International Code Of Ethics - ICOH

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internationalcode of ethicsfor occupationalhealth professionalsthird editionICOH impa EN.indd 116/12/14 13:25

ICOH impa EN.indd 216/12/14 13:25

First edition: 1992Second printing: 1994Third printing: 1996Second edition: 2002Second printing: 2006Third printing: 2009Third edition: 2014Editorial Group of the third editionK. Kogi (Chair)G. Costa, B. Rogers, S. Iavicoli, N. Kawakami, S. Lehtinen,C. Nogueira, J. Rantanen, E. Santino, P. Westerholm.Permission for translation and reproductionThe Code of Ethics of the International Commission on Occupational Healthmay be freely reproduced provided that the source is indicated. Proposal oftranslation into other languages, other than English and French, must beaddressed jointly to ICOH President and Secretary General. Translation intoother languages, other than the official ones, must be done by an ad hoc WorkingGroup appointed by ICOH President. ICOH President could nominate a PeerReviewing Group to revise the translated version, if necessary. The Chair of theWorking Group will submit the final revised translated text for approval byICOH President. Translated versions of ICOH Code of Ethics must include acopy of the Code either in English or French. Printing of ICOH Code of Ethicsis subject to prior authorization by ICOH President. Any printing financialsupport by any kind of organizations have to be preliminary communicated andapproved by ICOH President.*ICOH: International Commission on Occupational HealthSecretariat GeneralAddress: Sergio Iavicoli MD, PhDINAILVia Fontana Candida, 100040 - Monteporzio Catone (Rome) - ItalyTel: 39 - 06 - 94181506Fax: 39 - 06 - 94181556Email Address: icoh@inail.itInternational Commission on Occupational Health 2014 ICOHCommission Internationale de la Santé au Travail 2014 CISTICOH impa EN.indd 316/12/14 13:25

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INTERNATIONAL CODE OF ETHICS FOR OCCUPATIONAL HEALTH PROFESSIONALS5PrEface1. There are several reasons why the International Commission on Occupational Health (ICOH) has committed itself in the developmentof an International Code of Ethics for Occupational Health Professionals, as distinct from codes of ethics for all medical practitioners.The first one is the increased recognition of the complex and sometimes competing responsibilities of occupational health and safetyprofessionals towards the workers, the employers, the public, publichealth and labour authorities and other bodies such as social security and judicial authorities. The second one is the increasing number of occupational health and safety professionals as resulting fromthe compulsory or voluntary establishment of occupational healthservices. Yet another factor is the emerging development of a multidisciplinary approach in occupational health which is implying aninvolvement in occupational health services of specialists who belongto various professions.2. The International Code of Ethics for Occupational Health Professionals is relevant to many professional groups carrying out tasks andhaving responsibilities in enterprises as well as in the private and public sectors concerning safety, hygiene, health and the environment inrelation to work. The term occupational health professionals categoryis for the purpose of the Code defined as a broad target group whosecommon vocation is a professional commitment in pursuing an occupational health agenda. The scope of this Code covers activities ofoccupational health professionals both when they are acting in individual capacity and as part of organizations or undertakings providingservices to clients and customers. The Code applies to occupationalhealth professionals and occupational health services regardless ofwhether they operate in a free market context subject to competitionor within the framework of public sector health services.3. The 1992 International Code of Ethics first edition laid down general principles of ethics in occupational health. These are still validbut need to be updated and rephrased to reinforce their relevancein the changing environment where occupational health is practiced.Changes in working conditions and in social demand should be takenICOH impa EN.indd 516/12/14 13:25

6INTERNATIONAL CODE OF ETHICS FOR OCCUPATIONAL HEALTH PROFESSIONALSinto account including those brought about by political and social developments in societies; demands on utility value, continued qualityimprovements and transparency; globalization of the world economyand liberalization of international trade; technical development andintroduction of information technology as an integral element of production and services. All these aspects have repercussions on the context surrounding the occupational health practice and thereby influence the professional norms of conduct and the ethics of occupationalhealth professionals.4. The preparation of an International Code of Ethics for OccupationalHealth Professionals dates back to 1987 when it was discussed by theBoard of the ICOH in Sydney. The prepared draft was subject to aprocess of consultations. The 1992 Code of Ethics for OccupationalHealth Professionals was approved by the ICOH Board in November1991 and published in English and French in 1992, with many reprints and translation into other languages in the following years. AWorking Group was established in 1993 with the aim of updating theInternational Code of Ethics for Occupational Health Professionalsand agreed with the ICOH Board in 1997 that an in-depth revision ofthe Code of Ethics was necessary aiming at supplementing the Codewith new issues and themes needing to be addressed. The reconstituted Working Group on Ethics in Occupational Health (J.F. Caillard,G.H. Coppée and P. Westerholm) started the revision process of theCode in 1999 in consultation with selected ICOH members retainingits original structure and reorganizing the text in a more systematicmanner.5. The updated version of the Code of Ethics for Occupational HealthProfessionals was approved by the ICOH Board in March 2002. The2002 Code was widely recognized and used for the elaboration of national codes of ethics and for educational purposes. It was adopted asterms of reference in Argentina and Italy in the Framework Act for occupational safety and health. It was also included into the Rosenstockand Cullen text edition. Apart from the ICOH official languages, theICOH Code of Ethics was translated into Chinese, Greek, Italian,Japanese, Portuguese, Spanish and Turkish. In 2010, the United Nations Medical Directors Working Group agreed to advise that anyICOH impa EN.indd 616/12/14 13:25

INTERNATIONAL CODE OF ETHICS FOR OCCUPATIONAL HEALTH PROFESSIONALS7UN organizational statements of ethics in occupational health mattersshould be guided by, and consistent with the ICOH Code of Ethics.Furthermore there have been many adoptions on a voluntary basis asa standard for defining and evaluating professional conduct and it waswidely referred to in occupational health and related fields.6. The ICOH Board decided in 2008 to review the 2002 Code, andcommissioned the Working Committee on Ethics and Transparencyof the Board to perform the task at a Board meeting in Cape Townin March 2009. The committee consisted of Board Members P. Westerholm (chair), G. Costa, M. Guillemin, J. Harrison and J. HowardJr. acting as the ICOH Board Code Review Group. Board memberM. Fingerhut was affiliated to the Group to strengthen capacity forliaison in view of the global scope of the task. For strengtheningfield contacts, the Code Review Group was expanded by affiliatingJ.F. Caillard (ICOH Past President) and S. Iavicoli (ICOH SecretaryGeneral). For expanding contacts with world regions and professionalnetworks in Latin and South Americas, Africa and Asia, J. RodriguezGuzman, L. London and S. Horie were commissioned and affiliatedto the Code Review Group. In addition, a task group was constitutedas a subgroup of the Code Review Group to address Ethical Codeissues related to the cultural context on the African continent, withG. B. Tangwa, R. B. Matchaba-Hove, A. Nyika, N. MKhize and R.N. Nwabueze. The review work was carried out by drafting a series oftext reviews. The Code Review Group members used opportunities atICOH conferences in Europe, Africa, South and Latin Americas andAsia to discuss Code review matters with the members they met andwith other professional networks.7. A progress report of the Code Review Group was presented and discussed at the ICOH Board Midterm Meeting in Milan in February2011. The ICOH Membership became involved through communication of the preliminary review results to ICOH scientific Committees Chairs and Secretaries and ICOH National Secretaries. The CodeReview Group s report submitted by P. Westerholm, Chair of the Ethics and Transparency Committee, in September 2011 was discussed ata Code review meeting organized by ICOH President K. Kogi andattended by ICOH Officers and the members of the Ethics and Trans-ICOH impa EN.indd 716/12/14 13:25

8INTERNATIONAL CODE OF ETHICS FOR OCCUPATIONAL HEALTH PROFESSIONALSparency Committee. It was agreed to minimize the changes in theCode by examining the issues requiring revisions. A special session atthe ICOH Congress held in Cancun in March 2012 further discussedthese issues based on the review results. The changes required forthe Code were discussed at a workshop on the ICOH Code of Ethics organized at the University of Occupational and EnvironmentalHealth in Kitakyushu in August 2012. To finalize the Code revisionwork in view of the suggested amendments generated throughout thereview process, ICOH President K. Kogi organized a Code EditingGroup comprising ICOH Vice-Presidents S. Lehtinen and B. Rogers,Secretary-General S. Iavicoli, Past President J. Rantanen and Boardmembers G. Costa, N. Kawakami, C. Nogueira, E. Santino and P.Westerholm. In the meeting of the Code Editing Group held in June2013, the draft revisions of the Code were finalized. In addition, wegreatly acknowledge the editorial support for this third edition of Mr.Carlo Petyx (Coordinator), Ms. Valeria Boccuni, Ms. Erika Cannone,Mr. Pierluca Dionisi and Ms. Antonella Oliverio.8. In the review process, the fundamental point of departure and aimhave been to retain the already existing structure of the 2002 Codethroughout the review, for the purpose of serving continuity andrecognition of its contents by the successive generations of ICOHmembers and all readers within the occupational health professionalcommunity of the world. The review process has resulted in workingmaterials and documentation envisaged to be made available as supplementary entries on the ICOH website following the adoption ofthe revised Code by the ICOH Board. The proposed Code revisionswere presented to the ICOH Board Midterm Meeting held in Helsinki in February 2014. By further revising the proposed changes,the ICOH Board adopted the new International Code of Ethics forOccupational health Professionals on 10 February 2014.9. This Code of Ethics represents an attempt to translate in terms ofprofessional conduct the values and ethical principles in occupationalhealth. It is intended to guide all those who carry out occupationalhealth activities and to set a reference level on the basis of which theirperformance can be assessed. Its purpose is also to contribute to thedevelopment of a common set of principles for cooperation betweenICOH impa EN.indd 816/12/14 13:25

INTERNATIONAL CODE OF ETHICS FOR OCCUPATIONAL HEALTH PROFESSIONALS9all those concerned as well as to promote teamwork and a multidisciplinary approach in occupational health. It provides a frameworkagainst which to document and justify departures from acceptedpractice and places a burden of responsibility on those who do notmake their reasons explicit. It should also be noted that more detailedguidance on a number of particular aspects can be found in nationalcodes of ethics or guidelines for specific professions. Furthermore, theCode of Ethics does not aim to cover all areas of implementation orall aspects of the conduct of occupational health professionals or theirrelationships with social partners, other professionals and the public.It is acknowledged that some aspects of professional ethics may bespecific to certain professions and need additional ethical guidance.10. It should be stressed that ethics should be considered as a subjectthat has no clear end boundaries and requires interactions, multidisciplinary co-operation, consultations and participation. The processmay turn out to be more important than its ultimate outcome. Acode of ethics for occupational health professionals should never beconsidered as «final» but as a milestone of a dynamic process involvingthe occupational health community as a whole, the ICOH and otherorganizations concerned with safety, health and the environment, including employers’ and workers’ organizations.11. It cannot be overemphasized that ethics in occupational health isby essence a field of interactions between many partners. Good occupational health is inclusive, not exclusive. The elaboration and theimplementation of professional conduct standards do not involveonly the occupational health professionals themselves but also thosewho will benefit from or may feel threatened by their practice as wellas those who will support its sound implementation or denounce itsshortcomings. This document should therefore be kept under reviewand its revision should be undertaken when deemed necessary. Comments to improve its content should be addressed to the SecretaryGeneral of the International Commission on Occupational Health.12. The Code of Ethics of the International Commission on Occupational Health may be freely reproduced. Proposals of translation intoother languages, other than English and French, must be addressedICOH impa EN.indd 916/12/14 13:25

10INTERNATIONAL CODE OF ETHICS FOR OCCUPATIONAL HEALTH PROFESSIONALSjointly to ICOH President and Secretary-General. Translation intoother languages, other than the official ones, must be done by an adhoc Working Group appointed by ICOH President. ICOH Presidentcould nominate a Peer Reviewing Group to revise the translated version, if necessary. The Chair of the Working Group will submit the final revised translated text for approval by ICOH President. Translatedversions of ICOH Code of Ethics must include a copy of the Codeeither in English or French. Printing of the ICOH Code of Ethics issubject to prior authorization by ICOH President. Any financial support for printing by any kind of organizations has to be preliminarilycommunicated and approved by ICOH President.Kazutaka Kogi, MD, DMScICOH PresidentICOH impa EN.indd 10Sergio Iavicoli, MD, PhDICOH Secretary-General16/12/14 13:25

INTERNATIONAL CODE OF ETHICS FOR OCCUPATIONAL HEALTH PROFESSIONALS11introduction1. The aim of occupational health practice is to protect and promoteworkers’ health, to sustain and improve their working capacity andability, to contribute to the establishment and maintenance of a safeand healthy working environment for all, as well as to promote theadaptation of work to the capabilities of workers, taking into accounttheir state of health.2. The field of occupational health is broad and covers the prevention ofall impairments arising out of employment, work injuries and workrelated disorders, including occupational diseases, the protection andpromotion of workers’ health and all aspects relating to the interactions between work and health. Occupational health professionalsshould be involved, whenever possible, in the design and choice ofhealth and safety equipment, appropriate work methods and procedures and safe work practices relevant to health, safety and work ability of workers. They should encourage workers’ participation in thisfield as well as feedback from experience.3. On the basis of the principle of equity, occupational health professionals should assist workers in obtaining and maintaining employment notwithstanding their health deficiencies or their handicap.It should be duly recognized that there are particular occupationalhealth needs of workers as determined by factors such as gender, age,ethnicity, physiological condition, social aspects, communication barriers or other factors. Such needs should be met on an individual basiswith due concern to protection of health in relation to work and without leaving any possibility for discrimination.4. For the purpose of this Code, the expression «occupational healthprofessionals» is meant to include all those who, in a professionalcapacity, carry out occupational safety and health tasks, provide occupational health services or are involved in an occupational healthpractice. A wide range of disciplines are concerned with occupationalhealth since it is at an interface between technology and health involving technical, medical, social and legal aspects. Occupational healthprofessionals include occupational health physicians and nurses, la-ICOH impa EN.indd 1116/12/14 13:25

12INTERNATIONAL CODE OF ETHICS FOR OCCUPATIONAL HEALTH PROFESSIONALSbour inspectors, occupational hygienists and occupational psychologists, specialists involved in ergonomics, in rehabilitation therapy, inaccident prevention and in the improvement of the working environment as well as in occupational health and safety research. The competence of these occupational health professionals should be mobilizedwithin the framework of a multidisciplinary team approach.5. Many other professionals from a variety of disciplines such as chemistry, toxicology, engineering, radiation health, epidemiology, environmental health, environmental protection, applied sociology, healthand social insurance and health education may also be involved, tosome extent, in occupational health practice. Furthermore, publichealth and labour authorities, employers, workers and their representatives and first aid workers have an essential role and even a directresponsibility in the implementation of occupational health policiesand programmes, although they are not occupational health specialists by profession. Finally, many other professions such as lawyers,architects, manufacturers, designers, work analysts, work organizationspecialists, teachers in technical schools, universities and other institutions as well as the media personnel have an important role to playin relation to the improvement of the working environment and ofworking conditions.6. The term «employers» means persons with recognized responsibility, commitment and duties towards workers in their employment byvirtue of a mutually agreed relationship. The term «workers» appliesto any persons who work, whether full time, part time or temporarilyfor an employer; this term is used here in a broad sense covering allemployees, including management staff, the self-employed and informal sector workers (a self-employed person is regarded as having theduties of both an employer and a worker). The expression «competentauthority» means a minister, government department or other publicauthority having the power to issue regulations, orders or other instruction having the force of law, and who is in charge of supervisingand enforcing their implementation.7. There is a wide range of duties, obligations and responsibilities aswell as complex relationships among those concerned and involvedICOH impa EN.indd 1216/12/14 13:25

INTERNATIONAL CODE OF ETHICS FOR OCCUPATIONAL HEALTH PROFESSIONALS13in occupational safety and health matters. In general, these duties,obligations and responsibilities are defined by statutory regulations.Each employer has the responsibility for the health and safety of theworkers in his or her employment. Each profession has its responsibilities which are related to the nature of its duties. It is importantto define the role of occupational health professionals and their relationships with other professionals, with the competent

First edition: 1992 second printing: 1994 third printing: 1996 second edition: 2002 second printing: 2006 third printing: 2009 third edition: 2014 editorial group oF the third edition K. Kogi (Chair) G. Costa, B. Rogers, S. Iavicoli, N. Kawakami, S. Lehtinen, C. Nogueira, J. Rantanen, E. Santino, P. Westerholm. permission For translation and reproduction The Code of

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