asian pacific1 2010
TRANSCRIPT
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New emergingrisks
Asian-Pacifc NewsletterO N O C C U P AT I O N A L H E A L T H A N D S A F E T Y
Volume 17, number 1, May 2010
Occupational health andsaety training
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Contents
3 Editoria
Franois Eyraud, ILO, Turin
4 Imrovig OSH at costrctio sites throgh a arti-
ciator traiig aroach: Exeriece o Bagadesh
A.R. Chowdhury Repon, Bangladesh
9 Work-reated diseases A chaege or occatioa
heath ad bic heath traiig ad ractice
Jorma Rantanen, Finland
12 Occatioa saet ad heath traiig rogramme:
A Maasia ersectiveAbdul Mutalib Leman, Fadzil Othma, Abdul Rahman
Omar, Malaysia
14 The roe o worker ios i occatioa heath ad
saet at idstr eve
Bambang Surjono, Indonesia
16 Deveoig OSH traiig sstems Chaeges acig
ood eterrises i Chia
Yuhang WANG, China
19 Iteratioa Traiig Cetre traiig or the word
Teemu Lindors, Finland
20 Cardiovascar heath ad work o ocs
Suvi Lehtinen, Finland
21 ICOH ad traiig i occatioa heath
Suvi Lehtinen, Finland
Asian-Pacifc NewsletterOn OCCupATIOnAl HEAlTH AnD SAETy
Vome 17, mber 1, Ma 2010
Occupational health and saety training
Published byiish Istitte o Occatioa Heath
Toeiksekat 41 a A
I-00250 Hesiki, iad
Editor-in-Chief
Svi lehtie
Editor
Teem lidors
Linguistic Editing
Sher Hikkae
Layout
liisa Srakka, Kirjaaio usimaa, Stdio
The Editoria Board is isted (as o 1 December 2008)
o the back age.
This bicatio ejos coright der protoco 2 o
the uiversa Coright Covetio. nevertheess,
short excerts o the artices ma be rerodced
withot athorizatio, o coditio that the sorce
is idicated. or rights o rerodctio or trasatio,
aicatio shod be made to the iish Istitte o
Occatioa Heath, Iteratioa Aairs, Toeik-
sekat 41 a A, I-00250 Hesiki, iad.
The eectroic versio o the Asia-pacifc newset-
ter o Occatioa Heath ad Saet o the Iter-
et ca be accessed at the oowig address:
htt://www.tt.f/Asia-pacifcnewsetter
The issue 2/2010 o the Asia-pacifc newsletter deals
with Ijr ad disease reortig sstems.
Asia-pacifc newsetter is facia sorted
b the iish Istitte o Occatioa Heath, the
Word Heath Orgaizatio, WHO (the uS nIOSH
grat Iteratioa Traiig ad Research Sort
o Word Heath Orgaizatio (WHO) Coaboratig
Ceters i Occatioa Heath), ad the Itera-
tioa labor Ofce.
Photograph on the cover page:
A.R. Chowdhr Reo, Bagadesh
Printed publication:
ISSn 1237-0843
On-line publication:
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iish Istitte o Occatioa Heath, 2010
The resosibiit or oiios exressed i siged artices, st-
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bicatio does ot costitte a edorsemet b the Itera-
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Occupational saety and
health training
Lack o knowledge and competence in
dealing with occupational hazards is
one o the most important causes o
occupational accidents and diseases.
Occupational Saety and Health (OSH) train-
ing is a vital instrument or extending knowl-
edge and generating preventive attitudes and
behaviours. Tis is why training on OSH is
an indispensable element or the prevention
o occupational accidents and diseases. Tisimportance is recognized by the Internation-
al Labour Standards o the International La-
bour Organization as one o the main areas o
action that must be included in the national
OSH policies.
Many national OSH legislations include
OSH training as a workers and his/her rep-
resentatives right, and as an employers duty.
Besides workers, other actors are also required
to have OSH training in order to work as OSH
technical specialists, managers and supervi-
sors, or even as product manuacturers or ma-chinery/labour inspectors. Te volume o peo-
ple who need OSH training in each country
requires an important institutional eort, in
order to stimulate and involve the public and
private actors o each country or this task. Tis
eort requires encouraging and creating de-
mand by setting OSH standards, including the
right to receive and the duty to acilitate OSH
training, as well as the enterprises duty to have
sta specialized in OSH who conduct preven-
tive activities. It is also necessary to strengthen
the supply o inormation on OSH, correlat-
ed in quantity and quality to the needs o the
country, by improving the knowledge base and
materials on OSH, increasing the availability
o training and training experts, and including
the development o accreditation and certi-
cation systems or training service providers
and those receiving training.
In general, training programmes at the en-
terprise level must include both the existing
and potential occupational hazards present
in the work environment, must be ocused on
their prevention and control, and must provide
protection rom them. However, the trainingo dierent groups must be integrated with
the capacities, unctions and responsibilities
o each specic group, taking into account the
technical level o their tasks and the economic
sector o activity. For this reason, training ma-
terials and methods need to be adapted. OSH
training or workers or other groups at the
enterprise level (supervisors, oremen, sub-
contractors, etc.) needs to be closely linked to
other preventive activities at the enterprise,
including risk assessment, risk control, acci-
dent investigation or the supervision o sae
systems o work, since these can determinethe contents and objectives o training. It is
important to keep in mind that OSH train-
ing complements other measures to improve
working conditions and the environment, and
is not a substitute or these measures.
Other aspects, such as the level o literacy
among workers in developing countries or the
increasing number o migrant workers who do
not speak the language o the receiving coun-
try, also require special attention. In cases o
this kind, it would be very appropriate to lim-
it the use o materials and methods based onwritten communication and to avour meth-
ods based on oral and visual transer, making
the training methods as practical and easily
understood as possible. Posters, documenta-
ries or lms, role-play and audiovisual pres-
entations accompanied by explanatory discus-
sions (using a simple and easily comprehen-
sible language) are oen the most eective
techniques or communicating and instilling
OSH messages.
Finally, prevention o occupational acci-
dents and diseases is an important pillar in the
development and consolidation o a preven-
tive culture in society. For this purpose, the in-
troduction o OSH in the educational system
is undamental. It would be advisable to be-
gin even rom basic education, when children
would have the opportunity to acquire preven-
tive attitudes, and then to continue through-
out all levels o education and training, pay-
ing particular attention to OSH in vocational
training curricula.
Franois EyraudDirector
Iteratioa Traiig Cetre o IlO
Tri, Ita
Photo by ITCILO
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Imrovig OSH at costrctio sites throgha articiator traiig aroach:
Experience o Bangladesh
A.R. Chowdhr Reo, Bagadesh
Introduction
Te construction sector entails a wide range
o economic activities and has a very poor
health and saety reputation in the world o
work, owing to the dirty, dangerous and di-
cult nature o jobs. Work at construction sites
is one o the most dangerous occupations in
both developing and industrialized countries.
Construction is dierent rom other industries
in a number o important respects.
According to the International Labour Or-
ganization (ILO), 337 million occupational ac-
cidents occur on the job annually, while the
number o people dying o dierent work-re-
lated diseases is close to 2 million (1). One inevery six atal accidents on the job occurs at
construction sites. Each year a minimum o
60,000 atal accidents occur at construction
sites all over the world. Te increase in fex-
ible employment practices and outsourcing o
labour in the construction industry has had a
negative impact at the level o social protec-
tion o construction workers (2).
According to the Building and Workers
International (BWI) report, at least 108,000
workers are killed on the spot every year at
construction sites. Te report also states that
construction sites account or 30 per cent o all
atal injuries. Tis means that one person dies
every ve minutes due to poor and/or illegal
working conditions (3). Moreover, statistical
data rom a number o industrialized coun-
tries also indicate that construction workers
are three to our times more likely than otherworkers to die rom accidents at work.
Many more workers suer and die rom
occupational diseases arising because o their
past exposure to dangerous substances, such as
silica, asbestos etc. In addition, it is estimated
that 30 per cent o construction workers su-
er rom back pain or various other muscu-
loskeletal disorders.
In recent years, the participation o wom-
en workers in this sector has been increas-
ing in many developing countries around the
world. Tis is particularly true in the coun-
tries o the South Asian region.
o make the construction sector saer,
many approaches and initiatives are applied
in dierent countries around the world to de-
velop a preventive health and saety culture
and good practices to combat hazards and po-
tential saety risks at construction sites. Onesuch eort is the Work Improvement in Small
Construction Sites (WISCON) developed on
the basis o the Participatory Action Oriented
raining Approach.
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PAOT An Action Tool towards
Promotion o Sae Work
Te Participatory Action Oriented
raining (PAO) is one o the popu-
lar practical methods used to address
the occupational saety and health
hazards at workplaces and to support
workplace initiatives based on volun-
tary actions o sel-help (4). Tis meth-
od also assists the principal actors at
workplaces, i.e. workers and employ-
ers, to carry out immediate, low-cost
improvements in their working con-
ditions by using local resources and
positive ideas. PAO has also been rec-
ognized in many Asian countries as
a powerul tool or the promotion o
labour standardization, decent work,
industrial relations and productivity
at the workplace level.
Brie history and development
o PAOT
Te participatory approach was basi-
cally developed with the technical as-
sistance o the ILO. Its primary aim
is to improve working conditions at
small and medium-sized enterprises
(SMEs). PAO was widely applied in
the Work Improvement in Small En-
terprises (WISE) project in the Phil-
ippines. Tis project was nanciallysupported by the UNDP and techni-
cally assisted by the ILO. Since then,
the participatory work improvement
programme at small enterprises has
widely been known as WISE (Work
Improvement in Small Enterpises). Dr.
K. Kogi and Dr. . Kawakami made
very important contributions to its
development. Furthermore, the Japan
International Labour Foundation (JI-
LAF) played an important, acilitat-
ing role in promoting PAO through
the Participation Oriented Saety Im-
provement by rade Union Initiative
(POSIIVE) Programme developed
or trade union members active in
saety and health eorts at the work-
place (5).
In the PAO concept, those who
work by themselves understand their
work and develop practical solutions
to their problems. Since workers are
so amiliar with their daily work, they
need practical opportunities to involve
themselves in improvement o theirrespective workplaces. Te PAO ap-
proach helps the principal actors at
workplaces to start and increase their
sel-help activities by exploring avail-
able local knowledge, cooperation and
resources. Te principles o the PAO
are: it is built on local practice; it o-
cuses on sustainable achievements; it
links local conditions with other de-
cent work goals; it encourages sharing
o local experience, good examples and
practices; it applies learning by doing;
and it ocuses on positive aspects.
Basic training method o PAOT
PAO training programme starts with
an exercise involving the use o an ac-
tion checklist at workplaces. Tis is
ollowed by ormal presentations/lec-
tures on dierent key technical are-
as o PAO (i.e. materials storage and
handling, machine saety, the physical
environment, work station design and
work tools, welare acilities, environ-
mental protection, saety and healthorganizations, etc.) and group work,
development o an individual action
plan or work improvement, ollow-
up development actions at workplac-
es (based on the plan o action pro-
duced), collection o improvement ex-
amples and sharing with others, and
evaluation o actions through the new
plan o action.
Recent development o PAOT in
dierent Asian countries
Te Mekong Delta is known as the
place where PAO (Participatory Ac-
tion Oriented raining) originated. In
January 2000, the Mekong Delta PAO
programme was planned by Dr. on
Khai, Dr. suyoshi Kawakami and Mr.
oyoki Nakao when they visited Can
To City. Since then, the programme
has been repeated nine times, and it
has led to the development o many
ruitul PAO training programmes
and grassroots networks on saety and
health issues in dierent Asian coun-
tries (6). More than 200 participants
(trade union leaders, employer repre-
sentatives, NGO representatives work-
ing on health and saety issues, medical
doctors, nurses, public health experts,
academics, etc.) rom dierent Asian
countries (Bangladesh, Nepal, Tai-
land, Vietnam, Korea, Japan) have at-
tended those programmes in the past
nine years and have started new PAO
activities in their own countries.As results o the collective e-
orts over the past years, programmes
like WISCON (Work Improvement
in Small Construction Sites), WIND
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(WorkImprovement in Neighborhood De-
velopment), and WIPE (WorkImprovement
or Protection oEnvironment) were born in
Vietnam, and these programmes were accept-
ed by the local people smoothly and pleasant-
ly because the training tools were practical
and easy to understand. WISH (WorkIm-
provement or Sae Home) in Tailand and
the [Glocal (Globalised localism) Relation-
ship oAgricultural ImprovemeNts] by the
OSHE in Bangladesh are good examples o
its achievements.
Construction sector in Bangladesh
At present, the estimated civilian labour orce
in Bangladesh is 46.3 million, o whom 22.2%
are emale (7). Te labour market is charac-
terized by a high growth rate o the labour
orce growth, low rates o employment, a pre-
dominance o employment in agriculture ol-
lowed by the service sector, the existence ohigh underemployment, a low rate o emale
employment; squeezing o the public sector,
growth in the inormal sector and a high rate
o working children. Te ratio o the ormal
versus the inormal sector is 20:80.
Construction is one o the important la-
bour intensive industries in Bangladesh. It
plays a signicant role in the domestic econo-
my. It provides direct employment or 1.5 mil-
lion people, which is equivalent to 3% o the
total economically active working population
(aged 15 years and above). Tis estimate com-prises 1.4 million men and 104,000 women.
Besides government, more than 200 large
rms and 5,000 small and medium-sized con-
tracting rms and real estate companies in
the country are involved in the construction
business. Te industry has expanded rapidly
over the past years as a result o the increase
in inrastructure development programmes all
over the country. Te industry is also spurred
by growth o the real estate business in urban
areas o Bangladesh, where building is car-
ried out by the private sector. In the public
and private sectors, construction activities are
undertaken through a contractual system. At
one end there are registered contractors who
acquire a contract through open, selected or
negotiated tenders. Tese are ollowed by a
multitude o complex subcontracts or various
components o the entire project. In Bangla-
desh, there is a growing number o construc-
tion rms or companies involved in large-scale
construction works as well as a huge number
o small-scale subcontractors or subcontract-
ing rms or enterprises at the plant level.On the labour market, the construction
sector is considered an inormal sector, owing
to the nature o employment and work pat-
terns. Te industry has tremendous economic
muscle but has kept its workers mostly unor-
ganized. However, according to the Depart-
ment o Labour o Bangladesh, there are six
registered industrial trade union ederations
and 45 registered basic unions in Bangladesh
working in the construction sector. Tese or-
ganizations altogether represent about 10%
o organized workers in the countrys con-struction sector.
In general, the trade union movement in
Table 1
labor orce b emomet i major ecoomic sectors i Bagadesh
Sector Male Female Total Percentagel
Agrictre, orestr & fsheries 15,084,000 7,683,000 22,767,000 48.1%
Trades, hotes ad restarats 7,366,000 454,000 7,820,000 16.5%
Maactrig 1,298,000 3,926,000 5,224,000 11%
Trasort, storage ad comm-
icatio
3,910,000 66,000 3,976,000 8.4%
Commity ad persoa ser-
vices
1,654,000 968,000 2,622,000 5.6%
Heath, edcatio, bic admi-
istratio ad deece
1,982,000 568,000 2,550,000 5.4%
Costrctio 1,421,000 104,000 1,524,000 3.2%
fiace ad bsiess services
ad rea estate
619,000 126,000 745,000 1.6%
Eectricit, gas ad water 73,000 3,000 76,000 0.2%
Miig ad qarrig 44,000 7,000 51,000 0.1%
TOTAl 36,080,000 11,277,000 47,357,000
Sorce: Bagadesh Brea o Statistics, 2008
this sector is comparatively weaker than those
in the countrys other sectors, or a couple o
reasons. First, there is a weak institutional ca-
pacity to respond to the decent work issues.
Second, there is a lack o collective bargaining
at the national level and an absence o a tripar-
tite industrial relation structure at the national
level. Tese are the main reasons. On the oth-
er hand, employers in this sector (contractors
and real estate development areas) are largely
organized at the national level.
High rates o occupational accidents
and injuries
Te construction sector in Bangladesh is wide-
ly known as a death trap due to its poor health
and saety record and the high rate o occupa-
tional accidents occurring in the country each
year. At Bangladeshi construction sites, ordi-
nary workers normally do their job according
to the instructions given by the contractors orsubcontractors who employ them. Most o the
time, they work in an environment with high
levels o noise, dust and umes, insecure elec-
tricity, dirty water, harmul gases, poor light-
ing, lack o personal protective equipments,
lack o a pure drinking water supply, and lack
o toilet acilities.
An alarming number o construction
workers in Bangladesh experience occupa-
tional accidents, such as alling rom the top
o structures, injuries rom sharp objects and
tools and electric shock. Moreover, they areoen aected by toxic materials or harmul
gases. I an occupational accident occurs at
the workplace, the victim considers it per-
sonal bad luck and the contractor or subcon-
tractor normally blames the victim or being
careless at work.
Te industries in Bangladesh are mainly
governed by the Bangladesh National Building
Code o 2006 and partially by the Bangladesh
Environment Conservation Act o 1995. Tese
actually include only a ew regulations on sae-
ty and health issues. Te Bangladesh Labour
Act o 2006 applies in part to the construction
sector through the mobility o jobs and lack
o permanent workplaces or the same con-
struction rms or establishments. In reality,
however, workers in this sector get very little
protection or benet (health and saety issues)
rom those laws, owing to weak enorcement
and lack o inspections.
With relation to setting up a Code En-
orcement Authority under section 2.1 o
the Bangladesh National Building Code, the
Bangladesh Occupational Saety, Health and
Environment Foundation and the BangladeshLegal Aid and Services rust jointly led a
written petition in the High Court Division
on 27 January 2008 to readdress the ailure o
the government to establish an agency to en-
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orce the code, particularly the provisions relating to work-
ers saety issues. Te petition argues that most workplace
deaths among construction workers would be prevented i
the obligations under the Code are enorced, more specical-
ly those relating to measures to prevent alling rom heights
and electrocution. At the initial hearing on the petition on
7 February 2008, the High Court o Bangladesh passed a
rule asking the respondents or a show-case explaining why
the government should not establish a Code Enorcement
Agency as duly required by the Bangladesh National Build-
ing Code o 2006 and also why it should not be required to
secure compliance with the saety and security provisions
o the Bangladesh National Building Code o 2006 at every
level o construction and demolition o any building. Te
Court also requested the government to produce a report
on what steps it has taken so ar to secure compliance with
the code in Dhaka and Chittagong. Te Court allowed the
respondents our weeks to respond to their show-cause no-
tice. However, it has been over two years since this ruling
was handed down but, unortunately, the respondents have
not yet come up with any reply.
Owing to the absence o proper monitoring o occu-pational diseases and the lack o studies, the occupational
health status o the workers in this sector is mostly unknown.
It is assumed that a high number o construction workers
suer rom musculoskeletal disorders, silicosis and asbes-
tosis. Most workers in the construction sector lack proper
knowledge about the occupational saety and health (OSH)
issues and about their rights at workplaces.
A recent survey conducted by the Bangladesh Occupa-
tional Saety, Health and Environment Foundation (OSHE),
which monitored the news in sixteen leading daily newspa-
pers o Bangladesh, revealed that a total o 829 workers were
killed and 1,041 were critically injured by various occupa-tional incidents at their workplaces across the country rom
January to June 2009. Among these the highest number o
causalities (552) took place in the garment sector, ollowed
by the transport (486) and construction sectors (95) (8).
Another survey report o the OSHE ound that the total
number o occupational deaths caused by motorized equip-
ments in the construction sector in 2008 and 2007 were 120
Table 2
Cases o occatio-reated deaths i the Costrctio Sector i Bagadesh
i 2007 ad 2008
Cause o death 2007 2008 Total
Eectroctio 24 42 66
aig rom heights 26 37 63
Coase o a wa 27 7 34
Coase o earth 14 14 28
Ashxiatio 2 10 12
Hit b a aig object 6 2 8
Crshed b a object - 7 7
aig ito a hoe 2 - 2
Misceaeos 1 1 2
Sorce: OSHE Srve Reort 2007 ad 2008
and 102, respectively. able 2 shows the causes o common
occupational accidents in Bangladesh in 2007 and 2008.
Experience o the WISCON actions in Bangladesh
Considering the above reality in the construction sector,
the Bangladesh Occupational Saety, Health and Environ-
ment Foundation (OSHE) implemented a mini-project in
2009 with support rom the ILO. Te mini-project title was
Actions or improvement o occupational saety and health
conditions in Bangladesh: special ocus on construction sec-
tor; its objectives were to build workers and employers ba-
sic capacity at construction sites by means o participatory
workplace saety improvement actions through WISCON
(Work Improvement at Small Construction Sites).
Te direct target groups were worker and employer rep-
resentatives in the construction sector. Te geographical
coverage o the project activities included Dhaka (the capital
o Bangladesh) and Chittagong (the countrys second big-
gest city). Te key activities o the project were WISCON
training o the trainers, development o training materials
in the local language, ollow-up training at workplaces and
sensitization o actions at the work sites. Te technical ar-
eas on which the WISCON activities ocused were materi-als handling and storage, work at heights, work postures,
machine saety, the physical environment, welare acilities,
emergency preparedness, work organization, and saety and
health organizations.
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Achievements
At macro level, the WISCON project activities
in Bangladesh contributed to the successul in-
troduction and promotion o the Participatory
Low Cost Saety training and OSH actions in
the construction sector. It was also able to cre-
ate sensitization and awareness o OSH issues
in the construction sector.
At micro level, the WISCON project ac-
tivities gave rise to a group o new trainers
on WISCON (8). In all, 2000 copies o the
WISCON Action Checklist were produced in
the local language and 280 grassroots union
members rom dierent trade unions work-
ing in the construction sector were sensitized
on participatory workplace saety improve-
ment activities. Te project activities there-
ore meant the launching o a process o dia-
logue on OSH issues between trade unions and
employers organizations in the construction
sector and the ormation o a local WISCONrainers network.
A eld level evaluation has shown that
the participants who attended dierent ac-
tivities within the WISCON project presented
a good number o immediate initiatives ol-
lowing the training period and implement-
ed a good number o changes in the dierent
technical areas addressed during the train-
ing, i.e. materials handling and storage, work
at heights, work postures, machine saety, the
physical environment and welare acilities at
workplaces.
Key lessons learned
Te Participatory Action Oriented raining
Approach, o which the WISCON is a good ex-
ample in the construction sector, encourages
workers immediate, low-cost saety improve-
ment actions, contributes to improvement o
social dialogue, helps to improve bilateral co-
operation on saety and heath issues between
workers and employers, and helps to develop
collectivism or advancing the Decent Work
Agenda at the workplace level.
Reerences
1. World o Work (the magazine o ILO), issue no.
63, August 2008.
2. http://www.ilo.org/public/english/dialogue/sec-
tor/sectors/constr.htm.
3. http://www.bwint.org.
4. Participatory Action Oriented Training, ECHO,
August 2005.
5. POSITIVE Training Manual, Japan International
Labour Foundation (JILAF), September 1999.
6. Background paper on Mekong Delta PAOT
program 10th anniversary, The Mekong Delta
PAOT Programme Management Committee, 28
February 2010.
7. Labour Force Survey 200506, Bangladesh
Bureau o Statistics.
8. Occupational Saety, Health and Environment
Foundation (OSHE) Survey Report number 1
/2009.
A.R. Chowdhury Repon
Exective Director
Bagadesh Occatioa Saet, Heath ad
Eviromet odatio (OSHE)
44 /6, West pathaath (4th oor)
GpO Box- 2696
Dhaka-1215
BAnGlADESH
E-mai: [email protected], [email protected]
Web Address: htt://www.oshebd.org
photos b A.R. Chowdhr Reo
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Photo by Suvi Lehtinen
Work-related diseases A chaege or occatioa heath adbic heath traiig ad ractice
Jorma Ratae, iad
Introduction
Te concept o work-related disease was origi-
nally dened by a WHO Expert Committee in
1985 (1). Te Committee recognized the ol-
lowing conditions as work-related:
a. Te classic occupational diseases, in which
the actors in work environment are pre-
dominant and essential in the causation o
disease,
b. Diseases caused by exposures rom homeworkers working processes to amily mem-
bers or by worksite exposures to members
in the neighbourhood community
c. Multiactor diseases which, when occur-
ring in workers,
may be partially caused by occupation-
al actors
may be aggravated, exacerbated or accel-
erated by workplace exposures
may impair working capacity.
Te Expert Committee also stated that
work-related diseases are oen more com-mon than occupational diseases and deserve
adequate attention by the health services and
occupational health services.
Te 1985 Expert Committee already rec-
ognized several groups o diseases which were
recognized as work-related, including:
a. Behavioural responses and psychosomat-
ic illnesses
b. Hypertension
c. Ischemic heart disease
d. Chronic non-specic respiratory disease
e. Locomotor disorders.
Current situation in the identifcation
o work-related morbidity
Since the 1985 Expert Committee, clinical
and epidemiological research has provided
a great deal o new evidence on the work-
relatedness o the diseases recognized by the
Committee and on several new diseases. Te
attribution by work varies widely depending
on disease and type o work, as well as on
local working conditions and health condi-
tions o the community. A substantial part owork-related morbidity has been associated
with common non-communicable and com-
municable diseases prevalent among pop-
ulations, such as cardiovascular disorders,
respiratory disorders and musculoskeletal
disorders (2, 3). Due to their high preva-
lence, their work-relatedness is important
to recognize, as occupational causality pro-
vides avenues or eective prevention in the
occupational settings. In principle, all occu-
pational diseases can be prevented and the
risk o multiactorial work-related diseases
(WRDs) can be reduced to a substantial ex-
tent (which does not always correspond di-
rectly with the percentage o attribution) (4).On the other hand, i the causal actors do
expose workers at the workplace, the preven-
tive, control and curative actions directed to
non-occupational settings may remain ine-
ective. Te high prevalence o chronic non-
communicable diseases among workers, and
particularly among older workers calls or
preventive actions in occupational health in
order to protect and maintain work ability
and avoid health and economy losses rom
diseases among the productive raction o
population (5, 6).
Examples o studies providingevidence o work-relatedness in the
working populations morbidity
A ew examples o studies providing evidence
on the work-relatedness o common non-
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communicable and communicable diseases
are briefy discussed here.
Attribution o work to mortality o Finnish
working population
Tis study was one o the most extensive e-
orts or analysis o the work-relatedness o
non-communicable diseases (2). Te analysiscalculated the attribution o work to mortality
rom 45 specic diseases in 9 disease catego-
ries, including 26 malignant neoplasms (able
1). Te relevant occupational exposures and
related risks o mortality were assessed on the
basis o the FINJEM exposure matrix or var-
ious occupational groups and wide research
material providing evidence on related health
outcomes. able 2 describes the diseases with
substantial occupational attribution.
Te risk o work-related mortality was un-
equally distributed between genders: 10% ototal mortality among men was work-related.
Te respective gure or women was 2%. As
much as 86% o absolute cases o work-relat-
ed deaths occurred among working men and
14% among working women. Te largest gen-
der dierences were ound in lung cancer and
other respiratory diseases.
o put the work-related mortality in per-
spective with other comparable risks in the
year 1996 or which the calculations were
made, the total number o atal trac acci-
dents among the whole Finnish population
was 404. Te estimated total number o work-
related deaths among the Finnish working
population was 1800, i.e. 4.5 times higher.
WHO global burden o occupational diseases
study (4)
Te World Health Organization has repeated-
ly produced estimates or the global burden o
diseases (5, 6, 7). In 2005, WHO estimated the
contribution o 26 dierent occupational risk
actors to global burden o diseases. Te study
calculated both loss o healthy lie years (DA-
LY) due to mortality and healthy lie year loss
by morbidity (4). Five causal actors played asubstantial role as attributors to the global dis-
ease burden: Workplace carcinogens, airborne
particulates, hazards or injuries, ergonomic
stressors or back pain, and occupational noise
exposure. Te attribution by occupational ex-
posures to work-related morbidity measured
as global burden to diseases and injuries is
presented in able 3.
Te WHO study made a special assess-
ment o the work-related burden o two inec-
tious diseases and needle stick injuries among
health personnel. Te result ended with an es-timate o 40% attribution o work to the risk o
hepatitis B and C among health workers and
2% attribution to HIV/AIDS.
Te work-related share o all the assessed
diseases was 1.5% o the total DALYs o global
burden o diseases (rom all diseases and in-
juries o world population). Tis gure, how-
ever, is probably a substantial underestimate
due to the limited number o diseases calcu-
lated and due to diculty in estimation o
work-related attribution o several prevalent
diseases, such as the major inectious epidem-
ics. Tere are also several other actors lead-
ing to likely underestimation; the majority o
the worlds workers are employed in small-
scale enterprises, agriculture, and the inormal
sector which have low access to both health
services in general and no access to occupa-
tional health services at all. Tis implies that
both general health events and particularly
occupational and work-related events remain
largely unidentied, undiagnosed and unreg-
istered. No reliable estimate or such under-
reporting is available, but it can be assumed
to be substantial.
International study o work-related acute
heart inarction
Cardiovascular disorders are the worlds
Diseases
Inectious and parasitic diseases
Tbercosis
pemococca disease
Malignant neoplasms (site)
Ora cavit
pharx
Oesohags
Stomach
CooRectm
liver ad itraheatic bie dcts
Ga badder
pacreas
nose ad asa sises
larx
lg ad brochs
Boe
Meaoma o ski
Other maigat eoasms o ski
Mesotheioma (a sites)
Breast
uters (cervix teri ad cors teri)
Ovar
prostate
Kide
uriar badder
Brai
Hodgkis disease
no-Hodgkis mhoma
lekaemia
Diseases o the circulatory system
Ischemic heart disease
Cerebrovascar diseaseDiseases o the respiratory system
pemoia
Chroic obstrctive moar disease
Asthma
pemocoiosis
Crtogeic fbrosig aveoitis
Diseases o the genitourinary system
Chroic rea aire ad ehritic sdrome
Mental disorders
Vascar ad secifed demetia
Deressive eisodes
Nervous system diseasesSia mscar atroh
parkisos disease
Azheimers disease
Diseases o the digestive system
Gastric ad dodea cer
Accidents and violent incidents
Accidets
Homicides ad ijries
Sicides
Table 1. Diseases aased or attribtio b nrmie ad Karjaaie (2)
Table 2. Attributios by occuatioal actors to total mortality o iish workig oulatio (2)
Disease Attribution %
Circator sstem, a
Ischemic heart disease
Stroke
12
17
11
Maigat eoasms
lg cacer
8
24
Resirator diseases
COpD
4
12
Meta disorders 4
nervos sstem diseases 3
Accidets ad vioece 3
A work-reated mortait 7
10 Asia-pacifc newsett o Occ Heath ad Saet 2010;17:911
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number one cause o death by non-commu-
nicable diseases. Te work-relatedness o car-
diovascular disorders has been shown in nu-
merous studies and associated to numerous
risk actors such as several chemicals, physical
workload, unconventional working hours and
work stress. Te latter source has caused also
a great deal o controversy particularly among
employers. Te Interheart Study o 26000 sub-
jects (11119 patients and 13648 controls) in
52 countries o Asia, Europe, the Middle East,
Arica, Australia, North and South America
monitored the risk o acute myocardial inarc-
tion (MI) in relation to a number o psycho-
logical risk actors; work stress, home stress,
nancial stress and lie event stress (8). Te
measurement o stress exposure was made
through a questionnaire covering the period
beore inarction. Te study ound virtually
equally elevated risks (odds ratios 2.34 and
2.36, respectively) or permanent work stress
and permanent home stress, while the othersources o stress also played a role, but to a
much lower extent. Te contribution o work
stress to MI risk was seen only among men,
while other sources o stress contributed to the
elevation o the risk also among women, but at
a slightly lower level than among men. A dis-
tinct dose-response relationship was detected
between dierent doses o stress; some o
the time, several periods and permanent.
Te high incidence o cardiovascular dis-
eases among working-age populations makes
the work-relatedness aspect o this morbidityextremely important. As it seems to be a sub-
stantial several percentage attribution o occu-
pational actors to cardiovascular morbidity, it
also has an important occupational and pub-
lic health impact. Similarly the prevention o
these common diseases will get more support
or preventive programmes in occupational
settings. Te growing rates o work stress re-
ported by surveillance studies throughout the
world make stress-related cardiovascular dis-
orders even more important. able 4 shows
the odd ratios or various sources o perma-
nent stress.
Challenges o work-related diseases
to training and practices
Work-related diseases (WRD) were recognized
as early as in 1985 by WHO as an important
health impact o work, and numerous can-
didate WRDs were proposed by the WHO
Expert Committee. Since then, research has
produced much evidence on the work-relat-
edness o several diseases, many o which are
highly prevalent among working populations.Te quantitative estimates give the scale or the
problem o WRDs as a part o the morbidity o
working populations, and o the global burden
o all diseases o the world population.
Disease Men % Women % All %
Back ai 41 32 37
Hearig oss 22 11 16
COpD 14 6 13
Asthma 14 7 11
Cacer o trachea, brochs ad g 10 5 9
lekaemia 2 2 2
uitetioa ijries 15 2 10
Table 3. Attribtabe ractio (%) b occatioa actors to tota brde o diseases o 7
work-reated heath otcomes (4).
WRDs cause loss of work ability and life
years, which is likely to be at least an order of
magnitude larger than that of traditional occu-
pational diseases. Very little research is, how-
ever, available on registration, recognition,
loss of work ability, economic loss, and pos-
sible compensation of work-related morbidity.
This is made by difculty in the identication
of work-related aetiology at the individual
level. In the long run, work-related diseaseshave often been early cases of forthcoming
ofcially recognized occupational diseases.
he most important management strat-
egy o work-related diseases is prevention.
his requires identiication o the occupa-
tional actors causing such diseases, stud-
ies o their mechanisms o action and de-
velopment o eective prevention strate-
gies. It is also important to keep in mind
the work-related aetiology in clinical and
public health practices.
WRD morbidity constitutes a challenge
to the training o both occupational health
personnel and the experts in the rest o the
health service system, as well as those in so-
cial security. Knowledge on work-relatedness
should be distributed in the basic education
o health personnel, as well as proposals or
prevention and control. Te WRDs are im-
portant not only rom the occupational health
perspective. As they are oen simultaneously
common diseases among the general popula-
tion and the working population (which con-
stitutes some 5070% o the adult population
in all countries), work-related morbidity isalso a signicant public health challenge. Tis
requires close collaboration between training,
education and practices o occupational health
and public health.
Table 4. Odd ratios o acute myocardial iarctio rom various sources o ermaet stress (8)
Source o stress Cases Controls Odds ratio (99% CI)
Work 499 316 2.34 (1.862.93)
Home 249 135 2.36 (1.753.17)
Geera stress (work or home) 681 424 2.32 (1.932.80)
iacia 1231 1190 1.33 (1.171.50)
lie evets (2 or more evets) 1390 1304 1.51 (1.341.70)
Reerences
1. WHO. Identifcation and control o work-related
diseases. Report o a WHO Expert Committee.
Technical Report Series No. 714, WHO, Geneva
1985.
2. Nurminen M, Karjalainen A. Epidemiologic
estimate o the proportion o atalities related
to occupational actors in Finland. Scand J Work
Environ Health 2001;27(3):161213.
3. Kivimki M, Leino-Arjas P, Luukkonen R, Riihimki
H, Vahtera J, Kirjonen J. Work stress and risk o
cardiovascular mortality: prospective cohort study
o industrial employees. BMJ 2002;325:85761.
4. Fingerhut M, Driscoll T, Nelson D I, Concha-Bar-
rientos M, Punnett L, Pruss-Ustin A, Steenland K,
Leigh J, Corvalan C. Contribution o occupational
risk actors to the global burden o disease a
summary o fndings. SJWEH Suppl 2005;no
1:5861.
5. WHO. The World Health Report 2002. Reducing
risks, promoting healthy lie. Geneva 2002.
6. WHO. The global burden o disease: 2004 update.
WHO Geneva, 2008.
7. Rodgers A, Ezzati M, Vander Hoorn S, Lopez AD,
Lin R-B, et al. Distribution o Major Health Risks:
Findings rom the Global Burden o Disease Study.PLoS Med 2004 1(1): e27. doi:10.1371/journal.
pmed.0010027
http://www.plosmedicine.org/article/
ino:doi/10.1371/journal.pmed.0010027
8. Rosengren A, Hawken S, unpuu S, Sliwa K,
Zubaid M, Almahmeed WA, Blackett KN. As-
sociation o psychosocial risk actors with risk o
acute myocardial inarction in 11 119 cases and 13
648 controls rom 52 countries (the INTERHEART
study): case-control study. Lancet 2004;364:953
62.
Jorma Rantanen
proessor Emerits
Chairma o Seate
uiversit o Jvsk
Jvsk, iad
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Occatioa saet ad heath traiig
rogramme:A Malaysian perspective
Abd Mtaib lema
adzi Othma
Abd Rahma Omar
Maasia
Introduction
Occupational saety and health (OSH) pro-
vides a work environment which is conducive
to workers. Reasonable precautionary steps
are taken in order to ensure that workers are
protected rom injury or health hazards aris-
ing rom their work activities. Saety measures
and practices are undertaken to prevent and
minimize the risk o loss o lie, injury and
damage to property and environment. Occu-pational saety and health was rst implement-
ed in Malaysia some 130 years ago, towards
the end o the 19th century. Te Department
o Occupational Saety and Health (DOSH) is
the only government agency responsible or
administering, managing and enorcing legis-
lation pertaining to OSH in the country. Its vi-
sion is to make all occupations sae and healthy
while also enhancing the quality o work lie.
Increasing OSH observance levels
o ensure that workers saety, health and wel-
are are cared or, DOSH works to keep the
occurrence o industrial accidents in Malaysia
low. o this end, the OSH Master Plan 2015
was introduced. Tis plan sets out the direc-
tion o OSH in the country. It serves as a guide
or working cohesively with stakeholders and
social partners, including government agen-
cies, local authorities, labour unions, employer
associations, academic institutions and other
non-governmental organizations.
Te saety and health programme includes
our major elements that make up its basic
ramework. Louis J. DiBerardinis (1) reported
that an eective occupational saety and health
programme will entail:
Management commitment and employee
involvement
Analysis o worksite hazards
Hazard prevention and control
Saety and health training.
Occupational saety and health
trainingo ensure the success o any OSH programme,
adequate and eective training must be im-
plemented or all those responsible or OSH.
raining enables managers, supervisors and
workers to understand the unctioning o
saety management systems and compliance
with legislation. Tey will then understand
their own responsibilities and the necessary
actions to be taken towards upgrading sae-
ty and health at their respective workplaces.
Saety and health training is one o the tech-
niques available or promoting OSH while at
the same time reducing the number o acci-
dents. o oster ecient and eective training,the Malaysian Government has constructed an
OSH organization in the country.
Te Ministry o Human Resources has
been made responsible or managing OSH,
under the advice o the National Council o
Occupational Saety and Health (NCOSH).
Te NCOSH unctions in a policy advisory
and promotion capacity. Te Department o
Occupational Saety and Health (DOSH) was
ormed to ocus on administration and en-
orcement. Te OSH services can be catego-
rized into workplace monitoring and assess-ment, medical surveillance, medical treatment
and management, and rehabilitation services
and return to work programmes.
Education and training programme
raining is an integral part o OSH. Te educa-
tion and training programme involves several
institutions, including the National Institute o
Occupational Saety and Health (NIOSH), the
Construction Industry Development Board
(CIDB), Nuclear Malaysia, higher education
institutions and NGOs such as the Malaysian
Society o Occupational Saety and Health
(MSOSH), the Malaysia Industrial Hygiene
Association (MIHA) and the Federation o
Manuacturing Malaysia (FMM). Te private
sector involved in OSH activities includes the
Social and Security Organization (SOCSO),
the Employee Protection Fund (EPF) and in-
surance companies.
Te Hands on Guide OSH Manager Ma-
laysia (2) places the types o training into two
broad categories, hard skill OSH training and
so skill OSH training. In general, hard skillOSH training is usually mandatory. It entails
the training required to ensure that workers
are competent and qualied and that they ex-
ecute certain tasks related to OSH hazards.
Examples o such programmes are working
in conned spaces, a saety orientation course
or construction workers, and lockout and tag-
out with regard to electrical saety. So skill
training is oen voluntary, involving the rec-
ommended types o training. Examples are
saety management courses, OSH commu-
nication training, and training on the aware-
ness o OSH hazards and worker behaviour.
Some o the programmes required or in-house OSH training are orientation or new
employees, supervisor and management train-
ing, on-the-job training, training or specic
hazards (i.e. laser saety, lockout and tag-out),
training in standard operating procedures and
skill training.
Te National Institute o Occupation-
al Saety and Health (NIOSH) was chosen
as an example illustrating OSH training in
Malaysia. Te National Institute o Occupa-
tional Saety and Health was established as
a company limited by guarantee on 24 June1992 under the Ministry o Human Resourc-
es, Malaysia. Te NIOSH Board o Directors
consists o individuals rom the relevant gov-
ernment agencies and industrial and union
representatives; the Board prepares policies
and sets directions or the Institute in line
with the agreed strategy. With the stated vi-
sion to be the leading centre of excellence
in occupational safety and health, NIOSH
operationalized its strategic mission to read
Te preferred partner in occupational safe-
ty and health in carrying out its unctions,
which are the provision o training, consulta-
tion services, dissemination o inormation,
and conducting research in the eld o OSH.
Range o training programmes
Te NIOSH training programme has received
recognition rom DOSH, the regulatory body
or OSH in Malaysia, as well as rom industrial
associations, OSH practitioners, international
counterparts and workers at large. Apart rom
ensuring the competency o registered spe-
cialists, NIOSH training has been extendedto senior executives, saety and health com-
mittee members, saety supervisors, general
workers contractors, academicians and other
interested individuals.
12 Asia-pacifc newsett o Occ Heath ad Saet 2010;17:123
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nmber o
particiats70,000
60,000
50,000
40,000
30,000
20,000
10,000
0
Course participants by year
2006 2007 2008 2009
year
pbicrogrammes
Certifcate/Cometecprogramme
I-Hoseprogramme
Traiersprogramme
Coerece orSemiar
Saetpassortprogramme
raining activities are broadly classied
into three main groups: the implementation o
training programmes, development and revi-
sion o training modules, and monitoring and
evaluation o training activities. able 1 shows
the number o courses conducted by NIOSH
and the number o participants in 20062009.
Discussion
Te NIOSH Saety Passport is widely known.
Te course is conducted jointly with indus-
tries. It is recognized and put into practice by
Table 1. Corses codcted b the natioa Istitte o Occatioa Saet ad Heath i 20062009.
Types o Courses 2009*
Corses partic-
iats
2008
Corses partic-
iats
2007
Corses partic-
iats
2006
Corses partic-
iats
pbic rogrammes 161 2,535 125 2,114 94 1,420 88 1,397
Certifcate/Cometec rogramme 195 3,558 165 3,381 186 3,516 124 2,390
I-hose rogramme 609 11,597 432 9,321 453 10,09 367 8,403
Traiers rogramme 19 258 21 281 38 467 29 327
Coerece or semiar 24 3380 21 2,797 21 3,003 18 2,402
Saet passort programme 2,347 61,035 1460 39,927 1,046 27,780 1,009 26,615
TOTAL 3,355 82,363 2,768 71,941 2,321 59,972 1,635 41,534
*Amedmet ti December 2009
Figure 1. Traiig rogrammes codcted b the the natioa Istitte o Occatioa Saet
ad Heath rom 2006 to 2009
(EDOSH) and the Masters in Occupational
Saety and Health (MOSH) are jointly con-
ducted by NIOSH in collaboration with theOpen University Malaysia (OUM) and Uni-
versity Utara Malaysia (UUM).
Conclusion
o-date, the amount o training has increased
linearly. Te provision o training is based on
training programmes, seminars and coner-
ences. Te number o participants involved
is also increasing linearly every year. Malay-
sia set up the OSH Master Plan 2015 as the
target in order to minimize the number oaccidents. At the same time, it aims to in-
crease the number o courses and public pro-
grammes and emphasizes Occupational Saety
and Health training programmes.
Reerences1. L. J. DiBerardinis (Ed.). Handbook o Occupa-
tional Saety and Health. Wiley and Sons. New
York, USA 1999.
2. CCH Asia Pte Limited. The Hands on Guide OSH
Manager Malaysia. 2001
Abdul Mutalib Leman
uiversit T Hssei O Maasia
86400, parit Raja, Bat pahat,
Johor, Maasia
Te: +607 4537776
ax: +607 4536080
Emai: [email protected]
Fadzil Othman
natioa Istitte o Occatioa Saet ad
Heath (nIOSH)
lot 1, Jaa 15/1, Sectio 15, 43650 Badar Bar
Bagi,
Seagor Dar Ehsa
Maasia
Te: +603 87622100 (mai ie)
ax: + 603 89262900
Email: [email protected]
Training Programmes by yearnmbero Corses
2500
2000
1500
1000
500
0
2006 2007 2008 2009
year
pbicrogrammes
Certifcate/Cometecprogramme
I-Hose
programme
Traiersprogramme
Coerece orSemiar
Saetpassortprogramme
Figure 2. nmber o articiats i corses codcted b the natioa Istitte o Occa-
tioa Saet ad Heath rom 2006 to 2009
several multinational companies and inter-
national industries located in Malaysia. For
example, NIOSH has conducted a saety pro-
gramme with several companies, including
Petronas, Osam, NB, Shell, Genting and BP
Chemicals. Tese programmes conducted by
NIOSH are organized at the certicate level.
Several public and private institutions con-duct these programmes at diploma and degree
level; there are even Masters and Doctoral
degree programmes. However, the Executive
Diploma o Occupational Saety and Health
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The role o worker unionsi occatioaheath ad saet at idstr eve
Bambag Srjoo, Idoesia
Background
At the global level, according to the most re-
cent estimates o the International Labour O-
ce (ILO), about two million people die be-
cause o their work every year (1). Tese work-
related deaths represent only a small raction
o the suering caused. An estimated 160 mil-
lion people have work-related disease. Some
355,000 atal accidents take place every year.
For every atal accident at work, some 500
2,000 other non-atal injuries occur, depend-ing on the type o work. Yet these workplace
tragedies rarely make the headlines.
Fatalities and accidents are not bound to
happen. Tey are caused. Cancer caused,
or example, by asbestos, other carcinogen-
ic dusts and chemicals, and ionizing radia-
tion is the biggest reason or work-related
deaths (accounting or an estimated 32% o
work-related deaths), ollowed by circulatory
diseases caused, or example, by night work
and shi work, stress, some chemicals and
environmental tobacco smoke at workplaces (23%), accidents (19%) and communicable
diseases (17%). Te gures dier consider-
ably in various parts o the world: accident
rates, or instance, are very high in the Asian
iger economies.
The role o trade unions in OH&S
Work accidents can be prevented i all stake-
holders play an active role. Tree points need
to be stressed here:
Enterprise management and commit-
ment have a key role.
Companies that have an occupational saety
and health management system (OSH-MS)
set up according to ILO Guidelines (ILO-
OSH 2001) have better saety records and
better productivity records.
Te stronger the union, the safer the
workplace.
Even the best occupational health and sae-
ty regulations will have little impact un-
less the people concerned, the workers, are
able collectively to deend their interests.
It is vitally important that workers are in-volved in planning and running the com-
pany OSH management system and have
reedom o association. Te high saety
standard o Sweden, or example, is a di-
rect result o long-term policies on workers
involvement and a well-unctioning tripar-
tite mechanism.
Much of the action on safety and health
must be local, but much of the framework
must be global.
Tis is both a moral and a practical neces-
sity. Moral, because we cannot place a lower
value on workers lives in some parts o the
world than in others. Practical, because in
a global economy, we cannot allow saety
and health to be undermined by alse con-cerns about competitiveness.
On both o these counts, the ILOs Sae
Work Programme is well placed to infuence
the global agenda. Representatives o the
worlds workers, employers and governments
meet on equal terms within the ILO. rade un-
ion rights are at the heart o its standard-set-
ting activities, as are health and saety. More-
over, the ILO is currently campaigning or
the provision o decent work worldwide. It is
clear that decent jobs must also be sae jobs.
Occupational health and saety
training by trade unions
o promote the role o trade unions in occu-
pational health and saety activities in Indo-
nesia, the Conederation o Indonesian rade
Union (CIU) has devised an OH&S training
programme in cooperation with JILAF, the
Japan International Labour Foundation. Te
training is called the OHS POSIIVE training
programme. POSIIVE stands or Participa-
tion-Oriented Saety Improvement by rade
union InitiatiVE. Te POSIIVE programme
was developed as a participatory training pro-
gramme or the promotion o occupational
saety and health by trade unions (2).
Te basic principle o the programme is
participation. Seminar participants learn rom
local good examples that have already been
put into practice in order to improve the work
environment. Attention is given to low-cost
improvement. By using an action checklist in
an actual workplace and discussing the results
with their colleagues, union members receive
training that leads to activities improving oc-cupational saety and health at the workplace.
Follow-up activities are held, too; discussions
take place with the objective o supporting the
workers continued activities.
Te training is given in two steps:
a. Te rst step is the OH&S raining o
rainers (O) POSIIVE Programme.
Tis seminar takes our ull days.
b. Te second step is the OH&S Core rainer
raining (C) POSIIVE Programme,
comprising three ull days.
During each step o training, the partici-
pants visit a actory to observe good examples
o OH&S practice. A checklist prepared beore
the visit is used during the observation visit.
Tere are six technical aspects to be observed
(3):
1. Materials handling and storage
2. Change o work station
3. Machine saety
14 Asia-pacifc newsett o Occ Heath ad Saet 2010;17:145
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4. Physical environment
Picture # 4
5. Welare acilities
Picture # 5
6. Environment protection
Picture # 6
So ar CIU and JILAF have organized six
raining o rainer (O) seminars and seven
OH&S Core rainer raining (C) seminars
in Indonesia. Te training has been given in
some regions o Jakarta, East Java, West Java,
Central Java and in Riau Province, Batam Is-
land. Tere are about 120 Core rainers who
can provide training or Union members at
the workplace.
CIU and JILAF started to run POSIIVE
training programmes in 2006 and they have
continued until now. Each year at least two
set o OHS POSIIVE training seminars have
been held. Above are data on the POSIIVE
Programme raining in Indonesia organized
by CIU and JILAF in 20062009.
Results o training
Te O seminar participants have to make
improvements in OH&S conditions at their
workplace. Tese improvements should be
presented when they come or the C train-
ing about six months aer the O seminar
has been completed. Improvement o the
working conditions benets not only the
workers; it is also benecial to the employer in
terms o improved and increased productivity.
Improvement o OH&S is based on these con-
siderations:
Facilitate immediate improvements
Learn rom local good examples
Involve managers together through the vis-
ible benets (good work results) and low-
cost ideas
Promote solidarity by group work.
On the last day o each training seminar,
the participants have to present proposals or
improvement to the company they have visited
on the rst day o training. Te management o
the company visited is invited to the class, to
ollow the participants presentations. Most othe management representatives rom the ac-
tories visited have been very satised and have
appreciated that the participants were able to
identiy areas in need o improvements. Te
Date pace particiats
(n)
Tye o traiig
1217 ebrar 2006 Ciag, Bogor 24 TOT
56 november 2007 Cioto, Bogor 27 TOT
30 Ma2 Je 2008 Srabaa 26 TOT
31 October4 november 2008 Cisara, Bogor 24 TOT
25 Je 2009 Batam 24 TOT
912 Je 2009 Jogjakarta 24 TOT
1316 november 2006 Bogor 17 CTT2830 Agst 2007 Cisara, Bogor 14 CTT
46 Je 2008 Cisara, Bogor 23 CTT
1820 november 2008 Tretes, Srabaa 20 CTT
58 ebrar 2009 Cisara, Bogor 23 CTT
1618 november 2009 Badga, Semarag 14 CTT
2022 november 2009 Batam 25 CTT
companies have conrmed that the proposals
were very valuable to them.
As to the workers, their awareness o
OH&S at the workplace is increased through
improvements carried out at the workplace.
Reerences1. Dr. Jukka Takala, Director, Sae Work, Interna-
tional Labour Ofce (ILO).- Originally in the UK in
Hazards magazine or its International WorkersMemorial Day.
2. http://www.jila.or.jp/English-jila/genpro/posi-
tive/about/index.html, retrieved 10 January 2010.
3. Kazutaka K, Kawakami T. Trainer Guide or
OHS JILAF POSITIVE Program. The Institute or
Science o Labour, Japan International Labour
Foundation 2002.
Bambang Surjono
Vice Geera Secretar o Coederatio o
Idoesia Trade uios
paza Basmar 2d oor
J. Mamag praata 106
Jakarta 12790
Idoesia
photos b Bambag Srjoo
7. Training participants
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Developing OSH training systems Chaeges acig ood eterrises i Chiayhag WAnG, Chia
Development o ood enterprises in
China
Since the implementation o the Opening-up
Policy in 1978, the ood industries in China
have developed in rapid strides. In 2009, the
gross value o the industrial output o ood
industries reached 4.9 trillion RMB, an in-
crease o 14.6% on 2008; this is 6.6% higher
than the average growth rate or industrial
output. Food industries in China account or
about 20.4% o the increase value o indus-
trial output (1). Food industries are closely
linked to the living quality and health o the
people, and they play a major role in absorb-
ing redundant labour in rural areas o China.
Tere are more than 9.5 million workers em-
ployed in ood industries; this is about 17.9%
o the total ormal employment (2). Devel-opment o the ood industries has supported
the development o agriculture and armers,
increasing the armers income and spurring
urbanization (3).
From now on, development o the ood in-
dustries in China aces both challenges and op-
portunities (4). Among the opportunities are:
the State will invest more and more in sci-
entic and technological modernization o
the ood industries;
the rapid economic development, indus-
trialization, and urbanization give rise to
greater market demand or ood industry
products;
globalization provides wider resource al-
location or the ood industries.
Te challenges acing the ood industries in-
clude the ollowing:
the complicated international market has
intensied the competition or resourc-
es, markets, technology and intellectual
resources trade protectionism is rising;
industrialized countries benet rom their
dominant economic and technological po-
sition;
it is easy to orm a market monopoly in
China;
since the Opening-up Policy, oreign capital
has been fowing into Chinas ood indus-
tries, imposing heavy pressure on domestic
ood enterprises.
OSH situation o ood enterprises in
China
Food processing enterprises have certain ex-
tensive risks, as some chemical materials are
used, there are occupational hazards, many
fammable and explosive materials are present,
gigantic volumes o raw materials are stored
on site, logistics are on a large scale, many
man-machine interaces exist, and the new
processing project is proceeding very quick-
ly. All o these actors present comparativelyhigh risk levels to the ood industries in China.
According to incomplete statistics o the
State Administration o Work Saety, rom
2001 to 2009, 53 comparatively large-scale ac-
Photo by ILO
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cidents (an accident causing more than three
atalities is called a comparative large-scale
accident in the Chinese occupational saety
legislation, and inormation on them are pub-
lished in real time on the ocial website) oc-
curred in ood industries and led to 253 atali-
ties in total (trac accidents are not includ-
ed). Tese statistics mean that a comparatively
large-scale accident occurs in Chinese ood
enterprises every second month (5), (see a-
ble 1 and Figure 1). Te gures on accidents
causing one or two atalities may be dozens
o times higher than those or comparatively
large-scale accidents, but there is a lack o reli-
able data. From the point o view o the com-
paratively large-scale accidents that occurred
in the past nine years, the same types o acci-
dents happen again and again; the ood indus-
tries have not learned their lesson. Although
the level o risk in the ood industries is not
as high as in the mining, chemical, and con-
struction industries o China, nevertheless theood industries still have certain specic risks.
Challenges in OSH training acing
ood enterprises in China
A large number o small enterprises lack the
input o saety training
According to a White Paper o the Inormation
Oce o the State Council (6), there are 450,000
ood enterprises in China; most o them small
and medium-sized enterprises. A total o 80%
o them employ ewer than 100 people, and77% ewer than 10 people. A large proportion
o the home-style producers cannot meet the
saety standards at all (7). Owing to the intense
competition, the prot margin o ood process-
ing enterprises is very low, and the gross prot
margin is about 1020%. o cut costs, many en-
terprises reduce their input in saety and health
protection and there is little capital to und OSH
training, which worsens the occupational saety
and health situation.
A large number o migrant workers lack saety
awareness and skills
Migrant workers (also called arm workers
in China) have become a major labour orce
during the industrialization and urbanization
process in China. Tey migrate rom rural ar-
eas to cities every year, and contribute great-
ly to the development o society. But the mi-
grant workers are poorly educated and have
poor saety awareness. Tey do not have the
necessary saety protection ability. Te result
is great pressure on the occupational saety
management. In the past years, more than hal
o the work accidents and new cases o occu-pational diseases are suered by the migrant
workers. raining or migrant workers is ur-
gently needed to change the current serious
OSH situation (8) in China.
Figure 1. The tred o comarative arge-scae accidets i ood eterrises i
Chia.
Table 1. Comarative arge-scae accidets rom 2001 to 2009 i ood
eterrises i Chia
year Accidets ataities
2001 3 10
2002 9 36
2003 4 21
2004 5 26
2005 4 12
2006 5 28
2007 10 58
2008 6 29
2009 7 33
Tota 53 253
According to the Migrant Workers Inves-
tigation Reportof the State Council in 2006,
only 20% of the migrant workers can obtain
short-term occupational training, 3.4% have
primary-level occupational training, 0.13%
have intermediate-level level occupational
training, and 76.4% have no occupation-
al training at all. Thus the coverage of the
safety training for the migrant workers is
very low.
Migrant workers usually have a short-term
contract with their employers and there is an
oversupply of migrant workers. For these rea-
sons, employers are not willing to invest in
training for them. At the same time, migrant
workers lack safety protection awareness, nor
do they actively participate in safety training
activities. It is therefore very common for them
to work without safety training.
A lack o qualifed trainers and targeted docu-
ments
Some enterprises send their workers to occu-
pational training schools or organizations butthen complain aerwards that the outcome o
training is useless. Many training programmes
do not match the real needs. Some training
organizations cannot conduct saety training
properly, as they lack qualied trainers. Al-
though some workers obtain saety training,
their saety awareness and skills did not im-
prove remarkably (9).
The corps of trainers cannot keep up with
the rapid pace of development of the produc-
tion process, technological modernization, and
equipment updates, and they cannot solve the
new problems and situations. Most of the train-
ing materials are out-of-date and lack informa-
tion about the new situations, so the contents
of training are alienated from reality and do
not provide the proper guidance. The training
method is also stereotyped and has not been re-
vised. Most training is done in the classroom,
through lectures and listening; this passive
and dull method also compromises the train-
ing effect (10).
Occupational safety and health has some
common issues across industries, but there are
also differences between different industries.
Some high-risk industries in China, such as
petrol and chemical, mining, and construction
industries, have developed training materialstargeted to their individual characteristics. For
the food industries, however, no such efforts
have been made and no corresponding mate-
rials are available.
12
10
8
6
4
2
0
70
60
50
40
30
20
10
0
2001
2002
2003
2004
2005
2006
2007
2008
2009
Accidetatait
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A lack o relevant industrial authority
management on OSH issues
Mining, construction, and chemical industries
in China have their own individual industri-
al management authorities or occupational
saety and health issues. By contrast, the ood
industries lack an industrial authority to man-
age the OSH issues.
There is a China National Food Industry
Association (CNFIA), founded in 1981, that
plays an important role in the development
of the industrys economy, its scientic and
technological development, and fair compe-
tition. But the Association does not function
in OSH issues for the food industries. The
China Association of Work Safety, founded
in 2008, and the China Occupational Safety
and Health Association, founded in 1983, are
both general associations and do not have spe-
cic and professional activities involving the
OSH issues of the food industries.
Because o the lack o relevant industrialauthority management on OSH issues in the
ood industries, it is hard to implement in-
dustry-wide training programmes, and it is
hard to guarantee the training perormance.
Suggestions or developing OSH
training systems or ood enterprises
in China
Te major actor hindering OSH training
in the ood industries is the limited capital.
It is necessary to establish a mechanism tobalance the input rom the government,
employer and employee organizations.
Te government and employer organiza-
tion should shoulder more responsibilities
to build a training system that would cover
the OSH needs o the ood industries.
It is essential to improve the saety aware-
ness o employers and employees by using
the popular media to disseminate saety
awareness. Everybody really needs to buy
into the concept o putting people rst, car-
ing about lie and caring or saety. Tey
must be motivated to learn saety skills and
they must require higher saety conditions.
It is very important or China to have a lead-
ing organization that would pay close at-
tention to OSH issues or the ood indus-
tries. Such an organization would coordi-
nate with dierent stakeholders, develop
a training plan, obtain the capital, organ-
ize and conduct training programmes, and
meet the specic saety and health needs o
the ood industries.
Te Government or employer organiza-
tions should develop practical and target-ed training materials and should train more
and more qualied OSH trainers or the
ood industries.
New inormation technology, such as dis-
tance education and distance training on
OSH, should be considered in order to de-
crease the training cost and improve the
eect.
Reerences:
1. Xinhua net. This year the gross value o industrialoutput o ood industries reached 4.9 trillion RMB
in China. Available at: http://news.xinhuanet.com
Accessed 21 November 2009.
2. The Central Peoples Government o Peoples Re-
public o China. China Food Science and Technol-
ogy Development Report o 20072008. Available
at: http://www.gov.cn Accessed 7 April 2009.
3. China Agro-product Processing net. The National
11th Five Year Development Plan o Agro-product
Processing Industries. Available at: http://www.
csh.gov.cn Accessed 20 January 2007.
4. Liu Z, Hu L. Status and prospects o ood indus-
tries in national economy development. Food and
nutrition in China 2009;3:2325.
5. State Administration o Work Saety. AccidentsPublish and Search System. Available at: http://
media.chinasaety.gov.cn Accessed at 10 August
2009.
6. The Central Peoples Government o Peoples Re-
public o China. Inormation Ofce Issued China
Food Quality Situation White Paper. Available at:
http://www.gov.cn Accessed 17 August 2007.
7. Bureau o Economic Operations, National Devel-
opment and Reorm Committee. Restraining Fac-
tors and Counter Measures or Food Industries
Healthy Development. Chinese Medicine 2007
Jun;7.
8. Sun Y. Five Problems o the Farmer Workers
Saety Training. Labor Protection 2008;1:70.9. Huang Y. In-service Training or Migrant Workers:
Problems and Proposals. Journal o Shenzhen
Polytechnic 2007;1:8992.
10. Zhang Y, Wang Y, et al. Problems and Counter-
measures or Saety Training in China Enterprises.
In Proceeding o the 14th Symposium on Occupa-
tional Saety and Health rom Taiwan, Mainland,
Hong Kong and Macao. Xian, 2006.
Yuhang WANG
Det Maager
Work Saet Servisio Ofce
Chia Agri-Idstries Hodigs limited
Add:Rm02,17,COCO, orte paza,
nO.8 Chao yag Me Soth St.
Beijig, Chia 100020
Emai:[email protected]
Web:www.coco.com
PhotobyILO
18 Asia-pacifc newsett o Occ Heath ad Saet 2010;17:168
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InternationalTraining Centre traiig orthe word
Teem lidors, iad
Working conditions around the world are
not equal. Te conditions o work and even
the basic rights o workers vary considerably
between dierent countries. Many countries
around the world are making strong economic
progress while others are acing major chal-
lenges. Regardless o the progress or slack-
ness o the economy or political turbulence,
one should eel sae and equal at work. Te
International Labour Organization (ILO) is
devoted to advancing opportunities or wom-
en and men to obtain decent and productivework in conditions o reedom, equity, secu-
rity and human dignity. o urther the goal
o decent work or women and men, ILO and
the Italian Government established the In-
ternational raining Centre (ICILO) in u-
rin, Italy in 1964, as an advanced vocational
training institute.
Multinational training
Te Centre provides training and services that
develop human resources and institutional
capabilities. Each year about 11,000 people
rom over 180 countries take part in the Cen-
tres training activities and events. Altogether
more than 450 programmes and projects are
run every year. Te Centres demand-driv-
en training portolio consists o courses in
key work-related areas. Te orms o training
are standard courses, tailor-made courses and
comprehensive projects. o reach more and
more people, the Centre is using a series o
distance training programmes. Some o these
are complemented by ace-to-ace sessions.
Trough training, the Centre contributes toachieving the ILOs our strategic objectives:
to promote and realize standards and un-
damental principles and rights at work
to create greater opportunities or wom-
en and men to secure decent employment
and income
to enhance the coverage and eectiveness
o social protection or all
to strengthen tripartism and social dia-
logue.
Participants and benefts
Te participants o trainings usually hold
managerial or executive positions in minis-
tries, workers organizations, employers or-ganizations, enterprises, training institutions
or universities, etc. Many o the participants
are themselves trainers or trainers o trainers.
Trough the Institutes training, participants
gain an in-depth understanding and practice
concerning international labour standards,
decent work, social protection, social dialogue
and related development issues. Tey learn
to analyse common problems and challenges
and to nd sustainable solutions. All are cho-
sen careully to ensure the multiplier eect.
Aer their training, participants should ap-
ply their newly acquired insights and skills in
their work and pass them on.
Te Centre has ve Regional Programmes,
which include Arica, the Americas, the Arab
States, Asia and the Pacic, and Europe. Te
Centre ensures that its activities are relevant
and expedient to local needs, goals and con-
ditions. Regional needs are monitored and
activities coordinated in cooperation with the
eld oces o the International Labour Or-
ganization. Te regional oces also help raise
the unds that nance the Centres activities in
those regions.
Training in Asia and the Pacifc
Te ILOs International raining Centre works
in and with Asia and the Pacic to strengthen
the capacity o governments, workers organ-
izations, employers organizations and other
civil society bodies to solve problems, and to
devise policies and manage systems that pro-
mote decent work. In 2009, around 1,900 peo-
ple rom Asian and Pacic countries took part
in the Centres trainings. Te trainings were
held in urin, in many dierent countries and
on-line. Each Regional Programme has dier-
ent priority topics. For Asia and the Pacic the
Centre concentrates on: labour migration
youth employment
vocational training systems and skills de-
velopment
enterprise development and micronance
improvement o working conditions and
productivity
industrial relations
child labour and orced labour.
raining itsel is not a solution or prob-
lems in decent work but it gives a key to en-
hancement. By improving the skills and com-
petence o individuals, the awareness o rights
and entitlements in work lie increases. Tat
is the purpose o the International raining
Centre.
Additional inormation and contacts:
Iteratioa Traiig Cetre o the IlO
Viae Maestri de lavoro, 10
10127 Tri, Ita
E-mai: [email protected]
www.itcio.org
Corse caedar:
www.itcio.org/e/stadard-corses-regist-
ratio/corse-caedar
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Cardiovascular healthand work on ocus
Svi lehtie, iad
NIVA, the Nordic raining Institute
in Occupational Health, together with
ICOH Scientic Committees on Car-
diology, Occupational Medicine, and
Health Services Research and Evalua-
tion in Occupational Health, organized
a Symposium on recognition, preven-
tion and control o work-related car-
diovascular disorders on 2224 March
2010 in Espoo, Finland. Proessor Jor-
ma Rantanen served as the moderator
o the Symposium.
In his opening keynote Proessor
Pekka Puska, Director General o the
National Institute or Health and Wel-
are in Finland, and President o the
World Heart Federation stated that
thanks to eective prevention pro-
grammes, the incidence o cardiovas-
cular disorders (CVD) is declining in
many industrialized countries. It is,
however, growing in the developing
world.
Work-related CVDs constitute amajor burden to health and economies
o countries. In addition to traditional
cardiotoxic chemical and physical ac-
tors, the Meeting recognized the great
impact o psychosocial actors on mor-
bidity. We have evidence on temporali-
ty o association, and dose-response re-
lationship, but the complex multiacto-
rial relationships and conounding ac-
tors still constitute a