WGE/9912.01 [10.01.00]
INTERNATIONAL CODE OF ETHICS
FOR OCCUPATIONAL HEALTH PROFESSIONALS
WORKING DOCUMENT FOR ITS UPDATING
DRAFT
Geneva, 14-15 December 1999
Compilation finalized on 8 August 2000
Point of contact: Dr. G.H. Coppée
105 chemin des Cortets
74160 Collonges-sous-Salève
France
Tel: 00-33-450953075
First printing: 1992
Second printing: 1994
Third printing: 1996
First updating: 2000
Permission for translation and reproduction
This document may be freely reproduced provided that the source is indicated.
Translation is subject to the agreement of ICOH* and the translated version must include a
copy of the Code in either English or French. The part entitled "Basic
principles" summarizes the principles on which the Code of Ethics for Occupational
Health Professionals is based and could usefully be posted in occupational health
services.
*ICOH: International Commission on Occupational Health
Address: Professor Jerry Jeyaratnam
Department of Community, Occupational and Family Medicine
National University Hospital
Lower Kent Ridge Road, Singapore 0511
Republic of Singapore
Tel.: (65) 772 4290; Fax: (65) 779 1489
International Commission on Occupational Health - ICOH
Commission Internationale de la Santé au Travail - CIST
COMPOSITION OF THE BOARD TO BE ADDED
Preface
1. There are several reasons why an International Code of Ethics
for Occupational Health Professionals, as distinct from codes of ethics for medical
practitioners has been adopted by the International. Commission
on Occupational Health. (ICOH). One is the increased recognition
of the complex and sometimes competing responsibilities of occupational health and safety
professionals towards the workers, the employers, the public, public health and labour
authorities and other bodies such as social security and judicial authorities. Another
reason is the increasing number of occupational health and safety professionals as a
result of the compulsory or voluntary establishment of occupational health services. Yet
another factor is the development of a multidisciplinary approach in occupational health
which implies an involvement in occupational health services of specialists who belong to
various professions.
2. The International Code of Ethics for Occupational Health
Professionals is relevant to many professional groups carrying tasks and having
responsibilities in enterprises as well as in the private and public sectors concerning
safety, hygiene, health and the environment in relation to work. The occupational health
professionals category is seen for the purpose of this Code as a broadly defined target
group whose common feature is a professional commitment in pursuing an occupational health
agenda. The scope of this Code covers activities of occupational health professionals both
when acting in individual capacity and as part of organizations or undertakings providing
services to clients and customers. The Code applies to occupational health professionals
and occupational health services regardless whether they operate in a free market context
subject to competition or within the framework of public sector health services.
3. The 1992 International Code of Ethics laid down general principles
of ethics in occupational health which are still valid but need to be updated and
rephrased to some extent in order to take into account the changing environment where
occupational health is practised, the new terminology which is currently used and the
issues of occupational health ethics emerging in public and professional debates. Among
the changes in working conditions and in social demand which should be taken into account
are those brought about by political and social developments in societies; demands on
utility value, continued quality improvements and transparency; globalization of the world
economy and liberalization of international trade; technical development and introduction
of information technology as an integral element of production and services. All these
aspects have repercussions on the context surrounding the occupational health practice and
thereby influence the professional norms of conduct and the ethics of occupational health
professionals.
4. The preparation of an International Code of Ethics for Occupational
Health Professionals was discussed by the Board of the ICOH in Sydney in 1987. A draft was
distributed to the Board members in Montreal and was subject to a process of consultations
at the end of 1990 and at the beginning of 1991. The 1992 Code of Ethics for Occupational
Health Professionals was approved by the Board of the ICOH on 29 November 1991 and
published in English and French in 1992, reprinted in 1994 and 1996 and translated into
eight languages.
5. A Working Group was established by the ICOH Board in 1993 with the
aim of updating when appropriate the International Code of Ethics for Occupational Health
Professionals and for the purpose of following up the overall theme of ethics in
occupational health. Between 1993 and 1996 the Working Group included three members (Dr.
G.H. Coppée, Prof. P. Grandjean and Prof. P. Westerholm) and 17 associate members who
provided comments and proposed amendments. In December 1997, Dr. G.H. Coppée and
Prof. P. Westerholm indicated to the Bureau of the ICOH Board that an in-depth revision of
the Code of Ethics was not warranted but that an updating was justified since some parts
of the text were not clear or needed to be more precise to avoid misunderstandings.
6. A meeting of the members of the reconstituted Working Group on
Ethics in Occupational Health (Prof. LF. Caillard, Dr. G.H. Coppée and Prof. P.
Westerholm) took place in Geneva on 14 and 15 December 1999 and reviewed the comments on
the 1992 Code of Ethics received during the period 1993-99, in particular the
contributions from the, associate members. Since the purpose was not to revise but to
update the 1992 Code of Ethics, its original structure was retained. Similarly, the
wording of the paragraphs and their numbers were maintained although some improvements
could have resulted from certain suggestions made by associate members for reorganizing
the text in a more systematic manner.
7. The 1992 Code consisted of a set of basic principles and practical
guidelines presented in paragraphs using a mode of phrasing with a normative intent. The
Code was not and is not to become a textbook on ethics in occupational health. For this
reason, paragraphs were not supplemented with commentaries. It is considered that it
belongs to the professionals themselves and their associations to take an active role in
further defining the conditions of application of the provisions of the Code in specific
circumstances (e.g. by conducting case studies, group discussions and training workshops
using the provisions of the Code to fuel a technical and ethical debate).
8. It should also be noted that more detailed guidance on a number of
particular aspects can be found in national codes of ethics or guidelines for specific
professions. Furthermore, the Code of Ethics does not have the ambition to cover all areas
of implementation or all aspects of the conduct of occupational health professionals or
their relationships with social partners, other professionals and the public. It is
acknowledged that some aspects of professional ethics may be specific to certain
professions and need additional ethical guidance (e.g. engineers, nurses, physicians,
hygienists, psychologists, inspectors, architects, designers, work organization
specialists and professionals involved in research).
9. This Code of Ethics represents an attempt to translate in terms of
professional conduct the values and ethical principles in occupational health. It is
intended to guide all those who carry out occupational health activities and to set a
reference level on the basis of which their performance can be assessed. This document may
be used for the elaboration of national codes of ethics and for educational purpose. It
may also be adopted on a voluntary basis and serve as a standard for defining and
evaluating professional conduct. Its purpose is also to contribute to the development of a
common set of principles for cooperation between all those concerned as well as to promote
teamwork and a multidisciplinary approach in occupational health.
10. The ICOH Board wishes to thank all those who provided inputs and a
sound basis for an updating of the Code of Ethics, in particular the Hon. J.L. Baudouin
(Canada), Prof. A. David (Czech Republic), Prof. M.S. Frankel (United States), Prof J.
Jeyaratnam (Singapore), Dr. T. Kalhoulé (Burkina Faso), Dr. K. Kogi (Japan), Dr. M.
Lesage (Canada), Dr. M.I. Mikheev (Russian Federation), Dr. T. Nilstun (Sweden), Dr. S.
Niu (China), Prof. T. Norseth (Norway), Mr. I. Obadia (Canada), Dr. C.G. Ohlson (Sweden),
Prof. C.L. Soskolne (Canada), Prof. B. Terracini (Italy), Dr. K. van Damme (Belgium).
11. The updated version 2000 of the International Code of Ethics for
Occupational Health Professionals was circulated for comments to ....... and its
publication was approved by the Board of the ICOH on .......
12. It should be stressed that ethics should be considered as a subject
which remains always open and requires interactions, multidisciplinary cooperation,
consultations and participation. The process may turn out to be more important than its
outcome. A code of ethics for occupational health professionals should never be considered
as "final" but as a milestone of a dynamic process involving the occupational
health community as a whole, the ICOH and other organizations concerned with safety,
health and the environment, including employers' and workers' organizations.
13. It cannot be overemphasized that ethics in occupational health is
by essence a field of interactions between many partners. Good occupational health is
inclusive, not exclusive. The elaboration and the implementation of professional conduct
standards do not involve only the occupational health professionals themselves but also
those who will benefit from or may feel threatened by their practice as well as those who
will support its sound implementation or denounce its shortcomings. Ibis document should
therefore be kept under review and its revision should be undertaken when deemed
necessary. Comments to improve its content should be addressed to the Secretary-General of
the International Commission on Occupational Health.
Introduction
1. The aim of occupational health practice is to protect and promote workers' health,
to sustain and improve their working capacity and ability, to contribute to the
establishment and maintenance of a safe and healthy working enviromnent for all, as well
as to promote the adaptation of work to the capabilities of workers, taking into account
their state of health.
2. The field of occupational health is broad and covers the prevention of all
impairments arising out of employment, work injuries and work-related disorders and
stress, including occupational diseases and all aspects relating to the interactions
between work and health. Occupational health professionals should be involved, whenever
possible, in the design and choice of health and safety equipment, appropriate methods and
procedures and safe work practices and they should encourage workers' participation in
this field as well as feedback from experience.
3. On the basis of the principle of equity, occupational health professionals should
assist workers in obtaining and maintaining employment notwithstanding their health
deficiencies or their handicap. It should be duly recognized that there are particular
occupational health needs of workers because of gender, age, physiological condition,
social aspects, communication barriers or other factors. Such needs should be met on an
individual basis with due concern to protection of health in relation to work and without
leaving any possibility for discrimination.
4. For the purpose of this Code, the expression "occupational health
professionals" is meant to include all those who, in a professional capacity, carry
out occupational safety and health tasks, provide occupational health services or are
involved in an occupational health practice. A wide range of disciplines is concerned with
occupational health since it is at an interface between technology and health involving
technical, medical, social and legal aspects. Occupational health professionals include
occupational health physicians and nurses, factory inspectors, occupational hygienists and
occupational psychologists, specialists involved in ergonomics, in accident prevention and
in the improvement of the working environment as well as in occupational health and safety
research. The trend is to mobilize the competence of these occupational health
professionals within the framework of a multidisciplinary approach which may sometimes
take the form of a multiprofessional team.
5. Many other professionals from a variety of disciplines such as chemistry,
toxicology, engineering, radiation health, epidemiology, environmental health, applied
sociology and health education may also be involved, to some extent, in occupational
health practice. Furthermore, public health and labour authorities, employers, workers and
their representatives and first aid workers have an essential role and even a direct
responsibility in the implementation of occupational health policies and programmes,
although they are not occupational health specialists by profession. Finally, many other
professions such as lawyers, architects, manufacturers, designers, work analysts, work
organization specialists, teachers in technical schools, universities and other
institutions as well as the media personnel have an important role to play in relation to
the improvement of the working environment and of working conditions.
6. The term "employers" means legal persons with recognized responsibility,
commitment and duties towards workers in their employment by virtue of a mutually agreed
relationship (a self-employed person is regarded as being both an employer and a worker).
The term "workers" applies to any persons who work, whether full time, part time
or temporarily for an employer; this term is used here in a broad sense covering all
employees, including management staff and the self-employed (a self-employed person is
regarded as having the duties of both an employer and a worker). The expression
"competent authority" means a minister, government department or other public
authority having the power to issue regulations, orders or other instruction having the
force of law.
7. There is a wide rage of duties, obligations and responsibilities as well as complex
relationships among those concerned and involved in occupational safety and health
matters. In general, obligations and responsibilities are defined by statutory
regulations. Each employer has the responsibility for the health and safety of the workers
in his or her employment. Each profession has its responsibilities which are related to
the nature of its duties. It is important to define the role of occupational health
professionals and their relationships with other professionals, with the competent
authority and with social partners in the purview of economic, social, environmental and
health policies. This calls for a clear view about the ethics of occupational health
professionals and standards in their professional conduct. When specialists of several
professions are working together within a multidisciplinary approach, they should
endeavour to base their action on shared sets of values and have an understanding of each
others' duties, obligations, responsibilities and professional standards.
8. Some of the conditions of execution of the functions of occupational health
professionals and the conditions of operation of occupational health services are often
defined in statutory regulations, such as regular planning and reviewing of activities and
continuous consultation with workers and management. Basic requirements for a sound
occupational practice include a full professional independence, i.e. that occupational
health professionals must enjoy an independence in the exercise of their functions which
should enable them to make judgements and give advice for the protection of the workers'
health and for their safety within the undertaking in accordance with their
knowledge and conscience. Occupational health professionals should make sure that the
necessary conditions are met to enable them to carry out their activities according to
good practice and to the highest professional standards. This should include adequate
staffing, training and retraining, support and access to an appropriate level of senior
management.
9. Further basic requirements for acceptable occupational health practice, often
specified by national regulations, include free access to the workplace, the possibility
of taking samples and assessing the working environment, making job analyses and
participating in enquiries and consulting the competent authority on the implementation of
occupational safety and health standards in the undertaking. Special attention should be
given to ethical dilemma which may arise from pursuing simultaneously objectives which may
be competing such as the protection of employment and the protection of health, the right
to information and confidentiality, and the conflicts between individual and collective
interests.
10. The occupational health practice should meet the aims of occupational health which
have been defined by the ILO and WHO in 1950 and updated as follows by the ILO/WHO Joint
Committee on Occupational Health in 1995:
| Occupational health should aim at: the promotion
and maintenance of the highest degree of physical, mental and social well-being of workers
in all occupations; the prevention amongst workers of departures from health caused by
their working conditions; the protection of workers in their employment from risks
resulting from factors adverse to health; the placing and maintenance of the workers in an
occupational environment adapted to his physiological and psychological capabilities; and,
to summarize, the adaptation of work to man and of each man to his job. The main focus in
occupational health is on three different objectives: (i) the maintenance and promotion of
workers' health and working capacity; (ii) the improvement of working environment and work
to become conducive to safety and health; and (iii) development of work organizations and
working cultures in a direction which supports health, and safety at work and in doing so
also promotes a positive social climate and smooth operation and may enhance productivity
of the undertakings. The concept of working culture is intended in this context to mean a
reflection of the essential value systems adopted by the undertaking concerned. Such a
culture is reflected in practice in the managerial systems, personnel policy, principles
for participation, training policies and quality management of the undertaking. |
11. It cannot be overemphasized that the central purpose of any
occupational health practice is the primary prevention of occupational and work-related
diseases and injuries. Such practice should take place under controlled conditions and
within an organized framework - preferably occupational health services - in order to
ensure that it is relevant, knowledge-based, sound from a scientific, ethical and
technical point of view, and appropriate to the occupational risks in the enterprise and
to the occupational health needs of the working population concerned.
12. It is increasingly understood that the purpose of a sound
occupational health practice is not merely to perform assessments and to provide services
but implies to care for workers' health and their working capacity with a view to protect,
maintain and promote them. This approach of occupational health care and occupational
health promotion addresses workers' health and their human and social needs in a
comprehensive and coherent manner, which includes preventive health care, health
promotion, curative health care, first-aid rehabilitation and compensation where
appropriate, as well as strategies for prompt recovery and return to work. Similarly, the
importance to consider the links between occupational health, environmental health,
quality management, product safety and stewardship, public and community health and
security is increasingly understood. This trend is conducive to the development of
occupational safety and health management systems, an emphasis on the choice of clean
technologies and alliances of those who produce and those who protect in order to make
development sustainable, equitable, socially useful and responsive to human needs.
Basic principles
The three following paragraphs summarize the principles of
ethics and values on which is based the International Code of Ethics for
Occupational Health Professionals. prepared by the International Comission on
Occupational Health (ICOH).
The purpose of occupational health is to serve the health and
social well-being of the workers individually and collectively. Occupational health
practice must be performed according to the highest professional standards and ethical
principles. Occupational health professionals must serve the health and social
well being of the workers, individually and collectively. They also contribute to
environmental and community health.
The obligations duties of occupational health professionals
include protecting the life and the health of the worker, respecting human dignity and
promoting the highest ethical principles in occupational health policies and programmes.
Integrity in professional conduct, impartiality and the protection of the confidentiality
of health data and of the privacy of workers are part of these obligations
duties.
Occupational health professionals are experts who must enjoy full
professional independence in the execution of their functions. They must acquire and
maintain the competence necessary for their duties and require conditions which allow them
to carry out their tasks according to good practice and professional ethics.
Duties and obligations of occupational health professionals
Aims and advisory role
1. The primary aim of occupational health practice is to safeguard and promote the
health of workers, and to promote a safe and healthy working environment, to protect
the working capacity of workers and their access to employment. In pursuing this aim,
occupational health professionals must use validated methods of risk evaluation, propose effcient
effective preventive measures and follow up their implementation. The occupational
health professionals must provide competent and honest advice to the employers on
fulfilling their responsibility in the field of occupational safety and health and
they must honestly advise as well as to the workers on the protection and
promotion of their health in relation to work. The occupational health, professionals
should maintain direct contact with safety and health committees, where they exist.
Knowledge and expertise
2. Occupational health professionals must continuously strive to be familiar with the
work and the working environment as well as to improve develop their
competence and to remain well informed in scientific and technical knowledge, occupational
hazards and the most efficient means to eliminate or to reduce minimize
the relevant risks. As the emphasis must be on primary prevention defined in terms
of policies, design, choice of clean technologies, engineering control measures and
adapting work organization and workplaces to workers, occupational health
professionals must regularly and routinely, whenever possible, visit the workplaces and
consult the workers the technicians and the management on the work that
is performed.
Development of a policy and a programme
3. The occupational health professionals must advise the management and the workers on
factors at work within the undertaking which may affect workers'
health. The risk assessment of occupational hazards must lead to the establishment of an
occupational safety and health policy and of a programme of prevention adapted to the
needs of the undertakings and workplaces. The occupational health
professionals must propose such a policy and programme on the basis of scientific
and technical knowledge currently available as well as of their knowledge of the working
organization and environment. Occupational health professionals must also
provide advice on a programme of prevention which should be adapted to the risks in the
undertaking and which should include, as appropriate, measures for controlling
occupational safety and health hazards, for monitoring them and for mitigating their
consequences in the case of an accident ensure that they possess the required
skill or secure the necessary expertise in order to provide advice on programmes of
prevention which should include, as appropriate, measures for monitoring and management of
occupational safety and health hazards and, in case of failure, for minimizing
consequences.
Emphasis on prevention and on a prompt action
4. Special consideration should. be given to the rapid application of simple preventive
measures which are cost effective, technically sound and easily
implemented. Further evaluation investigations must check whether
these measures are effecient and effective or if a more complete solution
must be recommended, where necessary sought. When doubts exist about the
severity of an occupational hazard, prudent precautionary action should be taken
immedially must be considered immediately and taken as appropriate. When there
are uncertainties or differing opinions concerning nature of the hazards or the risks
involved, occupational health professionals must be transparent in this respect with all
concerned, avoid ambiguity in communicating their opinion and consult other professionals
as necessary.
Follow-up of remedial actions
5. In the case of refusal or of unwillingness to take adequate steps to remove an undue
risk or to remedy a situation which presents evidence of danger to health or safety, the
occupational health professionals must make, as rapidly as possible, their concern clear,
in writing, to the appropriate senior management executive, stressing the need for taking
into account scientific knowledge and for applying relevant health protection standards,
including exposure limits and recalling the obligation of the employer to apply laws and
regulations and to protect the health of workers in his or her their
employment. Whenever necessary, The workers concerned and their
representatives in the enterprise should be informed and the competent authority should be
contacted, whenever necessary.
Safety and health information
6. Occupational health professionals must contribute to the information of workers on
occupational hazards to which they may be exposed in an objective and understandable prundent
manner which does not conceal any fact and emphasizes the preventive measures. The
occupational health professionals personnel must cooperate with
the employer and assist him or her in fulfilling his or her responsibility of
providing, the workers and their representatives to ensure adequate
information and training on health and safety to the management personnel and workers, about
the known level of certainly concerning the suspected occupational hazards. Occupational
health professionals must provide appropriate information to the employers, workers and
their representatives about the level of scientific
certainty or uncertainty of known and suspected
occupational hazards at the workplace.
Commercial secrets
7. Occupational health professionals must not reveal are obliged
not to reveal industrial or commercial secrets of which they may become aware in. the
exercise of their activities. However, they cannot conceal must not withhold information which is necessary to protect
the safety and health of workers or of the community. When necessary needed,
the occupational health professionals must consult the competent authority in charge
of supervising the implementation of the relevant legislation.
Health surveillance
8. The occupational health objectives and the details of the,
methods and procedures of health surveillance must be clearly defined and
the workers must be informed about them with priority given to adaptation of
workplaces to workers who must receive information in this respect. The relevance and
validity of these methods and procedures must be assessed. The surveillance
The validity of such surveillance must be assessed and it must be carried out
with the informed consent of the workers by an occupational health professional
approved by the competent authory. The potentially positive and negative
consequences of participation in screening and health surveillance programmes should be
discussed with the workers concerned as part of the consent process.
The health surveillance must be performed by an occupational health professional approved
by the competent authority.
Information to the worker
9. The results of examinations, carried out within the framework of health surveillance
must be explained to the worker concerned. The determination of fitness for a given job should
be based on the assessment of the health of the worker and, when required,
must be based on a good knowledge of the job demands and of the worksite and on the
assessment of the health of the worker. The workers must be informed of the
opportunity to challenge the conclusions concerning their fitness in relation to
for their work that they feel contrary to their interest. A procedure of
appeal must be established in this respect.
Information to the employer
10. The results of the examinations prescribed by national laws or regulations must
only be conveyed to management in terms of fitness for the envisaged work or of
limitations necessary from a medical point of view in the assignment of tasks or in the
exposure to occupational hazards. General information on work fitness or in relation to
health or the potential or probable health effects of work hazards, may be provided with
the informed consent of the worker concerned.
Danger to a third party
11. Where the health condition of the worker and the nature of the tasks performed are
such as to be likely to endanger the safety of others, the worker must be clearly informed
of the situation. In the case of a particularly hazardous situation, the management and,
if so required by national regulations, the competent authority must also be informed of
the measures necessary to safeguard other persons.
Biological monitoring and investigations
12. Biological tests and other investigations must be chosen from the point of view of
their validity and relevance for protection of the health of the worker concerned,
with due regard to their sensitivity, their specificity and their predictive value.
Occupational health professionals must not use screening tests or investigations which are
not reliable or which do not have a sufficient predictive value in relation to the
requirements of the work assignment. Where a choice is possible and appropriate,
preference must always be given to non-invasive methods and to examinations, which do not
involve any danger to the health of the worker concerned. An invasive investigation or an
examination which involves a risk to the health of the worker concerned may only be
advised after an evaluation of the benefits to the worker and the risks involved
and cannot be justified for insurance purposes or in relation to with insurance
claims. Such an investigation is subject to the worker's informed consent and must be
performed according to the highest professional standards.
Health promotion
13. When engaging in health education, health promotion, health screening and public
health programmes, Occupational health professionals may contribute to public
health in different ways, in particular by their actvities in health education, health
promotion. and health screening. When engaging in these programmes, occupational
health professionals must seek the participation of both employers and workers in their
design and in their implementation. They must also protect the confidentiality of personal
health data of the workers, and prevent their misuse.
Protection of community and environment
14. Occupational health professionals must be aware of their role in relation to the
protection of the community and of the environment. With a view to contributing to
environmental health and public health, occupational health professionals must initiate
and They must initiate and participate, as appropriate, in
identifying, assessing, advertising and advising for the purpose of prevention
on the prevention of occupational and environmental hazards arising or
which may result from operations or processes in the enterprise.
Contribution to scientific knowledge
15. Occupational health professionals must report objectively to the scientific
community as well as to the public health and labour authorities on new or
suspected occupational hazards and for the purpose of searching relevant
preventive methods. Occupational health professionals involved in research must design and
carry out their activities on a sound scientific basis with full professional independence
and follow the ethical principles attached to research work and to medical research,
including an evaluation by an independent committee on ethics, as appropriate.
Conditions of execution of the functions of occupational health professionals
Competence integrity and impartiality
16. Occupational health professionals must always act, as a matter of priority
prime concern, in the interest of the health and safety of the workers.
Occupational health professionals must base their judgements on scientific knowledge and
technical competence and call upon specialized expert advice as necessary. Occupational
health professionals must refrain from any judgement, advice or activity which may
endanger the trust in their integrity and impartiality.
Professional independence
17. Occupational health professionals must maintain full professional independence and
observe the rules of confidentiality in the execution of their functions. Occupational
health professionals must under no circumstances allow their judgement and statements to
be influenced by any conflict of interest, in particular when advising the employer, the
workers or their representatives in the undertaking on occupational hazards and situations
which present evidence of danger to health or safety.
Equity, nondiscrimination and communication
18. The occupational health professionals must build a relationship of trust,
confidence and equity with the people to whom they provide occupational health services.
All workers should be treated in an equitable manner, without any form of discrimination with
regards to as regards their condition, their convictions or to
age, sex, social status, ethnic background, political, ideological or religious opinions,
nature of the illness or the reason which led to the consultation of the
occupational health professionals. Occupational health professionals must establish and
maintain clear channels of communication between themselves, A clear channel
of communication must be established and maintained between occupational health
professionals and the senior management executive responsible
for decisions at the highest level about the conditions and the organization of work and
the working environment in the undertaking, or with the board of directors,
and with the workers' representatives.
Clause on ethics in contracts of employment
19. Whenever appropriate, Occupational health professionals must
request that a clause on ethics be incorporated in their contract of employment. This
clause on ethics should include, in particular, the right of occupational health
specialists their right to apply professional standards and
principles of ethics, guidelines and codes of ethics. Occupational health
professionals must not accept conditions of occupational health practice which do not
allow for performance of their functions according to the desired professional standards
and principles of ethics. Contracts of employment should contain guidance on the legal,
contractual and ethical position on matters aspects and on management of
conflict, access to records and confidentiality in particular. Occupational health
professionals must ensure that their contract of employment or service does not contain
provisions which could limit their professional independence. In case of doubt about the
terms of the contract must be checked with the assistance of the competent
authority legal advice must be sought and the competent authority must
be consulted as appropriate.
Records
20. Occupational health professionals must keep good records with the appropriate
degree of confidentiality for the purpose of identifying occupational health problems in
the enterprise. Such records include data relating to the surveillance of the working
environment, personal data such as the employment history and health related occupational
health data such as the history of occupational exposure, results of personal
monitoring of exposure to occupational hazards and fitness certificates. Workers must be
given access to their own records the data relating to the
surveillance of the working environment and to their own occupational heath records.
Medical confidentiality
21. Individual medical data and the results of medical investigations must be recorded
in confidential medical files which must be kept secured under the responsibility of the
occupational health physician or the occupational health nurse. Access to medical files,
their transmission and as well as their release are and
the use of information contained. in these files is governed by national laws or
regulations and on medical data where they exist and relevant national codes of
ethics for health professionals and medical practitioners. The information
contained in these files must only be used for occupational health purposes.
Collective health data
22. When there is no possibility of individual identification, information on group
aggregate health data on groups of workers may be disclosed to management
and workers' representatives in the undertaking or to safety and health committees, where
they exist, in order to help them in their duties to protect the health and safety of exposed
groups of workers. Occupational injuries and occupational work-related
diseases must be reported to the competent authority according to national laws and
regulations.
Relationships with health professionals
23. Occupational health professionals must not seek personal information which is not
relevant to the protection of workers' health in relation to work. However,
occupational maintenance or promotion of workers' health in relation to work
or to the overall health of the workforce. Occupational health physicians may seek
further medical information or data from the worker's personal physician or hospital
medical staff, with the worker's informed consent, for the purpose of protecting
the health of this worker for the only purpose of protecting, maintaining or
promoting the health of the worker concerned. In so doing, the occupational health
physician must inform the worker's personal physician or hospital medical staff of his or
her role and of the purpose for which the medical information or data is required. With
the agreement of the worker, the occupational health physician or the occupational
health nurse may, if necessary, inform the worker's personal physician of relevant health
data as well as of hazards, occupational exposures and constraints at work which represent
a particular risk in view of the worker's state of health.
Combating abuses
24. Occupational health professionals must cooperate with other health professionals in
the protection of the confidentiality of the health and medical data concerning workers. When
there problems of particular importance, Occupational health professionals
must inform the competent authority of identify, assess and point out
to those concerned procedures or practices currently used which are,
in their opinion, contrary to the principles of ethies. This
concers in particular of ethics and inform the competent authority when
necessary. This concerns in particular instances of misuse or abuse of occupational health
data, concealing findings, violating medical confidentiality, including by
verbal comments, record keeping and the protection of confidentiality in recording and in
the use of information placed on computer and by inadequate protection of records
in particular as records information placed on computers.
Relationships with social partners
25. Occupational health professionals must increase the awareness of employers, workers
and their representatives of the need for full professional independence and avoid
any interference with commitment to protect medical confidentiality in
order to respect human dignity and to enhance the acceptability and effectiveness of
occupational health practice.
Promoting ethics and professional audit
26. Occupational health professionals must seek the support and cooperation of employers,
workers and their organizations, as well as of the competent authorities, for
implementing the highest standards of ethics in occupational health practice. Occupational
health professionals They should must institute a programme of
professional audit of their own activities in order
to ensure that appropriate standards have been set, that they are being met and that
deficiencies, if any, are detected and corrected and that steps are taken to ensure
continuous improvement of professional performance.
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