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Pan American Health OrganizationPan American Health Organization

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

WORLD HEALTH ORGANIZATION

Contribuciones de las distintas Contribuciones de las distintas Organizaciones y Agencias Internacionales y Organizaciones y Agencias Internacionales y

de Cooperación a la SSOde Cooperación a la SSO

DR. LUZ MARITZA TENNASSEEDR. LUZ MARITZA TENNASSEE Sustainable Development and Environmental Health

OPSEl Salvador, 29-30 Abril 2004

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Pan American Health OrganizationPan American Health OrganizationGlobalization: Strengths and weaknesses

Beneficial effect Adverse effect 5–7 % annual

growth trade and world production

Harder competition developing countries

Global market provides benefit of scale

Home markets are put under pressure

Higher efficacy and quality

Compromising health and safety standards

Elimination of time dimension from global market

Unphysiological time schedules, sleep debt,

vigilance problems

< costs of storage, high flow of production

Tight deadlines, psychological stress.

physical overload

Adapt to global market unconventional work

hours, source of flexibility: human labour

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Pan American Health OrganizationPan American Health OrganizationEnvironmental &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

• Protect the health and safety of workers

• Strengthen and promote ILO and WHO programmes to reducr occupational

deaths, injuries and illnesses.

•Link occupational health with public health promotion”

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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 Ministers, Private Sector, NGOs Unions to Create and

Maintain a Healthy Workplaces

•Basic Skills for Women to Utilize Housing and Working

Facilities

•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 OrganizationUN Millennium Development Goals Ensuring Environmental Sustainability

TARGET

TARGET

CONTRIBUTION

CONTRIBUTION

Integrate the Principles of Sustainable Development into Country Policies and

Programs and reverse the loss of Environmental Resources

•Regional Plan on Workers’ Health/Health Workplaces Initiatives

•Linkages between Health and Labor PAHO/ILO

By 2020 to have achieve a significant improvement in the Lives of at least 100 million

slum Dwellers – phase out and eradication

Creation of Healthy, Safe and Decent Workplaces

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Pan American Health OrganizationPan American Health OrganizationSITUATION ANALISIS IN THE AMERICASSITUATION ANALISIS IN THE AMERICAS

INEQUITIES – INSTITUTIONAL DISPERSION - REFORMS

• EAP: 351 million (> 50% Americas population).

- 69 million below poverty line.

- 52% Informal Sector ( women, children, migrants, indigenous)

- 49% women

- 24 million children work.

36 Injuries / minute

5 Million injuries / year


90,000 Fatal Injuries / year

• Morbidity: Traditional occupational illnesses, along with cancer,

asthma, depression, cardiovascular, musculoskeletal , immunological,

and nervous system, and re-emerging diseases.

9% - 12% of GDP in LAC

30% Receives Occupational Health Services (formal sector)

• EAP: 351 million (> 50% Americas population).

- 69 million below poverty line.

- 52% Informal Sector ( women, children, migrants, indigenous)

- 49% women

- 24 million children work.

36 Injuries / minute



90,000 Fatal Injuries / year

• Morbidity: Traditional occupational illnesses, along with cancer,

asthma, depression, cardiovascular, musculoskeletal , immunological,

and nervous system, and re-emerging diseases.

9% - 12% of GDP in LAC

30% Receives Occupational Health Services (formal sector)

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StateWorkforce Composition,

Migration, Precarious L.M, Poverty Feminization

EffectLost workdays,

Occupational Accidents & Diseases, Lower Productivity, Social

Costs

ACTION

Health Policies and Legislation

Quality of the Work

Environment

Promotion of Workers Health

Comprehensive Workers’

Services

PressureTechnology Transfer, Non-

traditional Expoprt Production Increase

Maquila

Exposure (Environmental)

Psychosocial, Ergonomic,Chemical, Biological,

Safety & Physical

DPSEEA Model

Driving ForcesGlobalization, Integration,

Technological ChangeReform of the State, Inequities

The Workers’ Health Plan

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Pan American Health OrganizationPan American Health Organization Economic impact

Musculoskeletal 40%

Heart diseases 16%

Injuries 14%

Respiratory diseases9%

Nervous Central System8%

Others13%

Other diseases include cancer, skin diseases and mental disorders

The Breakdown of Costs for Work-related Injuries and Diseases

Source: ILO, 1999

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Organization of American States

The Regional Workers’ Health Plan

III Summit of the Americas 2001

XII Inter-American Conference of the Ministers of Labor

October 2001- Septiembre 2003

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

Workers’ Health

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Pan American Health OrganizationPan American Health Organization Agreement PAHO - ILO

Extend Social Protection and Health Coverage within Excluded Groups

(ESPHC)

Agreement PAHO - ILOExtend Social Protection and Health Coverage

within Excluded Groups(ESPHC)

Approved by Directive Council

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Pan American Health OrganizationPan American Health Organization THE CHALLENGE

Magnitude of the Problem:Total population of Latin America and the Caribbean: 500 million.

27% of the population lacks access to permanent and basic health services (125 millon).

46% of the population does not have health insurance either public or private (230 millon).

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REASON FOR ESPHC IN THE AMERICAS REGION

Persistent economic, social, ethnic and cultural exclusion.

The present social protection mechanisms are insufficient to give answers to new problems.

It is necessary for the Reform Processes to contribute in the construction of socially inclusive societies for all its citizens.

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Access to Services

Home Financial Security

Quality of Health Services

CONDITIONS FOR THE EXTENSION OF SOCIAL PROTECTION IN HEALTH

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Pan American Health OrganizationPan American Health OrganizationMANDATES OF THE ILO/PAHO/WHO RELATED

TO THE EXTENTION OF SOCIAL PROTECTION IN HEALTH

PAHO/WHO• Reduction in inequities in the access to health services and in their financing

• Universal access to health services in order to achieve the goal of health for all

• Poverty reduction and development goals of the millenium

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Pan American Health OrganizationPan American Health OrganizationMANDATES OF THE ILO/PAHO/WHO

RELATED TO THE EXTENTION OF SOCIAL PROTECTION IN HEALTH

MANDATES OF THE ILO/PAHO/WHO RELATED TO THE EXTENTION OF SOCIAL PROTECTION IN HEALTH

ILO Promote opportunities for decent and

productive work under conditions of freedom, equity, safety and human dignity

Improve the coverage and effectiveness of social protection for all, including protection in health

New consensus of social security

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First Hispanic ForumOctober 2000

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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Hispanic population grew by 58% between 1990 and 2000:38.3 Million in the US, 3.8 Million in Puerto Rico

12.5% of the workforce is Hispanic. They bear 15% of the total US fatal occupational injuries.

Fatal occupational accidents have decreased overall, but risen alarmingly among the Hispanic labor force.

In the US there has been a 40 % increase in fatalities among Hispanic workers in the construction sector.

Alarming Increases in Work Accidents among Hispanics

0

200

400

600

800

1000

1200

1400

1600

1800

2000

0

1000

2000

3000

4000

5000

6000

7000

Fatal Work Injuries involving Hispanics Hispanic Construction Workers

Fatal Work Injuries Counts 2 per. Mov. Avg. (Fatal Work Injuries Counts)

2 per. Mov. Avg. (Fatal Work Injuries involving Hispanics) 2 per. Mov. Avg. (Hispanic Construction Workers)

Work Related Fatalities are Projected to Keep rising without preventive interventions

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US-Mexico Chamber of Commerce

IDB

Hispanic Workers Safety and Health

Susan Harwood Grants

OSHA

PAHO

Hispanic Forum

3M

Summit of the Americas-

OAS

NIOSH

Communications

Workshop

US-Mexico BHA

NSC

Puerto Rico

NATIONWIDE NETWORK: AN INVITATION TO JOIN AND SUPPORT

Interconnectivity and Support

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Pan American Health OrganizationPan American Health Organization Border Issues

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Pan American Health OrganizationPan American Health Organization Border XXI Program

“ To improve the environmental health of U.S.-Mexico border communities by identifying and addressing those environmental conditions posing the highest human health risk”

1983 La Paz agreement designated six work groups (Air, water, hazardous waste, contingency planning, pollution prevention and cooperative enforcement)

1996 Three groups were added: natural r esources, environmental information and environmental and occupational health.

Development of Environmental Health Indicators

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Pan American Health OrganizationPan American Health Organization Migrant Farm Workers

•Most farm workers have no insurance.

• 3 to 5 million of them are Hispanic.

•Most migrant workers are men in their 20s and send their earnings home to their families in Mexico, Guatemala, Honduras, El Salvador or Haiti.

•Most live in poor housing and unsanitary living conditions.

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Healthy Work Place InitiativeHealthy Work Place Initiative Healthy Work Place InitiativeHealthy Work Place Initiative

Central America Andean Region

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http://www.cepis.ops-oms.org

CONTENT:CONTENT:

•Best PracticesBest Practices

•DatabasesDatabases

•SoftwaresSoftwares

•Global LinksGlobal Links

•DECIDESDECIDES

•Long-Distance Long-Distance EducationEducation

ILOILO

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19%

9%

31%

21%

3%

17%22%

15%

11%15%

8%

29%

Current Occupation for Men by Hispanic Origin in the US 2000

Hispanic Non-Hispanic White

ServicePrecision production

Farming

Managerial, professional

Technical, sales Operators, laborers

Source: Current Population Survey, March 2000, PGP-4

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2%15%

35%

42%

1% 5%

26%

18%38%

2%

23% 16%

Current Occupation for Women by Hispanic Origin in the US 2000


ServicePrecision production

Farming

Managerial, professional

Technical, sales Operators, laborers


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Pan American Health OrganizationPan American Health OrganizationPercent Unemployed by Hispanic Origin Percent Unemployed by Hispanic Origin

and Sex in the US 2000and Sex in the US 2000(Population 16 years and over in the labor force)(Population 16 years and over in the labor force)

Per

cent

6.86.2

7.7

3.4 3.6 3.3

0

2

4

6

8

10

Both Sexes Male Female



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Pan American Health OrganizationPan American Health OrganizationPercent Below Poverty Level in 1999 by Age and Hispanic

Origin in the US

Per

cent

22.8

30.8

18.520.4

8 9.47.1 7.6

0

10

20

30

40

50

All ages Under 18 18 to 64 65 and over



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ECONOMIC BURDEN OSH

NIOSH/CDC

AIDS ALZH CANCERCIRCULOSH

171

33

67

154 170

0

20

40

60

80

100

120

140

160180

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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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parental health

workers health goals

link occupational health

occupational health

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public health promotion

quality compromising

safety of workers