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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
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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”