous Hazardous Non-Hazardous
1 50 1 FT SO 1 PT SO
1 FT SO &
51 200 1 FT SO
1 PT SO 1 PT SO
1 FT SO &
201 250 2 FT SO
1 PT SO
2 FT SO &
251 500 2 FT SO 2 PT SO
1 PT SO
501 750 1 FT SO
751 1000 2 FT SO
Every additional 500
1 FT SO 1 FT SO
or a fraction thereof
Every additional 250
1 FT SO
or a fraction thereof
 Rule 1030 Training &
Accreditation of Personnel in OSH
Duties of Safety Officer
Advice the employer, supervisors, & workers on
OSH;
Investigate accidents;
Coordinate safety training programs;
Conduct OSH inspections;
Maintain accident records system; &
Provide assistance to government agencies in the
conduct of OSH inspection, accident
investigation, or any other related programs.
 Rule 1030 Training &
Accreditation of Personnel in OSH
A FT SO must be duly accredited by the DOLE.

ACCREDITATION PROGRAM OF DOLE

Note: The employment of a FT SO may not be required if the
employer enters into a written contract with a qualified
consultant or consulting organization whose duties &
responsibilities shall be the duties of a safety practitioner as
stated in this Rule. The employment of a consultant, however,
will not excuse the employer from the required training of his
supervisors or technical personnel.
 Rule 1040 OSH Committee
a group of employees & management
personnel which plans & develops polices in
all matters pertaining to safety & health in the
workplace.
 Rule 1040 OSH Committee
Number of Composition
Type
Workers Chair Members Secretary
2 Dept Heads
A 401 4 Workers
Manager or OHP
authorized rep
(must be COO) 1 Supervisor
B 201-400 OHP or OHN
3 workers
SO
1 Foreman
Manager or
C 101-200 3 Workers
authorized rep
OHN
1 Foreman
D 100 Manager 3 Workers
OHN or FA
 Duties of OSH Committee (OSHS,
1978)
1. Plans & develops accident prevention program
2. Directs the accident prevention efforts.
3. Provides necessary assistance to government
inspecting authorities
4. Initiates & supervises safety trainings for
employees
5. Develops & maintains a disaster contingency
plan
 Duties of Employer (OSHS, 1978)
1. Establishes & adopts in writing administrative
policies on OSH.

2. Reports to the enforcing authority the policies

adopted & required report requirements.

3. Acts on recommended measures of the OSH

Committee &, in case of non-adoption, informs
the committee of the reason.
 Rule 1040 OSH Committee
OSH Rule Report/Form Where To File When To File

Rule 1040: OSH Report of Safety 2 copies to be Within 1 month

Committee Organization submitted to after the
(DOLE/BWC/IP-5) concerned RO, organization
copy-furnished
BWC

Minutes of the Quarterly

Meeting
RULE 1050 Notification & Keeping Records
of Accidents &/or Occupational Illnesses
1053.01: Notification All work accidents or
occupational illnesses, resulting in disabling conditions
or dangerous occurrences shall be reported by the
employer to the DOLE RO.
If a major work accident results in death or permanent
total disability, employer shall initially notify the DOLE RO
within 24 hours.

1054: Keeping of Records The employer shall

maintain & keep an accident or illness record which
shall be open at all times for inspection by authorized
personnel.
RULE 1050 Notification & Keeping Records
of Accidents &/or Occupational Illnesses
Provides the SO means for an
objective evaluation of the
program.

Helps identify high injury rates.

Provides information on accident

causes which contributes to high
injury rates.
RULE 1050 Notification & Keeping Records
of Accidents &/or Occupational Illnesses
OSH Rule Report/Form Where To File When To File

Rule 1050: Work 2 copies to be On or before the

Notification & Accident/Illness submitted to 20th day of the
Keeping of Report concerned RO, month following
Accidents &/or (DOLE/BWC/IP-6) copy-furnished the date of
Occupational BWC occurrence of the
Illnesses accident

Annual Exposure On or before Jan 20

Data Report of the following
(DOLE/BWC/IP-6b) year

Fatal/Major Within 24 hours

Accident
 RULE 1960 OH Services

Every employer is required to

provide in his workplace medical
& dental services, emergency
medicines, & dental facilities.
 OH Personnel
Refers to the qualified first aider, RN, DMD, or
MD, whose services have been engaged by
the employer in order to provide OH services
in the establishment.
Hazardous v Non-Hazardous Workplaces
OSHS Rule 1013
Dangerous environmental Potential risks of disabling Work operations or
elements, hazardous
contaminants, ionizing
radiation, chemicals,
flammable substances
Construction, mining, fire
fighting, stevedoring,
dock work, deep sea
fishing, mechanized
farming
Dangerous work
conditions
Manufacture or handling
of explosives, pyrotechnic
products
Heavy equipment or
power driven tools &/or
machinery
DOLE MC 02-98, Sec. 2(c)
injury, illness or death,
either because of the
presence of
Biologic agents
Radiation with or as an incident to
Chemical substances
Hazardous materials
Physical hazards in
the work
environment
Nature of the work
processes performed or
equipment used therein
DOLE DO 16-01, Rule
1032.07
practices performed by a
worker in the
establishment or
workplace in conjunction
such operations or
practices & which exposes
the employee or worker
to hazards likely to cause
disabling injury, illness,
death or physical or
psychological harm
 OH Personnel
No. of Workers Hazardous Non-Hazardous
1-50 FA/shift Medicines FA/shift Medicines
FA/shift
51-99 FA/shift ETR
PT OHN, 4h/d, 6d/wk ETR
FA/shift
FA/shift
100-199 FT OHN
PT OHN, 4h/d, 6d/wk ETR
PT MD/DMD, 4h/d, 3d/wk EMC
FA/shift
FA/shift
FT OHN
200-600 FT OHN
PT MD, 4h/d, 6d/wk
PT MD/DMD, 4h/d, 3d/wk ETR
PT DMD EH & DC
FA/shift FA/shift
FT OHN FT OHN
601-2000
FT MD or 2 PT MDs PT MD, 4h/d, 6d/wk
FT DMD EH & DC PT DMD EMC
FA/shift FA/shift
OHN/shift OHN/shift
2001
FT MD & PT MD/shift FT MD & PT MD/shift
FT DMD EH & DC FT DMD EMC & DC
 OH Services
Emergency Hospital An employer need not put up an emergency
hospital or dental clinic if there is a hospital or dental clinic which is
not more than 5 km. away in urban areas & 25-min. travel in rural
areas provided contracts are entered into with the said hospital or
dental clinic & that the employer provides transportation facilities.
However, not an excuse of not maintaining in the workplace an
emergency treatment room for his workers.

MD/DMD shall be subject to call at any time in other shifts during

emergencies.
 OH Services
OH Program The physician engaged by the employer, in
addition to providing medical services in cases of
emergency, must also perform the following:
Conduct PEME, free of charge, for the proper selection of workers;

Conduct free of charge APE of the workers;

Collaborate with safety & technical personnel in the selection &

placement of workers, including investigation of work-related
accidents due to exposure to health hazards; &

Develop & implement a comprehensive OH program for the

employees.
 RULE 1960 OH Services
OSH Rule Report/Form Where To File When To File

Rule 1960: OH Annual Medical 2 copies to be On or before the

Services Report submitted to last day of March
(DOLE/BWC/OH- concerned RO, of the year
47A) copy-furnished following the
BWC covered period
Other OSHS Rules/Requirements
Rule 1070 Occupational Health & Environmental Control

The employer shall exert efforts to maintain & control the working
environment in comfortable & healthy conditions for the purpose of
promoting & maintaining the health of his workers.

The employer shall carry out WEM where hazardous work is

performed & shall keep a record of such measurement which shall be
made available to the enforcing authority.

WEM shall include temperature, humidity, pressure, illumination,

ventilation, concentration of substances, & noise.

The WEM shall be performed periodically as may be necessary but

not longer than annually.
 Other OSHS Rules/Requirements
Rule 1080 PPE & Devices

1081.01 Every employer shall at his own

expense furnish his workers with protective
equipment & barriers whenever necessary.

1081.04 No person shall be subjected or

exposed to a hazardous environmental
condition without protection.
 Summary of Administrative Rules

Notification & Keeping of Records of Accidents &/or Occupational Illnesses (Rule

1050)

Occupational Health Services (Rule 1960)

Registration of business (Rule 1020)
Training & Accreditation of Personnel in OSH (Rule 1030)
Health & Safety Committee (Rule 1040)
 Summary of Report Requirements
Work Accident/Illness Report (WAIR)
Annual Exposure Data Report (AEDR)
Report of Safety Organization (RSO)
Minutes of the Meetings of Health and Safety
Committee
Annual Medical Report (AMR)
 DOLE Issuance
ISSUANCE TITLE

Guidelines for the Implementation of Drug-Free Workplace Policies &

DO 53-03
Programs for the Private Sector

Guidelines for the Implementation of Policy & Program on Tuberculosis

DO 73-05
(TB) Prevention & Control in the Workplace

Guidelines for the Implementation of HIV & AIDS Prevention & Control
DO 102-10
in the Workplace Program

Guidelines for the Implementation of a Workplace Policy & Program on

DA 05-10
Hepatitis B
 DOLE DO 53-03
Guidelines for the Implementation of Drug-Free
Workplace Policies & Programs for the Private
Sector
 Drug Situationer
According to the World Drug Report (2016)
247 M people worldwide used drugs in 2014
29 M suffer from drug use disorders
Only 1 in 6 people is in treatment
12 M inject drugs
1.6 M are living with HIV
6 M are living with hepatitis B
Cannabis & amphetamine are most commonly used
drugs
According to a 2012 survey commissioned by DDB
Estimated 1.3 M Filipino drug users
 Profile of drug users in the Philippines
National Household Survey Facility-Based
(2012) (2015)
Age group 20 -29 years old Mean age of 31 years old
Sex Male-to-Female, 10:1 Male-to-Female, 14:1
Civil status Married Single
Status of employment Employed Unemployed
Educational attainment High school level College level
Economic status - Average monthly family
income of 10,172.00
Nature of drug taking Polydrug use
Major drugs of abuse Methampethamine HCl Methampethamine HCl
(shabu) (shabu)
Cannabis (marijuana) Cannabis (marijuana)
Inhalants (contact cement) Cocaine
Major drugs of abuse & methods of use
Drugs of Abuse Methods of Use
Methamphetamine HCl Sniffing (snorting)
Ingesting
Inhaling (chasing the dragon)
Injecting

Cannabis Smoking
Contact cement adhesives Inhaling
Nalbuphine HCl Injecting
Meperidine HCl Injecting
Solvent Inhaling
Benzodiazepines & cough preparation Oral intake
 New psychoactive substances
Nalbuphine HCl
Included in the List of Dangerous Drugs (DDB
Regulation No. 1-2010)
Use:
Pain reliever
Side effects:
Depression, confusion, hallucinations, feeling of heaviness,
numbness, delusions, dysphoria, hypertension, hypotension,
bradycardia, tachycardia, pulmonary edema
In Cebu, nalbuphine HCl + methamphetamine HCl =
milkshake
Serious public health issue as there is a spread of HIV/AIDS &
hepatitis
 Impact of drugs at work
A negative impact on
Physical health: elevated heart rate & BP, respiratory failure,
convulsions, cardiovascular problems, certain forms of cancers,
liver/kidney impairment, & HIV/AIDS
Mental health: altered perceptions & emotions, changes in
personality, decreased social inhibitions, paranoia, anxiety,
irritability, & depression
Safety: loss of concentration & coordination, distorted vision &
hearing, sleepiness, & decreased awareness to touch & pain
Productivity: increase health care cost, number of accidents,
absenteeism, replacement costs; poor work relations, &
impaired performance
 Role of the workplace
Allows development of policies & strategies
Facilitates promotion of health messages
Facilitates referral of workers for care &
support
Provides opportunity for an effective
partnership
Problem of drugs in the workforce
Addiction
Problem use:
inappropriate use
Workers excessive use
who are
dependent use leading to or
worsening physical,
psychological, work,
Workers beginning
to experience problems social, safety problems
Recreational use
Experimental use
Work-related
situations:
Workers with no problems
shift work
travel away from home
stress/boredom
 What needs to be done?
Focus on prevention rather than treatment.

Prevention:
PhP is less expensive
has a greater impact
PhP reaches more people
is feasible in any
work environment
PhP
doesnt need
community resources
How do we prevent the problem?

Treatment
Dependent (if prevention fails)

Self-assessment
Beginning to
experience problems Counselling

Information
Workers with no problems & education
 RA 9165
Comprehensive Dangerous Drugs Act of 2002
 RA 9165

Article III Dangerous drugs test & record requirements.

Article V Promotion of a national drug-free workplace

program with the participation of private & labor sectors & the
DOLE.

Article VI Participation of private & labor sectors in the

enforcement of this Act.
Salient workplace provisions of RA 9165
MANDATORY TESTING RANDOM TESTING
applicants for firearms students
licenses/permit to carry
employees of public &
firearms
private offices
military, police, & law
enforcers

Mandatory drug testing for persons charged
with criminal offense & candidates for public
office have been declared unconstitutional by
an En Banc Resolution of the SC dated
November 2008.
Mandatory drug testing for
application of drivers license revoked
by new law, RA 10586 or the Anti-
Drunk & Drugged Driving Act of 2013.
Salient workplace provisions of RA 9165
Crafting of policy using tripartite approach
Management
Workers
Union, if organized
Contractors, subcontractors, concessionaires
Government organizations Technical
Non-government organizations assistance
 DOLE DO 73-05
Guidelines for the Implementation of Policy &
Program on Tuberculosis (TB) Prevention & Control
in the Workplace
 TB status

Over 95% of TB cases & deaths are in developing countries. Poor communities &
vulnerable groups are most affected. In the Philippines, efforts are intensified to
reach geographically isolated & disadvantaged populations. (WHO, 2015)
 TB statistics
Ranks alongside HIV as leading cause of death
worldwide (WHO, 2015)
9.6 million new cases 1.5 million deaths
5.4 million were men 890,000 were men
3.2 million were women 480,000 were women
PHL is one of the 7 countries that have already achieved
the MDGs in 2012
TB is more prevalent among males in PHL than females
& among 25 55 year olds. However, all sexes & age
groups are at risk.
Treatment success rate = 90% (DOH-NTP MOP, 5th ed.)
 TB estimates

3 lives are lost per minute

because of TB. By the time
you finish munching your
biscuit, 3 lives will be lost
unless we fight back.

(The Global Fund to Fight AIDS, Tuberculosis, & Malaria, 2015)

 Etiology

Mycobacterium tuberculosis

Typical signs & symptoms

 Mode of transmission
(Illustrations courtesy of The Global Fund to Fight AIDS, Tuberculosis, & Malaria, 2015) & PBSP
 Transmission & affectation
(Illustration courtesy of The Global Fund to Fight AIDS, Tuberculosis, & Malaria, 2015) & PBSP
Body parts affected by TB

Scrofuloderma

PTB
TBlymphadenitis
peritonitis
TB
Potts
TB meningitis
disease
Urogenital
TB pleurisyTB
TBpericarditis
Miliary TB
 Susceptible individuals
Children & the elderly
Those with medical conditions:
HIV infection
DM II
Severe kidney disease
Substance abuse (alcohol &/or drugs)
Low body weight
Certain cancers
On chemotherapy or corticosteroids
 TB & smoking
(Illustration courtesy of The Global Fund to Fight AIDS, Tuberculosis, & Malaria, 2015) & PBSP
 Diagnosis
(Illustrations courtesy of The Global Fund to Fight AIDS, Tuberculosis, & Malaria, 2015) & PBSP
 Treatment
(Illustrations courtesy of The Global Fund to Fight AIDS, Tuberculosis, & Malaria, 2015) & PBSP
 TB-DOTS facilities
(Illustration courtesy of The Global Fund to Fight AIDS, Tuberculosis, & Malaria, 2015) & PBSP

https://gis.philhealth.gov.ph/
 Prevention
Have a TB prevention & control policy program.
Practice good hygiene, i.e., proper coughing & sneezing
etiquette.
Be conscious of TB disease symptoms for early diagnosis &
treatment.
Consult with MDs in clinics or nearby health centers.
Minimize the crowding of workplaces.
Ensure proper ventilation in the workplace.
Encourage workers to strengthen their immune system
through healthy lifestyle.
 Infectiousness
Patients are not considered infectious if...

Cough becoming less & less productive.

Appetite becoming good.

Gaining weight.

Show increasing body strength & stamina.

TB & THE WORKPLACE
 Why the workplace?
Workers spend a significant portion of their day at
work
Presence of existing facilities, services, personnel for
health care delivery
Easy to implement health promotion activities &
convenient site for TB-DOTS
Facilitates monitoring, recording, & reporting
 Workplace issues in TB transmission
Transmission is most likely to occur from TB-infected workers:
Have unrecognized PTB
Not on effective anti-TB therapy
Continue to work despite being infectious
Host factors that enhance transmission:
Presence of coughing, sneezing, or other forceful expiratory measures
Presence of the acid-fast bacilli in sputum
Inability to perform coughing & sneezing etiquette
Work environment factors that enhance the likelihood of
transmission:
Exposure in relatively small & enclosed spaces
Inadequate local or general ventilation that results in insufficient dilution
&/or removal of infectious droplet nuclei
Re-circulation of air containing infecious droplet nuclei
 Workplaces with increased TB risk
Health care facilities
Homeless shelters
Prisons
Nursing homes
Workplaces with exposure to silica, biological wastes
Workplaces with poor conditions, i.e., overcrowded, poor
ventilation, & enclosed work areas
Industries with large migrant workforce
Sweatshops
 TB & Silicosis
The risk of PTB is even higher because the effect of silica
is superimposed on a high rate of PTB within the
population.
Silicosis is the accumulation of dust in the lungs & the
tissue reactions to its presence (ILO, 1970)
Fibrogenic dusts (silica, asbestos, mixed dusts) are the
causative agents
Industries involved:
Mining, quarrying, tunneling
Milling
Foundry work, abrasive blasting, glass manufacturing
Stone mason, sand blasting, pottery making, ceramics & tile
manufacturing, clay production, cement production
 DOLE DO 102-10
Guidelines for the Implementation of HIV & AIDS
Prevention & Control in the Workplace Program
 Definition
HIV - Human Immunodeficiency Virus
- destroys the immune system & causes AIDS.

HIV infection - a lifetime uncurable infection which may not

present signs & symptoms.

AIDS - Acquired Immune Deficiency Syndrome

- serious & usually fatal condition in which the bodys
immune system is severely weakened & cannot fight off
infection.
- condition where signs & symptoms appear as a result of
various opportunistic infections.
 Definition
Opportunistic infection - caused by biological agents which
find the opportunity to infect a
body that doesnt have the ability
to defend against illness or has a
compromised immune system.
 Disease Process
HIV infects Th cells

Blocks the recognition of foreign substances

HIV replicates inside T cells

T cells unable to fight off infections

Infected T cells produce more HIVs to destroy other

T cells
Progression of HIV infection
Progression of HIV infection
 HIV & AIDS
HIV remains dormant in the body for
several years before some unknown
factors trigger the infections associated
with AIDS.
Median incubation period can be as
long as 10 years.
During the incubation period, PLWH are
in asymptomatic stage & may look
healthy & unaware of their infection
status.
PLHIV can live a normal & productive
life & should not be discriminated &
isolated.
 Body fluids with high viral load
Blood
Semen
Vaginal & cervical mucus
Breast milk
Amniotic fluid
Cerebrospinal fluid
Modes of transmission
Reported Mode of HIV Transmission
(DOH-NEC, Jun 2016)
Prevention of HIV Infection

REMEMBER ABCDE!
Abstinence
Be faithful
Condom
Do not inject drugs
Education
 Am I at risk for HIV or AIDS?
1. Have you & your partner/s engaged in oral, vaginal, or
anal sex without using condom? Y/N
2. Have you & any of your partner/s had multiple sexual
activities in the last 12 months? Y/N
3. Did you or your partner/s have any STIs in the last 12
months? Y/N
4. Have you or your partner/s injected drugs, or shared
needles & syringes? Y/N
5. Did you or your partner/s receive blood transfusion or
organ transplant from a source not approved or
authorized by DOH or the hospital? Y/N
 Who are at risk?
1. MARP
a.
b.
MSM
Female sex workers
ANYONE
c. IDU
2. Workers exposed to blood & blood products
a. Health workers, first aiders
b. Mortuary workers
c. Cleaners, garbage collectors
3. Vulnerable population
a. Street children
4. Workers with increased vulnerability
1. Migrant workers
2. Seafarers
3. Transport workers
 Testing
Confidentiality
Exceptions:
When complying with the requirements for monitoring
procedures;
When informing other health workers directly involved or about to
be involved in the treatment or care of a PLWH; &/or
When responding to a subpoena duces tecum &/or subpoena ad
testificandum
Consent
Counseling
Recommended 3 6 mos. after possible exposure to HIV
 Testing hubs (www.pnac.org.ph)
Social Hygiene Clinics [Angeles City, Caloocan City,
Laoag City, Makati City, Mandaluyong City, Manila,
Marikina City, Pasay City, Pasig City, Puerto Galera,
Puerto Princesa City, Quezon City (Batasan Hills,
Bernardo, Project 7), Santiago City, Tuguegarao City,
Cebu City, Iloilo City, Lapu Lapu City, Mandaue City,
Butuan City, Davao City, Gen. Santos City, & Zamboanga
City]
 Testing hubs (www.pnac.org.ph)
L Baguio Gen. Hospital & Medical Center
L Cagayan Valley Medical Center
L RITM
L Bicol Regl Training & Teaching Hospital
L San Lazaro Hospital
L Ilocos Training & Regional Medical Center
L Jose B. Lingad Memorial Medical Center
L Jose Reyes Memorial Medical Center/MEDI-JRMMC
L PGH
 Testing hubs (www.pnac.org.ph)
V Vicente Sotto Sr. Memorial Medical Center
V Corazon Lacson Montelibano Memorial Regional
Hospital
V Western Visayas Medical Center
M Southern Philippines Medical Center
M Davao Regional Hospital
M Zamboanga City Medical Center
 Treatment
There are no proven cures yet for HIV infection & AIDS.
ARV drugs or ARTs only slow down the reproduction of HIV.
Other drugs are used against the opportunistic infections
occurring among AIDS patients.
Antibiotics dont prevent HIV infection or any STI.
Even if treatment & vaccines proved to be available, HIV
pandemic will not necessarily come under control.
Health education & promotion remain the foundations of
control.
 Treatment Hubs (DOH, Jun 2016)
Cagayan Valley Medical Center
Ilocos Training & Regl Medical Center
Jose B. Lingad Medical Center
Baguio Gen. Hospital & Medical Center MMC
PGH
James L. Gordon Memorial Hospital RITM
Bicol Regl Training & Teaching Hospital San Lazaro Hospital
TMC
Western Visayas Medical Center Eastern Visayas Regional
Medical Center
Corazon Locsin Montelibano
Vicente Sotto Memorial
Memorial Regl Hospital
Medical Center
Gov. Celestino Gallares
Northern Mindanao Medical Center Memorial Hospital
Zamboanga City Medical Center Southern Phils. Medical
Center
 Procedure on testing & follow up
Get tested!
1. Counseling
2. Screen for HIV Ab
ELISA test

(-) (+)

Confirmatory testing
Early medical treatment Western blot
Regular blood testing for CD4 count &
viral load
Healthy lifestyle & positive attitude (+) (-)
IMPACT OF HIV & AIDS
Quick facts (DOH-NEC, Jun 2016)
Figures on newly-diagnosed cases
(DOH-NEC, Jun 2016)
Percentage per region No. per day
 HIV & AIDS
& THE WORKPLACE
 Impact on workers

Stigma & discrimination

Loss of income & benefits

Pressure on families; dealing with

orphans & dependents
 Impact on enterprise
Loss of skills & experience

Reduced supply & increase of labor cost

Threatened OSH

Decreased productivity

Reduced profit & investment

 Impact on the country
Decrease in life expectancy

Decrease workforce

Weakened economic growth & development

Threatened food security

Pressure on health & social security systems

Increase child labor incidence
 HIV & AIDS & the workplace
HIV & AIDS is a workplace issue
Impact is felt by both workers & employers
together with their families
HIV primarily affect people who are in the
peak of their productive life.
Workplace intervention can help limit the
spread & mitigate the impact of HIV & AIDS.
 Role of the workplace
Allows development of policies & strategies
Facilitates promotion of health messages
Facilitates referral of workers for care &
support
Provides opportunity for an effective
partnership
 DOLE DA 05-10
Guidelines for the Implementation of a Workplace
Policy & Program on Hepatitis B
 Global impact of hepatitis B
Almost half of the worlds population lives in an area with high
hepatitis B prevalence.
2 billion with evidence of 15% 25% die of
HBV infection cirrhosis/liver cancer

300 400 million with chronic HBV

World population: 6 billion
Source: WHO & CDC fact sheets
 Local impact of hepatitis B
Country HBsAg (+), %
Taiwan 10.0 - 13.8
Vietnam 5.7 - 10.0
China 5.3 - 12.0
Africa 5.0 - 19.0
Philippines 5.0 - 16.0
Thailand 4.6 - 8.0
Japan 4.4 - 13.0
HBsAg Prevalence Indonesia 4.0
High ( 8%)
Intermediate (2% to 8%)
South Korea 2.6 - 5.1
Low (< 2%) India 2.4 - 4.7

Mast EE, et al., MMWR Recomm Rep., 2006;55:1-33. Russia 1.4 - 8.0
Custer B, et al., J Clin Gastroenterol., 2004;38(10 suppl.):S158-S168. US 0.2 - 0.5
 Local impact of hepatitis B
An estimated 16% or 1 out of 8 Filipinos have
hepatitis B (2003).
Approx. more than 13 million Filipinos have
been or will be discriminated from gainful
work & employment unless this discriminatory
practice of unlawfully labeling them as unift
to work is expressly prohibited.
 Why should Filipinos be aware of
hepatitis B?
Hepatitis B is caused by a virus that infects the
liver.
Its considered as the silent Asian epidemic.
Most dont even know theyre infected.
How is hepatitis B life-threatening?
1 in 4 hepatitis B carriers may die from liver cancer or
liver cirrhosis
Most common cause of liver cancer & liver cirrhosis
among Filipinos
Liver cancer 4th most common cause of cancer
among Filipinos & 2nd leading cause of cancer-
related deaths in the Philippines
70%-80% can lead healthy & productive lives if
diagnosed early & monitored regularly by a MD
How can hepatitis B affect ones work?
Occupations considered high risk for the
transmission of hepatitis B in the workplace are
those in the health care setting because it involves
exposure to blood & body fluids.
All other occupations that dont involve exposure to
blood & body fluids low risk for the transmission
of hepatitis B.
HEPATITIS 101
Hepatitis is...

an inflammation of the liver caused by viruses, drugs,

& toxins.
 Types of viral hepatitis
HAV HBV HCV HDV HEV HGV

Blood Blood Blood

Source Feces Feces Blood
Body fluids Body fluids Body fluids

Needles
Childbirth Blood
Needles Sex
Needles transfusion
Route of Blood Blood
Fecal-oral Sex Fecal-oral (requires HBV,
transmission transfusion transfusion
Blood HCV, or HIV co-
(sex, childbirth) (requires HBV
transfusion infection)
co-infection)

No (whether its
pathogenic to
Chronicity No Yes Yes Yes No humans
remains
unclear)

Blood donor
Active & passive Active & passive screening, Ensure safe Blood donor
Prevention HBV vaccine
vaccination vaccination Risk mgt., & drinking water screening
Education
 How is hepatitis B transmitted?
Mother to child (during pregnancy & childbirth)
Breastfeeding of infants by infective mothers provided that
HBIg & hepatitis vaccine are given at birth.
Exposure to contamined blood/body fluids
Cuts or grazes on skin & mucosa
Sharing personal items
Needle stick & sharps injuries
Acupuncture, tattooing, piercing, manicure, pedicure
Inadequately sterilized dental & surgical instruments
Sexual contact
Blood transfusion rare
 Who are at risk for hepatitis B?
Infants born to HBsAg(+) mothers
Individuals born in endemic areas
People with family history of liver disease
Recipients of blood products before 1990s
HCWs
Patients undergoing hemodialysis
Sexual partners of HBV carriers
Patients with STIs
IV drug users
People with multiple sexual partners
 Who are at risk for hepatitis B?
Categories of occupations according to risk of HBV exposure from
infected workers (HSP, 2011)
Category 1 Category 2 Category 3
HCWs who are HCWs who are not Non-HCW
performing or who performing or who All other occupations
have reasonable dont have the that dont fall into
expectation of reasonable Categories 1 & 2
performing EPPs expectation of
Other workers whose performing EPPs
occupation involves
potential for exchange
of bodily fluids
 How can we eliminate or prevent
transmission of hepatitis B?
Prenatal screening for all mothers
Vaccination
All newborn infants
Children of high risk groups
Adolescents & all children up to 18
Adults in high risk groups
Susceptible individuals
HBsAg (-) & anti-HBs (-)
HCWs
Universal precaution
PPE
How to take care of your liver?
Avoid drinking alcohol in excess
Avoid non-essential drugs or medications that
may adversely affect your liver
Avoid diet high in cholesterol & fat
OH-RELATED DOLE ISSUANCE
 Scope & Components
TITLE SCOPE COMPONENTS

DO 53-03: Guidelines for the Implementation of Mandatory for A. Advocacy,

a Drug-Free Workplace Policies & Programs for companies with 10 Information,
the Private Sector or more workers to Education
include supply &Training
chain B. Preventive
DO 73-05: Guidelines for the Implementation of All workplaces in Strategies
Policy & Program on Tuberculosis (TB) the private sector C. Social Policy
Prevention & Control in the Workplace including their D. Health Care
Services
DO 102-10: Guidelines for the Implementation supply chain E. Benefits &
of HIV & AIDS Prevention & Control in the Compensation
Workplace Program F. Monitoring &
DA 05-10: Guidelines for the Implementation of Enforcement
a Workplace Policy & Program on Hepatitis B
 Policy & Program Components
DO 102-10 DA 05-10
DO 53-03 DO 73-05
POLICY & PROGRAM (HIV & (Hepatitis
(Drugs) (TB)
AIDS) B)
Jointly developed by management &
/ / / /
workers
10
Mandatory; covers all workplaces / / /
workers
Advocacy, education, & training / / / /
Preventive strategies / / / /
Medical management (diagnosis,
/ / / /
treatment, & referral)
Social policy (non-discrimination, &
/ / / /
work accommodation)
Roles & responsibilities: Employers,
/ / / /
Workers, SHC, & Govt
Highlights of DOLE Issuance for Illnesses & Related
Concerns (Drugs, TB, HIV/AIDS, Hepatitis B)
Formulation of workplace policy & program
Policy & program may be a separate or integrated
into existing OSH policy & program of
establishment.
Collaboration of management & workers
representatives in development & implementation
of policy & program.
May be included as provisions of the CBA.
Highlights of DOLE Issuance for Illnesses & Related
Concerns (Drugs, TB, HIV/AIDS, Hepatitis B)
Components of prevention & control of
workplace policy & program
Advocacy, information, education, & training
Social policy
Non-discriminatory policy & practices
Confidentiality
Work accommodation & arrangement
Diagnosis, treatment, & referral for other services
Highlights of DOLE Issuance for Illnesses & Related
Concerns (Drugs, TB, HIV/AIDS, Hepatitis B)
Roles & responsibilities of employers &
workers

Implementation & monitoring

Within the establishment, safety & health
committee or its counterpart shall be tasked for
this purpose.
DOLE through its ROs
 Key Principles
Recognition of the different health concerns as
workplace issue
Non-discrimination
Healthy work environment
Social dialogue
Confidentiality
Continuation of employment relationship
Prevention
Diagnosis, treatment, & referral for other services
Roles & responsibilities of stakeholders
The LLCS Checklist (DO 131-13, as amended)
OSHS COMPLIANCE INDICATORS REMARKS
Registration of establishments Rule 1020, OSHS

Adequate aisles/passageways Rule 1060, OSHS; Sufficient width & height, &
w/ signs & markings
Good housekeeping Rule 1060, OSHS; Conditions of floors, walls, &
storage rooms
Emergency exits Rule 1940, OSHS; 2 per floor w/ no obstructions

Materials handling & storage Rule 1150, OSHS; Appropriate labels, dotting, &
storage
Waste disposal system Waste receptacle & its removal; drainage system

Adequate lighting Rule 1070, OSHS; In work areas, in aisles &

passageways
Noise pollution control Rule 1070, OSHS; Provision of appropriate PPE
or isolation of work area
The LLCS Checklist (DO 131-13, as amended)
OSHS COMPLIANCE INDICATORS
Proper ventilation
Radiation exposure control
Airborne contaminant control
WEM
PPE
Fire protection equipment/facilities
Proper machine guarding
Proper office spacing
REMARKS
Rule 1070, OSHS; Provision of natural or
artificial air supply
Provision of appropriate PPE, examination of
work area
Rule 1070, OSHS; Provision of appropriate PPE,
improvement of technical process,
improvement of ventilation
Rule 1070, OSHS
Rule 1080, OSHS; Provision & appropriate
training
Rule 1940, OSHS; Water tank, fire extinguisher,
conduct of fire drill
Rule 1200, OSHS; Railing or casing of moving
parts
Rule 1060, OSHS; Between workers & machines
The LLCS Checklist (DO 131-13, as amended)
OSHS COMPLIANCE INDICATORS REMARKS
No imminent danger situation Condition that could cause death or
serious physical harm
Personal facilities DOLE: Rule 1060, OSHS
a. Separate toilet DOH: IRR on Chapter VII, PD 856,
b. Supply of potable water amending AO 111 s. 1991
c. Washing facilities
Safety & health organization Rule 1040, OSHS; According to number of
employees
Safety personnel Rule 1030, OSHS; DO 16-01
a. Safety officer
b. Safety practitioner
Health personnel Rule 1960, OSHS
a. FA
b. OHN
c. OHP/OHD
The LLCS Checklist (DO 131-13, as amended)
OSHS COMPLIANCE INDICATORS
Medical facilities
a. Treatment room
b. Clinic
c. Hospital
Emergency medicines
Continuing training related to OSH
Administrative reports on safety & health
a. Minutes of meeting of SHC
b. Employees work accident/illness
exposure data
c. Annual work accident/illness
exposure data
d. Annual medical report
Registration w/ PCAB
REMARKS
Rule 1960; OSHS
Rule 1960, OSHS; Table 47
Rule 1030, OSHS; DO 16-01
- Rule 1040, OSHS
- Rule 1050, OSHS; For every accident
- Rule 1050, OSHS; Whether or not there
is an accident
- Rule 1050, OSHS; Health record of
program & activities
DO 13-98
The LLCS Checklist (DO 131-13, as amended)
OSHS COMPLIANCE INDICATORS REMARKS
DOLE-approved CHSP DO 13-98
Construction safety signages DO 13-98
Construction heavy equipment testing Rule 1410, OSHS; DO 13-98
Construction heavy equipment operator, TESDA Rule 1410, OSHS; DO 13-98
certified
Construction workers skills certificate for critical Rule 1410, OSHS; DO 13-98
operations
DO 53-03 (drug-free workplace) Written policies & programs reflecting the
elements required
DO 102-10 (HIV & AIDS in the workplace) Written policies & programs reflecting the
elements required
DA 05-10 (hepatitis B in the workplace) Written policies & programs reflecting the
elements required
DO 73-05 (TB in the workplace) Written policies & programs reflecting the
elements required
The LLCS Checklist (DO 131-13, as amended)
OSHS COMPLIANCE INDICATORS
Technical Safety
Boiler
Pressure vessel
Internal combustion engine
Elevators & other related equipment
Power piping lines inspection
Crane & hoist equipment
Turbine
Electrical wiring installation inspection
REMARKS
Rule 1160, OSHS; Permit to operate
Rule 1170, OSHS; Permit to operate
Rule 1180, OSHS; Permit to operate
Rule 1220, OSHS; Permit to operate
Rule 1240, OSHS; Permit to operate
Rule 1410, OSHS; DO 13-98; Permit to
operate
Permit to operate
Rule 1210, OSHS; certificate of electrical
inspection