The World Bank in its document under the title 'Investing in Health' (1993) states that the health status of the population, including the working population, and working conditions in individual countries depend essentially on the value of gross national product per capita. The attitudes towards the role and objectives of occupational medicine have changed significantly over the last three decades. A high priority given to primary prevention reflects the mainstream of a new approach to preventive measures. Advancements in technology, production and services, common use of computers and flattening of work organisation structures have brought about the need for workers' active participation in planning of activities and shaping working conditions in own enterprise. At the same time, workers are required to possess much higher qualifications facilitating their participation in applying new technologies and using new information systems, which resulted in a fierce competition on the labour market. In the countries in the political, social and economic transition, the conditions for introducing a new system of sustained development, described by Gustavsen at the 25th International Congress on Occupational Health have not as yet been established. A procedure-based system involving negotiations between employers and workers' representatives failed to be successful in improving working conditions as the roles of the state, employers and trade unions had not been defined precisely. It is expected that further health promotion at the worksites in these countries will depend mainly on the economic progress and the reformed system of education.

译文

世界银行在其题为“投资卫生”(1993年)的文件中指出,人口的健康状况,包括劳动人口,以及各个国家的劳动条件,基本上取决于人均国民生产总值。在过去的三十年中,人们对职业医学的作用和目标的态度发生了巨大变化。对初级预防的高度重视反映了预防措施新方法的主流。技术,生产和服务的进步,计算机的普遍使用以及工作组织结构的扁平化,要求工人积极参与活动的规划和塑造自己企业的工作条件。同时,要求工人具有更高的资格,以促进他们参与应用新技术和使用新信息系统,从而导致劳动力市场上的激烈竞争。在政治,社会和经济转型国家中,古斯塔夫森在第25届国际职业卫生大会上描述的引入新的可持续发展系统的条件尚未建立。涉及雇主和工人代表之间的谈判的基于程序的系统未能成功改善工作条件,因为国家,雇主和工会的角色并未得到准确界定。预计这些国家在工作场所的进一步健康促进将主要取决于经济进步和教育体制的改革。

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