Spotlight on Greece

Greek health and safety has undergone legal advancements, but now the nation
has to tackle public awareness.  By Dr
Theodore Bazas

Greece is a member state of the European Union, joining on 1 January 2001.
It has an economically active population of 3,900,000, employed in primary,
secondary and tertiary sector, mostly in small- and medium-sized enterprises
(SMEs). There is an estimated population of 200,000 to 400,000 immigrant workers
and the official unemployment rate is 11 per cent.

Around 22,000 work accidents2 are recorded annually (the construction
industry ranking the highest). Occupational diseases are diagnosed
sporadically, but data is not compiled. Cause-specific analysis of early
retirement due to occupational or non-occupational grounds have not been made.

Impressive steps

There are 25 specialists in occupational medicine3, 4 one in state general
hospitals, and 17 new trainees attending the four-year specialisation programme.
Physicians, designated as "occupational physicians" working mainly in
large or high-risk enterprises and banks, mostly on a part-time basis, number
about 400. There are a few dozen company nurses and several hundred safety
engineers/technicians. Most active agencies offer limited but substantial
services. No reference has been made by the two major political parties to OH
in their April 2000 written pre-election pronouncements

Since 19815, Greek legislation on occupational health and safety has taken
impressive steps forward, having been harmonised to that of the European Union,
mainly by way of presidential decrees3,6. It includes provisions on enforceable
occupational exposure limits for 550 chemicals, ergonomics, carcinogenic
substances, biological hazards, VDUs, work installations and equipment,
occupational rehabilitation for the mentally ill, protection of pregnant women
at work, night and shift work, employment in temporary and mobile work and
group occupational health services. Proven offenders of OH and safety
regulations have been fined.

However, actual law enforcement is lagging behind on account of shortage of
trained occupational physicians and appointed enterprise physicians offering
suitable, credible and adequate advice, and state safety
("technical") and medical occupational health inspectors.

Furthermore, the Workers’ Health and Safety at Work Committees, allowed for
in the law, have not been convened in many enterprises, possibly due to the
workers neglecting to request their establishment.

Occupational medicine is taught to undergraduate university medical
students, albeit in a fragmented way by epidemiologists, toxicologists and lung
specialists, and also to nursing students at the university and the tertiary
education level Institutes for Professional Training. Elements of safety
engineering and ergonomics are included in the undergraduate curriculum for
engineering students.

Little research

Hardly any research papers on occupational medicine are presented at the
annual Greek Medical Congress, or published in medical journals. There are no
journals specifically for OH.

In brief, there is a discrepancy between the major legislative advancement
and the diverse information activities aimed at the promotion of public
awareness on the one hand, and the actual surveillance, prevention, management
of ill-health, the health promotion in the field, and relevant education on the
other. Though there is ample room for improvement, the situation is not yet
daunting.

Dr Theodore Bazas, md, mfom (rcp, london) msc (london), dih (engl),
national secretary, international Commission On Occupational Health, 22
Yakinthon street, 154 52 Psychico, Athens, Greece

References

1. National Statistical Service of Greece (1999) Research Results on Labour
Force. Unpublished data, Athens.

2. National Insurance Administration (1998) Work Accidents Bulletin, for the
year 1996, Athens.

3. Bazas T. (1999) Occupational Medicine Subjects in Practice: A manual for
company physicians and managers. Second edition. Hellenic Management
Association, pp33-48, Athens.

4. Bazas T. (1994) Proposal for the Speciality and Specialisation Training
in Occupational Medicine. Health Review (Sciences-Technology-Policy); 5(4):
237-240, [Athens].

5. Bazas T. (1981) The OH approach in Greece. Occupational Health, 33 (11):
564-566, [UK].

6. Hellenic Institute for Occupational Health and Safety (1994) [CD-ROM
Revised 1999] Handbook of the Occupational Health and Safety Legislation,
Athens.

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