PROFESSIONAL SAFETY

Face-to-Face Interviews with NIOSH Steps to a Healthier US Workforce
Taskforce Members

Introduction

Experts agree that the current healthcare system has a life expectancy of about five to seven years before it implodes under its own weight. This impending crisis has not escaped the attention of NIOSH. Last October, NIOSH kicked off the first Steps to a Healthier US Workforce symposium in an effort to learn from the experts what can be done to help preserve the health and productivity of the American workforce.

John Howard, M.D., NIOSH Director, kicked off the 3-day “Steps” event with a Call to Action Keynote. “Our Symposium is the first event in a multi-year Initiative that NIOSH is launching in collaboration with its co-sponsors and supporters to bring a new, more coordinated approach to achieving the goal of healthier, safer American workers.”

The NIOSH Steps initiative brought together leaders from the occupational safety and health community with leaders from the health promotion community to take a first look at the science, policy and practice, and the economics of integrating injury prevention and health promotion programs at the worksite. In all three areas, researchers from Harvard School of Public Health, Cornell University’s Institute for Health and Productivity Studies, and the Rand Corporation presented white papers summarizing recent studies that strongly support the case for integration.

ASSE assembled a Wellness Taskforce to represent our organization at this landmark event. The taskforce members are Dave Heindorn, ASSE Director of Government Affairs; Jim Ramsay, Associate Professor of Safety and Health, Univ. of Wisconsin; Maureen Johnson, Regional Well-being Manager, IBM Corporation; and Fred Drennan (Taskforce Leader), President, Team Safety, Inc. Professional Safety interviewed them about their impressions of the first STEPS symposium, and what it means to the safety professional.

DAVE HEINDORN, Manager, Government Affairs, ASSE

PS: Why did ASSE involve itself in the NIOSH Steps Symposium?

A: An important element of ASSE's Government Affairs activities is to help ensure that public policy makers are aware of the knowledge and experience of ASSE members, thereby impacting government decision-making on matters concerning occupational safety and health. Through ASSE’s Partnership with NIOSH – recently renewed for three years on December 17, 2004 –ASSE and its members have opportunities to demonstrate that knowledge and experience in NIOSH activities like the Steps Symposium. Necessary for this involvement are members who want to step up and provide leadership in making this opportunity succeed. Fred Drennan, Jim Ramsay and Maureen Johnson were approached by ASSE to form a Wellness Task Force that provided the dynamic for ASSE participation in Steps. ASSE can open the door at federal agencies, but members like these are the ones who give life to that opportunity and step through the door.

PS: How do other ASSE members benefit from ASSE's involvement in Steps?

A: By ASSE members involving themselves in Steps, it spreads a positive awareness of ASSE member wellness capabilities. Participants that include corporate SH+E managers, other professional disciplines, and federal agencies learn about that capability. Without ASSE participation in Steps, there would have been little if any perspective from the safety professional's view on this issue that, based on the overwhelming interest in Steps, appears to be of quickly growing importance to employers. The members who participated set a stage for other members who want to make this issue part of what they can offer to employers. The common theme of Steps was employers' struggle to contain the quickly rising cost of providing health care coverage to their employees. Wellness efforts that reach beyond the company door can achieve cost savings. Steps opens the door for other members to make this issue part of their professional practice.

PS: How will ASSE further the Steps opportunity?

A: The Wellness Task Force will continue and will work to achieve other opportunities for ASSE and its members to provide leadership on wellness and help ensure the role of the safety professional in this issue. Integrating personal wellness with occupational safety and health is already a part of ASSE's 2005 PDC in New Orleans, as it has in previous years. ASSE, too, is looking to update publications on the issue. ASSE will cooperate with NIOSH in disseminating any wellness information that grows out of Steps and will work to help make sure NIOSH does not let the opportunity for furthering this issue that Steps has achieved. Wellness should have a permanent place in NIOSH's research and activity agenda each year. The success NIOSH had with Steps should breed greater opportunity for occupational safety and health stakeholders to develop more success on this issue.

JIM RAMSAY, PhD, MA, Assoc. Professor of Safety and Health, Univ. of Washington

PS. Is there really a lack of integration between safety and health programs at the worksite?

A: Yes! In fact, there was surprisingly little disagreement about this. Most at the Symposium indicated that safety is not well represented in the health policy debate. Most also agreed that there are several inherent economies of scale to be had by a more thoroughly integrated health and safety program: namely, health and safety programs share the same clientele, have similar objectives, have similar missions, and compete for the same time and dollars.

PS. What are some of the more major consequences to developing an “integrated” work environment?

A: As I see it, there are several immediate and some latent consequences to a federal policy initiative that looks to more completely integrates health and safety functions at the worksite. First, there are not enough safety practitioners right now who would know how to run comprehensive worksite health promotion programs. Conversely, most worksite health promotion practitioners know virtually nothing about running a compliant occupational health and safety program. Second, what might the curriculum look like that successfully trains an “integrated health and safety practitioner”? Third, moving to a more integrated practice environment suggests that academia needs to be positioned to produce PhDs who can educate and train tomorrow’s practitioners. Well, there is currently no PhD in SH&E and without a terminal degree in the discipline; the risk is that safety will continue to be under-represented in doctoral curricula.

PS. To what degree was the safety community and the environmental community represented at the Symposium?

A: ASSE was the only professional safety association represented at the Symposium. Further, it was clear that the environmental risk management community was not even aware of the Symposium and was not formally invited to my knowledge. Interestingly, I gave an invited presentation at the National Environmental Risk Managers’ Association meeting in Orlando in early October. The topic I was asked to present was on the logic and efficiencies of integrating environmental health and health promotion at the worksite. In my assessment, NIOSH and the CDC needs to offer a dedicated annual Symposia with lectures, workshops and activities designed to explore how integration might best be accomplished. Further, NIOSH and the CDC need to begin to fund R-01 grants that study how integration might be accomplished and how best to develop and promulgate doctoral programs in SH&E.

MAUREEN JOHNSON, Regional Well-being Mgr, IBM

PS. Why was it important for employers such as IBM to participate in this symposium?

A: I was proud to share information about IBM’s accomplishments in the area of “employee well-being,” IBM’s holistic approach to the integration of traditional occupational health and safety programs and preventative health/wellness. As part of our Well-being Management System, we value continuous improvement, which is made easier by learning from others. This symposium was a wonderful opportunity for people representing diverse organizations and disciplines – safety engineers, industrial hygienists, physicians, and wellness professionals from business, labor, academia, and government – to convene and share successes and challenges.

PS. The influence a business can have over employees’ lifestyle choices is pretty limited. Why not stick to workplace health and safety issues to drive a healthier workforce? Besides, wouldn’t a new focus on health promotion detract from health protection programs, resulting in more work-related injuries and illnesses?

A: Certainly an employer can’t control the lifestyle of employees, but we’ve learned from years of maintaining workplace safety programs the importance of giving working adults information to help them make good decisions. Just as we’ve informed employees why they should wear Personal Protective Equipment, we can offer information about their personal behaviors and possible consequences. We aren’t shifting, we are expanding our focus. We need to work with those we support, be it business, labor, etc., to control costs related to injury, illness, absence (be it work-related or not) and help people realize their full potential on the job.

PS. So, what’s next?

A: In my position, I’ve seen the value of removing the traditional “silos” where workplace safety and personal wellness programs are separate. With Safety Engineers, Industrial Hygienists, Occupational Nurses and Physicians, and Ergonomists united in one organization under the heading of “Well-being,” then with the addition of our health benefits professionals, IBM has an integrated approach to workforce well-being. The next steps to a healthier U.S. workforce must use the same open-minded, “no silos” methods, blending disciplines and unifying the groups who need to be involved. Given the enthusiasm I saw at the October symposium, I’ve no doubt this will happen.

FRED DRENNAN, Professional Safety Consultant, President, Team Safety, Inc.

Q. What surprised you most at the Symposium?

A: The biggest surprise was hearing that the symposium was sold out. It was gratifying to see considerable interest in integration. I was a little disappointed to find that attendance was overwhelmingly weighted toward MDs, Ph. Ds, and public health officials compared to safety professionals (only a handful.)

Q. How do you account for this disparity?

A: Two reasons: First, NIOSH has long-standing relationships with academia and public health organizations, a group that outnumbers safety professionals many times over. They are a well established research organization that focuses inherently on epidemiology and is largely supported by experts in that field. This alone would generate more attendance from that sector. Second, most safety professionals continue to focus on compliance and popular safety programs from behavior based safety to safety bingo. The relationship between lack of basic health and fitness and lost time injuries continues to slip under their radar screen. I’m hoping the Steps initiative will begin to enlighten management and safety in this regard.

Q. What will be biggest challenge in this endeavor?

A: As I see it, NIOSH has two major challenges: First, they must identify research and demonstration projects that convince key decision makers of the value to both large and small organizations. Employers who have already invested in less than successful worksite wellness programs (low participation, low ROI) may be reluctant to invest more.

Perhaps the biggest challenge will be to achieve a “meeting of the minds” between two very different professions: health promotion and industrial safety. For over 30 years safety professionals have reduced frequency, severity, and fatalities in the work place. Just the opposite has occurred in health promotion. Obesity is epidemic and over 700,000 Americans die each year as a result of unhealthy lifestyle choices such as smoking, poor diet, and physical inactivity; all of which have a major impact of worker safety and performance. It is clear that health promotion has a lot to learn from the safety profession in terms of on the job application. The healthcare community eclipses the safety profession in numbers, academic certification opportunity, and financial clout, and they will hold fast to their territory. NIOSH will have to facilitate a paradigm shift if integration is to evolve into policy and practice.

PS. This will take massive investment in time and resources. What can the safety professional do in the short term?

A: If a small grinder tool has a frayed electric cord, you don’t overhaul the main power supply, you repair the cord. The same is true in helping workers adopt healthier lifestyles. Safety professionals don’t need a PhD to begin the integration process. For example, a team-based daily flexibility and strength exercise can counter the effects of cumulative trauma, reduce pain and fatigue, and improve productivity. This is integration closest to the source. An information-based wellness program is certainly better than nothing, but leading workers to do something healthy every day will have a greater impact and become a catalyst for continued improvement. I’ve seen this happen many times in my practice.