health – Page 112 – SafetyAtWorkBlog

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_1 Kathleen’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

Fatigue, impairment and industrial relations

Many of the employees in the health sector in Australia have recently been negotiating new employment conditions. It is rare for the workplace hazards of fatigue and impairment to be given such prominence in industrial relations negotiations.

A major cause of fatigue is the lack of adequate resources for relieving staff. This issue has been identified for doctors, ambulance officers and firefighters over the last 12 months.

Many important OHS issues are identified in a recent ABC Radio interview with Dr David Fraenkel, the Treasurer of Salaried Doctors Queensland (SDQ). Dr Fraenkel mentions the following issues, amongst others:

Queensland Health‘s duty of care to the public
Queensland Health’s duty of care to its employees
“wrong site surgery” due to judgement impaired by fatigue

Dr Fraenkel also shows the institutional pressures on individual doctors to not discuss the implications of fatigue. He mentions that there is a code of conduct that impedes the discussion of issues by health care professionals.

He admits that should a young doctor leave their station to relieve their fatigue they would most likely be “called to account” for their action and their career may be jeopardised for what OHS professionals would admit is an individual taking responsibility for looking after their own safety and health.

Salaried Doctors Queensland has established a website in support of its campaign which includes some factsheets. The print media also picked up on the SDQ media statements.

Kevin Jones

Wriedt provides context of her depression

Former Tasmanian MP, Paul Wriedt, has provided an Australian Sunday newspaper with a long article that provides the context for her suicide attempt, depression and career implosion. The full article is well worth reading and shows the combination of factors that led to her suicide attempt.

Excessive workload is mentioned several times and, although it is only one of the confluence of factors, the workloads and working hours of politicians remain untreated elements of the health and wellbeing of important social p0licy decision-makers.

If, as many safety advocates profess, safety is led from the top, politicians are doing the safety profession a disservice by not structuring their work environments and schedules to ensure a healthy workplace.

One point is not mentioned in the article. Paula Wriedt is a spokesperson for beyondblue, the most prominent depression-related organisation in Australian. In fact Ms Wriedt is one of the organisation’s recent “ambassadors”.

Beyondblue has advised SafetyAtWorkBlog that the Sunday Herald-Sun article was Ms Wriedt’s own work and that beyondblue was not aware of the article before publication.

The beyondblue spokesperson said that the organisation is expanding its pool of ambassadors which should be of particular interest to those working in the workplace health sector. Ambassadors operate on a volunteer basis and may be eligible for the reimbursement of costs in specific circumstances.

[Hm, voluntary ambassadors lobbying on behalf of a health issue on a voluntary basis. Perhaps the safety profession could offer a similar “outreach program”]

Ms Wriedt was not obliged to mention beyondblue in the article and it is clear that she sees public discussion on depression issues to be one of her own career goals, but it would have been appropriate to mention her relationship, particularly as she is a beyondblue ambassador.

Kevin Jones

Meditation is a proven stress reduction method for workplaces

Meditation is not on the regular agenda at SafetyAtWorkBlog. If there was time to meditate, the time would probably be spent losing weight in the gym but there is fascinating research that provides some evidence of meditation’s benefit in reducing work-related stress.

At the Safety Conference in Sydney at the end of October 2009, Dr Ramesh Manocha of Sydney’s Royal Hospital for Women will release research that

“found that after eight weeks of mental silence meditation training called sahaja yoga, occupational stress scores improved [decreased?] 26 per cent. A non-mental silence relaxation program reaped a 13 per cent gain, while a waiting list control group lifted just 1 per cent.”

The language sounds slightly “new-age” but what makes the difference in this circumstance is that the initial research was undertaken with three groups mentioned above and, importantly, with a control group.

Below is a TV interview with Dr Manocha on the first stage of research.

When looking at workplace stress, people reduce stressors but Dr Manocha says this often requires impossible organisation restructuring due to internal political pressures. These techniques can be applied on a personal level that employees can take with them through their various life-stages.

Dr Manocha then applied the meditation training in real corporate situations. According to a media release provided in the lead-up to the conference:

“In a later field trial of mental silence meditation by 520 doctors and lawyers, more than half of the participants whose psychological state (K10) scores indicated they were “at risk” were reclassified as “low risk” after two weeks of meditation.”

It’s the application of this meditation in the workplace context that gained the attention of SafetyAtWorkBlog and what will be presented at the conference. The gentle skepticism evident in the TV interview above is understandable but in a time when safety professionals demand evidence, we must look seriously at evidence when it is presented.

More information on The Safety Conference is available HERE.

Kevin Jones

Public Comments – Fishing and Legionnaire’s

WorkSafe Western Australia has two documents currently open for public comment. One concerns a draft code of practice for the prevention of falls from commercial fishing vessels. The other may have a wider appeal as it is a draft code of practice for the prevention and control of Legionnaires’ disease.

The man overboard code is an example of established hazard management and risk control options for a niche hazard in a niche working environment, however, it is often in these areas where procedural and technical processes are most easily recognised. The draft code is in a format, and has a degree of clarity, that encourages discussion and examination.

Readers may find some useful information for those workers who work alone or in isolation, for those who need to undertake tasks at nighttime and in intense darkness, and for those workplaces that require a strict induction for new workers.

Similarly, the Legionnaire’s code of practice builds on established risk management concepts and shows that businesses still need to prevent legionnaire’s infections even if there is a regulatory/licensing system in place for cooling towers.

On a formatting note, both these draft codes could have benefited from the regulators embracing more of the Web 2.0 concepts. The PDF files do have some hyperlinks for some more information or emails but there could be a lot more effort put in to making the drafts a hub for the documents’ references. For instance, mentions of legislation could lead to online versions so that those commenting online can flick back and forth from reference to topic.

[Just imagine how much more helpful a code of practice with such functionality could be to a small business – wiki + blog+ safety = better compliance]

In the Legionnaire’s draft there are tags on page 36 that could lead to the online text of the Acts referred to. The tags are a good idea but could use increased functionality.

Lastly, the Legionnaire’s code references eight Australian Standards and publications. It is a reasonable expectation that, for this hazard, industry submissions will be the majority and those parties already have the Standards. However, if a broad consultation is required, many interested parties may find purchasing these Standards a substantial cost burden, which SafetyAtWorkBlog calculated to be at least $A390 for the PDF versions.

Kevin Jones

From worker safety to patient safety

Many of us grew up under the “shadow of the mushroom cloud” and have strong suspicions towards radiation of any kind but the OHS achievements of those working with radiation should be acknowledged.

In the latest edition of the IAEA Bulletin (May 2009) this achievement is clearly summarised as it relates to those in medical radiation.

The early emphasis on staff protection did pay rich dividends in terms of making staff safer. Currently, most (nearly 98%) of those who work with ionizing radiation in any area of medical practice receive a radiation dose that is lower than what they get from natural radiation sources — the so-called background radiation, e.g., cosmic radiation, radon, radiation from building material, earth, food, etc. Background radiation depends on the place you live, but typically is 1 mSv to 3 mSv per year, although in some places can be up to 10 mSv. The dose limit for staff currently recommended by the International Commission on Radiological Protection (ICRP), and adopted by the IAEA and most countries with few exceptions, is 20 mSv/year, expressed as 100mSv over a period of five years. Such has been the success of occupational radiation protection programmes that not even 0.5% of staff members who work in medical facilities (or in any nuclear facility) reach or exceed the dose limit.”

The siginifcance of the article from which this paragraph is taken comes from the next sentence:

“Since there are no dose limits for patients, many may incorrectly assume that there are no controls on patient exposure.”

The article by Madan M Rehani, and thankfully available online, discusses the possibility of introducing an ongoing monitoring system that records the cumulative exposure to radiation by patients. The smart card project launched by the International Atomic Energy Agency will be one to watch as there could be applications of such a system to other occupations and work-related hazards.

The importance of such a program is high as Rehani writes:

“The risk of cancer from radiation doses imparted through a number of CT scans is not insignificant. Most other radiation effects (such as skin injury, just to name one) can be avoided rather effectively, but this is not true for the risk of cancer. There are estimates of few million excess cancers in the USA over the next two to three decades from about 60 million CT scans done annually.”

Kevin Jones

Category: health

Early worker health statistics from WorkHealth

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Nursing home OHS – a 2001 interview with Kathleen Rockefeller

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Fatigue, impairment and industrial relations

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Wriedt provides context of her depression

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Meditation is a proven stress reduction method for workplaces

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Public Comments – Fishing and Legionnaire’s

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From worker safety to patient safety

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