What determines the health of working people
Economically active people spend, on average, about one-third of their time at work. Employment and working conditions have a major impact on health equity. Good working conditions can create social protection and status, as well as opportunities for personal development and protection from physical and psychosocial abuse. They also improve workers’ social relationships and self-esteem and have a positive impact on health.
The health of working people is an important precondition for family income, productivity and economic development. Therefore, restoring and maintaining the ability to work is an important function of health services.
Workplace health risks, such as elevated temperatures, noise, dust, hazardous chemicals, unsafe machinery, and psychological stress, cause occupational diseases that can exacerbate other health problems. Conditions of employment, type of work, and place in the work hierarchy also affect health. People who work in stressful or precarious work environments tend to smoke more, exercise less, and eat unhealthily.
In addition to general medical care, all workers, and particularly those who work in high-risk environments, need health services that can assess and reduce occupational risk exposures and engage in medical surveillance for the early detection of occupational diseases and injuries.
Chronic respiratory disease, musculoskeletal disorders, noise-related hearing loss, and skin problems are among the most common occupational diseases. Yet only one-third of countries have programs addressing these issues.
Work-related non-communicable diseases (NCDs), as well as cardiovascular disease and depression due to occupational stress, lead to higher rates of long-term disability and absence from the workplace. Occupational NCDs include occupational cancer, chronic bronchitis, and asthma caused by workplace air pollution and radiation.
Despite the presence of these diseases, doctors and nurses in most countries are not adequately trained to deal with work-related health problems, and many countries lack postgraduate training in occupational health.
Workplace health coverage
Most countries lose between 4% and 6% of GNP to work-related health problems. About 70% of workers have no insurance to compensate them for occupational diseases and injuries.
Universal health coverage combines access to health services (health promotion, prevention, treatment and rehabilitation, including those that address the determinants of health) necessary for good health, with financial security that prevents impoverishment due to ill health.
There are effective measures to prevent occupational diseases. For example, encapsulation of pollution sources, ventilation, noise control, replacement of hazardous chemicals, optimization of furniture and work organization.
The task of specialized occupational health services is to assess these risks and make recommendations to prevent occupational and work-related diseases. Workers at risk should undergo regular physical examinations to detect any health problem early on, where treatment and changes in the workplace can help prevent irreparable harm.
Currently, specialized occupational health services are available to only 15% of working people worldwide, mostly in large companies that pay for health insurance and provide benefits for work-related injuries. In the context of the global employment crisis, more and more people are seeking work in the informal sector, which has no insurance and no occupational health services. Many of these people often work under hazardous conditions and suffer from work-related illnesses, injuries and disabilities. In many social groups, when the breadwinner of a family gets sick, the whole family suffers because there is no social protection.
Primary health care centers can provide some basic occupational health services to workers in the informal sector and in small businesses in close proximity. Most often, workers at the centers visit workplaces and make recommendations to improve working conditions, as well as conduct preliminary and methodical physical examinations, diagnose and report on occupational and work-related illnesses. Primary health care stations could also provide training and outreach to volunteer health care assistants and workplace safety commissioners on simple measures to prevent occupational diseases, as well as counseling on safer work practices. The cost of such services ranges from $18 to $60 (at purchasing power parity) per worker. Such services make the following positive difference:
improvements in the workplace, even after the first visit;
early identification of work-related health problems and intervention; and
education and involvement of the workforce in their health care.
Studies have shown that workplace health measures help reduce sick leave time by 27 percent and health care costs for companies by 26 percent.