Total Worker Health 

The focus of my work career has been the prevention of occupational-based injury and illness. This is a rather narrowly focused and perhaps isolated field within the broader context of public health. Efforts to extend concepts of injury and disease prevention beyond the workplace and into the home have been made over the years, but the concept has never become fundamental to occupational safety.

It has been believed for some time that obesity is associated with increased risk injury. A study published in the American Medical Journal demonstrated a rather striking increase in workers’ compensation claims, indemnity costs, and lost workdays based on obesity classifications1.

Research is also showing more associations between individuals’ health status and their likelihood of experiencing a work-related accident. In a 2006 study published in the American Journal of Industry Medicine, researchers found six non-occupational health-risk factors which were statistically associated with a higher odds of being involved in a workplace accident. These factors included aerobic power, smoking status, percent body fat, body mass index (BMI), and flexibility measurements2.

This is the next frontier for the occupational health and safety profession – the melding of workplace safety and health into the total worker health. In June of 2011 the National Institute of Occupational Safety & Health (NIOSH) launched a program called “Total Worker Health.” This new initiative is defined as “a strategy integrating occupational safety and health protection with health promotion to prevent worker injury and illness and to advance worker health and well-being.”

The effort to collaboratively bring workplace wellness and health to the worker in a comprehensive package certainly makes a lot of sense. A comprehensive research compendium was published in 2012 and available on the NIOSH website summarizing some of the current literature3.

OSHA requires companies to determine the air concentrations of contaminants for substances to which workers are exposed. Where exposures do exist we carefully fit and test the effectiveness of respiratory protection that may be used. We train the workers in the proper fit and care of their respiratory protection so that they can avoid over-exposure to a toxicant. All of this effort to protect the lungs – yet following the training the participant decides to step outside and light one up. I often feel in this scenario our efforts are in vain. For many substances, smoking synergistically and dramatically increases the risk for health impacts.

Another example: A worker enters his workplace and dons a protective hardhat, safety glasses, and ear protection. But at the end of the day, he jumps on his motorcycle without a helmet, exposed to high levels of wind and motor noise which can impact hearing.

Safety and health initiatives can seem nearly pointless if we do not adopt them universally. The total worker health paradigm provides us with an opportunity to make a difference beyond the workplace. I am proud that our company has been proactive in encouraging the control of health risks. We have increased awareness of the importance of personal health and most importantly we have created some new healthy behaviors.

Can you point to one or two things that you have done differently in the past couple of years as a result of our organizational focus? I can. Integrating safety and health at work with safety and health outside the workplace makes perfect sense and … hopefully leads to perfect health.

1Ostbye, T., J. M. Dement, and K. M. Krause. "Obesity and Workers' Compensation: Results From the Duke Health and Safety Surveillance System." Archives of Internal Medicine 167.8 (2007): 766-73. Print.

2Craig, Brian N., Jerome J. Congleton, Carter J. Kerk, Alfred A. Amendola, and William G. Gaines. "Personal and Non-occupational Risk Factors and Occupational Injury/illness." American Journal of Industrial Medicine 49.4 (2006): 249-60. Print.

3"The Research Compendium: The NIOSH Total Worker Health™ Program: Seminal Research Papers 2012." Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, May 2012. Web. 25 Feb. 2014.