Wide disparities in risk exposure and negative health outcomes

Life expectancy has been steadily improving in Norway during the last decades. A recent report provides comprehensive information on working conditions and occupational health. Although, in general, workers considered the level of job demands, job control and social support as balanced, exposure to physical and chemical risks and work-related health outcomes remain a concern, especially in some economic sectors and occupational groups.

Background

The National Surveillance System for Work Environment and Occupational Health (Nasjonal overvåking av arbeidsmiljø og -helse, NOA) was established in Norway in 2006. Its first comprehensive report or fact book (in Norwegian) on the status of and trends in the work environment and occupational health was published in August 2007. The report was based on available data from surveys regularly performed by Statistics Norway (Statistisk sentralbyrås, SSB) over the past decade, as well as data from several other national bodies, including: the Norwegian Labour and Welfare Organisation (Arbeids- og velferdsforvaltningen, NAV); the National Institute of Occupational Health (Statens arbeidsmiljøinstitutt, STAMI) and its database for occupational exposure measurements (EXPO); and the Authorities’ Central Register of Chemical Products (Statens sentrale register over kjemiske produkter, Produktregisteret).

Psychological and social conditions at the workplace

Based on the SSB 2003 ‘Level of living survey’, most of the workforce regarded the level of job demands, control over work and social support in the workplace as being balanced. About 20% of the workers surveyed experienced quantitative demands above a level that may lead to negative health consequences. Some 80% of the respondents reported a satisfactory degree of social support and an absence of negative social relations with their colleagues or boss. However, almost 15% got hardly any feedback from their superior.

One out of 10 workers had a job where errors could represent a hazard to other people’s life and health. At the same time, one third of the workforce reported difficulties in combining work and private activities or family life, with this proportion increasing slightly among those with children and/or who worked long hours.

Chemical and physical risks

Each year, an estimated 7,000 samples are collected from Norwegian workplaces for occupational hygiene measurements at Norwegian chemical laboratories. Some 20% of the data are registered at STAMI in the EXPO database. For one third of the situations where the measured level exceeded the recommended concentration, personal protection equipment had not been used. Furthermore, only a small proportion of employers had performed adequate risk assessments.

Exposure to noise and vibration has remained relatively stable over the last 15 years: loud noise affects 9% of men and 6% of women, while the corresponding proportions for vibration are 6% and 1%–2%. In terms of economic sector, exposure is high in manufacturing, mining and quarrying, and construction. By occupation, the most exposed groups are plant and machine operators and assemblers, and craft and related trades workers.

As regards the ergonomic work environment, half of the workers surveyed report that they are standing or walking for most of their working hours. Some improvement was seen in the prevalence of lifting in awkward positions, with a 50% reduction over the past decade for young employees aged 16–24 years. Tasks involving repetitive manual strain affected 35% of the workforce, while more than 10% of workers had to lift more than 20 kg a minimum of five times a day.

Sick leave and occupational accidents

Despite the overall improvement in health as seen by the improvement in life expectancy, one tenth of people aged 16–74 years receive a pension, which is twice the proportion registered 25 years ago.

Overall, two out of five active workers who reported more than 14 days of consecutive health-related absence in the previous year stated that their working conditions caused the sick leave. Meanwhile, 20% of all those occupationally active reported a medium to high degree of musculoskeletal disorders during the month before the interview, most frequently affecting the shoulders, neck and upper part of the spine.

The number of occupational accidents varied depending on the source of registration. Each year, an estimated 78,000 accidents lead to contact with the healthcare system and/or sick leave. The number of fatal accidents – that is, leading to death within the subsequent 12 months – seemed rather constant over the years (Figure 1). Most of the fatal accidents occurred in land-based activities, but the number of accidents per employee was higher in sea transport and fishing.

Figure 1: Number of fatal occupational accidents, by year and area of activity

Figure 1: Number of fatal occupational accidents, by year and area of activity

Source: NOA, Fact book on the status of and trends in the work environment and occupational health, 2007

Differences among sectors and occupational groups

Almost 30% of economically active people reported that they did not get enough sleep every week. In some sectors, 25% to 30% of the workers reported a lack of sufficient rest and recreation between workdays, namely in agriculture and forestry, fishing, hotels and restaurants, and financial intermediation.

The proportion of self-reported work-related sick leave reveals clear differences between occupational groups. Typically, the occupations at the top of the graph in Figure 2 imply high income and sedentary work and lower levels of sick leave, while the occupations listed further down represent more unskilled workers and higher exposure to physical and chemical factors. These findings call for further efforts in research and risk prevention.

Figure 2: Reporting of sick leave, by occupational group (% within group)

Figure 2: Reporting of sick leave, by occupational group (% within group)

Source: SSB, Level of living survey, 2003, cited in NOA, 2007

Commentary

Norway is considered an egalitarian country but the first report from the NOA reveals that occupational risk exposure and indicators of negative health outcomes are not evenly distributed.

Tom K. Grimsrud and Steinar Aasnæss, NOA

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