As Wayne Maynard reports, whether you’re aiming for employee wellness or organisational wellness, the link with ergonomics is irrefutable.
There is no universally accepted definition of wellness. But for me, wellness is about the person and decisions they make about their health, safety and well-being both on and off the job.
Ergonomics is about designing the job to fit the capabilities and limitations of the worker. Primary factors influencing job demands to worker capacity include characteristics of materials, organisations, tasks and environment and characteristics of the worker including, psychological, physiological (fitness), and biomechanical capability (strength). The International Ergonomics Association (IEA) describes three domains of ergonomics:
1. Physical – concerned with human anatomical, anthropometric, physiological and biomechanical characteristics as they relate to physical activity.
2. Cognitive – concerned with mental processes, such as perception, memory, reasoning and motor response.
3. Organisational – concerned with the optimisation of sociotechnical systems, including organisational structures, policies and processes.
Job stress is the harmful physical and emotional responses that occur when the requirements of the job do not match the capabilities, resources or needs of the worker. Job stress can lead to poor health and even injury. Fatigue is closely related to job stress. People experience abnormal stress when either deprived or over stimulated; minimal stress occurs when stimulation is moderate.
Long work hours, demanding work schedules and sleep/wake durations are associated with adverse outcomes on worker safety, health and well-being. Shorter sleep durations are associated with cardiovascular disease, hypertension, diabetes, depression and obesity. Lack of sleep has been associated with traffic crashes and work-related injuries. Based upon available research, consider the following ergonomic guidelines when designing a shift system for safety and health:
- Day (morning) shifts are to be preferred over afternoon or night shifts.
- Limit work to five or six consecutive shifts in a row.
- Provide for frequent rest breaks. Hourly breaks are appropriate for many kinds of work, but for highly repetitive or strenuous work, breaks more frequently than once each hour are necessary.
As for night work, keep consecutive night shifts to a minimum. Only two to four nights in a row should be worked before a couple of days off. This stops circadian rhythms being disturbed and limits sleep loss. The European Commission’s Working Time Directive recommends keeping night work at an average of 48 hours per week, allowing up to six eight-hour night shifts or four 12-hour night shifts per week.
Lack of physical activity is one of the leading causes of preventable death worldwide. Prolonged sitting time, independent of physical activity, has emerged as a risk factor for various negative health outcomes. Studies have demonstrated associations of prolonged sitting time with premature mortality, chronic diseases such as cardiovascular disease, diabetes, cancer and obesity.
Sit-stand workstations allow the user to adjust the height of the work surface from a seated height to a standing height. The benefit is workers will be able to reduce sedentary time while at work by changing from sitting to standing thereby improving health outcomes, and possibly improving work productivity. Sit-stand workstation users, who received comprehensive training (1.5 hours) varied their postures at work, exhibited increased productivity at work, compared to those who were not trained.
Return to work (RTW) programmes can have a positive impact on overall health and wellness. The longer a person is away from work, the less likely it is that he or she will ever return. Supervisors trained to respond to work injuries in a positive way, including communication and problem-solving with employees on return to work accommodations, significantly reduced the number and cost of disabling WC claims. RTW programmes and integrated disability management strategies complement strategic health and wellness initiatives by shifting attention to employee health as an investment.
Obesity is one of the major health problems with over two-thirds of adults being overweight or obese. In America employers bear a large share of healthcare costs and it is estimated that in 2010 direct healthcare costs attributable to being overweight or obese exceeded $100 billion.
Research has shown a clear relationship between body mass index (BMI) and cost of WC claims. Insurance industry research has shown there are systematic differences in the outcomes for obese and non-obese WC claimants with comparable demographic characteristics, and a greater risk that injuries will create permanent disabilities if the injured worker is obese.
In studies, 81 per cent of lost time claims with a comorbidity diagnosis, such as diabetes, chronic pulmonary disease, drug abuse and hypertension, were attributed to obesity. Obesity also plays a role as a contributor to injury risk with obese workers 29 per cent more likely to sustain workplace injuries than those of normal weight.
Figures like this make the strongest case for engaging employees in health promotion programmes targeting obesity and healthy behaviours. These programmes can now be viewed as having a potentially protective benefit in terms of workplace safety and disability prevention.
Health promotion is the non-occupational side of wellness – traditional wellness programme interventions that focus on healthy lifestyles and healthy behaviours. A 2008 survey of large manufacturing employers reported that 77 per cent offered some kind of formal health and wellness programme. The survey reported benefits of a healthy workforce including reduced healthcare costs, reduced workers compensation costs and reduced costs associated with absenteeism (off the job) and presenteeism (on the job but not functioning at full capacity).
A number of studies over the years have shown positive return on investment (ROI) for work site wellness initiatives. Workplace health programmes generated a positive return on investment in all instances except randomised control trials.
In one US report (36 studies, many industries, and larger companies with more than 1000 workers) concluded on average that medical costs fell by about $3.27 for every dollar spent on wellness programs and absenteeism costs fell by about $2.73 for every dollar spent). Analysis criteria for this study included 1) must have had a well-defined intervention; 2) must have had a treatment and comparison group, and 3) must be a distinct new intervention. Average intervention size was >3,000 employees and comparison group 4,500 employees.
The physical domain is often recognised as ‘micro’ side of ergonomics and solutions mitigate physical risk factors associated with high repetition, long duration, high force, awkward postures and others. The organisational domain is the ‘macro’ side or simply macroergonomics. This domain addresses psychosocial risk factors or the organisational and work context issues described above.
According to the late Dr Hal Hendrick, “if you take a microergonomic approach and look at the research results over the years, successful programmes tend to get a 10-25 per cent improvement, whether it is in productivity or accident reduction. But when you get the macroergonomic level in there and it is a true macroergonomic intervention, we normally see 50-90 per cent improvement. Associated benefits include better productivity and quality, and improved job satisfaction and employee commitment.”
Macroergonomics utilises extensive employee participation in identifying work system deficiencies and designing solutions. Macroergonomic approaches include:
- Recognition of employees for good work.
- Opportunities for career development.
- Organisational culture that values the individual worker.
- Demands (both physical and mental) commensurate with capabilities and resources of individuals.
- Jobs designed to provide opportunities to use skills.
- Employees have input on decisions or actions that affect their jobs and the performance of their tasks.
There are many definitions of wellness but it is important for all stakeholders to understand how a well organisation and a well employee work together to form a win/win for both. Management commitment and employee involvement; especially a positive safety climate are critical variables to successful outcomes. The contribution of ergonomics to wellness at both micro and macro levels cannot be overstated and the evidence base is solid. Remember, ergonomics is about healthy jobs, healthy workers and healthy organisations.
Wayne Maynard is a Certified Professional Ergonomist and a Certified Safety Professional. He is a product director – workers compensation, ergonomics and tribology at Liberty Mutual Insurance, Massachusetts, USA. Tribology is the study of the interaction of sliding surfaces and is applied to pedestrian slips and falls. It is an area of research at the Liberty Mutual Research Institute for Safety.
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