Canadian Occupational Safety

AUGUST/SEPTEMBER 2018 17 paradigm that we are going to approach this issue. We're not just revamping the safety program to fit the Total Worker Health model, we're revamping our organization as a whole to better embrace the safety, health and well-being of our workers,'" says Chosewood. "These efforts really, to be most suc- cessful, have to be led by someone who has the authority over all of these lines of business." The goal is to shift the corporate culture to integrate health into all day-to-day activities, says Wahl. In order to do this, it's important that work- ers understand how their health relates to their job and why they need to take care of themselves. "Because they're crouching, because they're stand- ing, because they're lifting, because they're bending all day long," he says. "All of a sudden people are engaged because they understand the fundamental need of why it's relevant and that it's not going to kill them if they try to be healthy." When considering workers' overall well-being, it's important to take into account a wide variety of job-related factors, including work hours, wages, workload, stress level, sick leave, benefits, quality supervision, technology, flexibility and autonomy. "Giving people control over their start and stop time, how do they get from point A to point B? As long as they get to point B, give workers a say in how they do so and the path there really has tre- mendous opportunities to decrease stress, to build more engagement, to give them a stronger voice," Chosewood says. The safety department should re-examine how each job is designed, because that's where the great- est ability to impact health and safety outcomes lies, he says. "(Ask yourselves) 'Have we designed this job with health outcomes in mind?'" In order for Total Worker Health to be success- ful, workers need to be involved. Chosewood is strongly in favour of a participatory approach where the health, safety and well-being challenges are addressed by asking the workforce what they want. "Let them tell you where they want the program to go, not the other way around. Let them identify what are their top priorities," Chosewood says. "It isn't so much 'If we build it, they will come.' It's 'If they build it, they will come.'" Companies should be checking in with workers at least annually to this effect. And employers need to ensure their environment supports workers' health. "A lot of the time you see things like lip service, giving us something like, 'We want you to be healthy,' but then the environment, the leadership, the super- visors, they don't support that healthy behaviour in any way or give people the opportunity while on the job to engage in it," Wahl says. CHALLENGES One of the challenges companies may face when putting more of an operational focus on worker health and wellness is privacy — a common con- cern heard from employees. "It's especially true if we're saying, 'Not only am I interested in your health and well-being at work — the focus of most traditional safety programs — but I'm also interested in your overall health: How do you sleep at night and your access to health care and how you and your family are getting along and your health habits,'" says Chosewood. Discussing health is a personal matter and employees might not want co-workers knowing they are seeking help for a particular issue. Employ- ees need access to various services away from work — such as nutrition and fitness coaching — so if they are concerned about privacy, they can still improve their health behind closed doors or in the comfort of their own home, says Wahl. He recommends making health part of the company's occupational health and safety require- ments. This can be accomplished through job demands analysis, personal injur y prevention plans, bona fide testing and fitness for duty, warm- up programs and ergonomic programs. Employers should outline what they are able to do to help the workers, but also what the workers need to do to help themselves. "You say, 'As part of your job, here's the things that you need to do in order to be healthy to oper- ate in a safe and efficient manner,'" Wahl says. "All of a sudden that person who would never stretch on their own because they would feel stupid stretch- ing is now like, 'Well, everybody has to stretch.'… Or they get their blood tested or they meet with somebody about exercise and diet." The impact of removing the stigma, which allows workers to feel comfortable going into an environment they would have shied away from before, should not be underestimated, Wahl adds. The newly integrated health, safety and wellness strateg y must be audited. In order to do this properly, the safety manager needs to have a clear understanding of what she is trying to shift at the onset. For example, perhaps metabolic disease is a high-risk factor in an organization. The safety manager would measure how many workers are at risk before the program starts, put strategies in place and then take measurements again at the end of the program. "If you move the needle, great. Continue to do that or refine it. If you didn't move the needle, try something else," says Wahl. "It's a continuous improvement and the goal would be to reduce ill- ness, injury and incidence frequency." Safety professionals need to think about reporting on health data as much as they report on safety data. "They can report safety stats like crazy. I guarantee they can tell me dropped objects, recordables, inci- dent rate, whatever it is, but when it comes to health, what do they report for health stats?" asks Wahl. NIOSH is working on developing a tool to mea- sure worker well-being, expected to be available later this year. "If folks had as much attention to their bottom line, if they had as much of a focus on these greater health metrics as safety, then not only would worker health and safety be served but the orga- nization would benefit as well," says Chosewood. With the growth of the gig economy and individuals in non-standard jobs — part-time, contract, freelance — work arrangements are complex and require a more holistic approach to health and safety than what has been traditionally done. "We would encourage safety managers to swim further upstream than they have found themselves before and that means using all of the components of the organization other than just the safety team to examine this issue more broadly," Chosewood says. "You cannot overcome eight, 10, 12 hours a day of poor working conditions with a tai chi class at noon." CONTROL OF HAZARDS AND EXPOSURES • Chemicals • Physical agents • Biological agents OPERATION OF WORK • Fatigue and stress prevention • Overtime management • Flexible work arrangements BUILT ENVIRONMENT SUPPORTS • Healthy air quality • Access to healthy, affordable food options • Safe access to the workplace LEADERSHIP • Shared commitment to safety, health and well-being • Worker recognition and respect • Responsible business decision-making COMPENSATION AND BENEFITS • Adequate wages • Equitable performance appraisals and promotion • Paid time off (sick, vacation, caregiving) • Retirement planning and benefits • Chronic disease prevention and management COMMUNITY SUPPORTS • Safe, healthy and affordable housing options • Safe and clean environment (air and water quality, noise levels, tobacco-free policies) CHANGING WORKFORCE DEMOGRAPHICS • Multigenerational and diverse workforce • Workers with disabilities POLICY ISSUES • Health information privacy • Equal employment opportunity • Elimination of bullying, violence, harassment and discrimination • Prevention of stressful job-monitoring practices NEW EMPLOYMENT PATTERNS • Contracting and subcontracting • Multi-employer work sites • Organizational restructuring, downsizing and mergers • Financial and job security. TOTAL W O R K E R HEALTH Source: Fundamentals of Total Worker Health Approach, National Institute for Occupational Safety and Health There are many, many issues relevant to advancing worker well-being through NIOSH's Total Worker Health approach. The following are just a sampling of some that you may want to consider if your organization is trying to look at worker health and well-being through a wider lens.

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