Work and health : risk groups and trends

Why examine the future of work and health? 5 1.2 How should the future be studied? 7 1.3 Aim of this study 8 1.4 First phase: description of the recent past and present situation 9 1.4.1 Data sources used 9 1.4.2 The social security system in the Netherlands 11 1.5 Second phase: exploration of the future 14 2 How to define 'work' and 'health' 17 2.1 What do we mean by 'work'? 17 2.2 What do we mean by 'health'? 18 3 Theory: the quality of working life, work capacity and health 23 3.1 The relevance of work for health 23 3.2 The macro-determinants of the quality of working life 26 3.3 The quality of working life: stressors at work 27 3.4 Work capacity: the coping ability of working people 27 3.5 The effects of work on health and well-being 28 3.6 Working life, work capacity and health combined in a model 30 4 The macro-determinants of the quality of working life 33 4.1 Introduction 33 4.2 The economy as a determinant of the quality of working life 33 4.3 Technology as a detemiinant 35 4.4 Occupational health care as a detenninant 39 4.5 Dutch government policy as a determinant of working conditions 42 4.6 Summary and conclusions 45 Page 5 5.1 5.2 5.2.1 5.2.2 5.2.3 5.3 5.3.1 5.3.2 5.3.3 5.3.4 5.3.5 5.3.6 5.3.7 5.3.8 5.3.9 5.4 5.5 5.5.1 5.5.2 5.5.3 5.5.4 5.6 6 6.1 6.2 6.3 6.4 6.5 6.6 6.7 The quality of working life in the Netherlands Introduction Job content Monotonous work/short cycled work Training and experience in relation to the actual job content Work pace Working conditions Heavy physical work Noise at work Vibrations and shocks Climate and the Sick Building Syndrome Radiation Chemical agents and working conditions Biological agents and working conditions Dirty work Unsafe working conditions/dangerous work Labour relations Employment conditions Promotion possibilities/prospects Length of working hours New work patterns/work contracts Shift work Summary and conclusions Characteristics of the working population in the Netherlands Introduction The population and the labour force in the Netherlands Age Sex Education Norms and values about work Summary and conclusion 47 47 49 49 51 52 52 52 54 56 57 58 58 60 61 62 63 64 64 66 68 68 70 73 73 73 74 76 76 77 78 Page 7 The health of the working population 79 7.1 Introduction 79 7.2 Opinions of working people about their own health 79 7.3 Visits to GP's and the use of medicines by working people 83 7.4 Sickness absence 84 7.5 Prolonged employment disability 87 7.6 Occupational diseases and disorders related to work 92 7.7 Occupational accidents 97 7.8 Summary and conclusions 98 8 The future of work and health: introduction and methodology 101 8.1 The Delphi method in general 101 8.2 The seven scenarios of the Delphi study Work and Health 102 8.3 The selection of four industrial branches 104 8.4 The experts consulted (members of the panel) 104 8.5 The questionnaires used 106 8.5.1 The questionnaire for the first Delphi round 106 8.5.2 The questionnaire for the second Delphi round 110 8.6 Method of analysis of the answers to the questionnaires 111 8.7 The quality of the results of the Delphi study 112 8.7.1 The homogeneity of the answers of the experts 112 8.7.2 Impact of the feedback from the first round on the answers in the second round 113 8.7.3 Influence of experts' occupation on the responses 113 8.7.4 Influence of self-selection of the expert and the degree of expertise on the answers 114 8.8 Summary 116 9 Results: the six exploratory scenarios 119 9.1 Introduction 119 9.2 The six exploratory scenarios compared 119 9.3 Favourable and unfavourable developments in the quality of working life 1983/1986 - 2010 121 9.4 Favourable and unfavourable developments in health 1983/1986 - 2010 129 9.5 The differences in work and health between the four industrial branches 1983/1986 - 2010 132 9.6 Summary 134 Page 10 Results: the goal-oriented scenario 137 10.1 Introduction 137 10.2 Setting priorities in the nine policy areas 137 10.3 Concrete measures in the three most important areas 139 10.4 The costs of the proposed measures 141 10.5 Summary 142 11 Future projections of sickness absence and work disability 145 11.1 Introduction 145 11.2 Influence of economic developments on sickness absence and employment disability until the year 2010 146 11.3 Influence of the demographic distribution of the working population on sickness absence and employment disability until the year 2010 150 11.4 Summary, discussion and conclusions 153 12 Summary and final reflections 157 12.1 Aim and relevance 157 12.2 Recent developments in the area of work and health 158 12.3 Differences between age groups and between men and women 161 12.4 Differences between industrial branches today and in the future 163 12.5 What do the scenarios have in common? 166 12.6 Influence of the state of the economy on the future of work 169 12.7 Influence of policy measures on the future of work and health 171 12.8 How should sickness absence and employment disability be tackled? 173 12.9 Policy recommendations