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Crystalline silica is one of the most common minerals in the earth's crust. Crystalline silica dust is released during numerous operations in which silica-containing products undergo any process that can create visible or invisible dust particles, such as the drilling of concrete. Workers may be exposed to crystalline silica in many different workplaces and processes such as mines, construction sites, and during the making of ceramicss.   

Photocredit: NIOSH

Millions of workers in the Americas are exposed to crystalline silica. In Colombia alone, an estimated 1.8 million workers are at risk of developing silicosis, which is an incurable and irreversible lung disease caused by inhalation of dust containing free crystalline silica. Preventive action should be taken before workers are exposed.

The ILO/WHO International Programme on the Global Elimination of Silicosis calls for the elimination of silicosis worldwide by 2030. It includes:

  • formulation of national, regional and global action plans;
  • mobilization of resources for the application of primary and secondary prevention;
  • epidemiological surveillance;
  • monitoring and evaluation of results; and
  • strengthening required national capabilities and the establishment of national programmes.

The programme will depend heavily on cooperation between international organizations and industrialized and developing countries.

In 2005, WHO, PAHO, the Chilean Ministry of Health and ILO requested that NIOSH provide capacity-building technical assistance to eliminate silicosis in the Americas. The Americas Silicosis Initiative was born as a partnership between WHO, PAHO, ILO, Chile, Brazil, and Peru. This initiative is the first regional approach to mitigate silicosis and is based upon sharing expertise to benefit workers and communities of many countries.


pdf  Americas Elimination of Silicosis Initiative pdf

pdf  Iniciativa de las Américas para la Eliminación de la Silicosis pdf

pdf  A Iniciativa de Eliminição da Silicose nas Americas pdf



Chile Ministry of Health

Brazil Ministry of Health

Peru Ministry of Health

The National Institute for Occupational Safety and Health

International Labour Organization

The Asbestos Atlas Project

PAHO has decided to compile an Asbestos Atlas which will involve gathering information on the use and regulation of asbestos in each of the PAHO countries still using asbestos. For countries that have banned asbestos, we are requesting information from those involved in the banning process.

We hope that in starting a compilation of country asbestos profiles for the Atlas, we lay the foundation for future work on development of national plans for the elimination of the asbestos disease.  We also hope to produce a document that will be instructive and useful for public health workers around the world.

Influenza and Workers' Health

The transmission of infectious diseases such as influenza is a major problem that affects both patients as well as health care workers. Health care workers are especially vulnerable to influenza, as they are at the frontline against the spread of emerging and existing infections.

PAHO and its Collaborating Centers in Occupational Health are working with member states on several activities to reduce the risk of transmission of influenza in the workplace.

Photocredit: PAHO

Some activities that had been done in 2009 include:

  • For this year's Vaccination Week in the Americas, PAHO launched a regional slogan "Inmunization begins with health care workers: get vaccinated."
  • Awareness activities around this theme have been organized in the region.
  • Training programs for health care workers have been delivered in several countries to inform them about their occupational risk of exposure to biological agents, including influenza, and preventive measures against influenza in the workplace.*

*These resources and materials can be accessed via the Geolibrary under the special section on influenza.

Vaccination Week in the Americas 2009

Health care workers were a priority for this year's Vaccination Week in the Americas. As a fundamental part of health systems, health care workers need healthy and safe working conditions and environments to help ensure that patients receive appropriate and timely care. The occupational transmission of infectious diseases among health care workers, such as hepatitis B and influenza, account for significant illness among health care workers and are preventable by vaccination.

For this first year of the Region-wide campaign targeting health care workers, up to 16 countries aimed to vaccinate health care and other workers against diseases such as hepatitis B, measles, rubella, diphtheria, tetanus, and influenza.

Results of the 2009 Inmunization Week:
  • In Bolivia, nearly 2400 health care workers were vaccinated against measles and rubella, and almost 3300 were vaccinated against hepatitis B.
  • Health care workers in Uruguay received free influenza vaccines, highlighting the need to vaccinate health care workers against this disease to prevent further infections.
  • Suriname's yellow fever vaccination campaign was expanded to include 2475 health care workers, as well as over 3300 personnel in air and maritime transportation, immigration officers, police and military forces, and gold miners.
  • Hepatitis B vaccines were delivered to sanitation workers in Guyana.
  • Other countries such as Dominica took initiative to complement their vaccination week campaigns by training health care workers on infection control and healthy and safe vaccination practices, thus illustrating the comprehensive approach to safeguarding health care workers against vaccine-preventable diseases.

Vaccination Week coincided with World Day for Safety and Health at Work, an annual and global campaign to promote healthy and safe work for all. This year's theme was "Protecting the health and safety of health care workers".

Evidence-based interventions

Cochrane Systematic Review: Prevention of percutaneous injuries with risk of hepatitis B, hepatitis C, or other viral infections for health care workers

Health care workers are at risk of acquiring infectious diseases through exposure at work. Exposure to blood or bodily fluids from infected patients can lead to infection with hepatitis B, hepatitis C, or HIV viruses. These are serious infections that may cause chronic disease or initiate cancer, and eventually lead to death. Approximately two million health care workers across the world experience percutaneous exposure to infectious diseases each year. In Latin America and the Caribbean, the proportion of HBV, HCV, and HIV infections among health care workers due to occupational sharps injuries are the highest in the world at 55, 83, and 11 percent, respectively. 

The transmission of occupational blood-borne infectious diseases leads to absenteeism, morbidity, and in some cases mortality among health care workers. These ultimately lead to a reduction in workforce and consequently affect patients quality of care and safety. Health care workers may also suffer from psychological stress, which affects both work and personal life. There is also the financial burden imposed on hospitals due to occupational exposure to blood-borne diseases, which includes costs related to blood tests, treatment, outpatient visits, and lost working hours.'

Several strategies are available and widely used to prevent PEIs among health care workers. Therefore, it is important to know if these preventive interventions are effective. The objective of the Cochrane systematic review is to determine the benefits and harms of interventions for preventing percutaneous exposure incidents with risk of hepatitis B, hepatitis C, or other viral infections for health-care workers.


Finnish Institute of Occupational Health         

The Cochrane Collaboration