|Guide to Health and Hygiene in Agricultural Work (ILO, 1979, 328 p.)|
|6. Organisation of occupational health services and medical inspection of labour in agriculture|
1 See also ILO: The role of medical inspection of labour (Geneva, 1968)
Experience has shown that, even in countries where legislation on occupational health exists, it is not always applied according to its expressed aims. Sometimes employers and workers, either because of the pressure of production or because of their failure to understand the importance of occupational health-the significance of which has not always been fully appreciated, perhaps because of its relatively recent creation-have not been too keen on submitting to medical examination, or have made the doctor's task more difficult.
Since occupational health in agriculture is a comparatively new discipline, many subjects are obviously still very imperfectly understood. The co-ordination of investigations into a particular morbid condition or the working conditions of a particular agricultural occupation can be extremely useful in filling some of the gaps in knowledge. There is no doubt that a medical inspectorate should work in close collaboration with the universities to this end. Moreover, a university is particularly well equipped to undertake certain investigations. Its relationship with the inspectorate will enable it to direct its research work towards the most current and urgent problems.
We may consider an inspectorate as being responsible for a certain geographical region, so that it gains an idea of the different problems of that region. However, since inspectors should have the same qualifications as practising doctors, it would be extremely difficult for them to be specialists in all areas of medical knowledge, if only because of the range and complexity of medical science. Hence, the regional inspectorate should be backed up by a general inspectorate which would not only co-ordinate all the regional inspectorates but also maintain a staff of specialists for matters such as accidents, poisonings and zoonoses. The general inspectorate would thus be able to advise practising doctors or to undertake specialised investigations with a good chance of success.
Under which administrative authority should a medical inspectorate of agricultural labour be placed? Possible authorities are the ministry of agriculture, the ministry of labour or the ministry of health. The answer to the question depends largely on the national administrative policy of the country concerned. What is essential is that a competent medical inspectorate should exist.