Occupational cancer – minimising the risks

Photo by Pulmonary Pathology under Creative Commons Licence, via Flickr

Photo by Pulmonary Pathology under Creative Commons Licence, via Flickr

4 February 2004 was World Cancer Day, which forms part of the wider campaign to significantly reduce premature deaths from cancer and improve the quality of life for cancer sufferers and cancer survival rates.

According to Health and Safety Executive (HSE) figures (from August 2012) occupational ill-health accounted for over 20 million working days lost and an estimated 12, 000 deaths per year. Occupational cancer caused by exposure to carcinogens in the workplace is a major component of occupational ill health. It causes approximately 8,000 deaths and a further 14,000 cancer registrations annually, and is a major drain on the UK economy.

Unlike workplace accidents, which are easy to link directly to an incident in the workplace, it can often take several decades for cancer to develop following exposure to carcinogens making it difficult to associate cancer with work in many cases, especially if people have changed jobs or retired by the time the cancer is diagnosed.

Employers need to ensure that risks to health are minimised as much as possible, perhaps by substituting dangerous materials, providing personal protective equipment (PPE), or carrying out health surveillance to monitor the health of those who are potentially at risk in the workplace (if the need is identified from a risk assessment). This is often considered on a case-by-case basis according to the level of exposure, and depends on whether there is screening available. It is helpful to keep a register of projects involving the handling of carcinogens and the levels to which staff are exposed.

For more information on protecting the health of people in the workplace, see the guides on the Health for Work Adviceline knowledge base or search our blog.

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Changes afoot at the Health for Work Adviceline – telephone advice ends (but online guidance continues)

Health4Work crossThe Health for Work Adviceline (the Adviceline) has been a successful part of Government’s health, work and wellbeing strategy since it was launched in 2009. During the past 12 months, 130,000 visitors have accessed the Adviceline website, 25,000 people have registered to use the service, and the Adviceline has provided expert one-to-one advice and support to more than 3,000 businesses (i.e. via the telephone advice line, internet ‘live chat’, etc.).

Lessons learned from the Adviceline service have helped to inform the design of the Government’s Health and Work Service, which will be launched later this year.

The new Health and Work Service will provide advice via the internet and telephone, and an occupational health assessment and case management for those who have been on, or are expected to reach, four weeks’ sickness absence. The occupational health assessment will set out the issues preventing an employee from returning to work and provide a return to work plan for the employee, employer and GP that recommends how to overcome these issues.

The plan will include, where relevant, a timetable for a return to work, fitness for work advice and signposting to work-focused interventions. All employees will be case managed through this part of the service to ensure they are supported and their level of need is correctly identified.

From 29 January 2014, the Adviceline will no longer be offering telephone support or one-to-one advice from the website (i.e. ‘live chat’, ‘ask a question’). However, in the interim period until the launch of the Health and Work Service, the Adviceline website will continue to offer information on health and work issues to help people stay in and return to work, as well as offering access to over 240 guides and more than 170 blogs (more added regularly) to support employers, employees and GPs in managing issues relating to health at work.

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Effect of ill health in the workplace on worker productivity

Photo by William Brawley via Flickr, under Creative Commons License

Photo by William Brawley via Flickr, under Creative Commons License

According to research by Price Waterhouse Coopers, the annual cost of sickness absence has climbed to almost £29 billion for UK organisations. This is a mind-boggling figure, but to put it into some context, the cost of sickness absence was estimated to be approximately £600 per employee per year in 2012 (according to the CIPD 2012 Absence Management Survey).

There are many different costs associated with sickness absence including direct and indirect costs:

  • Direct costs: e.g. cost of replacement labour, absent employee’s salary, overtime incurred by staff covering the absent employee.
  • Indirect costs: e.g. additional stress on other staff who are covering absent employees, reduced productivity and customer service, time taken for a replacement to learn the role and become productive, training and support to other staff.

Of the indirect costs, reduced productivity is particularly hard to quantify but one person’s absence potentially means sharing a role out amongst other staff, and this is almost certain to lead to slippages in their existing workloads. Productivity reductions are particularly associated with the other result of ill health in the workplace, namely presenteeism (sometimes also known as ‘sickness presence’), which means people continuing to come to work even when they are really too ill to work effectively.

A 2010 report by the Work Foundation found that sickness presence was more prevalent than sickness absence (45% of the 510 survey respondents reported one or more days of sickness presence, compared with 18% reporting sickness absence over the same period).

Three factors, two of which were work-related, were significantly linked with higher levels of sickness presence:

  • Personal financial difficulties.
  • Work-related stress.
  • Perceived workplace pressure (from senior managers, line managers and colleagues) to attend work when unwell.

The presence of unwell employees can have many negative impacts including reduced productivity, work-related accidents, equipment breakage, errors in judgment, conflicts and interpersonal problems, and the Centre for Mental Health has calculated that presenteeism from mental ill health alone costs the UK economy £15.1 billion per annum, while absenteeism costs £8.4 billion.

In the long-term, the best that can be done to reduce the costs associated with sickness absence and presenteeism is investing effort into keeping workforces healthy and safe. This is why the Health for Work Adviceline, part of the Government’s Health, Work and Wellbeing initiative, offers web-based guidance to employers, employees and GPs on work health issues.

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Dry January – going alcohol-free to improve health

Photo by Wendy Longo photography via Flickr, under Creative Commons License

Photo by Wendy Longo photography via Flickr, under Creative Commons License

Many people across the UK waved goodbye to alcohol at the end of 2013 and embarked on ‘dry January’ – 31 booze-free days. In fact, currently over 17,000 people have signed up to the Dry January challenge, and many more are taking part without registering officially. For some this is easy, and for others it’s a struggle, but there’s no doubt that avoiding alcohol for an entire month is good for our health and wellbeing.

Many of us reach for a drink to relax after a hard day at work without giving it a second thought, and whilst the depressant qualities of alcohol may work in the short-term, in the long run it can contribute to depression, anxiety and difficulty dealing with stress. Alcohol also interferes with our sleep patterns and can mean that we wake up earlier than usual, and feeling exhausted. So even regular, low-level drinking can have a negative impact on our health and wellbeing.

Information on the Drinkaware website explains that alcohol is actually a poison and can have a number of negative effects on your body. It can:

  • slow down brain functions leading to a loss of sense of balance;
  • irritate the stomach causing vomiting and stopping the gag reflex from working properly (people can choke on, or inhale, their own vomit into their lungs);
  • affect the nerves that control breathing and heartbeat (it can stop both);
  • cause dehydration, which can cause permanent brain damage;
  • lower the body’s temperature, which can lead to hypothermia;
  • lower blood sugar levels potentially causing seizures.

Excessive alcohol consumption can cause seven types of cancer, including breast, bowel and liver cancer (according to Cancer Research UK). In fact, alcohol causes around 4% of cancers in the UK each year. Alcohol can also be very damaging for the liver because it can cause fat cells to be stored in it causing ‘fatty liver’ – the first stage of liver disease. The good news, however, is that the liver is the only organ in the body that has the ability to regenerate so it starts shedding this fat when alcohol consumption is stopped for two weeks and the daily unit guidelines are adhered to after that.

Many organisations are promoting the concept of staying alcohol-free as part of their focus on staff wellness, and because of the numerous short-term and long-term physical and mental health benefits of not drinking, many are supporting the Dry January campaign. (Of course, it doesn’t stop with ‘dry January’ – any month can be dry.)

An organisation’s staff are its most important asset so helping them to remain healthy and productive is advantageous for all. If you are looking for advice on work health issues, why not take a look at the Health for Work Adviceline website?

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Health questions during the recruitment process – what the Equality Act 2010 has to say

Photo by Victor1558 via Flickr, under Creative Commons Licence

Photo by Victor1558 via Flickr, under Creative Commons Licence

Research published in the journal Occupational Health [at Work] has revealed that the Equality Act 2010 has had a significant impact on the practice of asking pre-employment health questions during the recruitment process.

Section 60 of the Equality Act 2010 makes it unlawful for an employer to ask questions about a person’s health or disability prior to a conditional job offer being made, as some people risk being discriminated against and not being awarded jobs on merit if an array of health questions are asked before recruitment decisions are made. However, it is considered to be good practice to ask job applicants whether they need any adjustments for the recruitment process (e.g. altering the layout of the interview space, or allowing more time to complete interviews/tests), and it is lawful to ask questions about disabilities for equality monitoring purposes, so long as such information does not form part of the decision-making process.

A survey of 163 occupational health practitioners in public and private sector organisations has found that one in twelve employers (8%) still asks pre-employment health questions as part of the application form or at short-listing, compared to one in three (36%) when the same survey was carried out in 2006. The research has shown that many organisations are continuing to use health questions during the recruitment process but that these are now completed either when a conditional offer has been made (‘subject to a satisfactory health screening or medical’) or before the successful job applicant has started work.

For more information on the Equality Act 2010, see our blog (The Equality Act 2010 – what employers need to know) or look at the resources on the Health for Work Adviceline website.

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Sickness absence: the health of the nation

Photo by a.drian via Flickr, under Creative Commons Licence

Photo by a.drian via Flickr, under Creative Commons Licence

In the current environment of job insecurity, increased pressure at work and the subsequent increases in stress and stress related issues, occupational health services are more indispensable than ever.

Occupational health is a term we’ve all heard and one that we’re all very familiar with, but is it one that we actually fully understand? One definition of the term occupational health might be “the promotion and maintenance of the physical and mental wellbeing of all staff and the prevention of ill health” and it can be viewed almost as a middle-ground between the medical profession and the world of work.

Most employers are experts in their own field, but aren’t specialists in health. However, occupational health professionals have an understanding of working environments and health, and how the two interrelate. This means that they are able to take an unbiased view of working situations in order to decide whether there are risks to a person’s health.

In terms of its aims, occupational health could be described as follows:

  • Preventing work-related ill health
  • Promoting the wellbeing of workers
  • Ensuring that the work environment and work practices are assessed and modified to the needs of individuals, where necessary
  • Managing health-related risks in the workplace.

Employers can’t be expected to engage in good occupational health practices for purely altruistic reasons, however organisations have a duty to look after the people they employ while they are at work and these responsibilities are set out in legislation too.

Those organisations that don’t protect the health and wellbeing of their workers may face costly legal comebacks that can damage their reputations. Aside from fulfilling legal requirements, the most tangible and measurable benefit of occupational health services is an increase in staff productivity. It’s a simple premise: healthy, happy employees will be more productive; so looking after workers’ health is paramount to ensuring organisational success.

Let’s not forget that employees stand to gain from occupational health too. People want to work in safe environments – even those who love their jobs would not want to work in an environment that poses uncontrolled risks to their health. If risks are managed at work then people can continue to work safely and benefit from some of the broader benefits of working, such as financial standing, and improved self-esteem and self-confidence.

Sickness absence
This is all very well, but what about sickness absence, which continues to be such a major drain on the economy? After a small drop in absence levels in 2012, absence is back up to the levels observed in 2010 and 2011 at an average of 7.6 days per employee, according to the CIPD/Simplyhealth Absence Management Survey in 2013. The direct costs of sickness absence amounted to £14bn across the UK economy in 2012 (CBI’s Absence and workplace health survey 2013) and there are a number of indirect costs associated with sickness absence too, such as lost productivity or reduced customer service, which are harder to quantify and assign a cost to.

Sickness absence is the bane of many an organisation, particularly smaller ones. It is difficult for employers to arrange temporary cover at short notice (especially for specialist tasks) when employees are off work. Costs start to rocket as others are drafted in to cover the absent employee, which increases their workload and pressure, disrupts the workflow and potentially causes them to miss deadlines.

Subsequently, morale is threatened, particularly if those remaining at work feel that the person’s absence is an issue that’s not being addressed by management. Or the increased pressure on colleagues can cause accidents or more absence due to workload-induced illness.

Where good workplace wellness programmes are in place, however, they have been shown to offer a number of benefits, including a reduction in rates of sickness absence, reduced medical costs, productivity improvements and happier, healthier and more loyal employees.

Fairness, dignity and respect
Ill health cannot always be avoided, so those who have health issues should be treated fairly, with dignity and respect – a premise that is at the heart of both the Equality Act 2010 and the global standards for respecting human rights.

Workers have a right to an inclusive and safe working environment, and employers should consider workplace adjustments for staff who need them. Employers and managers should be trained to deal with attendance issues, which need to be dealt with efficiently and sympathetically in order to avoid them impacting on others in the organisation.

As we’ve seen, absence levels are on the rise, yet it’s interesting to note that the number of fatal workplace accidents is actually declining. According to HSE data, the number of workers fatally injured in the workplace fell from 172 to 148, however, annual fatality statistics shouldn’t be viewed in isolation, but in relation to trends over a number of years.

When compared to figures over the past five years the figures appear to be levelling off rather than actually falling. One major factor contributing to increased sickness levels is mental ill health, including stress, depression and anxiety, which are thought to be responsible for 91m lost working days each year, more than for any other illness, according to an ACAS report in 2012.

Stress can build up over time and can manifest itself in a range of illnesses if it’s left unchecked. It’s a difficult issue to tackle because it often goes unnoticed and can cause associated health issues almost before sufferers have acknowledged their stress.

In this uncertain economic climate, in which organisations and workers are under increased pressure to work long hours and to constantly perform at the peak of their ability, it is no wonder that stress issues, stress-related health problems and sickness absence associated with stress are on the rise and that occupational health services are arguably more indispensable than ever before.

This article appeared in ‘Safety Management‘ from the British Safety Council and was written by Renie Shaw, Marketing Manager of the Health for Work Adviceline. The Health for Work Adviceline offers free advice and guidance to organisations experiencing work health issues.

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Tips for surviving the festive season

Photo by danaberlith via Fickr, under Creative Commons License

Photo by danaberlith via Fickr, under Creative Commons License

For a whole host of reasons, the festive season can be a difficult time for many. Here are just some of the reasons why:

  • Loneliness: It is very common to feel lonely and isolated during the festive season when it appears that everyone else is enjoying themselves with their family and friends. If you live alone, have lost someone close through bereavement, or if you live at a distance from family and friends, it is understandable that you may feel very lonely.
  • Debt and money worries: There is a lot of pressure to spend money at this time of year and it is all too easy to spend more than you actually have. This can lead to increased stress and strain on you and on your family and relationships.
  • Families: Spending time with families at this time of year can be very stressful. Pressures may come from spending time with relatives that you don’t get on with, family feuds and arguments, issues to do with step families or blended families, disagreements about children, etc. If your relationship is already under a strain then the additional pressures of the festive season can bring things to a head.
  • Alcohol: Many people enjoy a drink at this time of year and alcohol plays a big part in ‘festive cheer’. However if you are someone who has difficulties with alcohol, or someone you are close to has these difficulties, then this can be a very hard time. Alcohol heightens our emotions and can lead to arguments and violence. Excessive alcohol use can lower our mood and make us feel physically unwell. Also be aware that your blood alcohol level may still exceed the legal limit for driving the morning after a night out.
  • Depression: If you are already feeling low, being surrounded by so much good cheer can make things seem even worse and it is not unusual for depression to worsen at this time of year. Suicides rise at this time of year as people imagine others nestling in the bosom of happy families and feel that they are the only ones not having a good time.

It’s not generally possible to escape the festivities altogether, but here are some tips on relieving the pressure:

  • Don’t try to please everyone all of the time.
  • Have realistic expectations. If your family isn’t generally harmonious, it is unreasonable to expect that things will be different during the festive period.
  • Only spend what you can afford – it’s not worth getting into debt because of Christmas.
  • Don’t assume that everyone else is having a wonderful time – lots of people are not!
  • Don’t bottle up your emotions, but try to talk to someone you trust.
  • Try to strike a balance between the festive treats and some healthy foods.
  • Get outside in the fresh air and take some exercise – it may help you feel better.
  • Try to find time for yourself – even if it is only to have a bath.
  • Try to politely say ‘no’ to the demands of relatives.

Balancing the festive season and work can be tricky, but looking after our health is crucial at this time of year. For advice about health issues related to work, contact view the resources on the Health for Work Adviceline website.

Our thanks to ‘Workplace Health and Wellbeing’ at Norfolk & Norwich University Hospital NHS Trust for allowing us to use content taken from their guide to surviving the festive season for this blog.

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Christmas. ‘Tis the season to be …. stressed?

Photo by Luca Venturi Oslo via Flickr, under Creative Commons Licence

Photo by Luca Venturi Oslo via Flickr, under Creative Commons Licence

The pre-Christmas season. A time for letting your hair down with friends and family and enjoying some festive cheer? That’s one way of looking at it. Alternatively, for some, it’s a struggle to manage the additional Christmas commitments alongside the usual balancing act of sustaining work and family life.

Many people put themselves under increased stress at this time of year with the pressures of shopping, time, financial concerns and social demands, as well as fatigue, general overindulgence and lack of physical exercise. It can be stressful even for those who are lucky enough to enjoy a stable home life, sufficient finances and a job they are happy in. But the Christmas season does have a habit of making those who are less than content with their lives acutely aware of the elements they are unhappy with.

So, bearing all of this in mind, it’s perhaps no great surprise that the Christmas period is one of the most stressful times of the year for many. According to the Money Advice Service’s 2013 Christmas spending survey:

  • 8 million people expressed concern about how they would afford Christmas this year and one in three UK adults said they expected to start 2014 in debt because of their Christmas spending.
  • 1.2 million people are expected to ask for loans from pay day lenders to fund their Christmas festivities this year.
  • One in 10 adults in November 2013 is still paying for Christmas 2012.
  • Two in five adults described feeling under pressure to spend more than they could comfortably afford to put on a special Christmas for their families.
  • One in four adults admitted to getting carried away with Christmas spending so that they end spending more than they can afford.

Add to these financial pressures the potential added strains in the workplace over the winter months such as travel disruption due to bad weather, winter colds and flu, increased stress in the workplace due to workloads and the effects of ongoing Christmas festivities, and the workplace has the potential to become a boiling pot for mental and physical health issues. If you’re an employer who is concerned about the health of your staff, or a worker who is having work-related health issues, why not view the resources on the Health for Work Adviceline website?

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HSE figures show extent of illness related to work in UK


Photo by JD Hancock via Flickr, under Creative Commons Licence

Figures from the Health and Safety Executive’s (HSE) annual statistics for 2012/13 have helped shed some light on the extent of the issue ill health related to work. The report has shown that 22.7 million working days were lost in the UK due to illness related to work during 2011/12*, and 1.1 million people who worked during the last year were suffering from an illness (long-standing as well as new cases) they believed was caused or made worse by their current or past work.

In terms of the specifics regarding work-related ill health:

  • Around 80% of self-reported new work-related health conditions comprised musculoskeletal disorders or stress, depression or anxiety.
  • Musculoskeletal disorders constitute the most common form of work-related ill health although mental health issues give rise to the most working days lost.
  • The industry sectors with ill health rates statistically significantly higher than the rate for all industries were human health and social work activities, public administration and defence, and education.

In general, however, the UK is faring fairly well in comparison with other EU countries in terms of fatal injury rates, non-fatal accidents and rates of work-related ill health resulting in sick leave (see the HSE report for more detail). However, this should be no reason for stepping back our efforts to prevent work-related ill health, and support those who are ill to remain in the workforce, where possible.

The free Health for Work Adviceline offers free, professional advice to organisations (employers and staff) on work-related health matters, as well as to GPs who are seeking guidance on the effect that work might be having on a patient’s existing health condition, or whether a particular illness might prevent a patient from doing a particular job. Visit our website to access guides on a whole host of occupational health topics.

* No Labour Force Survey data for ill health is available for 2012/13

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Working conditions in Amazon warehouse. Are workers under too much stress?

Photo by toolstop via Flickr, under Creative Commons Licence

Photo by toolstop via Flickr, under Creative Commons Licence

Amazon has featured strongly in the news this week with reports about warehouse workers at its Swansea warehouse being under inordinate amounts of stress. A man secretly filming his work as a picker at the warehouse reported working long shifts, covering long distances on foot (just under 11 miles in one shift in one case), and working under constant stress due to a scanner timing how long it took him to pick each item and beeping if he took too long, and the threat of disciplinary action if he didn’t work at a fast enough rate. However, Amazon has defended the expectations it places on staff and describes worker safety as its ‘number one priority’.

Those working in warehouse operations are subject to a number of job-specific hazards, including:

  • falls from height (e.g. when reaching high shelving);
  • moving and handling heavy or large items;
  • slips, trips, falls;
  • falling objects;
  • operation of lift trucks;
  • traffic movement (e.g. delivery vehicles);
  • risks posed by the use of equipment (e.g. conveyor belts, stretch wrapping machines, etc.).

These aspects are just some of the notable potential hazards that need to be considered by those employing staff to work in warehouse environments in order to keep employees safe, which gives some indication of the complexities of employing staff to do this kind of work.

Regardless of who is right or wrong in the case of the order picker versus Amazon, this story has highlighted the issue of warehouse working, especially in the run-up to Christmas when businesses take on vast swathes of new staff to service demand over the festive season. With order volumes increasing dramatically during the pre-Christmas season, and companies determined not to let customers down for fear of losing face with consumers and stakeholders, it is perhaps not altogether surprising that some businesses lose sight of the importance of looking after the health of staff. Thankfully, the Health for Work Adviceline website is available to offer professional guidance on work health issues in order to help organisations avoid making the mistake of neglecting the health of staff.

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