[ 1 6 8] Kazutaka Ko gi
Curre nt pro ble ms – e me rging issue s in o c c upatio nal and e nviro nme ntal he alth
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r esea r ch a r ea s con sid er ed by t h e cou n t r y r e p or t er s a s r eq u ir in g p a r t icu la r a t t en t ion , a s sh ow n in Ta ble III. We ca n con fi r m t h a t a ll t h e a r ea s list ed m ay con t a in m or e or less “em er gin g” t op ics in m os t of t h e cou n t r ies su r veyed . A st r on g em p h a s is is com m on ly p la ced on ca r cin ogen s a n d ot h er ch em ica l h a za r d s, wor k -r ela t ed d is ea ses a n d
er gon om ic p r oblem s. Sim ila r ly, k een in t er est is s h ow n in a r ea s d ir ect ly r ela t ed t o t h e or ga -n iza t io-n of occu p a t io-n a l h ea lt h a ct iv it ies,
su ch a s e p id em iologic a p p r oa ch es, or ga n iza -t ion of occu p a -t ion a l h ea l-t h ser v ices a n d t r a in in g m et h od s.
Accor d in gly, it is im p or t a n t t o exa m in e t h e in h er en t r ela t ion sh ip s b et w een t h e em er gin g t y p es of h a za r d s a n d t h e a cu t e or ga n iza t ion a l issu es in occu p a t ion a l h ea lt h in d iffer en t cou n t r ies. T h ese h a za r d t y p es a n d or ga n iza -t ion a l issu es m ay b e gr ou p ed in -t o -t h e -t h r ee ca t e gor ies m en t ion ed in Ta ble IV. For ea ch of t h em t h er e a r e fou n d : u n iver sa lly em er gin g issu es; iss u es p a r t icu la r ly r ela t ed t o r a p id in d u s t r ia liza t ion a n d r eleva n t ch a n ges; a n d issu es im p or t a n t for b a la n ced socio-econ om ic d evelop m en t .
It sh ou ld b e n ot ed t h a t t h es e em er gin g issu es r eq u ir e a close look a t ea ch loca l sit u a -t ion a n d loca lly ava ila ble solu -t ion s[4]. In -t h a -t r esp ect , it is d ifficu lt t o m a k e a clea r d ist in c-t ion b ec-t w een issu es a ffecc-t in g in d u sc-t r ia lized cou n t r ies a n d t h ose a ffect in g in d u st r ia lly d evelop in g cou n t r ies. Mor e im p or t a n t ly, n ot a few em er gin g is su es a r e com m on t o b ot h in d u s t r ia lized a n d d evelop in g cou n t r ies. Issu es r ela t ed t o in d u st r ia liza t ion a n d r ecen t t ech n ologica l d evelop m en t s a r e q u it e oft en fou n d in in d u s t r ia lly d evelop in g econ om ies. Issu es im p or t a n t for b a la n ced d evelop m en t a r e lik ew ise fou n d oft en in u n d er ser ved sit u -a t ion s in in d u st r i-a lized sit u -a t ion s[5].
T h e cor e of t h ese in t er r ela t ed iss u es a p p ea r s t o b e in h ow t o or ga n ize occu p a t ion a l h ea lt h m a n a gem en t of wor k er s exp osed t o m u lt ip le r isk s in ea ch loca l sit u a t ion w it h lim it ed fi n a n cia l a n d h u m a n r esou r ces. Table III
Are as re quiring partic ular atte ntio n in re se arc h in o c c upatio nal he alth fie lds: the numbe r o f c o untrie s in whic h the c o untry re po rte r agre e d o r disagre e d that the c o rre spo nding re se arc h are a re quire d partic ular atte ntio n in the c o untry. Re plie s fro m 1 5 c o untrie s and are as
Strongly Disagree or
Research area agree Agree uncertain
Physical hazards
(noise, etc.) 4 9 2
Chemical hazards
(carcinogens, etc.) 9 6 –
Biological hazards
(AIDS, etc.) 1 1 1 3
Work–related diseases 6 7 2
Ergonomics 6 9 –
Epidemiological studies 7 7 1
Organization of
occupational health 1 1 3 1
Training methods 3 1 0 2
Participatory approaches 1 1 1 3
Table IV
Example s o f e me rging issue s in o c c upatio nal he alth in the Asia-Pac ific re gio n
Issue category Emerging types of hazards Emerging organizational issues
Universally Combined environmental exposures Prac tic al health risk assessment emerging issues Indoor air quality Controlling c omplex exposures
Asbestos and other c arc inogens Re-organizing health surveillanc e AIDS at the workplac e Small-sc ale workplac es Musc uloskeletal hazards Ergonomic interventions Night work for women and men Partic ipatory approac hes Wastes disposal Environmental performanc e
Training for prac tic al solutions
Issues related to Long-term exposures Comprehensive risk management industrialization Mental work stress Health promotion in urbanization
Information tec hnologies Dealing with tec hno-stress Flexible working sc hedules Health for aged workers Psyc hosoc ial fac tors Effec tive mental health
Issues important Heat stress at work Prac tic al workplac e monitoring for development Unc ontrolled exposures Delivery of tec hnic al support
Pestic ides Health servic es in women’ s jobs Endemic diseases Absenteeism, rehabilitation Underserved situations Protec tion of working c hildren Poor nutrition Link with c ommunity health
[ 1 6 9] Kazutaka Ko gi
Curre nt pro ble ms – e me rging issue s in o c c upatio nal and e nviro nme ntal he alth
Enviro nme ntal Manage me nt and He alth
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Rea lis t ic s olu t ion s a n d a ct ion or ien t ed m a n a gem en t p r oced u r es a r e s ou gh t [6]. For exa m -p le, it is v it a l t o id en t ify b ot h a cu t e a n d lon g-t er m r is k s of wor k er s exp os ed g-t o com p lex en v ir on m en t a l h a za r d s a n d wor k st r es s es. Recen t exp er ien ces in t h e cou n t r ies in t h e r e gion r evea l t h a t t r a d it ion a l fa ct or -by -fa ct or su r veilla n ce t ech n iq u es h ave sh or t com in gs in s u ch a s it u a t ion . Close t ea m wor k of occu p a t ion a l h ea lt h ser v ice p er s on n el w it h m a n -a ger i-a l s t -a ff -a n d wor k er s seem s v it -a l t h er e. Su ch or ga n iza t ion a l m ea su r es n eed t o b e in t e gr a t ed in occu p a t ion a l h ea lt h s er v ices in d iffer en t in d u st r ia l sit u a t ion s fou n d in t h e r e gion . A good exa m p le is given by t h e n ew occu p a t ion a l sa fet y a n d h ea lt h p olicy of t h e Re p u blic of Kor ea t o b e a ch ieved by t h e yea r 2000. It p la n s t o focu s on volu n t a r y p r even t ive p r ogr a m m es, u p gr a d in g p r im a r y p r even t ion , fu ller u t iliza t ion of h u m a n r es ou r ces, aw a r e-n es s ca m p a ige-n s, a m ee-n it y -ee-n h a e-n cie-n g wor k en v ir on m en t , com p lia n ce w it h in t er n a t ion a l st a n d a r d s a n d in n ova t ive s olu t ion s.
Recen t a dva n ces in occu p a t ion a l h ea lt h p r ogr a m m es in t h e r e gion p r ov id e u sefu l clu es for fu r t h er in g t h is focu s on t h e or ga n i-za t ion a l a sp ect s of t h es e p r ogr a m m es. As su m m a r ized in t h e a r t icle “Or ga n iza t ion a n d ser v ices ” in t h is r ev iew, t h ese a dva n ces con -cer n loca lly a d ju st ed a ct iv it ies bu ild in g on loca l p r a ct ice, p r a ct ica l con t r ol of m u lt ip le r isk s a n d p a r t icip a t or y st e p s. T h e u s e of a ct ion -or ien t ed t ools is cr u cia l, s u ch a s ch eck lis t s, w a lk -t h r ou gh su r vey s, wor k st u dy com b in ed w it h exp os u r e m on it or in g, q u es -t ion n a ir es a n d p r a c-t ica l h ea l-t h m on i-t or in g t ech n iq u es, gr ou p wor k , h ea lt h cir cles a n d a ct ion t r a in in g[79]. A ch a n ge in t h e or ien t a -t ion of occu p a -t ion a l h ea l-t h p r ogr a m m es seem s n eces sa r y t o p er for m a ct ion -or ien t ed h ea lt h m on it or in g, in clu d in g t h e u s e of b io-m a r k er s a n d coio-m p la in t s s t u d ies, cover in g
in d iv id u a l wor k p r ocesses a n d va r iou s wor k -in g life fa ct or s. T h e exch a n ge of p osit ive exp e-r ien ces t h e-r ou gh in t ee-r n a t ion a l m eet in gs a n d va r iou s n et wor k in g a r r a n gem en t s ca n p r o-m ot e t h is ch a n ge.
References
1 In t er n a t ion a l La b ou r Or ga n iza t ion E lev en th A sia n R egion a l Con feren ce, Re p or t of t h e Dir ec-t or -Gen er a l, In ec-t er n a ec-t ion a l La b ou r Office, Gen eva , 1991, p p. 59-107.
2 J eya r a t n a m , J . (E d .), Occu p a tion a l H ea lth in Dev elop in g Cou n tr ies, Oxfor d Un iver s it y P r ess, Oxfor d , 1992.
3 Sa xen a , S.K., “Sy st em for t h e con t r ol of m a jor a ccid en t h a za r d s in In d ia ”, A sia n -Pa cifi c N ew sletter on Occu p a tion a l H ea lth a n d S a fety, Vol. 4 N o. 1, 1997, p p. 4-6.
4 Kogi, K. a n d Sen , R.N., “T h ir d Wor ld er gon om -ics ”, In ter n a tion a l R ev iew s of E rgon om -ics, Vol. 1, 1987, p p. 77-118.
5 Oxen bu r gh , M., In crea sin g Pr od u ctiv ity a n d Pr ofi t th r ou gh H ea lth a n d S a fety, CCH Au s-t r a lia Lim is-t ed , N or s-t h Ryd e, 1991.
6 Kogi, K., “T r a in in g in p r a ct ica l er gon om ics im p r ovem en t s”, J ou r n a l of H u m a n E rgolog y, Vol. 18, 1989, p p. 147-50.
7 T h u r m a n , J .E ., Lou zin e, A.E . a n d Kogi, K., H igh er Pr od u ctiv ity a n d a B etter Pla ce to W ork : Pra ctica l Id ea s for Ow n ers a n d M a n a gers of S m a ll a n d M ed iu m -siz ed E n ter p r ises, Act ion M a n u a l, In t er n a t ion a l La b ou r Office, Gen eva , 1988.
8 Im a d a , A., “T h e r a t ion a le a n d t ools of p a r t ici-p a t or y er gon om ics ”, in N or o, K. a n d Im a d a , A. (E d s), Pa r ticip a tor y E rgon om ics, Tay lor a n d F r a n cis, Lon d on , 1991, p p. 30-49.
