PROMOTING, PROTECTING AND SUPPORTING HEALTH IN WORK

  1. Protecting health at work from physical hazards

We in the Council for Work and Health have previously provided guidance on promoting, protecting and supporting mental health at work[1].  This month we bring attention to some other risks to health and how risks might be managed.

Nearly all employers will have at least some employees who use display screen equipment (DSE) daily, and many employees work a hybrid model, using DSE for part of the working week at home.  During the early months of the COVID-19 pandemic those who could work from home were told to do so; a rise was then seen in work related upper limb disorder and other adverse effects from using DSE.  The majority of employers will ensure employees working a day or more from home each week have the equipment for their DSE workstations at home to be set up as they would be in the office, but we still occasionally see some employees who have less than optimal home workstations.  HSE provide advice on working safely with DSE, and guidance for employers and employees on working from home[2].

Most employers of those who use vibrating tools, such as workers in construction and in facilities and grounds maintenance staff, will be aware of the need to protect workers from the effects of hand-arm vibration[3].   Occupational health professionals provide advice on prevention and health surveillance, which may include HAVS Tier 4 health surveillance assessments by occupational physicians when symptoms are identified on Tier 1 or Tier 2 screening questionnaires.  There is now increased attention on the effects of whole body vibration at work, and HSE have a webinar first issued in September 2023 that may be of interest to employers of those who may be at risk of back pain resulting from whole body vibration while driving[4].

  1. Protecting health at work from biological hazards

At this time of year, respiratory infections are common, including COVID-19.  Recent Government guidance has focused on preventing ill health from respiratory infections, including COVID-19, especially in social care settings[5].  For all workplaces, we would advocate the hierarchy of controls approach[6].  Whereas it will not be possible to eliminate respiratory infections, engineering and administrative controls may reduce risk to health and productivity.  Ventilation is an engineering control to reduce the likelihood of transmission of harmful substances such as dusts, toxic chemicals as well as biological agents[7]. Simple solutions will often be the most practicable.  As during the COVID-19 pandemic, discouraging presenteeism and keeping people away from the workplace when they have respiratory infections would be an example of an administrative control.  Personal protective equipment (PPE) such as masks are not generally advised now, unless the employer’s risk assessment indicates that this is needed.  Immunisation against COVID-19 and influenza remains advised for the over 65s, pregnant women and those who are clinically more vulnerable.  Occupational health professionals can also provide influenza vaccination for staff of those clients requesting this; this may reduce absence resulting from influenza.

  1. Supporting the health of those with Long COVID

Those of us engaged in engaged in health and work continue to see a number of people who have prolonged symptoms of COVID-19 (Long COVID)[8].  Whereas techniques taught through Long COVID services[9] will assist most people, there is currently no “cure” for Long COVID.  There are those who continue to have long term absence and/or difficulties at work, for whom there does not seem to be a likely time when this will resolve[10].

For those who have not improved sufficiently after a year or more to sustain them in their work, and prolonged absence and/or adjustments in place cannot continue to be accommodated by the employer, occupational physicians may advise that on the balance of probabilities they are not likely to improve for the foreseeable future.  The employer might follow their medical capacity processes, which may lead to the employee’s dismissal.

Where their pension scheme has this provision, occupational health professionals may advise that some of these employees also be considered for ill health retirement (IHR), i.e. early payment of pension benefits.  Under the Local Government Pension Scheme (LGPS) for example, IHR enables early payment of pension for those considered to meet the criteria for IHR.  The first criterion is that on the balance of probabilities the individual is considered unable to continue in their substantive role, and that this incapacity would be likely to continue at least until their retirement age.  The second criterion is that the employee is also unfit for other gainful employment (30 hours or more in any other work)[11].  There are three tiers for IHR under LGPS depending on how long it is considered incapacity for other work is likely to continue.

We consider that this approach supports the best interests of employers and employees, not least as for some people continuing to struggle in work may set them back in their recovery.  Although we advise that it is not likely that the employee would be able to return to the work they had been doing before the illness impacted on them, i.e. their substantive role, this does not mean that they cannot work at all.  They may for example in time be able to undertake some part time work. Being in work that is of the right type and amount for the individual is supportive of physical and mental health[12].

 

Dr Robin Cordell MBA FRCP FFOM

Consultant Occupational Physician

Deputy Chair, Council for Work and Health

[1] Council for Work and Health at: https://www.councilforworkandhealth.org.uk/blog/

[2] HSE guidance on homeworking at: https://www.hse.gov.uk/home-working/index.htm

[3] HSE guidance on hand-arm vibration at work at: https://www.hse.gov.uk/vibration/hav/index.htm

[4] Musculoskeletal Disorders and Whole-Body Vibration From Driving: Manage the Risk to Your Workforce at: Course: Musculoskeletal Disorders and Whole-Body Vibration From Driving: Manage the Risk to Your Workforce (hse.gov.uk)

[5] Infection prevention and control (IPC) in adult social care: acute respiratory infection (ARI) as at 31 January 2024 at: https://www.gov.uk/government/publications/infection-prevention-and-control-in-adult-social-care-acute-respiratory-infection/infection-prevention-and-control-ipc-in-adult-social-care-acute-respiratory-infection-ari

[6] Hierarchy of controls at: https://www.cdc.gov/niosh/topics/hierarchy/default.html

[7] Ventilation to reduce the spread of respiratory infections, including COVID-19 at: https://www.gov.uk/guidance/ventilation-to-reduce-the-spread-of-respiratory-infections-including-covid-19

[8] Prolonged symptoms of COVID-19 (Long COVID) at: https://www.nhs.uk/conditions/covid-19/long-term-effects-of-covid-19-long-covid/

[9] Rehabilitation through Long COVID services at: https://www.england.nhs.uk/coronavirus/post-covid-syndrome-long-covid/

[10] Yale Medicine.  What Happens When You Still Have Long COVID Symptoms at: https://www.yalemedicine.org/news/long-covid-symptoms

[11] Information on ill health retirement under the Local Government Pension Scheme at: https://www.lgpsmember.org/your-pension/planning/ill-health-retirement/

[12] TSO 2006.  Is work good work is good for your health and wellbeing ?  Waddell G and Burton K at: https://assets.publishing.service.gov.uk/media/5a7cd68640f0b6629523c1de/hwwb-is-work-good-for-you-exec-summ.pdf