Tackling Occupational Diseases for a Healthier Workforce

Mr Speaker, thank you for the opportunity to table my third Adjournment Motion related to workplace safety and health (WSH) and it is not on the right to disconnect.

In August 2022, I spoke about the need for us to prioritise the safety of every worker, as companies sought to clear the backlog of work caused by the COVID-19 pandemic. In September 2023, I spoke about the importance of keeping workplaces safe beyond the heightened safety period. Since then, thanks to the work put in by the Ministry of Manpower (MOM), the unions and our employers, our workplace fatal injury rate has dropped to 1.0 per 100,000 workers in 2023 and this continued into the first half of 2024.

My speech today will focus on an aspect of WSH that is often overlooked. This aspect of WSH is not as acute as workplace injuries and fatalities but can become as debilitating as injuries and mental health issues. I am referring to Occupational Diseases (ODs), a "silent terror" at the workplace.

ODs are health conditions caused by risk factors at the workplace. ODs not only cause debilitating effects but can have lasting negative effects on a worker's earning ability, productivity and employability. Some examples of ODs include noise-induced deafness due to exposure to excessive workplace noise and work-related musculoskeletal disorder due to physical factors, such as lifting heavy loads or working in awkward postures for extended periods of time. These two types of ODs made up more than 90% of our local OD cases reported in 2023 and the first half of 2024.

According to national WSH statistics released by MOM, there were over 1,200 cases of OD reported in 2023, a 17% increase from 2022; and about 473 reported cases in the first half of 2024. The increase in the number of reported cases over the past two years is the result of ongoing efforts to detect OD cases through enhanced surveillance and increased awareness in reporting among doctors and employers. I commend MOM for these efforts.

However, the Labour Movement is concerned that we have barely scratched the surface and that there remains significant under-reporting of OD cases in Singapore. Often, the worker's condition and symptoms will only show at a later stage after prolonged exposure to workplace risks and some could be mistaken for the side effects of ageing. I will elaborate more on this later.

Today, I wish to present some suggestions on how the Government and the industry can better prevent, detect and deal with OD cases at the workplace.

First, workplace health surveillance efforts should be expanded and more stringently enforced to ensure early detection and to tackle under-reporting of ODs. I earlier mentioned that Singapore was seeing a rising trend of OD cases. MOM has attributed the increase to the Enhanced Workplace Health Surveillance efforts, also known as the WHS+. I believe that the increase in OD cases that we have seen is only the tip of the iceberg. Let me explain.

WHS+ is currently focused on workers' exposure to excessive noise and chemical hazards. Sectors surveyed are limited to those in industrial settings, such as in construction. But we must not forget that workers in other workplace settings, such as food and beverage outlets that play persistent loud music, and call centres where the operators have to put on headsets throughout the day during work, may also be exposed to excessive noise, as experts have recently reported in a CNA article. I therefore urge MOM to expand WHS+ to require more companies and industries to undergo surveillance for excessive noise.

Surveillance under WHS+ should also be expanded to cover other types of OD, beyond noise. One example is what I have described earlier, work-related musculoskeletal disorder, the second-highest reported OD category in Singapore over the past three years. Work-related musculoskeletal disorder is not restricted to any sector but can affect workers across diverse work environments.

Office workers may unknowingly suffer from this disorder due to poor posture and doing repetitive activities. In healthcare, workers are subject to heavy loads due to shifting and assisting patients, which can lead to back injuries. Our taxi drivers and bus captains also tell me that they experience back pain from prolonged sitting. Expanding the scope of surveillance to include other ODs would enable early detection and facilitate timely treatment of conditions before they worsen.

Sir, we can do even more to detect ODs early. Today, the Workplace Safety and Health (Medical Examinations) Regulations specifies certain occupations in the First Schedule that are subject to periodic medical examinations due to the risks of ODs. The policy position taken in the Medical Examinations Regulations differs from that of the Work Injury Compensation Act, which states that ODs can happen from any occupation.

We should therefore amend the First Schedule of the Medical Examinations Regulations by expanding mandatory health screenings to all high-risk industries. In doing so, the Government can leverage the wide network of Healthier SG general practitioner (GP) clinics to ensure that our healthcare system would not be overloaded.

Mandatory health screenings will also go a long way in tackling the issue of under-reporting of OD cases. According to global research on ODs, there are many reasons for under-reporting of OD. For example, workers may not seek immediate medical attention from their workplace doctor because of a mild discomfort. Workers may also turn to a GP for temporary symptom relief, not understanding that the root cause of their pain was due to work. The potential hefty costs of having to see a specialist is another possible reason that could deter some from seeking treatment early.

We should conduct local studies to examine the prevalence of under-reporting of ODs locally. I hope that MOM will study and investigate all possible reasons for under-reporting of OD cases here in Singapore and take measures to plug the gap.

Sir, other countries are utilising additional data sources to provide a more representative picture of the prevalence of ODs. For example, the United Kingdom (UK) collects its WSH data from a wide variety of sources, including voluntary reporting of anonymised cases by specialist doctors and self-reported data through its labour force survey. This is in addition to data from its compulsory reporting regime. Through these, the UK was able to report in 2024 that it had an estimated 543,000 workers suffering from work-related musculoskeletal disorders, or a rate of 1,600 cases per 100,000 workers. We can learn from the UK and other countries how they collect and use additional data points to investigate the prevalence of OD.

I hope MOM will review how we in Singapore collect data on OD cases, with a view of reducing under-reporting. Timely, relevant and accurate data is crucial to help us assess the extent of OD in Singapore.

The use of technology can aid the early detection of OD risk factors at work and improve work processes to reduce workers’ exposure to OD risks. This includes the use of automation to limit human exposure, as well as preventive surveillance of risk factors.

As the popular proverb goes, “prevention is better than cure.” We must start by trying to prevent ODs from occurring in the first instance.

Employers have an onus in preventing ODs, by providing workers with the appropriate equipment and a safe working environment. This is a widely accepted principle in many countries, such as the United States and the UK, where obligations are placed on employers to help workers deal with the inherent risks associated with the work that they perform.

Here, I would like to highlight the proactive efforts of KK Women’s and Children’s Hospital (KKH) as an example of such preventive surveillance. The hospital has identified work-related musculoskeletal disorders as an issue affecting its healthcare workers and took measures to address this using technology. In collaboration with the National Trades Union Congress (NTUC), they will pilot a surveillance programme using thermal sensors to detect improper postures of workers during their work.

Thermal imaging has no known negative health side effects, but it adds also a layer of privacy as it does not allow for the identification of an individual. This allows risk factors leading to the disorder to be detected without compromising privacy concerns.

Such projects and innovations can help to uplift the safety standards, but I acknowledge that not all companies have the same investment capabilities as KKH. As such, I call on the Government to provide more funding support for more companies to innovate and adopt technological solutions to reduce workers’ exposure to OD risks.

Sir, we must also do more to raise awareness of OD among employers and workers. This is especially important for workers, who might not understand the impact that their jobs have on their health. We must educate our workers on the dangers of OD and place an emphasis on younger workers before prolonged exposure to OD risks causes irreparable damage to their health in the years ahead.

The WSH Council currently has a set of guidelines on the diagnosis and management of ODs. However, it has been 10 years since the guidelines were last updated in 2015. Therefore, it is timely to review and update these guidelines to ensure that they remain relevant and effective.

Singapore has numerous medical facilities and research institutes specialising in occupational health and disease. The Centre for Environmental and Occupational Health at the National University of Singapore and specialised clinics at Singapore General Hospital that focus on treating ODs, such as lung and skin conditions, are key examples. I propose for the Government to consolidate our all current expertise in OD to create a national Centre of Excellence for Occupational Diseases. This Centre would serve to galvanise all research on the various ODs, with a focus on our local context and, more importantly, consolidate resources for more effective public education on OD.

I hope the Government will also ramp up efforts to educate employers and workers on the long-term dangers of OD, and I invite employers to work with NTUC to identify and address OD risks at your specific workplace.

Sir, guidelines will simply remain as guidelines when there is no one assigned to act on it. I would therefore like to, once again, call on the Government to mandate the need for a WSH representative in all companies. I have been repeating this proposal for many years. The last, I think, was in 2017.

Having a mandatory WSH representative in all companies will allow MOM to impose an audit requirement, where every company, no matter how big or small, would need to take time to take care, just to borrow the tagline of the WSH Council, to examine if the work that they do can subject their workers to the risk of OD.

Sir, as Singapore becomes a super-aged society, we must do all we can to prevent OD from taking root, amend our existing regulations to be able to better detect OD early and put in place measures to allow workers to seek early treatment of ODs before their conditions worsen. We must also tap on existing expertise to develop more targeted, industry-specific guidance to reduce OD across all industries.

In the area of WSH, our emphasis has always been on safety, as any mishap there can be immediate and acute. However, ODs, if not dealt with, can have a long-lasting impact on workers’ productivity and health span. Workplace safety and health; it is time we pay equal emphasis on health as we do in safety. The Labour Movement stands ready to partner with all our tripartite partners to tackle ODs for a healthier workforce.