Workers with disabilities

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Liz Yeomans, Health & Safety Laboratory, UK

Introduction

This article will consider the health and safety risks for workers with disabilities with the focus on where these may be different to the risks faced by workers without disabilities. For the purposes of this article the European Agency for Safety and Health’s (EU-OSHA) definition of disability will be used as this covers both physical and mental impairments and covers, as well, all employees whose work performance might be hampered by their disability, including people with chronic, long-term or progressive conditions[1]. The appropriate risk management process for workers with disabilities will be considered and the article will also describe some of the accommodations and interventions that employers could consider to facilitate the recruitment and retention of workers with disabilities.

Workers with disabilities

Definition of disability

There is currently no definition of disability laid down in European Union (EU) legislation. The definitions and criteria for determining disability are set down in the national legislation and vary between individual EU Member States[2]. The European Court of Justice considered that, in the EU framework for anti-discrimination legislation, the concept of disability referred to a limitation resulting from particular physical, mental or psychological impairments, which hinder the participation of the person in professional life[2]. Similarly, the EU-OSHA defines a disabled worker as any employee with physical or mental impairments who might be hampered in work performance but emphasises the long-term nature of disability by including people with chronic, long-term or progressive conditions[3].

Disability employment

Disability and ill health affect a relatively high percentage of the workforce. It is estimated that 23.5% of the working population in the EU-27 have a chronic illness and 19% have long-standing health issues[4][5]. Disability prevalence rates are similar for males and females but the highest prevalence for disability is among people over 55 years of age[6]. More information on the health and safety risks associated with older workers can be found in the Older workers article. The most common forms of disability concern back or neck problems, followed by heart, blood pressure or circulation, and legs and feet[6]. The majority (50%) of people with disabilities acquired their disability due to non-work-related ill health. Nearly 17% of people with disabilities were born with their disability and 18% had work-related injuries or ill health[6].

However, in most EU Member States only a small proportion of working age individuals (16-64 age group) with severe disabilities are in employment, although there are substantial variations between EU countries. In 2002, only 20% of working age people (aged 16-64) with very severe disabilities participated in the workforce compared to 68% of non-disabled working age people. The statistics indicate that participation in the workforce varies with the degree of disability so that around two-thirds (67%) of working age people with moderate disability are employed[2][6][7].

The demographic trend in Europe is towards a rapidly ageing workforce. As the number of young people entering the workforce declines, people will need to work longer into older age in order to prevent labour shortages in Europe[4][5][6][8]. As previously noted, disability prevalence increases with age[6][8]; therefore, it is likely that more people with disabilities will need to be recruited and retained in the workforce to reduce labour shortages[4][5].

Employment legislation and workers with disabilities

Under European legislation, Member States are required to adopt regulations ensuring the health and safety at work of employees whilst at the same time having a duty to ensure equal treatment for people with disabilities. The EU Directive 89/654/EEC[9] covers minimum health and safety requirements for the workplace and directs that workplaces must be adjusted to take account, where required, of the needs of workers with disabilities. This provision applies in particular to the doors, passageways, staircases, showers, washbasins, lavatories and workstations used or occupied directly by disabled workers[1][2][3]. Directive 89/391/EEC[10], the Framework Directive, sets down that ‘particularly sensitive risk groups must be protected against the dangers which specifically affect them’[1]. Under this legislation, employers are required to carry out risk assessments, eliminate risks, and adapt work and the workplace to the workers, including workers with disabilities[11]. Anti-discrimination legislation also requires adaptations to work and workplace resources. Directive 2000/78/EC[12] establishes a general framework for equal treatment in employment and prohibits direct or indirect discrimination on the grounds of disability. This Directive requires employers to provide reasonable accommodations for people with disabilities. Reasonable accommodations include adapting premises and equipment, working hours, tasks and training, to enable a person with disabilities to access, participate in or advance in employment[1][11]. The two sets of legislation take similar approaches and can be seen as complementary. Health and safety legislation should not be used as an excuse to refuse a disabled person employment. Only in rare circumstances, where the employer can show clear evidence that no reasonable accommodations or job transfer can be put in place to overcome a properly assessed risk posed by employing the person with a disability, will it not be considered discrimination to not employ or retain this individual[11].

Risk management for workers with disabilities

Health and safety risks that workers with disabilities may face

Workers with disabilities form a very diverse group and, therefore, the health and safety issues that they may face also vary considerably[2]. Disabilities can range from very severe to mild and are not always obvious[13]. People with impairments may not consider themselves as having a disability and may not face any increased or additional risk compared to workers without disabilities[2]. Workers with disabilities are likely to face the same risks as workers without disabilities doing the same job. However, a worker with a disability may face additional risks or may be more susceptible to the same risks due to their condition[2]. For example, a person with a disability because of back problems may be more susceptible to manual handling risks than colleagues without disabilities. Similarly, people with disabilities who use assistive technology to overcome their impairment may face risks associated with the use of that particular piece of equipment which colleagues without disabilities carrying out the same job do not face[2].

If there is concern that a person with disabilities may face additional risks when carrying out a particular job, a full disability sensitive risk assessment should be carried out. However, employers should not make assumptions about the health and safety implications of a person’s disability as it might not make a difference to workplace risks. If employers carry out an individual risk assessment on a person with disabilities with no good reason it could be considered to be discriminatory[14]. When carrying out the risk assessment, it is important not to assume that if one person with a specific disability faces a particular risk, all people with that disability will be similarly at risk[11]. A complete (blanket) ban on the employment of anyone with a particular disability should not be put in place[14]. For example, an employer should not refuse to employ anyone with epilepsy or diabetes no matter what the job requirement is or however mild or well-controlled the condition is for an individual. The level of risk will depend on the individual’s level of impairment, the specific tasks required and the environment in which the tasks are carried out. For example, a person with a heart condition may not be at additional risk if the task is desk-based or requires little movement and is not stressful but may pose additional risk if that person is doing a physically demanding task[2].

In addition to the risk factors to which a person with disabilities is exposed as a consequence of his/her impairment, people with disabilities can face risk factors which are associated with the nature or type of work that they are more likely to be employed in because of being disabled[2]. Workers with disabilities tend to be employed in low-skilled jobs, on non-standard contracts such as part-time work or temporary contracts. These types of work are associated with increased psychosocial risks such as stress and anxiety as they often involve little autonomy and responsibility, poor job satisfaction and increased job insecurity[2]. However, part-time or temporary work may be viewed as beneficial for workers with disabilities if this flexibility enables them to achieve a better balance between their health needs and their work[2]. More information on the health and safety risks associated with temporary work can be found in the Temporary workers article. Workers with disabilities are also more likely to face discrimination as a result of their disability and bullying or harassment which are linked to increases in stress, anxiety and depression[2]. The Discrimination in the workplace article provides more information on discrimination and the Harassment at work article discusses bullying and harassment in more detail.

Disability sensitive risk assessment

A full and suitable risk assessment of a disabled worker carrying out a specific task or job is required in order to meet the health and safety, and non-discrimination obligations of the legislation[1]. A risk assessment involves a careful and thorough consideration of the worker, the work and the wider environment to identify hazards, evaluate the risks and to put in place preventative measures[11], the Occupational safety and health risk assessment methodologies article provides more information on the risk assessment process.

An employer should identify workers who might be at greater risk and carry out a specific assessment of the risks. This assessment should be tailored towards the individual and the specific risks associated with that individual, the job they will be required to do and the environment in which it is carried out. All stages of the disability sensitive risk assessment process should take account of, and aim to comply with, non-discrimination approaches[1]. Employers should take a sensible, pragmatic approach rather than be overprotective in the risk assessment approach as some level of risk is unavoidable in everything that workers do, whether or not they have a disability[14].

In addition the guidance on carrying out disability sensitive risk assessments suggests that those carrying out the assessment should:

  • Take account of the individual’s capabilities;
  • Take into account the nature and extent of the individual’s disability;
  • Take account of the specific requirements of the job;
  • Avoid making stereotypical assumptions about risks associated with a particular type of impairment;
  • Consult with the individual concerned at all stages;
  • Seek advice from Occupational Safety and Health (OSH) professionals, medical professionals, disability employment groups or organisations;
  • Coordinate between safety personnel and equality personnel;
  • Consider reasonable accommodations to prevent or reduce the assessed risks;
  • Consult with the individual to check that the accommodations suggested are suitable and appropriate before and after implementation.

[1][11][14][15]

To ensure unintentional discrimination through a lack of understanding, it is advisable that disability and equality training is provided for line managers, worker representatives, safety representatives and anyone who is likely to be carrying out or involved in the risk assessment process[11].

Accommodations for workers with disabilities

What are accommodations?

Accommodations or adjustments refer to changes to the work and workplace which can be provided to overcome barriers to work for people with disabilities. Often people think of accommodations for workers with disabilities in terms of providing disabled access to work premises[11]. Whilst accessibility adjustments are sometimes required, there is a much wider range of suitable accommodation which can be appropriate to prevent or reduce risk and enable disabled workers to participate in employment. Accommodations for disability include adjustments to:

  • Physical features of the workplace;
  • Work equipment;
  • Work organisation, duties and working hours;
  • Signs, signposting and emergency procedures;
  • Communications and support services;
  • Training and supervision.

[1][11]

These types of accommodations are discussed below.

Common accommodations

Not everyone who has a disability requires accommodations to be provided to the work or workplace in order to be able to work. Clearly it depends on the individual, his/her level of disability, the job and the environment. According to the 2003 Eurostat survey, nearly 44% of people with disabilities who were not in work considered that they would need some form of accommodation in order to work[6]. However, the same survey found that a third of people with disabilities considered that their condition did not pose any restriction on their ability to work[6][7]. Where accommodations were provided for workers with disabilities in the EU, information from the Eurostat 2003 survey indicates that the accommodations most often provided concerned the kind of work to be performed (37%), support and understanding by superiors and colleagues (15%) or the amount of work to be performed (13%)[6]. A more recent report for the EU-OSHA suggests that the most common workplace adjustments concern the provision or modification of equipment, the provision of flexible leave or alterations to working hours[1]. This contrasts with the common perception and concern of employers that providing accommodations for workers with disabilities usually involves expensive alterations to the workplace (e.g. to provide lifts or ramps). Where expensive workplace alterations are required, their provision usually benefits the entire workforce rather than just the employee with disabilities[1].

Types of accommodations

Adjustments to work organisation, duties and working hours

Adjustments to work procedures and the organisation include changing recruitment policies, promotion or training criteria, working conditions or contractual arrangements. This includes allowing flexible or reduced working hours, home working, flexible leave, adjusting work tasks, providing supervision, retraining or redeployment. Flexible or reduced working hours may enable the persons with disabilities to attend treatment or balance their health and personal needs with their work. It may also be necessary to consider transferring a worker with disabilities to a more suitable post or allocate some tasks to another worker (such as driving) [11].

Adjustments to physical features of the workplace

Ideally, accessibility and the needs of workers with disabilities should be considered at the design and planning stage for work premises[11]. Considerations should be given to the ease of access and use of the premises for people with learning difficulties, visual and hearing impairments as well as mobility difficulties[11]. Adjustments to the physical features of existing workplaces aim to overcome barriers created by the physical features of the building or premises. Examples of adjustments include removal or rearrangement of furniture, enhanced lighting and contrast, knocking down walls to create accessible work space, installing lifts, altering bathrooms, widening doorways, installing ramps, providing adequate seating, providing parking spaces close to entrances.

Adjustments to work equipment

The provision of specialist workstations and seating are examples of changes to the physical feature of the work place. This may be in the form of posture supporting seating, sit/stand workstations, or adjustable height desks.

The provision of additional equipment or support services includes the provision of specialist equipment such as adapted keyboards, braille keyboards or text to speech software. This is often associated with display screen equipment (DSE) and is referred to as ‘assistive technology’. Assistive technology includes adapted keyboards, alternative input devices, upper limb supports or larger screens. Much assistive technology is relatively inexpensive and widely supplied.

Additional or auxiliary equipment which does not concern DSE includes voice activated control units, hands-free phones, gripping devices for tools, magnifiers, optical character recognition devices and telecommunication aids.

When considering auxiliary equipment, employers should take into account that, to be successful in overcoming barriers for a worker with disabilities, training in the use of the software or equipment may need to be provided, the equipment or software needs to work with existing systems and it needs to be properly maintained and replaced where necessary[11].

Signs, signposting and emergency procedures

Suitable signage and signposting (e.g. using symbols or pictures, large print notices and signs, braille) should be provided to enable persons with disabilities (e.g. with visual impairments) to find their way around the premises[11]. It may be necessary to consider additional evacuation procedures for workers with disabilities. For example, locating the person in part of the building where evacuation is easier, providing specialist equipment such as an evacuation chair and designated, trained staff to assist or alert workers with disabilities. Employers could also consider providing both audio and visual alarm systems. Local emergency services and specialist disability organisations should be consulted about these issues[11].

Communications and auxiliary services

Materials focusing on OSH issues or training information may need to be provided in alternative, accessible formats such as picture boards, large print, braille or audio formats[11]. Individual, tailored training may be required. Additional supervision and support may be required and managers may require training in how to support workers with disabilities. Support services would include the provision of a reader, sign language interpreter or support worker. It may include providing the worker with disabilities with assistance to travel to and from work.

Training and supervision

The location, timing and medium of training may need to be altered to meet the requirements of a person with disabilities. This also applies to OSH training. Additional training may be needed or the training may need to be tailored to the individual requirements of the person with disabilities. A reader or interpreter may need to be provided so that the person with disabilities can understand and participate in training. It is good practice to provide training materials in simple, understandable language and in a format that is easily legible. A person with disabilities with learning difficulties, for example, may need additional supervision and support. Line managers and supervisors should be trained in how to provide this supervision and support. A dedicated support worker may be needed to assist the person with disabilities.

Barriers to providing reasonable accommodations

It is generally acknowledged that there is a lack of knowledge among employers regarding how to support and accommodate people with disabilities[7]. One of the recommendations of the EU in addressing the health and safety of disabled workers is the dissemination of good practice concerning the provision of reasonable accommodations[2].

Failure to consult with the worker with disabilities when planning and implementing reasonable accommodations may lead to expensive failures. It is essential that the individual worker is consulted and engaged in this process as they are likely to be the best judge of what they need[11][14].

Return to work and disability prevention

Where disability is work-related, it is essential that employers tackle the underlying causes of ill health, injury and disability in the workplace to prevent the occurrence of further disability to an individual and other workers. In addition to disability prevention, employers need to have in place return to work and worker retention policies[16][17]. More information on return to work and disability prevention can be found in Return to work strategies to prevent disability from musculoskeletal disorders and Return to Work after sick leave due to mental health problems articles.

References

  1. 1.0 1.1 1.2 1.3 1.4 1.5 1.6 1.7 1.8 1.9 EU-OSHA - European Agency for Safety and Health at Work, Workforce diversity and risk assessment: Ensuring everyone is covered, 2009. Available at: [1]
  2. 2.00 2.01 2.02 2.03 2.04 2.05 2.06 2.07 2.08 2.09 2.10 2.11 2.12 2.13 Berlin, A., Zamparutti,T., Tull, K., Hernandez, G.& Graveling, R., Occupational health and safety risks for the most vulnerable workers, European Parliament, 2011. Available at: www.europarl.europa.eu/document/activities/cont/201108/20110829ATT25418EN.pdf
  3. 3.0 3.1 EU-OSHA - European Agency for Safety and Health at Work (2013). Disabled people: General questions, Retrieved 07 January 2013, from: [2]
  4. 4.0 4.1 4.2 Knoche, K., Sochert, R. & Houston, K., Promoting healthy work for workers with chronic illness: A guide to good practice, European Network for Workplace Health Promotion (ENWHP), 2012. Available at: [3]
  5. 5.0 5.1 5.2 ENWHP - European Network for Workplace Health Promotion, Promoting healthy work for employees with chronic illness: The 9th ENWHP Initiative. Retrieved 07 January 2013, from: www.enwhp.org
  6. 6.0 6.1 6.2 6.3 6.4 6.5 6.6 6.7 6.8 Dupré, D. & Karjalainen, A. (2003). Eurostat, European Communities. Retrieved 09 January 2013, from: [4]
  7. 7.0 7.1 7.2 Greve, B., The labour market situation of disabled people in European countries and implementation of employment policies: a summary of evidence from country reports and research studies, Academic Network of European Disability experts (ANED), 2009. Available at: [5]
  8. 8.0 8.1 EU-OSHA - European Agency for Safety and Health at Work, Expert forecast on emerging psychosocial risks related to occupational safety and health, 2007. Available at: [6]
  9. COUNCIL DIRECTIVE 89/654/EEC of 30 November 1989 concerning the minimum safety and health requirements for the workplace. Retrieved 07 January 2013, from: [7]
  10. 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. Retrieved 07 January 2013, from:[8]
  11. 11.00 11.01 11.02 11.03 11.04 11.05 11.06 11.07 11.08 11.09 11.10 11.11 11.12 11.13 11.14 11.15 11.16 EU-OSHA - European Agency for Safety and Health at Work, Ensuring the health and safety of workers with disabilities Facts 53, 2004. Available at: [9]
  12. COUNCIL DIRECTIVE 2000/78/EC of 27 November 2000 establishing a general framework for equal treatment in employment and occupation. Retrieved 07 January 2013, from: [10]
  13. HSE - Health and Safety Executive (2012), The law relating to disabled people and their employers. Retrieved 03 December 2012, from: [11]
  14. 14.0 14.1 14.2 14.3 14.4 HSE - Health and Safety Executive, Health and safety for disabled people and their employers. Available at: [12]
  15. EU-OSHA - European Agency for Safety and Health at Work, Workforce diversity and risk assessment: ensuring everyone is covered. Summary of an Agency report. Facts 87, 2009. Available at: [13]
  16. EU-OSHA - European Agency for Safety and Health at Work, Work-related musculoskeletal disorders: Back to work A summary Facts 53, 2004. Available at: [14]
  17. EU-OSHA - European Agency for Safety and Health at Work (2013). People with Disabilities, Retrieved 07 January 2013, from: [15]

Links for further reading

HSE – Health and Safety Executive, Health and Safety for disabled workers and people who work for them: An easy read guide. Available at: [16]

NDA - National Disability Authority, Literature Review - Guidance on retaining employees with a disability. Available at: [17]

EU-OSHA - European Agency for Safety and Health at Work, People with Disabilities. Retrieved 03 December 2012, from: [18]

EU-OSHA - European Agency for Safety and Health at Work, Occupational safety and health and employability - programmes, practices and experiences, 2001. Available at: [19]

Contributors

Liz Yeomans