EME Established Market Economies

FSE Formerly Socialist Economies of Europe

IND India

CHN China

OAI Other Asia and Islands

SSA Sub-Saharan Africa

LAC Latin America and the Caribbean

MEC Middle Eastern Crescent

Our global annual estimate for all work-related deaths is: 1.1 million

The pattern of diseases varies in different regions of the world, particularly in developing countries. Overall estimates are only based on non-communicable diseases, which are still less dominant in the developing world, although rapidly increasing with urbanisation and industrialisation. In addition, in developing countries many communicable diseases, such as schistosomiasis, malaria, viral and bacterial infections, are clearly linked to work, such as agriculture and fishing where major parts of the active labour force in developing countries are employed.

The trends in both accidents and diseases are mixed. In industrialised countries we have seen a clear decrease of serious injuries. This is caused by both structural changes fewer workers in hazardous agricultural, industrial, construction and mining activities - and by real improvements in making work healthier and safer. Another contributing factor is the increasing capacity to provide first aid and emergency care which saves lives, although it does not reduce accidents. While the rate of traditional accidents is going down musculo-skeletal problems, stress and mental problems, asthmatic and allergic reactions and problems caused by hazardous materials including carcinogens, such as asbestos, are increasing. The economic costs of work-related injuries and diseases are rapidly increasing. While it is impossible to place a monetary value on human life, compensation figures give a rough idea of how an estimated 4 % of gross domestic product disappears with the costs of diseases through absenteeism, medical treatment, disability and survivor benefits.

In developing countries, the trends are even less favourable. People are migrating to cities, more industries are being set up - often informal and dangerous ones, globalization involves workers without previous experience in industrial work, new housing and premises are needed which increases construction work, infrastructures, such as roads, dams, telecommunication facilities and power generation installations are built up, road traffic increases, and new products and synthetic materials are produced using chemicals, fibres and minerals. All these factors influence the rates and numbers of injuries and diseases, for which upward trends are visible in many developing countries.

 Coverage

The coverage of the occupational safety and health policies and laws is not satisfactory in many parts of the world. While occupational safety and health law enforcement covers practically 100% in the Nordic countries, the figure for many developing countries is close to 10% or less, leaving major hazardous sectors and occupations uncovered, such as agriculture, small-scale enterprises and the informal sector. Often even very hazardous sectors, such as fishing, forestry and construction are not covered. The same applies to basic compensation in cases of accidents. Occupational and work-related diseases are seldom covered and are often not even recorded. Denmark records and compensates annually some 15,000 such diseases while many industrialized countries record only a fraction of that and a large number of countries practically none, although the problem is clearly there. Some 80% of the workforce in Finland are covered by occupational health services, 50-60% in Sweden, while 80-90% of countries in the world have neither ratified the ILO Convention on Occupational Health Services nor enacted other mechanisms to provide such services. The WHO estimates that this inaccessibility can be as high as 50% even in developed countries. Those countries which have ratified most of the ILO Conventions tend to have the highest legal coverage and the lowest reliable number of injuries.

The priorities to tackle are clearly variable:

• Stress, overload and pace of work, psychological factors, poor workplace relations and management
• Problems caused by aging workforce, maintaining ability to work
• Right-to-know, right to be informed, hazard communication
• Chemical substances, carcinogens, asbestos
• Ergonomics, repetitive work and musculoskeletal problems
• Organizational and safety and health (quality) management issues
• Preventive occupational health services, health promotion
• New technologies

• Agricultural work accounts for 2/3 of manpower and work-related problems
• Other hazardous sectors, such as mining, construction, fishery, logging, and particularly dangerous occupations
• Major industrial accidents and fires
• Traditional accident and safety problems, housekeeping and productivity
• Occupational diseases, Global Programme on the Elimination of Silicosis
• Vulnerable groups, in particular, child labour
• Transfer of technology

The ILO Declaration on Fundamental Principles and Rights at Work, adopted by the International Labour Conference in 1998, marks a renewed universal commitment amongst member States to respect, promote and achieve the principles of social justice and equity embodied in four fundamental Conventions, even if they have not ratified the Conventions in question. These are:

• freedom of association and the right to collective bargaining,
• elimination of all forms of forced and compulsory labour,
• elimination of discrimination in employment, and
• the abolition of child labour

To promote the universal application of these fundamental principles in combatting child labour, the International Labour Conference will hold the second discussion of a proposed Convention on the elimination of the worst forms of child labour at its 1999 Session with a view to its final adoption. The ILO through its International Programme on the Elimination of Child Labour (IPEC) offers technical cooperation and advisory services to promote the ratification and implementation of these fundamental principles by strengthening national capacities of member States towards the progressive elimination of child labour.

According to recent ILO estimates, there are at least 250 million children between age 5 and 14 engaged in economic activities worldwide, most of them in developing countries. For almost half of these children (120 million) this work is carried out on a full-time basis endangering their health, safety and development. The ILO has developed an approach for the protection of children =s health and well-being using both occupational safety and health and public health means of action. The model being tested in Brazil includes the assessment of hazardous work and its impact on children =s health and safety; withdrawal of the most vulnerable children from the workplace; protective and transitional measures, health services and rehabilitation programmes.

ILO Conventions and Recommendations on occupational safety and health (88 Conventions have references to these) form a baseline of fundamental, legal and ethical principles. This Aoccupational safety and health code @ has been converted to thousands of national laws, regulations and directives.

Policies and strategies in safety and health are also derived from these standards. The ethical values, presented in the ILO =s Constitution, Declarations and Conventions are the key features of the ILO. The Occupational Safety and Health Convention, No. 155 allocates duties and responsibilities, while the Occupational Health Services Convention (No. 161) and Recommendation (No. 171) cover in detail the ethical aspects.

ILO Codes of practice or Atechnical standards @ provide practical guidance on safety and health at work. Such kinds of standards are not strict scientific specifications of technical measures, but rather the application of scientific criteria based on compromise and consensus reached among relevant social partners. A recent example is the Code of practice on Ambient Factors at the Workplace adopted early this year, which provides guidance on the role and obligations of competent authorities, responsibilities of employers and duties and rights of workers and others with regard to hazardous ambient factors in the workplace. Another example is the newly published ILO Technical and Ethical Guidelines on Workers = Health Surveillance which establishes principles on the collection, processing and utilization of health-related information to protect workers = privacy. The ILO also cooperates actively with other international organizations in developing common international technical standards such as the international Basic Safety Standards for Protection against Ionizing Radiation and for the Safety of Radiation Sources.

A new ILO publication entitled A Fundamental principles of occupational health and safety @ is in preparation. Its main objective is to provide in one volume the key principles embodied in the ILO Conventions and Recommendations which would serve as a guide in the development and implementation of policies, laws, and programmes aimed at the protection of workers = health and safety and improvement of the working environment.

The ILO =s role in promoting social justice in the world is divided into four strategic objectives:

Item 3 covers all questions related to occupational safety and health including a special programme called SafeWork - the Global Programme on Safety, Health and the Environment.

International concern and awareness of the importance and magnitude of the problem caused by poor working conditions and environment remains surprisingly modest. Action, especially in developing and Atransition @ countries, is often hampered. Alarming though the fatality, accident and disease figures are, investment decisions - especially in Asia and Latin America (and spurred by globalization and competition for private investment) - often continue to be made in disregard of safety, health and environmental considerations. The major industrial accidents that have taken place around the world and the many deaths caused by fire in toy, textile and similar kinds of factories in many developing countries, and the new and growing work-related mental diseases and stress observed in industrialized countries attest to the serious risks facing workers and to the need for increased and sustained action.

The ILO =s SafeWork programme is designed to respond to this need. Its primary objectives are: (a) to create worldwide awareness of the dimensions and consequences of work-related accidents, injuries and diseases; (b) to promote the goal of basic protection for all workers in conformity with international labour standards; and (c) to build the capacity of member States and industry to design and implement effective preventive and protective policies and programmes.

The programme =s primary focus will be on workers in highly hazardous occupations, categories of workers vulnerable on account of gender or age, and workers in the urban informal sector who usually lack basic health protection.

Taking into account regional and country diversity, major activities will include the following:

• A worldwide advocacy campaign to inform, advise and pressure for improvements in safety procedures.
• Development of a global statistical programme focusing on hazardous occupations and sectors, to provide information essential for the establishment of international and national surveillance systems capable of providing early warnings on existing and new occupational and environmental hazards.
• Articulation and development of national programmes of action consistent with internationally agreed policies and principles.
• Development of nationally adapted training programmes and materials.
• Organization of technical meetings for the international exchange of information and experiences on workers = safety and health.

The SafeWork Programme relies heavily on voluntary mechanisms such as:

Safety Culture is a new concept among safety professionals that can be considered to include various aspects of occupational safety and health, such as safety attitudes and behaviours. Safety management, auditing and safety mapping, for example, can be used to shape and strengthen safety cultures, while labour and factory inspection and occupational health services can also play a major role.

To illustrate the spread of safety culture, I recently visited a small Mediterranean country. Coming out of the airport I took a taxi. I always use the safety belt if it exists - even though they are often so dirty that they soil my clothes. In this case I had barely sat down when the driver politely told me that the taxi cannot leave before the seat belts are fastened. I was, indeed, very happy to hear that. A few weeks later I arrived in the capital of a big Eastern European country. When I tried to pull out the dusty safety belt the driver forcefully asked me not to use it. He claimed that he was such a good driver that there was no need for it. He seemed to feel embarrassed when I showed my distrust and used it anyhow.

These were two small enterprise owners that demonstrated two different cultures - and the first one is an example of safety culture. We all want to follow the patterns of others and the behaviour is dependant on the environment and the surrounding cultures. If other people at the workplace use hard hats, even visitors are happy to do that. But to change a culture requires a lot of time. You have to convince managers, supervisors and opinion leaders. Legislation and enforcement is a good start but not enough.

Let me give you three striking examples where a safety culture could have made a major difference:

1. In the Bhopal accident in India where thousands of people were killed by the toxic release of methyl isocyanate there were several factors in the chain that contributed to the disaster. The cooling system for the reactive substance was switched off, impurities and water were results of the incomplete process, pressure was not monitored, a gas release burner flame was not in use and the scrubber insufficient. The next vessel was empty but not used for lowering the increasing pressure.

A proper safety culture would have alerted action to any of these factors.

2. In a recent airline disaster in Nova Scotia, where 229 people died, intense heat and smoke preceded the short-circuiting of the electrical system before the plane crashed. Light dimmers had been found to overheat, smoke and melting wires had been detected previously on a similar aircraft, insulation blankets designed to reduce noise could be ignited by molten wires.

The air traffic safety culture has already resulted in orders to replace such dimmers and insulation materials, while individual airlines around the world and authorities may or may not follow. The investigations continue.

3. A passenger ferry in the Baltic Sea lost its bow visor - a front part of the ship which opens - in rough seas damaging also the inner part of the gate and allowing water to enter the car deck. The design was not optimal: there were defective locks, similar incidents have taken place earlier - even with a sister vessel - although without such disastrous consequences, and the evacuation procedures were poorly planned and implemented.

Safety culture may positively reinforce individual safe behaviour e.g. by action and remarks from colleagues and peers. Such culture is essential when safety depends on concerted safe action by a large number of operators and managers, and not only in nuclear power plants and process industries but practically everywhere. Anyone can start contributing to safety culture starting here and now.

A specific component of, and a major contributor to safety culture is the management system. Quality management and environmental management has been guided for some time by management systems standards by the International Organisation for Standardization, ISO. Discussions on this subject have concluded that an occupational safety and health management system requires participation of governments, employers and workers, should be linked to legal requirements, and the principal requirements could be developed by the ILO. A technical standard or a code of practice is being prepared within the ILO =s tripartite system. The ILO and the ISO will collaborate in this matter and detailed implementation standards may well be left for the ISO. This technical standard will not only establish a procedure for management but be closely associated to the fundamental principles of occupational safety and health as specified in the ILO =s Conventions.

A new trend has gained momentum based on consumer action and aimed at influencing production patterns using consumer selection as a vehicle. Demands for information throughout the entire production chain are increasing along with the needs of manufacturers to obtain certification for their working conditions and environment. New Acodes of conduct @ for such purposes are mushrooming. While, in general, this increases the attention paid to questions on safety, health and the elimination of child labour, there are two major shortcomings:

1. Production processes that can be controlled by consumer labelling must be relatively simple and result in products used directly by consumers, such as the manufacture of soccer balls or sports shoes. Consumers are confused by more complicated and global production processes. For example, a label on a t-shirt cannot list all elements and conditions of production - cotton farming, ginning, baling, carding, spinning, and weaving, which may take place in different circumstances and countries; production and mixing of fibres, and dyes, production of machinery in several countries; distribution by various enterprises, importers, and the sales chain. There may be serious safety, health and human rights problems at every stage of production. When products that are not directly targeted to consumers are manufactured, it becomes impossible to control the work environment through this mechanism.
2. The codes of conduct, such as the SA 8000 standard, enterprise level codes and subsequent certification may include certain elements of the conditions which are convenient for the enterprises, and may even refer to hand-picked individual ILO conventions, but this cannot result in comprehensive coverage. Furthermore, certification is usually a one-time activity and cannot guarantee continuous and sustainable improvements.

Exposure to silica dust is extremely hazardous and continues to cause unnecessary premature deaths. Silicosis is entirely preventable; the technology for which need only be applied. The ILO and the World Health Organization (WHO) are setting up a joint ILO/WHO Programme on Global Elimination of Silicosis. The Programme will start on a regional basis taking into account the positive interest shown by countries like China, India, Indonesia, Viet Nam and South Africa. The ILO International Classification of Radiographs continues to be an important tool for the diagnosis of pneumoconiosis. The ILO conducts seminars to develop the capacity of health professionals to detect occupational respiratory diseases at an early stage. A digitalized version of the classification of radiographs is being prepared.

In the follow-up to the 1992 United Nations Conference on Environment and Development and in the 1997 Special Session of the United Nations General Assembly aimed at promoting sustainable development based on social justice and meaningful, healthy and decent employment, environmental issues have become integral to many of the ILO =s activities, intrinsically linked with occupational safety and health.

An Australian estimate of the magnitude of mortality due to occupational exposure to hazardous substances produced a number (2,290 deaths) that was four times higher than that caused by occupational accidents. When the same methodology is applied to the world, exposure to hazardous substances could cause some 340,000 deaths per year without counting the acute injuries caused by chemicals.

 Globally Harmonized System for Classification and Labelling of Chemicals

In promoting chemical safety worldwide, great importance needs to be attached to the development of standardized and globally understood labels and signs. Equally necessary is an effective and clear means to disseminate information on chemical hazards at the workplace, particularly in small and medium-sized enterprises.

Together with full participation by employers = and workers = organizations, the ILO works closely with other international organizations, in particular through the joint WHO/ILO/UNEP International Programme on Chemical Safety (IPCS), the Intergovernmental Forum on Chemical Safety (IFCS), which strives to reach consensus between countries on global priorities for action, and the Inter-Organization Programme for the Sound Management of Chemicals (IOMC).

In a globalized world in which chemical products and workers cross national borders with increasing frequency, developing a universally recognized harmonized system for the classification and labelling of chemicals is crucial. Together with the United Nations = ECOSOC Committee of Experts on the Transport of Dangerous Goods and the OECD, proposed classification criteria and tests for 14 hazard categories has been completed. The Globally Harmonized System for the Classification and Labelling of Chemicals should be available, by the end of the year 2000, encompassing labelling, chemical safety data sheets and training activities. Over the years, many of the signs and symbols designed by the ILO for the labelling of chemicals have been incorporated into international and regional labelling systems, such as that developed by the European Union. These symbols are highly visible in everyday life, from the workplace to supermarkets, from chemical containers and transport facilities.

The IPCS has continued to develop, translate and disseminate the International Chemical Safety Cards, supplying clear and standardized information on the properties of chemical substances. The cards provide a clear summary of essential health and safety information for use at the workplace by workers, employers and officials responsible for safety and health. This information is a perfect starting point to prepare Chemical or Material Safety Data Sheets on products and mixtures. The cards are available in English on two different CD-ROMs, on the Web in several languages including Japanese, and in print in some 20 languages.

A large proportion of workers = deaths and injuries every year can be attributed to a lack of safety and health information. The compilation and dissemination of safety and health information in a readily usable and internationally comparable form is of utmost importance in preventing of occupational accidents and work-related diseases. To this end, ILO activities focus on:

• making available to constituents authoritative and ready-to-use occupational safety and health information;
• developing the capacity of national services to use safety and health information more effectively; and
• expanding the network of national safety and health information services.

The ILO relies on the activities of the International Occupational Safety and Health Information Centre, which is the focal point of a network of some 120 National and Collaborating Centres. This network is largely connected to the Internet, and further links with related networks. In addition to the ILO/CIS network, these networks include the WHO Collaborating Centres on Occupational Health, the Hazard Alert System, IPCS Participating Institutions, International Social Security Association (ISSA) Sections on Safety and Health, European Union focal points, the Asian-Pacific Regional Network on Occupational Safety and Health, Organization of African Trade Union Unity and other trade union focal points, sectoral and professional networks, and others.

The ILO =s safety and health pages on the Internet offer thousands of pages free of charge, such as:

1. ILO Conventions and Recommendations and country ratifications
2. Selected Codes of practice, Chemical Safety Training Modules, other full text materials, and names and addresses of CIS National and Collaborating Centres
3. Catalogue of all ILO publications on occupational safety and health
4. Asian-Pacific Network home pages
5. Links to all networked centres, such as NIOSH in USA, Japan, CCOHS

An important tool in the ILO =s dissemination of safety and health information is the new 4^th Edition of the Encyclopaedia of Occupational Health and Safety, containing over 4,000 pages in four volumes, created by more than 2,000 experts from 65 countries, and published in both printed and CD-ROM formats. I am happy to announce that - as a result of the Spanish Government =s efforts, the three first volumes are already available in Spanish. Work on the French, Chinese, Japanese and Russian versions continues. I invite you to look at the English and Spanish versions at our ILO stand, and to see how the new Web version looks. The ILO has also published other CD-ROMs and other publications on safety and health, which I also invite you to peruse at our exhibition stands.

Increasing numbers of occupational accidents and diseases continue to stem from a lack of attention to ergonomics in the workplace. The application of ergonomic principles has still only reached a limited number of workplaces despite its great potential for improving working conditions and productivity. As a result, the gaps remain large in applying ergonomics in workplaces in different sectors and countries. The manual Ergonomic checkpoints, in 12 languages, bridges some of the gaps, particularly for small and medium-sized enterprises, by identifying simple, practical and inexpensive solutions to ergonomic problems applicable across a wide range of local situations.

The main subject areas of ILO technical cooperation projects are: design and implementation of national tripartite policies, human resources development and capacity building, safety in particularly hazardous occupations, and elimination of silicosis. Special regional programmes are being implemented for English and French-speaking countries of Africa, Asia and Pacific, Central America. In recent years we have successfully implemented activities for chemical safety and small coal mines in China, farm safety and health in Central America, OSH information and networking capacities in English and French-speaking Africa and Asia, and activities for the development of occupational safety and health in small enterprises in Central and Eastern Europe.

I would like to propose that we set the following targets which can be measured by fairly simple indicators:

1. Improved policies and legislation that result in better coverage of enforcement (inspection) and compensation in case of accidents and diseases.

Indicators: percentage of labour force covered by inspection and compensation

2. Occupational health services available

Indicators: percentage of labour force covered

3. Improved infrastructure and manpower

Indicators: number of inspectors, specialists, safety officers, safety representatives, information centres, research specialists in relation to the labour force

4. Better recording and notification systems

Indicators: Fatal injuries / 100,000, fatal occupational diseases / 100,000, disabling injuries and disease rates by sector and occupation, costs of accidents and diseases in relation to the gross domestic product of the country

5. Advisory bodies and voluntary mechanisms established

With better information and indicators of achievement we can show the importance of our work and obtain more visibility leading to better safety and health all over the world.