The role of the occupational physician in the enlarged European Union: challenges and opportunities The changing working world

In the future, many changes, currently observed in the USA [1] and, to a lesser extent, in western Europe, will extensively affect ‘workforce’, ‘workplace’ and ‘work organization’. The changes expected in the workforce will be a larger proportion of workers aged .55 years and of female and migrant workers, including workers from other European countries. Two main changes will affect the workplace: the increasing percentage of jobs in the service sector and the decreasing permanent relationship of the worker with the workplace with an increase in temporary work, on-call work and work at home. The evolution of global trade is accelerating the transformation of work organization, with important changes in management systems, production and services processes and their influence on the way work is performed. According to the progress of laws and integration of rules, it is expected that the future governance of the prevention system will be based on an extensive, effective, efficient and equitable occupational health care throughout the European region. However, because of the variety of drivers at play (Table 1), outlining what the future holds for health services in the next 10–15 years is a challenging task. The World Health Organization (WHO) Regional Office for Europe [2] developed a scenario based on the features of eight European countries. Life expectancy will grow, but more people will be affected by chronic diseases. In spite of health promotion programmes, society’s main health problems will be represented by poor diet, substance abuse, stress and sedentary lifestyle. Screening is emphasized as a tool for prevention but the full potential of screening programmes will be realized only when doctors will be able to deal with their patients’ genetic profiles. The health expenditure will increase and funding will be limited to health interventions of proven effectiveness.