1. The project LEONARDO DA VINCI PROJECT Ref. NL/99/2/09131/PI/II.1.1.a/FPC Communication of occupational physicians with workers on health and safety issues

2. The project Communication …

3. The project … of Occupational Physicians …

4. The project … with workers ….

5. The project … on health …

6. The project … and safety issues …

7. Project Planning (1) EASOM Proposal 1999: Phase 1. Duration 4 months. Inventory of current situation of workers’ instruction about risks at work: * available courses and materials * demands and needs of employers, workers, professionals and schools.

8. Project Planning (2) Phase 2. Duration 12 months. Development and practical test of teaching method and materials for workers. Specific elaborations for 3 branches of industry.

9. Project Planning (3) Phase 3. Duration 10 months. Development and practical test of training for OPs.

10. Project Planning (4) Phase 4. Duration 4 months. Dissemination of products to Schools of Occupational Medicine and OHSs in the EU Member States

11. Project Planning (5) Phase 5. Duration 18 months. Project and product evaluation. Final report.

12. Project Planning (6) Total duration 18 months. Phase 1. Months 1 thru 4. Phase 2. Months 3 thru 14. Phase 3. Months 5 thru 14. Phase 4. Months 15 thru 18. Phase 5. Months 1 thru 18.

13. Phase 1: the inventory: contents (1) A.Current situation about: 1.workers’ instruction about health and safety risks at work 2.available training courses and materials within schools of occupational medicine

14. Phase 1: the inventory: contents (2) B. Demands and needs of: Employers Workers Professionals

15. Phase 1: the inventory: respondents (1) Sweden / NIWL, Solna Finland / FIOH, Helsinki Poland / NIOM, Lodz Great Britain / Medical School, Newcastle Belgium / Catholic University Leuven Belgium / IDEWE Leuven Netherlands / NSOH Amsterdam

16. Phase 1: the inventory: respondents (2) Italy / University of Bari Italy / University of Brescia Italy / University of Modena Switzerland / Institut für Hygiene und Arbeitsphysiologie, Zürich

17. 1a. Does the legislation about health, safety and well-being at work contain specific regulations about communication, instruction and information to workers? Yes 10 Data about the workers’ instructions (1)

18. 1b.  Who is charged with these tasks by the law? The employer is responsible; in Italy the OP is responsible too. Data about the workers’ instructions (2)

19. 2a. Who are the providers of this instruction and information within the company? * the OHS 9 * the employer 6 * the hierarchical line 6  the OP 6 Data about the workers’ instructions (3)

20. 2a. Who are the providers of this instruction and information within the company? * specialised service (PL, UK, I/Modena) * Prevention and Protection Service (I/Brescia) * employer’s prevention adviser 1 (B) Data about the workers’ instructions (4)

21. 2b. Who are the providers of this instruction and information outside the company? governmental institutions 9 SF: FIOH PL: Labor Inspection, Sanitary Inspection UK: Government agencies (HSE, Ministries) B: Provincial Institute of Safety (Antwerp) Data about the workers’ instructions (5)

22. 2b. Who are the providers of this instruction and information outside the company? trade unions 8 employers’ organisations (branches) 6 non-governmental institutions 3 professional associations 3 insurance companies 2 Data about the workers’ instructions (6)

23. 3a. What types of health risks information are frequently given to the workers? information on work related health risks 10 health data from clinical examinations 6 laboratory and instrumental data 4 health advice 4 Contents and types of the workers’ instructions (1)

24. 3a. What types of health risks information are frequently given to the workers? information and advice about work accidents and safety risks 9 general (non-work related) health information 7 Contents and types of the workers’ instructions (2)

25. 3b. In what form this information is presented to the workers? oral explanation 10 written forms (brochures/leaflets/posters) 10 digital / electronic forms: e-mail, websites 5 Contents and types of the workers’ instructions (3)

26. 4. Does the OP have a formal task of providing information about health and safety risks to workers and employers? Yes 4 No 4 No clear answer 2 Position and role of the occupational physician (1)

27. 5. How much of his time (% or hours/month) he usually spends to this task? PL: 20 – 30 ( - 100) % I/Brescia: 10 – 20 % CH/Zurich: 10 – 20 % I/Modena: 20 % NL/Amsterdam: < 5 % Position and role of the occupational physician (2)

28. Working conditions / exposure: Ergonomics/working posture/movements Psychosocial stress Noise Chemicals Shift work Most frequent issues of workers’ risk information (1)

29. Specific health and safety risks: Musculo-skeletal Mental ill health Skin protection Respiratory Audiological Long term health effects after exposition to carcinogenics and infrared radiation Most frequent issues of workers’ risk information (2)

30. Improvement of health and safety behavior at work: Use of personal protective devices First aid in workplaces Influencing the personal risk behaviour Rights and duties Most frequent issues of workers’ risk information (3)

31. Health status and life style: Safety and health risk in general Describing the personal risk situation Explanation and providing a copy of clinical data Raising the awareness of early signs and symptoms General health surveillance Most frequent issues of workers’ risk information (4)

32. 6. Who is triggering the information task of the OP? occupational physician 7 Committee for safety and health 6 employer 5 individual worker 5 the trade unions 3 Position and role of the occupational physician (3)

33. 7. Has the OP received a formal training for his communication task? Yes 3 during his specialist training 2 · during continuing education programs 0 · during his in practice training within the OHS service 2 other (e.g. self learning) 0 Possible 2 No 5 Training of the occupational physician (1)

34. 8. Are there courses or materials available, also specifically used by OPs? Yes 6 No 2 Training of the occupational physician (2)

35. 9a. Demands of workers * occupational risks in their job  why they have to be visited  importance of the clinical analysis  previous health problems in their task anywhere else  importance of protection device and their better use  importance of the exposure for future risks Demands for risk information & instruction (1)

36. 9b. Demands of employers * how to improve health prevention * the real importance of the health surveillance in their firm * appropriateness of health surveillance * what is legally obligatory? Demands for risk information & instruction (2)

37. 9c. Demands of occupational physicians * better integration between the actors * demand of more investment in tools useful for health management * what is legally obligatory? Demands for risk information & instruction (3)

38. 9d. Demands of other occupational health professionals More Power! Demands for risk information & instruction (4)

39. 10a. Needs of workers More information and instruction by employers, hierarchical line and occupational physician Needs for risk information & instruction (1)

40. 10b. Needs of employers Occupational health professionals (other than OP) should be more competent Needs for risk information & instruction (2)

41. 10c. Needs of occupational physicans Professional guidelines based on scientific evidence of the approach Needs for risk information & instruction (3)

42. 10d. Needs of other occupational health professionals Continuous education Needs for risk information & instruction (4)

43. 10e. Who is making the needs assessment? Governmental agencies Workers’ unions Employers and their unions Occupational safety coordinators of the companies Physicians and OP associations Occupational hygienist Safety engineer Organisational psychologist Account manager of OHS Needs for risk information & instruction (5)

44. Conclusions

45. BACKGROUND In all surveyed countries, there is a legal obligation to inform and instruct workers about health and safety risks at work. The employer is responsible. Conclusions (1)

46. PRACTICE In most cases, information and instruction of workers about health and safety risks at work is provided by OHS professionals and company staff. Oral instruction and printed materials are most frequently applied. Conclusions (2)

47. TRAINING Only 2 out of 10 respondents indicate that training in risk communication is a regular part of the specialist training in occupational medicine. Conclusions (3)

48. APPRAISAL Employers: doubts about effectiveness and competencies Employees: risk information is perceived insufficient Professionals: practice is not evidence-based Conclusions (4)

49. ACTIONS (to be discussed) Employers: to enable employees … Employees: should be trained to assess and control their own health and safety risks Professionals: to train the employees in risk assessment, evaluation & control Conclusions (5)