How Employers Benefit from Good Occupational Health and Safety
In most countries of the world occupational health is regarded as a part of work safety, and it often has a minor status and significance. This may be due to the fact that only safety at work is considered to be the responsibility of the employer. Other matters that relate to health are generally taken care of in the context of separate public or private health care systems. Neither is the treatment of diseases considered to be a function of occupational health.
In Finland, however, the situation in this regard is different. Occupational health services are stipulated by law and regarded as the responsibility of the employer. As a consequence, the employer is responsible for arranging adequate and professional occupational health services. The professionals are occupational physicians and nurses, physiotherapists, psychologists, ergonomists and work hygienists.
Obligatory occupational health care in my country consists of workplace visits and surveys conducted by these professionals. During their visits they gather all the necessary information that they need for their activities. Generally a pre-survey is necessary before the first workplace visit. In this connection the line of business of the workplace, the functions and the developmental phase of the enterprise, as well as the working time arrangements, structure of the personnel including gender, age and job descriptions are charted. Occupational accidents and diseases and their causes are of special interest in this connection, as well as statistics on their type and quantity, and data on absenteeism.
A workplace inventory generally includes an investigation of the workplace as a whole. Attention is paid to items such as space allocation and structures, machines and equipment, illumination, temperature, draft, dust, noise, indoor climate, any possible physical and chemical exposure, work load, work stations, and risks in the environment, hazards during work, as well as bullying or harassment in the work community. To summarize, the duty of occupational health professionals is to disclose all hazards to the employees' health and welfare.
The thorough investigation of the enterprise leads to the establishment of an occupational health care project which is carried out according to a well planned schedule. The observed improvement needs and their gradual elimination are followed up. Any workers who are found to be exposed to some hazardous agent are referred to health checks where the type of hazard, whether physical or chemical, is investigated in connection with the person's work and health status. A third focus of examination is targeted at the other employees, and their health condition and work ability are followed up and controlled. The reason for this is to discover as early as possible any changes in health that may lead to problems, and then to take precautionary action and to assist and advise the persons in question.
The majority of Finnish employers have voluntarily made arrangements for medical care of their employees, who are entitled to the treatment of common illnesses at the obligatory occupational health service unit. The occupational health service consists of the services of general practitioners, who give acute preliminary treatment and follow-up treatment of, for example, hypertension, allergic diseases and musculoskeletar disorders. The employees can visit the doctors during working hours. No salary deductions are made during these services despite the recommendation that non-acute sicknesses should be taken care of outside the occupational health service system. The more expensive X-rays, laboratory tests, and medications, the employees have to pay themselves. The kind of health care arrangement described above is very common in Finland.
No doubt you are curious to know the indirect cost of the occupational health service system to the employer. If the employer does not have to pay the employee's salary during sick leaves for accidents, occupational diseases and other leaves due to the inability to work, the financial gain may be small. This question nevertheless has to be viewed as a societal responsibility. It should also be borne in mind that industrial safety regulations are obligatory to the employers according to the directives of the European Union. Another feature in the Finnish social security system is that employers fund partially this system, out of which the citizens are paid for expenses arising from medical treatment and costs of inability to work. The social security system reimburses 50% of the expenses incurred by the occupational health services paid by the employer. Additionally, according to recent legislation, employers are reimbursed 60% of the costs of work place surveys made by occupational health professionals. This is due to the appreciation and high priority given to the occupational health service system.
How does the employer benefit from all this?
The rising work absenteeism figures have attracted attention everywhere. Normal absenteeism figures are 3–4% for white-collar employees and 5–6% for blue-collar employees. These figures are averages and do not apply to small enterprises with only a few workers, as naturally even a single long period of absence can bias the statistics. Higher figures than the ones given above may reflect other perspectives than inability due to sickness. Some of these perspectives could well be problems in work attitudes and norms at the work place, a poorly functioning work community, unfair work arrangements, or lack of trust, confidence, appreciation, etc. The eventual loss is, however, a loss in production.
We have calculated that salaries make up a third of the overall costs, because absenteeism causes losses in production and expenses resulting from temporary labour compensation. If the occupational health service arrangement can decrease absenteeism by even one day, the cost of a single person's occupational health care is already refunded.
The prevention of diseases and the possibility of intervening rapidly and starting medical care at an early stage can significantly decrease the prolongation of a sick leave. Capable and motivated employees are an invaluable success factor for an enterprise.
It is interesting that in Finland employers pay the major part of the pension costs. This is why early retirement means significant costs for the employer. Consequently, Finnish employers want the occupational health service system to be as efficient as possible in general, but especially in the prevention of illnesses. A well organized occupational health service system is also an effective public relations asset. An employer who takes good care of the personnel is appreciated and held in high esteem; this ensures the availability of labour and wins the respect of the clients.
The occupational health service must be so successful and of such high quality that both the employer and the employee benefit essentially from it, despite its costs. It has to be based on the competence of qualified and motivated occupational health personnel.
In summary, if the work ability of workers can be enhanced, the number of work accidents and occupational diseases minimized, and illnesses treated rapidly and efficiently, it will lead to a lower rate of absenteeism and will benefit the enterprise as a whole.
I should like to emphasize that social insurance is reflected in the behaviour of people. The more responsibility that is delegated to people, the more responsibly will they tend to behave. Therefore, being dependent on social welfare should be based on actual need and should not be a too easy alternative, leading to misuse. An employee's salary during a sick leave is never compensated in full, i.e. 100%, or the normal wages. Reasonable sick-leave wages range from 70 – 75% of the person's actual wages. The level of work disability should not be regarded as either zero or a 100%, because the situation is seldom as simple as this. There should also be the possibility of a partial daily allowance, in which case the employer pays half of the employee's salary, and the state pays compensation for partial absenteeism or partial sick leave.
When a handicapped person is employed, the employer should pay him/her wages only for the actual work done. Additional compensation should be provided by the state. Private enterprises cannot carry the burden of additional costs, because they are not social institutions, and have to compete with other enterprises on the market and the jobs they offer.
MD. Chief Medical Officer
Confederation of Finnish Industries EK