Work-related health costs do not disappear despite continuous changes of working conditions

Abstract

Recent conservative figures (1) estimate that work-related deaths account for 2.5 per cent (women) and 3.9 per cent (men) of premature deaths between the ages of 25 and 74. Direct costs for treatment and indirect costs due to income loss and early retirement have been estimated in multiple countries. According to a 2008 publication ([German only] (2) by the German federal association of company health insurance providers the direct and indirect costs due to physical strain alone total 28 billion euros. A 2009 report by the Australian government (3) states that its work-related health costs amount to 57 billion Australian dollars, which represents 5.9 per cent of its GDP. Previous studies commissioned by SECO have estimated the health costs of stress and back pain in Switzerland. An elaborate survey by Ramaciotti and Perriard (2003) estimated the cost of stress in Switzerland at 4.2 billion Swiss francs. Using representative survey data and published cost estimates, Laubli and Muller (2009) (5) calculated the work-related costs of musculo-skeletal complaints to be over 3 billion Swiss francs. The restrictive definition of “occupational illness” in Switzerland means that only very few health problems are recorded as such. However, extrapolating from the Australian study suggests that costs in Switzerland amounted to over 30 billion Swiss francs in 2012. A better and more detailed cost calculation of the health consequences of arduous working conditions could help implement preventive measures more e ectively. Using data from representative interviews of wage-dependent workers in Switzerland, it was analysed how many of the reported health problems can be traced back to unfavourable working conditions. The calculations performed allowed these work-related health problems to be attributed to speci c types of demands at work . The main ndings by this study are presented below. Calculations were based on information provided by 397 women and 461 men in personal interviews. This information comprises details about their working conditions and health problems subjectively attributed to their work. The randomised nature of the sample enabled an extrapolation for all of Switzerland. Each of the 16 reported health problems were examined individually to calculate how strongly they correlate with 118 workplace conditions. The sheer number of statistical tests increases the chances of uncovering purely coincidental links. A very low signi cance threshold of p < 0.00043 was thus chosen to reduce the probability of such coincidental ndings. The results of this study indicate that the prevalence of work-related health problems di ered enormously depending on job situation, ranging from 8 % to 77 % for men and 1 % to 50 % for women. The pattern of work-related health problems differed between men and women. Women often reported headaches, but rarely injuries, hearing problems or allergies. Cluster analysis was used to group jobs into types according to their respective conditions. This statistical technique showed that o ce jobs, if not limited exclusively to computer work, rarely result in work-related health problems for men. For women, jobs requiring little physical activity while at the same time providing high job satisfaction are particularly advantageous. Work-related health problems are highly prevalent among men whose jobs simultaneously expose them to strenuous physical activity and high levels of smoke, cold or noise. Assembly line work combined with low job satisfaction, as well as nursing jobs (regardless of job satisfaction) are linked to frequent health problems in women. The working conditions that are most likely to cause health problems in men are (in order of importance) the inhalation of