Prevention and rehabilitation are topics that are not only of national interest. The European Parliament's Committee on Employment and Social Affairs is also working on an initiative report (2017/2227 (INI)) on pathways for the reintegration of workers into quality employment following an injury or illness.
European Parliament’s draft report
The report looks at three aspects: prevention and early intervention, return to work, and changing attitudes towards the reintegration of workers.
Early intervention is crucial to the success of occupational rehabilitation programs. In terms of psychosocial risks, the draft report states that preventive measures should be a core part of a modern work environment. Member States are encouraged to ensure that companies are supported in managing these risks.
The draft report emphasises that it is crucial that all stakeholders (workers, doctors, social services and employers) communicate with each other and adopt a multidisciplinary, collaborative approach for the successful physical and occupational rehabilitation of workers. The reintegration of a worker following an illness is doubly beneficial because it has positive effects both for the person concerned and from an economic point of view. This is also the conclusion of a study by the International Social Security Association (ISSA) on ‘The Return on Work Reintegration’ (see DSV report).
The draft report calls for a change of attitudes in order to raise general awareness of the limited opportunities afforded people with health problems, for example, when a health problem is accompanied by a social stigma.
Role of the EU
The report states that the EU can add value in this area by helping the Member States in the following areas:
- Develop preventive measures;
- Work out comprehensive strategies in the Member States including early intervention measures, institutional cooperation of all stakeholders, and individualised approaches to those affected;
- Encourage cultural change, positive social attitudes towards the workers concerned, and actions aimed at the lifelong psychosocial well-being of those affected.
Action is particularly needed for reintegrating workers in smaller companies because they often find this difficult due to a lack of the financial resources and expertise needed for this. External technical and financial support can help employers to put individual measures in place and establish reintegration options for workers following an illness. Targeted financial support from EU funds could play a significant role in supporting change. However, this financial support must always go hand in hand with a genuine change in the company culture.
Good, sustainable work is the best medicine
The European Social Insurance Platform, of which the German Social Insurance is a member, had also highlighted the importance of strategies for reintegration in a position paper in December 2017. The increase in chronic diseases affecting the working population suggests that a new policy focus is needed. National social and health policies in EU Member States should focus on return-to-work strategies to strengthen workers’ employability throughout their working lives. Possible measures include:
- combining prevention and well-being in the workplace with occupational rehabilitation,
- ensuring job retention and return-to-work options for persons with chronic disease,
- promoting holistic rehabilitation concepts including occupational participation.
Early intervention is crucial for successful reintegration processes in the workplace because the success rate drops by 50% after six weeks of sick leave. Also important are:
- good communication between GPs, specialist insurance doctors and occupational physicians,
- robust case-management by a qualified rehabilitation manager for complicated cases,
- employer responsibility for reintegration strategies and health-services near to the workplace, and
- cooperation between social insurance institutions and service providers in the field of rehabilitation to benefit workers.
Success story: Strength training at the airport
An interesting example of a joint project for preventing musculoskeletal disorders, involving several social insurance institutions as part of the National Prevention Act, is workplace health promotion for baggage handlers at Hamburg Airport (‘Healthy Work HH’). The project partners were the German Social Accident Insurance Institution for the Transport Industry, Postal Logistics and Telecommunications (BG Verkehr); the German Pension Insurance North; TK Health Insurance Fund; the German Social Accident Insurance Institution for the Public Sector in Schleswig-Holstein and Hamburg; Lifebonus GmbH; and Ground Handling Hamburg Airport.
Baggage handling at airports is a physically strenuous job, particularly in terms of back strain. Given demographic changes in the labour force of commercial handling staff and an increase in the number of sick days due to age, a concept was developed for reducing days lost. The starting point for the concept were the questions:
- whether it is possible to motivate employees by introducing targeted occupational health management, so they see that there is a demonstrable benefit for the health of the musculoskeletal system, and
- whether moving correctly when manipulating loads can be permanently trained and successfully integrated into daily working life.
A training concept was developed in conjunction with the Hamburg-based company Lifebonus and the BG Verkehr that included a ‘training satellite’ and a ‘mock-up’. The mock-up is a simple simulation room that can be adapted to a wide range of activities. This is set up close to the workplace and also includes integrated video analysis.
The training satellite enables job-specific training in the immediate vicinity of the workplace and in regular workwear. In addition to strength training for the back, the work simulator can be used to replicate a baggage trailer and the height-adjustable cargo hold of a commercial aircraft; this allows workers to learn and practice the correct way of handling loads under professional guidance.
As a result of the project, the average number of lost days due to back injuries in the target group decreased by around 40% in the years between 2013 and 2015. The pilot project for baggage handlers at Hamburg Airport was supported by the BG Verkehr. The programme will continue to be offered and, since the start of 2017, has been extended to workers who clean aircraft interiors, to workers in luggage halls and to bus and tractor drivers.
The European Parliament's Committee on Employment and Social Affairs will discuss the draft report in a meeting on 25 April 2018. The European Parliament is expected to vote on the draft on 28 May 2018.