SafetyAtWorkBlog has repeatedly called for the release of the report into the Beaconsfield mine disaster that was undertaken by Greg Melick, QC. The Tasmanian Government has today made the report and appendices available online.
The OHS-specific reports by Professor Michael Quinlan have also been released.
The tricky thing about getting safety right is making sure you are on top of where the dangers are. One danger that seems to be consistently “off the safety radar” for lots of workplaces, particularly small businesses, is falls.
Here’s some key stuff you need to be looking at:
Preventing falls is an excellent example of why the common legal duty to first look to eliminate a hazard or risk is a clever thing. I get the sense that lots of people quickly dismiss elimination as a viable option; it shouldn’t be the case. Hard thinking about elimination solutions needs to be first cab off the rank in risk control decisions, particularly when it comes to preventing falls.
SafetyAtWorkBlog has no expertise in the control of infectious diseases. Any enquiries received on the issue are directed to the official information on government websites such as Australia’s Dept for Health & Ageing or the US Centre for Disease Control, or international authorities such as WHO.
But this creates a dilemma for OHS regulators. If the regulator does nothing, it is seen as inactive – a bad thing. Or the regulator can issue its own guidance on infection control – a good or bad thing. It is an unenviable choice.
WorkSafe Victoria took the latter choice and issued their “OHS preparedness for an influenza pandemic: A guide for employers” in early May 2009. The guide is not intended to be definitive and may be useful in the future but infectious outbreaks can move rapidly and, to some extent, this document is shutting the door after the horse has bolted, in expectation of the next “door”.
The guide mentions the following sources but it could be asked what is gained by contextualising these Australian documents? Why not just direct companies to the raw documents?
The trap for producing localised guides is that recommendations may be made that are out-of-place, difficult to implement and, ultimately, question the credibility of the document. WorkSafe fell for this trap by specifying some recommendations for the legitimate control measure of “social distancing”.
In its employers guide it makes the following recommendations:
“A primary transmission control measure is social distancing, that is reducing and restricting physical contact and proximity. Encourage social distancing through measures such as:
- allowing only identified, essential employees to attend the workplace
- utilising alternative work options including work from home
- prohibiting handshaking, kissing and other physical contact in the workplace
- maintaining a minimum distance of one metre between employees in the workplace (person-to-person droplet transmission is very unlikely beyond this distance)
- discontinuing meetings and all social gatherings at work including informal spontaneous congregations
- closing service counters or installing perspex infection control barriers
- using telephone and video conferencing.”
The guide does recommend social distancing as part of a risk management process but “prohibiting handshaking, kissing and other physical contact in the workplace”? “Discontinuing … informal spontaneous congregations”?
How is a business expected to police these sorts of measures? Have someone walking the workplace reminding workers of the new “no touchy” policy?
The Australian Health Management Plan for Pandemic Influenza talks repeatedly about social distancing in workplaces, the community and families but never goes to the extent WorkSafe has.
The National Action Plan for Human Influenza Pandemic (NAP) defines social distancing as:
“A community level intervention to reduce normal physical and social population mixing in order to slow the spread of a pandemic throughout society. Social distancing measures include school closures, workplace measures, cancellation of mass gatherings, changing public transport arrangements and movement restrictions.”
NAP does not mention kissing, nor does the Business Continuity Guide For Australian Businesses .
WorkSafe WA has not issued anything specific on pandemic influenza, nor has SafeWorkSA, WorkCover NSW defers to NSW Health (which has a lot of information and a reassuring video from the health officer), and Queensland’s OHS regulator defers to its State health department.
Social distancing is an appropriate hazard control measure amongst other measures in an influenza risk management plan but the current WorkSafe Victoria guidance seems to be an unnecessary duplication, and on the matter of kissing, silly. Why, oh why did WorkSafe Victoria think it necessary to publish anything?
Recently I wrote an article for National Safety magazine entitled “Trials and Tribulations”. It came about because I heard about an OHS consultancy that was offering safety management services that included a component of insurance. The insurance was explained to me as covering any OHS fines or penalties that may eventuate for the consultancy’s clients.
This combination of services is very attractive and addresses fundamental OHS questions asked by employers of different sizes – “do I comply?” and “how do I know that I have a safe workplace?”. They’re slightly different questions but ones I come across regularly.
OHS regulators are getting better at helping small business establish a compliance benchmark through the use of compliance codes for some elements of workplace safety management – a semi-return to prescription. However, many small business owner do as much as they can to provide a safe workplace and still get prosecuted by the OHS regulator. This is frustrating and demoralising and in this context an insurance policy is attractive. The insurance would cover any penalties that the business receives even if the incident that generated the prosecution was “unforeseeable”.
The National Safety article includes legal opinions and insurance company opinions that don’t quite fit.
Some of the interviews I conducted with insurance brokers did little to assuage my unease at insurance policies. It seems to me that some insurance policies are taken out unnecessarily while other policies often exempt coverage for the very risks one thought the policy covered. I agree with many insurers who recommend that business insurance is best handled by an experienced risk manager. Sadly many OHS professionals do not have those skills.
In the context of the OHS consultancy, clients may be reassured by such an insurance policy but it should be an unnecessary expense. The consultancy provides a monthly assessment service that steers the company through specific workplace hazards. The consultancy provides some initial OHS advice and resources but no independent audits of the OHS system and the monthly monitors are not trained in OHS.
The consultancy says that following this system will provide compliance, and maybe it does. But even compliant workplaces can have incidents that could generate a prosecution. It is here where the insurance policy should apply.
The monthly assessment system needs to be diligently followed and payments kept current because non-compliance with the obligations of the system could leave an “out” for the insurer.
Statutory liability insurance, particularly for small business, needs to be examined by the OHS regulators. Most regulators approached would not comment on the record about such policies, others were dismissive. The article examines the legal issues further and, sadly, the article is not available online.
If the regulators are truly supportive of small business and OHS compliance for this sector, there should be some guidance on statutory liability issued. But like OHS professionals, regulators are not comfortable with policies that compensate (other than workers compensation). They focus on prevention and prosecution. It’s time to establish a broader source of OHS policy development, one which includes insurance companies, brokers and risk managers.
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.
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.
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.
