Occupational safety and health

Workplace safety notices at the entrance of a Chinese construction site

Construction workers not wearing fall protection equipment

Construction is one of the most dangerous occupations in the world, incurring more occupational fatalities than any other sector in both the United States and in the European Union.[40][41] In 2009, the fatal occupational injury rate among construction workers in the United States was nearly three times that for all workers.[40] Falls are one of the most common causes of fatal and non-fatal injuries among construction workers.[40] Proper safety equipment such as harnesses and guardrails and procedures such as securing ladders and inspecting scaffolding can curtail the risk of occupational injuries in the construction industry.[42] Due to the fact that accidents may have disastrous consequences for employees as well as organizations, it is of utmost importance to ensure health and safety of workers and compliance with HSE construction requirements. Health and safety legislation in the construction industry involves many rules and regulations. For example, the role of the Construction Design Management (CDM) Coordinator as a requirement has been aimed at improving health and safety on-site.[43]

The 2010 National Health Interview Survey Occupational Health Supplement (NHIS-OHS) identified work organization factors and occupational psychosocial and chemical/physical exposures which may increase some health risks. Among all U.S. workers in the construction sector, 44% had non-standard work arrangements (were not regular permanent employees) compared to 19% of all U.S. workers, 15% had temporary employment compared to 7% of all U.S. workers, and 55% experienced job insecurity compared to 32% of all U.S. workers. Prevalence rates for exposure to physical/chemical hazards were especially high for the construction sector. Among nonsmoking workers, 24% of construction workers were exposed to secondhand smoke while only 10% of all U.S. workers were exposed. Other physical/chemical hazards with high prevalence rates in the construction industry were frequently working outdoors (73%) and frequent exposure to vapors, gas, dust, or fumes (51%).[44]

Rollover protection bar on a Fordson tractor

Agriculture workers are often at risk of work-related injuries, lung disease, noise-induced hearing loss, skin disease, as well as certain cancers related to chemical use or prolonged sun exposure. On industrialized farms, injuries frequently involve the use of agricultural machinery. The most common cause of fatal agricultural injuries in the United States is tractor rollovers, which can be prevented by the use of roll over protection structures which limit the risk of injury in case a tractor rolls over.[45] Pesticides and other chemicals used in farming can also be hazardous to worker health,[46] and workers exposed to pesticides may experience illnesses or birth defects.[47] As an industry in which families, including children, commonly work alongside their families, agriculture is a common source of occupational injuries and illnesses among younger workers.[48] Common causes of fatal injuries among young farm worker include drowning, machinery and motor vehicle-related accidents.[49]

The 2010 NHIS-OHS found elevated prevalence rates of several occupational exposures in the agriculture, forestry, and fishing sector which may negatively impact health. These workers often worked long hours. The prevalence rate of working more than 48 hours a week among workers employed in these industries was 37%, and 24% worked more than 60 hours a week.[50] Of all workers in these industries, 85% frequently worked outdoors compared to 25% of all U.S. workers. Additionally, 53% were frequently exposed to vapors, gas, dust, or fumes, compared to 25% of all U.S. workers.[51]

As the number of service sector jobs has risen in developed countries, more and more jobs have become sedentary, presenting a different array of health problems than those associated with manufacturing and the primary sector. Contemporary problems such as the growing rate of obesity and issues relating to occupational stress, workplace bullying, and overwork in many countries have further complicated the interaction between work and health.

According to data from the 2010 NHIS-OHS, hazardous physical/chemical exposures in the service sector were lower than national averages. On the other hand, potentially harmful work organization characteristics and psychosocial workplace exposures were relatively common in this sector. Among all workers in the service industry, 30% experienced job insecurity in 2010, 27% worked non-standard shifts (not a regular day shift), 21% had non-standard work arrangements (were not regular permanent employees).[52]

Due to the manual labour involved and on a per employee basis, the US Postal Service, UPS and FedEx are the 4th, 5th and 7th most dangerous companies to work for in the US.[53]

The mining industry still has one of the highest rates of fatalities of any industry.[54] There are a range of hazards present in surface and underground mining operations. In surface mining, leading hazards include such issues as geological stability,[55] contact with plant and equipment, blasting, thermal environments (heat and cold), respiratory health (Black Lung)[56] In underground mining operations hazards include respiratory health, explosions and gas (particularly in coal mine operations), geological instability, electrical equipment, contact with plant and equipment, heat stress, inrush of bodies of water, falls from height, confined spaces. ionising radiation[57]

According to data from the 2010 NHIS-OHS, workers employed in mining and oil and gas extraction industries had high prevalence rates of exposure to potentially harmful work organization characteristics and hazardous chemicals. Many of these workers worked long hours: 50% worked more than 48 hours a week and 25% worked more than 60 hours a week in 2010. Additionally, 42% worked non-standard shifts (not a regular day shift). These workers also had high prevalence of exposure to physical/chemical hazards. In 2010, 39% had frequent skin contact with chemicals. Among nonsmoking workers, 28% of those in mining and oil and gas extraction industries had frequent exposure to secondhand smoke at work. About two-thirds were frequently exposed to vapors, gas, dust, or fumes at work.[58]

Beekeepers often wear protective clothing, for OHS reasons.

Healthcare workers are exposed to many hazards that can adversely affect their health and well-being.[59] Long hours, changing shifts, physically demanding tasks, violence, and exposures to infectious diseases and harmful chemicals are examples of hazards that put these workers at risk for illness and injury. Musculoskeletal injury (MSI) is the most common health hazard in for healthcare workers and in workplaces overall.[60] Injuries can be prevented by using proper body mechanics.[61]

According to the Bureau of Labor statistics, U.S. hospitals recorded 253,700 work-related injuries and illnesses in 2011, which is 6.8 work-related injuries and illnesses for every 100 full-time employees.[62] The injury and illness rate in hospitals is higher than the rates in construction and manufacturing – two industries that are traditionally thought to be relatively hazardous.

Dental professionals and their teams encounter multiple exposures daily to occupational hazards in dentistry.[63] These occupational exposures are detrimental to their health, especially when they are chronic in nature.[63]

• Exposure to noise: Any undesirable sound present in the working environment is referred to as occupational noise.[63] According to the OSHA, when working five days a week in any environment, the international standard of the eight-hour daily occupational exposure should not be greater than 85 decibels (dBA), and anything above this could cause noise-induced hearing loss.[63] Hearing loss due to irreversible injury to the inner ear from chronic, cumulative exposure to loud sounds is called noise-induced hearing loss (NIHL).[64] Buzzing and ringing of the ear, also called tinnitus, and dulled hearing are symptoms of NIHL.[64] Several health problems arise due to overexposure to loud noises such as stress, disruption in sleep patterns, cardiovascular disorders, anxiety, fatigue, and depression.[64] Dental professionals are exposed to noise generated by a wide variety of instruments like ultrasonic scalers, suction, and air rotor handpieces.[64] The recommended maximum exposure limit to sound in an 8-hour workday is 85 dBA.[64] In a study, unobstructed suction noise levels had a range of 75–79 dBA, while obstructed suction had a noise level of 96 dBA, and it was recommended that professionals should not have an exposure of more than 1 hour in such a workplace.[64] High-intensity sounds from ultrasonic scalers range between 69 and 84 dBA within the safe 8-hour limit for occupational noise.[63][64] Threshold shift, the reduction in hearing due to reduced sensitivity level of ears due to noise exposure, occurs due to the use of an ultrasonic scaler, and although this is found to last between 16 hours to almost 2 days, it could cause irreversible damage.[64] In a study conducted in the Dental School of Prince of Songkla University, Thailand, noise annoyance in the dental clinic has been reported by 80% of dental students.[65] The highest percentage of noise dose exposure is found in clinics for pediatric patients.[65]
• Exposure to inhalational anesthetics: Several inhalational anesthetic agents are used in dentistry nowadays like isoflurane, sevoflurane, desflurane, and halothane.[66] But we are most concerned about gaseous sedative, nitrous oxide.[66] Long-term exposures to nitrous oxide may lead to adverse effects on human health such as infertility, neurologic disorders, blood disorders, and spontaneous abortion.[67][68] Researchers believe that when operating rooms without proper ventilation systems have high non-scavenged gas exposures, the risk of spontaneous abortion increases.[68] It is found that despite intact scavenging systems in dental clinics, sometimes nitrous oxide exposure exceeds the NIOSH recommended limit of 25 ppm by more than 40 times.[69] NIOSH advises dental professionals to use additional ventilation or increase air circulation in the operating rooms to tackle the high nitrous oxide exposure.[69]
• Exposure to elemental mercury: The most likely source of exposure to elemental mercury for dental professionals is mercury release in dental amalgam restorations.[70] Due to prolonged practice in the field of dentistry and working with amalgam there is a significant exposure to mercury among professionals.[71] Inhalation of Hg leads to its absorption in the lungs and accumulation in kidneys, and evidence suggests that dental professionals have higher urinary mercury levels.[70][71] About 84.9% of dental practitioners among those attending a health screening program in the annual ADA session in San Francisco, California, were found to restore teeth with 1-200 dental amalgam restorations in a week, and about 4.2% did a minimum of 50 dental amalgam fillings in a week.[71] Minute quantities of elemental mercury elevate the Hg concentrations in dental clinics, such that it poses threat to human health.[70] Mercury vapors and elemental mercury remain in furniture, floors, clothes for years if not cleaned properly, and contribute to being a chronic source of exposure.[70] The limit for elemental mercury vapor in workplaces is 0.05 mg/m³ as recommended by OSHA, especially for workers working 40 hours in a week for 8 hours per day, and that for elemental mercury vapor in workplaces set by NIOSH is 0.05 mg/m³ for a work shift of 10 hours.[70] Inhaling elemental mercury vapors lead to serious health consequences in humans.[70] Acute exposure to elevated levels to Hg leads to headaches, insomnia, irritability, memory loss, and slow sensory and motor nerve function along with depressed cognition, renal failure, chest pain, dyspnea, and impaired lung activity.[72] Chronic exposures to elemental mercury lead to hypersalivation and erethism.[72] Several studies show the risk of spontaneous abortions and birth defects in infants on elemental mercury exposure.[72] Elemental mercury has a reference concentration of 0.0003 mg/m³, and when exposures are greater than this level, the possibility of harmful consequences to health increases.[72]

Number of occupational fatal work injuries in the U.S. from 1992 until 2014. Note, 2001 statistics do not include death related to the September 11 terrorist attacks.

The Occupational Safety and Health Statistics (OSHS) program in the Bureau of Labor Statistics of the United States Department of Labor compiles information about workplace fatalities and non-fatal injuries in the United States. The OSHS program produces three annual reports:

1. Counts and rates of nonfatal occupational injuries and illnesses by detailed industry and case type (SOII summary data)
2. Case circumstances and worker demographic data for nonfatal occupational injuries and illnesses resulting in days away from work (SOII case and demographic data)
3. Counts and rates of fatal occupational injuries (CFOI data)[73]

In 1970, an estimated 14,000 workers were killed on the job – by 2010, the workforce had doubled, but workplace deaths were down to about 4,500.[74] Between 1913 and 2013, workplace fatalities dropped by approximately 80%.[75]

The Bureau also compiles information about the most dangerous jobs. According to the census of occupational injuries 4,679 people died on the job in 2014.[76] In 2015, a decline in nonfatal workplace injuries and illnesses was observed, with private industry employers reporting approximately 2.9 million incidents, nearly 48,000 fewer cases than in 2014.[77] The Bureau also uses tools like www.AgInjuryNews.org[78] to identify and compile additional sources of fatality reports for their datasets.[79][80]

The rate of fatal work injuries per 100,000 full-time equivalent workers by employee status, 2006–17. Rate = (Fatal work injuries/Total hours worked by all workers) x 200,000,000 where 200,000,000 = base for 100,000 full-time equivalent workers (FTEs) working 40 hours per week, 50 weeks per year.  The total hours worked are annual average estimates from the Current Population Survey (CPS).

A total of 5,147 workers died from a work-related injury in the U.S. in 2017, down slightly from the 2016 total of 5,190. The fatal injury rate was 3.5 per 100,000 full-time equivalent workers, also down from 3.6 in 2016.[82]

About 2.8 million nonfatal workplace injuries and illnesses were reported by private industry employers in 2017, occurring at a rate of 2.8 cases per 100 full-time workers. Both the number of injuries and illnesses and the rate of these cases declined from 2016.[86]

In most countries males comprise the vast majority of workplace fatalities. In the EU as a whole, 94% of death were of males.[89] In the UK the disparity was even greater with males comprising 97.4% of workplace deaths. In the UK there were 171 fatal injuries at work in financial year 2011–2012, compared with 651 in calendar year 1974; the fatal injury rate declined over that period from 2.9 fatalities per 100,000 workers to 0.6 per 100,000 workers.[90] Of course the period saw the virtual disappearance from the UK of some historically risky industries (deep sea fishing, coal mining).

Source: official data FSSS, document Socio-economic indicators of the RF 1991-2016 / Социально-экономические показатели РФ в 1991-2016 on FSSS site

One of the decisions taken by Communists during the reign of Stalin was the reduction in the number of accidents and occupational diseases to zero.[91] The tendency to decline remained in the RF in the early 21st century, and the same methods of falsification are used, so that the real occupational morbidity and the number of accidents are unknown.[92]

After the destruction of the USSR, the enterprises became owned by new owners who were not interested in preserving the life and health of workers. They did not spend money on equipment modernization, and the share of harmful workplaces increased.[93] The state did not interfere in this, and sometimes it helped employers. At first, the process of growth was slow, due to the fact that in the 1990s this was compensated by mass de-industrialization (factories with foundries and other harmful types of production were closed). In the 2000s, this method of restraining the growth of the share of harmful workplaces was exhausted. Therefore, in the 2010s the Ministry of Labor adopted the Federal law 426-FZ, which equated the issuance of personal protective equipment to the employee to real improvement of working conditions; and the Ministry of Health made significant changes in the methods of risk assessment in the workplace.[94] This explains the "decline" in the proportion of workers working in harmful conditions after 2014 – it happened not in practice, but only on paper.

Specialists from the Izmerov Research Institute of Occupational Health (the oldest in the world) analyzed information about the health status of workers and the assessment of their working conditions using the new methods of risk assessment. Their findings show that new "methods" do not provide a real picture of working conditions. This is most clearly shown by the results obtained at enterprises producing aluminum. For example, the share of jobs with very harmful working conditions ("labor class" (health hazard class) = 3.4) decreased by an order of magnitude (from 11.6% to 1.2%). But the reduction of the level of harmful factors at these enterprises did not happen at all; and the proportion of workers with chronic intoxication with fluorine compounds was 38.7%.[95]

In the opinion of the state inspector, the use of punishment against the guilty manager (disqualification, ban on executive work) is too rare: "The practice of court decisions shows that disqualification of the leader is possible, but for this he or she must kill 5–7 employees, or more".[96] Responsibility for wrong decisions is absent or very low; and punishment of guilty executives in the construction industry usually does not occur.[97]

National management system standards for occupational health and safety include AS/NZS 4801-2001 for Australia and New Zealand, CAN/CSA-Z1000-14 for Canada and ANSI/ASSE Z10-2012 for the United States.[98][99] Association Française de Normalisation (AFNOR) in France also developed occupational safety and health management standards.[100] In the United Kingdom, non-departmental public body Health and Safety Executive published Managing for health and safety (MFHS), an online guidance.[101] In Germany, the state factory inspectorates of Bavaria and Saxony had introduced the management system OHRIS. In the Netherlands, the management system Safety Certificate Contractors combines management of occupational health and safety and the environment.

ISO 45001 was published in March 2018 and implemented in March 2021.

Previously, the International Labour Organization (ILO) published ILO-OSH 2001, also titled "Guidelines on occupational safety and health management systems" to assist organizations with introducing OSH management systems.[102] These guidelines encourage continual improvement in employee health and safety, achieved via a constant process of policy, organization, planning & implementation, evaluation, and action for improvement, all supported by constant auditing to determine the success of OSH actions.[102] From 1999 to 2018, the occupational health and safety management system standard OHSAS 18001 was adopted as a British and Polish standard and widely used internationally. OHSAS 18000 comprised two parts, OHSAS 18001 and 18002 and was developed by a selection of leading trade bodies, international standards and certification bodies to address a gap where no third-party certifiable international standard existed. It was intended to integrate with ISO 9001 and ISO 14001.[103]

Since March 2021, ISO 45001 has replaced OHSAS 18001 and now acts as a base for workplace health and safety.

In Australia, the Commonwealth, four of the six states and both territories have enacted and administer harmonised Work Health and Safety Legislation in accordance with the Intergovernmental Agreement for Regulatory and Operational Reform in Occupational Health and Safety.[106] Each of these jurisdictions has enacted Work Health & Safety legislation and regulations based on the Commonwealth Work Health and Safety Act 2011 and common Codes of Practice developed by Safe Work Australia.[107] Some jurisdictions have also included mine safety under the model approach, however, most have retained separate legislation for the time being. In August 2019 Western Australia committed to join nearly every other State and Territory in implementing the harmonised Model WHS Act, Regulations and other subsidiary legislation.[108] Victoria has retained its own regime, although the Model WHS laws themselves drew heavily on the Victoria approach.

In Canada, workers are covered by provincial or federal labour codes depending on the sector in which they work. Workers covered by federal legislation (including those in mining, transportation, and federal employment) are covered by the Canada Labour Code; all other workers are covered by the health and safety legislation of the province in which they work. The Canadian Centre for Occupational Health and Safety (CCOHS), an agency of the Government of Canada, was created in 1978 by an Act of Parliament. The act was based on the belief that all Canadians had "a fundamental right to a healthy and safe working environment." CCOHS is mandated to promote safe and healthy workplaces to help prevent work-related injuries and illnesses. The CCOHS maintains a useful (partial) list of OSH regulations for Canada and its provinces.[109]

In the European Union, member states have enforcing authorities to ensure that the basic legal requirements relating to occupational health and safety are met. In many EU countries, there is strong cooperation between employer and worker organisations (e.g. unions) to ensure good OSH performance as it is recognized this has benefits for both the worker (through maintenance of health) and the enterprise (through improved productivity and quality). In 1994, the European Agency for Safety and Health at Work was founded.

Member states of the European Union have all transposed into their national legislation a series of directives that establish minimum standards on occupational health and safety. These directives (of which there are about 20 on a variety of topics) follow a similar structure requiring the employer to assess the workplace risks and put in place preventive measures based on a hierarchy of control. This hierarchy starts with elimination of the hazard and ends with personal protective equipment.

However, certain EU member states admit to having lacking quality control in occupational safety services, to situations in which risk analysis takes place without any on-site workplace visits and to insufficient implementation of certain EU OSH directives. Based on this, it is hardly surprising that the total societal costs of work-related health problems and accidents vary from 2.6% to 3.8% of GNP between the EU member states.[112]

In Denmark, occupational safety and health is regulated by the Danish Act on Working Environment and cooperation at the workplace.[113] The Danish Working Environment Authority (Arbejdstilsynet) carries out inspections of companies, draws up more detailed rules on health and safety at work and provides information on health and safety at work.[114] The result of each inspection is made public on the web pages of the Danish Working Environment Authority so that the general public, current and prospective employees, customers and other stakeholders can inform themselves about whether a given organization has passed the inspection.[115]

In the Netherlands the laws for safety and health at work are registered in the Working Conditions Act (Arbeidsomstandighedenwet and Arbeidsomstandighedenbeleid). Apart from the direct laws directed to safety and health in working environments, the private domain has added health and safety rules in Working Conditions Policies (Arbeidsomstandighedenbeleid), which are specified per industry. The Ministry of Social Affairs and Labour (SZW) monitors adherence to the rules through their inspection service. This inspection service investigates industrial accidents and the service can suspend work when the Working Conditions Act has been violated and impose fines. Companies can raise their security levels by certifying the company with a VCA-certificate (Safety, Health and Environment). All employees have to obtain a VCA-certificate too, with which they can prove that they know how to work according to the current and applicable safety and environmental regulations. Besides the VCA-certification, companies and organisations are able to acquire certifications on ISO guidelines. The International Organization for Standardization publish guidelines for safety and health in working environments, mostly focused on a particular part, such as Risk Management (ISO31000) or Occupational Health and Safety (ISO45001).[116] By acquiring certifications to these guidelines, companies and organisations will often comply to demands from the government or insurance agencies.

The main health and safety law in Ireland is the Safety, Health and Welfare at Work Act 2005,[117] which replaced earlier 1989 legislation. The Health and Safety Authority, based in Dublin, is responsible for enforcing health and safety at work legislation.[117]

In Spain, occupational safety and health is regulated by the Spanish Act on Prevention of Labour Risks. The Ministry of Labour is the authority responsible for issues relating to labour environment.[118] The National Institute for Labour Safety and Hygiene is the technical public Organization specialized in occupational safety and health.[119]

In Sweden, occupational safety and health is regulated by the Work Environment Act. The Swedish Work Environment Authority is the government agency responsible for issues relating to the working environment. The agency should work to disseminate information and furnish advice on OSH, has a mandate to carry out inspections, and a right to issue stipulations and injunctions to any non-compliant employer.[120]

In India, the Labour Ministry formulates national policies on occupational safety and health in factories and docks with advice and assistance from Directorate General of Factory Advice Service and Labour Institutes (DGFASLI), and enforces its Policies through inspectorates of factories and inspectorates of dock safety.[121] DGFASLI is the technical arm of the Ministry of Labour & Employment, Government of India and advises the factories on various problems concerning safety, health, efficiency and well-being of the persons at work places.[121] The DGFASLI provides technical support in formulating rules, conducting occupational safety surveys and also for conducting occupational safety training programs.[122]

In Indonesia, the Ministry of Manpower is responsible to ensure the safety, health and welfare of workers while working, in a factory, or even the area surrounding the factory where labourers work. There are a few rules that control the safety of workers, for example Occupational Safety Act 1970 or Occupational Health Act 1992.[123] The sanctions, however, are still low and the violations of these laws are still at a high rate – with a maximum of 15 million rupiahs fine and/or a maximum of one year in prison.[124]

In Malaysia, the Department of Occupational Safety and Health (DOSH) under the Ministry of Human Resource is responsible to ensure that the safety, health and welfare of workers in both the public and private sector is upheld. DOSH is responsible to enforce the Factories and Machinery Act 1967 and the Occupational Safety and Health Act 1994. Malaysia has a statutory mechanism for worker involvement through elected health and safety representatives and health and safety committees. This followed a similar approach originally adopted in Scandinavia.

Hardware stores in China specializing in safety equipment

In the People's Republic of China, the Ministry of Health is responsible for occupational disease prevention and the State Administration of Work Safety for safety issues at work. On the provincial and municipal level, there are Health Supervisions for occupational health and local bureaus of Work Safety for safety. The "Occupational Disease Control Act of PRC" came into force on May 1, 2002.[125] and Work safety Act of PRC on November 1, 2002.[126] The Occupational Disease Control Act is under revision. The prevention of occupational disease is still in its initial stage compared with industrialised countries such as the US or UK.

In Singapore, the Ministry of Manpower operates various checks and campaigns against unsafe work practices, such as when working at height, operating cranes and in traffic management. Examples include Operation Cormorant and the Falls Prevention Campaign.[127]

In South Africa the Department of Employment and Labour is responsible for occupational health and safety inspection and enforcement in commerce and industry apart from mining and energy production, where the Department of Mineral Resources is responsible.

The main statutory legislation on Health and Safety in the jurisdiction of the Department of Labour is Act No. 85 of 1993: Occupational Health and Safety Act as amended by Occupational Health and Safety Amendment Act, No. 181 Of 1993.

Regulations to the OHS Act include:

• General Administrative Regulations, 2003[128]
• Certificate of Competency Regulations, 1990[129]
• Construction Regulations, 2014
• Diving Regulations 2009[130]
• Driven Machinery Regulations, 1988[131]
• Environmental Regulations for Workplaces, 1987[132]
• General Machinery regulations, 1988[133]
• General Safety Regulations, 1986[134]
• Noise induced hearing loss regulations, 2003[135]
• Pressure Equipment Regulations, 2004

In Syria, health and safety is the responsibility of the Ministry of Social Affairs and Labour.[136]

In Taiwan, the Occupational Safety and Health Administration of the Ministry of Labor is in charge of occupational safety and health.[137] The matter is governed under the Occupational Safety and Health Act.[138]

In 2007, the Taiwan Occupational Safety and Health Management System (TOSHMS), which defined the basic regulations about occupational safety standard, was released.[139]

OSHAD was introduced in February 2010 to regulate the implementation of occupational health and safety in the emirates of Abu Dhabi.[140]

Health and safety legislation in the UK is drawn up and enforced by the Health and Safety Executive and local authorities (the local council) under the Health and Safety at Work etc. Act 1974[141][142] (HASAWA). HASAWA introduced (section 2) a general duty on an employer to ensure, so far as is reasonably practicable, the health, safety and welfare at work of all his employees; with the intention of giving a legal framework supporting 'codes of practice' not in themselves having legal force but establishing a strong presumption as to what was reasonably practicable (deviations from them could be justified by appropriate risk assessment). The previous reliance on detailed prescriptive rule-setting was seen as having failed to respond rapidly enough to technological change, leaving new technologies potentially un-regulated or inappropriately regulated.[143][144] HSE has continued to make some regulations giving absolute duties (where something must be done with no 'reasonable practicability' test) but in the UK the regulatory trend is away from prescriptive rules, and towards 'goal setting' and risk assessment. Recent major changes to the laws governing asbestos and fire safety management embrace the concept of risk assessment. The other key aspect of the UK legislation is a statutory mechanism for worker involvement through elected health and safety representatives and health and safety committees. This followed a similar approach in Scandinavia, and that approach has since been adopted in countries such as Australia, Canada, New Zealand and Malaysia.

For the UK, the government organisation dealing with occupational health has been the Employment Medical Advisory Service but in 2014 a new occupational health organisation – the Health and Work Service – was created to provide advice and assistance to employers in order to get back to work employees on long-term sick-leave.[145] The service, funded by government, will offer medical assessments and treatment plans, on a voluntary basis, to people on long-term absence from their employer; in return, the government will no longer foot the bill for Statutory Sick Pay provided by the employer to the individual.

In the United States, President Richard Nixon signed the Occupational Safety and Health Act into law on December 29, 1970. The act created the three agencies which administer OSH: the Occupational Safety and Health Administration, National Institute for Occupational Safety and Health, and the Occupational Safety and Health Review Commission.[146] The act authorized the Occupational Safety and Health Administration OSHA to regulate private employers in the 50 states, the District of Columbia, and territories.[147] The Act establishing it includes a general duty clause (29 U.S.C. § 654, 5(a)) requiring an employer to comply with the Act and regulations derived from it, and to provide employees with "employment and a place of employment which are free from recognized hazards that are causing or are likely to cause [them] death or serious physical harm".

OSHA was established in 1971 under the Department of Labor. It has headquarters in Washington, DC, and ten regional offices, further broken down into districts, each organized into three sections; compliance, training, and assistance. Its stated mission is "to assure safe and healthful working conditions for working men and women by setting and enforcing standards and by providing training, outreach, education and assistance."[148] The original plan was for OSHA to oversee 50 state plans with OSHA funding 50% of each plan, although it has not worked out that way: there are currently 26 approved state plans (4 cover only public employees),[74] and no other states want to participate. OSHA manages the plan in the states not participating.[74]

OSHA develops safety standards in the Code of Federal Regulations and enforces those safety standards through compliance inspections conducted by Compliance Officers; enforcement resources are focussed on high-hazard industries. Worksites may apply to enter OSHA's Voluntary Protection Program (VPP); a successful application leads to an on-site inspection; if this is passed the site gains VPP status and OSHA no longer inspect it annually nor (normally) visit it unless there is a fatal accident or an employee complaint until VPP revalidation (after 3–5 years).[74] VPP sites generally have injury and illness rates less than half the average for their industry.

It has 73 specialists in local offices to provide tailored information and training to employers and employees at little or no cost.[5] Similarly OSHA produces a range of publications, provides advice to employers and funds consultation services available for small businesses.

OSHA's Alliance Program enables groups committed to worker safety and health to work with it to develop compliance assistance tools and resources, share information with workers and employers, and educate them about their rights and responsibilities. OSHA also has a Strategic Partnership Program that zeros in on specific hazards or specific geographic areas.[74] OSHA manages Susan B. Harwood grants to non-profit organisations to train workers and employers to recognize, avoid, and prevent safety and health hazards in the workplace. Grants focus on small business, hard-to-reach workers and high-hazard industries.

The National Institute for Occupational Safety and Health, created under the same act, works closely with OSHA and provides the research behind many of OSHA's regulations and standards.[149]

In Norway, the main required tasks of an occupational health and safety practitioner include the following:

• Systematic evaluations of the working environment
• Endorsing preventive measures which eliminate causes of illnesses in the workplace
• Providing information on the subject of employees' health
• Providing information on occupational hygiene, ergonomics, and environmental and safety risks in the workplace[150]

In the Netherlands, the required tasks for health and safety staff are only summarily defined and include the following:

• Providing voluntary medical examinations
• Providing a consulting room on the work environment to the workers
• Providing health assessments (if needed for the job concerned).[151]

"The main influence of the Dutch law on the job of the safety professional is through the requirement on each employer to use the services of a certified working conditions service to advise them on health and safety".[151] A "certified service" must employ sufficient numbers of four types of certified experts to cover the risks in the organisations which use the service:

• A safety professional
• An occupational hygienist
• An occupational physician
• A work and organisation specialist.[151]

In 2004, 37% of health and safety practitioners in Norway and 14% in the Netherlands had an MSc; 44% had a BSc in Norway and 63% in the Netherlands; and 19% had training as an OSH technician in Norway and 23% in the Netherlands.[151]

Leather craftsman gloves, safety goggles, and a properly fitted hardhat are crucial for proper safety in a construction environment.

The main tasks undertaken by the OHS practitioner in the US include:

• Develop processes, procedures, criteria, requirements, and methods to attain the best possible management of the hazards and exposures that can cause injury to people, and damage property, or the environment;
• Apply good business practices and economic principles for efficient use of resources to add to the importance of the safety processes;
• Promote other members of the company to contribute by exchanging ideas and other different approaches to make sure that every one in the corporation possess OHS knowledge and have functional roles in the development and execution of safety procedures;
• Assess services, outcomes, methods, equipment, workstations, and procedures by using qualitative and quantitative methods to recognise the hazards and measure the related risks;
• Examine all possibilities, effectiveness, reliability, and expenditure to attain the best results for the company concerned.[152]

Knowledge required by the OHS professional in the US include:

• Constitutional and case law controlling safety, health, and the environment
• Operational procedures to plan/develop safe work practices
• Safety, health and environmental sciences
• Design of hazard control systems (i.e. fall protection, scaffoldings)
• Design of recordkeeping systems that take collection into account, as well as storage, interpretation, and dissemination
• Mathematics and statistics
• Processes and systems for attaining safety through design.[153]

Some skills required by the OHS professional in the US include (but are not limited to):

• Understanding and relating to systems, policies and rules
• Holding checks and having control methods for possible hazardous exposures
• Mathematical and statistical analysis
• Examining manufacturing hazards
• Planning safe work practices for systems, facilities, and equipment
• Understanding and using safety, health, and environmental science information for the improvement of procedures
• Interpersonal communication skills.[153]

The terminology used in OSH varies between countries, but generally speaking:

• A hazard is something that can cause harm if not controlled.
• The outcome is the harm that results from an uncontrolled hazard.
• A risk is a combination of the probability that a particular outcome will occur and the severity of the harm involved.[156]

"Hazard", "risk", and "outcome" are used in other fields to describe e.g. environmental damage, or damage to equipment. However, in the context of OSH, "harm" generally describes the direct or indirect degradation, temporary or permanent, of the physical, mental, or social well-being of workers. For example, repetitively carrying out manual handling of heavy objects is a hazard. The outcome could be a musculoskeletal disorder (MSD) or an acute back or joint injury. The risk can be expressed numerically (e.g. a 0.5 or 50/50 chance of the outcome occurring during a year), in relative terms (e.g. "high/medium/low"), or with a multi-dimensional classification scheme (e.g. situation-specific risks).

Hazard identification or assessment is an important step in the overall risk assessment and risk management process. It is where individual work hazards are identified, assessed and controlled/eliminated as close to source (location of the hazard) as reasonably as possible. As technology, resources, social expectation or regulatory requirements change, hazard analysis focuses controls more closely toward the source of the hazard. Thus hazard control is a dynamic program of prevention. Hazard based programs also have the advantage of not assigning or implying there are "acceptable risks" in the workplace.[157] A hazard-based program may not be able to eliminate all risks, but neither does it accept "satisfactory" – but still risky – outcomes. And as those who calculate and manage the risk are usually managers while those exposed to the risks are a different group, workers, a hazard-based approach can by-pass conflict inherent in a risk-based approach.

The information that needs to be gathered from sources should apply to the specific type of work from which the hazards can come from. As mentioned previously, examples of these sources include interviews with people who have worked in the field of the hazard, history and analysis of past incidents, and official reports of work and the hazards encountered. Of these, the personnel interviews may be the most critical in identifying undocumented practices, events, releases, hazards and other relevant information. Once the information is gathered from a collection of sources, it is recommended for these to be digitally archived (to allow for quick searching) and to have a physical set of the same information in order for it to be more accessible. One innovative way to display the complex historical hazard information is with a historical hazards identification map, which distills the hazard information into an easy to use graphical format. In the construction industry specifically, job hazard analysis (JHA) software allows safety managers and crew members to identify potential hazards at the job site and improve accident prevention.[158]

Modern occupational safety and health legislation usually demands that a risk assessment be carried out prior to making an intervention. It should be kept in mind that risk management requires risk to be managed to a level which is as low as is reasonably practical.[159]

This assessment should:

• Identify the hazards
• Identify all affected by the hazard and how
• Evaluate the risk
• Identify and prioritize appropriate control measures.

The calculation of risk is based on the likelihood or probability of the harm being realized and the severity of the consequences. This can be expressed mathematically as a quantitative assessment (by assigning low, medium and high likelihood and severity with integers and multiplying them to obtain a risk factor), or qualitatively as a description of the circumstances by which the harm could arise.

The assessment should be recorded and reviewed periodically and whenever there is a significant change to work practices. The assessment should include practical recommendations to control the risk. Once recommended controls are implemented, the risk should be re-calculated to determine if it has been lowered to an acceptable level. Generally speaking, newly introduced controls should lower risk by one level, i.e., from high to medium or from medium to low.[160]

A nanomaterial containment hood, an example of an engineering control used to protect workers handling them on a regular basis

Nanotechnology is an example of a new, relatively unstudied technology. A Swiss survey of 138 companies using or producing nanoparticulate matter in 2006 resulted in forty completed questionnaires. Sixty-five per cent of respondent companies stated they did not have a formal risk assessment process for dealing with nanoparticulate matter.[164] Nanotechnology already presents new issues for OSH professionals that will only become more difficult as nanostructures become more complex. The size of the particles renders most containment and personal protective equipment ineffective. The toxicology values for macro sized industrial substances are rendered inaccurate due to the unique nature of nanoparticulate matter. As nanoparticulate matter decreases in size its relative surface area increases dramatically, increasing any catalytic effect or chemical reactivity substantially versus the known value for the macro substance. This presents a new set of challenges in the near future to rethink contemporary measures to safeguard the health and welfare of employees against a nanoparticulate substance that most conventional controls have not been designed to manage.[165]

Many countries' health and safety at work arrangements are currently focused on protection against the spread of COVID-19.[166][167] Both broad and industry-specific workplace hazard controls for COVID-19 have been proposed to minimize risks of disease transmission in the workplace.

The National Institute of Occupational Safety and Health (NIOSH) National Occupational Research Agenda Manufacturing Council established an externally-lead COVID-19 workgroup to provide exposure control information specific to working in manufacturing environments. The workgroup identified disseminating information most relevant to manufacturing workplaces as a priority, and that would include providing content in Wikipedia. This includes evidence-based practices for infection control plans,[168] and communication tools.

Occupational health disparities refer to differences in occupational injuries and illnesses that are closely linked with demographic, social, cultural, economic, and/or political factors.[169]