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This article is based on the standards, principles and approaches embodied in the ILO Occupational Health Services Convention, 1985 (No. 171); ILO Occupational Safety and Health Convention, 1981 (No. 164); and the Working Document of the Twelfth Session of the Joint ILO/WHO Committee on Occupational Health, 5-7 April 1995.

The ILO Occupational Health Services Convention (No.

Such interventions have been found to improve both the workers' access to the services and the cost effectiveness of the services provided.

The so-called work environment reform which took place in most of the industrialized countries in the 1970s and 1980s saw the production of important international instruments and guidelines.

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Even in countries where coverage rates are high, there are gaps, with small-scale enterprises, certain mobile workers, construction, agriculture and the self-employed being underserved.

Most countries have laws governing the provision of occupational health services, but the structure of the legislation, its content and the workers covered by it vary widely (Rantanen 1990; WHO 1989c).

The more traditional laws consider occupational health services as a group of specialized and separate activities such as occupational health care, occupational safety and hygiene services, workplace health promotion programmes and so on.

In many countries, instead of stipulating what might be regarded as programmes, the legislation stipulates the responsibility of employers to provide health risk assessments, health examinations of workers or other individual activities related to workers' health and safety.

More recent laws reflecting international guidelines such as those contained in the ILO Convention on Occupational Health Services (No.

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