Striking the Balance in Prevention

Occupational Safety and Health Promotion

Dr Jukka Takala
Executive Director
Workplace Safety and Health Institute
22 September 2013
2
 What we do
Singapores WSH Framework

Progressing WSH in Singapore

OSHD WSHC WSHI

Occupational Safety & Health Division Workplace Safety & Health Council Workplace Safety & Health Institute

REGULATOR INDUSTRY THINK TANK

PARTNER
Legislation, Policies, Educating & Engaging Charting New Grounds
Compliance Assistance & Stakeholders, Promoting for WSH Excellence and
Enforcement WSH Innovation

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 Work-related Fatalities World
2.99 billion economically active, 2008 (some data 2003)

Accidents
Fatal Fatal causing at
accidents accidents 1
least 4 days' Deaths
Economically reported best absence Work- Work- caused by
active to the ILO estimate Average est. related related dangerous
1
Region population (2008) 2008 2008 diseases mortality substances
EME 427,681,309 11,210 15,159 14,252,505 269,989 285,148 90,400
FSE 193,354,716 2,111 14,519 13,650,601 170,166 184,685 56,976
CHN 740,792,400 180 97,542 91,706,292 334,138 431,680 111,879
IND 473,300,000 179 46,928 44,120,055 355,863 402,791 119,153
OAI 457,166,678 1,247 80,567 75,746,706 269,541 350,107 90,250
SSA 273,414,298 15 57,771 54,314,626 364,551 422,322 122,062
LAC 222,632,385 2,196 31,165 29,300,625 107,180 138,345 35,887
MEC 128,010,251 929 14,296 13,441,062 73,687 87,984 24,673
All 2008: 2,991,283,518 21,604 320,580 317,421,473 2,022,570 2,343,149 910,286
USA 154,287,000 5,214 5,370 5,594,188 95,808 101,179 38,016
EU-27 237,997,300 4,706 5,900 7,374,297 161,970 167,870 73,989
Singapore new 3,340,000 61 61 57,000 1,388 1,449 566
Finland 2,726,000 41 49 42,708 1,693 1,734 871
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1 or latest relevant and available data
 Work-related Fatalities ASEAN
Accidents
causing at
least 3
Fatal Fatal
days' Accidents
accidents absence accidents causing at
Work-
Economically reported reported best least 3+ days' related Work-
active Total to the ILO to the ILO estimate absence. Best fatal related
Country population employment (2008) (2008) 2008 est. 2008 diseases mortality
Indonesia 111,947,000 102,553,000 12,555 10,462,628 91,203 103,758
Thailand 38,344,600 37,836,600 4,662 3,884,936 31,239 35,901
Malaysia** 11,028,000 10,659,600 969 807,109 5,412 6,381
Singapore* 1,928,400 1,852,000 67 69 57,508 946 1,015
Philippines 37,057,000 34,089,000 3,770 3,141,870 18,187 21,957
Vietnam 43,242,000 6,011 5,008,973 21,222 27,233
Myanmar 24,903,000 3,848 3,206,676 20,288 24,136
Brunei 157,600 146,254 5 4,457 77 83
Cambodia 6,683,000 6,560,630 1,106 846,759 3,280 4,296
Laos 2,778,000 451 375,771 1,363 1,814
TOTAL 278,068,600 33,446 27,796,687 193,217 226,574
*Singapore Labour Force Survey 2008 produced a figure of 56,600 for non-fatal accidents for permanent residents
**Malaysia: AmJIM published (Abas 2013) fatal accident rate was 9.2/100,000 (covering 7.0 mill.) resulting to 981 using Total employment
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EU-27 205,431,242 4,422 7,460 7,013,545 159,485 167,870
Work-related Annual Deaths World

Deaths attributed to work, 2.3 million/year

18%
0.4% 17%
1%
1%
32%

23%
8%

Communicable diseases Cancer

Respiratory Diseases Circulatory diseases
Mental Disorders Digestive systems diseases
Genitourinary system Accidents and violence

Sources: Hmlinen P, Takala J,

Saarela KL; TUT, ILO, EU-OSHA, 2008
Work-related Annual Deaths EU-27
Work-related Annual Deaths
Pattern in developed countries,
Singapore distribution of fatal illnesses, EU in brackets

Deaths attributed to work, Singapore (Res.) 924, EU: 168,000, ref. WHO A region

1% (0.4%) 4% (5%)
1% (1%)
3% (3%)
2% (4%)
22% (23%)

5% (6%) 62% (57%)

Communicable diseases Cancers

Respiratory Diseases Circulatory diseases
Mental Disorders Digestive systems diseases
Genitourinary system Accidents and violence
Sources: Hmlinen P, Takala J, Saarela KL; TUT,
ILO, WHO, EU-OSHA, WSH Institute Singapore
Estimate of Work-related Fatal Diseases, Taiwan1 Malaysia?
1 Based on ILO methodology, WHO A Region Economically active population: 82 million, total population 157.6 million, Taiwan Work
force 11.3 million, total population 23.3 million; Mortality data: WHO data 2008, reference group: WHO Western Pacific Region A
(Australia, New Zealand, Brunei, Japan, Singapore)), Fatal occupational injuries (accidents) were 313 in 2012.

Fatal Fatal Fatal Fatal

Work-related Work-related Work- Work-related
Diseases Diseases, related Diseases Diseases,
WHO Region A Taiwan WHO Region A Taiwan Taiwan
Disease category Men Men Women Women Total
Communicable
diseases 516 69 1,491 200 269
Malignant
neoplasms 32,896 4413 3,682 494 4907
Neuropsychiatric
conditions 1,006 135 378 51 186
Circulatory
diseases 11,123 1492 2,403 322 1814
Respiratory
diseases 2,910 390 331 44 434
Digestive diseases 255 34 50 7 41
Genitourinary
diseases 476 64 86 12 76
Total 49,182 6597 8,420 1130 7727

Ref. Australia: 6962 fatal work-related diseases and 213 fatal occupational injuries in 2008
Estimate of Work-related Fatalities, Singapore1
1 Based on ILO methodology, WHO data 2008, reference group: WHO Western
Pacific Region A, foreign worker population estimated as 50% of residents

Fatal Fatal
Work- Work-
related Permanent related Permanent
Diseases Residents Diseases Residents
Men Men Men Women Women Women
Communicable diseases 27 18 Communicable diseases
14 9
66 44 Malignant neoplasms
825 550 Malignant neoplasms
Neuropsychiatric Neuropsychiatric
25 17 conditions 8 5 conditions
279 186 Circulatory diseases 43 29 Circulatory diseases
74 49 Respiratory diseases 6 4 Respiratory diseases
6 4 Digestive diseases 2 1 Digestive diseases
12 8 Genitourinary diseases 1 1 Genitourinary diseases
1235 823 Total 153 101 Total

Fatal Work- Fatal Work-

related related
Diseases Diseases,
Total Residents

1388 924
 Division and estimates of global occupational injuries and disorders
What is reported
Work related injuries
and disorders
Fatal: 2.4 million a

Occupational Commuting Health problems

accidents accidents at work
Fatal: 321, 000 a Fatal: 80, 000 b Fatal: 2.03 million a

Injuries at Injuries in Occupational Work-related

workplace traffic at work diseases diseases
Fatal: 241,000b Fatal: 80,000b Fatal: <100,000b Fatal: 1.9 millionb

a = Global annual estimate, ILO/TUT/WSH Institute

b = Global annual estimate, J.Takala/WSH Institute
 Occupational Cancer

UK: 8010 deaths/year (Rushton L. a.o.: Br Journal of Cancer, 2012)

UK: ILO Attr.Fractions: 13 300 deaths/year

see also V McCormack, J Peto, G Byrnes, K Straif and P Boffetta, BJC 2012

USA today: 37 000 61 000 deaths/ year

Singapore: 594 (residents) 891(total economically active)

Sources: http://www.nature.com/bjc/journal/v107/n1s/index.html
http://www.ilo.org/wcmsp5/groups/public/@ed_protect/@protrav/@safework/documents/
publication/wcms_162662.pdf and TUT/WSH Institute/ILO/EU-OSHA documentation
http://www.nature.com/bjc/journal/v106/n3/full/bjc2011563a.html
Major causes of death by age group,
EU-25, 2001
DALYs in men in 2010 by age

Injuries

Transport injuries

Musculoskeletal

CVD
Mental health

Cancer

http://www.healthmetricsandevaluation.org/gbd/visualizations/region
DALYs in women in 2010 by age

Injuries

Musculoskeletal

Mental health
CVD

Cancer

http://www.healthmetricsandevaluation.org/gbd/visualizations/region
10 leading causes of DALYs in Western Europe

The disability-adjusted life year (DALY) is a measure of overall disease burden, expressed
as the number of years lost due to disability or early death
DALY = YLD (years lived with disability) + YLL (years of life lost)
http://www.healthmetricsandevaluation.org/gbd/visualizations/regional

Murray et al. Lancet 2012

 Work relatedness of common
diseases

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A Leading Institute for WSH Knowledge and Innovations
 Work relatedness of common
Work-relatedness of common diseases
diseases

Overall work-relatedness of mortality, ILO: 6.7%

GDP loss, Australian method SG: 3.2% ; AUS: new 4.8 % prev. 5.9%
Global Burden of disease and injury in Europe, WHO 5.0%

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A Leading Institute for WSH Knowledge and Innovations
 Magnitude of non-fatal work-related
illnesses and accidents: EU & SIN
1.5 % in
56,603 self-reported
Singapore
workplace injuries in
Singapore in 2008/11
7 million in Europe in 2007

11,113 reportable
workplace injuries in

6.9 % in Singapore in 2012

Singapore
20 million in Europe 2007

987 occupational diseases

(OD) were confirmed in
2012, self reported: 218,739
Singapore in 2008

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A Leading Institute for WSH Knowledge and Innovations
Projected cases of Selected diseases -
UK Population and working population, 2006-2030

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EU-OSHA Enterprise Survey of New
and Emerging Risks
For each of the following issues, please tell me whether it is of major
concern, some concern or no concern at all in your establishment
% establishments, EU27
10 0 .0

9 0 .0 20 21 20
8 0 .0 41 38

70 .0
26 62 62
35
6 0 .0
41
50 .0
22 31
4 0 .0

3 0 .0
53 19 19
44
2 0 .0
38 36
30
10 .0 18 18
0 .0
A ccid ent s M SD s W R St r ess D ang er o us N o ise and V io lence o r B ullying o r
sub st ances vib r at io n t hr eat o f har assment
vio lence

Major concern Some concern No concern DK/ NA

Problem

MYS 1970-2010
 Consumption of Asbestos and Deaths in the U.K.

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A Leading Institute for WSH Knowledge and Innovations
Metric
Historical Consumption of Asbestos Singapore
Tons (000)
35 Every 170 tons causes 1 mesothelioma case and 2-10 lung cancers ** Taiwan
Malaysia
30

25

20

15

10

0
1960 1965 1970 1975 1980 1985 * 1990 1995 2000 2005*
-5 Year
Total consumption in Taiwan 480,000, Singapore
100,000, and Malaysia 750,000 metric tons in
-10
Data Source: United States Geological Survey , * Exports bigger than imports
U.S. Department of Interior ** IntJOEH2004;10:22-25 & BJC(2012),106,575-584
-15
Asbestos exposure and mesothelioma deaths: U.K. and Malaysia

U.K

Malaysia

Malaysia
New and emerging risks

New risks e.g. Nanotechnologies

New industries e.g. Green jobs
Old risks new concerns: combined exposures
 Changes in employment structures

Tertiarisation of the workforce

Higher percentage of women in employment
More non-standard employment
Part-time,
Multiple jobs
Self-employment
Precarious work
Informal sector / undeclared work

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New Association between work and
health

Source: Jorma Rantanen, WSH Conference Singapore, 2012

New Association between work and
health

Source: Jorma Rantanen, WSH Conference Singapore, 2012

 Cost of injury and illness, Australia,
and others in 2012

4.8 % of GDP
in 2008-09
3.2 % of GDP in
Singapore, 2011

Others:
1.8%- 6 % of GDP
source: www.safeworkaustralia.gov.au/
http://www.safeworkaustralia.gov.au/swa/AboutUs/Publications
/CostofWork-relatedInjuryandIllness.htm
http://www.safeworkaustralia.gov.au/sites/SWA/about/Publications/Documents/660/Cost%20of%
20Work-related%20injury%20and%20disease.pdf

www.wshi.gov.sg
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A Leading Institute for WSH Knowledge and Innovations
 Iceland
Japan

Sustainable Work Life

And: Jorma Rantanen, WSH Conference Singapore, 2012, and JT

 Competitiveness and WSH: World
(selected countries)
Competitiveness Index Fatal accidents /
100 000 workers
Competitiveness rank Death rates Linear (Death rates) 2008
6 20

5.5
15

5
10

4.5

5
4

0
3.5

3 -5

Source: WSH Institute and World Economic Forum 2012-2013

http://www3.weforum.org/docs/WEF_GlobalCompetitivenessReport_2012-13.pdf
 Iceland

New Zealand
Norway, Switzerland

2012

Singapore

Finland

Source: OECD, Statistics Finland, WSH-Institute Singapore

Price of premature retirement and
early exclusion from employment

/ (1) Average retirement age 60.9yrs, Average exit age 61.2 yrs,
retirements/year loss of 4.1 yrs/person loss of 3.8 yrs/ person (3)

: Annual median income

SGD / SGD
15.1 billion 7.5 billion

: Annual cost to employer

/ SGD (2) 22.8 billion 9.0 billion

: GDP/employed
/ SGD
33.3 billion 18.9 billion

Statistics, Finland: Pensions 2012, Salaries 2012,

Population of Finland: 5.2 million, Singapore: 5.18 million (2011)
(1) Estimate based on number of employed Singapore Residents aged 45 and above, Labour Force Report
2012
(2) Including worker compensation, pension, medical, soc.security expenses etc. paid by employers,
Singapore estimate 120% of annual median gross salary (incl employer CPF)
(3) Estimate based on number of economically inactive Singapore Residents not working due to retirement,
Labour Force Report 2012

Costs of accidents and diseases, 4.8% of GDP: Finland 12.8 billion USD, (based on latest Australian
research on costs of poor work environment), Singapore 10.5 billion SGD, www.wshi.gov.sg
http://www.safeworkaustralia.gov.au/sites/swa/AboutSafeWorkAustralia/WhatWeDo/Publications/Pages/cost-injury-illness-2008-09.aspx
 self rated health in the
German population aged 51-65

health good/
poor
very good

working 9.0 Mio

not working 5.9 Mio

9.3 Mio 5.6 Mio

40
source: Hasselhorn , Work Wellbeing Wealth 27.08.2013, GEDA09, RKI 2010, weighted data, own calc.
 self rated health in the
German population aged 51-65
1. dont want 1. can
2. not allowed to 2. want
3. have to
health good/
poor
very good

working 6.3 Mio 2.7 Mio 9.0 Mio

not working 3.0 Mio 2.9 Mio 5.9 Mio

9.3 Mio 5.6 Mio

41 source: Hasselhorn , Work Wellbeing Wealth 27.08.2013, GEDA09, RKI 2010, weighted data, own calc.
The "Balance of Horror" in the
European Labour Market
EU: 200 bill. / year EU: 3000 bill. /year
Finland: 2 billion/y Finland: 30 bill./y
Malaysia: ? Malaysia: ?

Training
OHS
WA promotion
Early retirement
Recreation and culture
Corporate fitness
Sick-leaves
Communication Accidents
Permanent disability

****

(Presenteeism)

Source: Prof. G.Ahonen, adaptation Dr. J.Takala

 s

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PERCEIVED AND REAL RISKS

PERCEIVED RISK Evidence 2 Policy

Evidence 2 Practice
Terrorist
attack Violent
Mobile robbery
phones Avian flu
Stock exchange WORK
Airline crash
accident Glass of vine all
Work- Work-
related Work-
related
Work- related
related

Work-
related Work-
related Work-
related Work-
related Work-
Heat wave related
WAR
REAL RISK activities,
anywhere
Traffic
Accident Cancer
Circulatory diseases

WORK
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Sources: S. Hertlich, M.Hamilo, S.kuvalehti (FI), WHO/ILO/J.Takala all
 UN Secretary General
Kofi Annan in 2003:

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 H in Workplace Safety and Health

http://www.ilo.org/wcmsp5/groups/public/---ed_protect/---protrav/---safework/documents/publication/wcms_208226.pdf
Work-related Work-related Accidents Infectious Musculo- Psychosocial
cancer circulatory and skeletal disorders
diseases parasitic disorders
diseases
Asbestos Shift and night Lack of company Poor quality Heavy lifting, Lack of control,
work, overwork policy, drinking water loads, shapes of Effort reward
management materials imbalance
system,
worker/employer
collaborative
mechanism, poor
safety culture
Carcinogenic Strain by high Lack of Poor sanitation Repetitive Poor work-life
substances, demands, low knowledge, and sewage movements balance
processes, silica decision making solutions and system
and other dusts latitude good practices

Ionizing High injury risk Lack of guidance Poor hygiene, Poor design of Poor
radiation, or poor gvt lack of seats, tables, organisational
radioactive policies, poor knowledge tools, processes culture
materials legislation and
poor enforcement
and tripartite
collaboration
UV-radiation Chemicals Lack of incentive- Protection Low Role ambiguity
based against temperatures, or conflict,
compensation animals, vibration unclear or
system insects, snakes changing
priorities
ETS (passive ETS (passive Lack or or poor Job insecurity
smoking at smoking at OH services
work) work)

Diesel engine Poor recording

exhaust and notification
systems
 Basic associations

No Sickness Retirement on
disability absence health grounds
chronic disease
Premature
death

Psychosocial
factors

Prof. Mika Kivimki 2013, University College London, UK, WWW Conf. 26.08.2013
 No Sickness Retirement on
disability absence health ground/
chronic disease
Premature
death

TAKE HOME MESSAGE:

Psychosoci
THE STRONGEST ASSOCIATIONS WITH ALL-CAUSE DISABILITY
al factors
PENSION:
Sickness absence due to psychiatric disorders (RR = 4 to 9)
Sickness absence due to musculoskeletal disorders (RR = 3 to 7)

THE STRONGEST ASSOCIATIONS WITH CAUSE-SPECIFIC DISABILITY

PENSION
Sickness absence due to psychiatric disorders (RR = 14!)
Sickness absence due to musculoskeletal disorders (RR = 6)

Kivimki 2013
Trends change of mindset
 Challenge, not just for today
but for life

To achieve a sustainable
working life
The challenge to
employment
A holistic approach
Good Work!

http://www.theworkfoundation.com/DownloadPublication/Report/316_Good%20Work%20High%20Performance%20and%20Productivity.pdf

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http://www.theworkfoundation.com/assets/docs/publications/216_bupa_report.pdf
A Leading Institute for WSH Knowledge and Innovations
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 Total Workplace Safety and Health
(Total WSH)

A comprehensive and integrated approach to

managing workplace safety and health:
To provide and maintain a safe and healthy working
environment for all employees.
To identify and address WSH risks in a proactive and
integrated way with the active participation of
employees.

GOVERNMENT
SAFETY ISSUES HEALTH ISSUES
MANAGEMENT Occupational General Health Promotion
WORKER Diseases Diseases

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 Benefits of Total WSH
Enhanced
WSH Culture

Enhanced Sustainable
Productivity WSH gains

Key
Corporate
Benefits Lengthen
productive
Image
working life

Attract &
International
retain
Best Practice
employees

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 Ergo@WSH ~10,000
downloads

Launched at Singapore WSH Conference - Sept 2012

Awarded CIO 100 Honouree 2013
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 Accidents injuries
exposures or
Design for Safety,
Control Banding,
GHSevidence4action

http://www.asse.org/professionalaffairs_new/PtD/Opening%20Session/Paul%20Schulte.pdf
 A multifaceted approach to prevention

TOOLBOX FOR SAFETY AND HEALTH

Policy,
strategy,
programmes,
.. Systems
approach
management

Laws and Infra-

regulations structures
Knowledge,
Promotion,
information
advocacy

Collaboration
Technical
assistance,
advice, OSH Enforcement,
Services compliance,
inspection

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A Leading Institute for WSH Knowledge and Innovations
 World Day for Safety and Health at Work:
Singapore reaffirms its commitment to safety and health

Lee Hsien Loong, Prime Minister of Singapore,

April 28, 2013

http://www.ilo.org/safework/events/safeday/WCMS_211661/lang--en/index.htm

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 s

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 From Fragmentation to Leadership

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Targets and indicators
Conclusion
Conclusion
Conclusion