WMA Statement on Occupational and Environmental Health and Safety

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.

Workers represent at least half of the world’s population and are the backbone of many economies, but many may have inadequate access to occupational and environmental health services and do not operate in a safe working environment.

The International Labour Organization (ILO) defines decent work as opportunities for work that are productive and deliver fair income with dignity, equality, and within safe working conditions. Despite the fact that the right to decent work is recognized in the Universal Declaration of Human Rights, every 15 seconds, a worker dies from a work-related accident or disease ^, resulting in an annual 4% loss in global GDP.

Despite this, the proportion of work accidents and occupational diseases that are recorded and reported worldwide is incredibly small. It is estimated that less than 1% of occupational diseases are recorded.

Additionally, as many workers face greater pressures to meet the demands of working life, many of them are at risk to develop work-related stress which may occur when the demands of the job do not match or exceed the capabilities, resources or needs of the worker or when the knowledge or abilities of an individual worker or group to cope are not matched with the expectations of the organizational culture of an enterprise. High-level of stress can result in health impairments such as burnout, depression, anxiety, cardiovascular disease or even suicide.

Recently and even more due to the COVID-19 pandemic, the world has witnessed an increased number of employees working outside the employer’s premises using digital information and communication technologies either full-time or part-time. Despite some positive aspects, there are risks associated with this work arrangement as it isolates employees, particularly individuals living alone and can result in increased levels of stress and anxiety. Extended working hours and employee availability in addition to diminished boundaries between personal and professional life may impact work-life balance. A healthy digital working environment needs to be in place to ensure employee health and safety.

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 maintain physical, mental and social well-being for all workers, that will result in poverty reduction, sustainable development and saving millions of lives every year.

Physicians have a critical role in preventing, diagnosing, monitoring, treating and reporting work accidents and occupational diseases. In addition, physicians should promote equal, decent and inclusive work environments for all regardless of age, gender, ethnic origin, nationality, religion, political affiliation, race, sexual orientation, or the presence of a disability.

Despite many governments and employers’ and workers’ organizations placing greater emphasis on the prevention of occupational diseases. prevention is not receiving the priority warranted by the scale and severity of the occupational disease epidemic.

Physicians and 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 subsequently causes of mortality in the working population.

RECOMMENDATIONS

1. Physicians should play a pivotal role in the development of a workforce that is educated in and raise workplace awareness about the social determinants of health.
2. The field of occupational and environmental health and safety (OEHS) should be accorded the necessary importance in both graduate and post-graduate medical studies
3. Physicians must cooperate with the healthcare and occupational authorities to promote health and safety in the workplace.
4. 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.
5. WMA Constituent members should act proactively and encourage the expansion of the scope of OEHS services, in order to prevent and reduce occupational diseases, and injuries, reproductive health issues and protect the environment. They should also promote workplace gender equality and encourage improvement of recording and reporting systems for OEHS-related metrics. They should also focus on workforce capacity building, teaching and training, and collaborative research.
6. WMA Constituent members, together with governments, should take an active role, where appropriate, in the formulation and development of national systems that facilitate OEHS prevention, and the recording and reporting of occupational diseases and incidents in their respective countries.
7. Physicians who are evaluating workers’ compensation patients should be experienced in occupational and environmental medicine. When a relationship between the diagnosis and occupational and environmental exposures is established, the physician should report it through the appropriate reporting system.
8. Occupational diseases and injuries are often addressed in the context of insurance and compensation. Where these mechanisms are not in place, WMA Constituent members should advocate for the protection of workers by means of insurance or social security.
9. When rendering services for an employer, physicians should advocate that employers fulfil the minimum requirements set in the International Labour Organization’s (ILO) occupational standards, especially when such requirements are not set by national legislation.
10. Employers should provide a safe working environment, recognising and addressing the impact of adverse working conditions on individuals and society.
11. Employers should consider promoting and offering essential vaccines to employees.
12. WMA Constituent members should consider forming an internal body for addressing the problems of physicians working in OEHS and encourage them to contribute to research and related scientific studies.
13. Governments should collaborate in setting up an international system to assess occupational hazards and develop strategies to protect the health of workers.
14. Governments should establish legislative frameworks that protect the rights and health of workers, including reproductive health and health effects of work at home.
15. Governments and NMAs must promote the development of training, information and research programs in occupational health to their members.