Wel­fare and safety need equal billing

DR CLAIR DICKINSON, Of­fice of Rail and Road Oc­cu­pa­tional Health Pro­gramme Man­ager, looks at how im­prov­ing health and well­be­ing by bet­ter job de­sign leads to a bet­ter rail­way for staff, pas­sen­gers and the in­dus­try

Rail (UK) - - Opinion -

Ahealthy work­force is es­sen­tial for em­ploy­ers. Pro­tect­ing staff from in­jury and pre­vent­ing ill­ness need to be cen­tral to the plan­ning of any in­dus­try that as­pires to run ef­fi­ciently and pro­vide a good ser­vice to its cus­tomers.

Why? Well, of course ev­ery em­ployer has a duty of care to their em­ploy­ees, but, as well as that, the ef­fect of poor health on the bot­tom line is alarm­ing.

The rail in­dus­try em­ploys around 150,000 peo­ple in the UK. Ill health costs the rail in­dus­try around £ 790 mil­lion a year, and sick­ness ab­sence is run­ning at more than one mil­lion days per year. The ab­sence rate in rail is 3.9% com­pared with 1.8% in the pri­vate sec­tor, and for ev­ery £13 that is lost be­cause of sick­ness, only £1 is spent on try­ing to keep work­ers healthy.

Health risks faced by work­ers have his­tor­i­cally re­ceived less at­ten­tion than the safety risks. This is de­spite the fact that five times as many work­ing days are lost through work-re­lated ill-health than the 4.5 mil­lion days lost each year due to non-fa­tal in­jury. The an­nual cost of new cases of all Great Bri­tain’s work-re­lated ill-health in 2014/15 was £ 9.3 bil­lion.

The last thing the Of­fice of Rail and Road (ORR) wants to do is lessen the at­ten­tion paid to safety at work. What we want is to bring that same level of at­ten­tion to health, and in the past few years, we are pleased to see that the in­dus­try is in­creas­ingly dis­play­ing a gen­uine in­ten­tion to pro­tect its staff and pre­vent ill-health by bet­ter job de­sign and it is us­ing data, ev­i­dence and in­ge­nu­ity to achieve this aim.

Bet­ter job de­sign means mak­ing jobs fit the ca­pa­bil­i­ties and skills of in­di­vid­ual em­ploy­ees as well as mak­ing changes to the job so that both the short and long-term risk of harm is re­duced. In 2014, ORR pub­lished Bet­ter Health

is Hap­pen­ing, which high­lighted ar­eas of par­tic­u­lar con­cern in the rail sec­tor: HandArm Vi­bra­tion Syn­drome (HAVS), res­pi­ra­tory dis­ease, mus­cu­loskele­tal disor­ders, and is­sues caused by stress and men­tal health – and chal­lenged the in­dus­try to use ‘the 4Es’ to man­age health risks: Ex­cel­lence in health risk man­age­ment En­gage­ment Ef­fi­ciency and value for money En­abling – in­clud­ing train­ing and com­pe­tence

Hand-Arm Vi­bra­tion Syn­drome

HAVS causes loss of sen­sa­tion in the fin­gers and dam­age to the blood ves­sels in work­ers who use hand-held power tools. In 2016-17, there were 85 new or wors­en­ing cases of HAVS re­ported to ORR in the rail in­dus­try. Al­though this is still far too many, it rep­re­sents real im­prove­ment achieved through stronger health sur­veil­lance regimes and will pro­vide fu­ture im­pe­tus for seek­ing ever-bet­ter job de­sign to elim­i­nate ex­po­sure to vi­bra­tion and use of hand-held power tools.

ORR is work­ing closely with Net­work Rail’s prin­ci­pal con­trac­tors and labour sup­ply com­pa­nies to im­prove and ex­tend health sur­veil­lance through the sup­ply chain, and has agreed a ‘who should do what’ pro­to­col to en­sure that ev­ery­one knows their role in HAVS pre­ven­tion.

On the path to im­prove­ment there have been dis­ap­point­ments – ORR served one on Net­work Rail for a fail­ure to man­age HAVS risks - but pre­ven­tion through bet­ter job de­sign is start­ing to take hold across the in­dus­try as rail com­pa­nies seek to limit ex­po­sure by chang­ing how jobs are done.

Sil­ica ex­po­sure

Ex­po­sure to sil­ica can cause lung dis­ease and less­en­ing that risk has been a key fo­cus for ORR in­spec­tors, who are now lead­ing a na­tional ini­tia­tive to iden­tify and pre­vent ex­po­sure in rail prop­erty main­te­nance and re­fur­bish­ment projects.

ORR has worked with Net­work Rail on the

de­sign of new bal­last-clean­ing equip­ment with im­proved dust con­trols and retro-fit­ting ex­ist­ing kit with pro­tected op­er­a­tor cabs to limit work­ers’ ex­po­sure to dust.

The main­line Bal­last Dust Work­ing Group is col­lab­o­rat­ing to share ad­di­tional mon­i­tor­ing data on ex­po­sures to sil­ica dust, which will, in turn, lead to risk ar­eas be­ing iden­ti­fied and mit­i­gated, es­pe­cially dur­ing con­ven­tional re­newals projects.

Men­tal health and stress

Tack­ling men­tal health con­cerns re­mains a sig­nif­i­cant chal­lenge for our in­dus­try, al­though there are en­cour­ag­ing signs of progress.

As more rail com­pa­nies mon­i­tor and re­port data on men­tal health ab­sence, ef­fec­tive strate­gies are be­ing de­vel­oped to tackle the un­der­ly­ing causes and sup­port those af­fected. Train op­er­a­tors are in­creas­ingly proac­tive in sup­port­ing their staff ex­posed to trau­matic events and as­saults, and are shar­ing good prac­tice.

Net­work Rail has re­cently in­cluded a men­tal health re­silience project within its pri­or­ity Home Safe Plan; de­vel­oped new stan­dards on stress risk as­sess­ment and trau­matic in­ci­dent man­age­ment; and in­tro­duced a net­work of men­tal health cham­pi­ons.

Cur­rently avail­able data on shock/trauma in­ci­dents shows a broad down­ward trend across the in­dus­try in re­cent years, and an on­go­ing RSSB project to fur­ther im­prove health data col­lec­tion should en­able a bet­ter un­der­stand­ing of the incidence and causes of men­tal health, par­tic­u­larly work-re­lated stress. Sup­port from rail com­pa­nies will be es­sen­tial to a suc­cess­ful out­come on bet­ter health data.

Fit­ness for work

General fit­ness for work is also cru­cial and ORR is set to pub­lish a doc­u­ment on what stan­dards should be in place for med­i­cal as­sess­ments for safety-crit­i­cal roles within the in­dus­try. In ad­di­tion, an au­dit regime is be­ing de­vised to en­sure that ORR recog­nised doc­tors – who med­i­cally as­sess train driv­ers to en­sure they are fit to work – are fully trained on med­i­cal re­quire­ments for as­sess­ing driv­ers.

As things stand, the at­ten­tion paid to oc­cu­pa­tional health in the rail in­dus­try is not suf­fi­cient and, as a re­sult, work­ers are suf­fer­ing need­lessly, the in­dus­try is los­ing money it can ill-af­ford and pas­sen­gers have a less ef­fi­cient ser­vice than they should ex­pect.

But, we are trav­el­ling in the right di­rec­tion. The level of at­ten­tion paid to safety con­cerns is start­ing to be mir­rored by that paid to health mat­ters, and we are be­gin­ning to see the fruits of that new fo­cus.

ORR will con­tinue to high­light the ben­e­fits of bet­ter job de­sign and as it be­comes more and more em­bed­ded in daily work­ing prac­tice, we ex­pect to see even greater ben­e­fits for staff, pas­sen­gers and the in­dus­try.

The in­dus­try is in­creas­ingly dis­play­ing a gen­uine in­ten­tion to pro­tect its staff and pre­vent ill-health by bet­ter job de­sign.

Source: ORR

Rail oc­cu­pa­tional health facts


Ex­po­sure to sil­ica has been linked to lung dis­ease. With this in mind, the ORR is lead­ing a na­tional ini­tia­tive to iden­tify and pre­vent ex­po­sure to the rail work­force. The Bal­last Dust Work­ing Group has been es­tab­lished to share mon­i­tor­ing data on...

Source: ORR

Hand-Arm-Vi­bra­tion Syn­drome 2011-17

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