United we stand: are we harmonising the right OHS law?

We need a national OHS system that’s more suitable to contemporary workplaces and workers. Thomas Cunningham

2011 was a year of reforms that didn’t go smoothly and the Federal government’s attempt to harmonise occupational health and safety (OHS) legislation across the country was no exception. The intention of the legislation was to make it easier for employers with operations in more than one state to implement the law, but the government’s vision for the national system may itself be lacking.

All states and territories were due to have enacted the model legislation by the start of the year, but by January 1, only Queensland, New South Wales, the Australian Capital Territory and the Commonwealth had done so. Victoria has indicated it’ll delay making required changes while Western Australia has stated its intention not to adopt all aspects of the legislation. Meanwhile, there have been hiccups in South Australia, and Tasmania and the Northern Territory are behind schedule.

But while the government’s efforts have not gone as smoothly as hoped, a more fundamental question – about the kind of OHS laws we need – remains unaddressed by efforts to create a national system.

Modern OHS laws are a form of self regulation. They aim to have employers protect their employees from harm by creating safe and healthy working environments. They also establish a voice for workers in identifying, assessing and mitigating risks at work – as a means of “keeping the bastards honest” as the saying goes.

But the legislation assumes that work-related health problems are distinguishable from those not related to work. This functions well for the prevention of injuries – it’s usually clear when a worker has sustained an injury in a workplace and what has caused it.

But illness is a different matter.

Hidden causes

Diseases are multifactorial – they arise from a combination of environmental and personal factors. They can come from work or outside work; they can be genetic or behavioural; physical or psychological. And they often develop over a long time. As a result, most of the morbidity and mortality from work-related illness goes unrecognised.

Christopher Angell

SafeWork Australia only publishes statistics on traumatic injury fatalities, of which there were 442 over 2007 and 2008. It admits this number doesn’t include suicides or deaths from “natural causes, such as strokes or heart attacks”.

The number of deaths from work-related illness in Australia is usually calculated to be between 2000 and 3000 a year. But one study estimated that deaths due to exposure to hazardous substances in one year alone was 2290. The leading cause of such deaths is cancer.

There’s also a growing body of evidence showing that occupational stress causes serious illness, especially cardiovascular diseases that lead to strokes and heart attacks. This is amply illustrated in the report from the Employment Conditions Knowledge Network to the WHO Social Determinants of Health Commission (see pages 158 to 162).

And the potential for bullying or other occupational stressors at work contributing to suicide is painfully clear. Mental health problems, along with musculo-skeletal disorders, now cause as many workers compensation claims as injury, and they cost more.

So we cannot easily separate conditions caused by work from those which are not. Usually, it’s a combination of factors at work and outside work.

Toward an integrated model

Employers have a responsibility to provide a safe and healthy workplace, but workers have a responsibility to maintain their health too. At the moment we pretend some health problems are the responsibility of employers, through OHS, and some are the responsibility of workers, through workplace health promotion.

It’s common practice to offer health screening and advice on healthy eating, drinking, exercise and mental health, for instance, but to ignore the fact that we now know that poorly designed jobs or bad supervision cause pressure which leads to unhealthy behaviours.

But there’s evidence that if OHS and workplace health promotion are integrated, magic happens. The WellWorks project in the United States, for instance, integrated OHS and workplace health promotion programs for cancer. Along with tackling occupational carcinogens, the workplace health program tackled diet, smoking and exercise.

Project evaluation found that an integrated program was more effective in getting workers to take action for their health than traditional workplace health promotion programs. It seems the knowledge that management is doing what it can to create a workplace supportive of good health has a positive effect on worker willingness to take more responsibility for their own health.

Recently, the US National Institutes of Health and the Centre for Disease Control released an evidence-based integrated model. The model suggests what works for better health and productivity is action aimed at improving individual health-related behaviours and physical, organisational and psycho-social working environments as well as links to families to communities.

Coming full circle

Modern safety science was invented during the second industrial revolution in the United States at the turn of the twentieth century. So our fairly simplistic model of OHS, which has served very well for injury prevention, is relatively recent.

In the past, OHS and corporate social responsibility were integrated; a more comprehensive OHS model was practised during the first industrial revolution in the United Kingdom by the paternal philanthropists such as Robert Owen. In addition to improving the health and safety of his cotton mills in Manchester, Owen provided housing and education for his workers. And this may be something of a model for the future.

The Institute of Safety, Compensation and Recovery Research, which I head, recently undertook research on probable futures in OHS that showed a trend of diminishing direct control for governments. Instead, as the scope of workplace health gets bigger, governments will likely work in partnership with a range of different types of organisations. In Canada for instance, WorkSafe BC has co-ordinated a number of employers, unions, health organisations and other government departments to run an injury prevention campaign. It’s not limited to work-related injuries or branded WorkSafe BC.

As best-practice employers recognise that society now expects them to demonstrate value to the community beyond profit to shareholders, they’re likely to do more to contribute their expertise across their industry, especially to smaller organisations.

It is too late to review the fundamental principles underpinning Australia’s approach to OHS legislation, but perhaps a harmonised approach, when it eventuates, will make it easier to evolve the national workplace health and safety system into something more suitable to contemporary workplaces and workers.