New encyclopedia lists main threats to worker health worldwide

BOTH OLD, NEW MENACES TO SAFETY AND HEALTH COMPILED

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Prof. Jeanne Mager Stellman, editor-in-chief of the Encyclopedia, is available for interviews. To schedule, please call 703-820-2244.

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The International Labour Office (ILO) has published the latest edition of its Encyclopedia of Occupational Health and Safety, which shows that workers today face many of the same dangers that existed in 1930 when the First Edition was published. The traditional threats range from factory fires to catching tuberculosis in hospitals. New workplace concerns include eye and hand strain from working on computers, jet lag in business travel, and radiation leaks at nuclear power plants.

The 1998 Fourth Edition of the Encyclopedia is the world’s most authoritative compilation of the thousands of threats to health and safety in the workplace. The Encyclopedia also describes the range of actions that unions, companies and governments can take to protect people on the job. It comes in four hard-bound volumes numbering 4,231 pages, and is also available on CD-ROM. It is a greatly expanded, completely revised work from the Third Edition of 1983, reflecting the multidisciplinary and rapidly changing world of health and safety in the workplace.

“Despite all of the advances in knowledge and workplace protection of the 20th century, tens of millions of workers around the world are continually exposed to chemical, physical and social hazards that drain their health and their spirits,” says Michel Hansenne, Director-General of the ILO. “The ILO and other organizations must still combat many other forms of exploitation of working people, including child labor, indentured servitude and clandestine work, with their inevitably hazardous and oppressive conditions.”

The Fourth Edition was developed through a process of consultation with leading experts and health and safety institutions throughout the world. Experts from 60 countries — more than 1,000 collaborators in all — have contributed to the conceptualization, writing, editing and peer review of the Encyclopedia. Each article has also been peer-reviewed to ensure accuracy and relevance, and is intended for the specialist and non-specialist alike.

“The Encyclopedia has been designed to provide the general user with background information on the major disciplines of occupational health and safety in an understandable manner that will, at the same time, be considered rigorous by professionals in their fields,” says Jeanne Mager Stellman, Ph.D., editor-in-chief of the Fourth Edition. “We have attempted to provide sufficient depth and breadth of coverage to permit workers in one area to appreciate and be stimulated by the ideas and approaches of other disciplines in occupational health and safety.”

The audience for the Encyclopedia includes trade union leaders, company managers, lawyers, doctors, nurses, engineers, hygienists, toxicologists and regulators, each of whom will find comprehensive and accurate coverage of their fields and the information they could require in other disciplines. The aim is to provide practical, jargon-free answers to their questions about safety and health in one easy-to-use reference.

Some of the major risks to workers that appeared in the 1930 First Edition and also, greatly expanded, in the new edition include:

  • Factory fires — Workers, especially in the developing world, still face one of the grimmest threats, becoming entrapped in a factory that catches fire. Two deadly fires illustrate how the threat continues. The factory fire that held the record of the greatest deaths occurred at the Triangle Shirtwaist factory in New York City in 1911, killing 146 workers. That dismal record lasted until May 10, 1993, when the Kader Toy factory, located in Thailand, burst into flames, killing 188 workers — becoming the world’s worst accidental loss-of-life in an industrial building this century.

    Despite the 82 years between these disasters, the Encyclopedia points out many similarities between the fires. The two buildings had a poor arrangement for exits, the fixed fire protection systems were insufficient or ineffective, the initial fuel package was readily combustible, and the horizontal and vertical fire separations were inadequate. In addition, neither company had provided its workers with adequate fire safety training.

  • Occupational lung diseases — Respiratory diseases have been placed at the top of the ten leading work-related diseases and injuries. Their importance has been confirmed by several key chapters of the Encyclopedia. Global efforts have taken place against respiratory cancer, asbestos and tobacco smoke. Occupational asthma has become the most prevalent occupational lung disease in developed countries, says the Encyclopedia, and respiratory diseases caused by organic dusts among farmers are highlighted. Health effects of man-made mineral fibers and the potential for toxicity related to such fibers has been reviewed in the Encyclopedia.
  • Tuberculosis — This ancient and highly contagious scourge, once believed conquered in developed countries, has returned in a new antibiotic-resistant form during the 1990s, the Encyclopedia says.

    The transmission of Mycobacterium tuberculosis has become a recognized risk in health care facilities, including several recent TB outbreaks among people in U.S. health care facilities. Many of these outbreaks involved transmission of multi-drug-resistant strains of M. tuberculosis to both patients and health care workers. Most of the patients and some of the health care workers were HIV-infected persons in whom the new infection progressed rapidly to active disease. The death rate associated with these TB outbreaks has been high, with a range of 43 to 93 percent. Furthermore, the interval between diagnosis and death was brief, with a range of median intervals of 4 to 16 weeks.

  • Threats to agricultural workers — Agricultural laborers face both old and new risks, the Encyclopedia says. The older risks include poor housing and low sanitary standards; injuries from farm machinery; diseases, especially skin diseases. Newer threats come from exposure to herbicides, including one still legal in rice fields in the United States — known as 2,4,5-T.
  • Industrial wastewater — This is particularly a problem in the paper and pulp industries and in sugar refining plants. Pulp and paper mills consume vast amounts of fresh water. Exposure to these potential hazards is likely to depend on the extent of automation of the plant — more automated and enclosed plants expose maintenance, cleaning and quality assurance operations to greater threats.

    Pulp mills recover a significant portion of energy from burning waste materials and by-products of the process in power boilers. Materials such as bark, wood waste and dried sludge, collected from effluent treatment systems, may be burned to provide steam to power electrical generators, and also present threats to workers.

  • Silicosis — This ancient lung disease — workers who built the pyramids in Egypt are believed to have suffered from silicosis — was a major cause of sickness and death among workers worldwide earlier in this century. Silicosis derives from inhalation of silicon dioxide, commonly known as silica, in crystalline forms. Despite the knowledge of the cause of this disorder, workers worldwide still face exposure in mining, quarrying, tunneling, abrasive blasting and foundry work. Epidemics of silicosis continue to occur, even in developed nations.

Some of the new threats for workers that are analyzed in the Fourth Edition include:

  • Nuclear plant accidents and disasters — This is a problem that has grown in importance as major regions of the world have built more nuclear plants. Sites include power-generating stations, experimental reactors, facilities for the production and processing or reprocessing of nuclear fuel, and research laboratories. Military sites are among the most dangerous for workers, because they include plutonium breeder reactors and reactors located aboard ships and submarines.

    The most serious type of accident threatening nuclear power plants is a core meltdown with the emission of radioactive products. The Encyclopedia discusses the two notorious core-meltdown accidents, at Three Mile Island in Pennsylvania, in 1979, and at Chernobyl, Ukraine, 1986.

  • The microelectronics industry — This industry did not exist in 1930, but has emerged in the latter half of the century to make a profound impact on the evolution and the structure of the world’s economy, the Encyclopedia says. Six major fabrication processing steps are universal to all silicon semiconductor devices: oxidation, lithography, etching, doping, chemical vapor deposition and metallization, which are followed by assembly, testing, marking, packing and shipping. Each step presents separate risks for workers, which are detailed in the Encyclopedia.
  • Visual Display Units/repetitive strain — The Encyclopedia states that computers have both rendered work more interesting and resulted in improvement in the work environment and a reduction in the work load. But computerization has also increased the repetitive nature and intensity of tasks, and has led to a reduction in the margin for individual initiative, and the isolation of the worker. The Encyclopedia lists the various infirmities that repetitive strain can induce, such as epicondylitis, a painful condition that occurs at the elbow, where muscles that permit the wrist and fingers to move meet the bone, or carpal tunnel syndrome, a similar condition in the wrist. Data entry tasks have become a leading cause of such conditions in women.
  • Reproductive Hazards — The relationship between male and female reproductive toxicity and occupational health hazards is a vastly expanded topic in the Fourth Edition. The dangers include: environmental tobacco smoke; solvents — volatile or semi-volatile liquids; pesticides and related chemicals; endocrine disruptors; lead and other heavy metals. Discussion of the problem appears in dozens of sections of the four volumes.
  • Genetic Hazards — Biological monitoring helps to detect possible harmful genetic agents in the workplace environment that enter the body through respiration, skin absorption, and ingestion. First defined in 1980, biological monitoring is one of three important tools in the prevention of diseases due to toxic agents in the general or occupational environment, along with environmental monitoring and health surveillance, the Encyclopedia says.
  • Hazards of travel — Descriptions of the hazards and how to cope are given for problems that particularly affect people who travel for their jobs, including jet lag, mosquitoes and other biting pests, malaria, contaminated water, contaminated food, traveler’s diarrhea, altitude sickness, crime and civil unrest, and fatigue.

Environmental Cancer

As an example of how the Encyclopedia covers occupational threats in detail, excerpts from the chapter on Occupational Carcinogens are given below:

The first documented case linking carcinogens to the workplace occurred in 1775, when scientists identified soot as the cause of scrotal cancer in London child chimney-sweeps, who were forced to climb up narrow chimneys that were still hot. Despite this evidence, the British Parliament did not pass legislation to protect children in this profession until 1840, because of claims of the need to prevent fires from clogged chimneys.

In subsequent years, a number of other occupational causes of cancer have been demonstrated through epidemiological studies, including arsenic, asbestos, benzene, cadmium, chromium, nickel and vinyl chloride, the Encyclopedia says. Such occupational carcinogens are very important in public health terms because of the potential for prevention through regulation and improvements in industrial hygiene practices. Key facts include:

  • Some 20 agents and mixtures are established occupational carcinogens; a similar number of chemicals are highly suspected occupational carcinogens;
  • In industrialized countries, occupation has been causally linked to 2 to 8 percent of all cancers; among exposed workers. In some occupations however, the proportion is much higher;
  • No reliable estimates are available on either the burden of occupational cancer or the extent of workplace exposure to carcinogens in developing countries;
  • Although several occupational cancers are listed as occupational diseases in many countries, a very small fraction of cases is actually recognized and compensated.

Prevention: The most successful form of prevention — avoiding the use of recognized human carcinogens in the workplace — has been learned too late for the present populations of industrialized countries, since most occupational carcinogens have been identified by epidemiological studies of populations that were already occupationally exposed. In theory, the Encyclopedia says, developing countries can prevent the introduction of chemicals and production processes that have been found to be hazardous.

The next best option is the removal of established carcinogens once their carcinogenicity has been established or suspected. Examples include the closure of plants making the bladder carcinogens 2-naphthylamine and benzidine in the United Kingdom, the closure of Japanese and British mustard gas factories after World War II, and the gradual elimination of the use of benzidine in the shoe industry in Istanbul, Turkey.

In many instances, complete removal of a carcinogen (without closing down the industry) is either not possible, because alternative agents are not available, or is judged politically or economically unacceptable. Exposure levels must therefore be reduced by changing production processes or through industrial hygiene practices. A related approach is to reduce or eliminate activities that involve the heaviest exposure. Exposure can also be minimized through the use of protective equipment such as masks and special clothing, or by imposing more stringent industrial hygiene measures.

Fourth Edition and CD-ROM

The Encyclopedia concludes that an effective overall strategy generally involves a combination of approaches. One example is a Finnish government registry that seeks to increase awareness about carcinogens, to evaluate exposure at workplaces and to stimulate preventive measures. The registry contains information on both workplaces and exposed workers, and all employers are required to maintain and update their files and to supply information to the registry. The system appears to have been partially successful in decreasing carcinogenic exposures in the workplace.

The Fourth Edition also provides a centralized location in which all of the new threats facing workers are catalogued — with both descriptions and treatments offered in detail.

“Much progress has been made since the publication of the first edition of this work,” says Professor Stellman. “The world has completely eradicated the use of some extremely dangerous poisons, such as the deadly radium once routinely painted on watch faces to make them glow, and the crippling and disfiguring phosphorus that had been used as the combustible material for matches.”

Director-General Hansenne points out that most governments have also established regulations and have undertaken many noteworthy actions to guard against the entirely preventable tragedies of occupational death, disease and disability.

The ILO itself has contributed to this progress with Conventions, Recommendations and Codes of Practice governing many workplace conditions, as well as with its many technical cooperation programs and specialized publications, Mr. Hansenne says.

Mr. Hansenne adds that the capability of medicine, science and engineering to solve problems, and to provide better means of recognition and of hazard prevention has dramatically increased. Social systems are also in place for worker protection and for worker participation in decisions relating to their work environments. Each discipline — such as medicine, ergonomics, safety engineering, occupational hygiene, epidemiology, organizational psychology, toxicology and law — is covered in separate chapters and sections.

The four volumes include:

Volume I: This volume provides information on occupational disease and injury and on the management and health systems that have been developed to recognize, treat and prevent these problems. The volume also covers the basic tools and approaches used to detect, control and keep track of occupational injury and illness. It comprise four parts and 33 chapters. For some topics, major coverage can be found in more than one chapter.

Part I, The Body, focuses on occupational cancer and systemic conditions, written from an occupational medicine perspective.
Part II, Health Care, establishes the basic principles of occupational health care services.
Part III, Management and Policy, is devoted to prevention and management of occupational health and safety, including disability and workers compensation.
Part IV, Tools and Approaches, centers on the basic scientific and engineering foundations of occupational health and safety, including biological monitoring and toxicology.

Volume II: This volume is devoted to physical, psychosocial, environmental and safety hazards, their nature, occurrence, prevention and management, including the description of specific health hazards.

Part V, Psychosocial and Organizational Factors, focuses on the social and organizational structure of work, their effects and management.
Part VI, General Hazards, deals with physical and biological hazards, detection and prevention.
Part VII, The Environment, focuses on environmental health and its relationship to occupational health.
Part VIII, Accidents and Safety Management, examines accident theory, inspection and prevention, along with principals of safety.

Volume III: This volume addresses different industries and occupations. Each chapter provides an overview on the nature of the industrial process, its potential hazards and preventive management.

Parts IX through XVII deal with agricultural chemicals; industries based on biological resources (animal-related and farming industries, food and beverages, and wood-based products; industries based on natural resources (mining and quarrying, iron and steel, oil exploration and drilling, and power generation and distribution); chemical industries; manufacturing industries; textiles and apparel industries; transport industries; construction; and services and trade.

Volume IV: This volume contains guides, indexes, Directory of Experts. One such guide is the Guide to Chemicals, which provides information on some 2,000 chemicals, with tables containing data on chemical identity, physical, chemical and health hazards, and physical properties.

CD-ROM version: This CD includes all the information and logical organization in the four printed volumes plus — the added benefit of a powerful search and retrieval engine to make your search for information easy. Every word in the articles, references, and tables is searchable, and hyperlinks provide multiple ways to find data.

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