health – Page 134 – SafetyAtWorkBlog

George W Bush and workplace safety

In 2001, one of the first legislative actions of George W Bush was to repeal the United States ergonomics standard. At the end of his presidency there are indications that he is thinking about the regulatory impost of OHS on businesses again.

Crikey.com and others have reminded us of the Bush Administration’s plans concerning the exposure of workers to chemicals

“David Michaels, an epidemiologist and workplace safety professor at George Washington University‘s School of Public Health, said the rule would add another barrier to creating safety standards, in the name of improving them.

“This is a guarantee to keep any more worker safety regulation from ever coming out of OSHA,” Michaels said. “This is being done in secrecy, to be sprung before President Bush leaves office, to cripple the next administration.””

Propublica has reported that new rules that seem to run counter to current fatigue management guidelines elsewhere have been finalised.

“The Department of Transportation has finalized an interim rule for the number of hours a truck driver may spend on the road per day and per week. The rule, which has essentially been in effect since 2004, allows truckers to drive for 11 hours and work no more than 14 consecutive hours each day. They must rest 10 hours between shifts, and may not work more than 60 hours a week.”

An audio report from 2007 on the issue of working hours is available at NPR

It is hard to see the justification for these safety rule changes but these are just two of many changes in place or being finalised in a rush. Perhaps there is a grander strategy that the bigger perspective will show.

The actions are disappointing but not without precedent. It should be remembered that Democrat President, Bill Clinton, took full advantage of the opportunity.

In Australia and elsewhere, the movement to “cut red tape” gathers strength, it just seems that no one yet is applying the US solution of eliminating the regulatory need.

It is sad to see that throughout Bush’s tenure safety advocates and lobbyists were not able to gain concessions. It will be doubly difficulty to gain anything that may involve a cost to business in the current economic problems.

The challenge will be even greater in Australia where the Safe Work Bill has been withdrawn from Parliament and the Government is willing to weaken election commitments, such as on climate change, due to the economic context.

In just over a month’s time, we will see how new President Barack Obama acts on safety; Australia has much longer to wait.

Leading from the top on impairment

Advocates of safety culture regularly profess that it must be lead from the top of the corporate structure down. This applies a false definition of leadership. Leadership is innovation, understanding and support regardless of one’s position on the corporate ladder.

It is true that professing leadership and corporate goals should be supported by the appropriate actions but that is often the avoidance of hypocrisy rather than seeking active change. It must be acknowledged that leadership can also come from below – in the mail rooms, the cellars, the janitors and from the shopfloors.

Workers in many industries are subjected to random drug and alcohol tests. Often these apply to those workers who operate machinery or drive transport vehicles. And rightly so. These workers must undertake their tasks without any impairment of their cognitive functions. Impairment is a concept that the Australian union movement has struggled with for well over a decade mainly because in the industrial relations world this is close to being “fit for work” and how does one define that? It also has some relationship to “blaming the worker”. In occupational health and safety, it is seen as looking after one’s self whilst looking after others and the obligation to do this has existed for decades in OHS legislation.

Impairment is commonly discussed now in terms of driving while drunk or stoned or while using a mobile phone. But long before this there was “impaired judgement”. As well as being fit-for-work, people needed to be fit-to-think.

On 4 December 2008, the New South Wales Health Minister (and former Industrial Relations Minister) John Della Bosca rejected a proposal from the Rail, Bus & Tram Union (RTBU) to “to make breath-test kits available on a voluntary basis to MPs wanting to check their blood alcohol levels before they turn up for late night votes.”

It is reported that the RTBU secretary Nick Lewocki has said

“All rail workers are subjected to random drug and alcohol tests, an infringement on their personal lives that they are told is necessary due to the safety critical nature of their work. But driving the state is every bit as safety critical, and decisions our politicians make on issues as diverse as health, education and transport policy do affect public lives.”

Ignoring the political devilment of the RTBU, the comment focuses on being unimpaired when making decisions, regardless of the occupation, work task or corporate position. The Minister has been put in a difficult position where he can’t be seen as responding to union naughtiness but there is merit in leading from the top and making breath-test kits available. They are not suggesting random testing or mandatory testing but it is reasonable to expect important decision-makers to be fit-to-think and fit-to-decide.

Perhaps drug testing in the workplace would not be seen as the contentious issue it is if it had already been introduced in the boardroom. The gesture would not be as empty as the corporate leaders may think particularly leading into the season when sauce and ganders were traditionally eaten.

Management failures and a rape of a five-month-old baby

Earlier this year, SafetyAtWorkBlog reported on the attack on a nurse in the Torres Strait Islands north of Australia, the investigation of the issue by Queensland Health and the mechanisms introduced to get the working conditions and accommodation up to a safe level. In this case there was a clear link between occupational health and safety and the security of a worker.

OHS law in Australia obliges workers and those in control of a workplace to ensure the safety of people on their premises. Last week the Northern Territory government received a report (081128vol1-f9c6d46d-75d5-4a5e-95e7-7c040ae6600c1) into the security measures at the Royal Darwin Hospital. This hospital has undertaken fantastic medical work in the past, most noticeably, on a large scale following the bombings in Bali in October 2002.

However it failed to prevent the rape of a five month old female infant on 30th March 2006, while the indigenous baby was an inpatient.

Carolyn Richards, the Health & Community Services Complaints Commissioner, said in her report

As a result of a complaint reported to the Health & Community Services Complaints Commission an investigation was undertaken by the Director of Investigations, Mrs Julie Carlsen, who is employed as the Director of Investigations (DI) Health & Community Services Complaints Commission.

This report highlights that the Department of Health & Community Services (DHCS) needs to implement effective risk control mechanisms to minimise the risk of an assault on a vulnerable inpatient in the Royal Darwin Hospital (RDH). The investigation has led to the conclusion that DHCS (DHF) and RDH have not complied with the applicable Australian Standard. It has also revealed that crucial information has been withheld from an expert engaged by RDH to review security arrangements and from the DHCS (DHF) Security Manager based at RDH. This report also details inadequacies and failings by those responsible for managing RDH who have failed for over two years to implement and maintain better security for patients in the Paediatric Ward. It is published with the hope that it will cause DHCS (DHF) and RDH to give higher priority to improving its risk management and security procedures.

The Commissioner’s conclusions are worth including here so that OHS professionals and security officers can establish appropriate procedures for their workplaces.

1. On 30th March 2006:

There were no arrangements in place on the Paediatric Ward to ensure the safety and inviolability of vulnerable patients.

No risk assessment had been conducted.

The arrangements in place did not comply in any aspect with the Australian Standard which sets the benchmark for proper security.

There was no control on access to the Ward or to the patients.

The staff had not received adequate training, and possibly none at all, about the risks arising from lack of security arrangements.

In 2002 RDH had commissioned and received an expert consultant’s assessment and report on security arrangements at RDH. The Terms of Reference did not require 5B to be assessed. By 30 March 2006 the recommendations in the report had not been implemented in Ward 5B. This failure can only be described as shameful.

Following the rape of the infant police were not notified for about 2 hours.

2. Action taken by RDH after the rape to improve security was: (a) slow (b) inadequate, and (c) has not been adequately evaluated or reviewed to determine its effectiveness

3. RDH has a Security Manager on site as well as an NT Police member stationed at the hospital. Neither has been asked to evaluate the security on the Paediatric Ward either before or after the rape of the infant.

4. Staff working on the Paediatric Ward have not been trained at their induction on the elements of security arrangements to reduce the risk to vulnerable patients nor has there been adequate ongoing training of staff before or after the 30th March 2006 incident.

5. In 2007 the same expert safety and security consultant, as in 2002, was engaged to assess security arrangements at RDH. He was not informed of the rape of the infant in March 2006 nor was he asked to report specifically on arrangements in the Paediatric Ward.

6. On 21 November 2007 two investigation officers from the Health and Community Services Complaints Commission visited the Paediatric Ward by prior arrangement. They were able to enter the Ward and wander around, have entry to every part of it and stand at the nurse’s station, for about 25 minutes without anyone asking who they were and why they were there.

7. Management’s lack of commitment to the proactive identification of risks and to taking appropriate action has not created a culture where each member of staff takes responsibility for identifying and reporting risks and developing safe practices.

8. A security review of RDH was carried out by an expert hospital safety and security consultant who issued a report in 2007. The Security Manager of DHCS (DHF) was not given a copy even though he requested it. HCSCC enquired of RDH management why he was not given a copy and RDH have offered no explanation. On 31 October after this report was published to RDH and DHF the CEO of DHF advised this Commission that he had finally been given a copy and that he had seen a draft copy.

9. RDH Maternal and Child Health Clinical Risk Management Committee considered security in the Paediatric Ward following the incident. The Committee met on 16th May 2006, 2.5 months after the rape of the infant. It met a further 4 times. It submitted an action plan to the General Manager of RDH in July 2006. At its last recorded meeting on 5 September 2006 there had been no response from the General Manager on the recommendations, particularly with respect to installing CCTV cameras with recording facilities on the Paediatric Ward. There were still no recording cameras on the Paediatric Ward as at June 2008 although a CCTV system had been installed in the kitchen area to deter the pilfering of food. Dr David Ashbridge on 31 October 2008 advised, when responding to a draft of this report, that CCTV cameras were installed in Paediatrics on 25 August 2008.

10. The surveyors from the Australian Council of Health Standards which accredits RDH probably did not receive all relevant information about the incident of 30 March 2006 and what action RDH were taking. Those surveyors on 13 October 2006 were informed by RDH that the patient information pamphlet and admission interview are being reworded to reflect the changes to ward access. There was no verification throughout the investigation that any action had been taken by RDH to implement the recommendations of the review. Neither the report of ACHS nor records of information given to ACHS have been provided to the HCSCC. DHCS (DHF) was invited to provide me with those relevant documents in response to this draft. No response was received on this issue from DHF or RDH. According to the published information of ACHS the accreditation survey commences with a self assessment by the hospital concerned. This Commission specifically requested details and copies of the information provided to the ACHS surveyors but no response was received from either the CEO of the Department or the General Manager of RDH.

11. The governance arrangements at RDH do not promote adequate transparent accountability of the General Manager and the Department of Health and Families for the operation of the hospital. Control of all aspects of the day to day management of RDH rests in the hands of three individuals. This includes staff recruiting, training, security, nursing and medical services, procurement, record keeping, financial accountability and risk management. Such specialist management groups as exist are subordinate to the General Manager’s authority. The General Manager reports to the Director of Acute Services who reports to the CEO of the Department. I have been unable to find out what role the Royal Darwin Hospital Board has since its last annual report to 30 June 2006.

It is well worth obtaining the complete report to understand how such an individual tragedy occurred. As one media commentator has posited

“One wonders what the reaction would have been if a non-indigenous infant was raped.”

It is harder to prevent than compensate, but more important

Tonight in Adelaide the President of the Australian Human Rights Commission, Catherine Branson QC, will be delivering the 2008 Don Dunstan Foundation Oration.

Ms Branson has said

“I want to live in a society where everyone can take advantage of his or her abilities and where everyone has a real say about the world they live in, be they an Indigenous person, a person of Muslim faith, a parent wanting leave from work to care for a child, or a person in a same-sex relationship.

“We all want a society where we can all feel safe and protected from violence and harassment no matter who we are or where our children can access appropriate educational opportunities no matter where they live.

“These are hardly controversial ideas.”

Indeed they are not. But in many of the past discussions on human rights, rights at work are missed, yet they are just as important. The omission may be because it seems there is a plethora of avenues of appeal in the workplace – discrimination, unfair dismissal, sexual harassment tribunals etc. Yet none of these focus on the prevention of harm in the way that legislative OHS obligations do.

Until the human rights advocates’ speeches become inclusive of workplace matters, there will be societal anchor dragging on progress of basic human rights.

Beware the OHS hype on chronic obstructive pulmonary disease

World COPD day was held on 17 November 2008. COPD Stands for chronic obstructive pulmonary disease. As with many of these health-related days there is more hyperbole than substance and often the most relevant information appears after the hype has died down. This is the case with a report just released by the Occupational And Environmental Medicine. [[Chronic obstructive pulmonary disease mortality in railroad workers Online First Occup Environ Med 2008; doi 10.1136/oem/2008.040493]]

According to a media statement that accompanied the report:

They wanted to gauge the long term effects of diesel exhaust on the risks of developing chronic obstructive pulmonary disease (COPD), an umbrella term for progressive lung diseases, such as emphysema and bronchitis.

In 1946, just 10% of rolling stock was diesel powered; by 1959, virtually all rolling stock was.

The researchers checked the health records of the US Railroad Retirement Board, which has maintained digital records of all its employees since 1959, including a yearly listing of all job codes and time spent in post.

Anyone working on the trains (conductors, engineers, brakemen) was considered to have been exposed to diesel exhaust.

Those working in ticketing, signalling, maintenance, admin, and as station masters, were regarded as not having been exposed.

The results showed that those who had been exposed to diesel exhaust were more likely to die of COPD than their peers who had not been so exposed.

The risks increased by 2.5% with each year of employment among those who were recruited after conversion from steam to diesel locomotives.

This risk fell only slightly after adjusting for smoking, a known risk factor for COPD.

Of all the reports that were released in the last two weeks, this one is the clincher because it shows that smoking did not have an appreciable effect on the health findings. There is a direct relationship between a work activity in a work environment and worker health.

This correlation is sadly lacking from other COPD data which reads primarily as a new spin on anti-smoking campaigns.

According to the International COPD Coalition (“a nonprofit organization composed of COPD patient organizations around the world, working together to improve the health and access to care of patients with chronic obstructive pulmonary disease”)

World COPD Day 2008 features new patient and health professional initiatives that address the misconceptions and lack of awareness surrounding chronic obstructive pulmonary disease (COPD). These misconceptions – revealed in a global survey, the International COPD Coalition (ICC) Report – include poor public awareness that smoking is the main cause of COPD, a failure to diagnosis COPD in its early stages, when medication can be used to prevent further lung deterioration, and a mistaken belief that initial COPD symptoms, like coughing and shortness of breath, are a normal consequence of aging.

We may be unaware smoking leds to COPD but we are well aware that smoking can kill you. Whether it is emphysema, lung cancer, heart disease or COPD doesn’t change the fact that smoking increases the risk of premature death. It is insulting that a “World Anti-Smoking Day” needs to masquerade under a new health risk.

For those workers who have suffered work-related respiratory problems the Queensland governmenthave released a very good guide for those who have breathing difficutlies or for those who look after them – the Better Living With COPD – A Patient Guide (pictured below)

When too many graphic ads is never enough

Coming to the end of Australia’s school year, the government is going overboard with confronting advertisements for young people, be they related to work safety or binge drinking.

At least the OHS regulators watched other regulators information campaign and reduced their costs by resisting promoting the same message in the same way to the same demographic. WorkSafe Victoria‘s Homecoming campaign has been phenomenally popular and influential.

Sadly, the health promotion sector doesn’t coordinate their effort (or have exhaustive budgets). The Minister for Health, Nicola Roxon, has launched the latest set of confronting ads for teenagers, this time on binge drinking. With such a lack of coordination, the target audience is going to be quickly turned off the ads, instead of turning off the bad behaviour.

Each time this graphic approach is used, the message, regardless of the topic, is severely weakened.

Sadly, we’ve seen it all before (and only a month ago).

Sexual harassment and occupational health and safety

Some old-time safety professionals are struggling with the inclusion of psychosocial hazards in their safety management programs. Some deny the relevance of sexual harassment to their duties and hope that the issue can be contained within the human resources department, the “dark arts” of workplace safety.

Many of these same safety professionals are calling for more evidence-based decisions on workplace safety.

Evidence is now in on the social and work impact of sexual harassment. Australia’s Human Rights Commission has issued Effectively preventing and responding to sexual harassment: A Code of Practice for employers‘ which states on page 48

Employers have a common law duty to take reasonable care for the health and safety of their employees. This common law duty is reinforced by occupational health and safety legislation in all Australian jurisdictions.

An employer can be liable for foreseeable injuries which could have been prevented by taking the necessary precautions. As there is considerable evidence documenting the extent and effects of sexual harassment in the workplace, it has been argued that the duty to take reasonable care imposes a positive obligation on employers to reduce the risk of it occurring.

A work environment in which an employee is subject to unwanted sexual advances, unwelcome requests for sexual favours, other unwelcome conduct of a sexual nature, or forms of sex-based harassment, is not one in which an employer has taken reasonable care for the health and safety of its employees. A work environment or a system of work that gives rise to this type of conduct is not a healthy and safe work environment or system of work. An employer could be regarded as not having acted reasonably to prevent a foreseeable risk if practicable precautions are not taken to eliminate or minimize sexual harassment in the workplace.

Failure to fulfil the duty of care can amount to a breach of the employment contract as well as negligence on the part of the employer. This means that an employee who has been harmed could bring an action against their employer in contract or tort.

The guide can do with considerable translation to what businesses see as useful codes of practice in the application of safety management but perhaps that is for the private sector and State OHS regulators to work on.

There seems to be enough information available now on sexual harassment, fatigue, bullying, violence, fitness for work, shift work, depression and other matters, that the safety profession should be more embracing of these concepts in their own planning. Let’s hope that in this discipline we do not have to wait for generational change to achieve a change in approach.

Category: health

George W Bush and workplace safety

Like this:

Leading from the top on impairment

Like this:

Management failures and a rape of a five-month-old baby

Like this:

It is harder to prevent than compensate, but more important

Like this:

Beware the OHS hype on chronic obstructive pulmonary disease

Like this:

When too many graphic ads is never enough

Like this:

Sexual harassment and occupational health and safety

Like this:

Share this:

Like this:

Share this:

Like this:

Share this:

Like this:

Share this:

Like this:

Share this:

Like this:

Share this:

Like this:

Share this:

Like this: