The workplace is one of the most important settings for protecting and promoting health and safety, especially since an increasing proportion of the population participates in formal and informal employment. Work and the work environment determine a large proportion of the quality of life in general. The working environment is also one of the most important settings for preventing pollution of the ambient environment around the workplace. A key to sustainable development is to make all those involved in enterprises aware of the value not only of continuously improving their work environment but also of reducing or avoiding pollution of the ambient environment.
To ensure optimal health for employees and the population at large, the environmental management of an enterprise should include the sustainable use of natural resources, energy efficiency, waste minimization, cleaner production, and the minimization of risks to human health by improving workplace health and safety. It should apply an integrated, preventive environmental strategy to production processes, and to products throughout their life cycle. Pollution prevention should gradually replace pollution control.
This strategy features in the framework of Agenda 21 as formulated at UNCED (Rio de Janeiro, 1992), now coordinated by the United Nations Commission on Sustainable Development and implemented through national and local authorities. Agenda 21 recommends the establishment of industrial hygiene programmes in all major industries for surveillance of workers' exposure to health hazards.
Many workers, notably those who are engaged in industrial operations or who use new technologies such as visual display units, experience health impairments such as cumulative traumatic disorders and stress-induced illnesses. These complaints are often the result of multiple factors related to both work and private life. Occupational lung diseases are one of the largest categories of work-related diseases all over the world.
The composition of the labour force has changed, with increased proportions of elderly people, young people, disabled people and women. Part-time jobs, telework and temporary contracts have gained prominence. Migrant workers tend to be selected for more hazardous jobs than other workers, and it has been recognized that they may bring with them health problems from previous exposure. Vulnerable groups should receive sufficient support to allow them to continue working, to maintain or improve their working ability and to fulfil their social role (such as exercising their reproductive rights). Special attention also needs to be paid to employees of small and medium-sized enterprises, where there is less investment in occupational health.
Risk factors related to work organization are contributing more and more to the deterioration of employees' health, although physical, chemical and biological health hazards are still present in many workplaces. Psychosocial stress problems and musculoskeletal disorders are the most important occupational health issues. Significant risk factors include violence at work, excessive physical load and repetitive movement, noise, mental factors (i.e. the pace of work), exposure to chemicals and biological factors (i.e. infectious occupational diseases). Lifestyle factors (i.e. smoking and physical inactivity) are also important determinants of workers' health and ability to work.
Occupational health aims to minimize the risk to employees' health from work, and prevent occupational diseases and accidents. Occupational safety denotes the principles and procedures used to prevent occupational accidents and injuries in all production and servicing facility. Combining health promotion with occupational health and safety activities may be more effective in maintaining or improving the working capacity of employees – reducing sickness, absenteeism or premature permanent work disability – than only protecting the health and safety of employees from occupational risks.
In 1995, the Joint International Labour Organization/WHO Committee on Occupational Health revised the definition of occupational health to focus on three different objectives: (a) maintaining and promoting workers' health and working capacity; (b) improving the working environment and work to become conducive to safety and health; and (c) developing work organization and working cultures in a direction that supports health and safety at work and, in so doing, also promotes a positive social climate and smooth operation and may enhance the productivity of an undertaking.
About 3% of the total annual burden of disease is caused by preventable injuries and deaths in high-risk occupations and by chronic illness caused by exposure to toxic chemicals, noise, stress and physically debilitating work patterns. An estimated 30% of total deaths and 30% of the total loss of disability-adjusted life years in the European Region are related to environmental and lifestyle factors that might be controlled or influenced through health protection and promotion activities at the workplace.
The economic losses from occupational accidents in some European countries are estimated to comprise 3-5% of the gross national product. Measures should be taken to preclude the existing possibility of externalizing the costs of work-related and workplace-preventable ill health by transferring them to society through social insurance schemes or national health care systems. Internalization of health protection and promotion costs at the workplace is more efficient and compatible with sustainable development.
The Declaration of the Third Ministerial Conference on Environment and Health (London, 1999) states: We recognise the importance of instituting workplace measures to meet public health needs and goals, and the right of workers to be involved in the decision-making process on those measures. We will promote good practice in health, environment and safety management in enterprises, in collaboration with stakeholders in our countries such as local authorities, enforcement agencies, business (including small and medium-sized enterprises), trade unions, NGOs, social and private insurance institutions, educational and research institutions, auditing bodies, and providers of prevention services. The current regulatory frameworks and economical appraisal related to health and safety should be, if necessary, strengthened for this purpose and self-regulatory mechanisms (voluntary initiatives and agreements) should be used as complementary measures. We invite WHO and the International Labour Organization to work together to assist countries in developing processes, involving all stakeholders, for implementation of environmental practice which also promotes public health, and to develop close cooperation with the European Commission to assist the candidate countries for membership of the European Union to meet their obligations.
Article 3 of the European Social Charter (Revised) (Strasbourg 1996) provides: With a view to ensuring the effective exercise of the right to safe and healthy working conditions, the Parties undertake, in consultation with employers' and workers' organisations: 1) to formulate, implement and periodically review a coherent national policy on occupational safety, occupational health and the working environment. The primary aim of this policy shall be to improve occupational safety and health and to prevent accidents and injury to health arising out of, linked with or occurring in the course of work, particularly by minimising the causes of hazards inherent in the working environment; 2) to issue safety and health regulations; 3) to provide for the enforcement of such regulations by measures of supervision; and 4) to promote the progressive development of occupational health services for all workers with essentially preventive and advisory functions.
ILO promotes the identification, prevention and control of work-related diseases, with particular emphasis on activities to eliminate the exposure of workers to hazardous materials and chemicals and to unhealthy working conditions.
During the 1990s, there developed an awareness that reorienting occupational health services can help greatly in achieving the objectives of national health and environmental strategies. The health of the workforce is a result of all occupational and non-occupational health determinants. Further, control of environmental pollutants and hazards in the workplace benefits both workers and the quality of the ambient environment. Many European countries made considerable conceptual, political, legislative and practical progress in occupational health. However, the health and safety status of employees has worsened in some countries, mainly the NIS and some CEC.
In the USA, the Clinton administration implemented regulations aimed at reducing repetitive-motion injuries in the workplace on 16 January 2001, four days before President Bush took office. Citing the regulations' costs to businesses, the Bush administration repealed them within a few months.
There is a link between long hours and poorer health perceptions and between greater on-the-job freedom and better health perceptions. Employees who have some latitude in how they accomplish their tasks seem to have a brighter health outlook, compared with workers in jobs that come with more constraints.