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CISEO LIMA 2014: Congreso Internacional de Salud y Ergonomía Ocupacional
Derechos reservados, esta prohibida su reproducción sin su respectiva citación al autor. 1
CISEO LIMA 2014: Congreso Internacional de Salud y Ergonomía Ocupacional
Derechos reservados, esta prohibida su reproducción sin su respectiva citación al autor. 2
3
• 34………In addition, given the recurring loss to human life and assets across the world on account of unsafe working places, we direct the Task Force to partner with ILO in consultation with countries, and to consider how the G20 might contribute to safer workplaces……..
CISEO LIMA 2014: Congreso Internacional de Salud y Ergonomía Ocupacional
Derechos reservados, esta prohibida su reproducción sin su respectiva citación al autor. 3
Chemical risk factors: 100,000Biological agents: 200Physical factors: 50Adverse ergonomic conditions: 20Allergens: 3000
6
http://www.ilo.org/public/english/bureau/inf/download/safework.pdf
CISEO LIMA 2014: Congreso Internacional de Salud y Ergonomía Ocupacional
Derechos reservados, esta prohibida su reproducción sin su respectiva citación al autor. 4
7
Occupational injuries reported to ILO
Occupational injuries causing at least 4 days absence
Region Economicallyactive population
Total employment Fatal at least 4 days absence
Fatal injuries Lower limit (0.12)
Upper limit (0.08)
Average
High income countries (global)
494 365 003 465 270 658 11 850 4 959 039 14 090 11 732 104 17 598 156 14 665 130
LMIC Africa Region
251 588 449 98 984 676 759 46 616 44 699 37 248 941 55 873 412 46 561 176
LMIC Americas Region
315 509 490 225 696 648 1 944 657 580 25 534 7 092 881 10 639 321 8 866 101
LMIC EasternMediterraneanRegion
152 610 995 123 065 822 0 0 17 912 14 926 339 22 389 509 18 657 924
LMIC European Region
213 740 690 188 216 100 6 777 325 004 16 191 14 474 533 21 711 800 18 093 167
LMIC South-East Asia and Western Pacific Regions
642 390 831 205 151 369 81 1 676 83 096 69 247 025 103 870 537 86 558 781
Low income countries (global)
921 078 060 886 578 687 193 43 756 119 058 99 215 356 148 823 034 124 019 195
Total 2 991 283 518 2 192 963 960 21 604 6 033 671 320 580 253 937 179 380 905 768 317 421 474
Estimated numbers of occupational injuries in 2008 by WHO Regional grouping
LMIC - Low and Middle Income Countries
8
Occupational injuries reported to ILO
Global estimates of occupational accidents
FatalNon-fatal (at least four days absence)
Region Labour force Total employment Fatal Non-fatalLower limit
(0.13) Upper limit
(0.10) Average
High 498,833,289 446,194,700 4,092 4,120,618 11,396 8,766,278 11,396,161 11,222,581
AFRO 341,142,486 106,677,471 263 24,024 59,301 45,616,306 59,301,197 52,458,752
AMRO 279,490,780 248,755,700 3,096 1,184,336 18,433 14,179,165 18,432,914 16,306,040
EMRO 173,814,953 141,569,900 0 0 19,229 14,791,286 19,228,672 17,009,979
EURO 224,441,282 197,595,200 5,893 257,348 14,609 11,237,507 14,608,759 12,923,133
SEARO 759,562,909 201,728,000 683 147,348 114,732 88,255,426 114,732,053 101,493,739
WPRO 923,223,849 879,108,945 195 3,759 115,069 88,514,891 115,069,359 101,792,125
Total 3,200,509,548 2,221,629,916 14,222 5,737,433 352,769 271,360,858 352,769,116 313,206,348
Table 6. The number of occupational accidents in 2010 by region
CISEO LIMA 2014: Congreso Internacional de Salud y Ergonomía Ocupacional
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Countries Reported to the ILO on Occupational accidentsfrom 2000 to 2008
A.H.F : Agriculture, Hunting and Forestry
A.H.F.F : Agriculture, Hunting, Forestry and Fishing
Number of Reporting Years 9 8 7 6 5
Subtotal 4 3 2 1 Total
All Industries 13 12 5 7 8 45 7 3 1 7 63
Construction 12 11 5 6 5 39 6 1 1 7 54
Mining & Quarrying 9 9 4 7 6 35 6 1 2 5 49
A.H.F.F 8 8 5 6 5 32 6 1 2 6 47
A.H.F 3 7 2 6 5 23 6 3 1 6 39
10
List of the 45 countries frequently reporting to the ILOby geographical region
Region
No. Report Europe Asia America Oceania Africa
9
Austria, Bulgaria, Czech Rep., Germany, Latvia, Lithuania, Poland, Sweden (8)
Cyprus, Hon Kong (China), Israel (3)
Canada, United States
(2)
8
Estonia, Finland, Ireland, Romania, Slovakia, Spain, Switzerland (7)
Japan, Singapore (2)
Costa Rica (1) Australia, New Zealand (2)
7Croatia, Hungary, Italy, Portugal, Slovenia (5)
6
Korea Rep., Macau China, Thailand, Turkey (4)
Argentina, Mexico, Panama (3)
5Iceland, Malta, Norway, Ukraine (4)
Sri Lanka (1) Chile, Puerto Rico (2)
Mauritius (1)
CISEO LIMA 2014: Congreso Internacional de Salud y Ergonomía Ocupacional
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Reports of Occupational Diseases in Some Countries
Country Populations(Millions)
GDP per capita (US$)World bank
Reported Cases Occupational
Diseases
Year
Argentina 40 12,034 22,013 2010
Benin 6.6 1,583 1 2007
Burkina Faso 15.7 1,513 4 2007
China 1.339 9,233 27,240 2010
Cote d’Ivoire 17.5 2,039 11 2009
France 65 36,104 71,194 2010
Italy 60 33,111 46,558 2011
Japan 127 35,178 7,779 2011
Senegal 12.8 1,944 7 2008
Thailand 65 9,820 4,575 2009
UK 61 36,901 8,530 2009
USA 307 49,965 224,500 2009Shengli Niu 11
All occupationnel diseasesChina: 12,212 (2005) 27,240 (2010)France: 53,605 (2007) 71,194 (2010)Italy: 28,933 (2007) 46,558 (2011)Musculoskeletal disorders (MSDs)Korea: 1,634 (2001) 5,502 (2010) Mental disordersJapan: 108 (2003) 325 (2011)
Reporting of occupational diseases in selected countries
CISEO LIMA 2014: Congreso Internacional de Salud y Ergonomía Ocupacional
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China: Pneumoconiosis 23,812 out of 27,240 (2010)
United States: 224,500 reported cases in 2009 and the top three leading diseasesare: Skin diseases, hearing loss, respiratory diseases
Argentina: 22,013 reported cases in 2010 and the three leading diseases are: Hearing loss, MSD, respiratory diseases
Asbestos-related diseases:200,000 mesothelioma deaths expected during 1995-2029 in EU
Key occupational diseases
CISEO LIMA 2014: Congreso Internacional de Salud y Ergonomía Ocupacional
Derechos reservados, esta prohibida su reproducción sin su respectiva citación al autor. 8
CISEO LIMA 2014: Congreso Internacional de Salud y Ergonomía Ocupacional
Derechos reservados, esta prohibida su reproducción sin su respectiva citación al autor. 9
17
>352,000 work related fatal accidents
(due to adverse ergonomic factors?)
>1.9 Million fatal work related diseases
(due to adverse ergonomic factors?)
Fatal Diseases
1,979,262
86%
Fatal Accidents
352,769
14%
Work-related accidents and diseases
2.33 million
The hidden epidemic: a global picture
CISEO LIMA 2014: Congreso Internacional de Salud y Ergonomía Ocupacional
Derechos reservados, esta prohibida su reproducción sin su respectiva citación al autor. 10
www.ilo.org/safework
20
>313 million accidents causing
4 days’ absence from work
(due to adverse ergonomic factors?)
CISEO LIMA 2014: Congreso Internacional de Salud y Ergonomía Ocupacional
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21
160 million occupational diseases
(due to adverse ergonomic factors?)
4% of world’s gross national product is lost due to occupational injuries and diseases
Source: Kofi A. Annan. Occupational health and safety: a high priority on the global, international and national agenda. Asian-Pacific Newslett on OSH 1997;4:59
www.ilo.org/safework
Competitiveness and Safety
0
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Competitiveness (World Economic Forum)
Fatal accidents/100 000 workers
Sources: World Economic Forum; ILO/SafeWork
CISEO LIMA 2014: Congreso Internacional de Salud y Ergonomía Ocupacional
Derechos reservados, esta prohibida su reproducción sin su respectiva citación al autor. 12
Biological risks
Infectious diseases such as Ebola, Marburg virus, HIV, hepatitis, tuberculosis, SARS, avian flu or dengue fever are of increasing concern
Affect health care workers, farmers & workers in industries such as waste treatment
Intensification of global trading and traveling increases the problem
difficulty to develop effective responses
Physical risks
Main emerging physical risks relate to:
Lack of physical activity
Combined exposure to awkward postures or heavy physical work & vibration
Multi-factorial risks ex. Call centers (combined effects of poor ergonomic design, poor work organization , mental & emotional demands)
Complexity of technologies Increased mental & emotional strain
General increase of exposure to UV radiation while working outdoors and to new UV technologies
CISEO LIMA 2014: Congreso Internacional de Salud y Ergonomía Ocupacional
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Chemical risks
New chemicals and hazardous substances
Model for toxicological research on exposure limits and standards normally based on 70Kg male workers
Concern for people with different physiological sensitivities, such as young workers, pregnant women and other more vulnerable groups
An increasing proportion of vulnerable workers in the world’s workforce
Nanotechnologies
Nanomaterials (particles smaller than 100 nanometers)
Still Insufficient data to characterize health and environmental effects of exposure to such materials
Psychosocial factors
Conditions generating most stress are: precarious work, work intensification, violence and harassment
Changes in work design, organization, management & the introduction of new technologies or new forms of employment contracts can all result in increases stress levels
CISEO LIMA 2014: Congreso Internacional de Salud y Ergonomía Ocupacional
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OSH for Migrant workers
World’s migrant population has more than doubled between 1960 & 2005, reaching 191 million.
They are vulnerable in terms of OSH because:
Employed in high-risk & informal sectors, in “3 D work”
Language and cultural impediments to receiving OSH communication & training
Work long hours & suffer from poor general health
Not covered by social security
No data on migrant workers OSH problems to guide policy making.
The gender dimension
Need for occupational epidemiology sensitive to capture any gender-based disparities
Little information on the different gender-related risks of exposure to certain chemicals, some of which may have different long-term health effects on men & women.
Unexplained clusters of disease in the reproductive system are having an impact on particular working populations
Further research is needed to link such illnesses and occupational exposures.
CISEO LIMA 2014: Congreso Internacional de Salud y Ergonomía Ocupacional
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Ageing workers
UNFPA predicts that whereas 1 in 10 persons in the world today are aged 60 or over, this figure will rise to 1 in 8 by 2020.
In Europe the 45-64 age group is expected to represent almost half of the working population by 2020.
Older workers frequently have one or more chronic diseases or disorders that may impact functional performance, thus impact on safety.
The ageing process can also be accelerated by arduous working conditions.
However, the skills, experience and maturity of older workers often counteract such health concerns.
Studies show older workers are more dedicated to the workplace; have fewer sickness absences and stay longer in their jobs.
Older workers are a valuable asset, PAY ATTENTION TO THEIR SAFETY AND HEALTH!
The informal economy
Involves more than 80% of the working population. Mainly employs women, migrants and other vulnerable groups of workers
Experience most severe work deficits such as:
Unsafe and unhealthy working conditions; low level of skills & productivity; low or irregular incomes; long working hours & lack of access to information, markets, finance, training & technology.
Lack of protection, compulsory overtime or extra shifts, lay-offs without notice or compensation
CISEO LIMA 2014: Congreso Internacional de Salud y Ergonomía Ocupacional
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31
Lack of accurate and reliable data on occupational accidents/diseases
Inadequate legislation (coverage, mechanism to promote action at enterprises)
Lack of compliance assurance
Lack of OSH support service network
OSHmeasuresattheworkplacetocontrolhazardsandpreventoccupationaldiseasesandwork‐relateddiseases
SystemonreportingandreportingofoccupationaldiseasesparticularlyindevelopingcountriesMakeoccupationaldiseasesvisible
PayingattentionnewandemergingoccupationaldiseasessuchasMSDs,Stress‐relateddiseases.
CISEO LIMA 2014: Congreso Internacional de Salud y Ergonomía Ocupacional
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Ergonomic Problems at the Workplace
Bernardini Ramazzini an Italian physician and father of occupational medicine, in the 18th century, said the work relatedness of upper-extremity MSDs: “arise from three causes: first constant sitting, the perpetual motion of the hand in the
same manner, and thirdly the attention and the application of the
mind ”.
Ergonomic Problems at the Workplace
The first recorded epidemic of work-related musculoskeletal disorders in the UK occurred in the civil service in the 1830sand was associated with the introduction of the steel nib.
The report of an enquiry into a subsequent epidemic in the early 1900s, among the telegraphists, has been suggested by Lucire to be the origin of the term “nervous breakdown”
CISEO LIMA 2014: Congreso Internacional de Salud y Ergonomía Ocupacional
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The Fourth European Working ConditionsSurvey in 2005 (EWCS 2005)
MSDs are the most common work-related problems in the EU-27 countries
25% of European workers complain of backache 23% of muscular pains 62% of respondents are exposed to repetitive hand and
arm movements 45% report working in painful or tiring positions 35% are required to handle heavy loads in their work For certain risks, prevalence is higher amongst female
workers, notably in education and health.
(http://eurofound.europa.eu/exco/surveys/EWCS2005/index.htm).
CISEO LIMA 2014: Congreso Internacional de Salud y Ergonomía Ocupacional
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Musculoskeletal disorders are a particular problem in agriculture:
• Almost 60% of workers in agriculture and fishing are exposed to painful positions at work half the time or more, the highest of any sector
• Nearly 50% of workers in agriculture and fishing carry heavy loads half the time or more
• Over 50% of workers in agriculture and fishing are exposed to repetitive hand movements half the time or more
Ergonomic risk factors at the Workplace
Musculoskeletal, nerve and circulatory tissues can be affected by:
Repeated or forceful efforts sustained static loading anatomically non-neutral posture accelerated movements, externally applied compressive forces and Peak overload Vibration Environmental factors
CISEO LIMA 2014: Congreso Internacional de Salud y Ergonomía Ocupacional
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Psychosocial factors
Psychological job demands, decision latitude and social support are three key measures of psychosocial factors at the workplace affecting workers’ health
High psychological job demands in combination with low decision latitude may not only result in residual job strain but also cause chronic adverse health effects such as cardiovascular diseases if exposure is prolonged
Organization of Work & Social Issues
Psychosocial factors that result from the organization of work are considered to have impacts on the development of MSDs Working time arrangement, different work schedules (day work
versus various types of shift work) Transitions in work time arrangements Working long hours or over time has been shown to be
associated with poor subjective health, more injuries, unhealthy behaviour, and increased morbidity and mortality
Social issues, such as compensation laws and disability system
CISEO LIMA 2014: Congreso Internacional de Salud y Ergonomía Ocupacional
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MSDs
Exposure to each of these ergonomic factors can cause MSDs in one or more body regions.
The risk is especially noticeable when a job includes exposure to a combination of two or more of these risk factors.
Exposures of high intensity or long duration increase the risk of MSDs.
Work related MSDs may occur even when workers are exposed to an occupational risk factor on an occasional basis or for a 25% or less of the day.
Injuries and Diseases Caused by Adverse Ergonomic Working Conditions
Visual, muscular and psychological disturbances: eye strain Headaches Fatigue musculoskeletal disorders (MSDs) such as chronic
back, neck and shoulder pain, Cumulative Trauma Disorders (CTDs), Repetitive Strain Injuries (RSIs) and Repetitive Motion Injuries (RMIs)
psychological tension, anxiety and depression
CISEO LIMA 2014: Congreso Internacional de Salud y Ergonomía Ocupacional
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MSDs at Work
Ergonomic related injuries and illnesses can be temporary and may disappear
when the individual is removed from work or given an opportunity to rest at work, or
when the working conditions are improved.
Ergonomic related injuries and illnesses can also be permanent if exposures to poor ergonomic working conditions are prolonged
Prevention of MSDs
It has been estimated that at least 50% of all work-related MSDs among the working population could be prevented by appropriate ergonomic job design (Snook SH, et al,1978 & Snook SH, 1987).
CISEO LIMA 2014: Congreso Internacional de Salud y Ergonomía Ocupacional
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Prevention of MSDsThe most effective intervention programmes seem to be
those with multiple, coordinated activities, including:
application of the principles of ergonomics in the design of equipment, workstations, products and working methods according to human capabilities and limitations
training of workers improving health surveillance and management
systems general workforce empowerment top management’s active leadership and delegation of
decision-making authority regarding occupational safety
MSDs
Musculoskeletal complaints are a major cause of absence because of sickness in developed countries
In the United States, work-related MSDs comprise well over half of all reported occupational illnesses (OSHA, 2002)
More than half of all sickness absences lasting longer than two weeks were due to musculoskeletal complaints in Norway in 1998 (Brage S, et al)
In Sweden, up to 60% of people on early retirement or long term sick leave claimed MSDs as a reason (Swedish National Board on Health and Welfare, 2001).
MSDs are a major cause of years lived with disability in all continents and economies (Woolf AD & Pfleger B, 2003)
CISEO LIMA 2014: Congreso Internacional de Salud y Ergonomía Ocupacional
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Cost of Work Related MSDs
The cost of work-related MSDs was estimated to correspond to USD 13 billion in the United States and the US Department of Labour had estimated overall costs at nearly US$ 100 billion a year when such factors as lost work time, lost productivity and retraining costs are added (NIOSH 1996).
The cost of MSDs were estimated to have ranged from 2.7% to 5.2% of the gross national product (GNP) in Nordic countries in 1991, at a time when all costs due to illness were estimated to range from 15.8% to 22.2% of the GNP ((Hansen S 2003).
www.ilo.org/safework
Costs of work-related injuries and diseases
Costs by disease or injury
3% 8%9%
14%
7%16%
40%
3%
Tumors Central Nervous SystemRespiratory Diseases AccidentsMental Disorders Heart DiseasesMusculoskeletal Diseases Skin Diseases
CISEO LIMA 2014: Congreso Internacional de Salud y Ergonomía Ocupacional
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Cost of Work Related MSDs
For workers: Pain and suffering due to injuries and occupational
diseases (including RSI, CTD and RMI) Medical care cost Lost work time Lost future earning and fringe benefits Reduced job security and career advancement Lost home production and child care Home care costs provided by family members Adverse effects on family relations Lost sense of self-worth and identity Adverse effects on social and community relationships Adverse effects on recreational activities
Cost of Work Related MSDs
For employers: Increased absenteeism & lost working time Adverse effects on labour relations Higher insurance and compensation costs Increased probability of accidents and errors Restriction, job transfer and higher turnover of workers Scrap and decreased production Lawsuits Low-quality work Less spare capacity to deal with emergencies High administrative and personnel costs.
CISEO LIMA 2014: Congreso Internacional de Salud y Ergonomía Ocupacional
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Work Related MSDs
It was predicted that in UK by 2030 there will be a 9 per-cent increase in MSDs, affecting more than 7 million workers and a 5 per-cent rise in the rate of mental illness in the workforce to affect 4.2 million employees (Vaughan-Jones H & Barham L, 2009).
Work Related MSDs
The true magnitude of MSDs at the workplace is unknown.
CISEO LIMA 2014: Congreso Internacional de Salud y Ergonomía Ocupacional
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Work Related MSDs
The reasons for underreporting by employers and by workers likely include:
• Failure to recognize work-relatedness• Concern about job security• Workplace incentives for supervisors to discourage reporting• Employee preference to avoid the workers’ compensation system
and obtain medical care coverage through private insurance• Anticipated rejection of the claim• Self-denial of the injury because of financial need to support for
oneself and one’s family• Transfer or leaving of the workers• Disability retirement.
It has been estimated that at least 50% of all work-related MSDs among the working population could be prevented by appropriate ergonomic job design.
(Snook SH, et al,1978 & Snook SH, 1987).
CISEO LIMA 2014: Congreso Internacional de Salud y Ergonomía Ocupacional
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The International Labour Organization was founded to ensure everyone the right to earn a living in freedom, equity, dignity and security, in short, the right to decent work. We have never accepted the belief that injury and disease "go with the job”
Decent Work must be Safe Work
56
The Global Strategy:• reaffirmed the importance for all
countries to apply international labour standards on occupational safety and health
• requested the ILO to give highest priority to the development of new instruments in the areas of ergonomics and biological hazards.
(http://www.ilo.org/public/english/protection/safework/globstrat_e.pdf)
CISEO LIMA 2014: Congreso Internacional de Salud y Ergonomía Ocupacional
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ILO Convention No. 127 & Recommendation No. 128
www.ilo.org/safework
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New ILO List of Occupational Diseases
• ILO is the only UN Agency international list of occupational diseases
• It is designed to assist countries in the recording, prevention and compensation of occupational diseases
• For the first time, mental and behavioural disorders have been included
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Identification and Recognition of MSDs as Occupational
The classification of MSDs and the setting of diagnostic criteria are challengers in clinical practice and, accordingly, in epidemiological studies.
For some disorders, such as carpal tunnel syndrome and epicondylitis, the diagnostic criteria are fairly well established, whereas
for tendon disorders (tenosynovities, peritendinitis) the diagnostic criteria are more difficult to define. Perhaps most problems are encountered with back and neck disorders, for the majority of which the classification relies mainly on symptom reporting.
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63
Occupational MSDs included in the National Lists of Occupational Diseases
Occupational MSDs have been recognized by a number of countries e.g. Algeria, Australia, Bangladesh, Belgium, Canada, Colombia, Denmark, Finland, France, Italy, Japan, Republic of Korea, Latvia, Lithuania, Luxembourg, Malaysia, Poland, Portugal, Spain, Switzerland, United Kingdom. MSDs are also included in the 2003 European schedule of occupational diseases.
Replies to an ILO survey in 2005 in all its 176 member States on the list of occupational diseases indicated that the majority respondents were in favour to include in the list specified MSDs.
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Major outputs of the ILO
Review of the existing standards and development of new standards on OSH
Implementation of the existing standards
Guides and manuals including ergonomics checkpoints
Technical cooperation activities
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67
Major outputs of the ILO
Review of the existing standards and development of new standards on OSH
Implementation of the existing standards
Guides and manuals including ergonomics checkpoints
Technical cooperation activities
68
Review of the existing standards and development of new standards on OSH
Implementation of the existing standards
Guides and manuals including ergonomics checkpoints
Technical cooperation activities
CISEO LIMA 2014: Congreso Internacional de Salud y Ergonomía Ocupacional
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Major outputs of the ILO
Review of the existing standards and development of new standards on OSH
Implementation of the existing standards
Guides and manuals including ergonomics checkpoints
Technical cooperation activities
CISEO LIMA 2014: Congreso Internacional de Salud y Ergonomía Ocupacional
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www.ilo.org/safework
The promotion and maintenance of the highest degree of physical, mental and social well-being of workers in all occupations;
The prevention amongst workers of departures from health caused by their working conditions;
The protection of workers in their employment from risks resulting from factors adverse to health;
The placing and maintenance of workers in an occupational environment adapted to their physiological and psychological capabilities.
To summarize, the adaptation of work to the workers and of each worker to his or her job.
Adopted by the Joint ILO/WHO Committee on Occupational Health at its First Session (1950)
Aims of Occupational Health
www.ilo.org/safework
Ergonomics stresses fitting the job to the worker as compared to the more usual practice of obliging the worker to fit the job.
The aim of ergonomics is to optimize, first and foremost, the comfort of the worker, as well as his or her health, safety and efficiency.
Ergonomics is a field which integrates knowledge derived from the human sciences in particular anatomy, physiology and psychology to match jobs, systems, products and environments to the physical and mental abilities and limitations of workers.
Ergonomics is an essential and integral part of occupational health practice.
Applying ergonomic principles, obviously, is beneficial to both the workers and the employers.
Ergonomics and Occupational Health
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Shengli Niu 73
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Ergonomic Checkpoints
The practical guides of the checkpoints extends to all the main ergonomic issues which include:
materials storage and handling, hand tools, machine safety, workstation design, lighting, premises, control of hazardous substances and agents, welfare facilities, and work organization.
78
Ergonomic Checkpoints – 2nd Edition
WHY
RISKS/SYMPTOMS
SOME MORE HINTS
POINTS TO REMEMBER
Action phrase in a low-cost form
Illustrations showing good examples
HOW
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• Benefits for farmers• How to improve• Ways to promote cooperation• Some more hints• Points to remember
Action phrase in a low-cost form
Illustrations showing good examples
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ILO Encyclopaedia of Occupational Health and Safety
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CISEO LIMA 2014: Congreso Internacional de Salud y Ergonomía Ocupacional
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CISEO LIMA 2014: Congreso Internacional de Salud y Ergonomía Ocupacional
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Dr. Shengli NiuLead
Occupational Health Team LABADMIN/OSH
International Labour OfficeGeneva, Switzerland
[email protected]/safework