Dr. Renauld K.

2
 HSE OCCURENCES
•Unsafe Condition
•Unsafe Action

O H CONSEQUENCIES Safety Consequences

(chronic)  Occupational Illness ? (acute)  Accident !!!

Environment Consequences

(chronic/acute)  Wide Media Expose !!!!

3
 REFERENCES RELATED TO HEALTH

1. UU NO.1/1970 Keselamatan Kerja

2. UU NO.23/1992 Kesehatan
3. UU NO.13/2003 Tenaga Kerja
4. UU NO.3/1992 Jaminan Sosial Tenaga Kerja
5. KEPRES NO 22, 1993 Penyakit yang Timbul Karena
Hubungan Kerja
6. PERMENAKER 02/1980 Pemeriksaan Kesehatan Tenaga
Kerja Dalam Penyelenggaraan Tenaga Kerja

4
HEALTH DEFINITION

World Health Organization (WHO) Definition:

Health is a state of complete physical, mental and social

wellbeing, not merely the absence of disease or infirmity.

UU 23/1992 ttg Kesehatan :

Keadaan sejahtera dari badan, jiwa dan sosial yang

memungkinkan setiap orang hidup produktif secara sosial
dan ekonomis.

5
HEALTH DEFINITION PRACTICAL

Practical Definition:

Sehat adalah keadaan tubuh yang masih termasuk variasi

normal dalam standard yang diterima untuk kriteria
tertentu (jenis kelamin, umur, kelompok penduduk dll)

6
HEALTH EQUILIBRIUM

AGENT HOST

ENVIRONMENT
7
FACTORS INFLUENCING HEALTH CONDITION
 Genetics  5%
 Health Services  15%
Blum Theory
 Environment  30%
 Behaviour  50%
IF,
A B C D E F G H I J K L M N O P Q R S T U V W X Y Z
EQUAL WITH,
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26
THEN,
K + N + O + W + L + E + D + G + E
11 + 14 + 15 + 23 + 12 + 5 + 4 + 7 + 5 = 96 %
AND,
H + A + R + D + W + O + R + K
8 + 1 + 18 + 4 + 23 + 15 + 18 + 11 = 98 %
BOTH ARE IMPORTANT, BUT THE TOTAL FALLS JUST SHORT OF 100 %
BUT,
A + T + T + I + T + U + D + E
1 + 20 + 20 + 9 + 20 + 21 + 4 + 5 = 100 %

SAFETY IS REALLY ABOUT ATTITUDE, MAKE 100 % SAFE BEHAVIOR, EITHER AT HOME OR AT WORKPLACE

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OCCUPATIONAL HEALTH OVERVIEW

9
OCCUPATIONAL HEALTH OBJECTIVES:

 The promotion and maintenance of workers health

and working capacity

 The improvement of working environment to become
conductive for safety and health
 To Prevent the Occupational Illness
 Development of work organization and working

cultures in direction which support health and safety

at work

10
 OCCUPATIONAL HEALTH PROGRAM

Occupational Health Programs must be integrated and

comprehensive:

1. Promotive
2. Preventive
3. Curative
4. Rehabilitative

11
 WHAT ARE HEALTH HAZARD ?
Hazard : Potentiality for harming or damaging people, the environment or
property

Health Hazard is Any condition which have the potential to cause illness

PHYSICAL
HAZARDS BIOLOGICAL
HAZARDS
Noise Ionizing radiation Insects
Thermal stress Non ionizing rad. Microorganism
Illumination Poor ventilation Animals
Vibration

CHEMICAL ERGONOMIC
HAZARDS Dust/ particle HAZARDS
Gas Improper posture
Vapor Manual handling
Liquid Clearance
12
 Occupational Health Hazards and Its’ Risks

Occupational Health Occupation

Hazards al Illness

Physical  Noise  Permanent Hearing Loss

 Radiation  Cancer, Infertility

Chemical  BTX ( TLV-TWA Blood Cancer – merusak sel

0.5 ppm darah dan sumsum tulang

 Asbestos  Lung Cancer

Biological  Virus  Infection Diseases

Ergonomic  Awkward position  Musculoskeletal Disorder

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Definition

• Noise : bunyi yang tidak di inginkan

• Noise Induced Hearing Loss : A sensorineural hearing loss that is
attributed to noise and for which no other etiology can be
determined.

HOW DO WE
HEAR?

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 HEARING CONSERVATION PROGRAM- SOP 06- 408

Noise at work
 30 million workers are
exposed to harmful noise
 Hearing loss is 2nd most
reported occupational
illness
 Noise-induced hearing
loss is irreversible – but
preventable
 Only 20-60% of workers
use hearing protection,
and not all the time

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 DID YOU KNOW…...? THE 4 PS
Noise-induced
hearing loss is the
number one
occupational disability
It is generally
painless
It is progressive
over time
It is permanent
IT IS
PREVENTABLE!!!

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NO Area dBA

SENIPAH PROCESS AREA

1 Comp. Proc 87.2

2 Tandem Comp. A 102.8

3 Tandem Comp B 95.4

4 Piping (Upper) 101.2

5 Piping ( Lower) 97.9

6 Comp. (Low freq. caused blower) 87.3

7 Cooler Area (piping) 85.6

8 Generator Area (Power Housing) 86.7

9 Control room, power house 63.2

10 Test Valve (workshop) 138

PECIKO PROCESS AREA

11 Turbine Generator 97

12 Turbine (door open) 101.5

13 MP Compressor (above) 90.7

14 Refrigerant pump 92.8

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Source –dangerous level dBA SPL

Produces pain 140 – 150

Jet aircraft during takeoff (20 meters) 130

Discomfort level, tractor without cab 120

Rock concert 110

Hammer,chain saw, pneumatic drill 100 – 105

Semi-trailers (20 meters) 90

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Source dBA SPL

Heavy traffic 80

Automobile (20 meters) 70

Vacuum cleaner 65

Conversational speech (1 meter) 60

Quiet business office 50

Residential area at night 40

Whisper, 20

Rustle of leaves 10

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 KEPUTUSAN MENTERI NO 51/MEN/1999

Exposure Time Per day Noise Level dBA

8 Hours 85
4 Hours 88
2 Hours 91
1 Hours 94
30 Minute 97
Never be exposed to 140 dBA level and more at any time

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 JENIS HEARING PROTECTOR

User-molded earplug

Earmuff

Earmuff-hard hat
combination
Premolded earplug Semi – Insert earplug

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It’s Really Pretty Simple…..

•Wear this now... •Or wear this later!

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 KEGIATAN PROGRAM KONSERVASI PENDENGARAN di
TOTAL E & P Indonesie

• Hearing hazard Monitoring –

• Engineering and Administrative controls
• Tes audiometri. – 14 jam tanpa terexpose dengan bising
• Pemakaian Alat Pelindung Diri (APD).
• Komunikasi, Informasi, Edukasi (KIE).
• Pencatatan dan Pelaporan.
• Evaluasi program.

Gunakan Hearing Protection bila kebisingan > 85

dBA selama 8 jam kerja !!
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 The Spine

• 24 bones called
VERTEBRAE
• 23 Disc
• 40 Muscles Spinal cord
• 31 pairs of Nucleus
NERVES
• 1000 ligaments Nerves

Very Complex Mechanism

24
 The Spine

Spine straight
Equal share of weight on discs

25
 Never !!!

Find a Better Way...

Use Teamwork
Use Tools

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Find a Better Way...

27
Recap

28
 NOISE & VIBRATION

 NOISE
 Vibration:
 Whole body – 125
hz/ms2
 Hand arm – 4m/S2
 Health effects:
 HAVS ( Hand and Arm
Vibration Syndrome )
 Low back pain;
 Vibration meter.
( satuannya --- m/s2
Contoh : Kompressor
Hand Road Cutter
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 HEAT STRESS on Site
SOURCE HEALTH POPULATION LEVEL
OF EFFECT AT RISK OF
HAZARD TASK RISK
Sunlight Heat stroke Prd-outside ops Monitoring B
Heat exhaustion parameter at
Kidney stone Processing
Heat rash Area
Heat cramps Mechanic-tech Maintenance
Electric-tech installation at
Instrument-tech Processing
and GTS
area
Prd / wel-ops Monitoring,
Prd / wel-mnt Maintenance
Wls / ops installation at
GTS area

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 RADIATION ( 06 – 402 )

• Radiation:
 Ionizing:
– Alfa, beta, gamma, X-rays
– External dan internal hazards
– NORM ?
 Non Ionizing
– UV, Infra-red, microwave,
– Heating effects: corneal burn.
Maximum Allowable Dose rate for person other
than those protected and monitored as described
in this procedure : 0.75 mrems/hr, 7.5 µSv/hr

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 Health Hazards
- The source emits radiation continuously
- There is no sensation when exposure to radiation is taking place
- Injuries caused by radiation are not immediately obvious
- Injuries from over exposure ca be serious and permanent
- The effect is below the skin, Exposure cannot be neutralized or
washed off.
Local Effects :

These are burns caused by exposure to intense radiation, most

likely to occur on the fingers and hands. Eyes are also sensitive
and prolonged exposure may lead to a cataract formation
General Effects :

Excessive irradiation of the body damages the blood and cause

anemia (wounds become slow to heal )

Other Effect : Damage to growing tissue, sterility, loss of hair, skin

thickening, genetic damage
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 Consequences

Overradiation: 1 Person Exposed: 18 People

16 Days After Effects on Leg

the incident (70 days after the
incident 5/3/99)
Effects on Leg 3/8/99
(13:00pm 2/21/99) 33
 STRESS MANAGEMENT
75 – 90 % of Visit to Physicians’ clinics are for stress – related
health problem such as backache, headache, insomnia, anxiety,
depression, chest pain, hypertension, gastrointestinal and skin
disorders.

STRESS according to NIOSH is the harmful physical and

emotional responses that occur when the requirements of the job
do not match the capabilities, resources, or need of the worker

There are two forms of stress :

- Positive stress
- Negative stress
Long – term, poorly managed negative stress can get out control
and cause fatigue, exhaustion, depression, burn out or feeling
emotionally emptied, serious health problems

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 How the body react to stress

- Heart and circulatory system

- Respiratory System
- Digestive System
- Vision – the pupil dilate

MED DEPT. Need to have the comprehensive program to help

employees to reduce stress :
Annual Medical Check Up
Health campaign for stress management and workshop
Healthful eating – menu
Aerobic exercise – fitness and rehabilitation
Counseling and EAP ( Employee Assistance programs )

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36
 CHEMICAL HAZARD
BTX (Benzene, Toluene, Xylene)

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 BENZENE
Dampak Kesehatan :

Adalah Cairan kimia tidak berwarna, 1. Short Term :

mudah menguap dan terbakar,bau
Ngantuk,pusing, iritasi mata dan
seperti gasoline dengan rumus : C6H6
pernafasan

The Main route is inhalation 2. Long Term ( Human Carcinogen )

Penggunaan : Penurunan sel darah merah (anemia )

-Solvent di pabrik kimia dan farmasi Leukemia ( cancer darah )

-Additive in gasoline Benzene is present in the atmosphere

-Present naturally in Gasoline Natural Source : Forest fire, cigarette smoke
-Oil Refining Process Industry Source : automobile exhaust,
industry emissions, fuel evaporation from
gasoline station

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 Asbestos ( SOP 06 – 405 )
Asbes dari bahasa yunani artinya “ tidak TERBAKAR “ bersifat
menghambat panas dan listrik
Ada 6 jenis asbes , 3 yang sering digunakan :
1. Chrysotile ( asbes putih )- jenis yang sering dipakai
2. Amosite ( asbes coklat ) Paling berbahaya
3. Crocidolite ( asbes biru ) buat kesehatan
Semua jenis asbes cenderung pecah menjadi serat yang
sangat lembut ( mikroskope ) bila lepas ke udara mereka akan
tetap melayang di udara selama berjam – jam , bahkan berhari
hari
Serat asbes berbahaya bila terhirup
Acceptable Exposure Limit : 0,1 fiber/cc for hours a day

Airborne asbestos fiber considered dangerous - Diameter < 3µm

& L :>5µm
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Tempat pembuangan :
dikubur dibawah tanah
kedalaman 25 cm dengan
dibungkus plastik dan
diberi tanda.

# PPE yang wajib dipakai :

1. Respiratory Protection Equipment : Filter dengan
klasifikasi TWA < 0.05 mg/m3 atau SCBA bila perlu
2. Protective Clothing : Non woven textile
3. Gloves – rubber
4. Eye and Face protection equipment
5. Safety shoes and shoe cover

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 BIOLOGICAL HAZARDS

Plants
Wild Animals
Micro organism
(Parasites, Bacteria, Viruses)
Blood Borne Pathogen

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BIOLOGICAL HAZARD

 Blood Borne Pathogen

 Environmental bio-hazard
 Food borne Bacteria

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 ERGONOMIC HAZARD
 Manual Handling
 Repetitive motion
 Static Posture
 VDT
 Shift-work

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44
 Occupational Health Management System and Occupational Health Program
(Occupational Health Manual describes the OH-Management System)

OCCUPATIONAL HEALTH HAZARDS MANAGEMENT

IDENTIFICATION
& HRA

MONITORING
WORKPLACE & HUMAN

CONTROL

CONTINUOUS IMPROVEMENT

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 GENERAL PRINCIPLES of HAZARDS CONTROL
Source
M M M M
OWTU
1. Substitution with a less harmful
material (water in place of organic
solvent).
2. Change of process (Airless paint
spraying).
3. Enclosure of process (Glove/ Box).
4. Isolation of process (Space/ time).
5. Wet method (hydro blast).
6. Local exhaust ventilation (Capture
at source).
7. Adequate maintenance program.
Air path
1. House keeping (Immediate clean up)
2. General exhaust ventilation (Roof
fan).
3. Dilution ventilation (Supplied air).
4. Increase distance (remote location).
5. Continuous area monitoring (Limit
alarm system).
6. Adequate maintenance program.
46
Receiver
1. Training & education (Most
important).
2. Worker rotation (Split up dose).
3. Enclosure of worker (Air
conditioned cabin).
4. Personal monitoring devices
(Dosimeter).
5. Personal protective equipment
(Respirators).
6. Adequate maintenance program.
GENERAL PRINCIPLES of HAZARDS CONTROL

 Engineering Control
• elimination, substitution, insulation,
isolation
 Administration Control
• work shift, work limitation
 Personal Protective Equipment

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 PERSONAL PROTECTIVE EQUIPMENT
STANDARD PPE :
HLO :
1. Long Sleeve coverall
1. Ear Protector ( Ear Muffler )
2. Safety Boot or shoes
2. High Visibility Waist Coat
3. Safety Helmet with chinstrap
3. Safety Helmet with chinstrap
4. Gloves

5. Safety glasses

Fire Fighter : Chemical Handling :

1. Fire fighters’ boots 1. Chemical goggles

2. Fire fighters’ helmet ( with neck 2. Rubber gloves

curtain ) 3. Rubber apron
3. Firefighters’ jacket and trousers 4. Rubber boot
4. Firefighters’ gloves 5. Respiratory protector ( mask
5. SCBA when required with organic / inorganic filter )

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Laboratory :
Working at High :

1. Chemical goggles
1. Harness

2. Chemical Face shield

2. Securing line

3. Chemical Gloves
3. Karabiners
Electrical, Instrumentation :
4. Rubber Apron / Rubber boot
1. Electrical gloves
5. Respiratory protector ( mask
with organic / inorganic filter Painting, Sand Blasting, Cutting, Grinding :

Welding : 1. Chemical goggles

1. Welding face shield 2. Respiratory protector

2. Respiratory Protector ( dust for

welding ) Pest Control :

3. Welding jacket 1. Chemical goggles

4. Welding gloves 2. Respiratory Protector ( Mask

with pesticide filter )
5. Welding goggles

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 Medical Check Up (Fit to Work)

4 TYPE of Medical check up & Fitness for work

 Pre Employment
 During the Employment ( Annual MCU )
 Pre-Termination
 Visitor to offshore and remote
installation
 Specific MCU

Medical Check Up Principle :

1. Confidentiality
2. Non Discrimination
3. Acceptance
4. Validity
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DIAGRAM OF EMPLOYEE’S MEDICAL CHECK UP SYSTEM

51
52
53
There are 2 types of Specific MCU :

1. Specific Job Position MCU

1.1 Catering Crew
1.2 Crane Operator, Land Driver
1.3 Firemen and Security Personnel
1.4 Seafarers and Aircrew
1.5 Divers
1.6 Medics / ERT Members

2. Specific Occupational Hazard MCU

2.1 Noise
2.2 Dust ( Asbestos and Silica )
2.3 Ionizing Radiation – X-ray Tech, Corrosion & Welding Inspector
2.4 Chemical ( BTX )

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55
56
Health Education & Information (Promotive & Preventive)

Promotive Program
 Health bulletin/intranet
 Leaflet
 Health Talk
 Specific Hazard training
 Sport activity

Preventive Program
 Implement standard MCU
 Fit for Task regulation
 Health Surveillance
 Health Training
 HRA – RAF
 Hazard Control & PPE

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