Pledge on Worker’s Health - a ten year incubation period

WONCA News has begun a regular feature on the subject of Occupational Health including useful resources for clinical practice. This month we revisit the recent statement on worker’s health.  Peter Buijs (left) & Frank van Dijk (right) are the authors - they are Dutch occupational physicians and former family doctors, and for many years active in ICOH.

In the Pledge on Workers’ Health (made by WONCA and the International Commission on Occupational Health (ICOH) in Lisbon, in July 2014) both organisations state their intent to start addressing, together with the WHO, “gaps in services, research and policies for the health and safety of workers, and better integrate occupational health in primary care settings, to the benefit of all workers and their families.

See full story on the WONCA and ICOH statement and pledge on workers and their families.

This Pledge had a long incubation period, and is important for the vast majority of workers worldwide where there is no organised or legislated link between the work /health relationship. The incubation period started at the WONCA Europe Conference, in Kos (2005) where, Peter Buijs (ICOH, and the Dutch Work and Health Research Institute) was invited to present a paper on a kind of ‘Blind Spot’ in Primary Health Care: lack of attention to work-related health issues. The presentation was based on based on research by the Dutch Work and Health Research Institute.

In response, the then WONCA President-elect, Chris van Weel spoke on this theme at the ICOH Centennial Congress (Milan, 2006), and met ICOH-president Jorma Rantanen: the first meeting of WONCA and ICOH leaders. They concluded that workers’ health could benefit worldwide from better collaboration between GPs and occupations physicians. So they proposed the formation of a joint working party, which was established in Dubrovnik (ICOH, 2007). Igor Svab, as WONCA Europe president, represented WONCA there, and also at the next ICOH World Congress (Capetown, 2009). Meanwhile ICOH was present at the WONCA conferences in Istanbul (2008), Basel (2009) and also in Cancun (2010), where Chris van Weel chaired a Round Table on ‘Workers’ Health and primary health care’. So gradually mutual trust and understanding grew between two traditionally separated worlds, with the joint working party playing a connecting role..

It was very important, that the WHO became interested, knowing that only 10-15% of the global workforce has some kind of occupational health care. The rest has none, while often working under the hardest conditions. So, during a WHO expert meeting (Santiago de Chile, 2009), Carol Black (UK) and Peter Buijs proposed the exploration of the potential and willingness of primary health care to pay more attention to workers’ health, in collaboration with occupational health professionals. This became the focus of a successful WHO Conference (The Hague, 2011), with representatives from 40 countries worldwide, as well as WONCA and ICOH presidents (Rich Roberts and Kazutaka Kogi).

The conference outcome changed WHO-strategy towards workers’ health: for expanding workers’ health coverage, primary health care became essential, having a global coverage of 70-80% (1). During the World Health Assembly 2012, WHO organised a Special Session on this issue with Iona Heath being the WONCA speaker; and later the WHO organised a follow up in Geneva. Finally WHO assigned the conduct of a literature search on Primary Health Care and Workers’ Health (2) and supported the development of a website with learning materials for primary health care.

These positive developments eventually led to fruitful WONCA-ICOH talks about more collaboration, starting at the WONCA World conference in Prague (2013), with the authors of this page involved, and resulting in the joint Pledge. Meanwhile ICOH has formed a taskforce to proceed further. So hopefully the coming years will show concrete steps forward, supporting primary health care with tools and information – also the aim of this regular workers’ health article in WONCA News - “to the benefit of all workers and their families.”

Peter Buijs and Frank van Dijk,
occupational physicians/former GPs

1. WHO-director Maria Neira, ICOH World Congress, Cancun, 2012.
2. Buijs PC, Dijk FJH van. Essential interventions on Workers’ Health by Primary Health Care. A scoping review. TNO 2014