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17. Disability and Work

17. Disability and Work (10)

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17. Disability and Work

Chapter Editors: Willi Momm and Robert Ransom


 

Table of Contents

Figures

Disability: Concepts and Definitions
Willi Momm and Otto Geiecker

Case Study: Legal Classification of Disabled People in France
Marie-Louise Cros-Courtial and Marc Vericel

Social Policy and Human Rights: Concepts of Disability
Carl Raskin

International Labour Standards and National Employment Legislation in Favour of Disabled Persons
Willi Momm and Masaaki Iuchi

Vocational Rehabilitation and Employment Support Services
Erwin Seyfried

Disability Management at the Workplace: Overview and Future Trends
Donald E. Shrey

Rehabilitation and Noise-induced Hearing Loss
Raymond Hétu

Rights and Duties: An Employer’s Perspective
Susan Scott-Parker

     Case Study: Best Practices Examples

Rights and Duties: Workers’ Perspective
Angela Traiforos and Debra A. Perry

Figures

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18. Education and Training

18. Education and Training (9)

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18. Education and Training

Chapter Editor: Steven Hecker


Table of Contents

Figures and Tables

Introduction and Overview
Steven Hecker

Principles of Training
Gordon Atherley and Dilys Robertson

Worker Education and Training
Robin Baker and Nina Wallerstein

Case Studies

Evaluating Health and Safety Training: A Case Study in Chemical Workers Hazardous Waste Worker Education
Thomas H. McQuiston, Paula Coleman, Nina Wallerstein, A.C. Marcus, J.S. Morawetz, David W. Ortlieb and Steven Hecker

Environmental Education and Training: The State of Hazardous Materials Worker Education in the United States
Glenn Paulson, Michelle Madelien, Susan Sink and Steven Hecker

Worker Education and Environmental Improvement
Edward Cohen-Rosenthal

Safety and Health Training of Managers
John Rudge

Training of Health and Safety Professionals
Wai-On Phoon

A New Approach to Learning and Training:A Case Study by the ILO-FINNIDA African Safety and Health Project

Antero Vahapassi and Merri Weingerv

Tables 

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1. Teaching methods chart

Figures

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22. Resources: Information and OSH

22. Resources: Information and OSH (5)

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22. Resources: Information and OSH

Chapter Editor:  Jukka Takala

 


 

Table of Contents

Figures and Tables

Information: A Precondition for Action
Jukka Takala

Finding and Using Information
P.K. Abeytunga, Emmert Clevenstine, Vivian Morgan and Sheila Pantry

Information Management
Gordon Atherley

Case study: Malaysian Information Service on Pesticide Toxicity
D.A. Razak, A.A. Latiff, M.I. A. Majid and R. Awang

Case Study: A Successful Information Experience in Thailand
Chaiyuth Chavalitnitikul

Tables

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1. Some core periodicals in occupational health & safety
2. Standard search form
3. Information required in occupational health & safety

Figures

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23. Resources, Institutional, Structural and Legal

23. Resources, Institutional, Structural and Legal (20)

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23. Resources, Institutional, Structural and Legal

Chapter Editors:  Rachael F. Taylor and Simon Pickvance


 

Table of Contents 

Figures and Tables

Institutional, Structural and Legal Resources: Introduction
Simon Pickvance

Labour Inspection
Wolfgang von Richthofen

Civil and Criminal Liability in Relation to Occupational Safety and Health
Felice Morgenstern (adapted)

Occupational Health as a Human Right
Ilise Levy Feitshans

Community Level

Community-Based Organizations
Simon Pickvance

Right to Know: The Role of Community-Based Organizations
Carolyn Needleman

The COSH Movement and Right to Know
Joel Shufro

Regional and National Examples

Occupational Health and Safety: The European Union
Frank B. Wright

Legislation Guaranteeing Benefits for Workers in China
Su Zhi

Case Study: Exposure Standards in Russia
Nikolai F. Izmerov

International Governmental and Non-Governmental Organizations

International Cooperation in Occupational Health: The Role of International Organizations
Georges H. Coppée

The United Nations and Specialized Agencies

     Contact Information for the United Nations Organization

International Labour Organization

Georg R. Kliesch   

     Case Study: ILO Conventions--Enforcement Procedures
     Anne Trebilcock

International Organization for Standardization (ISO)
Lawrence D. Eicher

International Social Security Association (ISSA)
Dick J. Meertens

     Addresses of the ISSA International Sections

International Commission on Occupational Health (ICOH)
Jerry Jeyaratnam

International Association of Labour Inspection (IALI)
David Snowball

Tables

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1. Bases for Russian vs. American standards
2. ISO technical committees for OHS
3. Venues of triennial congresses since 1906
4. ICOH committees & working groups, 1996

Figures

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24. Work and Workers

24. Work and Workers (6)

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24. Work and Workers

Chapter Editors:  Jeanne Mager Stellman and Leon J. Warshaw 


 

Table of Contents 

Figures

Work and Workers
Freda L. Paltiel

Shifting Paradigms and Policies
Freda L. Paltiel

Health, Safety and Equity in the Workplace
Joan Bertin

Precarious Employment and Child Labour
Leon J. Warshaw

Transformations in Markets and Labour
Pat Armstrong

Globalizing Technologies and the Decimation/Transformation of Work
Heather Menzies

Figures 

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25. Worker's Compensation Systems

25. Worker's Compensation Systems (1)

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25. Worker's Compensation Systems

Chapter Editor: Terence G. Ison


 

Table of Contents 

Overview
Terence G. Ison

Part One: Workers' Compensation

Coverage    
Organization, Administration and Adjudication
Eligibility for Benefits
Multiple Causes of Disability
Subsequent Consequential Disabilities    
Compensable Losses    
Multiple Disabilities    
Objections to Claims    
Employer Misconduct    
Medical Aid    
Money Payments    
Rehabilitation and Care    
Obligations to Continue the Employment    
Finance    
Vicarious Liability    
Health and Safety    
Claims against Third Parties    
Social Insurance and Social Security

Part Two: Other Systems

Accident Compensation    
Sick Pay    
Disability Insurance    
Employers’ Liability

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Friday, 11 February 2011 21:07

Disability: Concepts and Definitions

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Preliminary Considerations

Most people seem to know what a disabled person is and are certain that they would be able to identify an individual as disabled, either because the disability is visible or because they are aware of a specific medical condition that lends itself to be called disability. However, what precisely the term disability means is less easy to determine. A common view is that having a disability makes an individual less capable of performing a variety of activities. In fact, the term disability is as a rule used to indicate a reduction or deviation from the norm, a shortcoming of an individual that society has to reckon with. In most languages, terms equivalent to that of disability contain the notions of less value, less ability, a state of being restricted, deprived, deviant. It is in line with such concepts that disability is exclusively viewed as a problem of the affected individual and that the problems indicated by the presence of a disability are considered to be more or less common to all situations.

It is true that a disabling condition may affect to varying degrees the personal life of an individual and his or her relations with family and community. The individual who has a disability may, in fact, experience the disability as something that sets him or her apart from others and that has a negative impact on the way life is organized.

However, meaning and impact of disability change substantially depending on whether the environment and the attitudes of the public accommodate a disability or whether they do not. For example, in one context, the person who uses a wheelchair is in a state of complete dependency, in another he or she is as independent and working as any other person.

Consequently, the impact of an alleged dysfunction is relative to the environment, and disability is thus a social concept and not solely the attribute of an individual. It is also a highly heterogeneous concept, making the search for a homogeneous definition a virtually impossible task.

Despite many attempts to define disability in general terms, the problem remains concerning what renders an individual disabled and who should belong to this group. For example, if disability is defined as dysfunction of an individual, how to classify a person who despite a serious impairment is fully functional? Is the blind computer specialist who is gainfully employed and has managed to solve his or her transport problems, secure adequate housing and have a family still a disabled person? Is the baker who can no longer exercise his profession because of a flour allergy to be counted among disabled job-seekers? If so, what is the real meaning of disability?

To understand this term better, one has first to distinguish it from other related concepts that are often confused with disability. The most common misunderstanding is to equate disability with disease. Disabled people are often described as the opposite of healthy people and, consequently, as needing the help of the health profession. However, disabled people, as anyone else, need medical help only in situations of acute sickness or illness. Even in cases where the disability results from a protracted or chronic illness, such as diabetes or a cardiac disease, it is not the sickness as such, but its social consequences that are involved here.

The other most common confusion is to equate disability with the medical condition that is one of its causes. For example, lists have been drawn up that classify disabled people by types of “disability”, such as blindness, physical malformations, deafness, paraplegia. Such lists are important for determining who should be counted as a disabled person, except that the use of the term disability is inaccurate, because it is confounded with impairment.

More recently, efforts have been made to describe disability as difficulty in performing certain types of function. Accordingly, a disabled person would be someone whose ability to perform in one or several key areas—such as communication, mobility, dexterity and speed—is affected. Again, the problem is that a direct link is made between the impairment and the resulting loss of function without taking into account the environment, including the availability of technology that could compensate for the loss of function and thus render it insignificant. To look at disability as the functional impact of impairment without acknowledging the environmental dimension means to put the blame for the problem entirely on the disabled individual. This definition of disability still stays within the tradition of regarding disability as a deviation from the norm and ignores all other individual and societal factors that together constitute the phenomenon of disability.

Can disabled people be counted? This may be possible within a system that applies precise criteria as to who is sufficiently impaired to be counted as disabled. The difficulty is to make comparisons between systems or countries that apply different criteria. However, who will be counted? Strictly speaking, censuses and surveys that undertake to produce disability data can count only people who themselves indicate that they have an impairment or a functional restriction on account of an impairment, or who believe that they are in a situation of disadvantage because of an impairment. Unlike gender and age, disability is not a clearly definable statistical variable, but a contextual term that is open to interpretation. Therefore, disability data can offer only approximations and should be treated with utmost care.

For the reasons outlined above, this article does not constitute yet another attempt to present a universal definition of disability, or to treat disability as an attribute of an individual or a group. Its intention is to create an awareness about the relativity and heterogeneity of the term and an understanding about the historical and cultural forces that have shaped legislation as well as positive action in favour of people identified as disabled. Such an awareness is the prerequisite for the successful integration of disabled people in the workplace. It will permit a better understanding of the circumstances that need to be in place to make the disabled worker a valuable member of the workforce instead of being barred employment or pensioned off. Disability is presented here as being manageable. This requires that individual needs such as skill upgrading or the provision with technical aids, be addressed, and accommodated by adjusting the workplace.

There is currently a vivid international debate, spearheaded by disability organizations, regarding a non-discriminatory definition of disability. Here, the view is gaining ground that disability should be identified where a particular social or functional disadvantage occurs or is anticipated, linked to an impairment. The issue is how to prove that the disadvantage is not the natural, but rather the preventable result of the impairment, caused by a failure of society to make adequate provision for the removal of physical barriers. Leaving aside that this debate reflects primarily the view of disabled people with a mobility impairment, the possible unwelcome consequence of this position is that the state may shift expenditures, such as for disability benefits or special measures, based on disability, to those that improve the environment.

Nevertheless, this debate, which is continuing, has highlighted the need to find a definition of disability that reflects the social dimension without sacrificing the specificity of the disadvantage based on an impairment, and without losing its quality as an operational definition. The following definition tries to reflect this need. Accordingly, disability can be described as the environmentally determined effect of an impairment that, in interaction with other factors and within a specific social context, is likely to cause an individual to experience an undue disadvantage in his or her personal, social or professional life. Environmentally determined means that the impact of the impairment is influenced by a variety of factors, including preventive, corrective and compensatory measures as well as technological and accommodative solutions.

This definition recognizes that in a different environment that erects fewer barriers, the same impairment could be without any significant consequences, hence without leading to a disability. It stresses the corrective dimension over a concept that takes disability as an unavoidable fact and that simply seeks to ameliorate the living conditions of the afflicted persons. At the same time, it maintains the grounds for compensatory measures, such as cash benefits, because the disadvantage is, despite the recognition of other factors, still specifically linked to the impairment, irrespective of whether this is the result of a dysfunction of the individual or of negative attitudes of the community.

However, many disabled people would experience substantial limitations even in an ideal and understanding environment. In such cases the disability is primarily based in the impairment and not in the environment. Improvements in environmental conditions can substantially reduce dependency and restrictions, but they will not alter the fundamental truth that for many of these severely disabled people (which is different from severely impaired) participation in social and professional life will continue to be restricted. It is for these groups, in particular, that social protection and ameliorative provisions will continue to play a more significant role than the aim of full integration into the workplace which, if it takes place, is often done for social rather than for economic reasons.

But this is not to suggest that persons thus defined as severely disabled should live a life apart and that their limitations should be grounds for segregation and exclusion from the life of the community. One of the major reasons for exercising utmost caution as regards the use of disability definitions is the widespread practice of making a person thus identified and labelled the object of discriminatory administrative measures.

Nevertheless, this points to an ambiguity in the concept of disability that gives rise to so much confusion and that could be a main reason for the social exclusion of disabled people. For, on the one hand, many campaign with the slogan that disability does not mean inability; on the other, all existing protective systems are based on the grounds that disability means inability to make a living on one’s own. The reluctance of many employers to hire disabled people may be founded in this basic contradiction. The answer to this is a reminder that disabled people are not a homogeneous group, and that each case should be judged individually and without bias. But it is true that disability may mean both: an inability to perform according to the norm or an ability to perform as well as or even better than others, if given the opportunity and the right kind of support.

It is obvious that a concept of disability as outlined above calls for a new foundation for disability policies: sources of inspiration for how to modernize policies and programmes in favour of disabled persons can be found among others in the Vocational Rehabilitation and Employment (Disabled Persons) Convention, 1983 (No. 159) (ILO 1983) and the United Nations Standard Rules on the Equalization of Opportunities for Persons with Disabilities (United Nations 1993).

In the following paragraphs, the various dimensions of the disability concept as it affects present law and practice will be explored and described in an empirical manner. Evidence will be provided that various disability definitions are in use, mirroring the world’s different cultural and political legacies rather than giving cause for the hope that a single universal definition can be found which is understood by everyone in the same manner.

Disability and normality

As mentioned above, most past regulatory attempts at defining disability have fallen prey, in one form or another, to the temptation of describing disability as primarily negative or deviatory. The human being afflicted with disability is seen as a problem and becomes a “social case”. A disabled person is assumed to be unable to pursue normal activities. He or she is a person with whom all is not quite in order. There is an abundance of scientific literature that depicts disabled people as having a behavioural problem, and in many countries “defectology” was and still is a recognized science that sets out to measure the degree of deviation.

Individuals who have a disability generally defend themselves against such a characterization. Others resign themselves to the role of a disabled person. Classifying persons as disabled disregards the fact that what disabled individuals have in common with the non-disabled usually far outweighs that which makes them different. Further, the underlying concept that disability is a deviation from the norm is a questionable value statement. These considerations have incited many people to prefer the term persons with disabilities to that of disabled persons, as the latter term could be understood as making disability the primary characteristic of an individual.

It is thoroughly conceivable that human and social reality be defined in such a way that disability be regarded as consistent with normalcy and not as a deviation from it. In fact, the Declaration that was adopted in 1995 by the heads of state and government at the UN World Summit for Social Development in Copenhagen describes disability as a form of social diversity. This definition demands a conception of society which is a society “for all”. Thereby previous attempts at defining disability negatively, as deviation from the norm or as deficiency, are no longer valid. A society which adapts itself to disability in an inclusive manner could substantially overcome those effects of disability which were previously experienced as overly restrictive.

Disability as identity

Despite the danger that the label will invite segregation and discrimination, there are valid reasons to adhere to the usage of the term disability and to group individuals in this category. It cannot be denied, from an empirical standpoint, that many individuals with disability share similar, mostly negative, experiences of discrimination, exclusion and economic or social dependency. There exists a factual categorization of human beings as disabled, because specific negative or censorious social behaviour patterns appear to be based upon disability. Conversely, where there are efforts made to fight discrimination on the basis of disability, it also becomes necessary to stipulate who should have the right to enjoy protection under such measures.

It is in reaction to the way society treats people with disabilities that many individuals who have experienced discrimination in one form or another because of their disability join together in groups. They do so partly because they feel more at ease among individuals who share their experience, partly because they wish to advocate common interests. They accordingly accept the disabled role, if indeed for very different motives: some, because they want to induce society to view disability, not as an attribute of isolated individuals, but rather as the result of action and neglect on the part of the community which unduly curtails their rights and opportunities; the others, because they acknowledge their disability and demand their right to be accepted and respected in their difference, which includes their right to struggle for equality of treatment.

However, most individuals who, on account of an impairment, have a functional limitation of one form or another appear not to see themselves as disabled. This creates a problem not to be underestimated for those engaged with the politics of disability. For example, should those who do not self-identify as disabled be counted among the numbers of disabled persons, or only those who register as disabled?

Legal recognition as disabled

In many constituencies definitions of disability are identical with an administrative act of recognizing a disability. This recognition as disabled becomes a prerequisite for the claiming of support on the basis of a physical or mental limitation or for litigation under an anti-discrimination law. Such support can comprise provisions for rehabilitation, special education, retraining, privileges in the securing and preserving of a place of employment, guarantee of subsistence through income, compensation payments and assistance with mobility, etc.

In all cases in which legal regulations are in force in order to compensate for or to prevent disadvantages, there arises the need to clarify who has a claim on such legal provisions, be these benefits, services or protective measures. It follows thereupon, that the definition of disability is conditioned by the type of service or regulation which is offered. Virtually every existing definition of disability thus mirrors a legal system and draws its meaning from this system. Being recognized as disabled means to fulfil the conditions for benefiting from the possibilities presented by this system. These conditions, however, may vary among constituencies and programmes and, consequently, many different definitions may coexist side by side within a country.

Further evidence that the legal realities of the respective nations determine the definition of disability is offered by those countries, such as Germany and France, which have introduced a regulation including quotas or the levying of fines in order to assure disabled people access to employment opportunities. It can be demonstrated that with the introduction of such legislation, the number of “disabled” workers has risen drastically. This rise is to be explained only by the fact that employees—often on the recommendation of employers—who in the absence of such a law would never have designated themselves as disabled, register themselves as such. These same individuals were also never previously registered statistically as disabled.

Another legal difference among countries is the treatment of a disability as a temporary or permanent condition. In some countries, which offer disabled persons specific advantages or privileges, these privileges are limited to the duration of a recognized disadvantage. If this state of disadvantage is overcome through corrective actions, the disabled person loses his or her privileges—independently of whether medical facts (e.g., the loss of an eye or a limb) remain. For example, an individual who has successfully completed rehabilitation that has re-established lost functional abilities may lose entitlements to disability benefits or may not even enter a benefit scheme.

In other countries, lasting privileges are offered to offset real or hypothetical handicaps. This practice has resulted in the development of a legally recognized disability status bearing elements of “positive discrimination”. These privileges often apply even to those who are no longer actually in need of them because they are socially and economically well integrated.

The problem with statistical registration

A definition of disability that can be applied universally is impossible, since every country, and practically every administrative body, works with different concepts of disability. Every attempt to measure disability statistically must take into account the fact that disability is a system-dependent, and therefore a relative, concept.

Consequently, most regular statistics contain information only about the beneficiaries of specific state or public provisions who have accepted disability status in accordance with the operative definitions of the law. People who do not view themselves as disabled and manage alone with a disability usually do not come within the purview of official statistics. In fact, in many countries, such as the United Kingdom, many disabled people avoid statistical registration. The right not to be registered as disabled is in keeping with the principles of human dignity.

Therefore, occasionally, efforts are made to determine the total number of disabled persons through surveys and censuses. As already argued above, these come up against objective conceptual limits which render the comparability of such data between countries practically impossible. Above all, it is controversial what precisely such surveys are meant to prove, in particular as the notion of disability, as an objective set of findings that is equally applied and understood in all countries, cannot be sustained. Thus, a low number of statistically registered persons with disability in some countries does not necessarily reflect an objective reality, but most likely the fact that the countries in question offer fewer services and legal regulations in favour of disabled persons. Conversely, those countries which have an extensive social protection and rehabilitation system are likely to show a high percentage of disabled individuals.

Contradictions in the use of the concept of disabled persons

Objective results are, therefore, not to be expected on the level of quantitative comparison. But there is also no uniformity of interpretation from a qualitative point of view. Here again, the respective context and the intention of lawmakers determine the definition of disability. For example, the effort to guarantee disabled persons social protection requires disability to be defined as the inability to earn one’s own living. In contrast, a social policy whose goal is vocational integration endeavours to describe disability as a condition that, with the help of appropriate measures, need not have any detrimental effects on the level of performance.

International Definitions of Disability

The concept of disability in Convention No. 159 of the International Labour Organization

The above considerations also underlie the framework definition used in the Vocational Rehabilitation and Employment (Disabled Persons) Convention, 1983 (No. 159) (ILO 1983). Article 1.1 contains the following formulation: “For the purposes of this Convention, the term ‘disabled person’ means an individual whose prospects of securing, retaining and advancing in suitable employment are substantially reduced as a result of a duly recognized physical or mental impairment”.

This definition contains the following constituent elements: the reference to mental or physical impairment as the original cause of the disability; the necessity of a state recognition procedure that—in accordance with the respective national realities—determines who should be considered disabled; the determination that disability is not constituted by the impairment itself but by the possible and real social consequences of an impairment (in this case a more difficult situation on the labour market); and the established entitlement to measures which help to secure equality of treatment on the labour market (see Article 1.2). This definition consciously avoids an association with concepts such as inability and leaves room for an interpretation which holds that disability can also be conditioned by misconceived opinions held by an employer which may result in conscious or unconscious discrimination. On the other hand, this definition does not rule out the possibility that, in the case of a disability, objective limitations with respect to performance can occur, and leaves open whether or not the equal treatment principle of the Convention would apply in this case.

The definition in the ILO Convention does not make a claim to be a comprehensive, universally applicable definition of disability. Its sole intention is to provide for a clarification of what disability could mean in the context of employment and labour measures.

The concept of disability in light of the definition of the World Health Organization

The International Classification of Impairments, Disabilities and Handicaps (ICIDH) of the World Health Organization (WHO 1980) offers a definition of disability, in the area of health policy, which differentiates between impairment, disability and handicaps:

  • “In the context of health experience, an impairment is any loss or abnormality of psychological, physiological, or anatomical structure or function.”
  • “In the context of health experience, a disability is any restriction or lack (resulting from an impairment) of ability to perform an activity in the manner or within the range considered normal for a human being.”
  • “In the context of health experience, a handicap is a disadvantage for a given individual, resulting from an impairment or a disability, that limits or prevents the fulfilment of a role that is normal (depending on age, sex, and social and cultural factors) for that individual.”

 

The new and distinctive aspects of this conceptual differentiation do not lie in its traditional epidemiological approach and its classificatory apparatus, but rather in its introduction of the concept of handicap, which calls on those concerned with public health policy to reflect on the social consequences of specific impairments on a person affected and to regard the treatment process as part of a holistic concept of life.

The WHO clarification was especially necessary because the words impairment and disability were previously often equated with concepts such as crippled, mentally retarded and the like, which convey an exclusively negative image of disability to the public. A categorization of this kind is, in fact, not suited to a precise definition of the concrete situation of a disabled individual within society. The WHO terminology has since become a reference for the discussion on the concept of disability at the national and international levels. It will, therefore, be necessary to dwell on these concepts a little more.

Impairment. With this concept, health professionals customarily designate an existing or developing injury to bodily functions or to vital life processes in a particular person that affects one or more parts of the organism or that indicates a defect in the psychic, mental or emotional functioning as the result of an illness, accident or congenital or hereditary condition. An impairment can be temporary or permanent. The influences of professional or social contexts or of the environment as a whole are not taken into consideration in this category. Here, the physician’s assessment of a person’s medical condition or an impairment is exclusively at issue, without consideration of the consequences that this impairment may have upon that person.

Disability. Such impairment or loss can result in substantial limitation to the active lives of persons afflicted. This consequence of impairment is termed disability. Functional disorders of the organism, such as, for example, psychic disorders and mental breakdowns, can lead to more or less severe disabilities and/or negative effects in the execution of specific activities and duties of daily living. These effects can be temporary or permanent, reversible or irreversible, constant, progressive or subject to successful treatment. The medical concept of disability designates, therefore, functional limitations which arise in the lives of specific individuals as the direct or indirect result of a physical, psychosocial or mental impairment. Above all, disability reflects the personal situation of the individual who has an impairment. However, as the personal consequences of a disability depend upon age, sex, social position and profession, and so on, the same or similar functional disorders can have thoroughly different personal consequences for different individuals.

Handicap. As soon as persons with physical or mental impairments enter their social, professional or private context, difficulties may arise which bring them into a situation of disadvantage, or handicap, in relation to others.

In the original version of the ICIDH, the definition of handicap signifies a disadvantage which emerges as the result of an impairment or a disability, and which limits an individual in the performance of what is regarded as a “normal” role. This definition of handicap, which bases the problem exclusively upon the personal situation of the person afflicted, has since come under criticism, for the reason that it does not sufficiently take into account the role of the environment and the attitude of society in bringing about the situation of disadvantage. A definition which takes these objections into account should reflect upon the relationship between the disabled individual and the manifold environmental, cultural, physical or social barriers that a society reflecting the attitudes of non-disabled members tends to erect. In light of this, every disadvantage in the life of a specific person that is not so much the result of an impairment or a disability, but of negative or unaccommodating attitudes in the largest sense, should be termed “handicap”. Further, any measures taken towards the improvement of the situation of disabled individuals, including those that help them to fully participate in life and in society, would contribute to preventing the “handicap”. A handicap thus is not the direct result of an existing impairment or disability, but the result of the interaction between an individual with a disability, the social context and the immediate surroundings.

It may not be assumed at the outset, therefore, that a person with an impairment or disability must automatically also have a handicap. Many disabled individuals succeed, despite the limitations caused by their disability, in the full pursuit of a profession. On the other hand, not every handicap can be attributed to a disability. It can also be caused by a lack of education that may or may not be linked with disability.

This hierarchical system of classification—impairment, disability, handicap—can be compared with the various phases of rehabilitation; for example, when the purely curative treatment is followed by rehabilitation of functional and psycho-social limitations and is completed with vocational rehabilitation or training for an independent pursuit of life.

The objective assessment of the degree of a disability in the sense of its social consequences (handicap) cannot, for this reason, rely solely upon medical criteria, but must take into account the vocational, social and personal contexts—especially the attitude of the non-disabled population. This state of affairs makes it quite difficult to measure and unequivocally establish a “state of disability”.

Definitions in Use in Various Countries

Disability as a legal category for the establishment of claims

Disability status is determined, as a rule, by a competent national authority on the basis of findings after an examination of individual cases. Therefore, the purpose for which disability status should be recognized plays an essential role—for example, where the determination of the presence of a disability serves the purpose of laying claim to specific personal rights and legal benefits. The primary interest in having a legally sound definition of disability is thus motivated not by medical, rehabilitative or statistical reasons, but rather by juridical reasons.

In many countries, persons whose disability is recognized can lay claim to the right to various services and regulatory measures in specific areas of health and social policies. As a rule, such regulations or benefits are designed to improve their personal situation and to support them in overcoming difficulties. The basis for the guarantee of such benefits thus is an act of official recognition of an individual’s disability on the strength of the respective statutory provisions.

Examples of definition from legislative practice

These definitions vary widely between different states. Only a few examples that are currently in use can be cited here. They serve to illustrate the variety as well as the questionable character of many definitions. As it cannot be the purpose here to discuss specific legal models, the sources of the quotations are not given, nor is an evaluation of which definitions appear more adequate than others. Examples of national definitions of disabled persons:

  • Those who are afflicted with a not only temporary functional impairment which is due to an irregular physical, mental or psychological condition or any who are threatened with such a disability. If the degree of disability amounts to at least 50%, it is considered a severe disability.
  • All those whose working capacity is diminished by at least 30% (for physical disability) or at least 20% (for mental disability).
  • All those whose opportunities to obtain and hold (secure and retain) employment are restricted by either a lack or limitation in their physical or mental capabilities.
  • All those who because of an impairment or invalidity are hindered or prevented from the accomplishment of normal activities. The impairment may concern both mental and bodily functions.
  • All those whose ability to work is permanently restricted because of a physical, psychical or sensory defect.
  • All those who need care or special treatment to assure the support, development and restoration of their vocational capabilities. This includes physical, mental, psychical and social disabilities.
  • All those who because of a permanent limitation to their physical, mental or sensory capabilities—independent of whether hereditary or acquired—enjoy only restricted opportunities to pursue an education and participate in vocational and social life.
  • Victims of industrial accidents, war disabled and individuals who suffer from a physical, mental or psychical impairment. The reduction of working capacity must amount to at least 30%.
  • All those who because of an impairment, illness or hereditary disease experience substantially reduced opportunities in securing and retaining employment appropriate to their age, experience and qualifications.
  • Persons with a physical or mental impairment which, to a significant extent, restricts an important part of their life activity or those who are assumed to suffer from such an impairment or for whom earlier records about such impairments exist.
  • Persons who are afflicted with a functional disorder or disease that leads to: (a) a total or partial loss of physical or mental functions; (b) illnesses caused or which will forseeably be caused by the presence of organisms in the body; (c) a loss of normal function due to deformation of body parts; (d) the appearance of learning difficulties not present in individuals without functional disorders or restrictions; (e) an impairment to behaviour, thought process, judgement and emotional life.
  • Persons who, due to physical or mental impairment as a result of a birth defect, illness or accident, are presumed incapable of earning their living, either permanently or for an extended period of time.
  • Persons who, as a result of an illness, injury, a mental or physical weakness, are not in the position for a period of at least six months to earn, from work that corresponds to their potential abilities and cultural level, a specific fraction (1/3, 1/2, 2/3) of that income, which an individual in good condition in the same profession and at the same cultural level would receive.
  • The term disability means, with respect to an individual: (a) a physical or mental impairment that substantially limits one or more of the major life activities of such individual; (b) a record of such an impairment; or (c) being regarded as having such impairment.

 

The multitude of legal definitions which partially supplement and partially exclude one another suggest that definitions serve, above all, bureaucratic and administrative goals. Among all the listed definitions not one can be considered satisfactory, and all raise more questions than they answer. Beyond a few exceptions, most definitions are oriented towards the representation of an individual deficiency and do not address the correlation between an individual and his or her environment. What in reality is the reflection of a complex relativity is reduced in an administrative context to an apparently clear-cut and stable quantity. Such oversimplified definitions then tend to take on a life of their own and frequently force individuals into accepting a status that is commensurate with the law, but not necessarily with their own potential and aspirations.

Disability as an issue for sociopolitical action

Individuals who are recognized as disabled are, as a rule, entitled to measures such as medical and/or vocational rehabilitation or to draw on specific financial benefits. In some countries, the range of sociopolitical measures also includes the granting of certain privileges and support as well as special protective measures. Examples include: a legally embodied principle of equality of opportunity in vocational and social integration; a legally established right to needed assistance in the realization of equal opportunity, a constitutional right to education and vocational integration; the furtherance of vocational training and placement in employment; and a constitutional assurance of increased support in case of need of special help from the state. Several states proceed from the absolute equality of all citizens in all areas of life and have set the realization of this equality as their goal, without seeing a reason for treating the special problems of disabled persons in laws enacted expressly for that purpose. These states usually refrain from defining disability altogether.

Disability in the context of vocational rehabilitation

In contrast to the establishment of pension claims or privileges, the definition of disability in the area of vocational integration emphasizes the avoidable and correctable effects of disability. It is the purpose of such definitions to eliminate, through rehabilitative provisions and active labour market policies, the vocational disadvantages connected with disability. The vocational integration of disabled persons is supported by the allocation of financial assistance, by accompanying provisions in the area of vocational training and by the accommodation of the workplace to the special needs of the disabled worker. Here again, the practices vary greatly between different countries. The range of benefits runs from relatively slight and short-term financial allocations to large-scale, longer-term vocational rehabilitation measures.

Most states set a relatively high value on the furtherance of vocational training for disabled individuals. This can be provided in ordinary or special centres run by public or private agencies, as well as in an ordinary enterprise. Preference given to each differs from country to country. Sometimes the vocational training is conducted in a sheltered workshop or provided as on-the-job training that is reserved for a disabled worker.

As the financial implications of these measures can be considerable for the taxpayer, the act of recognizing a disability is a far-reaching measure. Often, however, the registration is done by a different authority than that which administers the vocational rehabilitation programme and which meets its costs.

Disability as a permanent disadvantage

While the goal of vocational rehabilitation is to overcome the possible negative effects of disability, there exists wide agreement in disability legislation that further protective social measures are sometimes necessary to assure the vocational and social integration of rehabilitated individuals. It is also generally recognized that disability presents the continuing risk of social exclusion independent of the existence of an actual functional disorder. In recognition of this permanent threat, legislators provide a series of protective and supportive measures.

In many countries, for example, employers who are prepared to employ disabled persons in their companies can expect subsidies towards the wages and social security contributions of the disabled workers, the amount and duration of which will vary. Generally, an effort is made to assure that disabled employees receive the same income as non-disabled employees. This can result in situations wherein disabled individuals who receive a lower wage from their employers are refunded up to the full difference through arrangements made by the social protection system.

Even the establishment of small businesses by disabled individuals may be supported through various measures such as loans and loan guarantees, interest subsidies and rent allowances.

In many countries, the protection of disabled individuals from dismissal and the protection of their right to re-employment is handled in different ways. Many states have no special legal regulation for the dismissal of disabled persons; in some, a special commission or institution decides on the justification and legitimacy of a dismissal; in others, special regulations for victims of industrial accidents, for severely disabled workers and for workers on extended periods of sick-leave are still in effect. The legal situation with regard to the re-employment of disabled individuals is similar. Here too, there are countries which recognize a general obligation of the enterprise to keep a worker employed after injury or to re-employ him or her after completion of rehabilitation measures. In other countries, businesses are not under any obligation to re-employ disabled employees. Furthermore, there exist in some countries recommendations and conventions as to how to proceed in such cases, as well as countries in which the employee who has suffered a specific occupational disability is guaranteed either redeployment or return to the previous job after his or her medical recovery is complete.

Differences in treatment by cause of disability

The above overview helps to illustrate that laws provide different types of legal claim which bear clear consequences for the respective national concept of disability. Also the reverse is true: in those countries which provide no such legal entitlements, there exists no need to define disability in legally clear and binding terms. In such cases, the predominant inclination is to recognize as disabled only those who are visibly and markedly disabled in a medical sense—that is, persons with physical impairments, blindness, deafness or mental handicap.

In modern disability legislation—though less in the realm of social security provision—the principle of finality is becoming more grounded. This principle means that not the cause of a disability, but exclusively the needs associated with the disability and the final outcome of measures should be the concern of legislators. Nevertheless, the social status and the legal claims of disabled individuals are often dependent on the cause of their disability.

In consideration of the cause of disability, definitions differ not only in meaning but also in the implications they have in terms of potential benefits and assistance. The most important distinctions are made between disabilities that result from hereditary or birth-related physical, mental or psychological deficiencies or impairments; disabilities brought on by diseases; disabilities caused by home, work, sport or traffic accidents; disabilities brought on by occupational or environmental influences; and disabilities as a result of civil strife and armed conflict.

The relative preference shown to some disabled groups is often the consequence of their respectively better coverage under the social security system. Preference can also reflect the attitude of a community—for instance in the case of war veterans or accident victims—that feels a co-responsibility for the incident that led to the disability, while hereditary disability is often regarded as a problem of the family only. Such societal attitudes towards disability often have more significant consequences than official policy and can sometimes exert a decisive influence—negative or positive—on the process of social reintegration.

Summary and outlook

The diversity of historical, legal and cultural situations renders the discovery of a unitary concept of disability, equally applicable to all countries and situations, virtually impossible. For lack of a common and objective definition of disability, statistics are frequently provided by authorities as a means of keeping client records and interpreting the outcome of measures—a fact that makes an international comparison very difficult, as systems and conditions vary greatly among countries. Even where reliable statistics exist, the problem remains that individuals may be included in statistics who are no longer disabled or who, after successful rehabilitation, are no longer inclined to consider themselves disabled.

In most industrialized countries, the definition of disability is, above all, connected with legal entitlements to medical, social and vocational measures, to protection against discrimination or to cash benefits. As such, most definitions in use reflect legal practice and requirements that differ from country to country. In many cases, the definition is linked to an act of official recognition of disability status.

Owing to developments as different as the emergence of human rights legislation and technological advancements, traditional concepts of disability that led to situations of protected exclusion and segregation are losing ground. A modern concept of disability puts the issue at the intersection between social and employment policies. Disability is thus a term of social and vocational, rather than of medical, relevance. It demands corrective and positive measures to ensure equal access and participation, rather than passive measures of income support.

A certain paradox arises out of the understanding of disability as, on the one hand, something which can be overcome through positive measures, and, on the other, as something lasting which necessitates permanent protective or ameliorative measures. A similar frequently encountered contradiction is that between the idea of disability as fundamentally an issue of individual performance or function restriction, and the idea of disability as the unjustified cause for social exclusion and discrimination.

Opting for one all-encompassing definition can have grave social consequences for particular individuals. Were it declared that all disabled persons are able to work, many would be deprived of their pension claims and social protection. Were all disabled persons judged to show a reduced productivity/performance, hardly a disabled individual would obtain employment. This means that a pragmatic approach must be sought that accepts the heterogeneity of the reality that an ambiguous term such as disability tends to conceal. The new view of disability takes into account the specific situation and needs of disabled individuals as well as the economic and social feasibility of removing barriers to integration.

The goal of preventing undue disadvantage that may be linked with a disability will best be achieved where a flexible definition of disability is applied that takes into account the specific personal and social circumstances of an individual and that avoids stereotyped assumptions. This calls for a case-by-case approach to recognizing disability, which still is needed where different statutory rights and entitlements, notably those to achieve equal training and employment opportunities, are granted under various national laws and regulations.

Nonetheless, definitions of disability are still in use that evoke negative connotations and that contradict integrative concepts by overemphasizing the limiting effects of an impairment. A new view of the matter is called for. The focus should be on recognizing disabled individuals as citizens endowed with rights and abilities, and on empowering them to take charge of their destiny as adults who want to take part in the mainstream of social and economic life.

Likewise, efforts must continue to instill in the community a sense of solidarity that no longer uses a flawed concept of disability as grounds for the careless exclusion of fellow citizens. Between excessive care and neglect there should exist a sober conception of disability which neither mystifies nor underestimates its consequences. Disability can, but need not always, provide the grounds for specific measures. It should in no case provide a justification for discrimination and social exclusion.

 

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Until very recently the effectiveness of training and education in controlling occupational health and safety hazards was largely a matter of faith rather than systematic evaluation (Vojtecky and Berkanovic 1984-85; Wallerstein and Weinger 1992). With the rapid expansion of intensive federally-funded training and education programmes in the past decade in the United States, this has begun to change. Educators and researchers are applying more rigorous approaches to evaluating the actual impact of worker training and education on outcome variables such as accident, illness and injury rates and on intermediate variables such as the ability of workers to identify, handle and resolve hazards in their workplaces. The programme that combines chemical emergency training as well as hazardous waste training of the International Chemical Workers Union Center for Worker Health and Safety Education provides a useful example of a well-designed programme which has incorporated effective evaluation into its mission.

The Center was established in Cincinnati, Ohio, in 1988 under a grant which the International Chemical Workers Union (ICWU) received from the National Institute for Environmental Health Sciences to provide training for hazardous waste and emergency response workers. The Center is a cooperative venture of six industrial unions, a local occupational health centre and a university environmental health department. It adopted an empowerment education approach to training and defines its mission broadly as:

… promoting worker abilities to solve problems and to develop union-based strategies for improving health and safety conditions at the worksite (McQuiston et al. 1994).

To evaluate the programme’s effectiveness in this mission the Center conducted long-term follow-up studies with the workers who went through the programme. This comprehensive evaluation went considerably beyond the typical assessment which is conducted immediately following training, and measures trainees’ short-term retention of information and satisfaction with (or reaction to) the education.

Programme and Audience

The course that was the subject of evaluation is a four or five-day chemical emergency/hazardous waste training programme. Those attending the courses are members of six industrial unions and a smaller number of management personnel from some of the plants represented by the unions. Workers who are exposed to substantial releases of hazardous substances or who work with hazardous waste less proximately are eligible to attend. Each class is limited to 24 students so as to promote discussion. The Center encourages local unions to send three or four workers from each site to the course, believing that a core group of workers is more likely than an individual to work effectively to reduce hazards when they return to the workplace.

The programme has established interrelated long-term and short-term goals:

Long-term goal: for workers to become and remain active participants in determining and improving the health and safety conditions under which they work.

Immediate educational goal: to provide students with relevant tools, problem-solving skills, and the confidence needed to use those tools (McQuiston et al. 1994).

In keeping with these goals, instead of focusing on information recall, the programme takes a “process oriented” training approach which seeks “to build self-reliance that stresses knowing when additional information is needed, where to find it, and how to interpret and use it.” (McQuiston et al. 1994.)

The curriculum includes both classroom and hands-on training. Instructional methods emphasize small group problem-solving activities with the active participation of the workers in the training. The development of the course also employed a participatory process involving rank-and-file safety and health leaders, programme staff and consultants. This group evaluated initial pilot courses and recommended revisions of the curriculum, materials and methods based on extensive discussions with trainees. This formative evaluation is an important step in the evaluation process that takes place during programme development, not at the end of the programme.

The course introduces the participants to a range of reference documents on hazardous materials. Students also develop a “risk chart” for their own facility during the course, which they use to evaluate their plant’s hazards and safety and health programmes. These charts form the basis for action plans which create a bridge between what the students learn at the course and what they decide needs to be implemented back in the workplace.

Evaluation Methodology

The Center conducts anonymous pre-training and post-training knowledge tests of participants to document increased levels of knowledge. However, to determine the long-term effectiveness of the programme the Center uses telephone follow-up interviews of students 12 months after training. One attendee from each local union is interviewed while every manager attendee is interviewed. The survey measures outcomes in five major areas:

  1. students’ ongoing use of resource and reference materials introduced during training
  2. the amount of secondary training, that is, training conducted by participants for co-workers back at the worksite following attendance at the Center course
  3. trainee attempts and successes in obtaining changes in worksite emergency response or hazardous waste programmes, procedures or equipment
  4. post-training improvements in the way spills are handled at the worksite
  5. students' perceptions of training programme effectiveness. 

 

The most recent published results of this evaluation are based on 481 union respondents, each representing a distinct worksite, and 50 management respondents. The response rates to the interviews were 91.9% for union respondents and 61.7% for management.

Results and Implications

Use of resource materials

Of the six major resource materials introduced in the course, all except the risk chart were used by at least 60% of the union and management trainees. The NIOSH Pocket Guide to Chemical Hazards and the Center’s training manual were the most widely used.

Training of co-workers

Almost 80% of the union trainees and 72% of management provided training to co-workers back at the worksite. The average number of co-workers taught (70) and the average length of training (9.7 hours) were substantial. Of special significance was that more than half of the union trainees taught managers at their worksites. Secondary training covered a wide range of topics, including chemical identification, selection and use of personal protective equipment, health effects, emergency response and use of reference materials.

Obtaining worksite improvements

The interviews asked a series of questions related to attempts to improve company programmes, practices and equipment in 11 different areas, including the following seven especially important ones:

  • health effects training
  • availability of material safety data sheets
  • chemical labelling
  • respirator availability, testing and training
  • gloves and protective clothing
  • emergency response
  • decontamination procedures.

 

The questions determined whether respondents felt changes were needed and, if so, whether improvements had been made.

In general, union respondents felt greater need for and attempted more improvements than management, although the degree of difference varied with specific areas. Still fairly high percentages of both unions and management reported attempted improvements in most areas. Success rates over the eleven areas ranged from 44 to 90% for unionists and from 76 to 100% for managers.

Spill response

Questions concerning spills and releases were intended to ascertain whether attendance at the course had changed the way spills were handled. Workers and managers reported a total of 342 serious spills in the year following their training. Around 60% of those reporting spills indicated that the spills were handled differently because of the training. More detailed questions were subsequently added to the survey to collect additional qualitative and quantitative data. The evaluation study provides workers’ comments on specific spills and the role the training played in responding to them. Two examples are quoted below:

Following training the proper equipment was issued. Everything was done by the books. We have come a long way since we formed a team. The training was worthwhile. We don’t have to worry about the company, now we can judge for ourselves what we need.

The training helped by informing the safety committee about the chain of command. We are better prepared and coordination through all departments has improved.

Preparedness

The great majority of union and management respondents felt that they are “much better” or “somewhat better” prepared to handle hazardous chemicals and emergencies as a result of the training.

Conclusion

This case illustrates many of the fundamentals of training and education programme design and evaluation. The goals and objectives of the educational programme are explicitly stated. Social action objectives regarding workers’ ability to think and act for themselves and advocate for systemic changes are prominent along with the more immediate knowledge and behaviour objectives. The training methods are chosen with these objectives in mind. The evaluation methods measure the achievement of these objectives by discovering how the trainees applied the material from the course in their own work environments over the long term. They measure training impact on specific outcomes such as spill response and on intermediate variables such as the extent to which training is passed on to other workers and how course participants use resource materials.


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Tuesday, 15 February 2011 18:40

Community-Based Organizations

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The role of community groups and the voluntary sector in occupational health and safety has grown rapidly during the past twenty years. Hundreds of groups spread across at least 30 nations act as advocates for workers and sufferers from occupational diseases, concentrating on those whose needs are not met within workplace, trade union or state structures. Health and safety at work forms part of the brief of many more organizations which fight for workers’ rights, or on broader health or gender-based issues.

Sometimes the life-span of these organizations is short because, in part as a result of their work, the needs to which they respond become recognized by more formal organizations. However, many community and voluntary sector organizations have now been in existence for 10 or 20 years, altering their priorities and methods in response to changes in the world of work and the needs of their constituency.

Such organizations are not new. An early example was the Health Care Association of the Berlin Workers Union, an organization of doctors and workers which provided medical care for 10,000 Berlin workers in the mid-nineteenth century. Before the rise of industrial trade unions in the nineteenth century, many informal organizations fought for a shorter working week and the rights of young workers. The lack of compensation for certain occupational diseases formed the basis for organizations of workers and their relatives in the United States in the mid-1960s.

However, the recent growth of community and voluntary sector groups can be traced to the political changes of the late 1960s and 1970s. Increasing conflict between workers and employers focused on working conditions as well as pay.

New legislation on health and safety in the industrialized countries arose from an increased concern with health and safety at work amongst workers and trade unions, and these laws in turn led to further increases in public awareness. While the opportunities offered by this legislation have seen health and safety become an area for direct negotiation between employers, trade unions and government in most countries, workers and others suffering from occupational disease and injury have frequently chosen to exert pressure from outside these tripartite discussions, believing that there should be no negotiation over fundamental human rights to health and safety at work.

Many of the voluntary sector groups formed since that time have also taken advantage of cultural changes in the role of science in society: an increasing awareness amongst scientists of the need for science to meet the needs of workers and communities, and an increase in the scientific skills of workers. Several organizations recognize this alliance of interest in their title: the Academics and Workers Action (AAA) in Denmark, or the Society for Participatory Research in Asia, based in India.

Strengths and Weaknesses

The voluntary sector identifies as its strengths an immediacy of response to emerging problems in occupational health and safety, open organizational structures, the inclusion of marginalized workers and sufferers from occupational disease and injury, and a freedom from institutional constraints on action and utterance. The problems of the voluntary sector are uncertain income, difficulties in marrying the styles of voluntary and paid staff, and difficulties in coping with the overwhelming unmet needs of workers and sufferers from occupational ill-health.

The transient character of many of these organizations has already  been  mentioned.  Of 16  such  organizations  known  in the  UK  in  1985,  only  seven  were  still  in  existence  in  1995. In the meantime, 25 more had come into existence. This is characteristic of voluntary organizations of all kinds. Internally they are frequently non-hierarchically organized, with delegates or affiliates from trade unions and other organizations as well as others suffering from work-related health problems. While links with trade unions, political parties and governmental bodies are essential to their effectiveness in improving conditions at work, most have chosen to keep such relationships indirect, and to be funded from several sources—typically, a mixture of statutory, labour movement, commercial or charitable sources. Many more organizations are entirely voluntary or produce a publication from subscriptions which cover printing and distribution costs only.

Activities

The activities of these voluntary sector bodies can be broadly categorized as based on single hazards (illnesses, multinational companies, employment sectors, ethnic groups or gender); advice centres; occupational health services; newsletter and magazine production; research and educational bodies; and supranational networks.

Some of the longest-established bodies fight for the interests of sufferers from occupational diseases, as shown in the following list, which summarizes the principal concerns of community groups around the world: multiple chemical sensitivity, white lung, black lung, brown lung, Karoshi (sudden death through overwork), repetitive strain injury, accident victims, electrical sensitivity, women’s occupational health, Black and ethnic minority occupational health, white lung (asbestos), pesticides, artificial mineral fibres, microwaves, visual display units, art hazards, construction work, Bayer, Union Carbide, Rio Tinto Zinc.

Concentration of efforts in this way can be particularly effective; the publications of the Center for Art Hazards in New York City were models of their kind, and projects drawing attention to the special needs of migrant minority ethnic workers have had successes in the United Kingdom, the United States, Japan and elsewhere.

A dozen organizations around the world fight for the particular health problems of ethnic minority workers: Latino workers in the United States; Pakistani, Bengali and Yemeni workers in England; Moroccan and Algerian workers in France; and South-East Asian workers in Japan among others. Because of the severity of the injuries and illnesses suffered by these workers, adequate compensation, which often means recognition of their legal status, is a first demand. But an end to the practice of double standards in which ethnic minority workers are employed in conditions which majority groups will not tolerate is the main issue. A great deal has been achieved by these groups, in part through securing better provision of information in minority languages on health and safety and employment rights.

The work of the Pesticides Action Network and its sister organizations, especially the campaign to get certain pesticides banned (the Dirty Dozen Campaign) has been notably successful. Each of these problems and the systematic abuse of the working and external environments by certain multinational companies are intractable problems, and the organizations dedicated to resolving them have in many cases won partial victories but have set themselves new goals.

Advice Centres

The complexity of the world of work, the weakness of trade unions in some countries, and the inadequacy of statutory provision of health and safety advice at work, have resulted in the setting up of advice centres in many countries. The most highly developed networks in English-speaking countries deal with tens of thousands of enquiries each year. They are largely reactive, responding to needs as reflected by those who contact them. Recognized changes in the structure of advanced economies, towards a reduction in the size of workplaces, casualization, and an increase in informal and part-time work (each of which creates problems for the regulation of working conditions) have enabled advice centres to obtain funding from state or local government sources. The European Work Hazards Network, a network of workers and workers’ health and safety advisers, has recently received European Union funding. The South African advice centres network received EU development funding, and community-based COSH groups in the United States at one time received funds through the New Directions programme of the US Occupational Safety and Health Administration.

Occupational Health Services

Some of the clearest successes of the voluntary sector have been in improving the standard of occupational health service provision. Organizations of medically and technically trained staff and workers have demonstrated the need for such provision and pioneered novel methods of delivering occupational health care. The sectoral occupational health services which have been brought into existence progressively over the last 15 years in Denmark received powerful advocacy from the AAA particularly for the role of workers’ representatives in management of the services. The development of primary-care-based services in the UK and of specific services for sufferers from work-related upper limb disorders in response to the experience of workers’ health centres in Australia are further examples.

Research

Changes within science during the 1960s and 1970s have lead to experimentation with new methods of investigation described as action research, participatory research or lay epidemiology. The definition of research needs by workers and their trade unions has created an opportunity for a number of centres specializing in carrying out research for them; the network of Science Shops in the Netherlands, DIESAT, the Brazilian trade union health and safety resource centre, SPRIA (the Society for Participatory Research in Asia) in India, and the network of centres in the Republic of South Africa are amongst the longest established. Research carried out by these bodies acts as a route by which workers’ perceptions of hazards and their health become recognized by mainstream occupational medicine.

Publications

Many voluntary sector groups produce periodicals, the largest of which sell thousands of copies, appear up to 20 times a year and are read widely within statutory, regulatory and trade union bodies as well as by their target audience amongst workers. These are effective networking tools within countries (Hazards bulletin in the United Kingdom; Arbeit und Ökologie (Work and the Environment) in Germany). The priorities for action promoted by these periodicals may initially reflect cultural differences from other organizations, but frequently become the priorities of trades unions and political parties; the advocacy of stiffer penalties for breaking health and safety law and for causing injury to, or the death of, workers are recurrent themes.

International Networks

The rapid globalization of the economy has been reflected in trade unions through the increasing importance of the international trade secretariats, area-based trade union affiliations like the Organization of African Trade Union Unity (OATUU), and meetings of workers employed in particular sectors. These new bodies frequently take up health and safety concerns, the African Charter on Occupational Health and Safety produced by OATUU being a good example. In the voluntary sector international links have been formalized by groups which concentrate on the activities of particular multinational companies (contrasting the safety practices and health and safety record of constituent businesses in different parts of the world, or the health and safety record in particular industries, such as cocoa production or tyre manufacture), and by networks across the major free trade areas: NAFTA, EU, MERCOSUR and East Asia. All these international networks call for the harmonization of standards of worker protection, the recognition of, and compensation for, occupational disease and injury, and worker participation in health and safety structures at work. Upward harmonization, to the best extant standard, is a consistent demand.

Many of these international networks have grown up in a different political culture from the organizations of the 1970s, and see direct links between the working environment and the environment outside the workplace. They call for higher standards of environmental protection and make alliances between workers in companies and those who are affected by the companies’ activities; consumers, indigenous people in the vicinity of mining operations, and other residents. The international outcry following the Bhopal disaster has been channelled through the Permanent People’s Tribunal on Industrial Hazards and Human Rights, which has made a series of demands for the regulation of the activities of international business.

The effectiveness of voluntary sector organizations can be assessed in different ways: in terms of their services to individuals and groups of workers, or in terms of their effectiveness in bringing about changes in working practice and the law. Policy making is an inclusive process, and policy proposals rarely originate from one individual or organization. However, the voluntary sector has been able to reiterate demands which were at first unthinkable until they have become acceptable.

Some recurrent demands of voluntary and community groups include:

  • a code of ethics for multinational companies
  • higher penalties for corporate manslaughter
  • workers’ participation in occupational health services
  • recognition of additional industrial diseases (e.g., for the purpose of compensation awards)
  • bans on the use of pesticides, asbestos, artificial mineral fibres, epoxy resins and solvents.

 

The voluntary sector in occupational health and safety exists because of the high cost of providing a healthy working environment and appropriate services and compensation for the victims of poor working conditions. Even the most extensive systems of provision, like those in Scandinavia, leave gaps which the voluntary sector attempts to fill. The increasing pressure for deregulation of health and safety in the long-industrialized countries in response to competitive pressures from transitional economies has created a new campaign theme: the maintenance of high standards and upward harmonization of standards in different nations’ legislation.

While they can be seen as performing an essential role in the process of initiating legislation and regulation, they are necessarily impatient about the speed with which their demands are accepted. They will continue to grow in importance wherever workers find that state provisions fall short of what is needed.

 

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The Vocational Rehabilitation and Employment (Disabled Persons) Convention, 1983 (No. 159) and Vocational Rehabilitation and Employment (Disabled Persons) Recommendation, 1983 (No.168),  which  supplement  and  update  the  Vocational  Rehabilitation (Disabled) Recommendation, 1955 (No. 99), are the principal reference documents for a social policy on the issue of disability. However, there are a number of other ILO instruments which explicitly or implicitly make reference to disability. There are notably the Discrimination (Employment and Occupation) Convention, 1958 (No. 111), the Discrimination (Employment and Occupation) Recommendation, 1958 (No. 111), the Human Resources  Development  Convention,  1975  (No. 142)  and  the Human Resources Development Recommendation, 1975 (No.150)

In addition, important references to disability issues are included in a number of other key ILO instruments, such as: Employment Service Convention, 1948 (No. 88); Social Security (Minimum Standards) Convention, 1952 (No. 102); Employment Injury Benefits Convention, 1964 (No. 121); Employment Promotion and Protection against Unemployment Convention, 1988 (No. 168); Employment Service Recommendation, 1948 (No. 83); Labour Administration Recommendation, 1978 (No. 158) and Employment Policy (Supplementary Provisions) Recommendation, 1984 (No. 169).

International labour standards treat disability basically under two different headings: as passive measures of income transfer and social protection, and as active measures of training and employment promotion.

One early objective of the ILO was to ensure that workers receive adequate financial compensation for disability, in particular if it was caused in relation to work or war activities. The underlying concern has been to ensure that a damage is adequately compensated, that the employer is liable for accidents and unsafe working conditions, and that in the interest of good labour relations, there should be fair treatment of workers. Adequate compensation is a fundamental element of social justice.

Quite distinct from the compensation objective is the social protection objective. ILO standards which deal with issues of social security look at disability largely as a “contingency” which needs to be covered under social security legislation, the idea being that disability can be a cause of loss of earning capacity and therefore be a legitimate reason to secure income through transfer payments. The principal objective is to provide insurance against loss of income and thus guarantee decent living conditions for people deprived of the means of gaining their own income due to impairment.

In a similar way, policies which pursue a social protection objective tend to provide public assistance to people with disabilities not covered by social insurance. Also in this case the tacit assumption is that disability means incapacity to find adequate income from work, and that a disabled person has therefore to be the responsibility of the public. As a result, disability policy is in many countries predominantly a concern of the social welfare authorities, and the primary policy is that of providing passive measures of financial assistance.

However, those ILO standards which deal explicitly with disabled persons (such as Conventions Nos. 142 and 159, and Recommendations Nos. 99, 150 and 168) treat them as workers and put disability—quite in contrast to the compensation and social protection concepts—in the context of labour market policies, which have as their objective to ensure equality of treatment and opportunity in training and employment, and which look at disabled people as being part of the economically active population. Disability is understood here basically as a condition of occupational disadvantage which can be and should be overcome through a variety of policy measures, regulations, programmes and services.

ILO Recommendation No. 99 (1955), which for the first time invited member States to shift their disability policies from a social welfare or social protection objective towards a labour integration objective, had a profound impact on law in the 1950s and 1960s. But the real breakthrough occurred in 1983 when the International Labour Conference adopted two new instruments, ILO Convention No. 159 and Recommendation No. 168. As of March 1996, 57 out of 169 member States had ratified this Convention.

Many others have readjusted their legislation so as to comply with this Convention even if they have not, or not yet, ratified this international treaty. What distinguishes these new instruments from the former ones is the recognition by the international community and by employers’ and workers’ organizations of the right of disabled persons to equal treatment and opportunity in training and employment.

These three instruments now form a unity. They aim to ensure active labour market participation of disabled people and thus to challenge the sole validity of passive measures or of policies which treat disability as a health problem.

The purposes of the international labour standards which have been adopted with this objective in mind can be described as follows: to remove the barriers which stand in the way of full social participation and integration of disabled people in the mainstream, and to provide the means to promote effectively their economic self-reliance and social independence. These standards oppose a practice that treats disabled people as being outside the norm and excludes them from the mainstream. They object to the tendency of taking disability as a justification for social marginalization and for denying people, on account of their disability, civil and workers’ rights which non-disabled people enjoy as a matter of course.

For the purpose of clarity we may group the provisions of international labour standards which promote the concept of the right of disabled people to active participation in training and employment into two groups: those which address the principle of equal opportunity and those which address the principal of equal treatment.

Equal opportunity: the policy goal which lies behind this formula is to ensure that a disadvantaged population group has access to the same employment and income-earning possibilities and opportunities as the mainstream population.

In order to achieve equal opportunity for disabled people, the pertinent international labour standards have established rules and recommended measures for three types of action:

  • Action  to  empower  the  disabled  individual to  achieve  the  level of competencies and abilities required to take advantage of employment opportunity and to provide the technical means and the required assistance which would enable that individual to cope with the demands of a job. This type of action is what essentially constitutes the process of vocational rehabilitation.
  • Action which helps to adjust the environment to the special needs of disabled persons, such as worksite, job, machine or tool adaptations as well as legal and promotional action which helps to overcome negative and discriminatory attitudes that cause exclusion.
  • Action which ensures disabled people real employment opportunities. This includes legislation and policies which favour remunerative work over passive income support measures, as well as those which entice employers to employ, or to maintain in employment, workers with a disability.
  • Action which sets employment targets or establishes quotas or levies (fines) under affirmative action programmes. It also includes services by which labour administrations and other bodies may assist disabled people to find jobs and to advance in their careers.

 

Therefore, these standards, which have been developed to guarantee equality of opportunity, imply the promotion of special positive measures to help disabled people make the transition into active life or to prevent unnecessary, unwarranted transition into a life reliant upon passive income support. Policies geared to establish equality of opportunity are, therefore, usually concerned with the development of support systems and special measures to bring about effective equality of opportunities, which are justified by the need to compensate for the real or presumed disadvantages of disability. In ILO legal parlance: “Special positive measures aimed at effective equality of opportunity … between disabled workers and other workers shall not be regarded as discriminating against other workers” (Convention No. 159, Article 4).

Equal treatment: The precept of equal treatment has a related but distinct objective. Here the issue is that of human rights, and the regulations which ILO member States have agreed to observe have precise legal implications and are subject to monitoring and—in case of violation—to legal recourse and/or arbitration.

ILO Convention No. 159 established equal treatment as a guaranteed right. It furthermore specified that equality has to be “effective”. This means that conditions should be such as to ensure that the equality is not only formal but real and that the situation resulting from such treatment puts the disabled person into an “equitable” position, that is one which corresponds by its results and not by its measures to that of non-disabled persons. For example, to assign a disabled worker the same job as a non-disabled worker is not equitable treatment if the worksite is not fully accessible or if the job is not suited to the disability.

Present Legislation on Vocational Rehabilitation and Employment of Disabled Persons

Each country has a different history of vocational rehabilitation and employment of disabled persons. The legislation of member States varies due to their different stages of industrial development, social and economic situations, and so on. For example, some countries already had legislation on disabled persons before the Second World War, deriving from disability measures for disabled veterans or poor people at the beginning of this century. Other countries started to take concrete measures to support disabled persons after the Second World War, and established legislation in the field of vocational rehabilitation. This was often expanded following the adoption of the Vocational Rehabilitation of the Disabled Recommendation, 1955 (No. 99) (ILO 1955). Other countries only recently started taking measures for disabled persons due to the awareness created by the International Year of Disabled Persons in 1981, the adoption of ILO Convention No.159 and Recommendation No. 168 in 1983 and the United Nations Decade of Disabled Persons (1983–1992).

The current legislation on vocational rehabilitation and employment of disabled persons is divided into four types according to different historical backgrounds and policies (figure 1).

Figure 1. Four types of legislation on rights of persons with disabilities.

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We must realize that there are no clear divisions between these four groups and that they may overlap. Legislation in a country may correspond not only to one type, but to several. For example, the legislation of many countries is a combination of two types or more. It seems that the legislation of Type A is formulated in the early stage of measures for disabled persons, whereas the legislation of Type B is from a later stage. The legislation of Type D, namely the prohibition of discrimination because of disabilities, has been growing in recent years, supplementing the prohibition of discrimination on the basis of race, sex, religion, political opinion and so on. The comprehensive nature of legislation of Types C and D may be used as models for those developing countries which have not yet formulated any concrete legislation on disability.

Sample Measures of each Type

In the following paragraphs, the structure of legislation and measures stipulated are outlined by some examples of each type. As measures for vocational rehabilitation and employment of disabled persons in each country are often more or less the same, regardless of the type of legislation in which they are provided for, some overlaps occur.

Type A: Measures for disabled persons on vocational rehabilitation and employment which are provided for in general labour legislation such as employment promotion acts or vocational training acts. Measures for disabled persons may also be included as part of comprehensive measures for workers in general.

The characteristic of this type of legislation is that measures for disabled people are provided for in the acts which apply to all workers, including disabled workers, and to all enterprises employing workers. As measures on employment promotion and employment security for disabled persons are basically incorporated as part of comprehensive measures for workers in general, the national policy gives priority to internal rehabilitation efforts of enterprises and to preventive activities and early intervention in working environments. To this end, working environment committees, which consist of employers, workers and safety and health personnel are often set up in enterprises. The details of the measures tend to be provided for in regulations or rules under the acts.

For example, the Working Environment Act of Norway applies to all workers employed by most enterprises in the country. Some special measures for handicapped persons are incorporated: (1) Passageways, sanitary facilities, technical installations and equipment shall be designed and arranged so that handicapped persons can work in the enterprise, as far as possible. (2) If a worker has become handicapped in the workplace as a result of accident or sickness the employer shall, as far as possible, take the necessary measures to enable the worker to obtain or retain suitable employment. The worker shall preferably be given an opportunity to continue his or her former work, possibly after special adaptation of the work activity, alteration of technical installations, rehabilitation or retraining and so on. The following are examples of action that must be taken by the employer:

  • procurement of or changes to technical equipment used by the worker—for instance, tools, machinery, and so on
  • alterations to the workplace—this could refer to alterations to furniture and equipment, or to alterations to doorways, thresholds, installation of lifts, procurement of wheelchair ramps, repositioning of door handles and light switches, and so on
  • organization of the work—this could involve alteration of routines, changes in working hours, active participation by other workers; for instance, recording on and transcribing from a dictaphone cassette
  • measures in connection with training and retraining.

 

In addition to these measures, there is a system which provides employers of handicapped persons with subsidies concerning the additional cost to adapt the workplace to the worker, or vice versa.

Type B: Measures for disabled persons which are provided for in special acts which deal exclusively with vocational rehabilitation and employment of disabled persons.

This type of legislation usually has specific provisions on vocational rehabilitation and employment dealing with various measures, while other measures for disabled people are stipulated in other acts.

For example, the Severely Disabled Persons Act of Germany provides for the following special assistance for disabled persons to improve their employment opportunities, as well as vocational guidance and placement services:

  • vocational training in enterprises and training centres or in special vocational rehabilitation institutions
  • special benefits for disabled persons or employers—payment of application and removal costs, transitional allowances, technical adaptation of workplaces, payment of housing costs, assistance in acquiring a special vehicle or additional special equipment or in obtaining a driving licence
  • the obligation for public and private employers to reserve 6% of their workplaces for severely disabled persons; compensation payments must be paid in respect of the places not filled in this manner
  • special protection against dismissal for all severely disabled persons after a period of six months
  • representation of the interests of severely disabled persons in the enterprise by means of a staff counsellor
  • supplementary benefits for severely disabled persons to ensure their integration into occupation and employment
  • special workshops for disabled persons who are unable to work on the general labour market because of the nature or severity of their impediment
  • grants for employers of up to 80% of the wage paid to disabled persons for a period of two years, as well as payments in respect of the adaptation of workplaces and the establishment of specified probationary periods of employment.

 

Type C: Measures for the vocational rehabilitation and employment of disabled persons which are provided for in comprehensive special acts for disabled persons linked together with measures for other services such as health, education, accessibility and transportation.

This type of legislation usually has general provisions concerning the purpose, declaration of policy, coverage, definition of terms in the first chapter, and after that several chapters which deal with services in the fields of employment or vocational rehabilitation as well as health, education, accessibility, transportation, telecommunications, auxiliary social services and so on.

For example, the Magna Carta for Disabled Persons of the Philippines provides for the principle of equal opportunity for employment. The following are several measures from chapter on employment:

  • 5% of reserved employment for disabled persons in departments or agencies of the government
  • incentives for employers such as a deduction from their taxable income equivalent to a certain part of the wages of disabled persons or of the costs of improvements or modifications of facilities
  • vocational rehabilitation measures that serve to develop the skills and potentials of disabled persons and enable them to compete favourably for available productive and remunerative employment opportunities, consistent with the principle of equal opportunity for disabled workers and workers in general
  • vocational rehabilitation and livelihood services for disabled people in the rural areas
  • vocational guidance, counselling and training to enable disabled persons to secure, retain and advance in employment, and the availability and training of counsellors and other suitably qualified staff responsible for these services
  • government-owned vocational and technical schools in every province for a special vocational and technical training programme for disabled persons
  • sheltered workshops for disabled individuals who cannot find suitable employment in the open labour market
  • apprenticeship.

 

Furthermore, this act has provisions concerning prohibition of discrimination against disabled persons in employment.

Type D: Measures for prohibition of discrimination in employment on the basis of disability which are provided for in a comprehensive special anti-discrimination act along with measures for prohibition of discrimination in areas such as public transportation, public accommodation and telecommunications.

The feature of this type of legislation is that there are provisions which deal with discrimination on the ground of disability in employment, public transportation, accommodation, telecommunications and so on. Measures for vocational rehabilitation services and the employment of disabled people are provided for in other acts or regulations.

For example, the Americans with Disabilities Act prohibits discrimination in such important areas as employment, access to public accommodations, telecommunications, transportation, voting, public services, education, housing and recreation. As for employment in particular, the Act prohibits employment discrimination against “qualified individuals with a disability” who, with or without “reasonable accommodation”, can perform the essential functions of the job, unless such accommodation would impose “undue hardship” on the operation of the business. The Act prohibits discrimination in all employment practices, including job application procedures, hiring, firing, advancement, compensation, training and other terms, conditions and privileges of employment. It applies to recruitment, advertising, tenure, layoff, leave, fringe benefits and all other employment-related activities.

In Australia, the purpose of the Disability Discrimination Act is to provide improved opportunities for people with a disability and to assist in breaking down barriers to their participation in the labour market and other areas of life. The Act bans discrimination against people on the grounds of disability in employment, accommodation, recreation and leisure activities. This complements existing anti-discrimination legislation that outlaws discrimination on the grounds of race or gender.

Quota/Levy Legislation or Anti-discrimination Legislation?

The structure of national legislation on vocational rehabilitation and employment of disabled persons varies somewhat from country to country, and it is therefore difficult to determine which type of legislation is best. However, two types of legislation, namely quota or levy legislation and anti-discrimination legislation, seem to emerge as the two main legislative modes.

Although some European countries, among others, have quota systems which are usually provided in the legislation of Type B, they are quite different in some points, such as the category of disabled persons to whom the system is applied, the category of employers on whom the employment obligation is imposed (for example, size of the enterprise or public sector only) and the employment rate (3%, 6%, etc.). In most countries the quota system is accompanied by a levy or grant system. Quota provisions are also included in the legislation of non-industrialized countries as varied as Angola, Mauritius, the Philippines, Tanzania and Poland. China is also examining the possibility of introducing a quota system.

There is no doubt that a quota system that is enforceable could contribute considerably to raising the employment levels of disabled persons in the open labour market. Also, the system of levies and grants helps to rectify the financial inequality between the employers who try to employ disabled workers and the ones who do not, while levies contribute to accumulating valuable resources that are needed to finance vocational rehabilitation and incentives for employers.

On the other hand, one of the problems of the system is the fact that it requires a clear definition of disability for recognizing qualification, and strict rules and procedures for registration, and therefore it may raise the problem of stigma. There may also be the potential discomfort of a disabled person being at a place of employment where he or she is not wanted by the employer but is merely tolerated to avoid legal sanctions. In addition, credible enforcement mechanisms and their effective application are required for quota legislation to achieve results.

Anti-discrimination legislation (Type D) seems to be more appropriate for the principle of normalization, ensuring disabled persons equal opportunities in society, because it promotes employers’ initiatives and social consciousness by means of environmental improvement, not employment obligation.

On the other hand, some countries have difficulties in enforcing anti-discrimination legislation. For example, remedial action usually requires a victim to play the role of complainant, and in some cases it is difficult to prove discrimination. Also the process of remedial action commonly takes a long time because a lot of complaints of discrimination on the basis of disability are sent to courts or equal rights commissions. It is generally admitted that anti-discrimination legislation has still to prove its effectiveness in placing and maintaining large numbers of disabled workers in employment.

Future Trends

Although it is difficult to forecast future trends in legislation, it appears that anti-discrimination acts (Type D) are one stream which both developed countries and developing countries will consider.

It seems that industrialized countries with a history of quota or quota/levy legislation will watch the experience of countries such as the United States and Australia before taking action to adjust their own legislative systems. In particular in Europe, with its concepts of redistributive justice, it is likely that the prevailing legislative systems will be maintained, while, however, introducing or strengthening anti-discrimination provisions as an additional legislative feature.

In a few countries like the United States, Australia and Canada, it could be politically difficult to legislate a quota system for disabled people without having quota provisions also in relation to other population groups that experience disadvantages in the labour market, such as women and ethnic and racial minority groups currently covered by human rights or employment equity legislation. Although a quota system would have some advantages for disabled people, the administrative apparatus required for such a multicategory quota system would be enormous.

It appears that developing countries which have no disability legislation may choose legislation of Type C, including a few provisions concerning prohibition of discrimination, because it is the more comprehensive approach. The risk of this approach, however, is that comprehensive legislation which cuts across the responsibility of many ministries becomes the affair of a single ministry, mostly that responsible for social welfare. This may be counterproductive, reinforce segregation and weaken the government’s ability to implement the law. Experience shows that comprehensive legislation looks good on paper, but is rarely applied.

 

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The term environmental education covers a potentially wide range of issues and activities when applied to employees, managers and workplaces. These encompass:

  • education for general awareness of environmental concerns
  • education and training toward modifying work practices, processes and materials to reduce the environmental impact of industrial processes on local communities
  • professional education for engineers and others seeking expertise and careers in environmental fields
  • education and training of workers in the growing field of environmental abatement, including hazardous waste cleanup, emergency response to spills, releases and other accidents, and asbestos and lead paint remediation.

 

This article focuses on the state of worker training and education in the United States in the growing environmental remediation field. It is not an exhaustive treatment of environmental education, but rather an illustration of the link between occupational safety and health and the environment and of the changing nature of work in which technical and scientific knowledge has become increasingly important in such traditional “manual” trades as construction. “Training” refers in this context to shorter-term programmes organized and taught by both academic and non-academic institutions. “Education” refers to programmes of formal study at accredited two-year and four-year institutions. Currently a clear career path does not exist for individuals with interest in this field. The development of more defined career paths is one goal of the National Environmental Education and Training Center, Inc. (NEETC) at Indiana University of Pennsylvania. Meanwhile, a wide range of education and training programmes exist at different levels, offered by a variety of academic and non-academic institutions. A survey of the institutions involved in this type of training and education formed the source material for the original report from which this article was adapted (Madelien and Paulson 1995).

Training Programmes

A 1990 study conducted by Wayne State University (Powitz et al. 1990) identified 675 separate and distinct noncredit short courses for hazardous waste worker training at colleges and universities, offering over 2,000 courses nationwide each year. However, this study did not cover some of the primary providers of training, namely community college programmes, US Occupational Safety and Health Administration training programmes and independent firms or contractors. Thus, the Wayne State number could probably be doubled or tripled to estimate the number of noncredit, noncertification course offerings available in the United States today.

The major government-funded training programme in environmental remediation is that of the National Institute for Environmental Health Sciences (NIEHS). This program, established under the Superfund legislation in 1987, provides grants to non-profit organizations with access to appropriate worker populations. Recipients include labour unions; university programmes in labour education/labour studies and public health, health sciences and engineering; community colleges; and non-profit-making safety and health coalitions, known as COSH groups (Committees on Occupational Safety and Health). Many of these organizations operate in regional consortia. The target audiences include:

  • construction trades workers involved in cleanup of hazardous waste sites
  • emergency response personnel working for fire and emergency services agencies and industrial plants
  • transportation workers involved in transporting hazardous materials
  • hazardous waste treatment, storage and disposal facility workers
  • wastewater treatment workers.

 

The NIEHS program has resulted in extensive curriculum and materials development and innovation, which has been characterized by considerable sharing and synergy among grantees. The programme funds a national clearinghouse which maintains a library and curriculum centre and publishes a monthly newsletter.

Other government funded programmes offer short courses targeting hazardous waste industry professionals as opposed to front-line remedial workers. Many of these programmes are housed in university Educational Resource Centers funded by the National Institute for Occupational Safety and Health (NIOSH).

Education Programmes

Community colleges

The broadest change on the hazardous waste education and training landscape in the past few years is the dramatic development of community college programmes and consortia to improve vocational education at the associate’s degree level. Since the 1980s, community colleges have been doing the most organized and extensive curriculum development work in secondary education.

The Department of Energy (DOE) has funded programmes nationwide to provide for a trained workforce at sites where the need has changed from nuclear technicians to hazardous waste clean-up workers. This training is taking place most rigorously at community colleges, many of which have historically provided for personnel needs at specific DOE sites. DOE-funded programmes at community colleges have also given rise to major efforts in curriculum development and consortia for sharing information. Their goals are to establish more consistent and higher standards of training and to provide mobility for the workforce, enabling an individual trained to work at a site in one part of the country to move to another site with minimal retraining requirements.

Several consortia of community colleges are advancing curricula in this area. The Partnership for Environmental Technology Education (PETE) operates in six regions. PETE is working with the University of Northern Iowa to create a world-class network of community college environmental programmes, linked with high schools, that inform and prepare students for entry into these two-year degree programmes. The goals include the development of (1) nationally validated curriculum models, (2) comprehensive professional development programmes and (3) a national clearinghouse for environmental education.

The Hazardous Materials Training and Research Institute (HMTRI) serves the curriculum development, professional development, print and electronic communications needs of 350 colleges with two-year environmental technologies credit programmes. The Institute develops and distributes curricula and materials and implements educational programmes at its own Environmental Training Center at Kirkwood Community College in Iowa, which has extensive classroom, laboratory and simulated field site facilities.

The Center for Occupational Research and Development (CORD) provides national leadership in the US Department of Education’s Tech Prep/Associate Degree initiative. The Tech Prep program requires coordination between secondary and post-secondary institutions to give students a solid foundation for a career pathway and the world of work. This activity has led to the development of several contextual, experiential student texts in basic science and mathematics, which are designed for students to learn new concepts in relationship to existing knowledge and experience.

CORD has also played a significant role in the Clinton administration’s national educational initiative, “Goals 2000: Educate America”. In recognition of the need for qualified entry-level personnel, the initiative provides for the development of occupational skills standards. (“Skills standards” define the knowledge, skills, attitudes and level of ability necessary to successfully function in specific occupations.) Among the 22 skills standards development projects funded under the programme is one for hazardous materials management technology technicians.

Articulation between vocational and baccalaureate programmes

A continuing problem has been the poor linkage between two-year and four-year institutions, which hampers students who wish to enter engineering programmes after completing associate’s (two-year) degrees in hazardous/radioactive waste management. However, a number of community college consortia have begun to address this problem.

The Environmental Technology (ET) consortium is a California community college network that has completed articulation agreements with four four-year colleges. The establishment of a new job classification, “environmental technician”, by the California Environmental Protection Agency provides added incentive for graduates of the ET program to continue their education. An ET certificate represents the entry level requirement for the environmental technician position. Completion of an associate’s degree makes the employee eligible for promotion to the next job level. Further education and work experience allows the worker to progress up the career ladder.

The Waste-management Education and Research Consortium (WERC), a consortium of New Mexico schools, is perhaps the most advanced model which attempts to bridge gaps between vocational and traditional four-year education. Consortium members are the University of New Mexico, the New Mexico Institute of Mining and Technology, New Mexico State University, Navajo Community College, Sandia Laboratory and Los Alamos Laboratories. The approach to curriculum transfer has been an interactive television (ITV) program in distance learning, which takes advantage of the varied strengths of the institutions.

Students enrolled in the environmental programme are required to take 6 hours of courses from the other institutions through distance learning or an offsite semester of coursework. The programme is decidedly inter-disciplinary, combining a minor in hazardous materials/waste management with a major from another department (political science, economics, pre-law, engineering or any of the sciences). The programme is “both broad and narrow” in focus, in that it recognizes a need to develop students with both a broad knowledge base in their field and some specific training in hazardous materials and hazardous waste management. This unique programme couples student participation in realistic applied research and industry-led curriculum development. The courses for the minor are very specific and take advantage of the particularized specialties at each school, but each program, including the associate degree, has a large core requirement in humanities and social sciences.

Another unique feature is the fact that the four-year schools offer two-year associate’s degrees in radioactive and hazardous materials technology. The two-year associate’s degree in environmental science offered at the Navajo Community College includes courses in Navajo history and substantial courses in communications and business, as well as technical courses. A hands-on laboratory has also been developed on the Navajo Community College campus, an unusual feature for a community college and part of the consortium’s commitment to hands-on laboratory learning and technology development/applied research. The WERC member institutions also offer a “non-degree” certificate programme in waste management studies, which seems to be above and beyond the 24-hour and 40-hour courses offered at other colleges. It is for individuals who already have a bachelor’s or graduate degree and who further wish to take advantage of seminars and specialty courses at the universities.

Conclusions

Several significant changes have taken place in the focus of education and training related to the hazardous waste industry in the past few years, in addition to the proliferation of short-course training programmes and traditional engineering programmes. Overall, the Department of Energy seems to have focused education at the community college level on workforce retraining, primarily through the Partnership for Environmental Technology Education (PETE), the Waste-management Education and Research Consortium (WERC) and other consortia like them.

There is a major gap between vocational training and traditional education in the environmental field. Because of this gap, there is not a clear, routine career path for hazardous waste workers, and it is difficult for these workers to advance in industry or government without classic technical degrees. Although inter-departmental options for education at a management level are being established within economics, law and medicine departments which recognize the breadth of the environmental industry, these are still academic-based professional degrees which miss a large part of the available and experienced workforce.

As the environmental clean-up industry matures, the long-term needs of the workforce for more balanced training and education and a well-developed career path become more clear. The large numbers of displaced workers from closed military sites means more people are entering the environmental workforce from other fields, making the demand on union training and placement of displaced workers (both discharged military personnel and displaced civilian personnel) even greater than before. Educational programmes are needed which meet both the needs of personnel entering the industry and of industry itself for a more balanced and better-educated workforce.

Since labour union members are one of the main groups poised to enter the hazardous waste clean-up and environmental remediation field, it would seem that labour studies and industrial relations departments might be logical entities to develop degree programmes that incorporate a hazardous waste/environmental curriculum with development of labour/management skills.

 

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In the context of occupational health and safety, “right to know” refers generally to laws, rules and regulations requiring that workers be informed about health hazards related to their employment. Under right-to-know mandates, workers who handle a potentially harmful chemical substance in the course of their job duties cannot be left unaware of the risk. Their employer is legally obligated to tell them exactly what the substance is chemically, and what kind of health damage it can cause. In some cases, the warning must also include advice on how to avoid exposure and must state the recommended treatment in case exposure does occur. This policy contrasts sharply with the situation it was meant to replace, unfortunately still prevailing in many workplaces, in which workers knew the chemicals they used only by trade names or generic names such as “Cleaner Number Nine” and had no way to judge whether their health was being endangered.

Under right-to-know mandates, hazard information is usually conveyed through warning labels on workplace containers and equipment, supplemented by worker health and safety training. In the United States, the major vehicle for worker right to know is the Occupational Safety and Health Administration’s Hazard Communication Standard, finalized in 1986. This federal regulatory standard requires labelling of hazardous chemicals in all private-sector workplaces. Employers must also provide workers access to a detailed Materials Safety Data Sheet (MSDS) on each labelled chemical, and provide worker training in safe chemical handling. Figure 1 shows a typical US right-to-know warning label.

Figure 1. Right-to-know chemical warning label

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It should be noted that as a policy direction, the provision of hazard information differs greatly from direct regulatory control of the hazard itself. The labelling strategy reflects a philosophical commitment to individual responsibility, informed choice and free market forces. Once armed with knowledge, workers are in theory supposed to act in their own best interests, demanding safe working conditions or finding different work if necessary. Direct regulatory control of occupational hazards, by contrast, assumes a need for more active state interventions to counter the power imbalances in society that prevent some workers from making meaningful use of hazard information on their own. Because labelling implies that the informed workers bear ultimate responsibility for their own occupational safety, right-to-know policies occupy a somewhat ambiguous status politically. On the one hand, they are cheered by labour advocates as a victory enabling workers to protect themselves more effectively. On the other hand, they can threaten workers’ interests if right to know is allowed to replace or weaken other occupational safety and health regulations. As activists are quick to point out, the “right to know” is a starting point that needs to be complemented with the “right to understand” and the “right to act”, as well as with continued effort to control work hazards directly.

Local organizations play a number of important roles in shaping the real-world significance of worker right-to-know laws and regulations. First and foremost, these rights often owe their very existence to public interest groups, many of them community based. For example, “COSH groups” (grass-roots Committees on Occupational Safety and Health) were central participants in the lengthy rule-making and litigation that went into establishing the Hazard Communication Standard in the United States. See box for a more detailed description of COSH groups and their activities.

Organizations in the local community also play a second critical role: assisting workers to make more effective use of their legal rights to hazard information. For example, COSH groups advise and assist workers who feel they may suffer retaliation for seeking hazard information; raise consciousness about reading and observing warning labels; and help bring to light employer violations of right-to-know requirements. This help is particularly important to workers who feel intimidated in using their rights due to low education levels, low job security, or lack of a supportive trade union. COSH groups also assist workers in interpreting the information contained on labels and in Material Safety Data Sheets. This kind of support is badly needed for workers with limited literacy. It can also help workers with good reading skills but insufficient technical background to understand the MSDSs, which are often written in scientific language confusing to an untrained reader.

Worker right to know is not only a matter of transmitting factual information; it also has an emotional side. Through right to know, workers may learn for the first time that their jobs are dangerous in ways they had not realized. This disclosure can stir up feelings of betrayal, outrage, dread and helplessness—sometimes with great intensity. Accordingly, a third important role that some community-based organizations play in worker right to know is to provide emotional support for workers struggling to deal with the personal implications of hazard information. Through self-help support groups, workers receive validation, a chance to express their feelings, a sense of collective support, and practical advice. In addition to COSH groups, examples of this kind of self-help organization in the United States include Injured Workers, a national network of support groups that provides a newsletter and locally available support meetings for individuals contemplating or involved in workers’ compensation claims; the National Center for Environmental Health Strategies, an advocacy organization located in New Jersey, serving those at risk of or suffering from multiple chemical sensitivity; and Asbestos Victims of America, a national network centred in San Francisco that offers information, counselling, and advocacy for workers exposed to asbestos.

A special case of right to know involves locating workers known to have been exposed to occupational hazards in the past, and informing them of their elevated health risk. In the United States, this kind of intervention is called “high-risk worker notification”. Numerous state and federal agencies in the United States have developed programmes of worker notification, as have some unions and a number of large corporations. The federal government agency most actively involved with worker notification at present is the National Institute for Occupational Safety and Health (NIOSH). This agency carried out several ambitious community-based pilot programmes of worker notification in the early 1980s, and now includes worker notification as a routine part of its epidemiological research studies.

NIOSH’s experience with this kind of information provision is instructive. In its pilot programmes, NIOSH undertook to develop accurate lists of workers with probable exposure to hazardous chemicals in a particular plant; to send personal letters to all workers on the list, informing them of the possibility of health risk; and, where indicated and feasible, to provide or encourage medical screening. It immediately became obvious, however, that the notification did not remain a private matter between the agency and each individual worker. On the contrary, at every step the agency found its work affected by community-based organizations and local institutions.

NIOSH’s most controversial notification took place in the early 1980s in Augusta, Georgia, with 1,385 chemical workers who had been exposed to a potent carcinogen (β-naphthylamine). The workers involved, predominantly African-American males, were unrepresented by a union and lacked resources and formal education. The community’s social climate was, in the words of programme staff, “highly polarized by racial discrimination, poverty, and substantial lack of understanding of toxic hazards”. NIOSH helped establish a local advisory group to encourage community involvement, which quickly took on a life of its own as more militant grass-roots organizations and individual worker advocates joined the effort. Some of the workers sued the company, adding to the controversies already surrounding the programme. Local organizations such as the Chamber of Commerce and the county Medical Society also became involved. Even many years later, echoes can still be heard of the conflicts among local organizations involved in the notification. In the end, the programme did succeed in informing the exposed workers of their life-long risk for bladder cancer, a highly treatable disease if caught early. Over 500 of them were medically screened through the programme, and a number of possibly life-saving medical interventions resulted.

A striking feature of the Augusta notification is the central role played by the news media. Local news coverage of the programme was extremely heavy, including over 50 newspaper articles and a documentary film about the chemical exposures (“Lethal Labour”) shown on local TV. This publicity reached a wide audience and had enormous impact on the notified workers and the community as a whole, leading the NIOSH project director to observe that “in actuality, the news media perform the real notification”. In some situations, it may be useful to regard local journalists as an intrinsic part of right to know and plan a formal role for them in the notification process to encourage more accurate and constructive reporting.

While the examples here are drawn from the United States, the same issues arise worldwide. Worker access to hazard information represents a step forward in basic human rights, and has properly become a focal point of political and service effort for pro-worker community-based organizations in many countries. In nations with weak legal protections for workers and/or weak labour movements, community-based organizations are all the more important in terms of the three roles discussed here—advocating for stronger right-to-know (and right-to-act) laws; assisting workers to use right-to-know information effectively; and providing social and emotional support for those who learn they are at risk from work hazards.

 

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The heterogeneity of disability is mirrored in the diversity of legal provisions and benefits that most countries have introduced and codified over the last hundred years. The example of France is chosen because it has perhaps one of the most elaborate regulatory frameworks regarding the classification of disability. While the French system may not be typical compared with those of many other countries, it has—with respect to the topic of this chapter—all the typical elements of an historically grown classification system. Therefore, this case study reveals the fundamental issues that have to be tackled in any system that grants to disabled persons rights and entitlements which are subject to legal recourse.

The twentieth anniversary of the law of 30 June 1975 regarding disabled persons has triggered a renewed interest in the lot of the disabled in France. Estimates of the number of disabled French nationals range from 1.5 to 6 million (equivalent to 10% of the population), although these estimates suffer from a lack of precision in the definition of disability. This population is all too often relegated to the margins of society, and despite progress over the last two decades, their condition remains a serious societal problem with painful human, moral and emotional ramifications that transcend collective considerations of national solidarity.

Under French law, disabled persons enjoy the same rights and freedoms as other citizens, and are guaranteed equality of opportunity and treatment. Unless specific support mechanisms are implemented, this equality is, however, purely theoretical: disabled individuals may, for example, require specialized transportation and city planning to allow them to come and go as freely as other citizens. Measures such as these, which allow disabled persons to enjoy equal treatment in fact, are designed not to confer privilege, but to remove disadvantages associated with disability. These include legislation and other state-initiated measures that guarantee equitable treatment in education, training, employment and housing. Equality of treatment and palliation of the disability constitute the prime objectives of social policy concerning disabled persons.

In most cases, however, the various measures (usually termed political discriminatory measures) prescribed by French law are not available to all persons suffering from a given disability, but rather to selected subgroups: for example, a specific allowance or programme designed to favour occupational reintegration is available only to a specific category of disabled persons. The variety of disabilities and the multiple contexts in which disability may occur have necessitated the development of classification systems that take into account an individual’s official status as well as his or her level of disability.

Variety of Disabilities and Determination of Official Status

In France, the context in which disabilities arise constitutes the fundamental basis for classification. Classifications based on the nature (physical, mental or sensory) and degree of disability are also relevant to the treatment of disabled persons, of course, and are taken into account. These other classification systems are particularly important in determining whether health care or occupational therapy is the best approach, and whether guardianship is appropriate (persons suffering from mental disabilities may become wards of the state). Nevertheless, classification on the basis of the nature of the disability is the primary determinant of a disabled person’s official status, rights and eligibility for benefits.

A review of the body of French law applicable to disabled persons reveals the multiplicity and complexity of support systems. This organizational redundancy has historical origins, but persists to this day and remains problematic.

Development of “official status”

Until the end of the nineteenth century, care of the disabled was essentially a form of “good works” and usually took place in hospices. It was not until the beginning of the twentieth century that the ideas of rehabilitation and income replacement developed against the backdrop of a new cultural and social view of disability. In this view, the disabled were seen as damaged persons who needed to be rehabilitated—if not to the status quo ante, at least to an equivalent situation. This change in mentality was an outgrowth of the development of mechanization and its corollary, occupational accidents, and of the impressive number of First World War veterans suffering permanent disability.

The law of 8 April 1898 improved the occupational-accident compensation system by no longer requiring proof of employer liability and establishing a flat-fee compensation payment system. In 1946, management of the risk associated with occupational accidents and diseases was transferred to the social security system.

Several laws were passed in an attempt to correct prejudices suffered by injured or disabled First World War veterans. These include:

  • a 1915 law establishing an occupational retraining system
  • a 1916 law (complemented by a 1923 law) giving war invalids first call on public-sector jobs
  • the law of 31 March 1918 instituting the right to a fixed pension based on the degree of disability
  • the law of 26 April 1924 requiring private-sector companies to employ a specific percentage of war invalids

 

The interwar period saw the development of the first large-scale associations of civilian disabled persons. The most noteworthy of these are: the Fédération des mutilés du travail (1921), the Ligue pour l’adaptation des diminués physiques au travail (LADAPT) (1929) and the Association des Paralysés de France (APF) (1933). Under pressure from these associations and from unions, victims of work accidents, and eventually all the civilian disabled, progressively benefited from support systems based on those established for war invalids.

A disability insurance system was established for workers in 1930 and reinforced by the 1945 Decree creating the social security system. Under this system, workers receive a pension if their ability to work or earn a livelihood is significantly reduced by disease or accident. The right of victims of occupational accidents to retraining was recognized by a 1930 law. A training and retraining system for the blind was established in 1945 and extended to all seriously disabled persons in 1949. In 1955, the obligation to hire a minimum percentage of war invalids was extended to other disabled persons.

The development of the concept of occupational integration led to the promulgation of three laws which improved and reinforced existing support systems: the law of 27 November 1957 concerning occupational reclassification of disabled workers, the law of 30 June 1975 concerning disabled persons (the first to adopt a global approach to the problems faced by disabled persons, especially that of social reintegration), and the law of 10July 1987 favouring the employment of disabled workers. However, these laws in no way eliminated the specific dispositions of the systems responsible for war invalids and the victims of occupational accidents.

Multiplicity and diversity of regimes supporting disabled persons

Today, there are three quite distinct regimes providing support to disabled persons: one for war invalids, one for victims of occupational accidents, and the common-law system, which deals with all other disabled persons.

A priori, the coexistence of multiple regimes that select their clientele on the basis of the origin of disability does not appear to be a satisfactory arrangement, especially since each regime provides the same type of support, namely integration-support programmes, particularly those aimed at occupational reintegration, and one or more allowances. Accordingly, there has been a concerted effort to harmonize employment-support systems. For example, the vocational training and medical rehabilitation programmes of all the systems aim as much at distributing costs through society as at providing financial compensation for disability; the specialized training and medical rehabilitation centres, including the centres operated by the Office des anciens combattants (ONAC), are open to all disabled persons, and the reservation of positions in the public sector for war invalids was extended to disabled civilians by the Decree of 16 December 1965.

Finally, the law of 10 July 1987 united the private- and public-sector minimum-employment programmes. Not only were the conditions of these programmes extremely complex to apply, but they also differed depending on whether the individual was a disabled civilian (in which case the common law system applied) or a war invalid. With the coming into force of this law, however, the following groups are entitled to consideration for minimum-employment programmes: disabled workers recognized by the Commission technique d’orientation et de réinsertion professionnelle (COTOREP), victims of occupational accidents and diseases receiving a pension and suffering from a permanent disability of at least 10%, recipients of civilian disability allowances, former members of the armed forces and other recipients of military disability allowances. COTOREP is responsible, under the common law system, for the recognition of disabled status.

On the other hand, the actual allowances provided by the three regimes differ widely. Disabled persons benefiting from the common-law system receive what is essentially a disability pension from the social security system and a complementary allowance to bring their total benefit up to the adult disabled pension level (as of 1July 1995) of FF 3,322 per month. The amount of the state pension received by war invalids depends on the degree of disability. Finally, the monthly amount (or a lump-sum payment if the permanent disability is below 10%) received by victims of occupational accidents and diseases from the social security system depends on the recipient’s degree of disability and previous salary.

The eligibility criteria and amounts of these allowances are entirely different in each system. This leads to significant differences in the way individuals with disabilities of different organs are treated, and to anxiety that may interfere with rehabilitation and social integration (Bing and Levy 1978).

Following numerous calls for the harmonization, if not unification, of the various disability allowances (Bing and Levy 1978), the Government established a task force in 1985 to study solutions to this problem. To date, however, no solution has been forthcoming, in part because the different goals of the allowances constitute a serious obstacle to their unification. Common-law allowances are subsistence allowances—they are intended to allow recipients to maintain a decent standard of living. In contrast, the war disability pensions are intended to compensate for disabilities acquired while in national service, and allowances paid to victims of occupational accidents and diseases are intended to compensate for disabilities acquired while earning a living. These last two allowances are therefore generally significantly higher, for a given level of disability, than those received by individuals with disabilities that are either congenital or resulting from non-military, non-occupational accidents or illnesses.

Effect of Official Status on Assessments of the Degree of Disability

Different disability-compensation regimes have evolved over time. This diversity is reflected not only in the different allowances each pays to disabled persons but also in each system’s eligibility criteria and system for evaluating the degree of disability.

In all cases, eligibility for compensation and evaluation of the extent of disability is established by an ad hoc committee. Recognition of disability requires more than a simple declaration by the applicant—applicants are required to testify before the commission if they desire to be granted official status as a disabled person and receive eligible benefits. Some people may find this procedure dehumanizing and counter to the goal of integration, since individuals who do not wish to have their differences “officialized” and refuse, for example, to appear before the COTOREP, will not be granted official disabled-person status and will thus be ineligible for occupational reintegration programmes.

Disability eligibility criteria

Each of the three regimes relies on a different set of criteria to determine whether an individual is entitled to receive disability benefits.

Common-law regime

The common-law regime pays disabled persons subsistence allowances (including the adult disability allowance, a compensatory allowance, and the educational allowance for disabled children), to allow them to remain independent. Applicants must suffer from a serious permanent disability—an 80% disability is required in the majority of cases—to receive these allowances, although a lower level of disability (of the order of 50 to 80%) is required in the case of a child attending a specialized institute or receiving special education or home care. In all cases, the degree of disability is evaluated by reference to an official disability scale contained in Appendix 4 of the Decree of 4 November 1993 concerning the payment of various allowances to disabled persons.

Different eligibility criteria apply to applicants for disability insurance, which, like the common-law allowances, includes a subsistence component. To qualify for this pension, applicants must be receiving social security and must suffer from a disability that reduces their earning capacity by at least two thirds, that is, that prevents them from earning, in any occupation, a salary greater than one third of their pre-disability salary. The pre-disability salary is calculated on the basis of the salary of comparable workers in the same region.

There are no official criteria for the determination of eligibility, which instead is based on the individual’s overall situation. “The degree of disability is evaluated on the basis of residual fitness for work, overall condition, age, physical and mental faculties, aptitudes, and occupational training”, according to the social security law.

As this definition makes clear, disability is considered to include the inability to earn a living in general, rather than being limited to physical disability or the inability to exercise a given occupation, and is evaluated on the basis of factors likely to affect the occupational reclassification of the individual. These factors include:

  • the nature and severity of the disability, and the applicant’s age, physical and mental faculties, aptitudes, occupational training and previous occupation
  • the applicant’s residual fitness for work relative to the workforce in his or her region of residence.

 

To be eligible for specific occupational reintegration programmes, disabled adults must satisfy the following legal criterion: “a disabled worker is any person whose ability to obtain or maintain a job is reduced in fact as a result of inadequate or reduced physical or mental capacities”.

This definition was greatly influenced by the Vocational Rehabilitation of the Disabled Recommendation, 1955 (No. 99) (ILO 1955), which defines a disabled person as “an individual whose prospects of securing and retaining suitable employment are substantially reduced as a result of physical or mental impairment”.

This pragmatic approach nevertheless leaves room for interpretation: what does “in fact” mean? What is the standard to be used in determining whether fitness for work is “inadequate” or “reduced”? The absence of clear guidelines in these matters has resulted in widely divergent evaluations of occupational disability by different commissions.

Specific regimes

To accomplish their primary goal of reparation and compensation, these regimes pay the following allowances and pensions:

  • War disability pensions are based on the degree of purely physical disability, as evaluated by experts. Permanent disabilities of at least 10 and 30% are generally required for injuries and diseases, respectively. The degree of disability is evaluated using the official disability scale (Decree of 29 May 1919).
  • In the occupational accident system, victims of occupational accidents and diseases suffering from a permanent disability receive either a lump-sum payment or an allowance.

 

The degree of permanent disability is established using an official disability scale that takes into account the nature of the disability, and the applicant’s general condition, physical and mental faculties, aptitudes and occupational qualifications.

Disability evaluation scales

While eligibility for each regime’s benefits depends on administrative decisions, the medical evaluation of disability, established through examination or consultation, remains critically important.

There are two approaches to the medical evaluation of the degree of disability, one involving the calculation of compensation on the basis of the degree of permanent partial disability, the other based on the reduction in fitness for work.

The first system is used by the war disability system, while the occupational accident and common-law systems require the examination of the applicant by the COTOREP.

The degree of permanent partial disability in war invalids is established using standards contained in the official disability scale applicable to cases covered by the Code des pensions militaires d’invalidité et victimes de guerre (updated 1 August 1977 and including the scales of 1915 and 1919). For the victims of occupational accidents, a scale of occupational accidents and diseases established in 1939 and revised in 1995 is used.

The classification systems used in these two regimes are organ- and function-specific (such as blindness, renal failure, cardiac failure) and establish a level of permanent partial disability for each type of disability. Several possible classification systems for mental disability are suggested, but all of them are imprecise for these purposes. It should be noted that these systems, apart from their other weaknesses, may assess different levels of permanent partial disability for a given disability. Thus, a 30% reduction of bilateral visual acuity is equivalent to a permanent partial disability rating of 3% in the occupational-accident system and 19.5% in the war- disability system, while a 50% loss is equivalent to permanent partial disabilities of 10 and 32.5%, respectively.

Until recently, the COTOREP used the disability scale established in the Code des pensions militaires d’invalidité et victimes de guerre to determine compensation and benefits such as disability cards, adult disability allowances, and third-party compensatory allowances. This scale, developed to ensure fair compensation for war injuries, is not well suited to other uses, especially to birth rate. The absence of a common reference has meant that different sittings of the COTOREP have arrived at significantly different conclusions concerning the degree of disability, which has created serious inequities in the treatment of disabled persons.

To remedy this situation, a new scale of deficiencies and disabilities, which reflects a new approach to disability, came into force on 1 December 1993 (Appendix to Decree No.93-1216 of 4 November 1993, Journal Officiel of 6 November 1993). The methodological guide is based on concepts proposed by the WHO, namely impairment, disability and handicap, and is used primarily to measure disability in family, school and occupational life, regardless of the specific medical diagnosis. While the medical diagnosis is a critical predictor of the condition’s evolution and the most effective case management strategy, it nevertheless is of limited usefulness for the purposes of establishing the degree of disability.

With one exception, these scales are meant to be only indicative: their use is mandatory for the evaluation of permanent partial disability in recipients of military pensions who have suffered amputation or organ resection. Several other factors affect the evaluation of the degree of disability. In occupational accident victims; for example, the establishment of the degree of permanent partial disability must also take into account medical factors (general condition, nature of the disability, age, mental and physical faculties) and social factors (aptitudes and occupational qualifications). The inclusion of other factors allows physicians to fine-tune their evaluation of the degree of permanent partial disability to take into account therapeutic advances and the potential for rehabilitation, and to counteract the rigidity of the scales, which are rarely updated or revised.

The second system, based on the loss of working capacity, raises other questions. The reduction in working capacity may need to be evaluated for different purposes: evaluation of the reduction in working capacity for the purposes of disability insurance, recognition of the loss of working capacity by COTOREP, evaluation of an occupational deficit for the purposes of recognizing a worker as disabled or placing such a worker in a special workshop.

No standards can exist for the evaluation of the loss of working capacity, since the “average worker” is a theoretical construct. In fact, the whole field of working capacity is poorly defined, as it relies not only on an individual’s inherent aptitudes but also on the needs and adequacy of the occupational environment. This dichotomy illustrates the distinction between the capacity at work and the capacity for work. Schematically, two situations are possible.

In the first case, the degree of the loss of working capacity relative to the applicant’s recent and specific occupational situation must be objectively established.

In the second case, the loss of working capacity must be evaluated in disabled persons who are either not currently in the workforce (e.g., individuals with chronic illnesses who have not worked for a long time) or who have never been in the workforce. This last case is frequently encountered when establishing adult disability pensions, and eloquently illustrates the difficulties that physicians responsible for quantifying the loss of working capacity are faced with. Under these circumstances, physicians often refer, either consciously or unconsciously, to degrees of permanent partial disability for establishing working capacity.

Despite the obvious imperfections of this disability-evaluation system and the occasional medico-administrative contortions it imposes, it nevertheless allows the level of disability compensation to be established in most cases.

It is clear that the French system, involving official classification of disabled persons on the basis of the origin of their disability, is problematic on several levels under the best of circumstances. The case of individuals suffering from disabilities of different origins and who are therefore ascribed multiple official statuses is even more complex. Consider for example the case of a person suffering from a congenital motor disability who suffers an occupational accident: the problems associated with the resolution of this situation can easily be imagined.

Because of the historical origins of the various official statuses, it is unlikely that the regimes can ever be made completely uniform. On the other hand, continued harmonization of the regimes, especially their systems for the evaluation of disability for the purpose of the awarding of financial compensation, is highly desirable.

 

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The articles in this chapter have thus far concentrated on training and education regarding workplace hazards. Environmental education serves multiple purposes and is a useful complement to occupational safety and health training. Worker education is a critical and often overlooked aspect of a broad and effective environmental protection strategy. Environmental issues are frequently viewed as purely technological or scientific matters that stand outside the purview of workers. Yet worker knowledge is critical to any effective environmental solutions. Workers are concerned as citizens and as employees about environmental matters because the environment shapes their lives and affects their communities and families. Even when technological solutions are required that use new hardware, software or process approaches, worker commitment and competence are necessary for their effective implementation. This is true for workers whether involved directly in environmental industries and occupations or in other kinds of jobs and industrial sectors.

Worker education can also provide a conceptual foundation to enhance workers’ participation in environmental improvement, health and safety protection, and organizational improvement. The UNEP Industry and Environment Programme notes that “many companies have found that worker involvement in environmental improvement can yield important benefits” (UNEP 1993). The Cornell Work and Environment Initiative (WEI) in a study of US enterprises found that intense worker participation yielded triple the source reduction of technical or external solutions alone and boosted yields of some technological approaches even higher (Bunge et al. 1995).

Worker environmental education comes in a variety of forms. These include trade union awareness and education, occupational training and orientation, connecting environment to workplace health and safety concerns and broad awareness as citizens. Such education occurs in a range of venues including worksites, trade union halls, classrooms and study circles, using both traditional and newer computer-based delivery systems. It is fair to say that workers’ environmental education is an underdeveloped field, especially in comparison with managerial and technical training and school-based environmental education. At the international level, education of front-line workers is often mentioned in passing and is overlooked when it comes to implementation. The European Foundation for the Improvement of Living and Working Conditions has commissioned a series of studies on the educational dimension of environmental protection, and in its next programme of work will directly look at the shop-floor workers and their environmental educational needs.

What follows are several examples gathered through the WEI at Cornell University that illustrate both practice and possibility in worker environmental education.The WEI is a network of managers, trade unionists, environmentalists and government policy officials from 48 countries in all parts of the world, committed to finding ways that workers and the workplace can contribute to environmental solutions. It addresses a wide range of industries from primary extraction to production, service and public-sector enterprises. It provides a means for education and action on environmental matters that seeks to build knowledge at the workplace and in academic institutions that can lead to cleaner and more productive workplaces and better connection between internal and external environments.

Australia: Eco-Skills Modules

The Australian Council of Trade Unions (ACTU) has developed new approaches to workers’ education for the environment that provides both broad social awareness and specific competencies for employment, especially among young workers.

The ACTU has organized an Environment Training Company with a broad mandate to address a variety of sectors but with an initial focus on land management issues. This focus includes teaching ways to handle reclamation work safely and effectively but also ways to assure compatibility with indigenous peoples and natural environments. With input from trade unionists, environmentalists and employers, the training company developed a set of “Eco-Skills” modules to establish basic environmental literacy among workers from an array of industries. These are integrated with a set of skill competencies that are technical, social and safety oriented.

Eco-Skills modules 1 and 2 contain a broad base of environmental information. They are taught alongside other entry-level training programmes. Levels 3 and higher are taught to people who specialize in work focused on reduction of environmental impacts. The first two Eco-Skills modules are composed of two forty-hour sessions. Trainees attain skills through lectures, group problem-solving sessions and practical hands-on techniques. Workers are assessed through written and oral presentations, group work and role plays.

Concepts covered in the sessions include an introduction to the principles of ecologically sustainable development, efficient resource use and cleaner production and environmental management systems. Once Module 1 is completed workers should be able to:

  • identify the implications of a given lifestyle for long-term sustainability with specific emphasis placed on the learner’s present and future lifestyle
  • identify ways to reduce the environmental impact of human activities
  • describe strategies to reduce environmental impacts in a given industry (agriculture, forestry, manufacturing, tourism, leisure, mining)
  • describe the main features of an Environmental Management System
  • identify the role of stakeholders in reducing environmental pollution and resource depletion.

 

Module 2 expands upon these initial objectives and prepares workers to begin applying pollution prevention and resource conservation methods.

Some industries are interested in connecting environmental impact skills and knowledge to their industry standards at every level. Awareness of environmental issues would be reflected in the day-to-day work of all industry workers at all skill levels. An incentive for workers lies in the fact that pay rates are linked to industry standards. The Australian experiment is in its infancy, but it is a clear attempt to work with all parties to develop competency-based activities that lead to increased and safer employment while enhancing environmental performance and awareness.

Linking Occupational Health and Safety and Environmental Training

One of the most active unions in the United States in environmental training is the Laborers International Union of North American (LIUNA). US government regulations require that hazardous-waste abatement workers receive 40 hours of training. The union along with participating contractors have developed an intensive 80-hour course designed to provide potential hazardous-waste workers with greater awareness of safety and the industry. In 1995, over 15,000 workers were trained in lead, asbestos and other hazardous-waste abatement and other environmental remediation work. The Laborers–Associated General Contractors programme has developed 14 environmental remediation courses and associated train-the-trainer programmes to assist nationwide efforts at safe and quality remediation. These are conducted at 32 training sites and four mobile units.

In addition to providing safety and technical training, the programme encourages participants to think about larger environmental issues. As part of their classwork, trainees gather materials from local papers on environmental issues and use this local connection as an opening to discuss broader environmental challenges. This joint environmental training fund employs a full-time equivalent staff of 19 at its central office and spends over US$10 million. The materials and training methods meet high quality standards with extensive use of audio-visual and other training aids, specific competency focus, and quality commitment and assessment built in throughout the curricula. A “learn-at-home” video is used to help meet literacy concerns and environmental and basic literacy training are connected. For those who desire it, six of the courses are transferable into college credit. The programme is active in serving minority communities, and over half of the participants come from minority population groups. Additional programmes are developed in partnership with minority consortiums, public housing projects and other training providers.

The union understands that a great deal of its future membership will come in environmentally related businesses and sees the development of worker education programmes as building the foundation for that growth. While both safety and productivity are better on jobs using trained workers, the union also sees the broader impact:

The most interesting impact environmental training has had on members is their increased respect for chemicals and harmful substances in the workplace and at home. … Awareness is also increasing with respect to the consequences of continued pollution and the cost involved with cleaning up the environment. … The true impact is much greater than just preparing people for work (LIUNA 1995).

In the United States, such hazardous-materials training is also conducted by the Operating Engineers; Painters; Carpenters; Oil, Chemical and Atomic Workers; Chemical Workers Union; Machinists; Teamsters; Ironworkers and Steelworkers.

LIUNA is also working internationally with the Mexican Confederation of Workers (CTM), federal and private training groups and employers to develop training methodologies. The focus is on training Mexican workers in environmental remediation work and construction skills. The Inter-American Partnership for Environmental Education and Training (IPEET) held its first training course for Mexican workers during the summer of 1994 in Mexico City. A number of labour leaders and workers from local industries, including paint manufacturing and metal plating, attended the one-week course on environmental safety and health. Other LIUNA partnerships are being developed in Canada with French editions of the materials and “Canadianization” of the content. The European Institute for Environmental Education and Training is also a partner for similar training in Eastern European and CIS countries.

Zambia: Educational Manual on Occupational Health and Safety

In Zambia, too often occupational health and safety is taken seriously only when there is an incident involving injury or damage to company property. Environmental issues are also ignored by industry. The Manual on Occupational Health and Safety was written in an effort to educate employees and employers on the importance of occupational health and safety issues.

The first chapter of this manual outlines the importance of education at all levels in a company. Supervisors are expected to understand their role in creating safe, healthy working conditions. Workers are taught how maintaining a positive, cooperative attitude relates to their own safety and work environment.

The manual specifically addresses environmental issues, noting that all major towns in Zambia face

threats of increasing environmental damage. In specific, the Zambia Congress of Trade Unions (ZCTU) identified environmental hazards in the mining industry through strip mining and air and water pollution that results from poor practices. Many factories are responsible for air and water pollution because they discharge their waste directly into nearby streams and rivers and allow smoke and fumes to escape unchecked into the atmosphere (ZCTU 1994).

Though many African trade unions are interested in further education on the environment, lack of adequate funding for worker education and the need for materials that link environmental, community and workplace hazards are major barriers.

Employer-Based Worker Environmental Education and Training

Employers, especially larger ones, have extensive environmental education activities. In many cases, these are mandated training linked to occupational or environmental safety requirements. However, an increasing number of companies recognize the power of broad worker education that goes well beyond compliance training. The Royal Dutch/Shell Group of companies have made health, safety and environment (HSE) part of their overall approach to training, and environment is an integral part of all management decisions (Bright and van Lamsweerde 1995). This is a global practice and mandate. One of the company’s goals is to define HSE competencies for appropriate jobs. Worker competence is developed through improved awareness, knowledge and skill. Appropriate training will increase worker awareness and knowledge, and skills will develop as new knowledge is applied. A wide range of delivery techniques helps share and reinforce the environmental message and learning.

At Duquesne Light in the United States, all 3,900 employees were successfully trained “on how the company and its employees actually affect the environment.” William DeLeo, Vice-President of Environmental Affairs said:

To develop a training programme that enabled us to meet out strategic objectives we determined that our employees needed a general awareness of the importance of environmental protection as well as specific technical training relative to their job responsibilities. These two points became the guiding strategy for our environmental education program (Cavanaugh 1994).

Worker and Union-Based Environmental Education Programmes

The Workers’ Education Branch of the ILO has developed a six-booklet set of background materials to spark discussion among trade unionists and others. The booklets address workers and the environment, the workplace and the environment, the community and the environment, world environmental issues, the new bargaining agenda, and provide a guide to resources and a glossary of terms. They provide a broad, insightful and easy-to-read approach that can be used in both developing and industrial countries to discuss topics relevant to workers. The materials are based on specific projects in Asia, the Caribbean and Southern Africa, and can be used as a whole text or can be separated in a study circle format to promote general dialogue.

The ILO in a review of training needs pointed out:

Trade unionists must increase their awareness about environmental concerns in general and the impact their employing firms are having on the environment, including the safety and health of their workers, in particular. Trade unions and their members need to understand environmental issues, the consequences that environmental hazards have on their members and the community at large, and be able to develop sustainable solutions in their negotiations with company management and employers’ organizations. (ILO 1991.)

The European Foundation for the Improvement of Living and Working Conditions has observed:

Local trade unions and other employee representatives are in a particularly difficult situation. They will have the relevant knowledge of the local situation and the workplace but will, in most cases, not be sufficiently specialised in complex environmental and strategic issues.

They will, therefore, be unable to exercise their functions unless they received additional and specialised training. (European Foundation for the Improvement of Living and Working Conditions 1993.)

A number of national unions have urged increased workers’ education on the environment. Included among them is the LO in Sweden, whose 1991 Environmental Programme called both for more education and action at the workplace and for additional study circle material on the environment to promote awareness and learning. The Manufacturing Workers Union in Australia has developed a training course and set of materials to assist the union in providing environmental leadership, including how to address environmental issues through collective bargaining.

Summary

Good worker-based environmental education provides both conceptual and technical information to workers that assists them in increasing environmental awareness and in learning concrete ways to change work practices that are damaging to the environment. These programmes also learn from workers at the same time to build on their awareness, reflection and insight about workplace environmental practice.

Workplace environmental education is best done when it is connected to community and global environmental challenges so that workers have a clear idea of how the ways they work are connected to the overall environment and how they can contribute to a cleaner workplace and global ecosystem.

 

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Tuesday, 15 February 2011 18:43

The COSH Movement and Right to Know

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Formed in the wake of the US Occupational Safety and Health Act of 1970, committees on occupational safety and health initially emerged as local coalitions of public health advocates, concerned professionals, and rank-and-file activists meeting to deal with problems resulting from toxics in the workplace. Early COSH groups started in Chicago, Boston, Philadelphia and New York. In the south, they evolved in conjunction with grass roots organizations such as Carolina Brown Lung, representing textile mill workers suffering from byssinosis. Currently there are 25 COSH groups around the country, at various stages of development and funded through a wide variety of methods. Many COSH groups have made a strategic decision to work with and through organized labor, recognizing that union-empowered workers are the best equipped to fight for safe working conditions.

COSH groups bring together a broad coalition of organizations and individuals from unions, the public health community and environmental interests, including rank-and-file safety and health activists, academics, lawyers, doctors, public health professionals, social workers and so on. They provide a forum in which interest groups that do not normally work together can communicate about workplace safety and health problems. In the COSH, workers have a chance to discuss the safety and health issues they confront on the shop floor with academics and medical experts. Through such discussions, academic and medical research can get translated for use by working people.

COSH groups have been highly active politically, both through traditional means (such as lobbying campaigns) and through more colorful methods (such as picketing and carrying coffins past the homes of anti-labor elected officials). COSH groups played a key role in the struggles for local and state right-to-know legislation, building broad-based coalitions of union, environmental and public interest organizations to support this cause. For example, the Philadelphia area COSH group (PHILAPOSH) ran a campaign which resulted in the first city right-to-know law passed in the country. The campaign climaxed when PHILAPOSH members dramatized the need for hazard information by opening an unmarked pressurized canister at a public hearing, sending members of the City Council literally diving under tables as the gas (oxygen) escaped.

Local right-to-know campaigns eventually yielded more than 23 local and state right-to-know laws. The diversity of requirements was so great that chemical corporations ultimately demanded a national standard, so they would not have to comply with so many differing local regulations. What happened with COSH groups and right to know is an excellent example of how the efforts of labor and community coalitions working at the local level can combine to have a powerful national impact on occupational safety and health policy.

 

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Most persons with disabilities who are of working age can and want to work, yet they often encounter major obstacles in their quest for access to and equality in the workplace. This article highlights the principal issues concerning the inclusion of persons with disabilities in the world of work, with reference to social policy and human rights concepts.

First, the overall extent and consequences of disability, as well as the extent to which disabled persons have traditionally been excluded from full participation in both social and economic life, will be described. Human rights concepts will then be presented in terms of a process to overcome the obstacles to equitable employment faced by persons with disabilities. Such obstacles to full participation in the workplace and national life are often due to attitudinal and discriminatory barriers, rather than to causes relating to one’s disability. The end result is that persons with disabilities often experience discrimination, which is either deliberate or is a result of inherent or structural barriers in the environment.

Finally, a discussion of discrimination leads to a description of ways in which such treatment may be overcome through equitable treatment, workplace accommodation and accessibility.

Extent and Consequences of Disability

Any discussion of social policy and human rights concepts about disability must begin with an overview of the global situation persons with disabilities face.

The exact extent of disability is subject to wide interpretation, depending upon the definition used. The United Nations Disability Statistics Compendium (1990) (also referred to as the DISTAT Compendium) reports results of 63 surveys of disability in 55 countries. It notes that the percentage of disabled persons is between 0.2% (Peru) and 20.9% (Austria). During the 1980s, approximately 80% of disabled persons lived in the developing world; due to malnutrition, and disease, disabled persons form approximately 20% of the population of these nations. It is not possible to compare the percentage of the population that is disabled as reflected in various national surveys, due to the use of different definitions. From the overall but limited perspective provided by the DISTAT Compendium, it may be noted that disability is largely a function of age; that it is more prevalent in rural areas; and that it is associated with a higher incidence of poverty and lower economic status and educational attainment. Moreover, statistics consistently show lower labour-force participation rates for persons with disabilities than for the population in general.

With respect to employment. a graphic description of the situation faced by persons with disabilities was given by Shirley Carr, a member of the Governing Body of the ILO and a past president of the Canadian Labour Congress, who noted during a parliamentary forum on disability held in Canada in 1992 that disabled persons experience a “cement ceiling” and that “Disabled persons suffer from the three ‘U’s: under-employment, unemployment and under-utilization”. Unfortunately, the situation persons with disabilities face in most places in the world is at best like what exists in Canada; in many cases, their circumstances are far worse.

Disability and Social Exclusion

For a variety of reasons, many persons with disabilities have historically experienced social and economic isolation. However, since the end of the Second World War, there has been a slow but steady movement away from segregating disabled persons from the general population, and away from the view that “the disabled” need care, philanthropy and charity. Persons with disabilities are increasingly insisting on their right not to be excluded from the workplace but rather to be treated in an inclusive manner, equitable to other, non-disabled members of society, including the right to participate as active members of the economic life of the nation.

Disabled persons should participate fully in the labour force because it makes economic sense for them to have the opportunity to engage in remunerative employment to the fullest extent of their capacities, instead of drawing social assistance. However, disabled persons should first and foremost participate in the mainstream of the labour force and thus national life because it is ethically and morally the correct thing to do. In this regard, one is mindful of the remarks of the UN Special Rapporteur Leandro Despouy, who stated in his report to the Economic and Social Council of the United Nations (1991) that “the treatment given to disabled persons defines the innermost characteristics of a society and highlights the cultural values that sustain it”. He goes on to state what is, unfortunately, not obvious to all, that:

persons with disabilities are human beings—as human as, and usually even more human than, the rest. The daily effort to overcome impediments and discriminatory treatment they regularly receive usually provides them with special personality features, the most obvious and common are integrity, perseverance, and a deep spirit of comprehension in the face of a lack of understanding and intolerance. However, this last feature should not lead us to overlook the fact that as subjects of law they enjoy all the legal attributes inherent in human beings and hold specific rights in addition. In a word, persons with disabilities, as persons like ourselves, have the right to live with us and as we do.

Disability and Societal Attitudes

The issues raised by the UN Special Rapporteur point to the existence of negative societal attitudes and stereotypes as a significant barrier to equitable workplace opportunities for persons with disabilities. Such attitudes include the fear that the cost of accommodating persons with disabilities in the workplace will be too high; that persons with disabilities are not productive; or that other vocational trainees or employees and customers will be uncomfortable in the presence of persons with disabilities. Still other attitudes relate to the assumed weakness or sickness of persons with disabilities and the impact this has on “their” ability to complete a vocational training programme or to succeed in a job. The common element is that they are all founded on assumptions based on one characteristic of a person, the presence of a disability. As noted by the Province of Ontario (Canada) Advisory Council for Disabled Persons (1990):

Assumptions about the needs of persons with disabilities are often premised on notions about what the person cannot do. The disability becomes the characterization of the whole person rather than one aspect of the person.… Incapacity is seen as a generalized condition and tends to incorporate notions of incompetence.

Disability and Empowerment: The Right of Choice

Inherent in the principle that persons with disabilities have the right to participate fully in the mainstream of the social and economic life of the nation is the notion that such individuals should be empowered to exercise free choice as to their vocational training and choice of occupation.

This basic right is set forth in the Human Resources Development Convention, 1975 (No. 142) (ILO 1975), which states that vocational training policies and programmes shall “encourage and enable all persons, on an equal basis and without discrimination whatsoever, to develop and use their capabilities for work in their own best interests and in accordance with their own aspirations”.

Learning to make choices is an intrinsic part of personal development. However, many individuals with disabilities have not been given the opportunity to make meaningful selections concerning their choice of occupational training and placement. Persons with severe disabilities may lack experience in skills needed to identify personal preferences and to make effective choices from a series of options. However, the lack of self-direction and power is not related to impairments or limitations. Rather, as noted above, it is often due to negative attitudes and practices. Often, disabled persons are presented with options that are artificially preselected or restricted. For example, they may be pressured to participate in a vocational training course that happens to be available, without other options being seriously considered. Or the “choices” may merely be the avoidance of undesirable alternatives, such as agreeing to live in a group setting or with roommates not of one’s choice, to avoid even more unpleasant situations, such as having to live in an institution. Unfortunately for many disabled persons, the chance to express a vocational interest, to choose vocational training options or to seek a job is often determined by a person’s disability label and other people’s assumptions about the capabilities of the individual. This lack of choice also frequently stems from a historical attitude that as involuntary users of the social welfare system, “beggars can’t be choosers”.

This issue is of great concern. Research has shown that the degree of influence which individuals have on decisions that affect their working lives has a significant impact on job satisfaction, and hence on the success of integration strategies. Every person, notwithstanding the severity of his or her disabilities, has the right and ability to communicate with others, express everyday preferences, and exercise at least some control over his or her daily life. Inherent in liberty is the right to have freedom of vocational choice, the necessary training based on available technology, and respect for and encouragement to work. For disabled persons at all levels of severity and ability, including those who have intellectual and psychosocial disabilities, making choices is key to establishing one’s identity and individuality. It must also be recalled that it is part of the human experience to make mistakes and to learn from them.

It must be stressed again that disabled persons are human beings. It is a matter of basic respect of human dignity to provide disabled persons with opportunities to make those decisions in life that non-disabled persons routinely make.

Disability and Social Justice: The Issue of Discrimination

Why have negative stereotypes developed and how do they relate to discrimination? Hahn (1984) notes the apparent contradiction between the vast sympathy displayed toward individuals with disabilities and the fact that, as a group, they are subjected to patterns of discrimination more severe than any other recognized minority. This can be explained by the fact that persons with disabilities often display physical and behavioural characteristics that set them apart from the non-disabled population.

Without these identifiable physical differences, disabled persons could not be subjected to the same processes of stereotyping, stigmatizing, bias, prejudice, discrimination, and segregation that plague every minority group. Moreover, when such traits are coupled with adverse social labelling, the effects of discrimination are compounded.

Hahn also suggests that there is a positive correlation between the amount of discrimination experienced by persons with disabilities and the visibility of their disability.

The key, then, for persons with disabilities to attain equitable treatment in society and the workplace is the reduction and elimination of negative attitudes and stereotypes which result in discriminatory behaviour, coupled with the institution of practices and programmes that accommodate the special needs of disabled persons as individuals. The remainder of this article explores these concepts.

What Is Meant by Discrimination?

In the course of our lives, we “discriminate” on a daily basis. Choices are made concerning whether to go to the cinema or the ballet, or whether to buy the more expensive article of clothing. To discriminate in this sense is not problematic. However, discrimination does become troublesome when negative differentiations are made on the basis of immutable characteristics of persons, or groups of persons, such as on the basis of disability.

The International Labour Conference adopted a definition of the discrimination which is contained in the Discrimination (Employment and Occupation) Convention, 1958 (No. 111):

For the purpose of this Convention, the term “discrimination” includes—

(a) any distinction, exclusion or preference made on the basis of race, colour, sex, religion, political opinion, national extraction or social origin, which has the effect of nullifying or impairing equality of opportunity or treatment in employment or occupation;

(b) such other distinction, exclusion or preference which has the effect of nullifying or impairing equality of opportunity or treatment in employment or occupation as may be determined by the Member concerned after consultation with representative employers’ and workers’ organisations, where such exist, and with other appropriate bodies.

Three Forms of Discrimination

The above-noted definition is best understood in light of the three forms of discrimination that have arisen since the end of the Second World War. The following three approaches, first conceptualized in the United States, have now received widespread acceptance in many countries.

Evil motive or animus

Initially, discrimination was seen strictly in terms of prejudicial treatment, that is, harmful acts motivated by personal antipathy towards the group of which the target person was a member. These acts consisted of deliberate denials of employment opportunities. It was necessary to prove not only the act of denial, but also a motive based on prejudice. In other words the definition was based upon the evil-motive, mens rea, or state-of-mind test. An example of such discrimination would be an employer indicating to a disabled person that he or she would not be hired because of fear of negative customer reaction.

Differential treatment

During the 1950s and in the mid-1960s after the passage of the Civil Rights Act, agencies in the United States came to apply what is called the “equal protection” concept of discrimination. In this approach discrimination was seen to cause economic harm “by treating members of a minority group in a different and less favourable manner than similarly situated members of the majority group” (Pentney 1990). Under the differential treatment approach, the same standards are seen to apply to all employees and applicants without the need to demonstrate discriminatory intent. Discrimination in this context would include requiring disabled employees to undergo a medical examination to receive group health insurance benefits when such examinations are not required for non-disabled employees.

Indirect or adverse effect discrimination

Although the differential treatment model of discrimination mandates that employment policies and practices be equally applied to all, many superficially neutral requirements, such as education and testing, had unequal effects on various groups. In 1971, the United States Supreme Court dealt with this issue by articulating a third definition of employment discrimination in the famous case Griggs vs. Duke Power. Prior to the passage of the Civil Rights Act, Duke Power discriminated against Blacks by restricting them to the low-paying labour department. After passage of the legislation, completion of high school and successful completion of aptitude tests were made prerequisites to transfer out of the labour department. In the candidate catchment area, 34% of Whites but only 12% of Blacks had the necessary education. In addition, while 58% of Whites passed the tests, only 6% of Blacks were successful. These requirements were imposed despite evidence that showed that employees without these qualifications, hired before the policy change, continued to perform satisfactorily. The Supreme Court struck down the educational and test requirements that screened out a greater percentage of blacks, on the grounds that such practices had the consequence of excluding Blacks and because they bore no relationship to job requirements. The intent of the employer was not at issue. Rather, what was important was the effect of the policy or practice. An example of this form of discrimination would be the requirement to pass an oral examination. Such a criterion might have an adverse impact on deaf or orally impaired candidates.

Equal versus Equitable Treatment

The model of adverse impact or indirect discrimination is the most problematic for persons with disabilities. For if disabled persons are treated the same as everyone else, “how can it be discrimination?” Central to an appreciation of this concept is the notion that to treat all people the same is, sometimes, a form of discrimination. This principle was most eloquently put forth by Abella in her report (Canada Royal Commission 1984), when she noted:

Formerly, we thought that equality only meant sameness and that treating persons as equals meant treating everyone the same. We now know that to treat everyone the same may be to offend the notion of equality. Ignoring differences may mean ignoring legitimate needs. It is not fair to use the differences between people as an excuse to exclude them arbitrarily from equitable participation. Equality means nothing if it does not mean that we are of equal worth regardless of the differences in gender, race, ethnicity, or disability. The projected, mythical, and attributed meaning of these differences cannot be permitted to exclude full participation.

To underscore this notion, the term equitable is used increasingly, as opposed to equal treatment.

Disability and the Environment: Accessibility and Workplace Accommodation

Flowing from concepts of adverse impact discrimination and equitable treatment is the idea that in order to treat persons with disabilities in a non-discriminatory manner, it is necessary to ensure that the environment and workplace are accessible, and that efforts have been made to reasonably accommodate the individual workplace requirements of the disabled person. Both concepts are discussed below.

Accessibility

Accessibility does not just mean that a building entrance has been ramped for use by wheelchair users. Rather it requires that persons with disabilities are provided with accessible or alternative transportation systems to allow them to get to work or school; that sidewalk curbs have been lowered; that Braille indications have been added to elevators and buildings; that washrooms are accessible to persons who use wheelchairs; that carpets whose pile density provides an obstacle to wheelchair mobility have been removed; that visually impaired persons are provided with technical aids such as large-print manuals and audiocassettes, and hearing-impaired persons are provided with optical signals, among other measures.

Reasonable workplace accommodation

Equitable treatment also means that attempts should be made to reasonably accommodate the individual needs of disabled persons at the workplace. Reasonable accommodation can be understood as the removal of barriers which prevent persons with disabilities from enjoying equity of opportunity in vocational training and employment. Lepofsky (1992) notes that accommodation is:

tailoring of a work rule, practice, condition or requirement to the specific needs of an individual or group.… An accommodation can include such steps as an exemption of the worker from an existing work requirement or condition applicable to others.… The litmus test of the accommodation’s necessity is whether such a measure is needed to ensure that the worker can fully and equally participate in the workplace.

Actually, the list of possible accommodations is theoretically endless, since each disabled person has specific needs. Moreover, two persons who experience the same or similar disabilities may have quite different accommodation needs. The important thing to recall is that accommodation is based on the needs of an individual, and the person requiring the adjustments should be consulted.

However, it must be recognized that there are circumstances in which, despite the best of intentions, it is not possible to reasonably accommodate persons with disabilities. Accommodation becomes unreasonable or an undue hardship:

  • when an individual cannot perform the essential elements of a job, or cannot complete the essential or core elements of the training curriculum
  • when to accommodate the individual would result in a risk to health and safety either to the person concerned, or to others, which outweighs the enhancing of equality for disabled persons.

 

In ascertaining the risks to safety and health, consideration must be given to the willingness of a disabled person to accept the risk that providing the accommodation would engender. For example, it may not be possible for a person who must wear an orthopaedic prosthesis to use safety boots as part of a training programme. If no other safety footwear can be found, the requirement to use the boots should be waived, if the individual is prepared to accept the risk, based on an informed decision. This is known as the doctrine of dignity of risk.

Determination must be made as to whether accommodation poses a serious risk to persons other than the disabled individual, based on the accepted levels of risk tolerated within society.

Assessments of the degree of risk must be made on the basis of objective criteria. Such objective criteria would include existing data, expert opinions and detailed information about the employment or training activity to be undertaken. Impressions or subjective judgements are not acceptable.

Accommodation also is an undue hardship when the costs would substantially adversely affect the financial viability of the employer or training facility. However, many jurisdictions provide funds and grants in order to facilitate modifications that promote the integration of disabled persons.

Disability and Social Policy: Obtaining the Viewpoint of Disabled Persons’ Organizations

As already observed, persons with disabilities should have the inherent right of choice in all aspects of life, including vocational training and occupational placement. This implies, at the level of the individual, consulting with the person concerned as to his or her wishes. Similarly, when policy decisions are made by the social partners (employers’ and workers’ organizations and government), voice must be given to organizations that represent the views of persons with disabilities. Simply put, when considering vocational training and employment policies, persons with disabilities individually and collectively know their needs and how best to meet them.

In addition, it should be recognized that while the terms disability and persons with disabilities are often used generically, individuals who have physical or motor impairments have accommodation and vocational training needs that are different from those of people with intellectual or sensory impairments. For example, while ramped sidewalks are of great benefit to wheelchair users, they may present formidable obstacles to blind people who may not be able to ascertain when they have placed themselves in danger by leaving the sidewalk. Hence, the views of organizations that represent persons with various types of disabilities should be consulted whenever contemplating policy and programme changes.

Additional Guidance Concerning Social Policy and Disability

Several important international documents provide useful guidance on concepts and measures concerning equalization of opportunities for persons with disabilities. These include the following: the United Nations World Programme of Action Concerning Disabled Persons (United Nations 1982), the Vocational Rehabilitation and Employment (Disabled Persons) Convention, 1983 (No.159) (ILO 1983) and the United Nations Standard Rules on the Equalization of Opportunities for Persons with Disabilities (United Nations 1993).

 

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Contents

Preface
Part I. The Body
Part II. Health Care
Part III. Management & Policy
Part IV. Tools and Approaches
Part V. Psychosocial and Organizational Factors
Part VI. General Hazards
Part VII. The Environment
Part VIII. Accidents and Safety Management
Part IX. Chemicals
Part X. Industries Based on Biological Resources
Part XI. Industries Based on Natural Resources
Part XII. Chemical Industries
Part XIII. Manufacturing Industries
Part XIV. Textile and Apparel Industries
Part XV. Transport Industries
Part XVI. Construction
Part XVII. Services and Trade
Part XVIII. Guides