Executive Summary
More workers die from occupational diseases than from work accidents – according to the International Labor Organization (ILO), 2.78 million workers in the world die each year from injuries and work-related illnesses, of which 86% die from occupational diseases (and the rest from occupational accidents). However, the topic of occupational health is absent from the public and institutional agenda and does not receive as much attention in the media as do occupational accidents.
The number of workers affected by occupational diseases is underestimated – the number of workers affected by occupational diseases is underestimated in Israel and around the world. The Adam Committee report is based on ILO estimates regarding the number of occupational diseases casualties in Israel. the estimates indicate that there are tens of thousands of workers each year who contract occupational diseases and about 1,700 of them dies every year as a result of an occupational disease. However, this number is significantly larger than the number in the latest report published by the Registrar of Occupational Diseases in 2019, which indicates only 1,737 cases of occupational diseases.
Resources for research and enforcement are insufficient – there is a shortage of resources and manpower in every aspect of occupational health policy, including research, monitoring and enforcement. For example, there are only a small number of occupational physicians, who are a major source of information regarding occupational diseases and the primary point of contact for workers. In 2020, the number of occupational physicians in Israel stood at about 90 active physicians, which is 0.3% of all physicians. The workforce in Israel includes about 4.1 million workers and since 99.4% of all reported cases of occupational diseases are reported by occupational physicians, the scarcity of occupational physicians explains the low number of reported cases. The lack of resources is also apparent when it comes to enforcement. The Occupational Safety and Health Administration employs only 100 inspectors who are expected to enforce all occupational safety and health laws and regulations in Israel. However, in the last two year there was not even one occupational physician in the Administration. Most of their enforcement activity is focused on occupational safety and, consequently, the supervision of occupational diseases in Israel is extremely poor.
Many population groups are under-represented in occupational health statistics – ILO reports show that those populations most vulnerable to occupational diseases are also the populations about whom information is usually missing. Such populations include informal workers, workers of small and medium-sized employers and rural workers. In addition, increased competition and commonly used flexible employment patterns, such as temporary jobs, part-time jobs or “zero-hour” contracts, also make it difficult to collect data on the actual extent of occupational diseases. The data for Israel provided by the Registrar of Occupational Diseases and the ILO indicates that there is an under-representation of women, workers of small and medium-sized employers and informal workers, compared with an over-representation of cases reported among professional workers (55%) and workers employed in large entities with over 50 employees (66%). The over-representation is particularly prominent with employers who can afford to have an in-house clinic that provides a comprehensive solution to occupational health problems.
Recommendations not implemented – reports submitted to the relevant authorities include clear recommendations for reform obtained in consultation with many recognized experts in the field of occupational health. In practice, despite the resources invested in researching and formulating these recommendations, most of them are not implemented.
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