1. Facilitating Effective and Reliable Resources for Occupational Safety and Health in the Turkish metal sector Funded by the Netherlands embassy, Ankara, Turkey

2. Basic Occupational Health Services derived from material of the Coronel Institute, Academic Medical Center in Amsterdam, The Netherlands and with permission to use texts and figures of J. Rantanen of the Finnish Institute of Occupational Health in Helsinki, Finland 19/09/20152

3. 100- 200 million migrant workers 690.000 cases occupational diseases (most pneumoconiosis) 10 % OHS coverage BOHS pilot study in 19 counties Exploration various models, workers’ participation, integration with primary health care 19/09/20153

4. Coverage of OHS in 21 countries. 80 % of the working population has no access to OHS courtesy of J Rantanen

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7. Poor access to OHS especially for Developing countries, but also for special underserved groups & branches of industry in the developed world Small and medium sized companies and self-employed Agriculture, health care workers, construction industry, hotels/restaurants, Informal workers, illegal workers Child workers 19/09/20157

8. Stage I Starting level Stage II Basic Service Stage III International Standard Service Stage IV Comprehensive Service Field nurse Safety agent Physician and nurse with short special training Multidisciplinary team with special training Multidisciplinary specialists' team Advice in OH Accidents and ODs Acute ill-health PHC PHC Infrastructure Basic OHS content Toolboxes OHS Infrastructure ILO No. 161, 155 Multidisciplinary cont. Prevention plus curative services In-company or external special OHS units Comprehensive content: prevention, curative and promotion & develop- ment services Continuous development Objective for all ! SMEs,SSEs,SEs,IFS Big industries and Big OHS Centres courtesy of J Rantanen BOHS

9. Models for basic health service delivery Primary and community health care model Big company model Group services Social security model Industrial branch wise organisation Private physician and private health centre Local or regional hospitals Unions ? 19/09/20159

10. Integrated OS&H system National level Intermediate level Local level Regulation & policy Support services Service provision courtesy of J Rantanen

11. Other countries are active http://www.who.int/occupational_health/network/gohnet_15.pdf http://www.who.int/occupational_health/network/gohnet_15.pdf

12. China A large experiment with basic occupational health services in the province of Baoan. Conclusions of the evaluation: BOHS is feasible and effective – more awareness of hazards workers: increase 44% to 88 %; managers 55% to 95 % – BOHS coverage rose from 35 % to 82 % – Workers with health surveillance was 29%, now 81% – BOHS feasible, acceptable and affordable 19/09/201512

13. What are the features of BOHS? 1 focus on prevention with low-cost solutions primary or community health-care approach co-ordinated by health AND labour administration address local needs, applied to local conditions 19/09/201513

14. What are the features of BOHS? 2 affordable for companies and workers mostly organized by the employer for employees or provided by the public sector for self-employed and informal sector supported by intermediate level infrastructure part of universal social protection 19/09/201514

15. Surveillance of Work Environment Work Environment Risk Assessment Initiatives Accident prevention Prevention of OH hazards Emergency preparedness Evaluation Record keeping Surveillance of worker's health Assessment of individual's health risk Health education and health information Diagnosis of Occupational and Work-related Diseases First aid General health service Work environment Work organization Evaluation Interaction & Monitoring & Action Worker Orientation and planning Information Education Individual health record Initiatives Interaction & Initiatives Assessing The main activities and tools