Worst Case Scenarios and Pandemics – 2005 interview

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In 2005 I had the great opportunity to spend some time with Peter Sandman, a world renowned risk communicator.  We spoke about worst case scenarios and risk communication in those times of avian influenza and smallpox threats.  The interview has gained additional poignancy in this time of swine flu.  

Although the audio is “noisy” as Collins St in Melbourne had more traffic on a Sunday morning than I expected, I think some readers may find this excerpt very useful at the moment.

Click on the magazine’s cover image below to download the interview transcript.

[For Peter Sandman’s current commentary on swine flu, see http://www.psandman.com/index-infec.htm#swineflu1 and especially http://www.psandman.com/col/swinecomm.htm]

or Peter Sandman’s current commentary on swine flu, see
http://www.psandman.com/index-infec.htm#swineflu1 and especially
http://www.psandman.com/col/swinecomm.htm. 

 

Kevin Jones

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Handwashing as a risk control

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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.

Kevin Jones

Swine Flu – workplace preparations

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There is swine flu information coming at us from all directions.  Thankfully in Australia the flu itself has not appeared from any direction but…

For those businesses that are not prepared for potential pandemics, don’t panic, but remember that you have known about this potential since before SARS and if you have not put any plans in place, it’s your own fault.

Now that the criticism is out of the way, if you are concerned, what you should do is hit the Australian internet sites that are relevant to pandemic preparation.  One particularly good and local (ie Australian) site is the Australian Government site on pandemic influenza.

There is a very useful Australian podcast on the issue available through ABC Radio.

It is also useful for companies in general to remind its employees about basic hygiene practices.  A particularly good source of work-related information on hygiene is at the government site for infection control for health care providers.

Dr Danilla Grando is a hygiene expert and Lecturer in Clinical Microbiology in the School of Applied Sciences at RMIT University in Melbourne and provides her take on this simple and effective hazard control measure 

wash_dry_hands“Research has shown that one of the most powerful weapons against the spread of respiratory illness, including any strain of influenza, is simply improving your hand hygiene.

We know that contact transmission is one of the key ways that people become infected by influenza. While flu is an airborne virus, people often fall sick from touching something that carries the influenza germs and then putting their hands in their mouths, often while eating.

Always washing your hands before meals is vital but using an alcohol-based hand sanitiser throughout the day is also extremely effective, and an essential tool in helping to prevent the spread of influenza.

Several years ago SafetyAtWorkBlog interviewed Peter Sandman, a world-renowned risk communicator.  He had been undertaking some work in Asia with the World Health Organisation around the bird-flu outbreaks.  He and Jody Lanard wrote a series of articles on communicating an imminent pandemic.  It should be obligatory reading for those at the forefront of public health initiatives at the moment but safety and risk managers may find some assistance in how to communicate with one’s own staff.

The initial response to the current swine flu is generating optimism and it is heartening to see so many government departments reacting in a planned way.  However we should remember the lessons of SARS and the lasting impact SARS had on travel and trade.

Click on the image below for a 2003 edition of Safety At Work magazine which includes several articles about SARS and pandemic risks generally.

Kevin Jones

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Vision statements = hypocrisy (mostly)

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 I have experienced two situations recently which made me question the value of corporate mission statements.

Recently the CEO of an Australian company spoke about how safety was a core value and how committed to safety she was.   She is a recognised leader in safety and directly involves herself in safety management and meetings. However, her employees in the audience were shaking their heads because the safety culture she espoused was not as widespread through the company structure as she believed.

The other situation was a staff meeting I attended with a regional CEO and International CEO where they were unaware that employees in regional offices and undertaking shiftwork had not been integrated into the corporation. In fact the shiftworkers had not been informed of the CEO visits until the last minute.  The company has “integration” as a corporate value.

Leadership (a most dubiously-applied concept in my mind) and vision statements may “come from the top” but they do not flow by themselves to the four corners of a company. They must be worked on, almost as a full time mission.

Vision statements have been promoted in so many corporations that have fallen over through mismanagement that statements have become a bit of a joke, in most circumstances.   Nothing kills motivation quicker than hypocrisy.

(This also occurs in organisations that begin a program of corporate restructure and positioning, and the first item on the agenda is a “sexy new logo.)

It is important to remember that Enron’s motto was “Respect, Integrity, Communication and Excellence.”  If one thinks that Enron is an unfair corporate example, look at one’s own company statement and seriously ask yourself whether all elements of the company are operating to those standards.  Perhaps, someone needs to provide corporate morality audits.

Lastly, any vision statement must accept and mention that the principal aim of any company is to make money (a fact I learnt from Peter Sandman).  To omit this reality immediately shows that the statement is not grounded and is simply management spin.

Kevin Jones