17 Occupational Health and Anthropology

Urvashi Gupta and Meenal Dhall

Contents

1. Introduction

2. Work-related stress

3. Stress-related hazards at work

4. The role of occupational health

5. Staying safe at workplace

6. Do’s and Don’ts of occupational health

7. Universal health coverage of workers

Summary

Learning Objectives:

To understand the notion of Occupational Health
To know about the causes and types of stress experienced at a workplace
To explore the role of Occupational Health
To gain insights about the Universal health coverage of workers

1. Introduction

Occupational health is a special branch of medicine that focuses on the physical and mental wellbeing of employees in the workplace. Occupational health refers to the identification and controlling the risks arising from any physical, chemical and other workplace hazards in order to establish and maintain a safe and healthy working environment. These hazards may include:

Chemical agents and solvents
Heavy metals such as lead and mercury
Physical agents such as loud noise or vibration
Physical hazards such as electricity or dangerous machinery

According to National Institute of Occupational Health (NIOH), occupational health is a sustained activity aimed at promotion and maintenance of highest degree of physical, mental and social well being of workers in all occupations. So, occupational health deals with the aspects related to health and safety in a workplace. It has a strong focus on primary prevention of hazards.

Since 1986, the National Institute of Environment Health Sciences (NIEHS) has supported training and education programs designed to protect workers and their communities from exposure to toxic materials encountered during hazardous waste operations and chemical emergency response. This includes safety and health training for workers who are involved in hazardous waste removal and comprehensive training and environmental restoration for residents living near heavily polluted industrial waste sites.

The health of the workers has several determinants, such as the risk factors at workplace leading to cancers, accidents, musculoskeletal diseases, respiratory diseases, hearing impairment or its complete loss, circulatory diseases, stress related disorders, communicable diseases and others. Employment and working conditions in any formal or informal economy embrace other important determinants like:

Working hours
Salary
Policies at workplace
Promotion
Protection provisions, etc.

A healthy job is likely to be the one where the pressure on employees is appropriate in relation to their abilities and resources, the amount of control they have over their work and the support they receive from people who matter to them. As health is not merely the absence of disease or infirmity but a positive state of total physical, mental and social well-being. So, a healthy working environment is characterized by an abundance of health-promoting conditions and absence of harmful ones. It may include a continuous assessment of risks to health, a provision of appropriate information and training on health issues and the availability of health promoting organizational support practices and structures. A healthy work environment is one where the staff is able to achieve health, where the health promotion is a priority and part of their working lives.

2. Work-related stress

Stress arises in a wide range of working conditions. However, it is often made worse when the employees feel they have little support from their supervisors and colleagues, along with little control over the work processes. Work-related stress is a response to the work demands and pressures that arise when expectations are not matched with the knowledge and abilities of the employee, that consequently challenge their ability to cope with the stress.

Source: World Health Organization site for occupational health

Pressure at workplace is unavoidable due to the demands of the contemporary work environment. Pressure identified as acceptable by an individual, may even keep workers alert, motivated, able to work and learn, depending on the available resources and personal characteristics. However, when that pressure becomes excessive or otherwise unmanageable it leads to stress. Stress can damage an employees’ health as well as business performance and productivity. Work-related stress can be caused by

poor work organization (the way jobs and work systems are designed, and the way we manage them)
poor work design (for example, lack of control over work processes)
poor management
unsatisfactory working conditions
lack of support from colleagues and supervisors

Research findings have shown that the most stressful type of work is the one that values excessive demands and pressures which are not matched to workers’ knowledge and abilities, where there is little opportunity to exercise any choice or control, and little support is gained from others.

Employees are less likely to experience work-related stress when demands and pressures of work are matched to their knowledge and abilities, control can be exercised over their work and the way they do it. Appropriate support is received from supervisors and colleagues and participation in decisions that concern their jobs is provided.

3. Stress-related hazards at work

Stress related hazards at work can be divided into work content and work context.

Work content includes:

job content (monotony, under-stimulation, meaningless of tasks, lack of variety, etc)
work load and work pace (too much or too little to do, work under time pressure, etc.)
working hours (strict or inflexible, long and unsocial, unpredictable, badly designed shift systems)
participation and control (lack of participation in decision-making, lack of control over work processes, pace, hours, methods, and the work environment)

Work context includes:

career development, status and pay (job insecurity, lack of promotion opportunities, under- or over-promotion, work of ‘low social value’, piece rate payment schemes, unclear or unfair performance evaluation systems, being over- or under-skilled for a job)
role in the organization (unclear role, conflicting roles)
interpersonal relationships (inadequate, inconsiderate or unsupportive supervision, poor relationships with colleagues, bullying/harassment and violence, isolated or solitary work, etc)
organizational culture (poor communication, poor leadership, lack of behavioural rule, lack of clarity about organizational objectives, structures and strategies)
work-life balance (conflicting demands of work and home, lack of support for domestic problems at work, lack of support for work problems at home, lack of organizational rules and policies to support work-life balance).

4. The role of occupational health

The aim of occupational health is to prevent work-related illness and injury by:

Encouraging safe working practices
Designing ergonomically efficient and comfortable workstations
Monitoring the health of workforce
Supporting the management of sickness/ absence

An occupational health service also helps in following ways:

Work with the employer in implementing policies and ensure health and safety compliance
Conduct pre-employment health assessments
Support health promotion and education programmes
Provide advice and give counselling to employees about non-health related problems
Provide the employer with advice and guidance about making reasonable adjustments to the working conditions.

Occupational health provision in a company depends upon the size of the organization. In such a setting, it could be made available by a range of specialists, including:

Physiotherapists
Hygienists
Psychologists
Ergonomic experts
Occupational therapists
Specialised occupational health nurses and doctors

All such provisions must be provided to each and every employee by their employers. If such provisions are not available at the employing institution, then one can seek help from external occupational health care providers.

It has been noticed that occupational health problems occur mainly during performing a task at work place or because of the kind of work that a person does. These problems can include:

Cuts, broken bones, sprains, and strains
Loss of limbs
Repetitive motion disorders
Hearing problems caused by exposure to noise
Vision problems
Illness caused by breathing, touching, or swallowing unsafe substances
Illness caused by exposure to radiation
Exposure to germs in health care settings

Therefore, safety at the workplace and practices for prevention of misshapenness can reduce the risk of incidence of these problems. One should try to stay fit, reduce stress, set up the work area properly, and use the right equipment and gear.

5. Staying safe at workplace

Staying safe at work place is very important. If one does not work in a safe way, then he/she can get hurt or become sick. However by taking the following precautions, both at work place and home, could lower the chances of getting hurt.

Precautions to prevent injuries at work:

Lifting things safely
Arranging equipment to fit the body
Taking short breaks and stretch
Wearing protective equipments
Complete information about health resources at work

Since, the overall health of a person also affects the performance at work place and how the person feels, therefore to be able to work safely, it is important to:

Get enough sleep
Eat a healthy diet
Stay active
Keeping a watch at your weight
Manage stress

Source: newsroom.gy/2016/08/30/ministry-appoints-occupational-health-safety-council/

All types of jobs, even desk jobs, can lead to injuries. Back injuries in the form of lower back pain and stiffness are the most common type of workplace injury.

One is at risk of getting hurt at work if the person:

Lifts or carries heavy objects. This can strain or injure the back, shoulders, or neck.
Repeating the same activity over and over again, like typing or working on an assembly line. This can cause what is called a repetitive motion injury.
Not wearing the right protective equipment for the work one does, like earplugs or safety goggles.

Taking steps to stay safe and healthy at work can help to get more work done and giving an overall better feeling.

While lifting something heavy, one must:

Bend at knees, not at the waist.
Keep the back straight.
Test the object first. If it is too heavy, get help.
Wear protective equipment.

Wearing protective equipment can lower the chances of injury. Protective equipment includes the following:

Earplugs
Safety goggles
Work gloves
Hard hats

6. Common sanctions of Occupational Health

Following is a list of do’s and don’ts of the practices and activities that could be undertaken at a workplace so as to lead a safe, healthy, stress-free work life.

Take the time to arrange the equipment that fits your body. Do not try to adjust your body to work with equipment that is not set up right for you. Talk with your boss or employer about how to make sure your equipment is set up correctly.
Sit or stand up straight while you work. If you sit, adjust the chair or desk to your height.
If you use tools or equipment, put them where you can easily reach them.
Take breaks often when doing repetitive tasks.
“Warm up” and stretch before starting working.
Bursitis and tendinitis are the two common conditions that repetitive motion can cause. So, take short breaks. Even a 5-minute break can help increase concentration and reduce stress. Take short breaks often and stretch or go for a walk.
Understand the resources available at the work. Many employers offer free programs that could help stay healthy. So, one must find out what resources are available, even if the help is not needed right then.
Get enough sleep. Getting a good night’s sleep every night is important for performing well at workplace. After resting well enough, a person is likely to make good decisions and avoid getting hurt. To sleep better:

Do not eat a big meal close to bedtime.

Stay away from drinks with caffeine (like coffee, soda, and energy drinks) several hours before going to sleep.

Get regular physical activity, but do not exercise right before you go to bed.

Make sure your bedroom is dark and quiet.

Stay healthy. A healthy body helps in protecting/ faster recovery from injuries on the job. To stay in shape:

One must eat healthy, as our body needs the right vitamins, minerals and other nutrients to stay healthy.

Get active. To get the health benefits of physical activity, do a combination of aerobic and muscle-strengthening activities.

Watch your weight. To stay at a healthy weight, balance the calories you eat with the calories you use.

Steps should be taken to manage stress

Chronic stress at work or at home can increase the risk of getting sick or hurt.

Stress could be reduced by planning ahead, noticing when you feel stressed, and taking time to relax.

7. Universal health coverage of workers

Presently, only 15% of workers worldwide have access to specialized occupational health services carrying out prevention of occupational risks, health surveillance, training in safe working methods, first aid and advising employers in occupational health and safety.

More attention should be given to the psychological work conditions of the workers and employees in organizations in order to prevent poor work ability. It is a statutory and moral responsibility of the employers to safeguard the health, safety and welfare of workers, and to take reasonably practicable steps to prevent avoidable injuries. There has been considerable reduction in the physical demands of most work and much effort has gone into ergonomic improvements that have reduced many serious occupational health risks.

Resolution WHA 60.26 “Workers’ Health: Global Plan of Action” urged the member states to work towards full coverage of all workers, including those in the informal economy, small- and medium-sized enterprises, agriculture, and migrant and contractual workers, with essential interventions and basic occupational health services. This would help in primary prevention of occupational and work-related diseases and injuries. WHO secretariat was requested to develop timeline and indicators to establish occupational health services, for everyone at the global level.

WHO’s work on extending access to the most essential health interventions and services for workers’ health includes:

Enabling primary care centers to deliver preventive, curative and rehabilitation people-centred care according to the specific health needs of working people, particularly those who do not have access to occupational health services.
Strengthening the specialized occupational health services – multidisciplinary and basic and improving their link to primary care centres and to the rest of the health systems.
Stimulating international efforts to build human resource capacities for workers’ health, both in primary care and occupational health specialists.

At the World Day for Safety and Health at Work celebrated on 28 April 2014, WHO called for scaling up of workers’ health coverage. On the occasion, WHO urged countries and the global community to extend health coverage for all workers, including farmers and artisans, as well as contractual and migrant workers in the informal sectors.

Summary

Occupational health refers to the identification and controlling the risks arising from any physical, chemical, and other workplace hazards in order to establish and maintain a safe and healthy working environment. Health is not merely the absence of disease but a positive state of total physical, mental and social well-being. When the workplace pressure becomes excessive or otherwise unmanageable it leads to stress. Employees are less likely to experience work-related stress when demands and pressures of work are matched to their knowledge and abilities, control can be exercised over their work and the way they do it, support is received from supervisors and colleagues and participation in decisions that concern their jobs is provided.

Occupational health provisions not only work at individual level but are also active at the organizational level, in the form of various health specialists. It is a statutory and moral responsibility of the employers to safeguard the health, safety and welfare of workers, and to take reasonably practicable steps to prevent avoidable injuries. In this regard, World Health Association has urged its member states to work towards full coverage of all workers, including those in the informal economy, small- and medium-sized enterprises, agriculture, and migrant and contractual workers, with essential interventions and basic occupational health services. This would help in primary prevention of occupational and work-related diseases and injuries.

you can view video on Occupational Health and Anthropology

References and weblinks

Stellman, J.M. ed., 1998. Encyclopaedia of occupational health and safety. International Labour Organization.
Quick, J.C.E., Murphy, L.R. and Hurrell Jr, J.J., 1992. Stress & well-being at work: Assessments and interventions for occupational mental health. American psychological association.
http://www.springer.com/psychology/arbeits-+organisations-+%26+wirtschaftspsychologie/journal/41542
https://medlineplus.gov/occupationalhealth.html
http://fitforwork.org/employee/staying-in-work/the-role-of-occupational-health/
http://www.nioh.org/
https://www.niehs.nih.gov/health/topics/population/occupational/
http://www.who.int/topics/occupational_health/en/
https://healthfinder.gov/HealthTopics/Category/everyday-healthy-living/safety/stay-safe-at-work

Suggested Readings

Quick, J.C.E. and Tetrick, L.E., 2003. Handbook of occupational health psychology. American Psychological Association.
Harrington, J.M. and Gill, F.S., 1983. Occupational health. Blackwell Scientific Publications.

Terminologies used in occupational health:

Occupational Stress: Environmental and individual factors that contribute to stress stimulation process; moderators of stress-outcome relationships.
Economic Factors influencing Occupational Health includes job insecurity, unemployment, income disparity, and financial stress.
Occupational Health Interventions: Organizational, individual, social policy level, and multilevel interventions; health promotion; integrated safety & health programs.
Workplace Diversity and Discrimination: Minority and Immigrant Workers, Age/Gender/Race/Ethnicity/Disability Discrimination, Occupational Health Disparities.
Workplace Aggression: Prevalence, antecedents, and consequences of physical/verbal violence, harassment, bullying, incivility – prevalence, antecedents.
The Employment Relationship: Contract and temporary work; Self-employment; Seasonal Work; Under- and over-employment; unemployment; job insecurity.
Work Schedules: Part-time work; Night/evening work; Weekend schedules; irregular schedules; overtime; long work hours; flexible schedules; telecommuting.
Human Resource Management and Benefits: Health, pension, and other benefits; FMLA issues, Pay equity; Workers’ compensation program issues; job accommodations.
Work, Life, and Family: Work-life balance; Work-family conflict; Child and dependent care; Formal and informal family supports; Positive spillover.
Organizational Practices: Lean production; Downsizing and resizing; Globalization; Outsourcing; Continuous improvement; Process reengineering; Emerging technologies.
Job and Task Design: Worker control; Work pace and work overload; Emotional labor; Physical demands.
Social and Organizational Context: Organizational climate and culture; Social support; Supervision and leadership; Group dynamics; Communication.
High Risk Jobs and Populations: Younger and older workers; Hazardous work environments; High-risk occupations.
Traumatic Stress and Resilience: Assessment, prevention, mitigation, and treatment of traumatic stress; Resilience; PTSD; Treatment seeking.
Mental and Physical Health consequences of Job Stress: Depression, Obesity, Substance abuse, Musculoskeletal, cardiovascular, and immune system function; Suicide.
Sleep, Fatigue, and Work: Effects of work schedules on sleep; sleep disorders and medications; health and productivity implications of sleep disruptions.
Aging and Work Stress: Job design for aging workers, Attitudes toward aging workers; Disability management and accommodations; Health benefit implications.
Health Services and Health and Productivity Management: Employee Assistance Programs; Vocational rehabilitation & counseling; Disability management.
Safety Climate, Management, & Training: Safety communication, motivation and leadership; hazard identification and elimination; safety; climate and culture.
Professional and Educational Development: Graduate/Undergraduate/Employee training in Occupational Health disciplines; Career development programs.
Research Methodology: Innovations in occupational health research design, measurement, methodology.
Prevention / Intervention Methods and Processes: Field intervention design, barriers, and challenges; Intervention evaluation/implementation methods and standards.
Positive Aspects of Well-being: Job satisfaction, work engagement, job involvement, positive work experiences, benefit finding.
Individual Differences in Occupational Health: Personality, coping skills, demographic factors affecting occupational health outcomes.
Occupational health and employee retention: Health influences on turnover; Presenteeism; Absenteeism; Commitment; Organizational citizenship behaviors.
Rehabilitation and accommodation for disabilities: Re-entry to the workplace after injury and illness; accommodation for workers with disabilities, especially those disabilities that were work-related.
Accidents and injuries: Environmental and individual factors related to workplace accidents and injuries.
Musculoskeletal Disorders (MSD): Environmental and individual factors related to development of MSD.
Health promotion: The effectiveness of health promotion by organizations, for example, offering health programs for exercise or smoking cessation.
Dissemination and Implementation Science: Research approaches for translation of knowledge into practice, including identification of factors or methods affecting intervention adoption, scale up and sustainability.