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Swine Flu lessons – presenteeism is real

There is some debate today about whether Swine Flu (in deference to the request from some pig farmers, now renamed “the Mexican Flu outbreak of 2009“) has peaked. Colleagues in Asia over the weekend told SafetyAtWorkBlog that in most circles, the Mexican Flu outbreak has not generated the same level of interest, or concern, as elsewhere. Perhaps the media studies academics can contribute to a redefinition of “global pandemic” as any disease outbreak that occurs in a country next to the United States. (Beware the Canadian Beaver Flu)

But flippancy aside, this dry-run at an influenza pandemic has many benefits and one particularly useful benefit will be a change in attitude to presenteeism in workplaces.

As the Southern Hemisphere enters its flu season and the early round of flu vaccinations concludes, Australia and others will be a test case for any attitudinal change in workers towards bringing their flu-ridden bodies to work, or in workers objecting to the contagious hazards that the presenteeists (?) introduce.

It has always been a suitable HR and OHS process to send someone home who appears impaired or unfit-for-work. In the past “essential” staff would continue to work for the sake of workload or productivity. Over time the folly of such an attitude has become obvious and workplace safety advocates have had a major role in this change. The increased absenteeism of, and the decreased productivity from, a team who have been infected by a single member is now an unacceptable health hazard and productivity threat.

This change has also been helped by the increasingly viable option in some industries for people to work from home.

The Mexican flu outbreak is likely to verify the reality of presenteeism, probably from colleagues demanding that control measures be taken on the unthinking infectious workmate. Masks may be tolerated but in the tradition of the hierarchy of controls, elimination is always preferable to personal protective equipment.

In the 1980s taxation department and many other workplaces, telephone hygienists were employed to disinfect telephone handsets. Modern handsets cannot be disassembled in the same way however, SafetyAtWorkBlog was reminded of this, at the time, peculiar hygiene practices when watching Mexicans disinfecting subways and public telephones.

In all things there must be balance, but the Mexican flu outbreak of 2009 will undoubtedly revise the way people touch things and others. In relation to influenza this is a good thing.

Kevin Jones

Cost of occupational injuries and illnesses rise

According to a report in the Australian Financial Review (page 5, not available online) on 14 April 2009, the costs of work-related injury and disease has increased to $A57.5 billion. This represents 5.9% of the country’s gross domestic product, up from 5% in 2000-01.

Of perhaps more concern is the sectors of society which are estiimated to bear these increasing costs. 49% of costs are borne by workers, 47% by the community and 3% by the employers. Even if the insurance costs were allocated to employers, this would only amount to 18% of the injury and diseases costs.

The figures from the report conducted by the Australian Safety & Compensation Council could justify the push by some in the OHS profession to move workplace safety into the area of public health. Regardless, the spread of the cost should be borne in mind when OHS organisations lobby government for more support and attention.

Kevin Jones

April 28 – Workers’ Memorial Day

This annual event seems to receive more attention in Europe than elsewhere although over the years several Australian capital cities have erected workers’ memorial stones. It is usually here that ceremonies occur.

I always attend these services in my own right as it helps to keep me grounded as I wade through risk assessments, policies, consultations, and other safety ephemera.

One of the chilling parts of the service is always the reading of those who have died over the previous twelve months. This has echoes of the 9/11 recital each year but for the worker memorial there is a new set of names each year and a new set of families and a new round of grieving.

Please check your local town and city activities lists and attend this year’s event.

In support, the UK’s Hazards magazine has produced a simple but effective poster that can be downloaded.

Kevin Jones

OHS context of leave entitlements

Family-friendly work initiatives always get increased attention around International Women’s Day. This is a shame as work/life balance is not gender specific, however the dominant Western family structures make the application of the concept relative to gender. As long as the matter is perceived as a “women’s issue”, it will struggle for attention in a basically patriarchal society.

Family-friendly work structures are predominantly associated with hours of work and leave entitlements. These don’t seem to be OHS matters as they are mostly handled through HR or the pay department however there is a link and it is a link that work/life and work/family advocates may use as a strong argument for their cause.

Leave is a worker entitlement for several reasons:

Situations may occur where the employee is required to stay home to look after an ill relative;
The employee may stay home as they are too sick to work; and
The employee may feel they need time away from work to rebalance their lives.

The second point has an OHS relevance because going to work while sick may introduce a hazard to your work colleagues – presenteeism. In many jurisdictions it is a breach of an employee’s OHS legislative obligations to not generate hazards for their work colleagues or members of the public while at work.

The third point relates to an individual’s management of stress and/or fatigue.

In Australia, some workplaces allow for “doona days” (or for those in the Northern hemisphere’s winter at the moment “duvet days”). These are days where a workplace and the employee would benefit psychologically from some time-out in order to “reboot”.

It may also be a valid fatigue management mechanism where long hours have been worked to the extent where attending the workplace may present hazards to others, or to themselves by feeling impaired, or have the employee working well below the appropriate level of attentiveness for the job to be properly done.

Leave entitlements, to some extent, form part of the employer’s legislative obligations to have a safe and healthy work environment. But they also support the worker’s obligations to look after themselves and not present hazards to others.

The OHS element of leave entitlements should be emphasized when discussions of family-friendly workplaces occur. Not only does it legitimately raise the profile of OHS in business planning, it can add some moral weight to an issue that can get bogged down in industrial relations.

Some readers may want to check out recent presentations to the US Senate in early-March 2009, by various people on the issue of family-friendly work structure. These include

Eileen Appelbaum, Director of the Center for Women and Work at Rutgers University,

Dr Heather Boushey, Senior Economist at the Center for American Progress Action Fund,

Rebia Mixon Clay, a home health care worker who cares for her brother in Chicago. (Rebia’s video is below)

Kevin Jones

International Women’s Day (of safety)

The global theme for the 2009 International Women’s Day (8 March 2009) is

“Women and men united to end violence against women and girls”

The organising committee is at pains to stress that although this is a global theme, individual nations, individual states and organisations are able to set their own themes. Some themes already chosen include

Australia, UNIFEM: Unite to End Violence Against Women
Australia, QLD Office for Women: Our Women, Our State
Australia, WA Department for Communities: Sharing the Caring for the Future
UK, Doncaster Council: Women’s Voices and Influence
UK, Welsh Assembly Government: Bridging the Generational Gap

Given that Australian health care workers suffer occupational violence, amongst many other sectors, and that employers are obliged to assist workers who may be subjected to violence at work or the consequences of non-work-related violence, it seems odd that so often the major advocates of International Women’s Day remain the unions.

It is also regrettable that many of the themes internationally and locally are responding to negatives rather than motivating action from strengths.

As is indicated from the list above, the public sector agencies are keen to develop programs around the international day. The societal and career disadvantages of women are integral to how safety is managed.

Stress, violence, adequate leave entitlements, security, work/life balance, chronic illness – all of these issues are dealt with by good safety professionals. Perhaps a safety organisation or agency in Australia could take up the theme of “Safe work for women” and look at these issues this year using gender as the key to controlling these hazards in a coordinated and cross-gender fashion.

In support of women’s OHS (if there can be such a specific category), readers are reminded of an excellent (and FREE) resource written by Melody Kemp called Working for Life: Sourcebook on Occupational Health for Women

Kevin Jones

Eliminate the hazards

The first control measure on the “hierarchy of controls” is to eliminate the hazard. OHS consultants and professionals should always consider ways to achieve this. It may prove to be impractical, or politically unpopular, but it should always be discussed or recommended. Reports and submissions that do not consider this control measure can be considered invalid.

In late-January 2009, the organic farmers in Australia reminded the media that its farming members are developing a safer industry for the customer and the producer. This industry has boomed in Australia since the 1970’s in as a result of a desire and commitment to “eliminate the hazard”.

Interviews conducted by Biological Farmers of Australia (BFA) to help discover why producers ‘go organic’ reveal a high number of farmers consider the switch for the health of themselves and their families.

Rob Bauer (Bauers Organic Farm, Qld), one of Australia’s largest organic horticultural growers, says he turned to organic farming 27 ago after farmers in his area became ill with cancer.

He says he wanted to decrease health risks associated with synthetic farm chemicals.

“I started thinking about farming differently after growing up in the Lockyer Valley (Qld) where friends and family passed away in their fifties after years of intensive agrichemical production.”

He says neurological problems, tumours, and cancer were among the chronic diseases he watched take their toll on his local farming community.

“I wasn’t comfortable with producing food using harsh farm chemicals for consumers,” he says.

Steve Skopilianos, commercial lettuce producer from Ladybird Organics in Keilor (Vic) looked into organics when he started a family.

“We had been applying pesticide blends with no understanding of their effect on people and employees. There were times prior to organic conversion where I would not take my own produce home for my family to eat.”

Biodynamic producers of macadamias are happy to avoid high levels of agrichemicals typically used on the nuts.

“Working without a high exposure to synthetic chemical farm products is a weight off your mind,” says Marco Bobbert, from Wodonga Park Fruit and Nuts macadamia plantation (Qld), certified biodynamic since 1987.

He says direct chemical exposure could easily occur on conventional farms from accidents in production. “All it takes is a broken spray pipe.”

He says it is not just organic farmers who are concerned – “All farmers try to minimise their contact with chemicals on-farm. But organic production actively works toward negating that risk”.

Research has shown there is good reason for producers’ concern – a high exposure to some farm chemicals can lead to major health problems.

Particularly problematic substances include organophosphate insecticides and pesticides, which have been connected to several types of cancer, sterility and cognitive deficits (1).

The agrichemical endosulfan is one example of a highly toxic organochlorine cyclodiene) insecticide still in use in Australia.

1. (1) Ciesielski, S, Loomis, D, Rupp Mims, S, Auer, A, Pesticide Exposures, Cholinesterase Depression, and Symptoms among North Carolina Migrant Farmworkers; American Journal of Public Health, 1994.

Workplace health initiatives in unstable economic times

All through the Presidency of George W Bush, safety professionals have been critical of the lack of action on workplace safety. As with many issues related to a new Democrat President in Barack Obama, organisations are beginning to publish their wishlists. The latest is the American College of Occupational and Environmental Medicine (ACOEM).

On 9 January 2009, ACOEM released a media statement which began

“American College of Occupational and Environmental Medicine (ACOEM) calls on the Health and Human Services Secretary-designee Tom Daschle to address the critical link between the health, safety, and productivity of America’s workers and the long-term stability of its health care system and economy as he begins work on the Obama administration’s health care agenda.”

The requested changes could be interpreted as a criticism of what the situation has been under George W Bush. ACOEM says the next government

“must put a greater emphasis on ensuring the health of the workforce in order to meet the twin challenges of an aging population and the rise of chronic disease…”

ACOEM President Robert R. Orford, MD goes into specifics

“…calling on Daschle to focus on preventive health measures aimed at workers that could range from screening and early detection programs to health education, nutritional support, and immunizations.”

The ACOEM reform program is based on the following

“investing in preventive health programs for workers;
creating new linkages between the workplace, homes and communities to reinforce good health;
providing financial incentives to promote preventive health behaviors among workers; and
taking steps to ensure that more health professionals are trained in preventive health strategies that can be applied in the workplace.”

Accepting that one Australian State, Victoria, is considerably smaller than the US (Victoria has a population of around 5,200,000, the US had 301,621,157 in 2007), it is interesting to remember what the Victorian Government proposed (or promised) just on 12 months ago concerning its WorkHealth initiative.

“Over time the program is expected to free up $60 million per year in health costs, as well as:

Cut the proportion of workers at risk of developing chronic disease by 10 per cent;

Cut workplace injuries and disease by 5 per cent, putting downward pressure on premiums;

Cut absenteeism by 10 per cent; and

Boost productivity by $44 million a year.”

[It would be of little real benefit to simply multiple the Victorian commitments by the differential with the US population to compare monetary commitments, as there are too many variable but if the WorkHealth productivity was imposed on the US, there could be a $2.6 billion, not a lot considering the size of President Bush’s bailouts and Barack Obama’s mooted bailout package. However, in the current economic climate, in order to gain serious attention, any proposal should have costs estimated up front and, ideally, show how the initiative will have minimal impact on government tax revenues – an approach that would require.]

In each circumstance there is the logic that unhealthy people are less productive than healthy people. This sounds right but it depends very much on the type of work tasks being undertaken. It is an accepted fact [red flag for contrary comments. ED] that modern workloads are considerably more supported by technology than in previous labour-intensive decades. Perhaps there are better productivity gains through (further) increased automation than trying to reverse entrenched cultural activity.

In late 2008 an OHS expert said to a group of Australian safety professionals in late-2008 that WorkHealth

“is not well-supported by the stakeholders. The trade unions feel it is a diversion away from regulated compliance and that it is going to refocus the agenda on the health of the worker and the fitness of the worker as the primary agenda, which is not what the [OHS] Act is setup to focus on. The employers are basically unkeen to get involved on issues they think are outside their control.”

The expert supported the position of some in the trade union movement that WorkHealth was always a political enthusiasm, some may say folly.

This is going to be of great importance in Australia with the possibility of new OHS legislation to apply nationally but also muddies the strategic planning of any new government that needs to show that it is an active and effective agent of change, as Obama is starting to do. In the US, the public health system is not a paragon and the workplace safety regulatory system is variable, to be polite. Fixing the public health system would seem to have the greater social benefit in the long term, and a general productivity benefit.

(It has to be admitted that the packaging of health care in employment contracts in the US is attractive employment benefit and one that seems to be vital to those who have it. Australia does not have that workplace entitlement but those employers struggling to become employers-of-choice should serious consider it, particularly as a work/family benefit.)

Each country is trying to reduce the social security cost burden on government and it would seem that public health initiatives would have the broader application as it covers the whole population and not just employees, or just those employees who are unfit.

Work health proposals in both jurisdictions need to re-examine their focuses and to pitch to their strengths. Business has enough to worry about trying to claw its way out of recession (even if the US government is throwing buckets of money to reduce the incline from the pit). OHS professionals have enough work trying to cope with the traditional hazards and recent, more-challenging, psychosocial hazards. Workplace health advocates are muddying the funding pool, confusing government strategic policy aims, and blending competing or complementary approaches to individual health and safety in the public’s mind.

Kevin Jones

Update 16 January 2009

More information on this issue is available HERE

Category: community

Swine Flu lessons – presenteeism is real

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Cost of occupational injuries and illnesses rise

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April 28 – Workers’ Memorial Day

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OHS context of leave entitlements

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International Women’s Day (of safety)

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Eliminate the hazards

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Workplace health initiatives in unstable economic times

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