Occupational Health Action Plan to 2013
1. Background and context
Occupational diseases can and should be prevented. In many cases, knowledge exists to prevent occupational disease (or its recurrence). However, long latency periods following exposure and difficulties attributing the contribution of occupational causes of disease means that it is often more complex to understand than occupational injury. It is likely that this is part of the reason why compensation from ACC for occupational illness and disease is much less common than for occupational injury. As a result, workplace exposure to identified health hazards often ends up as a ‘poor cousin’ to injury prevention and management of safety hazards. This needs to change.
Under the Health and Safety in Employment Act 1992 (HSE Act), employers have the primary responsibility for taking all practicable steps to ensure the health and safety of employees and others at the workplace. Within the context of occupational health, this is done by managing workplace health hazards to reduce the likelihood of harm. For action to be effective, employers, managers and employees and their representatives must:
- have easily accessible information on the nature of a health hazard and how it can be controlled and monitored. This information must be updated as knowledge on new health hazards become known and new techniques for managing them are developed
- have the necessary capability – both through access to equipment and technology, and the managerial skills to ensure that good systems are in place, and
- be motivated to take action to control exposures to health hazards and reduce risk.
Employers and industry groups, together with trade unions and occupational health experts, must work together to ensure that information, capability and motivation are kept current. Innovation and leadership in health and safety management is a process that can only be led by industry and experts themselves to be effective. Exposures in workplaces are often complex, and may reflect production processes that differ between industries and require specialist technical knowledge. In addition, industry leaders are more likely to be aware of new technologies and processes that may either decrease the risk of exposure or result in newly identified health hazards.
The Department of Labour works closely with both clinical and industry specialists through the Notifiable Occupational Disease System (NODS). Notifications are made through NODS when harm (or suspected harm) has resulted from exposure to workplace health hazards. Through this system an average of 270 notifications are received each year[1], and investigated by multi-disciplinary teams. Specialist panels comprising medical and non-medical specialists from the private and public sectors review individual cases investigated by Inspectors and national patterns in notifications and make recommendations[2].
The seriousness of some harms and the impact on individuals and their families and communities means that legislated intervention is justified in the public good. These are made under either the HSE Act, or the Hazardous Substances and New Organisms Act 1996 (HSNO), and include:
- general regulations issued under the HSE Act that prescribe limits on noise exposure and place controls on the hazards presented by particular substances or processes; and
- Approved Codes of Practice that relate to a range of hazards associated with occupational disease, including isocyanates, noise, hazardous substances and the manufacture of paint, printing and resins.
Best Practice Guidelines and other types of information such as factsheets are also published by the Department of Labour for a range of hazards, including chemicals (e.g. benzene, glutaraldehyde, lead, organophosphates and solvents), asbestos, shiftwork, violence and bullying, hazardous goods and substances, and biological hazards (such as leptospirosis). Although these publications are not made under an Act, they are a valuable source of industry knowledge about appropriate means of control and have evidential value in the event of a prosecution.
In addition, the Environmental Protection Authority (EPA)[3] places controls on some hazardous substances under the HSNO Act to manage the adverse effects of these on people and communities. The Department of Labour ensures that the HSNO Act is complied with in workplaces and works in collaboration with the EPA to establish Workplace Exposure Standards. These standards are used by occupational health practitioners to monitor exposure to health hazards in the workplace. Under the HSE Act, employers are required to monitor employees’ exposure to a hazard (and its impact on their health) where identified workplace health hazards cannot be eliminated or isolated.
1.1 Giving occupational health issues more priority
This Action Plan has been prepared in response to the 2009 review of the Workplace Health and Safety Strategy for New Zealand to 2015 (WHSS). The review identified the need for a stronger focus on occupational health as a priority issue.
The WHSS National Action Agenda 2010-2013, released in March 2011, has set a new direction for action over the next three years and further highlights the need to:
- improve surveillance of occupational disease[4]
- raise awareness of occupational health issues, and
- reduce workers’ exposures to health hazards.
This Occupational Health Action Plan covers the time period from now until December 2013. However, it is also intended to make a longer-term contribution by:
- giving effect to the Government’s goal of ‘healthy people in safe and productive workplaces’[5], and
- contributing to the goal of a more effective labour market by ensuring that workplaces become healthier and safer[6].
This Action Plan complements the Action Plans developed for the five priority sectors (agriculture, construction, fishing, forestry, and manufacturing), some of which also include sector-specific occupational health focus areas. For example, the Agriculture Sector Action Plan focuses on animal handling (which encompasses zoonoses such as leptospirosis) and the physical and mental health/wellbeing of workers among other high hazard areas[7].
1.2 What is occupational health?
The World Health Organisation and the International Labour Organisation have jointly agreed on a definition of occupational health. They say that occupational health should aim at:
“the promotion and maintenance of the highest degree of physical, mental and social well-being of workers in all occupations; the prevention amongst workers of departures from health caused by their working conditions; the protection of workers in their employment from risks resulting from factors adverse to health; the placing and maintenance of the worker in an occupational environment adapted to their physiological and psychological capabilities; and, to summarise, the adaptation of work to a person and of each person to their job.”
1.3 The incidence and cost of occupational disease in New Zealand
Work has been completed in recent years to identify the incidence, prevalence and social and economic costs of occupational ill-health in New Zealand. According to Health Outcomes International (2005)[8], occupational disease in New Zealand accounts for greater mortality and morbidity than occupational injuries. It has been estimated that:
- about 700-1,000 deaths occur every year in New Zealand from occupational disease: particularly cancer, respiratory disease and ischaemic heart disease (such as coronary artery disease)[9]
- 2-4% of deaths of all people over the age of 20 are due to occupational disease and 3-6% of all cancer deaths in people aged 30 or older are due to occupational cancer
- there are about 17,000-20,000 new cases of work-related disease every year.
Based on available data, common occupational diseases arising from workplace exposures include:
- infectious diseases such as tuberculosis, pneumococcal disease and leptospirosis
- cancers as a result of workplace exposure to carcinogens
- anxiety, depression and psychological disorders
- diseases of the nervous system as a result of exposure to neurotoxins, such as toxic encephalopathy from chronic exposure to solvents
- vascular and musculoskeletal disorders
- respiratory disease, particularly asthma caused or exacerbated by work, and chronic obstructive pulmonary disease and pneumoconioses as a result of exposure to wood, coal and other dusts, minerals such as silica, fertilisers, chemicals and solvents
- skin conditions such as dermatitis as a result of exposure to chemicals (especially cutting fluids and solvents) and wet work such as in food handling and preparation; and
- noise-induced hearing loss as a result of persistent exposure to excessive noise.
Reducing workplace exposure to the hazards that lead to these conditions is critical for improving occupational health.
Occupational disease has social and economic costs for individuals and for the country as a whole through lost productivity. Direct financial costs include the value of lost production, lower incomes for the workers concerned, health and rehabilitation costs, and administrative and transfer costs[10]. The costs for cancer, in particular, are exceptionally high. In addition, there are further costs due to pain and suffering for individuals and their families and communities.
[1] Based on combined data from 2005/6 to 2010/11
[2] Current NODS panels are: Asbestos and Occupational Respiratory Disease; Chemical and Solvent; Musculoskeletal; Physical Hazards; and Psychosocial.
[3] Previously known as the Environmental Risk Management Authority (ERMA).
[4] Occupational disease is defined as disease/illness that is either caused by, or made worse by exposure to hazards at work.
[5] Workplace Health and Safety Strategy for New Zealand to 2015
[6] Department of Labour Statement of Intent 2011-2014 New Zealand thriving through people and work
[7] For further information about the Sector Action Plans
[8] Health Outcomes International Pty Ltd. Methods and Systems Used to Measure and Monitor Occupational Disease and Injury in New Zealand: NOHSAC Technical Report 2: Wellington, 2005.
[9] Driscoll T, Mannetje A, Dryson E, Feyer A-M, Gander P, McCracken S, Pearce N, Wagstaffe M. The burden of occupational disease and injury in New Zealand: Technical Report. NOHSAC: Wellington, 2004
[10] Access Economics. The economic and social costs of occupational disease and injury in New Zealand: NOHSAC Technical Report 4: Wellington, 2006.
