PAHO-2KPAHO-2K

Pan American Health OrganizationPan American Health Organization

PAN AMERICAN HEALTH ORGANIZATIONPan American Sanitary Bureau, Regional Office of the

WORLD HEALTH ORGANIZATION

XIII INTERAMERICAN XIII INTERAMERICAN CONFERENCE OF CONFERENCE OF

MINISTERS OF LABORMINISTERS OF LABOR

SEPTEMBER 24 TO 26, 2003SEPTEMBER 24 TO 26, 2003

SALVADOR, STATE OF BAHIA SALVADOR, STATE OF BAHIA

BRASILBRASIL

DR. LUZ MARITZA TENNASSEEDR. LUZ MARITZA TENNASSEE

PAHO-2KPAHO-2K

Pan American Health OrganizationPan American Health OrganizationPAHO as a Specialized Agency of

the UN and theInter–American System

Inter–AmericanSystem

PAHOPAHOUN

SystemUN

System

Regional Office Regional Office of theof the

World Health OrganizationWorld Health Organization

Regional Office Regional Office of theof the

World Health OrganizationWorld Health Organization

Specialized Agency Specialized Agency of the Organization of the Organization

ofofAmerican StatesAmerican States

Specialized Agency Specialized Agency of the Organization of the Organization

ofofAmerican StatesAmerican States

Office of External Relations

PAHO-2KPAHO-2K

Pan American Health OrganizationPan American Health Organization

PAHO-2KPAHO-2K

048TEN2K4

Pan American Health OrganizationPan American Health Organization

Workers’ Health in the AmericasWorkers’ Health in the Americas

Human Sustainable DevelopmentHuman Sustainable Development

HumanRights

DemocracyEquity

PAHO-2KPAHO-2K

Pan American Health OrganizationPan American Health Organization Workers’ Health

“Occupational Health and Safety:

a high priority in the global, international

and national agenda”

Kofi A. AnnanSecretary General United Nations

Johannesburg Summit 2002

PAHO-2KPAHO-2K

Pan American Health OrganizationPan American Health Organization

Organization of American States

Globalization: impact on work

III Summit of the Americas 2001

XII Inter-American Conference of the Ministers of Labor

October 2001

•Declaration and Plan of Action (OAS, ILO, PAHO, IDB, WB, ECLAC)

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Pan American Health OrganizationPan American Health OrganizationUN Millennium Development Goals

Relation to Workers’ Health

GOALS: CONTRIBUTION:

• Eradicate Extreme Poverty and Hunger

•Promote Gender, Equality and Empower Women

•Reduce Child Mortality and Improve Maternal Health

•Combat HIV/AIDS

•Synergy with Labor and Health Ministers, Private Sector, NGOs Unions to Create and Maintain a

Healthy Workplaces

•Basic Skills for Women to Improve Housing and Working

Conditions

•Improvement in Working Conditions to promote and

protect parental Health

•Through Promotion in the Workplace and healthcare

Sector

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Pan American Health OrganizationPan American Health Organization

Sources: World Competitiveness Report,Lausanne; ILO/SafeWork

90

0

80 70

60

50

40

30

20

10

USAFi

nlan

d

Nethe

rland

s

Switz

erla

ndIre

land

Ger

man

ySw

eden

Can

ada

Aus

tral

iaU

KN

orw

ayJa

pan

Fran

ceB

elgi

umS

pain

Mal

aysi

aC

hile

Hun

gary

Kor

ea R

.P

ortu

gal

Chi

naTh

aila

ndB

razi

lM

exic

oS

outh

Afr

ica

Indo

nesi

aR

uss

ia

Ind

ex

Competitiveness and Safety

Fatal accidents/100 000 workers

Competitiveness (World Competitiveness Report)

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Pan American Health OrganizationPan American Health OrganizationBurden of Disease: Economic Impact

Least-Development

Countries

Lower-Middle-Income

Countries

High-Income

Countries

Life Life ExpectancyExpectancy

Mortality Under Mortality Under Five YearsFive Years

PopulationPopulation

(Millions)(Millions)Development Development

CategoryCategory

891 25,730 78

2,094 1,200 70

643 296 51

GNP Per CapitaGNP Per Capita

(US Dls)(US Dls)

159

39

6

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Pan American Health OrganizationPan American Health OrganizationDominican

RepublicGuatemala

Turnover of Personnel 45% - 12%

Absenteeism 80%

Operation costs 30%

Global efficiency 48%- 80%

Staff increase 30%

Production 350%

Return on investment 372% (costos/beneficios)!!!

Accidents decreased to zero

Absenteeism decreased from 5% to 1%

…the consequences of investing in health

and safety...

PAHO-2KPAHO-2K

Pan American Health OrganizationPan American Health OrganizationThe Regional Plan on Workers’ Health

Strategic and Programmatic Orientations 1999-2007

Resolution DC XIII 1999

Strategic Plan 2003-2007

Inter-disciplinary

Transnational

Intersectoral

Human Sustainable Development

PAHO-2KPAHO-2K

Pan American Health OrganizationPan American Health Organization

Regional Plan on Workers Health

““Improve the living Improve the living conditions, health conditions, health and

safety in the workplace, safety in the workplace, and the well-being of and the well-being of

the working populationthe working population, , to advance towards to advance towards human sustainable human sustainable

development”development”

““Improve the living Improve the living conditions, health conditions, health and

safety in the workplace, safety in the workplace, and the well-being of and the well-being of

the working populationthe working population, , to advance towards to advance towards human sustainable human sustainable

development”development”

Actors:

- International

- Governmental

- Labor Organizations

- Private Sector

- NGOs

- Universities

- Media

- Collaborating Centers

STRATEGIC AREAS

• Quality of work environment

• Workers’ health promotion

• Policy and legislation

• Comprehensive health services

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Pan American Health OrganizationPan American Health Organization Workers’ Health Prevention

PrimaryPrevention Primary

Prevention

SecondaryPrevention

SecondaryPrevention

Tertiary Prevention

Tertiary Prevention

Clean Production

Pre-market Testing

Substitution and Elimination

Engineering Control

Environmental Monitoring

Personal Protective Devices

Biological Monitoring

Pre-clinical Medical Examination

Diagnosis

Therapy

Rehabilitation

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Pan American Health OrganizationPan American Health Organization DRIVING FORCES

… and Free Trade, Reform Processes, Labor Flexibilization

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Pan American Health OrganizationPan American Health Organization PRESSURES

New Technologies:Biotechnology and Genetic Engineering

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Pan American Health OrganizationPan American Health Organization Transfer of TechnologyIndustrial Free-Tariff Zones: Maquilas

- 2nd largest source of foreign exchange in Mexico

- 70% are U.S. owned

- Fastest growing sector of the economies of Mexico and Central America

- Chemical hazards: xylene, ethyl benzene, methylene chloride, acetone, toluene.

PAHO-2KPAHO-2K

Pan American Health OrganizationPan American Health OrganizationMAQUILA SECTOR IN CENTRAL AMERICA

Increased Migration

70%-80% Women

Chronometric control

Piece-work wages

Labor instability

Sexual harassment

Unhealthy environment and poor dwellings

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Pan American Health OrganizationPan American Health Organization STATE

Informal Sector

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Pan American Health OrganizationPan American Health Organization EXPOSURE

Risk Profiles

• Ergonomic

• Biological

• Physical

• Chemical

• Psychosocial

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Pan American Health OrganizationPan American Health Organization

• 36 Injuries/minute

• 5 Million/year

• 90,000 Fatal injuries/year

• 300 Deaths/day

• 9%-12% of GDP in LAC

EFFECTSImpact of Occupational Injuries and

Diseases

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Pan American Health OrganizationPan American Health Organization

• Income below basic needs level:

20%-40% Salaried workers

• Occupational health services:

30% of formal sector

• Mortality rate non-professionals/professionals: 3:1

• Fatal occupational injuries LAC/USA: 3:1

• Mortality of Hispanics in USA (construction): + 40%

• Higher impact:

children, women, migrants, elderly, indigenous

LABOR INEQUALITIES

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Pan American Health OrganizationPan American Health Organization

UnemploymentUnemployment

SocialInjustice

Syndrome

OccupationalCancer

OccupationalCancer

ReproductiveProblems

ReproductiveProblems

OccupationalStress

OccupationalStress

MusculoskeletalDisorders

MusculoskeletalDisorders

Accidents and InjuriesAccidents and Injuries

Hearing LossHearing Loss

Cardiovascular Diseases

Cardiovascular Diseases

Infectious DiseasesInfectious Diseases

Homicides Suicides Violence

Homicides Suicides Violence

Alcoholism and Substance AbuseAlcoholism and

Substance Abuse

PoisoningPoisoning

RespiratoryProblems

RespiratoryProblems

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Pan American Health OrganizationPan American Health Organization

Workers’ Health PromotionWorkers’ Health Promotion

BrazilIndustrial Sector

SESI Informal Sector

Central America • Agreement PAHO- 8 Ministers of Labor

• CARICOM 19 COUNTRIES• IDB• DOL (USA)

Hispanics in USA EPA, NSC, OSHA,

NAHH

- New Working Culture- Personal and Collective Development- Public Participation- Improvement of Working and Community Environments

HEALTHY WORKPLACES

Regional Global network (HECONET)

• Network of Collaborating Centers: Chile - Canada-

Colombia

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Pan American Health OrganizationPan American Health OrganizationPAHO/WHO COLLABORATING

CENTERS

U MichiganU Michigan

U IllinoisU Illinois

U Mass. LowellU Mass. Lowell

U TexasU Texas

John Hopkins UJohn Hopkins U

ISPISP

ACHSACHS

MINSAMINSA

INSAT INSAT

NIOSH NIOSH

CINBIOSE CINBIOSE

Centre Hospitalier

de Québec

Centre Hospitalier

de Québec

FUNDACENTROFUNDACENTRO

CBNSCBNS AREAS OF COLLABORATION

• Research

• Training

• Information

• Outreach

AREAS OF COLLABORATION

• Research

• Training

• Information

• Outreach

CCOHS

PAHO-2KPAHO-2K

Pan American Health OrganizationPan American Health Organization

HORIZONTALHORIZONTAL

COOPERATIONCOOPERATION

INTER-AGENCY SUPPORTINTER-AGENCY SUPPORTPAHO - AOSPAHO - AOS

CONSOLIDATED PROGRAMS

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Pan American Health OrganizationPan American Health Organization

Comprehensive ServicesComprehensive Services

Organize Pilot Projects. Organize Pilot Projects.

Agreement PAHO - ILOAgreement PAHO - ILOExtend Social Protection Extend Social Protection

and Health Coverage and Health Coverage within Excluded Groupswithin Excluded Groups

Agreement PAHO - ILOAgreement PAHO - ILOExtend Social Protection Extend Social Protection

and Health Coverage and Health Coverage within Excluded Groupswithin Excluded Groups

ProjectFASBASE - PAHO - World Bank

Conceptual Framework

ProjectFASBASE - PAHO - World Bank

Conceptual Framework

Development of Training GuidesDevelopment of Training Guides

Coordination:

• Ministers of Health• Municipalities• Public and Private Social Security• Companies• NGOs • Workers’ Clinics

www.cepis.ops-oms.org

PAHO-2KPAHO-2K

Pan American Health OrganizationPan American Health Organization

PAHO, Min. of Labor, SICA, COMISCA, RESSCAD

PROGRAM ONWORKERS’ HEALTH, GENDER AND EQUITY

- New working culture- Personal and collective development- Public participation- Improvement of working and community environments

PAHO-2KPAHO-2K

Pan American Health OrganizationPan American Health Organization

•==

DEVELOPMENT OF TOOLS

TO FACILITATE THE

IMPLEMENTATION OF THE INITIATIVE

HEALTH STANDARDS

PAHO-2KPAHO-2K

Pan American Health OrganizationPan American Health Organization

OCCUPATIONAL HEALTH STANDARDSOCCUPATIONAL HEALTH STANDARDS.

.

Objectives Objectives LevelsLevels

REGIONAL & SUB-REGIONAL

NATIONAL

SECTORAL

WORKPLACE

• IMPROVE THE WELL-BEING AND PRODUCTIVITY OF THE LABOR FORCE AND OF SOCIETY

• NEGOTIATE FAVORABLE WORKING CONDITIONS WITHIN INTEGRATION AND FREE TRADE PROCESSES

• STRENGTHEN THE CAPACITY TO IMPLEMENT WORKERS HEALTH STANDARDS AND TO PROMOTE PREVENTIVE PROGRAMS

• PROVIDE A BASIS FOR THE FORMULATION OF PUBLIC POLICY, LEGISLATION AND ADVOCACY

• STRENGHTEN THE CAPACITY OF COUNTRIES TO PROMOTE AND PROTECT WORKERS HEALTH

• PROMOTE FOLLOW-UP MECHANISMS FOR WORKERS HEALTH

• ENSURE THE WORKERS RIGTHS TO INFORMATION AND PARTICIPATION

PAHO-2KPAHO-2K

Pan American Health OrganizationPan American Health Organization Workers’ Health StandardsWorkers’ Health Standards

National Country Projects

HONM

HONM

CORM/F

CORM/F

PANF

PANF

NICM

NICM

ELSM

ELSM

BELMM

BELMM

GUAF

GUAF

DORM.

DORM.

PAHO/WHO - IDB - PROALCA/USAID - ILO - SID

SICA

COMMISCA

RESSCAD

MASICA

(PLAGSALUD)

IRET

ICAES

ITCA

MoH MoL ISS MoE

Network NGOs, Labor, Employers, Civil Society

National Councils of Occupational Health

...

Health and Safety Committees

INTEGRATION MECHANISMS

INTERINSTITUTIONAL AND INTERSECTORAL

COORDINATION

INTERPROGRAMMATIC

ACTION

PARTICIPATIVE

PLANNING

Maquiladora (M) - Floriculture (F)

PAHO-2KPAHO-2K

Pan American Health OrganizationPan American Health Organization PAHO/WHO

COLLABORATING CENTERS

IRET PAHO

COSTA RICA

SAN LUIS UNIVERSITY, GUATEMALA

OEA

IDB AREAS OF COLLABORATION

• Research

• Training

• Information

• Outreach

COLOMBIA

COMBIOSE QUEBEC

U. LEON NICARAGUA

CCOHS HAMILTON ONTARIO

CERSSO, EL SALVADOR

FUNDACENTRO

PAHO-2KPAHO-2K

Pan American Health OrganizationPan American Health Organization Healthy Workplaces

Nicaragua, Honduras,El Salvador and Guatemala

Maquila and Floriculture

PAHO- ILO - DoL (CERSSO)

ToolkitToolkit

PAHO-2KPAHO-2K

Pan American Health OrganizationPan American Health OrganizationThe novelty of this toolkit - HWI-The novelty of this toolkit - HWI-::

Seeks to strengthen the active participation of people involved in workplaces: that is, workers and

employers who execute most of the activities, which are monitored by a

team of facilitators.

PAHO-2KPAHO-2K

Pan American Health OrganizationPan American Health Organization Health of Hispanic Workers

TOPICS

• Inequities

• Environmental Justice

• Migrant Workers

• Border Health

ACTORS• EPA, OSHA, NIOSH (public sector)

• NSC, 3M (private sector)

• National Alliance for Hispanic Health (NGOs)

• PAHO, ILO, NAALC (international organizations )

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Pan American Health OrganizationPan American Health OrganizationHEALTHY HOTELS & OCCUPATIONAL HEALTH IN

THE REFORM OF THE HEALTH SECTOR

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Pan American Health OrganizationPan American Health Organization

WORKERS’ HEALTH

Basic Rights, Working Conditions, Safety and Health, Occupational Health Services