Nordic OHS policies and the human resources needed for developing them

1. Joint EASOM -NUM Meeting on Occupational Health and Safety Training Helsinki 25 August 2005 Nordic OHS policies and the human resources needed for developing them byProfessor Jorma Rantanen President of ICOH

2. OUTLINE • History of Nordic Collaboration • Nordic OSH Convention • OSH policy programs • Need of OHS HRs • European policies • Future challenges • Summary

3. History • 1952- Nordic Council • 1962 Helsinki Treaty • 1971- Nordic Council of Ministers • 1972 Nordic Working Group on Occupational Medicine • 1973 Committee of Senior Officials for Work Environment (with Research Group) • 1984 Working group for Work Environment Research • 1990 Nordic Work Environment Convention • 1991 Combining Committee for Work Environment and Committee for Labour Market

4. Helsinki Treaty 1962 II Cultural Cooperation Article 10 The High Contracting Parties should coordinate that part of the public education system that provides qualifications for certain occupations and professions. The qualifications provided by such education should, as far as possible, be recognised and accepted in all the Nordic countries. Requirements relating to supplementary education and training necessitated by national conditions may, however, be prescribed. Article 11 In those areas where cooperation is appropriate, the expansion of educational establishments should be coordinated through a continuous process of cooperation with regard to the planning and execution of such expansion.

5. Helsinki Treaty 1962 III Article 12 Cooperation in the field of research should be so organised that research grants and other resources are coordinated and used in the best possible way, including the establishment of joint institutions. Article 13 In order to support and strengthen cultural developments, the High Contracting Parties shall promote free Nordic adult education and exchanges between the Nordic countries in the fields of literature, art, music, theatre, film and other areas of culture, and in so doing, utilise the opportunities provided by radio and television. Social Cooperation Article 14 The High Contracting Parties shall seek to preserve and develop further the common Nordic labour market in accordance with the guidelines drawn up in previous Agreements. Employment services and vocational guidance shall be coordinated. There shall be a free exchange of trainees. Efforts should be made to achieve a uniform application of national regulations concerning health and safety at work and similar matters.

6. Implementation of the Treaty • Parliaments: Nordic Council • Governments: Council of Ministers Senior Officials • Expert Groups • Working Groups • Joint Institutions (NIVA, NHV) • NGO type activities: Associations, Voluntary groups

7. Nordic Work Environment Convention 1990 I • Common objectives, collaboration, harmonization • Continuous improvement of WE • Exchange of experiences • Harmonization of regulations • Common Nordic position in international organizations • Tripartite collaboration

8. Convention Principles • Safety activities • OHS • Authorities • Employer's primary responsibility • Safe planning of work • Equality • Prevention • Protection • Refusal of the dangerous work • WE will be developed in the pace of the social and technical development in the society • Standards

9. Convention Artikel 8 För att främja en rationell utbyggnad av företagshälsovården bör ett utbyte av erfarenheter ske mellan dem som i de olika länderna svarar för inriktningen av företagshälsovården eller medverkar i denna. Artikel 9 Det nordiska samarbetet inom arbetsmiljöforskningen skall främjas och vidareutvecklas i syfte att genom utbyte av erfarenheter och forskningsrön och genom en uppdelning av forskningsinsatser bidra till ett effektivt utnyttjande av tillgängliga resurser och forskningsresultat. Särskild uppmärksamhet ägnas forskningsområden som lämpar sig för gemensamma nordiska projekt. De offentliga institutioner i de nordiska länderna som beviljar bidrag till forskning, utbildning och information inom arbetsmiljöområdet bör hålla regelbundna kontakter för att utbyta erfarenheter och diskutera fördelning av stöd till olika områden liksom överlägga om förutsättningarna för att gemensamt stödja samnordiska projekt.

10. Convention Artikel 10 De offentliga institutioner som i de olika länderna planerar och genomför specialistutbildning inom arbetsmiljöområdet bör etablera fortlöpande kontakter med varandra. I den mån det är ändamålsenligt med hänsyn till utbildningskrav och resurser i de olika länderna bör gemensamma utbildningar anordnas. Artikel 11 För att främja utvecklingen av information och dokumentation bör nära samarbete etableras mellan de offentliga institutioner som i de olika länderna svarar för sådan verksamhet. Särskild uppmärksamhet ägnas möjligheterna till samordning och gemensamt utnyttjande av de olika ländernas dokumentationssystem och möjligheterna för informationssökande i de olika länderna att snabbt få tillgång till befintlig dokumentation.

11. Convention: topics of collaboration • Harmonisation of regulations • Development of occupational health services • Development of safety and health • Development of inspection • Development of training and education • Development of research • Development of information services

12. Convention: Provisions for Research and Training Article 9 and 10 Nordic collaboration in work environment research and training shall be further developed through: • exchange of experiences, • division of work • through facilitating effective use of resources and research results • joint projects • joint institution, NIVA

13. Convention: Implementation • NMR Work Environment Programme • Regular meetings of High Level Officials (DGs 2x a year) • Expert Groups (Directors of the Research Institutes, 2x a year) * Initiatives and statements * Research projects (ca 10) on priority areas * Publication of reports * Meetings and seminars (NAM) * Training courses (NIVA)

14. Expert Group for Occupational Medicine/Research on Work Environment • Making an early research policy plan and initiatives for research projects • Generating method for setting priority criteria for discussions with policy makers/authorities • Combining competences, resources and study materials • Utilising Nordic Institutes as operative arms • Utilising research results for training programmes (later on through NIVA) • Establishing the system for research management by the FG/NMR

15. History of NAM • The safety inspectors convened annually since 1928 • Hygienic laboratories met since 1945 • The First Nordic Congress on Occupational Medicine and Hygiene in 1951 • The second Nordic Congress on Occupational Medicine and Hygiene in 1956 • Since then annually • Since 1976 Financial support from NMR • North-European Conference attempt • NAM well established since the 1970's

16. Nordic cooperation in the labour market 2005-2008 • Enlargement of the work force and full employment security • Efforts to combat work environment problems • such as high levels of sick leave • Development of the working of the labour market • Nordic business policies in partnership • with the EU and other international forums

17. NMR Program 2005-2008 • Reduction of sickeness absenteeism • Improvement of physical and psychological work environment at the workplace • Development of inclusive work life and prevention of exclusion

18. NMR Program 2005-2008 • Ensuring life-long learning in work life • Ensuring work environment standards • Develop collaboration between policy-making and authorities for promotion of the "Nordic Model" • Prevention of exclusion from work life • Prevent accidents and occupational diseases through collaboration between research institutes and authorities • Develop further sustainable work environment strategy • Train and inform on work environment research results through Niva and information project

19. Nordic Work Environment Program2001–2004 Four priorities: • Full employment: Matching between supply/demand of the workforce • Good work: Safety in the work environment and in the work life • Lowering the borders in the Nordic Region: Further strengthening of Nordic collaboration • Promote the Nordic welfare model, European perspective and Neighbourhood collaboration

20. Nordic WE Programme: Good Work • Developing a deeper understanding of new forms of employment, working time arrangements, growing turnover and new forms of organization in work life • Prevention of exhaustion, early exclusion from labour market • Inter-sectorial collaboration between the work environment and health authorities • Collaboration in work environment research and organization of courses e.g. on: *work life *safety *psychosocial factors *work organization

21. Coverage of OHS in 21 countries

22. Coverage

23. Need of OHS personnel in the Nordic area

24. Human resources in the Finnish OHS ** The Reginal Institutes of Occupational health provide a rich spectrum of hygiene services

25. IOH COMPREHENSIVE OCCUPATIONAL HEALTH Advisory, analytical etc support services OCCUPATIONALHYGIENIST PSYCHOLOGIST OHP OHN ERGONOMICS Company resources SAFETY ENGINEER HRM OD EXPERTS WHP-MWA OHP,OHN PHN,PHP Minimum density in the BOHS 1+2/5000 Special training needed!

26. EUROPE % of Global 800 mill. population 15% 380 mill. workforce 16% 8050 bill. USD GDP 35% EU 400 mill. population 7.7% 150 mill. workforce 7.0% 6700 bill. USD GDP 29% 10 New members since 2004 75 mill population ~ 35 mill workforce 785 bill. USD GDP Russia and NIS-countries 400 mill. population 200 mill. workforce 843 bill. USD GDP

28. Nordic & European • Commission: ACSHHAW: SCOEL • Bilbao & Dublin • NEG • NIVA • European Risk Observatory • European Strategy • MDS

29. Investing in quality Social Social quality - social cohesion Economic Competitiveness - dynamism Employment Full employment - quality of work Source. European Commission 26.6.2001

30. Policy Amsterdam Treaty Lisbon Strategy: Quality of work OS&H Strategy 2002-2006 Public Health Programme Technology Programme Principles Strong social dimension High level of protection Social dialogue Primary prevention OH and OS&H integration Employers´primary responsibility Participation Instruments Framework Directive 20 + Daughter Directives OELs and standards HSMS MDS guideline List of ODs Other guidelines Topic Centers Dublin Surveys H&S Week campaign EU policy

31. Strategy objectives and actions From a global approach to well-being at work Strengthening the prevention culture Education, awareness, anticipation: improving people´s knowledge of risks Better application of existing law Combining instruments and building partnership Adapting the legal and institutional framework Encouraging innovative approaches Working to mainstream health and safety at work in other Community policies Preparing for enlargement Developing international cooperation Community Strategy on Health and Safety at work 2002 - 2006

32. Framework Directive 89/391 EEC • Basic instrument for safety and health at work • Defines responsibilities and rights of employers and workers at work • Provides basic principles for safety and health ( and more for safety than health): High level of protection Primary prevention at source Best available technology Right to know and right to get trained Right to participate Right to protective and preventive services • Complemented with numerous specific daughter directives, standards and guidelines

33. Agenda 2000: 13 countries applied the membership. Acquis Communitaire required i.e. accession criteria. Several requirements and tasks to OHS. Enlargement will be made by supporting the applicant countries to achieve the minimum level of OH&S as defined by the Acquis Communaitaire Phare economic and expert support and twinning instruments will be used to implement that principle. EU policy:Enlargement

35. Enterprise Reorganisation Networking, flattening, slimming Fragmentation Continuous change New technology Fast production Mobility Subcontracting, down- sizing, outsourcing Social responsibility Workforce Short-term contracts and precariocity Self-employees, SSEs Mobility Aging, young workers Feminisation Growing competence Ethnic heterogeneity Entrepreneurship Shortage of labour Lower unionisation Work and family life Change Economy

36. Traditional ODs Pneumoconioses Solvent injuries Metal poisonings Pesticide poisonings NIHL White finger disease Crude strain disorders Traditional contact dermatoses Traditional allergies New or re-emerging ODs Stress disorders New infections New allergies Musculoskeletal disorders Indoor air-related disorders New hypersensitivity outcomes Cancers, Asbestos cancer Reproductive disorders Work-relatedness of common NCDs Old and new occupational morbidity

37. Work-relatedness of common chronic diseases % Asthma (adult males) 30 (Karjalainen et al, 2001) Lung cancer 25-30 (Axelsson 2001) Cardiovascular disorders CHD 5-10 (Leigh 1997) Cerebrovascular 5 (Leigh 1997) Musculoskeletal disorders Upper extremities 15-40 (EU OSHA) Low back pain 40-50 (WHO 2002, NAS 2001)

38. Exposures and problems • Combination of physical, psychological and social "exposures" • Coexistence of "old" and "new exposures" • SMEs and SSEs, urban and suburban areas most exposed • New risk combinations • Great variations • Complex exposure patterns • Low-level long-term exposures • High short-term exposure peaks

39. Challenges to risk assessment in the postmodern era • Managing growing complexity, physical, chemical, behavioral, social • Changing temporal patterns vs. continuity • Control of dynamic base-lines • Management of uncertainty and complexity • Using new methodologies such as genomics • Multifactorial, multistage modeling • Bayesian causal modelling • Bayesian forecasting • RAPs • Case cross-over • From post-hoc RA to predictive management

40. Future perspectives in Europe • From control to prevention – from prevention to development • Interaction + specialization • Predictive methods • Enabling SMEs and SEs • Safety work tools for practitioners • Research-based evidence and solutions • Responding to new hazards and threats • Responding to enlargement • Safe Europe

41. New instruments • European surveys • European risk observatory • Indicators and benchmarks • OS&H Management systems • Good practice guidelines • Voluntary commitment to social responsibility • Development and harmonization of statistics • Bilbao Agency data banks and Topic Centres • European Week • Concerted research programms

42. Pre- cautionary principle High Best avail- able tech- nology(BAT) REGULATORY APPROACH Level of safety Best prac- ticable technology (BPT) As far as reasonably practicable (ALARA) VOLUNTARY ACTIVITIES As far as reasonable (AFR) Cost-benefit (C/B) Free choice Low Protection and prevention principle

43. Forretningspolitik - Arbejdsmiljø - Ligestillling/integration - Organisationsfrihed/kollektiv forhandlingsret - Børne/tvangsarbejde - Arbejdstid - Aflønning - Jobfastholdelse og integration af medarbejdere med nedsat arbejdsevne Styreprogrammer - Bestyrelses- og direktionsansvar - Arbejdsmiljø - Ligestilling/integration - Work/life - Medarbejderinddragelse - Overskudsdeling/medejendomsret - Medarbejdertilfredshed - Jobfastholdelse og integration af medarbejdere med nedsat arbejdsevne Rapportering - Årsrapport/Supplerende/www - Indhold: statements/cases/ kvalitativt/ kvantitativt Performance Indikatorer - Sygefravær - Arbejdsulykker - Timer til efteruddannelse og træning - Bøder/arbejdsmiljø - Medarbejdertilfredshed - Kvinder I bestyrelse/direktion - Minoriteter i bestyrelse/direktion/ arbejdsstyrke - Antal medarb. med nedsat arbejdsevne Verificiering - Intern/uavfheengig evaluering Nordic sustainability index:Medarbejdere

44. Challenges to training • New training methods • Quantitative training needs • New working practices • Multiprofessional collaboration • Networking • International work • New competences & contents • Psychosocial issues; stress • New work organizations • Aging workers • Continuous change

45. Emergence in modern OH&S STAGE III STAGE II Need of multidisciplinarity Demand of professional competence *Comprehensive *Promotion *Developing *Multidisciplinary STAGE I * Risk and risk factor- oriented *Preventive service" "OH&S = Loss control" • Injury and repair-oriented • "First aid and treatment" OHS = Development resource for workers and for the enterprise 1850 1950 1960 1970 1980 1990 2000

46. Need of Innovative approach!! Dr Shuaib Ismail Manjra

47. Basic Occupational Health Services

48. Summary • Europe is strong in social dimension at work • OH&S an important part of social dimension • Sustainability of good work is an important objective • OHS still underdeveloped; coverage below 50% • Many transitions ongoing: -From risk-specific safety to global well-being at work -From inequity to universal minimum level of safety and health -Mainstreaming OH&S with overall development -Developing new members to average European level -Developing adjacent areas to the EU level • Resources of OHS are scanty: quantitatively and qualitatively • New inputs from EU, NMR and Governments are needed • OH&S and QOW important elements for the welfare state and for competitiveness