The economic costs of a heart attack 1

A new Australian report estimates the total costs of heart attack and chest pain (Acute Coronary Syndrome or ACS) to the Australian economy – “total economic cost of $17.9 billion.”  This Access Economics report, released in June 2009, has broad application for public policy but has some relevant information for safety and health management in the workplace.

Costofheartattackandchestpain coverIf we take “productivity” as applying to work, as is reasonable, the report states that for 2009

“Indirect [health care system] costs [from ACS] are expected to account for $A3.8 billion, primarily due to lost productivity.”

This is a useful statistic for those workplace health advocates.  In fact, the report specifically identified the workplace as

“…an excellent environment to facilitate the ongoing rehabilitation and lifestyle changes to prevent the re-occurrence of ACS event”.

One gap it identified in the treatment and monitoring of ACS was  something that many have been advocating for some years, particularly with the aging population and increasing obesity rates:

“a standardised national program to support employees and employers and the extension of rehabilitation practices.”

Much of the report advocates important rehabilitation resources and services for when the patient is discharged from hospital.  The report includes the following graphic but also recommends the basic elements of post-hospital care after an ACS event.

Costofheartattackandchestpain-261-2 rehab table

“For rehabilitation to be effective, comprehensive patient follow-up interviews after discharge are essential.  At these follow-up interviews, the patient should undergo both physical assessments (e.g. blood pressure, cholesterol tests, ECGs) and emotional and psychological assessments (e.g. signs of depression, anxiety, stress, financial hardships).  The psychological impact following an ACS event is an important, but often neglected, area in the management of ACS.  Thus, if patients can better understand their conditions, it can empower them to cope with their anxieties caused by ACS.”

In specific reference to workplaces, the report says:

“Returning to work can require an adjustment in duties and the conditions under which the employee works.”

It is up to OHS and return-to-work professionals to determine exactly what strategies should be applied in these circumstances.

There were a couple of references in the report that may be worth following up:

Bhattacharyya MR, Perkins-Porras L, Whitehead DL, and A Steptoe (2007), Psychological and clinical predictors of return to work after acute coronary syndrome, European Heart Journal, Vol 28, Iss. 2, pp. 160-165.

Kovoor P, Lee AKY, Carrozzi F, Wiseman V, Byth K, Zecchin R, Dickson C, King M, Hall J, Ross DL, Uther JB, and AR Denniss (2006), Return to full normal activities including work at two weeks after acute myocardial infarction, American Journal of Cardiology, Vol 97, No. 7, pp. 952-958.

Kevin Jones

New research on casino worker risks from secondhand smoke Reply

The yet-to-be-released August 2009 edition of the American Journal of Public Health has an interesting report into the health risks of casino workers in Pennsylvania from second hand tobacco smoke.  The research report is quite complex for the casual readerr but the increased level of risk to casino workers seems convincing.

According to the report, secondhand smoke

“in Pennsylvania casinos produces an estimated excess mortality of approximately 6 deaths per year per 10000 workers at risk”.

People in the casinos for 8 hours would be breathing air that would match the “unhealthy air” definition of the US Air Quality Index.

The reseacrh concludes

“It is clear, however, that Pennsylvania casino workers and patrons are put at significant excess risk of heart disease and lung cancer from SHS through a failure to include casinos in the state’s smoke-free-workplace law.”

Randy Dotinga wrote for the Health Behavior News Services on the research report and asked questions of a gambling industry representative:

“Holly Thomsen, a spokesperson for the American Gaming Association, a trade group for the casino industry, said its members are committed to “the highest level of safety and comfort” inside casinos.

Casinos serve both smoking and nonsmoking customers, she said, and “we realize that balancing the needs of these two distinct sets of patrons, as well as those of our employees who don’t smoke, is of paramount importance.”

The AJPH article reference is

Repace, J. Secondhand smoke in Pennsylvania casinos: A study of nonsmokers’ exposure, dose, and risk. Am J Public Health 99(8), 2009.

Kevin Jones

Sleep disorders and workplace safety – new research grant 1

Recently, the Australian Government awarded some research grants of which at least one is relevant to workplace safety.  $2.5 million was given for the establishment of a Centre for Clinical Research Excellence in Interdisciplinary Sleep Health (CRISH).

When the grant was announced Professor Ron Grunstein of the Woolcock Institute of Medical Research said,

“Adequate sleep is as important as exercise and diet. Sleep loss and sleep disorders contribute to mortality, chronic disease, mental health problems and the economic health burden.

“This funding will allow us to establish a network of leading sleep researchers and physicians in different specialties to investigate the biology of sleep, and look at ways to prevent and treat sleep disorders.”

Amongst several social benefits of the research, the issue of shiftwork health was mentioned.  There are many contributory factors to the health of shiftworker and sleep disorders is only one, but an important one.

WakeUpAustralia-CoverThe most recent Australian data on the costs of sleep disorders was from 2004 by Access Economics, an organisation that the government often relies on for data.  Its report, Wake Up Australia, estimates that  sleep disorders such as obstructive sleep apnea and insomnia underlie 9.1 per cent of work related injuries.

The origin of this statistic needs to be closely examined in the body of the report (page 23) as there is quite a bit of statistical magic applied however the 9.1% figure has been referred to in relation to the potential benefit of the CRISH project.  The statistic is not invalid but it is also not so simple.

Kevin Jones

Peanut allergy fatality saga to continue 3

Safety management in the education sector seems to be one of the hardest management challenges.  There are overlapping safety obligations through OHS legislation, education department guidelines, public health matters and meeting the demands of parents and students.

700 Peanuts - Federal Court coverA decision in the Federal Court of Australia on 30 June 2009 illustrates the challenges.

A 13 year old boy from Scotch College, in Melbourne, Nathan Francis, died after eating from a ration pack of beef satay on a Defence Forces camp.  The school, which was supervising the camp, were aware of the boy’s severe allergy to peanuts.

The Australian Department of Defence was fined over $A200,000.

The full judgement of the court raises several  issues that are relevant to the management of safety of people in one’s care.  The judge has recommended a State coronial inquest to determine the roles and responsibilities of Scotch College in Nathan’s death.

Justice for Nathan and his family is likely to have many more months to go. [ SafetyAtWorkBlog will follow the issue.]

A fantastic audio report on the decision is available at the ABC website. The payment of the fine back to the government is not dealt with in this blog.

The first section of the judgement (below) indicates what the judge believes are the failures that need to be addressed through an appropriate safety process:

  • Communication;
  • Instruction;
  • Provision of appropriate supplies;
  • The importance of labelling; and
  • Following procedures and guidelines

Some readers may find that this prosecution could make an interesting case study for safety management.

Kevin Jones

Justice North found that the Federal OHS Act was breached by the Commonwealth government through the Chief of Army.  The respondent

(a) supplied Cadet Nathan Fazal Francis, Cadet Nivae Anandaganeshan and Cadet Gene van den Broek with one-man combat ration packs (CRP’s) containing a satay beef food pouch which contained peanuts or peanut protein for their consumption despite having been informed that the said cadets were allergic to peanuts;
and, in so doing, it failed to:

(b) warn parents of the [Australian Army Cadets] AAC cadets about the contents of the CRP’s;

(c) warn AAC cadets about the contents of CRP’s;

(d) warn AAC cadets with pre-existing food allergies of the contents of CRP’s;

(e) make appropriate use of information provided by AAC cadets and parents of AAC cadets regarding pre-existing or known allergic conditions and correlate that information with the potential risk of being exposed to allergies through the supply of food contained in CRP’s;

(f) ensure that the contents of CRP’s allocated to AAC cadets did not include food products or allergens that may have triggered allergic responses by removing or requiring the removal of peanut-based food products from CRP’s;

(g) prevent distribution or provision of peanut-based food products to AAC cadets with pre-existing allergic reactions by:

i. inspecting the contents of CRP’s to be allocated to those individual AAC cadets who had given notice of allergic conditions;

ii. isolating cadets with pre-existing medical conditions and/or notified food allergies at the time of distribution of CRP’s and issuing them with CRP’s that did not contain peanut products or other food allergens;

iii. removing all CRP’s known to contain peanut protein or other food allergens from circulation amongst AAC cadets;

iv. requiring all AAC cadets with notified allergic conditions to provide their own food supplies;

(h) issue any or any adequate instructions or provide adequate supervision regarding distribution of CRP’s;

(i) issue any adequate instructions or provide adequate supervision regarding consumption of contents of CRP’s;

(j) prevent the consumption of CRP’s containing food allergens by AAC cadets with food allergies;

(k) distribute CRP’s after consulting or considering pre-existing medical conditions; and

(l) take into consideration the findings of a report dated 22 November 1996 by the Australian National Audit Office entitled ‘Management of Food Provisioning in the Australian Defence Force’.

SafetyAtWorkBlog Progress 1

The middle of the year is a good place to measure progress.  Since its inception in February 2008, SafetyAtWorkBlog has been viewed almost 42,000 times.  The site has received almost 300 comments and 434 articles have been posted.

For a site that inhabits a niche area, does not receive advertising revenue and provides commentary and unique content almost all the time, the blog is a proud achievement.

Thanks to all the regular viewers.

Kevin JonesBlog stats

Cheeky workers compensation premium statistic 1

“The premium has dropped eight per cent from last financial year. This is the third consecutive drop in the Commonwealth sector premium rate.” [my emphasis]

Fantastic news – eight per cent reduction in 12 months!  The media release goes on:

“… this is a very pleasing result for Commonwealth agencies as it indicates injuries are continuing to fall due to effective prevention strategies that promote safer workplaces.”

The second quote is from Martin Dolan, CEO of Comcare in Australia, on his second-last day in the job.

But 8%? In one year?

The Comcare media release includes a table of premium figures for the five years.  The overall premium rate in 2008-09 was 1.36%.  For 2009-10 it will be 1.25%, that’s the 8% fall in Comcare media release terms.  In reality it is a fall of 0.11%

The premium rate is indeed low and it may be justified in congratulating Comcare on a job well done but expressing such a fall as  8%?  This is a cheeky farewell statistic for a CEO which should have said

“a 0.11% fall from 2008-09 and a decline of 0.5% over 4 years”.

This is surely a fairer statistic and a worthy achievement in itself, if not quite so sexy.

Kevin Jones

UPDATE: 1 July 2009

Martin Dolan is moving to the Australian Transport Safety Bureau.

Safety culture improvements in Spain Reply

The improved safety status in workplaces that have an active union presence has been verified through research, but what of the efforts on safety management from outside the union research efforts.

Below is the abstract of an article that was published online late-2008 (and is available for purchase).  The research was conducted in a country with a negative safety culture so the improvements may be more marked than from outside Spain.  However, the full study (not accessed by SafetyAtWorkBlog) may provide an interesting before-and-after story.

“Occupational accidents severely deteriorate human capital, and hence negatively affect the productivity and competitiveness of countries. But despite this, we still observe a scarcity of preventive practices, an unsatisfactory management commitment and an absence of safety culture among Spanish firms. The result is evident in firms’ high accident rates.  This situation is a consequence of the general belief among firms that investing in safety is a cost, and hence has negative repercussions for their competitiveness.  The current work aims to identify good practices in safety management, and analyse the effect of these practices on a set of indicators of organisational performance.  For this, we first carry out an exhaustive literature review, and then formulate a series of hypotheses.  We then test the proposed model on a sample of 455 Spanish firms.  Our findings show that safety management has a positive influence on safety performance, competitiveness performance, and economic-financial performance.  Hence they provide evidence of the compatibility between worker protection and corporate competitiveness.”

The full article is available in Safety Science (Volume 47, Issue 7, August 2009, Pages 980-991).

Kevin Jones

B Fernández-Muñiz, J Montes-Peón and C Vázquez-Ordás, ‘Relation between occupational safety management and firm performance’ (2009) Safety Science 47: 980-991.

More workplace stressors, email and upwards bullying 7

According to a paper presented at the latest Industrial & Organisational Psychology Conference organised by the Australian Psychological Society, poor quality emails are causing almost as much stress in the workplace as the number received.

New Zealand provisional (?) psychologist, Rowena Brown, was presenting findings from her PhD studies and said

“Email is a double-edged sword. We know that email can help employees to feel engaged with and connected to their work colleagues, however the impact of a poor quality email, combined with the expectation to respond immediately, can create unnecessary stress.  Our research raises important issues for employers, who have a responsibility to train their staff in appropriate email etiquette.”

This type of research really doesn’t help business and managers to deal with the stress of their employees because it doesn’t  provide any useful control measures.  There are more significant causes of stress that demand the attention of OHS professionals and managers.

The same conference illustrates one of those other stressors.  Sara Branch, a psychologist Griffith University was quoted on the matter of employees bullying their bosses.

“Upwards bullying, like other forms of workplace bullying, is often more subtle and less obvious to other staff. However, it can also include more aggressive behaviours such as yelling, verbal threats, and confrontational phone conversations.”

“Workplaces need to understand that bullying can occur at any level in an organisation. Although managers clearly have formal authority, they can also be victims of bullying and need just as much support as other staff.”

The study also found, according to a media release about the conference, that one of the main triggers for upwards bullying is organisational change.

“If an employee is disgruntled by change, such as new working conditions, management, or processes, they may blame their manager and respond by bullying them.”

With the increased attention to psychosocial hazards in the occupational health and safety profession, it is necessary to pay attention to these sorts of studies but they are simply new perspectives on established issues that should already be monitored and changed.

These studies may illustrate the issue that OHS professionals can use to gain that managerial or client attention but they should be handled carefully so that these specific issues do not dominate the understanding on the manager or client.

SafetyAtWorkBlog advocates looking outside the OHS discipline for new evidence and understandings of workplace issues be it sociology or psychology but one must avoid reacting to hype.

Kevin Jones

Union abuse of workplace safety Reply

The fragility of Australia’s agreement for OHS harmonisation is illustrated in an article by Michael Stutchbury of The Australian.  He  mentions the potential domino effect resulting from the West Australian Treasurer’s desire to keep his options open.  New South Wales and Queensland see that a (politically unpalatable) out is possible.

Pages from Open_Ltr_to_Premiers_and_Chief_Ministers_re_OHS_harmonisation_14.5.2009The freshest information in his article was that the CEO of the Business Council of Australia (BCA), Katie Lahey, has described OHS harmonisation as “linchpin” in the government’s push for a seamless national business economy, according to Stutchbury.  This perspective is one that should be watched closely as the BCA is not renowned for its OHS innovation or advice.

Stutchbury misinterprets the pledge by the Construction, Forestry Mining and Energy Union (CFMEU)

“to make safety the key to their battle against the ABCC’s powers”.

The union is applying safety to their industrial relations battle with the ABCC because their initial attack failed.  The Government has watered down the ABCC’s powers but the ABCC will continue to exist.  Indeed the “lawlessness” of the unions has caused the Government to continue with regulatory oversight of the construction industry beyond the ABCC.  The unions are flogging a dead horse (albeit for excellent ideological reasons) and, as a result, are reinforcing the political and community perspectives of union “thuggery”.

The ABCC action against unions has not been on the basis of health and safety, as far as SafetyAtWorkBlog is aware.  It has been on the issue of union conduct, the way the union progresses on OHS matters.  The ABCC concerns stem from the process itself and not the origin of the process.

The Australian union movement needs to realise that it is its heavy-handedness on industrial relations that is impeding its progress on several fronts.  It is not getting the ear of what traditionally has been a sympathetic political party and it is failing to gain any ground in the community because of its brash conduct.  As a result it is not attracting new members.

It is also disappointing that health and safety is trotted out as a Plan B.  This has happened repeatedly and has resulted in the tactic being seen as minimally effective.  The union movement needs to see that OHS is a core value of union membership.  Workers can be confident that an OHS issue brought to management with the union’s support will get an audience, and is more likely to get fixed.

The unions will gain new members by emphasising the positive and direct benefits of union membership.  A possible campaign start could be

“You will be safer at work with a union”.

There is a place for ideological protest.  The point needs to be made that the powers of ABCC are inappropriate.  But the ABCC was introduced in response to union arrogance and excessive testosterone.  A change of culture in the union movement some time ago would have allowed it to focus on the future of its members rather than continue with its outdated and unpopular belligerence.

Kevin Jones

Varanus Island is back to normal Reply

According to various Australian media reports, the natural gas plant at Varanus Island in Western Australia is now back to full capacity following the major pipeline explosion in 2008.

The government has estimated that the explosion blasted $A2 billion from the state economy and will be pursuing the pipeline’s owner, Apache Energy, through the courts.

The government says the pipeline was inadequately maintained and corrosion led to the failure of the pipe.

Apache has already been in the courts seeking an injunction to stop the Western Australian Mines & Petroleum Minister, Norman Moore, from seeing a “a federal-state government report into alleged regulatory lapses that may have contributed to the Varanus Island blast”.

Apache’s move is peculiar but the WA government has become more involved in the investigation of this explosion than others and the company has not been happy with the investigation process for some time.

Kevin Jones