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WHY IS MEDTRA PROJECT BORN Occupational Medicine Training Course

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1 WHY IS MEDTRA PROJECT BORN Occupational Medicine Training Course
WHY IS BORNE THE IDEA OF MEDTRA PROJECT WHY IS MEDTRA PROJECT BORN Occupational Medicine Training Course WHY IS BORNE THE IDEA OF MEDTRA PROJECT Occupational medicine training course

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4 Safety, Health and Environment
  Around the world, millions of men and women work in poor and hazardous conditions: Every year, more than 2 million people die of work-related accidents and diseases. More than 160 million workers fall ill each year due to workplace hazards. The poorest, least protected - often women, children and migrants - are also among the most affected. Micro- and small enterprises account for over 90 per cent of enterprises where conditions are often very poor and the workers in them are often excluded from all labour protection.

5 Human suffering has no measurable cost, unlike economic losses
Human suffering has no measurable cost, unlike economic losses. Estimates from, for example, the United States, the United Kingdom, Germany and Norway put the direct cost of accidents in billions of dollars. In many developing countries, death rates among workers are five to six times those in industrialized countries. Yet the phenomenon is still largely undocumented and there is insufficient political will to address the problem.

6 Global competition, growing labour market fragmentation and rapid change in all aspects of work creates a mounting challenge for labour protection, especially in developing countries. Workers in rural areas and the urban informal sector are often ignored or difficult to reach.

7 Safework will be focused on hazardous work and will give primary attention to workers in especially hazardous occupations in sectors where the risks to life and safety are manifestly high, such as agriculture, mining and construction, workers in the informal sectors, and those occupationally exposed to abuse and exploitation, such as women, children and migrants.

8 Showing that protection pays.
The prevention of accidents, improvement of working conditions and enforcement of standards are often seen as a cost to business. Little is known about the costs of not preventing accidents or poor working conditions, or of the benefits of improvements for productivity and competitiveness. Better information and analytical tools can help increase firms' and governments' willingness to invest in prevention.

9 . Main steps -Importance of the problem of cost evaluation and different approaches -Different categories of cost Impact of security and health costs at company level -Identification of the economic optimal point -Decision model

10 Base considerations on enterprises and costs
There is conflicting evidence as to whether or to what extent investment in Health and Safety will actually produce net benefits or net costs to a firm and varies depending on: The nature of the enterprise; The sector in which it is operating and the nature of the hazards which it generates; Whether there is a low or high risk.

11 A classification of safety costs
Here is presented a classification of safety costs as the whole coming from the simultaneous consideration of the costs coming from accidents, illnesses, injuries and of the cost supported to manage the risk. Main goal will be the demonstration that the correct management of safety costs does not always translate in an increase of total cost. Therefore increase of safety and decrease of total cost may go together in safety management too.

12 Enterprise costs Costs supported by enterprises are not the only costs connected to safety because there are social and workers costs too. Nevertheless a correct management of costs made by the enterprise has positive effects on the other two categories and may, therefore, be considered as the activity to start with.

13 Main categories of costs
. Main categories of costs Main categories of costs may be divided into two groups: -Costs for accidents and illnesses -Costs for risk management Precisely the first group concerns the costs that have to be sustained while an accident has already occurred while the second group concerns the costs that have to be sustained to reduce the risk.

14 . Costs for accidents The costs for accidents and illnesses may be divided respectively into three categories: -Direct and indirect costs -Insured and non insured costs -Controllable and non controllable costs

15 Insured and non insured costs
. Insured and non insured costs Normally there is a compulsory insurance for enterprises concerning working injuries but this is not a rule everywhere. Anyway the insurance gives a refund to the employer for the days of absence caused by accident. A correct insurance protects against loss of product and against loss of resources coming from an event reducing production capacity

16 Hidden and explicit costs
. Hidden and explicit costs Hidden costs represent all costs that normally do not appear in budget and therefore are hardly traceable or not clearly connected to safety management. Normally the impact of hidden costs is considered almost four times of the one of explicit costs. Explicit costs are, obviously, all those expenses that are certainly afforded in connection to safety management.

17 . Costs for community Society too have to face a share of economic passivity coming from professional illnesses and working accidents. This because where there is a compulsory public insurance system some of these costs are covered by public bodies and, therefore, by society with a higher taxation. This is why these are considered social costs.

18 . Main social costs -Costs for National Health System managing services aimed to the prevention, diagnosis, cure and rehabilitation with direct incidence on public expense concerning health; -Costs of justice administration concerning legal procedures connected to work accidents; -Costs coming from specific law production.

19 . The large majority of workers whose conditions are most in need of improvement are excluded from the scope of existing legislation and other protective measures. Existing policies and programmes need to be reviewed to extend their coverage. This will go hand in hand with action to strengthen labour inspectorates' capacity to develop broad prevention policies and to promote the protection of vulnerable workers, particularly women workers.

20 Alliances and networks will be extended to include ministries of health, industry, local government, education, and social services, as well as Universities. Emphasis will also be placed on achieving tangible results through practical action and exchanges of information on good practices.

21 Promoting workers' health and well-being.
The strategy to promote workers' health and well-being will involve the establishment of a data bank on policies, programmes and good enterprise-level practices so as to improve constituents' capacity to identify workers' protection issues and to provide guidance on new approaches.

22 Promoting workers' health and well being:
a data bank on policies, programmes and good enterprise-level practices; -training methodologies and diagnostic tools; -guidelines on occupational health care for all; -programmes to prevent and deal with the effects of workplace problems, including drugs, alcohol and stress;

23 Showing that protection pays
a statistical programme to develop new survey tools, carry out national surveys; - better national and global estimates of occupational fatalities and injuries; - report on the economics of accidents and preventive measures; - tools for inspection services to promote the benefits of prevention; - guides on occupational safety and health management systems and safety culture.

24 Sapienza developed during more than fifteen years a safety and health culture, forerunner compared to the slow awareness to safeguard worker’s safety and health and specially the students. The idea of Universitas, enlarged to the different programs of international mobility, more and more allowing students and searchers to move toward other universities and international research centres is setting up a new problem concerning the potential health risks connected with this mobility and the related responsibilities of the interested institutions.

25 Inside this mobility, when someone applies for foreign universities, many of these, to protect themselves , are starting to ask certificates testifying the clinical status of the students and/or searchers before accepting the applicants. This means that each University must be organised to support these requirements.

26 Specific working characteristics of the University (multiplicity of subjects attending the structures, risks connected with studying and working activities et cetera) strongly bring in evidence the preventive function that the worker care can assume when it is addressed to consistent social groups homogeneous in age, sex and working activity. The Centre of Occupational Medicine ( CMO ) is the sanitary structure created by the University “La Sapienza” to carry out the sanitary care, according to the law and to solve these problems. The different activities characterising the University are strongly inhomogeneous.

27 While the management is referred to planned systems and hence easily inserting in standardized situations referable to predefined models, didactic activity is only partly referable and must be correlated to the specific didactic disciplines in function of the differences of the risks: Low Risk : Law, Literature et cetera; High Risk : Chemistry, Biology, Medicine et cetera; The situation becomes more and more complex where research is carried out and acts also as a support to the didactic, specially in the fields where laboratory processes, connected to researches and hence innovative, are bound to operative variable conditions, not standardized, not reciprocally related to predefined models.

28 Preventive action carried out by CMO over a large number of workers allows an early identification of a number of pathologies, and a consulting of already known pathologies not work correlated, pathologies that almost systematically evolve in worsening having a negative relapse on social expenses. CMO takes on a particular relief in the prevention, in the limitation of public sanitary costs and in organising financial and logistic resources of a big multifunctional factory.

29 TEMPUS MEDA, action founded by European Commission, enables Universities from EU Members States to cooperate with the Mediterranean partner countries in higher education modernisation projects. University is a community sometime larger than a city where, searchers, technicians, management and, students seen as workers, live large part of his life, so they must be protected concerning their health and safety, applying all the best measures and rules considering their specific activities inside the Institution with particular attention to some dangerous research activities. .

30 International rules assimilate Students to the workers and their health and safety must be protected, considering them as to be a specific multiple risk group, in function of the activity they carry out inside the different departments and the different structures and laboratories were they develop their studies and researches.

31 EUROPEAN COMMISSION MEDTRA JEP_33042_2005
Directorate-General Education and Culture Tempus application form Joint European Project 2005 Occupational Medicine Training Course MEDTRA JEP_33042_2005

32 Title of the project: Occupational Medicine Training Course
• Acronym of the project:MEDTRA • Specific Objectives of the project: Training medical experts in Occupational Medicine and creating a vocational profile, awareness and a spread out culture in safety of the workplaces. MEDA DZ – Algeria MA – Morocco EG – Egypt PS – Palestinian Authority IL – Israel SY – Syria JO – Jordan TN – Tunisia LB – Lebanon

33 MEMBERS OF CONSORTIUM Syrian Ministry of Labour And Social Affairs
Unimed University “La Sapienza” University of Malta University of Damascus Aleppo Homs AL-Baath

34 In the Syrian faculties of Medicine there are no programs of study and specific interventions for the occupational medicine nor specific intervention for the subject. There is only a program dedicated to professional illness and managed within the activities of international health, in cooperation with the Ministry of Health. As a consequence of the Syrian government growing interest in industrial safety (testified by the issuing of laws and decrees related, for example, to the safety of pregnant women and working mothers, to the protection from sources of ionising radiations, related also to aspects of social security about work accidents and occupational diseases), it is necessary to prearrange national and specific advanced training courses in Occupational Medicine,

35 This specialty is currently performed only by few medical doctors in the whole Syria, completely insufficient and inadequate to the situation. Hence it is important and necessary to create an Occupational Medicine Centre. There is a need to define a program of complete intervention and efficient enough to satisfy the necessity of the country. This one must have as a priority the training of a sufficient number of specialized medical doctors in Occupational Medicine taking into account the number of inhabitants and looking at international standards in this field. The economic, agricultural and industrial development in Syria has created a new situation that includes all the characteristics and problems of the industrial environment, including the different risk factors cause, without doubts, of different professional illnesses.

36 Occupational Medicine Training Course MEDTRA
The project has been realised because of the precise wish of the Syrian Universities requesting collaboration to EC Universities to renew their “curricula”. The choice of the Universities of Rome “La Sapienza” and Malta comes out from the already existing cooperation for a long time in the different sectors, and the specific expertise in the subject. Moreover, all the Syrian Universities and the Universities of Malta and of Rome “La Sapienza” were Unimed members. On the basis of the JEP project Damascus University solicited Unimed to submit the project.

37 Taking into account the rules of the EU, Unimed and Damascus University have involved all the Syrian Universities with a Faculty of Medicine, and the Ministry of Social and Labour Affairs. This latter, is particularly interested in the creation of a new professional profile and it strongly supports the submission of the proposal. For Syrian Authorities, (as for the Public Authorities all over the world) having professional figures capable of dealing with health and security controls in workplaces, represents considerable savings of economic resources. In facts the costs of sanitary assistance to the workers is absolutely incomparable with the ones sustained for the prevention of work injuries.

38 UNIMED signed Grant Agreement in september 2008

39 After a preliminary meeting held in Damascus on 2007 October 2nd, with the participation of the consortium members, the course started on 2007 November 25th, carried out one week per months, according to the work plan as above. The partners agreed in holding the course in Damascus University, one week per month. EC agreed in such a kind of mobility.

40 Selection of the trainees, cared by the Syrian partners Universities, under the supervision of the European Coordinator. The Selection of the trainees is based on examination of their curricula vitae, taking into account the following requirements: -Knowledge of English language, -Post-Laurea specializations or doctorates dealing with social medicine, preventive workers medicine and psycho-technique, occupational medicine, industrial and environmental hygiene, legal medicine. -Degree thesis dealing with the above mentioned arguments

41 -Working experiences and/or apprenticeship dealing with subjects as above, in private companies or in public institutions, both at national or international level -Publication of articles on specialised magazines, and/or participation in congress or seminars These outcomes of activity have been agreed by a joint Commission of the consortium partners.

42 Upgrade of equipment A market analysis has been performed, in order to investigate the items to be bought in Europe or in Syria. Within MEDTRA Project preliminary meeting the places where the equipment has to be installed has been decided: the Department of Family and Community Medicine within the Faculty of Medicine of Damascus University and the faculty of Medicine in Aleppo and Homs University.

43 After having collected three different offers both from EU and from Syrian Companies, it was decided according to EU addresses to buy equipment in Syria, also to save delivery expenses. The project partners decided to purchase the equipment items per different lots, starting by Chemical and Environmental ones. Three Syrian companies sent to UNIMED the offers: a letter asking for clarifications on brands, technical characteristics and prices, prepared by EU experts has been sent to the Syrian companies,

44 training programme COURSE CONTENTS FIRST YEAR
Module n.1 – Occupational medicine: knowledge, development and purpose)Rome “la Sapienza” Prof. Giuseppe D’Ascenzo Prof. Fabrizio D’Ascenzo Module n.2 – Professional disease, outline of hygiene on workplace and industrial hygiene. Rome“La Sapienza”Prof. Alessandro Bacaloni Module n. 3 – Safety and health on workplace: legislative contents Simonetta Sandri (external expert) Damascus University Prof. Ahmed Deeb Dashash) n.4 – Risk evaluation: Principles of Industrial Toxicology. Rome“La Sapienza” Prof. Fabio Naro

45 Module n.5 – Practical exercise: analysis and survey of the occupational risks through the design of an innovative health risk evaluation form surveying occupational risks in the University context. Rome “la Sapienza “ Prof. Sabina Sernia Prof. Fabio Naro Module n.6 – Risks and health protocols: from risk evaluation to health monitoring Rome “la Sapienza”-Ispesl Prof. Roberta Curini Module 7 - Epidemiological and health statistics Malta University Dr. Julian Mamo Dr. Neville Calleja

46 COURSE CONTENTS SECOND YEAR
Module n.1 Professional pathology, biological monitoring and exposure limit values Rome “la Sapienza” Prof. Sabina Sernia Prof. Giuseppe D’Ascenzo Module n.2 Professional cancer ge nesis and teratogenesis Malta University Dr. Alfred Cuschieri Module n.3 Professional organic pathologies: Lung and Skin. 2 Syrian teachers

47 Module n.4 Professional organic pathologies: Visual Auditory and Cardiovascular apparatus, Kidney.
4 Syrian teachers, being one of them prof Reem Zarawi from Aleppo University Module 5 – Liver, Osteo-articular and Nervous system 3 Syrian teacher Module 6 - Biological risk. Risks and pathologies in medical professions Malta University Dr. Paul Cuschieri” Module 7 - Management of workplace’s sanitary emergencies: first aid in workplaces. Rome”La Sapienza

48 Module 9 -Design of sanitary complex systems monitoring -Rome”La Sapienza” -Syrian teachers Module 8 -Normalization and management of sanitary data. -Rome”La Sapienza” -Syrian teachers

49 (second session) SEPTEMPER 2009 PRACTICAL STAGE IN ROME
FINAL EXAMINATIONS (first session) JUNE 2009 (second session) SEPTEMPER 2009 Third year’s activity PRACTICAL STAGE IN ROME 20 Syrian trainees for 1 week in Rome subdivided in 4 groups (total 4 weeks) Friday 2 – Friday 30 October 2009.

50 branches in Aleppo and Al-Baath Homs University.
MAJOR FUTURE GOAL Establishment of an Occupational Medicine Centre in Damascus University, Faculty of Medicine, Department of Family and Community Medicine. branches in Aleppo and Al-Baath Homs University.

51 Sustainability The sustainability of the training will be carried out through future benefits to the project beneficiaries such as: The possibility for the Syrian universities to organise new degrees concerning safety and security in workplaces and specifically in the field of Medicine (Damascus and Aleppo universities) and in the field of Chemistry (Al Baath university) where the courses of MEDTRA project will be considered as credits to obtain the final degree.

52 The possibilities of further opportunities for PhD degrees and Master degrees in Italy at the University “La Sapienza” also through fellowships of the Italian Ministry of Foreign Affairs (One student already applied and won a fellowship for a three years PhD in Rome “La Sapienza” University, starting on November 2008).

53 The importance of the economic implication of this field and potential to develop the idea into further proposals. - Special attention, according to European rules has been given to the problem of particular risks, as for example chemicals agents, biological agents and carcinogens risks which need a particular specialist background like for example chemists and, to support this theory, chemists of Al Baath University have been admitted to the course.

54 - An agreement has been signed between ISPESL (Superior Institute for Prevention, Protection and Safety on Work in Italy) and the Syrian Universities, to establish possible initiatives of mutual interest, exchange of researchers, joint research programmes and technical contributions, to participate in the examining boards for the defence of some post-graduate thesis, to organize in cooperation with the concerned governmental authorities reciprocal qualification, recognition, rules plus the conditions of study stages and scientific degrees to enable students and graduates of either the university or ISPESL to pursue their studies in other institution.

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