Five Essential Elements of a Total Worker Health Program

Each year in the United States, about 4,500 workers die from work-related injuries, and more than 50,000 die from work-related illnesses. More than 3 million suffer nonfatal occupational injuries or illnesses; 2.8 million are treated in the emergency department; and 140,000 are hospitalized. The price tag to employers reaches $250 billion each year. Although employers have made progress in recent decades by reducing occupational injuries and illnesses and controlling their costs, there’s clearly more to do. And, getting it done may require a novel approach.

The National Institutes of Health’s (NIH) Office of Disease Prevention is working on just such an approach. It’s called Total Worker Health (TWH), and it’s a method for integrating occupational safety and health protections and wellness programs in a way that aims to protect workers from occupational hazards, promote health, and prevent disease.

Essential Elements of Effective Programs

The NIH is working together with the National Institute for Occupational Safety and Health (NIOSH) to create resources employers can use to develop TWH programs in their workplaces. One resource, NIOSH’s document Essential Elements of Effective Workplace Programs and Policies for Improving Worker Health and Wellbeing, is already available to help employers design and implement a program to sustain and improve worker health.

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Key recommendations for program design include:

• Integration of relevant systems. Before you can integrate anything, you have to know what you are already doing. Inventory and evaluate your existing programs and policies that apply to workers’ safety, health, and well-being, and look for potential connections. Your comprehensive program should eventually encompass behavioral health, mental health, physical health, and safety management within one cohesive program. Pay special attention to the integration of data systems.
• Elimination of recognized occupational hazards. It is not the only factor affecting worker health and safety, but it is the one that the employer has the greatest direct control over, so NIOSH considers eliminating recognized hazards in the workplace “foundational” to TWH principles.
• Strive for consistency. Did you know that blue-collar workers who smoke are more likely to quit and stay quit after a worksite tobacco cessation program if workplace dusts, fumes, and vapors are controlled, and workplace smoking policies are in place? Workers recognize when an employer’s policies are inconsistent and contradictory—and it makes the employer look hypocritical to say, “We want you to stop smoking, but we don’t care if you keep breathing the toxins that benefit us,” or “We want you to get enough sleep—but we also want you to work 20 hours of mandatory overtime each week.” Identify and correct inconsistent policies and practices.

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• Tailor your program to your workplace—and your workers. There’s no such thing as a one-size-fits-all program. Even if your workplace is of a specific type—a convenience store, residential construction, furniture manufacturing—your workforce, location, and other specifics will vary, and a program that doesn’t account for your unique conditions won’t get the job done.
• Make adjustments as you go. Whenever you make changes to your workplace, you may see unintended consequences. Be ready to respond to these by adjusting your program accordingly.

Tomorrow we’ll look at some ideas you can implement right now to begin integrating health protection and health promotion.