Cyprus: Employment opportunities for people with chronic diseases

  • Observatory: EurWORK
  • Topic:
  • Labour market policies,
  • Work organisation,
  • Disability and chronic disease,
  • Public services,
  • Working conditions,
  • Social policies,
  • Published on: 14 Kasım 2014



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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.

This report addresses the employment opportunities for people suffering from chronic diseases in Cyprus. According to some studies, the main chronic diseases reported in Cyprus are musculoskeletal disorders, rheumatic conditions, respiratory problems and any other physical or mental disease lasting 6 months or more. As regards employment of people suffering from chronic diseases, it has been reported that the main problems causing these diseases have to do with the type of work, the amount of work and travel to and from the place of work.

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

  • What definitions of “chronic diseases” in an employment context are used in your country?

In the 2006-2008 period, the Statistical Service, CyStat (Στατιστική Υπηρεσία Κύπρου) published two studies relating to chronic diseases in Cyprus. In both studies, long-term health problems were defined as any health problems or deviation from a normal physical condition lasting or expected to last 6 months or more. Furthermore, the 2010 Social Insurance Law defines as incapable of working any insured person who, due to a specific illness or physical or mental disability, is not employable in the occupation that he/she usually performed. 

  • What are the sources of these definitions (legislation, statistical sources, administrative documents, social security/health insurance systems)?

The Statistical Service of Cyprus has published two surveys containing the definition given in Block 1.1. The first was entitled Survey on People with Longstanding Health Problems or Disabilities, 2006 and the second European Health Survey 2008. The survey on People with longstanding Health Problems or Disabilities, 2006 is part of Labour Force Survey 2006 and covers 3.500 households in which 6805 individuals between 16-24 years completed the questionnaire.

The second definition sets the general framework of cases where a person can be deemed to be incapable of working. Within the definition given in the 2010 Social Insurance Law are included cases where, due to their chronic disease, people are incapable of working.  

  • What concrete chronic diseases are included in these national definitions?

Based on the Survey on People with Longstanding Health Problems or Disabilities, 2006, the most prevalent chronic problems in the people who took part in the survey were back, heart, blood pressure, circulatory and brain problems, mental, neurological or psychological problems, stomach, kidney, intestinal or liver problems, diabetes, chest or respiratory problems, and problems involving the upper limbs. According to the European Health Survey 2008, the most prevalent longstanding illnesses occurring in the population were hypertension, lower back disorders or other chronic back problems, severe headaches, asthma, ulcers and diabetes.

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

  • Are there national statistical sources (censuses, administrative registers, ad-hoc surveys on chronic diseases, working conditions surveys, other surveys, etc.) that analyse the issue of chronic diseases and their relation to employment and working condition? If so, identify them and provide information on the following issues (per identified information source if it is the case):

All the following data regarding the issue of the relation between work and chronic diseases are included in the two surveys by the Statistical Service of Cyprus entitled Survey on People with Longstanding Health Problems or Disabilities, 2006 and European Health Survey 2008.

  • What is the official name of this statistical source (in national language and translation into English) and its responsible body?

The official name is Στατιστική Υπηρεσία Κύπρου, Statistical Service of Cyprus (CYSTAT) and its responsible body is the Ministry of Finance.

  • What definition of chronic disease is used?

See Block 1.1.

  • What are the categories of chronic diseases surveyed/registered?

See Block 1.1.

  • What are the questions in relation to employment and working conditions?

In the survey entitled Survey on People with Longstanding Health Problems or Disabilities, 2006, the main questions in relation to employment refer to age groups, gender, area of residence, employment status, cause of the problems and the educational level of the people suffering from chronic diseases. It also investigates whether the people’s disease restricts them in the type of work they are able to perform, whether they work in a protected or supported job, whether the amount of work they are able to produce is limited due to the disease, whether they are limited in their ability to travel to and from the workplace, whether they are provided with some form of assistance in order to perform their work, whether they are in need of some form of assistance in order to perform their work, and what type of assistance they receive or need in order to perform their work.

In the survey entitled European Health Survey 2008, respondents were asked to what extent their activities were restricted due to their health, and whether they faced various factors in the workplace such as time pressure or excessive workload, noise or vibrations, difficult positions or movements, handling heavy loads, accident risks, violence or threats of violence, discrimination and psychological pressure. It must be noted that these questions were posed to all the participants in the survey, without specifying whether the answers were given by people suffering from chronic diseases or not. 

  • What is the methodology used to collect the data?

The survey entitled Survey on People with Longstanding Health Problems or Disabilities, 2006 covered a sample of 3,500 households all over Cyprus, and data were collected through personal interviews using laptop computers (Computer assisted personal interviews, CAPI).

The method used in the survey entitled European Health Survey 2008 was stratified random sampling and data were collected through personal interviews using laptop computers (CAPI) from 2,925 households in which 8,345 people were living.

  • What information is provided?

One of the main results of the Survey on People with Longstanding Health Problems or Disabilities, 2006 was the fact that a very large percentage of people facing longstanding health problems are limited in the type (30.2%) and the amount (28.6%) of work they are able to perform, as well as their ability to travel to and from the workplace (12.1%). In the European Health Survey 2008, it became apparent that as people’s age increases so does the percentage of chronic problems. In the 15-24 age group, only a small proportion of people (9.5%) stated that they suffer from a chronic health problem, unlike people aged 75+ where the vast majority (79.7%) suffer from a chronic disease.

  • Other info (time frequency, origin of the info, etc.)

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

  • Extent of the phenomenon of people with chronic diseases in your country, percentage of people affected by the problem in relation to total population. Evolution of the problem in recent years (Increase/decrease) and reasons for this evolution. More frequent pathologies/diseases.

In Cyprus no data are available on the percentage of people facing chronic diseases in relation to total population; however, based on the Survey on People with Longstanding Health Problems or Disabilities, 2006 12.2% of the sample aged 16-64 answered that they face a chronic health problem; 13.4% of men and 11.1% of women in the whole sample answered that they face a chronic health problem. There are no comparative data from previous years and thus we cannot observe the evolution of this phenomenon. Based on the above-mentioned survey, the most prevalent conditions faced by people with chronic diseases are back problems (21.3%), heart, blood pressure, circulatory and brain problems (20,7%), lower limb problems (11.2%), mental, neurological or psychological problems (10.2%), stomach, kidney, intestinal or liver problems (7.5%), diabetes (7.3%), chest or respiratory problems (5.3%) and upper limb problems (5.2%).

  • What is the employment situation of people with chronic diseases in your country (% of people in employment/unemployment/inactivity that are affected by chronic diseases)?

Based on the above-mentioned survey, 47.8% of people suffering from a longstanding health problem are in employment, 3.9% are unemployed and 48.3% are non-active. To the same question 8.3% of the employed replied that they are suffering with longstanding health problem or disability, 19,6% of the unemployed replied positive and 21,5% of the inactive also replied positive.

  • Are certain chronic diseases associated to or more prevalent in certain economic sectors/occupations?

In the above-mentioned surveys there are no data regarding the correlation between chronic diseases and specific sectors of economic activity or occupations. However, the survey by the Department of Labour Inspection, Ministry of Labour and Social Insurance entitled Assessment of the situation regarding physical and mental diseases of the working labour in Cyprus, 2006 analyses the occupations that are more likely to cause or being associated to health problems. The main health problems caused by the type of work reported by respondents facing health problems were musculoskeletal (70.8%) (pain in the bones, joints or muscles), general fatigue (32.1%), stress-related problems (23.2%), and heart disease or problems in the circulatory system and stress (8.9%). Fifty per cent of the people suffering from the above-mentioned health problems arising from the type of occupation reported that these problems are continuous, whereas 24% suffer from health problems a few times per month. On the basis of these data we can see which occupations cause the above-mentioned health problems, since this survey analyses the prevalence of problems by occupational category. Table 1 shows that continuous health problems are more prevalent among blue-collar workers/farmers and less prevalent among teaching staff.

Table 1: People continuously suffering from health problems caused by work, by occupational category, % 

Occupational Category

%

Managerial and senior staff

47

Scientific/specialized staff

53

Teaching staff

29

Technical/special auxiliary staff

40

Office staff

46

Services staff

51

Technicians

49

Machine operators

34

Blue-collar workers/farmers

61

Source: “Assessment of the situation regarding physical and mental diseases of the working labour in Cyprus, 2006,” Department of Labour Inspection, Ministry of Labour and Social Insurance.

  • What are the typical employment trajectories of workers affected by chronic diseases? (entry/exit patterns)

There are no data regarding this question.

  • What are the main difficulties/problems for people with chronic diseases to access or stay in the labour market?

The Survey on People with Longstanding Health Problems or Disabilities, 2006 includes data on the limitations of people with longstanding health problems in three employment parameters, which are also regarded as the main difficulties faced in accessing or staying in the labour market. The three parameters are the limitations regarding the type of work, limitations in the amount of work they are able to perform, and limitations in ability to travel to and from the workplace. 

Thirty per cent of the individuals answered that their health problem has significantly restricted the type of work they are able to perform; 43.5% are restricted to some extent; and 26.3% are not restricted at all regarding the type of work. The amount of work a person is able to perform is restricted significantly for 28.6% of the people, restricted to some extent for 39.6%, and is not restricted at all for 31.8%. The person’s ability to travel to and from the workplace is not restricted at all for the largest percentage of the people (77.8%). For only 12.1% of the people this ability is restricted significantly and for 10.2% it is restricted to some extent.

  • What are the main difficulties/problems for enterprises with workers affected by chronic diseases? What solutions do enterprises adopt to deal with these workers affected by chronic diseases?

There are no data about the main difficulties/problems faced by enterprises in the available sources. Only 4.1% of working people with the above-mentioned difficulties answered that they are provided with some form of assistance in performing their work, although the survey did not specify the type of assistance or give any other data. To the question what type of assistance people need to help them with their work, the answers were: assistance with the type of work (e.g. quality of work, relief from carrying heavy loads, possibility of working indoors or outdoors or performing sedentary work) at a rate of 60.1%, followed by assistance with travelling to and from work at a rate of 14.8%, assistance with the amount of work (e.g. number of hours or days they work or could work or the pay they could receive) at a rate of 9.2%, support and understanding by supervisors and colleagues at a rate of 7.5%, and assistance with mobility at work such as ramps for wheelchairs at a rate of 4.3%.     

  • Are there differences in the previously mentioned patterns by types of chronic diseases or groups of pathologies? are there differences according to age or gender

With regard to employment status and gender, according to the data from the Survey on People with Longstanding Health Problems or Disabilities, 2006, 57.8% of men suffering from a longstanding health problem or disability stated that they are in employment, 4.5% that they are unemployed and 37.6% that they are non-active. As regards women suffering from a longstanding health problem or disability, 36.5% are in employment, 3.3% are unemployed and 60.2% are non-active.

With regard to limitations on the type of work people are able to perform, according to this survey 35% of men are restricted significantly, 39.2% are restricted to some extent, and 25.8% are not restricted at all. With regard to women, 24.9% are restricted significantly, 48.3% to some extent and 26.8% are not restricted at all. As far as age is concerned, the biggest percentage of people (39.6%) who are significantly restricted as regards the type of work they are able to perform are in the 20-24 age group. The biggest percentage (52.8%) of people who are restricted to some extent are in the 16-29 age group, and the biggest percentage (39.1%) of people who stated that they are not affected at all regarding type of work are in the 30-34 age group.

With regard to limitations in the amount of work people are able to perform, according to the same survey 33.7% of men are restricted significantly, 34.5% are restricted to some extent, and 31.8% are not restricted at all. As regards women, 22.9% are restricted significantly, 45.3% to some extent and 31.7% not at all. With regard to age, the largest percentage of people (36.3%) is restricted significantly as regards the amount of work they are able to perform are in the 35-39 age group. the biggest percentage of people (47.5%) who are restricted to some extent are in the 20-24 age group, and the biggest percentage of people (46.1%) who stated that the type of work they perform is not affected are in the 30-34 age group.

With regard to limitations in the ability to travel to and from the workplace, according to the same survey 14.4% of men are restricted significantly, 9.5% to some extent and 76.1% not at all. As regards women, 9.4% are restricted significantly, 11% to some extent and 79.6% not at all. As regards age, the largest percentage of people (20.3%) who are significantly restricted in their ability to travel to and from the workplace are in the 16-19 age group. the biggest percentage of people (16.9%) who are restricted to some extent are in the 25-29 age group, and the biggest percentage of people (83.8%) who stated that they are not affected at all in the type of work they perform are in the 30-34 age group.

  • Is it possible to identify some changes in the previously mentioned patterns in recent years?, reasons for this and possible specific effects of the economic crisis

There are no available data for this question.

2.2. Working conditions of employed people affected by chronic diseases

According to the survey by the Department of Labour Inspection, Ministry of Labour and Social Insurance entitled ‘Assessment of the situation regarding physical and mental diseases of the working labour in Cyprus, 2006’, the main characteristics of jobs that cause musculoskeletal problems are painful and tiring posture and repetitive hand and arm movement. Eighty-nine per cent of people suffering from bone, joint and muscle pain reported that the work that caused their problems involves painful and tiring postures and 77% reported that their work includes repetitive hand and arm movements. To a large extent , work that causes problems is described as work performed at high speed or on tight schedules (60%) or requires carrying or moving heavy loads (57%). To the question what types of work cause musculoskeletal conditions, 32% answered that their work involves constant use of the hands, 18% answered that they work on a production line, and 13% answered that they work on computers. Reported to a lesser extent was work that includes frequent foot movements (2%), sedentary work (2%) and tiring posture (3%). Table 2 includes all the answers given by the people, who gave more than one answer.

Table 2: Types of work that cause musculoskeletal conditions

Type of work

Percentage of answers %

Production line work

18

Assembly line work

7

Packing work

6

Work on computers

13

Constant carrying of loads

13

Constant use of hands

32

Driving

8

Standing

12

Constant movement of feet

2

Sedentary work

2

Tiring posture

3

 

Source:  “Assessment of the situation regarding physical and mental diseases of the working labour in Cyprus, 2006,” Department of Labour Inspection, Ministry of Labour and Social Insurance.

  • 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.?

There are no data from surveys regarding reconciliation of working and family life of people with chronic diseases. However, according to representatives of trade union and employer organisations, in cases where there are people with chronic diseases in unionised enterprises they have the ability to make special arrangements and there is flexibility in employees’ working hours.

  • 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?

No data are available from surveys or other sources with regard to the issue of career and job security.

  • 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?

Despite the fact that there are no available data on skills development of people with chronic diseases, after questioning representatives from trade unions and employers organisations employers do not discriminate against such people as regards vocational training.

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

There are no available data regarding this question.

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

The surveys mentioned do not include data showing the effects of the economic crisis on people suffering from chronic diseases.

Block 3: Policies and measures adopted by public and private agents to favour the employment situation and working conditions of people with chronic diseases

3.1. Description of main policy measures/initiatives developed by public authorities or social partners

Law 146(I)/2009 on the recruitment of Persons with Disabilities (Special Provisions) in the Wider Public Sector

  • General information of the policy measure/initiative (name, dates, responsible body, participants, geographical and sectoral scope…)

It regulates the recruitment of people with disabilities who meet certain objective criteria, at a rate of 10% of the jobs to be filled in the broader public sector at any given time.

  • Objectives pursued (staying-in-work/return-to-work), support offered, activities carried out

The objective of the Law is to promote employment opportunities for people with disabilities, in order to counterbalance the reduced opportunities they have due to their disability.

  • Specific target groups

Beneficiaries for purposes of the Law are people who, after being assessed by a special multi-thematic committee, are deemed to have an impairment or handicap that causes a physical, mental or psychological limitation that is permanent or of indefinite duration, which effectively reduces or eliminates the possibility of finding and maintaining suitable employment.

  • Financing of the measures
  • Outcomes: major results/consequences of the measure on the improvement of working conditions of people with chronic diseases.

The percentage of jobs to be filled at any given time that correspond to people with disabilities who are entitled to a job, where they exist, is 10%.

Further facilitation for people with disabilities involves provision of reasonable adaptations and facilitation for their participation in written and/or oral examinations, provision and installation in the workplace of auxiliary technological equipment necessary for the performance of the job to which they are to be hired, which will serve both the needs of the service and also the special needs of the people, etc.

  • Assessment (lessons learnt, future prospects)

Before the end of 2011, 310 people were assessed, of whom 150 were judged to be people with disabilities eligible for appointment. In the end, 58 people were hired (54 in the educational service and 4 in the public service). Implementation of the Law in the public service during 2012 was significantly restricted due to a freeze on filling job vacancies.

  • Link to the identified measure/initiative

http://www.mlsi.gov.cy/mlsi/dsid/dsid.nsf/index_en/index_en?OpenDocument

Information campaign on the promotion of healthy jobs for people suffering from chronic diseases

  • General information of the policy measure/initiative (name, dates, responsible body, participants, geographical and sectoral scope…)

The campaign was undertaken by the Department of Labour Inspection of the Ministry of Labour and Social Insurance as the national contact point of the European Network for Workplace Health Promotion (ENWHP). The campaign lasted from 2011 to 2013 on a nationwide basis.

  • Objectives pursued (staying-in-work/return-to-work), support offered, activities carried out

The objective of this campaign was to support people suffering from chronic diseases so that they can continue to work, or to contribute to their process of re-integration in work after a period of absence.

The main activities of this campaign are:

a) Publication and distribution of the guide to good practice on the subject of Promotion of Healthy Work for People with Chronic Disease for employers and managers/supervisors who come up against the challenges of managing employees with chronic diseases. The guide includes an analysis of the concepts of promoting health at work, chronic disease and return to work, instructions to employers for promoting healthy work, economic argumentation in favour of investing in programmes for protecting the health of employees, contact information and useful sources of information, and a checklist for supporting return to work.

b) Publication and distribution of a flyer on the subject of promotion of healthy work for people suffering from chronic disease

c) A seminar on the subject of: European Campaign for the Promotion of the Health of Employees with Chronic Health Problems to be attended by all the social partners, employer and trade union organisations, the association of people with chronic diseases, and ministries and departments concerned.

  • Specific target groups

People suffering from chronic disease and facing serious difficulties concerning their remaining on the job or their return to work after a long period of absence.

  • Financing of the measures

The campaigned was co-financed 45% by the European Commission and 55% by the Republic of Cyprus.

  • Outcomes: major results/consequences of the measure on the improvement of working conditions of people with chronic diseases.

Increased awareness and knowledge of the public on the problems faced in employment by people with chronic diseases. A proposed action plan was created addressed to employers/enterprises for helping employees with chronic diseases to remain in employment. 

  • Assessment (lessons learnt, future prospects)

The campaign was judged to be a success, since a large proportion of the social partners and enterprises were informed about the issue and the guide that was created was distributed to many enterprises and organisations. The prospect created is further awareness and activation of employers and the state in the implementation of good practices and the introduction of new policies for promoting the employment of people with chronic diseases respectively.

  • Link to the identified measure/initiative

http://www.mlsi.gov.cy/mlsi/dli/dli.nsf/All/0858F155ED8242E4C2257AC50023638D?OpenDocument&highlight=χρονιες]

3.2. Examples of enterprises and/or collective agreements implementing initiatives or establishing clauses to support people with chronic diseases

There are many examples of good practice by enterprises that introduce measures to reduce and prevent musculoskeletal diseases among their employees; however, they are not regarded as examples of support for people with chronic diseases. Only one example has been recorded of an enterprise that supported the employment of a person with a chronic disease, whose details are as follows:

  • Name of the enterprise(s)/collective agreement, sector, size

Saint John Lampadistis Rehabilitation and Physiotherapy Centre, health sector

  • Objectives pursued and addressed target groups

Employment of a person with systemic lupus erythematosus (an autoimmune disease) on the scientific staff team. The objectives of this example are for the person to remain active in society as a whole, to be financially independent, to be able to self-manage her condition and to remain active and effective at work

  • Main activities conducted and/or measures devised (i.e. physical adjustments of workstations, planned support actions by colleagues, personalised working-time arrangements, internal mobility, commuting support, mid-career review, etc.)

The main measures taken are the following:

  • Flexible work schedule (working hours, appointments)
  • Leave of absence from work (flexibility)
  • Short emergency leave
  • Communication and psychological support from colleagues and supervisors
  • Mutual understanding
  • Medical support
  • Collaboration with doctors of various specialties
  • Encouragement of communication of the patient with the Cyprus Antirheumatic Association

Main results obtained and assessment of these results

The main results of this practice are increased productivity of the employee, increased sense of job security, more harmonious relations with colleagues and supervisors, efforts to reciprocate the support given by her employers by work intensification.

  • Link to the identified case study

http://www.mlsi.gov.cy/mlsi/dli/dli.nsf/All/F29812ACA594F3BEC2257B810036E98C?OpenDocument&t=d&e=

Commentary

The issue of chronic diseases in Cyprus has come to the forefront mainly as regards the prevention and treatment of diseases, rather than helping patients access or stay in employment. Issues of employee health have been highlighted to a large extent by the various state services and associations, and studies are being conducted in this regard, particularly for the purpose of raising awareness of the problems faced by these people and the extent of the phenomenon. The issue of chronic diseases in Cyprus has been of concern to the state and the social partners more in terms of research than at policy level in relation to their employment.

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