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In development cooperation, occupational diseases and accidents (OccD&A) are not a major focus. Globally, the vast majority of donor money goes to infectious diseases such as Malaria, Tuberculosis or HIV. The GIZ programme “Support of the Private Sector in Africa to Fight AIDS (SPAA)” has initiated this review to compare the magnitude of economic impact of bad working conditions with other diseases.
Methods
Searches in literature-databases (MEDLINE, WORLD OF SCIENCE, SCIENCE DIRECT, SCIELO, BVS) used terms in various combinations e.g.: occupational health, work, cost benefit, effectiveness, impact, HIV, Tuberculosis, health promotion, worksite health. Additional websites were searched for grey literature: WHO, ILO, World Bank/IFC, World Economic Forum, HSA/UK, OSHA-NIOSH/USA, EU-OSHA, Cochrane.
Results
RISKS: OccD&A are seen in around 10 to 15% of all patients in general practice. OccD&A are #5 in overall ranking of health-risk-factors, short after “Unsafe Sex”, “Alcohol” but BEFORE “Tobacco” and “Hypertension”. Work-Accidents account for 8.8% of mortality and 8.1% of DALYs by injuries.
MACROECONOMIC IMPACT (% GDP): OccD&A account for the SAME amount of loss-of-GDP than Cardiovascular-Diseases and probably for MORE GDP-loss than Diabetes-Mellitus 0.5-3%, HIV, Malaria 0.3-3%, Hypertension, Stroke 0.3-0.7%, Tobacco-use 0.3-4%, Tuberculosis 0.2-0.4%.
DEATHS: OccD&A account for the SAME amount of deaths than Diarrhoeal-Diseases or HIV (around 3.7% of total deaths worldwide) and for MORE than Tuberculosis (2.5%), road Traffic Accidents (2.2%), Diabetes-Mellitus (1.9%) of Malaria (1.5%)
Discussion:
Current priorities in development cooperation seem wrong and not supported by evidence on macro-economic impact. Neglect of bad working conditions (= occupational health) and overwhelming focus on infectious diseases seems fashionable but unjustified. Improvements in working conditions can have a greater economic impact than control of other diseases. Occupational Health needs to be included in each development project and deserves specific attention and programs.