Sixth Annual Meeting of the Baltic Sea Network on Occupational Health and Safety
9-10 November 2000
Uppsala, Sweden
Summary Report
Opening of the Meeting
1. The Sixth Annual Meeting of the Baltic Sea Network on Occupational Health and Safety was opened by Ms. Inger Ohlsson, Director General of the National Institute for Working Life in Sweden. In welcoming the participants to the Meeting, she also de-scribed the activities of the Swedish National Institute for Working Life, and called upon discussions on the highly actual problems of the working life, e.g. fragmentation and needs for life-long learning in connection with discussions on the training and edu-cation issues in occupational health and safety.
Dr. Boguslaw Baranski welcomed the participants on behalf of the World Health Or-ganization (WHO) and expressed the gratitude of the WHO Regional Office for Europe, to the National Institute for Working Life, for assuming the responsibility to organize the Meeting. He also expressed the gratitude of the WHO to the Finnish Institute of Oc-cupational Health for support and co-operation in the practical arrangements of the Bal-tic Sea Network on Occupational Health and Safety. He welcomed the idea of utilizing the network for discussing topical substance issues, such as training and education, and occupational health and safety indicators.
Ms. Suvi Lehtinen, Co-ordinator, Secretariat of the Baltic Sea Network on Occupational Health and Safety at the Finnish Institute of Occupational Health, welcomed all the par-ticipants to the Meeting. She reminded that the idea of the Network was put forward in November 1995, with the web-page of the telematic Network having been opened in March 1997. In spite of the short history of the Network, many advances have already been achieved thanks to the active efforts and commitments of the Network Members. The network structure is based on an inter-institutional and peer-to-peer activity, and voluntary commitment of the institutions. It aims at the full utilization of various infor-mation sources, both national and international. She also thanked the Swedish National Institute for Working Life, Ms. Inger Ohlsson, Mr. Bo Dahlner and Ms. Gunborg Jungeteg for hosting the Network Meeting, and the WHO/EURO through Dr. Baranski for support in all stages of the Network development.
2. Ms. Suvi Lehtinen, Finland, was elected Rapporteur of the annual follow-up meeting. The Programme of the meeting is attached as Annex 1 and the list of participants as Annex 2 to this Summary Report.
3. Mr. Lars Rydén introduced the activities of the Baltic Sea University that was estab-lished to serve the Baltic Sea drainage basin. He stressed the importance of networking in supporting the activities in various countries. He described the staff of the centres in various countries. Some of them comprise the researcher, lecturer, TV-producer, and students. TV is actively used because it is the most widely available channel. Altogether 35 TV programmes have been produced. Also, the units and the University itself pro-duce various course materials, such as sustainable development and industrial produc-tion. One of the topics of the University is environmental management (certification and audit, cleaner production, product design, and inspection and control), another is urban management. Much attention is given to the studies on pollution of the Baltic Sea. In-stead, occupational health is not a subject of the Baltic Sea University, i.e. the contact with the Baltic Sea Network is most useful and interesting.
Scope and purpose of the Meeting
4. The overall purpose of the Sixth Annual Meeting of the Baltic Sea Network on Occu-pational Health and Safety was to review and discuss optimal ways of using education and training for promotion and protection of the health of employees, their work ability and well-being.
Knowledge and information are the growingly important components of social and eco-nomic development in the modern societies. These factors dominate recent changes in production and servicing technologies and organization of work. Professional compe-tence and skills are highly dependent not only on the scope and quality of education re-ceived at school, university and postgraduate studies, but also on the scope and quality of continuous adult education.
The health, work ability and the well-being of employees, as well as their future em-ployability, depends to a large extent not only on their own education, but also on the education and professional skills of their employers, executive and personnel managers, and the various experts comprising the occupational health team. The role of education and training in occupational health and workplace health management seems to have been growing in recent years as a result of rapidly changing working conditions and fragmentation of the work life. Recognition of the role of workplace health management in achieving the overall public health objectives (e.g. reduction of chronic non-commu-nicable diseases of the working-age population, healthy ageing with prolongation of economically and socially productive life) is important.
The scope of the meeting covers education and training of employees, employers, and occupational health professionals, quality assurance in training and education, and the education of employees to enable them to maintain their work ability.
The specific objectives of the meeting were to:
· review the scope, purpose and methodology of education and training, including distance learning, in occupational health and safety, and training in the maintenance of work ability for professionals, employees and employers in countries around the Baltic Sea
· review methods used for quality assurance in training and education, including ac-creditation and certification of courses
· evaluate progress, and plan further development of the Baltic Sea Network.
5. Dr. Boguslaw Baranski described the activities of the WHO/EURO in 2000 within the Healthy Workplace Programme.
The scope and purpose of the European programme on good practice in health, envi-ronment and safety management in enterprises (GP HESME) has been prepared. This was reviewed by the WHO meeting of HESME focal points (nominated by ministries of health, environment and labour and by international organizations) held in Bilthoven on 23-24 March 2000. The meeting recommended the preparation of European criteria and indicators of GP HESME, jointly with ILO, UNEP and other international organiza-tions.
He mentioned that HESME is driven by the current regulatory requirements, voluntary initiatives and agreements, economic appraisal, and effective management procedures. He referred to the decision made by the Fourth Meeting of the Network of WHO Col-laborating Centres, held in Helsinki, on 7-9 June 1999, concerning the guidelines on economic appraisal. It will be published by WHO, Geneva in the near future. The Euro-pean networks supporting HESME are governmental focal points (20 countries), IGOs and NGOs focal points (ILO, UNEP, EC, OECD, CEFIC, ICOH, others) are also util-ized. The WHO Collaborating Centres in Occupational Health are included, as well as Social Insurance Institutions (14 countries), and the Baltic Sea Network on Occupa-tional Health and Safety (10 countries). Several publications have also been published to support the dissemination of information.
A working document on the European criteria and indicators of GP HESME has been prepared. This document has been assessed and amended by the First European Meet-ing of WHO Collaborating Centres in Occupational Health, held in Lodz, Poland, on 11-12 September 2000. A final draft of this document will be presented at the Second meeting of HESME focal points, to be held in Turku, on 22-23 April 2001 jointly or-ganized with the Finnish Ministry of Social Affairs and Health and the Social Insurance Institution, Turku, Finland.
Proposals for comprehensive workplace health policies based on the GP HESME ap-proach have been prepared and presented at international meetings of WHO/EURO, at two sessions of the European Environment and Health Committee, and at various inter-national and national meetings.
The Baltic Sea Telematic Network on Occupational Health and Safety has been further strengthened, and it provides mechanisms for sharing information, capacity building and harmonization of HES management in enterprises. The Fifth Annual Meeting was held in Berlin, Germany, 18-19 November 1999, and the Sixth Annual Meeting in Uppsala, Sweden, on 9-10 November 2000. The Network provides a good model for collaboration for other parts of the European region.
A new network of the European Social and Health Insurance Institutions for Workplace Health Promotion has been established, in collaboration with the Research and Devel-opment Centre, Social Insurance Institution, Turku, Finland. An initial meeting was held in Bilthoven, The Netherlands, on 21-22 October 1999, the first network business meeting on 23-24 May 2000 in Bonn, Germany and the second Network Business meeting is planned to be held in Reykjavik, Iceland, in March 2001.
Education and training in occupational health and safety
The Training Session was chaired by Professor Jorma Rantanen, Finland.
6. Ms. Inger Ohlsson described the needs for training of the experts in the occupational health team in Sweden: occupational health physicians, occupational health nurses, physiotherapists, psychologists, and safety and hygiene engineers. Nowadays, all of these experts work only seldom in a team. However, their expertise is needed as a com-bined entity in solving the problems at the workplace level. The two-year training pe-riod comprises studying, practical work, writing reports, etc. The length of the courses varies from a couple of days to several weeks. In the longer-term training courses all the central areas of expertise in occupational health and safety are covered. The training and education of the occupational health and safety professionals has been taken rela-tively good care of. Instead, the training of employers in occupational health and safety is lagging behind, as in many other countries as well. The nurses' courses are 11-week courses, and physiotherapists have 6 weeks of training. Shorter courses deal with occu-pational toxicology, occupational asthma, career choice and allergies, etc. International courses are running for Africa and Latin America, lasting 2 years. Part of that training is organized in Sweden, but the majority is conducted in their own region and their own countries. Between 1972-1999 altogether the following numbers of professionals have been trained: 1700 occupational health physicians, 3400 occupational health nurses, 1000 physiotherapists, 1600 safety and hygiene engineers, 350 psychologists, 260 qualified safety delegates, and 30 occupational hygienists. She mentioned the need for additional training because of the generation shift due to the approaching retirement age of the large age cohorts. In the discussion, the question was taken up how many of those having been trained will really go to occupational health services, and how many will drop out after the training. At the moment, there are no exact statistics about the situa-tion, but the impression was that many of the trained professionals actually go to practi-cal occupational health services
7. Professor Jorma Rantanen, FIOH, Finland, described the new challenges to training in occupational health and safety. He discussed the quantitative needs, the qualitative needs, and the new training strategies and opportunities. The problem in the occupa-tional health and safety training is monodisciplinarity, even though some countries stipulate the multidisciplinarity and certification. There is a continuous shortage of manpower resources for occupational health and safety. New substance areas needed in training of occupational health professionals were mentioned such as new technology, violence at the workplace, and psychosocial stress to mention but a few. There is a need to move from a risk-factor oriented approach in occupational health and safety to a comprehensive multidisciplinary development orientation. The work life is changing rapidly and hence the speed at which knowledge is being outdated is tremendous. Therefore the life-long learning is badly needed (knowledge renewal rate is 7% a year, while manpower turnover is 2% a year). In meeting the knowledge requirements in oc-cupational health and safety in the modern society, not only the explicit knowledge (the factual knowledge) but also tacit knowledge (silent knowledge, understanding, how-to-do-it knowledge) is needed. Tacit knowledge constitutes a crucial prerequisite for the learning basis in the future. Tacit knowledge comprises the technical part including skills, and the cognitive part. Tacit knowledge includes in addition to individual learn-ing also collective learning. Transferring the tacit knowledge into codified knowledge is needed and methods to carry out this in practice is a challenge also for occupational health and safety expert training. The basis for understanding should be ensured in oc-cupational health and safety training.
8. Professor Boguslaw Kedzia, CIOP, Warsaw, Poland, presented the Polish situation in occupational health and safety expert training. He described the training activities of the CIOP in the field of occupational health and safety. A total of 528 occupational fatali-ties and 1323 serious accidents occur in Poland annually. This will pose certain de-mands for the training of experts. It has been calculated that the total number of em-ployees at risk is 897,000. There is some variation among the branches of industry in the accident risk. The number of registered occupational diseases has increased during the past two decades. The training of trainers has been systematically organized. In Po-land, some institutes (such as the Nofer Institute of Occupational Medicine in Lodz) are concentrating on occupational health training, CIOP deals more with engineering and safety issues. The main target groups are employers, safety personnel, industrial hy-gienists, employees, and supervisors. Model programmes and model materials for training have been provided. Postgraduate studies ar also organized (240 contact hours). In 1997-2000, 330 graduates have been trained. Education packages contain 22 mod-ules covering all aspects of occupational health and hygiene. There is also a lecturer's guide to improve the impact of training. Specialized courses are arranged on topics such as first aid. The certification of the training is done for occupational safety and health lecturers, safety specialists, auditors of safety systems, ergonomists, etc. Distant learn-ing is being developed. New teaching aids, such as video clips in the multimedia pres-entations are utilized and multimedia training materials provided. CD-ROMs are also an effective form of presenting information, and Internet can be better used than previ-ously. Occupational health and safety issues and materials are provided for all levels of the education and training system in Poland.
In the discussion, the question of funding of training was taken up. The balance be-tween the regulatory and voluntary training should also be defined. It seems that the market-based economy does not allow the time for transforming the tacit knowledge to codified knowledge and vice versa. This is, however, important for the implementation of knowledge. It should be ensured in order to enable the occupational health and safety expertise to develop.