1. Wiking Husberg ILO Northern Dimension Partnership “Health at Work” Strategy

2. Global Estimates Global workforce: 2.8 billion Work related fatalities:2.2 million Occupational accidents:270 million Work-related diseases:160 million Global GDP (income)30 000 billion USD Lost GDP in accidents/diseases 4 % Illiterate:1000 million People in poverty:1000 million Child workers:246 million Global workforce: 2.8 billion Work related fatalities:2.2 million Occupational accidents:270 million Work-related diseases:160 million Global GDP (income)30 000 billion USD Lost GDP in accidents/diseases 4 % Illiterate:1000 million People in poverty:1000 million Child workers:246 million

3. Second Page Life expectancy at birth, in years Source: WHO/Europe, HFA Database, January 2005

4. Towards systematic approach 1981 ILO Convention 155; 1985 ILO Convention 161; 1989 EU Framework Directive 391; 2001 ILO-OSH 2001; 2003 ILO Global Strategy on OSH; 2006 ILO Convention 187 on Promotional OSH; 2007 EU Strategy on OSH 2007-12; 2007 WHO Global Plan of Action 2008-17

5. WHO Global plan of action on workers’ health 2008 - 2017 Policy instruments (national policy framework, national action plan Protect at the work place (define essential interventions, primary prevention) Access to occupational health services Surveillance of workers’ health – accurately identify and control hazards Inclusion of workers’ health in other sector policies

6. EU Community strategy 2007-2012 on health and safety at work Aims for a 25 % reduction of occupational accidents –EU strategy 2002-06 decrease 17 %, absence rate fallen by 20 % –But still 28 % of workers suffer non-accident problems 35 % feel that their job put them on risk

7. EU Community strategy 2007-2012 on health and safety at work (2) Develop national strategies; policy coherence (public health, social cohesion, employment); implement EU Directives Changes in the workplace, change of behaviour, especially SMEs Identifying and evaluating risks (risk assessment) Education and training programmes Improving health and promoting awareness

8. New ILO Convention 187 - 2006 NATIONAL OSH POLICY NATIONAL OSH SYSTEM NATIONAL OSH PROFILE NATIONAL OSH PROGRAMME Article 2

9. Health and Work Health Work Life style Habits Societal support systems Work ability Employability Occupational hazards and strains OSH system Primary health care system Health behaviour Some problems - social dialogue - variation and polari- sation of health - access to service - access to info - non-coherence of actions - costs and resources Employment relations International strategies and collaboration

10. Target population and work Population Informal work Micro companies & SMEs Formal empl. Unemployed Non-active population

11. Commonalities – WHO, ILO, EU »Right to health and safety »Right to health services »Right to know »Right to work Raising awareness, building preventative OHS culture Full coverage and access to quality, affordable services Collaboration and cooperation; intercountry, regional, national Incorporation of health and safety in all policies

12. Commonalities – WHO, ILO, EU (2) National systematic level: Government leadership Tripartite participation National OSH profiles and indicators National OHS strategy and plan Enforcement of legislation Institutional framework; health systems development, centres of excellence on OHS; labour inspection

13. Commonalities – WHO, ILO, EU (3) Tools and mechanisms Human resource capacities Basic and applied research Evidence based practices; guidelines Simple tools for practice Information dissemination; experts/workplaces/public; internet Mainstreaming OSH into trainig and education Follow-up and evaluation of progress

15. “Healthy life – healthy work” Forum WHO “the silent worker” –Informal sector, migrant workers, working children Keep up the political momentum –Provide “evidence based facts” Combine public health and occupational health ILO Systematic approach Conv 187 –Profile, programme, system –Safety culture –Awareness raising (ILO estimates, World Day 28 April) Tri-partism – access to work places

16. “Healthy life – healthy work” Forum EU: The community OSH strategy 2003 – 2007 has led to results –Decrease of fatalities 17 % –Decrease of absenteeism 20 % Increased practical implementation of the Directives Cope with demographic change –Ageing work force –Lack of work force Cooperation MinHealth – MinLabour ICOH: Broad concept of health “social determinants of health” Global pandemics (SARS, avian flu) – work related 50 % of Europeans not covered, inequity, high risk areas Several options for occ health services  BOHS

17. “Healthy life – healthy work” Forum Case of new EU Member State - Lithuania Differing trends in the EU 25 Case shows lower indicators; negative trends Challenges in system and in resources Improvement process started Strategy 2008 – 12 Baseline survey Based on int’l strategies Clear plans for improvement Although open indicators

18. Healthy life – healthy work Forum Healthy Workplace Initiative of the Bilbao Agency: –The economies are changing, new demographic phenomena: rapid ageing of the population; If we want to be high on the political agenda, we have to work for keeping people healthy up to the retirement age and beyond –in the complex situation in the workplace work across the borders of jurisdictions is a necessity; –167,000 fatalities attributed to work-related accidents and diseases in the EU-27 –importance of having reliable statistical data – has an effect on identifying the priorities –safety in societies will result in better productivity and competitiveness –Healthy workplace initiative – SMEs as a target point – other tools such as OSH Week needs to be harnessed to support this activity – 36 seminars –media should be used for disseminating information to the general public

19. “Healthy life – healthy work” Forum Reports on regional OSH projects ILO OSH Project in North-West Russia –Created and adapted new methodologies –Practical testing of ILO-OSH 2001 –Multiplying in other countries –Coop with Partnership South East European Network on Workers' Health –Establishment of SEE Network –Cooperation with the BSN OSH network and the Partnership SIHLWA/OSH network Baltic Sea Network on Occupational Health and Safety –Established networking and collaboration –Joining forces with Partnership SIHLWA/OSH

20. “Healthy life – healthy work” Forum Broadening “traditional” occupational health to lifestyle- related issues with a work aspect alcohol and work/ Sweden Alcohol still is a delicate issue to be discussed? NO! Alcohol toxication as a cause for occupational accidents Screening methodologies, voluntariness Workplace to be used as an arena for interventions alcohol and work (2007-2010)/ Finland Training of OH doctors, part of occ health services Material (guidebook, drinking diary) Early identification (screening), brief interventions Workplace is a good setting to prevent alcohol problems HIV/AIDS at workplaces Workplace programme for HIV/AIDS Link HIV/AIDS work with the OSH organisation

21. Partnership Health at Work Strategy Based on the WHO Global Plan of Action on Workers' Health 2008 – 2017, the ILO Global Strategy on Occupational Safety and Health (2003 – ) and the ILO Convention No. 187, the European Strategy for Safety and Health at Work 2007 – 2012, the new EU Health Strategy, 'Together for Health: A Strategic Approach for the EU 2008-2013' the new EU Second Programme of Community action in the field of Health 2008 – 2013

22. Partnership Health at Work Strategy The Partnership notes work and health are closely inter-related; all adverse health effects and injuries are preventable; health and safety at work require a systematic approach and strong leadership by the Governments; major inequities great variations in working conditions, in the health of the workers, and variation in access occupational health services underserved workplaces and workers need basic occupational health services, the basic conditions for high productivity; public health and occupational health are closely related and need to be developed in parallel; the improvement of workers' health is also strongly related to lifestyle issues, such as nutrition, smoking, alcohol consumption, physical exercise, etc.

23. Partnership Health at Work Strategy The Partnership resolves  the multifaceted interactions of work and health health should be integrated in all policies;  the strategies on occupational health and safety of WHO and ILO, as well as of the EU for the EU member countries, are to be implemented effectively;  the ILO Convention No. 187 on Promotional Framework adopted and implemented in full;  Actively diminishing the inequity in health between and within countries;  joint activities in the field of workplace health promotion to reduce communicable and non-communicable diseases;  allocating sufficient resources to projects and to development of occupational health service systems;  a closer collaboration between primary health care and occupational health services, including the need for competence and capacity building.

24. Health at Work Strategy The Partnership recommends Policies and programmes 1. Each Partner Country, whenever feasible, to draw up a national occupational safety and health profile according to the guidance provided by the ILO as the basis for the national programme on occupational health and safety. Such profiles should be used for the identification of the most urgent needs for action and for the follow-up of the progress made. 2.Each Partner Country, whenever feasible, to draw up a national policy and programme for the development of work life, health and safety at work and the development of working conditions conducive to health and well-being, as described in the ILO Convention No. 187. This task is recommended to be carried out in collaboration with other relevant ministries and stakeholders. 3. Each Partner Country, whenever feasible, to prepare a special national programme for the development of occupational health services for all working people. Where appropriate, the Basic Occupational Health Services approach is used for providing services particularly to the currently underserved groups in the formal and informal employment sectors.

25. Health at Work Strategy The Partnership recommends Specific actions 4. Special joint and national actions to be instituted for the elimination of the most dangerous hazards at work in the sectors and branches of economy at highest risk, by utilizing successful experiences from the Partner Countries and by sharing information, knowledge and good practices in such preventive work. 5.The Partner Countries to organize audits of occupational health and safety. The nature of the audits should be informational and they should promote learning rather than resemble inspections. Sharing the results of the audits will be used for learning from the partners. 6.Partner Countries may organize specifically targeted actions for the management of special occupational health and safety problems recognized as priority issues for a part or for the whole Region, such as the improvement of occupational health and safety in the transport sector.

26. Health at Work Strategy Capacity building 7. Partner Countries to organize region-wide joint seminars, courses and symposia for sharing experiences and for training experts working in authorities and in services in the field of health and safety. Information 8.Organized efforts for sharing information through the web to be enhanced by utilizing the existing information systems, such as the NDPHS Database, the Baltic Sea Network on Occupational Health and Safety, various newsletters and other media. Existing networks will be used for effective sharing of good practices. Simultaneously, the establishment of national and sectoral networks is encouraged to support the effective implementation of activities. The Partner Countries to organize joint information campaigns for awareness raising among the public at large and among the interested parties in particular on the importance of occupational health and safety for the development of the Region. For this purpose, the information support of the ILO, WHO and the European Agency for Safety and Health at Work should be fully utilized. Partnership to organize study tours for decision-makers, authorities and experts of individual countries to share experiences and learn from the neighbours. Follow-up and evaluation 9.The Partnership to organize a follow-up activity enabling the evaluation of achievement of the above activities by the end of 2011.

27. Background for the joint Plan of Action Recently endorsed OH&S strategies (ILO, WHO, EU) (discussed in Bonn, October 30,2007; Vilnius, November 14,2007) Analysis of OH&S status in the countries (draft reports of BSN network countries are available) NDPHS Strategy on Health at Work (prepared by NDPHS OSH expert group during 2007 to be further discussed by the Pre-PAC Forum on November 15,2007) Project proposal developing occupational health services, and preventing work-related ill-health (based on the discussions within the BSN and SIHLWA-OSH expert groups and eleborated by FIOH) Plan of Action will be translated into practical activities (BSN and SIHLWA – OSH will be utilized for coordination and guidance)

28. BSN Annual Meeting + SIHLWA/OSH Group (Partner countries+Int.Org.+Donors) I Preparation of National OSH Profiles - several activities II Preparation of the National OSH Programme - several activities III Providing Basic Occ Health Services - several activities Streamlining and coordinating the national projects within BSN and NDPHS SIHLWA/OSH Nat’l teams Nat’l teams A small steering group Nat’l teams IV Improving Health & Preventing Accidents in High-risk Sectors - several projects, different sectors, same approach V Advocacy, awareness raising, adding to the knowledge Project outline for implementation start

29. Cooperation between WHO, ILO and EU with BSN-OSH network and Northern Dimension Partnership on Health and Social Wellbeing (NDPHS), 14 Nov, Vilnius - provide joint assistance for basic occupational health systems development - sharing of information - risk assessment - best practice - awareness raising (WD 28 April, Safety week, Health Day) - support Partnership “Health at Work” strategy based on ILO, WHO and EU OSH strategies, and - give full approval of the Project concept for implementing the Partnership strategy

30. “Healthy life – healthy work” Forum recommends: to enhance the process of cooperation between WHO, ILO and EU, and between sub-regional networks to utilise WHO, ILO and EU OSH strategies to prepare national occupational health and safety systems at the national level increase cooperation to utilise all health and safety resources consider links between public health, occupational health and life style issues within a work place context the adoption of the Partnership “Health at Work” Strategy support the outline for a project to implement the Strategy