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Health promotion in the Scottish workplace: a case for moving the goalposts.

The workplace provides an important opportunity for health promotion, both in terms of allowing access to a large proportion of the adult population and encouraging developments within the workplace structure to improve health. This paper reports on the findings of a survey of Scottish workplaces carried out in 1996 for the Health Education Board for Scotland to assess the state of health promotion activity in the Scottish workplace setting. The results echo those from previous surveys in that most health promotion effort was centred around health and safety, smoking, and alcohol issues, particularly for the smaller and less well-resourced businesses. Under one-fifth of businesses surveyed addressed areas such as stress and mental health, which are being seen as increasingly important in terms of their contribution to the well-being of the employee and the organization. The main implication of these findings is that it is smaller businesses who potentially have the most to gain from workplace health promotion. In this context, the construction of relevant and sustainable health promotion programmes requires an organizational development perspective in order to encourage such businesses to regard workplace health promotion as part of good business practice.

Adult↗

'You ain't going to say...I've got a problem down there': workplace-based prostate health promotion with men.

Prostate health has emerged as a key health issue for men. Nearly 10,000 men die from prostate cancer each year and many more live with non-cancerous, but debilitating, prostate conditions. Despite the widespread prevalence, evidence suggests that men lack knowledge about male cancers and conditions, and are more likely to ignore signs and delay seeking help. Health promotion with men in the workplace is, therefore, increasingly being advocated as an important way of providing men with health information and encouraging them to see a health professional where appropriate. However, there has not been a developed account of men's views on health promotion within the workplace. This paper presents the findings of a small-scale qualitative study that explored men's perceptions and experiences of three different workplace-based health promotion interventions to improve prostate health awareness and their attitudes towards the workplace as an appropriate setting for promoting men's health. This paper shows that men generally welcomed a workplace-based health promotion campaign targeted specifically at them. However, the masculine 'culture' of the workplace, where concerns about health were likely to be met with ridicule rather than concern, was one important factor in understanding these men's views of different health promotion interventions.

Adult↗

Developing programmes to achieve a healthy society: creating healthy workplaces in Northern Ireland.

Healthy workplaces help to prevent occupational disease and injury as well as promoting positive healthy lifestyle behaviours. The concept of creating healthy workplaces through workplace health promotion has been identified as a legitimate area of activity for public health policy in Northern Ireland, supporting as it does, the settings approach as a means of improving the health and well-being of the population at large. Benefits accrue to businesses, organizations and individuals from the enhancement of positive healthy lifestyle messages in addition to reinforcing the principles of good occupational health practices. Developing a framework for the creation of healthy workplaces is part of a joint initiative between the Northern Ireland Health Promotion and Health and Safety Agencies. Commitment to delivering the concept is required from all the key players who include: employers, employees, trade union groups and health and safety professionals. A healthy workplace model needs to be created which is flexible and adaptable to suit all types of business and in particular the needs of small businesses which predominate in Northern Ireland. The principles underpinning the Business Excellence Model may be a useful vehicle for delivering workplace health promotion onto an organization's agenda.

Government↗

Defining the severity of workplace violent events among medical and non-medical samples. A pilot study.

The purpose of this study was to describe and compare medical and non-medical individuals' violence severity rank for 13 commonly cited events illustrative of workplace violence. One hundred thirty-six college students were provided a short checklist of 13 violent events in the workplace to determine the violence severity rank for each event. Two groups of college students with (n = 69) and without (n = 67) medical background participated. Student and registered nurses (medical group) agreed on the violence severity ranking of all 13 often-cited workplace violence events. Non-medical and medical groups, however, did not always agree on the degree of violence severity, especially for physical and sexual workplace violence events. Differences between groups may be explained by the possibility that nurses are socialized or desensitized in practice to possibly accept some workplace violence events as "part of the job." Gastroenterology nurses can benefit from this study by raising their sensitivity to and awareness of workplace violence in the practice setting.

Attitude of Health Personnel↗

Workplace smoking policies in the United States: results from a national survey of more than 100,000 workers.

OBJECTIVE: To determine the prevalence of smoking policies in indoor work environments as reported by a nationally representative sample of workers in the United States. DESIGN: Cross-sectional survey of households within the United States. SETTING: All 50 state and the District of Columbia, 1992-93. PARTICIPANTS: Currently employed indoor workers 15 years of age and older who responded to the National Cancer Institute's Tobacco Use Supplement to the Current Population Survey (n = 100,561). MAIN OUTCOME MEASURES: The prevalence and restrictiveness of workplace smoking policies as reported by workers currently employed in indoor workplaces in the United States. RESULTS: Most of the indoor workers surveyed (81.6%) reported that their place of work had an official policy that addressed smoking in the workplace; 46.0% reported that their workplace policy did not permit smoking in either the public/common areas--for example, restrooms and cafeterias--or the work areas of the workplace. The reporting of these "smoke-free" policies varied significantly by gender, age, race/ethnicity, smoking status, and occupation of the worker. CONCLUSIONS: Although nearly half of all indoor workers in this survey reported that they had a smoke-free policy in their workplace, significant numbers of workers, especially those in blue-collar and service occupations, reported smoke-free rates well below the national average. If implemented, the US Occupational Safety and Health Administration's proposed regulation to require worksites to be smoke-free has the potential to increase significantly the percentage of American workers covered by these policies and to eliminate most of the disparity currently found across occupational groups.

Adult↗

Costs of employee smoking in the workplace in Scotland.

BACKGROUND: Employers have responded to new regulations on the effects of passive smoking by introducing a range of workplace policies. Few policies include provision of smoking cessation intervention. OBJECTIVE: To estimate the cost to employers of smoking in the workplace in Scotland to illustrate the potential gains from smoking cessation provision. Costs vary with type of smoking policy in place; therefore, to estimate these costs results from a survey were combined with evidence drawn from a literature review. STUDY DESIGN: A telephone survey of 200 Scottish workplaces, based on a stratified random sample of workplaces with 50 or more employees, was conducted in 1996. Additional evidence was compiled from a review of the literature of smoking related costs and specific smoking related effects. RESULTS: 167 completed responses were received, of which 156 employers (93%) operated a smoking policy, 57 (34%) operated smoke free buildings, and 89 (53%) restricted smoking to a "smoke room". The research literature shows absenteeism to be higher among smokers when compared to non-smokers. The estimated cost of smoking related absence in Scotland is pound40 million per annum. Total productivity losses are estimated at approximately pound450 million per annum. In addition, the resource cost in terms of losses from fires caused by smoking materials is estimated at approximately pound4 million per annum. In addition, there are costs from smoking related deaths and smoking related damage to premises. CONCLUSION: This study shows how smoking cessation interventions in the workplace can yield positive cost savings for employers, resulting in gains in productivity and workplace attendance which may outweigh the cost of any smoking cessation programme.

Absenteeism↗

Effects of smoking restrictions in the workplace.

The health hazards caused by exposure to environmental tobacco smoke (ETS) are well established. Workplace exposure to ETS is strongly influenced by the types of workplace and smoking policy-total bans on smoking have become common in many countries. Blue-collar and service workers are more likely than other types of workers to be exposed to ETS in the workplace. Smokers who are employed in workplaces with smoking bans are likely to consume fewer cigarettes per day, are more likely to be considering quitting, and quit at an increased rate compared with smokers employed in workplaces with no or weaker policies. Despite substantial progress in protecting workers from ETS, additional efforts are needed in areas that include attention to exposure among blue-collar and service workers; policies in workplaces with a limited number of employees; and studies of enforcement, effects on smoking cessation in multiple settings, and cost-effectiveness.

Adult↗

Competing discourses of workplace health.

This article presents an analysis of workplace health programme discourses within an international information technology company. Discourse refers to a system of statements that share a common force and coherence and which are socially constitutive. The representation of entities such as workplace health can be subject to competition between discourses. A critical discourse analysis was undertaken on semi-structured interviews, participant observation and workplace health programme documents. Two competing discourses were identified: health as safety and health as lifestyle. Each discourse is described and shown to both implicitly and explicitly define health within this particular workplace. Lifestyle discourse encouraged moves towards linking of the employees' working and private lives while safety discourse defined health in the relationship between workers and their physical environment. Competition between discourses both constricts and opens spaces for alternative understandings of health in the workplace. The implications of this competition for workplace health policy and practice are discussed.

Attitude of Health Personnel↗

Risk assessment for heart disease and workplace ETS exposure among nonsmokers.

In 1994 the U.S. Occupational Health and Safety Administration (OSHA) published a study of risk assessment for heart disease and lung cancer resulting from workplace exposure to environmental tobacco smoke (ETS) among nonsmokers. This assessment is currently being revised. The present article considers different possible approaches to a risk assessment for heart disease among nonsmokers resulting from workplace ETS exposure, reviews the approach taken by OSHA in 1994, and suggests some modifications to that approach. Since 1994 the literature supporting an association between ETS exposure and heart disease among never smokers (sometimes including long-term former smokers) has been strengthened by new studies, including some studies that have specifically considered workplace exposure. A number of these studies are appropriate for inclusion in a meta-analysis, whereas a few may not be due to methodological problems or problems in exposure definition. A meta-analysis of eight relative risks (either rate ratios or odds ratios) for heart disease resulting from workplace ETS exposure, based on one reasonable selection of appropriate studies, yields a combined relative risk of 1.21 (95% confidence interval [CI], 1.04-1.41). This relative risk, which is similar to that used by OSHA in 1994, yields an excess risk of death from heart disease by age 70 of 7 per 1000 (95% CI 0.001-0.013) resulting from ETS exposure in the workplace. This excess risk exceeds OSHA's usual threshold for regulation of 1 per 1000. Approximately 1,710 excess ischemic heart disease deaths per year would be expected among nonsmoking U.S. workers 35-69 years of age exposed to workplace ETS.

Adult↗

The relative influence of personal and workplace descriptors on stress.

A survey canvassing self-reported workplace stress levels and personal/workplace demographics was conducted among a sample of Australian nurses. Stress ratings and demographics were cross-sectionally analysed. Quantitative and qualitative analyses of survey responses suggest that excessive workload is the likely dominant predictor of workplace stress. Personal and workplace demographics are shown to be relatively unimportant in comparison with workload-related factors. Regular exercise habit was shown to be correlated with reduced workplace stress ratings. The findings support a previously unreported view that nurses are unlikely to bring their personal stress with them to the workplace--rather the workload characteristics of the workplace itself are the principle stress determinants.

Adaptation, Psychological↗

Workplace culture, social interactions, and supports for transition-age young adults.

The role of the workplace and its culture in supporting social inclusion and workplace support for employees with disabilities is discussed and results of a qualitative study of the workplace experiences of 8 young adults with developmental disabilities presented. Data were collected using participant observation and semi-structured interviews. Four characteristics of supportive workplaces were identified: (a) multiple context relationships, (b) specific social opportunities, (c) a personal and team-building management style, and (d) interdependent job designs. The more supportive workplaces had all of these characteristics, suggesting that collectively they represent key features of a supportive workplace culture. Implications for job development and job creation are identified.

Adolescent↗

Questionnaire survey and environmental measurements that led to smooth implementation of smoking control measures in workplaces.

In order to promote smoking countermeasures in a manufacturing plant, we conducted a questionnaire survey about smoking control measures in workplaces. Twenty nine point five percent of the subjects responded that they were exposed to passive smoking where they worked and that the most common source of passive smoking in the workplace and rest areas was environmental tobacco smoke (ETS) leaking from smoking areas. For smoking control measures, 27.8% of employees preferred a total ban on smoking in the building while 55.2% preferred measures to prevent ETS leakage from smoking areas. Regardless of whether they were smokers or not, 99.2% of respondents believed that passive smoking countermeasures in the workplace were necessary and 88.9% of smokers responded that banning smoking in the building was unavoidable. Based on these results, a total ban on smoking in the building was implemented in those workplaces where it was feasible to do so, smoking areas in the remaining workplaces were upgraded to prevent ETS infiltration, and the effects were evaluated by real-time monitoring of the concentration of suspended particle matter. The questionnaire survey results showed that 79.9% of smokers were interested in smoking cessation, that awareness of the adverse health effects of smoking on the smoker and surrounding non-smokers and the nuisance it caused was significantly lower among smokers compared to non-smokers (p<0.01), and that 65.5% of non-smokers believed that smoking was beneficial to the mental health of smokers, despite the fact that they had no experience of smoking themselves. Reporting these results to the Safety and Health Committee was found to be useful both in ensuring thorough segregation of smoking areas and in supporting smoking cessation programs in places where no previous action had been taken because smoking was viewed as a matter of personal choice. We also believe that provision of accurate information tailored to actual smoking conditions in the workplace is useful in effectively implementing anti-smoking campaigns on the adverse effects of smoking and smoking cessation programs. The implementation of a questionnaire survey and environmental measurements that lead to countermeasures was shown to be effective in establishing designated smoking areas and educational programs for smoking cessation.

Air Pollution, Indoor↗

Networking grassroots efforts to improve safety and health in informal economy workplaces in Asia.

Many workers in Asia are in the informal economy. They often work in substandard conditions, exposed to hazards in the workplace. Learning from the recent successes of participatory training programmes to improve safety and health in Asia, the ILO has strengthened its partnership efforts with local people to improve safety and health of informal economy workplaces. The target groups were: (1) home workplaces in Cambodia and Thailand, (2) salt fields and fishing villages in Cambodia where many young workers are working, and (3) small construction sites in Cambodia, Laos, Mongolia, Thailand and Vietnam. The walk-through survey results showed that the workers and owners in the target informal economy workplaces had the strong will to improve safety and health at their own initiatives and needed practical support. In the participatory, action-oriented training workshops carried out, the participated workers and owners were able to identify their priority safety and health actions. Commonly identified were clear and safe transport ways, safer handling of hazardous substances, basic welfare needs such as drinking water and sanitary toilets, and work posture. The follow-up visits confirmed that many of the proposed actions were actually taken by using low-cost available materials. These positive changes were possible by applying the participatory training tools such as illustrated checklists and extensive use of photographs showing local good examples and placing emphasis on facilitator roles of trainers. In conclusion, the target informal economy workplaces in Asia made positive changes in safety and health through the participatory, action-oriented training focusing on local initiative and low-cost improvement measures. Local network support mechanisms to share lessons from good practices played essential roles in encouraging the voluntary implementation of practical improvement actions. It is important to increase our joint efforts to reach more informal economy workplaces in industrially developing countries and provide practical support measures focusing on local self-help initiatives.

Cambodia↗

Special report. Workplace violence: what all employers should know.

Violence in the workplace has been declared a national epidemic by the Centers of Disease Control and Prevention (CDC), Atlanta, GA, which found that homicide was the cause of death for an average of 750 workers annually between 1980 and 1989, making it the third leading cause of death in the workplace. Over 111,000 incidents of workplace violence were reported in 1992 alone. In its first-ever national census of workplace fatalities, the Bureau of Labor Statistics reported 1,004 workplace homicides in calendar year 1992. More than one-third of the 479 human resource professionals, responding to a recent survey by the Society of Human Resource Management, said incidents of violence had occurred where they work. Over half said that between two and five acts of violence were committed in their workplaces in the last five years. In this report, we'll present a number of approaches that all employers might consider in formulating programs for preventing incidents of violence.

Censuses↗

The alternative workplace: changing where and how people work.

Today many organizations, including AT&T and IBM, are pioneering the alternative workplace--the combination of nontraditional work practices, settings, and locations that is beginning to supplement traditional offices. This is not a fad. Although estimates vary widely, it is safe to say that some 30 million to 40 million people in the United States are now either telecommuters or home-based workers. What motivates managers to examine how people spend their time at the office and where else they might do their work? Among the potential benefits for companies are reduced costs, increased productivity, and an edge in vying for and keeping talented employees. They can also capture government incentives and avoid costly sanctions. But at the same time, alternative workplace programs are not for everyone. Indeed, such programs can be difficult to adopt, even for those organizations that seem to be most suited to them. Ingrained behaviors and practical hurdles are hard to overcome. And the challenges of managing both the cultural changes and systems improvements required by an alternative workplace initiative are substantial. How should senior managers think about alternative workplace programs? What are the criteria for determining whether the alternative workplace is right for a given organization? What are the most common pitfalls in implementing alternative workplace programs? The author provides the answers to these questions in his examination of this new frontier of where and how people work.

Commerce↗

Workplace violence in municipal occupations.

Although workplace homicide rates are decreasing, violent events in the workplace remain a high risk in many occupations. The number of violent victimizations in the workplace has been estimated to be as high as 2 million per year among workers. Many municipal workers are at high risk because they provide services and enforce regulations, often in unsecured environments. Compared to other causes of workplace death, homicides and other violent events are relatively new areas of formal study for occupational safety and health specialists. However, there is a growing body of knowledge about the types of interventions that are effective in reducing workplace violence. This chapter examines trends in workplace violence, risk factors for municipal workers, and approaches to prevention.

Accidents, Occupational↗

[Workplace health promotion program quality evaluation questionnaire].

There are substantial reasons for undertaking the evaluation of workplace health promotion (WHP) programs. The most important ones are: (a) the need to guarantee a competent organization of programs; (b) the feasibility to evaluate WHP programs, which take the form of medical services offered to employers on the health service market; (c) the need to disseminate the idea and support the workplace health promotion lobby; and (d) the use of evaluation as a tool for analyzing WHP promulgation process. The implementation of the scientifically-based evaluation of health promotion programs carried out in regularly functioning enterprises is very limited, hence the increasing interest in procedures of quality assessment already known and accepted by enterprises. This approach is recommended by the World Health Organization (WHO). In the European Union countries, a questionnaire on the workplace health promotion program evaluation is promulgated within the European Network for Workplace Health Promotion. The National Center for Workplace Health Promotion that coordinates the activities of the National Network for Workplace Health Promotion Centers in Poland has developed a Polish version of the questionnaire adopted to local conditions. The author presents the criteria and the most essential solutions that provided the ground for designing the questionnaire to be used by the organizers of WHP programs in enterprises for self-assessment of their own activities. It reflects the views on the strategy of the WHP evaluation presented by the National Center, and contains a simplified procedure that does not involve control groups so difficult to gather under the concept of "health promoting enterprise". The idea of control groups is usually misunderstood and disapproved by the management of enterprises involved in the implementation of WHP programs.

European Union↗

[Gender differences in workplace bullying].

BACKGROUND: Despite the attention that international Agencies give to the gender issue in situations of workplace bullying, few investigations have been performed on this topic. OBJECTIVES: The aim of the study is describe the gender differences in victims of workplace bullying observed in an Italian survey. METHODS: A total of 243 subjects (124 males and 119 females) were examined at the Centre for Occupational Stress and Harassment of the "Clinica del Lavoro Luigi Devoto" (University of Milan and IRCCS Foundation); they were selected among patients who met the criteria for being considered victims of negative actions at work leading to workplace bullying. Data regarding the person, workplace and the workplace bullying situation were collected by means of an ad hoc questionnaire. RESULTS: Analysis of the data, compared with those of IS-TAT 2002, showed a higher prevalence of females subjected to negative actions at work. In women, the risk of being subjected to negative actions leading to workplace bullying was shown to increase in the 34-44 age range and to decrease in higher age ranges; in men the risk remained elevated also after 55 years of age. CONCLUSIONS: In general, women were victims of negative actions regarding personal values related to emotional-relational factors, while men were attacked on their work performance. Sexual harassment, may mark the onset of other types of psychological harassment or can be one of its components.

Adult↗