prof. jorma rantanen/twin2kickoff fin-est twinning ii: kick off seminar 21 may 2003 tallinn eu...

Prof. Jorma Rantanen/TWIN2KICKOff

FIN-EST TWINNING II: KICK OFF SEMINAR21 May 2003 TALLINN

EU OBJECTIVES AND PERSPECTIVES FOR OCCUPATIONAL HEALTH

Professor Jorma Rantanen, Finnish Institute of Occupational Health


POLICY


EU policy:Enlargement Agenda 2000: 13 countries applied the membership. Acquis Communitaire

required i.e. accession criteria. Several requirements and tasks to OHS. Enlargement will be made by supporting the applicant countries to achieve

the minimum level of OH&S as defined by the Acquis Communaitaire Phare economic and expert support and twinning instruments will be used

to implement that principle. Copenhagen Summit 2002: 10 countries will join in April 2004


EU policyPolicy Amsterdam Treaty Lisbon Strategy: Quality of work OS&H Strategy 2002-2006 Public Health Programme Technology Programme

Principles Strong social dimension High level of protection Social dialogue Primary prevention OH and OS&H integration Employers´primary responsibility Participation

Instruments Framework Directive 20 + Daughter Directives OELs and standards HSMS MDS guideline List of ODs Other guidelines Topic Centers Dublin Surveys H&S Week campaign


Framework Directive 89/391 EEC Basic instrument for safety and health at work Defines responsibilities and rights of employers and workers

at work Provides basic principles for safety and health ( and more for

safety than health):

High level of protection

Primary prevention at source

Best available technology

Right to know and right to get trained

Right to participate

Right to protective and preventive services Complemented with numerous specific daughter directives,

standards and guidelines


Community Strategy on Health and Safety at work 2002 - 2006

Strategy objectives and actions For a global approach to well-being at work Strengthening the prevention culture Education, awareness, anticipation: improving people´s

knowledge of risks Better application of existing law Combining instruments and building partnership Adapting the legal and institutional framework Encouraging innovative approaches Working to mainstream health and safety at work in other

Community policies Preparing for enlargement Developing international cooperation


Investing in quality

EU Strategy on OH&S2002-2006

EconomicCompetitiveness - dynamism

EmploymentFull employment - quality of work

Social Social quality - social cohesion

Source. European Commission 26.6.2001


RISKS


3442

46

27

52

3241

35 35

47

30

4534

0102030405060708090

Exposures to various WE factors in 1997 and 2000 in Finland (Source: Piirainen et al 2000)


28

45

33

54 56

2820

29

4737

5660

2923

010

203040

506070

8090%

Exposures to various WE factors in the EU in 1995 and 2000 ( Source: Paoli 20000 )


Fatal accidents


Risk of death in the years 1986–90 by age and occupation in Finland (males) (Source: Valkonen et al. 1995)

0

0,1

0,2

0,3

0,4

0,5

20–24 25–29 30–34 35–39 40–44 45–49 50–54 55–59 60–64 65–69 70–74 75–79

Age

Blue collars

Higher whitecollars


Two levels of risk assessment Systems level Work place level

Observations Reference values Context dependent Locally applicaple Based on codified practice Made by work place actors

• D-R relationship• Generic standard• Universally

applicaple• Based on research

observations• Takes place at

national or international level

• Made by researchers


General overview of EU risk assessment process

INFORMATION GATHERING

EFFECTS ASSESSMENT• Hazard identification• Dose (concentration)-response (effect) assessment

EXPOSURE ASSESSMENT• Human exposure assessment (workers, consumers, via the environment)• Environmental exposure assessment (water, soil, air)

RISK CHARACTERISATION

HUMAN HEALTH Evaluation of effects data and comparison with exposure data

ENVIRONMENT Evaluation of effects data and comparison with exposure data

OUTCOME OF RISK ASSESSMENTOne or more of the following conclusions/results

i) No immediate concern ii) Further information needsiii) Concern, recommendationsfor risk reduction


Estimated asbestos-related cancer mortality per 100,000 by exposure level for a 20-year working period

(Source: Nicholson, US Dept. Labor 1998)

0

2

4

6

8

10

0 2000 4000 6000 8000 10000 12000

Mesothelioma

Lung

Mortality/100,000for 20 year exposed

Asbestos fibre concentration(f/ml)


Workplace risk assessment

1. PROGRAMMING

2. PLAN THE ASSESSMENT MODEL

3. FIND FACTS

4. IDENTIFY HAZARDS

5. IDENTIFY PEOPLE AT RISK

6. IDENTIFY THE ROUTES AND SOURCES OF EXPOSURE

7. ASSESS THE RISKS * Probability * Severity

8. DEFINE OPTIONS FOR RISK ELIMINATION OR MANAGEMENT

9. SET PRIORITIES, CHOOSE PRACTICES

10. IMPLEMENT

11. DOCUMENT

12. MEASURE EFFICIENCY

13. CHECK AND COMPLETE

Present measuressufficient

Present measuresinadequate

AssessmentValid

Improvement needed

STOP

STOP

STOP

14. FOLLOW THE IMPACT OF RA

15. MAKE RE-ASSESSMENT

Improvement yesNo improvement


Consequences/ Slightly harmful Harmful Extremely harmfulprobability

Discomfort, irritation, Long-lasting serious Constant serious effects,mild disease, draught, effects, burns, life shortening diseases,small burns, reddening frostbites, hearing poisoning, work-relatedof the skin loss, vibration white cancer, asthma, drowning,

finger, electric eye, loss of vision, heartskin rashes attack

Highly unlikely 1. Trivial risk 2. Tolerable risk 3. Moderate riskless than 50% (no action) (monitoring) (actions needed)of the OEL

Unlikely 2. Tolerable risk 3. Moderate risk 4. Substantial risk50-100% of (monitoring) (actions needed) (actions necessary)the OEL

Likely 3. Moderate risk 4. Substantial risk 5. Intolerable riskexceeding the (actions needed) (actions necessary) (instant actions)OEL

A simple health risk classification for chemical and physical factors based on British standard BS 8800


Those at risk of violence or threat of violence during the past 12 months, by age groups, % of respondents

(Source: Piirainen et al. 2000)

0 2 4 6 8 10

All

25-34

35-44

45-54

55-64

men

All

25-34

35-44

45-54

55-64

violence

threat

women


Risk factors of LBP and sciatica(Source: Heliövaara 1995)

Obesity + Height + Heavy work +++ Car driving

– LBP +– sciatica + +

Accidents +++ Smoking ++ Psychological stress + Immobility +

Risk factor Strength of evidence


0

10

20

30

40

50

60

70

<26 26–45 46–65 >65

02468101214161820

Total number of accidents/1000 Fatal accidents/100 000

Rates of accidents (total number/1000) and fatal accidents/100 000 in the EU by age group (EUROSTAT 1998)


00,2

0,40,6

0,81

1,21,4

1,61,8

2

Inc

ide

nc

e /

10

00

em

plo

ye

d Cases / total workforce

Cases / filtered workforce

Incidence of 31 occupational diseases in the Member States of European Union in 1995 (Karjalainen and Virtanen 1998)


Work-relatedness of common chronic diseases

%

Asthma (adult males) 30 (Karjalainen et al, 2001)

Lung cancer 25-30 (Axelsson 2001)

Cardiovascular disorders

CHD 5-10 (Leigh 1997)

Cardiovascular 5 (Leigh 1997)

Musculoskeletal disorders

Upper extremities 15-40 (EU OSHA)

Low back pain 50 ? (NAS 2001)

Total mortality 6.7 (Nurminen

Karjalainen 2001)


SERVICES


Workers covered by OHS in Europe(Source: Hämäläinen et al 2001, Rantanen 2002)

50

28

50

34

80

70

95

80

90

50 50

15

60 60

39

86

4

48

0

10

20

30

40

50

60

70

80

90

100

PT GR DK GB BE SE NL FR FI IT NOR EST BULG HUNG POL SLOV SL TURK

%


MOH&S or MOL

LABOURINSPECTORATE

IOH

IN-COMPANY OHS GROUP OHS PHC Private center

Big company

SME Company SE SME SSE SME

DOH&S DOH

INTEGRATED OH&S SYSTEM

OM OMCLINICS

SESE


Dept. of Health and OHESocial Welfare

District health office OHE

Municipal health Director OHE

Gjakova IOHIPH OH Unit

Pristina

District hospital

Big industryOHS

Obiliq

Referral

Family healthcentre

Group service

BranchOHS

OHE = occupational healthexpert

IOH = Institute of Occupa-tional Health

IPH = Institute of PublicHealth

OHS = Occupational Health Services

OH System for Kosovo (Rantanen,UNMIK and WHO 2000)


Core content of OHS Surveillance of working conditions for health and safety aspects at work Assessment of risks to health and safety, risk of overload and stress Surveillance of health of workers and identification of work-related and occupational diseases Information of workers and management on health hazards at work and on how to prevent

them including advice on safe and healthful working practices Advice on actions for preventive measures, control and risk management actions and for

improvement of workers´ health Organization and maintenance of first aid readiness at the workplace


Workers covered by OHS(Source: Hämäläinen et al 2001)

50

28

50

34

80

70

95

8590

50 50

0

10

20

30

40

50

60

70

80

90

100

PT GR DK GB BE SE NL FR FI IT NO

%


Finnish model for OH&S

COMPETENCEand skill development

HEALTH,Work abilityOHS,WHP

WORK ENVIRONMENT,Risk assessment,Risk managementErgonomics Safety promotion etc.

WORK COMMUNITY,Participation,Working culturesWork organization

High qualitywork life


Health Promotion

EMPLOYER Eliminating hazardous conditions Providing information

and advice Organising facilities and

enabling conditions Organising competitions and campaigns Following up the preogress Rewarding for success

WORKERS Responsibility on ones own health Dedication to health and safety Joining in groups Following up progress Encouraging and supporting fellow

workers Participating in collective campaigns "WHP Representative"


Scientific

evidence,

prediction

and risk

assessment

Professional

competence

experience,

multidisciplin

arity

Needs analysis

Client

participation

Infrastru

cture,

resources,

coverage,

operability

GOHP

Good occupational health practice (GOHP)


CHANGE


Roger´s diffusion (1980)

2,5

16

50

84

0

10

20

30

40

50

60

70

80

90

Time

% degree ofadoption

Innovators

Early adopters

Early majority

Late majority

LAGGARDS


Rule of law index and safety(Source: World Development Report 2000/2001)

210

Rule of law index

Fatal accident riskcases/100 000

10,000

30,000

Rule of law index

GDP/CAPITA USD

20,000


Comprehensive OHS&MWA Project at Dahlbo Co(Source: Näsman and Ahonen 1999)

Input costs300 000 FIM/Yr

Benefits: 10-fold

Reduction of sickness leave costs200 000 FIM/Yr

Increased productivity

1,200 000 FIM/Yr

Reduction of work disability pension costs 1, 600 000


Economic benefits from PMWA (Source: Peltomäki et al 1999)

0

10

20

30

40

50

60

Much Some Little Not at all Cannotsay

ManagementPersonnelOHS


Summary: 21st CenturyChallenges to the Profession From care to prevention, promotion and development Broadening competence From OM to OH Multidisciplinary collaboration Maintaining professional leadership Self-evaluation Drawing from research


Summary: 21st Century

OHS Work life will need OH&S more than ever Full coverage of services need to be organized Content and competence of OHS need to be renewed New service provision models are needed Multidisciplinary, comprehensive approach OHS has been found productive in view of health, work ability and enterprise and

national economy

prof. jorma rantanen/twin2kickoff fin-est twinning ii: kick off seminar 21 may 2003 tallinn eu...

Documents

risk reduction slide

exposure level

assessment model

quality of work

mainstream health

quality eu strategy

risk elimination

hs week campaign slide