asian pacific1 2010

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New emergingrisks

Asian-Pacifc NewsletterO N O C C U P AT I O N A L H E A L T H A N D S A F E T Y

Volume 17, number 1, May 2010

Occupational health andsaety training


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Contents

3 Editoria

Franois Eyraud, ILO, Turin

4 Imrovig OSH at costrctio sites throgh a arti-

ciator traiig aroach: Exeriece o Bagadesh

A.R. Chowdhury Repon, Bangladesh

9 Work-reated diseases A chaege or occatioa

heath ad bic heath traiig ad ractice

Jorma Rantanen, Finland

12 Occatioa saet ad heath traiig rogramme:

A Maasia ersectiveAbdul Mutalib Leman, Fadzil Othma, Abdul Rahman

Omar, Malaysia

14 The roe o worker ios i occatioa heath ad

saet at idstr eve

Bambang Surjono, Indonesia

16 Deveoig OSH traiig sstems Chaeges acig

ood eterrises i Chia

Yuhang WANG, China

19 Iteratioa Traiig Cetre traiig or the word

Teemu Lindors, Finland

20 Cardiovascar heath ad work o ocs

Suvi Lehtinen, Finland

21 ICOH ad traiig i occatioa heath

Suvi Lehtinen, Finland

Asian-Pacifc NewsletterOn OCCupATIOnAl HEAlTH AnD SAETy

Vome 17, mber 1, Ma 2010

Occupational health and saety training

Published byiish Istitte o Occatioa Heath

Toeiksekat 41 a A

I-00250 Hesiki, iad

Editor-in-Chief

Svi lehtie

Editor

Teem lidors

Linguistic Editing

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Layout

liisa Srakka, Kirjaaio usimaa, Stdio

The Editoria Board is isted (as o 1 December 2008)

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is idicated. or rights o rerodctio or trasatio,

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The eectroic versio o the Asia-pacifc newset-

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et ca be accessed at the oowig address:

htt://www.tt.f/Asia-pacifcnewsetter

The issue 2/2010 o the Asia-pacifc newsletter deals

with Ijr ad disease reortig sstems.

Asia-pacifc newsetter is facia sorted

b the iish Istitte o Occatioa Heath, the

Word Heath Orgaizatio, WHO (the uS nIOSH

grat Iteratioa Traiig ad Research Sort

o Word Heath Orgaizatio (WHO) Coaboratig

Ceters i Occatioa Heath), ad the Itera-

tioa labor Ofce.

Photograph on the cover page:

A.R. Chowdhr Reo, Bagadesh

Printed publication:

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On-line publication:

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iish Istitte o Occatioa Heath, 2010

The resosibiit or oiios exressed i siged artices, st-

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Occupational saety and

health training

Lack o knowledge and competence in

dealing with occupational hazards is

one o the most important causes o

occupational accidents and diseases.

Occupational Saety and Health (OSH) train-

ing is a vital instrument or extending knowl-

edge and generating preventive attitudes and

behaviours. Tis is why training on OSH is

an indispensable element or the prevention

o occupational accidents and diseases. Tisimportance is recognized by the Internation-

al Labour Standards o the International La-

bour Organization as one o the main areas o

action that must be included in the national

OSH policies.

Many national OSH legislations include

OSH training as a workers and his/her rep-

resentatives right, and as an employers duty.

Besides workers, other actors are also required

to have OSH training in order to work as OSH

technical specialists, managers and supervi-

sors, or even as product manuacturers or ma-chinery/labour inspectors. Te volume o peo-

ple who need OSH training in each country

requires an important institutional eort, in

order to stimulate and involve the public and

private actors o each country or this task. Tis

eort requires encouraging and creating de-

mand by setting OSH standards, including the

right to receive and the duty to acilitate OSH

training, as well as the enterprises duty to have

sta specialized in OSH who conduct preven-

tive activities. It is also necessary to strengthen

the supply o inormation on OSH, correlat-

ed in quantity and quality to the needs o the

country, by improving the knowledge base and

materials on OSH, increasing the availability

o training and training experts, and including

the development o accreditation and certi-

cation systems or training service providers

and those receiving training.

In general, training programmes at the en-

terprise level must include both the existing

and potential occupational hazards present

in the work environment, must be ocused on

their prevention and control, and must provide

protection rom them. However, the trainingo dierent groups must be integrated with

the capacities, unctions and responsibilities

o each specic group, taking into account the

technical level o their tasks and the economic

sector o activity. For this reason, training ma-

terials and methods need to be adapted. OSH

training or workers or other groups at the

enterprise level (supervisors, oremen, sub-

contractors, etc.) needs to be closely linked to

other preventive activities at the enterprise,

including risk assessment, risk control, acci-

dent investigation or the supervision o sae

systems o work, since these can determinethe contents and objectives o training. It is

important to keep in mind that OSH train-

ing complements other measures to improve

working conditions and the environment, and

is not a substitute or these measures.

Other aspects, such as the level o literacy

among workers in developing countries or the

increasing number o migrant workers who do

not speak the language o the receiving coun-

try, also require special attention. In cases o

this kind, it would be very appropriate to lim-

it the use o materials and methods based onwritten communication and to avour meth-

ods based on oral and visual transer, making

the training methods as practical and easily

understood as possible. Posters, documenta-

ries or lms, role-play and audiovisual pres-

entations accompanied by explanatory discus-

sions (using a simple and easily comprehen-

sible language) are oen the most eective

techniques or communicating and instilling

OSH messages.

Finally, prevention o occupational acci-

dents and diseases is an important pillar in the

development and consolidation o a preven-

tive culture in society. For this purpose, the in-

troduction o OSH in the educational system

is undamental. It would be advisable to be-

gin even rom basic education, when children

would have the opportunity to acquire preven-

tive attitudes, and then to continue through-

out all levels o education and training, pay-

ing particular attention to OSH in vocational

training curricula.

Franois EyraudDirector

Iteratioa Traiig Cetre o IlO

Tri, Ita

Photo by ITCILO

Asia-pacifc newsett o Occ Heath ad Saet 2010;17: 3


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Imrovig OSH at costrctio sites throgha articiator traiig aroach:

Experience o Bangladesh

A.R. Chowdhr Reo, Bagadesh

Introduction

Te construction sector entails a wide range

o economic activities and has a very poor

health and saety reputation in the world o

work, owing to the dirty, dangerous and di-

cult nature o jobs. Work at construction sites

is one o the most dangerous occupations in

both developing and industrialized countries.

Construction is dierent rom other industries

in a number o important respects.

According to the International Labour Or-

ganization (ILO), 337 million occupational ac-

cidents occur on the job annually, while the

number o people dying o dierent work-re-

lated diseases is close to 2 million (1). One inevery six atal accidents on the job occurs at

construction sites. Each year a minimum o

60,000 atal accidents occur at construction

sites all over the world. Te increase in fex-

ible employment practices and outsourcing o

labour in the construction industry has had a

negative impact at the level o social protec-

tion o construction workers (2).

According to the Building and Workers

International (BWI) report, at least 108,000

workers are killed on the spot every year at

construction sites. Te report also states that

construction sites account or 30 per cent o all

atal injuries. Tis means that one person dies

every ve minutes due to poor and/or illegal

working conditions (3). Moreover, statistical

data rom a number o industrialized coun-

tries also indicate that construction workers

are three to our times more likely than otherworkers to die rom accidents at work.

Many more workers suer and die rom

occupational diseases arising because o their

past exposure to dangerous substances, such as

silica, asbestos etc. In addition, it is estimated

that 30 per cent o construction workers su-

er rom back pain or various other muscu-

loskeletal disorders.

In recent years, the participation o wom-

en workers in this sector has been increas-

ing in many developing countries around the

world. Tis is particularly true in the coun-

tries o the South Asian region.

o make the construction sector saer,

many approaches and initiatives are applied

in dierent countries around the world to de-

velop a preventive health and saety culture

and good practices to combat hazards and po-

tential saety risks at construction sites. Onesuch eort is the Work Improvement in Small

Construction Sites (WISCON) developed on

the basis o the Participatory Action Oriented

raining Approach.

4 Asia-pacifc newsett o Occ Heath ad Saet 2010;17:48


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PAOT An Action Tool towards

Promotion o Sae Work

Te Participatory Action Oriented

raining (PAO) is one o the popu-

lar practical methods used to address

the occupational saety and health

hazards at workplaces and to support

workplace initiatives based on volun-

tary actions o sel-help (4). Tis meth-

od also assists the principal actors at

workplaces, i.e. workers and employ-

ers, to carry out immediate, low-cost

improvements in their working con-

ditions by using local resources and

positive ideas. PAO has also been rec-

ognized in many Asian countries as

a powerul tool or the promotion o

labour standardization, decent work,

industrial relations and productivity

at the workplace level.

Brie history and development

o PAOT

Te participatory approach was basi-

cally developed with the technical as-

sistance o the ILO. Its primary aim

is to improve working conditions at

small and medium-sized enterprises

(SMEs). PAO was widely applied in

the Work Improvement in Small En-

terprises (WISE) project in the Phil-

ippines. Tis project was nanciallysupported by the UNDP and techni-

cally assisted by the ILO. Since then,

the participatory work improvement

programme at small enterprises has

widely been known as WISE (Work

Improvement in Small Enterpises). Dr.

K. Kogi and Dr. . Kawakami made

very important contributions to its

development. Furthermore, the Japan

International Labour Foundation (JI-

LAF) played an important, acilitat-

ing role in promoting PAO through

the Participation Oriented Saety Im-

provement by rade Union Initiative

(POSIIVE) Programme developed

or trade union members active in

saety and health eorts at the work-

place (5).

In the PAO concept, those who

work by themselves understand their

work and develop practical solutions

to their problems. Since workers are

so amiliar with their daily work, they

need practical opportunities to involve

themselves in improvement o theirrespective workplaces. Te PAO ap-

proach helps the principal actors at

workplaces to start and increase their

sel-help activities by exploring avail-

able local knowledge, cooperation and

resources. Te principles o the PAO

are: it is built on local practice; it o-

cuses on sustainable achievements; it

links local conditions with other de-

cent work goals; it encourages sharing

o local experience, good examples and

practices; it applies learning by doing;

and it ocuses on positive aspects.

Basic training method o PAOT

PAO training programme starts with

an exercise involving the use o an ac-

tion checklist at workplaces. Tis is

ollowed by ormal presentations/lec-

tures on dierent key technical are-

as o PAO (i.e. materials storage and

handling, machine saety, the physical

environment, work station design and

work tools, welare acilities, environ-

mental protection, saety and healthorganizations, etc.) and group work,

development o an individual action

plan or work improvement, ollow-

up development actions at workplac-

es (based on the plan o action pro-

duced), collection o improvement ex-

amples and sharing with others, and

evaluation o actions through the new

plan o action.

Recent development o PAOT in

dierent Asian countries

Te Mekong Delta is known as the

place where PAO (Participatory Ac-

tion Oriented raining) originated. In

January 2000, the Mekong Delta PAO

programme was planned by Dr. on

Khai, Dr. suyoshi Kawakami and Mr.

oyoki Nakao when they visited Can

To City. Since then, the programme

has been repeated nine times, and it

has led to the development o many

ruitul PAO training programmes

and grassroots networks on saety and

health issues in dierent Asian coun-

tries (6). More than 200 participants

(trade union leaders, employer repre-

sentatives, NGO representatives work-

ing on health and saety issues, medical

doctors, nurses, public health experts,

academics, etc.) rom dierent Asian

countries (Bangladesh, Nepal, Tai-

land, Vietnam, Korea, Japan) have at-

tended those programmes in the past

nine years and have started new PAO

activities in their own countries.As results o the collective e-

orts over the past years, programmes

like WISCON (Work Improvement

in Small Construction Sites), WIND

Asia-pacifc newsett o Occ Heath ad Saet 2010; 17:48 5


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(WorkImprovement in Neighborhood De-

velopment), and WIPE (WorkImprovement

or Protection oEnvironment) were born in

Vietnam, and these programmes were accept-

ed by the local people smoothly and pleasant-

ly because the training tools were practical

and easy to understand. WISH (WorkIm-

provement or Sae Home) in Tailand and

the [Glocal (Globalised localism) Relation-

ship oAgricultural ImprovemeNts] by the

OSHE in Bangladesh are good examples o

its achievements.

Construction sector in Bangladesh

At present, the estimated civilian labour orce

in Bangladesh is 46.3 million, o whom 22.2%

are emale (7). Te labour market is charac-

terized by a high growth rate o the labour

orce growth, low rates o employment, a pre-

dominance o employment in agriculture ol-

lowed by the service sector, the existence ohigh underemployment, a low rate o emale

employment; squeezing o the public sector,

growth in the inormal sector and a high rate

o working children. Te ratio o the ormal

versus the inormal sector is 20:80.

Construction is one o the important la-

bour intensive industries in Bangladesh. It

plays a signicant role in the domestic econo-

my. It provides direct employment or 1.5 mil-

lion people, which is equivalent to 3% o the

total economically active working population

(aged 15 years and above). Tis estimate com-prises 1.4 million men and 104,000 women.

Besides government, more than 200 large

rms and 5,000 small and medium-sized con-

tracting rms and real estate companies in

the country are involved in the construction

business. Te industry has expanded rapidly

over the past years as a result o the increase

in inrastructure development programmes all

over the country. Te industry is also spurred

by growth o the real estate business in urban

areas o Bangladesh, where building is car-

ried out by the private sector. In the public

and private sectors, construction activities are

undertaken through a contractual system. At

one end there are registered contractors who

acquire a contract through open, selected or

negotiated tenders. Tese are ollowed by a

multitude o complex subcontracts or various

components o the entire project. In Bangla-

desh, there is a growing number o construc-

tion rms or companies involved in large-scale

construction works as well as a huge number

o small-scale subcontractors or subcontract-

ing rms or enterprises at the plant level.On the labour market, the construction

sector is considered an inormal sector, owing

to the nature o employment and work pat-

terns. Te industry has tremendous economic

muscle but has kept its workers mostly unor-

ganized. However, according to the Depart-

ment o Labour o Bangladesh, there are six

registered industrial trade union ederations

and 45 registered basic unions in Bangladesh

working in the construction sector. Tese or-

ganizations altogether represent about 10%

o organized workers in the countrys con-struction sector.

In general, the trade union movement in

Table 1

labor orce b emomet i major ecoomic sectors i Bagadesh

Sector Male Female Total Percentagel

Agrictre, orestr & fsheries 15,084,000 7,683,000 22,767,000 48.1%

Trades, hotes ad restarats 7,366,000 454,000 7,820,000 16.5%

Maactrig 1,298,000 3,926,000 5,224,000 11%

Trasort, storage ad comm-

icatio

3,910,000 66,000 3,976,000 8.4%

Commity ad persoa ser-

vices

1,654,000 968,000 2,622,000 5.6%

Heath, edcatio, bic admi-

istratio ad deece

1,982,000 568,000 2,550,000 5.4%

Costrctio 1,421,000 104,000 1,524,000 3.2%

fiace ad bsiess services

ad rea estate

619,000 126,000 745,000 1.6%

Eectricit, gas ad water 73,000 3,000 76,000 0.2%

Miig ad qarrig 44,000 7,000 51,000 0.1%

TOTAl 36,080,000 11,277,000 47,357,000

Sorce: Bagadesh Brea o Statistics, 2008

this sector is comparatively weaker than those

in the countrys other sectors, or a couple o

reasons. First, there is a weak institutional ca-

pacity to respond to the decent work issues.

Second, there is a lack o collective bargaining

at the national level and an absence o a tripar-

tite industrial relation structure at the national

level. Tese are the main reasons. On the oth-

er hand, employers in this sector (contractors

and real estate development areas) are largely

organized at the national level.

High rates o occupational accidents

and injuries

Te construction sector in Bangladesh is wide-

ly known as a death trap due to its poor health

and saety record and the high rate o occupa-

tional accidents occurring in the country each

year. At Bangladeshi construction sites, ordi-

nary workers normally do their job according

to the instructions given by the contractors orsubcontractors who employ them. Most o the

time, they work in an environment with high

levels o noise, dust and umes, insecure elec-

tricity, dirty water, harmul gases, poor light-

ing, lack o personal protective equipments,

lack o a pure drinking water supply, and lack

o toilet acilities.

An alarming number o construction

workers in Bangladesh experience occupa-

tional accidents, such as alling rom the top

o structures, injuries rom sharp objects and

tools and electric shock. Moreover, they areoen aected by toxic materials or harmul

gases. I an occupational accident occurs at

the workplace, the victim considers it per-

sonal bad luck and the contractor or subcon-

tractor normally blames the victim or being

careless at work.

Te industries in Bangladesh are mainly

governed by the Bangladesh National Building

Code o 2006 and partially by the Bangladesh

Environment Conservation Act o 1995. Tese

actually include only a ew regulations on sae-

ty and health issues. Te Bangladesh Labour

Act o 2006 applies in part to the construction

sector through the mobility o jobs and lack

o permanent workplaces or the same con-

struction rms or establishments. In reality,

however, workers in this sector get very little

protection or benet (health and saety issues)

rom those laws, owing to weak enorcement

and lack o inspections.

With relation to setting up a Code En-

orcement Authority under section 2.1 o

the Bangladesh National Building Code, the

Bangladesh Occupational Saety, Health and

Environment Foundation and the BangladeshLegal Aid and Services rust jointly led a

written petition in the High Court Division

on 27 January 2008 to readdress the ailure o

the government to establish an agency to en-



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orce the code, particularly the provisions relating to work-

ers saety issues. Te petition argues that most workplace

deaths among construction workers would be prevented i

the obligations under the Code are enorced, more specical-

ly those relating to measures to prevent alling rom heights

and electrocution. At the initial hearing on the petition on

7 February 2008, the High Court o Bangladesh passed a

rule asking the respondents or a show-case explaining why

the government should not establish a Code Enorcement

Agency as duly required by the Bangladesh National Build-

ing Code o 2006 and also why it should not be required to

secure compliance with the saety and security provisions

o the Bangladesh National Building Code o 2006 at every

level o construction and demolition o any building. Te

Court also requested the government to produce a report

on what steps it has taken so ar to secure compliance with

the code in Dhaka and Chittagong. Te Court allowed the

respondents our weeks to respond to their show-cause no-

tice. However, it has been over two years since this ruling

was handed down but, unortunately, the respondents have

not yet come up with any reply.

Owing to the absence o proper monitoring o occu-pational diseases and the lack o studies, the occupational

health status o the workers in this sector is mostly unknown.

It is assumed that a high number o construction workers

suer rom musculoskeletal disorders, silicosis and asbes-

tosis. Most workers in the construction sector lack proper

knowledge about the occupational saety and health (OSH)

issues and about their rights at workplaces.

A recent survey conducted by the Bangladesh Occupa-

tional Saety, Health and Environment Foundation (OSHE),

which monitored the news in sixteen leading daily newspa-

pers o Bangladesh, revealed that a total o 829 workers were

killed and 1,041 were critically injured by various occupa-tional incidents at their workplaces across the country rom

January to June 2009. Among these the highest number o

causalities (552) took place in the garment sector, ollowed

by the transport (486) and construction sectors (95) (8).

Another survey report o the OSHE ound that the total

number o occupational deaths caused by motorized equip-

ments in the construction sector in 2008 and 2007 were 120

Table 2

Cases o occatio-reated deaths i the Costrctio Sector i Bagadesh

i 2007 ad 2008

Cause o death 2007 2008 Total

Eectroctio 24 42 66

aig rom heights 26 37 63

Coase o a wa 27 7 34

Coase o earth 14 14 28

Ashxiatio 2 10 12

Hit b a aig object 6 2 8

Crshed b a object - 7 7

aig ito a hoe 2 - 2

Misceaeos 1 1 2

Sorce: OSHE Srve Reort 2007 ad 2008

and 102, respectively. able 2 shows the causes o common

occupational accidents in Bangladesh in 2007 and 2008.

Experience o the WISCON actions in Bangladesh

Considering the above reality in the construction sector,

the Bangladesh Occupational Saety, Health and Environ-

ment Foundation (OSHE) implemented a mini-project in

2009 with support rom the ILO. Te mini-project title was

Actions or improvement o occupational saety and health

conditions in Bangladesh: special ocus on construction sec-

tor; its objectives were to build workers and employers ba-

sic capacity at construction sites by means o participatory

workplace saety improvement actions through WISCON

(Work Improvement at Small Construction Sites).

Te direct target groups were worker and employer rep-

resentatives in the construction sector. Te geographical

coverage o the project activities included Dhaka (the capital

o Bangladesh) and Chittagong (the countrys second big-

gest city). Te key activities o the project were WISCON

training o the trainers, development o training materials

in the local language, ollow-up training at workplaces and

sensitization o actions at the work sites. Te technical ar-

eas on which the WISCON activities ocused were materi-als handling and storage, work at heights, work postures,

machine saety, the physical environment, welare acilities,

emergency preparedness, work organization, and saety and

health organizations.

Asia-pacifc newsett o Occ Heath ad Saet 2010; 17:48 7


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Achievements

At macro level, the WISCON project activities

in Bangladesh contributed to the successul in-

troduction and promotion o the Participatory

Low Cost Saety training and OSH actions in

the construction sector. It was also able to cre-

ate sensitization and awareness o OSH issues

in the construction sector.

At micro level, the WISCON project ac-

tivities gave rise to a group o new trainers

on WISCON (8). In all, 2000 copies o the

WISCON Action Checklist were produced in

the local language and 280 grassroots union

members rom dierent trade unions work-

ing in the construction sector were sensitized

on participatory workplace saety improve-

ment activities. Te project activities there-

ore meant the launching o a process o dia-

logue on OSH issues between trade unions and

employers organizations in the construction

sector and the ormation o a local WISCONrainers network.

A eld level evaluation has shown that

the participants who attended dierent ac-

tivities within the WISCON project presented

a good number o immediate initiatives ol-

lowing the training period and implement-

ed a good number o changes in the dierent

technical areas addressed during the train-

ing, i.e. materials handling and storage, work

at heights, work postures, machine saety, the

physical environment and welare acilities at

workplaces.

Key lessons learned

Te Participatory Action Oriented raining

Approach, o which the WISCON is a good ex-

ample in the construction sector, encourages

workers immediate, low-cost saety improve-

ment actions, contributes to improvement o

social dialogue, helps to improve bilateral co-

operation on saety and heath issues between

workers and employers, and helps to develop

collectivism or advancing the Decent Work

Agenda at the workplace level.

Reerences

1. World o Work (the magazine o ILO), issue no.

63, August 2008.

2. http://www.ilo.org/public/english/dialogue/sec-

tor/sectors/constr.htm.

3. http://www.bwint.org.

4. Participatory Action Oriented Training, ECHO,

August 2005.

5. POSITIVE Training Manual, Japan International

Labour Foundation (JILAF), September 1999.

6. Background paper on Mekong Delta PAOT

program 10th anniversary, The Mekong Delta

PAOT Programme Management Committee, 28

February 2010.

7. Labour Force Survey 200506, Bangladesh

Bureau o Statistics.

8. Occupational Saety, Health and Environment

Foundation (OSHE) Survey Report number 1

/2009.

A.R. Chowdhury Repon

Exective Director

Bagadesh Occatioa Saet, Heath ad

Eviromet odatio (OSHE)

44 /6, West pathaath (4th oor)

GpO Box- 2696

Dhaka-1215

BAnGlADESH

E-mai: [email protected], [email protected]

Web Address: htt://www.oshebd.org

photos b A.R. Chowdhr Reo



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Photo by Suvi Lehtinen

Work-related diseases A chaege or occatioa heath adbic heath traiig ad ractice

Jorma Ratae, iad

Introduction

Te concept o work-related disease was origi-

nally dened by a WHO Expert Committee in

1985 (1). Te Committee recognized the ol-

lowing conditions as work-related:

a. Te classic occupational diseases, in which

the actors in work environment are pre-

dominant and essential in the causation o

disease,

b. Diseases caused by exposures rom homeworkers working processes to amily mem-

bers or by worksite exposures to members

in the neighbourhood community

c. Multiactor diseases which, when occur-

ring in workers,

may be partially caused by occupation-

al actors

may be aggravated, exacerbated or accel-

erated by workplace exposures

may impair working capacity.

Te Expert Committee also stated that

work-related diseases are oen more com-mon than occupational diseases and deserve

adequate attention by the health services and

occupational health services.

Te 1985 Expert Committee already rec-

ognized several groups o diseases which were

recognized as work-related, including:

a. Behavioural responses and psychosomat-

ic illnesses

b. Hypertension

c. Ischemic heart disease

d. Chronic non-specic respiratory disease

e. Locomotor disorders.

Current situation in the identifcation

o work-related morbidity

Since the 1985 Expert Committee, clinical

and epidemiological research has provided

a great deal o new evidence on the work-

relatedness o the diseases recognized by the

Committee and on several new diseases. Te

attribution by work varies widely depending

on disease and type o work, as well as on

local working conditions and health condi-

tions o the community. A substantial part owork-related morbidity has been associated

with common non-communicable and com-

municable diseases prevalent among pop-

ulations, such as cardiovascular disorders,

respiratory disorders and musculoskeletal

disorders (2, 3). Due to their high preva-

lence, their work-relatedness is important

to recognize, as occupational causality pro-

vides avenues or eective prevention in the

occupational settings. In principle, all occu-

pational diseases can be prevented and the

risk o multiactorial work-related diseases

(WRDs) can be reduced to a substantial ex-

tent (which does not always correspond di-

rectly with the percentage o attribution) (4).On the other hand, i the causal actors do

expose workers at the workplace, the preven-

tive, control and curative actions directed to

non-occupational settings may remain ine-

ective. Te high prevalence o chronic non-

communicable diseases among workers, and

particularly among older workers calls or

preventive actions in occupational health in

order to protect and maintain work ability

and avoid health and economy losses rom

diseases among the productive raction o

population (5, 6).

Examples o studies providingevidence o work-relatedness in the

working populations morbidity

A ew examples o studies providing evidence

on the work-relatedness o common non-

Asia-pacifc newsett o Occ Heath ad Saet 2010;17:911 9


10/24

communicable and communicable diseases

are briefy discussed here.

Attribution o work to mortality o Finnish

working population

Tis study was one o the most extensive e-

orts or analysis o the work-relatedness o

non-communicable diseases (2). Te analysiscalculated the attribution o work to mortality

rom 45 specic diseases in 9 disease catego-

ries, including 26 malignant neoplasms (able

1). Te relevant occupational exposures and

related risks o mortality were assessed on the

basis o the FINJEM exposure matrix or var-

ious occupational groups and wide research

material providing evidence on related health

outcomes. able 2 describes the diseases with

substantial occupational attribution.

Te risk o work-related mortality was un-

equally distributed between genders: 10% ototal mortality among men was work-related.

Te respective gure or women was 2%. As

much as 86% o absolute cases o work-relat-

ed deaths occurred among working men and

14% among working women. Te largest gen-

der dierences were ound in lung cancer and

other respiratory diseases.

o put the work-related mortality in per-

spective with other comparable risks in the

year 1996 or which the calculations were

made, the total number o atal trac acci-

dents among the whole Finnish population

was 404. Te estimated total number o work-

related deaths among the Finnish working

population was 1800, i.e. 4.5 times higher.

WHO global burden o occupational diseases

study (4)

Te World Health Organization has repeated-

ly produced estimates or the global burden o

diseases (5, 6, 7). In 2005, WHO estimated the

contribution o 26 dierent occupational risk

actors to global burden o diseases. Te study

calculated both loss o healthy lie years (DA-

LY) due to mortality and healthy lie year loss

by morbidity (4). Five causal actors played asubstantial role as attributors to the global dis-

ease burden: Workplace carcinogens, airborne

particulates, hazards or injuries, ergonomic

stressors or back pain, and occupational noise

exposure. Te attribution by occupational ex-

posures to work-related morbidity measured

as global burden to diseases and injuries is

presented in able 3.

Te WHO study made a special assess-

ment o the work-related burden o two inec-

tious diseases and needle stick injuries among

health personnel. Te result ended with an es-timate o 40% attribution o work to the risk o

hepatitis B and C among health workers and

2% attribution to HIV/AIDS.

Te work-related share o all the assessed

diseases was 1.5% o the total DALYs o global

burden o diseases (rom all diseases and in-

juries o world population). Tis gure, how-

ever, is probably a substantial underestimate

due to the limited number o diseases calcu-

lated and due to diculty in estimation o

work-related attribution o several prevalent

diseases, such as the major inectious epidem-

ics. Tere are also several other actors lead-

ing to likely underestimation; the majority o

the worlds workers are employed in small-

scale enterprises, agriculture, and the inormal

sector which have low access to both health

services in general and no access to occupa-

tional health services at all. Tis implies that

both general health events and particularly

occupational and work-related events remain

largely unidentied, undiagnosed and unreg-

istered. No reliable estimate or such under-

reporting is available, but it can be assumed

to be substantial.

International study o work-related acute

heart inarction

Cardiovascular disorders are the worlds

Diseases

Inectious and parasitic diseases

Tbercosis

pemococca disease

Malignant neoplasms (site)

Ora cavit

pharx

Oesohags

Stomach

CooRectm

liver ad itraheatic bie dcts

Ga badder

pacreas

nose ad asa sises

larx

lg ad brochs

Boe

Meaoma o ski

Other maigat eoasms o ski

Mesotheioma (a sites)

Breast

uters (cervix teri ad cors teri)

Ovar

prostate

Kide

uriar badder

Brai

Hodgkis disease

no-Hodgkis mhoma

lekaemia

Diseases o the circulatory system

Ischemic heart disease

Cerebrovascar diseaseDiseases o the respiratory system

pemoia

Chroic obstrctive moar disease

Asthma

pemocoiosis

Crtogeic fbrosig aveoitis

Diseases o the genitourinary system

Chroic rea aire ad ehritic sdrome

Mental disorders

Vascar ad secifed demetia

Deressive eisodes

Nervous system diseasesSia mscar atroh

parkisos disease

Azheimers disease

Diseases o the digestive system

Gastric ad dodea cer

Accidents and violent incidents

Accidets

Homicides ad ijries

Sicides

Table 1. Diseases aased or attribtio b nrmie ad Karjaaie (2)

Table 2. Attributios by occuatioal actors to total mortality o iish workig oulatio (2)

Disease Attribution %

Circator sstem, a

Ischemic heart disease

Stroke

12

17

11

Maigat eoasms

lg cacer

8

24

Resirator diseases

COpD

4

12

Meta disorders 4

nervos sstem diseases 3

Accidets ad vioece 3

A work-reated mortait 7



11/24

number one cause o death by non-commu-

nicable diseases. Te work-relatedness o car-

diovascular disorders has been shown in nu-

merous studies and associated to numerous

risk actors such as several chemicals, physical

workload, unconventional working hours and

work stress. Te latter source has caused also

a great deal o controversy particularly among

employers. Te Interheart Study o 26000 sub-

jects (11119 patients and 13648 controls) in

52 countries o Asia, Europe, the Middle East,

Arica, Australia, North and South America

monitored the risk o acute myocardial inarc-

tion (MI) in relation to a number o psycho-

logical risk actors; work stress, home stress,

nancial stress and lie event stress (8). Te

measurement o stress exposure was made

through a questionnaire covering the period

beore inarction. Te study ound virtually

equally elevated risks (odds ratios 2.34 and

2.36, respectively) or permanent work stress

and permanent home stress, while the othersources o stress also played a role, but to a

much lower extent. Te contribution o work

stress to MI risk was seen only among men,

while other sources o stress contributed to the

elevation o the risk also among women, but at

a slightly lower level than among men. A dis-

tinct dose-response relationship was detected

between dierent doses o stress; some o

the time, several periods and permanent.

Te high incidence o cardiovascular dis-

eases among working-age populations makes

the work-relatedness aspect o this morbidityextremely important. As it seems to be a sub-

stantial several percentage attribution o occu-

pational actors to cardiovascular morbidity, it

also has an important occupational and pub-

lic health impact. Similarly the prevention o

these common diseases will get more support

or preventive programmes in occupational

settings. Te growing rates o work stress re-

ported by surveillance studies throughout the

world make stress-related cardiovascular dis-

orders even more important. able 4 shows

the odd ratios or various sources o perma-

nent stress.

Challenges o work-related diseases

to training and practices

Work-related diseases (WRD) were recognized

as early as in 1985 by WHO as an important

health impact o work, and numerous can-

didate WRDs were proposed by the WHO

Expert Committee. Since then, research has

produced much evidence on the work-relat-

edness o several diseases, many o which are

highly prevalent among working populations.Te quantitative estimates give the scale or the

problem o WRDs as a part o the morbidity o

working populations, and o the global burden

o all diseases o the world population.

Disease Men % Women % All %

Back ai 41 32 37

Hearig oss 22 11 16

COpD 14 6 13

Asthma 14 7 11

Cacer o trachea, brochs ad g 10 5 9

lekaemia 2 2 2

uitetioa ijries 15 2 10

Table 3. Attribtabe ractio (%) b occatioa actors to tota brde o diseases o 7

work-reated heath otcomes (4).

WRDs cause loss of work ability and life

years, which is likely to be at least an order of

magnitude larger than that of traditional occu-

pational diseases. Very little research is, how-

ever, available on registration, recognition,

loss of work ability, economic loss, and pos-

sible compensation of work-related morbidity.

This is made by difculty in the identication

of work-related aetiology at the individual

level. In the long run, work-related diseaseshave often been early cases of forthcoming

ofcially recognized occupational diseases.

he most important management strat-

egy o work-related diseases is prevention.

his requires identiication o the occupa-

tional actors causing such diseases, stud-

ies o their mechanisms o action and de-

velopment o eective prevention strate-

gies. It is also important to keep in mind

the work-related aetiology in clinical and

public health practices.

WRD morbidity constitutes a challenge

to the training o both occupational health

personnel and the experts in the rest o the

health service system, as well as those in so-

cial security. Knowledge on work-relatedness

should be distributed in the basic education

o health personnel, as well as proposals or

prevention and control. Te WRDs are im-

portant not only rom the occupational health

perspective. As they are oen simultaneously

common diseases among the general popula-

tion and the working population (which con-

stitutes some 5070% o the adult population

in all countries), work-related morbidity isalso a signicant public health challenge. Tis

requires close collaboration between training,

education and practices o occupational health

and public health.

Table 4. Odd ratios o acute myocardial iarctio rom various sources o ermaet stress (8)

Source o stress Cases Controls Odds ratio (99% CI)

Work 499 316 2.34 (1.862.93)

Home 249 135 2.36 (1.753.17)

Geera stress (work or home) 681 424 2.32 (1.932.80)

iacia 1231 1190 1.33 (1.171.50)

lie evets (2 or more evets) 1390 1304 1.51 (1.341.70)

Reerences

1. WHO. Identifcation and control o work-related

diseases. Report o a WHO Expert Committee.

Technical Report Series No. 714, WHO, Geneva

1985.

2. Nurminen M, Karjalainen A. Epidemiologic

estimate o the proportion o atalities related

to occupational actors in Finland. Scand J Work

Environ Health 2001;27(3):161213.

3. Kivimki M, Leino-Arjas P, Luukkonen R, Riihimki

H, Vahtera J, Kirjonen J. Work stress and risk o

cardiovascular mortality: prospective cohort study

o industrial employees. BMJ 2002;325:85761.

4. Fingerhut M, Driscoll T, Nelson D I, Concha-Bar-

rientos M, Punnett L, Pruss-Ustin A, Steenland K,

Leigh J, Corvalan C. Contribution o occupational

risk actors to the global burden o disease a

summary o fndings. SJWEH Suppl 2005;no

1:5861.

5. WHO. The World Health Report 2002. Reducing

risks, promoting healthy lie. Geneva 2002.

6. WHO. The global burden o disease: 2004 update.

WHO Geneva, 2008.

7. Rodgers A, Ezzati M, Vander Hoorn S, Lopez AD,

Lin R-B, et al. Distribution o Major Health Risks:

Findings rom the Global Burden o Disease Study.PLoS Med 2004 1(1): e27. doi:10.1371/journal.

pmed.0010027

http://www.plosmedicine.org/article/

ino:doi/10.1371/journal.pmed.0010027

8. Rosengren A, Hawken S, unpuu S, Sliwa K,

Zubaid M, Almahmeed WA, Blackett KN. As-

sociation o psychosocial risk actors with risk o

acute myocardial inarction in 11 119 cases and 13

648 controls rom 52 countries (the INTERHEART

study): case-control study. Lancet 2004;364:953

62.

Jorma Rantanen

proessor Emerits

Chairma o Seate

uiversit o Jvsk

Jvsk, iad

[email protected]



12/24

Occatioa saet ad heath traiig

rogramme:A Malaysian perspective

Abd Mtaib lema

adzi Othma

Abd Rahma Omar

Maasia

Introduction

Occupational saety and health (OSH) pro-

vides a work environment which is conducive

to workers. Reasonable precautionary steps

are taken in order to ensure that workers are

protected rom injury or health hazards aris-

ing rom their work activities. Saety measures

and practices are undertaken to prevent and

minimize the risk o loss o lie, injury and

damage to property and environment. Occu-pational saety and health was rst implement-

ed in Malaysia some 130 years ago, towards

the end o the 19th century. Te Department

o Occupational Saety and Health (DOSH) is

the only government agency responsible or

administering, managing and enorcing legis-

lation pertaining to OSH in the country. Its vi-

sion is to make all occupations sae and healthy

while also enhancing the quality o work lie.

Increasing OSH observance levels

o ensure that workers saety, health and wel-

are are cared or, DOSH works to keep the

occurrence o industrial accidents in Malaysia

low. o this end, the OSH Master Plan 2015

was introduced. Tis plan sets out the direc-

tion o OSH in the country. It serves as a guide

or working cohesively with stakeholders and

social partners, including government agen-

cies, local authorities, labour unions, employer

associations, academic institutions and other

non-governmental organizations.

Te saety and health programme includes

our major elements that make up its basic

ramework. Louis J. DiBerardinis (1) reported

that an eective occupational saety and health

programme will entail:

Management commitment and employee

involvement

Analysis o worksite hazards

Hazard prevention and control

Saety and health training.

Occupational saety and health

trainingo ensure the success o any OSH programme,

adequate and eective training must be im-

plemented or all those responsible or OSH.

raining enables managers, supervisors and

workers to understand the unctioning o

saety management systems and compliance

with legislation. Tey will then understand

their own responsibilities and the necessary

actions to be taken towards upgrading sae-

ty and health at their respective workplaces.

Saety and health training is one o the tech-

niques available or promoting OSH while at

the same time reducing the number o acci-

dents. o oster ecient and eective training,the Malaysian Government has constructed an

OSH organization in the country.

Te Ministry o Human Resources has

been made responsible or managing OSH,

under the advice o the National Council o

Occupational Saety and Health (NCOSH).

Te NCOSH unctions in a policy advisory

and promotion capacity. Te Department o

Occupational Saety and Health (DOSH) was

ormed to ocus on administration and en-

orcement. Te OSH services can be catego-

rized into workplace monitoring and assess-ment, medical surveillance, medical treatment

and management, and rehabilitation services

and return to work programmes.

Education and training programme

raining is an integral part o OSH. Te educa-

tion and training programme involves several

institutions, including the National Institute o

Occupational Saety and Health (NIOSH), the

Construction Industry Development Board

(CIDB), Nuclear Malaysia, higher education

institutions and NGOs such as the Malaysian

Society o Occupational Saety and Health

(MSOSH), the Malaysia Industrial Hygiene

Association (MIHA) and the Federation o

Manuacturing Malaysia (FMM). Te private

sector involved in OSH activities includes the

Social and Security Organization (SOCSO),

the Employee Protection Fund (EPF) and in-

surance companies.

Te Hands on Guide OSH Manager Ma-

laysia (2) places the types o training into two

broad categories, hard skill OSH training and

so skill OSH training. In general, hard skillOSH training is usually mandatory. It entails

the training required to ensure that workers

are competent and qualied and that they ex-

ecute certain tasks related to OSH hazards.

Examples o such programmes are working

in conned spaces, a saety orientation course

or construction workers, and lockout and tag-

out with regard to electrical saety. So skill

training is oen voluntary, involving the rec-

ommended types o training. Examples are

saety management courses, OSH commu-

nication training, and training on the aware-

ness o OSH hazards and worker behaviour.

Some o the programmes required or in-house OSH training are orientation or new

employees, supervisor and management train-

ing, on-the-job training, training or specic

hazards (i.e. laser saety, lockout and tag-out),

training in standard operating procedures and

skill training.

Te National Institute o Occupation-

al Saety and Health (NIOSH) was chosen

as an example illustrating OSH training in

Malaysia. Te National Institute o Occupa-

tional Saety and Health was established as

a company limited by guarantee on 24 June1992 under the Ministry o Human Resourc-

es, Malaysia. Te NIOSH Board o Directors

consists o individuals rom the relevant gov-

ernment agencies and industrial and union

representatives; the Board prepares policies

and sets directions or the Institute in line

with the agreed strategy. With the stated vi-

sion to be the leading centre of excellence

in occupational safety and health, NIOSH

operationalized its strategic mission to read

Te preferred partner in occupational safe-

ty and health in carrying out its unctions,

which are the provision o training, consulta-

tion services, dissemination o inormation,

and conducting research in the eld o OSH.

Range o training programmes

Te NIOSH training programme has received

recognition rom DOSH, the regulatory body

or OSH in Malaysia, as well as rom industrial

associations, OSH practitioners, international

counterparts and workers at large. Apart rom

ensuring the competency o registered spe-

cialists, NIOSH training has been extendedto senior executives, saety and health com-

mittee members, saety supervisors, general

workers contractors, academicians and other

interested individuals.



13/24

nmber o

particiats70,000

60,000

50,000

40,000

30,000

20,000

10,000

0

Course participants by year

2006 2007 2008 2009

year

pbicrogrammes

Certifcate/Cometecprogramme

I-Hoseprogramme

Traiersprogramme

Coerece orSemiar

Saetpassortprogramme

raining activities are broadly classied

into three main groups: the implementation o

training programmes, development and revi-

sion o training modules, and monitoring and

evaluation o training activities. able 1 shows

the number o courses conducted by NIOSH

and the number o participants in 20062009.

Discussion

Te NIOSH Saety Passport is widely known.

Te course is conducted jointly with indus-

tries. It is recognized and put into practice by

Table 1. Corses codcted b the natioa Istitte o Occatioa Saet ad Heath i 20062009.

Types o Courses 2009*

Corses partic-

iats

2008

Corses partic-

iats

2007

Corses partic-

iats

2006

Corses partic-

iats

pbic rogrammes 161 2,535 125 2,114 94 1,420 88 1,397

Certifcate/Cometec rogramme 195 3,558 165 3,381 186 3,516 124 2,390

I-hose rogramme 609 11,597 432 9,321 453 10,09 367 8,403

Traiers rogramme 19 258 21 281 38 467 29 327

Coerece or semiar 24 3380 21 2,797 21 3,003 18 2,402

Saet passort programme 2,347 61,035 1460 39,927 1,046 27,780 1,009 26,615

TOTAL 3,355 82,363 2,768 71,941 2,321 59,972 1,635 41,534

*Amedmet ti December 2009

Figure 1. Traiig rogrammes codcted b the the natioa Istitte o Occatioa Saet

ad Heath rom 2006 to 2009

(EDOSH) and the Masters in Occupational

Saety and Health (MOSH) are jointly con-

ducted by NIOSH in collaboration with theOpen University Malaysia (OUM) and Uni-

versity Utara Malaysia (UUM).

Conclusion

o-date, the amount o training has increased

linearly. Te provision o training is based on

training programmes, seminars and coner-

ences. Te number o participants involved

is also increasing linearly every year. Malay-

sia set up the OSH Master Plan 2015 as the

target in order to minimize the number oaccidents. At the same time, it aims to in-

crease the number o courses and public pro-

grammes and emphasizes Occupational Saety

and Health training programmes.

Reerences1. L. J. DiBerardinis (Ed.). Handbook o Occupa-

tional Saety and Health. Wiley and Sons. New

York, USA 1999.

2. CCH Asia Pte Limited. The Hands on Guide OSH

Manager Malaysia. 2001

Abdul Mutalib Leman

uiversit T Hssei O Maasia

86400, parit Raja, Bat pahat,

Johor, Maasia

Te: +607 4537776

ax: +607 4536080

Emai: [email protected]

Fadzil Othman

natioa Istitte o Occatioa Saet ad

Heath (nIOSH)

lot 1, Jaa 15/1, Sectio 15, 43650 Badar Bar

Bagi,

Seagor Dar Ehsa

Maasia

Te: +603 87622100 (mai ie)

ax: + 603 89262900

Email: [email protected]

Training Programmes by yearnmbero Corses

2500

2000

1500

1000

500

0

2006 2007 2008 2009

year

pbicrogrammes

Certifcate/Cometecprogramme

I-Hose

programme

Traiersprogramme

Coerece orSemiar

Saetpassortprogramme

Figure 2. nmber o articiats i corses codcted b the natioa Istitte o Occa-

tioa Saet ad Heath rom 2006 to 2009

several multinational companies and inter-

national industries located in Malaysia. For

example, NIOSH has conducted a saety pro-

gramme with several companies, including

Petronas, Osam, NB, Shell, Genting and BP

Chemicals. Tese programmes conducted by

NIOSH are organized at the certicate level.

Several public and private institutions con-duct these programmes at diploma and degree

level; there are even Masters and Doctoral

degree programmes. However, the Executive

Diploma o Occupational Saety and Health



14/24

The role o worker unionsi occatioaheath ad saet at idstr eve

Bambag Srjoo, Idoesia

Background

At the global level, according to the most re-

cent estimates o the International Labour O-

ce (ILO), about two million people die be-

cause o their work every year (1). Tese work-

related deaths represent only a small raction

o the suering caused. An estimated 160 mil-

lion people have work-related disease. Some

355,000 atal accidents take place every year.

For every atal accident at work, some 500

2,000 other non-atal injuries occur, depend-ing on the type o work. Yet these workplace

tragedies rarely make the headlines.

Fatalities and accidents are not bound to

happen. Tey are caused. Cancer caused,

or example, by asbestos, other carcinogen-

ic dusts and chemicals, and ionizing radia-

tion is the biggest reason or work-related

deaths (accounting or an estimated 32% o

work-related deaths), ollowed by circulatory

diseases caused, or example, by night work

and shi work, stress, some chemicals and

environmental tobacco smoke at workplaces (23%), accidents (19%) and communicable

diseases (17%). Te gures dier consider-

ably in various parts o the world: accident

rates, or instance, are very high in the Asian

iger economies.

The role o trade unions in OH&S

Work accidents can be prevented i all stake-

holders play an active role. Tree points need

to be stressed here:

Enterprise management and commit-

ment have a key role.

Companies that have an occupational saety

and health management system (OSH-MS)

set up according to ILO Guidelines (ILO-

OSH 2001) have better saety records and

better productivity records.

Te stronger the union, the safer the

workplace.

Even the best occupational health and sae-

ty regulations will have little impact un-

less the people concerned, the workers, are

able collectively to deend their interests.

It is vitally important that workers are in-volved in planning and running the com-

pany OSH management system and have

reedom o association. Te high saety

standard o Sweden, or example, is a di-

rect result o long-term policies on workers

involvement and a well-unctioning tripar-

tite mechanism.

Much of the action on safety and health

must be local, but much of the framework

must be global.

Tis is both a moral and a practical neces-

sity. Moral, because we cannot place a lower

value on workers lives in some parts o the

world than in others. Practical, because in

a global economy, we cannot allow saety

and health to be undermined by alse con-cerns about competitiveness.

On both o these counts, the ILOs Sae

Work Programme is well placed to infuence

the global agenda. Representatives o the

worlds workers, employers and governments

meet on equal terms within the ILO. rade un-

ion rights are at the heart o its standard-set-

ting activities, as are health and saety. More-

over, the ILO is currently campaigning or

the provision o decent work worldwide. It is

clear that decent jobs must also be sae jobs.

Occupational health and saety

training by trade unions

o promote the role o trade unions in occu-

pational health and saety activities in Indo-

nesia, the Conederation o Indonesian rade

Union (CIU) has devised an OH&S training

programme in cooperation with JILAF, the

Japan International Labour Foundation. Te

training is called the OHS POSIIVE training

programme. POSIIVE stands or Participa-

tion-Oriented Saety Improvement by rade

union InitiatiVE. Te POSIIVE programme

was developed as a participatory training pro-

gramme or the promotion o occupational

saety and health by trade unions (2).

Te basic principle o the programme is

participation. Seminar participants learn rom

local good examples that have already been

put into practice in order to improve the work

environment. Attention is given to low-cost

improvement. By using an action checklist in

an actual workplace and discussing the results

with their colleagues, union members receive

training that leads to activities improving oc-cupational saety and health at the workplace.

Follow-up activities are held, too; discussions

take place with the objective o supporting the

workers continued activities.

Te training is given in two steps:

a. Te rst step is the OH&S raining o

rainers (O) POSIIVE Programme.

Tis seminar takes our ull days.

b. Te second step is the OH&S Core rainer

raining (C) POSIIVE Programme,

comprising three ull days.

During each step o training, the partici-

pants visit a actory to observe good examples

o OH&S practice. A checklist prepared beore

the visit is used during the observation visit.

Tere are six technical aspects to be observed

(3):

1. Materials handling and storage

2. Change o work station

3. Machine saety



15/24

4. Physical environment

Picture # 4

5. Welare acilities

Picture # 5

6. Environment protection

Picture # 6

So ar CIU and JILAF have organized six

raining o rainer (O) seminars and seven

OH&S Core rainer raining (C) seminars

in Indonesia. Te training has been given in

some regions o Jakarta, East Java, West Java,

Central Java and in Riau Province, Batam Is-

land. Tere are about 120 Core rainers who

can provide training or Union members at

the workplace.

CIU and JILAF started to run POSIIVE

training programmes in 2006 and they have

continued until now. Each year at least two

set o OHS POSIIVE training seminars have

been held. Above are data on the POSIIVE

Programme raining in Indonesia organized

by CIU and JILAF in 20062009.

Results o training

Te O seminar participants have to make

improvements in OH&S conditions at their

workplace. Tese improvements should be

presented when they come or the C train-

ing about six months aer the O seminar

has been completed. Improvement o the

working conditions benets not only the

workers; it is also benecial to the employer in

terms o improved and increased productivity.

Improvement o OH&S is based on these con-

siderations:

Facilitate immediate improvements

Learn rom local good examples

Involve managers together through the vis-

ible benets (good work results) and low-

cost ideas

Promote solidarity by group work.

On the last day o each training seminar,

the participants have to present proposals or

improvement to the company they have visited

on the rst day o training. Te management o

the company visited is invited to the class, to

ollow the participants presentations. Most othe management representatives rom the ac-

tories visited have been very satised and have

appreciated that the participants were able to

identiy areas in need o improvements. Te

Date pace particiats

(n)

Tye o traiig

1217 ebrar 2006 Ciag, Bogor 24 TOT

56 november 2007 Cioto, Bogor 27 TOT

30 Ma2 Je 2008 Srabaa 26 TOT

31 October4 november 2008 Cisara, Bogor 24 TOT

25 Je 2009 Batam 24 TOT

912 Je 2009 Jogjakarta 24 TOT

1316 november 2006 Bogor 17 CTT2830 Agst 2007 Cisara, Bogor 14 CTT

46 Je 2008 Cisara, Bogor 23 CTT

1820 november 2008 Tretes, Srabaa 20 CTT

58 ebrar 2009 Cisara, Bogor 23 CTT

1618 november 2009 Badga, Semarag 14 CTT

2022 november 2009 Batam 25 CTT

companies have conrmed that the proposals

were very valuable to them.

As to the workers, their awareness o

OH&S at the workplace is increased through

improvements carried out at the workplace.

Reerences1. Dr. Jukka Takala, Director, Sae Work, Interna-

tional Labour Ofce (ILO).- Originally in the UK in

Hazards magazine or its International WorkersMemorial Day.

2. http://www.jila.or.jp/English-jila/genpro/posi-

tive/about/index.html, retrieved 10 January 2010.

3. Kazutaka K, Kawakami T. Trainer Guide or

OHS JILAF POSITIVE Program. The Institute or

Science o Labour, Japan International Labour

Foundation 2002.

Bambang Surjono

Vice Geera Secretar o Coederatio o

Idoesia Trade uios

paza Basmar 2d oor

J. Mamag praata 106

Jakarta 12790

Idoesia

[email protected]

photos b Bambag Srjoo

7. Training participants



16/24

Developing OSH training systems Chaeges acig ood eterrises i Chiayhag WAnG, Chia

Development o ood enterprises in

China

Since the implementation o the Opening-up

Policy in 1978, the ood industries in China

have developed in rapid strides. In 2009, the

gross value o the industrial output o ood

industries reached 4.9 trillion RMB, an in-

crease o 14.6% on 2008; this is 6.6% higher

than the average growth rate or industrial

output. Food industries in China account or

about 20.4% o the increase value o indus-

trial output (1). Food industries are closely

linked to the living quality and health o the

people, and they play a major role in absorb-

ing redundant labour in rural areas o China.

Tere are more than 9.5 million workers em-

ployed in ood industries; this is about 17.9%

o the total ormal employment (2). Devel-opment o the ood industries has supported

the development o agriculture and armers,

increasing the armers income and spurring

urbanization (3).

From now on, development o the ood in-

dustries in China aces both challenges and op-

portunities (4). Among the opportunities are:

the State will invest more and more in sci-

entic and technological modernization o

the ood industries;

the rapid economic development, indus-

trialization, and urbanization give rise to

greater market demand or ood industry

products;

globalization provides wider resource al-

location or the ood industries.

Te challenges acing the ood industries in-

clude the ollowing:

the complicated international market has

intensied the competition or resourc-

es, markets, technology and intellectual

resources trade protectionism is rising;

industrialized countries benet rom their

dominant economic and technological po-

sition;

it is easy to orm a market monopoly in

China;

since the Opening-up Policy, oreign capital

has been fowing into Chinas ood indus-

tries, imposing heavy pressure on domestic

ood enterprises.

OSH situation o ood enterprises in

China

Food processing enterprises have certain ex-

tensive risks, as some chemical materials are

used, there are occupational hazards, many

fammable and explosive materials are present,

gigantic volumes o raw materials are stored

on site, logistics are on a large scale, many

man-machine interaces exist, and the new

processing project is proceeding very quick-

ly. All o these actors present comparativelyhigh risk levels to the ood industries in China.

According to incomplete statistics o the

State Administration o Work Saety, rom

2001 to 2009, 53 comparatively large-scale ac-

Photo by ILO



17/24

cidents (an accident causing more than three

atalities is called a comparative large-scale

accident in the Chinese occupational saety

legislation, and inormation on them are pub-

lished in real time on the ocial website) oc-

curred in ood industries and led to 253 atali-

ties in total (trac accidents are not includ-

ed). Tese statistics mean that a comparatively

large-scale accident occurs in Chinese ood

enterprises every second month (5), (see a-

ble 1 and Figure 1). Te gures on accidents

causing one or two atalities may be dozens

o times higher than those or comparatively

large-scale accidents, but there is a lack o reli-

able data. From the point o view o the com-

paratively large-scale accidents that occurred

in the past nine years, the same types o acci-

dents happen again and again; the ood indus-

tries have not learned their lesson. Although

the level o risk in the ood industries is not

as high as in the mining, chemical, and con-

struction industries o China, nevertheless theood industries still have certain specic risks.

Challenges in OSH training acing

ood enterprises in China

A large number o small enterprises lack the

input o saety training

According to a White Paper o the Inormation

Oce o the State Council (6), there are 450,000

ood enterprises in China; most o them small

and medium-sized enterprises. A total o 80%

o them employ ewer than 100 people, and77% ewer than 10 people. A large proportion

o the home-style producers cannot meet the

saety standards at all (7). Owing to the intense

competition, the prot margin o ood process-

ing enterprises is very low, and the gross prot

margin is about 1020%. o cut costs, many en-

terprises reduce their input in saety and health

protection and there is little capital to und OSH

training, which worsens the occupational saety

and health situation.

A large number o migrant workers lack saety

awareness and skills

Migrant workers (also called arm workers

in China) have become a major labour orce

during the industrialization and urbanization

process in China. Tey migrate rom rural ar-

eas to cities every year, and contribute great-

ly to the development o society. But the mi-

grant workers are poorly educated and have

poor saety awareness. Tey do not have the

necessary saety protection ability. Te result

is great pressure on the occupational saety

management. In the past years, more than hal

o the work accidents and new cases o occu-pational diseases are suered by the migrant

workers. raining or migrant workers is ur-

gently needed to change the current serious

OSH situation (8) in China.

Figure 1. The tred o comarative arge-scae accidets i ood eterrises i

Chia.

Table 1. Comarative arge-scae accidets rom 2001 to 2009 i ood

eterrises i Chia

year Accidets ataities

2001 3 10

2002 9 36

2003 4 21

2004 5 26

2005 4 12

2006 5 28

2007 10 58

2008 6 29

2009 7 33

Tota 53 253

According to the Migrant Workers Inves-

tigation Reportof the State Council in 2006,

only 20% of the migrant workers can obtain

short-term occupational training, 3.4% have

primary-level occupational training, 0.13%

have intermediate-level level occupational

training, and 76.4% have no occupation-

al training at all. Thus the coverage of the

safety training for the migrant workers is

very low.

Migrant workers usually have a short-term

contract with their employers and there is an

oversupply of migrant workers. For these rea-

sons, employers are not willing to invest in

training for them. At the same time, migrant

workers lack safety protection awareness, nor

do they actively participate in safety training

activities. It is therefore very common for them

to work without safety training.

A lack o qualifed trainers and targeted docu-

ments

Some enterprises send their workers to occu-

pational training schools or organizations butthen complain aerwards that the outcome o

training is useless. Many training programmes

do not match the real needs. Some training

organizations cannot conduct saety training

properly, as they lack qualied trainers. Al-

though some workers obtain saety training,

their saety awareness and skills did not im-

prove remarkably (9).

The corps of trainers cannot keep up with

the rapid pace of development of the produc-

tion process, technological modernization, and

equipment updates, and they cannot solve the

new problems and situations. Most of the train-

ing materials are out-of-date and lack informa-

tion about the new situations, so the contents

of training are alienated from reality and do

not provide the proper guidance. The training

method is also stereotyped and has not been re-

vised. Most training is done in the classroom,

through lectures and listening; this passive

and dull method also compromises the train-

ing effect (10).

Occupational safety and health has some

common issues across industries, but there are

also differences between different industries.

Some high-risk industries in China, such as

petrol and chemical, mining, and construction

industries, have developed training materialstargeted to their individual characteristics. For

the food industries, however, no such efforts

have been made and no corresponding mate-

rials are available.

12

10

8

6

4

2

0

70

60

50

40

30

20

10

0

2001

2002

2003

2004

2005

2006

2007

2008

2009

Accidetatait



18/24

A lack o relevant industrial authority

management on OSH issues

Mining, construction, and chemical industries

in China have their own individual industri-

al management authorities or occupational

saety and health issues. By contrast, the ood

industries lack an industrial authority to man-

age the OSH issues.

There is a China National Food Industry

Association (CNFIA), founded in 1981, that

plays an important role in the development

of the industrys economy, its scientic and

technological development, and fair compe-

tition. But the Association does not function

in OSH issues for the food industries. The

China Association of Work Safety, founded

in 2008, and the China Occupational Safety

and Health Association, founded in 1983, are

both general associations and do not have spe-

cic and professional activities involving the

OSH issues of the food industries.

Because o the lack o relevant industrialauthority management on OSH issues in the

ood industries, it is hard to implement in-

dustry-wide training programmes, and it is

hard to guarantee the training perormance.

Suggestions or developing OSH

training systems or ood enterprises

in China

Te major actor hindering OSH training

in the ood industries is the limited capital.

It is necessary to establish a mechanism tobalance the input rom the government,

employer and employee organizations.

Te government and employer organiza-

tion should shoulder more responsibilities

to build a training system that would cover

the OSH needs o the ood industries.

It is essential to improve the saety aware-

ness o employers and employees by using

the popular media to disseminate saety

awareness. Everybody really needs to buy

into the concept o putting people rst, car-

ing about lie and caring or saety. Tey

must be motivated to learn saety skills and

they must require higher saety conditions.

It is very important or China to have a lead-

ing organization that would pay close at-

tention to OSH issues or the ood indus-

tries. Such an organization would coordi-

nate with dierent stakeholders, develop

a training plan, obtain the capital, organ-

ize and conduct training programmes, and

meet the specic saety and health needs o

the ood industries.

Te Government or employer organiza-

tions should develop practical and target-ed training materials and should train more

and more qualied OSH trainers or the

ood industries.

New inormation technology, such as dis-

tance education and distance training on

OSH, should be considered in order to de-

crease the training cost and improve the

eect.

Reerences:

1. Xinhua net. This year the gross value o industrialoutput o ood industries reached 4.9 trillion RMB

in China. Available at: http://news.xinhuanet.com

Accessed 21 November 2009.

2. The Central Peoples Government o Peoples Re-

public o China. China Food Science and Technol-

ogy Development Report o 20072008. Available

at: http://www.gov.cn Accessed 7 April 2009.

3. China Agro-product Processing net. The National

11th Five Year Development Plan o Agro-product

Processing Industries. Available at: http://www.

csh.gov.cn Accessed 20 January 2007.

4. Liu Z, Hu L. Status and prospects o ood indus-

tries in national economy development. Food and

nutrition in China 2009;3:2325.

5. State Administration o Work Saety. AccidentsPublish and Search System. Available at: http://

media.chinasaety.gov.cn Accessed at 10 August

2009.

6. The Central Peoples Government o Peoples Re-

public o China. Inormation Ofce Issued China

Food Quality Situation White Paper. Available at:

http://www.gov.cn Accessed 17 August 2007.

7. Bureau o Economic Operations, National Devel-

opment and Reorm Committee. Restraining Fac-

tors and Counter Measures or Food Industries

Healthy Development. Chinese Medicine 2007

Jun;7.

8. Sun Y. Five Problems o the Farmer Workers

Saety Training. Labor Protection 2008;1:70.9. Huang Y. In-service Training or Migrant Workers:

Problems and Proposals. Journal o Shenzhen

Polytechnic 2007;1:8992.

10. Zhang Y, Wang Y, et al. Problems and Counter-

measures or Saety Training in China Enterprises.

In Proceeding o the 14th Symposium on Occupa-

tional Saety and Health rom Taiwan, Mainland,

Hong Kong and Macao. Xian, 2006.

Yuhang WANG

Det Maager

Work Saet Servisio Ofce

Chia Agri-Idstries Hodigs limited

Add:Rm02,17,COCO, orte paza,

nO.8 Chao yag Me Soth St.

Beijig, Chia 100020

Emai:[email protected]

Web:www.coco.com

PhotobyILO



19/24

InternationalTraining Centre traiig orthe word

Teem lidors, iad

Working conditions around the world are

not equal. Te conditions o work and even

the basic rights o workers vary considerably

between dierent countries. Many countries

around the world are making strong economic

progress while others are acing major chal-

lenges. Regardless o the progress or slack-

ness o the economy or political turbulence,

one should eel sae and equal at work. Te

International Labour Organization (ILO) is

devoted to advancing opportunities or wom-

en and men to obtain decent and productivework in conditions o reedom, equity, secu-

rity and human dignity. o urther the goal

o decent work or women and men, ILO and

the Italian Government established the In-

ternational raining Centre (ICILO) in u-

rin, Italy in 1964, as an advanced vocational

training institute.

Multinational training

Te Centre provides training and services that

develop human resources and institutional

capabilities. Each year about 11,000 people

rom over 180 countries take part in the Cen-

tres training activities and events. Altogether

more than 450 programmes and projects are

run every year. Te Centres demand-driv-

en training portolio consists o courses in

key work-related areas. Te orms o training

are standard courses, tailor-made courses and

comprehensive projects. o reach more and

more people, the Centre is using a series o

distance training programmes. Some o these

are complemented by ace-to-ace sessions.

Trough training, the Centre contributes toachieving the ILOs our strategic objectives:

to promote and realize standards and un-

damental principles and rights at work

to create greater opportunities or wom-

en and men to secure decent employment

and income

to enhance the coverage and eectiveness

o social protection or all

to strengthen tripartism and social dia-

logue.

Participants and benefts

Te participants o trainings usually hold

managerial or executive positions in minis-

tries, workers organizations, employers or-ganizations, enterprises, training institutions

or universities, etc. Many o the participants

are themselves trainers or trainers o trainers.

Trough the Institutes training, participants

gain an in-depth understanding and practice

concerning international labour standards,

decent work, social protection, social dialogue

and related development issues. Tey learn

to analyse common problems and challenges

and to nd sustainable solutions. All are cho-

sen careully to ensure the multiplier eect.

Aer their training, participants should ap-

ply their newly acquired insights and skills in

their work and pass them on.

Te Centre has ve Regional Programmes,

which include Arica, the Americas, the Arab

States, Asia and the Pacic, and Europe. Te

Centre ensures that its activities are relevant

and expedient to local needs, goals and con-

ditions. Regional needs are monitored and

activities coordinated in cooperation with the

eld oces o the International Labour Or-

ganization. Te regional oces also help raise

the unds that nance the Centres activities in

those regions.

Training in Asia and the Pacifc

Te ILOs International raining Centre works

in and with Asia and the Pacic to strengthen

the capacity o governments, workers organ-

izations, employers organizations and other

civil society bodies to solve problems, and to

devise policies and manage systems that pro-

mote decent work. In 2009, around 1,900 peo-

ple rom Asian and Pacic countries took part

in the Centres trainings. Te trainings were

held in urin, in many dierent countries and

on-line. Each Regional Programme has dier-

ent priority topics. For Asia and the Pacic the

Centre concentrates on: labour migration

youth employment

vocational training systems and skills de-

velopment

enterprise development and micronance

improvement o working conditions and

productivity

industrial relations

child labour and orced labour.

raining itsel is not a solution or prob-

lems in decent work but it gives a key to en-

hancement. By improving the skills and com-

petence o individuals, the awareness o rights

and entitlements in work lie increases. Tat

is the purpose o the International raining

Centre.

Additional inormation and contacts:

Iteratioa Traiig Cetre o the IlO

Viae Maestri de lavoro, 10

10127 Tri, Ita

E-mai: [email protected]

www.itcio.org

Corse caedar:

www.itcio.org/e/stadard-corses-regist-

ratio/corse-caedar



20/24

Cardiovascular healthand work on ocus

Svi lehtie, iad

NIVA, the Nordic raining Institute

in Occupational Health, together with

ICOH Scientic Committees on Car-

diology, Occupational Medicine, and

Health Services Research and Evalua-

tion in Occupational Health, organized

a Symposium on recognition, preven-

tion and control o work-related car-

diovascular disorders on 2224 March

2010 in Espoo, Finland. Proessor Jor-

ma Rantanen served as the moderator

o the Symposium.

In his opening keynote Proessor

Pekka Puska, Director General o the

National Institute or Health and Wel-

are in Finland, and President o the

World Heart Federation stated that

thanks to eective prevention pro-

grammes, the incidence o cardiovas-

cular disorders (CVD) is declining in

many industrialized countries. It is,

however, growing in the developing

world.

Work-related CVDs constitute amajor burden to health and economies

o countries. In addition to traditional

cardiotoxic chemical and physical ac-

tors, the Meeting recognized the great

impact o psychosocial actors on mor-

bidity. We have evidence on temporali-

ty o association, and dose-response re-

lationship, but the complex multiacto-

rial relationships and conounding ac-

tors still constitute a

asian pacific1 2010

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