Working in heat – still contentious

Australians associate working in hot conditions as outside work although the occupational hazard of heat is just as relevant in bakeries and foundries.  OHS regulators and safety lobbyists often try to include too much in their heat-related strategies – heat stress, skin cancer, hydration, dust, and a range of other hazard combinations related to specific industries.

What the community and many workers want is a defined unsafe temperature limit.  Some will remember being allowed to take their school ties off when the temperature reached 38 degrees Celsius (100 degrees Fahrenheit).  But OHS legislation, more often than note, focuses on the system of work and this allows for work in excessive temperatures as long as the system can ensure this is safe.

Legislatively, this position is understandable but it is not what people want or expect.

The issue was raised recently at the Trade Union Congress in September 2009 in England in a discussion on working temperatures.  Pauline Nazir, representing the Bakers, Food and Allied Workers’ Union, said

“The question is why there is no maximum temperature and why has the Health and Safety Executive and the Government have consistently dodged calls for similar protection for those who work at the higher levels of temperature?  It is a big question for a big organisation, but one that the Health and Safety Executive has failed to answer logically despite years of pressure.  While they have failed to act, workers suffer the consequences, year in and year out.

It seems illogical that we have regulations that limit the temperatures at which cows and pigs can be transported around the country, but offers no protection other than the general health and safety legislative offerings.  It is true that if you move livestock in Britain, there is a maximum level of 35 degrees Centigrade within the carrier, but poor old human beings can regularly carry out physical and strenuous work at temperatures that far exceed these levels.  Why have we failed to get the Health and Safety Executive to act?”

Pages from guidance                   1rking          -346317709n       2.945398e-266at3The variety of factors contributing to excessive heat at work is probably the reason for lack of progress on the hazard.  There are many organisations advocating prevention of harm from working in heat but they all have their own funding models, costs, agendas and “sub”hazards.  Nazir’s call for the Health & Safety Executive to do something sounds unfair but the common activity she is referring to is working in heat so it is not unreasonable to expect an OHS regulator to coordinate resource and, perhaps, research.

Coordinated safety action is expected of business operators to ensure these hazards are controlled but that operator would need to read up to a dozen brochures, codes, guidances or policy statements to get close to achieving a situation that employees would consider safe.

It may never be appropriate for an OHS regulator to state a defined (un)safe temperature (the hygienists would argue safe working conditions) but what can be achieved is guidance that pulls together the multiple hazards and control measures so that achieving a safe workplace is as easy as can be.

WorkSafe Victoria has started along this path with a (thin) guidance and more generic terms of discomfort and illness but there is a need for a much more comprehensive guide.

Kevin Jones

UPDATE: 9 October 2009

A reader has pointed out a podcast by the Canadian Centre for Occupational Health and Safety from the July 2009 that explains some of the justification for not issuing a specific working in heat benchmark.

The retention of leave indicates a broken business

The Australian Chamber of Commerce & Industry (ACCI) has released a statement that discusses the economic and personal costs of presenteeism in relation to Australia’s new National Employment Standards.

In the statement the ACCI mentions:

“…the colossal national stockpile of annual leave and its toxic impact on the wellbeing of business and employees.”

“It doesn’t take Sherlock Holmes or even Dr Watson to deduce that employees who take their annual leave are far less likely to take a ‘sickie’ due to fatigue or illness.”

The statistics quoted by ACCI include:

  • 123 million days stockpiled nationally.
  • $33.3 billion value to national leave stockpile.
  • 73% of national leave stockpilers are likely to be managers and earn more than $70K per annum.
  • 71% of leave stockpilers nationally are likely to be male.
  • 73% of leave stockpilers consider work/life balance to be important to their lives.
  • 70% of leave stockpilers consider taking leave to be a good way to achieve work/life balance.

It is not unreasonable to assert that the excessive retention of leave by an individual is an indication that that person does not understand that annual leave is an important element of their own mental health and safety at work.

If an executive believes they are indispensable to the company then that executive is making poor OHS decisions that flow to other employees.  Just as positive change can come from the senior management so can unhealthy work practices.  The retention of leave is just such a practice.

In a broader corporate and management context, the retention of excessive leave is an indication of a poorly managed business.  Leave, and its mental health benefits, should be integrated into the operational business strategy.  No one should be indispensable in a work role, although it is acknowledged that Plan B’s are not always as effective as Plan A’s.

Business continuity and risk management demand that contingencies be put in place for prolonged absences, or short leave breaks.

ACCI has to be admired for bringing the retention of leave to the attention of its members but the release is principally an information leaflet for a government tourism website.  Being physically absent from work is very different from being mentally absent from work.

To achieve a proper break from work, contact with the workplace and clients must be severed.  Even in this situation it may take several days to break out of “work mode”, to stop reaching for the mobile phone, to stop worrying about whether a work task is being done and to start the process of relaxing.

A “good” workplace, a “workplace of choice”, should have work management structures in place to allow its employees to recuperate from the pressures of work.  This is beyond flexible work structures and needs a business to thoroughly understand the mental health needs of its workers and business continuity.

Kevin Jones

The original research data for the figures above has been located and is available elsewhere on SafetyAtWorkBlog

Civil liability and work-related diseases

On 4 October 2009, Queensland’s Attorney-General Cameron Dick released details of his intentions to increase the compensation available for individuals and their relatives through his  Civil Liability and Other Legislation Amendment Bill.  Below is a table which shows the level of the  increase.

It needs to be pointed out that this is not workers’ compensation but OHS legislation is blurring the demarcation between workers compensation and civil liability in the context of safety management.  New Australian legislation is placing OHS obligations on workers and employers for the off-site effects of workplace activities.

The Attorney-General, who is also the Minister for Workplace Relations had this to say about the importance and breadth of the draft Bill:

“This legislation will increase the maximum caps, for the first time in six years, on general damages available under the Civil Liability Act 2003 for personal injuries,” Mr Dick said…. “These amendments will afford injured persons the monetary compensation they need to help them get on with their lives.  The amendments also ensure a de facto partner of an injured person is now able to claim for loss of earnings.”

Dick goes on to discuss the good news concerning dust-related diseases as the amendments will also abolish the statutory limitation period for dust-related disease claims including asbestosis, mesothelioma and silicosis.  It is unclear whether workers’ compensation insurance has similar limitations.

“The removal of the statutory limitation period for dust-relates (sic) diseases will deliver significant benefits to sufferers, by improving their access to justice and reducing the costs and stress associated with pursuing a claim,” Mr Dick said.  “This amendment will have retrospective effect to ensure it captures current cases of dust-related disease originating from exposure during the 1950s, 1960s and 1970s.”

Dick said the amendments also ensure that the caps will be annually indexed to average weekly earnings.

These changes raise the possibility that a workplace may have an event that directly injures workers and also affects people outside the worksite. This could generate two processes for compensation – the workers and members of the public.  The business operator would be involved in both processes, of course.

But Australian OHS legislation is moving towards one OHS “Act” that would involve the management of a hazard and its potential off-site effects.  Why then split the compensation  mechanisms?  Would it not be easier for the business owner to manage the environmental, public and worker impacts of the one event in an integrated fashion?

The model OHS legislation deals with multiple parties affected by work processes surely the government should be looking at a single compensation process that also addresses multiple parties?

The workers’ compensation harmonisation review is still a couple of years away but potential changes should be anticipated.  The table below perhaps should be compared to the Table of Maims used in workers’ compensation in the spirit of harmonisation to determine a broader social justice.

Perhaps in this period of public comment on draft OHS model legislation, the government and stakeholders should anticipate the social consequences of the OHS management obligations it is currently considering.  If environmental legislation and management imposes a “cradle-to-grave” context, why should safety management legislation not?

Kevin Jones

Injury Injury Scale Value Currently worth Maximum from 1 July 2010 will be worth
Serious Facial Injury 14 to 25 $16,600 to $35,000 $19,550 to $41,220
Loss of one eye 26 to 30 $37,000 to $45,000 $43,560 to $53,000
Loss of one testicle 2 to 10 $2000 to $11,000 $2360 to $12,950
Loss of both kidneys 56 to 75 $110,360 to $166,400 $130,000 to $196,000
Loss of one arm from the shoulder 50 to 65 $93,800 to $136,100 $110,500 to $160,300
Loss of one hand 35-60 $56,000 to $121,400 $65,950 to $143,000
Loss of a finger 5 to 20 $5000 to $26,000 $5900 to $30,600
Loss of one leg above the knee 35 to 50 $56,000 to $93,800 $65,950 to $110,500
Loss of one foot 20 to 35 $26,000 to $56,000 $30,600 to $65,950
Total loss of hair on head 11 to 15 $12,400 to $18,000 $14,600 to $21,200

Freshening an OHS career

OHS professionals, as with any profession, can easily become out-of-touch with what their profession is all about.  This is to improve the safety of people through a professional and competent approach.

Some professionals lose touch because they may be dealing with corporate OHS policies all day,  they may never get away from head office and the endless round of meetings, they don’t get to go to events outside their own professional network or they are simply comfortable with  the “academic” role and not miss getting their hands dirty on the shop floor.

In each of these scenarios the OHS professional is doing themselves, and their profession, no favours.  Their career may progress but their thinking does not.  Some OHS professional associations are at the same plateau.

There are some small things one can do if one wants to break the cycle and obtain a better quality of work.

  • Test the validity of the corporate polices by arranging for an internal audit by someone else and participate as an observer.
  • Take one’s skills out of head office and offer to mentor some of your contractor’s OHS people.
  • Establish a pro-bono service for the smaller businesses nearby.
  • If one’s company is in an industrial estate, start-up an Estate OHS group where business owners can meet to share or create solutions.
  • Offer one’s OHS services to a not-for-profit organization, if your company offers “volunteer” leave.
  • Offer to assist students at all levels with their OHS assignments.
  • Take a sabbatical to majority world sectors, such as Asia, and offer one’s OHS skills to OHS and labour advocates in that region.*

The biggest threat to one’s safety skills is stagnation.  If one’s professional safety organisation does not have the programs available to freshen up your skills and approach, go outside the safety field.  It is surprising how one’s skills in one area can be applied in others, such a public health, environmental safety, transport or maritime safety.

Kevin Jones

* A particularly useful organisation that is worth contacting is ANROAV – the Asian Network for the Rights of Occupational Accident Victims

A colleague in Asia recently told SafetyAtWorkBlog that ANROAV is in need of variety of educational materials.  Many of these are basic tools such as jigsaws that can be used to identify hazards or safe work options.

$A10,000 would be a great help in establishing a basic education fund which could access a suite of OHS comics and short films that can be used for education on fire risk, cancer, mine safety, electronics, solvents etc..

Increasing risk of silicosis in the majority world

Australian safety expert and activist Melody Kemp reported from the annual meeting of the Asian Network for the Rights of Occupational Accident Victims (ANROAV) that was held in late September 2009 in Phnom Penh.

The meeting featured many stories about the increasing risk of silicosis in Asia.  Melody writes in the 27 September edition of the blog “In These Times”:

“Silicosis afflicts workers working with gems, ceramics, rock blasting, drilling and crushing, and mining. It haunts unprotected workers in glassworks, mines and foundries, as well as those who live within reach of the dust. It’s usually fatal by the time it is diagnosed.

Largely eradicated in the economic North, silicosis is now the scourge of the Global South. Millions die from the illness each year.”

The size of the growing occupational and community threat is frightening.

“China alone reports over 100,000 new cases of industrial lung disease per year, and has more than 4 million existing cases. And those are just the official figures. Even industrially advanced South Korea sees over 1,000 new cases of occupational chest disease each year, reported Dr. Domyung Paek, a pulmonary specialist from Seoul National University.”

Melody has contacted SafetyAtWorkBlog asking for assistance in attracting occupational medical experts to Cambodia and other countries undergoing rapid industrialisation.  She can be contacted by clicking HERE.

Kevin Jones

Early worker health statistics from WorkHealth

WorkHealth has released some data on the results of its first wave of free health checks (not yet available online)

“Recent results from tests of 3500 workers conducted as part of the ….WorkHealth program found more than half were overweight and/or had high blood pressure while a quarter had high levels of blood cholesterol.”

These figures are not as “surprising” as WorkHealth makes out as the health check program is free to all workers in the State of Victoria and is likely to be the first time that many of the workers would have undergone such checks.  Indeed, WorkHealth acknowledges this fact for its blue-collar male workers.

The data is summarised by WorkHealth below:

  • Male workers were more likely to have high blood pressure;
  • Female workers were more likely to have higher levels of cholesterol in their blood;
  • The majority tested eat less than the recommended five serves of vegetables each day; and
  • The majority of people tested eat at least two pieces of fruit each day.

A health profile of the general Australian population from 2008 found the following statistics, amongst others:

Coronary heart disease is the largest single contributor to the burden of disease
in Australia, followed by anxiety and depression.

Coronary heart disease is the largest single contributor to the burden of disease in Australia, followed by anxiety and depression.

Cardiovascular diseases, cancers and respiratory diseases remain the leading causes of death overall.  However, injury is by far the most common cause of death in the first half of life.

Many Australians live with long-term health conditions. Most of these conditions are not major causes of death, but they are common causes of disability and reduced quality of life.

WorkHealth may be a turning point in the health management for some of the participants, and even if this is a tiny minority, the WorkHealth program could be claimed as a success.

Now if we could only do more about the smoking, dust, fumes, forklifts, sedentary work, fatigues, shiftwork, depression, stress, alcoholism and anxiety…..

Kevin Jones

Nursing home OHS – a 2001 interview with Kathleen Rockefeller

The last time I spoke with Kathleen Rockefeller was in 2001 on the eve of her speaking at a conference organised by the Ergonomics Society of Australia.  At that time Kathleen was a physical therapist and ergonomist within the Washington State Department of Labour & Industries.  Her latest profile says that she is now in Florida (via Chicago) as an Assistant Professor at the School of Physical Therapy & Rehabilitation Sciences at University of South Florida.

Rockefeller interview 2001_Page_1Kathleen’s career may have progressed (as probably has her tan) but the hazards and control solutions that we discussed in 2001, sadly remain relevant.  I have reproduced some of the interview I conducted with Kathleen in those early days when no-lift policies were radical and  patient-handling equipment was expensive and rare.

SAW: Around the world the no-lift policy is being introduced but why is that policy the most popular risk control measure?

KR: I don’t know where it actually originated or where the term “no-lift” came from. It’s a horrible term because everyone in healthcare knows that it is a little unrealistic. I think some people have been turned off by the name. I prefer to call it “low-lift” or “minimal-lift”.

Looking at the literature and research clearly shows that decreasing the amount of times per day that the human body has to act like a derrick is a good idea. Each episode exposes the body to forces of a magnitude high enough to potentially be injurious. Anyone who has nursed or worked in nursing homes knows that lifting is not the only activity that carries physical risk. There are tasks like leaning over the bed to delivering treatment to changing clothing, repositioning—these activities can be stressful as well. I wish it were simple to say “let’s get rid of the lifting” but it is an important first step.

SAW: In Australia the no-lift push came from the unions in order to push management to get into action on a whole range of manual handling issues.

KR: I’ve heard a rumour over here, and I don’t know how true it is, that the equipment manufacturers began using the term “zero-lift” but I really don’t know.

SAW: Your research shows that financial incentives were used to encourage the purchasing of new equipment. Were the incentives really necessary?

KR: Washington State is unique in the US in that the workers compensation insurance is handling by a State agency. So the insurance is handled by us unless the company meets the requirements for self-insurance. The agency has monitored the data and monitored the trends to try some initiatives with a number of different industries, nursing homes were chosen for a research project. They were hurting financially. A major reason for not buying lifting equipment was financial.

The agency decided to allocate some of their funds to the nursing home industry and to see if offering some of the funds allocated for injury prevention projects would help. The funds weren’t handouts but discounts on the workers’ compensation premium in return for investing in equipment and beginning a manual handling improvement process. The program was designed as a trial project to see what effect this type of incentive might have.

SAW: How applicable is your research to other States, given Washington’s unique processes?

KR: Many recommendations will be applicable as the program wasn’t just on the financial incentives. The study was a state-wide and industry wide look at how nursing homes were doing overall in implementing zero-lift programs. The research has identified the problems of implementing a large-scale intervention and we can all learn from these problems.

SAW: Other than manual handling what are the major OHS risks in nursing homes?

KR: Of course, patient handling has various tasks and the higher risks are certainly the physical transferring but also the repositioning, delivering incontinence care to residents, changing their clothing. The other thing I noticed in the homes while following nursing assistants and doing sampling is the total amount of time they stand or walk. I think that fatigue must be a contributing factor, both local muscle and total-body fatigue. There is very little recovery time. I knew this already but doing the research really emphasised this.

SAW: Did you observe a high stress level? Was resident violence an issue?

KR: Those are certainly issues as well. The issues of staffing and turnover is huge. The turnover for nursing assistants is an industry average of 100% a year and can go much higher. The constant turnover creates turmoil.

An unexpected element was the huge turnover in management personnel. This was striking. When you think of a facility trying to keep stable processes and procedures and the head person leaves within 3 years or even one year— that is a real problem.

I heard a lot from the nursing assistants and through the literature about the importance of knowing the residents. You mentioned potential problems with the residents but if you work with the resident for a while you get to know them and then you may be able to pick up warning signs on behaviour. If you’re a short term agency nurse and you don’t know the residents, it may increase your vulnerability.

SAW: Perhaps the no-lift policy has been introduced due to the throughput of staff rather than dealing with a root cause of the manual handling injuries? Perhaps because no-lift can give immediate results?

KR: Expecting a zero-lift program to have miraculous results in light of these other issues leading to instability is an unreal unrealistic expectation. I think introducing the program and getting it to work as best you can while at the same time, people who can affect change, maybe us baby boomers, need to start screaming very loudly because our parents are next.

Injuries related to manual handling have a number of causes and efforts to decrease these injuries require multi-faceted approaches. The point is well taken because if you are going to expect a zero-lift program in itself to have miraculous results in light of these other issues leading to problems and instability, it is not a realistic expectation.

Kevin Jones

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