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OCCUPATIONAL HEALTH AND OCC.DISEASES STATUS OF PAKISTANPOPULATION OF PAKISTAN The population of Pakistan as per Planning & Development Division projection, estimated at 183.57 million on 16th May, 2013.

Labor force, total

The total number of Pakistan's labour force is 57.2 million, making it theninth largest countryin terms of available human workforce.About 43% of this labour is involved inagriculture, 20.3% inindustryand the remaining 36.6% in other services.

Labor force, total

The value for Labor force, total in Pakistan was 61,502,260 as of 2011. over the past 21 years this indicator reached a maximum value of 61,502,260 in 2011 and a minimum value of 31,715,010 in 1990.Labor force, female (% of total labor force) in Pakistan was 20.96 as of 2011. Its highest value over the past 21 years was 20.96 in 2011, while its lowest value was 12.33 in 1995.

Employed: Major Industry Divisions

Labor force, totalEmployed: Major Industry Divisions

Agriculture & allied activities is on wane (45.4%, 42.8%) while manufacturing 3.1%,14.2%),construction (6.4%, 7.5%) and other community/social & personal services (11.7%,14.4%) seem to be waxing. Transport/storage & communication (4.9%, 4.9%) levels same during the comparative period.Data on Burden of Occupational Diseases There is no data on Occupational morbidity and mortality rates overall and by industry segregated on the basis of Industrial Sector.NOTIFED OCC.DISEASES

8Diseases for which compensation may be claimed.

There is ambiguity in law regarding it.Labour laws to protect HSE at work place

Labour Force in the country NOT PROTECTED IN LAW Home based workers and Agriculture sector workers are left out from the purview of the law.Labour laws to protect HSE at work placeLabour laws are enacted to protect worker health and safety .Factory Act 1934 and its amended provisions and the points mentioned in it are very outdated now.Ambiguity in Act on Compensation issues and rates are very low in current economic situation. Except dockyard workers ,There are no separate laws for different economic sectors or different legal systems for different industrial sectors or otherwise.ROLE OF EMPLOYERS Very few industries are linked with Social Security Hospital and if doctor diagnose that the worker has some work related disease, employer release the worker of job instead of facilitating for treatment and implementing engineering or admin controls at workplace to safe guard against exposure.(although there are some exceptions)Government institute for OEH ProtectionThere are no Government institutions and agencies responsible for Occupational & Environmental Health, there is only one active institute being run by UN Support in Punjab province but its OH section is in active.No National Institute for Occupational health.workers who have any complains or suspected to have been suffering from occupationalWorkers usually end up either unemployed or keep on doing job till they die.Public health, medical and laboratory services overview Occupational health services are scanty, Organizations hire medical officers and then train them accordingly on the basis of their supply chain demandsRecently a modern lab has been established for forensics but not for toxicology. No certified clinical OEH practitioners (doctors, nurses, mid-levels). Occupational & Environmental Health support organizationsThere are no dedicated local or national trade unions, local NGOs or any local web site working exclusively for occupational health.CIWCE Punjab is being run by UN Support but its contribution towards OH is not worth mentioning. Laws related for Occupational Medicine and Medical Practitioners. GPs and Social security Doctors have not been empowered by the law to certify Occ. Disease. They can only identify the disease and then there is ambiguity in law for treatment ,rehabilitation and disposal of such cases. Process of Diagnosis for Occupational Disease. Public Health System is not integrated with the Occupational Disease Diagnosis procedure. If any social security entitled factory worker is referred to hospital ,he will be sent only twice or thrice by factory ,but at hospitals as workers number is more and they have to wait for the tests and it takes time for the doctors to reach occupational disease diagnosis so most of the time they end up taking medicines for general symptoms rather than having treatment for specific Occ. Diseases.There is also a delay in referrals by Factory admin and medical staff till the time they are too much ill.

Process of Diagnosis for Occupational Disease.There is limited knowledge of GPs, factory doctors and public health experts of workplace hazards, exposure and workplace job rotation or adaptations.If any case is identified and certificate has to be issued there is no set mechanism for its follow up and no chain of actions are mentioned in law about it. and worker who is suffering from even any notified occupational disease will end up with nothing in spite of its diagnosis.

Process of Diagnosis for Occupational Disease.Workers are scared to take any medical certificates they think it can lead to loss of job due to being ignorant about compensation. Although compensation rates are very low.Factories employer have representatives at Social Security Hospitals. All the workers are not entitled medical or social security benefits thats why major chunk of casual or contract staff engaged in hazardous operation who are more prone than permanent workers to exposure and illnesses/ occ. disease could not be sent to hospital or any SSH and can not be labeled as occupational environmental victims.

Certification requirement for OEH Practicein PakistanThe diagnostic methods and machines are either not available and if available at general hospitals doctors can not make a link of it to workplace, even if they are able to do ,they do not give certificate of it.There is shortage of specialized labs on OH.Current Curriculum for the Medical Practitioners on Occ. Diseases.There is no course for GPs. A teaching modules on Occupational health is taught as a part of curriculum of Community Medicine in Fourth Year of medical education to become a doctor.Two Institute( IPH and AFPGMI ) offer a module on Occupational Health as a part of masters in public health curriculum but being taught by those who do not have any work place working experience and the contents are the same as for medical graduates. Certification requirement for OEH Practicein PakistanNo PG level program available for Occupational Medicine There are no institutes offering training for doctors, nurses on OH. No Degrees and/or certifications offered (primary and continuing education)No Government certification requirements of OEH practiceWHAT WE ARE IN NEED OF ?A network of OEH medical professionals (doctors, nurses, Hygienists and technicians) at regional and global level who can support all interested parties concerned.Financial and institutional resources that can help provide opportunities for clinical and practical skills training and certification of OEH medical professionals.Establishment of Occupational Health Institutes at National Level.

WHAT WE ARE IN NEED OF ?Our work force is in need to know their OEH rights and services.General Physicians and Social Security Doctors should know local legal requirements and shall be trained to diagnose Occ.Disease.Establishment of OH labs and toxicology lab.At least every big chain of industrial concerns shall have one certified OH Practitioner.Expectations from this training.The beneficiaries of the Training Programs will be workers, employers ,medical institutes and OEH Medical Professionals.We plan to utilize the services of the Medical expert trained for dissemination of this information at all levels to workers, employers ,social security hospital staff through awareness session, news letter and by a web site.By teaching a revised module on Occupational Health at CIWCE,IPH and AFPGMI.Provision of early OH diagnostic services at Shop floor of Industries.Organizing OHSE Medical screening Camps.