Successful design and implementation of a TWH program in an organization requires knowledge and skills traditionally “owned” by a range of OEHS, medical, human resource, and business professionals. An emerging professional specialty in TWH that integrates competencies from these disciplines is supported by an expanding list of peer-reviewed literature, as research adds to the body of knowledge of TWH. NIOSH currently collaborates with six Centers of Excellence in TWH, and professional programs are now available.

So, what’s wrong with a concept that can provide health and safety benefits, improved efficiency in OEHS management, and cost savings for adopting organizations and their employees? Unfortunately, these benefits are unlikely to accrue to workers outside of standard employer/employee relationships, including millions in developing economies and increasing numbers in developed economies. The International Labor Organization has estimated that one-half to three-quarters of workers not including those in agriculture in developing countries are engaged in the informal economy. In the United States, 20 percent or more workers are “contract workers.” Workers in the informal sector; cottage industries; precarious and at-risk employment; gig, flexible, or migrant work; subcontracted employment; day labor; and so on have rarely benefitted from traditional OEHS programs, and are not likely to benefit from programs such as TWH and TEH that require sophisticated knowledge, investment of resources, and stability of workplace. How, then, can these be provided to workers outside of standard employment relationships? Thought leaders agree that the solution lies in returning industrial hygiene/occupational health to its roots in public health, including a wider educational base in fundamentals of public health and the social determinants of health. But what would such a development mean in terms of practice? Even the World Health Organization has stated that “occupational health and safety grew up in the environment of the large factory and enterprise, and we are only now learning how to carry it out in small enterprises and the informal sector.”  The answer to this challenge will likely require policy and legal changes, as well as the collaborative efforts of many partners: legislative bodies, governmental agencies including health departments, professional associations, trade and labor organizations, employer associations, academic institutions, and educational initiatives such as in the U.S. and in the European Union.  AIHA is forming an ACTIONS Subcommittee on protection for contingent workers. If you’d like to be part of the solution, join Mark Ames, our director of Government Relations, and me for an organizing meeting at AIHce EXP 2018. For more information, email or .