Occupational Health in Yugoslavia

Abstract

Occupational health in Yugoslavia was once well organized in accordance with WHO declarations and ILO conventions and recommendations. Since the 1990s, the system has been disrupted by destruction of the former Yugoslavia, wars, refugees, changes in the economy, and NATO bombardment. Economic trends, main industries, and employment and unemployment conditions in Yugoslavia are presented. The organization of occupational health services, their tasks, and prevailing problems are discussed. Occupational diseases and relevant research and educational opportunities are described. The authors conclude by suggesting approaches to improving worker's health in the future.     

Occupational medicine in European countries and in Yugoslavia

A recent publication on occupational health services in European countries prepared by the World Health Organization is reviewed. On the basis of guidance by the international organizations, the overall objectives of occupational health services are embodied in principles which are implemented in various ways in the practical activities undertaken in each country. The functions of occupational health services, organizational models, coverage, personnel, support systems (industrial hygiene, ergonomics, psychology, clinical occupational medicine) as well as research, training and funding are discussed. Comparison is made with the actual situation and development of occupational health service in Croatia with special reference to the conclusions drawn at a round table discussion organized by the Association of Occupational Health of the Croatian Medical Society in Pazin, in April 1991.     

A review on occupational health in Yugoslavia

A review on occupational health service and activities in Yugoslavia is presented. Information on relevant legislation, organization of occupational health and worker's health care, financing, practices of occupational health units, education concerning graduate and postgraduate studies and continuous education in this field are given. Workers' morbidity pattern is also briefly discussed as well as research activities. Concluding remarks include observations on foreseeable needs and developmental orientation in occupational health in the country.     

Occupational health in health care workers

Since the second half of the 20th century occupational health in health care workers is a well-established part of occupational medicine. Identification of environmental, biological, chemical, physical, and psychosocial hazards has lead to a number of preventive measures: Technical (e.g. use of safe instruments and double gloving as protection) and immunological (vaccinations) measures against biological hazards), and technical (lifting aides) and personal (back-schools) intervention to prevent musculoskeletal disorders are well-designed examples.     

Occupational health in Australia

Australia is a developed country in the Asia-Pacific Region with a large land area but a small population. Its main economic activities are mining, agriculture and manufacturing, with its service and high-technology industries being the fastest growing sectors in recent years. The regulation and enforcement of Occupational Health and Safety policies are mainly administered by the Industrial Relations Departments of eight State and Territory jurisdictions in the country. A National Occupational Health and Safety Commission coordinates occupational health and safety at the Commonwealth level. In 1987 the six occupational health and safety priorities in Australia were listed as occupational back pain, management of chemicals used at work, occupational noise-induced hearing loss, occupational skin disorders, occupational cancer and mechanical equipment injury. Australia has probably the highest incidence of malignant mesothelioma in the world, although the use of asbestos has been largely phased out. There was an almost explosive “epidemic” of repetition strain injury in the 1980s. Approximately 500 work-related fatalities and 10,000 work-related injuries are notified for workers' compensation every year. In addition, it is estimated that there are several thousand cases of work-related diseases every year, many of which go unreported. Occupational physicians undergo 4 years of specialisation training. Occupational hygienists, nurses and ergonomists receive training supervised by their respective professional organisations. Received: 2 March 1998 / Accepted: 10 March 1998     

Occupational health in China

China has been experiencing rapid industrialization and economic growth, resulting in a transformed industrial structure and expansion of the labor force. Occupational health and safety services, nonexistent before 1949, have made remarkable advances over the past decades. However, these services face greater challenges, consisting of both traditional and new occupational health problems. Poorly regulated work environments often lacking health services in recently developed and thriving small-scale industries and joint venture enterprises have created increasing risks for occupational diseases and work-related injuries. A special strategy based on cooperation among and contributions from the legal, administrative, social, economic, and scientific communities is critical to achieving the ultimate goal of control and prevention of these occupational health problems.     

Occupational health in Argentina

Argentina is within the denominated “new industrialised countries”, with the characteristic of having high contrasts in the urban population, based on service and industry, and in the rural population, based on agriculture and cattle, still the main sources of wealth in the country. The process of globalisation and the need to compete hard in international markets have provoked high unemployment and the transfer of workers from a formal market to an informal one. Legislation on occupational health is old and it is in the process of being updated. The system of prevention, assistance and compensation for accidents at work and for occupational illnesses has changed from being optative for employers, to the compulsory hiring of private insurance companies. The Government keeps the role of supervisor of the system. There are enough professionals in occupational health, hygiene and safety but not occupational nurses. The teaching is given by many universities and professional associations, some of which have an active profile in the occupational health of the country. Received: 18 February 2000 / Accepted: 22 February 2000     

Occupational health in Brazil

Brazil is a recently industrialised country with marked contrasts in social and economic development. The availability of public/private services in its different regions also varies. Health indicators follow these trends. Occupational health is a vast new field, as in other developing countries. Occupational medicine is a required subject in graduation courses for physicians. Specialisation courses for university graduated professionals have more than 700 hours of lectures and train occupational health physicians, safety engineers and nursing staff. At the technical level, there are courses with up to 1300 hours for the training of safety inspectors. Until 1986 about 19 000 occupational health physicians, 18 000 safety engineers and 51 000 safety inspectors had been officially registered. Although in its infancy, postgraduation has attracted professionals at university level, through residence programmes as well as masters and doctors degrees, whereby at least a hundred good-quality research studies have been produced so far. Occupational health activities are controlled by law. Undertakings with higher risks and larger number of employees are required to hire specialised technical staff. In 1995 the Ministry of Labour demanded programmes of medical control of occupational health (PCMSO) for every worker as well as a programme of prevention of environmental hazards (PPRA). This was considered as a positive measure for the improvement of working conditions and health at work. Physicians specialising in occupational medicine are the professionals more often hired by the enterprises. Reference centres (CRSTs) for workers' health are connected to the State or City Health Secretariat primary health care units. They exist in more populated areas and are accepted by workers as the best way to accomplish the diagnosis of occupational diseases. There is important participation by the trade unions in the management of these reference centres. For 30 years now employers organisations have also kept specialised services for safety and occupational health. Although they are better equipped they are less well used by the workers than the CRSTs. At the federal level, activities concerned with occupational health are connected to three ministries: Labour, Health and Social Security. The Ministry of Labour enacts legislation on hygiene, safety and occupational medicine, performs inspections through its regional units and runs a number of research projects. The Ministry of Health provides medical care for workers injured or affected by occupational diseases and also has surveillance programmes for certain occupational diseases. The Ministry of Social Security provides rehabilitation and compensation for registered workers. In spite of a decrease in the number of accidents at work during the past 25 years, working conditions have not improved. Changes in the laws of social security in the 1970s discouraged registration and reporting of occupational injuries and diseases. In consequence death rates due to accidents increased. With the implementation of the CRSTs, the recorded incidence of occupational diseases has risen, not only because of improved diagnosis, but also because of stronger pressure from the unions and better organisation of public services and enterprises. Received: 24 February 1997 / Accepted: 14 March 1997     

Occupational health in Mexico

This article describes the current situation of occupational health (OH) in Mexico, including socioeconomic context, legislation, health system, and educative and investigative resources, as well as the practice of OH. Workplace accidents per 100 workers decreased from 7.23 to 2.3 workers in 20 years; deaths decreased from 1.68 to 0.9 per 10,000 workers, while the occupational disease rate increased from 0.6 to 1 per 10,000 workers. This can be interpreted as an improvement in preventive measures as well as problems of recognition and registry. In Mexico OH faces challenges that range from needs for professional training and performance to needs for development of legal measures, coordination, information, and research.     

Occupational health in Taiwan

Challenges facing a developing country during transition to newly developed status include lack of: a hazard communication system, a prudent industrial zoning policy, and occupational safety and health (OSH) technology and personnel. The authors offer an approach to the future that encompasses implementation of a pollution prevention system, comprehensive coverage of occupational injuries and diseases, and integration of information technology with OSH protection.     

农业劳动的职业卫生

据世界劳工组织（ILO）统计，全球共有13亿农业劳动者，占全球劳动力的47％，发达国家农业劳动力人口一般不到10％，发展中国家可达59％。我国是农业大国，农村人口比例占总人口的57％（约7．4亿），其中半数以上全部或部分直接从事农业劳动。近年来，随着农业产业化进程加快，一方面，农业劳动职业危害逐渐引起人们重视；另一方面，雇佣劳动力逐渐增加，农业劳动职业危害的防治已经引起国家高度重视，成为职业卫生领域面临的重要课题。     

Occupational health in India

The population of India has crossed the billion mark; only one other country (China) shares this distinction. A declining female population and low literacy are negatives in an otherwise vibrant country. The empowerment of females and their role in society has become a point of debate, and radical economic changes are likely, to allow India to join the global economy. Problems in occupational health and safety (OHS) include: OHS legislation that covers only a minority of the working population; child labour; a physician-driven OHS model; little attention to industrial hygiene; poor surveillance of occupational diseases (making it impossible to gauge the burden of illness due to occupational exposures); and a fragile OHS academic base. A silver lining comprises the inclusion of OHS in national health policy and the decision by the Indian Medical Association to educate its members in occupational health. India urgently requires modern OHS legislation with adequate enforcement machinery, and establishment of centres of excellence in occupational medicine, to catch up with the rest of the world.