Occupational health

National and local profiles and indicators

Indicators are pointers that simplify phenomena and help to understand and monitor complex realities. Profiles are concise subject descriptions that usually also include quantitative indicators. A profile is more than a set of indicators because it provides an understanding and context that cannot be communicated by numbers only. Profiles and indicators of occupational health and safety are used to describe states of affairs, provide early signals for problems in the work life, monitor trends, assess the effectiveness of programmes, and present a baseline against which progress is measured.

WHO is responding to this important challenge to promote compilation of profiles and indicators at national and subnational levels, by establishing a WHO Task Force (TF 13 of the WHO CCs, chaired by Dr Kari Kurppa), whose role is to provide monitoring tools for rational management of occupational health and safety (OH&S).

In 2002, at the request of WHO/EURO, the Finnish Institute of Occupational Health (FIOH) surveyed the availability and analysed the inter-country comparability of several OH&S indicators in twenty-two European countries. Many problems were found in the availability of the indicators in the required form. Furthermore, the comparability of indicators between European countries was generally poor. On a global scale comparisons of indicators are even more problematic because of larger heterogeneity of cultural, legislative, administrative, socio-economic and other factors.

Data on occupational health and safety indicators, such as work injuries and occupational diseases, are collected in some form in nearly every country, but comparisons across countries are difficult because of differences in legislation, criteria, and reporting systems. Sub-national profiles (province, district, etc.) enable comparisons between different geographical areas or population segments. Strength of a sub-national approach is that contextual parameters (culture, language, legislation, administrative procedures) usually are similar, unlike when comparing different countries. Profiles increase transparency and visibility of OH&S and provide insights into the complexity of OH&S affairs, priorities, and needs of countries.

In 2001, a WHO CC meeting in Chiang Mai, Thailand, established a Task Force to encourage development of OH&S profiles and indicators. In 2003, a WHO CC meeting in Iguassu, Brazil, updated the strategy of the Task Force. At present, several institutions in Africa, Asia, Europe, and the Americas are involved in building OH&S profiles.

A Session of WHO CC Meeting in Iguassu, 2003, discussed concerns on data comparability. It was noted that a country profile is valuable as such, irrespective of problems about comparability across countries. All countries require a situation summary for their own needs. Overall comparisons between countries, not a main objective of a country profile, are possible even if individual indicators are somewhat different. Indicators are tools for policy needs, not for scientific use.

The comparability of data within a country between different regions and over time is generally much better than the comparability across countries. Data collected within a country enable subnational comparisons and surveillance of temporal changes.

The international standardization of data collection methods and harmonization of definitions and criteria of many nationally useful indicators would be a formidable task due to inherent differences between countries. Therefore, it is difficult to suggest one fixed standard for a set of national indicators. However, the WHO/EURO approach has provided one example for a thematic structure for national profiles. Certain themes, items, and issues are universally relevant to all countries. The best cross-country comparability of certain indicators could be achieved, at least within a region such as Europe, by using identical surveys with well-standardized methodologies.

A rational strategy for the TF13 is to make the existing and forthcoming profiles as widely available as possible through the Internet. Therefore the TF13 has established a Web site that organizes the profiles and indicators developed by CCs. The Web site also provides access to contact information, background documents, and useful sources in general. An Internet-based profiling instrument will be developed in order to expedite, and to harmonize to a reasonable extent, the building of OH&S profiles. The twenty-two country profiles from the WHO/EURO project have been made available through the Web site. The Web site also offers access to national profiles of other countries, and to subnational, sectoral, and subject-specific profiles, when such products become obtainable.

Many developing countries may have difficulties in writing a comprehensive national profile. In such a case a stepwise strategy could be employed by first writing a 'mini-profile' using information that is readily at hand, and gradually expanding the factual content when more information becomes available. Perhaps the most difficult part in writing a profile is taking a decision to start.

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