A/HRC/39/48 is estimated that an additional 29,000 deaths are due to the occupational diseases silicosis, asbestosis and pneumoconiosis.13 6. Due to differences in social roles, including occupational and household roles, women and men are exposed differently to toxic chemicals with respect to, among other things, the substances encountered and the degree of exposure. Biological differences between men and women, such as physiological and hormonal differences, create differing susceptibilities to the effects of exposure.14 For example, women are more likely to store higher levels of environmental pollutants in their adipose tissues than men. During pregnancy, lactation and menopause, women’s bodies undergo changes that may increase their susceptibility to health impacts from toxic exposures. 7. Of particular concern is the exposure to toxic chemicals of workers who are women of reproductive age. Protecting only pregnant women from exposure is insufficient because a developing fetus can be harmed by exposures that preceded knowledge of the pregnancy. Adverse health effects, especially in expectant mothers and the fetus but also for the workforce at large, occur at extremely low levels of exposure. As evidence of adverse effects accumulates, “safe” levels of exposure are continually revised downward and children continue to be born with a host of adverse health outcomes due in particular to the exposure of their mothers to toxic chemicals during pregnancy (A/HRC/33/41). 15 8. Official statistics are likely to underestimate the extent of the problem. For example, incidences of exposure are grossly underreported in some contexts and countries. 16 As official incidence rates are based on reported data, an advanced country such as Finland may show a higher incidence of occupational disease than a country such as India, merely because of the former country’s greater facility to diagnose and identify occupational exposure as the source of a disease. Furthermore, some countries have no legal definition or reference list of occupational diseases to facilitate reporting the incidence of diseases and deaths from specific causes. Major occupational diseases such as chronic obstructive pulmonary disease may not be well recognized and tend to be underdiagnosed. 17 Moreover, and importantly, self-employed workers, subsistence farmers and workers in the informal economy are rarely captured in national statistics. The informal workforce comprises a large portion of the global workforce and accounts for the majority of workers in certain countries, the largest and most populous of which are in less-developed regions.18 As many countries have inadequate capacity to collect information on causes of death, information on the disease and death patterns must be estimated. 9. Virtually every sector is implicated in this public health crisis, including both public and private sectors and the world’s most economically powerful industries. Many of these industries have — by their own design — vast and opaque supply chains, including links to the informal economy. Some of these business enterprises are not obviously implicated, for example a financial institution that trades gold mined using toxic mercury, resulting in severe impacts on informal workers and their children. A small selection of cases addressed by the mandate in recent years is provided in the annex to the present report. 10. In his report the Special Rapporteur analyses the human rights of workers implicated and affected by their occupational exposure to toxic and otherwise hazardous substances (toxic substances),19 followed by a summary of current challenges facing workers in the 13 14 15 16 17 18 19 4 WHO, Global Health Risks: Mortality and Burden of Disease Attributable to Selected Major Risks (Geneva, 2009), p. 25. United Nations Development Programme (UNDP), Chemicals and Gender, 2011. See also WHO, Summary of Principles for Evaluating Health Risks in Children Associated with Exposure to Chemicals (Geneva, 2011). ILO, “World Statistic: The enormous burden of poor working conditions” (n.d.). Hämäläinen, p. 17. Ibid., p. 7. Consistent with the previous reports of the current mandate holder and those of his predecessors, hazardous substances and wastes are not defined strictly; they include, inter alia, toxic industrial chemicals and pesticides, pollutants, contaminants, explosive and radioactive substances, certain food additives and various forms of waste. For ease of reference the Special Rapporteur refers to hazardous