Learning from different industries to improve safety, health, and well-being at work

Each industry has a unique set of workplace conditions, factors, environmental and occupational hazards, as well as organizational policies and practices that require careful planning to ensure the safety, health, and well-being of employees.

During the last four years, I have been working alongside and learning from scientists at Oregon Healthy Workforce Center (OHWC) at Oregon Health & Science University who conduct research to reduce injuries, improve health, and increase overall well-being for employees across different industries, using organization-focused approaches. In particular, these scientists and their hardworking teams are researching and developing workplace programs using the National Institute for Occupational Safety and Health’s (NIOSH) Total Worker Health® framework.

Total Worker Health® is defined by NIOSH as “policies, programs, and practices that integrate protection from work-related safety and health hazards with promotion of injury and illness-prevention efforts to advance worker well-being”, and is a holistic approach to improving the safety, health, and well-being of the worker. The core pieces in this holistic approach to worker well-being are addressed in NIOSH’s Fundamentals of Total Worker Health® document and offer these guiding principles:

· Engage leadership buy-in and commitment at all levels of the organization.

· Design the workplace to remove and/or reduce workplace safety hazards.

· Support workers in program engagement, implementation, and evaluation.

· Ensure confidentiality and respect the privacy of workers.

· Address issues at work to improve overall well-being.

In this article, I highlight six industries that I knew little about before working at the Oregon Healthy Workforce Center. Much of this information was eye-opening. Through ongoing research projects, I learned of the unique workplace safety and health concerns workers in these industries face when they go to work every day. It is important to acknowledge that we all come from all walks of life, experience the work-life and home life differently, and most importantly, have jobs that put us in a variety of working conditions and environments that can expose us to different hazards in the workplace.

Homecare

Homecare workers typically work in isolated settings and are at increased risk to injuries, such as sprains, strains, and other musculoskeletal injuries from moving and lifting consumer clients, and from slips, trips, and falls. It is sometimes difficult to protect these caregivers from workplace hazards because they often work alone and may lack access to training, ergonomic tools, and lack of social support from colleagues. Additionally, homecare workers can face harassment and violence at work, often unintentionally, from their clients leading to stress, burnout, depression, and sleep problems.

Homecare workers’ job duties generally include assisting older adults and people with disabilities with self-care and mobility in in-home settings with day-to-day activities, such as cleaning, cooking, bathing, dressing, grooming, and shopping. Many homecare workers make below-average wages with little to no benefits. However, they can make above minimum wage and receive full benefits if they work a total of 40 hours per month and an average of 10 hours per week. Injury rates for these workers are nearly four times higher than the U.S. average and they are at increased risks for mental and physical health problems.

Scientists, Dr. Ryan Olson and his research team at the Oregon Healthy Workforce Center (OHWC) partnered with the Oregon Home Care Commission to study and help improve the safety, health, and well-being of home care workers. These research efforts resulted in a toolkit called Communities of Practice And Safety Support (COMPASS). COMPASS includes a peer-led social support group that meets in person across 13 meetings that are designed to improve social resources, reduce the risk of injuries, and promote health and well-being among caregivers.

The COMPASS study included 149 homecare workers that were coordinated through the Oregon Home Care Commission that were compensated for their time to participate in the study. From the COMPASS study, researchers found that:

· 50% corrected slip, trip, and fall safety hazards and showed improvements in home care workers reporting improved safety practices on the job.

· 58% of home care workers participating in the study had more safety conversations with the consumers they serve.

· 60% and more reported eating more fruits and vegetables, and also a more enhanced professional social support network.

COMPASS has been adopted by the Oregon Home Care Commission and offers homecare workers a stipend and credits towards their professional development certification, to participate in the program. This continued partnership has since produced an online training for facilitators to help implement the toolkit, the translation of COMPASS into multiple languages, an adapted version of the program to include fewer meetings (7 versus 13 meetings), and a new version of the program’s guidebooks adapted to personal support workers, who provide in-home service to those experiencing intellectual and developmental disabilities.

The COMPASS toolkit is a free program and provides a format for in-person or virtual social support group meetings with 5 to 12 home care workers, where they can come together to learn and discuss lessons on injury prevention and health promotion topics relevant to home care across. In addition, the home care workers participate in team activities, group problem solving, and individual goal setting. Home care workers can increase social support, improve physical and psychological well-being, and reduce hazards in the homes they work within.

Construction

Construction workers in the U.S. are 3 to 5 times more likely to be injured or killed on the job compared to workers in other industries. Slip, trips, and falls are common and leading causes of deaths and injuries in construction, making up over 1/3 of fatalities and injuries for this industry. Construction work is physically demanding and workers are often exposed to physical and chemical workplace hazards.

U.S. construction workers face health risks such as having higher BMI, blood pressure, and obesity rates than the average adult males in America. These health risk behaviors include smoking, binge drinking, lack of sleep, no leisure-time physical activity, and not using a seatbelt. Research from NIOSH shows that certain health risk behaviors are higher in construction workers.

Supervisors and managers are oftentimes selected for their technical skills or experience, so they may need training in team building and supervision skills to support their employees’ work-life, on and off the job. Managers and supervisors are key to better health and safety in all organizations. By learning the skills and techniques proven effective, managers, supervisors, and lead workers in construction will more effectively teach and support safety and influence employees.

Researchers, Dr. Kent Anger and his team at OHWC developed BeSuper! to help the construction industry and their organizations improve safety, health, and well-being by educating supervisors on effective supervision, safety practices, and health promotion. BeSuper! was tested in a study with construction workers across four commercial construction companies. During a 14-week period, the study included program components consisting of online training for supervisors and managers to better support employee safety, health, and well-being, two weeks of behavior tracking (think of this as a fitness or food log, but for supporting employee well-being and safety), and health promotion team discussions with take-home activities. The study found important improvements in safety, health, and well-being for construction workers, such as:

· Decreases in pain and decreases in unhealthy food consumption including sugary snacks, sugary drinks, fast food, and caffeine.

· Increases in supportive supervisor behaviors and supervisor skills and knowledge.

· Improvements in healthy lifestyle knowledge, social support for a healthy diet, exercise behaviors, strength, and sleep duration.

The BeSuper! user guide and toolkit components are available to download on YourWorkpath.com.

Young workers

Young workers between the ages of 14 and 24 are at an increased risk for occupational injuries and are more likely to be injured on the job than older workers due to limited on-the-job experience, lack of training, and lifestyle habits. As many as 84% of young workers receive little or no training on workplace health and safety during their onboarding period of their new, and often, very first job. A way to reduce occupational injuries is through a workplace safety training program, which has been shown to effectively reduce the number of workplace injuries.

April to July, 2020 the U.S. saw an increase of 16 to 24 year old entering the workforce. With an increase of young workers in the workforce during the time of the pandemic, the need for workplace programs to keep young workers safe and well is even more critical as young workers tend to be employed in front-line industries such as retail, hospitality, restaurant, leisure, and similar industries.

Young workers are more likely to be injured on the job and are less likely to advocate for their right to safe work. Each organization must provide and ensure that the workplace is free of unsafe and/or dangerous equipment, safety training, access to supervisor support, as well as an awareness and education towards working conditions that may cause stress or pressure on young workers.

Scientist, Dr. Diane Rohlman studied young workers to help develop Promoting U through Safety and Health (PUSH), a Total Worker Health toolkit geared toward protecting young workers from workplace hazards, and enhancing employee well-being at work and outside of the workplace. The purpose is to engage supervisors and young workers in conversations about safety and health in the workplace. Portland Parks & Recreation partnered on the PUSH study to help provide standardized training for new hires in their Aquatics department.

PUSH is a scientifically-based toolkit that has been tested among 140 young adults at Portland Parks & Recreation Aquatics Department. From the study, scientists found:

· Over 95% of participants in the study learned something new.

· 58% enjoyed the PUSH training.

· 67% reported changing safety and health behaviors as a result of the training.

· An increase in safety and health knowledge for the young workers that participated in the program.

The PUSH toolkit includes a 50-minute self-paced online training to teach young workers about workplace safety, communication and health, and team-based activities called, “Start the Conversation” to tie in the lessons learned in the PUSH online training and to help with team building and open discussions around occupational safety and health. Additionally, focus groups and engagement surveys were conducted.

Since the dissemination of the toolkit into the community, St Louis Community College has started to plan a virtual roll-out of the PUSH program as an employee safety, health, and well-being training offering in Fall 2021 and beyond.

Promoting U through Safety & Health (PUSH) is a toolkit designed for organizations to reduce workplace injuries, increase healthy habits, and build communication skills. In turn, these outcomes could result in a healthy and productive young workforce.

Call-center and Sedentary workers

Sedentary behavior is a public health issue that has grazed many headlines. Sitting too much has been linked to health outcomes such as obesity, cardiovascular disease, diabetes, musculoskeletal injury, and increased risk of all-cause mortality.

The number of sedentary jobs in the U.S. has increased steadily since the 1960s, with over 30 million sedentary workers in the country. The call center industry reports some of the highest sedentariness in the U.S. and workers in these jobs, who may sit for over 80% of their time at work, are more likely to be sedentary during non-work time than employees in other sedentary jobs.

Previous research has shown that using standing or active workstations reduces workplace sedentary time, may reduce back pain and other musculoskeletal complaints. Also, it can help increase light physical activity throughout the day and overall caloric expenditure. Research shows that reduced sedentary time at work is related to improved mood, job satisfaction, and general well-being.

Dr. Brad Wipfli and his team at our center studied call center workers and strategies to reduce sitting time and improve overall workplace safety, health, and well-being for these workers. The Active Workplace Study and its resulting toolkit (available Fall 2021) aims to increase the use of active work stations like standing desks to impact and improve:

· Employee safety and health, as well as looking at different physiological markers such as hemoglobin A1C, blood pressure, and endothelial function.

· Key components of the Active Workplace toolkit, which is being adapted from call center workers to all sedentary working populations, include changing the work environment by using an active workstation like a standing desk, and organizational support and online training for health and safety for both managers and employees.

· Monthly supervisor and employee activities, paired with team competitions help engage workers to promote healthy and safe behaviors both, on the job and at home.

Results from the Active Workplace study are being analyzed and will be added to this article when they become available. The results and updates from the Active Workplace study and the full toolkit will be available in Fall 2021.

Team truck drivers

In 2018, the Bureau of Labor Statistics reported approximately 7.4 million people in the United States are employed as truck drivers, which makes up 5.8% of the U.S. full-time workforce.

Long-haul truck drivers often drive up to 11 hours per day and spend an average of 60 hours per week on the road. This work population has a high risk for drowsiness and fatigue while driving. Sleeping conditions are uniquely challenging due to long, irregular work hours and a truck sleeping environment that can be disrupted with noise, whole-body vibrations, and uncomfortable temperatures. Compared to solo drivers who sleep in parked vehicles, team drivers are twice as likely to wake up during their sleeping hours while on the clock, with vehicle movements and vibrations as a major important contributing factor.

Sleep health has been linked to a high risk of obesity, chronic disease, and early mortality. Long haul team truck drivers, where one driver sleeps in a moving vehicle while the other partner drives face challenging sleeping conditions given their environment on the road. Team drivers experience sleep disruption twice as often as solo trucker drivers.

Sleep deficiency, or insufficient quantity and/or quality of sleep has been linked to occupational safety and vehicle crashes and also with chronic disease, and early mortality. The sleep challenges and long sitting durations of trucking can easily trap drivers in ever-worsening negative feedback loops between the areas of sleep, health, and safety.

Scientist, Dr. Ryan Olson, and his research team wanted to learn more about how team truck drivers can better manage their sleep schedules, reduce fatigue, and examine available technologies that impact driver sleep and fatigue. Tech4Rest was a collaborative research study between OHWC and the University of Washington. The study looked at the effects of a multi-component intervention on truckers’ sleep health and safety. The intervention study includes a combination of physical changes in the truck to include an enhanced mattress and seat designed to reduce whole-body vibration and a behavior-change focused training for sleep hygiene.

This pilot study also showed that higher levels of whole-body vibration exposures may affect the alertness of truck drivers and contribute to overall cognitive fatigue. While the study is ongoing, the pilot study found:

• All 16 truck drivers that participated in the study preferred the therapeutic mattress.
• Small differences between the mattresses in the vibrations experienced by the mattress occupants.
• The unexpected factor creating the largest difference in vibration transmission through the mattresses was the type of tires on the truck.
• Compared to the standard innerspring mattress in trucks, the therapeutic mattress produced small increases in sleep duration but medium-to-large improvements in reported sleep quality and fatigue.
• There was not a way to link the vibration differences to the overwhelming preference for the therapeutic mattress.

Pilot study results can be found here. Tech4Rest will be publishing one-page summaries of initial research findings and will make them available to the industry in Winter 2021. Full Tech4Rest study results will be available in Spring 2021.

Leaders and managers in any industry

Each year, American Psychological Association (APA) conducts a “Stress in America” survey reporting that each year stress is a major cause of stress for Americans. The (APA) reports that long-term stress can be harmful to our physical and emotional health. Common sources of stress include low and inequitable salaries and wages, excessive workloads, lack of growth and advancements, engagement, low social support, autonomy and control over job-related tasks and decisions, and demands at work that are unclear or conflicting to a person’s job role.

How managers and supervisors support employees at work can impact employee health outcomes such as physical health and sleep quantity and quality, as well as work-life balance. We have heard this before, “people don’t quit their jobs, they quit their boss.”

The Harvard Business Review reports that supporting your employee’s mental health is one of the many tools that makes someone an effective manager. In addition, being able to mindfully invest in training and modifying practices and policies to be inclusive and building that incorporates a culture of check-ins is an important way to show your employees you care and support their safety, health, and well-being on and off the job.

OHWC Scientist Dr. Leslie Hammer developed the Safety and Health Improvement Program (SHIP) to help supervisors develop skills on how to better communicate with their employees and be more supportive leaders. In addition to online training, a daily behavior tracking sheet is used to help supervisors and managers reinforce what was learned in the online training, and to set goals and track their supportive behaviors when they interact with employees. Additionally, managers and supervisors facilitate discussions to improve team effectiveness, processes, and inefficiencies at work, as well as give a framework to help supervisors plan check-ins with their employees.

The SHIP study produced outcomes that included:

· Reduced worker blood pressure among the study population, specifically in the construction industry where 528 employees participated in the study.

· Improved perceptions of work team effectiveness and work-life balance, especially for workers who initially had weaker relationships with their supervisors and coworkers.

· Impacts on workers’ perception of their supervisors: Employee teams that saw the most improvements in safety, health, and well-being outcomes from the study when already had supportive supervisors before the study.

SHIP was developed to address supervisor support, job stress, and improve employee health and well-being. The SHIP online training and toolkit is available for free and ready to implement in all industry sectors that want to provide supervisor and manager training to help address areas of workplace safety, health, and well-being, and improve team effectiveness. SAIF, Oregon’s largest worker’s compensation insurance provider has partnered with Dr. Hammer and her team to disseminate the SHIP online training and toolkit as part of their Leadership series.

Final thoughts…

It is important to understand better that each workplace has a set of factors and needs that need to be met to keep their workforce safe, healthy, and well. Taking a Total Worker Health approach can help organizations create policies, practices, and training that can help employers holistically balance and address safety, health, and well-being at work. Oregon Healthy Workforce Center has developed and expanded organizational approaches across 10 years of research. There is still so much more work to be done.

Article by: Helen Schuckers, MPH, Dissemination Specialist and Research Associate at Oregon Healthy Workforce Center and Oregon Institute of Occupational Health Sciences at OHSU

This work was supported by the Oregon Healthy Workforce Center, a National Institute for Occupational Safety and Health (NIOSH) Total Worker Health Center of Excellence [grant number U19OH010154]. This work was also partly supported by the Oregon Institute of Occupational Health Sciences at Oregon Health & Science University via funds from the Division of Consumer and Business Services of the State of Oregon (ORS 656.630).