KUALA LUMPUR, Dec 27 — Experts are calling for more focus on health within the training and responsibilities of health safety officers and consultants, following the 2022 amendments to the Occupational Safety and Health Act (OSHA).
Anis Fahmy Pauzy, an associate consultant at the Malaysian Employers Federation (MEF), said occupational safety and health professionals should have a deeper understanding of health, instead of relying on medical doctors.
“In the future, I believe there will be a stronger emphasis on health, and it should align with the curriculum. If you are a safety and health officer, then the health component must be as substantial as safety.
“We need a broader range of occupational health professionals, not just depending on doctors. Occupational health and safety officers and consultants should have a deeper understanding of health. If not, it’s going to be very skewed towards safety as we have done in the past,” Anis said at the Industry Leadership Forum: “Building A Productive Workplace Culture of Health and Wellbeing” organised by the Galen Centre for Health and Social Policy here last October 23.
The Occupational Safety and Health (Amendment) Act 2022 (OSHA) now provides protection for general practitioners (GPs) against discrimination from organisations and companies.
Anis said that prior to the 2022 amendment, medical practitioners were not safeguarded against discrimination by companies.
He explained that companies had the discretion to refrain from engaging the services of these doctors in the future if the doctors reported an occupational injury to the Department of Occupational Safety and Health (DOSH).
“In the past, for example, if you were a medical practitioner and reported a case to the authority, you might not have been included in that company’s list of medical service providers the following year. However, now you are shielded from such discrimination,” Anis said.
The OSHA 1994, specifically in sections 19 and 24, deals with employers’ responsibilities in maintaining the health and safety of the workplace environment. However, it lacks clarity when it comes to addressing the health concerns of employees.
“It doesn’t really specify health in that sense. It’s a lot about workplace injury prevention and workplace safety. I think the industry is good at that (workplace safety) because there’s the surveillance reporting mechanism and enforcement. But on health, it has always been a private matter between the person and the company,” Anis said.
Section 19 of OSHA 1994 originally imposed a fine of RM50,000 on individuals found in violation of sections 15 to 18 of the act. However, with the latest 2022 amendment, this fine has been significantly increased to RM500,000.
Sections 15 to 18 delineate the general responsibilities of employers and self-employed individuals towards their employees.
This includes the obligation for employers to ensure, to the best of their abilities, the safety, health, and welfare of all employees during their work activities.
It also entails the responsibility of ensuring the safety of contractors, subcontractors, and any employees working under the company’s supervision, establishing an occupational safety and health policy, and guaranteeing the safety of premises accessible to employees.
Section 24 outlines the general duties of employees during their work activities. In the recent amendment, employees who fail to adhere to these duties can face fines of up to RM2,000 and a potential imprisonment period of up to two months.
Employees are required to exercise reasonable care for their own safety and to avoid compromising the safety of their colleagues while performing their duties.
Additionally, they must cooperate with their employer or any person in charge, continuously use the protective equipment or clothing provided by their employer, and comply with any directives or measures related to occupational safety and health instituted by their employer.
In 2022, DOSH recorded over 7,000 cases of occupational diseases, a substantial increase of 1,702 cases compared to the 5,298 cases recorded in 2021.
In response to this upward trend in occupational diseases, DOSH is aiming to achieve a 30 per cent increase in the reporting of such diseases.
This new target places a significant responsibility on occupational doctors, who must be adequately prepared to fulfil their role in the detection of these diseases.
Failing to detect these diseases would result in cases going unreported and consequently not being included in national statistics.
“It is crucial for human resource managers to have close contact with your panel doctors because they need to know how to report. It is their duty to report occupational disease to the DOSH authority,” Anis said.
According to Anis, the predominant occupational disease is hearing impairment, primarily attributed to the high levels of noise workers are exposed to in their workplace environments.
In 2021, the DOSH website reported 3,648 cases of hearing impairment. Although aggregated data for 2023 is not available, as of May 2023, DOSH recorded a total of 3,148 non-permanent work disabilities and 120 permanent disabilities.
While Anis calls for more focus on preventing hearing injuries, he stresses the more significant issue in occupational health is the lack of oversight on chemical safety data sheets.
Malaysia lacks an independent agency to verify the information provided to companies and employees, Anis said. These sheets, supplied by chemical manufacturers, offer crucial guidance on hazardous chemicals, including properties, hazards, and safety precautions.
It also offers guidance for each specific chemical, including details about personal protective equipment, first aid procedures, and spill clean-up protocols.
“We lack an independent agency that evaluates the validity of the content in safety data sheets. Unlike some developed nations, they have authorities that review the accuracy of safety data sheet content.
“This practice is carried out in countries like Korea and Japan. However, in Malaysia, we solely rely on safety data sheets provided by manufacturers,” Anis said.
“Essentially, what we receive is what we get. We heavily depend on safety data sheets and the chemical Safety and Health Officer (SSO), which is a key competency.
“Whenever chemicals are involved, a chemical risk assessment is necessary. However, since this assessment also relies on the safety data sheet, we face a dilemma in Malaysia.
“It’s challenging to ensure that the content of the safety data sheet accurately reflects the chemicals used in the workplace. This is a significant issue, and I hope it doesn’t escalate.
“However, if we don’t address this problem in the future, we may see an increase in cancer cases,” Anis said.
Another challenge is the shortage of certified chemical health risk assessors in Malaysia. Anis highlighted that the country only boasts 159 individuals capable of conducting these assessments, and all of them are employed in the private sector.
This shortage raises concerns for employers as these risk assessors can essentially set their prices, leaving companies with no option but to comply, regardless of the reasonableness of the costs.
Despite the deficit of certified OSH workers in certain areas, the 2022 OSHA Amendment mandates that employers appoint an occupational safety and health coordinator for workplaces with five or more employees.
Additionally, the amendment grants employees the authority to remove themselves from any imminent workplace danger.
Anis explained, “An employee can now refuse to continue work if they believe that it poses a threat to their wellbeing and can lead to life-threatening conditions. These are the new challenges employers are confronting.”
NCSM: SMEs Do Not Provide Good Patient Support
Dr Murallitharan Munisamy, managing director of the National Cancer Society Malaysia (NCSM), noted that small and medium enterprises (SME) lack adequate outpatient support for their ill employees.
“Generally, you have a small inpatient coverage which covers a bit of the care, but then after that, there’s quite a long way to go. And support from the employer in this perspective is not so helpful and considering that SMEs remain the largest employers within Malaysia, that’s something we need to do much faster,” said Dr Murallitharan.
Dr Murallitharan highlighted that the most compassionate employer in terms of providing outpatient care, especially for cancer, is the Malaysian government.
The government grants civil servants up to two years of paid leave to receive cancer treatment. In cases where treatment extends beyond this period, the government evaluates the situation and considers further actions through the medical board.
On the other hand, multinational corporations are also recognised by Dr Muralitharan for their sympathetic approach to employees’ medical needs. “They’re usually quite kind. They bring you slowly back to work and all that as well if that is your choice.”
NCSM, which offers cancer care and support for cancer patients and their families, follows a flexible policy when it comes to employees seeking treatment and time off to recuperate.
Dr Murallitharan said that while he recognises that SMEs are often constrained by factors such as insurance caps and group policies, he said that employees who have been given time off work for their treatments will often work harder for the company as they appreciate the company’s support.
“In a setting like ours where we’ve got a little bit of flexibility, I can tell you that when you do give that flexibility, we actually get a lot more productive input or output that gives back to the organisation.
“Another aspect is, and this is something we’ve been shouting to a lot of people about, the cost of health insurance. Due to the way SMEs are structured, they have very stringent limits or caps.
“A lot of people are covered by group insurance, but these caps and limits hinder comprehensive support.
“It is a sad reality that 40 per cent of the population has hypertension, or cholesterol or both, and 20 per cent of the country is diabetic, whether they like it or not,” he said.
Dr Murallitharan said factors such as skewed group insurance based on expenditure continue to strain organisations and sometimes force them into decisions they’d rather not make due to financial constraints.
Additionally, Dr Murallitharan suggested that clear standard operating procedures facilitating a flexible work culture and utilising a hybrid work-from-home model can help employees who may not be fit to come to the office but are still capable of working. This approach allows companies to meet their business objectives while caring for their employees’ wellbeing.
“When they catch Covid and we keep them at home, it doesn’t mean that they are ill enough not to work. The problem is we are keeping them at home to not infect half of everybody else. So, then very clearly we just have each department sit down and draw up things that they could do outside the office.
“For example, today, I have a nurse who reported she was positive for Covid over the weekend. What we put in place is there’s this whole set of data entry that needs to be done.
“The moment the nurse reported, ‘I have Covid. Three days,’ by mid-morning her HOD (head of department) would have called her and told her, ‘Okay, from home you do these tasks.’ So, that process you have to put very strategically into place. I realised, through multiple sessions, that there is no process that doesn’t allow you to work from home.”
However, post-Covid, some companies have reverted to office-centric work arrangements, missing opportunities to address the health issues faced by their employees effectively.
Dr Murallitharan believes that because employers do not carve out processes that will enable them to benefit from the work-from-home model, employees are forced to return, which in turn could lead to the transmission of communicable diseases to the rest of the workforce.
When it comes to health expenditure and investing in the health of the workforce, Dr Murallitharan advised employers to go with an incremental, gradual investment, where investment is built upon the returns that employers see.
“Many workplace investments that enhance employee productivity, actually, are very short-term. You can see results within about one or two months. Problem is, are you looking for it, and are you able to catch it?
“I notice a lot of workplaces aren’t able to do that. I think it (health care) needs to be tailored, one, to organisation, and second, with the clear understanding of bang to buck. If I’m going to spend RM1, exactly in two months what is this going to get for me.
“Again, it all comes back to this term ‘wellbeing’. They have very translatable, quantifiable workplace outcomes, and that is what people really need to think about,” Dr Murallitharan said.
Vaccine preventable respiratory diseases, such as pneumococcal disease, can be a severe health and financial burden, and is a cause of premature death in Malaysia.
Workers are vulnerable to such respiratory diseases due to existing comorbidities. Work environments that place employees in direct contact with individuals and communities can be sources of infection.
Effective vaccines such as pneumococcal conjugate vaccines are already available in Malaysia as viable options which confer strong long-term protection.