The Wiley Blackwell Encyclopedia of Health, Illness, Behavior, and Society, First Edition.

Edited by William C. Cockerham, Robert Dingwall, and Stella R. Quah.

2014 John Wiley & Sons, Ltd. Published 2014 by John Wiley & Sons, Ltd.
Occupational Health
and Safety
PENNY McCALL HOWARD
Maritime Union of Australia
The health and safety of people at work has
been of concern since the development of
waged labor, and particularly since those
engaged in waged labor developed represent-
ative trade unions. Despite the introduction
of occupational health and safety (OHS)
legislation and state inspection regimes in
many countries, as well as detailed voluntary
standards for corporate self-regulation, work-
related injuries and fatalities remain a signifi-
cant cause of harm, the full extent of which is
largely unknown (Bohle and Quinlan 2000).
At least 2.34 million people died from
work-related incidents or diseases in 2008
(6300 work-related deaths per day), a number
that is growing. A further 317 million work-
ers were injured (ILO 2011, 1011). Globally,
the number of work-related fatalities is esti-
mated to be greater than the number of road
fatalities or violent deaths. However, it is
widely acknowledged that official statistics
on fatalities, and to an even greater extent
injuries and diseases, are likely to undercount
the extent of the problem, as many fatalities
and injuries are not systematically reported
or recorded, and many work-related diseases
are not immediately apparent.
Not only is occupational health and safety
a serious problem, but the number of people
who supply labor for the production of
goods and services has grown from 1.9 bil-
lion in 1980 to 3.2 billion in 2011 (World
Bank 2012). These figures exclude unpaid
and informal workers. In less than 300 years
industrial production methods and capitalist
labor and market relations have expanded
from a small number of countries to enroll
people in most parts of the world. Shifts in
the geographical and organizational patterns
of industrial production associated with
neoliberal globalization and the global eco-
nomic crisis have in many cases increased the
intensity and precarity of work and the dan-
ger to workers, and reduced the regulatory
protection available to them.
OCCUPATIONAL HAZARDS
The hazards posed by particular types of
work that contribute to occupational injuries,
fatalities, and diseases have changed over
time and continue to change rapidly as new
technologies and work processes are devel-
oped. Common workplace hazards include
the physical hazards of working at heights,
crushes, lacerations, and falling. Other physical
hazards include exposure to noise, vibration,
heat and cold, types of radiation (nuclear,
ultraviolet, microwave, ultrasound), and haz-
ardous and potentially explosive substances
such as chemicals, minerals (particularly
asbestos), pathogens, dusts (silica, coal, wheat,
timber, and others), and petroleum products.
The way in which work is organized has a
significant impact on how hazards affect
workers particularly: the level of employment
security, management systems and supervi-
sory pressure, payment and incentive systems,
hours of work and shift arrangements, work-
load, workforce experience, language skills,
training, union involvement, the extent of
subcontracting, state regulatory regimes, and
company and state health care provisions.
Some forms of work organization can be
2
hazards in themselves, for example shift work
and high supervisory pressure.
The combination of physical, chemical, and
organizational hazards can make seemingly
ordinary tasks injurious to workers, particu-
larly through the body stressing that can result
from repetitive movements and constrained
postures that may be required to carry out the
same task for hours on end. Occupational stress
is another hazard, particularly for jobs that are
boring, monotonous, machine-paced, and
where workers have very little control over the
tasks they perform (list of hazards adapted
from Bohle and Quinlan 2000). OHS sociolo-
gists have argued that modern workplaces and
their economic, legal, and institutional under-
pinnings produce violence structurally and
systematically in the context of work because
of the prioritization of profit and production
over the health and safety of workers and une-
qual power relations between workers and
employers (Tombs and Whyte 2007: 7).
Unfortunately, state regulation of occupa-
tional health and safety has continued to lag
far behind the recognition of occupational
risks and diseases, which in turn generally lags
far behind workers experience of workplace
hazards and diseases. Regulation has often
been sparked by spectacular disasters involv-
ing mass fatalities, or decades of campaigning
by workers affected by occupational diseases.
Examples of disasters that have sparked new
regulation include the Triangle Shirtwaist fire
(with 146 fatalities in 1911 in New York City)
and the Piper Alpha oil platform explosion
(with 167 fatalities in 1988 in the North Sea).
The struggle for recognition of silicosis,
asbestosis, and repetitive strain injury (RSI) as
occupational diseases has been lengthy, and in
many countries they are still not recognized.
For example, exposure to asbestos causes
more than 100,000 deaths each year. Over 100
years since the first officially recorded asbestos-
related death, more than 40 countries have
banned the use of asbestos after campaigns by
victims, their families, and trade unions. Yet
the World Health Organization (WHO 2010)
estimates that 125 million people are still
exposed to asbestos in their workplaces.
Industrial manufacturing in Asia has risen
meteorically. Yet in the region only Japan and
Korea have banned asbestos; consequently
millions continue to be exposed toasbestos in
their work and through consumer goods
(especially in China, Thailand, and India).
Asbestos products also periodically appear in
countries where bans are in place and a great
deal of asbestos remains in infrastructure con-
structed before the bans took effect.
Asbestos is one particularly hazardous
mineral, but it is estimated that 25,000 new
chemicals are developed and introduced to
workplaces each year. Only a small propor-
tion of these have associated material safety
data sheets, far less proper testing for potential
human health effects, interaction with other
workplace hazards (such as other chemicals,
heat, lack of ventilation, and long hours of
work), and regulation of use and exposure.
The pattern is that health problems are
allowed to arise in workers or consumers;
there follows a lengthy struggle for the recog-
nition of these health problems and inves-
tigation of links to chemical exposure; and
sometimes regulatory limits are introduced
(for example, for polychlorinated biphenyls
(PCBs) and dioxins) but enforcement is
another matter. In addition to industrial
workers, chemical hazards also have a signifi-
cant impact on agricultural workers, cleaners,
transport workers, beauticians, consumers,
neighbors of chemical plants, and the envi-
ronment more broadly.
IMPROVING OHS
The physician Bernardo Ramazzini described
the harvest of diseases reaped by certain
workers by the crafts and trades they pursue
3
in 1713 (1964, 15). More than 100 years later,
Engels described horrifying living conditions
among Englands working class, includ-
ing working conditions in which women
[were] made unfit for childbearing, children
deformed, men enfeebled, limbs crushed,
whole generations wrecked, afflicted by dis-
ease and infirmity, a situation he described
as social murder (1999 [1845], 175, 107).
The British Factory Acts of 1844 are believed
to be the first instance of state-regulated
workplace safety standards, instituted as a
result of a combination of political pressure
from working-class organizations and phi-
lanthropists particularly concerned with the
protection of women and children. The Acts
included detailed technical standards to be
enforced by a government inspectorate an
approach that was expanded to include
workplaces in other sectors and which was
influential in Australia, New Zealand,
Canada, and other countries. However, histo-
rians have argued that not long after their
introduction, crimes under the UK Factory
Acts were conventionalized and, despite
frequent violations, prosecutions were few.
Factory laws were also passed in the nine-
teenth century in Germany, Sweden (empha-
sizing the participation of workers), and
France (emphasizing compensation rather
than prevention of injuries). In the United
States, OHS legislation remained fragmented
at a state level until the Occupational Safety
and Health Act of 1970.
Although workplace injuries and fatalities
are widely referred to as accidents, the
British Medical Journal has banned the use of
the term as most injuries and their precipi-
tating events are predictable and preventable
(BMJ 2001). Thus approaches to improving
OHS involve an implicit analysis of why
deaths, injuries, and diseases occur. This is
politically contentious as workers represent-
ative organizations, employers, governments,
and health and safety professionals frequently
have differing views on who is responsible for
health and safety in workplaces, and how to
improve it.
The Robens report issued in 1972 and sub-
sequently incorporated into United
Kingdom law marked an influential shift to
regulated self-regulation which borrowed
from the Scandinavian model to involve
workers and management in regulating
safety at a workplace level, while making the
unsubstantiated claim that they had a natu-
ral identity of interest on health and safety
issues. These reforms meant replacing or
reducing regulatory standards that specified
how work should be done safely, and intro-
ducing process standards that regulated
how safety was managed in workplaces.
Similar reforms were undertaken in much of
the English-speaking world, the Netherlands,
and France, and were incorporated into
ILO Convention 155 and EU standards.
From 1989 onward, European Union (EU)
Framework Directives (required to be incor-
porated into national law in EU countries)
also included process standards, mainly the
duty to assess and manage work risks using
competent support and to engage with
workers and their representatives in this
process. The notable exception is the United
States, where the 1970 Act is still based on the
older prescriptive model and contains no sig-
nificant provisions for the consultation or
participation of workers (McGarity and
Shapiro 1993).
Research has established that workers
participation is critical to improving OHS.
However, workers, their organizations, soci-
ologists, and historians have disputed the
claim that workers and employers have a
natural identity of interest on safety. Instead,
the evidence shows that the effectiveness of
worker participation in improving safety
depends on the presence of autonomous
worker organization at a workplace level and
on support from unions which employers
4
frequently oppose, and without which
consultation can become a token exercise
(Walters and Nichols 2009).
Private voluntary process standards on
OHS have also been developed, marketed,
and adopted by many companies. Many
OHS inspectorates take proof of adoption of
one of these voluntary standards as evidence
of compliance with government OHS pro-
cess regulations. However, these voluntary
standards vary widely in their incorporation
of workers participation and in their recog-
nition of organizational OHS risks and
hazards, and tend to focus on individual
measures such as medical screening and
monitoring and on modifying workers
individual behavior. Better standards involve
monitoring and modifying the work envi-
ronment where necessary. However, the
effectiveness of these voluntary systems
has rarely been independently tested. A
comprehensive approach to reducing work-
related harm requires workers participation
in processes for recog nizing and modifying
organizational and other hazards, supported
by independent union organization and
properly resourced OHS inspect orates
(Walters et al. 2011).
A plethora of process standards and
management systems tends to obscure and
divert attention from the supposed aim of
OHS laws to make workplaces safer for
workers. Globally, rising levels of workplace
deaths, injuries, and diseases do not indicate
that current approaches have been successful.
As working techniques and workplaces
change at a rapid pace, there is a great need for
ongoing research that examines the hazards
that workers experience, how these interact
withother hazards and unfold in different cir-
cumstances, and how to address them.
However, the history of asbestos, to pick just
one example, shows that knowledge is not
enough, as employers and governments may
ignore evidence or even block changes to
working practices that can prevent harm to
workers. Rising global inequality is both
caused by and reflected in global workplaces
through corporate downsizing, outsourcing,
casualization of work, and work intensifica-
tion. Theresult is frequently a reduction in the
organizational power andresources that work-
ers have to keep themselves safe, including
finding themselves nominally self-employed,
outside of consultative processes on safety,
without union support and representation,
and at greater risk of unemployment with
a more limited health and social safety
net. The proper introduction of measures to
significantly reduce work-related harm will
also require workers and those who wish to
reduce work-related harm to address these
broader economic and political questions.
SEE ALSO: EffortReward Imbalance;
Gendered Occupational Hazards; Habitus,
Class, and Health; Health and Globalization;
Health Inequalities, Work, and Welfare; Health,
Political Economy of; Health, Workers; Lay
Expertise; Mental Health and Work; Risk;
Stress and Work
REFERENCES
BMJ. 2001. BMJ bans accidents. British Medical
Journal 322: 13201.
Bohle, Philip, and Quinlan, Michael. 2000. Man-
aging Occupational Health and Safety: A Multi-
disciplinary Approach, 2nd ed. South Yarra,
Australia: Macmillan.
Engels, Friedrich. 1999 [1845]. The Condition of
the Working Class in England. Oxford: Oxford
University Press.
ILO. 2011. ILO Introductory Report: Global
Trends and Challenges on Occupational Safety
and Health. Geneva: International Labour
Organization.
McGarity, Thomas, and Shapiro, Sidney. 1993.
Workers at Risk: The Failed Promise of the Occu-
pational Safety and Health Administration.
Westport, CT: Praeger.
5
Ramazzini, Bernardo. 1964 [1713]. Diseases of
Workers. New York: Hafner.
Tombs, Steve, and Whyte, Dave. 2007. Safety
Crimes. Cullompton, UK: Willan.
Walters, David, and Nichols, Theo. 2009. Work-
place Health and Safety: International Perspec-
tives on Worker Representation. Basingstoke,
UK: Palgrave Macmillan.
Walters, David, Johnstone, Richard, Frick, Kaj,
Quinlan, Michael, Baril-Gingras, Genevieve,
and Thebaud-Mony, Annie, eds. 2011. Regu-
lating Workplace Risks: A Comparative Study
of Inspection Regimes in Times of Change.
Cheltenham, UK: Edward Elgar.
WHO. 2010. Asbestos: Elimination of Asbestos-
Related Diseases. World Health Organiza-
tion. Fact Sheet No. 343. http://www.who.int/
mediacentre/factsheets/fs343/en/. Accessed
April 24, 2013.
World Bank. 2012. Labor Force, Total. http://
data.worldbank.org/indicator/SL.TLF.TOTL.IN/
countries?display=graph. Accessed April 24, 2013.
FURTHER READING
Lochlann, Sarah S. 2006. Injury: The Politics of
Product Design and Safety Law in the United
States. Princeton, NJ: Princeton University
Press.
Nichols, Theo. 1997. The Sociology of Industrial
Injury. London: Mansell.
Rosner, David, and Markowitz, Gerald. 2006.
Deadly Dust: Silicosis and the On-Going Struggle
to Protect Workers Health, 2nd ed. Ann Arbor:
University of Michigan Press.
Tucker, Eric, ed. 2006. Working Disasters: The Poli-
tics of Recognition and Response. Amityville, NY:
Baywood.