DATA ON WORKERS' HEALTH FOR LATIN AMERICA & THE CARIBBEAN

Transcription

1 Report on DATA ON WORKERS' HEALTH FOR LATIN AMERICA & THE CARIBBEAN Jamaica Prepared For: By: The Pan American/World Health Organization Mirande Richards Date August 20, 1997

2 Table of Contents 1.0 Data on the Economy 1.1 Total Population 1.2 Total GDP By Economic Activity 1.3 Minimum Wage 1.4 & 1.6 Average Wage By Economic Sectors 1.5 Cost of the home Intake 2.0 Characteristics of the Workforce 2.1, 2.4, 2.8 Workforce By Sex & Age - Annual Average 2.9 Total Children & Teenage Workers 2.2, 2.3 Workforce - Employed Average 2.6 Urban & Rural EAP 2.7 Workforce - Employed Average By Economic Activity 2.10 Workforce - Employed Average By Size of Companies 2.11 Establishments By Size - Total & Percentage 3.0 Organization of Care in Occupational Health and Coverage 3.1 Structure of Health Coverage for the Whole Country and Percentage 3.2 General Roles in Occupational Health Established by Law 3.3 Bid for Occupational Health Insurance of Company used and Bid amounts & Percentage 3.4 Direct and Indirect Beneficiaries 3.5 Description of Existence of Occupational Health Program and Activities 4.0 Types of Services and Compensation that Provide Occ. Health Services Providers 4.1 Institutions that offer Services 4.4 Special Regimen of Occ. Health of Occupational Accidents and Diseases 4.5 Number of Workers Covered by Occupational Health Insurance 4.6 Types of Recognized Occupational Accidents 4.7 Subsidies and Pensions 4.8 Subsidies or Pensions - Employee Injury Benefits 4.9 Number of Workers and Hours/Days of Disability 4.10 Average Days of Disability per Worker 4.11 Average Amount of Subsidies or Pensions per Worker 5.0 Situation of Occupational Accidents and Occupational Diseases 5.1 Registry of Occupational Accidents and Occupational Diseases 5.2 Number of Workers and Fatal Occupational Accidents, subsidies and administration 5.3 By Fatal Occupational Accidents 5.4 Occupational Accidents 5.5 Distribution of the Cost of Treatment, Compensation, Subsidies, Administration of Occupational Accidents 5.6 Number of Occupational Diseases Registered 5.7 Distribution of the Cost of Treatment, Compensation, Subsidies, Administration of Occupational Diseases 5.8 Life Expectancy 5.9 General Retirement Age 6.0 Costs of Occupational Accidents and Occupational Diseases 6.1 Direct & Indirect Estimated Costs 6.2 Promoting Prevention of Accidents 7.0 Policies Developed in the Country APPENDICES Appendix I Appendix II Appendix I Appendix II Appendix III Appendix IV Appendix V Data Sources Additional Notes On Structure of the National Health Care System List of Occupational Diseases Disability Qualification Table Insurance Coverage for Workers Questionnaire Organizations to which Questionnaires were Distributed 1.0 Data on the Economy

3 DATA ON WORKERS' HEALTH FOR LATIN AMERICA & THE CARIBBEAN - Jamaica 1.1 Total Population of the Country (1996) Age Gender Males Females Total Total 1,259,518 1,268,178 2,527, , , , , , , , , , , , , , , , , , , , , , ,501 86, , ,630 64, , ,149 48,787 97, ,751 40,906 83, ,577 33,971 70, , , ,315 Source:Statistical Institute of Jamaica 3

4 1.2 Total GDP by Economic Activity Total GDP (1996) DATA ON WORKERS' HEALTH FOR LATIN AMERICA & THE CARIBBEAN - Jamaica Economic Activity Current Prices Constant Prices % Contribution J$ J$ to GDP At Constant Prices I. GOODS 86,383,904,000 8,091,108, Agriculture, Forestry & Fishing 16,869,746,000 1,519,080, Mining & Quarrying 11,914,802,000 1,682,843, Manufacturing 34,001,142,000 3,257,552, Construction & Installation 23,598,214,000 1,631,633, II. SERVICES 132,064,587,000 13,796,084, Electricity & Water 4,239,123, ,362, Transportation,Storage & Communication 21,622,530,000 2,459,093, Distributive Trade 45,812,007,000 4,064,520, Financial Institutions 18,554,030,000 2,600,479, Real Estate Services 9,467,623,000 1,612,638, Producers of Govt. Services 23,052,907,000 1,212,965, Hotels, Restaurants, Clubs 3,746,202, ,898, Other Misc. Services 4,229,092, ,362, Households & Private Non-profit 1,341,073, ,037, III. LESS IMPUTED SERV. CHARGES 16,310,813,000 3,900,114, TOTAL GDP 202,137,678,000 17,987,078, Source: Statistical Institute of Jamaica 4

5 DATA ON WORKERS' HEALTH FOR LATIN AMERICA & THE CARIBBEAN - Jamaica 1.3 Minimum Wage As of July 1, 1996 the national minimum wage was set at JA$800/US$23 per 40-hour work week. Source : Ministry of Labour, Social Security & Sports - Minimum Wage Section 1.4& 1.6 Average Wage By Economic Sectors Average Earnings Per Week of All Employed Persons in **Large Establishments, by Economic Sectors Economic Sector Average Earnings Per Week First Three Quarter (1996) Mining J$7,098 Electricity, Gas & Water 7,694 Manufacturing 3,028 Construction 3,469 Trade, Hotels & Restaurants 2,918 Financing, Insurance, Real Estate & Business Services 5,469 Community, Social & Personal Services 3,169 ALL SECTORS J$4,107 NB ** Large Establishments are deemed to be companies employing twenty (20) or more persons. However, establishments with as little as ten (10) workers are included in the definition of "Large establishments", in special circumstances. Special circumstances are those instances when an establishment which previously had a workforce of 20 or more persons reduces its numbers without reducing capacity/production load or major activity. Source:Statistical Institute of Jamaica 1.5 Cost of the home intake (earned salary of one or both head of the family) Data Not Available 2.0 Characteristics of the Work Force 5

6 DATA ON WORKERS' HEALTH FOR LATIN AMERICA & THE CARIBBEAN - Jamaica 2.1, 2,4 & 2.8 Workforce By Sex & Age - Annual Average (1996) Total Workforce Employed Labour Force Unemployed Lab. Force N % TOTAL 1,142, , , ,500 47, , , , , , , , , ,200 85, & Over 58,300 57,400 Male 614, ,300 61, ,100 34, ,500 87, , , , , ,000 72, ,300 51, & Over 39,500 38,825 Female 528, , , ,400 13, ,400 60, , , ,200 88, ,500 54, ,900 34, & Over 19,500 18, Total of Children & Teenage Workers a) Total Children No Data. Labour laws prohibit hiring of children. b) Total Teenage Workers Both Sexes Male Females Both Sexes Male Female ,623 2, ,475 2,423 1, ,725 15,600 9,125 23,225 14,450 8, ,525 36,700 39,825 63,825 35,275 28,550 NB. Totals may be distorted due to rounding. Source:Statistical Institute of Jamaica 2.2 & 2.3 EAP By Formal, Informal Sector No Data Available, however, data for employment status indicate formal and informal sectors 6

7 DATA ON WORKERS' HEALTH FOR LATIN AMERICA & THE CARIBBEAN - Jamaica Employment Status Annual Average Paid Government Employee 91,500 Paid Non-Govt. Employee 478,400 Unpaid Worker 23,500 Employer 21,900 Own Account Worker* 337,800 * includes homeworkers i.e. employees whose employment status has changed from that of "paid employee" Source:Statistical Institute of Jamaica 2.6 Urban & Rural EAP Not distinguishable 2.7 EAP by Economic Activity Industry/Sector Annual Average TOTAL 959,800 I. GOODS PRODUCING 405,200 Agriculture, Forestry, Fishing 217,300 Mining 6,300 Manufacturing 100,400 Construction 81,200 II. SERVICES 553,800 Transport, Storage & Communication 48,300 Financing, Insurance, Real Estate & Business Services 54,500 Community, Social & Personal Services 245,000 Electricity, Gas & Water 6,900 Wholesale & Retail, Hotels & Restaurant Services 199,000 III. INDUSTRIES NOT SPECIFIED 800 Source:Planning Institute of Jamaica (calculated from data supplied by Statistical Institute of Jamaica 2.10 EAP By Size of Companies Data Not Available 2.11 Establishments By Size - Total Number & Percentage Economic Activity Employment Size Groups 7

8 DATA ON WORKERS' HEALTH FOR LATIN AMERICA & THE CARIBBEAN - Jamaica All Size Groups N % N % N % All Sectors Mining Manufacturing Electricity, Gas & Steam, Water Works & Supply Construction Trade, Hotels, Restaurant Transport, Storage & Communications Financing, Ins., Real Estate & Business Services Community, Social & Personal Services (excl. Private Educational Services) Source: Statistical Institute of Jamaica 8

9 DATA ON WORKERS' HEALTH FOR LATIN AMERICA & THE CARIBBEAN - Jamaica 3.0 Organization of Care in Occupational Health and Coverage 3.1 Structure of the Health Coverage for the Whole Country and Percentage There is no formal organization of occupational health, notwithstanding provisions of the Public Health Act. In Jamaica the main focus has been safety. The general structure is as follows : Agency Current Activities Coverage Remarks Min of Health Env. Control Division Inspection of worksites: Country - All Integrated with env. health, utilizing a network of pub. health inspectors. 6 inspectors & 1 Nursing Supervisor have responsibility for OH.- For Health Hazards establishments Min of Labour, Soc.Sec. & Sports Industrial Safety Section Inspection of worksites Country - Establishments Headed by a Director. The Data Collation & Analysis registered as factories cadre is >10 inspectors. Physical hazards are the main focus. Social Security -NIS Unit Review & Payment of Claims Country - All establishments for Employment Injuries including farms Data Collation & Analysis Min of Agriculture & Mining Mining & Geology Dept. Inspection of Mines Mining & Quarry, Bauxite mining industry, (4 Data Collation & Analysis mining industry companies), is the focus. OH Annual Awards for Safety Performance is included in the Awards points system. SEE ALSO APPENDIX II 9

10 DATA ON WORKERS' HEALTH FOR LATIN AMERICA & THE CARIBBEAN - Jamaica 3.2 General Roles In Occupational Health Established by Law for : I Ministry of Labour Social Security & Sports a) Social Security Division Agency/Section National Insurance Office. The Law National Insurance Act, Sections 15-19, Scope - Geographical National Economic Sector All Sectors The Role The National Insurance Section is one of nine branches in the Social Security Division of the Ministry. The unit manages Employment Injury Benefits, processing claims in relation to work related injuries or illnesses, grouped as follows : Sections of the Act addresses "Benefit Attributable to Injury or Disease in Employment". The Act : * defines employment accident, benefits as a result of employment injury (Section 15) * prescribes occupational diseases. In keeping with its mandate the NIS Unit provides the following employment injury benefits for : * Temporary Incapacity. Benefits are paid up to 52 weeks at 75% of insurable wage. * Medical Treatment. Fees are paid for treatment received at an approved hospital or medical clinic. * Disablement. Benefits paid are based on the percentage disablement determined by a medical doctor who is guided by the schedule of Prescribed Degrees of Disablement. Death Benefits are paid if injuries are fatal, to a spouse or other prescribed persons. b) Labour Division Agency/Section Industrial Safety Section The Law The Factories Act (1968) & Factories Regulations (1970, Rev 1976) Scope - Geographical National Economic SectorFactories; Transportation, Storage & Communications (Docks & Ships); Construction NB. All sectors will be covered under the new Occupational Safety and Health Act which will be placed before Cabinet soon. The Role The Industrial Safety Section is responsible for the administration of the Factories Act and Regulations. The section functions through Factories Inspectors who, unlike Public Health Inspectors, have power of entry. The Permanent Secretary, in the Ministry, is the Chief Factories Inspector. The section is headed by a Director who manages the unit. The Factories Regulations address safety concerns in factories. Part III sections specifically addresses Health & Welfare requiring managers, inter alia, to : * implement effective housekeeping (Section 59) * prevent overcrowding and ensure adequate ventilation and lighting (Section 60 63) 10

11 DATA ON WORKERS' HEALTH FOR LATIN AMERICA & THE CARIBBEAN - Jamaica * provision of First Aid (Section 72) * ensure protection from dust, fume or other "impurity" likely to be injurious Section 74-77) II Ministry of Health a) Agency/Section Environmental Control Division The Law The Public Health Act (1985, Rev 1991) Scope - Geographical National Economic SectorAll Sectors The Role The Environmental Control Division (ECD), has responsibility for a wide range of environmental activities including sanitation, water quality, food hygiene and building integrity as it relates to health. The division also has responsibility for Occupational Health (OH), hence will have the responsibility of supervising the implementation OH regulations, prescribed by the Public Health Act Sect (f) and monitoring compliance. These regulations are still at the draft stage. Notwithstanding, Public Health Inspectors, currently inspect establishments to identify employment health hazards and recommend corrective measures. Coverage is country-wide. The Draft Regulations include provisions for: * notification of Occupational Diseases Section 4 (a), (b) * establishing standards for ventilation; lighting; control of noise, dust, fumes, etc. Section 6 (a) * personal protective devices Section 7 b) Agency/Section Pesticides Control Authority The Law Pesticides (1975, Revised 1987) & Regulations (1996) Scope - Geographical National Economic SectorAgriculture; Chemical Manufacturing; Community, Social & Personal Service (Pest Control); Wholesale & Retail Trade; Transport, Storage & Communication The Role While not explicitly empowered to perform occupational health functions, the inherent of prescribed functions address occupational health concerns. Section 4 of the Act prescribes the functions of the Pesticides Control Authority (PCA) which cover : * registration of pesticides * licensing persons who import or manufacture registered pesticides * licensing pest control operators Section 14 addresses prohibited pesticides (importation and use) while section 16 prescribes regulations in relation to: * medical examination for pest control operators and employees * labelling, packaging, storage, transportation, use and disposal of pesticides and packages * keeping and provision of records * protective clothing and the obligations of employers * prescribing permissible levels Section 18 prescribes the powers and duties of inspectors including power of entry including premises and vehicles. The PCA collaborates with existing agencies in fulfilling some of its roles including: 11

12 DATA ON WORKERS' HEALTH FOR LATIN AMERICA & THE CARIBBEAN - Jamaica * Rural Agricultural Development Agency (RADA) in collecting data for the evaluation of residue analysis RADA also advises on pesticides to be registered by Pest Control Authority. * Distributors in educating about the use of products * Pharmacy Council in licensing Retailers of Hazardous Chemicals (under the Dangerous Drugs Act). The Council currently registers all such chemicals. * The Jamaica Bureau of Standards in the analysis of pesticide samples. * Ministry of Agriculture : Veterinary Division regarding pesticides used in control of pest infestation of animals. Research & Development Division in the assessment of pesticides III Companies With Own Service a) Agency/Section Companies in the Mining & Quarries Sector The Law Mining & Quarries Act & Regulations (1977) The Role Companies in the Mining & Quarries industry are required to inter alia : * provide appropriate first aid facilities managed by "competent" (nurse, medical doctor, certified First Aider) persons. * have pre-employment and periodic medical examinations for all regularly employed workers * be guided by standards (TLVs for dust fumes, mists, gases, vapours, etc.); * Report on Occupational Injuries However, reports received and processed by this agency, are from the Bauxite mining sector. Annual awards are presented for safety performance within the sector. b) Agency/Section Factories The Law The Factories Act (1973) & Regulations (1976) Role The Factories Regulations addresses safety, health & welfare concerns in factories. Part III sections specifically addresses Health & Welfare requiring managers to, inter alia : * implement effective housekeeping (Section 59) * prevent overcrowding and ensure adequate ventilation and lighting (Section 60 63) * provision of First Aid (Section 72) * ensure protection from dust, fume or other "impurity" likely to be injurious Section 74-77) IV Insurance/Private Services a) Agency General Insurance Companies The Law Not Applicable. The Insurance Act (1971) & Regulations (1972) control the operation of General Insurance Companies. They do not specify OH concerns. The Companies, however, are third party risk takers in relation to employers liability against claims as a result of employment injuries considered a result of employers' negligence. 12

13 DATA ON WORKERS' HEALTH FOR LATIN AMERICA & THE CARIBBEAN - Jamaica Scope - Geographical National - Economic Sector All sectors The Role Providers of insurance regarding "Employers Liability". b) Agency Life Insurance Companies The Law The Insurance Act (1971) & Regulations (1972) govern the operations of the Companies, rather than prescribing for OH. Life Insurance Companies provide Group Personal Accident and Health Insurance coverage for employees. Scope - Geographical National - Economic Sector All Sectors The Role Providers of Group Health and Personal Accident Insurance to businesses. V Others a) Ministry of Agriculture & Mining The Agency The Law Mines & Geology Division - Ministry of Agriculture Mining Act Section 99 provides for Regulations governing occupational health and safety in mines and quarries Scope - Geographical National Economic SectorMining & Quarry The Role Supervision of the implementation of the Mining (Safety & Health) Regulations (1977) and inspection of mining & quarrying activities. The Regulations requires that mining establishments to, inter alia : * provide appropriate first aid facilities managed by "competent" (nurse, medical doctor, certified First Aider) persons. * have pre-employment and periodic medical examinations for all regularly employed workers * be guided by standards (TLVs for dust fumes, mists, gases, vapours, etc.); * Report on Occupational Injuries b) Ministry of Industry, Investment & Commerce The Agency The Jamaica Bureau of Standards Law Scope - Geographical National Industrial Sector All Sectors Role 13

14 The role of the Jamaica Bureau of Standards is to establish standards for manufactured products. The process of developing standards is facilitated through committees established by the Standards Council. One such committee is the Industrial Safety Committee. The committee's focus is developing standards for products such as personal protective equipment. More recently a sub committee was convened to develop the Occupational Health Management Systems Standard, which will be implemented soon. 3.3 Bid for occupational health insurance of companies, used and Bid amounts and percentage a) There is no insurance specific to occupational health, however, the following types of insurance provide some coverage for workers : Type of Coverage Group Covered i Group Health For employees and dependents ii Group Life For employees iii Personal Accident Includes employees iv Employers Liability Includes employees b) Coverage In the absence of specific data Group Insurance data could be used as a measure for occupational health coverage. See Appendix III for details regarding Insurance Coverage for workers NB Data for group insurance are not available from a single source and difficult to retrieve from individual companies due to the manner in which stored and end use by the companies. Hence, it was extremely difficult to obtain annual summaries 3.4 Direct & Indirect Beneficiaries & Number without Coverage Data Not Available 3.5 Brief description of existence of an occupational health programme and activities 1. Ministry of Health Not Known 2. Ministry of Labour Industrial Safety Division No programme 3. Private Insurance The companies to which questionnaires were distributed indicated that no Occupational Health Programmes were developed (neither in the capacity as employers nor service providers). However, one company reported activities in relation to disaster preparedness/emergency response 4. Companies (1 subsidiary of a multinational corporation, responded) Programmes reported were: a) Health Surveillance - Pre-employment & Periodic Medical Exam b) Industrial Hygiene - Identification, assessment & reduction of job hazards c) First Aid & Curative for injury and illness 5. Labour Organizations The Umbrella Organization for Labour Unions reported having Environmental/Occupational Health & Safety Education programme 2

15 6. Universities - University of the West Indies (UWI) a) Academic - Department of Community Health & Psychiatry Education & Training programme Health Promotion programme b) Personnel Department A programme has been developed and the following activities initiated: 7. NGOs - Health & Safety Committee established - Safety Policy booklet written & circulated - A lecturer assigned the responsibility for laboratory safety 8. Others a) Occupational Health Nurses Association of Jamaica Has no programme. However, the association has developed a curriculum for a programme of study in Occupational Health and has had discussions with the Department of Advanced Nursing Education, UWI to have the programme introduced in that Department. b) Jamaican Association of Safety Professionals Holds annual conferences and one day seminars for members. Has developed a research project for which funding is being sought. a) Dept. of Mines & Geology Programmes administered under the Mining (Safety & Health) Regulations - Reporting - Inspection - Investigation - Incentive Awards 4.0 Types of Services and Compensation that Provide Occupational Health Services Providers 4.1 Institutions which offer services in relation to Promotion, Prevention, Treatment & Rehabilitation. Very few institutions provide services specifically for occupational health. The following organizations reported/are known to provide related occupational health services : a) Promotion - Dept. of Mines & Geology; Industrial Safety Division; University (UWI); Trade Union Centre; CARHEPS Occupational Health & Safety Consultants b) Prevention - Dept. of Mines & Geology; Industrial Safety Division; University (UWI); CARHEPS Occupational Health & Safety Consultants c) Treatment - Companies that employ nurses, Life & Group Health Insurance Companies; General Insurance Companies; University (UWI) d) Rehabilitation - Not indicated by any of the institutions responding to the questionnaires 3

16 e) Compensation - Social Security Division of the Ministry of Labour Social Security & Sports; General & Life Insurance Companies; University (UWI) 4.4 Special Regimen of Occupational Health or of Occupational Accidents and Diseases National Insurance General Insurance Co. Life Insurance Co. Occ. Injury: Employers Liability Group Personal Accident Medical Treatment *Group Health Insurance Temporary Incapacity Disablement Death * While Health Insurance is expected to cover all health related problems, it is difficult to separate work-related problems from those derived from non-occupational sources. Also, health insurance benefits contribute to covering some costs related to treating work-related injury/illness. 4.5 Number of Workers Covered by Occupational Health Insurance Insurance Health Insurance 79,055 75,185 88,745 At Print Personal Accident (Policies Sold 2,614 1, At Print data on No. of workers not available) Employers' Liability D a t a N o t A v a i l a b l e NIS/Employment Injury Benefit Average is 600,000 annually Sources: Life Insurance Companies Association (LICA) (Four Companies) Statistics Unit - Social Security Division NB A fifth major carrier of health insurance covers a total of more than 80,000 persons (beneficiaries are not included in this total 4.6 Types of recognized occupational accidents Data were available for the bauxite industry only. Bauxite Mining Distribution of Injuries By Accident Cause 1994 cident Cause Lost Time CasesAll Injuries Percentage of Lost Time Percentage of Total correct posture iving Error ilure to Wear PPE ther Other classifications used - Type of accident e.g. disabling, medical - Location of accident e.g. production area, mining area 4

17 - Body part e.g. eye - Nature of Injury e.g. fracture, caustic burns - Accident source e.g. equipment defect, Source: Mines & Geology Division- Ministry of Agriculture & Mining 2. Industrial Safety Section - Ministry of Labour, Soc. Security & Sports for factories. 3. Other - International Standard Classification used by the ILO The other Six (6) organizations responding to the questionnaire indicated that they had no system of classifying occupational accidents as related data were not collected. 4.7 Subsidies or Pensions National Insurance - Employment Injury Benefits (EIB). There is an average of 600,000 contributors to the National Insurance Scheme (NIS), annually. Number of Claims Settled Amount Paid **Pensions/Subsidies Medical Care JA$ 181, , ,000 US$ 5,172 5,714 10,571 Temporary Disability 2,694 1,603 1,152 JA$ 1,717, , ,000 US$ 49,057 21,714 22,857 Permanent Disability JA$ 3,612,000 4,630,000 4,890,000 US$ 103, , ,714 Fatal Occ. Accident JA$ 87,000 50,000 30,000 US$ 2,486 1, Fatal Work Disease D a t a N o t A v a i l a b l e TOTAL 3,288 1,878 1,381 5,597,000 5,640,000 6,090,000 ** There is usually a time lag between submission of claims & payment of benefits. Hence, the amount paid in any one year may not be representative of benefits for injuries sustained in that year. Source: Social Security - Employment Injury Benefits Branch 4.8 Subsidies or Pensions, Employment Injury Benefit Duration of Payment Pension Amount/% of Wage for the Worker Paid By Temporary Disability 75% of insurable wage** up to 52 weeks NIS Permanent Disability*** Based on Schedule life NIS Fatal Occ. Accident 75% of insurable wage *52 weeks NIS 5

18 Fatal Work Disease 75% of insurable wage *52 weeks NIS Employers Liability Data not Available Not Available General Ins Co NB * Paid to the spouse or a dependent mother aged 55 or over or to a person caring for a child/children under the age of 18 years. Maximum payable is JA$735 per week ** That portion of wages on which NIS deductions are calculated e.g. the current ceiling is J$250,000 *** Disability is assessed at %. The benefit is then calculated at the percent disability times 75% of insurable wage. E.g. For disability of 10% the benefit would be 10% x (75% of insurable wage). Source:Social Security - Employment Injury Benefit Branch 4.9, Number of workers, hours or days of disability, average days of disability 4.10, per worker,average amount of subsidies/pensions per worker(of three previous 4.11 years Data were available for the Mining Industry only. 1. Bauxite Mining Time Period Disability Factors No. of Workers No. of Man-days Lost ,177 (includes 1 fatality) Average days of disability/worker Average amount of subsidies or N O T A V A I L A B L E pensions/worker Source:Mines & Geology Division- Ministry of Agriculture & Mining Data were not not available for other sectors. 5.0 Situation of Occupational Accidents & Occupational Diseases 5.1 Registry of Occupational Accidents & Occupational Diseases Registry Coverage Responsible Institution 6

19 Occupational Accidents Yes Occ. Accidents Ind. Safety Div. MOL Occupational Diseases No N/A NIS Office Data Utilization. Data is used by the Industrial Safety Division to determine and assign risk to establishments. 5.2 Number of Workers and Fatal Occupational Accidents a) Fatal Accidents Economic Activity Accidents Workers Agriculture ** ** ** ** ** ** Mining ,078 4,781 4,840 Manufacturing * ,431 48,513 47,856 Construction * 0 3 ** ** ** Electricity, Gas & Water * 0 1 1,134 1,094 1,028 Transport, Storage & Communication * 0 1 1,941 2,605 2,701 Trade ,337 1,418 1,539 Community, Social & Personal Services ,170 TOTAL ,727 59,219 59, Distribution of the compensating cost, subsidies and administration of fatal occupational accidents (total cost and percentage) Data were not accessible. Main reason given was that related information was fragmented and/or paperbased and difficult to retrieve. 5.4 Occupational Accidents Economic Activity Accidents Workers Agriculture ** ** ** ** ** ** Manufacturing * ,431 48,513 47,856 Construction * 1 5 * * * Electricity, Gas & Water * 0 2 1,134 1,094 1,028 Transport Storage & Communication * 0 0 1,941 2,605 2,701 Trade, Hotel & Restaurant * 0 0 1,337 1,418 1,539 Community, Social & Personal Services ,170 Sub-Total ,649 54,438 51,585 Mining ,078 4,781 4,840 7

20 TOTAL ,727 59,219 59,134 * Details not available ** No Data Available Sources: Ministry of Labour, Social Security & Sports Division - Industrial Safety Section Ministry of Agriculture & Mining - Mining & Geology Division 5.6 Number of Occupational Diseases Registered Data Not Available. No registry. 5.5 & Distribution of the cost of treatment, compensation, subsidies, administration of 5.7 occupational accidents & occupational diseases Amount in $$ Not Available, although one company in the Bauxite industry estimated the percentage of costs for non fatal accidents and the Industrial Safety Division estimated costs to be: Fatal Acc. non-fatal Occ. Dis. Acc. Accident ISD Bauxite Co. ISD Bauxite Co. ISD Bauxite Co. Treatment NK 90% NK NK No Est. NK Compensation NK 5% NK NK No Est. NK Subsidies NK 3% NK NK No Est. NK Administration J$1 mil/ 2% J$1.5 mil/ NK Nil NK US$28,572 US$42,857 Sources: Questionnaire (A Bauxite Mining Company & Industrial Safety Division - Ministry of Labour, Social Security & Sports) 5.8 Life Expectance of the country and per economic activity 1. Life Expectancy of the country Period Average Expected Years of Life at Birth Male Female Source:Statistical Institute of Jamaica 2. Life Expectancy of the country By Economic Sector Data not Available 5.9 General Retirement Age Gender Age of Retirement Men 65 8

21 Women 60 The Law National Insurance Act (1966, Rev. 1980) NB NIS Pension may be deferred to age 70 (men) or 65 (women) if individuals are gainfully employed at the legal age of retirement. Source:Social Security Division - National Insurance Section Appendix I DATA SOURCES SOURCE DEPT/AGENCY POSITION NON-GOVERNMENT Mrs. Gloria Grant Ja. Assoc. of Gen. Ins. Co Executive Director Membership List 1996 Occ. Health Survey Occ. Health Nurses Association of Jamaica CARHEPS (OH & S Consultants) Ltd. GOVERNMENT Ministry of Labour Social Security & Sports Mr. Neville Moodie Industrial Safety Division Director (Acting) Ms Andrea Miller Research & Statistics Acting Director Mrs. Patricia Hamilton Minimum Wage Director - Human Resources, Administration & Support Services Ms Etta Richards Social Security/EIB Head - EIB Mr. Simeon Johnson Social Security/Claims Unit Chief - Claims Unit Ms Ena West Social Security Director Mr. Errol Anderson Social Security - Statistics Statistician Ministry of Health Mr. Norbert Campbell Environmental Control Division Snr P. H. Inspector - Occupational Health Mrs Marcia Thompson Pest Control Authority Mr. Fitzroy Grant Ministry of Agriculture & Mining Mining & Quarries Division National Income & Product 1995 Statistical Institute of Jamaica National Income & Product (Prelim. Report) 1996 The Labour Force 1995 The Labour Force 1996 Demographic Statistics

22 Employment, Earnings & Hours Worked in Large Establishments Employment, Earnings & Hours Worked in Large Establishments Economic & Social Survey 1994 Economic & Social Survey 1996 Planning Institute Of Jamaica Ministry of Labour, Social Security & Sports Statistical Bulletin 1995 Statistical Bulletin 1996 Notes for Chairman and Members of Medical Boards National Insurance Scheme: All You Need to Know Research & Statitistics Section Research & Statitistics Section Statistics Unit Statistics Unit Factories Act 1956, Rev 1968) & Regulations (1961 Rev 1976) The Mining (Safety & Health) Regulations (1977) National insurance Act (1966 Rev 1980) Pesticides Act (1975 Rev 1987) & Regulations (1996) Public Health Act (1974, Rev 1987) & Draft Public Health (Occ. Health) Regulations (1986) Appendix II ADDITIONAL NOTES ON Structure of the National Health Care System Jamaica has a relatively well structured national health care system consisting of public and private care providers and institutions. The public health care system includes Primary Care, Curative & Rehabilitative services with support services at each level. The following exists in terms of public and private health care institutions throughout the country : Health Care Service Provider Hospitals Clinics/Medical Centres/Casualty Dept Government * Semi-Private 1 1 Private Providers 7 Data Not Available Companies - 66 Each parish has at least one (1) public general hospital and government health centres are dispersed throughout the country. All persons, including workers in neighbouring establishments, have access to these services. However, neither government nor private health care system is geared towards capturing of data for work related illnesses/ diseases as work history is not, routinely, a part of an individual's case history. At the Primary Care level, are six (6) Public Health Inspectors, whose responsibility includes occupational health functions and one (1) Occupational Health Nursing Supervisor. The Public Health Inspectors operate at the parish level while the Nurse's sphere of operation is national. The Inspectors and the Nursing Supervisor undertake inspection of facilities in relation to environmental and occupational health. Health care is also available through private medical clinics, hospitals and allied support services. Workers tend to have access to these facilities through group Health Insurance coverage and would be included among the clientele of these facilities. Work history is not included, routinely, in an individual's 10

23 case history. Medical practitioners in both private and public health care sectors are required, by law, to notify the Medical Officer of Health about prescribed diseases. Occupational diseases are not included among the notifiable diseases. Allied medical services include audiometric testing, spirometry and laboratory analysis of industrial samples are available albeit in limited numbers. Laboratory analyses are limited to tests for microorganisms such as bacteria. Very limited services are available for analysis of dust usually particulate count. Laboratory analyses of industrial samples for other substances such as VOC, are undertaken mainly in North America. Occupational Health Consultants. There are two known independent Occupational Health Consultancies, one of which is not active. The consultancy that is operational, provides a wide range of occupational health services including health risk assessments, health and safety audits and industrial hygiene services. Appendix II - ADDITIONAL NOTES Structure of the National Health Care System CONT'D. Most establishments have no occupational health or safety programmes 1. However, up to mid July 1996, 66 establishments were known to have employed 89 Registered Nurses and 6 Enrolled Assistant Nurses as is shown below 2. This has been mainly as a result of collective bargaining. Distribution of Nursing Personnel By Economic Sector (July 1996) Economic Sector Companies Nursing Personnel RN EAN Bauxite Mining Manufacturing Transport & & Communication Electricity Water Financing Hotels TOTAL Nurses Employed in Establishments in Jamaica 1 2 Richards, M. et al 1996; Final Report on an Occupational Health Survey; CARHEPS Ltd. Membership List, 1996; Occupational Health Nurses Association of Jamaica 11

24 Nurses in the Bauxite Mining sector and others in small number in the larger establishments, were more actively involved in occupational health activities than were some of their peers. For example, these nurses participated in plant tours, and collaborated with other Safety Officers, and Industrial Hygienists in monitoring the work environment. Many nurses, however, are limited to practice within the clinics, with main responsibility being First Aid and non work related health problems. In the case of those in hotels their main focus are the hotels' guests. Organization of Services All the establishments, that employ nursing personnel, have worksite clinics. At least four (4) of the larger establishments have medical doctors who visit at least one half day per week. Others have standing arrangements with medical centres or individual medical doctors to provide emergency services and/or employment medical examinations. The Bauxite companies have medical doctors on staff. One has a team of doctors headed by a Medical Director with one doctor at each of its other two locations, on a part time basis (approx. 4 hours per day). In addition there are two nurses on the morning shift and one on each of the other two shifts, daily at each location. Only two establishments, outside the bauxite mining sector, have nurses on all shifts. Industrial Hygienists are utilized mainly in the bauxite mining sector. Few are known to be employed in other sectors. 6.0 Costs of occupational accidents and occupational diseases The cost was estimated by the Industrial Safety Division to be : 6.1 Cost centres Direct Indirect $ (million) $ (million) for company J$40/US$1.14 J$112/US$3.2 for workers J$20/US$0.572 J$50/US$1.43 for provider services J$30/US$0.86 J$70/US$2.0 of occup. accidents J$90/US$2.57 J$224/US$6.4 of occup. diseases Nil Nil 6.2 Promoting prevention of accidents Direct Cost(million) Indirect Cost(million) J$0.5/ J$1.5/US NB. The bauxite company did not indicate an amount in "$$", however indicated that 100% of direct cost of occupational accidents and diseases was borne by the company) Source (6.1 & 6.2): Questionnaire from Industrial Safety Division - Ministry of Labour Social Security & Sports 7.0 Policies developed in the country 1. Ministry of Health 12

25 The Ministry of Health has drafted a National Action Plan for Workers' Health. Elements of the plan address: - Political Will - Legislation - Research - Occup. Health & Safety Programmes - Education & Training Source:Draft National Action Plan For the Development of Workers' Health 2. Industrial Safety Div. - Ministry of Labour, Social Security & Sports Draft Occupational Safety & Health Act, soon to be enacted. The cost for developing and implementing the policy has been estimated at J$2.5 million/us$71,429. Source:Questionnaire completed by the Dept. 3. Dept. of Mines & Geology Policies developed in relation to the following at an estimated cost of J$2.6 million/us$74,286 - Reporting format and frequency - Investigation & Enquiry of specified accidents - Inspection - Annual Incentive Awards Source:Questionnaire completed by the Dept. 4. University of the West Indies Policy developed re training for Health practitioners, Safety personnel and Managers in industry. Source:Questionnaire completed by the Dept. 5. Joint Trade Union Research Development Centre Policy statement developed regarding "The Environment and Sustainable Development". The statement includes social issues such as health and will form part of the ILO's Caribbean Policy Statement. The cost of developing and seeking concensus has been estimated at J$200,000/US$5,715. Source:Questionnaire completed by the Centre 6. Company in the Bauxite Sector This company reports having developed policies including those for : - No Smoking - Hazard Communication - Respiratory Protection - Hearing Conservation - Disability Management Source:Questionnaire completed by one company in the Sector 13

26 Appendix I. List of occupational diseases recognized in the country Schedule of Prescribed Diseases 3 (Regulation 19:5 of the National Insurance (Prescribed Diseases) Regulations, 1970 Description of Disease Nature of Occupation Involving Exposure Risk 1. Pneumonoconiosis All occupations as involving exposure to the risk concerned 2 Disease caused by beryllium or its toxic compounds " 3. Disease caused by phosphorus or its toxic compounds " 4. Disease caused by chrome or its toxic compounds " 5. Disease caused by manganese or its toxic compounds " 6. Disease caused by mercury or its toxic compounds " 7. Disease caused by mercury or its toxic compounds " 8. Disease caused by lead or its toxic compounds " 9. Disease caused by carbon bisulphide " 10. Disease caused by toxic halogen derivatives of hydrocarbons of the aliphatic series " 11. Disease caused by benzene or its toxic compounds " 12. Disease caused by nitro and amidotoxic derivatives of benzene or its homologues " 13. Disease caused by ionising radiations " 14. Primary epitheliomatous cancer of the skin caused by tar, pitch, bitumen, mineral oil, or the compounds, products or residues of those substances " 15. Anthrax infection Any occupation involving : a) work in connection with animals infected with anthrax b) handling of animal carcasses or parts of such carcasses including hides, hoofs and horns. c) loading or unloading or transport of merchandise which may have been contaminated by animals of animal carcasses infected with anthrax. Source: Ministry of Labour, Social Security & Sports Appendix II Disability qualification by occupational accidents and occupational diseases of the country 3 Notes for Chairmen and Members of Medical Boards, National Insurance Section; July 1988 p

27 I General Qualifying Conditions A contributor claiming employment-injury benefits must have : a) suffered an accident on the job, or b) be suffering from a prescribed disease i.e. a disease attributable to the type of work he does. See prescribed list. II Qualifying conditions for Disablement Disablement benefits are awarded on the basis of the percentage disablement sustained as a result of work related accidents. The Degrees of disablement are prescribed Prescribed Degrees of Disablement Description of Injury Degree of Disablement % Loss of both hands or amputation of higher sites 100 Loss of a hand and a foot 100 Double amputation through a leg or thigh, or amputation through leg or thigh on one side and loss of other foot 100 Loss of sight to such an extent as to render the claimant unable to perform any work for which eyesight is essential 100 Very severe facial disfigurement 100 Absolute deafness 100 Forequarter or hindquarter amputation 100 Amputation Cases - Upper Limbs (either arm) Amputation through shoulder joint 90 Amputation below shoulder with stump less than 8 inches from tip of acromion 80 Prescribed Degrees of Disablement Description of Injury Degree of Disablement % 15

28 Loss of both hands or amputation of higher sites 100 Loss of a hand and a foot 100 Double amputation through a leg or thigh, or amputation through leg or thigh on one side and loss of other foot 100 Loss of sight to such an extent as to render the claimant unable to perform any work for which eyesight is essential 100 Very severe facial disfigurement 100 Absolute deafness 100 Forequarter or hindquarter amputation 100 Amputation Cases - Upper Limbs (either arm) Amputation through shoulder joint 90 Amputation below shoulder with stump less than 8 inches from tip of acromion 80 Amputation from 8 inches from tip of acromion t less than 4 1/2 inches below tip of olecranon 70 Loss of hand or of the thumb and four fingers of one hand or amputation from 4 1/2 inches below tip of olecranon 60 Loss of thumb 30 Loss of thumb and its metacarpal bone 40 Loss of four fingers of one hand 50 Loss of three fingers of one hand 30 Loss of two fingers of one hand 20 Prescribed Degrees of Disablement Description of Injury Degree of Disablement % Amputation Cases - Lower Limbs Amputation of both feet resulting in end-bearing stumps 90 Amputation through both feet proximal to the metatarso-phalangeal joint 80 Loss of all toes of both feet through 16

29 the metatarso-phalangeal joint 40 Loss of all toes of both feet proximal to the proximal inter-phalangeal joint 30 Loss of all toes of both feet distal to the proximal inter-phalangeal joint 20 Amputation of hip 90 Amputation below hip with stump not exceeding 5 inches in length measured from tip of great trochanter 80 Amputation below hip and above knee with stump exceeding 5 inches in length measured from tip of great trochanter, or at knee not resulting in endbearing stump 70 Amputation at knee resulting in end-bearing stump below knee with stump not exceeding 3 1/2 inches 60 Amputation below knee with stump exceeding 3 1/2 inches but not exceeding 5 inches 50 Amputation below knee with stump exceeding 5 inches 40 Amputation of one foot resulting in end-bearing stump 30 Amputation through one foot proximal to the metatarsophalangeal joint 30 Loss of all toes of one foot through the metatarsophalangeal joint 20 Prescribed Degrees of Disablement Description of Injury Degree of Disablement % Other injuries Loss of one eye, without complications, the other being normal 40 Loss of vision of one eye, without complications or disfigurement of eyeball, the other being normal 30 Loss of : A. Fingers of right or left hand - Index Finger Whole 14 Two phalanges 11 One phalanx 9 Guillotine amputation of tip without loss of bone 5 17

30 Middle Finger Whole 12 Two phalanges 9 One phalanx 7 Guillotine amputation of tip without loss of bone 4 Ring or Little Finger Whole 7 Two phalanges 6 One phalanx 5 Guillotine amputation of tip without loss of bone 2 Prescribed Degrees of Disablement Description of Injury Degree of Disablement % B. Toes of Right or Left Foot - Great Toe Through metatarso-phalangeal joint 14 Part, with some loss of bone 3 Any Other Toe Through metatarso-phalangeal joint 3 Part, with some loss of bone 1 Toes of One Foot excluding Great Toe Through metatarso-phalangeal joint 5 Part, with some loss of bone 2 18

31 Three Toes of One Foot, Excluding Great Toe Through metatarso-phalangeal joint 6 Part, with some loss of bone 3 Four Toes of One Foot, Excluding Great Toe Through metatarso-phalangeal joint 9 Part, with some loss of bone 3 Source: Ministry of Labour, Social Security & Sports 19

32 Appendix III Insurance Coverage for workers Coverage Company 1 Company 2 Company 3 Company 4 Group Health Insurance Employer Gp/Co. (N) N/A ,059 Persons/lives covered (N) 12,300 28,000 94,768 41,064 Premium Income J$65,765,800/US1,992,903 J$250,000,000/US$7,575,758 #J$222,153,345/US$6,731,919 J$187,344,343/US$5,677,101 Claims paid J$64,819,499/US$1,964,227 J$189,000,000/US$5,727,273 #J$174,254,712/US$5,280,446 J$114,840,768/US$43,480,023 Group Life Insurance No Service No. of Employer Gp/Co. N/A 200 N/Applicable 1,140 No. of Persons/lives covered 56,584 14,000 N/Applicable 65,726 An. Prem Inc.(basic) J$48,436,502/US$1,467,772 J$9,900,000/US$300,000** N/Applicable J$74,491,495/US$2,257,318 An. Prem Inc.(ad&d) J$2,387,563/US$72,350 N/A N/Applicable N/A Sum Assured (basic) J$ bil/us$ mil N/A N/Applicable N/A Sum Assured (ad&d) J$3.140 bil/us$ mil N/A N/Applicable J$ bil/us$734,882,210** Claims paid J$18,679,536/US$566,047 N/A N/Applicable J$26,296,205/US$796,855 Personal Accident N/A N/A No Service No. of Employer Gp/Co. N/A N/A N/Applicable Not Known No. of Persons covered 5,000 N/A N/Applicable Not Known Premium Income J$5,127,000/US$155,364 N/A N/Applicable Not Known Claims Paid J$1,244,000/US$37,697 N/A N/Applicable J$5,621,795/US$170,357 NB ** Total Premium Income/Sum Assured - includes basic & ad&d # Data provided for Government workers only. Data for other workers (commercial groups) were not accessible. ad & d =accidental death and dismemberment Prem Inc = Premium Income N/A = Not Available/Information Not Provide bil = billion US$1 = J$33 Appendix III(cont'd) Insurance Coverage for workers

33 Coverage Company 1 Company 2 Company 3 Company 4 Group Health Insurance 1995 No. of Employer Gp/Co. N/A 530 1, No. of Persons/lives covered 16,700 30,000 83,879 26,556 Premium IncomeJ$141,414,700/US$4,285,294 J$297,000,000/US$9,000,000 #J$256,950,660/US$7,786,384 J$236,652,026/US$7,172,736 Claims paid J$122,223,500/US$3,703,742 J$237,000,000/US$6,771,429 #J$235,762,330/US$7,144,313 J$163,016,310/US$4,939,888 Group Life Insurance No Service No. of Employer Gp/Co. N/A 220 N/Applicable 904 No. of Persons/lives covered 85,131 15,000 N/Applicable 64,397 An. Prem Inc.(basic) J$78,055,908/US$2,365,330 J$11,000,000/US$333,333** N/Applicable (J$132,381,760/US$4,001,568** An. Prem Inc.(ad&d) J$ 9,041,094/US$ N/A N/Applicable ( Sum Assured (basic) J$ bil/us$ mil N/A N/Applicable (J$ bil/us$107,678,800** Sum Assured (ad&d) J$8.128 bil/us$ mil N/A N/Applicable ( Claims paid J$26,335,688/US$798,051 N/A N/Applicable J$48,015,727/US$1,455,022 Personal Accident No Service No. of Employer Gp/Co. N/A N/A N/Applicable 750 No. of Persons covered 9,000 N/A N/Applicable Not Known Premium Income J$10,145,600/US$307,442 N/A N/Applicable Not Known Claims Paid J$4,912,000/US$148,849 N/A N/Applicable J$5,621,795/US$170,358 NB ** Total Premium Income/Sum Assured - includes basic & ad&d # Data provided for Government workers only. Data for other workers not available ad & d = accidental death and dismemberment Prem Inc = Premium Income N/A = Not Available/Information Not Provide bil = billion Rate of Exchange US$1 = J$35 Appendix III(cont'd) Insurance Coverage for workers