330 likes | 341 Views
This article explores the economic positions and theories of determinants of occupational health, estimates of injury and illness, prevention approaches, and the impact of international trade agreements on occupational health. It also examines the occupational health situations in different countries and the role of regulations, national strategies, and international organizations in addressing occupational health and safety issues.
E N D
International Occupational Health & Safety Tim Morse, Ph.D. University of Connecticut Health Center, Farmington, CT, U.S. Spring 2002
Outline • Economic positions • Theories of determinants of occupational health • Estimates of occupational injury and illness • Approaches to prevention • Maquiladoras (Mexico) • NAFTA (North American Free Trade Agreement)
Labor Force Distribution, 1988, ILO 80 70 60 50 40 Cameroon 30 Tunisia 20 Portugal 10 Sweden 0 Mfg Services Agriculture Unemployed
World System Theory (Wallerstein, Elling) • Position in world system • Economic resources • Strength of worker movement
First World • Tripartite structure • Standards vs. guidelines
Sweden (Elling, 1988) • Labor strong • 85% organized • Labor party • National law (Co-determination) • Committee majority union • Stop production process • Hire/Fire company physician • 110,000 trained union reps • Linkage to health system
Third World • Combined with effects of poverty, nutrition • Priority of economic development • Agric (60-80%) & primary production • Development led to dislocation • High unemployment
Third World • Emphasize labor-intensive industries • Control technologies not affordable • Low or no workers’ compensation • Highest risk have low access to social resources
Injuries/ Fatalities • 100 million workplace accidents • 180,000 fatalities • Developing countries • 20% injuries • 30% fatalities • Fatal rate 3-4X in developing • Source: Takala, 1989 • 1.1 million fatalities injuries and ill (ILO)
Injury Fatality Rates (ILO, 1998; Cited in Herbert and Landrigan, 2000)
Global Burden(Leigh, et al, Epidemiology, 1999) • Indirect Method • 100,000,000 occupational injuries • 100,000 deaths • 11,000,000 occupational illnesses • 700,000 deaths • Finish OD, Australian Injury rates • Apply age/sex-specific rates to population • Double rates for less developed
Occupational Disease • Higher risk in LDC’s in occupations • Pesticide poisoning • 3 million acute poisonings/yr (Jeyaratnam, 1985) • 220,000 fatal • Concentrated in LDC • Organic dusts
Occupational Disease • Noise • Heat Stress • Reduces use of PPE • Bloodborne diseases • 2 billion hep B carriers (world) • HIV in Africa
Regulations • Alma Alta declaration, WHO • Incorp occ health services in primary care • Colonial history • Use modified western standards • Lag behind knowledge • Not suited to conditions
National Strategy should include (Reich & Okubo) • Institutional development • Info management • Training • Safety Standards • Enforcement • Social values
ILO (Intrl. Labor Office) • Standard setting • Training materials • CIS Centers • Chemical safety data sheets • Information exchange • Technical cooperation
Multi-nationals • Tension with US workers (jobs, NAFTA) • Lower wages, less job security, weak unions • Lower national standards & enforcement • Usually better conditions than other local plants (corporate policy)
Maquiladoras (1995) • 2,200 Maquilas along Mexican border • 90% US owned • 550,000 employed, 65% women • 48 hour standard work week • Ave. take home $15-25 per week • government unions
Maquiladoras (Moure-Eraso, 1997) • 65% women • Little industrial experience • Labor turnover high (14%-180% per year in different provinces) • Mixed studies on reproductive hazards
Maquiladoras: Survey(Moure-Eraso, 1997) • 267 maquila workers interviewed in home, 1992 • 81% female, mean age = 25 • Living conditions generally good; 80% indoor plumbing, 75% cement floors • 45-48 hour work week • Ave weekly wage=$40 US ($0.93/hr)
Exposures • Dust 51% • Gas 60% • Poor ventilation 51% • Skin contact 50%
Symptoms • 56% headache • 53% unusual fatigue • 51% depression for no reason • 41% forgetfullness • 41% chest pressure • 39% difficulty falling asleep • 37% stomach pain • 36% dizzy • 33% numbness/tingling
Lead among radiator repair Dykeman et al, 2002 • Radiator repair workers in Mexico • 35.5 ug/dl vs 13.6 for working controls • Risk factors • Smoking • # radiators repaired/day • Use of a uniform (not laundered)
Mexican Safety Regulation: GAO • Survey of 8 auto plants (of 12 selected) • advance notice • 2-day walkthrough • Interviews with Mexican officials, OSHA • 6/8 had parent company support for H&S • Use of older equipment • Had been visited by STPS • US: 80% of auto parts plants with OSHA violations
GAO Results • Lack of hazard-specific programs • Hazards present at all 8 plants • 42% workers reported hand/arm pain • 70% worked less than 6 months • machine guarding • 6 plants emerg exit problems • lack of safety signs; some English only
GAO Findings • 6 facilities over 90 dB noise • had plugs, many not using • Lead, silica, solvents, welding gases • Respirators not used properly
Mexican Regulation • Law strong in some respects • H&S Committees • Problems • No first instance penalties • Specific standards weak in key areas • Max fine $1,500 • Low WC costs
NAFTA Chapter 11 (Moyers) • Allows suits by companies or shareholders if “tantamount to expropriation” • Methanex $1 bil suit vs. California for regulating MTBE • Metalclad $16 mill settlement vs Mexico for not allowing haz waste plant to open • Ethyl $!3 mil settlement for temp ban on MMT gas additive, withdraw ban, letter • Secret tribunals • Expanded Free Trade Agreement for Americas • “Diminish value of investment”