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

COVID-19, caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), was first identified in Wuhan, China in late 2019. Rapidly spreading worldwide, it was declared a pandemic by the World Health Organization (WHO) in early 2020 [1]. Various mitigation strategies, such as physical distancing, travel restrictions, and other public health protocols, were enforced globally to curb virus transmission [2,3]. However, these measures also disrupted daily life, work environments, and public health systems, posing significant challenges in balancing virus prevention and continuation of economic activity [4]. This paper aimed to highlight key lessons from the Third Environmental and Occupational Health (EOH) Forum on public health emergency response as demonstrated by selected Asian countries. Proceedings from the forum were reviewed and analyzed, arriving at the following lessons and themes: proactive and strategic public health interventions, leadership and governance, community participation, policy adjustments, technological integration and innovation, and balancing health and economic activities. The forum, themed “Environmental and Occupational Health Initiatives During the COVID-19 Pandemic,” was held virtually in November 2020 [5]. Understanding environmental and occupational health interventions as well as the themes of strategies by Asian countries, provides valuable insights into early pandemic management and contributes to a repository of knowledge that can be adapted and applied globally, enhancing the overall effectiveness of pandemic responses.
Occupational Health ; Environmental Health ; Publich Health ; COVID-19 ; Pandemics ; Asia

Even after two years, the COVID-19 pandemic still disrupts public activities and services as it exposes vulnerabilities among the population and negatively impacts environmental conditions. The crisis also impeded global progress toward achieving Sustainable Development Goals (SDG). The Fourth Environmental and Occupational Health (EOH) Forum held virtually on November 25 to 26, 2021 provided a venue for learning about local and international COVID-19 responses to help prepare for the next global crisis. Through the systems thinking approach, the discussions prioritized analyses of leadership and governance, financing, human resource, technologies, information management, and service delivery. These analyses focused on community and/or workplace programs and services linked to air quality, waste management, psychosocial wellness, and COVID-19 vaccination. The forum amplified calls for climate actions and public health improvement and emphasized the significance of a collaborative, evidence-based, integrated public health response to a crisis underscoring the apparent interdependence of the SDGs.
Environmental Health ; Occupational Health ; Sustainable Development Goals ; Covid-19 ; air quality

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

Background: Ironically, the hospital which is believed to be a healthy and safe place can be dangerous to health. Pollutants such as particulate matter 2.5 microns (PM₂.₅) can be present in hospital indoor air and may adversely affect the health of the hospital occupants. Objective: Possible sources of indoor PM₂.₅ in an urban tertiary care hospital in the Philippines are identified and apportioned in this study. Methods: PM₂.₅ measurements were conducted in two naturally ventilated wards (NVWs), two mechanically ventilated wards (MVWs), and a roof deck near the hospital. Mass concentrations with analytical uncertainties of thirteen elements (Al, Na, S, Si, Cl, K, Ca, V, Fe, Zn, Br, Hg, Pb) from PM₂.₅ measurements were utilized with Positive Matrix Factorization (PMF) receptor model to identify and apportion possible sources of indoor PM₂.₅. Results: In NVWs and MVWs, four types of sources were identified including sodium and chlorine sources, crustal emissions, anthropogenic sulfur sources, and road dust. Cleaning agents used in the hospital were identified as an anthropogenic indoor source of sodium while the other factors mainly came from outdoor sources. Conclusion The contribution of anthropogenic outdoor pollutants such as road dust and sulfur sources to indoor PM₂.₅ are highlighted in the study. The types of both indoor and outdoor sources of indoor PM₂.₅ can be influenced by the type of ventilation.
Respiration, Artificial ; Air Pollution, Indoor

Environmental and occupational health are interconnected disciplines of public health that are concerned in maintaining a symbiotic relationship between the ecosystem and humans. This relationship is under threat by the continuous and alarming increase of the Earth's temperature causing climate change that impacts not just health but also the economy and the safety of the population. The First National Environmental and Occupational Health Forum was organized by the Department of Environmental and Occupational Health, College of Public Health, University of the Philippines Manila to address and discuss the complex issues that the Philippines is currently experiencing when it comes to environmental and occupational health by providing a space where stakeholders from different sectors can actively participate in mapping out challenges and opportunities. The organizer's long-term vision is to catalyze and build a network of collaboration that is geared towards the improvement of health and safety in the workplace that involves mitigating the effects of climate change. The discussions in the forum gave a comprehensive insight into the different challenges we face for being one of the most vulnerable countries to natural disasters: how this affects health, workplace, and environment. These challenges created new opportunities for the country to build resilience and formulate adaptive strategies to decrease the vulnerability of the population especially the workforce who are constantly exposed to different hazards that are exacerbated by changes in the environment.

Climate Change ; One Health ; Agriculture

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

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

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