Preventing alcohol use in the workplace:
A key initiative for healthy workplaces
Dr. Rokho Kim
World Health Organization
Regional Office for Europe
Outline
•
Introduction
•
Burden of alcohol-attributable diseases
•
WHO responses to alcohol challenges
•
Importance of health and safety at work
•
Healthy workplaces – holistic paradigm
•
Concluding remarks
Why healthy workplaces?
• Workers are half of the whole population
• Healthy workforce is a prerequisite for
sustainable development and social wellbeing
• Preventable consequences
– Workers: loss of health and wellbeing
– Community: loss of solidarity and equity
– Company: loss of productivity and profit
– Country: loss of 4-5% of GDP
• A major social determinant of health and equity
Our target population: 'the global workforce'
Most of the world's 2.8 billion
workers can benefit from a
"healthy workplace" approach,
and particularly…
– the 1.9 billion workers who are
employed in unhealthy &
unsafe workplaces…and that
include 170 million children
– 400 million workers in the WHO
European Region
Personal health practices (“risk factors”),
health costs, and productivity
Shain M , Kramer D M Occup Environ Med
2004;61:643-648
6 October 2011
©2004 by BMJ Publishing Group Ltd
Source: Joan Burton. WHO Healthy Workplace Framework and Model, 2010.
http://www.who.int/occupational_health/healthy_workplace_framework.pdf
Alcohol-attributable disease and injury (1/2)
Chronic disease:
Cancer: Mouth & oropharyngeal cancer, esophageal cancer,
liver cancer, female breast cancer
Neuropsychiatric diseases: Alcohol use disorders, unipolar
major depression, primary epilepsy
Cardiovascular diseases: Hypertensive diseases, hemorrhagic
stroke
Gastrointestinal diseases: Liver cirrhosis
Conditions arising during perinatal period: Low birth weight
Alcohol-attributable disease and injury (2/2)
Injury:
Unintentional injury: Motor vehicle accidents, drownings, falls,
poisonings, other unintentional injuries
Intentional injury: Self-inflicted injuries, homicide, other
intentional injuries
Preventive effects:
Diabetes
Ischemic heart disease
Ischemic stroke
Deaths among people aged 15–29 years related to
selected risk factors, European Region, 2004
Unmet contraceptive needs
Child sexual abuse
Low fruit/vegetable consumption
Iron deficiency
Occupational risks
Physical inactivity
High blood glucose
Illicit drug use
Unsafe sex
Alcohol use
0
20000
40000
Deaths
Deaths
Men
Women
60000
Total disability-adjusted life-years (DALYs) lost
due to selected risk factors, European Region,
2004
Global drinking and European drinking 2005
High exposure, high burden of mortality and
disease
• For men between ages of 15 and 64, 1 in 7
deaths in 2004 were caused by alcohol
(clearly premature deaths given the life
expectancy in Europe)
• For women of the same age category, 1 in 13
deaths in 2004 were caused by alcohol
What works in alcohol policy: evidence
Degree of
evidence
Action that reduces alcohol-related harm
Action that does not reduce alcoholrelated harm
Convincing
• Alcohol taxes
–
• Government monopolies on retail sale
• Restrictions on outlet density
• Restrictions on days and hours of sale
• Minimum purchase age
• Lower legal blood alcohol concentration for
driving
• Random breath-testing
• Brief advice programmes
• Treatment for alcohol use disorders
Probable
• Minimum price per gram of alcohol
• Lower taxes to manage cross-border trade
• Restrictions on the volume of commercial
messages
• Training of alcohol servers
• Enforcement of restrictions on sales to intoxicated
and underage people
• Consumer labelling and warning
messages
• Designated driver campaigns
• Public education campaigns
Limited/
Suggestive
• Suspension of driving licences
• Alcohol locks
• Workplace programmes
• Campaigns funded by the alcohol industry
Sixty-third World Health Assembly, 17–21
May 2010
Endorsed the global strategy
to reduce the harmful use of
alcohol in WHA63.13
European action plan to reduce the harmful use
of alcohol (EAAP) 2012–2020 – 10 action areas
•
Leadership, awareness and commitment, as sustainable intersectoral
action requires strong leadership and a solid base of awareness and
political will
•
Health services’ response, as these services are central to tackling health
conditions in individuals caused by harmful alcohol use
•
Community action, as governments and other stakeholders can support
and empower communities in adopting effective approaches to prevent and
reduce harmful alcohol use in both communities and at workplaces
•
Policies and countermeasures on drink–driving, as it is extremely
dangerous to drivers, passengers and other people using the roads
•
Availability of alcohol, as public health policies to regulate commercial or
public availability have proved to be very effective in reducing the general
level of harmful use and drinking among minors
EAAP 2012–2020 – 10 action areas
•
Marketing of alcoholic beverages, as systems are needed to protect
people, particularly children and young people, from advanced advertising
and promotion techniques
•
Pricing policies, as most consumers, particularly heavy drinkers and
young people, are sensitive to changes in the prices of alcohol products
•
Reducing the negative consequences of drinking and alcohol
intoxication, in order to minimize violence, intoxication and harm to
intoxicated people
•
Reducing the public health impact of illicit and informally produced
alcohol, as its consumption could have additional negative health
consequences due to its higher ethanol content and potential contamination
with toxic substances
•
Monitoring and surveillance, as relevant data create the basis for the
appropriate delivery and success of responses
New publication, launched on 27
March 2012.
Special chapter on Alcohol and
the workplace
“The workplace provides several
opportunities for implementing
prevention strategies to reduce
the harm done by alcohol, since
the majority of adults are
employed and spend a significant
proportion of their time at work.”
Workplace services and legislation
WHO survey in EU Member States (2011)
No of
countries
(N=29)
Prevention or counselling programmes at workplaces
National guidelines for prevention of and counselling for
alcohol problems at workplaces
18
8
Involvement of social partners representing employers
and employees in action to prevent and address
alcohol-related harm at workplaces
11
Legislation on alcohol testing at workplaces
10
Occupational health risks  diseases, injuries, deaths
• Occupational risks play a big role in chronic
diseases:
• 26% CVD & chronic pulmonary disease
• 15% asthma
• 10% cancer
• 8% injuries
• 8 % depression
• 300 000 deaths from work-related diseases in
the WHO European Region (4% GDP loss)
Health promotion: improved workers' health  better
performance
Workplace-based initiatives can help support, for
instance:
• Work-lfe bakance
• Smoking
• Drinking
• Obesity control
• Cardiovascular health
• Exercise & physical activity
Enterprise community involvement  social &
environmental determinants
• Safe/healthy access to work – public transport,
carpools, walking, cycling
• Voluntary pollution/waste control & cleanup
• Provision of primary health care and health
education unavailable through health care
services outside the workplace
60th World Health Assembly, May
2007
Resolution 60.26 "Workers'
Health: Global Plan of Action"
•The Global Plan of Action developed by the Member
States for the Member States
•WHA60 endorsed the global plan of action on
workers' health (2008-2017)
•WHA60 urged Member States to take an number of
measures on workers' health
WHO Model of Healthy Workplaces
Combining health protection & health promotion
Developed by leading occupational
health experts out of systematic
review of literature

October 2009 workshop involving
56 experts from 22 countries,
international worker & employer
representatives

24
Paradigm shift
From: Labour approach
Occupational health
To: Public health approach
Workers' health
Action at workplace
Action to include workers'
families & communities
Work-related health issues
only
Include all health
determinants
Work under labour contract
Include all workers (selfemployed, informal workers)
Employers' responsibility
All stakeholders' responsible
(insurance, health &
environm. authorities, a.o.)
Negotiation between
workers and employers
Health protection is a nonnegotiable
A holistic framework for action
1. Action in four realms:
Physical work environment
• Physical work
Mobilize
• Psychosocial environment
• Personal health
Assemble
Improve
Psychosocial
work
environment
Leadership
engagement
Evaluate
• Community involvement
ETHICS &
VALUES
Assess
Personal
health
resources
Worker
involvement
Do
Prioritize
Plan
2. A model of continuous
improvement
Enterprise community
involvement
26
• Eliminate a toxic chemical or
substitute with less hazardous
• Install machine guards/exhaust
ventilation
• Train workers on safe operating
procedures
• Personal protective equipment
such as respirators or hard hats
27

Reallocate work to reduce
workload

Zero tolerance for harassment,
bullying, discrimination

Respect work-family balance

Recognize and reward good
performance

Meaningful worker input into
decisions that affect them
28
• provide fitness facilities, classes or
equipment for workers;
• provide healthy food choices (e.g.,
cafeteria)
• put no-smoking policies in place,
provide smoking cessation assistance;
• provide information about alcohol and
drugs, and employee assistance
counseling
As an employer you can create or remove barriers to lifestyle
changes!
29
- Free/affordable Primary health care
to workers/family members;
- Voluntary controls over pollutants
released into the air or water;
- Financial support to worthwhile
community causes;
- Minimize greenhouse gas emissions.
30
Crosscutting principles for success
• Leadership engagement
• Involve workers & their representatives
• Do an effective gap analysis
• Learn from others
• Integrate activities
• Evaluate and improve
Outlook of WHO is based on its Constiution…
Healthy workplaces is inspired by the WHO definition of
health as:
“a state of complete physical, mental and social wellbeing and not merely the absence of disease or
infirmity”
WHO constitution, signed on
22 July 1946 by the
representatives of 61 States
and entered into force on 7
April 1948
32
How to convince the business community
1. The 'right' thing to do: businesses are part of
society and ethical/social frameworks
2. The 'legal' thing to do: in our globalized world,
businesses that ignore or undermine workers'
health are open to litigation and media scrutiny
3. The 'smart' thing to do: businesses that protect
workers' health are among the most successful
over time
Healthy companies are also profitable!
For every $ spent:
– Medical costs fall by $3.27
– Absenteeism costs fall by $2.73
“The wide adoption of wellbeing programs could
prove beneficial for budgets and productivity
as well as health outcomes”
(Baicker K, et al. Workplace wellness programs can
generate savings. Health Affairs, 2010)
A holistic framework for action
Physical work environment
Mobilize
Assemble
Improve
Psychosocial
work
environment
Leadership engagement
Evaluate
ETHICS & VALUES
Assess
Personal
health
resources
Worker involvement
Do
Prioritize
Plan
Enterprise community
involvement
35
Elements of good practices of health
workplaces initiative at the company level
•
•
•
•
•
•
•
•
•
•
•
Linking programmes to business objectives
Top management support
Employee advisory boards
Effective communication
Supportive environment
Use of incentives
Goal setting
Self-efficacy
Social environment, social norms and social support
Tailored programmes
Building effective programmes across the individual to
environment continuum
Healthy workplaces model: an integrated approach
A comprehensive approach that embraces:
•
Traditional & emerging occupational health –
minimizing workers' exposure to job-related physical
& psychosocial risks
•
Health promotion – promoting healthy behaviours
among workers, both job- and lifestyle-related
•
Enterprise involvement in community – to address
broader social & environmental determinants of
workers health
Together, we can make
a difference!
Thank you.
Acknowledgements: Parts of this presentation were
supported by my colleagues, Drs. Lars Moeller and
Evelyn Kortum.
Email: kimr@who.int
www.euro.who.int/alcohol
http://www.euro.who.int/en/what-we-do/healthtopics/environment-and-health/occupational-health
http://www.who.int/occupational_health/healthy_wor
kplaces