Concern for occupational health and safety has a long tradition in Westem countries. In
these countries, well-established disciplines are able to recognize and control inherent risks
of industrial processes. The occupational health care system is well-developed and occupational
health services play an important role in safeguarding workers' health. There is an
abundant body of scientific literature on almost evelY aspect of occupational health in
affluent nations.
In stark contrast, there is very little information available on work-related health hazards
in occupations in low-income countries, while the largest part of the worldwide workforce
is to be found in these low-income countries. Moreover, anecdotal evidence suggests that
working conditions in developing countries may substantially differ from those in affluent
nations, usually for the worse. Infonnation on the distribution of health hazards and the
prevalence of work-related diseases in low-income countries is extremely scarce or even
absent for many areas. In low-income countries, enforcement of labor laws is almost nonexistent,
occupational health services are not available and resources for identifYing and
cvaluating working conditions and consequent health effects are severely limited.
This thesis is about the health and safety of workers inlow-income countries and opportunities
to improve their working conditions. The origin of the thesis is the author's personal
experiencc in one specific program directed at improving the occupational health and
safety in tamleries in Kanpur, India, and his more general experience in international public
health