During the “13th Five-Year Plan” period (2016-2020), the Central Committee of the Communist Party of China and the State Council issued the “Healthy China 2030” Planning Outline, proposing the overall strategy of building a healthy China. Among them, the Outline emphasizes the need to strengthen Work Safety and occupational health, enhance safety in production, accelerate the construction of dual-defense line of risk level control and potential risks identification and management, and effectively reduce the frequency and harmful consequences of catastrophic accidents. It stresses the importance of industry self-discipline and supervision responsibilities, urging enterprises to implement their primary responsibilities, promote the source control of occupational disease, and strengthen work safety supervision in key industries such as mines and hazardous chemicals. It reinforces the occupational disease reporting system, carries out the promotion of occupational health by employers, prevents and controls work-related injuries and occupational diseases. It also enhances the management of individual radiation doses nationwide and radiation protection in radiodiagnosis and treatment.
By the end of 2022, China’s working-age population (ages 16-59) was 880 million, accounting for 62% of the total population of 1.42 billion. The number of new cases of occupational diseases reported nationwide decreased from 26,393 in 2013 to 11,108 in 2022, a reduction of 58%.
1. Major Policies, Regulations, and Standards on Occupational Safety and Health Issued Recently
In recent years, the main policies, regulations, and standards related to occupational safety and health are as follows:
Table 1: Overview of Major Policies on Occupational Safety and Health in Recent Years
| File Name | Release Time | Release Dept. |
|---|---|---|
| The “14th Five-Year” National Health Plan | April 2022 | State Council General Office |
| Regulations on Fines for Work Safety Accidents | Implemented from March 1, 2024 | Ministry of Emergency Management |
| Notice on Further Promoting Occupational Health Protection Actions to Improve Workers’ Occupational Health Literacy | January 2024 | Office of the National Health Commission and other eight departments |
| Notice on Further Standardizing the Management of Occupational Health Examinations and Occupational Disease Diagnoses | June 2023 | Office of the National Health Commission, Comprehensive Department of the National Center for Disease Control |
| General Specifications for Safety, Health, and Occupational Health at Construction and Municipal Engineering Sites (GB 55034-2022) | Implemented from June 1, 2023 | Ministry of Housing and Urban-Rural Development |
| Notice from the Office of the National Health Commission on Further Strengthening Occupational Health Training for Employers | December 2022 | Office of the National Health Commission |
| The 14th Five-Year National Work Safety Plan | April 2022 | State Council Work Safety Committee |
| Fifteen Measures for Work Safety | April 2022 | State Council Work Safety Committee |
| National Plan for the Prevention and Control of Occupational Diseases (2021-2025) | December 2021 | Office of the National Health Commission and other seventeen departments |
| Notice from the Office of the National Health Commission on Intensively Carrying Out Special Management Work on Occupational Disease Hazards | December 2021 | Office of the National Health Commission |
| Work Safety Law of the People’s Republic of China | June 2021 (Revised) | National People’s Congress |
| Management Methods for the Diagnosis and Identification of Occupational Diseases | Implemented from April 10, 2021 | National Health Commission |
| Regulations on Occupational Health Management at Workplaces (Order No. 5 of the National Health Commission of the People’s Republic of China) | Implemented from February 1, 2021 | National Health Commission |
1.1 Main Goals and Key Tasks for Occupational Safety and Health During the “14th Five-Year” Period
In December 2021, the National Health Commission along with seventeen other departments jointly issued the “National Plan for the Prevention and Control of Occupational Diseases (2021-2025).” In April 2022, the State Council Work Safety Committee issued the “14th Five-Year National Work Safety Plan.” Both plans set out the main goals for occupational health and work safety during the “14th Five-Year” period and specified the main target values for related indicators.
National Health Commission and other seventeen departments, “National Plan for the Prevention and Control of Occupational Diseases (2021-2025)” (December 7, 2021)
Table 2: Main Indicators for the Prevention and Control of Occupational Diseases During the “14th Five-Year” Period
| Indicators | Target Value |
|---|---|
| (1) Number of people insured for work-related injuries | enhance steadily |
| (2) Declaration rate of occupational disease hazards projects by industrial enterprises | ≥90% |
| (3) Qualification rate of occupational hazard factors monitored at workplaces | ≥85% |
| (4) Personal dose monitoring rate for non-medical radiation workers | ≥90% |
| (5) Awareness rate of occupational health knowledge among key populations | ≥85% |
| (6) Coverage rate of concentrated township rehabilitation services for pneumoconiosis patients | ≥90% |
| (7) Investigation and handling rate of occupational health violation cases | 100% |
| (8) Based on existing medical resources, provincial institutions for prevention and treatment of occupational diseases established is 100% | 100% |
| (9) At least one institution in each province to undertake technical guidance for engineering protection against occupational hazards such as dust, chemical poisons, noise, and radiation | 100% |
| (10) At least one public medical and health institution in each prefecture-level city to undertake occupational disease diagnosis | 100% |
| (11) At least one public medical and health institution in each county or district to undertake occupational health examinations | 95% |
State Council Work Safety Committee, “14th Five-Year National Work Safety Plan” (April 6, 2022)
Table 2: Main Indicators for Work Safety During the “14th Five-Year” Period
| Indicators | Target Value |
|---|---|
| Number of fatalities in Work Safety accidents | Decrease by 15% |
| Number of major and particularly major work safety accidents | Decrease by 20% |
| Fatality rate in work safety accidents per unit of GDP | Decrease by 33% |
| Fatality rate in work safety accidents per 100,000 employees in industrial, mining, commercial, and trade sectors | Decrease by 20% |
| Fatality rate per 10,000 operational vehicles | Decrease by 10% |
| Fatality rate per million tons in coal mines | Decrease by 10% |
Based on the “14th Five-Year Plan for the National Economic and Social Development of the People’s Republic of China and the Long-Range Objectives Through 2035,” and the “Planning Outline of Healthy China 2030,” the General Office of the State Council issued the “14th Five-Year National Health Plan” and the “14th Five-Year National Work Safety Plan.” These plans specify the main tasks for occupational health protection during the “14th Five-Year” period, with the following requirements for employers:
General Office of the State Council, “14th Five-Year National Health Plan” (April 27, 2022):
To Strengthen the prevention and control of occupational health hazards at their source and risk management. Establish and improve the system for monitoring and assessing occupational diseases and their causative factors, expanding the scope of active monitoring. By 2025, the qualification rate for monitoring occupational disease hazards in workplaces should reach over 85%. Improve the basic database for employers’ occupational health information and risk assessment, and construct a risk classification and grading, forecasting, early warning, and regulatory mechanism for occupational hazard risks, with major supervision implemented on high-risk enterprises. Strengthen the specialized management of occupational disease hazards in key industries. Encourage enterprises to improve occupational disease prevention facilities and working conditions.
To Enhance occupational health promotion. Encourage employers to carry out employee health management, strengthen the construction of the occupational health management team, and improve occupational health management capabilities. Improve workers’ occupational health literacy comprehensively, advocate healthy working methods, and significantly increase the prevalence of knowledge on the prevention and treatment of work-related musculoskeletal disorders, mental and psychological diseases, etc.
State Council Work Safety Committee, “14th Five-Year National Work Safety Plan” (April 6, 2022):
Strictly implement the legal liabilities of the principal responsible persons of production and business units as the first responsible units for work safety. Promote the establishment of a comprehensive work safety responsibility system for all staff from legal representatives and actual controllers to front-line employees, and improve the accountability system for work safety throughout the production and operation process. Guide enterprises to improve the work safety management system, enhance the safety risk grading control, and potential risks indentification and management dual prevention mechanisms, to build a self-restraining, continuously improving endogenous mechanism for work safety. Encourage large enterprises in key industries to establish work safety management and technical teams. Supervise enterprises should allocate and utilize work safety funds according to regulations, effectively applying relevant fiscal and taxation policies to support the transformation of safety technical equipment and facilities. To implement the occupational prevention action plan, fully leveraging the accident prevention role of the occupational insurance fund. Establish mechanisms for the assessment and recognition of accident losses. Strengthen integrity incentives and punishments for dishonesty, legally establish and improve the management system for the list of serious violations and dishonesty, and implement joint disciplinary actions according to the law, intensifying the accountability of entities with serious violations and dishonesty in work safety.
1.2 Strengthening the Principal Responsibility of Enterprises for Work Safety
In June 2021, the third amendment to the “Work Safety Law of the People’s Republic of China” was passed. The newly revised clauses emphasize the principal responsibility of production and business units. It clarifies that the main responsible person of the production and business unit is the primary and fully responsible person for the work safety of the unit, with other responsible persons accountable for work safety within their respective scopes of responsibility. It requires all types of production and business units to improve and implement a full work safety responsibility system, safety risk classification control, potential risks indentification and management dual prevention mechanism, strengthen standardization and informatization of work safety, and increase the funds, materials, technology, personnel to genuinely enhance the level of work safety.
State Council Safety Committee “Fifteen Measures for Work Safety” (April 2022)
The measures strictly implement the safety responsibility system for major hazards, pursuing legal responsibility of the actual controllers of enterprises for any fraudulent activities. Those primarily responsible for catastrophic accidents will be criminally prosecuted, and it’s clearly stated that they will be permanently barred from serving as the main responsible persons in their industries.
Regulations on Fines for Work Safety Accidents (Implemented from March 1, 2024)
The regulations have refined the discretionary basis for accident fines to protect the legal rights of the parties involved and legally standardized the identification of serious violations, adjusting the relevant fine amounts according to legal stipulations.
1.3 Clarifying Legal Requirements for Enterprise Occupational Health
Enterprises have a legal duty to prevent and treat occupational health issues for their workers. Based on the provisions of the “Law on the Prevention and Treatment of Occupational Diseases,” a series of policy documents have been issued in China to clearly implement the measures required by the law.
Regulations on Occupational Health Management in Workplaces (Order No. 5 of the National Health Commission of the People’s Republic of China)” (Implemented from February 1, 2021)
The regulations identify employers as the primary responsible unit for the prevention and treatment of occupational diseases and hold them accountable for occupational health hazards that arise in their establishments. The main responsible person of the employer is fully responsible for the occupational disease prevention and treatment of the unit. The regulations also specify the responsibilities of managerial personnel, occupational health training, plans and implementation schemes for the prevention and control of occupational health hazards, and occupational health records, outlining the corresponding supervisory and management requirements of relevant departments and the legal liabilities.
Workers should receive corresponding labor safety and health protection from their employers at all locations where they engage in occupational activities. The “Law on the Prevention and Treatment of Occupational Diseases” stipulates that “employers generating occupational health hazards must not only meet the establishment conditions specified by laws and administrative regulations but also ensure that their workplaces comply with the following occupational health requirements: (i) the intensity or concentration of occupational disease hazards meet national occupational health standards.”
Office of the National Health Commission, “Notice on Intensively Carrying Out Special Management Work on Occupational Disease Hazards” (December 27, 2021)
The notice specifies that from January 2022 to December 2025, special management work on occupational disease hazards will be carried out nationwide for industrial enterprises with more than ten employees and where the intensity (concentration) of hazards such as dust, chemical toxins, and noise exceeds standards. It sets the work target that “by the end of 2025, the working environment in the enterprises under management will be significantly improved, with the qualification rate for positions involving dust, chemical toxins, and noise reaching above 85%, and the application rate for occupational disease hazard projects and monitoring occupational disease hazards in workplaces greatly increased, meeting the requirements of the ‘National Plan for the Prevention and Control of Occupational Diseases (2021-2025)’.”
Office of the National Health Commission, “Notice on Further Strengthening Occupational Health Training for Employers” (December 13, 2022)
Occupational health training is an important means to improve the level of occupational disease prevention and control by employers and to enhance the occupational health literacy of workers. It is an important measure to prevent occupational hazards and protect the occupational health rights and interests of workers. The notice primarily addresses the importance of occupational health training,urges employers to strictly implement their primary responsibility for occupational health training, enhances the exchange and informatization construction of employers’ occupational health training, strengthens the guidance for employers’ occupational health training work and enhances the quality supervision and management of employers’ occupational health training, setting out specific requirements in five aspects to strengthen the occupational health training of employers.
General Specifications for Safety, Health, and Occupational Health at Construction and Municipal Engineering Sites (GB 55034-2022)” (Implemented from June 1, 2023)
Focus on workers engaging in occupational activities on construction and municipal engineering sites, the specifications detail the requirements for personal protective equipment that workers of different trades should be equipped with. It also emphasizes that “occupational health records and health monitoring records should be established and maintained for workers engaged in activities involving radioactivity, high toxicity, high-risk dust, etc., and medical consulting services should be provided regularly.”
Office of the National Health Commission and Other Eight Departments, “Notice on Further Promoting Occupational Health Protection Actions to Elevate the Occupational Health Literacy Level of Workers” (January 25, 2024)
The notice focuses on encouraging employers to fulfill their principal responsibilities: it requires strengthening occupational health training for employers, timely notification of the results of occupational hazard factor detection and evaluation, and occupational health examination results, enhancing the construction of healthy enterprises and the “Occupational Health Expert” activities, and promoting the organic integration of regulatory enforcement and popularization of science.
“Management Methods for the Diagnosis and Identification of Occupational Diseases” (Implemented from April 10, 2021)
The methods indicate that employers should fulfill their obligations related to the diagnosis and identification of occupational diseases according to the law. It also specifies the qualifications and responsibilities of diagnostic institutions, diagnostic processes, identification processes, and lists the corresponding supervisory and management requirements and the legal liabilities that occupational disease diagnostic institutions need to be borne.
Office of the National Health Commission, Comprehensive Department of the National Center for Disease Control, “Notice on Further Standardizing the Management of Occupational Health Examinations and Occupational Disease Diagnoses” (June 28, 2023)
To further standardize the management of occupational health examinations and occupational disease diagnoses and improve the quality and effectiveness of work, the notice requires that occupational health examinations for workers exposed to occupational disease hazards before employment, during employment, and upon leaving employment should be properly recorded and verified.
2. Future Trends
2.1 Strengthening Labor Safety and Health Protection for Workers in New Employment Forms and New Occupations Exposed to Occupational Diseases
With the development of new economic forms in China, the number of workers in ride-hailing, express delivery, and food delivery is increasing. At the same time, the widespread application of emerging technologies has also brought new occupational exposure population to some occupational diseases, such as near-source operation personnel in industrial inspection, miners highly exposed to radon, and some hospital staff in interventional radiology and nuclear medicine at risk of occupational radioactive diseases need enhanced protection urgently.
Enterprises should develop appropriate labor safety and health protection systems for workers in new employment forms and new occupations exposed to occupational diseases, equip them with required protective supplies at work, and continue to pay attention to potential occupational health hazards and take preventive measures.
2.2 Further Strengthening Enterprise Responsibility
The principal responsibility of enterprises will be further strengthened in the field of labor safety and health. In December 2023, the National Health Commission and several other departments stated in a joint press conference that they would continue to promote the construction of healthy enterprises extensively and in-depth, improve the level of occupational health management of enterprises, and improve workplace environments and labor conditions, further protecting the occupational health rights and interests of workers. Additionally, in January 2024, the National Health Commission and other eight departments jointly issued a “Notice on Further Promoting Occupational Health Protection Actions to Improve the Occupational Health Literacy Level of Workers,” which clearly stated to promote employers to implement their principal responsibility and further strengthening occupational health management.”
