Category: guidance

Corporate health adviser’s recommendations on swine flu

Recently SafetyAtWorkBlog wondered why the ACT OHS Commissioner referenced a commercial website instead of a government authority.  The commercial website was www.fluthreat.com operated by HSA Group which since early April 2009 is part of Medibank Private.

Fluthreat.com.au provides information on its Flu At Work page that is very flimsy and seems to be  intended to generate further enquiries to its commercial advisory service.  We’re not comfortable with that or the lack of badging from the parent company but…….

SafetyAtWorkBlog put some questions to HSA Group/Medibank and received the following responses from their media advisor over a week later.  We could be picky but we have decided to let the responses speak for themselves.

The questions were based on the bulletpoints listed on the Flu At Work page in order to flesh out the advice to a more practical level.

What does HSA Group recommend for basic personal respiratory hygiene methods?

HSA’s fluthreat website covers basic respiratory hygiene considerations.  Personal habits that we all should adopt include covering mouths when coughing and sneezing, using tissues and disposing of them properly, and regularly washing of hands.

In this time of swine flu, is the old way of throwing tissues in a waste basket no longer the right option?

Using a waste basket is fine.  The important thing is the waste is disposed of appropriately, and the waste basket does not require excessive handling in the disposal process.

Handwipes and gel have issues of their own – should they be applied after handwashing or instead of, should they be used after each sneeze or cough? What does HSA recommend?

Considerations of personal  hygiene should be a regular occurrence – not just simply after each sneeze or  cough.  Handwipes and gels are for occasions when you can’t wash your hands – it is not necessary to use both.  Handwipes and gels should be alcohol based, which has been shown to be effective in killing influenza type viruses.

Regarding adequate cleaning of surfaces and equipment, should this be undertaken by the users of the equipment or should cleaning contractors be contacted in order to upgrade their processes?

Unfortunately there is no one simple answer to this question.  Every business operates differently, and therefore will require a different response to a pandemic.  We encourage all businesses to have a pandemic plan, which will guide the business wide response.

Certainly cleaning of surfaces and equipment should be considered in the context of an organisation’s pandemic plan, and may include having staff take additional care for hygiene and cleaning, or having cleaning contractors upgrade their processes.  The appropriateness of such considerations are linked to the pandemic phase & an organisation’s response strategy in the context of their pandemic plan.

Regarding telephones, which are the closest item most office workers have to their mouths, years ago there were phone cleaners who  physically came to the office to clean and disinfect  handsets. Would HSA recommend this service be reinstated?

These services are still available for businesses who want them.  Alternatively staff can be trained to do it themselves with alcohol based wipes.  Again the specific needs of businesses will vary, and cleaning of telephone handsets should be set out in the pandemic plan.

In a closed environment, such as an office, where possible, should ventilation be increased by opening a window?  Some office buildings turn off they ventilation overnight even when nightshift workers are in the building.  Does HSA believe that nightshift workers could be at increased risk of contracting influenza?

Ventilation is important in workplaces, and not just due to swine flu. Where windows can be opened without affecting the air-conditioning flow this will help with ventilation. Air conditioning should remain on if people are present in the building.  However there is no evidence that nightshift workers are at an increased risk of contracting influenza – it is the behaviour of workers and their levels of personal hygiene that are the strongest influence on this.

Regarding encouraging sick persons to stay at home, why only “encourage”, when  employers have the legislative obligation to not place their employees at risk? What if the employee has shown no symptoms of influenza but may be infectious due to contact with a family member who is sick?

Employers should have policies in place that articulate how staff should  behave in such circumstances, and ideally a plan that covers pandemics specifically.  There is only a very small risk of people being infectious prior to symptoms appearing.

Sending workers home after the illness has appeared is an acknowledgement that illness is already present in the workplace.  In this instance, what would HSA advise the employer to do?

Employers should continue to activate their pandemic plan, which will trigger workplace specific staff communications and contingency plans.

Does HSA recommend the wearing of facemasks as a suitable control measure for anyone who may come to work sneezing (for whatever reason)?

Facemasks can be very helpful in controlling the spread of respiratory diseases.  However it should be noted that a sneeze does not necessarily equate to H1N1 or seasonal influenza.  A diagnosis of suspected H1N1 or seasonal influenza requires consideration of a number of other factors.

Regardless of the further information from HSA Group/Medibank, SafetyAtWorkBlog still recommends that the best advice is available from the relevant health authorities in your State or country.

Kevin Jones

Lack of restraint – Australian approach, Singapore deaths

sa0200906[1]_Page_1The Northern Territory OHS  authority issued a guidance this week about unrestrained travel in work vehicles, a practice many of us stopped some time ago.  Obviously not everyone has.

The NT guidance is a curious document as it strongly advocates that employers assess the hazards of unrestrained travel and decide the appropriate control measures.  This advice is in line with legislative requirements and safety management protocols but clearly the authority has much clearer advice.  The document is headed 

“No seat – No belt – No ride”

The assessment has been done and the heading gives the best advice.  In OHS profession speak – if there is no seat for a passenger and/or no seat belt then NT OHS says allowing someone to travel on or in the vehicle is not acceptable.

Australia can often be glib about workplace incidents as it always looks past its region for comparisons from the US or Europe rather than looking at its immediate neighbourhood.  

Singapore’s Strait-Times reported in May 2009 about the real consequences of unrestrained travel after

“…three foreign workers sitting in the back of a lorry died after it crashed into the back of a trailer. A fourth man in the front seat also died.”

The article goes on to list the law changes that Singapore has introduced but, more interestingly, tells how much more complicated the issue is than in Australia due to the level of foreign labour.

Kevin Jones

Should OHS regulators be involved in the competence of professionals?

WorkSafe and the Safety Institute of Australia are at the forefront of pushing for a defined level of competence for the safety professional.  WorkSafe identified this need many years ago and has been working on establishing alliances with safety professions since then to achieve its aims.

Significantly similar issues have been discussed in the United Kingdom over a similar period however, in that process the WorkSafe equivalent, the Health & Safety Executive (HSE), have chosen not to participate.  According to a recent article in HEALTH AND SAFETY AT WORK, the HSE has stated its position

“Speaking at IOSH’s recent conference, HSE chief executive Geoffrey Podger was adamant that the general description of competence in the Management of Health and Safety at Work Regulations 1999 (MHSW) Approved Code of Practice (ACoP) is sufficient. “I don’t think it helps the whole health and safety system if HSE tries to over-define the area,” he said, adding that there is still a “huge opportunity” for the professional bodies to work on their own definition.”

This position is considerably different from that in Australia where WorkSafe is now closely working (some would say too closely) with the SIA in developing standards and protocols that it and its partners want to operate nationally. Its aim seems to be similar to one the HSE and Health & Safety Commission established in 2007 – “Mapping Occupational Safety and Health (OSH) Professional Body Activities in Scotland”.  It is worth looking at the page to see the list of safety professional bodies who are listed, the services offered and the membership databases.

Pages from externalproviders[1]A crucial HSE document is the “HSE statement to the external providers of health and safety assistance”.  Its statement that competence should be a goal rather than a benchmark should worry the Australian competence lobbyists.  In the Ponting article above, IOSH calls for more clarity but, as discussed elsewhere in SafetyAtWorkBlog, OHS legislation clearly states it is the employers’ ultimate responsibility to establish a safe and healthy work environment.  They may choose assistance from competent people but why should it be the regulator that establishes this?  The professional bodies such as IOSH and SIA have existed for decades.  Have they not determined levels of competency for their own members by now?

Geoff Hooke of the British Safety Industry Federation says

“when you ask how you measure competence, the simple answer is: with great difficulty”.

In general, shouldn’t the response from OHS professional associations be along the lines of

“we believe that all members of the XXX Association are competent within their fields and we would not hesitate in recommending our professional members in providing competent advice to companies…”?

These organizations who are calling for a clear definition are often the same organizations that are in support of “as far as is reasonably practicable”, a vague management concept that can be defined and re-defined depending on which judge hears which OHS prosecution. – the antithesis to the prevention principles of OHS.  One cannot call for certainty in one area while advocating flexibility in another.

The UK Works and Pensions Committee was right in saying that more control is required on external consultants and clearly lobbed the responsibility on the professional bodies.

Ponting’s article concludes that it is the job of the professional bodies to organize accreditation and the maintenance of that accreditation but acknowledges that it is politically fraught.  That is not enough reason to look to the regulator to solve the problem as it only makes the regulator the target of criticism over the process and the results.  The professional bodies themselves must work to a commonality of purpose and relinquish years of demarcation and, sometimes, schism.

The Australian safety professions would ultimately gain far more credibility for themselves and their professions if they too took it upon themselves to define accreditation, audit their members’ competencies and assist in the maintenance of skills.  In that way Australia may gain a safety profession of which everyone can be proud.

Kevin Jones

New Youth@Work website

The South Australian government has launched a website focusing on young people at work, not surprisingly called Youth@Work.  

South Australia has a habit of marching to a slightly different beat to the dominant Australian States on OHS.  They did not follow WorkSafe Victoria’s “Homecomings” ads and they have been well ahead of anyone in researching and explaining the relevance of wellness as an OHS issue.

Kevin JonesposterA3v6 (2)

Influenza – dilemma for OHS regulators

SafetyAtWorkBlog has no expertise in the control of infectious diseases.  Any enquiries received on the issue are directed to the official information on government websites such as Australia’s Dept for Health & Ageing or the US Centre for Disease Control, or international authorities such as WHO.

vwa-pandemic-cover1

But this creates a dilemma for OHS regulators.  If the regulator does nothing, it is seen as inactive – a bad thing.  Or the regulator can issue its own guidance on infection control – a good or bad thing.  It is an unenviable choice.

WorkSafe Victoria took the latter choice and issued their “OHS preparedness for an influenza pandemic: A guide for employers” in early May 2009.  The guide is not intended to be definitive and may be useful in the future but infectious outbreaks can move rapidly and, to some extent, this document is shutting the door after the horse has bolted, in expectation of the next “door”.

The guide mentions the following sources but it could be asked what is gained by contextualising these Australian documents? Why not just direct companies to the  raw documents?

pandemicinal-7091883e-236bready1The trap for producing localised guides is that recommendations may be made that are out-of-place, difficult to implement and, ultimately, question the credibility of the document.  WorkSafe fell for this trap by specifying some recommendations for the legitimate control measure of “social distancing”.

In its employers guide it makes the following recommendations:

“A primary transmission control measure is social distancing, that is reducing and restricting physical contact and proximity. Encourage social distancing through measures such as:

  • allowing only identified, essential employees to attend the workplace
  • utilising alternative work options including work from home
  • prohibiting handshaking, kissing and other physical contact in the workplace
  • maintaining a minimum distance of one metre between employees in the workplace (person-to-person droplet transmission is very unlikely beyond this distance)
  • discontinuing meetings and all social gatherings at work including informal spontaneous congregations
  • closing service counters or installing perspex infection control barriers 
  • using telephone and video conferencing.”

nap-cover1The guide does recommend social distancing as part of a risk management process but “prohibiting handshaking, kissing and other physical contact in the workplace”? “Discontinuing … informal spontaneous congregations”?

How is a business expected to police these sorts of measures?  Have someone walking the workplace reminding workers of the new “no touchy” policy?

The Australian Health Management Plan for Pandemic Influenza talks repeatedly about social distancing in workplaces, the community and families but never goes to the extent WorkSafe has.

The National Action Plan for Human Influenza Pandemic (NAP) defines social distancing as:

“A community level intervention to reduce normal physical and social population mixing in order to slow the spread of a pandemic throughout society. Social distancing measures include school closures, workplace measures, cancellation of mass gatherings, changing public transport arrangements and movement restrictions.”

NAP does not mention kissing, nor does the Business Continuity Guide For Australian Businesses .

WorkSafe WA has not issued anything specific on pandemic influenza, nor has SafeWorkSA,  WorkCover NSW defers to NSW Health (which has a lot of information and a reassuring video from the health officer), and Queensland’s OHS regulator defers to its State health department.    

Social distancing is an appropriate hazard control measure amongst other measures in an influenza risk management plan but the current WorkSafe Victoria guidance seems to be an unnecessary duplication, and on the matter of kissing, silly. Why, oh why did WorkSafe Victoria think it necessary to publish anything?

Kevin Jones

 

 


Handwashing as a risk control

Everyone knows that we are cleaner for the washing of our hands.  The childhood fibs of our parents that potatoes will grow behind our ears if we don’t wash there regularly have been pretty much dismissed.  There was little evidence for the benefits of washing behind our ears other than the authority and wisdom of parents but for most of one’s life that’s enough (or at least till we turn and mistrust everything our parents say).

In Australia, OHS has been pushing for evidence-based decision making.  Some have twisted this noble aim into short-term empire building on concepts such as a “body of knowledge” (- the more important question should be why do particular people want to control this knowledge in the first place).  But evidence is important and over the last few years some researchers have been seeking the evidence for the safety benefits of hand-washing in infection control, particularly during times of epidemics or pandemics.

The current swine flu scare (it remains a “scare” in many parts of the world) is generating recommendations on personal hygiene, as reported in SafetyAtWorkBlog on yesterday, but is there evidence or is hand-washing a comforting distraction?

Earlier this year Jody Lanard and Peter Sandman wrote:

The “Cover Your Cough” page on the CDC’s seasonal flu website begins this way:

Serious respiratory illnesses like influenza, respiratory syncytial virus (RSV), whooping cough, and severe acute respiratory syndrome (SARS) are spread by: 

  •  
    • Coughing or sneezing
    • Unclean hands….

If you don’t have a tissue, cough or sneeze into your upper sleeve, not your hands.

We have been unable to find a single study that supports this recommendation with regard to influenza. The World Health Organization Writing Group report on “Nonpharmaceutical Interventions for Pandemic Influenza” makes the same recommendation for flu specifically, but concedes that it has been made “more on the basis of plausible effectiveness than controlled studies.”

As for hand-washing, a Mayo Clinic publication on hand-washing includes flu on a list of infectious diseases “that are commonly spread through hand-to-hand contact.” The Government of Alberta’s “Influenza Self-Care” publication advises: “Wash Your Hands to Prevent Influenza…. Next to immunization, the single most important way to prevent influenza is to wash your hands often.”

But here’s what the World Health Organization Writing Group report says: “Most, but not all, controlled studies show a protective effect of handwashing in reducing upper respiratory infections…. Most of the infections studied were likely viral, but only a small percentage were due to influenza…. No studies appear to address influenza specifically.” 

The Lanard/Sandman article discusses at length the way that hand-washing may be affecting our approaches to other control measures such as vaccination.  It tries to cut through the hyperbole on influenza and if you are a health care worker, the full article is strongly recommended.

At the moment there is no clear evidence of the benefits of hand-washing and if this swine flu scare remains a scare for most people, one of the areas for further research should be the effectiveness, and role, of hand-washing in the control of pandemic infections.  It just may be that “universal precautions” should not be so unquestioningly universal.

Kevin Jones

Two different approaches to risk management and safety in Australia

Australian Standards can have a major role to play in the management of safety in workplaces.  They apply to equipment, documents, decisions and can have legislative credibility if required by specific regulations.  Australian Standards are regularly referred to in guidances issued by OHS regulators adding further credibility.  The highest selling standard for many years has been Risk Management.

Unreasonable safety costs

One of SafetyAtWorkBlog’s long-held peeves needs to be stated here.  The standards are produced by a private company, Standards Australia.  The standards are only available for sale.  Small business, in particular, often baulks at OHS improvements because they see OHS management as a large cost for a small return, in a risk management context.  But the standards they need to satisfy regulatory compliance can only to be purchased.

If the Australian government is serious about easing the cost of regulatory compliance, make any Australian Standard that is mentioned in legislation available for free.

But government’s are only interested in reducing indirect OHS costs through paperwork and “red tape”, and OHS compliance requires some level of documentation.

Risk Management

Two important OHS documents that discuss risk management were released within weeks of each other.  First the Australian government released the second and final report of the Review into National Model OHS Laws (OHS Report).  The other report was the findings of the Tasmanian Coroner into the death of Larry Knight.  

The Coroner’s report was highly critical of the Beaconsfield mine’s (BGM) risk management process.

“BGM submits that there has been adequate documentation of its risk management…… I do not accept BGM’s submission” (pages 68-69)

The Coroner goes on to say

“…., the evidence is unclear upon the steps taken by BGM, prior to this decision, in its evaluation of those risks identified by its own risk analysis process. To illustrate:

  • There is no evidence to explain the decision to resume mining in contradiction of Mr Gill’s memorandum which had stipulated that forward modelling be completed beforehand.
  • Mr Gill had, in his memorandum posed the questions, “Are our current ground support standards sufficient for the seismicity being experienced?, and if they aren’t, “What is required?” However, there is not any evidence of BGM having undertaking an assessment of the sufficiency of its ground support standards so that these questions could be answered nor is there any record evidencing why the decision was taken to resume mining without these questions being addressed.
  • Dr Sharrock had identified an important depth of failure issue which Mr Gill acknowledged was raised by him at his close-out meeting yet there is no evidence to explain the evaluation of this concern by BGM and the basis for its rejection.
  • There does not appear to be any evidence of BMG having considered the reevaluation of its ground support after Mr Basson’s modelling results became available although this had been advised by Mr Turner.”  (pages 66-67, my emphasis)

The coroner’s report is full of this type of comment of an inadequate risk management and assessment process.

Reading the report in full generates a big question of how can a company be so deficient in its safety management system and still not be held responsible for the consequences of its actions?

The company remains belligerent  in its defence of the very risk assessment process that the Coroner slammed.  In a media statement, CEO Bill Colvin states

“…the company is disappointed at the lack of acknowledgement of the extensive risk assessment process undertaken by the Beaconsfield Gold mine following the October 2005 rock fall.

“Contrary to comments made by the Coroner, there was rigorous risk assessment, the mine did vary its ground support system and it changed its mining method. Nevertheless, the Coroner did find that no person contributed to the death of Larry Knight.”

Which report was he reading?

Outside of the coronial process, there seems to be sufficient evidence in the coroner’s report for Workplace Standards Tasmania to have another look at prosecuting BGM for failing to ensure that Larry Knight had a healthy and safe work environment.

Review Panel – Risk Management

The Review Panel decided not to include risk management as an enforceable element of national OHS legislation, even though it is a legislative requirement in Queensland.  The panel has reduced the emphasis on risk management by including it only “as part of an object of the model Act.” (page xviii) 

Placing it as an object of the Act puts risk management out of the public’s eye.  If risk management is not part of the obligations of an employer in law, we should not expect business operators to embrace them.  The BGM risk management process was found to be deficient by the Coroner and may have contributed to the death of Larry Knight but the Review Panel sets risk management as an aim and not an enforceable part of model OHS legislation.  It advocated the concept but would not committed

The panel heard, in a submission by Johnstone, Bluff and Quinlan, that

“The Model OHS Act should explicitly require duty holders to undertake systematic OHS management in order to comply with their general duty obligations, and the Act should outline the approach to be taken in a way that integrates the concept of ‘reasonably practicable’ into the process, and also shows how duty holders should use the provisions in regulations and codes of relevance to the issue being addressed in order to comply with the general duty.”

The Review Panel followed the recommendation of the Law Council of Australia that risk management be included in Regulations and not the Act itself.

But then, the review was not a review of occupational health and safety but of occupational health and safety law.  The management of safety was never its focus.

If it had been such a review, or if the government decides that a “safety management review” is warranted in the next few years, there would have been the opportunity to analyse the cost of managing safety and to show how the legal fraternity and the standards setting processes unnecessarily contribute to high compliance costs and red tape.

Risk management was clearly an important business process at Beaconsfield Gold even if the application of the process was poor.  The Coroner said

“one obvious line of defence is to have in place a systematic, comprehensive, rigorous and properly documented risk assessment process.  It is my opinion that BGM did not abide by such a process in the period between the October ’05 rockfalls and Anzac Day 2006.” (page 71)

Larry Knight died on Anzac day 2006.

The Review Panel believes risk management can sit in Regulations and in legislative aims.  Standards Australia continues to charge for its OHS and risk management standards.  The Australian government remains silent on providing free business management information that has the real possibility of saving lives.  Bring on the safety management review!

Kevin Jones

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