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Handbook of WMA Policies
R-2016-02-2016 ⏐ World Medical Association
WMA RESOLUTION
ON
OCCUPATIONAL AND ENVIRONMENTAL HEALTH AND SAFETY
Adopted by the 67th
WMA General Assembly, Taipei, Taiwan, October 2016
PREAMBLE
Occupational and environmental health and safety (OEHS) is an integral part of public
health, and the primary health care (PHC) system in particular, since it is often the first
level of contact of individuals, the family and the community with a health system,
bringing health care as close as possible to where people live and work.[1]
Workers represent at least half of the world’s population and are the backbone of many
economies, but may have inadequate access to occupational and environmental health
services[2]. Decent work sums up the aspirations of people in their working lives. It
involves opportunities for work that is productive and delivers a fair income, security in
the workplace and social protection for families, better prospects for personal development
and social integration, freedom for people to express their concerns, organize and
participate in the decisions that affect their lives and equality of opportunity and treatment
for all women and men (ILO).
Every 15 seconds, a worker dies from a work-related accident or disease,[3] and each year
there are 160 million cases of work-related/occupational diseases; 313 million work
accidents occur annually and over 2.3 million people die as a result of work accidents and
occupational diseases.[4]
Despite this, the proportion of work accidents and occupational diseases that are recorded
and reported is incredibly extremely small. It estimated that only less than 1% of
occupational diseases are recorded.[5]
The United Nations Development Programme’s Sustainable Development Goals 3, 5, 8
and 13 call for action in health promotion for all people of all ages, gender equality, decent
work and management of the impact of climate change; OEHS is well positioned to
impact positively within the work place on all the above mentioned sustainable
development goals.
Physicians have a critical role in preventing and protecting from, diagnosing, treating and
reporting work accidents and occupational diseases. Information, skills and functions of
physicians form the basis of service models that vary by countries and constitute key
elements in addressing OEHS. In addition, physicians should strive for inclusive working
life so that even employees with disabilities are given opportunities to stay integrated in
decent working life.
Despite many governments and employers’ and workers’ organizations place greater
emphasis on the prevention of occupational diseases. Prevention is not receiving the
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priority warranted by the scale and severity of the occupational disease epidemic.
Physicians and National Medical Associations can contribute to the identification of
problems, development of national reporting systems and formulation of relevant policies
in the field of OEHS.
Unsatisfactory and unsafe working conditions play a significant role in the development of
occupational diseases and injuries, which are, in their turn, a cause of mortality among
working population. Women bear the brunt of the work-related burden which often makes
them a more vulnerable group in working life.
RECOMMENDATIONS
1. Physicians should play a pivotal role in the development of a workforce that is
trained in the social determinants of health, and raise workplace awareness about
the social determinants of health.
2. The field of OEHS should be accorded the necessary importance in both graduate
and post-graduate medical studies.
3. All workers should have access to risk based OEHS services from the first day of
work, and extending beyond the last day at work in order to account for
occupational diseases with a long latency period. Service content should be
standardized and the role of physicians in the planning and implementation of
OEHS systems that are essentially preventive/protective must be recognized.
4. National Medical Associations should act proactively and encourage the expansion
of the scope of OEHS services, prevent and reduce occupational diseases, and
injuries, reproductive health and protect the environment. They should also
promote workplace gender equality, and improve recording and reporting systems.
In addition, they should focus on capacity building, teaching and training,
collaborative research and improving the qualifications of their members in this
field.
5. National Medical Associations, together with governments, should take an active
role, where appropriate, in the formulation and development of national systems
that facilitate OEHS prevention, and recording and reporting occupational diseases
in their respective countries and lead their member physicians in efforts to be made
in this area.
6. Occupational diseases and injuries are often addressed in the context of insurance
and compensation. Where these mechanisms are not in place, national medical
associations should advocate for the protection of workers through by means of
insurance or social security.
7. NMAs should engage in establishing “medical causality” in the context of
reporting accidents and diseases, and inform the public that the health impacts of
hazards and risk factors inherent to working life can be established and recorded
only through a well-developed reporting system.
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Handbook of WMA Policies
R-2016-02-2016 ⏐ World Medical Association
8. As part of medical care, physicians who are evaluating workers’ compensation
patients should be accredited in occupational and environmental medicine. The
first contact may be with the patient’s regular physician who should routinely
obtain history on patient’s occupation and environmental exposures. If the
physician establishes a relationship between the diagnosis and these exposures,
he/she must report it to the relevant authority and ideally refer the patient for an
evaluation by an accreddited occupational and environmental medicine physician.
9. National Medical Associations should consider forming an internal body for
addressing the problems of physicians working in this area and encourage them to
contribute to related scientific studies
10. National Medical Associations should promote opportunities for physicians to
benefit, in their daily professional practice, from systems identifying
environmental/occupational risks and hazards having an impact on workers’,
including pregnant workers, health and safety. In this context, apart from the lists
of WHO International Classification of Diseases and the International Labour
Organisation (ILO), they should promote an easy-to-use system for “exploring,
recording and reporting environmental risks and factors” that physicians can use
easily.
11. Governments should collaborate in setting up an international system to assess
occupational hazards and develop strategies to protect the health of workers.
12. Governments should establish legislative frameworks that protect the rights and
health of workers, including reproductive health and health effects of work at
home.
13. The active participation of employers’ and workers’ organizations is essential for
the development of national policies and programmes for the prevention of
occupational diseases.
14. Employers should provide a safe working environment, recognising and
addressing the impact of adverse working conditions on individuals and society.
15. When rendering services for an employer, physicians should advocate that
employers fulfil minimum requirements set in the International Labour
Organization’s (ILO) occupational standards, especially when such requirements
are not set by national legislation. Physicians must maintain their autonomy and
independence from employer.
[1] World Health Organization. Declaration of Alma-Ata: International Conference on
Primary Health Care, Alma-Ata, USSR, 6-12 September 1978.
[2] World Health Organization. Workers’ health: Global plan of action. WHA 60.26.
[3] International Labour Organization [internet]. Safety and health at work. ILO; [updated
2016; cited 2016 January 19]. Available from: http://www.ilo.org/global/topics/safety-and-
health-at-work/lang–en/index.htm
[4] Safety and health at work, ILO The Prevention of Occupational Diseases. World Day for
safety and health at work 28 April 2013.
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[5] The Prevention of Occupational Diseases. World Day for safety and health at work 28
April 2013.
National System for Recording and Notification of Occupational Diseases Practical guide
International Statistical Classification of Diseases and Related Health Problems (ICD-10) In
Occupational Health.
World Health Organization Geneva 1999.
Improving Workers’ Health Worldwide: Implementing the WHO Global Plan of Action on
Workers’ Health. GOHNET NEWSLETTER NO. 22. November 2013 Edition.
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