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

2. Annet de lange, New York, 28 March 2003 The Dutch situation 1. Facts and figures (also for Europe) 2. Work stress model for explanation 3. Dutch legal framework 4. Preventive measures 5. Lessons to be learned for other countries? 6. Sources for finding trend information

3. Annet de lange, New York, 28 March 2003 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

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

5. Annet de lange, New York, 28 March 2003 Job content (Netherlands) 1. 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. 2. 20% of Dutch people work in jobs with high job demands and low job control (Percentage in Europe: 25.7%)

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

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

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

9. Annet de lange, New York, 28 March 2003 Work related outcomes (Netherlands)? 1. Work incapacity or disability twice as high as other European countries 2. High Sickness absence: 25%-30% of long-term sick-leave (> 6 weeks) stress related 2. Work-related mental problems: -30% -40% of work disability -10% has been treated for burnout 3. Second diagnosis category: Musc. Skel. Disorders 4. Total costs: 25 billion US $

10. Annet de lange, New York, 28 March 2003 Main diagnoses of work incapacitation across time (Netherlands) Mental Musc. skel. Cardiovasc. Respiratory 1999 0 5 10 15 20 25 30 1967 197019751980198619901995 35 %

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

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

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

14. Annet de lange, New York, 28 March 2003 The Working Conditions Act 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)

15. Annet de lange, New York, 28 March 2003 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)

16. Annet de lange, New York, 28 March 2003 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

17. Annet de lange, New York, 28 March 2003 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

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

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

20. Annet de lange, New York, 28 March 2003 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

21. Annet de lange, New York, 28 March 2003 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

22. Annet de lange, New York, 28 March 2003 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

23. Annet de lange, New York, 28 March 2003 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.

24. Annet de lange, New York, 28 March 2003 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

25. Annet de lange, New York, 28 March 2003 Want to know more?  Websites: -www.europfound.iewww.europfound.ie -www.ilo.orgwww.ilo.org -www.socsci.kun.nl/psy/aenowww.socsci.kun.nl/psy/aeno -www.waop.nl (links)www.waop.nl  Example Articles: -Schaufeli, W. B. & Kompier, M. A. J. (2001). International Journal 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

26. Questions?