2. Outline of this presentation
• The health agenda
• Understanding sickness absence
• Identifying the underlying causes
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3. • Safety: Plant and machinery, cranes, hoists, lifts, etc., boilers, pressure vessels etc.,
fire, electrical matters, handling and storage of dangerous substances, handling of
heavy weights, maintenance, transport, e.g. fork lift trucks, protective clothing,
“housekeeping”, off-site workers if any;
• Health: Control of noise, control of toxic substances, environmental monitoring,
biological monitoring, disclosure of information, first aid;
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4. Work and Health – What we know??
• Work offers opportunities to promote individual health and well-being
• 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
• Long-term sickness absence is a strong predictor of disability and mortality
• Work has a positive impact on health and well-being (‘good jobs’ in well
managed organisations)
• Under some circumstances work can have adverse effects (‘bad jobs’)
• The key is prevention of underlying causes rather than relying just on
management of outcomes (secondary & tertiary interventions)
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5. Absence and Health
• Risk factors for sickness absence are not always the same as
risk factors for disease
• An holistic approach needs to focus both on the risk factors
that precede absence as well as implementation of policies &
procedures for monitoring & management.
• Sickness absence data collection, analysis and interpretation
methods need to reflect both aspects.
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6. Objective of Robens committee
• Safety and health objectives should be clearly defined at all levels within firms.
• Workers should be more involved in safety and health at their workplace.
• There should be a legal duty on employers to consult their employees on safety and health
matters necessary at their workplace.
• Voluntary codes of practice should be introduced.
• The scope of the legislation should be extended to include all employees (with minor
exceptions) and the self-employed.
• The existing safety and health inspectorates should be amalgamated.
• New administrative sanctions should be adopted.
• Local authority work should be co-ordinated with that of the new authority.
• The interests of the public should be taken into account in the new legislation.
• General fire precautions should be dealt with under a Fire Precautions Act.
• The Employment Medical Advisory Service should function as part of the new authority
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7. Health and safety statistics 2007-2008
Estimated incidence rates of self-reported work-related illness, for people working in the last 12
months
0
500
1000
1500
2000
2500
All illnesses Musculoskeletal disorders Stress, depression or anxiety Other illnesses
Incidencerate(per100000)
2001/02 2003/04 2004/05 2005/06 2006/07 2007/08 95% confidence interval
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8. A national study of absence:
Definitions:
• Disease: is defined in terms of objective biological
abnormalities in the structure and/or functions of bodily
organs and systems
• Illness : is the personal subjective perception of unwellness.
Therefore, if a person feels ill, they are ill
• 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’).
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9. A Population Study:
• Illness %
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33
23
5
8
3
2
1
Disease %
Absence %
>14 days
None of these
25%
Wikman et al (2005)
10. The Individual:
The bio psychosocial model: (Waddell & Burton, 2004)
Biological:
• The physical or mental health function
Psychological:
• Recognises that personal and psychological factors also influence
functioning and the individual must take some responsibility for
their behaviour
Social:
• Recognises the importance of the social context, pressures and
constraints, on behaviour and functioning
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11. General duties
• provision and maintenance of safe plant;
• provision and maintenance of safe systems of work;
• ensuring safe use of articles and substances;
• provision of such information, instruction, training, and supervision as
necessary;
• ensuring the workplace is maintained in a safe condition;
• provision and maintenance of a safe working environment and
adequate welfare arrangements;
• preparation and revision as necessary of a written statement of safety
policy and bringing it to the notice of all his employees;
• consultation with safety representatives;
• formation of a safety committee if requested to do so by the safety
representatives
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12. Drivers of sickness absence:
• Individual factors – personality and motivation; past behaviour;
sick role
• The ‘system’ – organizational culture and tolerability, what is
legitimate; sickness certification
• Non-work factors – life events and family pressures
• Work factors – absence as ‘coping’, job satisfaction, chronic
adverse features of work
• Commitment and involvement
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13. Safety policy
• It provides a statement of objectives, which is an important
part of efficient management;
• It clarifies positions and roles and therefore helps establish
responsibilities for safety;
• It provides a standard for measuring achievement;
• Formulation of the safety policy may highlight areas where the
organization is deficient
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14. Designing ‘good’ jobs
• Promote ‘healthy’ workplaces
• Prevention and management of common health problems
• Job content, job context and organizational arrangements
critical
• Move from a less desirable (‘bad jobs) to a more desirable
state (‘good jobs’)
• HSE Management Standards can help in prevention and
management
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15. Summary:
• The workplace offers the opportunity to promote and improve
the health of employees and their families
• The drivers for ill-health are not always the same as the drivers
for absence
• We need a better understanding of the causes of sickness
absence so these can be managed in a proactive manner
• Current attendance management practice and policy is based
on convention rather than evidence (IES, 2007)
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