OSH system at national level – Estonia

Occupational safety and health legislative framework

In Estonia, the Occupational Health and Safety (OSH) Act ^[1], the so-called framework law, is the most fundamental of the occupational health and safety legislations. It covers occupational health and safety requirements for the work of workers, rights and responsibilities of employers about employees' health in establishing and ensuring a safe work environment and organizing occupational health and safety at enterprise and national level. More than twenty regulations have been adopted under the Occupational Health and Safety Act, determining specific requirements for workplaces and work equipment and different work operations ^[2]. The regulations comprise requirements of the Directives of the European Council, such as the framework Council Directive 89/391/EEC ^[3], on account of which the requirements in force in Estonia are similar to those in place in other EU countries.

National OSH strategy and programmes

Occupational health and safety activities are regulated in two policies, which are in line with the EU Occupational Safety and Health (OSH) Strategic Framework 2014-2020. Both strategies are implemented by the Ministry of Social Affairs (Sotsiaalministeerium)^[4]. The Ministry has invited the Labour Inspectorate (Tööinspektsioon)^[5], Health Board (Terviseamet)^[6], Health Insurance Fund (Eesti haigekassa)^[7], Social Insurance Board (Sotsiaalkindlustusamet ) ^[8], National Institute for Health Development (Tervise Arengu Instituut)^[9] and the Society of Occupational Health Physicians (Eesti töötervisehoiuarstide selts)^[10] to draw up the strategies.

The Welfare Development Plan 2016–2023^[11] (WDP) (original version: Heaolu arengukava 2016-2023^[12]) focuses on the strategic objectives of labour market (incl. occupational health and safety), social protection, gender equality, and equal treatment policies for 2016–2023. The priority of the WDP is to support participation in the workforce and a long-term working life. One of the main objective of the WDP is high employment rate and a high-quality working life. The related sub-objective is: "Correlation between the demand and supply of the workforce ensures a high level of employment, and high-quality working conditions support long-term participation in working life". This sub-objective also covers all the relevant occupational health and safety policy instruments.The related measure in the implementation plan: "Maintaining employees' work ability, keeping them in the labour market, and bringing people with reduced work ability into the labour market".

The objectives of the WDP are:

1. High employment rate and a high quality working life
2. Reducing social inequalities and poverty, gender equality, and greater social inclusion

Whereas sub-objective 1 : "Correlation between the demand and supply of the workforce ensures a high level of employment, and high quality working conditions support long-term participation in working life".

The main OSH related policy intsruments are:

1. the capacity of working life participants must be increased for the implementation of rules for working environment, including for coping with new working environment risks, and for the prevention of the employee’s loss of ability to work;
2. the monitoring of the work environments shall be enhanced to identify and eliminate violations related to the work environment;
3. the legal framework regulating the working environment must be made clearer and compatible with the changing labour market situation and economy;
4. monitoring, outreach, and counselling activities must be made more efficient;
5. employers must be supported in improving working environments and conditions and in preventing employees’ loss of work ability, including reducing the employer’s occupational health and safety management burden;
6. greater attention shall be paid to shaping the work safety culture for the participants in working life, including compiling a risk analysis, assessment of new risks, and to the safety in using flexible forms of work;
7. the possibility of developing a compensation system for an incapacity for work shall be analysed to motivate preventing work interruptions and to encourage returning to work, including analysing the principles of the occupational health system and for compensating incapacity for work due to the employee’s health damage in order to enable early intervention.

The National Health Plan 2009-2020^[13] (NHP) (original version: Rahvastiku tervise arengukava 2009–2020^[14]) focuses on OSH in Sector III (Healthy living, working and learning environment) and in sub-objective (SO) 3 (Health risks from the living, working and learning environment are reduced). The goals and activities of the strategy are integrated into the application plan 2013–2016 of the NHP 2009–2020. It is designed to ensure that the people of Estonia live longer, happier, healthier lives. This can only be achieved if everyone works together: not just the people who live in the country, but also the state, local governments and the private and third sectors. NHP provides recommendations and indicates the directions that should be taking to achieve good health. It also assembles a large number of strategic documents which have already been implemented or which are soon to be implemented in other fields that have a role to play in achieving NHPs objective. Following measure was used in the period 2013-2016 to achieve the objectives: "Development of health-supporting working environment and decrease of health risks based on the working environment."

The priorities of the NHP in the field of occupational health are:

• Increasing the awareness of various target groups of the health risks from the living, working and learning environment and measures for management thereof.
• Enhancement of the system of evaluation, management and information of health risks from the living, working and learning environment.
• Enhancement of supervision in the living, working and learning environment.
• Improvement of the organisation of occupational health and significant improvement of the quality of occupational health services and ensuring the availability thereof for all employees.

Evaluation of the strategies is performed regularly:

The WDP is reviewed regularly to provide an overview of the achievement of the objectives of the Development Plan, a report on its fulfilment is compiled each year and a performance report on the implementation of measures and activities is compiled.

The NHP is reviewed:

• annually, including an overview of the activities in the development plan and current management decisions regarding the financing and implementation of activities;
• biennially, including (in addition to current management decisions) also updating of the indicators in the development plan, drafting of a fulfilment report and a decision of the government regarding the previous activities and possible new directions. Biennial updating of the indicators is based on the frequency of the population survey taking place with such frequency;
• every four years a comprehensive evaluation of the National Health Plan and reviewing of objectives is organised.

The former strategy was the Occupational Health and Safety Strategy 2010-2013 ^[15] supplemented by the Plan of Action ^[16]. They were the main guidance documents governing the actions at the national level in Estonia. The Occupational Health and Safety Strategy of Estonia ^[17] consisted of eight chapters and adopts comprehensive approach to well-being at work, taking into account changes in the work environment and working life and emergence of new risks. The Strategy was aimed at improving the quality of working life: its central component was a healthy and safe work environment and its starting point was the prevention of risks and strengthening of the partnership between all structural units dealing with occupational health and safety.

The Strategy had three sub-goals:

1. To sustain and promote workers health and their ability to work;
2. To improve the work environment so that it is possible to work without any risk to health;
3. To establish management systems and work organizations, which support health and safety at work, promoting positive psycho-social micro-climate at enterprises and creating a presumption for raising productivity of work.

Social dialogue

The Ministry of Social Affairs ^[18] is the responsible body for occupational safety and health in Estonia. The policies, strategies, and development programmes for occupational health and safety are discussed in the Advisory Committee of Working Environment. The Committee has representatives from the Ministry as well as from the trade unions and the employers' associations.

Little research has been conducted on the connections between social dialogue and working conditions in Estonia. The main sources of information have been the Working Life Barometer surveys [13], but no analysis on role and impact of social dialogue based on the survey data has been carried out. The available research has concentrated on the issues of social dialogue or working conditions separately and it is difficult to discern connections between these topics. Some issues have been studied in somewhat greater depth, i.e. employee participation, including information and consultation practices and efficiency.

Social dialogue at national level

The Working Environment Council operates within the governance of the Ministry of Social Affairs ^[19]. The Council is a tripartite advisory body comprising 15 members and its main task is to devise proposals and express opinions on the development and implementation of working environment policies.

Following the dissolution of the Occupational Health Centre in 2004, the Centre's executive role in the area of occupational health was assumed by the Health Care Board (the Working Environment Department)^[20]. State supervision regarding compliance with occupational health and safety requirements is the responsibility of the Labour Inspectorate ^[21] which, in terms of its structure and geographical scope of operation, is divided into Northern, Southern, Western and Eastern Inspectorates.

Social partners:

1. The Estonian Trade Union Confederation (Eesti Ametiuhingute Keskliit, EAKL) comprises of 19 branch unions that represent state and municipal government officials, educational workers, health care workers, transport workers (e.g. road, railway, sea and air transport), industrial workers (e.g. energy, light industry, food industry, timber and metal industry) and people employed in the service sector (postal, communication, trade, hotel and cleaning sector workers, etc.). ^[1]
2. The Estonian Employers’ Confederation (Tööandjate Keskliit) represents the largest number of employers in the local employers' organization and covers all economic sectors in Estonia. Within the European social model, the Confederation represents the joint interests of all economic sectors at both state and international levels as well as in dealings with state authorities and employee organizations.^[23]

Social dialogue at sectoral level

In Estonia there are no sectoral committees or boards. However worker representatives often participate in inspection activities and there is a close relationship between the unions (sectoral level) and the Labour Inspectorate^[24].

Social dialogue at enterprise level

According to the Occupational Health and Safety Act^[25], a work environment council must be set up in all enterprise with 50 or more employees. A work environment council is an internal institution, which contains an equal number both of employer’s and employees representatives and where issues related to occupational health and safety are discussed.

OSH infrastructure

OSH infrastructure scheme

In Estonia, the Ministry of Social Affairs^[26] takes the lead on governing occupational safety and health matters. Both the national labour inspection and occupational health affairs are under the jurisdiction of the Ministry (Figure 1) which also has responsibility for strategic level planning and follow-up of implementation.

National competent bodies

OSH authorities and inspection services

In the Estonian occupational health and safety system, the Ministry of Social Affairs^[28] is the executive authority which regulates the entire field, whereas two of its structural units (the Working Life Development Department, and the Health Department) are directly involved in occupational health and safety-related policy-making.

The Working Life Development Department is responsible for the overall co-ordination and management of the activities in the field of occupational health and safety. The Working Life Development Department:

• Plans and implements the working environment policy;
• Elaborates regulations on occupational health and safety.

Three Estonian governmental health authorities - Health Protection Inspectorate, Health Care Board and Chemicals Notification Centre are unified in the joint Health Board^[29] in 2010.

In the field of occupational health the Health Board's role is to:

• Participate in the preparation of occupational health programmes and organize their implementation;
• Analyze information concerning occupational illnesses and illness related to the work of *Organize refresher courses for occupational health specialists;
• Register occupational health service providers.

National enforcement of the Occupational Health and Safety Act^[30] and the requirements prescribed in legislation based on this act is carried out by the Labour Inspectorate^[31]. The Labour Inspectorate was reorganized in February 2008: The structure of the central office was changed and the number of local offices was reduced. There are now 131 positions and four (4) departments in the central office (Work Environment, Labour Relations, Communications, Finance and Administration Department). Currently there are four local inspectorates (instead of the previous 14): (1) Ida Inspectorate (Ida- and Lääne-Virumaa), (2) Lõuna Inspectorate (Jõgevamaa, Põlvamaa, Tartumaa, Valgamaa, Viljandimaa, Võrumaa), (3) Lääne Inspectorate (Hiiumaa, Järvamaa, Läänemaa, Pärnumaa, Raplamaa, Saaremaa) and (4) Põhja Inspectorate (Tallinn and Harjumaa).

The Labour Inspectorate^[32] is a government agency operating under the jurisdiction of the Ministry of Social Affairs, and its main functions are to:

• Arrange for the exercise of state supervision in the working environment with respect to compliance with the requirements of legislation regulating occupational health and safety and labour relations and to apply enforcement by the state on the bases and to the extent prescribed by law;
• Exercise market supervision over safety of the personal protective equipment in the use in the working environment and to ensure the protective properties of the equipment at sites of manufacturing and sale;
• Exercise supervision over investigations into occupational accidents and diseases and over the implementation of measures for the prevention of occupational accidents and diseases;
• Investigate fatal and if there is a need, then conduct an analysis of the causes of serious occupational accidents and diseases and analyze their causes;
• Collect statistics of accidents at work and conduct analysis thereof;
• Exercise supervision over the use of genetically modified micro-organisms in closed environments to the extent prescribed by law;
• Take decisions in cases prescribed by law on issuing or withholding approval;
• Carry out administrative proceedings; approve administrative acts and rules;
• Carry out extrajudicial proceeding of misdemeanours to the extent prescribed by law;
• Initiate criminal proceedings and carry out urgent investigative actions;
• Carry out and resolve petitions from individuals on working environment issues;
• Resolve individual labour disputes pursuant to the procedures prescribed by law.

OSH services

Internal OSH services According to the Occupational Health and Safety Act^[33], every company must have a person who functions in the capacity of working environment specialist. A work environment specialist is an engineer competent in matters of the work environment or some other specialist in an enterprise who has received appropriate training on work environment issues and who is authorized by the employer to perform occupational health and safety duties. This person must be familiar with the legislation governing occupational health and safety and who is aware of the company’s work conditions in order to monitor and review them, and adopt measures for reducing the impact of hazards in the working environment. In the absence of a competent person, the employee is required to hire a working environment specialist from outside the enterprise. A working environment specialist co-operates with workers and working environment representatives, the working environment council, workers’ representatives and occupational health care providers. The employer must notify the local office of the Labour Inspectorate^[34] within ten days of this appointment.

A work environment representative is a person elected by employees of the enterprise for a two year's term of office. A work environment representative represents the employees` views in negotiations with the employer on occupational safety and health issues. A work environment representative needs to be elected in enterprises with 10 or more employees. In an enterprise in which more than ten workers work on a shift at the same time or which comprises of several structural units, then workers shall elect one working environment representative for every structural unit or each shift. The tasks of a working environment representative are to:

• Observe that the workers are provided with personal protective equipment;
• Participate in the investigation of an occupational accident or disease;
• Notify the workers and the employer or the employer’s representative of a dangerous situation or deficiencies discovered in the working environment;
• Become familiarized with the instructions and legislation mandatory for workers;
• Monitor that the workers receive necessary knowledge, instructions and training in the field of occupational safety and health.

An enterprise with 50 or more employees must arrange a work environment council. However, according to the Occupational Health and Safety Act ^[35] the Labour Inspectorate [7] has the right to demand that a working environment council be set up in an enterprise with less than fifty workers depending on the risk factors present and the number of occupational accidents and cases of occupational disease within the enterprise. Employer and employee representatives are members of the council in equal parts. This is an internal association where occupational health and safety related issues are resolved. The local agency of the Labour Inspectorate^[36] must be notified of the formation of the supervisory board within ten business days.

The tasks of a working environment council are to:

• Regularly assess the working conditions in the enterprise, document developing problems, make proposals to the employer for the resolution thereof and monitor the implementation of adopted resolutions;
• Participate in the preparation of occupational health and safety strategies of the enterprise;
• Examine the results of internal controls of the working environment in the enterprise;
• Analyse occupational accidents, occupational diseases and other illnesses related to work;
• Assist in the creation of suitable working conditions and work organisation for female workers, minors and disabled workers.

The working environment council communicates its proposals to the employer in writing. If the employer does not consider it possible to undertake these proposals into effect, the employer shall respond to the council in writing within three weeks after receipt of the proposals, providing reasons for these decisions. The working environment councils report their activities in writing to the regional office of the Labour Inspectorate each year at 12 month intervals.

Occupational (external) OSH services According to the OHS Act [1], an occupational health service provider may provide the following occupational health services:

• Conduct risk assessments of the working environment, including the measurement of the parameters of risk factors;
• Medical examination of employees and evaluation of their state of health;
• Organization of medical rehabilitation for employees;
• Provision of advice to employers on the adaptation of work to the abilities and state of health of employees;
• Provision of advice to employers on the selection and use of work equipment and personal protective equipment, and on improvement of working conditions;
• Psychological counselling of employers and employees.

In Estonia, occupational health services are organised on a free market basis. For example, larger companies run their own clinics. In addition, private occupational health clinics also offer their services to enterprises. The Government does not subside the costs of the service in any way. The coverage of service is low – an estimate is 30% ^[37].

The employer’s obligation to organise medical examinations of employees is stated in the Occupational Health and Safety Act ^[38]: An employer is obliged to organise medical examination for employees whose health may be affected in the course of work by some risk factor in the work environment or the nature of work, and to bear the costs of the medical examination. In addition, an employer is obliged to organise a medical examination for employees who work during night time before they start night work as well at regular intervals during work and to bear the costs related to these procedures. The procedure for medical examination is established by the Minister of the Social Affairs [6] and described in the Regulation of the Minister of Social Affairs No 74 “Procedure for Medical examination“. In Annex 1 of the Procedure for Medical examination the list of risk factors in the work environment and the list of the nature of work are set out, and on that basis, a medical examination of employees should be arranged.^[39]

In Estonia, medical examination is provided by an occupational health doctor, who is required to examine the employee’s work place and work arrangement as well. The examination is organised during working hours and both the initial and the periodic medical examinations are at the expense of the employer. Medical examinations for adult employees are arranged every two to three years. The time and need for re-examination is determined by an occupational health doctor.

There are five different types of occupational health professionals in Estonia:

1. Occupational health doctor,
2. (Occupational) health nurse,
3. Occupational hygienist,
4. Ergonomist,
5. Occupational psychologist.

According to the Health Board^[40] in 2012 there are:

• 61 occupational health service providers,
• 101 certified occupational physicians,
• 28 certified occupational health nurses (since 2007 health nurse),
• 31 non-medical service providers included.

In Estonia, there are only external occupational health service providers. There are currently 61 OHS units and around 31 non-medical OHS units.^[41]

External service for technical control The Estonian Technical Surveillance Authority (Tehnilise Järelevalve Amet)^[42] is a governmental organization which aims to help in implementing the national economic policy through achieving improvements in safety, organizing the expedient use of limited resources and increasing the reliability of the products in the field of the manufacturing environment, industrial equipment, railway and electronic communication. The Technical Surveillance Authority intends to function as an effectively operating, competent and reliable regulatory and surveillance authority.

The Authority is divided into three divisions: Electronic Communication Division, Railway Division and Industrial Safety Division. In the field of the industrial safety, the Authority has three departments: Construction and Electricity Department, Technical Department and Chemical and Mining Department.

The aim of the Industrial Safety Division is to develop technical safety and reliability of the products and services. The main areas of activities of the Division of Industrial Safety are: Market surveillance to guarantee product safety, surveillance of industrial plants and installations, and development and support services.

The purpose of the Department of Technical Safety is to guarantee the highest possible standards of safety in its fields of activity. Its tasks of this Department include:

• State supervision of compliance with the requirements of the Pressure Equipment Safety Act^[43], the Gaseous Fuel Safety Act ^[44], the Lifts and Cableway Installations Safety Act^[45], the Machinery Safety Act^[46] and the Building Act^[47];
• State supervision of compliance with the requirements of the Chemicals Act concerning the safety of chemical handling equipment, compliance with the requirements for accounting and notification of chemicals as well as assessments of the hazard categories for enterprises^[48];
• Determination of the causes of breakdowns and accidents in its fields of activity;
• Approval of connections (other than welded connections) used in underground pipe connections;
• Approval of examination guidelines and topics for examination questions for authorities assessing and evaluating the qualifications of individuals.

Compensation and insurance bodies

The applicable basis for occupational disease is defined as a health disorder caused by a risk factor in the work environment mentioned in the list of occupational diseases and enforced through the Occupational Health and Safety Act^[51]. The list of the diseases recognized as occupational diseases is maintained by the Ministry of Social Affairs. In Estonia, occupational accidents and occupational diseases are reported by employers.^[52]

In a case of sickness (which is not related to work) a worker does not receive any compensation from the 1st to 3rd day. Sickness benefit is paid to the insured person starting from the 4th day of illness. From the 4th to 8th day of the insured person’s illness, the sickness benefit shall be paid by the employer and it amounts to 70% of the employee’s average wages. Starting from the 9th day of illness, the sickness benefit (70% of the employee's average wages) is paid by the Health Insurance Fund^[53].

The employer is not required to pay the benefit if the reason for absence leave is: occupational disease, accident at work, accident at work in traffic, complication/illness caused by accident at work, illness or injury during pregnancy. In such cases, sickness benefit is covered by the Estonian Health Insurance Fund^[54] In work-related sickness, the compensation amounts to 100% of the employee's average wages and is paid from the first sickness day.

In Estonia, the employer is required to submit a certificate for incapacity for work or its copy, along with the referral for certificate for incapacity for work and other necessary documents, to the regional department of the Estonian Health Insurance Fund^[55] within seven calendar days after he/she has received a certificate for incapacity for work from the employee (insured person).

Other OSH bodies

Prevention institutes

In Estonia, there are no prevention institutes as unlike the situation in some European countries. However, preventive activities are included and implemented, in the work of the Ministry of Social Affairs and the Labour Inspectorate most commonly through awareness raising campaigns.

Professional associations

Estonian Society of Occupational Health Physicians (Eesti töötervishoiuarstide selts)^[56] The Society was established in the 1990s. Its main activities are to provide additional training to occupational health physicians on current OSH topics, and to arrange workshops and seminars with other specialists, such as family doctors. In addition, the Society works with the Ministry of Social Affairs and the Labour Inspectorate on renewing OSH legislation, and it certifies the Estonian Occupational Health Physicians (the 5 year specialist training is provided by Tartu University and Tallinn Technical University). [29]

Previously there was a professional association for occupational health nurses in Estonia (Estonian Society of Occupational Health Nurses) but that association ceased its activities some years ago. The current status of occupational health nurses in Estonia is unclear, as nowadays, mainly it is general nurses who work in the occupational health services.^[57]

Education and training and awareness raising

Legally required training for OSH specialists

According to the Occupational Health and Safety Act ^[58] an employer is required to provide, at the employer’s expense during working hours, training or in-service training for a working environment representative or for members of the working environment council that is deemed necessary for the performance of his/her obligations.

Working environment representatives and specialists may only be trained by institutions approved and registered by the Ministry of Social Affairs^[59]]. Working environment representatives’ and council members’ training is required to be organized not later than two months from their election or appointment, and refresher training should, in minimum, be provided once in every five year. A refresher course is also required to be provided if 1) significant changes take place in the working environment; 2) technology or work equipment is changed or upgraded at the workplace; 3) significant changes are made to legislation regulating occupational health and safety; 4) a labour inspector deems it necessary; and/or 5) a working environment representative or the working environment council deems it necessary.^[60]

The training for working environment representatives should include following parts:

1. General provisions:
   • Definition of working environment; risks present in working environment; welfare facilities; obligations and rights of employers and employees; occupational accidents and cases of occupational disease (registration, notification, investigation); risk of accident; lability of employers and employees; and state supervision;
2. Organisation of occupational health and safety:
   • At state level: structure in a working environment system; legal bases;
   • At enterprise level: working environment specialist; working environment representative; working environment council; internal control, activity plan for occupational health and safety; medical examination of employees; and co-operation
3. Risk Assessment:
   • Definition of risk assessment; risk factors present in working environment, their effect on human health (physical risk factors, chemical risk factors, biological risk factors, and physiological and psychological risk factors); risk assessment methods; risk control measures; and ergonomics.

Training and certification of occupational health professionals ^[61] will be briefly summarized:

• Occupational health doctor – Four years at University of Tartu. A personal curriculum is planned for each physician. It consists of practical training, clinical training 22 months (general practitioner, cardiology, endocrinology, neurology, dermatology, rehabilitation, psychiatry, orthopaedics and traumatology, and rheumatology each two months; and ear-, nose and throat diseases, and ophthalmology each one month,), vocational training 22 months (service in occupational health unit eight months, centre for occupational health and occupational diseases five months, theory of work environment and practice three months, labour inspection two months, expert statements for commission), theoretical training 25 months (training in electrocardiography, seafarers’ health, laboratory tests, theory of occupational health, health risks and risk analysis, health examinations, occupational diseases and work-related diseases, work and safety legislation). ^[62]

• Occupational health nurse – currently no advance training to specialise on occupational health nursing is provided in Estonia. Instead there are general health nurses who are certified to work in family, school and also occupational health nursing fields. This advanced training is provided by the Tallinn Health Care College, and the average study time is 3.5 years. ^[63], ^[64]

• Occupational hygienist – MSc occupational hygienist specialty at Technical University of Tallinn (TTU), after completion of BSc chemistry specialty; Bachelor degree or an equivalent recognized qualification and according to the TTU regulations. Upon completion of the curriculum, the student:
  • Has systematic and thorough knowledge in chemistry and biology in order to work in biotechnological or synthetic chemistry enterprises, in private or government laboratories, or in a position that requires a master’s degree;
  • Knows theoretical schools of chemistry and biotechnology, trends, and actual problems and is able to choose relevant methods for solving chemical and biotechnological problems;
  • Has the necessary competence to control or analyze chemical processes and reactions, and make necessary calculations;
  • Is able to use his/her professional knowledge, theoretical concepts, trends and professional publications to formulate, analyze and solve chemical problems that appear in the workplace;
  • Is able to recognize interdisciplinary relationships between chemistry and the other sciences and is able to gather information independently and critically evaluate this information;
  • Has the necessary social skills, can operate information technology and is ready to participate in teamwork and lead it;
  • Is able to communicate orally and in written form to explain and professionally submit his/her work;
  • Is ready to actively participate in civil society, be tolerant when facing differing values and attitudes, and is able to estimate the scientific, social and ethical consequences of the results of his work on society;
  • Is able to participate in lifelong learning and self improvement. ^[65]

• Ergonomist – BSc engineering specialty (specialized on ergonomics), MSc ergonomics specialty at Estonian University of Life Sciences. The education consists of multidisciplinary modules (74 EAP), voluntary (6 EAP) and optional (10 EAP) courses and a master thesis (30 EAP). The modules are among others: ethics in engineering, ergonomics, noise and vibration, occupational toxicology and handling of dangerous substances, logistics, measuring and data processing, occupational health, functional anatomy, safety practices, ventilation and energy supplies of buildings, ergonomic bio-mechanisms, and work technology.^[66]

• Occupational psychologist – Two years for MSc on Work and Organizational Psychology at Technical University of Tallinn. The training includes: general studies (10 ECP), basic studies (14 ECP), core studies (30 ECP), special studies (30 ECP), free choice courses (6 ECP), and graduation thesis (30 ECP). The aim of the training is that these psychologists by using psychological principles and research methods they solve problems, increase workplace productivity, and improve the quality of work life. ^[67]

The provision of first aid in the event of accidents must be guaranteed in every company. The number of people holding the responsibility of providing first aid is not set out in law – it depends on the size of a company and the number of divisions or shifts and organization of work within the company. A company’s first aid officers are trained by institutions registered in the Ministry of Social Affairs ^[68]

Other vocational training

There are more than 50 vocational training schools in Estonia. Training in work environment issues, including safety training, are part of the vocational training curriculum and typically arranged before practical work life training periods.

The organisations providing occupational health and safety training are registered by the Ministry of Social Affairs^[1].

Awareness raising networks

The Estonian Occupational Health and Safety Network (OHNS)^[70] was established in 2001 by several key governmental and non-governmental agencies with the assistance of the EST-FIN Twinning Project^[71] and it operated in the years 2001-2004. The 14 members of the Network were representatives of organisations in the field of Estonian occupational safety and health. Five sub-networks were also active: networks of agricultural institutions, education and training institutions, the network of Tartu County and occupational health services and international organisations. The Network ceased operations in 2004 due to the end of the EST-FIN Twinnig Project^[72] and lack of interest by the parties.

The necessity for restarting the activities of the Network in spring 2012 (the Network was re-established in March) grew from the current situation in the field of Estonian occupational health and safety:

• The importance of occupational health and safety is not sufficiently acknowledged;
• Inadequate cooperation and poor exchange of information between the institutions active in the field of occupational health and safety;
• The knowledge, experience and economic resources of organizations and specialists could be used more efficiently through better planning and cooperation;
• The specialists of the field do not meet each other often enough in order to ensure *Work is duplicated at times and misunderstandings and misconceptions arise, caused by lack of knowledge and insufficient exchange of information between the institutions in the field;
• Specialists and organizations are insufficiently involved in discussions for important changes in the field of occupational health and safety;
• Participants in the field lack a common sense of direction;
• Inconsistency is particularly apparent when larger issues are tackled.

The objective of the Network is to develop the field of occupational health and safety by offering a framework that facilitates a more efficient use of the information, experience and knowledge related to occupational health and safety between the members of the Network. Members consist of organisations, such as universities, government institutes, private health care providers with activities in the occupational health and safety field. Other organisations interested in becoming members need to apply and be approved by the current members of the Network. The Network establishment is coordinated by the Ministry of Social Affairs, but its aim is in the coming year be a "self governed" network.^[73], ^[74]

In addition to the above primary objective, the Network also has certain additional objectives, such as:

• Disclosure and accessibility of information related to occupational safety and health;
• Spreading good practice;
• Promoting cooperation between the members of the Network;
• Coordinating activities in the field and increasing transparency;
• Helping specialists gather in societies and associations.

Specialized technical, medical and scientific institutions

Research institutes

The National Institute for Health Development (Tervise Arengu Instituut; NIHD)^[75] was established in 2003 as a governmental organization under the Ministry of Social Affairs of Estonia^[76]. The mission of NIHD is to promote the health of the Estonian population and enhance the quality of life through knowledge-based development and applied research activities. The main activities of the NIHD are research, development and implementation of activities in the health and social sectors.

Tartu University (Tartu Ülikool)^[77] has the following functions relating to occupational safety and health:

• Coordination of the occupational health (OH) teaching programme in the Faculty of Medicine (specialist training for physicians);
• Organisation of OHS and surveillance of the working environment in the university and connected units (Biomedicum, Clinicum, ect.);
• Leading of OH curricula development in the Department of Public Health;
• Organisation and participation in the training courses of OH for other institutions and specialist groups;
• Advisory role of OH expertise and programme development in the Ministry of Social Affairs^[78].

Tallinn University of Technology (Tallinna Tehn ikaülikool)^[79] undertakes basic research and development activity including among others basic research in order to endow the Estonian working environment with high level of safety, quality and productivity.

Standardization agencies

The Estonian Centre for Standardization (EVS)^[80]is a non-profit association, which was established by three founding members (Republic of Estonia, Chamber of Commerce and Industry, Confederation of Employers and Industry) in 1999. The Estonian Centre for Standardization operates as the Estonian standard organization pursuant to the Technical Regulations and Standards Act. EVS has accepted the WTO Code of Good Practice for the Preparation, Adoption and Application of Standards for the removal of technical barriers to trade.

Institutions and organizations

Source: Overview by the authors