1. Third Quarterly Report (5.11.2003-4.2.2004) of the Estonian-Finnish Twinning Project on Occupational Health Services 2003-4 (EE02IBSO03) Kari-Pekka Martimo Pre-Accession Advisor (PAA)

2. To reduce the number of work-related diseases in Estonia in the long run To increase the coverage, availability and accessibility of OHS throughout Estonia To increase employees’ and employers’ awareness on OH&S issues To support the practical implementation of EU regulations in the field of OH&S Objectives of the Project

3. Elements Policies and Strategies The MoSA and other relevant authorities will be supported OHS The development of the OHS infrastructure for better coverage and quality in the provision of services. Work-related diseases The development of coverage, quality and effectiveness of recognition of ODs and other WRDs Networking Developing and further strengthening relevant OHS Networks; Preparation of county, community and sectoral OHS profiles Information Awareness raising, dissemination of information, management of information General Informing relevant partners and stakeholders on the project

4. Uncertainty around OHC; functions to be divided between SoMA, Nat’l Inst for Health Development, Labour Inspectorate, Health Care Board? Letters by MS Project Leader and the Head of EC Delegation contributed to the survival of OHC Organisational changes at MoSA Involvement of social partners has been modest Collaboration at OHC has been successful Training events and seminars have attracted large number of participants General comments during the third quarter

5. 1. General EO I: Informing all involved parties on the objectives of the project –Various activities during the third quarter –www.ttk.ee/twin/index.htm EO II: Evaluation of the project –(In the end of the project) EO III: Project management/steering committee –Meetings on 21 August and 20 November

6. 2. Policy and Strategy EO I: Development of policy implementation –Description and analysis of OHS system in Estonia –Policy programmes have been implemented only partially EO II: Development of infrastructure –Seminar to be arranged on 16 February EO III: Support to the planning and evaluation on insurance system for occupational accidents and diseases –Seminar on 19 November

7. EO IV: Comparative analysis of registered work injury risks by sector of economy in Finland and Estonia –Completed; results presented on 19 November EO V: Consulting on the establishment of the National Topic Centre for good practices in OH&S –Seminar on 20 November; continuation depends on the future of OHC 2. Policy and Strategy

8. EO I: Good Occupational Health Practice –Training courses based on EBM and GOHP –Guidebooks on GOHP in Estonian have been distributed EO II: Developing the service provision infrastructure of OHS with widened coverage –Knowledge of employers and employees on the processes and benefits of OHS is low –Follow-up and evaluation by Health Care Board in the future? 3. Occupational Health Services

9. EO III: Agricultural OHS –Assessment of OH&S in agriculture accomplished –Visit of agricultural experts to Finland 5-7 November EO IV: Development of indicators for functioning and status of OHS –Focus on registers of occupational (Annex I) and work- related diseases (Annex II) –Symposium on 5-6 February, seminar on 6-7 April EO V: Increasing awareness and disseminating information through networks –In addition to networks, a seminar to the employers on 12 December 3. Occupational Health Services

10. EO I: Training curriculum on work-related and occupational diseases –Meetings on 1 October, 8 December, one more scheduled EO II: Training of the OH and family physicians –13/15 courses and 22/26 days of training accomplished with c. 90 participants each day EO III: Training of trainers –Courses arranged on 3 September and 14 November 4. Work-Related Diseases and Training

11. EO IV: Subnetwork on OH&S training institutions –Meetings on 2 December and 19 January EO V: Defining a policy for criteria, recognition and registration of occupational diseases and policies for prevention –Seminar of insurance systems on 19 November –Consultation on 25 November –Possible amendments in the definitions of the law 4. Work-Related Diseases and Training

12. EO I: National Occupational Health and Safety Network –Follow-up workshop to be arranged on 4 March EO II: County and community OH&S Profile –Under preparation; to be presented on 30-31 March EO III: Tartu County OH&S Network –Seminar scheduled on 30-31 March 5. Networking

13. EO IV: Subnetwork on OH&S in Agriculture –Follow-up workshop on 11 February –Good example of a well motivated network EO V: Sectoral profile on OH&S in agriculture –A draft outline has been prepared and discussed 5. Networking

14. EO I: Increasing awareness of stakeholders –Seminar on 12 December –Articles in newspapers and one radio interview EO II: Defining information needs –Guidelines and fact sheets under preparation EO III: Updating the Internet network strategy, producing information material for the Internet, and surveying the information –Follow-up seminar of the Agricultural OH&S Subnetwork on 11 February 6. Information

15. EO IV: Provision of information material for OH&S –Estonian Newsletter on OH&S is the main channel (also in the future?) –Other information material under preparation EO V: Promotion of the use of information –Training scheduled on 23 March 6. Information

16. Strengthened implementation of the Estonian Occupational Health Development Plan (until 2007) and the MoSA’s Strategy for OH&S 2003-2007 for development of OHS system Status: ++ Comments: Future status of the development plan and the strategy? Success in supporting the activities and defending the continuation of OHC Guaranteed result No. 1

17. Administrative structure and institutional capacity for recognising occupational diseases has been described, discussed and approved as part of national policy and strategy Status: ++(+) Comments: Future acceptability of Act on Insurance of ODs/OAs? Compensation to OH physician for examining suspected cases? Guaranteed result No. 2

18. Occupational health personnel and necessary public health personnel are trained on diagnostics, treatment and prevention of work- related diseases Status: ++(+) Comments: Possibilities to implement the acquired knowledge? Incentives for collaboration in primary and secondary health care? Guaranteed result No. 3

19. Guidelines for “Good Occupational Health Practice” will be distributed and trained to relevant practitioners Status: ++(+) Comments: In connection with training and the produced information material Not recognised by national legislation? Guaranteed result No. 4

20. National, local and subject-oriented OH&S networks are strengthened. Indicators, profiles, research studies, information on the occurrence of work- related diseases and preventive activities of OHS are available... Guaranteed result No. 5

21. ...in the National Network of Occupational Health for specialists, social partners, and the general public Up-to-date information on OHS and work- related diseases are available and disseminated Status: ++(+) Comments: The role of OHC in practical implementa- tion? Key roles of social partners? Sectoral approach recommended Guaranteed result No. 5