Although it has not been formally declared, I strongly feel that the theme of our efforts following upon the Fourth Network Meeting is most likely to be 'Occupational Health and Sustainable Development' - in line with the Global Strategy that was adopted at the Second Network Meeting, held in Beijing in 1994 - because this perspective constitutes a milestone of our Network activities.
As Dr. Richard Helmer said at the Network Meeting, the new Director-General of the World Health Organization, Dr. Brundtland, presented a strong plea at the 52th World Health Assembly, emphasizing that "breaking the vicious linking poverty, illness, illiteracy and malnutrition constitutes the central challenge to development policy as the new millennium dawns". In consequence of Dr. Brundtland's words, a new Cluster - named Sustainable Development and Healthy Environments (SDE) - was created. Occupational health is now located within the unit called Protection of the Human Environment. This unit handles issues pertaining to chemical safety, food safety, water sanitation, and occupational and environmental health.
Evidence-based research indicates that occupational diseases and occupational injuries are among the five most common causes of loss stemming from morbidity. Occupational diseases and occupational injuries cause major economic loss accounting for several per cent of GDPs. It is therefore clear that we have good reason to allocate occupational health and safety a higher priority at the global, international and national levels. Such action also amounts to a further endorsement of the WHO Global Strategy into the 21st Century.
How should we react to such far-reaching reform? Let us briefly reiterate the ten main priorities of the Global Strategy, spelled out in the 'Beijing Declaration:
- 1. Strengthening policies and developing policy tools for health at work;
- 2. Development of healthy a work environment;
- 3. Development of healthy work practices and health promotion;
- 4. Strengthening of occupational health services ;
- 5. Establishment of support services;
- 6. Development of occupational health standards;
- 7. Development of human resources;
- 8. Establishment of registration and data systems an development of information services;
- 9. Strengthening of research; and
- 10. Development of collaboration with other health services in issues pertaining to occupational health.
Through the discussions held in the working groups, the following fundamental priorities rose to the fore: elimination of silicosis; management of psychological stress at work; prevention of musculoskeletal disorders; and occupational health services for small-scale enterprises.
Personally, I fully agree with the agreement reached in the working groups. China today is undergoing a unique transitional period of economic development. The challenges facing occupational health services resemble a 'double-edged-sword', arising on the one hand from traditional production profiles and on the other hand from modern work processes. For example, a well recognised and ancient work-related disease, silicosis still tops the list of the ten leading occupational diseases, while psychological stress at work, musculoskeletal disorders and the occupational health and safety problems encountered in small-scale industries have been increasing since the 1980s. Therefore, there is a good setting for the network activity approach.
In response to the ILO/WHO Global Programme on Elimination of Silicosis, actions programmes have been taken in China at both State and local levels. The Shanghai Workshop on Prevention of Pneumoconiosis was held in 1977 under the auspices of the Ministry of Health, China, the WHO and the ILO. The workshop - attended by Dr. Fedotov of the ILO, Ms. Goelzer of the WHO, Prof. Guidotti from Canada and other foreign guests and also by some 100 domestic officers and experts - reached an agreement on several important points.
Once it has developed, silicosis is incurable; but the disease is completely preventable. Thus the principle that should be applied with regard to control of silicosis is: 'Prevention First'. Prevention of silicosis should be precisely targeted and improved through joint multidisciplinary efforts made by governmental agencies, occupational health and safety professionals, industries and trade unions. In order to eliminate silicosis, a well-developed proactive approach should be taken under a comprehensive national programme designed to this end. Finally, measures aiming to prevent silicosis should be implemented on the base of existing practical experiences. Summarized from our own practice, this base has been distilled into the approach known as 'eight words of regulation' - innovation, wet-processing, ventilation, enclosure, management, sanitation, protection and inspection. Nevertheless, there is an obvious need for international joint efforts.
We have benefited from having been designated a WHO Collaborating Centre in Occupational Health. We will continue to devote our best efforts to working with other Collaborating Centres within the Network towards further implementation of the Global Strategy of Occupational Health for All. We are confident that "good health is an integral part of good development, and good health and economic prosperity tend to support each other."
- Prof. You-Xin LIANG
- WHO Collaborating Centre for Occupational Health
- School of Public Health
- Shanghai Medical University
- Shanghai 200032, China
Asian-Pacific Newsletter 2/1999 p.48-49