Articles – Page 6 – Dr Farhan Shahzad

Health surveillance is simple. It means to monitor the health of a person over a period of time when that person is in an environment that could potentially damage them. Health checks vary between environments and they depend largely on the type of toxin or pollutant that is in a particular environment. For instance, noise exposure, vibration, ionising radiation, solvents fumes, dust and other biological agents that can or may cause toxicity need to be monitored.

Health Surveillance is often a legal requirement in a workplace where an employee is exposed to one or more of these elements.

Think of the recent TV show by HBO, based on the real-life disaster at the Chernobyl Nuclear Power Plant. Without adequate health surveillance, we risk grave consequences and mass illness. We have hopefully learned some valuable lessons from these historical catastrophes.

Under legislation, all Health Surveillance records will be retained for a minimum of 30 years with reports provided in accordance with legislative requirements.

How do we utilise Health Surveillance in the workplace?

Risk-based Health Surveillance, sometimes including biological monitoring, assesses possible health effects that may arise if occupational exposures exceed accepted or adopted exposure standards. It is imperative so that the employee is not put to risk, in which it may lead them to harm. The simple precaution monitors and detects any potential illness in their workers. The premise being early intervention. The emphasis also spans to checking whether their health surveillance is actually working too- and is a legal requirement of the state.

When should Health Surveillance be provided?

If there is a level of exposure that is or may be significant to an employee, then health surveillance should be conducted. This threat is detected by a risk assessment. Not all exposures are harmful, so other forms of management can be used from the Hierarchy of Controls. These include elimination, substitution, engineering controls, administrative controls and personal protective equipment (PPE).

Occupational Physicians are there to assess risk. They have the skills and expertise to monitor whether a pollutant is risky business. They also only recommend customised health surveillance once a thorough work assessment has taken place.

We Can Customise Health Surveillance

Health Surveillance may include a history, a physical examination, and often assessment of tests such as blood or urine samples, spirometry, or X-rays. These tests are only performed where there is such a need.

Sometimes we, as Occupational Health Physicians, assess an environment, we find that some of the routine tests are not needed. There have also been incidences where the tests administered are incorrect and totally unnecessary. These tests can also potentially miss any physiological changes that are indicative of harm or toxicity, meaning a person can become unwell from repeated exposure.

Is Health Surveillance only required for Hazardous Substances listed in Australian legislation?

The Commonwealth and State Workplace Health legislation outlines the mandatory substances only, and the number of substances are about to increase. There are also a number of other substances that have an effect on health that should be monitored for. As new substances are being created, we need to monitor the impact these have on people. With research, comes prevention. Occupational health physicians can assess environments for potential hazardous and carcinogenic substances that will protect your workplace from actual harm.

The Person-environment fit is a hot topic. Organisations are becoming more and more equipped and knowledgeable of culture and personality at work. This is due to the implications of sickness absence due to stress and burnout, but also, as a safeguard to moderate against conflict at work.

There are a number of workplace personality models that can help organisations manage staff wellbeing. The Cooper-Marshall Model, for instance, considers a range of organisational stressors and their potential impact on the individual (both physically and psychologically), as well as covering what they call ‘extra-organisational sources of stress’ that can also impact on the employee. These include family and financial problems that occur outside of work. Karasek (1979) offers an alternative account of occupational stress that is called the Job Strain Model. Job strain, or psychological strain, is the result of workload (or work demands) and not enough autonomy (which is defined as decision latitude). Strain occurs when the employee’s work demands are too high and the level of decision autonomy they have is low.

According to the Job Strain Model, low decision latitude and high job demands result in psychological strain, which can be counteracted by increasing the employee’s level of autonomy (or decision-making abilities). However, although increasing the employee’s decision latitude has been shown to reduce strain, beyond a certain level this may have an adverse impact on the employee’s wellbeing. Managerial staff, and what he defines as ‘low status workers,’ have shown strikingly different results when it comes to the impacts of decision latitude on wellbeing. Hence, it is important to account for an individual’s role within the organisation when determining what level of decision autonomy would be effective.

The Vitamin Model is another theory that utilises the analogy of vitamins A and D, and C and E, to gain an understanding on how job characteristics impact on employee wellbeing in a non-linear fashion. The Vitamin Model accounts for 12 job characteristics that can be compared to these vitamins. Six of the job characteristics are analogous to vitamins A and D and the other six are comparable to vitamins C and E. According to this model, just like our bodies require vitamins for survival, certain aspects of the job are required for wellbeing. However, just like vitamins A and D, which beyond a certain dose are harmful, certain job characteristics that are needed for wellbeing can also be harmful to employees beyond a certain threshold. These job characteristics include an opportunity for control, opportunity for gaining new skills and use of skills, externally generated goals, variety, environmental clarity and contact with others.

The Vitamin Model also stipulates that some job features are similar to vitamins C and E in that, even in excess, although they may not be harmful, they have no additional benefit. These include availability of money, physical security, valued social position, supportive supervision, career outlook and equity. The Vitamin Model is useful in that it allows organisations to acknowledge the characteristics that need to be in place for employee wellbeing, while emphasising that there can be ‘too much of a good thing’, which consequently impact on the wellness of employees.

How Can These Models Help You at Work?

Many organisations utilise a one-size fits all when dealing with employees. They see their staff members as people that think the same and behave the same. This is not the case. We all have unique personalities and we all operate differently. How one person copes, may be different to another.

It’s important to assess whether your team fits in. You need to know what type of person will work well in a particular role. It is also important to understand what stresses people out at work.

Organisations need to offer more space to their employees to allow them to grow and develop, to be trusted and to be given responsibilities that allow them to do better. Micromanaging people can have the opposite effect on motivation. It decreases morale and can leave a bad taste in the mouths of many of your staff.

How Health Surveillance Can Keep Australian Workers Safe

Personality at Work: Do Your Employees Fit in?

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