Medical Practitioners Meeting in Hong Kong,
October 28-29, 2013
Present By : EDWIN CHRISTIAWAN
INTRODUCTION
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Indonesia consists of :
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The largest archipelago
17000 islands
5 main islands
33 governors and 360 districts
population more than 220 million
INDONESIAN WORKERS CONDITION – INDONESIA CENTRAL STATISTIC
Total 114 Million workers in Indonesia ( Feb 2013 )
Elementary School 54,6 Million / 47,9 %
Junior High School 20,3 Million / 17,8 %
Diploma : 3,2 Million / 2,82 %
Degree : 7,9 Million / 6,96 %
Women : 36.08% / Men : 63.92%
WORKING ACCIDENT REPORT - ( no Occ Diseases Report )
On Jan 2013 from Jamsostek
Tahun
Working Accident
Claim
JK
JHT
Nominal
Kasus
JPK
Cases
IDR
Kasus
Nominal
Kasus
Nominal
2008
94.486
298.862
13.897
157.679
693.199
3.736.750
15.076.955
588.713
2009
86.224
337.568
14.557
179.851
884.930
5.789.278
14.745.849
662.193
2010
98.711
401.237
15.252
241.637
867.723
5.881.284
18.604.383
776.592
2011
99.491
213.672,07
16.738
136.555,67
904.927
6.825.013,78
10.784.906
433.557,76
2012
103.074
554.005,78
18.436
406.457,90
943.324
7.966.046,12
16.811.208
796.240,50
Total
481.986
1.805.344,85
78.880
1.122.181
4.294.103
30.198.372
76.023.301
3.257.296,26
Only < 48% WORKERS IN INDONESIA COVERED BY JAMSOSTEK
( GOVERNMENT HEALTH INSSURANCE )
ICE MOUNTAIN OF OFFICIAL REPORT
Reported
OD.
There is NIL data of Occ Diseases
in Indonesia
No Reported
Hospitality
Diagnosed, and
not doing medical Check up
Indicated without symptom
No Of Occupational Diseases suspected
is :1% ave / year from total accident
reported = 1,952/year average
( source Jamsostek )
INDONESIA OHS REPORTING FLOW
Ministry of MP
OHS Director of
Man power dept
Health Dept
Man power
Dept
Env Dept
BUMN
Local Comp Dept
Jamsostek
Worker Insurance
Employer
Company
Doctor
Most of problem in ground level
Union
OHS committee
NATIONAL INSTITUTE OF OHS – CERTIFICATED BY GOVERNMENT
NATIONAL INSTITUTE OF OH&S
ANALYTICAL
DIVISION
SAFETY
ANALYTICAL
SUB DIV
OSH HUMAN RESOURCE
DEVELOPMENT AND
PLANNING PROG. DIV.
HUMAN RESOURCE
DEVELOPMENT
SUB DIV
GENERAL
AFFAIR
DIVISION
FINANCE
SUBDIV
PERSONNEL
SUBDIV
INDUSTRIAL
HYGIENE &
OCC. HEALTH
SUB DIV
PLANNING
PROGRAM SUB DIV
HOME
AFFAIR
SUB DIV
OHS ISSUES AND NATIONAL ORGANIZING
Government
International
NGOs
Presser
Communication
Research
Workshop/t
raining
Consolidate
Labor Union
Pressure flow
Website,
Newspaper, TV
NGOs
Employers
By NGOs, OHS issues accelerate to
raise up to become serious issue
POLICY AND LEGISLATION OF OHS IN INDONESIA –
Gov Regulation Related
The main OSH legislation in Indonesia is Act no 1/1970
The Act no 3/1992 on worker compensation Act
Legislations related to working environment are Minister of Man Power Circular Letter
no SE/01/MEN/1997 on threshold limit value for chemical in the workplace, and
Minister of MP Decree no Kep 51/MEN/99 on TLV for physical aspects in the workplace
Minister of Manpower, Transmigration and Cooperation regulation No Per 1/MEN/1976
on the obligation to attend training courses on OHS for company medical doctors.
Minister of Manpower and Transmigration No Per 1/MEN/1979 concerning to
compulsory training in OHS for industrial medical officers
Minister of Manpower and Transmigration No Per 4/MEN/1987 concerning to OSH
committee the workplace
Minister of Manpower and Transmigration No Per 5/MEN/1996 concerning to OSH
management system
Minister of Manpower and Transmigration No Per 2/MEN/1992 concerning to
designation of obligation & authorization OSH officers.
GOVERNMENT REGULATION – OCCUP DISEASES COVERED BY LAW
Daftar Penyakit Akibat Kerja
Oleh: dr. Ikhwan Muhammad
Berikut adalah daftar 31 kelompok Penyakit Akibat kerja (PAK) sebagaimana yang tercantum pada Lampiran Keputusan Presiden Indonesia
Nomor 22 Tahun 1993 Tentang Penyakit Yang Timbul Karena Hubungan Kerja:
Pneumokonisis yang disebabkan debu mineral pembentuk jaringan parut (silikosis, antrakosilikosis, asbestosis) dan silikotuberkulosis yang
silikosisnya merupakan faktor utama penyebab cacat atau kematian.
Penyakit paru dan saluran pernafasan (bronkhopulmoner) yang disebabkan oleh debu logam keras.
Penyakit paru dan saluran pernafasan (bronkhopulmoner) yang disebabkan oleh debu kapas, vlas, henep, dan sisal (bissinosis).
Asma akibat kerja yang disebabkan oleh penyebab sensitisasi dan zat perangsang yang dikenal yang berada dalam proses pekerjaan.
Alveolitis allergika yang disebabkan oleh faktor dari luar sebagai akibat penghirupan debu organik.
Penyakit yang disebabkan berilium atau persenyawaannya yang beracun.
Penyakit yang disebabkan cadmium atau persenyawaannya yang beracun.
Penyakit yang disebabkan fosfor atau persenyawaannya yang beracun.
Penyakit yang disebabkan oleh krom atau persenyawaannya yang beracun.
Penyakit yang disebabkan oleh mangan atau persenyawaannya yang beracun.
Penyakit yang disebabkan oleh arsen atau persenyawaannya yang beracun.
Penyakit yang disebabkan oleh air raksa atau persenyawaannya yang beracun.
Penyakit yang disebabkan oleh timbal atau persenyawaannya yang beracun.
Penyakit yang disebabkan oleh flour atau persenyawaannya yang beracun.
Penyakit yang disebabkan oleh karbon disulfide.
Penyakit yang disebabkan oleh derivate halogen dari persenyawaan hidrokarbon afiliatik atau aromatic yang beracun.
Penyakit yang disebabkan oleh benzene atau homolognya yang beracun.
Penyakit yang disebabkan oleh derivate nitro dan amina dari benzene atau homolognya yang beracun.
Penyakit yang disebabkan oleh nitrogliserin atau ester asam nitrat lainnya.
Penyakit yang disebabkan oleh alcohol, glikol, atau keton.
Penyakit yang disebabkan oleh gas atau uap penyebab asfiksia atau keracunan seperti karbon monoksida, hirogensianida, hidrogen sulfide, atau
derivatnya yang beracun, amoniak seng, braso, dan nikel.
Kelainan pendengaran yang disebabkan oleh kebisingan.
Penyakit yag disebabkan oleh getaran mekanik (kelainan-kelainan otot, urat, tulang persendian, pembuluh darah tepi atau syaraf tepi).
Penyakit yang disebabkan oleh pekerjaan dalam udara yang bertekanan lebih.
Penyakit yang disebabkan oleh radiasi elektromagnetik dan radiasi mengion.
Penyakit kulit (dermatosis) yang disebabkan oleh penyebab fisik, kimiawi, atau biologik.
Kanker kulit epitelioma primer yang disebabkan oleh ter, pic, bitumen, minyak mineral, antrasena atau persenyawaan, produk atau residu dari zat
tersebut.
Kanker paru atau mesotelioma yang disebabkan oleh asbes.
Penyakit infeksi yang disebabkan oleh virus, bakteri atau parasit yang didapat dalam suatu pekerjaan yang memiliki resiko kontaminasi khusus
Penyakit yang disebabkan oleh suhu tinggi atau rendah atau panas radiasi atau kelembaban udara tinggi
Penyakit yang disebabkan bahan kimia lainnya termasuk obat
31 items
of
Industrial
Diseases
INDUSTRY IN BATAM
Bigest industrial Company located
in Batam :
Muka Kuning ,Sekupang ‘Batu
Ampar Batam Center,Tj Uncang
Most of them is electronic and ship yard company
FOREIGN ELECTRONIC INDUSTRY IN BATAM
Electronic company investment
Japan
Singapore
10%
3%
Europe
USA
27%
60%
Survey from 30 electronic company
of FSPMI Union Worker
BATAM INDUSTRIAL RELATION PROBLEM
1. Wage and welfare
55%
2. Outsourcing worker
30%
3. Safety of work
15%
Survey from 30 electronic company
of FSPMI Union Worker
INDONESIA REGULATION RELATED WITH OHS – Company scope
Function of OHS committee in the factory
(Permen No. Per-03/Men/1982 tentang Pelayanan Kesehatan Kerja, Pasal 2)
Annual medical check up ( general and special )
Control and reporting about working env, sanitary, chemical handling, and all related with OHS in factory .
Train to related OHS committee about first aid
Preventing and diagnosis for all industrial diseases .
Advising and make a plan to improve OHS condition in the factory include PPE
Hygiene control in factory include food and drinking water
Help and prevent Industrial accident and diseases.
Firs aid coordinator
Periodic report to government about 3 month activity in OHS related , include if any violation of law
Commitment and
policy
Evaluating
Planning
Controling
Organizing
Excusing
OHS HANDLING AND RESPONSIBILITY – COMPANY SCOPE
Employer
Workers
P2K3/
OHS
Committee
Company
doctor
Flow of accident report and handling in the company as government regulation
1. Report to coordinator (P2K3), that is one of Safety Health Committee.
2. Report to Government and Company doctor
3. Company doctor doing diagnosis and if necessary giving recommendation to specialist doctor to more deep
analysis
In this case Company doctor authorize can be treated to the next process ( hospitalization or check up by
specialist )
When victims felt they need further more medical treatment, they will report to P2K3
Usually P2K3 there is Industrial Accident Dept
Further
treatment
BATAM OHS PROBLEM –
Status of employee , Health assurance, and Company responsibility
1.Most of sub contractor worker did not cover by
Jamsostek ( Gov medical assurance service )
4.Not priority issue compare with wages and welfare
“If workers have
indicated of
occupational diseases,
max 3 years from
resignation time, they
can claim to the
company”
2.History of diseases for contract workers
( Gov Regulation )
Analysis :
1.Limitation of Government’s control
2.Most of them is not as LU members ( sub contractor worker )
3.Labor Union did not understand well about regulation
Analysis :
Government regulation legalize contract only 3 year max contract
each company
BATAM OHS PROBLEM –
Regular Medical Check Up and Diagnosis
Not all company follow Gov Regulation to
conducting annual medical check up
Analysis :
Cost consideration and not enough control from Gov
Medical check up by provider who assign
by company, and not deeply diagnosis
Analysis :
No deeply check up, just to full fill Gov regulation
“ Regular medical check up have 2
categories : Special ( work cond. and age
>40 year ) and General
BATAM OHS PROBLEM –
Company doctors and Occupational diagnosis
Government regulation said that “company doctor is general
doctor Not specialist doctors “
1.Company’s doctor have no capability to deeply analysis what
exactly disease for worker
2.Symptom of disease is non specific, some time overlap with other
illness
3.Limitation of medical device to diagnosis
UNION STRUGGLE IN ELECTRONIC SECTOR – PT VARTA
PT VARTA is Germany Company , doing Battery assembly that
contain Lithium Battery
Established 1994 year
Number of workers about 1200 ( 70% is Female )
Working service average 8 years
Permanent employee ration : 95% permanent
Working Hours Average : 12 hours / day
UNION STRUGGLE IN ELECTRONIC SECTOR – PT VARTA
We observed together with OHS in charge in this company, included HR Manager,
1st Step :
1.Identification of chemical using
2.Interview worker who have working service >5 years
3.Collect the data related with medical record ( annual medical record )
2nd Step :
1.Line observation to know more deeply about chemical and PPE using
2.Interview what their felt, and complaining and understanding about chemical
UNION STRUGGLE IN ELECTRONIC SECTOR – PT VARTA
3rd Step :
1.Explain risk of abnormality process finding
2.Looking for substitute of MSDS to replace with health
friendly material
Most of died members came from this
process
Laser Machine – Eyes, lung ,
breast, Ovary , etc
Gluing process – Skin, respiratory
UNION STRUGGLE IN ELECTRONIC SECTOR – PT VARTA
Another suspected base on workers claim of diseases
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pre discharge can make burn due to shortening between positive and
negative polarity.
Coding process can make disturbance of respiratory due to
chemical
Printing machine using paint can cause skin irritation.
Shrinking machine making risk burning if false setting and smoke can disturb lung
and heart.
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Welding machine (Resistance machine and Laser).
Resistance make sparking
Radiation of laser possible to make disturbance of
nerve, reproduction, lung and cancer.
UNION STRUGGLE IN ELECTRONIC SECTOR – PT VARTA
Chemical Using
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Solvent, ink
Thinner
Acetone
Extender
Silicone
Lithium
Prema bond
Super sight glue
Microcell
UNION STRUGGLE IN ELECTRONIC SECTOR – PT VARTA
4th Step :
1.Consolidate for victims representative by interview and collect medical records by raised questionnaire
2.Collect sample of workers history in suspected work place
Workers from Varta Micro Battery was death, indicated due to chemical
healing to their body ( Yellow color )
VICTIMS ORGANIZING – Focusing to 2 workers medical and behavior
1.Mr Yoga ( Line Lithium )
He was working in PT Varta about 15 years
He working handling chemical Lithium 12 hour / day, not use any PPE in the past
time
Health Complaint :
He felt sputum, in his throat never lost till now, since last 3 years , cough other wise
he never smoke .
2. Mr Sarno ( Laser Line )
He working there since 2002 ( 11 years )
Health complaint :
Always headache and he consume about 10 tablet of medicine everyday
He was worked at laser machine about 3 years, before moved to another working place
Its so serious, to more detail report, I asked to get medical report and screening record of 1 sample
Mr Sarno ( attached )
We got their medical record, scanning result, and we just gave
recommendation to company to cover their illness , without claim any
compensation
CASE HANDLING
Base on the Varta’s case, we just only collecting data related, and
recommended to the company to recover their health
Base on that, we shared problem to another factory, to raised up similar
issue and discuss with employer
TASK FOR DISCUSS ( OPEN ISSUES / PLAN )
Coordinate with local OHS network to bring and check up both of
victims by Volunteer OHS Doctor
Raise OHS issue becoming top issue of Indonesia Workers
Stop or replace strength chemical
Continue conducting workshop to increases awareness of workers
about OHS
Continue investigating another suspected of occupational diseases