New efforts from the Norwegian government to strengthen the occupational health services and work environment research

Closing speech at the 53rd Nordic Work Environment Meeting, Holmenkollen RICA Park Hotell, Oslo, Norway, Wednesday 27. August 2008

 

1. Introduction

First, let me start by thanking STAMI for hosting this Nordic meeting! It is clear, also from the outside, that these are exciting times for those of us concerned with work environment – both in terms of developments in the different Nordic countries as well as Nordic cooperation and dialogue.

Second, I must thank the arranging committee for inviting me to present this closing speech. On behalf of the Ministry of Labour and Social Inclusion – STAMIs managing ministry – I am pleased to state that STAMI has positioned itself as the Norwegian institute for research on occupational health. This status, which is based on merit rather than granted, was most recently confirmed in February, when the Parliamentary Committee on Labour and Social Affairs in a Recommendation to the Parliament complemented STAMI with its level of professionalism; maintaining both STAMIs prominent position both on chemical exposure as well as other areas of national interest.

And equally important, STAMI has internationally found a position among the leading research institutes on occupational health – a position demonstrated by favourable comparisons with its collaborating and competing institutes abroad, and not least by the recent invitation to apply for status as WHO Collaborating Centre in the area of Occupational Health. I feel confident that the evaluation associated with this application procedure will serve to reinforce STAMIs international position even further.

  

2. Nordic work environment research in a period of change

The notion of a “Nordic Model” is quite strong; emphasising among other things the strong tripartite cooperation between employers, employees, and the authorities.

However, in terms of work environment research, we may add a fourth party – and that is the academic community. It is probably fair to state that in this field, the cooperation between the “traditional” parties has paved the way for an opening of gates otherwise closed into the workplace, and thus provided researchers with access to topics and cases from the real working life. Hopefully, this “open door policy” has contributed to early discovery of risks – and thereby prevention of work related sickness and injuries in our countries.

Furthermore, this shared approach has lead to a strong sense of a Nordic community – which stands out among international work environment centres. This is clearly demonstrated by recent statistics, which suggest that the four Nordic countries hold a leading international position in terms of the number of articles published in occupational health journals.

I mentioned how we currently experience exciting times in terms of work environment, and especially so when it comes to work environment research. At least two trends unfold – both of which are challenging for work environment research; in Norway as well as in the other Nordic countries.

On the one hand, globalisation and labour migration reaches an all-time high. This development poses a challenge to current occupational safety structures; especially because these still, to a large extent, reflect protection of workers that faced yesterday’s challenges. Today, we especially find challenges in the service sector and the informal sector – both with a high proportion of foreign manpower.

It is probably also fair to say that the very distinction between occupational health and public health is becoming increasingly more complex and less clear cut. For instance, despite progresses in medicine and the general level of public health, we continue to observe increased demand on health-related welfare benefits – which in turn are often based on increasingly diffuse and complex diagnoses. Any work/life balance in terms of isolating occupational from public health is therefore getting harder to achieve.

Simultaneously, we have a challenge of a very different nature: A substantial number of our most experienced and senior researchers approach retirement age, pointing to a pressing need for sufficient financing of new research activities, the training of a new generation of researchers, and transfer of knowledge between generations.

As these trends unfold, it is reassuring to observe that our countries for the most part can benefit from strong, competent and even growing national work environment institutes. This is the best guarantee for continued Nordic cooperation.

 

3. Our general political agenda and priorities

I have been asked to address, among other topics, our agenda and priorities in the area of work environment and occupational health. I accept this task with pleasure; inasmuch as this administration and the Ministry I represent give high priority to efforts aimed at continuous improvement of the work environment. This administration considers a good work environment both as a goal in itself, AND as a means to increased productivity, good occupational health, and reduced levels of sickness absence and labour market expulsion. Active labour market policy – accompanied by a strong legislation for health and safety at work – is therefore considered part and parcel of our paramount objective of a more inclusive working life.

Let me illustrate by an example:

When this administration took office in 2005, one of our first priorities was to reverse a strategy for deregulations in areas regulated by The Working Environment Act. While not opposing flexibility as such, we did find it imperative to maintain and improve a legislative framework that continues to safeguard:

• a health-promoting work environment;
• safe employment conditions;
• individual adaptation; and
• workplace cooperation and partnership.

Topics such as employment protection, temporary employment, “whistleblower” protection and working time arrangements have thus been at the top of our agenda from day one in office.

This list of priorities corresponds to our general political agenda, in which worker protection and health feature prominently. I will not venture much deeper into the specifics of Norwegian labour and social protection initiatives here and now, but I maintain that over the last few years, we have managed to emphasise the role of health – including occupational health – in the continuous strategy to promote a more inclusive workplace and labour market.

 

4. Strengthening of occupational health services (OHS)

Although I’m aware that quite a few of you have attended the OHS workshop today, I’d like to elaborate a bit further on this important topic from the authorities’ point of view, inasmuch as the OHS is regarded as an important means in achieving a good and preventive work environment. Our system of OHS is currently being audited, and the Ministry´s proposals for change have recently been submitted to hearing among all relevant actors. The Ministry has received a great number of answers and comments which we are currently working our way through with great interest.

The current proposal from the Ministry of Labour and Social Inclusion is centred on a few main topics. First, we have proposed to revise and expand the branch regulation – that is, the set of rules determining the branches comprised by the OHS system. This particular revision is based on the fact that modern-day working life entails a wider set of risks than currently recognised; for instance risks associated with ergonomics and psycho-social issues. Based on a thorough review of candidate branches, the Ministry of Labour and Social Inclusion have therefore proposed to extend the regulation to comprise seven new branches, including health and social services, education, and security services. Provided a positive outcome of the current audit process, employees in these branches will obtain access to occupational health services, while branches already covered by the regulation will continue to do so.

Second, we propose the introduction of an official approval of individual OHS services; the approval being based on an assessment of competence, volume/coverage, and overall quality. This initiative is based on an aspiration to ensure better quality in OHS and to combat substandard services, not least by involving the Labour Inspectorate as partners for employers in need of assistance. While it’s recognised that the approval in itself will not relieve the problem of reluctant employers, it is assumed that some benchmark of quality in itself will ensure OHS services of high quality. The particularities of this arrangement have yet to be settled.

Third, we are prepared to back up the OHS revision with intensified public supervision and guidance vis-à-vis employers, both individually and on the branch level. Simultaneously, employers must be made aware of their responsibility to make use of the OHS services. The Labour Inspectorate is among the most important actors in this part of the strategy.

 

5. New initiatives in work environment research

Some of you are researchers, and all of you present here today are – in one way or another –intimately involved with the area of working conditions and occupational health and safety.   With your hands-on involvement in this area, you know the importance of committing resources to the maintenance of thorough and constantly updated knowledge on which to base both daily activities and long-term strategies. In addition to the always important question of funding, another keyword for research is predictability and long-term commitment; that is a reassurance that research projects will be carried out in a sufficiently prolonged manner.

I am not a researcher, but we policy makers certainly recognise the importance of the contribution from researchers as well as practitioners. In fact, in this area – for instance when we want to study health effects in conjunction with working conditions and exposure – we often find ourselves highly dependent on input and suggestions from the academic community.

Therefore, it is important to maintain and develop a sufficiently solid knowledge base – a knowledge base sensitive to the importance of resources, predictability, and long-term commitment. In terms of policy initiatives linked to a more inclusive labour market, I have already noted our renewed emphasis on health in general and occupational health in particular over the last few years. This focus is also reflected in new and strengthened initiatives in the area of work environment research.

Both in this area as well as in many others, the most important instrument is our national Research Council, through which designated research programmes are designed, funded, administrated and followed up. I would like to call attention to a few programmes of particular interest to this audience.

First, we have initiated a new Programme for Research on Causes for Sickness absence and labour market exclusion; a 10-year programme for the period 2007 – 2016. This programme is designed to foster a more comprehensive and strengthened knowledge base on causes of sickness absence, disability and labour market expulsion. Today, I am content with noting that work environment, working conditions and occupational health feature prominently among the research topics in this programme, which already comprise a handful of projects.

The new research programme represents a continuation of previous programmes on occupational health. The main rationale behind a renewed focus on occupational health is a widely recognised need to map and analyse the causal relationships between working conditions and occupational health. This knowledge, which is only achieved through long-term, comprehensive research, will provide a baseline for preventive measures.

Thus, it is imperative to identify the factors contributing to sick leave and exclusion. Both the physical as well as the psycho-social aspects of the work environment call for attention in this work. With respect to the latter aspect, the programme aims at mapping the relationship between health and factors such as demand/control in everyday tasks, and autonomy and authority in work – factors known to be associated with musculoskeletal disorders and quite possibly also with psychological ailments.

The new programme will also address the relationships between health and organisational issues such as reorganisations and downsizing. Another increasingly important factor in this organisational area is working time arrangements and the extent to which varying working conditions are systematically gender specific.

As you may have noticed during this conference, the issue of a more inclusive labour market is prominent in both the current political and academic discourse. The tripartite agreement underlying this campaign points to the importance of mapping the various labour market actors’ roles, actions, and interactions. For instance, it is pertinent to study the extent to which workplace adjustments and adaptations contribute to shortening short-term and temporary sickness absence spells and reducing long-term, or even permanent, labour market exclusion.

Another important initiative is The Working Life Programme. While maintaining a close focus on the general conditions for a more inclusive working life, it is fair to say that this programme has also witnessed a renewed emphasis on health and working conditions – thus clearly laying down the close relationship between health, inclusion and exclusion.

The need for a closer look at this relationship is particularly well illustrated by examining existing knowledge on early retirement and individual decisions on retirement among older employees. Research on these matters – of great importance to labour supply and social security expenditures – has to a large extent focused on financial incentives and questions of whether older employees have been “pushed” or “pulled” into early retirement. However, we have recently recognised the need to learn a lot more about the role of health-related causal factors and correlations as grounds for early retirement. In the same vein, more knowledge is also needed about the long-term health effects of restructuring, downsizing and other company-specific characteristics.

And let me also briefly mention current developments in the research programme on Health, Safety, and Environment in the Petroleum Sector. This initiative is an integrated part of a more comprehensive Programme on the Management of Petroleum Resources (PETROMAKS). The most recent developments in this particular programme are model illustrations of how inputs from various pilot projects in the petroleum sector eventually come to influence the research focus of a fairly large programme. More specifically, in this case, two pilots from 2006 on health effects of work schedule schemes and exposure to chemical agents, respectively, have resulted in the start-up of several long-term research projects on these issues – both being areas in which longitudinal projects are deemed essential.

Another initiative aimed at improving the knowledge base on work-health issues, this one explicitly linked to STAMI activities, is NOA – National Surveillance of Working Environment and Occupational Health. Established in 2006, this department at STAMI shall coordinate, systematise and disseminate information on current status and long-term trends in work related hazards, exposure and health outcomes. Founded with a specific mandate to serve decision makers and a variety of stakeholders, NOAs activities are more of a facilitating nature than analytical per se. Nevertheless, NOAs activities have already put occupational health issues on the agenda on several occasions, most recently demonstrated last week by the launch of a number of publications based on the 2006 Working Conditions Survey.

It is important for us to maintain institutes with competence on the often complex relationship between work environment and occupational health. This is why we have recently initiated a process to evaluate all occupational medicine departments – from STAMI to institutes and departments in Oslo, Bergen, Trondheim, Tromsø, and Skien. This comprehensive evaluation is specifically aimed at the match – or mismatch – between their capacity and the general challenges in the area of occupational medicine.

 

6. Conclusion

Let me conclude this closing speech by once again commending STAMI and the arranging committee with a successful Nordic meeting.

I share your commitment to the promotion of working environment issues, whether in the academic or in the practical field – because from my field of politics and policy making, it is evident that a working environment as healthy and safe as possible is the bedrock of a working life that is both inclusive and economically viable in the long run.

New challenges, risks and hazards arise in your area of expertise, and I therefore sincerely hope that these couple of days here in Oslo have provided you all with new and updated knowledge on a topic of great interest – and of great importance!

Thank you for your attention!