What’s the key to a successful occupational health program?

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The only way I figured that I could answer that question was to speak to the experts themselves, and I started with Melodie Gilbert. Melodie develops preventative strategies that work to prevent ill health in the workplace. Aside from being involved in the delivery of such a strategy on the London 2012 Olympic site, Melodie is now working on a range of projects, including the massive ~£14 billion pound construction of Crossrail. I was very grateful that Melodie was able to take time out of her day so I could gain an insight into the workings of one of the most successful occupational health programs implemented in the UK.

First up, if these programs are so successful, then Melodie would not have any gripes or any issues yes? Well we all have a gripe about something. It’s not really about us just complaining about the issue, it’s more about that one thing that bugs us that we work hard to overcome. Melodie explained that one of her pet gripes was that the term “occupational health” should really include occupational nurses, physicians, and occupational hygienists. On the Crossrail project for example, the occupational health team includes all of those elements onsite. By contrast to the typical construction project in Australia where workers are sent for pre-placement medicals off-site to an external provider, all pre-start medicals are performed onsite by the same team. Apart from the efficiencies of doing this, what appeared to be the case when I visited the Crossrail project yesterday, was that there was a great consistent approach and it became the first point of contact where “good-health” promotion started its journey. By keeping the occupational health team together in this way, it also provided a great opportunity for information sharing as the occupational hygienists were really the key link between the occupational health team and the safety team. In terms of gripes, I think that’s not a bad one to have!

One of the things that I struggle with sometimes is getting the message across that health is just as important as safety. Melodie agreed that sometimes it can be difficult initially for people to grasp the concept of health risk. For example, it is easy to see the risk of someone falling off a ladder, yet it’s more difficult to see the risk of developing silicosis when a worker is drilling into concrete. Our challenge as occupational hygienists is to effectively communicate that risk and the best way of doing that is through engaging with the workforce. Some of Melodie’s tips for other young hygienists (and safety professionals) are:

  1. Outreach – get out there and go out to the workplace and spend more of your time onsite rather than in the office.
  2. Mind the gap – check if what’s written down is really what is being done. If it’s not, go and find out why and start to work towards the solution.
  3. Keep it simple. Don’t overcomplicate your key messages.
  4. Look after the VIP. The VIP is the worker behind the shovel, the worker operating the drill, basically every single worker on your site.
  5. Put health into safety, and treat it with the same importance.

To see a successful occupational health program in action, I was then treated to a site visit at the Crossrail project with Eric Ball. Eric is an onsite occupational hygienist and provided some great insights to their program. I was able to visit and meet the occupational health team onsite, and what was evident was the clear focus on health, which was given equal importance as safety. So Melodie’s tips must have worked here!

One of the topics I quizzed Eric about was on occupational noise. The risk of developing noise induced hearing loss in tunnelling projects is normally quite high, and the workers typically have a heavy reliance on hearing protection.

Eric explained the process of noise control measures which included many items including hearing protection. Eric said that often people will ask him what the best hearing protection is to wear, whether that be ear plugs or muffs. He explained that the best hearing protection to wear is the one that they feel most comfortable in wearing and the one that has been assessed for the task they are doing in that environment. There is no easy and fast answer basically if the hygienist doesn’t know what they are doing. One thing that is done routinely at Crossrail as part of the noise assessment process is a noise frequency analysis.

A frequency analysis measures noise at each frequency or pitch. For workplace noise, octave bands are used where the audible sound frequency range (approximately 20 to 20,000 Hz) is divided into 11 octave bands. The frequency analysis measures the level of noise in each octave band. So why is this important? Well different hearing protection attenuates noise at different frequencies. Eric can use the frequency analysis to confirm that the hearing protection worn by Crossrail workers is really the best of the best when it comes to preventing noise induced hearing loss.

The key take-away that I got from meeting these two talented people, was that they both had a passion for occupational health and protecting the worker. Ultimately, if you are passionate about something and you believe in it, people are more likely to listen to you, and when they do, that results in a successful occupational health program.


A big thank you to Melodie and Eric for their time yesterday!



2 thoughts on “What’s the key to a successful occupational health program?

    Vinod Gopaldasani said:
    April 5, 2014 at 9:49 pm

    Kate. You’ve touched a very important topic here. In Australia the focus seems to be on safety so much that there is now a big divide between Occupational health and Occupational safety. To give some perspective, workcover NSW used to employ occupational physicians and nurses but now they don’t. A large proportion of workers are overweight or obese and start work dehydrated, Businesses just don’t seem to be interested in their workers’ health as long as they are meeting their legal obligations under the WHS legislation, they don’t go the extra mile to take care of their workers’ health. This has directly or indirectly resulted in more workers compensation claims and more costs for businesses. Research has shown that for every dollar spent on workers health, a return on investment of up to four dollars is seen (Henke et al. 2011 and Baicker et al 2010). Occupational health has a lot of catching up to do.


    Rachel M. Henke, Ron Z. Goetzel, Janice McHugh and Fik Isaac
    “Recent Experience In Health Promotion At Johnson & Johnson: Lower Health Spending, Strong Return On Investment”, Health Affairs, 30, no.3 (2011):490-499

    Baicker, Katherine, David Cutler, and Zirui Song. 2010.
    Workplace wellness programs can generate savings. Health
    Affairs 29(2): 304-311.

    […] Gopaldasani commented on “What’s the key to a successful occupational health program”  and I wanted to share his thoughts with you also. His thoughts resonated with me, and I […]

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