Tag: research

Comcare’s RTW performance has some worrying trends

RTWMatters, an Australian return-to-work website, has analysed some of the data that has been released through the annual data – Aust & NZ RTW Monitor.  The statistics show that the Australian Government’s workers’ compensation insurer, Comcare, has performed well on some performance indicators but others are raising concerns, particularly

  • “The cost of claims has risen from $15 000 in 2005-06 to almost $20 000 in 2008-09. This is substantially higher than the national average.
  • Around 1/3 of Comcare workers can identify a person who made it harder to RTW, which is higher than the national rate. Over the last three years there has been a significant increase in Comcare employees reporting their employer has hindered return to work.
  • Over the last two years, Comcare workers have found it increasingly difficult to find the information they need to make a claim.
  • Comcare workers rated their insurer customer service lower than the national average, with communication, advice about the claim and understanding the situation rated lowest.”

Paul O’Connor, at last week’s Comcare Conference in Canberra was very upbeat but was well aware of the challenges ahead particularly for the next five years during a period when the Australian government will attempt to harmonise the OHS laws in each jurisdiction.  It should be noted that Paul has been Comcare’s CEO since 1 September 2009.  He was formerly with the Transport Accident Commission in Victoria.

O’Connor quoted the Australian Finance Minister, Lindsay Tanner, during his conference presentation.  (The Tanner quotes are from August 2009)

“It is unlikely that we will see any major reform in this area in the near future, as Australia’s various governments are grappling with the challenging task of building uniform national industrial relations and occupational health and safety systems.

“Nevertheless, the current campaign for a national catastrophic injury compensations scheme should trigger a wider debate about injury compensation in our society generally. The present system is fragmented, inequitable, inefficient and arbitrary. Reform could be some time coming but it’s certainly long overdue.”

RTWMatters has identified that more groundwork is going to be needed in the lead-up to the reform process if any measurable improvements are to be achieved.  In their media statement, they say

“Real collaboration requires that all stakeholders be able to access information to assess the impact of legislative and systems changes on workers compensation and return to work outcomes.”

The road to reform that Geoff Fary described as very difficult will be an important one to watch.

Kevin Jones

[Kevin Jones is a feature writer with RTWMatters]

23rd suicide at France Telecome in 18 months

Adam Sage has been following the suicides that have occurred in France Telecome for some time.  On 23 September 2009 in the TimesOnline (a week later in The Australian newspaper??), Sage provides a useful summary and cogitation on the “cluster”.

But although this number of suicides in one company should be alarming, it is not really a cluster as the suicide rate for Telecome’s employees was only slightly above the national average of 14.7 per 100,000 people.  Sage reports that France is a country with a high comparative suicide rate.  The relevance to SafetyAtWorkBlog is that Sage goes on to identify work-related factors that contribute to suicides.

He quotes a sociology professor who says the French “define themselves by their professions”.  The risk with this basis for identity is always when the demand for the profession declines, one needs to redefine and this is not easy.

Sage finds a psychoanalyst who says that his patients feel isolated at work and have no support mechanisms.

A suicide prevention expert says that often a problem at home is the suicide trigger with someone who is feeling stressed at work.

Sage provides a potted history of the privatisation of France Telecome and speaks to a current employee bemoans the loss of camaraderie.

What is surprising about this article is that it seems France, and particularly France Telecome, are way behind other Western nations in having control measures in place for employee support programs and change management.

It is not as if France is ignorant of workplace stress issues or that workplace suicides have only occurred at France Telecome.  A major reason for its experiment with the 35-hour week was to

“…to take advantage of improvements in productivity of modern society to give workers some more personal time to enhance quality of life.”

In January 2008 (well before the current financial crises), the Institute for Economic and Social Research published “Workplace suicides highlight issue of rising stress levels at work “.  After some suicides at Renault and Peugeot it assessed the issues, acknowledged the trade union assertion that

“…excessive isolation of workers due to high workloads and fierce competition leads to a malaise in companies and thus call for a reflection on choices of work organisation.”

The article also reported

“The French Democratic Confederation of Labour (Confédération française démocratique du travail, CFDT) welcomed the ‘recognition of psychological factors being the cause of an occupational accident’ as it ‘opens the way to taking into account a form of suffering and malaise that, until now, has been minimised by companies’.”

A longer-lasting improvement will only come if this recognition is built on by all social structures in France.  Perhaps it should look across the channel at how the Health & Safety Executive and the corporate sector have responded to the report by Dame Carol Black – “Working for Health” – calling for an integrated approach to health management involving work, public health, health promotion and other elements of social capital.

France Telecome held an extraordinary Board meeting on 15 September concerning its suicide rate.  It made the following commitments:

  • “The national health, safety and working conditions committee (CNSHSCT) will be meeting on Thursday next week in the presence of Jean-Denis Combrexelle, the Ministry’s Director General for Employment.
  • To stop the phenomenon from spreading, it has been decided to immediately put in place a freephone number to promote dialogue. Psychologists from outside the company will be available to listen to and talk with any employees who may be having difficulties.
  • The first meeting for the negotiations on stress will be taking place on Friday September 18. On this occasion, the employee representatives will appoint an external consultancy to conduct an audit of the situation within France Telecom.
  • These negotiations will focus on the prevention of stress and psychosocial risks in the event of geographical or professional mobility among staff. To address this issue, a forward-looking employment and skills management (GPEC) system will be set-up with a view to offering employees and their direct managers visibility over their professional development and support.”

Didier Lombard, France Telecom’s Chairman and Chief Executive Officer, has set a tight timeframe for improvement.  On 15 September 2009 Lombard said

“December’s France Telecom will not be the France Telecom of today.”

Kevin Jones

UPDATE 30 SEPTEMBER 2009

Agence France Presse has reported a 24th suicide associated with France Telecom.  According to the report the 51-year-old male jumped to his death from an overpass onto a busy highway.  His suicide note to his wife expressly referred to the work environment as a reason for his action.

 

Increasing risk of silicosis in the majority world

Australian safety expert and activist Melody Kemp reported from the annual meeting of the Asian Network for the Rights of Occupational Accident Victims (ANROAV) that was held in late September 2009 in Phnom Penh.

The meeting featured many stories about the increasing risk of silicosis in Asia.  Melody writes in the 27 September edition of the blog “In These Times”:

“Silicosis afflicts workers working with gems, ceramics, rock blasting, drilling and crushing, and mining. It haunts unprotected workers in glassworks, mines and foundries, as well as those who live within reach of the dust. It’s usually fatal by the time it is diagnosed.

Largely eradicated in the economic North, silicosis is now the scourge of the Global South. Millions die from the illness each year.”

The size of the growing occupational and community threat is frightening.

“China alone reports over 100,000 new cases of industrial lung disease per year, and has more than 4 million existing cases. And those are just the official figures. Even industrially advanced South Korea sees over 1,000 new cases of occupational chest disease each year, reported Dr. Domyung Paek, a pulmonary specialist from Seoul National University.”

Melody has contacted SafetyAtWorkBlog asking for assistance in attracting occupational medical experts to Cambodia and other countries undergoing rapid industrialisation.  She can be contacted by clicking HERE.

Kevin Jones

Harmonisation documents available but path is far from settled

On 25 September 2009, Australia’s Workplace Relations Ministers Council
(WRMC) agreed to release the draft legislation for public comment.

According to one media report, the New South Wales Finance Minister, Joe Tripodi,

“…moved at the [WRMC] meeting to have union prosecutions included in the new laws and was defeated by eight votes to one.”

Pages from Discussionpaper_ExposureDraft_ModelActforOHS_PDFThe documents are now available for download HERE.

According to Safe Work Australia’s media statement:

“The suite of documents available for public comment includes a model Act, administrative Regulations and consultation Regulation Impact Statement (RIS). The RIS will allow individuals and organisations to comment on the potential costs and benefits of the proposed Regulations. The RIS has been prepared by Access Economics.”

Curiously, it also says that Access Economics is

“…surveying businesses across a range of sizes, industries and regions in an effort to obtain primary data on compliance costs and safety benefits.”

It is odd that this has not been done earlier to, perhaps, substantiate the claims that the OHS law changes will reduce costs and “red tape”.

At the Comcare Conference in Canberra in late September 2009, Geoff Fary, illustrated very effectively the small sector of business that would be affected by the national laws.  Fary estimates that only around 1% of Australian businesses are likely to be liable to the “red tape” argument.  Many of these companies could be expected to already have some form of national OHS management systems, perhaps through Australian management standards.

Whether the percentage of affected 1% or 5% it is hoped that the Access Economics survey does not focus only on this sector.  Previous surveys have indicated a large ignorance or apathy about national harmonisation.  This is likely because the vast majority of Australian businesses operate within a single jurisdiction so the harmonisation is considered irrelevant.  The sad reality is that the OHS legislative structures in Australia for the next 10 to 20 years will be determined by the corporate sector, the regulators themselves, and the labour law firms and not necessarily by the small to medium-sized businesses for whom OHS can be the most burdensome.

SafetyAtWorkBlog had the chance to ask Geoff Fary, the assistant secretary of the ACTU, of his thoughts on the continuing opposition to harmonisation expressed by Troy Buswell, the Western Australia Treasurer.  Fary said that harmonisation

“…could occur without Western Australia being involved.  It couldn’t occur, I believe, without Victoria or New South Wales or Queensland being involved but because of the nature of the place and the geography of the place it could occur without Western Australia, and I think there is probably a strong possibility….that harmonisation will proceed in the absence of Western Australia.”

If this evenuates the harmonisation process becomes an academic exercise yet again.

Kevin Jones

Early worker health statistics from WorkHealth

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

Nursing home OHS – a 2001 interview with Kathleen Rockefeller

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

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

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