Category: depression

Chronic disease report

The Australian Institute of Health and Welfare has released a report on the labour force effects of chronic illnesses.  The report, Chronic disease and participation in work,

shows that chronic diseases are associated with more days off work and/or being out of the workforce, and some of the biggest culprits are depression, arthritis and asthma.

The report focuses on chronic illnesses rather the workplace impacts of the illnesses themselves but there is information that is relevant to how we manage our employees and psychosocial hazards.  For instance the report says

Arthritis, asthma and depression were associated with 76% of the total loss due to days away from work (29% associated with depression, 24% with arthritis and 23% with asthma).

For people participating full-time in the labour force, there was a loss of approximately 367,000 person-years associated with chronic disease, approximately 57,000 person-years in absenteeism associated with chronic disease and 113,000 person-years were lost due to death from chronic disease.

The report acknowledges that any estimates of loss are underestimated and also provides very useful data on chronic diseases and absenteeism

Loss due to absenteeism from full-time and part-time employment was calculated as the difference between the number of days off work for people with chronic disease, and the number expected if age and sex-specific rates of absenteeism among people without chronic disease applied.

The loss from absenteeism associated with chronic disease was approximately 500,000 days per fortnight. This was equivalent to approximately 13.2 million days per year or 57,000 person-years of full-time participation (assuming 48 working weeks of 5 days duration with 10 public holidays per year).

About two-thirds of this cost was carried by males, and people aged 35-44 and 45-54 years accounted for the majority (75%) of lost days.

Analysis of absenteeism by specific chronic disease showed that depression, arthritis and asthma were associated with around 76% of days away from work.

A sort-of resolution for Paula Wriedt

Paula Wriedt, a Tasmanian Member of Parliament who attempted suicide in August 2008, resigned on 18 January 2009.  According to her media statement

“I have made a significant recovery since my hospitalisation in August, but I believe it is in my best interests, and the interests of my family, to concentrate on improving my health away from the daily pressures of being a member of Parliament.

“This illness has had a significant impact on my life.

“The many demands I faced last year, on both a professional and personal level, meant I neglected to take stock of my health until it was too late.

“During this time, I made a mistake by forming an inappropriate relationship with a member of my staff. This had significant implications for the families involved, and I am not proud of my actions.

“I deeply regret the hurt that has been caused by this.”

She goes on to speak positively of undertaking meaningful work outside of politics.  It is hoped that Paula does not feel obliged to follow other politicians into promoting depression support services.  For most Australians Paula Wriedt will be associated with her affair and suicide attempt.  Tasmanians should remember her as a good parliamentarian, as mentioned by the current Premier David Bartlett (who is only slightly older than Paula at 41), and for her achievements in the education portfolio.  

Kevin Jones

Other post concerning Paula’s situation are available by searching for “Wriedt” in the field below.

Mental support research

In SafetyAtWorkBlog in 2008 there have been several posts concerning suicide.  There is a growing research base on the matter and The Lancet adds to this through an article published in December 2008.

Researchers have found that the type of mental health services provided to the community can affect the rate of suicide.  This is important research even though SafetyAtWorkBlog regularly questions the applicability of research undertaken in Scandinavian countries to the rest of the world.  Bearing the cultural differences in mind, the research will stir debate and, hopefully, localised research along the same lines.

Below is the text of the press release about the research:

WELL-DEVELOPED COMMUNITY MENTAL-HEALTH SERVICES ARE ASSOCIATED WITH LOWER SUICIDE RATES

Well-developed community mental-health services are associated with lower suicide rates than are services oriented towards inpatient treatment provision in hospitals. Thus population mental health can be improved by the use of multi-faceted, community-based, specialised mental-health services. These are the conclusions of authors of an Article published Online first and in an upcoming edition of The Lancet, written by Dr Sami Pirkola, Department of Psychiatry, Helsinki University, Finland, and colleagues.

Worldwide, the organisation of mental-health services varies considerably, only partly because of available resources. In most developed countries, mental-health services have been transformed from hospital-centred to integrated community-based services. However, there is no decisive evidence either way to support or challenge this change.

The authors did a nationwide comprehensive survey of Finnish adult mental-health service units between September 2004 and March 2005. From health-care or social-care officers of 428 regions, information was obtained about adult mental-health services, and for each of the regions the authors measured age-adjusted and sex-adjusted suicide risk, pooled between 2000 and 2004 – and then adjusted for socioeconomic factors.

They found that, in Finland, the widest variety of outpatient services and the highest outpatient to inpatient service ratio were associated with a significantly reduced risk of death by suicide compared to the national average. Emergency services operating 24 hours were associated with a risk reduction of 16%. After adjustment for socioeconomic factors, the prominence of outpatient mental-health services was still associated with a generally lower suicide rate.

The authors conclude: “We have shown that different types of mental-health services are associated with variation in population mental health, even when adjusting for local socioeconomic and demographic factors. We propose that the provision of multifaceted community-based services is important to develop modern, effective mental-health services.”

In an accompanying Comment, Dr Keith Hawton and Dr Kate Saunders, University of Oxford Department of Psychiatry, UK, say: “The message to take from these findings must be that while well thought out and carefully planned new developments that increase access to secondary care services for mental-health patients are to be encouraged, measured progress towards flexible community care, not rapid ongoing change, should be the order of the day.”

 

Sexual harassment and occupational health and safety

Some old-time safety professionals are struggling with the inclusion of psychosocial hazards in their safety management programs.  Some deny the relevance of sexual harassment to their duties and hope that the issue can be contained within the human resources department, the “dark arts” of workplace safety. 

Many of these same safety professionals are calling for more evidence-based decisions on workplace safety.

Evidence is now in on the social and work impact of sexual harassment. Australia’s Human Rights Commission has issued Effectively preventing and responding to sexual harassment: A Code of Practice for employers‘  which states on page 48

Employers have a common law duty to take reasonable care for the health and safety of their employees. This common law duty is reinforced by occupational health and safety legislation in all Australian jurisdictions.

An employer can be liable for foreseeable injuries which could have been prevented by taking the necessary precautions. As there is considerable evidence documenting the extent and effects of sexual harassment in the workplace, it has been argued that the duty to take reasonable care imposes a positive obligation on employers to reduce the risk of it occurring.

A work environment in which an employee is subject to unwanted sexual advances, unwelcome requests for sexual favours, other unwelcome conduct of a sexual nature, or forms of sex-based harassment, is not one in which an employer has taken reasonable care for the health and safety of its employees. A work environment or a system of work that gives rise to this type of conduct is not a healthy and safe work environment or system of work. An employer could be regarded as not having acted reasonably to prevent a foreseeable risk if practicable precautions are not taken to eliminate or minimize sexual harassment in the workplace.

Failure to fulfil the duty of care can amount to a breach of the employment contract as well as negligence on the part of the employer. This means that an employee who has been harmed could bring an action against their employer in contract or tort.

The guide can do with considerable translation to what businesses see as useful codes of practice in the application of safety management but perhaps that is for the private sector and State OHS regulators to work on.

There seems to be enough information available now on sexual harassment, fatigue, bullying, violence, fitness for work, shift work, depression and other matters, that the safety profession should be more embracing of these concepts in their own planning.  Let’s hope that in this discipline we do not have to wait for generational change to achieve a change in approach.

sexual-harassment-cop2008-cover

Important victory for aircraft maintenance workers

The Department of Veterans’ Affairs may have to pay compensation to the maintenance crews of F-111 fighter planes.  In the 1970s employees worked within the fuel tanks of the fighters with little, if any, PPE.  In 2004 these workers were excluded from a healthcare and compensation scheme even though, according to one media report, evidence was presented that the workers had

  • a 50% increased risk of cancer
  • a two-fold increase in obstructive lung disease;
  • a two-and-a-half fold increase in sexual dysfunction; and
  • a two-fold increase in anxiety and depression.

One of the reasons the maintenance crews were denied compensation was that the Royal Australian Air Force (RAAF) had destroyed the maintenance records from before 1992.

An inquiry into the affair has received a submission from the commonwealth Ombudsman, John McMillan, and Labor MP, Arch Bevis, that strongly criticised the destruction and inadequacy of records.

In safety management, record-keeping is often seen, and dismissed, as “red tape”.  The reduction of red tape is not the elimination of red tape and the reality of Australia’s increasing litigious legal system is that more records need to be kept, and for longer, than ever before.

Perhaps, the government, in its pledge to reduce red tape and business costs, should look at the lawyers’ insistence to business that the first port-of-call after an industrial incident is to call them so that everything becomes covered by legal-client privilege.

Perhaps it is the pressure to create paperwork than the paperwork itself that is the problem.  In the case of the F-111 maintenance crews, regardless of the lack of paperwork, justice seems to be happening.  It is just sad that so much pain and suffering had to be endured before getting close to a resolution.

Click HERE for a personal reflection on the health issues of the workers from one of Australian Rugby League’s champions, Tommy Raudonikis.

Physical activity, mental health, alcohol consumption and productivity

The Victorian Government’s workplace health strategy may be “coughing up blood” but health promotion continues.  Last week, Australian health insurer, Medibank Private, released some statistics and cost estimates related to physical inactivity.

According to the media release, physical inactivity costing the Australian economy $13.8 billion a year. The findings are based on research conducted in conjunction with KPMG-Econtech which builds on Medibank’s 2007 research and “captures the healthcare costs, economy wide productivity costs, and the mortality costs of individuals passing away prematurely as a result of physical inactivity.”

Craig Bosworth of Medibank Private says, 

“Most Australians are aware of the benefits of physical activity but this latest round of Medibank research has revealed some alarming effects of physical inactivity. An estimated 16,179 people die prematurely each year due to conditions and diseases attributable to physical inactivity and that is frightening. And whilst the majority of these are from the older population there is also a large number of people dying under 74 years of age due to physical inactivity, particularly in the male population.”

Bosworth goes on to say:

“Like other health risk factors, physical inactivity can have an adverse effect on organisations as well as individuals. Specifically, physical inactivity can impact on employee productivity by causing increased absenteeism and presenteeism, which impose direct economic costs on employers. The Medibank research has found that productivity loss due to physical inactivity equates to 1.8 working days per worker per year.”

Three audio statements on this research are available – physical-inactivity-telephone-grabs-edit

The SuperFriend Industry Funds Forum Mental Health Foundation has also released statistics on mental health in the workplace. The survey also found that 50 per cent of Australians admit to often feeling stressed and a quarter often feel depressed. 

John Mendoza, Chair of SuperFriend’s Mental Health Reference Group, said, “There is increasing evidence of a link between stress in the workplace and mental illness. The cost of workplace stress to Australian business is potentially crippling.” Listen – workplace-mental-health-edit

The Superfriends survey found

StreetWise
StreetWise
  • One in two Australians believe that having a few drinks is a good way to maintain or improve their mental health;
  • 80 per cent of Australians believe watching TV has a positive impact on their mental health;
  • Australians are putting their bodies ahead of their brains, with three-quarters of Australians engaged in activity to maintain or improve their physical health, while only 50 per cent are actively engaging in activity to maintain or improve their mental health.
  • Older Australians are more likely to heed the call ‘use it or lose it’. While 57 per cent of all Australians feel they take good care of their mental health, 68 per cent of those over 50 feel they are looking after themselves emotionally.
  • Australians aged 40 to 49 are the unhappiest and unhealthiest. Those in this age group are more likely to feel stressed and depressed and less likely to look after their physical and mental health.

A good starting point in planning to manage stress is the StressWise publication by WorkSafe Victoria.

For many decades, perhaps centuries, unhappiness at work was countered, to varying degrees, through the consumption of alcohol.  According to the latest Australian Unity Wellbeing Index people who drink everyday are the happiest, whereas non-drinkers have a lower sense of wellbeing.

Amanda Hagan of Australian Unity summarises some of the research findings and supports the link between physical activity and positive wellbeing. Listen – australian-unity-wellbeing-index-aap-medianet-edit

WorkHealth – end is nigh after less than one year

Early in 2008, the Victorian Government sprung a surprise on the OHS and health promotion industries by announcing a world-first initiative – WorkHealth.  This program was to be funded by interest generated from the WorkCover scheme to the tune of hundreds of millions of dollars over the next five years.

WorkHealth loses stakeholder support

Two weeks ago, a well-respected OHS professional advised that key stakeholders in WorkHealth were very cool on the program.  This confirmed previous questions raised in SafetyAtWorkBlog about the promotion, transparency and organisational support for WorkHealth.  The professional stated that others were questioning the placement of WorkHealth in the OHS field rather than in health promotion.

Rumour has existed for some months that WorkHealth is a scheme that has been pushed by a narrow range of OHS and workers compensation advocates.

What made WorkHealth so interesting was that the concept originated from within the workers compensation field with workers compensation money.  At the time, the wisdom of committing such a large amount of money to the initiative was questioned by many in the trade union and business areas.  Why head in this direction when there were established mechanisms to reduce OHS and workers compensation costs?

The global economic problems, it is suspected, would have flowed to the investments of the WorkCover scheme and it would be interesting to know what the revenue allocation to WorkHealth now is calculated at.

OHS/Industrial Relations conflict

In The Age newspaper on 26 October 2008, WorkHealth gained some attention as business groups have now seen the criteria for the health assessments of workers.  David Gregory of the Victorian Employers’ Chamber of Commerce and Industry described the criteria as a potential “industrial weapon”.  According to the article,

“WorkSafe told The Age the idea of an initial ‘tick test’ screening process had been abandoned, and the proposed $130 million worth of prevention programs are not in the pilot at all.”

As is evident from the quote, it is the pilot scheme that is being rolled out, however it is clear from the comments of David Gregory and the state secretary of the Australian Manufacturing Workers’ Union, Steve Dargavel that industrial relations sensitivities have not been considered.

Gregory makes excellent points that good OHS professionals are already aware of – workplace safety can only succeed when industrial relations implications and conditions are considered before any intervention process.

OHS has broadened to include the hazards of fatigue, stress, anxiety, depression, workloads, bullying and other matters that have encroached on health promotion and human resources over the last decade or so.  A worker health program would have been more likely to be accepted through this osmosis rather than a surprise announcement.

Is this the end?

WorkHealth could work if it had been generated as a workplace application of public health programs.  The challenge would have been to legitimise the expenditure in an already cluttered health promotion sector.  How would WorkHealth have achieved this testing regime when business is already assessing its workers for psychological disorders, cholesterol, prostate health, hearing, asthma, and a whole range of modern health issues?  It is unlikely that it could so.

It came down to health assessments in a different context – a context where there had been insufficient groundwork to establish the value of the program to its fundamental stakeholders, the unions and employer groups.  To a much lesser extent, the program was not sufficiently integrated into the WorkSafe authority’s program before the announcement.

Also, the timing has been proven to be wrong.  The global economic problems are beginning to squeeze business’ bottom line.  The calls for workers’ compensation premium relief will increase in the same way that businesses have begun questioning the viability of an emissions trading scheme.  WorkHealth is likely to be one of those program cut, so the government will claim, due to the changing economic climate.  The lessons to be learnt are more wide-ranging than just economics.

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