Tenth Annual Meeting of the Baltic Sea Network on Occupational Health and Safety
Tenth Annual Meeting of the Baltic Sea Network on Occupational Health and Safety
21–22. October 2004, Copenhagen, Denmark
Summary Report
Opening of the Meeting
Dr. Ivan Ivanov from the WHO Euro opened the Meeting and welcomed the attendees to Copenhagen and WHO Regional Office for Europe. He expressed his pleasure for holding the Meeting in the place, where the BSN activity was originated ten years ago. Dr. Harri Vainio expressed his gratitude to Dr. Ivanov and WHO Euro for hosting the Meeting. He described shortly the main activities and purposes of the Network during the last ten years and encouraged the participants to consider, already during the Meeting, to which direction the Network should go in the future.
Ms. Anneli Vartio was elected as Rapporteur of the Meeting. The participants were introduced. The programme of the Meeting is attached as Annex 1 and the list of participants as Annex 2 to this Summary Report.
Toward a European Programme "Health in the World of Work"
Ivan Ivanov, WHO European Office
Dr. Ivanov introduced the WHO Euro Office project Health in the World of Work. The background of the project is the decisions made in the previous WHO Meetings, including the Budapest Ministerial Conference and the Nancy Meeting for WHO European Network of Collaborating Centres (CCs) in Occupational Health. In the 4th Ministerial Conference held in Budapest in June 2004 a decision on Children's Environment and Health Action Plan was made, as well as a decision to set up an Information System for European Environment and Health. In addition, the Meeting identified a need to strengthen the public health services in the Commonwealth of Independent States (CIS) and South East Europe (SEE), also including the occupational health services (OHS). The WHO Ministerial Conference on Mental Health, to be held in Helsinki in January 2005, is going to approve an Action Plan for Mental Health, also including mental health in work life.
The project has four parts: elimination of hazardous child labour, stress and psychosocial factors at work, occupational health policy and services in the SEE and CIS, and evidence base for occupational health action. The first intervention bases to the fact that children need adequate protection from work-related health risks and it is important to develop evidence base, support the countries and reinforce international collaboration in this area. The second module states that mental health is a big challenge for occupational health systems and services. Three sub-projects are responding to this challenge: 1) a toolkit on risk assessment of work-related stress and psychosocial risks; 2) assistance in incorporating mental health aspects into occupational health policies; and 3) awareness raising among policy makers about stress and psychosocial risks. The third priority states that countries in transition need support in upgrading their occupational health policies, systems and services. They need guidelines on national programmes, and on provision of basic OHS. The fourth priority states that occupational health action should be based on best available evidence. Facts and figures are needed on the OH situation of the whole European region. The goal is to support the member states to develop their OH&S profiles and studies on the burden of diseases.
These four priorities are linked together with continuous technical support, coordination and networking. There is a need to build critical core capacities for these actions at the regional level and reach out the policy making level in the member states. In this connection Dr. Ivanov thanked the Nordic institutes and ministries for adhering to the request that occupational health should remain on the agenda of the WHO Euro in the recent CC meeting in Stockholm.
Dr. Ivanov ended his presentation by telling that the actions in the near future include fund raising, improving visibility, delivery of products, and evaluation of the programme. Within three years, the strategic framework for European action on health in the modern world of work should be ready.
National networking in occupational health and safety (OH&S) in Estonia
Kari Kurppa, Finnish Institute of Occupational Health, Finland
Dr. Kurppa started by defining the concept networking. Many countries have vertical hierarchies in the field of OH&S, and horizontal flow of information is restricted on the top level, e.g. between ministries. Coordination of activities and information dissemination are, however, of vital importance in the complex field of OH&S. The idea of networking is to cross administrative borders of organizations and link fragmented capacities of manpower, professional skills, research abilities, etc., to a system, in order to make a greater impact with available resources.
Baltic Sea Network is an example of a decentralized peer-to-peer network. It is a human network in the first place; using Internet as a tool. Every network needs a secretariat to coordinate the activities of the network, e.g. meetings.
In Estonia several networks have been established: national OH&S network, sectoral OH&S network in agriculture, Tartu county OH&S network, and network of OH&S training institutions. These networks can provide a model for other countries, as well.
The aim of the national OH&S network in Estonia is to provide an infrastructure for coordination and cooperation, a quick channel to reach OH&S actors, a pool of expert resources, and a web-repository of information. Participants own information repositories are linked to a homepage, which serves as a channel to separate information repositories.
Sectoral network of agriculture has more than 15 members. The network task-forces have among others prepared a directory of members and an information management strategy, executed an inventory of information and training materials, prepared materials for the use of media and fact sheets, and compiled a sectoral profile of OH&S in agriculture. The Tartu county network provides a local infrastructure instrument for empowerment and cooperation at county level, and activates local experts to act. A profile of Tartu county has been prepared.
Occupational health and safety in agriculture in Latvia – a country report
Maija Eglite, Institute of Occupational and Environmental Health, Latvia
Dr. Eglite started her presentation with a general overview on the OH&S system in Latvia. Latvian OH&S system has undergone major changes during the last five years because of the transformation of law according to the EU requirements. Main principle for OH&S services today is the risk prevention approach. In the future, a list of dangerous fields of industry will be compiled. The enterprises on the list have to arrange external occupational health services (OHS) for their workers. Employers have to provide risk assessments for all workers and the results have to be applied in all OH&S activities of the enterprise, e.g. health check-ups.
Only in few big companies the OHS is arranged internally, the most common way is to arrange OHS externally in hospitals or medical service centres. There are 450 certified occupational medicine doctors in Latvia, but in the country side their coverage is poor. Agriculture is one of the main branches of economy in Latvia. In agriculture the majority of the work force lacks access to OHS. Self-employed agricultural workers are not controlled by State Labour Inspectorate and they can not get compensation for occupational diseases.
Incidence of occupational diseases has increased during the last 10 years from 9,58 to 93,6 per 100 000 workers. 9% of occupational diseases are in the agriculture and forestry sector. The three main reasons are musculoskeletal disorders, vibration and pesticides. Diagnostics of occupational diseases has improved because of the increase in the amount of occupational medicine doctors, higher general awareness, and the better functioning compensation system for occupational diseases. The incidence is still lower than the average in Europe. There are still not enough occupational medicine doctors in Latvia and no training for occupational health nurses.
As to occupational accidents, they have been decreasing during the past eight years. Also lethal accidents have decreased. In agriculture, the statistics show an underestimated amount of accidents (6%). Main causes for occupational accidents are employees' failure to meet work safety requirements (66%) and the insufficient organization of work (12%).
Dr. Eglite concluded that main problems in OH&S in agriculture in Latvia are the insufficient awareness among farmers on occupational hazards and prevention, and poor availability of personal protective equipment. In the future there is a need for a new strategy and new legislation of OH&S system in agriculture.
Discussion
Dr. Ivanov asked the coverage of agriculture workers by OHS and the amount of child labour in agriculture. Dr. Eglite replied that about 20% of agriculture workers are covered by OHS but the amount of child labour is not known. Dr. Vainio asked if lung diseases are considered as occupational diseases. Dr. Eglite answered that they are and they come out e.g. in poultry farms.
It was discussed, whether the more hazardous work is compensated by a better salary in various countries. Usually it is, but it was pointed out that in some cases this may reduce the effective attempts to remove hazardous work conditions.
Sectoral profile on occupational health and safety in Estonian agriculture
Marina Kempinen, Estonia
The sectoral profile was prepared under the umbrella of the Network on OH&S in Agriculture and the Estonian-Finnish Twinning project 2003–2004. The methods used in compiling the profile included farm visits with rapid assessments and interviews among farmers, the use of secondary sources, e.g. statistics and documents, an inventory of training materials, and a SWOT analysis. The profile gives information on occupational diseases, work-induced diseases and occupational injuries in agriculture, on the coverage of the workers by OHS, on agricultural labour force in Estonia, and on the sectoral Network on OH&S in Agriculture. Further, the profile gives information on accident insurance system, relevant legislation, and training and education. The contextual parts summarize the enterprise structure, production lines, agricultural holdings, rural development and the use of agrochemicals.
The results show that actually very little quantitative information regarding OH&S in agriculture is available in Estonia. Labour force in agriculture is characterized by high proportion of family members and pension-aged persons, and non-regular employees with small working times. No data exist on the amount of child labour. The data on work injuries show much less injuries than in European countries in average, mainly because of underreporting. Also occupational diseases statistics in agriculture show rather low numbers. Compensation for diagnosed occupational diseases is very small so the workers have no motivation for getting ODs reported.
A SWOT analysis identified the following strengths: legislation on OH&S, guidelines, the interest of the Estonian Farmers' Federation, and the general discussion about safety, sectoral network, and labour inspection system. The weaknesses were identified as follows: lack or weaknesses of the legislation, lack of reliable statistical data, lack of guidelines, fact sheets and other information material, lack of research, insufficient awareness among farmers about occupational hazards, and non-existing possibility for vacation and holidays. The following opportunities were mentioned: improvement of legislation, development of the network in agriculture, training and education in OH&S, and development of guidelines and fact sheets. Additionally, the old agricultural technology could be improved with financial support from the EU. Insufficient management skills of the farmers and high bureaucracy were mentioned as threats.
Ms. Kempinen concluded that the sectoral profile provides an overview of the current situation, and describes the major weaknesses and strengths in the field of OH&S in agriculture. In addition, it assesses awareness, attitudes and perception of risk by the farmers and workers. The profile gives valuable information to the decision makers.
Discussion
It was discussed that often the information gathered is not reliable and much information is missing due to poor reporting systems. According to Ms. Kempinen the qualitative data gathered shows the problems of self-employed workers with the OH system. Farmers are not covered by OHS, and even if the service exists, it may be too expensive to use it. Dr. Vainio pointed out that the Estonian agricultural profile is a good example on how the sectoral approach can give valuable information even without exact statistical data. Dr. Kurppa added that the indicators may often be misleading and the countries can not be compared because of the different definitions and registration basis. Especially then a situation description can provide us with a lot of useful information e.g. for planning the legislation and approaching the politicians.
Occupational health and safety in agriculture in Russia – a country report
Mikhail Mikheev, St. Petersburg Medical Academy of Postgraduate Studies, Russia
Dr. Mikheev gave an overview of the OH&S situation in Russia, especially in agriculture. The working population in agriculture comprises 11.8% of the total workforce. The proportion of SMEs in agriculture is 2.4%, the rest being collective farms. The OH&S legislation in Russia covers the agriculture also. OH&S has been divided between two ministries, Ministry of Labour (labour inspection) and Ministry of Health (sanitary inspection). These two ministries are going to be amalgamated to Ministry of Health and Social Development by the end of 2004. Also the Ministry of Agriculture has a department for safety matters.
In general the OHS in Russia are considered to be formal, loaded with duplicate work, and not efficient. They have a low priority due to the lack of a national OH&S agency.
Accidents, heavy non-ergonomic work, high concentration of different type of dust, vibration, noise, infections, parasites, and pesticides are the main occupational hazards in agriculture. Multiple exposure is typical. An official catalogue of permitted pesticides exists. 47% of workplaces in agriculture do not comply with national safety and health standards, in 52% the noise level is too high, 51% do not meet hygienic standards on vibration, and 33% do not meet microclimate requirements; 31% have too low illumination.
The number of new registered occupational diseases in 2002 was 11 090 (2,19 per 10 000 workers). In agriculture the same figure was 3,3–6,1 in southern regions of Russia and 1,3–2,0 in northern regions. The leading occupational diseases in agriculture are musculoskeletal disorders, respiratory diseases, brucellosis, vibration disease, hearing loss and intoxications. The number of accidents including fatal accidents in all sectors of economy is 4,5 per 1 000 workers and in agriculture 7,2 per 1 000 workers. The main cause of occupational diseases and injuries is inadequate and old technology, which causes 52.4% of all cases.