Absence management survey results

On January 8 2009, the Mercer’s 2008 Pan-European Health & Benefit Report was released.  It had some useful information about the causes of workplace absenteeism in Europe.  The information was compiled in 2008 so is as current as can be but also occurred in a  period of severe economic unrest.

As with all studies, the applicability to other nations and regions is up for debate but the data is a great starting point for discussion on managing these issues in workplaces.

According to the available report information

“Musculoskeletal conditions were identified by 78 percent of respondents as the cause of most long-term absences.  Thirty-one percent specifically referenced lower back pain and 47 percent other musculoskeletal conditions.  Stress and mental health issues (52 percent) and cancer conditions (20 percent) were also featured amongst the highest disability causes.”

By looking at policies and practices in the multi-jurisdictional structure of Europe, the demographic variations and management initiatives may be applicable elsewhere.

As Steve Clements of Mercer says

“Absence management remains haphazard at best.  Targeted absence management policies and procedures are by no means universally applied, and even the ability to quickly and accurately measure absence remains fairly poor.  Many employers offer a broad range of health-related benefits, but their presence is driven by recruitment and retention, and it appears there is only sporadic evidence of integration of these benefits within a broader employee health and wellness or absence management agenda.  At a time when cost is under the microscope, employee absence remains under-managed and presents a great opportunity for savings and improved productivity.”

Kevin Jones

Gillard’s plans for new OHS agency

In an interview with the Australian Financial Review of 20 January 2009, the Deputy Prime Minister and Minister for Workplace Relations, Julia Gillard, has indicated a preference for the Workplace Relations Ministerial Council to “create an executive agency that did not need the approval of parliament”. 

The article goes on to report Gillard’s OHS plan

“the states would use executive powers to create another regulator to control the new laws to avoid the need for approval from the federal parliament…”

The process she proposes has broader ramifications for the Rudd government’s reform agenda, as can be indicated by the placement of the article on the cover of the conservative newspaper, the Australian Financial Review

Gillard’s proposal is not ideal and as the AFR editorial points out, it is the inflexibility of the Coalition and Greens that has put this option on the Minister’s agenda.  It is an important move and one that is likely to receive support from the OHS professional organisations who have lobbied for a central OHS regulatory agency.

The next step is to see what the review panel into model OHS law recommends in its report due to be handed to the government at the end of January 2009.

[The articles are not available on line as AFR.com is a subscription-only service]

Kevin Jones

Safety promotion needs backup

vwa-billboard-2008-0022

WorkSafe Victoria has had considerable advertising success by focusing on the social impact of workplace injuries and death.  In the newspapers and television over Christmas 2008, WorkSafe ads, like the billboard above, were on high rotation but, after the high number of workplace fatalities in January 2009, the strategy must be needing a review.

In terms of OHS promotion generally, branding and awareness strategies are valid however, when the messages of the strategies continue to be ignored, alternatives need to be developed.  The fatality figures imply that family is “the most important reason for safety” but only for a short time or in limited circumstances.  When you return to work the work environment or your approach to the work tasks are worse than before Christmas.

The reality of advertising is that it is often cheaper to raise awareness than change the behaviour of clients, in terms of OHS, this would be both the workers and the employers.  Raising safety as a business priority requires considerably legwork by regulators on-site and through industry associations.  Few OHS authorities around the world seem to be applying hands-on approaches to the extent required.

Part of the reason is that trade unions used to be the shopfloor safety police, as anticipated by Robens in the early 1970s, but trade union membership is at record low levels.  The deficiency in the safety profile on the shopfloor or at the office watercooler is not being picked up by the employers.

Media campaigns are the public face of safety promotion but they should not be a veneer.  Regulators need to provide more information on the alternative strategies they already employ, or plan to introduce, so that promotion is not seen as an end in itself.  

Direct business and CEO visits have been used in the past but given up because these were short term initiatives.   In Victoria, high level visits by regulators to CEOs, board members and directors had a considerable impact in the 1990s but there was no follow-up strategy to maintain that profile.   Ten years on there are a new set of senior managers who could do with a bit of prodding.

Kevin Jones

OHS as an agent of change

Tom Bramble is a Queensland socialist academic who recently published a history of Australian trade unionism.  I attended his book launch in Melbourne and found it partly inspiring and partly disconcerting.

Tom (pictured here) was an excellent speaker and seemed to be a knownbramble-book-launch-0011 entity to the strongly socialist audience.  It was the audience that I found disconcerting.  I had not been in so overtly socialist circles for over a decade and although disconcerted, the atmosphere was refreshing due to the level of passion in the speakers.

I regularly write about the industrial relations context of workplace safety  so I was disappointed that Tom did not mention OHS as an agent of change.  I went back to his book and looked for mentions of workplace safety knowing that there have been disputes over OHS in the trade union movement and often workplace fatalities have generated politic pressure and outrage.  

There were some mentions of of safety or health conditions but these were often as an add-on to the more industrial issues such as wages.  Perhaps this is where OHS should be but I can’t help thinking that safety and health can be important elements of emphasising the importance of a dispute by appealing to basic worker and human rights.  One example in Tom’s book is the Mount Isa Mine dispute in 1964 where the state of amenities block was a source of tension.  Given the devastating effect of asbestos, lead and other industrial illnesses, I expected health and safety to have a much higher profile.

Perhaps, my expectations were too high as I had been reading a history of the Queensland Fire Service where the safety and safety equipment were important elements and even motivators for disputation.  Indeed, the issue of PPE in the emergency services remains a hot issue even in 2008.

Arguing for improved safety equipment is a useful example of OHS as an agent of change because of the direct relationship of PPE as a hazard control mechanism.

I don’t accept the position that firefighting is riskier than working in construction. Construction faces a constant presence of hazards whereas firefighting is highly intermittent even though the risks may be more intense.

Australian workplaces have a sad history of fatalities, falls, poisoning, suicides, amputations, crushings, runovers and drownings.  Each of these issues have generated change in specific workplaces.  Some have generated political, organisational and cultural change.  It seems to me that a history of workplace safety in Australia may be needed to show people how the little brother of industrial relations affects change from an, arguably stronger moral position.

Kevin Jones

Workplace health – international response

Rory O’Neil, editor of Hazards magazine has written in response the SafetyAtWorkBlog posting on workhealth initiatives.  His response was posted on one of the many safety-related Internet discussion forums and was brought to my attention by Andrew Cutz and others.

WorkHealth initiatives – it’s about the workers, isn’t it?

The Victorian system is not garnering the necessary support because it is lifestyle focussed and has not answered concerns raised by unions, who want the programme to also address conditions caused or exacerbated by work. Business is annoyed because unions had the audacity to require that workers have a say in measures relating to their health (the poor little things are supposed to be passive recipients, apparently, taking the medicine and behaving like good little children). Below is my little news summary from 1 November.

There’s a rash of these lifestyle related interventions around the industrialised world. The EU is pushing fruit into some workers’ mouths, for example, as part of the ISAFRUIT project. However, two apples a day don’t make a worker as happy and healthy as a pay rise or some constructive participation in decisions about how work is organised, how satisfying that work might be and at what pace and for what reward. Or wage levels that allow healthy dietary choices for the whole family, at home and at work.

The lifestyle-focussed projects tend to be couched in language about making the worker healthier but are frequently more concerned with reducing sickness absence costs and winnowing out all but the superdrones that can work long hours in bad jobs without complaint. If employers cared so much, sickness absence procedures would not include punitive elements and health and safety whistleblowers wouldn’t be an endangered species. The unionisation campaign at Smithfield is a pretty clear case in point – bad jobs, bad pay, runaway strains and injuries and victimisation for those would stood up against it.

I’ve nothing against been given free fruit, free gym membership or anything free for that. But the time to use the gym, eat the fruit and have a life both inside and outside work that is meaningful and fulfilling might make it easier to swallow. This issue is about good jobs, with good conditions of employment and good remuneration. If workplace health policy ignores these factors, then it is an irresponsible diversion.

This is my latest measured contribution on the issue:

You big fat liars [Hazards 104, October-December 2008]
Oh, they say it’s because they care. They’ll weigh us, keep tabs on our bad habits and ask questions when we are sick. And when we fall short of perfection, they label us shirkers, sickos and slobs. Hazards editor Rory O’Neill questions whether all this attention from employers is really for our own good. more
More on this theme: www.hazards.org/workandhealth

If ACOEM is developing policy, then it should consider how work factors dominate our working days and frames the comfort and health of our working lives and beyond. That means integrating better work into any health model and making sure workers are allowed to participate fully in – and influence the design and operation of – any workplace health system.

Rory also points to the Trade Unions Congress posting that quotes the Victorian union response to the WorkHealth program and says this about the major employer group’s position:

The employers’ group, meanwhile, is adamant it will not accept the changes under any circumstances. David Gregory, the head of workplace relations at the Victorian Employers Chamber of Commerce and Industry, said it amounted to making the programme an ‘industrial weapon.’

Eliminating hazards

In the aims of most of the Australian OHS legislation is 

“to eliminate, at the source, risks to the health, safety and welfare of employees and other persons at work…”

I have written elsewhere on how this conflicts with the push for “reasonably practicable” but the need to remember this important aim was emphasised by a study undertaken by the Graduate School of Public Health and the School of Medicine at the University of Pittsburgh and published in the January 2009 issue of “Neuropsychology”, which is published by the American Psychological Association.

The researchers followed up on the 1982 Lead Occupational Study, which assessed the cognitive abilities of 288 lead-exposed and 181 non-exposed male workers in eastern Pennsylvania.  It measured “five primary cognitive domains: psychomotor speed, spatial function, executive function, general intelligence, and learning and memory.”

According to the media statement, in the 2004 follow up study,

“Among the lead-exposed workers, men with higher cumulative lead had significantly lower cognitive scores. The clearest inverse relationships – when one went up, the other went down – emerged between cumulative lead and spatial ability, learning and memory, and overall cognitive score.

This linkage was more significant in the older lead-exposed men, of at least age 55. Their cognitive scores were significantly different from those of younger lead-exposed men even when the researchers controlled for current blood levels of lead. In other words, even when men no longer worked at the battery plants, their earlier prolonged exposure was enough to matter…”

“The men who built lead batteries were exposed to it in the air and through their skin. Other occupations, including semiconductor fabrication, ceramics, welding and soldering, and some construction work, also may expose workers. The authors wrote that, “Increased prevention measures in work environments will be necessary to reduce [lead exposure] to zero and decrease risk of cognitive decline.””

Lead has been identified as a major occupational hazard for a very long time and is a good example of how “reasonably practicable” is not always a reasonable solution.  Lead paint products have been banned in many countries.  Asbestos similarly so.  The attitude that there are “safe” levels of exposure to some industrial products is not worth pursuing in most circumstances.

Safety is similar to medicine in that both aim to “do no harm”.  If Hippocrates, or Galen, were alive today they would not say

“do no harm, as far as is reasonable practicable”.

That is not a belief that will establish a centuries-old profession and it should not be blindly accepted by the safety profession in the 21st century.

Kevin Jones

Workplace health initiatives in unstable economic times

All through the Presidency of George W Bush, safety professionals have been critical of the lack of action on workplace safety.  As with many issues related to a new Democrat President in Barack Obama, organisations are beginning to publish their wishlists.  The latest is the American College of Occupational and Environmental Medicine (ACOEM).

On 9 January 2009, ACOEM released a media statement which began

“American College of Occupational and Environmental Medicine (ACOEM) calls on the Health and Human Services Secretary-designee Tom Daschle to address the critical link between the health, safety, and productivity of America’s workers and the long-term stability of its health care system and economy as he begins work on the Obama administration’s health care agenda.”

The requested changes could be interpreted as a criticism of what the situation has been under George W Bush.  ACOEM says the next government

“must put a greater emphasis on ensuring the health of the workforce in order to meet the twin challenges of an aging population and the rise of chronic disease…”

ACOEM President Robert R. Orford, MD goes into specifics

“…calling on Daschle to focus on preventive health measures aimed at workers that could range from screening and early detection programs to health education, nutritional support, and immunizations.”

The ACOEM reform program is based on the following

  • “investing in preventive health programs for workers;
  • creating new linkages between the workplace, homes and communities to reinforce good health;
  • providing financial incentives to promote preventive health behaviors among workers; and
  • taking steps to ensure that more health professionals are trained in preventive health strategies that can be applied in the workplace.”

Accepting that one Australian State, Victoria, is considerably smaller than the US (Victoria  has a population of around 5,200,000, the US had 301,621,157 in 2007), it is interesting to remember what the Victorian Government proposed (or promised) just on 12 months ago concerning its WorkHealth initiative.

“Over time the program is expected to free up $60 million per year in health costs, as well as:

  • Cut the proportion of workers at risk of developing chronic disease by 10 per cent;
  • Cut workplace injuries and disease by 5 per cent, putting downward pressure on premiums;
  •  Cut absenteeism by 10 per cent; and
  •  Boost productivity by $44 million a year.”

[It would be of little real benefit to simply multiple the Victorian commitments by the differential with the US population to compare monetary commitments, as there are too many variable but if the WorkHealth productivity was imposed on the US, there could be a $2.6 billion, not a lot considering the size of President Bush’s bailouts and Barack Obama’s mooted bailout package.  However, in the current economic climate, in order to gain serious attention, any proposal should have costs estimated up front and, ideally, show how the initiative will have minimal impact on government tax revenues – an approach that would require.]

In each circumstance there is the logic that unhealthy people are less productive than healthy people.  This sounds right but it depends very much on the type of work tasks being undertaken.  It is an accepted fact [red flag for contrary comments. ED] that modern workloads are considerably more supported by technology than in previous labour-intensive decades.  Perhaps there are better productivity gains through (further) increased automation than trying to reverse entrenched cultural activity.

In late 2008 an OHS expert said to a group of Australian safety professionals in late-2008 that WorkHealth

“is not well-supported by the stakeholders.  The trade unions feel it is a diversion away from regulated compliance and that it is going to refocus the agenda on the health of the worker and the fitness of the worker as the primary agenda, which is not what the [OHS] Act is setup to focus on. The employers are basically unkeen to get involved on issues they think are outside their control.”

The expert supported the position of some in the trade union movement that WorkHealth was always a political enthusiasm, some may say folly.

This is going to be of great importance in Australia with the possibility of new OHS legislation to apply nationally but also muddies the strategic planning of any new government that needs to show that it is an active and effective agent of change, as Obama is starting to do.  In the US, the public health system is not a paragon and the workplace safety regulatory system is variable, to be polite.  Fixing the public health system would seem to have the greater social benefit in the long term, and a general productivity benefit.

(It has to be admitted that the packaging of health care in employment contracts in the US is attractive employment benefit and one that seems to be vital to those who have it.  Australia does not have that workplace entitlement but those employers struggling to become employers-of-choice should serious consider it, particularly as a work/family benefit.)

Each country is trying to reduce the social security cost burden on government and it would seem that public health initiatives would have the broader application as it covers the whole population and not just employees, or just those employees who are unfit.

Work health proposals in both jurisdictions need to re-examine their focuses and to pitch to their strengths.  Business has enough to worry about trying to claw its way out of recession (even if the US government is throwing buckets of money to reduce the incline from the pit).  OHS professionals have enough work trying to cope with the traditional hazards and recent, more-challenging, psychosocial hazards.  Workplace health advocates are muddying the funding pool, confusing government strategic policy aims, and blending competing or complementary approaches to individual health and safety in the public’s mind.  

 Kevin Jones

Update 16 January 2009

More information on this issue is available HERE

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