The World Health Organization (WHO) and the International Labour Office (ILO) today called for immediate, "ethically correct and economically sound" measures to improve the working conditions of the world's labour force of some 2500 million people. Unless working conditions are improved, governments would face serious and costly consequences, warned the two agencies

Their warning came in the wake of the International Conference on Occupational Health, which opened on Monday in Helsinki, Finland.

"From the occupational health perspective, trends towards globalisation of trade pose certain health risks," said Dr Richard Helmer, Director responsible for occupational health at WHO. "For example, in order to reduce costs, industries with their accompanying occupational hazards are being relocated to developing countries -- home to 75% of the global workforce."

"The problem is that many of these countries lack the technical and social infrastructure to provide protection for their working and non-working populations against hazards of physical, chemical, biological, psychosocial or ergonomic character. As a result, what is an economic blessing today, may lead to considerable deterioration in the health status of working populations of the developing world tomorrow," Dr Helmer pointed out.

Evidence already suggests that hundreds of millions of people throughout the world are employed in conditions that breed ill health and are unsafe. According to Dr Jukka Takala, Chief of the ILO's Health and Safety programme, each year work-related injuries and diseases kill an estimated 1.1 million people worldwide, roughly equal to the estimated total annual number of deaths from malaria. "This figure includes around 300 000 fatalities from an estimated 250 million accidents in the workplace, which often lead to partial or complete loss of capacity to work and generate income," he said.

At present, an estimated 160 million new cases of work-related diseases annually occur in the world, including respiratory and cardiovascular diseases, cancer, hearing loss, musculoskeletal and reproductive disorders, mental and neurological illnesses.

More than 50% of workers in industrialised countries complain today about stress in the workplace. Job stress and overwork have been associated with sleep disturbance and depression. There is enough scientific evidence to suggest that prolonged exposure to job stress is associated with several types of chronic health problems, including cardiovascular diseases, particularly hypertension, and musculoskeletal and psychological disorders. In the USA, for example, expenditure on health care is nearly 50% greater for workers who report high levels of stress at work.

The cost of occupational diseases and injuries is enormous. National and international reports indicate that in 1997, the global economic losses resulting from them reached an estimated 4% of the world's gross national product. In 1992, total direct and indirect costs associated with work-related injuries and diseases in the USA were assessed to be US$171 000 million, surpassing those of AIDS and on a par with those of cancer and heart disease. In 1994, the overall cost health to the British economy of all work accidents and work-related illnesses was estimated between £6 000 million and £12 000 million.

WHO and ILO admit that the evaluation of the global burden of occupational diseases and injuries is difficult. Reliable information for most developing countries is scarce, mainly due to underdiagnosis and serious limitations in the reporting systems. WHO estimates that in Latin America, for example, only between 1 and 4 % of all occupational illnesses are reported.

There are two main problems common in many countries: a certain unwillingness to recognize occupational causes of injuries or health problems, and failure to report them even when recognized. The history of occupational health has been that of a continuous struggle between workers fighting for protection or compensation and their employers seeking to deny or reduce their liability for work-related diseases and injuries. This conflict has greatly influenced statistical reporting. As a result, the burden of disease due to occupational exposures is usually underestimated.

The two agencies also warned that within the next 30-40 years, population ageing (with fewer children born and more people living longer) might change the proportions between the working and retired populations in certain industrialized countries. In 2040, France, for example, is expected to have 70 people over 60 years for every 100 aged between 20 and 59, almost double the current ratio. As a result, the French social security and pensions system is expected by that time to reach a deficit of some FF800.000 million (US$130 000 million).

The existing trends in occupational health need and must be changed in the interests of both workers and employers. It will be done if the quest for higher productivity and cost–effectiveness go hand in hand with considerations of safety and health at work, WHO and ILO said.