Oceania describes the countries of the Eastern Pacific Ocean, mainly small island nations of Melanesia, Micronesia and Polynesia, the largest of which are Fiji and the Solomon Islands, but also includes the more populous countries of Australia, Papua New Guinea and New Zealand. The distribution of industry varies considerably across the Oceania region. The distribution ranges from largely agriculture-based, rural workforces in many of the smaller nations, to service and industry-based workforces in the developed economies of New Zealand and Australia, although most of the rural-based countries are slowly transitioning to a more industrial and service-based workforce and this trend is likely to continue. Some of the key occupational health and safety (OHS) issues and priorities are common across Oceania, whilst others arise from the geography, climate and industry of the individual countries. Unfortunately, there is not a lot of published information on OHS for the countries of Oceania, apart from Australia and New Zealand.
In terms of overall disease burden, the most recent information (for 2013) from the Global Burden of Disease (GBD) project suggests that in individual countries of Oceania, occupational risk factors rank 9th to 12th in terms of the burden (measured in disability-adjusted life years) caused by the major risk factor groups . The GBD study does not include all work-related disorders, due to the stringent data requirements and the need for relevant data from the different world regions, but it provides a good guide to the major issues resulting in considerable work-related ill-health in the community. In the smaller island nations, the main risk factors were ergonomic risk factors resulting in low back pain; asthmagens; and particulate matter, gases and fumes resulting in chronic obstructive pulmonary disease. In Australia and New Zealand, the largest burden arose from ergonomic risk factors for low back pain, carcinogens and injuries.
The workers of Oceania face many of the same hazards, and so develop many of the same work-related disorders, as do workers elsewhere in the world. These include musculoskeletal disorders, noise-induced hearing loss, respiratory diseases, such as asthma and chronic obstructive pulmonary disease, and injury. Where information is available, it suggests an improvement over time for most of these disorders, but it is likely these issues will remain. Recent findings in Australia and New Zealand suggesting persistent problems with noise-induced hearing loss [2,3] and recognition of new cases of coal workers’ pneumoconiosis in Australia  serve as warnings of the importance of being vigilant in terms of ensuring adequate control measures are in place and are monitored over time. Work-related injury, particularly related to the use of motor vehicles and mobile equipment such as quad bikes , appears to be an important OHS issue across the region. In particular, vehicles are likely to continue to play an important role in work-related injury, given the lack of divided roads, the working conditions and the use of work vehicles in rural areas in many countries in the region .
Problems of decreasing physical activity related to work is an issue common across the developed countries of the regions and is likely to become increasingly important in the low- and middle-income island nations as they become more urbanized and a smaller proportion of the workforce is employed in rural occupations . This predisposes workers to a greater risk of chronic non-communicable disorders such as obesity, diabetes, cardiovascular disease and cancer, an issue that is likely to become the focus of active intervention in the near future.
In Oceania, as in most other regions, there has been a focus on occupational health-related disorders rather than on the exposures that lead to such disorders. More recently, some information on exposures has become available, particularly in Australia and New Zealand. This has shown, for example, that a considerable proportion of the Australian workforce is still exposed to carcinogens , and that some sections of the New Zealand workforce appear to have a considerable proportion of workers with exposure to dusts of various sorts; oils and solvents; smokes, gases and fumes; and irregular working hours . Monitoring of exposures is likely to become an increasing focus of OHS, particularly for those exposures resulting in conditions for which there is a long latency, because changes in exposure provide more direct and quicker feedback on the success or otherwise of measures implemented to control those exposures. Nevertheless, disease and injury surveillance and monitoring remain important, partly because accurate exposure monitoring is difficult as a result of the range of potential relevant exposures and the range of sources of any single exposure type.
There isn’t scope here to provide a detailed overview of problem exposures, but by way of illustration two relevant exposure issues common to the Oceania region are considered, one an old exposure that is likely to remain important for several decades, and one a relatively new exposure, the importance of which has been under-recognized. Asbestos-related disease, arising particularly from the use of asbestos-containing building products, has been an important problem in some areas of Oceania for several decades already. It is unlikely that significant amounts of asbestos are still imported into any of the countries of Oceania, but most have not implemented bans and even those which have, such as Australia, continue to have inadvertent importation of products containing asbestos. Nevertheless, there is a considerable amount of asbestos in the built environment, given the widespread use of asbestos building products and major infrastructure from the 1950s to the 1980s, and even later in some countries. As these asbestos materials age, and buildings and infrastructure (such as pipes) deteriorate and are demolished or removed, the likelihood of occupational exposure to asbestos will increase, with the associated increased threat of asbestos-related diseases, particularly cancers. Another example of a common challenge is climate change, which is starting to raise concerns in terms of OHS for most of the countries of Oceania. Foremost amongst these concerns is heat, with rising temperatures increasing the risk to outdoor workers, especially in tropical climates where the humidity decreases the body’s ability to lower body temperature through evaporation of sweat. This increases the need to have access to the important basic external heat-control strategies such as adequate water, shade and frequent work rest breaks. Even in Australia, where much of the country is not tropical, rising temperatures and more prolonged periods of sustained high heat raise challenges that are increasingly being encountered in terms of adequately controlling heat issues for outdoor (and some indoor) workers .
Another common group of exposures causing concern is pesticides and herbicides. With significant proportions of the workforce in many countries in Oceania employed in rural occupations, there are persistent concerns about occupational exposure to pesticides . There is little published evidence of definite harm arising from the use of pesticides in these countries, but the widespread use of pesticides and the recent classifications of various pesticides by the International Agency for Research on Cancer  highlight the importance of using adequate approaches to exposure control when using pesticides (and herbicides).
With so many small island nations in Oceania, it isn’t surprising that fishing is an important occupation for many workers. Commercial fishing has always been a hazardous occupation, and the challenges faced by commercial fishermen have been magnified by the need to spend more time at sea because of the depletion of fishing stocks. Issues such as fatigue from long shifts with few rest breaks, cramped quarters, incompletely controlled physical hazards, and isolation from family and friends are likely to continue for the region’s many commercial fishermen .
Another concern for many of the nations of Oceania is the relative lack of public and private resources available to use for OHS purposes. This has recently been highlighted as a particular concern for health workers potentially exposed to blood-borne virus infections , but it is equally important in a range of work circumstances and a variety of hazards. Although detailed information on the informal sector is lacking, it appears likely that the relative size of the informal sector varies considerably between countries, being small in Australia and New Zealand but substantial in many of the low- and middle-income nations in the region. This is important because the informal sector is not usually covered by official OHS statistics, is less regulated and has fewer resources able to be devoted to OHS.
In conclusion, OHS is an important issue for the countries of Oceania. Some of these issues arise from local factors, but many are common across much, or all, of the region. These problems are likely to persist and, in some cases, may even become worse, and their prevention and control require recognition, adequate resources and a considered and organized approach.