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8/19/2019 Progress Report Interim Report_25 Feb2014
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INTERIM REPORT 1
UKM PAKARUNDING SDN BHD
25th, February, 201
Dr! Ma"rura Saha#$ MD, MPH, PhD
Dr! %ha# K&' Me#( PhD
DETERMINATION OF APPROPRIATE BIOMARKER LEVEL
AND DIAGNOSIS CRITERIA FOR MEDICAL SURVEILLANCE
PROGRAMME
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Medical Surveillance Programme
Is implemented for early identification and prevention ofoccupational diseases secondary to exposure to hazardouschemicals in the work place
Based on the CH! as stipulated "y #SH!$ %S&CHH '((( )%seand Standard of &xposure of Chemicals Hazardous to Health$*
Is conducted using the availa"le +Guidelines on Medical
Surveillance 2001’
− ,he current availa"le guidelines need to "e updated in
order to stay relevant and up to date-
− ./ chemicals0compounds were discussed in the
guidelines with reference to !C1IH and 2I#SH %S!
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TERM OF REFERENCE
3 4etermination of appropriate "iomarker
level and diagnosis criteria for medicalsurveillance programme among workers
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Objectives
,o evaluate the standard of procedure for sample handling for thepurpose of medical surveillance-
,o identify the health effects or toxicities due to exposure to
hazardous chemicals-
,o evaluate the recent and appropriate test methods for the
purpose of medical surveillance-
,o allow the department to evaluate the medical surveillance
reports with more effective and in comprehensive manner-
,o improve the effectiveness and 5uality of pu"lic services
performed in accordance with the government6s effort to
continuously improve the delivery and services systems-
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,he Importance of the esearch
,o improve the effectiveness of monitoring medical surveillancereports-
,o assist the department in identifying and improving any arising
pro"lems-
,o improve the understanding of the medical surveillance among
occupational health doctor-
,o facilitate the occupational health doctor to conduct the medical
surveillance effectively-
,o assist departments to take preventive measures more
effectively-
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,a"le 78 Hazardous Chemicals 9isted in the Scope of Consultancy Services
7- !s"estos :- #rganophosphate 7/- Cadmium
'- !uramine ;- #rtholidine 7Cr)?I*@
A- Car"on disulphide 77- Potassium or Sodiumchromate or dichromate
7:- 9ead
/- Car"on tetrachloride 7'- Silica 7;- 2itro or aminoderivatives of phenoland of "enzene or itshomologues
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a** a & e *e e e%he/$a)*
No Chemicals IARC No Chemicals IARC
1 Asbestos 1 11 Potassium or Sodium chromate ordichromate
2 Auramine 2B 12 Silica 3
3 Benzene 1 13 Trichloroethylene 1
4 Carbon disulhide 14 !inyl chloride 1
" Carbon tetrachloride 2B 1" %a./$u/ 1
# $iasinidine 1# $isulhur dichloride
% $ichlorobenzene 2B 1% &e'a(alent Chromium comound)Cr*!I+,
1
- .r/anohoshate 1- 0ead 2B
.rthotolidine 1 Nitro or amino deri(ati(es o henoland o benzene or its homolo/ues
2B
1 Pitch 2 nhe'ane
5rou 1 Carcino/enic to humans
5rou 2A Probably carcino/enic to humans
5rou 2B Possibly carcino/enic to humans
5rou 3 Not classifiable as to its carcinogenicity to humans
5rou 4 Probably not carcino/enic to humans
IAR%%)a**$+at$
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Project Managers
BI NAMA PERANAN
1 En Mirza Safri Suan Pengarah Projek / KetuaPegawai Eksekutif KMP
2 En! "n#i Muha$$a# %usuf "n#iMa##uke&&eng
Pengurus Projek ' / Senior"ssociate Consu&tant
3 KM Pakarun#ing S#n (h#
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%ONSUTANT TEAMMEMBERS AND EPERTISE
NAME ROE Aa.e/$ua)$+at$&#*
EPERTISE
3 )r!MazruraSahani
Consu&tant'
M)* MP+*Ph)
O+)* P(,'C+E",T+
)r! ChanKok Meng
Consu&tant''
(Sc* Ph) TO-'CO,O.'ST
5 )r! urai#a
Moha$a#
Co0
consu&tant
M)* MP+ O+)* P(,'C
+E",T+
4 )r! Rosnah's$ai&
Co0consu&tant
M)* MP+ O+)* P(,'C+E",T+
)r Fari#ah"$in Co0consu&tant M)* MP+ O+)* P(,'C+E",T+
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Methodology
Row 1 Row 2 Row 3 Row 4
0
2
4
6
8
10
12
Column 1
Column 2
Column 3
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Re*earh A66r&ah
i6 0iterature re(ie7 and re(ie7 o e'istin/ data
Review of locals and internationals publications and journals Review of DOSH data on exposure surveillance (CHRA reports)surveillance
reports.
Scoe8
Review of appropriate samplin met!ods Review of "ualit# control and assurance durin samples !andlin $o update t!e acute and c!ronic toxicoloical effects of t!e !a%ardous
c!emicals listed in t!e scope of t!e consultanc#. $o present alternative recommendations for medical surveillance proramme
in avoidin t!e limitations in samplin and reportin of t!e occupationaldisease in &ala#sia
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'roress iteratures on toxicoloical profiles of t!e * c!emicals were
compiled and saved in t!e dropboxC!emicals +xample of t!e summar# c!emical properties and biomar,er used
C!ec,list of C!emicals and -iomar,ers.doc
&ain references on medical surveillance proramin ot!er countries /SA OSHA Screenin and Surveillance A 0uide to
OSHA Standards1 **2 Australia Desinated Doctor 'roram 0uidelines for
wor,place !ealt! surveillance1 *3*
Sinapore 4SH 0uidelines Statutor# &edical+xamination *35
http://chemicals/http://chemicals/
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Re*earhA66r&ah
$$! F$e). *tu.$e*
a! ue*t$#a$re Sur7ey
Sco1e2 to gather infor$ations fro$ O+)3s with regar#s to the usage of the $e#ica&
sur4ei&&ance gui#e&ine 5667* SEC++ for$s an# an8 issues or 1ro9&e$s encountere#
O9jecti4es2
7! to #eter$ine issues 1ertaining to con#ucting a $e#ica& sur4ei&&ance 1rogra$
5! to 1ro4i#e infor$ation for u1#ating the gui#e&ines on $e#ica& sur4ei&&ance
Progress2
7! Check&ist of :uestionnaire2 Check &ist on ;uestions to O+) Practictioner!#oc<
5! "11roach in con#ucting the sur4e80 with the assistance of O+ nit* )OS+ Putraja8a0 on&ine2
0 #uring O+) #ia&ogue sessions* u1co$ing session2 5=05> March 567?
@! Fina&ising the sur4e8 :uestionnaire2 )ate&ine2 =th March 567?
http://check%20list%20on%20questions%20to%20ohd%20practictioner.docx/http://check%20list%20on%20questions%20to%20ohd%20practictioner.docx/
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b! Hea)th R$*' A**e**/e#t
Sco1e2 to #eter$ine the 1re4a&ence an# &e4e&s of 9io$arkersfor screening of occu1ationa& #iseases #ue to e
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Fie Stu#ies
6 "cti4ities 7 )iscussion with the factor8 $anage$ent an#
safet8 e
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esearch !pproach Health isk !ssessment
Biological sampling will "e conducted to determine the levels of thecorresponding "iomarkers
,he selected Chemicals and the corresponding "iomarkers are listed in thefollowing ta"le
No Chemicals Biomarkers of Exposure Reference formethod
1 nhexane %rinary '$/hexanedione 2olasco et al )'((=*
! ,richloroethylene %rinary ,richloroacetic acid #4onnell et al )7;;/*
" Benzene %rinary Phenol and SPM! )S
Phenylmercaptouric acid*
NIOSH 1501
# Chromium Blood chromium%rinary Chromium
NIOSH 400
$ 9ead Blood 9ead%rinary 9ead
2I#SH :((.
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Progress and !ctivities for H! Pilot Study were done using the Pre ,est Duestionnaires
6 workers from various demography and work "ackground
6 Cron"ach alpha8 (-=' )relia"le if E(-=*
&sta"lishment of la" analysis for heavy metals and volatile organiccompounds
6 Colla"oration with %FM 9a"$ private 9a"s and 2I#SH
!ccredited in accordance to MSIS#0 I&C 7=('/
Gor interla"oratory comparisons
6 Gield studies
6 Selection of the workplace8
6 Based on the review of medical surveillance data at #H %nit HDand CH! report su"mitted to 4#SH Selangor$ few industries wereselected for the field studies
6 ,he field studies comprised of . steps8 preliminary visit for chemicalmonitoring area and personal air sampling$ 5uestionnaire an "iologicalsampling )urine and "lood*
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Pre ,est Duestionnaires
6 7= respondents were interviewed using the pre
test 5uestionnaires6 Duestionnaires approved "y the ethical "oard
7 orkers Grom8
6 India6 Bangladesh6 Pakistan6 Indonesia
7 #"Jectives of the Pre ,est6 ,o determine the feasi"ility and relia"ility of the
Duestionnaires
6 ,o identify the pro"lems that may "e encountered when
interviewing workers who are not well verse in Bahasa or&nglish
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Pre Test Sur4e86 Pro9&e$s '#entie#
7 ,anguage/Co$$unication 9arriers6 Me#ica& Ter$s/ #escri1tions of s8$1to$s an# #iseases
$a8 #ier fro$ #ierent countries
7 Re&uctant to 1artici1ate for fear of &ega& i$1&ications or#isc&osure of 1ersona& infor$ations #es1ite e
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,ist of 'n#ustries 'nc&u#e# or P&anne# to 9e 'nc&u#e# in theStu#8
8o 9ndust# $#pe of9ndustr# :isit Date $as, C!emical of 9nterest
3 +uro Space1Rawan ;urniture 53st1 October *35 'reliminar# :isit
/eda 'latin1S!a! Alam 'latin33st1 =anuar#1 *3>?t!1 =anuar#1 *3>
'reliminar# :isitC!emical Samplin-ioloical Samplin
ead$C+
5 @o,o!ama-atteries1Semen#i!
-atter#&anufacturin
3t!
1 =anuar#1 *3>32t!1 ;ebruar#1*3>*
'relimanar# :isitC!emical Samplin-ioloical Samplin
ead
> Dello#ed9ndustr#1 Blan&anufacturin 5
rd1 =anuar#1 *3> 'reliminar# :isit ead
< 9ntercedar9ndustr#1 /lu@am
-atter#Rec#clin 3t!1 ;ebruar#1*3> 'reliminar# :isit ead
Continental$#re1 '=&anufacturin
'lannin Staen!exaneC!romiumead
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ist of 9ndustries cont
8o 9ndustr# $#pes of9ndustr# :isit Date $as,sC!emicals of9nterest
/tusanBar#a1 -ani 'lannin Stae DOCs
? Siewer,&ala#sia1'uc!on
'lannin Stae n!exane
2 8i!on$exturin1 S!a!Alam
'lannin Stae $C+
3*Cameron&ala#sia1Suban
'lanninStae C!romium
33 &easteel Sdn-!d 'lannin Staen!exaneC!romium
3 $o!,en Sdn-!d P&anning Stage $C+
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,a9orator8 "na&8sis
6 E
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1antt ChartActivities*35 *3>
8ov Dec =an ;eb &ac Apr &a# =une =ul# Au Sep Oct
PR.P.SA0 PR9PARATI.N AN$C.NS:0TANT APP.INT;9NT
? 3 3 * > ? 5 5 >* >> >?
Eualitative Stud# iterature Review F F F FData review F F F
Incetion Reort Submission
;ield Surve# F F F F
Online Surve# F F
9n dept! 9nterview
9nterim Report 3 Submission
Data Anal#sis
9nterim Report Submission
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Row 1 Row 2 Row 3 Row 4
0
2
4
6
8
10
12
Column 1
Column 2
Column 3
Activities*35 *3>
8ov Dec =an ;eb &ac Apr &a# =une =ul# Au Sep Oct
Sta,e!older Consultation
Data Anal#sis
;inal Draft Report 'reparation
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,hank you