Occupation and Risk for Injuries

Abstract

The world of work has changed dramatically. Globalization affects the structure of workplaces, the way work is performed, and occupational safety and health (OSH). Despite great strides in improving OSH during the past century, an estimated 317 million nonfatal occupational injuries and 321,000 occupational fatalities occur globally each year, that is, 151 workers sustain a work-related accident every 15 seconds (ILO 2013a). Poor workplace safety and health place a substantial economic burden on individuals, employers, and society. Estimates from the International Social Security Association (ISSA) suggest that costs associated with nonfatal workplace accidents alone equal approximately 4 percent of world gross domestic product (GDP) each year (ISSA 2014; SafeWork 2012).Although virtually every job entails some risk for injury, the magnitude of risk varies widely across jobs, sectors, geographic regions, and individuals. Occupational injury rates have been rising in low- and middle-income countries (LMICs), but declining in high-income countries (HICs), although the effect of globalization has been mixed. The steady decline in Australia, North America, and Western Europe is due, at least in part, to the export of labor-intensive and often more dangerous industrial production to regions where salaries are lower, workplace regulations are less stringent, and working conditions are generally poorer. However, in HICs the number of small firms and informal sector jobs has grown markedly. These firms and jobs are underserved by OSH regulations and enforcement; are difficult to reach with traditional OSH services; and have greater, but largely hidden, risk for accident and injury. Consequently, although the true burden of occupational injury in HICs remains uncertain, an estimated 6.9 million worker injuries occurred in the European Union (EU) during 2006 and 8.5 million occurred in the United States during 2007 (Chau and others 2014; Leigh and Marcin 2012). Occupational injuries and fatalities take an even greater toll in LMICs, where a large portion of the population works in the informal sector or in high-hazard sectors, including agriculture, construction, fishing, and mining, with associated costs as high as 10 percent of GDP.The great recession of 2007–09 had a negative effect on OSH in many countries. Corporations downsized, restructured, and outsourced or transferred work to third-party employers, temporary employment agencies, or independent contractors. As of 2011, 22.3 million fewer adults and 6.4 million fewer youths participated in the labor force than anticipated according to global trends before the downturn. From 2007 to 2010, the ratio of jobs to population declined sharply—from 61.2 percent in 2007 to 60.2 percent in 2010 (ILO 2012c)—and the number of workers in precarious or vulnerable employment reached an estimated 1.52 billion, an increase of nearly 23 million since 2009 and 136 million since 2000. Latin America and the Caribbean, the Middle East, South Asia, South-East Asia and the Pacific, and Sub-Saharan Africa experienced the largest increase in vulnerable employment. Women were disproportionately affected in the Middle East, North Africa, and Sub-Saharan Africa.This chapter discusses the many changes in work and work-related injuries in seven sections. Following this introduction, the second section reviews the current state of occupational injury and safety in HICs, with an emphasis on recent developments and observations, and the third focuses on the situation in LMICs, again with an emphasis on recent developments. The fourth section reviews the effect of global supply chains on global business practices. The fifth section discusses the economic effects of these changes and interventions used in ameliorating the problems raised, drawing heavily from observations in the preceding sections to the extent possible. The sixth section provides a brief synopsis of the contributions that workplace physical, chemical, and biologic exposures may make to the occurrence of acute and chronic medical conditions. A final section provides conclusions.