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The link between MSDs and psychosocial risk factors

In this webinar presentation, Dr Jodi Oakman, Senior Lecturer at La Trobe University (LTU), will give an overview of current research evidence relating to the causes of MSDs, including the impact of psychosocial hazards. Additionally, she will present some of the findings from research currently being undertaken at LTU and discuss potential changes to the way MSD risks are managed.

Watch the recording of the webinar, or download the presentation (PDF, 1.52 MB).

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Psychosocial factors and musculoskeletal disorders: Using the evidence to inform risk management

MSD Webinar - 11 November 2015

Presented by:

Chair: Allicia Bailey - Manager, Engagement Services, Workers' Compensation Regulator

Speaker: Dr Jodi Oakman - Senior Lecturer, Centre for Ergonomics and Human Factors, La Trobe University

Allicia Bailey:

Good afternoon everyone. Thank you so much for participating in today's webinar. We are going to get started just because we are mindful of time. Today's webinar is on Psychosocial factors and musculoskeletal disorders: Using the evidence to inform risk management.

The topic and expert speaker for this session is brought to you by the Office of Industrial Relations which is comprised of the Electrical Safety Office, Workplace Health and Safety Queensland and the Workers' Compensation Regulator. Just to let you know, the Office of Industrial Relations is committed to driving initiatives across the whole scheme that improves safety, well-being and return to work outcomes for both employers and workers. Today's session is specifically an initiative of Workplace Health and Safety Queensland and it will provide you guys with an overview of current research evidence relating to the causes of MSDs including the impact of psychosocial hazards.

Just to let you know who you are listening to, my name is Allicia Bailey and I'm the Manager of Engagement Services for the Workers' Compensation Regulator and I will be the facilitator for today's session. Just before I introduce you to Dr Jodi Oakman, our presenter for today, I have just a few tips on how to make the most out of the webinar experience. Firstly, I'm mindful of time so we'll try to keep the webinar strictly to 45 minutes if we can. At the end of the presentation, there will be an opportunity for Jodi to answer some of your questions so we do really encourage that you make the most of this opportunity. So at any point throughout the webinar, if you do have a question, just use the chat box on the right hand side of the screen. We'll collate all your questions and then Jodi will work through as many as she can depending on time at the conclusion of the webinar.

A copy of the webinar will also be emailed through to you at the conclusion of today's session and we will also make it available on the Worksafe Queensland website. So please feel free to share this resource with any of your networks that you feel may benefit from today's session. If at any time during today's session you do experience audio issues, please again use that chat box on the right hand side of the screen. We have our IT experts on hand to help you, just to make sure that you don't miss out on any content so please let us know. Now that's the houseworking done so let's get straight into it.

In this specific webinar, we have Dr Jodi Oakman who is a senior lecturer at La Trobe University and she will present on some of the findings from research currently being undertaken at the uni to discuss potential changes to the way that MSDs are managed. Dr Oakman is a senior lecturer at the Centre for Ergonomics and Human Factors and a postgraduate coordinator for the Ergonomics, Safety and Health Program. Dr Oakman has worked extensively in industry as a consultant in ergonomics to many organisations. She is a qualified physiotherapist. She also has a PhD in the area of the ageing workforce and the impact of organisations on their employees' retirement intentions. So that is all the formalities done.

Now I will hand you over to Jodi and she'll take you through today's session.

Dr Jodi Oakman:

Hello and welcome. Thank you for taking time to attend the session today. So I'm going to talk a little bit about the current evidence around risk management of MSDs and I'm going to start with posing three key questions around:

  • are MSDs actually a problem;
  • what does the evidence tell us about musculoskeletal disorders; and
  • are there gaps in the current strategies that we use to manage musculoskeletal disorders or MSDs?

So, firstly, what are MSDs? There are many definitions around musculoskeletal disorders but mostly there is consensus that they affect tendons, tendon sheaths, muscles, nerves, blood vessels. What's important in a workplace setting is that they are a complex issue and they develop over time or exposure to a single event. This I think is one of the great challenges for us in the work environment is that mostly we are encouraged to think about exposure to single events but in reality what happens is that things develop over time and a single event may or may not be a significant issue.

So how do we know whether or not it's an injury or a disorder? So there are many diagnoses for musculoskeletal disorders but we know that the reliability of these diagnoses is often poor and we know that mostly they arise from exposure to a range of issues over time. In a workplace, unfortunately much of our attention gets skewed towards the right of this diagram from an injury diagnosis leading onto claims and then rehab rather than to the left at the onset of symptoms. So what we're suggesting is we should skew more of our focus in prevention activities towards the left identifying when people become symptomatic and not worrying so much about what the diagnosis is, given the issues around the reliability. This may be important in a clinical setting but in a workplace setting we really need to be identifying what are the workplace triggers - the workplace hazards - that are relevant to MSDs' development.

So we know that cumulative injury actually lowers the threshold for sudden onset injury. So that is, if you had a number of injuries, you're more susceptible to having an acute event. In 2012, the International Congress on Occupational Health developed a consensus statement around workplace risk management and what should be our primary goals and that was that we should be focused on reducing musculoskeletal discomfort that is at risk of worsening with work activities and that affects work ability or quality of life, not to focus on specific diagnoses, because this is not particularly relevant to workplace risk management. So I'm suggesting that we need to be careful because we know that it's often the straw the breaks the camel's back and if we focus all our activities on that, we may being led the wrong pathway towards identifying what are the key hazard and risk factors in the workplace.

So are they a problem in Australia? This is taken from the National Data Set of serious claims. We know that musculoskeletal disorders - injuries and disorders, we think about them that way - are the largest area of claims. What is interesting in recent years is there's been a fair shift - an increased focus on stress-related claims or mental health disorders and if we look at those in comparison to the MSDs, we can see that although they're important, they are a much smaller percentage of overall claims. Of course, there are many reasons for that - and not the focus of today's presentation - but in terms of workplace focus, musculoskeletal disorders are an important issue. The issue around mental health disorders is that they are very complex and very expensive to manage because there are significant challenges in getting people back to work so it's not to say they are not important, but by and large musculoskeletal disorders form a greater percentage of injuries.

They are not only a problem in Australia, they're a problem in Europe and a problem worldwide. We know that data is lacking in many developing countries and so it's hard to make reasonable comparisons, but a huge percentage of all back pain is - a significant percentage I should say - 37% of all back pain is attributable to work so it's a significant issue.

I am going to take you through the research evidence on MSD causes and the requirements for effective interventions because they should be linked. In 1995, Kuorinka & Forcier developed this model and I use this model, not because I haven't updated my slides, but because it shows that we have been thinking about the role of work-related factors for a long time now. So if we look at this model, we can see that there a number of features, some in the bottom of the figure including the traditional physical factors and then a whole range of other organisation and psychosocial work variables such as invariability, such as supervision, such as cognitive demands and a range of other factors. We see that these workplace features and so-called generic risk factors - and we may choose to relabel those now given evidence we have - but essentially workplace features which impacts the patho-physiology. We can see that within that exposure to these factors trigger a stress response, then we get a change in endocrine and hormone and immune system response. How we cope at an individual level of course varies but we get changes in tissue load with resulting mechanical, metabolic and biomechanical responses. These then increase the risk of development of musculoskeletal disorders which we know has a resultant impact on health and performance.

If we move forward to 2001, many of you will have seen this particular model. It's now one of the most well-known models in the area of musculoskeletal disorders and it's particularly significant for a number of reasons. One is that is out of America. It was developed by an expert panel which came together and reviewed a huge body of evidence around the development of musculoskeletal disorders and came up with a number of findings and this model. Now there has been strong resistance to the recognition of psychosocial factors in the role of musculoskeletal disorders and in fact that are work-related factors not just psychosocial.

So it was very significant and one that you will see in much of the literature around musculoskeletal disorders. But essentially building on that previous model showing that psychosocial hazards, manual handling hazards or the physical hazards as we know impact on a person. We see those physiological changes impacting on internal tolerances and then resulting in outcomes such as pain and discomfort or musculoskeletal disorders. Of course, there are individual factors but these are largely outside the control of workplaces. We know that we can't control age or gender or people's personality types so these are factors that we may have to manage in workplaces but they're not things within our direct control.

Then this simplified version out of our research here at La Trobe University where we've looked at a range of evidence and undertaken a number of different studies. We're interested in 'match' between individuals and their workplace and when we get an imbalance between those, we get these resultant effects within a person - high biomechanical loads, fatigue, reduced internal tolerance and a stress response resulting in tissue damage and/or pain. This starts to point us towards areas that we should be thinking about in terms of prevention activities.

So when we think about types of workplace hazards, we think broadly about manual handling hazards, so task specific, physical hazards, psychosocial hazards and we think about these as two sub-groups - organisational such as around the work organisation and job design, and social context around the sort of support, communication, relations with managers that we have. More specifically, looking at the sub-groups of psychosocial hazards, things around the organisational level are things like working hours, shift design, workloads, and you can you read the rest on the list there. Interesting that conflicting work demands - this is an increasing issue for people particularly as organisations downsize, to put it nicely, trying to do more with less. Then there are the social context hazards around the communication, the general culture of the organisation and individual relationships with colleagues and supervisors.

Important to note that the organisational hazards are the responsibility of managers and supervisors because they're involved in the design of work, the allocation of work and there's overlap because they also are in a position of being able to control those as well. So they may well be the instigators for some of those problems but they have within their remit the ability to control those.

The really critical thing that I hope that you take from looking at those models is that increased risk of MSDs is determined by a whole range of hazards - organisational, psychosocial and the more traditional physical ones. I think the important thing is that we often don't see that one group or the other result in injury but that it's usually a combination of factors. Many of these interact or they're additive if you have one then the other one becomes worse. However, there is still a perception, I think, that manual handling hazards are the real problem. So even though we've got these psychosocial issues, if we just focus on the manual handling ones then we should be able to solve the issue. So let's have a look at that further.

Bill Marras in 2009 - he's of a biomechanical persuasion so he's very interested in the physical factors, particularly around back pain. So we particularly like using his work because this is someone who traditionally would think that physical factors are the most important. So he and colleagues reviewed a range of epidemiological evidence and reported on the contribution of workplace factors to MSD development. What they found was that in terms of development of low back, physical factors contributed somewhere between 11% and 80% to the explanation of why people developed back pain, and psychosocial factors somewhere between 14% and 63%. Similar percentages for upper extremity.

Now you might say that's a really large variation in contributing factors. What does that mean? Well if you think about what workplaces are and the sorts of measures they use and the studies that they reviewed, then it's totally explainable. Workplaces are messy, challenging places to collect data and anyone that's tried to do workplace surveys and get really good response rates will know that it's very challenging but also that they're very different. So what's important in one workplace may not be so important in the other and I think the key message there is that physical factors and psychosocial factors are both contributing significantly to the development of physical presentations such as low back and upper extremity.

So Johnston looked at retail material handlers and I particularly like this study because it's got a very strong design, big population and a very physically orientated job. So what do we find here in terms of contribution or predictors of new back pain, that is, which psychosocial hazards are more likely to result in the development of reports of new back pain. We can see there that high job intensity has the strongest predictive contribution to the development of back pain. So that's job intensity, then scheduling demands, job dissatisfaction. So what about the physical aspects? Well there they are down the bottom. Lifting 20lbs at work usually every day - you can tell this is an American study - that's at 1.2 so still a significant predictor but not as strong as the intensity or the scheduling demands imposed on people in their work.

So our research. Let's bring it back to Australia just to see if we're any different. We've looked at seven organisations in warehousing, hospitals, ambulance, and what we've done in each of those is undertaken an employee survey and taken scores on workplace hazards, physical and psychosocial hazards, hazardous states so things like stress, fatigue, job satisfaction and work-life balance. Then we take an MSD score, a discomfort or pain score, across a number of body regions - I'll show you here - which asks how often have you felt discomfort or pain in the past six months and we look at frequency and severities. So it's a very comprehensive measure of pain and discomfort.

We look at a 12 item physical hazards scale and we use a psychosocial measure that has been used in a range of other studies - so we didn't develop it - but looked at measures around relationships with management, reward, workload and those psychosocial hazards that we saw earlier that are potential predictors of MSD risk. So what did we find? When we put all those results in the pot and undertook some statistical modelling, we were interested in what were the contributions of those particular hazards to the increased MSD risk which we used the pain and discomfort score as a proxy. So if you've got higher scores of pain and discomfort, more likely to go onto develop a musculoskeletal disorder.

So we find there that physical hazards and psychosocial hazards contribute very similar amounts. These figures here on the arrows are the amount of contribution those factors are making to the outcome which is increased MSD risk. We can see there that physical and psychosocial hazards are contributing very similar amounts. Job satisfaction also significant. The reason it's negative is because low job satisfaction results in increased MSD risk. So that's telling you that if you were to focus your prevention activities on one or the other groups of hazards, you're missing a large piece of the important factors in predicting increased MSD risk.

I think the important thing is that, yes, there is variability between the studies in their relative importance but I would suggest that this is totally explainable by those reasons I outlined before that workplaces aren't nice, clinical environments to take measurements and they're all very, very different. You wouldn't expect to get similarities but what is significant there is that we are saying that the importance of both psychosocial and physical hazards in the development of MSDs.

In terms of workplace practice - the implications for MSD risk management - because that's what most of us are really interested in, is in a workplace what does this mean. It means that it's clear that assessment and management of psychosocial hazards is essential. This is not optional. If we choose to ignore the psychosocial hazards, there's no doubt that we'll get some improvement but we may not get the full improvement or full reduction in MSD risk that we need. The severity of exposure to any single hazard is not necessarily a good indicator of overall MSD risk. So we need to look at multi-factorial ways of both identifying and then controlling MSD risk. The output of the tools for assessing adverse postures and/or biomechanical loads indicates the severity but it doesn't necessarily indicate overall MSD risk. So it's really important that we don't just look at particular aspects of people's jobs because we don't necessarily know whether that's the most important part which is causing the problem. Many times we actually focus on single aspects of people's work rather than their overall job and I think that's an important distinction and one that we argue in that particular paper I showed earlier.

So currently what do we know about what happens in workplace practices. One of the issues is that there's little published evidence of actual practices. But mostly what we know from the work that we've done is that there is a strong focus on physical hazards and there's not a lot of evidence to support the management of psychosocial hazards in relation to MSDs. We're currently undertaking a project where we're actually interviewing a whole range of managers, supervisors, health and safety reps in workplaces to ask them about current practices in their workplace and then reviewing their documentation around the management of musculoskeletal disorders and mental health disorders in order to address this evidence gap. There are some other examples of reports. Routinely in our work we have a look at MSD risk management practices to identify what the coverage is of all hazard and risk factors in relation to MSDs.

What do we need to do in terms of bridging this gap between research evidence and practice? At La Trobe we're currently developing a toolkit which will enable a comprehensive approach to the risk management of MSDs. Because for all the reasons I've just outlined, the current MSD risk management strategies don't reflect the research evidence as depicted in those frameworks from our model and others in real world practice. There are a number of barriers to more effective MSD risk management. One is that the approach is usually focused on physical hazards because they're often more explainable or traditionally better understood in workplaces compared to the role of psychosocial factors in MSDs. The other major problem is the concept of a hazard focuses attention on a single event or an object as the problem instead of looking at several interacting agents or events, so taking a really multi-factorial approach to the identification and management of hazard and risk factors.

Psychosocial factors often cause people to run away and say "Well how do I actually manage those?" because they're less concrete, harder to touch than the traditional physical factors. We're very comfortable with lifting, pushing, pulling, but things like relationships with colleagues, supervisor support, job design, people traditionally say that these are more difficult to measure and then develop an approach. They are challenging - there's no question about that - but one of the issues is that we don't necessarily measure them very well. The hazard is not necessarily proximal to the outcome and this perception, as I just said. But we do need to find a way to assess and control these hazards in the same way that we do with any other OHS hazard - chemicals, noise, lighting, physical hazards. We need to measure them and then look at those measures and develop risk management control plans as we do with all of those other hazards.

So in terms of a risk management toolkit, where are we at in terms of that? A MSDs' risk management toolkit needs to comprehensively address all hazards. It needs to target risk management at job level so we need to incorporate all those factors in people's work, just not individual tasks. We've undertaken a number of workshops in organisations where we involved a whole range of people using results from studies that I alluded to before and this enabled us to identify a number of cost-effective interventions based on results from the survey, but we need a toolkit to ensure that this able to be done by workplaces on their own.

It is a documented strategy for applying practical tools to support workplace changes to control so a specific risk - MSDs - and a number of hazards such as the physical and psychosocial hazards that we have been talking about. Most of us will be very comfortable with the definitions of those words - hazard, the inherent potential to cause harm, and risk relates to a harmful outcome stemming from exposure to one or more hazards, so probability and severity of harm.

This is an overview of the toolkit process. It very much fits in with a standard risk management approach. It's not to be an add-on. This is one of the issues in terms of MSD prevention. It often sits as an extra activity rather than being imbedded in normal overall risk management processes. So it involves having a risk management team, getting all the data together on MSDs, educating the management and supervisors so ensuring that they're up to speed with what is contemporary evidence on development of musculoskeletal disorders. So bridging that gap between introducing that concept of the role psychosocial factors in MSDs. Using the hazard and risk survey which I outlined before to survey staff. This enables a hazard and risk profile to be developed and then subsequent to that risk control, implementation and review. So very standard practices. The key difference here is bringing together or providing tools to workplaces to enable them to simply measure a range of hazard and risk factors that are relevant to musculoskeletal disorders. As I said before, that toolkit process very much sits in this framework which we're all very comfortable with.

Key requirements with WHO is that these toolkits are practical and easy to use, that they provide guidance material so that all workplaces can implement them by themselves, that they're applicable in most settings, they're cost effective, so very much it needs to be imbedded in current processes, not new ones developed, and it assists them to work through the full risk management cycle in accord with the WHO Healthy Workplace Model. I don't have time in this particular presentation to go through that but that is one of the requirements of risk management toolkits by the WHO.

Currently we are testing. We are undertaking an intervention project in the aged care sector to customise a toolkit and then test out its useability within workplaces. The intention is that it's interactive and it allows users to customise further and to enter workplace data to obtain guidance on risk control options and we'll be looking for opportunities to implement, evaluate and compare data across different sectors in future stages of the project. This is a key question - to what extent is customisation needed for different jobs and sectors? So how would the toolkit look so that workplaces are able to do that.

So back to the three questions. I hope that following this presentation and probably because you're here listening to this, you recognise that MSDs are a problem and one of the most significant OHS problems we need to manage in workplaces. What does the evidence tell us about musculoskeletal disorders? The evidence is telling us very clearly that these are complex problems that require identification of relevant hazards and risk factors in the workplace in order to be able to develop effective, comprehensive strategies to manage musculoskeletal disorders and are there gaps in current strategies used to manage MSDs? I would suggest - and I hope you agree - that in evaluating the evidence and in interviewing a whole range of people in different sectors, I would suggest that there gaps in current strategies to manage MSDs and that we need to be thinking about how we're actually going to address that if we're going to significantly improve the current problems in relation to MSDs.

The take home message is that I think there are three key points to consider in your own workplaces. Does your organisation's current policies and procedures reflect contemporary evidence relating to musculoskeletal disorders and perhaps a look and think about whether or not these are - and I digress a little bit here - that policies and procedures are really only the first part of effective risk management. But if these are not encouraging us to think broadly about this problem, then we may want to rethink those policies and procedures. Don't step away from the management of psychosocial hazards. It's difficult - not impossible - but we have to start somewhere and we know there are other areas of OHS that we have significantly improved in time how we manage this particular issue. So we do need to be brave and take steps forward in the management of psychosocial hazards. Strong leadership is pivotal. We need to have support in making changes happen and in reshaping the way we think about musculoskeletal disorders.

I am going to draw the first bit of this seminar to a close, but if you're interested in learning more, we will be running a short course early next year in Health and Design of Work - How do we design work to prevent MSDs and improve health and well-being. If you're interested in taking a big step into further education, the link there will take you through to our courses at La Trobe University. There are the references. There are a number of resources available online to support effective management of musculoskeletal disorders and stress at work and these can be found here. I will leave someone else to talk about that. I'd also like to say that we currently have a number of projects where we're seeking participation by organisations so we're always willing to talk to people about how we might be able to involve your organisation in our current projects or future projects. My contact details are at the end of this presentation.

So thank you and over to Allicia to start the questions rolling.

Allicia Bailey:

Thank you so much Dr Oakman. I guess it is just good to note that we didn't have a single participant drop off through the whole entirety of that presentation which I think is an excellent indication of how relevant the content you've delivered today is for our stakeholders. So thank you again for that. As Dr Oakman referred to just previously, there are many reference studies throughout this presentation so a list of those resources and references will be included in the presentation that we circulate to all participants following today's webinar.

We have shot your questions through to Dr Oakman so we will just give her a minute just to read over those, but while she is doing that, I will just quickly mention that we have the final webinar for this MSDs virtual series which is being held on the 17th of November so it's not too far away. In this particular webinar, we have Juliette Maynard who is the National Workplace Health and Safety and Injury Management Advisor and she'll be focusing on the enablers for success for the CSR Limited manual handling project. So registration for that particular webinar is open so secure your spot as it is the last one for this particular series. If Dr Oakman's ready, I'll hand back to you and she can work through the questions and thank you so much to those participants who have actually shot through questions.

Dr Oakman, over to you.

Dr Jodi Oakman:

Thank you Allicia. So the first question here is - What is the best way to identify and measure psychosocial hazards? I've got another question that's very similar to that around are there any standardised surveys that can be used with employees to assess physical and psychosocial hazards.

The best way with psychosocial hazards is to self-report because obviously it's very difficult to objectively measure some of these hazards around support at work, autonomy and control so these things need to be done by self-report. There are a whole range of tools and one of the websites that was provided a couple of slides back - the stress at work link there - has a number of measures on that website. As I said, we use a work organisation business questionnaire which is referenced somewhere. There you go. There's the occupational stress in people at work. There's a number of measures on that in terms of psychosocial hazards.

I think one of the key things with psychosocial hazards and with physical hazards is that we don't collect regular data of our employees routinely and so we don't have good indicators of what are the problems and where are the problems. So I think one of the keys things to embark on really identifying needs is that you need to take some measures over a period of time. So you need to commit to taking some annual measures so that you can actually see what the issues are, developing and implementing the controls and then re-evaluating what the impacts of those are.

The next question is - Is Jodi still looking for workplaces to participate in her studies on psychosocial factors in workplaces? That particular person who loaded the question, yes, please email me and we can discuss that further. Thank you, there's my contact details.

That was all the questions that came through.

Allicia Bailey:

Jodi, we do actually have a couple more if that is okay so I might just pitch them at you. One of the ones we have is - Where we can find further information to assist with the management of psychosocial issues? I think you have touched on that one already so I might just skip over to the next. One particular participant has said - Does any of the evidence or the studies discuss or include fatigue as a contributing factor to MSDs? It's an interesting area for HSSC and our fly-in/fly-out workers. So do you have any comments on that particular industry?

Dr Jodi Oakman:

Perhaps if I go broader than the contribution of fatigue - and actually not on these slides here I don't think. Yes, we would consider that fatigue is what we call an intermediate state. In itself it is not the problem because one of the issues with fatigue is that it often gets confused in terms of whether it's a predictor or an outcome. We would consider that it's a personal state so that it arises as exposure to work. It's actually a good thing because if we went all day and we weren't fatigued, maybe [inaudible] very much. But one of the issues is that, in that particular state, we are more likely to make perhaps decisions that aren't sensible. We're more likely to have fatigue in terms of muscles and the other structures around that so we're at increased risk because of that. So the issue there is that it predisposes us to increased MSD risk. There are a number of models that if you look at in terms of MSD development will have fatigue slotted in there.

Now in terms of particular industries, we know that, for example - I think the question was about fly-in/fly-out - that there are particular issues around the way that the work is constructed, ie that the hazard is around the organisation of the work, results in people being fatigued particularly when they're working for really quite long hours a number of days in a row without a break but they are then, by virtue of that, at increased risk of MSD development. I hope that answers that.

In the MSD literature around what are psychosocial and physical factors or what are in general workplace factors, you'll find fatigue included.

Allicia Bailey:

Thank you for that Jodi. If I can just quickly squeeze in one more because I am mindful of the time. In terms of the psychosocial risk assessments themselves, do you have any advice or I guess preference - should they be completed by HR or the Safety Department? Do you have any opinion or comment on that?

Dr Jodi Oakman:

Yes, actually I do. One of the things that I didn't get to emphasise enough in that presentation is that this process - the toolkit process I was talking about - is very participative. We know that the evidence supports a participative approach and that we have much better uptake and implementation of processes and prevention activities when participation is high. So in terms of the survey completion I think - Allicia you may need to correct me if I've misinterpreted that - but employees should be completing the surveys anonymously of course because, if they're not anonymous, then people are less likely to be honest about the particular issues at hand.

So if I take the approach that we use in terms of the toolkit, that employees in particular jobs that are being assessed would fill in surveys and those would be anonymous. The risk management team would arrange for those to be input into the database - at the moment it's an Excel database program - and this would then generate what were the particular risk factors that needed to be addressed - or the areas I should say. Then the controls need to be developed participatively with that risk management team which comprises reps at different levels but, importantly, employee reps - Health and Safety reps. Does that address the question?

Allicia Bailey:

I think that's great and I agree with that approach. As a bit of a follow-on question we have, if a control is not followed, do you think that HR or Safety should be the department disciplining for the non-conformance because I think a few of our participants are finding that it is a bit of a grey area and a bit of an uncertainty. Do you have any preference or I guess advice in regards to that particular issue?

Dr Jodi Oakman:

That is a very challenging question. I think not to dodge the question at all but I think it really depends on the organisation and how the work is organised because the primary responsibility actually is with the supervisor in charge of the work and, if that's not working, then it would be escalated according to the processes within the organisation. Now OHS usually sits within HR. There are many iterations to that - I should say often - often sits in HR. My preference would be for it not to get to that but it does need to go to the supervisor first. It would depend also on the severity or the implications for not adhering to that particular risk control. So it is difficult to answer that specifically but I think it needs to be thought through about how you deal with non-compliance in your particular organisation because that will differ. You're not depending on the organisation, the size of the organisation and the structure.

Allicia Bailey:

Yes, absolutely. I guess it just enforces that. There is no cookie cutter or one size fits all sort of approach to these types of issues.

Dr Jodi Oakman:

There are I think two key messages. One is there isn't a uniform fix and participation is vital.

Allicia Bailey:

Well thank you so much. I do recognise that there are a few questions that we didn't get a chance to get to but I am mindful of time so I will have to wrap-up the webinar for today now. If you do have a question or you think of something later, Dr Oakman has been kind enough to share her email address which is on the screen now or, alternatively, we're always here. So feel free to email and we can work with Dr Oakman to get a response out to you as well just to make sure that your concerns are addressed.

So on behalf of the Workers' Compensation Regulator and Workplace Health and Safety Queensland and Dr Oakman, thank you so much for participating in today's session. We value your feedback incredibly and we really are reliant on what you guys tell us you want. So if you have two minutes, we'll shoot you through to a quick survey and we'd love for you to fill out and let us know what you do want in the coming months and particularly for 2016.

Thank you so much. We will talk to you soon and have a great afternoon.
[End of Transcript]