A special report in the latest issue of HesaMag, the European Trade Union Institute (ETUI) periodical on health and safety at work, looks at the main factors that are undermining occupational health services in Europe.

First among such factors is a shortage of specialists. The average age of occupational doctors is high, and little new blood is entering the profession. In some European countries there are fewer than 10 doctors per 100 000 workers and less than 30% of workers are covered by occupational health services. The consequences of this situation are damaging: overwork that undermines the quality of services; loss of direct contact with actual working conditions; declining interest and a sense of being forsaken.

Some countries have sought to ensure health surveillance for workers by allowing doctors who have not completed the training course to provide occupational health services. The fact that nurses and other specialists with a role in the workplace often lack the protected tenure enjoyed by occupational doctors makes them more vulnerable to pressure from employers. The organization of external occupational health services has been inappropriately commercialized in many countries.

These developments can drive a hole through the requirement of collective prevention that must guide the occupational doctor’s work. Some occupational doctors carry out individual-oriented public health tasks that should be performed by other doctors. This is a trend encouraged by employers generally, who increasingly regard the occupational doctor more as an agent for the control of absenteeism – even in some cases for workforce selection – than as a key player in improving the working environment provided by their firm.