Chapter16-OccupationalHealthServicesSTANDARDS,PRINCIPLESANDAPPROACHESINOCCUPATIONALHEALTHSERVICESJormaRantanenandIgorA.FedotovThisarticleisbasedonthestandards,principlesandapproachesembodiedintheILOOccupationalHealthServicesConvention,1985(No.161)anditsaccompanyingRecommendation(No.171);ILOOccupationalSafetyandHealthConvention,1981(No.155)anditsaccompanyingRecommendation(No.164);andtheWorkingDocumentoftheTwelfthSessionoftheJointILO/WHOCommitteeonOccupationalHealth,5-7April1995.TheILOOccupationalHealthServicesConvention(No.161)defines"occupationalhealthservices"asservicesentrustedwithessentiallypreventivefunctionsandresponsibleforadvisingtheemployer,theworkersandtheirrepresentativesintheundertakingontherequirementsforestablishingandmaintainingasafeandhealthyworkingenvironmentwhichwillfacilitateoptimalphysicalandmentalhealthinrelationtoworkandtheadaptationofworktothecapabilitiesofworkersinthelightoftheirstateofphysicalandmentalhealth.Provisionofoccupationalhealthservicesmeanscarryingoutactivitiesintheworkplacewiththeaimofprotectingandpromotingworkers'safety,healthandwell-being,aswellasimprovingworkingconditionsandtheworkingenvironment.Theseservicesareprovidedbyoccupationalhealthprofessionalsfunctioningindividuallyoraspartofspecialserviceunitsoftheenterpriseorofexternalservices.Occupationalhealthpracticeisbroaderandconsistsnotonlyoftheactivitiesperformedbytheoccupationalhealthservice.Itismultidisciplinaryandmultisectoralactivityinvolvinginadditiontooccupationalhealthandsafetyprofessionalsotherspecialistsbothintheenterpriseandoutside,aswellascompetentauthorities,theemployers,workersandtheirrepresentatives.Suchinvolvementrequiresawell-developedandwell-coordinatedsystemattheworkplace.Thenecessaryinfrastructureshouldcomprisealltheadministrative,organizationalandoperativesystemsthatareneededtoconducttheoccupationalhealthpracticesuccessfullyandensureitssystematicdevelopmentandcontinuousimprovement.ThemostelaborateinfrastructureforoccupationalhealthpracticeisdescribedintheILOOccupationalSafetyandHealthConvention,1981(No.155)andtheOccupationalHealthServicesConvention,1985(No.161).TheestablishmentofoccupationalhealthservicesaccordingtothemodelsadvocatedbytheConventionNo.161anditsaccompanyingRecommendationNo.171isoneoftheoptions.ItishoweverevidentthatthemostadvancedoccupationalhealthservicesareinconcordancewiththeILOinstruments.Othertypesofinfrastructuresmaybeused.Occupationalmedicine,occupationalhygieneandoccupationalsafetymaybepractisedseparatelyortogetherwithinthesameoccupationalhealthservice.Theoccupationalhealthservicemaybeasingleintegratedentityoracompositeofdifferentoccupationalhealthandsafetyunitsunifiedbyacommonconcernforworkers'healthandwell-being.AvailabilityofOccupationalHealthServicesOccupationalhealthservicesareunevenlydistributedintheworld(WHO1995b).IntheEuropeanRegion,abouthalfoftheworkingpopulationremainsuncoveredbycompetentoccupationalhealthservices;thevariationamongcountriesisverywide,withcoveragefiguresrangingbetween5%and90%oftheworkforce.TheCentralandEasternEuropeancountriesnowintransitionarehavingproblemsinprovidingservicesduetoreorganizationoftheireconomicactivitiesandthebreak-upofthelargecentralizedindustriesintosmallerunits.Lowercoveragefiguresarefoundonothercontinents.Onlyafewcountries(UnitedStates,Canada,Japan,Australia,Israel)showcoveragefigurescomparable...
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