OSH challenges and perspectives in the new EU-Member States: Northern Dimension Partnership in Public Health and Social Well-being (NDPHS) Annual Conference “HEALTHY LIFE – HEALTHY WORK” Vilnius, 15 Nov 2007 OSH challenges and perspectives in the new EU-Member States: the case of Lithuania Romualdas Sabaliauskas Secretary of the Ministry of Health of Lithuania

Contents of the report Organisation of OS&H in Lithuania Situation and problems of OSH in Lithuania in the context of EU Member States Challenges for the implementation of WHO, ILO and EU occupational health and safety strategies in Lithuania National strategy for strengthening OSH services

Total Men (%) Women (%) Population, thousands 3.403 46,6 53,4 Employed, thousands 1.482 49,5 50,5 Average life expectancy at birth, years 71,1 65,3 77,0

Organization of OH&S system in Lithuania

Hazardous health conditions at work in Lithuania and EU-25 (EF 2005 survey of working conditions)

Workers exposed to health hazards at work in Lithuania and EU-25 (EF 2005 survey of working conditions)

Occupational health status and problems in Lithuania and EU-Member States (1) In Lithuania, compared to EU-25, more workers are faced to hazardous health factors, especially noise (10% ), low temperature (9.5%), standing and walking (8 %), heavy loads, vibration, dust, vapour, cigarette smoke (7.5%). (2) In Lithuania, compared to EU-25, more workers point out that work harms their health, especially due to the general fatigue (19%), back and muscle pain (14%), sight problems (13.5%), sleeping disorders, headaches (11%), breathing and skin problems and stress (10%).

Trends of fatal accidents at work in Lithuania and EU-15 (1998 = 100, Eurostat, 2005)

Trends of occupational diseases in Lithuania (State Register of Occupational Diseases, 2007)

New cases of occupational diseases in Lithuania and the old EU-Member States (Eurostat; National Register of occupational diseases,2004) Lithuania EU 12 ______________________________________________________________ All cases (per 100 thous. employed) 65,4 37,0 men 113,8 47,8 women 18,1 22,0 Age groups (years) 25-34 1,8 22,4 35-44 8,7 31,1 45-54 74,1 39,2 55-64 322,0 69,2 (“Visuomenės sveikata” (Public Health),Vol.31,2005)

Occupational diseases in Lithuania according to the sector and the status of employment (State Register of Occupational Diseases, 2006)

Perceptions of OH&S stakeholders on activities of OH services in Lithuania, Estonia, Latvia and Czech Republic (EU Inco-copernicus project, 2002) employers employees experts and representatives representatives administrators _______________________________________________________________________________________ Number of OH professionals sufficient physicians 26 25 25 hygienists 20 20 20 nurses 13 22 30 Medical services are available for those at risk large enterprises 53 39 55 medium enterprises 21 26 30 small enterprises 9 20 17 Well organized: registration of risks and injuries 16 10 30 Prevention actions 32 17 21 distribution of OH&S information 25 13 20

Occupational health status and problems in Lithuania and EU-Member states (3) In Lithuania, compared to other EU countries, the number of occupational medicine physicians is the lowest. Number of OH physicians per 1 thousand of workers is over 10 times less than in the neighbouring Latvia and Scandinavian countries. (4) Lithuania, like other new EU-Member States has not established an efficient system of occupational health services responsible for health care of the employed. As a result only large enterprises provide access to health care services to their workers while workers of medium and small enterprises do not have such services.

International standards for the development of OH&S systems and policies National System for Occupational Safety and Health Each Member shall establish, maintain, progressively develop and periodically review a national system for occupational safety and health, in consultation with the most representative organizations of employers and workers. (Article 4 of C187) National Programme on Occupational Safety and Health Each Member shall formulate, implement, monitor, evaluate and periodically review a national programme on occupational safety and health in consultation with the most representative organizations of employers and workers. (Article 5, C187) Occupational health services Each Member State undertakes to develop progressively occupational health services for all workers, including those in the public sector and the members of production co-operatives, in all branches of economic activity and all undertakings. The provision made should be adequate and appropriate to the specific risks of the undertakings. (Article 3, C161)

Expert estimation of the Lithuanian national system for OH&S (1996-2007) Main Components fully considerable some not achieved progress progress started __________________________________________________________________________________ OH&S legislation yes Authority, responsible for OH&S yes Inspection system yes Cooperation between E and W yes Tripartite advisory body yes Information and advisory services yes OH&S training system yes Occupational Health services yes OH&S research yes OA and OD data collection yes Occupational injuries insurance yes

Expert estimation of the Lithuanian national programmes for OH&S (1996-2000 and 2002-2004) Main Components fully considerable some not achieved progress progress started __________________________________________________________________________________ Promotion of the development of the national OH&S culture yes Contribution to the workers health protection yes Analysis of the national OH&S system yes Setting of the expected results and indicators of progress yes Support by the other national programmes yes

Expert estimation of the Lithuanian occupational health services (1995-2007) Main functions fully considerable some not achieved progress progress started _________________________________________________________________________________ Risk identification and assessment yes Surveillance of risks at work yes Advice on work organization yes Participation in the development of prevention programmes yes Advice on OH&S yes Surveillance of workers health yes Promotion of adaptation of work to worker yes Contribution to vocational rehabilitation yes Information, training and education yes Organization of first aid yes Analysis of occupational accidents and diseases yes

Main objectives of the planned National OH&S strategy for the years 2008-2012 Improvement of OH&S legislation: updating of existing legislation according to the EU and social partners requirements monitoring of legal requirements implementation Improvement of OH&S education, training and information system: promotion of OH&S prevention culture introducing OH&S training elements in all on-going programmes creation of full access OH&S information system development of OH&S research strengthening of intersectoral collaboration Enforcement the capacities for occupational health care: strengthening of occupational health services improvement of the basis for occupational health provision improvement of the qualifications of OH professionals increase the number of occupational medicine physicians

Outline of the planned activities for the implementation of the national OH&S strategy Lithuania has defined its OH&S problems and is ready for immediate actions. The national strategy implementation is foreseen as a considerable challenge for Lithuania as well as for other new EU-Member States. The expected results within the implementation of the Lithuanian OH&S strategy during the 2008-2012 years period are as follows: Decreasing the number of heavy and fatal accidents at work per 100 thousand employees; Increasing the number of occupational medicine physicians and other occupational heath professionals per 100 thousand employees; Increasing the number of in-plant and external occupational health services as well as increasing the percentage of enterprises that have implemented the international heath and safety management (OHSAS) system.

Thank you for your attention