ASSESSMENT REPORT IMPROVING THE HEALTH AND SAFETY OF MINERS IN EASTERN UKRAINE Published by the United Nations Development Programme (UNDP) in Ukraine Kyiv, Ukraine, November 2012 © UNDP, 2012 — All rights reserved All rights reserved. The views expressed in this publication are the author’s and do not necessarily represent those of the United Nations, including UNDP or its Member States. The mention of specific companies does not imply that they are endorsed or recommended by UNDP in preference to others of a similar nature. UNDP does not warrant that the information contained in this publication is complete and correct and shall not be liable for any damages incurred as a result of its use. United Nations Development Programme in Ukraine 1, Klovsky Uzviz Str. Kyiv, 01021, Ukraine Contents Contents EXECUTIVE SUMMARY. 5 KEY FINDINGS . .6 1. INTRODUCTION. 8 1.1 Miners. 8 1.2 Mining Industry. 8 1.3 National Priorities. .8 1.4 Gender Considerations . 9 2. COMMUNITY MEETINGS. 10 2.1 Methodology . .10 2.2 Factors Affecting the Health and Safety of Miners . 10 3. HEALTH DATA ON MINERS. 11 3.1 Key Findings from the Medical Exams of Miners . .11 3.2 Methodology for Conducting and Analysing the Medical Exams. 11 3.3 Health Data on Miners. 11 4. SAFETY DATA ON MINERS . .17 4.1 Key Findings. 17 4.2 Safety Data on Miners. 17 5. OPINION SURVEYS OF MINERS IN ROVENKY AND SVERDLOVSK . .18 5.1 Key Findings from Rovenky and Sverdlovsk . 18 5.2 Miners’ Opinions on Health . .18 5.3 Miners’ Opinions on Safety. 22 6. GENERAL RECOMMENDATIONS . .25 7. KRASNODON ACTION PLAN . .26 7.1 Key Findings. 26 7.2 Community Health Profile . .26 7.3 Krasnodonugol. 27 7.4 Priorities . .28 7.5 General Recommendations . .28 7.6 Action Items. 29 7.7 Budget . .33 8. ROVENKY ACTION PLAN. 34 8.1 Key Findings. 34 8.2 Community Health Profile . .34 8.3 DTEK Rovenkiantratsit. 34 8.4 Health and Safety of Miners . 36 8.5 Priorities . .36 8.6 General Recommendations . .37 8.7 Action Items. 37 8.8 Budget . .41 3 ASSESSMENT REPORT Improving the Health and Safety of Miners in Eastern Ukraine 9. SVERDLOVSK ACTION PLAN . .42 9.1 Key Findings. 42 9.2 Community Health Profile . .42 9.3 DTEK Sverdlovantratsit . .43 9.4 Health and Safety of Miners . 43 9.5 Priorities . .44 9.6 General Recommendations . .44 9.7 Action Items. 45 9.8 Budget . .49 10. REGIONAL CONSIDERATIONS. 50 11. APPENDIX. 52 12. BIBLIOGRAPHY . .55 13. ENDNOTES . .58 4 EXECUTIVE SUMMARY Executive summary The “Improving the Health and Safety of Miners in Eastern Ukraine” project aims to identify and address the health and safety needs of miners in Krasnodon, Rovenky and Sverdlovsk. This report summarises the results of the first or assessment phase of this project, while the second phase will focus on implementing the recommendations set forth in this report. To begin, UNDP partnered with DTEK and Metinvest, two of the largest energy and mining companies in Ukraine, to implement this project. UNDP also received endorsements from the mayors of Krasnodon, Rovenky, and Sverd- lovsk, as well as the governor of the Luhansk Oblast State Administration to proceed with the effort. UNDP then conducted dozens of interviews, focus groups, and community workshops to understand the health and safety needs of miners. UNDP also worked closely with DTEK Rovenkiantratsit, DTEK Sverdlovantratsit, and Metinvest Krasnodonugol to examine the working conditions of miners. Over the course of three months, UNDP had engaged over 250 miners, miners’ spouses, health workers, and government officials to discuss the miners’ needs and priorities. In addition, UNDP contracted GfK Ukraine, the country’s largest market research firm, to conduct a study on the health and safety of miners based on the medical exams and opinion surveys of 373 miners. The results of this study helped shape the proposed action plans for each of the three target communities. Overall, UNDP found the most pressing health and safety issues of miners to be respiratory diseases, cardiovas- cular diseases, and occupational traumas. While DTEK and Metinvest have done much to improve the health and safety of miners, there is still much work to be done. Each community has specific and unique needs, but in general, the proposed action plans focus on upgrading medical equipment, improving emergency transportation, and conducting preventative health work. The follow- ing sections describe the process, results, and proposed actions in greater detail. 5 ASSESSMENT REPORT Improving the Health and Safety of Miners in Eastern Ukraine Key findings The following list summarises the key findings from the health and safety assessment of miners in Krasnodon, Rovenky and Sverdlovsk. Subsequent sections explain the findings in further details. Health Issues • The most prominent health issues of miners in Krasnodon, Rovenky, and Sverdlovsk are respiratory diseases, cardiovascular diseases, occupational injuries and musculoskeletal conditions. • More than 37 per cent of miners in Rovenky and Sverdlovsk suffer from respiratory diseases. Chronic bron- chitis alone affects 330 per 1,000 miners—a rate seven times higher than the general adult populations in Rovenky and Sverdlovsk. • About 18 per cent of miners in Rovenky and Sverdlovsk suffer from cardiovascular diseases. For example, 57.6 per 1,000 miners suffer from ischemic heart disease compared to the national average of 53.1 per 1,000 people or the European average of 36.3 per 1,000 people.1 • In Rovenky and Sverdlovsk, the most common musculoskeletal conditions of miners are osteochondrosis (68 per 1,000 miners) and lower back pain (42 per 1,000 miners). • The Luhansk Clinic of the Ministry of Internal Affairs classified miners into three health groups: I) generally healthy, II) those who have had acute and/ or chronic disease(s) in the past, and III) those who currently have a chronic disease. Of those who took part in the study, 33 per cent were classified into Health Group I, 13 per cent into Health Group II, and 54 per cent into Health Group III. • Still, miners are rather optimistic about their heath: 61 per cent are satisfied with it even though 54 per cent are classified in Health Group III. In fact, only 8 per cent are dissatisfied with their health. • At the same time, 70 per cent of miners worry that their health might deteriorate because of harmful working conditions, and 46 per cent worry that it might deteriorate because of unhealthy habits (e.g., smoking, alco- hol consumption). • For the most part, miners consult doctors for their health problems (64%). They also consult health profession- als at their enterprise (34%), acquaintances and relatives (27%), pharmacists (23%), and the Internet (10%). • A large number of respondents prefer self-treatment or to do nothing in treating some of their health issues. For example, only 64 per cent of respondents consulted a doctor to treat bronchitis, 44 per cent for back- aches, and 40 per cent for sore throats over the last 12 months (August 2011-August 2012). • Fifty-nine per cent of miners (63% of underground workers and 47% among aboveground workers) consider that the health care system in their city satisfies their needs. • Eighteen per cent of miners are unsatisfied with the quality of medical care, 16 per cent with inconvenient schedules of medical institutions, 15 per cent with expensive medicines, and 12 per cent with expensive medical services. • Miners’ families and pharmacists play an important role in the health and wellbeing of miners. At least 15 per cent of miners use medical products advised by a pharmacist, 9 per cent use medical products advised by family members or acquaintances, and 8 per cent use folk remedies. 6 KEY FINDINGS Safety Issues • The rates of occupational injuries have decreased at all three enterprises since 2007: by 66 per cent at Krasno- donugol, 21 per cent at Rovenkiantratsit, and 20 per cent at Sverdlovantratsit. • In 2011, the national average for occupational injuries of.