Spotlight: going underground
Connect went to meet Dr Olivia Carlton,
Head of Occupational Health at Transport for London, for a look at
how psychological health among workers is just as important as
physical health…
From the terrorist bombers that brought the system to a halt
three years ago, to witnessing passengers jumping to their deaths
on the tracks, Dr Olivia Carlton’s team has its work cut out in
managing health risks to the 13,000 staff who work on London’s
tubes.
“Ten or so years ago, we were far more
focused on physical health but now we’re very keen to make sure
that the psychological aspect is covered just as much. When members
of staff are faced with trauma, it’s not always physical,” she
explains.
Olivia, Head of Occupational Health at Transport for London,
says that staff on the Underground can be exposed to two key types
of psychological trauma – violence and witnessing people jumping
onto the tracks in front of oncoming trains. Violence is a
particular problem – in the last year, operational staff had a 17
per cent chance of being involved in a verbal or physical assault.
While the number of what TfL calls, rather euphemistically, ‘person
under train’ incidents has dropped – 20 years ago, there were about
80 cases a year but it’s now under 40 – it’s still an obvious
issue.
Suicides make up the vast majority of ‘person under train’
cases. TfL actively looks for ways of deterring would-be suicides,
focusing on stations with a history of problems.
“Suicide statistics were higher at Mile End
station so we worked with staff, using their suggestions and ideas,
to put a programme together to tackle the issue. We made
adjustments to the lighting, put up posters for the Samaritans and
advised staff on what to do if they were faced with this type of
situation. We also got in touch with the local mental health
hospital and advised them that if a patient went missing to contact
us. It’s very important to have strong communication plans in place
with such a serious issue.”
Olivia and her team have set up trauma support groups to allow
people to volunteer to help at incidents.
“It’s important to get in people that can
support everyone – for example, when it’s ‘all hands on deck’ at
the scene of what could be a fatal accident, it’s tough to find
enough time to spend with the train driver.”
All staff and managers are trained, and TfL runs a programme
called ‘Remaining resilient’ to help people overcome trauma.
“We work hard to prevent suicides and other
incidents, but you can’t stop everything – that’s why it’s so
important that we support our employees.”
Counselling is offered to anyone who needs it. Experienced
counsellors explain to the worker what they should expect from
psychological trauma, including flashbacks, insomnia and general
irritableness.
“One of the best things we can do is tell
people that what they’re feeling is completely normal. But we will
always keep a close eye on them and if after six weeks they’re
still not better then we look at therapeutic interventions – say,
counselling or psychotherapies such as eye movement desensitisation
and reprocessing.”
There were 324 train suicide trauma counselling sessions in
2006/07. In 2007/08 it was down to 269.
“We firmly believe that this is down to the
services we offer. People are far more willing to talk about their
issues now than they used to. They can admit to being distressed
because they have people to talk to.”
On 7 July 2005 London was hit by a series of co-ordinated bomb
blasts that ripped through a bus and three underground trains. It’s
a day and an experience that Olivia remembers vividly.
“We were fortunate in that we didn’t lose any
members of staff. It was an extraordinary time – everyone pulled
together to help. Although it did come as a shock, we’ve always
been prepared for such a disaster.
“We held group meetings for everyone involved
to explain what to expect in terms of their response to being in
such a shocking event. We saw people one-to-one and brought in 24
hour phonelines to support people. We made the effort of
identifying everyone involved and writing to them to remind them of
the support we had on offer.”
After 20 years at TfL, Olivia still finds the job fascinating.
She constantly works to assess the way someone’s health is going to
impact them and their work.
“You’re trying to weigh up your own knowledge
of the job and your knowledge of the risks their medical conditions
bring – every case is different.”
The occupational health team’s work at TfL fits into three key
areas: the effect of health on work (is a train driver fit enough
to work?), the effect of work on health (does the job itself have
an impact on someone’s health?) and the workplace as an opportunity
to help people with their health.
TfL won the Employee Benefits Awards in 2007 for its effective
healthcare strategy and the wide range of support on offer. Its
intranet has information on alcohol, healthy eating, exercise,
female and male health.
“We’re really proud of our partnership with
the Men’s Health Forum. Eighty per cent of our operational staff
are male so we used men’s health booklets based on car manuals as a
quirky way of making the information more appealing.”
TfL also runs a programme of health fairs which give staff the
chance to talk to specialists. People who attend are encouraged to
fill in a questionnaire based on their health, fitness and diet. If
they need advice, then physiotherapists, nutritionists, stress
counsellors and nurses are available to talk to.
TfL tries to keep its health fairs and programmes fresh and
appealing. As well as changing the focus every year, the team
introduces new ideas such as diet advice written with their
employees’ multicultural backgrounds and shift patterns in
mind.
“Our main aim is to make sure that our teams
are healthy, fit and able to work. We offer them all the support we
can, and it’s fantastic when so many people are willing to get
involved.”
Factfile:
- Most of London’s Underground isn’t actually under ground – 60
per cent of it is classed as over ground
- The London Underground system is approximately 400 km long –
the longest metro system in the world
- In 2007 over one billion passenger journeys were recorded
- The Tube started operating in 1863
Links:
Dangerously safe: fighting fire with fire
Health and safety professionals don’t like
risks? We think not. In Connect, we’re running Seriously Fun,
Dangerously Safe, to profile the extreme sports and high risk jobs
our members are involved in.
Gail Cotton, Head of Occupational Health and Safety at
Leicestershire Fire and Rescue Service, talks to Connect about the
risks run by firefighters – even when they’re not out on a
‘shout’...
Despite the dangerous and often unpredictable nature of their
jobs, deaths and injuries among UK firefighters are thankfully
rare. This month, however, sees the anniversary of the warehouse
fire that claimed the lives of four members of the Warwickshire
Fire and Rescue Service. With Bonfire Night bringing its own unique
set of problems for crews up and down the country, both events
bring the vital role the fire service plays into sharp
perspective.
Gail Cotton is very familiar with the work of the fire service. She
runs an occupational health unit in Leicester which not only helps
injured firefighters through sometimes months of rehabilitation,
but also screens for health problems including heart disease,
diabetes and hearing and respiratory diseases.
The continuous and rigorous training firefighters go through as
part of their day-to-day job is a major reason why so few are
killed and injured while on duty. It’s when firefighters are back
at the station in ‘off-duty’ mode that the majority of injuries,
albeit minor, tend to happen.
“Fire-fighters spend around five per cent of
their time tackling fires,” says Gail. “They’re more likely to get
asked to attend road traffic accidents, rescues and fire prevention
sessions in local schools.
“It may seem an odd thing to say, but firefighting is a fairly safe
job. Slips, trips and falls are usually the most common type of
injury, and I guess that rings true for a lot of people in the
health and safety profession, whatever area they work in. In July,
for example, there were only three accidents throughout the whole
of Leicestershire Fire and Rescue Service. All of them were
relatively minor injuries, and one of them was a cook cutting
himself with a knife back at the station.
“When they get into their firefighting role
and are out on a call, they go into ‘safe’ mode. Their training
kicks in. It becomes second nature and all their senses are on a
state of high alert. It’s usually when they’re back at the station
that minor accidents happen.
“Basically, they see the station as a safe
environment. The body and brain relaxes, particularly after a
stressful situation, and that’s when they’re more likely to suffer
injuries because they are less alert.”
As well as the rehabilitation work Gail
oversees for more serious injuries, which often includes
physiotherapy and counselling, her team is also involved in
screening. “We mostly check for things like blood pressure and
general fitness for the job. We also help managers identify any ill
health trends through things such as days off sick.
“We’ve just got the results back from a mini
health screen we carried out for Men’s Health Week earlier in the
year, which will be published soon. The screening identified health
risks for diabetes, high cholesterol, blood pressure and increased
waist measurements. We’ve also just finished a campaign about
testicular cancer, with posters and leaflets up around fire
stations reminding men to carry out routine checks.”
Gail started her career in occupational health and safety in the
late 80s, and has seen a lot of changes in the profession since
then.
“In 1989 I started going to local IOSH branch
meetings after becoming a member that year. Back then, I can
remember the room full of dark suited men, mostly smokers! You
never heard any practical advice. Nothing was brought down to a
common sense level and everything had to be caged in rules and
regulations.”
Although the profession has undoubtedly changed over the years,
its perception in the press hasn’t. “I’m sick to death of the term
‘health and safety’ being used as a stick to beat people over the
head with – and I’m sure I’m not alone in saying that!”
Gail and her team have been actively changing the safety culture
within the service.
“Firefighting is a male dominated role, very
macho. We have to work especially hard in that environment. But the
benefits are really paying off – people are embracing the health
and safety culture. That said, more women are joining the service
as firefighters now and because of the diverse nature of the job,
health and safety is very high on the agenda.
“I’m fairly privileged in my role and I have
a lot of diversity. On one hand, I’m working with senior management
on strategic issues and, on the other, I’m involved on the clinical
side.”
The worst aspect of Gail’s job is the paperwork.
“It’s one of my biggest headaches! There are always targets and
stats to juggle, but I guess everyone has a bit of their job they
least like.”
Factfile:
- Gail has been an IOSH member for nearly 20 years and belongs to
the Midland Branch
- She is past President of the Association of Occupational Health
Nurse Practitioners (UK)
Links:
60 second interview
James Cheung, of James Safety Consultants
Ltd in Hong Kong, talks to Connect
What’s the most memorable experience you’ve had in your
career?
I used to work as a factory inspector, and was once called to
investigate an accident in which a worker was scalded by hot water
while he was working inside a manhole. After being taken to
hospital his condition deteriorated and he sadly died. I realised
just how important the job of a health and safety professional is
that day.
What do you get out of your job?
In my 28 years in health and safety I’ve seen continuous
improvement in Hong Kong. I’m proud that I’ve been able to
contribute to that. We have to face lots of different challenges –
from lack of management support to lack of resources – but the
satisfaction I get from overcoming each challenge is the motivation
for moving forward.
What issues can you see coming up in your
sector?
The financial crisis this year will impose huge economic impacts
on every industry, including construction. The construction
industry will see a drop in new projects and a drastic cut in
resources. There’s no doubt there will be a negative impact on
health and safety. Both company bosses and safety professionals
will face a very tough situation in the coming year.
Would you like to see any legislative changes in your
sector?
Yes, I’d like to see legal changes to raise standards in our
community. In 2000, the government introduced a new law that
required factories, construction sites, shipyards, the electricity
sector, town gas and LPG and container handling to establish a
safety management system. Many other organisations – in the public
and private sector – have since set up safety systems. The question
is should this law have a wider scope to cover all sectors?
What is the Hong Kong Branch doing to build links with
the government?
This is our major target this year. Our professional knowledge
is a valuable resource in helping the government formulate policy
and that’s why we’re working to make and maintain links with a
number of departments.
What approach to your job sets you aside from the
perceived public image of health and safety people being
bureaucratic busybodies?
Bureaucrats can be found in every sector. A typical bureaucrat
is someone who only does things ‘by the book’, without considering
the actual situation or the needs of others. But there’s always
more than one way to get things done.
Do you want to be considered for a 60 Second Interview?
Contact the e-Editor.
Quote Me
IOSH gets its message across...
The Times
Immediate Past President Ray Hurst responded to a story in
The Times claiming that poppies with pins are being
outlawed as a health and safety hazard. Ray said:
"As Europe's largest body for safety and
health professionals and as vice chairman of my local Royal British
Legion branch, I’m happy for Remembrance poppies to be offered with
pins. We at IOSH haven’t banned them on health and safety
grounds.
“This seems to be a little like the old
military story highlighting the dangers of miscommunication – 'send
reinforcements, we're going to advance' becomes 'send three and
fourpence, we're going to a dance'. There's a very low risk that
these pins will cause any danger at all.”
Construction News
Ray Hurst told Construction News that, despite a drop
in the number of deaths, there was still a lot left to do.
“It's concerning that we still have so many
preventable deaths in the construction industry. The risks in this
industry are well known, yet 72 workers were still killed last
year.
“I hope the new Health and Safety (Offences) Act will provide the
tougher penalties needed to make it even more obvious that society
isn't prepared to tolerate slackness on safety. For employers to
make major cutbacks on health and safety during the downturn would
be both irresponsible and dangerous for the future of our economy,
which is already entering a really testing period. We need to keep
reminding business to ensure health and safety is on their agenda.
We must get the message across that safety makes sense and does
pay.”
Annual Dinner and AGM
IOSH President Nattasha Freeman spoke at the IOSH AGM about a
new pilot training course in occupational health called 'Proactive
interventions - occupational health support', due to be launched in
December.
“The course is aimed at safety practitioners.
With joint funding by the DWP, it's our response to the
government’s bid to reduce the number of people currently on
incapacity benefit.
“It is hoped that the course will better arm
practitioners in both helping bosses to prevent workers getting ill
through work, and helping workers and their GPs in a structured and
more long term return to work. A focus on the ‘health’ in health
and safety can only underline the importance of working to live not
just living to work.”
New President Elect John Holden attacked the negative images
associated with the profession. He said:
“Health and safety professionals are being
made to seem out of touch with reality and as despised as the
jobsworth Warden Hodges from Dad’s Army. Most health and safety
professionals can’t understand why they’ve been tarred with this
brush.
“Despite IOSH sponsoring the World Conker
Championships, there are still commentators out there who believe
we ban conkers matches. Apparently, we also ban pins with poppies,
the collection of firewood and we’ll doubtless continue to be
blamed for all manner of Christmas bans. Come and talk to a health
and safety professional instead of hearing the hearsay. We’ll give
you a sensible, reasoned view.”
Burton Mail
IOSH Council member Stephen Asbury talked about his new book,
being published by IOSH, in his local newspaper, the Burton
Mail.
“It's a real pleasure to be asked to put pen
to paper again. This time I want to share my passion for best
practice in sustainability and other related matters.”