ACSEL 2015_Keynote Lecture_Prof. Chia Shin Eng[Compatibility Mode]

Turning Discovery into Healthier Communities

Total Workplace Safety and Health (TWSH): Management System for Occupational Safety and Health – SINGAPORE’S EXPERIENCE

Dr CHIA Sin EngMBBS, MSc (OM), MD, FAMS, FFOM

DirectorWorld Health Organization Collaborating Center in Occupational Health

Assoc Professor and Vice Dean (Academic Affairs) Saw Swee Hock School of Public Health

Joint Assoc ProfessorYong Loo Lin School of Medicine

National University of Singapore (NUS)

Turning Discovery into Healthier Communities 2

There are overlaps and interactions in the workplace

Psychosocial Work

Environment

Personal Health

Physical Work

Environment

W X

Y

W: Stressed and unhappy workers are more prone to accidents and WRMSD

“Perhaps the strongest justificationfor an integrated approach is the acknowledged interaction betweenoccupational and personal risk factors in disease and injury”

… WHOZ

X : Stressed workers smoke and drink more

Z: Smoker experiencing work stress has heart attack while lifting heavy loadY: Smoking and chemical exposures can result in higher exposures or risks


Diabetes mellitus

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Total Workplace Safety & Health Services (TWSH)


Diabetes mellitus

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Diabetes mellitus

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Diabetes mellitus

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Diabetes mellitus

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Diabetes mellitus

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Diabetes mellitus -giddiness

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Diabetesmellitus

Where is the patient,

the whole person?


Not comprehensive health care!


A doctor does not treat a patient before he/she makes a diagnosis.



SAFETY ISSUESHEALTH ISSUESGOVERNMENT

MANAGEMENTWORKER

Occupational Diseases General

DiseasesHealth Promotion

Total Workplace Safety & Health(TWSH)

SAFETY ISSUESHEALTH ISSUES

GOVERNMENT Occupational Diseases General



MANAGEMENT Occupational Diseases General



WORKER Occupational Diseases

GeneralDiseases

Health Promotion


TotalWSH

Services

SAFETY

HEA

LTH

WELL-B

EING

What is Total Workplace Safety & Health Services (TWSH)?


Definitions of Workplace Safety, Health & Well‐being• Safety – refers to the prevention of accidents and physical injury

at the workplace and includes elements such as heights, confined spaces, toxic fumes, heavy machinery, sharps and flammable or explosive mixtures.

• Health - refers to general illness and medical conditions caused or aggravated by workplace exposures such as hearing loss, occupational cancers, radiation exposures, laser exposures and chemical exposures etc.

• Well-being – refers to the promotion of mental well-being and healthy behaviors such as exercise, not smoking, healthy weight & diet etc.


Why the need for aTotal Workplace Safety & Health Services (TWSH)?

TotalWSH

Services

SAFETY

HEA

LTH

WELL-B

EING


Why the need for TWSH?

• Close relationship between Work & Health


WORK HEALTH & DISEASES





WORKCAN AFFECT HEALTH

HEALTH CAN AFFECT WORK



• Close relationship between Work & Health

• Different health factors that contribute to safety and health of worker

23Turning Discovery into Healthier Communities


Obese workers are more likely to have Diabetes and Heart diseases

Aging workers also have increased risk of Developing chronic diseases viz. diabetes, hypertension, high blood lipids, etc.

Work-related psychological hazards


Pain interfering with work is highly associated with mental stress at work

A worker with “Moderate/High” mental stress at work is 3.8x more likely to have “body pain interfering with work in the past 4 weeks”.


How to implement a Total Workplace Safety & Health services (TWSH)?

TotalWSH

Services

SAFETY

HEA

LTH

WELL-B

EING


• 30 companies, >10,000 workers encompassing manufacturing, marine, construction, service and pest control industries invited to participate in the study.

• Standardized Study Tools were used• Workplace walk-through assessment• Workplace Safety & Health Services Questionnaire (WSHQ)• Workplace Safety and Health 360 Questionnaire (WSH360)• Basic Health Survey (BHS)

Study

Chia SE, Wah LJ, Sng J, Yoong J, Lim RB, Chia KS. A Study on the Comprehensive and Integrated Workplace Safety and Health Services in Singapore. J Occup Environ Med. 2015 Sep;57(9):958-64.


How of TWSH

Assessment Recommendation & Intervention Evaluation

Phase 1 Phase 2 Phase 3


Phase 1 – Assessment Tools

• Workplace walk-through assessment• Identification of hazards at the workplace• Formulation of the Risk Assessment


• Workplace Safety & Health Services Questionnaire (WSHQ)• Assess the elements of basic WSH Management System.• Self-administered by HR & Safety/Health officer prior to

workplace study.

• Workplace Safety and Health 360 Questionnaire (WSH360)• Perception and communication of WSH priorities, services and

integration.• Face-to-face interview of senior management, HR, safety/health

officer, supervisor and worker.

• Basic Health Survey (BHS)• Basic health survey of all workers or random sample of workers.

Phase 1 – Assessment Tools


RESULTS


WSHQAspect Existing WSH in Workplace A

Policy Greater emphasis on safety

Management No central committee overseeing and coordinating WSH policies, programs & practices

On‐the‐ground practice

Lack of evidence‐based practices and collaboration among different departments

Evaluation Lack of evaluation on existing WSH programs & practices


WSH360

Local marine company Multi-national company

A: Expectations; B: Standards; C: Integration; D: Rewards & Discipline; E: Training/Capacity Building;F: Communication

Workplace A


BHS – Health statusBMI Number

(%)

Underweight (<18.5) 488 (5.3)

Normal (18.5 – 22.9) 3487 (37.6)

Overweight (23.0 – 27.4) 3281 (35.4)

Obese (>=27.5) 2022 (21.8)National Health Survey 2010: For working age group (18‐59) the IMPUTED prevalence of overweight and obesity are 28.6% and 21.0% respectively.

Lifestyle Number (%)

Current smoker 2400 (26.8)

Ex‐smoker 801 (8.9)

Regular exercise (>2x/wk.) 1356 (14.9)

Health screening (<2 years) 5457 (60.7)National Health Survey 2010: For working age group (18‐59) the IMPUTED prevalence of current smoking, regular exercise are 15.2% and 16.7% respectively.

Musculoskeletal pains

Shoulders Neck Lower back

Upper back

Wrists/ Hands

Mild 24.1% 25.3% 22.2% 17.9% 19.2%Moderate 12.2% 13.2% 12.8% 8.0% 4.9%Severe 23.4% 19.6% 21.2% 11.3% 4.5%TOTAL 59.7% 58.1% 56.2% 37.2% 28.6%


74.0%

78.2%

77.9%

70.6%

56.1%

45.4%

67.8%

20.4%

17.1%

16.5%

21.7%

31.3%

37.4%

25.8%

5.6%

4.7%

5.6%

7.7%

12.6%

17.2%

6.4%

0.0% 20.0% 40.0% 60.0% 80.0% 100.0%

Stronglyagree/Agree

Neutral

Stronglydisagree/Disagree

Proud to work for this company

Workload is cause of concern

Can easily balance demands of work and home

Feel safe at my workplace

Encouraged to report/feedback on unsafe working conditions

Management takes corrective actions

Overall satisfied with current physical work environment

BHS – EMPLOYEE PERCEPTIONS

Phase 2 –Recommendations and Intervention

Recommendations to improve the organisation and management system of safety, health and wellness issues, as well as safety, work flow, work stations at the workplace Implement recommendations after engaging and obtaining buy‐in from employer, management and worker

Tailored workplace health promotion programmes according to the needs of the workers

Examples:‐ Ergonomic programme‐Mental health programme‐ Healthy Eating (Weight Mgmt) programme‐ Smoking cessation programme

WORKPLACE LEVEL WORKER LEVEL


Recommendations to improve the organisation and management system of safety, health and wellness issues, as well as safety, work flow, work stations at the workplace Implement recommendations after engaging and obtaining buy‐in from employer, management and worker

WORKPLACE A


Recommendations ‐WorkplaceAspect Existing WSH in Workplace A What TWSH seeks to address

Policy Greater emphasis on safety Balancing of safety, health and wellbeing

Management No central committee overseeing and coordinating WSH policies, programs & practices

A systems‐level approach that oversees and coordinates WSH policies, programs & practices

On‐the‐ground practice

Lack of evidence‐based practices and collaboration among different departments

Promotes evidence‐based practices and encourages synergistic collaborations among different departments

Evaluation Lack of evaluation on existing WSH programs & practices

Evaluation of WSH programs & practices for continuous improvement


Tailored workplace health promotion programmes according to the needs of the workers

Examples:‐ Ergonomic programme‐Mental health programme‐ Healthy Eating (Weight Mgmt) programme‐ Smoking cessation programme

STAFF LEVEL


Staff

1. Ergonomics Programme (Cleaners, Lab Tech)

2. Stress Management Programme (Faculty, Research & Admin staff)

3. Weight Management Programme (Cleaners, Lab Tech, ? all staff)

Phase 3 - Evaluation

1. Benefit cost ratio of intervention programme

2. Work productivity gained from the intervention programme

3. Improvement in absenteeism from the intervention programme

1. Proportion of workers who enrolled and completed the intervention programme

2. Proportion of workers with increased knowledge and awareness after completion of intervention programme

3. Proportion of workers who reported improvement in health outcome after intervention programme (e.g. reduction in body pain due to work after ergonomic programme)

4. Proportion of workers who reported an increase in workplace satisfaction after intervention programme

WORKPLACE LEVEL WORKER LEVEL


Business Case for selected Workplace Intervention Programs


74.0%

78.2%

77.9%

70.6%

56.1%

45.4%

67.8%

20.4%

17.1%

16.5%

21.7%

31.3%

37.4%

25.8%

5.6%

4.7%

5.6%

7.7%

12.6%

17.2%

6.4%

0.0% 20.0% 40.0% 60.0% 80.0% 100.0%

Strongly agree/Agree

Neutral

Stronglydisagree/Disagree

Proud to work for this company

Workload is cause of concern

Can easily balance demands of work and home

Feel safe at my workplace

Encouraged to report/feedback on unsafe working conditions

Management takes corrective actions

Overall satisfied with current physical work environment

4.4x more likely to be proud to work for company

7.4x more likely to be satisfied with current job

1.7x more likely to report work‐life balance

RESULTS – EMPLOYEE PERCEPTIONS (TWSH vs. no TWSH) adjusted for company, ethnic , gender and age

Turning Discovery into Healthier Communities

Total Workplace Safety and Health (TWSH)

• A holistic and integrated system to manage workplace safety and health risks.

• Risk management approach that encompass BOTH safety and health risks.

• Encompasses promotion of health and well-being of workers.

43


Thank you


Documents

ACSEL 2015_Keynote Lecture_Prof. Chia Shin Eng[Compatibility Mode]