The review below is a summary of the Annual Report 2004. The whole publication can be ordered from the Office of Information and International Affairs, Ms. Inkeri Haataja, tel. + 358 9 4747 2470, fax. +358 9 2413 804.
Review of the Director General
Harri Vainio, Director General
In the year 2004 several expert reviews which dealt with the position and future of Finland in the changing world were carried out. The Finnish society is facing great challenges, as we have to find our place in the ever-tightening international competition, but at the same time we must ensure that our welfare state is on a sound economic basis and corresponds to the needs of our aging population.
The evaluations stressed the importance of know-how, innovativeness and the capacity for renewing activities. In order to be able to cope with the future challenges, we have to develop our capacity to understand, accept and profit from diversity. We need ever closer interaction and cooperation networks between citizens and different institutions. Interaction and cooperation are needed to build trust, which helps us to learn about each others' actions and views, and to come up with innovative solutions. This is a challenge to all parties in the Finnish society, also at the Finnish Institute of Occupational Health.
Working conditions have improved, but insecurity creates new threats
The working conditions in Finland have in recent years developed mainly in a positive direction. For instance, our review on Work and Health in Finland reported that passive smoking, manual lifting and moving of heavy loads, and the threat of violence at work have declined.
The insecurity of work life, the increased demands at work and great changes bring with them new kinds of health hazards. Some of the trends that arouse concern are, for instance, an increase in sickness absenteeism, and the increased prevalence of mental disorders, especially depression, as causes of sickness absence and work disability. We launched the Work and mental health action policy, and in the coming years we will investigate whether mental disorders have work-related causes, and how people suffering from mental disorders cope in work life.
The prevention of harmful work stress has become more important than ever. The spearhead research project of SITRA, Information-Intensive Work (2000–2004), coordinated by us, produced a large quantity of new knowledge and methods which will help reduce the loading caused by information-intensive work. Stressful situations may also arise from upheavals at the workplace, and the consequences of stress may even be fatal. According to our research, major reductions in personnel increased the mortality due to cardiovascular diseases among those who stayed on at work. After large-scale staff reductions, the employees who had kept their jobs had a two-fold risk to die from cardiovascular diseases compared to those at whose workplaces staff reductions had not been made. The mortality risk was greatest during the first few years after the reductions.
How to add 2–3 years to the work career?
According to the Government policy and the strategy of the Ministry of Social Affairs and Health, we are working to achieve the objective that Finnish people could be motivated to continue on at work longer than at present. Nowadays we Finns retire at the average age of 59 years, and recent questionnaire surveys have shown that we are not very enthusiastic to continue working after the age of 62.
A person's attitude to work varies in his or her different stages of life. Young people just starting on their work career, as well as older people who have a long work career behind them, look at work life from a very different perspective. Also functional capacity changes along with the years. Our Youth and Work Barometer demonstrated that young people appreciate good wages, pleasant or interesting work, a positive work atmosphere and freedom at work. The work environment survey of Statistics Finland, on its part, indicated that in the opinion of those over 45 years, staying on at work is motivated by such incentives as security, in other words, the certainty of keeping one's job, better rehabilitation possibilities and improving occupational health care, better pay, less haste, improving the work environment, as well as more flexible working time arrangements. These were mentioned at the top of the list as factors promoting the willingness to continue working. During the work career, the possibility to balance one's work with the current situation in the family was perceived as important. Sometimes returning to work after a long absence, for example, a long illness, unemployment or family leave, may be difficult. We are facing the challenge to find means to enable people in different life situations to participate in work life in ways that best suit them.
New action programs support work career
In 2004 we launched two new action programs. Our action program KESTO (2004–2007) is a collaborative endeavour to lengthen the work career of Finnish people. During the program we will find out what measures are most successful in lengthening the work career and in preventing marginalization and exclusion. The program encompasses an extensive support network of work life actors, consisting of authorities as well as actors in the realm of research and development. The KESTO program provides support for the national VETO program. The goal of our action program Work/Life balance (2004–200) is to support the reconciliation of work, family and other spheres of life, and in this way promote equality and versatility in work life, to support people to cope with their work, raise the attractiveness of work, and facilitate earnest participation in work life. The theme of the program concerns not only families with children, but is also topical to many working-aged people who bear the responsibility of caring for their aged parents. We are carrying out the program together with numerous national and international collaboration partners.
The 'Zero accident forum' was extended
Many accidents happen in vain, because accidents can be prevented. The 'Zero-Accident Forum', which is a network of Finnish workplaces, has functioned at the Institute for over a year. The members of the Forum want to improve safety at work and to learn from each other; their aim is to eliminate accidents at work altogether. The Forum is part of a national program to prevent occupational accidents (2001–2005), and it aims to take Finland to the forefront of the countries that have succeeded in achieving a high level of safety at work.
The Forum has already been joined by nearly a hundred enterprises with over 200 offices employing close to 80,000 people. During the year we have, for instance, started an inter-enterprise extranet and arranged several seminars and press conferences.
The health effects of sleep were studied
In the autumn we published the book Good sleep – Good work (Hyvä uni – hyvä työ), which presents the latest research results on the association between sleep, work and health. It arouses concern that some 10–20% of Finns suffer continuously from sleep deficiency, because it is impossible to cope efficiently with your daily routines, if you continue to ignore your biological sleep requirements and natural sleep-wake rhythm. A large part of the sleep deficiency of adults is related at least partly to work.
International comparisons indicate that more shift-work is done in Finland than in other European countries. Shift-work and cumulating sleep deficiency are associated with more serious health hazards than we could imagine only a decade ago. Night work and fatigue increase the risk for coronary disease as well as for serious traffic accidents. Night work and sleep deficiency are probably connected also with the development of obesity, diabetes, stroke, and breast cancer. It would be possible to alleviate considerably the disadvantages of shift-work by making rearrangements to prevailing work shifts. Therefore, it is not an insignificant matter how work shifts are organized.
Smoking in restaurants aroused debate
Whether to permit or forbid smoking in restaurants aroused a lot of debate during the year. Already in 1995, the spreading of tobacco smoke in workplaces indoors was banned in Finland, but smoking in restaurants has still been allowed under certain conditions. Now many countries have banned smoking also in restaurants. In Finland the situation has been investigated by Kari Reijula, Director of the Uusimaa Regional Institute of Occupational Health; the investigation was commissioned by the Ministry of Social Affairs and Health. In his report, Reijula recommended the total banning of smoking, or allowing smoking only in a separate area with no serving.
Tobacco smoke has been classified as a carcinogenic substance, and the association between tobacco smoke and e.g. lung cancer and cardiovascular disease has been demonstrated in numerous studies. It is therefore important to intervene with the employees' exposure, and the only tenable solution is to make all workplaces – also restaurants – smoke-free.
A mini-intervention cuts down the hazards of alcohol use
In the spring of 2004 we launched the project Mini-intervention for routine use by occupational health services (Mini-interventio työterveyshuollon arkikäyttöön) (2004–2006), during which we will train Finnish occupational health service units to help prevent intoxicant abuse. This preventive work is targeted at working-aged persons with a drinking problem, but who are not yet addicted to alcohol.
The mini-intervention is meant to tackle the problem early: During a visit to the occupational health physician or nurse, he or she covers questions on alcohol consumption, health risks due to alcohol, and cutting down the amount of alcohol consumed. The project is part of a national alcohol program.
The development of occupational health services was emphasized
In the autumn there was general discussion about inequality in the delivery of health services: getting health services was found to be connected to people's level of income. Some inequality was also seen in the delivery of occupational health services, as some big enterprises can offer comprehensive health care and curative services to their employees, whereas many small enterprises can provide only the minimal services stipulated by law, and sometimes not even those. The situation of people who are dependent on the diminishing municipal health services, for instance the unemployed, is the poorest.
Together with the different actors in the occupational health services and other actors in work life, we have developed methods that enhance the functioning of the occupational health service system, improve the coverage of the services, improve regional collaboration, and promote the mutual interaction between occupational health services and municipalities. We will continue with this work.
In May 2004 we established a Cochrane Occupational Health Field for international collaboration at our Institute. It is an international network which charts the impact of the methods used in occupational health services. At the same time we are offering occupational health professionals and others who are interested knowledge about the methods that best promote occupational health and safety at workplaces.
International collaboration was intensified
The role of collaboration within the EU has been emphasized in the past few years. We collaborated closely with e.g. the European Agency for Safety and Health at Work in Bilbao and the European Foundation for the Improvement of Living and Working Conditions in Dublin. We are also active in the network on WHO Collaborating Centres, and we are an expert institute of ILO.
The activities of FIOH were evaluated
In October of 2003 the Ministry of Social Affairs and Health set up an international scientific expert group to evaluate the scientific quality and efficiency of our activities. The group comprised nine scientific experts in the area of occupational health and safety, and their task was to assess how we have succeeded in our primary task in the years 1997–2003 and how we should develop our activities in 2004–2010.
The evaluation group noted that we have been highly successful in carrying out our task in enhancing the quality of work life and in ensuring the health and safety of the Finnish working population. Our expert staff carry out high-quality research and are very productive. Our strategy and action processes promote the realization of the strategic goals set by the Ministry of Social Affairs and Health, and our national and international collaboration partners have done fruitful collaboration with us.
Nevertheless, there is always room for improvement. The evaluation group made recommendations on how we could further develop our activity. The recommendations emphasized the development of internal cooperation and coordination, putting a greater effort on assessing the impact of the activity, as well as focusing on the personnel's competence and ability to cope with the work. The evaluation was a laborious task for our organization, but at the same time an edifying experience, and its effects will be evident in our activity in future years.
The condition of the state's sector research was charted
Professor Jussi Huttunen investigated the structural and functional development needs of the state's sector research system commissioned by the Science and Technology Policy Council of Finland. The report states that the FIOH activity should encompass also questions of work life development related to occupational health and well-being. We gladly take on this challenge; we have the readiness as well as enthusiasm to extend our expertise in this direction.
The joint collaboration forum composed of the top management of the research institutes within the same sector, and set up under the jurisdiction of the Ministry of Social Affairs and Health, met regularly to discuss possibilities to develop the collaboration.
The Institute prepared for organizational changes
During the year we planned and studied new ways of organizing some functions that would streamline our administrative and support services and help us to cope ever more fluently with our daily routines. As the administrative and support services become more effective, the other departments will be able to concentrate better than before on their own expertise areas. We also strengthened cross-disciplinary collaboration across departmental boundaries, so that we can in future reach innovative solutions to the needs of Finnish work life. The new ways of functioning will be converted from plans to practice during the course of the year 2005.
In March the Institute's premises were expanded, when Liisa Hyssälä, Minister of Health and Social Services, inaugurated a newly constructed building for our use. This "Occupational Health Building" is in joint use by FIOH and HUS (Helsinki and Uusimaa Hospital District), and houses FIOH's Training Centre and some units of the Department of Research and Development in Occupational Health Services. In the new building it is possible to organize coordinated and effective supplementary and further training for occupational health personnel and concentrate on developing OHS.
The discussion on decentralization touched also FIOH and raised some questions among the FIOH employees. However, our regional network covering the whole country and consisting of six regional institutes is already now comprehensive, and in future we will focus on developing it further.
Approaching the 60th jubilee year of FIOH
The year 2005 is the 60th anniversary of FIOH. At the same time as we celebrate our laudable history, we look towards the future: our strategy is being renewed, and so is our visual image. The new image can be seen already in the layout of this Annual Report.