On 17 September 2021, the World Health Organisation (WHO) and the International Labour Organisation (ILO) jointly published their estimates of the work-related burden of disease and injury, between 2000 and 2016.[i]
Producing these estimates is said to create a valuable basis for scoping, identifying, tracking, prioritizing, planning, costing, implementing and evaluating effective policies and interventive practices that will hopefully give rise to safer workplaces, thus improving worker population health and health equity at country, regional and global levels, across sectors.
The Global Monitoring Report is the ‘first fruit’ of the collaboration between the two multinational organisations, following the 2019 Collaboration Agreement to deliver occupational health statistics on a regular basis.
Using a single, unified methodology, it was approximated that in 2016, across 183 countries, there were 1.88 million deaths and 89.72 million disability-adjusted life years (DALYs) attributable to 41 pairs of occupational risk factors and health outcomes.
It is conceded that the ultimate work-related disease burden is likely to be substantially larger, as health consequences from various occupational risk factors are still yet to be quantified, e.g. deaths from COVID-19 infection. Nonetheless, the Report serves as a useful starting point.
Diseases accounted for a significant proportion of deaths and DALYs in 2016; 80.7% (1.52 million) and 70.5% (63.28 million), respectively. Comparatively, injuries accounted for 19.3% (0.36 million) of deaths and 29.5% (26.44 million) of DALYs.
The occupational risk factor responsible for the largest number of attributable deaths was long working hours (≥ 55 hours per week) (744,924), followed by exposure to occupational particulate matter, gases and fumes (air pollution) (450,381) and occupational injuries (363,283). The 1st and 3rd risk factors led to the most DALYs, along with occupational ergonomic factors.
What is more, chronic obstructive pulmonary disease (COPD) was the health outcome attributable to the most work-related deaths (450,381), followed by stroke (398,306) and ischaemic heart disease (346,618). The 1st and 2nd health outcomes were also imputable to the most DALYs, along with back and neck pain.
A disproportionately high death rate (above the global rate) was shown to exist for workers in South-East Asia and the Western Pacific, males and those over the age of 54. Whereas, workers in Africa, the Americas, Europe and the East Mediterranean were shown to have death rates lower than the global rate. The same conclusions was drawn for DALY rates, with the exception of African workers (above the global DALY rate, despite being below the global death rate).
In absolute terms, there were 177,914 more work-related deaths in 2016 than in 2000. Although occupational injuries contributed towards a large reduction in global deaths (32,591), this was offset by a dramatic increase in deaths owing to long working hours (165,356) – a relatively new, psychosocial risk factor. Incidentally, we previewed this discovery in edition 329 of BC Disease News (here). Observed trends equally affected work-related DALYs, which increased by 9.67 million from 2000 to 2016.
However, over the 16-year monitoring period, there was in fact a ‘substantial reduction’ in the work-related ill health burden on a per-head basis (i.e. in relative terms). Rates of total deaths attributable to occupational risk factors decreased by 14.2% (5.7 deaths per 100,000 of the working-age population), while rates of total DALYs attributable to occupational risk factors decreased by 12.9% (242.5 DALYs per 100,000 of the working-age population).
One occupational health risk to potentially keep a closer eye on moving forwards is kidney cancer caused by exposure to trichloroethylene, as this boasted the largest relative increases in rates of death (223.8%) and DALYs (45.8%) among working-age populations, between 2000 and 2016. The fact that in absolute terms, there was only an increase of 19 global deaths (0.0003 deaths per 100,000) could mean that, if one were to proceed heedlessly, a latent health outcome that has only recently emerged might slip under the radar.
[i] ‘WHO/ILO: Almost 2 million people die from work-related causes each year’ (16 September 2021 WHO) <https://www.who.int/news/item/16-09-2021-who-ilo-almost-2-million-people-die-from-work-related-causes-each-year> accessed 21 September 2021.