Occupational health relates to the impact health has on work and work has on health. Its objective is to prevent or reduce occupational health diseases developing such as asthma, hand-arm vibration and noise induced hearing loss. Sometimes the employee brings these conditions into work and sometimes they can be made worse or contributed to by the working environment. In all cases, the employer has a responsibility to manage occupational health issues and often will use the services of an occupational health provider to assist them. Clearly as staff are a key business asset and essential to good productivity and profitability, they need protecting.
Staff can be put at risk from workplace exposures in a number of ways: through excessive noise that might affect their hearing or extreme stress that might affect their ability to carry out their responsibilities. Excessive chemicals in the environment is another potential hazard if absorbed through the skin or breathed in. These dangers can lead to conditions such as respiratory disease, eye and skin irritation, muscle and nerve damage and even cancer.
Team work pays
The role of an occupational health team is to keep staff in the best of health – physically and mentally. In addition, it will do the appropriate risk assessments to lessen the chances of ill health in the workplace. If any risks remain, control measures will need to be put in place, part of which may be an occupational health surveillance programme.
An occupational health provider should be selected by the employer on the basis of being able to work with their risk assessment, work with the staff identified as being at risk and being able to set a programme and make appointments with those at risk before getting back to the employer with a comprehensive health action plan.
More access to care needed
About 45% of the world’s population and 58% of the population over 10 years old belong to the global work force. A recent WHO study revealed that unhealthy working conditions contribute to at least 1.6% of the ‘burden of disease’ in the WHO European region. The major occupational risks associated with this burden are injuries (40%), noise (22%), carcinogens (18%), airborne particulate matter (17%) and ergonomic hazards (3%).
The WHO created a global strategy for occupational health in 1994 which called for all countries to show a “progressive development of occupational health services with the ultimate objective of covering all workers with such services irrespective of the sector of economy, size of company, occupation, mode of employment, or nature of self-employment.”
It added that many individuals spend one-third of their adult life in hazardous working environments and that approximately 120 million occupational accidents with 200,000 fatalities are estimated to occur annually. Furthermore the costs involved in theses health hazards amount to several per cent of some countries GDP. However, just 5-10% of workers in developing countries and 20-50% of workers in industrialised countries have access to occupational health services. The need is particularly critical in developing and newly industrialised countries where around eight out of ten of the world’s workers live.
Where we are now globally
There are numerous challenges facing occupational health provision around the world today. These appear to be linked with new information technology and automation, new chemical substances, health hazards associated with new biotechnologies, an ageing working population plus the special problems of groups such as the chronically ill, the handicapped, migrants and the unemployed.
To frack or not to frack
In the United States (US) for example, issues affecting workers cut across several industry sectors. In an article in the US journal Occupational Medicine, John Howard of the National Institute for Occupational Safety and Health pointed out some of the issues that needed addressing. Firstly the development of ‘fracking’, the process to increase the energy output in the US, has brought with it new risks to the workforce involved in drilling and other activities in extracting oil and gas up to the point of shipment.
The rise of the robots
Meanwhile, job automation and robotics, where jobs formerly done by human workers are now done by machines, continues to disrupt the labour market in a number of key sectors. Robotic workers are also working alongside human workers and there have already been headlines about workers injured or killed by robots such as the employee at a Volkswagen assembly line whose chest was crushed after a robot gripped and pressed him up against a metal plate in June 2015 in Germany. Occupational safety and health professionals will need to take a proactive approach, said Howard, to the risk profile of occupational robotics.
In a recent article in Personnel Today, it was argued that Brexit could impact on occupational health and safety in the UK in two distinct areas. There is the potential knock-on effect for health and wellbeing spending should there be a downturn in the economy. Secondly there is the possibility of health and safety legislation being amended or watered down. Lucy Kenyon, communications director for the Association of Occupational Health Nurse Practitioners said there is a counter-argument to this in that in a recession or downturn, you need your skilled, experienced employees to be at work, fully fit and healthy even more.
On your bike!
In the UAE it has been suggested that sedentary desk jobs can contribute to physical inactivity and that stress in the workplace can result in lack of sleep and a poor diet and more needs to be done to tackle this. Dr Michael Bitzer, the chief executive officer at national health insurance company Daman said in an article in The National newspaper recently that encouraging a healthier lifestyle is key. He insisted that when organisations adopt a health-oriented strategy that prioritises the wellbeing of staff, it immediately impacts the employee-management relationship in a good way and can lead to increased loyalty. He suggested initiatives such as having weekly runs at a park or encouraging colleagues to get together for brisk walk or bike ride.
In their paper ‘Creating a Future for Occupational Health’, academics from the University of Washington suggested that changes in the workplace and the resulting job insecurity change the nature of risk to a large fraction of the workforce. The paper states: “Workforce demographics are changing, and economic disparities among working groups are growing. Globalization exacerbates the 'race to the bottom' for cheap labour, poor regulatory oversight, and limited labour rights. Largely, as a result of these phenomena, the historical distinction between work and non-work exposures has become largely artificial and less useful in understanding risks and developing effective public health intervention models.”
It added that additional changes related to climate change, governmental and regulatory limitations and inadequate surveillance systems can challenge and frustrate occupational health progress while new biomedical and information technologies expand the opportunities for understanding and intervening to improve worker health.
Better training and research
The University of Washington paper concluded that occupational health training, professional practice, and research should evolve towards “a more holistic, public health-oriented model of worker health. This will require engagement with a wide network of stakeholders. Research and training portfolios need to be broadened to better align with the current realities of work and health and to prepare practitioners for the changing array of occupational health challenges.”
The WHO said that with the rapid changes in modern working life such as the demands of learning new skills, adapting to new types of work, the pressures of higher productivity, work quality and time pressure, there are growing psychological and stress issues among the workforce. More attention and resources should be given to these matters within occupational health, which can ultimately play an important role in ensuring that productivity, quality, motivation and work satisfaction are maintained at a high level.
Governments’ key role
In response to this, the WHO has set out ten priority objectives for the development of occupational health at national and international levels. These include strengthening international and national policies for health at work and developing the necessary tools; developing healthy work practices and promoting health at work; establishing registration and data systems; using effective transmission of data and raising public awareness through public information.
The organisation says that the objectives reflect the importance of primary prevention and encourage countries with guidance and support from the WHO to establish their own national policies and programmes with the necessary infrastructure and resources for occupational health. The role of government in this will be crucial in order to set the standards for controlling risks at work and ensuring that compliance with such standards are adhered to. The principal players at the workplace level though are the employers and workers who should work closely together to ensure health and safety at work.