PERTANIKA JOURNAL OF SOCIAL SCIENCES AND HUMANITIES

 

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Challenges of Implementing Occupational Health Services (OHS) in Malaysia -Perspective of Occupational Health Doctors

Amalina Mohd Roze, Niza Samsuddin, Ailin Razali, Muhammad Zubir Yusof, Nor Azlina A Rahman, Suriati Sidek, Nik Ahmad Kamal Nik Mahmood, Nik Mohamed Nizan Nik Mohamed and Ahmad Fitri Abdullah Hair

Pertanika Journal of Social Science and Humanities, Volume 29, Issue 2, June 2021

DOI: https://doi.org/10.47836/pjssh.29.2.14

Keywords: Challenges, Malaysia, occupational health doctor, occupational health services, qualitative study

Published on: 28 June 2021

Mortality estimation due to work-related illness has reached up to 2.4 million each year. The current coverage of occupational health services (OHS) in Malaysia is still low. Occupational health doctors (OHDs) are one of the essential personnel to ensure proper execution of OHS. This study was conducted to explore the experiences and views of OHDs on the challenges in implementing OHS in Malaysia. Four focus group discussions were conducted with OHDs (N = 23) from four different states in Malaysia in 2016. Another five OHDs participated in in-depth interviews to implement the identified codes or themes. The discussions were recorded and transcribed verbatim. NVivo version 11.0 was used to facilitate data analysis. The data were analysed following the thematic analysis guidelines. Three themes were identified from the discussions: difficulties in diagnosing occupational diseases and poisoning; poor practices, attitudes, and commitment by both workers and employers; and non-compliance with laws and regulations related to the industries. The common challenges discussed by the participants were the lack of knowledge and skills among OHDs, and the shortage of standard procedures, leading to difficulties to screen occupational diseases. The poor cooperation and behaviour from the industries also hindered OHDs when performing their services. This study suggests better training and provision of standard tools or guideline to assist OHDs in making occupational disease diagnoses, increasing OHS awareness among the industries, and enacting OHS as part of the laws and regulations with adequate enforcement.

  • Azaroff, L. S., Levenstein C., & Wegman D. H. (2002). Occupational injury and illness surveillance: Conceptual filters explain underreporting. American Journal of Public Health, 92, 1421-1429. https://doi.org/10.2105/ajph.92.9.1421

  • Boschman, J. S., Brand, T., Frings-Dresen, M. H. W., & van der Molen, H. F. (2017). Improving the assessment of occupational diseases by occupational physicians. Occupational Medicine, 67(1), 13-19. https://doi.org/10.1093/occmed/kqw149

  • Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77-101. https://doi.org/10.1191/1478088706qp063oa

  • Carlsen, B., & Glenton, C. (2011). What about N? A methodological study of sample-size reporting in focus group studies. BMC Medical Research Methodology, 11, Article 26. https://doi.org/10.1186/1471-2288-11-26

  • Department of Occupational Safety and Health. (2005). Guidelines of Occupational Health Services 2005. Department of Occupational Safety and Health, Malaysia.

  • Department of Occupational Safety and Health. (2017). Occupational diseases and poisoning investigation. Author. https://www.dosh.gov.my/index.php/572-statistics/occupational-diseases-statistic/1862-occupational-diseases-and-poisoning-investigation

  • Department of Occupational Safety and Health. (2018). List of competent persons. Author. http://mykkp.dosh.gov.my/Semakan.aspx

  • Department of Statistics Malaysia. (2018). Key Statistic of Labour Force in Malaysia. Department of Statistic Malaysia. September 2018. https://www.dosm.gov.my/v1/index.php?r=column/pdfPrev&id=TmgwQ0R2a2VteHM3SEg0aUJqU25UZz09

  • Di Bona, L., Wenborn, J., Field, B., Hynes, S. M., Ledgerd, R., Mountain, G., & Swinson, T. (2017). Enablers and challenges to occupational therapist’ research engagement: A qualitative study. British Journal of Occupational Therapy, 80(11), 642-650. https://doi.org/10.1177/0308022617719218

  • Eurogip. (2018). Statistical review of occupational injuries FRANCE - 2016 data. https://www.eurogip.fr/images/pdf/Eurogip-135EN_Stat_Occ-Review-France2016.pdf

  • Freitas, H., Oliveira, M., Jenkins, M., & Popjoy, O. (1998). The focus group, a qualitative research method. http://gianti.ea.ufrgs.br/files/artigos/1998/1998_079_ISRC.pdf

  • Fusch, P. I., & Ness, L. (2015). Are we there yet? Data saturation in qualitative research. The Qualitative Report, 20(9), 1408-1416. https://doi.org/10.46743/2160-3715/2015.2281

  • Halcomb, E. J., & Andrew, S. (2005). Triangulation as a method for contemporary nursing research. Nurse Researcher, 13(2), 71-82. https://doi.org/10.7748/nr.13.2.71.s8

  • Hamalainen, P., Takala, J., & Tan, B. K. (2017). Global estimates of occupational accidents and work-related illnesses 2017. Workplace Safety and Health Institutes. http://www.icohweb.org/site/images/news/pdf/Report%20Global%20Estimates%20of%20Occupational%20Accidents%20and%20Work-related%20Illnesses%202017%20rev1.pdf

  • Hasle, P., & Limborg, H. J. (2006). A review of the literature on preventive occupational health and safety activities in small enterprises. Industrial Health, 44(1), 6-12. https://doi.org/10.2486/indhealth.44.6

  • Hollis, V., Openshaw, S., & Goble, R. (2002). Conducting focus group: Purpose and practicalities. British Journal of Occupational Therapy, 65(1), 2-8. https://doi.org/10.1177/030802260206500102

  • International Labour Organization. (2015). Global trends on occupational accidents and diseases. World Day for Safety and Health at Work. https://www.ilo.org/legacy/english/osh/en/story_content/external_files/fs_st_1-ILO_5_en.pdf

  • Japan Statistics Bureau. (2018). Labour Force Survey 2018. Ministry of Internal Affairs and Communication. http://www.stat.go.jp/english/data/roudou/index.html

  • Kabene, S. M., Orchard, C., Howard, J. M., Soriano, M. A., & Leduc, R. (2006). The importance of human resources management in health care: A global context. Human Resources for Health, 4, Article 20. https://doi.org/10.1186/1478-4491-4-20

  • Kirch, W. (Ed). (2008). Occupational health physician, encyclopaedia of public health. Springer. https://doi.org/10.1007/978-1-4020-5614-7

  • Kwon, S. C., Song, J., Kim, Y., & Calvert, G. M. (2015). Work-related asthma in Korea- findings from Korea work-related asthma surveillance (KOWAS) program, 2004-2009. Allergy Asthma & Immunol Research, 7(1), 51-59. https://doi.org/10.4168/aair.2015.7.1.51

  • Lambert, S. D., & Loiselle, C. G. (2008). Combining individual interviews and focus groups to enhance data richness. Journal of Advanced Nursing, 62(2), 228-237. https://doi.org/10.1111/j.1365-2648.2007.04559.x 

  • Lenderink, A. F., Spreeuwers, D., van der Klink. J. J. L., & van Dijk, F. J. H. (2010). Information and feedback to improve occupational physicians’ reporting of occupational diseases: A randomised controlled trial. International Archive of Occupational & Environmental Health, 83, 381-388. https://doi.org/10.1007/s00420-009-0468-8

  • Los, F. S., Hulshof C. T. J., & Sluiter J. K. (2019). The view and policy of management of occupational health services on the performance of workers’ health surveillance: A qualitative exploration. BMC Health Services Research, 19, Article 473. https://doi.org/10.1186/s12913-019-4296-6

  • Lucchini, R. G., & London, L. (2014). Global occupational health: Current challenges and the need for urgent action.  Annals of Global Health, 80(4), 251-256. https://doi.org/10.1016/j.aogh.2014.09.006

  • Malaysian Factories and Machinery Act 1967 (Act 139).

  • Malaysian Occupational Safety and Health Act 1994 (Act 514).

  • Martinsson, C., Lohela-Karlsson, M., Kwak, L., Bergstrom, G., & Hellman, T. (2016). What incentives influence employers to engage in workplace health interventions? BMC Public Health, 16, Article 854. https://doi.org/10.1186/s12889-016-3534-7

  • Morgan, D. L. (1988). Focus group as qualitative research. Sage.

  • Mori, K. (2018). Current status and issues for the role of occupational health physicians in Japan. Japan Medical Association Journal, 1(1), 15-21. https://doi.org/10.31662/jmaj.2018-0011

  • Moriguchi, J., Ikeda, M., Sakuragi, S., Takeda, K., Muto, T., Higashi, T., Weel, A. N. H., & van Dijk, F. J. (2010). Activities of occupational physicians for occupational health services in small-scale enterprises in Japan and in the Netherlands. International Archive of Occupational & Environmental Health, 83, 389-398. https://doi.org/10.1007/s00420-010-0514-6

  • Niskanen, T. (2015). Investigation into qualitative discourses of the occupational safety and health inspectors in order to promote enforcement. International Journal of Occupational Safety and Ergonomics, 21(4), 426-439. https://doi.org/10.1080/10803548.2015.1096062

  • Number of physicians specializing in occupational health in France in 2017. (2018). Statista. https://www.statista.com/statistics/745454/occupational-health-physicians-france-region/

  • Organization for Economic Co-operation Development. (2018). Labour Force (Indicator). https://data.oecd.org/emp/labour-force.htm#indicator-chart

  • Ramano, E., & Buys, T. (2018). Occupational therapist’ views and perceptions of functional capacity evaluations of employees suffering from major depressive disorders. South African Journal of Occupational Therapy, 48(1), 9-15. https://doi.org/10.17159/2310-3833/2017/vol48n1a3

  • Rampal, K. G., & Nizam, J. M. (2006). Developing regulations for occupational exposures to health hazards in Malaysia. Regulatory Toxicology and Pharmacology 46(2), 131-135. https://doi.org/10.1016/j.yrtph.2006.01.013

  • Rantanen, J. (2005). Basic occupational health services. African Newsletter on Occupational Health and Safety, 15, 34-37.

  • Rantanen, J., Lehtinen, S., & Iavicoli, S. (2013). Occupational health services in selected Internal Commission on Occupational Health (ICOH) members countries. Scandinavian Journal of Work, Environment & Health, 39(2), 212-216. https://doi.org/10.5271/sjweh.3317

  • Rantanen, J., Lehtinen, S., Valenti, A., & Iavicoli, A. (2017). A global survey on occupational health services in selected international commission on occupational health (ICOH) member countries. BMC Public Health 17, Article 787. https://doi.org/10.1186/s12889-017-4800-z

  • Reese, C. D. (2015). Occupational health and safety management: A practical approach (3rd ed.). https://books.google.com.my/books?id=2Oj5CQAAQBAJ&pg=PA139&lpg=PA139&dq=Occupational+physician+inability+to+relate+exposure+with+diseases&source=bl&ots=PBCys1WYPl&sig=ACfU3U2rv6FvaR5evaEpMkgeJwUdogGJWQ&hl=en&sa=X&ved=2ahUKEwjO0Oyou5ThAhXCh3AKHaw3CPAQ6AEwC3oECAkQAQ#v=onepage&q=Occupational%20physician%20inability%20to%20relate%20exposure%20with%20diseases&f=false

  • Rosenman, K. D., Reilly, M. J., & Kalinowski, D. J. (1997). A state-based surveillance system for work-related asthma. Journal of Occupational Environmental Medicine, 39(5), 415-425. https://doi.org/10.1097/00043764-199705000-00007

  • Singh, Z., & Sekhon, P. S. (2018). Need for risk management and regular occupational health safety assessment among workers of developing countries. Global Journal on Quality and Safety in Healthcare, 1(1), 19-24. https://doi.org/10.4103/JQSH.JQSH_2_17

  • Spreeuwers, D., de Boer, A. G. E. M., Verbeek, J. H. A. M., & van Dijk, F. J. H. (2010). Evaluation of occupational disease surveillance in six EU countries. Occupational Medicine, 60(7), 509-516. https://doi.org/10.1093/occmed/kqq133

  • Spreeuwers, D., de Boer, A. G. E. M., Verbeek, J. H. A. M., van Beurden, M. M., & van Dijk, F. J. H. (2008). Diagnosing and reporting of occupational diseases: A quality improvement study. Occupational Medicine, 58(2), 11-121. https://doi.org/10.1093/occmed/kqm146

  • Tateishi, S., Watase, M., Fujino, Y., & Mori, K. (2016). The opinions of occupational physicians about maintaining healthy workers by means of medical examinations in Japan using Delphi method. Journal of Occupational Health, 58(1), 72-80. https://doi.org/10.1539/joh.15-0188-OA

  • Zhang, J., & Zuo, H. (2012). Occupational health management research on small & medium-sized enterprises together with large & medium-sized state-owned enterprises- A case study in Hubei province. Procedia Engineering 43, 288-292. https://doi.org/10.1016/j.proeng.2012.08.049