International Journal of Emergency Mental Health and Human Resilience, Vol. 17, No.2, pp. 514-520, ISSN 1522-4821 IJEMHHR • Vol. 17, No. 2 • 2015 514 BACKGROUND The work conditions and the nature of work environment affect the health of employees. Factors, such as, temperature, sound, vibration, etc signifcantly determine the quantum and type of work-related ailments and injuries which occur due to unavoidable interaction between the physical–physiological systems of an individual with the external agents at work. Occupational safety and health (OSH) is the science of anticipation, recognition, evaluation and control of hazards arising in or from the workplace that could impair the health and well- being of workers (Alli, 2013). Besides work-related disorders, it also encompasses all contextual factors that affect health within a work environment. The burden of disease attributed to occupational diseases is high and it is estimated to be about 11 million cases annually, with about 700,000 deaths (Leigh et al., 1999). The World Health Organization estimates occupational health risks as the tenth leading cause of morbidity and mortality. Selected occupational risk factors account for 1.5% global burden of disease in terms of Disability Adjusted Life Years (DALY). The World Health Report 2002 reported that occupational risk factors accounted for 37% back pain, 16% hearing loss, 13% chronic obstructive lung disease, 11% asthma, 10% injuries, 9% cancer, and 2% leukemia (Wilkinson & Marmot, 1998). On the other hand, the WHO estimates that out of over 40 million working population only 10-15% of the workers have accesses to basic occupational health services (Census of India, 2001). Developing countries contribute to three-fourths of the global workforce; more than 125 million workers are victims of occupational accidents and diseases every year. In the wake of rapid industrial growth, the occupational morbidity pattern is fast changing. Poor occupational health and, in turn, reduced working capacity may cause an economic loss of up to 20% of the Gross National Product (GNP) (Mikheev, 1994; Zodpey et al., 2009). In India the rates of occupational fatalities and accidents are 10.4 and 8,700 per 100,000, respectively (Alli, 2013). The rapidly changing job patterns, working relationships & modalities of employment are the key barriers to effective management of occupational safety and health risks. According to a World Bank estimate, two thirds of the occupationally determined loss of disability-adjusted life years (DALYs) could be prevented by occupational health and safety programs (WHO, 1995). Concerted attention towards preventive, promotive and rehabilitative health and safety of workers in ‘hazardous occupations’ is long overdue. AIM AND OBJECTIVES This review paper critically examines the current occupational health scenario of railway employees in India in terms of the various types of hazards they are exposed to and the consequent health challenges. The paper considers the existing constitutional and legal frameworks to deal with employee safety and compensation. In the last section, it summarizes the level of preparedness of the employer to deal with such challenges. The paper is presented in two broad sections: the frst section discusses the occupational health challenges of railway workers and legislative safety nets; the responsibility of stakeholders, including of the government, the context and the emerging priorities for each responsibility is presented separately in the last section. MATERIALS AND METHODS We adopted a search strategy to retrieve information available on the internet. We used ‘PubMed Central’ search engine. A set of key words encompassing various domains related to occupational health were used. Those are: occupational health, occupational medicine, industrial health, industrial medicine, occupational health policies in India, occupational health of railway workers, health safety, and occupational hazards. The websites of the Ministry of Environment and Ministry of Labor, the International Labor Organization (ILO), World Health Organization (WHO), International Commission on Occupational Health (ICOH) and Indian Railways were also referred to. RESULTS Occupational Health Challenges of Railway Employees Indian railways (IR) are the backbone of passenger and freight transportation system in India. It is the largest rail network in Asia the second largest under one management, world over (Indian Railways). Occupational Health Challenges of Railway Employees in India – Towards Developing a Comprehensive Framework for Action Gyanaranjan Pradhan, Anindita Pattnaik, Subhrabhanu Panda, Bhuputra Panda* Public Health Foundation of India, Indian Institute of Public Health, Bhubaneswar, India ABSTRACT: Provision of occupational health services plays a critical role in employee retention, motivation and job satisfaction. Work related health and safety needs of railway employees in India have not received the due atten- tion. Lack of comprehensive framework for analysis and paucity of scientifc literature on the subject is a bottleneck for formulation and implementation of efective policies around the subject. Tis review paper ofers a framework for further consideration of the government. In the frst of its kind work, the paper also presents a unique and com- prehensive perspective of the responsibilities, contextual factors and emerging priorities with regard to occupational health challenges of railway workers. Opting for a comprehensive occupational health policy, capacity building of key stakeholders, regular supervision, strengthening of information management system and facilitating research and in- novation on the subject has the potentiality to pay rich dividends in the long run not only to individual workers but also to the economy and the railway industry. *Correspondence regarding this article should be directed to: bhuputra.panda@iiphb.org