International Occupational Health Safety

International Occupational Health & Safety Tim Morse, Ph.D. University of Connecticut Health Center, Farmington, CT, U.S. Spring 2002 Outline       Economic positions Theories of determinants of occupational health Estimates of occupational injury and illness Approaches to prevention Maquiladoras (Mexico) NAFTA (North American Free Trade Agreement) Per Capita GNP (1987, World Bank) 16000 14000 12000 10000 8000 6000 4000 2000 0 High World Low Labor Force Distribution, 1988, ILO 80 70 60 50 40 30 20 10 0 Cameroon Tunisia Portugal Sweden nemployed Mfg griculture Services World System Theory (Wallerstein, Elling) • Position in world system • Economic resources • Strength of worker movement First World • Tripartite structure • Standards vs. guidelines Sweden (Elling, 1988)  Labor strong • 85% organized • Labor party  National law (Co-determination) • • • • • Committee majority union Stop production process Hire/Fire company physician 110,000 trained union reps Linkage to health system Third World • Combined with effects of poverty, nutrition • Priority of economic development • Agric (60-80%) & primary production • Development led to dislocation • High unemployment Third World • Emphasize labor-intensive industries • Control technologies not affordable • Low or no workers’ compensation • Highest risk have low access to social resources Injuries/ Fatalities 100 million workplace accidents  180,000 fatalities  Developing countries  • 20% injuries • 30% fatalities Fatal rate 3-4X in developing  Source: Takala, 1989  1.1 million fatalities injuries and ill (ILO)  Injury Fatality Rates (ILO, 1998; Cited in Herbert and Landrigan, 2000) Rup. Of Korea Latin Am & Carrib Canada US European Union Sweden 0 5 10 15 20 25 30 35 Injuries by region, Leigh 1999 45000 40000 35000 30000 25000 20000 15000 10000 5000 0 EME FSE IND CHN OAI SSA LAC MEC Non-fatal (1000) fatal Occ Disease by Type, World, Leigh, 1999, in thousands MSD Skin Pneumoconiosis Cancer Pesticide 0 500 1000 1500 2000 2500 3000 3500 Global Burden (Leigh, et al, Epidemiology, 1999)  Indirect Method • 100,000,000 occupational injuries – 100,000 deaths • 11,000,000 occupational illnesses – 700,000 deaths Finish OD, Australian Injury rates  Apply age/sex-specific rates to population  Double rates for less developed  Occupational Disease  Higher risk in LDC’s in occupations  Pesticide poisoning • 3 million acute poisonings/yr (Jeyaratnam, 1985) • 220,000 fatal • Concentrated in LDC  Organic dusts Occupational Disease  Noise  Heat Stress diseases • Reduces use of PPE  Bloodborne • 2 billion hep B carriers (world) • HIV in Africa Regulations • Alma Alta declaration, WHO –Incorp occ health services in primary care • Colonial history • Use modified western standards –Lag behind knowledge –Not suited to conditions National Strategy should include (Reich & Okubo) • • • • • • Institutional development Info management Training Safety Standards Enforcement Social values ILO (Intrl. Labor Office) Standard setting  Training materials  CIS Centers  Chemical safety data sheets  Information exchange  Technical cooperation  Multi-nationals Tension with US workers (jobs, NAFTA)  Lower wages, less job security, weak unions  Lower national standards & enforcement  Usually better conditions than other local plants (corporate policy)  Maquiladoras (1995) 2,200 Maquilas along Mexican border  90% US owned  550,000 employed, 65% women  48 hour standard work week  Ave. take home $15-25 per week  government unions  Maquiladoras (Moure-Eraso, 1997) 65% women  Little industrial experience  Labor turnover high (14%-180% per year in different provinces)  Mixed studies on reproductive hazards  Maquiladoras: Survey (Moure-Eraso, 1997) 267 maquila workers interviewed in home, 1992  81% female, mean age = 25  Living conditions generally good; 80% indoor plumbing, 75% cement floors  45-48 hour work week  Ave weekly wage=$40 US ($0.93/hr)  Exposures  Dust  Gas ventilation  Skin contact  Poor 51% 60% 51% 50% Symptoms 56% headache  53% unusual fatigue  51% depression for no reason  41% forgetfullness  41% chest pressure  39% difficulty falling asleep  37% stomach pain  36% dizzy  33% numbness/tingling  Lead among radiator repair Dykeman et al, 2002  Radiator repair workers in Mexico  35.5 ug/dl vs 13.6 for working controls  Risk factors • Smoking • # radiators repaired/day • Use of a uniform (not laundered) Mexican Safety Regulation: GAO  Survey of 8 auto plants (of 12 selected) • advance notice • 2-day walkthrough      Interviews with Mexican officials, OSHA 6/8 had parent company support for H&S Use of older equipment Had been visited by STPS US: 80% of auto parts plants with OSHA violations GAO Results Lack of hazard-specific programs  Hazards present at all 8 plants  • • • • • 42% workers reported hand/arm pain 70% worked less than 6 months machine guarding 6 plants emerg exit problems lack of safety signs; some English only GAO Findings 6 facilities over 90 dB noise silica, solvents, welding • had plugs, many not using  Lead, gases  Respirators not used properly GAO: Hazard Programs 6 5 4 3 2 1 0 Ergo Fire PPE Hearing Respir Complete Partial None GAO: Hazard Programs 6 5 4 3 2 1 0 HazCom Lockout HazMat Lead Confine Complete Partial None Mexican Regulation  Law strong in some respects • H&S Committees  Problems • No first instance penalties • Specific standards weak in key areas • Max fine $1,500 • Low WC costs NAFTA Chapter 11 (Moyers)  Allows suits by companies or shareholders if “tantamount to expropriation” • Methanex $1 bil suit vs. California for regulating MTBE • Metalclad $16 mill settlement vs Mexico for not allowing haz waste plant to open • Ethyl $!3 mil settlement for temp ban on MMT gas additive, withdraw ban, letter    Secret tribunals Expanded Free Trade Agreement for Americas “Diminish value of investment”