Five facts about … worker health
Deb Sutherland, Michael Roberts, David Carroll and Zac Lowth present five discussion points about worker health to coincide with Tradies National Health Month this August.
1. Lifting position is one of many interactive factors in the risk management of musculoskeletal disorders
Musculoskeletal disorders (MSD) cost Australia over $24 billion per annum (Safe Work Australia 2015) and their workplace management is complex and controversial. One-third of serious injuries are associated with lifting and handling, and lifting is a risk factor for low back pain (LBP).
Attempts to mitigate LBP risk by proposing specific lifting postures has not been supported by current literature. Individuals with a more lordotic posture demonstrated a preference to lift with a stooped posture compared to those with a straighter back who chose a squat lift technique (Pavlova et al 2018). There was no evidence found that greater lumbar flexion was associated with an increased risk of LBP lifting less than 12 kilograms, nor for spinal postures lifting above this weight (Saracini et al 2020).
Occupational health practitioners utilise a risk management framework (Safe Work Australia 2018), recognising there can be many factors contributing to risk.
This traditional approach to biomechanical hazard management includes consideration of load characteristics, distance, repetitions, forces, individual capacity, mechanically optimal body positions, equipment, the environment, and organisational procedures. Assessment extends to the whole job and includes worker consultation.
MSD risks are interactive and affected by psychosocial factors (Eatough et al 2012). Extending risk management to include biomechanical and psychosocial risks, which integrate worker consultation in the process, creates an effective, holistic systems approach within the current legal framework. The Participatory Hazard Identification and Risk Management toolkit (Okman & Macdonald 2019) is an evidence- based online tool for this purpose.
2 Poor workplace culture over-rides planning, procedures and policies
There’s a common saying in management training that ‘culture eats strategy for breakfast’. In other words—if you allow unsafe habits, dodgy work practices, rushing and shortcuts to creep into your workplace, then all your paperwork might as well be wallpaper.
What we choose to do or not do is what will get us home safe and well each day; the paperwork ought to support safe and healthy choices, not just be for compliance’s sake.
If you actively participate in ensuring the procedures, training and safe work practices are followed and improved; then you have much greater chance of preventing injury to yourself or a workmate. This includes the courage to speak up (Edmondson 2019).
People often stay silent when they know they should speak up. Studies investigating employee experiences about speaking up have shown that up to 85 per cent of employees have stayed silent at least once, even when they believed the issue was important.
Building a ‘speak up’ culture takes effort, leading by example with a genuine interest to listen and solve problems.
Organisations are safer when people interrupt and speak up about safety and wellbeing concerns. Leaders who understand they cannot know everything are humble enough to actively ask people to ‘tell it like it is’.
The more straight talk is expressed the more likely it is for looming safety and health concerns to be addressed in time to prevent serious harm. This is how positive safety cultures are built and reinforced—making it safe to speak up, then responding positively when people do (Merchant 2011).
3 Workplace stress causes workers to lose days of work
Physiotherapists play a pivotal role in improving the health and safety of workers in Australia. According the World Health Organization (WHO), health is a state of complete physical, mental and social wellbeing, not merely the absence of disease or infirmity.
Increasingly, mental health conditions are affecting Australian workers and impacting their ability to achieve optimal health.
Mental health conditions cost Australian businesses $10.9 billion each year, resulting in about 12 million days of reduced productivity at work. Anxiety, depression and substance abuse are the top three mental health disorders in Australia.
By 2030, the WHO estimates depression will become the greatest health burden, over- taking cardiac disease.
Depression in the workplace can be caused or exacerbated by workplace accidents or safety issues, bullying and workplace conflict, problems with team morale, misuse of alcohol and other drugs, high workload and poor workplace design. This can lead to burnout, absenteeism and feelings of worthlessness or guilt.
Depression is unlikely to go away without treatment, and men are less likely to seek help then women. Workplaces can help reduce the impact of mental health disorders by raising awareness of mental health, reducing the stigma associated with mental health conditions and educating the workforce about how to identify teammates who may be struggling with their mental health.
Onsite physiotherapists can play an important role in facilitating these behaviours.
4. It is important to stay fit as a tradie
Staying physically fit will enable a tradie to be able to perform the physical demands of their work throughout their career and optimise their general health (Holtermann et al 2019).
Performing physical work can be great for musculoskeletal health, if you’re able to get the dose right (Straker et al 2018). Physical capacity can diminish as you age, so maintaining that capacity through exercise is a fantastic step for a tradie to take (Holtermann et al 2019).
Just how a tradie is able to exercise to maintain their physical capacity and optimise their health has been tricky currently, due to COVID-19 restrictions. Tradies who would normally exercise through team sports or at the gym would have been significantly affected.
Tips for tradies to stay physically fit during COVID-19:
- do home-based strengthening exercises such as body weight resistance training or Pilates (Van Eerd 2016)
- take an exercise-based walk after work with your family
- add a warm-up and stretching routine to your workday, in the same way an athlete would warm up for sport (McCrary et al 2014)
- complete exercise outside of the loading that occurs for your body during your workday. This will benefit your physical and mental wellbeing (Chekroud et al 2018).
5 Participatory ergonomics can influence worker health outcomes
The work of a tradie can be physically varied, and the effect reflects an interplay between physical challenges, organisational and psychosocial factors and individual capacity including skills, physical condition, age, behaviour and genetic vulnerabilities.
Participatory ergonomics harnesses workers’ insights into identifying hazards, analysing problems and creating solutions.
Benefits include injury reduction (Rivilis et al 2008), increased productivity (Guimaraes et al 2015), more human-centered work and the integration of technical, organisational and behavioural changes into work activities.
Further, workers are more likely to accept positive workplace changes when actively engaged in decision- making (Burgess-Limerick 2018).
Occupational physiotherapists who have ergonomic experience working across the diversity of trades act as trainers, expert consultants, facilitators and the onsite clinicians.
This involves collaborating with both management and workers to fit the participatory injury management, ergonomic, and health and safety strategies to specific jobs and business needs. It requires a deep understanding of the industry, and commonly involves changes to work processes, procedures, behaviour and equipment.
Participatory ergonomic interventions have been associated with variable health outcomes (Burgess-Limerick 2018).
The diversity of work tasks, commitment of management at all levels to support a program, resource availability, workplace relations and financial constraints can act as barriers to implementation.
Further, reticence to delegate decision-making to workers, psychosocial factors (Oakman & Macdonald 2019) and the permanence of interventions can influence success.
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APA Musculoskeletal Physiotherapist Deb Sutherland has a clinical background in musculoskeletal physiotherapy and has worked as an occupational health physiotherapist for 15 years. Deb is director of Occupational Wellbeing, a graduate from Monash University with an honours degree in economics, a workplace trainer and first aid mental health aider. She is the national chair of the APA Occupational Health Group.
Michael Roberts, APAM, a former Occupational Health Group NAC representative, is an experienced occupational health physiotherapist and founding director of SafetyCircle Pty Ltd. Michael has been working as a specialist workplace health and safety consultant and has over 25 years’ experience in work health and safety, training/coaching, office and industrial ergonomics, and incident investigation.
David Carroll, APAM, is the Victorian chair of the APA Occupational Health Goup. David has experience as an onsite physiotherapist in mining, manufacturing, construction and logistics industries. He now leads a team of 150 onsite physiotherapists in Australia and New Zealand to ensure the workers they engage with go home safe, healthy and injury-free.
Zac Lowth, APAM, is an experienced workplace physiotherapist and current Queensland chair of the APA Occupational Health Group. Zac has postgraduate qualifications in occupational health and safety, ergonomics, musculoskeletal and sports physiotherapy. He is the national operations manager for Employ Health in Australia and New Zealand. Zac enjoys working to obtain meaningful health, safety, and wellbeing outcomes for workers and businesses in the health industry.
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