WHO Network of Collaborating Centers - A Partnership for Protecting Workers' Health and Safety Globally
International Course on Biological Monitoring: A Valuable Tool for a Healthier Workplace

By Leslie Nickels

This article provides an overview of the key objectives of the Global Plan of Action for Workers Health 2008-2017 WHA 60.26, http://apps.who.int/gb/ebwha/pdf_files/WHA60/A60_R26-en.pdf, and an update on progress in developing the Network of Collaborating Centre’s 2009-2012 Work Plan, including, the purpose and objective of the Work Plan, priority initiatives, and expected outcomes.

The Network of Collaborating Centers in Occupational Health currently includes 65 government, research, professional and academic institutions from 37 countries, and three international professional associations, http://www.who.int/occupational_health/network/CC_Address_List_25.5.09.pdf.  The Collaborating Centers are active partners in helping to define priorities and in implementing programs to advance the GPA agenda. Through projects, which are part of a three year Work Plan, each Collaborating Center works with WHO headquarters in Geneva, the six regional offices, and other collaborating centers. The most recent 2009-2012 Work Plan,
http://www.who.int/occupational_health/network/newsletter_15_compendium/en/index.html , defined in 2008, was built upon the 2006-2010 Work Plan developed after the triennial meeting in Stresa, Italy. The purpose of the plan is to harness and combine the experience, expertise, and commitment to workers’ health of the individual institutions which comprise the Network of Collaborating Centers in Occupational Health.

The current 2009-2012 Work Plan consists of over 220 individual projects organized into 5 GPA objectives and 14 priorities managed by GPA Managers, initiative leaders, and in cooperation with occupational health staff in Geneva and regional offices. Priorities were established to focus efforts on crucial problems in workers’ health. For details of the priorities, please visit: http://www.who.int/occupational_health/network/oeh_Summary_of_Work_Plan_Priorities_May_2009.pdf.  A summary of the priorities includes:

• Priority1.1: profiles on workers’ health and evaluation of national action plans on workers’ health
• Priority1.2: the prevention of silica and other dust-related diseases.
• Priority1.3: the elimination of asbestos-related diseases.
• Priority1.4:  the comprehensive protection and promotion of health for health care workers, emphasizing HBV immunization.
• Priority2.1: practical toolkits for the assessment and management of OH risks
• Priority2.2: a global framework and guidance on healthy workplaces
• Priority2.3: toolkits for the assessment and management of global health threats including HIV, tuberculosis, malaria, and influenza (emphasizing vulnerable groups i.e. migrant workers)
• Priority3.1: provide technical assistance to countries for organization, delivery and evaluation of basic OH services
• Priority3.2: training materials and training for international capacity building in OH
• Priority4.1: practical research on emerging issues, including nano-materials and climate change
• Priority4.2: develop the global research agenda for workers’ health studies to clarify the economic benefits of workers’ health
• Priority5.1: studies to clarify the economic benefits of workers’ health
• Priority5.2: risks associated with the effects of globalization on workers’ health
• Priority5.3: implement sectoral toolkits for the assessment and management of OH risks in the most hazardous sectors (agriculture, construction, transport)

Following the passage of the GPA by the World Health Assembly in May 2007, the Collaborating Centers’ advisory committee recommended harmonizing the 200 projects in the existing Work Plan with the objectives of the GPA. GPA Managers, collaborating center directors, and project leaders identified and aligned projects with the GPA objectives and solicited new projects to help address priorities. The transition work was coordinated by the GPA Managers, who are supported by their institutions to assist in managing information and evaluation of Work Plan process, progress, successes and barriers to Work Plan implementation.  The GPA goals and managers include:

GPA Objective 1: to devise and implement policy instruments on workers’ health Manager: Claudina Nogueira, National Institute for Occupational Health, South Africa

GPA Objective 2: to protect and promote health at the workplace
Managers: Stavroula Leka and Aditya Jain, University of Nottingham, UK

GPA Objective 3: to improve the performance of and access to occupational health services
Manager: Timo Leino, Finnish Institute of Occupational Health

GPA Objective 4: to provide and communicate evidence for action and practice Manager: Jo Harris-Roberts and Ed Robinson, Health and Safety Laboratory, UK

GPA Objective 5: to incorporate workers’ health into non-health policies and Projects
Manager: Wendy Macdonald, La Trobe University

Ultimately, the work of the collaborating centers, as defined through the 2009-2012 Work Plan, will be to contribute to addressing the priority area objectives. Some anticipated outcomes include: comparative analysis of national strategies and action plans, national profiles, and reports on lessons learned; evaluation of national programmes, packages of essential interventions and good practices, for dust control, exposure and diagnostic criteria for pneumoconiosis; review of good practices for substitution of asbestos and prevention of exposure to asbestos; tools, inventories, and framework documents for risk assessment and management in agriculture, construction and transport; definition of common criteria for toolkits; review of effectiveness of existing programmes for healthy workplaces and tools for creating healthy workplaces including a health-promoting culture; and OH&S principles research report to identify relevant gaps in research.

A compendium of the projects, table of priorities and management leadership, and a summary of projects by GPA objective areas are living documents which will change as new projects that address the priority areas are added and those whose projects are completed are catalogued and disseminated. For more information on the Network of Collaborating Centers in Occupational Health, please visit: http://www.who.int/occupational_health/network/en/index.html. For information on the 2009-2012 Work Plan, please contact ochmail@who.int.

Progress, successes and challenges in implementing the Work Plan will be addressed at the next triennial meeting of Collaborating Centers in Occupational Health October 19-22, 2009 in Geneva, Switzerland. For information on this and associated meetings, please visit: http://www.who.int/occupational_health/network/collaborating_centres_meeting/en/index.html.

By Inakshi Naik, National Institute for Occupational Health, South Africa

	Course sponsors and speakers. L-R (back row) Ayyappan Ramalingam, Suzette Pelser, Henri Heussen, Helen Mans (front row) Magriette du Toit, Inakshi Naik, Kate Jones.

The Analytical Services Section of the National Institute for Occupational Health (NIOH), in collaboration with Ampath and Lancet Laboratories, presented a two day International Course on Biological Monitoring: A Valuable Tool for a Healthier Workplace. The course was presented in Johannesburg at the NIOH (20-21 October 2008) and Durban (23-24 October 2008) at the School of Medicine, University of KwaZulu Natal.

This course was presented as part of the Global Network Plan (2006-2010) of the WHO Collaborating Centres (CC) in Occupational Health.  NIOH has been a WHO CC in OH since January 2005. This particular NIOH project in the current Global Network Work Plan is titled “Developing capacity in biological monitoring in occupational and environmental health”and falls within Global Plan of Action Objective 3, capacity building.

The course was presented by international and local experts in the field of biological monitoring. The international experts were Ms Kate Jones - principal scientist from the Health & Safety Laboratory (HSL; a WHO CC in OH), UK and ambassador of the British Occupational Hygiene Society (BOHS) for South Africa for 2008;  Dr Henri Heussen - senior occupational hygienist / toxicologist and specialist in the application of biological monitoring in industrial settings, from Arbo Unie, Netherlands; and Mr Ayyappan Ramalingam -  senior lecturer and expert in industrial hygiene, risk assessment and environmental chemistry, from the  Department of Environmental Health Engineering, Sri Ramachandra University, Chennai, India (a WHO CC in OH). South African experts in the field included Johannesburg and Ms Sharita Ismail from Metallica Chemicals, Cato Ridge, KwaZulu Natal.

	International Course on Biological Monitoring

The course content and logistics were developed by Ms Inakshi Naik (Head of Section: NIOH Analytical Services) and Ms Kate Jones from the HSL, UK. The course is designed to cover topics such as: the role of biomarkers in exposure assessment of chemical exposures; practicalities and ethical issues in the development of a biological monitoring programme; the role of the laboratories in providing biological monitoring capacity; interpretation and communication of results; etc. Based on these topics, participants were given the opportunity to actively engage in practical exercises through structured interactive sessions throughout the course.

This was the first time that a comprehensive course in biological monitoring has been presented in South Africa, and it received excellent reviews from the 140 delegates who attended both sessions. It fostered a spirit of collaborative knowledge transfer, culminating in the decision to establish an electronic biological monitoring forum where professionals, both locally and internationally, could communicate regarding biological monitoring of chemical exposures in the workplace.

For more information regarding biological monitoring in the workplace please contact:

Ms Inakshi Naik
Tel:  (011) 712 6410
Fax: (011) 712 6533
E-mail:  ina.naik@nioh.nhls.ac.za