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Work health Integrating workplace safety, health and wellbeing
- Innovative projects summary Roslyn Miller Senior Advisor, Healthy Workers Initiative Workplace Health and Safety Queensland
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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
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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
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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.
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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
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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)
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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.
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“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.
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Healthy Worker framework – Building Sustainable Workplace programs
Management Commitment Wellness Planning Needs Assessment Action Plan Evaluation
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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
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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.
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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)
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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).
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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
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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.
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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)
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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)
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Healthy Work . Healthy You. Oil & Gas
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Mental Health and Wellbeing pilot
+ Independent Schools Queensland 10 Independent Schools Manufacturing 6 participants Transport 7 Participants
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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.
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Healthy Worker framework
Management Commitment Wellness Planning Needs Assessment Action Plan Evaluation Environment & Individual Objectives & Strategies Healthy People Survey
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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
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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 ……
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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
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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
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