Occupational Health and Importance of a Healthy Workplace
Occupational Health and Importance of a Healthy Workplace
Employees of iron and steel plant, despite vast differences in their physical, social, cultural, economic, and religious environments, face virtually the same kinds of workplace occupational health hazards. These hazards are traditionally categorized into four broad types namely (i) chemical, (ii) biological, (iii) physical, and (iv) psycho-social. There is danger of high and preventable burden of ill health which is faced by the employees contacting several classic occupational diseases, such as silicosis and lead poisoning, if suitable preventing actions are not taken. Many times the danger of occupational health hazards is the result of ignorance, inattention, or intent. The compelling evidence indicates that work-related health conditions can be substantially reduced, often at modest cost.
Conceptually when the healthy employees are placed on the jobs, they produce much better than what unhealthy employees produce. Larger the number of unhealthy employees, the greater is the loss to the organization in terms of low productivity, increasing healthcare cost, sickness absenteeism, and loss of production.
A successful organization recognizes that a healthy workplace is a happy and productive one. Regulatory authorities are starting to recognize that different levels of the organizational management have a leading role in preventing ill health and promoting good health. Employees also now recognize how important their health is with the senior employees need to stay fit and healthy to keep working and enjoy their latter years while the younger generation employees are more informed on health and they expect the management to actively provide healthy workplaces, not the ones which merely help them to earn their wages.
Occupational health system is needed for production sources, production processes, and a safe work environment so that it can ensure the health and the safety of the employees and other people who are in the work environment. A good occupational health system makes employees not worried about their safety so that the results of work or employee performance are better. The organization is obliged to improve occupational health. The organizational obligations for improving the occupational health include (i) choosing a safe and healthy workplace for the employees, (ii) comply with all standards and terms of employment, and (iii) record all incidents which occur related to occupational health.
The issue of occupational health is the responsibility of all the stakeholders, especially management, employees, regulatory authorities, and the community. Occupational health is an effort to prevent and reduce the risk of exposures and occupational diseases by identifying things which can potentially lead to work-related exposures and diseases as well as anticipatory actions in the event of exposures and occupational diseases. Occupational health programmes are very beneficial for both the organization and the employees. Occupational health system is expected to be influential in terms of the ability to maintain employee satisfaction so that it encourages them to work well and succeed in terms of quality and quantity related to performance.
The purpose of the occupational health programmes is to reduce costs when accidents and occupational diseases occur. Occupational health is required to be a top priority in the organization, but unfortunately, not the management of all the organizations understand the importance of the occupational health and know how to implement it well in the workplace environment. The potential for the organizational losses due to the weak implementation of the occupational health include the disruption of processes and the loss of employees work hours with the organization losing opportunities of gaining profits due to low employee productivity.
Physical and mental occupational disease and illness can be prevented. There is no excuse for the employees to lose their health such as suffer hearing damage, develop asthma, or have cancer from uncontrolled exposures at work. Working conditions are not to create environments which increase the likelihood of physical or mental ill-health, such as those associated with the occupational stress.
Occupational health is one of the most important aspects of human concern. It is a key element in achieving sustained decent working conditions and strong preventive safety culture in the organization. It deals with all aspects of health and safety in the workplace and has a string focus on primary prevention of hazards. The health of the employees has several determinants, which include risk factors leading to cancers, accidents, musculoskeletal diseases, respiratory diseases, hearing loss, circulatory diseases, stress related disorders, communicable diseases, and others.
Occupational health is generally normally defined as the science of the anticipation, recognition, evaluation, and control of hazards arising in or from the workplace which can impair the health and well-being of the employees, taking into account the possible impact on the surrounding communities and the general environment. This field is necessarily vast, encompassing a large number of disciplines and numerous workplace and environmental hazards. A wide range of structures, skills, knowledge, and analytical capacities are needed to coordinate and implement all of the ‘building block’ which make up the occupational health system so that protection is extended to both the employees and the environment. The scope of occupational health has evolved gradually and continuously in response to social, political, technological, and economic changes. In recent years, globalization of the world’s economies and its repercussions have been perceived as the greatest force for change in the world of work, and consequently in the scope of occupational health, in both positive and negative ways.
Occupational health is required to aim at (i) the promotion and maintenance of the highest degree of physical, mental, and social well-being of the employees in their occupations, (ii) the prevention amongst the employees of departures from health caused by their working conditions, (iii) the protection of the employees in their employment from risks resulting from factors adverse to health, (iv) the placing and maintenance of the employees in an occupational environment adapted to their physiological and psychological capabilities, and, (v) the adaptation of work to the employees and of employees to their jobs.
The main focus in occupational health is on three different objectives namely (i) the maintenance and promotion of the employees’ health and their working capacity, (ii) the improvement of work and working conditions so that they are conducive to safety and health, and (iii) the development of work organizations and preventive health and safety cultures in a direction which supports health and safety at the workplace. Such development promotes a positive social climate, enhances the smooth operation, and also the productivity of the employees and hence the organization. The term ‘culture’ in this context means an environment reflecting the ethics and the value systems adopted by the organization. Such a culture is reflected in practice in the managerial systems, personnel policies, training policies, principles for participation, and quality management of the organization.
The protection of employees from occupational accidents and diseases is primarily a management responsibility, on a par with other managerial tasks such as setting production targets, ensuring the quality of products, or providing customer services. Management sets the direction for the organization. The strategic vision and mission statement establishes a context for growth, production, and profitability, as well as placing a value on employees’ health throughout the organization. The system for managing employees’ health is to be integrated within the organizational work culture and processes. If management demonstrates in words and action, through policies, procedures, and financial incentives, that it is committed to the employees’ health, then the line managers and the employees respond by ensuring that work is performed in a healthy manner throughout the organization. Occupational health is required to be treated not as a separate process, but as one which is integral to the way in which all the activities take place in the organization. In order to achieve the objective of healthy working conditions and environment, management is required to introduce organizational arrangements adapted to the size of the organization and to the nature of its activities.
While the management has the ultimate responsibility for the health procedures in the organization, authority for ensuring healthy operation is to be delegated to all the levels of the management. Line managers are obviously the key persons for the implementation of the health procedures since they are in constant contact with the employees. The line managers help administer the organizational health and safety policy, provide the technical information, help with the training, and make available the training material to the employees.
The promotion of occupational health, as part of an overall improvement in working conditions, represents an important strategy, not only to ensure the well-being of the employees but also to contribute positively to their productivity. Healthy employees are more likely to be better motivated, enjoy greater job satisfaction, and contribute to higher quality of the products and services, and hence enhance the overall quality of life of the employees. The health, safety, and well-being of working employees are thus prerequisites for the improvements in quality and productivity, and are of the utmost importance for equitable and sustainable socio-economic development of the organization.
In order to ensure that satisfactory and durable results are achieved in the field of occupational health, the organization is required to put in place a coherent occupational health and safety policy. Such a policy is to aim at (i) promoting and advancing at all levels the right of the employees to a healthy and safe working environment, (ii) assessing and combating at source occupational risks or hazards, and (iii) developing an organizational preventive health and safety culture which includes information, consultation, and training. By striving to minimize the causes of hazards in the working environment, the occupational health policy reduces the costs of work-related injuries and diseases, contributes to the improvement of working conditions and the working environment, and improves productivity. The articulation of such a policy reaffirms the commitment of the management to the cause of a health and safe working environment and enables it to comply with its moral and regulatory obligations.
The important and the basic features of the organizational occupational health and safety policy are (i) the formulation of the policy as to reflect tripartite participation, i.e. there are inputs from the management and employees as well as from the regulatory authorities who are involved in the area of occupational health and safety, (ii) the policy is to be consistent with organizational development objectives and policies as a whole, (iii) the policy is to promote the right of the employees to have a decent, healthy and safe workplace conditions and environment, (iv) the policy is to include ways of promoting adequate employees awareness and eliciting endorsement of the stakeholders, (v) the policy is to promote the development of an organizational preventive health and safety culture which includes information, consultation, and training, (vi) the policy is to include a plan for mobilizing the necessary organizational and financial resources, (vii) coordination among all concerned organizational departments are to be fostered as an inherent element of the policy, (viii) all available means of action are to be used consistently, (ix) the policy is to encourage voluntary compliance at the departmental level, and (x) the policy is to be reviewed regularly.
Improvement in occupational health is a dynamic process and the objectives are to be of long-term nature. The implementation of any well-thought-out programme can thus be expected to extend over several years. Considerable developments or phenomena need to be identified, and the necessary actions are to taken by the management as well as within the departments to avoid possible disasters. Further, since the occupational health situation evolves, the policy itself is to be reviewed at appropriate intervals. This review can be an overall assessment of the policy or else focus on particular areas. The objectives of a policy review are to (i) identify major problems, (ii) devise effective methods of dealing with them, (iii) formulate and establish priorities for action, and (iv) evaluate the results.
The organizational occupational health system comprises all the infrastructures, mechanisms, and specialized human resources required to translate the principles and goals defined by the organizational policy into the practical implementation of the occupational health programmes. In turn, one of the main aims of the occupational health programmes is to strengthen the occupational health system in the organization. The occupational health system is required to respond to the effects of both socio-economic and technological changes taking place in the working conditions and the environment, and so is not built just once but is to be strengthened, reorganized, and reoriented through a permanent cyclical process of reviews, performance evaluations, and readjustments of the objectives and programmes or creation of new ones to meet new needs. Fig 1 shows continual improvement cycle for the occupational health system.
Fig 1 Continual improvement cycle for occupational health system
Workplace wellbeing relates to all aspects of the working life, from the quality and safety of the physical environment, to how the employees feel about their work, their working environment, the climate at work and work organization. The aim of measures for workplace well-being is to complement occupational health measures to make sure that the employees are safe, healthy, satisfied, and engaged at work. The wellbeing of the employees is a key factor in determining the organization’s long term effectiveness. Several studies show a direct link between productivity levels and the general health and well-being of the employees.
Workplace wellbeing is to complement occupational measures. Wellbeing at work is not a core part of occupational health and safety management and is not to be confused with the occupational health and safety. If Maslow’s hierarchy is considered then the occupational health and safety can be seen as the foundation, the basic needs within the workplace which is to be met first. Once these are clearly met, then one can move up in the hierarchy. Workplace wellbeing can help to fulfill the self-fulfilment aspects of Maslow’s hierarchy. Where confusion frequently arises, is the middle section of the hierarchy. Poor occupational health (and safety) undermines the psychological needs, whilst workplace wellbeing can bolster it.
Managing occupational health and safety risks are hence always be managed first. This provides a strong base and good foundation for the mid-section (psychological needs) and this is visible through improved employee engagement and physical and mental health. It is onto this where additional improvements can be made through effective wellbeing programmes. Failure to tackle and effectively manage occupational health undermines both health and safety management and any wellbeing initiatives. If the employees can choose healthy food options for lunch but inhale cancer causing dusts when working, then the organization has got its priorities wrong and the employees can see this.
A healthy workplace can be described as one where employees and managers actively contribute to the working environment by promoting and protecting the health, safety and well-being of all the employees. A study suggests that interventions are to take a three pronged approach consisting of (i) protect mental health by reducing work related risk factors, (ii) promote mental health by developing the positive aspects of work and the strengths of employees, and (iii) address mental health problems regardless of the cause.
The healthy workplace can be classified in three key areas namely (i) safety from machines or equipment, (ii) there are no hazards or danger arising from physical, chemical, and biological agents, and (ii) the human factors i.e. the employees are to be free from the psycho-social factors ( stress) and also there is to be health from their lifestyle.
Building on this, a guide from the World Economic Forum highlights the steps which the organization can take to create a healthy workplace. These steps are (i) awareness of the workplace environment and how it can be adapted to promote better mental health for different employees, (ii) learning from the motivations of organizational leaders and employees who have taken action, (iii) not reinventing the wheel by being aware of what other organizations who have taken action have done, (iv) understanding the opportunities and needs of individual employees, in helping to develop better policies for workplace mental health, and (v) awareness of sources of support and where people can find help.
Interventions and good practices which protect and promote mental health in the workplace include (i) implementation and enforcement of health and safety policies and practices, including identification of distress, harmful use of psychoactive substances and illness, and providing resources to manage them, (ii) informing employees that support is available, (iii) involving employees in decision-making, conveying a feeling of control and participation and organizational practices which support a healthy work life balance, (iv) programmes for career development of the employees, and (v) recognizing and rewarding the contribution of the employees. Mental health interventions are to be delivered as part of an integrated health and well-being strategy which covers prevention, early identification, support, and rehabilitation.
A healthy workplace is to encompass the definition of health of World Health Organization (WHO) which is ‘a state of complete physical, mental, and social well being and not merely the absence of disease’. Definitions of a healthy workplace have evolved greatly over the past several decades. From an almost exclusive focus on the physical work environment (the realm of traditional occupational health and safety, dealing with physical, chemical, biological and ergonomic hazards), the definition has broadened to include health practice factors (lifestyle, psychosocial factors (work organization and workplace culture), and a link to the community, all of which can have a profound effect on the employees’ health.
WHO defines a healthy workplace as ‘a healthy workplace is a place where everyone works together to achieve an agreed vision for the health and well-being of workers and the surrounding community. It provides all members of the workforce with physical, psychological, social and organizational conditions which protect and promote health and safety. It enables managers and workers to increase control over their own health and to improve it, and to become more energetic, positive and contented’.
A healthy workplace is one in which employees and managers collaborate to use a continual improvement process to protect and promote the health, safety and well-being of all the employees and the sustainability of the workplace by considering, based on identified needs, (i) health and safety concerns in the physical work environment, (ii) health, safety, and well-being concerns in the psycho-social work environment including organization of work and workplace culture, (iii) personal health resources in the workplace, and (iv) ways of participating in the community to improve the health of the employees, their families, and other members of the community. Fig 2 shows WHO model for healthy workplace.
Fig 2 WHO model for healthy workplace
Healthy workplace means creation of an environment which promotes a state of contentment. Such an environment allows employees to flourish and achieve their full potential for the benefit of themselves and their organization. Healthy workplaces in the organization reflect that ‘wellbeing’ is a personal, subjective state and that the organization has to create an environment and culture which empowers the employees to make positive personal lifestyle decisions, which hopefully enhance their sense of wellbeing.
Healthy workplaces are thus strongly linked to the employee engagement. With healthy workplaces an organization is created for which the employees want to work for since they feel safe, are valued by the management and feel part of a happy and supportive work community. This is part of what is frequently referred to as the ‘psychological contract’ which reflects the unwritten expectations that the employees and the management have about each other. The psychological contract recognizes that employees’ commitment and contentment is not achieved through wages alone.
Organizational management which pays attention to quality of life issues (the employees’ sense of wellbeing) can help secure employees’ commitment and motivation and improve productivity and employee retention rates. Changes in work practices are affecting some aspects of the psychological contract such as job security which the management can counter by looking after other areas which have an impact on employees’ wellbeing. The areas related to the employees’ well being have been identified as the five domains of wellbeing namely (i) physical, (ii) values, (iii) personal development, (iv) emotional, and (v) work organization. This holistic approach not only reflects that these elements are overlapping but that they enable the employees to fulfil their potential, which is also stated by the Maslow theory of motivation and in the case consists of growth, self actualization, the striving toward health, the quest for identity and autonomy, and the desire for excellence.
In the present day environment, organizational managements are recognizing the competitive advantage which a healthy workplace can provide to the organization, in contrast to their competition. These managements consider that a healthy and safe workplace is just a necessary cost in the operation of the iron and steel plant.
There are four key components of workplace health management. These are (i) occupational health and safety, (ii) workplace health promotion, (iii) social and lifestyle determinants of health, and (iv) environmental health management. In the past, occupational health policy has been frequently driven solely for meeting of the regulatory requirements. In order to be effective, workplace health management needs to be based on knowledge, experience, and practice accumulated in three disciplines namely (i) occupational health, (ii) workplace health promotion, and (iii) environmental health. It is important to see workplace health management as a process not only for continuous improvement and health gain within the organization, but also as framework for involvement between various agencies in the community.
Fig 3 shows effect of unhealthy and unsafe workplace on the organizational performance. It can be seen that the successful and the competitive organizations are those which have the best health and safety records, and the most physically and mentally healthy as well as satisfied employees.
Fig 3 Effect of unhealthy and unsafe workplace on organizational performance
The organization which wants to be successful and competitive normally has five objectives with regards to the occupational health. These objectives are (i) to devise and implement policy instruments on employees’ health, (ii) to protect and promote health at the workplace, (iii) to promote the performance of and access to occupational health services, (iv) to provide and communicate evidence for action and practice, and (v) to incorporate employees’ health into other policies. It is clear that all of these objectives are linked and overlap, as they are required to. For example, in order to ‘protect and promote health at the workplace, it is necessary to have policy instruments on employees’ health at the organizational level. Similarly for the employees to have access to occupational health, it is to be backed up by the best scientific evidence. In addition, employees’ occupational health is required to be integrated into other policies of the organization in order to truly protect and promote employees’ health.
Clearly, creating a healthy workplace which does no harm to the mental or physical health, safety, or well-being of employees is a moral necessity. From an ethical perspective also, it is considered wrong to expose employees to health hazards at the workplace. It is the moral responsibility of everyone (including management, employees, employee unions, and regulatory authorities) to see that there exists a healthy work environment for the employees at the workplace.
Creation of healthy workplaces in the organization is important for the management since it looks at the hard, cold facts of economics and organizational profits. All the workplaces in the organization need healthy employees for achieving the organizational goal and objectives, and hence there is a strong requirement of ensuring a mentally and physically healthy workforce in the organization. For this, it is essential the organization has health protection and promotion schemes supported by adequate budget.
The main steps and / or activities which are to be considered for the development and implementation of workplace health management in the organization are (i) development of a short policy statement from the management which explicitly states the commitment of the management to and acceptance of responsibility for the workplace health management strategy within the organization, (ii) educate managers and employees on the impact of environmental, occupational, and lifestyle determinants on their health and social wellbeing and on the economic situation and competing ability of the organization to facilitate their participation in workplace health management, (iii) determine the role of the medical, environmental, and safety experts and other professionals needed to assist in the implementation of the workplace health management strategy, (iv) discuss economic appraisal of existing and projected outcomes to health, safety, and environmental health from the activities of the organization, (v) train the employees in quality management principles and standards to be used for the workplace health management system, (vi) assure participation of the management and the employees in the development and implementation of workplace health management system, (vii) develop adequate tools for monitoring and evaluation of health, safety, social, economic, and environmental outcomes to determine the impact on wellbeing of the employees and competitiveness of the organization, (viii) introduce systematic internal auditing and evaluation to be able to make necessary adjustments to the workplace health management system, and (ix) external audit by a recognized certifying body, if necessary.
A good workplace wellbeing programme recognizes that there are inter-related elements which include the employees, the work environment / job, the organization, and the social engagement / values. Carried out properly, a wellbeing programme is more than just a few ‘healthy life’ initiatives. It is about creating an organizational culture which promotes (i) strong, ethical workplace relationships based on trust and respect, (ii) a collaborative and communicative management style, (iii) a culture in which learning and development is encouraged so that people can fulfil their potential, and (iv) good physical and psychological health, whilst enabling broader social engagement.
There is growing evidence that several workplace wellbeing programmes do not deliver any measurable benefits, most probably because organizations fail to recognize that these interrelated elements need to be tackled together (not to mention failing on getting the ‘foundations’ right i.e. good occupational health and safety). This then undermines the psychological contract. A common focus of wellbeing programmes is mental ‘resilience’ i.e. training on ‘how to cope’. Organizations wrongly believe that ‘inoculating’ their employees against occupational stress, particularly in ‘high performance’ organizations keep the employees working longer and make them happy. Rather, employees want and need a preventative approach which effectively manages the causes of occupational stress so that ‘inoculations’ are not necessary (and of course inoculations can have side effects and do not always work). It is the area of mental (ill) health, where there is frequently the most confusion between occupational health and workplace wellbeing programmes. It is simple however.
Organization is required to identify and prevent or manage the causes of occupational stress and what is frequently referred to as ‘psycho-social’ hazards and this can lead to physical and mental illness. This is occupational health issue and need to be tackled first. Wellbeing programmes can enhance mental health through continuous learning, social engagement, and encouraging physical exercise (all shown to improve mental health). Occupational health and wellbeing programmes can also work together to educate the employees on mental ill-health and this brings about workplace and individual benefits.
In fact the most effective workplace wellbeing programmes, are those which recognize the need to manage occupational health and safety. WHO has developed a healthy workplace model aimed at comprehensively addressing (i) work-related physical and psychosocial risks (occupational health and safety), (ii) promotion and support of healthy behaviours (wellbeing), and (iii) broader social and environmental determinants (wellbeing). This model identified five criteria (keys) to success. These criteria are (i) leadership commitment and engagement, (ii) involve employees and their representatives, (iii) organizational ethics and legality, (iv) use a systematic, comprehensive process to ensure effectiveness and continual improvement, and (v) sustainability and integration.
In America, the National Institute for Occupational Safety and Health (NIOSH) has developed ‘Total Worker Health’ (TWH), a holistic approach to occupational health and safety and employee wellbeing. This recognizes that work has an important function in the social determinants for health. TWH is defined as ‘policies, programmes, and practices which integrate protection from work-related safety and health hazards with promotion of injury and illness prevention efforts to advance employee wellbeing. This programme goes much further than other programmes and reflects the changing work environment, from new forms of employment to new technologies. It also reflects that non-work related ill-health can be adversely impacted by work, can have health and safety implications within the workplace, and, the way an organization manages ill-health (occupational or non-occupational) through sickness absence and rehabilitation policies, can have hugely positive or negative impacts on the individual and the organization.