Occupational safety and health (OSH) or occupational health and safety (OHS) is a multidisciplinary field concerned with the safety, health, and welfare of people at work (i.e., while performing duties required by one's occupation). OSH is related to the fields of occupational medicine and occupational hygiene and aligns with workplace health promotion initiatives. OSH also protects all the general public who may be affected by the occupational environment.
According to the official estimates of the United Nations, the WHO/ILO Joint Estimate of the Work-related Burden of Disease and Injury, almost 2 million people die each year due to exposure to occupational risk factors. Globally, more than 2.78 million people die annually as a result of workplace-related accidents or diseases, corresponding to one death every fifteen seconds. There are an additional 374 million non-fatal work-related injuries annually. It is estimated that the economic burden of occupational-related injury and death is nearly four per cent of the global gross domestic product each year. The human cost of this adversity is enormous.
In common-law jurisdictions, employers have the common law duty (also called duty of care) to take reasonable care of the safety of their employees. Statute law may, in addition, impose other general duties, introduce specific duties, and create government bodies with powers to regulate occupational safety issues. Details of this vary from jurisdiction to jurisdiction.
Prevention of workplace incidents and occupational diseases is addressed through the implementation of occupational safety and health programs at company level.
Definitions The International Labour Organization (ILO) and the World Health Organization (WHO) share a common definition of occupational health. It was first adopted by the Joint ILO/WHO Committee on Occupational Health at its first session in 1950:
In 1995, a consensus statement was added:
An alternative definition for occupational health given by the WHO is: "occupational health deals with all aspects of health and safety in the workplace and has a strong focus on primary prevention of hazards."
The expression "occupational health", as originally adopted by the WHO and the ILO, refers to both short- and long-term adverse health effects. In more recent times, the expressions "occupational safety and health" and "occupational health and safety" have come into use (and have also been adopted in works by the ILO), based on the general understanding that occupational health refers to hazards associated to disease and long-term effects, while occupational safety hazards are those associated to work accidents causing injury and sudden severe conditions.
History Research and regulation of occupational safety and health are a relatively recent phenomenon. As labor movements arose in response to worker concerns in the wake of the industrial revolution, workers' safety and health entered consideration as a labor-related issue.
Beginnings
Written works on occupational diseases began to appear by the end of the 15th century, when demand for gold and silver was rising due to the increase in trade and iron, copper, and lead were also in demand from the nascent firearms market. Deeper mining became common as a consequence. In 1473, , a German physician, wrote a short treatise On the Poisonous Wicked Fumes and Smokes, focused on coal, nitric acid, lead, and mercury fumes encountered by metal workers and goldsmiths. In 1587, Paracelsus (1493–1541) published the first work on the mine and smelter workers diseases. In it, he gave accounts of miners' "lung sickness". In 1526, Georgius Agricola's (1494–1553) De re metallica, a treatise on metallurgy, described accidents and diseases prevalent among miners and recommended practices to prevent them. Like Paracelsus, Agricola mentioned the dust that "eats away the lungs, and implants consumption."
The seeds of state intervention to correct social ills were sown during the reign of Elizabeth I by the Poor Laws, which originated in attempts to alleviate hardship arising from widespread poverty. While they were perhaps more to do with a need to contain unrest than morally motivated, they were significant in transferring responsibility for helping the needy from private hands to the state.
In 1713, Bernardino Ramazzini (1633–1714), often described as the father of occupational medicine and a precursor to occupational health, published his De morbis artificum diatriba (Dissertation on Workers' Diseases), which outlined the health hazards of chemicals, dust, metals, repetitive or violent motions, odd postures, and other disease-causative agents encountered by workers in more than fifty occupations. It was the first broad-ranging presentation of occupational diseases.
Percivall Pott (1714–1788), an English surgeon, described cancer in chimney sweeps (chimney sweeps' carcinoma), the first recognition of an occupational cancer in history.
The Industrial Revolution in Britain
The United Kingdom was the first nation to industrialize. Soon shocking evidence emerged of serious physical and moral harm suffered by children and young persons in the cotton textile mills, as a result of exploitation of cheap labor in the factory system. Responding to calls for remedial action from philanthropists and some of the more enlightened employers, in 1802 Sir Robert Peel, himself a mill owner, introduced a bill to Parliament with the aim of improving their conditions. This would engender the Health and Morals of Apprentices Act 1802, generally believed to be the first attempt to regulate conditions of work in the United Kingdom. The act applied only to cotton textile mills and required employers to keep premises clean and healthy by twice yearly washings with quicklime, to ensure there were sufficient windows to admit fresh air, and to supply "apprentices" (i.e., pauper and orphan employees) with "sufficient and suitable" clothing and accommodation for sleeping. It was the first of the 19th century Factory Acts.
Charles Thackrah (1795–1833), another pioneer of occupational medicine, wrote a report on The State of Children Employed in Cotton Factories, which was sent to the Parliament in 1818. Thackrah recognized issues of inequalities of health in the workplace, with manufacturing in towns causing higher mortality than agriculture.
The Factory Act 1833 created a dedicated professional Factory Inspectorate. The initial remit of the Inspectorate was to police restrictions on the working hours in the textile industry of children and young persons (introduced to prevent chronic overwork, identified as leading directly to ill-health and deformation, and indirectly to a high accident rate).
In 1840 a royal commission published its findings on the state of conditions for the workers of the mining industry that documented the appallingly dangerous environment that they had to work in and the high frequency of accidents. The commission sparked public outrage which resulted in the Mines and Collieries Act 1842. The act set up an inspectorate for mines and collieries which resulted in many prosecutions and safety improvements, and by 1850, inspectors were able to enter and inspect premises at their discretion.
On the urging of the Factory Inspectorate, a further Factory Act 1844 giving similar restrictions on working hours for women in the textile industry introduced a requirement for machinery guarding (but only in the textile industry, and only in areas that might be accessed by women or children). The latter act was the first to take a significant step toward improvement of workers' safety, as the former focused on health aspects alone.
The first decennial British Registrar-General's mortality report was issued in 1851. Deaths were categorized by social classes, with class I corresponding to professionals and executives and class V representing unskilled workers. The report showed that mortality rates increased with the class number.
Continental Europe Otto von Bismarck inaugurated the first social insurance legislation in 1883 and the first worker's compensation law in 1884 – the first of their kind in the Western world. Similar acts followed in other countries, partly in response to labor unrest.
United States The United States is responsible for the first health program focusing on workplace conditions. This was the Marine Hospital Service, inaugurated in 1798 and providing care for merchant seamen. This was the beginning of what would become the US Public Health Service (USPHS).
The first worker compensation acts in the United States were passed in New York in 1910 and in Washington and Wisconsin in 1911. Later rulings included occupational diseases in the scope of the compensation, which was initially restricted to accidents.
In 1914 the USPHS set up the Office of Industrial Hygiene and Sanitation, the ancestor of the current National Institute for Safety and Health (NIOSH). In the early 20th century, workplace disasters were still common. For example, in 1911 a fire at the Triangle Shirtwaist Company in New York killed 146 workers, mostly women and immigrants. Most died trying to open exits that had been locked. Radium dial painter cancers, "phossy jaw", mercury and lead poisonings, silicosis, and other pneumoconioses were extremely common.
The enactment of the Federal Coal Mine Health and Safety Act of 1969 was quickly followed by the 1970 Occupational Safety and Health Act, which established the Occupational Safety and Health Administration (OSHA) and NIOSH in their current form.
Workplace hazards
A wide array of workplace hazards can damage the health and safety of people at work. These include but are not limited to, "chemicals, biological agents, physical factors, adverse ergonomic conditions, allergens, a complex network of safety risks," as well a broad range of psychosocial risk factors. Personal protective equipment can help protect against many of these hazards. A landmark study conducted by the World Health Organization and the International Labour Organization found that exposure to long working hours is the occupational risk factor with the largest attributable burden of disease, i.e. an estimated 745,000 fatalities from ischemic heart disease and stroke events in 2016. This makes overwork the globally leading occupational health risk factor.
Physical hazards affect many people in the workplace. Occupational hearing loss is the most common work-related injury in the United States, with 22 million workers exposed to hazardous occupational noise levels at work and an estimated $242 million spent annually on worker's compensation for hearing loss disability. Falls are also a common cause of occupational injuries and fatalities, especially in construction, extraction, transportation, healthcare, and building cleaning and maintenance. Machines have moving parts, sharp edges, hot surfaces and other hazards with the potential to crush, burn, cut, shear, stab or otherwise strike or wound workers if used unsafely.
Biological hazards (biohazards) include infectious microorganisms such as viruses, bacteria and toxins produced by those organisms such as anthrax. Biohazards affect workers in many industries; influenza, for example, affects a broad population of workers. Outdoor workers, including farmers, landscapers, and construction workers, risk exposure to numerous biohazards, including animal bites and stings, urushiol from poisonous plants, and diseases transmitted through animals such as the West Nile virus and Lyme disease. Health care workers, including veterinary health workers, risk exposure to blood-borne pathogens and various infectious diseases, especially those that are emerging.