Occupational Safety and Health

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Occupational safety and health (OSH) also commonly referred to as occupational health and safety (OHS) or workplace health and safety (WHS) is an area concerned with the safety, health and welfare of people engaged in work or employment. The goals of occupational safety and health programs include to foster a safe and healthy work environment.[1] OSH may also protect co-workers, family members, employers, customers, and many others who might be affected by the workplace environment. In the United States the term occupational health and safety is referred to as occupational health and occupational and non-occupational safety and includes safety for activities outside work.[2]

In common-law jurisdictions, employers have a common law duty to take reasonable care for the safety of their employees.[3] Statute law may build upon this to impose additional general duties, introduce specific duties and create government bodies with powers to regulate workplace safety issues: details of this will vary from jurisdiction to jurisdiction.

As defined by the World Health Organization (WHO) "occupational health deals with all aspects of health and safety in the workplace and has a strong focus on primary prevention of hazards."[4] Health has been defined as "a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity."[5] Occupational health is a multidisciplinary field of healthcare concerned with enabling an individual to undertake their occupation, in the way that causes least harm to their health. Health has been defined as It contrasts, for example, with the promotion of health and safety at work, which is concerned with preventing harm from any incidental hazards, arising in the workplace.

Since 1950, the International Labour Organization (ILO) and the World Health Organization (WHO) have shared a common definition of occupational health. It was adopted by the Joint ILO/WHO Committee on Occupational Health at its first session in 1950 and revised at its twelfth session in 1995. The definition reads:

"The main focus in occupational health is on three different objectives: (i) the maintenance and promotion of workers’ health and working capacity; (ii) the improvement of working environment and work to become conducive to safety and health and (iii) development of work organizations and working cultures in a direction which supports health and safety at work and in doing so also promotes a positive social climate and smooth operation and may enhance productivity of the undertakings. The concept of working culture is intended in this context to mean a reflection of the essential value systems adopted by the undertaking concerned. Such a culture is reflected in practice in the managerial systems, personnel policy, principles for participation, training policies and quality management of the undertaking."

— Joint ILO/WHO Committee on Occupational Health[6]

Those in the field of occupational health come from a wide range of disciplines and professions including medicine, psychology, epidemiology, physiotherapy and rehabilitation, occupational therapy, occupational medicine, human factors and ergonomics, and many others. Professionals advise on a broad range of occupational health matters. These include how to avoid particular pre-existing conditions causing a problem in the occupation, correct posture for the work, frequency of rest breaks, preventative action that can be undertaken, and so forth.

"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 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.

History[edit]

Harry McShane, age 16, 1908. Pulled into machinery in a factory in Cincinnati and had his arm ripped off at the shoulder and his leg broken without any compensation.

The research and regulation of occupational safety and health are a relatively recent phenomenon. As labor movements arose in response to worker concerns in the wake of the industrial revolution, worker's health entered consideration as a labor-related issue.

In the United Kingdom, the Factory Acts of the early nineteenth century (from 1802 onwards) arose out of concerns about the poor health of children working in cotton mills: the Act of 1833 created a dedicated professional Factory Inspectorate.[7] :41 The initial remit of the Inspectorate was to police restrictions on the working hours in the textile industry of children and young persons (introduced to prevent chronic overwork, identified as leading directly to ill-health and deformation, and indirectly to a high accident rate). However, on the urging of the Factory Inspectorate, a further Act in 1844 giving similar restrictions on working hours for women in the textile industry introduced a requirement for machinery guarding (but only in the textile industry, and only in areas that might be accessed by women or children).[7] :85

In 1840 a Royal Commission published its findings on the state of conditions for the workers of the mining industry that documented the appallingly dangerous environment that they had to work in and the high frequency of accidents. The commission sparked public outrage which resulted in the Mines Act of 1842. The act set up an inspectorate for mines and collieries which resulted in many prosecutions and safety improvements, and by 1850, inspectors were able to enter and inspect premises at their discretion.[8]

Otto von Bismarck inaugurated the first social insurance legislation in 1883 and the first worker's compensation law in 1884 – the first of their kind in the Western world. Similar acts followed in other countries, partly in response to labor unrest.[9]

Workplace hazards[edit]

Main article: Occupational hazard

Although work provides many economic and other benefits, a wide array of workplace hazards also present risks to the health and safety of people at work. These include but are not limited to, "chemicals, biological agents, physical factors, adverse ergonomic conditions, allergens, a complex network of safety risks," and a broad range of psychosocial risk factors.[10] Personal protective equipment can help protect against many of these hazards.

Physical hazards affect many people in the workplace. Occupational hearing loss is the most common work-related injury in the United States, with 22 million workers exposed to hazardous noise levels at work and an estimated $242 million spent annually on worker's compensation for hearing loss disability.[11] Falls are also a common cause of occupational injuries and fatalities, especially in construction, extraction, transportation, healthcare, and building cleaning and maintenance.[12] Machines have moving parts, sharp edges, hot surfaces and other hazards with the potential to crush, burn, cut, shear, stab or otherwise strike or wound workers if used unsafely.[13]

Biological hazards (biohazards) include infectious microorganisms such as viruses and toxins produced by those organisms such as anthrax. Biohazards affect workers in many industries; influenza, for example, affects a broad population of workers.[14] Outdoor workers, including farmers, landscapers, and construction workers, risk exposure to numerous biohazards, including animal bites and stings,[15][16][17] urushiol from poisonous plants,[18] and diseases transmitted through animals such as the West Nile virus and Lyme disease.[19][20] Health care workers, including veterinary health workers, risk exposure to blood-borne pathogens and various infectious diseases,[21][22] especially those that are emerging.[23]

Dangerous chemicals can pose a chemical hazard in the workplace. There are many classifications of hazardous chemicals, including neurotoxins, immune agents, dermatologic agents, carcinogens, reproductive toxins, systemic toxins, asthmagens, pneumoconiotic agents, and sensitizers.[24] Authorities such as regulatory agencies set occupational exposure limits to mitigate the risk of chemical hazards.[25] An international effort is investigating the health effects of mixtures of chemicals. There is some evidence that certain chemicals are harmful at lower levels when mixed with one or more other chemicals. This may be particularly important in causing cancer.[26]

Psychosocial hazards include risks to the mental and emotional well-being of workers, such as feelings of job insecurity, long work hours, and poor work-life balance.[27] A recent Cochrane review - using moderate quality evidence - related that the addition of work-directed interventions for depressed workers receiving clinical interventions reduces the number of lost work days as compared to clinical interventions alone.[28] This review also demonstrated that the addition of cognitive behavioral therapy to primary or occupational care and the addition of a "structured telephone outreach and care management program" to usual care are both effective at reducing sick leave days.[28]

By industry[edit]

Specific occupational safety and health risk factors vary depending on the specific sector and industry. Construction workers might be particularly at risk of falls, for instance, whereas fishermen might be particularly at risk of drowning. The United States Bureau of Labor Statistics identifies the fishing, aviation, lumber, metalworking, agriculture, mining and transportation industries as among some of the more dangerous for workers.[29] Similarly psychosocial risks such as workplace violence are more pronounced for certain occupational groups such as health care employees, police, correctional officers and teachers.[30]

Construction[edit]

See also: Construction site safety

Workplace safety notices at the entrance of a Chinese construction site.

Construction is one of the most dangerous occupations in the world, incurring more occupational fatalities than any other sector in both the United States and in the European Union.[31][32] In 2009, the fatal occupational injury rate among construction workers in the United States was nearly three times that for all workers.[31] Falls are one of the most common causes of fatal and non-fatal injuries among construction workers.[31] Proper safety equipment such as harnesses and guardrails and procedures such as securing ladders and inspecting scaffolding can curtail the risk of occupational injuries in the construction industry.[33] Due to the fact that accidents may have disastrous consequences for employees as well as organizations, it is of utmost importance to ensure health and safety of workers and compliance with HSE construction requirements. Health and safety legislation in the construction industry involves many rules and regulations. For example, the role of the Construction Design Management (CDM) Coordinator as a requirement has been aimed at improving health and safety on-site.[34]

The 2010 National Health Interview Survey Occupational Health Supplement (NHIS-OHS) identified work organization factors and occupational psychosocial and chemical/physical exposures which may increase some health risks. Among all U.S. workers in the construction sector, 44% had non-standard work arrangements (were not regular permanent employees) compared to 19% of all U.S. workers, 15% had temporary employment compared to 7% of all U.S. workers, and 55% experienced job insecurity compared to 32% of all U.S. workers. Prevalence rates for exposure to physical/chemical hazards were especially high for the construction sector. Among nonsmoking workers, 24% of construction workers were exposed to secondhand smoke while only 10% of all U.S. workers were exposed. Other physical/chemical hazards with high prevalence rates in the construction industry were frequently working outdoors (73%) and frequent exposure to vapors, gas, dust, or fumes (51%).[35]

Agriculture[edit]

Main article: Agricultural safety and health

Rollover protection bar on a Fordson tractor.

Agriculture workers are often at risk of work-related injuries, lung disease, noise-induced hearing loss, skin disease, as well as certain cancers related to chemical use or prolonged sun exposure. On industrialized farms, injuries frequently involve the use of agricultural machinery. The most common cause of fatal agricultural injuries in the United States is tractor rollovers, which can be prevented by the use of roll over protection structures which limit the risk of injury in case a tractor rolls over.[36] Pesticides and other chemicals used in farming can also be hazardous to worker health, and workers exposed to pesticides may experience illnesses or birth defects.[37] As an industry in which families, including children, commonly work alongside their families, agriculture is a common source of occupational injuries and illnesses among younger workers.[38] Common causes of fatal injuries among young farm worker include drowning, machinery and motor vehicle-related accidents.[39]

The 2010 NHIS-OHS found elevated prevalence rates of several occupational exposures in the agriculture, forestry, and fishing sector which may negatively impact health. These workers often worked long hours. The prevalence rate of working more than 48 hours a week among workers employed in these industries was 37%, and 24% worked more than 60 hours a week. Of all workers in these industries, 85% frequently worked outdoors compared to 25% of all U.S. workers. Additionally, 53% were frequently exposed to vapors, gas, dust, or fumes, compared to 25% of all U.S. workers.[40]

Service sector[edit]

See also: Service sector

As the number of service sector jobs has risen in developed countries, more and more jobs have become sedentary, presenting a different array of health problems than those associated with manufacturing and the primary sector. Contemporary problems such as the growing rate of obesity and issues relating to occupational stress, workplace bullying, and overwork in many countries have further complicated the interaction between work and health.

According to data from the 2010 NHIS-OHS, hazardous physical/chemical exposures in the service sector were lower than national averages. On the other hand, potentially harmful work organization characteristics and psychosocial workplace exposures were relatively common in this sector. Among all workers in the service industry, 30% experienced job insecurity in 2010, 27% worked non-standard shifts (not a regular day shift), 21% had non-standard work arrangements (were not regular permanent employees).[41]

Mining and oil & gas extraction[edit]

See also: Mining

According to data from the 2010 NHIS-OHS, workers employed in mining and oil & gas extraction industries had high prevalence rates of exposure to potentially harmful work organization characteristics and hazardous chemicals. Many of these workers worked long hours: 50% worked more than 48 hours a week and 25% worked more than 60 hours a week in 2010. Additionally, 42% worked non-standard shifts (not a regular day shift). These workers also had high prevalence of exposure to physical/chemical hazards. In 2010, 39% had frequent skin contact with chemicals. Among nonsmoking workers, 28% of those in mining and oil and gas extraction industries had frequent exposure to secondhand smoke at work. About two-thirds were frequently exposed to vapors, gas, dust, or fumes at work.[42]

Healthcare and Social Assistance[edit]

See also: Health care and Welfare

Healthcare workers are exposed to many hazards that can adversely affect their health and well-being. Long hours, changing shifts, physically demanding tasks, violence, and exposures to infectious diseases and harmful chemicals are examples of hazards that put these workers at risk for illness and injury.

According to the Bureau of Labor statistics, U.S. hospitals recorded 253,700 work-related injuries and illnesses in 2011, which is 6.8 work-related injuries and illnesses for every 100 full-time employees.[43] The injury and illness rate in hospitals is higher than the rates in construction and manufacturing – two industries that are traditionally thought to be relatively hazardous.

The Occupational Health Safety Network (OHSN) is a secure electronic surveillance system developed by the National Institute for Occupational Safety and Health (NIOSH) to address health and safety risks among health care personnel. OHSN uses existing data to characterize risk of injury and illness among health care workers. Hospitals and other healthcare facilities can upload the occupational injury data they already collect to the secure database for analysis and benchmarking with other de-identified facilities. NIOSH works with OHSN participants in identifying and implementing timely and targeted interventions. OHSN modules currently focus on three high risk and preventable events that can lead to injuries or musculoskeletal disorders among healthcare personnel: musculoskeletal injuries from patient handling activities; slips, trips, and falls; and workplace violence. OHSN enrollment is open to all healthcare facilities.