Beware the OHS hype on chronic obstructive pulmonary disease

World COPD day was held on 17 November 2008.  COPD Stands for chronic obstructive pulmonary disease. As with many of these health-related days there is more hyperbole than substance and often the most relevant information appears after the hype has died down.  This is the case with a report just released by the Occupational And Environmental Medicine. [[Chronic obstructive pulmonary disease mortality in railroad workers Online First Occup Environ Med 2008; doi 10.1136/oem/2008.040493]]

According to a media statement that accompanied the report:

They wanted to gauge the long term effects of diesel exhaust on the risks of developing chronic obstructive pulmonary disease (COPD), an umbrella term for progressive lung diseases, such as emphysema and bronchitis.

In 1946, just 10% of rolling stock was diesel powered; by 1959, virtually all rolling stock was.

The researchers checked the health records of the US Railroad Retirement Board, which has maintained digital records of all its employees since 1959, including a yearly listing of all job codes and time spent in post.

Anyone working on the trains (conductors, engineers, brakemen) was considered to have been exposed to diesel exhaust.

Those working in ticketing, signalling, maintenance, admin, and as station masters, were regarded as not having been exposed.

The results showed that those who had been exposed to diesel exhaust were more likely to die of COPD than their peers who had not been so exposed.

The risks increased by 2.5% with each year of employment among those who were recruited after conversion from steam to diesel locomotives.

This risk fell only slightly after adjusting for smoking, a known risk factor for COPD.

Of all the reports that were released in the last two weeks, this one is the clincher because it shows that smoking did not have an appreciable effect on the health findings.  There is a direct relationship between a work activity in a work environment and worker health.

This correlation is sadly lacking from other COPD data which reads primarily as a new spin on anti-smoking campaigns.

According to the International COPD Coalition (“a nonprofit organization composed of COPD patient organizations around the world, working together to improve the health and access to care of patients with chronic obstructive pulmonary disease”)

World COPD Day 2008 features new patient and health professional initiatives that address the misconceptions and lack of awareness surrounding chronic obstructive pulmonary disease (COPD). These misconceptions – revealed in a global survey, the International COPD Coalition (ICC) Report – include poor public awareness that smoking is the main cause of COPD, a failure to diagnosis COPD in its early stages, when medication can be used to prevent further lung deterioration, and a mistaken belief that initial COPD symptoms, like coughing and shortness of breath, are a normal consequence of aging.

We may be unaware smoking leds to COPD but we are well aware that smoking can kill you.  Whether it is emphysema, lung cancer, heart disease or COPD doesn’t change the fact that smoking increases the risk of premature death.  It is insulting that a “World Anti-Smoking Day” needs to masquerade under a new health risk.

For those workers who have suffered work-related respiratory problems the Queensland governmenthave  released a very good guide for those who have breathing difficutlies or for those who look after them – the Better Living With COPD – A Patient Guide  (pictured below)

pages-from-better_living_with_copd_a_patient_guide_low_res1

When too many graphic ads is never enough

Coming to the end of Australia’s school year, the government is going overboard with confronting advertisements for young people, be they related to work safety or binge drinking.

At least the OHS regulators watched other regulators information campaign and reduced their costs by resisting promoting the same message in the same way to the same demographic.  WorkSafe Victoria‘s Homecoming campaign has been phenomenally popular and influential.

Sadly, the health promotion sector doesn’t coordinate their effort (or have exhaustive budgets).  The Minister for Health, Nicola Roxon, has launched the latest set of confronting ads for teenagers, this time on binge drinking.  With such a lack of coordination, the target audience is going to be quickly turned off the ads, instead of turning off the bad behaviour.

Each time this graphic approach is used, the message, regardless of the topic, is severely weakened.

Sadly, we’ve seen it all before (and only a month ago).

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The graphic workplace ads keep coming

On 29 October 2008, WorkSafe Alberta released a series of graphic workplace safety ads under the banner “BloodyLucky”.  They are as confronting as the recent WorkSafe Victoria ads and raise many of the same questions about appropriateness, applicability and effectiveness.

The website www.bloodylucky.ca has a cheesy format that doesn’t fit with the explicit nature of the ads.  It is as if they want to blunt some of the impact by adding cheesy humour but it is confusing.  It may be that they intend the cinema presentation to mask the initial advertising impact so that the crush injury from the forklift or the chemical burns to the young girl have maximum shock value.  

Overall the ads are confusing and the ironic title “bloody lucky” doesn’t work on all the ads.

Recently a domestic violence campaign in Australia went with an ironic “thank you” message against inaction and compliance.  This misses the target also except on the ad of the adult male shutting the bedroom door through which we view a young girl.  That ad is genuinely disturbing. [links will be provided when available online]

Compare this to the student-produced video that is effective and dramatic without being extreme, bloody or weakly humourous.  This ad is a little long for a commercial ad but as a short safety video it works very well and the positive steps that can be taken are part of the ad, not an obscure link.

Advertising safety

SafetyAtWorkBlog has received some terrific comments on the various marketing strategies for addressing the safety of young people at work and in their private (public) lives.

A colleague of mine in Western Australia remains sceptical of the type of imagery employed but below are two other comments:

”   thanks for your posting on the alcohol campaign, you are quite correct – these are the kinds of advertisements that connect with the younger set – they have grown up in a world of gore (video games, movies, TV shows that show more and more). Older people don’t understand this – just a generation gap thing.”

“I think it is an excellent way to reach our youth. If it only saves one teenager from a life of over-drinking or saves one innocent life on a highway, it has met the purpose.”

As with many safety campaigns, the measurements of success are often difficult to find.  OHS regulators point to declining fatality and injury figures but these, sometimes, don’t stand up to scrutiny.  With awareness campaigns of this type, performance indicators are crucial, and should be reported publicly.

Branding strategies are okay but their aims are limited and raising one’s awareness of something does not, in itself, change behaviour.  Awareness needs an extra spur for action to occur.  That is why I look forward to the next stages of these campaigns.   Let’s hope they build on their good work rather than tweaking a failing strategy.

Marketing to teenagers and youth

SafetyAtWorkBlog has mentioned several campaigns recently focusing on promoting safety to young people through graphic ads in Australia and Canada, and enticing websites.  The Queensland Government launched a promotional campaign to the same demographics this week but this one focuses on excessive, or binge, drinking. drink-counts This is timely leading into the Christmas season and Summer in the Southern Hemisphere and it should be successful in its first stage of cinema advertising and social marketing.   The campaign has a similar advertising structure to the graphic OHS ads but depicting a young person undertaking an activity and suddenly switching to an unexpected consequence. A spokesperson for the Every Dr1nk Counts campaign in Queensland’s Office of Liquor, Gaming and Racing told SafetyAtWorkBlog that the videos are initially shown only in cinemas on targeted movie sessions as the viewer is unable to avoid the 45 second images as easily as they can a television ad.  Also, cinema ads will be seen by the target audience in a group of their peers which will encourage discussion on the issues raised. The ads are confronting but are well made and subversive in getting one’s attention. Treasurer and Liquor Licensing minister Andrew Fraser said that

“This advertisement highlights the fatal consequences of excessive drinking in the hope that young adults will take notice and make more responsible choices for their futures.”

Minister Fraser also said

“our focus group research also revealed that many young people don’t realise that one stubby or one alco-pop is usually more than one drink. We are not asking young people to stop drinking, we are just asking them to recognise that there are worse consequences than a hangover.”

The correlation to youth marketing is clearly evident but excessive drinking and the associated culture of alcohol consumption is a problem that many workplaces are facing also.  It is common in some industries to have a worker be unfit for work after a heavy night and for alcohol and drug policies to be introduced and enforced.  There are bound to be some OHS Managers and workplaces who will see the benefit of obtaining some of the Every Dr1nk Counts resources in an workplace context.

Young Worker Safety – Part 3

Several colleagues have pointed to a young worker safety website that was established in Canada several years ago, http://www.notworthit.ca/ .   The site, part of the WCB’s Young Worker campaign, won an award from American Association of State Compensation Insurance Funds in their annual Communications Awards in 2007.

There are remarkable similarities to The Pain Factory, even to the point of encoruaging young workers to tell their own stories.  The similarity is, perhaps, justified when considering the safety message is aimed at the same demographics, however it shows that originality is rare in occupational health and safety promotions.  Certainly the use of internet videos is a marked difference between the sites but the success of NotWorthIt should be remembered if The Pain Factory is also put forward for advertising or communications awards.

WorkSafe CEO, John Merrit is a strong advocate of his organisation’s young worker campaign.

Unions question the targeting and success of graphic WorkSafe ads

One of the most popular recent postings at SafetyAtWorkBlog has concerned the graphic ads aimed at young workers by WorkSafe Victoria. Last week a safety group meeting was told that WorkSafe focus groups of teenagers had said that to get the attention of young people on workplace safety, advertisements needed to be graphic and confrontational.

However, other young workers tell a different story.  According to the Victorian Trades Hall,

“Feedback from young workers taken recently indicates the message they are taking from the ads is that if you get injured at work it is your fault. They paint a very negative stereotype of young workers.”

Trades Hall also reveals that WorkSafe’s own research does not necessarily fit with some of the current WorkSafe language:

“Research conducted for WorkSafe by Sweeneys in April this year does not demonstrate that young workers are ‘apathetic’. Rather it advises that young workers:

  • lack knowledge of their rights at work, what to do if they got injured, and of IR and OH&S issues;
  • mimic the behaviour and attitudes they observe around them from older workers and supervisors;
  • had a general reluctance to speak up or ask question because they are intimidated and worried about losing their job or think their boss will think they’re stupid;
  • are perceived as apathetic or arrogant by employers, which the research noted was due to young workers being too intimidated and worried about looking stupid to speak up.”
UPDATE: ads are now available through Youtube – nailgun, bakery,    kitchen  
It seems that the WorkSafe Victoria ads are not available on Youtube but the Canadian WSIB ads are.  It is worth reading some of the comments posted under the videos to see what a small section of Youtube viewers, presumably the “Youtube generation” the ads are aimed at, think of the ads.
Given that next week is Safe Work Australia Week and WorkSafe Victoria is likely to promote the young worker ads as a cornerstone of its safety promotions campaign, it is worth trying to listen behind, or between, the good news to determine if the campaign will, in reality, achieve the aims of reducing young worker deaths and injuries.
Recent satirical television shows, such as The Hollowmen, have shown a possible manipulation of focus groups in a similar way that the production of departmental reviews were shown to be politically influenced in Yes Prime Minister.  Focus groups and market research may be the best techniques we have but that doesn’t mean that the findings should be uncritically accepted.
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