The rapid development of workplace health protective and preventive services has been driven by government strategies and recommendations and the European Union legislation in health and safety at work and by the European Commission program in public health. This was also largely due to the new demands and expectations from employers, employees, and their representative bodies as they recognize the economic, social, and health benefits achieved by providing these services at the workplace, thus providing the available knowledge and evidence necessary for the continuous improvement of workplace health management.
Comprehensive workplace health management is a process involving all stakeholders inside and outside any business. It aims at empowering them to take control over their own health and their family’s health considering environmental, lifestyle, occupational, and social health determinants and quality of health care. It is based on health promotion principles, and it creates a great challenge to health, environment, and safety professionals providing services, advice, information, and education to social partners at work. It also involves taking care of the considerable socioeconomic interest of all involved stakeholders. It has been shown in several instances that the business utilizing well-managed research-based occupational health service can gain a competitive advantage by:
Protecting human health against health and safety hazards occurring in the work environment.
Promoting human health workplaces for all ages and healthy aging by appropriate work culture, work organization, and social cohesion support.
Promoting mental health, healthy lifestyle, and preventing major non-communicable diseases using specific workplace health policies and management tools.
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Maintaining workability thus also employability throughout working life.
Reducing health care costs caused by employees’ and employers’ injuries, diseases, illnesses, and premature retirement resulting from or influenced by occupational, environmental, lifestyle, and social health determinants
Using resources effectively, protecting the natural environment, and creating a healthy, supportive environment.
Improving social communication and literacy on health, environment, and ethics.
This article series describes the author’s observations of various roles undertaken by the occupational health nurse. Whilst recognizing the wide variation in occupational health nursing practice between different industrial and blue-collar environments, this series reflects the standards that have already been achieved where occupational health nursing is at its most advanced.
However, it has to be recognized that the level of education, professional skills, and the existing national legislation determines what role can actually be undertaken by occupational health nurses. Even more important is to remember that no one professional out of the exiting workplace health professions can now meet all health needs of the working population. A multi-disciplinary approach is needed to effectively manage the growing workplace health and safety demands in business today.
The workplace health services use many professionals such as specialist occupational physicians, safety engineers, occupational hygienists, occupational health nurses, ergonomists, physiotherapists, occupational therapists, laboratory technicians, psychologists, and other specialists. The role and tasks actually performed for the companies by representatives of different health and safety professions vary greatly depending upon legislative needs, the scope of the workplace health concept perceived by directors, enforcement practice, the level of their education, position in the occupational health infrastructure, actions undertaken by insurance institutions and many other factors. Occupational health nurses are the largest single group of health professionals involved in delivering health services at the workplace and have the most important role in workplace health management. They are at the frontline in helping to protect and promote the health of the nations working population.
The occupational health nurse’s role in workplace health management is a new and exciting concept designed to improve the management of health and health-related problems in the workplace. Specialist occupational health nurses can play a major role in protecting and improving the working population’s health as part of this strategy. Occupational health nurses can also make a major contribution to sustainable development, improved competitiveness, job security, and increased profitability of businesses and communities by addressing those related to the working population’s health.
By helping to reduce ill health, occupational health nurses can contribute to organizations’ increased profitability and performance and reduce health care costs. Occupational health nurses can also reduce the externalization of costs onto the taxpayer by preventing disability and social exclusion and improving rehabilitation services at work. By protecting and promoting the health of the working population and promoting social inclusion, occupational health nurses can also contribute to building a caring social ethos within the UK. This article provides guidance to employers and employees on establishing workplace health management systems within their own organizations. How to determine and develop the occupational health nursing specialist’s role and functions within each enterprise and where to go for additional help and advice about occupational health nursing.
Changing nature of working life and the new challenges
The world of work has undergone enormous change in the last hundred years. To a large extent, the very heavy, dirty, and dangerous industries have gone, and the burden of disease, which came with them, in most European countries, has declined. However, the new working environments and conditions of work that have replaced them have given rise to new and different concerns about the working population’s health. Exposure to physical, chemical, biological, and psychosocial risk factors at work is now much more clearly linked to health outcomes in the general public’s mind.
Expectations of society regarding health at work have also changed, with increasing demands for better standards of protection at work and the improvement of the quality of working life. Employers are also recognizing that health-related issues, such as sickness absence, litigation, and compensation costs, increasing insurance premiums, are expensive; ignoring them can lead to serious economic consequences. The best employers emphasize the important message that good health is good business and that much can be achieved in this field simply by introducing good management practices.
The Need for Workplace Management
There are approximately 400 million people who work in the EU Member States. The majority of whom spend more than one-half of their waking life at work. However, fatal accidents at work are still common. The standardized incident rates per 100,000 workers in the European Union show that the fatal accident rate varies between 1.6 in the UK to 13.9 in Spain, Austria, Greece, France, Italy, and Portugal, all above 5.0%. There are approximately 200 to 7500 non-fatal accidents per 100,000 employees per year in the entire European region. Around 10% are severe, leading to over 60 days absence from work, and up to 5%, per year, lead to permanent disability.
It has been estimated that the total cost to society of work-related injuries and ill-health in the European Union is between 185 billion and 270 billion ECU per year, which represents between 2.6% to 3.8% of Gross National Product (GNP) in member states. In both financial and human terms, the cost of workplace accidents and ill-health remains an enormous, largely unrecognized burden in the UK.
The majority of those accidents and diseases could have been prevented if appropriate action had been taken at the workplace. Many responsible employers have consistently demonstrated that by paying attention to these issues, this type of harm and the subsequent costs can be avoided, to the benefit of everyone concerned. An increasing concern is the growing awareness of occupational stress. Up to 42% of workers in a recent survey complained about the high pace of work. Job insecurity, fear of unemployment, lack of a regular salary, and the potential loss of workability are additional sources of stress, even for those in employment.
The wide-ranging social and health effects of occupational stress on the working population’s health are well documented; for example, 23% of workers surveyed claimed that they had been absent from work for work-related health reasons in the previous twelve months. The resulting cost of sickness absence in the United Kingdom is considered to be substantial. In the UK, 177 million working days were lost in 1994 due to sickness absence; this has been assessed at over 11 billion in lost productivity.
HSE statistics were encouraging given that in 2009, only 29.3 million days were lost overall, 24.6 million due to work-related ill health, and 4.7 million due to workplace injury. Much of this burden of ill health and the resulting sickness absence is caused or is made worse by working conditions. Even ill-health is not directly caused by work, but by other non-occupational factors such as smoking, lifestyle, diet, etc. Interventions designed to improve the health of the working population, delivered at the workplace, may reduce the burden of ill health. At present, the socioeconomic impact of environmental pollution caused by industrial processes on the working population is uncertain. Still, it is likely to contribute further to the burden of ill health in some communities.