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Occupational HealthOccupational Health in the Eastern Mediterranean Regionin the Eastern Mediterranean Region
Challenges & OpportunitiesChallenges & Opportunities
Dr. Said ArnaoutDr. Said ArnaoutRA/HSGRA/HSG,,WHOWHO--EMROEMRO
[email protected]@emro.who.int
Occupational Health ConferenceOccupational Health Conference11-1311-13 December 2006December 2006
Muscat - OmanMuscat - Oman
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Six WHO Regional OfficesSix WHO Regional Offices
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Palestine
Bahrain
22 Member States
Eastern Mediterranean RegionEastern Mediterranean Region
LEB
Population: 540 Million
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Per capita GDP in international dollars, Per capita GDP in international dollars, 20042004
Source: WHO Core Health Indicators 2006Source: WHO Core Health Indicators 2006
0 10000 20000 30000
SOMAFG
DJISUDYEMPAKSYRIRQ
EGYMO
JORLEBLIB
TUNIRNOM
KSAKU
UAEBAHQAT
GDP US$
QatarQatar: 2728427284
Afg:Afg: 430430
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Population of EMRPopulation of EMRin thousandsin thousands, WHO 2005, WHO 2005
0 50000 100000 150000 200000
BAHDJI
QATOMA
KULEBPALUAEJORLIB
SOMTUNSYRYEMKSAIRQ
AFGMORSUDIRN
EGYPAK
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Percentage of 15-64 Age GroupPercentage of 15-64 Age Group
0 20 40 60 80 100
SOMAFGYEMPALIRQ
SUDSYRPAKOMAJORDJI
KSAMOR
LIBLEBIRN
TUNBAHUAEQAT
KUW
15-64%
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0%
10%
20%
30%
40%
50%
60%
70%
80%
BAH KUW KSA UAE
Percentage of non-nationalsPercentage of non-nationals in the in the 15-6415-64 age group age group
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Labour Labour FForce in EMRorce in EMR
•10 – 50% of the active population
•Non-local/ immigrant workers represent the majority of the
workforce in some Gulf countries
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0 20 40 60 80 100
AFGDJI
SOMMorSyr
OmnIrnIrq
EgyKuwTunPalLibLebSauUAEJor
Bah
Ser.
Ind.
Agr.
Labor Force by Sector in EMRLabor Force by Sector in EMR
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Unemployed in EMR Unemployed in EMR 13%13%Source: RD’s AR 2004Source: RD’s AR 2004
0 20 40 60 80
EMR AVAFGBAH
DJIEGYIRNIRQJOR
KUWLEBLIB
MOROMNPAKPALQATSUDSYRTUNUAE
YEM
%
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IInformal labour fornformal labour forccee
•No precise estimates
•However, it represents about 24.7% of the currently employed labour force in Bahrain and about 46.8% in Pakistan
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Working childrenWorking children•Working children (Child labour)
are present in several countries•Figures are available only in few
of them •The working children are usually
present in:– agricultural activities ,– construction,– industrial activities and – small workshops
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Working Women Are in increaseWorking Women Are in increase
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What are the main What are the main challenges, facing challenges, facing
occupational occupational health in EMRhealth in EMR??
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The Definition of Occupational The Definition of Occupational Health (ILO & WHO)Health (ILO & WHO)
““The promotion and The promotion and maintenance of the highest maintenance of the highest degree of physical, mental, degree of physical, mental,
social well-being of workers social well-being of workers in all occupations – in all occupations – total total
health for all at workhealth for all at work””
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OH&S Dilemma in EMROH&S Dilemma in EMR•Rapid growth of general population and
young people reaching adulthood (huge increase in labour force, unemployment)
•Inequity, poverty, conflicts, disasters•Conventional as well as new challenges•Insufficient and inadequate OH&S
services (human resources, infrastructure, education, training, research)
•Diverse spectrum of occupational and general health risks (Triple Burden)
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Triple Burden of DiseaseTriple Burden of Disease
•Communicable Diseases
•Non-communicable Diseases
•Occupational and Work-related Diseases
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Regional SituationRegional Situation•OH Services are significantly varied from
one EM country to another •Variations include both qualitative and
quantitative parameters•There are very good amount of
experience in some EM countries, and could be used, exchanged or even
replicated by other countries•There is a pressing need to enhance and
progress OH services in every EM country
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The greatest challengeThe greatest challenge
•How to transform the
difficulties into
opportunities?
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Role of WHO/EMRORole of WHO/EMRO
•Extensive efforts are being made in countries of the region, in collaboration
with the Regional Office to further develop and strengthen national programmes on
occupational health and work safety
•Main Goal: By 2020 healthy workplaces and work practices will be widely
adopted in Eastern Mediterranean Countries
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Important Country ActivitiesImportant Country Activities•Bahrain: OSH Authority•Tunisia : -Regular publication of OHS Journal -Annual OHS Conference on regular basis•Jordan: National Strategy OHS•Iran: Training Course on ILO Classification of
Pneumoconiosis•Kuwait: Healthy Work Places Workshop•KSA: national Workshop on OHS in Medical practices•UAE: National Training Workshop on OHS for PHC
Physicians•Egypt: Several training courses for PHC workers
–National workshop on protecting HCWs & preventing needlestick injuries, 4-5 Dec. 2006
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Important Regional ActivitiesImportant Regional Activities•Regional Consultative meeting on the
development trends of occupational health and safety in the EMR “Current
status and perspective”, Damascus, Syria, 16-18 Dec. 2003
•Intercountry workshop on primary health care and basic occupational health
services: Challenges and opportunities in Eastern Mediterranean Region, Sharm
ElSheikh, Egypt, 12-14 July 2005
•Regional activities at GCC Level
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Some Regional PublicationsSome Regional Publications
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Inter-regional activitiesInter-regional activities the WHO/ILO Joint Efforts on the WHO/ILO Joint Efforts on
Occupational Health and Safety in AfricaOccupational Health and Safety in Africa •Unified Country Profile on Occupational Health
in Egypt, prepared jointly with all partners concerned on occupational health and safety at
national level •A workshop on the national occupational
health and safety profile in Egypt was successfully organized in EMRO, Egypt, 29–30
October 2003, as an activity of these joint efforts
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Palestine
Bahrain
17 Countries
Collaborative Programmes With WHO Collaborative Programmes With WHO in OSH for the in OSH for the 06-0706-07 Biennium Biennium
LEB
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The WHO Global Plan of The WHO Global Plan of Action on Workers HealthAction on Workers Health
2008-20172008-2017
A Fresh LookA Fresh Look
& &New OpportunitiesNew Opportunities
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In 1996, the 49In 1996, the 49thth WHAWHA with with Resolution 49.12 endorsedResolution 49.12 endorsed the the
Global Strategy on Global Strategy on Occupational Health for AllOccupational Health for All
(i)strengthening of international and national policies for health at work
(ii)promotion of a healthy work environment, healthy work
practices and health at work(iii )strengthening of
occupational health services(iv )establishment of
appropriate support services for occupational
health
(v )development of occupational health standards based on
scientific risk assessment ;
(vi )development of human resources ;
(vii )establishment of registration and data
systems; and (viii )strengthening of
research
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NNew political realities, ew political realities, initiatives and requests by initiatives and requests by the Member States the Member States call forcall for
renewed attention and renewed attention and global actionglobal action by WHO on by WHO on
occupational healthoccupational health
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WHO ResponseWHO Response
•There is a need to move from strategy to practical action in the area of
workers health
•WHO developed the Global Plan of Action on Workers Health 2008-2017 to
provide new impetus for action
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The plan is based on the The plan is based on the proposals for action made byproposals for action made by::
•the Member States,• the consultations with:
– WHO Regional Offices ,–relevant WHO technical programmes ,–the WHO Collaborating Centres for
Occupational Health ,–the International Labour Office/ILO and– international organizations of employers and
workers
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The health of the workers depends on a The health of the workers depends on a combination of factors and a complex combination of factors and a complex
interaction between theminteraction between them •Working environment: mechanical, physical,
chemical, biological, ergonomic, psycho-social factors;
•Social determinants related to work: employment status, occupational position, social
inequalities and poverty ;•Work-related health behaviour: individual
preventative health practices and personal health-related behaviour ;
•Access to health services: adequate and affordable occupational health services for
promotion, prevention, cure and rehabilitation ;
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This plan of action deals withThis plan of action deals with workers healthworkers health in a broader contextin a broader context
•Workers health is a public health approach to addressing the health
problems of working populations• It focuses on:
– primary prevention of occupational and work-related diseases and injuries
–protection and promotion of the health of workers
•Occupational health constitutes the core of this approach
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GPA on Workers’ HealthGPA on Workers’ Health2008 - 20172008 - 2017
•Outlines newly emerging challenges
•Sets goals for protection and promotion of
workers health
•Recommends a series of strategic actions to be taken by the Member States and the
WHO Secretariat over a ten year period
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Objectives of GPA on Workers’ HealthObjectives of GPA on Workers’ Health.1Develop and implement policy
instruments on workers’ health
.2Protect and promote health at the workplace
.3Improve the performance of and the access to occupational health services
.4Provide and communicate evidence for action and practice
.5Incorporate workers’ health into other polices
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The ChallengesThe Challenges•Too many workers are still:
–exposed to unacceptable levels of occupational hazards ,
–fall victim to occupational diseases and work accidents, and
–lose their working capacity and income potential
•In many countries the existence of occupational health services is very limited and less than 15% of workers have access
to them
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The Challenge & Opportunity The Challenge & Opportunity Globalization
•Major impact through:–growing internationalization, competition,–changes in the regulatory strategies ,–major changes in enterprise structures and
associated technology changes.•Numerous positive effects:
–Increasing world trade –Growing interaction among countries ,–The development of new information
technologies
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Positive Role of Positive Role of Some Multinational EnterprisesSome Multinational Enterprises
•Play an increasing role in shaping working conditions in the different
countries
•They can bring jobs, expertise, new work practices, better working
conditions, and preventive health culture to the host countries
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Negative Role ofNegative Role of Some Multinational EnterprisesSome Multinational Enterprises
•Different standards for health protection at work in the different
countries
•Commercial advantage
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The Challenge The Challenge UnemploymentUnemployment,, Job InsecurityJob Insecurity
&& increasing human interactionincreasing human interaction •Certain working methods and emerging
forms of work organization such as:–outsourcing ,–downsizing, and –flexible work practices have an impact on workers
•Psychosocial hazards, and work-related stress, resulting in burn-out, depression,
coronary heart disease, musculoskeletal and other physical and mental disorders
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The Challenge The Challenge IInformal Economynformal Economy
•The traditional worker-employer relationship does not exist
•No healthy and safe working conditions
• The costs are borne by the community and not by the employers
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The Challenge & OpportunityThe Challenge & OpportunityCCollaboration between ollaboration between
all actors in the health sectorall actors in the health sector •Occupational health is an integral
part of public health and its activities can be enhanced with
the involvement of:–health promotion ,–environmental health ,–disease prevention,–the provision of general health
services at work and other public health programmes
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The Challenge & OpportunityThe Challenge & Opportunity
MDGsMDGs
What actions
are needed to break the
vicious cycle?
HazardousHazardous workingworking
conditionsconditions
Ill Ill HealthHealth
PovertyPoverty
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The Challenge & OpportunityThe Challenge & Opportunity
MDGsMDGs •Elimination of hazardous child labour ,•Promotion of women's health and
protection of reproductive health at work ,
•Combating HIV/AIDS, tuberculosis, malaria, and other major diseases at
the workplace•Introduction of clean technologies
and systems for management of health at work
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Further improvement of the Further improvement of the health of workers requires a health of workers requires a
holistic public health approachholistic public health approach
•Combining occupational health with health protection and promotion ,
•Reaching out to workers families and communities,
•Tackling social determinants of health
•Providing health services adequate to the specific needs of working populations
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