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‘Achieving well-being through work’

Professor Aw Tar Ching

MBBS, PhD, FRCP, FFPHM, FFOM

Chair, Institute of Public Health, UAEU

Director, WHO CC for Occupational Health

Work and well-being

Basic premise:

“Work is good for you”

Work and well-being

Evidence:

Work self-esteem

Work income

Income access to healthy food, prompt access to health care, healthy home environment ….

No work and ill-health

Evidence:

Unemployment increase in cancer, heart disease, stroke, suicide, depression

20% excess mortality when unemployed compared to employed

Possible bias?

Social class

Excess remains even when adjusted for social class

Selection bias

Excess remains even when restrict comparison to those actively seeking work

The problem: Young NEETs

Related issues

Achieving well-being through work

Maintaining well-being at work

Achieving well being through work

Ultimate goal:

Make workers happy with their work

Worker well-being Physical Social Mental

Work Activities Exposures

Occupational health

Prevent ill-health due to workplace factors

Prevent pre-existing medical conditions affecting safe & effective work performance

Improve general health status

Seek to make workers happy with their work

1. Occupational health

Prevent ill-health due to workplace factors

Prevent pre-existing medical conditions affecting safe & effective work performance

Improve general health status

Seek to make workers happy with their work

http://www.google.co.uk/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0CAcQjRw&url=http://www.indexmundi.com/united_kingdom/age_structure.html&ei=1YvkVLD9LNbvatO5gKgF&bvm=bv.85970519,d.d2s&psig=AFQjCNEwJkmtD8ujpXN0yqqBBeZ6oBltFw&ust=1424350548613179

http://www.google.co.uk/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&ved=0CAcQjRw&url=http://abchek.blogspot.com/2013/10/121013-nurul-izzah-atau-khairipilihan.html&ei=f4vkVN-2C8_baq_egcAB&bvm=bv.85970519,d.d2s&psig=AFQjCNFk5wGsXLsaiCdpshsKDikCPy_tIw&ust=1424350461933598

UAE

The UAE workforce

High proportion of expatriate workers

Mainly males

Variety of countries, culture, and languages

Range of skills – inherent & acquired

Occupational conditions

Accidents

Heat stress

Respiratory diseases

Infections

Chemical poisonings

Translational research

Miller VS, Bates GP, Schneider JD, Thomsen J (2011)

‘Self-pacing as a protective measure against the effects of heat stress’

Annals Occ Hyg 2011;55(5):548-555

Achieving well being through work

Solution:

Obtain evidence through research

Translate evidence into practical advice

2. Occupational health

Prevent ill-health due to workplace factors

Prevent pre-existing medical conditions affecting safe & effective work performance

Improve general health status

Seek to make workers happy with their work

Fitness for work: the medical aspects 5th ed.

Palmer K, Brown I, Hobson J (2013) Oxford: OUP

Levels of Evidence

Level A

Randomized controlled trial (RCT)

Meta-analysis

Level B

Cohort studies,

Case-control studies

Level C

Consensus viewpoint

Expert opinion

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Training & back pain

Evidence-based review

Martimo K-P, Verbeek J, Karppinen J et al

BMJ Feb 2008

Databases (Medline, Embase, NIOSHTIC…) 6 RCTs + 5 cohort studies

Meta-analysis with primary & secondary analysis

Low back pain

Conclusion:

“Training workers in proper material handling techniques or providing them with assistive devices are not effective interventions by themselves in preventing back pain.”

Low back pain

Moderate quality evidence that reports of back pain, back-related disability, absence from work were no different between ‘trained’ group and controls.

Trained workers were satisfied, had increased knowledge, but no consistent translation into behaviour change

Training

May be accompanied by improvement in knowledge (Pre- and post- test)

But may not be accompanied by alterations in behaviour

Training occupational medicine doctors

Royal College of Physicians (Ire)

WHO 4-week course

FOM(I) Conferment ceremony, Al-Ain

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Training OH & safety professionals

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Training Remote healthcare practitioner

IRHC – as an institute of the Royal College of Surgeons

Rig medics

Conflict zones

Arctic & Antarctic

Seafarers

Desert areas

Achieving well being through work

Solution:

Identify & deal with challenges in provision of training versus encouraging behaviour change

3. Occupational health

Prevent ill-health due to workplace factors

Prevent pre-existing medical conditions affecting safe & effective work performance

Improve general health status

General health

Healthy workplaces & healthy lifestyles

Smoking

Diet

Exercise facilities

Stress reduction

Commuting to work

SMOKING

Not just an occupational well-being issue. A major public health problem

http://www.google.co.uk/url?sa=i&rct=j&q=&esrc=s&frm=1&source=images&cd=&cad=rja&uact=8&docid=j8xTitdVxsvM2M&tbnid=TTKTPA6OPzruuM:&ved=0CAUQjRw&url=http://www.personal.psu.edu/afr3/blogs/siowfa12/2012/09/which-is-worse-hookah-or-cigarettes.html&ei=poe2U4m8DqnC0QXhsIDYAw&psig=AFQjCNFkwzL9Gun9W8BlocXuUDk4DpM9AQ&ust=1404557586159569

EXERCISE

Encourage exercise at work

Active work stations

Walkways between carpark and office

Gym facilities

Encourage sports

Treadmill Workstations

Sports

Sports activity

Most dangerous sport for young US

females?

Visits to casualty: 1980 – 5000 cases

2007 – 27,000 cases

110 head & spine injuries over last 3 decades

Other injuries – heart problems and heat stroke

Cheerleaders and injuries: J Paediatrics

4. Occupational health

Prevent ill-health due to workplace factors

Prevent pre-existing medical conditions affecting safe & effective work performance

Improve general health status

Seek to make workers happy with their work

Achieving well being through work

Solution:

Make workers happy with their work

Happiness index

World Happiness report

April 2012, Sept 2013 & April 2015

United Nations; Columbia University

>150 countries ranked

Cantril scale – ‘happiness’ 2012 2013

1. Denmark 1. Denmark

2. Finland 2. Norway

3. Norway 3. Switzerland

4. Netherlands 4. Netherlands

5. Canada 5. Sweden

6. Switzerland 6. Canada

7. Sweden 7. Finland

2015

1. Switzerland

2. Iceland

3. Denmark

4. Norway

5. Canada

6. Finland

7. Netherlands

Happiness ranking 2013

Top 100

56. Malaysia

63. Vietnam

64. Hong Kong

76. Indonesia

92. Philippines

93. China

Bottom 100

103. Zimbabwe

105. Iraq

109. Laos

111. India

121. Myanmar

148. Syria

154. Central African Rep

Happiness ranking 2015

Top 100

61. Malaysia

72. Hong Kong

74. Indonesia

75. Vietnam

84. China

90. Philippines

99. Laos

Bottom 100

112. Iraq

115. Zimbabwe

117. India

129. Myanmar

136. Yemen

145. Cambodia

156. Syria

Happiness ranking 2015

Top 50

1. Switzerland

20. UAE

24. Singapore

34. Thailand

46. Japan

47. South Korea

Next 50

61. Malaysia

72. Hong Kong

74. Indonesia

75. Vietnam

90. Philippines

84. China

Conclusion:

Achieving well-being at work is not just attention to health promotion. It is attention to occupational health… and more

Terima kaseh

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Thank you