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PAHO-2KPAHO-2K
Pan American Health OrganizationPan American Health Organization
PAN AMERICAN HEALTH ORGANIZATIONPan American Sanitary Bureau, Regional Office of the
WORLD HEALTH ORGANIZATION
Contribuciones de las distintas Contribuciones de las distintas Organizaciones y Agencias Internacionales y Organizaciones y Agencias Internacionales y
de Cooperación a la SSOde Cooperación a la SSO
DR. LUZ MARITZA TENNASSEEDR. LUZ MARITZA TENNASSEE Sustainable Development and Environmental Health
OPSEl Salvador, 29-30 Abril 2004
PAHO-2KPAHO-2K
Pan American Health OrganizationPan American Health OrganizationGlobalization: Strengths and weaknesses
Beneficial effect Adverse effect 5–7 % annual
growth trade and world production
Harder competition developing countries
Global market provides benefit of scale
Home markets are put under pressure
Higher efficacy and quality
Compromising health and safety standards
Elimination of time dimension from global market
Unphysiological time schedules, sleep debt,
vigilance problems
< costs of storage, high flow of production
Tight deadlines, psychological stress.
physical overload
Adapt to global market unconventional work
hours, source of flexibility: human labour
PAHO-2KPAHO-2K
Pan American Health OrganizationPan American Health OrganizationEnvironmental &Workers’ Health
“Occupational Health and Safety:
a high priority in the global,
international and national
agenda”Kofi A. AnnanSecretary General United Nations
Johannesburg Summit 2002
• Protect the health and safety of workers
• Strengthen and promote ILO and WHO programmes to reducr occupational
deaths, injuries and illnesses.
•Link occupational health with public health promotion”
PAHO-2KPAHO-2K
Pan American Health OrganizationPan American Health OrganizationUN Millennium Development Goals
Relation to Workers’ Health
GOALS: CONTRIBUTION:
• Eradicate Extreme Poverty and Hunger
•Promote Gender, Equality and Empower Women
•Reduce Child Mortality and Improve Maternal Health
•Combat HIV/AIDS
•Synergy with Labor Ministers, Private Sector, NGOs Unions to Create and
Maintain a Healthy Workplaces
•Basic Skills for Women to Utilize Housing and Working
Facilities
•Improvement in Working Conditions to promote and
protect parental Health
•Through Promotion in the Workplace and healthcare
Sector
PAHO-2KPAHO-2K
Pan American Health OrganizationPan American Health OrganizationUN Millennium Development Goals Ensuring Environmental Sustainability
TARGET
TARGET
CONTRIBUTION
CONTRIBUTION
Integrate the Principles of Sustainable Development into Country Policies and
Programs and reverse the loss of Environmental Resources
•Regional Plan on Workers’ Health/Health Workplaces Initiatives
•Linkages between Health and Labor PAHO/ILO
By 2020 to have achieve a significant improvement in the Lives of at least 100 million
slum Dwellers – phase out and eradication
Creation of Healthy, Safe and Decent Workplaces
PAHO-2KPAHO-2K
Pan American Health OrganizationPan American Health OrganizationSITUATION ANALISIS IN THE AMERICASSITUATION ANALISIS IN THE AMERICAS
INEQUITIES – INSTITUTIONAL DISPERSION - REFORMS
• EAP: 351 million (> 50% Americas population).
- 69 million below poverty line.
- 52% Informal Sector ( women, children, migrants, indigenous)
- 49% women
- 24 million children work.
36 Injuries / minute
5 Million injuries / year
5 Million injuries / year
90,000 Fatal Injuries / year
• Morbidity: Traditional occupational illnesses, along with cancer,
asthma, depression, cardiovascular, musculoskeletal , immunological,
and nervous system, and re-emerging diseases.
9% - 12% of GDP in LAC
30% Receives Occupational Health Services (formal sector)
• EAP: 351 million (> 50% Americas population).
- 69 million below poverty line.
- 52% Informal Sector ( women, children, migrants, indigenous)
- 49% women
- 24 million children work.
36 Injuries / minute
5 Million injuries / year
5 Million injuries / year
90,000 Fatal Injuries / year
• Morbidity: Traditional occupational illnesses, along with cancer,
asthma, depression, cardiovascular, musculoskeletal , immunological,
and nervous system, and re-emerging diseases.
9% - 12% of GDP in LAC
30% Receives Occupational Health Services (formal sector)
PAHO-2KPAHO-2K
Pan American Health OrganizationPan American Health Organization
StateWorkforce Composition,
Migration, Precarious L.M, Poverty Feminization
EffectLost workdays,
Occupational Accidents & Diseases, Lower Productivity, Social
Costs
ACTION
Health Policies and Legislation
Quality of the Work
Environment
Promotion of Workers Health
Comprehensive Workers’
Services
PressureTechnology Transfer, Non-
traditional Expoprt Production Increase
Maquila
Exposure (Environmental)
Psychosocial, Ergonomic,Chemical, Biological,
Safety & Physical
DPSEEA Model
Driving ForcesGlobalization, Integration,
Technological ChangeReform of the State, Inequities
The Workers’ Health Plan
PAHO-2KPAHO-2K
Pan American Health OrganizationPan American Health Organization Economic impact
Musculoskeletal 40%
Heart diseases 16%
Injuries 14%
Respiratory diseases9%
Nervous Central System8%
Others13%
Other diseases include cancer, skin diseases and mental disorders
The Breakdown of Costs for Work-related Injuries and Diseases
Source: ILO, 1999
PAHO-2KPAHO-2K
Pan American Health OrganizationPan American Health Organization
Organization of American States
The Regional Workers’ Health Plan
III Summit of the Americas 2001
XII Inter-American Conference of the Ministers of Labor
October 2001- Septiembre 2003
•Declaration and Plan of Action (OAS, ILO, PAHO, IDB, WB, ECLAC)
Workers’ Health
PAHO-2KPAHO-2K
Pan American Health OrganizationPan American Health Organization Agreement PAHO - ILO
Extend Social Protection and Health Coverage within Excluded Groups
(ESPHC)
Agreement PAHO - ILOExtend Social Protection and Health Coverage
within Excluded Groups(ESPHC)
Approved by Directive Council
PAHO-2KPAHO-2K
Pan American Health OrganizationPan American Health Organization THE CHALLENGE
Magnitude of the Problem:Total population of Latin America and the Caribbean: 500 million.
27% of the population lacks access to permanent and basic health services (125 millon).
46% of the population does not have health insurance either public or private (230 millon).
PAHO-2KPAHO-2K
Pan American Health OrganizationPan American Health Organization
REASON FOR ESPHC IN THE AMERICAS REGION
Persistent economic, social, ethnic and cultural exclusion.
The present social protection mechanisms are insufficient to give answers to new problems.
It is necessary for the Reform Processes to contribute in the construction of socially inclusive societies for all its citizens.
PAHO-2KPAHO-2K
Pan American Health OrganizationPan American Health Organization
Access to Services
Home Financial Security
Quality of Health Services
CONDITIONS FOR THE EXTENSION OF SOCIAL PROTECTION IN HEALTH
PAHO-2KPAHO-2K
Pan American Health OrganizationPan American Health OrganizationMANDATES OF THE ILO/PAHO/WHO RELATED
TO THE EXTENTION OF SOCIAL PROTECTION IN HEALTH
PAHO/WHO• Reduction in inequities in the access to health services and in their financing
• Universal access to health services in order to achieve the goal of health for all
• Poverty reduction and development goals of the millenium
PAHO-2KPAHO-2K
Pan American Health OrganizationPan American Health OrganizationMANDATES OF THE ILO/PAHO/WHO
RELATED TO THE EXTENTION OF SOCIAL PROTECTION IN HEALTH
MANDATES OF THE ILO/PAHO/WHO RELATED TO THE EXTENTION OF SOCIAL PROTECTION IN HEALTH
ILO Promote opportunities for decent and
productive work under conditions of freedom, equity, safety and human dignity
Improve the coverage and effectiveness of social protection for all, including protection in health
New consensus of social security
PAHO-2KPAHO-2K
Pan American Health OrganizationPan American Health Organization
First Hispanic ForumOctober 2000
TOPICS
• Inequities
• Environmental Justice
• Migrant Workers
• Border Health
ACTORS• EPA, OSHA, NIOSH (public sector)
• NSC, 3M (private sector)
• National Alliance for Hispanic Health (NGOs)
• PAHO, ILO, NAALC (international organizations)
PAHO-2KPAHO-2K
Pan American Health OrganizationPan American Health Organization
Hispanic population grew by 58% between 1990 and 2000:38.3 Million in the US, 3.8 Million in Puerto Rico
12.5% of the workforce is Hispanic. They bear 15% of the total US fatal occupational injuries.
Fatal occupational accidents have decreased overall, but risen alarmingly among the Hispanic labor force.
In the US there has been a 40 % increase in fatalities among Hispanic workers in the construction sector.
Alarming Increases in Work Accidents among Hispanics
0
200
400
600
800
1000
1200
1400
1600
1800
2000
0
1000
2000
3000
4000
5000
6000
7000
Fatal Work Injuries involving Hispanics Hispanic Construction Workers
Fatal Work Injuries Counts 2 per. Mov. Avg. (Fatal Work Injuries Counts)
2 per. Mov. Avg. (Fatal Work Injuries involving Hispanics) 2 per. Mov. Avg. (Hispanic Construction Workers)
Work Related Fatalities are Projected to Keep rising without preventive interventions
PAHO-2KPAHO-2K
Pan American Health OrganizationPan American Health Organization
US-Mexico Chamber of Commerce
IDB
Hispanic Workers Safety and Health
Susan Harwood Grants
OSHA
PAHO
Hispanic Forum
3M
Summit of the Americas-
OAS
NIOSH
Communications
Workshop
US-Mexico BHA
NSC
Puerto Rico
NATIONWIDE NETWORK: AN INVITATION TO JOIN AND SUPPORT
Interconnectivity and Support
PAHO-2KPAHO-2K
Pan American Health OrganizationPan American Health Organization Border Issues
PAHO-2KPAHO-2K
Pan American Health OrganizationPan American Health Organization Border XXI Program
“ To improve the environmental health of U.S.-Mexico border communities by identifying and addressing those environmental conditions posing the highest human health risk”
1983 La Paz agreement designated six work groups (Air, water, hazardous waste, contingency planning, pollution prevention and cooperative enforcement)
1996 Three groups were added: natural r esources, environmental information and environmental and occupational health.
Development of Environmental Health Indicators
PAHO-2KPAHO-2K
Pan American Health OrganizationPan American Health Organization Migrant Farm Workers
•Most farm workers have no insurance.
• 3 to 5 million of them are Hispanic.
•Most migrant workers are men in their 20s and send their earnings home to their families in Mexico, Guatemala, Honduras, El Salvador or Haiti.
•Most live in poor housing and unsanitary living conditions.
PAHO-2KPAHO-2K
Pan American Health OrganizationPan American Health Organization
Healthy Work Place InitiativeHealthy Work Place Initiative Healthy Work Place InitiativeHealthy Work Place Initiative
Central America Andean Region
PAHO-2KPAHO-2K
Pan American Health OrganizationPan American Health Organization
http://www.cepis.ops-oms.org
CONTENT:CONTENT:
•Best PracticesBest Practices
•DatabasesDatabases
•SoftwaresSoftwares
•Global LinksGlobal Links
•DECIDESDECIDES
•Long-Distance Long-Distance EducationEducation
ILOILO
PAHO-2KPAHO-2K
Pan American Health OrganizationPan American Health Organization
PAHO-2KPAHO-2K
Pan American Health OrganizationPan American Health Organization
19%
9%
31%
21%
3%
17%22%
15%
11%15%
8%
29%
Current Occupation for Men by Hispanic Origin in the US 2000
Hispanic Non-Hispanic White
ServicePrecision production
Farming
Managerial, professional
Technical, sales Operators, laborers
Source: Current Population Survey, March 2000, PGP-4
PAHO-2KPAHO-2K
Pan American Health OrganizationPan American Health Organization
2%15%
35%
42%
1% 5%
26%
18%38%
2%
23% 16%
Current Occupation for Women by Hispanic Origin in the US 2000
Hispanic Non-Hispanic White
ServicePrecision production
Farming
Managerial, professional
Technical, sales Operators, laborers
Source: Current Population Survey, March 2000, PGP-4
PAHO-2KPAHO-2K
Pan American Health OrganizationPan American Health OrganizationPercent Unemployed by Hispanic Origin Percent Unemployed by Hispanic Origin
and Sex in the US 2000and Sex in the US 2000(Population 16 years and over in the labor force)(Population 16 years and over in the labor force)
Per
cent
6.86.2
7.7
3.4 3.6 3.3
0
2
4
6
8
10
Both Sexes Male Female
Hispanic Non-Hispanic White
Source: Current Population Survey, March 2000, PGP-4
PAHO-2KPAHO-2K
Pan American Health OrganizationPan American Health OrganizationPercent Unemployed by Hispanic Origin Percent Unemployed by Hispanic Origin
and Sex in the US 2000and Sex in the US 2000(Population 16 years and over in the labor force)(Population 16 years and over in the labor force)
Per
cent
6.86.2
7.7
3.4 3.6 3.3
0
2
4
6
8
10
Both Sexes Male Female
Hispanic Non-Hispanic White
Source: Current Population Survey, March 2000, PGP-4
PAHO-2KPAHO-2K
Pan American Health OrganizationPan American Health OrganizationPercent Below Poverty Level in 1999 by Age and Hispanic
Origin in the US
Per
cent
22.8
30.8
18.520.4
8 9.47.1 7.6
0
10
20
30
40
50
All ages Under 18 18 to 64 65 and over
Hispanic Non-Hispanic White
Source: Current Population Survey, March 2000, PGP-4
PAHO-2KPAHO-2K
Pan American Health OrganizationPan American Health Organization
ECONOMIC BURDEN OSH
NIOSH/CDC
AIDS ALZH CANCERCIRCULOSH
171
33
67
154 170
0
20
40
60
80
100
120
140
160180
PAHO-2KPAHO-2K
Pan American Health OrganizationPan American Health Organization
UnemploymentUnemployment
SocialInjustice
Syndrome
OccupationalCancer
OccupationalCancer
ReproductiveProblems
ReproductiveProblems
OccupationalStress
OccupationalStress
MusculoskeletalDisorders
MusculoskeletalDisorders
Accidents and InjuriesAccidents and Injuries
Hearing LossHearing Loss
Cardiovascular Diseases
Cardiovascular Diseases
Infectious DiseasesInfectious Diseases
Homicides Suicides Violence
Homicides Suicides Violence
Alcoholism and Substance AbuseAlcoholism and
Substance Abuse
PoisoningPoisoning
RespiratoryProblems
RespiratoryProblems