Integrating Safety and Wellness

9 min readApr 19, 2020

A safe workplace is a healthy workplace is a competitive workplace.

Since 2003, the National Institute for Occupational Safety and Health (NIOSH) has explored efforts into the integration of occupational safety and health protection and health promotion (i.e. employee wellness), through a program called Total Worker Health® (TWH).

NIOSH defines TWH 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 (NIOSH, 2016).

The principles of TWH, in terms of both the employer and employee having a responsibility in occupational health and safety (OHS), are not new, as legally employers have a legal duty to establish suitable arrangements to manage health and safety. Arrangements include policies, practices, risk assessments, and health surveillance (Virgin Pulse Webinar Series, 2018).

Research done by McLeroy et al. (1988) who stated that employee injury or illness (relating to the domain of OHS) requires a systems approach, in which individual and occupational/organizational risk factors must be considered. This is different from traditional interventions who place sole responsibility on the employee to manage risks. Such occupational/organizational risk factors are explained in the next Implementation section.

Considering occupational/organizational risk factors is more efficient as root causes of employee safety and wellness, not just symptoms, are targeted. As the Harvard T.H. Chan School of Public Health states in its robust Implementing an Integrated Approach: Weaving Worker Health, Safety, and Well-Being into the Fabric of Your Organization resource, occupational/organizational risk factors may be root causes of employee stress, versus a symptomatic solution of employee stress reduction sessions (Harvard T.H. Chan School of Public Health, 2017).

In doing so, the TWH approach has shown:

· Reduction in workplace injuries and illnesses, more informed decision-making

· Improved job satisfaction

· Enhanced organizational culture of trust, safety, health

· Reduction in work-related stress

· More productive employees

· Family, community, and societal gains

(Understanding TWH Webinar Series, 2019)

Human Factors Within Safety

It is the purpose of this article that individual factors, classified as Human Factors, play a role in employee safety, thus symbolizing the case for integration of employee safety and wellness. Compromised employee wellness can impact employee safety, leading to possible adverse changes in attitude and behaviour, manifested by:

· Increased fatigue (i.e. low energy)

· Poor concentration and distraction (i.e. mistakes)

· Reduced memory and recall (i.e. retention loss)

· Reduced flexibility and mobility

(Virgin Pulse Webinar Series, 2018)

OHS research has shown across the five-year period (2013–2017), the rate of occupational injuries and illnesses resulting from overexertion and bodily reaction, reflective of musculoskeletal conditions (such as conditions of the neck, back, and hips), is the most common type of event or exposure. This is a finding in which enhancing human factors provided by employee wellness can exist and therefore complement employee safety efforts.

Figure 1: Nonfatal occupational injury and illness rates for cases with days away from work by selected event or exposure (U.S. Bureau of Labor Statistics, November 2018).

It is evident in Figure 2 below how common musculoskeletal (MSK) conditions are to days away from work, employee absenteeism. Again, it is by addressing Human Factors through employee wellness efforts that these MSK conditions can be prevented and sometimes, even reversed.

Figure 2: Median days away from work and incidence rate due to injuries and illnesses by nature, all ownerships (U.S. Bureau of Labor Statistics, November 2018).

Implementation

There are five defining elements of TWH, which include:

1) Demonstrate leadership commitment to worker safety and health at all levels of the organization.

2) Design work to eliminate or reduce safety and health hazards and promote worker well-being.

3) Promote and support worker engagement throughout program design and implementation.

4) Ensure confidentiality and privacy of workers.

5) Integrate relevant systems to advance worker well-being.

For the remainder of this article, further details regarding suggestions on how to fulfill the various defining elements of TWH are presented.

1) The first defining element includes leadership commitment as a top priority for organizations, and as stated as Benchmark #1 (Committed and Aligned Leadership) by the Wellness Council of America (WELCOA) for creating comprehensive wellness programs. Among reasons such as providing or approving resources for employee safety and wellness efforts, leadership play a key role in communicating the importance of these efforts to all employees and managers. In doing so, when company productivity demands may discourage employee participation in safety and wellness efforts, employee participation does not hinder.

Leaders, and managers, can support TWH by:

· Encouraging workers’ feedback on work conditions [alluding to occupational/organizational risk factors] and working collaboratively with them to make changes. Extending this aspect of leadership support is the principle for leaders to be aware of helping to make employees feel comfortable expressing their views
(Harvard T.H. Chan School of Public Health, 2017)

· Appreciating and rewarding team leaders and employees who take the initiative to improve work processes, reduce work stress, or improve the quality of work life. Employees who show engagement as such have been shown by research (evidence-based) to be safer, healthier, and more productive in their jobs
(Harvard T.H. Chan School of Public Health, 2017)

· Incorporating employee safety and wellness metrics into corporate reporting as a measure for gauging corporate performance or sustainability (Loeppke, 2015)

· Increasing their visibility, as shared in the below graphic from The State of the Sector 2020, by Gatehouse and Gallagher Company, for tactics to increase leadership visibility through a comprehensive mix of face-to-face, print, and digital channels.

2) TWH has created a conceptual model for prioritizing efforts to address employee safety and wellness, called the Hierarchy of Controls Applied to NIOSH TWH® (Figure 3). What level is most effective appears at the top of the hierarchy, Eliminate. At the same time, some hazards cannot be eliminated, but can still be managed through the following engineering, administrative, or individual-level changes (Fundamentals of TWH Approaches, 2016). Individual-level changes include support from the organization for healthier decision-making and/or the assistance of risks or challenges. See the Centres for Disease Control (CDC) Worksite Health Scorecard in Appendix A for the questions relating to Occupational Health and Safety for examples of fulfilling the hierarchy of controls [many of which allude to occupational/organizational risk factors].

Figure 3: Hierarchy of Controls Applied to NIOSH TWH® (Fundamentals of TWH Approaches, 2016)

3) Promoting and supporting worker engagement centres around encouraging feedback and communicating strategically. Feedback effectively helps to identify potential, and albeit hidden, barriers for employee safety and wellness efforts.

In addition, for communicating strategically, reaching the attention of senior managers may require different forms of communication, versus reaching the attention of front-line employees. Communicating strategically also includes satisfying that everyone with a stake in employee safety and wellness efforts know what they are doing and why. This includes: we are doing [what] for [who] and [why], or more evidently:

________ (the health issue) is a big challenge for our ________ (focus population) because
of ________ (unmet population needs) that continue to cause ________ (significant negative impacts).
Our organization can make an important impact because with our
________ (core competencies and resources), we can develop new solutions to address
the ________ (root causes of the issues) that affect our ________ (focus population).
(Healthy Business Coalition, BSR, 2019)

For accountability, remember WWWF, who does what by when and the follow up (Crucial Accountability).

To determine effectiveness of communication, and doing so through quantitative and qualitative metrics, the below graphic from The State of The Sector 2020, by Gatehouse and Gallagher Company, shares observational data for how surveyed organizations are measuring their internal communication efforts for their impact.

4) When thinking about integrating relevant systems for employee safety and wellness efforts, to prevent silo’s (Loeppke et al.,2015), an initial assessment of how existing workplace policies, programs, and practices relate to one another and to employee safety and wellness, can be used. Examples of such include policies and procedures for identifying hazard, disclosing job fatigue, and work-life balance. Lastly, bringing together leaders from overlapping or complementary responsibilities is a form of integration. This point is reflected in the creation of diverse champions committees (Note: champions are employees who help to figure out how an integrated approach fits into an organization’s culture and business plan) (Harvard T.H. Chan School of Public Health, 2017). What this comes down to is participatory planning — considering whether you have relevant employee groups and internal and external stakeholders involved in operations planning. Stakeholders from marketing, IT, HR, finance, social committees, project management, learning and development, building maintenance, and of course, leadership.

Systematic policies and procedures for identifying hazard can obtain input and ensure more days are the best days. Outlined in The Whole Worker: Guidelines for Integrating Occupational Health and Safety with Workplace Wellness Programs by the Commission on Health and Safety and Workers’ Compensation (2008) is a planning worksheet for active worker participation.

Overall Questions to Consider

Lastly, to augment employee safety and wellness efforts, the following self-reflective questions proposed by TWH and the Commission on Health and Safety and Workers’ Compensation are shown below. It is the solutions arriving from these questions as such that TWH can be established, and therefore, worker well-being (employee safety and wellness). Notice how the questions can reflect occupational/organizational risk factors.

· Do we regularly seek the input of our workers on the selection of our employee safety and wellness efforts (i.e. participatory planning)?

· How can we change or adjust management policies or programs to more effectively support improved employee safety and health?

· Is “individual action” the sole component of any of the health promotion programs? Are occupational factors ignored in favour of personal factors alone?

· Are there “family friendly” policies (child care, elder care, flexible work hours, etc.)?

· What influence do our workplace or organizational norms have on employee safety and wellness habits?

· Are incentives positive (not punitive)? Do they avoid creating a sense of “winners and losers”?

· What sorts of community support, would be useful in helping to reinforce and support our employee safety and wellness efforts?

· Is there a way to regularly and accurately evaluate the progress of the program?

· For privacy and confidentiality specifically, is the privacy of individual worker health information protected? Are regulatory requirements being followed? (See resources section for HIPPA, ADA, state law resources)? Does a third party assist with ensuring confidentiality?