Engr.

Ana Rivera
Department of Health Philippines

National Chemical Safety Management and Toxicology Policy

Engr. Ana Trinidad F. Rivera, MSc Environmental and Occupational Health Office National Center for Disease Prevention and Control Department of Health

Ten Chemicals of Major Public Health Concern (WHO)

Chemicals are part of our

daily life. Many chemicals can, when properly used, significantly contribute to the improvement of our quality of life, health and wellbeing. But other chemicals are highly hazardous and can negatively affect our health and environment when improperly managed

Scope: a. Environmental, economic, social, health and labour aspects of chemical safety, b. Agricultural and industrial chemicals, with a view to promoting sustainable development and covering chemicals at all stages of their life-cycle, including products Overall objective of the Strategic Approach; achieve the sound management of chemicals throughout their life-cycle so that, by 2020, chemicals are used and produced in ways that lead to the minimization of significant adverse effects on human health and the environment. implementation of activities set out in the Global Plan of Action.

Strategic Approach to International Chemicals Management (SAICM) under UNEP/WHO/FAO/ILO

SAICM: Objectives
Risk reduction (10)
To minimize risks to human health, including that of workers, and to the environment

throughout the life cycle of chemicals

Knowledge and information (10)

To ensure that knowledge and information on chemicals and chemicals management

are sufficient to enable chemicals to be adequately assessed and managed safely throughout their life cycle;

Governance (14) Capacity-building and technical cooperation (9)

Illegal international traffic (3)

Looking back, what happened in the past?

The DOH has been called upon to provide technical assistance to the following concerns;

SMALL AND LARGE SCALE MINING

Mining Abandoned mercury mines Small-scale gold mining Large scale copper, nickel and gold mining

Marinduque Mine Spill Quicksilver Mines in Palawan Mt Diwalwal and Tagum Gold Processing Rapu-Rapu Mine Spill Philex Mine (2013)

Pesticide (carbamate) poisoning in Mabini, Bohol, 2005

Mercury Spill In Paranaque, 2006

-Aerial Spraying of Pesticides -Paraquat Exposure Among Cacao Farmers -Pesticide Use in Cutflower Industry

Gas leak Ammonia, chlorine, hydrogen sulfide, LPG

Guimaras Oil Spill 2006

MV Princess of the Stars Tragedy June 2008

Pipeline Leak of Petroleum Substances in Makati City

HUMAN HEALTH RISK ASSESSMENT

Activities Undertaken: 1. Environmental Site Assessment Study 2. Vapor Intrusion 3. Human Health Risk Assessment (USEPA) a. Chemicals of Potential Concern b. Exposure Assessment c. Toxicity Assessment d. Risk Characterization Carcinogenic Non-Carcinogenic e. Remediation Action Goals

Multi-Phase Extraction Technology for the Clean-Up

Serendra Incident
Gas samples were measured using

RAE multi-gas monitors. VOCs were measured by a photoionization detector (PID)

Fabella Hospital Mercury Spill

Mercury Standards
Description Occupational standards Concentration (ug/m3) Remarks Airborne concentrations to which workers can be exposed for 8 hours without any adverse effects; assumption workers are adults and can wear appropriate PPE 50 ug/m3 or (50,000 ng/m3) 100 ug/m3 or (100,000 ng/m3) Workers are required to wear chemical cartridge respirators a worker's exposure to mercury vapor shall at no time exceed this ceiling level; necessary to be equipped with chemical protective clothing, full face-piece air purifying respirator or self-contained breathing apparatus An atmospheric concentration of any toxic, corrosive or asphyxiant substance that poses an immediate threat to life or would cause irreversible or delayed adverse health effects or would interfere with an individual's ability to escape from a dangerous atmosphere.

NIOSH Recommended Exposure Limit (REL)/ DOLE threshold limit Value (TLV) ceiling limit

Immediately Dangerous to Life or Health (IDLH)

10,000 ug/m3 or (10,000,000 ng/m3)

Recommended Institutional (residential, school or hospital) Guidelines recommended limit for continual habitation by children 0.2 g/m3 which is the minimal risk level (MRL) set by the Agency for Toxic Substances and Disease Registry (ATSDR , 1999). 5,000 ug/m3 Set by the IACEH for institutions because of vulnerabilities of children and patients. Minimal risk levels are defined as estimates of daily human exposure to a chemical that is likely to be without an appreciable risk of harmful effects over a specified duration of exposure.

DENR National Emission Standards for Source Specific Air Pollutants

Source Specific Emissions by Industries

Recently..
Petroleum leak in Pandacan

Cavite petroleum spill

San Juan gas explosion Oil spill in Cebu Ammonia gas leak in Negros Occidental

Commonly encountered toxicants, UP-NPMCC, 2008 (N=3,931)

6% 7% 6% 5% 4% 21%

9% 13% 14%

15%

Alkali Paracetamol Alcohol(household) Salicylates

Kerosene Ethanol(beverage) Acid

Silver jewelry cleaner Mixed pesticide Iron

Commonly encountered toxicants among children, UP-NPMCC 2008 (N=1,927)

5% 5% 4% 4% 3% 26%

8% 8% 15% 8% 14%
Alkali Alcohol(household) Salicylates Jathropa Silver jewelry cleaner Paracetamol Button batteries

Kerosene Pyrethroids Elemental mercury Iron

Commonly encountered toxicants among adults, UP-NPMCC, 2008 (N= 1,748)

6% 7% 5% 4% 4% 22%

9% 11% 15%
Paracetamol Acid Benzodiazepine

17%

Alkali Silver jewelry cleaner Iron Alcohol (household)

Alcohol (beverage) Mixed pesticide Organophosphate

Poisoning Telephone Inquiries at the NPMCC, Philippine General Hospital, 1993-2009

3500 3000 3268 3118 3037 2900 2904 2853 2822 2682 2408 1937 1682 1377 1055 700 270 565 1771

Number of inquiries

2500 2000 1500 1000 500 0

19 93 19 94 19 95 19 96 19 97 19 98 19 99 20 00 20 01 20 02 20 03 20 04 20 05 20 06 20 07 20 08 20 09
Year

Commonly encountered toxicants, telephone referrals, UP-NPMCC, 2006

6% 7% 5% 5% 23%

7% 7% 11% 14%

15%

Kerosene Sodium hypochlorite Mixed pesticide Elemental mercury Paracetamol Silica gel Jewelry cleaner Ferrous sulfate Hydrochloric acid Isoniazid

Majority of the referrals came from hospitals (81.0%). House calls composed 19.0% of the referrals.

EAMC Poison Center, Poisoning Cases* CY 2007

Number of patients seen 417(1.14 patient/day)

Number of patients admitted 364

Number of deaths 7 (1.7%) Top 10 poisoning agents
Cleaning agents (22.3%) Pharmaceuticals (19.9%) Hydrocarbons Pesticides Food

(16.7%) (12.9%) ( 10.6%)

industrial products (6.2%) - others (5.3%) - personal care (2.1%) - mixed (2.1%) - plant (1.7%)

No. of clinical toxicologist =1

* No mass chemical poisoning referral

Poison Control and Information Centers, Philippines

UP-NPMCC East Avenue Medical Center

Rizal Medical Center

Western Visayas Medical Center

Batangas Regional Hospital

Zamboanga Regional Hospital and Medical Center

Eastern Visayas Regional Medical Center

Mechanism for the Development of a National Framework on Chemical Safety and Toxicology
UNEP funding support

Convened the IACEH Chemical Sector

Prepared the National Profile on Chemical Safety

Management Identified status, issues and gaps Developed the national framework Issuance of and Administrative Order

Quick Start Program

Development of an effective national

chemical safety program towards chemical poisoning prevention and control

SAICM: Global Plan of Action (GPA)

Legal Mandate and Functions

LEGAL MANDATE Executive Order No. 489 Institutionalizing the Inter-Agency Committee on Environmental Health (IACEH) signed 22 Nov 1991 Chair: Secretary of the DOH Vice-Chair: Secretary of DENR Members: Secretary of DILG Secretary of DOST Secretary of DTI Secretary of DA Secretary of DOLE Secretary of DOE Secretary of DOTC Director General of NEDA Director General of PIA

Functions of IACEH
1.Formulate policies, promulgate guidelines and develop programs for environmental health protection; 2. Coordinate, monitor and evaluate environmental health programs; 3. Undertake information dissemination and education campaigns on environmental health programs; 4. Coordinate in, assist and/or support the conduct of researches to carry out the provisions of the EO.

IACEH Reconstituted: Sectoral Task Forces

Solid Waste Climate Change Air

Academe

NGOs

GAs/Legislative

Food Safety

Water

LGUs
Toxic Substances and Hazardous Waste

Sanitation Occupational Health

Industry

Strengthening Organizational Structure for Chemical Safety at Different Levels of Governance.

IACEH (EO 489) DOH (Chair), DENR (Vice-Chair) DOLE, DOST, DPWH, DA, DOTC, DILG, DTI, DOE, DepEd, NEDA, PIA, LGUs, NOGs, POs, Academe

Contents of the National Profile

Introduction to the National Profile National Background Information Chemical Production, Import, Export
Data Access and Use Technical Infrastructure International Linkages Awareness/Understanding of Workers and the

and Use Priority Concerns Related to Chemical Production, Import, Export and Use Legal Instruments and NonRegulatory Mechanisms for Managing Chemicals Agencies and other Institutions Managing Chemicals
Relevant Activities of Industry,

Public Resources Available and Needed for Chemical Management

Public Interest Groups and the Research Sector Inter-Agency Commissions and Coordinating Mechanisms

Situation and Gap Analysis

Situation Analysis Problem Areas

Policy and Legislation
Grey areas in implementing mandates related to

chemical management No specific budget appropriated for chemical management except for the Fertilizer and Pesticide Authority and Environmental Management Bureau
laws do not give much emphasis on the preventive

aspect of chemical safety lack of police power of regulatory agencies to impose sanctions, penalties and legal actions

Gap Analysis
Capacity for Implementation & Enforcement
the lack of a clear mechanism to translate the program goals,

objectives and activities into workable and systematic means

In the present system, existing laws and programs on chemical

safety cannot be fully implemented because of insufficient budgetary, manpower infrastructure support and other constraints.

Gap Analysis
Capacity to respond to emergencies
protocols stating specific roles and responsibilities of responding

agencies are not clearly established familiarity to the Incident Command System (ICS) is a problem because of the lack of uniformity in the implementation of response systems. Although already being practiced, it is not even clear if the Chemical and Hazardous Wastes Emergency Management Program (CHWEMP) has been formally adopted by the government Currently we are collaborating with PSCOT on the development of guidelines on chemical emergency response for the health sector

Gap Analysis
Capacity for rehabilitation of contaminated sites
There are no existing protocols for clean-up. The country is dependent on foreign agencies and international

private groups for personnel, technical expertise and equipment in the clean up and rehabilitation of contaminated sites. The World Bank-IPOPs project - incorporate remediation of POPs contaminated sites ; soil standards Proposed bill on hazardous and nuclear wastes included provisions on contaminated sites and soil standards

Gap Analysis
Capacity for Treatment of Cases
Few treatment facilities capable of managing patients suffering

from chemical emergencies

Continuous

turnover of personnel necessitates education and training of medical and allied personnel

continuing

Few health personnel trained in toxicology and epidemiology

Continuing activity of the DOH in partnership with UP-NPMCC

Development of clinical practice guidelines

Metals (completed) Gases (2013) Petroleum products (2014)

Situation Analysis Problem Areas

Capacity for risk assessment and interpretation
Joint DOH-DENR-FDA training program on risk analysis

September, 2013 (1st batch)

Risk Management Policy & Precautionary

Principle Approach
Incorporates precautionary principle in policies

Information gathering and dissemination

- Reporting of poisoning cases (HEMS and NEC)

Effective education
Poison prevention Week 4th week of June

Objectives
General Objective
To formulate an integrated and comprehensive national chemical

safety management program that will effectively address the gaps in chemical management in the Philippines.
Specific Objectives
To formulate strategies to minimize the health and environmental

risks associated with chemical use, production and trade To improve the knowledge and awareness of stakeholders on chemical management To strengthen the governance and coordination of agencies involved in chemical management To promote capacity-building and technical cooperation among stakeholders To prevent illegal trafficking of toxic and dangerous chemicals in the country

Guiding Principles
Precautionary Principle and Prevention

Workers' Right to Know

Integrated life-cycle approach Pollution prevention Policy Coherence and Governance

Private-Public Partnership

Strategic Approaches
Capacity Building for Personnel

Capacity for Risk Assessment, Reduction, Management

and Communication Capacity for Implementation & Enforcement Capacity to Respond to Emergencies Capacity for Rehabilitation of Contaminated Sites Capacity for Surveillance and Treatment of Cases Awareness and Education Research - Evidence-based studies Information Gathering and Dissemination Monitoring & Evaluation

Salamat po!