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The article focuses on a summer course which aims to train healthcare professional working in occupational health (OH) in low- and middle-income countries. The course highlights the practical OH aspects instead of research methods for OH. The first part of this paper describes the course structure, teaching concept and participants, while the second part illustrates the content of the course by comparing OH safety in 18 countries worldwide.

Background: Occupational injuries are a public health problem, estimated to kill more than 300,000 workers worldwide every year and to cause many more cases of disability. We estimate the global burden of fatal and non-fatal unintentional occupational injuries for the year 2000., Methods: The economically active population (EAP) of about 2.9 billion workers was used as a surrogate of the population at risk for occupational injuries. Occupational unintentional injury fatality rates for insured workers, by country, were used to estimate WHO regional rates. These were applied to regional EAP to estimate the number of deaths. In addition to mortality, the disability-adjusted life years (DALYs) lost, which measure both morbidity and mortality, were calculated for 14 WHO regions., Results: Worldwide, hazardous conditions in the workplace were responsible for a minimum of 312,000 fatal unintentional occupational injuries. Together, fatal and non-fatal occupational injuries resulted in about 10.5 million DALYs; that is, about 3.5 years of healthy life are lost per 1,000 workers every year globally. Occupational risk factors are responsible for 8.8% of the global burden of mortality due to unintentional injuries and 8.1% of DALYs due to this outcome., Conclusions: Occupational injuries constitute a substantial global burden. However, our findings greatly underestimate the impact of occupational risk factors leading to injuries in the overall burden of disease. Our estimates could not include intentional injuries at work, or commuting injuries, due to lack of global data. Additional factors contributing to grave underestimation of occupational injuries include limited insurance coverage of workers and substantial under-reporting of fatal injuries in record-keeping systems globally. About 113,000 deaths were probably missed in our analyses due to under-reporting alone. It is clear that known prevention strategies need to be implemented widely to diminish the avoidable burden of injuries in the workplace., (2005 Wiley-Liss, Inc.)

Background: Around the globe, work has a heavy impact on health. To better advise policy makers, we assessed the global burden of disease and injury due to selected occupational hazards. This article presents an overview, and describes the methodology employed in the companion studies., Methods: Using the World Health Organization (WHO) Comparative Risk Assessment methodology, we applied relative risk measures to the proportions of the population exposed to selected occupational hazards to estimate attributable fractions, deaths, and disability-adjusted life years (DALYs). Numerous occupational risk factors had to be excluded due to inadequate global data., Results: In 2000, the selected risk factors were responsible worldwide for 37% of back pain, 16% of hearing loss, 13% of chronic obstructive pulmonary disease (COPD), 11% of asthma, 8% of injuries, 9% of lung cancer, and 2% of leukemia. These risks at work caused 850,000 deaths worldwide and resulted in the loss of about 24 million years of healthy life. Needlesticks accounted for about 40% of Hepatitis B and Hepatitis C infections and 4.4% of HIV infections in health care workers., Conclusions: Exposure to occupational hazards accounts for a significant proportion of the global burden of disease and injury, which could be substantially reduced through application of proven risk prevention strategies., (2005 Wiley-Liss, Inc.)

Background: Occupational non-malignant respiratory disease arises from exposure of workers to airborne agents, mostly particulate or dusts. We describe the worldwide mortality and morbidity from asthma, chronic obstructive pulmonary disease (COPD), and pneumoconioses arising from these occupational exposure and focus on cases reported in the year 2000., Methods: The proportions of workers exposed to the agents, and their levels of exposure, were estimated using workforce data and the CAREX (CARcinogen EXposure) database. These were combined with relative risk measures (for asthma and COPD) or absolute risk measures (for the pneumoconioses) to develop estimates of deaths, disability-adjusted life years (DALYs) and attributable fraction (for asthma and COPD)., Results: There were an estimated 386,000 deaths (asthma: 38,000; COPD: 318,000; pneumoconioses: 30,000) and nearly 6.6 million DALYS (asthma: 1,621,000; COPD: 3,733,000, pneumoconioses: 1,288,000) due to exposure to occupational airborne particulates., Conclusions: Occupational airborne particulates are an important cause of death and disability worldwide., (2005 Wiley-Liss, Inc.)

Background: The worldwide mortality and morbidity from lung cancer, leukemia, and malignant mesothelioma arising from occupational exposures to carcinogens are described. Cases reported in the year 2000 that resulted from relevant past and current exposures are assessed., Methods: The proportions of workers exposed to the carcinogens of interest, and their levels of exposure, were estimated using workforce data and the CAREX (CARcinogen EXposure) database. These were combined with relative risk measures (for lung cancer and leukemia) or absolute risk measures (for malignant mesothelioma) to develop estimates of deaths, disability-adjusted life years (DALYs) and attributable fraction (for lung cancer and leukemia)., Results: There were an estimated 152,000 deaths (lung cancer: 102,000; leukemia: 7,000; and malignant mesothelioma: 43,000) and nearly 1.6 million DALYS (lung cancer: 969,000; leukemia: 101,000; and malignant mesothelioma: 564,000) due to exposure to occupational carcinogens., Conclusions: Occupational carcinogens are an important cause of death and disability worldwide., (2005 Wiley-Liss, Inc.)

Background: Over the last decade, there have been several attempts to estimate the global burden of ill health due to work activity. The most recent of these is the Comparative Risk Assessment (CRA) project of the World Health Organization., Methods: Published estimates of global burden of injury and disease due to occupational factors were summarized, compared, and contrasted with the aim of putting the CRA estimates into context, identifying the most reliable and appropriate estimate for total burden due to occupational risks, and making recommendations regarding future work., Results: The best estimate of global work-related deaths of workers is approximately two million per year, with disease responsible for the vast majority of these, but even this is likely to be a considerable underestimate of the true number of deaths because of shortcomings in the available data., Conclusions: The CRA estimates of burden due to individual risk factors appear appropriate for the limited number of exposures and conditions included, but are a major underestimate of the overall number of work-related deaths at a global level due to exclusion of risk factors because of data limitations. Improvements in global estimates are likely to come from the use of different methodologies and improvements in the availability and use of local data., (2005 Wiley-Liss, Inc.)

Background: Excessive noise is a global occupational health hazard with considerable social and physiological impacts, including noise-induced hearing loss (NIHL). This paper describes the worldwide morbidity of occupational NIHL in the year 2000., Methods: The proportion of the population exposed to occupational noise was estimated using noise exposure data from the US National Institute for Occupational Safety and Health (NIOSH), adjusted by data on the distribution of the work force by occupational category and economic sector, and economic activity rates in each WHO subregion. These values for the exposed population and risk measures for NIHL were used to develop estimates of the attributable fraction (AF) of adult-onset hearing loss resulting from occupational noise exposure. The AFs were applied to WHO estimates of total disability-adjusted life years (DALYs) from adult-onset hearing loss to estimate the DALYs due to occupational noise., Results: Worldwide, 16% of the disabling hearing loss in adults (over 4 million DALYs) is attributed to occupational noise, ranging from 7% to 21% in the various subregions. The effects of the exposure to occupational noise are larger for males than females in all subregions and higher in the developing regions., Conclusions: Occupational noise is a significant cause of adult-onset hearing loss. The majority of this NIHL burden can be minimized by the use of engineering controls to reduce the generation of noise at its source., (2005 Wiley-Liss, Inc.)

Background: There is little information about the global burden of non-traumatic low back pain (LBP) attributable to the effects of physical and psychosocial occupational stressors., Methods: Based on a review of the epidemiological evidence, occupation-specific relative risks were used to compute attributable proportions by age, gender, and geographical sub-region for the economically active population aged 15 and older. The reference group was professional/administrative workers; other risk categories were Low, clerical and sales; Moderate, operators (production workers) and service; and High, farmers., Results: Worldwide, 37% of LBP was attributed to occupation, with twofold variation across regions. The attributable proportion was higher for men than women, because of higher participation in the labor force and in occupations with heavy lifting or whole-body vibration. Work-related LBP was estimated to cause 818,000 disability-adjusted life years lost annually., Conclusions: Occupational exposures to ergonomic stressors represent a substantial source of preventable back pain. Specific research on children is needed to quantify the global burden of disease due to child labor., (2005 Wiley-Liss, Inc.)