Workplace health initiatives in unstable economic times

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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

Safety challenges for English pantomime

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Today, the UK Daily Mail published an example of the mish-mash of safety management problems that are confusing the public about what an OHS professional does.

An amateur Christmas pantomime is confused by the plethora of safetyand health obligations being placed on them by, it is assumed, a variety of regulators.  Let me speculate on what may be behind some of the issues.

“scenery is free from sharp edges” – a good set designer, even an amateur one, should already have this aim as part of their skills.  Backstage in theatrical productions is notoriously dark and often full of people, round the edges of scenery is not an unreasonable expectation.

The theatre company chairman says that the facility is not the best.

“Mr Smith, 59, a training manager, also claims that Brierley Hill Civic Hall’s backstage facilities are ‘poorer than Cinderella’s kitchen’ making it all the more difficult to meet the health and safety requirements.”

Ice cream and milk temperature is a matter of food safety.  These can easily be managed by the facility manager providing suitable refrigeration.  If the facility is a regular venue for theatrical productions it is not unreasonable to expect the venue to be fit-for-purpose.  Graeme Smith says that the company has already solved the issue to some degree:

“The 100-strong am-dram group, which was first formed 60 years ago, has also bought a freezer because it does not trust the reliability of the venue’s, Mr Smith said”

Clearly, Mr Smith has as many problems with the venue as he does with the safety needs of his production.

Climbing a beanstalk with a harness – many theatrical productions have incorporated harness into aerial effects or revised their sets and direction to depict climbing without physically climbing 30 feet.  This is a pantomime and it involves acting so act like you’re climbing a beanstalk.

Chaperoning children – mothers of stage children have been doing this for years.  The nature of backstage may require supervision of children to reduce the hazards of dozens of excited children causing problems and creating hazards for other stage workers.  Depending on the layout of the facility the dressing rooms may some way from the stage, perhaps through public areas, and supervision is not an unreasonable expectation.

“do not enter the props storage area” – all workplaces have areas that restrict unauthorised access for good reason.  Supervision may be the best available control measure for the circumstances.  The article refers to pyrotechnics.  If these were to be used in this production and the pyrotechnics were stored in the props area, entry restriction would be more than reasonable.

“inform the audience before the performance if pyrotechnics are to be used.”  It is peculiar that the audience is informed as pyrotechnics should be configured to operate with no risk to audience, actors, or stage staff.  If the reason for this advice is fire safety, then this relates again to the suitability of the facility itself, to fireproofing, fire exits etc.  Given the fires that have resulted from unsafe use indoors of pyrotechnics over the last few years, increased warnings seems appropriate.

I am not sure about the need to identify curtain users but the need to prevent people falling into the orchestra pit is obvious.  It is implied that this would only occur outside of productions and rehearsals and, in that case, this would be the responsibility of the facility manager.  Boarding up the pit may be an excessive control measure and alternative barriers may be appropriate.  Again this also relates to the initial design of the facility.

There are enough hints in the article to show that the suitability of the Brierley Hill Civic Centre for theatrical productions needs to be reviewed.  Many of the theatre company problems seem to be to accommodate design and layout deficiencies.

The Australian theatrical union issued safety guidelines for live theatre productions in 1999

The HSE and the Association of British Theatre Technicians has safety guidelines on pyrotechnics  and a range of other publications related to theatrical productions.

Clearly there is no “idiot’s guide to amateur productions” but there may be a need for such a publication.  The experience of the Brierley Hill Musical Theatre Company shows how one small event can be bombarded by attacks from all sides when all the company wants to do is put on a pantomime.  Theatrical productions have always been big management challenges and health and safety has always been part of this process. 

It was a fantasy sixty years ago when Judy Garland and Mickey Rooney could put an elaborate stage show together overnight in the movies. It remains a fantasy.

Kevin Jones

Mobile Phones and Driving

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Work tools, such as the company car and the mobile phone, can be fun and functional but when used at the same time, the combination is deadly. 

According to media reports a study by the Federal Department of Transport survey of 1500 drivers has shown that 

[in Victoria] about 61 per cent said they had used a mobile while driving, up from 47 per cent in 2005…. More than one-quarter admitted reading a text message while driving, while 14 per cent said they had sent one.
Yet 42 per cent of drivers nationally supported any law banning the use of hands-free mobiles while driving.
Victoria Police caught more than 1800 drivers for mobile phone offences during the holiday period.

SafetyAtWorkBlog has mentioned previously that road safety research rarely logs whether a vehicle is being used for work purposes.  The full survey report is  not yet available and, to a large extent, the media reports have focused on activities related to the Australian h0liday season – alcohol use as well as texting.  

When it is available, SafetyAtWorkBlog will report on any data that could indicate the use of work vehicles as it is inaccurate to simply use road safety data as an overlay of occupational activities.

The use of company vehicles is a complicated area due to the status of the vehicles changing depending on whether the vehicle is a “pool vehicle” or whether the vehicle is able to be used for private purposes.  The one vehicle could be both a work vehicle and private vehicle at different times of the day.  This is the challenge for OHS professionals – to deal with a workplace and an employee who is neither of these 100% of the time.  Unless this status is clarified, any potential policy on mobile phone use whilst driving remains problematic.  Yet the hazard remains.

safe_driving-coverWorkSafe Victoria released a safe driving guide in November 2008 that acknowledges the hazard but clearly leaves it up to the employer to determine the appropriate policy:

The TAC  (Transport Accident Commission) and WorkSafe recommend that hands free calls be kept to a minimum and reserved for emergency type calls.
Handheld mobile phone use is illegal and should not be considered under any circumstances while driving.  Texting or reading texts or caller ID should not be done at any time whilst driving.

Without definitive advice from regulatory bodies but with mounting evidence of the heightening risk of injury and property damage, it will be a brave company that bans the use of mobile phones whilst driving (the ideal OHS control measure).  However, this is one of the risks faced when evidence of hazards is called for but we don’t like the evidence.

OHS Podcast with Andrew Douglas

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One of the services that Workplace Safety Services (the company behind SafetyAtWorkBlog) provides to its clients are podcasts.

The Safety Institute of Australia had a podcast produced principally to promote its Safety In Action Conference, which is in Melbourne Australia on 31 March to 2 April 2009, that includes an interview with Andrew Douglas.  Andrew is speaking at the SIA09 conference and is a director of Douglas Workplace and Litigation Lawyers.

In the podcast he discusses making OHS a core business function, the OHS role in small business and the not-for-profit sector, and how important it was for him personally and professionally to be involved with the Safety In Action conference.

The podcast is a short promotional one but you may find Andrew’s comments of interest and use.

Mental support research

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In SafetyAtWorkBlog in 2008 there have been several posts concerning suicide.  There is a growing research base on the matter and The Lancet adds to this through an article published in December 2008.

Researchers have found that the type of mental health services provided to the community can affect the rate of suicide.  This is important research even though SafetyAtWorkBlog regularly questions the applicability of research undertaken in Scandinavian countries to the rest of the world.  Bearing the cultural differences in mind, the research will stir debate and, hopefully, localised research along the same lines.

Below is the text of the press release about the research:

WELL-DEVELOPED COMMUNITY MENTAL-HEALTH SERVICES ARE ASSOCIATED WITH LOWER SUICIDE RATES

Well-developed community mental-health services are associated with lower suicide rates than are services oriented towards inpatient treatment provision in hospitals. Thus population mental health can be improved by the use of multi-faceted, community-based, specialised mental-health services. These are the conclusions of authors of an Article published Online first and in an upcoming edition of The Lancet, written by Dr Sami Pirkola, Department of Psychiatry, Helsinki University, Finland, and colleagues.

Worldwide, the organisation of mental-health services varies considerably, only partly because of available resources. In most developed countries, mental-health services have been transformed from hospital-centred to integrated community-based services. However, there is no decisive evidence either way to support or challenge this change.

The authors did a nationwide comprehensive survey of Finnish adult mental-health service units between September 2004 and March 2005. From health-care or social-care officers of 428 regions, information was obtained about adult mental-health services, and for each of the regions the authors measured age-adjusted and sex-adjusted suicide risk, pooled between 2000 and 2004 – and then adjusted for socioeconomic factors.

They found that, in Finland, the widest variety of outpatient services and the highest outpatient to inpatient service ratio were associated with a significantly reduced risk of death by suicide compared to the national average. Emergency services operating 24 hours were associated with a risk reduction of 16%. After adjustment for socioeconomic factors, the prominence of outpatient mental-health services was still associated with a generally lower suicide rate.

The authors conclude: “We have shown that different types of mental-health services are associated with variation in population mental health, even when adjusting for local socioeconomic and demographic factors. We propose that the provision of multifaceted community-based services is important to develop modern, effective mental-health services.”

In an accompanying Comment, Dr Keith Hawton and Dr Kate Saunders, University of Oxford Department of Psychiatry, UK, say: “The message to take from these findings must be that while well thought out and carefully planned new developments that increase access to secondary care services for mental-health patients are to be encouraged, measured progress towards flexible community care, not rapid ongoing change, should be the order of the day.”