Conclusions
The burden of occupational health problems is staggering in both human and economic costs, and workers in the developing world bear this burden disproportionately. Moreover, the most vulnerable—children and the poor—are also disproportionately at risk. Compounding this tragedy is that many effective and economically feasible interventions are available to address these largely preventable health conditions.
Despite relatively little systemic data on cost and cost-effectiveness, even this "tip of the iceberg" picture demonstrates work-related conditions contributing significantly to overall mortality and morbidity and demonstrates the overall societal benefit of their prevention and treatment. Externalization of costs by employers—to the society as a whole—often obscures the actual overall benefit of a framework that relies on government regulation and enforcement, education, and best practices. Effectively addressing these problems takes active involvement from national and local government, employers, and workers and their representatives. The challenges to reducing the burden are heightened to the degree that public health and health care delivery systems isolate occupational health from the mainstream of health and health care.
Despite structural and political barriers to overcoming this high burden of disease and injury, evidence exists of enormous progress in the industrial world and of isolated progress in parts of the developing world. Targeted future investments in research and public health and health systems are critical to ensuring that progress continues and is more equitably distributed.
