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
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