Summary of Hospital Operations and Areas of Safety Concern (Cebu North General Hospital): Cebu North General Hospital

operates as a full-service medical facility with 24/7 clinical, diagnostic, and support services. Departments such as Nursing,
Pharmacy, Engineering, Housekeeping, Laboratory, and Radiology perform high-volume tasks essential to patient care. Safety concerns observed across departments include inadequate PPE compliance, poor housekeeping and storage practices, insufficient
maintenance of safety systems, lack of ergonomic provisions, and inconsistent implementation of safety protocols. These findings highlight the need for stronger safety enforcement, preventive maintenance, and training across all hospital units.

1. Engineering and Maintenance Department

This department handles high-volume, daily repair and maintenance requests across the hospital. Staff respond to service calls, inspect faulty equipment, and perform urgent fixes based on caller reports. Workload is constant due to the hospital’s
operational demands.

1. Plumber: Tasks include fixing clogged toilets, repairing leaking pipes or faucets, replacing broken valves, checking drainage systems, and restoring water supply. Plumbers often respond to urgent calls and may work in wet or confined spaces.
2. Carpenter: Repair doors, window frames, broken furniture, and cabinets. They assist during renovations by installing partitions, reinforcing walls, or mounting fixtures. They frequently use power tools and sharp instruments.
3. Engineering Head & Assistant: Supervise technical staff, review daily work logs, schedule preventive maintenance, and ensure resource availability. Office-based tasks include preparing maintenance reports, coordinating with suppliers, and
updating service records.
4. Safety and Pollution Control Officer: Conducts routine safety checks across hospital facilities, covering equipment, electrical safety systems, fire safety systems, hazardous materials, and contractor compliance with safety protocols.
5. Safety & Security Supervisor: Supports safety monitoring and also coordinates with security teams on emergency drills, access control, and incident response.
6. Biomed Technician: Maintain and repair biomedical equipment such as vital sign monitors, suction machines, defibrillators, and infusion pumps. Tasks include inspecting malfunction reports, running diagnostic tests, and conducting preventive
maintenance.
7. Electrician: Repairs electrical outlets, light fixtures, circuit breakers, and wiring. Performs routine checks on electrical panels and responds to power issues. Repairs electrical outlets, light fixtures, circuit breakers, and wiring. Performs routine
checks on electrical panels and responds to power issues.
8. Painter: Handles repainting of walls and doors. Painters prep surfaces, mix paint, and work in both ventilated and enclosed areas. Demand increases during remodeling or facility upgrades.
9. Aircon technician: Clean and maintain AC units. Tasks involve checking refrigerant levels, replacing filters and servicing units in elevated locations.
10. Mechanical technician: Handles welding, machine repairs, fabrication, and adjustments to mechanical equipment. Tasks often involve heat, sparks, and heavy tools.
11. Other Services: Engineering staff also handle various support tasks beyond their main roles. These include installing CCTV units, replacing empty oxygen tanks at the manifold, assisting with equipment setup, and helping in sewage treatment
plant operations such as carrying chemicals and collecting sludge.

Safety Observation (Hazard Identification)

1. Poor implementation of safety procedures. Safety posters are present, but actual practices such as Lock-Out Tag-Out (LOTO) are not properly enforced. Work permits are not consistently issued or monitored for personnel performing tasks.
2. Inadequate ergonomic furniture. Chairs in the area are makeshift or DIY and do not meet ergonomic standards, posing long-term health risks to personnel performing desk or monitoring tasks.
3. Insufficient and Disorganized Storage. While a stockroom is available, some materials lack designated storage and are being kept in the common area used by personnel. Additionally, although there are designated shelves for heavier items
such as three-phase motors, these are placed on upper shelves, which require extra caution during handling due to the risk of falling objects and manual handling strain. The overall setup increases the potential for trips, falls, or accidental
injury.
4. Lack of Personal Protective Equipment (PPE). Personnel such as electricians are observed working without gloves, safety shoes, hard hats, or reflective vests. Painters and carpenters lack proper respiratory protection such as masks or
respirators.
5. Inadequate Ventilation for Electrical Equipment. The ATS (Automatic Transfer Switch) is installed in an enclosed space with only a ceiling fan providing air circulation. While this helps reduce heat buildup, it may not be sufficient for long-term
ventilation requirements, especially during high-load operations. Additional exhaust or forced ventilation should be considered to prevent overheating and reduce fire risk.
6. Poor lighting in the office lobby (common area). The Engineering Services lobby lacks adequate illumination. While paperwork is not a primary daily task for most, basic lighting is still essential for safety and visibility.
7. Scrap Material Accumulation Near Access Path. Scrap metals and discarded materials are placed along the access path leading to the Engineering Department. While the walkway remains passable, the visible buildup creates a slight
obstruction and increases the risk of tripping, cuts, or other physical injuries. This accumulation is primarily due to insufficient storage space, especially during periods of renovation.
8. Unsafe oxygen tank storage. Oxygen tanks from the manifold system are stored near active welding and carpentry work areas due to limited space—posing significant fire and explosion hazards.
9. High-risk proximity of generator set and waste storage. The generator set is situated next to the Materials Recovery Facility (MRF), where infectious waste is temporarily stored before pickup. This increases the risk of contamination, fire, or
chemical exposure.
10. Lack of 5S implementation in office areas. Office materials, especially paperwork, are not properly organized due to the lack of sufficient file organizers. Documents are often randomly piled up, making tracking and retrieval difficult.
11. Exposure to Various Occupational Hazards Due to the nature of work performed by plumbers, electricians, carpenters, painters, and air conditioning technicians, the Engineering Services Department is exposed to a wide range of hazards
such as electrical, chemical, physical, ergonomic, and fire-related risks.
12. Potential Maintenance Gaps in Fire Protection Systems While fire extinguishers are routinely maintained, other key fire protection components—such as sprinkler systems, standpipes, fire pumps, and kitchen hood suppression systems—have
no documented or consistent maintenance schedule.
Hazard Identification, Risk Assessment, and Control (HIRAC)
This document outlines the identified hazards, assessed risks, and recommended control measures based on a safety walkthrough and inspection conducted by the Safety Officer and OSH Committee of Cebu North General Hospital. The goal is to ensure a
safe and healthful working environment across all departments, in compliance with relevant occupational safety standards.

HIRAC FORM
Company: Cebu North General Hospital Conducted By: Mohammad Julkabir B. Awab, SO2
Department: Engineering Service Department Validated By: Noliver A. Platino, SO3
Department Head / Representative: Origination Date: Revision Date: Approved By: Vivan P. Abing, Hospital Administrator

I. Hazard Identification II. Risk Assessment III. Risk Control

Which can Cause
No. Work Activity Hazard Specific Hazard Existing Risk Control Likelihood Severity Risk Recommended Control Measures
/ Effect
Elimination: Relocate oxygen storage area away from any welding/cutting activities
1 Welding, Machine Repairs Safety Hazard Sparks near oxygen tanks Fire, explosion, fatality No separation/barriers, PPE (inconsistent) 5 5 Extreme Engineering: Install non-combustible fire
Administrative: Implement zoning rules and enforce hot work permits

Elimination: Relocate oxygen storage area away from any welding/cutting activities
Storage of oxygen tanks near Close proximity of
2 hot works
Safety Hazard combustibles
Explosion, fire, fatalities No proper segregation 5 5 Extreme Engineering: Install non-combustible fire
Administrative: Implement zoning rules and enforce hot work permits

Inadequate fire protection Unchecked sprinklers, Administrative: Implement a documented fire protection maintenance schedule (minimum
3 system maintenance
Safety Hazard standpipes
System failure during fire No record of schedule 4 5 Extreme quarterly for sprinklers, monthly visual checks, and semi-annual kitchen hood inspections).

Administrative: Conduct regular toolbox meetings and refresher training on electrical

Electrical Repairs by Exposure to live wires or Electrical shock, burns, safety and LOTO
4 Electricians
Safety Hazard faulty breakers electrocution
Some signage; PPE (not provided) 4 4 High Administrative: Strict enforcement of LOTO and permit-to-work systems for all tasks
PPE: Provide electrical-rated PPE (insulated gloves, dielectric boots, arc-rated helmets)
Heavy cylinder handling; Hand/finger injury, back Administrative: Conduct training on safe handling techniques
Replacement and manual
5 handling of oxygen tanks
Safety Hazard sharp valve edges; sudden strain, bruises, cuts, high- None (No proper gloves, no lifting aids) 4 4 High PPE: Provide proper PPE (cut-resistant gloves), use lifting aids (cylinder trolley with
pressure release pressure burst exposure securing chain

Tool malfunctions due to Administrative: Conduct documented tool safety training, enforce toolbox meetings, and
Use of power tools (carpentry, Cuts, fractures, Minimal signage present. Some tools have built-in guards.
6 mechanical)
Safety Hazard improper use or
amputations No formal in-house training documentation
3 4 High implement pre-use inspection logs
maintenance PPE: Mandatory gloves, goggles, safety shoes

PPE use observed but not consistently enforced; no visible Engineering: Install certified anchor points and fall arrest systems for elevated access
Falls, electrocution,
Equipment repairs in confined Working above ceilings, PPE: Mandatory use of harnesses, non-slip footwear, hard hats
7 or elevated spaces
Safety Hazard inside shafts, or wet areas
asphyxiation, severe injury, anchorage points or fall protection systems; confined space 4 4 High Administrative: Confined space permit system, LOTO enforcement, pre-task toolbox
permanent disability protocols not consistently followed briefing, designated safety watchers
Inhalation of chemical Administrative: Post signage, assign safety observer during confined paint jobs, schedule
Respiratory issues, long-
8 Painting works Health Hazard fumes in enclosed or
term lung effects
No masks observed 4 4 High work when fewer people are exposed
poorly ventilated areas PPE: Provide and enforce use of OSHA-approved respirators
Lack of gloves, safety Electric shock, slips, Posters are posted, but PPE use is not monitored or
Improper PPE usage across Safety & Health shoes, masks, vests, or puncture wounds, Administrative: Provide complete PPE, enforce usage through regular monitoring, and
10 roles Hazard hard hats depending on respiratory problems, long-
enforced. No evidence of regular issuance or replacement 4 4 High conduct routine toolbox meetings for compliance and awareness.
task term illness of PPE for all roles.
Generator heat or spark Contamination, smoke
Generator beside waste Safety & Health Engineering: Install a fire-rated physical barrier between generator and MRF
11 storage Hazard
could ignite or combustible inhalation, fire, explosion, A physical barrier is present, but it is not solid or fire-rated 3 4 High Administrative: Enforce zoning policy; install proper signage and access restriction
waste environmental hazard

Scrap accumulation in access Sharp scrap metals, trip Cuts, puncture wounds, No organized disposal area. Walkway still passable, but Elimination: Immediate scrap hauling during or after work activity
12 Safety Hazard hazard slips scrap accumulation
4 2 Medium Engineering: Install separate, secured scrap storage or disposal bin away from access path
path

Routine plumbing, drain Infections, diarrhea, skin Basic PPE (gloves, boots) provided but not consistently PPE: Elbow-length gloves, waterproof apron or coverall, N95 masks or face shields (during
13 Health Hazard Exposure to wastewater
irritation, respiratory illness used. No SOP or warning
3 3 Medium heavy unclogging), slip-resistant boots
unclogging

Fire, system failure,

ATS operation and Overheating due to poor Engineering: Install exhaust ventilation or forced-air cooling; consider temperature alarm
14 Safety Hazard ventilation
hospital-wide power loss, Minimal ventilation (ceiling fan) 3 4 Medium system
maintenance injury
 Falling objects causing foot Standard shelving in place but no mechanical lifting aid; no
Heavy items (e.g., motors) or head injury; back strain Engineering: Reconfigure shelving to keep heavy items below chest level; install lower or
15 Improperly stored heavy items Safety Hazard stored on upper shelves or hernia due to awkward
warning labels or weight indicators; manual handling from 3 3 Medium reinforced storage racks
manual lifting from height height
Electric shock, burns,
Safety Hazard and Testing equipment without PPE is inconsistently used and inappropriate in some cases (PPE) Require activated carbon mask or vapor-filtering respirator, not just N95; also, safety
16 Biomed equipment repair shield
respiratory irritation
(e.g., N95 mask used for soldering, instead of vapor-rated).
3 2 Medium glasses and anti-static gloves when needed
Health Hazard (solder fumes)

Office/Desk Tasks – Head, Poor seating, prolonged Back pain, posture issues, Movement between tasks reduces prolonged exposure; no
17 Health Hazard sitting musculoskeletal disorders ergonomic chairs
2 3 Low Administrative: Provide basic ergonomic chairs or seat support where feasible
Assistant

Safety & Health Inadequate lighting / Low Eye strain, possible trip Existing ceiling light insufficient. No additional lighting Engineering: Install adequate lighting in lobby area to meet standard illumination levels
18 Poor lighting in lobby area visibility hazard installed or planned.
3 2 Low (lux rating based on office/lobby setting)
Hazard

Minor trip hazard, delayed

Poor 5S in Office (paperwork
19 Safety Hazard Cluttered workspace document retrieval, fire No file organizers 3 2 Low (Engineering): Provide proper shelves, filing cabinets, label folders
piled up) load buildup

Hazard Ranking Matrix Hazard Probability and Severity Matrix

5
1 2 3 4 Severity
Probability / Major Damage Probability
Negligible or Minor Damage Minor Damage Major Damage Ranking To what degree can the impact affect the employees? How extensive is the impact? How long will the
Severity or Fatal and What is the probability that the impact will occur? Does it have a following control?
Near Miss or First Aid or Lost Time or Disability impact last?
Catastrophic

1 Improbable Negligible or Near Miss

1. There are engineering controls
Trivial Risk Trivial Risk Trivial Risk Low Risk Low Risk 1 2. There are signage/warnings and/or administrative control
1. Impact will not result in any injury or ill health effect.
Improbable 2. Impact will not result in any damage to property.
3. There is provision for appropriate PPEs.

Minor Damage or First Aid

2 Less Probable 1. Impact will cause minor injury requiring first aid.
1. There are engineering controls.
Trivial Risk Low Risk Low Risk Medium Risk Medium Risk 2 2. NO signage/warnings and/or administrative controls
2. Impact will cause temporary ill health discomfort (headache, dizziness, nausea, muscle
Less Probable pain, etc.)
3. NO provision for appropriate PPEs.
3. Impact will cause minor damage to property of the concerned section of the plant.

Minor Damage or Lost Time

3 Probable 1. Impact will cause minor injury resulting in lost time.
1. NO or inefficient/insufficient engineering controls.
Trivial Risk Low Risk Medium Risk High Risk High Risk 3 2. There are signage/warnings and/or administrative controls.
2. Impact will cause short-term ill health effects (fever, upper respiratory infection,
Probable allergies, diarrhea, sore eyes, etc.)
3. There is a provision for appropriate
3. Impact will cause minor damage to property of two or more sections of the plant.

Major Damage or Disability

4 Almost Certain 1. Impact will cause major injury resulting in permanent disability.
1. NO engineering controls.
Low Risk Medium Risk High Risk High Risk Extreme Risk 4 2. There are signage/warnings and/or administrative controls or there is provision for
2. Impact will cause long-term ill health effects (permanent hearing loss, cancer,
Almost Certain hypertension, etc.)
appropriate PPEs 3. Impact will cause major damage to the whole plant.

5 Certain Major Damage or Fatal and Catastrophic

1. NO engineering controls. 1. Impact will cause major injury or illness resulting in permanent disability.
Low Risk Medium Risk High Risk Extreme Risk Extreme Risk 5 2. NO signage/warnings and/or administrative controls. 2. Impact will cause major damage resulting in catastrophe.
Certain 3. NO PPEs. 3. Impact will cause major damage to the whole plant and neighboring communities.

Hierarchy of Controls

1. Elimination (Physically remove the Hazard), 2. Substitution (Replace the Hazard), 3. Engineering Controls (Isolate workers from Hazard), 4. Administrative Controls (Change the way work is performed), 5. PPE (Protect the worker with personal protective
equipment).