DOLE/BWC/OHSD/OH-47 A

Republic of the Philippines

Department of Labor and Employment
Bureau of Working Conditions

Occupational Health and Safety Division

ANNUAL MEDICAL REPORT FORM

For Period January 1, 2013 to December 31, 2013

1. Name of Establishment : COCA- COLA BOTTLERS PHILS.

2. Address : FATIMA VILLAGE, TACLOBAN CITY
3. Name of Owner / Manager : Reynaldo L.Queque
4. Nature of Business and Products/Service (Ex. Manufacturing, Textile)
MANUFACTURING/BEVERAGE
5. Total Number of Employee : 205 Number of Shifts: 2

6. Number Distribution of Employee as to nature of workplace, sex and work shift

Office Production / Shop

nd
1st Shift 2 Shift 3rd Shift
Male : 169
Female : 36

Total : 205

7. Preventive Occupational Health Services : (Check or Cross)

a. Occupational Health Services is organized / provided by:

( / ) the establishment / undertaking
( ) government authority / institution
( ) other bodies/groups/institution (specify)

b. Occupational health services as described under & above, is organized/provided as a

service:
( /) solely for the workers of the establishment / undertaking
( ) common to a manner of establishment / undertakings

c. The employer engages the services of:

( ) Occupational health practitioner
Name:
Address :
( / ) Occupational Health Physician
Name: RENATO D. ARCEÑO MD
Address : V&G TACLOBAN CITY
( / ) Occupational Health Nurse
Name: Merlinda M. Fabi R.N
Address : PALO, LEYTE

B. The occupational health physician/practitioner/nurse/personnel conducts an inspection of the

workplace:
( / ) once every month ( ) once every three (3) months
( ) once every two (2) months ( ) once every six (6) months
 ( / ) other details First Aid Kit/ Canteen Inspection

8. Emergency Occupational Health Services:

a. The Employer provides a treatment room/medical clinic in the workplace with

medicines and facilities:

( / ) Yes……….......... ( ) No………
( ) Others, please
specify……………………………………………………………………

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b. Schedule of attendance in the workplace:
Workshift
Occupational health physician :-------4---------------------hrs./day--------------------------------
Occupational health dentist :----------------------------hrs/day----------------------------------
Occupational health practitioner:----------------------------hrs/day---------------------------------
Occupational health nurse :-------8----------------------hrs/day-------------------------------

9. Occupational Health Services:

a. The occupational health personnel of this establishment conducts regular appraisal of

the sanitation system in the workplace:
( / ) Yes ( ) No

b. Numbers of Workers who underwent the following medical examinations:

Physical Exam X-rays Urinalysis
1. Pre-placement ____23____ __23_ ___23___
2. Periodic ____163_____ __163__ __163__
3. Return to Work ____________ ______ ________
4. Transfer ____________ ______ ________
5. Special ____________ ______ ________
6. Separation ___________ ____ _____

Stool exam Blood test ECG Others

1.Pre-placement ___23___ __23__ __23_ _11___
2 .Periodic ___163_ __163 _93
3 Return to Work ________ ______ _____
4 Transfer ________ ______ _____
5 Special ________ ______ _____
______
6 Separation _______ _____ ____
______

10. Report of Diseases:

a. Number of consultations/treatments for the following disease

Total Number
Male Female of cases
Skin:
( / )infection as folliculitis/absecess/
Paronychia/allergy/dermatoses 97 5 102
( / ) Others 1 1 2

Head:
( / ) Migraine headache 2 2
 ( / ) tension headache 27 9 36
( ) Others ___________

Eyes:
( / ) Error of refraction 21 10 31
( / ) Bacterial/Viral conjunctivitis 11 11
( ) Cataract
( ) Others

Mouth & ENT:

( / ) Gingivitis 4 4
( ) Herpes Labiales / nasalis
( ) Otitis Media / Externa 4 1 5
( ) Deafness
( / ) Meniere’s Syndrome/Vertigo 3
3
( / ) Rhinitis / Colds 169 21 190
( / ) Nasal Polyps 5 5
( / ) Sinusitis 4 1 5
( / ) Tonsillopharyngitis 16 _____2_____ 18
( / ) Laryngitis 6
6
( / ) Others 12 12

Respiratory:
( / ) Bronchitis 51 6 57

( / ) Bronchial Asthma 9 9
( / ) Pneumonia 1
1 _____2______
( ) Tuberculosis __ _________
( ) Pneumoconiosos _____
( / ) Others 138 14 _
152_ _

Heart and Blood Vessel

( / ) Hypertension 190 190

( ) Hypotension
( ) Angina Pectoris
( ) Myocardial Infarction
( ) Vascular disturbances in
extremeties due to
continuos vibration
( / ) Others 32 32

Gastrointestinal:
( / ) Gastroenteritis/Diarrhea 40 1 41
( / ) Amoebiasis
( / ) Gastritis / Hyperacidity 27 4 31
( ) Appendicitis
( ) Infectious Hepatitis
( ) Liver Cirrhosis
( ) Hepatic Abscess/Parynchimal
( ) Cancer ( Hepatic/Gastric)
( ) Ulcer
( / ) Others 35 ____1_____
_____36________
Genito Urinary:

( / ) UTI 7 2 9

( / ) Stones 17 17
( ) Cancer
( ) Others
Reproductive:
( / ) Dysmennorhea 10 10
( ) Infection ( cervicitis/vaginitis)
( ) Abortion (Threatened)
( ) Hyperemesis Gravidanum
( ) Uterine Tumors
( ) Cervical Polyps/Cancer
(/ ) Ovarian Cyst/Tumor 2 2
( ) Sexually Transmitted Dse.
( ) Hernia (inguinal/Femoral)
( ) Others

Neuromuscular/Skeletal/Joints:

( / ) Peripheral Neuritis 12 12

( / ) Torticolis 2 2
( / ) Arthritis/Gout 29 29
( / ) Others 90 18 108

Lymphatic and Circulatory:

( / ) Anemia 1 1

( ) Leukemia
( ) Cerebrovascular accidents
( ) Lympoma
( ) Others

Infectious Diseases:
( / ) Influenza 3 1 4
( ) Thypoid/Paratyphoid fever
( ) Cholera
( / ) Measles 1 1
( ) Mumps
( ) Tetanus
( / ) Herpes Zoster/Simplex 1 1
( ) Malaria
( ) Schistosomiasis
(/ ) Chicken Fox 1 1
( ) German Measles
( ) Rabies
( ) Others

Diseases due to Physical Environment:

a) Diseases due to noise and vibration
( ) deafness ( noise induced) _______ ___________ _____________
( ) White fingers disease _______ ___________ _______________
( ) Musculo-Skeletal disturbances _______ ___________ _____________
 ( ) Fatigue _______ ___________ _______________
b) Diseases due to abnormalities
in temperature and humidity
c ) Diseases due to abnormalities
in air pressure
d ) Poisoning / Overdosage/ Chemicals _______ __________
_______________

TOTAL NUMBER………. 1,062 112

1,174_____

11. Report of Occupational Accidents /Injuries

Total Number
Nature Male Female of cases

Contussion, bruises, hematoma

Abrasions Cuts, Lacerations, Punctures

Concussion
Avulsion
Amputation, loss of body parts
Crushing injuries
Spinal injuries
Cranial injuries
Sprains
Dislocation / Fractures
Chemical Burns

12. Immunization Program (Indicate the number)

Total Number
Male Female of cases
Tetanus Toxoid Injection 52 10 62____
Tetanus Antitoxin Injection
Tetanus Globulin Injection ___ _______
Anti-Cholera, Anti-Thypoid Triple Vaccine 2 2
Others (Please Specify)Flu (Emp/Dep) 106
HEPA __1_____ ____3____ ____4___
Leptospirosis Propylaxis 238 44 282

13. Keeping of Medical – Records of Workers (Please Check)

( / ) done ( ) not done

14. Health education and counselling by Health and Safety personnel:

(Please check one or more)
( / ) done individually as each worker comes to the clinic for consultation.
( / ) done in organized group discussions / seminars.
( / ) done with the use of visual displays and / or promotional materials, leaflets, etc.

15. Other Health Programs.

Kinds of Program Seminar Use of Visual Counseling

Aid/Materials
 Nutrition Program
Maternal and Child Care Program
Family Planning
Mental Health Activities
Personal Health Maintenance
Health & Wellness Program
Physical Fitness Program
Sports Activities
Others ( Please Specify)
16. Hazards in the Workplace: ( Please check and give details of the substance )
a. Chemical Hazards:
( / ) dust ( ex.Silica dust
( ) liquids (ex.mercury)
( ) mist/fumes/vapors (ex.mist
from paint spraying
( ) gas (ex.CO,H2S)
( ) others ( please specify )
( ex. Solvent)
b. Physical Hazards
( / ) noise
( ) temperature/humidity
( ) pressure
( ) illumination
( ) radiation/ultraviolet/microwave
( ) vibration
( ) others (please specify)
c. Biological Hazards
( ) Viral
( ) Bacterial
( ) Fungal
( ) Parasitic
( ) others
d. Ergonomic Stress
( ) exhausting physical work
( ) prolonged standing
( ) low back pain
( ) unfavorable work posture
( ) static/monotonous work
( ) Others; specify
( ) (/ )
( ) ( ) ( )
(/ ) (/) (/)
( ) ( ) ( )
(/) (/) (/)
(/) (/) ( )
(/ ) Yes ( ) No
( ) Yes ( ) No
Substance and/or No.of Workers
sources exposed
Methyline Blue,EDTa,Silica Gel,Phenolpthalein
- 40
Acetic Acid, Sulfuric Acid, Hydrochloric Acid,
Phosporic Aci d - 40
---------------------- ------------------------
Carbon Dioxide, Ammonia, Acetylene, Butane
- >60
Ethyl alc,Hexane,Methanol
- 25
---------------------- -----<60-------------------
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Merlinda M. Fabi,RN- Plant Nurse January 27, 2014
Medical Personnel/Plant Nurse Date

Noted by:

Marlon M Ventulan
Human Resource Executive

Republic of the Philippines

DEPARTMENT OF LABOR AND EMPLOYMENT
REGIONAL OFFICE NO.8
TACLOBAN CITY

Name of Stablishment : COCA COLA BOTTLERS PHILS.

Nature of Business : MANUFACTURING

Address : FATIMA VILLAGE, TACLOBAN CITY

Exposure Date : JANUARY TO DECEMBER 2013

Number of Employees: (205) REGULAR

Total Man-hours Worked by All: 578,240

Injury Summary : 0

Total – All Disabling Injuries/ Illness 0

Total Non- Disabling 0
Frequency Rate 0

Marlon M. Ventulan
Human Resource Executive

1. This report shall be accomplished whether or not there were an accident/ illness occurrences
during the period covered and submitted to the Regional Labor Office or Local Government
having jurisdiction not later than 30th of the month following the end of each calendar year.
2. Frequency Rate is the total number of disabling injuries per million employee hours of
exposure.
 FREQUENCY RATE = NUMBER OF DISABLING INJURIES X 1,000,000
EMPLOYEE HOURS OF EXPOSURE

= 0 X 1,000,000
578,240

= 0

3. Severity Rate is the total number of days lost or charged per million employee hours of
exposure.

SEVERITY RATE = NUMBER OF DAYS LOST OR CHARGED X 1,000,000

EMPLOYEE HOURS OF EXPOSURE

= 0 X 1,000,000
578,240

= 0

4. Exposure is the total number of hours worked by all employees in each established
including employees of operating production, maintenance, transportation, electrical,
administrative, sales and other departments.
5. Disabling injuries – work injuries, which result in death, permanent total disability,
permanent partial disability or temporary total disability or partial disability.
6. Non-disabling injuries ( Medical Treatment ) – injuries which do not result into disabling
injuries but required first aid or medical attention of any kind.
TO : OIC-Director Exequiel R. Sarcauga

DEPARTMENT OF LABOR, REGION XIII

FROM: COCA-COLA BOTTLERS -FEMSA PHILS.

TACLOBAN PLANT

DATE : January 27,2014

SUBJECT: AMR/ISR 2013

Submitting herewith the following attached data for CCBP-Tacloban Plant:

 Annual Medical Report ( January-December 2013)

 Injury Summary Report ( Exposure Period: January-December 2013)

More Power! “BANGON TACLOBAN”

Merlinda M Fabi, RN
CCBP-Plant Clinic