The missing link

What is the connection between health improvement and injury prevention?

posted January 23, 2015

By Deb Fell-Carlson, SAIF policyholder safety and wellness adviser

The link between safety and healthYou won't see SAIF's safety management consultants taking blood pressures or providing diabetes education to your employees, but they will be discussing the link between safety and health with policyholders.

Health improvement as an injury prevention strategy may be new to some, but injury-prevention experts agree that the only way to achieve and sustain a zero-injury work environment is to embrace health as an injury prevention strategy. SAIF is equipping our safety professionals to help employers do just that. The National Institute for Occupational Safety and Health (NIOSH) calls this broad, integrated approach to safety the Total Worker HealthTM Initiative.

Studies show that a healthy, fit individual is more alert and able to respond more quickly to unexpected events. This means he or she is less likely to be injured. In addition, studies show that a healthy, fit person who does suffer an injury typically recovers more quickly.

Controlling the risks

One way to promote health improvement at the organizational level is by helping employees identify and control issues that work against alertness, productivity, and safety. These can be simplified into three categories: what to do, what to avoid, and what to eat.

What to do

Inactivity can cause presenteeism (see below), as well as contribute to obesity, and other chronic conditions. But brisk activity for at least 30 minutes a day improves alertness and cardiac fitness. Besides cardiovascular endurance, functional fitness is important to injury prevention. This approach to fitness focuses on muscular strength and endurance, body composition, flexibility, mobility (the ability to move a limb through full range of motion with control), muscle symmetry (stretch tight muscles and strengthen weak muscles), stability; and coordination (motor control).

In the workplace:

  • Remove barriers to movement; for example, identify nearby options for safe walking, bring equipment on-site, or subsidize gym membership.
  • Encourage walking meetings and walking on breaks.
  • Phase in sit-to-stand workstations for sedentary workers.
  • Provide information* to employees and families on the importance of movement and the hazards of sitting.
  • Educate employees on safe walking practices, such as the need for high-visibility, reflective clothing; obeying traffic laws for pedestrians; and walking facing traffic, especially on rural roads without sidewalks.
  • Consider investing in expert assistance to create an exercise program designed for your unique workforce needs.

Fatigue contributes to inflammation, obesity, and presenteeism. Being awake for 20 hours or more is likely to result in impaired judgment, reduced mental flexibility and response times that are similar to the legal intoxication limit. Seven to nine hours of sleep per night is optimal for most adults.

In the workplace:

  • Explore strategic napping on lunch breaks.
  • Assess and address lighting, noise, and housekeeping.
  • Provide sleep hygiene and lifestyle training* for workers and supervisors.
  • Educate supervisors and employees on fatigue management strategies such as recognizing fatigue, scheduling, and task variation.
  • Look at fatigue factors in your workplace as hazards that can be controlled.
  • Address shiftwork and overtime policies.

What to avoid

Chronic stress 
Chronic stress contributes to presenteeism, obesity, and inflammation. 

In the workplace:

  • Use your existing risk management process.
  • Work with employees to identify stressors unique to your organization and to identify and implement controls to reduce the impact.
  • Educate employees on stress self-management; make clinical resources available for crisis needs.

Tobacco and nicotine use contribute to presenteeism by diminishing overall health. Tobacco use may also increase an employee's health risk when exposed to other substances at work or at home.In the workplace:

  • Implement a tobacco-free workplace and provide employees with help to quit. The Oregon Health Authority has excellent resources for employers and employees, including a fact sheet on e-cigarettes.
  • Assure proper use of engineering controls and other methods to reduce exposures to chemicals and other substances.
  • Wear appropriate, properly fitted, personal protective equipment when needed.

What to eat

Healthy foods 
Refined, processed, and sugary foods and beverages can cause inflammation, obesity, and other chronic conditions. Sugary foods may also contribute to presenteeism.In the workplace:

  • Choose wholesome, healthy fruits and vegetables for vending machines, meetings, and company events where food is served.
  • Facilitate employee access to healthy foods. For example, bring a farmers' market or community-supported agriculture program onsite.
  • Provide information* on healthy food choices to employees and families.

When we are dehydrated, brain function decreases, blood pressure and heart rate can rise, and we are prone to soft tissue injuries. Individual water needs vary, but a good indicator of proper hydration is light yellow or straw-colored urine.

In the workplace:

  • Provide fresh, cool water at worksites and encourage consumption.
  • Provide water instead of soft drinks at company functions.
  • Educate employees on the importance of healthy hydration.

*Every company is different. Consider the needs of your employees when providing information intended to help them meet their health goals.

Presenteeism and absenteeism: Is there a difference?

More than 70 safety and health professionals from SAIF received training last summer designed to bridge the gap between the health promotion efforts of wellness programs and the injury prevention efforts of safety programs. Also receiving this training were our association partners that provide direct safety and health services: Associated Oregon Loggers, Association of General Contractors, and Home Builders' Association of Oregon. The foundation of the training is preventing "presenteeism."

We may be more familiar with the term "absenteeism," which is when we're physically away from work. Presenteeism is when we're physically on the job, but our mind is preoccupied. Presenteeism renders an individual unable to fully focus on a task due to health-related issues. When the task is safety-sensitive, presenteeism can lead to disaster, whether at work or at home. SAIF's approach is to assist employers with organizational strategies to address six presenteeism risk factors. Although the immediate goal is injury prevention, controlling these risk factors also contributes to long-range health improvement goals of traditional wellness programs.  

Cheap and free

Simple ideas that can improve health

  • Organize walking meetings.
  • Compete as a work team in community events.
  • Serve fruits and veggies for snacks.
  • Volunteer to help a co-worker or someone in the community.
  • Spend time outdoors enjoying nature.
  • Provide incentives at work for employees who share with their families at home the safety and wellness they practice at work.
  • Spend quality time with a child or family member.
  • Compliment a co-worker for something specific.
  • Stop using tobacco.
  • Hold a sun safety campaign: Wear sunscreen or other protection.

Friendly competitions that help engage employees 

  • Health screening challenge
  • 32-ounces-a-day for hydration
  • Mile-per-day (or steps) challenge
  • Healthy meals cooking contest
  • Bike-to-work challenge
  • Noon walk competition with teams of coworkers
  • Eat-a-healthy-breakfast challenge
  • Avoid the elevator competition
  • Sleep-eight-hours-a-night challenge

Community resources

  • Local hospital 
    - Community education 
    - Diabetes education 
    - Physical therapy
  • County health department 
    - Communicable disease education and immunizations 
    - Tobacco prevention coordinator
    - Healthy Communities Coordinator
  • Local gym
  • YMCA or YWCA
  • Local parks and recreation department
  • Local community education offerings
  • Local walking clubs
  • Local pool
  • Community fitness events

Additional resources

"Hazards of Cigarette Smoking," Centers for Disease Control and Prevention
"The Benefits of Healthy Whole Foods - What's the difference between whole foods and processed foods?" R. M. Griffin, WebMD.
"Presenteeism: at work-but out of it," Paul Hemp, Harvard Business Review (2004)
Let's Move! The President's Council on Fitness, Sports, and Nutrition
"What is Total Worker HealthTM?"National Institute for Occupational Safety and Health (2014).
"Eat smart for a healthier brain," Carol Sorgen, WebMD.
MyPlate, a resource to help consumers make healthier food choices, United States Department of Agriculture