Brigitte-FRONEBERG_14-March-2011_EN

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					                                                Türkiye’de İşyerlerinde İş Sağlığı ve Güvenliği Koşullarının
                                                İyileştirilmesi Projesi (www.isgip.org)

                                                Improvement of Occupational
                                                Health and Safety Conditions at Workplaces in Turkey
         This project is co-financed by         (www.isgip.org)
the European Union and the Republic of Turkey




                                                      ISGIP Project
              Metal &Mining Sector Kick-off Meeting

                         Health Surveillance
             xDr. Brigitte Froneberg, KE “Health Surveillance & Management”
                               brigitte.froneberg@gmail.com




                                                                                                               1
                                                Türkiye’de İşyerlerinde İş Sağlığı ve Güvenliği Koşullarının
                                                İyileştirilmesi Projesi (www.isgip.org)

                                                Improvement of Occupational
                                                Health and Safety Conditions at Workplaces in Turkey
         This project is co-financed by         (www.isgip.org)
the European Union and the Republic of Turkey




  Occupational Physician & Epidemiologist
                   Medical Informatics, Environmental Health,
                   Social Medicine, Diploma Tropical Diseases

  Medical School Göttingen
  London School of Hygiene &Tropical Medicine
  NIOSH Cincinnati USA
  Labor Inspectorate Bavaria
  Federal Institute for Occupational Safety & Health Berlin
                   Head, Department Occupational Health Protection
  ILO Geneva 2002-06
  EU Twinning Project «Improving Labor Inspection System» 2008-09
                 Turkish Estimates
                  Global
                 Global workforce                                                  2.8 billion

                 Work related fatalities                                           1,043
                                                                                   2.2 million
                 Occupational accidents                                            80,602
                                                                                   270 million
                 Work-related diseases                                             160 million

                 Global GDP loss
                 TurkishGDP (income)                                               30 billion $
                                                                                   21 000 billion $
                 Lost GDP in accidents/diseases                                    4 %

                 Migrants                                                          175 million
                 llliterate                                                        1000 million
                 People in poverty                                                 1000 million
                 Child workers                                                     246 million
(Takala, 2005)        Brigitte Froneberg, 23 National OHS Week, Bursa 2009-05-10
Occupational injuries and diseases
 Comparisons reported data and ILO estimates

                         Turkey, official                              ILO estimate
                         statistics (2001)
  Occ. accidents
  (3 days absence)
                                     2,183                               2,881,405
                                                      >1000
  Occ. accidents                     1,008                                 3,776
  (fatal)                                                     >3
  Work-related
                                       440                                28,187
  diseases (deaths)                                     >70
  Total work-related
                                     1,448                                63,925
= mortality                                           >40
                       >5%
                       Brigitte Froneberg, Zonguldak 2011-03-14
                                                                       Death all causes: 175,137
                                                                  21
Occupational Accidents and Diseases in Turkey
                    (SGK, 2008)

• Workplaces in Turkey                  1.710.248
•   Workers                              8.802.989
•   SMEs (% workplaces)                      99.7 %
•   % of workers in SMEs                     83 %
•   Occupational accidents                  72.963
•   Occupational diseases                      539
•   Fatal Occupational Accidents and Diseases 866
SSI Statistics   Mining     Metal      Construction   Total for All
  for 2008       Sector     Sector       Sector         Sectors

Number of         4.933     90.008        189.071      1.170.248
Workplaces       (%0.41)    (%7.7)       (%16.15)       (%100)
 Number of       134.962     904.097    1.663.587      8.802.989
  Workers        (%1.53)    (%10.27)    (%18.90)        (%100)
Occupational      6.516      17.190       5 .664        72.963
 Accidents       (%8.93)    (%23.56)     (%7.76)        (%100)

 Fatalities in     66         97           303            865
Occupational     (%7.63)    (%11.21)     (%35.02)       (%100)
  Accidents
Occupational       358        73           7              539
 Diseases        (%66.42)   (%13.54)     (%1.30)        (%100)

Fatalities due      -          -            -             1
    to OD                                               (%100)
                Health risk in Mining
Sharing the “Fate” of 28 coal miners
… The coal that powers some 24 percent of
Turkey's electricity -- and, in lump form, still
warms the homes of many of its poorest
people -- had a very high price last week
when the bodies of 28 mine workers were
found after a gas explosion in a coal mine
near the country's Black Sea coast…
Methan explosion …


                                                  ??? Occupational
                                                       diseases
                                                    in mining ???
                               Brigitte Froneberg, Zonguldak 2011-03-14
Elements of preventive OSH
Systematic surveillance of the work environment
Systematic surveillance of workers„ health
Trained professionals for both (in adequate number)
Training institutions and training curricula for both
Reliable databasis (all enterprises, all major accidents, all
ODs per sector etc.)
Professionals and procedures to establish, maintain and
use these databases
Adapted regulation, guidance, training, incentives,
public awareness raising

                  Brigitte Froneberg, Zonguldak 2011-03-14
    ISGIP Health-related activities

•   OHS-MS and 3 sector-specific OHS-MSs
    = > (Baseline assessments of the CoBPs)

•   Occupational Health Surveillance Guideline
•   Occupational Diseases Diagnosis Guideline

•   Health Surveillance Training

                   Brigitte Froneberg, Zonguldak 2011-03-14
Key elements of successful OHS - MS
                                                                   Company
   Information link                                                policy on OHS
   Control link                   Policy                            Indicators
                                                                   OHS infrastructure,
                                                                   organization
                             Organizing                              Indicators
                                                                   Implementation
                           Planning and                            plan with OHS
   Auditing                Implementing                            objectives, time
                                                                     Indicators
                                                                   limits, measurable
                      Measuring Performance                        targets

                      Reviewing Performance
                                                                    Indicators
                                                                   Review and
                                                                   adjustment of OHS
(Source: HSE 1997)                                                 system
                        Brigitte Froneberg, Zonguldak 2011-03-14
1. Policy
2. Organisation, resources, roles, responsibility, accountability and authority
3. Identification and communication of legal & other requirements
4. Hazard identification, risk assessment and controls
5. Health assessment and surveillance
6. 1. Policyprogrammes
    Objectives and
7. Communication, participation and consultation
   2. Planning
8. Elimination and control of risks
9. Incident investigation and corrective and preventive action
10. 3. Implementation and operation
    Competence, training and awareness
11. Controls for tasks needing formalised systems, including record and document
    4. Checking and corrective action
    management
12. Emergency preparedness and response
    Performance standards, measurement and
13. 5. Management Review monitoring
14. Evaluation of compliance
15. Incident investigation procedures
16. Internal audit
17. Judgement, strategy and feedback
                   OHS models
                                                                         E
Enterprise
                                                    E                
                                                                E
             OHS                                        
                                                E                        E
                                                               OHS

Enterprise

                      OHS                                E           E




                    Brigitte Froneberg, Zonguldak 2011-03-14
              Health surveillance
• A responsible person looking for a clear reaction where someone is
    working with something that could harm their health (EU: Designat-
    ed worker)
•   A qualified person asking employees about symptoms of ill health,
    or inspecting or examining individuals for signs of ill health (OHN)
•   Medical surveillance by a doctor, which can include clinical
    examinations, for example to look for a reaction from exposure to
    some chemicals (OP of OHS or Community Center).
•   Biological and biological effect monitoring to measure and assess
    the take-up of, or the effects of, exposure to substances such as lead
    or other chemicals, by testing blood, urine or breath samples
    (ISGÜM)
•   Keeping individual health records (OP)
                           Brigitte Froneberg, Zonguldak 2011-03-14
          Health surveillance
• Baseline health assessment, carried out when a person takes up
  or changes job
• Pre-placement and periodic health examinations to assess
  an individual’s fitness for work or a specific job
• Monitoring sickness absence records
• Workplace (lifestyle) health promotion and educat-
  ion to explain the benefits of a healthy diet, taking regular
  exercise, drinking sensibly and stopping smoking
• General testing of workers for evidence of drug or alcohol
  misuse, unless there are specific safety-critical implications


                       Brigitte Froneberg, Zonguldak 2011-03-14
          Health surveillance
•       Workplace surveillance
    •      Risk assesssment
           •    Safety expert (employer)

•   Workers„ health surveillance
    •      Health examinations
           •    Occupational physician


                    Brigitte Froneberg, Zonguldak 2011-03-14
Changing Role of Occupational Physician
            • Consultant
                – individual level
                – company level
            • Physician and Health Manager
            • Team Worker
            • Moderator
            • Change Agent
            • Supplier of
             customer-oriented
             Service
              Brigitte Froneberg, Zonguldak 2011-03-14
             Health surveillance
                              Is there a hazard to
                                     health ?
                   Y         <agents and activities at
                                     work>
                                             N
                                                                        => Contact Health and
   Is there a significant                      No Health                Safety Professionals;
           risk ?                N            Surveillance
                                                                            => See Health
                                                needed
     < risk assessment >
                                                                       Surveillance Guidelines
                                             Y
               Y
Control                    Is health surveillance                           N
measures                       appropriate ?
                                   <legislation>
                            Brigitte Froneberg, Zonguldak 2011-03-14
1. Policy
2. Organisation, resources, roles, responsibility, accountability and authority
3. Identification and communication of legal & other requirements
4. Hazard identification, risk assessment and controls
5. Health assessment and surveillance
6. Objectives and programmes
7. Communication, participation and consultation
8. Elimination and control of risks
9. Incident investigation and corrective and preventive action
10. Competence, training and awareness
11. Controls for tasks needing formalised systems, including record and document
    management
12. Emergency preparedness and response
13. Performance standards, measurement and monitoring
14. Evaluation of compliance
15. Incident investigation procedures
16. Internal audit
17. Judgement, strategy and feedback
OH assessment – By company




         Brigitte Froneberg, Ankara 2011-03-30
        Brigitte Froneberg, Ankara 2011-03-30
OH Assessment – By item




       Brigitte Froneberg, Zonguldak 2011-03-14
          ISGIP approach
• Assisting in building up OHS MS in enterprises
  (structures, functions, instruments, guidance)

• Training of enterprise responsable staff

• Training of occupational health professionals
• Assisting in improving the Notification and
  Recording System for Occupational Diseases


                     Brigitte Froneberg, Zonguldak 2011-03-14
                       OSH and Competitiveness
Rank
60

50

                                                                                         Competitiveness (World Economic Forum)
40

30

20

10
                                                                                                                                            Fatal accidents / 100 000 employees
 0
                                                                                              France




                                                                                                                                                                                        Chile


                                                                                                                                                                                                         Portugal
                                                                                                                 Japan




                                                                                                                                                                                                                               Thailand



                                                                                                                                                                                                                                                           Indonesia
                                                                                     Canada




                                                                                                                                  Ireland
                                                                                                       Belgium




                                                                                                                                                                                                                    Malaysia
                                                                                                                                                                             Korea R.
                                                                                                                                            Spain




                                                                                                                                                                                                                                                                       Russia
               USA




                                                                                                                                                    South Africa
                                                                                                                         Norway




                                                                                                                                                                                                                                                  Mexico
                                                           Sweden
                                                                    UK
     Finland




                                                                                                                                                                                                                                          China
                                             Switzerland




                                                                                                                                                                   Hungary
                                                                         Australia
                     Netherlands
                                   Germany




                                   Brigitte Froneberg, ILO 09/2005                                                         (Source: World Economic Forum / Takala 2003)                         Brazil
                                                           Çok
Thanks
   for                                                 teşekkür
         your                         ederim
            attention

 Danke                    !

            Brigitte Froneberg, Zonguldak 2011-03-14

				
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