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Shining the light on workplace health conditions

Hear from Dr Elizabeth Pritchard, School of Public Health and Preventive Medicine, Monash University, on the latest research around work health and chronic disease, and the impacts this can have on workers.

This presentation was part of the Healthy Work Design forum held on 22 March 2023.

Download a copy of this film (ZIP/MP4, 860MB)

Speaker 1 (00:00):
Good morning. As managers, leaders, teachers, employers in any industry, we often think of occupational health and safety as those things about mechanical injuries. We think about slips, trips, falls, things like this, getting up on stage without rails. And we tend to miss those things of health conditions or mental health environments like was so well portrayed by that murky fishbowl. So however, with the implementation of the Code of Practice, we have the opportunity to include a focus on mental health conditions, psychological distress, and how to mitigate that and decrease that risk to some degree, and encourage flourishing mental health. So today I'm shining a light on these conditions and presenting some of the findings from the Driving Health Study, as Michelle has stated, of the truck drivers in Australia, and to look at what we can learn from this for across all of our industries. So Wunya, Kia ora koutou, as you can hear, I'm a kiwi, I'm now based in Melbourne, and I bring greetings from my homeland to you. Welcome today.

I acknowledge the sacred land of the Yuggera and Turrbal people on which we stand, work, play, and live today. I give my respects to the thousands of years of wisdom and knowledge found in the Indigenous owners of the land. And I pay my respects to the elders past, present and emerging on which we stand and which we can celebrate the diversity of the Aboriginal and Torres Strait Islander people and their ongoing cultures and connections to the land and the waters of Queensland. I see this as our cornerstone, our foundation. When we recognize and understand that we can embrace diversity and we can encourage an amazing environment in our workplaces, where everyone is respected regardless of a diagnosis, regardless of a personality, regardless of culture, regardless of gender, then that we can build a more psychologically safe environment going forward.

So my plan today is to talk a little bit about the incidents of work-related illness. And we've already had some statistics which are pretty horrifying, really, when we think about it. And then I'm going to share a wee bit about the Driving Health Study. Yes, I interviewed truck drivers across Australia. It was absolutely awesomely cool. We got down and dirty with all sorts of things. It was great. They were very open and talked about some of the problems in their field definitely going forward and now. Risks to harm, we look at what are the risks to harm that were similar that came up in the Driving Health Study that are reflected in the Code of Practice, and what are the challenges of mitigating these risks going forward? And what next for everyone in this room? Because I know you're not all in the transport industry, by any means.

So how big is the problem? The Australian Bureau of Statistics, we have to have statistics. We're academics, we need to have some sort of benchmark and baseline. So around half a million people across Australia in the financial year 21 to 22 had a work-related illness or injury, and 66% of those had time off work. Now that's where the rubber hits the road, that's where the dollar, lack of productivity, and it hits our purse as organizations and companies. The fifth most common cause was stress. And in looking at the time off work, it had the highest time off work, nearly six weeks on average, and approximate an average of six weeks or more off work for stress or mental ill health. So it's something we need to think about and recognize and work towards and that's why this wonderful Code of Practice is coming into play.

So the transport industry was the third-highest rate of injuries and that was third-highest below accommodation and forestry accommodation. Yeah, I've got the specifics in my notes. So we looked at a Driving Health Study, analysis has gone on for six years through Monash University, and also various funders as well. And we have investigated reports, we've investigated compensation claims, life insurance data, and looked at the literature throughout the world that has been published around driving health and what are some of the problems. We have published over 10 reports, many different papers, webinars. We had a series of webinars for people in industry to share our findings in plain language, not academic speak. And we've also had a whole lot of media coverage throughout Australia and beyond and conference papers and things as well. So we want to get the word out there. It's not a good industry at this stage to work in long-term. We need to do some changes, we need to look at what can we do to change this.

Phase two of the Driving Health Study was we did an online survey where we had nearly 1400 drivers complete an online survey. And then 332 of them offered to give us some more of their time and we did a telephone survey with them to find out a little bit more about their health status and what were some of the deeper understandings of the factors involved there. I was also involved in interviewing in-depth 17 drivers and nine family members to explore the issues longer and deeper.

And then from there, phase three we piloted an intervention phase where we distributed some training materials, and I'll talk a little bit more about that soon. Training materials to the managerial type level in the truck driving industry. So that was allocators, supervisors, managers, those people who distribute the loads, the lifts, the shifts, who does what delivery and when. So those people who organize the drivers. And we had 47 of those completed. So I'm going to share a little bit about the findings of those things too.

So how big is the problem of work-related illness or injury? And when we're saying illness and injury, we're talking about musculoskeletal things. We're talking about heart conditions, stroke, diabetes, obesity, and also mental health, psychological distress. So they're three times more likely to break bones at work, 13 times more likely to die at work, four times more likely than the general population in Australia to be injured at work, and 83% of those injuries were due to psychological stress, not crashes. People often think, oh yeah, the injuries are crashes. It's only 17% of injuries in the driving industry that are related to crashes. And drivers 65 years and plus had the highest risk of work-related injury or disease. So we have an aging workforce in Australia, well throughout the world, and we need to look at these types of things as well. It's like what is this about? What can we do about it? It's huge.

But to start with, we didn't know how big it was in Australia, so that was part of a lot of our study to start with. So the actual findings that came through from the online survey, cardiovascular disease, heart disease is the leading cause of death in drivers over 40 years of age. That's a worry. A lot of drivers are over 40. One in two drivers are obese compared to one in three Australian men. And there's lots of factors around this and that came through very, very strongly in our Driving Health Study as well. It's not just the fault of the driver, it's not just the fault of your employer, employee, there's many other factors, like Sam was talking about. What is the environment? How clean is the water? What other things we're putting in place? What are the policies that we're adhering to? How are we actually creating an environment for a healthy person to work?

In obesity, there was association with poor workability, so they were not as able to get in and out of the cab, check their vehicles, tie down the loads, loading, unloading, those types of things, and poor general health. High blood pressure was reported in over one in four truck drivers, and 68% of the truck drivers did not meet the dietary guidelines which are set down across Australia, and 50% did not meet exercise guidelines. Now we can say it's that person's fault, it's that driver's fault, they need to eat more healthy. Why do they choose the Coke instead of the water? And there's a lot of other factors involved. Many of the road houses has closed down. Many of the places where they used to get healthy foods, they're no longer able to park there because their trucks are too big and they'll get a fine, and the fines can be up to one to two weeks wages, there are lots of other factors involved.

And so we need to think about, what does that mean in my industry that you're working in and leading? What are the factors involved that are bigger than the employee? How can we encourage and create a more healthy environment? Some of the psychological distress findings were that one in two truckees had psychological distress, and drivers under 35 years of age had four times the psychological distress of those over 55. More hours worked, that means over 41 hours, people experienced more severe psychological distress, and suicide was the second leading cause of death under 39 years. These are horrifying statistics that we need to think about. Drivers that were less likely also to access services when needed. And we know there's this whole stigma around accessing mental health services, accessing counselors or chaplains or psychologists or psychiatrists or those trained professionals that can actually help if we're feeling anxious or depressed or financially stressed or all types of psychological ill health symptoms. It's like there's this whole stigma around it. Again, that's part of the environment. What can we do around that in our workplaces to make it different?

Okay, I'm going to the good side. Okay, here we go. Some of the things that came out that supported drivers were having strong connections. Those ones that had really strong connections with their allocators, their supervisors, their managers, had strong connections with friends and mates, went on the radios overnight and they talked to each other through the night to get through. Those people had strong connections and had great coping strategies. They had an optimistic approach, good problem solving skills, and they were able to appreciate the moment. Now there's a lot of research around it that is coming out in the last decade or so around appreciation and gratitude and the impact that has on your psychological health and your physical health. And so many of the truck drivers were going, "I have seen the most phenomenal weather conditions, storms, sunrises, sunsets, that most incredible land and environment that I'm driving through." And when we appreciate the moment, we change the environment, we change the environment within us and we change the way that we interact with people around us. Those people who actively seek help, they were felt more supported and were much more able to cope with those pressures in life going through.

So factors associated with both psychological health and general health from the telephone study, positive association, it means they both go up, one goes up, the other goes up, good diet, longer driving experience, were better for psychological health and general health. One goes up, one goes down, the negative association, means high financial stress, things that we'd expect. High body mass index, experiencing loneliness, poor sleep, preexisting physical conditions, high risk of or poor work environments. Those things, your psychological health goes down.

So why such low levels of health with drivers? Now these are 12 of the 14 risk factors that are identified in the code. And when I was looking at the code going, I need to do a bit of homework here, I'm talking at this whole forum around it. And so I was looking at, what is this? What is our research telling us and what actually can I go? Yeah, it meets all of these unfortunate risks of harm. There was 12 of them, you can see them there.

And they link also to the SMART work design that Professor Sharon Parker is going to talk about in a minute as well. The high job demands, these low stimulation, they're in the truck for hours on end until their next break is locked in their logbook, and then there's intolerable demands. "Be here by here," and it was like, "Yeah, well I can't, there's road works," or, "Ah, I can't do this because the truck's broken down," or whatever. And then there's a roll on impact. So what's the overflow roll on impact for yourselves and your organization as well from some of these things? Poor support, low job control, even in manufacturing there can be job control within it, and the SMART work design, Sharon's going to talk a little bit about that as well. It was like, how do we give our employees these things so that we have a better environment for them to be in? And you can read some of the other ones there too.

Some of the divers stated these, it's the amount of hours you do. You're just sitting in a truck. It's still physically demanding. So there's a lot of cognitive work, but they're sedentary, it's so sedentary. And if you're out there, you're on your own all the time. It's the isolation. Some people interpreted the isolation as time on their own and they loved it. Others interpreted it and felt really lonely and separated from people. So we looked at what can we do about this? It is more than just the employee. It is more than just the driver. What can we do about this? So we created a pilot intervention where people online, they registered, they had some pre-questions, they watched a video. And the video was taken, and we had actors who created three different snapshots in the workplace, and the narrative for the actors was taken directly from all of the interviews that I did with people, with drivers and family members.

And it was powerful. It was powerful. It was basically saying, well, there's lots of things that I can't control. It's like I have to do this because of that. My boss expects me to do this, then I have to meet this and I need to meet that. And if I don't do that, I may get fined one to two weeks wages because of blah. And they explained some of the influencing factors that were around, that many people in Australia didn't realize within the industry. Some of them were recognized previously, many of them weren't. And then we did post questions to see if the people's, the managers' and allocators', supervisors', understanding had changed at all, but from listening to the video. And then there was an access to a whole lot of resources that we'd created throughout the previous five years of the study.

So yes, it's a bit of a complicated graph, don't worry about it too much. Apart from the fact of recognizing that the intervention was showing that there was some movement in the understanding of the managers, supervisors, that there was factors that they could impact in the workplace. Factors like the driver weight, which people often say it's their fault, it's their problem. Family financial stress, driver physical activity. And then the other ones, physical health, mental health, fatigue and sleep. Everything shifted a little bit. And the factors that people were saying in the intervention was that they were saying, "I can have a conversation with this person." I can say, "How are you going?" I can be interested in them. I can be open. I can actually listen to them more. And so those are some of the things that we can take into any workplace.

We can listen more. We can be interested in employees, and our people that we are working with. So we need to think about the things that we could mitigate the risks with, our attitudes and stigma around mental health, our attitudes and stigma around, we've got a Code of Practice and we have to be compliant. What the heck? I was like, so what is our attitude around it? Where's that opportunity mindset to go, "Oh, we've got this opportunity to make this workplace more effective. A place where people want to stay longer, so we don't have to spend all that money in training people up again when people leave." And it's a win-win. And you can see some of the quotes here from some of the drivers. The whole stigma around mental illness, especially with males, is you just can't talk about it. And if you speak up, you're a tosser, and you just need to harden up.

That was not helpful. And so it's good to have these things out here and be seen and be shown that, okay, how do we, as leaders in industry, manage this? How do we make it okay for people to speak up? What is our workplace culture? What is that inside of the fishbowl? What is the pH balance within our environment? What are we actually exuding? What are we allowing within our organizations going forward? Lack of control, huge thing. So many things beyond the control of the driver that they get so frustrated about, that we need to have an all-encompassing interaction going forward. And the costs. We need to recognize that the costs are not just monetary costs, the costs of physical costs, social costs, emotional costs on the person, their family, the environment, is huge.

So why is considering health conditions right across different type of conditions for workers important? We also did another study, we had to get help in with this one because it was a super huge, a study that looked at projection of numbers in relation to what is the cost if we do nothing? For the data that we'd gathered from the drivers in Driving Health. And over the next 10 years, it was associated with 18,294 years of poor quality life. So I don't know about you, but I don't even want to have one of those 18,500 years of poor quality life. I don't even don't even want to have two weeks of poor quality life. And if we do nothing with the data that we had, the projections were that there will be over 18,000 years of poor quality life. And the monetary costs are enormous. Now, this is just on the Driving Health data. This is just from the Driving Health data projections of the next 10 years.

The costs of 485 million in healthcare costs, 2.6 billion in lost productivity, and 4.7 billion in lost years of life. These are factors we must stand up and recognize, and we must look at how can we do something and what are we going to do about it? So management of risks across all industries. I've shared some reasonably horrifying statistics and I hope you recognize that there's many factors that we can take across each of the industries that are represented in this room, and that's the exciting part of it. We can look at, yes, there's workers. So we need to look at what is the worker health? How can we encourage that to be better? What are the factors involved? What are the programs involved? Do we all have vending machines in our workplaces that are full of sugar and fats? It's a simple first thing to change.

There's studies around how to change those. They change them in hospitals really easily, not by saying, "Okay, they're all out. Nobody's allowed those anymore." Not that sort of way because everybody reacts and everybody goes, "Who are you to tell me what I'm allowed to eat?" So there's ways around that. There's the regulators in the policymakers and the Code of Practice that's out now, is part of that. There's managers, there's companies, all different levels of management in the industries. And also the public. Particularly very much so with the drivers, it was the public, the public drivers. There were many things where they were talking about frustration, abuse, harassment, violent acts to any truck driver when they hadn't actually done anything, being blamed for certain accidents when they were actually first on the scene helping somebody who was injured in a car. All sorts of things like that.

So it was like what is the public perception? What are our clients and our customers and the people that we engage with, our students, [inaudible 00:22:03]? What is the public, what the interaction there? And how can we work together in collaboration to have a better workplace going forward? Consultation, consultation, consultation. Not tokenism, not a little conversation here or a little survey there and we go tick, done that box. Consultation, interaction, collaboration. And as we talk about in New Zealand, partnership. We cannot do anything without partnering with the people involved. Not just a token conversation, but we are partnering through that consultation.

So I hope this has shone a light a little bit on workplace factors. I'm going to get you to stand up and have a jiggle in a minute. Take it off. And there is our contact details. I'm presenting on behalf of the Driving Health Team, which is led by Professor Alex Collie and Associate Professor Ross Iles, and my colleagues as well. So if you wanted to contact us at any time, we're at Monash University in Melbourne. Thank you so much for your time.