Work harder? You must be mad

On 24 January 2010, the Australian Prime Minister, Kevin Rudd, encouraged all Australians to increase their “productivity growth“.  But what if increased productivity could result in developing a mental disorder?

The February 2010 edition of the  Harvard Mental Health Letter includes a report that lists the following key points:

  • “Symptoms of mental health disorders may be different at work than in other situations.
  • Although these disorders may cause absenteeism, the biggest impact is in lost productivity.
  • Studies suggest that treatment improves work performance, but is not a quick fix.”

Will the Australian Government review its policy on mental health?  Will the Prime Minister accept that productivity and mental health are both long term problems that need strategies that extend beyond his next term in office? Continue reading “Work harder? You must be mad”

Dipping into workplace violence

Jeff Sparrow recently gained considerable media attention with his book that reflected on violence in society.  Yossi Berger once described occupational health and safety as a “kind of violence” in his book of that title.  There is a lot of research  into occupational violence, much of it from the United States which, to some extent, has an unrepresentative view of this hazard.

An interesting, and brief, discussion on the matter is a chapter in the book “Perspectives on Violent and Violent Death” published by Baywood Publishing.  The existential perspective of one particular chapter may make it impractical for safety management purposes but as a background article for provoking thought, it is very good.

Without this chapter I would not have found the work of C E Newhill* into client violence in social work or that of C L Charles.  Charles identified some factors that have contributed to the “anger epidemic” which may provide some clues on understanding occupational violence.   These are listed below:

Dignity At Work, different UK and Australian approaches

On 26 January 2010, a fascinating document was released from England concerning  workplace harassment and violence.  This builds on earlier work in Europe and has led to the joint guidance on “Preventing Workplace Harassment and Violence“.

The guidance has the demonstrated support of employer, employee and government representatives who have committed to

“…ensuring that the risks of encountering harassment and violence whilst at work are assessed, prevented or controlled.”

Significantly they also state

“We will implement our agreement and review its operation.”

Continue reading “Dignity At Work, different UK and Australian approaches”

Stress management may be only a chocolate cake away

Safety professionals often struggle to manage stress in their employees and themselves but new research has found links between the consumption of chocolate and a reduction in stress.

The study in the Journal of Proteome Research entitled “Metabolic Effects of Dark Chocolate Consumption on Energy, Gut Microbiota, and Stress-Related Metabolism in Free-Living Subjects” Continue reading “Stress management may be only a chocolate cake away”

Heat stress (in the middle of Winter)

For those in the Northern Hemisphere at the moment, the risk of heat stress for workers is an extremely low priority but in Australia, even in the cooler parts and suburbia, the Summer temperatures are tipped to reach 38 degrees Celsius (100 degrees Fahrenheit) over the next few weeks.  Away from the urban and coastal centres, temperatures of 45 degrees C and higher will be common.

The Queensland Government’s OHS regulator has released new guidance on heat stress.  As it was only released on January 5 2010, it is the most current information.  The guidance seems aimed at rural workers and particularly those industries which may have a transitory labour force from cooler climates.

The guidance is useful in that it recommends some engineering solutions instead of just PPE.  For instance,

  • “creating some shade structure (tarp, umbrella) or at least find a tree for outdoor workers’ rest breaks
  • automating or mechanising tasks that require heavy or physical activity
  • reducing radiant heat emissions from hot surfaces and plant e.g. by insulation and shielding.”

Although it would have been good to see some mention of reassessing the need to work in heat at all as discussed elsewhere in SafetyAtWorkBlog.

The Queensland guidance recommends the following heat stress control measures:

  • “use sun protection – hat, sunscreen and light sun-protective clothing
  • drink at least one litre of cool water an hour when working in the sun
  • take breaks during the day in cool shaded areas to enable a rapid return of core temperature to normal
  • acclimatise to outdoor work gradually
  • have eaten during the day to ensure their energy and salt levels are maintained.
  • avoid alcohol, caffeine and drugs which can increase urine output and therefore fluid loss.”

Kevin Jones

New guidelines on aggression in health care

WorkSafe Western Australia and the other OHS regulators in Australia have produced a very good, and timely, guideline for the “Prevention and Management of Aggression in Health Services“.

The hazard has existed for many years and hospitals, in particular, are torn between the competing priorities of keeping their staff safe and maintaining  contact with their clients.   Glass screens and wire are effective barriers to violent attacks but it can be argued that such structures encourage aggression by implying that “violence happens here”.

The guidelines, or what the regulators call a “handbook for workplaces” (How does that fit in with the regulatory hierarchy for compliance?), provides good information on the integration of safe design into the health service premises.  But as with most of the safe design principles, as is their nature, they need to be applied from initial planning of a facility and so, therefore, are not as relevant to fitting-out existing facilities.  In health care, it often takes years or decades before upgrades are considered by the boards and safe design is still a new concept to most.

Another appealing element of the guide is that it does not only consider the high customer churn areas such as casualty or emergency.  It is good to see the important but neglected issue of cash handling mentioned even in a small way.

Another positive is the handbook includes a bibliography.  This is terrific for those who want to establish a detailed understanding of the issues and the current research.  For the OHS regulators, it allows them to share the burden of authority.  Just as in writing a blog, by referencing source material the reader understands the knowledge base for the opinions and the (blog) writer gains additional credibility by showing they have formed opinions and advice from the most current sources.

Having praised the bibliography, it is surprising that of all the Claire Mayhew publications and papers mentioned her CCH book “Guide to Managing OHS Risks in the Health Care Industry”, was omitted.

The regulators have often had difficulty determining whether checklists or assessment forms should be included in their guidances.  In Victoria one example of the conflict was in the Manual Handling Code of Practice that included a short and long assessment checklist.  Hardly anyone looked beyond the short version and many thought this undercut the effectiveness of the publication.

The fact is that safety management takes time and business want to spend as little time on safety as possible but still get the best results.  Checklists are an audience favourite and contribute to more popular and widely read guidelines, and broad distribution of the safety message is a major aim.

Interestingly amongst the checklist in this health services aggression publication a staff survey has been included.

(At least) WorkSafe WA has listened to the frustrations of readers who download a PDF version but then have to muck about with, or retype, the checklists.  This handbook is also available as an RTF file for use in word processing.

This is the first OHS publication that has come out from a government regulator with this combination of content, advice and forms.  It is easy to see how this will be attractive to the intended health services sector.

Kevin Jones

Self development course contributes to a workplace suicide

What would you do if a work colleague strips, screams, acts “like a child having a tantrum”, starts to sing and then jumps out of a window to her death?  That is the situation that was faced by staff at the Sydney office of the Royal Australasian College of Physicians in December 2005.

Only days earlier, 34-year-old Rebekah Lawrence, had participated in a self-development course called “The Turning Point” conducted by Zoeros P/L trading as People KnowHow.  The course, according to one media report, the course included a session called “The Inner Child”

“in which those taking part were encouraged to develop a dialogue between their child and adult selves.”

Lawrence’s actions just before her death mirrored some of the course teaching.

PeopleKnowHow’s website has closed down with an announcement that all of its courses are under review.  Other organisations that provide similar courses are running for cover.  Transformational Learning Australia has said it

“…no longer has a professional relationship, affiliation or any other connection with People Knowhow.” [emphasis added]

TLA also says any relationship ended in 2005.  That the company has felt it necessary to make a media statement about the end of the relationship shows the extent of the effect of Rebekah Lawrence’s death on this industry sector.

TLA goes on to say that

Our organisation does not accept participants who have a recent history of chronic mental illness, participants under the care of a treating professional who have not obtained that professional’s consent to participate, or people who demonstrate a propensity towards psychological fragility or a significant lack of cohesion during the introductory sessions of the program.”

The New South Wales Coroner found that in the absence of any history of psychosis in Rebekah Lawrence that,

The evidence is overwhelming that the act of stepping out of a window to her death was the tragic culmination of a developing psychosis that had its origins in a self-development course known as ‘The Turning Point’ conducted by Zoeros Pty. Ltd, trading under the name of ‘People Know-How” on the 14, 16, 17 and 18 December 2005.

The full coronial findings are difficult to read due to the personal details of Lawrence’s life, her relationship with her husband David and the general picture of her personality that comes through.   An upsetting and enlightening interview with David Booth is available online from earlier in the investigation process.

The findings also provide considerable detail to the components of the course that Lawrence undertook.  There is a greater level of detail than would be expected to be known by someone signing up for such a course and this is where the lessons can be learnt for the OHS professional and safety manager.

It has become common in many corporations who are trying to improve or introduce a positive workplace culture, to supplement their own efforts with “self-help” or “self-awareness” courses.  Lawrence’s death has highlighted the lack of regulation or accountability in some sectors of this industry.  This also highlights the need for people managers to thoroughly investigate such courses to ensure that good intentions are not likely to increase the risk of harm or damage to the employees who participate.

An audio report on the Coroner’s findings is available online.

Counselling Services

Many workplaces often provide access to counselling services through schemes such as Employment Assistance Programs.  The Coroner’s recommendations have some direct bearing on the issue of “counsellors”.

“The Executive Director of the Australian Psychological Society, Professor Lynne Littlefield pointed out that there are no legal restrictions in Australia for practising under the title ‘psychotherapist’ or under the title ‘counsellor’ and therefore no public safeguards against untrained or incompetent practitioners in this field.

Professor Littlefield pointed out that although there were many skilled counsellors and psychotherapists, there were also many whose competence is questionable and without any regulating mechanisms to stipulate the required training and levels of competence, there was no way of protecting the public from these poorly trained practitioners.”

Rebekah Lawrence’s death is receiving considerable media coverage in Australia at the moment and the New South Wales Government is carefully considering the Coroner’s recommendations concerning the regulation of some areas of the self-development industry.  Employers and safety professionals are going to have a very different set of criteria shortly from which such workplace-related courses need to be evaluated.

One media report has indicated the start of the ramifications of this unfortunate death:

“The NSW Health Minister, Carmel Tebbutt, said she had asked her department for ”urgent advice” on the case and would consider the coroner’s recommendations. A code of conduct for counsellors and psychologists had already been implemented and the Health Care Complaints Commission now monitored practitioners.

The Royal Australian and New Zealand College of Psychiatrists called for closer monitoring and accountability of self-help and psychotherapeutic courses.”

Kevin Jones

Work-related suicides in Europe

The Irish Times has reported on a speech made by Dr Jukka Takala, Director of EU-OSHA, in Spain in November 2009.

“[Dr Takala] said since the publication of a recent study showing a very high level of work-related suicides by French Telecom workers, there was an urgency about getting this information. “Personally, I favour a system such as they have in Japan where the families are compensated for the suicide of a relative, and the debate has already started in this organisation and in the commission and some of the member states,…”

It is not uncommon in OHS to hear calls for further research and more research on work-related suicide is definitely needed.  (Australia has some very good work in this area.)

Caution has to be voiced on the risk that suicides be seen as the mental health version of workplace fatalities.  Research and OHS statistics often focuses on fatalities for various reasons including that the statistics are easy to quantify.  If a worker dies from being crushed by a machine, its a workplace fatality.  There is a trap in terms of suicides where the cause and effect is not so clear, or mechanical.

Only recently have workplace fatalities begun to be investigated with consideration of the social or non-work contributing factors.  If the machine operator was pulled into the machine because they were inattentive, why were they inattentive?  In terms of suicides, the agency of injury will be fairly obvious but the contributory factors could be far more complex.  And if the suicide victim has not left a note explaining the reasons for their action, it is even harder to determine “cause”.

Looking at suicides runs the risk of  not paying enough attention to the mental health issues that have not reached the suicide level.  The focus should not be researching suicides but researching the combination of issues leading to suicide.  It is a much greater challenge but is likely to have more long term benefits.

Takala’s comments about family compensation and the need to acknowledge the reality of work-related suicides gained the attention of The Irish Times because they meet the imperatives for a newsworthy angle.  Takal’s speeches at the Healthy Workplaces European Summit 2009 covered much greater territory than the Irish Times article and should be read to better understand the comment’s context.

There are hundreds of work risks that require assessment and psychosocial hazards is one of those areas.  A full list of speakers at the conference is available by looking at the program.  Abstracts of most presentations are available for download.

Kevin Jones

Managing stress the Wall Street Journal way

When a financial newspaper or website posts an article about workplace safety, it is worth reading.  The fact of such an article does not mean, though, that safety management is the focus of the story.

A 17 November 2009 article in the Wall Street Journal, ” Workers Denied Company Help Due to Stress-Related Complaints” understandably reports on new workplace stress statistics in a way attractive to its readers.  Sadly it reports on “how can the problem be managed?” rather than the next step that OHS professionals should always take, “how can this problem be eliminated?”

The paragraph that clearly illustrates this myopia is

“Companies are now faced with critical decisions over how to tackle stress. The first step, according to Dr. Wright, is to provide workers with access to a dedicated help line service. “Picnics, parties … those things are nice to have when the times are good, but it is the fundamental things – like making sure your role fits your skills and having the support of your manager – that matters the most now.”

A help line as a first step?  The article is full of statistics that illustrate the reality of the hazards.  Talking to a sympathetic counselor throws the responsibility (blame?) onto the individual and away from the organisation.

Earlier in the article Aviva’s Dr Wright said that workers are

“…being pushed to work harder, longer hours, in roles they are often not trained for…”

He acknowledges that workload and excessive hours is a contributory factor but makes no recommendations for changing these hazards.  Dr Wright accepts the traditional wisdom that harsh economic times leads to these pressures and individuals must cope, with some assistance from the employer.

It is probably unfair to expect the Wall Street Journal to publish an article that proposes fundamental change to the corporate order on the basis of valuing the mental health of employees.  But OHS professionals and advocates, those speaking from a position of independence, must keep reminding business, and (sadly) some OHS regulators, that long-term sustainability will only come from valuing the workforce as human beings and not as cogs in the race for executive performance bonuses.

Kevin Jones

Below is a list of links to some of the reports mentioned in the WSJ article.

National Institute for Health and Clinical Excellence

Aviva UK Health of the Workplace 2009 (report not found)

Chartered Institute of Personnel and Development

Pure research and applied research on shiftwork

At secondary school there used to be a pure science and applied sciences.  Pure dealt with concepts and applied concerned the application of the concepts.  This dichotomy exists in most disciplines and occupational health and safety is no different.

Both elements are equally important, research should be able to be applied for social benefit and applied sciences constantly needs new information to try.

Some pure research was supplied to SafetyAtWorkBlog last week from the publishers of the Chronobiology International The Journal of Biological and Medical Rhythm Research, a publication not usually on our reading list.  Within this research on shift work was a useful summary of some of the issues shift work and health issues that OHS Managers must deal with.

The article is called “Wearing Blue-Blockers in the Morning Could Improve Sleep of Workers on a Permanent Night Schedule: A Pilot Study” and was published on 12 November 2009. It’s aims are below:

“The circadian clock is most sensitive to the blue portion of the visible spectrum, so our aim was to determine if blocking short wavelengths of light below 540 nm could improve daytime sleep quality and nighttime vigilance of night shiftworkers…..Blue-blockers seem to improve daytime sleep of permanent night-shift workers.”

The role of the circadian rhythm would be familiar to most readers who have had a role in managing shift workers or fatigue but it is difficult to see how the aims and findings of the research can directly assist safety managers.  The article’s introduction gives a great summary of the hazards of shift work and the research references.  It says

“In our modern society, working at night has become unavoidable in many fields. Night work is not only associated with acute (Giebel et al.,2008) and chronic health problems (Haus & Smolensky, 2006), but also with social impairment (Wirtz et al., 2008), lower performance (Rosa et al., 1990), increased risk of error (Gold et al., 1992), and industrial (Frank, 2000; Ong et al., 1987; Smith et al., 1994) and road accidents (Akerstedt et al., 2005; Folkard et al., 2005; Ingre et al., 2006; Novak & Auvil-Novak, 1996). Essentially, the most frequent complaints among shiftworkers are the lack of proper sleep during the day and lower vigilance while working at night (Akerstedt et al., 2008; Shield, 2002).”

The report goes on to explain the research study and how blueblocking helps eye discomfort, visual acuity and other shift-related issues but applying the OHS perspective to the hazards associate with shift work would require one to ask whether the shift work is required in the first place.  The decision-making process would then descend through the hierarchy of controls to possibly, engineering or administrative controls, where the Chronobiology International research may have some application.

The Chronobiology article is a good example of academic research into a particular problem.  It does not provide a particular practical solution but it provides an option that an OHS professional could consider by itself or in conjunction with other measures.  It may be that a major solution could only come through a combination of minor solutions.

The context of the research’s application is understandable even if most of the study is too technical for the usual OHS professional’s mind but along the way the “pure” science has provided a very contemporary summary of shift work safety research as well as a possible control option.

Kevin Jones