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Managing the impact of chronic diseases and disabilities in the workplace

Ageing is accompanied by a higher risk of developing health conditions, and with older age chronic diseases are increasingly prevalent in the workplace. Fortunately employers can do a lot to support the retention and return-to-work of staff who suffer from long-term conditions.


European citizens are both working and living longer, but longer working life also means longer exposure to risks. Chronic conditions such as musculoskeletal disorders (MSDs), cardiovascular disease and mental health issues, e.g. depression affect around 33% of older workers, compared to 15% of younger workers, according to EU-OSHA’s analysis report on rehabilitation and return to work.

22% of workers over 50 think they would not be able to do their current job at the age of 60, according to the 2015 European Working Conditions Survey by Eurofound. Furthermore, data from the European Survey of Enterprises on New and Emerging Risks (ESENER - 2) indicate that 32% of organisations have no procedure to support return to work of workers followed by long term sick leave.

Long-term sickness absence often leads to unemployment and is a major predictor for all types of labour market exit, including disability pension and early retirement. These are all major financial burdens for employers, governments and society in general. 

The impact of chronic diseases is compelling employers in Europe to improve sickness absence management. Many chronic conditions can be prevented or managed through simple adjustments. Indeed, more and more companies are adapting their work environments to cater for workers with chronic conditions and mild disabilities.

Prevention at first, followed by early intervention has shown to be an effective strategy for retaining workers who are subject to considerable physical, mental or social strain. This was the case for Northumbrian Water Limited (NWL) in the United Kingdom who wanted to reduce the approximately €1.4 million that sick leave was costing the company every year. They put in place a well-being programme which succeeded in reducing sick rates, absences related to MSDs, stress-related absence and employee turnover.

NWL introduced a robust absence-recording system that analysed absence data and partnered with RehabWorks, a chartered physiotherapist company, to provide injury management and rehabilitation services. RehabWorks provide early access to physiotherapists for workers with injuries. They also focus on prevention and early intervention through enhanced training in manual handling and body mechanics, which help to identify ergonomic improvements.

With a different approach, ARACT Aquitaine (a regional unit of the National Agency for the Improvement of Working Conditions) in France partnered with 15 small and medium-sized enterprises and two larger companies to help design projects for workers with chronic diseases. They also helped to implement company strategies to improve working-time arrangements or adapt working conditions and retain workers with such diseases.

ARACT carry out an initial assessment of companies to identify the number of employees with chronic diseases or limited capacities. Following an assessment of agro-food company Delpeyrat, for example, workplace adaptations were made which enabled workers suffering from such conditions to either remain in their roles, or move to another job in the company.

Companies are also introducing rehabilitation and return-to-work measures to help get people back to work after a period of sick leave. This has shown to help recovery and can help to reduce the risk of older workers being excluded from the labour market before they reach retirement age. The availability of occupational health services and financial support for employers to undertake workplace adaptations are also key, particularly for keeping workers with chronic conditions in work.

As EU-OSHA’s info sheet on the topic explains, successful return-to-work systems require clear coordination between all actors involved in the process. The scope of the system should be broad, targeting all workers with health problems and case managers should be in place to help workers through the different steps of the process. Intervention at the earliest stage of sickness absence is vital, together with tailoring interventions to workers’ needs and abilities through an individual plan.

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