Health and safety at work in Spain: an overview

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Drawing on a range of recent sources, this feature analyses a number of current issues relating to health and safety at work in Spain, including the incidence of occupational illness, accident rates and measures to prevent risk.

Occupational illnesses and accidents

The incidence of occupational illnesses reported in Spain in 1996 was 75.76 for every 100,000 workers, including 6,885 minor illnesses, 183 major ones and one fatal. However, there is no doubt that these figures are highly underestimated. The table below gives figures for the incidence of occupational illnesses from across the EU.

Table 1. Occupational illness rates reported in 11 EU countries
Country Year Occupational illness rate*
Austria 1993 58
Belgium 1993 922
Denmark 1993 600
Finland 1992 319
Germany 1993 249
Ireland 1993 7
Italy 1989 85
Luxembourg 1992 74
Netherlands 1993 18
Spain 1993 46
Sweden 1994 852

* Occupational illness reported per 100,000 workers

Source: Drawn up by author from "European working environment in figures. Availability of occupational health and safety data in 16 European countries", S Nossent, B Groot, European Foundation for the Improvement of Living and Working Conditions, Dublin (1992)

Rates of accidents at work in Spain are also high, as the table below indicates. A study shows that the Spanish mortality rates due to traumatic accidents at the workplace - an indicator that is comparable internationally because it excludes accidents due to natural causes and on the way to and from work - are considerably higher than those in Germany, France or Britain (see "Los accidentes de trabajo en España: un gran problema, mayor olvido", S Moncada, L Artazcoz, Quadern CAPS (1991))

Table 2. Spanish accident rates at work involving time off work, 1996
Wage-earners Minor Major Fatal
number number rate number rate number rate
9,330,620 604,570 64.79 10,685 1.15 982 0.11

Denominators: annual average wage-earning population 1996. Source: EPA.

Exposure to occupational hazards

Of the population interviewed in the latest available National Survey of Working Conditions (ENCT) in 1993 ("Encuesta nacional de condiciones de trabajo 1993", Instituto Nacional de Seguridad e Higiene en el Trabajo, Madrid (1995)), 59% stated that they were exposed to hazards at work. In the ENCT, noise is the most common occupational hazard (33% of workers exposed), while 32% of the working population mentioned exposure to chemical pollutants (a third of industrial workers). Nearly 50% of workers maintain static postures or perform repetitive movements during a quarter of their working time ("Encuesta nacional de condiciones de trabajo. Datos para una reflexión", M Zimmermann, J Maqueda, A Almodóvar A., MV de la Orden, Rev. Esp. Salud Pública (1996)).

Information from other sources, such as the 1994 Health Survey of Catalonia (ESCA), provide specific information by age, sex and occupation ("Enquesta de Salut de Catalunya 1994", L Artazcoz, S Moncada, Salut Laboral, Servei Català de la Salut, Barcelona, mimeo (1996)). Though it covers only Catalonia, the ESCA's results help to throw light on the situation regarding occupational health in Spain.

According to the ESCA, 37% of male workers and 29% of female workers consider that their work represents a risk to their health. Amongst the men, the highest proportions of occupational hazards identified are found in agriculture, construction, transport and communications; amongst women they are found in agriculture, mining and mineral processing, other manufacturing industries and other services.

Uncomfortable postures and physical effort are the most common occupational risk for both sexes. Amongst men the inhalation of powders and fumes occupies second place with almost the same percentage, while amongst women the hazards that occupy second, third and fourth places correspond to those of the psycho-social environment.

According to the European Survey on Working Environment of 1992 and 1996 ("First and Second European surveys on the work environment", P Paoli, European Foundation for the Improvement of Living and Working Conditions, Dublin, (1992 and 1996), exposure to risks of an organisational type is of great importance, although exposure to traditional risks (such as noise, toxic materials and heavy loads) is also relevant. The 1996 survey points towards an increase in the intensity of work and the maintenance of similar levels of exposure to hazards of a physical type as in 1992.

How workers view their state of health

Some 86% of male workers and 83% of female workers interviewed in the ESCA believe that their state of health is excellent, very good or good (see table below for further details). The state of health is worse among older workers, manual workers and women, and above all among women in catering. There is a clear association, which has already been described in other studies ("La salut laboral a Barcelona", S Moncada, L Artazcoz, Barcelona Societat (1994)), between state of health, social class and sex. Thus, manual workers have a worse state of health than non-manual workers and women have a worse state of health than men, the least favoured group being female manual workers.

Table 3. Prevalence of a good state of health by occupation in Catalonia, 1994
. Men (%) Women (%)
Professional 90.2 89.6
Executive 92.0 89.8
Administrative 89.1 90.2
Retail 87.7 84.0
Catering 85.8 69.8
Agriculture 81.2 70.4
Industry/Construction/Transport 82.7 75.7

Source: ESCA, 1994.

Prevention in Spanish companies

The ENCT of 1993 reflects a very low level of prevention in Spanish companies. Only 71.1% of the companies that should have set up a health and safety committee had done so; in 88.2% no study of accidents or occupational illnesses was ever made; 75% had never requested specialised advice; 86% did not provide regular education on safety and occupational health; and 58% did not provide adequate information to workers.

Half of the Catalonian companies legally obliged to have a company medical service did not have one in 1996 ("Encuesta a los servicios médicos de empresa de Catalunya", FG Benavides, J Montserrat, Societat Catalana de Seguretat i Medicina del Treball, Barcelona, unpublished report (1996)). Though there is no equivalent survey for the whole of Spain, there is no reason to believe that the national picture is any better than that in Catalonia.

A changing context

The world of work in Spain is currently subject to great change, as summarised in the following table (drawn up by the author based on "Occupational health in the 1990s", World Health Organisation (1992) and "Encuesta nacional de condiciones de trabajo", INSHT (1995)).

Table 4. The world of work in a context of change
Factors of change Examples of impact
Microeconomy Increasing importance of tertiary sector - 56.18% of workers in services in 1990, 64.04% in 1996. Prevalence of small and medium-sized enterprises.
Demographic evolution Ageing of the working population, increasing female participation rates and better qualified women. Increase in emigration.
Political changes European Union (mobility of companies, workers and capital).
Legislation EU Directives, Law on Prevention of Occupational Hazards and corresponding regulations, management of temporary invalidity, collaboration of the Mutual Insurance Societies for Accidents at Work with Occupational Illness section of Social Security in establishing regulations.
Health model Separation of the planning and provision of services; health plans, transfer of responsibility for occupational health (General Health Law, 1986).
Labour market Increase in jobs involving arduous conditions (major psychological demands, interference of society and family, isolation). High unemployment rates Continuing segregation of work according to sex. Temporary contracts cover 18.4% of workers (ENCT, 1993). Increase in the rotation of the workforce.
Scientific knowledge Increasing. More research into psycho-social factors, population surveys. Gender bias (more research for male population)
Exposure to physico-chemical hazards "Polymicroexposure" in low doses (non-specific effects on health)
New technologies Late 1990s in Europe: one visual display unit per non-manual worker.
Importance of psycho-social factors Organisation of work, welfare, absenteeism, productivity, satisfaction, interaction of extra-occupational factors.
Production of goods and services Growing interest in quality.

This context of change must involve, as is already happening, changes in the epidemiological distribution of job-related illnesses. In general they are tending towards greater non-specificity.

The law on the prevention of occupational risks and its corresponding regulations have led to the universal legal protection of health at work, the integration of prevention into management structures of companies and an increase in worker participation. Other changes have been made in the regulation of collaboration between the Mutual Insurance Societies for Accidents at Work (MATEPSS), which manage temporary invalidity schemes, and national systems covering health and social security.


Legislative changes, the evolution of health indicators amongst the working population, technological and organisational innovation by companies and the dynamics of labour relations lead to the forecast that from now on the question of health and safety at work in Spain will be considered within a new framework characterised by:

  • the integration of prevention into the structure and line management of companies;
  • greater worker participation in management in this area;
  • prevention oriented towards solving problems and acting according to needs; and
  • companies oriented toward efficiency targets.

In this context, social dialogue is vital. Spanish companies have lagged behind in the protection of health and safety at work, and it is clear that it is their responsibility to guarantee a working environment that does not involve health hazards. Furthermore, they must understand that investments in health and safety are not only necessary, but productive (more than 14 million working days were lost in 1995 due to accidents at work), and that workers should participate in the protection of their own health. For the moment cautious optimism is called for.

The signing of a basic agreement on occupational health between the Catalan Association of Small and Medium-sized Enterprises (PIMEC) and the CC.OO and UGT unions in Catalonia in 1996 is a cause for celebration. However, this agreement must be developed and promoted, and the social partners at a national level - as well as the other Catalonian employers' organisation, Foment del Treball, which did not sign the agreement - must be encouraged to follow this example. For the moment, this seems to be a difficult goal to achieve.

The amendments to Spanish legislation are not free from dangers. The law on prevention of occupational hazards and its corresponding regulations may be difficult to apply if they are not accompanied by suitable policies and budgets. Amendments in the role played by the MATEPSS in the prevention of occupational hazards, and above all in the management of temporary invalidity, raise certain questions concerning the maintenance of the greatest achievement of the Spanish National Health System: the high degree of equity enshrined in its services. (Salvador Moncada, Centre for Occupational Health, Municipal Institute of Public Health of Barcelona, University Institute of Public Health of Catalunya)

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