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Safeguard OSH Solutions - Thomson Reuters

Safeguard OSH Solutions - Thomson Reuters

Safeguard Magazine

Comment—Health like safety? Yeah, nah

It is often said that health should be treated like safety. ALLYSON HARWOOD agrees, but only in part.

Health and safety are inextricably linked, yet in many organisations they often run in parallel, with little crossover. Health is often called the poor cousin of safety because symptoms of exposures to health risks can take a long time to emerge, so the natural human tendency is to ambulance-chase after safety incidents and to overlook the health side of the ledger.

This has led to a catch-cry – “Do health like safety!” – in a bid to encourage people to pay more equal attention to work-related health. This is a useful motto when it comes to risk assessment: we should indeed consider health risks – physical and mental – when we are looking at the risks created by our work activities. And then put in place controls to eliminate or minimise those health risks, alongside the controls we put in place for safety risks. No problem there.

But when ill health arises following workplace exposure, or when someone presents with a health condition which could cause a safety incident, the “do health like safety” approach doesn’t work so well. Why not? Because a person’s health is regarded as a private matter, so there is often reluctance to discuss health problems with a supervisor, let alone make someone at PCBU officer level aware of them. (From the employer’s perspective, a worker being ill is also often viewed as a private matter, regardless of the cause of the illness, which can lead employers to deny any responsibility.)

So if the health risk controls are failing, the PCBU often lacks the information to enable it to complete the feedback loop and improve the controls.

Conversations about health need to happen in every workplace, but how does a supervisor, manager or officer talk to someone about their health? It’s a taboo subject, so if we’re feeling like crap we usually wait until it miraculously goes away by itself (she’ll be right!), or we go to our doctor, who usually doesn’t consider or think about workplace exposures – especially when the symptoms often mimic non-work-related conditions like influenza.

(Without knowledge, a worker who is exposed to welding fumes is unlikely to go their GP and say “I think I have metal fume fever – again”. They are more likely to say “I think I’ve got the flu”, and another opportunity for diagnosis and reporting is missed.)

Also, in some cases, by the time a worker has figured out their symptoms could be work-related years will have elapsed and the team they work with now might not be the team they worked with at the time of exposure. There may be no one left to talk to who remembers those times and the processes that were in place.

The occupational health nurse plays an important role in this process. An OHN is in a prime position to have those difficult conversations about personal health, and to initiate conversations about a health risk that might be safety-critical.

An OHN has direct and intimate conversations about a person’s health because we have the necessary technical knowledge and the freedom of honesty to ask the hard questions. An OHN is really good at making a complete stranger disclose all manner of health-related information because we set up personal relationships based entirely on trust.

OHNs are also well placed to intervene in health-related safety risks. Recently our practice had a couple of workers come to annual health monitoring who were found to have extremely high blood pressure readings. One of them was a line worker who declared he needed to hop back into his truck and climb a pole, promising to see his GP the next day. The OHN firmly suggested that driving anywhere was out of the question, and had him driven to his GP immediately. The OHN’s mana persuaded him that this was a good course of action; his supervisor may not have had the same influence.

This transfer of information about a person’s health is not always expected or even accepted, due to privacy concerns. Curiously, the opposite applies to a safety incident, where within half an hour it seems everyone on site knows who was involved and has developed their own opinions about cause and feels free to discuss theories openly.

Questions matter. Leading is about allowing opportunities for good questions to be asked, and to respond without judgment or recrimination. Leading has much to do with quality of listening.

So, should organisations treat health like safety? On the risk management side, certainly. There is no excuse for failing to recognise health risks and dealing with them.

But downstream, after the exposure? That’s when it gets a little bit harder. Health becomes a different game then, and it requires different conversations.

Allyson Harwood is managing director of Midway Occupational Health Services and is president of the NZ Occupational Health Nurses’ Association.

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