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Prof. Jorma Rantanen/TWIN2KICKOff FIN-EST TWINNING II: KICK OFF SEMINAR 21 May 2003 TALLINN EU OBJECTIVES AND PERSPECTIVES FOR OCCUPATIONAL HEALTH Professor.

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Presentation on theme: "Prof. Jorma Rantanen/TWIN2KICKOff FIN-EST TWINNING II: KICK OFF SEMINAR 21 May 2003 TALLINN EU OBJECTIVES AND PERSPECTIVES FOR OCCUPATIONAL HEALTH Professor."— Presentation transcript:

1 Prof. Jorma Rantanen/TWIN2KICKOff FIN-EST TWINNING II: KICK OFF SEMINAR 21 May 2003 TALLINN EU OBJECTIVES AND PERSPECTIVES FOR OCCUPATIONAL HEALTH Professor Jorma Rantanen, Finnish Institute of Occupational Health

2 Prof. Jorma Rantanen/TWIN2KICKOff POLICY

3 Prof. Jorma Rantanen/TWIN2KICKOff EU policy:Enlargement l Agenda 2000: 13 countries applied the membership. Acquis Communitaire required i.e. accession criteria. Several requirements and tasks to OHS. l Enlargement will be made by supporting the applicant countries to achieve the minimum level of OH&S as defined by the Acquis Communaitaire l Phare economic and expert support and twinning instruments will be used to implement that principle. l Copenhagen Summit 2002: 10 countries will join in April 2004

4 Prof. Jorma Rantanen/TWIN2KICKOff EU policy Policy l Amsterdam Treaty l Lisbon Strategy: Quality of work l OS&H Strategy l Public Health Programme l Technology Programme Principles l Strong social dimension l High level of protection l Social dialogue l Primary prevention l OH and OS&H integration l Employers´primary responsibility l Participation Instruments l Framework Directive l 20 + Daughter Directives l OELs and standards l HSMS l MDS guideline l List of ODs l Other guidelines l Topic Centers l Dublin Surveys l H&S Week campaign

5 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

6 Prof. Jorma Rantanen/TWIN2KICKOff Community Strategy on Health and Safety at work Strategy objectives and actions l For a global approach to well-being at work l Strengthening the prevention culture l Education, awareness, anticipation: improving people´s knowledge of risks l Better application of existing law l Combining instruments and building partnership l Adapting the legal and institutional framework l Encouraging innovative approaches l Working to mainstream health and safety at work in other Community policies l Preparing for enlargement l Developing international cooperation

7 Prof. Jorma Rantanen/TWIN2KICKOff Investing in quality EU Strategy on OH&S Economic Competitiveness - dynamism Employment Full employment - quality of work Social Social quality -social cohesion Source. European Commission

8 Prof. Jorma Rantanen/TWIN2KICKOff RISKS

9 Prof. Jorma Rantanen/TWIN2KICKOff Exposures to various WE factors in 1997 and 2000 in Finland (Source: Piirainen et al 2000)

10 Prof. Jorma Rantanen/TWIN2KICKOff % Exposures to various WE factors in the EU in 1995 and 2000 ( Source: Paoli )

11 Prof. Jorma Rantanen/TWIN2KICKOff Fatal accidents

12 Prof. Jorma Rantanen/TWIN2KICKOff Risk of death in the years 1986–90 by age and occupation in Finland (males) (Source: Valkonen et al. 1995) Blue collars Higher white collars

13 Prof. Jorma Rantanen/TWIN2KICKOff Two levels of risk assessment Systems levelWork 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

14 Prof. Jorma Rantanen/TWIN2KICKOff 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 ASSESSMENT One or more of the following conclusions/results i) No immediate concernii) Further information needs iii) Concern, recommendations for risk reduction

15 Prof. Jorma Rantanen/TWIN2KICKOff Estimated asbestos-related cancer mortality per 100,000 by exposure level for a 20-year working period (Source: Nicholson, US Dept. Labor 1998) Mortality/100,000 for 20 year exposed Asbestos fibre concentration (f/ml)

16 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 measures sufficient Present measures inadequate Assessment Valid Improvement needed STOP 14. FOLLOW THE IMPACT OF RA 15. MAKE RE-ASSESSMENT Improvement yes No improvement

17 Prof. Jorma Rantanen/TWIN2KICKOff Consequences/Slightly harmfulHarmfulExtremely harmful probability Discomfort, irritation,Long-lasting serious Constant serious effects, mild disease, draught,effects, burns,life shortening diseases, small burns, reddeningfrostbites, hearingpoisoning, work-related of the skinloss, vibration whitecancer, asthma, drowning, finger, electric eye,loss of vision, heart skin rashesattack Highly unlikely1. Trivial risk2. Tolerable risk3. Moderate risk less than 50%(no action)(monitoring)(actions needed) of the OEL Unlikely2. Tolerable risk3. Moderate risk4. Substantial risk % of(monitoring)(actions needed)(actions necessary) the OEL Likely3. Moderate risk4. Substantial risk5. Intolerable risk exceeding the(actions needed)(actions necessary)(instant actions) OEL A simple health risk classification for chemical and physical factors based on British standard BS 8800

18 Prof. Jorma Rantanen/TWIN2KICKOff Those at risk of violence or threat of violence during the past 12 months, by age groups, % of respondents (Source: Piirainen et al. 2000) women

19 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

20 Prof. Jorma Rantanen/TWIN2KICKOff Rates of accidents (total number/1000) and fatal accidents/ in the EU by age group (EUROSTAT 1998)

21 Prof. Jorma Rantanen/TWIN2KICKOff Incidence of 31 occupational diseases in the Member States of European Union in 1995 (Karjalainen and Virtanen 1998)

22 Prof. Jorma Rantanen/TWIN2KICKOff Work-relatedness of common chronic diseases % Asthma (adult males) 30 (Karjalainen et al, 2001) Lung cancer (Axelsson 2001) Cardiovascular disorders CHD 5-10 (Leigh 1997) Cardiovascular 5 (Leigh 1997) Musculoskeletal disorders Upper extremities (EU OSHA) Low back pain 50 ? (NAS 2001) Total mortality 6.7 (Nurminen Karjalainen 2001)

23 Prof. Jorma Rantanen/TWIN2KICKOff SERVICES

24 Prof. Jorma Rantanen/TWIN2KICKOff Workers covered by OHS in Europe (Source: Hämäläinen et al 2001, Rantanen 2002) %

25 Prof. Jorma Rantanen/TWIN2KICKOff MOH&S or MOL LABOUR INSPECTORATE IOH IN-COMPANY OHS GROUP OHS PHC Private center Big company SMECompanySESME SSESME DOH&SDOH INTEGRATED OH&S SYSTEM OM OM CLINICS SE

26 Prof. Jorma Rantanen/TWIN2KICKOff Dept. of Health and OHE Social Welfare District health office OHE Municipal health Director OHE Gjakova IOH IPH OH Unit Pristina District hospital Big industry OHS Obiliq Referral Family health centre Group service Branch OHS OHE = occupational health expert IOH = Institute of Occupa- tional Health IPH = Institute of Public Health OHS = Occupational Health Services OH System for Kosovo (Rantanen,UNMIK and WHO 2000)

27 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

28 Prof. Jorma Rantanen/TWIN2KICKOff Workers covered by OHS (Source: Hämäläinen et al 2001) %

29 Prof. Jorma Rantanen/TWIN2KICKOff Finnish model for OH&S COMPETENCE and skill development HEALTH, Work ability OHS,WHP WORK ENVIRONMENT, Risk assessment, Risk management Ergonomics Safety promotion etc. WORK COMMUNITY, Participation, Working cultures Work organization High quality work life

30 Prof. Jorma Rantanen/TWIN2KICKOff 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"

31 Prof. Jorma Rantanen/TWIN2KICKOff Scientific evidence, prediction and risk assessment Professional competence experience, multidisciplinarity Needs analysis Client participation Infrastructure, resources, coverage, operability GOHP Good occupational health practice (GOHP)

32 Prof. Jorma Rantanen/TWIN2KICKOff CHANGE

33 Prof. Jorma Rantanen/TWIN2KICKOff Roger´s diffusion (1980) Time % degree of adoption Innovators Early adopters Early majority Late majority LAGGARDS

34 Prof. Jorma Rantanen/TWIN2KICKOff Rule of law index and safety (Source: World Development Report 2000/2001) 2 10 Rule of law index Fatal accident risk cases/ ,000 30,000 Rule of law index GDP/CAPITA USD 20,000

35 Prof. Jorma Rantanen/TWIN2KICKOff Comprehensive OHS&MWA Project at Dahlbo Co (Source: Näsman and Ahonen 1999) Input costs FIM/Yr Benefits: 10-fold Reduction of sickness leave costs FIM/Yr Increased productivity 1, FIM/Yr Reduction of work disability pension costs 1,

36 Prof. Jorma Rantanen/TWIN2KICKOff Economic benefits from PMWA (Source: Peltomäki et al 1999)

37 Prof. Jorma Rantanen/TWIN2KICKOff Summary: 21st Century Challenges to the Profession l From care to prevention, promotion and development l Broadening competence l From OM to OH l Multidisciplinary collaboration l Maintaining professional leadership l Self-evaluation l Drawing from research

38 Prof. Jorma Rantanen/TWIN2KICKOff Summary: 21st Century OHS l Work life will need OH&S more than ever l Full coverage of services need to be organized l Content and competence of OHS need to be renewed l New service provision models are needed l Multidisciplinary, comprehensive approach l OHS has been found productive in view of health, work ability and enterprise and national economy


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