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)

pages-from-better_living_with_copd_a_patient_guide_low_res1

Dangerous Forklift Behaviour

At the risk of increasing a young person’s infamy, SafetyAtWorkBlog draws your attention to a (former) YouTube video of a young forklift driver misusing a forklift.

According to a WorkSafe media release:

Dangerous forklift driving has cost a young worker his job, his forklift licence and earned him 50 hours of community work and an order to do a 5-day health and safety course.

WorkSafe today prosecuted 20-year-old Seymour man, Matthew Garry Ward, after posting on YouTube a video of him doing stunts on a forklift.

The video, which has now been removed, showed him deliberately crashing into concrete pipes, doing burnouts and overloading the machine so he could do wheelies.

Seymour Magistrate Caitlin English convicted Mr Ward, ordered him to do 50 hours of unpaid community work complete a five-day Occupational Health and Safety course and pay WorkSafe’s court costs of $1200. 

Mr Ward was also sacked for misconduct.

Forklifts are possibly the most dangerous piece of equipment on worksites.  Statistics show a high frequency of death and injury associated with their use.

Before phone cameras and YouTube this type of workplace behaviour would never have received the attention that this case has.  The worker may have been sacked for being “bloody stupid” but there would not be the notoriety that can come from this type of act.  The Ward case has appeared on several television broadcasts, is in the papers and is mentioned in blogs like this.

The worker’s actions only came to light when his employer at Australasian Pipeline and Pre-Cast Pty Ltd, which produces reinforced concrete pipes at nearby Kilmore, viewed the video.  If Ward did not have a vigilant internet-savvy boss, it is likely the video would still exist on YouTube and the worker would not have come to the attention of the OHS regulator.

The Ward prosecution came at an opportune time for WorkSafe to re-emphasise their young worker safety campaign in the context of their long-active forklift safety program.

The Ward case indicates the choices young people make between potential internet fame and personal trouble.  There are many examples of this risk management decision in a range of areas related to the internet. Matthew Ward made the wrong decision, or he just took things that little bit too far.  At least he is facing the consequences of his decision.

Marketing to teenagers and youth

SafetyAtWorkBlog has mentioned several campaigns recently focusing on promoting safety to young people through graphic ads in Australia and Canada, and enticing websites.  The Queensland Government launched a promotional campaign to the same demographics this week but this one focuses on excessive, or binge, drinking. drink-counts This is timely leading into the Christmas season and Summer in the Southern Hemisphere and it should be successful in its first stage of cinema advertising and social marketing.   The campaign has a similar advertising structure to the graphic OHS ads but depicting a young person undertaking an activity and suddenly switching to an unexpected consequence. A spokesperson for the Every Dr1nk Counts campaign in Queensland’s Office of Liquor, Gaming and Racing told SafetyAtWorkBlog that the videos are initially shown only in cinemas on targeted movie sessions as the viewer is unable to avoid the 45 second images as easily as they can a television ad.  Also, cinema ads will be seen by the target audience in a group of their peers which will encourage discussion on the issues raised. The ads are confronting but are well made and subversive in getting one’s attention. Treasurer and Liquor Licensing minister Andrew Fraser said that

“This advertisement highlights the fatal consequences of excessive drinking in the hope that young adults will take notice and make more responsible choices for their futures.”

Minister Fraser also said

“our focus group research also revealed that many young people don’t realise that one stubby or one alco-pop is usually more than one drink. We are not asking young people to stop drinking, we are just asking them to recognise that there are worse consequences than a hangover.”

The correlation to youth marketing is clearly evident but excessive drinking and the associated culture of alcohol consumption is a problem that many workplaces are facing also.  It is common in some industries to have a worker be unfit for work after a heavy night and for alcohol and drug policies to be introduced and enforced.  There are bound to be some OHS Managers and workplaces who will see the benefit of obtaining some of the Every Dr1nk Counts resources in an workplace context.

Young Worker Safety – “The Pain Factory”

At a recent safety conference in Australia, many presenters used videos downloaded from the internet, either to educate the audience or to titillate.  The internet abounds with videos of people doing stupid things or injuring themselves.

I am not beyond laughing at a man being hit in the testicles.  Indeed most “family” movies currently have a bang in the testicles, a fart gag or a pooh joke. 

WorkSafe Victoria has made a valiant effort to link stupid internet videos with a message about workplace safety.  Recently the authority produced a website “The Pain Factory“.  This site has a collection of internet videos that show people being hurt.  Whether the injuries are severe and required hospitalisation is unclear.

Viewers are encouraged to watch a number of  videos to accrue “points” from which special locked videos are available.  These videos depict another bang in the scrotum, a BMX rider smashing his face and a skateboard rider being run over by an SUV.

I don’t like the approach, the language is sometimes dismissive of injuries and the issue of pain is uncomfortable but this site is not meant for me and it may appeal to those under 20 years.  I kept remembering the trade union comments about the recent graphic ads and I wondered if, from the Pain Factory, young workers will ask their employers for help or feel ashamed of their own stupidity and not report an injury.  There is little indication of the support systems and services that are available to workers.

However, WorkSafe is trying something new, different and using Web 2.0.  It’s a step in the right technological direction but I suspect the safety conservatives may complain (if they find the site – it’s not linked through the WorkSafe website, however this may be on purpose)

Longford explosion anniversary, Andrew Hopkins and a new book

October 2008 was the tenth anniversary of the explosion at Longford gas plant in Australia that resulted in many injuries, two fatalities and almost two weeks of severely interrupted gas supply to the State of Victoria.

The Longford explosion at an Exxon-Mobil site resulted in a Royal Commission, an OHS prosecution and a record fine.  Recently it was often invoked in comparison to the Varanus Island pipeline explosion in Western Australia.

Professor Andrew Hopkins, sociologist with the Australian National University, was studying safety management systems well before the Esso Longford explosion but it was that major disaster that added international prominence, and a substantial extra workload, to Andrew.  Other than domestic acclaim, in July 2008, the European Process Safety Centre declared Andrew winner of the EPSC Award for 2008.  He is the first person outside of Europe to win this award.  It is believed that Andrew was formally presented with the award at the EPSC conference earlier this month.

Andrew has a refreshing perspective on safety management systems, partly because he has brought a sociologist’s eye to management decisions; his vision is not clouded by the OHS baggage through which many other analysts struggle.

Andrew’s next book due out this month through CCH Australia is Failure to Learn The BP Texas City refinery disaster and could have him travelling frequently the United States to offer his wisdom.

SafetyAtWorkBlog is working on a new interview with Andrew when he returns to Australia but in the meantime, a 2000 interview with Andrew is available as a page on this blog.  The interview was conducted at a book launch in September 2000 for Lessons From Longford.

Professor Andrew Hopkins (right) receiving the award from Christian Jochum, Director of the European Process Safety Centre
Professor Andrew Hopkins (right) receiving the award from Christian Jochum, Director of the European Process Safety Centre

Irrational decision-making

Occupational health and safety often gets sidetracked from the main issue of preventing injury and illness at work.   I often hear employers, particularly in small business, complaining that their workers continue to do the wrong thing even though the employers have done everything they can think of.  

Sometimes an approach is offered that seems like a quick-fix to all the safety problems.  The one that always annoys me is behavioural-based safety.  BBS is like the Hydra and reappears regularly in different guises and with different jargon.

A podcast crossed my desktop this morning that provides a different perspective on “why rational people make irrational decisions”.  

The podcast illustrates the conflicts in trying to make the right decision by discussing the decision of a pilot in the Canary Islands who caused a major crash.  The pilot was also the head of safety at KLM Airlines.

The podcast does not focus on workplace safety but the discussion is probably the better for it.

New Guidance on Preventing Fatigue

Australian OHS authorities have been struggling for many years to address issues of fatigue in the workplace.  Partly this has been because the issue of stress and bullying came to dominate the psycho-social agenda.

The transport industry has pushed fatigue into the unavoidable hazard basket.  New South Wales’ experience with this issue has been particularly interesting and continues to do so. France’s experiment with a maximum set of working hours, partly on the grounds of occupational health and safety, has proven to be a brave experiment.  The Australian Trade Unions’ campaign on “reasonable hours” had safety echoes.

But, as with so many long-term OHS initiatives, Australia waited until England’s Health & Safety Executive (HSE) did all the leg work before tailoring fatigue guidelines to its own circumstances. At least this guideline acknowledges the HSE’s work.

On 4 August 2008, WorkSafe Victoria and WorkCover New South Wales published their guidelines on “Fatigue – Prevention in the Workplace”.  As far as it goes, it is a good addition to OHS information and, if its existence is publicised sufficiently, should place fatigue on the radar of OHS professionals.  Prior to this guide, the only fatigue information that WorkSafe produced was concerning fatigue in the forestry industry in March 2004! – hardly something that any other industry would see as relevant to themselves.

It is worth comparing some of the basic concepts that the OHS regulators have put forward.

The differing definitions reflect the perceptions of the OHS regulators, the state of knowledge at the time, the approach taken by the organisation consulted in the development of the guidances, they anticipate the level of resources allocated to the promotion and enforcement of fatigue management.  The contrast between the Victorian “definitions” of 2004 and 2008 are particularly marked.

Guidelines only go so far and then it is up to business to consider the advice and decide what to do.  The success of the new fatigue guideline won’t be in evidence for several years and, of course, that relies on the very dim chance of anyone undertaking an assessment of the guideline at all.

There are several issues that I think should be considered when reading the new guidance:

The role of the second job.

Second jobs, often undertaken by shift workers are assessed, if at all, for potential conflicts of interest.  The impediment in being “fit for work” in the principal employment is never assessed.  This guideline, in a roundabout manner, identifies this risk. 

The need for nightshift.

Often nightshift, or specific shift rosters, are traditional structures.  “This is the way it has always been done”.  The existence of nightshift in every workplace should be reassessed on a regular basis as economic factors change and as knowledge of the extent of harm presented by nightshift accumulates.

Overlap of Human Resources and OHS

I have bleated on for years about the silo mentality of the OHS and HR disciplines.  The demarcations have been eroding for ages in the real world of business and this trend has been increases as more and more psychosocial hazards are placed within the OHS context.  But the HR professional and the OHS professional continue to speak different languages and with competing agenda.

Fatigue cannot be successfully managed without a common understanding between HR and OHS.

Impairment

Impairment has been a concept floating around the trade unions for some time and they have never found the right approach to getting this on the OHS agenda.  Much of the content in the new fatigue guideline is broader than fatigue and deals with interaction with our employees and colleagues.  The guideline clearly identifies issues from outside work that may exacerbate fatigue in the workplace. (That other demarcation between work and non-work hazards does not apply to fatigue)

Fatigue impairs judgement as well as actions.  Mental fatigue is applicable to a broader range of occupations than physical fatigue and reaches into occupations that are not familiar with OHS, such as judges and politicians, whose important decisions must not be impaired.

 

Fatigue should not be one of the workplace hazards that are increasing shuffled off into the miasma that is work/life balance and wellness.  It relates directly to the traditional areas of OHS but can only be controlled by non-traditional approaches.  There lies the challenge.

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