Occupational medicine 4.0: health in a globalized economy

Interview with Prof. Hans Drexler, Director, Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Friedrich-Alexander University Erlangen-Nuremberg

Digitization changes the working world - we all know that. While agriculture, industry and skilled trade had a nine-to-five working day in the past, networking and continuing flow of information sometimes render the nine-to-five job obsolete. The multimedia-based job involves its very own health risks.


Photo: Man in a suit sits in front of a book shelf

Prof. Hans Drexler; ©privat

Prof. Hans Drexler spoke with MEDICA-tradefair.com about occupational medicine in a networked economy, why powered off servers do not reduce stress and how corporate health physicians can reach people before they actually get sick.

Prof. Drexler, the German Society for Occupational and Environmental Medicine (Deutsche Gesellschaft für Arbeits- und Umweltmedizin) DGAUM recently published a report with 14 statements on occupational medicine 4.0. These days, this type of version numbers can be found quite often. What exactly is behind all this?

Prof. Hans Drexler: We occupational physicians take our cue from the term Industry 4.0 here, that being global networking in a multimedia society that also includes new health risks for the employees. Of course, we should remember that there are still jobs in agriculture, skilled trade and the industry with their respective health risks - work 1.0, 2.0 and 3.0 so to speak. However, "Occupational Medicine 4.0" guides the employees into the new industry.
Photo: Man in a suit is multitasking with many arms

More and more modern office jobs demand the ability to multitask and tempt employees to be continously available. This causes new health risks that occupational medicine needs to face; ©panthermedia.net/ alphaspirit

What are some issues of Occupational Medicine 4.0?

Drexler: We might have problems with our traditional occupational health and safety concepts in a globalized economy. Communication takes place around the clock in global companies. More and more employees are continuously available at their own volition, even after hours; or they want to be because they would like to advance their careers or feel obligated to. Of course, this results in stress and the associated health risks for the employee, for instance by taxing the mind and the cardiovascular system.

Generally, however, the employer requires this not so frequently. Some companies, such as VW for example, even turn off the mail servers for a portion of its employees. However, this only helps the company’s employees in a limited fashion because it forces them to complete their tasks during a set time frame. Yet some people might actually prefer to read their emails in the evenings and now feel obligated to read them during working hours.

This is why it is not easy to establish general rules on occupational health and safety. Basically, these questions have not yet been scientifically addressed since the technology surrounding smartphones and tablets has virtually overrun our lives over the past ten years. Research lags behind in this aspect.

What is the current status of prevention and workplace health promotion in Germany?

Drexler: I think its importance increases every day. On the one hand, the Prevention Act that will be implemented on January 1, 2016, has now finally been passed after four failed attempts. On the other hand, companies increasingly recognize the value of prevention because their employees are aging and there is less new talent. An aging workforce is sick more often and for extended amounts of time. An employee that has been absent for a long time needs to be rehabilitated into the company. That is why the value of preventive measures at the workplace makes sense.

What exactly does the Prevention Act stipulate?

Drexler: Many people in our society only visit a doctor when they are already sick. However, corporate health physicians have the chance to reach approximately 43 million employees with checkups and individual consultations long before they become sick. The Prevention Act stipulates that the corporate health physician should now be increasingly involved in general health promotion.
Photo: Man at a laptop takes an apple

Health promotion at the workplace unfortunately cannot merely be described by the saying "An apple a day..." - but employers who promote healthy eating already help a lot; ©panthermedia.net/ aremafoto

How does Germany fare in terms of health promotion compared to other countries?

Drexler: I believe the Scandinavian countries are definitely still farther ahead than we are when it comes to health promotion. Otherwise, however, Germany already holds a leading position in this area.

How important are prevention and health promotion in the education of physicians in Germany?

Drexler: This topic is a compulsory subject and according to the German Medical Licensure Act mandatory to obtain a medical degree. Nevertheless, many young physicians actually choose at a much later point to work in the prevention area, as an occupational physician for example. If they have worked as therapists for a while, they realize prevention is also important to avoid diseases.

Are there specific obstacles for companies that prevent them from taking on prevention responsibilities?

Drexler: Major German companies such as BASF, Audi, BMW or Boehringer Ingelheim for example, have already addressed health management, health promotion, and prevention for many decades. However, this is not because of altruism but because this pays off for them and they also meet their obligation to their shareholders to make money.

That said, due to financial reasons, small and medium-sized companies are not able to simply hire a health manager. This is where we need concepts, for instance, networks where smaller companies can implement the idea of health promotion as part of a group the same way large industrial enterprises are able to.
Photo: Timo Roth; Copyright: B. Frommann

© B. Frommann

The interview was conducted by Timo Roth and translated from German by Elena O'Meara.