Occupational safety and health in Europe - state and trends 2023 
European Agency for Safety and Health at Work – EU-OSHA 18 
clients’ places. Also ergonomic risks — repetitive hand-arm movements, tiring and painful positions, 
lifting and carrying, and prolonged sitting — can pose major health risks, and the statistics show  no 
significant decrease.  
There is a shift of workforce to administrative, communicative, and emotionally demanding and 
client-oriented sectors, like the sectors ‘Education, human health and social work activities’ and ‘Trade, 
transport, food/accommodation and recreation activities’ (more human–human interaction, less human–
machine interaction). Consequently, this development caused an overall shift of risks to psychosocial 
and emotional challenges and — mostly but by far not always — less physical activity. Some health 
risks worsen in such types of work, like work with difficult clients or long working hours. Many approaches 
and pilot projects have been developed to mitigate these workloads, but the implementation seems to 
be limited to a minority of workplaces with high awareness of work -related health issues. Also, since 
2005, statistics and surveys find a stagnation (practically no increase and no decrease) concerning the 
development of working time, time pressure and high workload for workers.  
When looking at the overall relationship between work and some major diseases in the adult 
population (cardiovascular diseases, cancer, musculoskeletal disorders, pulmonary diseases, hearing 
loss), there is a clear connection to socioeconomic status that is a major cause of low life expectancy 
and high morbidity. In public health morbidity and mortality studies, a more precise analysis of impact 
of working conditions on health, as a very important factor of socioeconomic status, is very rare. This 
would require more detailed knowledge and analysis of the health impacts of occupations and work 
tasks and of the preventive measures at work, as well as an improvement in the detection capacities of 
preventive and monitoring health systems. Identification of the approximate attributable fraction of 
work to diseases is still the subject of intense scientific debate, with clearer results for some relations 
and less clear results for others. 
The level of implementation and enforcement of compliance with legislation seems to stagnate. The 
capacities of the OSH infrastructure at national levels show a mixed picture in EU Member States. 
Across the EU, between 2010 and 2020, the labour inspectorates performed on average two million 
labour inspections per year , in approximately 22 million businesses. To enhance the level of 
implementation in terms of coverage and quality, many labour inspections tried to enhance the 
effectiveness of common drop-in company inspections by smart enforcement and supervision 
concepts.  
There is no measurable progress in the types of work with eroded employer –worker relations  
(subcontracts, involuntary self -employed). The reliability of statistical monitoring fades where the 
employer–worker relationship is less clear  (regarding aspects such as work ing conditions, work 
accidents and work-related diseases, and of compliance with legislation).  
Many enterprises and particularly MSEs and the self -employed very often cannot fully comply with 
more complex risk prevention tasks (e.g. psychosocial, chemical, biological, optical, electromagnetic 
risks) due to lack of resources, expertise and awareness (ESENER data). In general, enforcement 
authorities can only supervise a small percentage of enterprises, particularly not a substantial portion of 
MSEs, of self-employed or of non- standard types of work; some Member States included in their 
strategic approaches the objective to reach these enterprises/self -employed. The reason for the 
continued levels  of intensification of work from 2005 onwards  might be that the  related tasks were