1. Farmers’ Occupational Health Services in Finland K. Taattola & al Finnish Institute of Occupational Health, P.O. Box 93, FIN-70701 Kuopio, Finland –Organisations –Statistics –History and Devellopment of FOHS –FOHS in practice

2. Kirsti Taattola, Chief of office (agricultural ingeneur) Pirjo Jokela, OH-physician -researcher Birgitta Kinnunen, OH-nurse (rn)-researcher Jukka Mäittälä, Occupational hygienist Pirjo Pulkkinen-Närhi,Financial secretary Adress:P.O.B. 93, FIN-70701 KUOPIO Tel.+358-17-201 211 Fax+358-17-201 221 emailN.N@occuphealth.fi Personnel of the National Centre for Agricultural Health

3. 1. Improve the effectiveness and coverage of FOHS (Farmers' Occupational Health Services) in municipal health centres  inform and motivate OH personnel and local authorities (site visits, news bulletins, telephone consultations, web-site)  encourage farmers to join FOHS 2. Inform and train  organize training courses for OH-personnel, farmers, agricultural advisors, representatives of insurance companies, and public labour inspectors  compile information booklets  compile good occupational health practises guidelines for FOHS  compile articles for journals 3. Evaluate and develope FOHS  research 4. National and international co-operation Activities of the National Centre for Agricultural Health

4. HEALTH AND SAFETY LEGISLATION OCCUPATIONAL SAFETY LEGISLATION AND ORDERS SUBSTITUTE FARM WORK SERVICES, ACT IN FINLAND SINCE 1974 EMPLOYEMENT ACCIDENT INSURANCE COVERS ALL WAGE EARNERS, ALSO FARMERS IN FINLAND OCCUPATIONAL HEALTH CARE ACT IN FINLAND SINCE 1979, JOINING VOLUNTARY FOR FARMERS

5. Active farms 72 000 Dairy20 000 Other husbandry10 000 Crop40 000 Forestry 1 000 Others 1 000 Agricultural labour force 112 000 Farmers82 000 Family members 8 000 Permanent employees22 000 Municipalities 450 FOHS units in municipal health care centres 270, private OH-units 14 providing FOHS Statistics

6. COVERAGE OF FOHS IN FINLAND IN 2002 42 800 Farmers and familymembers have joined FOHS 37 300 persons get exempt from part of the insurance costs (Farmers Social Insurance Institution) regional variation from 20 to 60% of farmers: - production line - size of farm - age of farmer

7. HISTORY The planning and development of farmers’ occupational health services (FOHS) in Finland has been carried out since 1979 by the Finnish Institute of Occupational Health and the Social Insurance Institution and financed also by the Farmers’ Social Insurance Institution

8. HISTORY In 1985, the National Board of Health issued an ordinance initiating FOHS in municipal health care centres. This ordinance was thorougly revised in 1989.

9. GOOD OCCUPATIONAL HEALTH PRACTICE IN FARMERS’ OCCUPATIONAL HEALTH SERVICES In 1995, a new concept Good Occupational Health Practice (GOHP) was incorporated into Finnish legislation GOHP emphasises in the conduct of OHS: - quality - effectiveness - ethics The Ministry of Social Affairs and Health issued an ordinance GOHP in FOHS in the beginning of 2000

10. THE NEW ACTS SINCE 1999 A National Centre for Agricultural Health (NCAH) was founded by special legislation to aid the continuous development of GOHP in FOHS. The law has required FSII to exempt those who have joined FOHS and received regular farm visits by FOHS, from 20 % of their workers’ compensation insurance costs (in 2000 about 160 FIM per farmer).

11. GOOD OCCUPATIONAL HEALTH PRACTICE IN FARMERS’ OCCUPATIONAL HEALTH SERVICES resources available and training of occupational physicians and occupational health nurses turnover of physicians and nurses activity of the local board for FOHS marketing of services to farmers coverage of services activity and function of the services (how the protocol for FOHS has been carried out) consultations with the local agricultural advisor activities maintaining work ability. existence and quality of displays of personal protective equipment

12. The principal limitations are lack of resources of FOHS personnel training of FOHS personnel marketing of services the inactivity of the local FOHS boards coverage lack of organised activities to maintain work ability.

13.  how to decrease high prevalence of work-related diseases and occupational accidents  how to maintain Farmers coping with their work and family  how to improve the functional adequacy of FOHS  how to change farmers attitudes and to make them more active FOHS Challenges to farmers' occupational health and safety activity

14. Future needs of FOHS Information, training, motivation Continuous evaluation and development of FOHS Networking OHS –Authorities –Research –Agricultural advisory services –OH-units Integrating FOHS into the Quality Management System for farming