Jo OSH GLOBAL TRENDS ON OCCUPATIONAL ACCIDENTS AND DISEASES

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WORLD DAY FOR SAFETY AND HEALTH AT WORK, 28 APRIL 2015Join in building a culture of prevention on OSHGLOBAL TRENDS ON OCCUPATIONAL ACCIDENTS AND DISEASESGLOBAL TRENDS ON OCCUPATIONALACCIDENTS AND DISEASES1The overall costs of occupational accidents anddiseases are often much greater than immediatelyperceived. Conversely, investing in occupationalsafety and health (OSH) reduces both direct andindirect costs, decreasing insurance premiums whilealso improving performance and productivity. It alsoreduces absenteeism and increases worker morale.Nationally, reduced social security and health carecosts means lower taxes, better economic performanceand enhanced social benefits.FIGURE 1OCCUPATIONAL FATAL ACCIDENTS AND DISEASES eddiseases86%According to the ILO estimates, every year over2.3 million women and men die at work from anoccupational injury or disease. Over 350,000 deathsare due to fatal accidents and almost 2 million deathsare due to fatal work-related diseases. In addition,over 313 million workers are involved in non-fataloccupational accidents causing serious injuries andabsences from work. The ILO also estimates that160 million cases of non-fatal work-related diseasesoccur annually. These estimates imply that that everyday approximately 6,400 people die from occupationalaccidents or diseases and that 860,000 people areinjured on the job. Furthermore, as estimates show,work-related diseases represent the main cause ofdeath at work, killing almost six times more workersthan occupational accidents. This should highlightthe need for a new paradigm of prevention: one thatalso focuses on work-related diseases, not only onoccupational injuries.The devastating effects on workers and their familiescannot be fully calculated; however, the ILO hasestimated the great economic burden of not investingin OSH so as to prevent occupational accidents anddiseases. The total costs amount to approximatelyfour per cent of the world’s GDP per year (roughly2.8 trillion US dollars). Further to the economic

WORLD DAY FOR SAFETY AND HEALTH AT WORK, 28 APRIL 2015Join in building a culture of prevention on OSHconstraints, the human costs are unacceptable; aglobal society has a moral obligation to reduce thehuman and economic costs.GLOBAL TRENDS ON OCCUPATIONAL ACCIDENTS AND DISEASESWHY DO WE NEED TO IMPROVE THERECORDING AND NOTIFICATION OFACCIDENTS AND DISEASES?2The ILO estimates of occupational accidents anddiseases are based on the information available fromnational statistics, which often are heterogeneous interms of definitions, data collection methodologies,and quality. As such, they provide more of anapproximation of the burden of work-related accidentsand diseases than an accurate assessment. Manycountries still lack the expertise and the resources tocollect statistics that would allow a satisfactory andreliable evaluation of the magnitude of work-relatedaccidents and diseases. Moreover, in some countries,responsibility for health and safety at work may besplit between labour and health ministries, and socialsecurity institutions, rendering data collection andanalysis difficult. As data on work-related accidentsand diseases are essential for prevention, there is astrong need in these countries to improve recordingand notification systems and data analysis. This wouldprovide countries with more reliable indicators of theeffectiveness of national OSH systems and help themin prioritizing which OSH issues should receive thesometimes scarce resources needed to resolve them.Furthermore the harmonization of national recordingand notification systems would allow for global datacollection and analysis.Good quality data on occupational accidents anddiseases are not only useful for compensationpurposes, but essential to design an effectiveprevention strategy on OSH, both at the national andenterprise levels. Reliable data are indispensable for:ºº Identifying hazardous sectors and occupationswhich require prioritizing and formulating effectivelegislation, policies and programmes, as well asmonitoring the implementation of these programmesat the national level; andºº Identifying priorities for setting the right targetstowards reducing occupational accidents anddiseases, which in turn contribute to the productivityand economic growth of the enterprises.Unfortunately, data on occupational accidentsand diseases are not available from all countriesin the world and under-reporting still represents awidespread problem. As mentioned before, availabledata are gathered from a wide variety of differentsources: social security and insurance institutions,labour inspectorates, occupational health services,or other authorities and bodies. Furthermore, officialreporting requirements frequently do not cover allcategories of workers. Rural workers, workers insmall and medium-sized enterprises (SMEs), andthose in the informal economy - representing the vastmajority of the global workforce - tend to be outsideof the systems that prevent, report, and compensate

WORLD DAY FOR SAFETY AND HEALTH AT WORK, 28 APRIL 2015GLOBAL TRENDS ON OCCUPATIONAL ACCIDENTS AND DISEASESJoin in building a culture of prevention on OSH3occupational diseases. Moreover, the intensificationof migration flows, the ageing of the workforce and theincreasing numbers of workers in temporary, casual,or part-time work and precarious employment, donot only increase their disposition to accept unsafeworking conditions but also makes them invisibleto adequate health surveillance, and recording andnotification of occupational diseases, all of which arerequired for the effective implementation of preventivestrategies.As the establishment of mechanisms for the recordingand notification of occupational accidents anddiseases and the regular publication of collectedstatistics are essential for setting priorities forimplementing preventive and protective measures,the ILO provides guidance through a numberof instruments to support member States inimproving their recording and notification systemsof occupational accidents and diseases. TheOccupational Safety and Health Convention, 1981(No. 155), and its accompanying Recommendation(No. 164) provide guidance on a national system ofrecording and notification of occupational accidentsand diseases; the Convention is complemented by theProtocol of 2002 (No. 155) and the List of OccupationalDiseases Recommendation, 2002 (No. 194). TheProtocol incorporates further provisions on theestablishment and periodic review of requirementsand procedures for the recording and notificationof occupational accidents and diseases, and forthe publication of related annual statistics. TheRecommendation provides for the regular review andupdate through tripartite meetings of experts of theILO list of occupational diseases included in the Annexof the Recommendation. The list of occupationaldiseases1, which is reviewed periodically, reflects thelatest knowledge in the identification and recognitionof occupational diseases, and is used by memberStates to the develop their own national lists. TheCode of practice for Recording and notification ofoccupational accidents and diseases provides forthe basic requirements of a system of recording andnotification of occupational accidents and diseases,giving prominence to the effective use of collected,recorded and notified data for preventive action. It hasbeen developed through international consultation andcan be used by countries as models for building theirsystems.THE NEED FOR A NEW PARADIGMOF PREVENTIONAnalysing the features of work-related fatalities, aswell as of non-fatal occupational injuries and diseases,is critical to define priorities and design effectivepreventive strategies on OSH. If underreportingof occupational accidents is a serious problem,the situation is even more dramatic concerningoccupational diseases. Occupational and work-relateddiseases remain largely invisible in comparisonto occupational accidents. In most countries only1The latest update of the list took place in 2010.

WORLD DAY FOR SAFETY AND HEALTH AT WORK, 28 APRIL 2015GLOBAL TRENDS ON OCCUPATIONAL ACCIDENTS AND DISEASESJoin in building a culture of prevention on OSH4a fraction of the real cases are diagnosed andreported. Diseases are diagnosed by physiciansand their attribution to work has to be assessed forrecognition of their occupational origin. Therefore,diagnosis of occupational diseases requires specificknowledge and experience that are not alwaysadequately available in many developing countries.This limits data collection and national capacityin occupational health surveillance. Moreover, insome countries, responsibility for health and safetyat work may be split between labour and healthministries, and social security institutions, renderingdata collection and analysis difficult. Furthermore,many occupational diseases, such as occupationalcancers, are characterized by long latency periods andare, therefore, difficult to recognize until the clinicalmanifestation of their symptoms. The increasedmovement of workers to different jobs, their exposureto various agents during their working life, along withnon-workplace factors associated with the emergenceof a disease, can make it difficult to determine theoccupational origin. Additionally, some workersmay contract a disease in jobs involving exposureto substances that have not yet been identified ashazardous.The nature of occupational diseases is alteringrapidly: technological and social changes, along withglobal economic conditions are aggravating existinghealth hazards and creating new ones. Well-knownoccupational diseases, such as pneumoconioses,remain widespread; epidemiological studies indeveloping countries show that between 30 per centand 50 per cent of workers in primary industries andhigh-risk sectors may suffer from silicosis and otherpneumoconioses. At the same time, relatively newoccupational diseases, such as musculoskeletal disorders(MSDs) and mental health disorder, are on the rise.The increase in sedentary work, prolonged standingat work, the growing use of computers and automatedsystems, and poor ergonomic conditions inworkstations, have led to a global rise of MSDs. AsFigure 2 shows, MSDs represent 40 per cent of globalcompensation costs of occupational and work-relatedinjuries and diseases. In 2005, MSDs were the mostcommon work-related health disorders, representingFIGURE 2GLOBAL COMPENSATION COSTS OF OCCUPATIONAL AND WORKRELATED ACCIDENTS AND DISEASESaccidents 14%tumors 3%skindiseasesmusculoskeletaldisorders3%40%mental us system8% impairmentshearth &16% circulatory diseas

WORLD DAY FOR SAFETY AND HEALTH AT WORK, 28 APRIL 2015Join in building a culture of prevention on OSHGLOBAL TRENDS ON OCCUPATIONAL ACCIDENTS AND DISEASES59 per cent of all recognized diseases across the27 European Union Member States, according to theEuropean Occupational Diseases Statistics.5Furthermore, due to changes in work organization andlabour relations, flexible and precarious employment,and increased pressures to meet the demands ofmodern working life, the number of cases of mentalhealth disorders, associated with work-related stress,burnout, and work-related violence also has beenincreasing. Work-related stress is the second mostfrequently reported work-related health problemin Europe (after MSD), representing the cause ofbetween 50 and 60 per cent of all lost working days. In2013–14, the cases of work-related stress, depressionand anxiety represented 39 per cent of all workrelated illnesses in the UK.2 In addition work-relatedstress can also contribute to MSDs and other healthdisorders, such as hypertension, peptic ulcers, andcardiovascular diseases.Concerted efforts are needed at national andinternational levels to tackle the “invisibility” ofoccupational diseases and to correct this Decent Workdeficit. Their effective prevention requires awarenessand advocacy programmes, including global andnational campaigns, for an improved understanding ofthe magnitude of the problem and the need for urgentaction. Greater efforts to compile relevant data toimprove preventive strategies for occupational diseasesthrough collaboration between OSH institutions and2 HSE – Stress-related and psychological disorders in Great Britain 2014social security systems at national and internationallevels are also necessary. Effective prevention ofoccupational diseases also requires the continuousimprovement of national OSH systems, preventionprogrammes and compensation systems through thecollaborative effort of government and employers’ andworkers’ organizations in ILO member States.THE IMPACT OF THE GLOBALRECESSION ON OSHThe ongoing globalization of the world economy hasundoubtedly been a major driver for change in theworld of work, with both positive and negative impactson levels of compliance and good practice. However,efforts to tackle OSH problems are often dispersedand fragmented and do not seem to reach the level ofcohesion necessary to achieve a progressive reductionof work-related fatalities, accidents, and diseases.Traditional tools for the prevention and control ofhazards and risk are still effective, but need to becomplemented by strategies designed to addressthe consequences of the continuous adaptation ofworkplaces to a rapidly changing world of work. Inparticular, many countries need to devote greaterresources to OSH research, knowledge managementand dissemination, and consistent law enforcement.In the past 20 years, globalization broughttechnological, social and organizational changesin workplaces which have been accompanied byemerging risks; these may arise from:

WORLD DAY FOR SAFETY AND HEALTH AT WORK, 28 APRIL 2015GLOBAL TRENDS ON OCCUPATIONAL ACCIDENTS AND DISEASESJoin in building a culture of prevention on OSH6ºº New and more complex technologies, such asnanotechnologies, biotechnologies, etc.;ºº increased exposure to hazardous agents and poorworking conditions;ºº New forms of work organization, including workintensification, working time arrangements, thefragmentation of production processes, andorganizational restructuring;ºº no safety and health training for these workers;ºº Emerging forms of employment, with the prevalenceof temporary, part-time and home-based work,outsourcing, and self-employment;ºº Job insecurity, higher demands, and precariousemployment which have intensified in developedcountries with the crisis and recession;ºº Demographic and political changes in the workforcecomposition due to migration, the ageing of theworkforce, lack of access to employment of youngworkers and an increasing number of workers in theinformal economy.The trends in a changing world and workforce areexpected to continue and be aggravated by the globalrecessions. The evidence from other crises showsthat such events put working conditions and qualityof production at risk. They cause uncertainty andantagonisms at all levels of the organization andsociety. The organizational changes associated torestructuring, such as outsourcing, increased part-timework, and subcontracting, complicate the managementof safety and health at work. This creates uncertaintyand misunderstandings about the respectiveresponsibilities and can lead to:ºº less autonomy over their work;ºº less opportunity to participate in workplacedecision making.Management changes during a period of recessionmay lead to decreased investments in prevention andcontrol of traditional risks, under the argument of anecessary reduction in costs. This is often the casein small-scale enterprises which traditionally lack theresources and the know-how to manage occupationalsafety and health and may consider it a cost ratherthan an investment.The impact of the crisis and recession on the health ofworkers goes beyond the victims of downsizing andthe remaining workers. It also affects their families, andthe communities in which the restructuring occurs.A number of workplace accidents and diseases dueto restructuring and unemployment may rise in lightof the present recession, as some companies andgovernments may be tempted to ignore occupationalsafety and health standards. A decrease in publicspending can also compromise the capacities oflabour inspectorates and other OSH services.With the pace of change in patterns of employmentand in developing technologies over recent years,it has become ever more important to anticipatedifferent, often new, and sometimes emerging, work-

WORLD DAY FOR SAFETY AND HEALTH AT WORK, 28 APRIL 2015GLOBAL TRENDS ON OCCUPATIONAL ACCIDENTS AND DISEASESJoin in building a culture of prevention on OSH7related risks if they are to be effectively managed.Foresight processes emerged in recent years, mostlyin Europe3, aiming to identify today’s research andinnovation priorities on the basis of scenarios of futuredevelopments in science and technology, society, andthe economy. Forecasting, technology assessment,future studies and other foresight processes try toidentify long-term trends and thus guide decisionmaking. The recent application of the foresightmethodology to OSH enables potential hazards andrisks to be determined in advance, so that effectivepreventive actions are taken. This approach is apowerful tool for anticipating emerging risks soonerthan traditional methods based on accident anddisease statistics and epidemiological data. Moreover,many long-standing OSH concerns are beingreconsidered in the light of changing patterns of workand technologies. The health effects from traditionalworkplace exposure are known and documented;what changes is the fact that emerging risks are nowincreasingly linked to new technologies developedand implemented without enough consideration givento OSH aspects, to new types of workplaces, and tosocial and organizational changes. Due to the effectsof the globalization of economies, these problems canalso be observed in many emerging countries facingrapid industrialization.3 After the European Union decision to apply this foresight or forecastingprocess to the identification of emerging risks in the OSH field, EuropeanRisk Observatory was established by the European Agency for Safety andHealth at Work (EU-OSHA), which defines an “emerging OSH risk” as anyoccupational risk that is both “new” and “increasing”.TO LEARN MOREPrevention of Occupational DiseasesEmerging risks and new patterns of prevention in achanging world of work

are due to fatal accidents and almost 2 million deaths are due to fatal work-related diseases. In addition, over 313 million workers are involved in non-fatal occupational accidents causing serious injuries and absences from work. The ILO also estimates that 160 million cases of non-fatal work-related diseases occur annually.

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