Industrial Hygiene Practice Industrial Hygiene Practice in China in China –– an Overviewan Overview

Peter Peter ShenShen, CIH, CIHDelta ConsultantsDelta Consultants

800800--477477--74117411518518--203203--00640064

pshen@deltaenv.compshen@deltaenv.com

Occupational Health ChallengeOccupational Health Challenge

Rapid industrialization brought millions out Rapid industrialization brought millions out of poverty but created unprecedented of poverty but created unprecedented occupation health problems nationwide.occupation health problems nationwide.Continuously increasing number of Continuously increasing number of occupational injuries and diseases occupational injuries and diseases Ailing occupational health infrastructure Ailing occupational health infrastructure left millions of workers with no access to left millions of workers with no access to basic occupational health services.basic occupational health services.Weak law enforcement capabilityWeak law enforcement capability

A Look at the NumbersA Look at the Numbers-- Occupational DiseasesOccupational Diseases

Occupational diseases reported from 2001 to 2006 Occupational diseases reported from 2001 to 2006 13,218 cases in 2001;13,218 cases in 2001;12,212 cases in 2005; 12,212 cases in 2005; 11,519 cases in 2006; 11,519 cases in 2006;

Profile of 2006 report representative of allProfile of 2006 report representative of all76% Pneumoconiosis, such as black lung, silicosis76% Pneumoconiosis, such as black lung, silicosis11% pneumoconiosis with <5yrs exposure history11% pneumoconiosis with <5yrs exposure history41% of all from coal industry41% of all from coal industry13% of all from non13% of all from non--ferrous metal industryferrous metal industryMigrant workers taking a heavy tollMigrant workers taking a heavy toll

““Due to incomplete reports, the actual statistics are far Due to incomplete reports, the actual statistics are far worseworse”” –– MOH openly acknowledges this.MOH openly acknowledges this.

A Look at the NumbersA Look at the Numbers-- Other Published DataOther Published Data

Medium to small industrial enterprises comprise Medium to small industrial enterprises comprise of >90% total.of >90% total.2/3 of the nation2/3 of the nation’’s population is active workforces population is active workforce200 millions workers exposed to occupational 200 millions workers exposed to occupational health hazards. 100 millions are migrant workers health hazards. 100 millions are migrant workers from rural areas.from rural areas.1010--20% workers have access to basic 20% workers have access to basic occupational health servicesoccupational health servicesLosses due to occupational injuries and Losses due to occupational injuries and diseases estimated at 300 billions RMB (US$40 diseases estimated at 300 billions RMB (US$40 billions) every year billions) every year –– 1/60 of 2005 GDP; 1/70 of 1/60 of 2005 GDP; 1/70 of 2006 GDP2006 GDP

-- Ailing Occupation Health Services Ailing Occupation Health Services and Inadequate Law Enforcementand Inadequate Law EnforcementWho are providing the services Who are providing the services –– Health Health and Epidemic Prevention Station (HEPS) and Epidemic Prevention Station (HEPS) (now under the name of China CDC)(now under the name of China CDC)Only 10Only 10--20% workers in China have 20% workers in China have access to basic occupational health access to basic occupational health services. WHO estimated even lower.services. WHO estimated even lower.MakeMake--up of occupational health workersup of occupational health workersMakeMake--up of law enforcement agencyup of law enforcement agency

Are There Occupational Health Are There Occupational Health Regulations in China?Regulations in China?

Occupational disease prevention lawOccupational disease prevention lawHygiene standards for industrial designHygiene standards for industrial designPermissible exposure Limits (330 substances)Permissible exposure Limits (330 substances)Biological exposure indices (11 substances)Biological exposure indices (11 substances)Radiation hygiene standards (more than 20)Radiation hygiene standards (more than 20)Occupational disease diagnosis standards (110)Occupational disease diagnosis standards (110)Air sampling and analytical standards (85)Air sampling and analytical standards (85)Biological sample analytical standards (63)Biological sample analytical standards (63)

What Drives the Fast Change in What Drives the Fast Change in Legislation and Law EnforcementLegislation and Law EnforcementPublic attentions due to media coverage of Public attentions due to media coverage of high profile occupational injury caseshigh profile occupational injury casesInternational pressuresInternational pressuresGovernment recognition of the gravity of Government recognition of the gravity of occupational health problemsoccupational health problemsLawyers fighting for harmed workersLawyers fighting for harmed workersResponsible corporations set good Responsible corporations set good examples for othersexamples for others

Are These Regulations Enforced?Are These Regulations Enforced?

China has always believed in China has always believed in ““preventive preventive measuresmeasures”” but law enforcement is always but law enforcement is always problematic. problematic. The hygiene design standards are enforced on The hygiene design standards are enforced on new construction projects.new construction projects.The The PELsPELs are largely not enforced at present.are largely not enforced at present.The disease diagnosis standards are not very The disease diagnosis standards are not very helpful.helpful.These regulations and standards provide legal These regulations and standards provide legal basis for harmed workers to seek legal basis for harmed workers to seek legal redress.redress.

Government FocusGovernment Focus-- Occupational Diseases ControlOccupational Diseases ControlStrengthen law enforcement capacityStrengthen law enforcement capacityRestore the occupational health services Restore the occupational health services infrastructureinfrastructureA new pilot project aimed at setting A new pilot project aimed at setting models for the nation models for the nation –– ““Get Workers Get Workers Basic Occupational Health ServicesBasic Occupational Health Services””The success of all these finally rests on The success of all these finally rests on people who do the work.people who do the work.

A Few High Profile Cases in the A Few High Profile Cases in the MediaMedia

2007 2007 –– Cadmium poisoning in a NiCadmium poisoning in a Ni--CdCd battery plant in battery plant in WuxiWuxi2006 2006 –– Media reported 4 cases of lung cancer mortality Media reported 4 cases of lung cancer mortality in a pharmaceutical company in Chongqingin a pharmaceutical company in Chongqing2005 2005 -- 28 of 31 female workers poisoned by n28 of 31 female workers poisoned by n--hexane in hexane in a cell phone accessory plant in Guangdong.a cell phone accessory plant in Guangdong.2004 2004 -- 177 workers battery making factories in Huizhou 177 workers battery making factories in Huizhou were poisoned by cadmium.were poisoned by cadmium.2003 2003 –– 1010’’s of workers diagnosed with acute silicosis in s of workers diagnosed with acute silicosis in ZheJiangZheJiang..2002 2002 -- 5 workers in a handbag factory died of benzene 5 workers in a handbag factory died of benzene poisoning. poisoning. 2000 2000 -- 35 of 220 gem cutting workers were diagnosed 35 of 220 gem cutting workers were diagnosed with accelerated silicosis in a factory in Guangdong.with accelerated silicosis in a factory in Guangdong.

All the Parties InvolvedAll the Parties Involved-- the Regulatorsthe Regulators

Occupational health administration is only a Occupational health administration is only a small department under the Ministry of Health small department under the Ministry of Health –– Occupational Health Law Enforcement Occupational Health Law Enforcement AgencyAgencyChina Center for Disease Control (CDC)China Center for Disease Control (CDC)is a government founded nonprofit institution is a government founded nonprofit institution ––think tank for the government.think tank for the government.Occupational Health and Poison Control Occupational Health and Poison Control Institute under China CDC could be ChinaInstitute under China CDC could be China’’s s ““NIOSHNIOSH””..State Administration for Work Safety (SAWS)State Administration for Work Safety (SAWS)

All the Parties InvolvedAll the Parties Involved-- IH PractitionersIH Practitioners

China CDC affiliates China CDC affiliates –– backback--bone of occupational health bone of occupational health services providers services providers –– conflict of interest?conflict of interest?

Government sponsored and designated;Government sponsored and designated;Professionals graduated from medical schools;Professionals graduated from medical schools;

Certified safety engineers are playing a major role at Certified safety engineers are playing a major role at facility level in lieu of industrial hygienist.facility level in lieu of industrial hygienist.International consultantsInternational consultantsWill China allow private consultants to get involved? Will China allow private consultants to get involved? The government recognized the need for occupational The government recognized the need for occupational health and hygiene practitioners with crosshealth and hygiene practitioners with cross--disciplinary disciplinary training and educational background.training and educational background.

Industrial Hygiene ProfessionIndustrial Hygiene Profession

Public health schools evolved/split from the Public health schools evolved/split from the traditional medical schoolstraditional medical schools““Occupational HealthOccupational Health”” from from ““Industrial MedicineIndustrial Medicine””;;““Environmental HealthEnvironmental Health”” from from ““Environ. MedicineEnviron. Medicine””““Industrial HygieneIndustrial Hygiene”” –– often an inaccurate often an inaccurate translation of translation of ““Industrial/Occupational HealthIndustrial/Occupational Health””..““Industrial HygieneIndustrial Hygiene”” in the ABIH definition is only in the ABIH definition is only emerging in China.emerging in China.

Occupational Health Academic Occupational Health Academic Programs in ChinaPrograms in China

University programs are accredited by the University programs are accredited by the Ministry of Education. Ministry of Education. Occupational and environmental health are Occupational and environmental health are under under ““Preventive MedicinePreventive Medicine”” –– medical Degreemedical DegreeMissing courses in public health schools:Missing courses in public health schools:

Exposure assessment;Exposure assessment;Environmental chemistry;Environmental chemistry;Risk assessment;Risk assessment;Ventilation and engineering control;Ventilation and engineering control;Introduction to manufacturing processesIntroduction to manufacturing processes

Occupational Health Academic Occupational Health Academic Programs in ChinaPrograms in China

““Industrial Hygiene EngineeringIndustrial Hygiene Engineering”” –– a course a course offered under Safety Engineering.offered under Safety Engineering.The evolution of public health schools and their The evolution of public health schools and their academic programs just started a few years ago.academic programs just started a few years ago.““Environmental and Occupational HealthEnvironmental and Occupational Health”” as a as a specialty under preventive medicine in 2001.specialty under preventive medicine in 2001.A wealthier China is getting ready for an A wealthier China is getting ready for an industrial hygiene profession that embraces all industrial hygiene profession that embraces all the four fundamental elements.the four fundamental elements.

Best Public Health SchoolsBest Public Health SchoolsBeijing University School of Public HealthBeijing University School of Public HealthHuazhongHuazhong University SPHUniversity SPHBest environmental and occupational health Best environmental and occupational health program; program; Environmental medicine program established in Environmental medicine program established in 1978; 1978; Changed to environ. & occupational health in Changed to environ. & occupational health in 2001.2001.A text book A text book ““Occupational Hygiene and Occupational Hygiene and MedicineMedicine”” will be completed soon.will be completed soon.

Will There be CIH and CIHA?Will There be CIH and CIHA?MOH has recognized the need for certification and MOH has recognized the need for certification and licensing the occupational health/hygiene profession.licensing the occupational health/hygiene profession.Will this end up to be another certification and license for Will this end up to be another certification and license for doctors? doctors? –– Likely not but still confusing.Likely not but still confusing.Success in the governmental sponsored Certified Safety Success in the governmental sponsored Certified Safety Engineer (CSE) program.Engineer (CSE) program.Setting the right bar for the future CIH in China not easy.Setting the right bar for the future CIH in China not easy.China Preventive Medicine Association (CPMA) China Preventive Medicine Association (CPMA) –– The The Industrial Hygiene and Occupational Disease SectionIndustrial Hygiene and Occupational Disease SectionChina Occupational Safety and Health AssociationChina Occupational Safety and Health Association

ProspectProspectChina needs IH programs at university levels.China needs IH programs at university levels.The nation is in desperate need of The nation is in desperate need of occupational health and hygiene practitioners.occupational health and hygiene practitioners.The nationThe nation’’s systems, both government and s systems, both government and educational institution, were largely copied educational institution, were largely copied from Russia but are increasing influenced by from Russia but are increasing influenced by the US.the US.Exchange between AIHA and their Chinese Exchange between AIHA and their Chinese counterparts will certainly help promote the counterparts will certainly help promote the growth of the IH profession in the nation.growth of the IH profession in the nation.

Thank You!Thank You!

Peter Peter ShenShen, CIH, CIHDelta Consultants Delta Consultants 800800--477477--74117411518518--203203--00640064pshen@deltaenv.compshen@deltaenv.com