RESUMEN
The 2030 United Nations Goal 8 for sustainable development focuses on decent work. There is utility in identifying the occupational safety and health aspects of Goal 8, as they pertain to the four pillars of decent work: job creation, social protection, rights of workers, and social dialogue. A workgroup of the International Commission on Occupational Health and collaborators addressed the issue of decent work and occupational safety and health (OSH) with the objective of elaborating a framework for guidance for practitioners, researchers, employers, workers, and authorities. This article presents that framework, which is based on an examination of the literature and the perspectives of the workgroup. The framework encompasses the intersection of the pillars of decent (employment creation, social protection, rights of workers, and social dialogue) work with new and emerging hazards and risks related to various selected determinants: new technologies and new forms of work; demographics (aging and gender); globalization; informal work; migration; pandemics; and OSH policies and climate change. The OSH field will need an expanded focus to address the future of decent work. This focus should incorporate the needs of workers and workforces in terms of their well-being. The framework identifies a starting point for the OSH community to begin to promote decent work.
Asunto(s)
Salud Laboral , Empleo , Humanos , Política Pública , Desarrollo Sostenible , Naciones UnidasRESUMEN
BACKGROUND: Occupational health and safety (OHS) is relevant for occupational health professionals (OHP) throughout the world. However, training opportunities are often limited and exchange between OHP from industrialized and developing countries is sparse. We aimed to contribute to the international exchange of OHP through a 2-week summer school program. METHODS: Twenty-three OHP from 11 countries participated. Teaching methods included interactive lectures, participants' presentations, case-based e-learning, enterprise visits, and hands-on sessions. After completion, participants evaluated the course. RESULTS: OHS systems of 18 different countries were presented using the same set of clinical cases as a starting point. Opportunities and challenges in the different OHS systems were considered. On median, participants rated the course as excellent and totally agreed that it will help them in their daily work. CONCLUSIONS: An international summer school teaching basic aspects of different OHS systems is a useful tool for training and exchange at the global level.
Asunto(s)
Accidentes de Trabajo , Tecnología Educacional , Internacionalidad , Salud Laboral , Instituciones Académicas , Enseñanza , Adulto , Países Desarrollados , Países en Desarrollo , Evaluación Educacional , Escolaridad , Becas , Femenino , Alemania , Humanos , Cooperación Internacional , Masculino , Persona de Mediana Edad , Modelos Educacionales , Desarrollo de Programa , Desarrollo de Personal , UniversidadesRESUMEN
BACKGROUND: The Comparative Risk Assessment (CRA) project of the World Health Organization (WHO) assessed worldwide mortality and morbidity in the year 2000 resulting from exposures to selected occupational hazards. This article summarizes findings of the WHO CRA project, presents the estimates of the International Labor Organization (ILO) for total deaths due to workplace risks, and calls for action. OBJECTIVES: Global burden estimates and counts of deaths assist ministers and other decision and policy makers to make informed decisions and to take action regarding risk reduction. METHODS: The WHO CRA methodology combined the proportions of the population exposed to five occupational hazards (excluding numerous risks due to inadequate global data) with relative risk measures to estimate attributable fractions of the selected health outcomes for both morbidity and mortality. ILO estimates of total numbers of global work-related injury deaths apply national fatality rates to employment data for the particular country; for disease deaths ILO uses an attributable risk approach. RESULTS: In 2000, the selected occupational risk factors were responsible worldwide for 37% of back pain, 16% of hearing loss, 13% of chronic obstructive pulmonary disease (COPD), 11% of asthma, 8% of injuries, 9% of lung cancer and 2% of leukemia, and about 100% of pneumoconioses and mesothelioma. These selected risks at work resulted in the loss of about 24 million years of healthy life and caused 850,000 deaths worldwide, about 40% of the ILO estimate of 2.2 million total deaths. CONCLUSIONS: These global and regional analyses have identified areas where specific preventive actions are required.
Asunto(s)
Salud Global , Enfermedades Profesionales/epidemiología , Riesgo , Accidentes de Trabajo/mortalidad , Asma/epidemiología , Asma/etiología , Dolor de Espalda/epidemiología , Dolor de Espalda/etiología , Enfermedad Crónica , Recolección de Datos , Infecciones por VIH/epidemiología , Infecciones por VIH/transmisión , Pérdida Auditiva/epidemiología , Pérdida Auditiva/etiología , Hepatitis Viral Humana/epidemiología , Hepatitis Viral Humana/transmisión , Humanos , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/estadística & datos numéricos , Esperanza de Vida , Neoplasias/epidemiología , Neoplasias/etiología , Enfermedades Profesionales/mortalidad , Enfermedades Profesionales/prevención & control , Salud Laboral , Enfermedad Pulmonar Obstructiva Crónica/epidemiología , Enfermedad Pulmonar Obstructiva Crónica/etiología , Medición de Riesgo , Factores de Riesgo , Organización Mundial de la Salud , Heridas y Lesiones/epidemiología , Heridas y Lesiones/etiologíaRESUMEN
Changes in the world of work in the last few decades have markedly affected questions regarding occupational safety and health (OSH). Jobs in our economy continue to shift from manufacturing to services. Longer hours, shift work, reduced job security, temporary work are realities in the modern workplace, new chemicals, materials, processes are developed at an ever accelerating pace. The workforce is also changing. It will become older and more racially diverse and women are increasing. These changes present new challenges to protect worker safety and health and it was been indispensable to redefine priorities, by consulting all those involved in OSH. The present study therefore made a critical comparative analysis of the main published projects to identify research priorities in the OSH field, comparing methods, approaches and results. Comparison of the priority areas established in each of these studies is inherently difficult due to differences in socio-cultural backgrounds, in the methods employed to identify priority topics, and the many factors involved. However, it is clear that the Delphi technique is widely used as a reliable method, in that it covers a broad range of qualified witnesses, from a variety of backgrounds--such as trade union representatives and researchers--providing different viewpoints. It also takes account of the intrinsic features of OSH which--compared to other disciplines--involves multidisciplinary factors calling into play a range of scientific settings, such as toxicologists, molecular biologists, epidemiologists, occupational hygienists and occupational physicians. This analysis showed how important it is to reach consensus among all those operating in the OSH sector, in order to establish standard methods that can be applied in different contexts, and give results that can be validly compared.
Asunto(s)
Salud Laboral , InvestigaciónRESUMEN
The first Work Plan of the Global Network of WHO Collaborating Centers (CCs) in Occupational Health was initiated in November 2001, following input of the CCs to choose the 15 priority areas of work for the period 2001-2005. This article reflects upon the successes and limitations of the Work Plan, describes some of the products, and points out some 'lessons learned' that were incorporated into the 2006-2010 Work Plan that was adopted by the CCs at the Seventh Network Meeting in Stresa, Italy, in June 2006. All 64 Collaborating Centers, three non-governmental organizations (International Commission on Occupational Health, International Occupational Hygiene Association and the International Ergonomics Association) and the International Labor Organization contributed 350 projects in the priority areas of the 2001-2006 Work Plan. An evaluation of the success of the Work Plan concluded that the working together of the CCs in a common Work Plan was successful and beneficial to nations and regions, and globally.
Asunto(s)
Accidentes de Trabajo/prevención & control , Planificación en Salud , Medicina Naval/organización & administración , Enfermedades Profesionales/prevención & control , Servicios de Salud del Trabajador/organización & administración , Salud Global , Humanos , Cooperación Internacional , Organización Mundial de la SaludRESUMEN
BACKGROUND: Around the globe, work has a heavy impact on health. To better advise policy makers, we assessed the global burden of disease and injury due to selected occupational hazards. This article presents an overview, and describes the methodology employed in the companion studies. METHODS: Using the World Health Organization (WHO) Comparative Risk Assessment methodology, we applied relative risk measures to the proportions of the population exposed to selected occupational hazards to estimate attributable fractions, deaths, and disability-adjusted life years (DALYs). Numerous occupational risk factors had to be excluded due to inadequate global data. RESULTS: In 2000, the selected risk factors were responsible worldwide for 37% of back pain, 16% of hearing loss, 13% of chronic obstructive pulmonary disease (COPD), 11% of asthma, 8% of injuries, 9% of lung cancer, and 2% of leukemia. These risks at work caused 850,000 deaths worldwide and resulted in the loss of about 24 million years of healthy life. Needlesticks accounted for about 40% of Hepatitis B and Hepatitis C infections and 4.4% of HIV infections in health care workers. CONCLUSIONS: Exposure to occupational hazards accounts for a significant proportion of the global burden of disease and injury, which could be substantially reduced through application of proven risk prevention strategies.
Asunto(s)
Accidentes de Trabajo/estadística & datos numéricos , Salud Global , Enfermedades Profesionales/epidemiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Estudios Epidemiológicos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Exposición Profesional/efectos adversos , Medición de Riesgo , Factores de RiesgoRESUMEN
BACKGROUND: Occupational non-malignant respiratory disease arises from exposure of workers to airborne agents, mostly particulate or dusts. We describe the worldwide mortality and morbidity from asthma, chronic obstructive pulmonary disease (COPD), and pneumoconioses arising from these occupational exposure and focus on cases reported in the year 2000. METHODS: The proportions of workers exposed to the agents, and their levels of exposure, were estimated using workforce data and the CAREX (CARcinogen EXposure) database. These were combined with relative risk measures (for asthma and COPD) or absolute risk measures (for the pneumoconioses) to develop estimates of deaths, disability-adjusted life years (DALYs) and attributable fraction (for asthma and COPD). RESULTS: There were an estimated 386,000 deaths (asthma: 38,000; COPD: 318,000; pneumoconioses: 30,000) and nearly 6.6 million DALYS (asthma: 1,621,000; COPD: 3,733,000, pneumoconioses: 1,288,000) due to exposure to occupational airborne particulates. CONCLUSIONS: Occupational airborne particulates are an important cause of death and disability worldwide.
Asunto(s)
Contaminación del Aire/efectos adversos , Salud Global , Exposición por Inhalación/efectos adversos , Enfermedades Pulmonares/epidemiología , Exposición Profesional/efectos adversos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Enfermedades Pulmonares/etiología , Enfermedades Pulmonares/mortalidad , Masculino , Persona de Mediana Edad , Riesgo , Factores de RiesgoRESUMEN
BACKGROUND: The worldwide mortality and morbidity from lung cancer, leukemia, and malignant mesothelioma arising from occupational exposures to carcinogens are described. Cases reported in the year 2000 that resulted from relevant past and current exposures are assessed. METHODS: The proportions of workers exposed to the carcinogens of interest, and their levels of exposure, were estimated using workforce data and the CAREX (CARcinogen EXposure) database. These were combined with relative risk measures (for lung cancer and leukemia) or absolute risk measures (for malignant mesothelioma) to develop estimates of deaths, disability-adjusted life years (DALYs) and attributable fraction (for lung cancer and leukemia). RESULTS: There were an estimated 152,000 deaths (lung cancer: 102,000; leukemia: 7,000; and malignant mesothelioma: 43,000) and nearly 1.6 million DALYS (lung cancer: 969,000; leukemia: 101,000; and malignant mesothelioma: 564,000) due to exposure to occupational carcinogens. CONCLUSIONS: Occupational carcinogens are an important cause of death and disability worldwide.
Asunto(s)
Carcinógenos , Salud Global , Neoplasias/epidemiología , Enfermedades Profesionales/epidemiología , Exposición Profesional/efectos adversos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Bases de Datos como Asunto , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Neoplasias/mortalidad , Riesgo , Factores de RiesgoRESUMEN
BACKGROUND: Excessive noise is a global occupational health hazard with considerable social and physiological impacts, including noise-induced hearing loss (NIHL). This paper describes the worldwide morbidity of occupational NIHL in the year 2000. METHODS: The proportion of the population exposed to occupational noise was estimated using noise exposure data from the US National Institute for Occupational Safety and Health (NIOSH), adjusted by data on the distribution of the work force by occupational category and economic sector, and economic activity rates in each WHO subregion. These values for the exposed population and risk measures for NIHL were used to develop estimates of the attributable fraction (AF) of adult-onset hearing loss resulting from occupational noise exposure. The AFs were applied to WHO estimates of total disability-adjusted life years (DALYs) from adult-onset hearing loss to estimate the DALYs due to occupational noise. RESULTS: Worldwide, 16% of the disabling hearing loss in adults (over 4 million DALYs) is attributed to occupational noise, ranging from 7% to 21% in the various subregions. The effects of the exposure to occupational noise are larger for males than females in all subregions and higher in the developing regions. CONCLUSIONS: Occupational noise is a significant cause of adult-onset hearing loss. The majority of this NIHL burden can be minimized by the use of engineering controls to reduce the generation of noise at its source.
Asunto(s)
Salud Global , Pérdida Auditiva Provocada por Ruido/epidemiología , Ruido en el Ambiente de Trabajo/efectos adversos , Enfermedades Profesionales/epidemiología , Exposición Profesional/efectos adversos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Pérdida Auditiva Provocada por Ruido/etiología , Humanos , Masculino , Persona de Mediana Edad , Medición de Riesgo , Factores de RiesgoRESUMEN
BACKGROUND: Over the last decade, there have been several attempts to estimate the global burden of ill health due to work activity. The most recent of these is the Comparative Risk Assessment (CRA) project of the World Health Organization. METHODS: Published estimates of global burden of injury and disease due to occupational factors were summarized, compared, and contrasted with the aim of putting the CRA estimates into context, identifying the most reliable and appropriate estimate for total burden due to occupational risks, and making recommendations regarding future work. RESULTS: The best estimate of global work-related deaths of workers is approximately two million per year, with disease responsible for the vast majority of these, but even this is likely to be a considerable underestimate of the true number of deaths because of shortcomings in the available data. CONCLUSIONS: The CRA estimates of burden due to individual risk factors appear appropriate for the limited number of exposures and conditions included, but are a major underestimate of the overall number of work-related deaths at a global level due to exclusion of risk factors because of data limitations. Improvements in global estimates are likely to come from the use of different methodologies and improvements in the availability and use of local data.
Asunto(s)
Accidentes de Trabajo/estadística & datos numéricos , Salud Global , Enfermedades Profesionales/epidemiología , Exposición Profesional/efectos adversos , Heridas y Lesiones/epidemiología , Humanos , Enfermedades Profesionales/mortalidad , Medición de RiesgoRESUMEN
BACKGROUND: There is little information about the global burden of non-traumatic low back pain (LBP) attributable to the effects of physical and psychosocial occupational stressors. METHODS: Based on a review of the epidemiological evidence, occupation-specific relative risks were used to compute attributable proportions by age, gender, and geographical sub-region for the economically active population aged 15 and older. The reference group was professional/administrative workers; other risk categories were Low, clerical and sales; Moderate, operators (production workers) and service; and High, farmers. RESULTS: Worldwide, 37% of LBP was attributed to occupation, with twofold variation across regions. The attributable proportion was higher for men than women, because of higher participation in the labor force and in occupations with heavy lifting or whole-body vibration. Work-related LBP was estimated to cause 818,000 disability-adjusted life years lost annually. CONCLUSIONS: Occupational exposures to ergonomic stressors represent a substantial source of preventable back pain. Specific research on children is needed to quantify the global burden of disease due to child labor.
Asunto(s)
Salud Global , Dolor de la Región Lumbar/epidemiología , Enfermedades Profesionales/epidemiología , Exposición Profesional/efectos adversos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Ergonomía , Femenino , Humanos , Dolor de la Región Lumbar/etiología , Masculino , Persona de Mediana Edad , Enfermedades Profesionales/etiología , Prevalencia , Riesgo , Medición de RiesgoRESUMEN
BACKGROUND: Occupational injuries are a public health problem, estimated to kill more than 300,000 workers worldwide every year and to cause many more cases of disability. We estimate the global burden of fatal and non-fatal unintentional occupational injuries for the year 2000. METHODS: The economically active population (EAP) of about 2.9 billion workers was used as a surrogate of the population at risk for occupational injuries. Occupational unintentional injury fatality rates for insured workers, by country, were used to estimate WHO regional rates. These were applied to regional EAP to estimate the number of deaths. In addition to mortality, the disability-adjusted life years (DALYs) lost, which measure both morbidity and mortality, were calculated for 14 WHO regions. RESULTS: Worldwide, hazardous conditions in the workplace were responsible for a minimum of 312,000 fatal unintentional occupational injuries. Together, fatal and non-fatal occupational injuries resulted in about 10.5 million DALYs; that is, about 3.5 years of healthy life are lost per 1,000 workers every year globally. Occupational risk factors are responsible for 8.8% of the global burden of mortality due to unintentional injuries and 8.1% of DALYs due to this outcome. CONCLUSIONS: Occupational injuries constitute a substantial global burden. However, our findings greatly underestimate the impact of occupational risk factors leading to injuries in the overall burden of disease. Our estimates could not include intentional injuries at work, or commuting injuries, due to lack of global data. Additional factors contributing to grave underestimation of occupational injuries include limited insurance coverage of workers and substantial under-reporting of fatal injuries in record-keeping systems globally. About 113,000 deaths were probably missed in our analyses due to under-reporting alone. It is clear that known prevention strategies need to be implemented widely to diminish the avoidable burden of injuries in the workplace.
Asunto(s)
Accidentes de Trabajo/estadística & datos numéricos , Salud Global , Heridas y Lesiones/epidemiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Bases de Datos como Asunto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Vigilancia de la Población , Medición de Riesgo , Factores de RiesgoRESUMEN
OBJECTIVES: Working conditions in the developing world seldom meet the minimum standards required by international agencies. This article addresses some of the major obstacles to occupational and environmental health and suggests methods by which they can be overcome. METHODS: International agencies such as the World Health Organization (WHO) and the International Labor Organization (ILO) offer a number of programs that address the problem. RESULTS: The results of international efforts to date have been disappointing. There is a need for renewed efforts on the part of international agencies and the developed countries. CONCLUSIONS: Occupational health and safety can be advanced in the developing world with modest funding of innovative programs.
Asunto(s)
Accidentes de Trabajo/estadística & datos numéricos , Países en Desarrollo , Empleo/estadística & datos numéricos , Salud Global , Enfermedades Profesionales/epidemiología , Salud Laboral/estadística & datos numéricos , Seguridad , Accidentes de Trabajo/economía , Adolescente , Niño , Humanos , Agencias Internacionales , Enfermedades Profesionales/economía , Ocupaciones , MigrantesRESUMEN
The WHO Network of Collaborating Centres in Occupational Health comprises 70 Collaborating Centres. Four of these Centres are specialised in Maritime Occupational Health and they are situated in Poland, Germany, Denmark and the Ukraine. All Collaborating Centres follow the mandate of the Occupational Health Programme in WHO, which is the Global Strategy on Occupational Health for All. Collaborating Centres in Maritime Occupational Health cover a specific group of workers who are exposed to different work environments than workers on land. They are often not at all or only insufficiently covered by any health services. The Collaborating Centres in Maritime Occupational Health provide an excellent example of international collaboration.