See all slides at: https://www.slideshare.net/jstakala

Carcinogens at work: a look into the future Austrian EU Presidency, Vienna 24-25 Sep. 2018

Dr Jukka Takala (Adjunct Prof), DSc MSc BSc, FFOM (Hon) Executive Director emeritus

President

International Commission on Occupational Health

Commission Internationale de la Santé au Travail

Comisión Internacional de Salud en el Trabajo

2

s s

Elimination of Occupational Cancer through Exposure Reduction

About ICOH 1906

Milan 1906

Milan

1972

Buenos Aires

1975

Brighton 1963

Madrid

2003

Iguassu Falls

1928

Budapes

t

1931

Geneva

1987

Sydney

1984

Dublin

1960

New York

1954

Naples

1948

London

1938

Frankfurt

1935

Brussels

1978

Dubrovnik

1910

Brussels

1925

Amsterdam

1969

Tokyo

1966

Vienna

1957

Helsinki

1951

Lisbon

1981

Cairo

1996

Stockholm

1990

Montreal

1993

Nice

2000

Singapore

2009

Cape Town 2006

Milan

2012

Cancun

2015

Seoul

2015

Seoul

SUSTANING MEMBERS AFFILIATE MEMBERS

The International Commission on Occupational Health (ICOH)

is an international non-governmental professional

society whose aims are to foster the scientific progress,

knowledge and development of occupational health and safety

in all its aspects.

COLLABORATION WITH INTERNATIONAL NGO’s

PARTNERS

2018

Dublin

2018

Dublin

2021

Melbourne 2021

Melbourn

e

1898-1905 – Simplon-Tunnel Construction Giuseppe Volante

www.ICOHweb.org

Cancer, AFwork=13.8%

CVD, AFwork=14.4%

Injuries

Deaths in 2016 by age, Western Europe

AF= Attributable

Fraction, re work

Communicable AFwork=13.3%

GBD= Global Burden

of Disease

Violence

DALYs in women in 2010 by age, high-income Asia-Pacif.

Injuries

Mental health,

AFwork= 30+ %

Cancer

AFwork= 5.5-8 %

CVD,stress

AFwork= 7.9 %

DALY= Disability

Adjusted Life Years

DALYs in 2016 by age, Western Europe

AF= Attributable Fraction, re work

Communicable AFwork=13.3%

Global figures 2017 Estimated 2.78 million deaths

Fatal occupational accidents

380,500

Non-fatal occupational accidents 374 million (at least 4 days absence)

Fatal work-related diseases

2.4 million

Occupational cancer 742,000

2014

Estimated 2.32 million deaths

Fatal occupational accidents

341,373

Non-fatal occupational accidents 302 million (at least 4 days absence)

Fatal work-related diseases

1.98 million

Occupational cancer 666,000

Sources: ILO, WHO, Scientific reports

Work-related Deaths, Costs, EU 28 and Global Eur.Union

• Work-related circulatory diseases - 48,500

• Occupational cancer + 106,300

• Work-related communicable dis. (5,000)

• Respiratory diseases ++ (12,100)

• All work-related diseases ++ 200,209

• Fatal occupational injuries 3,739

• Total occupational mortality 203,946

• GLOBAL ++ 2.78 mill. ============

Cost %

of GDP

0.81%

3.20%

0.06%

3.26%

3.94% ===========

2,5%

52.1% EU cancer deaths: 106,000 of which asbestos 85,900 (ILO 2017 and GBD2016) …

5,7%

28,0%

6,0%

0,8% 1,0% 2,4%

CommunicableDiseasesMalignantneoplasmsNeuropsychiatricconditionsCirculatorydiseasesRespiratorydiseasesDigestive diseases

GenitourinarydiseasesAccidents &violence

Circulatory

Diseases

Cancers

In EU28, cardiovascular and circulatory diseases accounts for 28% and cancers at 52%.

They were the top illnesses responsible for 4/5 of deaths from work-related diseases.

Occupational injuries and infectious diseases together amount accounts for less than 5%.

Work-related Deaths caused by Illness and Injury, EU and High Income countries

See “Global estimates”: https://goo.gl/hTZaW5

Austrian cancer deaths: 1896 ILO 2017

Work-related (w)

w

w

w

w

w

w

W-r

w

w

w

w

w

w

w

w

w

w

w

Disability Adjusted Life Years, DALYs in Global Burden of Disease

Death rate (per 100,000) Non-smoker Smoker

No asbestos 11 123

Asbestos 58 602

Age-standardized lung cancer death rates

Hammond EC, Selikoff IJ, Seidman H. Asbestos exposure, cigarette smoking and death rates.

Ann N Y Acad Sci 1979;330:473-90.

Example of poor emphasis on work exposures Combined effect of exposures to asbestos and smoking on lung cancer

Applicable to selected other carcinogens

Attributable Fraction, AF is

based on risk ratio, RR

AF = (RR-1)/ RR

GBD/IHME

AF Principle

2098

And new ILO data released in 2017

106,307

Source new,

ILO:

goo.gl/hTZaW5

Source:

goo.gl/fuUXsl

Switzerland 1905

GBD/IHME

in 2017

Source new,

GBD/IHME:

goo.gl/isCng3

99,083

Norway 759

17

1481

849

1896

183

2326

1285

303

1163

12,623

18,180

1678

1860

13

968

18

11,057

23

510

710

110

80

23

3879

7874

2457

4498

10

1211

446

10,248

2201

14,082 19,232

Latest 2017 data, EU-OSHA,

ICOH and WSH-Institute

Latin America (L.A.) numbers compared

https://osha.europa.eu/en/about-eu-osha/press-room/eu-osha-presents-new-figures-costs-poor-workplace-safety-and-health-world

EU-28 proportion (%) of the main causes for work-related mortality and morbidity in DALYs per 100,000 employees

Morbidity, DALYs

Mortality, deaths

Sources: ILO, WHO, Scientific reports

https://goo.gl/

Global figures Sources: ILO, WHO, Scientific reports

Comparative analysis

based on past 2014 country

data

Latest 2017 data, EU and High-Income Countr.

https://osha.europa.eu/en/about-eu-osha/press-room/eu-osha-presents-new-figures-costs-poor-workplace-safety-and-health-world

http://www.omfi.hu/cejoem/accident.htm

https://goo.gl/hTZaW5

http://www.efbww.org/pdfs/CEJOEM%20Comparative%20analysis.pdf

Source: John Cherrie, IOM, ICOH/Takala

CAREX Canada

Not covered by GBD/IHME

Cost Comparison with selected countries

As a proportion of GDP, cost of work-related injuries and ill-health

Korea, 3.58%

Australia, 3.00%

Singapore, 3.46% (3.46-4.06%. Singapore’s est. 3.8% )

Global, 3.94%

New Zealand, 3.19% United States, 3.25%

United Kingdom, 2.90%

Finland, 3.34%

Germany, 3.33%

Netherlands, 3.12%

Japan, 2.65%

9

WHO Western Pacific 3.98%

WHO South East Asia 4.40%

EU 28 3.26%

Source: ILO/ICOH/EU

Cost Estimates of

Occupational Accidents

and Work-related

Diseases, 2015

ASEAN 4.12%

L.America, 3.71%

(3.47-4.33%) Ireland, 3.47% Bulgaria, 3.65%

WHO Africa, 4.00%

Deaths at Work/All Estimated Global Mesothelioma Deaths (annual, based on WHO data

* Reported N* in 59 countries, estimated M* in 172 countries, Odgerel,Takahashi et al17

Asbestos related lung cancer and other asbestos related deaths (Takala et al, modified from CEJOEM)

Methods of estimated lung cancer deaths using

mesothelioma as a proxy for asbestos use

Lung cancer/

mesotheliom

a rate

Asbestos related lung, other cancer (and other asbestosis) deaths

World China

McCormack, Peto et al. (2013) average estimate using

chrysotile, lung cancer, all , GBD 2015 Study

6.1 197,475

McCormack, Peto et al. (2013), low - high estimates, lung

cancer, all, GBD

2.0-10 64,746 – 323,730

GBD2016 based rate between (global asbestos-related lung

cancer, ovary and larynx cancers, asbestosis),and

mesothelioma death numbers at work, GBD2016,

6.92

222,322work – 247,363work

based on GBD/IHME 2016work Area Meso/ARLC/Ova/Lary,Asbestosis China 2,178/17,971/270/198/323 Earth 27,612/181,450/6022/3743/3495

Global asbestos deaths, work: 222,321 - 242,802 Mid-point 232,562

All asbestos exposed, global: 243,223 - 260,029 Mid-point 251,626

www.mdpi.com/1660-4601/15/5/1000

Asbestos deaths at work, GBD2016 detailed table located at the end of this presentation

Lung Mesothelioma Ovary Larynx Asbestosis TOTAL cancer +Chronic

USA 34,270 3,161 787 443 613 39,275

EU28 85,914

China 17,971 2,178 270 198 323 20,940

UK 14,056 2,837 760 174 209 18,036

Belgium 2,391 278 65 34 25 2,794

Austria 769 118 41 12 3 942

Finland 602 103 29 6 20 760

Earth 181,450 27,620 6,062 3,743 3,495 222,321

Sources: GBD 2016 https://vizhub.healthdata.org/gbd-compare/ The Lancet 2017; 390: 1345–422 Global asbestos disaster Int. J. Environ. Res. Public Health 2018, 15(5), 1000; https://doi.org/10.3390/ijerph15051000 And Supplementary tables ZIP document from the website http://www.mdpi.com/1660-4601/15/5/1000

‘Human health is a precondition for, and an outcome, and

indicator of all three dimensions of sustainable development’

“1. Everyone has the right to just and favourable conditions of work. Every worker has a right to

dignity, to be treated ethically, with respect and without being subjected to conditions of work that are

dehumanizing or degrading. States have undertaken an ambitious goal under the Sustainable

Development Goals: to ensure decent work for all by 2030.

2. Despite clear obligations relating to the protection of workers’ health, workers around the world find

themselves in the midst of a public health crisis due to their exposures to hazardous substances at work.

While the World Health Organization (WHO), the International Labour Organization (ILO) and others

have called for action on this public health crisis for decades, the global problem of workers’ exposure

to hazardous substances remains poorly addressed.

3. It is estimated that one worker dies every 15 seconds from toxic exposures at work, while over

2,780,000 workers globally die from unsafe or unhealthy conditions of work each year. Occupational

diseases account for 2.4 million (over 86 per cent) of total premature deaths. An “occupational disease”

is any disease contracted primarily as a result of an exposure to risk factors arising from work activity,

including chronic exposure to toxic industrial chemicals, pesticides or other agricultural chemicals,

radiation and dust, among other hazards. Approximately 160 million cases of occupational disease are

reported annually. Inaction by States and businesses on this global public health crisis is estimated to

cost nearly 4 per cent of global gross domestic product, or virtually $3 trillion.” …

“The exposure of workers to toxic substances can and should be considered a form of exploitation and

is a global challenge…”

Report of the Special Rapporteur on the implications for human rights of the

environmentally sound management and disposal of hazardous substances and wastes

(United Nations Human Rights Council, Sep 2018)

• Exposures until today determine future trends,

exposure elimination/limitation has been poor and

cancer cases go up;

• Most changes in future exposures depend on

structural changes and new technological processes,

not (yet) initiated by preventive measures;

• One cannot fight cancer at work in general, it must be

based on detailed measures for limiting each

individual exposures;

• Ramazzini: “May I ask what is your occupation?”

• CAREX – Cancer exposure Register - by occupation;

Summary

• Priority order is important, 50 exposure limits;

• Hierarchy of control is vital: elimination, substitution..;

• Most people think that the asbestos problem is

solved.. Another wave of exposures/cancers may be

coming from today’s and near future demolitions,

removal and related exposures. Such work is not

properly done in most countries in the EU today;

• Capacity of Member states;

• EU Campaign and programme on occupational cancer

Summary

Dublin Statement on Occupational Health

The 32nd International Congress on Occupational Health in Dublin on Friday May

4th, 2018, adopted the Dublin Statement on Occupational Health, which expressed

the commitment of ICOH to take action for prevention of occupational cancer and

ARDs in collaboration with other relevant international actors. The statement was

signed by Dr. Martin Hogan, president of the ICOH Congress 2018 and Dr. Jukka

Takala, president of ICOH.

Download the Dublin Statement on Occupational Health

https://www.slideshare.net/jstakala

Additional Slides

Examples of attributable fractions

Strategies for Preventing Occupational Cancer contnd.

• (i) advocate measurable and continuous reduction of exposures to gradually eliminate occupational cancer.

• (ii) An international programme ‘Elimination of occupational cancer’ should be launched

• (iii) The EU must be a key driver for such programme, collaborating with ILO and WHO and all relevant organisations, including professional organisations,

Strategies for Preventing Occupational Cancer contnd.

• (iv) CAREX should be updated, new major model Burden of Occupational Cancer by Canada

www.occupationalcancer.ca/2011/burden-of-occupational-cancer/

• (v) Exposure limit values should be updated:

- USA reduced the exposure limit for silica dust from 0.1 mg/m3 to 0.05 mg/m3. OSHA/USA expects to eliminate 60% of the silica caused fatalities with this measure

Strategies for Preventing Occupational Cancer contnd.

- New exposure limits ? Diesel exhaust, Chromium VI…

- European Commission new proposal, reduces silica exposures and 100,000 lives saved in 50 years, 2,000 year;

- If new USA new limit followed, another 100,000 lives saved

- Dutch Expert Committee on Occupational Safety (DECOS) has proposed that the occupational exposure limits (OELs) for asbestos be reduced from 10,000 fibres/m3 (all types) to 420 fibres/m3 for amphibole asbestos, 1,300 fibres/m3 for mixed asbestos fibres, and 2,000

fibres/m3 for chrysotile asbestos.

Strategies for Preventing Occupational Cancer contnd.

• A comprehensive set of recommendations are given in : https://osha.europa.eu/en/tools-and-

publications/publications/reports/report-soar-work-related-cancer

In 2017 WHO, ILO and ICOH reached out to experts for systematic

reviews of evidence to support estimation of burden for each pair Pair Risk factor Health outcome 1 Occupational ergonomic factors Musculoskeletal disorders

(except low back pain) 2 Occupational exposure to dusts and fibres Pneumoconiosis 3 Occupational exposure to ultraviolet radiation Cataracts

Melanoma and non-melanoma skin cancer

4 5 Occupational noise Deaths from cardiovascular

disease 6 Occupational violence Inter-personal violence

(intentional injuries) 7 Psychosocial risk factors (i.e., one of: job strain, job

control, effort-reward imbalance, job insecurity, long working hours or shift work)

Ischemic Heart Disease Stroke

8 Depression 9 Alcohol use (intermediary

Outcome)

10

Slide source: Marilyn Fingerhut, ICOH

225.939 37.198

50.038 29.036 56.277

110.662 233.085

103.863

60.151

48.580 50.597

129.992

246.885

223.105 51.363

21.419

18.834 27.123

13.714

215.118 128.018

10.757

65.145

19.388 21.113

14.159

124.404

125.535

0

100.000

200.000

300.000

400.000

500.000

600.000

700.000

800.000

900.000

High Afro Amro Emro Euro Searo Wpro

Occupationalinjuries

Genitourinarydiseases

Digestive diseases

Respiratory diseases

Occupational Deaths: World, 2015 in WHO Regions

AMRO

AFRO

HIGH EURO

EMRO

SEARO

WPRO

Additional Slides

Additional Slides

Additional Slides 313.000

GBD/IHME

Summary

Rank Country Total Occupational exposure to asbestos Mesothelioma

(observed)

%

Occupat

ARLC/

Meso

Asbestosis

(observed) Total Mesothelioma Lung cancer Ovarian cancer Larynx cancer Asbestosis

B+C+D+F+G A+B+C+D+E A B C D E F A/F B/A G

1 United States 39,395 39,275 3,161 34,270 787 443 613 3,282 96.3% 10,84 613

2 China 21,510 20,940 2,178 17,971 270 198 323 2,747 79.3% 8,25 323

3 United Kingdom 18,063 18,036 2,837 14,056 760 174 209 2,864 99.1% 4,96 209

4 Japan 16,648 16,591 1,449 14,529 189 105 320 1,506 96.2% 10,03 320

5 Italy 15,422 15,394 1,699 12,810 488 297 101 1,727 98.4% 7,54 101

6 Germany 15,278 15,242 1,729 12,613 509 193 199 1,765 98.0% 7,29 199

7 France 12,508 12,481 1,546 10,083 379 215 257 1,573 98.3% 6,52 257

8 India 7,565 7,136 1,976 4,018 144 517 482 2,405 82.2% 2,03 482

9 Canada 5,911 5,896 648 5,031 89 67 61 663 97.8% 7,76 61

10 Spain 4,952 4,932 494 4,137 108 121 71 515 96.0% 8,37 71

11 Russia 4,843 4,776 624 3,716 294 113 29 691 90.2% 5,96 29

12 Netherlands 4,671 4,664 639 3,845 122 45 13 647 98.9% 6,02 13

13 Turkey 4,282 4,250 507 3,573 65 83 22 539 94.1% 7,04 22

14 Australia 4,058 4,048 766 3,017 140 48 77 776 98.7% 3,94 77

15 Brazil 3,528 3,441 691 2,417 129 139 64 778 88.8% 3,5 64

16 Poland 2,930 2,913 234 2,510 95 61 12 251 93.2% 10,74 12

17 Belgium 2,799 2,794 278 2,391 65 34 25 283 98.3% 8,6 25

18 Vietnam 2,038 2,000 127 1,834 11 23 5 165 77.3% 14,4 5

19 South Africa 1,839 1,823 280 1,338 35 54 117 296 94.6% 4,78 117

20 South Korea 1,780 1,760 117 1,586 18 15 24 138 85.0% 13,5 24

21 Iran 1,666 1,630 363 1,162 10 84 11 399 91.0% 3,2 11

22 Argentina 1,597 1,580 202 1,255 58 39 26 219 92.3% 6,22 26

23 Bangladesh 1,572 1,525 137 1,319 5 37 27 183 74.7% 9,64 27

24 Thailand 1,556 1,522 222 1,255 10 31 4 255 86.8% 5,66 4

25 Ukraine 1,364 1,344 309 825 178 25 7 329 93.9% 2,67 7

26 Switzerland 1,276 1,273 203 1,015 36 16 3 206 98.3% 5,01 3

27 Denmark 1,265 1,263 131 1,061 47 13 10 134 98.2% 8,07 10

28 Mexico 1,167 1,123 323 690 53 33 24 366 88.1% 2,14 24

29 Sweden 1,161 1,157 173 898 63 10 13 177 97.7% 5,2 13

30 Myanmar 1,131 1,108 166 798 117 25 3 188 87.9% 4,81 3

31 Greece 1,098 1,093 79 967 27 19 2 83 94.5% 12,25 2

32 Indonesia 1,088 984 337 556 47 29 15 440 76.5% 1,65 15

33 Austria 946 942 118 769 41 12 3 121 96.9% 6,54 3

34 Pakistan 873 819 158 537 32 60 31 212 74.6% 3,4 31

35 Taiwan 766 756 52 677 5 8 14 62 83.8% 13 14

36 Finland 763 760 103 602 29 6 20 106 97.9% 5,83 20

37 Croatia 747 745 67 637 16 19 6 69 97.3% 9,55 6

38 Norway 645 643 80 527 23 5 8 82 97.7% 6,6 8

39 Philippines 643 605 105 471 13 9 7 142 73.5% 4,5 7

40 New Zealand 610 609 97 478 16 7 10 99 98.3% 4,91 10

41 Portugal 560 556 63 460 13 14 6 67 93.4% 7,32 6

42 Romania 545 536 62 436 22 14 2 71 87.4% 7,03 2

43 Hungary 510 506 35 444 16 9 1 40 88.9% 12,51 1

44 Czech Republic 494 489 47 414 21 6 2 51 91.1% 8,84 2

45 Ireland 454 453 44 389 10 6 4 46 96.5% 8,82 4

46 North Korea 414 404 34 354 5 3 8 45 77.2% 10,29 8

47 Colombia 397 380 83 265 13 12 7 100 83.1% 3,18 7

48 Serbia 391 388 32 338 8 9 1 36 88.9% 10,71 1

49 Israel 381 378 45 310 16 5 2 48 94.2% 6,89 2

50 Chile 363 355 58 279 9 6 3 66 89.1% 4,77 3

51…

…195

Global 224,918 222,321 27,612 181,450 6,022 3,743 3,495 30,208 91.4% 6,57 3,495

42

Significance of health at work in sustainability

Health and work ability of the working population is a key asset to sustainability. The ultimate outcome of the input of the global workforce is a total global gross domestic product (GDP) of USD 75 trillion per year (some 22,000 USD per worker). This GDP provides the economic and material resources, which sustain all other societal activities, including health and social services, training and education, research and cultural services. In addition to these material and tangible values, human labour is also behind the most intangible assets of society such as sustainability of the social fabric, level of education, general knowledge and social cohesion.

44

SDG 3: Ensure healthy lives and promote well-being for

all at all ages

Targets Indicators1 Public health interventions

3.4 by 2030 reduce by one-third pre-

mature mortality from non-

communicable diseases (NCDs)

through prevention and treatment, and

promote mental health and wellbeing

3.4.1 Mortality of

cardiovascular

disease, cancer,

diabetes, or chronic

respiratory disease

Managing OH Risks

•Substitute occupational carcinogens

•Dust control

•Improve work organization

•Prevent and manage stress

•Workplace health promotion

•Smoke free workplaces

3.8 achieve universal health

coverage (UHC), including financial

risk protection, access to quality

essential health care services, and

access to safe, effective, quality, and

affordable essential medicines and

vaccines for all.

t.b.d.

• Build capacities of primary care

to deliver essential interventions for

workers' health

• Scale up coverage with basic and

specialized occupational health

services

• Provide health coverage to all

workers, including in the

informal sector

3.9 by 2030 substantially reduce the

number of deaths and illnesses from

hazardous chemicals and air, water,

and soil pollution and contamination

3.9.2 Mortality rate

attributed to

hazardous,

chemicals, water

and soil pollution

and contamination

• Safe management of chemicals

at the workplace

• Pesticide safety

SDG 8. Promote sustained, inclusive and sustainable

economic growth, full and productive employment and decent

work for all

Targets Indicators1 Public health interventions

8.7 take immediate and effective

measures to secure the prohibition and

elimination of the worst forms of child

labour, eradicate forced labour, and by

2025 end child labour in all its forms

including recruitment and use of child

soldiers

8.7.1 Percentage

and number of

children aged 5-17

engaged in child

labour, by sex and

age group

• Detection and prevention of

hazardous child labour

• Prohibition of hazardous child

labour

8.8 protect labour rights and promote

safe and secure working environments

of all workers, including migrant workers,

particularly women migrants, and those in

precarious employment

8.8.1 Frequency

rates of fatal and

non-fatal

occupational

injuries and

diseases, by sex

and migrant status

• Regulations and enforcement

for occupational safety and

health Hazard mitigation and

substitution

• Engineering and

administrative controls

• Health education of workers

• Personal protection

• Health surveillance

46

Sustainable Development Objectives – Progress 1990-2030

47

Dissemination: what format book/e-format

Sustainable Development Goals – Occupational risks 2016 Singapore

Sustainable Development Goals – Occupational risks 2016 Finland

GBD DALYs/100,000 rate – Improvement in occupational risks 1990 - 2016 World, Belgium circled

Source: https://vizhub.healthdata.org/sdg/

Conclusions and recommendations of the ICOH 2018 Congress

Preamble

UN SDGs particularly 1,3,8

ILO Declaration No 112 on human rights, and key conventions, C 136, 155, 161, 187, and ILO Resolution

1 June 2006 on asbestos

WHA Resolution on Cancer Prevention and Control 2005: “to pay special attention to cancers for

which avoidable exposure is a factor, particularly exposure to chemicals and tobacco smoke in the

workplace and the environment, certain infectious agents, and ionizing and solar radiation”;

WHO Tokyo Declaration on Universal Health Coverage, GPA for Workers’ health and WHO 2020

Conclusions of the 21st World Safety Congress Singapore, WSH2017 on Zero Vision and Global

Coalition

ILO/WHO Joint Committee Recommendation (2003): ”Elimination of Asbestos-Related Diseases”

(ARD’s) endorsed by ILO Governing Body and WHO Governing Council

1. Information and education

a) Elevation of awareness among decision-makers and stakeholders (International organizations, NGOs)

b) Promotion of banning asbestos among non-banning countries, and strict management of asbestos

present in existing infrastructure everywhere

c) Support the non-banning countries and particularly the Low Income Countries (LIC’s) with

education, technical advice, and feasible good practice guidelines in preparation and implementation of

the ban and elimination of ARDs

d) Providing information on economic and health appraisal of cancer prevention and elimination of

ARDs (WHO Euro)

2. Implementation

All countries to strengthen policies, means and practices feasible and effective for implementation:

a) Mapping existing asbestos in infrastructure, marking and labelling the in situ possible exposure

sources (surveys and data sources)

b) Distribution of information and providing technical advise and support for safe alternatives

c) Regulation and its implementation for asbestos demolition work and waste handling & disposal

d) Monitoring and registration of exposures by competent measurements (if not available, JEMs,

CAREX)

e) Enhancement of competence and capacity in diagnosis of ARDs

f) All countries to register effectively ARDs; Advice and Support by International Organizations

g) Surveys of exposed populations for ARDs

h) Good care of the diseased, including secondary and tertiary prevention, cancer treatment,

rehabilitation, immunizations

h) Justice and fairness in compensation of diagnosed occupational cancers and ARDs

j) Intersectoral collaboration: In addition to Labour, Health, Industry, social partners, several other

ministries should be involved (e.g. Social, Education, Defence, etc., i.e. WHO Health in All Policies)

3. International actions

a) International Organizations, WHO, ILO, International NGOs, ISSA and others to organize

and implement the Global Covenant for support of implementation of the SDGs of the UN

2030 Sustainable Development Agenda

b) Draw up a Covenant for global ban of asbestos, including Pan–European ban and

combined with the EU Parliament’s ‘Freeing the EU from asbestos by 2030’ initiative

c) Provide financial, technical and training, education and information support for

countries willing to join the global asbestos ban and implement National Programmes for

Elimination of Asbestos-related Diseases

d) International Organizations, ILO, WHO, UNEP, IMF and the IIB, to follow the example of the

World Bank and set Decent Work Programmes and Prevention of Occuptional Cancer,

including asbestos ban and elimination of ARDs, as conditions for public investments,

loans and development aid

4. ICOH contribution

a) ICOH to join with the UN and International Organizations and, within the limits of its resources,

provide commitment and expertise for all relevant activities for implementation of the UN

Sustainable Development Goals, particularly the SDGs No. 1, 3 and 8

b) ICOH to join and contribute to the organization and activities of the Global Occupational

Safety and Health Coalition

c) ICOH to provide its knowledge and expertise for collaboration with other international

and national actors for prevention of occupational cancer and elimination of ARDs

d) ICOH to draw up an ICOH Programme for Prevention of Occupational Cancer, including

the ICOH Programme element for Global ban of Asbestos and Elimination of Asbestos-

related Diseases, ARDs

e) In the drawing and implementation of the ICOH programmes, all the means, available for ICOH

should be employed; research, information and education and develoment and

dissemination of good practices

57

SDG 3: Ensure healthy lives and promote well-being for

all at all ages

Targets Indicators1 Public health interventions

3.4 by 2030 reduce by one-third pre-

mature mortality from non-

communicable diseases (NCDs)

through prevention and treatment, and

promote mental health and wellbeing

3.4.1 Mortality of

cardiovascular

disease, cancer,

diabetes, or chronic

respiratory disease

Managing OH Risks

•Substitute occupational carcinogens

•Dust control

•Improve work organization

•Prevent and manage stress

•Workplace health promotion

•Smoke free workplaces

3.8 achieve universal health

coverage (UHC), including financial

risk protection, access to quality

essential health care services, and

access to safe, effective, quality, and

affordable essential medicines and

vaccines for all.

t.b.d.

• Build capacities of primary care

to deliver essential interventions for

workers' health

• Scale up coverage with basic and

specialized occupational health

services

• Provide health coverage to all

workers, including in the

informal sector

3.9 by 2030 substantially reduce the

number of deaths and illnesses from

hazardous chemicals and air, water,

and soil pollution and contamination

3.9.2 Mortality rate

attributed to

hazardous,

chemicals, water

and soil pollution

and contamination

• Safe management of chemicals

at the workplace

• Pesticide safety

SDG 8. Promote sustained, inclusive and sustainable

economic growth, full and productive employment and decent

work for all

Targets Indicators1 Public health interventions

8.7 take immediate and effective

measures to secure the prohibition and

elimination of the worst forms of child

labour, eradicate forced labour, and by

2025 end child labour in all its forms

including recruitment and use of child

soldiers

8.7.1 Percentage

and number of

children aged 5-17

engaged in child

labour, by sex and

age group

• Detection and prevention of

hazardous child labour

• Prohibition of hazardous child

labour

8.8 protect labour rights and promote

safe and secure working environments

of all workers, including migrant workers,

particularly women migrants, and those in

precarious employment

8.8.1 Frequency

rates of fatal and

non-fatal

occupational

injuries and

diseases, by sex

and migrant status

• Regulations and enforcement

for occupational safety and

health Hazard mitigation and

substitution

• Engineering and

administrative controls

• Health education of workers

• Personal protection

• Health surveillance

59

Sustainable Development Objectives – Progress 1990-2030

60

Dissemination: what format book/e-format

Sustainable Development Goals – Occupational risks 2016 Singapore

Sustainable Development Goals – Occupational risks 2016 Finland

GBD DALYs/100,000 rate – Improvement in occupational risks

1990 - 2016 World, Belgium circled

Source: https://vizhub.healthdata.org/sdg/

Conclusions and recommendations of the ICOH 2018 Congress

Preamble

UN SDGs particularly 1,3,8

ILO Declaration No 112 on human rights, and key conventions, C 136, 155, 161, 187, and ILO Resolution

1 June 2006 on asbestos

WHA Resolution on Cancer Prevention and Control 2005: “to pay special attention to cancers for

which avoidable exposure is a factor, particularly exposure to chemicals and tobacco smoke in the

workplace and the environment, certain infectious agents, and ionizing and solar radiation”;

WHO Tokyo Declaration on Universal Health Coverage, GPA for Workers’ health and WHO 2020

Conclusions of the 21st World Safety Congress Singapore, WSH2017 on Zero Vision and Global

Coalition

ILO/WHO Joint Committee Recommendation (2003): ”Elimination of Asbestos-Related Diseases”

(ARD’s) endorsed by ILO Governing Body and WHO Governing Council

1. Information and education

a) Elevation of awareness among decision-makers and stakeholders (International organizations, NGOs)

b) Promotion of banning asbestos among non-banning countries, and strict management of asbestos

present in existing infrastructure everywhere

c) Support the non-banning countries and particularly the Low Income Countries (LIC’s) with

education, technical advice, and feasible good practice guidelines in preparation and implementation of

the ban and elimination of ARDs

d) Providing information on economic and health appraisal of cancer prevention and elimination of

ARDs (WHO Euro)

2. Implementation

All countries to strengthen policies, means and practices feasible and effective for implementation:

a) Mapping existing asbestos in infrastructure, marking and labelling the in situ possible exposure

sources (surveys and data sources)

b) Distribution of information and providing technical advise and support for safe alternatives

c) Regulation and its implementation for asbestos demolition work and waste handling & disposal

d) Monitoring and registration of exposures by competent measurements (if not available, JEMs,

CAREX)

e) Enhancement of competence and capacity in diagnosis of ARDs

f) All countries to register effectively ARDs; Advice and Support by International Organizations

g) Surveys of exposed populations for ARDs

h) Good care of the diseased, including secondary and tertiary prevention, cancer treatment,

rehabilitation, immunizations

h) Justice and fairness in compensation of diagnosed occupational cancers and ARDs

j) Intersectoral collaboration: In addition to Labour, Health, Industry, social partners, several other

ministries should be involved (e.g. Social, Education, Defence, etc., i.e. WHO Health in All Policies)

3. International actions

a) International Organizations, WHO, ILO, International NGOs, ISSA and others to organize

and implement the Global Covenant for support of implementation of the SDGs of the UN

2030 Sustainable Development Agenda

b) Draw up a Covenant for global ban of asbestos, including Pan–European ban and

combined with the EU Parliament’s ‘Freeing the EU from asbestos by 2030’ initiative

c) Provide financial, technical and training, education and information support for

countries willing to join the global asbestos ban and implement National Programmes for

Elimination of Asbestos-related Diseases

d) International Organizations, ILO, WHO, UNEP, IMF and the IIB, to follow the example of the

World Bank and set Decent Work Programmes and Prevention of Occuptional Cancer,

including asbestos ban and elimination of ARDs, as conditions for public investments,

loans and development aid

4. ICOH contribution

a) ICOH to join with the UN and International Organizations and, within the limits of its resources,

provide commitment and expertise for all relevant activities for implementation of the UN

Sustainable Development Goals, particularly the SDGs No. 1, 3 and 8

b) ICOH to join and contribute to the organization and activities of the Global Occupational

Safety and Health Coalition

c) ICOH to provide its knowledge and expertise for collaboration with other international

and national actors for prevention of occupational cancer and elimination of ARDs

d) ICOH to draw up an ICOH Programme for Prevention of Occupational Cancer, including

the ICOH Programme element for Global ban of Asbestos and Elimination of Asbestos-

related Diseases, ARDs

e) In the drawing and implementation of the ICOH programmes, all the means, available for ICOH

should be employed; research, information and education and develoment and

dissemination of good practices