Global Occupational Health: Current Challenges

Categories: Globalization Health Care Safety Universal Healthcare Workplace

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Introduction

Global Occupational Health and Safety (OHS) is very much in tune with the transformation of economic globalization. As global marketing grows, the gap between developed and underdeveloped countries, occupational illnesses and injuries affect a large number of workers worldwide. Global OHS issues are local in developed countries due to many factors, including migrant workers, construction, and agriculture who are not trained in the informal sector.

Worldwide, 2.3 million workers die every year from occupational accidents and work-related illnesses; This equates to 6300 deaths daily.

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In addition, more than 300 million workers have fatal occupational accidents, resulting in disability and unemployment; More than 2.3 million work-related deaths per year due to tuberculosis, AIDS, and road accidents. This burden is particularly high in low- and middle-income countries, where production is often concentrated and the health and safety law and its application are often poorly enforced.

Global Occupational Health And Safety:

If Global Health is to adopt a broader approach to public health internationally, Occupational Global Health will focus on preventing illnesses and injuries in the workplace.

The Global Impacts of Occupational Health and Safety (OHS) are directly related to the internationalized dynamics of the global economy.

The ambitious goal of creating occupational health plans for at least 70% of countries is set by the VIII Public Works Program. To achieve this goal, the WHO Workers Health Program collaborates with IL0 and countries to identify health risks at work, identify national priorities, evaluate occupational health measures, provide information to employers and workers, and advocate for high-risk groups, child workers, and agriculture.

Meet the needs of workers, mining, and small-scale workers, and those working in the construction and home industries. Training on occupational health issues for both occupational health and primary care workers was encouraged. In addition, a global data system for tracking morbidity and mortality trends in major occupational and work-related illnesses and injuries was requested, as well as standard guidelines for data collection and reporting. Guiding principles and standards for industry exposure limits were also expected. Much emphasis has been placed on the communication of inter-professional occupational health information and the development of a network of cooperative centers on occupational health.

Economists generally believe that OHS is a step in the line of growth and should be carried out as soon as the economy is strong enough to absorb the additional costs required for prevention. It is assumed that rapid industrialization requires investment in manufacturing first, and that wealth can only be invested in social goods such as improved health, labor security and protection of the environment.

The acceptance of health risks in the name of industrialization has devastating implications not only for developing countries but worldwide. Of the world. In fact, globalization risks become a ' race to the bottom' rather than an opportunity to harmonize health and safety standards.

Current Challenges in Global Occupational Health

Occupational health and safety should be a high priority on the international agenda, but the improvement in OHS infrastructures and systematic preventive approaches in izing industrialized countries is very slow. Although many countries have developed laws and enforcement activities, working conditions for most of the world's workers do not meet the minimum standards and guidelines set by the World Health Organization (WHO) and the International Labor Organization (ILO).

OSH rules cover only 10% of the population in developing countries. These laws exclude many high-risk sectors, such as agriculture and domestic work, which are not specifically considered 'industries.' Informal sectors typically include a more vulnerable sub-population of employees such as child labor, pregnant women and the elderly, with limited access to health care.

Only 5% to 10% of workers in developing countries and 20% to 50% of professionals in industrialized countries have access to adequate occupational health services. Although a survey of occupational health members of the International Commission of Industrial and Industrialized Countries found that 0% were in place of OHS and 0% noted the existence of a national institution for OHS, the estimated coverage of workers with OHS services was only 1%.

So far, only 24 countries have ratified the ILO Employment Injury Benefits Convention (No. 121) adopted in 1964, which lists occupational diseases for which compensation must be paid and only 31 have approved the Convention on Occupational Health Services (No. 161). Adopting these conventions should be the first step towards implementing the OHS system.

Lack of OSHA Infrastructure And Global Consequences

The world is facing a serious shortage of safety equipment in the professional environment. This can be depicted in 2014 outbreak of the Ebola virus, during which more than 100 health care workers were infected and more than half have died.
It had caused the public health care emergency. The lack of knowledge regarding OHS infrastructure has enormous implications in these cases, where the shortage of health care workers is already a public health problem that is further amplified by the disease and deaths caused by the exposure to biological agents.
A vast depiction of this scenario can be seen currently as the world is facing a deadly biological agent that has caused the illness of coronavirus that has killed many people around the world and world is facing a serious shortage of personal protective equipments (PPE).Many health care workers have themselves became the victim of the disease.
Drug-resistant tuberculosis (TB) is another important biological hazard affecting health workers in many parts of the world. With a mortality rate comparable to Ebola. The lack of an OHS infrastructure in South Africa, one of the countries with the highest drug-resistant TB burden globally, remains a serious challenge for the control of the disease.
• The health burden of poorly controlled industrialization is not limited to communicable diseases but the projections of the incidence of chronic neurodegenerative diseases indicate a dramatic increase in the industrialized and developed countries likely due to environmental exposure and the prolonged aging of the population, resulting in higher cumulative lifetime exposure.
• So the providing of health safety equipment for the health care workers should be considered as a priority on the national as well as international basis.

Global Occupational Health and Safety Development

Globalization

Globalization is the process of the removal of barriers that prevent the growth of trade and cross-border investment and is typically considered a positive transformation of modern times. Global occupational health and safety development is linked to the economic development and globalization. When the world was developing there was the vast increase in the diseases related to the occupational health and safety and injuries affect a vast number of workers worldwide. Global Occupational health and safety issues also became local in developed countries due to many factors, including untrained migrant workers in the informal sector, construction, and agriculture.

Development of the Market System and Its Consequences

The market system has been formed as a result of the process of globalization in many countries with the weakest capacities to create and enforce a regulatory system to protect workers and consumers. This has resulted in the appearance of existing hazards in new forms. For example, market liberalization of pesticide distribution under the structural adjustment program. This has also caused an increase of E-waste due to the technological development in the modern world.

Industrialization:

Rapid industrialization include the development of industrial goods . Rapid industrialization is thought to require investment in production first and that, only once wealth is created, can it be invested in social goods such as improved health, worker protections, and protection of the environment. The acceptance of health risks in the name of industrialization has catastrophic implications, not only for developing countries but also globally.

Current Status of OSHA in Developed Countries

Occupational health and safety should be given the highest importance in the working environment but unfortunately the development in OHSA infrastructures and systematic preventive approaches in industrializing countries are extremely slow. Although many countries have developed laws and enforcement activities, working conditions for the majority of the world’s workers do not meet the minimum standards and guidelines set by the World Health Organization (WHO) and the International Labor Organization (ILO). Until now, only 24 countries have ratified the ILO Employment Injury Benefits Convention (No. 121), adopted in 1964, which lists occupational diseases for which compensation should be paid and only 31 have ratified the Convention on Occupational Health Services (No. 161). The adoption of these conventions should be the first step toward the implementation of an OHS system. OSH regulations cover only about 10% of the population in developing countries.

Occupational Hazards in Developing Countries

The biggest threat to workers' health and safety is their working environment and they spend about one third of their lifetime at workplace. The current global workforce stands at about 2.8 billion. Workers expect a safe working environment as their fundamental human right. However, due to rapid industrialization, technological advancement, and globalization, workers all over the world face dual occupational hazards due

The standard of Occupational health and safety (OHS) available at any work place is the main determinant of workers’ health. OHS is a field not completely established in developing countries. It has been estimated that more than 80% of global occupational hazards occurs in developing countries and so workers and their families suffer from pain and misery, economic and job losses. The majority of the workforce does not have access to health services. Poverty, illiteracy, abrupt growth of industries, lack of training, lack of reliable OSH data and poor implementation of existing legislation are some of the major factors responsible.

The chart shown below is the estimated work-related mortality by the United Nations geographical regions. Among the five regions Asia had the highest number mof work-related mortality. About two-thirds of the work-related mortalities came from the Asian region (Figure 1). In fact, Asia had the highest number of work-related deaths due to disease, including occupational injuries.

Most work-related deaths and non-fatal occupational accidents occur in low- and middle-income countries in South-East Asia and the Western Pacific region. These countries have the highest proportion of the world’s working population, in addition to having a high proportion of workers in risky jobs, as is found in other developing countries. Deficiencies of occupational health in the developing world reported in distinct locations as Bangladesh, Central America, Lebanon, South Africa, and Thailand are attributed to a lack of governmental interest in occupational health, poor data and data collection systems, and weak enforcement of health and safety regulations.

The concept of occupational hazard and risk is universal but mitigation measures are different because of the different scenarios that each geographical location poses. It is believed that the most fundamental component of this is legislation and developing countries do not take safety seriously or have inadequate legislation to minimize risks.

Occupational Hazards in Pakistan

Pakistan like many other developing countries faces challenges of economic transition and in the field of occupational Health and safety (OHS). In the country one of the most neglected areas of governance is that of inspection and monitoring of the labour force employed in hazardous occupations. The highest rate of injuries occurs in the agriculture and fisheries sector due to poor quality conditions, outdated machinery, and unhygienic environment, especially in the fish ¬processing units where mainly women and children are employed.

The Global Rights Index 2016 of the International Trade Union Confederation ranked Pakistan among the worst countries in the world for workers, with a ranking of four on a scale of five. According to Labour Watch Pakistan, more than 200 Wapda workers die each year due to electrocution, and many more are disabled. Deaths in the stone crushing sector and Silica-related lung disease are so common that the Supreme Court ordered all provinces to follow safety guidelines for the prevention of silicosis, but due to the absence of legislation and implementation mechanisms, not much progress has been made. While many Rules and Acts are present but these are not effectively enforced, nor are any prohibitive penalties imposed on contractors.

4. Ergonomics, engineering measures, medical measures and legislative measures in industries in developing world:

Ergonomics:

Ergonomics is the adjustment of man, machine and work environment. Ergonomics draws on a number of scientific disciplines, including physiology, biomechanics, psychology and anthropometry. The risk of musculo-skeletal disorders (MSDs) increases in manual handling of too heavy, too large and difficult to reach loads. Repetitive activities, prolonged standing often combined with a bent over or awkward position and sitting for long hours also result in MSDs. Cumulative-trauma-disorders (CTDs) are cumulatively received over time minor back injuries due to improper work postures. These have leg pain, tingling and numbness as an early sign and end up in disc rupture.

Engineering Measures

Engineering measures emphasize controlling a hazard at the source. Engineering measures include designing out hazards when new materials, equipment and work systems are being planned for the workplace, routine maintenance and house-keeping, general ventilation, mechanization, substitution, redesign or improved work processes, wet processes, total enclosure, isolation, dust suppression, local or general exhaust ventilation systems, job rotation, protective devices, environmental monitoring, statistical monitoring, research & training. Personal protective equipment (PPEs) are the devices that serve as barriers between a hazard and the worker. Disallowing exposure to noise equivalent of 85 dB by increasing distance, enclosure, and using less vibrant & absorbent materials are important measures. The probable connection between noise and industrial accidents could be because of the masking of sound signals like warning shouts, sirens and machinery noise etc. Water pollution and soil pollution add toxicity to agricultural products causing human nutritional problems. Fire prevention is done through clearance of hazardous and combustible materials, exit lights, clear exits, smoke detectors, alarm systems, fire extinguishers, and fire drills. Fencing of machines, uniform, a device for emergency cutting off power, standardized lifts, lifting ropes & machines fully maintained, floors, stairs, passages with no pits, maximal limit of manual weight-bearing, dangerous fumes, no portable light carrying in fumes, fire exits are some of the important issues. Toilets, kitchen, canteens must be clean. Impact of the occupational setting on the outside community including noise, smell and dusts may be reduced. Adapting tasks, work stations, tools, and equipment to fit the worker can help reduce physical stress on a worker’s body and eliminate many potentially serious, disabling work related MSDs. Ergonomic education and short breaks during work can address these.

Medical Measures

Health assessment, which includes a pre-employment, pre-placement and periodic medical examination. Besides notification, supervision of working environment, medical surveillance, analysis of records, epidemiological research, toxicology for identification and evaluation of recognized & unrecognized hazards, and health education & counselling are also included. The pre-placement examination enables to keep away the one-eyed or epileptic workers from fast running machines & fire. Diseases like asthma, cancers, pneumoconiosis, contact dermatitis, NIHL, and injuries may be notified, compensated as well as rehabilitated for prompt return to work. Health and safety education and training should start as part of the induction course, following a transfer of employee to a new station, change in a working method and as refreshers, by using bulletin board, awareness seminars, workshops, Q&A session, videos, expert lecture, journals and books. Workers need to know not only how to do their jobs, but also how to protect their lives and health and those of their co-workers so as to recognize their legal, social and medical rights.

Legislative Measures

Legislative measures include all those measures taken by the Government and administration for the health & safety of workers such as hazard allowances, overtime, shift duty allowances, interest-free housing & vehicle loans, life and health insurance, transport, subsidizing cafeteria services, balanced diets, adequate running water for personal hygiene, educational facilities to children of employees, in service training and recreational facilities are also included. After independence, the developing countries inherited policies and regulations of their former colonial masters which were revised as and when required in the course of time. OHS policy must be reflected in legislation, and legislation must be enforced. International organizations have initiated various legislations for standardization and regulation of OSH. The different factory acts, child labor laws, leave with wages, occupational diseases, employment in hazardous processes and welfare of the employees fall under the purview of these measures. These include engineering controls and medical services. Different types of enforcement activities by any agency to enforce compliance with OSH regulation consist of inspections and audits, warnings intended to change work practices, monetary penalties, prosecution, and closure of the firm either temporary or permanent.