In order to structure and prioritize their occupational safety and health activities, social security institutions establish a prevention framework focusing on four key areas of action: workplace safety and health, safe technology, individual prevention capacities and behaviour, and clear instructions/guidance. If all these are addressed systematically, continuous improvement in safety and health can be expected. These areas are often enshrined in a prevention strategy, which defines objectives to reduce the number of occupational accidents and diseases within a given time frame and outlines the cooperation with other actors, including the social partners and safety and health authorities (through labour inspection).
At the international level, the International Labour Organization (ILO) Promotional Framework for Occupational Safety and Health Convention, 2006 (No. 187), calls for setting up a national occupational safety and health policy, system and programme, and the World Health Organization (WHO) has adopted its Global Plan of Action on Workers’ Health (2008–2017). The member states of the European Union operate under the priorities and defined objectives set up in the Community Strategy on Health and Safety at Work, which obliges them to establish national prevention strategies and programmes that contribute to the implementation of the Community Strategy. One example is the United Kingdom, where the Health and Safety Executive has published The health and safety of Great Britain: Be part of the solution.
A consistent organizational priority for social security organizations around the world is the objective of continuously reducing the number of occupational incidents, accidents and occupational diseases as well as of the promotion of wellbeing at the workplace. The ISSA’s Special Commission on Prevention has developed the “Vision Zero” approach, based on the view that all accidents are preventable and that a world without fatal and serious accidents is possible. Vision Zero promotes a culture of prevention and a commitment to safety by all people at the workplace. Importantly this culture must be an integral part of management systems, based on the philosophy that in principle no single accident is acceptable, as this provides a basis for learning from accidents and improving processes to avoid similar incidents in the future.
The Ministry of Manpower of Singapore has introduced Vision Zero as a national strategy, linking it to the ISSA’s Vision Zero approach as well as to ILO Convention Nos 155 and 187. The German Social Accident Insurance (Deutsche Gesetzliche Unfallversicherung – DGUV) has adopted a Vision Zero strategy that assumes that safe and healthy workplaces are not an illusion but a realistic objective, provided all suitable means are taken, and that every fatal and serious work accident or occupational disease can and should be prevented by targeted measures. Concentrating prevention actions on fatal and serious cases will therefore raise the general level of safety and health.
According to national safety and health legislation, the prime responsibility for prevention measures at enterprise level lies with the employer. National safety and health systems and policies supervise and support the employer in his or her duties. These systems include a tripartite approach based on social dialogue between workers and employers, enforcement of the legal provisions by the competent safety and health authorities (through labour inspection), support provided through occupational health and prevention services, including services provided by social security institutions, etc. The ILO Occupational Safety and Health Convention, 1981 (No. 155), provides an outline for a sound national occupational safety and health programme.
Work injuries and occupational health risks are usually insured under a state-run social security system (e.g. social accident insurance scheme, workers’ compensation board, etc.), which in most cases cover both occupational accidents and occupational diseases. In a number of countries, insurance is not managed by a specialized institution but by a social security fund that covers multiple branches of social security, such as unemployment, pensions, health or family benefits, in addition to work injuries.
In some countries where a compulsory insurance system for occupational risks has not yet been put in place, private sector schemes exist. Where there is a state-run social security system, private sector schemes can complement it by insuring those work-related risks that may not be covered by the state system, in some cases, occupational diseases.
Health insurance schemes are also concerned with the prevention of occupational risks. Depending on the duration and nature of the injury or illness, payment of medical benefits for the insured may either be shared between the health insurance scheme and a workers’ compensation board or be entirely covered by the health insurance scheme, depending on the provisions of the national social security legislation. As an injury may also lead to disability, pension funds also have an interest in early intervention and the reduction of occupational accidents leading to a disability pension claim.