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Provision of occupational health services means carrying out activities in the workplace with the aim of protecting and promoting workers' safety, health and well-being, as well as improving working conditions and the working environment. These services are provided by occupational health professionals functioning individually or as part of special service units of the enterprise or of external services.
Occupational health practice is broader and consists not only of the activities performed by the occupational health service. It is multidisciplinary and multisectoral activity involving in addition to occupational health and safety professionals other specialists both in the enterprise and outside, as well as competent authorities, the employers, workers and their representatives.
Such involvement requires a well-developed and well-coordinated system at the workplace. The necessary infrastructure should comprise all the administrative, organizational and operative systems that are needed to conduct the occupational health practice successfully and ensure its systematic development and continuous improvement.
The establishment of occupational health services according to the models advocated by the Convention No. It is however evident that the most advanced occupational health services are in concordance with the ILO instruments. Other types of infrastructures may be used. Occupational medicine, occupational hygiene and occupational safety may be practised separately or together within the same occupational health service.
The occupational health service may be a single integrated entity or a composite of different occupational health and safety units unified by a common concern for workers' health and well-being.
The Central and Eastern European countries now in transition are having problems in providing services due to reorganization of their economic activities permit expediting services chicago the break-up of the large centralized industries into smaller units.
Lower coverage figures are found on other continents. Even in countries where coverage rates are high, there are gaps, with small-scale enterprises, certain mobile workers, construction, permit expediting services chicago and the self-employed being underserved.
Thus, there is a universal need to increase the coverage of workers by occupational health services throughout the world. In a number of countries, intervention programmes to increase the coverage have demonstrated that it is possible to substantially improve the availability of occupational health services in a relatively short time and at a reasonable cost.
Such interventions have been found to improve both the workers' access to the services and the cost effectiveness of the services provided.
Policy Impact of International Instruments The so-called work environment reform which took place in most of the industrialized countries in the s and s saw the production of important international instruments and guidelines.
They reflected the responses of occupational health policies to the new needs of working life, and the achievement of an international consensus on the development of occupational safety and health.
By 31 May40 ratifications of these Conventions had been registered, but their practical impact was much wider than the number of ratifications, since many countries had implemented the principles embodied in these instruments, although they had not been able to ratify them.
Simultaneously, the WHO Global Strategy Health for All by the Year HFAfirst launched inwas followed in the s by introduction and implementation of regional and national HFA strategies in which workers' health constituted an essential part.
The most important features of the international consensus on occupational safety and health are: Its Agenda 21 contains elements on providing services for underserved workers and ensuring chemical safety at the workplace. The Rio Declaration emphasized peoples' right to lead "healthy and productive lives in harmony with nature", which would require work and working environment to meet certain minimum health and safety standards.
Such instruments and international programmes directly or indirectly stimulated the inclusion of the provision of occupational health services in the national Health for All by the Year programmes and other national development programmes.
Thus, the international instruments have served as guidelines for the development of national legislation and programmes. Legislative Structures for Occupational Health Practice Most countries have laws governing the provision of occupational health services, but the structure of the legislation, its content and the workers covered by it vary widely Rantanen ; WHO c.
The more traditional laws consider occupational health services as a group of specialized and separate activities such as occupational health care, occupational safety and hygiene services, workplace health promotion programmes and so on.
In many countries, instead of stipulating what might be regarded as programmes, the legislation stipulates the responsibility of employers to provide health risk assessments, health examinations of workers or other individual activities related to workers' health and safety.
The legislation usually delegates the authority to establish, implement and inspect occupational health services to such ministries or agencies as Labour, Health or Social Security WHO There are two main types of legislation regulating occupational health services: One views the occupational health service as an integrated multidisciplinary service infrastructure and stipulates the objectives, activities, obligations and rights of the various partners, the conditions of operation, as well as the qualifications of its personnel.
The other type of legislation is found in most industrialized countries and is more fragmented. Instead of a single act stipulating the occupational health service as an entity, it involves a number of laws that simply oblige employers to carry out certain activities.
These may be stipulated quite specifically or merely in general, leaving issues of their organization and conditions of operation open WHO c. In many developing countries, this legislation is applicable only to main industrial sectors, while large numbers of other sectors as well as agriculture, small-scale enterprises and the informal sector remain uncovered.
During the s, particularly in industrialized countries, social and demographic developments such as ageing of the working population, increase in disability pensions and sickness absenteeism, and difficulty in controlling social security budgets led to some interesting reforms of national occupational health systems.
These focused on the prevention of both short-term and long-term disability, preservation of working capacity, particularly of older workers, and reducing early retirement. For example, the amendment of the Dutch ARBO Act Kroon and Overeynder together with three other social laws aimed at the prevention of short- and long-term disability stipulated important new requirements for occupational health and safety services at the plant level.
This new system will be implemented stepwise and should be mature before the end of the s. Amendments of the Finnish Act on Occupational Health Services in and introduced the maintenance of working capacity, particularly of ageing workers, as a new element in the legislation-based preventive activities of occupational health services.
Implemented through the close collaboration of all the actors in the workplace management, workers, health and safety servicesit involves improvement and adaptation of work, working environment and equipment to the worker, improving and maintaining the physical and mental working capacity of the worker, and making the work organization more conducive to maintaining the work capacity of the worker.
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