African Newsletter 1/2014, Healthy workplaces - managing stress

African Newsletter O N O C C U PAT I O N A L H E A LT H A N D S A F E T Y

Volume 24, number1, April 2014

Healthy workplaces - managing stress

African Newsletter on Occupational Health and Safety Volume 24, number 1, April 2014

Healthy workplaces - managing stress Published by Finnish Institute of Occupational Health Topeliuksenkatu 41 a A FI-00250 Helsinki, Finland Editor in Chief Suvi Lehtinen E-mail: suvi.lehtinen@ttl.fi Editor Marianne Joronen E-mail: marianne.joronen@ttl.fi

Contents 3 Editorial Evelyn Kortum WHO Articles 4 WHO Healthy Workplaces

Evelyn Kortum WHO

7 Managing stress

Adamson Mukhalipi Zambia

9 Stress management: an abandoned work-ethic in agriculture

Linguistic Editors Alice Lehtinen Delingua Oy

Layout Kirjapaino Uusimaa, Studio

The Editorial Board is listed (as of January 2013) on the back page.

A list of contact persons in Africa is also on the back page.

13 Why stress should be managed in the workplace?

This publication enjoys copyright under Protocol 2 of the Universal Copyright Convention. Nevertheless, short excerpts of articles may be reproduced without authorization, on condition that source is indicated. For rights of reproduction or translation, application should be made to the Finnish Institute of Occupational Health, International Affairs, Topeliuksenkatu 41 a A, FI-00250 Helsinki, Finland.

15 The Workers’ Health Education initiative

The African Newsletter on Occupational Health and Safety homepage address is: http://www.ttl.fi/AfricanNewsletter The next issue of the African Newsletter will come out at the end of July 2014. The theme of the issue 2/2014 is Diversity in the world of work.

Photographs of the cover page: © International Labour Organization / M. Crozet

© Finnish Institute of Occupational Health, 2014

Printed publication: ISSN 0788-4877 On-line publication: ISSN 1239-4386

Samuel Olowogbon Nigeria

11 Teacher’s burnout syndrome: a short review

Ayman Ekram Fahim Egypt

Phillimon Lajini Botswana

16 Rethinking our intervention frameworks to tackle psycho social risks and work-related stress in developing countries

Stavroula Leka, Evelyn Kortum UK/ WHO

18 Organizational requirements for the implementation of Effective Occupational Safety and Health Management Systems

Matthew M Ncube Zimbabwe

20 Mapping working conditions using a participatory approach - A case study in a rubber plantation in Ghana

Salli Rose Tophoj, Jane Frølund, Thomsen, Edith Clarke Denmark, Ghana

23 ICOH Mid-term meeting in Espoo, Finland ILO OSH activities under development Suvi Lehtinen

Finland The responsibility for opinions expressed in signed articles, studies and other contributions rests solely with their authors, and publication does not constitute an endorsement by the International Labour Office, World Health Organization or the Finnish Institute of Occupational Health of the opinions expressed in it.

Editorial

Healthy workplaces – managing stress

S

tress at work is a topic that has been discussed and researched at length over the last decade and even earlier.

This is not surprising, because the global world of work, just as the world in general, has changed considerably and we are constantly experiencing re-organizations, downsizing, job insecurity, increased workloads, and deteriorating work environments – all with the aim of constantly saving costs. But does this really happen? And if so, at what expense; our mental health, our physical health, early disability, increased health costs, our dignity, our social lives and work-life balance, increased competition and decreased solidarity at work or more precarious jobs? All these, and maybe even more factors are affected.

Today we know enough to understand that such adverse working and employment conditions, often resulting in limited possibilities for a healthy and balanced lifestyle, are closely linked to chronic/non-communicable diseases (NCDs) such as depression and other mental health problems, cardiovascular diseases, various types of cancer, obesity, diabetes, musculoskeletal disorders and others. We also know that most NCDs are preventable: the WHO global burden of disease figures show that at least half of cardiovascular diseases, chronic obstructive and pulmonary diseases, cancers and diabetes can be successfully tackled through the workplace.

Indeed, the health impact of stress at work negatively affects workers and their communities, with a clear financial impact on businesses and beyond. Variables include sickness absences, the hidden cost of presenteeism when a sick worker is present at work and not fully productive, and unemployment. It is estimated that the cost of work-related ill-health and the associated productivity loss will reach around 4–5% of GDP. This situation has facilitated public dialogue, particularly on the European level, and has led to many studies and programmes that attempt to address and prevent the causes of stress at work.

Protecting and promoting workers’ health is the essence of WHO’s Global Plan of Action for Workers’ Health (2008–2017), in particular the WHO healthy workplace initiative, which is an evidence-based model for health action at the workplace, and addresses occupational risks, work organization, behaviour-

al factors and corporate social responsibility. It sets psychosocial workplace hazards and work-related stress on an equal footing with the physical work environment. The global approach to dealing with well-being issues, including psychosocial risks, was a much needed variation from the traditional occupational health and safety approach. The WHO approach also covers personal health resources and the interface with the community in which the company is active, in order to ensure the application of business social responsibility. Linked to the global plan is the WHO Mental Health action plan (2013–2020), which addresses mental health at work through, for example, promoting participation in work and return-to-work programmes, training on mental health for managers, workplace wellness programmes and tackling stigmatization and discrimination. The Global action plan for the prevention and control of NCDs (2013–2020) also sees workplaces as one of the key settings for actions to prevent and control NCDs. Many workplace interventions can address behavioural risk factors, by promoting, for example, 100% smoke-free workplaces and smoking cessation, modifying the work environment, and combatting sedentary work.

Clearly, psychosocial risks and work-related stress are not prioritized by policy-makers anywhere, and the development of clear key messages to reach policy-makers, accompanied by clear communication structures, is essential in order to bring about change. The public health impact of stress at work, added to the health impact of traditional occupational risk factors, is enormous: it can no longer be ignored at a global level. A call to employers, worker representatives, researchers and policy-makers to include these emerging issues within comprehensive and broad approaches to occupational health, is a call for attention to occupational health per se.

Evelyn Kortum, PhD, Interventions for Healthy Environments, Department of Public Health and Environment, WHO headquarters, Geneva, Switzerland

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Evelyn Kortum WHO

WHO Healthy Workplaces This article underlines the importance of the inclusion of the psychosocial work environment within a comprehensive policy framework on occupational health, and explains why this inclusion has such a high relevance for the health of workers, for national health systems and the economy of a country at large.

The WHO action on protecting and promoting the health of workers is mandated by the Constitution of the Organization, as well as a number of resolutions passed at various sessions of the World Health Assembly, the supreme decision-making body of the Organization with its 194 Member States to date. Currently, and despite the existence of effective interventions to prevent occupational diseases and injuries, there are still major gaps in the health status of workers between and within countries. The current global policy instrument in place, the WHO Global Plan of Action on Workers’ Health (1), 2008–2017, provides a political framework for the development of policies, infrastructure, technologies and partnerships to achieve a basic level of health protection in all workplaces throughout the world. It reiterates that it is important that the workplace is not detrimental to health and well-being and it recognizes the close link between occupational or workers’ health on the one hand, and public health on the other, which is an opportunity to lift workers’ health issues onto the public health agenda.

The WHO Healthy Workplace Initiative

The advantage of the WHO Healthy Workplace Initiative (2) is that it combines all approaches that have proven to be successful in building healthy and safe workplaces and the model is applicable to all sizes of workplaces. It also has been well accepted by the international scientific and business community as a useful approach to ensuring workers’ health.

The definition of a healthy workplace is strongly based on the WHO definition of health which is enshrined in its Constitution and which stresses an integrated approach to health: “A state of complete physical, mental and social well-being, and not merely the absence of disease”, as well as evidence from best practice in the research and practice literature. The WHO definition of a healthy workplace (3) encompasses the four avenues of influence where actions can best take place and the most effective processes by which employers and workers can take action: 4 • Afr Newslett on Occup Health and Safety 2014;24:4–6

A healthy workplace is one in which workers and managers collaborate to use a continual improvement process to protect and promote the health, safety and well-being of all workers and the sustainability of the workplace by considering the following, based on identified needs: • health and safety concerns in the physical work environment; • health, safety and well-being concerns in the psycho. social work environment including organization of work and workplace culture; • personal health resources in the workplace provided by the employer; and • ways of participating in the community to improve the health of workers, their families and other mem bers of the community.

Particularly, the global approach to dealing with well-being issues in the psychosocial work environment was a much needed variation from the traditional occupational health and safety approach (4). And indeed, inquiries from developing countries seem to indicate that there are effects of work-related stress to an increasing level.

The four avenues of influence of the model in Figure 1 refer to the content and not the process. Each of the four avenues is explained further below, however, important to note is that all four avenues interact and have common denominators.

The physical work environment is the part of the workplace facility that can be detected by human or elec-

Figure 1. The four avenues of influence

tronic senses, including the structure, air, machines, furniture, products, chemicals, materials and processes that are present or that occur in the workplace, and which can affect the physical or mental safety, health and well-being of workers.

Personal health resources encompass the supportive environment to include health services, information, resources, opportunities and flexibility that an enterprise provides to workers to support or motivate their efforts to improve or maintain healthy personal lifestyle practices. Enterprise community involvement or business responsibility comprises the activities, expertise and other resources an enterprise engages in or provides to the social and physical community or communities in which it operates; and which affect the physical and mental health, safety and well-being of workers and their families.

It includes activities, expertise and resources provided to the immediate local environment, but also the broader global environment. The psychosocial work environment includes the organization of work and the organizational culture; the attitudes, values, beliefs and practices that are demonstrated on a daily basis in the enterprise/organization, and which affect the mental and physical well-being of employees. These are sometimes generally referred to as workplace stressors, which may cause emotional or mental stress to workers, such as reallocating work to reduce workload; enforcing zero tolerance for harassment, bullying or discrimination; allowing flexibility in how and when work is done to respect work–family balance; recognizing and rewarding good performance appropriately; or allowing meaningful worker input into decisions that affect them.

The way an enterprise addresses the four avenues must be based on the needs and priorities identified through an assessment process that involves extensive consultation with workers and their representatives through health and safety committees. Implementing a healthy workplace programme that is sustainable and effective in meeting the needs of workers and employers requires more than knowing what kinds of issues to consider. To successfully create a healthy workplace, an enterprise must follow a process that involves continual improvement (a management systems approach).

Figure 2. Continuous improvement cycle

Figure 3. The WHO Healthy Workplace model and framework

This is graphically represented by the continuous improvement loop of mobilizing, assembling, assessing, prioritizing, planning, doing, evaluating and improving demonstrated in Figure 2.

Two core principles that underlie this model are featured in the centre of Figure 3. These principles of management commitment and workers’ involvement are not merely steps in the process, but are ongoing circumstances or conditions that must be tapped into at every stage of the process.

ally in addition to, in particular, absenteeism due to work-related mental health problems and the rising cost to economies, employers and insurances. Statistics show that in many industrialized countries, 35–45% of absenteeism from work is due to mental health problems (7) and that about 40% of employee turnover is due to stress at work. Table 1 demonstrates the national and global business cases with respect to the global level of absences due to work-related stress resulting in mental health problems.

Generally, statistics from industrialized countries show that the collective cost of work-related stress is high, having potentially major impacts on national economies. And the link between health and productivity has been recognized for centuries as the cornerstone for a healthy economy (8–10). The high costs of the impact of work-related stress have facilitated public dialogue, and the issuance of many studies that attempt to address the causes and origins of work-related stress, followed by preventive action.

Usually, workers in industrialized countries enjoy a welfare system that provides a public “safety net”, as a result of which the burden of unemployment is shared by the government (11). In the absence of a welfare system that may protect individuals who are unable to work, for example, as a result of their mental illness, workers in developing countries are likely to continue to work despite their disability (11) and the impact on workplace productivity and personal suffering is, therefore, even magnified, and goes beyond the direct costs as a result of impairment in the workplace.

Lack of attention to the psychosocial work environment

Psychosocial hazards have nowadays become a global phenomenon, but are still ignored by many. Signs are established as poorer physical and mental health outcomes and/or poor health behaviours from experiences of repeated reorganizing, downsizing and expanding of workplaces or increasing job insecurity e.g., EU-OSHA (5). The WHO estimated that 400 million people around the world suffer from mental or neurological disorders, or from psychosocial problems, such as those related to smoking, drinking and drug abuse (6). A number of health outcomes, particularly from work-related stress, have been well documented in the literature, such as heart disease, depression and musculoskeletal disorders. Also the inter-linkages of these health outcomes and work-related stress have been studied broadly (3).

Absences caused by occupational injuries or ill health affect not only workers’ lives, but also businesses and their communities. This is of growing concern glob-

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Table 1.1 Global financial and mental health impact of work-related stress

1

Type of cost

Country

Estimated cost

Source

Work-related health loss and associated productivity loss

Globally

4–5% of the GDP

Takala 2002

Occupational diseases and accidents

Commonwealth 10 million disability-adjusted life years (DALYs) lost

CDPP 2007

Work-related stress and related mental health problems

EU (15 Member States)

On average between 3% and 4% of the GNP = €265 billion/year

Gabriel and Liimatainen 2000

Stress at work

UK

Estimate 5–10% of the GNP/year costing employers around €571 million

Worrall and Cooper 2006

Sick leave due to stress and mental strain

Sweden

€2.7 billion

Koukoulaki 2004

Stress-related illnesses

France

Between €830 and €1,656 million

EU-OSHA 2009

KORTUM, E. (2013). THE WHO GLOBAL APPROACH TO PROTECTING AND PROMOTING HEALTH AT WORK. GOWER PUBLISHING.

Politicians, policy-makers, trade unions and employers need to be convinced of the importance of occupational health and safety (12) in an effort to bridge research and practical application. Trade unions and employer organizations believe that, a priori, there is a lack of awareness about the issue of work-related stress, and governments primarily blame low prioritization of psychosocial issues in general for the lack of initiatives in this area (13).

Overall, psychosocial hazards and work-related stress are not prioritized by policy-makers anywhere in the world and clear key messages for policy-makers, accompanied by clear communication structures, are essential for obtaining impact (14). The Healthy Workplace model provides a clear format for messages to policy-makers as it addresses psychosocial hazards globally and in unison with other workplace hazards, which lacks in many past country frameworks. The public health impact from psychosocial risks, added to the traditional health impact, is enormous and worldwide attention is required.

Evelyn Kortum Technical Officer Occupational Health World Health Organization Interventions for Healthy Environments Dept. of Public Health & Environment kortume@who.int www.who.int/occupational_health

6 • Afr Newslett on Occup Health and Safety 2014;24:4–6

References 1. World Health Organization 2007. Global Plan of Action for Workers’ Health, 2008–2017. Geneva: WHO. 2. World Health Organization. WHO Healthy Workplace Framework and Model: Background and Supporting Literature Review. WHO, 2010.

3. World Health Organization. Healthy Workplaces: A Model for Action. For Employers, Workers, Policymakers and Practitioners. 2010.

4. Kortum E. Editorial: A need to broaden our perspective to address workers’ health effectively in the 21st Century. Industrial Health 2012;50:71–2.

5. European Agency for Safety and Health at Work (EU-OSHA). Expert Forecast on Emerging Psychosocial Risks Related to Occupational Safety and Health. Luxemburg: Office for Official Publications of the European Communities, 2007.

6. World Health Organization. Mental Health in Europe. Regional Office for Europe, Copenhagen: WHO, 2001.

7. World Health Organization. Investing in Mental Health. Geneva: WHO, 2003.

8. Goetzel RZ, Ozminkowski RJ, Sederer LI, Mark TL. The business case for quality mental health services: Why employers should care about the mental health and well-being of their employees. Journal of Occupational and Environmental Medicine 2002;44:320–330.

9. Oxenburgh M, Rapport N, Oxenburgh PM. Increasing Productivity and Profit through Health and Safety: The Financial Returns from a Safe Working Environment. Boca Raton: CRC Press LLC, 2004.

10. Stewart WF, Ricci JA, Leotta C. Health-related lost productive time (LPT): Recall interval and bias in LPT estimates. Journal of Occupational and Environmental Medicine 2004;46:S12–S22.

11. Dewa CS, McDaid D, Ettner SL. An international perspective on worker mental health problems: Who bears the burden and how are costs addressed. Canadian Journal of Psychiatry 2007;52:346–56.

12. Rantanen J, Lehtinen S, Savolainen K. The opportunities and obstacles to collaboration between the developing and developed countries in the field of occupational health. Toxicology 2004;198(1–3):63– 74.

13. Natali E, Deitinger P, Rondinone B, Iavicoli S. The European Framework for Psychosocial Risk Management: PRIMA-EF. In The European Framework for Psychosocial Risk Management, edited by S. Leka and T. Cox. Nottingham: Institute for Work, Health and Organisations, 2008;79–114.

14. Leka S, Jain A, Iavicoli S, Vartia M, Ertel M. The role of policy for the management of psychosocial risks at the workplace in the European Union. Safety Science 2010;49(4):558–64.

Photo by Suvi Lehtinen

Adamson Mukhalipi Zambia

Managing stress “Stress is like spice - in the right proportion it enhances the flavour of a dish.

Too little produces a bland, dull meal; too much may choke you.” Donald Tubesing Introduction

Workplace stress has become an issue of great concern over the last few years, both internationally and nationally. Given the value of work in this era, the amount of time spent at work and the current changes that are affecting the nature of work, it is not surprising that work stress appears to be increasing.

For instance, the rapidly changing global economy has resulted in organizations operating in cultures of increased speed, efficiency and competition. Consequently, this has resulted in economic imperatives and hence the need to retain competitive advantage which has led to restructuring and uncertainty. For instance, workforces are constantly being downsized, small organizations are merging or being subsumed by larger, more competitive organizations, and change is the only constant.

However, while it is acknowledged that workers who experience stress at work may not proceed to the point of lodging a claim for psychological injury, it is necessary to understand the entire experience of work stress.

Consequently, this paper will examine factors contributing to workplace stress and also discuss ways through which organizations are managing stress.

The value of work

According to World Health Organization, health is defined as not merely the absence of disease or infirmity, but a positive state of complete physical, mental and social well-being; a healthy work environment is one in which there is not only an absence of harmful conditions, but an abundance of health promoting ones.

Therefore, we must avoid making the impression that work is a psychologically ‘dangerous’ activity as the intrinsic value of work to the health and life satisfaction of the worker is well recognized. For instance, early motivational theorists such as Maslow have suggested that work does not only fulfil basic needs for security, food or

shelter, but also provides a means by which higher level needs, such as need for competence, meaning and social engagement are met.

Similarly, more recent researchers have shown that work is integrally involved in the process of identity development and self-esteem, as it provides a medium by which people identify themselves in society, and can be influenced by economic, societal, cultural and individual factors. It must be noted that a person’s identity is a function of his/her validated social roles, particularly those associated with occupation. Work, therefore, plays a major role in people’s lives and wields an important influence on their sense of well-being and identity.

Therefore, any loss of such valued roles can lead to psychological distress and subsequent loss of function.

For many individuals, the loss of work has been associated with extremely negative reactions that include psychological or physiological distress, loss of social contact, and suicide. In addition to loss of income, unemployment has been found to lead to a breakdown of social relationships and an increase in stress and anxiety, loneliness and deprivation of social position, reduced social support, poor health, a higher incidence of disability and chronic illness.

What is work stress?

Therefore, work stress is the response people may have when presented with work demands and pressures that are not matched to their knowledge and abilities and which eventually challenge their ability to cope. Excessive and otherwise unmanageable demands and pressures can be caused by poor work design, poor management and unsatisfactory working conditions. Similarly, these things can result in workers not receiving sufficient support from others or not having enough control over their work and its pressures.

For instance Figure 1 below highlights some other Afr Newslett on Occup Health and Safety 2014;24:7–8 •

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References 1. Managing the causes of work-related stress. A stepby-step approach using the Management Standards.

HSG 218. ISBN 9780717662739.

Free download available. http:// www.hse.gov.uk/ pubns/priced/ hsg218.pdf 2. Working together to reduce stress at work. A guide for employees.

INDG424. Free download available. http://www. hse.gov.uk/pubns/ indg424.pdf 3. How to tackle work-related stress; A guide for employers on making the Management Standards work.

Free download available. http:// www.hse.gov.uk/ pubns/indg430.pdf 4. European Community Social Partners Voluntary Agreement. http://www. hse.gov.uk/stress/ pdfs/eurostress.pdf

Source: Designed by Author 2014

Figure 1. Problem diagram of work stress

factors that contribute to work stress as follows: A poor work organization culture, that is the way jobs are designed and the work systems, and the way these are managed, could cause work stress. This is often made worse when employees feel that they have little support from their supervisors and colleagues and also when they have little or no control over work so that they cannot cope with its demands and pressures.

The more the demands and pressures of work are matched to the knowledge and abilities of workers, the less likely they are to experience work stress.

The more support workers receive from others at work, or in relation to work, the less likely they are to experience work stress. The more control workers have over their work and the way they do it and the more they participate in decisions that concern their jobs, the less likely they are to experience work stress.

8 • Afr Newslett on Occup Health and Safety 2014;24:7–8

Most of the causes of work stress concern the way work is designed and the way in which organizations are managed.

As these aspects of work have the potential for causing harm, they are called ‘stress-related hazards’.

Management strategies of work stress

There are a number of ways in which organizations are reducing work stress and some of which are stated below as follows: a) Primary prevention, reducing stress through ergonomics, work and en vironmental design, organizational and management development. b) Secondary prevention, reducing stress through worker education and train ing. c) Tertiary prevention, reducing the im pact of stress by developing more sen sitive and responsive management sys-

tems

Conclusion and recommendation

From the foregoing, we have seen that organizations are themselves the source of different types of risk. Therefore, a good employer should design and manage work in a way that avoids common risk factors for stress and prevents foreseeable problems as much as possible. This will allow employees to be more productive at all times as they will feel appreciated and cared for.

Adamson Mukhalipi Mopani Copper Mines Plc Central Offices, Kitwe, Zambia

Contact address: Adamson Mukhalipi 15 Unity Way Parklands Kitwe, Zambia Email: adamsonmukhalipi@ymail.com

Photo by Suvi Lehtinen

T. S Olowogbon Nigeria

Stress management: an abandoned work-ethic in agriculture Nigeria, an agrarian society and the most populous black nation has a total land area of 91.1 million ha and 1.3 million ha of water bodies. The agricultural area is approximately 83.6 million ha, which comprises arable land (33.8%), land permanently in crops (2.9%), forest or woodland (13.0%), pasture (47.9%), and irrigable land or fadama (http://www.lsada.org/pages/fadama/ whatfadama.html) (2.4%) (1). Nigeria’s population estimate is approximately 140 million; of this population approximately 65% live in rural areas and are engaged in agriculture. Agriculture’s contribution to the non-oil gross domestic product (GDP) is stable at approximately 40% in recent years (2). More than 70% of the farming population in Nigeria consists of smallholder farmers, each of whom owns or cultivates less than 5 ha of farmland. These smallholder producers account for 81% of total cultivated land and 95% of agricultural output (3).

Agriculture, the mainstay of most African economy is one seated with deep culture of unwise risk taking and lack of appreciation of the role good health and safety management can play (4). Thus, agriculture is an important sector for the development of Nigeria. The sector is also largely regarded as an informal sector in Nigeria and also as a safety-neglected sector.

Generally, the UK Health and Safety Executive defines stress as the adverse reaction people have to excessive pressure or other types of demand placed on them (http://www.hse.gov.uk/stress/index.htm), and ranks it as a major occupational health problem. Work- related stress is a major source of psychosocial hazards that has not been given priority in the agricultural sector of most developing countries. These stress factors could be of a physical, psychological or social nature. This is probably due to the unique nature of how agriculture is carried out. Aside from farming, ‘agriculture’ covers many other associated activities, such as crop processing and packaging, irrigation, pest management, grain storage, animal husbandry, and construction. In addition, agricultural work also includes domestic tasks (carrying water or wood for fuel, etc.). The distinguishing character-

istic of agricultural work is that it is carried out in a rural environment where there is no clear-cut distinction between working and living conditions. As agricultural work is carried out in the countryside, it is subject to health hazards of the rural environment, as well as those inherent to the specific work processes involved (5). Agriculture is not only physically, (and at times emotionally), demanding; it is also time-intensive. There is never a shortage of tasks to complete, planning to do, or bookkeeping to catch up on. This can be stressful for some people; especially those who like to feel a sense of completion (7).

Psychosocial hazards are aspects of work that are associated with negative health and safety outcomes. These constitute a psychiatric, psychosocial and/or physical risk to workers’ health and safety (6). Psychosocial hazards also deal with interpersonal relationships or colleague relationships, worker/management relationship or boss/subordinate relationship. This relationship, if not properly handled, could lead to emotional and psychological stress that could affect job satisfaction, efficiency and productivity. Also, high job demands, unreasonable targets and fear of termination of employment and other inter- and intra-personal conflicts could affect workers’ holistic job performance. In addition, because agricultural operations are mostly seasonal and mostly self-owned, it is difficult to distinguish between farming and rural living. This makes it difficult for farm workers to observe adequate periods of resting. In fact, experts have also recommended 10–15 minutes of rest for every 2 hours of continuous work as a means of balancing work with health to minimize the effect of psychosocial hazards on farm workers’ health. Farm safety researchers have also recommended that farmers should also avoid ‘overworking syndrome’ because inadequate resting periods could lead to health issues that will lead to absenteeism, loss of production and other hazards affecting a farmer’s productivity and economic well-being.

Other sources of agriculturally related stress include inadequate access to correct market information emaAfr Newslett on Occup Health and Safety 2014;24:9–11 •

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References

Photo by © International Labour Organization / M. Crozet

nating from poor price mechanisms, inadequate access to timely farm input, such as fertilizers, loans, labour, agrochemicals, environmental stress factors such as unfavourable weather conditions, natural disasters and production output uncertainty. As reported by the University of California, younger farmers, especially those younger than 50, report more stress than older farmers. Also, farmers that practice mixed farming (for example, crop and livestock farming) report higher stress levels than those in crop farming only.

Farmers employed in off-farm jobs report more stress than full-time farm operators (7). Women working on farms may experience additional stress factors. Besides working as a full partner in the farm business, many women have sole responsibility for the home and family matters.

A woman with an off-farm job faces very difficult demands in addition to being the traditional nurturer for the rest of the family (8).

Stress management is one of the agricultural safety and health best practices.

Its importance cannot be overemphasized ranging from productivity management to health and developing a safe farming community. Stress management is a required work ethic in agricultural operations especially now that agriculture is practised as a business, ‘agribusinesses’.

Proper hazard management starts from proper understanding of the hazards and the work environment. A thorough analysis of the farm-related stress factors is necessary to channel the best farm-related stress control strategy.

Way forward

The way in which the individuals react to 10 • Afr Newslett on Occup Health and Safety 2014;24:9–11

stress obviously varies with each person at any particular point in time. Fatigue, health status, depression, social environment, excitement, elation and invigoration all influence how one experiences and copes with stress. Though people do deal with stress in many ways, it is important to recognize that not all coping strategies are positive or constructive. Examples of destructive coping mechanisms include the overconsumption of alcohol or constant worry. Effects of not dealing with stress constructively may include sleeplessness, depression, anxiety, or prolonged anger. It has been found that farmers (women and men) tend to be reluctant to seek professional help when stress becomes severe, but there are many ways to manage stress (7, 9) The following stress management standards could be adapted to manage agricultural related stresses. As documented by the UK Health and Safety Executive (HSE), work-related stress management standards could be used in managing stress. The standard addresses concerns from sources of stress-related hazards in the workplace. This includes managing stress from the following sources:

• Work-related stress management standards 1. Work demands: This first standard en tails controlling the sources of work-re lated stress factors. This includes stress

factors related to workload, work pat terns and the work environment with specific adaptability to the agricultur al sector. Farm work may be bro ken into parts, the pattern should not be strenuous and the environment should be safe.

2. Work control: this has to do with the

1. Adetunji O. Creating appropriate technology as a means of waste minimization in cassava end products. www.nifst. org/?nifst:articles. 2006 Retrieved on 10/11/13.

2. Federal Department of Agriculture/ Federal Ministry of Agriculture and Rural Development (FDA/FMARD). Progress in implementation of Presidential Initiative on Rice, 2006.

3. National Agricultural Research Project (NARP). National Agricultural Research Strategy Plan, Draft Report on North West Zone. 1994.

4. Chris I. Pastoral care, Safety Health Practitioner Magazine, Nov 2008 United Media.

5. National Safety Council. International Accident Facts (Illinois, United States, 1995).

6. Psychosocial health for small business, Workplace health and Safety Queensland available at www.dei.qld.gov.au/workplace/.../psycho-health-smallbusiness.pdf accessed on 2 June, 2010.

7. Kristin R. Stress Management for Women Farmers & Ranchers. University of California (UC) Small Farm Program Publication, Agriculture and Natural Resources, 1111 Franklin Street, 6th Floor, Oakland, CA 94607, (510) 987-0096.

8. Molgaard V, Miller L. Manage Stress to Increase Farm Safety. SAFE FARM- Promoting Agricultural Health & Safety Project, Iowa State University Extension, Ames. www.cdc. gov/nasd/ 1996. (Revised 2002).

9. Pitzer R. Stress and Coping on the Farm.

University of Minnesota Extension Service.

Online resource: www.extension.umn.edu.

1987 Accessed 2/19/08.

freedom of an individual to have con trol over the way he/she carries out farm work.

3. Farm support: this includes farm work support ranging from motivation to work, incentives, resources provid ed by the organization to aid farm op erations, line management and col leagues.

4. Farm relationships: this includes pro moting positive working relationships to avoid conflicts and dealing with un acceptable behaviour.

5. Work role: This has to do with a prop er understanding of the work role by workers and delegation of responsibil ity by the farm management. Inade quate information on an individual’s role could lead to work-related stress.

6. Organizational change: This deals with how organizational change is managed and communicated to all stakeholders in the farm community.

• Work-related Stress Risk Assessment:

The farm-related stress management risk assessment entails (i) identification of farm-related stress factors through symptoms and those that will be harmed, (ii) Evaluating the risks and deciding on actions, (iii) Document findings and implementing them, (iv) Review assessment and updates as necessary.

• Time management: Recent studies have also shown that good time management practices and planning reduce workplace stress. This could also be adopted in the control of psychosocial hazards on the farm.

• Learn to accept things that cannot be changed and devote energy to things that can be changed.

• Relaxation and exercise time should be taken seriously.

• Farm networking: Good social relationships and networking helps to generate positive energy in order to manage stress.

Conclusion

Agricultural related stress is a common hazard in the agricultural sector due to the complex nature of the work involved. However, with adequate agricultural safety and health management in place, the sector could be safe and healthy in all its production processes.

Samuel T. Olowogbon Department of Agricultural Economics, University of Ilorin Ilorin, Nigeria Email:olowogbonsam@yahoo.com

European Agency for Safety and Health at Work Healthy Workplaces Manage Stress – campaign is lauched in April 2014.

See tips and tools to manage stress and psychosocial risks in your workplace.

Visit page: http://www.healthy-workplaces.eu/en EU-OSHA C/Santiago de Compostela 12 48003 Bilbao, Spain E-mail: information@osha.europa.eu http://osha.europa.eu

Ayman Ekram Fahim Egypt

Teacher’s burnout syndrome: a short review Teachers are the cornerstone of the educational system. Effective and motivated teachers guarantee the successful achievement of educational goals.

In recent years, teacher stress has been increasingly recognized as a widespread problem (1,2). Approximately one third of the teachers surveyed in several studies reported that, teaching is a highly stressful job (3). Occupational stressors within the teaching environment include work overload, role ambiguity and conflict, pressures of the teachers’ role, inadequate resources, poor working conditions, lack of professional recognition, low remuneration, lack of involvement in decisionmaking, lack of effective communication, staff conflicts, and student misbehaviour (1).

Burnout is a major problem in education, teaching environments in particular have been identified as stressful workplaces. First introduced by Freudenberger (4), professional burnout occurs in response to prolonged work tensions and stressors.

Pine and Keinan (5) reported that it happens most often among those who work with people and results from the emotional stresses that arises during the interaction with them. According to Maslach and Jackson (6), burnout is comprised of three dimensions: emotional exhaustion, lack of personal accomplishment and feelings of de-personalization.

Friedman (7) found that the main components of burnout among teachers are: exhaustion, a sense of lacking professional fulfilment and an attitude of depersonalization. He also stated that the essence of burnout among teachers is the feeling of professional failure as a result of the gap between the actual feel-

ings of personal competence and the ideal competence to which the teacher aspires and also to the teacher’s performance in the school organization.

Teacher burnout may be caused by various factors, including excessive work, lack of administrative and parental support, inadequate salaries, disciplinary problems, lack of interest shown by students, overcrowded classrooms, public criticism of teachers and their work, inordinate time demands, large class sizes, lack of recourses, role ambiguity, lack of support, involvement in decision making, and student behavioural problems, in addition to, lack of self-esteem, and lack of in-service training opportunities. In addition, some demographic variables, such as age, marital status, work experience and gender, were found to be related to burnout (8–11).

Consequences of burnout include a significant decrease in the quality of teaching, extended periods of absence, early departure from the profession, diminished job satisfaction and reduced teacher-pupil rapport. Decreased teacher effectiveness in meeting educational goals and reduced pupil motivation also result from burnout (12).

Special education teachers

Special education teachers are those teachers dealing with the gifted and talented individuals whose abilities, talents and potential for accomplishments are exceptionally advanced as well as students suffering from disabilities and various

Afr Newslett on Occup Health and Safety 2014;24:11–12 •

11

References

Photo by © International Labour Organization / M. Crozet

handicaps for whom special education and support services are needed in order to meet educational objectives and goals in the general education.

Various factors related to burnout among special education teachers included excessive work, working conditions and low satisfaction with regard to promotion and pay and time constraints are predictors of burnout (11,13). Of particular importance to special educators are the performance of custodial and managerial tasks, an excessive amount of direct contact with children, a perceived lack of job success, programme structure, and work overload (10, 8).

Burnout syndrome among special education teachers leads to poor quality of the services provided by the organization, lack of social support at work and autonomy. Furthermore, work overload among teachers of students with special needs has been reported to be a major predictor of burnout (10). Burnout has a negative effect not only on work performance and satisfaction but also on one’s social life and personal relationships (14). Consequently, staff stress has been found to be associated with intended turnover and absenteeism from work.

Dr. Ayman Ekram Fahim, MD, DHPE Asst. Prof. of Occupational & Environmental Medicine, Department of Community Medicine, Faculty of Medicine, Suez Canal University Ismailia 41522, EGYPT. Email: afahim70@gmail.com 12 • Afr Newslett on Occup Health and Safety 2014;24:11–12

1. Kim Mi, Lee J, Kim J. Relationships among burnout, social support, and negative mood regulation expectancies of elementary school teachers in Korea. Asian-Pacific Newslett Educ. Rev. 2009;10:475–82.

2. Chan D. Burnout, self-efficacy, and successful intelligence among Chinese prospective and in-service school teachers in Hong Kong. Educational Psychology 2007;27:33–49.

3. Borg M. Occupational stress in British educational settings: A review. Educational Psychology 1990;10:103–26.

4. Freudenberger HJ. Burnout. New York, 1980: Doubleday.

5. Pines A, Keinan G. Stress and burnout: The significant difference. Personality and Individual Difference, 2005;39:625–35.

6. Maslach C, Jackson S. Maslach Burnout Inventory Manual (2nd ed.), 1986. Palo Alto, CA: Consulting psychologists Press.

7. Friedman I. Burnout: shattered dreams of impeccable professional performance. Journal of Clinical Psychology 2000;56:595–606.

8. Alkhrisha M. Burnout among a selective sample of American and Jordanian teachers. Dirasat, Educational Sciences 2002;29:405–14.

9. Sari H. An analysis of burnout and job satisfaction among Turkish special school headmasters and teachers, and the factors effecting their burnout and job satisfaction. Educational Studies, 2004;30:291–306.

10. Hoffman S, Palladino J, Barnett J. Compassion fatigue as a theoretical framework to help understand burnout among special education teachers. Journal of Ethnographic & Qualitative Research 2007;2:15–22.

11. Kokkinos C. Job stress, personality and burnout in primary school teachers. British Journal of Educational Psychology 2007;77:229–243.

12. Abel M, Sewell J. Stress and burnout in rural and urban secondary school teachers. Journal of Educational Research 1999;92:287–295.

13. Platsidou M, Agaliotis I. Burnout, job Satisfaction and instructional assignment-related sources of stress in Greek special education teachers. International Journal of Disability, Development and Education 2008;55:61–76.

14. Hastings RP, Horne S, Mitchell G. Burnout in direct care staff in intellectual disability services: a factor analytic study the Maslach burnout inventory. Journal of Intellectual Disability Research 2004;48:268– 73.

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Why stress should be managed in the workplace Introduction

Stress is defined in various ways, basically it is a reaction experienced by an individual, particularly when he/ she fails to cope with the situation. Stress can be caused by situations outside the workplace. When it is caused by situations arising from the workplace it becomes workplace stress; no workplace is immune to stress. Stress has adverse effects on workers and organizations.

The European Risk Observatory Report of 2009, states that the concept of stress was introduced to physiology in the 1930s by Hans Selye (1), who defined it as a non-specific response of the organism to any pressure or demand. The Health and Safety Executive (2) defines stress as the adverse reaction people have to excessive pressure or other types of demand placed on them.

Stress causes ill health, affecting the mental health and physiology of the body. Individuals react in various ways when affected by stress; the effects of stress include behavioural changes, gastrointestinal disorders, fatigue and sleep disorders. It also increases the risk of other diseases such as cardiovascular disease and other psychological disorders.

Can stress be managed?

If stressors in the workplace are known and can be detected, it is possible to manage stress. Hazards presenting a risk of stress in the workplace have been identified.

The ILO and other safety and health organizations such as the UK Health and Safety Executive (HSE) and the US National Institute for Occupational Safety and Health (NIOSH) have identified and explained in their publications the causes of stress in the workplace. Therefore, if the causes of stress in the workplace are known they can be identified using appropriate tools and managed.

Causes of stress have been identified as shown in the table below; A risk assessment is conducted to detect hazards and risks in the workplace, making it a suitable tool for detecting causes of stress as well. This shows that it is possible to manage stress by managing the causes.

The ILO has developed and published a guide to a practical way of managing stress, the HSE (UK) and NIOSH (USA) also came up with standards for managing stress. It must be kept in mind that commitment drives all initiatives in the workplace and its importance should not be overlooked; in order to improve effectiveness,

Table 1. Causes of stress (2, 3 and 6) Organization

Causes of stress in the workplace

Health and Safety Executive (UK) National Institute for Occupational Safety and Health (USA)

Relationship, demand, role, change, control, lack of support Design of tasks, management style, interpersonal relationships, work roles, career concerns, environmental conditions Job demands, job control, social support, physical environment, work-life balance and working time, recognition at work, protection from offensive behaviour, job security, information and communication

International Labour Organization

teamwork must be promoted. In both ILO and HSE publications it is clear that the best approach to manage stress is team work, employees must be involved and information should be available.

Stress management in Botswana

The understanding and management of workplace stress is still a challenge in Botswana. In order to obtain a full picture of the extent of workplace stress, its management and its importance, questionnaires completed by employers and/or management were distributed to 21 workplaces in Francistown, Lobatse and Selibe-Phikwe.

The following information was generated: • 95% agreed that stress can be caused by work.

• 81% agreed that stress incurs losses • 81% agreed that stress in the workplace can be managed.

• 38% claimed that causes of occupational stress have been identified in their workplace.

• 33% claimed that stress is managed in their work place.

The understanding of the relationship between stress and the workplace is still a challenge, and thus it is important to acknowledge that work can cause stress and therefore stress should be prevented. To most employers the cost incurred by stress is blurred, which is the reason why the issue of stress in the workplace is often ignored.

However, the government of Botswana operates an active wellness programme which is used to address some stress factors. All levels of government are expected to Afr Newslett on Occup Health and Safety 2014;24:13–14 •

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Photo by © International Labour Organization / M. Crozet

must not be underestimated. It contributes to other work-related diseases, accidents and dangerous occurrences. Just like any other disease, prevention of stress is better than cure and prevention can be achieved by managing it. Preventing stress in the workplace will therefore improve the quality of lives and contribute positively towards sustaining the business and the economy of the country.

Acknowledgement have functional wellness committees, at ministerial level, headquarters, regional offices and district offices. By holding informative wellness sessions and organizing sports activities, some of the issues in Table 1 are addressed such as social support, work life balance and working time, and information and communication.

Importance of managing stress

There is a correlation between an employee’s health and higher productivity; the employee should have a healthy body and mind. Keeping the employee healthy should be part of the business plan to sustain productivity, this means taking all hazards and risks in the workplace into consideration including the issue of stress.

The adverse effects of stress will affect the employee and consequently the organization. Therefore, it is more cost effective to prevent stress in the workplace by managing it, rather than cure its adverse health effects. To quote Professor Lennart Levi (4), “an ounce of prevention is worth a pound of cure”. Information that has been gathered over the years in different countries on the impact of stress verifies the negative impact stress has on employees, organizations and countries. Examples of the negative effects on employees from the European Risk Observatory Report of 2009 include: • In 2007, a 52-year old employee in France died 20 days after collapsing at work; medical evidence later proved his heart attack was caused by work place stress.

• Also in France, a car company techni cian committed suicide. It was later es tablished after investigations that the suicide was triggered by stress factors in the workplace.

The negative effects in the organization include:

• Damage to an organization’s reputa tion due to employees’ attitude and be haviour, legal issues may also affect the reputation • Poor customer service • Absenteeism – According to the UK Health and Safety Executive, 11 mil lion days were lost in the United Kingdom in 2005-06. Studies indicate that 50% to 60% of days lost have some link to work-related stress according to the European Risk Observatory Report of 2009.

• Productivity declines • The organization risks litigation.

Countries are also affected, they lose revenue because tax payers are disabled by ill health or die and their health system is constrained. Examples from some of the countries; • It was estimated in France in 2000 that the cost to the society of occupa tional stress is somewhere between EUR 830 and EUR 1.656 million.

In Germany, the cost of psychological disorders (with depression) was esti mated to be EUR 3.000 million in 2001 according to the European Risk Observatory Report of 2009. (1) Stress in the workplace will cause ill health; consequently there will be lowered productivity, absenteeism and other related costs. It is therefore necessary to manage this issue. The systematic approach adopted and the level of implementation can be different depending on the risks within the organization. ILO 2003 report states that behind the statistics lie deeply personal tragedies, but the costs and the solutions rest with society as a whole (6).

Conclusion

It is important to have a healthy mind and body in the workplace. Stress affects the employer and employee in many ways and

14 • Afr Newslett on Occup Health and Safety 2014;24:13–14

I would like to extend my appreciation to Mr Gaabetwe Motladi and Mr Tabulawa Seepa who are both officers in the Department of Occupational Health and Safety stationed in Lobatse and Selibe-Phikwe respectively for their assistance with the questionnaires.

Phillimon Lajini Ministry of Labour and Home Affairs Department of Occupational Health and Safety Private Bag 00241 Gaborone, Botswana E-mail: plajini@gov.bw

References 1. European Agency for Safety and Health at Work. OSH in figures: Stress at work-facts and figures, 2009. Available from www.osha.europa.eu/en/publications/ reports/TE-81-08-478-EN-C_OSH_in_figures_stress_at_work [Accessed 25/02/14].

2. Health and Safety Executive. Managing the causes of work-related stress: A step-by-step approach using the management standards (2ndedn), 2007. HMSO. 3. National Institute for Safety and Health: Stress at work. Available from www. cdc.gov/niosh/docs/99-101/. [accessed 25/02/14] 4. International Labour Organization: Developing a workplace stress prevention programme. Available from www.ilo.org/ wcmsp5/groups/public/---ed_protect/--protrav/---safework/documents/publication/ wcms_118184.pdf. [accessed 25/02/14] 5. International Labour Organization. Safety in numbers-pointers for global safety culture at work, 2003. Available from http://www. ilo.org/legacy/english/protection/safework/worldday/report_eng.pdf [accessed 27/02/14] 6. International Labour Organization.

Stress prevention at work checkpoints, 2012. Available from www.ilo.org/wcmsp5/groups/public/@dgreports/@ dcomm/@publ/documents/publication/ wcms_168053.pdf [Accessed 24/02/14]

The Workers’ Health Education initiative: a website that offers learning and information materials for workers’ health. www.workershealtheducation.org

ricula, etc.

Aim

Current materials

Workers’ Health Education is an initiative aiming to stimulate and support education and training in basic occupational safety and health all over the world.

The initiative is meant to improve the situation for the large number of workers worldwide that lack (semi)professional support in labor health and safety, and to be used by educators and individual professionals such as general physicians, nurses, technical experts or community workers.

It is funded in 2011 by the Coronel Institute of Occupational Health, a department of the Academic Medical Center of the University of Amsterdam, The Netherlands. The initiative is part of, and supported by the WHO Network of Collaborating Centers in Occupational Health. The International Commission on Occupational Health, ICOH, is encouraging the initiative.

We developed the website to be used by schools and institutes developing and giving courses.

About

The website provides learning materials, easily accessible and in general free-of-charge, on as-much-as-possible relevant content areas. For primary health care workers, additional information materials, such as scientific articles, lectures and reports, are made available on a separate page of the website.

Exchange of materials and experiences between all those committed in supporting basic services in occupational health and safety is encouraged by facilitating a Forum, via which users from all over the world can exchange questions, and all kind of basic services experiences, plans, programs, cur-

To date the website covers a total of 43 learning materials and 42 information materials in different languages. Topics covered in the learning materials are (numbers of learning materials are indicated): • Education in basic and specialist occupational health practice (n=10) • Exposure, effects & accidents: Bio logical risk factors (n=2); Chemical risk factors (n=8); Physical risk fac tors (n=2); Psychosocial risk factors (n=3); Accident risk factors (n=2) • Sector-specific material: Agriculture (n=6); Construction (n=1); Health care sector & social work (n=2) • Risk control & occupational health care (n=10) • Community strategies and policies (n=3) Current information materials are primarily selected towards the interest of primary health care professionals.

Materials cover a wide range of intervention types, disease categories, and sectors. You can make a selection using the menus or the advanced search function.

Newsletter

On a regular basis a Newsletter is made and spread by mail. The Newsletter provides a quick overview on latest developments, experiences and newly added materials. The Newsletter is free and subscription only needs your valid email address. Please visit the homepage of the website for your subscription.

Contact

For contact, please use the “Contact us” page on the website or email to info@ workershealtheducation.org.

“Sharing a Vision for Sustainable Prevention” XX World Congress on Safety and Health at Work 2014 Global Forum for Prevention 24-27 August, Frankfurt, Germany www.safety2014germany.com

Side Event

Inclusive Work Life - Ensuring health, safety and work ability of working people of all ages Sunday, 24 August 2014 at 13.00-16.00 hrs Congress Centre Frankfurt (tbc) Draft programme

13.00 - 13.10 Opening of event - Ms Paula Risikko, Minister of Health and Social Affairs, Finland 13.10 - 13.25 Health and well-being at work to secure social inclusion and sustainable growth - Hans-Horst Konkolewsky, Secretary General, ISSA 13.25 - 13.40 Willing and able to work at all ages - Juhani Ilmarinen, Professor, Finland 13.40 - 13.50 Korea: Investing in safety and productivity - Seong-Kyu Kang, Director General, KOSHA, Korea 13.50 - 14.00 Discussion 14.00 - 14.15 Age management: Good practice or lucky coincidence? - Sarah Copsey, Project Manager, EU-OSHA, Bilbao 14.15 - 14.45 Coffee - Discussion during break 14.45 - 14.55 Quality work in Singapore for young and seniors - Hawasi Daipi, Senior Parlamentary Secretary, Ministry of Manpower, Singapore 14.55 - 15.05 Iceland: The long work careers of the Vikings - Eyjólfur Sæmundsson, Director, Vinnueftirlitið, Iceland 15.05 - 15.15 Discussion 15.15. - 15.35 Work fragmentation in 2030: Safety and wellbeing or the law of the jungle? - Guy Ryder, Director General, ILO (tbc) 15.35 - 15.50 Commentary (5 min each) ITUC and IOE (tbc) 15.50 - 16.00 Wrap up and summary

Organized by the Ministry of Social Affairs and Health, Finland Pls register to riitta.gronroos@stm.fi, free attendance, English language, no translation.

For more information: • follow http://www.stm.fi/en/working-life/occupationa-safety/inclusiveworklife • LinkedIn Group XX World Congress on Safety and Health at Work 2014 - Global Forum for Prevention • or contact Mr Wiking Husberg, Ministerial Adviser, +358 295 163 475, firstname.surname@ stm.fi

Afr Newslett on Occup Health and Safety 2014;24:15 •

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Stavroula Leka, University of Nottingham & Evelyn Kortum, World Health Organization

Rethinking our intervention frameworks to tackle psychosocial risks and work-related stress in developing countries In many developing countries, little is being done in the area of occupational health in general and psychosocial risks in particular. Decision-makers still perceive occupational health as a luxury, hence the lack of political action, poor monitoring, and weak enforcement of relevant regulations (1). However, despite differences in their environments, workers around the world face practically the same types of workplace challenges in terms of chemical, biological, physical and psychosocial hazards (2). Research studies that have dealt with psychosocial risks and work-related stress are largely limited to industrialized settings. The World Health Organization outlines a few studies that point to the importance of these issues in developing countries, but the evidence base is not conclusive in terms of the impact of psychosocial risks (3).

One main challenge for global application has been, as Kang and colleagues (4) have pointed out, that theoPhoto by Š International Labour Organization / M. Crozet

16 • Afr Newslett on Occup Health and Safety 2014;24:16–17

retical and empirical research in the work-related stress literature has mainly focused on the individual or job task domain causes of work-related stress. Another main challenge is the current division between the psychosocial and the physical work environment, which makes it harder to include psychosocial risks in legislation, and more difficult for most occupational health and safety professionals to identify them. This, in many countries, is exacerbated by the lack of a functional labour inspection authority (5).

Understanding psychosocial risks is a key issue and also a basic prerequisite for grasping the larger picture: on the one hand, psychosocial risks are situated at the micro-level of the enterprise, but on the other, they are influenced and shaped by developments occurring at the macro, national or global levels. To be effective in terms of addressing global developments, we increasingly require integrated and holistic approaches that take into

account the changing world of work, and prevent new and emerging risks as well as traditional hazards (6,7).

Therefore, legislation in any given country has to provide a framework for the promotion of both health and safety, and guidelines for this to be achieved at the workplace level. If these elements are not in place, they need to be developed in collaboration between an industrialized and developing target country and modified according to local and national conditions (8). In addition, since much of the responsibility for promoting health and safety at the workplace lies with companies themselves, the development of healthy workplaces should also represent a priority at the organizational level.

In line with these challenges, we suggest a broader focus of interventions on not only the workplace and organizational levels, but also on the macro level (socioeconomic and political conditions). The framework presented in Figure 1 argues for an integrated and holistic approach that pays attention to the changing world of work and the prevention of new and emerging risks in addition to traditional hazards. It outlines the role of the globalization processes in creating positive or negative influences on employment and working conditions. These, in turn, are affected by the developmental stage of the existing infrastructure, including the potential for providing occupational health and safety services that are subject to the level of stakeholder mobilization, the international exchange of information and collaboration, the level of capacity building, and the level of research beyond individual and workplace levels, and for feeding infrastructure development.

The existence of favourable employment and working conditions then depends on the extent to which legislation is enforced to protect workers meaningfully, and the extent to which it is monitored.

If this is of a satisfactory level, the output is a healthy and productive working population. In the extreme opposite case, without the regulation or enforcement of standards, poverty and ill health are the result, particularly in vulnerable working populations. Monitoring and surveillance underpin the extent to which any type of occupational risk, including psychosocial risks, are addressed.

To effectively apply this framework, we need a cross-fertilizing, multi-stake-

Stakeholder mobilization

Processes of globalization

Goverment

Employment & working conditions

Infastructure development including OSH services & standards

No regulation or enforcement Vuinerable working populations including informal economy

Regulation/ Leglislation Monitoring & Surveillance

Poverty & ill health

International exchange & collaboration Capacity building Extended research paradigm

Enforcement

Healthy & productive working population

Figure 1. Needs and actions required for a healthy workforce (10)

holder, multi-disciplinary and multicountry effort to reach more stakeholders and to stimulate action and positive change in the world of work. Both researchers and policy-makers have their own roles to play in this process and both need to broaden their perspectives (9).

Correspondence to: Dr Stavroula Leka Professor in Occupational Health Psychology Centre for Organizational Health & Development

University of Nottingham Level B, Yang Fujia Building Jubilee Campus, Wollaton Road Nottingham NG8 1BB, UK Stavroula.Leka@nottingham.ac.uk Evelyn Kortum Technical Officer Occupational Health World Health Organization Interventions for Healthy Environments Dept of Public Health & Environment kortume@who.int www.who.int/occupational_health/

References 1. Nuwayhid IA. Occupational health research in developing countries: a partner for social justice.

American Journal of Public Health 2004;94:1996–921.

2. Rosenstock L, Cullen MR, Fingerhut MA. Disease control priorities in developing countries. Occupational Health 2006;1127–45.

3. World Health Organization. Health impact of psychosocial hazards at work: an overview. Geneva, Switzerland: WHO, 2010.

4. Kang SY, Staniford A, Dollard MF, Kompier M. Knowledge development and content in occupational health psychology: a systematic analysis of the Journal of Occupational Health Psychology, and Work & Stress, 1996–2006. In: J. Houdmont J, McIntyre S, ed. Occupational health psychology: European perspectives on research education and practice. ISMAI Publishers. Maia, Portugal, 2008:27–62.

5. Jeyaratnam J. Development of methods and models, and good practice. People Work Research 2002;49:87–91.

6. Kortum E, Leka S, Cox T. Psychosocial risks and work-related stress in developing countries: health impact, priorities, barriers and solutions. International Journal of Occupational Medicine and Environmental Health 2010;23(3):1–14.

7. Kortum E, Leka S, Cox T. Perceptions of psychosocial hazards, work-related stress and workplace priority risks in developing countries. Journal of Occupational Health 2011;53(2):144–55.

8. Rantanen J, Lehtinen S, Savolainen K. The opportunities and obstacles to collaboration between the developing and developed countries in the field of occupational health. Toxicology 2004;198(1–3):63– 74.

9. Kortum E. A need to broaden our perspective to address workers’ health effectively in the 21st Century. Industrial Health 2012;50,71–72.

10. Kortum E, Leka S. Tackling psychosocial risks and work-related stress in developing countries: the need for a multi-level intervention framework. International Journal of Stress Management 2014;21(1):7–26.

Afr Newslett on Occup Health and Safety 2014;24:16–17 •

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Matthew M Ncube Zimbabwe

Organizational requirements for the implementation of effective Occupational Safety and Health Management Systems Background

This article has been compiled to analyse the essential requirements for the design, development and implementation of effective and efficient Occupational Safety and Health Management Systems in the Africa region.

Furthermore, the ultimate focus of the article is to identify the critical considerations for occupational safety and health at national and enterprise levels in emerging economies.

Current experience clearly indicates that the organization methods for the proper delivery of Occupational Safety and Health Management Systems and operational support activities vary widely in the Africa region. Despite the guidelines that are laid out in the respective ILO Conventions and Recommendations pertaining to occupational safety and health, the trends in this field demonstrate that serious challenges prevail at national and enterprise levels.

The key concerns cover the fundamental principles, national legislation, national organization and enterprise organization for the required operational management systems. Furthermore, the requirements for professional service delivery remain shrouded by the involvement of different professions who in most cases tend to be driven by myopic perceptions about the functional roles that are essential. This is further compounded by the lack of comprehensive understanding and definition of the field of occupational safety and health with regard to the required integrated and interactive management systems.

It is against this background that this article has been compiled.

Current trends in the delivery of occupational safety and health services in Africa

The evolution of occupational safety and health from the Factories Inspectorate to the current situation has not been very efficient in terms of a properly structured process. In some countries of Africa, the name change to occupational safety and health occurred without the actual organizational transformation. One of the main attributes to this is the lack of transformation in opera18 • Afr Newslett on Occup Health and Safety 2014;24:18–20

tional leadership.

The legal approach to occupational safety and health has long been proven not to be sustainable. The ILO Optimization Process of the Eastern Cape in South Africa clearly demonstrated that the management systems approach is not only effective but addresses occupational safety and health from a very comprehensive perspective regarding the implementation of the fundamental functional principles. The way forward is very clear because the systematic approach is essential at both national and organizational levels.

The envisaged rationalization of the ISO 14001 and OSHAS 18001 standards gives credence to the need to adopt very effective and efficient strategic and operational integrated management systems that will optimize performance in the achievement of the set objectives for the improvement of working conditions. The fragmented approach is the most significant factor that has had adverse effects on the implementation of the required occupational safety and health management systems.

Organizational framework – an essential prerequisite for organizations

The organizational framework for effective Occupational Safety and Health Management Systems is premised on six key elements that are essential at both national and enterprise levels. The diagram below gives an annotated profile of the typical set up.

This is the most important phase of effective organization and planning for the establishment of comprehensive Occupational Safety and Health Management Systems.

The two levels stated below pertain to the actual sustainable implementation of the required effective strategies and operational programmes that are subject to evaluations and reviews based on set measures of performance.

Organization

This focuses on the prevailing formulated and implemented coherent policies for the implementation of comprehensive Occupational Safety and Health Management Systems based on the systematically determined needs

Typical organizational components for occupational safety and health management

for the improvement of working conditions and environment. Three essential elements for organization focus on a set Vision, Values and Mission to guide the framework for the organization of occupational safety and health.

The Vision is very important because it sets the tone and direction of the objectives for the long-term achievement of the desired Occupational Safety and Health Management Systems through integrated national and enterprise priorities. Occupational safety and health focuses on the sustained economic growth of a country through the implementation of value adding management systems for the protection of workers and workplaces, while enhancing the optimized performance of the organizational operations. This vein of thought process should prevail in all aspects of planning and implementation of the relevant management systems.

Values are essential as an aspect of organization because they support the implementation of the vision through certain guiding principles. The notion of “Zero” that has been readily embraced by organizations needs to be properly articulated. Zero Harm means no injuries or occupational illnesses at all. Therefore, applications of the lagging indicators for measuring performance based on the reduction of injuries or even fatalities based on the historical data can be used for prioritizing preventive actions.

It should be stressed that ‘zero’ harm implies planning for the total elimination or reduction of any adverse effects that may cause injuries or ill-health to workers. This approach assumes that effective and efficient risk management processes are designed to address issues of concern

effectively through the implementation of the required hierarchy of controls.

Mission determines the roadmap to be navigated in the implementation of the required proactive and resilient Occupational Safety and Health Management Systems at national or enterprise levels.

At national level, the tone is clearly set for the implementation of non-negotiable national values for occupational safety and health based on non-acceptance or tolerance of substandard factors that adversely impact the performance of operational programmes. Nationally, the legal compliance interventions need to ensure that enterprise organizations are aligned to these operational objectives. Proper determination of the mission statements essentially guides organizations on the roadmap to be charted by the Occupational Safety and Health Management Systems.

Organizational Framework implies the proper establishment of organizational requirements for the co-ordination of the implemented and maintained Occupational Safety and Health Management Systems. Such organization includes the definition of the operational programmes to be implemented based on the national legal provisions, codes of practice and technical standards. However, enterprises need to implement Occupational Safety and Health Management Systems through the development and implementation of the relevant operational standards and procedures specific to the nature of their respective branches of economic activity.

Competent professionals need to be recruited to provide the required input into the implementation of effective and efficient management systems bearing in mind the multidisciplinary functionality of occupational safety and health.

Leadership is essential for the required effective commitment to the implementation of properly designed Occupational Safety and Health Management Systems. At national level, leadership comes from the national tripartite collaboration involving government, employer organizations and worker organizations.

At enterprise level, leadership is drawn from top, middle and lower level management with the involvement of the unions and other relevant organizations for workers. Social dialogue plays an essential role in this regard because it ensures that there is collective ownership, collaboration and co-operation in the implementation of the required effective management systems. The leadership framework is essential for the proper planning, implementation, reviews and execution of the required improvements for the Occupational Safety and Health Management System.

Implementation is the essential component for Occupational Safety and Health Management Systems. At national level, competent government personnel need to be appointed to co-ordinate the implementation and maintenance of the relevant management systems through proper interpretation and enforcement of legal provisions. Enterprises need to ensure that professionally competent people are trained and educated to provide the required Occupational Safety and Health Management Systems. Implementation is based on clearly defined operational programmes that are based on national legal provisions, operational standards and operational procedures. Operational programmes are implemented through specifically designed activities that are based on set objectives for performance.

Reviews are an essential part of any implemented Occupational Safety and Health Management System. Objectives need to be correctly set for the achievement of the overall system based on intermediary periodic performance goals and targets. Performance measures should be properly set for the Occupational Safety and Health Management Systems focusing on the leading indicator actions that are required as input for the desired outcomes to be realized.

The lack of clarity on the defined performance measures has been a significant factor that has contributed to the failure of national and enterprise occupation-

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al safety and health management systems.

Reviews are based on clearly defined inputs and outputs of the required operational programmes. This should be supported by a comprehensive system for the collection and collation of information and data in order to analyse the performance of the systems.

Improvements are an essential element of any properly developed, maintained, reviewed and monitored Occupational Safety and Health Management System. Improvements need to be informed by the objectives and strategies set for the implementation of the required Occupational Safety and Health Management System. Priorities for improvement need to be identified from reviews of the entire occupational safety and health management system. This aspect applies to operational programmes implemented at both national and enterprise levels. It needs to be understood that the detailed elements of these components described need to be fully developed as required by the ILO Guidelines for Occupational Safety and Health Management Systems (ILO-OSH 2001).

Conclusion

The lack of a systematic approach to occupational safety and health management has contributed to the ineffective implementation of the required operational programmes and activities. Safety and Health Culture Transformation in organizations is an essential prerequisite for the adoption of the modern approach to Occupational Safety and Health Management Systems. The referred culture transformation is driven by the belief that occupational accidents, injuries and illnesses are not part of the accepted way of life in the world of work. All occupational injuries and illnesses are preventable and their occurrence clearly indicates failure in the Occupational Safety and Health Management Systems.

Matthew M Ncube Executive Consultant Senior Specialist for Occupational Safety, Occupational Health and Environmental Management Group CEO of Centre for Business Excellence Zimbabwe +27 76 931 9306 mmncube23@yahoo.com chikanda.ncube@gmail.com

20 • Afr Newslett on Occup Health and Safety 2014;24:18–20

Salli Rose Tophøj, Jane Frølund Thomsen, Edith Clarke DENMARK, GHANA

Mapping working conditions using a participatory approach – A case study in a rubber plantation in Ghana Introduction

The rubber plantation ‘Ghana Rubber Estates Limited’ is the oldest and largest rubber company in Ghana, and is located in the Western Region. In this study we assessed the occupational hazards for field workers, using a participatory approach.

Based on the workers’ experience and knowledge of their working conditions, we made recommendations for the company in order to improve working conditions there.

In Ghana, as in many other developing countries, the agricultural sector is one of the most hazardous of all sectors. Many workers in this sector suffer from risks posed by occupational hazards, which include accidents, manual handling of heavy materials and loads, strenuous work postures, exposure to extreme weather conditions and exposure to pesticides and insect bites (1).

Based on personal communication with local doctors working for the Ghana Health Service, researchers concluded that the occupational health and safety (OH&S) system in Ghana is fragmented.

One objective of the Ghana Health Service is to manage resources for the provision of health services in the country, and in 2012 the Ghana Health Service prepared a draft for a new national OH&S Policy that would cover all sectors, including agriculture, and would be more specific than the old laws. The draft is based on the participatory approach where employees together with employers participate in the organization of OH&S activities at the enterprise level. It is expected to

be approved this year.

The idea of the participatory approach is supported by the actions manuals for improvement of the work environment, ‘Work Improvement in Small Enterprisers’ (WISE) (2) and ‘Work Improvement in Neighbourhood Development’ (WIND) (3), developed by the International Labour Organization (ILO). WISE is also known as ‘Higher Productivity and a Better Place to Work’. It builds on local practices and promotes the involvement of the workers, which is recognized as being crucial for health and safety at work (4). Furthermore, previous studies on approaches involving workers in the improvement of their working conditions have reported good results. Among these is a study conducted in a rubber plantation in Thailand, which reported a decrease in work-related accidents, pain and treatment costs (5).

How the study was carried out

The method for hazard identification included observations made on the plantation, individual interviews and focus group discussions with workers within each work function. The participants in this study were headmen, field workers and managers at the plantation. The foreman was the senior employee for around 20 field workers in one work group.

Among the field workers, we focused on the 4,650 field workers performing the four most frequent work functions. These included herbicide sprayers, slashers, budders and tappers; field workers who are responsible for taking care of the primary

Field workers doing their daily tasks.

From the left: A sprayer, a slasher, a budder and a tapper.

needs on the plantation, i.e. slashing the weed growing between the trees, spraying with herbicide, planting new trees and tapping the rubber from the trees.

Observations The observations were made during four 2-hour guided tours on the plantation, one for each work function. The guides were the respective managers for the different work functions.

Individual interviews The participants comprised five randomly selected field workers and one foreman from each of the four work functions. For three out of four groups, the researchers needed a translator, who in such cases was the foreman of the group.

The interviews took place on the basis of prepared questionnaires enquiring into the workers’ experience of the working conditions (such as training, instruction and supervision), risk of accidents, exposure to pesticides and other agrochemicals, biological hazards, ergonomic work, noise, vibration and welfare facilities. Questions about allergic symptoms and the workers’ mental health were also asked. The questionnaires were based on the official workplace assessment checklists from The Danish Working Environment Authority (6) and on WISE and WIND. Aside from these interviews, three managers and one medical assistant were asked general questions about the OH&S in the company. These questions dealt with the OH&S organization, salaries, sick leave days, personal protective equipment, the accident rate and occupational hazards among the field workers.

Focus group discussions We held four focus group discussions – one for each work function. The participants were the individual interview

Table 1. List of prioritized hazards by selection criteria Hazard

Prioritization

General

1) Deep holes covered by weed (made by gold diggers from neighbouring villages) 2) Excessive heat 3) Lack of clean drinking water 4) Lack of first aid equipment 5) High weed 6) Slippery roads

Slashers

1) Insufficient personal protective equipment 2) Physically exhausting work 3) Bees 4) Red ants

Sprayers

1) Herbicide exposure 2) Lack of extra respirator filters 3) Insufficient uniforms 4) Lack of shower facilities 5) Insufficient training

Tappers

1) Heavy load 2) Chemical exposure (stimulants)

Budders

1) Fungicide exposure

respondents (five field workers per function) and their foreman. The intention of the focus group discussion was to give the workers an opportunity to interact and exchange experiences. A focus group discussion is particularly well suited for exploratory studies in a new field, as the ideas surfacing during the discussion can be more spontaneous, expressive and emotional than those brought up during individual interviews (7).

The tasks for the group members were: 1) to make a list of the important hazards at work; 2) to prioritize them; and 3) to come up with ideas and workable solutions about how to minimize or reduce the hazards, thereby leading to improvement of the work environment on the plantation. The foreman was the chairman and translator of the focus group discussion, because in most cases he was the only one who could speak English, the language used by the researcher to commu-

nicate with the respondents.

The hazards

By involvement of the workers through interviews and focus group discussion, we were able to map the most important general hazards affecting more than one work function and the most important specific hazards affecting only one of the work functions. The general hazards were determined by the consistency of a hazard between more than one group and the likelihood of the impact on more work functions. The results of the observations, interviews and focus group discussions served as the base for compiling a list of prioritized hazards by applying the following selection criteria: 1) the consistency of the field workers’ answers; and 2) the professionals’ assessment of the hazards, based on the frequency and severity of the hazard, the possibility of minimizing or eliminating the hazard, and the costs that

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References

minimization or elimination of the hazard would entail (Table 1).

1. Bruce TF. Occupational health and safety in agriculture in Ghana; Afr Newslett on Occup Health and Safety, 2001; 1(2):48–9.

2. Work Improvement in Small Enterprises Action Manual, ILO/DANIDA, 2009, viewed 28.9.2013, http:// www.ilo.org/wcmsp5/groups/public/---ed_protect/---protrav/---travail/documents/instructionalmaterial/wcm_041851.pdf 3. Kawakami T, Khai T, Kogi K. Centre for Occupational Health and Environment/ILO. Work Improvement in Neighbourhood Development. Vietnam, 2003, viewed 28.9.2013, http://www.ilo.org/wcmsp5/ groups/public/---ed_protect/---protrav/---safework/documents/instructionalmaterial/wcms_178800. pdf.

4. Kogi K. Roles of Participatory Action-oriented Programs in Promoting Safety and Health at Work.

2012;3(3):155–65. PubMed. 5. Arphorn S, Chaonasuan P, Pruktharathikul V, Singhakajen V, Chaikittiporn C. A program for thai rubber tappers to improve the cost of occupational health and safety. Industrial Health. 2010;48(3):275– 82. PubMed. 6. The Danish Working Environment Authority, Checklists for Workplace Assessment, Agriculture (Danish), viewed 28.9.2013, http://arbejdstilsynet.dk/da/arbejdspladsvurdering/apv-tjeklister/find-din-apvtjekliste/~/media/at/at/05-arbejdspladsvurdering/tjeklister/landbrug1pdf.ashx.

7. Kvale Steinar and Brinkmann S. Interview - Introduktion til et håndværk (Danish). 2. Edition ed: Hans Reitzels Forlag; 2009.

8. An introduction the WISE program, ILO 2007, viewed 28.9.2013, http://www.ilo.org/wcmsp5/groups/public/---ed_protect/---protrav/---travail/documents/instructionalmaterial/wcms_152469.pdf

Evaluation of the method

By interviewing a limited number of workers from only four different work functions on the plantation, we got an idea of the working conditions and the most important occupational hazards present there. These may differ from one work group to another. If there had been more time available for the project, it would have been more advisable to interview field workers from two or three different work groups within the same work function.

Using the foreman to translate in the individual interviews and focus group discussions increases the likelihood of bias, although the foreman seemed to be loyal to the field workers.

In this study, the observations supported the results obtained through the interviews and the focus group discussions. We believe that this finding suggests that if observations are performed very systematically, they can replace the function of the individual interviews, which required a lot of time.

Recommendations

Based on the identified hazards (Table 1), we compiled recommendations for a healthier and safer work environment for the field workers. The recommendations focused on the prevention of hazards rather than on the treatment of possible work-related illnesses.

The recommendations were divided into general and specific recommendations. The first general recommendations relate to proposals aimed at reconstructing the organization of OH&S in the company. Our approach is also based on the successes achieved in the Philippines, Mongolia, Haiti (8), Thailand (5) and other countries by involving the employees in the process of improving the work environment. This is the most important recommendation because a new OH&S structure has the potential to minimize all existing occupational hazards. The new structure we recommended is an expansion of the existing one. It includes an OH&S committee made up of representatives of both employees and the management. The OH&S committee should include OH&S managers, safety coordi-

nators and representatives elected from among the field workers and headmen.

All field workers and headmen should know who their representatives are so that their ideas, comments etc. could be represented in the OH&S committee meetings.

Furthermore, we suggest that more comprehensive OH&S training sessions should be organized for all new field workers and headmen, including training in the most important occupational hazards as well as an introduction to hazard identification and the company’s OH&S organization. The intention of the training sessions is to give the workers some tools to use in the process of improving their work environment as well as a chance to vote for a representative within their work function. The remaining recommendations corresponded to the hazards shown in Table 1, e.g. the prevention, identification and repair of deep holes, the provision of clean drinking water, the provision of first aid equipment, more slashing in bushy areas, and frequent road repair.

Future goals

The list of recommendations has been sent to the company. This will be followed up to ensure that the company implements some or all of them. Motivations encouraging the employer to adopt this new structure of the OH&S organization at the workplace include the benefit of more satisfied workers as well as fewer occupational accidents or diseases, thereby

22 • Afr Newslett on Occup Health and Safety 2014;24:20–22

reducing the economic losses arising from expenditures for health care. The intention of the improvements is not only to have a more satisfied workforce but also to create a more efficient workplace.

However, there is still a need for research on the participatory approach in implementing programmes for work environment improvements. Such research should deal with cost-benefit analyses and better systems for registering work-related accidents and injuries.

Salli Rose Tophøj Faculty of Health and Medical Sciences University of Copenhagen Blegdamsvej 3B 2200 København N sallirose@gmail.com Dr. Jane Frølund Thomsen Department of Occupational and Environmental Medicine Bispebjerg University Hospital Copenhagen Jane.Froelund.Thomsen@regionh.dk Dr. Edith Clarke Programme Manager for Occupational and Environmental Health Ghana Health Service Private Mail Bag Ministries Accra, Ghana clarke.edith@gmail.com

Suvi Lehtinen

ICOH Mid-term Meeting in Espoo, Finland The International Commission on Occupational Health, ICOH, holds its midterm meetings between the Board and General Assembly meetings of the triennial congresses. The next ICOH International Congress will be held in Seoul, Republic of Korea, on 31 May–5 June 2015.

The latest Mid-term Meeting was held on 8–10 February 2014 in the Hanasaari Cultural Centre in Espoo, Finland. Traditionally, Officers, Board members and the Chairs/Secretaries of the Scientific Committees met to check the developments since the previous World Congress, held in March 2012 in Cancun, and plan the activities for the remaining part of the Triennium.

Two other very important items were on the agenda: the status of and further plans for the ICOH 2015 International Congress, to be held in Seoul next year, and the approval of the revised ICOH Code of Ethics for Occupational Health Professionals.

The main themes for Keynote Lectures and for Semiplenary Sessions for ICOH2015 are undergoing the final deci-

sion process. The Second Announcement will be available on the Congress website in April 2014, and the deadline for submission of abstracts was set as 31 August 2014. More detailed information will be available on the Congress website in April.

The ICOH Code of Ethics for Occupational Health Professionals was revised in a three-year process which began after the Cape Town Congress in 2010. The Revising Group prepared its proposal by the time of the Cancun Congress in 2012.

This was then edited and finalized by the Code Editing Group, established by the ICOH President. The revision work carried out along the years has involved ICOH Board members, ICOH National/

Area Secretaries, and the Chairs and Secretaries of the Scientific Committees. In the final phase of the revision process, all ICOH members had the opportunity to comment on the amendments and changes of the Code before its approval by the ICOPH Board.

The ICOH Code of Ethics is widely utilized by occupational health professionals in various countries, and it is a useful tool in both everyday and demanding situations in current global work life.

In addition, it has been used by some countries as guidance for developing legislation on the occupational health and safety work of occupational health professionals.

Additional information for ICOH Code of Ethics http://www.icohweb.org/site_new/ico_ core_documents.asp# Additional information on ICOH2015 Congress in Seoul http://www.icoh2015.org/kosha_eng_ web/main/main.jsp

ILO OSH activities under development The International Labour Office has a network of National Information Centres in Occupational Safety and Health.

The ILO-CIS Centre Annual Meeting was held in November 2013 Turin, Italy.

The main theme for discussions was how the CIS Centres will work in the future, as the world around the UN organizations and the National Information Centres is undergoing a rapid change. A great deal of time was devoted to looking into the new forms and contents for collaboration among the ILO-CIS and the National Centres. In addition to collecting information, the aim is to ensure dissemi-

nation via channels that are feasible and user-friendly from the constituents’ point of view. The crucial question is: With the abundance of information, do we utilize it in the best way for making a change at the workplace? With increasing internet literacy, we should be able to provide the countries and OSH experts with knowledge that can help improve working conditions and workers’ health. In response to this challenge, a Planning Group is being established to assist the ILO Unit to invite various national information centres to contribute to the joint work plan.

28 April - World Day for Safety and Health at Work The theme for the 2014 World Day for Safety and Health at Work is “Safety and health in the use of chemicals at work“.

See report: www.ilo.org/safeday Contact: safeday@ilo.org

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Contact persons/country editors Director Department of Occupational Health and Safety (Ministry of Labour and Home Affairs) Private Bag 00241 Gaborone BOTSWANA Samir Ragab Seliem Egyptian Trade Union Federation Occupational Health and Safety Secretary 90 Elgalaa Street Cairo EGYPT Kebreab Zemer Ghebremedhin Ministry of Labour and Human Welfare Department of Labour P.O. Box 5252 Asmara ERITREA Ministry of Labour and Social Affairs P.O. Box 2056 Addis Ababa ETHIOPIA Commissioner of Labour Ministry of Trade Industry and Employment Central Bank Building Banjul GAMBIA Dr Edith Clarke Program Manager Occupational & Environmental Health Ghana Health Services Private Mail Bag Ministries Accra GHANA

RD

IC ECOL A

BE L

NO

The Director Directorate of Occupational Safety and Health Services P.O. Box 34120-00100 Nairobi KENYA

441 763 Printed matter

SLY-Lehtipainot OY, Kirjapaino Uusimaa, Porvoo

The Director Occupational Safety and Healh Private Bag 344 Lilongwe MALAWI H. Ali El Sherif Chief Medical Officer Occupational Health Service Ministry of Health and Social Services P/Bag 13198 Windhoek Namibia Mrs Ifeoma Nwankwo Federal Ministry of Labour and Productivity Occupational Safety and Health Department P.M.B. 4 Abuja NIGERIA

Editorial Board as of 1 January 2013

Director, Department of Occupational Health and Safety Ministry of Labour and Home Affairs BOTSWANA Occupational Safety, Health and Working Environment Department Ministry of Labour and Social Affairs ETHIOPIA Chief Inspector of Factories Ministry of Employment and Social Welfare GHANA

Chief Inspector of Factories Ministry of Labour SIERRA LEONE

The Director, Occupational Safety and Health Ministry of Labour, Industrial Relations & Employment MAURITIUS

Peter H. Mavuso Head of CIS National Centre P.O.Box 198 Mbabane SWAZILAND

Seiji Machida, Director Programme on Safety and Health at Work and the Environment (SafeWork) International Labour Office Geneva, SWITZERLAND

Chief Executive Occupational Safety and Health Authority (OSHA) Ministry of Labour and Employment P.O. Box 519 Dar es Salaam TANZANIA

Evelyn Kortum Technical Officer Occupational Health Interventions for Healthy Environments Department of Public Health and Environment World Health Organization Geneva, SWITZERLAND

Commissioner Occupational Safety and Health Ministry of Gender, Labour and Social Development P.O. Box 227 Kampala UGANDA

Jorma Rantanen Past President of ICOH ICOH International Commission on Occupational Health Harri Vainio Director General Finnish Institute of Occupational Health FINLAND