In this first social report from Novo Nordisk, we have chosen to present only H&S data for Denmark as an indication of our performance relating to occupational injuries and diseases.

In Novo Nordisk's experience, the number of accidents at work often increase in areas undergoing major change. This emphasises the importance of including H&S issues as an integral part of any restructuring within a particular area. Occupational injuries at Novo Nordisk occur most frequently as a result of the incorrect use of tools, incorrect movements and, more rarely, as a result of using hazardous substances and materials.

From 1994 to 1997, the frequency of occupational injuries at Novo Nordisk fell by 15% to 9.2 injuries per million working hours. The target in 1998 was to maintain this level. However, the figure for 1998 was 10.5.

The areas with the most significant increase were cleaning staff, service workshops and canteens (part of Corporate Staffs). This could be due to a transition to partly self-governing groups and the phasing out of many managerial positions.

Our key categories of occupational diseases are allergies, eczema and disorders of the musculoskeletal system as a result of monotonous, repetitive work.

In 1998, we aimed to reduce the total incidence of occupational diseases but this target was not met. In 1998, 32 cases of occupational diseases were reported compared to 30 in 1997.

In 1998, Enzyme Business focused on exposure to enzymes in both laboratories and production. Enzymes are proteins and can, as such, cause allergic reactions in some people, just like proteins in flour, pollen and animal hair. Allergy to enzymes is solely an occupational hazard and negative effects on end-consumers using products containing enzymes have not been reported during the last 25 years.

Investigations in 1998 identified certain problem areas which may be the cause of enzyme allergy among Novo Nordisk employees. After 10-15 reported enzyme allergy cases per annum over a number of years, it is pleasing to note only two cases in 1998 but it is too early to say if this is a new trend. From 1994-1998, disorders due to monotonous, repetitive work increased from 9 to 15. In 1999, projects in selected areas with a high frequency of disorders will focus on this issue.

Research project on musculoskeletal disorders
For many years, the Novo Nordisk Association of Laboratory Technicians and Novo Nordisk's Occupational Health Service have cooperated to improve working conditions for laboratory technicians. The aim was to reduce the occurrence of symptoms and disorders in the hands, arms and shoulders. Nonetheless, new cases of this type of occupational disease still occur.

In 1998, 15 of 32 cases of occupational diseases in Denmark were disorders due to monotonous, repetitive work making this our most serious problem in terms of cases. Seven of these cases involved laboratory technicians.

To address the issue of musculoskeletal disorders, in 1997 Novo Nordisk teamed up with researchers at the departments of occupational health at two Danish hospitals and a research project was initiated. The purpose is, firstly, to identify ergonomic risk factors in laboratory work and, secondly, to see if there is any correlation between these factors and symptoms in the hands, arms and shoulders.

As a first step in the project, in 1997 a survey was carried out where more than 1,000 laboratory technicians were invited to participate. 87% responded to an extensive questionnaire concerning symptoms in the arms, shoulders and neck. Of these 170 laboratory technicians with significant symptoms were selected as well as a symptom-free control group of 110 people. All the data has been collected and is currently being analysed. The findings of the project are expected to be ready by the end of 1999.

Night work and health
It is well known that working at night may disrupt a person's social and family life. Furthermore, it may increase the risk of cardiovascular disease and gastrointestinal disorders. Much of Novo Nordisk's production is based on continuous processes, however, so night shifts are often required.

In January 1998, we introduced an optional health check-up in line with an EU directive from 1993. We are one of the first companies in Denmark to do so. Approximately 1,100 employees can make use of the offer and, at the close of 1998, 104 night workers had applied for and undergone a check-up. Eight of these were advised to consider changing to day work if possible and two were strongly advised to do so for health reasons.

It is too early to draw firm conclusions based on examining one tenth of the total night workforce in Denmark. However, by the end of 1999, we will have produced a new evaluation based on a statistical analysis of the sample.