Putting the ‘health’ back into health and safety at work

The average person will spend about 90,000 hours working across their lifetime – that’s a third of your time on Earth. Work is therefore a crucial influencer on your health.

Evidence tells us that good work provides meaning and purpose in life, status in society, enables financial independence, and is therefore generally good for our health.

Employment and education are two of the key drivers by which social inequalities in health can be addressed. It’s very evident at the other extreme that unemployment is bad for health, shortening life expectancy between five and 10 years, causing low self-esteem, poorer mental health, increasing risk of self-harm and suicide, more pain, and driving more healthcare use.

Work as a public health opportunity

Employees are generally accustomed to following policies and procedures in the workplace, to comply with health and safety regulations.

Humans also naturally follow group norms for behaviour at work. These tendencies can encourage less healthy behaviours such as “smokos”, but can be used strategically by employers to promote more healthy behaviours, such as healthy eating, physical exercise, and smoking cessation.

Designing workplaces and fostering cultures that support workers’ physical and mental health needs, as well as encouraging them to improve their own behaviours, benefits both workers and employers.

Poor working environments can cost employers

In this fictional but highly representative example, a new fuel company has set up a call centre to market its product:

Staff are employed on casual contracts at minimum wage, with no allowance of annual leave or sick pay. Working hours are 6am-10pm, seven days per week, with several shifts. Employees are given three days’ notice of their shifts for the following week. The open-plan offices are in a basement with no natural light, accommodating up to 150 staff at workstations just 120cm wide. Staff failing to meet mandatory call targets are given one warning, and then fired. Employees are allocated a single 10-minute break per four-hour work session, and are not allowed to leave their workstation at any other time.

Many aspects of this model are typical of commercial call centres, an industry notorious for high staff turnover rates of 30% to 40% each year. Recruitment costs often ring up at about 33% of the average staff member’s salary, and work-related stress claims are high. It’s easy to see how short-sighted cost savings can erode long-term profits, and reputational damage over time can make recruitment more difficult.  

Thoughtful concessions can vastly improve worker satisfaction

In a real-world example, staff in the intensive care unit at a Melbourne hospital experienced an eight-fold increase in admissions and numbers of beds during the COVID-19 pandemic. They were asked to work extra hours and defer annual leave.

The lead consultant expressed concerns about the likely impact of the high work demands and long hours on the mental health of the staff, and engaged the services of a clinical psychologist to provide one-to-one confidential support to any of the staff.

Appointments were made available within 36 hours of a request, and treated in strict confidence. While many staff made use of the service, nobody was expected to disclose they had done so.

Hospital records showed that sickness absence rates didn’t increase throughout the pandemic. The most recent annual staff satisfaction survey showed an 80% increase in the number of staff that reported themselves satisfied or highly satisfied with their employer, despite the demands of the previous year.

Workplace wellbeing programs

There’s an overwhelming range of workplace health interventions in general circulation – provision of gym membership, pedometer challenges, desk-based massage ... the list goes on.

Despite the dramatic expansion in “workplace wellbeing” initiatives across the commercial sector, there’s been remarkably little evaluation of most of these approaches.

What’s well-known from other public health research is that even when individuals know what constitutes healthy behaviours, they continue to find reasons to avoid them. High-quality evaluation with longer-term follow-up is badly needed, to assess the effectiveness of workplace interventions to promote sustained healthier lives.

What constitutes good work?

Good work must, of course, be safe work. Workplaces can be hazardous places, with exposures ranging from biological and chemical through to physical dangers such as working at height, with intense heat, or in awkward postures. Psychosocial risks include lack of control, high demands, and stress.

Employers have a responsibility to ensure the safety of their workforce by undertaking risk assessments, mitigating or reducing all risks as far as possible, and providing necessary training and personal protective equipment.

Some basic principles agreed on by many researchers in this field are that using a co-design approach between employers and staff when creating health interventions is more likely to be successful; that the strongest influencer of an employee’s satisfaction with their company is their relationship with their immediate supervisor; flexibility in work and working conditions builds loyalty and conscientiousness; and good work can be good for our health, and we can all contribute to better, healthier working lives.

The Monash Centre for Occupational and Environmental Health (MonCOEH) has an international reputation for its research identifying and quantifying hazards in the workplace, in a range of high-risk occupations such as firefighters, petroleum sector workers and miners.

But we’re widening our focus to meet some of the issues faced by the vast majority of workplaces that fall into a normal risk category.

By researching how employers can deliver good work to their staff, we hope to understand how to prolong healthy working lives, and what specific needs aren’t being met for female workers, older workers, and people coping with long-term health conditions.