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Occupational Health Services. Kari-Pekka Martimo Pre-Accession Advisor (PAA). Five element objectives (EO). Good Occupational Health Practice (GOHP) guideline in Estonia Developing the service provision infrastructure of OHS with widened coverage
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Occupational Health Services Kari-Pekka MartimoPre-Accession Advisor (PAA)
Five element objectives (EO) • Good Occupational Health Practice (GOHP) guideline in Estonia • Developing the service provision infrastructure of OHS with widened coverage • Agricultural OHS, making an assessment of the OH&S situation in farms • Development of indicators for functioning and status of OHS • Increasing awareness and disseminating information through networks
EO I: GOHP guideline in Estonia • Aim was to introduce GOHP guidelines into practice in Estonia • Activities: • Principles adopted in all activities since the beginning of the project • GOHP guideline published in January 2004 • Other published guidelines and fact sheets supported the adoption of GOHP • Several seminars and meetings to support the implementation of GOHP
EO I: GOHP guideline in Estonia • Conclusions: • Guidebook was considered important even if it needs more adaptation to Estonian system • Present legislation supports GOHP • Project supported quality improvement required by Ministry of Social Affairs • Ethics and effectiveness of health examinations need more consideration
EO I: GOHP guideline in Estonia • Impact: • The wide distribution of guidebooks and popularity of the training events together with perceived needs to develop OHS most likely lead to improvements in the OHS processes
EO II: Developing OH service provision infrastructure with widened coverage • Aim was to link family doctor network to the infrastructure of OHS • Activities included • 26 days of training on work-related diseases to 1556 participants • Involvement of stakeholders through various meetings and seminars • Study visit of OH physicians and clinical specialists to FIOH on 16-19 March 2004
EO II: Developing OH infrastructure • Conclusions: • Other specialists interested in work-relatedness of diseases and in collaboration with OHS • Some employers more interested in OH&S issues than required by law • More flexibility in provision of OHS needed (e.g. SMEs, farmers, self-employed) • Statutory obligations and possibilities of OH physicians collide
EO II: Developing OH infrastructure • Impact: • 63 (+14) OH physicians, 197 family physicians and other specialists and 9 agricultural experts have been informed on OHS system, its strengths and weaknesses, as well as opportunities for development and threats
EO III: Agricultural OH&S, making the assessment of the situation in farms • Aim was to develop a model for OHS arrangements in agriculture • Activities: • Four farms were visited on 4-5 September 2003, and a suggestion for the OH&S model has been made • Study visit of five agricultural experts to Finland on 5-7 November 2003 • Visit to the Minister of Agriculture on 12 January 2004
EO III: Agricultural OHS • Conclusions: • Farmers’ associations have been active in promoting OH&S • More research needed on incidence of work accidents and work-related diseases among farmers, as well as more training and information on OH&S issues • Collaboration between public health and OH authorities needed to expand OHS expertise to rural areas
EO III: Agricultural OHS • Impact: • Project activities have contributed to the initiation of development of occupational health and safety services in agriculture • Practical aids have been produced
EO IV: Development of indicators for functioning and status of OHS • Aim was to develop models and indicators (quantitative and qualitative) for evaluation of OHS unit’s functions. • Planned activity was to instruct OHC on indicators to collect information for the Ministry, and for self-evaluation of the units • Several meetings and seminar focused on indicators
EO IV: Development of indicators • Conclusions: • At present, the service providers are well documented, but too little information exist on the processes and customers of OHS in Estonia • Registry of W-RDs makes an alternative for that of ODs • Self-assessment of effectiveness and quality was supported with practical aids
EO IV: Development of indicators • Impact: • Preparedness for use of indicators has increased • Future role of Health Care Board in follow-up of OHS?
EO V: Increasing awareness and disseminating information through networks • Aim was to increase awareness and information among interest groups in collaboration with network element • Activities: • All meetings, seminars and training events have distributed information on OHS • On 12 December 2003 a special seminar was organised to the employers
EO V: Increasing awareness... • Conclusions: • General interest of employer and employee organisations on OH&S issues has been modest • Public interest increased after latest amendment of Act on OH&S and during discussions on insurance of ODs and work accidents • OH&S issues have not been in the agenda of decision makers during the project
EO V: Increasing awareness... • Impact: • The project has analysed the present situation and produced material for improvement of the OH&S in Estonia
Recommendation for future actions • Amendments needed in the Act on OH&S: • Employer’s duty to provide continuous access to OH specialist • OH services should be obligations instead of possibilities • Inconsistencies concerning ODs/W-RDs • Good Occupational Health Practice • Promotion as well as protection and prevention • Follow-up and evaluation at national level
Recommendation for future actions • Incentives for the employers to improve OH&S • More responsibility for work-related ill-health • Premiums through insurance system • Information on productivity and health and safety at work • Adequate resources for Labour Inspectorate
Recommendation for future actions • Alternative models for OHS • Profit making enterprises and self-employed do not cover peripheral regions • Large enterprises may prefer in-house OH specialists for closer collaboration • Family physicians should get more involved in OHS but only if adequately trained and supervised by OH specialists • Professional independence is a challenge in every model
Recommendation for future actions • Strong competent authority needed • Prerequisite for development of OHS • Needed for • Training • Expert advice • Research • Information • Collaboration • For public image of OHS