XXII World Congress on Safety and Health at Work 2021

Prevention in the connected age – insights from the World Congress

XXII World Congress on Safety and Health at Work 2021

Prevention in the connected age – insights from the World Congress

The COVID-19 pandemic and rapid change of working environments are challenging for social security and for the occupational health and safety community worldwide. The global discussion on how to achieve resilient social security coverage for all and zero injuries, zero diseases and zero deaths at work covers many work-related aspects. This includes the digital transformation of work, the use of new technologies for prevention, social dialogue, mental health protection, and the promotion of a global prevention culture.


These topics were highlighted during the XXII World Congress on Safety and Health at Work, 20–23 September 2021, which was conducted in a fully digital format for the first time in its history. Its digital streaming platform provided interactive elements, such as brain dates and connection rooms where 2,000 delegates from over 120 countries could meet and exchange their professional views.

Organized by the International Social Security Association (ISSA) and the International Labour Organization (ILO), and hosted by the Institute for Work & Health (IWH) and the Canadian Centre for Occupational Health & Safety (CCOHS), the World Congress featured over 200 speakers. The main theme of the Congress – Prevention in the Connected Age – had been chosen long before the COVID-19 outbreak, but the pandemic then turned this event into a real first-hand experience of connectivity.

Zero deaths at work

The World Congress operated against the background that over 2 million people die each year due to work-related accidents. Therefore, international organizations, governments, social security institutions, employers and workers’ organizations, academia and occupational safety and health (OSH) professionals called for global solutions to achieve safe and healthy work for all. These included the promotion of the ISSA’s Vision Zero strategy to create the best possible work environment based on safety, health and well-being in a changing world.

Guy Ryder, Director General of the ILO called for “A future in which public institutions, the private sector, employers, workers, and their organizations engage in collective action to achieve the still unattained goal of zero injuries, zero disease, and zero deaths at work.”

Nicolas Schmit, European Commissioner for Jobs and Social Rights stated that “we must commit to a 'Vision Zero' approach when it comes to work-related deaths in the EU.” Following the global trend towards the objective of zero accidents and zero harm for every workplace, the European Commission had recently adopted the Vision Zero approach (to eliminate fatal accidents) into the new EU Strategic Framework on Health and Safety at Work 2021-2027.

Professor Joachim Breuer, President of the ISSA, reminded all World Congress participants that Vision Zero has grown out of its infancy. It is no longer just a campaign with over 15,000 supporters, but has become a strategic tool for every nation, organization, company and every person, that wants to contribute to the improvement of the world of work. Vision Zero should be the new mindset for all workplaces, including for the elimination of COVID-19.

Resilience of social security systems

COVID-19 has sharply disrupted employment in many countries around the globe. Measures taken to counteract COVID-19 have also had significant effects on workers’ compensation systems and the broader social security system. As documented by the ISSA COVID-19 Monitor, in order to support the economy, temporary social security measures, were introduced and supported the broader public health response and containment efforts in many countries. Social security institutions once again proved to be at the forefront of crisis management and were able to support national strategies to mitigate the social and economic impact of the crisis.

The resilience of social security systems to protect workers and support businesses throughout the pandemic was also highlighted at the ISSA’s Global Forum for Work Injury Insurance that was part of the World Congress. The discussions focused on the opportunities and challenges that occupational accident insurance systems are facing today, such as the impact of technological progress in the areas of prevention as well as long-term COVID-19 rehabilitation. During the pandemic, employment injury insurance schemes assumed their pivotal role by providing necessary compensation and rehabilitation to injured workers, and by also promoting prevention. The Global Forum reiterated the key message that prevention comes first, followed by treatment, rehabilitation and compensation.

Protection for all

The pandemic also showed the gaps in the coverage of social security, occupational safety and health and prevention systems. Some population groups could not benefit from social and economic measures introduced to soften the impact of COVID-19, e.g. people working in the informal economy. The growing work community of the gig economy and platform workers have blurred the lines between the self-employed and a regular employment status. Their dependency on a platform, which is often managed by a multinational company, and their job delivery across borders (e.g. via videocalls and filesharing) challenges regulators.

A new teleworking and digital reality characterizes the world of work. Millions of workers and their companies have adjusted to teleworking. The physical location of work has become more flexible, but new challenges have emerged in this context.

Many people that work remotely may not (or no longer) have a regular employment status. To provide protection for all employees in this context requires flexibility in social security and occupational safety and health standards, both in terms of responsiveness of legislation as well as regulations governing compliance.  Improvements in OSH and in social security coverage for all workers in the formal and the informal economy and for an international collaborative approach to achieve resilient and sustainable working conditions is therefore desirable.

Psycho-social risks while working from home

One example of these new challenges is that mental health concerns have increased in the field of OSH. The factors affecting a worker’s health and safety go beyond the physical workplace. Home office workers may find themselves isolated. A special concern is well-being, as many employees have been struggling with blurred boundaries between their work and their private life, thus being prone to work outside the regular working hours and exposed to psychosocial and potentially also ergonomic risks. A home that has turned into a workplace might also be a space with an exposure to domestic violence. Cases were reported, where the model of working remotely has become an extremely challenging setting for the worker, causing additional stress.

Mental health has a significant impact on productivity and the organisation’s performance. A holistic approach to supporting the mental health of workers and addressing psychosocial risks factors can in turn have a positive return on OSH investment. Training courses for managers and supervisors, addressing mental health and psychosocial factors, implementing the inclusion of mental health aspects into the company culture and providing early interventions schemes based on international guidelines and social dialogue can be valuable approaches. The need to ensure proper working conditions for persons working from home in order to reduce the negative impact of psycho-social aspects should also be taken into account.

Connectivity, communication and digitalization

There are many new technological opportunities for prevention (e.g. smart clothing, smart glasses, head mounted display or hybrid assistive limb exoskeleton suit, internet of things, and so on) and the World Congress underlined the need for their further development.

Despite the wide availability of digital communication channels, there is still a connectivity gap in terms of equipment, internet-based solutions for prevention and digital proficiency between many countries and continents. A lack of knowledge about how to use digital communication tools is a major barrier in this regard. It is important to ensure that everyone can take part, regardless of their age or digital skills, as this is a basis for successful prevention communication.

Frequent, authentic and transparent communication from leaders is an important way to build trust and enhance social connection. The new connectivity also helps facilitate the transfer of knowledge between countries, organizations and individuals. A good example is the inter-generational “agriculture family model”, where all family members live on the same farm (the elder generation with the experience and know-how and the younger generation with the digital skills). They benefit from each other’s skills and knowledge to build and refine their OSH culture.

Measuring prevention culture

Prevention culture indicators

  1. Management commitment and visibility
  2. Communication including feedback loops
  3. Productivity versus safety – time and pressure
  4. Information, instruction and training – increasing worker knowledge and evidencing continued professional development (CPD)
  5. Safety resources
  6. Participation – worker buy in and peer group attitude
  7. Shared perceptions about safety and risk
  8. Trust – transparency, a just and fair culture
  9. Autonomy – job satisfaction, being valued, incentives
  10. Reporting – accidents and near misses, investigations and controls

Culture is often described as “the way we do things around here”. The World Congress emphasized the need to promote and advance a prevention culture, i.e. a culture that transfers a positive OSH awareness and OSH values into the daily life of workers and managers. Prevention culture indicators are a helpful tool to keep track of developments and to trigger positive changes in the short and the long run. The ISSA Prevention Section on Education and Training, together with the ISSA Prevention Section for a Culture of Prevention, have developed prevention culture indicators, by conducting a literature review and a survey to which 840 OSH professionals contributed. In addition, the ISSA now offers a set of 14 Proactive Leading Indicators, based on the three Vision Zero pillars of safety, health and well-being. The indicators build on elements from the 7 Golden Rules of the ISSA Vision Zero prevention strategy, such as leadership commitment, participation or training, and help companies improve their prevention culture.

In his intervention, Marcelo Abi-Ramia Caetano, Secretary General of the ISSA, pointed out, that “Prevention is an essential part of social security. Without employment injury insurance, the world would be more socially unjust, less inclusive and less productive. The ISSA is fully engaged in the promotion of prevention and supports all its members in setting up prevention programmes, campaigns or other activities.”

Supply chains and labour standards

Supply chains are becoming increasingly important, in order to deliver a positive message of prevention in terms of good working conditions and social security coverage for each worker. If suppliers do not adhere to labour standards and tolerate poor working conditions on their production sites, the model of subcontracting production can have negative impacts. Functioning supply chains require a positive influence at the top of the chain, which then transforms the working conditions towards a safer, healthier and more environment-friendly setting among suppliers.

The World Congress called for more transparency in supply chain policies, stronger adherence of fundamental labour principles and stronger supervision of international labour standards.

One of them, the new ILO Convention on Eliminating Violence and Harassment in the World of Work (C190), which came into force on 25 June 2021, is the first international treaty to recognize the right of everyone to a world of work free from violence and harassment, including gender-based discrimination. Governments that ratify C190 will be required to introduce relevant policy measures to stop work-related violence and harassment. The Convention was found to represent a great opportunity to shape the future of work, by ensuring dignity and respect for all.

Threats and opportunities for a safer world of work

The threats and opportunities for a safer world of work need to be considered in the context of the digital transformation of the economy and the changes in the world of work. The World Congress raised a number of interesting considerations in this regard:

  • Regulation and enforcement strategies, including labour inspection are effective tools to ensure compliance. And yet strategies must be found for those who do not comply, in order to complement the existing system. One way of doing this is to raise awareness and make people feel responsible for their own safety. Another approach is management leading by example, and a third one a focus on participation. No one should feel that OSH does not matter to them.
  • The future of work is impacted by socio-economic conditions including demography, technology, digitalization, climate change and other societal and environmental aspects. This is the framework in which prevention strategies must be defined and implemented. In addition, prevention should be part of wider efforts to provide decent working conditions and at the same time ensure sustainable business operations and contribute to a greener planet. Social dialogue is important in this regard.
  • Prevention does not stop after the occupational accident or disease. Disability management and return-to-work programmes should be recognised more widely as part of prevention. Preventing permanent disability leads again to the important role of social security. The ISSA Guidelines on Return to Work and Reintegration are a helpful strategic tool for social security institutions working in this area. Return to work programmes can be considered an effective strategy, as is it documented in the ISSA study on the Return on Work Reintegration. The World Congress also pointed out that more opportunities should be created for people living with a disability to be integrated in the world of work.
  • Communication and connection is key to prevention, and multi-media tools are becoming more accessible and important. This was also shown by the International Media Festival for Prevention (IMFP) that is an integral part of the World Congress and has been organised by the ISSA Prevention Sections on Electricity and on Information. This year the IMFP received a record number of 289 submitted entries from 40 countries (www.mediainprevention.org). The entries demonstrated that film and media contribute significantly to successful prevention when they carry a message to which people can connect. Most of the stories displayed real-life events and were able to deliver a convincing message to the audience that prevention must be a top priority in life. Successful stories were presented in an understandable, emotional way, pointing to the cause of the accident, its connection to a previous event or behaviour. The message of the IMFP was clear: the more connections media can create, the better the prevention outcome. Connection is, and remains, a secret ingredient for effective communication in any work environment.
  • The digital transformation of the world of work has driven more and more businesses to automate their production lines and processes in order to reduce production costs and increase their efficiency, e.g. via intelligent Internet of Things (IoT) communication networks. These automated systems and IoT can improve workplace safety through better prevention mechanisms (e.g. tracing contact system used during pandemic), while robotics and artificial intelligence can eliminate stressful tasks, which cause musculoskeletal disorders or are detrimental to mental health. However, work pace which rapidly increased due to the automation of the global economy can cause fatigue, affect mental well-being and as a consequence lead to accidents. Therefore, as new technologies present both a risk and an opportunity for the world of work, new policies need to be developed to address these challenges.


The World Congress made clear that the digital transformation of work is in full swing and that it is going to stay. New technologies, like the internet of things, safety cameras, real-time data exchanges, cloud-based technologies, etc., that are currently used to increase the efficiency and productivity at work can also be used to protect people at work and to support their professional rehabilitation.

Dr Cameron Mustard, from the Canadian Institute for Work & Health and President of the World Congress concluded that “successful occupational health and safety initiatives at the workplace would only succeed if the initiatives were developed with the participation of workers and their representatives and everyone should carry this key principle forward in the work”.

While social dialogue clearly remains a key factor to address all occupational safety and health challenges at present in in the future, the role of accident insurances cannot be underestimated. Not only do they compensate the workers who suffered from an occupational accident or disease, but, together with the social partners and the ministries in charge of occupational safety and health they actively promote a global prevention culture with the goal of zero occupational accidents and diseases.

Safety, health and well-being were some of the most discussed topics during this World Congress and the participants expressed their wish to continue this exchange at the next World Congress, which will be held from 27–30 November 2023 in Sydney, Australia.