Health and Safety in the Workplace
Okay, it is pretty common to see the word ‘Health’ used interchangeably within a practicing Safety Professional role. What does health mean to you? Are you thinking of industrial hygiene? Are you thinking of wellness? How well has your company integrated health within the company? Does your company have a health program?
When I think of health, I think of it from an occupational illness perspective. Many random thoughts move through my mind each day so I’m not sure what prompted me to look up the job responsibilities of a Safety Professional from a Health standpoint.
Integrating Health and Safety in Modern Labor
I read a very interesting article on integrating health and safety in the workplace from the Journal of Occupational and Environmental Medicine. The purpose of this publication is to compare and contrast various methods US employers have used in combining assorted professional voices from industrial hygienists, safety engineers, occupational health physicians, nurses and other practitioners of Occupational and Environmental Medicine.
When OSHA began in 1970, safety made extreme improvements in workplace conditions from the use of risk assessments, medical surveillance examinations, safety training, improved protective equipment, better mechanical safety engineering and other physical changes in the workplace.
Increased cost associated with health care costs is what originally drove OSHA to begin. As these costs increased, countless employers began wellness programs within their companies. According to the scholarly article, Integrating Health and Safety in the Workplace, early workplace wellness programs consisted of health screenings, smoking cessation, weight-loss education, and on-site exercise offerings.
Over time, these programs evolved, including health risk appraisals (HRAs) and biometric monitoring, programs for the management of chronic health conditions, such as diabetes, behavior modification, and large-scale population health strategies based on clinical data. Many large employers have established medical clinics and coverage onsite.
"Culture of Health" Alongside a Culture of Safety
In order to successfully integrate a culture of health together and safety management, there needs to be an interest from the community and workplace to address global health issues. The ultimate link to address global health issues include the trio of the community (public health), the home (primary care), and the workplace (occupational health and safety).
The National Institute for Occupational Safety and Health (NIOSH), launched its Total Worker Health initiative in an effort to stunt wider integration of health and safety in the workplace. NIOSH’s successful strategy is health promotion to prevent worker injury and illness and to advance health and well-being.
Amplify Safety and Health Sustainability Within the Workplace Through Dow Jones Sustainability Indices
After about 21 years, the DJSI has been globally recognized by investors as the leading standard for corporate sustainability, tracking the performance of the world’s leading companies, and they have had a real impact in terms of changing organizational behavior and corporate culture.
Standards and Metrics for an Integrated Health and Safety Index
A popular quote which I use in a lot of my safety management and KPI documentation is, “what gets measured, gets changed”. Identifying the critical points of health which needs to be tied into safety KPIs will overall aid in the integration into a company. Utilizing the DJSI, the three dimensions of the Index include: economic, environmental, and social.
As with any successful program implemented within a company, it needs to show leadership and management commitment and support. One of the ideas identified in the journal article I strongly value is incorporating Index goals and programs directly into performance reviews. Overall, all health and safety and even environmental should be incorporated into performance reviews. What individuals are reviewed on show what a company values and is truly a condition of employment and operational success.
Other important economic aspects I found to be key, involve integrating health and productivity. Leadership and management are always looking for ways to identify how any program they implement adds value to an operation. The value of adding health can be identified by:
- Measuring the link between worker health and productivity and direct employer investments into interventions that improve health and organizational performance
- Population health management incorporated in the organization’s business strategy
- Efforts are made to quantify the total economic impact of health, including direct medical and pharmacy costs of health care as well as indirect productivity-related costs, such as absenteeism and presenteism.
- Presenteism is the problem of employees who are not fully functioning in the workplace because of an illness, injury or other condition. Even though the employee may be physically at work, they may not be able to fully perform their duties and is more likely to make mistakes on the job.
It is standard practice for safety professionals to understand how to identify potential hazards in the workplace, whether it is chemicals, noise, indoor air quality or the like. We use incident information, hazard recognition, participation from employees, education and training to mitigate risk.
The social section of the article does a great job providing examples of how a successful company added to their safety and health programs. The social section along with its metrics are great to use in integrating within a safety management system. These include:
- Standards for Engagement in Prevention and Wellness by employer/employees
- Prevention strategies by health promotion, lifestyle management, and safety engineering programs to health coaching, bio-metric testing, and active disease management from the community (public health), the home (primary care), and the workplace (occupational health and safety)
- Standards for Value-Based Health Benefits Management
- Actuarial claims analysis for trends in diagnoses and costs for planning appropriate disease management and health promotion programs
- Pharmacy benefit plan design is used to reduce costs, while providing access to appropriate medications, and is designed on the basis of beneficiary health factors
- Standards for Corporate Social Responsibility
- The organization is aligned with the goals of the community in which it operates, acting as a transparent and trusted partner
- Clear lines of communication are in place to link the organization with community stakeholders, including public health organizations and safety and health agencies
- The organization leverages its health and safety policies to benefit the community and has strong policies in place to ensure attention to issues of importance
- Wellness programs
- Percentage of employees completing an annual HRA
- Percentage of employees completing annual bio-metric screenings
- Percentage of employees completing a primary care physician periodic wellness visit
- Prevalence of chronic health conditions and health risks
- Percentage of employees in individual high health risk levels at baseline and annual follow-up
- Percentage of employees in low, medium, and high health risk categories at baseline and annual follow-up
- Impact of health conditions
- Working days lost per year by disease category (diabetes, obesity, and hypertension) x 100 divided by working days available in the same year
- Workplace demographics – employee composition reflects the demographics of the community by sex, ethnicity, sexual orientation, disability, age, etc, at multiple organizational levels
- Number of employees in an equity group x 100 divided by the total number of employees at same point in time
- Community engagement
- Number of community activities engaged in annually
Health and wellness is implemented similarly in comparison to other safety programs. Depending on the structure of the company, the departments may be Environmental, Health and Safety, Human Resources, and onsite Occupational Health Nurses/Occupational Therapists.
Once the target team is identified, they begin combining efforts to implement the program: plan, assess, implement, monitor and review. From what I have seen within companies, the monitoring and review phases have lagged, especially over time. Owning any program does take accountability and upkeep to what it offers, especially in order to have employee involvement in the long-term.
The first phase in beginning a program is planning. Understanding and explaining the scope to team members and individuals who are to buy-in are key to having a successful program.
- Good for business and help improve productivity
- Create a happier, less stressful, and more prosperous business environment
- Do better at their jobs and contribute more
- Are absent from work less and more productive when at work
- Enjoy their jobs more, reducing turnover costs
- A vision and supporting mission statement can help organizations:
- Craft a human-centered culture by inspiring effective programs and policies
- Keep health and safety issues front and center for senior leaders because they balance organizational priorities
- Set the tone for interactions between mid-level managers, front-line team leaders, and workers
- Engage workers by seeking active worker, participation, input and involvement
- Show community and industry leadership to customers, shareholders and
What are the present conditions? Where do we want to go? In looking at these questions, we gather metrics which are directly related to what we want to change.
- Health care – related costs, participation in medical plans, short- and long-term disability
- Human resources
- Absenteeism, workforce demographics, employee turnover, job satisfaction and employee engagement
- Risk management
- Workers’ compensation insurance costs, premiums and losses/claims, insurance broker, carrier, third-party administrators
- OSHA statistics, incidence rates, other safety performance metrics
- Operations management
- Productivity costs per unit/output/service, key performance metrics
- Finance or payroll
- Gross margin per unit/service, wages, total hours worked and full time equivalent employees, organizational structure and reporting relationships (also, human resources)
When do we want to begin? What is the timeline for implementation? Does it need to be rolled out in phases? Can it be rolled out at once? How will it be communicated and streamlined?
- Establish a sense of urgency
- Creating a guiding coalition
- Developing a change vision – overall initiative and creates a compelling communication of the desired end state
- Empowering broad-based action
- Developing best practices, removing obstacles to change, and identifying goals and objectives to achieve a vision of integration
- Communicating the vision for buy-in
- Phased roll-out
Periodic evaluation of how the program is doing will improve its effectiveness. Especially if employees offer suggestions and insight as to something that is failing, unrealized or missing. There is always opportunity for improvement. Having the willingness to prioritize improvements in employee health and wellness will create a culture amplifying active caring.
- Return on investment or value of investment once or twice a year
- Effects of strategies on claims cost, workers’ compensation costs, OSHA recordables, disability/absenteeism numbers
Scheduled review is similar to periodic evaluation if there are specific areas which can be improved. With this portion of program management, it incorporates larger feedback and group discussions. During review, additional reward and recognition may be added to increase the program’s effectiveness.
- Program evaluation
- Determining the success of programs can be achieved through interviews, group-discussion meetings and anonymous surveys, examination of anything that was expected during the process as well as anything that happened but was not anticipated
- Incorporating lessons learned
- Next steps should be determined from lessons learned, employee feedback, and key metric results
- Ranging from discounts at local health clubs and healthy food choice discounts to health insurance premium discounts, additional days off, and direct salary/bonus payment incentives
Actively caring about an employee is demonstrated through effective health and safety management. To get the most out of the health portion of the safety program, investing time in wellness programs will have a work culture which shows you are ahead of the game.
Ideally, every employee wants to feel valued by the employer; when an employer takes initiative to improve their culture, it shows through productivity increase, cost decrease, more active involvement from employees and possibly even longer tenure employees.
This topic is near and dear to me. I enjoy taking my time to actively care about employees and do what I can to make their work experience as safe as possible. Through actively caring, I get the opportunity to get to know employees on a personal level and learn what they enjoy doing outside of work. I become an individual they can count on to improve their workplace so they can go home the same way they came in.
I would love to help additionally by improving their health and wellness so they can further enjoy the activities they do during their free time. More to come on this last part!
Until next time,
- Loeppke, Ronald R. MD, MPH, FACOEM; Hohn, Todd CSP; Baase, Catherine MD, FACOEM, FAAFP; Bunn, William B. MD, JD, MPH, FACOEM; Burton, Wayne N. MD, FACOEM; Eisenberg, Barry S. CAE; Ennis, Trish CSP, ARM, CRIS; Fabius, Raymond MD, CPE, DFACPE; Hawkins, R. Jack CSP; Hudson, T. Warner MD, FACOEM, FAAFP; Hymel, Pamela A. MD, MPH, FACOEM; Konicki, Doris MHS; Larson, Paul MS; McLellan, Robert K. MD, MPH, FACOEM, FAAFP; Roberts, Mark A. MD, PhD, MPH, FACOEM; Usrey, Cary; Wallace, Joseph A. CSP, RRE; Yarborough, Charles M. MD, MPH, FACOEM; Siuba, Justina MPH Integrating Health and Safety in the Workplace, Journal of Occupational and Environmental Medicine: May 2015 – Volume 57 – Issue 5 – p 585-597 doi: 10.1097/JOM.0000000000000467