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Worker health doesn't stop at the hospital door
NIOSH promotes integrated WorkLife approach
One employee comes into your office with back strain due to patient lifting. Another is identified by the wellness program as having uncontrolled high blood pressure. Those two issues may seem completely unrelated. But with its WorkLife Initiative, the National Institute for Occupational Safety and Health (NIOSH) is urging employers to integrate workplace safety with personal health promotion.
"Our fundamental message is if you are concerned about workforce health and well-being, think about work as a place to intervene," says Greg Wagner , MD, senior advisor for NIOSH and an adjunct professor of environmental health at the Harvard University School of Public Health. Wagner is leading the NIOSH WorkLife Initiative.
Employers are increasingly interested in promoting employee health as a way to reduce medical costs. Smoking cessation and fitness programs are commonplace. Yet those efforts will have limited success if they are not part of a broader emphasis on health and safety, says Michael Silverstein , MD, MPH, clinical professor of environmental and occupational health sciences at the University of Washington School of Public Health in Seattle and founder of French Loop Associates, a safety and health consulting firm in Olympia.
Silverstein served on a workgroup that developed a set of NIOSH recommendations, Essential Elements of Effective Workplace Programs and Policies for Improving Worker Health and Wellbeing ( www.cdc.gov/niosh/worklife/essentials.html ).
"Let's say you have a workplace where workers are exposed to hazardous chemicals or to smoke. The employer comes in one day and says, 'I'm introducing a smoker cessation program and I want everyone to participate,'" relates Silverstein.
"Unless efforts are made to address the kinds of exposures and hazards people face on the job, they may not feel very inclined to participate in an off-the-job risk," he says. "If we're going to be successful with public health at the workplace, we have to address both the workplace hazards and the hazards that exist when someone is off work."
There are many natural links between workplace health and personal health, says Wagner. For example, employees who drive at work and adopt work-related safety measures will maintain enhanced safety on the roads outside of work. The Veterans Health Administration is launching a pilot program at 10 facilities that provides integrated services for employee health and well-being, he says.
Meanwhile, employers must address the aging of the work force, says Silverstein. For example, aging may lead to changes in vision, increased prevalence of arthritis, and greater risk of back injury. "We've got to think about designing workplaces that are age-friendly," he says.
NIOSH suggests programs that are tailored to the workplace, incorporate employee participation, and include assessment of effectiveness. An employee health and wellness program should be developed in the context of a "culture of safety" that encourages worker input, NIOSH says.
Basic health screening is quite cost-effective, including screening for colon cancer, high blood pressure, and high cholesterol, notes Silverstein.
"There's a big gap between what's needed and what employers are actually doing," he says." It's a failure of vision and understanding rather than a failure of will and desire. A lot of employers just don't understand how effective these programs can be for relatively little cost or how great the cost will be if they ignore it."