Engagement in Health and Safety at the Workplace: A New Role for the Occupational Health Physician

Engagement in Health and Safety at the Workplace: A New Role for the Occupational Health Physician

Nicola Magnavita (Università Cattolica del Sacro Cuore, Rome, Italy)
DOI: 10.4018/978-1-4666-9992-2.ch013


Dramatic changes in the age structure of the population have led to a rise in the age of retirement. An ageing working population may be a problem for companies and for their health and safety services that must face the long-term management of active, chronically ill workers. For sustainability reasons the discipline of occupational medicine must be replaced by occupational health, which not only combats occupational diseases, but actively works to promote the health of older workers. More in general, occupational health has a strong interest in promoting engagement in professional activities. Shifting from a reactive to a proactive logic will take time and require a big effort on the part of employers, employees and health and safety staff in order to develop participatory ergonomics and best health promotion practices in the workplace.
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Over the next few decades, the rapid ageing of populations will be one of the most powerful forces for change in society. The increase of life span, and a lower fertility rate, particularly in industrial nations, have caused a dramatic demographic shift towards an increase in the mean population age: fewer people are being born and people are living longer.

Long-term projections show that although this demographic shift started in developed countries, it is fast becoming a global challenge. Currently 10% of the global population is over 65 years old, but this figure is expected to jump to 22% by 2050. The total number of people aged 60 years and over is expected to increase from 605 million to 2 billion over the same period. This will have a significant impact on areas such as public health and economic prosperity.

Highly significant changes are expected to occur in the age structure of the EU population. While in 2015 the most numerous male and female cohorts are around 45 years old, in 2060 the number of elderly people is expected to account for a rising share of the population (European Commission, 2015). This is due to the combined effect of the numerous cohorts born in the 1950s and 1960s – the baby boomers- and the continual increase in life expectancy. At the same time, the base of the age pyramid is decreasing on account of reduced replacement fertility rates.

This rapid change in the structure of the population has already placed significant pressure on social security systems. Dependency ratios (people aged 65 or above in relation to those aged 15-64) have rapidly increased in all developed countries and the rising costs of retirement and health care have produced an increasingly heavy burden. In the EU as a whole, the demographic old age dependency ratio is predicted to increase from the 2013 27.8% figure to 50.1% in 2060. This would mean that instead of having approximately four working-age technician for every person aged over 65 years, there would be only two working-age people (European Commission, 2015). Ageing also puts the supply and quality of social and health care services (including occupational health services) at risk (Reday-Mulvey, 2005).

These predictions have made European governments increasingly aware of the economic importance of older workers, since their participation in the labor market could help to secure economic productivity and sustain social welfare and pension systems. To this end, the Lisbon European Council (2000) and the Stockholm European Council (2001) developed policies containing joint strategic aims for strengthening employment, economic reform and social cohesion in a knowledge-based economy. Their main aim was to increase the average employment rate of older people aged 55–64 years to 50% by 2010 (Winkelmann-Gleed, 2008). All EU states have introduced pension reforms, and we can already see the first effects of these provisions. In Europe, there are now many more workers aged ≥50 than those aged ≤25 years and this situation is expected to last for decades. This may pose a problem for companies and their health and safety services as many new jobs are designed for young workers. This means that there is a real risk that some older workers will be unable to reach the minimum performance standard required for their work. Moreover, the reduction in retirement ratios will lead to an increase in the number of workers with health problems. This will pose new problems for health and safety services in the workplace. Production requirements will force companies to face a new problem – presenteeism - specifically connected with the presence in the workplace of workers with chronic diseases.

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