Introduction
What is occupational safety and health?
OSH legislation
European Union’s OSH regulations are derived from the European Framework Directive 89/391/EEC (Council Directive of 12 June 1989) [2]. The purpose of this Directive was the introduction of measures to encourage improvements in the safety and health of workers at work. It contains general principles concerning the prevention of occupational risks, i.e. prevention of unsafe working conditions. It should be noted that the Directive 89/391/EE sets minimum standards, and that Member States can introduce more rigorous provisions to protect their workers. The Framework Directive is applicable to all sectors of activity, both public and private.
Companies have the ethical and legal responsibility to ensure that their workers, the workers from subcontractors that are doing work in their facility or any other person, for instance a person visiting their facilities, remain safe at all times.
OSH is multidisciplinary
Occupational Safety and Health (OSH) is an interdisciplinary activity concerned with the prevention of occupational risks inherent to each work activity. The main aim is the promotion and maintenance of the highest degree of safety and health at work, therefore creating conditions to avoid the occurrence of work accidents and ill health. The achievement of this desirable state of safe working conditions implies that employers must perform risk assessment regarding safety and health at work, and must decide if actions are required and what kind of OSH measures should be implemented. According to the International Labour Organization, OSH encompasses the social, mental and physical well-being of workers, that is the “whole person” [3]. Therefore OSH is not only avoiding work accidents or occupational diseases, but the result of taking actions to identify their causes (hazards existent at workplace) and the implementation of adequate preventive OSH control measures. To accomplish such objective it is necessary to have interactions with other scientific areas, like occupational medicine, public health, industrial engineering, ergonomics, chemistry and psychology.
Basic OSH concepts
Some key concepts in OSH are:
- Hazard –- source, situation, or act with a potential for harm in terms of human injury or ill health, or a combination of these [4], i.e. anything present in the workplace that has the potential to cause an injury to workers, either a work accident or an occupational disease.
- Risk – combination of the likelihood of an occurrence of a hazardous event or exposure and the severity of injury or ill health that can be caused by the event or exposure [5].
- Risk assessment – is the process of evaluating risks to workers’ safety and health from workplace hazards. It is a systematic examination of all aspects of work that considers:
- what could cause injury or harm
- whether the hazards could be eliminated and, if not,
- what preventive or protective measures are, or should be, in place to control the risks [6].
- Safety – it is very difficult to define. Safety is the state of being "safe" i.e. free from harm or risk, but in practice this state is never obtained. Therefore safety must be seen as a value judgment regarding the level of risk of being injured which is considered to be acceptable [7].
- Health – in relation to work, indicates not merely the absence of disease or infirmity; it also includes the physical and mental elements affecting health which are directly related to safety and hygiene at work [8].
- Occupational disease – disease contracted as a result of an exposure over a period of time to risk factors (chemical, physical or biological agents) arising from work activity [9], that is any chronic ailment that occurs as a result of work or occupational activity. It is typically identified when it is shown that it is more prevalent in a given body of workers than in the general population, or in other worker populations. Examples include respiratory diseases (e.g. asbestosis or occupational asthma), skin diseases, musculoskeletal disorders (e.g. carpal tunnel syndrome) and occupational cancer.
- Work accident – is a discrete occurrence in the course of work (even if the accident happens off the company’s premises, or if it is caused by third parties), which leads to physical or mental harm [10].
- Prevention – all the steps or measures taken or planned at all stages of work in the undertaking to prevent or reduce occupational risks [11].
Regarding scope, the concepts of OSH are applicable to any type of work, from construction, agriculture, manufacturing, mining, fishing, to shop, office or healthcare; and also to subcontracted work. Furthermore, for OSH purposes, besides the period of work activity, commuting to and from place of work is also considered as part of a working day. Therefore safe commuting is also a concern in OSH.
Managing OSH
Prevention as key concept in OSH Management
Prevention is a key concept in OSH. In fact, prevention of work accidents and occupational diseases must be the main objective of any OSH management system, rather than attempting to solve problems after they have occurred. This principle is assuming an increased importance since organisations are rapidly changing (due to globalization, downsizing, part-time work, temporary work, subcontracting, ageing workforce…), thus calling for a dynamic OSH approach [12].
The general principles for the prevention of unsafe working conditions set by Framework Directive have been continuously restated in the EU and further developed in other documents. For instance, the “Luxembourg Declaration on Workplace Health Promotion in the European Union” sets out several principles, which aim at preventing ill-health at work (including work-related diseases, accidents, injuries, occupational diseases and stress) and enhancing health-promoting potentials and well-being in the workforce [13]. These principles are:
- Company codes of conduct and guidelines that view employees not only as cost factors, but as important success factors;
- Company culture and management policies that include the participation of the employees and encourages them to assume responsibility;
- Work organisation that enables employees to balance the demands made by the job with their own personal skills and to control their own work and social support;
- Personnel policies that incorporate health targets into all other areas of the company;
- Integrated occupational safety and health services;
- Inclusion of employees in health issues at all levels (participation);
- Systematic implementation of all measures and programmes (project management);
- Linking risk reduction strategies with the development of safety factors and health potentials (comprehensive approach).
Considering the above-mentioned principles and the need to focus on the prevention of work accidents and occupational diseases, companies should implement and integrate an OSH Management system in their management system. Such system is intended to develop and implement company’s OSH policies and manage its OSH risks [14].
Control and prevention measures
As mentioned before, risk assessment regarding safety and health at work is performed to decide if actions are required and what kind of OSH measures should be implemented in the workplaces. Such OSH control measures should be based on updated technical and/or organisational knowledge, and good practices. The implementation of control measures should be done using the following hierarchy [15]: (1) Preventive measures, (2) Protection measures, and (3) Mitigation measures. A brief description of these types of control measures is presented hereafter.
Preventive measures aim to reduce the likelihood of occurrence of a work accident or an occupational disease. Preventive measures can be of two types:
- engineering or technical measures - designed to act directly on the risk source, in order to remove, reduce or replace it;
- organizational or administrative measures – meant to force changing of behaviours and attitudes and promote a safety culture.
Protection measures should consider primarily collective measures and, if they are not deemed feasible or effective, consider as alternative individual measures. Therefore, protection measures include:
- collective measures – designed to enclose or isolate the risk, for instance through the use of physical barriers, organizational or administrative measures to diminish the exposure duration ( job rotation, timing of the job, safety signs) and then;
- individual measures - any adequate Personnel Protective Equipment designed to protect the worker from the residual risk.
Mitigation measures aim to reduce the severity of any damage to facilities and harm to employees and public. Several examples include:
- emergency plan;
- evacuation planning;
- warning systems (alarms, flashing lights);
- test of emergency procedures, exercises and drills, fire-extinguishing system;
- return-to-work plan.
Risk assessment as the key action
Risk assessment constitutes the basis for implementation of appropriate safety control measures. According to the Framework Directive [16], risk assessment is the starting and crucial step of the OSH risk management process.
There are several methods to perform risk assessment, ranging from simple to complex methods and from the involvement of isolated experts to participatory methodologies. Risk assessment involves evaluating, ranking, and classifying risks.
Unsafe working conditions can result from risks of operation or from risks of environment. The first type receives the focus of ‘Safety at Work’, whose objective is work accident prevention. Table 1 presents several examples of work situations that can constitute a hazard, thus can lead to work accidents [17].
Table 1. Examples of hazards that can lead to work accidents 
Source: [18].
The second type is dealt by ‘Health at Work’, whose objective is the prevention of occupational diseases and work-related ill-health. Table 2 presents several examples of work situations that can lead to ill-health [19]. There are other aims, not specific to any of these approaches, which include the social protection of certain groups of vulnerable workers and working time regulations. Therefore, the results of risk assessment are used for deciding on the need of implementing safety and health control measures and to help establishing which type of measures can be more effective, for the specific workplace context.
Table 2 - Examples of hazards that can lead to ill-health 
Source: [20].
In terms of periodicity, it is advisable to perform risk assessments on regular basis and whenever a change is introduced in the workplace, for instance due to the introduction of new materials, chemical substances, tools, equipment or procedures.
Awareness and worker participation in OSH
In addition to being an EU legal requirement, providing information and training courses to workers is essential in any OSH programme, since they contribute to raise awareness about OSH, allowing the early recognition of:
- hazardous working situations;
- symptoms and signs of any occupational disease;
- risks they can be exposed to.
Communication must be an OSH management priority. Management must be engaged on communicating with workers on shop floor.
Awareness and worker participation in OSH contribute to a better safety and health environment. In fact, besides the role of a strong management (employers) commitment, a high level of workers’ involvement and participation is also crucial for successfully implementing an OSH programme.
Employers need to consult workers and/ or their representatives and allow them to take part in discussions on all questions regarding OSH at work. The actions resulting from such participation may focus, for instance, on adapting the work to the individual, especially on what regards the design of work places, the choice of work equipment or of working and production methods. Workers contribution can be very helpful on finding solutions, namely for modifying inadequate working conditions (e.g., monotonous work, working at a predetermined work-rate) and reducing their effect on health [21].
In order to increase an early awareness of OSH it has been suggested that OSH issues should be integrated into education.
Costs of work accidents and occupational diseases
There are several reasons (legal, economic, financial, ethical, and social responsibility) that can be very important triggers for a company's commitment to OSH.
The expenditure associated with the implementation of adequate OSH control measures must be seen as an investment and not as a cost. Since OSH can promote the decrease of work accidents and illnesses it can lower the risk for liabilities and absenteeism, therefore contributing to the reduce costs (medical care, sick leave and disability benefit costs) and the possibility of disruption of the production processes. As with any other business expenditure, a business case can be made for expenditure on improving OSH[22].
According to the EU-OSHA, every few minutes somebody in the EU dies from a work-related cause [23]. Furthermore, every year 4.9 million accidents result in 3 or more days of workers’ absence from work. Other key facts [24]:
- Men have more accidents than women.
- Young workers have a much higher accident rate than other age groups; older workers have more fatal accidents.
- The rate of accidents is higher in small and medium-sized enterprises.
- Accident rates are higher in some sectors, including agriculture and construction.
- Accidents occurring at night tend to be more fatal than ones occurring at other times.
- Wounds and superficial injuries are the most common type of injury.
- Workers on shift work have a higher accident rate.
The cost of work accidents and occupational diseases ranges for most countries from 2.6 to 3.8% of Gross National Product [25]
Work related accidents and occupational diseases represent an enormous cost for companies and also an enormous cost in terms of human suffering for the victims and their families. These costs, which can be classified as direct and indirect costs, apply both to workers and employers. Table 3 present examples of such costs [26] [27].
Table 3 – Workers and employers costs 
Source: [28] [29].
The indirect costs can be four to ten times greater than the direct costs - the so called iceberg theory of incident costs [30].
Injury insurance systems have in common the aim of offering protection to the injured worker and their dependants; however the compensation varies significantly from country to country. In addition, in some EU Member States, insurers try to encourage the adoption of preventative measures by offering economic incentives to employers[31].
Accident and disease costs are paid by all of us, taxpayers and consumers. The question is: Are we really willing to continue to pay this high price? This is essentially a question of political will, as the economics speak for themselves: more effective accident prevention would not only reduce costs but also boost productivity [32].
According to one study, that explored the Return on Prevention (ROP) in respect of improving occupational health, the benefits from doing so included:
“..added value generated by better corporate image, added value generated by increased employee motivation and satisfaction and cost savings through prevention of disruptions"[33].
The report concluded that spending on occupational safety and health was an investment that “pays off” for companies, with the ROP assessed to be 2.2 (i.e. a more than doubling of the return on investment).
New risks and future OSH
Societal evolution, technological development and changes in the structure of the labour market due to globalisation and growth of the service sector are influencing changes in working methods and work environment worldwide. These changes are causing the appearance of new OSH risks[34]. EU-OSHA defined ‘new and emerging risks’ as risks that, among other criteria, did not previously exist and is caused by new processes, new technologies, new types of workplace, or social or organisational change. As part of the development of a culture of risk prevention EU-OSHA’s European Risk Observatory conducted four expert forecasts, to anticipate new and emerging risks related to four main areas of OSH risks: physical [35], chemical, biological, and psychosocial. More recently, it has prepared an overview report from the Second European Survey of Enterprises on New and Emerging Risks (ESENER-2) on emerging OSH issues[36].
New and emerging OSH risks may have different origins, namely: new technologies, new production processes, new working conditions, and emerging forms of employment. New products and new processes arise everyday, namely has a consequence of development of e.g. nanotechnology. Nanomaterials are becoming increasingly more common in our daily life, for instance in health care, biotechnology, clean energy production, information and communications, chemical, electronic and military industries, agriculture and construction. Their use can offer various benefits, however the current speed of nanotechnology development means that, despite on-going research, there are still knowledge gaps concerning the evaluation of OSH risks. New biological risks arise for instance in the biotechnology industry, where those engaged in the development of new products and genetically modified organisms can be at particular risk. In addition, workers from the health care, emergency and rescue workers, agriculture or waste management can be exposed to newly emergent infectious diseases, drug-resistant types of infectious diseases, antimicrobial resistant organisms, animal wastes and endotoxins.
New working conditions (for instance, the implementation of lean production models) can lead to higher workloads if implemented without ergonomic adjustments [37]. Work intensification resulting from downsizing, poor conditions associated with migration for work and jobs in the informal economy can also cause new OSH risks.
The structure of the workforce is also changing, namely the ageing workforce and the increasing participation of women in the work market. New forms of employment and jobs, namely temporary contracts, self-employment, subcontracting and out-sourcing are very common nowadays. One consequence of new ways of working has been the increase in the number of lone workers. These present particular problems, partly in respect of the difficulties in managing the conventional risks to which they might be exposed (such as manual handling, violence, etc.) but also because of the new psychosocial risks they face as a result of the increased isolation and lack of peer-support[38].
These emerging forms of employment have an impact on working conditions, making it harder to achieve a healthy work-life balance. Taken together with other factors, such changes have led to increasedwork-related stress and other forms of mental ill-health, trends that can be all more acute during global economic crises [39]. Some ergonomics or human factors risks were also identified as emerging [40], for instance poor design of human-machine interaction interfaces due to excessively complex or requiring high forces for operation.
As a conclusion it is worth highlighting the importance of raising the awareness among employers’, workers’ and workers’ organizations on the rapid and constant change of OSH risks, which can occur as a consequence of changes, for instance in technology and working conditions. Therefore it is essential to manage and control such changes. OSH management systems have a vital role on the prevention of occupational accidents and ill-health in the continuously evolving work system.
