Decline in occupational illnesses over past 10 years

A recent study published by the Institute for Public Health reveals a decrease in the number of new cases of occupational diseases in Romania. The most common work-related illnesses are silicosis, diseases caused by noise or by inhaling toxic fumes, and asthma. The areas of economic activity reporting the highest incidence of occupational illness are metal and iron ore quarrying and preparation, road transport and metallurgy.

Trends over 10 years

The Institute for Public Health (Institutul de Sănătate Publică Bucureşti, ISPB) has recently published a study on work-related diseases, entitled Occupational morbidity in Romania in 2006 [[Morbiditatea profesională în România în 2006 (in Romanian, 1.1Mb PDF)](http://www.protectiamuncii.ro/pdfs/Lucrare BP 2006.pdf)], based on annual data reported by occupational doctors. Between 1996 and 2006, statistical data reveal a generally decreasing trend in the number of new cases of diseases and in the incidence of occupational illnesses.

During the 10-year period, the incidence of occupational diseases declined from 2,015 cases in 1996 to 910 instances in 2006. At the same time, the index of incidence per 10,000 persons exposed to risk decreased from a rate of 204.2 to 51.2 over the same period (Figure 1). Persons considered as being at risk include employees working in an environment exposed to factors such as hazardous substances, asbestos, ionising radiation, noise, and other chemical, physical and biological agents.

Figure 1: Trends in incidence of occupational morbidity, 1996–2006

Source: Todea, A. and Frencz, A., Occupational morbidity in Romania in 2006, ISPB, Bucharest, 2007

Reasons for decline

The authors of the study identified the following factors in explaining the substantial reduction in the number of reported new cases of occupational diseases in recent years:

• the improvement in working conditions, introduction of new technologies and new company policies focusing on risk prevention measures;

• the difficulty of precisely calculating the number of exposed workers, due to frequent changes in the profile of companies, for example as a result of restructuring of the production process, or due to instances of undeclared work (RO0708019I);

• the non-reporting of numerous cases of occupational diseases due to various reasons, such as neglect on the part of the employer or fear of losing their jobs among the employees affected;

• the fact that those who are exposed to hazardous factors do not undergo specialised medical examinations and regular checkups, due to the lack of appropriate medical equipment.

Sectors most at risk

The 10 economic activities reporting the highest incidence of occupational diseases represent 72.4% of all new cases, despite the fact that only 13.7% of the total number of exposed persons are working in these subsectors. Compared with the average incidence in the entire economy, the incidence of work-related diseases is 46 times higher in the extraction and preparation of metal and iron ores industry, and is 6.7–8.5 times higher in the next three high-risk fields of activity (see table).

Incidence of occupational diseases, by economic activity, 2006
In 2006, significant sectoral differences emerged in the incidence of work-related illnesses, compared with the national average.

10 economic activities recording highest incidence of illness	Persons exposed to risk factors	New cases of illness	Incidence (per 10,000 persons exposed)
Total	1,776,541	910	51.2
Extraction and preparation of metal and iron ores	7,284	173	2,375.1
Other forms of transport	7,161	31	432.9
Metallurgy	50,493	199	394.1
Recreational, cultural and sporting activities	3,482	12	344.6
Road transport	32,604	100	306.7
Other non-ferrous metal production	15,063	24	159.3
Coal extraction and preparation	21,452	22	102.6
Research and development	12,144	12	98.8
Manufacture of machinery and equipment	69,250	65	93.9
Manufacture of electrical machinery and apparatus	24,992	21	84.0

Source: ISPB, 2007

Most frequent types of work-related illness

In the EU15, comprising the EU Member States prior to enlargement of the European Union in 2004 and 2007, occupational diseases caused by wear and tear or overuse of joints and muscles – that is, musculoskeletal disorders – were most prevalent (TN0611018S), followed by illnesses due to noise and skin diseases. Meanwhile, silicosis or lung disease caused by inhalation of silicon powders ranked 10th on the EU15 list.

However, in Romania, silicosis ranked first, followed by bronchial asthma and chronic bronchitis, and illnesses caused by noise. During the last decade, silicosis and diseases caused by noise or by inhaling toxic fumes represented more than 60% of all new cases of work-related illness (Figure 2).

Figure 2: New cases of occupational disease, by year and type of illness (% of total)

Source: ISPB, 2007

Commentary

The report aims to play a part in underlining health and safety in the workplace, and in fostering a transition from the concept of occupational disease to that of health on the job. Nonetheless, it is difficult to believe that this transition will be achieved in a short time in Romania, given the study results: only 289 doctors were working in the field of labour medicine for 4.5 million employees in Romania, and in three of the country’s 41 counties there was no occupational doctor.

Luminiţa Chivu, Institute of National Economy, Romanian Academy