A/HRC/20/15 They create a standard against which States can be held accountable, and allow for monitoring progress over time. 35. The right to occupational health indicators and benchmarks must be developed with the participation of workers and trade unions, including those in the informal economy. Monitoring of occupational health laws and policies on the basis of these mechanisms must be done transparently and in partnership with workers and the civil society, and all information resulting from this process must be made publicly available and accessible. Moreover, States must ensure that workers are intimately familiar with the right to health indicators and benchmarks so they can participate in the monitoring and evaluation of occupational health laws and policies on the basis of these mechanisms. Workers are best positioned to determine whether laws and policies affecting their occupational health are meeting the right to health benchmarks, and they have the greatest stake in ensuring that these laws and policies comply with the right to health. Ensuring that workers are familiar with the right to health indicators and benchmarks will additionally facilitate prospective State accountability by allowing workers to ascertain whether their right to occupational health is being realized. III. Substantive occupational health issues and the right to occupational health A. Hazards 36. The right to health requires States to take steps to prevent, treat and control diseases related to work. Despite the well-established connection between work and disease, 30 the nexus between factors in the work environment and workers‟ health outcomes is not always clear or easily defined. This is particularly the case with regard to diseases caused by multiple factors. The complex relationship between work and disease is recognized in the ILO classification of diseases related to work as “occupational diseases,” which have a specific link to a causal agent within the work environment; “work-related diseases,” which have multiple causal factors, one of which may include a factor in the work environment; and “diseases affecting working populations,” which lack a causal relationship with work but may be aggravated by factors in the work environment. 31 37. For example, in extractive industries, exposure to dust, fumes and particulates places workers at increased risk of being affected by a number of diseases, including occupational diseases, such as coal miner‟s pneumoconiosis; work-related disease, such as chronic obstructive pulmonary disease; and diseases affecting working populations, such as asthma.32 The right to health requires States to prevent, control and treat these diseases. Primary prevention is considered the most effective means of reducing the burden of disease, and as such prevention of disease should be the principal aim of States. 33 States are required to ensure adequate research and monitoring of the relationship between work 30 31 32 33 12 See WHO, Closing the gap in a generation: Health equity through action on the social determinants of health, Final Report of the Commission on Social Determinants of Health (Geneva, 2008). M. Lesage, “Work-related diseases and occupational diseases: The ILO international list,” ILO Encyclopaedia of Occupational Health and Safety (1998), vol. 1, part III, chapter 26, available at http://www.ilo.org/safework_bookshelf/english?d&nd=170000102&nh=0. A.M. Donoghue, “Occupational health hazards in mining: an overview,” Occupational Medicine, vol. 54 (2004), pp 283–289. Benjamin O. Alli, Fundamental principles of occupational health and safety (Geneva, ILO, 2001), p 18.