Occupational Health and Safety Programme until 2000

The need for the Occupational Health Programme is based on the implementation of the requirements of the Framework Directive 89/391/EEC on Occupational Safety and Health for the accession of Estonia into the European Union.

1.Occupational health situation in Estonia

In its essence occupational health is preventive health-care that aims to ensure individual and collective protection of workers and normal working conditions in an undertaking as a vital pre-requisite for effective management in a well-functioning company.

Occupational health is a wide field that includes all work-related hazards that result from the relationship between work and health. It is therefore important to determine the role of occupational health specialists and their relations with other healthcare experts and social partners.

In practice the main objective of occupational health is to protect the workers' health and to promote a safe and healthy working environment. Occupational health is regarded as an important component of an economic infrastructure.

Although Estonia was one of the first post-socialist countries that prepared to reform its occupational health system, this process has now stalled. The main constraints are the lack of necessary legislation (conflicts between various interest groups), underfinancing of the reform process and organisational difficulties in implementing new occupational health procedures.

This has created the situation where the remains of the outdated and inefficient Soviet occupational health system, largely in conflict with corresponding EU principles and requirements, still functions.

The conditions currently prevailing in Estonia indicate that 1998 could produce a breakthrough in the development of occupational health by laying a foundation for a rapid development of a new occupational health system (see Annex).

2.Objective of the Occupational Health Programme

The objective is to:

  • Harness the competence of occupational health specialists in the form of a multidisciplinary group, an occupational health service. Its main objective is to avoid or reduce health risks in the working environment and to prevent the diseases that may result from the occupational work of employees;
  • protect the worker's health and to help create and maintain a safe and healthy working environment as well as to adapt the work with the worker's abilities, taking account of his or her health condition;
  • ensure that the problems of occupational health and safety are resolved with a high quality with the help of occupational health research.

Under occupational health specialists we mean all persons who deal with occupational health and safety for professional reasons.

Occupational health specialists include occupational health physicians and nurses who are responsible for preventing work accidents and improving the working environment; labour inspectors; occupational hygiene; occupational psychologists; ergonomics; research specialists in occupational health and safety.

Social and financial losses caused by work disability and occupational accidents

The statistical data for 1997 shows that workers received compensation for a total of 7,573,872 sick days; temporary disability payments amounted to EEK 552,022,244.

It means that each day 32,787 employees were on sick leave; their work had to be done by someone else resulting in a loss of GDP.

It is estimated that the GDP in 1997 was approximately EEK 63 billion which makes about EEK 430 per employee a day.

Because of the workers' illness, daily losses amount to approximately EEK 14 million (EEK 430 x 32,787).

In 1997 a total of 70,091 sick days in the amount exceeding EEK 7 million were compensated as a result of occupational accidents.

All daily costs (health costs of workers, work disability benefits and loss of GDP) amount to approximately EEK 20 million.

The main objective of the Programme is to reduce or minimalise health hazards resulting from the working environment with the help of functioning occupational health services.

This should help to reduce illness of workers, the number of occupational accidents, the costs of work disability benefits and treatment as well as increase revenues to the GDP.

Provided that the implementation of the Occupational Health Programme will help us reduce the number of illnesses among employees by only one per cent, it will cut public spending by about EEK 55 million a year based on the 1997 data.

3. Action plan for Occupational Health Programme

3.1 To speed up the legislative process in occupational health issues. A large number of Soviet work safety standards, norms, instructions, etc. are still in place. The priority is to adopt Occupational Safety and Health Act and the Occupational Accident and Vocational Disease Insurance Act.

3.2 Setting up the Occupational Health Centre

To set up the Occupational Health Centre, an independent institution, and to provide its financing from state budget.

The duties of the Occupational Health Centre are:

  • to participate in preparing an occupational health development strategy;
  • to participate in drafting legislation in occupational health issues;
  • to organise specialised training for occupational health specialists;
  • to prepare and methodologically guide specialists of occupational health services;
  • to carry out expert studies of occupational diseases;
  • to keep statistics of occupational diseases;
  • to give expert opinion in the field of occupational health;
  • to cooperate with other institutions involved in occupational health and working environment.

3.3 Reorganisation of the Occupational Diseases Clinic

The aim is to link the functions of the Clinic with the Occupational Health Centre of the Institute for Experimental and Clinical Medicine.

The hospital of the Clinic will be restructured to a department for studying occupational diseases. The occupational disease policlinic will be maintained in the composition of the Occupational Health Centre to serve the whole Estonia.

In spite of the fact that the Occupational Disease Clinic has recently been in financial problems, it is vital that the Clinic continues to function. According to the forecasts, the work volume of the Clinic is due to increase notably in the nearest years both as a policlinic and in terms of expert studies. The Clinic is a unique medical establishment which may be used as a basis for training occupational health physicians and nurses.

3.4 Training and re-training of occupational health specialists

The training of occupational health specialists that is based on the achievements of modern science and on the principles of free market economy is a vital pre-requisite for continuing the reform in the occupational health sector. At this stage it is important to increase the qualification of existing teaching staff and to ensure training and re-training of line specialists in occupational health - occupational hygienists, occupational health physicians and nurses, specialists in ergonomics, occupational psychologists, working environment engineers and labour inspectors.

The training programme for 1998 should receive notable assistance from Finland (Finnish Institute for Occupational Health), Sweden (Project SIDA) and the Nordic Training Centre (NIVA).

3.5 Setting up an occupational health service

The duties of the occupational health service shall be:

  • to measure the characteristics of working environment and to analyse working conditions;
  • to assess the health hazard of workplaces;
  • to monitor the health condition of workers;
  • to consult the employer in developing the measures for improving working conditions;
  • to contribute to the medical and vocational rehabilitation of workers;
  • to participate in the organisation of information, training and re-training in the field of occupational health and safety;
  • to organise first aid in an undertaking and to train workers for the provision of first aid.

Regional occupational health services shall be set up in Tallinn, Tartu, Kohtla-Järve and Pärnu.

These regional services will be gradually manned by the necessary specialists (occupational health physician, nurse, occupational hygienist, specialist in ergonomics, work psychologist, working environment engineer) so that practically all problems related to occupational health can be solved by the undertaking.

Current experience shows that the abovementioned regional occupational health services must be launched with state funding. In the early years, however, the services provided by these centres will gradually increase and the state assistance will decrease.

3.6 To develop applied research work in the field of occupational health.

The number of issues that must be approached from a research angle has increased dramatically in recent years due to the restructuring of the whole economy and because of the need to harmonise corresponding EU directives.

The only research establishment that is competent to deal with such problems is the Occupational Health Centre that operates under the Institute of Experimental and Clinical Medicine

In 1999-2000 the three following projects should be considered a priority:

Studying the ability to work of workers in the risk group

As is well known, the ability to work is an integral indicator of a person's health condition. By studying the ability to work we can assess the health of workers, the impact of work factors that are hazardous to the health of workers, help design scientific methods for the improvement of working conditions and for enhancing the ability to work.

Studying and avoidance of health hazards caused by asbestos

Asbestos can cause not only asbestosis, but also lung cancer, mesoteliom? And other PAHALOOMULINE? KASVAJA. After World War II large quantities of asbestos were imported from Russia. In limited quantities, asbestos is used also today: 22,000 tons of asbestos or asbestos products were used in Estonia as late as until 1993. About 10,000 workers are currently exposed to asbestos in Estonia. The goal of the project is to assess the asbestos-related situation in Estonia, to determine the frequency of asbestos incidents and to prepare measures for removing the asbestos hazard.

Setting up a register for the workplaces with a high degree of hazardness

The goal of Stage 1 is to register the workplaces where cancerogens are used (A1, A2, A3) and to evaluate current working conditions. Recommendations for reducing the health risk resulting from the use of cancerogens will be prepared.

3.7 Organisation of occupational health information

One important complaint that the employers make is the lack or unavailability of the information on occupational health that is necessary for an undertaking. For instance, brochures that shortly and in plain text explain the occupational health and safety issues when working with a health-hazard factor (noise, vibration, toxic substance, etc.) or

Work (miners, welders, painters, etc.). There is a lack of objective and comparable data on personal protection equipment on sale. Also the information which former Soviet standards, norms and regulations are being replaced by new regulations is insufficient, etc.


4. Occupational Health Programme: Budget (thousand EEK)






Setting up the Occupational Health Centre




Development of the Occupational Health Service

1 200

1 000


Research & Development

1 420

1 430


Training of occupational health specialists 





3 520

3 330


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