From awareness to action: Sudbury, mining and occupational disease in a time of change.

BACKGROUND: Miners work in highly hazardous environments, but surprisingly, there are more fatalities from occupational diseases, including cancers, than from fatalities from injuries. Over the last few decades, the mining environment has become safer with fewer injuries and less exposure to the toxins that lead to occupational disease. There have been improvements in working conditions, and a reduction in the number of workers exposed, together with an overall improvement in the health of miners. OBJECTIVES: This study attempted to gain a deeper understanding of the impetus for change to reduce occupational exposures or toxins at the industry level. It focuses on one mining community in Sudbury, Ontario, with a high cancer rate, and its reduction in occupational exposures. It explored the level of awareness of occupational exposures from the perspective of industry and worker representatives in some of the deepest mines in the world. Although awareness may be necessary, it is often not a sufficient impetus for change, and it is this gap between awareness and change that this study explored. It examined the awareness of occupational disease as an impetus to reducing toxic exposures in the mining sector, and explores other forces of change at the industrial and global levels that have led to an impact on occupational exposures in mining. METHODS: From 2014 and 2016, 60 interviews were conducted with individuals who were part of, or witness to the changes in mining in Sudbury. From these, 12 labour and 10 industry interviews and four focus groups were chosen for further analysis to gain a deeper understanding of industry and labour's views on the changes in mining and the impact on miners' health from occupational exposures. The results from this subsection of the data is the focus for this paper. RESULTS: The themes that emerged told a story about Sudbury. There is awareness of occupational exposures, but this awareness is dwarfed in comparison to the attention that is given to the tragic fatal injuries from injuries and accidents. The mines are now owned by foreign multinationals with a change from an engaged, albeit paternalistic sense of responsibility for the health of the miners, to a less responsive or sympathetic workplace culture. Modernization has led to the elimination, substitution, or reduction of some of the worst toxins, and hence present-day miners are less exposed to hazards that lead to occupational disease than they were in the past. However, modernization and the drop in the price of nickel has also led to a precipitous reduction in the number of unionized miners, a decline in union power, a decline in the monitoring of present-day exposures, and an increase in non-unionized contract workers. The impact has been that miners have lost their solidarity and power to investigate, monitor or object to present-day exposures. CONCLUSIONS: Although an increase in the awareness of occupational hazards has made a contribution to the reduction in occupational exposures, the improvement in health of miners may be considered more as a "collateral benefit" of the changes in the mining sector. Multiple forces at the industrial and global level have differentially led to an improvement in the working and living environment. However, with the loss of union power, the miners have lost their major advocate for miner health.

Can inequality be tamed through boundary work? A qualitative study of health promotion aimed at reducing health inequalities.

This paper examines the organisational dynamics that arise in health promotion aimed at reducing health inequalities. The paper draws on ethnographic fieldwork among public health officers in Danish municipalities and qualitative interviews from an evaluation of health promotion programmes targeting homeless and other marginalised citizens. Analytically, we focus on 'boundary work', i.e. the ways in which social and symbolic boundaries are established, maintained, transgressed and negotiated, both at the administrative level and among frontline professionals. The paper discusses three types of boundary work: (i) demarcating professional domains; (ii) setting the boundaries of the task itself; and (iii) managing administrative boundaries. The main argument is that the production, maintenance and transgression of these three types of boundaries constitute central and time-consuming aspects of the practices of public health professionals, and that boundary work constitutes an important element in professional practices seeking to 'tame a wicked problem', such as social inequalities in health. A cross-cutting feature of the three types of boundary work is the management of the divide between health and social issues, which the professionals seemingly seek to uphold and transgress at the same time. The paper thus contributes to ongoing discussions of intersectoral action to address health inequalities. Furthermore, it extends the scope and application of the concept of boundary work in the sociology of public health by suggesting that the focus in previous research on professional demarcation be broadened in order to capture other types of boundaries that shape, and are shaped by, professional practices.

Lo que vale el trabajo en el sector público: estudio exploratorio del significado de los valores organizacionales en el sector público en Perú / The value of work in the public sector: the case of organizational values in the public sector in Peru

Este estudio, de carácter exploratorio, analiza los valores organizacionales en el sector público peruano. Estos valores fueron clasificados y jerarquizados según el modelo triaxial en tres ejes principales: el ético, el económico y el emocional. Participaron en el estudio 338 servidores públicos que ocupaban puestos de nivel medio-alto. Los principales resultados revelan que de los 62 valores presentados, 42 han sido clasificados en los tres ejes mencionados y que los cinco valores predominantes pertenecen al eje de valores pragmáticos. Además, se identificaron algunas variaciones por factores demográficos y organizacionales. Las conclusiones y recomendaciones resaltan la importancia de continuar estudiando el tema de los valores en el sector público a fin de comprender sus posibles consecuencias prácticas en la gestión de personas (AU)

This exploratory study examines organizational values in the Peruvian public sector. These values were classified and rank ordered according to the tri-axial model under three main axes: ethical, economic, and emotional. A sample of 338 public servants in mid to high level positions participated in this study. The main results show that 42 out of the 62 values were classified in the three axes mentioned above and that all of the 5 dominant values belonged to the pragmatic axis. In addition, some variations in the classification of values due to demographic and organizational factors were identified. The conclusions and recommendations highlight the importance to continue studying the topic of values in the public sector, in order to understand their potential practical implications for people management (AU)