WHY IS BORNE THE IDEA OF MEDTRA PROJECT

Occupational medicine training course

WHY IS BORNE THE IDEA OF MEDTRA PROJECT

WHY IS MEDTRA PROJECT BORN Occupational Medicine Training Course

•PERSONAL PROTECTIVE EQUIPMENT

Safety, Health and Environment

  Around the world, millions of men and women work in poor and hazardous conditions: Every year, more than 2 million people die of work-related accidents and diseases. More than 160 million workers fall ill each year due to workplace hazards. The poorest, least protected - often women, children and migrants - are also among the most affected. Micro- and small enterprises account for over 90 per cent of enterprises where conditions are often very poor and the workers in them are often excluded from all labour protection.

Human suffering has no measurable cost, unlike economic losses. Estimates from, for example, the United States, the United Kingdom, Germany and Norway put the direct cost of accidents in billions of dollars. In many developing countries, death rates among workers are five to six times those in industrialized countries. Yet the phenomenon is still largely undocumented and there is insufficient political will to address the problem.

Global competition, growing labour market fragmentation and rapid change in all aspects of work creates a mounting challenge for labour protection, especially in developing countries. Workers in rural areas and the urban informal sector are often ignored or difficult to reach.

Safework will be focused on hazardous work and will give primary attention to workers in especially hazardous occupations in sectors where the risks to life and safety are manifestly high, such as agriculture, mining and construction, workers in the informal sectors, and those occupationally exposed to abuse and exploitation, such as women, children and migrants.

The prevention of accidents, improvement of working conditions and enforcement of standards are often seen as a cost to business. Little is known about the costs of not preventing accidents or poor working conditions, or of the benefits of improvements for productivity and competitiveness. Better information and analytical tools can help increase firms' and governments' willingness to invest in prevention.

Showing that protection pays.

.

-Importance of the problem of cost evaluation and different approaches

-Different categories of costImpact of security and health

costs at company level-Identification of the economic

optimal point-Decision model

Main steps

There is conflicting evidence as to whether or to what extent investment in Health and Safety will actually produce net benefits or net costs to a firm and varies depending on:The nature of the enterprise;The sector in which it is operating and the nature of the hazards which it generates; Whether there is a low or high risk.

Base considerations on enterprises and costs

Here is presented a classification of safety costs as the whole coming from the simultaneous consideration of the costs coming from accidents, illnesses, injuries and of the cost supported to manage the risk.Main goal will be the demonstration that the correct management of safety costs does not always translate in an increase of total cost. Therefore increase of safety and decrease of total cost may go together in safety management too.

A classification of safety costs

Costs supported by enterprises are not the only costs connected to safety because there are social and workers costs too.Nevertheless a correct management of costs made by the enterprise has positive effects on the other two categories and may, therefore, be considered as the activity to start with.

Enterprise costs

.

Main categories of costs may be divided into two groups:-Costs for accidents and illnesses-Costs for risk managementPrecisely the first group concerns the costs that have to be sustained while an accident has already occurred while the second group concerns the costs that have to be sustained to reduce the risk.

Main categories of costs

.

The costs for accidents and illnesses may be divided respectively into three categories:-Direct and indirect costs-Insured and non insured costs-Controllable and non controllable costs

Costs for accidents

.

Normally there is a compulsory insurance for enterprises concerning working injuries but this is not a rule everywhere. Anyway the insurance gives a refund to the employer for the days of absence caused by accident.A correct insurance protects against loss of product and against loss of resources coming from an event reducing production capacity

Insured and non insured costs

.

Hidden costs represent all costs that normally do not appear in budget and therefore are hardly traceable or not clearly connected to safety management.Normally the impact of hidden costs is considered almost four times of the one of explicit costs.Explicit costs are, obviously, all those expenses that are certainly afforded in connection to safety management.

Hidden and explicit costs

.

Society too have to face a share of economic passivity coming from professional illnesses and working accidents. This because where there is a compulsory public insurance system some of these costs are covered by public bodies and, therefore, by society with a higher taxation. This is why these are considered social costs.

Costs for community

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-Costs for National Health System managing services aimed to the prevention, diagnosis, cure and rehabilitation with direct incidence on public expense concerning health;-Costs of justice administration concerning legal procedures connected to work accidents;-Costs coming from specific law production.

Main social costs

. The large majority of workers whose conditions are most in need of improvement are excluded from the scope of existing legislation and other protective measures. Existing policies and programmes need to be reviewed to extend their coverage. This will go hand in hand with action to strengthen labour inspectorates' capacity to develop broad prevention policies and to promote the protection of vulnerable workers, particularly women workers.

Alliances and networks will be extended to include ministries of health, industry, local government, education, and social services, as well as Universities. Emphasis will also be placed on achieving tangible results through practical action and exchanges of information on good practices.

The strategy to promote workers' health and well-being will involve the establishment of a data bank on policies, programmes and good enterprise-level practices so as to improve constituents' capacity to identify workers' protection issues and to provide guidance on new approaches.

Promoting workers' health and well-being.

-a data bank on policies, programmes and good enterprise-level practices; -training methodologies and diagnostic tools; -guidelines on occupational health care for all; -programmes to prevent and deal with the effects of workplace problems, including drugs, alcohol and stress;

Promoting workers' health and well being:

-a statistical programme to develop new survey tools, carry out national surveys; - better national and global estimates of occupational fatalities and injuries; -- report on the economics of accidents and preventive measures; -- tools for inspection services to promote the benefits of prevention; -- guides on occupational safety and health management systems and safety culture.

Showing that protection pays

Sapienza developed during more than fifteen years a safety and health culture, forerunner compared to the slow awareness to safeguard worker’s safety and health and specially the students.The idea of Universitas, enlarged to the different programs of international mobility, more and more allowing students and searchers to move toward otheruniversities and international research centres is setting up a new problem concerning the potential health risks connected with this mobility and the related responsibilities of the interested institutions.

Inside this mobility, when someone applies for foreign universities, many of these, to protect themselves , are starting to ask certificates testifying the clinical status of the students and/or searchers before accepting the applicants.

This means that each University must be organised to support these requirements.

Specific working characteristics of the University (multiplicity of subjects attending the structures, risks connected with studying and working activities et cetera) strongly bring in evidence the preventive function that the worker care can assume when it is addressed to consistent social groups homogeneous in age, sex and working activity.

The Centre of Occupational Medicine ( CMO ) is the sanitary structure created by the University “La Sapienza” to carry out the sanitary care, according to the law and to solve these problems.The different activities characterising the University are strongly inhomogeneous.

While the management is referred to planned systems and hence easily inserting in standardized situations referable to predefined models, didactic activity is only partly referable and must be correlated to the specific didactic disciplines in function of the differences of the risks:Low Risk : Law, Literature et cetera;High Risk : Chemistry, Biology, Medicine et cetera;

The situation becomes more and more complex where research is carried out and acts also as a support to the didactic, specially in the fields where laboratory processes, connected to researches and hence innovative, are bound to operative variable conditions, not standardized, not reciprocally related to predefined models.

Preventive action carried out by CMO over a large number of workers allows an early identification of a number of pathologies, and a consulting of already known pathologies not work correlated, pathologies that almost systematically evolve in worsening having a negative relapse on social expenses. CMO takes on a particular relief in the prevention, in the limitation of public sanitary costs and in organising financial and logistic resources of a big multifunctional factory.

TEMPUS MEDA, action founded by European Commission, enables Universities from EU Members States to cooperate with the Mediterranean partner countries in higher education modernisation projects. University is a community sometime larger than a city where, searchers, technicians, management and, students seen as workers, live large part of his life, so they must be protected concerning their health and safety, applying all the best measures and rules considering their specific activities inside the Institution with particular attention to some dangerous research activities..

International rules assimilate Students to the workers and their health and safety must be protected, considering them as to be a specific multiple risk group, in function of the activity they carry out inside the different departments and the different structures and laboratories were they develop their studies and researches.

EUROPEAN COMMISSION

Directorate-General Education and Culture

Tempus application formJoint European Project 2005

Occupational Medicine Training CourseMEDTRA

JEP_33042_2005

MEDA DZ – Algeria MA – Morocco EG – Egypt PS – Palestinian Authority IL – Israel SY – Syria JO – Jordan TN – Tunisia LB – Lebanon

Title of the project: Occupational Medicine Training Course

• Acronym of the project:MEDTRA

• Specific Objectives of the project:Training medical experts in Occupational Medicine and creating a vocational

profile, awareness and aspread out culture in safety of the workplaces.

MEMBERS OF CONSORTIUM

Syrian Ministry of Labour And Social Affairs

• University of• Damascus

• University of• Aleppo

• University of• Homs AL-Baath

• Unimed

• University• “La Sapienza”

• University of• Malta

In the Syrian faculties of Medicine there are no programs of study and specific interventions for the occupational medicine nor specific intervention for the subject. There is only a program dedicated to professional illness and managed within the activities of international health, in cooperation with the Ministry of Health.

As a consequence of the Syrian government growing interest in industrial safety (testified by the issuing of laws and decrees related, for example, to the safety of pregnant women and working mothers, to the protection from sources of ionising radiations, related also to aspects of social security about work accidents and occupational diseases), it is necessary to prearrange national and specific advanced training courses in Occupational Medicine,

This specialty is currently performed only by few medical doctors in the whole Syria, completely insufficient and inadequate to the

situation.Hence it is important and necessary to create an OccupationalMedicine Centre. There is a need to define a program of complete intervention and efficient enough to satisfy the necessity of the country. This one must have as a priority the training of a sufficient number of specialized medical doctors in Occupational Medicine taking into account the number of inhabitants and looking at international standards in this field.The economic, agricultural and industrial development in Syria has created a new situation that includes all the characteristics and problems of the industrial environment, including the different risk factors cause, without doubts, of different professional illnesses.

The project has been realised because of the precise wish of the Syrian Universities requesting collaboration to EC Universities to renew their “curricula”. The choice of the Universities of Rome “La Sapienza” and Malta comes out from the already existing cooperation for a long time in the different sectors, and the specific expertise in the subject. Moreover, all the Syrian Universities and the Universities of Malta and of Rome “La Sapienza” were Unimed members.On the basis of the JEP project Damascus University solicited Unimed to submit the project.

Occupational Medicine Training CourseMEDTRA

Taking into account the rules of the EU, Unimed and Damascus University have involved all the Syrian Universities with a Faculty of Medicine, and the Ministry of Social and Labour Affairs. This latter, is particularly interested in the creation of a new professional profile and it strongly supports the submission of the proposal. For Syrian Authorities, (as for the Public Authorities all over the world) having professional figures capable of dealing with health and security controls in workplaces, represents considerable savings of economic resources. In facts the costs of sanitary assistance to the workers is absolutely incomparable with the ones sustained for the prevention of work injuries.

UNIMED signed Grant Agreement in september 2008

After a preliminary meeting held in Damascus on 2007 October 2nd, with the participation of the consortium

members, the course started on 2007 November 25th, carried out one week per months, according to the work plan as

above.

The partners agreed in holding the course in Damascus University, one week per month. EC agreed in such a kind of

mobility.

Selection of the trainees, cared by the Syrian partners Universities, under the supervision of the European Coordinator. The Selection of the trainees is based on examination of their curricula vitae, taking into account the following requirements:-Knowledge of English language,-Post-Laurea specializations or doctorates dealing with social medicine, preventive workers medicine and psycho-technique, occupational medicine, industrial and environmental hygiene, legal medicine. -Degree thesis dealing with the above mentioned arguments

-Working experiences and/or apprenticeship dealing with subjects as above, in private companies or in public institutions, both at national or international level-Publication of articles on specialised magazines, and/or participation in congress or seminarsThese outcomes of activity have been agreed by a joint Commission of the consortium partners.

Upgrade of equipment A market analysis has been performed, in order to

investigate the items to be bought in Europe or in Syria. Within MEDTRA Project preliminary meeting the places

where the equipment has to be installed has been decided: the Department of Family and Community Medicine within the Faculty of Medicine of Damascus University and the

faculty of Medicine in Aleppo and Homs University.

After having collected three different offers both from EU and from Syrian Companies, it was decided according to EU addresses to buy equipment in Syria, also to save delivery expenses. The project partners decided to purchase the equipment items per different lots, starting by Chemical and Environmental ones. Three Syrian companies sent to UNIMED the offers: a letter asking for clarifications on brands, technical characteristics and prices, prepared by EU experts has been sent to the Syrian companies,

• COURSE CONTENTS FIRST YEAR

• Module n.1 – Occupational medicine: knowledge, development and purpose)Rome “la Sapienza”

• Prof. Giuseppe D’Ascenzo • Prof. Fabrizio D’Ascenzo

• Module n.2 – Professional disease, outline of hygiene on workplace and industrial hygiene.

• Rome“La Sapienza”Prof. Alessandro Bacaloni

• Module n. 3 – Safety and health on workplace: legislative contents

• Simonetta Sandri (external expert)

• Damascus University Prof. Ahmed Deeb Dashash)

• n.4 – Risk evaluation: Principles of Industrial Toxicology.

• Rome“La Sapienza”• Prof. Fabio Naro

training programme

• Module n.5 • – Practical exercise:

analysis and survey of the occupational risks through the design of an innovative health risk evaluation form surveying occupational risks in the University context. Rome “la Sapienza “

• Prof. Sabina Sernia• Prof. Fabio Naro

• Module n.6• – Risks and health

protocols: from risk evaluation to health monitoring

• Rome “la Sapienza”-Ispesl

• Prof. Roberta Curini • Module 7 -

Epidemiological and health statistics

• Malta University• Dr. Julian Mamo Dr. Neville Calleja

COURSE CONTENTS SECOND YEARModule n.1

Professional pathology,

biological monitoring

and exposure limit

values

Rome “la Sapienza” • Prof. Sabina Sernia

Prof. Giuseppe D’Ascenzo

Module n.2

Professional cancer ge

nesis and teratogenesis

Malta University

Dr. Alfred Cuschieri

Module n.3 Professional organic

pathologies: Lung and

Skin. 2 Syrian teachers

• Module n.4 Professional organic pathologies: Visual Auditory and Cardiovascular apparatus, Kidney.

• 4 Syrian teachers, being one of them prof Reem Zarawi from Aleppo University

• Module 5 – Liver, Osteo-articular and Nervous system

• 3 Syrian teacher

• Module 6 - Biological risk. Risks and pathologies in medical professions Malta University

• Dr. Paul Cuschieri”

• Module 7 - Management of workplace’s sanitary emergencies: first aid in workplaces.

• Rome”La Sapienza

Module 8

-Normalization and

management of sanitary

data.

-Rome”La Sapienza”

-Syrian teachers

Module 9

-Design of sanitary

complex systems

monitoring

-Rome”La Sapienza”

-Syrian teachers

FINAL EXAMINATIONS (first session) JUNE 2009

(second session) SEPTEMPER 2009

Third year’s activity

PRACTICAL STAGE IN ROME20 Syrian trainees for 1 week

in Rome subdivided in 4 groups (total 4 weeks)

Friday 2 – Friday 30 October 2009.

MAJOR FUTURE GOAL

• Establishment of an Occupational Medicine Centre in Damascus

University, Faculty of Medicine, Department of Family and Community

Medicine. • branches in Aleppo and Al-Baath Homs

University.

The sustainability of the training will be carried out through future benefits to the project beneficiaries such as:-The possibility for the Syrian universities to organise new degrees concerning safety and security in workplaces and specifically in the field of Medicine (Damascus and Aleppo universities) and in the field of Chemistry (Al Baath university) where the courses of MEDTRA project will be considered as credits to obtain the final degree.

Sustainability

- The possibilities of further opportunities for PhD degrees and Master degrees in Italy at the University “La Sapienza” also through fellowships of the Italian Ministry of Foreign Affairs (One student already applied and won a fellowship for a three years PhD in Rome “La Sapienza” University, starting on November 2008).

-The importance of the economic implication of this field and potential to develop the idea into further proposals.

- Special attention, according to European rules has been given to the problem of particular risks, as for example chemicals agents, biological agents and carcinogens risks which need a particular specialist background like for example chemists and, to support this theory, chemists of Al Baath University have been admitted to the course.

- An agreement has been signed between ISPESL (Superior Institute for Prevention, Protection and Safety on Work in Italy) and the Syrian Universities, to establish possible initiatives of mutual interest, exchange of researchers, joint research programmes and technical contributions, to participate in the examining boards for the defence of some post-graduate thesis, to organize in cooperation with the concerned governmental authorities reciprocal qualification, recognition, rules plus the conditions of study stages and scientific degrees to enable students and graduates of either the university or ISPESL to pursue their studies in other institution.