Sweden: Work-related diseases more often caused by social factors
Work-related diseases due to organisational and social factors are increasing in Sweden, according to the Swedish Environment Authority. Since 2011, diseases due to these factors have increased by 77%. This, plus a recent spike in sick leave, has sparked a debate on how best to combat ill-health in the workplace.
The amount of sick leave being taken has increased considerably in Sweden during the last few years. Sick leave has been a much-debated topic and a major issue for the social partners and policymakers. The Swedish Work Environment Authority (Arbetsmiljöverket) regularly conducts statistical reports on occupational accidents and work-related diseases. The report for 2015, published in June 2016, found that work-related diseases have increased in Sweden since 2009 and that social and organisational factors are mostly to blame.
The report by the Work Environment Authority builds on data from the Swedish Information System for Occupational Accidents and Work-related Diseases (ISA), reported under the 1976 Work Injury Insurance Act. The data contain cases of work-related diseases (and the possible reasons for them) registered with the Social Insurance Agency (Försäkringskassan) in 2015, and is disaggregated by sex, age and economic activity. The types of workers included in the data are employees and the self-employed.
The report defines organisational and social factors as issues related to high workloads or problems with social relations in the workplace. This includes: difficulties in cooperating, harassment, bullying or social exclusion, whether by supervisors, colleagues or third parties (for example a patient or patient’s relative).
Social and organisational factors
The report concludes that there has been an increase in work-related diseases during the period 2009–2015. In 2015, there was a total of 12,141 registered cases of work-related diseases. According to the data, work-related diseases due to social or organisational factors have increased by 77% since 2011. In 2015, the number of such cases amounted to 4,174, meaning that social and organisational factors now make up around one-third of the registered cases of work-related diseases.
The highest absolute number (1,831) of work-related diseases due to social or organisational factors was found in the health and social care sectors. These sectors account for more than half of the incoming registrations among women, and almost one-third among men. The second and third highest numbers were found in education (734) and public administration (554). However, in relative numbers, the greatest amount of work-related diseases due to social or organisational factors was in the public administration and defence sectors, for both men and women.
Overall, ergonomic factors are the most common reason for work-related diseases with 4,559 cases. Physical factors (for example noise and vibrations) make up a total of 1,739 cases, while chemical/biological substances or factors account for 1,245 cases. Other (undefined) reasons amount to 424 reported cases.
Differences between the sexes
The report shows that work-related diseases are, overall, more common among women (7,518) than men (4,623) and are also increasing more among women (+5% since the previous year) than among men, for whom the figures have remained relatively stable.
As for work-related diseases caused by social or organisational factors, the increase among women amounted to 83% since 2011, while the corresponding figure for men was 48%. In 2015, organisational or social factors were the most common reason behind work-related diseases for women, while ergonomic factors remained the primary cause for men’s reported work-related diseases.
Employees’ report shows similar results
The Swedish Confederation of Professional Employees (TCO) published a report in May 2016, revealing similar results on the impact of social factors on employees’ health (PDF). According to the report, organisational and social factors have a significant impact on workers’ health. The authors explain that jobs where the employee experiences high demands but a low level of control increase the risk of ill-health among workers. The authors underline that high demands are not harmful, as such, and indeed can even be stimulating and positive. However, such workers require strong social support from managers and colleagues. When these requirements are not met this may, they can, in the long run, lead to a higher number of people on sick leave, or increased numbers of sick employees at work.
As with the WEA report, the TCO report also pointed out differences between men and women. For example, it was twice as common for women than men to feel that they had jobs with high demands and low levels of control. Also, women more often experienced work-related problems such as not being able to mentally disconnect from work, having trouble sleeping, being reluctant to go to work, and experiencing physical fatigue and upper-back pains. Younger women were found to be more affected by these issues than older ones.
Government and social partner reactions to rise in sick leave
Work-related diseases and sick leave have recently been something of a hot topic in Sweden. To help deal with the increasing amount of sick leave, the Swedish government proposed making employers partly financially responsible for employees’ long-term sick leave. The proposal was heavily criticised and unanimously opposed by the social partners.
The Confederation of Swedish Enterprise (Svenskt Näringsliv) initiated a big campaign against the proposal, arguing it would have devastating consequences for employers and employees. Johan Larsson, Vice President of the Swedish Association of Health Professionals (Vårdförbundet), said that making employers partly responsible for the costs could hinder the employment of individuals with chronic diseases. He pointed to the possibility that employers would be financially incentivised to hire only healthy workers and ignore those who risked becoming ill.
The Swedish Association of Local Authorities and Regions (SKL) also rejected the proposal, arguing that employers already had enough economic incentives for preventing long term sick leave (PDF), and that the proposal would affect regions and municipalities who are already the most economically vulnerable. Thus, the proposal could have a counterproductive effect on sick leave numbers.
The strength of opposition led to the government deciding to withdraw its proposal. The social partners have instead drafted different proposals for reducing sick leave numbers. One such proposal (PDF) was recently jointly presented by the Confederation of Swedish Enterprise, The Swedish Trade Union Confederation (LO) and the Swedish Council for Negotiation and Cooperation (PTK). The proposal is currently being studied by the government.