Collection Occupational hygiene, Issue 32, 2001 year
The concept of occupational health risk as the basis for improving the prevention of occupational diseases
V. I. Chernyuk
doi
Institute of Occupational Health of the Academy of Medical Sciences of Ukraine, Kiev
As you know, the concept of "zero risk" based on such humane principles as the principle of "threshold action", "the principle of advance", the principle of "primacy of medical indications over technical achievability" ...
However, the humane principles underlying the concept of "zero risk" often turn into illusions when the question of their implementation in production conditions arises, ie. providing MPC and PDU for harmful factors at the workplace with specific technical solutions or the use of protective equipment. Such concepts as “today's technical achievability” and “economic feasibility” come into force.
Back in the 1930s, the state transferred all labor protection issues to trade unions, without providing the necessary funding. The designers sought to reduce the cost of construction by saving funds for labor protection - enterprises were put into operation without treatment facilities, without effective ventilation, without utility rooms, etc. The medical service of enterprises gradually became dependent on the administration (bonuses, salaries, housing, vouchers) and this influenced the identification of occupational diseases and injuries.
Therefore, the desire for "absolute security" has always been of a declarative nature and reflected, first of all, a certain ideological position of certain administrative and political structures of the most humane state in the world. Ideology is most often a substitution of reality, its idealization - "wishful thinking is presented as reality." In fact, the excess of MPC and MPL of harmful production factors at workplaces has always been and is an objective reality for mass occupations employed in production; the situation is unlikely to change for the better in the foreseeable future.
As you can see, data on the study of occupational health risks are still extremely insufficient. At the same time, obtaining such data is extremely important because expands the possibilities of improving medical care for workers in harmful and hazardous working conditions, improving preventive measures.
It is quite obvious that in modern conditions, the strategy of relations (legal, economic) between the employer and the employee, the strategy of social insurance of workers, in particular the implementation of the law on social insurance against occupational diseases and industrial accidents, should be based on the knowledge of objective quantitative criteria of occupational risks. Data on occupational risks should become an organic part of the system of hygienic regulation of hazardous production factors, namely, used as clinical criteria for guaranteeing the safety of justified MPC and MPL. The same applies to the development of a system of social benefits and compensations, planning of medical care, justification of the economic feasibility of certain health-improving measures in comparison with damage from harm to health, the development of measures to “protect by time” workers in harmful and hazardous working conditions. All this determines the relevance and prospects of this scientific direction in occupational medicine.