TOPIC 1

CONCEPT OF OCCUPATIONAL HEALTH AND SAFETY IN AN

ORGANIZATION

MEANING OF EMPLOYEE HEALTH AND SAFETY

The terms health and safety are very closely related but different.

Health is broader and more vague and difficult to explain than safety. A
person is said to be healthy, if he or she is free from illness, injury, and
mental problems that can impair his or her performance capability.

Safety, on the other hand, is more specific and easier to understand. Safety
is relative freedom from or protection against hazards at the place of work. A
person is said to be safe, if he or she is free from physical harm. The main
purposes of employee safety programmes, is to prevent work-related injuries
and accidents.

WORKING CONDITIONS AFFECTING HEALTH

The following are the working conditions which once provided promote
health in the organization:-

 Cleanliness
 Lighting
 Temperature
 Ventilation
 Freedom from noise
 Dust control
 Working space
COST CONSIDERATION FOR EMPLOYEES’ HEALTH AND SAFETY

Generally, there are costs related to organization’s failure to take

appropriate measures to ensure employees health and safety. Burke et al
(2011) classified these costs into direct costs and indirect costs.

Direct Cost

These are costs which are directly tied to organization’s failure to ensure
employees’ health and safety. These include the following:-

Cost of compensation

In many states the laws require compensation to employees for disablement

or death caused by or resulting from injuries or diseases sustained or
contracted in the course of employment.

Cost of loss of morale

Employees who are subjected to unsafe or unhealthy work environment are

like to lose morale of doing job.

Medical Cost

Organisations incur a large cost for medical treatment to employees who

sustain occupational injuries or contract occupational diseases.

Cost of inspection

Every work organization should have health and safety programme. It is the
duty of responsible department for employees’ health and safety to ensure
that there is periodic inspection of the aspects of the programme by external
and internal inspectors to ensure that the programme is intact.

Cost of health and accident insurance

Basing on the nature of their jobs or industry some employees are provided
with health and accidents insurance facilities by their employers

Loss of productivity

Employees who have sustained occupational injuries or contracted

occupational diseases can stop producing or can no longer produce at the
same level as before.

MEASURES TO IMPROVE OCCUPATIONAL HEALTH AND SAFETY

The measures that can be applied by employer to improve occupational

health and safety are as follows:-

Creating a positive safety culture

The employer should strive to establish a positive safety culture among its
employees. The safety culture of any organization is the outcome of
individual and group values, perceptions, attitudes, competencies and
behavioral patterns that determine the commitment to, and the style and
proficiency of an organisation’s health and safety management.

Emphasizing on organizational learning

Employers should emphasize and establish Organisations that continuously

learn from events of accidents and health problems occurring at the work
place.

Introduction of risk assessment technique

In this approach an organization should identify health and safety hazards

and analyze the risk associated with those hazards. Thereafter, organization
should determine appropriate ways to eliminate the hazard, or control the
risk when the hazard cannot be controlled.

Provision of occupational health and safety training to employees

The employer should regularly provide health and safety training to
employees so as to equip them with adequate knowledge and skills on
occupational health and safety

Provision of incentives

The organization should provide incentives to employees who show

compliance to health and safety requirements at work place. Incentives
should also be provided to employees for extra ordinary act in case of an
accident.

Formulation of health and safety policy

The organization should formulate the policy to guide occupational health

and safety issues. The policy formulation should involve all important stake
holders

Enacting rules and regulations

The organization should formulate rules and regulations on occupational

health and safety. Such rules and regulations should be clear to all stake
holders.

SIGNIFICANCE OF OCCUPATIONAL HEALTH AND SAFETY

Torrington et al (2017) provided the following benefits of occupational health

and safety:-

Recruitment

An organization with a well-managed health and safety programme is likely

to attract applicants for vacancies that they advertise.

Improved performance
Good management of occupational health and safety enables an
organization to have employees who are always fit for the job. As the results
the organization is likely to achieve improved performance.

Competitive advantage

Some organizations argue that investing in health and safety of employees

helps in building competitive advantage through employees. This is because
such organizations will have employees who are fit and therefore more
productive.

Positive employees’ attitude

Organizations that invest in employees’ health and safety will have

employees who are more engaged, committed, and contended. These
positive employees’ attitudes will be demonstrated to be performance
enhancing.

Retention

Organizations with well-managed employees’ health and safety programme

will have fewer employees who will be lost due to illness. In addition,
employees’ intention to quit employment will likely be reduced as the result
of positive employees’ attitudes.
 TOPIC 2

OCCUPATIONAL DISEASES AND STRESS

OCCUPATIONAL DISEASES

Meaning of Occupational disease

An occupational disease refers to any chronic ailment that occurs as a result

of work or occupational activity. That means occupational disease means a
disease of occupational origin. Such disease can either be compensable or
non-compensable with regards to the prevailing laws of the country.
Occupational disease is an aspect of occupational health and safety. An
occupational disease is typically identified when it is shown that it is more
prevalent in a given body of workers than in the general population, or in
other workers populations.

4.1.2 Types of Occupational Diseases

There is a large number of occupational diseases prevailing in organizations.

In addition, it is not necessary for disease that prevails in one organization to
prevail in the other as well. This is because the nature of disease prevailing
somewhere apart from other things depend much on the nature of industry
and the work environment of the organization in question. Being large in
number and difference in prevalence impose a certain degree of difficulty in
categorization of occupational diseases. However, the common types of
occupational diseases are as outlined below:-

Lung Diseases
These are diseases caused by inhalation of certain dusts, fumes or gases at
the work place. Breathing in these materials can lead to serious lung
diseases.

Examples of lung diseases are like asbestosis, COPD (Chronic Obstructive

Pulmonary Disease), silicosis, asthma and cancer.

The industries and job roles which are at high risk include construction
works, stone working, textiles, welding, farming and hairdressing.

Prevention

The measures that should be taken to prevent workers to confront these

diseases include:-

i. Make sure workers are effectively protected

ii. Thorough risk assessment
iii. Educating the staff
iv. Provision of safety equipment

Lead Poisoning

It is the most serious type of occupational disease caused by breathing in

lead dust. When lead is absorbed, it circulates in the bloodstream before
accumulating in your bones.

Breathing in lead dust can eventually lead to serious health issues like
infertility, kidney disease and brain damage. Workers who have absorbed
lead can go many years before symptoms like nausea, weight loss, memory
issues or stomach pains start to show.

Lead poisoning can be a risk for anyone who spent time in ship building, lead
smelting, pottery glazing, stripping paint or plumbing.

Prevention
 i. Provision of a designated eating area for any one working with lead:
This will prevent swallowing lead through drinking or eating
ii. Provision of protective equipment like masks: These will prevent
absorbing lead through breathing
iii. Provision of education to staff
iv. Regular risk assessments
v. Ensuring the presence of enough space and adequate ventilation

Carpal Tunnel Syndrome

Anyone can be at risk of Carpal Tunnel Syndrome if they carry out the same
tasks each day with their hands. This is because repetitive hand motions and
awkward wrist positions can increase the pressure on the nerves and
tendons in the carpal tunnel.

The groups which are in danger of developing Carpal Tunnel Syndrome are
cashiers, hair dressers, knitters mechanics using screwdrivers, musicians
playing an instrument with a bow and assembly workers using hand tools.

Prevention

i. Evaluation of work environment and daily tasks: This is in order to

see on whether they put their hands or wrists in awkward positions.
ii. Redesigning of the workplace to reduce the pressure on their hands
iii. Educating the staff about the danger repetitive movements
iv. Regular speaking to workers: It helps to show them that you care
about their wellbeing and helps to enforce safety culture

Computer Vision Syndrome

A long period of time spent staring at computer screen can lead to serious
eye conditions. Additionally, poor lighting, seating posture and improper
viewing distance can all force our eyes to work harder and need to strain.
Glare on a digital screen or monitor can also cause our eyes to struggle.

People who suffer from Computer vision syndrome could complain of eye
strain, headaches, muscle aches, blurred vision, eye irritation or dry eyes
and the likes.

The groups which are in danger of developing computer vision syndrome

include those whose works compel them to use computer daily. Examples of
these groups are accountants, academicians, Information and
Communication and Technology Officers.

Prevention

i. Taking steps to ensure each worker’s setup is correct: That means

there is enough lighting, proper viewing distance etc.
ii. Provision of special eyewear: These reduce glare and make it easier
for our eyes to cope with long hours in front of the screen.
iii. Educating staff: Educating on the danger of starring at a screen all
day and suggest the ways to reduce them
iv. Encouraging the staff to take regular breaks

Skin Diseases

Any exposure to strong irritants or prolonged contact with water can lead to
skin diseases. Skin conditions are very common for anyone working with
detergents, acids, wet cement or oils.

Examples of skin diseases are dermatitis, urticarial and even skin cancer.

Industries like catering, hairdressing, construction and printing are especially

at risk of workers developing skin diseases.

Prevention
Skin diseases at work can be prevented through APC approach as follows:

 Avoid - make sure staff avoid direct contact with substances, products
and wet work
 Protect - safety gloves can protect the skin from contamination and
irritation. Wash hands before drinking and eating.
 Check - by checking for conditions, like itchy, dry or red skin, you can
spot the early signs of dermatitis and other issues.

4.1.3 Management of Occupational Diseases

In order to prevent and control occupational diseases the following measures

can be considered:-

Administrative Measures

i. Formulation of health guidelines: For example guidelines on storage,

use, disposal and spillage of chemicals.
ii. Provision of appropriate tools and mechanical aids: For example
using tools like hand pumps to transfer chemicals can reduce direct
skin contact with irritating chemicals to minimize the risk of skin
diseases.
iii. Regular repair and maintenance: Different tools, equipment,
machines, ventilation systems and protective gears should be
regularly repaired and maintained properly to reduce the possibility
of contaminating the causative agents of occupational diseases.
iv. Job rotation and appropriate rest breaks: Rotating employees to
different work positions as far as practicable can reduce their
prolonged contact with work hazard which can lead to occupational
diseases. Also arranging appropriate rest breaks for employees
minimizes their risk of suffering occupational diseases
 v. Provision of information and training: Providing employees the
necessary information and training helps employees to be proactive
in implementing measures to prevent occupational diseases

Engineering control measures

This is an effective measure widely adopted. Engineering control measures

include:-

i. Enclosure: This involves enclosure of the hazardous work processes

to reduce employees’, exposure to the hazards thus minimizing the
possibility for occupational diseases. For example enclosing the
process of rock crushing in a quarry can prevent employees from
contracting silicosis by the inhalation of silica dusts
ii. Isolation: Employees should be isolated from work processes which
can increase the possibility of contracting occupational diseases. For
example when removing materials or plants containing asbestos,
isolating the removal area from other work areas to minimize the
spread of asbestos through air can prevent employees from
contracting asbestosis and mesothelioma.
iii. Wet method: Hazards such as dust or fibers in the air can be
reduced by water spraying to lower the risk of inhaling these
substances by employees.
iv. Good ventilation system: It does not only bring fresh air into a work
place and provides a comfortable work environment, but also helps
extract harmful substances from the environment to safeguard
employees health

Elimination

This involves complete removal of hazard from the workplace. It is

appropriate not to adopt work processes that will generate hazards. This is
the most effective control and must be considered first. Without hazards at
work place employees will not suffer from occupational diseases. For
example avoiding hand-dug caisson work which exposes employees to
exceptionally high concentration of silica dust can minimize employees’ risk
of contracting silicosis

Substitution

If it is not possible to avoid work processes with health hazards, use safer
alternative materials, tools or machines as far as practicable to minimize
adverse health effects on the employees. For example substituting low-noise
machines for noisy ones can reduce employees’ risk of suffering occupational
deafness

Personal Protective Equipment (PPE)

PPE should be provided to employees. There should be regular checking of

its effectiveness, cleanliness and as well as proper storage after use. For
example, wearing gloves can prevent laboratory workers from direct
contacts of their hands with chemicals.

Regular environmental monitoring

Regular environmental monitoring indicates the level of hazards in the work

environment and the effectiveness of existing control measures. For example
taking air sample regularly for lead analysis can help to prevent employees
from lead poisoning.

Health Surveillance
This is important for early detection of any deviance in employees’ health
due to work, so that they can seek appropriate treatment as early as
possible and take corresponding preventive measures at the workplace. For
example employees exposed to ionizing radiations should undergo pre-
employment and periodic medical examinations and blood tests for early
detection of health problems caused by ionizing radiation. For example,
dermatitis.

OCCUPATIONAL STRESS

Meaning of Occupational Stress

The word stress is derived from Latin term ‘stringers’ which means to ‘draw
tight’. The word stress has been defined differently by different scholars.

Gupta (2009) defined stress as a mental, emotional or physical reaction

resulting from an individual’s response to environmental pressure and similar
stimuli. It refers to pressures people feel in life.

Griffin (2016) defined stress as an individual’s response to a strong stimulus

called a stressor.

People experience stress in private life and at work place. Minimal level of
stress is required for organizations to operate effectively. Excessive stress is
harmful for the individual’s health as well as organizational performance
Occupational stress is stress related to one's job. Occupational stress often
stems from unexpected responsibilities and pressures that do not align with
a person's knowledge, skills, or expectations, inhibiting one's ability to cope.
Occupational stress can increase when workers do not feel supported by
supervisors or colleagues, or feel as if they have little control over work
processes

Features of Stress

An individual who is stressed is likely to indicate the following signs:-

i. Nervousness and tension

ii. Digestive problems
iii. Chronic worries
iv. Fast heartbeats
v. High blood pressure
vi. Excessive smoking
vii. Excessive drinking
viii. Excessive sweating
ix. Difficulty to sleep
x. Uncooperative attitude
xi. Feeling of inability to cope
xii. Anger
xiii. Impatience
xiv. Aggression

4.2.4 Causes of Occupational Stress

Organizational Causes

i. Administrative policies and strategies. These include downsizing;

competitive pressure; merit-pay plans; rotating work shifts;
bureaucratic rules; and advanced technology.
ii. Organizational structure and design: These include centralization
and formalization; line-staff conflicts; Specialization; Role ambiguity;
Absence of opportunity for advancement; restrictive and untrusting
culture.
iii. Organizational processes. These include tight controls; little
performance feedback; only downward communication; centralized
decision making; lack of participation in decision; punitive appraisal
systems.
iv. Working conditions. These include crowded area; noise, heat or cold;
polluted air; strong odor; unsafe dangerous conditions; poor lighting;
physical or mental strain; toxic chemicals or radiations.
v. Career development : This includes status incongruent; under-
promotion; over-promotion; mid-career, obsolescence

Individual causes

i. Biographical variables
ii. Needs and values
iii. Life stage
iv. Introversion
v. Locus of control
vi. Flexibility or rigidity
vii. Type A or B behavior

4.2.5 Impact of Stress

High level of occupational stress has an impact not only to organizations but
also to individual employees.

To an organization

Generally, high level of occupational stress harms organizational

performance in the following ways:-

i. Low productivity
ii. Poor quality
iii. Increased absenteeism
iv. Low job satisfaction
v. Accident proneness
 vi. Poor interpersonal communications

To individuals

Generally, high level of occupational stress has an impact to employees’

health and life balance in the following ways:-

i. Physical ailment: This includes headache, indigestion, insomnia,

heart trouble etc.
ii. Mental problems: These include anxiety, irritability, lack of clear
thinking, inability to relax, frustration, helplessness, loneliness etc.
iii. Behavioral problems: These include excessive smoking or drinking,
withdrawal from relationships, speech disturbances etc.

4.2.6 Methods of Managing Occupational Stress

As we stated before that high level of stress is not healthy for any
organization. Therefore, organizations should make sure that they manage
stress to its employees such that it becomes at lowest level as possible. In
managing occupational stress there are organizational and individual
measures. Some of these measures are as outlined below:-

Organizational measures

i. Proper job design: Job should be designed in such a way that it

clarify roles and therefore reducing the danger of role ambiguity and
role conflict.
ii. Improvement in working conditions: Organizations should create
conducive work environment for their employees. For instance
ensuring the presence of good ventilation, enough office space, and
absence of noise pollution
iii. Counselling: Organizations should give employees opportunity to
talk about their problems with a member of HR Department or
through any other designated individuals.
 iv. Change in management style: Organizations should turn to
management style with democracy, transparency and other features
which are not stressful to employees.
v. Setting reasonable targets and performance standards:
Organizations should set reasonable and achievable targets that
may stress individuals but do not place impossible burden to them.
vi. Appropriate job placement: Organizations should ensure that they
place individuals to jobs that are within their capabilities
vii. Appropriate performance management processes: Organizations
should have performance management processes which allow a
dialogue between managers and about the latter’s work problems
and ambitions
viii. Appropriate career development plans: Organizations should have
appropriate career development plans for their employees so as to
avoid status incongruence, over-promotion, under-promotion and
other negative aspects
ix. Appropriate introduction of changes: Organizations should make
sure that their change introduction processes take into account
employees’ participation and good analysis of supporting and
restraining forces
x. Management training: Managers should be trained on what to do to
minimize or alleviate their own stress as well as others’ stress.

Individual measures

i. Improvement in diet and nutrition: Individuals should take a diet that

will increase body’s capability to cope with stress.
ii. Maintenance of physical fitness: Individuals should take regular
exercises so as to improve body physical fitness and resistance
against negative impact of stress.
iii. Effective relaxation: Effective relaxation enhances individual’s
capability to resist the negative effects of stress
 iv. Meditation: This involves learning to clear one’s mind of the external
thoughts often by repeating the selected syllable over and over
again. The syllable being repeated is called mantra
v. Exercise control over your cognitive reaction: The individuals should
exercise on how to control over-thinking or worrying about things.

TOPIC 3

INDUSTRIAL HAZARDS

1.1 Meaning of Industrial Hazard

Industrial hazard refers to aspect of the work environment that has the
potential of causing immediate and sometimes violent harm or even death.
Examples of industrial hazards include noisy machinery, a moving fork lift,
chemicals, electricity, working at heights, repetitive jobs, bullying and
violence at workplace etc.

Types of Industrial Hazards

There are several types of industrial hazards that employees may be

exposed to depending on the industry. These include:-

Physical hazards

Physical hazards refers to environmental factors that can lead to injuries.

These include falling objects, electrical wiring, wet floors and other
conditions that can cause slips, cuts, falls or other injuries.
Biological hazards

Biological hazards can result to infections, diseases and other serious health
conditions. Fungi and Mold, blood and other bodily fluids, viruses, bacteria,
sewage, and vermin are all examples of biological hazards.

Chemical hazards

Chemical hazards can be inhaled as gases or vapors, or come in contact with

skin as a liquid or solid. They can lead to burns, irritation, blindness,
respiratory problems, or other serious health complications. Chemicals such
as Cleaning products, pesticides, acids and petroleum products need to be
handled with care with proper PPE so as to prevent exposure.

Ergonomic hazards

Ergonomic hazards put strain on tendons, muscles, and other connective

tissues of the body. They can result from bad posture, failure to use
mechanical assistance like dollies, repetitive movement of the body part or
awkward lifting. Ergonomic hazards can lead to musculoskeletal injuries,
such as ruptured or herniated disc, muscular sprains, and carpal tunnel.

Psychological hazards

Psychological hazards can result to concentration problems, depression,

inattention or negligence. This type of hazard includes fatigue, work-related
stress, violence and harassment. These conditions can result into moral
issues, reduced productivity and quality of work, and increased risk of injury.

Hazards Control System

Hazard control system refers to summation of control elements which

function together in interrelationship to prevent accidents and mitigate
accident consequences.
Components of Hazards Control System

There are no universal components for hazard control system. The

components depend upon the nature of industry as well as the environments
of the state where an organization in question is located. However, the
common components of hazard control system are as explained below:-

Identification of hazard sources

In any hazard control system there should be a mechanism to identify hazard

sources. The hazard sources at workplace include installations, stored
material, technological processes and physical environment which have
potential to cause serious accidents which would be destructive to human
life and property.

Information about sources

Once the hazard sources are identified, an organization should ensure that
all necessary information about them are gathered, recorded and arranged
systematically in such a way that they can be used by interested parties
from both inside and outside the organization.

Activities inside the industry

There are activities that should be performed inside the organization as the
part of hazard control system. These activities include designing safety
policy, conducting periodic inspections, carrying out regular maintenance
and repairs, modification of machinery so as to ensure safety maintenance,
training of employees on operating instructions etc.

Actions by government authorities

There are activities that should be performed by government agencies

responsible for health and safety which constitute hazard control system. A
good example is Occupational Health and Safety Authority (OSHA) which is
responsible for regulation of occupational health and safety in Tanzania.
Among other things the activities that should be performed by these
authorities include assessment of hazards for licensing, licensing, regular
inspection etc.

Emergency planning

Emergency planning focus on reducing accidents consequences. In

emergency planning the organization reveals what should be done in case an
accident breaks out.

Protection Techniques for Industrial Hazards

The typical techniques for protection against industrial hazards include the
following:-

Engineering control

Engineering Control involves controlling of hazards at the source. The

responsible authority should make sure that exposure to hazardous
substances like asbestos is well prevented or controlled through engineering
controls. Examples of engineering controls are enclosure of machinery to
avoid accidents, and using muffler for encasing noise source.

Substitution

Where practicable, the responsible authority should require to replace

hazardous substance by substitute materials for workers protection if
applicable.

Work practices and organizational methods

Where engineering control and substitution seem to be impracticable,

organizations should opt to reduce exposure to hazards through
organizational or administrative measures. One of organizational measures is
reducing the number of workers exposed as for instance by carrying out
noisy operations during the night or weekends when fewer workers are
around.

Personal Protective Equipment (PPE)

When the above approaches seem to be impractical the solution is to provide

the employees exposed with suitable and standard PPE.

Consequences of Industrial hazards

Alli (2008) argues that if industrial hazards are not taken care they can lead
to occupational diseases, accidents and injuries. According to him these do
not only cause severe pains sufferings and deaths to the victims but also
result in:-

i. loss of skilled and unskilled but experienced labour;

ii. material loss, that means damage to machinery and equipment as
well as spoilage of products; and
iii. high operational costs through compensation, medical care,
replacement or repair of damaged machinery and equipment.

NB. Add more consequences

 TOPIC 4

Occupational Health and Safety Act of Tanzania

Introduction

In any state there are laws which regulate the employers' responsibility to
protect employee health and safety. In Tanzania there is Occupational Health
and Safety Act No. 5 of 2003 (OHSA, No.5/2003). Generally, the contents of
the law indicate the country's concern for its employees' health and safety.

Provisions of OHSA

The provisions of OHSA are as follows:-

i. Administration
ii. Registration of Factories or work places
iii. Safety Provisions
iv. Health and Welfare provisions
v. Safety and Special provisions
vi. Hazardous materials
 vii. Chemical Provisions
viii. Offences and Legal proceedings

i. Administration

Appointment and power of the Chief Inspector

This part states that the Minister appoints the Chief inspector from amongst
persons who possess the necessary qualifications, experience and
competence to perform the functions under OSHA and its Executive Agencies
Act of 1997. It further states that the Minister responsible for labour may
designate any other officer serving in the authority to act as the Chief
Inspector during the absence or incapacity or, where no person has been
designated as Chief Inspector; until a chief inspector is designated.

The Act states that the functions of the Chief Inspector are as follows:-

i. To keep record of publication on health and safety standards which

are incorporated in the Regulations, rules or orders;
ii. To keep record of amendments or substitution of any health and
safety standard so published;
iii. To keep and maintain register of factories;
iv. To keep records and other register of any other matters which need
to be registered under the Act;
v. To do such other functions as may be required by the Act; and
vi. To make available for inspection by interested persons, any register
or extract therefrom.

Appointment of Inspectors

The Act states that the Chief Inspector may designate any person as an
inspector to perform, subject to the control and directions of the chief
inspector, any or all of the functions assigned to an inspector by the Act.
Every inspector is furnished with a certificate of his appointment and when
visiting any factory or workplace shall produce the certificate to the occupier
or other person holding a responsible management position at a factory or
workplace.

The Act states that for the purpose of performance, the inspector has the
power to do any of the following:-

i. Without prior notice, to enter, inspect and examine, by day or night,

a factory or workplace if he has reasonable cause;
ii. To inspect and examine any machinery, plant, or appliance, in a
factory or workplace;
iii. To take with him any assistant or a police officer if he has reasonable
cause to apprehend any serious obstruction in the execution of his
duty;
iv. To require the production of a register, a certificate, notice, a
document, an article, any substance, plant or machinery or a part or
a sample in pursuance of the Act;
v. To inspect, examine and copy any of the documents mentioned
above;
vi. To direct any employer, employee or user, to appear before him at
such time and place as may be determined by him and question that
employer
vii. To examine any person, either alone or in the presence of any other
person, as he thinks fit, with respect to matters under this Act.
viii. To carry out investigation on any matter under the Act and to
prepare the relevant report.

Health and Safety Committee

The Act states that an employer shall in respect of each factory or workplace
where two or more health and safety representatives have been designated,
establish one or more committees.

At every meeting of such a committee, the employer shall consult with the
committee.

The Act states that the functions of health and Safety Committee are as
follows:-

i. To make recommendations to the employer or, where the

recommendations fail to resolve the matter, to an inspector
regarding any matter affecting the health or safety of persons at the
factory or workplace.
ii. To discuss any incident at the factory or workplace in consequence
of which any person was injured, became ill or died.
iii. To keep record of each recommendation made to an employer and
of any report made to an inspector
iv. May perform such other functions as may be prescribed.

ii. Registration of Factories or Work Places

Under this part the Act states that:-

i. There shall be a register of factories or workplace in which Chief

Inspector shall enter such particulars in relations to factories or
workplace;
ii. Any person being the owner or occupier of a factory or workplace,
shall before operating, register such factory or workplace;
iii. Where the Chief Inspector is satisfied that the premises are suitable
for use shall register the premises and issue to the applicant a
certificate of registration;
 iv. Where the Chief Inspector refuses to issue certificate of registration
shall state in writing the grounds for the refusal;
v. Where the occupier closes a registered factory or workplace, he shall
inform the Chief Inspector that he has closed the factory;
vi. Where there is a change of occupier or industry, the new occupier
shall within one month of the change inform the Chief Inspector in
writing of the changes;

iii. Safety Provisions

Under this part the Act has the following provisions:-

Medical examination

The Act states that a thorough pre – placement and periodic occupational
medical examination for fitness for employment and for employees shall be
carried out by qualified health physician

Machinery

Under this part the Act states that every dangerous part of all machines shall
be secured and fenced unless they are safe by position or construction

Safety devices

The Act states that efficient device or appliances shall be provided and
maintained in every work place.
Generally the provision under this part gives guidelines on the usage of
equipment and machines at the factory or work place.

iv. Health and Welfare Provisions

The Act has the following provisions with reference to health and welfare:-

Supply of drinking water

The Act states that the employer shall ensure that adequate supply of clean
and safe water and drinking water is provided, maintained and accessible to
all persons employed on the premises.

Sanitary convenience

The Act states that sufficient and suitable sanitary conveniences shall be
provided for persons employed in a factory and shall be kept clean.

Washing facilities

The Act states that there shall be and maintained for the use of all persons
employed adequate and suitable facilities for washing which shall be kept
clean.

Accommodation for clothing

The Act states that there shall be provided for all workers adequate and
suitable accommodation for clothing not worn during working hours.

First Aid facilities

The Act states that there shall be provided and maintained a first aid box or
cupboard to the prescribed standards and it should be marked “FIRST AID”
having only appliances or stocks of first aid equipment.

v. Safety Special Provisions

Under this part the Act has the following provisions

Risk assessment

The Act states that every factory where activities are carried out involve
hazardous process or equipment or use of chemicals substances, likely to
result in adverse effect to people or properties, the employer shall ensure
that :-

i. Risk assessment is conducted annually or any other time when

needed;
ii. Evidence of assessment is furnished to the Chief Inspector when
requested.

Removal of dust or fumes

The Act states that in any factory which is in connection with any process
carried on, there are given off any dusts or fumes or other impurities of such
character;

i. Measures should be taken to protect workers

ii. Appliances should be provided
iii. No person is allowed to feed or drink in any workroom where
poisonous substance is used

Provision of protective equipment

The Act states that where in any factory or workplace workers are employed
in any process involving exposure to any injurious, protective equipment
shall be provided by employer.

Power to take samples and measurements

The Act states that an inspector may, at any time after informing the
employer of the undertaking:-

i. Take for analysis biological samples of workers exposed to

hazardous substances used in a factory or workplace
 ii. Take measurements and photographs, of any substances,
machinery, materials, building or video shooting which he thinks
may be useful in subsequent legal proceedings.

Safety or health of agricultural activities

The Act states that every person who employ persons in agricultural
activities be under the obligation to ensure that no employee is exposed to:-

i. Hazardous machinery and equipment; or

ii. Harmful animals and insects; or
iii. Infectious agents or allergens; or
iv. Hazardous chemicals; or
v. Hazardous environments while doing work as agricultural worker.

vi. Hazardous Materials and Process

The Act has the following provisions concerning hazardous materials and
process:-
Safety of electrical installations and apparatus

The Act states that all electrical apparatus, fittings and conductors shall be
sufficient in size and power for the work they are meant for and shall be so
constructed, installed or protected

It further states that every factory or workplace using electricity shall be

inspected annually by an authorised electrical inspector.

Toxic materials

The Act states that:-

i. Toxic materials or substances shall only be used where the use of a

non-toxic material is not reasonably practicable.
 ii. Where toxic materials are present or used, the number of employees
exposed to risk shall be kept to a minimum and where there is anti-
dote, supplies shall be kept ready.
iii. Where there is a risk of toxic materials, employee shall not eat, drink
or smoke in any workroom
vii. Chemical Provisions

The Act has the following provisions related to handling of chemicals:-

General Precautions in Handling Chemicals

The Act states that the employer shall ensure that preventive, administrative
and technical measures are taken to prevent or reduce the contamination of
the work or environment

Provision of Chemical data sheets

The Act states that it shall be the duty of the manufacturer or importer of the
chemical to provide to the employer in respect of hazardous chemicals. The
data sheet will contain essential information regarding identity, supplier,
classification, hazards, safety precautions, and emergency procedures.

Labeling of hazardous chemicals

The Act states that every employer shall ensure that the package of
hazardous chemical is labeled and that appropriate chemical data sheet has
been delivered to the factory or workplace.

Offences, Penalties and Legal Proceedings

The Act states that a person will be said to have committed offence if:-

i. He contravenes any provision of this Act, regulations or any rule or

order made under this Act;
ii. He intentionally or recklessly interfere with or misuse anything which is
provided in the interest of health or safety, commits an offence
 Occupational Safety and Health Authority in Tanzania (OSHA)

Background of OSHA

OSHA was established on 31 August, 2001 under the Government Agencies

Act No. 30 of 1997 as the part of improvements in provision of public service.
Before the establishment of the Authority, management of occupational
safety and health was a section under the Department of Labour which was
known as Factory Inspectorate Unit. The narrow legal scope of this unit made
it fail to cater for the state’s occupational safety and health needs. Basically,
such management didn’t suit the criteria put forward by the International
Labour Organisation (ILO) which needed all the member states to have a
state apparatus for management of occupational safety and health.
The motive behind the establishment of this Authority was to get a state
apparatus that would be responsible for improvement and management of
occupational health and safety at Tanzania Mainland, whereby in such
management there will be value addition and increased productivity thus
improving national income.

Responsibilities of OSHA

The Authority has four responsibilities as explained below:-

i. To oversee the implementation of Occupational Safety and Health

Act No. 5 of 2003.
ii. To advise the government on occupational safety and health, on
policies, orders and various guidelines on management of safety and
health in the country
iii. To improve stakeholders’ awareness on issues concerning safety and
health through various training including provision of professional
advice to stake holders.
iv. To conduct various researches on issues concerning occupational
safety and so as to be able to advise the government on the correct
way to implement the relevant Act.

Functions of OSHA

OSHA performs the following functions:-

i. Registration of workplaces
ii. General Inspections
iii. Special inspection like, inspection of electrical installations, Pressure
vessels, and lifting appliances
iv. Risk assessment
v. Inspection and approval of architectural drawings and maps
vi. Health and diseases investigation in respect of the work at the
workplace
 vii. Accident investigation
viii. Industrial hygiene surveys and measurements
ix. Provision of ergonomic advise
x. Licensing for fulfillment of safety and health standards at the
workplace

Workers Compensation Fund (WCF)

Introduction

Workers Compensation Fund (WCF) is a social security scheme established in

accordance with Section 5 of the Workers Compensation Act [Cap 263
Revised Edition of 2015].

The main purpose for the establishment of the Fund is to provide for
adequate and equitable compensation for employees who suffer
occupational injuries or contract occupational diseases arising out of and in
the course of their employment and in case of death, for their dependents.

Objectives of WCF

The objectives of WCF are as follows:-

 i. Provision of adequate and equitable compensation to employees
ii. Implementation of the National Social Security Policy of 2003 which
requires having a system in place to cover contingencies for work-
related injuries, diseases and deaths
iii. Implementation of provision of Section 5 of the Workers
Compensation Act [Cap 263 Revised Edition of 2015]
iv. Provision of a framework for effective, prompt and empathetic
consideration, settlement and payment of compensation benefits
v. Provision of a framework for control and administration of
contributions to and payments from the Fund
vi. Promotion of prevention of accidents and occupational diseases
vii. Provision of rehabilitation services
viii. Compliance with international obligations with respect to workers
compensation

Functions of WCF

The functions of the Fund are:-

 Registration of all employers in Mainland Tanzania

 Assessment of risk exposure at work places and tariffs determination
 Collection of contributions from employers
 Investment of available funds
 Payment of compensation to employees
 Maintenance of statistics for all occupational accidents, diseases and
deaths
 Promotion of prevention of occupational accidents, diseases and
deaths
 Public education and awareness programs at the workplace
 TOPIC 5

Rehabilitation and Fitness Programmes to Manage Employees

Health

Employees’ Assistance Programmes (EAPs)

EAPs can be defined as an employer-sponsored service designed for

employees’ personal or family problems including mental health, substance
abuse, addictions, parental problems, marital problems, emotional problems,
or financial or legal issues.

Initially EAPs focused on occupational alcoholism only. Currently, the EAPs

have expanded their scope to assist employees with mental health problems
like depression, and anxiety as well as other personal problems such as
marital, or financial problems that are likely to affect their work

Components of EAPs

In general, the typical EAP consist of the following:-

v. Policy and procedures statement that clarify the responsibilities of

both the employer and workers on health and personal problems
affecting the job
vi. Employees’ education campaign that may include posters, letters or
extensive training programmes
vii. A supervisory training programme on problem recognition and
performance documentation
viii. Clinical services that may be offered by either professional in-house
staff or off-site agencies
ix. Monitoring as a part of follow-up to ensure real problem resolution has
occurred.

7.3 Benefits of EAPs

The well-implemented EAPs are like to have the following benefits to

organizations:-

i. Improved productivity and employees engagement

ii. Developed employees’ and managers’ competencies in managing
workplace stress
iii. Reduced workplace absenteeism and unplanned absences
iv. Reduced work place accidents
v. Reduced health care costs
vi. Reduced employees’ turnover and related replacement cost

7.4 Employees’ Problems/Issues that Can be Addressed by EAPs

There are many employees’ problems that can be addressed by EAPs. Those
problems can be categorized into the following groups:-

Substance abuse

Substance abuse is the problem facing a large number of employees.

Employees tend to abuse mainly alcohol or drugs in the form of cocaine and
marijuana.

The following are examples of behavioral problems indicating possible

substance abuse among employees:-

i. Absenteeis
ii. Poor job performance
iii. High accident rateS
iv. On-the-job absences
v. Poor relationship with co-workers:

Substance abuse is not only harmful to employees’ physical and mental

health but also to organizations’ overall performance. Examples of
impacts of substance abuse to organizations include the following:-

i. loss of productivity;
ii. frequent accidents;
iii. disciplinary problems; and
iv. involuntary turnover

Mental health

There are millions of employees suffering from mental health issues. Mental
health problems may be brought into the workplace from either employees’
personal lives or the work itself.

Mental health problems among employees can be indicated by many signs.

Examples of these signs are:-
 i. depression;
ii. suicide attempts;
iii. gambling;
iv. anxiety;
v. eating disorder; and
vi. poor financial management

Organizations are likely to be affected by employees’ mental health

problems in the following forms:-

i. absenteeism;
ii. low job satisfaction;
iii. interpersonal conflicts;
iv. indecisiveness; and
v. reduced productivity

Personal problems

There are millions of employees who are faced by personal problems which
affect their behavior at the place of work as well as their overall
performance. Examples of the employees personal problems are as follow:-

i. marital problems;
ii. sexual problems like impotence;
iii. difficulty with family or children;
iv. legal problem; and
v. financial problems

7.2 Employee Wellness and Health Promotion Programs

Employee wellness programmes (EWPs) or health promotion programmes

(HPPs) consist of activities that promote employee behavior and
organizational practices that ensure employee health and fitness. HPPs and
wellness programmes base on the premise that wellness is more than the
mere absence of disease. These programmes attempt to encourage
individuals to adopt lifestyles that promote overall well-being.

The four common components of HPPs and wellness programmes are

exercise and fitness, nutrition and weight control, smoking cessation,
hypertension control. The detailed information about these components is as
provided below.

Exercise and fitness interventions or programmes

These are among the most popular HPPs and well-being interventions,
especially among large employers. These programmes can provide a wide
range of services including jogging trails, on-site fitness centers, exercise
breaks and employer-sponsored sport leagues. One of the strong driving
force behind the strong interest in exercise and fitness programmes is to
reduce the risk of developing cancer, coronary heart diseases, and other
leading causes of death by adopting a healthy life style.

Organizations that support exercise and fitness programmes expect to enjoy

the following benefits:-

i. Greater ability to attract talented employees

ii. Greater ability to retain talented employees
iii. Positive employees attitude
iv. Reduced absenteeism
v. Reduced turnover
vi. Cut down of health care cost
vii. Increased productivity

The major obstacle to the effectiveness of exercise and fitness programmes

may be persuading the employees who would benefit mostly from them to
participate.
In order to ensure effectiveness of exercise and fitness programmes the
organization should adhere to the following aspects:-

i. Identification of the needs of all employees and provide incentives to

ensure participation of those who are at great risk
ii. Systematic outreach and follow-up counselling
iii. Establishment of goals and objectives
iv. Obtaining management commitment
v. Hiring quality staff
vi. Development of an evaluation strategy
vii. Recruitment of participants

Smoking cessation

Smoking is one of the health risk that is mostly publicized not only in the
society but also at the workplace. Smoking is greatly linked to the incidence
of coronary heart diseases, cancer, stroke and emphysema. Evidences show
that smoking leads to health risks both to smokers and non-smokers.
Organizations have increased their concern for smoking cessation
programmes so as to help employees, reduce costs and provide safer
workplace.

Organizations can sponsor smoking cessation programme as a part of HPPs

and wellness programmes or EAPs.

The two measures of effectiveness of smoking cessation programme are the

quit rate and the percentage of smokers who take a part in the programme.
This programme has health benefits to employees and cost effective on
organization’s side.

Nutrition and weight control interventions or programmes

There are millions of employees who are obese all over the world. Obesity is
associated with hypertension, musculoskeletal problems, high level of blood
sugar and cholesterol, and some forms of cancer. Health and cost
consequences brought about by obesity necessitate nutrition and weight
control interventions in organizations

The content of these programmes varies and can include the following:-

i. Educational activities such as newsletters, leaflets, cooking

demonstrations, weigh-ins, advice on developing weight-loss
programmes
ii. Stocking of cafeterias with healthy, low-fat foods and post nutritional
information concerning food sold in their cafeteria
iii. Provision of healthy coach to assist employees with obesity issues

Hypertension control programme

There are millions of workers suffering from hypertension all over the world.
Also, organizations lose millions of work days per year because of health
problems resulting from hypertension. Health problems related to
hypertension include heart diseases and stroke. Despite its potentially
devastating effects, hypertension can often be controlled through:-

i. exercise;
ii. weight reduction;
iii. medication;
iv. stress reduction;
v. Low salt diet etc.

Hypertension control can be a part of organization’s fitness programme. A

typical hypertension control programme may include the following:-

i. Provision of educational materials

ii. Blood pressure screenings to identify hypertensive employees
iii. Referral of such employees for treatment
 iv. Installation of blood pressure screening equipment for employees to
use to monitor their own blood pressure
v. Low-salt foods available in both cafeteria and vending machines
vi. Periodic monitoring of employee progress

Employee Counselling

Meaning of Employee Counselling

Employee counselling can be defined as the discussion of a problem with an

employee for purposes of helping him or her either solve it or cope with it so

that he or she can become a more effective organisational member. The

basic theory underlying stress is that stress and personal problems have
undesirable effects on organisational performance and the personal life of
the employees. It is therefore in the interests of the employee, and the
employer to counsel employees when they are in problems or under stress.
In organisations where counselling is ignored, employees are single-handedly
overwhelmed by problems, experience rising stress levels, and consequently
cannot contribute their best towards the organisation's performance, ruin
their health, and finally quit or die.

Employee counselling programmes is one of the necessary interventions in

employees’ assistance programmes and employees’ wellness and health
promotion programmes.

Components of a Typical Counselling Programme

The employees counselling programs vary in terms of problems addressed

and techniques used. However, the typical employee counselling programme
consist of the following activities:-

Problem identification

Problem identification usually involves the use of a screening device like

questionnaire or diagnostic test and/or the training of employees and
supervisors in the identification of problems

Education

Education typically includes providing information about the nature,

prevalence, likely causes and consequences of a problem, and ways the
problem can be prevented.

Referral

Referral involves directing the employee to the appropriate resources for

assistance.

Counseling

At a minimum, counseling involves a person with whom employees can

discuss difficulties and/or seek further help. The type of counseling can vary
from a frank discussion with a supervisor about work-related performance
problems to meeting with a mental health professional skilled in diagnosing
and treating problems such as depression or substance abuse.

Treatment/intervention

Treatment includes the actual intervention to solve the problem. For

example, a nutrition program may include cooking classes or the offering of
healthy foods in the cafeteria.

Follow-up

Some form of monitoring is needed to ensure that the employee is carrying

out the treatment and to obtain information on employee progress.

Who Provides Employees’ Counselling Service?

An organization can offer a counselling programme in two ways as follows:-

By using in-house experts

In-house or on site programmes involve using current employees or hiring

specialists, such as psychologists, social workers, or other trained
individuals, to operate the programme.

By using out-of-house experts

This involves contracting the service out to a third party who can be a local
specialist or organization

HIV/AIDS PREVENTION PROGRAMME

IMPACT OF HIV/AIDS ON ORGANIZATIONAL PERFORMANCE

 High caring cost for infected employees

  Low morale
 Low productivity due to absenteeism
 Low quality of products
 Loss of customer base
 Loss of technical skills and experiential knowledge
 Increased cost of death and funeral benefits
 High cost of hiring and training new workers

CONTENTS OF HIV/AIDS PREVENTION PROGRAM

 Education: On responsible sexual behavior

 Creation of suitable work environment: Facilitating the employees
travelling with their wives in case of long time assignments
 Condom distribution
 Treatment of sexual transmitted infections eg. Gonorrhea and
Syphilis
 Testing: Employees should be encouraged
 Counseling
 Supporting: The infected employees
 Policies
 Rules and regulations

CHALLENGES OF HIV/AIDS PROGRAMME IMPLEMENTATION

 Financial constraints
 Legal constraints: Some preventive measures like mandatory
testing are illegal
 Religious believes: In some religions using condoms is a sin
 Cultural constraints: In Nepal talking on sexual issues publicly is
illegal
 Ethical challenge: Lack of confidentiality
  Stigma and discrimination
 Suspicion: Employees doubt on the intent of the employer on
testing
 Fear: Employees are uncertain on what will be their aftermath in
case they will be found positive
 Limited condom use
 Ignorance etc.

TOPIC 6

Occupational Health Surveillance

Meaning of Occupational Health Surveillance

The term ‘surveillance’ is derived from the French word meaning ‘to watch
over’.

Surveillance can be defined as close observation a group of person or group,

especially one under suspicion. Also surveillance can be defined as the act of
observing or the condition of being observed’

In public health, surveillance was originally developed as part of efforts to

control infectious diseases, but the principles of surveillance can potentially
be applied to other problems such as chronic diseases (for example cancer
and coronary heart diseases), social problems (for example drug addiction)
and threat of bioterrorism.

What is occupational health surveillance?

Occupational Health Surveillance can be defined occupational health

surveillance as the process which involves medical examinations of workers
to ensure that their state of health is compatible with their job assignments
and that their exposure to hazards does not have any detrimental effects on
their health. Surveillance also involves health examinations to identify
conditions which may make a worker more susceptible to hazardous agents
and to detect early signs of health impairment caused by them. The main
purpose of occupational health surveillance is primary prevention of work
related injuries and diseases.

5Objectives of Occupational Health Surveillance

The objectives of occupational health surveillance programme include the

following:-

i. Medical checks to ensure that employees remain in good health

and not being harmed by their work

ii. Protecting the health of individual employees by the early detection

of adverse health effects which may be caused by significant
exposure to hazardous activities or substances
iii. Identifying and implementing specific health surveillance
requirements for employees liable to be exposed to certain
substances and/or working in potentially hazardous processes
iv. Evaluation of existing control measures and identification of areas
where improvements may be required
 v. Collect, maintain and use results and information to assist in
determining and evaluating hazards to health

vi. Compliance with Occupational health and safety legislation

Assignment : Explain the nature and importance of occupational health

surveillance

Scope of Occupational Health Surveillance Programme

Occupational health and safety programme include the following important

activities:-

Pre-assignment medical examinations

These are carried out before the placement of employees in jobs or their
assignment to specific tasks which are likely to involve danger to their health
or that of others. The main purpose of such examination is to determine in
what capacity the prospective employees can be utilized most efficiently
without detriment to himself or herself or to fellow workers. The importance
of pre-assignment medical examinations is as follows:-

i. They provide clinical information and laboratory data on the

employees’ health status at initial employment stage
ii. They provide baseline for evaluation of any changes in health status
that may occur later on
iii. They help in placing employees in jobs that are compatible with their
health status

Periodic health evaluation

These are performed at appropriate intervals during employment with the

major purpose to determine whether the worker’s health remain compatible
with his her job assignment and to detect any evidence of ill health
attributed to employment. The main objectives of periodic health
assessment include:-

i. identification of any adverse health effects caused by work practice

or exposure to hazards as early as possible; and
ii. detection of possible hazards

Return-to-work health assessment

This is done so as to determine whether a worker is fit to resume his or her

duties after prolonged absence for health reasons. Such assessment may
lead to recommendations for appropriate actions to protect the workers
against future exposure or may identify a need for re-assignment or special
rehabilitation.

Post-assignment health examination

This is done after termination of assignments involving hazards which could

cause or contribute to future health impairment. Its purpose is to have a final
assessment of employees’ health and compare it with previous medical
examinations results so as to see whether job assignments have affected
their health.

Monitoring of sickness absence

It is important for organizations to keep records of absence from work

because of sickness. Monitoring of sickness absence can assist in
identification on whether there is any relationship between the reasons for
absence or ill health and health hazards which may be present at the place
of work.

Determination of the degree of exposure to health hazards

The responsible authority should develop the criteria to determine the
degree of workers’ exposure to hazardous substances or agents. If it is
appropriate the authority should also specify levels as indicators for
surveillance of the working environment with a view to implement the
required preventive measures.

Record keeping

Employers should keep the records of monitoring of employees exposure to

health hazards for the period determined by the competent authority.

Implementation of control measures to eliminate root causes of health

hazards

After identification of health hazards and the degree of employees’ exposure

to health hazards organizations should design and implement control
measures so as to eliminate the root causes of such hazards if it seems to be
practicable.

Reporting of occupational accidents, injuries and diseases.

The responsible authority has the task to ensure there is establishment and
application of notification procedures for occupational diseases, accidents
and injuries by employers.

Managing treatment

Organizations should have a well-established system to ensure that

employees who sustain occupational injuries or confront occupational
diseases get medical treatment.

Type of Work Which May Require Health Surveillance

There are many types of work which may require health surveillance.
Generally, the work where health surveillance is appropriate are those which
include significant exposure to one or more of health hazard category as
follows:-

i. Work which involve exposure to respiratory or skin sensitizers

ii. Work which involve exposure to chemical agents
iii. Work with vibrating tools
iv. Work in noisy environment
v. Wet work
vi. Work with ionizing radiation
vii. Work in compressed gas atmosphere like divers or miners

5.4 Health Surveillance Process

Health surveillance process should include a series of steps as follows:-

Step 1: Health surveillance risk assessment

This is the first step. It involves carrying out of risk assessment of the task
and/or work place to identify if there is a need of health surveillance to staff.

Step 2: Type of health surveillance needed:

This is the second step. It involves determination of the type of health

surveillance needed on the basis of nature of hazards present and the level
of exposure of each individual

Step 3: Determining the risk to individuals

This is the third step. It involves determination of the extent of health risk
involved to different groups of employees as the results of exposure to
health hazards.

Step 4: Requesting health surveillance

This is the fourth step. It involves submission of a formal request to the
occupational health team through health surveillance request form. This is
done once the need for health surveillance has been identified. Step 5: Carry
out health surveillance

This is the fifth step. It follows after the approval of health surveillance
request. Here the individuals requiring health surveillance will be contacted
by the occupational health team who will make all necessary arrangements.

Step 6: Record results and review regularly

This is the sixth step. Here the results of health surveillance will be recorded
by occupational health team. These results will help to determine the need
for further health surveillance.

Key Players in Occupational Health Surveillance

There are many players involved in occupational health surveillance.

However those players can be grouped into four key players which include
competent authority, employers, workers, and occupational health
professionals.

Competent authority

i. It should formulate national policy on occupational health in general

and on workers’ health surveillance in particular in consultation with
representative organizations of employers and workers
ii. It should set minimum standards with regard to workers’ health
surveillance
iii. It should encourage the establishment of occupational health
services and designation (registration, licensing) of specific medical
services and local hospitals within the national health infrastructure
for provision of occupational health services
 iv. It should determine the qualifications required for personnel
providing occupational health services in accordance with the duties
to be performed.
v. It should supervise the implementation of workers’ health
surveillance
vi. It should review national practice on workers’ health surveillance,
set priorities and devise an approach to ensure that workers’ health
surveillance is managed in cost effective manner with no loss of
quality
vii. It should establish a list of occupational diseases subject to
surveillance which should be reviewed periodically
viii. It should adopt provisions to ensure the protection of workers’
privacy in surveillance and to ensure that health surveillance is not
used for discriminatory purpose.

Employers

i. The employer should provide workers with access to health

surveillance with without incurring any cost
ii. The employer should ensure that workers have access to health
surveillance appropriate to the health risk they incur at work
iii. The employer should ensure that workers participate in health
surveillance programme
iv. The employer may request for medical examination for workers in
their employment or for workers they intend to recruit if there is
justification
v. The employer may request may request anonymous , collective
health-related information from health professionals for taking
appropriate measures to protect workers’ health and to prevent
further occurrence of occupational accidents
 vi. If a particular job is found medically contra-indicated for a worker,
the employer must make effort to find alternative employment or
another appropriate solution

Workers

i. Workers should actively participate in occupational health

surveillance programme
ii. Workers should be involved in decision making concerning
organization of the implementation of health surveillance
programme
iii. Workers should have the right to receive collective report on health
surveillance and medical examinations
iv. Workers must participate and cooperate with occupational health
professionals and the employers in implementation of occupational
health surveillance
v. Workers undergoing health assessment or medical examination
must be informed in advance of its purpose and the use of
information that will be obtained from it.
vi. Medical examination or health assessment should involve informed
consent and should be voluntary if health surveillance programme
is not prescribed by national laws and regulations
vii. Workers should have the right to request for health assessment in
the form of medical examination or other tests if a disorder occurs
which the workers believe it is due to or related to work.

Occupational health professionals

i. They should assist employers in fulfilling their obligation of taking

the due care for workers health
ii. They should assist workers in protecting and promoting their health
in relation to work and in maintaining their working capacity
 iii. They should assist workers’ representatives and health and safety
committees in fulfilling their tasks related to workers health and
safety
iv. The should strictly observe medical confidentiality with regard to
results of workers’ health assessment
v. They should notify the competent authority of occupational
accidents and diseases in conformity with professional ethics if the
national laws require them to do so
vi. They must acquire and maintain the competence necessary for their
duties
vii. They should carry out health assessment of workers within the
framework of recognized occupational health services and under
the supervision of a physician.
viii. They have the right to request for health assessment of workers
when it seems to be necessary in the course of taking care of
workers’ health
ix. They have a special responsibility to preserve and safeguard their
professional independence in all circumstances
x. They should examine their occupational health practice on ethical
or technical grounds regularly.

5.7 Challenges of Occupational Health Surveillance

Occupational health surveillance may be faced by a number of challenges.

Some of these are as explained below:-

i. Lack of awareness on the importance of health surveillance: Some

employers are not aware on the importance of occupational health
surveillance
ii. Poor managerial support: In some cases top management fail to
provide full support to occupational health surveillance programme
iii. Budgetary constraints: Some organizations have no enough budget
to implement occupational health and safety programme
iv. Shortage of experts: In some cases the organizations fail to get
enough experts like medical personnel for implementation of
occupational health surveillance
v. Poor monitoring and evaluation: In some cases organizations fail to
make regular review and assessment of the implementation of
occupational health surveillance programme.
vi. Poor workers representation on health and safety issues: In some
cases employees are not participated in decision making concerning
occupational health surveillance
vii. Cheating: In some cases workers as well as some health experts
cheats on medical examination results. For instance in pre-
employment examinations