Semi-Plenary Speakers

Dr Blanaid Hayes

National Survey of Wellbeing of Hospital Doctors in Ireland

Blánaid has worked as an occupational physician in the health sector for over 20 years and is currently Dean of the Faculty of Occupational Medicine (RCPI).
She is a Fellow of the Royal College of Physicians of Ireland (FRCPI) and of the Faculty of Occupational Medicine (FFOM). She is a former president of the Irish Society of Occupational Medicine (ISOM).
Her research interests include doctors’ wellbeing, needlestick injury and influenza immunisation in healthcare workers. She was lead investigator in the first national survey of hospital doctors in Ireland which explored various personal and workplace wellbeing measures as well as lifestyle behaviours.


Introduction: Doctors’ wellbeing is increasingly attracting the attention of researchers. It is of interest of itself and because of its potential impact on the health of others. In the wake of the global recession of the past decade, Ireland dramatically cut its healthcare expenditure resulting in significant staff shortages at a time of growing population, more challenging healthcare delivery and increased societal expectation. This has created a highly challenging psychosocial environment for healthcare workers.  Consultants feel undervalued and are concerned about the quality of care they provide.  They perceive care to be thwarted by managers being reactive and not focused on longterm planning.  As well as feeling undervalued, trainees too have concerns about the quality of care they provide and they struggle to manage both service and training demands.

Method: Utilising validated questionnaires, a national cross-sectional survey of hospital doctors, undertaken in 2014, sought responses from consultants and trainees working in the sector.  The response rate was 55%.

Results: Hospital doctors in Ireland had higher levels of psychological distress than elsewhere.  They also had significant symptoms of depression and anxiety as well as high levels of burnout and occupational stress.  Self-stigma in relation to mental illness was more common in doctors than in the general population.  However, current desire to practice remained high.

Discussion: The high levels of personal and workplace distress identified in this study suggest that much needs to be done to highlight the importance of doctors’ wellbeing in this country.  Self-stigmatisation is likely a barrier to early identification and treatment of mental health problems.  Post-graduate training bodies have already begun to address these issues with trainee and trainer members.  Occupational health services have a key role to play in ensuring appropriate access to care and in determining necessary workplace restrictions and/ or supports for this group.


Keywords: doctors’ wellbeing, psychological distress, burnout, occupational stress.

Prof David Koh

Occupational Health Aspects of Emerging Infections – SARS Outbreak Affecting Healthcare Workers

Distinguished Professor of Occupational Health and Medicine
Vice-President and Assistant Vice-Chancellor (Research and Innovation)
Universiti Brunei Darussalam, Brunei Darussalam.

David qualified in medicine and specialized in occupational medicine in Singapore and the UK. He is a Fellow of the Faculty of Occupational Medicine, RCPI.
He was previously Chair of the Department of Community, Occupational and Family Medicine; Director of the national Preventive Medicine Residency program and Director of the NUS Centre for Environmental and Occupational Health Research in Singapore. He joined UBD in 2012.

Dr Paul Kuijer

Knee Arthroplasty and the Unforeseen Impact on Work

Paul Kuijer’s research goal is enhancing work participation in patients with musculoskeletal disorders by improving integrated patient-centred care by orthopedic surgeons and occupational physicians. His focus is on workers with end-stage knee osteoarthritis. Paul works as an assistant professor and consultant on work-related musculoskeletal disorders at the Coronel Institute of Occupational Health, Academic Medical Center (AMC) in Amsterdam, the Netherlands. Paul represents the Centre of Excellence of the Netherlands Society of Occupational Medicine in the development of clinical guidelines for general practitioners and orthopedic surgeons on the aforementioned topics


Introduction: Total knee arthroplasty (TKA) is increasingly being performed among working patients suffering from knee osteoarthritis. As the retirement age is rising and more workers are being overweight or obese, a further increase is expected in the upcoming decade. Unfortunately, limited disorder-specific evidence is available for clinicians to support these patients in return to work (RTW). This semi-plenary provides an interactive overview, using quiz-questions, of what we know now and how to guide these workers to secure a timely and sustainable RTW.


Methods: Questions that will be addressed are: how many patients do RTW after TKA?, which TKA patients should be referred to work-directed care?, which work-related knee-demanding activities improve most after TKA?, what do workers expect from TKA before surgery?, do orthopaedic surgeons and occupational physicians provide the same answers regarding prognosis for RTW?, and what kind of vocational rehabilitation is effective for RTW?.

Result: Two quiz-questions are already answered. First, based on a systematic review, 71–83% of TKA patients in working age returned to work: so 2 to 3 out of 10 did not. The average time varied from 8 to 12 weeks although large differences were noted. Second, the Work, Osteoarthritis or joint-Replacement Questionnaire (WORQ) was used to assess the self-perceived difficulty performing 13 work-related knee demanding activities like kneeling, lifting, and working with hands below knee height. Patients who benefitted most from TKA are those whose work involved operating a vehicle or who have a job which requires periods of standing or walking on level ground.


Discussion: In the upcoming decade, more TKA patients will have to RTW after surgery, and expect sound advice and guidance from their physician. Given the limited evidence available and the large group of workers involved, effective interventions to secure a timely and sustainable RTW should be developed.


Keywords:  TKP, work participation, quiz

Mrs Agnes Parent-Thirion

6th European Working Conditions Survey: Job Quality in Europe

Agnès Parent-Thirion is Senior Research Manager in the Working Life Unit, tasked with the planning, development and implementation of working conditions research projects at Eurofound, in particular the European Working Conditions Survey (EWCS) and its analyses. Her research interests include working conditions, job quality, the monitoring of working conditions, work organisation, gender, the future of work and time. She has been working in the area of European comparative surveys for more than a decade, in all aspects including design, questionnaire development, fieldwork, quality control and analysis. Ms Parent-Thirion is a graduate in economics and management of Paris IX Dauphine and Paris I Panthéon Sorbonne. Before joining Eurofound, Ms Parent-Thirion worked for a number of years at the European Commission.


Agnès Parent-Thirion, Isabella Biletta, Jorge Cabrita, Oscar Vargas, Greet Vermeylen, Alksandra Wiczynska, Mathijn Wilkens

Eurofound, Dublin, Ireland


Introduction: The Union and Member states shall have as their objectives … improved living and working conditions ( article 151 of the TFEU). More and better job is an important policy objective for the European Union.


Methods: Statistical analysis of the 6th European Working Conditions Survey. In 2015, the Sixth European Working Conditions Survey interviewed almost 44,000 workers in 35 European Countries.


Result: Seven job quality indices are produced which at the level of the job, gathers these characteristics of work and employment that have been associated in positive or negative with health and wellbeing of workers. The job quality indices are: physical environment, social environment, work intensity, working time quality, skills and discretion, prospects and earnings. They are presented and discussed. Each index is associated with a positive experience of working life in health and well being, work life balance, engagement and motivation, financial security. The job quality indices are pooled together to create cluster of jobs in Europe on the basis of the job quality : high flyers, smooth running, active manual, under pressure, poor quality. They are presented and discussed


Discussion: Results support the importance of monitoring job quality in Europe and in the world. How can they be improved? 


Keywords:  Occupational Health, work, Europe, Job quality

Mrs Anna-Maria Teperi

Applying Human Factors for Promoting a Positive Safety Culture

Affiliation: Specialist Researcher, Finnish Institute of Occupational Health
Country: Finland
Ms Teperi, PhD has worked in research and the implementation of human factors and safety management for over 15 years. She has modified easy-to-use models and tools for enhancing the mastery of human factors in safety-critical fields such as aviation, railway and the maritime and nuclear industries. She has also conducted long-term projects in the public sector, post-incident mental first aid in particular. The focus of her work has been the utilization of ideas from cultural, organizational and system thinking for improving the safety and well-being of organizations and professional fields.


Introduction: Safety management has traditionally been based on technical solutions and regulations. Although these traditional safety methods are still needed, they do not necessarily raise real safety levels. A prerequisite for improving safety is proper safety management, implemented by people who create and maintain safety through vigilance, competence, communication and group work, if the organisational structures around them support this human success. In this review, I summarise the research and development processes implemented in 2000–2017 to improve the safety, efficiency and well-being of organisations, from the aspect of human factors (HF) with safety critical domains.

Methods: In 2000–2017, we conducted interviews, questionnaires and interventions among operative personnel, management and experts in the nuclear industry and the aviation, railway, and maritime sectors. Both business and authorities were represented. The HF tool was designed and modified for each field and the user experiences are presented here. The HF tool consists of a single tool, material for HF training, techniques for analysing cases at work, and proceedings for corrective actions. Its aim is to promote a positive safety culture.

Result: The HF interventions helped the organisations handle incidents more transparently, giving way to more open discussions on demanding situations at work. The HF tool became more of a philosophy, with which to highlight and understand human performance at the individual, work, group and organisational level, also taking successes into account. It helped concreticise cognitive, work and organisational psychology as a facilitator of safety.

Discussion: The HF tool promoted Safety-II thinking, which has recently been actively discussed as a safety paradigm shift, but has lacked the concrete tools to transform it from scientific debate to practice.

Keywords:  Occupational Health, human performance, safety management


Prof Pierluigi Cocco
Prevention of Sleep Disorders Among Shift Workers and Drivers

Prof. Cocco graduated at the Medical School of the University of Cagliari in 1977, and completed his residency in Occupational Medicine in 1981. He’s currently appointed as ordinary professor of Occupational Medicine at the University of Cagliari from 2015. For about 35 years, his main field of research has been occupational and environmental epidemiology, in collaboration with the Occupational and Environmental Epidemiology Branch of the U.S. National Cancer Institute, and by conducting independent research in Italy. However, his activity extends beyond scientific research, to clinical work and teaching graduate and postgraduate courses of Occupational Medicine, and Epidemiology.
Author of more than 300 publications, and numerous presentations in national and international scientific conferences. Referee for various international professional journals. Lectures in various Universities and Research Institutes in Italy, United Kingdom, France, U.S.A., and Mexico. Active member of the InterLymph Consortium , he contributes to lymphoma research mainly in the field of occupational risk factors, thanks to his long term expertise in retrospective exposure assessment.
Prof. Cocco is currently the P.I. of a multicentre Italian study on gene-environment interactions in lymphoma etiology, and of an European project on prevention and control of sleep disorders among shiftworkers and drivers. He’s also been a member and vice president of the Scientific Committee of the European Environment Agency, Copenhagen, Denmark, and currently he’s a member of the Planetary Protection Working Group of the European Space Agency, Brussels, Belgium.


Introduction: Sleep is a vital function regulated by a circadian rhythm. Its restriction results in daytime sleepiness, which disrupts social life and affects behaviors that have survival value, particularly for occupations requiring  a high level of alertness, such as shift workers and drivers.

Methods: Data from published reports and unpublished preliminary results will be used to illustrate the genetics of the sleep/wake cycle and the mechanisms underlying the health consequences of sleep loss.

Result: Shift-work can alter the sleep/wake cycle and the circadian rhythm of biological functions, which results in daytime sleepiness and disruption of social life. About 10% shift workers complain daytime sleepiness or insomnia, impairment in their performance, and cardiovascular, digestive and neuropsychiatric symptoms. Polymorphisms in genes expressing the proteins that regulate the circadian functions result in different chronotypes with diverse capability of adapting to shift rotation schedules. Circadian genes also regulate the maintenance of energy balance; sleep loss is a contributor to the development of metabolic disorders, whichm in turn, are a major risk factor for obstructive sleep apnea syndrome (OSAS). Daytime sleepiness is frequently consequent to OSAS, a major cause of deadly road accidents, and an occupational hazard for drivers of commercial and public transport vehicles and commuters to work, but also for the general public. Early detection of OSAS symptoms shall be part of health surveillance protocols of workers in commercial and public transport trades.

Discussion: Several approaches are suggested to detect and monitor daytime sleepiness and OSAS among shiftworkers and long haul drivers, including specific questionnaires, and biomonitoring the salivary concentration of melatonin and cortisol level at a specific day time.  A carefully designed biomonitoring protocol would help to reduce the health burden of sleep disorders and to save lives.

Keywords:  Health surveillance, sleep loss, OSAS.


Mrs Karen Michell

The Quality and Governance of Occupational Healthcare Services in South Africa: What Lessons for Universal Health Coverage?

Karen Michell is a member of Concept Safety Systems and is a SASOHN past president, where she is also an honorary life member. She was inducted as a Fellow of the Academy of Nursing South Africa in 2015. Karen has numerous publications both national and international to her name and is the editor of the SASOHN book “A practical approach to occupational health nursing”. Karen is completing a PhD at School of Public Heath, University of Witwatersrand investigating the perceived levels of quality and compliance of occupational health services in South Africa.


Karen E Michell 1,2 Laetitia Rispel 2

  1. Concept Safety Systems cc, Johannesburg, South Africa
  2. School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa


Introduction: The 2015 United Nations sustainable development goals have underscored the importance of universal health coverage (UHC), a healthy, well-educated workforce and compliance with international occupational health and safety standards. This paper draws on key findings of a doctoral research study to explore the [dis] connections between quality, governance and models of occupational health service (OHS) delivery in South Africa. Within the context of UHC, the paper will highlight key recommendations emerging from the study.

Methods: The Human Research Ethics Committee provided ethics approval. The research used a combination of methods, which included a review of occupational health (OH) legislation and policy documents; in-depth interviews with 12 key informants; 11 focus group discussions in three South African provinces, and a web-based survey of OHS practitioners. We used thematic content analysis to analyse the qualitative data and STATA to analyse the web-based survey.

Results: The study found diverse models of OHS delivery in South Africa, of varying quality, with an excessive focus on physical examinations to achieve legal compliance. Furthermore, OHS occupy a relatively low priority on the health reform agenda and are delivered in a fragmented and complex legislative framework. These quality and governance problems are exacerbated by a perceived lack of employer emphasis on OH, insufficient human and financial resources, and lack of specific quality of care standards for OH. The survey found that external assessment of OHS is associated with improved compliance with relevant legislation. 

Discussion: Improvement in the quality and governance of OHS delivery is essential to realize South Africa’s quest for UHC. While the exact nature and form of external assessment needs to be determined, there is need for nationally agreed upon standards for the delivery of OHS, implemented through a cohesive structure which is cost effective, sustainable, and mandatory without marginalising small to medium service providers.

Mr Jani Ruotsalainen

My Truth is Better Than Yours – How to Fight Back in The Age of Alternative Facts

Jani Ruotsalainen is the Managing Editor of Cochrane Work Review Group, which is housed at the Finnish Institute of Occupational Health in Kuopio, Finland. He manages the production of Cochrane systematic reviews about occupational safety and health topics. He also promotes the group’s review findings using a range of contemporary tools including social media, newsletter, webinars, podcasts and infographics. Jani is also the secretary of the ICOH Scientific Committee Effectiveness in Occupational Health Services.



Abstract: Apparently we live in the time of post-truth and alternative facts. However, we do not have to take this lying down. What we, the scientific community, can offer is a viable alternative, meaning real facts. There are two things that are critical in this: what to do when faced with outright lies or opinions parading as facts and what to offer in their place. The key to both issues is bias. Alternative facts consciously ignore biases and their effects. Somehow a personal gut feeling just trumps scientific reasoning. The best thing we can do is to accept the existence of biases and to try and minimise their effects in what we do. One way to do this is by means of systematic review. It is a means of abstracting a higher level of truth from multiple scientific studies that each examine a similar issue. Whilst synthesising their results and formulating overall conclusions, one explicitly displays the biases affecting both the existing research (what others have done) and the process of synthesis (what you do to combine the results of the studies in one conclusion).

For example, a Cochrane review found high quality evidence that the use of blunt needles appreciably reduces the risk of exposure to blood and bodily fluids for surgeons and their assistants over a range of operations. High quality evidence means that the finding is not significantly affected by biases in the evidence or in the process to combine their results. Future research is unlikely to change this conclusion. Conversely another Cochrane review found very low quality evidence that bullying behaviours may be prevented in the workplace. Future research is very likely to change this conclusion.

Know thyself and be open about your failings. That is a sound basis for true facts.


Prof Iman Nuwayhid

Health of Working Children: Beyond Workplace Hazards

Iman Nuwayhid is a Professor and Dean of the Faculty of Health Sciences at the American University of Beirut (AUB); Lebanon. He received his MD from AUB and his MPH and DrPH in Occupational Health from The Johns Hopkins University. He is Board Certified in Occupational Medicine; a member of the editorial board of “International Journal of Occupational and Environmental Health”; an elected fellow to the Collegium Ramazzini; and an inducted Hopkins University Scholars.
His research interests include ecosystem approach to human health (Ecohealth), occupational health with a focus on working children, and public health in the Arab World.



Abstract: Apparently we live in the time of post-truth and alternative facts. However, we do not have to take this lying down. What we, the scientific community, can offer is a viable alternative, meaning real facts. There are two things that are critical in this: what to do when faced with outright lies or opinions parading as facts and what to offer in their place. The key to both issues is bias. Alternative facts consciously ignore biases and their effects. Somehow a personal gut feeling just trumps scientific reasoning. The best thing we can do is to accept the existence of biases and to try and minimise their effects in what we do. One way to do this is by means of systematic review. It is a means of abstracting a higher level of truth from multiple scientific studies that each examine a similar issue. Whilst synthesising their results and formulating overall conclusions, one explicitly displays the biases affecting both the existing research (what others have done) and the process of synthesis (what you do to combine the results of the studies in one conclusion).

For example, a Cochrane review found high quality evidence that the use of blunt needles appreciably reduces the risk of exposure to blood and bodily fluids for surgeons and their assistants over a range of operations. High quality evidence means that the finding is not significantly affected by biases in the evidence or in the process to combine their results. Future research is unlikely to change this conclusion. Conversely another Cochrane review found very low quality evidence that bullying behaviours may be prevented in the workplace. Future research is very likely to change this conclusion.

Know thyself and be open about your failings. That is a sound basis for true facts.


Prof. Michael Riediker

Seed Safety and Health When Rushing to Help

Michael Riediker is Research Director at IOM (Institute of Occupational Medicine) Singapore, Adjunct Assistant Professor at Nanyang Technological University (NTU) in Singapore, and Private-Docent of the University of Lausanne, Switzerland. He obtained his Masters and Doctoral Degree in Natural Sciences (Environmental Hygiene) at the Swiss Federal Institute of Technology of Zurich (ETHZ), Switzerland. He is a highly experienced Occupational and Environmental Health researcher, certified as Occupational Hygienist (SGAH/IOHA), and an accredited Trainer and Grad IOSH (Institution of Occupational Safety and Health). He has extensive research experience in risk assessment relating to exposure to health hazards from environmental and industrial sources.

Michael Riediker1,2,3, Magda Stepanyan4
1 IOM (Institute of Occupational Medicine) Singapore, Singapore, Singapore
2 School of Materials Science & Engineering, Nanyang Technological University, Singapore, Singapore
3 Institut universitaire romand de santé au travail, University of Lausanne, Epalinges, Switzerland
4 The Risk Society, Den Hague, The Netherlands

Introduction: Helping local populations develop economic independence is an important aspect of international development programming, and can be critical for longer-term resilience building after major natural disasters. When teaching new skills and methods, one needs to make sure that 1) those teaching the skills stay healthy while on site, and 2) that the new workforce learns about the essential elements of workplace safety and health (WSH) so that they stay healthy while becoming economically more stable.
Methods: The principle to keep both, trainers and trainees safe and healthy during a training and later on is universal. However, many of these interventions happen in ill-controlled situations with many other concerns such as security and administrative challenges related to the exceptional situation. Furthermore, many well-intending teams perceive the situations as “emergency”. Combined with the hesitance to be “better treated” than the locals, this can lead to them accepting and taking more risks than they would accept at home.
Result: Trainers need to plan how to recognise and teach good safety and health practices in situations where they don’t have access to sophisticated or expensive measures. They can set an example to the local population by using WSH methods that are adapted to the specific risks of the solutions. They need to be simple and cheap so that they can later be applied by the locals. Trainers need to emphasise the importance of WSH to prevent the creation of long-term health problems.
Discussion: Once development partners and emergency responders understand these WSH-challenges, they can plan for them. It is important to train all stakeholders in how to include WSH aspects. Also donors need to understand the importance of WSH so that they can accept, if not even demand that WSH is given importance also from a perspective of value for money.
Keywords: Development Programming, Emergency Interventions, Method Adaptation

Prof Margaret Quinn

Healthy Aging, Healthy Work: A Global Perspective on the Home Care Workforce

Margaret M. Quinn, ScD, CIH is a Professor of Public Health at the University of Massachusetts Lowell, USA with expertise in occupational and environmental exposure assessment for studies of human health effects. She co-founded the Lowell Center for Sustainable Production which seeks to integrate occupational health and environmental sustainability into the design of systems of work. She directs the Safe Home Care Project, funded by the U.S. National Institute for Occupational Safety and Health, with the mission of promoting the health and well-being of home care workers, an essential workforce for aging populations.


Introduction: By 2030 one billion people worldwide will be 65 years of age or older. While populations in industrially-developed countries are aging rapidly, the most dramatic increases are occurring in developing countries. Because most elders prefer to be cared for at home, these profound demographic shifts are driving a global need for home care (HC) at an unprecedented rate. As a result, HC aide jobs are among the fastest growing occupations and yet their occupational safety and health (OSH) experience is nearly invisible. The Safe Home Care Project at the University of Massachusetts, Lowell USA, funded by the US National Institute for Occupational Safety and Health, was established to protect and promote the OSH of the HC workforce.
Methods: We used mixed methods ranging from focus groups to large scale OSH questionnaire surveys, microbiology field studies, and laboratory experimental studies of chemical, biologic, and biomechanical hazards. These studies were performed among HC aides and elders who are HC recipients.
Results: HC aides experience numerous OSH hazards similar to hospitals and nursing homes: back injuries from patient lifting; needlestick injuries; respiratory irritant exposures from cleaning and disinfecting; and serious encounters with violence from patients or family members. Aides also experience hazards not seen in institutional settings: exposure to second-hand smoke, risk of fire from patients smoking cigarettes while on oxygen, patients re-using needles for injections and storing them improperly, and lack of medical equipment for patient lifting. Overall, we found that high quality care delivery depends significantly on HC aide safety.
Discussion: HC aides need OSH protections. Despite OSH challenges, the great majority of aides report high job satisfaction due to meaningful relationships with patients and families and to the relative autonomy compared to institutional care work. Interventions should enhance these beneficial aspects of HC work as well as improve OSH.

Prof Maureen Dollard

Work Stress, Capitalism and the Idea of Psychosocial Safety Climate. Psychosocial Safety Climate: Causes and Costs of Psychosocial Risks at Work

Maureen Dollard is Professor of Work and Organisational Psychology and Director of the Asia Pacific Centre for Work Health and Safety, a WHO Collaborating Centre in Occupational Health, University of South Australia. Maureen is on the Editorial Board for Work and Stress, Journal of Organizational Behavior, and the European Journal of Work & Organisational Psychology. She is Co-chair of the ICOH Scientific Committee, Work Organisation and Psychosocial Factors (WOPS) and was Chair of the ICOH-WOPS 2014 congress in Adelaide. She is President-Elect of the Asia Pacific Academy for Psychosocial Factors at Work and Fellow of the European Academy of Occupational Health Psychology.


Introduction: The driving beat of most modern societal structures is economic rationalism under capitalism. Relentless demands for increased profits, performance and productivity coupled with reduced resources, predispose workers to poor quality work conditions. In turn, poor quality work conditions can lead to mental and physical ill-health, with significant costs to organisations such as high rates of sickness absence and reduced performance, and costs to society such as loss of potential labour supply and high rates of unemployment. Organisations characterized by a good psychosocial safety climate (PSC) offer a point of resistance to these pressures.

Psychosocial safety climate concerns the value and priority given to worker psychological health compared to productivity imperatives likely achieved through economic rationalist approaches such as downsizing and lean structures. Far from undermining productivity we expect that pro-social options embodied in high PSC organisations that value worker psychological health will lead to better quality work options, increased meaningfulness, increased possibility for creativity and innovation, and reduced productivity costs associated with sickness absence and presenteeism. This presentation responds to a public health priority and a call from the OECD to prevent and manage mental ill-health and promote health and well-being by drawing attention to the connection between work and mental health.

Methods: Multilevel evidence from around the globe will be presented to show that PSC precedes work quality (demands, resources) and the social-relational aspects of work (harassment & bullying, social support). Evidence supporting the expansion of work stress theories to include national (e.g., culture, legislation and regulation, corrupt values, welfare regimes, union representation), organisational (e.g., PSC) and team level factors will be explored. International research showing the impact of PSC on working conditions, health and productivity; cost estimates for improving PSC at work; PSC benchmarks for job strain and depression; and implications for work systems improvements will be discussed.

Results: Evidence supports PSC as a ‘cause of the causes’ of work stress, and a theoretical precursor to many job design-based work stress theories.

Discussion: This presentation will discuss contemporary economic policies, work stress issues, PSC theory and evidence-based implications for organisations and national level, policy, practices and procedures for worker psychological health. The presentation will highlight how PSC affects working conditions, employee health and well-being, and organisational outcomes, with evidence from around the globe.

Keywords:  Mental Health, Work Stress, Psychosocial Safety Climate

Prof Mary Ross

Infections in the Workplace: Identifying Problems and Applying Research to Prevention

Mary is an Occupational Medicine and Public Health Medicine specialist and an honorary professor at the University of the Witwatersrand, holding fellowships from the South African Colleges of Medicine, Faculties of Occupational Medicine, Public Health and Travel Medicine (UK), and Australasian College of Tropical Medicine. Achievements include establishing the first African travel medicine course and occupational health research programme for the mining industry; and leading the National Institute for Occupational Health and a global mining medical service.
Mary was Scientific Chair for ICOH2009, served as ICOH Board member (2009-2015) and is Chair of the Working Group on Occupational Infectious Agents.


Introduction: Infections are the only occupational diseases that can be transmitted from one worker to another. Although workplace and community-acquired infections have a long history of affecting health and productivity, from miners’ ‘consumption’ and seafarers’ plague to influenza and Ebola, occupational infections have been under-recognised, under-reported and under-researched. In most workplace settings, infectious diseases have not received the same attention as physical, chemical and psychosocial challenges. Similarly, workplaces have generally been underutilised in the prevention and control of infections. However, epidemics in the 21st century have evoked attention not only from the occupational health fraternity, but also from employers, workers and the media seeking policies and procedures to prevent and manage infection in the workplace.

Methods: Selected infections and their impact in various occupational settings are explored to illustrate the challenges of their identification and management, as is the interface between public health and occupational health surveillance, research and interventions. The unique nature of infectious agents as an occupational hazard is considered, while longstanding and new public health research and strategies for prevention are evaluated in an occupational context.

Discussion: A major challenge for research and prevention is measuring occurrence, morbidity or mortality from occupationally-acquired infections, especially when exposure in the workplace is not always recognised. Primary prevention interrupting the transmission cycle of micro- organisms comprises a variety of interventions that are implemented concurrently rather than in a hierarchy of control, while secondary prevention for affected individuals, becomes effective primary prevention for others. To date, even for health care workers, who dominate global research and interventions related to occupational infections, success has been somewhat limited to better resourced workplaces. It is vital for the focus to extend beyond the workplace in collaboration with public health care to promote research, recognition, prevention and management of infectious diseases for all workers.

Keywords: Occupational Infectious Agents, public health

Dr Keiko Kono

Development of Occupational Health Nursing Assessment Tool for Individual and Group/Organization

Research Center of Occupational Health Nursing, Yokkaichi Nursing and Medical Care University, Japan.
Highest Education and Specialized Field:
University of Tokyo
Specialized Field: Occupational Health Nursing
Business career:
1962 to 1989 – Fuji Electric Co. as Occupational Health Nurse
1989 – Prof. of Occupational Health Nursing, College of Nursing, University of Occupational and Environmental Health
2007 – President of Yokkaichi Nursing and Medical Care University
2013: Honorary President of Yokkaichi Nursing and Medical Care University Director of Occupational health Nursing Research Center
Social Activity:
2012 to present – President of Japan Academy of Occupational Health Nursing


Introduction: In order to provide high quality activities in occupational health (OH) nursing, it is essential to assess the worker and the group/organization. However, these kind of tools have not been available until we developed the OH nursing assessment tools. Methods we have developed the assessment tools for both individual and group/organization by the task force consisting of 17 OH nurses from 2000 through 2014. In the development of the tool for Individual, we based on the frame work of North American Nursing Diagnosis International (NANDA I), and for group/organization we referred to the Community as Partner Model by Anderson and the Hanasaari Conceptual Model which was developed in the 1st International Symposium on OH Nursing Education in Finland in 1988.

Results: The tool for Individual has been divided into 13 domains with a face sheet. By using the face sheet, we can capture work/life style history of individual effectively. The 13 domains consist of Health Promotion, Nutrition, Elimination, Activity/Rest, Perception/Cognition, Self-Perception, Role Relationships, Sexuality, Coping/Stress Tolerance, Life Principle, Safety/Protection, Comfort and Growth/Development.   The tool for group/organization has been comprised 8 core items (Company Outline, Organization Outline, Constitution of the Worker, Human Resources/ Labor Management/Education, Culture, Labor Condition, Health Status and Safety/Health), which directly related with the worker belonging to the group/organization, and 5 sub-items (Administration, Economy, Environment, Social Resource and Traffic), which will be indirectly related with the worker.

Conclusion: These tools are useful to catch the information about workers and their surroundings including labor standpoint. As the result, currently many OH nurses in Japan utilize these tools in daily work that can help them to assess the worker holistically and to assess the group/organization comprehensively and systematically.        

Keywords: Occupational Health Nursing, Assessment Tool

Prof Zhijun Zhou

Understanding administrative regulation on occupational health in China

Dr. Zhijun ZHOU is professor and chairperson in Department of Occupational Health and Toxicology, School of Public Health, Fudan University, Shanghai. He got his Bachelor (1985) and Master (1988) degree of medicine in Shanghai Medical University, and got his Doctor degree of Medical Science (1996) in University of Erlangen, Germany under support of DAAD. He is a member of National Occupational Exposure Limits Setting Committee, and expert of State Administration on Work Safety in China. He delivers several courses, such as occupational health, toxicology, occupational epidemiology. His research focuses on field survey on health problem due to occupational hazards exposure; toxicological study; and management of occupational hazards. He served as national secretary of ICOH for two terms.

Dr Wantanee Phanprasit

Global Warming and Occupational Heat Standard in Thailand

Associate Professor Wantanee Phanprasit, serves as an Industrial Hygienist and Department Head of Occupational Health and Safety, Faculty of Public Health, Mahidol University. She mainly teaches exposure assessment and industrial hygiene. Her fields of interest include exposure and health risk assessment (HRA). She studied asbestos use in Thailand and belongs to the Asbestos Banning Group in Thailand. However, asbestos has not been banned completely. As a member of the Occupational Heat, Light and Noise Regulation Drafting Committee, the topic, “Does global warming impact on heat standards in Thailand?” is currently of immense interest.


Wantanee Phanprasit1, Kannikar Rittaprom1, Vorakamol Boonyayothin1

1Dept. of Occupational Health and Safety, Faculty of Public Health, Mahidol University, Bangkok, Thailand

Introduction: The current occupational exposure to heat and hot environment standard of Thai law was issued in 2006. The wet bulb globe temperature (WBGT) index was defined for 3 workload levels without a work-rest regimen. To assess heat exposure according to the law, workload and WBGT is monitored for 2 hours during the hottest period of the day in summer. As has been predicted, global warming could significantly impact labor capacity and productivity in Southeast Asian countries. Thus, this study aimed to explore whether the occupational standard could protect outside workers focusing on construction workers in Thailand.

Methods: This cross-sectional study included 18 medium and small construction sites and involved 90 heat acclimatized construction workers. Most wore cotton long sleeve shirts and pants. Heart rate (HR) and Aural (tympanic) temperature of the participants were recorded continuously for 2 hours. Exposure data comprised relative humidity, wind velocity and WBGT, including dry bulb, wet bulb and globe temperatures, were monitored and the participants’ workloads were estimated, simultaneously with the collection of physiological and environmental data, i.e. March to June. In addition a questionnaire was used to collect data of the participants.

Result: WBGT ranged from24.35 – 34.18 OC, and 47 participants were exposed to WBGT exceeding the standard. Average air velocity and RH were 1.11 m/s and 35.77%, respectively. The range of average core body temperature and HR for 3 levels of workload were 36.60 – 39.4 OC, 70 – 97 bpm, 36.62 – 39.58 OC, 80 – 126 bpm and 37.04 – 40.08 OC, 82 – 127 bpm respectively. Core body temperature of 29 of 47 participants exposed to heat above the standard exceeded 38OC, among these 11 had symptoms of heat related illness. In all, 18 participants were exposed to heat below the standard but their core body temperatures were higher than 38OC.

Discussion: The weather was hot and dry with occasional good air movement. However, 32% of construction workers worked in high risk conditions (WBGT above the standard). Furthermore, 18 (20%) participants worked in an environment below the standard but their body core temperatures exceeded 38OC. Thus, this group of workers was not protected by the standard.


Keywords: construction, outdoor, WBGT

Prof Jong-uk Won

Social Security System and Occupational Injuries

Dr. Jong-Uk Won is physician and professor of The Institute for Occupational Health, Graduate School of Public Health, and Department of Preventive Medicine at Yonsei University College of Medicine in Seoul, South Korea. He is a Vice president in the Korean Society of Occupational and Environmental Medicine, and is a director of General Affair in the Korea Academy of Independent Medical Examiners.
He contributes to the Industrial Accident Compensation Insurance Reexamination Committee as a committee member, Ministry of Employment and Labor as both a member of Policy Making Expert committee on Industrial Accident Compensation Insurance and a member of Evaluation Committee on Occupational Disease Investigation, and Korean Workers’ Compensation and Welfare Service as a member of Expert committee on Policy making.
In all aspects of his career, Dr. Won strives for workers’ health issues especially, return to work for industrially accident workers and workers compensation system since even not set any baseline of occupational health system in Korea. For substantive workers’ health promotion, he was engaged in meeting industrially injured workers as patients. As a result, he is only a few medical expert in this field with three certifications of medical board Family Medicine, Prevent Medicine, and Occupational Medicine.
Until recently, Dr. Won is conducting outstanding research team including occupational medicine expert, public officer of Ministry of Employment and Labor, and specialist of public safety and health. Also he has published a number of peer-reviewed papers, books, and articles. His study focuses on workers’ safety and health, worker’s compensation, and prevention of industrial accident now.


Worker’s compensation is different for each country according to their histological and cultural background and socioeconomic status. The number of workers and the kind of diseases covered by worker’s compensation differs for each country depending on approval criteria and degree of worker’s compensation.

It has close relationship with social security system of each country. Therefore, it is important to understand various situations when using worker’s compensation statistics or comparing with other countries. We compared and analyzed worker’s compensation and social security systems of South Korea, Japan, Germany and US, and studied the correlation between socioeconomic status and worker’s compensation statistics of OECD countries. Occupational injury rate of South Korea is not high compared to Japan, Germany or US, but fatal injury rate is significantly high. This is presumably related to under-reporting and the under- reporting is in relation with social and political situations of Korea. US shows very high ratio of musculoskeletal diseases including sprains and strains, while Germany shows lower ratio. This seems to be related with paid sick leave of each country. South Korea, Japan and Taiwan have almost identical approval criteria for cerebrovascular diseases, but approval rate is exceptionally high in South Korea. This is because of high application ratio due to the fact that the all cerebral hemorrhage cases during work were compensated as occupational diseases in South Korea in the past. For developing countries trying to benchmark other countries’ worker’s compensation system, should consider not only the workers’ compensation system, but also other social security systems and the socioeconomic status.


Keywords: workers’ compensation, social security, occupational injury

Prof  Yawen Cheng

Emerging Psychosocial Work Hazards and Evolving Policy Actions: Experiences of Taiwan and Other East Asian Countries

Professor, Institute of Health Policy and Management, College of Public Health, National Taiwan University.

Dr. Yawen Cheng is professor of Health Policy of the National Taiwan University. She received her bachelor degree in public health from NTU in 1990 and doctoral degree in epidemiology from Harvard School of Public Health in 1998. Combining epidemiological and policy analytical approaches, Dr. Cheng is conducting research to assess health impacts of psychosocial hazards at work, and to examine how legal frameworks and policies influence psychosocial work conditions and occupational safety and health (OSH) outcomes. Dr. Cheng is active in both research and policy advocacy, and is a founding member of the Taiwan OSH Link, a non-governmental organization dedicated to promoting workers’ health rights.


Emerging psychosocial work hazards and evolving policy actions: Experiences of Taiwan and other East Asian Countries

Yawen Cheng

Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan.


Psychosocial work hazards including prolonged working hours, heavy workloads, irregular work shifts, workplace bullying and violence, precarious employment and income insecurity have been emerging occupational health concerns worldwide.  These issues appear to be significant in the East Asian region, where long working hours are commonplace and extreme cases of stress-related events such as sudden deaths, cardiac attacks and severe mental disorders including depression and suicide have plagued the workplace.  In the first part of the talk, I will briefly review the development of work stress as a major policy concern in this region, and summarize epidemiologic findings concerning the prevalence, social distribution and trends of major psychosocial work hazards as well as their safety and health consequences for workers.  Some culture-specific coping behaviors to combat work-related fatigue such as the use of betel nuts, alcoholic energy drinks and substances will be addressed.  In the second part, I will describe policy-level intervention strategies which have been adopted in response to work stress in Taiwan and compare that with policy actions adopted in other East Asian countries.  Unique features in terms of the nature of psychosocial work environment and social attitudes and reactions toward work stress from an international perspective will be explored.


Keywords: work stress, prevention, compensation

Pauli Forma

From fragmentation to a holistic view of the working life: challenges, possibilities and solutions

Dr. Pauli Forma is Chief Data Officer at Finnish Institute of Occupational Health. He completed his PhD in 1999 in social policy at the University of Turku. His primary current interests lie in the areas of changing work and its impact on occupational health, wellbeing and work disability. He is currently in charge for building a new kind of data-base which aims to provide a comprehensive and up-to-date snapshot of the Finnish working-life by compounding different traditional and new data-sources (big data). Dr. Forma holds titles of docent in social policy in University of Turku and social research in University of Helsinki. Previously he has worked as a professor of social policy at the University of Turku and as a Director of working life services at Keva which is responsible for providing pensions for public sector workers in Finland.


The working life is changing significantly especially due to technological development. Among the most important technological drivers are digitalization, development of artificial intelligence and increasing role of the platform economy. These trends have substantial impact on the different areas of the working life. Entire industries will be under disruption, skills and competencies needed in different occupations are going to change and totally new occupations and job functions will be created. The development also has many consequences to the occupational safety and health. Improving occupational safety and health has always been based on data and cumulated knowledge. However, technological development and changing working life is going to change the utilization of the data. Challenges as well as possibilities can be identified here. When it comes to challenges, first, the relevant data is fragmented. At the national level, different institutions, organizations and authorities have data concerning some part of the working life. Different data-sets can include information on work disability, work accidents, occupational health or well-being at work. Due to this fragmentation, the picture concerning the working life is incomplete. The second challenge is that the traditional data and classifications may be inadequate. For example, new categories of employment (e.g. platform workers) are created and traditional datasets do not provide information on their risks, work ability and wellbeing. We might even need a totally new segmentation model for the occupational safety and health. Third, we lack data concerning the new risks on occupational safety and health due to digitalization and other aspects of the changing working life.            


However, possibilities can also be identified. Because of the digitalization, data is produced in almost every action we take before, during and after the working day. This data can be related for example to working hours, productivity, wellbeing, health, stress and recovery. In a way, the entire “digital working day” can be measured and this information can be used to improve occupational safety and health. Sources for this type of data can be HR-systems, registers, platforms and employees’ own devices (MyData). Thus, in addition to traditional data-sources we have to use also new sources of data on occupational safety and health. It is also evident that due to digitalization we have more tools to analyze the data. When it comes to solutions, the Finnish project “National Working Life Indicators”, which tries to overcome these challenges and benefit these possibilities, will be demonstrated. The aim of the project is to provide near online information concerning the Finnish working life and occupational safety and health. In the project, relevant data focusing on different aspects of the working life will be collected to one data-base. Both traditional data-sources and big data will be used. Based on the data, key-indicators describing development of the Finnish working life will be identified. The data-base will include traditional data (e.g. survey-data and registers) as well as “big data.” The portal makes it possible for the different stakeholders to access the data through the dashboard. The aim of the database is to support decision-making, research and improving occupational safety and health.

Dr Rajiv Kumar Jain

Occupational Health and Epidemiological Methods Research: Challenges and Opportunities

Dr. Rajiv Kumar Jain, Additional Chief Medical  Director (Health and Family Welfare) and Joint Food Safety Commissioner,  Northern Railway, New Delhi, India, holds degrees of MBBS(MAMC, New Delhi), MD (Community Health Administration), DNB(Health Administration including Hospital Administration) and Certificate and Diploma in Chinese Language(University of Delhi). He has more than 33 years of experience in Health and Hospital Administration. He has special interest in Hospital Accreditation, Quality in Health Care, Health Administration incl. Hospital Administration, Epidemiology, Occupational Health, Child Health, Hospital and Health Care Strategic Planning, Medical Regulation and Infectious Diseases

He is Fellow of Indian Public Health Association. He is Member of International Commission on Occupational Health (ICOH) and Life Member of International Epidemiological Association (IEA). .  He has been awarded Fellowships/Scholarships by World Health Organization(WHO), National Institutes of Health(NIH); Canadian Society for International Health(CSIH), International Clinical Epidemiology Network, and International Society for Priorities in Health Care.


Purpose: It is widely accepted that there is definite need for strengthening research in developing, validating and refining epidemiological methods for application in Occupational Health, if preventive strategies have to be devised on actual evidence.  There is need to further identify and manage the challenges and also diffuse the opportunities available for collaboration in conducting research in Epidemiological Methods for Occupational Health.

Review and Discussion: Developing improved methods for exposure assessment, statistical analysis, studying migrant workers and other vulnerable populations, the use of biomarkers, and new hazards provide challenges and opportunities.

Issues of challenges due to lack of validated statistical tools, complexity of ethical considerations, lack of training in occupational epidemiological methods, non-clarity in methods for accurate determination of proportion of disease/diseases attributable to occupation, shifting of hazardous industries from developed to developing countries, lack of collaboration mechanisms with veterinary epidemiologists, lack of participatory research, effective and appropriate communicating tools, preventability paradox and maintaining public health perspective to ensure proper population perspective, shall be discussed.

Conclusion and Outcome: Opportunities for developing, nurturing, financing and implementing local, regional and global collaboration through fair, transparent, democratic and participative consortiums/forums/alliances of people, civil society and public and private institutions and Governments, in the field of epidemiological methods research shall be explored and discussed. A case for germinating an Institute of Occupational Health Metrics and Evaluation in a developing country environment shall be built upon.

Prof Narufumi Suganuma

International Cooperation in Occupational Physician Training for Preventing Occupational Respiratory Diseases

Born in Nagasaki in 1968. MD (’93: Okayama Univ), PhD (’98: Okayama Univ). Professor and Chief of Environmental Medicine at Kochi Medical School, Kochi University. Serving as Vice President of Kochi University. Has special interest in medical screening of occupational environmental respiratory diseases using radiography and CT. A US NIOSH B reader (currently an International Successful Examinee of NIOSH B reader exam) since 2006. Served as a committee member of revision of ILO International Classification of Radiograph of Pneumoconioses. Contributed as an ILO expert at Pneumoconioses Workshops held in various countries in accordance with ILO/WHO Global Programme for the Elimination of Silicosis. Proposed International Classification of HRCT for Occupational and Environmental Respiratory Diseases, which will supplement ILO classification. Now conducting a world biggest birth cohort study on environmental factors and children’ s health (JECS).


Introduction: Early detection of the disease, by routine standard chest x-ray, is one of the essential measures for secondary prevention. ILO has provided the guideline for radiographs reading for pneumoconioses according to the ILO classification to support the medical screening test and clinical purposes. The aim of this article is to describe the history and concept of the AIR Pneumo.


Methods: Asian Intensive Reader of Pneumoconioses (AIR Pneumo) is a quality assurance program to train and certify physicians who works for prevention of pneumoconises, which is one of the major occupational health problems worldwide. The system is useful for epidemiological research, screening and surveillance of high-risk workers, diagnosis and compensation. Because of variability of reading by physicians, some organization, e.g., US NIOSH, has developed the certification testing, called B –reader.


Result: Since its first Bangkok workshop in 2006, AIR Pneumo has conducted 17 workshops 6 times in Thailand, 4 times in Brazil, twice in Japan, and one in each in Philippines and India. As Bangkok workshops invited international participants, most of physicians from ASEAN countries and D. R. Congo has attended the workshops.


Discussion: The classification system holds its uniqueness in possessing standard radiographs that show profusion 0 to 3 for each types of small opacities, large opacities and pleural abnormalities. By using standard radiograph side-by-side to the subject radiographs that physicians are reading and classifying, higher inter reader agreement can be achieved. Understanding and using the classification properly demands certain amount of training. In accordance with WHO/ILO Global Programme for Elimination of Silicosis, ILO has been encouraging GPES participating nations to educate physicians to increase proficiency of reading radiographs of pneumoconioses. The AIR Pneumo, an academia based quality assurance of physicians proficiency in reading pneumoconiosis radiographs is sustainable approach with active involvement of local experts in GPES participant nations.


Keywords:  Occupational Lung Disease, Radiograph Classification, Education

Dr Lucia Rotenberg

Working Too Much, Anywhere and At All Times: Workers’ Health in Our Contemporary Communication Society

Lucia Rotenberg is a Researcher in Public Health in Oswaldo Cruz Foundation, in Brazil, a prominent institution of science, technology and health linked to the Brazilian Ministry of Health. With a background on Biology, and PhD on Psychology, she coordinates the Environmental and Health Education Laboratory. Since the 1990’s her research group is focused on health consequences of “temporal challenges” of work, such as night/shift work, long work hours, working under time pressure, with special interest in the gender perspective. In recent years, she has been devoted to studies on time-dealing difficulties among healthcare workers and university teachers.


The advancement of information and communication technologies (ICT) has changed spatial and temporal dimensions of work.  Currently, in several occupations, there is a blurring of the boundaries between professional and private life, thus providing access to workers at any time of the day or night.  This presentation will deal with consequences of ICT to workers’ health and well-being, including the supplemental work from home, intensification of work, and the intrusion of work into individuals’ personal life, affecting work life balance.  Besides, the presentation will focus the phenomenon of constant connection and its relation to a general feeling of time scarcity, also with implications to well-being.  The view of organizations that care about working conditions, such as the Eurofound and the International Labor Office, will also be addressed, as well as policies to protect workers, such as the so-called “right to be disconnected” recently implemented in France.

Prof Jari Kaivo Oja

Artificial Intelligence and Robotics as Challenges and Tools of New Occupational Healthcare

Research Professor, Dr. Jari Kaivo-oja is the Research Director at the Finland Futures Research Centre of the Turku School of Economics as well as an Adjunct Professor at the University of Helsinki and at the University of Lapland. He has worked for the European Commission (FT6, FP7, H2020), the European Foundation, the Nordic Innovation Center (NIC), the Finnish Funding Agency for Technology and Innovation (TEKES), EUROSTAT, RAND Europe, and for the European Parliament. Currently he is a researcher at RISCAPE (Horizon 2020), at EUFORIE (Horizon 2020), at EL-TRAN (Academy of Finland) and at TRYOUT! (The European Regional Development Fund, ERDF). He has worked recently in the field of technology foresight and ongoing technology disruption. He was submitting in 2015 a special report to European Commision´s EU OSHA in (Bilbao, Spain) about work life changes and quality of working conditions of robotics and artificial intelligence. He has written various scientific articles about knowledge and ubiquitous society, technology foresight and work life developments. In September 2017 he was nominated by Minister Sanni Grahn-Laasonen to the National Competence Panel of Experts of the Ministry of Education and Culture in Finland. This special expert panel will focus on deep learning, educational reforms in disruptive conditions, and socio-economic work life impacts of AI and robotics in the Finnish Labor Markets.

Prof Andrew Curran

Developing a National Strategy for Occupational Health: the experience from Great Britain

Andrew is the Chief Scientific Adviser and Director of Research at the Health and Safety Executive (HSE) in the UK.

He has responsibility for the professional leadership of 850 scientists, engineers and physicians, and for development and delivery of HSE’s science strategy. Andrew’s background is in the area of occupational lung disease, where he has published extensively and lectured both in the UK and overseas. More recently he has been accountable for commissioning the evidence needs of the UK regulator for health and safety, across all areas of health and safety including occupational health.

Andrew has oversight of HSE’s Scientific Advisory Committee on Workplace Health (WHEC), is the Chair of the Sheffield Group (global network of national health and safety research organisations), a member of the Steering Group of PEROSH (Partnership for European Research in Occupational Safety and Health) and a Board Member of ICOH (International Commission for Occupational Health).

He is a Fellow of the Royal Society of Biology, and the Chartered management Institute, and an Honorary Fellow of the Faculty of Occupational Medicine (UK). Andrew is an Honorary Professor at two leading UK Universities, Sheffield and Manchester.


Introduction: India has a serious occupational health service coverage problem for 400 million Informal Workers. Indian Association of Occupational Health took up the Mission BOHS. The project based on the WHO strategy of Universal Health Coverage and The BOHS strategy of WHO, ILO, WONCA and ICOH. An integral step towards BOHS movement in India involves training of primary care professionals in OH.


Methods: Task Force appointed to identify all Informal industries in India; study profile, size, characteristics of work and occupational health risks of each such informal industry. Capacity building in OH for Physicians from Primary Health Centres, Community Health Centres and sub-centres; ESIS Hospitals; Family Physicians. 22 Informal Industries identified. Published “Basic Occupational Health Services for Informal Industry: Manual for Primary Care Providers” covering 22 informal industries; Printed and E-Book versions. Created 24 Videos based on the Manual for training of the target audience. Videos also used for Satellite telecast.


Result: Pilot face-to-face training seminars found to be impractical and unaffordable.


Satellite telecast with distribution of e-book and screening of videos have proven useful in two states.IAOH website offers Printed/E-book downloads. BOHS Missionaries are appointed in all major states to disseminate the knowledge, attitudes and replicate BOHS programs.


Discussion: In India, the Primary Care Ecosystem offers the best medium for BOHS service delivery for the informal sector. Significantly, OH training with focus and emphasis on the informal sector would offer higher chances of success. Mission BOHS, is work in progress and offers a potential model intervention in OH for the informal sector in developing countries.


Keywords: Informal Industries, BOHS Training,

Dr Max Lum

Digital Darwinism: What Works for Moving your Information to Engagement and Impact-the Good, the Bad and the Really Ugly

Dr. Lum is an e-communication and research translation senior advisor at NIOSH in the Office of the Director where he connects with communities, partners and organizations helping to navigate the digital space-creating new channels for providing science-based OSH information for engagement, action and impact.

Dr. Lum served for fifteen years as NIOSH’s Communication Director, responsible for initiatives in health communication, marketing and media relations and served as team leader for the international program portfolio of the Institute until his retirement on January 1, 2011. Before moving to Washington, D.C., he served with the Centers for Disease Control and Prevention’s Agency for Toxic Substances and Disease Registry, in Atlanta Georgia, as the Director of the Division of Health Education and Promotion, responsible for the agency’s activities in environmental, community and health professions education. 

Max’s Masters and Doctoral work in public management and communication were received at the University of Southern California. Dr. Lum lectures extensively on new media with a focus on hazard communication and research translation. He holds an adjunct-lecturer appointment at the George Washington University School of Public Health and Health Services and is the founding chair of the International Congress on Occupational Health’s (ICOH) communication network.


This presentation will address the following key factors: How do we best use the new digital technology to deliver our OSH information for engagement and impact?;  What techniques and strategies actually work and how do we know?; What might the future look like and how are we adapting? Digital Media is at the very heart of the Fourth Industrial Revolution, changing our approach to communication and increasing the delivery of information with exceptional speed to our audiences. Digital technology is evolving faster than organizations can adapt. It is a fate that challenges most organizations in almost every industry. Digital technology has exploded and is being continually modified especially since the new millennium. We find ourselves skyrocketing into an entirely new world of communication and information sharing. We now reach out and connect to our friends, family and co-workers virtually instantaneously with the touch of a few buttons. This new constant connection has fundamentally changed the way we interact with each other and our target audiences. Because of continual digital modifications we must be agile and alert to utilizing better strategies and techniques to deliver information to improve decision making by our citizens in their working environment not only for today but also for the unforeseeable future.

This presentation using globally derived data will discuss the use of a variety of the most popular digital communication platforms from Facebook and Twitter to Wikipedia, their international effect on Search Engine Optimization (SEO) and their potential impact for extending the global reach of our OSH health information and expanding the engagement with both health professionals and the general public. This presentation has been organized to highlight the good, and the not so good challenges we face in the advanced digitization environment. The good: (1) The promise of Increased reach of our information with minimal cost and effort; (2) The opportunity for closer global collaboration of information generation; (3) Easy to use digital impact and engagement measures; and (4) A proven mechanism to reach the ever increasing independent work force. The not so good: (1) A lack of imagination and strategy, coupled with unpredictability and poor data quality: (2) A lack of agility and insufficient encouragement towards innovation: and (3) A lack of pertinent competencies and insufficient strategies to overcome consolidation by information generators whose algorithms tend to favor sensationalism over science, fabricated news over facts and are increasingly monetized ads over meaningful content.  

These challenges will be addressed by a selection of case studies which highlight mechanisms and strategies to overcome transformational barriers in the digital environment. 


Keywords: Health communication, digital transformation, digital Darwinism, science communication, information dissemination.

Dr Paul Schulte

Overview of the current state of knowledge about the health effects of nanomaterials

Paul A. Schulte, Ph.D., is the Director of the Education and Information Division, and Co-Manager of the Nanotechnology Research Center, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention. Dr. Schulte has 40 years experience in conducting research and developing guidance on occupational cancer, nanomaterials, risk communication, workplace well-being, and genetics He is the co-editor of the textbook entitled, “Molecular Epidemiology: Principles and Practices.”


Introduction: It has been close to 20 years that engineered nanomaterials have entered commerce.  There are tens of thousands of types of nanomaterials that have been produced and the hazard potential varies across them.  Some may be hazardous and some not.  The last decade of research has begun to identify important determinants of ENM toxicity but there is still much uncertainty about hazard potential.  It is useful to attempt to sort out what currently is known and not about hazards of ENMs.

Methods: The scientific literature from 2000-2017 was assessed using keywords and environmental scanning techniques to capture information about the health effects of ENMs.  The focus will be on high volume ENM.

Result: The extent of research health effects that have been identified for various high volume ENMs will be described.  While many nanomaterials have been developed there are a limited number that are widely used in commerce. Common determinants of toxicity will be identified.

Discussion: Assessing the hazard potential of ENM is a complex task since there are so many combinations of physio-chemical parameters that may lead to ENMs having differential toxicity.  The implications of this will be discussed as well the research needed to address the hazard potential of engineered of nanomaterials that are or could be in commerce.

Keywords: Occupational health, risk assessment, and risk management

Prof. Alexis Descatha

Emergency in Occupational Health: from Preparedness and Response to Well-being?

Prof. Alexis Descatha’s  major field of work is in occupational health. He leads the occupational health unit at Poincaré Teaching hospital (Paris Hospital AP-HP, Garches) and is a Professor at the Versailles and St Quentin University (UVSQ Paris-Saclay). In addition of research on epidemiology of musculoskeletal disorders, Prof. Descatha  has developed teaching and research on emergencies in occupational health and works as a practitioner in the Emergency Unit of his hospital (Samu92). He is chairman of the scientific committee of Emergency Preparedness and Response. He is the Editor-in-chief of les Archives des maladies professionnelles et de l’environnement.


Abstract: Many occupational practitioners have to face emergencies in occupational setting, from life-threatening emergencies to current urgent care. Actually, workplace emergencies have singularities that usual emergency teams are not aware of – like use of hazardous substances, dangerous working conditions. Furthermore, responders and emergency professionals have to face to major hazards requiring prevention.

In the context of a new scientific committee created in ICOH in 2015 about Emergency Preparedness and Response in Occupational Health (EPROH), we aimed to take different examples to illustrate the importance for workers and population health and well-being, including emergency responders. Perspectives and challenges for next decades will be discussed.

Keywords:  Anticipation, Prevention, Training

Judith K Sluiter

Workability and the design of health surveillance programmes

Judith Sluiter (1962) is Professor in occupational medicine and leads the Coronel Institute of Occupational Health (Academic Medical Center/University of Amsterdam) in The Netherlands since September 2017. She is director of the Amsterdam Public Health research institute, a collaboration between the two universities in Amsterdam. Her research focus is on prevention in occupational health. The design and implementation of Workers’ Health Surveillance protocols and medical examinations with interventions are studied on sector- or job-level when workers are exposed to high psychological and physical work demands which effect their psychological or physical health. Applying innovative ways and methods of assessing work ability, work functioning and chronic stress are a second focus in research.


Introduction: Designing Workers’ Health Surveillance (WHS) anno 2018 asks for better Occupational Physician (OP) guidance and theories on how we can improve the workability of our work force. In order to improve these activities, job-specific workability should be in the heart of the design of a WHS.


Methods: In the Dutch guidance document on how to design (the content of) a job-specific WHS, (2013) we included that assessing a workers’ workability during WHS should be based on three core topics: i) on the job-specific health risks; ii) on the impact that diseases/health problems have with respect to the job-specific health requirements; iii) on the individual risk factors that may hamper the workers’ future general health. Advices in an intervention protocol is part of the design in order to maximize its’ theoretical effect.

The recognized job demands are translated by the occupational physicians into work-related health effects to be included in the WHS for the first core topic. The known mental, physical, sensory, emotional or biomechanical requirements for the job, makes the OP translate this information into health problems that may affect these health requirements. Finally, evidence on how to screen for common life style related diseases could be included for the third core topic.


Result and discussion: Examples are provided to assess job-specific workability (e.g. ambulance workers, firefighters, hospital nurses and doctors, police officers) this way. We now know that neither general workability questions nor the assessment of health complaints or diseases alone can be sufficient to detect workers with possible and relevant work limitations, given the precise requirements. We also need specific signal questions by which certain relevant health complaints are coupled to the decreased ability given the defined requirements needed for performing the job demands. Job-specific medical examinations with more precise questions and/or tests included in the examination protocol with direct association to the defined requirements are envisioned to help workers in future WHS.



Keywords:  WHS, workability, Occupational Physician

Jean Mangharam

The development of a statewide framework for the prevention and management of work-related musculoskeletal disorders: A Western Australian experience

Jean Mangharam is the Principal Scientific Officer of the Human Factors & Ergonomics Team at WorkSafe WA. WorkSafe’s Human Factors and Ergonomics Team is a multidisciplinary team made up of Scientific Officer/Inspectors that address hazards within the realms of physical, cognitive and organisational ergonomics.  Jean leads a team of specialists that develop strategies and implement public health and policy intervention through education, partnership and enforcement in Western Australia, focusing primarily on work-related musculoskeletal disorders, psychosocial issues and occupational slips trips and falls. Jean has a background in Physiotherapy (BSc Hons- Curtin University, WA- 1992), Ergonomics and Industrial Hygiene (MSc EnvHlth- University of Cincinnati, Ohio- 1998).  She is a Certified Professional Ergonomist (CPE).   Since commencing her professional career in 1993, she has practiced as a clinical physiotherapist and ergonomist in Australia, UK and USA.

  1. Mangharam1, E. S. Chew1, L. Coubrough1

Human Factors and Ergonomics Team, WorkSafe, Western Australia, Australia


Introduction: In Australia, work-related musculoskeletal disorders (WMSD) is a workplace condition that has been prioritised to be addressed at state and national levels. The cost and burden associated with musculoskeletal disorders workers’ compensation claims in Western Australia (WA) as a result of body stressing and slips, trips and falls is high and accounts for approximately 60% of claims.  Time trends have demonstrated that on average, each WMSD claim has become more expensive and led to longer periods off work. 

Preventing and managing WMSDs are complex, owing to the interaction of multiple risk factors, including workplace physical, workplace psychosocial and individual risk factors. An array of primary, secondary and tertiary prevention level interventions such as ergonomic intervention, risk management, wellness programs, early and appropriate clinical intervention and return to work rehabilitation programs have been tested.  Wide scope public health influencers exist in several forms, including education, stakeholder partnership and legislation.  Collectively, the complexity of this problem indicates that public health strategies for this condition require a multidisciplinary and multifaceted approach that should be sustained over a period of time. Musculoskeletal models of care and frameworks that have been developed by multiple stakeholders at statewide levels have been shown to be of value.  This talk will describe the process of developing such a framework through surveys and focus groups for the state of Western Australia.

Methods: Key stakeholders for WMSDs in WA were initially identified and placed in a network database.  These comprised of government agencies, employer and employee groups, special interest groups, professional bodies, key academics, industry peak bodies and the insurance sector. Surveys and focus groups were held across Western Australia over a 3 month period.  The primary aim of the qualitative data collection was to gain an understanding of the views of key stakeholders in relation to the prevention and management of work-related musculoskeletal, particularly their believes of the risk factors, facilitators and barriers for success and their views of current policy and legislation associated with this condition. 

Results: Information collected demonstrated that a high proportion of key stakeholders viewed this as a significant state-wide issue.  The views of key stakeholders in relation to risk factors, barriers and facilitators for the prevention and management of this condition varied across the stakeholder groups and trends could be identified within and between stakeholder groups.  Results show the interconnection between these stakeholder groups and the potential value of systematic and organised information sharing and staged collaborative intervention.

Conclusion: The development of a state-wide framework for WMSDs requires an understanding of the evidence behind the multifaceted interventions, and a staged and consultative approach to achieve ownership and confidence in the stakeholders and implementers of the framework.  

Keywords: Musculoskeletal disorders, ergonomics, injury, prevention, policy, framework

Dr Lesley Rushton OBE

Role of Epidemiological Research in the prevention of occupational ill health.

Lesley Rushton is an epidemiologist/statistician with extensive research experience into occupational and environmental causes of ill health, including studies of workers in several industries such as the oil industry, silica sand and printing industries, children’s health and air pollution, estimation of burden of occupationally-related cancer in Britain, design and application of an occupational module for UK Biobank. Methodological research includes systematic review and meta-analysis in the areas of risk assessment and cross-design synthesis. She is member of the UK Committee on Carcinogenicity and the UK HSE Engineering and Environmental Assurance Committee.

  1. Introduction: Concerns about occupationally-related diseases that are rare in the general population have provided an impetus for the development of epidemiological research (the study of the distribution and causes of disease in human populations) into the adverse health effects of the workplace.

    Methods: There are numerous epidemiological studies of specific industries, occupations and  workplace ‘exposures’, from chemical, physical and biological agents to ergonomic factors and psychosocial stressors. These are usually observational in design and ‘classical’ intervention studies are much rarer. Occupational epidemiology plays an important role in identifying and quantifying risks and understanding the aetiology of disease and makes important contributions towards (i) risk and health impact assessment, (ii) setting standards/ limits in workplaces and the general environment (iii) provision of evidence for compensation (iv) estimation of the burden of occupational disease to society.

    Results: Epidemiological studies of current risks from past exposure have directly informed strategic workplace risk reduction programmes and campaigns and production of guidance and practical interventions for stakeholders. Together with mechanistic information they contribute to occupational exposure limit (OEL) setting. More recent studies illustrate prediction modeling of the impact of reduction of OELs and r strategies such as improving compliance. Results from epidemiological studies are also incorporated into economic evaluations of risk options and this in turn has been important in decision making e.g. in the choice of EU OELs. International epidemiological studies can demonstrate important differences across nations in workplace exposures, resulting health consequences and use/lack of prevention measures.

    Discussion: Occupational epidemiology thus plays a vital role in increasing awareness of occupational disease and enumerating the impact of adverse working conditions and exposures. The occupational health community should continue to push for increased education on occupationally related ill-health, encourage routine collection of occupational data and, of course, persuade organisations to fund appropriate research.  

    Keywords: Occupational epidemiology; Intervention research; Health impacts

Dr William Buchta

Novel Delivery Models for Occupational Health: Responding to the Healthcare Worker Shortage

Dr. Buchta has specialized in occupational medicine since 1988 with a focus on healthcare worker issues.  Having retired from the Mayo Clinic in Rochester, Minnesota, in 2016, he is now Chief Medical Officer for Logistics Health, Inc, offering health screening and evaluation services to military members and veterans in the USA.  Dr. Buchta has been active in ICOH since 2006 and was Chair, Scientific Committee on Occupational Health for Healthcare Workers, from 2012 to 2015.  He will have just become President of the American College of Occupational and Environmental Medicine just 2 days before his presentation.


As healthcare becomes a recognized human right across the globe, there is a commensurate demand for healthcare workers in all fields, including occupational health.  However, current models of healthcare delivery are not scalable to meet the need, either in terms of funding or availability of healthcare workers.  In this semi-plenary presentation, we will confront the problem and explore existing and potential solutions to meet that need, particularly the preventive services, surveillance, diagnostics, and treatment afforded to the working population in all countries and cultures.

Keywords:  Telemedicine, Virtual Medicine, Protocols

Professor John Harrison

The role of education and training to sustain and develop an occupational health workforce for the benefit of working people

Professor Harrison is Head of the National School of Occupational Health in Health Education England and an Associate Professor at Brunel University. He is also Chief Medical Officer for Devon and Cornwall Police, moving in 2014 from his post of Clinical Director Organisational Health and Wellbeing at Imperial College Healthcare NHS Trust.  He is a former Director of NHS Plus and an advisor to the Health and Work team of the England Department of Health. Previously he has been Academic Dean of the Faculty of Occupational Medicine (UK), a board member of ICOH and a past Chairman of EASOM.


Introduction: The world of work in the twenty-first century presents a number of challenges to occupational health practitioners. Why should organisations invest in occupational health provision?  What are the political, economic and social drivers and how will changes in technology and the environment influence the competencies and composition of future occupational health workforces? Education and training must prepare practitioners for practice that is relevant and marketable to improve the reach and efficacy of occupational health, as well as underpinning attractive careers. This talk will review work that is on-going to address these issues.


Methods: Consideration of different initiatives globally, with particular reference to work in the United Kingdom regarding the development of a multidisciplinary occupational health workforce.


Discussion: Education and training must address structural differences in occupational health provision, as described in the basic occupational health services model. Future occupational health workforces will be multidisciplinary and viewed holistically as part of a public health provision. Wellbeing at work is contingent on assessing and meeting a hierarchy of workplace and organisational needs and practitioners will need the requisite competencies to meet market demands. Consideration is necessary as to how established training provision will adapt to deliver accessible, timely, affordable and effective educational resources. 

Keywords:  Multidisciplinary, wellbeing, Public Health

Professor Stavroula Leka

Promoting a positive psychosocial work environment: Individual, organisational and societal benefits

Stavroula Leka is Professor of Work, Health & Policy and Director of the Centre for Organizational Health & Development – a World Health Organization Collaborating Centre in Occupational Health. She is Chair of the School of Medicine Work, Health & Wellbeing Committee and the Faculty of Medicine & Health Sciences Work, Health & Wellbeing Executive Group. She is member of the School of Medicine Strategic Staffing Committee. She is also a member of the Executive, and Lead for Impact in the Division of Psychiatry & Applied Psychology. She is Chartered Psychologist, member of the International Commission on Occupational Health, and the European Academy of Occupational Health Psychology, Associate Fellow of the British Psychological Society and Fellow of the Royal Society of Public Health. She studied Psychology at the American College of Greece, followed by postgraduate studies in Occupational Health Psychology at the University of Nottingham.

Stavroula is member of the Executive Committee of the European Academy of Occupational Health Psychology (EAOHP). She is also Chair of the scientific committee ‘Work Organization & Psychosocial Factors’ of the International Commission on Occupational Health (ICOH). Her main research interests are the translation of occupational health and safety policy and knowledge into practice, psychosocial risk management and the promotion of mental health in the workplace.


Promoting a positive psychosocial work environment: Individual, organisational and societal benefits

Stavroula Leka1,2

1Director, Centre for Organizational Health & Development, University of Nottingham

2Chair, ICOH Scientific Committee ‘Work Organization & Psychosocial Factors’


Abstract: The psychosocial work environment underpins every organization’s operations and concerns psychological and social dimensions of the work environment relevant to aspects of work organization, design and management, and interpersonal relationships. Despite often viewing the psychosocial work environment as something new, the way we organise our work and how we work with others are issues that are as old as work itself. What has brought about an increased focus on the psychosocial work environment is the accumulating evidence on the negative outcomes of poor management in terms of potential harm to employee health, safety and well-being, poor organizational performance with associated negative societal impacts.

Efforts have been made over the past decades to promote a positive psychosocial work environment and mental health and well-being in the workplace. These include interventions both at the policy and at the organizational level. This presentation will consider the action framework so far implemented to address the psychosocial work environment across the world. It will discuss differences across countries and highlight priorities to be addressed. It will showcase successes and good practice examples.

Taking the overall state of the art in this area into consideration it will identify necessary actions both in relation to policy and practice for necessary progress to be achieved. These will specifically consider evolution in knowledge, technology, and society that has brought about inevitable changes in our working practices and experiences. It is important to develop systems that allow us to forecast and document these changes and enable us to implement appropriate actions to respond and adapt appropriately to these changes, learning from past experiences. It will also be highlighted that it is important to promote comprehensive approaches that address not only potential negative impacts but also positive outcomes and synergistic effects across several policy and organizational interventions.

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