International Occupational Health: Why Does It Matter?

The health and safety of workers and the preservation of work ability are key factors in socioeconomic growth and sustainability of all countries. In recognition of this, the Decent Work Agenda was launched in 1999 by the International Labor Organization (ILO), and eventually became part of the United Nations’s plan for sustainable development. Decent work is defined as “productive work for women and men in conditions of freedom, equity and human dignity.” The concept of “Decent Work” consists of four interrelated objectives:

Employment, fundamental worker rights, social security, and occupational health (OH) and safety coupled with gender equality, non-discrimination, and two-way social dialogue (Rantanen et al., 2020).

To fulfill the goals of the Decent Work Agenda, the World Health Organization, the U.S. National Institute for Occupational Safety and Health (NIOSH) Total Worker Health© program, and European efforts for worker well-being must not only continue to mitigate exposures to physical, chemical, and biological agents, but also account for demographic changes (i.e., an increasing number of women, immigrants, and older individuals in the workplace) coupled with an increase in mental and physical chronic diseases, globalization, emerging psychosocial hazards, rising employment and economic pressures, and changing work environments (Schulte et al., 2022).

What is the current status of international OH efforts to meet the objectives of the Decent Work Agenda? The International Commission on Occupational Health (ICOH, 2023) is a non-governmental, international professional society which specializes in the training and education of OH experts to better navigate the rapidly changing world of work. In 2017, a total of 49 ICOH member nations—which employ approximately 70% of the world labor force—responded to an ICOH sponsored survey. While OH structures, funding methods, and guidelines differed across the globe, the basic goals of OH were surprisingly similar. Eighty-two percent of the member countries noted they were engaged in risk assessment, accident prevention, medical surveillance of workers and the workplace, health education, and the diagnosis of occupational diseases. In 67% of the participating countries, OH policies were developed, and services implemented via institutes of OH, national OH authorities, professional organizations, and universities (Rantanen et al., 2017).

While many countries may have OH policies and goals, there is an implementation gap. The occupational health services coverage of all workers was estimated to be 24.8% with wide variations across regions. The content of OH services in ICOH member countries is in line with international guidance. Yet, international OH coverage remains inadequate due to a shortage of appropriately trained, multidisciplinary OH professionals, a lack of systematic tracking statistics, and poor infrastructures (Rantanen et al., 2017).

Differences in OH structures, national health care systems, and social security affect the content, coverage, and capacity among nations. For OH nurses working in companies with both national and international locations, developing a better understanding of the similarities and differences across national contexts can help inform evidence-based solutions at both policy and practice levels (Jain et al., 2021). Well-trained, experienced OH nurses are needed domestically and internationally to ensure high-quality OH services are available to all (Rantanen et al., 2017).