Biological agents and prevention of work-related diseases: a review - Summary European Agency for Safety and Health at Work Biological agents and prevention of work-related diseases: a review European Risk Observatory Summary 0 European Agency for Safety and Health at Work – EU-OSHA Biological agents and prevention of work-related diseases: a review - Summary Authors: Marie Meima, Eelco Kuijpers, Claudia van den Berg, Astrid Kruizinga, Nicole van Kesteren, Suzanne Spaan (TNO, the Netherlands) Editor and project manager: Elke Schneider, European Agency for Safety and Health at Work Contribution from: Remko Houba (NECORD, the Netherlands) Frank Dieterich (BAuA, Germany) Jos Verbeek, Kyösti Louhelainen (FIOH, Finland) Torben Sigsgaard, Vivi Schlünssen (Aarhus University, Denmark) Gérard Lasfargues, Juliette Bloch (ANSES, France) This report was commissioned by the European Agency for Safety and Health at Work (EU-OSHA). Its contents, including any opinions and/or conclusions expressed, are those of the authors alone and do not necessarily reflect the views of EU-OSHA. Europe Direct is a service to help you find answers to your questions about the European Union Freephone number (*): 00 800 6 7 8 9 10 11 (*) Certain mobile telephone operators do not allow access to 00 800 numbers, or these calls may be billed. More information on the European Union is available on the Internet (http://europa.eu). Cataloguing data can be found on the cover of this publication. Luxembourg: Publications Office of the European Union, 2020 © European Agency for Safety and Health at Work, 2020 Reproduction is authorised provided the source is acknowledged. 1 European Agency for Safety and Health at Work — EU-OSHA Biological agents and prevention of work-related diseases: a review - Summary Contents Abstract................................................................................................................................................... 3 Executive summary ................................................................................................................................ 3 Definitions and scope of the project .................................................................................................... 3 Project design ..................................................................................................................................... 4 Methods .............................................................................................................................................. 4 Literature review (task 1) ................................................................................................................. 4 Semi-structured interviews with experts on policy measures (task 2) ............................................ 5 Focus groups (task 3)...................................................................................................................... 5 Stakeholder workshop (task 4) ........................................................................................................ 5 Results ................................................................................................................................................ 5 High-risk occupations ...................................................................................................................... 6 Other occupations and sectors ....................................................................................................... 9 SMEs .......................................................................................................................................... 9 Vulnerable groups ........................................................................................................................... 9 Emerging risks ............................................................................................................................... 10 Monitoring systems ....................................................................................................................... 12 Further recommendations ................................................................................................................. 15 Improving the prevention at the workplace ................................................................................... 15 The importance of allergens .......................................................................................................... 20 Being prepared for outbreaks of serious diseases ........................................................................ 22 Sector level .................................................................................................................................... 22 National level ................................................................................................................................. 23 European level .............................................................................................................................. 24 References ........................................................................................................................................ 25 2 European Agency for Safety and Health at Work — EU-OSHA Biological agents and prevention of work-related diseases: a review - Summary Abstract A subset of all microorganisms cause disease(s) in humans (pathogens), and the health effects caused by biological agents have a major impact on public health. Worldwide, an estimated 320,000 workers die annually from work-related infectious diseases, 5,000 of whom in the EU. More insight into and awareness of biological risks is therefore vital for a detailed evaluation of these health effects, including those of combined exposures. This‘ review on work-related diseases due to biological agents’ project, commissioned by EU-OSHA, intended to provide more insight into the problems and to provide information about health effects related to biological agents for policymakers, actors in occupational disease monitoring and recognition, actors at the enterprise level and those in sectoral organisations. The report presents the results of the review, including information on emerging risks, monitoring systems and examples of prevention measures. The views of different parties, workplace practitioners and experts (based on interviews and focus groups), and their converging and diverging views, were included. As biological agents are widespread, several sectors were addressed more specifically: animal-related work, waste and wastewater treatment, healthcare, arable farming, and occupations that involve travelling or exposure to travellers. Recommendations at the European level from the project include harmonisation of monitoring systems with regard to collection of data, the need for better implementation of policy measures to increase their effectiveness, more knowledge exchange, developing reliable and standardised measurement methods for exposure to biological agents, and suggestions for changes in the EU Directive on biological agents. At the national level, the visibility and the approachability of experts should be improved, and the importance of dealing with the workplace risks from biological agents and awareness raising should be emphasised. At the sector and company level, wider approaches for sector-transcending risks and process approaches with a broader scope and higher level solutions should be implemented. An approach similar to a lifecycle approach in chemicals management could be adopted that includes all steps and tasks of a worker (locally), seeing all possible risks that the worker encounters. A combined risk approach (taking a broader scope and including more (diverse) risks (biological risks, physical risks, chemical risks, and/or risks from biological agents) would emphasise the importance of workplace risk assessment. More general, broader prevention policies and measures that also protect workers from exposure to biological agents should be implemented to tackle unintentional exposures. Executive summary This project, commissioned by EU-OSHA, intended to provide more insight into the health problems encountered by workers that are exposed to biological agents and the challenges to their employers. It also aimed to provide information on structured approaches to recognising and preventing the effects of biological agents that may support the work of policymakers, actors in occupational disease recognition and reporting, actors at the enterprise level and those in sectoral organisations. Definitions and scope of the project Directive 2000/54/EC on the protection of workers from risks related to exposure to biological agents at work defines ‘biological agents’ as micro-organisms, including those which have been genetically modified, cell cultures and human endoparasites, which may be able to provoke any infection, allergy or toxicity. It goes on to define ‘micro-organism’ as a microbiological entity, cellular or non-cellular, capable of replication or of transferring genetic material. This research project uses a wider definition of biological agents, namely: microorganisms and carriers of plant or animal origin that can cause adverse health effects in workers, and that can be divided into two groups: living (micro)organisms (such as bacteria, viruses, fungi, yeasts and prions) and substances or structures that originate from living or dead organisms (such as exotoxins, endotoxins, glucans, mycotoxins and allergens). Only a small subset