Major and chronic diseases

Work health related diseases


Given that most people spend 8 hours a day, 5 days a week, 50 weeks a year at work, and given that human-work relations have been intensively studied from a political, economical, sociological, psychological, and medical point of view, working life affairs have so far played only a minor role in health monitoring. However, it is increasingly being realized that work is not only a source of community wealth but can also have negative effects on human and public health, and therefore is a cost factor to modern societies. As an example, with respect to loss of life years, WHO and the World Bank attribute 3% to the factor work. The International Labour Office estimates that work-related diseases and accidents account for economical losses as high as 4% of the world-wide gross domestic product. In several EU Member States work-related health monitoring schemes do exist. These schemes often operate on a regional or industry-branch level and focus on occupational diseases, work accidents, and on the mere description of working conditions. However, at a national as well as international level, discussions on the standardization of more comprehensive reports have taken place and key indicators have been proposed by several bodies, including the WHO and the EU Commission.

Responding to the need of comparable indicators for work-related health monitoring

The project WORKHEALTH - Indicators for Work-Related Health Monitoring in Europe is a project in the framework of the Community Health Programme, coordinated by the BKK Bundesverband, aims to establish indicators for work-related health monitoring in Europe from a public health perspective. It will be carried out by means of three work packages. First, a synopsis of existing work-related indicator sets will be produced followed by the identification of areas still to be developed. These indicator sets usually consist of so-called generic indicators (e.g. physical workplace exposures), which then have to be detailed by operational definitions (e.g. prevalence of exposure to noise). While there are common indicators, these sets differ considerably with respect to the scope and degree of work-relatedness. However, establishing indicators from a public health perspective should make use of existing indicator schemes. Based on the synopsis, the second step is aimed at the supplementation of new indicators for work-related health monitoring. Considerable efforts will be directed to indicators which allow for the comparison and monitoring of health policies (e.g. effects of work-site health promotion programmes). The work package includes the identification of data needs, which at the same time has to be accompanied by a description of what information is available routinely at national or international level. This step finally allows for identification of data sources and data needs to improve implementation. The feasibility of work-related health monitoring at the EU level depends not only on the availability but also on the quality of the data. The last work package therefore focuses on the operational definitions of the indicators.

The need of comparable prevalence work-related health rate

It has long been accepted that a trade or occupation can be the cause of a disease, or at least a contributory factor to it. This realisation has led to a wide range of measures, backed up by legislation, designed to regulate safety at work, although new hazards are always likely to arise. However, there is also an interest in how a person's work affects their general state of health. Eurostat has analysed the data from several sources:

Recognised occupational diseases (EODS): Based on the experiences of a pilot data collection performed in 1998 (data of 1995) Eurostat has collected the first statistical data on recognised occupational diseases (EODS) for the reference year 2001. Recognition practices and social security arrangements for occupational diseases differ between the Member States, and the core data includes only those 68 occupational disease items which are covered by all national systems. The incidence rate per 100 000 workers was higher among men (48) than among women (22). The ten most common occupational diseases in the 12 Member States were hand or wrist tenosynovitis, epicondylitis of the elbow, contact dermatitis (4 457), noise-induced hearing loss, Raynaud's syndrome or vibration white-finger, carpal tunnel syndrome, mesothelioma, asthma, asbestosis and coal worker's pneumoconiosis. According to the European Schedule of Occupational Diseases the majority of the cases fell in the main categories of diseases caused by physical agents (20 937 cases), diseases caused by inhalation of substances and skin diseases.

The module from the EU Labour Force Survey 1999 in which respondents gave a self-assessment of their work-related state of health. In this study the focus was on health problems, excluding accidental injuries (and irrespective of their severity), that respondents considered were caused or only made worse by their current or past working conditions. Over the period 1998-99 it was estimated that 7.7 million persons in the EU suffered from one or more work-related health problems (WRHP) (excluding accidents), including cases where the onset was earlier but continued to cause problems. By contrast, the comparable annual total for accidents at work was 7.4 million workers. These problems were more numerous among workers aged 45 and over (57%), and among male workers (54%). In addition, 12% of victims had suffered from more than one WRHP over the year, but the characteristics of only the most serious problem were included. Musculoskeletal disorders were by far the most common medical problem (53% of all persons with a WRHP), followed by stress/depression/anxiety (18%). Interestingly, within the group of non-active persons who had worked previously only 8% reported stress/depression/anxiety as a problem, though this does not mean that diseases such as depression disappear among this population but that they are much less related to their past work.

See Work and health in the EU. A statistical portrait. Data 1994-2002
See European social statistics - Accidents at work and work-related health problems 1994-2000

The European Foundation for Improvement of Living and Working Conditions has carried out three surveys on the working environment in Europe (in 1990/1, 1995/6 and 2000) and also surveyed the acceding and candidate countries in 2001/2. These surveys provide an overview on the state of working conditions throughout Europe. Exposure to physical hazards at the workplace, intensification of work and flexible employment practices are still a primary cause of health problems for workers in the European Union. The survey reveals that no significant improvement in risk factors or overall conditions in the workplace took place over the ten-year period since the first survey was carried out. However, an increasing proportion of workers report work-related health problems. Musculoskeletal disorders (backache and muscular pains, particularly in the neck and shoulders) are on the increase, as is overall fatigue. There are strong correlations between stress and musculoskeletal disorders and features of work organisation such as repetitive work and pace of work.

See Working Conditions surveys - European Foundation for Improvement of Living and Working Conditions

The European Agency for Safety and Health at Work aims to make Europe's workplaces safer, healthier and more productive.

See European Agency for Health and Safety at Work