health – Page 155 – SafetyAtWorkBlog

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.

Important victory for aircraft maintenance workers

The Department of Veterans’ Affairs may have to pay compensation to the maintenance crews of F-111 fighter planes. In the 1970s employees worked within the fuel tanks of the fighters with little, if any, PPE. In 2004 these workers were excluded from a healthcare and compensation scheme even though, according to one media report, evidence was presented that the workers had

a 50% increased risk of cancer
a two-fold increase in obstructive lung disease;
a two-and-a-half fold increase in sexual dysfunction; and
a two-fold increase in anxiety and depression.

One of the reasons the maintenance crews were denied compensation was that the Royal Australian Air Force (RAAF) had destroyed the maintenance records from before 1992.

An inquiry into the affair has received a submission from the commonwealth Ombudsman, John McMillan, and Labor MP, Arch Bevis, that strongly criticised the destruction and inadequacy of records.

In safety management, record-keeping is often seen, and dismissed, as “red tape”. The reduction of red tape is not the elimination of red tape and the reality of Australia’s increasing litigious legal system is that more records need to be kept, and for longer, than ever before.

Perhaps, the government, in its pledge to reduce red tape and business costs, should look at the lawyers’ insistence to business that the first port-of-call after an industrial incident is to call them so that everything becomes covered by legal-client privilege.

Perhaps it is the pressure to create paperwork than the paperwork itself that is the problem. In the case of the F-111 maintenance crews, regardless of the lack of paperwork, justice seems to be happening. It is just sad that so much pain and suffering had to be endured before getting close to a resolution.

Click HERE for a personal reflection on the health issues of the workers from one of Australian Rugby League’s champions, Tommy Raudonikis.

Physical activity, mental health, alcohol consumption and productivity

The Victorian Government’s workplace health strategy may be “coughing up blood” but health promotion continues. Last week, Australian health insurer, Medibank Private, released some statistics and cost estimates related to physical inactivity.

According to the media release, physical inactivity costing the Australian economy $13.8 billion a year. The findings are based on research conducted in conjunction with KPMG-Econtech which builds on Medibank’s 2007 research and “captures the healthcare costs, economy wide productivity costs, and the mortality costs of individuals passing away prematurely as a result of physical inactivity.”

Craig Bosworth of Medibank Private says,

“Most Australians are aware of the benefits of physical activity but this latest round of Medibank research has revealed some alarming effects of physical inactivity. An estimated 16,179 people die prematurely each year due to conditions and diseases attributable to physical inactivity and that is frightening. And whilst the majority of these are from the older population there is also a large number of people dying under 74 years of age due to physical inactivity, particularly in the male population.”

Bosworth goes on to say:

“Like other health risk factors, physical inactivity can have an adverse effect on organisations as well as individuals. Specifically, physical inactivity can impact on employee productivity by causing increased absenteeism and presenteeism, which impose direct economic costs on employers. The Medibank research has found that productivity loss due to physical inactivity equates to 1.8 working days per worker per year.”

Three audio statements on this research are available – physical-inactivity-telephone-grabs-edit

The SuperFriend Industry Funds Forum Mental Health Foundation has also released statistics on mental health in the workplace. The survey also found that 50 per cent of Australians admit to often feeling stressed and a quarter often feel depressed.

John Mendoza, Chair of SuperFriend’s Mental Health Reference Group, said, “There is increasing evidence of a link between stress in the workplace and mental illness. The cost of workplace stress to Australian business is potentially crippling.” Listen – workplace-mental-health-edit

The Superfriends survey found

One in two Australians believe that having a few drinks is a good way to maintain or improve their mental health;
80 per cent of Australians believe watching TV has a positive impact on their mental health;
Australians are putting their bodies ahead of their brains, with three-quarters of Australians engaged in activity to maintain or improve their physical health, while only 50 per cent are actively engaging in activity to maintain or improve their mental health.
Older Australians are more likely to heed the call ‘use it or lose it’. While 57 per cent of all Australians feel they take good care of their mental health, 68 per cent of those over 50 feel they are looking after themselves emotionally.
Australians aged 40 to 49 are the unhappiest and unhealthiest. Those in this age group are more likely to feel stressed and depressed and less likely to look after their physical and mental health.

A good starting point in planning to manage stress is the StressWise publication by WorkSafe Victoria.

For many decades, perhaps centuries, unhappiness at work was countered, to varying degrees, through the consumption of alcohol. According to the latest Australian Unity Wellbeing Index people who drink everyday are the happiest, whereas non-drinkers have a lower sense of wellbeing.

Amanda Hagan of Australian Unity summarises some of the research findings and supports the link between physical activity and positive wellbeing. Listen – australian-unity-wellbeing-index-aap-medianet-edit

WorkHealth – end is nigh after less than one year

Early in 2008, the Victorian Government sprung a surprise on the OHS and health promotion industries by announcing a world-first initiative – WorkHealth. This program was to be funded by interest generated from the WorkCover scheme to the tune of hundreds of millions of dollars over the next five years.

WorkHealth loses stakeholder support

Two weeks ago, a well-respected OHS professional advised that key stakeholders in WorkHealth were very cool on the program. This confirmed previous questions raised in SafetyAtWorkBlog about the promotion, transparency and organisational support for WorkHealth. The professional stated that others were questioning the placement of WorkHealth in the OHS field rather than in health promotion.

Rumour has existed for some months that WorkHealth is a scheme that has been pushed by a narrow range of OHS and workers compensation advocates.

What made WorkHealth so interesting was that the concept originated from within the workers compensation field with workers compensation money. At the time, the wisdom of committing such a large amount of money to the initiative was questioned by many in the trade union and business areas. Why head in this direction when there were established mechanisms to reduce OHS and workers compensation costs?

The global economic problems, it is suspected, would have flowed to the investments of the WorkCover scheme and it would be interesting to know what the revenue allocation to WorkHealth now is calculated at.

OHS/Industrial Relations conflict

In The Age newspaper on 26 October 2008, WorkHealth gained some attention as business groups have now seen the criteria for the health assessments of workers. David Gregory of the Victorian Employers’ Chamber of Commerce and Industry described the criteria as a potential “industrial weapon”. According to the article,

“WorkSafe told The Age the idea of an initial ‘tick test’ screening process had been abandoned, and the proposed $130 million worth of prevention programs are not in the pilot at all.”

As is evident from the quote, it is the pilot scheme that is being rolled out, however it is clear from the comments of David Gregory and the state secretary of the Australian Manufacturing Workers’ Union, Steve Dargavel that industrial relations sensitivities have not been considered.

Gregory makes excellent points that good OHS professionals are already aware of – workplace safety can only succeed when industrial relations implications and conditions are considered before any intervention process.

OHS has broadened to include the hazards of fatigue, stress, anxiety, depression, workloads, bullying and other matters that have encroached on health promotion and human resources over the last decade or so. A worker health program would have been more likely to be accepted through this osmosis rather than a surprise announcement.

Is this the end?

WorkHealth could work if it had been generated as a workplace application of public health programs. The challenge would have been to legitimise the expenditure in an already cluttered health promotion sector. How would WorkHealth have achieved this testing regime when business is already assessing its workers for psychological disorders, cholesterol, prostate health, hearing, asthma, and a whole range of modern health issues? It is unlikely that it could so.

It came down to health assessments in a different context – a context where there had been insufficient groundwork to establish the value of the program to its fundamental stakeholders, the unions and employer groups. To a much lesser extent, the program was not sufficiently integrated into the WorkSafe authority’s program before the announcement.

Also, the timing has been proven to be wrong. The global economic problems are beginning to squeeze business’ bottom line. The calls for workers’ compensation premium relief will increase in the same way that businesses have begun questioning the viability of an emissions trading scheme. WorkHealth is likely to be one of those program cut, so the government will claim, due to the changing economic climate. The lessons to be learnt are more wide-ranging than just economics.

New presenteeism survey figures

Frequently I receive audio media releases from the US about a range of workplace safety matters. These releases are scripted and can sometimes sound corny but within them is a usually a useful nugget of information.

The latest one I received concerns presenteeism and mental health so, being so close to World Mental Health Day, I thought it is worth mentioning. The audio release is from Cigna Health Care, an American insurance company, and can be heard by clicking 35580_09ny08-0039-_cigna-w

Cigna has a couple of fact sheets in support of the survey findings and an article specifically concerning mental health and wellness which may be worth a look.

An earlier posting on presenteeism is available and I recommend going to the World Health Organisation, UN or ILO sites for more independent information.

Category: health

Beware the OHS hype on chronic obstructive pulmonary disease

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When too many graphic ads is never enough

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Sexual harassment and occupational health and safety

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Important victory for aircraft maintenance workers

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Physical activity, mental health, alcohol consumption and productivity

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WorkHealth – end is nigh after less than one year

WorkHealth loses stakeholder support

OHS/Industrial Relations conflict

Is this the end?

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New presenteeism survey figures

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WorkHealth loses stakeholder support

OHS/Industrial Relations conflict

Is this the end?

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