Occupational Safety and Health in

the Philippines: Facing new

Challenges
 The Philippine
REFOCUSING OCCUPATIONAL HEALTH IN THE PHILIPPINES:

COVID-19
Situation
THE CHALLENGE OF COVID 19

• Daily status update from Philippine Department

of Health in Filipino Language
• Total Cases: 531,699
• Active Cases: 32,775 (6.2%)
• Recovered Cases: 487,927 (91.8%)
• COVID-19 Deaths: 10,997 (2.07%)

• Positivity rate as of 4 February 2021: 5.8%

• Hospital Facility Availability
• ICU beds = 60%
• Isolation beds = 65%
• Ward beds = 76%
• Ventilators = 80%
https://www.facebook.com/OfficialDOHgov/photos/4117266008284620
• As a result of workplace accidents, about 46,283 cases
of occupational injuries were recorded in 2017. Both
cases of occupational accidents and cases of
occupational injuries in 2017 were comparatively lower
by 14.5 percent and 9.2 percent, respectively from
2015. (Figure 1)
• Among cases of occupational injuries, about 43.9
percent were non-fatal cases with lost workdays while
about 1 percent were fatal cases. More than half of all
occupational injuries (55.1%) were accounted to cases
of injuries without lost workdays.
• By industry, manufacturing accounted for the highest
share of occupational injuries at 49.7 percent of the
total cases. Far second was wholesale and retail trade;
repair of motorcycles at 11.4 percent, followed by
administrative and support service activities at 7.2
percent share.
OCCUPATIONAL HEALTH

Definition adopted by the Joint ILO/WHO Committee on

Occupational Health (1950)

Aims at the:
– promotion and maintenance of the highest degree of physical, mental and
social well-being of workers in all occupations

– prevention amongst workers of departures from health caused by their

working conditions

– protection of workers in their employment from risks resulting from factors

adverse to health

– placing and maintenance of the worker in an occupational environment

adapted to his physiological and psychological capabilities
What is the world of
work? WORK SYSTEM
- Productive
- Income
- Advocacy People

Why do people work?

- Hierarchy of needs
- Self-fulfillment Equipment
Environment
What is decent work?
- 4 pillars
- Employment
creation
- Rights at work
- Social dialogue Materials
- Social protection
 What determines workers health?
•Working environment
Work-related health practices
–Mechanical
• individual risk-taking behaviour
–Physical • physical exercise, sedentary
–Chemical work
–Biological • diet and nutrition
–Ergonomic • unhealthy habits – smoking,
–Psycho-social risks alcohol
Access to health services:
•Social factors
• preventive occupational health
–occupational status, employment
services
conditions
• specialized curative care and
–income rehabilitation
–inequities in gender, race, age, residence • health and accident insurance
etc.
Occupational Health Hazards
Chemical Physical
hazards hazards

Ergonomic Biologic
stresses hazards
Psychosocial hazards
Mental health
Important concepts in Occupational
Safety and Health
 Health Hazards Safety Hazards
• working conditions which result in • Result to an injury (non-
an illness
disabling, disabling, fatal)

• exposure to dangerous substances • Injury is immediate

or conditions, such as chemicals,
gases, dusts, noise etc. • Secondary to an unsafe act
or unsafe condition
• often, latency between exposure
and disease
 Hazard and Risk Examples of Hazards and Their
Effects
• A hazard is any source of
potential damage, harm or Workplace Example of Example of Harm
adverse health effects on Hazard Hazard Caused
something or someone Tool Knife Cut
under certain conditions at
work Substance/ Benzene Leukemia
Chemical
• Risk is the chance or Material Asbestos Mesothelioma
probability that a person
will be harmed or Source of Electricity Shock, electrocution
experience an adverse Energy
health effect if exposed to a Condition Wet floor Slips, falls
hazard.
Process Welding Metal fume fever

Practice Repetitive Musculoskeletal

movements injuries
 Examples of Risk
1. The risk of developing cancer from
smoking cigarettes
Risk= Hazard x Exposure
2. The risk of developing lung cancer
from exposure to asbestos Reproduction number=
3. The risk of suffering from hearing
Transmission rate (Minimum
loss when working very noisy public health standards)
workplaces
x contact rate (crowding or Mass
4. The risk of cataracts from gatherings)
exposure to infra-red or ultraviolet x duration of infectiousness
radiation
(Isolation, contact tracing, quarantine
efficiency)
 Risk Assessment Process
• IDENTIFY the hazards
• ASSESS the risks and available control
measures
• MANAGE the risk
– CONTROL the risks through implementation of
appropriate control measures
– MONITOR the controls to evaluate their
effectiveness
– Communication of Risks & Controls
 IDENTIFY POTENTIAL
HAZARDS
The most important step in any Risk Assessment -
hazards can only be controlled if they are identified

Equipment Procedures Agents

People Environment
➢Each step is analyzed for potential inherent hazards
➢Decision on the relevance of any particular hazard
come later in the risk assessment processes
Hierarchy of Risk Control
Measures
Will exposure to hazards in the
workplace always cause injury,
illness or other adverse health
effects?

NO
Factors that determine the
disease development

Workplace Individual
Factors Susceptibility

Occupational and Work-Related Disease

Who gets sick?

• Host Factors
– Age
– Health Habits (e.g. smoking, alcohol, drugs)
– Reproductive Status
– Medical History
• Dose
– Duration of exposure
– Concentration of Agent
– Route of Exposure
– Workplace Control Measures
– Personal Hygiene
 Occupational Health
• Occupational
• Conditions
• Are

PREVENTABLE
Effective Safety and Health Programs

–Reduces the extent and severity of work related injuries

and illnesses

–Improves employee morale and productivity

–Reduces workers’ compensation costs

 PREVENTION AND CONTROL OF OCCUPATIONAL HAZARDS

Monitoring Activity Workplace-Related Events Health Effects

Environmental Exposure at the workplace

monitoring - Chemicals None
- Physical agents

Biologically significant exposure

- Chemicals absorbed
Biological
monitoring and - Early (reversible) changes
surveillance
Early

Clinical diagnosis
- measurable health effects

Treatment and
Late
surveillance
End effects
- Morbidity
- diseases
- Mortality
- unfavorable events
(spontaneous abortion)
 MONITORING
• Systematic continuous, repetitive health-related activities
that should lead to corrective action
• Types of monitoring
– Ambient / Environmental
– Biologic
– Medical surveillance
Why Do Medical Surveillance?

• Identify cases
– Early detection of job-related health problems
(2°)
– Determine their causes

• Analyze Trends and Patterns in the

Workforce to Guide Prevention Efforts (1°)
– Supplement Environmental Monitoring to Confirm
the Effectiveness of Controls

• Meet Regulatory Requirements

 Workplace Hazards
• Chemical • Biological • Ergonomics
– Gases – Mold – Repetitive and/or
– Dust – Fungi prolonged activities
– Fumes – Bacteria – Forceful Exertions
– Vapors – Virus – Bad body
– Mists – Insects mechanics
– Awkward Positions
– Improper lifting
 Workplace Hazards
• Direct • Physical
– Unguarded machines – Noise
– Extreme Temperature
– Vibration
– Inadequate
Illumination
– Extreme Pressure
– Falling Objects – Inadequate Ventilation
– Electrical Hazards – Radiation
 Chemical Hazards
• Various forms of chemicals are potentially
toxic or irritating to the body
• toluene-based chemicals-Paints, varnish
• gases

Cleaning chemicals

Gases
Cement burns
Solvent hands
CHEMICAL HAZARDS and THEIR
ADVERSE HEALTH EFFECTS
 Basic Toxicology Terminology

Toxicity
- intrinsic capacity of a chemical agent to affect an
organism adversely

Toxic substance
- agent that causes toxicity
• With proper handling, even
highly
toxic chemicals can be used
safely.
• Less toxic chemicals can be
extremely hazardous if handled
improperly.
 Toxic agent becomes hazardous when there is potential for worker
exposure

TOXICITY x EXPOSURE = HAZARD

With proper handling, even highly toxic chemicals can be used safely.
Less toxic chemicals can be extremely hazardous if handled improperly.
What is risk?

Risk is the probability or likelihood that adverse

effects will occur when a living organism is
exposed to a toxic agent.
What determines risk?

• Response of the host (based on host’s physiology)

• Physical properties of the toxic agent

• Dose or concentration of toxin which includes the

amount of the substance, duration of exposure and
frequency of exposure

• Synergistic effects - combination of different elements

or materials
Occupational
hazards genetic medical
history
factors
age gender

Social history
Smoking, alcohol
 Multiplicity
of exposure
Physical Exposure
properties duration
Occupational
hazards
Timing of Magnitude of
exposure exposure
 Who gets sick?

Host Factors
Age
Health Habits (e.g. smoking, alcohol, drugs)
Reproductive Status
Medical History
Dose
Duration of exposure
Concentration of Agent
Route of Exposure
Workplace + Personal Hygiene
 Routes of Entry into the Body

Inhalation

Ingestion

Skin Contact
Absorption through the skin and mucous membrane of the eyes:
absorption is faster through abraded or inflamed skin
Ingestion:
eating – contaminated hands
swallowing - accidental
 Concepts in Toxicology

DOSE:
• Dose The amount of a substance absorbed
inside the body
• Dose-Response • Number of doses
• Interaction • Frequency
• total time period of the exposure

Dose-Response
• correlates exposures and the spectrum
of induced effects
• based on observed data
• the higher the dose, the more severe
the response
Dose estimate of toxic effects:

LD 50 - Dose lethal to 50% of test animals

 What is the LD50 for chemical XYZ, based on the figure below?

12 mg
15 mg
17 mg
 Interactions
• the presence of one chemical may
drastically affect the response to
another chemical.

1+1=2

1+1=0

1+0=2

1+1=3
 Chemical Interactions
• Independent effects
• Inorganic Lead and organophosphate
• Additive effects
• N-hexane and MEK (1+1=2)
– Nerve toxicity

• Synergistic effects
• Ethanol and carbon tetrachloride (1+2=5)
– Liver toxicity

• Potentiating effect
• Isopropanol and Carbon tetrachloride (0+5=15)
– Liver toxicity

• Antagonistic effects
• Benzene and Toluene (4+6=8)
• Antidotal effect: CO and hyperbaric O2
 General Classification of Toxic Effects

Local toxicity vs Systemic toxicity

Local Systemic
Occurs at the site of chemical Distant site from point of contact,
contact may involve many organ systems

Contact with acid creating a chemical Consumption of lead causing

burn damage to the kidneys

Ozone exposure causing lung Exposure to hydrogen fluoride

irritation causing pulmonary edema
Exposure to arsine causing
Aldehyde splash in the eyes.
hemolysis of red blood cells
 Toxicity

Acute Toxicity vs Chronic Toxicity

Chronic
Acute ◼ represents cumulative damage to
◼occurs almost immediately specific organ systems
(hours/days) after an exposure ◼ many months or years to have
recognizable clinical disease.
Skin Absorption Inhalation
Absorption of phenol through the Consumption of lead causing
skin creating a chemical burn damage to the kidneys
Inhalation Inhalation
Inhalation of formaldehyde causing Inhalation of asbestos causing
irritation to mucus membranes cancer to the lungs
 Organ Specific Toxic Effects
• Blood/Cardiovascular Toxicity
• Dermal/Ocular Toxicity
• Genetic Toxicity (germ cells)
• Hepatotoxicity
• Immunotoxicity
• Nephrotoxicity
• Neurotoxicity
• Reproductive Toxicity
• Respiratory Toxicity
Occupational Kidney Diseases

Causative Agents Industry Diseases

Mercury, Lead Battery., Chronic renal failure,

Cadmium Chemical Ind, Renal stones
Battery Mfg. (Cadmium)
Nephrotic Syndrome
(Mercury)

Chloroform, Solvents, chemical Acute renal

Carbon tetrachloride industries failure

Ethylene glycol Solvents, cosmetics

Carbon disulfide Solvent, pesticide Chronic renal failure
 Respiratory Toxicity
• pulmonary irritation
• asthma/bronchitis
• reactive airway disease
• emphysema
• allergic alveolitis
• fibrotic lung disease
• pneumoconiosis
• lung cancer
Examples of Illnesses From Chemical
Exposure

(Pneumoconiosis)
 Dermal Toxicity
• dermal irritation due to skin exposure to
gasoline
• dermal corrosion due to skin exposure to
sodium hydroxide (lye)
• dermal hypersensitivity due to skin exposure
to poison ivy
• skin cancer due to ingestion of arsenic or skin
exposure to UV light
Arsenic Exposure

Chromium Exposure
 Occupational Hematologic
(Blood) Diseases

Causative Agents Industry/Process Disease

Lead Battery manufacturing Anemia

Lead Smelting

Benzene Solvent Aplastic

Soap manufacturing anemia

Arsine gas Chemical industries Destruction of

red blood cells
Occupational Liver Diseases

Causative Agents Industry/Process Disease

Carbon Cleaning fluids, Acute liver

tetrachloride Dry cleaners toxicity

Arsenic Smelting, Insecticides Cirrhosis

Chlorinated `Chemical industry
hydrocarbons

Epoxy resins Rubber, synthetic Acute

fabric manufacturing hepatitis

Vinyl chloride Plastics, Vinyl chloride Liver Cancer

monomer manufacturing
Occupational Heart Diseases

Causative Agents Industry/Process Disease

Lead, Cadmium (?) Battery mfg. Hypertension

Recycling

Carbon disulfide Degreasing, Dry Atherosclerosis

Cleaning

Fluorocarbons Refrigeration, Abnormal heart

Trichloroethylene solvent workers rhythm

Nitrates Explosives Angina, heart attack

 Eye Toxicity
• acids and strong alkalis may cause severe
corneal corrosion

• methanol (wood alcohol) may damage the

optic nerve
 Neurotoxicity

• neuronopathies (neuron injury)

– Organic mercury
• axonopathies (axon injury)
– Inorganic lead
– n-hexane
• demyelination (loss of axon insulation)
– Tricholoroethylene
• interference with neurotransmission
– Organophosphates
 Peripheral
polyneuropathy from
n-hexane
 Immunotoxicity
• Hypersensitivity
– allergy and autoimmunity
• Immunodeficiency, and uncontrolled
proliferation
– Leukemia (benzene)
Examples of Illnesses From Chemical
Exposure

Stevens-Johnson
Syndrome
 Reproductive Toxicity
• decreased libido and impotence
• infertility
• interrupted pregnancy (abortion, fetal death,
or premature delivery)
• infant death or childhood morbidity
• altered sex ratio and multiple births
• chromosome abnormalities and birth defects
• childhood cancer
Proven reproductive hazards (based on human studies)

Anesthetic gases Miscarriage, death of

Diethylstilbestrol (DES) newborn
Hepatitis B Cancer
Organic mercury Newborn hepatitis, liver
cancer
Lead Cerebral palsy, brain
malformation
Miscarriage, premature birth
Polychlorinated Low birth-weight
biphenyls (PCBs)
Radiation
Miscarriage, brain defects,
skeletal defects
Suspected reproductive hazards (based on human studies)

Carbon monoxide Slowed growth

Cytotoxic drugs Miscarriage
Ethylene oxide Miscarriage
Hexachlorophene Birth defects
Organic solvents Cleft palate, miscarriage,
newborn
infection, childhood cancer

2,4,5 trichlorophenol Miscarriage

Vinyl chloride Brain defects
 CHEMICALS IN THE
WORKPLACE
AIR SURFACES, ETC.

ENVIRONMENTAL
BLOOD TARGET ORGANS
MONITORING

FECES URINE
SWEAT
EARLY EFFECTS

BIOLOGIC
MONITORING HEALTH
IMPAIRMENT
 PREVENTION AND CONTROL OF OCCUPATIONAL HAZARDS

Monitoring Activity Workplace-Related Events Health Effects

Environmental Exposure at the workplace

monitoring - Chemicals None
- Physical agents

Biologically significant exposure

- Chemicals absorbed
Biological
monitoring and - Early (reversible) changes
surveillance
Early

Clinical diagnosis
- measurable health effects

Treatment and
Late
surveillance
End effects
- Morbidity
- diseases
- Mortality
- unfavorable events
(spontaneous abortion)
 Physical Hazards
• Noise
• Extreme temperatures
–Heat
–cold
• Radiation
• Vibration
Segmental Vibration
Whole-body vibration
UV Keratitis
NOISE
 Hearing Damage from Noise Exposure
:
Acute: from loud noise such as blasts
(140-160 dB damages the eardrum)
Chronic: Due to long-term exposure to
hazardous noise levels
Major risk Factor: Prolonged exposure to
unprotected levels of noise
(> 85 dB)
 Types of Noise-Induced Hearing Loss

Temporary threshold shift (auditory fatigue)

– temporary loss of hearing acuity after exposure to loud noise
– recovery within 16-48 hrs.

Permanent threshold shift

– irreversible loss of hearing
– difficulty in understanding spoken words
– familiar sounds are muffled
– frequent tinnitus
Sensorineural Hearing Loss
 Approximate Decibel Level

Decibels (dB) Examples

0 The quietest sound you can hear
30 Whisper, quiet library
60 Normal conversation, sewing machine,
typewriter
70-80 Television
90 Lawnmower, shop tools, truck traffic
(8 hours per day is the maximum exposure)
100 Chainsaw, pneumatic drill, snowmobile;
115 Sandblasting, loud rock concert, auto horn
140 Gun muzzle blast, jet engine
(causes pain)
 Harmful Effects of Noise Early Signs of Hearing Loss
– Hearing Damage
– Interfere with work performance
– Disturbs relaxation and sleep • Difficulty in understanding spoken words in
– Hypertension a noisy environment
– Hyperacidity • Need to be near or look at the person
– Palpitations speaking to help understand words
– Stress-related disorders • Familiar sounds are muffled
• Complaints that people do not speak clearly
• Ringing noises in the ears (tinnitus)
 VIBRATION

Vibrations are mechanical oscillations, produced by either

regular or irregular periodic movements of a body about
its resting position.
Categories:
1. Whole-body vibration: the whole body is brought into
vibration via the feet (in standing work) or via the seat (in
seated work).
– Usually, the vibration is predominantly vertical, such as in
vehicles.
2. Hand-arm vibration affects only the hands and arms
Segmental Vibration
 Vibration

– Hand Arm Vibration

Syndrome (HAVS)
– (secondary Raynaud’s
Syndrome)
– tingling, numbness,
blanching of fingers
– pain
 Vibration

•Whole Body Vibration:

•(heavy equipment operators,
bus/truck drivers)
–degenerative spinal changes
–gastrointestinal disturbances
–muscular and joint disorders
ILLUMINATION
 Inappropriate Illumination

• Usual Complaints
– Visual Fatigue
– Double Vision
– Headaches
– Painful irritation,
– Lacrimation, Conjunctivitis
Occupational Effects of Visual
Fatigue
– Loss of productivity
– Increased Accident Rate
– More Mistakes
– Lowering of Quality
– Visual Complaints
Recommended Illumination Levels

Area of Operation Min Lighting Level (lux)

Cutting Cloth  2000

Fine machining

Transcribing handwriting 1000

Drafting

Welding First 500

Aid station

Lunch Room 300

Rest Room
HEAT
 Disorders Related to Heat Stress
DISORDERS CAUSES MAIN CLINICAL TREATMENT PROGNOSIS
FEATURES

Miliaria rubra Malfunction of Pruritic rash Symptomatic Good

sweat glands

Heat cramps Loss of water and Cramps in limbs Rest, fluids with Complete
electrolytes added salt recovery

Heat Physical exertion, Dizziness, blurring Rest, cooling in Complete

exhaustion loss of water & of vision with cold well-ventilated recovery usual
electrolytes and clammy skin surroundings

Heat stroke Failure of Convulsions, Stripping down High mortality;

temperature muscle twitch, and vigorous Sequelae: poor
control center in delirium with hot cooling with ice memory &
brain and dry skin; Temp baths concentration,
> 41°C headache
RADIATION
 Radiation: Non-Ionizing & Ionizing

Radiation Sources Effects

Non-Ionizing
Ultraviolet Sunlight, Arc flash erythema, skin
Welding cancer, sunburn

Microwaves Radar, Ovens Can interfere with

pacemaker & medical
devices
Infrared Glass Blowing, Cataracts
Furnaces
Ionizing X-rays, Gamma Cancer, congenital
Radiation rays defects, death
Cataract
UV Keratitis
Infection/Biological Hazards

Infectious/biological agents, such as:

• bacteria
• viruses
• fungi
• parasites

may be transmitted by contact with infected co-employees

 Biologic Hazards
–Anything of biological nature
–Has potential to cause harm to humans
–Viruses, bacteria, fungi, parasites
Dangerous plants and animals (for example parasites or insects)
Harmful by-products of living things
Biological agents can cause three types of disease:
• Infections
• Allergies
• Poisoning or toxic effects
 Managing Biological Hazards

Identifying the hazard

–Sources
–Transmission
–Host
Assessing the risk
Controlling the risk
 High-Risk Settings
working with animals or plants
working with people who might be infectious (eg
patients in hospitals)
handling waste material that may be contaminated with
microorganisms (eg refuse disposal)
working in an environment or with equipment that could
be contaminated (eg sewer maintenance)
Assessment of Risk
Who are exposed?
–contact with infectious micro-organisms at work?
–contact with people or animals?

Where does exposure come from

–Source of contamination in your workplace?
–For example legionella bacteria in airconditioning unit

Characterize hazard exposure

–how often the task is carried out;
–how many employees are exposed
–how much infectious material is handled

Immunization status of exposed workers

 Controlling the Risk
Three main approaches

Good occupational hygiene

Good environmental hygiene

and design

Good personal hygiene

 Good Occupational Hygiene

• Wear appropriate protective clothing to stop personal

contamination
• Appropriate ventilation mechanisms
• Adequate space requirement to avoid congestion
• Good housekeeping
• Control of other occupational hazards
• Access to sanitation facilities
 Good Environmental Hygiene

Ensure safe and clean water systems, air conditioning systems

Proper waste disposal
Control pests within the workplace
 Good Personal Hygiene
Proper hand washing
Avoid hand-mouth or hand- Training and education equally
eye contact important
–No eating or drinking in Regular replacement,
working areas maintenance and cleaning of PPE
Showering Consider what you would do in an
Change to clean street clothes emergency situation
before heading for home
 COMPONENTS OF WORKPLACE GUIDELINES FOR COVID19

Increasing physical and Minimizing contact rate

mental resilience
A C

Reducing transmission of B D Reducing risk of infection from

COVID-19 COVID-19
ERGONOMICS

“Fitting the task to the person”

 Ergonomic and Psychosocial Hazards

• Musculo-skeletal disorders
–Low back pain
–Neck-shoulder pain
–Wrist pain –carpal tunnel
syndrome
• Stress
• Violence
Location of
WMSDs
Location of WMSDs
 Ergonomic Stresses

Forceful Exertion
Overcome weight,
resistance, inertia
– Lift, Push, Pull, Carry
 Ergonomic Stresses

Posture
Awkward posture
Static posture
 Ergonomic Stresses

Movement
Extreme range of motion
– Twisting, bending
Repetitive
– same motion pattern
– short cycle time
 Ergonomic Risk Factors for Hand/Wrist WMSDs
Repetitive exertions
–Performing the same act over and over
again
–Repetitive wrist extension/flexion;
ulnar/radial deviation; supination or
pronation
 Ergonomic Risk Factor

Awkward Posture
–Overreaching
 Ergonomic Risk Factors

Forceful exertions
Awkward posture
Repetitive motion
 Ergonomic Risk Factors

Static posture
Repetitive task
Occupational Non-Occupational
Factors Factors

Lifting Age
Pushing/pulling Severe postural
deformities
Prolonged sitting Smoking
Whole body Sports (golf, bowling,
vibration jogging, etc.)
Work dissatisfaction Hypochondriasis
Approach in Ensuring Well-Being of
Workers

Looking at regulatory Looking at developmental

requirements strategies

–Information
Relevant laws, standards, –Education
issuances and guidelines –Training
–Campaigns
•Enforcement –Good practices
•Implementation –Successful cases
–Competitions
•Inspection –Demonstrations
–Interventions
•Evaluation
 Health Programs

Hazards/Disease Source Health Health Program

Effect
Chemical
Solvents Paints, Irritant, Biologic
Thinners Multisystem Monitoring;
effects Surveillance for
chemical
exposure
Physical
Noise Polishing Hearing Hearing
Operations Impairment Conservation
Program
 Health Programs

Hazards/Disease Source Health Health Program

Effect

Biologic
Tetanus Dirty Nails Lockjaw, Immunization
rigidity,
death
Ergonomic
Stresses Awkward Musculoskele Worker
Cumulative Trauma postures, tal Strain education and
Disorder Heavy loads training;
Back Care
Program
 Risk Evaluation
➢ Consider existing controls
➢ Engineering controls (Fumehood, glovebox, chains for
cylinder, etc.)
➢ Administrative controls (Signage, training, SOPs, others)
➢ Personal Protective Equipment
➢ Existing control will not change the severity but only
likelihood
➢ Severity & likelihood is based on 3 by 3 matrix and the
respective criteria specified
➢ Risk rating is the product of severity by likelihood
➢ Refer to acceptability criteria on the recommended action
for different risk rating
➢ For medium & high risk, additional controls will be
required
 Risk Evaluation
Severity Categories & Description
Level Human (Impact to Biological Impact Environmental
Physical Being) Damage

(1) Minor No Injury or light injury May not cause human disease, if does, the Reversible
requiring only first aid disease is unlikely to spread to the community
treatment (MC < 4 days and there is usually effective prophylaxis or
MC) treatment available;

(2) Moderate Any injury/ill health Can cause severe human disease, not ordinarily Reversible but takes
leading to ≥ 4 days MC spread by casual contact from one individual to years
or ≥ 1 day hospitalisation another; it may spread to the community, but
or leads to temporary there is usually effective prophylaxis or
disability treatment available

(3) Major Fatality, permanent Can cause lethal human disease, may be Irreversible
Disability or life readily transmitted from one individual to
threatening disease another, or from animal to human or vice-versa
directly or indirectly, or casual contact, it may
spread to the community; usually no effective
prophylaxis or treatment available
 Risk Evaluation

Likelihood Categories & Description

Level Events Frequency

(1) Remote Undesired event which may occur but unlikely, once in 5
years
(2) Possible Undesired event which is probable, once in a year

(3) Frequent Undesired event which probably occur in most

circumstances, once or more in a month
 Risk Evaluation
Acceptability of Risk

Risk Risk Acceptability

Recommended Actions
Score Level of Risk

Low No additional risk control measures required. To continue to monitor to

<3 Acceptable ensure risk do not escalate to higher level.
Risk
Acceptable to carry out the work activity; however, task need to be
reviewed to bring risk level to As Low As Reasonably Practicable.
Medium Moderately Interim control measures such as administrative controls can be
3–4
Risk Acceptable implemented. Supervisory oversight required.

Job must not be carried out until risk level is brought to at least medium risk
level.
Risk controls should not be overly dependant on personal protective
equipment. Controls measures should focus on Elimination, substitution
High Not and engineering controls.
>4
Risk Acceptable Immediate Management intervention required to ensure risk being brought
down to at least medium level before work can be commenced.
Control Measures
 Risk Control

➢ Using Hierarchy of Controls to reduce the risk

➢ Using the concept of As Low As Reasonably Practicable
(ALARP)
 Additional Controls
Responsible person and timeline
➢Additional control for risk rated more than 3 or
medium & high risk
➢Reduce risk to as low as reasonably practicable
➢Who and When?
➢Responsible person to implement the identified
control measures and
➢Timeline for completion → update the risk
assessment upon completion of the additional
control measures
Implementation & Review
1. OSH Committee will need to approve the implementation of control
measures.
2. Monitoring of the process or activity has to be carried to ensure that there
is no residual risk or additional risk arising from the control measures.
3. Safety Officers have to check or monitor the new implementation of
control measures and to communicate with workers.
4. Review on Risk Assessment to be carried on the following basis:
- At lease once every three years base on legislative requirements
- After an accident/incident occurrence
- Any change in process or activity
GUIDELINES FOR THE IMPLEMENTATION
OF MENTAL HEALTH WORKPLACE
POLICIES AND PROGRAMS FOR THE
PRIVATE SECTOR
Department Order No. 208, Series of 2020

BUREAU OF WORKING CONDITIONS

Department of Labor and Employment
 Mental Health
It is a state of well-being in which
every individual realizes his or her
own potentials, can cope with
the normal stresses of life, can
work productively and fruitfully,
and is able to make a
contribution to her or his
community.

Understanding Mental Health 139

 Mental Health Condition
A neurologic or psychiatric condition
characterized by the existence of a
recognizable, clinically-significant disturbance in
an individual’s cognition, emotional regulation, or
behavior that reflects a genetic or acquired
dysfunction in the neurological, psychosocial or
developmental processes

The determination of neurologic and psychiatric

conditions shall be based on scientifically
accepted medical nomenclature and best
available scientific and medical evidence
Understanding Mental Health 140
 Understanding Mental Health
▪ Over 450 million people around the world suffer from different
mental or neurological disorders.
▪ 18 million work days were lost to sickness absences due to
mental health conditions, 2015.
▪ WHO predicts that by 2030, businesses around the world will
lose approximately 12 billion workdays due to depression and
anxiety disorders.
▪ 9 out of 10 people with mental health condition experience
stigma and discrimination
▪ 2,558 suicide cases caused by mental health problems in the
Philippines, 2012
▪ Estimated 4.5 million Filipinos was projected to be suffering
from depression or any mental health issues
Understanding Mental Health 141
 Overview of RA 11036 and its IRR
▪ Entitled An Act Establishing a National Mental Health
Policy for the Purpose of Enhancing the Delivery of
Integrated Mental Health Services, Promoting and
Protecting the Rights of Persons Utilizing Psychiatric,
Neurologic, Psychosocial Health Services, Appropriating
Funds Therefor, and for other Purposes

▪ Otherwise known as “The Mental Health Act”

Overview of RA 11036 and its IRR 142

 Timeline
Enacted on Took effect on Published on
20 June 2018 05 July 2018 04 February 2018

Published in the Issued IRR on IRR took effect on

Official Gazette 22 January 2019 19 February 2019

Overview of RA 11036 and its IRR 143

 Duties and Responsibilities of the
DOLE under RA 11036
1. Develop guidelines and
standards on evidence-based
mental health programs for the
workplace and
2. Develop policies that promote
mental health in the workplace
and address stigma and
discrimination suffered by
people with mental health
conditions .

Overview of RA 11036 and its IRR 144

 Duties and Responsibilities of the
DOLE under the IRR
1. Issue appropriate guidelines in the
development and implementation of
workplace policies and programs in
coordination with DOH & MH experts;
2. Develop MH programs for OFWs; and
3. Provide assistance to employers in
the development and promotion of
mental health programs in the
workplace including access to
mental health services.

Overview of RA 11036 and its IRR 145

 DEVELOPMENT OF DO 208-20
Signed Published Effective

11 February 2020 17 February 2020 04 March 2020

*6 Consultation Meetings; 2 Tripartite Executive Committee Meetings; 2 National Tripartite Industrial Peace Council Meetings

Department Order No. 208, Series of 2020 149

 Mental Health Promotion and
Policies in the Workplace
Employers shall develop appropriate
policies and programs on mental health
designed to:
1. Raise awareness,
2. Correct stigma and discrimination,
3. Identify and provide support for
individuals at risk, and
4. Facilitate access to treatment and
psychosocial support.

Overview of RA 11036 and its IRR 150

 Objective
Guide employers and workers for the effective implementation
of MH Workplace Policies and Programs in accordance with
the following:
1. Mental Health Law (RA 11036) & its IRR;
2. Magna Carta for Persons with Disability (RA 7277, as
amended by RA 10524) and its IRR;
3. OSH Law (RA 11058) and its IRR;
4. United Nations Convention on the Rights of Persons with
Disabilities;
5. Anti-Bastos Law (RA 11313); and
6. Other relevant policy issuances.
Department Order No. 208, Series of 2020 151
 Scope and Coverage

Applies to all workplaces and establishments in the formal

sector including those which deploy Overseas Filipino Workers
(OFWs)

Department Order No. 208, Series of 2020 152

 Formulation of Mental Health
Policy and Program
It is mandatory for all workplaces and establishments and shall:
1.Raise awareness, prevent stigma and discrimination,
provide support and facilitate access to medical health
services.
2.Promote workers’ well-being towards healthy and
productive lives.
3.Be Jointly prepared by management and workers’
representatives and be made integral part of the
company’s OSH policies and programs.

Department Order No. 208, Series of 2020 153

 Formulation of Mental Health
Policy and Program
The Mental Health Workplace Policy and Program shall be:
1.Properly coordinated and
2.Monitored and regularly reviewed and updated, as
necessary.

*Assistance may be sought from the DOLE, DOH and/or organizations

rendering mental health services such as PAP, PPA, PNA, PGCA, and PMHA.

Department Order No. 208, Series of 2020 154

 Components and Implementation
Strategies of the MH WP&P
1. Advocacy, Information, Education and Training
▪Provision of basic information and education on mental
health;
▪Extension of its activities to the workers’ families through
CSR;
▪Conduct of capacity building of OSH personnel and
Human Resource Officers on the identification,
recognition of psychosocial hazards and management
of mental health problems; and
▪Coordination with DOH, NCMH or with other mental
health service providers.
Department Order No. 208, Series of 2020 155
 Components and Implementation
Strategies of the MH WP&P
2. Promotion and enhancement of workers’ well-being to
have healthy and productive lives
▪Increase workers’ awareness;
▪Promote healthy lifestyle and work-life balance;
▪Identify and manage work-related stress and stressors;
▪Manage effectively changes in the work organization
and utilization of human resources systems;
▪Establish programs on mental health, recognition of
workers’ achievements and efforts, and psychosocial
support and
▪Conduct capacity building of managers and HR.
Department Order No. 208, Series of 2020 156
 Components and Implementation
Strategies of the MH WP&P
3. Social policy
▪Non-discriminatory policies and programs
▪Confidentiality
a. communicated and understood by all workers
b. prepared advance directive by the worker to
form part of workers record (201 file)
c. bound by rules of confidentiality/Data Privacy
Act of 2012

Department Order No. 208, Series of 2020 157

 Components and Implementation
Strategies of the MH WP&P
▪Disclosure
a. encourage workers’ to disclose his/her mental heath
condition for purposes of reasonable accommodation
b. disclosure of workers’ mental health condition is
allowed in any of the following condition:
− required by law

− consent from the worker with mental health condition

− life threatening emergency cases (ex. self harm)

− administrative, civil or criminal case filed against mental health professional for negligence

Department Order No. 208, Series of 2020 158

 Components and Implementation
Strategies of the MH WP&P
▪Work accommodation and work arrangement
a. agreements shall be made between management
and workers’ representative
b. work accommodation and support must be clearly
explained to the worker preferably in the presence of
family member
c. return to work with reasonable accommodation may
be allowed as recommended by the mental health
professional and concurred by OH physician, if any
d. changes in workers’ behavior/attitude should be
monitored and evaluated

Department Order No. 208, Series of 2020 159

 Components and Implementation
Strategies of the MH WP&P
4. Treatment, rehabilitation and referral system
▪Provision of mental health services by employer or
through the company’s workers assistance program;
▪Referral to mental health facility or mental health service
providers; and
▪Utilization of leave credits.

Department Order No. 208, Series of 2020 160

 Components and Implementation
Strategies of the MH WP&P
5. Benefits and compensation
▪Determination of appropriate compensation shall be
based on the current health benefit packages of
PhilHealth, ECC or SSS, whichever is applicable;
▪Entitlement to all monetary and non-monetary statutory
benefits; and
▪Encouraged to include mental health services in their
health packages with 3 party healthcare providers.
rd

Department Order No. 208, Series of 2020 161

 Components and Implementation
Strategies of the MH WP&P
6. Support mechanism program
▪Counselling through referral

Department Order No. 208, Series of 2020 162

 Duties and Responsibilities of
Employers
1. Develop, implement, monitor
and evaluate mental health
workplace policies and
programs;
2. Develop and implement
programs with reporting
mechanism;
3. Ensure adequate resources to
implement and sustain mental
health workplace programs;

Department Order No. 208, Series of 2020 163

 Duties and Responsibilities of
Employers
4. Provide necessary training to OSH personnel and HR
Officers;
5. Provide necessary work accommodation, when needed;
6. Develop referral mechanism of workers at risk of
developing or with mental health condition; and
7. Ensure compliance to all requirements of existing
legislations and guidelines related thereto

Department Order No. 208, Series of 2020 164

 Duties and Responsibilities of
Workers
1. Participate actively in the formulation and effective
implementation of the workplace policies and programs
on Mental Health ;
2. Provide assistance, in
any form, to improve
the condition of co-
workers who are at risk
of developing or with
mental health condition
and refrain from any
discriminatory acts
against them ;
Department Order No. 208, Series of 2020 165
 Duties and Responsibilities of
Workers
3. Seek assistance from the company’s OSH personnel on
conditions which may be related to or may result to a
mental health condition for appropriate medical
intervention and possible work arrangement;

4. Not themselves engage in bullying, harassment, all forms

of work-related violence, threats, shaming, alienation and
other forms of discrimination;

Department Order No. 208, Series of 2020 166

 Record Keeping and Reporting
Requirements
▪ Keep or maintain medical
records inside the company
clinic
- If the clinic is not yet
legally required, the
medical records shall be
kept with HR.
▪ Report cases to DOLE using
the AMR form

Department Order No. 208, Series of 2020 167

 Monitoring and Evaluation
▪ Implementation and monitoring shall be
the responsibility of the employer
through the OSH committee.
▪ Annually or as necessary, review and
evaluate Mental Health Workplace Policies
and Programs and
▪ Submit to the DOLE-RO, having jurisdiction
over the company, a copy of the company
policy or program.

Department Order No. 208, Series of 2020 168

 Compliance and Enforcement
▪ Compliance of establishments
in the private sector with this
Guideline shall be enforced by
the DOLE Regional Office
which has jurisdiction over the
company, in accordance with
RA 11058.

Department Order No. 208, Series of 2020 169

 DTI-DOLE Interim Guidelines on Workplace
Prevention and Control of COVID-19
▪ To assist private institutions allowed to operate during
the ECQ and GCQ in developing the minimum health
protocols and standards in light of the COVID-19
pandemic.
▪ Applies to all workplaces, employer and workers in the
private sector.
▪ Aligned with DOH AO 2020-0015 (Guidelines on the Risk-
based Public Health Standards for COVID 19 Mitigation;
April 27, 2020)
Department Order No. 208, Series of 2020 170
 DTI-DOLE Interim Guidelines on Workplace
Prevention and Control of COVID-19
▪ Workplace Safety and Health
A. Increasing physical and mental resilience
1. Emphasize every day actions to stay healthy
- eat nutritious food
- drink plenty of fluids, avoid alcoholic beverages
- adequate rest and sleep
- exercise regularly
2. Enjoin companies to provide free medicines and vitamins
3. Provide referral for workers needing counselling or
presenting mental health concerns
Department Order No. 208, Series of 2020 171
 DTI-DOLE Interim Guidelines on Workplace
Prevention and Control of COVID-19
▪ MH indicators
−15,693 establishments
monitored
−294 establishments need to
have physical and mental
resiliency activities
−249 establishments lacking of
referral system
*Source: MIS data as of 08 July 2020

Department Order No. 208, Series of 2020

172
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Gender-Based Sexual Harassment in the Workplace 174
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Gender-Based Sexual Harassment in the Workplace 175
 For inquiries, you may reach us at:

DOLE
HOTLINE
1349
 Take Away Message

“No One is safe until everyone is safe…we must all act

responsibly…
THANK YOU

For inquiries, you can reach us at

DOLE Hotline 1349
[email protected]
[email protected]
DOLE BWC Website
Facebook: BWC 1949