Escolar Documentos
Profissional Documentos
Cultura Documentos
Journal of
Occupational Health
Field Study
8
3
0.07
10.05
0.35
6.56
17.04
0.05
14.41
0.45
7.34
22.25
0.04
17.29
0.56
8.90
26.79
Number of factories
Number of workers
2,323
1,731
977
934
674
410
307
107
58
9
596,552
392,297
146,575
282,788
196,947
71,416
130,075
30,789
15,318
3,113
58,102
50,723
21,559
14,602
16,214
1,616
8,404
972
297
67
study of BOHS.
In the last ten years, the need for OHS in Baoan has
increased dramatically, as more and more factories were
built and a large amount of migrant workers came to
Baoan. However, the coverage of OHS reached just
12.3% in 2001 according to our survey, which was low,
as in other areas in China4, 5). The reasons for the low
coverage were fourfold. The first was that the managers
and workers of factories were originally farmers who
were little educated and unaware of the occupational
hazards of the materials they used. Second, it was
impossible for the factories to provide OHS for the
workers by themselves. Because most factories were
SMEs, they could not provide in-company OHS like big
companies. Third, the government could not offer the
services to all workers due to a lack of professional staff
and finances. Fourth, there was a large informal sector
in Baoan, and the informal sector workers were exposed
to occupational hazards without access to OHS.
The BOHS system in Baoan
To achieve a wide coverage of BOHS, we developed
a three-level occupational health system which provided
services through the primary health care approach. This
system was led by a government group. The group
members included the district governor, leaders of the
Fig. 1. The BOHS system in Baoan, integrated in the primary health care system.
Table 3. Target groups and contents of services of the BOHS three-level system
Administrative level
Target group
Content
Upper
Intermediate
Lowest
Table 4. Summary of the awareness of occupational health among the interviewees between 2006 and 2008
Part
Workers (N=4,500)
2006 (N (%))
2008 (N (%))
2,136 (47.4)
1,987 (44.2)
1,467 (32.6)
1,039 (23.1)
276 (6.1)
4,236 (94.1)*
3,972 (88.2)*
4,296 (95.5)*
4,157 (92.3)*
2,723 (60.5)*
Managers (N=150)
2006 (N (%))
2008 (N (%))
103 (68.7)
82 (54.6)
67 (44.7)
42 (28.0)
21 (14.0)
146 (97.3)*
143 (95.3)*
139 (92.7)*
142 (94.7)*
129 (86.0)*
*: p<0.01, Chi-square tests for comparison between 2006 and 2008. The matching of companies was not considered because some
different companies responded to surveys in 2006 and 2008.
Results
The comparison between 2006 and 2008 showed that
the knowledge and recognition rate of occupational
diseases increased significantly. There were 69
questionnaires having missing data in our survey.
Among the 150 managers and 4,500 workers, only 66
managers and 1,347 workers were aware of the
knowledge of occupational health in 2006. While in
2008, the number of managers and workers had
reached 143 and 4,043, respectively. The awareness
rate also rose in each part of the questionnaire (Table
4).
Discussion
To provide OHS for the employees in Baoan, a series
of measures were taken. These measures have been
proved to be effective and accepted by society, including
the government, employers and employees. Though the
BOHS system was adaptable to Baoans economic and
social development, it was not perfect because the
services could not cover all workers. We found it
difficult to cover the workers who changed their
workplaces and jobs frequently. Such workers
changed jobs three or more times a year. How to
provide OHS to these workers remains to be further
investigated.
It is indispensable to integrate occupational health
with a primary health care system to provide universal
BOHS. To build up a new system providing OHS
independent of the primary health care system is
probably the best solution but it is rather optimistic to
expect realization in the short run. Society and the
government do not yet have enough funds and human
resources to develop such a system. With the help of the
primary health care system, we trained physicians and
nurses in primary health care in occupational health and
got them involved in the BOHS system, rather than
hiring new staff for BOHS. We found the physicians
and nurses grasped the knowledge of occupational
health more easily than other people, because they
had majored in medicine or nursing.
The development of OHS was divided into four
stages: the starting level (Stage I), BOHS (Stage II),
international
standard
services
(Stage
III),
comprehensive OHS (Stage IV)2) . Part of our OHS,
including the services provided
References
1) International Labor Office. Thirteenth session of the
Joint ILO/WHO Committee on Occupational Health;
Dec 912 2003: Summary Report JCOH/2003/D.4.
Geneva: ILO; 2003.
2) Rantanen J. Basic occupational health services: A
3)
4)
5)
6)
Pada tahun 2006, ada 10.600 pabrik dan 2,1 juta pekerja
di Baoan. Jumlah pabrik ditutupi oleh OHS adalah
3.700, dan jumlah pekerja yang menerima
pengawasan kesehatan adalah 610.000. Pada tahun
2008, BOHS tertutup 9.200 pabrik dan 1,9 juta
pekerja dari 11.200 pabrik dan 2,3 juta pekerja.
Tingkat cakupan dari pabrik meningkat dari 35% pada
tahun 2006 menjadi 82% pada tahun 2008. tingkat
cakupan dari pekerja dengan pengawasan kesehatan
meningkat dari 29% menjadi 81%.
Survei kami menunjukkan bahwa BOHS yang layak,
diterima dan terjangkau bagi pengusaha. Menurut
estimasi kami, pengusaha menghabiskan hanya 200
RMB untuk setiap pekerja kesehatan kerja per tahun
untuk menghindari hilangnya 3.000 RMB disebabkan
oleh penyakit akibat kerja per tahun. Kami berasumsi
bahwa salah satu pekerja menderita penyakit akibat
kerja di pabrik mempekerjakan 100 pekerja.
Hilangnya ke pabrik adalah 300.000 RMB, termasuk
denda dan ganti rugi. Namun, pengeluaran untuk
BOHS hanya 20.000 RMB, termasuk pengawasan
kesehatan dan pengawasan lingkungan kerja.
Kerugian dan pengeluaran diperkirakan dari
pengalaman kami. Pengusaha menemukan BOHS
yang efektif biaya, sehingga mereka bersedia untuk
meminta BOHS bagi pekerja mereka.
Diskusi
Untuk memberikan OHS untuk karyawan di Baoan,
serangkaian langkah-langkah yang diambil. Langkah-