Transcript THE FOLLOWING LECTURE HAS BEEN APPROVED FOR ALL STUDENTS BY BIRMINGHAM CITY UNIVERSITY This lecture may contain information, ideas, concepts and discursive anecdotes that.

THE FOLLOWING LECTURE HAS BEEN APPROVED FOR
ALL STUDENTS
BY BIRMINGHAM CITY UNIVERSITY
This lecture may contain information, ideas,
concepts and discursive anecdotes that may be
thought provoking and challenging
Any issues raised in the lecture may require
the viewer to engage in further thought,
insight, reflection or critical evaluation
health.bcu.ac.uk/craigjackson
Occupational
ill-health
People are made sick
by the work they do
Dr. Craig Jackson
Prof of Occupational Health Psychology
Education Law & Social Sciences
BCU
www.health.uce.ac.uk/craigjackson
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)
Return to Work
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 16 18 20 22 24
months not working
Waddell, 1994
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
China & Egypt
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). DeMorbis Artificium
Industrial Revolution UK.
Factory Act. 1802
Annie Bessant. Matchworkers
Sir Thomas Legge (1863 – 1932) 1st Inspector of Factories
1848 – Factory act
1848 – Factory act
1848 – Factory act
England
England: Black Country
England: Black Country
England: Black Country
Photo courtesy of Institute of Rural Health
England: Black Country
Photo courtesy of Institute of Rural Health
England: Black Country
Photo courtesy of Institute of Rural Health
England: Black Country – environmentally friendly?
Photo courtesy of Laurie Leeming-Latham of MOHS
England: Black Country – environmentally friendly?
Photo courtesy of Alastair Robertson
Mystery Health Problems ?
Mystery Health Problems ?
Economics of Scale - Solway Harvester
Photo courtesy of Dr Gordon Baird
Solway Harvester
Numerical
%
Isle of Whithorn
7/300
2.3
Wigtownshire
7/20,000
0.03
London
7/6,000,000
0.00001
Equivalent to 7 people from Wigtownshire
Equivalent to 120,000 people from London
Not just the crappy jobs. . .
Pleural thickening
Pleural thickening
Testing Workers’ Lung Function
Core Occupational Diseases (EU)
Chemical
Inorganic
Chemical
Organic
Biological
Physical
Dusts
Physical
Others
Cadmium
CS5
Zoonoses
Asbestos
Radiation
Chromium
Benzene
Hepatitis
Silica(te)
NIHL
Mercury
Chlorine
TB
Mesothelioma
Cataract
Manganese
Aromatics
Vibration
Nickel
P.aromatics
Dermatitis
Lead
Isocyanates
21st 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
21st 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
21st Century Workplaces
Current Sources of Occupational Ill-Health
Chemicals
Gasses
Dusts
Particles
Light
Heat
Noise
Vibration
Stress
Radiation
Slips, trips, falls
Working hours
Ergonomics
Troublesome Occupations
Top 5 Modern Day Occupational Health Problems
Hearing Loss (NIHL, TTS)
Industry, Drivers, Emergency work
Respiratory Problems
Asbestos, Industry, Recycling
Skin Problems
Nurse, Hairdressers, Industry
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
Who is susceptible to stress ?
“Veal – Fattening Crate”
“Small, cramped office workstations built of fabric covered disassemblable
wall partitions and inhabited by junior staff members. Named after the small
pre-slaughter cubicles used by the cattle industry”
Douglas Coupland
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
Non-Specific Symptoms
Often missed in assessment
Prevalence of Non-Specific Symptoms
Symptom
Prevalence %
Stuffy nose
46.2
Headaches
Tiredness
Cough
Itchy eyes
Sore throat
Skin rash
Wheezing
Respiratory
Nausea
Diarrhoea
Vomiting
33.0
29.8
25.9
24.7
22.4
12.0
10.1
10.0
9.0
5.7
4.0
Heyworth & McCaul, 2001
Modern day complaints
Multiple Chemical Sensitivity
Chronic Fatigue Syndrome
Sick Building Syndrome
Gulf War Syndrome
Low-level Chemical Exposure
Electrical Sensitivity
Historical complaints
Railway Spine
Neurasthenia
Combat Syndrome
Potential Health Risks
3x
Cardiovascular problems
2x Substance abuse
2-3x Injuries
2-3x Infections
High Effort
Low Reward
+
High Demand
Low Control
2-3x
Mental health problems
Shain 2001
3x Back pain
5x Certain cancers
2-3x Conflicts
What kids think of stress
Stress
Looks like a flaming deamon
Sounds like an eagle squaking
Tastes like a burnt sausage
Smells like sour milk
Feels like stroking a hedgchog
Stress is when mum says NO!!!!!
by Andrew (aged 10)
Year 5
Potley Hill Primary School
Stress
Golden Age of Stress
Everyone is Stressed
BBCi - “Stress” = 16,000 finds
More people experiencing more stress
Greater demands from employers
People working longer hours
24 / 7 society
World Wars I and II
Where was stress?
Possible evidence from dud shells
Karasek’s demand-control model of stress development
high
Productive,
Motivated
active
job control
low strain
high strain
low
passive
low
high
job demands
Karasek 1979
Risk of
psychological
strain and
increased illness
job demands
low
high
active
passive
high strain
low
job control
high
low strain
Karasek 1979
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
Occupational Alveolitis
Not our problem anymore. . . .
A Final Truth
“People who work sitting down get paid more
than people who work standing up”
Ogden Nash (1902 - 1971)