The evidence on occupational lung diseases remains inadequate

Workplace injury statistics are always less than reality as they are based on the number of workers’ compensation claims lodged with occupational health and safety (OHS) regulators or insurance agents.  The nature of occupational illnesses is that there may be many years before their presence is physically identified making them more contestable by insurers and less likely to appear in compensation data.  The frustration with this lack of data was voiced on November 13 2017 in an article in the Medical Journal of Australia (not publicly available).

A summary of the research article includes this alarming statistic:

“Occupational exposures are an important determinant of respiratory health. International estimates note that about 15% of adult-onset asthma, 15% of chronic obstructive pulmonary disease and 10–30% of lung cancer may be attributable to hazardous occupational exposures.”

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Smoke-related heart attacks decline in England but how so for hotel workers?

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The British Medical Journal has released a report into the effects of smoke-free workplaces on the rate of heart attacks in the English population.  The report finds that a ban on smoking in workplaces has resulted in a 2.4% fall in heart attacks which equates to 12,000 people.  This is good news but it could have been better, or more relevant to workplace safety issues.

The study conclusion acknowledges that

“The considerably smaller decline in admissions observed in England compared with many other jurisdictions probably reflects aspects of the study design and the relatively low levels of exposure to secondhand smoke in England before the legislation.” [emphasis added]

Low levels of cigarette smoke may have been the reality across all workplaces but this is unlikely to have been the case in English pubs, from personal experience.

Research, similar to that undertaken above, would be very useful if it was to assess the cardiovascular disorder rate in hotel workers where the smoke-free obligation has existed since July 2007.  Hotel workers are a readily defined group who could not avoid exposure to second-hand tobacco smoke and a study of the health impacts of this sector could reinforce the wisdom of smoke-free legislation and could show how quickly a common social and public health hazard can be turned around.

The above study is good news, particularly for the 12,000 who may now have the chance to die from old age, but analysing a smaller, more targeted population sample in high exposure environments might have more international significance and application.

Kevin Jones

Health Department bans all employees from smoking at work

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Most of the Australian media have reported on a memo to staff of the Australian Department of Health that only allows smoking while on meal breaks.  Health Department employees are not permitted to smoke while undertaking departmental duties or “when representing the department in any capacity”.

Government authorities have long participated in smoking reduction campaigns which have succeeded in minimising smoking.  Workplaces in Australia already have workplace smoking bans.  So what’s caused the memo (a copy which has not been seen by SafetyAtWorkBlog) to be issued?

The principal reason seems to be to improve the “professional reputation of the department”.  It has always been a ridiculous image to see Health Department employees crowding around departmental doorways smoking cigarettes.   Continue reading “Health Department bans all employees from smoking at work”

The biggest management hurdle on workplace smoking

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Smoking in the workplace is increasingly banned in countries around the world.  The mob of smokers in fire escapes and outside office building front doors are common occurences.  There is no denying that smoking is hazardous but this established fact does not seem to help with the regular management challenge – smokers work less than non-smokers and non-smokers resent this.

A recent study of workplace smoking in over a dozen countries published in the online edition International Journal of Public Health illustrates the continuing struggle.

“The study also found that overall employees estimated spending an average of one hour per day smoking at work, but most employees (almost 70 percent) did not believe that smoking had a negative financial impact on their employer.  However, about half of employers interviewed did believe that smoking had a negative financial impact on their organization.”

This people management issue often bleeds into the realm of the OHS manager as it is the health risks to the smokers and other workers than generated this division.  Clearly these statistics show the problem persists.

The tension comes from non-smokers working a full shift when a non-smoker is permitted to work at the same tasks for the same pay but work one hour less.  No companies have been able to solve this tension in any way other than encouraging smokers to quit smoking.  It may be attractive to OHS managers to leave this issue to the HR managers to struggle with but when planning any anti-smoking programs, this tension needs to be anticipated by OHS professionals.

“Several previous studies indicate that despite the beliefs of smoking employees and some employers in our study, smoking does have a substantial negative impact on a business’ finances,” [Michael Halpern PhD of RTI International] said. “More research needs to be done to quantify the economic impacts of workplace smoking and educate both employers and employees on those effects.”

Halpern’s comments illustrate a major limitation to the thinking of researchers on this issue and other similar workplace matters.  Workers’ health and compensation costs are rarely included in such surveys as business economics look at salary and time management issues yet business admits that worker health costs are part of the decision-making processes.

It is not that worker health costs are not quantifiable.  There is plenty of premium data, insurance figures and public health costs to include in the calculations but largely this data is ignored.  The researchers could take a two stage approach of, what they consider, primary labour costs with a mention of secondary health and compensation costs.  It would be possible to say something like “labour costs equate to $xxx – a substantial business costs but if workers’ compensation costs are included, an even more startling picture emerges…”

OHS professionals know that their job is not really one of handling safety issues exclusively but of managing safety within the business context.  To achieve this OHS professionals must be alert to all elements of business operation.

Kevin Jones

Evidence of heart attacks due to secondhand smoke

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According to a media release from the Institute of Medicine (IOM) in the United States, a new research report says:

“Smoking bans are effective at reducing the risk of heart attacks and heart disease associated with exposure to secondhand smoke, says a new report from the Institute of Medicine.  The report also confirms there is sufficient evidence that breathing secondhand smoke boosts nonsmokers’ risk for heart problems, adding that indirect evidence indicating that even relatively brief exposures could lead to a heart attack is compelling.”

iStock_000008022857Large match lowThe report claims to have undertaken “a comprehensive review of published and unpublished data and testimony on the relationship between secondhand smoke and short-term and long-term heart problems”.  It has looked at “animal research and epidemiological studies” and “data on particulate matter in smoke from other pollution source”.

The study was sponsored by the U.S. Centers for Disease Control and Prevention which has summarised the report on a new webpage.  SafetyAtWorkBlog has been unable to obtain a copy of the full report.

The report is unlikely to help those safety professionals who need to control the hazard of secondhand smoke in the workplace.  Legislation has been in some States of America for over thirty years identifying where people cannot smoke and around the world the major control measures are moving smokers outside and encouraging them to quit.

The IOM report seems to confirm the seriousness of the issue but provides no new ideas for control.  This would be like producing a new research report that says mercury, lead or asbestos are harmful – like duh?

US OSHA provides some data on legislative interventions on tobacco smoke but new information on this hazard in the workplace setting is thin.  The US Cancer Institute issued a monograph in 1999 defining ETS as

“…an important source of exposure to toxic air contaminants indoors. There is also some exposure outdoors in the vicinity of smokers.  Despite an increasing number of restrictions on smoking and increased awareness of health impacts, exposures in the home, especially of infants and children, continue to be a public health concern.  ETS exposure is causally associated with a number of health effects.”

More recent monographs are available at the Tobacco Control Research site.

The UK Health & Safety Executive provides this specific environmental tobacco smoke advice

  1. Employers should have a specific policy on smoking in the workplace.
  2. Employers should take action to reduce the risk to the health and safety of their employees from second hand smoke to as low a level as is reasonably practicable.
  3. Smoking policy should give priority to the needs of non-smokers who do not wish to breathe tobacco smoke.
  4. Employers should consult their employees and their representatives on the appropriate smoking policy to suit their particular workplace.

The status of workplace smoking and secondhand smoke in most westernised countries seems to have plateau-ed or perhaps got to the point where every control measure that is reasonably practicable has been done.

That people continue to die directly and indirectly from tobacco smoke illustrates the flaw in the reasonably practicable approach to safety legislation and management which is “so what do we do next?”  Perhaps the attention being given to nano particles may help but is it the particulates in secondhand smoke that is the problem or the fumes themselves? Regardless, a new approach is needed to control this persistent workplace hazard.  Shoving smokers onto the streets and balconies is not enough.

Kevin Jones