Occupational safety and health in Europe - state and trends 2023 
European Agency for Safety and Health at Work – EU-OSHA 99 
satisfaction, for example, A ustria, Cyprus, Germany, Greece, Ireland, Hungary, the Netherlands, 
Portugal and Slovakia. The one negative item might also be work-related health problems, for example, 
for Sweden and Finland.  
Most countries show more extreme contradictions, that is, being in some aspects better and in others 
worse than average, like Estonia, Lithuania, Poland, Bulgaria, Portugal, Slovenia and Spain. Many of 
these countries have very low figures for work -related health problems. Contradictory but mostly 
negative responses (two or three fields with values under average) we find for Austria, Belgium, Croatia, 
France, Latvia, Lithuania, Malta, Romania, Poland, Spain and Slovenia. 
 
4.4 Conclusions  
Work accident data — fatal and non-fatal — show an impressive decline in the past 20 years, even if 
one takes into account the significant level of underreporting. Preventive technical and organisational 
safety measures and sectoral shifts were the crucial factors for this improvement. The relevance of non-
fatal accidents with severe health consequences — permanent disability or more than three months’ 
time-off period (more than 230,000) — should be recognised and further investigated.  
Public health data show a significant increase in life expectancy and substantial shifts in morbidity 
during the past three decades at EU  level, also documenting major differences between EU Member 
States in mortality and morbidity. Socioeconomic inequality  is an evident reason for higher mortality 
and morbidity. There is less evidence concerning the correlation between working conditions — as a 
major element of the socioeconomic status — and mortality and morbidity at EU level.  
The clearest evidence on the relationship between working conditions and diseases  exists for 
recognised occupational diseases, and for these, the trend is also strongly downwards. In contrast, t he 
estimates of the development of work-related diseases — based on fractions of diseases attributable 
to work occupation — show a persistently high burden. The current estimates of ILO/WHO and of ICOH 
range between 115,000 and 180,000 deaths and between 4.5 million and 6.9 million DALYs; advanced 
research and the incorporation of more disease groups — mental health, diseases caused by biological 
agents — will significantly increase these figures. Literature, studies and surveys like the EWCS, LFS 
and the Flash Eurobarometer clearly  show the strong relations between health status and occupation. 
Eurostat works on improvements concerning the morbidity statistics (task force, pilot statistics on 
occupational diseases). EU-wide morbidity statistics from national administrative sources might be 
available in the future; currently self-reported health data are the major source for EU-wide harmonised 
quantitative data.  
Wellbeing and satisfaction at work  show similar patterns as health and work accidents and work -
related health issues. Sectors with high physical demands and high customer and client orientation and 
occupations with a lower skill level report lower wellbeing and satisfaction levels; these groups report a 
good health status — mostly being younger —  but fewer expectations to be able to work in this 
occupation until the age of 60. Professions with strong customer and client orientation have lower-than-
average wellbeing and satisfaction rates. 
Workers in manual occupa tions 265  have higher accident rates, lower life expectancy and les s 
expectancy to do the job until age 60. Administrative workers (clerical, managerial)  have a better 
status in the above-mentioned aspects but report a worse health situation. For many items the eastern 
EU Member States — often all of them — report the least positive data. The healthy worker effect and