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.
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.
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.
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.
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.
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.