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More than 1.4 billion people, most of them in developing countries, work in hazardous settings or occupations. Despite international efforts, the number of workers in vulnerable employment increases by around 11 million each year. Developing countries seldom have enforceable occupational and environmental regulations. Occupational health should have high priority on the international agenda, but occupational safety and health (OSH) regulations and laws cover only about 10% of workers in developing countries and do not include many major hazardous industries and occupations. Progress in bringing occupational health to the industrializing countries is painfully slow. In some of the poorest countries, there has been no progress at all.

The world’s workforce sustains more than 370 million injuries every year, a figure that would be much higher if reliable reporting existed. Only 15% of workers worldwide have access to specialized occupational health services that provide for prevention of occupational risks, health surveillance, training in safe working methods, first aid, and consulting with employers on occupational health and safety. The global epidemic of occupational injury and disease is not new. It is inherent in the nature of industrial development that poorer countries adopt hazardous production. The resultant epidemic of injuries and illnesses is compounded by the rapid transfer of hazardous industries no longer compatible with developed country government regulation. While international standards appear to obligate employers to provide occupational health and safety procedures, and to pay for occupational injury and disease, inadequate prevention, detection, and compensation undermine these standards.

There are nearly 3 million workers known to die each year from occupational accidents and occupational diseases. More people die from traumatic work-related injuries in China than in any other country or region in the world. High workplace fatality figures are also seen in India and in sub-Saharan Africa. The vast majority of these deaths are avoidable and preventable. Occupational cancer is responsible for almost a third of all work-related deaths. Circulatory diseases are the second most common cause of death, accounting for almost a quarter of deaths. Acute traumatic injuries account for just under one-fifth of deaths attributable to work, followed by communicable diseases and respiratory diseases.

Occupational injuries and diseases have a profound effect on the health of the world’s population. Occupational injuries and diseases play an even more important role in developing countries, where 70% of the working population of the world lives. Occupational injuries and diseases have a serious impact on the economy of all countries. Occupational injuries and diseases cause permanent disabilities and economic losses amounting to 4–6% of national incomes, costs to developing countries in excess of $10 trillion. These preventable injuries and diseases also have profound impacts on the work productivity, income, and social well-being of workers and their families. Often ignored is the reality that a single occupational injury or illness can tip an entire family into poverty.

Musculoskeletal disorders account for nearly half ...

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