Message from the President

NEWSLETTER
International Commission on
Occupational Health – ICOH
Commission Internationale de
la Santé au Travail – CIST
Volume 5, Number 2
In this number
„ Message from the
President
1
„ From the Editor
3
„ The Cochrane
Occupational Health
Field; first results
4
„ The History of Work,
Environment and
Health
J H Verbeek
„ Obituaries
6
8
„ Supporting Health at
Work – international
perspectives on
Occupational Health
Services
9
P Westerholm, D Walters
„ Meetings of Scientific
Committees
10
„ Other Meetings and
Congresses
13
„ Résumé en français
17
August 2007
Message from the President
Solidarity –
a key ICOH objective
Work is one of the most central aspects of human life, producing the resources we live
on and providing, besides income, important social contacts, learning opportunities,
skills development, and career development, among other things. Work seems to be
highly important for our self-esteem, self-identification, and it also has an impact on
our role in society. The role of work in our lives has expanded during the past two
decades. At the same time, working people are expected to produce more, adapt to
constant changes, change jobs, and adjust to new conditions of work and new types
of work organizations. A secure job makes life itself more secure, while job insecurity
correspondingly makes the conduct of life very uncertain. We cannot, however, turn
the clock backwards. Progress is inevitable, but we can discuss the rules of the game
and the conditions on which the changes happen. Several reports by scientists and
international organizations conclude that the faceless globalization makes people
compete harder and harder not only with other enterprises, with workers of other
countries, but with workers in their own organisations, too.
One of the key features in the development of our civilization during the past
4000 years has been the increasing solidarity between people. Social scientists have
found the current level of competition to weaken the traditional solidarity between
people and increase of the highly individualistic “I want everything and I want it now”
culture. In fact, the word solidarity is not very popular in current public discussion,
which is heavily loaded with competition and individualism representing greed as a
virtue and treating the best speculators earning the greatest sums of money with no
serious work as heroes. Some philosophers fear that such development may in fact
lead to a decline of the value of human work. They also fear the regression of humanity and a reinstation of the law of the jungle.
Occupational health requires solidarity. It is an activity for the production of
common good, making working conditions safer, healthier, and human for everyone.
Individual occupational health is, of course, important, but individualistic occupational health is a theoretical impossibility. In all occupational health activities, we need
to work with others and for others. Even the most independent self-employee needs
other people in making work safe and healthy for him/herself. The individual in a
larger working community exists in a continuous “safety dependence” relationship
with other people, and the dependence is mutual.
ICOH is a global NGO the existence of which is based on global solidarity;
solidarity between our Members has brought us together. We also feel solidarity with
the UN International Organizations, numerous professional organizations, our sister NGOs active in occupational health, and most importantly, toward our clients:
working people and their workplaces. The objective of this solidarity is the best occupational health for everyone. Such a target is a typical common good; it is good for all
and it is not exhausted, regardless of the number of users. Global occupational health
Æ
International Commission on Occupational Health – ICOH
Commission Internationale de la
Santé au Travail – CIST
NEWSLETTER
Volume 5, Number 2
August 2007
ICOH Newsletter
Published by the
International Commission on
Occupational Health
Editorial Board
Suvi Lehtinen
[email protected]
Sergio Iavicoli,
[email protected]
René Mendes
[email protected]
Franklin Muchiri
[email protected]
Louis Patry
[email protected]
Ken Takahashi
[email protected]
Editor
Suvi Lehtinen
Layout
benefits everyone. And as proposed by Jürgen Habermas, we need to be inclusive, not
exclusive in the promotion of such solidarity in the contemporary world1).
ICOH has a special international role in the promotion of global solidarity. With
the help of our scientific input and practical applications, we advocate for better health
and safety conditions and help our target groups and clients to conduct a healthy work
life. The global role of ICOH needs the enhancement of all the ICOH activities: advocacy and information for raising awareness, research for providing sound scientific basis
for proposals, methods and practices, and good practice guidelines for making practical impact. Moreover, a strong ethical voice for our own professional conduct and for
emphasizing the importance of ethical principles in all activities of the modern work life
is needed, particularly with regard to the globalization process.
In its daily activities, ICOH implements its solidarity in several different ways.
The solidarity toward ICOH Members is implemented, for example, through our
special support to members from developing countries. Solidarity to the world and our
target groups is implemented at best in our daily practical activities in the various
professional roles of our membership as scientists, educators, service providers, information experts, and advisors or service providers for authorities or our target groups,
workers and employers.
Transmitting the message of genuine solidarity to younger ICOH generations is
of utmost importance particularly in a world where the value insecurity is a growing
trend.
The ICOH 2009 Congress will be an important forum for solidarity. The ICOH
Members will soon be able to find more detailed information on the Congress from the
ICOH websites. By ensuring your participation, you can promote solidarity to your
profession and discipline, to workers of the world, and particularly to South-Africa
and Africa as a whole. We Officers and the South African organizers are currently
working hard to get additional funding for ICOH 2009 participants coming from
developing countries.
The Officers of ICOH held their meeting in Cape Town at the beginning of July
together with the Organizing Committee of the ICOH2009. The preparations are well
under way, and you will soon find more information about the programme at: http:/
/www.icoh2009.co.za/index_html
Tuula Solasaari-Pekki
The electronic version of the ICOH
Newsletter on the Internet can be accessed at the following address:
www.icohweb.org/newsletter
The responsibility for opinions expressed in signed articles, studies and
other contributions rests solely with
their authors, and publication does not
constitute an endorsement by the International Commission on Occupational
Health of the opinions expressed in
them.
© International Commission on
Occupational Health, 2007
ISSN 1459-6792 (Printed publication)
ISSN 1795-0260 (On-line publication)
2
Jorma Rantanen
President of ICOH
From the Editor
Contents of this issue
Information and communications technology has brought about profound
changes to the information environment
of all working people. Evidence-based information is sought to support decision
making in all sectors of society, not least
in occupational health and safety. This is
due to the fact that societal decision making is becoming more and more critical:
well-informed decisions are needed at all
levels – political and administrative as well
as in practical actions.
For the series of articles on topical
issues of occupational health and safety
we have therefore selected a paper discussing Cochrane collaboration in the
field of occupational health which brings
evidence-based information in occupational health and safety into focus. The
article has been prepared by Dr. Jos Verbeek.
We develop ideas for forthcoming
topics in collaboration with the Editorial
Board. Should you have some issue of
occupational health and safety in mind
that you think would be of interest to experts in other countries, we would very
much appreciate having your ideas and
proposals.
The feedback and material from so
many Scientific Committees in informing other experts about their forthcoming meetings and using the Newsletter to
recount their activities is also more than
welcome. The number of contributions
from the Scientific Committees in four
issues of the ICOH Newsletter in 2004–
2005 was 22, and a corresponding figure
in 2006–2007 was 26. The many examples of news and reports from the Scientific Committees in this Newsletter hopefully encourage others to do the same in
the next issues.
Next issue
The next issue of the ICOH Newsletter
will be out at the end of December 2007.
The deadline for materials is 10 November 2007. Please send your contributions
to [email protected].
Changes of addresses
To ensure that you receive the Newsletters in time, please check that you have
paid your membership fee and informed
the ICOH Secretariat of possible changes
to your address, at [email protected]
or [email protected].
Suvi Lehtinen
Editor
3
The Cochrane Occupational
Health Field; first results
Jos H Verbeek
Introduction
In 2004, the registration of the occupational health field was launched with the
Cochrane Collaboration. In the past three
years, a vast amount of work has been
done to become familiar with the Cochrane methodology and to get the first
reviews published. Institutions strongly
involved in the activity at present come
from the Netherlands, Finland and Australia. The operating unit is located in Finland.
The Cochrane Collaboration uses
a highly structured but, in the field of occupational health, not widely known format both for gathering and summarizing evidence. It is primarily based on a
clinical model of intervention, but it has
also been successfully applied to public
health interventions. For this reason, we
must compromise between the Cochrane
format and the needs and demands of
occupational health practice. Here, I
would like to give a brief overview of the
results that we have been able to realize
and some of the interesting methodological problems we have encountered.
Reviews and protocols
In the past three years, we have been able
to register 19 review titles with the Cochrane Collaboration. According to the
review process, you must first register a
title, then write and publish a protocol
for the review, and then write and publish
the review. At present, there are four reviews and 11 protocols on occupational
health interventions published in the Cochrane Library (www.cochrane.org) and
an additional four titles registered. This
is an indication that this is a feasible
project that is fully accepted by the various review groups in the Cochrane Col4
laboration. The topics of the reviews are
listed in Table 1. The topics, covering a
wide range of issues, are determined by
the stakeholders’ and reviewers’ interests.
The format of a Cochrane
systematic review
Thus far, Cochrane systematic reviews
have dealt only with the effectiveness of
interventions. A systematic review should
always contain a clearly formulated question, preferably formatted according to
the PICO acronym.1 The P stands for the
population or type of patients at which
the intervention is targeted. This should
be followed by a definition of the Intervention of interest. Next, the review should
mention the Comparison group against
which the outcome in the intervention
group will be compared. Finally, the Outcome of interest or by which the effectiveness of the intervention will be measured should be stated. This will result in
questions such as, is advice for manual
material handling effective in preventing
or treating back pain in workers?
A systematic review requires the
definition of clear inclusion and exclusion
criteria for the studies. This does not only
relate to the PICO features, but also to
the types of study design. In addition, the
assessment and reporting of methodological quality is a required aspect of every Cochrane Review.
A comprehensive search strategy is
Table 1. Current situation of occupational health reviews and protocols
Stage
Review
Review
Review
Review
Protocol
Protocol
Protocol
Protocol
Protocol
Protocol
Protocol
Protocol
Protocol
Protocol
Title
Title
Title
Title
Title
Interventions for treatment of dysphonia
Manual material handling advice for preventing and treating back pain
in workers
Preventing occupational stress in healthcare workers
Interventions to promote the wearing of hearing protection.
Interventions for occupational accidents in the construction industry
Return to work interventions for adjustment disorders
Interventions to improve occupational health in depressed people
Interventions for the prevention of noise induced hearing loss
Interventions for prevention of dysphonia
Exercises for prevention of recurrences of low-back pain
Alcohol and drug screening of people whose work involves driving, for
preventing injury
Patient consultation letters for patients with medically unexplained symp
toms
Interventions for occupational accidents in farmers
Interventions for prevention and treatment of venous ulcers in standing
work
Interventions for preventing exposure to chemical substances at work
Interventions to prevent work disability
Interventions to prevent needle stick injuries to prevent Hepatitis or HIV
Health and functional assessment examinations to prevent occupational injuries and disease
a logical result of using a structured approach. The inclusion criteria have to be
transformed into search words that can
be used to locate studies of interest in electronic databases such as Medline. Next,
one has to select manually the studies that
fulfill all inclusion criteria.
The methods for summarizing the
studies can be either quantitative, as in a
meta-analysis, or qualitative in the manner of levels of evidence.2
Well posed questions
In occupational health, as in other preventive specialties, there is a tendency to
justify preventive activities as good in
themselves. The line of thinking is that if
there are work-related health risks, then
everything should be done to try to avoid
them. However, all interventions use resources, and some can actually do more
harm than good. An example of this is
debriefing in post-traumatic stress syndrome. Debriefing has long been considered an intervention that could prevent
stress symptoms. Good evaluation studies with well posed questions and systematic reviews of these studies have nevertheless shown that, in fact, the opposite is
true. Debriefing can actually induce posttraumatic stress syndrome and does not
prevent it.3 Well posed questions can help
to avoid confusion about prevention. The
mere fact of preparing the questions forces us to think about how the applied intervention might work, and what kind of
outcomes ought to be promoted or
avoided.4
Is there not enough evidence
of work-related health risks?
Do we really need evaluation research to
prove that occupational health interventions are effective? One can easily infer
that if there is a strong relation between a
risk at work and a health outcome, then
taking away the risk will also reduce the
health outcome. This may well be true,
but since there are many different ways
by which to eliminate risks, we should be
interested in finding the most efficient
ways of doing so. For example, with view
to asbestos, is it better to ban it, impose
taxes, or provide subsidies for using alternatives? In the case of noise, we have
been applying interventions for years already, but so far have been able to detect
only a very slow decline in occupational
noise-induced hearing loss. This can simply imply that our methods are not very
effective. Rigorous evaluation might shine
a new light on what works and what does
not.
What kind of evidence to
use?
A common criticism of the Cochrane
Collaboration is that it is too restrictive
in the use of research designs, most often
limited to randomized controlled trials.
Especially in the area of occupational
health, use of randomized design can be
very difficult or even impossible. This raises many interesting questions. If a randomized design is not appropriate for studying occupational health, then what type
of design should we opt for?
It is our opinion that the study design is not related to the setting, but rather to the type of intervention applied. Clinical interventions are usually applied at
the individual level and yield only minor
to moderate effects. The use of methodologically weaker designs can easily lead to
bias that completely distorts more moderate results. This is a strong incentive to
randomize individuals, since randomization has been shown to best prevent bias.
However, interventions that aim at changing the work environment, for instance
by lessening exposure to noise, are usually applied at the group level. Even though
it is possible to randomize groups, this is
more difficult. In the case of regulations
or policy changes as an intervention, the
level of application is a whole country or
an entire population. Even though in theory it would be possible to randomize
there, in practice this is impossible. In
these cases, it is obvious that we would
need research designs that differ from
randomized controlled trials.
Are all interventions focusing on
occupational health different from those
in the clinical setting? It seems clear that
we require more and better knowledge
about occupational health interventions.
It can easily be shown that we apply a
wide variety of interventions at different
levels. Many return-to-work interventions are individually directed and do not
differ much from an ordinary clinical intervention. We feel that randomized designs are needed to evaluate these interventions.5, 6 Interventions aimed at decreasing exposure can be randomized at
the workplace level. In a study advising
employers about reducing wood dust exposure, researchers were able to use a cluster randomized design. They were surprised to find much smaller reductions
in wood dust than they anticipated.7 We
feel that this should be a strong incentive
to use this design in the evaluation of environmental interventions. The question
then remains, how to evaluate policy
measures and national regulations. The
time-series design we currently use in our
reviews of preventing injuries is also feasible here.
Conclusion
The systematic approach of the Cochrane
Collaboration can be applied to a large
share of occupational health interventions. Applying the Cochrane methodology to the area of occupational health
raises many interesting questions either
about the methodology or about the alternatives. Finding answers to these questions is a challenge for everyone active in
the field of occupational health. Those
wishing to get involved in the collaboration can find more information on the
website www.cohf.fi.
References
1. Verbeek JH, van Dijk FJ, Malmivaara
A, Hulshof CT, Räsänen K, Kankaanpaa EE, et al. Evidence-based medicine for occupational health. Scand J
Work Environ Health 2002;
28(3):197–204.
2. Cochrane Handbook for Systematic
Reviews of Interventions 4.2.5. 2005.
3. Rose S, Bisson J, Churchill R, Wessely
S. Psychological debriefing for preventing post traumatic stress disorder (PTSD). Cochrane Database Syst
Rev 2002;(2):CD000560.
4. Campbell M, Fitzpatrick R, Haines A,
Kinmonth AL, Sandercock P, Spiegelhalter D, et al. Framework for design
and evaluation of complex interventions to improve health. BMJ 2000;
321(7262):694–6.
5. Schonstein E, Kenny DT, Keating J,
Koes BW. Work conditioning, work
hardening and functional restoration
for workers with back and neck pain.
Cochrane Database Syst Rev
2003;(1):CD001822.
6. Verbeek JH. How can doctors help
their patients to return to work? PLoS
Med 2006; 3(3):e88.
7. Lazovich D, Parker DL, Brosseau LM,
Milton FT, Dugan SK, Pan W, et al.
Effectiveness of a worksite intervention to reduce an occupational exposure: the Minnesota wood dust study.
Am J Public Health 2002;92(9):1498–
505.
5
Conference Report:
The History of Work,
Environment and Health
Dudley, West Midlands
18–21 April 2007
T
he International Commission on
Occupational Health has previously sponsored two major conferences on the history of occupational
health and environmental health, in Rome
(1998) and Norrköping (2001). This year,
a third such historical event took place in
Dudley in the West Midlands. The conference was hosted by the Centre for the
History of Medicine at Birmingham and
attracted an international group of scholars working in a particularly interdisciplinary and specialized field of medical
history.
Following introductory comments
by two of the conference organizers, Tim
Carter and Robert Arnott (University of
Birmingham, UK), and a welcome from
Sergio Iavicoli, Secretary-General of
ICOH, the conference quite appropriately, given its location, commenced with a
session entitled ‘Cradles of Industry’.
Rather than focus on the particular cradle of industry in the immediate vicinity
of the conference, the first panel covered
a wide range of topics in terms of both
geography and chronology.
Alberto Baldasseroni (AUSL, Italy),
in the conference’s first keynote address,
focused on the Milan Exhibition of 1906,
which coincided with the completion of
the Simplon Tunnel. The reduction in
both disease and injuries because of effective preventive measures compared to
the St Gotthard tunnel (1872–82) was a
cause for celebration. In subsequent
years, occupational health remained a
priority in Italy, not least because the Clinica del Lavoro was founded in Milan
only four years later. The second paper,
by Robert Arnott (University of Birmingham, UK), examined the potential hazards of workers centuries earlier from
evidence gathered at a copper-smelting
6
site in Crete. Workers here seem to have
been aware of the hazards as they treated
their ailments with remedies made at the
site, perhaps the earliest medicines found
in Europe. The following paper by PaulAndre Rosenthal (INED, France) examined the role of government in the treatment of silicosis in ten countries. In the
case of France, some of the most significant work appears to have been carried
out by the Vichy government, collaborators with the Nazis, rather than, ironically, by labour-friendly administrations.
The penultimate paper of the day was by
Toshio Matsushita (Kagoshima University, Japan), who discussed the westernstyle industrial modernization project,
known as Shuseikan, at Satsuma, while
Jonathan Reinarz (University of Birmingham, UK) concluded the session by returning to the Midlands in his exploration of occupational health as revealed in
the records of Birmingham teaching hospitals during the nineteenth century.
The following day commenced with
a keynote paper by Geoffrey Tweedale
(Manchester Metropolitan University,
UK) who, among other things, considered the localization of industrial disease
by discussing regional clusterings of mesothelioma in Clydeside and Merseyside
and lamented the scarcity of such localized historical approaches, which tend to
be more common in the work of epidemiologists, as well as economic historians. His paper was followed by six very
regional studies of ‘towns, trades and diseases’, demonstrating both the influences
of local politics in occupational health
history and the localization of knowledge.
These included Tim Carter’s (University
of Birmingham, UK) expert study of anthrax in Edwardian Kidderminster and
two other papers, by Pierluigi Cocco (University of Cagliari, Italy) and Douglas
Buchanan (University of Manchester,
UK), which together explored both the
global and regional history of malaria
campaigns, Buchanan concentrating on
the Roan Antelope Mine in Northern
Rhodesia. Mining remained the focus for
two additional papers, Zodwa Ndlovu’s
(NIOH, Johannesburg, SA) concentrating on 64,000 Chinese miners who helped
South Africa re-establish itself as the leading producer of gold after the Boer war
and Alessandro Porro’s (University of
Brescia, Italy) highlighting the specific
hazards posed by one of Europe’s leading zinc mines in Buggerru in Sardinia between 1907–1926 as revealed in the records
of the local mining hospital. While mining deaths in the West declined in subsequent years, the final paper in this session
by Robert McKnight (University of Kentucky, USA) demonstrated how agricul-
tural deaths failed to decline in line with
those of other industries, especially as
agricultural work became more mechanized in the 20th century. After lunch and
further discussion, the delegates departed on a coach tour of the Ironbridge
Gorge in order to explore the rich industrial history of the Severn Gorge.
The following day was characterized by sessions united in their focus on
technology, the first on the new risks posed
by innovation, the second on the way in
which technology has aided historians of
occupational health. The former session
was commenced by Paul Blanc’s (University of California, USA) keynote which
considered wood preservatives and glues,
less in terms of social history than as
product histories, highlighting the way in
which new hazards are generally quick to
be identified, but responses to these hazards materialize more slowly. The second
paper, by Silvana Salerno (ENEA, Italy),
was a more traditional biography of the
first woman graduate of Sapienza University in Rome, Maria Montessori, better known for her work on children’s education than as a pioneer in the field of
ergonomics. Minori Nakata (Kanazawa
Medical University, Japan), in one of many
Asian studies, examined the debate provoked in Japanese society by the state’s
inaction to the new risks that faced keypunchers in the 1950s. A session on the
technologies of the historian began with
an introduction to the South Wales Coalfield Collection by Sara Knight (Swansea
University, UK), before Pier Bertazzi (University of Milan, Italy) discussed and demonstrated the 36,000 documents recently
digitalized and made available online by
the Clinica del Lavoro in Milan. Arthur
McIvor (University of Strathclyde, UK)
concluded the session with a sensitive
reading of oral history testimony and
demonstrated the potential of this underused source to occupational health historians.
The final session on ‘social and political responses to harm from work’ commenced with a final keynote paper by Ian
Eddington (University of Queensland,
Australia) who discussed the motivations
of two occupational health reformers
concerned with lead poisoning in Australia to draw out the features from successful and unsuccessful campaigns that are
still relevant for practitioners. This was
followed by a paper by Heikki Vuorinen
(University of Helsinki, Finland) who discussed the emergence of a national health
policy in Finland in the late 19th century,
when the country’s economy was still primarily agricultural in nature. In many
ways, development of health care for
Finnish workers benefited from a weak
industrial sector, that was less able to
block progress as was seen in other more
heavily industrialized nations. Francesco
Carnevale (AUSL, Florence, Italy) then
took us back to Italy in his paper on the
beginnings of a Medical Inspectorate of
Work in that country in the decade before WWI, describing the difficulties of
regulating three diverse industries and
processes, namely silk, pneumatic hammers, and home-based labour. Kang
Seong-Kyu (Korea Occupational Safety
and Health Agency, Korea) then brought
us up to date in his fascinating discussion of the development of worker’s compensation in Korea, where 11 million
workers are covered by what has very
quickly evolved into a system of social
security in a country where no such safety net otherwise exists. Jennifer Zelnick’s
(Tufts University, USA) paper maintained
the contemporary theme by focusing on
organized labour’s role in tobacco control in the US service sector, where shared
space, among other things, has lent a nonunionized workforce considerable control
over workplace hazards. Vicky Long’s
(University of Warwick) paper discussed
industrial health education in Britain in
the inter-war period and the equivocal
stance of the trade unions on educational initiatives that could divert the blame
for harm from poor working conditions
to careless workers. Gordon LeRoux
(Shrewsbury Hospital, UK) presented the
final paper on the long and interesting
history of music, work and health, punctuated with examples from a rich and
under-used sound archive.
In a very fruitful closing commentary, Tim Carter (University of Birmingham) adeptly drew out some key themes
from what had been a very rich programme. While some themes had
emerged from the four strong panels prepared by the organizers, recognition of
harm, its validation and the diffusion of
knowledge and action to prevent risks, on
reflection, appear to have been important
themes addressed by papers across regions and time periods. While the programme was remarkably international in
scope, both in terms of presenters and
subject matter, Carter additionally offered
a framework for considering such diverse
studies in the history of industrial health.
In particular, he suggested an approach
that might be described as ‘an ecology of
occupational health’. This might assist
historians in their attempts to explain why,
for example, a particular species of disease called byssinosis evolved in Lancashire and then spread around the world.
While this example might in future be
grappled with by historians of occupational health, the growing prevalence of
the historical geographical approach
among historians of medicine suggests
these particular debates and concerns will
be of interest well beyond specialist workshops and conferences.
Robert Arnott
7
Obituaries
Professor Xue-qi GU – in memoriam
Professor Xue-qi GU passed away in Shanghai on 11 June 2007 at age of 96 years. His death is a great loss to the
University, to Shanghai City and the whole China, as well as to the international occupational health community.
Professor GU was born in Shanghai in 1911. He graduated in 1938 from the National Shanghai Medical College
and was granted a master’s degree in Public Health by Harvard School of Public Health in 1947.
Professor GU served for many years as the Director of Department of Occupational Health, and as Acting Dean
of the School of Public Health of Shanghai Medical University. He also served as
the Director of the Shanghai WHO Collaboration Centre in Occupational Health,
and he was a senior leader of the ILO/WHO Silicosis Elimination Programme in
Shanghai. Professor Xue-qi GU was an Emeritus Member of ICOH and he played
an important role in the generation and development of the ICOH mission in
China and more broadly in Asia. He was a wise and dedicated scientist, scholar
and teacher to whom several generations of occupational health experts owe
their highest respect and gratitude. His students continue his work both in Shanghai and internationally, including activities within ICOH.
We express our sincere condolences to our Shanghai colleagues and have
asked them to convey our deepest sympathy to the Family.
Helsinki 20 June 2007
Professor Jorma Rantanen, MD, PhD
President of ICOH
Professor Le Van Trung – in memoriam
This week we received the sad message that Professor Le Van Trung, MD, PhD had
passed away. Le Van Trung was a long time collaborator, colleague and friend to
many of us. He served as Director of the National Institute for Occupational and
Environmental Health in Vietnam. He was a Founding Father and served as President for the Vietnamese Association of Occupational Health. He made a major
national impact by leading the development of occupational health and occupational medicine in research, education and practices and by advising his national Government and other authorities in decisions on occupational health. He was particularly active in silicosis research and in the ILO/WHO Elimination of Silicosis Programme of his country. He educated a whole generation of experts in occupational
health for Vietnam.
Professor Trung was also very active internationally, creating both bilateral
and multilateral collaboration relations with many countries, and his contribution
to the WHO Global Network of Collaborating Centres in Occupational Health was particularly significant. He and his
Institute have been honoured with distinguished awards both nationally and internationally.
Many of us had the privilege to know Le van Trung personally from our frequent contacts in numerous
international and professional meetings, including ICOH events. We remember him as a modest, friendly and peaceful personality, who was always very attentive in discussions and presented his views in a very concise and constructive
way. Long experience and wisdom spoke through him to us.
We express deep condolences to our Vietnamese colleagues and have asked them to convey our heartfelt feelings
of sympathy to the Family of Professor Trung.
Helsinki 20 June 2007
Professor Jorma Rantanen, MD, PhD
President of ICOH
8
Supporting Health at Work – International
Perspectives on Occupational Health Services
(Eds: Peter Westerholm and David Walters)
Special Issue of “Policy and Practice in Health and Safety” published by the Institution of
Occupational Safety and Health, UK 2007
Abstract:
This report is an anthology of chapters dealing with the structures and functioning of Occupational Health Services (OHS) in
ten European countries (Austria, Czech Republic, Denmark, Finland, France, Germany, Norway, Sweden, UK, UK/Scotland)
and Japan. Countries and authors were selected by conveniency
sampling bringing together a team of well-known OHS professionals and experts to draft national reports addressing current
and salient issues in their home countries. Laurent Vogel , representing the European Trade Union Confederation, contributes
with a trade union perspective in drawing of observations and
experiences from some European countries which were not included in study sample.
One important point of departure has been the observation of wide between-country variations in approaches of OHS
professional organizations and roles of OH professionals despite working life of countries exhibiting similar OH hazard profiles, trends of development and OH professional competency
profiles. In the national chapters the authors present a descriptive narrative of OHS functioning in the context of national
regulations and existing pressures and expectations of stakeholders, in some countries added to by conditions in a health
market where OHS organizations are competing for clients and
customers
Editors supply an introduction of the anthology (D.Walters)
and concluding comments (P.Westerholm). All national contributions provide comprehensive updated insights into challenges facing OHS organizations in their different settings, including
trends in development and current issues to confront. Readers
have much to learn from all national contributions. No claim is
made for representativeness of study sample. It is nevertheless
likely that some observations may apply also in countries other
than those sampled for the study.
One striking general observation is the scarcity of occupational health service research in many countries and, in consequence, a comprehensive research database. OHS research does
not occupy a prominent place in the published peer-reviewed
international literature. Closely related to this aspect is the paucity of scientific evaluations of OHS processes, outcomes and
impact.
For proper understanding of between-country differences in OHS functions, roles and approaches knowledge of contextual and cultural factors in their setting is essential.
One key question and at the same time determinant factor
concerns the commitment of the State and its structures in governance of OHS in the interests of public health. State policies in
this direction exist in Finland, France, Germany and the Czech
Republic. By contrast, in countries where OHS service units are
regarded as producers of health market commodities other OHS
agendas are likely to take first priority. Questions to examine in
national or international comparative studies of OHS are:
- commitment of the State and its structures to organization,
tasks and professional competencies of OH professionals?
- roles of OHS organizations as agents of public health or
commercially based organizations providing services in a
health market to paying customers/clients?
- professional competencies of OH staff in meeting challenges of a changing world at work?
- Conception of service quality?
- Strategies for evaluations of OHS taking into account multiplicity of stakeholders?
- Pitfalls and ethical challenges in having OHS organizations
commercialized and dependent on market mechanisms?
It is argued that an international convergence of practices
of OHS organizations may be a worthwhile pursuit. In exploring a such major undertaking it is, however, argued that steps
should be taken to improve understanding of inter-country differences with regard to OHS roles and tasks in their respective
structural, legal and cultural settings and to take into account
the importance of market mechanisms brought into play in
countries where OHS are primarily seen as providers of health
commodities under the conditions of a commercial market.
Peter Westerholm
Ref: Special Issue of Policy and Practice in Health and
Safety available on IOSH website
www.iosh.co.uk/policyandpractice
9
Call for applications:
The Danish Working Environment Research Fund offers grants to review projects in the form of
reference documents on occupational diseases. Grants may be offered to the following themes:
1. Correlations between fixed night shifts and/or recurring night shifts and the development
of ischaemic heart disease
2. Correlations between exposures at work and degenerative diseases of the cervical spine,
including arthritic degeneration and prolapsed disc
3. Correlations between exposures at work and jumper’s knee
4. Correlations between hairdresser work and the development of cancer diseases
A total of DKK 2 million (approx. 270.000 euros) is set aside for the four reviews. Applications must
reach the Working Environment Research Fund not later than October 1 2007.
See the full text of the call at http://www.at.dk/sw41046.asp
Please contact Torben Grønnebæk or Chris Bahne at The Danish Working Environment Authority for further questions
regarding this call. Email [email protected] or [email protected] Phone +4572208713 or +4572208704.
Meetings of Scientific Committees
It is our great pleasure to invite you to the 14th Congress
of the ICOH Scientific Committee entitled
OCCUPATIONAL HEALTH SERVICES
IN TRANSITION IN EASTERN AND
WESTERN EUROPE
The Congress to be held on 8–11 November 2007 in Dubrovnik, Croatia as a joint event with the 4th Croatian Congress on Occupational Health. This International Congress on
Occupational Health Services will be hosted for the first time in
Croatia, after the recent congresses held in Denmark (Aarhus,
2001), the Netherlands (Amsterdam, 2002), Belgium (Gent,
2003), Italy (Modena, 2004) and Japan (Utsunomiya, 2005).
The congresses are under the auspices of Stjepan Mesic,
President of the Republic of Croatia: Government of the Republic of Croatia, Ministry of Health and Social Welfare, Ministry of Science Education and Sports, Ministry of Economy, Labour and Entrepreneurship of the Republic of Croatia, Croatian
Medical Association, Croatian Medical Chamber, Medical
School, University of Zagreb and Dubrovnik City Council.
Key-note speakers are:
1. Rokho Kim, MD DrPH PhD, Programme Manager, WHO/
EURO Centre for Environment and Health: ‘Global issues
in occupational health’.
2. Evelyn G.E. Kortum, MSc, Responsible Officer, Occupational
Psychology Interventions for Healthy Environments, WHO
Department of Public Health and Environment: ‘A perspective on work-related stress in countries in economic transition.’
3. Igor Švab, MD, PhD, WONCA: ‘Family medicine and Occupational Health’
10
4. Paul Swuste, PhD, is an Associate Professor of the Safety
Science Group of the Delft University of Technology, The
Netherlands: ‘Assessment of causality of occupational accidents, and major developments in the safety science and
consequences of this for stakeholders in daily practice: professionals, employers, trade-unions.’
5. Peter Westerholm, emeritus professor at the former National Institute for Working Life in Stockholm (and now related
to the University of Uppsala): ‘Practical ethics in the field of
occupational health’. Peter took the initiative to co-edit a book
‘Practical ethics in occupational health’ (Oxford, Radcliffe
Medical Press 2004) together with Tore Nilstun and John
Ovretveit.
6. Carel T.J. Hulshof, MD, PhD, Associate Professor, Coronel
Institute of Occupational Health, Academic Medical Center,
University of Amsterdam, The Netherlands: ‘The application of evidence-based medicine in the daily practice of an
occupational physician’ (based on the PhD-thesis by Frederieke Schaafsma).
7. Willem van Mechelen (Full Professor in Occupational Medicine and Sports Medicine) from the Free University of Amsterdam: ‘The importance of exercise and lifestyle issues in
occupational health.’
Additional events will be The Second International Workshop on “Strengthening the Health System to address Occupational Health Risks in the South Eastern Europe” -organized by
SEE Network of WHO Collaborating Centres.
More details at the web page: http://kongres.mediaplus.hr
The ICOH SCs on Occupational Toxicology (SCOT), Toxicology of Metals (SCTM) and Rural Health (SCRH), together
with the Ministry of Health and the National Natural Science Foundation of China, and the University of Beijing invite
you to attend the
7th International Symposium on
Biological Monitoring in Occupational and Environmental Health (ISBM 7)
Biological Monitoring in a Globalized World
to be held in Beijing, China,
from September 10 to 12, 2007
Local organizer: Sheng Wang from the University of Beijing Health Science Center, with the collaboration of Claude Viau (Chair
of SCOT), Maurizio Manno (Secretary of SCOT), Monica Nordberg (Chair of SCTM) and Claudio Colosio (Chair of SCRH).
The ISBM 7, the first event of this kind to be held in China, has three objectives: 1. to present and discuss the state
of the art research in occupational and environmental health biomarkers with the aim to improve the standardization of
methodologies and the interpretation of biomonitoring results at the global level, 2. to facilitate interaction and collaboration
among eastern and western OH scientists and professionals, and 3. to strengthen the institutional collaboration among the three
ICOH Scientific Committees participating.
The topics of the symposium include:
Adducts
Analytical methods
Biomarkers of effect, exposure, susceptibility
Biomonitoring and risk assessment
Endocrine disruptors
Ethics of biomonitoring
New tools in biomonitoring
Pesticides
Population studies
Metals
Toxicokinetics
Trace elements
Variability in biomonitoring results
The symposium will feature several plenary, parallel and poster sessions, various collateral scientific events, and the following
keynote lectures:
• Michael Alavanja, USA: The effect of pesticide exposure misclassification on cancer risk estimates in the agricultural health
study
• Hua Fu, China: Importance of biological monitoring in occupational health
• Sean Hays, USA: Biomonitoring equivalents and risk assessment
• Juha Ari Laitinen, Finland: Fire fighters trainers’ exposure to carcinogenic agents in smoke diving
• Gunnar Nordberg, Sweden: Biomarkers of exposure, effects and susceptibility in humans and their application in studies of
interactions among metals in China
• Tetsuo Satho, Japan: Extremely sensitive biomarker of organophosphate insecticide exposure in rats and humans
• Claude Viau, Canada: If biomonitoring is the solution, what is the problem?
Shortly before ISBM 7, the Biological Exposure Indices (BEI) Committee of the American Conference of Governmental
Industrial Hygienists (ACGIH) will hold a regular BEI Committee meeting from September 7 to September 9 in Beijing.
A Special Session will be dedicated to propose and discuss an ICOH Consensus Document on Biological Monitoring in
Occupational Health, to be sent to the ICOH Board for evaluation and approval. The approved document will be publicized
within the international scientific and professional occupational health community.
The Proceedings of ISBM-2007 will be published in Toxicology Letters.
Expected number of participants is 150–200. A reduced registration fee is available for ICOH Members and young
participants. For more information, visit the ISBM-2007 web site at http://www.isbm2007.org. Should you have any questions,
please do not hesitate to contact [email protected].
Maurizio Manno
Secretary of SC on Occupational Toxicology (SCOT)
11
Third ICOH International Conference on Psychosocial Factors at Work
From Knowledge to Action
The Third ICOH-WOPS international conference will take place in Québec City, September 1–4, 2008. The two first International
ICOH Conferences on Psychosocial Factors at Work were held in Copenhagen in 1998 and in Japan in 2005. Both conferences
were highly successful attracting more than 300 international researchers in the field.
The 2008 conference will address four major themes: Preventive interventions; Disability management and Return to
work; Psychological harassment at work; and Public policies on mental health at work. Papers will include mental health,
musculoskeletal and cardiovascular diseases; quantitative and qualitative methodology.
Visit our website at www.icoh-wops2008.com
We hope that you will attend the Conference and it will be a pleasure to welcome you.
Renée Bourbonnais (Laval University)
Michel Vézina (Laval University and Québec Public Health Institute)
Organizing and scientific committee chairs
Welcome to India, the happening place on
international scene.
Indian Association of Occupational Health
invites you to the 58th National Conference
and International Update in Mumbai, India
from 22nd to 25th January 2008.
Conference theme is ‘Basic Occupational Health Services in
Emerging Economies; Challenges and Opportunities’.
Conference will be preceded by an International Workshop on ‘Basic Occupational Health Services’, organized by ICOH
Scientific Committee on Occupational Health & Development
in collaboration with other scientific committees of ICOH.
ICOH President, Jorma Rantanen, ICOH Board members, Kaj Elgstrand & Suvi Lehtinen and other international experts are expected to participate in the conference. It will have an
interesting scientific programme comprising keynote addresses,
oral presentations, workshops, stimulating symposia, guest lectures by international experts, scientific / research papers presentation, poster presentations, etc.
Scientific papers / abstracts are invited for presentation in
the conference. Last date for sending the abstract is 30th November 2007. Early bird registrations close on 31st October 2007.
Conference website - www.iaohconference.com
For details on participation in the conference, please contact Dr. Chaitanya Gulvady, Organising Secretary
([email protected]).
For sending abstract / paper for presentation, please contact Dr. Shyam Pingle, Chairman, Scientific Committee of the
Conference ([email protected]).
12
The Central American Institute for Studies on
Toxic Substances of the Universidad Nacional
(IRET-UNA) in Costa Rica is pleased to be
organizing
EPICOH-NEUREOH 2008
The 20th International Conference on Epidemiology
in Occupational Health (EPICOH) and the 10th
International Symposium on Neurobehavioral
Methods and Effects in Environmental and
Occupational Health (NEUREOH) will take place
June 9-11 and June 11-13, 2008 respectively.
They will share one day (Wednesday, June 11) of
scientific content and will be organized in such a
way that participants can attend one or both
events. The theme for both events is “Multiple
Exposures, Multiple Effects.”
Scientific topics have been recently announced and can be found
on the website: www.epicoh-neureoh2008.com. We will soon be
announcing the keynote speakers and the call for abstracts.
We are currently soliciting suggestions and volunteers for
organizing mini-symposiums and pre/post conference workshops.
If you have specific questions, please contact Jennifer
Crowe, conference secretary at [email protected]
or at telephone number +506 853-5957.
On behalf of Conference President, Catharina Wesseling,
EPICOH Co-President, Hilkka Riihimäki, and NEUREOH CoPresident, Donna Mergler, the Costa Rican Organizing Committee welcomes you to join us for an outstanding pair of conferences in the beautiful country of Costa Rica.
Querétaro/Mexico congress 2007
In September, 2007 Medichem will hold its 33rd Annual Congress in Queretaro, Mexico, in conjunction with FeNaSTAC, the
national federation of societies of occupational medicine in Mexico. The programme, entitled “Responsible Use of Chemicals” is
anticipated to be an excellent one. The congress will take place on 13–15 September. Joint sessions will be held in the mornings,
including a joint opening ceremony. In the afternoons, Medichem and Fenastac will have their own sessions. Simultaneous
translation (Spanish/English) will be provided at the joint morning sessions. At the Medichem-homepage (www.medichem.org)
or at the Internet side http://www.12congresost.com/index.php?seccion=1&idioma= more information about the congress is
available.
The congress-costs for Medichem members are USD 450, non-Medichem Members pay USD 500, to attend the congress.
The Hotel Costs for a single or double room are USD 86 (65 euros) + tax (15%) and services (2.5%).
In addition, a second AHLS course is planned as a Pre-Congress activity. The first was sponsored in Rome in conjunction
with the ICOH Congress in Milan. Again Medichem will co-sponsor an Advanced Hazmat Life Support Course. Medichem will
provide two instructors, Stephen Borron and Jorge Morales to teach in the 3-day course and provide scholarships to occupational health professionals.
Other Meetings and Congresses
A year to go before XVIII World Congress on
Safety and Health at Work
•
We have a year to go before the
opening of XVIII World Congress on Safety and Health at Work to be held in COEX
Convention Center, Seoul for 4 days from
June 29 to July 2 2008. Korea Occupational Safety and Health Agency (KOSHA)
has prepared the World Congress by
launching the planning organization for
the congress in January 2006 since it received the approval to host the World
Congress from International Labour Organization (ILO) and the International
Social Security Association (ISSA) in September 2005. KOSHA also established the
Secretariat for the World Congress on
Safety and Health at Work in January
2007, and have systematically prepared
the giant event.
•
The World Congress on Safety
and Health at Work, which has been held
every three year since it took place for the
first time in Rome, Italy in 1955, is the
world’s biggest international forum in
terms of the safety and health field. This
World Congress in Korea in 2008 is the
second one that has ever been held in Asia
as India had also hosted it. The World
Congress will be a great opportunity for
safety and health related decision makers
and professionals, those representing
workers and employers, and social security experts to share information and
knowledge related to the prevention of the
industrial accidents each other and to
mutually exchange experiences and knowhow regarding the prevention of the in-
dustrial accidents and occupational diseases
•
There will be a lot of presentations
and discussions over XVIII World Congress on Safety and Health at Work held
next year under the motto of “Safety and
health at work: A societal responsibility”,
which will focus on the four main topics
such as “Strategies and Programmes of
Safety and Health for the Future”, “Impact of Changes of Working Conditions
on Workers’ Protection”, “New Challenges and Opportunities in Occupational
Safety and Health”, “Safety and Health
Management Systems”. Joint organizers
including the ILO, the ISSA and KOSHA
have prepared the world congress by
closely cooperating each other in order
to provide a practical chance to discuss
The history of the World Congress
Year
Place
Organizer
Period
Participation
Details
The 13th (1993)
New Deli, India
Indian Safety
Association
4/4~ 4/8
(5 days)
50 countries
1,080 persons
The 14th(1996)
Madrid,Spain
Labor & Social
Safety Dept.
4/22~4/26
(5 days)
105 countries
2,200 persons
The 15th (1999)
Sao Paulo, Brazil
Brazil CIS Center
(FUNDACENTRO)
4/12~4/16
(5 days)
73 countries
2,000 persons
The 16th(2002)
Wien,Austria
AUVA
The 17th(2005)
Orlando,USA
NSC
5/26~5/31
(6 days)
77 countries
2,400 persons
9/18~9/22
(5 days)
111 countries
3,000 pensions
13
the recently emerging major issues in relation to safety and health and to come
up with the measures to handle the safety
and health related problems.
•
Over the next year’s World Congress, especially, Seoul Declaration on
Safety and Health at Work will be announced after the Safety and Health Summit for the first time in history. Ministers
responsible for occupational safety and
health, industry leaders, high-level representatives from employers‘ and workers‘
organizations, as well as leading occupational safety and health specialists from
around world will participate in the discussion to exchange each other’s opinions
on safety and health at work as a basic
human right and a means to economic
growth and development. The Regional
Meetings for the discussion of the pending issues related to the safety and health
of the five continents including the Americas, Asia-pacific, Europe, Africa, and
Arab states and the Symposia for the exchange of mutual experiences and opinions regarding the prevention of the industrial accidents and occupational diseases will also be held during the World
Congress. KOSHA has made every effort
to prepare brand-new programmes for
the World Congress perfectly.
•
The International Film and Multimedia Festival (IFMF), which will be
held concurrently with the World Congress, will provide the participants with
the opportunity to enjoy the worldwide
films and multimedia products regarding safety and health and to release their
own products. You can present your
products for the festival now. You can also
find out the ways to solve the problems
related to safety and health in your workplaces if you visit the International Safety
and Health Exhibition showing the global cutting-edge safety and health related
machinery and tools, equipment, and
technology, which will also be held at the
same time during the period of the congress.
•
KOSHA has ever hosted the International Organization Committee
(IOC) twice, the National Organization
Committee (NOC) three times, and the
preparation and support committee 12
times, discussing and fixing the schedule
and the operational way of the World
Congress’s programmes including the
Safety and Health Summit, the Plenary
Session, the Technical Session, the Regional Meetings, and the Symposium and of
the Opening Ceremony, the Closing Ceremony, the Welcome Reception, and the
14
National Evening for the World Congress.
Therefore, the overall timetable for the
World Congress has potentially been
fixed.
•
Joint organizers including the ILO,
the ISSA, and KOSHA will issue and distribute the 2nd announcement for the
World Congress written in five official languages (English, French, Spanish, German, and Korean), Chinese, and Japanese in September this year. Furthermore,
we will make it possible for participants
to register, make a reservation for their
accommodation, and send Call for Papers through the Internet starting from
September this year by reforming the current official website by the end of August.
•
KOSHA, which decided to host the
World Congress in order to make safety
and health the nation’s top priorities in
deciding any policy, to establish the position of the northeastern Asia as the hub
of the occupational safety and health and
to pave the way for building a good relationship between the labor and management by improving level of the global
occupational safety and health, will try
its best to host XVIII World Congress on
Safety and Health at Work successfully
with the strategies to prepare excellent
programmes, operate the congress to offer the best services, organize the event
with the Korean traits mixed, and build
the safety-oriented operation system.
•
We need active contribution and
participation of safety and health related
people across the world to revitalize the
World Congress. I would appreciate it if
you positively participate in this international event.
Organizing Committee
Congress President:
Dr Claudio Taboadela MD (ICOH NS Argentina)
Honorary Presidents:
Dr Antonio Werner MD (ICOH Honorary Member) –
Dr Guillermo D’Aragona MD (ICOH Emeritus Member)
Congress Themes Include:
•
•
•
•
•
•
•
Occupational Risk Assessment:
- Chemical Factors
- Biological Factors
- Psychosocial Factors
- Physical Factors
- Ergonomic Factors
Occupational Accidents
In itinere Accidents
The rol of the OH Physician in the XXI Century (Symposium)
OH Physician Education (Symposium)
Latin American ICOH NS Meeting
Celebration of the 25th Anniversary of the Province of Buenos Aires
Occupational Health Society
Who should attend:
Anyone involved in Occupational Health with an interest in improving the workplace
health and safety in Latin America. This includes health and safety specialists, senior
industry leaders, government program staff, policy staff, lawyers, academics, labour inspectors, human resources specialists, etc.
The deadline for submitting proposals is 1 October 2007. To submit your
proposal write to: [email protected] or [email protected] Webpage: www.smtba.com.ar
News
WHO organized a Regional Workshop in Africa
on improving workers’ health
The workshop on Workers’ Health in Africa: Action in Partnership was convened
by the WHO Regional Office for Africa in
Brazzaville from 21 to 23 August 2007.
The meeting was attended by experts
nominated by the governments requesting WHO’s assistance in occupational
health: Benin, Botswana, Kenya, Swaziland, South Africa, The Gambia, Namibia, as well as by representatives of the
International Organization of Employers
(IOE) and the Pan-African Employers’
Confederation (PEC), the WHO collaborating centres for Occupational Health
(Finnish Institute of Occupational Health,
University of Illinois in Chicago, USA, and
the University of Abomey Calavi, Benin),
WHO Headquarters and the Regional
Office for Africa (programmes for occupational health; HIV/TB/Malaria; health
promotion; mental health; poverty), ILO
Headquarters (Safe Work) and Regional
Office for Africa.
Many advances were reported to
have taken place in the participating countries during the past years, but at the same
time it was recognized that there is a lot
of space for closer collaboration and more
concrete joint efforts.
Several of the meeting participants
were also ICOH members, and others
were also invited to join the work of
ICOH, which provides additional opportunities to join a range of other networks.
SL
Basic Occupational Health Services for Vietnam
The Vietnam Government has in 2006
launched a new Vietnam National Strategy on Preventive Medicine to 2010 and
Orientation Towards 2020 and the Master Plan on Development of Vietnam’s
Health Care System to 2020 and Vision to
2020. The Strategy and the Master Plan
aim particularly at the strengthening of
preventive health services, including occupational health. The health organizations are differentiated for hospital (curative services) and for preventive services
at all levels: National, Provincial and District levels. The primary health care approach is applied in the organization of
grassroots-level services.
On the request of the WHO Western Pacific Regional Office, WPRO, Professor Jorma Rantanen, President of
ICOH, made a study and consultation
visit to Vietnam on 15–23 August 2007.
The aim of the visit was to advise the Vietnamese Government on the develop-
Photo. Professor Khuc Xyuen, Vice
President and Secretary General of the
Vietnam Association of Occupational
Health and Professor Rantanen in Hanoi
ment of Basic Occupational Health Services, BOHS, as an occupational health element in the Vietnamese health sector
reform. The BOHS approach seems to fit
particularly well to the Country’s new
health system affording high priority to
preventive orientation and grassroots-level activity.
During his visit Professor Rantanen
met with the leadership of the Vietnamese Occupational Health Association that
has 700 Members. The Association runs
active training and education programmes and participates with other Vietnamese bodies in the organization of
the periodical International Conference
on Occupational Health. Strengthening
the contacts of the ICOH with the national associations was discussed, and the
Association proposed the nomination of
a National Secretary for Vietnam. ICOH
was invited to participate in the Fourth
International Conference on Occupational Health in Hanoi in October 2008. The
Association also expressed its thanks for
ICOH contribution to the development
of Vietnam’s occupational health services
system. During Professor Rantanen’s visit, applications for a dozen new ICOH
members were signed.
15
Second International Conference
on Occupational Health Nursing in
Bangkok 23–27 August 2007
The Mahidol University Faculty of Public
Health, the Occupational Health Nursing Association of Thailand and the Gifu
College of Nursing, Japan, organized the
2nd International Conference on Occupational Health Nursing in collaboration
with several Thai and International bodies, including the ICOH Scientific Committee on Occupational Health Nursing,
SCOHN. The Theme of the Conference
was: Alliance for Promoting Quality of
Work Life: Challenges in Occupational
Health, Safety and Environment.
The Conference was solemnly
opened by Her Royal Highness, Princess
Somsawalee, who emphasized regional
collaboration in the improvement of
health and well-being of working people
and confirmed the commitment of the
Thai Government in the development of
occupational health nationally and internationally.
The Minister of Labour of the Thai
Government, Mr. Apai Chandanachulaka, emphasized the importance of alliances for multidisciplinary and multisectorial collaboration in implementing the
strategies for people-centered services and
in creating supportive environments in
occupational health. The Chair of
SCOHN, Ms. Marjatta Peurala served as
the Co-chair of the Conference and contributed to the scientific programme.
The Conference was attended by
some 250 participants from 22 countries.
The session themes of the Conference
covered Occupational health and safety
The key organizers of the Bangkok Conference and the ICOH
President. From left: Ass. Professor Pimpan Silpasuva, Mahidol
University, Secretary General,
Thailand, Professor Estsuko
Fukuoka, Gifu College of Nursing,
Japan, Ass. Professor Phitaya
Charupoonphol, Mahidol University,
Chairman of the Organizing
Committee, Professor Jorma
Rantanen, ICOH and Professor
Yukiko Okui, Gifu College, Japan,
Co-Chairman
16
management, Workplace health promotion, Occupational health services, Occupational health service professionals,
Health care workers, Job stress, and Work
and health. A total of 57 oral presentations, keynotes, and special lectures were
delivered in the Conference, complemented with 34 poster presentations and very
active discussion. About one third of the
presented papers were delivered by ICOH
Members.
The ICOH President Jorma Rantanen stated in his keynote presentation
that while traditional occupational accidents and diseases still need to be given
high priority, development of new competences among occupational health personnel is also needed to broaden their
scope of knowledge towards new and
emerging challenges and to better apply
the research results in practice. Particularly the recognition and prevention of
musculoskeletal disorders and psychosocial problems at work, including stressrelated morbidity and work-related morbidity in general need new approaches.
The major changes in client structures
also call for new models and methods of
service provision. The ICOH in collaboration with WHO and ILO has developed
a new service provision approach called
Basic Occupational Health Services,
BOHS, which is distributed to all continents. Occupational health nurses play
the most central role in the implementation of the new approach.
New Members
Wendy Anne MACDONALD
Australia
José Marcelo Oliveira PENTEADO
Brazil
Mario BONCIANI
Brazil
Vanda Andres FELLI
Brazil
Siu C. CHAN
Canada
Oscar NIETO-ZAPATA
Colombia
Catalina GUERRERO
Costa Rica
Vivi SCHLUNSSEN
Denmark
Mirja Kristiina KIILUNEN
Finland
Alexis DESCATHA
Clotaire AKOUELE
France
France
Andre KLUSSMANN
Germany
Alkinoi Krikella
Greece
Clodagh CASHMAN
Ireland
Giuseppina PALUMBO
Michele Augusto RIVA
Italy
Italy
Carlos ESPEJO
Mexico
Naïma JERRI
Morocco
Paal MOLANDER
Tore TYNES
Norway
Norway
Omar Eduardo TORREBLANCA GARCIA
Peru
Gloria Mercedes Solsol Tafur Peru
Gladys Acosta Gallegos
Peru
Silvia Nelly RAMIREZ VARGAS Peru
Mariana STOLERU
Corina Lacramioara SUTEU
Elena Magdalena MOGHIOR
Lavinia Delia Calugareanu
Luparu RAZVAN
Gabriel Lucian TEFAS
Gica JIGAU
Corina Lacramioara SUTEU
Letitia BUCUR
Iuliana Carmen JIGAU
Romania
Romania
Romania
Romania
Romania
Romania
Romania
Romania
Romania
Romania
Gunnar Arvid AHLBORG
Malin JOSEPHSON
Sweden
Sweden
Susan Q. WILBURN
Switzerland
Teunis BRAND
Gerard FRIJSTEIN
The Netherlands
The Netherlands
Özlem ÖZKAN
Turkey
Knut RINGEN
Saeher A. Fatima MUZAFFAR
Esther Luenda CHARLES
Peter HOONAKKER
Beth Alison BAKER
Barry EISENBERG
Cody David HEINER
USA
USA
USA
USA
USA
USA
USA
Résumé en français
Message du Président
Solidarité – un objectif clé de la
CIST
Le travail est un des aspects les plus importants de la vie, produisant des biens
dont nous dépendons et apportant, en
plus de revenus, des contacts sociaux, des
occasions d’apprendre et de se développer. Le travail est aussi primordial pour
l’estime de soi et pour notre identification ; il influence aussi notre rôle dans la
société. L’importance du travail dans nos
vies a augmenté au cours des deux dernières décennies. De ce fait, les travailleurs
sont supposés être plus productifs, de
suivre les constants changements, de changer de travail et de s’adapter à de nouvelles conditions et à de nouveaux types d’organisations de travail. Un emploi stable
rend la vie plus sûre tandis que l’insécurité dans la vie professionnelle cause de
nombreuses incertitudes. Nous ne pouvons pas remonter le temps mais il est
possible de discuter des règles du jeu.
Un des axes principaux dans le développement de notre civilisation au
cours des 4.000 ans qui se sont écoulés, a
été la solidarité croissante entre les gens.
Selon les scientifiques sociaux, le niveau
actuel de compétition affaiblit la solidarité traditionnelle entre les gens et favorise
une culture individualiste. En fait, le mot
solidarité n’est pas très populaire dans la
discussion publique actuelle.
La santé au travail nécessite pourtant de la solidarité. En fait, c’est une activité qui produit un bien commun en rendant les conditions de travail plus sûres
et plus saines pour tout le monde. La santé
au travail d’un individu est biensûr importante, mais une santé au travail individualiste est théoriquement impossible.
Dans toutes les activités de la santé au
travail, nous devons travailler avec les
autres et pour les autres. Une personne
travaillant à son compte, même la plus
indépendante, a besoin des autres pour
avoir un travail plus sûr et plus sain.
La CIST est une organisation non
gouvernementale dont l’existence est basée sur la solidarité globale et la solidarité
entre nos membres. Nous nous sentons
solidaires avec les organisations internationales des Nations Unies, avec de nom-
breuses organisations professionnelles,
avec nos organisations soeurs dans le
domaine de la santé au travail et, avant
tout, envers nos clients : les travailleurs et
les milieux de travail.
La CIST a un rôle important au plan
international dans la promotion de la
solidarité. A l’aide de notre apport scientifique et des applications pratiques, nous
défendons de meilleures conditions de
santé et de sécurité au travail et nous
aidons nos groupes cibles et nos clients à
mener une vie saine au travail. Le rôle global de la CIST requiert le renforcement
de toutes nos activités : l’information
pour sensibiliser les gens, la recherche pour
assurer une solide base scientifique, des
propositions, des méthodes et des pratiques et des instructions pratiques pour
les professionnels.
Dans ses activités quotidiennes, la
CIST excerce sa solidarité de plusieurs
façons ; un exemple étant un soutien spécial déstiné aux membres venant des pays
en voie de développement. Notre solidarité dans le monde et envers nos groupes
cibles se manifeste le mieux dans les activités exercées par nos membres dans des
métiers différents en tant que scientifiques,
formateurs, prestataires de services, experts d’information, conseillers et fournisseurs de services, travailleurs et employeurs.
Le Congrès CIST 2009 sera également un important forum pour la solidarité. Vous pouvez bientôt trouver plus
d’informations sur le Congès à www.icohweb.org.
Mots de l’Editeur
Contenu de ce numéro
Les technologies de l’information et de la
communication ont profondément changé l’environnement informatique des travailleurs. L’information basée sur l’évidence scientifique est nécessaire pour la
prise de décision dans tous les secteurs de
la société, la santé et la sécurité au travail
y compris. C’est pourquoi nous avons
choisi pour notre série d’articles, un texte
qui traite de la Cochrane Collaboration
dans le domaine de la santé au travail.
Cet article écrit par le docteur Jos Verbeek
met l’accent sur l’information basée sur
l’évidence scientifique.
Le Comité de rédaction développe
des idées d’articles pour les prochains
bulletins. Si vous avez des propositions
sur des thèmes intéressants, nous vous
serions reconnaissants d’y prendre part.
Nous voulons également encourager les
Comités Scientifiques à continuer d’utiliser le bulletin comme moyen
d´information pour diffuser leurs nouvelles. Le nombre de contributions des
Comités Scientifiques était de 22 durant
la période 2004–2005 et de 26 pour la période 2006–2007.
Le prochain bulletin paraîtra à la
fin du mois de décembre 2007. La date
limite de réception du matériel est le 10
novembre 2007.
Pour recevoir votre exemplaire à
temps, veuillez vérifier que vous êtes en
règle et que vous avez informé de tout
changement d’adresse à CarloPetyx
@libero.it ou à [email protected].
Le domaine de la Cochrane
Collaboration sur la santé au
travail ; premiers résultats
par Jos H. Verbeek
Introduction
En 2004, l’Institut finlandais de la santé
au travail a décidé de se joindre à la Cochrane Collaboration ce qui a eu pour résultat l’enregistrement du domaine de la
santé au travail dans le cadre de cette collaboration. Pendant les trois dernières
années, nous avons beaucoup travaillé
pour nous familiariser avec la méthodologie Cochrane et pour publier les premières revues. Je voudrais donner ici un
bref aperçu sur les résultats que nous
avons obtenus et sur d’intéressants problèmes méthodologiques que nous avons
rencontrés.
Revues et protocoles
Au cours des trois dernières années, nous
avons été capable d’enregistrer 19 titres
dans la Cochrane Collaboration. Le pro17
Résumé en français
cessus pour créer une revue est que l’on
enregistre d’abord un titre, ensuite on écrit
et publie un protocole et après on rédige
et publie ladite revue. En ce moment, 4
revues et 11 protocoles sur les interventions de la santé au travail ont été publiés
dans la bibliothèque Cochrane
(www.cochrane.org) et il y a en plus 4 titres enregistrés (tableau 1).
Le format d’une revue systématique
Cochrane
Jusqu’ici, les revues systématiques de la
Cochrane Collaboration ont examiné seulement l’efficacité des interventions en
santé au travail. Dans une revue systématique, il faudrait toujours avoir une
question bien définie, préférablement formulée selon l’acronyme PICO
(P=population étudiée, I=intervention
étudiée, C=contrôle c-à-d groupe de comparaison O=résultat).
Tableau 1. Situation actuelle des revues et des protocoles sur la santé au travail
Phase
Revue
Revue
Revue
Revue
Protocole
Protocole
Protocole
Protocole
Protocole
Protocole
Protocole
Protocole
Protocole
Protocole
Des questions bien formulées
Dans le domaine de la santé au travail, il y
a une certaine tendance à justifier les activités préventives comme étant bonnes en
soi. Le raisonnement est que s’il y a des
risques liés au travail, tout ce qui est possible devrait être fait pour les éviter. Toutes les interventions consomment pourtant de nos ressources, et quelques-unes
peuvent même causer plus de mal que de
bien. Des questions bien formulées peuvent nous aider à éviter toute confusion
concernant la prévention. Elles nous obligent à nous demander comment l’intervention utilisée fonctionne et quelles sortes de résultats nous voulons augmenter
ou réduire.
N’avons-nous pas suffisamment
d’évidence sur les risques de santé
liés au travail ?
Devons-nous vraiment évaluer si les interventions en santé au travail sont efficaces ? On peut facilement conclure que
si il y a un fort rapport entre un risque au
travail et un résultat sur la santé, l’élimination du risque réduit aussi les impacts
sur la santé. Ceci peut bien être vrai mais
puisqu’il y a plusieurs façons d’éliminer
les risques, nous nous intéressons aux
façons les plus efficaces.
Quelles sortes d’évidence utiliser ?
18
Titre
Titre
Titre
Titre
Titre
Interventions pour le traitement de la dysphonie
Conseil sur la manutention manuelle pour prévenir et traiter la douleur
du dos chez les travailleurs
Prévention du stress lié au travail chez les travailleurs dans les services de
santé
Interventions pour promouvoir l’utilisation du protecteur de l’ouïe
Interventions pour les accidents du travail dans l’industrie de la cons
truction
Interventions pour faciliter le retour au travail suite au trouble de l’adap
tation
Interventions pour améliorer la santé au travail des gens déprimées
Interventions pour prévenir la perte auditive causée par le bruit
Interventions pour la prévention de la dysphonie
Exercises pour prévenir les récurrences de la douleur lombaire basse
Test de dépistage de l’alcool et des drogues pour prévenir les accidents
chez les personnes conduisant dans leur travail
Lettres de consultation pour les patients qui ont des symptômes médi
calement inexplicables
Interventions pour les accidents du travail chez les agriculteurs
Interventions pour prévenir et traiter les ulcères veineux dans le travail
debout
Interventions pour prévenir l’exposition aux substances chimiques au
travail
Interventions pour prévenir l’incapacité de travail
Interventions pour prévenir les blessures par seringue pour parer à l’hé
patite ou le HIV
Evaluation de la santé et de la capacité fonctionnelle pour prévenir les
maladies professionnelles et les accidents du travail
La Collaboration Cochrane est souvent
critiquée pour trop limiter l’utilisation des
protocoles de recherche, étant le plus souvent restreints aux essais randomisés. Particulièrement dans le domaine de la santé
au travail, il peut être très difficile d’utiliser un plan randomisé. Cela suscite beaucoup de questions intéressantes. Si un plan
randomisé n’est pas approprié pour étudier la santé au travail, qu’est-ce qu’il l’est ?
A notre avis, le protocole d’étude
n’est pas lié au domaine mais plutôt à l’intervention. Les interventions cliniques
sont généralement appliquées au niveau
individuel et ont des effets moyens ou faibles. L’utilisation de protocoles d’étude
méthodologiquement plus faibles peut
facilement causer une erreur systématique qui fausse les résultats moyens. Pourtant, les interventions dont le but est de
changer l’environnement de travail, comme p. ex. diminuer l’exposition au bruit,
sont généralement appliquées au niveau
d’un groupe. Bien qu’il soit possible de
rendre aléatoire des groupes, l’élaboration d’un protocole demeure par contre
plus difficile. Lorsqu’il s’agit de règlements
ou de changement de politique, l’application s’effectue au niveau d’un pays ou
d’une population entière. Même si en
théorie, il est possible de randomiser dans
ces cas, en pratique c’est impossible.
Conclusion
L’approche systématique de la Cochrane
Collaboration peut être appliquée à une
grande partie des interventions en santé
au travail. L’application de la méthodologie Cochrane dans le domaine de la santé
au travail suscite beaucoup de questions
sur la méthodologie et ses alternatives.
De trouver des réponses à ces questions
est un défi pour ceux qui travaillent dans
le domaine de la santé au travail. Ceux
Résumé en français
qui veulent nous rejoindre dans cet effort, peuvent trouver plus d’informations
à www.cohf.fi.
Rapport de conférence :
L’histoire du travail, de
l’environnement et de la
santé
La Comission Internationale sur la Santé
au Travail avait déjà parrainé deux conférences importantes sur l’histoire de la
santé au travail et de la santé environnementale à Rome (1998) et à Norkopping
(2001). La troisième fois, un tel évènement historique a eu lieu à Dudley où une
conférence organisée par le Centre d’Etude et d’Histoire de la Médecine de Birmingham a attiré un groupe international d’universitaires travaillant dans un
domaine de l’histoire médicale particulièrement interdisciplinaire et spécialisé.
La conférence a commencé par une
séance intitulée Berceaux de l’industrie.
Lors de la première allocution principale
de la conférence, Alberto Baldasseroni
(AUSL, Italie) s’est concentré sur l’exposition de Milan en 1906 qui a coïncidé avec
l’achèvement des travaux du tunnel du
Simplon. Le deuxième papier par Robert
Arnott (Université de Birmingham,
Royaume-Uni) a examiné les risques po-
tentiels auxquels les travailleurs étaient
exposés des centaines d’années auparavant, en se basant sur l’évidence recueillie
dans un site de fusion de cuivre en Crète.
Le papier suivant par Paul-André Rosenthal (INED, France) a examiné le rôle du
gouvernement dans le traitement du silicose dans dix pays. Toshio Matsushita
(Universisité de Kagoshima, Japon) a présenté l’avant-dernier papier de la journée
qui portait sur un projet de modernisation industrielle de style occidental réalisé
à Satsuma, connu sous le nom de Shuseikan, tandis que Jonathan Reinarz (Université de Birmingham, Royaume-Uni) a
conclu la séance par une exploration de la
santé au travail des Midlands durant le
dix-neuvième siècle se référant aux documents des hôpitaux d’enseignement de
Birmingham.
La deuxième journée a commencé
par un discours d’orientation par Geoffrey Tweedale (Université de Manchester
Metropolitan, Royaume-Uni) qui a, entre autres, examiné la localisation des
maladies professionelles. Sa présentation
était suivie par six autres portant sur les
études à caractère très régional qui ont
démontré les influences des politiques locales et de la localisation du savoir dans
l’histoire de la santé au travail (les présentations étaient données par Tim Carter, Pierluigi Cocco, Douglas Buchanan,
Zodwa Ndlovu, Alessandro Porro et Ro-
bert McKnight). La journée suivante était
caractérisée par les séances qui mettaient
l’accent sur la technologie, la première
séance traitait des risques liés aux innovations et la deuxième de la façon dont la
technologie a facilité le travail des historiens dans le domaine de la santé au travail.
Dans son très intéressant commentaire de clôture, Tim Carter (Université
de Birmingham) a souligné quelques thèmes centraux du programme très varié
tels que l’identification des dommages, la
diffusion du savoir et l’action pour prévenir les risques. Le programme était remarquablement international aussi bien
au niveau des orateurs que des thèmes et
Carter nous a offert un cadre dans lequel
il est possible de réfleter ces études diverses par rapport à l’histoire de la santé
professionnelle. En particulier, il a suggéré une approche qui pourrait être décrite
comme “l’écologie de la santé au travail”.
Cette approche peut aider les historiens à
expliquer pourquoi, par exemple, une
maladie particulière appelée byssinose
s’est développée à Lancashire et s’est ensuite disséminée partout dans le monde.
Publishing dates for
the ICOH Newsletter in 2007 and 2008
3/2007 end of December 2007
1/2008 end of April 2008
2/2008 end of August 2008
3/2008 end of December 2008
materials by 10 November 2007
materials by10 March 2008
materials by 10 July 2008
materials by 10 November 2008
19
ICOH
Officers
President
Prof. Jorma Rantanen
c/o Finnish Institute of
Occupational Health
Topeliuksenkatu 41a A
FIN – 00250 Helsinki, Finland
Tel: +358 30 474 2010
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e-mail: [email protected]
Secretary General
Prof. Sergio Iavicoli
ISPESL
National Institute for Occupational Safety and Prevention
Via Fontana Candida 1
00040 Monteporzio Catone
(Rome), Italy
Tel: +39 06 94181407
Fax: +39 06 94181556
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USA
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National Institute for Working
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Dept. of COFM, Faculty of Medicine (MD3),
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Federal Institute for Occupational Safety and Health
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Health Occupational Health Department
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