Finnish Institute of Occupational Health PRO MEMORANDUM
av/baltdata/rep9_00
Baltic Sea Network on Occupational Health and Safety
Sixth Workshop for Coordinators
28-29 September 2000, Helsinki, Finland
Introduction
The meeting was the sixth meeting for the coordinators of the Baltic Sea Network on Occupational Health and Safety (BSN) project. The contact persons from seven countries, Estonia, Finland, Latvia, Lithuania, Norway, Poland, and Sweden participated.
Ms Suvi Lehtinen, Chief of Office of Information and International Affairs, FIOH opened the meeting and wished the participants welcome. She shortly went through the milestones of the BSN-project and mentioned that the coordinators are used to have their meetings twice a year in addition to the WHO/EURO Annual Meeting which this year is going to be held in Uppsala, Sweden, in November. She also referred to the discussions in previous Coordinator Meeting in Vilnius with the conclusion to start to plan and collect material for a publication concerning occupational health services in BSN-countries. Being a topical subject for all participating countries the occupational health services were chosen in Vilnius to be the main topic of this meeting.
The programme of the Meeting is in Annex 1, and the list of participants in Annex 2.
Country Reports
Estonia
The EU Phare Twinning project on occupational health has started in August 2000 with the Finnish Institute of Occupational Health as the member state partner. A workshop on stress and multidisciplinary team work was arranged in Tallinn on 13-14 September following by a High-level Policy Forum compined with the Second Occupational Health Day on 15 September. The Twinning project will open the web-pages in the near future.
A survey on Working environment in companies has been conducted in Estonia and some main results were introduced. The results can be found on the Estonian web-pages under the subtitle News and activities.
The number of small companies is very large in Estonia; more than 70 % of the companies have less than 20 employees. The survey has been conducted on two levels; employers (N=402) and employees (N=797). Employers' survey findings show e.g. that only 5 % of employers are not aware of the requirements of the law on OH & S. When different parameters of the work environment are assessed, the mental stress received the most negative assessment. About 90 % of the employers cannot evaluate how big is the economical loss caused by the absense from work. According to employees' findings the most important factor causing mental stress is the dangerousness of the work. Better salary, better working system, and new equipment are the most important items for working conditions improvement.
Latvia
Requirements of the Council Directive 89/391 EEC have been transposed into the new "Law on Labor Protection" which is expected to come into force in January 2002. The draft of the law is on web-pages in Latvian language.
New textbook on occupational medicine is going to be published in the middle of October. Also a textbook on occupational hygiene is in the editing phase at the moment. New information booklet "What an employer and employee should know about occupational health?" has been published and it will be put to the web-pages. New programme for postgraduate training of occupational physicians has increased the number of training hours from 120 to 160 hours with more practical training provided.
There is a Twinning project starting also in Latvia with the Swedish National Board of Occupational Safety and Health as the member state partner.
BSN pages have been technically updated. The homepage of the State Labor Inspectorate is expected to be released in the near future. The new homepage of the Ministry of Welfare is opened in Latvian language (
More detailed information on Latvian activities is given in Annex 3.
Lithuania
A Twinning project entitled Strengthening Enforcement of Occupational Safety and Health Policy is starting in October 2000 in Lithuania. The responsible authorities in Lithuania are the Ministry of Health and the State Labour Inspectorate. The project leader is Germany and France is the other EU member state partner. The project includes e.g. risk assessment (incl. mental stress); legislation harmonization, and development of database on chemical substances with the model from Germany. Telematic assistance or national networking has not, at least yet, been specifically defined as a part of the project.
Information in News and Activities has been updated and includes e.g. the INCO Copernicus FIBELLC project's first report, information on ECOHSE meeting in Kaunas on 4-6 October, and the National Environmental and Health Action Plan.
Updatings in Legislation include the Law on Labour Protection, harmonized with EC 89/391 directive, which is just to be approved in the Lithuanian parliament. Law on Occupational Health Care has been updated as well.
The subtitle Statistics includes new information on risk assessment in Lithuanian enterprises and official information of the State Labour Inspectorate, e.g. workers exposed to occupational hazards at work, in-plant occupational health services in Lithuania and obligatory workers' health examinations.
Poland
The NIOM (Nofer Institute of Occupational Medicine) pages are constantly updated and a new webmaster has recently started at the Institute. The BSN pages will be more integrated with NIOM website as there is relatively poor participation of other institutions. Polish Association of Occupational Medicine and Polish Society of Industrial Hygiene are participating actively.
The advisory function of the website is increasing in Poland as there is a new type of clients (mainly local authorities) asking information and advice. Presentations about BSN held in different occasions also generate new contacts and clients.
New topics currently discussed in Poland include health promotion at the workplace, evaluation of OHS, good occupational health practice, good practice in HESME (Health, environment and safety management in the enterprise), and economic appraisal. These topics are offering potential material to the web-pages, as well.
Forthcoming meetings in the field include the WHO Healthy Cities meeting in Lodz in 2001 and the Conference of the ICOH Scientific Committee in Lodz in September 2001. The BSN Coordinator Meeting is going to be held in Lodz in spring 2001.
Finland
The main task has been the planning of the new page lay-out of the BSN. Further designing of the logo and postcard will be made once the new lay-out has been planned completely.
The pages of the Finnish Institute have been developed further and, for example, the pages in Swedish language have been opened recently.
The new Phare Twinning project with Estonia is closely related to BSN activities as one of the main elements of the project is to plan and create national networking arrangements in Estonia.
Other OH&S developments in Finland include the reviewing and renewing of the Law of OHS (1978) and Labour Safety Act (1958). A recent survey on the status of work environment and occupational exposures in Finland shows that while in some occupations and branches the haste and pressure at work is diminishing, it is increasing in the health care and social sector. As the average age of occupational hygienists is about 50 years there is a generation shift expected in a couple of years time. This has emerged an urgent training need in occupational hygiene. This same phenomenon applies to all expert groups in OH.
A new Department of Occupational Health Services is going to be established at the FIOH. Several telematic projects are underway (e.g. seamless care) and the new laboratory building is completed. The participants had an opportunity to make a round in the new facilities.
Norway
The Norwegian pages have been recently updated but they are not yet very comprehensive and there is not yet much information in the English language. There is not very many providers of English information available and the same problem concerns the National Institute of Occupational Health's web-pages. There is not very much literature or other printed information available in English either.
The future development of the Norwegian pages is still open and no decisions have been made concerning e.g. the languages of the pages. The resources going to be put to the development and updating work are also still an unsolved problem.
There is a large link collection in the net but there not yet exists a coordinated national network in Norway.
Sweden
The Swedish BSN-pages have 200 links in English with 40-45 sites linked. The number of visitors is increasing constantly. During July 2000 the total number of requests were 737, total number of visitors 100 and total number of visits 164. Most of the visitors came from the USA.
A report of the Swedish BSN-pages concerning July 2000 is attached in Annex 4.
Discussion
The need to know more about each others Twinning projects in order to e.g. avoid duplicate work and to learn from each others' experiences was discussed. An idea was put forward to approach the Phare office with a request to share information about each others projects more effectively. At the moment there is no system for this kind of information exchange and dissemination. The same concerns other international bodies and funding agengies which could be approached with an informative letter telling about the BSN project. The letter will be drafted to be presented in Uppsala meeting for further discussion.
New page lay-out and navigation in the BSN
Miikka Rantanen, FIOH, Finland
The new page lay-out was introduced. The new pages are still in experimental use and not open to public. The main page information content shall also be updated as a consequence of some new grouping of information, e.g. international links are categorized and a welcome text will be added to the main page. Afterwards the list of development projects will be situated on the main page in addition to country pages. Basicly, however, the information content will remain the same also on the new pages.
To allow effective feedback the webmasters' addresses are added to the main page. Each country has its own identifying colour. Each country main page could also have a welcome text of its own.
Navigation has been developed and a navigation bar is situated in the left side of every page. Navigation bar for countries is situated on the top of every page. Navigation within one sub-title, e.g. legislation will be possible directly from one country to another using the navigation bar for countries. Under the level of the main country menu the information and lay-out remain the same as previously.
The search system was briefly discussed as well as the use of one common server vs. every country's own server. The further development of the search system was left for the discussions of the technical group.
The new lay-out and draft logo were basicly accepted by the group but some improvement ideas were put forward.
Country profiles in occupational health services (OHS)
The group discussed about the indicators and lists of concepts and questions related to compiling comparable OHS country profiles in BSN-countries.
Concerning Poland the questionnaire sent after the last meeting by Jacek Michalak to other focal points was brought up. The following questions were introduced:
- What is the understanding of OHS in Poland?
- What are the main objectives of OHS?
- What are the most important legal bases of OHS?
- What is the structure of OHS?
- What are the main methods for quality improvement in OHS?
- What are the main financial resources for OHS?
- What is the education and training required for occupational physician?
- What other important issues do you recognize as unique features of your OHS?
The questions with Polish model answers are described in Annex 5 in more detail.
A proposition for a country profile was made in the presentation of Latvia. The main categories are 1) problems (trends in the past years; statistics on e.g. occupational accidents, occ. diseases); 2) legal basis; 3) organizational structure; 4) specialists (training, personnel); 5) financing. The Latvian presentation in more detail is attached in Annex 6.
The new structure of the Estonian working environment system as a part of the Occupational Health Programme 2000 was demonstrated. The Ministry of Social Affairs (MoSA) is the supreme administrative authority in working environment system. There are two lines under MoSA; labour inspection on the one hand, and occupational health centre and occupational health services on the other hand. The description of the Estonian OH system in more detail is in Annex 7.
The definition for OHS will clarify the scope of OHS in each country but it was pointed out, additionally, that the OHS concept has different content in different countries. To find out the coverage of OHS, it has to be defined e.g. what means the access to OHS. Moreover, in addition to definitions also benchmarks are needed.
Draft proposal for a Lithuanian country profile included the following eight categories: 1) definitions (labour inspection, occupational medicine, occupational health care); 2) structure of OHS; 3) legal background (workers health examinations, risk assessment); 4) functions; 5) financing of services; 6) personnel; 7) education and training; 8) indicators. Information on these categories can be found on Lithuanian web-pages (Annex 8).
Occupational health and safety in Lithuania is divided into two lines where safety part is conducted by the State Labour Inspectorate with control of workplaces according to legal requirements, and the occupational health part is divided into risk assessment and prophylactic activities.
Introduction to the development of indicators for occupational health services
Jorma Rantanen, Director General, FIOH, Finland
The transparencies of the presentation are attached in Annex 9. The number of the transparency is given in parentheses in the text.
Analysis of the future of the European working life
There are two major trends in the European working life:
1. big companies are merging together to even larger entities having a high impact on the world economy. Due to economic rationality the big companies are often more interested in work environment matters than the national governments;
2. at the national level the companies are splitting to smaller units (downsizing, outsourcing, etc). (see transparency 1)
The support system in working life is getting more fragmented and incontinuous, e.g. through outsourcing of OH from companies to external units, even though research results show that inplant service is the best alternative for the workers. Problems are cumulating to those workers who work shortest time in companies (e.g. hired workers). (transp. 2)
1/3 of the workers works more than 45 hrs/week, even though average work time is decreasing because of the growing number of part time workers. 1/4 of the workers works more than 50 hrs/week. (transp. 3)
Statistics about the European workers show that the Finns have slightly more of risky types of work than workers in EU in general (transp. 4). The health complaints by EU workers reveal new types of health complaints, such as stress, poor working conditions, high production and quality pressures. (transp. 5)
Different types of small workplaces use new patterns of employment where the OHS system is missing. (transp. 6) This may imply to problems to provide OHS in the future. In resolving traditional OH & S problems good results have been gained whereas relatively poor results have been gained in solving new problems. The countries in transition have a slightly different situation in which traditional hazards still have a higher priority.
Compared to occupational safety system the occupational health services are more heterogeneously organized in Europe. The principles that the European OHS are following include protection and prevention, adaptation to workers' individual needs, health promotion (which is very heterogeneous in Europe today), rehabilitation and therapy for aging workers, (who need also curative services especially if the primary health care is not functioning very well), maintenance of work ability, development of a healthy enterprise and general health service.
Description of the development of OHS system
A flow-chart of OHS functions according to Good Occupational Health Practice (GOHP) was presented. It has three viewpoints: workers, work organization and work environment. (transp. 7)
There are different models of providing organized OHS in the European countries. The Finnish model has four types of OHS organizations: primary health care (PHC) -model, in-plant -model, group service -model and private centre -model. It is mandatory for primary health care units (municipal health centres) to provide OH services for enterprises if they are not willing to adopt another alternative model. (transp. 8) The assessment of different OHS-models was shown. (transp. 9) As to the employees covered by OHS it can be noted that Finland has been able to increase the coverage of OHS very successfully with the help of the PHC-model. (transp. 10)