Occupational health and safety in agriculture: situation and priorities at the beginning of the third millennium

Agriculture is a human activity, which includes a number of different tasks and occupies a huge number of people worldwide. Estimates of World Bank for 2003 suggest that 51% of globalpopulation lives in rural areas. ILO estimates that 1.3 billion of workers are engaged in agriculture, and they represent almost a half of the total number of economically active subjects (2,838,897,404). In developed countries, agriculture workers are only a small fraction of the whole work force (up to 9% according to ILO data), while in developing countries, especially in Asia, agriculture workers represent up to the 60% of the total work force. Most agriculture workers reside in Asia, in the Pacific (74%) and in Africa (16%). ILO estimates suggest that half of fatal occupational injuries in the world are attributable to agriculture. This means that around 170,000 agriculture workers die every year as a consequence of occupational injuries. Using the same estimate, half of the fatal accidents could be linked to agricultural activities (more than 130 million). Comparing this estimate with the 6.328.217 people injured in war in 2002 or with the 20-50 million injured victims of road accidents, one has a much clearer picture about the importance of preventing agricultural injuries. In a complicated situation such as occupational health and safety problems in agriculture, it is not so easy to select priorities clearly. But "legalization" of agriculture workers could be a key to solving all the other problems. Actual data on fatal and non-fatal occupational injuries in agriculture show that occupational health and safety issues are among the top priorities for that discipline.     

Global,regional and national burden of disease attributable to 19 selected occupational risk factors for 183 countries, 2000–2016: A systematic analysis from the WHO/ILO Joint Estimates of the Work-related Burden of Disease and Injury

ObjectivesWe provide a brief introduction to the objectives, data, methods and results of the World Health Organization (WHO)/International Labor Organization (ILO) Joint Estimates of the Work-related Burden of Disease and Injury (WHO/ILO Joint Estimates), which estimated the burden attributable to 19 selected occupational risk factors.MethodsThe WHO/ILO Joint Estimates were produced within the global Comparative Risk Assessment framework, which attributes the burden of one specific health outcome (ie, disease/injury) to a specific occupational risk factor. For 39 established occupational risk factor-health outcome pairs, estimates are produced using population attributable fractions (PAF) from recent burden of disease estimates. For two additional pairs, PAF are calculated from new databases of exposure and risk ratios produced in WHO/ILO systematic reviews. Attributable disease burdens were estimated by applying the PAF to total disease burdens.ResultsGlobally in 2016, it is estimated that 1.88 [95% uncertainty range (UR) 1.84–1.92] million deaths and 89.72 (95% UR 88.61–90.83) million disability-adjusted life years were attributable to the 19 selected occupational risk factors and their health outcomes. A disproportionately large work-related burden of disease is observed in the WHO African Region (for disability-adjusted life years), South-East Asia Region, and Western Pacific Region (for deaths), males and older age groups.ConclusionsThe WHO/ILO Joint Estimates can be used for global monitoring of exposure to occupational risk factors and work-related burden of disease and to identify, plan, cost, implement and evaluate policies, programs and actions to prevent exposure to occupational risk factors and their associated burden.     

Global estimates of fatal work-related diseases

BACKGROUND: Work-related mortality is a relatively new concept which aims to widen occupational health and safety; to take into account not only recognized fatal occupational accidents and diseases but also other work-related deaths. Few countries in the world have a register for work-related diseases. METHODS: Estimates are calculated using baseline world mortality scenarios of all diseases for the year 2000 and attributable fractions made for work-related diseases in Finland, as adjusted. RESULTS: It is estimated that about 2 million work-related deaths take place annually. Men suffer two thirds of those deaths. The biggest groups of work-related diseases are cancers, circulatory diseases and communicable diseases. CONCLUSIONS: Information about work-related diseases is needed for prevention, as people in developed countries are working longer, and the age of retirement is being raised in many countries. As a result, workers are being exposed to different kinds of substances and working conditions for a longer time. In developing countries, work exposures may already start in infancy. Due to industrialization, workers in developing countries are facing new conditions with a lack of relevant knowledge and skills. With the help of information, nations can direct resources and skills for appropriate purposes such as regulatory measures on health and safety at work.     

The contribution of occupational risks to the global burden of disease: summary and next steps

BACKGROUND: The Comparative Risk Assessment (CRA) project of the World Health Organization (WHO) assessed worldwide mortality and morbidity in the year 2000 resulting from exposures to selected occupational hazards. This article summarizes findings of the WHO CRA project, presents the estimates of the International Labor Organization (ILO) for total deaths due to workplace risks, and calls for action. OBJECTIVES: Global burden estimates and counts of deaths assist ministers and other decision and policy makers to make informed decisions and to take action regarding risk reduction. METHODS: The WHO CRA methodology combined the proportions of the population exposed to five occupational hazards (excluding numerous risks due to inadequate global data) with relative risk measures to estimate attributable fractions of the selected health outcomes for both morbidity and mortality. ILO estimates of total numbers of global work-related injury deaths apply national fatality rates to employment data for the particular country; for disease deaths ILO uses an attributable risk approach. RESULTS: In 2000, the selected occupational risk factors were responsible worldwide for 37% of back pain, 16% of hearing loss, 13% of chronic obstructive pulmonary disease (COPD), 11% of asthma, 8% of injuries, 9% of lung cancer and 2% of leukemia, and about 100% of pneumoconioses and mesothelioma. These selected risks at work resulted in the loss of about 24 million years of healthy life and caused 850,000 deaths worldwide, about 40% of the ILO estimate of 2.2 million total deaths. CONCLUSIONS: These global and regional analyses have identified areas where specific preventive actions are required.     

Farmers' occupational health care--worldwide

This review will summarize the current state of preventive health care systems for farmers in the world. It is obvious that well-organized occupational health care systems for farmers occur sporadically in only a few countries, and generally are in the initial stages of development. Large cooperative farms and plantations may have industrialized occupational health care. In some countries in Europe, e.g., France and Austria, farmers' organizations may include a certain amount of health and safety activity within their social insurance systems for farmers. Moreso than in other places, the Scandinavian countries have tried different approaches to provide comprehensive health services among farmers. Regardless of the kind of system, it is obvious from experiences worldwide that agriculture is a risky occupation and farmers are exposed to numerous hazards which may result in injuries, work-related diseases, and death. It is promising to note an increased interest in this situation from many parts of the world.     

The social consequences of occupational injuries and illnesses

BACKGROUND: Most outcome studies of occupational injuries and illnesses have tended to focus on direct economic costs and duration of work disability. Rarely have the broader social consequences of work-related disorders or their impacts on injured workers' families, coworkers, and community been investigated. This paper examines a wide range of social consequences including workers' psychological and behavioral responses, vocational function, and family and community relationships. METHODS: Literature review and development of conceptual framework. RESULTS: Complex and multifactorial relationships are described whereby occupational injuries and illnesses produce a variety of social consequences involving filing and administration of workers' compensation insurance claims, medical care experiences, domestic function and activities of daily living, psychological and behavioral responses, stress, vocational function, rehabilitation and return to work, and equity and social justice. CONCLUSION: A research agenda is proposed for guiding future investigations in this field.     

The impact of work on morbidity-related early retirement

Aim The purpose of this study was to assess the influence of occupations and job exposures on morbidity-related early retirement in Germany by estimation of work-related relative and attributable risks. Subjects and methods Occupational histories of 28,000 persons, who were granted a disability pension in 1999, and of some 260,000 employed persons serving as controls were recorded. After developing suitable methods to map occupational histories to exposures odds ratios and attributable risks of early retirement were calculated in a case-control study. The direct costs of early retirement, taken as the utilization of medical resources, were calculated from statistics of the German Health Insurance System. The indirect costs were calculated by estimating the loss of productivity resulting from early retirement. The total of the direct and indirect costs multiplied with the population attributable risk yields the desired work-related costs of early retirement. Results In Germany the work-related costs of early retirement are estimated as at least 10.3 billion Euros annually, including 1.2 billion Euros direct costs. The most important exposures are heavy work (lifting) and low job control. It is estimated that a moderate increase in job control could save up to 2 billion Euros annually. The strongest associations to disability pensioning could be seen for occupations in nursing and mining. Conclusion This study shows a considerable impact of work on early retirement. This impact is seen with respect to increased risks for a number of occupations and workload factors. The results point to the importance of work-site health promotion and prevention as there seems to be a considerable potential not only for reducing the individual burden of early retirement, but also for high economic savings.     

Early retirement due to occupational injury: Who is at risk?

BACKGROUND: As the workforce is rapidly ageing, research on the consequences of occupational injuries in older workers is becoming more important. One adverse outcome unique to older workers, early retirement, has significant negative social and economic consequences for workers and employers. Although linked to poor worker health, the roles of workplace factors and occupational injury have not been well-defined. METHOD: Changes in retirement plans attributed to an occupational injury were studied in a population-based sample of 1,449 New Hampshire workers aged 相似文献   

International Code of Conduct (Ethics) for Occupational Health and Safety Professionals

Abstract

This communication summarizes the available data on work-related determinants of health in Central America. The Central American working population is young and moving from agriculture toward industry and services. Ethnicity, gender, migration, subemployment and precarious work, informality, rural conditions, low-level educational, poverty, ubiquitous worksite health hazards, insufficient occupational health services, low labor inspection density, and weak unions define the constellation of social determinants of workers' health in Central America. Data are, however, scanty both for hazards and work-related illnesses and injuries. Governments and industries have the responsibility of opening decent work opportunities, especially for those facing multiple inequalities in social determinants of health. A first step would be the ratification and implementation of the ILO Convention (187) on occupational safety and health by the seven national governments of the region.     

Social determinants of workers' health in Central America

This communication summarizes the available data on work-related determinants of health in Central America. The Central American working population is young and moving from agriculture toward industry and services. Ethnicity, gender, migration, subemployment and precarious work, informality, rural conditions, low-level educational, poverty, ubiquitous worksite health hazards, insufficient occupational health services, low labor inspection density, and weak unions define the constellation of social determinants of workers' health in Central America. Data are, however, scanty both for hazards and work-related illnesses and injuries. Governments and industries have the responsibility of opening decent work opportunities, especially for those facing multiple inequalities in social determinants of health. A first step would be the ratification and implementation of the ILO Convention (187) on occupational safety and health by the seven national governments of the region.     

Evaluation of the burden of logging injuries using West Virginia workers' compensation claims data from 1996 to 2001

BACKGROUND: The risks associated with logging are well documented, however little work has been done on estimating the economic impact of injuries among loggers. METHODS: West Virginia Workers' Compensation claims data for the period 1996-2001 was used to assess the economic burden of logging injuries in the state. RESULTS: There were 1,371 claimants during this period with the highest number of claims (39%) in the 25-34 years age category. The total cost of injuries was over US dollars 14 million. The most severe injuries, traumatic brain injuries (TBI), thoracic, cervical, and lumbar, resulted in the highest medical costs, indemnity costs and permanent disability. The average medical cost for logging-related to TBI was US dollars 198,048 compared to US dollars 15,321 for other major industries. CONCLUSIONS: The magnitude of the economic costs underscores the need for active research of injury prevention among loggers and for greater attention to occupational safety and health programs.     

International agency efforts to protect workers and the environment

Every year 335,000 workers die in occupational accidents and altogether 1.1 million fatalities are caused by work-related factors. Some 250 million nonfatal accidents causing absence from work are aggravated by permanent disabilities, reduced capacity of life and work, and economic losses amounting to 4% of gross national product. The role of the International Labour Office (ILO) in promoting social justice is based on ethical principles and demonstrated by the ILO's standard-setting work, information exchange, and proposed Global Program on Occupational Safety, Health and the Environment, Ethical and policy dimensions of the ILO's practices are targeted to a participatory process aimed at better legislation and enforcement, as well as trained and well-informed specialists to modify work environments and cultures to eliminate or reduce the problems and suffering. The ILO's key present and new activities and outputs, such as the new 4th edition of the Encyclopedia on Occupational Health and Safety, are described. A better system of collaboration and networking in occupational safety and health is still needed.     

Summary of "Proposed national strategies for the prevention of leading work-related diseases and injuries, Part 1"

Strategies for the prevention of leading occupational health problems have been proposed by the National Institute for Occupational Safety and Health (NIOSH). NIOSH prepared these strategies following publication in 1983 of its suggested list of ten leading work-related diseases and injuries. At a national symposium in 1985, occupational health experts from academia, organized labor, management, professional associations, and voluntary organizations conducted an in-depth evaluation of the prevention strategies for the first five conditions on the list: occupational lung diseases, musculoskeletal injuries, occupational cancers, severe occupational traumatic injuries, and occupational cardiovascular diseases. The strategies were then revised to incorporate improvements suggested at the symposium and were published in booklet form. A summary of the revised strategies is provided.     

The ratification status of ILO conventions related to occupational safety and health and its relationship with reported occupational fatality rates

The aim of this study was to assess the relationship between the ratification status of occupational safety and health (OSH)-related ILO conventions and reported occupational fatality rates of ILO member countries, while controlling for possible confounding factors. ILO member states were divided into 4 levels of income status, based on the gross national income per capita. Seventeen conventions designated as OSH-related were examined. Reported country occupational fatality rates were compared according to the ratification status of these 17 conventions and multiple regression analyses were conducted to assess the relationship between the fatality rates, ratification status, income level and length of ILO membership. Fatality rates were inversely and significantly related to income levels. In general, non-ratifying countries had higher work-related fatality rates than ratifying countries. A statistical model for identifying predictors of fatal injury rates showed that a larger number of conventions ratified was significantly associated with lower fatality rates. The fact that non-ratifying countries generally have higher fatality rates than ratifying ones supports the notion that all countries should promote ratification of ILO conventions aimed at improving OSH conditions.     

Economic evaluation of interventions to reduce road traffic injuries--a review of the literature with applications to low and middle-income countries

Road Traffic Injuries (RTIs) kill over one million people worldwide annually. This article takes the perspective of economic costs and benefits to review the impact of available road safety interventions in industrialized countries--and the potential effect of these interventions in low and middle-income countries, where RTIs pose an increasingly large public health problem. A comprehensive review of the literature on cost-benefits and cost-effectiveness studies related to road traffic injuries internationally, with comparisons of costs adjusted for inflation and exchange differentials was conducted. In the United States (U.S.), motor vehicle inspection laws resulted in annual savings of US $1.7 to $2.3 billion. The installation of seatbelts results in net savings of $162 per vehicle; with benefits outweighing costs by a factor ranging from 240 to 1727. Other cost effective interventions include mandatory seatbelt use, lowering speed limits, motorcycle helmet laws, and traffic calming devices such as speed bumps and road deviations. The dearth of similar economic evaluations of interventions for road traffic injuries in low and middle-income countries represents a serious research gap and hinders the implementation of effective strategies in those countries.     

International occupational health

Working conditions for the majority of the world's workers do not meet the minimum standards and guidelines set by international agencies. Occupational health and safety laws cover only about 10 percent of the population in developing countries, omitting many major hazardous industries and occupations. With rare exception, most countries defer to the United Nations the responsibility for international occupational health. The UN's international agencies have had limited success in bringing occupational health to the industrializing countries. The International Labor Organization (ILO) conventions are intended to guide all countries in the promotion of workplace safety and in managing occupational health and safety programs. ILO conventions and recommendations on occupational safety and health are international agreements that have legal force only if they are ratified by ILO member states. The most important ILO Convention on Occupational Safety and Health has been ratified by only 37 of the 175 ILO member states. Only 23 countries have ratified the ILO Employment Injury Benefits Convention that lists occupational diseases for which compensation should be paid. The World Health Organization (WHO) is responsible for the technical aspects of occupational health and safety, the promotion of medical services and hygienic standards. Limited WHO and ILO funding severely impedes the development of international occupational health. The U.S. reliance on international agencies to promote health and safety in the industrializing countries is not nearly adequate. This is particularly true if occupational health continues to be regarded primarily as an academic exercise by the developed countries, and a budgetary triviality by the international agencies. Occupational health is not a goal achievable in isolation. It should be part of a major institutional development that touches and reforms every level of government in an industrializing country. Occupational health and safety should be brought to industrializing countries by a comprehensive consultative program sponsored by the United States and other countries that are willing to share the burden. Occupational health and safety program development is tied to the economic success of the industrializing country and its industries. Only after the development of a successful legal and economic system in an industrializing country is it possible to incorporate a successful program of occupational health and safety.     

Work-related reproductive,musculoskeletal and mental disorders among working women--history,current issues and future research directions

According to the recent changes of working environments and socio-economical conditions, the proportion of working women are increasing in Japan. Characteristics of occupational workload and stress of Japanese working women are consistent with those in many industrialized countries except man-dominant culture. In this review we describe the history, current issues, and future research directions on occupational health of working women, especially focused on reproductive health, work-related musculo-skeletal disorders (WMSDs), and mental disorders. In the reproductive health survey, traditionally main concern was about pregnancy outcomes, then fecundity studies, such as time to pregnancy, became topics recently. Future research will be shifted to outcomes not only during pregnancy but also disorders of hormonal balance and climacterium or health conditions after menopause. WMSDs are reviewed on mainly gender difference and its causative factors. Historically, mental health of working women in Japan has focused on the job stress of nurses. We compare results with a lot of recent researches in Europe and U.S.A., where interaction between occupational stress and family roles were studied. It is not easy to predict the prospective status of female workers in Japan, but social, workplace and familial supports will enhance their health promotion.     

Globalization and occupational health: a perspective from southern Africa

Increased world trade has generally benefited industrialized or strong economies and marginalized those that are weak. This paper examines the impact of globalization on employment trends and occupational health, drawing on examples from southern Africa. While the share of world trade to the world's poorest countries has decreased, workers in these countries increasingly find themselves in insecure, poor-quality jobs, sometimes involving technologies which are obsolete or banned in industrialized countries. The occupational illness which results is generally less visible and not adequately recognized as a problem in low-income countries. Those outside the workplace can also be affected through, for example, work-related environmental pollution and poor living conditions. In order to reduce the adverse effects of global trade reforms on occupational health, stronger social protection measures must be built into production and trade activities, including improved recognition, prevention, and management of work-related ill-health. Furthermore, the success of production and trade systems should be judged on how well they satisfy both economic growth and population health.     

The impact of systematic occupational health and safety management for occupational disorders and long-term work attendance

Despite several years of conducting formalized systematic occupational health and safety management (SOHSM), as required by law in Sweden and most other industrialized countries, there is still little evidence on how SOHSM should be approached to have an impact on employees' health. The aim of this study was to investigate the importance of SOHSM, considering structured routines and participation processes, for the incidence of occupational disorders and the prevalence of long-term work attendance among home care workers (HCWs). Municipal human service organizations were compared concerning (a) their structured routines and participation processes for SOHSM and (b) employee health, i.e. the municipal five-year incidence of occupational disorders and prevalence of work attendance among HCWs. National register-based data from the whole population of HCWs (n=154 773) were linked to register-data of occupational disorders and prevalence of long-term work attendance. The top managers and safety representatives in selected high- and low-incidence organizations (n=60) answered a questionnaire about structure and participation process of SOHSM. The results showed that prevalence of long-term work attendance was higher where structure and routines for SOHSM (policy, goals and plans for action) were well organized. Highly structured SOHSM and human resource management were also related to high organizational incidence of reported occupational disorders. Allocated budget and routines related to HCWs' influence in decisions concerning performance of care were also related to long-term work attendance. The participation processes had a weak effect on occupational disorders and work attendance among HCWs. Reporting occupational disorders may be a functional tool to stimulate the development of effective SOHSM, to improve the work environment and sustainable work ability.     

Cost of work-related injuries in insured workplaces in Lebanon

OBJECTIVE: To estimate the medical and compensation costs of work-related injuries in insured workplaces in Lebanon and to examine cost distributions by worker and injury characteristics. METHODS: A total of 3748 claims for work injuries processed in 1998 by five major insurance companies in Lebanon were reviewed. Medical costs (related to emergency room fees, physician consultations, tests, and medications) and wage and indemnity compensation costs were identified from the claims. FINDINGS: The median cost per injury was US dollars 83 (mean, US dollars 198; range, US dollars 0-16,401). The overall cost for all 3748 injuries was US dollars 742,100 (76% of this was medical costs). Extrapolated to all injuries within insured workplaces, the overall cost was US dollars 4.5 million a year; this increased to US dollars 10 million-13 million when human value cost (pain and suffering) was accounted for. Fatal injuries (three, 0.1%) and those that caused permanent disabilities (nine, 0.2%) accounted for 10.4% of the overall costs and hospitalized injuries (245, 6.5%) for 45%. Cost per injury was highest among older workers and for injuries that involved falls and vehicle incidents. Medical, but not compensation, costs were higher among female workers. CONCLUSION: The computed costs of work injuries--a fraction of the real burden of occupational injuries in Lebanon--represent a considerable economic loss. This calls for a national policy to prevent work injuries, with a focus on preventing the most serious injuries. Options for intervention and research are discussed.