DEVELOPMENT OF THE SLOVENIAN SYSTEM OF OCCUPATIONAL HEALTH AND SAFETY
Metoda Dodič Fikfak
Clinical Center Ljubljana, Institute of Occupational, Traffic and Sports Medicine, Ljubljana, Slovenia

Introduction

Many European countries have "improved " their occupational health and safety (OccH&S) system during the years 1960-80. The main subjects of improvement were to add health to safety at work and to introduce the so-called Tripartite System. Based on their experiences for the years 1960-1980 many countries have contributed to the new European Community legal act for OccH&S: Framework Directive (FD) 391/89.
The FD is formulated in such a way that each member state is free to make its own choices on how to fulfill the requirements in the FD, according to the member state's internal needs, traditions and resources. The major requirements of the FD are: ·

• All workers to be protected for health and safety;
• the employer to be directly responsible for implementation of the new regulations at his factory;
• the employer and the worker to participate both in a joint planning process in co-operation with the Ministry in charge of OccH&S (Tripartite System);
• (NB: there are no requirements as to financing and insurance system, which belongs to other article under Rome Treaty).

While the main FD stated the basic content of a common OccH&S system for all member states, a whole series of supplementary directives have been issued to specify the crucial areas and the minimal requirements and standards which have to be fulfilled by all member states for proper function. Among these requirements are: ·

• Safety statement, meaning a modern concept of Risk Assessment which automatically also includes risk management: when one has identified the risk he must reduce or remove it! "moving from supervision to prevention";
• multidisciplinary Occupational Health Services: a group of different experts to assist factories in solving the OCCH&S problems;
• workers information and training for active participation in OccH&S activities;

After 1989 all member states have been forced to adapt step by step their National OccH&S system to the EU FD requirements by systematic transposition of the National legislation and restructuration of the national OccH&S system and creating new institutions where this was necessary. Each member state has different needs and resources and traditions. The result is a wide spectrum of solutions of "National OccH&S systems", but all are in conformity with the EU FD.

Some MS have formally fulfilled the minimal requirements of the law. But, others like Scandinavian countries and Netherlands, Germany with strong trade union traditions have a high degree of workers participation and rights in the new system (good relations between employer and worker lead to joint agreements on future organization of OccH&S system). The solutions of the system in these countries lie above the minimal requirements of the law.

The European Foundation for Improvement of Living and Working Conditions in Dublin has made a research on the present situation of OccH&S system in each member state. The features, which are of highest importance for a good system, are: ·

• a well functioning tripartite system;
• a well functioning labor inspectors with inspectors knowing about health and safety and about how to give advice for prevention - and being independent of the employer;
• the experts in occupational hygiene, ergonomic expert,- safety and - medicine;
  
  Member states with difficulties featured one or several of the following factors:
  
  
• lack of well trained and informed staff at labor inspectors;
• insufficient training programs;
• many small and medium size enterprises (SME) who have difficulties in following the rules of the law;
• lack of innovation and research, monitoring.

Slovenia has a long tradition in OccH&S, which should be a major strength and resource for building up the future system. But the main purpose of the previous system was not really to reduce occupational diseases and accidents but more to follow the status of workers (1).

Being a country under accession Slovenia, like all other accession countries, had to adapt EU legislation, among which EC FD and the supplementary directives. In July 1999 Slovenia adopted a new law of Occupational Safety and Health, which is in agreement with FD 89/391.The law is already in full power. Under this law employer is fully responsible for health and safety at work. He has to make a statement about safety at work. To inform workers about new technologies, to worn them about the danger for accidents or diseases at work, to give them protective equipment, to have safety engineer who cares about safety at work, to have an occupational physician who is responsible for health at work.
Occupational Health and Safety Law also says that Slovenian parliament has to adopt the National plan of occupational health and safety in which the strategy of the development of occupational health and safety is determined. A group of specialists is just finishing the review of the Plan.

The proposed system of Occupational Health and Safety

In the second half of 1999 and 2000 a group of 50 Slovenian specialists and Danish, German and Austrian advisers worked on the project Development of the Slovenian system of occupational health and safety. The main aims of the project were to: ·

• ensure healthy and safe work,
• develop user-friendly system and
• The project had an important role in preparing Republic of Slovenia for the adhesion in EU.

The main tasks of the project were:

• harmonisation of legislation,
• institution building,
• education and research,
• labour inspection,
• financing and
• information system building and availability of the information about work related diseases and accidents, and
• raising public awareness.

All the project activities were based on four basic stones: prevention, inspection, insurance and education. The project proposes the model of the system, which consists of only seven institutions. Each of them has its own defined working field, so that they do not work double work, which is quite the case in our country. All those seven institutions have to share the information. This is possible only if they are in the same net. To do this we need organisational and institutional changes.

The first proposed institution in the system is a Board for Health and Safety. It is a consulting body for the government. Step by step this institution has to take over some tasks of the existing Social Economic board. Even this institution has been established two years ago. The members did not meet yet. The main task of the board is to build and to follow the policy of occupational health and safety, to follow the implementation of the national program of OccH&S, and to develop and follow the strategy for prevention of occupational diseases and accidents.

The governmental offices have legislative responsibilities and they also have function of inspection and enforcement. They work preventive work and have an important role in health promotion at workplace. The opinion of the working group was to reorganise three offices, which existed at that time in only one office with the name Agency of occupational health and safety. Because of the tradition this was simply impossible to do: we had three directors, each of them was a director in one office, so we ended up with the proposal of close collaboration of three offices.

The key institution, which has to be established, is the insurance for occupational health and safety. The proposal was that the institution, which will take care about so call work insurance, has to be independent, non-profit institution. A working group proposed an obligatory system of insurance for health and safety at work for each company and each worker. This will only become possible with the adoption of a special law, which should define the method of insurance, field of activities, beneficiaries, method of financing… Prevention activities and mechanisms of giving incentives, which would stimulate the employers to respect health and safety at work, should have a priority in setting up scheme. Up to now, the "sins" of some employers are treated on a solidarity- principle and simply remained unnoticed. In the case that each employer would pay to insurance the contribution rate which would depend on the number of work related diseases and work related accidents, he would be stimulated to take actions to prevent disease or accident at workplace. Especially if this share would not be fixed but would depend on the stimulation in the company. The working group also believed that this kind of work would be the only way to stimulate the employer for health and safety work.

The chair for occupational health and safety should be organised in the University of Ljubljana and has to be interdisciplinary. The students could be lawyers, machine engineers, and medical doctors. The institute of Occupational Health and Safety would be, according to this proposal, the main doctrinaire institution, which would develop: a doctrinaire principle for health and safety at work, research and education on the field. A working group proposed to modernise the existing Institute of Occupational, Traffic and Sports medicine, which would not work only for medical purposes but would also be a teaching bases for Chair for Occupational health and safety.

The basic unit in the system is the Occupational Health and Safety Service, which is organised in the factory or close to the factory. The organisation of these units follows the ILO convention 161. This unit is the carrier of the preventive work at the workplace. It works like an advising unit for workers and employers. Its main duty is not to make medical check-ups, which are still the most popular among Slovenian occupational physicians, but to cure the work environment. These units are composed from the psychologists, physicians and safety engineers. Their work is exclusively preventive. Each company has its own unit or asks for the help of outside one. The units educate the workers; they inform them about the technology, about the changes in technology, they teach them how to work safely, how to use protective equipment, etc…

On the enterprise level employer is responsible for the protection of health and safety of workers. The basic function and the responsibility of the employer is to ensure safety of the worker, therefore the employer should implement all the necessary measures to ensure health and safety at work. While the worker should respect and apply all health and safety procedures to protect his own life and health, and the life and health of other persons, by using safety equipment and personal protection equipment. The worker and the employer are responsible for mutual exchange of information, joint discussion and joint decision making, as set by the Health and Safety at Work Act and relevant regulations.

The employer is responsible for:

• preparing and adopting the safety statement in writing;
• informing workers on introducing new technologies and equipment, for issuing instructions for safe work where there is a potential risk for injuries and health impairments, and for issuing procedures for safe work;
• training workers for safe work;
• providing means and equipment for personal safety at work;
• authorising a professional worker for tasks related to safety and a physician for health protection;
• taking measures for ensuring fire prevention according to special regulations;
• taking measures for providing first aid and evacuation in case of emergency;
• ensuring periodic examinations of the workplace and periodic testing of the working equipment;
• ensuring periodic medical examinations of workers and · Informing the workers on special medical requirements at a workplace.

The workers and the employers must establish co-operation in a working environment directly via the worker's council or via worker's representatives.
In the future it would be necessary to increase the role of trade unions and the trustees for health and safety at work. The trade union or council, or the workers' trustee can play an important role, particularly in education and training, and in raising the awareness for safe and healthy work (2).

For the practical implementation of the act the plan foresees a stimulus to the system, which is carried out through education, inspection work and making the public aware of the relevant issues as well as the necessary link of the institutions to a uniform computer network.
The system can start operating when the links between individual institutions have been established and the definition of data flow set.
The precondition for successful functioning of the system is a well aware public. Systematic work in the field of public contacts concerning the issues dealing with occupational safety and health should be continued.
The development of the programs concerning the education in occupational health and safety should be committed to institutions, which could offer appropriate conditions for project interdisciplinary work and would promote inter-sector co-operation (3).

Conclusion

In spite of the fact that more than ten years ago occupational safety and occupational health were divided, their development was on a relatively high level in Slovenia. It therefore seems to be wise to propose the changes and co-ordination with EU schemes on the basis of the then existing system. Unfavourable attitude of the politics towards occupational health and safety caused the collapse of the system, so that it has to be set anew. As far as possible we try to preserve positive experiences from the past and add the EU requirements to the system.

If the guidelines of the project Development of Occupational Health and Safety System in Slovenia are compared with the actual situation, the following can be established:

• The Council for Occupational Health and Safety was founded and just started to operate. It is in the faze of adoption of guidelines of the national program; subsequently the latter has to be passed by the Parliament;
• a procedure has been started with the Ministry of Health to revive the Institute of occupational medicine, i.e. a doctrinal institution for occupational health. It was not possible to establish the institute of occupational health and safety;
• Branch offices of Labour Inspectorate have been connected to the network. The network between individual institutions has not been implemented yet;
• only sporadic promotion of occupational safety and health was established;
• The utmost priority is the introduction of occupational health and safety insurance scheme. This project is still at the beginning and seems quite controversial;
• a chair or educational institution for occupational health and safety will be probably establish under public health school;
• Interdisciplinary occupational health and safety services were not founded in Slovenia and safety engineers are working mostly separated from occupational physicians. Decision- makers did not find important to promote such services and to my opinion this is the greatest flaw of the present system of the OccH&S in Slovenia.

References

1. Silberschmidt M. Occupational Health and Safety in Members States. A presentation in Slovenian parliament. Ljubljana 2000.
2. Development of the Slovenian System of Occupational Health and Safety-Phare project. Final report. Ljubljana 2000.
3. Dodič Fikfak M, Bilban M, Dšuban G. The system of Occupational Health and Safety in Slovenia. In: CD: XIth world congress on Safety and health at work, Vienna 26-31 May 2002
   
   
   Sažetak
   SISTEM RAZVOJA MEDICINE RADA U SLOVENIJI
   
   Od 1960 do 1980 godine evropske zemlje članice su popravile svoj sistem zaštite zdravlja na radu. Tako je i Slovenija kao pridružena članica morala prilagoditi svoj sistem sistemu EU. Zato je 1999. i 2000. odobren "Pharov projekt": Razvoj sistema sigurnosti zdravlja na radu. Ciljevi projekta su bili garantirati sigurnost zdravlja na radu, razviti sistem rada; projekt je imao značaj u procesu pridruževanja EU. Glavne smjernice projekta su bile: harmonizacija slovenskog zakonodavstva sa zakonodavstvom EU, uz reorganiziranje institucija koje bi to mogle sprovoditi, razviti primjeren sistem edukacije i istraživanja u području zdravlja na radu, inspekciji na radu gdje je trebalo provesti inovacije, razviti sistem finansiranja sistema, izgraditi informacijski sistem zdravlja na radu, promotivnim aktivnostima podići osvješćenost ljudi o značaju zaštite na radu. Sve aktivnosti se baziraju na preventivi, inspekciji, zagovaranju i edukaciji.