Tinjauan Umum

Prof.Tan Malaka, MD, MOH, DrPH, SpOk, HIU

Ketua Perkumpulan Profesi Higiene Industri Indonesia
Fakultas Kedokteran Unsri
2018
HSE
England,
2010
Definisi K3 Permen 05 th 2018
Sistim Management K3
Continual
Continual Improvement
Improvement

OH&S Policy
Management
Review

Planning

Checking and Implementation

Corrective And operation
action
OGP /IPIECA 2011
 Menghapuskan Kemiskinan;
 Pencapaian Pendidikan Dasar;
 Persamaan jender dan pemberdayaan
perempuan;
 Mengurangai kematian bayi;
 Meningkatkan Kesehatan Ibu;
 HIV/AIDs dan penyakit infeksi lain;
 Menjamin ketahanan lingkungan;
 Kerjasama Global.

Deklarasi 189 negara anggota PBB, September 2000.

 Kemiskinan
 Pendidikan dasar
 Persamaan, jender
 Frekuensi kematian bayi
 Kesehatan Ibu
 HIV/Malaria/TB
 Ketahanan Lingkungan
 Kerjasama global
 Produktivitas
 Pendidikan non formal
 Job description;
 Antenatal care
 Pencegahan dan Promosi
kesehatan
 HE/Dots/Prevent.
 Industrial Hygiene
 MNC - guidelines
HEALTH OCCUPATION
(Kesehatan) (Pekerjaan)
 Occupational Medicine

Industrial Hygiene
Ergonomic,
Epidemiology
OH Team:
Occ. Health Physician
Occ. Health Nurse;
Industrial Hygienist;
Safety Officer;
HR/ Plant Manager
Definisi Ilmu Kesehatan Kerja
 Occupational health is the multi disciplinary
approach to the recognition, diagnosis, treatment
and prevention and control of work related diseases,
injuries, and other conditions. It is a part of Public
Health.
 Ilmu kesehatan kerja adalah bagian dari ilmu
kesehatan masyarakat yang mengkaji secara multi
disipliner pengenalan, diagnosis, pengobatan dan
pengendalian penyakit terkait pekerjaan,
kecelakaan dan berbagai keadaan lainnya yang
terkait pekerjaan.
 addresses the two way relationship between work
and health (hubungan timbal balik antara
kesehatan dan pekerjaan)
 ILO/WHO: The promotion and maintenance of the
highest degree of physical, mental and social well-
being of workers in all occupation;
 The main emphasis is on prevention of
occupational diseases and promotion of the
worker’s health (penekanan utama program
kesehatan kerja adalah Pencegahan dan
Promosi kesehatan)
 OH Rule and Regulations
Peraturan Perundangan
 Act no 1 - 1970: Occupational Safety.
 Permenaker 02/1980: Health Examination;
 Permenaker 03/1982: Occ. Health Services;
 Permenakertrans no 5/2018: NAB faktor Fisik dan Kimiawi;
 Kepres no 22, 1993: Work Related Diseases;
 Permenaker 04/1987: OSH Committee;
 Act no 36/2009: on Health (Chapter 12 on OH);
 Act no 3/92: Workers Insurance
 Act no 13/2013 on Manpower Resource.
 Gov’nt Reg. no 23/2000 on Radiation (ionizing) Safety;
 Kepmenkes no 492/2010 on Drinking Water.
 Kepmenkes 1096/2011 Canteen Hygiene.
 PP no 88 th 2019 ttg Kesehatan Kerja.
 Promosi kesehatan pekerja dan kapasitas
kerja;
 Perbaikan cara kerja dan lingkungan kerja
yg. kondusif untuk kesehatan, keselamatan
dan produktifitas;
 Mengembangkan organisasi kerja dan
budaya kerja yang menunjang kesehatan
dan keselamatan kerja.
OH Servie Objective
Basic Occupational Health
Center Services (BOHCS)
(US-PHS)
 On-site First Aid and Emergency Response. FOH
professionals provide first aid for minor injuries and
illnesses, respond to medical emergencies, and refer
employees to primary care providers for follow-up care.
 Immunizations. FOH Health Centers provide
immunizations against influenza, tetanus and
pneumonia. Current information for required and
recommended vaccinations for travel abroad, whether
for government business or pleasure, is also provided.
 Physician-Prescribed Services. To minimize time
away from work, FOH medical staff will administer
services prescribed by the employee’s personal
physician, such as allergy treatments, blood pressure
and glucose monitoring.
BOHCS continues
 Health Awareness Programs. FOH offers
workshops on topics such as cancer risks, nutrition,
smoking cessation, and stress reduction. These programs,
in combination with FOH health education materials,
empower employees to make lifestyle changes that
improve their health and well being.
 Health Screenings. FOH offers health screenings for
high blood pressure, cholesterol, diabetes, and vision.
Additional screenings for hearing, glaucoma, lung function
and TB testing are also available at some locations. Early
detection can help prevent costly and debilitating diseases.
 Recordkeeping. FOH maintains employee health
records and ensures compliance with all applicable
provisions of the Privacy Act.
 Health Risk Assessment
Penilaian Risiko Kesehatan
 Hazard Identification (Identifikasi Bahaya):
 Departmental level;
 MSDS;
 Hazard Measurement and Exposure Evaluation
(Pengukuran dan Evaluasi Pemaparan):
 Noise & Vibration; Gas, vapor, dust; Thermal stress;
Radiation; Biological; Ergonomic; Psycho-social;
 Environmental and Biological Monitoring.

 TLVs and BEIs

 Risk Control (Pengendalian Resiko):
 Engineering; Administrative; PPE. (ALARP)
 HIGH RISK GROUPS
Pekerja dgn Resiko Tinggi

 Exposure to Chemicals, eg. solvents,

heavy metals, free silica, pesticides, etc.
 Exp. to Noise & Vibration;
 Exposure to Radiation;
 Exp. to extreme temperature;
 Special Groups: Food-handlers, Drivers,
Welders, Health personnel, Fire brigade,
etc.
MEDICAL EMERGENCY
RESPONSE PLAN (MERP)
 MERP (Rencana Gawat Darurat Medik:Tertulis,
Terencana,Terlatih);
 First Aid System;
 first 5 minutes: BLS;
 Number and Distribution;
 Onsite clinic :Stabilization;
 Referral:
 Transfer & Follow up
 Regular Exercise.
 Job-related Health Examination :
(Pemeriksaan Kesehatan-terkait jabatan)
 Pre-employment;
 Periodic;
 Pre-placement, etc.
 Data Klinik Perusahaan;
 Data Absenteeism;
 Data Rawat Inap;
 Data Rawat Jalan.
Pengujian Kesehatan Terhadap Pekerja
Resiko Tinggi

 Group/Exposure:  Recommended Tests:

 Noise:  Audiometry
 Dusts:  Spirometry, Chest X-ray
 Heat Stress  Harvard Step Test; ECG
 Solvent Vapor  Neurological, e.g. Swedish
Q16; Renal function, LFTs,

Spirometry, Bio-monitoring
 Urinalysis, Bio-monitoring
 Welders
 Eye/ear testing, ECG (> 40)
 Drivers
 Feces culture, Chest X-ray
 Canteen Personnel
 Medical personnel
 Serology for Hep-B, LFTs,
 Chest X ray.
HEALTH PROMOTION
(Promosi Kesehatan)

 Healthy Life Style:

 Healthy diet;
 Physical fitness;
 Smoking;
 Drug and Alcohol;
 Safe sex, AIDS, Hep-B;
 Stress Management;
 Env. and Personal Hygiene
 Environment: TBC, DHF, Malaria; etc.
 Workplace Sanitation
Sanitation
 Food Sanitation & Hygiene
 Water supply Sanitation;

 Domestic waste Management

 Vector Control

 Indoor Air Quality

 Recording & Reporting
Work Related Diseases & Injury

 Occupational Diseases:
 baseline; exposure;biological plausibility;
 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.
 Masalah Kesehatan Kerja Indonesia Dalam
Dissertasi Doktoral 1985 - 2004
P enulis M asala h y g Dite liti Uni versitas Tah un

Um a r Fa hm i Ahma di Pe ma pa ran thd Pe sti sida Griffi th, Aus tra lia 1985

Ta n Ma laka Ke se ha tan Pe rn afa san Peke rja Ha waii, USA 198 8

Ha ry oto K. Putra nto Low Ba ck Pai n Pe ke rja Pi tts burg, USA 19 90

Zi ulm ia r Ya nri Pe ny aki t Pa ru Ke rja Curta in,Australia 19 97

Erna Tres naningsih Ergonom i Ke rja Pi tts burg, USA 1995

Ye nni Ba sy irudin Tuli Ak iba t Bis in g UI 20 03

Re tno Widowa ti Ke se ha ta n Kulit Pe ke rja UI 19 99

Sa ntos o Pe ny aki t Pa ru Ke rja UI 1993

M eil yWidja ya Sil icosis Pe ke rja Se me n UI 20 04

Ke m an S LungFunction Wage ni nge n 1998

No te : Se m ua pe ne lit ian m em pe rlihatk an pe ny ak it te rk a itpe k e rja an di In do ne s ia

Malaka T (2008)
Information,Instruction and Training
(Informasi dan Pelatihan)

 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;
 HS Executive;COSHH;
 WHO/ILO
 Indonesia:
 Depnaker;
 Balai Hiperkes Depnaker;
 AHKKI, IDKI, Perdoki.
 Depkes: Litbangkes.
 Subdir KK Depkes
 Universitas (UI,Unair,USU,Gama,Udayana)
 RECORD KEEPING
 Data bases: Dataset Lingkungan
(pemaparan) dan Dataset Medik.
 Medical check up data, Daily medical;
 Confidentiality, legibility, security;
 Paper and Electronic;
 Retention time:
 best practice: 30 years;
 Indonesian law: 5 years.
CHEMICAL HOUSE
Exposure to
Solvent
Power Plant
 Fihak Yang Berperan Penting
Dalam Kesehatan Kerja
• Perusahaan:
– Oil & Gas, Mining, Manufacturing, Agriculture,
Jasa.
• Pemerintah:
– Depnaker
– Depkes
– Depertam dan energi
• LSM (IDKI,Perdoki,AHKKI, ACOH,ICOH)
• Universitas.
• Lembaga International;
– WHO,ILO
Occupational Safety
Keselamatan Kerja

Prof. Dr. Tan Malaka

Pasca Unsri IKM 2015
Keselamatan Kerja
 Keselamatan yang bertalian dengan
 Mesin,
 pesawat,
 Peralatan/pelengkapan kerja;
 Bahan-bahan,
 proses,
 Lingkungan kerja,
 Produk dan
 Tatacara melakukan pekerjaan.
History
 2100 BC: code of Hammurabi, concerned
with personal injury and loses;
 400 BC – 300 AD: exposure to metal;
 1700 B Ramazzini menerbitkan buku The
Disease of Workers.
 UU no 1 1970 ttg Keselamatan Kerja.
 UU no 13 th 2003 ttg Tenaga Kerja: SM – K3.
 OH Rule and Regulations
Peraturan Perundangan

 Act no 1 - 1970: Occupational Safety.

 Permenaker 02/1980: Health Examination;
 Permenaker 03/1982: Occ. Health Services;
 Permenakertrans 13 th 2011: TLV for Chemical
Substance and Physical factors.
 Kepres no 22, 1993: Work Related Diseases;
 Permenaker 04/1987: OSH Committee;
 Act no 36/2009: on Health (art. 12 on OH);
 Act no 3/92: Workers Insurance
 Act no 13/2003 on Manpower Resource.
 Gov’nt Reg. no 23/2000 on Radiation (ionizing) Safety;
Occupational Safety and
Health
 It is the dicipline concerned with preserving
and protecting human and facility resources
in the workplace.
 Practitioners in this field are concerned with
preventing needless deaths and injuries to
the workers.
 Occ safety and heath act 1970 (US): every
employer in USA is required to provide safe
and healthful workplace.
OSHA requirements
 Establish policies, procedures and controls to
ensure a safe workplace;
 Provide Safety and Health related Information
to employees;
 Provide Training to employees;
 Provide employee access to appropriate
exposure and medical records;
 Record and analyze injuries and illness.

Occupational Safety and Health Administration - OSHA

Chevron,
2009
Ref: Taylor G et al 2004
Occupational Safety Hazards

 Walking and Walking Surfaces

 Mechanical

 Material Handling

 Electrical hazards

 Confined Space Hazards

 Workplace violence, etc.

Beberapa Program dalam OS
 Safety Induction
 Fire Prevention
 Risk Assessment
 Emergency Response Plan - ERP
 PPE
 Human Factors and Safe behavior
 Safe Driving
 Chemical safety
 Electrical Safety
 Hazards Communication
 Tools and machine guarding
 Injury and illness investigation and Reporting, etc.
Role of Safety Personnel
 Accident Investigation;
 Emergency Response Team;
 Environmental Protection;
 Ergonomics
 Fire Protection;
 Hazards Recognition;
 Hazardous Materials Management;
 Health Hazards Control
 Inspection and Audit;
 Record keeping
 Regulatory compliance
 Training.
Terminology
 Safety
 Safety Professional
 Safety Engineer
 Industrial Hygienist
 Loss Prevention
 Loss control
 Risk
 Hazards
 Beberapa Sumber
Informasi Penting dalam K3
 Domestik:
 Depnaker
 Depkes
 Mancanegara
 WHO/ILO
 US-NIOSH
 US-OSHA
 ACGIH/AIHA
 National Safety Council - USA
 Health and Safety Executive – England
 Work Safe – Australia.
Salah satu tujuan pokok Occ. Safety:

Preventing fatal and disabling

injury yg terjadi di tempat kerja.
 Occupational Accidents in Indonesia
(1999 – 2004)
Results

Disability
Accident Death (Funtion + Total + Recovery (STMB)
No Year
Cases Temporary)

Number (%) Number (%) Number (%)

1 1999 91.510 1.476 1.61 11.871 12.97 78.163 85.41

2 2000 98.902 1.592 1.61 12.025 12.16 85.285 86.23

3 2001 104.774 1.768 1.69 12.566 11.99 90.440 86.32

4 2002 103.804 1.903 1.83 10.345 9.97 91.556 88.20

5 2003 105.846 1.748 1.65 7.228 9.82 93.703 88.53

6 2004 95.418 1.736 1.81 9.106 9.54 84,576 88,63

 Frekwensi Kematian Karena Kecelakaan Kerja
Indonesia 1985 - 2004
16

14

12

10
%

85 86 87 88 89 90 91 92 93 99 00 01 02 03 04

Tahun

Malaka T (2008)
Angka Kematian Akibat
Kecelakaan Kerja di Indonesia
 2015:
 Kecelakaan Kerja 105 182
 Kematian: 2375
 Case Fatality Rate: 2,26 % SEKITAR
 2016
 Kecelakaan Kerja: 101 367 2%
 Kematian: 2382
 Case Fatality Rate: 2,35 %

Sumber: Menaker R! 2017, mengutip data BPJS Tenaga Kerja.

Beberapa Sertifikasi K3
Penting di Indonesia
 Ahli K3
 Higiene Industri
 HIMu
 HIMa
 HIU
 Paramedic
 Hiperkes Dokter
 SM K3
 OSHAS Auditor