Occupational Health
Occupational Health
Introduction
Occupational health and safety (OHS) management protects the safety, health, and welfare of people at the workplace. In 1950, the first session of the joint International Labour Organization (ILO) and the World Health Organization (WHO) Committee on Occupational Health adopted a definition of
their working conditions; the protection of workers in their employment from risks resulting from factors adverse to health; the placing and maintenance of the worker in an occupational environment adapted to his physiological and psychological capabilities and, to summarize: the adaptation of work to man and of each man to his job. (Guidotti 2011, 5)
All occupational health and safety programs aim to foster a safe work environment, including the protection of employers, suppliers, customers, family members, nearby communities, and other members of the public who could be affected by a companys operations. Such programs draw on disciplines such as occupational medicine, occupational or industrial hygiene, public health, safety engineering, chemistry, health physics, ergonomics, toxicology, epidemiology,
occupational health. The definition was subsequently revised in 1995 and states:
Occupational health should aim at the promotion and maintenance of the highest degree of physical, mental and social well-being of workers in all occupations; the prevention amongst workers of departures from health caused by
This guidance note was prepared by Josefina Doumbia (Principal Environmental Specialist, CESI). Peer reviewers included Adriana Triana (Environmental Specialist, CESI) and Mauricio Athie (Senior Environmental Specialist, CESI). Additional comments and contributions were provided by Bilal Rahil (Senior Manager, CESI), Carlos Arias (Senior Environmental Specialist, CESPQ), Johanna van Tilburg (Senior Counsel, LEGES), and Robert Gerrits (Senior Social Development Specialist, CESI). Editorial assistance was provided by Stan Wanat (Consultant), Juliette Guantai (Program Assistant, ENV) and James Cantrell (Communication Analyst, ENV). The task team leaders for this product are Kulsum Ahmed (Lead Environment Specialist, ENV) and Helena Naber (Environmental Economist, ENV). The product was prepared under the guidance of the following World Bank Group management: James Warren Evans / Mary Barton-Dock (Directors, Environment Department, World Bank), Bilal Rahill (Senior Manager, IFC), and Frank Lysy / Ravi Vish (Director, MIGA).
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exposure to bacteria, viruses, biogenic toxins, and allergens is characteristic of biological risks.
To address occupational health and safety, a business should identify the workplace hazards (see Appendix, page 10). A hazard refers to a circumstance that has the potential to cause harm. It may indicate a physical situation or it may indicate the omission of necessary preventative measures. An example of a physical situation would be exposure to equipment with sharp edges that could cause lacerations, while an example of an omission would be the failure to provide a guard to prevent injury from the sharp edges on the equipment.
Modern occupational health and safety legislation usually demands that a risk assessment be carried out prior to making an intervention. Risk management requires risk to be managed to a level that is as low as is reasonably practical. This assessment should detect the hazards, identify all affected by the hazards, evaluate the risk, and offer and prioritize appropriate control measures.
The evaluation of risk is based on the likelihood or probability of the harm being realized and the severity of the consequences. This can be expressed mathematically as a quantitative assessment by assigning integers to denote low, medium, or high likelihood, and assigning integers to indicate the severity of the consequences. The integer assigned for likelihood and the one assigned for severity can be multiplied together to obtain a risk factor. Risk can also be evaluated qualitatively by describing the circumstance in which the harm could arise. Newly
introduced controls should lower risk by one level (for example, from high to medium or from medium to low). Risk increases as the seriousness of resulting harm increases, and as the likelihood increases that
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the circumstance will occur. Ideally, all risks would be mitigated; however, this is usually not feasible. Box 1 lists a typical risk-control hierarchy.
Advocacy
for
behavior-based
safety
has
also
stimulated controversy, with some arguing that a behavioral focus puts excessive responsibility on the workers, and that BBS is too limiting and should aim
Implementing an occupational health and safety management system, which can be carried out inhouse or by specialized consultants, is a reliable way of improving occupational health and safety
for a more holistic or culture-focused approach. In any case, behavioral safety has provided a platform for constructive debate, and the conflicting opinions have provided the opportunity to learn more about the psychology of injury prevention (Cooper 2007; Geller 2004).
performance in the workplace. These health and safety systems promote, facilitate, and enable
consistency throughout workplace activities and processes. It is important to note that the system alone will not produce safe behavior or a safe workplace. System effectiveness comes from complete To be successful, the BBS program must include all employees from the CEO to the most basic job position, since the changes needed cannot be accomplished without buy-in and support from all involved in making those decisions. Central elements of a BBS program include (a) common goals for the employees Behavior-Based Safety. Behavior-based safety (BBS) is an approach used to reduce workplace accidents and fatalities. It is set on the premise that safety in the workplace is a combination of three measurable components: personality, environment, and behavior. Only when these three elements are combined can the workplace be accident free. BBS argues that by observing and analyzing the interactions between people's behavior and the work environment, it is possible to identify factors that support safe or unsafe behavior. BBS also maintains that by changing the environment to support safe behavior and OHS Application in Small and Medium-Sized Enterprises. Small enterprises are commonly defined as having 149 employees and medium-sized and the managers, (b) behavioral
commitment to the health and safety system. This includes proper implementation, follow-up, and training.
observation and feedback processes, (c) formal review of observation data, (d) improvement goals, and (e) reinforcement for improvement and goal attainment. Other aspects that can contribute to a BBS programs success include (a) multilevel teams for the
assessment phase, the observation and the review phases, or for all three phases; (b) placing the focus on site observation; and (c) recognizing that BBS is not a quick fix, but rather a commitment to a safer environment and injury reduction.
implementing proven behavioral safety processes, a business can dramatically reduce the number of losttime and minor injuries.
enterprises as having 50249 employees. As key drivers in the world economies, small and mediumsized enterprises (SMEs) need to have their safety and
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health performance on a par with that of larger companies. If an SME did not understand its health and safety risks, then it would lack the knowledge to manage its health and safety performance, and as a result may not assign needed resources to provide adequate training.
systems potential to reduce the human cost of physical harm and the financial cost of the accidents, in relation to the costs associated with the
management system.
Sometimes, the lack of clear health and safety regulations may hinder the implementation of
Typical occupational health and safety management for SMEs includes the following: meeting legal responsibilities, establishing an organizational health and safety structure, developing a written health and safety policy, assessing risks, training the workforce, consulting with the workforce, monitoring and improving safety performance, and providing safe facilities. The requirements for the safe environment of an SME are not different from those for any other business. However, the economic impact of an accident is more severe on a SME than on a big company, since an SME has less working capital. Mechanisms to overcome SMEs occupational health and safety issues might include organizing to obtain collective training from the government, or
Box 2. Basic Elements for Good Health and Safety Management Systems
Management Commitment and Employee Involvement. The manager or management team leads the way by setting policy, assigning and supporting responsibility, setting an example, and involving employees. Worksite Analysis. The worksite is continually analyzed to identify all existing and potential hazards. Hazard Prevention and Control. Methods to prevent or control existing or potential hazards are put in place and maintained. Training for Employees, Supervisors and Managers. Managers, supervisors, and employees are trained to understand and deal with worksite hazards. Follow-up. To determine what is working well and what changes are needed.
Practicalities of implementation.
business practice for all operations, regardless of size, to have an occupational health and safety
management system commensurate with their risks. However, implementing such a system may involve costs that businesses had not anticipated and may be unwilling to bear. Businesses should quantify the costs associated with accidents that cause harm to people or property. Deciding whether to allocate resources to develop an occupational health and safety management system should be based on the
business practice to refer to established sector-specific benchmarks for good health and safety practices, and established occupational health and safety regulations from other regions.
If the workforce has low literacy or educational levels, and/or lacks the appropriate skills set (for example, farmers becoming factory workers, and women or
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youngsters becoming part of the labor force), it is highly advisable that businesses focus additional efforts to train the labor force so as to minimize the likelihood conditions. of accidents and unsafe working
required for workers' compensation, insurance audits, and government inspections, must be maintained as long as the actual need exists or as required by law. Keeping records of all activities, such as policy statements, training sessions, safety and health meetings, information distributed to employees, and
In a few circumstances, cultural beliefs may prevent some health and safety controls from being applied (for example, in the United Kingdom, Sikhs required an exemption from the regulation that drivers of motorcycles wear crash helmets). Where such
Maintaining essential records will demonstrate sound business management as supporting proof for credit applications, for insurance and other audits.
constraints occur, it is especially important that technical solutions are found to minimize health and safety risks in the workplace.
Furthermore, such records help in the review of ongoing safety and health activities for better control of current operations and to plan improvements. Records of accidents, related injuries, illnesses, and
Any good management system requires periodic review to determine what is working well and what changes are needed. A widely accepted way to identify hazards is to conduct safety and health inspections. Using checklists is a good way to get an indication of where to begin taking action towards a safer and more healthful business. The self-inspection checklist in Appendix 1 includes a basic, but not exhaustive, list of areas to be considered when assessing health and safety risks.
occupational
health
safety
management priorities. Thus since management may not carry out early identification and proper
assessment of health and safety risks, it cannot make its employees aware of the workplace risks, and training programs may not be properly established. New businesses should begin addressing health and safety from day one (see box 2). Open communication with the employees is crucial to the success of an occupational health and safety system. The employees cooperation depends on their understanding of the systems goals, why it is important to them, and how it affects their work. Additionally, documentation of the activities in all elements of the safety and health program is important. Essential records, including those legally
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economic
benefits,
and/or
to
satisfy
legal
proportional to the businesss occupational health and safety risks. There is little to be gained from a management system that generates paperwork and takes up significant time and effort, but results in little or no risk reduction. To help businesses in identifying work-related hazards, there are commercially
requirements. Economic benefits are secondary to human health and safety as a rationale for health and safety protection. However, businesses may consider calculating the total (direct and indirect) costs of work-related injuries and illnesses to determine the economic benefits that may achieved by preventing injuries and illnesses. Conversely, businesses may recognize the economic disadvantages of poor occupational health and safety performance in terms of lost productivity, and the requirements to pay compensation and fines.
Established businesses with a good safety record may become complacent and overlook the inherent risks associated with their operations. If there is a long period with zero accidents, management might wrongly relax safety practices, assuming that the
When operating with appropriate occupational health and safety systems, businesses may recognize that these systems improve staff performance and
workplace is safe. Established operations should carefully implement occupational health and safety principles and closely monitor occupational health and safety performance data, including reports of near misses and incidents.
availability for work, help in recruiting and retaining key skills and expertise, avoid possible disability discrimination, reduce workers compensation
insurance costs and medical expenditures, and produce fewer faulty products. Other indirect benefits may include increased morale, better labor and management relations, reduced turnover, and better use of human resources. There is an ongoing tendency to integrate the occupational health and safety management system Governments experience the disadvantages of poor occupational health and safety performance through lost tax revenue, through increased welfare costs for social security payments and medical treatments, and through the social costs of accidents. Governments respond through the enactment of legal instruments to enforce minimum health and safety standards. with other structures typically used to manage businesses successfully. These other structures
include the environmental and social management system and the quality management system. This approach allows a business to address the key aspects of its operations through a coordinated approach by integrating all of the businesss systems and processes into one complete framework.
The complexity of a businesss occupational health and safety management should be directly
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A good practice is to benchmark a businesss occupational health and safety performance to establish the systems level of effectiveness. Good sources include the benchmarks published by some countries regulatory agencies responsible for health and safety enforcement, for example the U.K. Health and Safety Executives Corporate Health & Safety Performance Index (HSE Web site), the industrial trade associations, IFC environmental guidelines, the EU Best Available Technique Reference Notes (BREF), the ILO small and medium enterprise toolkits, Occupational Health and Safety Advisory Service (OHSAS) 18001:2007, the American National
Sometimes the regulatory framework combines the two approaches. In the United Kingdom, for example, while there is a movement towards risk assessment in recent laws governing asbestos and fire safety management, prescriptive legislation requires that all dangerous parts on workplace equipment be suitably guarded to prevent harm to people, if such guarding is technically possible.
Many
governments
have
established
national
agencies whose role it is to carry out research, provide occupational health and safety information and training, inspect workplaces, and enforce regulatory compliance.
Standards Institute (ANSI) and American Industrial Hygiene Association (AIHA) Z10-2005, and British System (BS): 8800:2004.
Good business practices would also consider the benefits of a sound occupational health and safety
Certification to the standard may confer a marketing advantage and be of commercial benefit to some businesses, particularly to satisfy the supply-chain requirements of clients that have their own
system from the perspective of avoiding penalties from lack of compliance with government
requirements, anticipating legal challenges, and possibly benefiting from better insurance premiums.
National governments may take a prescriptive approach to occupational health and safety
Practical Examples of Targeting Occupational Health and Safety and Lessons Learned
Brazil. A large Brazilian construction company significantly reduced the number of accidents and fatalities by developing a rigorous occupational health and safety program. Key elements of this program included (a) a detailed workers toolkit identifying all job-related risks, typical accident causes, and clear ways to prevent/avoid them; (b) rigorous and focused H&S training for managers and supervisors; (c) constant worker H&S induction and
legislation, or they may embrace the concept of risk assessment, which aims to identify hazards and implement reasonably practical measures to reduce risks to the lowest possible level. Judgments about what is reasonably practical include economic analysis of costs and benefits as well as consideration of the range of available technology.
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training; and (d) monetary rewards to the entire team including project manager and employees. The source of these financial incentives is the money allocated for accidents/fatalities compensation not having to be used for that purpose. The number of accidents and fatalities has been reduced below the typical
China.
Chinese chemical company decided that, in addition to its standard safety procedures and practices, it would ask each employee to bring a family picture to work in order to create a family bulletin board for each work area. The board was located in the room where, each morning, the workers had a five-minute safety talk and pledged to their families to have a safe workday. After introducing these practices,
management noticed that workers began talking about safety among themselves, and management credits these innovations as contributing to a reduced accident rate.
B-Safe Management Solutions Inc., Franklin, Indiana. http://bsmsinc.com/articles/White.pdf. European Agency for Safety and Health at Work, EU-OSHA Welcome! European Agency for Safety and Health at Work, http://osha.europa.eu. Geller, E. S. 2004. Behavior-Based Safety: A Solution to Injury Prevention: Behavior-Based Safety Empowers Employees and Addresses the Dynamics of Injury Prevention. Risk & Insurance 15 (12): 66. Gervais, R. L., Z. Pawlowska, R. Bojanowski, A. Kouvonen, M. Karanika-Murray, K. Van den Broek, and M. De Greef. 2009. Occupational Safety and Health and Economic Performance in Small and Medium-Sized Enterprises: A Review. Working Environment Information Working Paper, European Agency for Safety and Health at Work, Luxembourg. http://osha.europa.eu/en/publications /reports/TE-80-09-640-ENN_occupational_safety_health_economi c_performance_small_medium_sized_e nterprises_review. Guidotti, T. L., ed. 2011. Global Occupational Health. New York: Oxford. HSE (Health and Safety Executive). 1997. Successful Health and Safety Management. Suffolk, UK: HSE Books, http://www.qub.ac.uk/safetyreps/sr_webpages/safety_downloads/succe ssful_h&S_management.pdf. , Corporate Health and Safety Performance Index, HSE, www.chaspi.info-exchange.com. , Home, HSE, http://www.hse.gov.uk/. ILO (International Labour Organization), Programme on Safety and Health at Work and the Environment (SAFEWORK), ILO, http://www.ilo.org/safework/lang-en/index.htm. , Promoting Jobs, Protecting People, ILO, www.ilo.org. NIOSH (National Institute for Occupational Safety and Health) Malaysia, National Institute of Occupational Safety and Health (Malaysia), Ministry of Human Resources, Malaysia, NIOSH Malaysia, http://www.niosh.com.my/. Occupational Health and Safety Group, The Health and Safety and OHSAS Guide,
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Occupational Health and Safety Group, http://www.ohsas-18001-occupationalhealth-and-safety.com. Stellman, J. M., ed. 1998. Encyclopaedia of Occupational Health and Safety. Geneva: International Labour Organization. http://www.ilo.org/safework/info/databas es/lang--en/WCMS_113329/index.htm US Department of Labor, Occupational Safety and Health Administration (OSHA), US Department of Labor, http://www.osha.gov/. WHO (World Health Organization), Occupational Health, WHO, http://www.who.int/occupational_health/ en/.
This guidance note is part of World Bank Group publication: Getting to GreenA Sourcebook of Pollution Management Policy Tools for Growth and Competitiveness, available online at www.worldbank.org
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