01 August 2005
Lawrence Waterman

In part 21 of our Back To Basics series Lawrence Waterman tells us to think about what's making us ill as much as what we're being paid

When anyone talks about health-and-safety, all one word, they are conjuring up images of accidents at work and safety officers laying down the law. As we have seen in this series of articles, the truth lies somewhere between this, and a management approach that thinks through from hazard to risk to precautions in a balanced and sensible way.

Similarly, the words "occupational health" seem to conjure pictures of men and women in white coats with stethoscopes when reality suggests that it is more about reducing the risk of back pain from heavy lifting. So, this short article asks the same question as before, what are the basics to know how to deal with this - what are the basics of occupational health (OH)?

First, the scale of the problem; in the world of work, deaths from ill health outnumber accidental deaths by at least 4 to 1. In the UK, this is closer to 10 to 1. At the less extreme end, ill health accounts for millions of lost days, and lost workers who take incapacity benefit rather than a salary. There isn't a business in the country that isn't affected by sickness absence, and some of it is the result of work-related ill health. The statistics tell one story, but in every small firm and every team or department there are key people, the loss of whom would impact very severely on the ability to provide services or make goods.

That is why, as part of protecting those teams, you need to think about what can make them ill in the same way that you think about paying sufficient wages, offering development opportunities and the other factors that lead to job satisfaction. Recruitment and retention of good people is one of the most challenging aspects of running any organisation and good health strategies can play their part.

As well as looking at the various ways in which health can be harmed, such as stress, noise exposure or heavy manual handling, it is also sensible to have an overall picture of what a good strategy for good health looks like. There are several interlinked aspects to health management at work, for example health promotion (helping staff to cease smoking or encouraging good diets) can play its part, the core "know how" is to prevent your people being harmed by the work that they do. That involves having an effective health and safety management system, and then within it to focus in on the elements which can prevent ill health.

The top box in Figure 1 (see page 30) represents the standard Plan-Do-Check-Act management system for health and safety. If you have a Policy Statement which commits you to look after the staff and others who may be affected by their work, a serious approach to identifying hazards and assessing and controlling risks, and arrangements for monitoring and review, then you are well on the way to a decent approach to managing health as well as safety risks. The 4 boxes below are the elements that are specific to health issues.

Entry health checks

There are 2 ways to look at this - either "raising the bar" to make it difficult for anyone less than an Olympic athlete to get a job, or alternatively ensuring that people and the jobs that they do are a "good fit". Fitness for work is a variable issue, in some careers it is crucial: how fit do you want your airline pilot or train driver to be? In others, it may be relatively unimportant. Initial health questionnaires, confidential and professional assessment and advice on how to deal with any issues revealed have become the standard way to address this.

Risk control

If people are fit for work then the work should be fit for the people. That means the usual litany of hazard identification, risk assessment and effective controls. Physical hazards such as noise, chemical hazards and ergonomic challenges are all to be considered, but only if they represent significant risks. This is the heart of the health programme, protecting people from coming to harm, from developing an illness or otherwise having their health adversely affected.

On-going health checks

If the risks are serious - such as the regular use of vibrating tools (hand arm vibration syndrome), working in noisy environments (noise induced hearing loss), spraying twin-pack paints (asthma) or handling epoxy resins (dermatitis) - you will have done a lot of work under the heading of "Risk control". But how do you know that the precautions are adequate and working effectively? One way of monitoring is to carry out periodic checks on the exposed workers' health, which may be done by a trained employee. This can work well for detecting the early signs of dermatitis. It may be necessary to employ a nurse to carry out routine checks; for example lung function can be measured and acts as an early warning of developing lung sensitisation before asthma is diagnosed. In most cases, an occupational physician will define the checks required and analyse the data.

Retention and rehabilitation

Unfortunately, despite your best efforts, workers get ill. This may be as a result of workplace exposures to health hazards or from other causes outside of your control. Either way, the harm that sickness absence can do to your efforts to manufacture goods, build structures or provide services suggests that there is a good business case for helping people stay at work as they recover, or return to work as soon as is possible.

Much ill health actually gets better sooner if people are active and back at work - this usually applies to conditions such as back pain and to low-level depression. Here again, professional advice and assistance is helpful to employers who try to minimise absence.

Occupational health support

The launch in 2006 of Workplace Health Direct, with an investment by the Government of £20 million, is a clear sign that the future for OH is as a normal part of health and safety at work, with directors, managers and workers having access to professional advice and assistance in putting those 4 elements in place; pre-employment fitness for work checks, effective control over exposure to health risks, health surveillance and retention and rehabilitation. While you're waiting, there is an insight to the approach being adopted and helpful tips on getting started  through a number of websites. These include www.fitbuilder.com for construction firms and their workers,   and the site for the Scottish project to provide OH advice to small firms www.safeandhealthyworking.com.

Watch this space, there is a real effort to put "health" into health and safety, and it is likely to affect everyone at work.

Categories:
Chemicals, Construction, Management skills, Public services, Retail and distribution, Sickness absence, Transport, Utilities, Article, Financial / general services, Manufacturing / engineering