Occupational health

Global strategy on occupational health for all: The way to health at work

Recommendation of the second meeting of the WHO Collaborating Centres in Occupational Health, 11-14 October 1994, Beijing, China

Executive summary

About 45% of the world’s population and 58% of the population over 10 years of age belong to the global workforce. Their work sustains the economic and material basis of society which is critically dependent on their working capacity. Thus occupational health and the well-being of working people are crucial prerequisites for productivity and are of utmost importance for overall socio-economic and sustainable development.

It is the objective of this Strategy that by the year 2000 the countries where trends in occupational health and safety are already positive, should demonstrate a further improvement of occupational health and safety indicators, showing a reduction of the difference between the level of health and safety of low-risk and high-risk occupations and enterprises. In countries where the present trends are still negative, positive development is expected and the le-gal and other actions, including the development of necessary resources and infrastructures, should be taken to make such positive trends possible. All countries should show a progressive development of occupational health services with the ultimate objective of covering all workers with such services irrespective of the sector of economy, size of company, occupation, mode of employment, or nature of self-employment.

The workplace is a hazardous environment. Occupational health and safety hazards are common in many economic sectors and affect large numbers of workers. Approximately 30-50% of workers report hazardous physical, chemical or bio-logical exposures or overload of unreasonably heavy physical work or ergonomic factors that may be hazardous to health and to working capacity; an equal number of working people report psychological overload at work resulting in stress symptoms. Many individuals spend one-third of their adult life in such hazardous work environments. About 120 million occupational accidents with 200,000 fatalities are estimated to occur annually and some 68-157 million new cases of occupational disease may be caused by various exposures at work. In addition to unnecessary human suffering, the costs involved in these health hazards have been estimated to amount up to several percent of some countries’ gross national product (GNP).

The most important challenges for occupational health by the year 2000 and beyond will be: occupational health problems linked with new information technologies and automation, new chemical substances and physical energies, health hazards associated with new biotechnologies, transfer of hazardous technologies, ageing of working populations, special problems of vulnerable and underserved groups (e.g. chronically ill and handicapped), including migrants and the unemployed, problems related to growing mobility of worker populations and occurrence of new occupational diseases of various origins.

In some regions and countries, only 5-10% of workers in developing countries and 20-50% of workers in industrialized countries (with a very few exceptions) have access to occupational health services in spite of an evident need virtually at each place of work. The need for occupational health services is particularly acute in the developing and newly industrialized countries (NICs). Furthermore, approximately eight out of 10 of the worlds workers live in these countries. Such services, if organized appropriately and effectively for all workers, would con-tribute positively not only to workers’ health, but also to overall socio-economic development, productivity, environmental health and well-being of countries, communities, families and dependants. Also the control of unnecessary costs from sickness absenteeism and work disability, as well as costs of health care and social security can be effectively managed with the help of occupational health.

Rapid change of the modern working life is associated with increasing demands of learning new skills, need to adapt to new types of work, pressure of higher productivity and quality of work, time pressure and hectic jobs and with growing psychological workload and stress among the workforce. Such developments require higher priority to be given for psychological quality of work and the work environment, and more attention to psychosocial aspects of work.

Health at work and healthy work environments are among the most valuable assets of individuals, communities and countries. Occupational health is an important strategy not only to ensure the health of workers, but also to con-tribute positively to productivity, quality of products, work motivation, job satisfaction and thereby to the overall quality of life of individuals and society.

This proposed Global Strategy on Occupational Health for All presents a short situation analysis by using available occupational health indicators, identifies the most evident needs for the development of occupational health and safety, in-2.eluding the priority areas at both national and international levels, and proposes the priority actions for WHO’s Workers’ Health Programme.

On the basis of the global situation analysis, the analysis of expected future trends in working life, the documents of international organizations and professional bodies, the proposals made during the discussions of the Network of the WHO Collaborating Centres in Occupational Health and the Planning Group, ten priority objectives are proposed for the development of occupational health at international and national levels.

The 10 priority objectives proposed by the strategy are as follows:

  • Strengthening of international and national policies for health at work and developing the necessary policy tools
  • Development of healthy work environment
  • Development of healthy work practices and promotion of health at work
  • Strengthening of occupational health services (OHS)
  • Establishment of support services for occupational health
  • Development of occupational health standards based on scientific risk assessment
  • Development of human resources for occupational health
  • Establishment of registration and data systems, development of information services for experts, effective transmission of data and raising of public awareness through public information
  • Strengthening of research
  • Development of collaboration in occupational health and with other activities and services

Each objective has two different targets in view of the international and national actions that are needed to meet the strategy objectives.

The objectives emphasize the importance of primary prevention and encourage countries with guidance and support from WHO to establish national policies and programmes with the required infrastructures and resources for occupational health. In this development of national systems the role of the government is central. Further development of occupational health services is strongly emphasized. Mechanisms for setting standards or guidelines for control of various exposures at work and inspection to ensure compliance with such standards was also pro-posed. According to the principles of the IL0 Convention No. 161 on Occupational Health Services, the primary responsibility for improvement of health and safety at work and for occupational health services at the workplace and within 3.the enterprise lies with the employer. Most countries implement occupational health and safety policies and practices at the national level through tripartite collaboration between government, employers and employees.

Principal actors responsible for occupational health and safety at the workplace level are the employers and workers who according to the internationally accepted principles should collaborate in carrying out activities for health and safety at work. They often need advice, assistance and services of occupational health and safety experts. To implement such a strategy and to achieve the proposed objectives, higher priority should be given to occupational health in the WHO Programmes of Work and in budget plans. A follow-up system for the implementation of the strategy is also presented.

This Strategy document provides background for the Declaration on Occupational Health for All that was adopted by the Second Meeting of the WHO Collaborating Centres in Occupational Health on 13 October 1994 in Beijing.