Early worker health statistics from WorkHealth

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WorkHealth has released some data on the results of its first wave of free health checks (not yet available online)

“Recent results from tests of 3500 workers conducted as part of the ….WorkHealth program found more than half were overweight and/or had high blood pressure while a quarter had high levels of blood cholesterol.”

These figures are not as “surprising” as WorkHealth makes out as the health check program is free to all workers in the State of Victoria and is likely to be the first time that many of the workers would have undergone such checks.  Indeed, WorkHealth acknowledges this fact for its blue-collar male workers.

The data is summarised by WorkHealth below:

  • Male workers were more likely to have high blood pressure;
  • Female workers were more likely to have higher levels of cholesterol in their blood;
  • The majority tested eat less than the recommended five serves of vegetables each day; and
  • The majority of people tested eat at least two pieces of fruit each day.

A health profile of the general Australian population from 2008 found the following statistics, amongst others:

Coronary heart disease is the largest single contributor to the burden of disease
in Australia, followed by anxiety and depression.

Coronary heart disease is the largest single contributor to the burden of disease in Australia, followed by anxiety and depression.

Cardiovascular diseases, cancers and respiratory diseases remain the leading causes of death overall.  However, injury is by far the most common cause of death in the first half of life.

Many Australians live with long-term health conditions. Most of these conditions are not major causes of death, but they are common causes of disability and reduced quality of life.

WorkHealth may be a turning point in the health management for some of the participants, and even if this is a tiny minority, the WorkHealth program could be claimed as a success.

Now if we could only do more about the smoking, dust, fumes, forklifts, sedentary work, fatigues, shiftwork, depression, stress, alcoholism and anxiety…..

Kevin Jones

New ISO risk management standard

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I am old enough to remember the world of management before it had a risk management standard.  In fact I was studying risk management in OHS when the Australian Standard 4360 was released.  It substantially changed the way OHS was managed in Australia (and lined the pockets of the publishers).  It increased the significance of management standards beyond Quality and helped considerably in progressing an integrated approach to managing a broad range of workplace risks.

[The process also instilled in me a distrust of the standards development process when I sat through a seminar from one of the risk management standards committee members where he spruiked a PC-based management system that “anticipated” the new standard…….. at $30,000 setup fee???  Clearly in this case, and I have been told in almost all cases, the participants always have one eye on the commercial benefits of participation]

Grant Purdy recently discussed the new international risk management standard ISO 31000:2009.  At one of his presentations he said that the new standard has a definition of risk that “shifts the emphasis from “the event” to “the effect” and, in particular, the effect on objectives.”

The previous risk management standard overlapped with auditable elements in other management standards – OHS, environment, and quality.  This new definition may cause problems across these sectors.

Purdy said that risk is now not only perceived as a negative.

“Risk has in th past been regarded solely as a negative concept….[but] it is now recognised that risk is simply a fact of life that cannot be avoided or denied.”

He speaks of the traditional way of measuring risk as sometimes creating “phantom risks” due to an overstated likelihood.  This seems particularly relevant to OHS and may be part of the reason that some OHS issues are seen as excessive or, at worst, a joke.

Purdy stated that there are 11 statements of effective risk management. [Modern management writers love numbers.  I should write a book called “The hundredth time I have had to sit through a numbered list of strategies at conferences before walking out”]  The statements are that risk management

  • creates and protects value
  • is an integrated part of all organisational processes
  • is part of decision making
  • explicitly addresses uncertainty
  • is systematic, structure and timely
  • is based on the best available information
  • is tailored
  • takes human and cultural factors into account
  • is transparent and inclusive
  • is dynamic, iterative and responsive to change
  • facilitates continual improvement of the organisation.

The implementation of this standard and other international standards is going to be confusing, initially, for Australian managers but the choice is easy.  Why follow an Australian standard that needs explaining overseas when there is already an international standard that requires no explanation?  Go global and expand your auditing and accountability options.

[Please note that ISO31000 is not an auditable standard but I suspect you will not have to wait long for one.]

Kevin Jones

Imminent release of OHS model law draft

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In the film Mrs Doubtfire,  it was said that her husband’s concept of foreplay was “Effie, brace yourself.”  Australian safety professionals should follow Mr Doubtfire’s advice for, according to a media release from Safe Work Australia:

The Safe Work Australia Council met in Sydney today (18 September 2009) to consider a suite of draft documents on model occupational health and safety (OHS) legislation.

Mr Tom Phillips, Safe Work Australia Council Chair, said that this was a significant development in the harmonisation of OHS laws around Australia.

The Council agreed to recommend to the Workplace Relations Ministers’ Council (WRMC) that it approve the release of a suite of documents for a public comment period of six weeks.

“We have reached a key milestone proving Safe Work Australia is on track to deliver national OHS laws by December 2011,” said Mr Phillips.

The documents to be made available for public comment will include an exposure draft of the model OHS Act, discussion paper, key administrative Regulations and the consultation Regulation Impact Statement.

To continue the Doubtfire analogy, let’s look forward to the post-coital glow of legislative harmony, industrial peace and safe workplaces.

Kevin Jones

[Note: the original book, Madame Doubtfire by Anne Fine, is very funny too but in a less Robin-Williams sort of way. KJ]

Nursing home OHS – a 2001 interview with Kathleen Rockefeller

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The last time I spoke with Kathleen Rockefeller was in 2001 on the eve of her speaking at a conference organised by the Ergonomics Society of Australia.  At that time Kathleen was a physical therapist and ergonomist within the Washington State Department of Labour & Industries.  Her latest profile says that she is now in Florida (via Chicago) as an Assistant Professor at the School of Physical Therapy & Rehabilitation Sciences at University of South Florida.

Rockefeller interview 2001_Page_1Kathleen’s career may have progressed (as probably has her tan) but the hazards and control solutions that we discussed in 2001, sadly remain relevant.  I have reproduced some of the interview I conducted with Kathleen in those early days when no-lift policies were radical and  patient-handling equipment was expensive and rare.

SAW: Around the world the no-lift policy is being introduced but why is that policy the most popular risk control measure?

KR: I don’t know where it actually originated or where the term “no-lift” came from. It’s a horrible term because everyone in healthcare knows that it is a little unrealistic. I think some people have been turned off by the name. I prefer to call it “low-lift” or “minimal-lift”.

Looking at the literature and research clearly shows that decreasing the amount of times per day that the human body has to act like a derrick is a good idea. Each episode exposes the body to forces of a magnitude high enough to potentially be injurious. Anyone who has nursed or worked in nursing homes knows that lifting is not the only activity that carries physical risk. There are tasks like leaning over the bed to delivering treatment to changing clothing, repositioning—these activities can be stressful as well. I wish it were simple to say “let’s get rid of the lifting” but it is an important first step.

SAW: In Australia the no-lift push came from the unions in order to push management to get into action on a whole range of manual handling issues.

KR: I’ve heard a rumour over here, and I don’t know how true it is, that the equipment manufacturers began using the term “zero-lift” but I really don’t know.

SAW: Your research shows that financial incentives were used to encourage the purchasing of new equipment. Were the incentives really necessary?

KR: Washington State is unique in the US in that the workers compensation insurance is handling by a State agency. So the insurance is handled by us unless the company meets the requirements for self-insurance. The agency has monitored the data and monitored the trends to try some initiatives with a number of different industries, nursing homes were chosen for a research project. They were hurting financially. A major reason for not buying lifting equipment was financial.

The agency decided to allocate some of their funds to the nursing home industry and to see if offering some of the funds allocated for injury prevention projects would help. The funds weren’t handouts but discounts on the workers’ compensation premium in return for investing in equipment and beginning a manual handling improvement process. The program was designed as a trial project to see what effect this type of incentive might have.

SAW: How applicable is your research to other States, given Washington’s unique processes?

KR: Many recommendations will be applicable as the program wasn’t just on the financial incentives. The study was a state-wide and industry wide look at how nursing homes were doing overall in implementing zero-lift programs. The research has identified the problems of implementing a large-scale intervention and we can all learn from these problems.

SAW: Other than manual handling what are the major OHS risks in nursing homes?

KR: Of course, patient handling has various tasks and the higher risks are certainly the physical transferring but also the repositioning, delivering incontinence care to residents, changing their clothing. The other thing I noticed in the homes while following nursing assistants and doing sampling is the total amount of time they stand or walk. I think that fatigue must be a contributing factor, both local muscle and total-body fatigue. There is very little recovery time. I knew this already but doing the research really emphasised this.

SAW: Did you observe a high stress level? Was resident violence an issue?

KR: Those are certainly issues as well. The issues of staffing and turnover is huge. The turnover for nursing assistants is an industry average of 100% a year and can go much higher. The constant turnover creates turmoil.

An unexpected element was the huge turnover in management personnel. This was striking. When you think of a facility trying to keep stable processes and procedures and the head person leaves within 3 years or even one year— that is a real problem.

I heard a lot from the nursing assistants and through the literature about the importance of knowing the residents. You mentioned potential problems with the residents but if you work with the resident for a while you get to know them and then you may be able to pick up warning signs on behaviour. If you’re a short term agency nurse and you don’t know the residents, it may increase your vulnerability.

SAW: Perhaps the no-lift policy has been introduced due to the throughput of staff rather than dealing with a root cause of the manual handling injuries? Perhaps because no-lift can give immediate results?

KR: Expecting a zero-lift program to have miraculous results in light of these other issues leading to instability is an unreal unrealistic expectation. I think introducing the program and getting it to work as best you can while at the same time, people who can affect change, maybe us baby boomers, need to start screaming very loudly because our parents are next.

Injuries related to manual handling have a number of causes and efforts to decrease these injuries require multi-faceted approaches. The point is well taken because if you are going to expect a zero-lift program in itself to have miraculous results in light of these other issues leading to problems and instability, it is not a realistic expectation.

Kevin Jones

Alarming statistics on young workers and compensation

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Safe Work Australia has issued some important statistical reports on workplace injury statistics.  One statistic, in particular, stood out:

“…young workers aged 15 to 24 incurred much higher rates of injury than other age groups and were the least likely to apply for workers compensation”

The injury statistic is not surprising and is consistent with other data but why are young workers “least likely to apply for workers compensation”?  Are they unaware of their rights?  Do they work in a situation where claiming compensation is taboo?  Is illiteracy a deterrent?  Has their employer deterred them from applying?  Is their type of work illegal, casual, or in the black market?

SafetyAtWorkBlog asked Safe Work Australia, if not through workers compensation, how are young people funding their medical/rehabilitation costs.  A spokesperson provided the following non-age specific response:

“We are unable to provide an answer to this question as the data has not been analysed separately by age.

However, the last section of the report on workers’ compensation applications shows the various forms of financial assistance that all injured workers used.

For all injured workers, 34% received workers’ compensation, 39% did not access any financial assistance (these were mostly injuries involving no time lost from work) and the remaining 27% did access some form of assistance. Within this latter group regular sick leave was the most common.

Of the injured employees who did not access workers’ compensation, 18% used their regular sick leave, 9% accessed Medicare or other social security benefits, 7% had costs paid by their employer, 5% used other resources such as money from family and friends while 4% access private health insurance or income protection insurance.

Respondents to the survey could select more than one response to this question.”

Inverting some of these stats raises some concerns. (Please note that statistics is not the strongest skill of SafetyAtWorkBlog, so please correct any issues through the comments section below).

For all injured workers, 66% did not receive workers compensation. This should be a big red flag to OHS regulators and deserves more analysis.

Of the 66% over half  (57%) funded their injuries without recourse to health insurance, sick leave, employer contributions, support from family or friends, Medicare or social security.  Expanding the young worker question above to workers generally, how are these injured workers funding their rehabilitation from outside the regulated and social support mechanisms?

Some years ago SafetyAtWorkBlog attended an international conference on OHS.  There were many people at this Melbourne conference who spoke about the Asian and African countries where injured workers must rely on family, or other social security mechanisms, for an income, as workers’ compensation was non-existent.  This is one element of  economic integration into the Asian region that Australia should not be tolerating.

A spokesperson for Safe Work Australia told SafetyAtWorkBlog (read slowly as there are numbers involved):

“The survey estimated that 689,500 workers were injured at work during 2005-06. Of these, 625,900 were employees and hence eligible for workers’ compensation. However, 388,100 did not apply for compensation and 23,800 applied but did not receive compensation.

This means that 66% of injured employees did not receive compensation. While this equates to 60% of injured workers not receiving compensation it is not correct to use this figure as 12% of workers were not eligible for it.

Looking only at the 411 900 injured employees who did not apply for workers’ compensation

  • 75,700 accessed regular sick leave
  • 30,100 had their employer pay their costs
  • 35,500 used Medicare/social security
  • 18,200 used private health insurance/ income protection insurance, and
  • 18,700 accessed money from other sources such as family and friends.

Please note that when looking at these figures that 42% of injuries involved no time off from work and hence costs would be very small.

Analysis of additional data from the survey, that has not been included in this round of reports shows that over 60% of injured workers aged 15 to 24 felt their injury was too minor to claim or that they felt it was not necessary to claim. This is double the percentage for all workers. While this may sound like young people had more minor injuries, this is not the case. Young workers had the same proportion of injuries that involved no time off work as the workforce as a whole and the same proportion that involved longer periods of time off from work.”

The last paragraph cycles this article back to the start.

….over 60% of injured workers aged 15 to 24 felt their injury was too minor to claim or that they felt it was not necessary to claim. This is double the percentage for all workers.

There is something missing from how OHS is promoted to young workers.  The quote above indicates that young workers know about OHS but do not understand OHS.  But that’s not something that can be provided in a 30 minute TV ad, a medium that young people are increasingly less interested in.

Perhaps, we should be spending less time telling people not to stick their hands in a guillotine and more time empowering them in their workplace rights.

Kevin Jones