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PUBH6002: Global and environmental health PUBH6002: Global and environmental health Module 5 Week 1 Module 5: Injury, workplace environments and health Sources of injury Injury burden and prevention Haddon Matrix Environmental influences of injury Workplace risk Assessment 2 Module 5 Week 1 This week we explore environmental influences on injury. In Chapter 22 Frumkin defines injuries as damage that results from intolerable exposure to heat/cold/radiation (energy), or deprivation of elements necessary for life and function. Injuries are considered to be preventable, but continue to create a substantial public health and clinical care burden in both developed and developing countries. This week introduces the concepts of injury burden, prevention and control, the Haddon matrix for evaluating injury, and considers injury prevention interventions and the delicate balance between freedom of choice and public health and safety. What can cause injury? Environmental hazards Man-made In nature Attacks Exercise Natural events Car accidents Workplace hazards Recreational activities https://i.ytimg.com/vi/jJgJiCCQORw/maxresdefault.jpg What does it have to do with public health? Almost half a million people a year were hospitalised in Australia as a result of an injury in 2011–12. The annual number of cases has risen from around 327,000 in 2002–03 to 454,000 in 2011–12. The overall rate of injuries resulting in hospital stays has also risen over recent years by an average of 1% a year since 1999–00. Australian Institute of Health and Welfare (2015) http://www.aihw.gov.au/injury/ Injury rates around the world https://vizhub.healthdata.org/gbd-compare/ https://vizhub.healthdata.org/gbd-compare/ https://vizhub.healthdata.org/gbd-compare/ 8 Traffic Accidents and Injury Traffic Accidents and Injury Traffic Accidents and Injury in Australia Watch: http://www.abc.net.au/7.30/young-australians-count-costs-of-accidents/4466442 - from 2013 Read the article by Judith Ireland from 2017 What are the trends in traffic accidents in Australia? Take a moment to google the burden of injury for your own country. Can you find this information? How does it compare to Australia? Injury ‘Damage that results from intolerable exposure to energy (eg. Mechanical, electrical, thermal) or deprivation of elements necessary for life and function’ ( Hess & Razzak, 2010, in Frumkin) Injury control: Prevention, acute care, rehabilitation Preventable Substantial public health burden (see Haagsma et al., 2016; Sethi, 2007) Injury prevention and control 1. Define the health problem; 2. Identify causes, risk factors, and protective factors associated with the problem; 3. Develop and test interventions to reduce the problem’s impact; and 4. Implement successful interventions, evaluate their impact, and ensure widespread acceptance and implementation of prevention principles and strategies of control. Frumkin Ch 22 pp 806-807 14 PhasesHostAgentEnvironment Pre-eventAlcohol, speedTires, brakesSigns, signals, EventBelt use, helmet useSeat belt, air bagsSide slope, guard rails Post event Health, Age Fuel system, materialsEMS response, road shoulders See page 811, Hess & Razzak, (2010) Injury: Haddon matrix Host, disease vector (agent) and environment: Interact to cause injuries Temporal phases: pre-event, event, post event First applied to road traffic injuries Examine the matrix to identify opportunities to prevent or control injuries Injury: Options analysis – injury control Prevent creation of a hazard Reduce the amount of hazard Prevent the release of a hazard that already exists Modify the rate of distribution of release of the hazard from its source Separate, by time or space, the hazard from its host Physically separate, by barriers, the hazard from its host Modify surfaces and basic structures to minimize injury Make that which is to be protected more resistant to damage Mitigate damage already done Stabilize, repair and rehabilitate the injured person Haddon (1973) in Hess & Razzak, (2010), p812 Injury prevention example: Pedestrian injury Polick et al (2001). http://www.sciencedirect.com/science/article/pii/S1353829211001262#gr1 Activity In groups of two choose a method of injury Consider the societal, community, interpersonal and individual/intrapersonal elements required to facilitate effective injury prevention Think back to our discussion of ethics in Week 1. What are the ethical implications of regulating or controlling the causes of injury at each level? Work environments Work environment and nature of employment: significant impact upon health Workplace: unique environment – spend large amounts of time, diverse exposures, has specific legal and social implications High-risk industries: mining, construction, agriculture, manufacturing Risks of occupational injury and disease: high in poorer countries Strategies for prevention of workplace injury and disease: process re-engineering, work environment controls, administrative controls, and behavioural controls - See Perry & Hu (2010) – chapter 20 in Frumkin 19 ‘Risky’ forms of labour What forms of employment put people’s health at risk? Which industries would you expect to experience the highest rates of workplace injury? Read the article provided. Is this what you would have expected? Why do you think these industries are so dangerous? How do you think it might compare to your home country? Assessment 2: Work Health Safety Assessment Using guidelines in Assessment brief: Conduct a Work Health Safety risk assessment. This can be your home work environment or a professional one (get permission if latter). Write up this case study 1500 words +/- 10% - between 1350 and 1650 words 30% Assessment 2: Work Health Safety Assessment Identify your workplace Use template provided Review the 6 steps to completing a work safety assessment Assessment 2: Work Health Safety Assessment Work through the 6 steps: Hazard identification Risk identification Risk Assessment Risk Control Documenting the process Monitoring and reviewing Assessment 2: Work Health Safety Template Use the template to identify: Any hazards Existing controls Relative risk level Controls needed to further reduce risk A diverse workplace might include sub-populations with greater vulnerability to risk: identify and describe, and propose solutions for mitigating these risks Assessment 2: Work Health Safety Template You could identify vulnerable populations under ‘task/scenario’ – and then complete columns, or you could do separate table for vulnerable populations Assessment 2: Work Health Safety Risk Assessment See page 10, Work safe ACT (2012) Assessment 2: Work Health Safety Assessment Write up your case study: Identify and describe any key agencies or institutions that govern work health safety in this type of working environment, and any policies that are relevant to maintaining a safe work environment (policies can be organisational, discipline-specific and/or national). Research this in regard to your specific workplace Identify and describe your chosen workplace so the context is clear – do this early in your assignment Assessment 2: Work Health Safety Assessment Write up your case study: 2. Summarise the findings of your work health safety assessment, including details relevant to managing risk for vulnerable populations, and provide recommendations to resolve the work safety risks identified. Write this up in the body of your report Provide your completed table (template) – refer to in your text Assessment Criteria Knowledge, understanding and application (40%) Understanding of the concepts that underpin Work Health safety assessment Application of the six steps of risk assessment to identify and evaluate elements of risk in the environment Analysis and application with synthesis of new knowledge (30%) Development of recommendations appropriate to the risk and context Ethic-Moral Reasoning (10%) Awareness of vulnerable groups in the workplace i.e. disability, gender, ethnicity, and the effect of work health safety risks for those vulnerable groups Academic conventions (20%) Is well written with appropriate sentences construction and without typing, grammar and punctuation errors Adheres to academic conventions and appropriate terminology Uses APA style for in-text citation and references PUBH6002: Global and environmental health Module 5 Week 2 Module 5 Week 1 A substantial proportion of our time is spent at work, and as a consequence the work environment and the nature of employment has a substantial impact on health. This includes injury, as discussed in Week 1, but encompasses a range of other factors and influences on health. The Work Health and Safety Act (2011) is a piece of Australian legislation that governs workplace health and safety (WH&S) policies that are required in each state and territory of Australia. The resources for this week discuss concepts relevant to WH&S, and directs you to the Safework Australia website resources. The Safework Australia guide to the act provides a brief explanation of the conditions laid out in the legislation. All states and territories except Victoria and Western Australia use harmonised Work Health and Safety (WH&S) legislation to govern safety in the workplace. The Safework Australia handbook on the principles of work design demonstrate how to implement the tenets of the act. You may wonder why this Australia-specific content has been included – the Frumkin chapter is more general about workplace health but is also highly America-centric. The Australian legislation has a week to itself because we must include workplace relevant content, and is included here because many students already work in Australia or wish to work in Australia, and will be required to participate in some form of workplace health and safety exercise as part of their employment in this country. Familiarity with this will give them an advantage in navigating WHS when they encounter it, and possibly ease the way for employment. 31 Work health and safety Discussion: How can our place of work impact on our health? Unemployment Precarious employment Informal employment/jobs Child labour Slavery/Bonded labour Forms of employment: Five dimensions Precarious Work ‘Non-standard’ employment that is: Poorly paid Insecure Unprotected Cannot support a household Precarious work associated with poor health: Lack of resources Hazardous working environments Informal employment Lack of statutory regulation to protect: Working conditions Wages Occupational health and safety Injury insurance Limited access to labour organisations Informal employment: Poor health outcomes Legal provisions for Workplace Health and Safety in Australia National legislation: The Work Health and Safety Act (2011) This governs the policies in each state This mini-lecture compares Australian and UK safe work legislation – an interesting comparison, especially for those new to working in Australia: https://youtu.be/4Re6rXdaaGE Accompanying sheet here: http://www.kitney.com/wp-content/uploads/2017/03/Info-Sheet-WHS-in-Australia-LSBU-mini-lecture-39025-02.pdf Each state has a state-specific policy for Work Health and Safety Example: SA Work Health Safety Act: https://vimeo.com/60983250 (from 0:34) 36 What does Workplace Health and Safety involve? A safe working environment is a workplace that is free of hazards and risks to the people working there. Your employer is responsible for providing and maintaining a clean, tidy and safe working environment. Clean and tidy work areas with rubbish and debris removed Clean and level floors with no tripping hazards or open pits Storage of tools, equipment and chemicals Similarly, you are also responsible for checking that your work area is clean and tidy and that your actions and behaviour do not create an unsafe working environment. How does a workplace do this? Policies and procedures – employers are required to have a general WHS policy that describes their commitment to WHS and how responsibilities are delegated to everyone in the workplace. Safe operating procedures (SOPs) are documents explaining how to work safely and efficiently in hazardous work situations, such as when operating machinery or using chemicals. Machine guarding protects machine operators and others in the work area from the hazards