1. Pan American Health Organization.... Title of the presentation Author Title of the presentation Author III HEMISPHERIC WORKSHOP ON OCCUPATIONAL HEALTH AND SAFETY “Searching for improvements in the Occupational Health and Safety conditions of our workers” Cusco, Peru October 21 st, 2008 Dr. Luz Maritza Tennassee Senior Regional Advisor on Workers' Health Marie-Claude Lavoie

2. Pan American Health Organization Acknowledgments  OAS  Minister of Labor and Employment Promotion of Peru  ILO  OAS Members countries  WHO/ PAHO Collaborating Centers in Occupational Health  OAS  Minister of Labor and Employment Promotion of Peru  ILO  OAS Members countries  WHO/ PAHO Collaborating Centers in Occupational Health  National Councils for Occupational Health  Civil Society  Unions  Employers  Academia  WHO/PAHO colleagues

3. Pan American Health Organization Global Burden of Disease from Occupational Diseases and Injuries  25% of the global burden of disease and mortality is due to occupational and environmental risk factors 1  2 million deaths per year globally are attributable to occupational diseases and injuries 2  90,000 die annually from asbestos- related diseases 3  25% of the global burden of disease and mortality is due to occupational and environmental risk factors 1  2 million deaths per year globally are attributable to occupational diseases and injuries 2  90,000 die annually from asbestos- related diseases 3 Global burden of disease: occupational risk factors 1. Pruss-Ustun & Corvalan 2006; 2. ILO/WHO 2005; 3. WHO 2006

4. Pan American Health Organization Workers' Health in Latin America and the Caribbean Inequities 27,000 – 68,000 work- related fatalities/ year 1 20 - 80 million workers suffer from occupational injuries or diseases 1 20 - 40% of the employed population do not have sufficient economic resources to meet the minimum for the healthy living 1 Only 10 - 15 % of workers have access to a basic occupational health services 3 Mortality is higher among temporary workers compared to permanent workers 4 Hispanic workers in the US have a 25% higher risk of dying than non-Hispanic workers 2 1. PAHO Health in the Americas 2007; 2. NIOSH World Health Chartbook 2004; 3. Rosenstock et al. 2005; 4. WHO Commission on the Social Determinants of Health 2008

5. Pan American Health Organization Only 5 - 10% of all occupational diseases are reported 5% of occupational research is conducted in developing countries which possess 90% of the burden of disease

6. Pan American Health Organization Universal Declaration of Human Rights 1948 ILO Occupational Cancer Convention (C139) 1974 UN Conference on Environment and Development, Brazil 1992 WHO Global Strategy on Occupational Health for All 1995 Rotterdam Convention 1998 World Summit on Sustainable Development, South Africa 2002 Millenium Development Goals 2000-2015 Summit of the Americas 2005 ILO Promotional Framework for OSH Convention (C187) 2006 Regional and Global Mandate IV Summit of the Americas DECLARATION 33. We will promote integrated frameworks of public environmental, employment, health, and social security policies to protect the health and safety of all workers and foster a culture of prevention and control of occupational hazards in the Hemisphere ACTION 16. To promote occupational health and safety conditions and facilitate healthy work environments for all workers, and, to that end, ensure effective labor inspection systems. For this purpose, it is essential to foster strategic alliances between the labor, health, environment and education sectors.

7. Pan American Health Organization WHO Workers’ Health Global Plan of Action (2008-2017) 1.Provide and communicate evidence for preventive action Systems for surveillance of workers’ health for the identification, and control of occupational hazards and occupational diseases and injuries 2.Devise national policy instruments on workers' health 3.Protect and promote health at the workplace 4.Improve the performance of and access to occupational health services 5.Incorporate workers' health into other policies 1.Provide and communicate evidence for preventive action Systems for surveillance of workers’ health for the identification, and control of occupational hazards and occupational diseases and injuries 2.Devise national policy instruments on workers' health 3.Protect and promote health at the workplace 4.Improve the performance of and access to occupational health services 5.Incorporate workers' health into other policies http://www.who.int/gb/ebwha/pdf_files/WHA60/A60_R26-en.pdf

8. Pan American Health Organization  Driving Forces –Globalization  Pressures –Agricultural industrialization –Technology transfer  Situation –Composition of the labor force –Migration  Exposure –Psychological, ergonomic, chemical, safety, biological and physical  Effects –Lost work days, accidents and occupational diseases –Low productivity and social costs  Driving Forces –Globalization  Pressures –Agricultural industrialization –Technology transfer  Situation –Composition of the labor force –Migration  Exposure –Psychological, ergonomic, chemical, safety, biological and physical  Effects –Lost work days, accidents and occupational diseases –Low productivity and social costs Action Policies and legislation Healthy workplace environment Promotion of decent work Comprehensive occupational health services Information systems Information System for Action

9. Pan American Health Organization Governmental Institutions Governmental Institutions International Databases International Databases Academic Individual Sub-group Population Sub-group Population Extrapolated Data Sources Measurement Data Policy Programs and interventions Situation analysis Research Functions Private Sector Unions Private Sector Unions Occupational Health Surveillance Systems Ongoing systematic collection, analysis, interpretation, and dissemination of data for purposes of improving health and safety Used to record occupational injuries, illnesses, hazards and exposures Occupational Health Surveillance Systems Ongoing systematic collection, analysis, interpretation, and dissemination of data for purposes of improving health and safety Used to record occupational injuries, illnesses, hazards and exposures Others Social, economic, political, cultural contexts,

10. Pan American Health Organization Situation PLAGSALUD (Occupational and Environmental Aspects of Exposure to Pesticides) Local Sectoral Pesticide Commissions (CLIPS) Ministry of Environment Ministry of Labor Situation Analysis Working hours and Conditions Child Labor Gender Use of Safety Equipment Training Ministry of Agriculture Ministry of Health Health Impact Lung cancer Cervical cancer Skin cancer Neurological dysfunction Health Impact Lung cancer Cervical cancer Skin cancer Neurological dysfunction Local health care facilities Acute Pesticide Poisoning Civil Society Community participation- Policies-Training- Inter Sectorial Coordination- Surveillance- Research

11. Pan American Health Organization PLAGSALUD Impact  Acute pesticide poisoning surveillance integrated into national epidemiological system;  300 (CLIPS) Intersectoral local commissions across 7 countries;  Legislation for the ban or restriction of 119 pesticides across 7 countries  Education (various topics, and audiences)  Development of alternatives agriculture  Acute pesticide poisoning surveillance integrated into national epidemiological system;  300 (CLIPS) Intersectoral local commissions across 7 countries;  Legislation for the ban or restriction of 119 pesticides across 7 countries  Education (various topics, and audiences)  Development of alternatives agriculture Reduction of occupational mortality and incidence of acute intoxications in Nicaragua, 1994-2006

12. Pan American Health Organization Worker ’ s Health Referral Centres (CEREST) South 28 North 19 Middle- west 14 North-east 56 150 installed (2007) Goal – 200 (2008) Number of Workers’ Health Referral Centres (proportionally with regions’ population) South-east 83 Functions : Give technical support for workers’ health assistance, surveillance and promotion to all levels of public health services (primary, secondary, hospitals and surveillance services) 150 services (2007)

13. Pan American Health Organization ILO/WHO International Programme on the Global Elimination of Silicosis Americas Silicosis Initiative WHO, PAHO, ILO, U.S NIOSH, Chile Institute of Public Health and Ministry of Health, Brazil FUNDACENTRO, Peru MODELO DE MATRIZ DE EXPOSICION OCUPACIONAL Rama Económica A Rubro con actividades presencia de Sílice N° de Trabajadores No Expuestos a Sílice N° de Trabajadores con probabilidad Baja a Mediana de Exposición a Sílice N° de Trabajadores con alta probabilidad de Exposición a Sílice National Plan-Program components 1.Implementation of control methodology 2.Laboratory Analytical Techniques 3.Respiratory Protection Training 4.Training courses on spirometry & radiologic ( ILO technique) 5.Silicosis Surveillance System Crystalline silica  Group1 human carcinogen  Million of workers exposed Silicosis  Incurable and irreversible lung disease

14. Pan American Health Organization Other Examples of Information System in the Region  Jamaica and Guyana –Surveillance system for work-related injuries  Canada –Workplace Hazardous Materials Information System  Costa Rica, Nicaragua, Colombia –CAREX (exposure to carcinogenic agents)  Peru and the Caribbean –Hepatitis B Immunization Coverage among health-care workers.  Brazil –Informal work in the health-care sector  Jamaica and Guyana –Surveillance system for work-related injuries  Canada –Workplace Hazardous Materials Information System  Costa Rica, Nicaragua, Colombia –CAREX (exposure to carcinogenic agents)  Peru and the Caribbean –Hepatitis B Immunization Coverage among health-care workers.  Brazil –Informal work in the health-care sector

15. Pan American Health Organization Reaching Higher  Information Systems  Responding to the situation  Policies  Preventive Programs and measures  Access to health services  Determinants factors  Regional Commitment to Occupational Health and Safety (Summit of the Americas)  Collaboration, Coordination, Commitment, Cooperation

16. Pan American Health Organization Gracias Thank you Merci Obrigado Solpay Gracias Thank you Merci Obrigado Solpay