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Occupational Health Services Convention, 1985 (No. 161) - North Macedonia (RATIFICATION: 1991)

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Previous comments: C.13, C.119, C.136, C.139, C.148, C.155, C.161, C.162 and C.187

In order to provide a comprehensive view of the issues relating to the application of the ratified Conventions on Occupational Safety and Health (OSH), the Committee considers it appropriate to examine Conventions Nos 13 (white lead), 45 (underground work (women)), 119 (guarding of machinery) 136 (benzene), 139 (occupational cancer), 148 (air pollution, noise and vibration), 155 (OSH), 161 (occupational health services), 162 (asbestos) and 187 (promotional framework for OSH) together.
Legislative developments and application in practice of Conventions Nos 13, 119, 136, 139, 148, 155, 161, 162 and 187. The Committee notes the information provided by the Government on the recent legislative measures taken in consultation with the employers’ and workers’ organizations, including the amendment or adoption of new Rulebooks on safety and health. It also notes the Government’s indication that consultations have been held with government institutions, employers’ and workers’ organizations, as well as OSH experts, for the drafting of a new regulation on occupational safety and health in manual handling of loads, as well as a new law on occupational safety and health. The Committee also notes the information provided by the Government in its report on the number of inspections carried out, violations detected, and sanctions imposed. The Committee requests the Government to continue to provide information on the application in practice of the ratified Conventions on OSH, including the number, nature and cause of the occupational accidents and diseases notified, as well as information on the inspection activities carried out, including the number of inspections conducted, violations detected, and penalties imposed.

A. General Provisions

Occupational Safety and Health Convention, 1981 (No. 155) and Promotional Framework for Occupational Safety and Health Convention, 2006 (No. 187)

The Committee notes the information provided by the Government on Article 5(a),(b), (c), (d) and (e),Article 10,Article 11(a), (b), (d) and (f), and Article 14 of Convention No. 155, as well as Article 2(2) and Article 4 of Convention No. 187, which respond to the Committee’s previous requests.
Article 2(3) of Convention No. 187. Ratification of relevant OSH Conventions of the ILO. Further to its previous comments, the Committee notes the information provided by the Government on the initiatives and procedures taken in consultation with employers’ and workers’ organizations for the possible ratification of the Safety and Health in Construction Convention, 1988 (No. 167), the Safety and Health at Work in Mines Convention, 1955 (No. 176) and the Safety and Health in Agriculture Convention, 2001 (No. 184), including the conduct of gap analyses of the legislation in relation to the standards provided for by these Conventions. It also notes the Government’s indication that the discussion on the possible ratification of these Conventions is on the agenda of the next session of the tripartite Economic and Social Council. The Committee requests the Government to continue to provide information on the consideration given to the ratification of Conventions Nos. 167, 176 and 184, including progress made in this regard. It also requests the Government to provide information on the consultations held in that respect in the Economic and Social Council.
Articles 4, 6, 7 and 15 of Convention No. 155 and Article 3 of Convention No. 187. National policy on OSH. Further to its previous comments, the Committee notes the Government’s indications that, in accordance with section 43(2) of the OSH Law of 2007, the National Council for Safety and Health at Work (OSH Council) examines and makes recommendations on the situation in the field of OSH, the development of OSH laws and regulations, policies to prevent and reduce occupational accidents and diseases and the OSH programme. The Council meets at least three times a year.
The Committee notes the Government’s indications that the Strategies for Safety and Health at Work for 2020 and 2021–25, and its corresponding Action Plans, were prepared in coordination with the OSH Council, as well as with employers’ and workers’ organizations and relevant OSH experts. Implementation of the Strategy for 2020 included the initiation of consultations for the amendment of the OSH Law, training activities on the prevention of occupational risks carried out by the State Labour Inspectorate and various workers’ organizations, awareness-raising activities in the field of OSH carried out by the Institute of Occupational Medicine and university institutions and research activities for the prevention of work-related stress. The review and evaluation process of the OSH Strategy 2020 was carried out within the OSH Council. Several areas for improvement were identified, including mechanisms for the notification of occupational accidents and diseases and the effective implementation of the National Programme for the Elimination of Diseases caused by Asbestos.
The Government indicates that the priorities of the OSH Strategy for 2021–25 include the improvement of the OSH legal framework and the implementation of OSH measures to respond to existing and emerging risks. The OSH Strategy for 2021–25 focuses on risk prevention, awareness-raising and the participation and cooperation of relevant OSH actors, including government institutions, employers’ and workers’ organizations, occupational medicine and educational institutions. The Committee requests the Government to continue to provide information on the implementation and periodic review of the OSH strategies, in consultation with employers’ and workers’ organizations. In this regard, it requests the Government to indicate the results of these reviews including the main problems identified, the methods for addressing them and the priorities for action established.
Article 11(c) and (e) of Convention No. 155. Establishment and application of procedures for the notification of occupational accidents and diseases and production and publication of annual statistics. Further to its previous comments, the Committee notes that under section 36 of the OSH Law, the employer has the obligation to immediately, and at the latest within 48 hours after the event, notify the labour inspector and the president of the trade union organization of any deaths, collective accidents or injuries at work and of any phenomenon that poses an immediate danger to the safety of workers. The Committee requests the Government to provide further information on the measures taken to progressively carry out the application of procedures for the notification of occupational accidents and diseases by employers, insurance institutions and others directly concerned. It also requests the Government to provide information on the measures taken for the production and publication of annual statistics on occupational accidents and diseases.
Article 12 of Convention No. 155. Obligations for those who design, manufacture, import, provide or transfer machinery, equipment or substances for occupational use. The Committee requests the Government to provide information on the measures taken, in law and in practice, to ensure the responsibilities of those who design, manufacture, import, provide or transfer machinery and equipment for occupational use with regard to the safety and security of concerned persons, as required by Article 12 of the Convention.
Article 5. National programme on OSH. Further to its previous comments, the Committee notes the Government’s indications that the Action Plan for the period 2021–23 for the implementation of the OSH Strategy for 2021–25, has been established in consultation with employers and workers organizations. The documents on the OSH Strategy for 2021–25 and its corresponding plan for the period 2021–23 have been distributed to all relevant OSH entities and have been published on the website of the Ministry of Labour and Social Policy. The Committee further notes that the Action Plan establishes the corresponding time frames for each of the activities, the responsible institutions for each of the activities planned, as well as the monitoring indicators. The Committee requests the Government to provide information on any evaluation carried out of the OSH Action Plan for the period 2021–23 in consultation with the social partners, and on how this evaluation contributes to the formulation of the Action Plan for the subsequent period.

Occupational Health Services Convention, 1985 (No. 161)

The Committee notes the information provided by the Government on Article 5 of the Convention on functions of occupational health services, which responds to the Committee’s previous requests.
Article 1(a)(ii) of the Convention. Adaptation of work to the capabilities of workers. Further to its previous comments, the Committee notes that the Government indicates that, among its functions, the Institute of Public Health proposes and applies the criteria for the assessment of workers’ capacity to work required by other regulations. It also notes that under section 20 of the OSH Law of 2007, authorized health institutions are responsible for submitting proposals on safety measures and for consulting on the selection of more suitable work tasks. The Committee requests the Government to provide further information on how the criteria proposed by the Institute of Public Health on the assessment of workers’ capacity to work are taken into account by occupational health services when advising employers, workers and their representatives in undertakings on the adaptation of work to the capabilities of workers in the light of their state of physical and mental health.
Articles 2 and 4. Coherent national policy on occupational health services in consultation with the most representative organizations of employers and workers and measures taken to give effect to the provisions of the Convention. In response to its previous comments, the Committee notes that the Government indicates that (i) representative organizations of employers and workers are consulted in the framework of the tripartite OSH Council and Economic and Social Council; (ii) in accordance with section 43(2) of the OSH Law of 2007, the OSH Council examines, issues opinions and recommendations and continuously reviews the national occupational safety and health strategies and their action plans, as well as the development of OSH laws and regulations; (iii) the review of the implementation of strategic priority No. 2 of the National Strategy for Safety and Health 2021–25 and its Action Plan for Safety and Health at Work 2021–23 concerning the protection of workers’ health highlights the need to improve both public and private occupational health services, in terms of the coverage of occupational health services, the functions they perform, the quality of the services provided and the surveillance of workers’ health; and (iv) under section 23 of the Law on Health Care, the Institute of Public Health, as coordinator of the national Network of Occupational Health, including public and private occupational health services, provides methodological and expert advice to occupational health services. The Committee requests the Government to provide information on the measures taken to ensure the effective implementation of the national OSH strategies and their action plans, with respect to occupational health services, including the progress made in addressing the deficiencies identified.
Article 3. Progressive development of occupational health services for all workers. In response to its previous comments, the Committee notes that the Government indicates that work activities excluded from the OSH Law of 2007 are covered by occupational health services provided by different State agencies and ministries including the Ministry of Health, the State Sanitary and Health Inspectorate, the Pension and Disability Committees from the Pension and Disability Insurance Fund and the army headquarters. The Government also indicates that the Institute of Public Health has initiated public health interventions in cooperation with the Ministry of Health and the Ministry of Labour and Social Policy to increase the coverage of occupational health services for vulnerable groups of workers, including workers in the informal economy, and adds that there is still a need for further development of occupational health services in order to improve their coverage for all workers in practice, including young workers, older workers, women workers, workers in high-risk sectors such as construction, agriculture, mining and health, as well as workers in small and medium-sized enterprises, migrant workers and workers in the informal economy. The Committee requests the Government to continue to provide information on the measures taken to ensure the progressive development of occupational health services for all workers in practice.
Articles 7, 9 and 10. Organization and conditions of operation for occupational health services. With reference to its previous comments, the Committee notes that the Government indicates that: (i) occupational health services are an integral part of the country’s healthcare system; (ii) the occupational health network, composed of public and private healthcare facilities, is coordinated by the Institute of Public Health, which has a multidisciplinary approach; (iii) according to the data from the Ministry of Health, there are 52 authorized occupational health facilities with 71 occupational health specialists; (iv) under section 7 of the OSH Law of 2007, occupational health services shall cooperate with the other services in the undertaking; and (v) it is necessary to establish coordination mechanisms between occupational health services and other services with health competencies. The Committee requests the Government to provide information on the measures taken to ensure adequate cooperation and co-ordination between occupational health services and, as appropriate, other bodies concerned with the provision of health services.
Article 15. Occupational health services to be informed of any known factors which may affect the health of workers. The Committee requests the Government to provide information on the measures taken to ensure that occupational health services are informed of cases of ill health among workers and of absence from work for health reasons, so as to be able to identify whether there is any link between the reasons for ill health or absence and any health risks that may be present in the workplace.

B. Protection against specific risks

White Lead (Painting) Convention, 1921 (No. 13)

Article 5, Part III(a). Notification of cases of lead poisoning. The Committee refers to its comment above on Article 11(c) of Convention No. 155.

Guarding of Machinery Convention, 1963 (No. 119)

The Committee notes the information provided by the Government concerning Articles 12 and 14 of the Convention, which responds to the Committee’s previous request.
Article 1(3) of the Convention. Application of the provisions of the Convention to road and rail vehicles and to mobile agricultural machinery. The Committee once again requests the Government to provide information on any measures taken or envisaged to ensure the effective application of the provisions of the Convention to road and rail vehicles and to mobile agricultural machinery.
Articles 2 and 4. Prohibition of the sale, hire, transfer in any other manner and exhibition of machinery of which the dangerous parts are without appropriate guards. Recalling once more that the objective of Article 2 of the Convention is to guarantee that machines are safe before they are operated or in use, the Committee, once again, requests the Government to provide information on any measures taken or envisaged to ensure that the sale and hire of machinery of which the dangerous parts specified in Article 2(3) and (4) are without appropriate guards shall be prohibited by national laws or regulations or prevented by other equally effective measures.
Article 3(3). Sale or transfer of machinery for storage, scrapping or reconditioning. The Committee, once again, requests the Government to provide information on measures taken or envisaged to give effect to Article 3 of the Convention.
Article 10. Measures establishing the employers’ obligation to bring relevant national legislation to the notice of workers and workers’ instructions. The Committee requests the Government to indicate how employers give notice to workers and instruct them regarding the dangers arising, and the precautions to be observed, in the use of machinery and establish and maintain environmental conditions so as not to endanger workers covered by the Convention.

Benzene Convention, 1971 (No. 136)

Legislation. With reference to its previous comments, the Committee notes the information provided by the Government on the measures giving effect to the Convention set out in the Rulebook on the minimum requirements for safety and health at work for employees from risks related to exposure to carcinogens, mutagens or substances toxic to the reproductive system No. 110 of 2010.
The Committee also notes the information provided by the Government on the measures set out in the Rulebook on the minimum requirements for occupational safety and health of employees from risks related to exposure to chemical substances, published in the Official Gazette No. 46 of 2010. It notes the prohibitions on the production and use of benzene established in Appendix No. 3, as well as the binding limit value for occupational exposure to benzene of 1 ppm established in Appendix No. 1 of this Rulebook. Lastly, it notes the Government’s indication that the State Labour Inspectorate together with the State Sanitary and Health Inspectorate are the authorities competent to supervise the compliance of the Rulebooks. The Committee notes this information which responds to its previous request.

Occupational Cancer Convention, 1974 (No. 139)

The Committee notes the information provided by the Government concerning Article 6(a) and (b) of the Convention on consultations with the most representative organizations of employers and workers concerned and bodies in charge of ensuring compliance with the provisions of the Convention, which responds to the Committee’s previous request.
Article 1(1) of the Convention. Periodic determination of carcinogenic substances and agents to which occupational exposure shall be prohibited or made subject to authorization or control.The Committee requests the Government to indicate the measures taken to ensure that the carcinogenic substances and agents to which occupational exposure shall be prohibited or made subject to authorisation or control is periodically determined taking into account the latest information contained in the codes of practice or guides which may be established by the ILO, as well as information from other competent bodies.
Article 5. Medical examination and health supervision. Further to its previous comments, the Committee notes the Government indications of the requirements related to health examination prior to and during the employment relationship (section 1 of the Decree on the type, method, scope and price list of health examinations of employees No. 60 of 2013).
It also notes the Government’s indication that under section 16(2) of the Rulebook on the minimum requirements for safety and health at work for employees from risks related to exposure to carcinogens, mutagens or substances toxic to the reproductive system of 2010, workers should be provided with information and advice on the subsequent monitoring of health conditions after the end of exposure. It further notes the Government’s indication that medical examinations after termination of employment are not frequently carried out in practice. The Committee once again requests the Government to provide information on the measures adopted to ensure that workers exposed to carcinogenic substances and agents are provided with medical examinations or biological or other tests or investigations after the period of employment, to evaluate and supervise their state of health in relation to occupational hazards, in accordance with Article 5 of the Convention.

Working Environment (Air Pollution, Noise and Vibration) Convention, 1977 (No. 148)

The Committee notes the information provided by the Government, in response to its previous request, on the measures to give effect to Articles 1(2) and (3), 7(2), (1) and (2), 11(3) and 12 of the Convention.
Article 8(3). Criteria for determining the hazards of exposure to air pollution, noise and vibration and exposure limits.The Committee requests the Government to provide information regarding the manner in which it is ensured that criteria and exposure limits are revised regularly in the light of current national and international knowledge and data, taking into account as far as possible any increase in occupational hazards resulting from simultaneous exposure to several harmful factors at the workplace, in accordance with Article 8(3) of the Convention.
Article 12. Notification to the competent authority.The Committee requests the Government to provide information regarding the measures taken or envisaged to give full effect to this provision of the Convention in respect of noise and vibration.

Asbestos Convention, 1986 (No. 162)

Article 3 of the Convention. Protection of workers against health hazards due to occupational exposure to asbestos. With regard to its previous comment on the implementation of the prohibition of asbestos established in the List of Prohibition and Restrictions for Use of Chemicals No. 57 of 2011, the Committee notes the information provided by the Government on the enforcement activities conducted by the State Labour Inspectorate and information and awareness activities carried out. It also notes the information provided by the Government on the difficulties encountered in the implementation of the prohibition of asbestos, including (i) the lack of knowledge and information of employers regarding their obligations in the implementation of the Rulebook on minimum requirements for safety and health of employees from the risks associated with exposure to asbestos at work (including obligations on measurements of asbestos fibres, on the training of employees and issuance of certificates to the employer for competency to work with asbestos materials) and (ii) the number of workers in the informal economy who perform activities with asbestos.
In this regard, the Committee notes the information provided by the Government on the considerable number of workers who work with asbestos comprising employees working in the maintenance and demolition of older buildings built with materials containing asbestos in the storage and transportation of asbestos waste and in the maintenance of household appliances and motor vehicles containing parts of asbestos materials. In this context, the Committee requests the Government to continue to provide information on the implementation of measures to protect workers who may be exposed to asbestos in the course of their work, including with respect to the application of Article 13 (employer’s obligation to notify certain types of work involving exposure to asbestos), Article 15 (obligations regarding the limits for the exposure of workers to asbestos), Article 17 (obligations regarding demolition of plants or structures containing asbestos), Article 18 (obligations regarding workers’ clothing and washing facilities), Article 19 (obligations regarding the disposal of waste containing asbestos) and Article 22(1) (medical examinations; measures when continued assignment to work involving exposure to asbestos is found to be medically inadvisable) of the Convention.
Article 4. Consultations with the most representative organizations of employers and workers concerned regarding the measures to be taken to give effect to the provisions of the Convention. Further to its previous comments, the Committee notes the Government’s indication that during 2018 and 2019, the Institute of Occupational Medicine implemented a campaign to strengthen awareness and capacities to deal with the problem of asbestos at the national, local and enterprise levels, within the framework of the National Programme for the Elimination of Diseases Caused by Asbestos.
The Committee further notes that the OSH Strategy for 2021–25 and the OSH Action Plan for the period 2021–23, which have been developed in consultation with employers’ and workers’ organizations, provide for a number of activities, including the revision of limit values, the identification of risk groups of workers, the implementation of the National Programme for the Elimination of Diseases Caused by Asbestos and the preparation of an awareness-raising campaign on the risk of the harmful effects of asbestos in the working environment for different target groups. Taking due note of these measures, the Committee requests the Government to provide information on the results achieved in the activities concerning the protection of workers’ safety and health from asbestos carried out in the framework of the OSH Strategy for 2021–25 and the OSH Action Plan for the period 2021–23, including information on the implementation of the National Programme for the Elimination of Diseases Caused by Asbestos.
Article 21(5). Notification of occupational diseases. Further to its previous comments, the Committee notes the information provided by the Government on issues related to the non-reporting of asbestos-related occupational diseases, including insufficient information on the number of workers with previous exposure to asbestos and the difficulties with the registration of occupational diseases in the Institute of Public Health.
It notes in this respect that the National Programme for the Elimination of Diseases Caused by Asbestos foresees the creation of a register of workers with current and previous exposure to asbestos and an increase in the number of laboratories to carry out measurements of asbestos concentration in the working environment.
In addition, the Committee notes that the Institute of Occupational Medicine developed a methodology for screening of asbestos-related diseases applicable to current and previous occupational exposure, which was applied in a pilot study in 2018 monitoring the effects of previous asbestos exposure of 110 employees of a former asbestos cement production plant. Noting that the improvement of the registration of occupational diseases is one of the most important courses of action within the National Programme for the Elimination of Diseases Caused by Asbestos and the OSH Strategy for 2021–25, the Committee requests the Government to provide information on the progress made with the registration of asbestos related-diseases of workers with previous and current occupational exposure, as well as on the development of a system of notification of occupational diseases caused by asbestos, in conformity with Article 21(5) of the Convention. It also requests the Government to provide information on the number of cases of occupational diseases caused by asbestos identified through the application of the screening methodology developed and notified to the competent authority.

A. Protection in specific branches of activity

Underground Work (Women) Convention, 1935 (No. 45)

The Committee recalls that the ILO Governing Body (at its 334th Session, October–November 2018), on the recommendation of the Standards Review Mechanism (SRM) Tripartite Working Group, classified Convention No. 45 as an outdated instrument, and has placed an item on the agenda of the 112th Session of the International Labour Conference (2024) concerning its abrogation. The Governing Body also requested the Office to follow-up with member States currently bound by Convention No. 45 to encourage the ratification of up-to-date instruments concerning OSH, including but not limited to the Safety and Health in Mines Convention, 1995 (No. 176), and to undertake a campaign to promote the ratification of Convention No. 176. The Committee therefore encourages the Government to follow up the Governing Body’s decision at its 334th Session (October–November 2018) approving the recommendations of the SRM Tripartite Working Group and to consider ratifying the most up-to-date instruments in this subject area.

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The Committee notes with concern that the Government’s report has not been received. It hopes that the next report will contain full information on the matters raised in its previous comments.
Repetition
Article 1(a)(ii) of the Convention. Adaptation of work to the capabilities of workers. Pursuant to its previous comments, the Committee notes the Government’s indication that the Institute of Public Health (the Institute) is the specialized public health institution responsible for the collection, processing and evaluation of health statistics within all areas of health care (Law on Healthcare Records, Official Gazette of Republic of Macedonia No.20/2009). The Institute established a registry in 2014 and is currently collecting and processing data on the operation of the authorized occupational health institutions. An integral part of this registry includes data for advising employers, workers and their representatives of companies that have concluded agreements with authorized occupational health institutions or institutions that otherwise provide services that arise from Law on Occupational Safety and Health (Law on OSH).The Committee requests the Government to provide information on the data gathered by the registry of the Institute, and how effect is given to this Article of the Convention for workers who work in companies which have not concluded an agreement with the authorized occupational health institutions.
Articles 2 and 4. Coherent national policy on occupational health services in consultation with the most representative organizations of employers and workers and measures taken to give effect to the provisions of the Convention. The Committee notes the information in the Government’s report that there are currently no records which refer to consultations with the representative organizations of employers and workers for measures that need to be undertaken in order to protect and promote the health of workers’, as previously requested by the Committee. The Committee recalls that in accordance with Articles 2 and 4 of the Convention, the competent authority shall, both in regard to the formulation, implementation and periodic review of a coherent national policy on occupation health services and the measures taken to give effect to the provisions of the Convention, consult with most representative organizations of employers and workers, where they exist. It further notes that the Occupational Safety and Health Strategy of the Republic of Macedonia (2011–15) is available on the Ministry of Health’s website.The Committee requests the Government to take the appropriate measures to ensure that consultations with the most representative organizations of employers and workers are held, both in regard to the formulation, implementation and periodical review of a coherent national policy on occupational health services and with regard to measures taken to give effect to the provisions of the Convention, and to provide information in this respect.
Article 3. Progressive development of occupational health services for all workers. The Committee notes from the Government’s report under the Working Environment (Air Pollution, Noise and Vibration) Convention, 1977 (No. 148) that activities regulated by special laws, such as the armed forces, the police, and some of the activities of the rescue and protection forces, as well as customs workers, are not covered by the Law on OSH. It also notes the Government’s indication that the Military Medical Centre provides occupational safety and health for the members of the armed forces and that the Polyclinic of the Ministry of Internal Affairs provides services for the employees of that Ministry.The Committee requests the Government to indicate the measures taken or envisaged to ensure the progressive development of occupational health services for all other workers that are not covered by the Law on OSH.
Article 5. Functions of the occupational health service. Noting that the Government has not supplied the information requested in this respect, the Committee once again requests the Government to indicate the specific provisions which give effect to each paragraph under Article 5.
Articles 7, 9 and 10. Organization and conditions of operation for occupational health services. The Committee notes from the Government’s report that the integration of the occupational safety and health functions is presently under analysis to identify the strengths and weaknesses of the actual occupational safety and health system. Pursuant to the decision by the Government on 19 November 2013, proposed by the Committee on Health and Environment, in cooperation with the Institute of Public Health of Republic of Macedonia, data is being collected on performed risk assessments, the number of workplaces under risk, the number of exposed workers and equipment owned by these institutions, in order to be able to perform the periodic measurements of the hazards in the working environment. The Committee notes the Government’s indication that while the analysis should identify the strengths and weaknesses of the OSH system, in the past three years, the largest occupational health institutions have not submitted their work reports, although a request by the Minister of Health was delivered in April of this year.The Committee requests the Government to provide information on the outcome of the analysis of the performed risk assessments. It reiterates its request for the Government to take measures, in law and in practice, to ensure the full application of Articles 7, 9 and 10 concerning the organisation and conditions of operation of occupational health services and to provide information in this respect.
Article 15. Occupational health services to be informed of any known factors which may affect the workers’ health. The Committee notes that Occupational Health Services shall be notified of any identified risks at the workplace through referrals for preventive health examinations and that sick leave, temporary absence from work due to medical reasons, shall be issued by selected physicians who provided integrated health protection services to patients. It further notes that in cases of increased frequency of sick leave, the employer may require data analysis.The Committee requests the Government to provide detailed information on the measures taken to ensure that occupational health services are informed of occurrences of ill health among workers, and absence from work for health reasons, in order to identify whether there is any relation between the reasons for ill health or absence and any health hazards which may be present at the workplace.
Application of the Convention in practice. The Committee notes from the Government’s report that, in 2013, labour inspectors in the area of occupational safety and health performed a total of 10,699 regular inspection supervisions; 4,167 control inspection supervisions, and 1,338 inspection supervisions based on injuries reported at work. In the same year, labour inspectors adopted 3,698 decisions regarding irregularities and deficiencies within specified deadlines out of 15,687 deficiencies identified. The Committee notes that most of the identified deficiencies concerned mandatory health examinations of employees in the authorized health institutions in the field of occupational medicine, and that the third leading cause was failure to conduct training of workers in occupational safety and health. Nonetheless, the Committee notes the Government’s statement that identified deficiencies are in decline compared to 2012 and that the inspections indicate the increased awareness of employers regarding safety at work and the safety of each employee.The Committee requests the Government to continue to give a general appreciation of the manner in which the Convention is applied in the country and to provide relevant statistics.

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The Committee notes that the Government’s report has not been received. It hopes that the next report will contain full information on the matters raised in its previous comments.
Repetition
Article 1(a)(ii) of the Convention. Adaptation of work to the capabilities of workers. Pursuant to its previous comments, the Committee notes the Government’s indication that the Institute of Public Health (the Institute) is the specialized public health institution responsible for the collection, processing and evaluation of health statistics within all areas of health care (Law on Healthcare Records, Official Gazette of Republic of Macedonia No.20/2009). The Institute established a registry in 2014 and is currently collecting and processing data on the operation of the authorized occupational health institutions. An integral part of this registry includes data for advising employers, workers and their representatives of companies that have concluded agreements with authorized occupational health institutions or institutions that otherwise provide services that arise from Law on Occupational Safety and Health (Law on OSH). The Committee requests the Government to provide information on the data gathered by the registry of the Institute, and how effect is given to this Article of the Convention for workers who work in companies which have not concluded an agreement with the authorized occupational health institutions.
Articles 2 and 4. Coherent national policy on occupational health services in consultation with the most representative organizations of employers and workers and measures taken to give effect to the provisions of the Convention. The Committee notes the information in the Government’s report that there are currently no records which refer to consultations with the representative organizations of employers and workers for measures that need to be undertaken in order to protect and promote the health of workers’, as previously requested by the Committee. The Committee recalls that in accordance with Articles 2 and 4 of the Convention, the competent authority shall, both in regard to the formulation, implementation and periodic review of a coherent national policy on occupation health services and the measures taken to give effect to the provisions of the Convention, consult with most representative organizations of employers and workers, where they exist. It further notes that the Occupational Safety and Health Strategy of the Republic of Macedonia (2011–15) is available on the Ministry of Health’s website. The Committee requests the Government to take the appropriate measures to ensure that consultations with the most representative organizations of employers and workers are held, both in regard to the formulation, implementation and periodical review of a coherent national policy on occupational health services and with regard to measures taken to give effect to the provisions of the Convention, and to provide information in this respect.
Article 3. Progressive development of occupational health services for all workers. The Committee notes from the Government’s report under the Working Environment (Air Pollution, Noise and Vibration) Convention, 1977 (No. 148) that activities regulated by special laws, such as the armed forces, the police, and some of the activities of the rescue and protection forces, as well as customs workers, are not covered by the Law on OSH. It also notes the Government’s indication that the Military Medical Centre provides occupational safety and health for the members of the armed forces and that the Polyclinic of the Ministry of Internal Affairs provides services for the employees of that Ministry. The Committee requests the Government to indicate the measures taken or envisaged to ensure the progressive development of occupational health services for all other workers that are not covered by the Law on OSH.
Article 5. Functions of the occupational health service. Noting that the Government has not supplied the information requested in this respect, the Committee once again requests the Government to indicate the specific provisions which give effect to each paragraph under Article 5.
Articles 7, 9 and 10. Organization and conditions of operation for occupational health services. The Committee notes from the Government’s report that the integration of the occupational safety and health functions is presently under analysis to identify the strengths and weaknesses of the actual occupational safety and health system. Pursuant to the decision by the Government on 19 November 2013, proposed by the Committee on Health and Environment, in cooperation with the Institute of Public Health of Republic of Macedonia, data is being collected on performed risk assessments, the number of workplaces under risk, the number of exposed workers and equipment owned by these institutions, in order to be able to perform the periodic measurements of the hazards in the working environment. The Committee notes the Government’s indication that while the analysis should identify the strengths and weaknesses of the OSH system, in the past three years, the largest occupational health institutions have not submitted their work reports, although a request by the Minister of Health was delivered in April of this year. The Committee requests the Government to provide information on the outcome of the analysis of the performed risk assessments. It reiterates its request for the Government to take measures, in law and in practice, to ensure the full application of Articles 7, 9 and 10 concerning the organisation and conditions of operation of occupational health services and to provide information in this respect.
Article 15. Occupational health services to be informed of any known factors which may affect the workers’ health. The Committee notes that Occupational Health Services shall be notified of any identified risks at the workplace through referrals for preventive health examinations and that sick leave, temporary absence from work due to medical reasons, shall be issued by selected physicians who provided integrated health protection services to patients. It further notes that in cases of increased frequency of sick leave, the employer may require data analysis. The Committee requests the Government to provide detailed information on the measures taken to ensure that occupational health services are informed of occurrences of ill health among workers, and absence from work for health reasons, in order to identify whether there is any relation between the reasons for ill health or absence and any health hazards which may be present at the workplace.
Application of the Convention in practice. The Committee notes from the Government’s report that, in 2013, labour inspectors in the area of occupational safety and health performed a total of 10,699 regular inspection supervisions; 4,167 control inspection supervisions, and 1,338 inspection supervisions based on injuries reported at work. In the same year, labour inspectors adopted 3,698 decisions regarding irregularities and deficiencies within specified deadlines out of 15,687 deficiencies identified. The Committee notes that most of the identified deficiencies concerned mandatory health examinations of employees in the authorized health institutions in the field of occupational medicine, and that the third leading cause was failure to conduct training of workers in occupational safety and health. Nonetheless, the Committee notes the Government’s statement that identified deficiencies are in decline compared to 2012 and that the inspections indicate the increased awareness of employers regarding safety at work and the safety of each employee. The Committee requests the Government to continue to give a general appreciation of the manner in which the Convention is applied in the country and to provide relevant statistics.

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Article 1(a)(ii) of the Convention. Adaptation of work to the capabilities of workers. Pursuant to its previous comments, the Committee notes the Government’s indication that the Institute of Public Health (the Institute) is the specialized public health institution responsible for the collection, processing and evaluation of health statistics within all areas of health care (Law on Healthcare Records, Official Gazette of Republic of Macedonia No.20/2009). The Institute established a registry in 2014 and is currently collecting and processing data on the operation of the authorized occupational health institutions. An integral part of this registry includes data for advising employers, workers and their representatives of companies that have concluded agreements with authorized occupational health institutions or institutions that otherwise provide services that arise from Law on Occupational Safety and Health (Law on OSH). The Committee requests the Government to provide information on the data gathered by the registry of the Institute, and how effect is given to this Article of the Convention for workers who work in companies which have not concluded an agreement with the authorized occupational health institutions.
Articles 2 and 4. Coherent national policy on occupational health services in consultation with the most representative organizations of employers and workers and measures taken to give effect to the provisions of the Convention. The Committee notes the information in the Government’s report that there are currently no records which refer to consultations with the representative organizations of employers and workers for measures that need to be undertaken in order to protect and promote the health of workers’, as previously requested by the Committee. The Committee recalls that in accordance with Articles 2 and 4 of the Convention, the competent authority shall, both in regard to the formulation, implementation and periodic review of a coherent national policy on occupation health services and the measures taken to give effect to the provisions of the Convention, consult with most representative organizations of employers and workers, where they exist. It further notes that the Occupational Safety and Health Strategy of the Republic of Macedonia (2011–15) is available on the Ministry of Health’s website. The Committee requests the Government to take the appropriate measures to ensure that consultations with the most representative organizations of employers and workers are held, both in regard to the formulation, implementation and periodical review of a coherent national policy on occupational health services and with regard to measures taken to give effect to the provisions of the Convention, and to provide information in this respect.
Article 3. Progressive development of occupational health services for all workers. The Committee notes from the Government’s report under the Working Environment (Air Pollution, Noise and Vibration) Convention, 1977 (No. 148) that activities regulated by special laws, such as the armed forces, the police, and some of the activities of the rescue and protection forces, as well as customs workers, are not covered by the Law on OSH. It also notes the Government’s indication that the Military Medical Centre provides occupational safety and health for the members of the armed forces and that the Polyclinic of the Ministry of Internal Affairs provides services for the employees of that Ministry. The Committee requests the Government to indicate the measures taken or envisaged to ensure the progressive development of occupational health services for all other workers that are not covered by the Law on OSH.
Article 5. Functions of the occupational health service. Noting that the Government has not supplied the information requested in this respect, the Committee once again requests the Government to indicate the specific provisions which give effect to each paragraph under Article 5.
Articles 7, 9 and 10. Organization and conditions of operation for occupational health services. The Committee notes from the Government’s report that the integration of the occupational safety and health functions is presently under analysis to identify the strengths and weaknesses of the actual occupational safety and health system. Pursuant to the decision by the Government on 19 November 2013, proposed by the Committee on Health and Environment, in cooperation with the Institute of Public Health of Republic of Macedonia, data is being collected on performed risk assessments, the number of workplaces under risk, the number of exposed workers and equipment owned by these institutions, in order to be able to perform the periodic measurements of the hazards in the working environment. The Committee notes the Government’s indication that while the analysis should identify the strengths and weaknesses of the OSH system, in the past three years, the largest occupational health institutions have not submitted their work reports, although a request by the Minister of Health was delivered in April of this year. The Committee requests the Government to provide information on the outcome of the analysis of the performed risk assessments. It reiterates its request for the Government to take measures, in law and in practice, to ensure the full application of Articles 7, 9 and 10 concerning the organisation and conditions of operation of occupational health services and to provide information in this respect.
Article 15. Occupational health services to be informed of any known factors which may affect the workers’ health. The Committee notes that Occupational Health Services shall be notified of any identified risks at the workplace through referrals for preventive health examinations and that sick leave, temporary absence from work due to medical reasons, shall be issued by selected physicians who provided integrated health protection services to patients. It further notes that in cases of increased frequency of sick leave, the employer may require data analysis. The Committee requests the Government to provide detailed information on the measures taken to ensure that occupational health services are informed of occurrences of ill health among workers, and absence from work for health reasons, in order to identify whether there is any relation between the reasons for ill health or absence and any health hazards which may be present at the workplace.
Application of the Convention in practice. The Committee notes from the Government’s report that, in 2013, labour inspectors in the area of occupational safety and health performed a total of 10,699 regular inspection supervisions; 4,167 control inspection supervisions, and 1,338 inspection supervisions based on injuries reported at work. In the same year, labour inspectors adopted 3,698 decisions regarding irregularities and deficiencies within specified deadlines out of 15,687 deficiencies identified. The Committee notes that most of the identified deficiencies concerned mandatory health examinations of employees in the authorized health institutions in the field of occupational medicine, and that the third leading cause was failure to conduct training of workers in occupational safety and health. Nonetheless, the Committee notes the Government’s statement that identified deficiencies are in decline compared to 2012 and that the inspections indicate the increased awareness of employers regarding safety at work and the safety of each employee. The Committee requests the Government to continue to give a general appreciation of the manner in which the Convention is applied in the country and to provide relevant statistics.

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Article 1(a)(ii) of the Convention.Adaptation of work to the capabilities of workers. The Committee notes that section 3 of the Law on Occupational Safety and Health (Official Gazette of RM br.92/07) (Law on OSH) defines an “authorized health institution” as a health institution specialized in occupational medicine in accordance with the regulations in the field of health, engaged by the employer to provide health care at work. The Committee asks the Government to indicate the measures taken or envisaged to ensure that occupational health services advise the employer, the workers and their representatives, on the adaptation of work to the capabilities of workers.

Articles 2 and 4.Coherent national policy on occupational health services in consultation with the most representative organizations of employers and workers. The Committee notes that section 4 of the Law on OSH states that the Government is to adopt a programme for OSH which lays down the strategy for development of OSH in terms of protection of the life, health and working ability of the employees and prevention from workplace injuries and occupational and other diseases related to work. The Government indicates that despite the commitment for development of the programme and strategy for occupational and professional safety and health, in accordance with the Programme for Preventive Healthcare in the Republic of Macedonia for 2009, there is still no plan for the progressive development of occupational health services. The document is now expected to be prepared by the newly appointed Council for Occupational Safety and Health. The Committee asks the Government to provide further information on the formulation, implementation and periodical review of a coherent national policy on occupational health services (Article 2); to indicate the consultations that have taken place with the most representative organizations of employers and workers on the measures to be taken to give effect to the provisions of this Convention (Article 4); and to provide further information on the Council for Occupational Safety and Health.

Article 3.Progressive development of occupational health services for all workers. The Committee notes that section 2 of the Law on OSH specifies that the provisions of the Law apply in all spheres of the public and private sector, for all persons insured against workplace injury or occupational diseases in accordance with the regulations on pension, disability and health insurance, as well as for all other persons involved in the work processes, but that the provisions of the Law do not apply to activities regulated by special regulation (armed forces, police, etc.) or to domestic workers. The Committee asks the Government to indicate the measures taken or envisaged to ensure the progressive development of occupational health services for all workers.

Article 5.Functions of the occupational health service. The Committee notes that the primary tasks of the authorized health institution, depending on the type of activity carried out by the employer and the type and level of risk of injury or health impairment at work, are listed under section 20 of the Law on OSH. The Committee asks the Government to indicate the specific provisions which give effect to each requirement under Article 5.

Articles 7, 9 and 10.Organization and conditions of operation for occupational health services. The Committee notes the information provided by the Government which indicates that the staff of the labour medicine services involved in carrying out medical activities related to occupational health care, and professionals working and participating in providing occupational safety services (industrial hygiene and safety), are independent legal entities. The Committee asks the Government to provide further information on the measures taken or envisaged, in law and in practice, to ensure the full application of Articles 7, 9 and 10 concerning the organization and conditions of operation of occupational health services.

Article 15.Occupational health services to be informed of any known factors which may affect the workers’ health. The Committee notes the information that there is no fixed obligation to notify the health care services for fixed work absenteeism and the reasons for determining the causes of impairment of health. The Government indicates that while the employer is not required to notify, there is a legal obligation that the employer be informed of the reason for absence from work (diagnosis of disease) and for any reasonable medical leave from work. The Committee asks the Government to indicate the measures taken or envisaged, in law and in practice, to give full effect to the provisions of Article 15.

Part VI of the report form. Application of the Convention in practice.The Committee asks the Government to give a general appreciation of the manner in which the Convention is applied in the country, and to provide, where such statistics exist, information on the number of workers covered by the legislation, the number and nature of the contraventions reported, and the number, nature and cause of occupational accidents and diseases reported.

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