wellness – Page 60 – SafetyAtWorkBlog

The economic costs of a heart attack

A new Australian report estimates the total costs of heart attack and chest pain (Acute Coronary Syndrome or ACS) to the Australian economy – “total economic cost of $17.9 billion.” This Access Economics report, released in June 2009, has broad application for public policy but has some relevant information for safety and health management in the workplace.

If we take “productivity” as applying to work, as is reasonable, the report states that for 2009

“Indirect [health care system] costs [from ACS] are expected to account for $A3.8 billion, primarily due to lost productivity.”

This is a useful statistic for those workplace health advocates. In fact, the report specifically identified the workplace as

“…an excellent environment to facilitate the ongoing rehabilitation and lifestyle changes to prevent the re-occurrence of ACS event”.

One gap it identified in the treatment and monitoring of ACS was something that many have been advocating for some years, particularly with the aging population and increasing obesity rates:

“a standardised national program to support employees and employers and the extension of rehabilitation practices.”

Much of the report advocates important rehabilitation resources and services for when the patient is discharged from hospital. The report includes the following graphic but also recommends the basic elements of post-hospital care after an ACS event.

Costofheartattackandchestpain-261-2 rehab table

“For rehabilitation to be effective, comprehensive patient follow-up interviews after discharge are essential. At these follow-up interviews, the patient should undergo both physical assessments (e.g. blood pressure, cholesterol tests, ECGs) and emotional and psychological assessments (e.g. signs of depression, anxiety, stress, financial hardships). The psychological impact following an ACS event is an important, but often neglected, area in the management of ACS. Thus, if patients can better understand their conditions, it can empower them to cope with their anxieties caused by ACS.”

In specific reference to workplaces, the report says:

“Returning to work can require an adjustment in duties and the conditions under which the employee works.”

It is up to OHS and return-to-work professionals to determine exactly what strategies should be applied in these circumstances.

There were a couple of references in the report that may be worth following up:

Bhattacharyya MR, Perkins-Porras L, Whitehead DL, and A Steptoe (2007), Psychological and clinical predictors of return to work after acute coronary syndrome, European Heart Journal, Vol 28, Iss. 2, pp. 160-165.

Kovoor P, Lee AKY, Carrozzi F, Wiseman V, Byth K, Zecchin R, Dickson C, King M, Hall J, Ross DL, Uther JB, and AR Denniss (2006), Return to full normal activities including work at two weeks after acute myocardial infarction, American Journal of Cardiology, Vol 97, No. 7, pp. 952-958.

Kevin Jones

Sleep disorders and workplace safety – new research grant

Recently, the Australian Government awarded some research grants of which at least one is relevant to workplace safety. $2.5 million was given for the establishment of a Centre for Clinical Research Excellence in Interdisciplinary Sleep Health (CRISH).

When the grant was announced Professor Ron Grunstein of the Woolcock Institute of Medical Research said,

“Adequate sleep is as important as exercise and diet. Sleep loss and sleep disorders contribute to mortality, chronic disease, mental health problems and the economic health burden.

“This funding will allow us to establish a network of leading sleep researchers and physicians in different specialties to investigate the biology of sleep, and look at ways to prevent and treat sleep disorders.”

Amongst several social benefits of the research, the issue of shiftwork health was mentioned. There are many contributory factors to the health of shiftworker and sleep disorders is only one, but an important one.

The most recent Australian data on the costs of sleep disorders was from 2004 by Access Economics, an organisation that the government often relies on for data. Its report, Wake Up Australia, estimates that sleep disorders such as obstructive sleep apnea and insomnia underlie 9.1 per cent of work related injuries.

The origin of this statistic needs to be closely examined in the body of the report (page 23) as there is quite a bit of statistical magic applied however the 9.1% figure has been referred to in relation to the potential benefit of the CRISH project. The statistic is not invalid but it is also not so simple.

Kevin Jones

More workplace stressors, email and upwards bullying

According to a paper presented at the latest Industrial & Organisational Psychology Conference organised by the Australian Psychological Society, poor quality emails are causing almost as much stress in the workplace as the number received.

New Zealand provisional (?) psychologist, Rowena Brown, was presenting findings from her PhD studies and said

“Email is a double-edged sword. We know that email can help employees to feel engaged with and connected to their work colleagues, however the impact of a poor quality email, combined with the expectation to respond immediately, can create unnecessary stress. Our research raises important issues for employers, who have a responsibility to train their staff in appropriate email etiquette.”

This type of research really doesn’t help business and managers to deal with the stress of their employees because it doesn’t provide any useful control measures. There are more significant causes of stress that demand the attention of OHS professionals and managers.

The same conference illustrates one of those other stressors. Sara Branch, a psychologist Griffith University was quoted on the matter of employees bullying their bosses.

“Upwards bullying, like other forms of workplace bullying, is often more subtle and less obvious to other staff. However, it can also include more aggressive behaviours such as yelling, verbal threats, and confrontational phone conversations.”

“Workplaces need to understand that bullying can occur at any level in an organisation. Although managers clearly have formal authority, they can also be victims of bullying and need just as much support as other staff.”

The study also found, according to a media release about the conference, that one of the main triggers for upwards bullying is organisational change.

“If an employee is disgruntled by change, such as new working conditions, management, or processes, they may blame their manager and respond by bullying them.”

With the increased attention to psychosocial hazards in the occupational health and safety profession, it is necessary to pay attention to these sorts of studies but they are simply new perspectives on established issues that should already be monitored and changed.

These studies may illustrate the issue that OHS professionals can use to gain that managerial or client attention but they should be handled carefully so that these specific issues do not dominate the understanding on the manager or client.

SafetyAtWorkBlog advocates looking outside the OHS discipline for new evidence and understandings of workplace issues be it sociology or psychology but one must avoid reacting to hype.

Kevin Jones

Worker health continues to get government support

Just because Victoria’s WorkHealth program is not functioning anywhere near its initial intention, it does not mean that the issue of workers’ poor health is being ignored. In mid-June 2009, Australia’s federal government announced a targeted program called the Tradies Tune-Up.

The funding for this program is very modest in comparison with WorkHealth’s proposed riches. According to a media statement, the government is allocating $A219,500 to “monitor and check on the health of building and construction workers.” This sector was chosen because statistics show

“…that men working in manual occupations, like construction, have higher mortality rates, disability and serious chronic disease than other professions. Statistically, they are also at greater risk of self-harm and suicide.”

This program has a greater opportunity for success as it is coordinated through OzHelp Foundation, a partnership between the ACT branches of the Master Builders Association and the Construction, Forestry, Mining and Energy Union. The construction unions, to the knowledge of SafetyAtWorkBlog, have always had strong mental health and wellbeing support programs, often run through chaplaincies, a much neglected form of employee assistance program.

As has occurred elsewhere in Australian workplace services, the program will operate with the support of a mobile assessment vans. The program will have

“a specially equipped van and accompanying health staff including a registered nurse will set-up ‘pit-stops’ at construction and building sites testing workers in 20 minute sessions on their levels of cholesterol, blood pressure, blood glucose and waist size.”

The government has also committed to develop a National Men’s Health Policy to be finalised later this year.

Health assessment programs that go to the workplace and, importantly, have the support of the union movement have a good chance of success but that success is not just the number of visits. They must have tangible health improvements to the workers.

Also assessments are not enough to simply inform someone they are fat and unhealthy. There must be a support program for health improvement and the reduction of unhealthy distractions.

OzHelp should not be seen as a Rudd government initiative or only something that can thrive under a sympathetic Labour government. The foundation has existed for almost five years as can be seen by this media statement.

Such programs also must operate with specific performance benchmarks. Currently there is no information available about program benchmarks or what timeline is being applied to the program. As the program is receiving government funding, it may be necessary to await for department annual reports, if this type of program is reported at all.

Kevin Jones

Relocation is always an option for an improved work/life balance

A couple of years ago there was a campaign in Australia to increase the number of general practitioners in rural areas due to a doctor shortage. One doctor, Nicole Anderson, chose to relocate from tropical Queensland to temperate Tasmania. She did so for several reasons including improving her work/life balance.

During the campaign in November 2007 I had the chance to talk with Nicole about her experience and her life choices for a SafetyAtWork podcast

As part of the Rural Health Workforce Australia campaign, short videos were produced of which Nicole’s story was one. Click HERE to see the wonderful countryside Nicole has chosen to practice in.

Kevin Jones

Resilience, stress and safety management

The July 25 2007 SafetyAtWork podcast is now available for download. It includes an interview with Michael Licenblat where we discuss the psychological approach to individuals taking control of their own safety, the benefits of wellbeing programs and the changing workplace.

On listening back to the podcast today, I was struck by several issues he raises:

Michael is one of the few wellbeing gurus who directly link the management of stress to the productivity of the worker. He displays more awareness than many others of the “proactive” OHS context of this approach to human capital.
He discusses why it is difficult for all of us to say no to some work tasks, even if the task is high risk and may injure ourselves and others.
He states two core elements of workplace cultures that seem to revolve around the established OHS obligation of consultation. Perhaps OHS managers can become real agents of change by cranking up consultation.

Kevin Jones

Corporate health adviser’s recommendations on swine flu

Recently SafetyAtWorkBlog wondered why the ACT OHS Commissioner referenced a commercial website instead of a government authority. The commercial website was www .fluthreat .com operated by HSA Group which since early April 2009 is part of Medibank Private.

Fluthreat.com.au provides information on its Flu At Work page that is very flimsy and seems to be intended to generate further enquiries to its commercial advisory service. We’re not comfortable with that or the lack of badging from the parent company but…….

SafetyAtWorkBlog put some questions to HSA Group/Medibank and received the following responses from their media advisor over a week later. We could be picky but we have decided to let the responses speak for themselves.

The questions were based on the bulletpoints listed on the Flu At Work page in order to flesh out the advice to a more practical level.

What does HSA Group recommend for basic personal respiratory hygiene methods?

HSA’s fluthreat website covers basic respiratory hygiene considerations. Personal habits that we all should adopt include covering mouths when coughing and sneezing, using tissues and disposing of them properly, and regularly washing of hands.

In this time of swine flu, is the old way of throwing tissues in a waste basket no longer the right option?

Using a waste basket is fine. The important thing is the waste is disposed of appropriately, and the waste basket does not require excessive handling in the disposal process.

Handwipes and gel have issues of their own – should they be applied after handwashing or instead of, should they be used after each sneeze or cough? What does HSA recommend?

Considerations of personal hygiene should be a regular occurrence – not just simply after each sneeze or cough. Handwipes and gels are for occasions when you can’t wash your hands – it is not necessary to use both. Handwipes and gels should be alcohol based, which has been shown to be effective in killing influenza type viruses.

Regarding adequate cleaning of surfaces and equipment, should this be undertaken by the users of the equipment or should cleaning contractors be contacted in order to upgrade their processes?

Unfortunately there is no one simple answer to this question. Every business operates differently, and therefore will require a different response to a pandemic. We encourage all businesses to have a pandemic plan, which will guide the business wide response.

Certainly cleaning of surfaces and equipment should be considered in the context of an organisation’s pandemic plan, and may include having staff take additional care for hygiene and cleaning, or having cleaning contractors upgrade their processes. The appropriateness of such considerations are linked to the pandemic phase & an organisation’s response strategy in the context of their pandemic plan.

Regarding telephones, which are the closest item most office workers have to their mouths, years ago there were phone cleaners who physically came to the office to clean and disinfect handsets. Would HSA recommend this service be reinstated?

These services are still available for businesses who want them. Alternatively staff can be trained to do it themselves with alcohol based wipes. Again the specific needs of businesses will vary, and cleaning of telephone handsets should be set out in the pandemic plan.

In a closed environment, such as an office, where possible, should ventilation be increased by opening a window? Some office buildings turn off they ventilation overnight even when nightshift workers are in the building. Does HSA believe that nightshift workers could be at increased risk of contracting influenza?

Ventilation is important in workplaces, and not just due to swine flu. Where windows can be opened without affecting the air-conditioning flow this will help with ventilation. Air conditioning should remain on if people are present in the building. However there is no evidence that nightshift workers are at an increased risk of contracting influenza – it is the behaviour of workers and their levels of personal hygiene that are the strongest influence on this.

Regarding encouraging sick persons to stay at home, why only “encourage”, when employers have the legislative obligation to not place their employees at risk? What if the employee has shown no symptoms of influenza but may be infectious due to contact with a family member who is sick?

Employers should have policies in place that articulate how staff should behave in such circumstances, and ideally a plan that covers pandemics specifically. There is only a very small risk of people being infectious prior to symptoms appearing.

Sending workers home after the illness has appeared is an acknowledgement that illness is already present in the workplace. In this instance, what would HSA advise the employer to do?

Employers should continue to activate their pandemic plan, which will trigger workplace specific staff communications and contingency plans.

Does HSA recommend the wearing of facemasks as a suitable control measure for anyone who may come to work sneezing (for whatever reason)?

Facemasks can be very helpful in controlling the spread of respiratory diseases. However it should be noted that a sneeze does not necessarily equate to H1N1 or seasonal influenza. A diagnosis of suspected H1N1 or seasonal influenza requires consideration of a number of other factors.

Regardless of the further information from HSA Group/Medibank, SafetyAtWorkBlog still recommends that the best advice is available from the relevant health authorities in your State or country.

Kevin Jones

Category: wellness

The economic costs of a heart attack

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Sleep disorders and workplace safety – new research grant

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More workplace stressors, email and upwards bullying

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Worker health continues to get government support

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Relocation is always an option for an improved work/life balance

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Resilience, stress and safety management

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Corporate health adviser’s recommendations on swine flu

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