Health and Safety
Executive
Health and Work
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Outline of this presentation
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The health agenda
Understanding sickness absence
Identifying the underlying causes
Health: the role of the workplace
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75% of working age people in Britain are in employment
and spend a high proportion of their waking hours in the
workplace
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The workplace offers great scope for targeting of
messages and initiatives about healthy living – with
potential impact on both employees and their families
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Need to go beyond essential compliance with health
and safety legislation and promote health and wellbeing more generally
Work and health – what we know
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Work offers opportunities to promote individual health and wellbeing
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Work should be recognised by all as important and beneficial, and
access to, and retention of work promotes and improves the
overall health of the population
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Long-term sickness absence is a strong predictor of disability and
mortality
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Work has a positive impact on health and well-being (‘good jobs’ in
well managed organisations)
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Under some circumstances work can have adverse effects (‘bad
jobs’)
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The key is prevention of underlying causes rather than relying
just on management of outcomes (secondary & tertiary
interventions)
Absence and Health
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Risk factors for sickness absence are not always
the same as risk factors for disease
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An holistic approach needs to focus both on the
risk factors that precede absence as well as
implementation of policies & procedures for
monitoring & management.
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Sickness absence data collection, analysis and
interpretation methods need to reflect both
aspects.
Health and safety statistics 2007/08
Estimated incidence rates of self-reported work-related illness, for people working in the last 12
months
2500
Incidence rate (per 100 000)
2000
1500
1000
500
0
All illnesses
2001/02
2003/04
Musculoskeletal disorders
2004/05
2005/06
2006/07
Stress, depression or anxiety
2007/08
Other illnesses
95% confidence interval
A national study of absence
Definitions:
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Disease: is defined in terms of objective biological
abnormalities in the structure and/or functions of bodily
organs and systems
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Illness : is the personal subjective perception of
unwellness. Therefore, if a person feels ill, they are ill
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Sickness: is derived from the concept of the “sick role”,
a role that carries certain privileges (to stay away from
work), as well as obligations (to seek medical help and
to ‘get well’).
Ill health: A Population Study
Illness %
Disease %
33
3
Absence %
>14 days
2
None of
these 25%
8
1
23
5
Wikman et al (2005)
Sickness Absence: NHS Trust
Typical - Stress Sickness Abscence Data
(n=3600, mean 27 days)
80
70
No. INCIDENTS
60
50
40
30
20
10
0
01-10
11-20
21-30
31-40
41-50
51-60
61-70
71-80
81-90
DURATION - DAYS
91-100
101-110 111-120 121-130 131-140 141-150
151+
The Individual
The biopsychosocial model: (Waddell & Burton, 2004)
Biological:
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The physical or mental health function
Psychological:
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Recognises that personal and psychological factors also
influence functioning and the individual must take some
responsibility for their behaviour
Social:
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Recognises the importance of the social context,
pressures and constraints, on behaviour and functioning
Drivers of sickness absence
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Individual factors – personality and motivation;
past behaviour; sick role
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The ‘system’ – organizational culture and
tolerability, what is legitimate; sickness
certification
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Non-work factors – life events and family
pressures
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Work factors – absence as ‘coping’, job
satisfaction, chronic adverse features of work
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Commitment and involvement
Designing ‘good’ jobs
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Promote ‘healthy’ workplaces
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Job content, job context and organizational
arrangements critical
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Move from a less desirable (‘bad jobs) to a more
desirable state (‘good jobs’)
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HSE Management Standards can help in
prevention and management
Prevention and management of common health
problems
Summary
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The workplace offers the opportunity to promote and
improve the health of employees and their families
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The drivers for ill-health are not always the same as the
drivers for absence
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We need a better understanding of the causes of
sickness absence so these can be managed in a
proactive manner
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Current attendance management practice and policy is
based on convention rather than evidence (IES, 2007)