Presentation by dr. Igor FEDOTOV, Coordinator, Occupational and Environmental Health, ILO Progamme SAFEWORK,Geneva, at the WHO/TNO/Dutchgovernment Congres 'Connecting Health and Labour' 29 - 1 December 2012

1. WHO Global Conference: Connecting Health and Labour (29 Nov.-1 Dec.2011, the Hague)
Labour and social protection policies and primary health care
Igor FEDOTOV, M.D., Ph.D,
Coordinator, Occupational and Environmental Health, ILO Progamme SAFEWORK, Geneva,
Switerland

2. Major Challenges for Occupational Health Services

3. Major Challenges for Occupational Health Services
 Fragmentation of work, no more one job for life
 Increasing number of work-related accidents
and diseases, many are not registered
 Growth of the informal economy
 High numbers of vulnerable workers (migrants, HIV/AIDS,
disabled) and ageing workforce
 Impact of crisis: downsizing OSH, income inequalities
 Escalating health costs
 Disruptions of social security schemes
 Lack of OSH personnel and inadequate resources
How can labour and social protection policies
meet these challenges?

4. Investment in occupational health
Worker Health:
- added value for productivity and sustainable development
- indicator of success of social and economic policies
- critical economic factor at enterprise and nationally
Policies should aim at:
- risk management, disease prevention & health promotion
- reduction of social costs through prevention
Policies be based on:
principles of equity, affordability and accessibility

5. ILO Occupational Health Services Convention 161
Primary task
Entrusted with essentially preventive functions and responsible
for advising employers and workers on requirements for
establishing and maintaining a safe and healthy work
environment and adaptation of work to the capabilities of
workers
- Requires the establishment of comprehensive national
policy on OH Services
- Determines functions, organization and conditions of
operation

6. Labour policies – national labour codes
Solid OSH legislation
Employer liability in case of work-related accidents and diseases
Enforcement of law – labour inspection
Tripartite cooperation (collective agreements)
National safety and health tripartite body
Main goals
Reduction of risks, prevention of occupational injuries and diseases, health promotion, medical
rehabilitation, and return to work

7. Labour policies strengthening legal OSH frameworks
Occupational Safety and Health C. 155 requires:
- to formulate and implement a coherent national policy (Art.4)
- policy shall include the respective functions and responsibilities for OSH of public authorities,
employers, workers … (Art. 6)
- the necessary coordination between various authorities and bodies (Art.15)
Promotional Framework for OSH C. 187 requires:
- development of national OSH policy, system, programme and profile
National system includes:
- occupational health services
- collaboration with insurance or social security schemes to cover work injuries and diseases
- support mechanisms for progressive improvement of OSH conditions in SMEs and in the informal
economy
National programme:
to be endorsed and launched by the highest national authorities

8. Social security policies – national social security codes
Social security legislation
Health insurance (general) to cover medical care of any mobid condition and
sickness benefit
Employment injury insurance to cover medical, sickness, disability and
survivors benefits in case of occupational accidents and diseases
Main goal
Social protection of victims of work related injuries and diseases and social
rehabilitation

9. Social polcies strengthening social protection
Minimum Standards of Social Security C. 102
Part VI. Employment Injury Benefit – to preserve minimum contingencies to be covered due to accident
or disease resulting from employment
Employment Injury Benefits C. 121
National legislation on employment injury benefit shall protect all employees
It includes Schedule I. List of occupational diseases
- ILO adopted Rec. 194, 2002, that requires a national list of occupational diseases for the purposes of
prevention, recording, notification and compensation to be established by the competent authority
- national list to be reviewed in line with the most up-to-date list of ILO
- ILO revised the list of occupational diseases in 2010
Medical Care and Sickness Benefit C.130
Part II. Medical care: requires to secure to the persons protected the provision of medical care of
curative and preventive nature in case of contingencies, including incapacity to work resulting from
sickness
Part III. Sickness benefit: requires to secure to the persons protected the provision of sickness benefit in
case of contingencies, including incapacity to work resulting from sickness

10. Synergies of Labour and Social Policies
To be effective, the policies should aim at:
- keeping labour and social protection high on technical and political
agendas
- establishing OH Services and social security institutions
- developing overall infrastructure for OH practice
- promoting creation of safety culture at the level of society, enterprise
and individual
The policies should address risks:
- in humans (biological) – to prevent ill-health, loss of working capacity,
temporary or permanent disability
- in society (economic) – to prevent loss of income due to occupational
injuries and diseases

11. UN Initiative on Social Protection Floor
• ILO and WHO the lead agencies
• WHO – basic health protection and medical care services
development
• ILO – basic income protection (disability, maternity, pension,
unemployment)
• Standard setting item for International Labour Conference, 2012
“Recommendation on the social protection floor”

12. Conclusions
 Labour and social protection policies are in the
core of the ILO Decent Work Agenda
 Effective labour and social policies are critical for
good governance and sustainable development
 Countries need to recognize a critical importance
of developing OH Services to cover all workers
 To create synergies: labour, health and social
policies should be comprehensive, consistent and
complimentary

13. Recommendations
1.
Develop:
a. Mechanisms for multi-channel provision of OH
services, especially through PHC system, and
indicators for measuring progress
b. Cooperation between labour and health sectors
on OH Services and their expansion into the
informal economy
c. Training tools and good practice guides to assist
countries in stepwise development of OH
Services
2.
Promote: ratification and application of the ILO
Conventions 161 and 187

14. Recommendations
3Link the development of OH Services with the
establishment of comprehensive national OSH
action programs and countries’ profiles
.Build up wide partnerships to strengthen ILO and
4. WHO actions to influence decision-making
and provision of resources at national and
international levels

15. WHO Global Conference: Connecting Health and Labour (29 Nov.-1 Dec.2011, the Hague)
Igor FEDOTOV, M.D., Ph.D
Coordinator, Occupational and Environmental
Health
Thank You! ILO Programme SAFEWORK
Geneva, Switzerland
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www.ilo.org/safework