Reporting and monitoring occupational accidents and diseases in Europe
Markku Aaltonen, Timo Kauppinen and Anja Saalo, Finnish Institute of Occupational Health
Effective prevention requires that statistics are reliable and accurate enough to allow the identification of industries, occupations and work tasks where there is a high risk of accident or disease. The measures can then be focused on these tasks and future cases may thereby be prevented.
This article describes how monitoring of occupational accidents and diseases may be integrated into the national surveillance systems of occupational health and safety. European data collection and reporting systems are described for accidents and diseases. Finally, references and links are provided for further information on this topic.
Framework and use of statistics
Occupational accidents and diseases are the types of health outcomes which have been monitored in almost every country already for decades. There are two main reasons for continuous monitoring (surveillance) of occupational accidents and diseases so that
- they can be prevented in the future; and
- compensation can be paid to the victims.
The free and wide availability of statistics is essential because information about risks needs to reach the individuals and organisations so that they can influence working conditions in the workplaces.
The development of occupational health and safety policy is increasingly guided by basing policy decisions on up-to-date information about the current state of OSH, exposures to health and safety risks, and the consequences of such exposures at both the individual and population levels. This type of information is also of critical importance for setting priorities for further development and identification of needs for actions. The basic requirements for health, safety and environment are laid down in legislation, such as the Directives on Safety and Health at Work of the European Union.
World Health Organisation (WHO) has proposed four categories of OSH indicators:
- health policy indicators;
- social and economic indicators;
- indicators of health care delivery; and
- indicators of health status.
Statistics on occupational accidents and diseases belong to the indicator category on health status and they represent a foundation on which to base important OSH policy activities in a country. Health surveillance indicators include also information about mortality, other work-related diseases, work absenteeism, occurrence of symptoms, life-style factors, etc.
The OSH Barometer provided by the European Agency for Safety and Health at Work (EU-OSHA)  is based on the following categories of OSH indicators:
- Generic information;
- Steering of OSH;
- OSH outcomes and working conditions;
- OSH infrastructure.
Statistics on work accidents, health perception and exposure to physical and mental risk factors are included in the third category.
Indicators are an appropriate way to illustrate the state of OSH in the EU, a country or region. The data analysis phase of gathering the indicators should be followed by the interpretation and evaluation of their significance (see Figure 1).
This analysis should be carried out by experts familiar with the subject matter. It is crucial that the process will proceed to appropriate actions on:
Thus reliable, comparable, up-to-date statistical information is vital for setting policy objectives and adopting suitable policy measures. An accurate statistical picture of health and safety at work is critical for monitoring policy and identifying preventive needs
The Strategic Framework on Health and Safety at Work 2021-2027 emphasises that efforts must be deployed to reduce work-related diseases and accidents as much as possible, in line with a Vision Zero approach. Actions to support these efforts include improving data collection on accidents at work and occupational diseases, and analysing the root causes for each work-related death or injury.
The European Framework Directive 89/391/EEC on the introduction of measures to encourage improvements in the safety and health of workers at work and its daughter directives represent the legal basis for all matters related to safety and health at work. All EU member states have transposed these directives into national law.
In the European Union, there is a legal obligation to report occupational accidents and diseases. Regulation 1338/2008/EC states that Member States are obliged to supply statistics to Eurostat on accidents at work, occupational diseases and other work-related health problems and illnesses. An accident at work is defined as a discrete occurrence in the course of work which leads to physical or mental harm. The data on occupational accidents must be collected, for the entire workforce, for fatal accidents at work and accidents at work resulting in more than three days of absence from work. Implementing Regulation 349/2011/EC defines the variables of the statistics on accidents at work according to the European Statistics on Accidents at Work (ESAW) methodology (see below). Based on the provisions of this Regulation Member States are required to provide data quality assessments on occupational accidents statistics, as well as metadata sheets detailing definitions and methodologies, with a view to further improving comparability across countries. The study report on the evaluation of the EU Strategic Framework on Health and Safety at Work 2014-2020 states that having a clear legal basis for data collection has allowed Member States to produce consistent datasets and improvements have been made with regard to the comparability of data between countries.
Regulation 1338/2008/EC not only obliges Member States to provide data on occupational accidents but also on occupational diseases. The Regulation defines a case of occupational disease as a case recognised by the national authorities responsible for recognition of occupational diseases. The data must be collected for incident occupational diseases and deaths due to occupational disease. Since the procedures and systems to recognise occupational diseases differ between Member States, it remains difficult to collect comparable data on occupational diseases (see below).
Sources of data and reporting systems
Since 1994, a single system, the European Statistics on Accidents at Work (ESAW), has been used to collect statistical data on accidents at work in the European Union. This system allows a uniform presentation for European and member state statistics and a comparison between the statistics gathered by member states. Within ESAW, a harmonised methodology for the data collection has been established. Information is collected on the following variables: economic activity of the employer, occupation of the victim, age and sex of the victim, type of injury, body part injured, time of the accident, size of the enterprise, employment status of the victim and days lost. Since 2001, phase 3 of the European Statistics on Accidents at Work methodology has been gradually implemented. In addition to the above variables, it includes information concerning the circumstances and events leading up to the accidents. The details of the ESAW methodology are found in the report "European statistics on accidents at work (ESAW) - Methodology - 2013 edition”. A resume of the concepts and the coverage of the data can also be found in the report "Work and health in the EU. A statistical portrait 1994–2002".
The ESAW data are based on the datasets provided by the Member States that are collected through the national systems for reporting and notifying accidents at work (Workers' Compensation Systems). Such data sources offer the advantage that data are readily available and have a large coverage. The downside is that these systems can be prone to underreporting and the reporting requirements sometimes exclude some categories of workers.
Next to the ESAW data, Eurostat also presents statistics on self-reported accidents at work based on the ad hoc module from the Labour Force Survey (EU-LFS). The EU-LFS is the largest European household sample survey, providing quarterly and annual results on persons, aged 15 and over, in the labour force (employed and unemployed) as well as outside the labour force (students, retired people, etc.). The survey is implemented on a continuous basis and data are generally collected through interviews. In addition to the core variables, the EU-LFS also has modules that can vary from year to year. Ad hoc modules on accidents at work and work-related health problems have been carried out in 2007, 2013 and 2020 .
The European Statistics on Occupational Diseases (EODS) and national data sources have been used to collect statistical data on occupational diseases. The project on European Statistics on Occupational Diseases started in 1995. The details of the EODS methodology Phase 1 are found in the report "European occupational diseases statistics (EODS) – Phase 1 Methodology"  and the first results were published in 2010 based on data from 2005 to 2007. However, this project was discontinued due to comparability issues. In 2017 a new pilot was launched since improving the availability of data on occupational diseases was as one of the main priorities in the field of data availability on OSH at EU level under the Strategic framework 2014-2020. As under the previous phase, EODS involves 24 Member States that are providing data on recognised occupational diseases for a number of variables. To overcome the harmonisation shortcomings highlighted in the first EODS programme, the current data are limited and consist of one indicator (EU Index). This index shows the evolution of occupational diseases over time, at EU level. The index is only shown for occupational diseases on the 'core list' and is published at EU-aggregate level from 2013 onwards. The core list of occupational diseases is composed of 16 diseases, of which 13 are presented in four main groups :
- Selected occupational cancers
- Selected musculoskeletal disorders
- Contact dermatitis.
The index is complemented by national country profiles.
Statistical data on occupational accidents and diseases
Eurostat provides the statistics on occupational accidents and occupational diseases in its data browser under the entry Health and Safety at Work 
- Accidents at Work (ESAW, 2011 – 2020) - Main indicators (8 tables) - Details by sector (NACE) (7 tables) - Causes and circumstances (9 tables)
- Self-reported accidents at work (EU-LFS Ad hoc modules 2007, 2013 and 2020) (16 tables).
- Occupational diseases (from 2013 onwards; EODS, EU index) (1 table)
The data browser makes it possible to visualise and customise all available data tables.
Furthermore, the Eurostat webfeature Statistics explained contains 5 basic pages on accidents at work and occupational diseases. Each of the pages provides a summary of the key statistics and a short explanation on the methodology:
- Accidents at work statistics 
- Self-reported accidents at work - key statistics 
- Accidents at work - statistics by economic activity 
- Accidents at work - statistics on causes and circumstances 
- Occupational diseases statistics 
National country profiles on occupational diseases are available for Belgium, Bulgaria, Czechia, Denmark, Estonia, Ireland, Spain, France, Croatia, Italy. Cyprus, Latvia, Lithuania, Luxembourg, Hungary, Malta, Netherlands, Austria, Poland, Romania, Slovenia, Slovakia, Finland and Sweden .
The ESAW data (occupational accidents) are also shown in the OSH Barometer (EU-OSHA):
- non-fatal accidents (trend 2010 – 2018) 
- fatal accidents (average number of fatal accidents per 100 000 employees) 
The OSH Barometer offers the advantage of a user-friendly visualisation tool making data on occupational accidents easily accessible and comparable e.g. between countries or between a country and the EU-average.
- Rantanen, J., Kauppinen T., Toikkanen, J., Kurppa, K., Lehtinen, S., Leino, T., 'Work and health country profiles - Country profiles and national surveillance indicators in occupational health and safety', People and Work - Research Reports 44, Finnish Institute of Occupational Health, Helsinki 2001.
- Eurostat – statistical office of the European Union, Health and safety at work in Europe (1999–2007) - A statistical portrait, Eurostat Statistical Books, 2010. Available at: 
- Council Directive 89/391/EEC of 12 June 1989 on the introduction of measures to encourage improvements in the safety and health of workers at work. Available at: 
- Regulation (EC) No 1338/2008 of the European Parliament and of the Council of 16 December 2008 on Community statistics on public health and health and safety at work. Available at: 
- Commission Regulation (EU) No 349/2011 of 11 April 2011 implementing Regulation (EC) No 1338/2008 of the European Parliament and of the Council on Community statistics on public health and health and safety at work, as regards statistics on accidents at work . Available at: 
- EU Commission. Study to support the evaluation of the EU Strategic Framework on health and safety at work 2014-2020, 2021. Available at: 
- EC – European Commission, European statistics on accidents at work (ESAW), Methodology, 2013 Available at: 
- EC – European Commission, Work and health in the EU, A statistical portrait: Data 1994-2002, Luxembourg, 2004. Available at: 
- ILO. Quick Guide on sources and uses of statistics on occupational safety and health, 2020. Available at: 
- Eurostat. EU Labour Force Survey 2020 module on accidents at work and other work-related health problems — Assessment report, 2021. Available at: 
- EC – European Commission, 'European occupational diseases statistics (EODS) – Phase 1 Methodology', Population and social conditions 3/2000/E/n°19, Luxembourg, 2000. Available at: 
- Eurostat. European Statistics on Occupational Diseases (EODS). Experimental statistics. Available at: 
- Eurostat. European Statistics on Occupational Diseases (EODS). Experimental statistics. Core (short) list of diseases. Available at: 
Links for further reading
EU-OSHA – European Agency for Safety and Health at Work. OSH Barometer 
ILO - International Labour Organisation. Country profiles on occupational safety and health and labour inspection 
ILO - International Labour Organisation. Statistics on safety and health at work.