Occupational Health – What Is the BIG Picture of OH?

The rapid development of workplace health protective and preventive services has been driven by government strategies and recommendations, as well as by the European Union legislation in the areas of health and safety at work and by the European Commission programme in public health. This was also largely due to the new demands and expectations from employers, employees and their representative bodies as they recognize the economic, social and health benefits achieved by providing these services at the workplace, thus providing the available knowledge and evidence necessary for the continuous improvement of workplace health management. Comprehensive workplace health management is a process involving all stakeholders inside and outside any business. It aims at empowering them to take control over their own health and their family’s health considering environmental, lifestyle, occupational and social health determinants and quality of health care. It is based on health promotion principles and it creates a great challenge to health, environment and safety professionals providing services, advice, information and education to social partners at work. It involves also taking care of considerable socioeconomic interest of all involved stakeholders. It has been shown in several instances that the business utilizing a well managed research based occupational health service can gain a competitive advantage by:

Protecting human health against health and safety hazards occurring in the work environment.
Promoting human health workplaces for all ages and healthy aging by appropriate work culture, work organization and support to social cohesion.
Promoting mental health, healthy lifestyle and preventing major non-communicable diseases using specific workplace health policies and management tools.
Maintaining work ability thus also employability throughout working life.
Reducing health care costs caused by employees’ and employers’ injuries, diseases, illnesses and premature retirement resulting from or influenced by occupational, environmental, life style and social health determinants
Using resources effectively, protecting the natural environment and creating a health supportive environment.
Improving social communication and literacy on health, environment and ethics.

This article series describes the author’s observations of various roles undertaken by the occupational health nurse. Whilst recognizing the wide variation that exists in occupational health nursing practice between different industrial and blue collar environments this series reflects the standards that have already been achieved where occupational health nursing is at its most advanced. However it has to be recognized that the level of education, professional skills and the exiting national legislation determines what role can be actually undertaken by occupational health nurses. Even more important is to remember that no one professional out of the exiting workplace health professions is now capable to meeting all health needs of the working population. A multi-disciplinary approach is needed to effectively manage the growing workplace health and safety demands in business today.

The workplace health services use the skills of many professionals such as specialist occupational physicians, safety engineers, occupational hygienists, occupational health nurses, ergonomists, physiotherapists, occupational therapists, laboratory technicians, psychologists and other specialists. The role and tasks actually performed for the companies by representatives of different health and safety professions vary greatly depending upon legislative needs, scope of the workplace health concept perceived by directors, enforcement practice, the level of their education, position in the occupational health infrastructure, actions undertaken by insurance institutions and many other factors. Occupational health nurses are the largest single group of health professionals involved in delivering health services at the workplace and have the most important role to play in the workplace health management. They are at the frontline in helping to protect and promote the health of the nations working population.

The role of the occupational health nurse in workplace health management is a new and exciting concept that is designed to improve the management of health and health related problems in the workplace. Specialist occupational health nurses can play a major role in protecting and improving the health of the working population as part of this strategy. Occupational health nurses can also make a major contribution to the sustainable development, improved competitiveness, job security and increased profitability of businesses and communities by addressing those factors which are related to the health of the working population. By helping to reduce ill health occupational health nurses can contribute to the increased profitability and performance of organizations and reduce health care costs. Occupational health nurses can also help to reduce the externalization of costs onto the taxpayer, by preventing disability and social exclusion, and by improving rehabilitation services at work. By protecting and promoting the health of the working population, and by promoting social inclusion, occupational health nurses can also make a significant contribution towards building a caring social ethos within the UK. This article provides guidance to employers and employees on establishing workplace health management systems within their own organizations. On how to determine and develop the role and functions of the occupational health nursing specialist within each enterprise and where to go for additional help and advice in relation to occupational health nursing.

Changing nature of working life and the new challenges

The world of work has undergone enormous change in the last hundred years. To a large extent the very heavy, dirty and dangerous industries have gone, and the burden of disease, which came with them, in most European countries, has declined. However, the new working environments and conditions of work that have replaced them have given rise to new and different concerns about the health of the working population. Exposure to physical, chemical, biological and psychosocial risk factors at work are now much more clearly linked to health outcomes in the mind of the general public. Expectations of society in regard to health at work have also changed, with increasing demands for better standards of protection at work and for the improvement of the quality of working life. Employers are also recognizing that health-related issues, such as sickness absence, litigation and compensation costs, increasing insurance premiums, are expensive; ignoring them can lead to serious economic consequences. The best employers’ emphasize the important message that good health is good business, and that much can be achieved in this field simply by introducing good management practices.

The Need for Workplace Management

There are approximately 400 million people who work in the EU Member States. The majority of whom spend more than one half of their waking life at work. However, fatal accidents at work are still common. The standardized incident rates per 100,000 workers in the European Union show that the fatal accident rate varies between 1.6 in the UK to 13.9 in Spain, with Austria, Greece, France, Italy and Portugal all above 5.0%. In the entire European region there are approximately 200 to 7500 non-fatal accidents per 100,000 employees per year, of which around 10% are severe leading to over 60 days absence from work, and up to 5%, per year, lead to permanent disability. It has been estimated that the total cost to society of work related injuries and ill health in the European Union is between 185 billion and 270 billion ECU per year, which represents between 2.6% to 3.8% of Gross National Product (GNP) in member states. The cost of workplace accidents and ill health, in both financial and human terms, remains an enormous, largely unrecognized burden in UK. The majority of those accidents and diseases could have been prevented if appropriate action had been taken at the workplace. Many responsible employers have consistently demonstrated that by paying attention to these issues this type of harm and the subsequent costs can be avoided, to the benefit of everyone concerned. Increasing concern is the growing awareness of occupational stress. Up to 42% of workers in a recent survey complained about the high pace of work. Job insecurity, fear of unemployment, lack of a regular salary and the potential loss of work ability are all additional sources of stress, even for those in employment.

The wide ranging social and health effects of occupational stress on the health of the working population are well documented, for example 23% of workers surveyed claimed that they had been absent from work for work related health reasons in the previous twelve months. The resulting cost of sickness absence in United Kingdom is considered to be substantial. In the UK 177 million working days were lost in 1994 as a result of sickness absence; this has been assessed at over 11 billion in lost productivity. HSE statistics are encouraging given in 2009; only 29.3 million days were lost overall, 24.6 million due to work-related ill health and 4.7 million due to workplace injury. Much of this burden of ill health and the resulting sickness absence is caused, or is made worse by working conditions. Even where ill health is not directly caused by work, but by other non-occupational factors such as smoking, lifestyle, diet etc. Interventions designed to improve the health of the working population, delivered at the workplace, may help to reduce still further the burden of ill health. At present the socioeconomic impact of environmental pollution caused by industrial processes on the working population is uncertain, but it is likely to contribute further to the burden of ill health in some communities.

Health Anxiety and Solutions

It’s always important to take care of oneself using all the principles of good health. Regular check-ups, proper nutrition and healthful living all enable one to keep on top of their health in a careful yet reasonable way. Often one becomes overly concerned with health issues and caught up in a cycle of health worries. One health issue is reconciled when another immediately pops up to take its place. These worries become all encompassing and exhausting after a while.

Eventually, the individual realizes that this cycle of health anxieties has intruded upon the quality of their life. A dark cloud, always hovering over daily living, this intrusive form of anxiety has to be addressed. One begins by determining why this is occurring, what purpose does it serve and how to interrupt this behavior.

Reason for Health Anxiety

Health worries actually serve a purpose and this purpose is not difficult to detect if one looks deep enough into this pattern of behavior. Often this pattern involves the brain distracting from specific emotions which the individual finds difficult to address.

Many emotions are so overwhelming, such as anger, grief or fear, that the brain looks for ways to distract. Health worries fit the bill because when one worries intensely about their health, there is little room to address an upsetting emotion.

Health worries blanket every other thought and this WORKS. This is the perfect distraction from unsettling emotions. When one worry is reconciled, another takes it place to veil the unaddressed emotion. Each health worry has a strong purpose, as it masks the true upsetting emotion, which is much more difficult to face in the long run.

Solution

– Recognition and acknowledgment of the Health Anxiety habit, one worry quickly following another in a noticeable loop that never ends. Awareness of this cycle is always the first step to reconciliation of the issue.

– Determining if this health worry is a true physical problem by visiting one’s primary physician and ruling out a definite physical cause for the difficulty. Always rule out a physical cause before assuming it is merely health anxiety.

– Noticing that these health worries settle down when you become intensely interested in another topic or swept into a new relationship, job or cause.

– Identify your patterns. Do you experience twinges of symptoms that often jump from one area of the body to another? Do you find yourself overestimating physical intrusions and instantly jump to the conclusion that they signify danger or warrant the attention of an alert?

– Find interests that involve your entire being. Lose yourself in things that allow you little time for inward thinking. True illness does not surface through boredom as do these behaviors. True health problems do not generally follow the same time table as health anxieties do. Health worries are stronger during times of boredom and when one lacks interests. An intelligent mind requires challenges and goals.

– Activity is an important therapeutic tool against health worries. Exercise and movement invigorate and stimulate the mind and body in a positive way. Endorphins are released and Serotonin levels are boosted naturally when activity is a part of a daily routine. Moderate walking, jogging, tennis, swimming and dancing are all helpful activities that bring forth positive results.

– Nutrition is also essential to good health which in itself helps eliminate the strong habit of negative thinking, often concerning health worries. When eating properly, Serotonin levels are naturally boosted and blood sugar levels remain stable. This helps settle down an over-reactive mind, leading to a lessening in health anxieties.

– Talk back to the brain by firmly telling it to stop when health worries enter the mind. Shift into a more positive mode of thinking because you always have a choice in what you think about.

The mind will respond by quieting down as negative thoughts subside. The brain, caught red handed in this behavior is instantly embarrassed causing it to suspend this cycle of negative thought. This is comparative to a child being caught with his hand in the cookie jar. Embarrassment at being caught, stops this intrusive behavior.

– Be aware of “what if” thinking. If the majority of sentences you think begin with “what if” then this is proof of a strong health anxiety habit. Change “what if” thinking to “so what” and watch the cycle break.

Most of all, understand that worry solves nothing. Health worries, in particular will only serve to exhaust and deplete both mind and body. Consciously make a concerted effort to change the way you think and you will succeed in changing your life. You will go from self victimization to freedom from the intrusive habit of fearful worry.