Netherlands: Employment opportunities for people with chronic diseases

  • Observatory: EurWORK
  • Topic:
  • Labour market policies,
  • Työaika,
  • Health and well-being at work,
  • Working conditions,
  • Published on: 14 marraskuu 2014



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Netherlands
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Disclaimer: This information is made available as a service to the public but has not been edited by the European Foundation for the Improvement of Living and Working Conditions. The content is the responsibility of the authors.

There is no clear national definition of a chronic disease in a work situation in the Netherlands. Questionnaire data shows that between 25% and 30% of all workers are affected by a chronic disease. Worker with a chronic disease have slightly different working conditions as compared to workers without a chronic disease but differences may be also due to age, gender or sectoral differences between workers with and without a chronic disease. On a policy level the focus in the Netherlands is on participation. The latest regulation regarding this is the introduction of the ‘Participatiewet’ (participation law) which is expected to come into force on 1 January 2015.

Block 1: Concept, definitions, sources of information and methodological issues on chronic diseases and work from the national perspective

1.1. National definition of chronic disease

In the Netherlands there is no generally used definition of a chronic disease in an employment status.  However, in the legislative system a number of laws are relevant regarding the definition of a chronic disease.

The first is the Equal treatment on grounds of disability or chronic illness Act. ( WGB disability or chronic illness )
 The WGB disability or chronic illness came into force in 2003 and prohibits unequal treatment of people with a disability or chronic illness. The terms “disability " and "chronic illness" are not defined in the Act .The act states that there should be no discrimination on grounds of disability or chronic illness in conditions of employment and employers need to make the necessary work adaptations in order to  enable effective work participation of disabled and chronically ill.

The second is the legislation regarding work disability, the work and Income according to the ‘Work and Income according to Working Capacity Act’ (WIA). This law does not specifically aim at defining chronic diseases, and no specific diseases are mentioned. However a timeframe is: one is eligible for a work disability benefit if he or she is unable to fully or partially work on a long-term or permanent basis due to an illness after 2 years of sickness absence.  Whether or not someone qualifies for benefit payments under the WIA depends on the extent of their incapacity to work (and the resulting loss of income). The assessment for the benefit may include a full (80-100% disability) or  a partial disability (35-80%).

The third is the WSW (sheltered employment). Sheltered employment is available for persons with a physical, psychological or mental impairment that are unable to work in a regular workplace. Again no specific diseases or timeframe had been mentioned.

1.2. Information on national sources of statistical information dealing with the issue of chronic diseases and their relation to employment and working conditions

Next to the above mentioned information regarding chronic diseases and work there are several large national questionnaires that aim to measure chronic disease.  Table 1 gives an overview of these questions.

Statistics Netherlands (CBS) asks about chronic diseases in two of their questionnaires, the ‘Health Questionnaire’ (Gezondheids enquête) and the Dutch Labour force Survey (Enquête beroepsbevolking, EBB). Both questionnaires ask whether a person has a long-term disease. The labour force survey in addition questions whether this disease hinders one in obtaining work or in work performance.

The Netherlands organisation for Applied Scientific research (TNO) in collaboration with Statistics Netherlands measures chronic disease in the Netherlands Working Conditions Survey (NWCS). It is asked whether one has a chronic disease and if so what this disease is. Furthermore it is asked whether this disease hinders work and whether it is causes by the work and if workplace adaptations have been made because of the chronic disease of further workplace adaptations are needed.


Table 1 - Questions regarding chronic diseases and work in large national surveys

Source

Methodology

Definition of Chronic disease (question asked)

Diseases included

Questions in relation to work and employment

 


Labour force Survey (Enquête beroepsbevolking, EBB), Statistics Netherlands


Yearly cross-sectional questionnaire, among about 18.000 households (max 8 persons per household). Since 2010 by,


Do you have one or more long-term illnesses or conditions


-


Employment status

Does this hinder you in your work

Does this hinders you in obtaining work


 


Health Questionnaire (Gezondheidsvragenlijst), Statistics Netherlands


Yearly, crosssectional questionnaire among about 15.000 persons (respons 60-65 percent)


Do you have one or more long-term illnesses or conditions


-


Employment status


 


Netherlands working conditions survey (Nationale Enquete Arbeidsomstandigheden, NEA/ NWCS), TNO


Yearly, cross-sectional,  questionnaire among about 25.000 employees. First questionnaire was executed in 2005 (after a pilot in 2003)

 


Do you have one or more of the following long-term illnesses, disorders or disabilities, and if so, please indicate which one?
(multiple answers possible)


Diabetes

Problems with arms or hands (including arthritis, rheumatism, RSI)

Serious skin problems

Problems with legs or feet (including arthritis, rheumatism)

Psychiatric symptoms / diseases

Problems with back and neck (including arthritis, rheumatism, RSI)

Hearing Problems

Migraine or severe headache

Epilepsy

Cardiovascular disease

life-threatening diseases (eg cancer, AIDS)

Asthma, bronchitis, emphysema

Problems seeing

Stomach or intestinal problems

Other


Employment status

Does your illness, disease or disability hinder you in performing your job?

Does your illness, disease or disability result from the work
you did?


Were – because of your health- adjustments made in your workplace or your work in the last 12 months?

Do you think that further adjustments in your workplace or your work are necessary because of your health


National Employer  Work Survey (Werkgevers Enquete Arbeid; WEA)


Every other year since 2008; since 2012 it will be every four years. Every time a (cross-sectional) representative sample of employers is approached. In the response weighting takes place to have a response that is representative for company size and sector. It is a paper & pencil (PAPI) questionnaire for employers. The survey is aimed to have a net response of 5000 employer.


Employers are asked whether they have an explicit policy in place for specific target groups amongst which precarious workers.


Not specified


Not specified


 

Block 2: Prevalence, recent evolution and effects of the problem of chronic diseases among workers and companies

2.1. People affected by chronic diseases and employment

Table 2 gives the percentage of persons with a chronic disease by employment status for the 2000-2011 period. Just under 1 in 4 persons (age 15-65) has a chronic disease, this percentage is higher among those who do not work than among those who do work.  It is clear that in the last few years (2009-2011) this percentage has dropped quite a lot. This is probably due to the fact that the questions were asked in a different way in these years (by phone, and/or only in a single quarterly measure instead of 4 quarterly measures).

The NWCS (table 3) shows that among employees about 1 in 3 has a chronic disease. A percentage that fluctuates slightly over the years, but does not show a clear in- or decrease.  Most prevalent are musculoskeletal problems (especially back problems), migraine/headache, and Asthma, bronchitis, emphysema

Patterns of chronic disease prevalence as well as in the type of conditions vary by age and gender.  Women more often have a chronic disease. This is found for all types except for cardiovascular disease, hearing problems and problems with vision. Elderly workers (age 55-64) more often have a chronic disease than middle aged or young workers. However: migraine/headache is most often found among workers between 25 and 54. (table 4)

Table 5 shows the prevalence of occupational diseases by sector. It is clear that there is a relation between occupational group and chronic diseases. This seems to be related to working conditions (Eg. musculoskeletal are more prevalent in sector with a high physical load such as health care, while hearing problems are more prevalent in industry and construction where loud noises are common), but may also be related to worker characteristics (e.g. cardiovascular diseases are more prevalent in public administration a sector with a relative high average age of the workers).

Table 6 shows that workers with a chronic disease have difficulties to both obtain work and to remain employed. In 2009 92% of all workers were still employed one year later. However for workers with a chronic disease this is only true for 89% of the population. Workers with a chronic disease also seem to have troubles obtaining work. In general about 14% of the unemployed are in employment one year later. However there is a large difference between workers with a chronic, long-term, disease and workers without a chronic disease, with only 8% of the first group being employed one year later versus 17% in the last group.

The WEA (Netherlands Employer Work Survey) provides information on how companies deal with groups of so called ‘fragile workers’ this includes (but is not limited to) workers with a chronic health problem that affects their work (work handicapped) (table 7).  Almost 14% of all companies state that they have consciously hired fragile workers. 3,8% states that this is an explicit part of their mission. Table 8 shows that many companies experience obstacles in hiring fragile workers. Mostly because they feel that the work is unsuitable, but also because they feel that these workers do not apply for a job and because they expect a lot of additional administration.


Table 2: Percentage of persons aged 15-65 with a chronic disease or a work handicap (chronic disease that hinders work).

 

 

2000

2001

2002

2003

2004

2005

2006

2007

2008

2009

2010

2011


total population


% chronic condition


23,5%


24,4%


24,8%


24,9%


24,8%


24,9%


24,6%


 


22,8%


23,2%


21,2%


19,2%


 


% work  handicap


13,7%


14,5%


16,5%


16,6%


16,5%


16,1%


15,4%


 


 


15,0%


13,4%


12,6%


population eligible to work


% chronic condition


19,2%


19,1%


19,3%


19,5%


19,4%


19,4%


19,3%


 


17,6%


17,9%


16,0%


13,7%


 


% work  handicap


11,2%


11,2%


11,3%


11,2%


11,2%


10,7%


10,2%


 


 


9,8%


8,2%


7,2%


population actually working


% chronic condition


18,8%


18,8%


18,8%


19,1%


18,8%


18,8%


18,5%


 


17,1%


17,5%


15,6%


13,2%


 


% work  handicap


11,0%


11,0%


11,0%


10,9%


10,7%


10,2%


9,5%


 


 


9,5%


7,8%


6,8%


unemployed population


% chronic condition


28,9%


27,4%


29,5%


27,3%


28,2%


28,6%


31,1%


 


28,3%


25,0%


23,5%


22,2%


 


% work  handicap


16,7%


16,3%


18,9%


17,7%


18,5%


17,8%


20,4%


 


 


16,0%


15,0%


13,8%

Source: Source EBB


Table 3: Prevalence of chronic disease among employees in the 2005-2012 period

 

Average
2005-2012

2005

2006

2007

2008

2009

2010

2011

2012


 

No chronic disease


 

63,4%


 

66,3%


 

64,3%


 

64,7%


 

63,1%


 

61,9%


 

61,5%


 

64,2%


 

62,7%


Problems with arms or hands (including arthritis, rheumatism, RSI)


 

5,6%


 

5,7%


 

6,1%


 

5,5%


 

5,5%


 

5,4%


 

5,7%


 

5,3%


 

5,5%


· Problems with legs or feet (including arthritis, rheumatism)


5,3%


4,8%


4,9%


4,3%


5,8%


5,9%


5,2%


5,8%


5,3%


Problems with back and neck (including arthritis, rheumatism, RSI)


10,4%


10,8%


10,9%


9,9%


10,2%


10,6%


11,0%


10,1%


10,1%


Migraine or severe headache


5,6%


5,4%


5,3%


5,5%


5,5%


5,6%


6,1%


5,4%


5,7%


Cardiovascular disease


2,8%


2,6%


2,9%


2,5%


2,6%


3,1%


3,0%


2,8%


3,1%


Asthma, bronchitis, emphysema


5,3%


5,1%


5,3%


5,2%


5,3%


5,4%


5,4%


5,5%


5,5%


Stomach or intestinal problems


3,6%


3,6%


3,4%


3,4%


3,6%


3,8%


3,9%


3,5%


3,8%


Diabetes


2,1%


1,8%


1,9%


2,1%


2,0%


2,3%


2,0%


2,2%


2,2%


· Serious skin problems


0,9%


1,0%


0,9%


0,8%


0,7%


1,0%


0,9%


0,8%


0,8%


Psychiatric symptoms / diseases


2,7%


2,0%


2,4%


2,4%


2,4%


3,1%


3,1%


2,5%


3,0%


Hearing problems


2,1%


1,6%


2,1%


2,2%


2,2%


2,3%


2,1%


2,1%


2,2%


Epilepsy


0,4%


0,3%


0,4%


0,4%


0,3%


0,5%


0,4%


0,4%


0,4%


life-threatening diseases (eg cancer, AIDS)


0,7%


0,5%


0,6%


0,7%


0,8%


0,7%


0,8%


0,7%


0,7%


Problems seeing


1,8%


0%


1,9%


2,1%


2,1%


2,0%


2,0%


2,1%


2,2%


Other


5,9%


5,6%


6,1%


5,6%


5,9%


5,9%


6,4%


5,7%


6,0%


N


205.181


23.320


23.500


21.962


21.208


22.025


23.007


 22.456


24.801

Source NEA 2005-2012

 

 

 

 



Table 4: Prevalence of chronic diseases in employees by age and gender


 


Total


Gender


Age


 


 


· Women


· Men


· 15-24 years


· 25-54 years


· 55-64 years


N:


25.223


11.973


13.250


3.849


17.398


3.975


%:


 


47%


53%


15%


69%


16%


Year [N=25.223]


 


 


 


 


 


 


· 2012


100%


100%


100%


100%


100%


100%


No chronic disease


62,7%


60,0%▼▼▼


65,2%▲▲▲


74,8%▲▲▲


63,5%▲▲▲


47,4%▼▼▼


Problems with arms or hands (including arthritis, rheumatism, RSI)


5,5%


6,9%▲▲▲


4,3%▼▼▼


1,7%▼▼▼


5,2%▼▼


10,6%▲▲▲


Problems with legs or feet (including arthritis, rheumatism)


5,3%


5,7%▲


5,0%▼


2,2%▼▼▼


4,6%▼▼▼


11,5%▲▲▲


Problems with back and neck (including arthritis, rheumatism, RSI)


10,1%


11,2%▲▲▲


9,2%▼▼▼


3,8%▼▼▼


10,3%


15,6%▲▲▲


Migraine or severe headache


5,7%


8,2%▲▲▲


3,4%▼▼▼


4,4%▼▼▼


6,2%▲▲▲


4,4%▼▼▼


Cardiovascular disease


3,1%


2,0%▼▼▼


4,0%▲▲▲


0,5%▼▼▼


2,3%▼▼▼


9,0%▲▲▲


Asthma, bronchitis, emphysema


5,5%


6,3%▲▲▲


4,7%▼▼▼


5,5%


5,2%▼


6,4%▲▲


Stomach or intestinal problems


3,8%


4,2%▲▲


3,5%▼▼


3,0%▼▼


3,9%


4,2%


Diabetes


2,2%


1,7%▼▼▼


2,6%▲▲▲


0,6%▼▼▼


1,7%▼▼▼


5,8%▲▲▲


Serious skin problems


0,8%


0,9%


0,8%


0,6%


0,9%


1,0%


Psychiatric symptoms / diseases


3,0%


3,3%▲▲


2,7%▼▼


2,3%▼▼


3,1%


3,0%


Hearing problems


2,2%


1,6%▼▼▼


2,8%▲▲▲


0,8%▼▼▼


1,8%▼▼▼


5,5%▲▲▲


Epilepsy


0,4%


0,3%▼


0,4%▲


0,2%


0,4%


0,5%


life-threatening diseases (eg cancer, AIDS)


0,7%


0,8%


0,6%


0,0%▼▼▼


0,6%▼▼


2,0%▲▲▲


Problems seeing


2,2%


1,9%▼▼


2,5%▲▲


1,8%


2,1%▼


3,3%▲▲▲


Other


6,0%


6,9%▲▲▲


5,1%▼▼▼


5,1%▼


6,0%


6,7%▲


No chronic disease


62,7%


60,0%▼▼▼


65,2%▲▲▲


74,8%▲▲▲


63,5%▲▲▲


47,4%▼▼▼

 

 

Notes: . Percentages are column percentages, and are tested with the Pearson χ² test (horizontal comparisons). The contrast is subgroup vs other cases (weighted deviation contrast). ▲: p<0,05, ▲▲: p<0,01, ▲▲▲: p<0,001 (and ▼): significantly high (low) percentages (2-tailed). Symbols are based on significance only, not on effect size.

 

 

Source: NEA 2012

Table 5 - Prevalence of chronic conditions in employees by sector

Prevalence of chronic conditions in employees by sector



 


Total


Sector, SBI2008, 13 categorieën. Partly based on registry


 


 


· A (01-03). Agriculture, forestry and fishing


· B-E (06-39). Manufacturing


· F (41-43). Building and construction


· G (45-47). Trade (retail and wholesale)


· H (49-53). Transport and storage


· I (55-56). Horeca


· J (58-63). Information and communication


· K (64-66). Financial services


· L-N (68-82). Profit services and brokers


· O (84). Public Administration


· P (85). Education


· Q (86-88). Health and social care


· R-U (90-99). Cultural, sports and other services


N:


25.223


278


2.769


1.198


4.284


1.189


1.016


767


1.008


4.111


1.706


1.692


4.313


892


%:


 


1,1%


11%


4,7%


17%


4,7%


4,0%


3,0%


4,0%


16%


6,8%


6,7%


17%


3,5%


Problems with legs or feet (including arthritis, rheumatism)

 


5,3%


3,8%


7,1%▲


6,0%


4,7%▼


5,4%


4,5%


2,1%▼


3,2%▼


5,1%


5,2%


5,6%


6,3%▲


5,1%


Problems with back and neck (including arthritis, rheumatism, RSI)

 


10,1%


7,2%


12,6%▲


10,7%


8,7%▼


12,4%▲


7,5%▼


7,7%▼


9,5%


8,9%▼


11,5%


10,0%


11,1%▲


10,7%


Migraine or severe headache

 


5,7%


3,5%


5,1%


3,4%▼


4,8%▼


3,9%▼


6,9%


5,8%


4,3%


5,6%


6,7%


6,9%▲


7,7%▲


4,5%


Cardiovascular disease

 


3,1%


2,6%


4,1%▲


3,7%


2,7%


4,4%▲


1,1%▼


2,8%


3,6%


2,8%


4,5%▲


2,8%


2,9%


1,2%▼


Asthma, bronchitis, emphysema

 


5,5%


5,4%


5,7%


4,2%


5,0%


4,8%


4,9%


6,3%


5,0%


5,2%


5,5%


6,1%


6,2%▲


5,9%


Stomach or intestinal problems


3,8%


4,2%


4,6%▲


3,3%


3,2%▼


4,1%


3,1%


3,0%


4,2%


3,3%


5,4%▲


4,2%


4,1%


3,1%


Diabetes

 


2,2%


0,7%


3,5%▲


2,2%


1,8%


3,4%▲


1,4%


1,6%


1,9%


2,2%


2,9%▲


1,6%


2,0%


1,3%


Serious skin problems

 


0,8%


0,7%


0,6%


1,6%▲


0,7%


0,7%


0,8%


0,7%


0,9%


0,9%


1,1%


0,9%


0,9%


0,6%


Psychiatric symptoms / diseases

 


3,0%


0,6%▼


4,2%▲


2,3%


2,6%


2,6%


1,9%▼


2,8%


2,6%


3,0%


2,5%


3,9%▲


3,1%


3,9%


Hearing Problems

 


2,2%


1,3%


3,5%▲


3,4%▲


1,6%▼


3,3%▲


0,8%▼


1,1%▼


1,1%▼


1,9%


2,7%


2,7%


2,1%


1,8%


Epilepsy

 


0,4%


0%


0,8%▲


0,3%


0,3%


0,3%


0,1%


0,3%


0,5%


0,4%


0,3%


0,4%


0,2%▼


0,4%


life-threatening diseases (eg cancer, AIDS)

 


0,7%


0,5%


0,6%


0,5%


0,5%▼


0,6%


0,5%


0,6%


1,3%▲


0,6%


1,0%


1,2%▲


0,9%


1,2%


Problems seeing


2,2%


2,7%


2,4%


2,5%


2,2%


1,7%


1,3%▼


4,1%▲


2,6%


2,1%


3,1%▲


2,6%


1,6%▼


1,9%


Other


6,0%


4,7%


6,6%


4,5%▼


5,8%


6,5%


5,2%


3,9%▼


4,9%


5,9%


5,0%


6,6%


6,7%▲


7,8%▲

Notes: Percentages are column percentages, and are tested with the Pearson χ² test (horizontal comparisons). The contrast is subgroup vs other cases (weighted deviation contrast). ▲: p<0,05, ▲▲: p<0,01, ▲▲▲: p<0,001 (and ▼): significantly high (low) percentages (2-tailed). Symbols are based on significance only, not on effect size.

Source: NEA 2012

Table 6: Transitions in employment for workers with and without a chronic disease in the 2003-2009 period; employment status one year later

Transitions in employment for workers with and without a chronic disease in the 2003-2009 period; employment status one year later



 


 


2003


2004


2005


2006


2008


2009


Employed


Total


93%


93%


94%


95%


93%


92%


 


chronic disease


90%


90%


92%


93%


90%


89%


 


no chronic disease


94%


94%


95%


95%


94%


93%


Unemployed


Total


12%


13%


14%


15%


14%


14%


 


chronic disease


6%


7%


8%


8%


7%


8%


 


no chronic disease


14%


16%


17%


19%


18%


17%

Source: EBB

Table 7: Employers vision on hiring ‘fragile’ or precarious workers

Employers vision on hiring ‘fragile’ or precarious workers



 


 


Total


Agriculture


Manufacturing


Building and construction


Trade


Horeca


Transport & communication


Financial services


Profit services


Public Administration


Education


Health and social care


Other


 


N:


5.230


504


351


420


1.254


404


216


145


1.090


16


103


384


345


 


%:


 


9,6%


6,7%


8,0%


24%


7,7%


4,1%


2,8%


21%


0,3%


2,0%


7,3%


6,6%


 

Hiring fragile/precarious workers is an explicit part of the mission


· Yes


 


4%


3%


7%


1%


4%


2%


5%


2%


4%


14%▲


6%


4%


3%


· No


 


89%


86%


85%


93%


88%


88%


86%


87%


91%


77%


85%


92%


90%


· Don’t know


 


7%


11%


8%


6%


9%


10%


9%


11%


4%


9%


9%


4%


7%


 

Hired fragile/precarious workers in the past 2 years


· Yes


 


13%


15%


23%▲


10%


12%


18%


23%▲


10%


10%


20%


13%


14%


9%


· No


 


85%


85%


76%▼


89%


85%


81%


72%▼


90%


88%


69%


85%


83%


88%


· Don’t know


 


2%


0%


1%


1%


3%


2%


5%▲


0,2%


2%


10%▲


2%


3%


3%


 

obstacles in hiring fragile/precarious workers


· a. Expected costs of guidance


 


13%


12%


16%


21%▲


10%


11%


6%▼


12%


15%


11%


9%


7%


15%


· b. Financial risks duet o productivity loss


 


13%


18%


15%


21%▲


9%


19%


10%


10%


15%


7%


4%▼


7%▼


10%


· c. expected organizational trouble


 


14%


23%▲


16%


15%


12%


18%


12%


11%


15%


7%


6%▼


8%


14%


· d. it does not fit the work done here in this organuzation


 


54%


60%


51%


65%▲


50%


54%


53%


46%


48%


48%


52%


68%▲


53%


· e. Don’t know where to find these precarious workers


 


3%


3%


4%


3%


3%


6%


3%


2%


3%


2%


5%


1%


4%


· f. Precarious worker does not try to get a job at our organization


 


15%


18%


12%


20%


16%


19%


10%


17%


15%


13%


14%


12%


14%


· g. There are no barriers


 


18%


8%▼


19%


13%


20%


17%


15%


18%


26%▲


20%


13%


14%


10%▼


· h. Other


 


8%


9%


6%


4%


7%


10%


11%


9%


9%


11%


19%▲


9%


11%


· i. Don’t know


 


8%


4%


8%


6%


12%


6%


10%


5%


8%


11%


4%


4%


13%

Note: Percentages are column percentages, and are tested with the Pearson χ² test (horizontal comparisons). The contrast is subgroup vs other cases (weighted deviation contrast). ▲: p<0,05, ▲▲: p<0,01, ▲▲▲: p<0,001 (and ▼): significantly high (low) percentages (2-tailed). Symbols are based on significance only, not on effect size.

Source: WEA (NEWS; Netherlands Employer  Work Survey;  2012)

2.2. Working conditions of employed people affected by chronic diseases

The purpose of this section is to analyse whether there are any distinctive characteristics of the working conditions of the people affected by chronic diseases in comparison to the average (national, sectorial), considering the four EF’s WC categories (Health and well-being; Reconciliation of working and non-working life; Career and employment security issues; Skills development) :

·      Health and well-being: Are certain occupations/jobs/sectors associated to certain chronic diseases? Possible relation between occupations and chronic diseases; what are the factors behind this (exposure to risks and hazards, job intensity, type of work, etc.); are special H&S measures implemented at workplace level to avoid/palliate this?

·      Reconciliation of working and non-working life: are people with chronic diseases allowed special conditions in terms of work-life balance, flexibility at work to cope with the diseases/attend treatment, ability to set their own working time arrangements, etc.?

·      Career and employment security: to which extent and how is the employment status of people with chronic diseases affected by their health situation?; is there an impact in their remuneration levels/conditions?; in what measure is there a repercussion on their employment security and working career?; are they allowed/forced to changes in their jobs?

·      Skills development: in what measure have chronic diseases an impact in the access of workers to training activities promoted by the employer? Has the training anything to do with the disease situation?

·      Are there any significant differences in these working conditions according to different groups of affected workers (type of disease, gender, age, sector, etc.)?

·      Are there any significant changes in recent years? Possible effects of the economic crisis on these situations, if any.

Table 5 showed that chronic conditions are more prevalent in some sectors and that this seemed at least partly related to the exposure to risks. Table 8 shows exposure to physical and psychological risks at work. Workers with a chronic condition report a higher exposure to both physical and psychological risk factors. Although there are differences between specific diseases this pattern is found for all chronic diseases. Table 9 shows that workers with a chronic disease more often feel that (additional) health and safety measures need to be taken regarding exposure to risk factors.  About 20% of the workers with a chronic disease report that a personal measure was taken because of their health (7% for workers without a chronic disease). About 25% feels that additional personal health and safety measures are necessary. (table 10)

There is no specific regulation that workers with a chronic disease are allowed to receive more flexibility at work regarding working times or work-life balance. Table 11 shows that workers with a chronic condition report the possibility to determine ones working times slightly to be more important than workers without a chronic disease. However this is not found for the possibility to work from home. People with chronic disease are less satisfied with the actual situation regarding influencing working times and working from home. Workers with a chronic disease slightly more often report problems with work-life balance.

Workers with a chronic disease are more concerned about keeping their job than workers without a chronic disease.  However, there are no clear clues that workers with a chronic disease indeed more often are forced to change jobs. They more often have a permanent job and have had this job for more years than workers without a chronic disease. Although no official numbers about income differences between workers with or without a chronic disease are available, workers with a chronic disease more often state that in their household there is a lack of money. (Table 12)

Access to training is slightly lower for employees with a chronic disease. About 1 out of 3 workers without a chronic disease are stimulated by their supervisor to develop their knowledge and skills; about 1 in 2 has actually had any form of training in the previous 2 years. Despite that workers with a chronic disease feel less stimulated to develop their knowledge and skills their training is more often initiated and (partially) paid for by the employer. The aim of the training slightly differs between workers with and without a chronic disease. For workers with a chronic disease the training slightly more often aimed at ‘being able to deal with future changes in their current employment’ while workers without a chronic disease more often received training in order to enlarge their chances of a job in the future. (Table 13).

Table 8: Exposure to physical and psychosocial risk factors reported by employees with and without chronic disease

Exposure to physical and psychosocial risk factors reported by employees with and without chronic disease



 


Totaal


No chronic disease


A chronic disease


N:


25.223


15.555


9.247


%:


 


63%


37%


Dangerous work


 


 


 


· Yes, often


4,2%


4,2%


4,3%


· Yes, sometimes


18,7%


17,5%▼


20,6%▲


· No


77,1%


78,3%▲


75,1%▼


Use of force


 


 


 


· Yes, often


20,4%


19,2%▼


22,4%▲


· Yes, sometimes


23,5%


23,3%


23,4%


· No


56,1%


57,5%▲


54,2%▼


Use of tools


 


 


 


· Yes, often


8,8%


8,5%▼


9,2%▲


· Yes, sometimes


9,1%


9,1%


9,2%