8287691 Occupational burden of disease and mortality in The Netherlands

<h3>Background</h3> A large proportion of the working population is at risk of illnesses, accidents and mortality caused by exposure to unfavourable working conditions, such as chemicals, physical strain, noise and stress. To assess the health impact of occupational exposures in the population, we estimated Population Attributable Fractions (PAFs). PAF is defined as the fraction of all cases of a particular disease in a population that is attributable to a specific exposure. The PAF provides insight in the estimated fraction of all workers that would not have occurred if there had been no exposure. <h3>Methods</h3> In the context of the Public Health Foresight Study 2024, we estimated the attributable mortality, years of life lost, years of life lived with disability and disability-adjusted life years (DALYs) for a selection of occupational risk-outcome pairs. PAFs were calculated using relative risks (RRs) of a given outcome and the proportion of workers exposed to the working conditions. RRs were derived from the literature, data on occupational exposure from Dutch studies. If these were not available, PAFs from the literature were used. The estimated PAFs were combined with the disease-specific burden and mortality results and summed. <h3>Results</h3> In 2022, unfavourable working conditions caused 4.1% of the total disease burden and 2.4% of the total mortality in The Netherlands. Exposure to substances leads to the highest occupational burden, followed by psychosocial stressors. The highest occupational burden is due mental disorders, followed by respiratory diseases, cancer and musculoskeletal disorders. Whereas most work-related deaths are caused by cancer, followed by heart diseases and respiratory diseases. <h3>Discussion</h3> Attributable burden of disease assessments provide comprehensive, comparable estimates of health impacts and their associated occupational risks. These estimates give policy makers insight in the influence of occupational risks on the health of employees.