Corporate Health: Fit for Work

The thematic area of Corporate Health at A+A 2017 in Düsseldorf covers a wide range of preventative products and services aimed at helping the workforce stay fit for work for as long as possible and avoid occupational diseases. The leading international trade fair and convention on occupational health and safety will be held for the 35th time from October 17 to 20, 2017. The convention will feature more than 50 series of events, with 350 prominent health and safety experts from politics, research and practical application.

“Health and safety is particularly under discussion in connection with the latest push for digitization,” says Bruno Zwingmann, CEO of the German Federal Association for Occupational Safety and Health (Basi). Basi is the convention organizer at A+A. This year’s convention will be partly on the economic impact of working days missed through sickness or accidents. The German Federal Institute for Occupational Health and Safety (BAuA) has found that the average number of sick-leave days taken by employees in 2015 was 15.2 days, totalling 587.4 million days in all. According to the Institute, this caused a EUR 64 billion production shortfall and a loss of EUR 113 billion in gross added value.

A culture of preventative healthcare — executive staff with a new mindset

This situation can be remedied substantially by a corporate culture that seeks to promote health and safety, according to Prof. Bernhard Zimolong, honorary board member of the German Professional Association in Psychology for Occupational Health and Safety (PASIG). “If there is support from the management, then this kind of preventative healthcare culture will also form in the minds of the workforce. And, in fact, it can be achieved in any industry, regardless of technology,” says Prof. Zimolong. This, he says, has made it possible to ensure a drastic reduction in accident figures, and “for many years, it would have been unthinkable for any industry, including those with hard physical work, to fall below ten accidents per million working hours.” A good accident-avoidance strategy needs to be developed in collaboration with the management, and the first question should not primarily be who is to blame, “but rather, what we can learn from a given accident. It’s a matter of questioning how working routines should be designed, whether the management has done enough to promote them and whether rules have been violated. One then needs to discuss with the workforce how such situations can be avoided in the future,” says Prof. Zimolong. This change in mindset, he believes, is an important step towards a positive error culture that does not aim to ascribe blame to any specific individuals. “But such a culture can only develop if it has the full backing of the management.”

As he sees it, a changed attitude towards health within a company can also help to combat backaches and stress among the workforce. Yet even today, health is still often seen as a private matter, even though numerous studies have shown that, for example, backache — a frequent cause of sick leave — can be positively impacted by changes in working routines, management activities and health-promoting activities in the workplace. Over a period of two years, nine German tax offices succeeded in reducing their instances of backache and, thus, also the number of sick-leave days among their workforce. This was the outcome of a joint project, supported by PASIG, entitled Integrated Network, Organizational and HR Development (INOPE). “One decisive factor,” says Prof. Zimolong, “was that the tax-office managers reorganized the work routines at their offices in collaboration with the workforce, thus making the work less stressful.” For example, whenever scheduled contact times with citizens were particularly stressful, those opening hours were reorganized through rotas. Also, greater decision-making powers were granted for routine processing activities. Prof. Zimolong says that many among the staff began to take active responsibility for their own health. Companies and executives wanting to strengthen or improve their preventative healthcare culture will benefit from numerous seminars on Preventative Healthcare 4.0 at this year’s A+A convention. PASIG members also provide training and consultancy outside the A+A trade fair.

Psychosomatic clinics to prevent stress-related illnesses

For many years, one major question that was ignored in the world of labour was how many employees suffered from stress, anxiety, depression and other mental-health issues at work. Yet the actual figures speak for themselves: “It has been estimated that, within a given year, almost every third adult in Germany suffers from mental-health problems of some kind. They can take a variety of forms, as nearly everyone feels stressed out, depressed or insecure from time to time. However, the earlier one perceives and responds to the warning signals of the body and the mind — e.g. backache, stomachache, sleep disorders or exhaustion — the more likely it is that suitable treatments will be effective and that it is possible to restore people’s long-term efficiency and performance, both among the wider workforce and the management,” says Hilde Lindlohr, an occupational health specialist, general practitioner and in-house doctor at the University Hospital of Cologne. Lindlohr also gives professional-development courses on psychotherapy, systematic therapy and consultancy.

For the last five years, she has offered psychosomatic consultations for employees as part of her in-house medical service. Her experience has been good: “This low-threshold in-house service has met with a good response. The sessions are one-on-one and solution-focused, i.e., we take plenty of time with each person, and we try to understand their situations.” Sometimes, one or two 50-minute sessions are sufficient, but if an issue is more complex or requires a longer therapy, then Dr. Lindlohr guides the patient towards colleagues in her therapists’ network. “Depending on the person’s situation, it may even be helpful for them to spend some time as an inpatient,” says Hilde Lindlohr. To sum up, “a psychosomatic clinic at the workplace makes good sense and should be offered by company doctors wherever this is possible, provided they have received suitable training. After all, they are the ones who know the working environment of their company and who can therefore be highly specific in any advice they give on workplace-related issues.”

At A+A 2017, the German Federal Institute for Occupational Health and Safety (BAuA) will present a research project on the specifics of psychosomatic therapy in the workplace, such as holding consultations. The focus will be, in particular, on an example from the German federal state of Lower Saxony.

REHADAT has practical examples for employers

The information system REHADAT (www.rehadat.de) provides practical examples for employers, helping them to assist people with chronic diseases and disabilities. REHADAT is a 25-year-old project that was set up by the Federal German Ministry of Labour and Social Affairs (BMAS) and forms part of the Institute of the German Economy in Cologne.

REHADAT runs numerous websites and databases with practical examples of disabled-friendly workplaces and technical facilities, as well as sponsorship options and plenty of information. At the end of June 2017, REHADAT will be releasing a series of brochures on the issue of depression and workplace participation.

Petra Winkelmann heads a sector of expertise entitled Workplace Participation and Inclusion at the Institute of the German Economy. Being aware of the need for such information, she came to the conclusion that “such knowledge should be made available to employers, company doctors and affected persons in a compact format. Quite often, after all, an ageing workforce means that people become disabled or sick. Such groups must not be excluded, particularly as the entire issue of inclusion is now being debated on such a wide, international scale, even in industry.” Another reason why today’s employers should take a greater interest in creating disabled-friendly workplaces and in facilitating workplace participation is that it has become a legal requirement under Germany’s Workplace Regulations. “Moreover,” says Petra Winkelmann, “there is a skills shortage, and many SMEs and trade enterprises, in particular, are having problems finding trainees.”

The new brochure on depression at work contains tips and advice on dealing with depression-related illnesses in the workplace. It tells the reader what to watch out for if a person is depressed and what might be the effects. The brochure also contains details of support measures and practical solutions on work organization and design in cases where employees are affected by depression.

The series and a wide range of material and resources offered by REHADAT will be presented at A+A 2017.

Health Scouts for medium-sized businesses

When it comes to raising awareness about health issues, small and medium-sized enterprises still have a long way to go. “One reason is that, unlike large companies, they don’t have specially dedicated health and safety officers,” says Dr. Stefanie Eiser, section consultant at the German Federal Centre for Nutrition (BZfE). Within her section, Healthy Nutrition and Sustainable Consumption, she spent over a year running a project entitled “Food and Fitness at Work — SMEs in Good Shape”, a project which has been receiving federal funds under a national action plan called “IN GOOD SHAPE — Germany’s Initiative on Healthy Nutrition and More Exercise”.

“Food and Fitness at Work” is a holistic approach and will be presented at A+A 2017. Its aim is to encourage more exercise and healthier nutrition in SMEs. The project started with a Day of Health. Dr. Eiser reports that “training was provided not only for executives, but above all, for one or two so-called Health Scouts from each of the 19 participating companies. These Scouts then organized numerous activities at their companies, such as running or walking together after work or a Muesli Bar in the kitchen for healthy snacks during breaks.” Nineteen companies were involved in “Food and Fitness at Work”, and the general model was developed by the Five-a-Day Club together with the Institute for Health Promotion in the Workplace (BGF). BGF handled the training of the Scouts, and the Five-a-Day Club created a newsletter which continued to provide ideas for post-training activities in the various clubs.

“What matters,” says Dr. Eiser, “is the sustainable structures that were created at those companies as a result.” These structures and the good experiences of the participants are now forming the basis for a follow-up project. Further training courses are now in the pipeline, and so is the creation of a better network between Health Scouts and a possible expansion of “Food and Fitness at Work” to cover not only the Rhineland but also other parts of Germany.

German Social Accident Insurance Association (DGUV): Preventative healthcare does not stop at retirement.

Although many people successfully get through their working careers without major health issues and with a good level of fitness, they may still carry occupational diseases. “Sometimes, work-related and occupational diseases don’t occur until after a given strain started and, in some cases, not until a person is no longer in that job,” says Dr. Matthias Kluckert, Head of the Occupational Medicine Competence Centre in the German Professional Association of Raw Materials and the Chemical Industry and Chairman of the Occupational Medicine Committee of the German Social Accident Insurance Association (AAMED-GUV). Therefore, he concludes, certain activities must be followed up by preventative “followup” healthcare, in compliance with Germany’s Preventative Occupational Healthcare Regulations (ArbMedVV). “Everyone has a right to preventative followup healthcare if, as part of their job, they have been exposed to certain carcinogenic or mutagenic substances or mixtures. In addition, there is the special case whereby employees have a right to preventative healthcare if their former jobs involved exposure to a hazardous substance and if a given job is classified as a carcinogenic activity or process in category 1A or 1B under Germany’s Hazardous Substance Regulations,” says Kluckert.

In recent years, the duty to provide such services has been delegated by employers to accident-insurance companies. The insurers then offer preventative followup healthcare through services organized by themselves. The two biggest and best-known services of this kind are the Organizational Service for Medical Followup Examinations (ODIN, odin-info.de) and Preventative Healthcare (GVS, gvs.bgetem.de). “What distinguishes preventative followup healthcare from preventative occupational healthcare,” says Dr. Kluckert, “is that it no longer puts the emphasis on consultancy, e.g., by advising workers to use specific gloves when handling benzene. Instead, we establish at the earliest possible stage whether, for instance, a tumour has developed through contact with carcinogenic substances. If a tumour is discovered early, it can often be treated more efficiently.” A+A 2017 includes presentations of the full range of services provided by statutory accident insurers on preventative followup healthcare. Also, the creation of a preventative healthcare website will be discussed as a way of bundling information and enabling access to the relevant organizations and employers’ liability-insurance associations. “The site, which will be called DGUV Vorsorge (Preventative Followup Healthcare of the German Social Accident Insurance Association), will make it easier for employers to meet their duty to provide preventative follow-up healthcare, enabling them to delegate this duty to accident insurers.

Stopping artificial light from causing occupational sickness

Increasing numbers of people are working under artificial lighting conditions, so that they are seeing less and less daylight. This is the case, for instance, if their workplace is situated in a shopping mall or a large hall, if they work as nurses at an intensive-care station or if they are shift workers who need to turn night into day. Occupational health and safety experts are, therefore, focusing more and more on artificial lighting that imitates the human day-and-night cycle. “The wrong light at the wrong time can cause fatigue during the day or sleep disorders at night and thus increase the risk of an accident,” says Angela Janowitz, Deputy Head of the Commission for Occupational Health and Safety and Standardization (KAN). Take, for instance, the blue light on a Smartphone: when a person checks e-mails after dark, this light might give their body the wrong signal that it is time to liven up again.

“All light,” says Angela Janowitz, “affects us biologically. Light is of vital importance to our vision, yet it also sets the pace for our day-and-night cycle. The human eye has special cells that process light and that control hormone production in our bodies. Melatonin, for instance, is a hormone that makes us feel tired and lowers our activity level. But our well-being, too, is affected by light.”

Dr. Anna Dammann, section consultant at KAN, says: “There are several studies on the non-visual impact of artificial lighting, but some of the results are contradictory and cannot easily be compared. In order to obtain reliable evidence in terms of health and safety and to determine the need for further research, it’s important to take a close look at the current state of research achieved up to now. KAN therefore wishes to commission a literature study with the aim of identifying findings in this area that are relevant to occupational health and safety, so that we can formulate the research questions which are still open. This literature study would need to cover expertise in chronobiology, occupational medicine and light engineering.” The first priority is to create foundations. These are needed in occupational health and safety, so that there is basis for developing regulations that specify how we should handle biologically effective lighting. “Health and safety must not be left to standardization specialists, as they are actively at work in this area already.”

With this in mind, a number of groups are currently looking into the issue of artificial lighting. At the same time, two organizations — the German State Committee for Workplaces and the Lighting Unit at DGUV — are currently exploring whether and how they can provide suitable information. “It must be the aim of all stakeholders,” says Angela Janowitz, “to ensure that new technology is used responsibly and in a way that sustains people’s health.”

About the German Federal Association for Occupational Safety and Health:

Further details about the German Federal Association for Occupational Safety and Health (Basi) can be found at www.basi.de.

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