Legal basis and linked policy framework
- The order is issued pursuant to Executive Order No. 187, which institutes a comprehensive and unified policy for tuberculosis control in the Philippines (CUP).
- The workplace TB program is required to be aligned with EO 187 and the CUP.
- DOTS use and case management are tied to the CUP and the National Tuberculosis Control Program (NTP).
- The guidelines require workplace reporting in line with DOLE occupational safety and health reporting requirements, including OSHS Rule 1965.01 (4) and Rule 1053.01 (1).
- Enforcement is tied to the DOLE labor standards enforcement framework (DOLE DO 57-04).
Coverage and who must comply
- These guidelines apply to all establishments, workplaces and worksites in the private sector.
- All private establishments, workplaces, and worksites must formulate and implement a TB prevention and control policy and program.
- Employers must disseminate these guidelines in their respective workplaces.
- Workplace health and safety arrangements are implemented through a workplace health and safety committee responsible for oversight.
Required TB workplace policy and program
- Establishments must create and implement a TB prevention and control policy and program as a mandatory workplace requirement.
- The workplace TB policy and program must be made an integral part of the enterprise’s occupational safety and health and other related workplace programs.
- Management and labor representatives must jointly develop the TB workplace policy and program aligned with EO 187 and the CUP.
- In organized establishments, the TB workplace policy and program must be included, as much as possible, as part of Collective Bargaining Agreements (CBA).
- The workplace TB policy and program must include components covering: prevention, treatment, rehabilitation, compensation, restoration to work, and social policies.
Preventive strategies and workplace controls
- Establishments must carry out TB Advocacy, Education and Training, and measures to improve workplaces in all workplaces.
- A TB awareness program must be undertaken through information dissemination.
- The TB awareness program must address: the nature, frequency and transmission of TB, treatment with DOTS, and control and management of TB in the workplace.
- DOTS is required to be treated as a comprehensive TB control strategy composed of five components:
- Political will or commitment to ensuring sustained and quality TB treatment and control activities.
- Case detection by sputum-smear microscopy among symptomatic patients.
- Standard short-course chemotherapy using regimens of 6 to 8 months for all confirmed active TB cases (including smear positive or those validated by the TB Diagnostic Committee), with complete drug taking through direct observation by a designated treatment partner during the whole course of treatment.
- A regular, uninterrupted supply of all essential anti-tuberculosis drugs and other materials.
- A standard recording and reporting system to assess case finding and treatment outcomes per patient and assess program performance overall.
- Workers must receive proper information to strengthen immune responses against TB infection, including good nutrition, adequate rest, avoidance of tobacco and alcohol, and good personal hygiene practices.
- Intensive prevention efforts must be geared toward accurate information on TB etiology and complete treatment of cases.
- To control contamination from TB airborne particles, workplaces must provide:
- Adequate and appropriate ventilation in line with DOLE-Occupational Safety and Health Standards (OSHS), Rule 1076.01, and
- Adequate sanitary facilities for workers.
- Work areas must be managed so that the number of workers in a work area does not exceed the required number of workers for a specified area and must observe the standard for space requirement under OSHS Rule 1062.
- Capability building on TB awareness raising and training on TB Case Finding, Case Holding, Reporting and Recording of cases, and implementation of DOTS must be given to company health personnel or the occupational safety and health committee.
Medical management requirements
- Establishments must adopt DOTS in the management of workers with tuberculosis and their dependents.
- TB Case Finding, Case Holding, and Reporting and Recording of cases must follow the CUP and the National Tuberculosis Control Program (NTP), including the NTP policies and procedures referenced as Annex 1.
- Establishments must refer workers and family members with TB to private or public DOTS centers as a minimum workplace requirement.
- The TB benefits determination for compensation from ECC, SSS and PhilHealth must use the diagnostic and treatment criteria in the current NTP policy as the basis for appropriate TB benefits.
Recording, reporting, and TB database link
- Establishments must report all diagnosed cases of TB to the Department of Labor and Employment using an appropriate form, including the Annual Medical Report, in line with OSHS Rule 1965.01 (4) and Rule 1053.01 (1).
- Reported information must be part of the TB Registry of the DOH.
- SSS must report members who applied for Disability Benefit for TB to PhilCAT or other bodies designated to manage the National TB Data Base.
- PhilCAT must share TB data with DOLE, specifically with the OSHC.
Social policies and worker protections
- Workers who have or had TB must not be discriminated against.
- Workers with TB must be supported with adequate diagnosis and treatment.
- Workers with TB must be entitled to work as long as they are certified by the company’s accredited health provider as medically fit.
- Workers must be supported for restoration to work as soon as their illness is controlled.
- Work accommodation measures are encouraged through agreements between management and workers, including:
- Flexible leave arrangements,
- Rescheduling of working times, and
- Arrangements for return to work.
- A worker may return to work with reasonable working arrangements determined by the company’s Health Care Provider and/or the DOTS provider.
Roles of TB-affected workers and employers
- Workers who have symptoms of TB must seek immediate assistance from their health service provider.
- Workers at risk for TB, including those with family members with TB, must seek immediate assistance from their health service provider.
- Once diagnosed, workers must avail of DOTS and adhere to the prescribed course of treatment.
- Employers must trace any workplace contact and clinically assess the contacts.
- Employers are encouraged, through Corporate Social Responsibility and OSH and related programs, to extend the TB program to workers’ families and their respective communities.
Implementation, monitoring, and enforcement
- The Occupational Safety and Health Center (OSHC) must provide preventive and technical assistance for implementing the Workplace TB program at the enterprise level.
- The Bureau of Working Conditions (BWC) and DOLE Regional Offices through their labor inspectors enforce these guidelines using the labor standards enforcement framework under DOLE DO 57-04.
- Employers must disseminate these guidelines in their workplaces.
Miscellaneous and transitory effectivity
- Compliance with all provisions of the Department Order must be achieved within 30 days from publication in a newspaper of general circulation.
- The Department Order is adopted on 30 Mar. 2005 and is signed by PATRICIA A. STO. TOMAS, then Secretary.