ILO Code of Practice

Paul Oldershaw (UK, IOHA President-elect)

The work of the International Labour Office (ILO) has a major impact on occupational health, and the hygiene profession. IOHA has been developing its collaboration with ILO and was invited to contribute to the production of a "Code of Practice on Ambient Factors in the Workplace". The meeting of experts to discuss this was held in Geneva, from January 27 to February 2.

The experts group comprises three panels of five nominees each from employers, workers and governmental representatives, and a small number of NGO observers, who were able to contribute. Written comments had been provided by 30 governments.

The Code is a lengthy document, and sets out the basic principles of occupational hygiene; the roles of employers, workers and governments in applying them, and gives more detailed technical guidance on hazardous substances; optical, ionising and non-ionising radiation; heat, cold and humidity; noise and vibration. It does not cover ergonomic risks or psychosocial factors. It brings together requirements from several binding Conventions and Recommendations, including the guidelines for health surveillance, in which IOHA has also had input. The Code is not a binding legal document but is important as an internationally agreed statement of hygiene requirements, and will be influential in many countries.

The draft document for expert discussion was a worthy effort at covering a broad area. During discussions, IOHA's input was particularly focussed on the:

Discussion was often polarized on workers' rights and the duties of employers. The problem of controlling by hazard or risk was a recurrent difficulty, particularly where some languages make no distinction. We hope that IOHA's participation will have made a positive contribution towards the product of this meeting, and we look forward to seeing the final Code.

103rd Session of WHO Executive Board

Kurt Leichnitz (Germany, IOHA Secretary-Treasurer)

The Director-General (DG) of the World Health Organization (WHO) invited the non-governmental organizations (NGOs) in official relation with WHO to attend the 103^rd Session of the Executive Board, from January 25 to February 3, in Geneva. IOHA was represented by its Secretary-Treasurer Kurt Leichnitz.

In her address to the Executive Board, the new DG Dr. Gro Harlem Brundtland reported on the comprehensive changes to the structure and the management of WHO that have occurred, as well as the direction that the organization should take over the next years. One of the major items on the Board's agenda was the WHO budget of $1.8 billion (USD) for the years 2000-2001.

Among the main elements of the reform are:

The new Cluster on Sustainable Development and Healthy Environment covers projects related to occupational hygiene. This Cluster is subdivided into four programmes (Departments): "Health in Sustainable Development", "Nutrition for Health and Development", "Protection of the Human Environment", "Emergency and Humanitarian Action".

WHO's focal point for IOHA is Berenice Goelzer, who works in the department "Protection of the Human Environment". This programme covers a broad range of risk assessment and normative work on issues such as food and water, sanitation and chemical safety, radiation and occupational health. Its activities are in four major directions: chemical safety, carried out under the umbrella of the ILO/UNEP/WHO International Programme on Chemical Safety (IPCS); food safety; water supply and sanitation; occupational health. In addition, the Department advises on the creation of supportive environments for health (e.g. healthy cities, workplaces).

The collaboration between WHO and its NGOs was assessed by a WHO Standing Committee. The evaluation showed that not all NGOs met the WHO criteria and therefore their official relations with WHO were discontinued. The evaluation of IOHA was positive, which means that our official relationship with WHO will be maintained.

Hygiene Practice Around the World

The majority of IOHA member associations could be characterized as "western" in outlook. Even in (say) Hong Kong, British traditions have had a strong influence. In this issue, we bring you some stories of occupational hygiene (OH) practice from diverse regions of the world.

With the inexorable progression of globalization, and world-wide harmonization of standards, these should be of interest to all. Both AIHA and ACGIH groups have been active in Poland, which has been described in their newsletters. In fact, the (former) communist block represents a vast part of the industrialized world where the model of occupational hygiene evolved quite differently.

We begin with Latvia, where a hygienist is fundamentally a physician, archetypical of the profession as developed in many nations under a communist system. We move to Australia and Southern Africa, and end up in Latin America.

We would also like to point out the availability of the Asian-Pacific Newsletter on Occupational Health and Safety, published by the Finnish Institute of Occupational Health, on the web. Number 3 of 1998 details musculoskeletal disorders; issues published in 1999 will feature psychological stress, agriculture and pesticides. This is at:

www.ilo.org/public/english/270asie/asiaosh/index.htm

Occupational Hygiene in Latvia

Maija Eglite*, Ilze Jekabsone*, Mudite Kipure**, Ivars Vanadzins*

(*Institute of Occupational and Environmental Health, Medical Academy of Latvia; ** State Labour Inspectorate, Ministry of Welfare, Republic of Latvia).

Latvia, situated on the Baltic Sea, is a country geographically larger than Denmark, Switzerland or the Netherlands, yet has a population of less than 3 million. During its previous phase of independence between the world wars, it flourished in many respects: there was opportunity to develop the wealth of unique and ancient cultural heritage; in the 1930s, the per capita University enrollment in Latvia was the highest of all European nations, and the national literacy percentage was in the high 90s.

Under the Soviet regime, it experienced various hardships, many of which were intended to eliminate uniqueness. As a consequence, the Latvian people are now barely a majority in their own nation (independent again, since 1991), and the sociodemographic parameters have been turned upside down. For example, Latvia now has the lowest "average life expectancy at birth" of all European countries, and the lowest rate of population increase in the world (actually negative). However, the people valiantly struggle on, determined to become accepted again as the nation that boasts of "Paris of the North" (its capital, Riga).

I was privileged to work there for a while in 1997, and gained many fascinating insights. It is intriguing (for example), from a North American perspective, to realize that occupational health and safety is regarded as part of the health care system. Of course, this is how it must be, if we are to successfully rationalize the long term investments necessary for achieving healthful work environments. This article has been substantially abbreviated from a submission by some of the leading professionals in Latvia. (In case there is a trace of bias in the above, you should note that I am Latvian, as well as Canadian - ed.)

Latvia clearly is a "society in transition". Essential changes have affected every aspect of life - from politics and the national economy, to health; the whole system of health care is under consolidation and reconstruction. This, of course, also affects the system of occupational health and safety (OH&S) as a natural part of the health care system. The problems of occupational health services (OHS) are very closely related to overall problems of economics. A most important task for all countries in transition is a reorganization of OHS originally created in a system of central planning (the former Soviet Union) to a market driven economy with its dynamic development. It is also essential to follow the international directives concerning organization of OHS, in the country's path to becoming fully integrated into the European community. Latvia has already ratified ILO Convention 155 (1981) and EC Directive 89/391/EEC.

The main industries are textile, building materials, chemico-pharmaceutical, woodworking and, the processing of agricultural and fish products. It is very typical that industrial worksites have decreased in number in recent years, and public service work has increased. Work conditions in many industrial workplaces (and also in agriculture) are very hazardous, because old technologies are still in widespread use and nothing has been done in many enterprises to improve occupational health and safety for many years. National data show that the number of first-diagnosed occupational diseases per 100,000 workers were 5.1 in 1981, 10.7 in 1989, 23.5 in 1994 and 16 in 1998. The number of occupational accidents has also grown rapidly during recent years; in 1997 there were 9.4 fatalities per 100,000 workers.

In Latvia, occupational hygiene is defined as the branch of medicine dealing with prevention, that investigates possible effects of the working environment on the human organism and determines the necessary hygienic and medical measures for prevention of adverse effects on workers' health, as well as for an improvement of workers' work ability and productivity.

During Soviet times, special departments in the State Sanitary Epidemiological Stations dealt with problems of OH. Occupational hygienists' main functions were regular inspection and measurements of hazardous factors in workplaces, leading to control. At that time there were around one hundred occupational hygienists working in Latvia.

The social and economic transition has introduced new trends in the development of OH. Now, under a Labour Code adopted in 1995, Latvian employers are responsible for the fulfilment of hygienic and medical measures for the benefit of workers' health. After the regaining of independence in Latvia, the State Sanitary Epidemiological Stations were closed or restructured to Environmental Health Centres. Most occupational hygienists had changed their occupation due to the economic situation; now, 30 occupational hygienists are still active in the field, many employed by the State Labour Inspectorate (SLI) that was established in 1993.

The main tasks of SLI are: inspection of work conditions at enterprises; supervision of work relations between employer and employee; coordination of a tripartite system; issuing of licenses to Alegal persons' providing worker training in occupation safety; issuing of licenses for the introduction and use of the dangerous equipment; investigation of work accidents and occupational diseases; registration of dangerous equipment; participation in the creation of regulatory documents in occupational health; consultations for employers and employees about questions related with occupational health and safety; training of labour inspectors.

During the Soviet era, there were ubiquitous OH standards for the work environment, established in Moscow. The main difference from Western standards was that only human health, and not technical and practical aspects, were considered during the elaboration of the standards. So, we had very strict and safe standards that nobody was able to fulfill. There were many cases where dust levels were 20-50 times higher than the standard; furthermore, "area" (rather than "personal") sampling was the approach taken with evaluation. Similarly, even newly-built Soviet tractors had vibrations higher than the standard permitted.

Standards are now adopted by the Technical Committee on the Working Environment, at the National Centre for Standardization and Metrology. Standards are developed taking into account the requirements of the European Commission, standards of other Western countries and standards of former Soviet Union. Right now there are around 50 standards for chemical substances already adopted, taking into account EC requirements. Another 10 standards have been elaborated taking into account standards of other countries. Standards for noise and vibration are currently under development and will be adopted soon.

During Soviet times OHs were trained in the Medical Institutes of Moscow, St. Petersburg and Kiev, in Sanitary Faculties; they were physicians trained in occupational hygiene. Besides that, a short course in Occupational Hygiene and Occupational Diseases was included in the training curricula of higher medical education as far back as 1949 when the Department of Hygiene was founded in Riga's Medical Institute (later Medical Academy of Latvia - MAL). From 1989 till 1992 special training curricula of higher education in preventive medicine including occupational hygiene and medicine were introduced at MAL.

The MAL Institute of Occupational and Environmental Health (IOEH) is a leading institution providing education for all kinds of occupational health professionals, at different levels, as well as being a leading authority of research in occupational health and safety. The Institute's main tasks (besides the training) are: evaluation and harmonization of occupational exposure limits of chemical and biological substances in accordance with European standards; development of chemical methods for the analysis of harmful substances in workplace air and in biological samples; research work in the field of occupational health and safety (done in collaboration with different organizations, enterprises and institutions); provision of highly qualified diagnostic and therapeutic expertise for the patients with occupational diseases; creating and updating of data base about occupational diseases; providing expert help to general health services with proper and modern methods for early diagnosis, treatment and rehabilitation of work related diseases; providing information on different aspects of occupational health and safety.

It has also started to build and maintain web pages of Latvian OHS http://www.parks.lv/home/ioeh/visitthe.htm within the recently introduced Baltic Sea Network on Occupational Health and Safety http://www.occuphealth.fi/eng/project/baltic

The Institute's main research activities currently encompass: occupational lung diseases (i.e. pneumoconioses, chronic bronchitis etc.); occupational health problems of workers working with asbestos and, those employed in the building materials industry (dermatoses as well as lung disease, etc.); monitoring of workers in chemico-pharmaceutical enterprises; chronic lead poisoning; environmental and occupational allergic diseases; estimation of health status and follow-up of the Chernobyl Nuclear Power Station accident clean-up workers.

In Latvia, in some cases there still is an opportunity to learn about the dose-response relationships for chemical substances in markedly overexposed workers. For example, in roofing workers, asbestos fibre exposures up to 4.5 f/cc (average) and 14 f/cc (short term).

Since the breakdown of the Soviet Union, control of working conditions in almost all industries is unsystematic and is mainly based on the services provided by various laboratories, either from the Environmental Health Centres or factories. Besides that, some independent / research laboratories have been starting to offer their services. That has been possible because of the recently introduced obligatory certification of laboratories performing hygienic measurements.

We face challenges at many levels. Employers are typically not committed to an improvement of working conditions, arguing that only bare survival is possible in our economic circumstance. This situation will be improved by the Social Security Law coming into force. It is foreseen that insurance premiums paid for the employees by the employer will be set for each enterprise according to its working conditions and existing harmful factors. This will mean that the enterprises with the worst conditions and highest number of occupational diseases will pay higher premiums.

Although the Cabinet has promulgated a new regulation (in 1997) about "Compulsory health status control and teaching of first aid for persons working in harmful and dangerous working conditions" this has not led to a resolution of many problems, because: working conditions and hazardous factors can sometimes change very quickly; no educational programme has been provided to employers to make them to understand that such regulations are not a governmental activity directed against them (through higher costs for check-ups, compensations, protective measures and etc.) but rather, a crucial activity meant to improve the health of their work force and improve their competitiveness in modern marketing economy; workers are trying to hide any complaints they might have, as they are afraid of losing their jobs. It is also true that they are unaware of harmful factors in their work environment; most people don't care about their health, thus the overall prestige of health is very low. Workers often mistreat or don't use personal protective measures because they do not understand their role and significance.

Occupational hygienists currently working in Latvia are physicians by their background so, in many cases their knowledge and advices are limited to medical aspects of hygiene like evaluation of effects of harmful factors, and working out different methodologies for the prevention of workers' diseases. Their knowledge is often insufficient for successful solutions in practical and technical aspects. In Western countries occupational hygienists are able to deal with broader range of problems and are not so limited by their narrow professional background.

At the moment we are trying hard to develop a proper system of occupational health and safety. Great efforts have been invested in creation and harmonization of a legal basis for OHS as this is particularly crucial for successful development of OHS in any country. Every effort has to be taken for national and international collaboration and exchange of experience, as well as for improvement of training for OHS personnel. Many other tasks lie ahead but, from meeting these challenges we will reap lasting rewards.

Australia's Organizational Profile

Noel Tresider (President, AIOH)

The Australian Institute of Occupational Hygienists (AIOH, Inc.) was formed in 1980, and is the only professional association for OHs in Australia. It has over 340 members and represents the Australian OH profession both nationally and internationally. AIOH members work for governments (both state and federal), semi-government organisations, every major (scientific) university in Australia, most of the top 300 companies in Australia, and also as consultants to large and small business, and unions.

Australians are not insular in spirit; they make up over 3% of the BOHS membership, and apart from the US and Canada, AIOH has more CIHs than the rest of the world combined. AIOH is one the few organisations who run the ABIH Exam outside of the US and Canada. Some 3% of AIOH membership is based overseas. So, contacts with other Occupational Hygiene associations are broad and linked.

AIOH was one of the founding members of IOHA in 1987, and the late Pam De Silva (AIOH Fellow and past President of AIOH) was President of IOHA in 1989. Brian Davies (AIOH Fellow) is the current IOHA President and continues the involvement of AIOH with IOHA, as does the Cairns 2000 IOHA Conference.

Many of the issues that confront the AIOH are also of concern to our sister organisations such as BIOH, BOHS, AIHA, ACGIH, Inst. Of Occ Hygienists of Southern Africa (IOHSA). AIOH can learn from their efforts; adopt those ideas that suit the AIOH and its members, modify those which we like, discard those we don't, and develop and implement new ideas of our own. For example, the approach taken by IOHSA with regard to professional registration is one such concept that is particularly appealing.

The IOHA has a role to play in fostering this interchange of ideas and also coordinating such efforts. One example would be world-wide mutual recognition of professional qualifications. For example AIOH recognises "CIH" as a measure of professional competence (although the OH&S legal framework is different), yet AIOH does not have a similar recognition of BIOH or IOHSA Exams - perhaps it should. None of the overseas organisations recognise full membership of AIOH as a measure of professional competence, and this may be due to lack of understanding of the AIOH process to attain full membership. This mutual recognition may lead to an internationally recognised minimum standard of professional competence which would benefit all associations and the profession in general.

AIOH also shares the view of pursuing global harmonisation in the development of exposure standards. A sound scientific basis for exposure standards is universal, even though individual national standard setting processes may vary from country to country. For example, few may realize that Australia may have one of the best and largest sets of matched health and dust monitoring data records for coal mining - in excess of 15,000 I am told. Would not this data be useful in identifying a health based coal dust exposure standard? AIOH believes it will be of mutual benefit for all members of IOHA to cooperate and share our resources in the development of exposure standards.

The AIOH supports IOHA in its efforts for international recognition of the profession through such forums as WHO and ILO as this will ultimately be to the benefit of the working communities we all serve.

Accreditation of OHs in Southern Africa

Rob Ferrie (IOHSA President-elect)

The Institute of Occupational Hygienists of Southern Africa (IOHSA) was officially launched in 1993, following a request by the South African health and safety legislators that a formal education, training and registration programme be established. The growth of the Institute has progressed steadily and the standards for registration have been improved continuously. The long-term goal is to develop an OH community in the Southern African region which will be capable of applying the highest international professional standards to the often unique workplace conditions prevailing in this region.

Currently, around 150 hygienists are registered with IOHSA. There are 3 registration categories: Hygienists - requiring an M+4 qualification (i.e. BSc Hons) in an appropriate field of study plus 5 years of comprehensive experience; Technologists - requiring an M+3 qualification (i.e. BSc) in an appropriate field of study plus 2 years of comprehensive experience; and Assistants - persons working under a registered hygienist or engaged in occupational hygiene study.

In addition, hygienists and technologists are required to pass a 50 question written theory exam plus attend a structured oral interview where their ability to apply the theory in practice is evaluated. Assistants are only required to attend a less formal interview.

In order to ensure that hygienists who have been practising for many years are not discriminated against by these standards, we currently allow the substitution of two years of comprehensive experience for each year of formal study that the applicant may be short of academic requirements. We have, however, also implemented a Points Maintenance Scheme which requires registered hygienists to maintain and upgrade their knowledge and skills on an ongoing basis. It is intended to eventually replace the general educational qualification requirement with the successful completion of a structured programme of modular training courses.

IOHSA is a member of the Association of Societies for Occupational Safety and Health (ASOSH) in South Africa. This Association has recently established a web site at http://www.asosh.org which provides comprehensive information on OHS&E activities in South and Southern Africa, but also has extensive links to other sites which should be of interest to OH&S personnel around the world. The site was constructed by David Stanton, the Vice President of ASOSH.

Development of Occupational Hygiene (OH) in Latin America

Ruth Kaufman (USA)

Invited OH colleagues representing 11 countries in Latin America and the Caribbean gathered in São Paulo, Brazil on Dec. 8-10, 1998. Also participating were representatives from the U.S., Canada, Spain and Switzerland (World Health Organization - WHO). "This group undertook what should be considered a landmark activity intended to help guide the development of the hygiene profession in Latin America", according to Berenice Goelzer (WHO).

The workshop/meeting, hosted and jointly sponsored by Fundacentro (a Brazilian institution similar to U.S. NIOSH), was initiated by the Pan American Health Organization (PAHO) and WHO; it was supported by many partners including PAHO, AIHA, ACGIH, NIOSH, IOHA, ABHO (Brazilian Occupational Hygiene Association), Procter and Gamble, and 3M. Other institutions contributed travel expenses for individual participants. Conducted in English, Spanish and Portuguese, it was both a stimulating and productive meeting.

The specific objective of the São Paulo workshop was to draft a Latin American consensus document describing the OH profession, baseline areas of knowledge, education and training requirements, etc. After review and finalization of the draft, the next step will be broad distribution of this PAHO/WHO/Fundacentro-endorsed document to governmental and academic institutions in the region, and other organizations (such as NIOSH, World Bank, major funding organizations, etc.). While these guidelines are voluntary, having such guidelines readily available will fill an information void that has already delayed the development of occupational hygiene in Latin America.

The workshop was modelled after a similar exercise organized by Berenice Goelzer, that has been successful in harmonizing the OH profession among the nations of the European Union. The European Consensus document, published by the WHO in 1992, entitled "Occupational Hygiene in Europe B Development of the Profession", was used as a basis for discussion for the Latin American Consultation Meeting. Ugis Bickis (Canada) made a presentation on behalf of IOHA.

Country representatives reported on the status of the OH profession in the region. The consensus is that (due to growing industrialization in Latin America) there is a need for increased professionally trained human resources in industrial hygiene. Although there are some trained, skilled OH professionals in the region, there are not nearly enough to "go around" and, the profession itself is not well recognized or established. Typical OH work is often done by occupational physicians, engineers, or others with varying degrees of technical OH background. Some countries have university level OH education available but the duration, quality and focus of these programmes varies.

By the end of the consultation, there was a collective enthusiasm for furthering the profession, and a desire to expedite the completion of the outcome document. There are still significant challenges on the road ahead, and include maintaining the momentum generated by this meeting as well as how to optimize limited resources. There is a need for more collaboration on strategies designed to continue development of the occupational hygiene profession. In particular, approaches are needed to address education and training, accreditation of educational institutions and, professional certification. The organizations identified above will continue to partner with and support national associations and members in their endeavours to advance the OH profession.

The final document describing meeting results will be available publicly from PAHO and the WHO. Another mechanism for communication on Latin American issues and activities will be a list-server furnished by CEPIS, situated in Lima; you should be able to track the progress of the process at http://www.cepis.org.pe/

OccHygPro -

An internet-based discussion group

for accredited occupational hygiene personnel

The result of a collaborative effort between the Canadian Registration Board of Occupational Hygienists (CRBOH) at http://www.crboh.ca and the Canadian Centre for Occupational Health and Safety (CCOHS) at http://www.ccohs.ca the intent of OccHygPro is to provide a high-quality, low-volume forum for accredited occupational hygiene personnel from around the world in which to discuss insightful (and/or inciteful) issues and, to exchange technical information, at a professional level and in a focussed manner. In effect, it provides encouragement and support for national programmes of accreditation of occupational hygienists. The eligibility criteria are based on the IOHA document "Certification of occupational hygienists - a survey of existing schemes throughout the world" (1995, and as updated from time to time). This is available in the online library

subscription instructions can be found at http://www.crboh.ca/OCCHYGPR.htm

Standards of practice

Wolfgang Gegusch gegusch#agsa.din.de secretary of CEN/TC 137 "Assessment of workplace exposure" and also familiar with the International Standardization in ISO/TC 146/SC2 "Workplace atmospheres" indicates that CEN has published EN 1540 "Workplace Atmospheres Terminology" in October 1998. This European Standard gives definitions for 36 terms in English, French and German. The terms, starting with "air pollutant" include "biological agent", and end with "workplace". The standard is available via the national standards organizations.

IOHA Executive (1998-99)

President: Brian Davies <aehs#w150.aone.net.au>

President-Elect: Paul Oldershaw paul.oldershaw#hse.gov.uk
Vice-President: Vern Rose vernrose#email.msn.com [us]
Past-President: Riitta Viinanen riitta.viinanen#neste.com [fi]
Secretary-Treasurer: Kurt Leichnitz kurt.leichnitz#t-online.de

The names, and contact coordinates of all IOHA Board members, are listed on this web site.

IOHA Secretariat: Pamela Blythe pblythe#compuserve.com
2 Georgian House, Great Northern Road, Derby, DE1 1LT, UK
Tel: +44 1 332 298 101 Fax: +44 1 332 298 099
http://www.bohs.org/ioha/

Newsletter Editor: Ugis Bickis uib#phoenix-ohc.on.ca
Phoenix OHC, Inc., 837 Princess St., Suite 500, Kingston, ON, Canada K7L 1G8

Webmaster: David Bloor david#bloor.demon.co.uk

DIARY DATES - These have been added to IOHA Calendar