1. Australian Hazard Exposure Assessment Datasets (AHEAD) COMCARE National Conference 2007 Dr Anthony Hogan

2. Acknowledgements Co-researchers –Wayne Creaser, Peta Miller, Su Mon Kyaw-Myint, Christine Chalmers (OASCC) Close collaborators –Bill Straveski (Victorian WorkCover) –Kirsten Way (Workplace Health & Safety Queensland) –Members of the ASCC

3. Role of ASCC Leads & coordinates national efforts to prevent workplace death, injury & disease; & improve workers’ compensation arrangements, & rehabilitation & return to work of injured workers Provides a national forum by which representatives of State & Territory govts, employers & employees consult & participate in development of policies relating to OHS & workers’ compensation matters Promotes national consistency in the OHS & workers’ compensation regulatory framework

5. Evidence of work-relatedness Magnitude Severity Long latency Evidence of effective prevention options Opportunities for action e.g. national standards Stakeholder activity or support How were disease priorities determined?

6. Occupational cancer Respiratory diseases Contact dermatitis Noise induced hearing loss Musculoskeletal disorders Mental disorders Infectious & parasitic diseases Cardiovascular diseases Priority Diseases

7. For diseases of long latency existing workers’ compensation and other health data does not provide an accurate picture of current exposures

8. Occupational diseases are often not recognized due to long gap between exposure & disease www.rovenlaw.com/images/301-a.jpg Asbestos exposure in aircraft manufactures

9. Often not claimed due to poor awareness and recognition of work-relatedness Note lack of adequate hearing protection!

10. Skin cancers in an arc welder welding produces the full spectrum of UV radiation Often not claimed due to difficulties separating work & non work attribution

11. Often not claimed or compensated due to concerns about job security, legal costs or employees too ill to claim GPs & workers often prefer to stay outside the system

12. Why are occupational diseases a ASCC National Priority? Condition% caused by workPeople affected MSD19421,000 Asthma16235,000 CVD12.5184,000 Depression636,000 Cancers3.26,700

13. For 5 priority diseases –More than 880,000 workers already with disease –Direct health costs exceed $1bn –Millions with potential hazard exposures (ASCC, 2007) National impact

14. ASCC agrees we must not wait & just ‘count health effects’ of exposure to hazards We need to measure current exposures to disease causing agents Estimate that approximately 1.5 million Australian workers potentially exposed to carcinogens at work –this does not consider the adequacy of workplace controls which may eliminate or reduce exposure

15. Better data can improve disease prevention 5% improvement would result in 44,000 Australians each year NOT developing occupational diseases & $200m savings on health costs

16. Existing data sets inadequate for targeting occupational diseases Logic was to focus on –known disease causing hazard exposures –surveillance to inform prevention The AHEAD project began ……. –with a focus on priority diseases The need for a new data set

17. Hazards assessed in the presence of what controls! Australian exposures - what, how much, how long, where, when, and to whom?

18. Hazards assessed in the presence of what controls!

19. The ongoing systematic collection, analysis, interpretation and dissemination of current and historical data on occupational hazards and exposures, new processes and technologies, and hazard and exposure controls for the purpose of prevention of disease or injury in the workplace. A. Griefe, 1995 AOEH 10(9) 737-742 Exposure Surveillance

20. Project design

22. Provide data to guide preventive action –Estimate and profile the prevalence of exposures to priority disease causing hazards Nationally Possibly by industry Ideally by worker –Document the use of hazard controls –Target national prevention activity –Monitor progress of prevention efforts overtime Project Aims

23. Response biases Limited resources mean limited number of surveys administered Reasonably long and moderately complex questionnaire Prevalence of exposures varies greatly Early samples will not be big enough to report expose by occupation Larger samples needed to detect small shifts in exposure reduction over time Limitations of surveys

24. Questionnaire Design

25. Logic of survey structure What Hazard Where Industry/ Sub Industry Workplace types When exposed Tasks & processes What exposure Controls How Much Dose OEL Adequacy Task context Who Occupations GenderAge Employment arrangements ChemicalPhysical PsychosocialBiological

26. Whether has exposure and if so how long e.g. exposed to fumes/vapours For physical and chemical hazards –Name of hazard if known e.g. benzene Questions for physical hazards

27. Psycho-social hazards measure –Karasek demand support control model Musculoskeletal risks –EU Working Conditions Survey and the Swedish Environment working survey Hazards using psycho-metric questions

28. Survey content

29. European Working Condition Survey NOES Survey (NIOSH, USA) Danish Work Environment Cohort Study Swedish Workplace & Environment Survey Nordic Skin Questionnaire Job Content Questionnaire Working Life in New Zealand Study, and Victorian WorkCover Authority Worker Survey Health & Safety Executive (UK) Source of questions

30. National standards exist for the measurement of noise and airborne hazards Specific protocols being developed for the consistent reporting of measured hazards into database Reporting physical hazards

31. Sample selection Population –randomly selected –15 years or older –in paid employment –worked last week in a priority industry Priority industries –construction, manufacturing, health and community services, transport and storage, agriculture, forest and fisheries Target sample N=1,500

32. Analysis plan What are current exposures? –Do they differ by industry, occupation, gender, ethnicity or region?

33. Conduct on-line or telephone surveys using random samples of staff members –Conditional on sharing de-identified data with Office of ASCC Complete OHS professionals survey form on selected worksites Share measures of physical exposure studies into database How can we participate?

34. Subject to ASCC agreement the Hazard Exposure Project will collect, analyse and report on exposure data to inform actions within the National OHS Strategy to reduce the level of work related injury, death and disease in Australian Workplaces

35. Further information Email anthony.hogan@ascc.gov.au