Occupational safety and health in Europe - state and trends 2023 
European Agency for Safety and Health at Work – EU-OSHA 139 
OSH infrastructure and monitoring capacity 
 Indicator: Enforcement capacity (descriptive) 
 Indicator: OSH statistics and surveys (descriptive) 
 Indicator: International organisations / programmes (descriptive) 
  
During this development, other indicators were discussed but excluded due to complexity, necessary 
granularity and likely required effort, for example, compensation and insurance systems (of work 
accidents and diseases), preventive capacities and services in and outsi de enterprises, training and 
education capacities for OSH practitioners and professionals, OSH research capacities, OSH networks, 
major guidance and support offers for enterprises.  
 
7.4.3 Relationship between preventive actions and outcomes 
It can be difficult to demonstrate a causal relationship between working conditions and health 
and safety outcomes , (outcomes = accidents including traffic and near -accidents, work -related 
diseases or the level of wellbeing), that is, a reliable cause-effect relationship. Generally, in the field of 
safety such a relation can be much easier identified (accidents ► injuries) than in the field of health, in 
almost all cases an injury is an immediate consequence of an accident at work.  
Scientists and practitioners have also often determined clear connections between prevention 
actions and outcomes , also between certain exposures and recognised occupational diseases , 
and between types and quality of safety instructions and the occurrence of accidents .500 
Still, there exist many  less visible and statistically hard -to-detect relations between working 
conditions, preventive actions and accidents, and health and workplace wellbeing , and very 
specific research and knowledge is needed to describe and analyse them more in detail. Most important 
are the confounding context factors, for example, the reduction of work accidents in a sector might be 
strongly influenced by context developments, for example, economically induced sector shifts, or 
important technological changes.501 In addition, health and wellbeing are influenced by other aspects of 
working conditions, like working time or contractual security. 
Moreover, due to effective preventive work, extreme exposures at work that in the past often led to a 
recognised occupational disease h ave been mitigated , reduced or even eliminated by preventive 
measures and/or technological changes. Some examples are very loud noise, specific permanent tiring 
postures, very heavy loads, extreme dust and fume exposure, and reduction or elimination of well-
studied highly toxic chemical substances. In short, preventive measures — in particular if legally required 
— contributed to an overall reduction of the number of workers exposed to extremely ‘unhealthy’ 
workplace exposures.  
 
7.4.4 On the way to better evidence – major data, research gaps and open 
questions  
This report used EU -OSHA reports, foresight studies and reviews, and several EU -wide surveys and 
statistics on working conditions, namely ESENER, EWCS, Eurostat’s statistical data, the Eurostat LFS 
and its Ad hoc modules, the Flash Eurobarometer, academic reviews, and data and reports from EU  
institutions or EU agencies like DG EMPL, DG SANTE, Eurofound, EIGE, FRA, Cedefop, ECHA and 
from international organisations like the ILO, WHO, OECD, ICOH, UN and UNEP. These statistics, 
surveys and reports mostly apply a harmonised EU -wide or international approach  to make the 
situation in different countries comparable.  
Many more national statistics and surveys on working conditions exist, often with a higher level of 
detail, but they are rarely used for a comparative view, due to the inevitable methodological differences. 
Costly research work would be needed to cover all relevant national studies and monitoring data in all