1) The Netherlands has a population of 7.3 million employees, with 4.4 million working at small- and medium-sized companies and 2.9 million at large companies. There are also 1.5 million self-employed professionals and 600,000 companies. 2) Dutch companies utilize occupational health and safety services called Arbodienst, which are private enterprises that must comply with legal requirements. They provide expertise in industrial medicine, safety, hygiene, and organizational science. 3) Around 20,000 work-related diseases are reported annually in the Netherlands. The top three are back/neck pain, hearing loss, and psychosocial stress, though occupational deaths are mainly due to dangerous substance exposure.

1. OSH policies The Netherlands
Jan Michiel Meeuwsen

2. Key figures The Netherlands
7.3 million employees
2.9 million at large companies (> 250 employees)
4.4 million at small- and medium companies (< 250)
• 1.5 million self-employed professionals
• 600.000 companies
• 4% absenteeism
• 20,000 employees with a work-related disease each year
Jan Michiel Meeuwsen
OSH policies The Netherlands

3. Dutch Occupational Health and Safety Service
System (Arbodienst)
Dutch: Arbodienst
A service provider offering professional support in the area of working
conditions
These services are private enterprises, but must comply with
certain legal requirements
Most of them are external services
Some larger companies have internal services (KLM, SHELL)
Jan Michiel Meeuwsen
OSH policies The Netherlands

4. Dutch Occupational Health and Safety Service
System
Expertise in four disciplines
• Industrial medicine (Occupational Health Physician)
• Industrial safety (Safety expert)
• Industrial hygiene (Occupational hygienist)
• Organisation science (Occupational- and organizational expert)
Jan Michiel Meeuwsen
OSH policies The Netherlands

5. Registration of Work-related Diseases
The Netherlands Centre for Occupational Diseases (NCvB) registers
and reports occupational diseases via the national notification and
registration System and a number of specific surveillance projects.
• 20.000 work-related diseases are reported and registered
Jan Michiel Meeuwsen
OSH policies The Netherlands

6. Top 3 Work-related Diseases
1. Back and neck pain
2. Hearing loss/damage
3. Psychosocial stress
About 90% of all work related
diseases.
However, occupational deaths:
• 3000/year are related to
exposure to dangerous
substances
• 75% after they stopped working
Jan Michiel Meeuwsen
OSH policies The Netherlands

7. Risque professionelle versus Risque social
Risque professionelle
• Social benefit depends on the cause of the disease (distinction
between occupational or non-occupational disease)
Risque social (The Netherlands)
• Social benefit does not depend on the cause of the disease (No
distinction between occupational or non-occupational diseases)
Both systems have advantages and disadvantages
NL: Occupational risks should be considered as a risk of society
at large that should be covered by employers and/or social
security schemes
• No debate about the definition of an occupational disease
Jan Michiel Meeuwsen
OSH policies The Netherlands

8. Work-related diseases versus Occupational
diseases (WHO definitions)
• “Occupational disease” is any disease contracted primarily as a
result of an exposure to risk factors arising from work activity.
• “Work-related diseases” have multiple causes, where factors in the
work environment may play a role, together with other risk factors, in
the development of such diseases.
Netherlands: because of risque social system only work-related
diseases are relevant
Jan Michiel Meeuwsen
OSH policies The Netherlands

9. Work incapacity in the Netherlands
First two years
• Employer is responsible for costs (70% of the wage, possibly
insured by private insurance companies)
• Why? Incentive for employers and insurance companies for an
active policy to prevent absenteeism
After two years
• Labour Capacity Act (WIA) benefit (through statutory premium
collectively paid by employers and employees depending on sector)
• Why? Incentive for employers and sectors to keep an interest in
preventing employees from becoming entitled to such an income
compensation for another three years
Jan Michiel Meeuwsen
OSH policies The Netherlands

10. Work-related healthcare: Policy in Progress
Challenges:
• Not enough new occupational physicians in training
• Lack of cooperation between occupational physician and public
healthcare
• Work-related diseases are often not recognized and reported
• Limited focus on prevention at the workplace
Jan Michiel Meeuwsen
OSH policies The Netherlands

11. Compensation Occupational Diseases
Policy in Progress
Challenges
• Going to court as an employee with an occupational disease is
expensive and lengthy
• Judges have no medical knowledge to determine causality between
occupation and disease
• Possible solution: an independent institution with expertise in
causality between occupations and diseases
Jan Michiel Meeuwsen
OSH policies The Netherlands

12. Jan Michiel Meeuwsen
OSH policies The Netherlands
OSH infrastructure
compilation of players/stakeholders
in a country plus their network
relations contributing to and
influencing the state of occupational
safety and health at shop floors in
the organisations where people work

13. Jan Michiel Meeuwsen
OSH policies The Netherlands
Players in OSH
infrastructures
• the national government;
respective ministries
• The inspections authorities
(either safety or health
• Social partners
• Occupational safety and health
services
• Research institutes
• Associations of OSH
professionals
• Insurance companies

14. legislation
enforcement
OSH services
Employers’ organisations
Trade Unions
Publishers
Research
institutes
Government
Inspection authority
Organisations; their managers and workers
influencing,
advice
collective bargaining
regulation,
certification
advice
promotion,
public information
issuing,
disseminating
assignments,
research programming
disseminating results
Jan Michiel Meeuwsen
OSH policies The Netherlands