World Day for Safety and Health at Work 2013

Case Study - Malaysia: National System for the Recognition of Occupational Diseases

Occupational disease data are required to inform us which groups of diseases are more prevalent and which workers or groups of workers are more affected. Such information is critical for determining the key areas where priority should be given for the prevention and control of risks. Decreases in the incidence of occupational disease cases overtime can indicate the effectiveness of prevention and control measures at the workplace. Malaysia like many countries across the world is working to improve their system for the identification, recording and compensation of occupational diseases.

Diagnosis of occupational diseases requires specific medical capacity and in Malaysia the Department of Occupational Safety and Health requires doctors who wish to practice and conduct medical surveillance to register. They should also undertake the Occupational Health course organized by the National Institute of Occupational Safety and Health. In Malaysia there are currently 484 registered and qualified doctors, well-informed about the guidelines for the diagnosis of occupational diseases which have also been disseminated throughout the country.

As seen below, since 2005, Malaysia has experienced an almost exponential rise in the number of reported cases of occupational diseases.

Source: Social Security Organization, Malaysia

While the phenomenon may have been caused by different factors, the increase in recorded cases coincided as indicated with two specific events: 
  1. The introduction of guidelines for the diagnosis of occupational diseases by the Social Security Organization in 2005: and  
  2. The update of the occupational diseases schedule in 2008 when the list of occupational diseases rose from 88 to 226.
It is therefore conceivable that the apparent increase in the number of cases of occupational diseases has not been the result of a fall in health and safety standards but, rather, a consequence of efforts to improve the systems for their recognition and compensation through the introduction of the guidelines and the training of physicians, which made certain illnesses that were previously overlooked, to be now recognized as occupational diseases. For example, in the new schedule the following musculoskeletal disorders were among those included:
  •     Thoracic Outlet Syndrome
  •     Rotator Cuff Syndrome
  •     Medical epicondylitis (Golfer’s elbow)
  •     Lateral epicondylitis (Tennis elbow)
  •     Radial styloid tenosynovitis (De Quervains tenosynovitis)
  •     Carpal Tunnel Syndrome (Median nerve)
The table below shows the increase in the number of cases relating to noise induced hearing loss and musculoskeletal disorders following the update of the schedule:

 Total cases of Noise induced hearing lossTotal cases of Musculoskeletal disorders
2010 148 238
2011 252 268 
2012 237 449 
Source: Social Security Organization, Malaysia.

The guidelines, therefore, are considered to have been instrumental in improving the identification and diagnosis of occupational diseases.
As a result of recognizing this increase in numbers of occupational diseases, Malaysia can contribute to make employers and workers aware of the situations that cause occupational disease. We have used Malaysia as an example to demonstrate the importance of collecting accurate data on occupational diseases and indeed identifying reasons for changes in data trends, this is an important part of what is required to create awareness. Acting on the data by identifying the causes of the occupational diseases and establishing appropriate prevention and control measures are also vitally important in reducing the risks of occupational diseases.