Study urges improvements to occupational health strategy

An evaluation has been made of the first phase of Germany’s Joint Occupational Safety and Health Strategy (GDA). The evaluation examines unpublished reports from inspections carried out under the GDA of occupational safety and health work programmes, and also considers the strategy’s overall objectives. The report suggests that the GDA needs to change some of its indicators, and that its efforts should be focused on workplaces where there is clearly room for improvement.

Background

Germany’s Joint Occupational Safety and Health (OSH) Strategy (GDA, 34.3 KB PDF) was set up in 2008 by the German Federal Government, the federal states and the public accident insurers. The strategy aims to provide quantitative and qualitative OSH targets and to harmonise the regulations of 16 regional states. It also wants better coordination of the regional labour inspection bodies and the accident insurers which provide consultancy services.

GDA bodies are obliged by law to evaluate the attainment of the strategy’s objectives. Targeted OSH work programmes are evaluated by the GDA and the results are not made public.

A top-level interim evaluation has now been made of the first programme phase, from 2008 to 2012. The evaluation examined overriding GDA effects, and was conducted by independent research organisation Kooperationsstelle Hamburg IFE and market research company TNS Infratest. The research will help shape the second programme phase covering 2013 to 2018.

The evaluation is critical of some previously defined outcome-related indicators. It also suffers from uncoordinated data by regional GDA actors. GDA’s ambitious multi-stakeholder and multi-action approach is said to ‘mirror challenges of early implementation phases also seen in other EU Member States realising new OSH strategies’.

Evaluation methodology

In 2010, the GDA bodies designed a preliminary methodology for the GDA evaluation (see table). The GDA’s own description of it states that ‘the objectives and actions of the GDA are intended to be interpreted in socio-political terms and are not derived from scientifically sound hypotheses on interconnections to be examined between measures (interventions) and effects’.

Preliminary evaluation methodology

Objectives 2008–2012

Measures to be implemented

Questions for evaluation

Evaluation indicators

1. National occupational safety and health objectives: Reduction in workplace accidents, in musculoskeletal strains and disorders and in skin disorders

Eleven targeted work programmes conducted by labour inspection/insurers (including construction sector, temporary agency work, office work)

Are the national occupational safety and health objectives reached?

Reduction in days of sickness leave because of workplace accidents or musculoskeletal disorders;

number of visited companies with ‘prevention culture’ compared to all visited companies;

promotion of health competence of workers and managerial staff.

2. Improving the effectiveness of the OSH system at establishment level

Awareness-raising measures; design from GDA guidelines on labour inspection and health risk assessment (joint approach by the federal states)

Can the acceptance and effectiveness of the consultancy and monitoring of the supervisory services in the companies be increased with the GDA?

Number of visited companies;

implementation of health risk assessments;

workplace management systems;

knowledge of existing OSH regulation;

knowledge of GDA activities.

3. Improving the cooperation between labour inspection and public accident insurers

Joint working programmes, agreed regulations, coordination of activities

Do state occupational safety and health authorities and public accident insurance institutions work together appreciably more effectively for the companies?

Design and implementation of GDA regulations and guidelines

4. Improving cooperation with external partners

New concepts on cooperation with additional partners (including health insurers, sports clubs, social partners), regional networking

Can the cooperation with health insurance funds, pension insurance institutions, industry and networks be improved under the GDA?

Number of projects involving additional partners;

quality of activities;

inter-disciplinarity of approach.

5. Improving workplace health prevention as well as the competitiveness of businesses

Integration of the trade unions, of sectoral business and employer organisations

How are company prevention systems and their effects on workers’ health and on the competitiveness of the companies developing?

Workers’ satisfaction with OSH systems and work-related health strains;

employers’ perception of OSH and prevention costs and their company’s competitiveness;

reaching of national OSH targets (Objective 1)

Source: GDA (2010), Terms of Reference (in German, 42 KB PDF)

The top-level evaluation relied on two representative cross-sectoral telephone surveys covering establishments (N=6,500 establishments) and workers (N=5,512 workers), on administrative statistics, figures from the labour inspectorate and 57 expert interviews. Evaluations of the 11 targeted work programmes were not available at the time of writing.

Reduction in workplace accidents

The study looked at data from the German Social Accident Insurance (DGUV) and the Federal Accident Insurance Fund (Unfallkasse Bund). Researchers found workplace accidents declined by 33.4% from 2000 to 2011, compared to only 5.4% from 2008 to 2011. They state that the accident rate is influenced by macroeconomic developments – including the 2008–2009 crisis and economic upswing – and is an invalid GDA indicator. However, the GDA establishment survey shows a stronger decline in workplace accidents in establishments visited under the framework of the GDA work programme than in other establishments. The findings were based on routine inspection and non-routine inspections.

Reduction in musculoskeletal strains and disorders

The evaluation also rejects the defined GDA indicator ‘days of sickness leave because of MSD’ – musculoskeletal strains and disorders. For sickness leave, MSD is defined in line with the International Classification of Disease ICD Code (M00–M99) which does not require a clearly identifiable work-related cause. The study also says that the impact of the GDA on the MSD rate cannot be inferred from short-term data because these disorders take years to develop. Trend data are not given.

However, the authors refer to the EWCS 2000 and EWCS 2010 findings on Germany, and conclude that they indicate a decrease in ‘constant strenuous postures’. However, they also suggest an increase in occasional exposure to high physical demands. Researchers say this tendency is also mirrored by the 2011 GDA survey which finds that only 37% of workers are never exposed to high physical demands. Figures show 25% are often exposed to high physical demands, 16% are sometimes exposed to high physical demands and 22% are rarely exposed to these strains.

Reduction in skin disorders

DGUV statistics indicate an increase in skin disorders and in reported work-related skin diseases. These are not classified as occupational diseases by insurers. The number of reported cases rose from 7,151 in 2000 to 9,042 in 2009, and to 15,269 in 2010. DGUV attributes the 2009–2010 increase to better recording methods. There appears to be no impact from the GDA.

Improving the effectiveness of the OSH system

GDA data and worker surveys show that there is considerable room for improvement in small establishments and the service sectors. Physical strains are highest in the manufacturing industries, construction, the energy waste disposal sector and food processing. Psychosocial issues are highest in education, health and social care, and public administration. The research shows:

  • 59% of all establishments do not consult an occupational safety specialist;
  • 60% do not consult a works doctor;
  • although establishments employing more than 20 workers are obliged by law to have an OSH committee, 62% do not have one that involves worker representatives;
  • in establishments with a works or staff council, 81% of workers say that the council members ‘sufficiently engage in OSH issues’;
  • 79% of establishments say they conduct health risk assessments, but only 56% of workers report a visit at their workplace.

More than 80% of workers say they receive OSH information about machinery, chemical substances and accident risks. However, only 53% are informed about the risks of strenuous postures and 42% on the stress risks of work organisation.

The application of these legal obligations differs depending on establishment size. It is highest in large manufacturing companies and in public administration and lowest in small service companies.

The study is critical of the defined GDA indicators – these include the number of companies visited, and the number of measures implemented. The evaluators say they found process indicators more indicative than outcome indicators. They suggest that the GDA’s indicators should include the following.

Knowledge and perception of OSH regulations:

  • about 25% to 48% of establishments do not know about fundamental OSH regulations (such as giving workers information and health risk assessments);
  • 82% say that the regulations are clear about employers’ obligations;
  • 60% think the OSH regulations are not helpful, 54% say regulations are hard to put into practice.

Knowledge of the GDA:

  • Only 17% of surveyed establishments know about the GDA strategy.

Perception of labour inspection:

  • Establishments of all sizes are quite positive about labour inspections and visits by the insurers. Figures show 67% say they clearly distinguish between the tasks performed by labour inspectors and insurers, 72% do not feel disturbed because of the visits, while 68% appreciate the quality of the consultancy.

Establishing of a preventive culture

The frame of reference of the evaluation was that ‘preventive culture’ consists of:

  • the integration of OSH and health issues into overall communication and learning processes at establishment level;
  • workers with the ‘health competence’ and sufficient interest to engage in OSH issues and to use and comply with health-related measures provided by the employer.

The survey found that:

  • debates on OSH and health issues at department level or in teams happen at least once a year in about 60% of the establishments;
  • when it comes to workplace health provisions and measures, brief individual physical health testing is provided by 31% of establishments, employee surveys on OSH are conducted by 27%, health circles and company sports are provided by about 10% of establishments;
  • training of managerial staff about health prevention and OSH is carried out by 38% of establishments.

Findings on the ‘health competence’ of workers show that 80% to 95% report that they follow OSH rules and regulations, they feel responsible for OSH in the company or they will intervene when someone breaks OSH rules. Just over half (56%) say they suggest OSH improvements in their establishment.

The evaluators found room for improvement in participation in health promotion and company sports, and in the provision of health circles or company-based drug prevention measures, since less than half (43%) of workers said they had taken up one or more of the measures proposed at their establishment during the previous 12 months. Researchers also thought private habits could be improved, for example by offering information on maintaining a balanced diet, doing regular exercise and attending regular medical examinations. The survey data showed that 44% of workers said they had regular medical check-ups, 40% engaged in sports and 34% had ‘balanced eating habits’.

The study also says more should be done to convince employers that good OSH practice and prevention will make them more competitive and strengthen their performance. The survey found 47% of owners/managers and 43% of leading managerial staff agreed with this and said that good OSH helps to cut costs.

Only 9% of owners/managers and 9% of leading managerial staff said they held the opposite view and considered OSH to be a cost driver.

However, 40% of the owners/managers and 46% of the leading managerial staff say OSH has neither a positive nor a damaging impact on the performance of the business. The evaluators say this large group should be provided more information on the subject.

Summary

The evaluators recommend the setting up of a traffic-light system to make it possible for the GDA to be focused on ‘red dot’ establishments of particular concern. They say this would be preferable to quantitative targets for accidents or MSD.

Survey findings on establishments visited under GDA work programmes show positive results for OSH infrastructure compared to companies not visited. Problems of uncoordinated visits by inspectors and insurers do exist, but are rare.

However, there should be a clear distinction between inspection and consultancy to help establish a preventive culture. Consultancy should involve support by external partners, such as health insurers, sports clubs or social partner organisations.

Overall, there is a need for increased awareness-raising. The provision of more information is likely to mobilise a broader interest in OSH on the part of employers and workers.

Reference

Nationale Arbeitsschutzkonferenz (2013), Arbeitsschutz auf dem Prüfstand: Zwischenbericht zur Dachevaluation der Gemeinsamen Deutschen Arbeitsschutzstrategie (1.93 MB PDF) [Occupational safety and health put to the test: Interim report of the top-level evaluation of the joint German OSH strategy], National Occupational Safety and Health Conference, Berlin.

Birgit Kraemer, Institute of Social and Economic Research, WSI

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