OCCUPATIONAL HEALTH PRACTICE IN
BOHS-Basic Occupational Health Services
-A WHO/ILO/ICOH/FIOH JOINT EFFORT The WHO/ILO/ICOH/FIOH have launched the joint
effort on the development of Basic Occupational
Health Service (BOHS) policy and guideline in order
to improve coverage and quality of occupational
health services (OHS) in the world.
The principle of BOHS is to ensure the provision of
OHS for all workers by developing new service
provision models, which are adaptable to local
conditions, low cost, widely covered the workforce,
and still meet the quality requirements of OHS.
Primary Health Care (PHC)
The renewal of primary health care (PHC), which
has been recently put forward by WHO,
convincingly demonstrates the importance of the
provision of occupational health through PHC in
addition to multidisciplinary health services in
order to reach underserved working populations.
What is occupational health ?
social, mental and
of workers, that is
the“ Whole Person”
The ILO Convention 161
The ILO Convention No.161 defines occupational
health services as services entrusted with
essentially preventive functions and responsible
for advising the employer, the workers and their
representatives in the undertaking on the
requirements for establishing and maintaining a
safe and healthy work environment which will
facilitate optimal physical and mental health in
relation to work and the adaptation of work to the
capabilities of workers in the light of their state of
physical and mental health.
Broadest context of Occupational Health
In its broadest context, occupational health
practice should be understood as the activities of
all those who contribute to the protection and
promotion of workers’ health and to the
improvement of the working conditions and the
These activities should not be seen as limited only
to the practice of occupational health
Why is occupational health important?
Workers spend at least
eight hours a day in the
Work plays a central role
in people's quality of
As a result of the hazards
and a lack of attention
given to health and
accidents and diseases
are common in all parts
of the world.
Basic Aim of Occupational Health
Overall, efforts in
and safety must aim to
diseases, and at the
same time recognize
between worker health
and safety, the
workplace, and the
Poor working conditions affect worker health and safety
Poor working conditions
of any type have the
potential to affect a
worker's health and
hazards can have
harmful effects on
workers, their families,
and other people in the
community, as well as
on the physical
Why it’s difficult to Identify the cause of Occupational disease ?
The long latency period
It may be too late to do anything about it
or treat / cure them even
Difficulty to trace back what hazards the
worker was exposed to in the past.
Personal behaviours (such as smoking
tobacco or drinking alcohol)
New chemicals and new technologies are
being introduced which present new and
often unknown hazards to both workers
and the community.
Hazards at Workplaces are only
the best options, to prevent
Costs of occupational injury/disease
Work-related accidents or
diseases are very costly and
can have many serious effects
on workers, their families and
Unfortunately some employers
assume little responsibility
for the protection of workers'
health and safety.
In fact, some employers do not
even know that they have the
moral and often legal
responsibility to protect
Direct costs of an injury or illness for Workers
1. Pain and
suffering of the
2. Loss of income;
3. Possible loss of
Indirect costs of an accident or illness
Injured/ill worker has to be
A new worker has to be trained
and given time to adjust;
It takes time before the new
worker is producing at the rate of
the original worker;
Time must be devoted to
obligatory investigations, to the
writing of reports and filling out
Accidents often arouse the
concern of fellow workers and
influence labour relations in a
Poor health and safety conditions
in the workplace can also result
in poor public relations.
The costs to employers:
Payment for work not
Repair or replacement of
damaged machinery and
Reduction or a temporary
halt in production;
Possible reduction in the
quality of work;
Negative effect on morale
in other workers.
The investment on prevention Pays
The investment in prevention is meaningful from
the economic point of view. Prevention reduces
costs due to occupational injuries and diseases.
It is estimated that the social cost of occupational
diseases is two-threefold higher than the
investment that would have been necessary to
It is crucial that employers, workers and unions are
committed to health and safety
Workplace hazards are
controlled - at the source
Records of any exposure
are maintained for many
Both workers and
employers are informed
about health and safety
risks in the workplace;
There is an active and
effective health and safety
committee that includes
both workers and
Worker health and safety
efforts are ongoing.
A successful Occupational health and safety
2. Trade Union
More Important Role to be played by:
-----------------------They need to understand the
dynamics of HazardsHealth issues, which are
specific to Industries, unlike
in general practice.
BOHS eventually Aims at
BOHS programs should aim to strengthen the
entire national OSH system and to foster a
preventative approach and safety culture that are
critical to achieving sustainability of
improvements in safety and health at work.
It is the way forward towards a progressive
development of occupational health services in
all parts of the world with an utmost goal to cover
all workers in all occupations.
Prevention is the key AIM of
Overall, efforts in
occupational health and
safety must aim to
accidents and diseases,
and at the same time
worker health and
safety, the workplace,
and the environment
outside the workplace.
Hopefully this Module would have helped to appreciate
the Fundamentals of Occupational Health and the
Basic Occupational Health Services (BOHS) being
promoted by IAOH, in the context of making a start at
Primary Health Care Levels.
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