Occupational safety and health in Europe - state and trends 2023 
European Agency for Safety and Health at Work – EU-OSHA 87 
living with a mental disorder, with anxiety and depressive disorders being the most common. 228 The 
OECD estimates that approximately one- third of all disability benefits is due to these groups of 
diseases.229  
 
WHO definition of mental health from 2001: ‘Mental health is a state of well-being in which the 
individual realises his or her own abilities, can cope with the normal stresses of life, can work 
productively and fruitfully and is able to make a contribution to his or her community’. 
ICD 11 (06) Mental, behavioural or neurodevelopmental disorders: ‘Neurodevelopmental 
disorders / Schizophrenia or other primary psychotic disorders / Catatonia / Mood disorders / Anxiety 
or fear-related disorders / Obsessive-compulsive or related disorders / Disorders specifically 
associated with stress / Dissociative disorders / Feeding or eating disorders / Elimination disorders / 
Disorders of bodily distress or bodily experience / Disorders due to substance use or addict ive 
behaviours / Impulse control disorders / Disruptive behaviour or dissocial disorders / Personality 
disorders and related traits / Paraphilic disorders / Factitious disorders / Neurocognitive disorders / 
Mental or behavioural disorders associated with pregnancy, childbirth or the puerperium. ’ 
 
The cost factor is enormous ; the OECD and European Commission estimated that the overall 
financial costs of mental disorders , including direct medical as well as indirect costs through care 
and lost productivity, amount to more than €600 billion per year in the EU230 (see also Andlin-Sobocki 
et al. (2005)231). ICOH has started to integrate the newest estimates of mental health disorders with the 
AF (based on Niedhammer et al.232). The first calculations result in 7.5 million DALYS for the EU27, for 
work-related job strain, depression and resulting cardiovascular diseases (all other diseases 6.9 million). 
The strong rise in ‘Mental and behavioural disorders’ as a reason for absence from work or early 
pensions surely contributes to this change. 233 EU and global institutions have started several long-term 
policies and actions on mental health, for example, the EU Framework for Action on Mental Health and 
Wellbeing.234  
The term ‘Musculoskeletal diseases’ covers the most common group of diseases (ICD 11- 15 
‘Diseases of the musculoskeletal system or connected tissue’). 235 These diseases have the highest 
prevalence, approximately 60% of the EU working population report one or several MSDs.236 MSDs that 
are caused or made worse by work can be defined as work-related MSDs.237 Work-related MSDs arise 
from regular exposure to a c ertain posture or workload. It is a problem that affects all forms of working 
environments, from physically arduous work to low-intensity static work.238  
Moreover, the prevalence of MSDs is not decreasing, as could be expected due to the sectoral shifts 
of workforce from industry and agriculture to services. The authors of the EU-OSHA study ‘Work-related 
musculoskeletal disorders: why are they still so prevalent?’ consider several reasons for this: the 
ergonomic burden shifted to other tasks, for example, handling of patients instead of handling of heavy 
loads, more inactivity with other musculoskeletal consequences, more time pressure, an ageing 
workforce, and inadequate work organisation and contractual arrangements. 239  
The tremendous shift of workforce to administrative and often digitalised work contributes to an increase 
of the number of workers suffering from the consequences of physical inactivity due to permanent 
sedentary work, mostly with digital equipment. The fi gure below shows the spread of these diseases 
in different occupations.240