What is TWH???

Total Worker Health?, TWH, is a framework of business policies, programs, and practices that integrate safety throughout the business instead of setting it up as just another department that is the current norm.?Many Safety Managers say they are lucky to get a word in with the owner and/or managers while riding in the elevator.?In the Safety world there is an axiom: Last hired, first fired.?Even though the safety profession was identified as an essential service, the high number of new job postings in the field may indicate that the businesses do not see Safety as essential to their business.?Resulting in layoffs due to COVID-19, when safety and health personnel were most needed.

I was prepared to dislike TWH as another fad. The word “well-being” and the required knowledge of an employee’s activities outside the workplace, seemed intrusive for the worker and a potential loss of trust when new hires are hard to get, and keep.?Many current and long term employees are facing a gradually increasing burnout from longer hours and/or more work.?This article in the August 31, 2022 Harvard Business Review on Quiet Quitting that discusses the trend of workers “whether their “work environment is a place where people want to go the extra mile.”” ?

In conclusion the article stated “this research is telling us to look within and recognize that individuals want to give their energy, creativity, time, and enthusiasm to the organizations and leaders that deserve it.”?This places the onus on the businesses moving to the TWH system to demonstrate the intent is to engage with the workers to make their workplace safer, not add to their work.

When I went back for another look at the Total Worker Health? premise and processes I found that it is hard to dislike an initiative that addresses so many of my core beliefs about the implementation of safety in the workplace.?For example, I believe that the most effective use of a Safety Manger’s time and skill is addressing work-related safety and health hazards before they become a near miss or an accident.?TWH requires the promotion of injury and illness prevention efforts to advance worker well-being.

In my experience a near miss is an accident in every way except luck and luck is not a reliable hazard control.?I was called to investigate a fatality that occurred just 3 months after a near miss accident under the exact same circumstances.?The root cause was an unsafe condition identified on page 3 of the owner’s manual for the equipment the employees had used.?TWH processes incudes a rigorous investigation into near miss accidents, as does Simple Safety Coach’s safety management software.

Implementing Total Worker Health? broadens the scope of safety across the business creating transparency, engagement, and responsibility at all levels, the priority in the development of SSC.?This will set the conditions for a safer, healthier, and stronger workplace and workplace culture.?This is made possible through coordinated programming and collaboration around organizational leadership and commitment to ensure the following are developed and implemented in a manner supportive of TWH:

·????????supportive organizational policies and practices

·????????management and employee engagement strategies

·????????supportive bene?ts and incentives

·????????accountability and training

·????????integrated real-time evaluation and surveillance with praise or corrective action as indicated

My main concern about TWH was this statement, “the integration efforts have expanded to consider the synergistic opportunities between and among the health of workers at and away from work and a broader look at the interplay of work and non-work factors and in?uences on the well-being of workers.”?

The way I read that sentence is provision of authority, and responsibility, to a business to require knowledge of employee’s activities when they leave work.?This could also indicate the business could be held responsible for employee exposures under conditions the business could not control.?This could have seriously negative effects on the employer/employee relationship as well as potential for legal action.

On the other hand, it has long been known that employee exposures must be viewed in the context of their exposures at work for an accurate evaluation of risk to their health.?For example, 1910.95, the Occupational Noise standard’s exposure limits are based on time away from noise for the nerve cells in the ears to recover, which is why the Action Level decreases when the shift length increases.?What about the employee who plays in a rock band??The exposures could result in an increased risk of hearing loss than other employees. ?Given that, it’s in the best interest of the employee not to assign them to high noise areas.?

Many employees in Wisconsin have fireplaces, wood stoves, and use wood to heat water to create radiant heat and hot water for their homes.?A typical fall includes use of chain saws, axes, awls, and the various ergonomic hazards associated with carrying and stacking wood.?A workplace that uses the siloed approach to safety, even with a worksite wellness program, could require the worker use the same muscles on Monday that were used all weekend.?Increasing the risk of an ergonomic injury at work, on the injury/illness logs, as well as creating murky waters for worker’s comp claims resulting in extra administrative hours, delayed treatment, and so on, and so on.?However, if this seasonal task is coordinated with tasks in the workplace this risk could be reduced or avoided.

My conclusion is that the benefit to the employee by moving from a siloed approach to safety, which assumes the employee has no off-site exposure, to jointly and comprehensively address any synergistic or additive exposures as well as exposures at either inside or out of the workplace exceeds my concerns.

Now, let’s take a closer look at TWH so you can decide if it could benefit your organization.?In 2014 the National Institute of Occupational Safety and Health released a proposal for a national Total Worker Health? Agenda for stakeholder comments that shaped the National Occupational Research Agenda/National?Total Worker Health??Agenda (2016-2026). ?

The difference in approach to worker safety can be seen in new, or changes to existing, definitions:

Built environment “encompasses all buildings, spaces, and products that are created or modified by people. It impacts indoor and outdoor physical environments (e.g., climatic conditions and indoor/outdoor air quality), as well as social environments (e.g., civic participation, community capacity, and investment), and subsequently our health and quality of life.” Source: National Institutes of Health.

Conditions of work “workplace factors that shape the way workers perform their jobs. These factors include interpersonal interactions at work, such as supervisor-employee interactions, co-worker interactions, and customer interactions. Other factors include hours of work, rest periods, work schedules, physical work environment, physical demands, job strain associated with stress, and on-the-job hazards.” Source: NIOSH.

Health “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.” ?Source: World Health Organization.

Hierarchy of Controls (as applied to TWH) is “a conceptual model for prioritizing efforts to advance worker safety, health, and well-being. It expands the traditional hierarchy from occupational safety and health to include controls and strategies that more broadly advance worker well-being, such as eliminating workplace conditions that cause or contribute to worker illness and injury and redesigning the work environment to include health-enhancing organizational policies.” ?Source: NIOSH.

Organization of work “involves the work process (the way jobs are designed and performed) and the organizational practices (management and production methods and accompanying human resource policies) that influence job design. Also included in this concept of organization of work are external factors, such as the legal and economic environment and technological factors that encourage or enable new organizational practices.” ?Source: NIOSH.

Total Worker Health? “includes policies, programs, and practices that integrate protection from work-related safety and health hazards with promotion of injury and illness prevention efforts to advance worker well-being.” ?Source: NIOSH.

Worker well-being “an integrative concept that characterizes quality of life with respect to an individual’s health and work-related environmental, organizational, and psychosocial factors. It is the experience of positive perceptions and the presence of constructive conditions at work and beyond that enable workers to thrive and achieve their full potential.” ?Source: NIOSH; RAND Corporation.

Total Worker Health? has 5 defining elements:

1. Demonstrate leadership commitment to worker safety and health at all levels of the organization.
2. Design work to eliminate or reduce safety and health hazards and promote worker well-being.
3. Promote and support worker engagement throughout program design and implementation.
4. Ensure confidentiality and privacy of workers.
5. Integrate relevant systems to advance worker well-being.

The Essential Elements for Advancing Worker Safety, Health, and Well-Being, NIOSH publication #2017-112, December 2016 is about the fundamental principles of TWH.?It states that “job-related factors can have an important impact on the well-being of workers, their families, and their communities.”?Workers and their family’s health being impacted by the worker is a long-standing aspect of occupational health and safety hazard assessments.?For example, a worker can bring chemical or harmful elements home on their clothing, shoes, skin, and hair.?However, “and their communities” is new and not as direct a line of connection to the worker’s health and well-being. ?Taxes paid by businesses have a beneficial effect on a community, increasing funds for road maintenance etc.?Acts of charity by the business or workers also improve the health of the community in many ways but participation is voluntary.?

Even so, there is a lot of potential in the Total Worker Health? initiative.?My favorite quote from Fundamentals of Total Worker Health? Approaches: Essential Elements for Advancing Worker Safety, Health, and Well-Being (link) ?“the TWH approach recommends that employers and workers collaborate to design safe and healthy workplaces that support all workers”?This document contains a lot of ‘how to’ information, links to resources, and suggested venues for involvement for top leaders, mid-management, and managers as well as including reminders to encourage input from the most vulnerable employees, those that are on 3rd shift, drivers, salesforce, our aging workforce, our new hires, and lower wage workers.

?If you would like more information there are quite a few pages, with links to yet more pages, on the CDC/NIOSH website related to TWH.?There are several ancillary projects related to TWH, such as the NIOSH?Future of Work (FOW) Initiative was launched in May 2019.?The purpose of the Initiative is to try to get ahead of changes in the workplace, such as the growing opioid crisis and our aging workforce, by broadening the approach to worker safety, health, and well-being.?By using a multidisciplinary approach and encouraging collaboration “across the spectrum of organizational policies, programs, and practices that influence the safety and health of workers, their families, communities, employers, and society.”?

?My conclusion, after a deeper dive into Total Worker Health?, is that is closely aligned with the actions and benefits we built into Simple Safety Coach. ?The hardest thing for the average Safety Manager to do is to help management demonstrate their support for worker safety.?Even with the tools in Simple Safety Coach, if the Safety Manager has no access to upper management the odds of getting their involvement are not good.?With TWH there is a blueprint for owners, management, workers, supervisors, and the Safety Manager to launch their own TWH project.

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Here are just two of many systems in Total Worker Health? that are already built into Simple Safety Coach, our Safety Management Software system:

1.??????TWH is based on an inclusive, coordinated, effort (from CEO to production floor) in the development and implementation of safety programs and policies.?

a.??????Our software has 12 venues for anyone in the business to communicate and track safety information.

2.??????TWH recognizes that integrating data systems and processes can reduce multiple points of data entry while increasing the effectiveness of any process.?

a.??????Our software centralizes all safety processes and distributes data to ensure maximum communication and use.

b.??????This simplifies monitoring and evaluation, while enabling tracking of actions and results for continual workplace safety improvement.

?Our subscribers are well placed to start their Total Worker Health? program.?Interested??Contact us and we’ll show you how it works!

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?An elderly woman was asked by the doctor after her physical was complete if she had any concerns.

“Well,” she said delicately, “I have been, um, breaking wind, more frequently.?But I’m not sure it’s a concern since I don’t make any noise and there is no, er, smell.”

“I see,” the doctor says, and writes her a prescription.?“take these and we’ll make an appointment for next month to see how you’re doing.”

?A month later the woman returns and she’s very put out.?“Doctor, whatever was in those pills made my, uh, problem much worse, much more…. Smelly!”

“Good,” said the doctor.?“Now that we have your sinuses cleared out let’s do something about your hearing.”