Barbara Oaff questions how to avoid the onset of workplace ailments and minimise their impact, but says that the first vital steps are to identify the work-related illnesses and diseases that could present danger
Case Studies: Nestle, NRB Engineering Consulting
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Work has always come with a health warning. Advances in technology, management and medicine have certainly downgraded that warning, but, employees still can, and do, develop a range of work-related ailments and illnesses. Some are recognised, others hidden. So for forward-thinking human resources professionals, the question is how do you avoid their onset and minimise their impact? Dr Mark Simpson, managing director of Axa PPP Healthcare Occupational Health Services, explains there are six main work-related ailments and illnesses. The first is asthma, which can be caused by more than 200 substances.
Those at risk range from soldiers to bakers to fishermen. The second is dermatitis, which again can be caused by a whole range of substances. Those that can be affected in this case range from hairdressers to staff in power plants and food production factories. The third is hand arm vibration, brought on by using heavy percussive equipment. It affects people in many types of jobs, including groundsmen, car repairers and construction workers. The fourth threat is cancer, which can be caused by over exposure to substances such as lead, asbestos, sunlight and second-hand cigarette smoke. While workers are rarely subjected now to the first two causes, those based in the horticulture and the hospitality industry, for example, continue to be vulnerable.
The fifth threat is depression caused by things like being exposed to physical violence, which can affect a wide range of professions such as counsellors, police officers, aid workers, traffic wardens and passenger transport workers. On a more general level, staff can also find themselves at risk from stress. As for which dangers could be called hidden, Simpson says it all depends on who you ask. "Certainly, most large corporations will be aware of the possible threats facing their workforce, but some small and medium-sized organisations will be rather less informed. It doesn't help that the science behind the conditions is still evolving and that proving causation can be difficult." The law delivers some guidance on employers' responsibilities.
Section 2 of the Health and Safety at Work Act 1973 is quite clear about their obligations. "It shall be the duty of every employer to ensure, so far as is reasonably practicable, the health, safety and welfare at work of all their employees," explains Simpson. It is less clear, though, about the practicalities. Most experts recommend a proactive approach. Neil Budworth, president of the Institution of Occupational Safety and Health, says: "You need to get competent advice and then you need to act on it." For some organisations, this will ultimately mean reviewing the use and maintenance of equipment, machinery and chemicals. For others, it will mean introducing extra environmental safety guards. It could also mean re-examining health-related policies, which is where human resources can most actively play a part.
Employers are urged to take a planned, tactical approach. "You can throw money at this but that's no guarantee you'll get a solution. You have to know what you want to achieve. And why. You must be targeted," adds Budworth. There are five key options to consider. The first is proactive, health screenings. These are an annual comprehensive medical check-up, which will test someone for a selection of work-related ailments and illnesses. Available from £7 per employee per month, its early-intervention nature means problems can be averted or at least flagged up for attention. Simply offering health screenings though is not enough.
Paul Roberts, strategic director of IHC, a company specialising in medical and health insurance broking, says to be effective, the screenings should be tailored, compulsory and, within the bounds of patient confidentiality, analysed afterwards. When a work-related ailment or illness does emerge what then? Private medical insurance (PMI) can be useful. It gives instant access to both hospital and outpatient care. By ensuring that employees receive private treatment immediately, rather than having to wait for treatment on the NHS, they are able to regain their health, and return to their post, much quicker. But PMI is not an ideal solution. It is far from cheap, costing around £560 per employee per year. And it covers only acute illnesses.
Chronic illnesses, those that persist into the long term despite treatment, are excluded. So too are pre-existing illnesses. Evidently, any company thinking of paying for it needs to do serious cost-benefit analysis. A less expensive and a more comprehensive alternative is a healthcare cash plan. Priced from £1 per week per employee, these contribute to the cost of various treatments provided by specialists such as physiotherapists, chiropractors and opticians. And the idea is that if employees don't have to pay the full price of private treatment they will be more inclined to take it. But there is a caveat. Healthcare cash plans don't offer a full refund on everything - it can be as low as 30% - and some treatments have an annual spending cap on them. The incentive to use the service may, therefore, be lessened somewhat, along with its effectiveness.
Clearly, an organisation interested in rolling out a healthcare cash plan should give careful consideration to its mix of treatments and the level of coverage. While private medical insurance and healthcare cash plans seek to curtail the effect of various work-related ailments and illnesses, another possible option concentrates on one in particular. Employee assistance programmes make counselling available which can lower employees' stress levels. Telephone counselling can cost approximately £6-8 per employee per annum and face-to-face counselling twice that. Just making a talking therapy available though is not sufficient. Kate Bawden, a health management consultant at Mercer Human Resource Consulting, says it must be specific. "[It should] focus strongly on job demand, control and working relationships [and not just] general problems people face," she explains. If none of the above have been able to restore an employee's health, and they are now on sick leave, there is a final option - a rehabilitation service.
Dr Les Smith, group medical director of FirstAssist, says this can identify the services an employee needs, help them to access those services, and supervise and monitor the progress they make with. Obviously the cost of the treatment will vary; the fee for case managing the ill employee, for three months, is £200-£300. Whatever decision an HR department makes, however, doing nothing is not an option while hidden work-related ailments and illnesses persist.
Case Study: Nestle
Nestle has a long history of looking after employees' wellbeing. Dr David Batman, head of occupational health and safety, says: "As you might expect, we have a comprehensive range of policies and procedures in place that seek to prevent our workforce from developing any work-related ailments or illnesses." The types of illnesses and issues affecting employees has changed over time. Initially, workers were exposed to factors that could induce work-related asthma but changes have virtually eliminated that now. The greatest threat today is not physical but psychological. "People do suffer from stress. Most of it relates to external factors but we have decided to offer counselling regardless of whether the issue is professional or personal. As a company we are quite caring and we recognise that happier people make for better workers." Nestl™ provides a range of other health services, such as an on-site physiotherapist, fitness centre and online personal health audit.
Case Study: NRB Engineering Consulting
The greatest work-related health threat to employees at NRB Engineering Consulting is stress. Jo Blackwell, director, says: "I have always tried to help anyone who has come across a difficulty with their job, but when we began to expand I knew I wouldn't be able to stretch to everybody so it was decided to arrange for counselling to be made available." NRB's employees can speak to someone over the phone about their work and gain confidential, expert advice on how they can proceed. "I think the Healthsure service is very helpful to us and to our people. It means we can all work well and enjoy what we do. And this fits with our ethos being a caring, family business," adds Blackwell. NRB Engineering Consulting also provides private medical insurance for the organisation's directors.