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Making Sense of Health and Wellbeing Risk Assessment

Spotting a safety incident after the event is often easy. Trying to prevent that event is difficult but using past events to understand the type of incidents that may occur is a regular activity in safety management leading to the prevention of many accidents and saving lives. Spotting an occupational health or health and wellbeing event is comparatively difficult and therefore learning from the events, understanding the size of the risk and mitigating that risk is difficult.

There are fundamental differences between spotting a safety cause or contribution to an accident or injury versus our ability to attribute individual or series of exposures to recognised occupational health hazards as the direct cause of an occupational disease in an individual. These include the latency period between workplace exposures experienced in a current or previous job, any effect recognised to be associated with work, the number of causes that might lead to the effect, and the identification of the effect on the person.

Respiratory conditions such as occupational asthma or diseases such as silicosis or those due to asbestos can take multiple exposures over periods of months or years to cause symptoms or for biological to be found by medical tests. A respiratory condition could be grounded in an individual’s personal habits such as smoking or hobbies such as DIY and motorsport, just as much as their own workplace activities such as working with ballast. Is the individual’s poor respiratory condition just a part of their DNA, the result of getting old or is it work-related in some way? More likely it is a complex combination of events. Attempts to unpick this may be done by GPs, occupational health professionals, specialists in lung disease and claims courts should as cause for concern come to the attention of a professional. Or, as we suspect happens quite commonly, the individual may see a respiratory condition as a part of life and something they expected and accepted about their job and thought not to mention it until they can avoid it no longer at some point after stopping work Sometimes a post-mortem discovery triggers a series of enquiries.

Separation between legal, business and personal risk is also difficult for health and wellbeing for anyone where this is part of their role. Companies have a legal duty to manage the business risk posed by workplace stress but are worried they could hit shaky ground if the individual is having marital issues alongside problems at work. When is involvement in an employee’s personal matters for during a conversation with a manager overstepping the mark? If the stress issue is not seen as work-related and there is no legal implication for the company to do more, is this situation really any better for the company if an individual requires a long time from work to recover? Does acknowledging the stress risk mean it is more likely to occur or does it mean issues that have always been there are now being tackled?

Let us consider a Musculoskeletal incident. This is often seen as a safety incident and it is taken at face value that the activity where the event occurred is the main cause of any injury. However, the weakening and aging of an individual’s body parts will happen over many years until seemingly the most innocuous of events lead to a debilitating injury. Maybe this was caused at work but felt at home or vice versa. The way we view Musculoskeletal Disorders within rail is from a safety approach. Simple cause and effect. Record where the incident occurred and whether time-off was needed and maybe required a RIDDOR report. At this time, whether this incident will now happen more readily is not of interest for most cases. If it happens at home, it is not work related. If it happens again at work, can it be tied to a relatively significant incident and does it require time off? If not then it may not be recorded, if so it is not seen as a repeat event.

These many complications will be exacerbated through aging and more sedentary workforce, changing work patterns, environmental threats to health and the UK obesity epidemic leading to further health complications over a larger timespan of employment and increased health and wellbeing risks for a broader range of health problems. If we can understand these risks early, we can directly and indirectly mitigate some of the effects and invest in change over time. 

We know we can do some of these preventative steps in ways that are economically viable and sustainable over a long time – some of these are already known and others are on the horizon. So, let us invest now in better understanding the business risks associated with these issues. We do not yet have all the tools we need to manage them because our safety tools are not an exact fit. However, we are practiced in managing safety risks and this does give us a head start in identifying what we need to do. As part of the health and wellbeing roadmap rail companies will continue to press to unravel this complexity and provide business information for better decision making.

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