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Existence, Goals And Functions Of Occupational Health Institutes

Almost all countries with successful occupational health systems have a national institute and there are many similar institutes to NIOH around the world. This does not imply that having a national institute necessarily guarantees a good OHS system, but such institutes do seem to be essential components of good systems.

National institutes are not only found in wealthier developed countries. The network of World Health Organisation Collaborating Centres for Occupational Health includes national institutes in a variety of countries spanning varying degrees of economic development from the United Kingdom to Bulgaria, Chile, People’s Republic of China, Columbia, India and South Africa. The NIOH is part of this network, having been granted the status of a WHO collaborating centre in January 2005.

Occupational health institutes exist because the discipline of occupational health and safety is often complex, needing multi-disciplinary teams comprising many areas of expertise. Also, with the scarcity of trained occupational health practitioners, the best way to carry out the functions is through a collective of practitioners and specialists organised into a national institute. This arrangement provides career paths for existing practitioners and a multi-disciplinary environment for capacity development of skilled practitioners to meet national needs.

The goals and functions of these institutes are remarkably similar around the world and the NIOH is no exception. In general, the goal is to promote good occupational health and working life through being centres of knowledge and development. They achieve the goal largely through developing national capacity by training occupational health professionals; providing a wide range of support services; conducting research and performing occupational disease surveillance.

The institutes are often housed in the national Department of Labour, Health or Social Security but there are many different models of governance. For example, the National Institute for Occupational Safety and Health (NIOSH) in the United States of America is part of the Centres for Disease Control and Prevention reporting via the Department of Health and Human Services to the Federal Government, while the Health and Safety Laboratory (HSL) in the United Kingdom, is part of the Health and Safety Executive. NIOH is an institute within the National Health Laboratory Service (NHLS), a public entity reporting to the Minister of Health. This positioning, alongside the National Institute for Communicable Diseases and Regional Laboratory networks, greatly facilitates administration of the NIOH, such as quality control and accreditation, provisioning for laboratories, competitive pricing for technical equipment and access to specialists in related scientific and medical disciplines. Some national institutes have regional or provincial branches so that services are provided at different levels of specialisation to the whole country in a coherent way. Where this is not the case, as with the NIOH, the institutes have national level tasks and regional or provincial counterparts provide the less specialised functions. For this to succeed, the institute’s functions need to be part of a coherent, greater plan. In South Africa, the NIOH’s role in the occupational health and safety system was defined by the Minister of Health’s Committee on Occupational Health which published its report in 1996. The NCOH, as it was then, was substantially restructured in 1997 to serve the greater occupational health and safety system which encompassed both public health aspects and the inspectorates. Part of the plan was to build provincial and district level infrastructure so that the NIOH would provide national or referral level functions, while the day-to-day functions would be carried out at sub-national level. This sub-national infrastructure has not been developed adequately so that in some fields of work, the NIOH has both national and sub-national responsibilities.