The HEALTHatWORK project reviewed the current state of knowledge and issues related to the economic impact of health and safety at work. The project synthesised and analysed data from national projects and surveys in the participant countries, and recommended future actions for research and policy development aimed at improving health and safety at work in a changing labour market environment in the European Union.
This was achieved through co-ordinated reviews and the development of common datasets of indicators of health and safety at work. The use of geographical information systems (GIS) and statistical analysis facilitated the identification of patterns of the above indicators across countries and time. A pilot study was also designed to evaluate the cost and benefit of investing in health and safety at work.
The increasing competition prompted by globalisation, and the rising job insecurity associated with labour market flexibility and demographic developments in the composition of the workforce, pose important challenges for the occupational health and safety (OSH) of workers in modern economies. Evidence from psychological research suggests that individuals consistently underestimate the probability of an accident/illness at work.
There are considerably large economic costs associated with the lack of provision of health and safety in the workplace (about 3% of lost life years due to the factor ‘work’, work-related diseases and accidents account for financial losses as high as 4% of world-wide GDP). For each worker in the EU-15, an average of 1.3 working days is lost each year due to an accident at work and 2.1 days are lost because of other work-related health problems.
The social costs of occupational injuries and illnesses (the cost to families/communities/national social insurance systems that have to bear the burden of disabled and idle workers, and the early retirees etc.) are largely overlooked in the relevant discourse. Indicators that capture the efficiency of OSH management by firms are inadequately monitored at present.
Information regarding many aspects of OSH management is not readily available in European or international labour market datasets. There is generally a lack of reliable statistical information about the harmful consequences of carcinogens or the beneficial effects of any preventative actions. In addition, many governments and the European Commission have recently paid greater attention to the need to tackle the non-trivial costs to both individual and societal welfare that the lack of OSH entails, as part of their overall goal to overhaul social security regimes. This project investigated issues related to theory and empirical evidence of the market for occupational safety and health.
The HEALTHatWORK project reviewed the current state of knowledge and issues related to the economic impact of health and safety at work. The project has synthesised and analysed, assembled, organised, analysed and synthesised data from national projects and surveys in the participant countries, and recommended future actions for research and policy development aimed at improving health and safety at work in a changing labour market environment in the European Union.
The aims of the project was achieved through, co-ordinated reviews, the development of common datasets and their statistical analysis. The use of GIS analysis facilitated the identification of patterns of the OSH indicators across countries and time. In co-ordination meetings and workshops the status of OSH was reviewed, its repercussions for the quality of work examined and a comparative EU-wide assessment of the structure and dynamics of OSH carried out.
A pilot study was designed to evaluate the willingness of employers and employees to invest in health and safety at work. Policy recommendations aimed at improving the health and safety in the context of changing labour market environment and its repercussions in the competitiveness of European labour markets were proposed.
Work sickness absences of women and men are found to be related to both working conditions and household background. Workers that appear to be particularly unhappy about their job conditions are more likely to report mental health problems. Health and safety regulations (SHRHSR) at the workplace and labour market institutions (LMR) can explain a significant part of the cross-country differences. Countries with high levels of LMR and low levels of SHR are associated with critical levels of mental health distress (Greece, France and Italy), while higher levels of HSR and intermediate level of LMR appear, on average, to reduce workers’ mental health distress (Austria, Ireland, United Kingdom and Denmark). Conversely, countries with both high HSR and LMR show a high incidence of mental health problems (Sweden and Finland). Women workers exhibit higher sickness absence than men across all ages. The absence rate of part-time workers is significantly higher when compared to full-timer workers.
Rates of sickness absence seem to fall as earnings increase. There are regional variations in the rate of sickness absence, though there is no single obvious explanation for this. Rates of sickness absence also vary by industry and occupation, and these seem to be connected to the status of the occupation and the nature of the work undertaken. The rates of sickness absence increase with time in tenure with an employer and with the number of employees at the workplace. Much of the regional difference in absenteeism is due to the incentives that workers face in attending an extra hours of work either because of the direct wage remuneration or because better attendance translates into higher wage rates in the future and or due to the direct health effects that a higher income can provide in terms of a healthier life.
There appear to be minor effects of workplace innovations on sickness absence and accidents at work in some countries, such as Finland, that are in sharp contrast to other countries reporting a positive relationship between workplace innovation systems and sickness absence. This may reflect the tradition of close cooperation between employers and employees characterising the labour market institutions of these countries. This suggests that improved cooperation between employees and employers help to reap the benefits to be gained from wider use of innovative work practices. The socio-economic status plays a role in explaining the risk of sickness absence due to the potential impact that occupation and education – which is closely related to socio-economic status - on absenteeism. The regional differences in absenteeism are a matter of economic development and creating opportunities for regional labour markets. Simply reducing absenteeism should not be the only target because increasing output is only an intermediate target to achieving the real target of increasing welfare.
Achieving a work-life balance is an important objective but simply increasing incentives for nobody to ever be absent should not be the target nor is it achievable. It is neither efficient nor desirable for workers to continue to attend work when genuinely ill because they may pass on transmittable diseases to others and also because this may harm their long-term health status. The statistical relationship between absenteeism and family obligations has practical implications for personnel policy as well as social policy. If – in the lack of public care infrastructure – women are considered responsible for household and care work, employers will expect women (with children) to be absent more often than men. Nonetheless, in order to avoid a self-fulfilling prophecy of an employer’s expectations of a higher care-related absence rate of a female employee, resulting in less pleasant job characteristics and working conditions, social policy should provide an infrastructure of care facilities that would ease the link between absenteeism and family obligations.
The direct application is to improve understanding of the determinants of health and safety at work and to provide information for policies needed to ensure the provision of incentives via appropriate legislation to improve OSH. The applications for the outcomes of this project are its policy implications and therefore in assisting decision-makers to orientate prevention policies and improve working conditions at European level. The study provides important new information about topics that occupational health researchers and policy makers should take into consideration when developing job retention programs and OSH policies.
Knowledge of how health is affected by the work environment and employment arrangements is clearly of policy relevance as it provides key equity considerations to complement the efficiency argument advocated by employers. Moreover, the extent of these problems seems to vary across countries according to the legal and social protection for worker’s health and safety. The policy implications for health expenditures, work related disability benefits and, more generally, for worker’s overall wellbeing are also of interest. Policy measures should combine renewed efforts to monitor working conditions at workplaces, help firms to improve the overall quality of work, as well as regulating work-related physical hazards and psychological job stressors.
Policy makers should make efforts to evaluate the cost, both at the economic and social level, of health problems deriving from an adverse work environment, focusing on the role played by new risk factors such as psychosocial hazards. Situations in which the risks are not known to workers, as in the case of health hazards or situations in which the labour market is not competitive, market forces might not operate effectively to internalise the risk. These cases provide an opportunity for cost effective government intervention.
Introducing laws in favour of the workplace health promotion may provide a policy strategy to incentivise employers to provide more safety at work. For instance, financial aid for employers who provide innovations in work organisation practices should be expected to lead to lower probability of accidents and lower employer costs in OSH. The evidence also shows that measures such as appointing a health and safety representative, good communication on OSH and compliance with simple regulatory requirements such as displaying health and safety information or providing leaflets on health and safety at work are significantly effective.
Overall, regulation is necessary for an economy to attain efficient and equitable levels of OSH. The basis of this type of regulation is the actual probability of occupational risk. In this sense, the regulatory activity should take into account the objective probability of accident or illness at work for the particular occupation, and intervene by setting appropriate health and safety standards. Monitoring and enforcing these standards (by the imposition of financial penalties or prosecution to non-compliers) seems to be necessary given the observed tendency of workers’ job risk underestimation.
The economic evaluation of occupational and safety health interventions play an important role in the orientation of prevention policies. Comparative analyses of different prevention interventions are useful for establishing priorities and trade-offs, based on a cost-benefit criterion. It is also a way to investigate the distribution of costs among the different diseases, types of exposures and economic sectors in order to focus interventions on these specific issues.