Work, stress and health in the Netherlands?

1. Work, stress and health in the Netherlands? Annet de Lange 28 Maart 2003 Mount Sinai Medical School New York

2. The Dutch situation • Facts and figures (also for Europe) • Work stress model for explanation • Dutch legal framework • Preventive measures • Lessons to be learned for other countries? • Sources for finding trend information Annet de lange, New York, 28 March 2003

3. Some information about the Dutch working population • Workforce: 6.8 Million. • 73% services, 23% industry, 4% agriculture • 17% male and 86% female are part-timers • 12% work incapacitated Annet de lange, New York, 28 March 2003

4. Facts and Figures (Netherlands versus Europe) • Job content • Work related outcomes Annet de lange, New York, 28 March 2003

5. Job content (Netherlands) • High work pressure: -1997: highest level compared to European countries (58%; Paoli, 1997), increase of 11% from 1991-1995 -2002: second position, Sweden nr. 1. • 20% of Dutch people work in jobs with high job demands and low job control (Percentage in Europe: 25.7%) Annet de lange, New York, 28 March 2003

6. Pace of work (Europe) Annet de lange, New York, 28 March 2003

7. Job control (Netherlands) Workers having a choice over their % Source: Houtman et al. (2002) Annet de lange, New York, 28 March 2003

8. Job Control (Europe) Annet de lange, New York, 28 March 2003

9. Work related outcomes (Netherlands)? • Work incapacity or disability twice as high as other European countries • High Sickness absence: 25%-30% of long-term sick-leave (> 6 weeks) stress related • Work-related mental problems: -30% -40% of work disability -10% has been treated for burnout • Second diagnosis category: Musc. Skel. Disorders • Total costs: 25 billion US $ Annet de lange, New York, 28 March 2003

10. Main diagnoses of work incapacitationacross time (Netherlands) 35 30 25 Musc. skel. % 20 Cardiovasc. Respiratory 15 Mental 10 5 0 1967 1970 1975 1980 1986 1990 1995 1999 Annet de lange, New York, 28 March 2003

11. Work related outcomes (Europe) Annet de lange, New York, 28 March 2003

12. Work related mental problems and stress are a problem! Not only in the Netherlands, but also in Europe!! Annet de lange, New York, 28 March 2003

13. Work stress model for explanation stress complaints Annet de lange, New York, 28 March 2003

14. Dutch legal framework:The Working Conditions Act • Assess psychosocial risk-factors • Take preventive measures (at the source) • Design jobs properly (‘healthy jobs’) • Join an Occupational Health and Safety Service (OHSS) Annet de lange, New York, 28 March 2003

15. Working Conditions Act [Employer’s obligations] 1. Active policy to enhance occupational health, safety, and well-being 2. Active policy to prevent sickness absence and to promote rehabilitation of sick employees 3. Risk identification and assessment via an organizational audit 4. Join an Occupational Health and Safety Service (OHSS) Annet de lange, New York, 28 March 2003

16. Healthy jobs? • Proper matching between job and employee • Sufficient job control • Possibilities for skill enhancement • Opportunity for social contacts with colleagues • Information and feedback about purpose and results of one’s work • Avoidance of repetitive, short-cycle work • No sexual harassment or discrimination Annet de lange, New York, 28 March 2003

17. Tasks of OHSS’s • Carry out risk assessments • Implement measures to increase employee’s health, safety, and well-being • Social-medical guidance and rehabilitation of sick employees • Carry out voluntairy individual medico-psychosocial examinations Annet de lange, New York, 28 March 2003

18. By law: Occupational Physician Safety Engineer Work Hygienist ‘Work and Organization Expert’ Additional: Human Factors Engineer Work and Organizational Psychologist Occupational health nurse Occupational Health and Safety Services[Professions] Annet de lange, New York, 28 March 2003

19. Work & Organizational Expert [tasks] • Organizational advice and recommendation of measures • Psychosocial risk assessment • Implementation of measures • Co-ordination and integration of measures Annet de lange, New York, 28 March 2003

20. Preventive measures[types] • Training of employees 9% • Team meetings 8% • Reduction of workload 7% • Training of supervisors 7% • Task rotation 5% • Task enrichment 5% Source: Houtman et al., 1998 Annet de lange, New York, 28 March 2003

21. Preventive measures[critical success factors] • Stepwise and systematic approach • Adequate diagnosis or risk analysis • Combination of measures • Participatory approach • Top management support Source: Kompier & Cooper, 1999 Annet de lange, New York, 28 March 2003

22. What lessons may be learned? [1] 1. An active governmental policy works 2. Working conditions legislation should and can include psychosocial work characteristics 3. A national infrastructure (OHSS’s) is crucial 4. Special attention is needed for small and medium sized companies Annet de lange, New York, 28 March 2003

23. What lessons may be learned? [2] 5. Privatization of occupational health has negative side effects 6. More stress intervention projects need to be carried out and evaluated (best practices) 7. Research and practice mutually reinforce each other 8. A positive social climate stimulates applied research. Annet de lange, New York, 28 March 2003

24. Conclusions • Job stress is a problem in the Netherlands (& Europe) • Research examining the relationship between work and health is needed • Some lessons can be learned from the Dutch situation Annet de lange, New York, 28 March 2003

25. Want to know more? • Websites: -www.europfound.ie -www.ilo.org -www.socsci.kun.nl/psy/aeno -www.waop.nl (links) • Example Articles: -Schaufeli, W. B. & Kompier, M. A. J. (2001). InternationalJournal of Stress Management, 8, 15-34. -Houtman, L. D., & Kompier, M. A. J. (1995). In: SL Sauter & LR Murphy (Ed.), Organizational risk factors for job stress. Washington: APA, 209-225 Annet de lange, New York, 28 March 2003

26. Questions?