Declaration on occupational health for all
The Second Meeting of the WHO Collaborating Centres in Occupational Health, which was held in Beijing, People’s Republic of China, II-14 October 1994, discussed and adopted a proposal for a WHO Global Strategy for ‘Occupational Health for All’. In adopting the strategy, the meeting recognized the urgent need to develop occupational health at a time when rapid changes in working life are affecting both the health of workers and the health of the environment in all countries of the world. The meeting also adopted a proposal for action aimed at implementation of the strategy.
The meeting was attended by representatives of thirty one, collaborating centres in twenty seven countries, WHO, the International Labour Office, the United Nations Development Programmc and the International Commission on Occupational Health. The WHO Workers’ Health Programme and the Institute of Occupational Medicine of the Chinese Academy of Preventive Medicine were the main organizers of the meeting.
Health at work: a priority issue
1. According to the best available estimates 100 million workers are injured and 200 000 die each year in occupational accidents and 68-157 million new cases of occupational disease arc attributed to hazardous exposures or workloads. Such high numbers of severe health outcomes contribute to one of the most important impacts on the health of the world’s population. Occupational injuries and diseases play an even more important role in developing countries where 70% of the working population of the world lives. By affecting the health of the working population, occupational injuries and diseases have profound effects on work productivity and on the economic and social well-being of workers, their families and dependents. According to recent estimates, the cost of work-related health loss and associated productivity loss may amount to several per cent of the total gross national product of the countries of the world.
2. The formal workforce constitutes on average 50-60% of a country’s total population. If informal work and work at home are also taken into account, the major part of the population is involved in work. This work products all economic and material values and sustains all other societal activities thus ensuring the socioeconomic development of countries.
The Constitution of the WHO, the Alma Ata Declaration on Primary Health Care, the WHO Global Strategy on Health for All, plus the ILO Conventions on Occupational Safety and Health and on Occupational Health Services stipulate among other issues the fundamental right of each worker to the highest attainable standard of health. To achieve this objective, access to occupational health services should be ensured for all workers of the world irrespective of age, sex, nationality, occupation, type of employment, or size or location of the workplace.
3. Although effective occupational health and safety programmes and many structural changes have improved the conditions of work in some sectors, several hazardous agents and factors such as physical, chemical, biological as well as psychosocial stress in addition to occupational accidents still threaten the health of workers in all countries continuing to cause occupational and work-related diseases and injuries throughout the world. In some economic sectors and in some countries occupational health indicators show even worse trends than in the past.
Although the transfer of healthy and safe technologies has had a positive impact on development, the transfer of hazardous technologies, substances and materials to developing countries, which have insufficient capacity to deal with such problems, constitute a threat both to the health of workers and the environment.
4. New developments in work, the work environment and work organization, the introduction of new technologies, new chemical substances and materials in all countries, and the growing mechanization and industrialization in developing countries can lead to new epidemics of occupational and work-related diseases and injuries.
In addition, demographic changes in working populations call for new strategies and programmes for occupational health throughout the world.
5. The level of occupational health and safety, the socioeconomic development of the country and the quality of life and well-being of working people are closely linked with each other. This suggests that intellectual and economic inputs in occupational health are not a burden but have a positive and productive impact on the company and national economy. Some industries and countries have demonstrated that it is technically feasible and economically productive to prevent and minimize hazards at work.
Thus occupational health is an important factor for sustainable socioeconomic development that enables workers to enjoy a healthy and productive life both throughout their active working years and beyond.
Way to a new healthy working life
6. Health and safety at work are important matters tbat relate to the general health and well-being of working people and that should be given due consideration in policies at all levels (i.e. company, national and international). Health and safety problems at work are, in principle, preventable and should be prevented by using all available tools-legislative, technical, research, training and education, information, and economic instruments.
Governments are encouraged to prepare a special national policy and programme for occupational health that include actions for providing competent occupational health services for all people at work. Such a programme should include the development of appropriate legal provisions, and systems for enforcement, and inspection by competent authorities specially responsible for occupational health.
7. Governments should ensure the development of necessary infrastructures for effective implementation of occupational health programmes, including occupational health services, research programmes, training and education, information services and data banks. Networking of such infrastructures within and among the countries would substantially facilitate their efforts to implement national programmes.
8. It is a realistic long-term objective to organize well functioning and competent occupational health services for all workers to ensure healthy and safe workplaces as well as the required services for each individual worker. In order to be comprehensive such an occupational health service should include first of all a multidisciplinaly preventive element, including surveillance of the work environment and health of workers and, where appropriate, relevant curative and health promotion elements.
9. The focal point for practical occupational health activities is the workplace. Employers are responsible for planning and designing a safe and healthy work, workplace, work environment and work organization, as well as for maintaining and constantly improving health and safety at work.
Workers in many countries are trained in occupational safety and health. They have the right, to know the potential hazards and risks in their work and workplace, and they should, through appropriate mechanisms, participate in planning and decision-making concerning occupational health and other aspects of their own work, safety and health.
Workers should be empowered to improve working conditions by their own action, should be provided information and education, and should be given all the information, in order to produce an effective occupational health response through their participation. Workers with individual susceptibilities, handicaps and other characteristics affecting their working capacity have a right to job adaptation that fits the work to the worker.
In order to provide necessary expert support to such workplace level activities, expert communities, appropriate professional bodies and other nongovernmental organizations are encouraged to participate in and give support to occupational health activities at all levels, including the workplace.
10. Necessary action should be taken to ensure and enable appropriate collaborative links between occupational health and other associated activities, such as occupational safety, environmental health, environmental protection, primary and specialized health services, and social security.
11. WHO should consider giving higher priority and better visibility to its policies and programmes for occupational health. In so doing, WHO should give a full consideration to the fact that workers are a key target population for health policies at both international and national levels. Giving priority to occupational health will be a move towards a healthy working life and thereby to healthy socioeconomic development. As an organization committed to the protection of eople’s health, WHO and its Office of Occupational Health should take the leading role in the global development of occupational health in general and occupational health services in particular. Collaboration of the WHO Workers’ Health Programme with other relevant programmes of WHO and with other international intergovernmental and nongovernmental organizations should be ensured.
12. The Second Meeting of the WHO Collaborating Centres in Occupational Health (currently a network of 52 institutions), by adopting this Declaration, wishes to encourage Member States and WHO to further develop their occupational health programmes. The meeting recommends that the proposal for the WHO Global Strategy on ‘Occupational Health for All’ that was adopted by the Meeting, should be presented to the Executive Board and further to the World Health Assembly. The strategy should thereafter be used as the basis for the development of occupational health activities within the framework of the WHO General Programme of Work. The collaborating centres commit themselves to give all support within their possibilities to the implementation of the strategy at international, national and local levels.
Authorized by the Second Meeting of the WHO Collaborating Centres in Occupational Health, WC Chairpersons of the meeting and the Planning Group of the Collaborating Centres’ Network sign this Declaration.
Beijing, 13 October 1994
Pr Jorma Rantanen
Finnish Institute of Occupational Health, Finland
Pr HE Fengshong
Institute of Occupational Medicine, China
Vice Chairperson of the Meeting
Chairperson of the Organizing Committee
Dr Richard A. Lemen
National Institute for Occupational Safety and Health, USA
Pr Nikolai F. Izmerov
Institute of Occupational Health, Russian Federation