DRAFT VERSION: 2 JUNE 2009 · Priority1.2: Develop and disseminate evidence-based prevention tools and raise awareness for the prevention of silica- and other dust-related diseases

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Work Plan 2009- 2012

WHO Global Network of Collaborating Centers in

Occupational Health

DRAFT VERSION: 2 JUNE 2009

COMPENDIUM

GPA Objective 1: To devise and implement policy instruments on workers' health, Claudina Nogueira

GPA Objective 2: To protect and promote health at the workplace, Stavroula Leka and Aditya Jain

GPA Objective 3: To improve the performance of and access to occupational health services, Timo Leino GPA Objective 4: To provide and communicate evidence for action and practice, Jo Harris-Roberts, Edward Robinson GPA Objective 5: To incorporate workers' health in to other policies Wendy Macdonald

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GPA Objective 1 : GPA Objective 1: To devise and implement policy instruments on workers' health, Claudina Nogueira Manager: Claudina Nogueira ACTION AREAS: 6. National policy frameworks for workers’ health should be formulated taking account of the relevant international labour conventions and should include: enactment of 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. 7. National action plans on workers’ health should be elaborated between relevant ministries, such as health and labour, and other major national stakeholders taking also into consideration the Promotional Framework for Occupational Safety and Health Convention, 2006. 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. 8. National approaches to prevention of occupational diseases and injuries should be developed according to countries’ priorities, and in concert with WHO’s global campaigns. 9. Measures need to be taken to minimize the gaps between different groups of workers in terms of levels of risk and health status. Particular attention should be paid to high-risk sectors of economic activity, and to the underserved and vulnerable working populations, such as younger and older workers, persons with disabilities and migrant workers, taking account of gender aspects. Specific programmes should be established for the occupational health and safety of health-care workers. 10. 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 – bearing in mind a differentiated approach to regulating its various forms – in line with relevant international legal instruments and the latest evidence for effective interventions, as well as immunization of health-care workers against hepatitis B, and other actions addressing priority work-related health outcomes. PRIORITIES: Priority 1.1: Develop/update national profiles on workers’ health and provide evidence base for development, implementation and evaluation of national action plans on workers’ health Outputs: Comparative analysis of national strategies and action plans, national profiles, and reports on lessons learned Support: CC: Jovanka Bislimovska, Institute of OH, FYR of Macedonia WHO/HQ: Ivan Ivanov Priority1.2: Develop and disseminate evidence-based prevention tools and raise awareness for the prevention of silica- and other dust-related diseases. Outputs: Evaluation of national programmes, packages of essential interventions and good practices, for dust control, exposure and diagnostic criteria for pneumoconiosis Support: CC: Maria Lioce-Mata and Catherine Beaucham, NIOSH US WHO/HQ: Ivan Ivanov Priority1.3: Develop and disseminate evidence-based tools and raise awareness for the elimination of asbestos-related diseases.

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Outputs: Estimates of the burden of asbestos-related diseases, review of good practices for substitution of asbestos and prevention of exposure to asbestos, health surveillance of exposed workers Support: CC: Ken Takahashi Institute of Industrial Ecological Sciences, Japan WHO/HQ: Ivan Ivanov Priority 1.4: Conduct studies and develop evidence-based tools and information materials for the comprehensive protection and promotion of health for health care workers, emphasizing HBV immunization. Outputs: Tools, guidance documents, assistance to countries for implementing and evaluating programs, training on national programs Support: CC: Ahmed Gomaa, NIOSH, US WHO/HQ: Susan Wilburn

GPA1.6a - Formerly AA2:NP5

GPA Objective Objective 3: To improve the performance of and access to occupational health services CC or NGO Name Institute for Occupational Health, Kiev, Ukraine Project title Ways of strengthening occupational health services for prevention of occupational cancer in

Ukraine Keywords Occupational cancer, workers, cancer-related dangerous productions, epidemiology,

prevention, monitoring, occupational health services Project leader Email address

Prof. Yuriy Kundiyev [email protected], [email protected],

Partners (of the CC Network)

Institute of Occupational Health of the Academy of Medical Sciences of the Russian Federation; Instytute Medycyny Pracy, Lodz (Poland)

Other partners National Cancer Registry of Ukraine, Institute of Oncology of the Ministry of Health of Ukraine Funding Budget funding through the Academy of Medical Sciences of Ukraine

Objective of the project To decrease the risk of development of cancer morbidity among workers of professions dangerous from cancer point of view and that of production processes.

Project outcome(s) and deadline(s) for completion of the project

Stage I – to develop an information system for collection, epidemiological and medico-statistical analysis of the data on cancer morbidity at enterprises dangerous from cancer point of view (2006-2007); Stage II – to develop a system of primary prevention of cancer pathology among workers of enterprises dangerous from cancer point of view; Stage III – to introduce and to monitor the state of health of workers using the developed systems, to assess the efficiency of preventive measures (2009-2010).

Target group and/or beneficiaries

Workers of professions dangerous from cancer point of view and that of production processes, administrations of enterprises dangerous from cancer point of view, national service of occupational pathologies, trade unions.

Summary of the project (max 100 words)

The problem of occupational cancer prevention in Ukraine is still not fully solved, because of the lack of the effective system for it earlier detection, full medico-statistical registration, lack of the combined system of prevention at the state and regional levels. The present Project is focused directly to solving the mentioned problems.

Dissemination The results of studies will be introduced in Ukraine through the Ministry of Health and Ministry of Social Policy and Labour, Academy of Medical Sciences; they will also be used for training medical students, family doctors, physicians for occupational pathologies and physicians-hygienists.

Impact (global or regional)

A model of the effective system for monitoring the health of high risk group of workers in dangerous cancerogenic enterprises; the system of cancer morbidity primary prevention among workers of dangerous enterprises from cancer development point of view will be legally realized. It is intended to determine an order for conducting medical examinations of

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workers at the reminded enterprises.

The global contribution of this scientific and research work is in the use of the proposed preventive model for countries of the Central and Eastern Europe.

Progress (maximum 100 words)

System of data collection about occupational cancer patients in Ukraine was developed. The system will be implemented in 27 regions of Ukraine. Medical and social monitoring of occupational cancer patients will be promoted in Ukraine and results can be presented in IARC. Methodical recommendations concerning industrial carcinogenic danger evaluation, revealing and statistical registration of occupational cancer patients and conception of subregister of occupational cancer patients were developed.

GPA1.6b - Formerly AA5:1c GPA Objective

Objective 4: To provide and communicate evidence for action and practice

CC or NGO Name

Institute for Occupational Health, Kiev, Ukraine

Project title

Develop the 2006-2010 Plan for Introduction of the National Strategy for Providing Safe and Healthy Conditions for Workers in Ukraine as a Demonstration Area for CIS Countries

Keywords

National policy in medicine and occupational safety, improvement of occupational health

Project leader Email address

Prof. Yuriy Kundiyev [email protected]


Institute of Occupational Health of the Academy of Medical Sciences of the Russian Federation

Other partners

Trade unions, Ministry of Health, Ministry of Labour and other governmental bodies of Ukraine

Funding

Budget funding of the Academy of Medical Sciences of Ukraine, WHO Grant

Objective of the project

To decrease the risk of development of occupational and work-related morbidity among workers of dangerous professions and those of production processes, basing on social and hygienic monitoring conducted jointly with Partners in Ukraine, providing joint efforts of national and international partners in this field.


The Project will be implemented in 3 stages: Stage I – to develop the information system for accumulation and analysis of the data

related to work conditions at enterprises of Ukraine and to elaborate Plan for introduction of the Strategy on three-party levels (2006-2007);

Stage II – in the framework of the Strategy to develop a system of the primary prophylaxis of professions with high occupational risk (2008-2009);

Stage III – to introduce the Strategy at the national level in the framework of the section of the national Program “Health of the Nation” and to assess its efficiency (2009-2010).


Workers of dangerous professions and those engaged in dangerous production processes, administrations of dangerous enterprises, services of occupational pathologists, Government, Federation of Employers of Ukraine.


The problem of prevention of occupational diseases remains to be studied in Ukraine not in full extent as a result of the lack of the combined three-party system for occupational risk management and preventive intervention at the governmental and regional levels. There was no distinct strategy for providing occupational health. The presented Project is focused directly to solving the mentioned problems.

Dissemination

The results of investigations will be used by the Government of Ukraine and by the Ministry of Health, Ministry of Social Policy and Labour, Ministry for Emergency Measures, Academy of Medical Sciences of Ukraine and for Businessmen and Trade Unions. They will be also

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used for training Workers and Businessmen, medical students, occupational physicians, physicians-hygienists and engineers in occupational safety.


There will be developed an effective system of the state monitoring of workers of dangerous occupations and the system of the primary prevention of occupational morbidity among workers at enterprises with high occupational risk. The global level, i.e. to consider Ukraine as a WHO demonstration area in implementation of the Strategy for improving working conditions of workers.


The information system for collection and analysis of the data related to work conditions at enterprises of Ukraine and a Plan for introduction of the Strategy at the three-party level (2006-2007) was developed. A set of priority tasks for inclusion in the Draft of the State Program for Improvement of Safety, Occupational Health and Working Environment on 2007-2011 has been developed for Ukrainian government. The draft of the Recommendation «Development of methods for risk assessment of exposure to chemical, physical, biological and physical factors of the working environment in conditions of the modern production” is in the process of adoption. The developed methodical approaches were taken into account in the «Decree of the Cabinet of Ministers of Ukraine on 22 February 2006, № 182 «On adoption of the procedure of the state social and hygienic monitoring».

GPA1.6c - Formerly AA4:TM1k GPA Objective Objective 2: To protect and promote health at the workplace CC or NGO Name National Institute of Occupational Health and Poison Control, Chinese Centre for Disease

Control and Prevention, Beijing

Project title Development of National Action Plan for Health Promotion Enterprises in China 2005-2010 Keywords National action plan, health promotion enterprises Project leader Email address

Tao Li [email protected]


WHO, ILO, University Illinois, USA

Other partners Funding

National finance support of China, WHO, ILO

Objective of the project To build 100 Health Promotion Enterprises in China. Project outcome(s) and deadline(s) for completion of the project

Manual for how to build Health Promotion Enterprises. Standard established for Health Promotion Enterprises. Build National Action Plan for Health Promotion Enterprises. Spread the successful experiences and models to other enterprises.


Policy makers, occupational health and safety researchers, enterprise managers, workers


Establish a standard for health promotion enterprises to carry out the law of occupational disease prevention and control of P.R.C. Write a manual to guide enterprises how to build Health Promotion Enterprises. By examining the enterprises about occupational health prevention and control, select several good examples by different industries as Health Promotion Enterprises.

Dissemination WHO documents and National documents Impact (global or regional)

Both global and national

Progress on Project We have conducted several training courses to spread the knowledge about how to establish health promotion enterprises. We arranged seven training courses which topic is about the standard to evaluate the national enterprise model, how to apply suitable technology to control benzene poison, propagandizing for the law of occupational diseases prevention and control related regulations, technical requirement of occupational health facility and personal protection providing, etc. Over 750 participants from provincial institutions and enterprise groups attended. Also we held two meetings about national enterprise model and over 500

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participants from MOH, SAWS, labour union, enterprises, guild and CDC attended the meetings and changed their experiences. Now we are organizing itinerant lectures to spread the experiences.

New Project 1.6d CONTRIBUTING PROJECT Title Work plan project number (to be added by WHO)

Strengthening of health system to address occupational health risks - development of National strategy on occupational health and safety

GPA Objective and Action

GPA Objective 1: To devise and implement policy instruments on workers' health GPA action 1.6-1.8

Priority Initiative Priority1. 1: Develop/update national profiles on workers’ health and provide evidence base for development, implementation and evaluation of national action plans on workers’ health

Responsible CC or NGO Name

Serbian Institute of Occupational Health “Dr. Dragomir Karajović“, Belgrade, Serbia

Project leader (contact name and email address)

Prof. dr Petar Bulat ([email protected])

Network partners (CC name, country, email)

Andrija Stampar School of Public Health, School of Medicine University of Zagreb, Zagreb, Croatia-Prof. dr Jadranka Mustajbegović ([email protected]) Institute of Occupational Health, WHO Collaborating Center, Skopje, Republic of Macedonia-Prof dr Jovanka Karadžinska Bislimovska ([email protected])

WHO Regions involved in this CONTRIBUTING project (contact name and email)

WHO Regional Office for Europe –Dr. Rohko Kim ([email protected])

Country ministries involved in this CONTRIBUTING project (contact name and email)

• Serbian Ministry of Health, Dr. Elizabet Paunović ([email protected]) • Serbian Ministry of Labour-Occupational Safety and Health Directorate, Vera Božić

([email protected])

External partners for this CONTRIBUTING project (contact name, organization and email)



The purpose of this activity is to strengthen country’s capacities to develop and implement occupational health policy, legislation and action plans with the participation of social partners. National strategy on occupational health and safety will address important issues of OH&S: • Occupational diseases and accidents insurance; Guidance on risk assessment and

management; Abolition of the compensation approach to high-hazard workplaces; • Protection of vulnerable groups of workers; • Restructuring traditional medical services to multidisciplinary services incorporating risk

assessment and prevention; • New list of occupational diseases; • Reorganization of data collection system and reporting of occupational injuries and

occupational diseases; • Occupational health and safety promotion


Workers, policy makers, occupational health and safety professionals, researchers, enterprise managers.

Events-opportunities for furthering the project

Meeting with other SEE OH experts at workshops, seminars and congresses etc.

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Expected results of this project by 2012 (outcomes)

• The preparation of the National strategy on occupational health and safety which will be adopted by Ministry of Health, Ministry of Labour, Occupational safety and Health Directorate and National government

• Developing/updating national legislation on occupational health and safety according to provisions set in national strategy on occupational health and safety

• International workshop with participation of SEE countries aimed at exchange of experience and discussing common problems and challenges regarding implementation of national strategies and the status of occupational health in the SEE region

• Making reports to WHO Regional Office for Europe on the current situation of occupational health and safety

• Technical assistance to national government in developing occupational health policies, systems and services

• Provision of information materials to national government and all other relevant levels of government

• Establishment of national mechanisms for social dialogue with regards to occupational health and safety

• Establishment of national programmes for training employers, workers representatives in enterprises and labour inspectors

Indicators of achievement (impact)

The number of workers covered by OH. Adoption of national strategy. Implementation of national strategy

Major Milestones (list up to three dates and milestones)

The draft of the national strategy is expected by the end of year 2010. The adoption by national government and parliament is expected in 2010. The action plan for implementation of strategy is expected in 2011 Implementation 2012

Public health impact Funding source(s) In addition to national funding (primarily from public sources) the opportunities for getting

financial support such as EU pre accession funding, EU social Fund, South East European Health Network may be available.

Dissemination National strategy on occupational health and safety will be disseminated through the network of occupational health services, WHO collaborating centres and SEE Network on Workers’ Health.

New Project 1.6e CONTRIBUTING PROJECT Title Work plan project number (to be added by WHO)

SWIFT– Sustainable Waste Management Initiative For A Healthier Tomorrow - A Comprehensive, Sustainable Approach Focused On The Determinants Of Social Exclusion, Poverty And Health In The Roma, Ashkali And Egyptians In Belgrade, Serbia


GPA Objective 1: To devise and implement policy instruments on workers' health GPA action 1.9

Priority Initiative Priority 1. 1: Develop/update national profiles on workers’ health and provide evidence base for development, implementation and evaluation of national action plans on workers’ health


WHO Country Office in Serbia


Gerry McWeeney ( [email protected])


Institute Of Occupational and Radiological Health “Dr Dragomir Karajović“, Belgrade, Serbia, Dr Martin Popevic ( [email protected])

WHO Regions involved in this CONTRIBUTING


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project (contact name and email) Country ministries involved in this CONTRIBUTING project (contact name and email)

• Serbian Ministry of Health, Dr. Elizabet Paunović ([email protected]) • Serbian Ministry of Labour-Occupational Safety and Health Directorate, Vera Božić

([email protected])



Social exclusion and poverty are extensive, well documented for the Roma population in Serbia. Multiple determinants can be identified for health, exclusion and poverty. In order to start addressing these issues, a comprehensive and multifaceted approach is required. Informal recycling of materials from waste represents an important survival strategy for Roma in Belgrade. Adults and children can be seen rummaging through communal waste bins, dumping areas, without protection, exposed to occupational health hazards. This “scavenging” is a large scale operation, occurring throughout Belgrade. Objective of the project is to convert current Roma waste “scavenging” into an effective and safer means of income whilst tackling health and human rights issues. The second objective is to devise and implement policy instruments on workers’ health.


Roma population Health care workers and policy makers Occupational physicians Social services and educators


Meeting with other SEE OH experts at workshops, seminars and congresses etc.


Health System • Health System development and assessments during this and the following BCA period,

focusing on: o BOHS (particularly vulnerable workers) o Hazardous employment

”Direct to Worker” • Assessment and report on the Occupational health hazards and injuries suffered by the

informal waste collectors • Formal training and certification (Probable UK NVQ) and educational awareness building

with the informal waste collectors based on the assessment findings and report. • SWIFT Recycling Centre – Health and safety Training


• Report of the assessment and occupational health hazards and injuries suffered by the informal waste collectors

• Formal proposal of occupational health policy, legislation and action plans with the participation of social partners

• SWIFT Recycling Centre – Health and safety Training


• Assessment and report on the Occupational health hazards and injuries suffered by the informal waste collectors (2009/2010)

• Formal training and certification of the informal waste collectors based on the assessment findings and report (2010/2011)

• SWIFT Recycling Centre – Health and safety Training (2011/2012)

Public health impact Funding source(s) SWIFT Project (BCA 2008-9 and BCA 2010-11) funded from the Norwegian Ministry of

Foreign Affairs

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Dissemination Project reports will be disseminated through WHO to related health authorities and stakeholders. Findings will be presented at relevant international/ national conferences and/or meetings. Possible publication in international journal.

GPA 1.6f

GPA Objective GPA objective 1: to devise and implement policy instruments on workers’ health. Priority 1.1 CC or NGO Name Asociación Chilena de Seguridad Project title Epidemiologic surveillance for occupational diseases (Provimep) Keywords Epidemiologic surveillance Project leader Email address

Dr. Verónica Herrera [email protected]


None

Other partners None Funding Asociación Chilena de Seguridad

Objective of the project To contribute decisively to prevent occupational diseases under surveillance and to avoid the progression of those developed.


Surveillance programs for a variety of risk agents


Chilean and Latin-American workers


The main activities that will be develop in the period are: To update the Provimep for workers exposed to Silica To update the Provimep for workers exposed to Pesticides To formulate the Provimep for workers exposed to High Altitude To formulate the Provimep for workers exposed to Diving conditions To assess the economics involved in the Achs Provimep To implement preventive actions in specific high-risk and disabled populations. To implementation preventive actions in noise exposed populations according to their willing to change attitude. To improve monitoring and measurement of specific Provimep processes. To improve the integration of the Achs' information systems of prevention and curative areas. To develop information systems to offer Provimep information to companies through the web site www.achs.cl To implement health promotion strategies in the working population.

Dissemination Paho's documents Ciencia& Trabajo journal Achs web site Fundación Científica web site Regional and International meetings


Regional


GPA1.7d Formerly AA2:NP17

GPA Objective Objective 1: to devise and implement policy instruments on workers’ health CC or NGO Name WHO Collaborating Centre for Occupational Health in Vietnam, National Institute of

Occupational & Environmental Health (NIOEH)

Project title National action plan on prevention of occupational diseases and intervention measures

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Keywords National action plan, occupational hazards, occupational risks, occupational diseases, silicosis,

occupational hearing loss, asbestosis, etc. Project leader Email address

Dr. Nguyen Thi Hong Tu, General Deputy Director, Vietnam Administration for Preventive Medicine, 138 A Giang Vo Str., Hanoi, Vietnam Email address: [email protected]


NIOSH

Other partners The University of Washington, US. Funding

Vietnamese government

Objective of the project To reduce the rate of occupational diseases by 10% in 2010 and to improve workers’ health at high risk in Vietnam.


The outcomes of the project: • To develop the national policy in prevention of occupational diseases (by 2008) • To develop the surveillance programs on prevention of each occupational disease (2009) • To develop the control toolkit for each risk factor e.g. silica, noise, chemical, etc. (2009) • To develop national action plan and intervention measures on prevention of occupational

diseases (2010) Target group and/or beneficiaries

Policy makers, occupational health and safety researchers, enterprise managers, workers at high risk


- A description of the current situation of occupational diseases in Vietnam - An analysis of how these occupational disease are influencing on workers’ health,

their families, enterprises and national economy - The identification of control toolkit for management of each occupational risk factor - The identification of actions and intervention measures to be taken - Development of national policy on prevention of each occupational disease

Dissemination National policy, WHO documents Impact (global or regional)

National, regional and Global

Progress on Project (max 100 words)

The National Programme on labour protection and occupational safety and health was adopted by the Vietnamese government in October 2006 and many activities were implemented in 2007. These include the development of training courses on diagnosis of occupational disease; conducting a survey of occupational risk factors for pneumoconiosis, skin diseases, noise-induced deafness and infectious disease; evaluation of the situation of occupational disease examination, treatment, rehabilitation and expertise in the provinces and in industrial sectors; and development of plans of action for occupational disease prevention in health care workers, on injury prevention in the health care sector and on basic occupational health services.

Please indicate whether this is a:

New Project 1.7e

CONTRIBUTING PROJECT Title Work plan project number (to be added by WHO)

Evaluation of the effectiveness of national action plans on prevention of occupational diseases in Vietnam


GPA Objective 1 :Devise and implement policy instruments on workers’ health Action 1.7

Priority Initiative Responsible CC or NGO Name

WHO Collaborating Centre for Occupational Health in Vietnam, National Institute of Occupational & Environmental Health (NIOEH)


Dr. Tran Thi Ngoc Lan, General Deputy Director, Vietnam Administration for Preventive Medicine and Environment, 138 A Giang Vo Str., Hanoi, Vietnam Email address: [email protected]

Network partners (CC

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name, country, email) WHO Regions involved in this CONTRIBUTING project (contact name and email)

Southeast Asia Pacific


Ministry of Health in Vietnam



The national action plans on prevention of occupational diseases has been started in 2007 and will be evaluated after 5 years, in 2012. Several activities have been and will be implemented during 5 years to aim at reduce the rate of occupational diseases and to improve workers’ health at high risk in Vietnam. This action plan will be evaluated in several aspects and lessons will be drawn.


Policy makers, occupational health and safety practitiioners, enterprise managers, Workers at high risk of occupational diseases



- Prevention model for some common occupational diseases will be developed and applied such as pneumoconiosis, noise-induced deafness, skin disease and infectious disease (hepatituis B)

- The rate of some comon occupational diseases will be reduced by 10% - Capacities of envionment monitoring and occupational disease diagnosis and

detection will be improved for OH practitioners - Training materials will be developed and disseminated - Legislative documents on occupational disease prevention will be reviewed,

supplemented, and promulgated Indicators of achievement (impact)

- The rate of some occupational disease reduced by 10% - 80% of workers at high risk will be examined and detect occupational diseases


Public health impact Workers’ health will be improved Funding source(s) Vietnamese Government Dissemination National policy, WHO documents Please indicate whether this is a:

New Project 1.7f


Changing world of work in nursing sector and migration: developing preventive strategies


1.7

Priority Initiative Priority 1: Develop guidance for national action plans on workers’ health, including vulnerable groups (Action 1.7). Projects include inventory of action plans, evaluation of national plans and lessons learned (1.9).


ISPESL – Dept. of Occupational Medicine ITALY

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Dr Sergio Iavicoli ([email protected]) Dr Antonio Valenti ([email protected])


European Agency for Safety and Health at Work, Spain FIOH, Finland Swedish Work Environment Autority, Sweden


WHO - EURO




Nursing shortage is reported to be an increasing problem worldwide due mainly to early retirement from work and insufficient turnover of nurses coming from educational programmes. The shortage of nurses in Italy is 99.000 (OECD). Work flexibility by acquiring professionals through outsourcing (social cooperatives and work supply) and facilitation of migration flow of foreign nurses have been introduced to tackle the problem. In Italy, their presence in hospitals has tripled in the period 2002 – 2005. The project is aimed to identify key priorities for developing strategies and tools for better work organization in nursing sector with special focus on migration


Healthcare sector (nurses and migrant workers)


International congresses (e.g. ICOH 2009 Cape Town, 22-27 March 2009),


Questionnaire to identify gaps and needs in OSH for nursing sector Publication of results Tools for information and prevention in nursing sector



2009 : Analysis of scientific literature on the subject, census of the sources and regulatory context. Identification of a representative sample of the population under study 2010: Production of a survey and critical analysis of results 2011: Dissemination of results by targeted tools and events

Public health impact Regional Funding source(s) Self-funding

Dissemination Documents, guidelines, workshops Please indicate whether this is a

1.7g New


Knowledge transfer about occupational hazards to precarious women workers


Objective 2: Protect and promote health at the workplace Action 2.11

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Priority Initiative Develop sectorial toolkits for the assessment and management of occupational risks in the most hazardous sectors


Centro de Estudios de la mujer


Katherine Lippel, [email protected] Ximena Díaz, [email protected]


Asociación Nacional de Mujeres Rurales e Indígenas ANAMURI [email protected] presidenta

WHO Regions involved in this CONTRIBUTING project

Country ministries involved in this CONTRIBUTING project



This project is part of a program of research «Araucaria project» whose objectives are to generate knowledge about mental health problems related to working conditions, to transfer knowledge and Know-how from Canadian experts, and to disseminate information in order to raise awareness of policy makers and practitioners to psychosocial risks related to working conditions.

raining material directed to women who work in precarious jobs in agriculture and other illas) will address a variety of hazards to which they are exposed with particular attention to to working conditions, working environment and working relationships. Also we will address


New Project 1.7h


Aged persons and their occupational skills. Development of methods for the prevention of impairments. First phase development of a Network


2

Priority Initiative 2 Develop a global framework and guidance on healthy workplaces (Action 2.13). Responsible CC or NGO Name

IfADo – Leibniz Research Centre for Working Environment and Human Factors (Institut für Arbeitsforschung an der TU Dortmund)


Barbara Griefahn, Professor, MD, [email protected]


Project leaders of the IfADo: Michael Falkenstein, Barbara Griefahn, Herbert Heuer, Gerhard Rinkenauer, Klaus-Helmut Schmidt, Edmund Wascher

The project should be integrated into the network initiated by WHO on aged workers. If this initiative is not realized at the start of the next GPA the following institutes (most of which have expressed their interest in contributing to the WHO-initiative) will be asked for co-operation: Centre for Occupational and Health Psychology (Andy Smith), Cardiff University, UK Coronel Institute of Occupational Health (Judith Sluiter), University of Amsterdam, NL Institute for Work and Health (Brigitta Danuser), Lausanne, CH National Centre of Hygiene (Emilia Ivanovich), Sofia, Bulgaria National Institute of Public Health (Pavel Urban), Prague, CZ Finnish Institute for Occupational Health (Juhani Ilmarinen, Mikko Härmä), Helsinki, Fi LaTrobe University (Wendy McDonald), Melbourne, Australia JNIOSH (Shin-ichi Sawada, Masaya Takahashi), Tokyo, Japan

WHO Regions involved in Australia

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this CONTRIBUTING project (contact name and email)

Asia Europe Bonn Rokho Kim


-



Persons above the age of 50 years are systematically investigated in the IfADo with respect to cognition/ performance (attention, response preparation, motor skills) indicators of strain, age diversity, age adapted human-machine interfaces and shift work. The final goal is to define conditions that facilitate the work of the elderly and to develop methods/instruments for the prevention of (premature) impairments.


Workers above 50 years of age


Meeting with other experts at workshops, seminars and congresses etc.


Development of training programs for elderly workers. Publications



Depends on the success of the WHO initiative but by 2012 there should be a network for concerted actions towards better integration of aged persons in the working process

Public health impact global Funding source(s) in place

Dissemination Publication in international journals

GPA 1.7i

GPA Objective GPA objective 1: to devise and implement policy instruments on workers’ health. Priority 1.2 CC or NGO Name Asociación Chilena de Seguridad Project title Eradication of silicosis Keywords Silicosis Project leader Email address

Dr. Gustavo Contreras [email protected]


Chilean Institute of Public Health

Other partners None Funding Asociación Chilena de Seguridad

Objective of the project This project has two objectives. One regional oriented to collaborate with the Chilean National Silicosis Eradication Program. The other international to collaborate with regional efforts to eradicate silicosis


Chest x-ray training courses Research projects on silica exposed workers New legal documents for Chilean workers


Chilean and Latin-American Workers


At national level starting in 2009 efforts will be made to: • To improve legal documents that define the diagnosis of silicosis and incapacity

evaluation provoked by it. • To improve the coverage of exposed workers under surveillance program. • To improve the quality medical centers that diagnose and treat workers affected by

silicosis. • To continue delivering the training course on chest x-ray interpretation

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• To develop a research project on silicosis risk for construction workers At international level starting in 2009 efforts will be made to:

• To continue delivering the training course on chest x-ray interpretation • To promote the implantation of a regionalexam for physicians interpreting chest x-

rays Improving legal documents will decrease the uncertainty that workers affected by silicosis face today in Chile. Improving the coverage of exposed workers under surveillance program will move our country closer to the goal of eradicating silicosis Improving the quality medical centers that diagnose and treat workers affected by silicosis will assure a better quality of life for those affected by the disease The research project will provide information needed to formulate surveillance and prevention programs New training course on chest x-ray interpretation will increase the number of physicians capable of diagnosing the disease in the region. The regional exam for physicians interpreting chest x-rays will contribute to the same goal.

Dissemination Impact (global or regional)

Regional


GPA1.9a

Formerly AA2:PM7 GPA Objective Objective 1: to devise and implement policy instruments on workers’ health CC or NGO Name National Institute of Occupational Health and Poison Control, Chinese Centre for Disease

Control and Prevention, Beijing Project Title The draft of National Occupational Disease Prevention and Control Program in China 2005-

2010 Keywords Occupational disease, prevention, control, program Project leader Email Address

Tao Li

[email protected] Partners (of the CC Network)

WHO, ILO, HSL UK

Other partners Funding National finance support of China, WHO, ILO Objective of the project To provide the draft of National Occupational Disease Prevention and Control Program in

China 2005-2010 Project outcome(s) and deadline(s) for completion of the project

The draft of National Occupational Disease Prevention and Control Program in China 2005-2010


Policy makers, occupational health and safety researchers, enterprise managers, workers


By investigating the status of occupational disease prevention and control, this project will analyses the information and draw up the draft of National Occupational Disease Prevention and Control Program in China 2005-2010.

Dissemination WHO documents and National documents Impact (global or regional)

Both global and national


We have finished the National Occupational Disease Prevention and Control Program in China 2007-2015 in Chinese version. It will promulgated soon.


1.9b AA2:PM3

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Child labour: strategies for prevention


1.9

Priority Initiative Priority 1: Develop guidance for national action plans on workers’ health, including vulnerable groups (Action 1.9). Projects include inventory of action plans, evaluation of national plans and lessons learned


ISPESL – Dept. of Occupational Medicine ITALY


Dr Marta Petyx ([email protected]) Dr Grazia Fortuna ([email protected]) Dr Fabio Boccuni ([email protected])





ICOH, International Commission on Occupational Health


Child labour above all in the frameworks (as all family run activities in agriculture, craftsmanship and trade sectors) that avoid knowledge and control. Project activities have focused on developments at a national level. Principal target groups have been identified (children and trainers) and intervention activities are planned taking into consideration important ethnic, religious and social aspects. Training tools are being developed to improve knowledge and awareness of child labour amongst children. In the forthcoming second stage, risk perception will be targeted and links between child labour, migration and school attendance will be investigated. Focus of the project will be: A) The analysis in European industrialized countries of the situation of child labour among migrant children. B) Contribute to dissemination of “awareness and visibility” of child labour at national level.


Prevention experts, teachers and students.


- Scientific publications. - The ISPESL Project “Child labour – to know so as to act”. - Fact Sheets addressing various issues related to child labour in Italy: school dropout; minor differences between Italian and foreign minors to work. - Web page devoted to Child Labour on ISPESL portal.


- Analysis of feasibility to develop an information path on child labour in Europe starting to the school in order to raise the awareness and the visibility of this problem with specific focus on migrant children (2009). - Scientific publication on child labour in Italy: comparison of data and strategies under way (2009). - Scientific publication on reducing child labour by 2016; the second ILO global report on child labour (2009). - Presentation and dissemination of the project and single teaching units on a web page devoted to this issue on ISPESL portal (2010).

Indicators of Evaluation questionnaires

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achievement (impact) Major Milestones (list up to three dates and milestones)

- To develop a new “awareness and visibility” of child labour with a special training programme (2009). - To assess a specific analysis of immigrant minors and child labour in Europe also in view of legislation framework. Case studies will be developed in European countries (2009). - To promote a “cultural change” in the approach to child labour by practical actions of information for trainers, students and opinion leaders (2010).

Public health impact Global and regional Funding source(s) Self funding

Dissemination Training programmes, ad hoc publication and reports, website, fact sheets.


1.9c AA2:RS7


Controlling Occupational Safety and Health Hazards among Health Care Workers (Current title: Emerging Occupational Health Hazards among Health Care Workers in the New Millennium)

GPA Objective and Action 1.9 Priority Initiative Priority 1 Responsible CC or NGO Name

National Institute of Occupational Safety and Health, Japan (JNIOSH)


Masaya Takahashi, Ph.D., [email protected]


None


WPRO


Ministry of Health, Labour and Welfare, Japan


Derek R. Smith, Ph.D., WorkCover NSW Research Centre of Excellence, University of Newcastle, [email protected]


The objective of this project is to investigate the sleep problems associated with work schedules, musculoskeletal disorders and care equipment, preventive factors of needlestick and sharps injuries among health care workers (HCW) in hospitals and nursing homes. The results obtained will be made use of developing the educational and guidance documents to help improve the levels of occupational safety and health of HCW.


HCW in a variety of Asia-Pacific countries, especially those working in hospitals and nursing homes


Collaboration with a US NIOSH project to devise work schedule risk prevention training programs


Evidence and the relevant materials to improve the working conditions for HCW in terms of work schedules, musculoskeletal disorders, and needlestick/sharps injuries


Number of peer-reviewed articles and guidance documents in plain language

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Publication in peer-reviewed journals (at least one paper per year) and the guidance documents by 2012

Public health impact Improved occupational safety and health among HCW as direct impact and upgraded quality of health care service to the recipient as indirect impact

Funding source(s) JNIOSH

Dissemination Peer-reviewed scientific publications, conference abstracts, and guidance documents.

GPA1.9d Formerly AA2:RS8

GPA Objective Objective 1: to devise and implement policy instruments on workers’ health CC or NGO Name CATHOLIC INDUSTRIAL MEDICAL CENTRE(CIMC), Korea Project title Prevention management program of musculoskeletal diseases using the participatory

action oriented training (PAOT) in the health care workers Keywords Musculoskeletal disease, health care workers, prevention management program, PAOT

(participatory action oriented training) Project leader

Email address

Jung-Wan Koo, M.D., Prof.

[email protected] Partners (of the CC Network) Toshiaki Higashi, Japan ; Kazutaka Kogi, Japan Other partners Funding

- Research and grant proposal

- Contracts with companies

Objective of the project The objectives is to find out for themselves the improvement opinion of health care workers for prevention of work-related musculoskeletal diseases (WRMSDs) by participatory action oriented training (PAOT).


- The participants accomplish the real action plans for improvement of their own hospitals by PAOT. And they have positive thinking for improvement of their wards and become good facilitators to be able to perform PAOT. Deadline: 2006.12


Health care workers


PAOT workshop consists of 6 technical sessions. At the 1st session, each action checklist item is explained and on-site checklist exercise is carried out. And from 2nd to the 6th session, good example pictures on 5 principles – treatment and management of medicines, medical instrument and equipment / patient care, work environment safety and job management, a ward design, welfare facilities – and group discussion is carried out by the participants. In the 6th session in implementation of improvement, each participant is asked to present 2~3 short-term and long-term action plans for their own ward improvement.

This study is assured that the PAOT program shows high potentials as an intervention program to prevent WRMSDs in hospitals.

Dissemination - Results will be submit to relevant journals for publication

- Presentation at relevant conferences and meetings

- Reports Impact (global or regional) Global Progress on Project (max 100 words)

After participating in PAOAP workshop, work improvements have been achieved on the basis of their own ideas. A lot of improvements were helpful to prevent musculoskeletal disorders. This study so far has shown that the PAOAP had high potentials as a useful program to prevent work-related musculoskeletal disorders (WRMSD) in hospital.

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Now that the 1st stage of PAOT program at Uijeongbu St. Mary's hospital is finished, the 2nd stage is in preparation within the same hospital. This may also be applied to other hospitals in the future.

GPA1.9e Formerly AA2:RS9

GPA Objective Objective 1: to devise and implement policy instruments on workers’ health CC or NGO Name National Institute for Occupational Health (NIOH), SA Project title An ergonomics audit in South African public hospitals Keywords Nurses; patient handling tasks; ergonomic risk factors; work related musculoskeletal

disorders Project leader

Email address

Ms. Sindiswa Dyosi

[email protected] Partners (of the CC Network) National Institute for Occupational Health, South Africa Other partners Center of Ergonomics for Developing Countries, Sweden Funding The study will be funded by the NIOH Objective of the project To prevent occurrence of musculoskeletal problems among nurses Project outcome(s) and deadline(s) for completion of the project

1. To conduct a pilot project in one of the public hospitals (by June 2006) 2. To conduct this project among public hospitals in all South African provinces (by end

2009) 3. To develop a database with statistics on prevalence of musculoskeletal pain among

South African nurses (by 2009) 4. To develop guidelines for prevention of work related musculoskeletal disorders

associated with patient handling tasks for nurses working among public hospitals in developing countries (by end 2010)


Health care workers and managers


Musculoskeletal disorders (MSDs) may develop from exposure to ergonomic hazards. However, symptoms are multifactorial. They include pain and numbness. Disability may arise if these disorders are not diagnosed at an early stage because they may remain asymptomatic for years before the symptoms manifest. Nurses are not exceptions. Tasks that involve manual handling of patients have been identified as the leading causes of MSDs among nurses but not in South Africa. This project aim is to determine the prevalence of musculoskeletal pain among nurses working in public hospitals and associated ergonomic risk factors in order to develop guidelines on their prevention.

Dissemination Workshops and seminars; conferences; brochures and booklets Impact (global or regional) SADC region Progress on Project (max 100 words)

The project has completed its first phase of the "Pilot". A protocol is currently being prepared for the full study, which is scheduled to be completed by end of 2009. The title of this project is due to change to account for development of an intervention tool in the form of guidelines for the healthcare workers. There are intentions to form project links with regard to data collecting tools, which will aim to allow us to generalize the findings worldwide.

GPA1.9g Formerly AA3:H1

GPA Objective Objective 1: to devise and implement policy instruments on workers’ health

CC or NGO Name Asociación Chilena de Seguridad (ACHS) Project title Job stress surveillance in health care workers Keywords Job stress, surveillance, work organization, health workers


Dr. Marisol Concha, [email protected] Sr. Rodrigo Pezo, [email protected]

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Partners (of the CC Network) Universidad Andrés Bello

Other partners Funding Asociación Chilena de Seguridad (ACHS), Objective of the project To develop a surveillance system in health care workers


A validated surveillance system for health care workers One year from the starting point

Target group and/or beneficiaries Health care workers


To develop a surveillance system based on self-administered questionnaires and organization data among others. Sensitivity and specificity of the system will be calculated. Data collection validation will be carried out in a sample of health workers. We will develop a quantitative scale to identify different degrees of stress in health workers. According to the workers stress level derivation to interventions will be carried out. Impact of the interventions will be evaluated using quantitative and qualitative methods. Identification and selection of interventions using evidence-based medicine will be carried out.

Dissemination Government, mutual, meeting, Labour and Health Ministry Impact (global or regional) Regional


A literature review (general and specific) as been concluded and at the moment work is being carried out on the surveillance system design. The proposal, based on the bibliography, consist on a two step survey system applied as a panel study on selected occupational sites. The instruments correspond to: a) short self- administered survey of high sensibility and b) interview survey of high specificity. The surveys will be administered sequentially on working places recognized for being stressors in the literature. The proposal will be finished (first draft) September.

GPA1.9h Formerly AA3:H2


CC or NGO Name Clinica del Lavoro “Luigi Devoto”, Milano, Italy Istituto Nacionale de Salud de los Trabajadores (INSAT), LA HABANA-Cuba

Project title Occupational risks in Cuban health care workers: exposure assessment, prevention, training and guidelines.

Keywords Exposure assessment; risks prevention; anaesthetic gases exposure; industrial hygiene; stress at work; psychosocial factors; health care workers; burn out.


Silvia Fustinoni, e-mail: [email protected] M.E. Linares, H. Diaz, e-mail: [email protected] Patrizia Deitinger e-mail: [email protected]

Partners (of the CC Network) ISPESL, Rome, Italy

Other partners Fondazione IRCCS Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, Milano Associazione Italia-Cuba

Funding


To conduct a study on exposure to anaesthetic gases in health care workers in Cuba and their outcome on workers’ health − To improve technical capability of laboratories in Cuba dealing with environmental and biological monitoring of occupational exposure − To develop training programs for physicians, and nurses, industrial hygienists, and all the subjects 80 involved in prevention

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− To publish guidelines, booklets to address risk management and scientific articles to report the results of the studies.


Improvement of working and health conditions in health care Cuban workers; Improvement of know-how through educational courses for prevention operators. Training packages for operators of prevention (industrial hygienists, occupational physicians, psychologists)


Health care workers, occupational health physicians, nurses, industrial hygienists, laboratory technicians, psychologists, institutions for safety and prevention at work.


Assessment of exposure to anaesthetic gases and risk reductions: 1. Complete methods development; 2. Apply methods to evaluate exposure and its neurobehavioral effects in health care workers; 3. Study solutions for the reduction of exposure and apply them in the polluted environments; 4. Test the efficacy of the adopted solution. 5. Education: 6. Organization of specific frontal training packages on industrial hygiene and biological monitoring and psychosocial risks in health care workers.

Dissemination Guidelines for safety and prevention at work, booklets and training packages for workers and operators of prevention, scientific publications.

Impact: global/regional Regional


The Cuban colleagues are working to the assays for measuring: 1) airborne exposure to anaesthetic gases in health care workers in Cuba . 2) urinary levels of anaesthetic gases in occupationally exposed subjects.Italian experts from the "Clinica del Lavoro provide Cuban colleagues with useful supplies and advices. ISPESL, Italy, translated in Spanish a booklet, originally edited in Italian, dedicated to health care workers. The booklet is titled: "Stress & burnout - how recognize symptoms and prevent risk". This booklet has been presented to the Cuban colleagues during the II INTERNATIONAL CONGRESS ON HEALTH AN WORK, CUBA 2007

GPA1.9i Formerly AA3:H3


CC or NGO Name Institute and Outpatient Clinic for Occupational and Environmental Medicine, University Munich

Project title Assessment of exposure to antineoplastic agents in pharmacy and hospital personnel Keywords Antineoplastic drugs, biological monitoring, wipe samples Project leader Email address Dr. Rudi Schierl, [email protected]


National Institute for Occupational Safety & Health (NIOSH), USA Centre for Environmental and Occupational Health, Porto, Portugal

Other partners

Funding Initial funding is secured from a German pharmacy network. Funding for the next years has to be applied for.


Examination of safe working conditions related to handling of antineoplastic drugs during drug preparation or administration in hospitals


To test the wipe-kit that will be readily usable for different countries (by 2007) • To develop training courses for the wipe-kit (by 2009)

Target group and/or beneficiaries Pharmacy technicians, pharmacists, nurses, medical doctors


There is a risk of adverse health effects for personnel with occupational exposure to antineoplastic agents. The study is aiming at identification, quantification and evaluation of potential health hazards of exposed personnel in pharmaceutical and oncological departments. Biological monitoring for important substances had produced evidence for uptake, but sources remained doubtful in many cases.

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Therefore we developed an environmental monitoring strategy in order to detect contamination and to improve working procedures. Within this scheme we are sending a wipe-sampling-kit with detailed instructions to hospitals and pharmacies, where sampling is done by local staff. Analyses, evaluation and recommendations were carried out from our institution.

Dissemination Publications, university studies, reports Impact: global/regional Global


“Wipe-Kit” with which can be delivered to pharmacies and hospital units. A detailed instruction with photos is included. At present also a CD-ROM with a video (in German) is available. After sampling the parcel is send back to Institute and Outpatient Clinic for Occupational and Environmental Medicine laboratory and analyses were performed. Finally, the Institute sends the results together with evaluation and recommendations. During the last year they sent their "wipe-kit" to about 50 participants in Germany in order to look for contamination at pharmacies and hospitals. There was also cooperation with a big hospital in Paris, where they did monitoring at several sites (publication under preparation). Publications: 1) Turci R, Sottani C, Schierl R, Minoia C: Validation protocol and analytical quality in biological monitoring of occupational exposure to antineoplastic drugs. Toxicol Lett 162 (2-3), 256-262 (2006) 2) Sottani C, Turci R, Schierl R, Gaggeri R, Barbieri A, Violante SF and Minoia C: Simultaneous determination of Gemcitabine, Taxol, Cyclophosphamide and Ifosfamide in wipe samples by HPLC-MS/MS: Protocol of validation and Uncertainty of Measurement. Rapid Communications in Mass Spectrometry 2007 , in print.

GPA1.9j Formerly AA3:H4


CC or NGO Name National Institute for Occupational Health (NIOH), SA Project title Identification and prevention of occupational risks for Health Care Workers (HCWs)

Keywords Risk Assessment Health Care Workers Prevention of occupational illness Ergonomics HIV and other infectious diseases

Project leader Email address Prof M Ross for NIOH [email protected]


OEHRU CC (University of Cape Town), SA Singapore CC (National University of Singapore) HSL CC (UK)

Other partners

Health Protection Agency (UK) Center of Ergonomics for Developing Countries, Sweden, National Institute for Communicable Diseases (NICD), South Africa (WHO CC in Communicable Diseases), WAHSA initiative on HIV in HCWs, University of British Columbia (UBC)

Funding

Funding from the National Health Laboratory Service, South Africa to develop surveillance system for laboratory workers (NIOH) Unsuccssful funding proposal for 2009 to CIDA for surveillance system and evaluation of surveillance system for public hospitals – support from SA provincial governments and UBC obtained

Partner contributions and funding to be explored in 2008 Objective of the project

Develop & pilot practical tools & methods for risk assessments in health care settings: primary and secondary preventive intervention


Outcomes and deadlines of the project. • To develop a health care workers’ toolkit comprising: risk assessment tools, case studies and materials for promotion of occupational health for HCWs (2008) • To develop training packages for the toolkit deliverable through e-learning and face-to-face (by 2009) • To develop a model for implementing the toolkit within a basic occupational health service for HCWs (2010) 1) Collection of data &case studies in South Africa on tuberculosis incidence and HIV infection in HCWs. 2) NICD and Cellestis to conduct prospective study on Quantiferon to assess latent TB and progress to active TB in high and medium risk HCWs and guidelines for HCWs. 3) Obtain materials/ courses from partners eg Singapore, HPA

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4) Training information on dealing with high risk situations 5) Occupational health surveillance system

Target group and/or beneficiaries Health Care workers, particularly for developing countries


The project will address the risk assessment and prevention of global occupational illness such as biological exposures (e.g. HIV, TB, HBV, HCV, Avian flu), chemical (e.g. latex), physical (e.g. violence) exposures and ergonomics.

Dissemination Publications, reports Impact: global/regional Global

Progress on Project a (max 100 words)

To develop toolkit for risk assessment, case studies, materials ( due 2008) 1. Collection of data &case studies in South Africa on tuberculosis incidence and

HIV infection in HCWs. Review of incidence of TB in NHLS laboratory workers commenced and other cases to be collated in 2008 for partners to review

2. NICD and Cellestis prospective study on Quantiferon to assess screening guidelines. Further discussions in October 2007 with funder and NICD - finalising protocol and obtaining results from Japan, investigating private sector project in Canada

3. Obtain materials/ courses from partners Developed chapter on walk through risk assessment in health care facilities for Malaysian Medical Association textbook – available after publication in 2008.

4. Training materials for pandemics: September 2007 developed a pandemic flu policy for occupational health practitioners to assist business continuity: to be circulated to partners for comment in 2008

5. Occupational health surveillance systems: NIOH piloted HCW surveillance tool (paper-based) and refined data collection sheet and developed electronic system to interface with personnel data. Presentation on surveillance and pilot made at Federation for Infectious Diseases Societies of Southern Africa October 2007 (available on request). Electronic pilot by June 2008.

GPA1.9l Formerly AA3:H6


CC or NGO Name National Institute of Occupational Health and Poison Control, Chinese Centre for Disease Control and Prevention, Beijing

Project title Risk assessment for health care workers Keywords risk assessment, health care workers Project leader Email address

Tao Li [email protected]

Partners (of the CC Network) WHO, ILO

Other partners Funding

National finance support of China, WHO, ILO


To give occupational health standard of Bloodborne Pathogens prevention and control to protect the corresponding health care workers.


Investigate the status about risks to Health Care Workers especially for sharp injury. The regulation about sharp injury, such as where is often happened. Standard established for occupational health protection and control of Bloodborne Pathogens.


Policy makers, occupational health and safety researchers, enterprise managers, health care workers

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Investigate the institution, such as research institution, medical institution, disease prevention and control institution, laboratory etc. To study the status of injury of Bloodborne Pathogens. To establish occupational health standard of Bloodborne Pathogens protection and control. Select different region, different scale institution as pilot departments carrying out the standard.

Dissemination WHO documents and National documents

Impact (global or regional) Both global and national


We have investigated the institution, such as research institution, medical institution, disease prevention and control institution, laboratory etc and analysed the data about health care workers’ injury. Now we have provided the opinion draft.

GPA1.9m Formerly AA3:H8

GPA Objective Objective 1: to devise and implement policy instruments on workers’ health CC or NGO Name National Institute for Occupational Safety and Health

Project title Assessment of Environmental and Health Risks in a Mega Hospital (Cairo University Hospitals)

Keywords Environment, health, risk, infection, ergonomic, musculo-skeletal, chemicals, radiation


Dr. Hussein abd el hay ibrahim

E-mail : [email protected]


Other partners Kasr El-Aini Faculty of Medicine and Cairo University Hospitals (Cairo University)

Funding Egypt NIOSH (LE.20000)

Objective of the project Assessing various environmental and health risks present in Cairo University Hospitals and impacting the employees, patients, visitors, as well as the service itself


Project outcomes (expected):

1. Have a clear "Environment and health risk model" in large hospitals,

2. Help the hospital management, through risk characterization report, to manage the identified risks,

3. Disseminate the outputs and lessons' learnt through training workshops targeting managers of hospitals and health care centers affiliated to Ministry of Health and Population.

Deadline for completion of the project: December 2010


- Health care workers (physicians, nurses, technicians and workers) at the Cairo University Hospitals.


The main objective of the project is to assess the various environmental and health risks present in Cairo University Hospitals and impacting the employees, patients, visitors, as well as the service itself. The project started July 2007, at the Cairo University Hospitals (6000 beds and variety of supporting facilities and utilities) and is executed through a team of research physicians, hygienists, and engineers from both the NIOSH and Cairo University Hospitals). The project methodology depends on applying a series of formats, checklists (derived from US-EPA and similar agencies), and measuring tools for various hazards identified in the hospital including infection,

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ergonomic, musculo-skeletal, chemicals, radiation, and others. The methodology also constitutes a health survey of a large representation of the workforce at the hospital.

Dissemination Ministry of health and Population related departments.


Help the hospital management, through risk characterization report, to manage the identified risks

Progress on Project as of December 07 (Maximum 100 words)

1. Design and standardize the study tools (forms, checklists, measuring tools, etc.),

2. Having all related permissions for executing the study,

3. Execution of about one-half of the environmental survey, including measurements of workplace environmental concerns (chemicals, radiation, etc.)

4. Execution of health survey on about one-third of the target workforce

GPA1.9n

Formerly AA4:CE2 GPA Objective Objective 1: to devise and implement policy instruments on workers’ health CC or NGO Name National Institute for Occupational Safety and Health (NIOSH) Project title Protecting Health Care Workers in International Settings Keywords HIV, Infectious disease, Injuries, Health Care workers Project leader Email address

Ahmed Gomaa, MD, ScD [email protected]


WHO; PAHO; NIOSH/OD; NIOSH/DESHEFS (Walter Alarcon); One Latin American country

Other partners

Funding NIOSH Objective of the project This project advances WHO’s efforts to reduce HIV and Hepatitis B and C virus

infections due to needlestick injuries among health care workers in international settings.


From 2002-2006 • A multidisciplinary team of national health, injection safety, occupational

health, and national nursing organizations was formed in each of the 3 project countries.

• WHO and ICN held an international planning meeting in Geneva followed by 3 national workshops to develop country plans for implementation of the tool kit.

• The project teams evaluated and recommended adaptation of the tools to incorporate concepts of occupational health and the hierarchy of controls to protect workers from occupational hazards.

• Three countries conducted a baseline assessment of supplies, knowledge, skills, and behaviors prior to implementation of training tools and resources followed by a repeat assessment demonstrating an increase in knowledge of risk and controls, access to Post-exposure follow-up and prophylaxis, and in 2 of 3 countries use of sharps containers for the first time and use of safer needle devices for the first time.

• The resulting WHO tool kit was created and piloted by groups in 5 countries in southern Africa. This new resource: Preventing Needlestick Injuries and Occupational Exposure to HIV/AIDS recognizes the high risk procedures and devices not covered by injection safety tools endangered from the use of intravenous and phlebotomy (blood-filled) and incorporates broader principles of infection prevention and control and occupational health. The tool kit, which was launched at SIGN in 2005 includes: a revised assessment tool, key elements for occupational health programs, sharps injury log and anonymous survey to determine proportion of underreporting of incidents, and PowerPoint presentations for use as training tools and resources.

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By 2006-2010 1) WHO will identify occupational health professionals through ICOH, WHO Collaborating Centers, health care worker representative (unions), and professional associations; compile interests and resources and publish an annotated list of resources available globally. WHO will facilitate regional teleconferences between partners to share resources and build a network of support for country policy on health care worker safety. 2) An Aide Memoire for health care worker occupational health and safety will be developed and disseminated. 3) In Vietnam, the project will expand to consider all hazards to health care workers and develop occupational health services for health care worker health and safety. The experience in Vietnam will be shared widely in Southeast Asia and technical assistance provided to countries to develop national health care worker safety policy and programs. 4) WHO will explore the development of a campaign to immunize health care workers against Hepatitis B in collaboration with the WHO Hepatitis B immunization programs and the MOH Expanded Program of Immunizations (EPI). 5) WHO OHP and project staff will explore implementation of the needlestick prevention project in the Eastern Mediterranean Region in consultation with the newly appointed director of SIGN, Selma Khamassi, formerly of the EMRO office. 6) WHO Occupational health program will consult on health & safety education curriculum with the model health care waste management project between WHO, the UN Environment Program (UNEP).


The world’s 35 million healthcare workers.


This project advances the WHO’s efforts to reduce blood-borne pathogen infection due to needlestick injuries among health care workers in international settings. Findings will be disseminated relating to the risks encountered by individual workers. This project will adapt and translate a Toolkit, developed and tested by WHO in Asia and in Africa, to Latin America.

Dissemination Various approaches will be taken to announce the availability of products, as mentioned above. The availability of the Toolkit in Latin America will be announced on listservs in Spanish and English (Red de Seguridad y Salud de los Trabajadores, Duke Occupational and Environmental Medicine listserv), through the NIOSH eNEWS, and through PAHO, WHO and ILO email lists. The document will be available at the NIOSH, PAHO, and WHO Web sites and it should be identified in any search of “hepatitis”, “SIDA”, “inyecciones”, “herramientas” (Spanish for hepatitis, AIDS, injections, tools). Also, an overview will be presented at upcoming national and international public health meetings. Finally, two new booklets will be published in the WHO Protecting Workers Health series: 1) a summary of preventing needlestick injuries lessons learned and best practices and 2) a general summary of health hazards to health care workers and control measures


Global.

GPA1.9p

Formerly AA4:CE3g GPA Objective Objective 1: to devise and implement policy instruments on workers’ health CC or NGO Name WHO CC National University of Singapore

Project title Video-Conference Seminar on Usage of personal protective equipment for health care

workers

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Keywords Video-conference teaching, personal protective equipment;, health care workers Project leader Email address

Dr CHIA Sin Eng Email [email protected]


WHO CC, University of Occupational and Environmental Health, Japan (responsible person Dr Ken Takahashi) National Institute for Occupational Health (NIOH), South Africa

Other partners National Cheng Kung University and Medical Center, Taiwan (responsible person Dr Leon Guo )

Funding None. Funded by respective WHO CCs. Objective of the project To assist participants from developing countries on the different type of personal

protective equipment (PPE) that could be use to protect health care workers. To enable participants to choose the correct type of PPE and the right way of wearing it. To set an example for other WHO CC to use this method (Video-conferencing) to reach out to large number of participants without them having to travel to other countries for the training Builds on experience of 2005 in implementing tele-conference on occupational health among several of the above institutions.


Project Outcomes • HCW will know what type of PPE to use to protect themselves against different type of hazards at their workplace and how to wear them correctly • The lectures and discussion will be recorded in a CD and this will be given to the participants and any other WHO CCs who need it. • That other WHO CCs will also adopt this method of training for some of education packages. Deadlines We plan to have this one-day seminar in 2006 with a possible repeat in 2007 if there is a demand for it. The CD of the Seminar should be ready with a week from the date of the Seminar.


Health Care workers, particularly from developing countries


This Video-Conference Seminar includes lectures, forum and panel discussion among expert in this field from Singapore, South Africa, Japan and Taiwan. Speakers and participants will participate in the lectures, forum and panel discussion via video-linked with the respective countries. The Seminar will be recorded in CD and make available to all WHO CC who needs it.

Dissemination

Via WHO CC channels


Global as participants will be coming from different countries with a large portion from the developing countries.

Progress on Project Dr Mary Ross, the director of National Institute for Occupational Health (NIOH), South Africa has left NIOH. We are trying to reestablish contact again. Counterpart at National Cheng Kung University and Medical Center, Taiwan have left the university for National Taiwan University (NTU). We have established link with him at NTU. The International Society for Respiratory Protection (ISRP) have agreed to join us. It would be able to provide valuable assistance in producing training package for usage of respiratory and perhaps sponsored some N95 respirators for us in developing countries

GPA1.9q

Formally AA 4: CE5d GPA Objective Objective 1: to devise and implement policy instruments on workers’ health CC or NGO Name National Institute for Occupational Health (NIOH), South Africa Project title Prevention of Needlestick Injuries in Healthcare Workers

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Keywords Health, safety, needlestick, injury, healthcare workers, bloodborne diseases Project leader Email address

Ms. Busisiwe Nyantumbu [email protected]


NIOH, South Africa WHO

Other partners International Council of Nurses Democratic Nursing Organisation of South Africa Department of Health, South Africa SADC AIDS Network for Nurses and Midwives

Funding NIOH - as part of the overall project on healthcare workers managed by Prof. Mary Ross

Objective of the project Prevention of needlestick injuries and bloodborne infections in healthcare workers Project outcome(s) and deadline(s) for completion of the project

1. Produce piloted and tested materials from the WHO Injection Safety toolkit to educate and train healthcare workers 2006 2. Facilitate training of healthcare workers using these materials 3. Incorporate the materials in the curricula for medical students 4. Produce information materials (posters and brochures)


Healthcare workers including doctors, interns, registered nurses, student nurses, assistant nurses, general assistants and allied workers


Healthcare workers are exposed to many hazards. One of them is needlestick injury. Needlestick injury can transmit infections of bloodborne pathogens namely Hepatitis B (HBV), Hepatitis C (HCV) and the virus that causes AIDS (HIV). It is estimated that 2 million needlestick injuries occur in healthcare workers worldwide. The bulk of needlestick injuries occur in the developing countries. The global burden of acquired infections from occupational exposure including needlestick injuries is 40% HBV, 40% HCV and 2.5% HIV. This has implications on healthcare service delivery. Needlestick injuries can be prevented through education and training of workers. Therefore, the aim of this project is to use education and training of healthcare workers to prevent the occurrence of needlestick injuries and associated infections. Initially, this project is going to be conducted at the National Health Laboratory Services (NHLS) Laboratories followed by the public hospitals in South Africa and will also be appropriate for the SADC countries.

Dissemination Presentations at meetings and workshops of medical organizations, professional societies and unions

Impact (global or regional) Regional

Progress on the project The education, training and technical materials, which this project seeks to do is dependent on the WHO Pilot Project on the prevention of needlestick injuries in healthcare workers. In this pilot project, the WHO injection Safety toolkit was piloted in two health care facilities in South Africa. The aim of the pilot was to determine the effectiveness of the toolkit. The last part of the pilot which is crucial in deciding whether the toolkit works or not has not been done. At the end of June, the pilot project team is going to have a meeting to decide on the way forward and finalization of the polite. There is hope that the pilot project will be finalized before the end of 2007 which will pave way for the current project “Promotion of the Health and Safety of Healthcare Workers.”

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GPA1.9r Formerly AA 4:TM1b

GPA Objective Objective 1: to devise and implement policy instruments on workers’ health CC or NGO Name National Institute for Occupational Health (NIOH), South Africa

Project title Latex Allergy & Asthma – Risk management programme for healthcare workers

Keywords Latex, allergy, asthma, healthcare workers


Ms. Tanusha Singh [email protected]

Partners (of the CC Network) NIOH: South Africa University of Cape Town (UCT): South Africa

Other partners BGFA (Germany)

Funding

The project will be partially supported by NIOH, UCT

Objective of the project To develop a comprehensive latex risk management programme in public health care settings.


To develop a screening questionnaire for latex allergy (by end 2006) To develop a poster of the stepwise approach to diagnosing latex allergy (by end

2006) To develop an information sheet on latex allergy and its prevention directed at

employees and employers, available both electronically and in hard copy (by end 2007) Target group and/or beneficiaries

Healthcare facilities, clinics and dental institutions and laboratories, particularly in rural settings


The promulgation of health and safety regulations requiring employers to provide protective measures for their employees has led to an increased demand for latex gloves resulting in increasing incidence of latex allergy. Latex allergy has serious personal and health service consequences including potential work restriction and morbidity. This project aims to educate hospital management and exposed workers about latex allergy through implementing a latex awareness programme which includes an approach to diagnosis and management of latex allergy and asthma within public sector health services and laboratories in southern Africa.

Dissemination Through workshops with health service representatives and employees.

Impact (global or regional) Global – the intention is for the project to be a model for use in other countries. GPA1.9s

Formerly AA 4:TM1c GPA Objective Objective 1: to devise and implement policy instruments on workers’ health CC or NGO Name National Institute for Occupational Health (NIOH), South Africa Project title Enhanced diagnosis and management of pulmonary tuberculosis: flow sheet for

healthcare workers Keywords PTB, diagnosis, performance review Project leader Email address

Prof. Jill Murray [email protected]


Other partners Medical School, University of the Witwatersrand (South Africa) Funding

Objective of the project To update and ‘fine-tune’ the existing flow sheet for use internationally. Project outcome(s) and deadline(s) for completion of the project

An improved, internationally applicable one page evidence based flow sheet for the enhanced diagnosis and management of PTB. December 2007


All occupational health practitioners


Earlier studies explored an effective method for improving the diagnosis and management of PTB by identifying, producing and distributing appropriate educational material for the implementation of best practice. Process review was identified to be an effective way of developing successful practice habits.

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Implementation of the program in the South African mining industry resulted in significant improvement in the diagnosis of PTB. This project seeks to update the tool and to implement its use internationally.

Dissemination Web based Impact (global or regional)

Global

Progress on Project No update Progress on Project The tool has been updated to incorporate changes in management with respect to

Anti-retroviral therapy. The tool was presented in a workshop at the 38th Union World Congress on Lung Health in Cape Town in 2007 and currently is being used in an assessment of TB services in both South Africa and UK.

GPA1.9t

Formerly AA4:TM1e GPA Objective Objective 1: to devise and implement policy instruments on workers’ health CC or NGO Name • Andrija Stampar School of Public Health, School of Medicine University of

Zagreb, Zagreb, Croatia • Institute of Occupational Health, WHO Collaborating Center, Skopje, Macedonia

Project title COUNTRIES IN TRANSITION: HOW TO PROMOTE HEALTH AT WORK IN HEALTH ORGANIZATIONS

Keywords healthcare workers, stress at work, burn out, mobbing, work ability index, risk assessment

Project leaders Email address

• Professor Jadranka Mustajbegovic, MD, PhD [email protected] • Professor Jovanka Karadzinska Bislimovska,MD,PhD occhemed@on. net. mk,[email protected]


Institute of Occupational and Radiological Health, Beograd-Serbia & Montenegro

Other partners School of Medicine University of Tuzla, Department of Occupational and Environmental Health, Bosnia & Herzegovina

Funding Croatian and Macedonian Ministry of science; Croatian and Macedonian Ministry of health; Institute of Occupational Health, WHO CC, Skopje Macedonia; Macedonian Medical Chamber; Social partners.

Objective of the project To spread awareness, knowledge and skills in work-related stress within healthcare workers in tackle work-related stress; to co-ordinate stress risk assessment; to educate workers and management in health organizations how to work in partnership to address work-related stress throughout the organization; to provide some solutions & directions. Train the trainer materials, documents and materials


• To develop curriculum and toolkit to tackle work-related stress (by 2007); • To list the mayor stressors in healthcare workers (by 2008); • To assess stress and work ability index in the representative sample of healthcare workers (by 2009) international application or adaptation; • To create the stress guidance pack– curriculum for training and education (by 2010).


All workers in health organizations, especially health workers and health managers


Globalisation, process of transition, high rate of unemployment emphasized the problem of work-related stress in transitional countries. Stress, mobbing and burnout are believed to be due to bad work organization in healthcare services. Activities are designed to explore the major determinants of work-related stress in healthcare workers using European Foundation for Living and Working Environment methodology for workplace surveys developed. Develop common set of indicators and develop national plans of actions on work-related stress. Intercountry collaboration could take the form of regional fora: conferences, workshops in particular area of stress at work with participation of the social partners.

Dissemination Meetings and workshops of health care workers, health managers, health and labour administration; WHO/ILO documents;


Regional (countries)

Progress on Project Cross-sectional study was conducted in four clinical hospitals in Zagreb, over the 6

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months, ending January 2007. Self-reporting questionnaires about work-related stressors and Work Ability Index were completed by 395 physicians and 1086 nurses. Factor analysis classified the stressors into 7 groups: Work management and financial issues, Public criticism, Shift work, Professional demands, Interpersonal communication, Professional health hazards, Job dissatisfaction. Physicians reported organization of work, financial issues, public criticism, law suits, shift work, professional and intellectual demands as very stressful. Nurses with secondary school perceive all of the 7 groups of stressors more stressful than nurses with higher education. Hazards perception and dissatisfaction with job contribute to low (WAI<37), while professional and intellectual demands, and job satisfaction cause higher chance for a good and excellent work ability (WAI>37).


New Project 1.9u


HOW TO MAINTAIN HEALTH CARE WORKERS WORKABILITY AND QUALITY OF LIFE


GPA Objective 1 and Action 1.9

Priority Initiative Priority 1: Develop guidance for national action plans on workers’ health, including vulnerable groups


Andrija Stampar School of Public Health, School of Medicine University of Zagreb, Zagreb, Croatia


Professor Jadranka Mustajbegovic, MD, PhD [email protected]


Institute of Occupational and Radiological Health, Beograd, Serbia; [email protected] Institute of Occupational Health, Republic of Macedonia, WHO CC; [email protected] School of Medicine University of Tuzla, Bosnia and Herzegovina; [email protected]


WHO/Regional/HQ lead: dr. Ivan Ivanov, [email protected] WHO/EURO Centre for Environment and Health: dr.Rokho Kim, [email protected] WHO Liaison Officer in Croatia: dr. Antoinette Kaic-Rak, [email protected]


Croatian Ministry of Health and social Welfare: dr. Dunja Skoko-Poljak: [email protected]


IBG Institut für Humanökologische Unternehmensführung GmbH, dr. Rudolf Karazman, [email protected]


Research into workplace stress, work ability and quality of life indicates worryingly high levels of poor psychosocial health in the healthcare population as vulnerable group which is recognised by WHO. The need is to build a healthcare system compatible with the psychological, social and physical characteristics of the human beings, either patients or healthcare professionals, in order to improve work ability, quality of life and quality of patient’s care. To achieve this goal we need to determine factors that are associated with changes and preservation of healthcare professionals’ work ability, quality of life and to what extent.

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All workers in health organizations, especially health care workers/providers and health managers


Inter country collaboration could take the form of regional cooperation, e.g. conferences and workshops in particular area with participation of the social partners. Recognising these priorities on national and regional level can have great impact in promotion of health care workers mental health and healthy workplace, quality of patient’s care and patient safety.


The project will produce a guidance document which includes a range of successful initiatives adopted by Croatian Ministry of Health and Social Welfare in order to improve health care workers’ work ability and quality of life.


Expected direct outputs will be a developed toolbox of workplace-related indicator system for adequate assessing of hospital healthcare providers’ work ability and quality of life. Concept of educational contents and programmes for sustainable work ability and quality of life, strategic hospital management and healthcare providers will be developed.


2009.-2010. Developing toolkit, action plan and regional cooperation network, reaching hospitals, conduct surveys 2010.-2011. Analyzing collected data, publication of results, developing prevention plan 2011.-2012. Reaching hospitals management (meetings, workshops) and developing final guidance document on national and regional level.

Public health impact Health of healthcare providers, personal development and life quality represent a high value not only for employers but also for the health care system, for countries’ democratic sustainability and social coherence based on human sustainable development. Recognising these priorities on regional and national level can have great positive public health impact not only on health workers mental health preservation, but also on the improvement of patient safety.

Funding source(s) Croatian Ministry of Science, Education and Sports; Croatian Ministry of Health and Social Welfare; Social partners.

Dissemination Workshops; Publications; WHO/ILO documents; meetings;

GPA1.9v

Formerly AA4:TM1o


CC or NGO Name Federal State Scientific Institution Ufa Research Institute of Occupational Health and Human Ecology of Federal Service for Surveillance on Consumer Rights Protection and Human Well-being.

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Project title Assessment of the present working conditions and specific features of promoting health, safety and well-being in health care sector in the Republic of Bashkortostan

Keywords Working conditions, health promotion, occupational morbidity, occupational risks, prevention

Project leader

Email address

Director of the Ufa Research Institute of Occupational Health and Human Ecology, M.D., prof. Akhat B. Bakirov


Health Ministry and Academy of Sciences of the Republic of Bashkortostan

Other partners Regional Department of the Federal Service for Surveillance on Consumer Rights Protection and Human Well-being in the Republic of Bashkortostan;

Bashkortostan republican organisation of the Russian Federation of health care workers trade union

Funding Objective of the project The objectives of the project are to obtain better knowledge on the causes of

occupational diseases, to reduce occupational and work-related morbidity, to study working conditions influencing work ability, to identify individual risk factors of health care workers in the Republic of Bashkortostan


To develop a toolkit in the prevention of occupational diseases (by 2008)

To develop methodological materials for publication (by 2009)


The government of the Republic of Bashkortostan

Public health care Summary of the project (max 100 words)

The project focuses on assessment and analysis of workplace health promotion, safety and work ability in health care work environment depending on the occupation; general and occupational morbidity among health care workers; assessment of the immune status of the body and microflora of the mucous membranes of the nose and pharynx: development of early diagnostic methods of occupational diseases including allergic and infection genesis (tuberculosis, hepatitis, HIV); rehabilitation methods, criteria of occupational selection and occupational suitableness.

Dissemination WHO/ILO documents; methodologic recommendations (Ministry of Health); meetings in the trade unions of health care units.


Regional

Progress on Project No update GPA1.9w

Formerly AA6:SWI5 GPA Objective Objective 1: to devise and implement policy instruments on workers’ health CC or NGO Name Great Lakes Centers, University of Illinois, Chicago, USA Project title WHO/Trade Unions Network on Implementing Workers Health Initiatives Keywords Trade Unions, ICFTU, SustainLabour Project leader Email address

Dr Peter Orris [email protected]


UIC GLC WHO HQ Public Health and Environment

Other partners SustainLabour, ICFTU, TUAD ISTAS (proposed) ILO, ISSA, IFCS, SAICM, EU, UNEP, and OECD as well as under the WHO Commission on Social Determinants of Health (proposed)

Funding In Kind from Partners

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Project specific fund raising proposed

Objective of the project Support of the growing collaboration WHO and Trade Unions in the area of occupational health and safety and the Environment as a follow up of WILL2006 facilitating the transmission of WHO health information resources to work places throughout the world on areas of concern to workers


Specific collaboration between WHO and Trade Unions will be established in the short term on the following topics: • elimination of asbestos related diseases • prevention of chemical risks at the workplace • HIV/AIDS at the workplace • ICFTU’s national profiles for occupational health and safety • occupational health services • prevention of work-related stress • smoke-free and alcohol-free workplaces


Workers, their families, and communities


The project will coordinate the activities of interested collaborating centers with national and international trade unions and to participate in the growing WHO and other international organizations collaboration with global trade unions on issues of Health Safety and the Environment.

Dissemination The resources of the global unions will be enlisted to disseminate the products of this collaboration to workplaces throughout the world.


Global

PROGRESS ON PROJECT This project provides technical assistance to support collaboration between international groups. Progress includes the following:

ASBESTOS: A strategy meeting was held in Brussels in the fall of 2006 concerning the practical aspects of banning asbestos.

MERCURY : The World Medical Association at it's General Assembly in October of 2007 endorsed a resolution concerning removal of Mercury from health care and referred it for discussion to the national medical associations for final passage at the 2008 General Assembly.

Zero Waste/Recycling: Meetings were held in Geneva in October 2007 with Public Services International, an international trade union secretariat, concerning the development of an international trade union campaign in conjunction with environmental coalitions to promote recycling and a zero waste goal.

WHO-ITUC: A meeting was held in April of 2006 between representatives of the International Trade Union Confederation and SustainLabour with the leadership of the Public Health and the Environment Department of WHO. This resulted in an agreement for continuing collaborative work in the occupational and environmental arena.


New Project 1.9x


Establishing health and safety programs for health care workers in Vietnam





Project leader (contact name and email

Dr. Nguyen Duy Bao, Director, National Institute of Occupational & Environmental Health (NIOEH), 1B Yersin Str., Hanoi, Vietnam

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address) Email address: [email protected]


WHO Collaborating Centre for Occupational Health in Kytakyushu University of oOccupational and Environmental Health, Japan







The baseline studies were already conducted. Based on these results of the current situation of working conditions, occupational hazards, occupational diseases, work-related diseases in health care workers in Vietname, evidence-based tools and information materials wil be developed for the comprehensive protection and promotion of health for health care workers, emphasizing HBV immunization. Projects include guidance documents, implementing programs, and training on OSH for HCW.


Policy makers, occupational health and safety practitiioners, enterprise managers, health care workers



- Prevention model for infectious diseases in HCW will be developed and applied - Training materials will be developed and disseminated - Health criteria for pre-employment and periodic examination for HCW exposed

to radiation and microorgnism will be developed and promulgated


- 100% of HCW at the pilot health care facilities will be immunised hepatitis B and examined and detect occupational diseases

- 100% of HCW will be trained on OSH


Public health impact Workers’ health will be improved Funding source(s) Vietnamese Government Dissemination National policy, studies, workshop, training materials, WHO documents


New Project 1.9y


Training of trainers on the usage of respiratory protection for Health Care workers (HCW) in Cambodia who work with suspected avian influenza patients

GPA Objective and GPA Objective 1,

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Action Priority Initiative Priority 4, Project C Responsible CC or NGO Name

NUS


Sin-Eng CHIA, [email protected]


Catholic University, Korea, Prof Hyunwook Kim, [email protected]


WPRO Sharon Salmon, Technical Officer-Infection Control World Health Organisation [email protected]


Cambodia, Ministry of Health, Dr Sok Srun, [email protected]


Mr Simon Smith, International Society for Respiratory Protection (ISRP), [email protected] , Singapore International Foundation (SIF), Ms Phua Pei Pei, [email protected]


This pilot Respiratory Protection Program Training Course for Trainers course aims to

1) make available a set of training material, contextualize to Cambodia, on the usage of respiratory protection among Health Care Workers (HCW),

2) train group of trainers, selected by Ministry of Health, CDC, on the usage of different type of respiratory protection and the correct way of wearing and maintaining them,

3) provide the necessary type of respirator protection for the training Course and a set of the respirators to be use when managing suspected Avian Influenza


Health Care workers in Cambodia designated hospitals for suspected avian influenza


After the pilot programme, the approach, modified according to the review will be implemented in an expanding role as more trainers are engaged:

• Other healthcare facilities in Cambodia • Healthcare facilities in other countries – initial targets will be other south-east

Asian countries and Africa • Other industries requiring respiratory protection which are currently in need of

appropriate education.


We aim to train all the trainers in Cambodia designated hospitals for suspected avian influenza.


HCW in the Cambodia designated hospitals for suspected avian influenza would have the correct respirators and wearing them correctly.

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End May 09 – start of pilot 1 week training Course End May 10 – 2nd 1 week Training Course End Dec 10 – 3rd 1-week Training Course End May 11 – 4th 1-week Training Course

Public health impact If the training courses are successfully implemented HCW in the Cambodia designated hospitals for suspected avian influenza would be protected against infected with AI. This preventive measure would have empower the HCW to continue to provide health care services to the community which is so very important in a pandemic. There is the possibility that this program could also be replicated in other developing countries who have similar needs.

Funding source(s) SIF & ISRP

Dissemination Please indicate whether this is a:

Existing Project 1.10a


Establishment of malignant mesothelioma surveillance system



Priority Initiative Develop and disseminate evidence-based prevention tools and raise awareness for the elimination of asbestos-related diseases


CATHOLIC INDUSTRIAL MEDICAL CENTRE(CIMC), Korea


Hyoung Ryoul Kim, M.D. ph.D. e-mail: [email protected]


KOSHA(Korea Occupational Safety & Health Agency), Seong-Kyu Kang, Korea : [email protected]


SEARO


Labor ministry, Korea Jungyeon Kim, e-mail: [email protected]


Dewi Rahayu, Indonesia OSHA, E-mail:[email protected]


We already established malignant mesothelioma surveillance system. About 50cases are reported by pathologists in Korea(less than 1/million). However MM is expected to increase considering the former use of asbestos in Korea. We will try to estimate the peak time for prevention and making proper policy. And we will make special acts for compensation in the patients who can’t verify their work-relatedness. In Indonesia, asbestos textile factories are operating now. These factories were moving from Korea and Japan. We have a plan to support the screening system of asbestos related disease in Indonesian workers. And we also try to support the innovation of

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the workplace environment. Target group and/or beneficiaries

General population, former high exposed group, the patient having asbestos related disease


Making homepage or blog for assisting the patient and communicating with other researchers


1. Making Special acts for compensation in the patient who can’t verify their work-relatedness

2. Estimation of the peak time in Malignant mesothelioma Indicators of achievement (impact)

Publication of the report and article


1. DEC. 2009. : supporting the screening system of asbestos related disease in Indonesian workers

2. DEC.2010: Making special acts for compensation for environmental asbestos related disease

3. DEC. 2012. : Estimation of the peak time of MM in Korea Public health impact Informing the public of the risk of asbestos Funding source(s) KOSHA

Dissemination - Results will be submitted to relevant journals for publication - Presentation at relevant conferences and meetings - Reports


New Project 1.10b


The national strategic plan and action for prevention and control of asbestos related diseases in Thailand


GPA Objective 1 :Devise and implement policy instruments on workers’ health, Action 1.10

Priority Initiative Yes Responsible CC or NGO Name

Bureau of Occupational and Environmental Diseases, Ministry of Public Health, Thailand


Dr. Somkiat Siriruttanapruk [email protected]


UOEH (Japan), KOSHA and CUK (Korea), NIOEH (Vietnam)


WHO (SEARO and Geneva)


Ministry of Public Health, Ministry of Labour, Thailand


-


Thailand is currently the world 4th largest importer of asbestos. This will be

one of the most important public health problems in the country in the near future. The aims of this project are to implement and support the national strategic plan and action for prevention and control of asbestos related diseases in Thailand.

Asbestos has been imported to Thailand for more than 40 years for use by several industries. In 2006, the amount of imported asbestos was approximately

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140,000 Tons. There were at least 16 asbestos–using factories with 1,800 exposed workers in the country. With the support of international agencies, such as ILO and WHO, Thailand had already set up and developed the national strategic plan and action for control and ban of asbestos/Elimination of asbestos related diseases. The plan consists of 4 main topics including: 1) Workers and public protection, 2) Prevention, control, and ban of asbestos use in industries, 3) Collaboration among relevant organizations at all levels, 4) Improvement of disease diagnosis and surveillance.


Workers who are exposed to asbestos in their working environment, Public who use asbestos containing materials


National and international meeting


1. Description of the asbestos situation at national and local level 2. Implementation of some control measures


Reduction of asbestos use in the country


2009: Labeling of warning sign on asbestos containing products 2010: Development of asbestos related disease surveillance system 2012: Number of asbestos used dropped by 25%

Public health impact Prevent and control of asbestos related diseases for high risk workers and public

Funding source(s) Thai government budget, WHO (Thailand)

Dissemination Thailand and Internationally Please indicate whether this is a:

New Project 1.10c


Asian Asbestos Initiative

GPA Objective and Action 1: Devise and implement policy instruments on workers’ health Priority Initiative 3: Develop and disseminate evidence-based prevention tools and raise

awareness for the elimination of asbestos-related diseases (Action 1.10) Responsible CC or NGO Name

Institute of Industrial Ecological Sciences (IIES), UOEH, Japan


Ken Takahashi [email protected]


National University of Singapore; National Institute of Occupational & Environ Health, Vietnam; Catholic University of Korea, KOSHA; Ministry of Public Health, Thailand


WPRO (Dr. Hisashi Ogawa [email protected]), SEARO


Ministry of Public Health, Vietnam (Dr. Tran Thi Ngoc Lan); Ministry of Public Health, Thailand (Dr. Somkiat Siriruttanapruk); Ministry of Human Resources, Malaysia (Dr Amin Faridah)

External partners for this CONTRIBUTING project (contact name,

ILO (Dr. Igor Fedotov [email protected]); Liaoning Province CDC, China; Wenzou Medical College, China; Srinakarinwilot University, Thailand, University of Malaya, Malaysia

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organization and email) Summary of the project (max 100 words)

Identify and share technologies for prevention of asbestos diseases at all 3 levels of prevention in recognition of the variable national phases in terms of asbestos use and recognition of asbestos diseases. In particular, produce training materials (eg, video) for the effective expert training of relevant experts at all 3 levels of prevention. Formulate a model from which other parts of the world can benefit.


Beneficiaries are countries (practitioners and administrators) currently depending on asbestos use which should be expecting an unfolding of asbestos diseases soon


Annual National Seminars (2008 done, 2009 planned in Thailand, 2010 planned in Kitakyushu)


Development of training tools for prevention (eg, video); Holding of International Seminars; International Training Sessions


Surveillance system of asbestos exposure and ARDs installed


By 2010, complete national profiles on asbestos use and ARDs; By 2011, initiate surveillance system of asbestos exposure and ARDs

Public health impact Prevention of asbestos diseases and transition to asbestos-free societies

Funding source(s) Japan Society for the Promotion of Sciences (JSPS)

Dissemination Training materials (eg, video) Please indicate whether this is a:

New Project 1.10d


Detection of impaired lung function in early stages of asbestosis by means of gas diffusion parameters

GPA Objective and Action Objective 1; Action 1,10 Priority Initiative Responsible CC or NGO Name

Institute of Occupational Medicine and Maritime Medicine, Hamburg, Germany


Alexandra Preisser, MD Mail: [email protected]


Centre for Occupational Health at the National Institute of Public Health, Prague, Czech Republic


Europe


Ministry of Health, Germany


Not at all

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Lung fibrosis and pleural plaques are frequent findings in asbestos workers. Asbestosis results in a restrictive ventilation pattern with decreases of diffusion capacity and lung compliance. The effect of pleural plaques on the gas diffusion, measured as CO diffusion capacity (DL,CO) is controversially discussed. Our aim is to objectify functional impairment of pleural plaques and initial parenchymal fibrosis by means of DL,CO, the new analyzing method DL,NO, and the alveolar-arterial PO2 difference in the exercise test (spiroergometry). The data will be compared with results from spirometry, compliance, chest X-ray (CT, when available) and the estimated cumulative asbestos dose.


Workers previously occupationally exposed to asbestos in shipyards and other industries


Development of a sensitive diagnostic tool for asbestos-induced plaques and asbestosis at early stages


Description of the best method for measurement of impaired gas diffusion in the lung already detecting initial changes in lung function


Evidence-based recommendations for detecting early stages of asbestos-related benign lung disorders


Examination of 100 former asbestos-exposed workers with lung function analysis and chest x-ray (2009); Statistical analysis of the data (2010); Analysis and publication of the data and recommendations (2012)

Public health impact Global Funding source(s) No funds Dissemination Results and recommendations will be published in workshops and international

journals

GPA1.10e Formerly AA2:NP13

GPA Objective Objective 1: to devise and implement policy instruments on workers’ health CC or NGO Name National Institute for Occupational Safety and Health (NIOSH)

Project title Best laboratory practices globally for analysis of crystalline silica

Keywords Crystalline silica analysis, exposure assessment, silicosis


Dr Rosa J. Key-Schwartz, Ph.D. [email protected]

Partners (of the CC Network) WHO, ILO, PAHO, ISP (Chile), NIOH (South Africa) FUNDACENTRO CC Programme [Ana Maria T. Bom [email protected]]

Other partners International Standards Organization (ISO), ASTM International Standards (ASTM), U.S. Occupational Safety and Health Administration (OSHA), U.S. Mine Safety and Health Administration (MSHA), Wisconsin Occupational Health Laboratory (United States)

Funding

NIOSH

Objective of the project This project will establish best laboratory practices for precise and accurate exposure assessment for crystalline silica in collaboration with national and international partners.


To provide standardized guidelines to developing countries for exposure assessment studies used in silicosis prevention initiatives (by 2008)

To assist laboratories in developing countries in implementing quality assurance programs and in applying for laboratory accreditation (beginning in 2006)

To train laboratory chemists in running standardized analytical methods for crystalline silica exposure assessments (beginning in 2006)

To publish ISO/ASTM Guidelines for Quality Assurance and Method Selection for Crystalline Silica Analysis (by 2010)

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Laboratories in developing countries and national laboratories seeking to comply with ISO standards and guidelines (e.g., the European Union) for analysis of crystalline silica for exposure assessments studies


To collate data on laboratory practices in order to reach consensus on best practices for precise and accurate exposure assessment for crystalline silica in support of silicosis prevention programs. Specific aims include:

Development and publication of evidence-based guidelines for best laboratory practices and analytical method selection via the mechanisms of ISO and ASTM

Facilitating exchange of information and resources through international linkages (e.g., coordinated videoconferencing, developed and developing countries “twinning)

Developing print and electronic resources (NIOSH web page, CD-ROM) to provide analytical laboratory information and utilizing networks and partnerships for translating and disseminating materials to a broader audience

Dissemination Dissemination will be accomplished through multiple routes including: ISO Guidelines ASTM Guidelines ASTM symposium (planned for 12/08) IOHA presentations NIOSH web site for silica will include information on analytical methods and

quality assurance programs Impact (global or regional) Global and regional Progress on Project (max 100 words)

ISO work: Project leader for the ISO work on guidance has been agreed and draft guidance is in progress. ASTM work: Involvement with industry is proving successful in the development of guidance and definitions related to air quality and bulk materials. Training and QC schemes relating to analytical methods for exposure monitoring and assessment have been implemented across South American countries using new equipment sourced for this purpose.

GPA1.10f Formerly AA2:RS4

GPA Objective Objective 1: to devise and implement policy instruments on workers’ health CC or NGO Name Center for Occupational Health at the National Institute of Public Health, Prague, Czech

Republic Project title Lung function reduction associated with different levels of occupational exposure to

asbestos particles. Keywords asbestos, occupational exposure, lung functions Project leader

Email address

MUDr. Lenka Rychlá

[email protected] Partners (of the CC Network) Other WHO CC engaged in the same topic Other partners 1. Department of Occupational Medicine, 1st Faculty of Medicine, Charles University, and

General Teaching Hospital, Prague

2. Department of Biostatistics and Informatics, National Institute of Public Health, Prague

Funding State budget and grant projects Objective of the project To study development of lung functions changes following exposure to asbestos Project outcome(s) and deadline(s) for completion of the project

• Selection of study subjects from the database of former workers occupationally exposed to asbestos by beginning of occupational exposure (2006).

• Entry and processing of follow-up data from lung function tests and chest films (2007-2009).

• Statistical analysis of data and final assessment of reduction of selected lung function parameters in study groups. Integration of results for estimate of postexposure

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progression of lung function damage (2009-2010).


• Retired and former workers occupationally exposed to asbestos in an asbestos processing plant in the Czech Republic under different conditions of particulate matter air pollution.

• Group 1: workers occupationally exposed to asbestos since 1975 • Group 2: workers occupationally exposed to asbestos since 1976 - 1996. • Groups 1 and 2 were selected so as to reflect conditions prior to and after the

implementation of effective measures against airborne particulate matter at the asbestos processing plant, respectively.


Assessment of changes in selected lung function parameters in workers occupationally exposed to asbestos at an asbestos processing plant in the Czech Republic who started their job under different conditions of particulate matter air pollution at workplaces. Estimate of the progression of lung function damage in these workers over postexposure years. The results obtained would be a key to the implementation of preventive measures for reducing occupational risk and follow-up check-ups in the occupations and countries where asbestos has still been processed.

Dissemination WHO documents, scientific meetings and publications Impact (global or regional) Both regional and global


Over 2006, records of 615 persons were studied for the purpose of this work. From this, 331 subjects have been investigated for whom at least 2 lung function examination results were obtained at an interval of not less than 1 year. These subjects were then divided into 2 groups to reflect the conditions prior to and after the implementation of effective measures against airborne particulate matter at the asbestos processing plant: Group 1: workers occupationally exposed to asbestos until 1975 Group 2: workers occupationally exposed to asbestos from 1976 to 1996. Data has been entered into an appropriate statistical program throughout 2006 for analysis.

GPA1.10g Formerly AA2:RS5

GPA Objective Objective 1: to devise and implement policy instruments on workers’ health CC or NGO Name CATHOLIC INDUSTRIAL MEDICAL CENTRE(CIMC), Korea Project title Establishment of infrastructure to evaluate the risk of asbestos exposure Keywords Asbestos, Infrastructure Project leader

Email address

Hyunwook Kim, Ph.D

e-mail: [email protected] Partners (of the CC Network) Morimoto Y, Japan : UOEH Other partners Funding

- Research and grant proposal

- Governmental assistance

- Contracts with companies Objective of the project Prevent asbestos related disease through educating risk of asbestos and establishing

infrastructure to control asbestos exposure Project outcome(s) and deadline(s) for completion of the project

- Establishing educational institute for asbestos

- Training laboratories dealing with asbestos and making accreditation system

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- Development of substitute for asbestos to prohibit the use of all asbestos

Deadline: 2009.12 Target group and/or beneficiaries

Workers exposed to asbestos and general population in the face of environmental exposure of asbestos


This project is conducted to minimize and prevent asbestos related disease in Korea. We estimated the increase of this kind of diseases like asbestosis and mesothelioma. Our estimation became true, so, a lot of cases of mesothelioma are being reported in Korea. First of all we considered establishing infrastructure for asbestos as the most important thing to solve this problem.

Now we collaborate with Korean government(Ministry of Labor) about this project. Dissemination - Results will be submitted to relevant journals for publication

- Presentation at relevant conferences and meetings

- Reports Impact (global or regional) Global Progress on Project (max 100 words)

1. Report submitted to the Ministry of Labour recommending expertise, guidance, training and ban on use/import of asbestos products (to be actioned in Korea by 2009). 2. Ministry to create provision/training/etc in 2006 for asbestos demolition/clearance workers. 4. Microscopy course designed for analysts and quality control scheme established. Grant proposals submitted to support (due March, 2007). 5. Steps taken to collaborate with other WHO partners.

GPA1.10h Formerly AA2:RS6

GPA Objective Objective 1: to devise and implement policy instruments on workers’ health CC or NGO Name Institute of Occupational Medicine Project Title Consistency in laboratory analysis of samples to determine airborne concentrations of

asbestos and other fibres. Keywords Asbestos fibres, mineral fibres, fibre counting, proficiency testing, Fibre counting rules Project leader Email Address

Dr Alan Jones

[email protected] Partners (of the CC Network) HSL/HSE (UK); Catholic Institute of Industrial Medicine (Korea); National Institute for

Occupational Health (South Africa) Other partners Funding Participant laboratories in the proficiency testing schemes, and UK Health and Safety

Laboratory/Executive. Objective of the project The project will seek to improve and maintain the consistency between laboratories

nationally and globally in the analysis of samples to determine airborne concentrations of asbestos and other fibres. One of the factors that may affect consistency is a change in the method for the analysis: the WHO-published all-fibre counting method becomes the standard method in Europe in 2006. The change in technique may be reflected in data reported by laboratories. The data will be examined to assess the effect of the change.


The outcome should be the improvement and maintenance of consistency between laboratories in the counting of asbestos and other fibres (ongoing). A specific outcome will be an assessment of the effect of the change to a new method of fibre counting as the standard method in Europe. A paper on the progress and findings will be produced (2008).


The health and safety professionals involved in measurement of asbestos fibres, the people who rely on those measurements being consistent.

Summary of the project (max Concentrations of airborne asbestos are determined by counting of fibres under phase

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100 words) contrast optical microscopy. Proficiency testing (PT) checks that laboratories are producing consistent results. This is needed as large differences between analysts and laboratories can occur. During 2006, adoption of the WHO all-fibre counting method will affect the count that should be obtained on some samples. In the UK, laboratories are being helped prepare by a special training exercise. The international PT schemes will have to allow for laboratories switching to new counting rules. PT results will be analysed to determine progress.

Dissemination By communications to laboratories worldwide, by reports, and by published paper(s). Impact (global or regional) Global Progress on Project (max 100 words)

In November 2006, operation of the UK fibre proficiency testing schemes transferred to HSL. IOM remains closely involved. The training (for PT labs) helped a smooth transition to the new WHO-published counting method. We will collaborate with HSL on a paper reporting the change and its effects.

The international PT schemes have continued, with some new members, including HSL, and the format of reports to participants has been improved. International contacts have continued, with successful visits to IOM in 2006 from WHO-CCs in Korea (Catholic University) and South Africa (NIOH). A larger Korean delegation will visit IOM in July 2007.

GPA1.10i Formerly AA3:S1


CC or NGO Name National Institute of Occupational Health, Ahmedabad India.

Project title Development of Risk Management Toolkit for Silicosis in Small Silica Flour Milling Units

Keywords Silicosis, Silica Flour Mills, Technology, Toolkit


Dr L J Bhagia [email protected] Project Manager NIOH and Dr S K Dave [email protected] Director, NIOH. Dr Habibullah N Saiyed, (Past Director, NIOH) [email protected]


CC: Dr Andy Cecala National Institute of Occupational Safety and Health (NIOSH) (Pittsburgh Laboratory) USA. Dr Richard W. Niemeier, Education and Information Division NIOSH (Cincinnati)

Other partners

Prof Scot Clark - University of Cincinnati USA Department of Labour Govt of Gujarat Department of Labour Govt of Rajasthan Association of silica flour manufacturers.

Funding Ministry of Health Govt of India (First year) Indian Council of Medical Research (2nd and 3rd year) National Institute of Occupational Safety & Health USA (for the visit of US scientists)

Objective of the project To develop toolkit for control of silica dust for small silica flour mills.

Project outcome(s) and deadline(s) for completion of the project Target group and/or beneficiaries

• Development of a toolkit for dust control for small silica flour mill units that will be readily usable by 2008. • Disseminate the information to the beneficiaries through pamphlets, internet etc. after successful development of the toolkit. By 2009. Small silica flour mill units in India initially and subsequently similar units in the other developing countries in the rergion.

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NIOH studies have shown that about 50% of the young workers develop accelerated silicosis/silico-tuberculosis within 2-3 years of exposure. With the local expertise, we devised dust control techniques which could reduce the air borne silica dust up to 95%. Under the Indo-US collaborative research programme we are now developing silica control tools which are suitable for the small silica flour mills in India and other developing countries. The intervention measures based on toolkit will be implemented in few selected factories. There will be periodic monitoring and modification based on the feed back.

Dissemination State the method of disseminating the project outcomes. For example: WHO/ILO documents; university studies; worker and enterprise meetings

Impact (global or regional) Region


Indo-US workshop on Practical methods of silica dust Control was organized at Beawar, India from 17-18 January, 2006 where factory owners , supervisors and factory Inspectors from Gujarat and Rajasthan states participated. US team was represented by Dr.Clark, Dr.Rice from Cincinnatti and Mr.Andy Cecala from NIOSH. A workshop was followed by an awareness programme for workers. A booklet giving details of silicosis and its control and general work practices in Hindi was published and distributed to all participants and workers. Later on ,CDs of all the presentations and recommendations of the workshop were sent to all the participants. After the work shop, one mill owner at Godhra(Gujarat ) was encouraged with the help of Director, Industrial Health and Safety (DISH ),Gujarat and he volunteered for new set-up including most of the recommendations of the workshop. New set up will have ramp, hopper ,crusher with dust control, covered conveyor belts. All dust generation points like hammer mill , magnetic seperator, rotary screen etc. will be connected to bag filter and fan with duct work. Installation will be completed by September 2007.Dust monitoring will be carried out after September 2007.

GPA 1.10j Formerly AA3:S2


CC or NGO Name FUNDACENTRO Project title National programme on elimination of silicosis – Brazil (NPES-B) Keywords silica, silicosis, elimination Project leader Email address

Eduardo Algranti MD, DPH, Division of Medicine [email protected]


NIOSH PAHO

Other partners Ministries of Labour and Employment, Health, Social Security, Department of Justice, PAHO and ILO/Brazil

Funding Fundacentro, Ministries of Labour and Employment, Health, Social Security, Department of Justice, PAHO and ILO/Brazil


To reach a significant reduction in incidence of silicosis by 2015 To eliminate silicosis as a public health problem by 2030


The NPES-B’s proposal involves a cooperative participation of the government, represented by the Ministries and the international organizations. The program is run by a Managerial Group, formed by a member of each of the participating institutions, by the consultants and managers of the Sector Groups described as follows:

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Mining and mineral processing Ceramic and glass Metallurgy Construction industry Between 2005 and 2007 we intend to consolidate the Sectoral Groups. Each SG is going to establish a tripartite or quadripartite discussion with a view to selecting action wise priorities, implantation of strategies and maximizing NPES-B action in different regions of Brazil. Sectoral agreements are our top priority and may be achieved through: Changes in legislation Collective Agreements Specific Research Educational Actions


Mining and mineral processing Ceramic and glass

Metallurgy Construction industry


The National Program for the Elimination of Silicosis, Brazil (NPES-B) started in mid 2002. The NPES-B has developed an array of actions under the designation of Policy and Legislation, Information, Education and Research tailored for application in the sectoral groups (see above) in observance of parameters of risk magnitude, sector awareness and priorities. The Sectoral Groups (SG) were established with the purpose of having NPES-B’s actions applied correctly, each one sector’s peculiarities taken into consideration, thus making possible necessary adaptation, since there is an understanding that the risk of exposure to silica is distinctive in those areas. Every SG has a manager who is in charge of coordinating the specific activities within each group. The main goals reached so far are: The signature of bilateral Memoranda of Understanding for technical cooperation between FUNDACENTRO and the Ministries of Labor and Employment, Health, Social Welfare and Public Counsel, and also with the ILO/Brazil An estimation of the potentially exposed population by economic sectors through a job exposure matrix method A ban on the use of sand as a blasting agent in the Brazilian territory The development of a programme website

Dissemination The NPES-B brings a novel approach for silicosis elimination. We intend to disseminate our national experiences to other countries with similar profiles of limited resources (both human and material) but with a potential of implementing good work practices.



• Meeting at the Instituto de Salud Publica, Chile in September 2006 with ISP and NIOSH to define forms and extent of collaboration

(Meeting report probably made by NIOSH) • Training course in the ILO 2000 Classification of Radiographs. Fortaleza, 31st

Oct – 2nd Nov. Participation of ILO. Attended by 25 physicians (22 from Brazil and 3 from Angola) with an international faculty from Brazil, USA, Germany and Switzerland.

• Contributing text for the NIOSH proposal of Silicosis Elimination in the Americas The text focused on the situation of silica exposure and silicosis in Brazil, and possibilities of collaboration within the American continent

• Workshop on the Prevention and Control of Occupational Exposure to Dust (PACE)for Portuguese speaking countries, with the participation of SENAC/Brazil, SESI/Brazil, INSA/Portugal and NIOH/South Africa. São Paulo, 5-6 Dec

• Upload of relevant publications in Portuguese dealing with silica and silicosis into the GEOLIBRARY

GPA1.10k Formerly AA3: S3

GPA Objective Objective 1: to devise and implement policy instruments on workers’ health CC or NGO Name National Institute for Occupational Safety and Health (NIOSH)

Project title Development and implementation of Silica Control Tool Kits for priority exposure situations in the Americas

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Keywords Control banding, risk management, intervention effectiveness, controls, silica, silicosis, Americas


TJ Lentz [email protected] Aaron L Sussell [email protected] IOHA Dave Zalk [email protected]


Instituto de Salud Publica (ISP) Chile and WHO and PAHO and ILO, Fundacentro, IOHA

Other partners Health ministries in region: Chile, Brazil, Colombia, Argentina, Peru, Venezuela and Mexico

Funding NIOSH and partner countries


To assist countries in the Americas focus scarce occupational health resources where they can be most effective in reducing hazardous silica exposures in high-risk industries. This will enhance global safety and health through international collaborations and increase the capacity of health ministries in the region to evaluate and control silica hazards. The project will also show the effectiveness of the control banding approach in developing countries.


• Assist Chile to select high-risk industries and common processes within those industries for control banding intervention (by 2006) • Assist Chile to assess the baseline silica exposure levels in those processes (beginning in 2006). • Assist Chile to develop and implement a region-specific Silica Toolkit for risk management in two targeting industries – mining and quarries (beginning in 2006) • Evaluate the effectiveness of implementation of the Silica Control Toolkit in Chile and modify it based on results (by 2007) • Assist Chile and other countries in the region to develop technical capability to evaluate controls and intervention effectiveness (starting 2006) Replicate the Silica Control Toolkit in other industries in Chile and in other countries in collaboration with health ministries in region (by 2009)


All enterprises in mining and quarries – especially those where expertise is missing such as SMEs. Ministries of health in the Andean region. Other countries with similar exposure situations.


Silicosis remains a persistent public health problem. In Latin America, millions of workers are at risk of developing the disease due to uncontrolled exposures. This project is designed to increase technical knowledge and professional capacity in participating government Health Ministries for silica exposure assessment, industrial hygiene, and implementation of effective controls. The project is directly related to WHO, ILO, PAHO and NIOSH strategic goals.

Dissemination Publication of a Silica Toolkit that will present control banding approach for high-risk silica exposures in the Americas.

Impact (global or regional) Global


In July 2007, NIOSH co-organized and co-chaired with the Chilean Institute of Public Health (ISP) a 3-day Control Banding Workshop for Chilean, Brazilian, and Peruvian experts who developed simple and inexpensive control guidance for small businesses in brick-making and stone-crushing industries. Part of the effort involved the introduction and ongoing evaluation of a hazard assessment and risk management tool developed by the ISP for specific tasks and industries. In September 2007, another NIOSH team made a series of initial and follow up field visits with ISP staff to observe processes and work activities in the Santiago region with high-risk occupational exposures to respirable crystalline silica, focusing on general industry and on mining.

GPA1.10l Formerly AA3:S4


CC or NGO Name Institute of Public Health, Chile

Project title Implementation of Control Banding Methodology for Silica Control

Keywords silica, silicosis, control banding

Project leader Email address Rodrigo Solis – [email protected] Juan Alcaino – [email protected]

Partners (of the CC Network) NIOSH

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Other partners Comunidad Andina. Instituciones responsables de la salud de los trabajadores de los países de la región.

Funding Instituto de Salud Pública; Niosh

Objective of the project to implement new qualitative assessment methodologies and silica control

Project outcome(s) and to train Chilean professionals in control banding (2006), to train

deadline(s) for completion of the project

employers and workers involved in the project (2006-2007), to develop an implementation manual for silica control banding (2006-2007), to contact other countries of the region interested in implementing control banding (2007)

Target group and/or beneficiaries Workers exposed to silica dust


to contact, select and recruit factories (business) willing to participate in the project, take videos from that factories (business) and send them to Niosh. Niosh will review the videos, make decision on target processes and write down together with Instituto de Salud Publica the Silica Tool Kit for Chile. Niosh teaches Control Banding Methodology in Chile, ISP take air samples prior and post application of the methodology to study the effect. This is a 2 year project: first year focused on mining and quarries and second year on dental labs and stone art craft.

Dissemination training course to Chilean professional and, later on, to other countries interested in.



Instituto de Salud Publica has worked on (until May 2007): -Translating into Spanish of HSE silica guidance sheets. -Visiting industries of pilot project (stone crushing station). -Designing and application of a qualitative diagnostic sheet related to the exposure to silica in stone crushing station. This methodology will be validated with NIOSH. In this point, ISP is designing control sheets for stone crushing station. -Training of employers and employees about respiratory protection. -Coordinating the second Control Banding Course in Chile.

GPA1.10m Formerly AA3:S5


CC or NGO Name National Institute for Occupational Health (NIOH), SA

Project title SA Silica Pilot Project - Silica Exposure Reduction using Occupational Risk Management Modeling (control banding) in quarries

Keywords Silica, Quarry, ’Control Banding’, and Good Practice

Project leader Email address Mr. Rob Ferrie [email protected] Mr. Kevin Renton [email protected]

Partners (of the CC Network) HSE – UK, NIOSH – USA, WHO

Other partners Occupational Health Management Board, Zambia Quarry Associations in Southern Africa

Funding Funding is being negotiated through NIOH (South Africa)

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The objective of this study is to evaluate whether the silica control tool, Silica Essentials, that is being developed by the British Health and Safety Executive (HSE) is appropriate and suitable for use in Southern African quarries.


• To report findings in South Africa (mid 2007) • Development of case studies and success stories (end 2008) • Compile international evaluation of the method (2009)

Target group and/or beneficiaries All enterprises – especially those where expertise is missing such as SMEs


Silica Essentials includes an extensive set of proven control methods for quarries. A sample of eight quarries (four in Gauteng and four in Western Cape) have been selected for the study from the list of quarries registered with the Department of Minerals and Energy (DME). At each quarry the work methods will be observed and personal exposure to respirable crystalline silica measured. The type and effectiveness of the control measures in place will be compared to that given in Silica Essentials. The results will be evaluated by relating exposure to the observed control practices.

Dissemination A scientific report – written and in video format - to be disseminated electronically, and a journal article to be submitted for publication in the hygiene literature.



Respirable crystalline silica exposures have been measured at two stone and two sand quarries in Gauteng, South Africa. It was found that a simple checklist method of determining the number of control recommendations in place did not correlate well with the measurements of respirable crystalline silica dust or the subjective opinions of the mining inspectorate.

Two presentations have been delivered: IOHA 6th International Scientific Conference, held in South Africa September 2005 http://www.saioh.org/ioha2005/Proceedings/PPT/SSI/I2_3PPTweb.pdf A workshop on control banding organised by the South African Department of Labour at Boksburg on the 22-23 March 2006

GPA1.10n Formerly AA3: S7


CC or NGO Name Department of Occupational Health, Fudan University, Shanghai, China Project title Identifying Risk Factors for Pulmonary Tuberculosis in Chinese Miners Affected by Silicosis:

A Combined Effect of Pathogen, Occupation and Host Genetic Susceptibility

Keywords Pulmonary Tuberculosis, Silicosis, Occupations, host Genetic Susceptibility


Zhaolin Xia Email address: [email protected]


Other partners Maanshan Coal Mine Hospital

Funding Each collaborating partner is responsible for its respective costs

Objective of the project To evaluate the dose-response relationship between cumulative silica exposure and prevalence of silicosis in miners To evaluate the dose-response relationship between cumulative silica exposure and prevalence of silicosis in miners; To carry out a case-control study about the possible risk factors of silico-tuberculosis; To detect the

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distribution of single nucleotide polymorphisms (SNP) of candidate genes. To calculate the Attributable Risk of specific genotype to silicosis and Pulmonary Tuberculosis.


the interaction of pathogen, occupational factors and host genetic susceptibility will be studied in order to perform individual risk assessment in workplace. the deadline: December 2008


Coal miner


In order to identify current status of the prevalence of tuberculosis in silicosis, a case-control study will be carried out about the possible risk factors of silico-tuberculosis. The distribution of single nucleotide polymorphisms (SNP) of candidate genes will be detected to calculate the Attributable Risk of specific genotype to silicosis and Pulmonary Tuberculosis.

Dissemination publishing papers and project reports Impact; global/regional Global


A paper “Genetic Polymorphisms in Alveolar Macrophage Response-Related Genes and Risks of Silicosis, Pulmonary tuberculosis in Chinese Iron Miners” will be published in Int. J. Hyg. Environ. Hlth

GPA1.10o

Formerly AA 4: CE3e GPA Objective Objective 1: to devise and implement policy instruments on workers’ health CC or NGO Name National Institute for Occupational Health (NIOH), South Africa Project title Training on asbestos and its identification Keywords asbestos, microscopy, identification, crocidolite, amosite, chrysotile, tremolite-actinolite. Project leader Email address

Dr. James Ian Phillips [email protected]

Partners (of the CC Network) HSL, UK Other partners University of the Witwatersrand, School of Public Health, South Africa

Relevant partners as required

Funding NIOH

Objective of the project To increase knowledge and capacity to identify asbestos in the SADC region Project outcome(s) and deadline(s) for completion of the project

• Develop training materials and training course content (during 2006) • Present the training courses (2007) • Establish a regional reference and training centre in conjunction with the Occupational Hygiene Section of the NIOH (2008)


Occupational and Environmental Hygienists


Because of the potential of asbestos to cause adverse health effects, there is a need to identify asbestos in the workplace and the environment. The techniques used at the NIOH are of international standard. The capacity to perform asbestos analysis is not available in all parts of the region. Simpler, less costly methods can be useful in determining the presence of asbestos and determining its type. The workshop aims to increase the capacity to identify asbestos in the region.

Dissemination - SADC Region - Associations of occupational and environmental hygienists

Progress on Project Agreement has been reached by the cooperating centres – NIOH and HSL to conduct a workshop in September/October 2008. The workshop will be held at the NIOH Johannesburg and a representative from the HSL, Barry Tylee will be coming to Johannesburg to assist with the workshop. A smaller, local workshop is being piloted on the 8th Novemebr 2007. It is hoped that feedback from this workshop will assist in the content of the WHO collaborative w/s.

GPA1.10p Formerly AA4:CE3i

GPA Objective Objective 1: to devise and implement policy instruments on workers’ health CC or NGO Name Instituto de Salud Publica de Chile

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Project title Promoting a Regional Diagnosis of exposure to silica.

Keywords Diagnosis, silica, exposure, evaluation Project leader Email address

Juan Alcaíno - [email protected] Juan Ferruz – [email protected]

Partners (of the CC Network) Other partners Andean community. Institutions responsible for the health of workers in the region

Andean community. Funding

Instituto de Salud Publica de Chile

Objective of the project To make technological transference to the countries of the Region for the elaboration of a national diagnosis of exposure to silica.


To train in topics like criteria and strategies of sampling, chemical analysis of samples, to offer the participation in laboratory intercomparison program for respirable free silica samples, bibliographical support, statistical analysis. All this will be made in period 2006-2010.


Countries of the region.


Instituto de Salud Publica de Chile offers an apprenticeship to the countries of the region interested in the elaboration of a national diagnosis of exposure to silica. Instituto de Salud Publica support bibliographical items, in country traveling, training and sample shipment for the intercomparison program. Tickets (to Chile) and per diem should be financed by the interested countries.

Dissemination Offering the course to countries of the Region. Impact (global or regional) Regional

Progress on Project Two ISP experts went to CENSOPAS, belonging to the Peruvian National Institute of

Health, to give a training course in chemical agents, focusing on silica and asbestos. This training was directed to personnel of CENSOPAS and Peruvian OSHA. One person from CENSOPAS visited ISP for a apprenticeship about silica and chemical agents in hospitals.

GPA1.10q Formerly AA4:CE4d

GPA Objective Objective 1: to devise and implement policy instruments on workers’ health CC or NGO Name Instituto de Salud Publica de Chile Project title Support in the methodology to train workers involved in asbestos removal activities. Keywords Asbestos, asbestosis, mesothelioma, qualification, removal. Project leader Email address

Juan Alcaíno Lara – [email protected]

Partners (of the CC Network) Other partners Institutions responsible for the worker health in countries of the region Funding

Delivering of the original manual (hard copy), manual in CD, phone conferences, and any support via fax and e mail will be paid by the Instituto de Salud Publica.

Objective of the project To give enough knowledge to asbestos removal workers to do theses activities in a safely way.


To establish coordination with institutions indicated in “Other Partners”, to make effective the offering (2006-2010). - to give advice through the indicated ways (2006-2010).


Workers of the region working in asbestos removal activities.


Firstly, Instituto de Salud Publica de Chile stablishes communications with interested countries. After that, they are given the manual for workers involved in removal activities and the CD. Bilateral coordinations settle down to specify forms and timetable. Chilean professionals could give in field assistance but interested countries should fund this.

Dissemination Institutional communications Impact (global or regional) Regional

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Progress on Project No update GPA1.10r

Formerly AA4:CE4e GPA Objective Objective 1: to devise and implement policy instruments on workers’ health CC or NGO Name National Institute for Occupational Safety and Health (NIOSH) Project title Training programs and guidance materials for surveillance, diagnosis, and treatment of

silica exposed workers globally

Keywords Silicosis, silicosis diagnosis, medical surveillance


Joe Burkhart, DRDS ; [email protected]; Kristin Cummings [email protected]; Maria Lioce-Mata [email protected]

Partners (of the CC Network) Institute of Public Health (ISP) (Chile) International Labour Organization (ILO) World Health Organization Pan American Health Organization (PAHO) University of Michigan

Other partners Silicosis experts in other NIOSH divisions; Occupational Health Management Board (OHMB) of the Zambian Ministry of Health; additional partners welcome

Funding NIOSH

Objective of the project To provide guidance and training concerning standardized diagnostic procedures for silicosis.


Increased capacity of partner countries to provide training to personnel in their respective countries concerning the diagnosis of silicosis and increased awareness of occupation related medical surveillance. Guidance developed in this effort will be fed into dissemination efforts – see project titled: “Global Silica Information Dissemination”. Deadlines to be worked out with partners in Zambia and Chile.


Partner countries and their medical community will have greater capabilities to serve their working populations. The information transferred during this project will in turn be transferred to other countries; this is especially true in the case of Chile which plans to aide other countries in the region.


The purpose of this project is to aid the ILO/WHO/PAHO campaign to prevent silicosis. This will be accomplished by helping to train physicians and medical technicians in partner developing countries in the provision of medical screening (pulmonary function tests and chest x-rays) of silica exposed workers.

Dissemination Through direct contract with personnel in the partner countries and though NIOSH information products.


Progress on Project Radiologic reading and spirometry courses were taught in Zambia and in Chile. GPA1.10s

Formerly AA 4: TM1i GPA Objective Objective 1: to devise and implement policy instruments on workers’ health CC or NGO Name National Institute for Occupational Health (NIOH), South Africa Project title The use of autopsy data as a gold standard to develop a set of digital X-rays for silicosis

which can be used as reference standards Keywords silicosis, pneumoconiosis, digital X-rays


Ms. Ntombizodwa Ndlovu [email protected] Prof. Jill Murray [email protected]

Partners (of the CC Network) NIOSH (USA), HSL (UK) Other partners MBOD - Medical Bureau for Occupational Diseases (South Africa), Department of

Radiology, University of the Witwatersrand (South Africa) South African Mine Medical Services

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Funding

Possible sources of funding - South African Mine Medical Services South African Mine Health and Safety Council

Objective of the project To produce a set of digital X-rays verified by autopsy findings that can be used for the diagnosis of silicosis.


To establish if there is enhanced sensitivity for the diagnosis of less extensive silicosis with the use of digital X-rays. To produce a set of digital X-rays.


All occupational health practitioners


Several studies have shown that the specificity of standard X-rays for the diagnosis of silicosis is greater than 90% but the sensitivity is much lower. Digital X-rays are now being widely used in medical surveillance programs. It is believed that these X-rays are more sensitive in the detection of less extensive pneumoconiosis than standard X-rays (e.g. ILO category 0/1 or 1/0). Autopsy findings and pre-mortem digital X-rays in silica exposed subjects (South African gold miners) will be used to establish if there is enhanced sensitivity. If so, a set of reference digital X-rays will be developed.

Dissemination Web based Impact (global or regional) Global

Progress on Project 25-02-2008. This project is to form part of a larger project, to be funded by the Mine

Health and Safety Council SA, to develop a set of reference xrays, taking into account problems of high tb prevalence settings. The MHSC is still seeking a project manager. Hopefully the project will get underway late this year.

GPA1.10t

Formerly AA4:CE1 GPA Objective Objective 1: to devise and implement policy instruments on workers’ health CC or NGO Name National Institute for Occupational Health (NIOH), South Africa Project title Silica, silicosis and tuberculosis Keywords Practical solutions, dust control, prevention of tuberculosis, training materials, managers,

workers, practitioners, inspectorate Project leader Email address

Prof. David Rees [email protected]

Partners (of the CC Network) NIOH, South Africa

Other partners 1. University of the Witwatersrand, South Africa 2. Occupational Health Management Board, Zambia 3. Eduardo Mondlane University, Mozambique 4. National Institute for Public Health, Sweden

Funding

The project is funded through the Swedish International Development Cooperation Agency and is a component of the Work and Health in Southern Africa (WAHSA) Programme, and supported by the NIOH, South Africa.

Objective of the project Develop education, training and technical materials for The reduction of silica dust exposure in key industries in the region Improved prevention of tuberculosis in silica exposed workers


• A training course for OHS inspectors on the measurement and control of dust by mid-2006. Presented in 3 countries by end 2006 • A costed and tested set of practical solutions for dust control in the quarry industry appropriate for the region by end 2007. • Information materials for workers, managers and practitioners by end 2007 • Information materials on chemoprophylaxis for silica exposed workers for practitioners by end 2007.


Silica exposed population, occupational health and safety practitioners and inspectors, enterprise managers.


Silica exposure with its attendant diseases, particularly tuberculosis, is a major issue in the southern African region. A multi-faceted approach is needed to reduce exposure and prevent disease. This project aims to improve the capacity of the health and safety inspectorates by developing and presenting a course on dust measurement and control, to develop practical dust control solutions in a key sector (the quarry industry) which will serve as a model and be widely

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disseminated, to improve knowledge of the key stakeholders (workers, managers and practitioners) through information materials appropriate for the region, to promote appropriate practice on tuberculosis prevention through expert group meetings and dissemination of consensus statements.

Dissemination Worker and enterprise meetings and associations, professional associations, WHO/ILO documents; regional Departments of Labour and Health, as well as appropriate electronic dissemination.

Impact (global or regional) Southern African region primarily but useful for developing countries in general. Progress on Project Programs conducted throughout the SADC region included:

(1) Workshops/courses/ seminars on Dust Control and Measurement in the Quarry Industry (2) Dust control intervention introduced at three quarries – in Zambia, Mozambique and Lesotho. (3) A regional Expert Group Meeting – “Preventing TB in silica-exposed workers” formulation of guidelines for treating silica-exposed workers and (5) development materials for practitioners (WAHSA and other programmes in the SADC Region):

Resource on silicosis for health practitioners Ntate Thabang and Sello’s Story - training DVD in Sotho, with English subtitles,

for mining workforce Manual Preventing Silicosis – a guide for H&S representatives Deskpad – A Silicosis Information Resource – aimed at managers and

occupational health practitioners Document from the expert group meeting – Guidelines of isoniazid preventive

therapy (IPT) Handbook for quarry managers – Control of Dust in Resource Poor Quarries in Southern Africa

GPA1.10u

Formerly AA6:KTBP3 GPA Objective Objective 1: to devise and implement policy instruments on workers’ health CC or NGO Name National Institute for Occupational Safety and Health (NIOSH)

Project title Global Silica Information Dissemination

Keywords Silicosis, Information, Dissemination


Faye Rice, Epidemiologist [email protected]


• Institute of Public Health (ISP) (Chile) • International Labour Organization (ILO) • Pan American Health Organization (PAHO) • National Institute of Occupational Health (India) • World Health Organization Headquarters • National Institute for Occupational Health (NIOH), South Africa (David Rees, Rob Ferrie,

Kevin Renton [email protected]; [email protected]; [email protected])

• Fundacentro, Brazil (Ana Maria Bom, Alcinéia Santos [email protected]; [email protected])

• CENSOPAS, Peru (Luis Santa-Maria)

Other partners Silica experts throughout NIOSH West Virginia University University of Cincinnati

Funding

NIOSH


To produce and disseminate NIOSH information products and provide training and technical assistance to prevent silica-related disease.

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A multi-year project with deadlines to be determined for these anticipated outcomes: • review existing NIOSH materials on laboratory analyses, exposure assessment, exposure

control, diagnosis, and treatment • determine the form of NIOSH information products to best serve our international

partners • design and produce the information products • provide technical assistance to customers in developing countries • obtain feedback from partners to help evaluate and/or improve our products


NIOSH information products are disseminated worldwide. Partner countries without silica subject matter experts are a specific target of the project.


The purpose of this project is to aid the ILO/WHO and PAHO silicosis elimination campaign by producing and disseminating useful and accessible information products that will educate our global partners in the areas of laboratory analysis of crystalline silica, assessment and control of silica dust exposures, and diagnosis, treatment, and surveillance of silica-related diseases. Project staff includes silica subject matter experts that will address requests for information from developing countries and will work together to develop NIOSH information products from existing information. The experts may also provide training or other technical assistance to health professionals in partner countries.

Dissemination NIOSH information products, training, technical assistance


Global

PROGRESS ON PROJECT

NIOSH staff provided training and technical assistance to ISP Chile in 2006 and 2007. A review of existing materials was conducted and the development of information products is in progress.


New Project 1.10v


Establishment and evaluation of surveillance programs for silicosis.






Dr. Nguyen Duy Bao, Director, National Institute of Occupational & Environmental Health (NIOEH), 1B Yersin Str., Hanoi, Vietnam Email address: [email protected]






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Surveillance program for silicosis is one activity of the national action plan on prevention of occupational diseases. Projects include interventions for control of exposures and diagnosis of diseases.


Policy makers, occupational health and safety practitiioners, enterprise managers, Workers at high risk of silicosis



- Prevention model for silicosiss will be developed and applied - The rate of silicosiss will be reduced by 10% - Capacities of envionment monitoring and silicosis diagnosis and detection will

be improved for OH practitioners - Training materials will be developed and disseminated - Legislative documents on silicosis prevention will be reviewed, supplemented,

and promulgated


- The rate of silicosis reduced by 10% - 80% of workers at high risk of silicosis will be examined and detect

occupational diseases Major Milestones (list up to three dates and milestones)

Public health impact

Workers’ health will be improved

Funding source(s) Vietnamese Government Dissemination National policy, WHO documents


New Project GPA1.10w


AFRICA Fibre Counting Scheme


1.10 w

Priority Initiative 1.3 Responsible CC or NGO Name

Institute of Occupational Medicine (IOM), UK


Dr. Alan Jones [email protected]


[to be confirmed]

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Several of the participating laboratories are government labs and so are linked to relevant ministries or regional government , e.g. in [Belgium, Spain, Korea, Hong Kong, Italy, ]:


[to be confirmed]


“AFRICA” is an international proficiency testing scheme for laboratories that measure airborne asbestos fibre concentrations using the phase contrast optical microscopy counting method. The scheme enables participating laboratories to compare their counting levels with those of other laboratories and with reference counts, in order to assist them in quality control of their counting performances. Testing proficiency in fibre counting process is crucial to the reliability of measurements of asbestos concentrations in air. Without it, huge differences can arise between laboratories. Reliability of measurements of concentrations of asbestos is an important element in combating the international epidemic in asbestos related diseases.


Immediate: Laboratories internationally who engage in fibre counting (Asbestos or MMMF), and their clients Indirect: People exposed to asbestos, whose protection depends on valid assessment of their exposures


Information about the scheme will be made available through various channels including the IOM website and conferences.


The operation of the schemes is being re-launched after a period when operation had lapsed due to resourcing issues. There has been a high level of response among past and potential new participants of the AFRICA (asbestos scheme) and the scheme is re-launching this summer. The outcomes by 2012 are expected to be regular operation of the schemes core function during 2009, reviews of general patterns of international comparability within the scheme during 2010, 2011 and 2012 with assessment of progress. There has been a sequence of contacts with other National PT schemes, including visits from those organisations to IOM. We anticipate those will continue. Our expectation is that membership of the scheme is likely to grow from its current level by 2012 due to the ongoing concern about control of exposure to asbestos internationally and especially in the developing economies.


Immediate: The number and distribution of participating laboratories (i) overall; (ii) that demonstrate proficiency in counting

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December 2009: completion of first round of re-launched scheme. Summer 2010: review of progress in comparability. Summer 2011: publication of peer review paper on outcomes at that stage.

Public health impact

Reliable measurement of asbestos exposures is necessary for proper risk management and so for control of risks, notably of cancer (lung, mesothelioma)

Funding source(s) The participating laboratories

Dissemination (i) The proficiency status of participating labs is made public on the IOM website; (ii) Reports on the operation of the scheme will be published from time to time (iii) As appropriate, methodological advances will be published in the scientific journals