OBJECTIVE: The study aimed to collect data on the occupational health systems implemented across selected healthcare facilities in the Philippines, including: (1) governance system for occupational health and safety (OHS), (2) OHS information systems, (3) OHS financing systems, (4) technology and related systems for OHS, (5) the OHS workforce, and (6) the delivery of OHS services.
METHODS: The data were collected through a walkthrough survey of the selected facilities as well as through the review of records and relevant documents found in the facilities.
RESULTS: Governance and financing systems for OHS are not present in any of the facilities. 3 out of the 13 hospitals studied have employee medical records, accident/incident reports while none of the 19 facilities have Workplace Environment Monitoring Reports (WEM), implying the lack of OHS information systems. Due to the lack of a financing mechanism for occupational health services, there is a lack of OHS technology in the facilities which include but are not limited to the presence of an Immunization and Post-Exposure Program (present in 7 out of 13 hospitals and none of the 6 RHUs studied). 1 out of 19 facilities reported to having personnel delegated for OHS activities in their facility. Lastly, 1 out of 19 facilities have emergency treatment and medical facilities for their employees, indicating inadequate OHS service delivery in the facilities studied.
CONCLUSIONS: Standards and laws such as the Philippine OHS Standards and Department of Health (DOH) Administrative Order (AO) 2012-0020 have provisions with regard to OHS in these facilities, and stricter implementation of these provisions could help in filling in the gaps in the OHS systems in these facilities. This will provide a healthy workforce capable of giving better healthcare services to the general population.

Human ; Occupational Health Services ; Occupational Health ; Workplace ; Rhus ; Safety ; Immunization ; Vaccination ; Hospitals ; Medical Records ; Emergency Treatment

OBJECTIVES: The study evaluated the quality of indoor air in households surrounding a coal-fired power plant in Pagbilao, Quezon and its impact to the residents in these communities. 
METHODS: The researchers used a quantitative approach and gathered both primary and secondary data from the Province of Quezon, Municipalities of Pagbilao and Padre Burgos and 12 other barangays from January to June 2008. A household survey was conducted to obtain the health and socio-demographic characteristics of the respondents. Likewise, indoor air quality surveys, respiratory health profiling and pulmonary function tests were done. Indoor air quality monitoring measured eight hour levels of particulate matter -10 (PM10) in "near" and "far" barangays and sulfur dioxide (SO2) and nitrogen dioxide (NO2) in two primary impact barangays as indicated in the environmental impact assessment of the power plant.
RESULTS AND CONCLUSION: Results showed that there is no significant difference (p= <0.05) in the eight-hour average of indoor PM10 in  "near" and "far" barangays. The monitoring results for SO2 and NO2 are below the ambient air quality standards. The results of respiratory profiling and pulmonary function testing revealed that the significant risk factors for respiratory symptoms and pulmonary function parameters are generally demographic characteristics such as sex, height and weight. However, cigarette smoking and indoor PM10 levels, which came out as significant risk factors for wheezing and the predicted forced expiratory volume at 1 second (FEV1), respectively, reflect the environmental exposure of children inside their homes.

Human ; Male ; Female ; Aged ; Middle Aged ; Adult ; Young Adult ; Adolescent ; Child ; Air Pollutants ; Coal ; Gases ; Air Pollution, Indoor ; Coal ; Environmental Exposure ; Nitrogen Dioxide ; Risk Factors ; Smoking ; Sulfur Dioxide ; Environmental Illness ; Tobacco Smoke Pollution

OBJECTIVES: This study was conducted to determine the cadmium (Cd) concentration in brown and polished rice collected from the 9 farms in Barangay Real, Calamba City. This study also assessed the non-cancer health risk to adults (?20 years old) of long-term consumption of rice with Cd using the non-cancer hazard quotient (NHQ).

METHODS: Rice grains with hull were collected in November-December 2013. Both rice types were analyzed for Cd using a graphite furnace atomic absorption spectrophotometer (GFAAS). The NHQ was calculated by dividing the estimated daily intake of Cd via rice consumption by the oral reference dose (RfD) for Cd.

RESULTS: Mean Cd concentrations in brown and polished rice collected from the 9 farms in Barangay Real ranged from 0.0062 to 0.0725 mg/kg and 0.0047 to 0.0778 mg/kg, respectively. The NHQ values of Cd in both rice types were less than 1.0 for adults (?20 years old).

CONCLUSION: Cd concentrations in brown and polished rice from the 9 farms did not exceed the 0.4 mg/kg maximum allowable Cd concentration in rice set by FAO/WHO. Since the NHQ did not exceed 1.0, long-term exposure to Cd through consumption of brown and polished rice from these farms is unlikely to cause non-cancer health effects in adults (?20 years old). It is unlikely for adults to develop kidney diseases such as tubular proteinuria, decreased glomerular filtration rates, and itai-itai disease.

Human ; Male ; Female ; Aged ; Middle Aged ; Adult ; Young Adult ; Oryza ; Cadmium ; Neoplasms

OBJECTIVES: Asbestos is a carcinogenic mineral substance formerly used widely in the construction industry, all forms of which, except for chrysotile asbestos, have been banned in the Philippines. This article aims to propose policy alternatives to reduce the health and economic effects of continued asbestos use in the country.
METHODS: Records of asbestos-related diseases, and asbestos industry-related data in the country were consolidated. The impact of continued asbestos use on the national economy were estimated incorporating natural mortality, regulations of the Department of Labor and Employment (DOLE), and concepts of multiplier effect and net present value. Round table discussions validated data and generated policy recommendations.
RESULTS: Filipinos directly and indirectly exposed to asbestos-containing materials (ACMs) are 5,289 and 30,000, respectively. The contributions of these groups to the national economy were estimated at PhP 1.08 Billion annually for workers directly exposed to ACMs and PhP 6.83 Billion annually for workers indirectly exposed. Two policy options--adjustment of threshold limit values, and a total ban--are presented.
CONCLUSION: A total ban on all forms of asbestos is shown to be the more cost-effective policy option for the country. It is recommended that government agencies, stakeholders in the asbestos industry, and the general public be involved in strategies for improving surveillance on asbestos exposure, increasing public awareness, and promoting the use of asbestos alternatives.

Asbestos, Serpentine ; Threshold Limit Values ; Construction Industry ; Philippines ; Asbestos ; Carcinogens ; Policy ; Government Agencies ; Employment

OBJECTIVES: This study aimed to a) evaluate the knowledge of water refilling station (WRS) owners and operators regarding the proper techniques and procedures applicable to WRS based on the Certification Course for Water Refilling Station and Plant Operators (CCWRSPO); b) assess compliance to regular physical-chemical and microbiological testing of product water and sanitary permit acquisition and c) determine the quality of product water of selected water refilling stations (WRS) in a municipality in Cavite.

METHODS: The study includes WRS owners and operators who participated in the CCWRSPO from 2005 to 2009. A 50-item objective examination administered by the researchers was used to evaluate the knowledge of the respondents. This was formulated based on the objectives of the CCWRSPO. The compliance to legal requirements for WRS was assessed according to the results of the physical-chemical and microbiological tests (Multiple Tube Fermentation Technique and Pour Plate Method) and the presence of an updated sanitary permit. Results of product water analyses were compared to the 2007 Philippine National Standards for Drinking Water. Water refilling stations that failed to meet at least one of the three legal requirements were considered as "non-compliant".

RESULTS AND CONCLUSION: Results showed that 71.8% of the respondents passed the written examination whereas 28.2% obtained scores less than 50.0%. Chi-square analysis indicated that there was no significant difference between the knowledge of the trainees in 2005 to 2008 and the trainees in 2009. Similarly, majority (78.9%) of the WRS included in the study were found to be non-complaint with the provisions of P.D. 856 and the prescribed standards for water quality. The quality of product water served as an important determinant of the compliance of WRS. Although majority of the water samples tested had acceptable microbiological examination results, 16.9% of the samples exceeded the standards for microbiological water quality. Aside from this, the non-compliance of WRS was attributed to the absence of an updated sanitary permit, which was one of the important indicators of product water quality. Chi-square analysis showed that the trainees who have been operating WRS for only a year after the certification course were less compliant as compared to those operating for two to five years.

Water Quality ; Drinking Water ; Fermentation ; Patient Compliance ; Microbiological Techniques ; Surveys And Questionnaires ; Certification

BACKGROUND: There is a perceived need among policymakers and other actors in the local health system to better address the challenges in financing healthcare, in general, and chronic or debilitating conditions, in particular, in order to develop appropriate policy and program responses.
OBJECTIVE: This paper aimed to present perceived issues and challenges in financing schizophrenia and colorectal cancer in the Philippine context, as identified by stakeholders.
METHODS: Verbatim transcription of the proceedings of a moderated discussion of stakeholders in schizophrenia and colorectal cancer care was analyzed for themes on challenges and recommendations in the financing of the two conditions in the local setting.
RESULTS: A total of 28 stakeholders representing healthcare providers, professional organizations, health maintenance organizations, patient support groups, and government participated in the meeting. Three main issues on financing debilitating conditions were identified by participants: a) government support for the two conditions is currently limited; b) coverage by third-party payors for schizophrenia or colorectal cancer is either absent or restricted; and c) the process of accessing medicines or alternative modes of financing for healthcare was perceived to be disparate and inconvenient for patients and their caregivers. Participants also provided recommendations in improving the mechanism of healthcare financing.
CONCLUSION: The general picture that emerged from this moderated discussion pointed to limitations in the prevailing mechanisms for financing schizophrenia and colorectal cancer in the Philippines. Improvements in the current financing mechanisms, and identification of alternative modes, is necessary to ensure universal health coverage.

Human ; Healthcare Financing ; Health Maintenance Organizations ; Caregivers ; Universal Coverage ; Delivery Of Health Care ; Insurance, Health, Reimbursement ; Government ; Self-help Groups ; Colorectal Neoplasms ; Schizophrenia

OBJECTIVES: The aim of the project is to develop water safety plan (WSP) guidelines specific for water refilling station (WRS) operators. The guidelines will serve as model for future formulation of WSP among WRS across the country.
METHODS: A criteria was developed for selecting WRS. Site visits were initially done along with the selection of eight (8) water refilling stations from pre-identified areas across the country. The operators of the selected WRS together wih their respective local sanitary inspectors underwent a workshop where they were trained and guided on the step-by-step process of devising a WSP. Coaching and mentoring was then conducted for the improvement of the draft WSPs. A guideline manual on how to develop WSPs for WRS was drafted to serve as reference for other WRS in the country.
RESULTS: The study developed a WSP model specifically made for WRS setting. Eight (8) final drafts of WSP were also accomplished. WRS operators and local sanitary inspectors were trained on how to develop WSP which will support and facilitate appropriate implementation of these functional WSPs.
CONCLUSION: The formulation of WSPs among WRS ensures delivery of safe drinking-water among its consumers. It serves as an initial step in realizing the vision of DOH of institutionalizing WSPs among all water utilities in the country. The guidelines developed will be a useful tool for other WRS in the country for preparing their own WSPs.

Human ; Male ; Female ; Diarrhea ; Gastroenteritis ; Safety ; Models, Theoretical ; Motor Vehicles ; Water ; Water Supply ; Risk Management

The Sixth Environmental and Occupational Health Forum, conducted virtually on November 23 to 24, 2023, focused on "Accelerating the Development of Healthy and climate-smart Hospitals in the Southeast Asian Region." This forum, a collaborative effort of the University of the Philippines Manila and Health Care Without Harm Southeast Asia, aimed to explore and exchange strategies, challenges, and innovative practices for integrating environmental sustainability in healthcare settings across Southeast Asia. The event gathered healthcare professionals, policymakers, and environmental experts to discuss the transformation of hospitals into health and climate-smart institutions. Keynote speakers from various countries presented case studies and research findings, emphasizing the need for holistic approaches that include policy development, stakeholder engagement, and continuous education. Significant outcomes highlighted were the identification of effective policies for sustainable hospitals, understanding the impact of healthcare facilities on climate change, and the necessity for political acumen in promoting environmental stewardship in healthcare. The forum concluded with a consensus on the critical need for ongoing collaboration and innovation in environmental and occupational health, underscoring the importance of transforming healthcare facilities into entities that prioritize both patient care and planetary health.
Delivery of Health Care ; Occupational Health

OBJECTIVE: The study aimed to determine the physico-chemical and microbiological quality of ice blocks sold in selected wet markets located in the city of Manila.

METHODS: Twenty-eight samples were collected from three markets. Microbiological quality was analyzed in terms of the presence or absence of coliforms with E. coli as indicator organism. Physico-chemical quality was determined by measuring turbidity, apparent color, pH, iron, and residual chlorine. Measurements obtained were compared with the 2007 Philippine National Standards for Drinking Water (PNSDW).

RESULTS: Results showed that all samples tested positive for coliforms while 25 out of the 28 samples were positive for E. coli. Mean turbidity was 2.74 ± 3.68 NTU; for both apparent color and iron tests, all samples complied with the PNSDW standard limit set; mean pH was 6.15 ± 0.64; and mean residual chlorine was 0.06 ± 0.02 mg/L. Average values of apparent color and iron comply with the PNSDW standards. Six out of 28 samples had turbidity values exceeding the standards. All samples were found to have residual chlorine levels below the standards.

CONCLUSION: Ice in markets do not comply with key 2007 PNSDW standards and findings warrant strict compliance of ice quality from manufacturers to the point of distribution to protect consumer health.

Escherichia Coli

Objective: To assess the competency levels of the technical staff of the Center for Health Development Calabarzon (CHD 4A) to inform the development of a human resource management plan. Methods: A cross-sectional assessment design to determine the CHD 4A technical staff's competency level was utilized. The team from the College of Public Health, University of the Philippines Manila invited all the CHD 4A technical staff to complete a self-assessment using the Learning and Development Needs Assessment Tool (LDNA) (version 3-45), rating their perceived competency and the level of importance to their functions on core and functional competencies stipulated in the Department of Health Compendium of Competency Standards. Gaps were identified by comparing perceived competency levels with a predetermined standard for each agency's salary grade or position. Results: All 67 technical staff took part in the assessment. Entry- and senior-level professionals had minimal deviations from predetermined standards, with gaps in quality service focus and teamwork for the former and planning and political savvy for the latter. In contrast, mid-career professionals had larger gaps in magnitude and number than entry and senior-level staff – the largest being on results orientation – reflective of newly-promoted staff's adjustment period. Of note, these gaps were based on the prevailing competency standards in force at the time of assessment in 2015. Findings may need to be revisited when the agency updates the core and functional competency standards. Conclusion The participants perceived core and functional competencies as important, with the level of perceived importance increasing as the salary bracket increases. Core competency gaps were widest in integrity and quality service focus. Simultaneously, results orientation, and planning and organizing were the functional competencies that registered the widest gap and prioritized. Training needs assessments should be conducted in times of change to ensure an organization's training programs' relevance and to develop peak-level employee performance.
Staff Development ; Needs Assessment