1. Dietmar Elsler, Prevention and Research Unit, EU-OSHA
The value of safety and health – recent research on economic impact for different stakeholders
Dietmar Elsler, Prevention and Research Unit, EU-OSHA

2. Background of EU-OSHA activity on costs and benefits of OSH?
Strategic background
Europe 2020 Strategy: More and better jobs
European Commission Strategic Framework on Health and Safety at Work
EU-OSHA Multi Annual Strategic Programme
Objectives
Provide policy makers with relevant information on the economic impact of poor or non-OSH at macro level.
Highlight contribution of OSH to improving productivity and competitiveness and thus increase the OSH motivation of enterprises
Raise awareness about the costs of non-OSH among policy makers outside the field of OSH.
In order to get a better overview of the different methodologies used, we commissened a project on the « estimation of the costs of non-OSH at macro level
Provide policy makers with relevant information
OSH contributes to productivity and competitiveness
Raise awareness outside the field of OSH
Workshop together with NL FOP in October/November

3. Background: diversity of estimates, global 3.9 % and EU28 3.3% of GDP
Country
Estimate
% share GDP
Year
Netherlands
3.0
2004
Spain
1.7
United Kingdom
1.2
2007
Australia
4.1
2013
New Zealand
3.4
2006
Germany
3.6
Austria
2.7
2008
On society level the cost of non-OSH, that means the cost that are lost as a consequence of occupational diseases, is usually measured as percentage of GDP, Gross-Domestic Product.
The ILO estimates a percentage of 4 % of GDP for industrialised countries, that means 490 billion Euro at EU-level
The less developed the OSH system in a country, the higher the percentage of its GDP spent on health care and State benefits linked to work-related injury and illness, draining resources away from more productive activities, up to 10 % in Latin America
Below we see a number of more recent studies, they range between 1.2 and 4.1 percent
The diversity of estimates is due to
Different methodologies
Different availiability of data
Different costs and benefits included
The estimates are often based on sick leave data, but do not include e.g. productivity losses, opportunity costs, etc.

4. Home: https://visualisation. osha. europa. eu/osh-costs#
Home: Mortality: deaths resulting from work-related injury and illness (number of fatalities)

5. EU estimates – Analysis by illnesses Main work-related illnesses and DALY (Years of life lost and lived with disability) per 100,000 workers (EU28 and Iceland and Norway + Austria + Belgium + Bulgaria)

6. Home What are the main work-related illnesses and injuries resulting in death and in DALY?
Cancer is the biggest killer with most fatal cases per year in EU28, followed by Circulatory illnesses.
Also, Cancer has the highest DALY (Years of Life Lost or Years lived with Disability)

7. Cost of different stakeholders in different countries

8. Business case at enterprise level
Return on prevention (ISSA, 2011) EUR return for every Euro invested in OSH
BenOSH (2011): cost-benefit ratio 1.36 – 2.70
Positive results from recent studies

9. Case studies in SMEs (EU-OSHA 2014) Example: Backing healthy backs
Issue
Fußboden Brandenburg is a parquet reclining company with six employees
Laying carpet, laminate or flooring is heavy work
Long sick leaves can threaten the existence of the business
Action
Specialists of IKK Nordrhein developed a back pain prevention programme
workers were trained in better manual handling of loads and in respecting their individual limits to avoid overstrain
In addition, various lifting aids were purchased
Results
Doing back exercises has become routine in the company.
A before / after comparison in the guided intervention showed positive training results of all workers.
Since five years, the workers have not missed a single day because of back ache or muscular complaints.
Issue
Fußboden Brandenburg is a parquet reclining company with six employees. Laying carpet, laminate or flooring is heavy work: especially manual lifting and moving of carpets and of furniture is strenuous for the backs of the workers but often underestimated by them as being a health risk. On the contrary, for the artisan workers it is still professional honour to be strong and fit even when the going gets tough.
For small trades sick leave can easily affect their general situation and turn the business into a struggle for survival: deadlines can not be met anymore, contractors threaten with penalty clauses and unsatisfied clients turn away and look for alternatives. Especially musculoskeletal disorders can cause long term absence of employees.
Action
In collaboration with IKK Nordrhein which is the health insurance of many trade businesses in Germany, the owner of Fußboden Brandenburg, Klaus Brandenburg, started a project for healthy backs for his workers. The project combined health promotion and technical prevention measures. Specialists of IKK Nordrhein developed a back pain prevention programme. The workers were trained in better manual handling of loads and in respecting their individual limits to avoid overstrain. In a nearby rehabilitation and training centre (RehAktiv) the workers ran through a special training programme to learn the exercises which take some minutes per day in the normal course of life. Klaus Brandenburg not only initiated but supported the project actively and keeps it still running.
Results
Doing back exercises has become routine in the company.
A before / after comparison in the guided intervention showed positive training results of all workers.
Since the start of the interventions and the training five years ago, the workers at Fußboden Brandenburg have not missed a single day because of back ache or muscular complaints.

10. Economic benefits: Fußboden Brandenburg
A cost-benefit analysis, calculated for four years at a discount rate of 4% gave the following results: 
Pay-back period (years)
Return on investment %
Net present value , Euro
Benefit-cost ratio
Pure consideration of health costs makes intervention already profitable
Non-tangible costs, such as improved motivation and increased productivity have not been considered

11. Business Case at Society Level Example: Incentive model in German butchery sector
Preventive approach
Tangible measures
Bonus Points (can reduce premium by 5%)
Technical measures
Use special safety knives
8 points
Organisational measures
Road safety training for drivers
Individual measures
Use skin protection agents
6 points
We can collect Bonuspoints like Bonus-Miles for your Airline-Company, so we could talk of „OSH-Miles“.
In Germany, the statutory insurance institutions must have a bonus or malus system by law which reflects the number and or costs of accidents which insured companies had the year before. Especially for SME, already one accident can lead to a malus or loss of a bonus, even though the company may do a lot for prevention. Therefore, a system had been installed that rewards the entrepreneur‘s effort without taking into account the accident situation which is dealt with separately by the bonus or malus system.
Road accidents can not be included in the bonus-malus system, but since these accidents are rather costy, their prevention is promoted by the incentive system. As an example, premiums on driver‘s training are given, using public transport is rewarded rather than the own car.
Occupation diseases are not included in the bonus-malus system either, and in order to help prevent these, issues like skin protection, protection against cold and noise etc. are addressed.
The system is flexible, the questions can be adapted every year if necessary and thus take into consideration national campaigns like for skin protection last year or the implementation of new regulations like the need to have a system of reintegration of long-term patients, which became law in Germany in 2004, and which we considered in our catalogue one year after.
As in 2007 no less than 46% of all companies insured participated in this incentive programme, which delivers a good insight on which preventive measures are implemented in the meat industry in general. Therefore, the analysis of the more than 8000 filled in premium check-lists allow to evaluate the prevention status in the companies.

12. Business Case at Society Level Example: Incentive model in German butchery sector
Both groups start at the same level
The difference between the lines is about 1000 accidents per year
We have a control group comparison, much better than the most we have
It is not the intention of the insurance to increase the difference between the groups, but to have in general as little accidents as possible
We have to be realistic: This is not in a laboratory where you can control everything, but this is the reality!
This graph underlines that regular participation in the has a positive impact on the accident rate.

13. Butchery sector incentive scheme leads to ca. 1000 accidents less/year
Business Case at Society Level Example: Incentive model in German butchery sector
Butchery sector incentive scheme leads to ca accidents less/year
Costs for incentives € 8.32 Mio Euro (6 years, )
HSE estimates 6670 € costs for each reportable accident
Business case
6000 accidents X € = Mio €
4.81 € savings for every 1 € invested
Elsler D, Treutlein D, Rydlewska I, Frusteri L, Krüger H, Van Den Broek K, Veerman T, Eeckelaert L, Roskams N, Taylor TN (2010). Scandinavian Journal of Work, Environment & Health
We published the economic evaluation of this and other economic incentive schemes in a scientific journal
The savings of only this incentive system were € 40 Mio
The budget of the agency is € 14.8 mio 13

14. Conclusions
The cost to society is significant for the EU EURO 476 billion, 3,3% of GDP
The main cost driver is work-related cancer, followed by MSDs
The distribution of costs by stakeholders varies, depending on
the social and economic system of a country
the costs included in the calculation
Positive business case for OSH at
Enterprise level
Society level

15. Thank you!
Dr. Dietmar Elsler Project Manager European Agency for Safety and Health at Work