Tuesday, 15 February 2011 18:56

International Cooperation in Occupational Health: The Role of International Organizations

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The role of international organizations is essentially to offer an organized framework for international cooperation. Over the centuries people have exchanged information and experiences in many ways. Cooperation between countries, scientists and professional groups developed progressively over time, but by the beginning of the 20th century it had become obvious that some issues could be faced only collectively.

In general, a distinction is made between “intergovernmental” and “non-governmental” international organizations. Intergovernmental organizations (IGOs) include the United Nations and its specialized agencies. There are also many other intergovernmental organizations, such as the Organization for Economic Cooperation and Development (OECD), the Organization of African Unity (OAU), the Organization of American States (OAS), and regional or subregional entities, such as the European Union (formerly the European Communities), MERCOSUR (Southern Market—Mercado Comun del Sur), the Caribbean Community (CARICOM), the European Free Trade Association (EFTA) and the North American Free Trade Agreement (NAFTA) between Canada, the United States and Mexico.

Some international non-governmental organizations, such as the International Commission on Occupational Health (ICOH) and the International Social Security Association (ISSA), cover all aspects of occupational health and safety. Many international non-governmental organizations are interested in occupational health and safety within the frameworks of their broader activities, such as the employers’ and workers’ organizations and the international associations of various professional groups. Some non-governmental organizations, such as the International Organization for Standardization (ISO), deal with standardization, and many other non-governmental organizations deal with specific subject areas or with specific sectors of economic activities.

Many intergovernmental and non-governmental organizations have interests in occupational health and safety, which involves technical, medical, social and legal aspects as well as a variety of disciplines, professions and social groups. There is a comprehensive network of organizations whose knowledge and capabilities can be used to promote exchange of information and experience among countries.

Aims and Purposes of Intergovernmental Organizations

One of the important roles of international organizations is to translate agreed-upon values into rights and obligations. The Charter of the United Nations (United Nations 1994) provides a good example of what the role of an international organization in the UN system should be—that is, “to achieve international cooperation in solving international problems of an economic, social, cultural, or humanitarian character, and in improving and encouraging respect for human rights and for fundamental freedom for all without distinction as to race, sex, language or religion.” The International Covenant on Economic, Social and Cultural Rights refers to the principles proclaimed in the Charter of the United Nations and recognizes the right of everyone to safe and healthy working conditions.

The aims and purposes of international organizations are set out in their Charters, Constitutions, Statutes or Basic Texts. For example, the Constitution of the World Health Organization (WHO) (1978) states that its aim is “the attainment by all people of the highest possible level of health”. Protection of the worker against sickness, disease and injury arising from employment is one of the tasks assigned to the International Labour Organization (ILO) in the words of the Preamble of its Constitution (see below and ILO 1992). The Declaration on the Aims and Purposes of the International Labour Organization, adopted by the International Labour Conference at its 26th Session in Philadelphia in 1944, recognizes the obligation of the ILO to further, among the nations of the world, the implementation of programmes that will achieve “adequate protection for the life and health of workers in all occupations”.

The international community recognizes that there are issues where countries are interdependent. One of the main roles of the intergovernmental organizations is to address such issues. The Preamble of the ILO Constitution adopted in 1919 recognizes that “the failure of any nation to adopt humane conditions of labour is an obstacle in the way of other nations which desire to improve the conditions in their own countries” and considers that “a universal and lasting peace can only be established if it is based on social justice”. The ILO Declaration of Philadelphia states that “poverty anywhere constitutes a danger to prosperity everywhere”. The WHO Constitution states that an “unequal development in different countries in the promotion of health and control of diseases, especially communicable diseases, is a common danger” and that “the achievement of any State in the promotion and protection of health is valuable to all”. The role of international organizations is to ensure a continuity and create a stability over time towards such long-term policy objectives, while short- and medium-term planning often prevails at the national level because of local social and economic conditions and political circumstances.

Each international organization has a mandate assigned by its constituents. It is within their mandates that international organizations address specific issues such as occupational health and safety. Common features of intergovernmental organizations are that they provide guidance, formulate recommendations and develop standards. International instruments created within the United Nations system that can be applicable at the national level may be divided into two categories. Nonbinding instruments usually take the form of recommendations or resolutions and can serve as a basis for national legislation. Binding instruments entail the obligation that national laws and practices will be brought into line with the decisions agreed upon at the international level. Most binding instruments take the form of international Conventions that require an additional international act of ratification, approval or accession whereby a State establishes its consent to be bound by the obligations of the Convention.

International organizations represent a forum where their constituents elaborate and establish their common policies and strategies in a great variety of fields, including occupational safety and health. This is where countries confront their values and their opinions; exchange information and experience; discuss and propose solutions; and determine the ways to work together towards objectives in order to achieve consensus, agreement, or international conventions that define a common understanding of what is right to do and what should not be done.

One of the advantages of an international organization is to provide for international debates a controlled environment that is governed by rules and procedures agreed upon by its constituents, allowing, at the same time, for a multitude of informal and diplomatic contacts much wider than those that can be made at the level of a single country. Various groups and countries having similar problems in common may compare their approaches and improve their strategies. From an international perspective, it is easier to achieve objectivity about difficult but specific problems linked to national institutional arrangements or to particular historical conditions. Social partners who can hardly meet at the national level sit at the same table. The dialogue is renewed, and hope for a consensus may come to light where it might have been impossible at the national level. Pressure groups can play a catalytic role in the process of consensus building without a need for aggressive strategies. Not only can exchanges of information and experience take place at international conferences, but various groups can measure the worldwide acceptability of their ideas, values and policies at these conferences.

In practice, intergovernmental organizations are involved in a wide variety of activities covering exchange of information, transfer of knowledge, harmonization of terminology and concepts, consensus building, codes of conduct and of good practice, and promotion and coordination of research. Most international organizations also have numerous programmes and activities aimed at assisting their member States to achieve objectives relevant to their mandate, including technical cooperation. International organizations have at their disposal a variety of means of action, such as reports and studies, meetings of experts, seminars, workshops, symposia, conferences, technical advisory services, information exchanges, and a clearinghouse role. In the course of time, basic mandates of international organizations have been enlarged and made more specific by resolutions and programmes that have been approved by their constituents on the occasion of their general assemblies, such as the International Labour Conference of the ILO or the World Health Assembly of the WHO.

The United Nations and Its Specialized Agencies

In the United Nations system, two specialized agencies are directly concerned with occupational health and safety taken as a whole: the International Labour Organization (ILO) and the World Health Organization (WHO). Among the specialized agencies of the United Nations, the International Labour Organization has a unique character since it is tripartite (i.e., its constituents are governments, employers and workers). Another characteristic of the ILO is its standard-setting activities (i.e., the International Labour Conference adopts international Conventions and Recommendations). Since the working environment is considered an integral part of the human environment (International Labour Organization/United Nations Environment Programme/World Health Organization 1978) the United Nations Environment Programme (UNEP) also deals with the matter, in particular as regards chemicals. Its International Register of Potentially Toxic Chemicals (IRPTC) cooperates closely with the ILO and the WHO within the framework of the International Program on Chemical Safety (IPCS).

Apart from their headquarters, international organizations have field structures and specialized institutions or bodies, such as the WHO’s International Agency for Research on Cancer (IARC), and the Pan-American Centre for Human Ecology and Health (ECO), which contributes to the implementation of the Regional Workers’ Health Program of the Pan-American Health Organization (PAHO). The ILO International Training Centre in Turin (Italy) carries out training activities in occupational health and safety and develops training materials for various professional groups, and the International Institute for Labour Studies (IILS) addresses from time to time occupational safety and health issues. The WHO and the ILO have regional offices, area offices and national correspondents. Regional ILO and WHO conferences are convened periodically. The PAHO was founded in 1902 and is also the WHO Regional Office for the Americas. In 1990, the Pan-American Sanitary Conference adopted a resolution on workers’ health (PAHO 1990) which established guidelines for PAHO’s programme and designated 1992 the “Year of Workers’ Health in the Americas”.

The ILO headquarters and field structures support the commitment and the activities of its member States in occupational health and safety within the framework of its International Programme for the Improvement of Working Conditions and Environment (PIACT) (ILO 1984). This programme includes a large variety of advisory services and technical cooperation activities all over the world. The ILO has recently adopted an active partnership policy (APP) that brings the organization closer to its tripartite constituents in member States by strengthening its field structures, most notably through the establishment of multidisciplinary teams (MDTs).

Several other UN specialized agencies have an important role concerning specific aspects of occupational health and safety, such as the International Atomic Energy Agency (IAEA), which is concerned with nuclear safety, the protection of workers from radiation, and the safety of radiation sources. The United Nations Industrial Development Organization (UNIDO) is concerned with occupational safety and health in specific sectors of industry, and is engaged together with the UNEP and the World Bank in preparing guidelines for industrial pollution prevention and control that cover occupational health and safety issues as well. The Food and Agriculture Organization of the United Nations (FAO) promotes safety in the use of pesticides (FAO 1985) and occupational health and safety in forestry, including cooperative arrangements with the ILO and the United Nations Economic Commission for Europe.

The Committee of Experts on Transport of Dangerous Goods of the Economic and Social Council of the United Nations prepared the Recommendations on the Transport of Dangerous Goods, which provide guidance in drafting national legislation and achieving some uniformity throughout the world for various modes of transport. The International Civil Aviation Organization (ICAO) has established international standards for the operation of aircraft and has published a manual of civil aviation medicine that covers aspects relating to occupational health for flying personnel. The International Maritime Organization (IMO) has adopted an International Convention on Safety of Life at Sea (SOLAS). The WHO, the ILO, and the IMO have prepared an International Medical Guide for ships that includes distinct parts containing a schedule for the contents of a ship’s medicine chest and a medical section of the International Code of Signals. A medical first aid guide for use in accidents involving dangerous substances was jointly prepared by the IMO, the WHO and the ILO.

Funding organizations such as the United Nations Development Programme (UNDP) have been financially supporting over the last 25 years a large number of occupational health and safety projects in many countries, including the establishment of national occupational safety and health institutes. The executing agencies for these projects have been the ILO, the WHO, and both organizations jointly. In its economic development projects, the World Bank takes into account environmental, health and human ecological considerations (World Bank 1974), including occupational health and safety. In 1987, the World Bank embarked on a major effort to incorporate environmental concerns into all aspects of its activities. This includes a stronger focus on the development of institutional capacity for environmental management at the country level, a greater recognition of the need to embed environmental concerns into sectoral work, and increased emphasis on the social aspects of environmentally sustainable development (World Bank 1993a). Furthermore, the Report Investing in Health, examines the interplay between human health, health policy and economic development (World Bank 1993b).

Other Intergovernmental Organizations

The activities of the Organization for Economic Cooperation and Development (OECD) are particularly important as regards environmental health issues, safety in the use of chemicals, methods for the evaluation of chemical risks, and protection from radiation. The Council of Europe has adopted a number of resolutions relating to occupational safety and health concerning, for example, safety services within enterprises. The European Social Charter, adopted by the Council of Europe in 1961, recognizes the right of workers to safe and healthy working conditions. The Nordic Council is concerned with occupational safety and health and environmental problems and makes recommendations regarding toxic and dangerous substances, nuclear safety, and protection from radiation, as well as programmes of action on the occupational environment. The Arab Labour Organization, chartered in 1965, is a specialized agency within the framework of the Arab League; it undertakes studies and conducts research in industrial safety and occupational health. The countries from MERCOSUR have a special commission for the harmonization of legislation in occupational health and safety.

The European Union adopts directives that are compulsory for its member States and should be translated into national laws. The European directives cover the whole field of occupational health and safety with the aim of harmonizing national legislation, taking into account the principle of subsidiarity. Three levels of directives can be identified (TUTB 1991): the framework directives, such as the Directive on the Introduction of Measures to Encourage Improvement in Safety and Health of Workers at Work (89/391); those that cover the risks to which workers are exposed (lead, asbestos, noise, ionizing radiation and so on); and those that establish the rules governing the design of work equipment. Technical standards are developed by European Commissions for Standardization (CEN, CENELEC). The Commission of the European Union (formerly the Commission of the European Communities) prepares the directives and has an important occupational safety and health programme (Commission of the European Communities 1990). The European Foundation for the Improvement of Living and Working Conditions, in Dublin, has activities in occupational safety and health, including a working group on occupational health strategies in Europe. The year 1992 was designated the “European Year of Safety, Hygiene and Health Protection at Work”, and a large number of occupational safety and health activities have been supported in countries of the European Union. A European Agency for Safety and Health at Work was established in Bilbao (Spain) as a specialized body of the European Union.

International Non-governmental Organizations

Scientific, professional and other groups also felt the need to develop international cooperation and join in international non-governmental organizations. They may be formed of individual specialists, national associations of specialists, or institutions. The International Commission on Occupational Health (ICOH) was founded in 1906 as the Permanent Commission on Occupational Diseases. It is discussed in a separate article in this chapter.

The International Social Security Association (ISSA) is an international organization of official agencies responsible for the administration of social security and has had a programme concerning the prevention of occupational risks since 1954 and is also discussed separately in this chapter.

While the ICOH and the ISSA are concerned with the whole field of occupational health and safety, there are a number of non-governmental organizations that deal with specific sectors of economic activity, such as agriculture, or with specific subject areas as varied as technology, toxicology, psychology, work organization, process safety, human engineering, epidemiology, social medicine, lifting appliances, cargo handling, pressured vessels, transport of containers and of dangerous materials, safety signals, road safety and nuclear safety. Numerous international non-governmental organizations are concerned with the environment and the protection of consumers, including the International Union for Conservation of Nature and Natural Resources—World Conservation Union (IUCN) and the International Organization of Consumers Unions (IOCU). They are interested in environmental health and, to some extent, in occupational health, particularly in chemical safety and pesticides.

In the field of the protection of workers, patients and the public from adverse effects of ionizing radiation, the work of the International Commission on Radiological Protection (ICRP) is authoritative worldwide and serves as a basis for international recommendations by intergovernmental organizations. The International Radiation Protection Association (IRPA) has established an International Commission on Non-Ionizing Radiation Protection (ICNIRP), which issues guidelines on exposure limits and contributes to the ILO and WHO publications on non-ionizing radiation. Many other international non-governmental organizations or associations could be mentioned since they deal with occupational health and safety or are interested in specific aspects of occupational health and safety, including the International Ergonomic Association (IEA), the Ergonomics Society of French-Speaking Countries (SELF), the International Council of Nurses (ICN), the Inter-American Safety Council (IASC), the International Association of Labour Inspection (IALA), the International Occupational Hygiene Association (IOHA), the International Association on Agricultural Medicine and Rural Health (IAAMRH), the International Association of Public and Rural Health, the Latino-American Association of Occupational Safety and Hygiene (ALASEHT), the International Federation of Associations of Specialists in Occupational Safety and Industrial Hygiene, the European Association of Schools of Occupational Medicine, the World Federation of Associations of Clinical Toxicology and Poison Control Centres, and the International Safety Council, a global subsidiary of the US National Safety Council.

Another group of non-governmental organizations consists of those having standardization as their objective, such as the International Organization for Standardization (ISO) and the International Electrotechnical Commission (IEC). ISO is discussed in a separate article in this chapter.

International employers’ and workers’ organizations play a significant role in defining occupational health and safety policies and priorities at the international level. Their involvement is important because national labour laws and regulations make employers responsible for protection against occupational hazards, and the most concerned are the workers themselves, since it is their health and safety that are at risk. A number of employers’ and workers’ international organizations are concerned with occupational safety and health taken as a whole, including the International Employers Organization (IOE), the Union of Industrial and Employers Confederations of Europe (UNICE), the International Confederation of Free Trade Unions (ICFTU), the World Confederation of Labour (WCL), and the World Federation of Trade Unions (WFTU). There are many sectoral international trade union organizations that deal with specific aspects, such as the International Confederation of Chemical, Energy, Mine and General Workers’ Union (ICEM), the International Metal Workers Federation (IMF), the International Federation of Building and Wood Workers (IFBWW), the International Federation of Plantation, Agricultural and Allied Workers, and the International Federation of Commercial, Clerical and Technical Employees (FIET). There also exist regional organizations, such as the Organization of African Trade Union Unity (OATUU) and the European Confederation of Trade Unions (ECTU), which has established a European Trade Union Technical Bureau for Occupational Safety and Health (TUTB). These organizations have a wide variety of activities, in particular concerning the dissemination of information, technical advice, and training in occupational health and safety.

Producers, manufacturers, and operators are also active in the field of occupational safety and health, either through their associations or through institutes and bodies that they have established, such as the International Council of Chemical Associations (ICCA), the European Council of Chemical Manufacturers Federations (CEFIC), the International Group of National Associations of Agrochemical Manufacturers (GIFAP), the International Air Transport Association (IATA), the World Association of Nuclear Power Plant Operators (WANO), the Illuminating Engineering Society (IES), the Asbestos International Association (AIA), the International Fiber Safety Group (IFSG), and the Viral Hepatitis Prevention Board (action on hepatitis B as an occupational hazard). In addition, a number of institutions and international bodies established by producers, manufacturers and their organizations develop activities relating to the protection of the environment and environmental health, which may include occupational health to some extent, such as the International Centre for Industry and the Environment (ICIE), the International Council on Metals and the Environment (ICME), the International Primary Aluminum Institute (IPAI), and the Oil Companies International Study Group for Conservation of Clean Air and Water (CONCAWE).

Finally, there are many international non-governmental organizations established by scientists, professional associations or groups having similar scientific, humanitarian or economic interests that do not have direct interests in occupational health but are dealing with scientific, technical, medical or social issues that are relevant to occupational health and safety, such as the World Medical Association (WMA), the Council for International Organizations of Medical Sciences (CIOMS), the International Union of Pure and Applied Chemistry (IUPAC), the International Council for Building Research Studies and Documentation, the International Epidemiological Association, the International Society for Labour Law and Social Security, and the International Bureau for Epilepsy (IBE), which prepared a Code of Principles of Good Practice for Employing People with Epilepsy.

Joint Programmes in International Cooperation

It is interesting to examine how international organizations complement each other and mobilize their various means of action to combat specific occupational hazards. As regards noise and vibration, for example, the IEC provides standards for measuring equipment, the ISO defines methods of measurement, the WHO provides health criteria, the ILO recommends exposure limits in its Code of Practice on Noise and Vibration and defines a general approach and strategy in its Working Environment (Air Pollution, Noise and Vibration) Convention, 1977 (No. 148) and Recommendation (No. 156).

The role of international organizations is increasingly characterized by cooperation within the framework of international programmes or joint ventures on specific subjects involving the countries themselves and inter-governmental and non-governmental organizations. International cooperation in protection against ionizing radiation and in promotion of chemical safety are two examples of such activities.

In the field of protection against ionizing radiation, the International Commission on Radiological Protection (ICRP) and the United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR) provide the scientific input. The ILO adopted in 1960 the Radiation Protection Convention (No. 115) and Recommendation (No. 114), which make specific reference to the guidance issued by the ICRP. More guidance is given in a number of codes of practice prepared by the IAEA, cosponsored by the ILO and the WHO, where appropriate, and in the ILO Code of Practice on Radiation Protection (ionizing radiation), 1987. These are supplemented by guides, manuals, training materials and technical documents published essentially by the IAEA and by the Nuclear Energy Agency of the OECD. Technical cooperation activities in this field are mainly carried out by the IAEA; other organizations are involved when needed.

In 1990, an important step towards international harmonization of radiation safety took place: the Inter-Agency Committee on Radiation Safety (IACRS) was established as a forum for consultation on and collaboration in radiation safety matters between international organizations. A joint secretariat was set up to revise the 1982 edition of the IAEA/ILO/WHO/NEA-OECD Basic Safety Standards for Radiation Protection. Six international organizations—the FAO, the IAEA, the ILO, the Nuclear Energy Agency of the OECD, the PAHO, and the WHO—joined to prepare international standards with the aim of helping their member States in drafting their own laws. Under the leadership of the IAEA, a major process of consultations with countries and among intergovernmental and non-governmental organizations, including employers’ and workers’ organizations, led to the elaboration of the International Standards for Protection against Ionizing Radiation and the Safety of Radiation Sources (IAEA 1994). These international standards can be regarded as unified standards for the UN system.

International cooperation in promoting chemical safety illustrates how international organizations interact in order to respond to concerns of people in the world expressed by the international community, and how general declarations of principles adopted by intergovernmental conferences are translated into programmes of action and practical activities based on scientific knowledge. There is a consensus that the evaluation of chemicals should address concerns about occupational exposures, public exposures, and the environment. To carry out risk assessments in an international framework is an asset for mobilizing limited expertise and resources. This led to the establishment in 1980 of the International Programme on Chemical Safety (IPCS) by the WHO, the United Nations Environment Programme (UNEP) and the ILO. The commitment of the three cooperating organizations to collaborate in the IPCS was expressed through a memorandum of understanding in 1988 that establishes the objectives of the IPCS. The technical work of the IPCS relies on a network of national and international institutions that participate in its activities and are responsible for particular tasks. The programme maintains close and efficient working relations with several other intergovernmental and non-governmental organizations, associations, and professional bodies that have important activities in the field of chemical safety.

The United Nations Conference on Environment and Development (UNCED), held in Rio de Janeiro in 1992, recognized the need to ensure the environmentally sound management of toxic chemicals and identified six programme areas for international cooperation:

  1. expanding and accelerating the international assessment of chemical risks
  2. harmonization of classification and labelling of chemicals
  3. information exchange on toxic chemicals and chemical risks
  4. establishment of risk reduction programmes
  5. strengthening of national capabilities and capacities for management of chemicals
  6. prevention of illegal international traffic of toxic and dangerous products.


This was followed in 1994 by an International Conference on Chemical Safety (Stockholm Conference 1994), which established the Intergovernmental Forum on Chemical Safety, identified a number of priorities for action, and invited intergovernmental organizations to participate in an expanded collaborative programme on chemical safety. An Inter-Organization Programme for the Sound Management of Chemicals (IOMC) was established in which the WHO, ILO, UNEP, FAO, UNIDO and OECD participate. It includes an Inter-Organization Coordinating Committee (IOCC), which ensures the coordination of activities on chemical safety carried out by the participating organizations, individually or jointly, and follows up the implementation of the recommendations of UNCED.

There are signs of an increasing trend to mobilize expertise and resources within the framework of joint activities. Such is the case, for example, in the field of training and information exchange in occupational health and safety. As regards biological safety, cooperation was developed between the UNIDO, the UNEP, the WHO and the FAO, and some activities were carried out within the framework of the IPCS. The UNIDO has been designated to follow up Chapter 16 of Agenda 21 (environmentally sound management of biotechnology) of the Rio Conference, to catalyze joint activities and programmes, and to develop common UN system strategies on biotechnology. The OECD has a programme on environmental aspects of biotechnology. The European Directive concerning the protection of workers against biological agents at work (90/679 and 93/88) was adopted in 1990 and modified in 1993. In 1993, the International Labour Conference of the International Labour Organization adopted a resolution concerning exposure to and safety in the use of biological agents at work that indicates that the issue should be studied, including the need for new international instruments (convention, recommendation, or both) to minimize the risks to workers, the public and the environment.

Two additional examples concern the protection of workers against non-ionizing radiation and the harmonization of chemical classification and labelling systems. Environmental health criteria documents on non-ionizing radiation were prepared by the WHO, the UNEP and the International Commission on Non-Ionizing Radiation Protection (ICNIRP). A broader cooperation on protection against non-ionizing radiation, including occupational exposure, is now developing, which includes the ILO, the Commission of the European Union, the International Electrotechnical Commission (IEC), the International Agency for Research on Cancer (IARC) and the Scientific Committee on Radiation and Work of the ICOH. The harmonization of chemical classification and labelling systems is a field where extensive cooperation is promoted, under the leadership of the ILO, among countries, intergovernmental organizations (e.g., OECD; the European Union), non-governmental organizations (employers’ and workers’ organizations; international consumer and environmental protection associations), the UN Committee of Experts on Transport of Dangerous Goods, the FAO, the UNEP, the WHO, the IMO and the ICAO.

There are many other fields where new, flexible forms of international cooperation among countries and international organizations are emerging or could be developed, such as occupational stress and combating occupational lung diseases, in particular silicosis. International networking for occupational health and safety is developing increasingly with objectives such as coordinating research. It would be an advantage if an international network for occupational health and safety could be developed on the basis of existing structures in international organizations that could be interconnected, such as the Collaborating Centres of WHO, the Scientific Committees of ICOH, the International Sections of ISSA, the National Correspondents of IRPTC, the contact points of the OECD Complementary Information Procedure, the Participating Institutions of IPCS, the National and Collaborating Centres of the ILO International Occupational Safety and Health Information Centre (CIS), and the designated bodies of the ILO International Occupational Safety and Health Hazard Alert System.

Common Goals and Complementary Approaches in Occupational Health

In the field of occupational health, the ultimate goals of the WHO and the ILO are the same: to protect and promote the health of the workers in all occupations. Policy guidance is given by the ILO on the basis of its international Conventions and Recommendations on occupational health and safety and by the WHO through the resolutions adopted by the World Health Assembly concerning workers’ health and the primary health care approach that it advocates.

Since the Primary Health Care Conference in Alma-Ata in 1978, the WHO workers’ health programme has attempted to extend its health protection and health promotion activities to cover all people at work, paying special attention to the underserved and the vulnerable working populations. The 40th World Health Assembly requested the Director-General of the WHO:

  1. to promote the implementation of the workers’ health programme, as part of the national health system based on primary health care, in close cooperation with other relevant programmes, non-governmental organizations, and all United Nations agencies
  2. to elaborate guidelines on primary health care in the workplace, addressed particularly to the underserved working populations and including the educational materials needed at various levels
  3. to develop guidelines on health promotion in the workplace in cooperation with the WHO collaborating centres
  4. to promote regional activities in workers’ health where appropriate.


In October 1994, the Second Meeting of the Network of Collaborating Centres in Occupational Health (52 research and expert institutions from 35 countries) adopted a “Global Strategy on Occupational Health for All” and recommended that this document be submitted for consideration by the WHO to be converted into the WHO “Global Strategy on Occupational Health for All”. This was done in May 1996, with the support of the ILO.

The ILO Conventions and Recommendations on occupational safety and health define the rights of the workers and allocate duties and responsibilities to the competent authority, the employers and the workers in the field of occupational safety and health. The ILO Conventions and Recommendations adopted by the International Labour Conference, taken as a whole, constitute the International Labour Code, which defines minimum standards in the labour field. The ILO policy on occupational health and safety is essentially contained in two international Conventions and their accompanying Recommendations. The ILO Occupational Safety and Health Convention 1981 (No. 155) and Recommendation (No. 164), provide for the adoption of a national occupational safety and health policy and describe the actions needed at the national level and at the enterprise level to promote occupational safety and health and to improve the working environment. The ILO Occupational Health Services Convention 1985 (No. 161) and Recommendation (No. 171), provide for the establishment of occupational health services which will contribute to the implementation of the occupational safety and health policy and will perform their functions at the enterprise level.

In 1984, the International Labour Conference adopted a Resolution concerning the improvement of working conditions and environment, which recalled that the improvement of the working conditions and environment was an essential element in the promotion of social justice. It stressed that improved working conditions and improved environment are a positive contribution to national development and represent a measure of success of any economic and social policy. It spelled out the three fundamental principles that:

  • Work should take place in a safe and healthy working environment.
  • Conditions  of  work  should  be  consistent  with  workers’ well-being and human dignity.
  • Work should offer real possibilities for personal achievement, self-fulfilment, and service to society.


There are many similar features between the ILO strategy for the improvement of the working conditions and environment and the WHO primary health care approach. They rest on similar basic principles and they both:

  1. aim at all concerned, workers or the public
  2. define policies, strategies and means of action
  3. insist on the responsibility of each employer for the health and safety of the workers in his or her employment
  4. emphasize primary prevention, control of risk at the source, and health education
  5. give special importance to information and training
  6. indicate the need to develop an occupational health practice that is easily accessible to all and available at the workplace
  7. recognize the central place of participation—community participation in health programmes and workers’ participation in the improvement of the working conditions and the working environment.
  8. highlight the interactions between health environment and development, as well as between occupational safety and health and productive employment.


The current trend of globalization for the world economy, and regional integration, has increased interdependence and the need for cooperation between countries. This overview shows that there are common goals, approaches and policies in occupational health and safety. There is also a structure on which a global cooperation can be built. This is the objective of the Global Programme on Safety, Health and the Environment, to be launched by the ILO in 1998.



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