text: These changes in the size of the workforce in aggregated sectors contributed to the development of 
  health and safety that we observed in the past 30 years, and the decrease in**accidents and**
  **traditionally recognised occupational diseases**. 
  
  These sectoral changes**also triggered a crucial extension of the focus of OSH**, adding to accidents 
  and specific occupational diseases the work-related diseases, broadly extending the scope of 
  occupational diseases. The relation between work-related risks and major disease groups came into 
  focus. Most of these diseases groups are not covered by the spectrum of conventional occupational 
  diseases, for example, most musculoskeletal and digestive diseases, cardiovascular and mental 
  diseases. Work is a crucial element for health in life, and to neglect its impact would generate a less 
  than complete picture of health risks. 
  
  These trends led to structural changes and adaptations in practices of OSH,**topics like work**
  **organisation and psychosocial risks**gained a much higher importance in the assessment of working 
  conditions.267 
  
  In a wider context, the shift to service work also changed the**work performance measuring methods**. 
  Performance measuring cannot be based anymore on simple output rates (measured in pieces of a 
  product, or in physical quantities like cubic or square metres).**The output measurement methods**
  **shifted to the achievement of objectives, milestones, deadlines, measurable service outputs,**
  **client satisfaction**and other typical service-related performance indicators. 
  
  The change towards service sectors also goes along with a fast, large-scale shift in the provision of 
  education and care**from families to professionals**. This means a growth of workforce in sectors with 
  human–human interaction and the associated**emotional challenges**.268 This is not the case only in 
  education and care; in general there is a higher psychosocial burden in those occupations where work 
  with**human beings as ‘clients’**takes place, increasing the risks of emotional exhaustion and of difficult, 
  inattentive or even aggressive clients. 