African Newsletter 2/2013, Prevention culture

African NewsletterVolume 23, number 2, August 2013

O N O C C U P A T I O N A L H E A L T H A N D S A F E T Y

Prevention culture

Contents

3 Editorial Building prevention culture Seiji Machida, ILO SafeWork

Articles

28 Promoting social security and prevention of occupational diseases in Africa Hans Horst Konkolewsky ISSA

31 The Finnish Zero Accident Forum Markku Aaltonen FINLAND

32 Preventive occupational safety and health culture: the situation in developing countries Yusuf Katula UGANDA

35 Towards safety prevention culture in Kenya Pius W. Makhonge KENYA

37 Safety education – a preventive measure in OH&S: the case of agriculture S.T. Olowogbon, A.S. Akinwande NIGERIA

41 Prevention of non-communicable diseases at the workplace in Tanzania Mwele Malecela, Mary Mayige TANZANIA

44 Publications

45 Conferences

46 8. Global Conference on Health Promotion Suvi Lehtinen FINLAND

African Newsletter ON OCCUPATIONAL HEALTH AND SAFETYVolume 23, number 2, August 2013 Prevention culture

Published by Finnish Institute of Occupational Health Topeliuksenkatu 41 a A FI-00250 Helsinki, Finland

Editor in ChiefSuvi Lehtinen

EditorMarianne Joronen

Linguistic EditorsAlice LehtinenDelingua Oy

Layout Kirjapaino Uusimaa, Studio

The Editorial Board is listed (as of January 2013) on the back page. A list of contact persons in Africa is also on the back page.

This publication enjoys copyright under Protocol 2 of the Universal Copyright Convention. Nevertheless, short excerpts of articles may be reproduced without authorization, on condition that source is indicated. For rights of reproduction or translation, application should be made to the Finnish Institute of Occupational Health, International Affairs, Topeliuksenkatu 41 a A, FI-00250 Helsinki, Finland.

The African Newsletter on Occupational Health and Safety homepage address is:http://www.ttl.fi/AfricanNewsletter

The next issue of the African Newsletter will come out at the end of December 2013. The theme of the issue 3/2013 is Construction.

Photographs of the cover page:

© International Labour Organization / J. Maillard

© Finnish Institute of Occupational Health, 2013

Printed publication: ISSN 0788-4877On-line publication: ISSN 1239-4386 The responsibility for opinions expressed in signed articles, studies

and other contributions rests solely with their authors, and publication does not constitute an endorsement by the International Labour Offi-ce, World Health Organization or the Finnish Institute of Occupational Health of the opinions expressed in it.

Editorial

Afr Newslett on Occup Health and Safety 2013;23:27 • 27

Building prevention culture

The fostering and promotion of a prevention culture or in ILO terms “Preventative safety and health culture” at both national and enterprise levels is a fundamen-tal basis for improving occupational safety and health (OSH) performance in the long term.

Continuous improvement of national OSH performance requires a systematic approach with various actions. These actions should in-clude introduction of a national legal framework, a government in-spection, a training network and technical support services. With the framework of national OSH system, prevention activities have to be carried out at the enterprise level by the management and the work-ers as an integral part of a business operation. Every day, both em-ployers and workers have to make decisions which have impact on OSH performance. Thus, it is critical that management and workers share common values on safety and health, in other words enterprise preventative safety and health culture. Such an enterprise culture should facilitate joint efforts to continuously improve OSH perfor-mance with the right balance of business objectives and prevention.

The starting point for the building of national or enterprise pre-ventative safety and health culture is to understand what it would cover. According to the Promotional Framework for Occupational Safety and Health Convention, 2006 (No. 187), “a national preventa-tive safety and health culture” is a culture in which the right to safe and healthy working environment is respected at all levels, where government, employers and workers actively participate in securing a safe and healthy working environment through a system of defined rights, responsibilities and duties, and where the principle of preven-tion is accorded the highest priority.

An important basis for preventative safety and health culture is the recognition by all concerned, including management and work-ers that workers have the right to a safe and healthy working envi-ronment. Such a right is often clarified in national legislation as a fundamental right of workers. In the countries where it is not clari-fied, the provisions of the Convention No. 187 could be referred to as a basis. Active participation of all concerned, in formulating policy and action plans both at the national and enterprise levels, is another

critical factor for practical OSH prevention measures.In order to build national or enterprise preventative safety and

health culture, improvement of OSH knowledge and awareness at all levels (government officials, corporate top management, supervi-sors, and workers) is essential. Continuous and systematic activities including information, consultation and training have to be imple-mented for this purpose. These activities should promote basic prin-ciples of prevention such as assessing occupational risks or hazards; eliminating hazards; and combating occupational risks or hazards at source.

One of the concrete steps taken by the ILO to promote the build-ing and the maintenance of a national preventative safety and health culture is the observation of the World Day for Safety and Health at Work on 28 April every year. Various national and enterprise level activities are organized around the World Day in over 100 countries facilitating active discussions for the improvement of national and enterprise level OSH systems. Another important mile stone is the adoption of the Seoul Declaration on Safety and Health at Work at the Safety and Health Summit in 2008. The Seoul Declaration recog-nizes that promoting high levels of safety and health at work is a re-sponsibility of society as a whole and calls for building and mainte-nance of a national preventative safety and health culture and placing OSH high on national agendas.

We should continue to build preventative safety and health cul-ture among all concerned as a fundamental pillar for improving OSH performance and as a facilitator and promoter for strengthening na-tional and enterprise OSH systems and programmes.

Seiji MachidaDirector, SafeWork, ILOInternational Labour Office

28 • Afr Newslett on Occup Health and Safety 2013;23:28–30

IntroductionOccupational diseases are posing an ever increasing chal-lenge to workers’ compensation systems. Out of the 2.34 million annual work-related deaths reported by the Inter-national Labour Organization (ILO) (1), the vast major-ity – approximately 2.02 million – are due to work-related diseases. As a consequence, occupational safety and health policy is shifting from an injury and accident centered ap-proach to one that increasingly is occupational disease fo-cused. To effectively address occupational diseases (ODs), many social security organizations responsible for insuring and compensating these risks are adopting a more proactive and preventive approach. Their leitmotif can best be de-scribed as ‘prevention is better than compensation’. Adopt-ing such an approach also forms part of a broader under-standing of the role that social security can play in promot-ing and shaping a national prevention culture.

Global ranking of occupational diseasesAs the main insurer of occupational diseases, social securi-ty plays a key role in addressing the consequences of occu-pational diseases. A survey conducted in 2011 among 123 member organizations of the International Social Security Association (ISSA) allows for the preparation of the follow-ing “top five” listing. The main ODs giving rise to claims are respiratory diseases, musculoskeletal disorders and diseases caused by physical agents (Figure 1).

Promoting social security and prevention of occupational diseases in Africa

Figure 1. Top 5 occupational diseases compensated by ISSA mem-ber organizations (2011)

Types of ODs Percentage of total

Respiratory diseases 28.8%

Musculoskeletal disorders 18.5%

Diseases caused by physical agents 18.5%

Skin diseases 11.7%

Biological agents and infections or parasitic diseases

6.8%

Photo by John Hogg / W

orld Bank

Hans Horst KonkolewskyISSA

Afr Newslett on Occup Health and Safety 2013;23:28–30 • 29

National listsSocial security institutions normally base their decisions on awarding compensation for an occupational disease on the official national OD list, which in many cases is based on the ILO’s list of occupational dis-eases. As the nature of health risks at work is changing rapidly as a consequence of new technologies, substances, work organ-ization and environmental conditions, it is crucial that these lists are updated regu-larly. The ILO has established international criteria for updating national OD lists (see Box 1).

Box 1:ILO criteria for updating national OD lists:• causalrelationshipwithaspecific exposure;• occurrenceinconnectionwith the work environment;• higherfrequencyamongcon- cerned groups of persons;• scientificevidenceofaclearly defined pattern of disease following exposure and plausibility of cause.

Challenges for social securityWhen addressing ODs, social security sys-tems are faced with the challenge of how to best protect the insured, while deliver-ing excellent services and sustaining viable social security systems. Over the last years the ISSA organized several Technical Sem-inars in Africa1 which identified a series of important questions that social security in-stitutions should take into consideration:

Sustainability of the social security systemSome ODs, such as asbestosis, silicosis or other diseases of the respiratory system and occupational cancers are character-ized by a long latency or recovery period, which makes it difficult for social security administrations to calculate the duration of treatment and associated costs. For oth-er ODs, such as infectious diseases, skin ailments or diseases caused by very high or low temperatures, a probability of success-

ful recovery can be anticipated. In order to be able to insure occupational diseases, so-cial security institutions must therefore be aware of the latency periods and potential hidden costs of occupational diseases.

Increasing coverage of the working populationAfrica’s occupational disease challenges are also closely linked to the informal sec-tor, resulting in high numbers of workers without occupational accident and disease insurance coverage. Workers in the rural informal sector often receive irregular in-come because of their seasonal employ-ment. In addition, some micro and small-scale enterprises in the informal sector do not have a permanent work location, which makes it difficult for social securi-ty institutions to contact them. The Social Security and National Insurance Trust of Ghana found that these difficult economic and geographic circumstances add to the general unwillingness to pay contributions. (2) This unwillingness amongst people working in the informal sector is closely linked to a general lack of awareness of the concept and benefits of social security and to a certain extent distrust as regards the institutions administering social security funds. The ISSA is therefore assisting its member organizations in developing good governance practices and improving their management and administration systems. Combined with public awareness cam-paigns such efforts, according to experi-ences in other regions, could lead to higher levels of social security coverage amongst people working in the informal sector.

UnderreportingAs an example, only 109 ODs were regis-

tered in Senegal between 2000 and 2010 (3), which are approximately 11 cases per year for a country with over 13 million in-habitants and a GDP of 13.8 billion USD.(4) Many OD-cases remain unregistered in Africa, because neither the workers con-cerned, nor their employers are sufficient-ly informed about the possibility to re-ceive compensation and consequently do not present compensation claims. Again there is a need for information campaigns to raise awareness about the benefits and services of social security as regards ODs. In addition, national statistics on public health, occupational accidents and disease cases would need to be further developed and regularly updated.

Diagnosis and service quality It is paramount for social security systems to ensure that the covered population does not face economic insecurity as a conse-quence of possible delays in ascertaining the validity of their claim to worker com-pensation benefits. If there is a pertinent risk that occupational diseases are not recognized as such by the treating physi-cians, including family doctors, procedures should be developed for the diagnosis, the reporting and recording of ODs. An ap-propriate infrastructure needs to be devel-oped allowing for accurate diagnosis and treatment carried out by a sufficient num-ber of qualified and well-trained medical staff. Diagnosis, treatment and individual preventive measures should also be carried out at the earliest stage possible in order to foster a more rapid recovery.

In terms of service quality response rates, positive developments can already be noted: Gabon’s National Social Secu-rity Fund (CNSS) managed to significant-

Figure 2. Delays in processing technical requests

Source: CNSS-DGA-AC & Budget, December 2012.

120 %

100 %

80 %

60 %

40%

20 %

0 %

2009 2010 2011 2012

43 %

38 %

8 %11 %

34 %

23 %

13 %20 %11 %

15 %

26 %

11 %

32 %

15 %

13 %

23 %

18 %

38 %

10 %

> 90 days

60 - 90 days

46 - 59 days

30 - 45 days

< 30 days

1 The Seminars were held in Kribi, Cameroon (March 2007), in Marrakesh, Morocco (Octo-ber 2012) and in Banjul. Gambia (April 2013).


ly reduce the response time to claims over a period of three years. In 2009, almost half of the claims took over 90 days to be pro-cessed. This duration was gradually reduced which contributed to an increased client satisfaction of 95.9% for services delivered. (Figure 2)

Legal mandate for preventionOther important challenges as regards the prevention of ODs are the current limita-tions in the legal mandate and the organiza-tional structure of the social security institu-tion. Usually, the institution’s mandate is re-duced to offer insurance against occupation-al risks, and in the case of work accidents or ODs, to offer benefits, including compensa-tion. The prevention of the occupational in-jury, however, is not included in their legal mandates as such activities normally fall un-der the responsibility of a state authority, e.g. the ministry of labour or the state labour in-spectorate. The ISSA strongly advocates for an active involvement of social security in-stitutions in prevention, supplementing and supporting the responsible safety and health authorities, and has prepared occupation-al risk prevention guidelines for its global membership. Notably, some institutions in Africa have already taken or are initiating measures to include risk prevention in their core insurance activities:

• Gabon’sNationalSocialSecurityFund has created a structure for the prevention of ODs that focuses on the prevention and early diagnosis of certain illnesses, including both communicable and certain chronic diseases.

• AfterNigeria’s2010reformofitswork injury programme, the Nigeria So- cial Insurance Trust Fund (NSITF) now provides compensation for insured workers and their dependents for work-related death, injury, disease and disability. The new Act also rec- ognizes mental stress as a work-related chronic health problem for which compensation may be paid. This development suggests that occupational safety and health specialists and the NSITF staff be trained for work accident prevention and the handling of cases.

• InZimbabwe,theMinistryofLabour and Social Services has the overall re-

sponsibility for social security and Oc- cupational Safety and Health (OSH). The management of social security and OSH has been delegated to the Nation- al Social Security Authority (NSSA) which now runs an OSH division of 98 persons, dealing with promotion and training, factory and labour inspections, occupational health services as well as research and development. AtripartiteZimbabweOccupational SafetyandHealthCouncil(ZOHSC) has also been set up providing a forum for discussion and consensus building.

OutlookThe above mentioned examples demonstrate that social security institutions in Africa are still facing important challenges with regard to protecting workers against occupational diseases, and in the event that they occur, to offer adequate benefits and services. But they also showcase the potential of social se-curity to provide a significant contribution to the existing national occupational pre-vention systems and thereby to help shape a national prevention culture. Importantly, social security systems in Africa increasing-ly acknowledge the added value of invest-ing in people, supporting employment and improving the general health of the popula-tion, both for the sustainability of their sys-tems and for society as a whole. (5) There-fore, the role of social security in conduct-ing prevention activities and specifically addressing occupational diseases should be

References

1. The prevention of occupational diseases, International Labour Office, Geneva, 2013.

2. Technical Seminar on Work Accidents and Occupational Diseases in Africa, Banjul, Gambia, 25.04.2013–26.04.2013, International Social Security Association, Geneva, 2013.

3. Seneweb. Retrieved 02 August 2013: “Occupational diseases” http://www.seneweb.com/news/Sante/maladies-professionnelles-109-cas-enregistres-entre-2000-et-2010_n_93462.html

4. International Monetary Fund. Retrieved 02 August 2013. Country profile “Senegal” http://www.imf.org/external/pubs/ft/weo/2013/01/weodata/weorept.aspx?pr.x=36&pr.y=16&sy=2009&ey=2012&scsm=1&ssd=1&sort=country&ds=.&br=1&c=722&s=NGDPD%2CNGDPDPC%2CPPPGDP%2CPPPPC%2CLP&grp=0&a=

5. Africa: A new balance for social security (Developments and trends, 2012). Geneva, International Social Security Association. http://www.issa.int/layout/set/print/Resources/ISSA-Publications/Africa-A-new-balance-for-social-security

6. The ISSA Guidelines on occupational risks as well as other prevention related Guidelines will be launched at the World Social Security Forum in Doha, Qatar in November 2013.

http://www.issa.int/News-Events/Events/wssf2013

2 According to the ISSA’s 2012 member sur-vey, 70 % of members in Africa are interested in Workplace health promotion, 64 % in Pre-vention of work injuries, and 41 % in Return to work guidelines.

further strengthened. The ISSA has developed a set of three

Prevention Guidelines, addressing occu-pational risk prevention, workplace health promotion and return-to-work, and pro-viding basic principles, planning tools and good practices to help social security insti-tutions introduce and conduct prevention services. (6) In addition, from 2014 onwards the ISSA’s new Centre for Excellence will offer member organizations technical sup-port and capacity building facilities in their efforts to develop prevention services as an integrated part of their overall programme. Given the high levels of interest in these guidelines expressed amongst the ISSA’s membership in Africa2, the future outlook for the prevention of occupational accidents and diseases in the region looks positive.

Hans-Horst KonkolewskySecretary GeneralInternational Social Security Association (ISSA)4 Route des MorillonsCase postale 1CH-1211 Geneva [email protected]


IntroductionOccupational accidents are unwanted ad-verse events at work which affect not only individuals, but also society as a whole. As well as having a negative impact on health, they also negatively affect the success of a company, its image, recruitment practices and staff turnover. It is therefore important to develop new methods and approaches for improving safety. It is estimated that if all ILO Member States used the best accident prevention strategies and practices that are already easily available, some 300,000 deaths and 200 million accidents could be prevent-ed annually (1).

Why the zero accident goal?Zeroaccidentvision(ZAV)isincreasinglyadopted by companies. Enterprises simply want to eliminate workplace accidents, be-cause they are tired of their negative conse-quences.ZAVisbasedontheassumptionthat all accidents are preventable. If acci-dents are not preventable immediately, they verylikelywillbeinthelongrun.ZAVthusprovides an ethically sustainable basis for accident prevention. However, zero accident thinking is both an intellectual and a practi-cal challenge for safety work. Promoting this vision is an important weapon in the battle against fatalism, which is quite common.

Zero Accident Forum in FinlandTheZeroAccidentForumhasbeenactivesince 2003 in Finland. The Forum is a vol-untary network of Finnish workplaces, and is open to any workplace, regardless of its size, economic sector or level of occupation-al safety. The Forum is a network through which the Finnish Institute of Occupation-al Health promotes accident prevention to-gether with Finnish workplaces. Members of the Forum share a common vision of be-coming leaders in safety, and are willing to share their experiences for the benefit of other members. The Forum provides ex-amples of good practices from other work-places, spreads success stories, and moti-

The Finnish Zero Accident Forum

vates and encourages workplaces to strive for a high level of safety. The Forum also organizes national and regional seminars and provides materials and tools to promote the “vision zero” concept. Materials include campaigns,websitesandtheZeroAccidentForum Newsletter. Commitment to the ze-ro accident goal is the key to Forum mem-bership. In joining the Forum, workplac-es commit to working together to improve safety at work by accepting six basic state-ments issued by the Forum. Over 300 or-ganizations from all over Finland had joined theZero-AccidentForumbyAugust2013.These workplaces employ over 300,000 peo-ple, which is more than 10% of the Finnish working population. (2)

ConclusionsNormally workplaces aim to lower their number of accidents, but in practice this is not easy. Even if they succeed in reaching a good safety level, it is difficult to maintain it. Workplaces should thus be encouraged to set a goal of “zero accidents”. (3) Only this vision can provide an ethically sustainable basis for accident prevention. Safety is a val-ue as such, and an accident-free workplace should be a human right for every worker.

Safety is also a part of the quality of produc-tion. Accidents and near-accidents indicate problems in work processes. Safety culture is part of the company image. It is easy to lose but very difficult to regain. The safety and health of employees can also be an integral part of a company’s competitiveness.

Markku V.P. AaltonenFinnish Institute of Occupational HealthTopeliuksenkatu 41 a A00250 Helsinki, [email protected]

References

1. Takala, J., 2002. Introductory Report: Decent Work – Safe Work. Paper Presented at

the XVIth World Congress on Safety and Health at Work, Vienna, 27 May 2002.

2. The Finnish Zero Accident Forum [home-page on the Internet]. [cited 2013 08 17].

Available from: www.ttl.fi/zeroaccidentfo-rum.

3. Gerard I.J.M. Zwetsloot, Markku Aaltonen, Jean-Luc Wybo, Jorma Saari, Pete Kines, Rik Op De Beeck. The case for research into the zero accident vision. Safety Science, Volume 58, October 2013, Pages 41–48. http://dx.doi.org/10.1016/j.ssci.2013.01.026 [cited 2013 08 17].

Photo by Sarno Ojell

The member organizations of Zero Accident Forum receive the Safety Level Certifications 2012.

Markku V. P. AaltonenFINLAND


Photo by Suvi Lehtinen

Yusuf KatulaUGANDA

IntroductionUganda is a country with a population estimated at 30.7 million people and a labour force estimated at 13.4 mil-lion (1). The country has an active labour force of 12.9 mil-lion people. More than 70% of the population is actively involved in agriculture, most of which is subsistence agri-culture. However, there are commercial firms in the area of sugar cane, for the production of sugar, with more than ten sugar processing factories. The three main players pro-duced an estimated 357,000 tonnes, while new players are estimated to have produced 20,000 tonnes for the financial year of 2012/13. The planting, weeding, loading and un-loading of sugar cane has to some extent been mechanized, but the sugar cane is usually cut manually. Large quantities of chemicals are used in the early stages of cane growing, namely fertilizers and weed killers.

The second main crop is tea, which is grown by both

Preventive occupational safety and health culture: the situation in developing countries

companies and outgrowers. The production of tea stands at 56 million kg, which is obtained from about 23,000 hec-tares. The sector employs about 50,000 people, the majority of whom (70%) come in for green leaf plucking on the plan-tations. Tea, like other commercial crops, requires the appli-cation of chemicals – especially for pest and weed control.

The third important crop, which is termed non-tra-ditional and whose production picked up in the 1990s, is flowers. There are over 16 flower firms in Uganda, dealing in both cut flowers and roses, all of them grown in green-houses. The sub-sector employs about 25,000 workers di-rectly, the majority of whom are women of reproductive age.

Significant gains have been made in the push for indus-trial development, which is partly agro–processing for value addition. The iron and steel industry is still in its infancy. The first decade of this millennium brought the discovery of oil and gas deposits in the country, creating the prospect of an emerging oil and gas industry, with all its complexities in terms of safety and health.

The above picture indicates that Uganda is an economy which is significantly agricultural-based. Resources at the disposal of the inspectors would be required so that they could constantly monitor the workplaces where the work is being done. This has not been the case, as the country has an established structure with less than 40 inspectors na-tionwide whose work is specific to safety and health at the workplace.

In 2007, eleven workers were killed when a hotel struc-ture under construction in Bwebajja, along Entebbe Road, collapsed and in 2009, seven workers were fatally wounded while working on a construction site in the capital, Kampa-la. Investigations showed that at one of the sites, where the excavation ran more than 15 metres deep, no adequate and suitable measures had been put in place to ensure that the soil on the hanging wall of the excavation would not col-lapse on the workers below. At the other site, though the persons supervising the building work were competent, their experience for construction of that magnitude ap-peared to have been inadequate, as one of the major causes


was the removal of concrete supports for the floors before the concrete had properly set. The quality of the materials and the mix-tures was another issue.

The situation in other developing countries The early part of the year has been very traumatic for many families in Bangladesh. On 24 April 2013, a building housing a gar-ment manufacturing concern on the out-skirts of Dhaka, the capital, collapsed, kill-ing more than 1,100 workers and leaving a score of others with varying degrees of inju-ries. Fifteen days later, in the very same capi-tal of Bangladesh, another eight workers met their death when a fire broke out at night at another garment manufacturing facility.

Late last year, on 11 September 2012, a garment factory in Karachi, Pakistan caught fire, killing 289 employees largely due to smoke inhalation, burns and stampede. The fire began as a result of an explosion in the boiler house. Investigations found that: I) all of the factory’s exit doors were locked and many of its windows were covered with iron bars, which made it difficult for workers to escape when the fire broke out. Consequently, many of the deaths were caused by suffoca- tion.II) there were deficiencies in fire safety preparedness which had been noted previously but had purportedly been rectified.III) the owner had reportedly prevented inspections of the factory by the authorities.

Meanwhile in Lahore, still in Pakistan, at the same time, a shoe factory caught fire, killing 25 employees largely also due to smoke inhalation, burns and stampede. The fire started as a result of sparks from an elec-tric generator installed in the garage of the premises, where chemicals were also kept. The garage served as the workers’ only entry and exit point.

In summary, all of the above incidences, which took a large toll on the lives of work-ers, were preventable. The common denom-inator in all of these cases is that the regula-tory agencies were not only ineffective, but in some cases they were too weak to be felt on the ground. This is the prevailing situa-tion in many developing countries, where many governments focus largely on eco-nomic growth without paying attention to the quality of the work environment. The

situation is exacerbated by the high num-bers of unemployed persons.

ConsequencesThe consequences in the above scenarios are far ranging, the immediate being the unnec-essary loss of life on such a large scale. Many of those lost may have been the breadwin-ners for their families, who thus face an un-known and uncertain future.

Globally, the financial burden of com-pensation, healthcare, rehabilitation and dis-ability that stems from workplace accidents is significant. The cost is estimated to be equivalent to 4 per cent of global GDP per annum. For some developing countries, the cost of work-related accidents alone can be as high as 10 per cent of GDP (2).

The economic consequences thus di-rectly connected to the above instances are significant and would have been avoided if the governments had put considerable effort into the promotion of prevention and the achievement of a better work environment. This could be done by enabling their respec-tive national regulatory authorities to work more effectively.

In one of the scenarios above, the re-sponsible agencies would need to have: I) the proper designs made by competent personnel, such as architects, on the basis of the client’s needs and the location, II) the designs approved by the competent authorities,

III) a developer to engage a competent firm to draw up the bills of quantities for the structure, IV) a qualified construction firm hired to build the structure,V) the construction of the structure su- pervised and built according to the specifications of the design.

Inspection agencies in developing countries It has been observed in many developing countries that the inspection agencies or authorities are poorly equipped, with many lacking the adequate human resources to carry out monitoring inspections effectively. They also lack both the necessary equipment to assist them in conducting inspections us-ing an evidence-based approach and the necessary professional skills development to enable the inspectors to carry out their du-ties competently in the continuously chang-ing work environment.

Benefits of prevention It is of great importance to note that the benefits of prevention have been proved be-yond reasonable doubt. A study on the costs and benefits of prevention to companies, conducted by the International Social Secu-rity Association (2), indicates that there are benefits resulting from investment in occu-pational safety and health in microeconom-ic terms, with the results offering a Return on Prevention ratio of 2.2. In practice, this

Photo by Barbra Khayongo

At one accident scene: House on construction collapsed as the material mixture was poor and no com-petent workers were undertaking the works.


means that for every 1 Euro (or any other currency) per employee per year invested by companies in workplace prevention, compa-nies can expect a potential economic return of 2.20 Euros.

Prevention measures at the individual level support workers’ well-being and are therefore essential for a healthy and active life. For workers, investment in prevention measures leads to a significant decrease in reported work accidents, fatalities and occu-pational diseases. The improved health and employability which thereby accrues helps secure stable incomes and improved living conditions for the workforce.

For employers, investment in prevention is not only a legal and moral obligation, but it is also good for the success of their busi-nesses and their corporate image. A healthy workforce leads to workers’ increased pro-ductivity, which in turn leads to better com-petitiveness on their respective markets.

The way forward Work-related accidents and illnesses can and indeed must be prevented. Therefore there is a need for action at all levels – inter-national, national and company levels, re-spectively.

Developing countries need to move a step further and I) enact adequate national legislation on occupational safety and health and promote compliance with it by facilitating the responsible national authorities so that they can run effective prevention programmes, II) provide more and better education and training, with occupational safety and health integrated into both voca- tional training courses and enterprise training programmes, III) adopt a positive commitment and ensure that once they have committed themselves, they follow up with the necessary practical measures,IV) build networks and synergies among the regulatory authorities, to promote more effective activities.

Industrialized countries, the destination of some of the goods and services, also have a role to play. It is important to note that both the industrialized and the developing countries are party to the Seoul Declaration on Safety and Health at Work, 2008 (3) ei-ther directly or indirectly. The declaration proclaims that:

“A national preventative safety and

References

1. The Status of Labour Market Information in Uganda, June 2011, p9–10.2. International Social Security Association, Social Policy Highlight 19: Prevention is good for health and

good for business, p. 2–4.3. Seoul Declaration, 2008 on Safety and Health at Work. http://www.seouldeclaration.org/en/content/download/81/323/version/3/file/Seoul_Declaration_

EN.pdf http://www.ilo.org/wcmsp5/groups/public/@dgreports/@dcomm/documents/statement/

wcms_095910.pdf

Literature

Prevention: A Global Strategy, ILO Report for World Day for Safety and Health at Work Geneva, 2005,http://www.ilo.org/legacy/english/protection/safework/worldday/products05/report05_en.pdf

health culture is one in which the right to a safe and healthy working environment is respected at all levels, where governments, employers and workers actively participate in securing a safe and healthy working envi-ronment through a system of defined rights, responsibilities and duties, and where the principle of prevention is accorded the high-est priority”, among others, and that:

“Governments should: I) Ensure that continued actions are taken to create and enhance a national preventative safety and health culture,II) Ensure that the occupational safety and health of workers is protected through an adequate and appropriate system of enforcement of safety and health standards, including a strong and effective labour inspection system.

Therefore the industrialized countries could play an active role by ensuring that goods or services destined to their countries are produced under conditions which satisfy certain minimum safety standards. Second-

ly, technical support for skills development to enable them address workplace issues more effectively, will go a long way in assist-ing in the promotion of the preventive safety culture. Employers should take prevention as an integral part of their activities, as high safety and health standards at work go hand in hand with good business performance.”

Conclusion Developing countries need to embrace a preventive safety and health culture for the benefit of their economies and their labour force.

Yusuf KatulaPrincipal General Safety Inspector Occupational Safety and Health Department Ministry of Gender, Labour and Social De-velopment P. O. Box 227 Kampala, UGANDAEmail: [email protected]/ [email protected]

Workers in a steel plant have no proper per-sonal protec-tive equipment.

Photo by Barbra Khayongo


Training of workers at all levels on health and safety is very important.

Introduction There appears to be no single definition of “safety culture”. The term first arose after the investigation into the Cherno-byl nuclear disaster in 1986, which led to safety culture being defined as “an organizational atmosphere where health and safety is understood to be, and is accepted as the number one priority”.

There is an old saying that ‘accidents do not just happen, they are caused!’ They are caused by the way we do things, so culture as a factor is vital in the causation. This could lead us to ask ourselves a few questions. a) What makes workplace supervisors and managers want to ensure health and safety in the workplace without a government officer visiting the workplace and directing improvements to be undertaken?b) What makes employees see the need to help managers implement measures to create a safer work environment and also encourage fellow employees to support safety in the workplace?c) In a nutshell, how can everyone be encouraged to act safely whether someone is watching or not?

Factors for promoting occupational safety and health cultureThe available literature indicates that there are several fac-tors that play an important role in improving the overall oc-cupational health and safety performance of an organization and also create a good safety culture. Such factors include the following:• FormulationandimplementationofaHealthandSafety Policy both at national and enterprise levels. The policy is an important tool in directing the way forward on safety and health matters.• Includingoccupationalhealthandsafetyprogrammesin organizational strategic plans which ensure that resources are allocated to safety so that safety matters do not come as afterthought.• Performancemeasurementtoprovideinformationonthe extent to which plans were undertaken and for account ability.

Towards safety prevention culture in Kenya

Pius W. Makhonge KENYA

Photo by © International Labour Organization / M. Crozet


Photo by Tom Namasaka

The World Day for Safety and Health at Work com-memoration event where best performing insti-tutions and individuals on occupational safety and health practice were awarded certificates.

• Trainingofworkersatalllevelson health and safety so that workers have the skills and knowledge to perform their work safely. • Appropriateriskassessmentsforthe purpose of identifying the risks and providing the control measures before work is done.• Reportingandrecordingofallacci- dents, both minor and serious. This provides an opportunity to think about small things that can turn into greater dangers. • Aclearcommunicationplanforeffec- tive transfer of information from management to staff and back, as well as horizontal communication between individuals, departments and teams, is important for achieving good health and safety performance. Visible safety posters, safety policy statements, notic- es and newsletters describing safety issues and accident statistics demonstrate good safety communications. • Self-regulationthroughregularinter- nal audits by management and health and safety committees. This ensures continuous improvement without wait- ing for an enforcement officer to direct the necessary improvements.• Involvingworkersdirectlyandhealth and safety committees in the improve-

ment processes provides a good opportunity for workers’ input and ownership of the safety plan and arrangements. • Andlastlyrecognizingandcelebrating success through a system of regular rewards is likely to motivate everybody to do even better in safety matters.

In Kenya efforts have been made to in-clude most of the aforementioned factors in the national occupational safety and health legislation.

In addition, a national occupational health and safety policy has been formu-lated and approved by the Cabinet. One key issue addressed in the policy is main-streaming safety education at all levels of school learning. Once in place it is hoped that it will establish and foster a health and safety culture among the workers of the fu-ture early as they grow.

To create capacity at a professional level, two universities have started post-graduate training programmes on occu-pational health and safety . Those trained can be used at national and enterprise lev-els to promote health and safety in work-places. Furthermore, the government is in the process of building an institution to provide solutions-oriented research and skills development in occupational health and safety.

Funding for effective development and implementation of occupational safe-ty and health programmes has been a se-rious challenge to the growth of occupa-tional health and safety. To address this challenge, the government has established an occupational health and safety fund to support the development and implemen-tation of systems for occupational health and safety.

ConclusionThe initiatives outlined above, if adequate-ly implemented and with commitment from all players in the long run, will bring about the desired change in the way occu-pational health and safety is perceived and the culture of safety at work.

Pius MakhongeDirectorMinistry of LabourDirectorate of Occupational Safety and Health ServicesP.O. Box 34120 -00100Nairobi, Kenya


Photo by Suvi Lehtinen

S.T Olowogbon, A.S AkinwandeNIGERIA

IntroductionThe farm is not just the workplace of most rural dwellers; it is also their home. In addition, farming is not just an occu-pation for these dwellers but their way of life and source of livelihood. This underscores the importance of a safe farm environment to work and to live.

It has been said that; ‘If man knows what is good he would do it’ and ‘how can he know what is good if he is not informed’. In this regard, it has been observed in different quarters and by various agricultural stakeholders that farm safety is yet to be accepted as a core concept that could con-tribute substantially to the successful running of any farm business. It has also been recognized that where there is no or inadequate knowledge on an issue – in this case farm safety – people will suffer.

Knowledge and education should be adapted as a means of promoting the mental well-being and tradi-tions of the various people, conserving as far as possible all sound and healthy elements in the fabric of their social life while advancing well-being. Knowledge can also be adapted where necessary as a tool to change circumstances through the introduction of progressive ideas able to serve as an agent of natural growth and evolution (1). Effective awareness can be eval-uated or measured by the level of attitudinal change among farm workers, from poor safety habits to a good and sound safety culture.

The need to raise the level of awareness about farm safety was substantiated by the results of my study on the knowledge, atti-tudes and perceptions about farm safety, con-ducted among agricultural professionals with at least a secondary-level degree and among farm workers. According to the study, 40% of the agricultural professionals were at an aver-age level on the scale of awareness about oc-cupational health and safety issues in agricul-ture, while 32% were at a low level and 28% at a very low level.

Safety education – a preventive measure in OH&S: the case of agriculture

If the situation is that poor among professionals, what is the fate of the farmers on the field? Among the farmers, about 80% of the respondents had a severe wrist/hand in-jury and 75% lower back pain, both ailments being work-related. On average, 63% of the respondents have been un-able to do their work as a result of occupational injuries and illness leading to lost time, restricted work cases and fatali-ties; all of these mean loss of production. In addition, 80% of the respondents do not use any form of personal protec-tive equipment (PPE) due to poor knowledge about the role of PPE. Moreover, 80% of the farmers are not even aware of farm safety concepts and procedures, let alone their appli-cation. Inadequate information and lack of awareness to-gether with cost implications were ranked the highest on the list of constraints hindering the adoption of farm safety measures.

Thus, on the basis of the study, the dissemination of information on farm safety, a subsidized well-implement-ed farm safety programme, and a record-keeping and re-porting system for farm accidents were recommended (2).


While there may be variability in the data, based on the economic development of na-tions, the above study reflects the need for massive global awareness on farm safety.

Ways of creating the required awareness

Training agricultural extension workers in farm safetyAgricultural extension education in health and safety is a focal issue in disseminat-ing knowledge to farmers about how to reduce occupational injuries, illnesses and fatalities and about the use of knowledge as a tool for improving both the produc-tion level and the standard of living in the agricultural sector. Hence, the importance of health and safety extension education in agriculture cannot be overemphasized. There is a need to create awareness about farm health and safety and how it affects or influences the productivity of the sector by training the extension workers. Exten-sion education is an applied behavioural science, the knowledge of which is applied to bring about desirable changes in the be-havioural complex of human beings usual-ly through various strategies, programmes of change, by applying the latest scientific and technological innovation (3). Since ag-ricultural extension workers are the closest to these farmers, they are then equipped with the right information on farm safety

for them to be able to deliver efficient in-formation to the end users or target group, who in this case are the farmers.

Integrating farm health and safety into the agricultural curriculumThe purpose of health and safety education for agricultural personnel is to enhance awareness about the hazards to which they may be exposed, and ultimately for them to take appropriate action to control the hazards and prevent occupational acci-dents, intoxication, musculoskeletal disor-ders, diseases. Prevention reduces lost time due to injuries and restrictions, thereby in-creasing productivity.

The specific learning needs of those engaged in agriculture vary according to the ecological and agricultural patterns of the particular region. Small subsistence farmers have different learning require-ments from those of progressive commer-cial farmers. Educational services for rural areas and developing countries must take note of this. In addition to basic education, rural agricultural dwellers need instruc-tions in simple agrarian technology, par-ticularly in the case of subsistence farm-ers. Literacy training for adults is essential for them to understand agrarian technol-ogy (4).

One of the aims of an occupational health and safety programme is to protect workers from accidents in the workplace.

Therefore, safety programmes should in-clude education and training elements. Ed-ucation and training in this sector are used in the context of acquisition of knowledge and skills. It is usual to consider this as a process involving three stages: the provi-sion of information; a change in the recipi-ents’ attitudes; and the alteration of behav-iour. These stages must be kept in mind when considering health and safety edu-cation programmes in the agricultural in-dustry (4). The inclusion of farm safety in the education curriculum for agriculture students from the primary level to tertiary institutions would also help in creating the required awareness.

Effective communication on farm safetyCommunication is a necessary skill for farm safety awareness. An extra effort should be made so that the communica-tion is effective in order for the goals of farm safety to be achieved.

For provision of information, the cus-todian of the information must be compe-tent in conveying the message, with accu-rate and timely information explained in simple terms, using the appropriate me-dia while also studying the situational and cultural context of the audience. The com-munication process does not end at that. It proceeds to scrutinizing for attitudinal change in the audience, from poor farm

Photo by J. Maillard, © International Labour Organization

Safety and health education to agricultural personnel about hazardous chemicals and other hazards in farm work cannot be overemphasized. Family mem-bers as well as children should also be informed and protected.


safety habits to a good farm safety culture, which in turn alters their behaviour. At this point we can say that the communica-tion has been effective, since the goal has been met.

This tool is essential for extension workers and big farm organizations with a large workforce. Farm works need this information, and it must be communicat-ed to them. The process is said to be com-plete if both the sender and the receiver of the message perceive the message in the same way.

CommunicatorAudience

Information on farm safety

Attitudinal change and behavioural alternation of farm workers

Figure 1. The funnel blend of the communica-tion process for farm safety.

Figure 2. Farm Health and Safety Extension Education Integration Model and the holistic effect of farm safety information.

*Abbreviations: VEA = Village Extension Agent, EA = Extension Agent, T&V = Training & Visit

VEA, EA, T & V*

Training on farm safety, for agroprofessionals

Health and Safety Knowledge

Agricultural professionals

Increased productivity and output

Increased morale & effiency

Safe working conditions

Farmers

Healthy workforce

Low sickness absence, few lost time injuries, few restricted work cases and little short term disability.

However, effective communication ab-solutely requires the consideration of the following factors:* The individuality of the audience* The communicator’s competence in listening and communication skills* Clearly stated goals of communication* Accurate information and the validity of points* The situational and cultural context* The media of delivery* Well-planned method of delivery* Emotional stability and apt gestures

Use of information and communica-tion technologyFor adequate information and orienta-tion for farmers on health and safety the adoption of information and communica-tion technology (ICT), such as mobile text messaging, email, social networks and oth-er ICT-based measures, would go a long

way in creating the required awareness.

The SMS experimentAs reported by Jørs and colleagues in the African Newsletter issue 1 of 2012; SMS messages can be utilized in information dissemination.

Three public health students from Copen-hagen University and three environmen-tal health students from Makerere Univer-sity together with the project staff planned the content of the messages and sent them through a telecommunication company to the farmers in Pallisa over a fourteen-day period in February 2012. Seventy farmers filled in a questionnaire both before and af-ter the messages, and four focus group dis-cussions were conducted with the farmers to evaluate the change in their knowledge and awareness, to determine whether they found the messages useful, and to explore how to improve the messages and whether

to continue with the campaign in the fu-ture. Some of the participating farmers were trained by the Pesticide-Health-Environ-ment (PHE)-project while others were not. The messages, sent out with an introductory slogan, were: ‘Children are our future – Use boots and other personal protective equip-ment when handling pesticides to avoid poi-soning yourself and to reduce the risk of not being able to have children’. ‘Children are our future – Change your clothes and wash them and yourself after using pesticides to avoid poison etc’.

Based on the effectiveness of the method, they concluded that SMS messages can be used to spread health information, as they are taken seriously and they are read and discussed by the farmers, their families and neighbours. However, SMS messages can-not stand alone, due to their limited con-tent; they should be followed up by meetings and discussions in the villages, organized


References

1. http://wiki.answers.com/Q/How_is_edu-cation_an_agent_for_change

2. Olowogbon ST, Fakayode SB, Jolaiya A, Adenrele AY. ‘‘Economics of farm safety: The Nigerian scenario’’. Journal of Development and Agricultural Economics 2013;5(1):7–11.

3. http://www.krishiworld.com/html/agri_extension_edu1.html

4. Mostafa A, El Batami. Health of Agri-cultural Workers in Agriculture: World Health Regional Publication, Eastern Mediterranean Series 25, 2003.

5. Erik Jors, Aggrey Atuhaire, Katia Buch Har-vig, Lene Kierkegaard, Majbrit Molgaard Nielsen, [3]Mercy Wanyana, Bernadette Mirembe, Charles Okorimong, Deogra-tias Sekimpi. Are SMS messages the way forward in spreading health information? Afr Newslett on Occup Health and Safety 2012;22:18–9, Finnish Institute of Occupa-tional Health and Safety.

by trained farmers and agricultural exten-sion workers, and by radio programmes that expand on the subjects raised in the mes-sages, and posters (5). Based on this experi-ment, the use of SMS messages is a welcome development in creating awareness on farm safety .

The use of mass mediaThe use of mass media, such as radio and television programmes on farm safety, would help in creating awareness. Studies have shown that rural dwellers are ardent radio listeners; hence such media could be used in enlightening them on farm safety, since most rural dwellers are farmers.

Well-implemented and formulated occupational policyIncorporating agricultural safety specifi-cally into the national policies, such as the occupational health and safety policy and agricultural policies, would signal the sig-nificance and importance of farm safety and its adoption by different stakeholders, for instance farm workers, employers and policy-makers. The stakeholders would also be enlightened better on the conse-quences of not adopting agricultural safety measures; for example, reduced productiv-ity, increased production losses, increases

in accident cases, decreased morale, fatali-ties and a bad reputation for farm busi-ness.

Social awareness; The social capital approachSocial platforms, such as farmers’ coop-erating societies, organizations and other social platforms, could be used in creat-ing this awareness. For example, farm safe-ty moments, where a farm safety special-ist is invited to present seminars or to talk on some farm safety issues that are of great relevance in the farmers’ contextualized environment, could be included in regular meetings. This could be carried further by holding group discussions ensuring proper assimilation of the concept.

ConclusionPrevention is better and cheaper than cure. Knowledge and information on farm safe-ty are therefore pivotal to having low sick-ness absence, few lost time injuries, few restricted work cases, little short-term and long-term disability, and few fatali-ties in the agricultural sector. There is a need for the massive adoption of all forms of means, method and media in getting the correct and accurate message on farm safety across to the end users in order to

achieve the optimal use and benefits as a preventive measure. Farm safety education is therefore a key preventive measure in OH&S, and the concept should be adopted by the various stakeholders charged with the responsibility of preventing farm-relat-ed health and safety challenges.

This article is adapted from book; Toyin S. Olowogbon (2013) A Systematic Approach to Health and Safety in Agricul-ture; a global approach published by LAP LAMBERT Academic Publishing. Hein-rich-Böcking-Str. 6-8, 66121, Saarbrücken, Germany, available at www.lap-publishing.com.

This article is published with the permis-sion of the publisher.

Toyin S. Olowogbon1, Akanmu S. Akinwande2,1 Occupational Health and Safety Division of Vertext Media ltd, MokolaIbadan, Nigeria.E-mail: [email protected]

2 Department of Curriculum StudiesFederal College of Education, Okene, Kogi State, Nigeria.

Photo by Trevor Samson /World Bank.


Mwele Malecela, Mary MayigeTANZANIA

Photo by © International Labour Organization / M. Crozet

Prevention of non-communi-cable diseases at the workplace in TanzaniaIntroductionThe focus in Tanzania has mainly been on communicable diseases, in particular HIV/AIDS, TB and Malaria. Child-hood illnesses, including diarrhoea and upper respiratory tract infections, have also received a great deal of attention. More recently, efforts have been directed towards neglected tropical diseases. However, the burden of communicable dis-eases is still high, so the increase in non-communicable dis-eases (NCD) creates a double burden to both individuals and the health system in general.

NCDs are becoming more prevalent globally, especially in Sub-Saharan Africa, including Tanzania. WHO (1). es-timates that NCDs cause over 36 million deaths each year, 80% of which occur in low and middle-income countries. Cardiovascular diseases account for most NCD deaths (17 million) followed by cancers (7.6 million), respiratory dis-

eases (4.2 million), and diabetes (1.3 million) (2). The preva-lence of NCDs and related deaths is expected to grow, with the largest projected increase expected to occur in the Afri-can Region by 2020 (3). This is due to socioeconomic trans-formation, which has raised the level of exposure to NCD risk factors.

NCD risk factors include behavioural risk factors: un-healthy diet, excessive alcohol consumption, smoking and low levels of physical activity; and consequent physiological risk factors: raised blood pressure, overweight and obesity, hyperglycemia and hyperlipidemia. NCD risk factors are be-coming more prevalent in developing countries such as Tan-zania (4).

In 2008, WHO (5) reported that in Tanzania NCDs are estimated to cause about 27% of all deaths, with cardiovas-cular diseases accounting for 12%. Of NCD deaths, over 50%


occur below the age of 60. The prevalence of raised blood pressure is 39.2%, and overweight and obesity 22%.

The burden of NCDs in Tanzania is high both in terms of health care costs and economic loss due to premature mortality and work absenteeism. It is projected that Tanzania will lose about 0.5 billion dollars of its income due to heart disease, stroke and diabetes (6).

In Tanzania, a study has shown that working executives were at a higher risk of NCDs, 48% compared to the 10% aver-age of the general population. This differ-ence could be attributed to the work envi-ronment, which predisposes to low levels of physical activity and high rates of obe-sity (7).

A recent study carried out among civ-il servants showed that 58% were either overweight or obese and had low levels of physical activity (a mean of 6000 steps a week) (8). NCDs currently affect peo-ple below the age of 60, who constitute the major proportion of the workforce in Tan-zania. It is imperative, therefore, that ef-forts are made to deal with NCDs at the workplace, in order to curb the burden of these diseases.

For many employees in Tanzania, lead-ing a healthy lifestyle may be a challenge for a number of reasons. Normal working hours in Tanzania are from 8am to 4-5 pm, so most of the day is spent at work. This poses the following challenges: unhealthy diet – many employees do not have access to healthy food or snacks at work and are therefore forced to eat what is available, most of which is unhealthy; the price of food – this may deter people from eating healthy lunches and cause them to resort to cheaply available fast foods.

Another challenge is the lack of physi-cal activity. Due to heavy traffic, people are forced to leave their homes very early and return late. This means hardly any time is left for exercise. In the civil servant study, 60% of the staff interviewed indicated that they had no time for physical activity. Oth-er barriers to exercise could be environ-mental; there are no defined routes for pe-destrians and cyclists for example, which means people have no incentive to walk or cycle to work.

Another shortcoming is that the cul-ture of leisure time physical activity is non-existent. The study reported that the pro-portion of respondents engaging in leisure

time physical activity was less than 7% (9). Employees whose work does not in-volve physical activity are at a greater risk of NCDs.

Socio-demographic and economic transition plays a great role in the current rise in NCDs in developing countries. In-creased urbanization in developing coun-tries means that people are more at risk because the urban environment exposes them to more risky behaviour. Socioeco-nomic factors, cultural factors and lay be-liefs also further contribute to the current trends in NCDs and further compound poor health behaviour. In addition, as the control of communicable diseases im-proves, many people survive to old age and are thus more prone to degenerative dis-eases.

With the increasing risk factors for NCDs, there is a need for an immediate response. The majority of these NCDs are preventable through simple lifestyle meas-ures. What we need are cost-effective cul-turally appropriate interventions to help people maintain a healthy lifestyle. This would include improved city planning to allow people to walk and cycle, should they choose to do so.

Many patients are not aware that they have high blood pressure until it is measured.

Photo by NIMR, Tanzania


The prevention of NCDs at the work-place will require a multisectoral approach. The occupational health law (Occupational Health and Safety Act of 2003) in Tanza-nia stipulates that each employee undergo a medical examination at enrolment. This could be expanded to include periodic ex-aminations. Employers should push insur-ance companies to cover such examina-tions.

Other options that could be useful are the HIV committees already in place at workplaces. In Tanzania, the workplace is obliged to have health committees for HIV that co-ordinate HIV prevention activi-ties and the care of HIV positive individu-als. These structures could be used to also co-ordinate NCD prevention activities at workplaces.

Another option could be to promote physical activity at the workplace through sports competitions, designated sports days or sports bonanzas. Even simple daily exercises carried out before work could be very useful.

More advocacy is needed to raise the profile of the burden of NCDs and to bring them to the attention of policy-makers.

Below there are recommendations to create a sustainable health-promoting en-vironment and to reduce the burden of NCDs at workplaces.

Primary preventionLegislation needs to be put in place to con-trol the harmful use of alcohol, for exam-ple, and to reduce smoking. Currently in Tanzania it is illegal to drink alcohol or

smoke at workplaces.Responsible marketing of unhealthy

foods also needs to be enforced by law. The sale of sugary drinks and fast foods at the workplace, for example, could be re-stricted.

Workplace screening programmes for high-risk individuals and instituting ap-propriate prevention interventions would also be useful.

Secondary prevention There is a need for measures for early de-tection of NCDs through screening and referral for appropriate care. Proper care is also essential to prevent further complica-tions and reduce the burden due to NCDs.

We must take advantage of existing in-frastructure, for example, workplace health education and screening interventions for high-risk groups. Resources for the pre-vention, care and treatment of NCDs must be mobilized. Employees must be given more access to health insurance schemes.

RehabilitationThose with disabilities due to workplace injuries and chronic NCDs have rights to social protection, and their employment must be safeguarded.

Mwele Malecela, Mary MayigeNational Institute for Medical Research 2448 Barack Obama Rd,DaressalaamTanzania

Recommendations for health-promoting workplaces

• Ensure avaibility of facilities for physical activity, such as gyms• Create strong leadership for prevention of non-communicable diseases (NCDs)• Promote physical activity among employees• Encourage use of stairs instead of lifts at workplaces• Ensure avaibility of healthy foods, for example fresh fruits and vegetables available at workplace canteens and price measures to make food cheaply available• Strong support from management/employers• Stakeholder involvement

References

1. WHO Media centre. Factsheet: Noncom-municable diseases. Updated March 2013. http://www.who.int/mediacentre/factsheets/fs355/en/

2. Lim AA, Vos T, Flaxmman AD, et al. A comparative risk assessment of burden of disease and injuries attributable to 67 risk factors and risk factor clusters in 21 regions, 1990 to 2010. A systematic analy-sis for the Global Burden of Disease Study 2010. Lancet, 2012;380(0859):2224–60.

3. The global burden of disease: 2004 up-date. Geneva, World Health Organization.

4. Mayige M, Kagaruki G, Ramaiya K, Swai A. Non communicable diseases in Tanzania: a call for urgent action (2011).Tanzania Journal of Health Research Volume 14, Number 2, April 2012, http://dx.doi.org/10.4314/thrb.v13i5.7

5. World Health Organization, NDC Country Profiles 2011. http://www.who.int/nmh/countries/tza_en.pdf

6. Preventing Chronic Diseases: A vital Investment: Geneva, World Health Or-ganization. 2005.

7. Policy Implications of Adult Morbidity and Mortality End of Phase One Report, August 1997.

8. IUHPE – International Union for Health Promotion and Education. Physical Activ-ity among civil servants in Government Ministry, Dar es Salaam, Tanzania: Assess-ment of knowledge, attitude and practice and population based intervention (preliminary report). 2009. http://iuhpe.org/uploaded/Activities/Scientific_Af-fairs/CDC/CVHP/TANZANIACaseStudy-ofCVHP.pdf

9. Tanzania National STEPS Survey of Non-Communicable Risk Factors, 2012.

44 • Afr Newslett on Occup Health and Safety 2013;23:44

Prevention of child labourNew ILO tool steps up fight against child labour

The International Labour Office (ILO) has launched a new tool to guide efforts to-wards the goal of eliminating the worst forms of child labour by 2016. The tool is - “Implementing the Roadmap for achieving the elimination of the worst forms of child labour - A training guide for policy mak-ers”. It defines the worst forms of child la-bour, presents key strategies for their elim-ination, outlines recommended actions for governments, employers’, workers’ and other civil society organizations and ad-dresses monitoring and evaluation as an essential feature of successful action plans. This guide is both a training tool and a stepping-stone towards the drafting or re-vision of a National Action Plan (NAP) against the worst forms of child labour.

ContactInternational Programme on the Elimination of the Child LabourIPECwww.ilo.org/ipecE-mail: [email protected]

Prevention of chronic diseasesChronic diseases, such as heart disease, stroke, cancer, chronic respiratory dis-eases and diabetes, are by far the leading cause of mortality in the world, represent-ing 60% of all deaths. Out of the 35 mil-lion people who died from chronic disease in 2005, half were under 70 and half were women.

This invisible epidemic is an under-ap-preciated cause of poverty and hinders the economic development of many countries. Contrary to common perception, 80% of chronic disease deaths occur in low and middle income countries.

Chronic diseases and health promotionWorld Health OrganizationAvenue Appia 20CH-1211 [email protected]

Noncommunicable diseasesThe Global Status Report on Noncommu-nicable Diseases 2010 is the first report on the worldwide epidemic of cardiovascular diseases, cancer, diabetes and chronic res-piratory diseases, along with their risk fac-tors and determinants.

See material on Internet:http://www.who.int/chp/en/

Healthy Workplaces campaign

Working together for risk preventionEuropean Weeks for Safety and Health at work in October 2012 and 2013

Find useful information on webside:www.healthy-workplaces.eu

Central to the Healthy Workplaces Cam-paign is the provision of resources to help employers, workers and other stakeholders to improve occupational safety and health. Check out our case studies, publications, practical tools along with campaign and promotional materials.

• Casestudies• Publications• Preventivesolutions checklists for construction, health care and Horeca sectors (hotels, restaurants, catering)• Practicaltools• OnlineinteractiveRiskAssessment (OiRA)• Campaignessentials• Promotionmaterials• Napofilm• OnlineCampaigntoolkit

European Agency for Safety and Health at WorkGran Via 33, 48009 Bilbao, SpainE-mail: [email protected]


11-13 February 2014Hanasaari Cultural CenterEspoo, Finland

The Finnish Institute of Occupational Health is organizing the conference in collaboration with the International Commission on Occupational Health, ICOH.

The Conference will deal with the most recent research results and the current views of leading experts on asbestos exposure moni-toring, diagnostics and early detection of asbestos-related diseases (ARDs).

The main themes of the Conference are:• Exposuremonitoring• ARDs–mechanismsandcausation• EpidemiologyandtrendsofARDs• Healthsurveillance,biomarkersanddiagnostictools• Screeningofasbestos-relatedlungcancer• Asbestosexposureinasbestosremovalwork

The Conference is open to everyone interested in prevention of as-bestos exposure and asbestos-related diseases. It aims at bringing together occupational health and safety experts and scientists, oc-cupational hygienists, public health managers, decision-makers, and insurance experts.

Deadline for abstract submission 15 October 2013Deadline for early registration 15 December 2013

More information on the conference, abstract submission and reg-istration on the website www.ttl.fi/helsinkiasbestos2014

Contact informationHelsinki Asbestos 2014 SecretariatFinnish Institute of Occupational HealthE-mail: [email protected]

Conference OfficeTAVI Congress BureauEmail: [email protected]

Sharing a Vision for Sustainable PreventionXX World Congress on Safetyand Health at Work 2014

Global Forum for Prevention24-27 August 2014 Frankfurt, Germany

The World Congress 2014 offers a plat-form for the exchange of information and opinion to experts in safety and health, representatives of companies and em-ployees, decision-makers from gov-ernment and pub-lic authorities, the social partners, and anyone active in the area of oc-cupational safe-ty and health. Political fora, specialist events and workshops provide an op-portunity to pool experience, to co-operate on specific issues, and to present best-practice examples.

The three main topics are:Prevention Culture – Prevention Strategies – “Vision Zero”Challenges in Occupational HealthDiversity in the World of Work

Deadline for receipt of abstracts is 30 November 2013.Deadline for early bird register by 15 December 2013.

The OrganizersInternational Labour Organization (ILO)International Social Security Association (ISSA)German Social Accident Insurance (DGUV)

ContactGerman Social Accident Insurance (DGUV)“XX World Congress on Safety and Health at Work 2014Global Forum for Prevention”Alte Heerstrasse 11153757 Sankt Augustin, GermanyE-mail: [email protected]

Registration and information:www.safety2014germany.com

International Conference on Monitoring and Surveillance of Asbestos-Related Diseases 2014


Suvi Lehtinen,FINLAND

Health promotion is crucial to us all, including the 3.2 bil-lion working people of the world. This topic with all its as-pects was discussed in detail on 10−14 June 2013 in Hel-sinki, Finland. The 8th Global Conference on Health Pro-motion was organized by the World Health Organization (WHO) in collaboration with the Finnish Ministry of So-cial Affairs and Health, the National Institute of Health and Welfare, and the Finnish Institute of Occupational Health.

Mr. Sauli Niinistö, President of the Republic of Finland, opened the 8th Global Conference, by emphasizing that people’s health and well-being are of the utmost importance for all nations. Health is a pivotal precondition for achieving many other goals in our societies. Yet we need to remember that health is also an essential value in its own right.

Health also forms a central area of public policy-mak-ing. Good public health does not simply include hospitals

8. Global Conference on Health Promotion

and a functioning health system. In addition to these, it re-quires the prevention of diseases and active promotion of well-being. Mr. Niinistö concluded his opening remarks by saying that the role of the World Health Organization in ad-vancing health continues to be of central importance.

Dr. Margaret Chan, Director General of WHO, remind-ed us of the importance of consistent long-term commit-ment to health, despite many deviating and even conflict-ing interests. She also emphasized that decisions related to health are often made outside the health sector.

Professor Mwele Malecela, Director General, National Institute for Medical Research, United Republic of Tanzania, described the activities of the IANPHI Network. She em-phasized the role of the National Public Health Institutes in implementing health promotion activities, involving com-munities to contribute to the work. She also described the

Photo by Sami Perttilä


positive effects and impacts that a joint network can have for stimulating devel-opment in the countries. Learning from neighbours and sharing information form the cornerstones of a global network.

Dr. Kimmo Leppo, one of the found-ing fathers of the health promotion move-ments, was awarded the Citation for Life-time Achievement in Health Promotion. Dr Leppo, who is former Director General of the Health Department at the Minis-try of Social Affairs and Health in Finland, has held several key positions in Finn-ish health planning. “It almost seems that whenever something important was hap-pening in health policy, whether at nation-al, regional or global level, Kimmo Leppo wasthere,”saysZsuzsannaJakab,Directorof the WHO Regional Office for Europe.

Kimmo Leppo expressed his gratitude at the award ceremony on Thursday. “This Citation is a great honour and I accept it with gratitude and humility. I have been

lucky to always work with excellent teams over the decades.”

“One thing I have learnt in the course of my working life, particularly in health promotion, is the importance of combin-ing different perspectives in order to un-derstand issues, work out solutions and manage policy processes,” Dr. Leppo con-cluded.

Further information on the presen-tations of the 8th Global Conference on Health Promotion http://www.healthpromotion2013.organd the book Health in All Policies is available as a full text at:http://www.hiap2013.com/?page_id=17

Nearly 900 delegates from all over the world discussed during five days how political deci-sions on health are implemented into practical actions.

Photos by Sami Perttilä

Contact persons/country editorsEditorial Boardas of 1 January 2013

Director, Department of Occupational Health and SafetyMinistry of Labour and Home AffairsBOTSWANA

Mathewos MejaOSH Information ExpertMinistry of Labour andSocial AffairsETHIOPIA

Chief Inspector of FactoriesMinistry of Employment andSocial WelfareGHANA

The Director, Occupational Safety and Health Ministry of Labour, Industrial Relations& EmploymentMAURITIUS

Chief Inspector of FactoriesMinistry of LabourSIERRA LEONE

Seiji Machida, DirectorProgramme on Safety and Health at Work and the Environment (SafeWork)International Labour OfficeGeneva, SWITZERLAND

Evelyn Kortum Technical OfficerOccupational HealthInterventions for Healthy EnvironmentsDepartment of Public Health and EnvironmentWorld Health OrganizationGeneva, SWITZERLAND

Jorma RantanenPast President of ICOHICOH International Commission on Occupational Health

Harri VainioDirector GeneralFinnish Institute of Occupational HealthFINLAND

DirectorDepartment of Occupational Health and Safety(Ministry of Labour and Home Affairs)Private Bag 00241GaboroneBOTSWANA

Samir Ragab SeliemEgyptian Trade Union FederationOccupational Health and Safety Secretary90 Elgalaa StreetCairoEGYPT

Ministry of Labour and Social AffairsP.O. Box 2056Addis AbabaETHIOPIA

Commissioner of LabourMinistry of Trade Industry and EmploymentCentral Bank BuildingBanjulGAMBIA

The DirectorDirectorate of OccupationalSafety and Health ServicesP.O. Box 34120-00100NairobiKENYA

The DirectorOccupational Safety and HealhPrivate Bag 344Lilongwe MALAWI

H. Ali El SherifChief Medical OfficerOccupational Health ServiceMinistry of Health and Social ServicesP/Bag 13198WindhoekNAMIBIA

Mrs Ifeoma NwankwoFederal Ministry of Labour and ProductivityOccupational Safety andHealth DepartmentP.M.B. 4 AbujaNIGERIA

Peter H. MavusoHead of CIS National CentreP.O.Box 198MbabaneSWAZILAND

Chief ExecutiveOccupational Safety andHealth Authority (OSHA)Ministry of Labour and EmploymentP.O. Box 519Dar es SalaamTANZANIA

CommissionerOccupational Safety and Health Ministry of Gender, Labour and Social DevelopmentP.O. Box 227KampalaUGANDA

Kebreab Zemer GhebremedhinMinistry of Labour and HumanWelfareDepartment of LabourP.O. Box 5252AsmaraERITREA

SLY-Lehtipainot OY, Kirjapaino Uusimaa, Porvoo

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African Newsletter 2/2013, Prevention culture