The Workplace as a setting for
Health Protection and Health
Promotion in Ireland
Anne Drummond
Associate Professor in Occupational Safety and Health
UCD School of Public Health, Physiotherapy and Sports Science
Occupational Health
Environmental, occupational and personal risk factors
Health Protection
Health Promotion
Work systems designed to protect workers from
disease and injury by preventing and reducing risks
Activities that improve or maintain health.
Assisting workers in improving health behaviours
• Occupational risk factors (hazards) • Personal risk factors (smoking,
diet, drinking, stress)
• Multi-disciplinary
•
•
•
•
Ergonomics
Occupational Hygiene
Occupational Health
Occupational Safety
Health
Protection
• Often behaviour-orientated
WHP
Wellness
This is the data our OSH statistics
try to capture
Work-related
injury, illness
and Fatalities
Data from:
• Fatality notification to HSA
• HSA accident notification
• Central Statistics Office (CSO),
Quarterly National Household
Survey (QNHS)
• Occupational Injuries Scheme
• THOR
Accident
Injury
Timeline: Seconds
Health Status + (Multiple) Exposure
+
Timeline: Days, months, years or decades
Illness
Occupational or work-related?
Occupational Disease
A case of occupational disease is
defined as:
“a case recognised by the national
authorities responsible for recognition
of occupational diseases.
The data shall be collected for incident
occupational diseases and deaths due
to occupational disease”.
Work-related illness
• Work-related health problems and
illnesses are those health problems and
illnesses which can be caused,
worsened or jointly caused by working
conditions.
• This includes physical and psychosocial
health problems.
• A case of work-related health problem
and illness does not necessarily refer to
recognition by an authority…
Work-related
Work
Life
Self-employed
SMEs
http://www.hsa.ie/eng/Publications_and_Forms/Publications/Corporate/HSA_Statistics_Report_2013-2014.pdf
Work-related Illness rates
are rising
http://www.hsa.ie/eng/Publications_and_Forms/Publications/Corporate/HSA_Statistics_Report_2013-2014.pdf
Work-related illhealth
Drilled down into the CSO data
MSD
Stress, depression, anxiety
https://www.esri.ie/pubs/RS40.pdf
Illness rates
rising
Associated
with certain
work
patterns
WR Illness
• F > M (2008-2012)
• Boom > recession
• Probability of illness increases with age,
longer hours of work, short number of
hours, highly variable working hours,
shift work and working at night
• Self employed do not differ from
employed
(pages 60-61)
https://www.esri.ie/pubs/RS40.pdf
Social patterning to risk
Risks in agriculture, forestry and fishing,
mining, quarrying and manufacturing
Psychosocial risks
Particularly in public sector and the health
and social work sector
https://www.esri.ie/pubs/RS46.pdf
Occupational Health Risks to our
Working Population
• Rising rates of work-related illness
• Commonest conditions are ‘MSD’ and ‘Stress, Anxiety and
Depression’
• Presenteeism?
• Leaveism?
• Impact of job characteristics (working hours, shift
patterns, night work) on health
• Work-related illness
• Sectors at risk (agriculture, construction, transport, health
sector)
http://www.cso.ie/en/media/csoie/census/documents/census2011profile3/Profile,3full,doc,for,web,sig,amended.pdf
4.6 million population
3.1 million in the 15 to 64 age group (working age population)
2.2 million in the labour force, of which
1.9 million are at work
Among those aged 15 years and over:
939,000 males at work
839,000 females at work.
Census 2011
Public Health Perspective
• Rising rates of chronic illness
• Highest causes of death in under 65s
• cancer and diseases of the circulatory system
• Modifiable lifestyle and behaviour factors
http://health.gov.ie/publications-research/statistics/statistics-by-topic/causes-of-death/
Disability
http://www.cso.ie/en/media/csoie/census/documents/census2011profile8/Profile,8,Full,document.pdf
Work can be a
contributory factor to
chronic disease
Safety and Health at Work
• Health and Safety Authority
2001
NATIONAL Strategy for Workplace Health
and Wellbeing 2008
2008
National Strategy for workplace
health and wellbeing
• Workplace culture … that will promote health and wellbeing,
prevent ill health, and support rehabilitation to the workplace of
those who are out of work through ill health or disability
• Recognition that it goes beyond legislative requirements
• Multi and cross-departmental response needed (HSA, HSE, DSFA,
DHC, NDA, IBEC, ICTU, FOM [RCPI], IES,
• Small and micro enterprises 97% of businesses
• About 0.8 million workers
• Public sector and medium to large enterprises
• About 1.2 million workers
Workplace Health Promotion
Large organisations
Public sector organisations
Multi-nationals
Small and micro enterprises
Construction Workers’ Health Trust
2008
2011
Key indicator: improving the promotion
of health and wellbeing at work
2011
“Work is good and unemployment bad
– for physical and mental health, but
the quality of work matters”
2010
“Puts ill health prevention in the
context of the social determinants of
health … involvement of
stakeholders…schools, workplaces,
home…all have the potential to help or
hinder ill-health prevention”
“Occupational health and vocational
rehabilitation should be fully integrated
into the NHS, providing a Fit for Work
model….”
http://www.instituteofhealthequity.org/projects/fair-society-healthy-lives-the-marmot-review
Promotion of health and well-being at work
2011
prompted by
Black Report
Employees
“… clear patterns
2010 in the data that show
that provision is more prevalent in large
organisations, especially those in the
public sector and those with trade
union presence”.
Employers
Findings reflected employees’
experience
Larger organisations, public sector
organisations and those with Unions
2011
prompted by
Black Report
• More than a third of employees had a
health condition (spread across all
occupations, industries and sizes of
organisation)
• 42% with a2010
health condition remained
in work, despite it having a considerable
effect on their work
• Over a third considered that their
health condition had been made worse
by their work
• Health and Wellbeing Policies explored
were:
Focus on sickness absence but
followed up on health and wellbeing
• Flexible working (74%)
• Injury prevention training (76%)
• Occupational Health Services (65%)
• Independent counselling services (39%)
• Stress management training (31%)
Healthy Workplaces Bill currently proposed
HSA is represented on Healthy Ireland Council Cross-Sectoral Group
Workplace Health and Wellbeing
Checklist
Probable mental health problems
http://health.gov.ie/wp-content/uploads/2015/10/Healthy-Ireland-Survey-2015-Summary-of-Findings.pdf
Changes
individuals
may like to make
Occupational Health Cochrane
Evidence
Limited evidence
Occupational Context
Hours of work,
night and shift work,
job tenure
Self-employed and high risk work patterns
In addition to known occupational hazards
National Context
Ageing workforce,
Retiring later,
http://www.euro.who.int/en/publications/policy-documents/ottawa-charter-for-health-promotion,-1986
Ottowa Charter
• “Health is...seen as a resource for everyday life, not the
objective of living”
It goes on to say:
• “Health is a positive concept emphasising social and personal
resources, as well as physical capabilities. Therefore, health
promotion is not just the responsibility of the health sector,
but goes beyond healthy lifestyles to wellbeing”
CSHW AD
http://www.enwhp.org/fileadmin/downloads/free/Luxembourg_Declaration_June2005_final.pdf
Luxembourg Declaration
on Workplace Health Promotion in the EU
“The combined efforts of employers, employees and society to
improve the health and wellbeing of people at work”
“WHP is a modern corporate strategy which aims at
preventing ill health at work and enhancing health promoting
potentials and wellbeing at work”
Jan 2007 version
CSHW AD
National Health Perspective
• The Workplace as a setting for Health Protection and Health
Promotion in Ireland ?
• Health protection from work-related hazards
• OSH system, albeit facing new problems
• Addressed under the remit of the HSA
• WHP not universal; growing but economic issues
• Health protection from non-work or work-life risk factors
• Public Health System; facing new problems (which follow through to
the workplace)
• Working-age population is a prime target for health protection and
health promotion activities
• Sectors and company types not in the WHP net
• Multi-departmental approach
• Who pays for it?
• 'Well-being at work cannot be brought about simply by way
of health and safety policy: there are strong links with the
way work equipment is designed, with employment policy,
with policy on disabled people, and with other policies like
transport and, of course, health policy in general, whether
it be preventative or curative”
• European Commission. (2002). Adapting to change in work and society: a new
Community strategy on health and safety at work 2002–06.
• http://europe.osha.eu.int/systems/strategies/future/#270
CSHW AD