The following lecture has been approved for University

The following lecture has been approved for University Undergraduate Students This lecture may contain information, ideas, concepts and discursive anecdotes that may be thought provoking and challenging It is not intended for the content or delivery to cause offence Any issues raised in the lecture may require the viewer to engage in further thought, insight, reflection or critical evaluation

Occupational Health Promotion Stopping people from being made ill by the work they do Prof. Craig Jackson Head of Psychology Division BCU

A Truth “Peoples’ health should be no worse at the end of a working day than it was at the start” M. J. Harrington (1997)

A Truth “People who work sitting down get paid more than people who work standing up” Ogden Nash (1902 - 1971)

The Godfather of Occupational Disease “When you come to a patient’s house, you should ask him what sort of pains he has, what caused them, how many days he has been ill, whether the bowels are working and what sort of food he eats. So says Hippocrates. I may venture to add one more question: what occupation does he follow? ” Bernard Ramazinni (1633 -1714)

History of Occupational Illness Stone-age was first age of occupational risk Iron-age and smelting worsened this Mining in Egyptian period: worse job going Bernardino Ramazzini (1633 -1714). De. Morbis Artificium Industrial Revolution UK. Factory Act. 1802 Annie Bessant. Matchworkers Sir Thomas Legge (1863 – 1932) 1 st Inspector of

Return to Work Waddell, 1994 10 20 30 40 50 60 70 80 90 100 % returning to work Longer off work = Less likely to return to work <1 2 4 6 8 10 12 14 20 22 24 months not working 16 18

Regional Picture Self-reporting? Who’s best off? Who’s worse off?

Work Related Ill-Health in the UK 33 Million days lost per year Males lose more working days than females Days lost increase with age Low managerial / professionals had highest rate of absence Most sickly occupations are health & social welfare, construction, teaching, and research

Work Related Ill-Health in the UK Bakers appear highly with occupational asthma Metal workers appear highly with upper limb problems Mesothelioma deaths high in shipbuilders and asbestos workers Stress, depression and anxiety highest in: Public admin. Defence Education Health work Social work

Troublesome Occupations

Occupational Health Promotion Pre-employment screening Health Surveillance Health & Wellbeing Promotion

1) Pre-Employment Screening Ensure new employee…. … is fit to work … has no pre-existing health conditions that could pre-dispose him/her… … and increase risk of occupational disease / injury If health problem or pre-disposition is found, work with the employee to still allow them to take the job: 1) Eliminate Risk 2) Reduce Risk

2) Health Surveillance Routine medicals / examination of employer and / or Routine collection of data Ensure the current employee…. … is still fit to work … that pre-existing health conditions have not increased risk of occupational disease / injury

3) Health and Wellbeing Promotion Ensuring ways of working are engineered to optimize health 1/3 of lifetime spent working Ideal environment to “educate” the population Stop smoking clinics Healthy eating Diet advice Exercise clubs Gym memberships Ergonomic design and planning

Core Occupational Diseases (EU) Chemical Physical Inorganic Others Biological Cadmium Zoonoses CS 5 Physical Dusts Asbestos Radiation Chromium Benzene Hepatitis Silica(te) NIHL Mercury Chlorine TB Mesothelioma Cataract Manganese Aromatics Nickel P. aromatics Dermatitis Vibration

Mystery Health Problems ?

Not just the crappy jobs. . .

Pleural thickening

Testing Workers’ Lung Function

21 st Century Workplaces • Global companies and operations • Leaner & Meaner managers • Gender issues • Disability issues • Migrant issues • Longer & less fixed working hours • Shorter contracts • Dirty jobs out-sourced

21 st Century Workplaces

The World of Work and People • More complex • Illness + Disease Focused • Health & Safety Obsessed • Market-forces Dominated • Quality Management Driven • SMEs Predominant • Mass production • Low Skills or Training required = low pay

Current Sources of Occupational Ill-Health Chemicals Gasses Dusts Particles Light Heat Noise Vibration Stress Radiation Slips, trips, falls Working hours Ergonomics

Top 5 Modern Day Occupational Health Problems Hearing Loss (NIHL, TTS) Industry, Drivers, Emergency work Respiratory Problems Recycling Asbestos, Industry, Skin Problems Industry Nurse, Hairdressers, Mental Health / Stress / Anxiety Office workers Musculoskeletal problems Office, Drivers, Industry, Construction

Work Related Ill-Health in the UK MSDs and Stress show little change since 2002 Mesothelioma deaths and Asbestosis slowly rise Asthma and Contact Dermatitis show little change Occupational infections high in 2002 – diarrhoeal disease Occupational Deafness slowly declining

The New Millennium – The Existential Age • Stress • Post Traumatic Stress Disorder • Chronic Fatigue Syndrome • Multiple Chemical Sensitivity • Diffuse Pain Syndromes (RSI, MSD, WI) • Non-Specific Effect Modifiers • Psycho-Immunology

Professional Meddling?

So what of Birmingham. . . ? • Local Industries • Local populations • Biggest Local Health Problems • Any Complicating / Confounding Factors? • What is Birmingham famous for? • What has Birmingham achieved? • Occ Ill-Health in your family?

Occupational Alveolitis

Not our problem anymore. .