Dzhusupov KO, et al. The State of Higher Education in Occupational Health and Safety in Central Asian Countries. Annals of . 2018; 84(3), pp. 397–407. DOI: https://doi.org/10.29024/aogh.2322

ORIGINAL RESEARCH The State of Higher Education in Occupational Health and Safety in Central Asian Countries Kenesh O. Dzhusupov*, Cholpon T. Sulaimanova*, Karlygash K. Toguzbayeva†, Ramin Tabibi‡, Bakhtiyar Serik§, Cholpon K. Chonbasheva‖, Khusseyn Egamnazarov¶ and Maigul S. Kainarbayeva†

A healthy workforce is vital for the sustainable social and economic development of any country. Assuring occupational health and safety (OHS) depends not only on the passing of quality working legislation and inspection of workplaces, but also on preparation of qualified specialists on OHS. Aimed at assessing of relevance of the content of training at Central Asian universities to the needs in prevention of risks of accidents and injuries and promotion of a preventive culture in the workplace, and finding out how they are compliant with the recommendations of the Mainstreaming occupational safety and health into the education (2010), we examined curricula of 20 medical and non-medical universities across Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan and Uzbekistan. The analysis of training programs showed that education in OHS and preparation of qualified specialists in Central Asiana countries is up-to-date and tailored to local needs for prevention of risks of accidents and injuries and promotes the notion of a preventive culture in the workplace.

Introduction The European Agency for Safety and Health at Work A healthy workforce is vital for sustainable social and indicated challenges to integrating OHS into university- economic development of any country. Assuring occu- level education compared to other levels of education [2]. pational health and safety (OHS) depends not only on In its report it recommended to include OHS as an obliga- the passing good working legislation and inspection of tory element in courses at university level. workplaces but also on preparation of qualified special- The purpose of this work is: 1) to assess the relevance ists in OHS. In the Global Plan of action on Workers’ of the training content at Central Asian universities to the Health 2008–2017, the World Health Organization (WHO) needs in preventprevention of risks of accidents and inju- urged the governments to strengthen the development of ries and to the promotion of a preventive culture in the human resources for workers’ health (Objective 3; 18). It workplace, and 2) how they are compliant with the recom- should be done by “further postgraduate training in rel- mendations of the mainstreaming occupational safety and evant disciplines; building capacity for basic occupational health into the ­education (2010). health services; incorporating workers’ health in the train- With this purpose we examined curricula of 20 medical­ ing of primary practitioners and other profes- and non-medical universities across five Central Asian sionals needed for occupational health services; creating countries: Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan incentives for attracting and retaining human resources and Uzbekistan. for workers’ health, and encouraging the establishment of networks of services and professional associations. Atten- Materials and Methods tion should be given not only to postgraduate but also For the present study we searched literature sources to basic training for health professionals in various fields ­available in English and Russian languages. We searched such as promotion of workers’ health and the prevention electronic databases such as PubMed, Medline, eLibrary, and treatment of workers’ health problems [1].” and Google Scholar. The key terms used were: history of education in occupational health, education in occu- pational health and safety, universities, Central Asia (in * International School of , Bishkek, KG course: Kyrgyzstan, Kazakhstan, Uzbekistan, Tajikistan † Asfendiyarov Kazakh National Medical University, Almaty, KZ and Turkmenistan). We also manually searched various ‡ Abadan School of Medical Sciences, Abadan, IR hard copies of local journals and books in the librar- § Karaganda State Medical University, Karaganda, KZ ies of medical universities, libraries of the Ministries of ‖ Akhunbaev Kyrgyz State Medical Academy Bishkek, KG Health of Tajikistan,­ Kyrgyzstan and Kazakhstan, and ¶ Avicenna Tajik State Medical University, Dushanbe, TJ the Kyrgyz, Tajik and Kazakh national libraries. We also Corresponding author: Kenesh O. Dzhusupov, MD, PhD conducted review and analyses of curricula and syllabi ([email protected]) on Occupational­ Health for undergraduate, graduate 398 Dzhusupov et al: The State of Higher Education in Occupational Health and Safety in Central Asian Countries and postgraduate students,­ materials of international the reign of Peter I. In 1719, Peter I approved the Decree ­conferences and round tables, and educational projects. on the establishment of the Berg-Collegium, to monitor Included articles would address any aspect of the ­history the ­mining industry. In 1734, the Empress Anna issued and present state of education in occupational health a decree on labor protection and surveillance of work- and safety in Central Asian countries such as Kazakhstan, ing conditions, for which she employed 4 commissars to Kyrgyzstan, Tajikistan, Uzbekistan and Turkmenistan. “deal with for the best for the factories”. In 1744, a law was Works with the general description of issued that regulated work in factories and plants and lim- in these countries were excluded. ited night shift duration [21, 22]. In total, we reviewed 19 journal articles in English and The workers’ health protection in Russia was reflected 12 journal articles in Russian published at earliest in 1963; in the works of M.V. Lomonosov, A.N. Nikitin, D.P. two books in English and four books in Russian, one ency- Nikolsky and others [23, 24]. In 1763, in the treatise clopedia and one textbook in English, one textbook and “The First Foundations of Metallurgy or Ore Mining”, M.V. one national guideline in Russian, and four ILO national Lomonosov spoke in favor of the necessity of ventilation profiles in English. Twenty relevant articles and all other of mines, fastening of mine workings, removal of mine publications were considered for the present review. waters, protective clothes for miners, etc. In 1841, Russia issued the first law on the work-norm setting – “Work reg- Results ulations for cloth and ship factories [25].” The review of literature on the development of occu- The first Russian book on occupational diseases is pational health and education on OHS in Central Asian the “Diseases of Workers with Indications of Protective countries showed the long history (Table 1). Measures” (1847) by A.N. Nikitin, the first Russian to analyze and describe 120 professions whose History of education in OHS in former soviet republics representatives develop diseases. He also published in the Since ancient times, the training of medical doctors has journal “Friend of Health” a number of articles on protec- carried out in Central Asia, mainly at the Zoroastrian tem- tive measures against diseases in various industries [26]. ples. Along with , doctors who did A.P. Dobroslavin (1842–1889), one of the founders not receive special medical training used conspiracies and of Russian , described the working conditions other mystical devices which had significant influence. In at tobacco factories, in mines, caissons, and a of Central Asian cities, secular medical schools existed in the pneumoconiosis of various etiologies, lead and hydrogen first half of the 1st millennium AD and already prepared sulfide poisoning [25]. His reasoning about the need to medical professionals. In the cities, secular doctors had study all the factors of the labor process, which can affect free medical practice. Nestorian doctors who fled from the health and work capacity of a person, fully correspond Byzantium, and Indian Buddhist doctors were among to the scientific concepts of today. those doctors [3]. E.M. Dementieva greatly influenced the development In Central Asia, like in ancient Iran, the elements of the of occupational health in Russia in “Factory, what it gives specialization of medical activities were noted: there were the population and what it takes from it” (1893), in which surgeons and special engaged in cerebrovascu- he painted a vivid picture of the influence of sanitary con- lar and neurological diseases management, eye diseases, ditions of labor on the physical development of workers dental diseases, mental illnesses and assisted in childbirth [24]. The mass scale and severity of occupational diseases [4–10]. No later than 5–6 centuries later, there were facili- among workers in that time attracted the attention of ties for inpatient treatment of patients and charity of the public doctors. disabled at temples and in cities [11–15]. At the end of the 19th century, under the guidance of They paid great attention to hygienic measures: clean- the first hygiene professor at the Faculty of Medicine of liness of the body, housing and clothing, supervision of the Moscow Imperial University, F.F. Erisman (1842–1915), domestic animals, control of insects and rodents, diet and a group of local sanitary doctors examined 1080 factories sexuality, hygiene of a pregnant woman and a and plants in the Moscow province and 114 thousand mother [4, 7, 16]. Particular attention was paid to working workers. The doctors published the survey results in 19 conditions and the prevention of occupational poisoning volumes (over 6,000 pages), and the results were valuable [17]. Thus Abu Ali Hussein ibn Abdallah Ibn Sino, better in characterizing the status of the working class in Russia known as Avicenna (980–1037), in his famous “Canon of [26–29]. Medical Science”, described the causes and clinical mani- Erisman’s “Professional Hygiene, or the Hygiene of festations and treatment of lead poisoning, mercury and Mental and Physical Labor” (1877) is the first original other salts [10, 11, 17, 18]. In his “Treatise on Hygiene” he ­publication in Russia on the incidence of workers in vari- describes the great importance of environmental factors, ous professional groups [28]. including the workplace conditions [19, 20]. The latter G.V. Khlopin (1863–1929) made a significant contribu- development of labor protection and occupational health tion in the development of preventive medicine [26, 30] is closely linked with the development of workers’ health through large-scale experimental work on the effect of protection in Russia. industrial poisons on the body, the physiology of labor In Russia, the development of the science of labor (energy expenditure) and occupational in the hygiene and occupational diseases is associated with chemical and mining industries. the development and growth of industry. The history of In 1882, Russian officials issued a law concerning the supervision of industrial production has dates back to organization of a factory inspection and on the work of Dzhusupov et al: The State of Higher Education in Occupational Health and 399 Safety in Central Asian Countries (contd.) Highlights as The role of A.N. Nikitin and F.Erisman pioneers of IH and OH Rhazes and direct involvement of Avicenna, other scholars in human dissection Rhaze’s tracheostomy technique, description of pollynosis hygiene, view on anatomy, Avicenna’s ­ infectious diseases of ENT and its treatment view on care of Description of Avicenna’s infants, their hygiene (bathing, swaddling, etc), breastfeeding and upbringing Medicine defined as an art of maintaining a healthy body. The role of diet, hygiene and sport. Clinical description of meningitis, surgical operation of short frenum classification and diagnostics of Avicenna’s cataracts definitions Concurrency of Avicenna’s and understanding of stroke with current ­ concepts medicine and the role of Place of Persian in the historyAvicenna of medicine Description of levels and kinds spinal impairments caused by spinal traumas; Usage of its treatment based on etiology. ­ different treatment methods (food and drug cupping, dry massage, phlebotomy, , sauna, and ). Place Russia, USSR Central Asia Persia, Central Asia Persia, Central Asia Persia, Central Asia Central Asia Central Asia Persia, Central Asia Persia, Central Asia Persia, Time period CE 19–20 AD BC–14 10 AD 865–1037 AD 980–1037 AD 800–1110 AD 980–1037 AD 980–1037 AD V BC–1122 AD 980–1037 - Topic/focus/questions History of OH in Eastern Europe (USSR): OHS services, education and research periods Review of major influential Persian and the individuals who contributed to development of anatomy “Canon of Contributions of Avicenna’s to and Rhazes’s “Liber Continens” ­ Medicine” the development of “Canon Analysis of the chapter Avicenna’s about the care of newborns of Medicine” Analysis of the text oldest known medi language cal treatise in Persian “Canon of Contribution of Avicenna’s to diagnosis and treatment of eye Medicine” diseases “Canon of on of Avicenna’s Focused his description of definitions and ­ Medicine”, diagnostics, clinical manifestations, etiology, prognosis of stroke History of Iranian Medicine, surgery and ­ pharmacology including input of Avicenna viewpoint on spinal trauma and its Avicenna’s treatment in his “Canon of Medicine” Language Eng Eng Eng Eng Eng Eng Eng Eng Eng Type of Type ­ publication Journal article Journal article Journal article Journal article Journal article Journal article Journal article Journal article Journal article History of the development Occupational Health in Central Asia. Author/date Malan RM. (1963) Mohammadali M. et al. (2007) Azizi. M-H. (2007) Modanlou HD. (2008) Azizi M. Nayernouri T, (2011) Nejabat M, et al. (2012) Zargaran A, et al. (2013) (2015) Nayernouri T. et al. (2015) Ghaffari F, Table 1: Table 400 Dzhusupov et al: The State of Higher Education in Occupational Health and Safety in Central Asian Countries (contd.) Highlights view on drug therapy; Avicenna’s ­ concurrency of his concepts to the modern ­ medicine Description and assessment of the existing training programs Recommendations to improve training programs There are some missing etiologies of ­ intestinal obstruction in modern medicine Detailed description of rabies among a ­ number of infectious diseases. The role of control insects and rodents, supervision of domestic animals The role of Russian doctors, scientists and Russian Emperors in the establishment of scientific school of industrial hygiene and studies of occupational diseases I and Anna Empress in the The role of Petr development of preventive medicine Khlopin’s large-scale experimental work on the effect of industrial poisons on body, the physiology of labor (energy expenditure) Results of the first big examination ­ Russian workers Current issues of preparation specialists in HistoryOHS in Kazakhstan. of the National Center for IH and OD Erismann in the development The role of F. of OH as a science and discipline Khlopin in OHS history; The role of G.V. Main publications of N.A. Nikitin Place Uzbekistan Kazakhstan Central Asia Persia, Central Asia Persia, Russia, the USSR the USSR, Russian federation Russia, the USSR Russia Kazakhstan Russia Russia, the USSR Time period AD 980–1037 2015 AD 980–1037 AD 980–1037 1700–1980 1714–2000 1900–1925 1841–1915 1950–2015 CE 19 CE 19–20 occupational development of Topic/focus/questions his contribution Short biography of Avicenna, to the development of world’s medicine Needs analysis for retraining and advanced training of specialists in OHS Kazakhstan views on the causes of intestinal Avicenna’s obstruction and their comparison to current views “Canon of on of Avicenna’s Focused his description of transmission ­ Medicine”, route, clinical manifestation and treatment of infectious diseases History of development the subject with stress on Russian diseases” ­ “occupational and USSR period of developments The history of preventive medicine with the focus on Russian and USSR developments Khlopin in the ­ The role of G.V. the Russian and Soviet school of ­ health Erisman in development of Role of F.F. ­ National center for industrial Role of Kazakh hygiene and occupational diseases in training of occupational therapists in Kazakhstan Erisman, their Analysis of main works F. significance Main stages of the development Preventive Erisman, Khlopin, F. medicine, the role of G.V. A.A. Nikitin and others in history of OHS in USSR Language Eng Eng Eng Eng Russian Russian Russian Russian Russian Russian Russian Type of Type ­ publication Journal article Journal article Journal article Journal article Journal article Journal article Journal article Journal article Journal article Journal article Journal article EN. (2003) ĭ Author/date Buranova DD. 2015 Sadykova JM, et al. (2015) Moradi Z, et al. (2016) Dalfardi B, et al. (2017) Goncharenko YuF, Chernobrova OV. (1982) NP, Voskresenskaia Bylinski (2006) Izmerov NF. (2009) Izmerov NF. Otarbayeva MB. (2015) Shigan EE. (2016) Shigan EE. (2016) Dzhusupov et al: The State of Higher Education in Occupational Health and 401 Safety in Central Asian Countries - century th Highlights Basic and special differences between Canon and modern medicine Role of environmental factors, including working conditions Metal poisonings, their treatment his view on Logic, Philosophy of Avicenna, Empiricism and Metaphysics. His works Erisman in the development of The role of F. occupational hygiene and health Role of environmental factors, including working conditions. Metal poisonings, their treatment Role of environmental factors, including working conditions Metal poisonings, their treatment and fastening of mining work Ventilation Lomonosov ings by M.V. on workers’ health protection in Russia Focus in 18 Place Central Asia Central Asia Persia, Central Asia Persia, Russia Worldwide, Central Asia Persia, Central Asia Persia, Russia Russia Time period AD 980–1037 AD 980–1037 AD 980–1037 1700s AD 980–1037 AD 980–1037 1760–1780 1700s diagnostics, diagnostics, Topic/focus/questions Knowledge presented by Canon Basic and special differences between Canon and modern medicine philosophy of Anatomy of human body, ­ well-being of a man, causes disease, manifestations, treatment, dietetics, hygiene, environment al factors etc his contribution to Biography of Avicenna, the development of world’s medicine, ethics. His works philosophy, developments of occupational health History, practice philosophy of Anatomy of human body, ­ well-being of a man, causes disease, manifestations, treatment, dietetics, hygiene, environment al factors etc philosophy of Anatomy of human body, ­ well-being of a man, causes disease, manifestations, treatment, dietetics, hygiene, environment al factors etc manifestations, ­ etiology, History, treatment and prevention main of ­ occupational diseases manifestations, ­ etiology, History, treatment and prevention main of ­ occupational diseases Language Eng Eng, Arabic Eng Eng Russian Russian Russian Russian - Type of Type ­ publication Book Book Encyclopedia Textbook Book Book Textbook National guide line Author/date Avicenna Digital (World Avicenna Library Gutas D. (2016) HA. (1989) Waldron Abu Ali ibn Sina ­ (Avicenna) 1979 Abu Ali ibn Sina 1982) (1980; ­ (Avicenna) Babanov VV, Kosarev SA., (2010) (2011) Izmerov NF. 402 Dzhusupov et al: The State of Higher Education in Occupational Health and Safety in Central Asian Countries minors. Night shift was completely banned for children diagnosis, treatment, and rational employment of patients under 15 years old, and for teenagers aged 12 to 15 years, with occupational disease. A number of works of Soviet an eight-hour day was allowed [30]. ­scientists in the field of dust pathology, occupational dis- In 1918, in post-revolutionary Russia, the Commissariat eases of blood, etc. have acquired world significance. of Labor compiled a list of hazardous industries and pro- During the World War II, a network of medical and sani- fessions and subsequently introduced, the issuance of tary units at enterprises was reinforced in the USSR, the protective clothing in all hazardous industries [24]. number of which had already increased to 145 in 1942 [24]. The rapid development of the labor protection and In the postwar years, rapid recovery of the national inspection system in Russia and in the republics of Central economy, rapid growth of metallurgical, chemical, mining Asia is associated with the emergence of Soviet power. and light industry were due to well-established preventive In 1918, the first “Code of Labor Laws” was approved. In work on the background of a general decline in occupa- 1919, the State Industrial Sanitary Inspection was formed. tional pathology. So only in the mining industry for 10 In 1923, the Moscow Department of Health put forward post-war years the incidence of workers has decreased by the slogan “From the fight against to the sani- 13.5 times. tation of labor and life.” In 1923, the department estab- The first research establishment in Central Asia lished the Research Institute for Occupational Diseases was the Research Institute of , Hygiene and (now the Scientific Research Institute of Occupational Occupational Health (RISHOH) created in Tashkent in Health of the Russian Academy of Medical Sciences) and 1934 in accordance with the decree of the Council of the first occupational diseases clinic in Moscow [24]. People’s Commissars of Uzbekistan No. 685 of July 16, Later in the 1920s, research institutes of labor hygiene 1934. and occupational health were established in other parts After World War II, the sanitary and hygiene faculties of Russia and in Ukraine. At first, the course of occupa- with departments of labor hygiene and occupational tional health at the medical faculties was taught at the health were established in the Central Asian soviet departments of therapy. Later, as a result of the expansion republics. of the sanitary and hygiene faculties, the teaching of labor In Kyrgyzstan, such faculty with the Department of hygiene and occupational health in medical universities Hygiene was created at the Kyrgyz State Medical Institute began to be conducted in specially organized of only in 1953. The occupational health course was taught occupational health and at the labor hygiene chairs. within the Internal Diseases course and a separate course The decision of the Central Committee of the VKP (b) only in 1980. of December 18, 1929, “On medical care for workers and In 1958, the Ministry of Health of the Kazakh SSR estab- peasants”, put the need for preferential servicing of indus- lished the National Research Center of Labor Hygiene trial workers in the leading industries as a primary goal and Occupational Health (NRCLHOH) in Karaganda [31]. of . A wide network of health centers at the The first Department of labor hygiene in Kazakhstan enterprises were subsequently created in the USSR [25]. was established in 1963 at the Karaganda State Medical With the introduction of medical preventive examina- Institute and of Occupational Health – in 1966. tions at industrial enterprises, the study of occupational diseases began to develop taking into account the morbid- The modern state of the study of OHS in Central ity and its causes in various industries and the toxicity of Asian countries substances used in industry. Since 1933, the State Sanitary Currently, the two above mentioned research centers are Inspectorate has started to monitor the performance of engaged in scientific research in the field of labor hygiene and existing legislation by industrial enterprises. occupational health: the RISHOH in Tashkent ­(Uzbekistan) In 1939, the first all-Union sanitary norms and rules and the NRCLHOH in Karaganda (Kazakhstan) [31–33]. for the construction design of industrial enterprises were Their main scientific goal is the establishment of pat- developed and published by the construction and archi- terns in the formation of the industrial environment at tecture ministry. industrial enterprises, the hygienic assessment of the occu- In the USSR, in order to prevent exposure to hazardous pational risk of workers, the development of measures to occupational factors at workplace, workers were given pro- optimize working conditions, the prevention of occupa- tective clothing, footwear, personal protective equipment, tional and work-related diseases on the basis of risk theory. and preventive at the expense of the employer In the field of industrial toxicology, the main task is to in accordance with the adopted norms [24]. determine the extent and nature of the biological effect, In the Soviet Union, for the first time in the world, medi- based on an assessment of the toxicity and hazard intro- cal and sanitary units were set up and preventive and cura- duced by new chemical compounds. tive work was performed at enterprises. The creation of Another activity of these research centers is the assess- sanitary and epidemiological stations on the territorial ment and the certification of workplaces, the development principle was also completely innovative. of sanitary and technical passports, as well as in-depth During this period, extremely high rates of industrial medical examinations of workers of various enterprises development were combined with a decrease in occupa- and institutions. tional disease incidence. The within these scientific centers handles In the years before the World War II, the issues of the diagnostics, treatment, medical examinations, exper- pathogenesis of occupational diseases were studied in tise of professional fitness and medical rehabilitation of the USSR. This helped in the development of issues of patients with various forms of occupational diseases, as Dzhusupov et al: The State of Higher Education in Occupational Health and 403 Safety in Central Asian Countries well as prevention of occupational and general diseases in Altitude into their undergraduate program of Preventive workers exposed to harmful occupational factors. Medicine. This course integrated all collective knowledge The occupational health in Uzbekistan has 100 regarding features of effects of main occupational factors beds, a dispensary department for 33,000 visits per year, on the background of external hypoxia at industries in three laboratories, a , a power unit and other high altitude. The main bulk of knowledge bulk is com- auxiliary departments. prised of local researchers from Institute for High Altitude The occupational health hospital in Kazakhstan has Physiology and Medicine on quantification of changes in four branches for total 117 beds in Karaganda, Ust- energy expenditures, cardiovascular, respiratory systems, Kamenogorsk, Chimkent and Aktyubinsk cities [31]. thermoregulation, psychomotor status and other systems In Kyrgyzstan, there is an occupational health unit with of human body during labor process at different altitude 10 beds at the National hospital in Bishkek. above sea level. The course participants are to master In Central Asia, 10 medical universities run the skills on formulation of recommendation on work-norm undergraduate and postgraduate programs in Labor setting: duration and organization of daily work and rest, Hygiene and Occupational Health: five in Kazakhstan, work shift and days-off, compensation rate for salary, etc. two in Uzbekistan and one in Kyrgyzstan, Tajikistan and At the Kyrgyz technical university, at all faculties they Turkmenistan each. introduced the subject of Industrial Safety. For students of The summary of the characteristics of courses on mining and geology, the department of Industrial Safety Occupational Health, Labor Hygiene, Labor Protection introduced new program “Risk management in mining”. and Safety taught in these countries is presented in the The university is actively introducing e-learning with the Table 2. The number of credit hours for training on Labor use of problem based learning. Hygiene in medical universities ranges from 6 to 10.2 cred- its, on occupational health 1.75 to 3 credits. The purpose 2. Kazakhstan: Distant and on-site CPD courses in OHS of training students in Labor Hygiene is to provide basic Due to a need for the training and retraining of spe- theoretical and practical training of a physician in the field cialists, the National Center of Industrial Hygiene and of Labor Hygiene and Physiology, which allows physicians Occupational Health at the Kazakh Ministry of Health to solve current sanitary and epidemiological surveillance and the Chair of Labor Hygiene at the Karaganda State issues at facilities under construction and projected facili- Medical University are main producers of specialists in ties for industrial and agricultural purposes, and also to occupational health and safety in Kazakhstan [34]. They substantiate and develop a set of preventive recommenda- ­developed eight new distant continuing professional tions and ways for their implementation based on legisla- development courses, including “Preliminary and peri- tion documents. The aim of training medical students on odical medical examination of workers”, “Occupational Occupational Health to enable them to timely diagnose health risk assessment in mining”, “Occupational health occupational and work-related diseases and to organize risk assessment in oil industry”, “Certification of industries proper treatment of patients. on working conditions”, etc [36]. Beside medical universities, the main technical universi- ties of this region prepare specialists for labor protection 3. Uzbekistan: Occupational health of women working in silk and safety [32–35]. In all technical (transport specialists, production architects, engineers, geologists, designers, construction Specialists of the Research Institute of Sanitation, Hygiene technology, food technology, machine technology, IT) and Occupational Diseases at the Ministry of Health of and pedagogical universities of all republics, teaching the Republic of Uzbekistan (NIISH) studied occupational of occupational safety is compulsory. Disciplines such as health of women employed in silkworm breeding, grena- “Life Safety”, “Fundamentals of Labor Protection”, “Labor dier, silk weaving, knitwear and textile industries. The Protection by Industry”, “Civil Protection” and “Industrial study results formed the basis of postgraduate Preventive Safety.” Time allocated for training in occupational health Medicine program at the Tashkent Medical Academy. and safety varied from 4 to 9.4 credits. As continuing professional development for all non-medical specialists, 4. Regional projects: Tempus and Erasmus Plus project on training in occupational safety is recommended at 1 credit Central Asian network in Environmental and Occupational (basic training), 2 credits (repeated training after 3–5 years Health of work). For professional retraining of labor protection Because universities perceive their prestige as closely and safety specialists there is courses of up to 7 credits. linked to their master & doctoral programs, the lack of Reviewing the educational programs, we decided to resources and expertise can be covered by the devel- highlight the features of some good examples of training opment of an appropriate set of PhD and MSc courses programs from different countries of this region. in environmental and occupational health to prepare strongly needed graduates in such disciplines. MSc Some examples of good practice from Central Asian & PhD programs can strongly benefit from interna- countries tional cooperation and from state-of-the-art teaching 1. Kyrgyzstan: Occupational health and safety in conditions ­technologies. of high altitude By inititaive of the International school of medicine The Chair of environmental studies and the Chair of hos- (Bishkek, Kyrgyzstan) and the University of Milan the pital therapy at the Kyrgyz State Medical Academy intro- regional educational project “Central Asian Network for duced course of Occupational Health and Safety in High Education, Research and Innovation in Environmental 404 Dzhusupov et al: The State of Higher Education in Occupational Health and Safety in Central Asian Countries

Table 2: The summary of description of curricula and syllabi in Occupational Health and related subjects in Central Asian countries.

Kazakhstan Kyrgyzstan Tajikistan Uzbekistan Curricula (total numbers) Medical 5 1 1 2 universities Technical 2 2 1 2 universities Pedagogical 1 2 1 1 universities Syllabi (total number) Medical 5 1 1 1 universities Features Labor Hygiene Labor Hygiene Labor Hygiene Labor Hygiene of course Credits: 10.2 Credits: 6 Credits: 6.6 Credits: 9.5 ­syllabi: Focus areas: Focus areas: Focus areas: Focus areas: – Risk Assessment – Labor physiology and – Risk Assessment – OHS in mining, – OHS in mining, oil OHS in industries in – OHS in oil & gas metal industry and industry and agriculture altitude conditions ­industry ­agriculture – Certification of working – OHS in agriculture – OHS in agriculture – Toxicology of places – Certification of working – Toxicity of new ­pesticides places ­pesticides & chemicals Occupational Health Occupational Health Occupational Health Occupational Health Credits: 3 Credits: 1.75 Credits: 2 Credits: 3 Focus areas: Focus areas: Focus areas: Focus areas: – Medical examination of – Lead intoxication – Molecular and sub-cell – Medical examination workers – Brucellosis in farmers bases of effects of of workers – Rehabilitation of – Work-related infectious physical and chemical – Work-related patients OD and diseases factors ­diseases ­work-related diseases Technical 2 1 1 1 universities Features of Total: 7–8 credits Total: 7–8 credits Total: 7–8 credits Total: 8.5–9.4 credits syllabi: Subjects: Subjects: Subjects: Subjects: – Labor Protection by – Labor Protection by – Labor Protection by – Labor Protection by Industry, Industry, Industry, Industry, – Fundamentals of Labor – Fundamentals of Labor – Fundamentals of – Fundamentals of Protection, Protection, Labor Protection, Labor Protection, – Civil Protection, – Civil Protection, – Civil Protection, – Civil Protection, – Industrial Safety – Industrial Safety – Industrial Safety – Industrial Safety

CPD training on CPD training on CPD training on CPD training on ­Occupational Safety ­Occupational Safety ­Occupational Safety ­Occupational Safety 1–2 credits 1–2 credits 1–2 credits 1–2 credits Retraining course for labor Retraining course for Retraining course for Retraining course for protection & safety: 7 labor protection & safety: labor protection & safety: labor protection & credits 7credits 7credits safety: 7credits Pedagogical 1 1 1 1 universities Features: Life Safety Life Safety Life Safety Life Safety 5 credits 4 credits 4 credits 4 credits and Occupational Health” (CANERIEH) is realized in Commission TEMPUS program allowed the consortium to Kyrgyzstan, Kazakhstan and Tajikistan. The project consor- reach several significant goals. tium included six medical universities from these Central First, researchers began building capacity in educa- Asian countries, including the University of Milan (Italy), tion and research in these fields. Training was provided the University of Gothenburg (Sweden) and University for teaching staff and researchers. PhD programs were of Tartu (Estonia). Finanical support from the European successfully introduced in participating Central Asian Dzhusupov et al: The State of Higher Education in Occupational Health and 405 Safety in Central Asian Countries universities. Additionally, centers for education, research & Acknowledgements innovation in Occupational & were We would like to express the gratitude to the University established in these universities and created anetwork for of Milan team led by Prof. Claudio Colosio, to the Tartu collaborative activities. PhD students are recruited and University team led by Dr. Hans Orru, the University of started their training and research activities. Gothenburg (Prof. Rune Andersson), Technical University The second project «STrengthening Network for Berlin team (Dr. Elena Eygorn and Dr. Arnold Sterenharz) EdUcaTiOn, Research and Innovation in Environmental and the Foundation for Learning and Development of HeALth in Asia»/TUTORIAL 2016–2019 is sponsored by Occupational Health, Netherland (Prof. Gert van der Laan, European Commission ERASMUS Plus program become a Prof. Frank van Dijk and Prof. Paul Smits) for supporting continuation of the first international project. the development of educational programs and introduc- The main objective of the TUTORIAL project is to tion of blended learning approach in teaching and learn- strengthen research capacities in partner countries in ing OHS. areas of public health, promote a sound exchange of The special thanks to the European Commission information and building capacities between higher edu- Erasmus Plus program for sponsoring the development of cation institutions of European Union and Central Asia. our PhD programs in OHS and Central Asian network for This objective will be achieved by tuning existing doc- education, research and innovation (2012–2019). toral studies, developing new MSc programs in relevant areas and implementing blended learning approach. 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How to cite this article: Dzhusupov KO, Sulaimanova CT, Toguzbayeva KK, Tabibi R, Serik B, Chonbasheva CK, Egamnazarov K and Kainarbayeva MS. The State of Higher Education in Occupational Health and Safety in Central Asian Countries. Annals of Global Health. 2018; 84(3), pp. 397–407. DOI: https://doi.org/10.29024/aogh.2322

Published: 31 August 2018

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