Asian-Pacific Newsletter

O N O C C U PAT I O N A L H E A LT H A N D S A F E T Y
Volume 17, number 1, May 2010

New emerging
Occupational health and
risks training
safety
Asian-Pacific Newsletter
on Occupational Health and Safety
Contents
Volume 17, number 1, May 2010
Occupational health and safety training
3 Editorial
Published by François Eyraud, ILO, Turin
Finnish Institute of Occupational Health
Topeliuksenkatu 41 a A
4 Improving OSH at construction sites through a parti-
FI-00250 Helsinki, Finland
cipatory training approach: Experience of Bangladesh
Editor-in-Chief A.R. Chowdhury Repon, Bangladesh
Suvi Lehtinen

Editor
9 Work-related diseases – A challenge for occupational
Teemu Lindfors
health and public health training and practice
Jorma Rantanen, Finland
Linguistic Editing
Sheryl Hinkkanen 12 Occupational safety and health training programme:
Layout
A Malaysian perspective
Abdul Mutalib Leman, Fadzil Othma, Abdul Rahman
Liisa Surakka, Kirjapaino Uusimaa, Studio
Omar, Malaysia
The Editorial Board is listed (as of 1 December 2008)
on the back page. 14 The role of worker unions in occupational health and
safety at industry level
This publication enjoys copyright under Protocol 2 of Bambang Surjono, Indonesia
the Universal Copyright Convention. Nevertheless,
short excerpts of the articles may be reproduced 16 Developing OSH training systems – Challenges facing
without authorization, on condition that the source food enterprises in China
is indicated. For rights of reproduction or translation, Yuhang WANG, China
application should be made to the Finnish Institute of
Occupational Health, International Affairs, Topeliuk- 19 International Training Centre – training for the world
senkatu 41 a A, FI-00250 Helsinki, Finland. Teemu Lindfors, Finland
The electronic version of the Asian-Pacific Newslet-
20 Cardiovascular health and work on focus
ter on Occupational Health and Safety on the Inter-
Suvi Lehtinen, Finland
net can be accessed at the following address:
http://www.ttl.fi/Asian-PacificNewsletter
21 ICOH and training in occupational health
Suvi Lehtinen, Finland
The issue 2/2010 of the Asian-Pacific Newsletter deals
with Injury and disease reporting systems.

Asian-Pacific Newsletter is financially supported

by the Finnish Institute of Occupational Health, the
World Health Organization, WHO (the US NIOSH
grant ”International Training and Research Support
of World Health Organization (WHO) Collaborating
Centers in Occupational Health”), and the Interna-
tional Labour Office.

Photograph on the cover page:

A.R. Chowdhury Repon, Bangladesh

Printed publication:
ISSN 1237-0843 The responsibility for opinions expressed in signed articles, stu-
On-line publication: dies and other contributions rests solely with their authors, and
ISSN 1458-5944 publication does not constitute an endorsement by the Interna-
tional Labour Office, the World Health Organization or the Fin-
© Finnish Institute of Occupational Health, 2010 nish Institute of Occupational Health of the opinions expressed
in them.
Photo by ITCILO
Occupational safety and
health training
L
ack of knowledge and competence in
dealing with occupational hazards is
one of the most important causes of
occupational accidents and diseases.
Occupational Safety and Health (OSH) train-
ing is a vital instrument for extending knowl-
edge and generating preventive attitudes and
behaviours. This is why training on OSH is
an indispensable element for the prevention
of occupational accidents and diseases. This
importance is recognized by the Internation-
al Labour Standards of the International La-
bour Organization as one of the main areas of
action that must be included in the national
OSH policies.
Many national OSH legislations include
OSH training as a worker’s and his/her rep-
resentative’s right, and as an employer’s duty.
Besides workers, other actors are also required
to have OSH training in order to work as OSH
technical specialists, managers and supervi-
sors, or even as product manufacturers or ma-
chinery/labour inspectors. The volume of peo-
ple who need OSH training in each country
requires an important institutional effort, in
order to stimulate and involve the public and
private actors of each country for this task. This
effort requires encouraging and creating de-
mand by setting OSH standards, including the
right to receive and the duty to facilitate OSH
training, as well as the enterprise’s duty to have
staff specialized in OSH who conduct preven-
tive activities. It is also necessary to strengthen
the supply of information on OSH, correlat-
ed in quantity and quality to the needs of the
country, by improving the knowledge base and
materials on OSH, increasing the availability
of training and training experts, and including
the development of accreditation and certifi-
cation systems for training service providers
and those receiving training.
In general, training programmes at the en-
terprise level must include both the existing
and potential occupational hazards present
in the work environment, must be focused on
their prevention and control, and must provide
protection from them. However, the training
of different groups must be integrated with
the capacities, functions and responsibilities
of each specific group, taking into account the
Asian-Pacific Newslett on Occup Health and Safety 2010;17: •
technical level of their tasks and the economic
sector of activity. For this reason, training ma-
terials and methods need to be adapted. OSH
training for workers or other groups at the
enterprise level (supervisors, foremen, sub-
contractors, etc.) needs to be closely linked to
other preventive activities at the enterprise,
including risk assessment, risk control, acci-
dent investigation or the supervision of safe
systems of work, since these can determine
the contents and objectives of training. It is
important to keep in mind that OSH train-
ing complements other measures to improve
working conditions and the environment, and
is not a substitute for these measures.
Other aspects, such as the level of literacy
among workers in developing countries or the
increasing number of migrant workers who do
not speak the language of the receiving coun-
try, also require special attention. In cases of
this kind, it would be very appropriate to lim-
it the use of materials and methods based on
written communication and to favour meth-
ods based on oral and visual transfer, making
the training methods as practical and easily
understood as possible. Posters, documenta-
ries or films, role-play and audiovisual pres-
entations accompanied by explanatory discus-
sions (using a simple and easily comprehen-
sible language) are often the most effective
techniques for communicating and instilling
OSH messages.
Finally, prevention of occupational acci-
dents and diseases is an important pillar in the
development and consolidation of a preven-
tive culture in society. For this purpose, the in-
troduction of OSH in the educational system
is fundamental. It would be advisable to be-
gin even from basic education, when children
would have the opportunity to acquire preven-
tive attitudes, and then to continue through-
out all levels of education and training, pay-
ing particular attention to OSH in vocational
training curricula.
François Eyraud
Director
International Training Centre of ILO
Turin, Italy
3
Improving OSH at construction sites through
a participatory training approach:
Experience of Bangladesh
A.R. Chowdhury Repon, Bangladesh
Introduction
The construction sector entails a wide range
of economic activities and has a very poor
health and safety reputation in the world of
work, owing to the dirty, dangerous and diffi-
cult nature of jobs. Work at construction sites
is one of the most dangerous occupations in
both developing and industrialized countries.
Construction is different from other industries
in a number of important respects.
According to the International Labour Or-
ganization (ILO), 337 million occupational ac-
cidents occur on the job annually, while the
number of people dying of different work-re-
lated diseases is close to 2 million (1). One in
every six fatal accidents on the job occurs at
construction sites. Each year a minimum of
60,000 fatal accidents occur at construction
sites all over the world. The increase in flex-
4 • Asian-Pacific Newslett on Occup Health and Safety 2010;17:4–8
ible employment practices and outsourcing of
labour in the construction industry has had a
negative impact at the level of social protec-
tion of construction workers (2).
According to the Building and Workers
International (BWI) report, at least 108,000
workers are killed on the spot every year at
construction sites. The report also states that
construction sites account for 30 per cent of all
fatal injuries. This means that one person dies
every five minutes due to poor and/or illegal
working conditions (3). Moreover, statistical
data from a number of industrialized coun-
tries also indicate that construction workers
are three to four times more likely than other
workers to die from accidents at work.
Many more workers suffer and die from
occupational diseases arising because of their
past exposure to dangerous substances, such as
silica, asbestos etc. In addition, it is estimated
that 30 per cent of construction workers suf-
fer from back pain or various other muscu-
loskeletal disorders.
In recent years, the participation of wom-
en workers in this sector has been increas-
ing in many developing countries around the
world. This is particularly true in the coun-
tries of the South Asian region.
To make the construction sector safer,
many approaches and initiatives are applied
in different countries around the world to de-
velop a preventive health and safety culture
and good practices to combat hazards and po-
tential safety risks at construction sites. One
such effort is the Work Improvement in Small
Construction Sites (WISCON) developed on
the basis of the Participatory Action Oriented
Training Approach.
PAOT – An Action Tool towards
Promotion of Safe Work
The Participatory Action Oriented
Training (PAOT) is one of the popu-
lar practical methods used to address
the occupational safety and health
hazards at workplaces and to support
workplace initiatives based on volun-
tary actions of self-help (4). This meth-
od also assists the principal actors at
workplaces, i.e. workers and employ-
ers, to carry out immediate, low-cost
improvements in their working con-
ditions by using local resources and
positive ideas. PAOT has also been rec-
ognized in many Asian countries as
a powerful tool for the promotion of
labour standardization, decent work,
industrial relations and productivity
at the workplace level.
Brief history and development
of PAOT
The participatory approach was basi-
cally developed with the technical as-
sistance of the ILO. Its primary aim
is to improve working conditions at
small and medium-sized enterprises
(SMEs). PAOT was widely applied in
the Work Improvement in Small En-
terprises (WISE) project in the Phil-
ippines. This project was financially
supported by the UNDP and techni-
cally assisted by the ILO. Since then,
the participatory work improvement
programme at small enterprises has
widely been known as WISE (Work
Improvement in Small Enterpises). Dr.
K. Kogi and Dr. T. Kawakami made
very important contributions to its
development. Furthermore, the Japan
International Labour Foundation (JI-
LAF) played an important, facilitat-
ing role in promoting PAOT through
the Participation Oriented Safety Im-
provement by Trade Union Initiative
(POSITIVE) Programme developed
for trade union members active in
safety and health efforts at the work-
place (5).
In the PAOT concept, those who
work by themselves understand their
work and develop practical solutions
to their problems. Since workers are
so familiar with their daily work, they
need practical opportunities to involve
themselves in improvement of their
respective workplaces. The PAOT ap-
proach helps the principal actors at
workplaces to start and increase their
self-help activities by exploring avail-
able local knowledge, cooperation and
resources. The principles of the PAOT
are: it is built on local practice; it fo-
cuses on sustainable achievements; it
links local conditions with other de-
cent work goals; it encourages sharing
of local experience, good examples and
practices; it applies learning by doing;
and it focuses on positive aspects.
Basic training method of PAOT
PAOT training programme starts with
an exercise involving the use of an ac-
tion checklist at workplaces. This is
followed by formal presentations/lec-
tures on different key technical are-
as of PAOT (i.e. materials storage and
handling, machine safety, the physical
environment, work station design and
work tools, welfare facilities, environ-
mental protection, safety and health
organizations, etc.) and group work,
development of an individual action
plan for work improvement, follow-
up development actions at workplac-
es (based on the plan of action pro-
duced), collection of improvement ex-
amples and sharing with others, and
evaluation of actions through the new
plan of action.
Recent development of PAOT in
different Asian countries
The Mekong Delta is known as the
place where PAOT (Participatory Ac-
tion Oriented Training) originated. In
January 2000, the Mekong Delta PAOT
programme was planned by Dr. Ton
Khai, Dr. Tsuyoshi Kawakami and Mr.
Toyoki Nakao when they visited Can
Tho City. Since then, the programme
has been repeated nine times, and it
has led to the development of many
fruitful PAOT training programmes
and grassroots networks on safety and
health issues in different Asian coun-
tries (6). More than 200 participants
(trade union leaders, employer repre-
sentatives, NGO representatives work-
ing on health and safety issues, medical
doctors, nurses, public health experts,
academics, etc.) from different Asian
countries (Bangladesh, Nepal, Thai-
land, Vietnam, Korea, Japan) have at-
tended those programmes in the past
nine years and have started new PAOT
activities in their own countries.
As results of the collective ef-
forts over the past years, programmes
like WISCON (Work Improvement
in Small Construction Sites), WIND
Asian-Pacific Newslett on Occup Health and Safety 2010; 17:4–8 • 5
(Work Improvement in Neighborhood De-
velopment), and WIPE (Work Improvement
for Protection of Environment) were born in
Vietnam, and these programmes were accept-
ed by the local people smoothly and pleasant-
ly because the training tools were practical
and easy to understand. WISH (Work Im-
provement for Safe Home) in Thailand and
the [Glocal (Globalised localism) Relation-
ship of Agricultural ImprovemeNts] by the
OSHE in Bangladesh are good examples of
its achievements.
Construction sector in Bangladesh
At present, the estimated civilian labour force
in Bangladesh is 46.3 million, of whom 22.2%
are female (7). The labour market is charac-
terized by a high growth rate of the labour
force growth, low rates of employment, a pre-
dominance of employment in agriculture fol-
lowed by the service sector, the existence of
high underemployment, a low rate of female
employment; squeezing of the public sector,
growth in the informal sector and a high rate
of working children. The ratio of the formal
versus the informal sector is 20:80.
Construction is one of the important la-
bour intensive industries in Bangladesh. It
plays a significant role in the domestic econo-
my. It provides direct employment for 1.5 mil-
lion people, which is equivalent to 3% of the
total economically active working population
(aged 15 years and above). This estimate com-
prises 1.4 million men and 104,000 women.
Besides government, more than 200 large
Table 1
Labour Force by employment in major economic sectors in Bangladesh
Sector
Agriculture, forestry & fisheries
Trades, hotels and restaurants
Manufacturing
Transport, storage and commu-
nication
Community and personal ser-
vices
Health, education, public admi-
nistration and defence
Construction
Finance and business services
and real estate
Electricity, gas and water
Mining and quarrying
TOTAL
Source: Bangladesh Bureau of Statistics, 2008
6 • Asian-Pacific Newslett on Occup Health and Safety 2010;17:4–8
firms and 5,000 small and medium-sized con- this sector is comparatively weaker than those
tracting firms and real estate companies in in the country’s other sectors, for a couple of
the country are involved in the construction reasons. First, there is a weak institutional ca-
business. The industry has expanded rapidly pacity to respond to the decent work issues.
over the past years as a result of the increase Second, there is a lack of collective bargaining
in infrastructure development programmes all at the national level and an absence of a tripar-
over the country. The industry is also spurred tite industrial relation structure at the national
by growth of the real estate business in urban level. These are the main reasons. On the oth-
areas of Bangladesh, where building is car- er hand, employers in this sector (contractors
ried out by the private sector. In the public and real estate development areas) are largely
and private sectors, construction activities are organized at the national level.
undertaken through a contractual system. At
one end there are registered contractors who
High rates of occupational accidents
acquire a contract through open, selected or
and injuries
negotiated tenders. These are followed by a
multitude of complex subcontracts for various The construction sector in Bangladesh is wide-
components of the entire project. In Bangla- ly known as a ‘death trap’ due to its poor health
desh, there is a growing number of construc- and safety record and the high rate of occupa-
tion firms or companies involved in large-scale tional accidents occurring in the country each
construction works as well as a huge number year. At Bangladeshi construction sites, ordi-
of small-scale subcontractors or subcontract- nary workers normally do their job according
ing firms or enterprises at the plant level. to the instructions given by the contractors or
On the labour market, the construction subcontractors who employ them. Most of the
sector is considered an informal sector, owing time, they work in an environment with high
to the nature of employment and work pat- levels of noise, dust and fumes, insecure elec-
terns. The industry has tremendous economic tricity, dirty water, harmful gases, poor light-
muscle but has kept its workers mostly unor- ing, lack of personal protective equipments,
ganized. However, according to the Depart- lack of a pure drinking water supply, and lack
ment of Labour of Bangladesh, there are six of toilet facilities.
registered industrial trade union federations An alarming number of construction
and 45 registered basic unions in Bangladesh workers in Bangladesh experience occupa-
working in the construction sector. These or- tional accidents, such as falling from the top
ganizations altogether represent about 10% of structures, injuries from sharp objects and
of organized workers in the country’s con- tools and electric shock. Moreover, they are
struction sector. often affected by toxic materials or harmful
In general, the trade union movement in gases. If an occupational accident occurs at
the workplace, the victim considers it per-
sonal bad luck and the contractor or subcon-
tractor normally blames the victim for being
careless at work.
Male Female Total Percentagel The industries in Bangladesh are mainly
governed by the Bangladesh National Building
15,084,000 7,683,000 22,767,000 48.1%
Code of 2006 and partially by the Bangladesh
7,366,000 454,000 7,820,000 16.5% Environment Conservation Act of 1995. These
1,298,000 3,926,000 5,224,000 11%
actually include only a few regulations on safe-
ty and health issues. The Bangladesh Labour
3,910,000 66,000 3,976,000 8.4% Act of 2006 applies in part to the construction
sector through the mobility of jobs and lack
1,654,000 968,000 2,622,000 5.6% of permanent workplaces for the same con-
struction firms or establishments. In reality,
however, workers in this sector get very little
1,982,000 568,000 2,550,000 5.4% protection or benefit (health and safety issues)
from those laws, owing to weak enforcement
1,421,000 104,000 1,524,000 3.2% and lack of inspections.
With relation to setting up a Code En-
619,000 126,000 745,000 1.6% forcement Authority under section 2.1 of
the Bangladesh National Building Code, the
73,000 3,000 76,000 0.2% Bangladesh Occupational Safety, Health and
Environment Foundation and the Bangladesh
44,000 7,000 51,000 0.1%
Legal Aid and Services Trust jointly filed a
36,080,000 11,277,000 47,357,000 written petition in the High Court Division
on 27 January 2008 to readdress the failure of
the government to establish an agency to en-
force the code, particularly the provisions relating to work-
ers’ safety issues. The petition argues that most workplace
deaths among construction workers would be prevented if
the obligations under the Code are enforced, more specifical-
ly those relating to measures to prevent falling from heights
and electrocution. At the initial hearing on the petition on
7 February 2008, the High Court of Bangladesh passed a
rule asking the respondents for a show-case explaining why
the government should not establish a Code Enforcement
Agency as duly required by the Bangladesh National Build-
ing Code of 2006 and also why it should not be required to
secure compliance with the safety and security provisions
of the Bangladesh National Building Code of 2006 at every
level of construction and demolition of any building. The
Court also requested the government to produce a report
on what steps it has taken so far to secure compliance with
the code in Dhaka and Chittagong. The Court allowed the
respondents four weeks to respond to their show-cause no-
tice. However, it has been over two years since this ruling
was handed down but, unfortunately, the respondents have
not yet come up with any reply.
Owing to the absence of proper monitoring of occu-
pational diseases and the lack of studies, the occupational
health status of the workers in this sector is mostly unknown.
It is assumed that a high number of construction workers
suffer from musculoskeletal disorders, silicosis and asbes-
tosis. Most workers in the construction sector lack proper
knowledge about the occupational safety and health (OSH)
issues and about their rights at workplaces.
A recent survey conducted by the Bangladesh Occupa-
tional Safety, Health and Environment Foundation (OSHE),
which monitored the news in sixteen leading daily newspa-
pers of Bangladesh, revealed that a total of 829 workers were
killed and 1,041 were critically injured by various occupa-
tional incidents at their workplaces across the country from
January to June 2009. Among these the highest number of and 102, respectively. Table 2 shows the causes of common
causalities (552) took place in the garment sector, followed occupational accidents in Bangladesh in 2007 and 2008.
by the transport (486) and construction sectors (95) (8).
Another survey report of the OSHE found that the total
Experience of the WISCON actions in Bangladesh
number of occupational deaths caused by motorized equip-
ments in the construction sector in 2008 and 2007 were 120 Considering the above reality in the construction sector,
the Bangladesh Occupational Safety, Health and Environ-
ment Foundation (OSHE) implemented a mini-project in
Table 2 2009 with support from the ILO. The mini-project title was
Causes of occupation-related deaths in the Construction Sector in Bangladesh “Actions for improvement of occupational safety and health
in 2007 and 2008 conditions in Bangladesh: special focus on construction sec-
tor”; its objectives were to build workers’ and employers’ ba-
Cause of death 2007 2008 Total sic capacity at construction sites by means of participatory
Electrocution 24 42 66 workplace safety improvement actions through WISCON
(Work Improvement at Small Construction Sites).
Falling from heights 26 37 63 The direct target groups were worker and employer rep-
Collapse of a wall 27 7 34 resentatives in the construction sector. The geographical
coverage of the project activities included Dhaka (the capital
Collapse of earth 14 14 28
of Bangladesh) and Chittagong (the country’s second big-
Asphyxiation 2 10 12 gest city). The key activities of the project were WISCON
training of the trainers, development of training materials
Hit by a falling object 6 2 8
in the local language, follow-up training at workplaces and
Crushed by an object - 7 7 sensitization of actions at the work sites. The technical ar-
eas on which the WISCON activities focused were materi-
Falling into a hole 2 - 2
als handling and storage, work at heights, work postures,
Miscellaneous 1 1 2 machine safety, the physical environment, welfare facilities,
Source: OSHE Survey Report 2007 and 2008
emergency preparedness, work organization, and safety and
health organizations.

Asian-Pacific Newslett on Occup Health and Safety 2010; 17:4–8 • 7

 Achievements
At macro level, the WISCON project activities
in Bangladesh contributed to the successful in-
troduction and promotion of the Participatory
Low Cost Safety training and OSH actions in
the construction sector. It was also able to cre-
ate sensitization and awareness of OSH issues
in the construction sector.
At micro level, the WISCON project ac-
tivities gave rise to a group of new trainers
on WISCON (8). In all, 2000 copies of the
WISCON Action Checklist were produced in
the local language and 280 grassroots union
members from different trade unions work-
ing in the construction sector were sensitized
on participatory workplace safety improve-
ment activities. The project activities there-
fore meant the launching of a process of dia-
logue on OSH issues between trade unions and
employers organizations in the construction
sector and the formation of a local WISCON
Trainers network.
A field level evaluation has shown that
the participants who attended different ac-
tivities within the WISCON project presented
a good number of immediate initiatives fol-
lowing the training period and implement-
ed a good number of changes in the different
technical areas addressed during the train-
ing, i.e. materials handling and storage, work
at heights, work postures, machine safety, the
physical environment and welfare facilities at
workplaces.
Key lessons learned
The Participatory Action Oriented Training
Approach, of which the WISCON is a good ex-
ample in the construction sector, encourages
8 • Asian-Pacific Newslett on Occup Health and Safety 2010;17:4–8
workers’ immediate, low-cost safety improve-
ment actions, contributes to improvement of
social dialogue, helps to improve bilateral co-
operation on safety and heath issues between
workers and employers, and helps to develop
collectivism for advancing the ‘Decent Work
Agenda’ at the workplace level.
References
1. World of Work (the magazine of ILO), issue no.
63, August 2008.
2. http://www.ilo.org/public/english/dialogue/sec-
tor/sectors/constr.htm.
3. http://www.bwint.org.
4. Participatory Action Oriented Training, ECHO,
August 2005.
5. POSITIVE Training Manual, Japan International
Labour Foundation (JILAF), September 1999.
6. Background paper on Mekong Delta PAOT
program 10th anniversary, The Mekong Delta
PAOT Programme Management Committee, 28
February 2010.
7. Labour Force Survey 2005–06, Bangladesh
Bureau of Statistics.
8. Occupational Safety, Health and Environment
Foundation (OSHE) Survey Report number 1
/2009.
A.R. Chowdhury Repon
Executive Director
Bangladesh Occupational Safety, Health and
Environment Foundation (OSHE)
44 F/6, West Panthapath (4th Floor)
GPO Box- 2696
Dhaka-1215
BANGLADESH
E-mail: oshe@agni.com, oshe@citech.net
Web Address: http://www.oshebd.org
Photos by A.R. Chowdhury Repon
Work-related diseases
– A challenge for occupational health and
public health training and practice
Photo by Suvi Lehtinen
Jorma Rantanen, Finland

Introduction
The concept of work-related disease was origi-
nally defined by a WHO Expert Committee in
1985 (1). The Committee recognized the fol-
lowing conditions as work-related:
a. The classic occupational diseases, in which
the factors in work environment are pre-
dominant and essential in the causation of
disease,
b. Diseases caused by exposures from home
workers’ working processes to family mem-
bers or by worksite exposures to members
in the neighbourhood community
c. Multifactor diseases which, when occur-
ring in workers,
• may be partially caused by occupation-
al factors
• may be aggravated, exacerbated or accel-
erated by workplace exposures
• may impair working capacity.
The Expert Committee also stated that
work-related diseases are often more com-
mon than occupational diseases and deserve
adequate attention by the health services and
occupational health services.
The 1985 Expert Committee already rec-
ognized several groups of diseases which were
recognized as work-related, including:
a. Behavioural responses and psychosomat-
ic illnesses
b. Hypertension
c. Ischemic heart disease
d. Chronic non-specific respiratory disease
e. Locomotor disorders.

Current situation in the identification

of work-related morbidity
Since the 1985 Expert Committee, clinical
and epidemiological research has provided
a great deal of new evidence on the work-
relatedness of the diseases recognized by the
Committee and on several new diseases. The
attribution by work varies widely depending
on disease and type of work, as well as on
local working conditions and health condi-
tions of the community. A substantial part of
work-related morbidity has been associated
with common non-communicable and com-
municable diseases prevalent among pop-
ulations, such as cardiovascular disorders,
respiratory disorders and musculoskeletal
disorders (2, 3). Due to their high preva-
lence, their work-relatedness is important
to recognize, as occupational causality pro-
vides avenues for effective prevention in the
occupational settings. In principle, all occu-
pational diseases can be prevented and the
risk of multifactorial work-related diseases
(WRDs) can be reduced to a substantial ex-
tent (which does not always correspond di-
rectly with the percentage of attribution) (4).
On the other hand, if the causal factors do
expose workers at the workplace, the preven-
tive, control and curative actions directed to
non-occupational settings may remain inef-
fective. The high prevalence of chronic non-
communicable diseases among workers, and
particularly among older workers calls for
preventive actions in occupational health in
order to protect and maintain work ability
and avoid health and economy losses from
diseases among the productive fraction of
population (5, 6).
Examples of studies providing
evidence of work-relatedness in the
working population’s morbidity
A few examples of studies providing evidence
on the work-relatedness of common non-

Asian-Pacific Newslett on Occup Health and Safety 2010;17:9–11 • 9

Table 1. Diseases analysed for attribution by Nurminen and Karjalainen (2) 14% among working women. The largest gen-
der differences were found in lung cancer and
Diseases other respiratory diseases.
To put the work-related mortality in per-
Infectious and parasitic diseases Malignant neoplasms (site)
spective with other comparable risks in the
Tuberculosis Oral cavity
year 1996 for which the calculations were
Pneumococcal disease Pharynx
made, the total number of fatal traffic acci-
Diseases of the circulatory system Oesophagus
dents among the whole Finnish population
Ischemic heart disease Stomach
was 404. The estimated total number of work-
Cerebrovascular disease Colon
related deaths among the Finnish working
Diseases of the respiratory system Rectum
population was 1800, i.e. 4.5 times higher.
Pneumonia Liver and intrahepatic bile ducts
Chronic obstructive pulmonary disease Gall bladder
WHO global burden of occupational diseases
Asthma Pancreas
study (4)
Pneumoconiosis Nose and nasal sinuses
The World Health Organization has repeated-
Cryptogenic fibrosing alveolitis Larynx
ly produced estimates for the global burden of
Diseases of the genitourinary system Lung and bronchus
diseases (5, 6, 7). In 2005, WHO estimated the
Chronic renal failure and nephritic syndrome Bone
contribution of 26 different occupational risk
Mental disorders Melanoma of skin
factors to global burden of diseases. The study
Vascular and unspecified dementia Other malignant neoplasms of skin
calculated both loss of healthy life years (DA-
Depressive episodes Mesothelioma (all sites)
LY) due to mortality and healthy life year loss
Nervous system diseases Breast
by morbidity (4). Five causal factors played a
Spinal muscular atrophy Uterus (cervix uteri and corpus uteri)
substantial role as attributors to the global dis-
Parkinson’s disease Ovary
ease burden: Workplace carcinogens, airborne
Alzheimer’s disease Prostate
particulates, hazards for injuries, ergonomic
Kidney
Diseases of the digestive system stressors for back pain, and occupational noise
Urinary bladder
Gastric and duodenal ulcer exposure. The attribution by occupational ex-
Brain
Accidents and violent incidents posures to work-related morbidity measured
Hodgkin’s disease
Accidents as global burden to diseases and injuries is
Non-Hodgkin’s lymphoma
Homicides and injuries presented in Table 3.
Leukaemia
Suicides The WHO study made a special assess-
ment of the work-related burden of two infec-
tious diseases and needle stick injuries among
Table 2. Attributions by occupational factors to total mortality of Finnish working population (2)
health personnel. The result ended with an es-
timate of 40% attribution of work to the risk of
Disease Attribution %
hepatitis B and C among health workers and
Circulatory system, all 12 2% attribution to HIV/AIDS.
Ischemic heart disease 17 The work-related share of all the assessed
Stroke 11 diseases was 1.5% of the total DALYs of global
Malignant neoplasms 8 burden of diseases (from all diseases and in-
Lung cancer 24 juries of world population). This figure, how-
ever, is probably a substantial underestimate
Respiratory diseases 4
due to the limited number of diseases calcu-
COPD 12
lated and due to difficulty in estimation of
Mental disorders 4 work-related attribution of several prevalent
Nervous system diseases 3 diseases, such as the major infectious epidem-
Accidents and violence 3 ics. There are also several other factors lead-
All work-related mortality 7 ing to likely underestimation; the majority of
the world’s workers are employed in small-
scale enterprises, agriculture, and the informal
sector which have low access to both health
communicable and communicable diseases related risks of mortality were assessed on the services in general and no access to occupa-
are briefly discussed here. basis of the FINJEM exposure matrix for var- tional health services at all. This implies that
ious occupational groups and wide research both general health events and particularly
Attribution of work to mortality of Finnish material providing evidence on related health occupational and work-related events remain
working population outcomes. Table 2 describes the diseases with largely unidentified, undiagnosed and unreg-
This study was one of the most extensive ef- substantial occupational attribution. istered. No reliable estimate for such under-
forts for analysis of the work-relatedness of The risk of work-related mortality was un- reporting is available, but it can be assumed
non-communicable diseases (2). The analysis equally distributed between genders: 10% of to be substantial.
calculated the attribution of work to mortality total mortality among men was work-related.
from 45 specific diseases in 9 disease catego- The respective figure for women was 2%. As International study of work-related acute
ries, including 26 malignant neoplasms (Table much as 86% of absolute cases of work-relat- heart infarction
1). The relevant occupational exposures and ed deaths occurred among working men and Cardiovascular disorders are the world’s

10 • Asian-Pacific Newslett on Occup Health and Safety 2010;17:9–11

number one cause of death by non-commu-
nicable diseases. The work-relatedness of car-
diovascular disorders has been shown in nu-
merous studies and associated to numerous
risk factors such as several chemicals, physical
workload, unconventional working hours and
work stress. The latter source has caused also
a great deal of controversy particularly among
employers. The Interheart Study of 26000 sub-
jects (11119 patients and 13648 controls) in
52 countries of Asia, Europe, the Middle East,
Africa, Australia, North and South America
monitored the risk of acute myocardial infarc-
tion (MI) in relation to a number of psycho-
logical risk factors; work stress, home stress,
financial stress and life event stress (8). The
measurement of stress exposure was made
through a questionnaire covering the period
before infarction. The study found virtually
equally elevated risks (odds ratios 2.34 and
2.36, respectively) for permanent work stress
and permanent home stress, while the other
sources of stress also played a role, but to a
much lower extent. The contribution of work
stress to MI risk was seen only among men,
while other sources of stress contributed to the
elevation of the risk also among women, but at
a slightly lower level than among men. A dis-
tinct dose-response relationship was detected
between different “doses” of stress; “some of
the time”, “several periods” and “permanent”.
The high incidence of cardiovascular dis-
eases among working-age populations makes
the work-relatedness aspect of this morbidity
extremely important. As it seems to be a sub-
stantial several percentage attribution of occu-
pational factors to cardiovascular morbidity, it
also has an important occupational and pub-
lic health impact. Similarly the prevention of
these common diseases will get more support
for preventive programmes in occupational
settings. The growing rates of work stress re-
ported by surveillance studies throughout the
world make stress-related cardiovascular dis-
orders even more important. Table 4 shows
the odd ratios for various sources of perma-
nent stress.
Challenges of work-related diseases
to training and practices
Work-related diseases (WRD) were recognized
as early as in 1985 by WHO as an important
health impact of work, and numerous “can-
didate” WRDs were proposed by the WHO
Expert Committee. Since then, research has
produced much evidence on the work-relat-
edness of several diseases, many of which are
highly prevalent among working populations.
The quantitative estimates give the scale for the
problem of WRDs as a part of the morbidity of
working populations, and of the global burden
of all diseases of the world population.
Table 3. Attributable fraction (%) by occupational factors to total burden of diseases of 7
work-related health outcomes (4).
Disease Men % Women % All %
Back pain 41 32 37
Hearing loss 22 11 16
COPD 14 6 13
Asthma 14 7 11
Cancer of trachea, bronchus and lung 10 5 9
Leukaemia 2 2 2
Unintentional injuries 15 2 10
Table 4. Odd ratios of acute myocardial infarction from various sources of permanent stress (8)
Source of stress Cases Controls Odds ratio (99% CI)
Work 499 316 2.34 (1.86–2.93)
Home 249 135 2.36 (1.75–3.17)
General stress (work or home) 681 424 2.32 (1.93–2.80)
Financial 1231 1190 1.33 (1.17–1.50)
Life events (2 or more events) 1390 1304 1.51 (1.34–1.70)
WRDs cause loss of work ability and life References
years, which is likely to be at least an order of
1. WHO. Identification and control of work-related
magnitude larger than that of traditional occu- diseases. Report of a WHO Expert Committee.
pational diseases. Very little research is, how- Technical Report Series No. 714, WHO, Geneva
ever, available on registration, recognition, 1985.
loss of work ability, economic loss, and pos- 2. Nurminen M, Karjalainen A. Epidemiologic
estimate of the proportion of fatalities related
sible compensation of work-related morbidity. to occupational factors in Finland. Scand J Work
This is made by difficulty in the identification Environ Health 2001;27(3):161–213.
of work-related aetiology at the individual 3. Kivimäki M, Leino-Arjas P, Luukkonen R, Riihimäki
level. In the long run, work-related diseases H, Vahtera J, Kirjonen J. Work stress and risk of
cardiovascular mortality: prospective cohort study
have often been early cases of forthcoming
of industrial employees. BMJ 2002;325:857–61.
officially recognized occupational diseases. 4. Fingerhut M, Driscoll T, Nelson D I, Concha-Bar-
The most important management strat- rientos M, Punnett L, Pruss-Ustin A, Steenland K,
egy of work-related diseases is prevention. Leigh J, Corvalan C. Contribution of occupational
This requires identification of the occupa- risk factors to the global burden of disease – a
summary of findings. SJWEH Suppl 2005;no
tional factors causing such diseases, stud-
1:58–61.
ies of their mechanisms of action and de- 5. WHO. The World Health Report 2002. Reducing
velopment of effective prevention strate- risks, promoting healthy life. Geneva 2002.
gies. It is also important to keep in mind 6. WHO. The global burden of disease: 2004 update.
the work-related aetiology in clinical and WHO Geneva, 2008.
7. Rodgers A, Ezzati M, Vander Hoorn S, Lopez AD,
public health practices.
Lin R-B, et al. Distribution of Major Health Risks:
WRD morbidity constitutes a challenge Findings from the Global Burden of Disease Study.
to the training of both occupational health PLoS Med 2004 1(1): e27. doi:10.1371/journal.
personnel and the experts in the rest of the pmed.0010027
health service system, as well as those in so- http://www.plosmedicine.org/article/
info:doi/10.1371/journal.pmed.0010027
cial security. Knowledge on work-relatedness
8. Rosengren A, Hawken S, Öunpuu S, Sliwa K,
should be distributed in the basic education Zubaid M, Almahmeed WA, Blackett KN. As-
of health personnel, as well as proposals for sociation of psychosocial risk factors with risk of
prevention and control. The WRDs are im- acute myocardial infarction in 11 119 cases and 13
648 controls from 52 countries (the INTERHEART
portant not only from the occupational health
study): case-control study. Lancet 2004;364:953–
perspective. As they are often simultaneously 62.
common diseases among the general popula-
tion and the working population (which con- Jorma Rantanen
stitutes some 50–70% of the adult population Professor Emeritus
in all countries), work-related morbidity is Chairman of Senate
also a significant public health challenge. This University of Jyväskylä
requires close collaboration between training, Jyväskylä, Finland
education and practices of occupational health jorma.h.rantanen@gmail.com
and public health.
Asian-Pacific Newslett on Occup Health and Safety 2010;17:9–11 • 11
Occupational safety and health training
programme: A Malaysian perspective
Abdul Mutalib Leman
Fadzil Othma
Abdul Rahman Omar
Malaysia
Introduction
Occupational safety and health (OSH) pro-
vides a work environment which is conducive
to workers. Reasonable precautionary steps
are taken in order to ensure that workers are
protected from injury or health hazards aris-
ing from their work activities. Safety measures
and practices are undertaken to prevent and
minimize the risk of loss of life, injury and
damage to property and environment. Occu-
pational safety and health was first implement-
ed in Malaysia some 130 years ago, towards
the end of the 19th century. The Department
of Occupational Safety and Health (DOSH) is
the only government agency responsible for
administering, managing and enforcing legis-
lation pertaining to OSH in the country. Its vi-
sion is to make all occupations safe and healthy
while also enhancing the quality of work life.
Increasing OSH observance levels
To ensure that workers’ safety, health and wel-
fare are cared for, DOSH works to keep the
occurrence of industrial accidents in Malaysia
low. To this end, the OSH Master Plan 2015
was introduced. This plan sets out the direc-
tion of OSH in the country. It serves as a guide
for working cohesively with stakeholders and
social partners, including government agen-
cies, local authorities, labour unions, employer
associations, academic institutions and other
non-governmental organizations.
The safety and health programme includes
four major elements that make up its basic
framework. Louis J. DiBerardinis (1) reported
that an effective occupational safety and health
programme will entail:
• Management commitment and employee
involvement
• Analysis of worksite hazards
• Hazard prevention and control
• Safety and health training.
Occupational safety and health
training
To ensure the success of any OSH programme,
adequate and effective training must be im-
plemented for all those responsible for OSH.
Training enables managers, supervisors and
12 • Asian-Pacific Newslett on Occup Health and Safety 2010;17:12–3
workers to understand the functioning of
safety management systems and compliance
with legislation. They will then understand
their own responsibilities and the necessary
actions to be taken towards upgrading safe-
ty and health at their respective workplaces.
Safety and health training is one of the tech-
niques available for promoting OSH while at
the same time reducing the number of acci-
dents. To foster efficient and effective training,
the Malaysian Government has constructed an
OSH organization in the country.
The Ministry of Human Resources has
been made responsible for managing OSH,
under the advice of the National Council of
Occupational Safety and Health (NCOSH).
The NCOSH functions in a policy advisory
and promotion capacity. The Department of
Occupational Safety and Health (DOSH) was
formed to focus on administration and en-
forcement. The OSH services can be catego-
rized into workplace monitoring and assess-
ment, medical surveillance, medical treatment
and management, and rehabilitation services
and return to work programmes.
Education and training programme
Training is an integral part of OSH. The educa-
tion and training programme involves several
institutions, including the National Institute of
Occupational Safety and Health (NIOSH), the
Construction Industry Development Board
(CIDB), Nuclear Malaysia, higher education
institutions and NGOs such as the Malaysian
Society of Occupational Safety and Health
(MSOSH), the Malaysia Industrial Hygiene
Association (MIHA) and the Federation of
Manufacturing Malaysia (FMM). The private
sector involved in OSH activities includes the
Social and Security Organization (SOCSO),
the Employee Protection Fund (EPF) and in-
surance companies.
The Hands on Guide OSH Manager Ma-
laysia (2) places the types of training into two
broad categories, hard skill OSH training and
soft skill OSH training. In general, hard skill
OSH training is usually mandatory. It entails
the training required to ensure that workers
are competent and qualified and that they ex-
ecute certain tasks related to OSH hazards.
Examples of such programmes are working
in confined spaces, a safety orientation course
for construction workers, and lockout and tag-
out with regard to electrical safety. Soft skill
training is often voluntary, involving the rec-
ommended types of training. Examples are
safety management courses, OSH commu-
nication training, and training on the aware-
ness of OSH hazards and worker behaviour.
Some of the programmes required for in-
house OSH training are orientation for new
employees, supervisor and management train-
ing, on-the-job training, training for specific
hazards (i.e. laser safety, lockout and tag-out),
training in standard operating procedures and
skill training.
The National Institute of Occupation-
al Safety and Health (NIOSH) was chosen
as an example illustrating OSH training in
Malaysia. The National Institute of Occupa-
tional Safety and Health was established as
a company limited by guarantee on 24 June
1992 under the Ministry of Human Resourc-
es, Malaysia. The NIOSH Board of Directors
consists of individuals from the relevant gov-
ernment agencies and industrial and union
representatives; the Board prepares policies
and sets directions for the Institute in line
with the agreed strategy. With the stated vi-
sion “to be the leading centre of excellence
in occupational safety and health”, NIOSH
operationalized its strategic mission to read
“The preferred partner in occupational safe-
ty and health” in carrying out its functions,
which are the provision of training, consulta-
tion services, dissemination of information,
and conducting research in the field of OSH.
Range of training programmes
The NIOSH training programme has received
recognition from DOSH, the regulatory body
for OSH in Malaysia, as well as from industrial
associations, OSH practitioners, international
counterparts and workers at large. Apart from
ensuring the competency of registered spe-
cialists, NIOSH training has been extended
to senior executives, safety and health com-
mittee members, safety supervisors, general
workers contractors, academicians and other
interested individuals.
Table 1. Courses conducted by the National Institute of Occupational Safety and Health in 2006–2009.

Types of Courses 2009* 2008 2007 2006

Courses Partic- Courses Partic- Courses Partic- Courses Partic-
ipants ipants ipants ipants
Public programmes 161 2,535 125 2,114 94 1,420 88 1,397
Certificate/Competency programme 195 3,558 165 3,381 186 3,516 124 2,390
In-house programme 609 11,597 432 9,321 453 10,09 367 8,403
Trainer’s programme 19 258 21 281 38 467 29 327
Conference or seminar 24 3380 21 2,797 21 3,003 18 2,402
Safety Passport Programme 2,347 61,035 1460 39,927 1,046 27,780 1,009 26,615
TOTAL 3,355 82,363 2,768 71,941 2,321 59,972 1,635 41,534
*Amendment until December 2009

Number Training Programmes by year

Public
of Courses programmes
2500
Certificate/

Competency
2000 Programme (EDOSH) and the Master’s in Occupational
Safety and Health (MOSH) are jointly con-
1500 In-House
Programme ducted by NIOSH in collaboration with the

1000 Trainer´s Open University Malaysia (OUM) and Uni-
Programme versity Utara Malaysia (UUM).
500 Conference or
Seminar
0 Safety Conclusion
2006 2007 2008 2009 Passport
Programme To-date, the amount of training has increased
Year
linearly. The provision of training is based on
Figure 1. Training programmes conducted by the the National Institute of Occupational Safety training programmes, seminars and confer-
and Health from 2006 to 2009 ences. The number of participants involved
is also increasing linearly every year. Malay-
sia set up the OSH Master Plan 2015 as the
Number of Course participants by year target in order to minimize the number of
Participants Public
programmes accidents. At the same time, it aims to in-
70,000
Certificate/ crease the number of courses and public pro-
60,000 Competency grammes and emphasizes Occupational Safety
50,000 Programme
and Health training programmes.
In-House
40,000 Programme
30,000 Trainer´s References
Programme 1. L. J. DiBerardinis (Ed.). Handbook of Occupa-
20,000 tional Safety and Health. Wiley and Sons. New
Conference or
10,000 York, USA 1999.
Seminar
2. CCH Asia Pte Limited. The Hands on Guide OSH
0 Safety Manager Malaysia. 2001
2006 2007 2008 2009 Passport
Year Programme
Abdul Mutalib Leman
Figure 2. Number of participants in courses conducted by the National Institute of Occupa- University Tun Hussein Onn Malaysia
tional Safety and Health from 2006 to 2009 86400, Parit Raja, Batu Pahat,
Johor, Malaysia
Tel: +607 4537776
Fax: +607 4536080
Training activities are broadly classified several multinational companies and inter- Email: mutalib@uthm.edu.my
into three main groups: the implementation of national industries located in Malaysia. For
training programmes, development and revi- example, NIOSH has conducted a safety pro- Fadzil Othman
sion of training modules, and monitoring and gramme with several companies, including National Institute of Occupational Safety and
evaluation of training activities. Table 1 shows Petronas, Osfam, TNB, Shell, Genting and BP Health (NIOSH)
the number of courses conducted by NIOSH Chemicals. These programmes conducted by Lot 1, Jalan 15/1, Section 15, 43650 Bandar Baru
and the number of participants in 2006–2009. NIOSH are organized at the certificate level. Bangi,
Several public and private institutions con- Selangor Darul Ehsan
Discussion
duct these programmes at diploma and degree Malaysia
The NIOSH Safety Passport is widely known. level; there are even Master’s and Doctoral Tel: +603 87622100 (main line)
The course is conducted jointly with indus- degree programmes. However, the Executive Fax: + 603 89262900
tries. It is recognized and put into practice by Diploma of Occupational Safety and Health Email: fadzil@niosh.com.my

Asian-Pacific Newslett on Occup Health and Safety 2010;17:12–3 • 13

The role of worker unions in occupational
health and safety at industry level
Bambang Surjono, Indonesia
Background
At the global level, according to the most re-
cent estimates of the International Labour Of-
fice (ILO), about two million people die be-
cause of their work every year (1). These work-
related deaths represent only a small fraction
of the suffering caused. An estimated 160 mil-
lion people have work-related disease. Some
355,000 fatal accidents take place every year.
For every fatal accident at work, some 500–
2,000 other non-fatal injuries occur, depend-
ing on the type of work. Yet these workplace
tragedies rarely make the headlines.
Fatalities and accidents are not bound to
happen. They are caused. Cancer – caused,
for example, by asbestos, other carcinogen-
ic dusts and chemicals, and ionizing radia-
tion – is the biggest reason for work-related
deaths (accounting for an estimated 32% of
work-related deaths), followed by circulatory
diseases – caused, for example, by night work
and shift work, stress, some chemicals and
environmental tobacco smoke at workplaces
– (23%), accidents (19%) and communicable
diseases (17%). The figures differ consider-
ably in various parts of the world: accident
rates, for instance, are very high in the Asian
Tiger economies.
The role of trade unions in OH&S
Work accidents can be prevented if all stake-
holders play an active role. Three points need
to be stressed here:
• Enterprise management and commit-
ment have a key role.
Companies that have an occupational safety
and health management system (OSH-MS)
set up according to ILO Guidelines (ILO-
OSH 2001) have better safety records and
better productivity records.
• The stronger the union, the safer the
workplace. put into practice in order to improve the work
Even the best occupational health and safe-
ty regulations will have little impact un-
less the people concerned, the workers, are
able collectively to defend their interests.
It is vitally important that workers are in-
volved in planning and running the com-
pany OSH management system and have
freedom of association. The high safety
standard of Sweden, for example, is a di-
14 • Asian-Pacific Newslett on Occup Health and Safety 2010;17:14–5
rect result of long-term policies on workers’ The training is given in two steps:
involvement and a well-functioning tripar- a. The first step is the OH&S Training of
tite mechanism. Trainers (TOT) POSITIVE Programme.
• Much of the action on safety and health This seminar takes four full days.
must be local, but much of the framework b. The second step is the OH&S Core Trainer
must be global. Training (CTT) POSITIVE Programme,
This is both a moral and a practical neces- comprising three full days.
sity. Moral, because we cannot place a lower During each step of training, the partici-
value on workers’ lives in some parts of the pants visit a factory to observe good examples
world than in others. Practical, because in of OH&S practice. A checklist prepared before
a global economy, we cannot allow safety the visit is used during the observation visit.
and health to be undermined by false con-
cerns about competitiveness. There are six technical aspects to be observed
On both of these counts, the ILO’s Safe (3):
Work Programme is well placed to influence 1. Materials handling and storage
the global agenda. Representatives of the
world’s workers, employers and governments
meet on equal terms within the ILO. Trade un-
ion rights are at the heart of its standard-set-
ting activities, as are health and safety. More-
over, the ILO is currently campaigning for
the provision of decent work worldwide. It is
clear that decent jobs must also be safe jobs.
Occupational health and safety
training by trade unions
To promote the role of trade unions in occu- 2. Change of work station
pational health and safety activities in Indo-
nesia, the Confederation of Indonesian Trade
Union (CITU) has devised an OH&S training
programme in cooperation with JILAF, the
Japan International Labour Foundation. The
training is called the OHS POSITIVE training
programme. POSITIVE stands for “Participa-
tion-Oriented Safety Improvement by Trade
union InitiatiVE”. The POSITIVE programme
was developed as a participatory training pro-
gramme for the promotion of occupational
safety and health by trade unions (2).
The basic principle of the programme is 3. Machine safety
participation. Seminar participants learn from
local good examples that have already been
environment. Attention is given to low-cost
improvement. By using an action checklist in
an actual workplace and discussing the results
with their colleagues, union members receive
training that leads to activities improving oc-
cupational safety and health at the workplace.
Follow-up activities are held, too; discussions
take place with the objective of supporting the
workers’ continued activities.
4. Physical environment
Date Place Participants Type of training
(N)
Picture # 4 12–17 February 2006 Cipayung, Bogor 24 TOT
5–6 November 2007 Ciloto, Bogor 27 TOT
30 May–2 June 2008 Surabaya 26 TOT
31 October–4 November 2008 Cisarua, Bogor 24 TOT
2–5 June 2009 Batam 24 TOT
9–12 June 2009 Jogjakarta 24 TOT
13–16 November 2006 Bogor 17 CTT
28–30 August 2007 Cisarua, Bogor 14 CTT
4–6 June 2008 Cisarua, Bogor 23 CTT
18–20 November 2008 Tretes, Surabaya 20 CTT
5–8 February 2009 Cisarua, Bogor 23 CTT
5. Welfare facilities
16–18 November 2009 Bandungan, Semarang 14 CTT
20–22 November 2009 Batam 25 CTT

7. Training participants
Picture # 5

6. Environment protection

Picture # 6

So far CITU and JILAF have organized six
Training of Trainer (TOT) seminars and seven
OH&S Core Trainer Training (CTT) seminars
in Indonesia. The training has been given in
some regions of Jakarta, East Java, West Java,
Central Java and in Riau Province, Batam Is-
land. There are about 120 Core Trainers who
can provide training for Union members at
the workplace.
CITU and JILAF started to run POSITIVE
training programmes in 2006 and they have
continued until now. Each year at least two
set of OHS POSITIVE training seminars have
been held. Above are data on the POSITIVE
Programme Training in Indonesia organized
by CITU and JILAF in 2006–2009.
Results of training
The TOT seminar participants have to make
improvements in OH&S conditions at their
workplace. These improvements should be
presented when they come for the CTT train-
ing about six months after the TOT seminar
has been completed. Improvement of the
working conditions benefits not only the
workers; it is also beneficial to the employer in
terms of improved and increased productivity.
Improvement of OH&S is based on these con-
siderations:
–– Facilitate immediate improvements
–– Learn from local good examples
–– Involve managers together through the vis-
ible benefits (good work results) and low-
cost ideas
–– Promote solidarity by group work.
On the last day of each training seminar,
the participants have to present proposals for
improvement to the company they have visited
on the first day of training. The management of
the company visited is invited to the class, to
follow the participants’ presentations. Most of
the management representatives from the fac-
tories visited have been very satisfied and have
appreciated that the participants were able to
identify areas in need of improvements. The
companies have confirmed that the proposals
were very valuable to them.
As to the workers, their awareness of
OH&S at the workplace is increased through
improvements carried out at the workplace.
References
1. Dr. Jukka Takala, Director, Safe Work, Interna-
tional Labour Office (ILO).- Originally in the UK in
Hazards magazine for its International Workers
Memorial Day.
2. http://www.jilaf.or.jp/English-jilaf/genpro/posi-
tive/about/index.html, retrieved 10 January 2010.
3. Kazutaka K, Kawakami T. Trainer Guide for
OHS JILAF POSITIVE Program. The Institute for
Science of Labour, Japan International Labour
Foundation 2002.
Bambang Surjono
Vice General Secretary of Confederation of
Indonesian Trade Unions
Plaza Basmar 2nd Floor
Jl. Mampang Prapatan 106
Jakarta 12790
Indonesia
bambang_surjono@yahoo.com
Photos by Bambang Surjono

Asian-Pacific Newslett on Occup Health and Safety 2010;17:14–5 • 15


Developing OSH training systems
– Challenges facing food enterprises in China
Yuhang WANG, China
Development of food enterprises in
China
Since the implementation of the Opening-up
Policy in 1978, the food industries in China
have developed in rapid strides. In 2009, the
gross value of the industrial output of food
industries reached 4.9 trillion RMB, an in-
crease of 14.6% on 2008; this is 6.6% higher
than the average growth rate for industrial
output. Food industries in China account for
about 20.4% of the increase value of indus-
trial output (1). Food industries are closely
linked to the living quality and health of the
people, and they play a major role in absorb-
ing redundant labour in rural areas of China.
There are more than 9.5 million workers em-
ployed in food industries; this is about 17.9%
of the total formal employment (2). Devel-
opment of the food industries has supported
the development of agriculture and farmers,
increasing the farmers’ income and spurring
urbanization (3).
16 • Asian-Pacific Newslett on Occup Health and Safety 2010;17:16–8
From now on, development of the food in-
dustries in China faces both challenges and op-
portunities (4). Among the opportunities are:
–– the State will invest more and more in sci-
entific and technological modernization of
the food industries;
–– the rapid economic development, indus-
trialization, and urbanization give rise to
greater market demand for food industry
products;
–– globalization provides wider resource al-
location for the food industries.
The challenges facing the food industries in-
clude the following:
–– the complicated international market has
intensified the competition for resourc-
es, markets, technology and intellectual
resources
–– trade protectionism is rising;
–– industrialized countries benefit from their
dominant economic and technological po-
sition;
Photo by ILO
–– it is easy to form a market monopoly in
China;
–– since the Opening-up Policy, foreign capital
has been flowing into China’s food indus-
tries, imposing heavy pressure on domestic
food enterprises.
OSH situation of food enterprises in
China
Food processing enterprises have certain ex-
tensive risks, as some chemical materials are
used, there are occupational hazards, many
flammable and explosive materials are present,
gigantic volumes of raw materials are stored
on site, logistics are on a large scale, many
man-machine interfaces exist, and the new
processing project is proceeding very quick-
ly. All of these factors present comparatively
high risk levels to the food industries in China.
According to incomplete statistics of the
State Administration of Work Safety, from
2001 to 2009, 53 comparatively large-scale ac-
cidents (an accident causing more than three Table 1. Comparatively large-scale accidents from 2001 to 2009 in food
fatalities is called a comparative large-scale enterprises in China
accident in the Chinese occupational safety
legislation, and information on them are pub-
Year Accidents Fatalities
lished in real time on the official website) oc-
2001 3 10
curred in food industries and led to 253 fatali-
ties in total (traffic accidents are not includ- 2002 9 36
ed). These statistics mean that a comparatively 2003 4 21
large-scale accident occurs in Chinese food 2004 5 26
enterprises every second month (5), (see Ta- 2005 4 12
ble 1 and Figure 1). The figures on accidents 2006 5 28
causing one or two fatalities may be dozens 2007 10 58
of times higher than those for comparatively 2008 6 29
large-scale accidents, but there is a lack of reli-
2009 7 33
able data. From the point of view of the com-
Total 53 253
paratively large-scale accidents that occurred
in the past nine years, the same types of acci-
dents happen again and again; the food indus-
tries have not learned their lesson. Although 12 70
the level of risk in the food industries is not 10 60
as high as in the mining, chemical, and con-
50 Accident
struction industries of China, nevertheless the 8
food industries still have certain specific risks. 40 Fatality
6
30
4
Challenges in OSH training facing 20
food enterprises in China 2 10
A large number of small enterprises lack the 0 0
input of safety training
2001

2002

2003

2004

2005

2006

2007

2008

According to a White Paper of the Information
Office of the State Council (6), there are 450,000
food enterprises in China; most of them small
and medium-sized enterprises. A total of 80%
of them employ fewer than 100 people, and
77% fewer than 10 people. A large proportion
of the home-style producers cannot meet the
safety standards at all (7). Owing to the intense
competition, the profit margin of food process-
ing enterprises is very low, and the gross profit
margin is about 10–20%. To cut costs, many en-
terprises reduce their input in safety and health
protection and there is little capital to fund OSH
training, which worsens the occupational safety
and health situation.
A large number of migrant workers lack safety
awareness and skills
Migrant workers (also called farm workers
in China) have become a major labour force
during the industrialization and urbanization
process in China. They migrate from rural ar-
eas to cities every year, and contribute great-
ly to the development of society. But the mi-
grant workers are poorly educated and have
poor safety awareness. They do not have the
necessary safety protection ability. The result
is great pressure on the occupational safety
management. In the past years, more than half
of the work accidents and new cases of occu-
pational diseases are suffered by the migrant
workers. Training for migrant workers is ur-
gently needed to change the current serious
OSH situation (8) in China.
Figure 1. The trend of comparatively large-scale accidents in food enterprises in
China.
According to the Migrant Workers Inves-
tigation Report of the State Council in 2006,
only 20% of the migrant workers can obtain
short-term occupational training, 3.4% have
primary-level occupational training, 0.13%
have intermediate-level level occupational
training, and 76.4% have no occupation-
al training at all. Thus the coverage of the
safety training for the migrant workers is
very low.
Migrant workers usually have a short-term
contract with their employers and there is an
oversupply of migrant workers. For these rea-
sons, employers are not willing to invest in
training for them. At the same time, migrant
workers lack safety protection awareness, nor
do they actively participate in safety training
activities. It is therefore very common for them
to work without safety training.
A lack of qualified trainers and targeted docu-
ments
Some enterprises send their workers to occu-
pational training schools or organizations but
then complain afterwards that the outcome of
training is useless. Many training programmes
do not match the real needs. Some training
organizations cannot conduct safety training
2009
properly, as they lack qualified trainers. Al-
though some workers obtain safety training,
their safety awareness and skills did not im-
prove remarkably (9).
The corps of trainers cannot keep up with
the rapid pace of development of the produc-
tion process, technological modernization, and
equipment updates, and they cannot solve the
new problems and situations. Most of the train-
ing materials are out-of-date and lack informa-
tion about the new situations, so the contents
of training are alienated from reality and do
not provide the proper guidance. The training
method is also stereotyped and has not been re-
vised. Most training is done in the classroom,
through lectures and listening; this passive
and dull method also compromises the train-
ing effect (10).
Occupational safety and health has some
common issues across industries, but there are
also differences between different industries.
Some high-risk industries in China, such as
petrol and chemical, mining, and construction
industries, have developed training materials
targeted to their individual characteristics. For
the food industries, however, no such efforts
have been made and no corresponding mate-
rials are available.

Asian-Pacific Newslett on Occup Health and Safety 2010;17:16–8 • 17

A lack of relevant industrial authority

Photo by ILO
management on OSH issues
Mining, construction, and chemical industries
in China have their own individual industri-
al management authorities for occupational
safety and health issues. By contrast, the food
industries lack an industrial authority to man-
age the OSH issues.
There is a China National Food Industry
Association (CNFIA), founded in 1981, that
plays an important role in the development
of the industry’s economy, its scientific and
technological development, and fair compe-
tition. But the Association does not function
in OSH issues for the food industries. The
China Association of Work Safety, founded
in 2008, and the China Occupational Safety
and Health Association, founded in 1983, are
both general associations and do not have spe-
cific and professional activities involving the
OSH issues of the food industries.
Because of the lack of relevant industrial
authority management on OSH issues in the
food industries, it is hard to implement in-
dustry-wide training programmes, and it is
hard to guarantee the training performance.

Suggestions for developing OSH

training systems for food enterprises
in China
• The major factor hindering OSH training
in the food industries is the limited capital.
It is necessary to establish a mechanism to
balance the input from the government,
employer and employee organizations.
The government and employer organiza-
tion should shoulder more responsibilities
to build a training system that would cover
the OSH needs of the food industries.
• It is essential to improve the safety aware-
ness of employers and employees by using
the popular media to disseminate safety
awareness. Everybody really needs to buy
into the concept of putting people first, car-
ing about life and caring for safety. They
must be motivated to learn safety skills and
they must require higher safety conditions.
• It is very important for China to have a lead-
ing organization that would pay close at-
tention to OSH issues for the food indus-
tries. Such an organization would coordi-
nate with different stakeholders, develop
a training plan, obtain the capital, organ-
ize and conduct training programmes, and
meet the specific safety and health needs of
the food industries.
• The Government or employer organiza-
tions should develop practical and target-
ed training materials and should train more
and more qualified OSH trainers for the
food industries.
• New information technology, such as dis-
tance education and distance training on
OSH, should be considered in order to de-
crease the training cost and improve the
effect.
References:
1. Xinhua net. This year the gross value of industrial
output of food industries reached 4.9 trillion RMB
in China. Available at: http://news.xinhuanet.com
Accessed 21 November 2009.
2. The Central People’s Government of People’s Re-
public of China. China Food Science and Technol-
ogy Development Report of 2007–2008. Available
at: http://www.gov.cn Accessed 7 April 2009.
3. China Agro-product Processing net. The National
11th Five Year Development Plan fo Agro-product
Processing Industries. Available at: http://www.
csh.gov.cn Accessed 20 January 2007.
4. Liu Z, Hu L. Status and prospects of food indus-
tries in national economy development. Food and
nutrition in China 2009;3:23–25.
5. State Administration of Work Safety. Accidents
Publish and Search System. Available at: http://
media.chinasafety.gov.cn Accessed at 10 August
2009.
6. The Central People’s Government of People’s Re-
public of China. Information Office Issued China
Food Quality Situation White Paper. Available at:
http://www.gov.cn Accessed 17 August 2007.
7. Bureau of Economic Operations, National Devel-
opment and Reform Committee. Restraining Fac-
tors and Counter Measures for Food Industries
Healthy Development. Chinese Medicine 2007
Jun;7.
8. Sun Y. Five Problems of the Farmer Workers’
Safety Training. Labor Protection 2008;1:70.
9. Huang Y. In-service Training for Migrant Workers:
Problems and Proposals. Journal of Shenzhen
Polytechnic 2007;1:89–92.
10. Zhang Y, Wang Y, et al. Problems and Counter-
measures for Safety Training in China Enterprises.
In Proceeding of the 14th Symposium on Occupa-
tional Safety and Health from Taiwan, Mainland,
Hong Kong and Macao. Xian, 2006.
Yuhang WANG
Deputy Manager
Work Safety Supervision Office
China Agri-Industries Holdings Limited
Add:Rm02,17F,COFCO, Fortune Plaza,
NO.8 Chao Yang Men South St.
Beijing, China 100020
Email:wang.yh@cofco.com
Web:www.cofco.com

18 • Asian-Pacific Newslett on Occup Health and Safety 2010;17:16–8

International
Training Centre
– training for
the world
Teemu Lindfors, Finland
Working conditions around the world are
not equal. The conditions of work and even
the basic rights of workers vary considerably
between different countries. Many countries
around the world are making strong economic
progress while others are facing major chal-
lenges. Regardless of the progress or slack-
ness of the economy or political turbulence,
one should feel safe and equal at work. The
International Labour Organization (ILO) is
devoted to advancing opportunities for wom-
en and men to obtain decent and productive
work in conditions of freedom, equity, secu-
rity and human dignity. To further the goal
of decent work for women and men, ILO and
the Italian Government established the In-
ternational Training Centre (ITCILO) in Tu-
rin, Italy in 1964, as an advanced vocational
training institute.
Multinational training
The Centre provides training and services that
develop human resources and institutional
capabilities. Each year about 11,000 people
from over 180 countries take part in the Cen-
tre’s training activities and events. Altogether
more than 450 programmes and projects are
run every year. The Centre’s demand-driv-
en training portfolio consists of courses in
key work-related areas. The forms of training
are standard courses, tailor-made courses and
comprehensive projects. To reach more and
more people, the Centre is using a series of
distance training programmes. Some of these
are complemented by face-to-face sessions.
Through training, the Centre contributes to
achieving the ILO’s four strategic objectives:
• to promote and realize standards and fun-
damental principles and rights at work
• to create greater opportunities for wom-
en and men to secure decent employment
and income
• to enhance the coverage and effectiveness
of social protection for all
• to strengthen tripartism and social dia-
logue.
Participants and benefits
The participants of trainings usually hold
managerial or executive positions in minis-
tries, workers’ organizations, employers’ or-
ganizations, enterprises, training institutions
or universities, etc. Many of the participants
are themselves trainers or trainers of trainers.
Through the Institute’s training, participants
gain an in-depth understanding and practice
concerning international labour standards,
decent work, social protection, social dialogue
and related development issues. They learn
to analyse common problems and challenges
and to find sustainable solutions. All are cho-
sen carefully to ensure the multiplier effect.
After their training, participants should ap-
ply their newly acquired insights and skills in
their work and pass them on.
The Centre has five Regional Programmes,
which include Africa, the Americas, the Arab
States, Asia and the Pacific, and Europe. The
Centre ensures that its activities are relevant
and expedient to local needs, goals and con-
ditions. Regional needs are monitored and
activities coordinated in cooperation with the
field offices of the International Labour Or-
ganization. The regional offices also help raise
the funds that finance the Centre’s activities in
those regions.
Training in Asia and the Pacific
The ILO’s International Training Centre works
Asian-Pacific Newslett on Occup Health and Safety 2010;17:19 •
in and with Asia and the Pacific to strengthen
the capacity of governments, workers’ organ-
izations, employers’ organizations and other
civil society bodies to solve problems, and to
devise policies and manage systems that pro-
mote decent work. In 2009, around 1,900 peo-
ple from Asian and Pacific countries took part
in the Centre’s trainings. The trainings were
held in Turin, in many different countries and
on-line. Each Regional Programme has differ-
ent priority topics. For Asia and the Pacific the
Centre concentrates on:
• labour migration
• youth employment
• vocational training systems and skills de-
velopment
• enterprise development and microfinance
• improvement of working conditions and
productivity
• industrial relations
• child labour and forced labour.
Training itself is not a solution for prob-
lems in decent work but it gives a key to en-
hancement. By improving the skills and com-
petence of individuals, the awareness of rights
and entitlements in work life increases. That
is the purpose of the International Training
Centre.
Additional information and contacts:
International Training Centre of the ILO
Viale Maestri del Lavoro, 10
10127 Turin, Italy
E-mail: communications@itcilo.org
www.itcilo.org
Course calendar:
www.itcilo.org/en/standard-courses-regist-
ration/course-calendar
19

Professor Pekka Puska discussed with symposium participants promotion
of cardiovascular health.
Cardiovascular health
and work on focus
Suvi Lehtinen, Finland
NIVA, the Nordic Training Institute
in Occupational Health, together with
ICOH Scientific Committees on Car-
diology, Occupational Medicine, and
Health Services Research and Evalua-
tion in Occupational Health, organized
a “Symposium on recognition, preven-
tion and control of work-related car-
diovascular disorders” on 22–24 March
2010 in Espoo, Finland. Professor Jor-
ma Rantanen served as the moderator
of the Symposium.
In his opening keynote Professor
Pekka Puska, Director General of the
National Institute for Health and Wel-
fare in Finland, and President of the
World Heart Federation stated that
thanks to effective prevention pro-
grammes, the incidence of cardiovas-
cular disorders (CVD) is declining in
many industrialized countries. It is,
however, growing in the developing
world.
Work-related CVDs constitute a
major burden to health and economies
of countries. In addition to traditional
cardiotoxic chemical and physical fac-
tors, the Meeting recognized the great
20 • Asian-Pacific Newslett on Occup Health and Safety 2010; 17:20
impact of psychosocial factors on mor-
bidity. We have evidence on temporali-
ty of association, and dose-response re-
lationship, but the complex multifacto-
rial relationships and confounding fac-
tors still constitute a challenge. A new
comprehensive paradigm is needed.
The “implementation gap” still re-
mains wide and needs to be narrowed.
Besides research on new CVD haz-
ards, efforts for effective use of existing
knowledge are warranted. Workplace
is a promising arena for prevention of
both CVDs in general and work-relat-
ed CVDs in particular. In such preven-
tion, strategies for developing work life
to become more conducive to cardio-
vascular health are crucial.
The presentations made at the
Symposium will be published as Pro-
ceedings, and used as background doc-
umentation for the sessions on this
very topic in the ICOH2012 Congress
in Monterrey, Mexico.
Photos by Suvi Lehtinen
Nordic Institute for Advanced Training
in Occupational Health, NIVA
NIVA is a Nordic training institute that operates under
the Nordic Council of Ministers (NCM) and focuses on
advanced training in occupational health. From 1982,
in other words the year it was established, NIVA has
been actively collaborating with the Finnish Institute
of Occupational Health.
The training curriculum has included more ‘tra-
ditional’ NIVA courses, such as the safety and OLS
(Occupational Exposure Limits) courses, but also a
highly relevant course on nanotechnology and safety,
and courses that link more closely to general develop-
ments within the labour market. Examples of the latter
include such themes as the ageing of the workforce,
employability of the handicapped, lack of workforce,
and the increasing cultural heterogeneity of the po-
tential workforce.
The courses are highly international, and even
though most of the participants come from the Nord-
ic countries, there are also participants from as far as
Russia, Asia, North America and Australia. The course
language is English which is likely to contribute to this.
More information on NIVA: www.niva.org

ICOH and training in occupational health
Suvi Lehtinen, Finland
International Commission on Occupational
Health (ICOH), founded in 1906, is a profes-
sional association of occupational health ex-
perts whose mission is to advance research,
training, and information on occupational
health. In addition to scientific and profes-
sional activities, ICOH recognizes the pro-
motion of professional ethics in all occupa-
tional health activities as its key global role.
ICOH leadership has fostered professional
ethics to become one of the themes in every
training event.
The biggest international training event
in occupational health is the triennial ICOH
Congress. The ICOH International Congress
makes an inventory of the most recent re-
search in various topics of occupational health
and safety worldwide and provides platforms
for workshops, seminars and meetings on
implementation of good occupational health
practices in various parts of the world. This
is extremely important because work life is
changing rapidly and all experts working in
the field of occupational health and safety
sorely need continuous and life-long learn-
ing. This is ICOH’s response to that need. In
connection with the world congresses, as well
as in many symposia and conferences, pre-
and post-congress courses are also organized,
just to ensure that the knowledge and skills of
experts in our field are continuously updated.
The previous ICOH International Con-
gress was successfully organized in March
2009 in Cape Town, South Africa and prep-
arations for the next, scheduled for 18–23
March 2012, to be held in Monterrey, Mexi-
co (http://www.icohcongress2012.org/1024+/
index.html), are well underway. The theme
of ICOH2012 in Monterrey is Occupational
Health for All: From Research to Practice.
Scientific Committees
ICOH has 35 scientific committees active
in various fields of occupational health re-
search. They cover the following topics: Ac-
cident prevention; Ageing and work; Allergy
and immunotoxicology; Cardiology in occu-
pational health; Education and training in oc-
cupational health; Epidemiology in occupa-
tional health; Fibres; Health service research
and evaluation in occupational health; Histo-
ry of the prevention of occupational and en-
vironmental diseases; Indoor air quality and
health; Industrial hygiene; Musculoskeletal
disorders; Neurotoxicology and psychophysi-
ology; Occupational and environmental der-
matoses; Occupational health nursing; Oc-
Asian-Pacific Newslett on Occup Health and Safety 2010;17:21–3 •
Photo by Suvi Lehtinen
cupational medicine; Occupational toxicol-
ogy; Occupational health and development;
Occupational health for health care workers;
Occupational health in the chemical industry
(MEDICHEM); Occupational health in the
construction industry; Radiation and work;
Reproductive hazards in the workplace; Res-
piratory disorders; Rural health: agriculture,
pesticides, and organic dusts; Shift work and
working time; Small-scale enterprises and the
informal sector; Thermal factors; Toxicology
of metals; Unemployment, job insecurity and
health; Vibration and noise; Women, health
and work; Work and vision; Work disability
prevention and integration; and Work organi-
zation and psychosocial factors.
For additional information, see: http://
www.icohweb.org/site_new/ico_scientific_
committees.asp
During the previous triennium, a total of
59 conferences organized by the ICOH Sci-
entific Committees were recorded and at least
twice as many conferences during the same
period enjoyed scientific committee members’
contributions to various international and na-
tional meetings.
This wide selection of topics also indicates
the multidisciplinary nature of occupational
health and safety which is another challenge
21

for the training and education of occupational
health and safety experts.
Each ICOH member in good standing can
be a member of a maximum of three Scientific
Committees of his/her own choice.
In-between the ICOH triennial Con-
gresses, the Scientific Committees organize
symposia focusing on the topics of their own
substance areas. The most recent examples
of these are the Conferences of EPICOH and
MEDICHEM, organized a couple of weeks ago
in Taipei. Another example of ICOH training
activity organized in collaboration with NIVA,
the Nordic Training Institute, is briefly de-
scribed elsewhere in this issue of the Asian-
Pacific Newsletter.
Scientific Committee on Education
and Training
ICOH has recognized the importance of ed-
ucation and training of occupational health
and safety experts, as it has a specific Scientific
Committee for the topic. The aim of the Sci-
entific Committee is to identify education and
training modalities in occupational health that
can be used to improve the training of profes-
sionals. Sharing the knowledge learned with
workers and managers is also of importance.
The Committee organized several events dur-
ing the previous triennium aimed at ensuring
the introduction and utilization of the most
recent new tools for education and training.
E-learning in occupational health and dis-
tance education demonstrating current mo-
dalities and planning for global courses were
also among the topics on the agenda. An in-
ternational survey on occupational medicine
training was co-sponsored by the Committee.
ICOH Code of Ethics
The most important ICOH document is the
1993 International Code of Ethics for Occu-
pational Health Professionals, revised in 2002.
The Code defines the basic ethical principles for
occupational health practice, the obligations of
22 • Asian-Pacific Newslett on Occup Health and Safety 2010;17:21–3
Photo by Suvi Lehtinen
health professionals, and the professional inde-
pendence of occupational health experts. The
Code stipulates 26 different duties and obli-
gations for occupational health professionals,
guiding them in various practical activities ac-
cording to ICOH ethical principles.
These guides cover the following areas of
occupational health practice:
• maintenance and upgrading of competence,
including knowledge of conditions of work
and scientific and technical knowledge
• advice on policies and programmes for im-
proving occupational health
• emphasis on preventive and promotion ac-
tions
• follow-up on remedial actions
• provision of information on safety and
health
• protection and management of company in-
formation, health surveillance, workers’ in-
formation on health examinations, employ-
er’s information on health examinations, and
protection of confidential health data
• biological monitoring
• health promotion
• protection of community and environment
• contributions to scientific knowledge, com-
petent scientific judgement, integrity and im-
partiality, professional independence, equity
• clause of ethics in employment contracts
for occupational health personnel
• record-keeping
• medical confidentiality
• collective health
• relationship with health professionals
• relationship with social partners
• ethics promotion
• professional audits.
The original ICOH Code is in English and
French. It has been translated into several oth-
er languages (Spanish; Portuguese; Japanese;
Turkish; Italian; Chinese; Greek; and Finnish),
thus contributing to training of occupational
health experts in many different countries.
http://www.icohweb.org/site_new/ico_
core_documents.asp#
Training activities
ICOH also organizes various training cours-
es in connection with national occupational
health and safety conventions, disseminates
information and produces position papers,
fact sheets, evaluations and guidelines for oc-
cupational health practices. One of the key
topics for recent training activities has been
the introduction and piloting of Basic Occu-
pational Health Services, BOHS, which is a
joint endeavour of WHO, the ILO and ICOH.
The aim of this approach is to survey the fea-
sibility of providing occupational health serv-
ices through primary health care in order to
increase the availability and accessibility of
occupational health services to all workers of
the world. This goal is included in the WHO
Global Plan of Action on Workers’ Health and
also strived for in ILO Convention on Promo-
tional Framework for Occupational Safety and
Health. The Global Network of WHO Col-
laborating Centres is preparing an extensive
programme to facilitate the production and
dissemination of training materials and infor-
mation tools for development of occupational
health services worldwide.
As another example of its wide collabora-
tive network, ICOH is co-sponsoring an in-
ternational meeting that will be organized by
the Finnish Institute of Occupational Health
in June 2011. The meeting is co-organized by
WHO and the ILO. Several other co-sponsor-
ing organizations will be involved. The meet-
ing entitled International Forum on Occupa-
tional Health and Safety: Policies, profiles and
services, is scheduled for 20-22 June 2011, and
is organized in Espoo, Finland.
The full list of ICOH-organized and -spon-
sored conferences, symposia and meetings is
available at: www.icohweb.org.
ICOH National Secretaries
In order to facilitate the networking of ICOH
members at the country level, ICOH also
has a National Secretary in many countries,
whose tasks include acting as a representative
of ICOH in his/her own country and dissemi-
nating information that is useful and neces-
sary for ICOH members. One of the tasks is
also to provide relevant information to po-
tential new members. For this purpose, the
National Secretaries report back on their ac-
tivities every year of the triennium. The situ-
ation after the first year of the current trien-
nium shows that there are several recent ex-
amples of combination of well-planned train-
ing activities and promoting occupational
health by the ICOH National Secretaries in
Argentina, Austria, Brazil, Colombia, Czech
Republic, Finland, France, Greece, India, Ire-
land, Italy, Nepal, Romania, Sweden, Turkey,
Ukraine and the United States, to mention the International Ergonomics Association,
just a few. The contact information of ICOH IEA. In addition, ICOH has signed a Memo-
National Secretaries is available at: http:// randum of Understanding with International
www.icohweb.org/site_new/ico_national_ Social Security Association, ISSA, the Interna-
secretaries.asp tional Association of Labour Inspectors, IA-
LI; and most recently with the International
Association of Rural Health and Medicine,
Collaborative links
IARHM. These collaborative links provide an
ICOH works in close collaboration with the excellent forum for strengthening each others’
Inter-Governmental Organizations, the ILO training and information activities.
and WHO as their NGO in official relations.
We also work together with other Non-Gov- Suvi Lehtinen
ernmental Organizations active in the field of Vice President
occupational health, such as the International International Commission on
Occupational Hygiene Association IOHA, and Occupational Health
EWIC 2010 - 12th
European Workshop
on Imagery and
Asian-Pacific Newsletter themes in 2010
The themes of the Newsletters to be published in 2010 are:
Cognition
2/2010 Injury and disease reporting systems
3/2010 Informal sector Helsinki, Finland
Manuscripts addressing the above themes and other topics in the field of occupational health and 16–19 June 2010
safety are welcome. If you plan to submit a manuscript, kindly contact the Editorial Office in advance.
Readers may also send proposals on potential authors and articles.

Contact: The European Workshop on Image-

Ms. Suvi Lehinen, Editor-in-Chief ry and Cognition (EWIC) is a biennial
Asian-Pacific Newsletter on Occupational Health and Safety meeting devoted to scientific study of
Finnish Institute of Occupational Health mental imagery and cognition.
Topeliuksenkatu 41 a A
FI-00250 Helsinki, Finland The core topic covered by the work-
E-mail: suvi.lehtinen@ttl.fi
shop is mental imagery in the visuo-
spatial and other sensory modalities:
auditory imagery, action and motor
imagery, and imagery processes and
interference. Other themes related to
cognitive mechanisms in the intersec-
tion of memory and perception are al-
so represented: working memory and
attention, crossmodal and haptic spa-
ce, spatial cognition and navigation,
language comprehension and problem
solving, and sensory and cognitive de-
ficits.

Applied issues in imagery and cogni-

tion research will have their own ses-
sion, and a satellite symposium ”Safe-
ty in Traffic” will be held in the context
of the EWIC 2010.
The 12th EWIC is organised by the Fin-
nish Institute of Occupational Health
(Brain and Work Research Centre) and
the University of Helsinki (Cognitive
Science).

Contact address:
EWIC2010@ttl.fi.

Internet:
http://www.helsinki.fi/ewic2010

Asian-Pacific Newslett on Occup Health and Safety 2010;17:21–3 • 23

Editorial Board Le Van Trinh
Director
as of 1 December 2008 National Institute of Labour Protection
99 Tran Quoc Toan Str.
Hoankiem, Hanoi
Ruhul Quddus K. Chandramouli VIETNAM
Deputy Chief (Medical) Joint Secretary
Department of Inspection for Factories and Ministry of Labour Gabor Sandi
Establishments Room No. 115 Head, CIS
4, Rajuk Avenue Shram Shakti Bhawan International Occupational Safety and
Dhaka-1000 Rafi Marg Health Information Centre
BANGLADESH New Delhi-110001 International Labour Office
INDIA CH-1211 Geneva 22
Chimi Dorji SWITZERLAND
Licencing/Monitoring Tsoggerel Enkhtaivan
Industries Division Chief of Inspection Agency Evelyn Kortum
Ministry of Trade and Industry Ministry of Health and Social Welfare Technical Officer, Occupational Health
Thimphu Labour and Social Welfare Inspection Agency Interventions for Healthy Environments
BHUTAN National ILO/CIS Centre Department of Public Health and
Ulaanbaatar 210648 Environment
Yang Nailian Baga Toirog 10 World Health Organization
National ILO/CIS Centre for China MONGOLIA 20, avenue Appia
China Academy of Safety Sciences and CH-1211 Geneva 27
Technology Lee Hock Siang SWITZERLAND
17 Huixin Xijie Head, International Collaboration
Chaoyang District OSH Specialist Department Jorma Rantanen
Beijing 100029 Occupational Safety and Health Division ICOH, Past President
PEOPLE’S REPUBLIC OF CHINA Ministry of Manpower FINLAND
18 Havelock Road, # 03-02
Leung Chun-ho Singapore 059764 Harri Vainio
Deputy Chief Occupational Safety Officer SINGAPORE Director General
Development Unit Finnish Institute of Occupational Health
Occupational Safety and Health Branch John Foteliwale Topeliuksenkatu 41 a A
Labour Department Deputy Commissioner of Labour (Ag) FI-00250 Helsinki
25/F, Western Harbour Centre Labour Division FINLAND
181 Connaught Road West P.O. Box G26
Hong Kong, CHINA Honiara
SOLOMON ISLANDS