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Safeguard OSH Solutions - Thomson Reuters

Safeguard OSH Solutions - Thomson Reuters

Safeguard Magazine

Regulator report—Health: let’s widen the measures

CHRIS JONES challenges us to use lead indicators of exposure to health risks to help change the conversation about work-related ill health.

Last year I joined 60 people in Wellington to discuss health and safety in a particular industry, as part of WorkSafe’s regular engagement with stakeholders.

After a morning of discussing acute harm and safety incidents, one of the speakers showed a graph highlighting that 95% of deaths in that industry were from work-related diseases and only 5% were caused by acute incidents. The people on my table, all organisational leads in health and safety, were shocked and surprised – yet, within a minute or two, the conversation turned back to the subject of acute harm and safety risks.

I listened for a few minutes before asking the group why. The response told me a lot about the change in mentality we need if we are to really make a difference in the way health risks are considered: “The numbers on health are really just a window into the past that I can’t change,” said one of them. “Safety is something I can make a difference in today”. The others round the table nodded in agreement.

There’s some degree of truth in that. When we talk about the estimated 600 to 900 people who die from work-related diseases annually, they’re generally long-latency conditions that take years to develop. It’s estimated1 that just over 50% of all work-related disease deaths are cancerous, 22% are related to cardiovascular diseases and 18% are non-cancerous respiratory diseases, all of which generally take years or decades before they can even be detected. When we talk about these numbers, it’s true that we’re often talking about harm that’s occurred in the past.

But the response was entirely wrong about health simply being a window into the past: workers in New Zealand are still being exposed to many of the same health risks that may, in the future, cause ill-health or early death. A 2010 study2 found that 75% of trade workers reported being exposed to dust, 43% of plant/machine operators reported being exposed to smoke and fumes, and 63% of agricultural and fishery workers reported being exposed to pesticides at work, all of which have the potential to lead to disease and ill-health. So those numbers aren’t just a window into the past, they’re also an indication of what we may continue to see in the future if we don’t reduce exposures to health hazards at work that are happening now.

Would the conversation around that table have been different, and more focused on health being a manageable problem, if the presenter had reported on the exposures occurring, rather than the deaths that were happening? I think it may have been; we need to recognise that talking exclusively about long-term health outcomes may not have the motivating or galvanising effect we often expect.

This doesn’t mean the 600 to 900 people dying every year of work-related diseases, or the tens of thousands of workers developing serious health conditions each year because of their work, should be ignored. Of course not; every single one of them is evidence of harm that, in the vast majority of instances, was probably preventable. In safety and acute harm, there’s been a move towards leading indicators and predictors of harm in addition to reporting on the harm that actually occurs. Similarly, it’s time our conversations on work-related health focus as much on leading indicators as they do the lagging indicators of harm through diagnoses.

We have to challenge ourselves to consider how we talk about “performance” in work-related health. Is performance about the number of people being harmed? Ultimately, yes. After all, the ultimate measure of success in health and safety has to be fewer workers experiencing harm caused by their work. But does a focus on this, without any broader measures, provide us with a helpful picture about risks being experienced? And does it create any real sense of being able to prevent harm? I don’t believe it does.

All of us within the health and safety system need to take a broader approach to work-related health “performance”. If you use a health and safety dashboard, does it routinely describe predictive measures of harm to health or is “health performance” measured by the number of work-related health conditions being identified?

WorkSafe is nearing completion of a strategic plan for work-related health that will direct our activities over the coming ten years. A core element will be a ramped-up focus on research, surveillance and intelligence to understand exposures to various work-related health hazards, as well as the prevalence of work-related ill-health.

Our aim is to make it clear that work-related health isn’t just a window into the past, but an issue of the here-and-now.

Chris Jones is Manager Occupational Health with WorkSafe New Zealand.


  1. *Chris Jones is Manager Occupational Health with WorkSafe New Zealand.
  2. 1Anonymous, (2010). Work-Related Disease in New Zealand. The state of play in 2010. Wellington: Ministry of Business, Innovation and Employment
  3. 2Eng, A., et al, (2010). The New Zealand Workforce Survey I: Self-Reported Occupational Exposures.  Annals of Occupational Hygiene, 54 (2); 144–153
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