Occupational health and safety services

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Jan Harmen Kwantes, Wendela Hooftman, Fenny Michel, TNO

Introduction

The position, role and aim of the protective and preventive services (article 7 of the Framework directive (89/391/EEC[1] within the legal OSH-system will be the focus point of this article.

Article 13 of the EU Treaty gives the EU the possibility to draft a legal framework on occupational safety and health. The fundamental elements of such an European legal framework on OSH-policy have been written down in the Council Directive of 12 June 1989 (89/391/EEC)[2]. Every employer is obliged to organise support on OSH from persons and/or organisations with expertise and knowledge on OSH. The main objective of article 7 of the Framework Directive is to organise this expertise internally, via the designated worker/employee. If this is not possible the employer has the opportunity to contract competent external persons or services.

EU Member States which have ratified ILO-Convention C-161 on Occupational Health Services[3] have to use the more specific obligations as set out in this convention. This C-161 Convention is accompanied by an ILO-recommendation on occupational health services (R-171)[4].

OSH-management and OSH services

OSH management system

In every OSH-management system[5] the employer is responsible for the occupational safety and health performances. The employer, regardless the size of the company, has to:

  • make an OSH-policy;
  • identify the risks;
  • make a plan of action;
  • implement actions;
  • evaluate the plan of action;
  • adapt the OSH-policy.

If such an OSH-management system is carried out in a systematic and structural way, the chance of being successful is reasonably high. The goals of such an OSH-management system can be:

  • lowering the numbers of accidents and diseases;
  • being more pro-active than re-active in OSH-policy;
  • to decrease the number of incidents that hinder production;
  • to lower the amount of employees with sick leave or disabilities related to occupational safety and health;
  • to minimize the costs of accidents and diseases.

Of course this OSH-management system can only be successful in close cooperation with the employees and the representatives of the employees. Also an adequate cooperation with external parties is a part of such an OSH management system, for example trade-unions and the Labour Inspectorate. A policy on OSH can be carried out by the employer and the employees themselves. However the problems related to OSH can be difficult and an expert may be needed. Of course many companies (especially regarding SME’s) do not have an OSH-management system.

Position of OSH-service and -professionals within OSH management

Since the industrialization of Europe the need for expertise related to occupational safety and health has risen. Two experts were especially needed: safety engineers and occupational health physicians with knowledge of occupational health. These experts became employees in bigger companies (internal experts) or were hired (external experts). Sometimes these experts operated in a team within a company (internal service) or created an external OSH-service. In some countries the occupational health physician is an integral part of the general health care system. The employers, especially those with high risks, need to contract these OSH-professionals or –services to comply with the rules of the OSH legislation. Of course OSH-legislation can force (groups of) employers to act in this way. The OSH-service and –professionals work for the company but need to stay impartial and independent from the employer and the employees. Sometimes this can be a difficult task, especially when the OSH-service or professional is paid directly by the employer. In the legislation of many Member States this independent position of the OSH-service or –professional is emphasized by creating provisions to protect the (internal) OSH-service or –professionals against disadvantages treatment from the employer.

Added value of OSH-services and –professionals

Safety engineers and occupational health physicians are no longer the only OSH-experts. Ergonomist, occupational health psychologists, industrial hygienists and others nowadays operate as OSH-experts as well. Mostly all these OSH-experts are highly educated and skilled to assist the employer with technical and scientific tools and methods. Especially the profession of the occupational health physician is protected by health legislation. In many countries the OSH-experts have the obligation to follow courses on a regular basis to keep their profession up-to-date and to provide the employer with the latest advices. The EU countries have created national infrastructures on OSH. Part of such infrastructures are universities, groups of OSH-professionals, OSH-training companies, employer- and employee organisations, Labour Inspectorate, etc.

EU Legislation on OSH

Article 153 of the Treaty of the functioning of the European Union[6] is the legal starting point of the OSH-legislation in the European Union. Already in the eighties of the last century the first OSH-directives were published. The main OSH directive is the Framework directive (Council Directive 89/391/EEC of 12 June 1989[7] on the introduction of measures to encourage improvements in the safety and health of workers at work). This Framework directive forms the organizational basis of all other 19 directives, sometimes labeled the ‘daughter-directives’. Subject of every OSH-‘daughter’-directive is a (group of) risk(s) (e.g. noise, vibration), an activity (e.g. manual handling of loads), a specific sector (e.g. mineral extracting industry) or certain employees (e.g. pregnant workers). OSH Management Systems All EU Member States should implement the core-elements of this Framework to realize a minimum level of prevention in the EU.

Protective and preventive services

Structure

Section II of the Framework directive[8] provides obligations for employers. Article 7 of the Framework is dealing with “protective and preventive services”. Apparently this is the article about OSH-experts and –services, although these words cannot be found in article 7 of the Framework directive. The structure of this article is the following: every employer should designate one or more employees “to carry out activities related to the protection and prevention of occupational risks”. If such designated workers cannot be found within the organization “for lack of competent personnel” the employer is allowed to “enlist competent external services or persons”. So the employer should always give priority for an internal solution regarding protective and protective services than an external solution. The Court of Justice of the EU has confirmed this priority rule in its judgment between the European Commission and the Dutch Government about article 7 of the Framework directive. Article 7 does not clarify what kind of expertise is needed for this designated worker. It is up to the Member States and their OSH-legislation to make a (clear) choice. The advantage of this approach is that every Member State can shape it’s protective and preventive services to their own, often for long existing, national OSH-service-system. Based upon a presentation of the ESENER results in 2009 one can see there is big variety between the EU-countries concerning the contracting of external OSH service providers performing the risk assessment. For example in Denmark only 7% of the companies use external OSH service providers and in Slovenia 75% of the companies use an external OSH service provider to perform the risk assessment. In the EU as a whole the average percentage is 37%.[9]. Remarkably the Framework directive doesn’t mention experts like the occupational health physician and the safety engineer at all. Looking at the results of the ESENER survey in the European Union the safety experts and the occupational health physician are mentioned as the experts most often consulted by the employers. Larger companies use also other OSH experts, such as occupational psychologists and industrial hygienists[10].

Internal designated worker

Nevertheless the employer has to designate an employee for carrying out the protective and preventive activities. What the level of expertise of such an employee should be is not made clear by the Framework directive. So the Member States have the freedom to make their own considerations for the provisions of the expertise level of the designated worker. In the European Union you see a big variety of the expertise-levels of the designated workers, from a layman with a short OSH-course to a more educated and skilled OSH-expert. It is allowed for Member States that some employers have the right to perform the tasks of the designated worker by him- or herself. Article 7 of the Framework directive protects the designated worker against any disadvantage by the employer. This gives the designated worker relatively an independent position within the company.

External competent persons / services

If the employer contract an external competent person or service he/she must provide them with all relevant information about the risks within the organization. No specific requirements for these external persons or services are mentioned, except that they should have the necessary aptitude, personal and means.

Organization of the OSH services in the EU-Member States

Thus the European Union has no specific rules or policy for OSH-services. The Member States can organize this according to their own national system. Of course it is possible for EU Member States to make use of the ILO Convention[11] on Occupational Health services and the ILO Recommendation (R-171) on Occupational Health Services[12]. The ILO-convention on Occupational Health Services establishes provisions on the function, the organization and the conditions of operations for Occupational Health Services. This Convention creates a framework for countries of how to organize the occupational health service. The following EU-members states have ratified this C-161 Convention, and are obliged to implement the Convention’s provisions: Belgium, Czech Republic, Finland, Germany, Hungary, Luxemburg, Poland, Slovakia, Slovenia and Sweden Every EU-Member State has its own organization of OSH-services. For 6 countries a description of their national ‘infrastructure’ on OSH-services will be given: the Czech Republic, Germany, Italy, the Netherlands, the UK and Sweden. For every country mentioned we describe the following main elements :

  • Which OSH-expert is involved and the level of competence;
  • Multi- or mono-disciplinary approach;
  • Focus on prevention and/or sickness absence (social security);
  • Registered or certified OSH-experts;
  • Organisation of the OSH-service itself.

Czech Republic

In the Czeck Republic OH services are provided for the national health service and private health care facilities[13]. There are 2 types of occupational Health providers: occupational health physicians and non-specialists, usually general practitioners. Furthermore companies can use their own employees to provide in-company preventive care, companies that are unable to do so can make use of contracted OH service providers. In all cases the independence of the health care providers need to be guaranteed. OH services are obliged to focus on:

  • Surveillance of workers health
  • Assessment and surveillance of health hazards
  • Training and information provision for workers
  • First aid and emergency treatment.

Advising on occupational safety, work adaptation, work organization etc. The private health care facilities need to be registered an licensed.

Germany

Since in Germany all employers are obliged to have an occupational accident insurance a large role is played by the public insurance companies (Statutory Accident Insurance). They both directly (by proposing regulations regarding accident prevention) and indirectly (through financial incentives for employers) influence OSH management. Employers are obliged to use the service of a company doctor and a safety engineer. These can be employees of the company but if the necessary competences are not available within the company it is mandatory to make use of an external service. This can be part of an external multidisciplinary service, but also self-employed workers. An external service should include at least an occupational health physician and a safety specialist. OSH systems at national level - Germany Legislation specifies the competences which people that work for an external service must have. Depending on the services offered, other occupational groups can be involved. E.g. , ergonomists, OH psychologists, health experts etc. The company doctor is responsible for advising the employer regarding occupational medicine, carrying out medical supervision and preventive measures regarding occupational accidents and sickness absence. The safety engineer advises the employer about safety, check the work equipment and checks whether the preventive measures are actually used. Since it is mandatory for all employers to join a UVT’s (Unfallversicherungsträger; insurance company) (the prevention of) work accidents is an important topic. However, the tasks of the UVT’s goes beyond accident prevention. The UVT’s tasks among others include prevention of occupational diseases and work related health risks and an efficient Emergency medicine. There is no mandatory certification of accreditation of external services as a whole, but there is a system of voluntary certification.

Italy

In Italy there is an obligation to set up an OSH service for companies with more than 200 workers and/or in specific sectors OSH systems at national level - Italy. This can be an internal or external OSH service provider. Use of an external provider is mandatory if the necessary competences are not present internally. External OSH services are usually multidisciplinary and generally cover occupational safety, occupational medicine, Industrial health and ergonomics. The tasks of the OH services are

  1. Identification of risk factors
  2. Setting up health and safety measures and procedures
  3. Training and educating workers
  4. Advising employers on all relevant health and safety issues

There are no occupational groups that legally need to be involved. However, usually engineers and industrial health experts are involved. Qualification can be obtained by completing a specific education or following additional courses next to secondary school. External prevention and protective services are organized by private organisations and do not have to be certified.

Netherlands

OSH management in the Netherlands is organized by private, for profit, companies. Many companies make use of external services in large, multidisciplinary ‘arbodiensten’ (OSH service providers). However, an employer can also choose to hire an independent (often self-employed) company doctor. An OSH service provider needs to be certified[14][15]. Certification is valid for a 4 year period, and then needs to be reissued. An external OSH service needs to have specialists in at least 4 area’s.

  1. Occupational Medicine
  2. Occupational safety
  3. Occupational hygiene
  4. Work organization.

Other occupational groups can also be involved. All above mentioned Occupational Health specialists need to be certified. This guarantees that their knowledge is and remains sufficient. Furthermore, every company must have at least one health and safety officer in charge who can execute measures and supervise the execution of preventive measures. The health and safety officer can be an employee or, in small businesses, the director may also act as a prevention officer. However, the profile of the health and safety officer is not stated clearly, and their level of expertise can therefore be low. OSH service providers and company doctors mainly focus on the reduction of sickness absenteeism. Other disciplines as safety engineers and occupational hygienists focus more on prevention, for example the examination of the Risk Inventory and Assessment and the plan of action.

Sweden

Occupational Safety and Health services are mainly organized by private organization. Companies are only required to make use of an external OSH service if their internal competencies are not adequate. The staffing of an OH service organization is not standardized, however, usually there are occupational health physicians, occupational nurses, physiotherapists, ergonomists, work environment engineers and OH psychologists. Companies with 5 or more workers are obliged to have a safety worker. The role of the OH services is an advisory one. OH services need to focus on the prevention and elimination of health hazards in workplaces. If a certain level of risk is present (or if a collective agreement requires this) medical surveillance is mandatory. OH professionals are trained by universities and colleges. A variety of occupational groups can be involved, e.g. nurses, OH psychologists, doctors, work environment engineers, physiotherapists. There is no mandatory certification or accreditation for the OH service organization, but OH services can voluntarily be certified. The Swedish Work Environment Authority has the task a.o. to enforce the legislation on OH service[16].

UK

A fundamental principle of the British system is that responsibility for health and safety lies with those who own, manage and work in industrial and commercial undertakings. This includes the self-employed. OSH services are therefore organized by 3 separate parties: public organisations, private organisations and the employers, but they all fall under the supervision of the National Health services (NHS). Employers must appoint one or more ‘competent persons’ to help them meet the requirements of health and safety law. A competent person is someone who has sufficient training and experience or knowledge and other qualities that allow them to assist the employer properly[17]. Employers must assess the risks attached to their activity and take appropriate action. The focus therefore is mainly on risk reduction. Employers are not legally obliged to use an external OSH service. If they do, the disciplines covered (and thus the multidisciplinary) varies and depends on the services needed by the employer. The level of competence required will depend on the complexity of the situation and the particular help the employer needs. Certification or accreditation of an OSH service is not mandatory. Furthermore, in the UK the regulatory trend is not one of prescriptive rules, but towards risk assessment and control.

Conclusions

The way in which the OSH-services are organized varies among the EU-countries. In some countries the OSH-services are closely related to the Public Health care sector. There is a wide variety of OSH-services operating within the EU. In most countries there are at least two disciplines active within an OSH-service: safety engineers and an Occupational health physicians. These experts are not obliged to work together in an interdisciplinary way to give practical and applicable advice to employers and employees in every country. The standards set to OSH disciplines and OSH services also differ, especially regarding certification and accreditations. These can be generally or explicitly formulated and in some instances by disciplines themselves. Because of this difference the provision of services can diverge. Although all countries formulated country specific laws according to the guidelines, the service also might work out differently due to the cultural background of the country and/or to the historical background such as the public health care sector. As a result, it might not be possible for – for instance a safety engineer – to provide adequate services in another country due to the standards in that country. The European Network of Safety and Health Professional Organisations (ENSHPO) has developed a voluntary European certification standard for occupational safety and health. It will help to verify the competence of OSH professionals[18]. Another inter-country difference concerns public and private OSH-services as well as profit and non-profit OSH services. This might have an effect on as well the activation of OSH services by companies, as well as an integrated approach – working conditions and health - of the OSH-services. Concluding remark: there is, on EU-level, no explicit legislation related to standards of OSH-services only the obligation for employers to use external OSH-services or persons is formulated, but when and in what context is rather generally formulated.

References and links for further reading

References

  1. Council Directive 89/391/EEC of 12 June 1989 on the introduction of measures to encourage improvements in the safety and health of workers at work, Official Journal of the European Communities, article 7, page 4. Retrieved 24 August 2012. Available at: http://eur-lex.europa.eu/LexUriServ/LexUriServ.do?uri=OJ:L:1989:183:0001:0008:EN:PDF
  2. Council Directive 89/391/EEC of 12 June 1989 on the introduction of measures to encourage improvements in the safety and health of workers at work, Official Journal of the European Communities, article 13, page 7. Retrieved 24 August 2012. Available at: http://eur-lex.europa.eu/LexUriServ/LexUriServ.do?uri=OJ:L:1989:183:0001:0008:EN:PDF
  3. Occupational Health Services Convention, 1985 (No. 161), Convention concerning Occupational Health Services (Entry into force: 16 Feb 1988), ILO – International Labour Organization, retrieved 24 August 2012. Available at: https://www.ilo.org/dyn/normlex/en/f?p=1000:12100:0::NO::P12100_INSTRUMENT_ID:312306
  4. Occupational Health Services Recommendation, 1985 (No. 171), Recommendation concerning Occupational Health Services, ILO – International Labour Organization, retrieved 25 August 2012. Available at: http://www.ilo.org/dyn/normlex/en/f?p=1000:12100:0::NO:12100:P12100_INSTRUMENT_ID:312509
  5. EU-OSHA - European Agency for Safety and Health at Work (2010). Mainstreaming OSH into business management, Factsheet 92 (2010), retrieved 24 August 2012, from: http://osha.europa.eu/en/publications/factsheets/92
  6. Consolidated versions of the Treaty of the European union and the treaty on the functioning of the European Union, Article 153 of the Treaty of the functioning of the European Union, pages 117-118, 2010, retrieved 24 August 2012. Available at: http://eur-lex.europa.eu/JOHtml.do?uri=OJ:C:2010:083:SOM:EN:HTML
  7. Council Directive 89/391/EEC of 12 June 1989 on the introduction of measures to encourage improvements in the safety and health of workers at work, Official Journal of the European Communities, article 13, page 7. Retrieved 24 August 2012. Available at: http://eur-lex.europa.eu/LexUriServ/LexUriServ.do?uri=OJ:L:1989:183:0001:0008:EN:PDF
  8. Council Directive 89/391/EEC of 12 June 1989 on the introduction of measures to encourage improvements in the safety and health of workers at work, Official Journal of the European Communities, article 7, page 4. Retrieved 24 August 2012. Available at: http://eur-lex.europa.eu/LexUriServ/LexUriServ.do?uri=OJ:L:1989:183:0001:0008:EN:PDF
  9. EU-OSHA – European Agency for Safety and Health at Work (2009). European Survey on New and Emerging Risks – Overview and main results 2009. PP-presentation.Retrieved 5 november 2012 http://osha.europa.eu/en/publications/reports/esener1-summary_data/ESENER-presentation1.pptx&sa=U&ei=juCXUL_mBISFhQfg64FY&ved=0CAcQFjAA&client=internal-uds-cse&usg=AFQjCNFUz51E14ABxbtopyFPYNZ8G7nkdQ
  10. EU-OSHA – European Agency for Safety and Health at Work (2010). European Survey of Enterprises on New and Emerging Risks (ESENER), retrieved 5 November 2012, from: http://osha.europa.eu/en/publications/reports/en_esener1-summary.pdf
  11. Occupational Health Services Convention, 1985 (No. 161), Convention concerning Occupational Health Services (Entry into force: 16 Feb 1988), ILO – International Labour Organization, retrieved 24 August 2012. Available at: https://www.ilo.org/dyn/normlex/en/f?p=1000:12100:0::NO::P12100_INSTRUMENT_ID:312306
  12. Occupational Health Services Recommendation, 1985 (No. 171), Recommendation concerning Occupational Health Services, ILO – International Labour Organization, retrieved 25 August 2012. Available at: http://www.ilo.org/dyn/normlex/en/f?p=1000:12100:0::NO:12100:P12100_INSTRUMENT_ID:312509
  13. The National Policy on Occupational Safety and Health, Ministry of Labour and social affairs, page 12, Occupational health services (2008), Retrieved 24 August 2012, from:http://osha.europa.eu/fop/czech-republic/en/systems
  14. Dutch Accreditation Council/RVA - Raad voor Accreditatie, About Accreditation. Retrieved 24 August 2012, from: http://www.rva.nl/resources/AMGATE_10218_1_TICH_R6714153203732/AMGATE_10218_0_TICH_R68430685607
  15. SBCA - Stichting Beheer Certificatieregeling Arbodiensten, Certification health & safety services, Retrieved 24 August 2012, from: http://www.sbca.nl/
  16. Systematic work environment management (2001), page 9, page 12, Swedish Work Environment Authority. Retrieved 24 August 2012, from: http://www.av.se/dokument/inenglish/legislations/eng0101.pdf
  17. OSHR - Occupational Safety and Health Consultants Register, About OSHR (2012). Retrieved 24 August 2012, from: http://www.oshcr.org/Page/AboutOSHCR
  18. ENSHPO - European Network of Safety and Health Professional Organisations (2012).Retrieved 31 oktober from: http://www.enshpo.eu/index.php?option=com_content&view=article&id=85:enshpo-launches-new-european-certification-standard&catid=36:latest-news&Itemid=61


Links for further reading

International Occupational Safety and Health Information Centre (CIS), International Labour Organization – ILO. Available at: http://www.ilo.org/safework/cis/lang--en/index.htm

EU-OSHA – European Agency for Safety and Health at Work. European Safety and Health Legislation. Retrieved 24 August 2012. Available at: http://osha.europa.eu/en/legislation

EU-OSHA – European Agency for Safety and Health at Work. Risk assessment. Retrieved 24 August 2012. Available at: http://osha.europa.eu/en/topics/riskassessment

EU-OSHA – European Agency for Safety and Health at work (2008). Risk Assessment - roles and responsibilities, Factsheet 80 (2008), Retrieved 24 August 2012, Available at: http://osha.europa.eu/en/publications/factsheets/80

EU-OSHA – European Agency for Safety and Health at Work. Publications – sorted by type of publication. Retrieved 24 August 2012. Available at: http://osha.europa.eu/en/publications

EU-OSHA – European Agency for Safety and Health at Work. The Use of Occupational Safety and Health Management Systems in the Member States, experiences at company level (2002). Retrieved 24 August 2012. Available at: http://osha.europa.eu/en/publications/reports/307

EU-OSHA – European Agency for Safety and Health at Work. Mainstreaming OSH into businessmanagement (2010), Retrieved 24 August 2012, Available at: http://osha.europa.eu/en/publications/reports/mainstreaming_osh_business

ENSHPO - European Network of Safety and Health Professional Organisations (2012).Retrieved 31 oktober. Available at: http://www.enshpo.eu/index.php?option=com_content&view=article&id=85:enshpo-launches-new-european-certification-standard&catid=36:latest-news&Itemid=61

Contributors

Irene Houtman, Palmer