11 General introduction position, it is not just a matter of improving individual skills. We should also support workers with enabling factors in the work and personal environment to effectively deal with problems that affect their sustainable employability. Therefore, it is important to investigate how we can support workers in a vulnerable position on how to effectively deal with these (health) problems. The role of occupational health professionals in supporting workers in a vulnerable position To improve the health and sustainable employability of workers in a vulnerable position occupational health professionals (OHPs) can provide adequate support. OHPs are professionals who provide advice and/or guidance to ensure a safe and healthy work environment, such as occupational physicians (OPs) or occupational nurses. In the Netherlands, the Working Conditions Act forms the basis for general rights and duties for employers and workers to ensure safe and healthy working environment. Employers are required to have a contract with an occupational health service and/or OHP, in which the acquired services are specified. Employers are also required to seek support from an OP in case of long-term sickness absence (i.e., more than 6 weeks in the Netherlands), and to perform risk assessments and evaluations on health and safety (RI&E in Dutch). Based on these risk assessments and evaluations OHPs can adapt work tasks and/or working conditions to reduce health risks or implement various tools, such as a preventive medical examination for the early detection of work-related health risks. Workers are also by law enabled to visit, at any time, an OP to receive preventive advice on work-related health problems. However, OHPs still spend most of their time providing advice to workers already on sick leave (38). This is unfortunate, as OHPs can play a key role in the early detection of work-related health risks and problems and initialize actions to prevent early drop-out from the labor market, especially among workers in a vulnerable position. Considering the extensive role of OHPs in the workplace, they could also be very well suited to play a role in the early detection of and solving non-work-related health risks and problems. However, existing interventions mainly focus on the identification of and solving work-related health risks and problems. For example, in the Participatory Approach workers mainly identify and solve workrelated problems under the guidance of an OHP and with involvement of relevant stakeholders at the workplace (39). Even though, the use of the Participatory Approach could also involve identifying and solving non-work-related problems that hinder return to work. Another example is job crafting, wherein workers make proactive changes in their job demands and job resources to optimize the fit between their job and personal needs at work (40). Work-related health risks and problems are important to address, but there is a need for interventions that solve work- and non-work-related health risks and problems. Problems both in- 1
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