Occupational safety and health in Europe - state and trends 2023 
European Agency for Safety and Health at Work – EU-OSHA 80 
highest quintile, a difference of 21% ( EU27, 2019).196 The European Quality of Life Survey  (EQLS) 
finds that 13% of the lowest quartile report bad health ( EU28, 2016), compared to only 4% of the 
respondents of the highest income quartile.197  
The relation between socioeconomic status — measured by income — and working conditions 
is often not further analysed, at least not on an aggregated statistical level. Due to complex 
methodological difficulties and strong national variations of the health systems , there are until now no 
EU-wide morbidity statist ics available, based on administrative data. 198 A ‘Morbidity Task Force’ 
at EU level worked between 2005 and 2011 on the development of such statistics. 199 Country-specific 
data — without a harmonised approach between countries — are provided in EU and OECD publication 
series.200  
The system of European Core Health Indicators (ECHI) provides an overview on prevalence of major 
diseases.201 Main morbidities covered until now are asthma, chronic obstructive pulmonary diseases 
(COPD), c ommunicable diseases, depression, dementia, diabetes, diseases caused by drugs, 
HIV/AIDS, and physical or sensory functional limitations. However, in ECHI there is no option to relate 
these diseases to sectors or occupations.  
The impact of work — as one essential element of the socioeconomic status — on health was the subject 
of numerous academic studies, often performed as specific case studies. The authors of an overview 
study on ‘Cross-country inequality in the EU’ summarise (more references in the original text):  
‘Occupational grade and labour market status are among the factors most often studied in relation to 
health and mortality. Occupational grade has been found to be associated with self-rated health, mental 
and physical health, such as the presence of long- standing illness and a number of diseases. Lower 
occupation might affect health through poor working conditions, such as the higher exposure to 
occupational hazards and toxic compounds, health- damaging behaviours and psychosocial stress. 
Work-based stress combined with a lack of autonomy over one’s work are believed to be the 
psychosocial factors that can cause physiological changes, such as increased risk of cardiovascular 
diseases and reduced immune system response. It has been shown that the gaps in mortality between 
different occupational grades persist in old age and tend to widen with age. 202  
Eurostat provides in the LFS 2020 Ad hoc module on ‘Accidents at work and other work-related health 
problems’ a rough overview on such relations, with  some specification, for example,  for sectors, 
attainment levels, professional status, size of enterprise or occupation.203 The differences between four 
aggregated occupational groups and work-related health problems is shown in the next table.  
 
Table 23: People reporting work -related health problems by group of occupations (ISCO)  – LFS Ad hoc 
2020204 
 
9.4% of the group of ‘Managers, professionals, technicians and associate professionals’ and also 9.4% 
of the group of ‘Clerical support workers, service and sales workers’ report work-related health problems, 
2.4% to 4% lower than the two groups with predominantly manual occupations.  
Based on a systematic review  of literature on the topic of health factors, a consortium of World Bank 
and Harvard School of Public Health developed for the WHO in the early 1990s a new approach, the 
Global Burden of Disease (BoD). 205 This approach is meanwhile used by researchers and health 
institutes across the globe.206