Forthcoming in 2013 in:

The Wiley-Blackwell Encyclopedia of Health, Illness, Behaviour, and Society

Occupational Health and Safety
Dr. Penny McCall Howard

Abstract
At least 2.34 million people died from work-related incidents or diseases in 2008, and the number is
growing. Workplace hazards range from physical to chemical and organizational, and change continually.
Since the 1970s, many countries (as well as EU and ILO standards) have shifted to regulated self-
regulation for the control of occupational health and safety (OHS) in systems which involve workers
and management in regulating safety at a workplace level, while reducing technical standards. At the
same time, corporate downsizing, outsourcing, casualization of work, and work intensification have had
a negative impact on OHS which must be addressed in order to reduce work-related harm.

Keywords: class; death; disease; employment; globalization; industry; work

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 representative 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 significant 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 workers were injured (ILO 2011,
1011). Globally, the number of work-related fatalities is estimated 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 billion 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 geographic and
organizational patterns of industrial production associated with neoliberal globalization and the global
economic crisis have in many cases increased the intensity and precarity of work and the danger 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 developed. 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 hazardous 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 supervisory pressure, payment
and incentive systems, hours of work and shift arrangements, workload, 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 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, particularly 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 sociologists have argued that modern workplaces and their economic,
legal, and institutional underpinnings 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
unequal power relations between workers and employers (Tombs and Whyte 2007: 7).
Unfortunately, state regulation of occupational 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 involving 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 over 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 (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 to asbestos 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 constructed 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 proportion 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 recognition of these health problems and
investigation 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 significant impact on agricultural workers, cleaners,
transport workers, beauticians, consumers, neighbors of chemical plants, and the environment more
broadly.

Improving OHS
The physician Bernardo Ramazzini described the harvest of diseases reaped by certain workers by the
crafts and trades they pursue in 1713 (1964: 15). Over 100 years later, Engels described horrifying living
conditions among Englands working class, including working conditions in which women [were] made
unfit for childbearing, children deformed, men enfeebled, limbs crushed, whole generations wrecked,
afflicted by disease and infirmity, a situation he described as social murder (1845 [1999]: 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 philanthropists 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, historians 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 nineteenth century in Germany,
Sweden (emphasizing 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 precipitating 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 representative 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 subsequently 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 natural 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 introducing 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
incorated into ILO Convention 155 and EU standards. From 1989 onward, European Union (EU)
Framework Directives (required to be incorporated 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 significant 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, sociologists, 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 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 process regulations. However, these
voluntary standards vary widely in their incorporation of workers participation and in their recognition
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 environment 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 recognizing and modifying organizational
and other hazards, supported by independent union organization and properly resourced OHS
inspectorates (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 rapid pace, there is a great need for ongoing research that
examines the hazards that workers experience, how these interact with other hazards and unfold in
different circumstances, 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 intensification. The result is frequently a reduction in the organizational
power and resources that workers 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. Managing Occupational Health and Safety: A Multidisciplinary
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 Occupational Safety
and Health Administration. Westport, CT: Praeger.
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. Workplace Health and Safety: International Perspectives on Worker
Representation. Basingstoke, UK: Palgrave Macmillan.
Walters, David, Johnstone, Richard, Frick, Kaj, Quinlan, Michael, Baril-Gingras, Genevieve, and
Thebaud-Mony, Annie, eds. 2011. Regulating Workplace Risks: A Comparative Study of Inspection
Regimes in Times of Change. Cheltenham, UK: Edward Elgar.
WHO. 2010. Asbestos: Elimination of Asbestos-Related Diseases. 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:
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 Politics of Recognition and Response. Amityville, NY: Baywood.