R&D Programme: Research Brief
Management of health conditions and diseases (T382)
Introduction
This project was launched in April 2005
and has been carried out by Environmental
Resources Management (ERM) with
support from the Institute of Occupational
Medicine (IOM).
The main project
deliverable is a toolkit which was
completed in May 2006. T382 has been
conducted in close co-operation with the
related T389 project (Management of
Health Needs), which addresses high level
management issues in occupational health
(OH).
Project Aims
The aim of this research project is to help
the rail industry to better identify,
understand and proactively manage health
conditions which may impact on the safe
and efficient operation of the railway. The
primary deliverable is a toolkit of guidance
to help the industry improve management
of the five highest priority conditions
currently affecting employees and the
industry as a whole, by providing advice on
how to improve staff health, safety,
performance and morale in the workplace
as well as reducing the liklehood of illhealth and maximising business efficiency.
The main users of this toolkit are expected
to be railway line managers, (engineering
and operations managers, HR and H&S
managers etc) but the toolkit may also be
of value to others. It is not a substitute for
medical assessment but is designed to
help managers recognise when poor staff
performance could be attributed to a health
condition and to encourage early
intervention (by consulting a GP or OH
specialist), before it introduces risk to the
safety of the railway.
Methodology
The following tasks were carried out in
order to meet the above project aims. The
project team:
Created on 24 May 2006
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Consulted a wide range of stakeholders
and gathered information on health
risks and health management in the rail
industry.
Conducted a comprehensive risk
assessment of all health conditions and
their impacts on the industry, to identify
the five highest priority conditions to
provide adequate guidance in the
toolkit for railway line managers.
Reviewed how the industry currently
manages
these
conditions,
and
practices in other countries and
sectors.
Developed guidance and tools to help
railway staff manage the conditions.
Developed and tested the toolkit
Conducted final reviews of the toolkit
with key industry experts to ensure it
was fit for purpose.
Findings
This research project considered a total of
20 health conditions which were estimated
to cost the industry as a whole
approximately £230 million per year. This
estimate includes the direct costs of
sickness
absence,
performance
impairment at work due to ill health, early
retirements or severances on medical
grounds and potential compensation
payments. Performance impairment and
sickness absence were the most
significant, contributing respectively 61%
and 33% of the total cost.
The assessment of safety risks relating to
the health conditions indicated that the
conditions that pose the highest inherent
safety risks (regardless of their prevalence)
are common mental health issues, sleep
disorders, major psychiatric disorders, post
traumatic stress disorders, heart problems
and endocrine disorders (such as
diabetes).
If prevalence is taken into
account then major psychiatric disorders
and post traumatic stress disorders drop
significantly down the priority list.
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R&D Programme: Research Brief
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The highest overall priority health
conditions were identified based on a
combination of factors: their total impacts
and costs to the industry, impacts on the
individuals, safety risks, the opportunity to
improve the management of these
conditions within the rail industry, and
stakeholder views.
The top five priority health conditions
identified were as follows:
1. Musculo-Skeletal Disorders (MSDs) (eg
back pain, upper limb disorders)
2. Common mental health conditions (eg
stress, anxiety, depression)
3. Endocrine disorders (eg diabetes)
4. Heart and circulatory disorders (eg
ischemic heart disease, high blood
pressure)
5. Sleep disorders (eg obstructive sleep
apnoea)
This list was presented at a meeting of the
Association of Train Operating Companies
(ATOC) in November 2005. There was a
high level of support for the selected top
five priority health conditions.
The evaluation of current practices
indicated that there are highly variable
practices across the industry, with some
areas of good practice. There is limited
guidance, training or procedures for
specific conditions other than those directly
caused by work. There are various sources
of guidance available which could improve
the general level of practice found in the
industry, such as:
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Health and Safety Executive guidance
on stress and MSDs
British Occupational Health Research
Foundation guidance on common
mental health conditions
Information
from
British
Heart
Foundation, Diabetes UK, US National
Centre on Sleep Disorders Research
Created on 24 May 2006
The Australian National Standard for
Health Assessment of Rail Safety
Workers
A toolkit has been developed based on the
above sources of information and taking
into account what stakeholders said they
wanted to see included.
The toolkit
provides railway managers with general
guidance on how to identify and manage
the five health conditions and contains
links to further detailed sources of
information.
The toolkit is available from the RSSB
website. It contains the following sections
of advice for each of the five health
conditions:
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A summary of the key health issues
A section which describes the health
condition in layperson terms
Information on the impacts of the condition
on the individual and the workplace,
potential effects of work on a person with
the condition and overall costs to the
industry associated with the condition
A summary of legislation requirements
relating to the condition
Information on how to identify a person
who may have the condition
Screening and monitoring techniques to
diagnose and monitor the condition
Guidance on when it may be appropriate
to make referrals to health specialists
Methods for preventing the condition
Methods for managing employees with the
condition, including assessing the risks
and determining fitness for work,
managing absence, rehabilitation and
return to work, etc.
Advice to employees on how to recognise,
avoid and manage the condition
Links to further sources of information and
advice
Next Steps
The toolkit can be viewed or downloaded
from the RSSB website. It is being
launched at a rail industry seminar in
London on 26 June 2006.
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R&D Programme: Research Brief
Contact
Michael Woods
Head of Operations Research
Research and Development Programme
Rail Safety and Standards Board
research@rssb.co.uk
Created on 24 May 2006
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