International Occupational International Occupational Health & SafetyHealth & Safety

Tim Morse, Ph.D.

University of Connecticut Health Center, Farmington, CT, U.S.

Spring 2002

OutlineOutline

Economic positions Theories of determinants of occupational

health Estimates of occupational injury and illness Approaches to prevention Maquiladoras (Mexico) NAFTA (North American Free Trade

Agreement)

Per Capita GNP Per Capita GNP (1987, World Bank)(1987, World Bank)

0

2000

4000

6000

8000

10000

12000

14000

16000

High World Low

Labor Force Distribution, 1988, ILOLabor Force Distribution, 1988, ILO

01020304050607080

Agriculture

Mfg

Services

Unem

ployed

CameroonTunisiaPortugalSweden

World System Theory World System Theory (Wallerstein, Elling)(Wallerstein, Elling)

• Position in world system

• Economic resources

• Strength of worker movement

First WorldFirst World

• Tripartite structureTripartite structure

• Standards vs. guidelinesStandards vs. guidelines

Sweden (Elling, 1988)Sweden (Elling, 1988) Labor strong • 85% organized• Labor party

National law (Co-determination)• Committee majority union• Stop production process• Hire/Fire company physician• 110,000 trained union reps• Linkage to health system

Third WorldThird World

• Combined with effects of poverty, nutrition

• Priority of economic development

• Agric (60-80%) & primary production

• Development led to dislocation

• High unemployment

Third WorldThird World

• Emphasize labor-intensive industries

• Control technologies not affordable

• Low or no workers’ compensation

• Highest risk have low access to social resources

Injuries/ FatalitiesInjuries/ Fatalities 100 million workplace accidents100 million workplace accidents 180,000 fatalities180,000 fatalities Developing countriesDeveloping countries• 20% injuries20% injuries• 30% fatalities30% fatalities

Fatal rate 3-4X in developingFatal rate 3-4X in developing Source: Takala, 1989Source: Takala, 1989 1.1 million fatalities injuries and ill (ILO)1.1 million fatalities injuries and ill (ILO)

Injury Fatality Rates Injury Fatality Rates (ILO, 1998; (ILO, 1998; Cited in Herbert and Landrigan, 2000)Cited in Herbert and Landrigan, 2000)

0 5 10 15 20 25 30 35

Sweden

European Union

US

Canada

Latin Am & Carrib

Rup. Of Korea

0

5000

10000

15000

20000

25000

30000

35000

40000

45000

EME FSE IND CHN OAI SSA LAC MEC

Injuries by region, Leigh 1999

Non-fatal (1000)

fatal

0 500 1000 1500 2000 2500 3000 3500

Pesticide

Cancer

Pneumoconiosis

Skin

MSD

Occ Disease by Type, World, Leigh, 1999, in thousands

Global BurdenGlobal Burden(Leigh, et al, Epidemiology, 1999)(Leigh, et al, Epidemiology, 1999)

Indirect MethodIndirect Method• 100,000,000 occupational injuries100,000,000 occupational injuries

– 100,000 deaths100,000 deaths

• 11,000,000 occupational illnesses11,000,000 occupational illnesses– 700,000 deaths700,000 deaths

Finish OD, Australian Injury ratesFinish OD, Australian Injury rates Apply age/sex-specific rates to Apply age/sex-specific rates to

populationpopulation Double rates for less developedDouble rates for less developed

Occupational DiseaseOccupational Disease

Higher risk in LDC’s in occupationsHigher risk in LDC’s in occupations Pesticide poisoningPesticide poisoning• 3 million acute poisonings/yr 3 million acute poisonings/yr

(Jeyaratnam, 1985)(Jeyaratnam, 1985)• 220,000 fatal220,000 fatal• Concentrated in LDCConcentrated in LDC

Organic dustsOrganic dusts

Occupational DiseaseOccupational Disease

NoiseNoise Heat StressHeat Stress• Reduces use of PPEReduces use of PPE

Bloodborne diseasesBloodborne diseases• 2 billion hep B carriers (world)2 billion hep B carriers (world)

• HIV in AfricaHIV in Africa

RegulationsRegulations

• Alma Alta declaration, WHOAlma Alta declaration, WHO– Incorp occ health services in Incorp occ health services in

primary careprimary care

• Colonial historyColonial history

• Use modified western standardsUse modified western standards–Lag behind knowledgeLag behind knowledge–Not suited to conditionsNot suited to conditions

National Strategy should National Strategy should include (Reich & Okubo)include (Reich & Okubo)

• Institutional developmentInstitutional development

• Info managementInfo management

• TrainingTraining

• Safety StandardsSafety Standards

• EnforcementEnforcement

• Social valuesSocial values

ILO (Intrl. Labor Office)ILO (Intrl. Labor Office)

Standard setting Training materials CIS Centers Chemical safety data sheets Information exchange Technical cooperation

Multi-nationalsMulti-nationals

Tension with US workers (jobs, Tension with US workers (jobs, NAFTA)NAFTA)

Lower wages, less job security, Lower wages, less job security, weak unionsweak unions

Lower national standards & Lower national standards & enforcementenforcement

Usually better conditions than Usually better conditions than other local plants (corporate policy)other local plants (corporate policy)

Maquiladoras (1995)Maquiladoras (1995)

2,200 Maquilas along Mexican border2,200 Maquilas along Mexican border 90% US owned90% US owned 550,000 employed, 65% women550,000 employed, 65% women 48 hour standard work week48 hour standard work week Ave. take home $15-25 per weekAve. take home $15-25 per week government unionsgovernment unions

Maquiladoras Maquiladoras (Moure-Eraso, 1997)(Moure-Eraso, 1997)

65% women65% women Little industrial experienceLittle industrial experience Labor turnover high (14%-180% per Labor turnover high (14%-180% per

year in different provinces)year in different provinces) Mixed studies on reproductive Mixed studies on reproductive

hazardshazards

Maquiladoras: SurveyMaquiladoras: Survey(Moure-Eraso, 1997)(Moure-Eraso, 1997)

267 maquila workers interviewed in 267 maquila workers interviewed in home, 1992home, 1992

81% female, mean age = 2581% female, mean age = 25 Living conditions generally good; 80% Living conditions generally good; 80%

indoor plumbing, 75% cement floorsindoor plumbing, 75% cement floors 45-48 hour work week45-48 hour work week Ave weekly wage=$40 US ($0.93/hr)Ave weekly wage=$40 US ($0.93/hr)

ExposuresExposures

Dust 51% Gas 60% Poor ventilation 51% Skin contact 50%

SymptomsSymptoms

56% headache 53% unusual fatigue 51% depression for no reason 41% forgetfullness 41% chest pressure 39% difficulty falling asleep 37% stomach pain 36% dizzy 33% numbness/tingling

Lead among radiator repair Lead among radiator repair Dykeman et al, 2002Dykeman et al, 2002

Radiator repair workers in MexicoRadiator repair workers in Mexico 35.5 ug/dl vs 13.6 for working 35.5 ug/dl vs 13.6 for working

controlscontrols Risk factorsRisk factors• SmokingSmoking• # radiators repaired/day# radiators repaired/day• Use of a uniform (not laundered)Use of a uniform (not laundered)

Mexican Safety Regulation: GAOMexican Safety Regulation: GAO

Survey of 8 auto plants (of 12 selected)Survey of 8 auto plants (of 12 selected)• advance noticeadvance notice• 2-day walkthrough2-day walkthrough

Interviews with Mexican officials, OSHAInterviews with Mexican officials, OSHA 6/8 had parent company support for H&S6/8 had parent company support for H&S Use of older equipmentUse of older equipment Had been visited by STPS Had been visited by STPS US: 80% of auto parts plants with OSHA US: 80% of auto parts plants with OSHA

violationsviolations

GAO ResultsGAO Results

Lack of hazard-specific programsLack of hazard-specific programs Hazards present at all 8 plantsHazards present at all 8 plants• 42% workers reported hand/arm pain42% workers reported hand/arm pain• 70% worked less than 6 months70% worked less than 6 months• machine guardingmachine guarding• 6 plants emerg exit problems6 plants emerg exit problems• lack of safety signs; some English onlylack of safety signs; some English only

GAO FindingsGAO Findings

6 facilities over 90 dB noise6 facilities over 90 dB noise• had plugs, many not usinghad plugs, many not using

Lead, silica, solvents, welding Lead, silica, solvents, welding gasesgases

Respirators not used properlyRespirators not used properly

GAO: Hazard ProgramsGAO: Hazard Programs

0

1

2

3

4

5

6

Ergo Fire PPE Hearing Respir

CompletePartialNone

GAO: Hazard ProgramsGAO: Hazard Programs

0

1

2

3

4

5

6

HazCom Lockout HazMat Lead Confine

CompletePartialNone

Mexican RegulationMexican Regulation

Law strong in some respectsLaw strong in some respects• H&S CommitteesH&S Committees

ProblemsProblems• No first instance penaltiesNo first instance penalties

• Specific standards weak in key areasSpecific standards weak in key areas

• Max fine $1,500Max fine $1,500

• Low WC costsLow WC costs

NAFTA Chapter 11 (Moyers)NAFTA Chapter 11 (Moyers) Allows suits by companies or shareholders if

“tantamount to expropriation”• Methanex $1 bil suit vs. California for regulating

MTBE• Metalclad $16 mill settlement vs Mexico for not

allowing haz waste plant to open• Ethyl $!3 mil settlement for temp ban on MMT gas

additive, withdraw ban, letter Secret tribunals Expanded Free Trade Agreement for Americas “Diminish value of investment”