THE FOLLOWING LECTURE HAS BEEN APPROVED FOR ALL STUDENTS BY BIRMINGHAM CITY UNIVERSITY
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Transcript of THE FOLLOWING LECTURE HAS BEEN APPROVED FOR ALL STUDENTS BY BIRMINGHAM CITY UNIVERSITY
THE FOLLOWING THE FOLLOWING LECTURELECTURE HAS BEEN APPROVED FORHAS BEEN APPROVED FOR
ALL STUDENTSALL STUDENTSBY BIRMINGHAM CITY UNIVERSITYBY BIRMINGHAM CITY UNIVERSITY
health.bcu.ac.uk/craigjackson
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
Occupational Occupational ill-healthill-health
People are made sick People are made sick by the work they doby the work they do
Dr. Craig JacksonDr. Craig JacksonProf of Occupational Health PsychologyProf of Occupational Health Psychology
Education Law & Social SciencesEducation Law & Social SciencesBCUBCU
www.health.uce.ac.uk/craigjacksonwww.health.uce.ac.uk/craigjackson
““When you come to a patient’s house, you should ask him what sort 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, 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 whether the bowels are working and what sort of food he eats. So says Hippocrates. says Hippocrates.
I may venture to add one more question: what occupation does he I may venture to add one more question: what occupation does he follow? ” follow? ”
Bernard Ramazinni (1633-1714)Bernard Ramazinni (1633-1714)
The Godfather of Occupational DiseaseThe Godfather of Occupational Disease
Return to WorkReturn to Work
Longer off work = Less likely to return to workLonger off work = Less likely to return to work%
retu
rnin
g to
wor
k
10 2
0 3
0 4
0 5
0 6
0 7
0 8
0 9
0 10
0
months not working
<1 2 4 6 8 10 12 14 16 18 20 22 24
Waddell, 1994Waddell, 1994
Regional PictureRegional Picture
Self-reporting?Self-reporting?
Who’s best off?Who’s best off?
Who’s worse off?Who’s worse off?
Work Related Ill-Health in the UKWork Related Ill-Health in the UK
33 Million days lost per year33 Million days lost per year
Males lose more working days than femalesMales lose more working days than females
Days lost increase with ageDays lost increase with age
Low managerial / professionals had highest rate of absenceLow managerial / professionals had highest rate of absence
Most sickly occupations are health & social welfare, construction, teaching,Most sickly occupations are health & social welfare, construction, teaching,and researchand research
Work Related Ill-Health in the UKWork Related Ill-Health in the UK
Bakers appear highly with occupational asthmaBakers appear highly with occupational asthma
Metal workers appear highly with upper limb problemsMetal workers appear highly with upper limb problems
Mesothelioma deaths high in shipbuilders and asbestos workersMesothelioma deaths high in shipbuilders and asbestos workers
Stress, depression and anxiety highest in:Stress, depression and anxiety highest in:Public admin. Public admin. DefenceDefenceEducationEducationHealth workHealth workSocial workSocial work
China & EgyptChina & Egypt
History of Occupational IllnessHistory of Occupational Illness
Stone-age was first age of occupational riskStone-age was first age of occupational risk
Iron-age and smelting worsened thisIron-age and smelting worsened this
Mining in Egyptian period: worse job goingMining in Egyptian period: worse job going
Bernardino Ramazzini (1633-1714).Bernardino Ramazzini (1633-1714). DeMorbis Artificium DeMorbis Artificium
Industrial Revolution UK. Industrial Revolution UK.
Factory Act. 1802Factory Act. 1802
Annie Bessant. MatchworkersAnnie Bessant. Matchworkers
Sir Thomas Legge (1863 – 1932) 1Sir Thomas Legge (1863 – 1932) 1stst Inspector of Factories Inspector of Factories
1848 – Factory act1848 – Factory act
1848 – Factory act1848 – Factory act
1848 – Factory act1848 – Factory act
EnglandEngland
England: Black CountryEngland: Black Country
England: Black CountryEngland: Black Country
England: Black CountryEngland: Black Country
Photo courtesy of Institute of Rural Health Photo courtesy of Institute of Rural Health
England: Black CountryEngland: Black Country
Photo courtesy of Institute of Rural Health Photo courtesy of Institute of Rural Health
England: Black CountryEngland: Black Country
Photo courtesy of Institute of Rural Health Photo courtesy of Institute of Rural Health
England: Black Country – environmentally friendly?England: Black Country – environmentally friendly?
Photo courtesy of Laurie Leeming-Latham of MOHS Photo courtesy of Laurie Leeming-Latham of MOHS
England: Black Country – environmentally friendly?England: Black Country – environmentally friendly?
Photo courtesy of Alastair Robertson Photo courtesy of Alastair Robertson
Mystery Health Problems ?Mystery Health Problems ?
Mystery Health Problems ?Mystery Health Problems ?
Economics of Scale - Solway HarvesterEconomics of Scale - Solway Harvester
Photo courtesy of Dr Gordon Baird Photo courtesy of Dr Gordon Baird
Numerical %
Isle of Whithorn 7/300 2.3
Wigtownshire 7/20,000 0.03
London 7/6,000,000 0.00001
Solway HarvesterSolway Harvester
Equivalent to 7 people from WigtownshireEquivalent to 7 people from Wigtownshire
Equivalent to 120,000 people from LondonEquivalent to 120,000 people from London
Not just the crappy jobs. . .Not just the crappy jobs. . .
Pleural thickening Pleural thickening
Pleural thickening Pleural thickening
Testing Workers’ Lung FunctionTesting Workers’ Lung Function
Core Occupational Diseases (EU)Core Occupational Diseases (EU)
ChemicalChemical ChemicalChemical BiologicalBiological PhysicalPhysical PhysicalPhysicalInorganicInorganic OrganicOrganic DustsDusts OthersOthers
CadmiumCadmium CSCS55 ZoonosesZoonoses AsbestosAsbestos RadiationRadiation
ChromiumChromium BenzeneBenzene HepatitisHepatitis Silica(te)Silica(te) NIHLNIHL
MercuryMercury ChlorineChlorine TBTB MesotheliomaMesothelioma
CataractCataract
ManganeseManganese AromaticsAromatics VibrationVibration
NickelNickel P.aromaticsP.aromatics
DermatitisDermatitis
LeadLead IsocyanatesIsocyanates
2121stst Century Workplaces Century Workplaces
• Global companies and operationsGlobal companies and operations
• Leaner & Meaner managersLeaner & Meaner managers
• Gender issuesGender issues
• Disability issuesDisability issues
• Migrant issuesMigrant issues
• Longer & less fixed working hoursLonger & less fixed working hours
• Shorter contractsShorter contracts
• Dirty jobs out-sourced Dirty jobs out-sourced
2121stst Century Workplaces Century Workplaces
The World of Work and PeopleThe World of Work and People
• More complexMore complex
• Illness + Disease FocusedIllness + Disease Focused
• Health & Safety ObsessedHealth & Safety Obsessed
• Market-forces DominatedMarket-forces Dominated
• Quality Management DrivenQuality Management Driven
• SMEs PredominantSMEs Predominant
• Mass productionMass production
• Low Skills or Training required = low payLow Skills or Training required = low pay
2121stst Century Workplaces Century Workplaces
Current Sources of Occupational Ill-HealthCurrent Sources of Occupational Ill-Health
ChemicalsChemicals
GassesGasses
DustsDusts
ParticlesParticles
LightLight
HeatHeat
NoiseNoise
VibrationVibration
StressStress
RadiationRadiation
Slips, trips, fallsSlips, trips, falls
Working hoursWorking hours
ErgonomicsErgonomics
Troublesome OccupationsTroublesome Occupations
Top 5 Modern Day Occupational Health ProblemsTop 5 Modern Day Occupational Health Problems
Hearing Loss (NIHL, TTS)Hearing Loss (NIHL, TTS) Industry, Drivers, Emergency workIndustry, Drivers, Emergency work
Respiratory ProblemsRespiratory Problems Asbestos, Industry, RecyclingAsbestos, Industry, Recycling
Skin ProblemsSkin Problems Nurse, Hairdressers, IndustryNurse, Hairdressers, Industry
Mental Health / Stress / AnxietyMental Health / Stress / Anxiety Office workersOffice workers
Musculoskeletal problemsMusculoskeletal problems Office, Drivers, Industry, ConstructionOffice, Drivers, Industry, Construction
Work Related Ill-Health in the UKWork Related Ill-Health in the UK
MSDs and Stress show little change since 2002MSDs and Stress show little change since 2002
Mesothelioma deaths and Asbestosis slowly riseMesothelioma deaths and Asbestosis slowly rise
Asthma and Contact Dermatitis show little changeAsthma and Contact Dermatitis show little change
Occupational infections high in 2002 – diarrhoeal diseaseOccupational infections high in 2002 – diarrhoeal disease
Occupational Deafness slowly decliningOccupational Deafness slowly declining
Who is susceptible to stress ?Who is susceptible to stress ?
“ “Veal – Fattening Crate”Veal – Fattening Crate”
““Small, cramped office workstations built of fabric covered disassemblable Small, cramped office workstations built of fabric covered disassemblable wall partitions and inhabited by junior staff members. Named after the small wall partitions and inhabited by junior staff members. Named after the small pre-slaughter cubicles used by the cattle industry”pre-slaughter cubicles used by the cattle industry”
Douglas CouplandDouglas Coupland
The New Millennium – The Existential AgeThe New Millennium – The Existential Age
• StressStress
• Post Traumatic Stress DisorderPost Traumatic Stress Disorder
• Chronic Fatigue SyndromeChronic Fatigue Syndrome
• Multiple Chemical SensitivityMultiple Chemical Sensitivity
• Diffuse Pain Syndromes (RSI, MSD, WI)Diffuse Pain Syndromes (RSI, MSD, WI)
• Non-Specific Effect ModifiersNon-Specific Effect Modifiers
• Psycho-ImmunologyPsycho-Immunology
Professional MeddlingProfessional Meddling
Non-Specific SymptomsNon-Specific Symptoms
Often missed in assessmentOften missed in assessment
Prevalence of Non-Specific SymptomsPrevalence of Non-Specific Symptoms
Modern day complaintsModern day complaints
Multiple Chemical SensitivityMultiple Chemical SensitivityChronic Fatigue SyndromeChronic Fatigue SyndromeSick Building SyndromeSick Building SyndromeGulf War SyndromeGulf War SyndromeLow-level Chemical ExposureLow-level Chemical ExposureElectrical SensitivityElectrical Sensitivity
Historical complaintsHistorical complaints
Railway SpineRailway SpineNeurastheniaNeurastheniaCombat SyndromeCombat Syndrome
SymptomSymptom Prevalence % Prevalence %
Stuffy noseStuffy nose 46.246.2HeadachesHeadaches 33.033.0TirednessTiredness 29.829.8CoughCough 25.925.9Itchy eyesItchy eyes 24.724.7Sore throatSore throat 22.422.4Skin rashSkin rash 12.012.0WheezingWheezing 10.110.1RespiratoryRespiratory 10.010.0NauseaNausea 9.09.0DiarrhoeaDiarrhoea 5.75.7VomitingVomiting 4.04.0
Heyworth & McCaul, 2001Heyworth & McCaul, 2001
High EffortLow Reward
+High DemandLow Control
2x Substance abuse
2-3x Injuries
2-3x Infections
3x Back pain
5x Certain cancers
2-3x Conflicts
2-3xMental health problems
3xCardiovascular problems
Potential Health RisksPotential Health Risks
Shain 2001Shain 2001
What kids think of stressWhat kids think of stress
Stress Stress
Looks like a flaming deamon Looks like a flaming deamon Sounds like an eagle squaking Sounds like an eagle squaking Tastes like a burnt sausage Tastes like a burnt sausage Smells like sour milk Smells like sour milk Feels like stroking a hedgchog Feels like stroking a hedgchog Stress is when mum says NO!!!!! Stress is when mum says NO!!!!!
by Andrew (aged 10)by Andrew (aged 10)
Year 5Year 5
Potley Hill Primary SchoolPotley Hill Primary School
StressStress
Golden Age of StressGolden Age of Stress
Everyone is StressedEveryone is Stressed
BBCi - “Stress” = 16,000 findsBBCi - “Stress” = 16,000 finds
More people experiencing more stressMore people experiencing more stressGreater demands from employersGreater demands from employersPeople working longer hoursPeople working longer hours24 / 7 society24 / 7 society
World Wars I and IIWorld Wars I and IIWhere was stress?Where was stress?Possible evidence from dud shellsPossible evidence from dud shells
Karasek’s demand-control model of stress developmentKarasek’s demand-control model of stress development
lowlow high highjob demandsjob demands
job
co
ntr
ol
job
co
ntr
ol
low
low
hig
h h
igh
low strainlow strain
passivepassive
activeactive
high strainhigh strain
Risk of Risk of psychological psychological strain and strain and increased illnessincreased illness
Productive, Motivated
Karasek 1979
job
co
ntr
ol
job
co
ntr
ol
low
low
hig
h h
igh
Karasek 1979
job demands job demands
lowlow high high
activeactivelow strainlow strain
passivepassive high strainhigh strain
So what of Birmingham. . . ?So what of Birmingham. . . ?
• Local IndustriesLocal Industries
• Local populationsLocal populations
• Biggest Local Health ProblemsBiggest Local Health Problems
• Any Complicating / Confounding Factors?Any Complicating / Confounding Factors?
• What is Birmingham famous for?What is Birmingham famous for?
• What has Birmingham achieved?What has Birmingham achieved?
• Occ Ill-Health in your family?Occ Ill-Health in your family?
Occupational Alveolitis Occupational Alveolitis
Occupational Alveolitis Occupational Alveolitis
Not our problem anymore. . . . Not our problem anymore. . . .
““People who work sitting down get paid more People who work sitting down get paid more
than people who work standing up” than people who work standing up”
Ogden Nash (1902 - 1971)Ogden Nash (1902 - 1971)
A Final Truth A Final Truth