Republic of the Philippines Department of Health OFFICE OF THE SECRETARY OCT 09 2012 ADMINISTRATIVE ORDER No. 2012-_0020 pte SUBJECT: Guidelines Governing the Occupational Health and Safety of Public Health Workers Rationale ‘Workers in all types of occupations are entitled to a healthy and safe working place. However, the health sector is one of the neglected groups in the working population which is not given the needed priority when it comes to program or services on occupational health and safety. The healthcare workers are undeniably more exposed to hazardous working environment compared to their counterparts in the industry sector. Their prolonged and continuous exposures to infectious diseases and other health risks inherent in working in the healthcare facility make them highly vulnerable to injury, sickness and even death. Hence, pursuant to the provisions stipulated under the rules and regulations governing the Magna Carta of Public Health Workers (RA 7305), the Occupational Safety and Health Standards under the Labor Code of the Philippines, the Implementing Rules and Regulation of Chapter VII on Industrial Hygiene under the Sanitation Code of the Philippines, the Civil Service Commission rules and regulations, the Philippine Health Insurance Corporation (RA 7875 as amended by RA 9241), and the Employees Compensation Commission based on PD 626, healthcare workers are entitled to a humane working environment and shall be protected from hazards and risks associated with their occupations. In addition, Occupational Health and Safety programs are not a burden but have positive and productive impact on the institution and the national economy and contributory to sustainable development. Strengthening the occupational safety and health service provisions of public health workers through evidence-based policy guidelines will support the attainment of the “Kalusugan Pangkalahatan” implementation strategy of the Aquino Health Agenda as part of ensuring access to quality health care, Objectives 1. To promote occupational health and safety in the healthcare facilities; 2. To protect public health workers from the hazards and risks associated in their Va ine 31-7000 Diet Linc 9501 secadoh.zov.ah Nae Building 1, San Lazaro Compound, Rizal Avenue, Sta. Cruz, 1003 Manila ¢ Tran ax: 743-1829; 74-1786 © URL: hiip:/wwn.deh.gov.ph; e-mailml. 3. To prevent diseases and injuries to public health workers; and 4. To provide access to treatment, rehabilitation and compensation of work connected illnesses and injuries affecting public health workers, whenever applicable. Scope and Coverage ‘These guidelines shall cover all public health workers engaged in health and health-related work in healthcare facilities such as but not limited to hospitals, sanitaria, health centers/rural health units, barangay health stations, and other health- related establishments owned and operated by the government or its political subdivisions regardless of the employment status. It also covers medical and allied health professionals, as well as administrative and support personnel, regardless of their employment status, For purpose of this policy, volunteer health workers and trainees are also included, Definition of Terms ‘As used in this Administrative Order, the terms below are defined as follows: 1. Employed — refers to a state of being appointed to a position in government whether permanent, temporary, contractual/casual, full-time or part-time status. 2. Hazard ~ refers to the potential of causing illness or injury to the health and safety of health workers. 3. Head of Healthcare Facility ~ refers to a high ranking official in a healthcare facility and health-related establishment in-charge of implementing Occupational Health and Safety programs. Health and Safety Committee (HSC) - refers to a group of health workers and ‘management representative/s concerned with the planning, policy-making, implementation, monitoring and evaluation of all matters pertaining to occupational health and safety. 5. Healthcare Facility - refers to any government entity whose primary function according to its legal mandate is the delivery of health services and the operation of hospitals, sanitaria, health infirmaries, health centers, rural health units, barangay health stations, clinics or other institutional forms which similarly perform health delivery functions, like clinical laboratories, treatment and rehabilitation centers, x-ray facilities and other similar activities involving the rendering of health services to the public. 6. Health-Related Establishment — refers to a health service facility or unit which performs health service delivery functions within an agency whose legal mandate is not primarily the delivery of health services. This applies to, among others, clinics or medical departments of government corporations, ‘medical corps and hospitals of the Armed Forces of the Philippines, and the specific health service section, division, bureau or any type of organizational 210. ul. 12, 1B. 14. 15. 16. subdivision of a government agency. In no case shall this policy apply to the whole agency when the primary function of the agency is not the delivery of health services. Occupational Health and Safety (OHS) — refers to the promotion and maintenance to the highest degree of physical, mental and social well being of all occupations; prevention among workers in the employment from risks resulting from factors adverse to health; placing and maintenance of the worker in an occupational environment adapted to his/her physiological and psychological capabilities (ILO/WHO Joint Safety and Health Committee). Occupational Health and Safety Personnel ~ refers to qualified first aider, nurse, dentist, physician o safety officer engaged by the employer to provide OHS services. Occupational Health and Safety Practitioner- refers to a physician, nurse, engineer, dentist or chemist and other qualified health professional duly licensed to practice his/her professions in the Philippines and possessing all of the additional qualifications required by Department of Labor and Employment (DOLE). Occupational Health and Safety Program (OHSP) - refers to planned activities aimed in the identification, evaluation and control of occupational hazards and risks in the workplace. Occupational Safety and Health Standards (OSHS) - refer to the set of rules and regulations issued by DOLE and adopted by the Department of Health (DOH) through its Implementing Rules and Regulations (IRR) of Chapter VII - Industrial Hygiene of the Sanitation Code of the Philippines (PD 856). OSHS mandates the adoption and use of appropriate practices, means, methods, operations or processes and working conditions reasonably necessary to ensure safe and healthful employment, as may be applicable and necessary. Public Health - refers to the art and science of preventing diseases, promoting health and prolonging life through organized community efforts. Public Health Workers ~ refer to persons engaged in health and health-related occupations in any public healthcare facility and health-related establishments, It covers medical and allied health professionals, as well as administrative and support personnel, regardless of their employment status. For the purpose of this policy, it also covers volunteer health workers and trainees. Risk- refers to the probability of harm or likelihood of causing illness or injury to the health and safety of public health workers. ‘Trainee - refers to any individual providing healthcare services usually under the supervision of a chief/head of unit through residency, practicum, internship and other related on the job training. Volunteer health workers - refer to individuals or group who for reasons arising from their socio-developmental, business and corporate orientation, 3 shilaVi. 17, commitment or conviction, contribute time, service and resources whether on full time or part time basis to a just and essential social development cause, mission or endeavor in the belief that their activity is mutually meaningful and beneficial to public interest as well as to themselves. Work-connected illnesses and injuries — refer to illness or injury caused by employment, subject to the proof that the risk of contracting the same is increased by working conditions. ‘Statement of Policy 1 Health is a basic human right. Public health workers shall be able to enjoy the highest attainable standard of physical, mental, social well- being and favorable working conditions. Primary prevention of occupational hazards shall be given priority. The promotion of health and the protection from hazards at work shall require enacting regulations and adopting a basic set of occupational health standards. This is to ensure that all health facilities and health-related establishments comply with minimum requirements for health and safety protection, and shall ‘be implemented in close collaboration among concerned agencies. All components of health systems shall be integrated and responsive to the specific health needs of public health workers. Public health workers, employers and their representatives shall participate in the planning, implementation and evaluation of occupational health and safety program with a view of reducing inequalities in worker’s health. Implementing Mechanisms 1 Organizational Structure Based on the strategic activities, organizational structures shall be established, with delineation of roles and responsibilities, and identification of areas of coordination and collaboration among all occupational health and safety stakeholders. a, National Structure Under the Inter-Agency Committee on Environmental Health (IACEH), the Occupational Health (OH) Sector shall be convened. It shall be composed of core staff from government and non-government agencies, professional societies, academe, other public and private sectors. It shall be responsible for developing and implementing a national action plan for Occupational Health and Safety for Public Health Workers. a.1 Enforcement and Monitoring ‘The National Center for Disease Prevention and Control, National Center for Health Facility Development, Bureau of Health Facilities and 4. /1 pesServices, Centers for Health Development, PhilHealth shall regularly coordinate with DOLE Offices - Bureau of Working Condition, DOLE Regional Offices, and other attached agencies i.e. Occupational Safety and Health Center, and Employees Compensation Commission, Civil Service Commission, Department of Interior and Local Government and Local Government Units for the effective implementation and monitoring of the national action plan. ‘A composite team headed by the DOH shall be formed to conduct regular assessment, monitoring and evaluation of the implementation and progress of this issuance. Assessment and evaluation tool/s shall be developed for this purpose. b. Regional Structures Program strategies and activities undertaken at the regional level shall tbe managed by the OH sector under the Regional Inter-Agency Committee for Environmental Health or by existing committees that can absorb this function. The composition and organizational arrangements shall correspond to the IACEH-OH sector. For OH sector without regional counterparts, other stakeholders shall be encouraged to be involved. c. Provincial and Local Structures In addition to DOH-retained health facilities and specialty hospitals, program implementation shall also be carried out at the provincial, city, municipal and barangay levels. The composition and organizational arrangements shall relate to the R[ACEH-OH. Each corresponding level shall be under the leadership of the local chief executive. For OH sector without local counterparts, other stakeholders shall be encouraged to be involved. General Guidelines a. Anoccupational health and safety policy shall be formulated by each healthcare facility addressing health and safety concems in workplaces ‘and worksites classified as a healthcare facility or health-related establishment in accordance with DOH and other related issuances. b. The Head of the healthcare facility shall organize a health and safety committee in the workplace based on Rule 1040 of the OSHS whose main function is to develop and oversee the implementation of an OHSP to include health worker’s orientation and awareness on hazard identification, risk evaluation, prevention and control and medical surveillance and reporting; c ‘The Head of the healthcare facility shall determine/designate the applicable number of health and safety personnel to compose the OHS Committee. The Committee may include the following based on the Rules 1030 and 1960 OHS-DOLE: Safety Officer, Occupational Health Nurse, Occupational Health Physician and First-aider. This shall also include representatives from both the management and employees groups 7 5 paled. The Head of the healthcare facility shall require their health workers to undergo an Orientation and Refresher Courses on OHS. €. The Head of the healthcare facility shall ensure the active participation of health workers in the implementation of OHS programs and projects such as, but not limited to the active role in education and training, reporting of work-related diseases and injuries and in the implementation of continuing OHS programs f The Head of the healthcare facility shall ensure the preparation and submission of all reportorial requirements to the National Center for Disease Prevention and Control through channel. VIL. Specific Guidelines A. Components of the Occupational Health and Safety Program (OHSP). ‘The OHSP shall include: 1. Administrative Support and Policy but not limited to: Organize a health and safety committee; Designate a health and safety officer, occupational health nurse, occupational health physician and other responsible personnel; # Allocate resources relevant to the administrative duties and functions of the committee. 2. Hazard Identification, Risk Prevention and Control to reduce the extent of exposure to hazards and to reduce the likelihood that these hazards will cause illness or injury. These shall include the following but not limited to: Industrial Hygiene Program. Hazard Communication Plaw/Program Health Surveillance Program Immunization and Post Exposure Programs Infection Control Program including Blood-borne Pathogens Waste Management Program Mercury Elimination Program Ergonomics Program ‘Workplace Sanitation Program Emergency Preparedness & Response Plan Personal Protective Equipment Program Drug-Free Workplace Program Healthy Lifestyle Program Healthcare Facility Safety Program Other programs applicable to the facility (i. radiation safety, yg, chemical safety) ] www weer eee eee TAReferral and Access to Medical and Welfare Services ~ appropriate services as required under Rule 1960 of the OSHS shall be made available to all health workers depending on their work assignments which would address all potential hazards in their work environment. 4, Training and Capacity-Building— Develop and begin a training program for health workers, based on job responsibilities. A Public Health Worker assigned to implement the OHS Program in the healthcare facility shall be required to attend basic training/post- graduate course on OHS provided by the CSC, DOH, DOLE, UP College of Public Health, and other accredited institutions (¢.g. OHNAP, PCOM, etc.) or its equivalent. 5, Program Evaluation ~ Based on the results of periodic safety inspections, industrial hygiene monitoring and health and workplace surveillance programs to find patterns of hazards and risks, to measure the success of the health and safety program, and to determine the effectiveness of controls. Results of periodic studies done shall be reported to NCDPC and disseminated to all IACEH/RIACEH members. 6. Records Management - Maintain records of results for all surveys, evaluations, monitoring, corrective actions, and worker medical examinations. Records must be maintained in accordance with applicable laws and regulations. Confidentiality must be adhered. B. Duties and Responsibilities of the OHS Committee (Based on Rule 1040 — OSHS and as stated in Chapter VI, 2C of this Order) 1. Plans and develops OHS programs for the healtheare facility; 2. Directs OHS efforts of the healthcare facility in accordance with government regulations to prevent diseases and injuries in the workplace; Conducts OHS meetings at least once a month; Reviews reports of inspection, accidents investigations, disease outbreaks and implementation of OHS program; 5. Submits reports to the Head of healthcare facility on its meetings and ae activities, 6. Provides necessary assistance to inspecting authorities in the proper conduct of their activities such as the enforcement of the provisions of this Order; 7. Initiates and supervises OHS training of healthcare workers; and 8. Develops and maintains contingency plans and organizes emergency service units as may be necessary to handle such situations. VI. Funding ‘The head of the agency, local government units, healthcare facility and other health-related healthcare establishments shall ensure that funds for this purpose shall be allocated.IX. XL. XL Effect on Existing Issuances and Agreements This issuance shall serve as policy guidelines for the DOH and its attached ayencies, local government units, as well as partner agencies in the administration and enforcement of applicable licensing and accreditation rules and regulations. Nothing herein shall be construed to authorize diminution or reduction of benefits being enjoyed by the public health workers at the time of issuance hereof. Penalty Clause Penalties resulting from non-compliance to these policy guidelines will follow the existing penal provisions as mandated. Repealing Clause All other issuances whose provisions are inconsistent with this Order are hereby repealed and rescinded, Effeet ity This Order shall take effect immediately. TG. ENRIQUE T. ONA, MD Secretary of Health San Lazaro Compound, Rizal venue, Sta. Cruz, 103 Manila « Trunk Line 75-83-01 Dieet Line: TH-9501 Fas: 743-1899; 70-1786 © URL? gp ice dohgo: ph ema arecadah go. pr