Work and Occupational Accidents
A large part of social security seeks to provide protection against the risks of the modern workplace. Indeed, this was the main purpose of social security in Switzerland until the mid-20th century.
When the public authorities and political parties in Switzerland began discussing workers’ protection and social insurance in the 1860s, their main concern was the risks involved in factory work. Completely new working conditions, with previously unknown occupational risks, had emerged with the creation of new industrial jobs at the end of the 18th century. This focus on industrial work had lasting consequences, as welfare state arrangements in consequence largely ignored the dangers in non-industrial sectors, including in agriculture or in private households, until the 20th century.
The new occupational hazards were particularly striking in the industrial sector. Early forms of industrial production, such as in the textile industry, had largely been based on work done at home, and was criticized for the long working hours this involved. Such home-based work would increasingly be replaced by factory work in the 19th century, driven by the mechanization of spinning and weaving. Factory production, not just limited to the textile and machinery industry but which had extended into other sectors, was considered particularly dangerous. Criticism came from philanthropic bodies as well as the workers’ associations which would later become modern trade unions. Contemporary observers saw industrial machinery, equipment and vehicles – such as the railway – as sources of risk symbolic of the industrial age. Even the compensation model associated with industrial work, rewarded by a wage, concealed the risks. Workers thus fell into new dependencies. Economic slumps or crises resulted in large swathes of the population in industrial areas suddenly having no gainful employment and sinking into poverty. Safeguards only began to expand in the second half of the 19th century, including early health or unemployment funds. Phases of poverty made worse by the state of industry at a given time meant local authorities, particularly poor relief organizations, with faced with difficult financial and socio-political challenges. Furthermore, in branches employing many women and children, such as the textile industry, workers were considered especially deserving of protection. Along with the proliferation of elementary schools and the propagation of bourgeois family values, the regulating of child labor and protecting working women became the core concerns of early legislative measures designed to reduce the risks of industrial work. The expansion of hazardous chemical and electrical industries towards the end of the 19th century and into the early 20th century intensified the desire for effective work safety rules.
At the national level, the Swiss Factory Act of 1877 was a milestone in the governmental regulation of factory work. It made employing children younger than 14 in the industrial sector illegal (but not, however, in agriculture), set the maximum hours that could be worked per day to 11, and made factory owners liable for physical injuries at the workplace. A system of national factory inspectors was also introduced, he first of whom, and to date the best known, was the Glarus doctor Fridolin Schuler.
A Liability Act followed in 1881, one which increasingly led factory owners to arrange for private insurance coverage against the risk of accidents. In 1912, after a second try, the Health and Accident Insurance Act both replaced the previous liability provisions with compulsory accident insurance and nationalized a large part of the accident insurance market. In 1918, implementation of governmental accident insurance was delegated to the Swiss Institute for Accident Insurance (Suva), which encompassed both industrial and commercial occupations. Suva defined accidents broadly, such that recognized occupational illnesses as well as accidents occurring during time off work were also covered. In parallel, the federal authorities improved occupational protection for women in 1920, notably by banning women’s work in occupations hazardous to health. Working hours were likewise further restricted with the introduction of the 48-hour week, although this would only gradually become more widely practiced in the 1930s. Following the Second World War, the Labor Act of 1964 expanded workers’ protection to the service sector. All dependent workers – including those working in agriculture – must have accident insurance since 1984. In the 1990s, employers' peak associations in particular called for deregulation of the Labor Act. A revision in 1998 lifted the ban on night work for women, extended the working hours which did not require a permit until 11 p.m., and reorganised the rules on additional compensation for night work. Cantonal labour inspectorates monitor compliance with the Labor Act and the provisions of the Accident Insurance Act. They are supervised and coordinated by the Federal Labour Inspectorate.
At the beginning of the 20th century, when accident insurance was introduced, the Swiss authorities looked primarily to the German model. Under Bismarck in the 1880s, the German Empire had created the world's first governmental accident insurance, though its implementation was left to workers' compensation associations specific to each branch of industry. These public service organizations are composed of employers' and workers' representatives. Switzerland adopted this form of organization, though unlike in Germany, a single, central organization – the Suva– was created rather than a multitude of occupation-specific associations. Like the German associations, in which employers, employees, and government are all represented, Suva is corporatist. In addition, the system of contributions and accident prevention efforts are organized by occupation in Switzerland. The contrasting model is found in nation-states where accident protection is regulated by a liability law, and employers insure themselves against liability for work accidents using private insurance policies. Great Britain, France and above all the US used this second model, at least until the Second World War.
For a long time, occupational risks were perceived as the hazards of factory work and hence predominantly at male-dominated workplaces. Female-specific occupational risks were inadequately taken into account or only with considerable delay. This was the case, for example, for occupational risks in healthcare (such as nursing), in office jobs or in household work. In the circles concerned with accident prevention, these issues only began to be discussed more broadly beinging in the 1970s and 1980s.
Thanks to the empirical statistical data gathered by Suva, it is possible to reconstruct, at least approximately, the development of insured occupational risks in the 20th and early 21st centuries. Generally, the risk of an accident occurring at the workplace depended on a wide range of factors, including measures taken to prevent accidents, changes to the structure and condition of the economy, technical progress, the structure of the enterprise, and the individual perception of risk. An overheated economy leads to more accidents than do economic downturns. Companies that actively took accident prevention measures had lower accident rates than those companies that did not invest in prevention. Accident risks in the workplace have fallen by around a third since the early 20thcentury. A key reason for this development has been the increase in the service sector after the Second World War. Even though individual service sector occupations, such as nursing, certainly involved significant occupational risks, the mean potential for risk in the tertiary sector was considerably lower than in the industrial sector. Suva’s contribution to accident prevention in this trend cannot be measured with any accuracy. An inverse trend only arose during the Second World War, when the risk of accidents increased by around a quarter. Today, there are approximately seven occupational accidents each year for every 100 people insured.
In contrast, leisure time accidents, largely traffic and sports accidents, have developed differently. The number of yearly accidents per policyholder has risen continuously, to roughly 13 incidents per 100 policyholders each year as of 2013. The risk of accidents while engaged in leisure activities has doubled over the last century. This trend reflects the increasing motorization of society as well as the reduction of annual work time due to greater leisure and holiday entitlements.
Occupational illnesses play a significant role in the risks of work. They are often harder to diagnose compared to accidents at work, not least due to their gradual progression. When Suva began its work in 1918, it decided to include recognized occupational illnesses in its insurance coverage. For an occupational illness to be recognized, however, Suva requires evidence that a toxic substanceat the workplace stood in causal relation to the illness. It can often prove difficult to furnish such evidence in the case of new or unconventional occupational illnesses. Harmful effects to health caused by substances such as lead in the painting business, phosphorous in match manufacturing, or carcinogenic aniline in the chemical industry, were covered without much debate. By contrast, other substances, such as quartz dust that could lead to chronic pulmonary complaints (silicosis) – and ultimately disability and death – or toxic substances used in households, were long underestimated. Quartz dust was only definitively included on the list of occupational illnesses in 1937, after years of debate. In 1960, Suva changed its classification system and introduced ‘maximum workplace concentration’ (MAK) as a criterion for assessing occupational illnesses. In contrast to the previous model, the MAK values set a threshold of toxic substances not to be exceeded in the workplace.
The discussions about occupational illnesses has developed in new directions in recent years. Health problems with complex causes, no previously considered as occupational illnesses, have come more into focus. The new concept of psychosocial risks summarizes the risks to health caused by an unfavorable climate at work and unfavorable organization and structuring of work. Such health problems include stress, burnout, or diffuse back pain. Suva has thus far excluded these problems as well as various other disputed illnesses from insurance benefits. However, it has recently intensified research in this area in order both to find out more about their causes and to develop suitable preventative measures. However, labor law encourages employers to minimize the triggering factors of psychosocial risks. As of 2014, the State Secretariat for Economic Affairs (SECO) encouraged labor inspectorates to focus on preventing psychosocial risks.
> Accident insurance: data and figures
Literatur / Bibliographie / Bibliografia / References: Schaad, Nicole (2003), Chemische Stoffe, giftige Körper: Gesundheitsrisiken in der Basler Chemie, 1860-1930, Zürich; Lengwiler, Martin (2006), Risikopolitik im Sozialstaat. Die schweizerische Unfallversicherung 1870-1970; Website 100 Jahre Suva: https://www.suva.ch/de-ch/die-suva/100-jahre-suva