1. Work health Integrating workplace safety, health and wellbeing
- Innovative projects summary
Roslyn Miller
Senior Advisor, Healthy Workers Initiative
Workplace Health and Safety Queensland

2. Healthy Workers Initiative - Qld
Workplace Health and Safety Queensland funded by Department of Health under Healthier.Happier.Workplaces program*, expires December 2015.
Smoking, Nutrition, Alcohol, Physical Activity, Obesity + Mental Health (SNAPOM)
All industry
targeted initiatives for priority industries in Construction, Transport, Manufacturing, Mining, Agriculture, Public Service and Small Business
*Initially funded under National Partnership Agreement on Preventive Health

3. Workplace Health and Safety Queensland Healthy Workers Initiative
OUR AIM IS TO REDUCE CHRONIC DISEASE RISK FACTORS BY:
SMOKING
HEALTHY EATING
PHYSICAL ACTIVITY
ALCOHOL
OBESITY
MENTAL HEALTH
THE STORY SO FAR…
66,270 Workers
2,597 Workplaces
A Queensland Government initiative
3 Grant Rounds
101 Recipients
49,000 plus workers
83 Professional Development Forums
758 organisations
1331 attendees
22 Leadership Forums
952 organisations
1918 attendees
8 Research Initiatives
In Transport, Construction & Agriculture Industries
$2,280,000
Invested
Chronic disease impacted by work is now identified as one of 7 priority disorders within WHSQ
June 2011 to September 2015
Funded by the Queensland Government under
Healthier. Happier. Workplaces

4. What Queenslanders really look like……
Obesity
65% of adults are overweight or obese.
 22% in 4 years & is the highest in Australia
414,000 businesses
1,243,500 workers
Type 2 Diabetes
1 in 12 Queenslanders has type 2 diabetes
1 undiagnosed case for every 4 diagnosed.
Cancer
1/3 of the total burden of cancer was due to preventable risk factors - tobacco, physical activity, obesity & alcohol the largest causes.
Mental Health
1 in 2 adults reported a mental health disorder in their lifetime. 1 in 5 in the last 12 months
Queensland Health. The health of Queenslanders th report of the Chief Health Officer Queensland.

5. Benefits of H&W Programs
Likelihood of return to work following a physical injury:
20 days – 70% of returning
45 days – 50% of returning
70 days – 35% of returning
Injury risk is 13% higher for obese or overweight workers compared to healthy weight workers. 3 
Workers with 2 or more chronic illnesses have 2 ½ times longer sickness absences than healthy workers (9.3 days vs 3.7days) 2
Workers who smoke have a 38% higher risk of work-related injury than those who never smoked. 3 
1. Medibank Private 2005, The health of Australia’s workforce, Medibank Private, Australia.
2. Wright, TA, Cropanzano, R, Denney, PJ & Loline, GL 2002, ‘When a happy worker is a productive worker: A preliminary examination of three models’, Canadian Journal of Behavioural Science, vol. 34, pp. 146–150.
Workers who are overweight/obese miss more than twice as many workdays for work-related injuries compared to workers of a healthy weight.1
7.4 days vs 3.3 days
Van Nuys, K., Globe, D., Ng-Mak, D., Cheung, H., Sullivan, J & Goldman, D. (2014) 
Casimirri, E. et al (2014)
Dong, Z.S. Wantg, Z. & Largay, J.A. (2015)
Recognising the Health Benefits of Work

6. The Case for Intergration
Health behaviours
(e.g. smoking, nutrition)
Health outcomes
(e.g. obesity, diabetes)
WHS performance
(e.g. incidents, work comp)
Personal factors
(e.g. lifestyle habits, socio-economic status)
Work related factors
(e.g. work demands, working hours)
Business outcomes
(e.g. increase productivity, increased morale, decreased injuries)

7. A modern regulator approach
PRIMARY INTERVENTION
Prevention
Risk Management
SECONDARY INTERVENTION
Responding to early indicators of absence, injury and illness
TERTIARY INTERVENTION
Injury
management
Rehabilitation
Return-to-Work
Complaint work
Healthy Worker Initiative - Chronic Disease
IPAM Program – WHS improvement
People at Work – Psychosocial
PerFORM – Musculoskeletal
Here, we have 3 types of an intervention to manage risk:
Traditionally, organisations have focussed their efforts on tertiary-level interventions where workers are already injured (whether this be physical or psychological injury). This is quite a reactive approach to injury management.
Secondary intervention also reflects a reactive approach, responding to indicators once they show themselves.
Health and Wellbeing is viewed as a primary intervention – preventative/early intervention approach which allows organisations to take a more proactive, preventative stance in managing chronic disease risks before it leads to an injury or illness. Therefore, potential costs associated with lost productivity and workers compensation claims are heavily reduced, or avoided
Integrating HWB programs can be thought of as a broadening of existing risk management systems.

8. “Not our problem” mindset
Barriers to overcome…..
Privacy
“Nice to have”
Silo Approach
Not Legislative
Evaluation
Cost
Targets Individuals
Adhoc
“Not our problem” mindset
Time
“The distinction between disease and ill health arising from the workplace and that arising from other causes is increasingly diffcult to define- because many illnesses have several causes, with occupational factors being one of many factors. The blurred boundaries between occupational and personal risk factors largely contribute to why worker health and wellbeing and health and safety are not integrated. These barriers include:
Overwhelming compliance focus
Legislation exists in this country that places an obligation on businesses to ensure a workplace free of risks to safety.
There is no legal requirement to promote and support the health of workers
these types of initiatives are implemented voluntarily by employers.
Cost
There is a view that resources are best needed for safety initiatives and campaigns
Any additional resources dedicated to supporting health and wellbeing are competing with and a diversion of existing resources – both time and money.
Target Individuals
Safety and workers’ comp systems are designed to take an environmental and organisational approach.
There is a view health and wellbeing tends to have a more individual focus on personal health risks.
This can often raise concerns about the targeting or discrimination of individuals in the workplace.
A prime example of this is the precarious balance of interests needed to manage the perception that collection of personal information about health behaviours is not confidential and that the organisation can misuse this information.
Not our problem mindset
Individuals who sustain an injury or illness caused by their work are eligible for workers’ compensation benefits whereas individuals who present with a disease or illness propagated by lifestyle factors are not eligible.
This leads to an arbitrary definition of ‘work-related’ and ‘non-work-related’ conditions. Often these non-work-related conditions will be dismissed as a personal consideration and not that of the workplace.
However, workers compensation is only aspect to consider.
Workers suffering lifestyle-related diseases are still likely to be absent from work, unproductive and disengaged if they remain at work or separate from the organisation entirely meaning lost skills and experience.
Think that Health/Healthy Dept will pick it up.
Lack of awareness of chronic disease risks.
Silo approach
Safety is often the responsibility of a different work unit (‘silo’) than health and wellbeing in an organisation.
Health and wellbeing typically resides in non-health orientated units (e.g. HR) with no clear objectives and sometimes limited capability or capacity for interventions.
Scepticism or misunderstanding from management can also inhibit efforts, unlike WH&S which is often a strategic priority – health and wellbeing can be seen as merely a nice-to-have employee incentive that comes under the microscope in difficult periods.

9. Healthy Worker framework – Building Sustainable Workplace programs
Management Commitment
Wellness Planning
Needs Assessment
Action Plan
Evaluation

10. Innovation grants Live Well Farm Well
Project
Live Well Farm Well
Healthy work – healthy you video resources
Train the champion – sedentary project
Turf growers accreditation
ESSA professional development points
Shift work & nutrition resource
Nutrition standards for work camps
Electrical industry resource development
Mental health and wellbeing pilot
Shifting Gears - Transport
Project
Outcome/Deliverable
Train the Champion – sedentary project
Develop, user test, implement and evaluate a “Train the Champion” sedentary reduction resource toolkit for white collar workers. Partner: University of Queensland
Turf growers accreditation - HWB integrated into Turf Queensland accreditation program
Shift Work resource - Guidelines to healthy eating for shift workers. Employers guide also developed by WHSQ
Nutrition standards for FIFO - Nutrition standards and point of choice labelling for remote area camps to reduce chronic disease risks for FIFO workers
Live Well Farm Well - Development and distribution of a package of modified resources (based on 5 step framework) targeting horticulture industry
Blue Collar video resources - Develop evidence based educational resources to deliver health and wellbeing insights, tips and guidance for managers and blue collar workers
Mental health and wellbeing pilot - Undertake psychosocial and health and wellbeing risk assessments of 10 Queensland independent schools and identify strategies to improve mental health in the workplace
Electrical industry resource development - Toolbox talks, healthy behaviours wallchart. Distributed to over 5000 employees Developed by NECA
Evaluated by RMIT

11. Innovative Research Project
Shifting Gears – Transport
Linfox & Toll NQX
44 drivers – 34 local, 10 long haul
Average Age – 47 (local) 46 (long haul)
20 Week active living and healthy diet program
Jawbone device used to self monitor
Incentive scheme to encourage engagement
This project tested the impact a smartphone intervention had on the physical activity and healthy dietary choices of Queensland local delivery and long haul truck drivers.
Drivers attended an educational workshop (March 2014) and implemented an active living and healthy diet program for 20 weeks (April-August 2014). The program focused on integrating small changes in physical activity and healthy food and drink choices (reduced fat and sugar options) into the working day.
To facilitate self-monitoring and regulation of healthy choices, drivers were offered a free Jawbone wristband and access to an interactive smartphone application (UP). The wristband synchronised with the application to upload daily step counts, allowed drivers to manually input or barcode diet choices, and to virtually connect with researchers and other drivers.

12. Innovative Research Project
To encourage engagement, the program also used an incentives scheme, whereby points and vouchers were accumulated relative to the number of healthy choices made. Drivers aimed to progress through six Gear Shifts, ranging from points. Gear Shifts were in turn linked to incentives, whereby drivers received points and vouchers relative to the number of healthy choices made.
The UQ researches could log in to the app ‘UP’ and track the number of healthy choices drivers had made.
Driver interviews highlighted that the incentives program was well received and provided a challenge against which drivers could evaluate their progress and the progress of others.
However, the consensus was that the incentives program was not a major determinant of project engagement. The intrinsic need to be healthier was considered to be the main reason why drivers engaged with the program.
13 drivers reached Gear shift 3 (50 points)
4 drivers reached Gear shift 6 (200 points)

13. Innovative Research Project Outcomes
Sitting Time:
Local Delivery
Long Haul
During Shift Movement
1.2 hours
.6 hours
Local move more during shift
During Shift Stationary
2 hours
1 hour
Local sit/lie more during shift
Time spent driving or standing
7.8 hours
10.2 hours
2.5 hours higher for Long Haul
Based on a 24-hour monitoring period, drivers spent hours not moving (this includes sleep time) on both work and non-workdays.
Drivers averaged over an hour less sleep on workdays compared to non-workdays (5.1 hours verses 6.3 hours).

14. Innovative Research Project Outcomes
Quantitative Changes:
sitting by 2.4 hours/day (Long haul drivers )
5% reduction in sedentary time during shifts over the program (approx. 40min decrease)
Systolic blood pressure & waist circumference measures
Average steps/day steps/day (8994 total)
24% choosing healthier options & less saturated fat
Outcomes
Smoking
No significant change
Base line - 75% had never smoked or were ex-smokers
Alcohol
Base line - 73% drank alcohol with approx. 50% consuming more than 2 standard drinks/day

15. Innovative Research Project Outcomes
Qualitative Changes:
At the individual level – healthy choices more often
Increased self-awareness of good choices
virtual connection with health experts and other drivers
Most healthy changes were still evident at two months follow-up.
At the individual level, activity trackers, smartphone technology and incentives played a facilitative role in ‘switching’ drivers onto healthy choices and improving some chronic disease risks.
Increasing self-awareness of good choices, being able to self-monitor and compare progress, and virtually connect with health experts and other drivers underpinned positive changes.
These processes embedded good choices into work routines, and while smartphone use tended to cease after the intervention, most healthy changes were still evident at two months follow-up.

16. Innovative Research Project Outcomes
What the drivers & managers said:
One of the guys told me the band is the best thing that happened to him because it shows him what he had done in the day. Manager
It was brilliant. It motivated me to move as much as possible. It made me more mindful about the sleep as well. Long Haul Driver (casual)
Monitoring the steps is easier, you just wear the band. The diet is a bit harder and I tried to improve one little step at a time. Local Delivery Driver (casual)
I liked it because I could see how many steps I did in the day. I had some problems with the band and I had to drop out for a while. I’d cut down on what I was eating and stuff and I just stayed with what I was doing with the band. Local Delivery Driver (casual)

17. Innovative Research Project Outcomes
Future Recommendations:
Management and Union Support
Use smartphones and incentives
Use Champions
Multi-pronged health approach
Environmental & organisational changes e.g. fridges and cooking equipment
Further Research
Management and Union Support: to get drivers involved in health change. These barriers specifically related to longer driving hours, invariable shift patterns and lack of routine, limited organisational support, and an unwillingness to take individual responsibility for change.
Champions: Recruit driver health champions as mentors and role models for industry change.
Multi-pronged health approach: Healthy choices are not the sole responsibility of drivers – engage companies, servo environments and regulators to encourage a change in culture at the industry level.
Further Research: Evidence is very limited on ‘what works’ for truck driver health – encourage scientific studies that inform the translation of strategies into industry. Ensure these studies target different driver types and use objective, validated measures to accurately assess intervention impact.
This type of program is what we need for truck drivers. All trucking companies should take a look at their drivers and try to enhance their health and fitness to give a better performance. Local Delivery Driver (casual)

18. Healthy Work . Healthy You. Oil & Gas

20. Mental Health and Wellbeing pilot+
Independent Schools Queensland
10 Independent Schools
Manufacturing
6 participants
Transport
7 Participants

21. Work-related stress framework
Psychological
Injury/Illness
Poor health
behaviours
Physical
Illness
Work-related Stress
HIGH JOB DEMANDS
1. Demand: role overload,
cognitive demand,
emotional demand
2. Role conflict and role
ambiguity
3. Relationships: group task
conflict, group relationship
conflict, bullying
LOW JOB RESOURCES
4. Control
5. Support: supervisor
and co-worker support
6. Change consultation
7. Recognition and reward
8. Procedural justice
Response rate 81%
Teachers showed high emotional demands, change, role clarity and relationships – low psychological wellbeing scores
Adminstration & other roles – similar demands, scored higher in psychological wellbeing
The survey responses were consistent with what most schools expected. One school reported concerns with harassment identified, however no cases had been reported to the school Equity/Safety Officer.

22. Healthy Worker framework
Management Commitment
Wellness Planning
Needs Assessment
Action Plan
Evaluation
Environment & Individual Objectives & Strategies
Healthy People
Survey

23. The process Evaluation Info day
Project aims
Resources
Communication strategies
Baseline survey
Engage with staff
Planning day Risk factors & how to control
ACTION PLAN
Survey conducted
Staff complete online
Individual report
Except if less than 20 staff
Debrief / 1 hr feedback consultation
feedback if required
Implementation of strategies in action plan
Focus groups
Workplace consultation
Evaluation
Consultation offer

24. Key Learnings Systems based approach – “the way we do business”
Focus on business outcomes and work related factors
Develop a committee, identify champions to share the load
Sustainability requires a mix of strategies (environmental & individual)
Provide education, awareness and capacity building
Start small and build up
Promote the successes, big and small
Along the way we have learned a lot on integrating worker health, wellbeing and safety.
The first of which is to focus on the those business outcomes that will make a difference and the work related factors that workplaces can address. This needs to link in with as much as possible to what is done with safety
Be consistent with language. If we start using terms like wellness, health promotion or health prevention then these will get lost. Worker health and defining it is important.
Utilise a top down and bottom up approach with workplaces to get the messages out there- this is no different than what is done with safety
Continue to provide education and awareness- repetition is key to getting the message out there.
Biggest barrier: Worker Health is not legislative; it is not seen to be mandatory for workplaces to addresses. Have had to focus on business outcomes and what organisations can do from a work environment perspective
Being based in the regulatory body initially provided challenges as workplaces thought we were there to engage and audit their workplaces. Had to emphasis we had no powers to write notices. However, being based with regulatory body has allowed access to workplaces and provide opportunities to link health and wellbeing with safety
In general, both internal and external stakeholders can put up a front and said that health issues are personal- we cant do anything about this- we cant control what someone eats, if they smoke etc. Have had to emphasis we are addressing work related factors
A lot of the high risk industries have poor safety systems in place-. If an organisation has poor safety systems in place-hard to be able to then get them to engage with addressing worker health. Priority is for workplaces to get their safety systems to suitable standard to meet compliance.
1/3 of people overweight/obese perceive themselves as healthy weight.
Individuals & employers perceive ……

25. Organisational Systems Benchmarking Tool
Key Features:
Re-released in June 2015 with 32+ used the tool of which 50% all three systems
3118 Registered users
Online self assessment for Workplace Health & Safety, Work Health & Wellbeing, Rehabilitation & Return to Work
Benchmarks against other organisations of similar size & industry
Integrated systems based approach
Choice to complete 1, 2 or all 3
A comprehensive summary report
Comparison over time
Free & confidential.
Go to
The OSBT has been around for approximately three years and assessed safety. It has recently been redeveloped to include Work health and wellbeing and rehabilitation and return to work.
To complete the tool, go too the worksafe website to assess your business systems for workplace health and safety, worker health and wellbeing and rehabilitation and return. You can complete one or all three survey’s at any one time and at the end you will be given a benchmark to how you are going against others who have completed the tool from a similar industry and business size. You will also be given a comprehensive report with links to useful information and support. The pictures in the slide are of the tables and graphs you get in the report once completing the survey’s.
Other features include: over time you can compare previous survey’s with new ones and the additional section on integration. The results are completely confidential.
So to complete – go to

26. WHSQ Work Health website www.worksafe.qld.gov.au
For more information
WHSQ Work Health website
Healthier.Happier. Workplaces
WHSQ Web page
Range of information and statistics that can help inform your business case and planning
Range of case studies will continue to grow
Send an to or calling
Subscribe to e-SAFE
eNewsletter distributed monthly by WHSQ
Run a range of health-related articles
Promote new opportunities
Encourage you to subscribe to keep in touch