Activities and ways of organizing better occupational health and safety in small workplaces: special focus on information

Information is needed in all activities aiming at the development and improvement of working conditions. The information and communication technology has made it possible to have information available 24 h a day, 360 d a year. The administrative structures in various countries also call for more information steering at the workplace level. This means that more web-based and other materials for small enterprises are needed in all countries in order to improve safety and health of the workers. Four different approaches to improve workplace level activities are described here to provide models for others to modify them to their local conditions. The networking of small workplaces supports the development of their safety and thereby also their productivity and possibilities to offer jobs also in the future.     

Advances in participatory occupational health aimed at good practices in small enterprises and the informal sector

Participatory programmes for occupational risk reduction are gaining importance particularly in small workplaces in both industrially developing and developed countries. To discuss the types of effective support, participatory steps commonly seen in our "work improvement-Asia" network are reviewed. The review covered training programmes for small enterprises, farmers, home workers and trade union members. Participatory steps commonly focusing on low-cost good practices locally achieved have led to concrete improvements in multiple technical areas including materials handling, workstation ergonomics, physical environment and work organization. These steps take advantage of positive features of small workplaces in two distinct ways. First, local key persons are ready to accept local good practices conveyed through personal, informal approaches. Second, workers and farmers are capable of understanding technical problems affecting routine work and taking flexible actions leading to solving them. This process is facilitated by the use of locally adjusted training tools such as local good examples, action checklists and group work methods. It is suggested that participatory occupational health programmes can work in small workplaces when they utilize low-cost good practices in a flexible manner. Networking of these positive experiences is essential.     

徐州铁路职业危害工作场所从业人员健康教育效果评价

目的为了解决职业危害因素对作业场所人员健康问题,预防职业病的发生,开展职业危害工作场所健康教育,更好提高职业人群健康水平。方法徐州地区站段（含分段）所有接触职业病危害因素作业场所接触人员进行健康教育,用F、t检验分析,对开展职业危害工作场所健康教育前、后职业卫生数据进行比较分析,并评价其教育效果。结果职业危害工作场所从业人员健康教育前后效果有统计学意义（t=332,P〈0.01）,取得了明显效果,（1）不同性别从业人员教育前、后分值男职工始终高于女职工（P〈0.01）;（2）健康教育后不同层次学历职工健康教育分值均显著高于健康教育前（P〈0.01）,且本科学历层次最高;（3）不同工龄从业人员在经过教育后分值情况均显著高于健康教育前（P〈0.01）,且工龄越长越高;（4）不同婚姻状况的从业人员健康教育前后分值均有统计学意义（P〈0.01）,且已婚从业人员健康教育效果最高。结论开展职业危害工作场所从业人员健康教育,提高职业危害工作场所从业人员的健康水平是十分必要的。     

Approaches to addressing occupational and environmental health needs in Mexico.

The University of California, Los Angeles, has somewhat shifted the focus of its Fogarty program, taking a four-pronged approach: conducting high-level collaborative scientific research with Mexican faculty and trainees at the most advanced institutions in the country; providing training and collaborative research opportunities to faculty/students at other institutions in Mexico (primarily through training faculty who do not hold doctoral degrees); providing environmental and occupational health training to the professional community throughout Mexico; and developing short courses on special topics that provide means for greater research collaboration and skill building. The program is also working with existing institutions to develop academic programs that will enlarge the environmental and occupational health infrastructures in Mexico and Latin America.     

美国作业场所职业安全健康体系综述与启示

为了深入分析研究美国作业场所职业安全健康体系, 选取美国职业安全健康法律法规和政府监察体系, 从政府管理的角度对其发展现状和特点进行归纳总结。研究发现:美国作业场所职业安全健康法律法规具有覆盖面广、科学性强和操作方便等特点; 作业场所职业安全健康监察具有决策科学、重点突出和自由裁量等特点。结合我国安全生产和职业健康发展现状与趋势, 提出应从加快职业安全健康法制建设、完善职业安全健康多方参与机制和强化职业安全健康监察执法建设等三个方面, 进一步推进我国职业安全健康体系的发展和进步。     

Approaches to sharing occupational safety and health information on a global scale

BACKGROUND: The global burden of occupational morbidity and mortality is staggering. Information sharing has been identified as a major way of reducing this burden. Past and current approaches to such sharing and application are worth examining in order to guide future efforts. METHODS: Recent literature from international agencies and others was examined to identify examples of information sharing and to determine the status of such sharing and related issues. Literature was included from the areas of surveillance, priority setting, research, dissemination, and risk management. RESULTS: Examples of global information sharing were identified and lessons were drawn from the issues attendant to them. CONCLUSIONS: Results indicate that a broad range of efforts actively promote the global distribution of occupational safety and health information. To advance global approaches to the sharing of occupational and safety and health information, it is critical to improve the opportunity and capacity to access information. Important objectives in achieving this goal are developing coherent and transparent information policies, conducting research on dissemination, adaptation, and utilization of information, and overcoming barriers to information and training.     

参与式培训对洁净车间劳动者职业健康的促进作用

目的 分析对洁净车间劳动者进行参与式培训的成效.方法 对深圳市某区8家企业246名洁净车间的劳动者进行参与式培训,并在培训前后分别进行问卷调查,比较培训前后的知信行情况.结果 参与式培训后,劳动者对6条职业病防治相关知识的知晓率均高于培训前(P＜0.05).劳动者培训后对职业病可以预防、佩戴防护用品不舒服但应该坚持、正确佩戴防护用品可以预防职业病、应该配合企业开展职业病防治工作等四点持相信态度高于培训前(P＜0.05).劳动者培训后主动了解职业病防治知识、主动佩戴防护用品、关注自己岗位职业病危害因素和出现手脚麻木要求进行职业病诊断的人数均高于培训前(P＜0.05).结论 参与式培训能够提高劳动者对职业病防治知识的了解程度,增强劳动者职业病危害防护意识,使其更主动地采取职业病防治措施,降低职业中毒风险.     

参与式培训在珠宝加工企业健康教育中应用效果分析

目的 探讨适合珠宝加工企业的健康教育方式。 方法 实验组采用多媒体授课、小组讨论、个人防护用品使用练习等参与式培训方式对100名工人进行培训;传统组采用传统的授课方式对另100名工人进行相同内容的培训。在培训前后对两组进行测验,对得分进行汇总、分析。 结果 两组员工培训后绝大部分得分有所提高。实验组工人培训前得分总分为(41.29 ±8.59)分,培训后得分总分为(81.06 ±11.78)分,两者比较,差异有统计学意义(t=10.11,P < 0.05)。传统组培训前得分为(53.68 ±10.58)分,培训后得分为(61.37 ±15.39)分,两者比较,差异无统计学意义(t=1.39,P > 0.05)。实验组不同学历、工龄、技术职称的员工得分在培训前后比较,差异均有统计学意义(P < 0.05)。传统组小学及以下人员、工龄小于15个月人员和初级工在培训后得分有提高,但与培训前相比,差异无统计学意义(P > 0.05)。 结论 参与式培训在珠宝加工企业健康教育中效果明显,可以很好地提高工人的职业健康安全知识水平。     

Development of multi-dimensional action checklist for promoting new approaches in participatory occupational safety and health in small and medium-sized enterprises

To meet diversified health needs in workplaces, especially in developed countries, occupational safety and health (OSH) activities should be extended. The objective of this study is to develop a new multi-dimensional action checklist that can support employers and workers in understanding a wide range of OSH activities and to promote participation in OSH in small and medium-sized enterprises (SMEs). The general structure of and specific items in the new action checklist were discussed in a focus group meeting with OSH specialists based upon the results of a literature review and our previous interviews with company employers and workers. To assure practicality and validity, several sessions were held to elicit the opinions of company members and, as a result, modifications were made. The new multi-dimensional action checklist was finally formulated consisting of 6 core areas, 9 technical areas, and 61 essential items. Each item was linked to a suitable section in the information guidebook that we developed concomitantly with the action checklist. Combined usage of the action checklist with the information guidebook would provide easily comprehended information and practical support. Intervention studies using this newly developed action checklist will clarify the effectiveness of the new approach to OSH in SMEs.     

瑞安市企业作业场所有害因素监测结果分析

目的:了解瑞安市各企业作业场所现状。方法:对该市230家重点企业作业场所有害因素粉尘、苯系物、铜、铬、噪声等进行监测。结果:作业场所噪声的合格率最低,为66.1%,其次是苯和电焊烟尘,合格率分别为71.8%和73.5%。不同类型的作业场所的苯合格率差异有显著性(χ2=95.06,P<0.005)。结论:瑞安市的职业病危害因素以噪声和苯为主,应加强监督执法力度,对不合格的重点企业及其作业场所进行重点整治,重点监管,切实保护劳动者身体健康。     

Establishing health systems financing research priorities in developing countries using a participatory methodology

Donor funding for health systems financing (HSF) research is inadequate and often poorly aligned with national priorities. This study aimed to generate consensus about a core set of research issues that urgently require attention in order to facilitate policy development. There were three key inputs into the priority setting process: key-informant interviews with health policy makers, researchers, community and civil society representatives across twenty-four low- and middle-income countries in four regions; an overview of relevant reviews to identify research completed to date; and inputs from 12 key informants (largely researchers) at a consultative workshop.     

2个工作场所职业紧张干预效果研究

目的 探讨工作场所职业紧张的干预方法,评估工作环境与职业紧张管理训练(SMT)对改变紧张特征以及心理健康问题的效果.方法 采用准实验设计方法,选取上海某企业和研究所作为干预现场.干预前、后分别进行基线调查和效果评估调查,调查内容包括社会人口特征因素、职业紧张认知、职业紧张状况评估、抑郁、焦虑、工作耗竭以及工作满意度、工作效能感、血压以及肌肉骨骼症状等.干预方法为环境组织改变和SMT的认知行为训练和放松技术训练,采取每次90 min,共3次的培训课程.结果 SMT干预可改善工作要求、工作控制、同事支持,提高职业紧张认知水平、工作满意度和自我效能感,改善焦虑、躯体化症状评分.而环境组织改变结合SMT干预除能取得SMT干预效果之外,还改善工作回报、领导支持和内在驱动,改善工作耗竭症状评分.观察期内2种干预方法均未发现对血压和肌肉骨骼症状产生影响.结论 SMT对提高工作紧张相关应对知识、改善职业紧张特征和心理症状有一定效果,结合工作环境改变的干预效果更为明显.     

Present condition of health information control and attitudes of occupational health professionals in collecting and utilizing health information in workplaces]

Since the Labor Safety and Health Law of Japan provides that the employer is responsible for taking custody of personal information obtained in periodic health examinations, we are anxious about infringement of privacy. This study was conducted to investigate the present condition of health information control in each workplace and attitudes of occupational health professionals in collecting and utilizing personal health information by means of self-administered mail questionnaires. The numbers of respondents were a total of 549 (physicians: 237, public health nurses: 175, nurses 122, others & unknown: 15). The major results were as follows. 1. Percentage of workplaces in which only health professionals can know personal health data from periodic health examinations was 24% altogether, but it was 39% in large workplaces where full-time occupational physicians were working. 2. More than half of the respondents were of the opinion that the results of routine health activities could be presented in academic conferences unconditionally or under comprehensive approval of the representative of each workplace. 3. About a half of the respondents believed that it was necessary to consider the intention of each examinee in utilizing blood specimen collected at health examinations for research purposes, even though personal identification had been erased. 4. There were many differences among types of occupation or age groups in the attitude to changing the procedure for health examination. And it was the majority opinion that personal health data provided to the employer should be the minimum in order to protect individual benefits. 5. The proportion of physicians who felt it necessity to ask about the occupational history at the employment health examination was significantly higher than that of public health nurses. 6. When a disease was discovered, there were great differences among types of disease in the attitude to give the name or condition of the disease to the employer without the consent of the patient or his family. In view of these results, we feel that occupational health professionals are in a dilemma in introducing modern ideas which lay stress on privacy into the Japanese occupational health care system which is still operating on the basis of traditional paternalism.     

Development and process evaluation of the participatory and action-oriented empowerment model facilitated by occupational health nurses for workplace health promotion in small and medium-sized enterprises

The objective of this study is to develop an available empowerment model for workplace health promotion (WHP) in small and medium-sized enterprises (SMEs) and to evaluate its applicability and feasibility. Semi-structured interviews with employers and workers in SMEs were conducted to assess their actual requirements for support. The structure of our new empowerment model was discussed and established through several rounds of focus group meetings with occupational safety and health researchers and practitioners on the basis of results of our interviews. We developed a new participatory and action-oriented empowerment model based on needs for support of employers and workers in SMEs. This new model consists of three originally developed tools: an action checklist, an information guidebook, and a book of good practices. As the facilitators, occupational health nurses (OHNs) from health insurance associations were trained to empower employers and workers using these tools. Approximately 80 SMEs (with less than 300 employees) were invited to participate in the model project. With these tools and continued empowerment by OHNs, employers and workers were able to smoothly work on WHP. This newly developed participatory and action-oriented empowerment model that was facilitated by trained OHNs appears to be both applicable and feasible for WHP in SMEs in Japan.     

乡镇工业职业卫生服务试点研究

目的 本文实践表明,要搞好乡镇工业职业卫生服务工作,应重视职业卫生在政策环境与工作环境建设,形成职业卫生工作氛围,以企业实施劳动卫生许可证,职工健康证与职业卫生制度,医疗卫生保健制度以及作业场所岗位安全卫生操作规范的管理,是实现职业卫生服务规范化管理的有效方法,把职业卫生健康教育纳入政府创建卫生城市规划,是提高企业文明素质,增强职业卫生与法律意识的有效途径,对职业危害污染源的控制,应采取行政干预手     

Leaving it up to the workers: sociological perspective on the management of health and safety in small workplaces.

Small workplaces present particular challenges for the promotion of occupational health and safety. However, little is known about the social organization of work in such settings and how it relates to matters of health and safety. The research on which this article is based relates patterns of occupational health behavior to the nature of social relationships within the workplace. From a qualitative analysis of interviews with 53 small business owners, the author describes the most common approach to managing workplace health and safety: leaving it up to the workers. This posture is explained in terms of the owners' perception of risk, particularly their understanding of workplace hazards, and their assessment of the social costs of ignoring or addressing such issues. Owners tended to discount or normalize health hazards, and to believe that management intervention in employee health behavior was paternalistic and inconsistent with prevailing patterns of labor relations and norms respecting individual autonomy. Many owners understood health and safety not as a bureaucratic function of management but as a personal moral enterprise in which they did not have legitimate authority. The conceptualization of the owners' responses in terms of "social rationality" has implications for addressing problems of health and safety in small workplaces.     

Comparing working conditions and physical and psychological health complaints in four occupational groups working in female-dominated workplaces

Background  

Dominant theories of working conditions and their effects on poor employee health have been criticized for failing to consider how psychosocial factors interact and how such relationships may differ across occupational groups.