Baltic Sea Network on Occupational Health and Safety

Fifth Workshop for Coordinators

Introduction

The meeting was the fifth meeting for the coordinators of the Baltic Sea Network on Occupational Health and Safety project. The contact persons from six countries, Estonia, Germany, Latvia, Lithuania, Poland, and Sweden participated, in addition to the members of the Finnish planning group of the project.

Dr Robertas Petkevicius, Director of the Institute of Hygiene, Ministry of Health, opened the meeting and wished the participants welcome. Short welcome addresses were also presented by Dr Remigijus Jankauskas, Centre of Occupational Health and Ms Suvi Lehtinen, Finnish Institute of Occupational Health.

The programme of the meeting is in Annex 1, and the list of participants in Annex 2.

A Summary of the WHO/EURO Berlin meeting, November 1999

Suvi Lehtinen, FIOH, Finland
The annual meetings of WHO/EURO are organized for long-term strategic planning with apprx. 0,5 days devoted to the Baltic Sea Telematic Network development items. The coordinators' meetings, on the other hand, are to put forward the decisions and recommendations made in the annual meeting.

The Berlin meeting gave a very good feedback to the Baltic Sea Telematic Network. The Network was deemed to be an excellent instrument for information exchange, especially for the research institutions in the participating countries. An idea to be put forward was to provide materials for self-learning. Thus, the participating countries were encouraged to put the information about the training events on the net.

When developing the content of the network the issues of special attention would be: current research projects; survey on the needs and feasibility of OH & S information systems; need for substantive information; support to training (distance learning); forthcoming training courses; and expansion of the network for also other users than research institutions (government bodies, expert communities, academia, OH practices, and NGOs).

It was also noted that to apply funding for the Network in an individual country requires strength in activities and materials collected, as well as good plans for the future activities.

Country Reports

Estonia

The subtitle publications has been updated with recent central articles of Estonian Newsletter on Occupational Health and Safety.

A survey has been started in Estonia in connection with the Estonian acquisition process to EU. The description of the survey and the questionary form is to be found in the subtitle news and activities of the Estonian pages. The survey has two parts, a survey for employers and a survey for employees.

The news and activities also include a title "Baltic Sea Network - today and future" which includes information on a national networking meeting in Estonia held on 1.3.2000. The four universities (Tallinn Technical University, Tarto Agricultural University, Tallinn Pedagogical University and Tarto University) and various other information providers and users of OH & S, e.g. Association of Estonian Farmers, Labour Inspectorate, Occupational Health Centre, Organization of Occupational Health Nurses, Occupational Diseases Clinic, etc.; took part in the meeting, totalling 13 participants.

Subtitle training courses and conferences includes the training plan of labour inspectors for the year 2000 and information on a workshop in ergonomics to be held in Tallinn on 14 April 2000.

Under legislation there is an updated list of regulations based on OHS Act and Chemical Act.

Latvia

There has not been very quick progress in the content of the pages since the last Coordinators' Meeting. Instead, it has been the time for evaluation, information spreading and raising of knowledge. The Latvian language pages of the Institute are completed. Some updating work has been done, e.g. statistics. Much effort has been put to the preparation of a new textbook in OH (due in July 2000).

New pages include: list of certified occupational physicians (in Latvian and in English) and complete list of legal OHS acts with revisions (in Latvian). Information on social services and compensation on occupational diseases in Latvian, and publications by Latvian authors in OH & S in Latvian and in English are available.

Meeting with some of the Latvian partners for BSN was arranged in December 1999 and it was agreed that there is a mutual interest in further developing the pages and a further meeting in spring 2000.

State labour inspection is considering setting up their homepage and contributing to BSN with statistical information. Setting up of the homepage for clinical university hospital with links to BSN would be ready by April/May 2000.

Some problems arisen:

• delays with organizational profiles and other activities by Latvian partners
• still relatively low coverage of internet access and internet use of Latvian physicians
• delays with acceptance and implementation of national law on OHS (based on EU directive)
  

Future activities include:

• continuation of data collection and updating
• further activation of Latvian partners for participating in BSN
• once more a presentation of BSN in the Conference of Latvian Association of Occupational Physician, and distribution of information material in May 2000
• meeting with active Latvian partners (follow-up for December 1999 meeting) on further development and contribution, funding possibilities
• chapter on web-sources in OH & S will be included in the new textbook (featuring also BSN)

Lithuania

New pages of the Occupational Medicine Center were presented. The Research Department of the Center conducts research e.g. on work ability, cardiovascular functions, and work environment.

Information has been added to background information, and organizational profiles will be implemented with the pages of Labour Inspectorate in Lithuanian language. Full text of legal acts in Lithuanian are also presented. Some problems have arisen with gathering the contact information from the Lithuanian institutes.

Occupational health and safety information centre will be developed to be not only a good source of information but to be effective in the dissemination of information as well.

Subtitle news and activities is including a link to the homepage of the Second Conference on Public Health Research in the Baltic Countries, to be held in Kaunas on 15-18 June 2000 and a link to IEA European Regional Meeting "From Molecules to Public Health", to be held on 24-26 August 2000, in Kaunas.

Under the subtitle legislation, the governmental regulation on list of occupational diseases has been translated into English. The law on labour protection is to be harmonized with EC Directives. Joining the EU requires translation of legal texts which will take apprx. 1,5 years.

The subtitle statistics includes information on occupational diseases in Lithuania. In addition, the pages of the Labour Inspectorate provide information on occupational accidents in Lithuanian language.

The plans for the near future include e.g. the improving of the search system.

Poland

The Polish pages are providing information for two types of clients: international and national, with different needs.

The homepage of the Nofer Institute of Occupational Medicine has been further developed. For making the BSN more visible Dr Michalak suggested that a logo for BSN would be created.

Some links have been added, e.g. the Ministry of Health which have information in Polish. As to the OH institutes under organizational profiles, the last one not having information in English (Institute of Occupational Medicine and Environmental Health) is currently preparing pages in English language.

The BSN will be presented by Dr Michalak at the meeting of the Polish Association of Occupational Medicine. For future marketing of the BSN in Poland possible channels are the Polish Journal of Occupational Medicine and the forthcoming Conference for OH physicians.

It is considered problematic also in Poland that the response rate is rather low to attempts to collect information. On the other hand, the huge amount of publications makes it difficult to select relevant ones.

Training courses and conferences contains information in Polish. In legislation there are two official translations into English. Joining the EU will have as a consequence that more official translations will be made.

Other information contains useful links e.g. to universities.

Finland

The database of the Finnish development projects and collaborative actions in the neighbouring regions has been put to the Finnish web-pages. The entry to the database is in the main country menu of Finland.

At the moment information on 8 projects has been collected. The collection of some projects is still under work. The database has been collected by using a standardized questionary. Much emphasis has been put to collect detailed contact information about the collaborating institutes and experts in the countries of activitity. Thus, the database not only serves as a project database but it is also a good source for contact information and thus, it will facilitate further collaboration and creating contacts between individual experts.

It is the purpose that the same information would be collected from other Finnish sources/authorities etc. and from other Baltic Sea countries.

The pages of the FIOH are updated regularly. Currently the information by subject areas can be found in Finnish about ergonomics, occupational accidents, chemical safety, and occupational health services. The information by subject areas will also be translated into English.

Germany

The Bilbao Network pages of Germany in the English language were introduced. They contain a lot of information on occupational health and safety. A list of German state and federal institutions in OH & S is to be found on the pages. Information on publications are only in German language.

Subtitle News & Events include a link to A&A 99 (International Congress for Occupational Safety and Health, held in 1999) homepage. In the legislation section the law on company doctors, safety engineers and other industrial safety advisers has been translated into English.

Feeding the statistical information (e.g. occupational diseases) is in starting process at the moment.

Sweden

The Swedish BSN-pages have 200 links at the moment.

A 'hot spot' has been added to draw attention to new and actual information. Information by subject areas includes information on research, standards, regulations, etc. of chemical hazards, toxicology, climate, ventilation, and various other substance areas.

Training courses and conferences include information about training of Swedish OH professionals. Even if the training itself is conducted in Swedish; the curricula have been translated into English for spreading information and to give ideas to other countries how training can be arranged.

The amount of visitors on NIWL homepages has been constantly growing; from 300/month to over 500/month.

A communication platform for BSN participants is currently developed on the Swedish pages.

Goals and objectives of the BSN Coordinators' Meetings; need for reorientation?
Kari Kurppa, FIOH, Finland

The Baltic Sea Network is based on a strategy of a decentralized peer-to-peer network. This is an approach also giving flexibility to the network arrangements. The FIOH has been given the task to act as a secretariat or facilitator of the common network arrangements, including also the task to give technical support when needed.

The summary of the objectives of the BSN agreed at the Helsinki Coordinators' Meeting (9/99) is in Annex 3. It is however important to discuss time to time, whether the statement should be the same or if it should be changed somehow.

Currently, there are three meetings of the BSN yearly:
- one Annual Meeting for leaders and decision makers
- two Coordinators' Meetings for decision makers and technical experts
It is to be discussed whether the organization of the Coordinators' Meetings should be changed somehow or should it remain the same in the future.

The group agreed that the conclusions of the previous Coordinators' Meeting are still valid and the Baltic Sea Network is well in progress. The structure of the meetings were discussed in small groups.

Goals and objectives of the BSN Coordinators' Meetings; technical aspects
Miikka Rantanen, FIOH, Finland

The Baltic Sea Network uses Internet technologies for information distribution. It has a distributed network architecture. Each country is responsible for its own sub-site. Each country also has built its own tecnical infrastructure, i.e. network, hardware and software.

Currently all member states pages are covered by a search engine. The search system has for the last time been indexed at the end of 1999 so it should be indexed again.

The first version of the Project database on the development projects in the area has been published. At the moment it contains only information on Finnish projects.

The new page lay-out is under preparation. All the shared BSN-pages have META-tags in order to help search engines to find the site. The information content is growing all the time.

The Baltic Sea Network connects all sub-sites of the countries to one OH & S related portal. It has some shared resources, but the main content is provided by each country. The network has two kind of users, international and national.

From the technical point of view, ensuring of the functionality is one of the most important challenges. There still exist connecting problems. Heavy complexity is the enemy of usability. With increasing content it is important to take care about the good functioning of the pages; easy navigation, logical structure, navigation aids, whether it is easy to find information on our pages and whether it is easy to publish new documents on the site.

Major reasons for visiting new www-pages according to Tauscher and Greenberg are listed in Annex 4. How BSN is answering to these questions is indicated in Annex 4 as well. As a general conclusion, the BSN should provide added value to the visitor.

Group work

Two groups were formed:

1. Bo Dahlner, Maija Eglite, Remigijus Jankauskas, Grzegorz Krzychowicz, Angelika Limbach, Ester Rünkla
2. Milvi Jänes, Sarunas Krisciukaitis, Suvi Lehtinen, Jacek Michalak, Ivars Vanadzins, Anneli Vartio

The groups were asked to weigh the pros and cons of the present meeting system and discuss the possible needs for development.

Task for group work:

1. List justifications for the continuation of BSN coordinators' meetings in the future (now: 2 meetings, plus one annual meeting)
for: a) leaders, decision-makers;
b) web experts.

2. Is there a need for reorientation of coordinators' meetings? How?

3. New items for the agenda?
- e.g. position papers (overviews) by country on subject areas that are important to all; a joint BSN summary paper to be published together
- definitions of terms/concepts as now understood in member countries (e.g., occupational health; occupational health services; etc.)

Results of group 1

1. One coordinators' meeting and one annual meeting but the use of the email network more than today

2. A reorientation of the coordinators meeting is not needed

3. Aims of the coordinators' meeting:
1. to discuss technical questions
2. to share information about the development of BSN country homepages
3. to show the easiest way to find information on a special subject
4. to discuss special topics that need preparation or collection of data, summarized in a
position paper

Other comments:
- more systematic increase of information content would be needed, e.g. an agreement that a certain topic will be developed

Results of group 2

1. The spring meeting (March/April) jointly for decision-makers and technical coordinators (web-experts); the autumn meeting (September) for technical coordinators only. The Annual Meeting (October/November) for decision-makers and other experts in the field.

2. new items:

position papers, overviews by country on subject areas which are important to all
Good practice in OHS to set up of a priority list for country guidelines, Internal control of OHS
BSN summary paper to publish together
Other ideas:
- to invite the host country's key persons to the meeting in addition to regular participants
would bring new fresh views to the discussions at the meetings
- in spring meeting tasks to participants could be given to be prepared for the annual meeting
- priority lists for important matters to a certain country could be prepared

Consideration of cultural differences (national, organizational) between and within Baltic Sea countries
Kari Kurppa, FIOH, Finland

(Transparencies of the presentation are in Annex 5.)

People's relationship to the world may be something between the dominance orientation and the one of harmony. The difference can be described with the following examples:

Basho (1644-1694): "When I look carefully, I see nazuna blooming by the hedge!" (harmony; respect)
Alfred Tennyson: "Flower in the crannied walls, I pluck you out of the crannies; - Hold you here, root and all, in my hand, Little flower - but if I could understand What you are, root and all, and all in all, I should know what God and man is." (dominance)

Or also:
Western press: "Man conquers mountain"
Chinese press: "Man befriends mountain"
(about Sir Edmund Hillary on Mt. Everest)

The different layers of culture according to Hofstede (1996) are as follows: a national level, a regional level, an ethnic level, a religious level, a linguistic level, a gender level, a generation level, a social class level and an organizational level. As to the value systems of a human, the cultural aspects are programmed to a human being during the first 10 years and deep value systems do not change very much after that. Therefore the globalization may take generations before having any effect to the cultures.

The definitions of culture by Adler (1997) and Hall (1977) are in Annex 5 (1). The national culture as the most important thing explaines 50% of work related values and attitudes; the position within the organization, profession, age or gender are less important.

The table in Annex 5 (2) shows the individualism index in various countries. According to the table the most individualistic country is USA while the South American countries are least individualistic. The United States is characterized by being strongly individualistic, weak on its loyalty to groups and communities, and singling out individual excellence. As a consequence, USA is characterized being a temporary society with temporary systems, uprootedness, disconnectedness, nonpermanent relationships and high mobility.

In the figure in Annex 5 (3) the individualism index is shown by masculinity-femininity and individualism-collectivism dimensions in various countries. It shows that e.g. the Nordic countries have a similar value system. European countries incl. Nordic countries are down in the scale (individualistic), while South American and Far East countries are on up on the scale (collectivistic). In total, collectivist countries form the majority and individualistic countries a minority among the countries in the world.

The collectivism means a "family-type" of system, loyalty to one's in-group, also in work life. The examples of a car accident and a former Dutch missionary, described in Annex 5 (4,5), clarify this difference between countries.

Despite of the differences between cultures there are also universal precepts in all moral traditions, which are listed in Annex 5 (6).

The cultural differences will come out in OH & S in connection with the globalization. We do not necessarily need to accept other cultures but it helps if we understand their cultural heritage and "programming" differences.

Discussion

Based on the presentation of Dr Kurppa the group discussed about the ethics of various choises which may be taken in occupational medical activities. It was discussed which ethical principles are for or against doing the following activities:

A) Screening train drivers for the presence of alcohol
B) Screening bus drivers for the presence of drugs
C) Screening chemical workers for the presence of genetic abnormalities

In A) and B) it was deemed right to schreen the workers because of the fact that the drivers may cause a risk or a danger for many people if driving drunk. It was pointed out, however, that the human rights have to be respected and that it depends on the role of the OH specialist - whether he/she is a decision maker or a consultant only - how ethically right the screening is.

In case C; the protection of the person speaks for screening, if there is evidence that certain chemicals can affect for workers health in certain heritage cases. OHS should know about persons health to be able to help and to give advise.

As reasons against the screening it was mentioned human rights and legal, economical or technical problems related to the screening.

The results of a survey (Aw 1997) concerning these ethical questions are given in Annex 5 (7). In Finland the answer to A and B would be yes and to C - no.

D) Excluding an obese person from a job for safety reasons, e.g. working in a crowded kitchen.

Accident prevention speaks for the activity; the accident risk may increase for the obese person herself or for other workers. It was also considered that the safety (accident prevention, minimizing risk) should be put above other reasons and it would be ethical to exclude an obese person from work in a pre-employment examination.

The OHS personnel should advise the worker if the work is hazardous to him/herself; not however make decisions for exclusion.

E) Recommending acceptance of an ablebodied person in preference to a disabled person, other qualifications being equal

In Tallinn the county council is employing disabled persons for IT-tasks to give a good example for others and to show willingness to find workplaces for disabled persons, which is a big social political decision, as well.

The question of discrimination (racial, sex, disabled) was taken up; it is important also to ask whether the ablebodied persons are discriminated.

To conclude: to support the disabled persons speaks for and discrimination speaks against the case E). The results of the survey of Aw (1997) are given in Annex 5 (8).

Next, it was discussed whether a disclosure of medical information is ethical or not in the following circumstances:

F) Possible danger to the individual from work

It was considered ethical to inform the worker if the work forms a possible danger to him/her. However, the OHS personnel could only inform the worker and not the management. In case of a certain danger, however, also the management should be informed. There was also another opinion revealed according to which a possible danger is already a risk; therefore both the worker and employer should be informed.

G) Possible danger to the public

The group were considering it ethical to disclosure medical information in case there is a risk to other persons.

H) Possible high costs from individual's medical bills

Both opinions, yes and no were revealed. Economical reasons speak for disclosure but some ethical reasons speak against it.

I) Specific request from the chief executive

In many countries the employer sets rules for OH personnel which they have to follow. This was considered to be a clear ethical problem.

The results of a survey (Aw 1997) concerning questions F) to I) are given in Annex 5 (9).

Workshop about training and development (Annex 6)
Bo Dahlner, NIWL, Sweden

First, information about the next Annual Meeting of the Baltic Sea Network was given. The meeting will be held on 9-10.11.2000 in Uppsala Baltic University. Arrival on 8.11.2000.

The definition for the word compentence was given. The difference between compentence and expertise was discussed. Expertise can be defined as an ability to carry out special duties; competence is a prerequisite for becoming an expert.

The Swedish school system was taken as an example. It consists of successive steps and various complementary and refreshment courses on different levels. The training on occupational health services is post-graduate training, for example, the training for occupational health physicians. Many pedagogical means are used in courses of OHS. The list of the means is in Annex 6.

The following questions were discussed:

What influence the training may have in the development of the participants?
The group listed at least the following influences:

increase of knowledge and understanding
improvement of competence
social skills
development of expertise and know-how
self-improvement
tolerance
development of quality of work life
Why is a project included in the courses?
The group listed at least the following reasons:

to operationalize the theoretical part of the course
a project may release a lot of creativity
it makes the learning more efficient
increase working on practical level; to give practical experience
to learn something about yourself and your methods of learning
Discuss and mention some effects such project may cause

effects on personal level; company level (improvement in working conditions); country level
to create a model for others on a national level, e.g. general awareness
a project can start a development process in a country
In Annex 6 further alternative answers are given (the questions 2-4 in Annex were not taken up for discussion). The group discussed about the training and education required from certified OH physicians in different countries.

Plenary discussion and conclusions

Summary of the technical group discussions

The meeting of the technical group started with short reviews of each country from the technical point of view. Also the development in www and internet in general was discussed.

Evaluation of the new page structure and lay-out resulted in some good and useful ideas e.g. for making the pages more user-friendly. The search system was not much discussed this time.

Following topics were agreed:
- the new draft of the lay-out will be sent to all members. The technical coordinators will comment the new demo version before the next coordinators' meeting
- the logo for BSN will be planned; the first draft will be made at the FIOH for the next meeting

The target is to have the new pages working by the next Annual Meeting in Uppsala.

Conclusions and recommendations of the meeting

1. The BSN is well developed; more development is still needed in the substance information as a continuous process. Some of this can be implemented on a project basis. More focus will be put on coordinators' meetings to prepare in the long run these contents.

2. The contacts among the experts in the Baltic Sea region were deemed useful and important for

• exchange of information
• exchange of ideas
• learning from each others

Therefore, after discussions in the working groups and exchange of ideas in the plenary session, for the time being, regular coordinators' meetings will be continued as previously.

• first meeting March, other August/September
• annual meeting, November; 1/2 day reserved for telematic network

3. The format and orientation of the coordinator meetings was deemed good. However, it was decided that local experts be invited to selected sessions of the coordinators' meetings in order to encourage collaboration and increase the status of OH & S.

4. Media will also be contacted to inform the great public about the BSN

5. Marketing of the BSN was found important. The coordinators of the BSN were encouraged to inform about the network activities in various meetings. Other ways of marketing that were mentioned:

A joint article on BSN was decided to be published after the next coordinators' meeting
A printed postcard to be distributed to potential clients
6. A survey on terms and concepts related to OHS will be conducted in the BSN countries.

7. A summary of core competences on OHS, related legislation, funding arrangements, on OHS functions, etc.

8. New page lay-out to be developed by the Uppsala meeting

9. Each country homepage will be included in search system

10. Forthcoming topics:

• occupational stress
• musculoskeletal diseases, lowback pain; upper limbs
• textile industry (noise)
• asthma & allergic diseases
• OHS comparison
• SSEs/SMEs
• farmers' health
• forestry

Next meeting and future plans

It was suggested that the next Coordinators' Meeting would be held in Poland on the last week of September 2000. Information on occupational health services in each country was suggested for the agenda. This was considered to be an actual and important topic.

Jacek Michalak proposed a questionary to be done in BSN countries about the OHS. He also was willing to make a draft for the questionary for others to comment after the meeting. Remigijus Jankauskas and Milvi Jänes were also willing to contribute to the planning of the questionary. The questionary would deal with a situation description and comparison of OHS in Baltic countries, Poland and Russia.

It was also agreed that all five countries could briefly describe the situation in OHS on paper and the descriptions would be sent to the participants 2 weeks before the next meeting.

Furthermore, it was suggested that a specific form could be planned for gathering information on various substance areas so that in every country same information would be collected. This idea could be further developed in the next Coordinators' Meeting. All participants considered for example occupational stress, textile industry and musculoskeletal disorders to be important subject areas.

Last Modified: 8.1.2003