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ST ND RD

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0% found this document useful (0 votes)
37 views5 pages

ST ND RD

Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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DOLE/BWC/OHSD/OH-47 A

Republic of the Philippines


Department of Labor and Employment
Bureau of Working Conditions

Occupational Health and Safety Division

ANNUAL MEDICAL REPORT FORM

For Period January 1, 19____


2023 to December 31, 19_______
2023
___________________________________________________________________________________________________
___________________________________________________________________________________________________
1. Name of Establishment: ___________________________________________________________________________
BEDC Philippines Limited Inc.
2. Address: _______________________________________________________________________________________
3F Filinvest Two Bldg. Northgate Cyberzone, Filinvest Corporate City, Alabang, Muntinlupa City
3. Name of Owner/Manager: _________________________________________________________________________
Eva L. Macatol - HR Manager / Ben Powles - CEO
4. Nature of Business and Products/Service (Ex. Manufacturing, Textile)
_______________________________________________________________________________________________
Consultancy Services/Outsource Services/BPO
5. Total Number of Employees: __________
316 Number of Shifts: _______________________________________________
3
6. Number Distribution of Employees as to nature of workplace, sex and workshift

Office Production/Shop
1st Shift 2nd Shift 3rd Shift

Male: ____________________
160 _______________
68 _____________
30 _______________
62
Female: __________________
156 _______________
74 _____________
22 _______________
60
Total: ____________________
316 _______________
142 _____________
52 _______________
122

7. Preventive Occupational Health Services: (Check or Cross)

a. Occupational Health Services is organized/provided by:


(X) the establishment/undertaking
( ) government authority/institution
(X) other bodies/groups/institution (specify) _______________________________________________________
Planning to request WEM from any WEM provider Accredited by DOLE-OSHC
__________________________________________________________________________________________
b. Occupational Health services as described under 8a above, is organized/provided as a service:
(X) solely for the workers of the establishment/undertaking
( ) common to a number of establishments/undertakings

c. The employer engages the services of:


( ) Occupational health practitioner

Name: __________________________________________________________________________________
Address: ________________________________________________________________________________
( ) Occupational health physician

Name: __________________________________________________________________________________
Address: ________________________________________________________________________________
(X ) Occupational health nurse

Name: __________________________________________________________________________________
Joseph Karlo Corachea, Rn
Address: Brgy.
________________________________________________________________________________
Alangilan, Batangas City
d. The occupational health physician/practitioner/nurse/personnel conducts an inspection of the workplace:

(X) once every month ( ) once every three (3) months


( ) once every two (2) months ( ) once every six (6) months
( ) other details ____________________________________________________________________
_________________________________________________________________________________
_
8. emergency Occupational Health Services:

a. The employer provides a treatment room/medical clinic in the workplace with medicines and facilities:
(X) Yes _____________ ( ) No _________________
( ) others, please specify ______________________________________________________________________
___________________________________________________________________________________________

b. Schedule of attendance in the workplace:


Workshift

Occupational health physician: __________________________ hrs/day ___________________________


Occupational health practitioner: __________________________ hrs/day __________________________
Occupational health nurse: __________________________
8 hrs/day ______________________________
First Shift
-2-

c. Schedule of attendance of full-time first-aider:


(X) 1st workshift
(X) 2nd workshift
(X) 3rd workshift

d. The following occupational health personnel of this establishment have undergone training in occupational health and
safety/first aid:
( ) occupational health physician
(X ) occupational health nurse
(X) first-aider
( ) others, please specify _________________________________________________________________
___________________________________________________________________________________

9. Occupational Health Services:


a. The occupational health personnel of this establishment conducts regular appraisal of the sanitation system in the
Workplace:
(X) Yes ( ) No
b. Number of workers who underwent the following medical examinations:

Physical Exams X-rays Urinalysis

1. Pre-placement ______________
0 ________
0 __________
0
2. Periodic ______________
316 ________
316 __________
316
3. Return-to-work ______________
0 ________
0 __________
0
4. Transfer ______________
0 ________
0 __________
0
5. Special ______________
0 ________
0 __________
0
6. Separation ______________
0 ________
0 __________
0
Stool Exams Blood Test ECG Others
1. Pre-placement ______________
0 __________
0 __________
0 ________
0
2. Periodic ______________
316 __________
316 __________
20 ________
0
3. Return-to-work ______________
0 __________
0 __________
0 ________
0
4. Transfer ______________
0 __________
0 __________
0 ________
0
5. Special ______________
0 __________
0 __________
0 ________
0
6. Separation ______________
0 __________
0 __________
0 ________
0

10. Report of Diseases


a. Number of cases diagnosed/treated for the following diseases ((/ of X):

Male Female Total Number of Cases

Skin:
( ) allergy _____________
0 ____________
0 ____________
0
( ) dermatoses
( ) infection as folliculitis/ _____________
0 ____________
0 ____________
0
absecess/paronychia
( ) Others _____________
0 ____________
0 ____________
0

Head:
(X) migraine headache _____________
10 ____________
22 ____________
32
( ) tension headache _____________
0 ____________
0 ____________
0
( ) Others _____________
0 ____________
0 ____________
0

Eyes:
( ) Error of refraction _____________
0 ____________
0 ____________
0
( ) Bacterial/Viral conjunctivities _____________
0 ____________
0 ____________
0
( ) Cataract _____________
0 ____________
0 ____________
0
( ) Others _____________
0 ____________
0 ____________
0

Mouth & ENT:


( ) Gingivitis _____________
0 ____________
0 0
____________
( ) Herpes Labiales/nasalis _____________
0 ____________
0 ____________
0
( ) Otitis Media/Externa _____________
0 ____________
0 ____________
0
( ) Deafness _____________
0 ____________
0 ____________
0
( ) Meniere’s Syndrome/Vertigo _____________
0 ____________
0 ____________
0
(X) Rhinitis/Colds _____________
12 ____________
19 ____________
31
( ) Nasal Polyps _____________
0 ____________
0 ____________
0
( ) Sinusitis _____________
0 ____________
0 ____________
0
( ) Tonsillopharyngitis _____________
0 ____________
0 ____________
0
( ) Laryngitis _____________
0 ____________
0 ____________
0
( ) Others _____________
0 ____________
0 ____________
0
-3-

Male Female Total Number of Cases

Respiratory:
( ) Bronchitis _____________
0 ____________
0 ____________
0
( ) Pronchial Asthma _____________
0 ____________
0 ____________
0
( ) Pneumonia _____________
0 ____________
0 ____________
0
( ) Tuberculosis _____________
0 ____________
0 ____________
0
( ) Pneumoconiosos _____________
0 ____________
0 ____________
0
( ) Others _____________
0 ____________
0 ____________
0

Heart and Blood Vessel:


(X) Hypertension _____________
0 ____________
1 ____________
1
( ) Hypotension _____________
0 ____________
0 ____________
0
( ) Angina Pectoris _____________
0 ____________
0 ____________
0
( ) Myocardial Infarction _____________
0 ____________
0 ____________
0
( ) Vascular disturbances _____________
0 ____________
0 ____________
0
in extremeties due to
continuous vibration
( ) Others _____________
0 ____________
0 ____________
0

Gastrointestinal:
( ) Gastroenteritis/Diarrhea _____________
0 ____________
0 ____________
0
( ) Amoebiasis _____________
0 ____________
0 ____________
0
( ) Gastritis/Hyperacidity _____________
0 ____________
0 ____________
0
( ) Appendicitis _____________
0 ____________
0 ____________
0
( ) Infectious Hepatitis _____________
0 ____________
0 ____________
0
( ) Liver Cirrhosis _____________
0 ____________
0 ____________
0
( ) Hepatic Absecess _____________
0 ____________
0 ____________
0
( ) Cancer (Hepatic/Gastric) _____________
0 ____________
0 ____________
0

( ) Others _____________
0 ____________
0 ____________
0

Genito-Urinary:
(X) Urinary Tract Infection _____________
0 1
____________ ____________
1
( ) Stones _____________
0 ____________
0 ____________
0
( ) Cancer _____________
0 ____________
0 ____________
0
( ) Others _____________
0 ____________
0 ____________
0

Reproductive:
(X) Dysmenorrhea _____________
0 ____________
7 ____________
7
( ) Infection (Cervicitis) _____________
0 ____________
0 ____________
0
(Vaginitis) _____________
0 ____________
0 ____________
0
( ) Abortion (Spontaneous) _____________
0 ____________
0 ____________
0
(Threatened) _____________
0 ____________
0 ____________
0
( ) Hyperemesis Gravidarum _____________
0 ____________
0 ____________
0
( ) Uterine Tumors _____________
0 ____________
0 ____________
0
( ) Cervical Polyp/Cancer _____________
0 ____________
0 ____________
0
( ) Ovarian Cyst/Tumors _____________
0 ____________
0 ____________
0
( ) Sexually-Transmitted Diseases _____________
0 ____________
0 ____________
0
( ) Hernia (Inguinal) _____________
0 ____________
0 ____________
0
(Femoral) _____________
0 ____________
0 ____________
0
( ) Others _____________
0 ____________
0 ____________
0

Neuromuscular/Skeletal/Joints:
( ) Peripheral Neuritis _____________
0 ____________
0 ____________
0
( ) Torticollis _____________
0 ____________
0 ____________
0
( ) Arthritis _____________
0 ____________
0 ____________
0
( ) Others _____________
0 ____________
0 ____________
0

Lymphatics and Circulatory:


( ) Anemia 0
_____________ ____________
0 ____________
0
( ) Leukemia _____________
0 ____________
0 ____________
0
( ) Cerebrovascular Accidents _____________
0 ____________
0 ____________
0
( ) Lymphadenitis _____________
0 ____________
0 ____________
0
( ) Lymphoma _____________
0 ____________
0 ____________
0

Infectious Diseases:
( ) Influenza _____________
0 ____________
0 ____________
0
( ) Typhoid/Paratyphoid Fever _____________
0 ____________
0 ____________
0
( ) Cholera _____________
0 ____________
0 ____________
0
( ) Measles _____________
0 ____________
0 ____________
0
-4-

Male Female Total Number of Cases

( ) Mumps _____________
0 ____________
0 ____________
0
( ) Tetanus _____________
0 ____________
0 ____________
0
( ) Malaria _____________
0 ____________
0 ____________
0
( ) Schistosomiasis _____________
0 ____________
0 ____________
0
( ) Herpes Zoster _____________
0 ____________
0 ____________
0
( ) Chicken Fox _____________
0 ____________
0 ____________
0
( ) German Measles _____________
0 ____________
0 ____________
0
( ) Rabies _____________
0 ____________
0 ____________
0
( ) Others _____________
0 ____________
0 ____________
0

Diseases due to Physical Environment:


( ) Diseases due to abnormalities _____________
0 ____________
0 ____________
0
in temperature and humidity
( ) Diseases due to abnormalities _____________
0 ____________
0 ____________
0
in air pressure
( ) Poisoning/Overdosage to _____________
0 ____________
0 ____________
0
Chemicals
TOTAL NUMBER . . . . . . . . . . . _____________
22 ____________
50 ____________
72

11. Report of Occupational Accidents/Injuries

Parts of Body Affected


Nature Male Female Total Number of Cases

Contussion, bruises, hematoma _____________


0 ____________
0 ____________
0
Abrasions _____________
0 ____________
0 ____________
0
Cuts, Lacerations, punctures _____________
0 ____________
0 ____________
0
Concussion _____________
0 ____________
0 ____________
0
Avulsion _____________
0 ____________
0 ____________
0
Amputation, loss of body parts _____________
0 ____________
0 ____________
0
Crushing injuries _____________
0 ____________
0 ____________
0
Spinal injuries _____________
0 ____________
0 ____________
0
Cranial injuries _____________
0 ____________
0 ____________
0
Sprains _____________
0 ____________
0 ____________
0
Dislocation/Fractures _____________
0 ____________
0 ____________
0
Chemical Burns _____________
0 ____________
0 ____________
0

12. Immunization Program (Indicate the number)

Tetanus Taxoid Injection _____________


0 ____________
0 ____________
0
Tetanus Antitoxin Injection _____________
0 ____________
0 ____________
0
Tetanus Globulin Injection _____________
0 ____________
0 ____________
0
Anti-Cholera, Anti-Typhoid Triple Vaccine _____________
0 ____________
0 ____________
0
Others (Please specify) _____________
0 ____________
0 ____________
0

13. Keeping of Medical-Records of Workers (Please check) (X) done ( ) not done

14. Health Education and Counselling by Health and Safety Personnel:


(Please check one or more)
(X) done individually as each worker comes to the clinic for consultation.
( ) done in organized group discussions/seminars.
(X) done with the use of visual displays and/or promotional materials, leaflets, etc.

15. Other Health Programs

Use of Visual Aid/


Seminar Materials Counselling
X
Nutrition Program X
Maternal and Childcare Program
Family Planning Program
Mental Health Activities X X
Personal Health Maintenance X X
-5-

Physical Fitness Program: (Please check)

Sports Activities (X) Yes ( ) No


Recreation Activities (X) Yes ( ) No
Others (Please specify) ( ) Yes ( ) No

16. Hazards in the Workplace: (Please check and give details of the active substance)

Substances and/or Sources Number of Workers Exposed

a. Chemicals Hazards:
( ) dust (Ex. Silica dust) ______________________
N/A ______________________
0
( ) liquids (Ex. Mercury) ______________________
N/A ______________________
0
( ) mist/fumes/vapors
(Ex. Mist from paint spraying) ______________________
N/A ______________________
0
( ) gas (Ex. CO, H2S) ______________________
N/A ______________________
0
( ) others (please specify) ______________________
N/A ______________________
0

b. Physical Hazards:
( ) noise ______________________
None / In Good Condition ______________________
0
( ) temperature/humidity ______________________
None / In Good Condition ______________________
0
( ) pressure ______________________
N/A ______________________
0
( ) illumination ______________________
None / In Good Condition ______________________
0
(X) radiation/ultraviolet/microwave ______________________
Desktop / Laptop ______________________
316
( ) others (please specify) ______________________
None ______________________
0
None (Not allowed to
c. Biological Hazards: work if not physically fit
( ) Viral ______________________
or need to WFH) ______________________
0
( ) Bacterial ______________________
None ______________________
0
( ) Fungal ______________________
None ______________________
0
( ) Parasitic ______________________
None ______________________
0
( ) Others ______________________
None ______________________
0

d. Ergonomic Stress:
( ) Exhausting physical work ______________________
None ______________________
0
( ) Prolonged standing ______________________
None ______________________
0
( ) Low Back Pain ______________________
None ______________________
0
( ) Unfavorable work posture ______________________
None ______________________
0
( ) Static/monotonous work ______________________
None ______________________
0
(X) Others, specify ______________________
Prolonged Sitting ______________________
0
(Already Managed)

Submitted by:

Joseph Karlo Corachea, Rn


___________________________________________ ______________________________
March 25, 2024
Medical Personnel/Title Date

Noted by:

__________________________________________________
For: Eva Macatol - HR Manager
Employer

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