of 22

Medical Surveillance

Published on January 2017 | Categories: Documents | Downloads: 5 | Comments: 0

Comments

Content

MEDICAL
SURVEILLANCE
dr. I.B Adiatmaja
Occupational Health – HSSE Corporate

Occupational Health Program




Health Prevention/Protection:
 Health Risk Assessment;
 Health Surveillance;
 Instruction and Training;
 First Aid and Medical Emergency Treatment;
 Sickness Monitoring; Canteen Hygiene;
 Record Keeping
Health Promotion:
 Assessment of Risk: Life style and Environment;
 Drug and Alcohol Policy;
 Aids and the work place;
 Information and assistance.

Pengertian
 Surveilans = mengawasi

Surveilans Kes. Kerja
 Pengumpulan data secara sistematik
 Analisis : frekuensi, distribusi, tren
 Interpretasi dan dikomunikasikan
 Tindakan pencegahan
HAZARD BASED
Page 3

Komponen Surveilans Kes. Kerja
 Surveilans hazard kesehatan
Pengukuran hazard - dibandingkan dengan NAB/TLV

 Surveilans efek kesehatan
Pemeriksaan kesehatan

 Biological monitoring
Pemeriksaan biomarker - dibandingkan dengan BEI

Page 4

TUJUAN
 Identifikasi pola penyakit
 Deteksi dini paparan hazard

 Memantau pekerja yang terpapar di

luar pekerjaan
 Melindungi pekerja yang rentan
 Mematuhi peraturan
 Identifikasi kebutuhan pelayanan
kesehatan

Page 5

MANFAAT
 Metode untuk deteksi dini
 Penentuan PAK/Non PAK
 Dasar untuk upaya preventif dan

promosi kesehatan

Page 6

Health Risk Assessment






Hazard Identification:
 Departmental level;
 MSDS;
Hazard Measurement and Exposure
Evaluation:
 Noise & Vibration; Gas, vapor, dust;
Thermal stress; Radiation; Biological;
Ergonomic; Psycho-social;
 Environmental and Biologic Monitoring.
 TLVs and BEIs
Risk Control:
 Engineering; Administrative; PPE. (ALARP)

RECOMMENDED MEDICAL TEST
FOR HIGH RISK GROUPS
Group/Exposure:

Noise

Dusts

Heat Stress

Solvent Vapor







Welders
Drivers
Canteen Personnel
Medical personnel

Recommended Tests:

Audiometry

Spirometry, Chest X-ray

Harvard Step Test; ECG

Neurological, e.g. Swedish
Q16; Renal function, LFTs,
Spirometry, Bio-monitoring

Urinalysis, Bio-monitoring

Eye/ear testing, ECG (> 40)

Feces culture, Chest X-ray

Serology for Hep-B, LFTs,

Chest X ray.

RECORD KEEPING
 Data bases: Medical and






Environmental (exposures);
Medical check up data, Daily medical;
Confidentiality, legibility, security;
Paper and Electronic;
Retention time:
best practice: 30 years;
 Indonesian law: 3 years.


MEDICAL SURVEILLANCE




Pre-employment medical:
 Baseline data;
 Prevalent diseases in the community;
Pre-placement;




Periodic:






Job related;

Job Related;
Health Promotion;

Post Sickness;
Termination.

KAPAN
 OSHA : 28 pajanan
 Dianjurkan :

-

Pajanan berisiko
Belum diketahui efek kes.nya
Banyak keluhan pekerja
Ada individu dengan risiko tinggi
“Acton level” bahan belum diketahui

Page 11

HIGH RISK GROUPS
 Exposure to Chemicals, eg.







solvents, heavy metals, free silica,
pesticides, etc.
Exp. to Noise & Vibration;
Exposure to Radiation;
Exposure to extreme temperature;
Special Groups: Food-handlers,
Drivers, Welders, Health personnel,
Fire brigade, etc.

Sickness Monitoring
 Occupational Diseases:
baseline; exposure;
 Reportable


 Morbidity statistics (onsite clinic):
 National Disease Registry;
 Monthly, Annually;
 Data analysis an inference:
 Medical check up data and clinic data;
 in/out patient data; Medical absenteeism.

Information, Instruction and Training








Health Policy and OH program;
Safe work procedures;
 Chemical Safety;
 Food Safety;
 Confined space;
Protective equipment:
 Ear, eye, skin, respiratory.
Training plan for OH officers;
Clear job description?
Access to internet/e-mail.

OH INFORMATION




Worldwide:
 US-OSHA/NIOSH;
 ACGIH, ACOEM, AIHA;
 HSE Executive;COSHH;
 WHO/ILO
Indonesia:
 PNKK Depnaker;
 Balai Hiperkes Depnaker;
 AHKKI, IDKI.
 Depkes: SIKER.

PAK
PENYAKIT AKIBAT KERJA ADALAH
SETIAP
PENYAKIT
YANG
DISEBABKAN OLEH PEKERJAAN
ATAU LINGKUNGAN KERJA
PERMENAKERTRAN 1/1981

Page 16

PENGERTIAN
• PAK : Penyakit yang diderita pekerja dalam

hubungannya dengan kerja, baik karena faktor risiko
kondisi tempat kerja, peralatan kerja, material yang
dipakai, proses produksi, cara kerja, limbah perusahaan
dan hasil produksi (Harjono)

•Kepres 22/1993 : Penyakit yang timbul karena
hubungan kerja
• Pasal 1 : penyakit yg disebabkan oleh perkerjaan atau
lingkungan kerja
• Pasal 4 : 31 jenis penyakit
•Kepmenaker 79/2003 : Pedoman Diagnosis dan
Penilaian Cacat karana Kecelakaan dan Penyakit Akibat
kerja
Page 17

No

Penyakit Akibat kerja

Penyakit
Berhubungan
Dengan Kerja

Penyakit Umum di
kalangan pekerja

1

Termasuk kecelakaan
kerja

Bukan (?) termasuk
kecelakaan kerja

Bukan termasuk
kecelakaan kerja

2

Ada jaminan asuransi
kecelakaan kerja
(kompensasi)

Tidak ada (?)
jaminan asuransi
kecelakaan kerja

Tidak ada jaminan
kecelakaan kerja

3

Biasanya disebabkan
oleh 1 faktor di
pekerjaan

disebabkan oleh
multifaktor, tetapi
faktor pekerjaan
cukup dominan

Disebabkan oleh 1
atau multi faktor,
tidak/sedikit
sekali
berhubungan
dengan pekerjaan

4

Contoh : Tuli Akibat
Bising di tempat kerja,
asbestosis, silikosis,
dermatitis di tempat
kerja, asma di tempat
kerja

Contoh : penyakit
jantung koroner,
psikosomatis.

Contoh : Infeksi
telinga, gondok,
demam berdarah,
tifus

Page 18

NIHL = TULI AKIBAT BISING

Page 19

ASBESTOSIS & MESOTELIOMA

Page 20

Page 21

CTS = CARPAL TUNNEL SYNDROME

Page 22

Sponsor Documents

Hide

Forgot your password?

Or register your new account on INBA.INFO

Hide

Lost your password? Please enter your email address. You will receive a link to create a new password.

Back to log-in

Close