TG on Occupational Safety and Health 3rd Meeting (jointly with the NCD EG) Helsinki, Finland May 2012

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TG on Occupational Safety and Health 3rd Meeting (jointly with the NCD EG) Helsinki, Finland 24-25 May 2012 Reference OSH 3/2/1 Title Situation analysis of existing OHS systems in OH&S Submitted by Summary / Note Requested action Ms. Raimonda Eičinaitė-Lingienė (Lithuania) The presentation deals with the comparative analysis of the practical set-up of occupational health services (OHS), their structure, content and professionals engaged in selected NDPHS countries (Estonia, Latvia, Lithuania, Finland, Norway, Germany and Poland). For information and reference

PROJECT Situation analysis of existing OHS systems in OH&S funded by the NDPHS Raimonda Eičinaitė-Lingienė Lithuania, 2012-05-24

- Participating countries

The aim of the project is comparative analysis of the practical set-up of occupational health services (OHS) their structure, content and professionals engaged in selected NDPHS countries (Estonia, Latvia, Lithuania, Finland, Norway, Germany and Poland).

Type of the research: descriptive comparative Methodology of the research: The tool of the research - the questionnaire.

The questionnaire (Model-I) was prepared after analyses of the international and national OSH legislation, OSH services establishment policy, main functions of OHS specialists. The poll was performed in June-August 2011, using the electronic communication means.

The questionnaire (Model-II) was used for preparation of database and primary analyses of the data received. Using the Model(II) all the received information was generalised and the report of analysis primary data was prepared. The said primary reports were sent to the participating in the research countries for information check-up. The revised country analyses reports were received from 8 participating countries by the end of 2011.

Main parts of the questionnaire A. Basic information; B. Organisation of OHS; C. Coverage of OHS in 2010; D. Content of OHS; E. Occupational health professionals; F. Liaison with; G. Disputes and Penalties.

A. Basic information Framework and specific legislation, concerning occupational health and safety (OH&S) and occupational health services (OHS); Organisation of OH&S system and supporting services (institutional bodies responsible for organising OH&S system; please provide the scheme and describe it). Main statistical data on population, labour force, key public health and OH&S indicators.

B. Organisation of OHS Voluntary or mandatory? Who is responsible for the organising of OHS at national, regional, enterprise level? Existing models for providing of OHS in the country: internal (in-plant) and external Funding of OHS: state budget, employers organisations, social security, trade unions, etc. Main requirements and procedures for the accreditation of OHS Enforcement and control of implementation of OHS

C. Coverage of OHS in 2010 What is the reporting procedure about OHS establishment? Are OHS registered officially? Figures on capacity of internal and external OHS Main activities of OH (medicine) physician, OH nurse, OH hygiene physician, Occupational hygienist, other OH professionals

D. Content of OHS Hazard identification: are these activities performed by OHS? Health risk assessment: are these activities performed by OHS? Pre-employment and periodic health exams: are these activities performed by OHS? Informing and educating workers and employers: are these activities performed by OHS? Work ability assessment and promotion: are these activities performed by OHS? Rehabilitation: are these activities performed by OHS? First aid: are these activities performed by OHS? Curative services: are these activities performed by OHS? Record keeping: are these activities performed by OHS? Control of the content of OHS Health promotion of OHS

E. Occupational health professionals Definition of OH professionals Qualifications of OH professionals Rights of OH professionals Confidentiality of OH professionals Training and certification of OH professionals

F. Liaison with Employers, employees, workplace safety committees State authorities Occupational safety services Public health services Health services

G. Disputes and Penalties Type of penalties Who can imply them? What instance handles the disputes?

Legislation on occupational health and safety (OH&S) and occupational health services (OHS) in selected NDPHS countries Lithuania Latvia Estonia Poland Finland Norway Russia Germany C161 Occupational Health Services Convention, 1985 X X X? X C187 on Promotional Framework for Occupational Safety and Health Council Directive 89/391/EEC of 12 June 1989 on the introduction of measures to encourage improvements in the safety and health of workers at work) X X X X X X X X X X National Strategy on Occupational Safety and Health X X X X X National Law on Safety and Health X X X X X X X X National Regulation on Safety and Health Services X X X X X X (for OHS) X National Regulation on Professional Requirements for OHS specialists X X X X X X X X National Regulation on Professional Development / Training Programme Requirements for OHS Specialists X X X X X (partly) X Labour/OSH Inspectorate Law X X X X X X

Research capacity in the country Research capacity in the country Lithuania Latvia Estonia Poland Finland Norway Germany Institute of Occupational Health Occupational Health Centre, Institute of Hygiene Institute of Occupational health and environmental safety of Riga Stradins University National Institute for Health Development 1) Nofer Institute of Occupational Medicine (in Lodz); 2) Institute of Occupational Medicine in Sosnowiec. Finnish Institute of Occupational Health (some 300-400 person-years for research and development Occupational health al aspects The Federal Institute for Occupational Safety and Health (BAuA):aims are policy advice, sovereign duties, research, development and knowledge transfer in all matterns on safety and health at work University departments Public health departments Department of Occupational and environmental medicine and Faculty of Public Health at Riga Stradins University, Latvian University, Riga Technical university 1) Tallinn Technical University, department of working environment; 2) University of Tartu, department of public health; 3) Estonian University of Life Sciences, institute of technology; Several universities and polytechnics One small department at the University of Bergen on Occupational Health. Some Public Health departments can have projects with occupational health aspects Departments for public health, occupational medicine or hygiene, ergonomics and other work studies Private consultancies X (yes) possibly, no specific data Research institutes Centres for occupational medicine and safety engineering Hospital occupational medicine Centre of Occupational and Radiological medicine at P. Stradins clinical university hospital The Occupational Diseases and Health Centre Occupational health departments Other Centre for Ergonomic studies at Latvian University Central Institute of Labour Protection, State Sanitary Inspection, State Labour Inspection Some medical departments with interest also in occupational aspects in their Institutions of the German Social Accident Insurance (Deutsche Gesetzliche

LITHUANIA: Organisational structure of Occupational Health and Safety system LITHUANIAN GOVERNMENT Lithuanian Safety at Work (tripartite) Council MINISTRY OF HEALTH MINISTRY OF SOCIAL SECURITY AND LABOUR Safety at Work (tripartite) Commission Occupational health institutions Occupational safety institutions Occupational Health Centre at the Institute of Hygiene Central Occupational Medicine Expertise Commission State Labour Inspectorate

POLAND: Organisation of OH&S system and supporting services (institutional bodies responsible for organizing OH&S system; please, provide the scheme) Supreme Court of the Republic of Poland The Parliament Regional Courts CREATION OF LEGISLATION Labour Protection Council The Government POLICY MAKING Supreme Audit Office State Labour Inspection Social Insurance Institution Main Statistical Office SURVEILLANCE State Mining Authority Central Institute of Labour Protection Ministry of Labour and Social Policy Institute of Occupationa l Medicine SURVEILLANCE AND / OR ADVISORY SERVICES Ministry of Health Sanitary Inspectio n Ministry of Economy POLICY MAKING Office of Technical Inspection SURVEILLANCE Other supervisory bodies Other ministrie s Other scientifi c- research institute s.... Occupational safety & hygiene service Occupational safety & hygiene commission Occupational medicine service Trade unions at company level Employer (company) Social labour inspection Employers organizations Employees organizations

ESTONIA: Organisation of OH&S system and supporting services (institutional bodies responsible for organising OH&S system) Ministry of Social Affairs Working Life Development Department Health Department Labour Inspection 4 Regional Inspectorates -legislation - directions Health Board Occupational Health Department - enforcement -inspection - training -registers -consultations -monitoring -analysis -registers Working environment specialist Working environment representative Working environment council WORKPLACE Employer Employee First aid specialist Occupational health services -risk assessment -health examination -consultations Estonian Employers Confederation -consultations - training Social partners Estonian Trade Union Confederation -agreements - information Research and advisory support - Labour Policy Information and Analysis Department Ministry of Social Affairs - Advisory Committee of Working Environment - National Institute for Health Development - University of Tartu - Tallinn Technical University - Estonian University of Life Sciences - OHS Training Centres - Laboratories of Working Environment Measurement -education - research -development -analysis - assessments -advice - implementation - expert services -measurements

FINLAND: Organisation of OH&S system and supporting services

NORWAY: Organisation of OH&S system and supporting services (institutional bodies responsible for organising OH&S system) Norwegian government Ministry of Health Ministry of Labour Departments of Occupational Medicine at 5 major hospitals Labour Inspection Agency National Institute of Occupationa l Health Authorised Independent OHS Providers

Germany: Organisation of OH&S system and supporting services (institutional bodies responsible for organizing OH&S system; please, provide the scheme) E U d ire c tiv e s B a s ic L a w (C o n s titu tio n ) S t a t e O S H le g is la tio n S o c i a l S e c u r i t y L a w (S G B V II) L a w s O r d i n a n c e s A c c i d e n t p r e v e n t i o n re g u la tio n s Current Dual OSH legislation and regulation system in Germany /Source: DGUV German dual OSH system - institutional framework /Source: BAuA

Do organisation of OHS is mandatory in the country by legal acts Russia (large enterprises where the number of employees more than 500-2 OH professional) Germany Lithuania (large enterprises, where the number of employees makes more than 100 or 200) Latvia yes no Norway Estonia Finland Poland

Existing OHS providing models in the countries Lithuania Latvia Estonia Poland Finland Norway Germany Russia big industry in-plant service X X X X X X X X external X X X X X X X private health centre either providing occupational health services only or occupational health as a part of its services X X X X X X private physician with special competence in occupational health internal (in-plant) X X X X X X X X X X X primary health care institutions or other public health service X X X X X group service owned or organised by several companies jointly X X X X

Occupational Health Services TEAM Lithuania Latvia Estonia Poland Norway Finland Russia Germany Occupational Health Physician Occupational Health Nurse General Nurse Occupational Hygienist Occupational hygiene physician Occuaptional psychotherapist, psychologist, ergonomist, public health specialist

Funding of OHS in the country Lithuania Latvia Estonia Poland Finland Norway Russia Germany employers X (95 %) X (95 %) X (100 %) X X (87 %) X X X (100 %) state budget (Government s special agencies in OH&S and in the health sector) X X X X X associations of agricultural producers and small enterprises X X provincial and local municipal authorities X X X social insurance social partners, employers organisations and trade unions X X X branch organisations and chambers of commerce associations of occupational health professionals X X

Accreditation of OHS in the countries No accreditation Accreditation of OHS in the country Accreditation of external OHS services Lithuania Latvia Estonia Poland Finland Russia Norway Germany Accreditation of internal (in-plant) OHS specialists

Occupational health (medicine) physicians per 1.000 population 0,23 0,00365 0,04 0,07 Lithuania Norway Estonia Germany Poland 0,15

An expected result Analysis of general and specific legislation and models of occupational health services in the NDPHS countries ; Analysis and comparison of funding, accreditation, enforcement and control of implementation of OHS in the NDPHS countries ; Comparative analysis of existing practical set-up of occupational health service systems, occupational health teams, professionals and their main activities; The survey Situation analysis of existing OHS systems in OH&S, funded by NDPHS, contributes to the implementation of the NDPHS Health at Work Strategy, item 3 on occupational health services.

Scientific value of the project A publication Occupational health care practice in Lithuania and the other countries will be prepared for the Institute of Hygiene scientific journal Public Health.

Practice value of the project thematic report, based on a document-based survey; a measure on the development and upgrade of the effectiveness and professional competence of Lithuania s occupational health services system foreseen in the National Strategy on Occupational Safety and Health for the year 2009-2012 will be implemented. material for the Conference The progress in occupational health and recommendations for the new OSH strategy will be prepared (Vilnius, Lithuania; October, 2012).

THANK YOU