Occupational safety and health is emerging as an important concern in many Asian and Pacific countries. Economic growth and technological developments have brought about significant economic and social benefits in incomes and the quality of life. But new technologies and new work procedures have given rise to new hazards and risks of accidents and diseases, which have resulted in great increases in the number of people killed and injured at work. To protect workers from occupational injuries and diseases, urgent action is required at the national and industry levels.

Over the last 75 years, the OLO has been striving to protect working people. A number of international labour standards developed by the ILO provide principles for protecting workers from hazards at work. Comprehensive standards include the Occupational Safety and Health Convention, 1981 (No. 155), and the Occupational Health Services Convention, 1985 (No. 161).

On a national level, it is essential to develop and implement programmes to protect workers, especially those in hazardous occupations. This booklet presents a practical plan of action for promoting safety and health in hazardous occupations. It has been published on the occasion of the 75th anniversary of the International Labour Organization in 1994, and is one of a series produced by the ILO Regional Office for Asia and the Pacific.

 The publication has been prepared under the responsibility of Mr. Seiji Machida, Occupational Safety and Health Technical Specialist, ILO/EASMAT. Special thanks are due to ILO consultant, Dr. Kazutaka.Kogi, who drafted this document.

 We hope this booklet will inspire governments, employers and workers to step up their efforts to reduce the risks of accidents and diseases at work.

Assefa Bequele

Director

ILO East Asia Multidisciplinary

Advisory Team (ILO/EASMAT)

Introduction

 Many workers, particularly in developing countries, continue to be killed or to become seriously ill as a result of unsafe and unhealthy working conditions. Work-related diseases are affecting the health of a large number of workers. The unsafe use of pesticides and agricultural machinery is also causing serious injuries and fatalities. Because of major accidents in Bhopal, Bangkok and elsewhere, there is apprehension about the potential of industrial disasters and their consequences for workers, the public and the environment.

Occupational accidents and diseases are a common occurrence. The number of reported accidents has increased sharply in countries where industrial development has been rapid or where reporting systems for accidents have improved. Many of these accidents are serious, resulting in fatalities. Accident rates remain particularly high in hazardous industries such as mining, construction and forestry. 

There are no records of occupational diseases in many countries in the region. This hampers analysis of the incidence of these diseases. Nevertheless, confirmed and unconfirmed reports point to the serious nature of occupational diseases in most countries.  

There is a growing awareness, too, of the close relationship between working conditions and productivity. The improvement of occupational safety and health is considered an important prerequisite for economic and social development. 

In response, most governments have taken steps to review policy and legislation. Employers and workers are becoming increasingly aware that safe and healthy working conditions are essential for sustainable growth.

The ILO is providing assistance to governments, and employers' and workers' organizations in: improving legislation, policy, inspection, technical services and training; setting up safety and health centres; and facilitating the exchange of experiences and information. This assistance has enabled them to take prompt action on their own initiative.

It is important to realize that health and safety problems must be solved through the commitment of all concerned. Technical solutions alone cannot lead to concrete improvement. This booklet thus focuses on positive experiences involving such commitment and on practical measures that can be taken in the region.

The Bhopal disaster in India just a decade ago killed over 2,500 people and injured more than 200,000 as a result of the release of a toxic gas from a chemical plant. This incident has made governments and people in Asia aware of the need for action against hazards at work. 

There is increasing awareness of the high accident risks in industry and agriculture, the widespread nature of occupational health hazards, and the high economic costs of accidents and illnesses. Such awareness can be a good basis for joint efforts to reduce risks.

High accident risks at work 

Although accurate statistics on work accidents in Asia and the Pacific are unavailable, the ILO estimates that world-wide about 200,000 workers die annually and as many as 120 million are injured or become ill. Presumably over half of these figures are for the Asian and Pacific region, implying high risks in many industries.

 Where accident rates are known, they are alarming. Both injury and fatality rates are high, especially in developing countries in the region. Figure 1 compares fatal occupational accidents in selected countries. The rates are alarmingly high in some developing countries in Asia, being several times higher than those of industrialized countries -- at around 30 to 43 per 100,000 workers.

Some industries, such as mining, construction, transport and forestry, report a greater number of fatalities. China, for example, in 1993, reported over 10,000 fatalities in mining and 3,000 in construction. Tens of thousands of Asian workers die because of work accidents in these hazardous industries.

These high rates of fatalities are apparently related to rapid industrialization, modernization of agriculture and the introduction of new technologies, including dangerous machines. The increased use of hazardous chemicals is presenting special risks to workers and the environment, but accidents and diseases due to chemical use are not yet recorded in the accident statistics of many countries. Rapid changes in work methods and new work situations, including the movement of heavy materials, have also increased accident risks. The situation can be aggravated by newly transferred technologies.

FI = Finland; SE = Sweden; NO = Norway; DK = Denmark; BE = Belgium; US = USA; CA = Canada; AU = Australia; JP = Japan; MY = Myanmar; TH = Thailand; KR = Republic of Korea; ID = Indonesia; FJ = Fiji.

 These high accident rates reflect the lack of adequate preventive measures in many workplaces. This lack of protection is further evidenced by a series of major industrial accidents reported in a number of countries. They include explosions in chemical plants, release of toxic substances and major traffic accidents.

Source: Information collected from government sources.

These major accidents, which often involve large numbers of workers and the public, and adversely affect the environment, have highlighted the dangers in both large and small enterprises.

In many industrialized countries, work accidents have been reduced significantly. For example, fatal accidents have decreased to less than half during the last two decades. This is encouraging as it shows the possibility of reducing accident rates drastically if concerted efforts are mad.

While accident rates, particularly fatality rates, have generally decreased in many industrialized countries, this trend is not seen in some developing countries. For example, in Malaysia, the number of people reported to have been affected by work accidents increased from 88,127 in 1988 to 124,898 in 1991 (Table 2). The figures cover all accidents reported to the Social Security Organization. The annual accident rate has remained constant, at about 25 per 1,000 workers. This indicates that the increase in frequency was mainly because of expanded coverage of workers by the Social Security Organization, especially in manufacturing and service industries.

Table 3 shows a similar situation in Thailand, based on information from the Workmen's Compensation Fund. The number of people reported to have been affected by work accidents increased from 49,874 in 1988 to 103,296 in 1991. There was also a sharp rise in the number of fatal cases, from 352 in 1988 to 665 in 1991. The annual rate of accidents per 1,000 workers was relatively stable.

These increases can be attributed to expanded coverage of the national social security system, industrial expansion and improved reporting. However, it must be noted that the figures represent a net increase In accident numbers.

On the other hand, the much lower occupational accident rates reported by some countries in the region may reflect more limited social security coverage or reporting systems rather than better occupational safety programmes.

However, national statistics on occupational diseases are found in only a few countries/territories in the region, including Australia, Hong Kong, Japan, the Republic of Korea, New Zealand and Singapore. As the reported diseases in these countries are very similar and associated with a wide range of industrial activities, we can assume that non-reporting in other countries is due to lack of adequate reporting mechanisms.

Source: Based on data from the Social Security Organization, Malaysia

Source: Based on data from the Workmen's Compensation Fund, Thailand

As an example we can consider Singapore, which some years ago established a national system of certifying "Designated Factory Doctors". Singapore has well-established procedures for reporting work accidents. The Department of Industrial Health of the Ministry of Labour carefully follows the incidence of occupational diseases. Confirmed figures reported to the Department are given in Table 4. 

The figures in Table 4 were reported from among about half a million workers. There were a large number of workers suffering from noise-induced deafness, identified by a well-controlled hearing examination scheme. The rather high incidence of industrial dermatitis was similar to the situation in many other countries. A number of other serious occupational diseases were reported, including asthma, silicosis, asbestosis, poisoning and gassing. Although the table does not list figures for back injuries and other musculoskeletal conditions, including those of the neck, arm and hand, there were reports of some workers suffering from such symptoms.  

Australia reports about 12,000 workers' compensation disease cases annually. They include work injuries caused by repeated or long-term exposure to chemical agents, and employment injuries which are the result of a single traumatic event where there is a long latency period (for example, the development of hepatitis following a single exposure to the infection). The Republic of Korea reports several thousand cases of suspected occupational diseases annually.

lntercountry differences in the rates and distribution of occupational diseases are due, in part, to differences in types of industries. They may also result from difficulties in diagnosis and reporting. There is often also an underreporting of diseases. If rates similar to those found in Singapore apply generally, then hundreds of thousands of people in the region are likely to be suffering each year from occupational diseases, although only a small number of such cases are being reported.

Table 4. Occupational diseases in Singapore, 1990-1992 

Source: Ministry of Labour, 1993. Department of Industrial Health Annual Report 1993. Singapore

 As the reporting of occupational accidents and diseases improves, many countries in the region are becoming increasingly aware of the associated economic costs. They include costs for lost work time and productivity, compensation and medical expenses by the social security system, and accident damage.

 Where workers' compensation costs arising from occupational accidents can be studied in detail, the figures are enormous. They point not only to the economic costs, but also to the social burdens associated with such costs and the suffering of individual workers and their families. Figure 2 shows workers' compensation costs as a percentage of major labour costs in different sectors in Australia. While it is encouraging to see the downward trend in workers' compensation costs in all sectors, the percentage is still over 2 per cent for all industries. The percentage is considerably higher for construction, manufacturing and mining, amounting to 3 to 4 per cent during the period of 1986/87 to 1990/91. This level is significant enough to affect the economic performance of the industries concerned. The disclosure of such data on the costs of occupational accidents and diseases has given impetus to concerted efforts to reduce them. Similar efforts should be undertaken in other countries and industries.

Figure 2. Workers' compensation costs in Australia, 1986/87 to 1990/91

Source: Australian Bureau of Statistics: Major Labour Costs, Australia, 1988/89 and 1990/91 (Catalogue No.63480).

There are many constraints to the solution of safety and health problems that are common to such industries as mining, construction, transport and agriculture. The constraints are not only economic, but also due to the lack of good management and appropriate technical support. These constraints are reflected in the low priority that some countries and industries assign to occupational safety and health. 

Several issues common to many countries in the region deserve urgent attention. They include obsolete, inadequate or fragmented safety and health legislation that covers only some hazards, hazardous industries and workplaces. There is also an acute shortage of trained inspectors to enforce safety and health legislation, a shortage of safety and health professionals at the national and enterprise levels, and a lack of readily available technical support from safety and health centres. Inadequate training and information facilities for employers and workers hamper their active participation. 

To find common solutions to such problems, the general and specific problems of the hazardous industries must first be made known to all concerned. There is a general perception that safety and health problems are difficult to tackle under the economic conditions prevailing in most developing countries. However, if constraints relate to technical, administrative or educational aspects, there is potential for removing them without waiting years for "sufficient" economic growth to take place.

 The construction industry has contributed greatly to economic growth. This sector accounts for nearly 10 percent of workers in most countries. The variety of activities, ranging from the construction of buildings to civil engineering works, and the transient nature of sites make this industry particularly hazardous. The prevailing contract system, unstable employment and the large number of seasonal and migrant workers also contribute to safety and health problems. 

Occupational safety and health problems are common in the construction industry. Working conditions at sites are increasingly affected by the use of new technology, hazardous chemicals and a wide variety of materials and equipment. In spite of its rapid growth, the sector maintains the traditional employment structure, a high labour turnover and a large proportion of small firms operating with minimum outlay and capital. As a result, insufficient attention is paid to welfare, sanitation, first-aid, and health-care facilities. Given the speed at which the industry is developing, the safety and health implications of its complex and rapidly changing site operations need urgent attention. 

The construction industry accounts for a significant proportion of occupational accidents in most countries in the region. In China, 6.2 million workers were employed in the state-owned construction industry in 1992. The number of workers in the construction industry in 1992. The number of workers in the construction industrial was 56,000 in Hong Kong, in 1993, 6.5 million in India in 1990, 2.4 million in Indonesia in 1992, 6.4 million in Japan in 1993, 1.7 million in the Republic of Korea in 1993, 2 million in Pakistan in 1992, and 1.1 million in the Philippines in 1993.

  Although it is difficult to obtain accurate statistics because many accidents are not reported, the injuries in construction frequently exceed those in other industries. For example, in India, the accident rate in this sector is reportedly three times higher than in the manufacturing sector.

Construction industry accidents were reported as follows: China, 3,000 fatal accidents (1993); Hong Kong, 19,113 accidents, including fatalities (1992); Japan, 993 fatal accidents, accounting for 42 per cent of the total for all industries (1992); the Republic of Korea, 26,129 injuries, with 636 fatalities (1993); Malaysia, 3,615 accidents, with 39 fatalities (1992); Papua New Guinea, 237 injuries (1989); Singapore, 775 accidents (1993). 

The high risks in the construction industry call for a comprehensive programme of action. Often the coverage of laws and regulations needs to be extended to the sector. The extension of inspection and social security services to this sector, particularly, requires urgent action. The promotion of training in occupational safety and health is equally important. Training should be obligatory for all new workers and operators of dangerous equipment. The fundamental question is how quickly the industry can establish a good management system within each construction site. The active participation of supervisors, contractors and workers is imperative.

The shortage of skilled workers and trained supervisors and the lack of experience in modern technology increase the risk of occupational accidents and diseases. Except for Australia and Japan, accident rates in the region are much higher than in Europe. China has a high fatal accident rate in coal mining - about 10,000 deaths annually. In India, more than 200 fatalities and about 1,500 serious injuries are reported in mines each year. In Pakistan, in the province of Sind alone, occupational injuries in mines range between 2,600 and 5,200 each year. Obsolete regulations, coupled with practically non-existent occupational safety and health services, aggravate the situation in many countries. 

Small-scale mines, which account for an important and growing volume of mining in the region, are associated with labour-intensive and low-productivity activities. Migrant rural workers without skills or training are often employed in these mines. This leads to much higher risks of accidents, particularly where workers are not organized and beyond the scope of protective legislation.

 While several countries are carrying out programmes to promote the mining sector, efforts to introduce coherent occupational safety and health strategies are reaching only a limited range of mines. Upgrading legislation and strengthening the mining inspectorate are urgent tasks ahead. Lack of knowledge, expertise and training for enterprise-level action is a further constraint

In many countries in Asia, 5 to 10 per cent of the workforce is employed in the inland transport sector. The sector provides important support to industry and is expanding rapidly.  

It is assumed that a high proportion of traffic accidents involve transport workers, although the exact proportion is not known. The high figures of fatal and serious injuries due to traffic accidents are a common concern. Factors related to poor road design, vehicles not adapted to local people, excessive hours of work, fatigue, and poor driving skills associated with inexperience and poor judgement are common causes of traffic accidents. 

Loading and unloading heavy cargoes, noise, vibration, irregular meals, stress from long working hours and night driving are causing serious health problems for many transport workers. The poor maintenance of both roads and vehicles and the lack of proper roadside facilities are also common constraints. The transport of hazardous materials and wastes, the nature of which is often not known to workers, poses a special risk. The provision of adequate training and information is urgent in view of the special precautions required throughout the transport industry. Because of the constant movement of the workplace, it is difficult to regulate the design and maintenance of roads and vehicles and to incorporate safety and health aspects in management.  

Transport accidents often involve the public and can threaten the environment. This draws attention to the need for occupational safety and health efforts, combined with general transport safety campaigns.

Agriculture and forestry 

In many countries in the region, the agricultural sector accounts for most of the workforce. The proportion is smaller in some industrialized or newly industrializing countries, including Australia (6 per cent), Japan (10 per cent), the Republic of Korea (34 per cent) and Malaysia (31 percent).  

As agricultural workers work in remote and dispersed places and legislation does not effectively cover them, the exact rates of accidents and diseases in this sector are not known. Nevertheless, diversified and seasonal agricultural activities, mechanization and the increasing use of pesticides bring special risks to agricultural and forestry workers. Severe climatic conditions, arduous work such as cultivation and carrying heavy loads, poor sanitation in living quarters and generally poor living standards expose such workers to safety and health risks.

 Within one year, Sri Lanka reported about 1,000 fatalities and 14,000 hospital admissions due to pesticide poisoning. While many of these cases related to suicides, a significant number resulted from occupational use. A field survey in Thailand showed that 40 per cent of pesticide sprayers developed symptoms of pesticide poisoning.

 Technological innovations in agriculture offer encouraging prospects for increasing productivity and incomes. However, they also bring new hazards, such as those inherent in heavy vehicles, abrasive wheels, dangerous machine parts, explosives, electricity, hoists, lifts and agrochemicals.

 Unfortunately, despite their major national economic role in most countries, agricultural workers are poorly protected against occupational accidents and health hazards. Commonly, national safety and health legislation and enforcement agencies do not extend protection to the informal and rural sectors.

 In the forestry sector, available data confirm extremely high accident rates, particularly in tropical wood harvesting. During harvesting operations in Sarawak, Malaysia, 982 fatalities were recorded between 1973 and 1984, amounting to 6.6 fatalities per million cubic meters of felled wood. The figure is 15 times higher than that reported for forestry work in British Columbia, Canada.

 As in agriculture, basic accident prevention regulations for wood harvesting. Do not exist in most countries. Workers often have to cope with poor working and living conditions, besides poor health and nutrition. Employers rarely appreciate the link between safety and health and productivity. With the increasing use of chain saws, different types of tractors, and portable tools, greater emphasis needs to be placed on extending protection to this sector.

 The review of safety and health in hazardous industries in the region indicates that risks are increased because of the lack of organized efforts to eliminate or minimize them. The real problem is not necessarily that occupational hazards exist, but the relative lack of commitment to undertake safety and health measures, the lack of good management, the absence of practical information and training, and the lack of readily available expertise to deal with risks. Similar problems occur in less hazardous industries, but to a lesser extent.

 These problems are apparent in high technology plants, such as the one which caused the Bhopal disaster, and in various small workplaces throughout the region. Safety and health at work will not improve! merely by pursuing economic development or technological progress. Explicit commitments to safety and health, involving governments, employers and workers, and utilizing available resources, are needed.

 Many industrial disasters have come to be known by the place of their occurrence, such as "Seveso" (the release of pesticide in Italy, in 1976), "Mexico City" (the 1984 explosion of a liquefied petroleum gas facility which killed about 600 people) and "Bhopal". The Bhopal disaster in December 1984 killed over 2,500 and injured more than 200,000 inhabitants as a result of the release of a toxic chemical (methyl isocyanate). Similar incidents continue to occur, indicating that the risks are particularly great in storage and handling of highly flammable materials or highly toxic substances.

 Major industrial accidents can result from the sudden leakage of flammable materials or toxic chemicals. Such leakages occur when operating conditions deviate from the norm due to technical failure, sudden damage to components or human error.

 In many countries, adequate regulations and support mechanisms for countering major industrial accidents and for emergency planning do not exist. Experience shows the importance of evaluating potential hazards and their possible consequences beforehand, and of undertaking systematic preventive measures.

 It is necessary to train supervisors and workers in emergency procedures so that any major accident can be controlled at an early stage. Preparedness for a major accident should include: planning and training in organizing all the necessary emergency activities promptly; informing the local authorities and the public; evacuation, if necessary; and arranging for rescue, fire-fighting and first-aid.

 It is important to register storage and chemical installations with a potential for major accidents and to establish a preventive programme for each of them. Governments should define criteria for such major hazard installations, taking into consideration the dangerous nature and the quantities of substances present or likely to be present on the site. Once registered, each installation should complete a safety report showing the results of the hazard evaluation, control measures taken and emergency plans. Such a preventive programme is provided for in ILO Convention No. 174 on the prevention of major industrial accidents, adopted in 1993.

 It is urgent to establish a national system to register potential major hazard installations in each country and require them to complete a safety report. Technical standards and guidelines for such installations must, at the same time, be upgraded. Safety measures at each site must be cornplemented by strengthened inspection by government inspectors, training of managers and workers, and cooperation with' local authorities. The linkage between a major hazard control system and the overall chemical safety programme should be emphasized.

Small and medium-sized enterprises contribute greatly to economic growth. In many countries, they account for the majority of employment. They create a pool of skilled and semi-skilled workers and promote balanced development involving diversified sectors and rural and isolated areas. 

Small enterprises are often characterized by poor working conditions and a hazardous working environment. Surveys of small and medium-sized enterprises in some developing countries demonstrated high risks of occupational accidents and diseases. The results of one such report from Thailand are given in Table 5.

Most small enterprises have safety and health risks of the types listed in Table 5.

Source: K. Kogi. 1985. Improving Working Conditions in Small Enterprises in Developing Asia. ILO, Geneva

Their small size does not allow them to make the same efforts in improving occupational safety and health as large enterprises. They are often reluctant to make additional investments. As their managers have to deal with many day-to-day problems, they devote less time to improving safety and health and working conditions. Small enterprises do not always have access to the skills and expertise they need. Such constraints mean that they are not well placed to plan and implement safety and health measures for their workers. It is important to provide practical support for solving safety and health problems in these enterprises.

 On the positive side, technological progress relieves workers of arduous tasks and protects them against exposure to harmful dusts, fumes and gases. The number of workers at risk is also reduced as fewer are needed to perform the tasks previously undertaken by many. New methods of work organization, likewise, provide an opportunity to introduce greater flexibility and improvements in job content.

 On the negative side, technological change has given rise to new problems. Workers using new types of equipment and machinery, particularly in small enterprises in the construction, mining and manufacturing industries, may not properly understand the associated hazards. Modern equipment often involves special hazards which are difficult to control, such as noise, vibration, radiation and hazardous chemicals. New biological agents are often potential threats to health. Work on complex or computerized machinery can induce visual strain, mental stress, musculoskeletal disorders and accidents.

 One particular aspect of technology transfer is the difficulty in adapting it to local climatic and sociocultural conditions, as well as body size. Often the skills and training required for operating and maintaining imported technologies are not transferred with them. Further, because of economic constraints and currency restrictions, developing countries may be compelled to purchase cheaper equipment and processes which do not meet minimum safety requirements. Technology and chemicals banned in the exporting countries may be exported to countries where stringent safety and health regulations either do not exist or are not enforced.

 Awareness is increasing that efforts should be made to enhance knowledge and understanding of the risks of transferred technologies and of the countermeasures to be taken not only immediate safety and health risks, but also long-term hazards must be taken into account. This requires special measures, good work organization, and support through legislation, training and information.

 Working children, in many sectors, are often involved in unsafe work. As abolition of child labour is the common goal of all countries in the region, urgent attention must be paid to children in hazardous employment. For many children, work is an ordeal, characterized by excessively long hours, low pay, occupational hazards, and physical and psychological abuse. Protection of children requires legislative and social measures to ensure safe conditions at work, provide education and training, and ensure that at least very young children do not work, provide education and training, and ensure that at least very young children do not work. Innovative health care systems must be implemented to protect them.

 Migrant workers also need special protection. They usually work under conditions which are unfamiliar to them and are less protected for various economic and social reasons. Their precarious employment conditions often mean that they have to endure unsafe working conditions. Many of them have difficulty in following instructions and safety warnings in a language other than their own. The places where they work, in particular in small and medium-sized enterprises, construction, agriculture and plantations, are often not effectively covered by legislation on occupational safety and health.

Disabled, older and indigenous workers are also vulnerable groups. They tend to accept unsafe and unhealthy working conditions. Many of them work outside the organized sector and are not union members. Because of their employment circumstances, they are not given support to improve their conditions. Special protective measures should be developed for them.

Working women and mothers form an increasing proportion of the workforce. The basic issue is to provide equal employment opportunities for both women and men. This requires that due regard be paid to family needs while working to enable all individuals to amply develop their potential: child-care services, flexible working time arrangements, non-penalizing career breaks, leave schemes. Access to training, also, needs special attention. In fact, all these measures contribute to securing safety and health of working women and mothers.

The problems of these special groups are connected with the overall problem of protecting all workers. Legislation that has weaknesses in addressing safety and health at work, generally, cannot deal adequately with the particular problems of these specific groups. The same can be said for enforcement of laws and regulations, risk evaluation and control, technical advice, training and information services. Therefore, comprehensive policies and programmes should be developed to address occupational safety and health issues and establish priorities to meet local needs. ILO Conventions and Recommendations on occupational safety and health can provide a firm basis for such policies and programmes.

There is urgent need throughout Asia and the Pacific for more systematic workplace-level action to improve safety and health. Two trends are apparent in the efforts of countries in the region to cope with the challenging task of ensuring safety and health at work. The first is a commitment to integrating a clear occupational safety and health policy in national development plans. Based on this commitment, efforts are being made to upgrade legislation and secure support and action from employers and workers in different sectors. The second is concerted, practical action to solve priority problems.

These trends were highlighted during the Eleventh Asian Regional Conference of the ILO in November-December 1991, in Bangkok, which discussed occupational safety and health as a major agenda item. Representatives of governments, and employers' and workers' organizations from all ILO member countries in the region agreed that national policies and programmes on occupational safety and health, extending protection to all workers, should be established in each country. They pointed to the need to take practical steps to solve common priority problems. They further agreed that ILO standards should form the basis for national-level action.

Each country should urgently develop a strategy for establishing and pursuing priorities for action. Such a strategy requires a national mechanism to ensure upgrading of legislation, effective enterprise-level action with tripartite consensus, development of local capabilities and training at different levels, promotional activities and the exchange of experiences. In designing such a strategy, it is useful to refer to recent ILO standards on occupational safety and health. It is also useful to take into account programme of the World Health Organization emphasizing the extension of occupational health services for all workers.

Several ILO Conventions and recommendations provide basic principles for organizing occupational safety and health activities at both national and enterprise levels. In particular, the Occupational Safety and Health Convention, 1981 (No. 155), and the Occupational Health Services Convention, 1985 (No. 161), refer to the need for a national policy, and action at national and enterprise levels to implement the policy. The Conventions give useful guidance on upgrading national legislation.

Convention No. 155 and accompanying Recommendation No. 164 provide that a country should adopt a coherent national policy on occupational safety and health and the working environment. The policy should progressively extend improvements in safety and health to all workplaces. Steps should be taken to ensure tripartite participation in the formulation, implementation and review of the policy and in practical measures. Based on the policy, governments should upgrade legislation, establish inspection services to ensure its enforcement, and provide support for implementation of the policy and programmes. Employers have the responsibility to ensure, as far as is reasonably practicable, that the workplace, processes, equipment and the working environment are safe and without risks to health.

Workers have the duty to cooperate and the right to be trained and participate in safety and health activities. Further, safety committees, in which workers participate, as well as workers' safety delegates should be provided adequate information on safety and health matters. They should be consulted when new safety and health measures are envisaged, so that they can contribute to the decision-making process.

Convention No. 161 and accompanying Recommendation No. 171 provide that occupational health services should progressively cover all workers. They should be entrusted with preventive functions and be responsible for advising employers, workers and their representatives on:

• The requirements for establishing and maintaining a safe and healthy working environment which will facilitate optimal physical and mental health 
• The adaptation of work to the capabilities of workers in the light of their state of physical and mental health.

Occupational health services should include: 

• surveillance of the working environment and working practices
• surveillance of workers' health
• provision of information, education, training and advice
• organization of first-aid, emergency treatment and health promotion.

Occupational health services can be organized by a single enterprise or be shared among enterprises. A rnuitidisciplinary approach is necessary to fulfill their functions. The conditions of operation and training needed for their personnel are provided in ILO Convention No. 161 and Recommendation No. 171. The professional independence of personnel and the confidentiality of health data are emphasized.

More recent Conventions and Recommendations include the following: 

• Asbestos Convention No.162 and Recommendation No.172 (1986)
• Safety and Health in Construction Convention No.167 and Recommendation No.175 (1988)
• Chemicals Convention No.170 and Recommendation No.177 (1990)
• Night Work Convention NO.171 and Recommendation No.178 (1990)
• Prevention of Major Industrial Accidents Convention No.174 and Recommendation No.181 (1993)

There are also a series of ILO codes of practice on various aspects of occupational safety and health. In 1988, the ILO published Safety, health and working conditions in the transfer of technology to developing countries: An ILO code of practice. The code aims to ensure that transferred technology is appropriately designed, properly installed and safely operated

 As we have seen, there are multiple safety and health hazards in any workplace. While hazards may differ across industries and among workplaces, many problems are common. The core problems relate to lack of commitment and poor organization of safety and health programmes.

 Thus, the key to a national policy and programmes on occupational safety and health is good workplace-level organization of safety and health activities, involving both employers and workers. ILO Conventions and Recommendations emphasize the roles of employers and workers in this regard. Employers must be fully aware of their responsibilities in ensuring a safe and healthy working environment. They should consider workers' safety and health as part of their daily business. Managers and supervisors, at all levels, should be able to assess existing safety and health risks and plan and implement, in close collaboration with workers and their representatives, all necessary measures to eliminate or minimize them.

 Safety and health programmes must be responsive to local needs. Adequate support is necessary for the promotion of local initiatives in planning and implementing effective programmes in the local enterprise and workplace context.

 Important elements of an effective and coherent national policy and programmes on occupational safety and health include: 

• reinforced structures for tripartite cooperation among government, employers and workers, including a national tripartite consultative mechanism and a national tripartite occupational safety and health council 
• upgraded legislation on occupational safety and health to ensure all necessary measures in all workplaces and effective enforcement of relevant laws and regulations through inspection services 
• adequate reporting of occupational accidents and diseases 
• provision of technical support and advice for effective enterprise-level action 
• organization of nationwide promotional campaigns and activities to secure the commitment of employers and workers to improving occupational safety and health, with emphasis on selected priorities and practical preventive measures 
• promotion of action-oriented safety and health training in assessing and controlling risks at work, with the support of train-the-trainer programmes 
• dissemination of ready-to-use information materials on hazards and preventive measures. 

In implementing these elements, it is useful to develop and promote joint, industry-wide action and encourage the exchange of practical solutions through locally available means. Regional and international cooperation can play an important role in this regard.

 The legal standards for workplace safety and health must cover all hazardous jobs. It is essential to make employers legally responsible for all hazardous jobs in all workplaces and to specify, for employers, health standards and appropriate preventive measures to improve the safety and health of their workers.

 Where necessary, provisions on registration and examination of important hazardous plants and equipment, as well as certification of people dealing with particularly dangerous equipment and processes, should be incorporated in legislation.

 It is essential to ensure the efficient and effective administration of occupational safety and health legislation. Particular attention is drawn to the role of the administration in ensuring the reporting of occupational accidents and diseases.

Experiences in many countries in the region have shown that safety and health action at the enterprise level is greatly facilitated by adequate support. Particularly important is direct support for: 

• establishing organizational structures to assign responsibility for safety and health at different management levels 
• undertaking management-initiated risk assessments using practical methods, including inspection of the workplace, monitoring of the working environment and examining workers' complaints 
• conducting surveillance of the health of workers and their adaptation to work 
• identifying available, technically sound solutions, including simple, low-cost improvements 
• providing action-oriented training and information. 

Successful safety and health programmes at the workplace in Asia have some common features, including:

• building on local practice (taking into account the local situation, and starting from interventions that can be undertaken by extending the knowledge and experiences of local people)
• focusing on local achievements (rather than outside standards and criteria)
• providing guidance on practical solutions that can bring immediate benefits (simple, easy- implement, low-cost solutions, as well as productivity- enhancing improvements)
• facilitating the active participation of all concerned (especially employers and workers).

The support for management initiatives and worker participation must be very concrete. For example, providing textbook-based knowledge is far from sufficient. Instead, managers, supervisors and workers should be assisted in recognizing their obligation to improve safety, and initiatives in this area should be encouraged. Further, collection and dissemination of practical manuals, as well as reporting of locally achieved improvements, are useful. Guidance should be practical and point out solutions that are available at low cost under existing conditions. It is also necessary to facilitate the active participation of all concerned.

 Occupational safety and health centres in many countries provide pivotal support in assessing workplace risks and designing practical solutions. They include national and provincial centres and their affiliates, services attached to ministries and university departments, local health centres and private safety and health institutions. Some national safety councils and training and consultancy institutions provide similar support. As these institutions represent the technical expertise available in the country, it is important to establish and strengthen their facilities and functions.

 Equally important is the role of healthcare institutions in supporting health surveillance of workers. Often hospitals and clinics attached to government and public agencies and large enterprises or plantations can perform health surveillance checks for their workers and for those working in affiliated or associated undertakings. For small and medium-sized enterprises, local hospitals and general practitioners can perform such checks and provide advice, based on the results. The training of health personnel and the exchange of technical experiences are needed.

 In several countries, there are an increasing number of inter-enterprise services providing support, on a contract basis, for environmental and health surveillance, particularly for small and medium-sized enter- prises. These group services can also play an important role in providing advice on solutions and in promoting training. Measures should be taken to strengthen their activities.

 Workers' participation is essential in ensuring that planned activities are realistic and actually implemented. Representatives of workers' organizations should participate fully in formulating national and industry-level policies and programmes for safety and health at work. Attention should be paid to the mechanisms for securing such participation.

 The active participation of workers in individual enterprises or workplaces is also critical. Safety and health committees should be made obligatory for enterprises and independent work sites with a certain number of workers. The committees should meet regularly to review safety and health conditions and required action. Recent work-related accidents and diseases should also be discussed. For smaller workplaces, safety delegates should be selected from among the workers.

 The participation of workers is also necessary for assessing risks at the work-place and finding and implementing available solutions. Provision of practical information about risks and solutions and action-oriented training constitute an important basis for this. Participatory methods of risk assessment, such as walk-through surveys, checklist application and group discussions, are effective in promoting worker participation. The planning of practical solutions should also involve workers.

Recent training and education activities in occupational safety and health in the region have highlighted several practical principles. Such activities should be action-oriented and reflect the local situation. They should provide guidance on ways to: 

• identify problems and assess risks
• select priority areas for action
• identify feasible solutions, including safe work practices and simple, low-cost solutions, using locally available material and skills
• encourage participation.

Training of new workers and retraining must take these factors into account. The content of training should include the genera] principles of safety and health at work, as well as the specific risks in the job. It is useful to establish training packages for new workers and new work assignments. Further, occasions such as tool-box meetings, seminars and workshops should be utilized for discussing safety issues.

Training of trainers is very important. It should focus on practical risk assessment and finding feasible solutions. Trainers should learn about participatory methods such as group discussions, joint walk- through surveys and consensus building. Inspectors, safety and health personnel, safety committee members and local community leaders can be trained as trainers.

Ready-to-use information should be provided in order to assist in training. Information sheets describing hazards, preventive measures and emergency procedures should be developed and disseminated widely, e.g. chemical safety datasheets for hazardous chemicals. Similar information sheets can be used for physical and biological hazards, ergonomic problems and other aspects of working conditions.

 The. channels for disseminating such practical information must be developed aria maintained based on existing channels, rather than devising complicated networks that are difficult to maintain. These channels can also be used for making inquiries about technical knowledge and available solutions.

ILO's innovative training approach, known as Work Improvements in Small Enterprises (WISE), provides useful insights into ways to develop training which can lead to immediate positive results. The WISE methodology is based on recent experiences in some developing countries in Asia and Latin America. It links productivity with improvernents in working conditions, making them attractive to owners of small enterprises. Its application has confirmed that training is effective when it focuses on (i) multiple improvements which build on local practice; (ii) positive achievements and feasible solutions which are locally attainable using available skills and materials, including simple, low-cost solutions; and (iii) learning- by-doing, which directly involves managers and workers as training partners.

A series of training programmes have been organized using the WISE approach for small and medium-sized enterprises in the region, including in India, Indonesia, the Philippines and Thailand. The results have shown that training which emphasizes solutions rather than problems is more likely to result in action. One of the best ways to motivate and enable people to carry out immediate improvements at the workplace is by demonstrating examples of successful experiences in other local workplaces, and by providing practical advice and guidance in carrying out similar improvements. Further information is available in the ILO publication Higher productivity an a better place to work: Action manual.

Promotional activities can play a vital role in encouraging local safety and health initiatives. The principal aim of such activities is to secure national and workplace-level commitment to action. Promotion of awareness, not only of existing hazards but also of available practical solutions, is thus important. It is useful to link these promotional activities with intensive campaigns on selected occasions, routine practices for daily business and regular training activities.

The organization of a national safety week is particularly useful. The safety week can combine promotional activities through mass media, training activities, national and local conferences, distribution of ready-to-use information material and safety awards. Similarly, promotional campaigns can be organized within each industry or enterprise for the benefit of managers, supervisors and workers.

 It is essential to make these promotional activities solution-oriented, and not merely for hazard identification purposes. The feasibility of solving existing safety and health problems must be publicized. It is useful to encourage the exchange of information on achievements between workplaces. When examples of accidents and diseases are given, information about how these risks were prevented or could have been prevented should also be provided. Local examples of effective improvements, especially low-cost improvements, should be collected and disseminated widely. There should, therefore, be a close link between promotional and training activities.

Tripartite national safety councils, national or provincial commissions and similar independent institutions can play a vital role in promoting workplace safety and health. Prominent among such organizations are the National Safety Councils in India and Singapore, the Japan Industrial Safety and Health Association, the Korean Industrial Safety Corporation and the Korean Industrial Health Association. The National Occupational Health and Safety Commission (Worksafe Australia) in Australia, associated with the Department of Industrial Relations, coordinates and promotes national, state-and enterprise-level activities. Often these bodies play a key role in organizing national safety weeks, national conferences and other promotional and training programmes.

In organizing effective safety and health programmes, it is useful to plan and implement practical steps suited to the local situation. The best way to define such steps is to organize group consultations among all concerned. The steps can be planned both nationally and at industry, enterprise and workplace levels. Some suggested steps are listed below:

• Establish a company safety policy and make it known to all workers. 
• Draw up an annual plan and select priority activities for the year. 
• Assign clear responsibilities for over-seeing and implementing safety and health action at all levels of management. 
• Organize a safety and health committee in each enterprise and at each work site.  
• Establish and implement a routine procedure for inspecting equipment, the working environment and work methods, and for discussing necessary improvements. 
• Develop and implement action-oriented, participatory training programmes for newly assigned workers and for retraining workers regularly. 
• Disseminate practical information materials, including chemical safety data-sheets and safety and health leaflets, explaining practical measures, including low-cost improvements. 
• Plan and carry out promotional campaigns, with emphasis on advocating best performances and the exchange of positive experiences.  

In promoting such action, the cooperation of the concerned government agencies and safety and health advisory and training institutions is essential. In particular, the ministries of labour and health should closely coordinate with each other in extending occupational health services to all workplaces, with the active involvement of employers' and workers' organizations.

 Establishment of national policies and programmes and support for effective enterprise-level action should be promoted on a step-by-step basis. Plans should be made by involving employers and workers and their representatives at national, industry and enterprise levels. All concerned should be aware of the importance of safety and health action, both in achieving sustainable socioeconomic development and in making immediate workplace improvements. Regional cooperation can play a vital role in raising such awareness.

 The ILO has established three multi-disciplinary advisory teams in Asia and the Pacific - in Bangkok for cast Asia, in New Delhi for south Asia, and in Manila for south-east Asia and the Pacific. They provide ad- vice in an integrated manner, based on an analysis of country objectives. The exchange of experiences and expertise facilitated through' the teams can further strengthen regional cooperation.

 The Finnish-funded ILO Asian-Pacific Regional Programme on Occupational Safety and Health, based in Bangkok, covers 20 countries and one territory. It provides support for planning effective programmes on occupational safety and health and for training and information activities by governments, and employers' and workers' organizations. It plays a key role in developing regional networks and practical training programmes and materials. 

Regional cooperation is especially important in promoting support for practical action at the national and enterprise levels, including:  

• developing national safety and health standards, effective reporting procedures for occupational accidents and diseases, and regulatory measures 
• providing advice on locally applicable, practical workplace safety and health improvements which demonstrate effective solutions, including simple, low-cost solutions 
• organizing participatory occupational safety and health programmes 
• facilitating tripartite cooperation among governments, employers and workers in planning and implementing national and industry-level programmes on occupational safety and health 
• reorienting support and technical services towards action-oriented occupational safety and health approaches.