Australia’s occupational health and safety regime needs first aid

Work has shifted from manufacturing to knowledge industries but OHS hasn’t kept up. Karenne Sylvester

Only 13%* of Australian workplaces comply with Safe Work Australia’s new code of practice on first aid, according to research by St John Ambulance. But this is only the tip of the iceberg for the crisis in Australian occupational health and safety, which itself appears to need first aid.

St John Ambulance’s survey assessed the extent to which workplaces recognised their first aid needs, supplied first aid equipment and appropriately trained first aiders. Over half of workplaces (55%) were unaware of the code of practice, although the CEO of St John’s Ambulance admitted the survey targeted low-risk workplaces and he recognised that large, high-risk workplaces tended to be more compliant.

While these results may come as a surprise to many Australians, for those of us who work in occupational health and safety it’s business as usual. Observations of the gap between knowledge of what action would prevent work-related ill health and implementation of preventative measures are common.

We have known how to prevent noise-induced hearing loss for decades, for instance, but it’s still responsible for 3.6% of all workers compensation claims in Australia. Safe Work Australia has codes of practice for noise control too. And while a new code for manual handling was issued by Safe Work Australia in 2011, musculoskeletal disorders are still responsible for more than half of all workers’ compensation claims, and an even higher proportion of costs.

But what’s most surprising is how little we know about what works in occupational health and safety regulation.

Health and safety regulations prescribe a general duty of care for employers to provide safe and healthy working environments. They also provide for the empowerment of selected workers to play a role in assisting employers to meet these obligations or, at least, to hold them to account.

Employers have the responsibility to assess the health and safety risks of their businesses and to control them. And the role of government OHS authorities is to regulate their self-regulation.

In keeping with the findings of the St John study on first aid, this approach seems to have worked best for large organisations whose work processes have significant physical hazards. Such organisations are sensitive to the loss of reputation arising from causing fatalities or serious injuries. But in recent decades, the nature of work, workplaces and workforces have changed dramatically and how governments can and should regulate for health and safety compliance has become a pressing question.

As work has shifted from manufacturing to knowledge industries (and intensified), injuries have declined and been replaced by musculoskeletal disorders and psychological ill health. In 2010, the Productivity Commission found that inspectorates around Australia were not well equipped to meet the new challenge of mental health.

What’s more, the strength of the employment relationship – a key foundation for the principle of self-regulation – is in decline. Workers are more likely to be employed on a casual basis, and to be employed in smaller businesses with fewer resources for health and safety. And union membership is falling.

Research on the extent of compliance with standards, such as that undertaken by St John’s Ambulance is good start, as is Safe Work Australia’s foray into surveillance of hazards in industry. But we also need more research on how best to use government resources.

Questions being asked include – what is an optimal balance of resources for enforcement, education and encouragement? What is the potential for private-public partnerships in delivery of enforcement, education and encouragement? And how best to use the growing influence of corporate social responsibility?

Research underway at the centre I head is helping WorkSafe Victoria determine the optimal mix of enforcement, compliance, and promotion to ensure that OHS continues to be embraced as a core element of operating a successful business. Other projects, such as one developing reliable leading indicators of safety intervention effectiveness, and the recent evaluation of WorkHealth, which implemented workplace health promotion, will provide evidence for new approaches to address the issues arising in many of today’s workplaces.

* This figure has been corrected. The original version incorrectly said 16%.

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