Dr Britta Schmitt: Statutory and operational framework conditions for best possible efficacy of external OSH services in Germany – problems and possible solutions as reflected by current research and recent legislation Revised: January 2014

TAIEX-Workshop Ankara, Dr. Britta Schmitt 2 Overview About BAuA – facts and figures Initial situation: safety and occupational-health supervision in Germany External OSH Services: Problems and solutions Conclusion and outlook Photo: FOX / Uwe Völkner

TAIEX-Workshop Ankara, Dr. Britta Schmitt About BAuA - facts and figures Federal Institute for Occupational Safety and Health (BAuA) Federal institution with tasks in research and development (Governmental research institution) Status: subject to public law, directly subordinated to the Federal Ministry of Labour and Social Affairs (BMAS) Locations in Dortmund, Berlin, Dresden and Chemnitz Budget: 65.5 million € (quota 2013) Staff: 699 (April 2013)

TAIEX-Workshop Ankara, Dr. Britta Schmitt Impressions Dortmund Chemnitz Dresden Berlin

TAIEX-Workshop Ankara, Dr. Britta Schmitt Initial situation: company size distribution in Germany 0.8% 23.7% 71% 4.6% 94.7% The overwhelming majority of the 2.3 million German companies with employees are small and medium-sized enterprises (SMEs) Source: Federal Statistical Office 2011

TAIEX-Workshop Ankara, Dr. Britta Schmitt Initial situation: provision of services of occupational safety specialists (OSS) and occupational physicians N= Betriebe Provision to all companies in Germany 59% of companies are supported by an occupational safety specialist (OSS) 40% of companies are supported by an occupational physician Source: Company and employee survey as part of the GDA umbrella evaluation

TAIEX-Workshop Ankara, Dr. Britta Schmitt Initial situation: provision with services of occupational safety specialists (OSS) and occupational physicians Source: Company and employee survey as part of the GDA umbrella evaluation Σ = gap in provision

TAIEX-Workshop Ankara, Dr. Britta Schmitt Initial situation: Need of OSH services for SME 60% of all fatal occupational accidents take place in SME<50 employees You could say: 60% are less than the SME- percentage of all German companies. But: Let‘s have a look to the percentage of employees, who work in SME… SME Source: (fatal occupational accidents , June 2012www.baua.de/Toedliche-Arbeitsunfaelle (fatal occupational accidents , June 2012

TAIEX-Workshop Ankara, Dr. Britta Schmitt Distribution of company size versus distribution of employees per company size Source: Company and employee survey as part of the GDA umbrella evaluation …only about 45% of all German employees work in SME 60% of fatal accidents take place among only 45% of all employees!

TAIEX-Workshop Ankara, Dr. Britta Schmitt 10 External OSH services: Problems and solutions Demand side: Gap of knowledge: Only 43% of the companies evaluate their own state of knowledge on the prescribed use of OSH services as “fairly high” or “very high” Gap of consciousness: Companies want to save costs Gap of inspection frequency: Low frequency of checks by labour inspection, especially for SMEs Supply side: Shortage of experts: Approx. 120,000 safety specialists trained since 1979 (currently practising: approx. 40,000) Shortage of doctors: 11,361 doctors with competence in occupational medicine; of these, 42% are aged 65 or above (practising as occupational physicians: approx. 5,800) Presumed causes for gap in provision

TAIEX-Workshop Ankara, Dr. Britta Schmitt 11 External OSH services: Possible solutions More flexible and non-discriminatory regulations Information and consciousness raising campaigns especially among SME Improved training as an occupational safety specialist Advertisement among students of medicine for the subject “occupational medicine”

TAIEX-Workshop Ankara, Dr. Britta Schmitt 12 Possible solutions: what had to be done? Since October 2013, SME<10 empl. must also document their risk assessment (amendment to the Occupational Safety and Health Act) Since 2011, Regulation 2 of the German Social Accident Insurance (DGUV) has been in force: according to this regulation, dedicated working hours of occupational physicians and OSH professionals are no longer prescribed in a uniform manner; rather, they must be determined by the employer based on its risk assessment External occupational-safety experts can improve their business acquisition and provide increased assistance in the compilation of the operational risk assessment

TAIEX-Workshop Ankara, Dr. Britta Schmitt 13 Possible OSH supervision models according to DGUV Regulation 2 In principle, the prescribed OSH supervision consists of: Basic supervision and company-specific supervision 1. Model: “Standard supervision” – Characteristics (two elements): Basic supervision: In basic supervision, the dedicated working hours of occupational physicians and OSH professionals are determined by the number of employees and assignment of the company's industry to the high-, medium- or low-risk group Company-specific supervision: For specific operational hazards, situations and circumstances, the employer stipulates the need and extent on the basis of the operating conditions. This stipulation is to be reviewed regularly, usually annually.

TAIEX-Workshop Ankara, Dr. Britta Schmitt 14 Possible OSH supervision models 2. Model: “Alternative, needs-based supervision” – Characteristics (also two elements): Accessible for SME, i.e.: Companies with 1–30 employees and companies with 30–50 employees (for transitional period) The basic supervision: is taken over by the employer himself. For this purpose, this person must complete a seminar held by his (or her) accident- insurance organisation. The prerequisite is that the employer is actively involved in the company's operations. Additional company-specific supervision: the employer makes use of this as required with external OSS and physicians or competence centres. Possibilities include: motivational and information measures, assistance in specific occupational-safety matters SME

TAIEX-Workshop Ankara, Dr. Britta Schmitt 15 Use of OSH supervision models (safety specialist) – Baseline 2011 The 2011 umbrella evaluation of the Joint German Occupational Safety and Health Strategy (GDA) shows: N= 6,500

TAIEX-Workshop Ankara, Dr. Britta Schmitt 16 Use of OSH supervision models (occupational physician) – Baseline 2011 The 2011 umbrella evaluation of the Joint German Occupational Safety and Health Strategy (GDA) shows: N= 6,500

TAIEX-Workshop Ankara, Dr. Britta Schmitt 17 Safety Specialist: Reformed training structure (more suitable and online-based) Attendance Period I 1 week Attendance Period II 1 week Attendance Period III 2 weeks Attendance Period IV 1 week Attendance Period V up to 1 week Self-Learning Period I Self-Learning Period II Self-Learning Period III Examination 1 Practical placement Examination 2 Examination 3 Examination 4 Training Level I Training Level II Training Level III

TAIEX-Workshop Ankara, Dr. Britta Schmitt 18 Acquisition of safety competence as a prerequisite for professional activity in accordance with the Occupational Safety Act (ASiG) Objective: Supporting companies in all occupational-safety matters Competence to act autonomously Technical knowledge Methodological competence Social abilities Certificate Training as a safety specialist is provided by all accident- insurance organisations and 30 independent organisations

TAIEX-Workshop Ankara, Dr. Britta Schmitt 19 What is the current estimate of the required level of occupational health supervision? Other operational services in occupational health Maximum demand scenario Medium demand scenario Minimum demand scenario Total in million h/a This includes, for example: -General health check-ups and health consultations -Vaccination advice and general vaccination programmes (without specific link to professional activity) -Care for pregnant women and seriously disabled persons -Ambulance and rescue service -Staff-doctor examinations such as: -pre-employment medical examinations -aptitudinal tests according to other legal sources Source: BAuA Research Project F 2326, system concept, research report in preparation

TAIEX-Workshop Ankara, Dr. Britta Schmitt 20 What level of occupational health supervision is expected to be required for the year 2021? Source: BAuA Research Project F 2326, system concept, research report in preparation maximum demand scenario medium development scenario maximum development scenario high-quality needs-based supervision Time minimum development scenario Million hours per year Supervision based on mimimum sizes Continuation of currently implemented supervision

TAIEX-Workshop Ankara, Dr. Britta Schmitt 21 Conclusion and outlook In Germany, a considerable supply gap exists in the services of occupational- safety experts, especially with regard to SMEs (mainly external). This supply gap is expected to continue to grow. Possible future solutions: Delegation of occupational medical services to medical assistants and, if possible, to occupational-safety nurses (profession do not yet exist in Germany) Opening up the admission criteria for training to be a safety specialist: not only qualifications as an engineer, technician or master craftsman, but also social professions Greater acquisition of external occupational-safety experts in SMEs More information on regulations and OSH benefits as well as stricter checks of labour inspection

TAIEX-Workshop Ankara, Dr. Britta Schmitt Thank you very much for your attention