health – Page 120 – SafetyAtWorkBlog

Fatigue is the biggest threat to a person’s safety

Not so long ago, it was considered a legitimate criticism to blame the individual for “doing the wrong thing” at work. Depending on the type of worksite, this was considered “human error” or “bloody stupid”.

Fatigue is an interesting illustration of how occupational health and safety must cope with new perspectives on established hazards. Australian OHS legislation operates on a responsibility to manage the systems of work in a workplace, of which only one element is the worker.

A good incident investigation goes beyond the incident to see what led up to a worker acting the way they did, the reasons behind the decision. Instead of “tell me about your childhood”, OHS practitioners can legitimately ask “tell me about your sleep patterns”, or “tell me about your second job”, or “tell me about your relationship with your partner”, as these can be contributory factors to the decision made on the day or the work environment at the time of the incident.

Some recent AAP articles provide interesting examples of the different contexts in which fatigue as a workplace issue can manifest:

“Ambulance Employees Australia (AEA) said weary paramedics had fallen asleep at the wheel and administered wrong drugs because they did not have enough time off between shifts.

They have called for a minimum 10-hour break between shifts, compared with eight hours under the current award.

But Ambulance Victoria has said the fatigue issue was one of 175 union claims, which it said sought $800 million from pay talks.”

“Investigators examining the near-catastrophe at Melbourne Airport last month are exploring whether fatigue was a factor after being told the pilot had barely slept the day before the flight.

Emirates pilots are permitted to fly a maximum of 100 hours each 28 days and the pilot was also almost at the legal threshold of the number of hours he was able to fly.

Emirates has issued a statement saying safety was a top priority for the airline.”

A higher priority than a good night’s sleep apparently! Clearly it is the spread of hours that is the issue not the total over a fixed period.

Both these examples relate to workers’ interactions with the public and reflect the complexity of OHS’s spread to public safety.

It seems that every investigation now automatically assesses the fatigue level, or impairment, of the participants in incidents in the same way mobile phone records are checked in car accidents and blood-alcohol levels or drug testing in some industrial events.

If your OHS professional does not consider psychosocial issues in developing safety management plans or incident investigation, seek a second opinion, or better yet, make sure the first opinion is comprehensive.

Kevin Jones

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

Australian Prime Minister talks to the great unwashed

The edge of panic is starting to appear in Australian concerns over swine flu. Some health officials, who should know better, are slipping slightly off message. The Queensland government’s chief medical officer has recommended that food should be stockpiled. This was quickly jumped on by the Federal Health Minister, Nicola Roxon, has tried to provide a more palatable context to the stockpiling:

“We want people to be aware of the risk of this disease, we want people to be taking sensible planning steps but we don’t want panic,” she said. “It’s very important that we don’t have a rush on products that people just during the course of their ordinary shopping might think about whether they have some of these extra supplies.”

The Australian Prime Minister, Kevin Rudd, has offered some of the blandest, but relevant, advice:

“For all Australians to engage in the simple practice of washing their hands with soap on a regular basis.”

Kevin Rudd is not the poster boy for personal hygiene unless eating one’s earwax is a suitable hygiene practice.

SafetyAtWorkBlog will continue to watch for evidence of the effectiveness of handwashing in influenza control.

Roxon’s advice is sound however in one very important way – sensible planning steps. Cut through the hyperbole. Listen to reputable health advice, and keep your colleagues and employees informed. If that happens, we’ll get through this threat.

Kevin Jones

Safe Work Australia Awards 2008

Safe Work Australia is a fairly new configuration for Australia’s OHS department but it’s awards have been going for some years. On 28 April 2009 the awards were held in Canberra. The timings don’t seem quite right but that is the scheduling of these sorts of things in Australia.

The award winners from the State events are nominated for national awards, usually, conducted six months later. SafetytWorkBlog has written elsewhere about the need to review this system.

The winners this evening were congratulated by the Workplace Relations Minister and Deputy Prime Minister, Julie Gillard and were

ETSA Utilities(SA) for best OHS managemetn system
The Dorsal Boutique Hotel(NSW) for best OHS solution
WP Projects(NSW) for best OHS practice in small business
Eraring Energy(NSW) for a leadership in injury management
Viki Coad (SA) for best individual OHS contribution

The obvious peculiarity in the award winners is the absence of winners from Victoria, Western Australia and Queensland, states with large populations and/or large mining sectors.

The Dorsal Boutique Hotel gained considerable kudos in New South Wales’s awards in October 2008 with its bed elevator that reduces the need for housekeepers to bend when making the beds. It is a good example of thinking further into the problem and asking why beds are designed the way they are and why can’t we change it. It has a limited use but considerable appeal to the millions of hotels around the world. More information can be found on the solution at the NSW WorkCover Awards site.

It is always more gratifying to see successful things rather than successful programs as the things are often transferable to many workplaces and are visual solutions to problems, sometimes problems we weren’t aware of. Leadership and management awards are more a recognition that a company has taken safety seriously which has been a legislative requirement on business for decades. There is little innovation to show in these areas. More the award is for the fact that known techniques have been applied in difficult work situations or industry sectors or company configurations.

This is not to say the effort of the award winners is less valuable than tangible solutions but often these changes come from a changed management structure or a traumatic event or new focus from the board. It is easier to understand the significance of these OHS “agents for change” when focusing on an individual achievement. The award for Viki Coad is a great example of the difference one person can make. It is these achievements that should be more widely applauded.

Indeed readers could benefit greatly from looking at the State winners in this individual category for that is where inspiration can be found.

Kevin Jones

(Kevin was invited to attend the awards event by Safe Work Australia)

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

Swine Flu – workplace preparations

There is swine flu information coming at us from all directions. Thankfully in Australia the flu itself has not appeared from any direction but…

For those businesses that are not prepared for potential pandemics, don’t panic, but remember that you have known about this potential since before SARS and if you have not put any plans in place, it’s your own fault.

Now that the criticism is out of the way, if you are concerned, what you should do is hit the Australian internet sites that are relevant to pandemic preparation. One particularly good and local (ie Australian) site is the Australian Government site on pandemic influenza.

There is a very useful Australian podcast on the issue available through ABC Radio.

It is also useful for companies in general to remind its employees about basic hygiene practices. A particularly good source of work-related information on hygiene is at the government site for infection control for health care providers.

Dr Danilla Grando is a hygiene expert and Lecturer in Clinical Microbiology in the School of Applied Sciences at RMIT University in Melbourne and provides her take on this simple and effective hazard control measure

“Research has shown that one of the most powerful weapons against the spread of respiratory illness, including any strain of influenza, is simply improving your hand hygiene.

We know that contact transmission is one of the key ways that people become infected by influenza. While flu is an airborne virus, people often fall sick from touching something that carries the influenza germs and then putting their hands in their mouths, often while eating.

Always washing your hands before meals is vital but using an alcohol-based hand sanitiser throughout the day is also extremely effective, and an essential tool in helping to prevent the spread of influenza.”

Several years ago SafetyAtWorkBlog interviewed Peter Sandman, a world-renowned risk communicator. He had been undertaking some work in Asia with the World Health Organisation around the bird-flu outbreaks. He and Jody Lanard wrote a series of articles on communicating an imminent pandemic. It should be obligatory reading for those at the forefront of public health initiatives at the moment but safety and risk managers may find some assistance in how to communicate with one’s own staff.

The initial response to the current swine flu is generating optimism and it is heartening to see so many government departments reacting in a planned way. However we should remember the lessons of SARS and the lasting impact SARS had on travel and trade.

Click on the image below for a 2003 edition of Safety At Work magazine which includes several articles about SARS and pandemic risks generally.

Kevin Jones

“Getting back on the (trauma) horse”

Mental health in the workplace is one of those recent manifestations of psychosocial hazards. It continues to evolve and during this process one is never quite sure where the best and most relevant information can be obtained.

Cnfusion for the safety professional can come from new, slightly off-topic, issues that can skew the public perception and understanding of exactly what it is one is trying to manage.

Is it reasonable to take inspiration (if that is the right term) from studies of Iraq War sufferers of post traumatic stress syndrome in providing clues to handling mental health issues at work?

During tertiary risk management courses the debt owed to the armed forces and their planning processes is acknowledged but soldiers operate in a unique culture of accountability, clearly defined duties and a rigid hierarchical structure. In most circumstances only the broadest of concepts could be translated to the real (non-militarised) workplace. In a similar way studies of Scandinavian workforce management are interesting but are highly unlikley to be transferable outside the cultural geography.

A very recent example of this problem of getting excited about innovation and then wondering about its genuine applicability, can be seen in the TV show, Catalyst, (video available online for a short time) broadcast by the Australian Broadcasting Corporation on 16 April 2009.

The program provides a profile on a computer simulation program that purports to aid the rehabilitation of war veterans by returning them to traumatic events of the war zone. It seems that the theory is the same as “getting back on the horse that threw you”.

In OHS terms, the applicability for firefighters, emergency response personnel etc is obvious but SafetyAtWorkBlog has reservations. The use of video simulations and games by the armed services before, during and after combat is discomforting.

Managers and health care professionals may need to carry some of the responsibility for the cloudiness of mental health and trauma by applying the hyperbole of trauma to relatively benign workplace issues. Many elements of work are being described as traumatic when they are not. They maybe disturbing, disconcerting or even harmful but there is a big difference between being punched in the face by a psych patient and driving over a car of civilians in an armoured vehicle.

In other industry sectors, such hyperbole would be described as spin. It is the responsibility of OHS professionals to cut through the spin and not be distracted by “exciting”, but indirect, innovative solutions. Let’s look for the evidence and operate from what we know works. At least until new evidence appears.

Kevin Jones

Category: health

Fatigue is the biggest threat to a person’s safety

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Swine Flu lessons – presenteeism is real

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Australian Prime Minister talks to the great unwashed

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Safe Work Australia Awards 2008

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Handwashing as a risk control

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Swine Flu – workplace preparations

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“Getting back on the (trauma) horse”

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