Nordics counting the costs of work-related illness

There were 11,730 work-related deaths in the Nordic countries in 2019, according to the ILO. Out of these, one per cent – 143 – were a result of workplace accidents. When a death or accident happens directly in connection with work, it is classified as an occupational death or accident. It is registered and compensated for and, as a result, easy to measure.  

Work-related deaths and illnesses are much harder to pinpoint, however. Both because the concept is broader and because symptoms might not show until much later and become part of a bigger problem. Many more die from work-related illnesses than from workplace accidents. 

Celebrating the World Day for Safety and Health at Work

So what should the countries’ safety representatives and occupational health authorities do to prevent and detect work-related injuries? That was the theme for the conference “Work-related fatalities – lessons from the Nordic Countries”, held in Stockholm in late April as part of the World Day for Safety and Health at Work.

Finnish Jukka Takala is one of the day's founders. He has a long international track record of occupational health and safety work, including 27 years at the ILO. On a link from Helsinki, he explained how 150 countries mark the World Day for Safety and Health at Work on 28 April. Every year has a separate theme. In 2024 it was how climate change influences work environments. 

From the left: Susanna Stymne Airey, Wiking Husberg, Bengt Järvholm, Riku Rajamäki, Monica Seem and Karin Gunther.

Nordic work collaboration has international impact

Jukka Takala with colleague Wiking Husberg and other Nordic researchers have also written the report “Work-related fatalities in the Nordic countries”, financed by the Nordic Council of Ministers. Wiking Husberg asked the rhetorical question “Do we have good work environment processes in the Nordics?” and concluded, “Yes pretty much, but not for everyone”.

His conclusion is that things can improve through Nordic collaboration. There are also huge advantages from learning from each other and for the Nordic countries to develop a stronger voice internationally by creating a united front. 

One example is the time when the Nordic countries joined forces and succeeded in creating common Noridic safety regulations for chainsaws. The collaboration also made it easier to present the regulations internationally.

“When we work together across the Nordics, we get more power internationally and we can gain even more influence across the whole world,” said Wiking Husberg.

At the end of the 1900s, the number of occupational deaths and accidents was considerably higher than it is today. In Finland, for instance,  in the 1970s and 80s, some 170 people died at work every year. Today, the annual number of fatal accidents at work is 20 – plus/minus five. 

Figures vary between the Nordic countries but all have seen a trend of considerably falling numbers that have now reached a certain level. Work-related deaths and illnesses have risen, however. 

“Occupational diseases have a legal definition, which means economic compensation is available, and they can be measured. Work-related illnesses and fatalities are more about estimates and harder to measure. And it is harder to do something about that which you cannot measure,” said Wiking Husberg. 

Common for many of the professions that are considered dangerous is workers being exposed to small particles in the air. Bakeries are at number 10. (Illustration)

Ten top professions for work-related illnesses

The professions in which workers are most at risk of developing work-related illnesses include working with reinforced plastics, dusty construction work or being exposed to dust in mines or quarries, flooring, cement product manufacturing, car painting, formaldehyde and adhesives in the wood industry, welding and gas cutting of metal products and aluminium. Last on the list is bakeries.

The most common illness from being exposed to these professions is cancer, at 46 per cent, followed by respiratory and circulatory diseases at 27 per cent and mental illnesses at 8 per cent. These are the largest proportions of diseases that can be linked to the exposure.

Working with asbestos increases the risk of developing cancer fivefold and for smokers, the risk is much higher again. But smoking means it is harder to have the exposure acknowledged as an occupational illness and hence worthy of compensation.

In Finland, around 70 people annually have their lung cancer recognised as occupational damage. Another 700 develop work-related lung cancer but do not get it recognised because they are smokers. And all these illnesses could have been prevented, concluded Jukka Takala.

“Cancer is an illness. Work-related cancer is an administrative decision,” he said. 

Lost life years

Several illnesses can be caused by work, even if they are not deadly. These include strain injuries, mental challenges and circulatory disorders. The World Health Organisation, WHO, has introduced the term ”Disabilities Adjusted Life years” – DALYs – that describe years lost due to work-related illnesses. One DALY represents the loss of one year of good health.

Developing lung cancer, for instance, shortens life expectancy by 16 years. Many other work-related illnesses or handicaps mean a major loss of possible working and life years. Stress, mental illness, violence, threats and bullying are other work environment factors which lead to lost years and problems in workplaces. 

The point of using DALYs as a measurement is to visualise the cost of work-related injuries, illnesses and premature deaths. The 11,730 work-related deaths that the ILO calculated for the Nordic countries in 2019 correspond to 464,000 DALYs, or 464,000 healthy years lost. This costs 3.4 per cent of GDP, not including work-related absences. 

“We have to get better at measuring work-related illnesses. How else will we be able to know that we are introducing the right work environment measures,” said Wiking Husberg.

The costs linked to work-related illnesses are large – in Finland alone poor work environments cost taxpayers 24 billion euro annually. Husberg asks whether a fresh focus on work environment efforts is needed, and notes that it is important to broaden oversight to include more than just accidents. 

“We have to ask ourselves whether we are looking at the right things. Should we be reprioritising our preventative efforts? The Nordics have the advantage that the social partners cooperate and that we dare listen and talk about these problems,” said Wiking Husberg.