Overview of workers’ health conditions in the Caribbean

Workers' health issues in the Caribbean are reflective of the economic, social and environmental characteristics of the region. General environmental considerations include the high temperatures and humidity which outdoor workers are exposed to in tropical Caribbean countries. Environmental conditions are of particular importance, given the number of agricultural workers in the region. In Dominica, for example, 40% of the labour force, is in agriculture (CIA Factbook 2001).  

Also developing countries in the Caribbean generally have transitional economies moving towards greater levels of industrialisation. With increasing industrialisation there are accompanying occupational hazards and health risks to be considered. 

The Caribbean workforce is also becoming more differentiated. More women, adolescents and elderly people are going to work. Female workers have to cope with a number of workplace hazards, including reproductive hazards. Women working in the medical sector, if exposed to ionising radiation, may become infertile or suffer miscarriages. Female welders, exposed to lead, may suffer similar fates. Apart from reproductive health, women are more prone to job related stress, and are more likely to suffer from ergonomic related illnesses. Additionally, women in non-traditional areas of employment often have to cope with equipment and protective gear designed for men. As a result, women may suffer from muscoskeletal disorders, as the equipment is not adapted for their build and physiology. 

Young workers are more prone to occupational accidents and illnesses due to their limited training, experience and skills. Young and elderly workers may be more likely to suffer the effects of physical overload and extreme environmental conditions. They may also have increased susceptibility to chemical exposures.

There are 20-27 million work-related accidents in Latin America and the Caribbean annually. In the Caribbean in particular, there has been a general increase in the number of occupational accidents and diseases reported.

The most frequently reported occupational diseases in the Caribbean are pesticide and heavy metal poisoning. Skin, respiratory diseases and occupational hearing loss are also common.

Caribbean countries such as St. Lucia and Guyana have relatively modern Occupational Safety and Health (OSH) legislation. In most of the countries, however, the existing legislation is largely outdated. The statutes do not apply to all workplaces and penalties do not provide effective deterrent to OSH violators. Also, the existing legislation does not have provisions for current industrial practices, workplace technologies, physical, chemical and biological hazards.

Several of the countries in the Caribbean region are attempting to put in place appropriate legislation. These proposed statutes are in keeping with the Caribbean Community (CARICOM) Model law on Occupational Safety and Health and the Working Environment, which was developed and approved by the Ministries of Labour, the International Labour Organisation (ILO) and regional Employers Associations. The Guyanese Occupational Safety and Health Act is largely based on this model legislation.

The CARICOM model legislation incorporates the tripartite principle described in ILO Convention 155 and ILO Recommendation 164. The law applies to all branches of economic activity, a feature lacking in some of the existing pieces of legislation. The model law also applies to self-employed persons, thus, there is some coverage of the informal sector. The legislation has provisions for physical chemical and biological agents. It requires that all employers inventory the hazardous chemical and physical agents in their workplaces and ensure that the materials are properly labelled. The model law calls for the designation of safety and health representatives and safety committees. 

The lack of relevant OSH data in the region has been repeatedly described as a major concern. Deficiencies in OSH reporting and surveillance are evident in both medical and administrative arenas. Recognising the need for reliable OSH data, regional and international agencies such as PAHO have initiated measures to improve workers’ health surveillance and reporting. 

Administrative needs

In several of the countries, the responsibility for OSH is shared among various agencies usually within the Ministry of Labour and the Ministry of Health. There are constraints to this fragmented system. 

Priority economic sectors/industries

The construction industry is a source of concern for OSH in the Caribbean, as is the case internationally. Construction work is labour intensive and physically demanding. Workers are exposed to hazards, such as noise, chemicals and dust. Common occupational diseases include pneumoconiosis cased by dust and fibre inhalation. Skin diseases are also prominent, a result of exposure to compounds in solvents, adhesives and oils. Also, skill levels in the construction industry are considerably lower than in other sectors. Workers are often employed on a casual and temporary basis, subcontracting is also common. These factors make it difficult for OSH inspectors to regulate and monitor this sector. Thus, the high number of occupational accidents, which characterise the construction sector, is to be expected.

Tourism is an important industry in most Caribbean countries and another sector, which requires improvements in the levels of occupational safety and health. OSH hazards typical of this industry include slips, falls and strains from manual handling. OSH regulation in the tourism sector is limited by the legislation, which in some countries does not extend to hospitality establishments. This has been cited as a major constraint in Barbados, given the large number of hospitality workers and OSH incidents in that country’s tourism sector. Thus, amending the existing legislation to include tourist establishments or incorporating this sector into proposed legislation would assist in improving OSH conditions regionally

The agricultural sector has been identified as another critical sector, specifically with regards to pesticide related health problems. As mentioned earlier, pesticide related illnesses are often misdiagnosed and subsequently underreported. There have also been calls for better worker and employer education on the safe use of pesticides, as well as, better labeling, handling and storage of pesticides. Pesticide related illnesses and accidents have been identified as priority areas in the OSH working plans of several countries including Dominica and Grenada.

Throughout the Caribbean there is a greater focus on occupational accidents and injuries rather than occupational health. Additionally, there are few occupational health professionals in the region, a factor that should be addressed. It has also been suggested, in numerous studies, that doctors and other medical personnel should be better trained in the recognition of work related illnesses. Also, as is the trend internationally, non-traditional occupational diseases such as stress, mobbing and alcoholism (psychosocial diseases) should perhaps be given greater recognition. Internationally, diseases such as HIV/AIDS are also being incorporated in workers health programmes. Regionally, the OSH unit in Guyana has also been working on AIDS/HIV awareness in the workplace. 

International trends/ technological challenges

Internationally, technological development and the associated changes in production strategies have resulted in new and varied forms of occupational hazards Keeping abreast of these new technologies, tools, chemical and biological hazards is on ongoing challenge for OSH officials and regulatory bodies.

There is increasing emphasis on non-traditional OSH issues such as ergonomics and psychosocial diseases. Ageing workforces are also a concern. While these issues are not as prominent in the Caribbean, in countries with large service and information based sectors (like Barbados) they are becoming increasing important. These issues should be give greater recognition in the Caribbean and be provided for the in legislation and inspection procedures.