Background to National Institutes for Occupational Health 

National institutes for occupational health and safety are common around the world; all BRICS countries have these institutes in one form or another. They are common because occupational health and safety requires specialised interdisciplinary functions; an institute is a means of bringing the requisite disciplines together to support and develop the occupational health and safety system (OHSS.) Specialised occupational health and safety practitioners are usually in short supply. A national institute is a mechanism for establishing capacity in a range of key disciplines and providing and developing expertise through critical masses of practitioners.

National Institutes for Occupational Health are almost always multi-disciplinary and function to develop and support the occupational health and safety system of a country. The work of these institutes is a mixture of technical/professional activities and activities to support the development of policy, legislation and regulation. They rarely enforce legislation or engage in compensation tasks. Occupational health requires interdisciplinary action; consequently a feature of many of these institutes is that they cover all the major disciplines of occupational health, and often safety as well. Because occupational health and safety laboratory capacity typically is neglected without special focus, many of these institutes provided strategic laboratory analyses.

The provision of occupational health services to individual workers (currently employed and those who have left work) is only one aspect of the occupational health and safety system. Policy development, legislation and regulation, and enforcement are major components of the OHSS. Specialised functions are required for the system to work, for example to build a culture of prevention in communities, to prevent injury and disease, to quantify workers’ exposure, to disseminate information and to produce practitioners.  Research and surveillance are major activities because of the very many workplace hazards in many diverse industrial sectors.

Because of the complexity of the OHSS, a number of government departments typically contribute to occupational health and safety in a country. National institutes, therefore, generally support more than one government department.

A National Institute for Occupational Health (NIOH) for South Africa

South Africa needs a NIOH because the OHSS is underdeveloped and because critical services, unavailable elsewhere, will not be provided without a NIOH. At this stage in the development of OHS in South Africa, a national institute is a key element in providing essential services and in developing capacity and supporting policy formulation.

The OHSS is evolving in South Africa. Additionally, the intention to establish NAPHISA,  new funding arrangements for the NIOH, the reengineering of primary health care and developments around the NHI have all created opportunities to examine aspects of the occupational health and safety system in South Africa, and the role of the NIOH in it.

A Concept Paper on Occupational Health and Safety in South Africa

The opportunities listed above led the Executive Director of the NIOH, Dr Sophia Kisting, to commission a Concept Paper to review the character of occupational health and safety systems (OHSS) around the world with a view to appropriately extracting system elements representing best practice. The Concept Paper was drafted by Prof. Jonny Myers but has been revised following comments. The Concept Paper also considers the role of the National Institute for Occupational Health (NIOH), because in the poorly resourced area of occupational health and safety (OHS) the institute is an important component for future development of an effective OHSS.

We hope that the Concept Paper will stimulate discussion about a future OHSS in South Africa.