Global Initiatives in Occupational Safety and Health

Gwen Brachman

MD, MS, MPH, FACOEM

gobmd@yahoo.com

World Health OrganizationWHO

• Directing and coordinating authority on international health within the United Nations’ system.

• Constitution came into force on 7 April 1948 celebrated as World Health Day

• 194 Member States, across six regions, and from more than 150 offices

World Health OrganizationWHO

• providing leadership on matters critical to health and engaging in partnerships where joint action is needed;

• shaping the research agenda and stimulating the generation, translation and dissemination of valuable knowledge;

• setting norms and standards and promoting and monitoring their implementation;

World Health OrganizationWHO

• articulating ethical and evidence-based policy options;

• providing technical support, catalysing change, and building sustainable institutional capacity; and

• monitoring the health situation and assessing health trends.

World Health OrganizationWHO

• Health systems

• Health through the life-course

• Noncommunicable diseases

• Communicable diseases

• Preparedness, surveillance and response

• Corporate services

WHO - WORKERS’ HEALTH:GLOBAL PLAN OF ACTION (2008-2017)

• To devise and implement policy instruments on workers’ health;

• To protect and promote health at the workplace;

• To improve the performance of and access to occupational health services;

• To provide and communicate evidence for action and practice;

• To incorporate workers’ health into other policies.

Global Plan of Action

• Primary prevention of occupational hazards

• Favorable working conditions

• Better response from health systems to workers’ health

• Physical and mental health

• Protection and promotion of health at work

• may be setting for delivery of other essential health interventions

International Labour Organization

ILO• Created in 1919

• Part of the Treaty of Versailles that ended World War I

• Belief that universal and lasting peace can be accomplished only if it is based on social justice.

• Only tripartite UN agency - government, employer, and worker representatives.

International Labour Organization

ILO

• Set and promote standards and fundamental principles and rights at work

• Create greater opportunities for women and men to decent employment and income

• Enhance the coverage and effectiveness of social protection for all

• Strengthen tripartism and social dialogue

International Occupational Medicine Society Collaborative

IOMSC

• Medical and scientific organization representatives of occupational and environmental medicine societies worldwide

• Designed to build stronger relationships between medical societies around the world that represent the physicians and other health professionals who promote the health of workers

• address and collaborate on issues of concern and opportunities; advance the specialty of occupational and environmental medicine; and promote the provision of evidence-based occupational and environmental medicine

• IOMSC membership has grown to 40 societies in 37 countries

Workplace Health Without Borders

• Founded 2011 – Occupational Hygienists

• Members from 30+ countries

• Provides information, technical assistance, training and skills development

• Develop educational materials and programs

• Provide training and expertise on occupational hazard assessment and control

❖ International non-governmental professional society

❖ World's oldest and leading international scientific society in the field of occupational health with a membership of 2,000 professionals from

93 countries.

ICOH

Recognized by the United Nations and has a close working relationship with

International Labour Organization and

the World Health Organization

ICOH

Foster the scientific progress, knowledge and development of occupational health and safetyin all its aspects.

37 Scientific Committees

Several Working Groups

.

Global Stop-TB Effort

#9 cause of death globally

#1 cause of death from a single infectious agent:

10.4 million new cases in 2016

1.3 million deaths annually

Global Stop-TB Effort

• Ongoing Global Effort: Goals to Stop TB

– WHO : Reducing Deaths by 90% by 2030

– UN Sustainable Development Goals:

End TB epidemic by 2030

• New Efforts

– Preparatory Global Ministerial Meeting in Moscow November 16-17, 2017

– UN General Assembly high-level meeting on TB September 2018

Global Stop-TB Effort

HCW

Risk of acquiring TB 2-4X general population depending on country burden

8,144 healthcare workers with TB reported in 2016 in 60 countries

Global Stop-TB Effort

Silica exposure

Silica dust exposure increases risk of acquiring TB

up to 4-fold

Combined silicosis and HIV in miners increases risk of acquiring active TB by 15 times

Respirable silica is IARC Group 1 carcinogen: reduction prevents both cancer and TB

Inclusion of OSH in Moscow Declaration

• Moscow Global Ministerial Conference on Ending TB November 16-17, 2017 – ICOH sent Perry Gottesfeld to represent ICOH

– Contacts at Moscow Meeting included WHO, ILO

– ICOH and partners had reached out to Health Ministers

• Discussions appreciated the addition of OSH preventive measures to PREVENT cases of TB among health care workers and workers exposed to respirable silica dust

• Partnerships identified and more are desired!

– ICOH joined Global Stop TB Partnership http://www.stoptb.org/

Inclusion of OSH in Moscow Declaration

• Now specifically identifies as high risk TB populations:

• Health care workers

• Care givers

• Miners and other workers exposed to silica dust

• Recognizes as risk factors for TB:

• Working conditions

• Silicosis

• Calls for “new and more effective tools and

innovative approaches for prevention” not just programs to identify and treat TB infections

• Provides credibility for ministers to support OSH efforts

Participation of ICOH inGlobal Stop TB Effort

Two ICOH Stop TB Components

• HCW-TB led by SC OHHW and

Working Group Occupational Infectious Agents (WGOIA)

• Si-TB led by SC MinOSH and WGOIA

• Actions to be developed: repository of policies, practices and training programs; partnerships; etc

UN TB Declaration

“Commit to…..implementing primary prevention in high-risk occupations by reducing silica dust exposures in mining, construction and other dusty workplaces, and worker tuberculosis surveillance and infection prevention and control in healthcare settings.”

UN TB Declaration

• ~ 2.4 million deaths annually are attributed to work-related NCDs.

• Pollution was responsible for an estimated 9 million NCD deaths in 2015

• ~ 16% of the 55 million NCD deaths that occur world-wide each year.

Cancers, chronic respiratory diseases, neurologic disorders, cardiovascular diseases and adverse reproductive outcomes.

UN TB Declaration

• Unprotected child laborers and pregnant workers

• Low- and middle-income countries where they overshadow the effects of behavioral and metabolic risk factors such as tobacco, alcohol, diet and exercise.

• Nearly 92% of pollution-related deaths occur in low and middle income countries and, in countries at every income level, disease caused by pollution is most prevalent among minorities and the marginalized.

UN TB Declaration

The use of occupational safety and health measures along with safe handling of waste and by-products and the prevention of pollution would greatly decrease the exposures in the workplace and environment and the subsequent development of chronic, non-communicable diseases.

UN NCDs Declaration (3rd)

“Expand strategies for NCD prevention to incorporate reduction in toxic occupational exposures and control of environmental pollution known to cause disease, with special attention to children, pregnant women and the elderly.”

UN NCDs Declaration (3rd)

• OP 15. Increase global awareness, action and international cooperation on environmental risk factors, to address the high number of premature deaths from non-communicable diseases attributed to human exposure to indoor and outdoor air pollution, and underscoring the particular importance of cross-sectoral cooperation in addressing these public health risks

UN NCDs Declaration (3rd)

• OP16. Promote healthy communities by addressing the impact of environmental determinants on non-communicable diseases, including air, water and soil pollution, exposure to chemicals, climate change and extreme weather events; as well as the ways in which cities and human settlements are planned and developed, including sustainable transportation and urban safety, to promote social integration and connectivity transportation and urban safety, to promote

UN NCDs Declaration (3rd)

• OP28(a). Promoting and creating safe and healthy working environments, by implementing occupational health measures, including by establishing tobacco free workplaces, through good corporate practices, workplace wellness programmes and health insurance plans, as appropriate

QUESTIONS?

gobmd@yahoo.com