prof. jorma rantanen/twin2kickoff fin-est twinning ii: kick off seminar 21 may 2003 tallinn eu...
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Prof. Jorma Rantanen/TWIN2KICKOff
FIN-EST TWINNING II: KICK OFF SEMINAR21 May 2003 TALLINN
EU OBJECTIVES AND PERSPECTIVES FOR OCCUPATIONAL HEALTH
Professor Jorma Rantanen, Finnish Institute of Occupational Health
Prof. Jorma Rantanen/TWIN2KICKOff
POLICY
Prof. Jorma Rantanen/TWIN2KICKOff
EU policy:Enlargement Agenda 2000: 13 countries applied the membership. Acquis Communitaire
required i.e. accession criteria. Several requirements and tasks to OHS. Enlargement will be made by supporting the applicant countries to achieve
the minimum level of OH&S as defined by the Acquis Communaitaire Phare economic and expert support and twinning instruments will be used
to implement that principle. Copenhagen Summit 2002: 10 countries will join in April 2004
Prof. Jorma Rantanen/TWIN2KICKOff
EU policyPolicy Amsterdam Treaty Lisbon Strategy: Quality of work OS&H Strategy 2002-2006 Public Health Programme Technology Programme
Principles Strong social dimension High level of protection Social dialogue Primary prevention OH and OS&H integration Employers´primary responsibility Participation
Instruments Framework Directive 20 + Daughter Directives OELs and standards HSMS MDS guideline List of ODs Other guidelines Topic Centers Dublin Surveys H&S Week campaign
Prof. Jorma Rantanen/TWIN2KICKOff
Framework Directive 89/391 EEC Basic instrument for safety and health at work Defines responsibilities and rights of employers and workers
at work Provides basic principles for safety and health ( and more for
safety than health):
High level of protection
Primary prevention at source
Best available technology
Right to know and right to get trained
Right to participate
Right to protective and preventive services Complemented with numerous specific daughter directives,
standards and guidelines
Prof. Jorma Rantanen/TWIN2KICKOff
Community Strategy on Health and Safety at work 2002 - 2006
Strategy objectives and actions For a global approach to well-being at work Strengthening the prevention culture Education, awareness, anticipation: improving people´s
knowledge of risks Better application of existing law Combining instruments and building partnership Adapting the legal and institutional framework Encouraging innovative approaches Working to mainstream health and safety at work in other
Community policies Preparing for enlargement Developing international cooperation
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Investing in quality
EU Strategy on OH&S2002-2006
EconomicCompetitiveness - dynamism
EmploymentFull employment - quality of work
Social Social quality - social cohesion
Source. European Commission 26.6.2001
Prof. Jorma Rantanen/TWIN2KICKOff
RISKS
Prof. Jorma Rantanen/TWIN2KICKOff
3442
46
27
52
3241
35 35
47
30
4534
0102030405060708090
Exposures to various WE factors in 1997 and 2000 in Finland (Source: Piirainen et al 2000)
Prof. Jorma Rantanen/TWIN2KICKOff
28
45
33
54 56
2820
29
4737
5660
2923
010
203040
506070
8090%
Exposures to various WE factors in the EU in 1995 and 2000 ( Source: Paoli 20000 )
Prof. Jorma Rantanen/TWIN2KICKOff
Fatal accidents
Prof. Jorma Rantanen/TWIN2KICKOff
Risk of death in the years 1986–90 by age and occupation in Finland (males) (Source: Valkonen et al. 1995)
0
0,1
0,2
0,3
0,4
0,5
20–24 25–29 30–34 35–39 40–44 45–49 50–54 55–59 60–64 65–69 70–74 75–79
Age
Blue collars
Higher whitecollars
Prof. Jorma Rantanen/TWIN2KICKOff
Two levels of risk assessment Systems level Work place level
Observations Reference values Context dependent Locally applicaple Based on codified practice Made by work place actors
• D-R relationship• Generic standard• Universally
applicaple• Based on research
observations• Takes place at
national or international level
• Made by researchers
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General overview of EU risk assessment process
INFORMATION GATHERING
EFFECTS ASSESSMENT• Hazard identification• Dose (concentration)-response (effect) assessment
EXPOSURE ASSESSMENT• Human exposure assessment (workers, consumers, via the environment)• Environmental exposure assessment (water, soil, air)
RISK CHARACTERISATION
HUMAN HEALTH Evaluation of effects data and comparison with exposure data
ENVIRONMENT Evaluation of effects data and comparison with exposure data
OUTCOME OF RISK ASSESSMENTOne or more of the following conclusions/results
i) No immediate concern ii) Further information needsiii) Concern, recommendationsfor risk reduction
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Estimated asbestos-related cancer mortality per 100,000 by exposure level for a 20-year working period
(Source: Nicholson, US Dept. Labor 1998)
0
2
4
6
8
10
0 2000 4000 6000 8000 10000 12000
Mesothelioma
Lung
Mortality/100,000for 20 year exposed
Asbestos fibre concentration(f/ml)
Prof. Jorma Rantanen/TWIN2KICKOff
Workplace risk assessment
1. PROGRAMMING
2. PLAN THE ASSESSMENT MODEL
3. FIND FACTS
4. IDENTIFY HAZARDS
5. IDENTIFY PEOPLE AT RISK
6. IDENTIFY THE ROUTES AND SOURCES OF EXPOSURE
7. ASSESS THE RISKS * Probability * Severity
8. DEFINE OPTIONS FOR RISK ELIMINATION OR MANAGEMENT
9. SET PRIORITIES, CHOOSE PRACTICES
10. IMPLEMENT
11. DOCUMENT
12. MEASURE EFFICIENCY
13. CHECK AND COMPLETE
Present measuressufficient
Present measuresinadequate
AssessmentValid
Improvement needed
STOP
STOP
STOP
14. FOLLOW THE IMPACT OF RA
15. MAKE RE-ASSESSMENT
Improvement yesNo improvement
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Consequences/ Slightly harmful Harmful Extremely harmfulprobability
Discomfort, irritation, Long-lasting serious Constant serious effects,mild disease, draught, effects, burns, life shortening diseases,small burns, reddening frostbites, hearing poisoning, work-relatedof the skin loss, vibration white cancer, asthma, drowning,
finger, electric eye, loss of vision, heartskin rashes attack
Highly unlikely 1. Trivial risk 2. Tolerable risk 3. Moderate riskless than 50% (no action) (monitoring) (actions needed)of the OEL
Unlikely 2. Tolerable risk 3. Moderate risk 4. Substantial risk50-100% of (monitoring) (actions needed) (actions necessary)the OEL
Likely 3. Moderate risk 4. Substantial risk 5. Intolerable riskexceeding the (actions needed) (actions necessary) (instant actions)OEL
A simple health risk classification for chemical and physical factors based on British standard BS 8800
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Those at risk of violence or threat of violence during the past 12 months, by age groups, % of respondents
(Source: Piirainen et al. 2000)
0 2 4 6 8 10
All
25-34
35-44
45-54
55-64
men
All
25-34
35-44
45-54
55-64
violence
threat
women
Prof. Jorma Rantanen/TWIN2KICKOff
Risk factors of LBP and sciatica(Source: Heliövaara 1995)
Obesity + Height + Heavy work +++ Car driving
– LBP +– sciatica + +
Accidents +++ Smoking ++ Psychological stress + Immobility +
Risk factor Strength of evidence
Prof. Jorma Rantanen/TWIN2KICKOff
0
10
20
30
40
50
60
70
<26 26–45 46–65 >65
02468101214161820
Total number of accidents/1000 Fatal accidents/100 000
Rates of accidents (total number/1000) and fatal accidents/100 000 in the EU by age group (EUROSTAT 1998)
Prof. Jorma Rantanen/TWIN2KICKOff
00,2
0,40,6
0,81
1,21,4
1,61,8
2
Inc
ide
nc
e /
10
00
em
plo
ye
d Cases / total workforce
Cases / filtered workforce
Incidence of 31 occupational diseases in the Member States of European Union in 1995 (Karjalainen and Virtanen 1998)
Prof. Jorma Rantanen/TWIN2KICKOff
Work-relatedness of common chronic diseases
%
Asthma (adult males) 30 (Karjalainen et al, 2001)
Lung cancer 25-30 (Axelsson 2001)
Cardiovascular disorders
CHD 5-10 (Leigh 1997)
Cardiovascular 5 (Leigh 1997)
Musculoskeletal disorders
Upper extremities 15-40 (EU OSHA)
Low back pain 50 ? (NAS 2001)
Total mortality 6.7 (Nurminen
Karjalainen 2001)
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SERVICES
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Workers covered by OHS in Europe(Source: Hämäläinen et al 2001, Rantanen 2002)
50
28
50
34
80
70
95
80
90
50 50
15
60 60
39
86
4
48
0
10
20
30
40
50
60
70
80
90
100
PT GR DK GB BE SE NL FR FI IT NOR EST BULG HUNG POL SLOV SL TURK
%
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MOH&S or MOL
LABOURINSPECTORATE
IOH
IN-COMPANY OHS GROUP OHS PHC Private center
Big company
SME Company SE SME SSE SME
DOH&S DOH
INTEGRATED OH&S SYSTEM
OM OMCLINICS
SESE
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Dept. of Health and OHESocial Welfare
District health office OHE
Municipal health Director OHE
Gjakova IOHIPH OH Unit
Pristina
District hospital
Big industryOHS
Obiliq
Referral
Family healthcentre
Group service
BranchOHS
OHE = occupational healthexpert
IOH = Institute of Occupa-tional Health
IPH = Institute of PublicHealth
OHS = Occupational Health Services
OH System for Kosovo (Rantanen,UNMIK and WHO 2000)
Prof. Jorma Rantanen/TWIN2KICKOff
Core content of OHS Surveillance of working conditions for health and safety aspects at work Assessment of risks to health and safety, risk of overload and stress Surveillance of health of workers and identification of work-related and occupational diseases Information of workers and management on health hazards at work and on how to prevent
them including advice on safe and healthful working practices Advice on actions for preventive measures, control and risk management actions and for
improvement of workers´ health Organization and maintenance of first aid readiness at the workplace
Prof. Jorma Rantanen/TWIN2KICKOff
Workers covered by OHS(Source: Hämäläinen et al 2001)
50
28
50
34
80
70
95
8590
50 50
0
10
20
30
40
50
60
70
80
90
100
PT GR DK GB BE SE NL FR FI IT NO
%
Prof. Jorma Rantanen/TWIN2KICKOff
Finnish model for OH&S
COMPETENCEand skill development
HEALTH,Work abilityOHS,WHP
WORK ENVIRONMENT,Risk assessment,Risk managementErgonomics Safety promotion etc.
WORK COMMUNITY,Participation,Working culturesWork organization
High qualitywork life
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Health Promotion
EMPLOYER Eliminating hazardous conditions Providing information
and advice Organising facilities and
enabling conditions Organising competitions and campaigns Following up the preogress Rewarding for success
WORKERS Responsibility on ones own health Dedication to health and safety Joining in groups Following up progress Encouraging and supporting fellow
workers Participating in collective campaigns "WHP Representative"
Prof. Jorma Rantanen/TWIN2KICKOff
Scientific
evidence,
prediction
and risk
assessment
Professional
competence
experience,
multidisciplin
arity
Needs analysis
Client
participation
Infrastru
cture,
resources,
coverage,
operability
GOHP
Good occupational health practice (GOHP)
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CHANGE
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Roger´s diffusion (1980)
2,5
16
50
84
0
10
20
30
40
50
60
70
80
90
Time
% degree ofadoption
Innovators
Early adopters
Early majority
Late majority
LAGGARDS
Prof. Jorma Rantanen/TWIN2KICKOff
Rule of law index and safety(Source: World Development Report 2000/2001)
210
Rule of law index
Fatal accident riskcases/100 000
10,000
30,000
Rule of law index
GDP/CAPITA USD
20,000
Prof. Jorma Rantanen/TWIN2KICKOff
Comprehensive OHS&MWA Project at Dahlbo Co(Source: Näsman and Ahonen 1999)
Input costs300 000 FIM/Yr
Benefits: 10-fold
Reduction of sickness leave costs200 000 FIM/Yr
Increased productivity
1,200 000 FIM/Yr
Reduction of work disability pension costs 1, 600 000
Prof. Jorma Rantanen/TWIN2KICKOff
Economic benefits from PMWA (Source: Peltomäki et al 1999)
0
10
20
30
40
50
60
Much Some Little Not at all Cannotsay
ManagementPersonnelOHS
Prof. Jorma Rantanen/TWIN2KICKOff
Summary: 21st CenturyChallenges to the Profession From care to prevention, promotion and development Broadening competence From OM to OH Multidisciplinary collaboration Maintaining professional leadership Self-evaluation Drawing from research
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Summary: 21st Century
OHS Work life will need OH&S more than ever Full coverage of services need to be organized Content and competence of OHS need to be renewed New service provision models are needed Multidisciplinary, comprehensive approach OHS has been found productive in view of health, work ability and enterprise and
national economy