EXECUTIVE BOARD 120th Session Provisional agenda item 4.10
EB120/28 2 January 2007
Workers’ health: draft global plan of action Report by the Secretariat 1. By resolution WHA49.12 the Forty-ninth World Health Assembly endorsed WHO’s global strategy for occupational health for all and urged Member States to devise national programmes on occupational health for all workers, and particularly for high-risk sectors, vulnerable groups and underserved populations. A number of high-level meetings, such as the World Summit on Sustainable Development, (Johannesburg, South Africa, 2002) and regional ministerial conferences on health, labour and the environment, have subsequently called on WHO to further strengthen its action on occupational health and to link it to health promotion.1 2. Accordingly, the Secretariat has drawn up a draft global plan of action on workers’ health 2008–2017 in order to provide a policy framework for concerted action to protect, promote and improve the health of all workers. Based on proposals for national and international action received from 104 countries through a survey carried out in 2005, it takes into account directions set out in the Eleventh General Programme of Work and the Medium-term Strategic Plan 2008–2013. Member States, international organizations of employers and trade unions, and WHO collaborating centres for occupational health were consulted in finalizing the document.2 It is expected that the plan will stimulate the development of policies, infrastructure, technologies and partnerships that will contribute to achieving a basic level of health protection in all workplaces. 3. Workers represent half the world’s population and are the major contributors to economic and social development. Their health is determined not only by workplace hazards but also by social and individual factors and access to health services. 4. Despite the availability of effective interventions to prevent occupational hazards and to protect and promote health at the workplace, large gaps exist between and within countries with regard to the health status of workers and their exposure to occupational risks. Still only a small minority of the global workforce has access to occupational health services. 5. Increasing international movement of jobs, products and technologies can help to spread innovative solutions for prevention of occupational risk, but can also lead to a shift of that risk to less advantaged groups. The growing informal economy is often associated with hazardous working conditions and involves such vulnerable groups as children, pregnant women, older people and migrant workers.
See, for example, Plan of Implementation of the World Summit on Sustainable Development. Document A/Conf.199/20, Annex. 2
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The full text of the document will be available in the Board room.
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6. The proposed plan of action deals with all aspects of workers’ health, including primary prevention of occupational hazards, protection and promotion of health at work, employment conditions, and a better response from health systems to workers’ health. It is underpinned by certain common principles. All workers should be able to enjoy the highest attainable standard of physical and mental health and favourable working conditions. Primary prevention of occupational health hazards should be given priority. All components of health systems should be involved in an integrated response to the specific health needs of working populations. The workplace can also serve as a setting for delivery of other essential public-health interventions, and for health promotion. Activities related to workers’ health should be planned, implemented and evaluated with a view to reducing inequalities in workers’ health within and between countries. Workers and employers and their representatives should also participate in such activities. 7. The plan aims to achieve the objectives described below:
Objective 1: to devise and implement policy instruments on workers’ health 8. National policy frameworks for workers’ health should be formulated and should include: enactment of framework and specific legislation; establishment of mechanisms for intersectoral coordination of activities; funding and resource mobilization for protection and promotion of workers’ health; strengthening of the role and capacities of ministries of health; and integration of objectives and actions for workers’ health into national health strategies. 9. National action plans on workers’ health should be elaborated between ministries of health, ministries of labour and other major national stakeholders. Such plans should include: national profiles; priorities for action; objectives and targets; actions; mechanisms for implementation; human and financial resources; monitoring, evaluation and updating; reporting and accountability. 10. National approaches to eliminate asbestos-related diseases and to immunize all health-care workers against hepatitis B should be formulated in concert with WHO’s global campaigns. 11. Special measures need to be taken to reduce the gaps between different groups of workers in terms of levels of risk and health status, such as high-risk sectors of economic activity and underserved working populations. Specific programmes should be established for the occupational health and safety of health-care workers. 12. WHO will work with Member States to strengthen the capacities of the ministries of health to provide leadership for activities related to workers’ health, to formulate and implement policies and action plans, and to stimulate intersectoral collaboration. Its activities will include global campaigns for elimination of asbestos-related diseases and immunization of health-care workers against hepatitis B.
Objective 2: to protect and promote health at the workplace 13. The assessment and management of health risks at the workplace should be improved by: enacting specific regulations to ensure that all workplaces comply with minimum health requirements; adopting a basic set of occupational health standards; strengthening enforcement systems; and defining essential interventions for prevention and control of mechanical, physical, chemical, biological and psychosocial risks in the working environment. Such measures involve integrated management of chemicals at the workplace, elimination of second-hand tobacco smoke from all indoor workplaces,
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improved occupational safety, and introduction of health-impact assessment when new technologies and work processes are designed. 14. Capacities should be built for primary prevention of occupational hazards, including strengthening of human, methodological and technological resources, training of workers and employers, introduction of healthy work practices and work organization, and of a health-promoting culture at the workplace. Mechanisms need to be established to stimulate the development of healthy workplaces, including consultation with, and participation, of workers. 15. Health promotion and integrated prevention of chronic diseases should be further stimulated in the workplace, in particular by advocating healthy diet and physical activity among workers, providing employee assistance schemes against substance abuse, and promoting mental health at work. Global health threats, such as tuberculosis, HIV/AIDS and malaria, also need to be prevented and controlled at the workplace. 16. WHO will work on creating user-friendly tools for assessment and management of occupational risks, determining minimum health requirements for workplaces, providing guidance on development of healthy workplaces, and promoting health at the workplace. It will also incorporate workplace actions in international programmes dealing with global health threats.
Objective 3: to improve the performance of and access to occupational health services 17. Coverage and quality of occupational health services should be improved by: integrating their development into national health strategies, health-sector reforms and plans for improving healthsystems performance; determining standards for organization and coverage of occupational health services; setting targets for increasing the coverage of the working population with occupational health services; creating mechanisms for pooling resources and for financing the delivery of occupational health services; ensuring sufficient and competent human resources; and establishing qualityassurance systems. Basic occupational health services should be provided for all workers, including those in the informal economy, small enterprises, and agriculture. 18. Core institutional capacities should be built at national and local levels in order to provide technical support for basic occupational health services, in terms of planning, monitoring and quality of service delivery, design of new interventions, dissemination of information, and provision of specialized expertise. 19. Development of human resources for workers’ health should be further strengthened by: further postgraduate training in relevant disciplines; building capacity for basic occupational health services; incorporating workers’ health in the training of primary health care practitioners and other professionals needed for occupational health services; creating incentives for attracting and retaining human resources for workers’ health, and encouraging the establishment of networks of services and professional associations. 20. WHO will provide basic packages, information products, tools and working methods, and models of good practice for occupational health services. It will also stimulate international efforts for building the necessary human and institutional capacities.
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Objective 4: to provide and communicate evidence for action and practice 21. Systems for surveillance of workers’ health should be designed that include establishing national information systems, building capability to estimate the burden of occupational diseases, and creating registries of exposure to major risks. 22. Research on workers’ health needs to be further strengthened, in particular by framing special research agendas, giving it priority in national research programmes and grant schemes, and fostering practical and participatory research. 23. Strategies and tools need to be elaborated for improving communication and raising awareness about workers’ health. They should target workers, employers and their organizations, policy-makers, the general public, and the media. Knowledge of health practitioners about the link between health and work and the opportunities to solve health problems through workplace interventions should be improved. 24. WHO will define indicators and information platforms for surveillance of workers’ health, and will include links between diseases and work in the eleventh revision of the International Classification of Diseases.
Objective 5: to incorporate workers’ health into other policies 25. The capacities of the health sector to promote the inclusion of workers’ health in other sectors’ policies should be strengthened. Measures to protect workers’ health should be incorporated in economic development policies and poverty reduction strategies. The health sector should collaborate with the private sector and encourage corporate social responsibility in order to protect health at the workplace. Similar measures should be incorporated in national plans and programmes for sustainable development. 26. Workers’ health should likewise be considered in the context of trade promotion. Dialogue should be encouraged between ministries of health, labour and trade, in order to identify potential opportunities and challenges of trade and trade agreements for the health of workers, and particularly in free-trade zones. 27. Employment policies also influence health by, for example, avoiding discrimination at the workplace. Assessment of the health impact of employment strategies should be encouraged. Environmental protection should be strengthened in relation to workers’ health through, for instance, implementation of the risk-reduction measures foreseen in the Global Plan of Action of the Strategic Approach to International Chemicals Management, and consideration of workers’ health aspects of multilateral environmental agreements and mitigation strategies, environmental management systems and plans for emergency preparedness and response. 28. In general, workers’ health should be promoted through sectoral polices for different branches of economic activity, in particular those with the highest health risk, and taken into account in primary, secondary and higher level education and vocational training.
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IMPLEMENTATION 29. Improving the health of workers can be achieved through well-coordinated efforts of society as a whole, under government leadership and with substantial participation of workers and employers. A combination of actions, adapted to national specificities and priorities, is needed to meet the abovementioned objectives. Actions are designed for implementation at national level, and through intercountry and interregional cooperation. 30. WHO, working through its network of Collaborating Centres for Occupational Health and in partnership with other intergovernmental and international organizations, will support the implementation of this plan of action by: • providing leadership to international efforts on workers’ health, engaging in partnership and joint action where necessary with ILO and other organizations of the United Nations system, organizations of employers, trade unions and other stakeholders in civil society and the private sector; • setting standards for protection of workers’ health, providing guidelines, and promoting and monitoring their use; • articulating policy options for framing national agendas for workers’ health based on best practices and evidence; • providing technical support for tackling the specific health needs of working populations and building core institutional capacities for action on workers’ health; • monitoring and addressing trends in workers’ health. 31. Progress in implementing the plan of action will be reviewed and monitored using a set of national and international indicators of achievement.
ACTION BY THE EXECUTIVE BOARD 32. The Executive Board is invited to consider the following draft resolution: The Executive Board, Having considered the draft global plan of action on workers’ health,1 RECOMMENDS to the Sixtieth World Health Assembly the adoption of the following resolution:2 The Sixtieth World Health Assembly,
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As contained in document EB120/28.
See document EB120/28 Add.1 for the administrative and financial implications for the Secretariat of this resolution.
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Having considered the draft global plan of action on workers’ health; Recalling resolution WHA49.12 which endorsed the global strategy for occupational health for all; Recalling and recognizing the recommendations of the World Summit on Sustainable Development (Johannesburg, South Africa, 2002) on strengthening WHO action on occupational health and linking it to public health;1 Recalling the Promotional Framework for Occupational Safety and Health Convention, 2006 and the other international instruments in the area of occupational safety and health adopted by the General Conference of the ILO;2 Considering that the health of workers is determined not only by occupational hazards, but also by social and individual factors, and access to health services; Mindful that interventions exist for primary prevention of occupational hazards and for developing healthy workplaces; Concerned that there are major gaps between and within countries in the exposure of workers to occupational hazards and in their access to occupational health services; Stressing that the health of workers is an essential prerequisite for productivity and economic development, 1. 2. NOTES the global plan of action on workers’ health 2008-2017; URGES Member States: (1) to devise national policies and plans for implementation of the global plan of action on workers’ health and to establish appropriate mechanisms for their execution, monitoring and evaluation; (2) to work towards full coverage of all workers, including those in the informal economy, small- and medium-sized enterprises and agriculture, with essential interventions and basic occupational health services for primary prevention of occupational and work-related diseases and injuries; (3) to take measures to establish and strengthen core institutional capacities and human resource capabilities for dealing with the special health needs of working populations; (4) to ensure collaboration and concerted action by all national health programmes relevant to workers’ health, such as those dealing with prevention of
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Plan of implementation of the World Summit on Sustainable Development. Document A/Conf.199/20, Annex. International Labour Conference, Ninety-fifth Session, Geneva 2006. Provisional Record 20A.
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occupational diseases and injuries, communicable and chronic diseases, health promotion, mental health and environmental health; (5) to encourage incorporation of workers’ health in national and sectoral policies for sustainable development, poverty reduction, employment, trade, environmental protection, and education; 3. REQUESTS the Director-General: (1) to promote implementation of the global plan of action on workers’ health 2008–2017 at national and international levels; (2) to strengthen collaboration with ILO and to stimulate joint regional efforts on workers’ health; (3) to maintain and strengthen the network of WHO collaborating centres for occupational health as an important mechanism for implementation of the global plan of action; (4) to report to the Executive Board in 2013 and in 2018 on the progress made in the implementation of the global plan of action.
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