Steve Perkins, Managing Director at Steve Perkins Associates, unpacks the big picture of workplace health and argues the ‘system’ for protecting worker health is flawed, particularly in the world of construction.
“What gets measured gets managed”
So said Peter Drucker, the well-known management thinker. And it’s generally true. Unfortunately when it comes to protecting the physical health of our workers from exposures that cause disease and death, we tend to count the corpses rather than focus on controlling the exposures that produce them.
And even then, that counting only goes on at national level in the Health and Safety Executive’s (HSE) annual statistics. Did you know that the construction sector in Great Britain is responsible for 3,500 occupational cancer deaths, plus 5,500 new cases of occupational cancer each year? And at any one time there are some 81,000 construction workers with work-related ill-health . When you think that the Highways sector accounts for about 30% of all construction activity that’s potentially a lot of occupational cancer caused by highways work.
So what are we measuring when it comes to health protection?
Or maybe a more pertinent question is how do our current health, safety and wellbeing metrics impact on health protection?
Well, numbers of mental health first aiders or champions is certainly important, but wellbeing-related measures like that won’t have any impact on reducing the physical, chemical or biological workplace exposures that cause the occupational diseases we’re discussing. To put it bluntly, no amount of mindfulness will stop you get silicosis or noise induced hearing loss! (We’ll come to how wellbeing, occupational health and occupational hygiene work in relation to one another in a moment.)
And then there’s LTI, LTA, AFR… (otherwise known as ‘Looking Good Indices’.) All of which focus on accidents, not ill-health. It could be argued that even in terms of preventing accidents these metrics are not a lot of help due to their lagging nature. They don’t reveal anything about what is being done now to reduce workplace risk and so decrease the likelihood of future accidents. But I digress; that’s a different article.
Well surely then, RIDDOR is the answer when it comes to health metrics and we all count RIDDOR reportable diseases. Unfortunately RIDDOR is to health protection what AFR’s are to accident prevention – seriously lagging! The key thing about the most serious occupational diseases is that they are ‘long latency’ i.e. it can take years if not decades for many of them to develop. So, by the time the disease manifests, the damage is done and, because there are no cures for these diseases, it’s too late to stop them progressing.
The BIG picture of workplace health
I mentioned earlier that we’d look at how wellbeing, occupational health and occupational hygiene work in relation to one another. There are 3 broad, but overlapping dimensions to workplace health.
- The classic understanding of health at work comes under the banner of Occupational Health. This is the clinical arena that’s all about managing the health of workers as it is today. It covers the work of doctors and nurses on things like fitness for work, medicals and health surveillance.
- Wellbeing is the second dimension of health at work. This is primarily about encouraging individuals to make healthy lifestyle choices and has benefits for both employees and employers.
- The third dimension of health at work is Occupational Hygiene. This is all about protecting people from workplace health risks. These are the entirely preventable risks the workplace itself creates, which are regulated by the HASAWA 1974. Preventing ill-health is all about controlling exposures; it’s not about clinical treatment or health promotion. It’s about protection. Occupational Hygienists are highly qualified applied scientists who deal with the anticipation, recognition, evaluation and control of workplace health risks. Theirs is a cross-cutting discipline encompassing aspects of physics, chemistry, biology, medicine, ergonomics, toxicology and engineering.
Is health, safety and wellbeing really protecting our worker’s health?
Let’s return to our original question. Someone once said, “the system you have is perfectly designed to give you the results you’re getting”. If the HSE’s statistics are anything to go by the ‘system’ for protecting worker health is pretty dysfunctional, particularly in our world of construction.
Unfortunately these levels of serious occupational disease and death reported by HSE have been going on for decades and they’re generally not reducing. It seems to me that it’s hard to conclude anything other than the answer to our original questions is a resounding ‘NO’. By any outcome measure, at an industry level, health, safety and wellbeing is not really protecting our worker’s health.
Good practice in highways worker health protection
That’s that not to say there aren’t pockets of good practice, and at the Highways UK show in November I’ll be unpacking some great examples from Connect Plus’s award-winning Healthier Highways initiative on the M25. You may be wondering by now what should we be measuring if we want to really protect our worker’s health? Remember – it’s all about reducing exposures. Come along in November to find out more!
 HSE (December 2021). Occupational Cancer statistics in Great Britain 2021. © Crown copyright 2021
Steve will be speaking at Highways UK on 2-3 November at the NEC in Birmingham on the Big Thinking Stage. See the full speaker line up here: https://www.terrapinn.com/exhibition/highways-uk/speakers.stm