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Ewan is an occupational physician who trained in occupational medicine in the coal mining industry and has since led the UK and international services in industrial sectors as diverse as computing, textiles, aluminium production and health care. He is a former Dean of the UK Faculty of Occupational Medicine and founder and Past President of the Occupational Medicine section of the Union of European Medical Specialists. He retired from the Scottish NHS at the end of 2011, having developed the Salus service in NHS Lanarkshire. Salus is the largest NHS based occupational health and safety service which has a track record of innovation, developing services for the workless, and income-generating for the NHS.

At the University of Glasgow, he established the Healthy Working Lives Group and proposed the Healthy Working Lives paradigm which became the strategy of the Scottish Government in 2004. Subsequently, he stimulated its review which led to the Health Works policy. In 2011 he chaired the implementation group of the first Health Works pilot to introduce a redesigned musculoskeletal service in one health board which is now being rolled out across Scotland with the aim of ensuring a more patient-centred faster service with a focus on return to maximum function including work where appropriate. His research has evolved from a focus on the health problems caused by work to the health problems caused by worklessness and he believes that worklessness is the major contributor to increased morbidity, mortality, health inequalities and social exclusion in Scotland. He established with others, the Scottish Observatory for Work and Health which is based in his group at the University and current research projects include evaluation of return to work initiatives, extending working lives, the biological changes underpinning health inequalities, long working hours and doctors health, health and safety in equine vets, work health needs of high altitude climbing Sherpas, and early interventions in sickness absence.