NIOSH’s “Steps to a Healthier US Workforce” – A Step in the Right Direction.

By Fred Drennan, ASSE Task Force Leader for the Steps program,
and President, Team Safety, Inc.

Have you ever found yourself holding your breath, wondering if that overweight, Baby Boomer will be able to climb that ten-foot ladder one more time without falling, injuring a knee, or worse, having a heart attack? You’re not alone.

In October, 2004, The National Institute of Occupational Safety and Health (NIOSH) launched its “Steps to a Healthier US Workforce” initiative to encourage workplace programs that focus on:

• Preventing work-related illness, injury, and disability, and
• Promoting healthy living and lifestyles to reduce and prevent chronic disease

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 participants included representatives from 22 industry and labor groups, international corporations, and professional and government organizations. “Our partnership,” said Dr. Howard, “should be a synergy of prevention strategies whose objectives are more than achieving zero adverse work-related outcomes, but rather a holism where work is self-defining in the most enhancing way possible, where a worker can enjoy their retirement years with intact health, and where health-enhancing behaviors are valued and promoted in the workplace along with safety and health protection.”

The NIOSH Steps initiative officially recognizes a growing problem: Chronic disease caused by unhealthy lifestyles and lack of personal health and fitness are having a grave impact on worker safety and productivity.

To focus most of our injury prevention effort on standard safety issues such as OSHA compliance is to ignore the root cause of more than half of worker’s comp and healthcare costs: cumulative trauma disorders (CTDs). These “soft tissue” injuries are primarily the result of a lack of basic fitness and health. How so? Workers who lack basic fitness are more likely to have a musculoskeletal injury, on or off the job. For example, excess weight and lack of basic abdominal strength put extra stress on the low back; back injuries are still the second leading cause of work absenteeism. Obese individuals have three to five times the incident rate for carpal tunnel syndrome (CTS) compared to slim individuals; CTS claims are the third most costly worker’s comp claim, despite ergonomic interventions and training. Worksite safety programs have not addressed the fact that many on the job injuries are the result of lack of physical fitness. Organizations are paying the price in workers comp and healthcare costs. Howard emphasized at the Symposium that we can no longer accept the “disconnect” between those promoting healthy living and those promoting worker safety on the job.

These efforts must be integrated if we are to keep our aging workforce healthy and productive through retirement.

The First Step is to Breakdown the Barriers to Integration

Research shared at the symposium showed that the worksite has a profound effect on employee’s attitudes and behaviors, and can be a viable interface for promoting safe work and healthy living. But how do you begin? Should you allow an overweight worker to climb a 10-ft portable ladder, or should you wait until an accident confirms your suspicion that he lacked balance and agility to climb? Will your action violate a labor law? Should you accommodate the employee? Should you involve Human Resources? Should the employer be responsible for compensation when an employee’s injury is clearly the result of poor personal fitness? How can an employer demand that employees adopt healthier lifestyles? These are controversial questions that illustrate the difficulty managers and supervisors face in preventing injuries in an aging, out of shape workforce. With increased government focus on the problem through the NIOSH Steps Initiative, organizations will eventually get some help with establishing policy and procedures that address these issues.

A primary task of the first Steps symposium was to identify the barriers to integration. The most common barrier voiced among participants was the persistence of sacred resource silos within organizations (some call this protected turf). Stakeholder silos such as human resources, benefits, occupational medicine, and safety often compete for resources when they clearly share common goals and objectives. Additional tasks were to identify best practices and the economic value to organizations. The benefits of integrated safety and health have already been demonstrated by forward-looking organizations; however, official endorsement of best practices by NIOSH will only occur as the result of demonstration projects and empirical study. In the long term, these will provide employers with validated direction in the area of integrated safety and wellness.

What can the safety practitioner do in the near term?

In the near term, you can realize many benefits by looking for ways to integrate worker safety and worker fitness in your organization:

1. Start breaking down the barriers. By far, the most important first step is to breakdown the barriers to integration by starting the communication process. Both formally and informally, identify the common goals and agendas of the various stakeholders. Help them to recognize the “disconnect” and honestly evaluate sacred silos. Are you duplicating effort, missing employee interface opportunity, protecting ineffective sacred cows? Can you realize greater ROI by moving or combining resources?
2. Identify your Champions. Look for others in your organization who are willing to promote integrated safety and fitness. Be a liaison between your organization and the progress of the NIOSH Steps initiative. Bring your expertise to the executive table.
3. Answer the “Call to Action.” Safety professionals should view this government focus on integration as a “call to action.” As the NIOSH initiative moves forward, more information will be available on the best practices, economic value, and resources to help organizations integrate worker safety and worker health at the worksite. You should also look to professional organizations such as the American Society of Safety Engineers (ASSE) and educators at the university level to provide insights and training in effective integration models that you can apply on the job. Employers will benefit by combining costs of delivering worker health and worker safety programs to their employees and having more opportunities to motivate workers to adopt healthier lifestyles.
4. Increase your value to the organization. Your skills as a safety practitioner can not only impact worker’s comp, but also healthcare costs and productivity. Safety practitioners across the country have—year after year for more than 30 years—reduced the number and severity of job related injuries and deaths; while health promoters have had little impact on the number of deaths and chronic diseases due to unhealthy lifestyles. (Over 300,000 deaths in the United States are due to the effects of obesity alone.) The health promotion field stands to learn much from safety professionals and can gain greater access to workers in an integrated setting.

Fred Drennan, American Society of Safety Engineers (ASSE) Task Force Leader for the Steps Initiative, is a long-standing supporter of integrated fitness and health into daily safety routines and management practice. For more information about Team Safety’s integrated safety, fitness, and supervisor leadership programs, contact Fred Drennan at fdrennan@teamsafetyinc.com or visit the website at www.teamsafetyinc.com. For more information about the NIOSH Steps to a Healthier US Workforce initiative, visit www.cdc/NIOSH/Steps.