Construction work health forum encore webinar series

Office of Industrial Relations

Good. Better. Best.
Applying good work design principles to maximise health and wellbeing.

Presented on: 3 August 2016

Presented by: Alison Abbott, Acting Manager, Healthy Workers Initiative, Workplace Health and Safety Queensland

Presenter: Rebecca Loudoun, Senior Lecturer, Griffith University

Alison Abbott:

Welcome to the Construction Work Health Webinar Series. My name's Alison Abbott and I am the Facilitator for today's webinar. I am the Acting Manager at the Healthy Workers Initiative here at Workplace Health and Safety Queensland.

The inaugural Construction Work Health Forum was held in March earlier this year. The forum was well attended and more importantly, very well received by industry. So we have created this webinar series based on some of the most popular presentations and workshops on the day so that they may be shared with a broader audience than those who were able to attend the forum. However, if you were able to attend on the day I'm sure you will enjoy seeing the presentation again.

We are fortunate that a number of presenters from the forum have kindly made themselves available to present their presentation from the forum again and we thank them all very much for doing so.

This five part webinar series covers a range of topic areas and these are Good Better Best - applying good work design principles to maximise health and wellbeing presented by Dr Rebecca Loudoun, Engaging your workforce presented by Daniel Hummerdal, Silica – Managing the risks, presented by our own Brad Geinitz, Alert at work – a practical approach to identifying and managing workplace fatigue risks, presented by Jenny Krasny and finally, the fifth one, Who is at risk of too much sitting in construction presented by Dr Nick Gilson.

Registration for the remaining webinars is still open. The registration links are available on the work safe website on the 'What's on' page.

We do anticipate that today's session will take approximately 45 minutes and a recording of the webinar will be made available on the work safe website in a couple of weeks. So we encourage you to share this with your colleagues and networks.

The presentation itself should take about 30 minutes and will be followed by a short question and answer session. If you have any questions during the presentation please enter them into the chat box and select 'send to all panellists'. Or type your questions through the Q&A chat box. We will try and get through as many questions as possible at the end of the presentation.

Today's presentation is entitled 'Good. Better. Best. Applying good work design principles to maximise health and wellbeing' and I would now like to introduce you to today's presenter, Dr Rebecca Loudoun.

Dr Loudoun is a Senior Lecturer at Griffith University and a member of the Griffith Centre for Work, Organisation and Wellbeing. She is a Program Director of the Griffith University Graduate Certificate and Masters of Personal Injury Management and she supervises PhD students and teaches undergraduate and postgraduate courses in work health and safety, negotiation and employment relations.

Together with colleagues she has successfully completed several large research consultancies for private, union and state based departments on work health and safety management in the UK, Italy and in Australia.

So I'll now hand you over to Dr Loudoun to get us started on today's webinar.

Rebecca Loudoun:

Hello everybody and thank you very much for joining me today. I'm very, very excited to be sharing the findings of this research project with you. We were very privileged to do this project in partnership with Hutchinson's and with Workplace Health and Safety Queensland.

The project was about developing tools to assist with designing healthier workplaces on project construction sites.

We were interested in doing a project on this topic because chronic diseases such as diabetes and coronary heart disease are amongst the most common causes of death in Australia generally and construction is one of the most at risk industries.

Prevalence of behavioural risk factors for coronary heart disease and other chronic diseases is high in construction compared with the general population and with most other industries.

Construction is the third highest paid in Australia yet the health benefits generally accrued with higher economic status are not present in this population group.

We put a team together from Griffith University with expertise in not just health, but industrial relations, human resource management and particularly construction. We made the decision that based on the timeline we had available for the study which was 14 months, focusing on improving health promoting behaviour around dietary intake was the most sensible SNAPO risk factor for us to focus on.

It's also important to note that research shows that improvement in this area is likely to have positive flow on effects to other SNAPO risk factors and that poor nutrition has a complex relationship with other health and safety issues in construction.

For example there are clear links between nutrition related diseases such as cardiovascular disease and diabetes in safety. Uncontrolled diabetes can cause blindness and numbness and reduce feeling in hands and feet making it easier for things like blisters to appear, to detect and become infected. Once infected they're harder to treat.

Diabetes is also a leading cause of amputation in Australia. Furthermore about eight per cent of people with type 2 diabetes are overweight or obese, so the link with nutrition is even clearer.

Importantly in construction nutrition is also related to mental health. Suicide and poor mental health is an increasing problem in this industry.

On this slide I've got some pictures of one of our sites that we did the study on. It's the Milton site with Hutchinson's. We did the study at six sites and what I'm reporting on today is part of the larger study which was an intervention study with pre and post measures of health markers.

One hundred and eighty six trades workers were involved in the survey part of the study. We also interviewed approximately 23 managers and performed 18 focus groups with trades workers at three time points over a 14 month period. I mention in the larger study the way of giving a context to this smaller aspect but also because baseline measures of health that we gathered and behaviours around food on site and beliefs about food on site in part led us to the decision that a tool aimed at changing the work environment was needed in this context.

For example we found that only 27 per cent of our sample were within the healthy weight range at baseline, 55 per cent identified as overweight and 14 per cent as obese. So it's almost 70 per cent of the sample being categorised as overweight or obese.

Although this is a frightening statistic this isn't dissimilar to Australian values for men but keep in mind that for our survey we use self report data around BMI for example and this tends to underestimate obesity.

Looking at risk of developing chronic diseases such as diabetes one tool that we used was the AUSRISK tool that I've got on this slide to calculate risk. You can see that 42 per cent of the sample were at moderate risk of developing diabetes within the next five years and almost 10 per cent were at high risk.

The AUSRISK tool or score does include age as a risk factor with increased points given for increasing age, meaning a trend towards higher risk with age will be likely. However in this group risk appeared to peak between 35 and 55 years of age on site. So there is clearly something more going on in construction.

Once we had some information about the healthiness of the workforce we were interested in what food and behaviours around food look like in construction. So what drives people to eat the food they eat and what are the obstacles if any to eating good food?

So our starting point was understanding the unique aspects of this industry that are driving problems. Public health research to date hasn't taken into account or even identified in any systematic way drivers and obstacles in this industry. So we thought this was a very important place to start.

We found that guidelines around healthy behaviours did not guide food intake in construction. Most people were aware of guidelines around nutrition, for example the National Heart Foundation guidelines but they didn't think they applied to them. They thought they were for desk workers, for white collar workers. We also found that money does not drive food choices. Most people were spending on average about $125 a week on food at work only. This is a big slice of someone's pay packet, particularly an apprentice.

We found that time was a big driver of food habits. People were too tired to eat, they didn't have enough time to eat or to source or prepare healthy food. We also found that people were confused about food labelling and the media around food but they didn't connect this with their behaviour. Most people thought they were doing very well in the food department. Fifty-five per cent said they were already eating healthily and they didn't need to change. Only seven per cent of our sample indicated that they had thought about eating more healthily. Clearly those views don't align with the risk health indicators I just mentioned.

Also when looking specifically at what people were eating as I've got on this slide here, you can see that when we talk about trends for weekly saturated fat and fibre, they were in opposite directions. So most people were eating a low fibre diet and a medium to high intake of fat. We found an industry that was full of urban myths and hangovers from years gone by about pie vans and tuck trucks that didn't exist on urban construction sites anymore.

Having a Subway for example, so a take away store and Coles or Woolworth's or a supermarket on almost every other corner and new products to market have changed the things that people eat and where they get them from.

So this is of some pretty clear eating patterns just as a summary. People were abstaining from food for long periods of time, usually breakfast, and then they were overeating. People were comfort or convenience eating from vending machines or some other food source close by.

We found that people were replacing food with drinks or cigarettes, this meant replacing food with energy drinks or soft drinks.

Just to give you an example of that, energy drinks or more appropriately, formulated caffeine beverages are very prevalent in this market and this is not surprising because they're geared towards this market. They are deliberately marketed to men, particularly young, well paid men and in an industry where people are time poor and do physical work, the label 'energy drink' is understandably very attractive.

We found energy drinks on every site. They were drunk by people of every age. The pattern that people used when drinking them might have differed but they were prevalent in all age groups on all sites.

We found a significant link between the length of work hours and how much caffeine workers consumed.

There was almost no knowledge amongst our sample about what is in energy drinks and how much is too much and why it's too much, what they do to your body in general and specifically around issues that are relevant in this context such as dehydration or hydration.

So just to summarise the data, so far we found that food habits on site were generally poor. We found knowledge and awareness about healthy food choices were generally poor. We found that health indicators were worrying. So we started to get a feel at this stage for some of the drivers of food habits and certainly having time to prepare, source and consume healthy food was one driver.

Looking at possible opportunities or agents for change, we asked whose responsibility food was on site.

Respondents' answers made it clear that the individualistic focus that we have in Australian society or that we tend to have in Australian society towards food whereby it is a personal responsibility was widespread in this context. All managers and workers held the view that health was an individual's responsibility and that managers do not and should not have any influence over the eating habits of workers on their sites.

There's some quotes on this slide to illustrate these very strong views. Most managers in addition to saying that they didn't have any influence or scope for influence thought it would be rude or crossing a line to try to do so.

Having said that though, it was very clear that managers were making decisions every day that influenced dietary habits. The influence was unintended, it was unrecognised and it was often hidden but it was present nonetheless.

These decisions were about things like the timing of breaks, the products stocked in vending machines, behaviours encouraged and discouraged on site, catering, on site barbecues, the placement, size and fitout of lunch rooms beyond what was outlined in the site agreement.

It was also clear that some managers were already making decisions about these things with workers in mind. However the managers did not make the connection between these decisions and food behaviours. It was more about keeping the peace, being respectful and reducing tension on site than about making better food choices.

For example one manager tried to organise the lunch room around trade groups so that different groups could feel some ownership of their area. They could care for it, leave basic food items and condiments and they did this because they were trying to increase trust around food so that people would leave their food in the lunch room rather than taking it in Eskys around site. They found that the Eskys produced clutter on the site particularly when they took them up to higher floors and they were concerned that they were a trip hazard.

Managers tended to base their ideas on their experiences when they were on the tools or from being a manager on site rather than using any informed or strategic approach.

This made us start to think about how we could change their decisions to get a better outcome for workers. We decided that if we could convince managers to make changes that didn't impinge on personal choice which was very important for everybody, then a positive impact on food consumption was likely to follow.

The last finding that prompted us to look at a work environment design tool was the clear view that a whole of site approach was needed to generate change in this area. Anything solely aimed at individuals was not going to receive a warm welcome. Indeed the broader intervention that we did which I spoke about before confirmed this at the end of the 14 month period or study period where we found no change in the individual treatment groups that didn't include an organisational component.

We found that employees of both the principal contractor and the subcontractor felt very strongly that it was important for the success of the project to see everyone playing their part. Rather than the individual worker only participating in behaviour change there was a general consensus that no one person or group had the responsibility or the capacity to change health promoting behaviours on site.

I think one quote that really illustrates this was somebody who said, 'If it's an industry problem then it has to be an industry fix. Everyone has to share the pain, that way everyone who causes the problem is motivated to fix it and lose it a bit until they do. At the moment the only people who lose are us', 'us' being the trades workers.

'It doesn't matter to managers if we can't work. They just replace us with somebody else.'

So to the tool that we designed. There is of course a lot of research available about manipulating people to alter their food choices. Our supermarkets do it every day.

For example you'll often find that fresh produce, so fruit, vegetables and flowers is the first thing you see at the entrance of most supermarkets, followed by freshly baked bread or roasting chicken. These sites and smells reinforce how fresh the produce is and makes us feel hungry. The vibrant colours put us in a good mood and the happier we are the more we are likely to spend. Product placement to maximise sales of certain items is also another common strategy of supermarkets. You might have heard the term 'eye level is buy level'.

Putting complementary foods next to each other – drink and crisps in the same aisle is an obvious example. If we are buying soft drinks, crisps sometimes seem like a good idea and convenience makes the purchase more likely.

We drew on this research to manipulate the food environment on sites to encourage people to adopt more positive behaviours around food, to choose healthier foods and drinks. We aimed to devise a tool to assist with setting up the site to best facilitate healthy eating while still allowing for the many and varied restrictions on urban sites bought about by build, size, type and location.

When we were developing the tool we started with identifying relevant health promotion tools that assess both nutrition relevant variables and other relevant areas and assessing their suitability for the construction context as well as the unique drivers of poor nutrition on site.

There were two main validated tools that were considered - the commonly used Checklist of Health Promotion Environments at Work or the CHEW tool and the State of Queensland Healthy Places Survey. Some items from these tools were replaced. Others were retained but modified and some were not used because they didn't match the physical set up of construction sites.

Just as one example, stairs and elevators were not included as these are dependent on the build and the item description centred on the physical signage and other stationery features at a building which simply weren't present on our sites. So new or modified items that were developed were done using our project team expertise, healthy eating principles developed by governments and other sources such as healthy vending machines developed by the Government of Western Australia using input from health and safety experts in construction, registered dieticians and nutritionists and the interviews and focus groups that we did with workers, site manager, teams on site and subcontractor managers.

The main areas in the tool outlined on this slide are vending machines, nutritional information, site lunch room set up, site barbecues and catering, nutritional initiatives for example hygiene and location review, so looking around the site at food options available.

After deciding on suitable items a series of iterative changes were made to items, wording and response options following repeat rounds of scoring from site managers, on site health and safety officers, corporate health and safety managers and the research team.

You might notice when you look on the slide or if you download a copy of the tool you'll see that it's designed with a sliding scale and a lollipop type scoring system. We did this so that Hutchinson's, our partner organisation, could use it to compare sites but also to compare the same site over time.

The tool is broader than simply design changes in the lunch room. It's aimed at changing behaviour of all people on site, not just trades workers.

You might notice the discussion in the tool about posters and information giving. Awareness raising and education about food was clearly needed in this environment.

When deciding on the topics to focus on for these education raising initiatives, we started with the topics that we thought would attract both attention in the first instance. So those were the topics that participants identified as of interest and/or around which they were particularly confused.

You will notice we didn't choose the most important factors around chronic disease or what research has identified as most risky behaviours. We chose this approach because we were aware we were touching on a sensitive area as I said, where individual choice and control were considered important.

We thought any obvious attempt to have an influence on this control would be met with resistance. So we chose things that people were interested in, relevant things of course.

We had different talks with different audiences and different focus within the same topic for different audiences. For managers we talked about how chronic health disease can impact on productivity and safety.

Workers wanted to know things such as the best choice to make, a take away option such as Subway or the Sushi Shop.

So we took groups on excursions to the local eateries in lunch breaks. They wanted to know where food manufacturers were hiding nasty things, if they were trying to be healthy. They wanted to know about the best sports drinks or other options beyond water to choose for hydration, how hydration affects their body and influences their mood and food cravings. They also wanted to know why water doesn't make them feel hydrated over time. So they were the sorts of things that we started with, to grab people's interest.

When you have a look at the tool you'll also notice that the tool is in two parts. The first is this tool you can see on the slide which is a tool that can be used to assess the food environment at a point in time. There is another tool that is a site setup tool that can be used when making decisions about how to set up the site or when the site is changing, how to change with the site. This was a very deliberate decision that we made because not only did Hutchinson's want to have an idea of existing sites and where they were at, but they also wanted to set up sites from the get go in a way that was conducive to healthy eating.

So how well was the tool received? There were of course some challenges and some unique enablers or buy in in this environment. We found that making the links between nutrition and safety, making those links clearer certainly got a lot of buy in. Nutrition on its own was not the highest priority for many people on site and we understood that.

So we needed to find ways to raise its profile so to speak and certainly looking at links with safety was one of those ways. Participants rarely noted direct links between chronic health problems and safety but many managers at all levels pointed to areas of interest in safety that had a clear overlap with health.

Most managers as I said, on site did not consider health promotion activity as part of their job role but they did when they thought it interacted with safety. One particular area that managers connected with safety and expressed a strong interest in was hydration. Energy drinks were also of high importance to most managers due to perceived impacts on safety and hydration. Yet excessive energy drink consumption in itself was not seen as a health issue.

We also found opportunities to promote this health intervention around conflict or tension on site. Although few interviewees mentioned direct links between ill health and interpersonal relations on site, most spoke about poor food and drink choices making people irritable and difficult.

So a quote to give an example of that, one person said, 'Harmony or industrial relations on site is so important and everyone at every level is attuned to it. I think food or bad food and drinks on site have industrial implications but people don't see them. Everyone knows people work hard on site and they get tired, but this comes about much sooner if people are eating pies, chips, chocolate and soft drink. They feel rubbish and tired and they're irritable. This has a ripple effect until the whole site is down and difficult. Everyone can feel it when a site has industrial problems but I don't think they connect it with food in the way individuals feel physically and how this then affects how they talk to others on site, whether they clean up or do the job slowly which impacts on others and then it flows around the site.'

So I think there's a real opportunity here to use these links as a leverage point for health promotion. Research indicates that construction owners and contractors rank conflict among construction project participants as the highest factor affecting project costs. So there's some real opportunities here.

We also found that morale and reputational benefits was another potential area of interest. In general investing in health promotion was met with suspicion and then surprise that the principal contractor was interested in workers' health.

Once the suspicion was overcome people expressed very positive views about the parent company. It had a positive impact on morale and company image for very little investment. This was apparent throughout interviews with all levels of employees, managers and subcontractors. It's not unusual for organisations to use positive elements of their health and safety practices to promote themselves as employers of choice within particular industries but it is a strategy rarely used in construction to date. So I think there are some opportunities there too.

Looking at productivity, this was another area and particularly with the site setup tool where managers could see that this was going to save them time and there were fewer decisions that they then had to make, they were really very interested.

So these were some things that we found. There is of course still research to be done with the tool. So looking at where we go from here, from the perspective of the food environment tool we need further research to validate the tool with a wider cross section of sites in a bigger sample. We know it works in urban construction sites for this large construction firm, but we would like to test it in firms with different location, size and organisational structure.

Nonetheless in this intervention we achieved considerable change as we went along, not just in identifying barriers and possible levers for the implementation of health promotion activities on site, but we also have made some real gains with this particular tool.

It was a very successful intervention. It was well received and I think a lot of people, not just in project construction, but more broadly in construction will find it very valuable for their use.

So I'll hand it back to you Alison. Thank you.

Q&A Session

Alison Abbott:

Thank you Dr Loudoun and for all the questions that have been coming in throughout the presentation. We will attempt to get through as many as we can in the time we have left.

The first question is,
Q: Can this environmental tool be used in other industries?

Rebecca Loudoun:

I definitely think this tool can be used in other industries but I will just say that we went to a lot of effort as I said, earlier in my presentation, to make sure that the language was right for construction, it was suitable for this context. So I would suggest assessing its suitability and possibly adapting it if needed for other industries.

It's also relevant to say that with our partner organisation, managers have a lot of autonomy. They're empowered to make decisions about how they set up the site or change the site. So that's something that I would consider with managers in other industries when using the tool, but beyond that, the tool as I said, came from validated tools that are already in existence. We added to them, we changed them and modified them for this context but they are validated tools and we validated this tool as well. So I certainly think that it would be valuable for other industries, yes.

Alison Abbott:

Thank you.

Q: Now you did say that you got manager support, but how do you get organisational buy in into the subject of health overall in their supply chain?

Rebecca Loudoun:

There are currently about 1,500 workplace health programs covering approximately 400,000 employees in existence in Australia.

We know from those programs that a comprehensive workplace health intervention that incorporates individual approaches and changes to workplace culture and structure have the most impact.

This holistic approach is increasingly called 'healthy work organisation' which is a little bit what I'm talking about here or what I'm talking about here forms part of that. It focuses on how the structure and fabric of the organisation function to impact on the health and wellbeing of employees creating healthy or unhealthy work systems.

Within that we know that a partnership approach between employers and employees and employee representatives works best. That's certainly what worked best with our project. As I said, we had a number of sites and we used different approaches with each of the sites to compare them. The sites that had this partnership approach certainly worked best. They worked best in terms of encouraging participation and making the most gains with the actual intervention. So we saw the most change.

Obviously generating high levels of engagement and participation at all levels is essential for this holistic approach. The least healthy employees are the least likely to initially participate in programs and increasing overall participation rates draws higher risk individuals into the program.

So encouraging managers and supervisors and people higher up in the organisation to get involved even if they don't see that it's relevant or directed to them helps other people who have a higher need to be involved or who are the target audience. It helps them to get involved.

On average you can expect about 60 per cent participation in an effective program. It's unrealistic to expect to achieve 100 per cent. So having that in mind helps well I think with the organisation and helps them to be realistic with what they can achieve.

We know that making healthy choices, the easy choices works best. By this I mean where possible design in the environment as we've been talking about today and the work systems where possible to make the healthy choice the path of least resistance.

It also means finding out the barriers to making the health or indeed participating in the program at the beginning and once it's started. So keeping a check on that, why do people drop out and this is going to help keep organisational interest as well because organisations lose interest very quickly if people drop out or they think it's not relevant to them.

Something people don't often think about is that the most successful workplace health programs have involved creative marketing, selling the value of the solution of participation.

With the particular program that we did I mentioned that we chose to talk about initially topics that were of most interest to people, but we also did a lot of things on site. We did art displays instead of just putting up posters and on those art displays we included things like quotes from trade workers on site, with their permission. Then once people got some idea about that or got wind of that there was lots of talk around 'Who said that?', 'Whose quote was that?' Anything that gets people to pause and consider the information to get them talking is going to help with the health promotion.

We move those art displays around the site because people stop looking at things after a while. There is a lot of visual graffiti on sites. So we really worked hard in this area.

People are often very good at establishing goals and objectives and timelines and responsibilities but they often forget to evaluate. This makes it hard to establish the return on investment. So if you're looking at organisational buy in you want to be able not only to sell it but to show that it's made a difference.

I know there's a trend to try and establish productivity gains when talking about workplace health and safety but with promotions aimed at chronic health problems evaluation needs to be much broader. The timelines are longer, the steps are often smaller. So having smaller steps on the way when you're evaluating is also helpful with getting organisational buy in. Using validated tools to measure the health climate of the organisation is important. They're becoming more established and available now, but at least two to three years is needed to see any long term benefits in health indicators.

So several measures and different measures are needed as I said, throughout this timeline to maintain interest.

The last thing I would say and I've left this 'til the end because I think we all know it is that senior leadership support is critical to building and sustaining successful health programs. So I've talked a little bit here generally about getting organisational senior leadership buy in and I talked specifically in the presentation about leverage points that we found in this particular context for people to think about, so around safety, morale and productivity.

Alison Abbott:

Thank you. That's some great, practical examples there for the different types of work places that you may have on site.

Now we've got one more question.

Q: Is the tool available online and if so, where can we access it?

Rebecca Loudoun:

The tool is absolutely available online and free to use. There's a website up. The slide that's on your screen at the moment has a website link at the bottom of it. If you use that link you will find the tool there available to download.

Alison Abbott:

Thank you Dr Loudoun for taking the time out of your busy schedule to present again for us. We sincerely thank you for doing so. I am sure everyone would agree that your presentation was insightful and gave us all a lot to think about.

Thank you all once again for participating in this webinar and we remind you to register as soon as you can for the remaining webinars in this Construction Work Health Series.

If you would like to access more information on how to initiate or enhance your health and wellbeing in the workplace, please visit the work safe website which was on the last slide of Dr Loudoun's presentation and click on the 'Injury prevention and safety' tab. That will take you to a whole website that's got lots of information on workplace health and wellbeing.

Your feedback is always valuable for us. So please take 30 seconds to complete the survey that will pop up once the webinar is over. We value that feedback.

Thank you and goodbye.

[End of Transcript]

Office of Industrial Relations

Engaging your workforce

Presented on: 4 August 2016

Presented by: Deidre Rutherford, Principal Advisor – Ergonomics, Workplace Health and Safety Queensland

Presenter: Daniel Hummerdal, Director Safety Innovation - Art of Work

Deidre Rutherford:

Well hello everyone and welcome to the Construction Work Health Webinar Series. My name is Deidre Rutherford and I am the Facilitator for today's webinar. I am a Principal Advisor in the Ergonomics Unit here at WHSQ.

The inaugural Construction Work Health Forum was held in March earlier this year. The forum was well attended and more importantly, very well received by industry. We have created this webinar series based on some of the most popular presentations and workshops on the day so that they may be shared with a broader audience than those who were able to attend the forum. However, if you were able to attend on the day I'm sure you will enjoy seeing the presentation again.

We are fortunate to have a number of presenters from the forum and they have kindly made themselves available to present again and we thank them all very much for doing so.

This five part series covers a range of topic areas.

These are Good Better Best - applying good work design principles to maximise health and wellbeing presented by Dr Rebecca Loudoun, Engaging your workforce presented by Daniel Hummerdal, Silica – Managing the risks, presented by our own Brad Geinitz, Alert at work – a practical approach to identifying and managing workplace fatigue risks, presented by Jenny Krasny and finally, Who is at risk of too much sitting in construction presented by Dr Nick Gilson.

Registration for the remaining webinars is still open. The registration links are available on the WorkSafe website on the 'What's on' page.

We do anticipate that today's session will take approximately 45 minutes and a recording of the webinar will be made available on the WorkSafe website in a couple of weeks. We encourage you to share this with your colleagues and networks.

The presentation itself should take about 30 minutes and will be followed by a short Q&A session. If you have any questions during the presentation please enter them into the chat box and select 'send to all panellists'. Or type your question through the Q&A chat box. We will try and get through as many questions as possible at the end of the presentation.

Today's presentation is entitled 'Engaging your workforce' and I would now like to introduce you to today's presenter Daniel Hummerdal. After an initial career as a commercial pilot Daniel decided to study psychology. He has worked as an Accident Investigator with the Swedish Civil Aviation Administration and as a Human Factors Consultant with Dedale in France and as a safety innovation leader in Australian engineering, construction and mining businesses. Daniel is the founder of www.safetydifferently.com and the Director of Safety Innovation – Art of Work.

His goal is to help organisations to find new and more functional ways to improve safety. I'll now hand you over to Daniel to get us started on today's webinar.

Daniel Hummerdal:

Thank you Deidre. It is a pleasure to be here and to talk with you again about engaging with people for high performance.

I would like to start with a question which I normally ask when I run these presentations and that is 'What is safety?'

'How can we know that we are safe?', 'Are you safe right now?' and 'How can you know that you are safe indeed?' When I ask those type of questions I often get very vague answers. Very few organisations have actually defined what they mean by safety and that is a little bit surprising given that they actually have safety departments, safety professionals and they report safety in their annual reports.

Up on this slide I have put up some of the most common words that you can hear when people talk about safety and this seems to be what people associate with safety. On the left we have all the things that we do not want to have and they are unwanted outcomes, they are harms, accidents, incidents, illnesses, injuries, deaths and lost time incidents and so on. So safety is connected to those unwanted aspects.

So when we talk about safety we talk a lot about the stuff that we do not want to happen. In the middle we have words that are associated with that but they are more the triggers or the causes or assumed causes of those things, like hazards and dangers and risks and shortcuts and workarounds. Essentially we have more of the things that we do not want to happen. So when we talk about safety we talk about things that we do not want to happen and we talk more about the things that we do not want to happen. Then we sprinkle on top of that a set of relatively unsexy control mechanisms to make sure that people don't end up anywhere near either those causes or the unwanted outcomes.

I find safety increasingly and an incredibly boring, tedious and negative topic with a culture that is dreadfully heavy to deal with quite often. So this is the world of safety. This is the words of safety if you will. Then we ask people to be switched on and to be engaged with safety. This is not an easy sell.

For a long time many organisations have based their safety interventions and safety program on the idea that they can improve or achieve safety by focusing on what goes wrong, by preventing anything from going wrong. Then they will arrive into the promised land where nothing bad happens. So we should have a negative focus.

But today I want to argue and I want to explain how organisations and practitioners can and actually should engage with normal work, things that go right. Whatever that means, we will look at that today, because if we don't do this we risk being stuck in a reactive, negative and tedious culture and we're going to have increasingly large problems in engaging our people in creating successful workplaces.

So let's start by looking at a concrete example.

Why do people come to work? Why do you come to work? Do you come to work to be safe?

Most of the time people come to work in order to do work, to carry out a job. Yet organisations continue to believe that safety will prevail if we only stop bad things from happening, sort of an anti goal of why people come to work.

I believe that we can turn this around. Safety can and should be about enabling people to achieve great outcomes across varying conditions. To do this however, we need to change the lens through which we understand how work happens, what happens at work and also what safety is. We need to start asking a different set of questions with which we can engage our workforce.

So look at this worker in this picture. He is tightening a nut onto a bolt to fasten a beam. To increase the torque he has put a piece of pipe on a spanner and created what is commonly called a 'cheater bar'. When I saw this he at one stage squatted down and put his back under the pipe and stood up and pushed the piece of pipe up as to really get some serious torque.

Now we can of course ask if this is a safe practice. I don't think it is. I don't think the spanner has been designed to carry any random load like that. There might be all kinds of pinch points in the attachments between the piece of pipe and the spanner and maybe other things that can go wrong as well. I know that some organisations have actually banned solutions such as these from their sites, but not everyone. It's sort of in that grey zone.

But instead of looking at this as either safe or unsafe and just then draw a line in the sand, let's start to ask why are people doing this?

Is it because they are risk takers or they are bad workers or that they don't care about safety? I don't think that's the case. I believe that people do this because they want to be successful, because they are indeed committed to the organisation, to project delivery. They want their teammates and colleagues to be productive and have successful outcomes, but I also believe that people do this because at the time there's probably no better solution available to them or they can't get access to it. This is the problem, that people will work with whatever you provide them with to get the job done.

Now if we would engage with this guy and ask him 'What went wrong today?' you probably wouldn't hear about this because nothing goes wrong here. You could potentially hear it if it would slip off and hit him in the face and he would break a few teeth and something like that, but even if you asked about 'Were you exposed to any dangers today?' you're quite unlikely to capture this.

But I think if we would tweak the question and start asking about normal work, we stand a better chance to capture these things. You could for example ask him about 'What was frustrating today?', 'What was physically challenging?' or 'What ideas do you have how we can make your job easier or more productive?'

Then we can capture the sensitivities that people are exposed to and how they overcome challenges that they have in their workplace. Then we can have a discussion about whether that is good and what we can do to support people.

The point I'm trying to make here is that successful outcomes are infinitely more complicated than just stopping unwanted outcomes. Safety is not a binary thing. It happens along a continuum and unless you try to understand what people want to achieve you're going to be reactive and stuck in a reactive mode in how you engage with people.

But if you engage with what people try to achieve and we look at the ways they go about that, you are more likely to capture sensitivities, inefficiencies and dependencies that are in the workplace. Then you can boost whatever people rely on to achieve success. That will move you away from safety events and move you towards greater productivity, efficiency, wellbeing.

Now there is always a gap between what is provided by an organisation and the work that needs to be done. This quote from Henry Petroski summaries this as a relative ignorance about what is actually going on. This is the case because when we design something and this could be a tool, it can be a procedure, it could be a checklist, that thing is generic. Now in reality we need to be specific and there's always a little bit of a gap between the generic and the specific. This gap can be small and insignificant and sometimes it doesn't really present a problem. But sometimes it's large and it creates a challenge for people to overcome.

So I think that this is a real important task for an organisation and I think safety professionals in particular have a beautiful position to do this, to chart, to assess and to understand the gap and understand ignorance, what we don't know about ourselves as an organisation.

So before I describe some ways that people and organisations can do this, where they can chart and understand what's going on, let's look at some more examples of how this gap is playing out in practice.

You probably won't find a procedure that tells people to find a random piece of wooden block and some wannabe shims to support a piece of pipe when doing this maintenance task.

But this is likely to happen if you as an organisation have not provided a better tool because the work needs to get done. There's a purpose that people come to work to fulfil.

So if you as an organisation do not have a practice of asking about the solutions and what people do to overcome and how they create success, chances are that you will never know about these things until it's too late.

There's a beautiful saying which is that people finish the design and by 'design' this is design with a small 'd'. They take things to its completion. They look at the drawings and then they go the extra mile because that is what is needed to make work happen.

This operator's panel has had some modifications done to it after it was installed. If you look at the top of it and also sort of underneath that LCD display you can see that they put some stickers or labels – they've printed stickers and labels and put them on there with instructions. If you look at the bottom where you see the red and the green buttons you can see that someone has written little instructions or the bit of text next to the buttons.

The stickers and the little text, that's effectively an operating manual. That is telling people. That is supporting people what to do about this. In this particular case which I investigated following an accident, I found a manual, the actual written down manual from the manufacturer. Now this manual was written in German and this was in central Queensland, right, where people in general do not speak German. But it didn't really matter that it was written in German because it was also found in one of the manager's drawers, far away from this operator's panel. As a consequence people had to figure things out and they had to learn from their mistakes. They handed over the knowledge to their colleagues in this fashion by putting instruction immediately on the operating panel.

There was also one time where one of the operators of this panel squatted down and he put his hands around the LCD display to shield out any glare from the sun so he could really see the colours of the display. Again people finish the design and they do this every day on every site in so many different ways. That creates sensitivities and it exposes our people to carry the load. It can find its way into their bodies and put stress on muscles and bones and whatever, but also the psychology of the workplace and create stress. But people save the day, every day in so many different ways.

People are the solution but we need to engage with them as if they are the solution and find out what they do. If you only go out there and look for hazards and controls, you're not going to find this. This is a different focus but this is also where safety problems grow and you can have accidents coming from this because you don't know about this. These solutions that they come up with may be more sensitive than something that you have used your collective wisdom from engineers and safety professionals and occupational hygienists and other groups.

If you want to better understand where your organisation can support your people and move towards more stable solutions, look for these traces of where people have bridged the gap on their own. Look for differences between what is engineered and what looks home made. In the previous example I had with the guy with the spanner and the cheater bar, the spanner was nice and shiny and looked very engineered whereas the piece of pipe was rugged and had pieces of paint on it. Those are the traces. You can see things that are tied together. You can really spot quite easily when things are home made.

Don't see that as a deviation, as something you need to ban. See that as a clue, as an entry point for you to understand or to start exploring what is going on in your organisation.

Now here's another trace. It's – what do you call these – a zip band, a cable tie that has been attached to a handrail running next to a small railroad. When I saw this I thought that it looked conspicuous. Again it was like seeing the spanner and the piece of pipe.

So I started asking around 'What is the function of this piece of plastic sticking out here? Now you can see in the background of the photo that there's a train. So I spoke with the driver of that train and he proudly explained to me that he used it as a marker when parking the train. The challenge for the driver was that he could more or less see just straight ahead. There was a video camera and a little display in the driver's cabinet showed him what went on behind the train but the task for him when parking the train was to line it up with a tipping station right next to the train.

So he needed to have information where he was sideways and he couldn't see that from the driver's cabin. So he had put this little marker on the handrail and he said 'When I park the train, I'm going to park it so the marker hits the third row of the safety net to the driver's cabin.' So he did.

Now I don't know if this has any safety implication whatsoever but I think the moral of this story and the other stories is that people will achieve success. They will achieve the purpose that they come there for. That is their job and they will do so in remarkable ways, in genius ways because people are amazing. We have a chance to work with people in this.

I guess my point is that this is not a choice. You cannot choose if this is going to go on or not because it happens every day, every site, many times over, in small and large qualities, in insignificant qualities and things that are really dangerous. It might be innovative, that can help lots of other people. It's just this grey area that organisations don't know about.

So the choice is not whether to allow this to go on. The choice is whether you want to know about this or not and if you do want to know about it, then I think I've provided a pretty compelling case why you should know about it. You need to start asking a different set of questions.

So work with people. Set them up for success. Ask them where the sensitivities are, where the organisation has failed to set them up. Ask them about their frustrations, what's pissing them off. Ask them the things that they have to tolerate or the ideas they have on how they can support people and we're going to look at some really good questions that I have found very useful so you can learn from normal work rather than waiting for a failure to happen.

Before we do so I just want to link this back to some theoretical musings around this. So the thing about success is that of course we need our work to be based on tested and validated principles, best standards, things that we have learnt in the past as reliable ways of going about work. These are things that you can read about in a book. These are concepts or ideas. They are always abstract to some degree but we need them. We need to base our success on these things. We cannot forget about them and just stand naked in the mud and hope that things will work out.

But when doing things in reality, when implementing things and building things, everything is unique. Every setting is unique. Every group of people coming together is unique. The historical trajectory of that particular organisation carrying out the work is unique. You can never read about the uniqueness in a book. You have to create that knowledge in a unique setting.

So what you're dealing with here is two different spheres of expertise. You have the conceptual which you normally have people who are in managerial positions where they have read stuff in books and they've trained and they know about that sort of knowledge. But then you have the people with the most intimate understanding about work conditions on the other side and unless you can get these two sides to talk to each other and create a good meeting point about the challenges that happen in the translation of the conceptual to the contextual, you're going to be behind.

In safety unfortunately we've been very good in sort of telling and not so good in asking or listening. So I think there's an opportunity for us to turn this equation around or even make it a bit more balanced. I guess that's my point.

Now how can we do this in practice? Well I today want to share three different ways and the first way is to make use of something you already have and that is your safety observations or your safety walks when you go out and you just look for things.

My encouragement in that space would be to expand the focus that you already have when you do site visits or safety walks. Go beyond and outside checklists and hazard hunting. Look for the traces of home made solutions. See them not as deviations but as a starting point for further assessment and understanding and then you invite more and more people into the discussion about 'What is happening here?', 'What can be done about it?', 'How can we support you further in making this an even better solution?' Look for the good outcomes rather than just stopping bad outcomes.

This also links into the next one which I call explorative conversation, also very easy. I think that anyone can implement.

If you think about, well one example would be to look at your executive safety walks for example. Don't have your CEOs and the other executive managers checking the expiry date of the first aid kits or the fire extinguishers. It's a waste of time and a missed opportunity. Lots of other people can do that.

Instead you should pay interest. Pay attention to the work that people do. Let them tell the stories. Let them tell you about their experience, about what it's like to work in a particular site. Ask open ended questions about difficulties and frustrations, roadblocks, innovations, ideas, dependencies and even strengths. Then you do something with that information. You spread good practice, you address sensitivities, you remove roadblocks and bottlenecks and you take steps to address and to learn and become better.

That way you need to engage with work even before it has become a safety issue. You need to be committed to creating a successful workplace.

Now the third option which I will explain in a few slides is to have a more in-depth, structured or systematic approach and we call that a 'collaborative improvement' or 'collective improvement'. But before we go onto that let's look at the questions that you can use when you go out and you do these explorative conversations.

Here are some of the questions that I've used successfully over time. My favourite – well favourite. My most used question is probably the top one here. 'When is your work difficult?', 'Can you tell me about a time?' and people might say 'My supervisor is really annoying. That is difficult for me.' You can't really do much with that information but keep digging and ask people to tell you about a time when work was difficult.

'Well two weeks ago I was doing this type of work and he kept checking me every two minutes and he was drip feeding information. My work was disorganised and disrupted all the time', and then you understand what that is. Then you can explore 'Who is a good supervisor?', 'What do they do?' and you can start having a discussion around that.

The second question is a really good engagement question that never fails. You ask people 'What if you could have $50,000 to make this a better place to work, a more successful place to work for you and your colleagues?', 'How would you invest them?' Then people will say – normally they give you a very short answer. They'll say 'Better uniforms', 'More tools', 'Do something around the drawings', 'Maybe have a barbecue.

Whatever people say that is your starting point. You say "Okay, you said 'barbecue'. Why did you say 'barbecue'? What's the problem a barbecue is going to fix?" Then they will say 'Well at the moment the team spirit is really down the drain because we have all these contractors coming in and taking our work. We don't really trust each other anymore.' If it's something around tools, 'We don't have the right tools' or 'not enough tools', whatever it is. This question will guide the discussion towards the sensitivities where people feel that 'There's a bit of stress here. We need to invest in this space.'

'What conditions do you have to tolerate here?' That is a really good question to broaden the discussion and start talking about nuisances in the workplace like noise, dust, humidity, rain and mud and things like that.

Now the fourth question, 'What solutions have you come up with that makes you work more effective, safer, productive?' It's a smart way to start talking about workarounds if you will. 'What do you do to overcome the challenges?', 'What is it that we don't know about?' but ask about them as something positive, if people have made a contribution. Then you engage with that and see how you can make that better.

Now the next question, 'What procedure causes the most grief?' or if we even tweak that question to ask 'How do the procedures support you in your work?' that is a really good way to start approaching the topic of shortcuts. But I never ask about shortcuts because every sensitive topic, people will just shut down and they will not engage with it. But let's complain about the procedures instead of complaining about behaviour. That way you can see where the gap is and you can understand how procedures can support your people and how they sometimes miss the point of what is actually going on at work. They will reveal important information.

The next question is also a little bit about procedure, but 'What is the most stupid thing you have to do around here?' It's a great question where you can start decluttering your system and see where you have a completely eroded respect for certain things, normally for very good reasons.

Now the bottom question here, 'What used to happen here but doesn't happen anymore?' That is a good question to engage with change, to see what has been helpful changes for people and things that they appreciate or if things are going the wrong way, start capturing things that have changed either in the good or the bad way and it brings out a lot of – it's an open question. You have no idea what's going to come out of it. People know what changes have happened in the last two years and so on. So all these are good, practical questions that you can use when you go out.

So collective improvement is an initiative that we've run at Art of Work with various organisations and we have this type of focus that we've just been talking about. We do it in a structured way and it happens in three stages.

The first step is to engage with employees at all levels of a project. We have separate focus groups for frontline employees, for supervisors and for managers. We explore different topics and we ask the type of questions you saw on the previous slides. We really try to capture examples of work, things that have happened and conditions that are out there.

Then we collect those examples, record the conversations and we identify those examples and remove any type of information that can be used to identify who said what. We're not interested in people's performance. We're interested in evaluating 'What kind of workplace is this?', 'What is it like to work here?'

Then we come back and we do collaborative analysis where we get the organisation to analyse, to pinpoint the challenges and where they can improve things. Then of course we implement something where you do something with the information.

So here's a couple of examples of the type of examples that we get from this type. The first one here is from a transport organisation. There was a supervisor who said 'I had FedEx, the other coordinator had StarTrack. Both had half a crew each. FedEx made deadline by 30 seconds. It was just a mad, mad rush, push, sweat, scream just to get the goods out. Severely undermanned. Not enough leading hands, only one leading hand on shift every night.'

So this is what an example can look like, just a short story like this. But it engages the entire organisation in a very different way compared with having a number, whether you were on time or not in that particular freight delivery.

It engages the organisation to analyse. So I ask people 'What is the impact in performance here?', in this example, and they start talking about manning, manpower and how tasks are sometimes coming in in an unpredictable kind of way.

Here's another example that came from a construction site.

The story here was there was a structure that was going to be built repeatedly, six times at six different locations by the same drawings, but somehow there were multiple drawings and people had to create their own single source of truth that they could rely on.

This was an electrician who I spoke with and he was one of very few people who travelled between different sites. So he had different ways of putting these identical buildings together. So he created that on his phone, a single source of truth and he started spreading that. Of course this is globally a really bad solution for any construction site like this, but for him, he needed to do that to get the job done.

People create solutions whether you want it or not. You just need to be involved and know what is going on. That is your best chance to create a better workplace.

Now every focus group generates about 20 to 40 examples. I have lots of examples after that. Then I go back and I put every example – I print them out on an A4 sheet and put them up on a wall. I invite a cross section of the organisation to come together to analyse this. So they read the examples, they talk and they combine people in a new way. 'What is going on here?', 'What is impacting performance?' and then they define the key challenges for the organisation.

Then normally the findings, the issues that people identify are not very breathtaking. It's not something you didn't know about. It is just normal work really but when you read the examples and how it's all playing out, you have a very different understanding and it hits you in the belly in a different way.

So it's just normal work and you have to do something about this. You can see how different sites gravitate towards different issues and then of course you have to do something with it. This is where we create a site improvement team where we ask frontline leaders or frontline people to speak up about their ideas and their solutions that they would like to see.

This is really important because traditionally we've had leaders implement their solutions and they impose that on work. But if people are allowed to create their own solutions under the supervision, under the approval of managers and so on, they can create solutions that they care about and you start having a care factor at work. This is really critical if you want to have sustainable solutions in your organisation.

Now the benefits of doing this, I can always promise that you will have an increased understanding of project complexities. It will automatically improve communication and participation or engagement. You will have a chance to improve employee satisfaction and morale by having the viewpoints taken seriously. It's a bit tricky.

The risk here is if you don't do anything with the information it's going to be quite insulting to the people who spoke up, that 'Thank you. We now know that you're suffering every day. We're not going to do anything about it.' You're essentially going to end up worse off than if you didn't do this. So it comes with a risk and you have to be committed to seeing this through.

But of course you will also have an increased probability of innovative solutions that can improve efficiency, productivity and safety and move people away from where bad things happen towards more positive outcomes.

If you want to know more about this go to our website, artofwork.solutions. We're running a master class on Friday and next week. You should come and you can learn about how to do this in practice yourself.

I think we're running out of time. Do we have any questions Deidre?

Deidre Rutherford:

Thank you Daniel. Your presentation highlights the effectiveness of the participative approach where workers are actively engaged in identifying the issues, sensitivities and collaboratively coming up with solutions.

Q&A Session

Thank you for the questions that are coming through. If you do have a question now is your chance to ask Daniel. So please send your questions through.

We'll attempt to get through as many as we can with the time we have left.

The first question to Daniel.

Q: How do you get the initial buy in from the executive level, appreciating that this approach is resource intensive in the start up stages?

Daniel Hummerdal:

Good question.

I'm not sure how the magic happens but I know when it happens. It normally happens after there has been an incident and they realise that 'We actually don't know what is going on on this site. We need a new way to engage with our people, to hear them about all the stuff that is going on under the radar and so on.' They recognise that this is a great way of doing it and they can also improve engagement. I really try to sell those benefit points that I had on the previous slide saying that this is a new way for you to do work. If you pull this off, you've got to go from the worst performer to being the star of the class.

I also push that you need to be committed to the whole process. You cannot just say 'We're going to listen to people', then do nothing about it. So I try to say that this is an engagement which goes beyond anything that you've done before. I undersell it and make it difficult for them if anything. They understand that this is important. This is their chance to show their commitment to their people.

Deidre Rutherford:

Thanks Daniel, and another question.

Q: How do you tackle the different communication engagement styles of the managers who will be a part of implementing this engagement approach?

Daniel Hummerdal:

Yes. As you so delicately didn't put it, everyone is not a great communicator.

But I think everyone can be. I know that some people really don't want to have social engagement with people. So first of all if you don't want to go out and talk to people maybe you shouldn't be a leader in that role, but if you do want to go out there's a number of things you can do to get better at this.

First of all you need to understand that you don't have all the answers. You need something from your people.

So that is part of what I've been trying to do here today to explain why we need to ask questions. The second thing is of course you need to have questions to ask and understand what is a good question. Don't ask a 'yes' or 'no' question. Don't ask 'Why?' questions. Have these open ended questions that engage people rather than put them on the defence.

Three, you need to know how to listen. It's one thing to ask questions but if you don't know how to listen it's not going to make a difference whatsoever.

Deidre Rutherford:

Thank you for that Daniel. We have another question.

Q: Is there a particular way or ways you've found successful to get employers to offer up solutions? Bad experience often stops people from speaking up.

Daniel Hummerdal:

Yes.

That is so accurate that bad past experience stops people from speaking up. The rule of thumb seems to be that people try to speak up three times. If nothing gets done they will stop speaking up and why would they? It's as I said, insulting if nothing gets done about it and there are all kinds of stupid mechanisms that will deteriorate. So I do ask 'What happens when you speak up?', 'When have you seen someone tell it straight?' and 'What happened to that person?'

It's a little bit like a broken record when you start engaging with that and people will talk about that over and over again. So you really have to sort of try to move away from that and start talking about the future. 'Okay, we understand that did not work. Now what are the opportunities?', 'What should we be focusing on now?', 'How can you help us understand where we should invest?', 'Let's work together on this.'

So admit and embrace that everything has not been perfect but that we still have a chance because the future is unwritten and we can create it together. That's how I would go about it, yeah.

Deidre Rutherford:

Thanks Daniel, and another one linking back to that management buy in.

Q: How do you encourage an aloof leader to accept that safety accountability?

Daniel Hummerdal:

I don't know really. I haven't had this problem. I personally think that everyone wants to be safe and they want their workplaces to be safe. No one wants to see people injured and it might be a trick to get that leader to see the benefits of safety and how that is actually going to help him to deliver better productivity, efficiency, wellbeing and be successful, that safety is actually an outcome of all those things where you manage your project well. Safety is not something you can be committed to in isolation apart from managing your work well. It's part of being a good manager is to manage that well as the way you manage work.

So I really try to spread safety out as being part of normal work. That's how I would do that. I don't know if it's particularly effective. I have had very little experience with aloof leaders in that space, so unfortunately I cannot give you a better answer on that today.

Deidre Rutherford:

Thanks Daniel. Great insights into a wonderful engagement approach.

Well unfortunately we're now out of time. We have had a number of questions that we weren't able to get to today. We will endeavour to reply to you via email in the next couple of days.

Thank you Daniel so much for taking your time out of your busy schedule to present to us. We sincerely thank you for doing so. I am sure that everyone would agree that your presentation was insightful and gave us a lot to think about.

Thank you all once again for participating in this webinar and we remind you to register as soon as you can for the remaining webinars in this Construction Work Health Series.

Your feedback is always valuable for us. So please take 30 seconds to complete the survey that will pop up once the webinar is over.

Thank you all once again and goodbye.

[End of Transcript]

Office of Industrial Relations

Alert at work
A practical approach to identifying and managing workplace fatigue risks

Presented on: 18 August 2016

Presented by: Deidre Rutherford, Principal Advisor – Ergonomics

Presenter: Jenny Krasny, Master Facilitator - International Worldview Academy of Change

Deidre Rutherford:

Hello. Welcome to the Construction Work Health Webinar Series. My name is Deidre Rutherford and I am the Facilitator for today's webinar. I am a Principal Advisor in the Ergonomics unit here at WHSQ.

The inaugural Construction Work Health Forum was held in March earlier this year. The forum was well attended and more importantly, very well received by industry. We have created this webinar series based on some of the most popular presentations and workshops on the day so that they may be shared with a broader audience than those who are able to attend the forum. However if you were able to attend on the day I'm sure you will enjoy seeing the presentation again.

We are fortunate that a number of presenters from the forum have kindly made themselves available to present their presentation from the forum again and we thank them all very much for doing so.

This five part webinar series covers a range of topic areas. These are Good Better Best - Applying good work design principles to maximise health and wellbeing presented by Dr Rebecca Loudoun, Engaging your workforce presented by Daniel Hummerdal, Silica – Managing the risk presented by our own Brad Geinitz, Alert at work – a practical approach to identifying and managing workplace fatigue risks presented by Jenny Krasny and finally, Who is at risk of too much sitting in construction presented by Dr Nick Gilson.

Registration for the remaining webinar is still open. The registration link is available on the WorkSafe website. We do anticipate that today's session will take approximately 45 minutes and a recording of the webinar will be made available on the WorkSafe website in a couple of weeks. We encourage you to share this with your colleagues and networks.

The presentation itself should take about 30 minutes and will be followed by a short Q&A session. If you have any questions during the presentation please enter them into the chat box and select 'send to all panellists'. Or type your question through the Q&A chat box. We will try and get through as many questions as possible at the end of the presentation.

Today's presentation is entitled 'Alert at work – a practical approach to identifying and managing workplace fatigue risks' and I would now like to introduce you to today's presenter Jenny Krasny. With over 15 years of consulting experience Jenny has led some of Australia's most respected mining, construction, engineering and manufacturing organisations through strategy development, safety culture change, change management, executive coaching and leadership development. A dynamic and engaging facilitator, Jenny is accredited in a variety of leadership and culture tools and is a Master Facilitator with the International Worldview Academy of Change.

While any opportunity to take a person, team or organisation from a state of good to great is work that Jenny embraces wholeheartedly, projects that involve navigating through the seemingly impossible to find a path of clarity is work which she most thrives.

Jenny has a Master of Organisational Psychology Degree from the University of Queensland specialising in cynicism to organisational change and is currently completing a PhD under the guidance of Professor Sidney Dekker and Drew Rae from Griffith University where she is focused on identifying the elements that contribute to progress in safety within the mining, manufacturing and engineering sectors within Australia and overseas.

I'll now hand you over to Jenny to get us started on today's webinar.

Jenny Krasny:

Well hello everyone. Before we get started what I'd love to do is to encourage you to engage with the poll question that you should be seeing on the slide in front of you and the question is 'What are your attitudes towards someone suffering from fatigue?' Some of your answer options are you'll see on the screen, one, 'Fatigue is the new stress, an excuse to get out of hard work', 'Fatigue seems to be part and parcel of today's world' or finally 'Fatigue is nothing that a good night's sleep cannot fix.'

If you are willing to respond please do so and I will certainly engage with your response later throughout the presentation.

Each time I ask this question I think of my father. My father is now sadly, deceased. He passed away when I was 16, however my dad was a shift worker. He worked along building railroads across Australia. He travelled to different construction sites and when he'd come home he'd want to be a dad as well. So he worked long hours. He then made his day longer by attending to us kids and my mum would often ask him 'How about you go and have a sleep? How are you feeling?' My dad would often respond to this whole thing of fatigue and exhaustion, 'I'll have time for sleep when I'm six foot under.' Well I'm hoping he's having a really great sleep now.

Just like the need to eat, drink and exercise the need for sleep is normal and natural. Human beings need it for optimal performance.

Despite a growing knowledge about the benefits of sleep we continue to be the only species on earth that denies itself sleep.

The impact of this?

We sometimes need a hand to pick us up, call it out and even remove us from the direct line of fire.

Just a cuppa won't do.

Even the most skilful, safest operators will lapse into fatigue. We are terrible at being able to correctly assess how we are feeling. This operator has 25 years' experience behind the wheel. One of the safest and most reliable operators on site, yet despite indicating he was fit for work during the prestart he managed to drive into a drill rig during a micro sleep.

This training officer again like his colleague before, also indicated feeling alert and fit for duty. He too managed to drive himself into a hole and cause $1.5 million damage to the truck, all due to falling asleep at the wheel. Interestingly he was in with a trainee driver at the same time that this occurred.

These fatigue events are not unique. Unfortunately one in five people report to be sleep deprived, be it due to medical reasons, emotional concerns, financial pressures, little kids running around the house, pets jumping on the bed or even sleep hygiene reasons. This figure is staggering.

What is more staggering is when asked if people would speak up during a prestart or a meeting, or if in the unfortunate event of an accident would they admit to feeling fatigued, less than 25 per cent of the population would be willing to let their employer know.

With the stigma associated with speaking up about fatigue it makes it difficult for the organisation or loved ones of the individual to intervene and not doing so can lead to many undesired consequences - individual or organisational.

Fatigue is estimated to cost Australia over $3 billion a year and that figure is staggering given that this is based on figures and data given from people who will speak up about fatigue, not to mention those who won't.

So what can we do about it?

As is the case with most things there are always two sides to every coin. In this case it takes both the work of the employer and the employee to make a meaningful difference.

For the employer, as a start consider these four broad questions. If your answer falls into the 'I don't know', or 'no' category, I'd encourage you to have a poke around and investigate.

Places to start? Does your environment, your contracted work schedule, your culture, your conditions promote optimal performance?

Now for the employee. Despite an organisation's best efforts you have a role to play too. It's tough for an organisation to act and help you if you can't even help yourself. Do you work hard and party hard? Where does sleep factor in your dynamic at work and at home?

Many organisations have a lot of great things in place to help reduce the risk of fatigue. There's education, there's policies, there's procedure. These days with the dawn of technology individuals and organisations can take a step forward towards better managing their fatigue.

With technology now we can make better, informed decisions about how we work. Be it gadgets that can be worn on the eyes, wrist or head through to units installed in our vehicles, each can serve to help catch an employee when they need it most, as they're about to fall asleep or when they're distracted.

This data can then help inform work schedules or particularly breaks within the work schedules, not to mention educating the employee themselves how they can better manage their sleep.

Training and education is important. Without it we cannot expect our people to know what to do and how to do it. Coupled with technology training now becomes more meaningful with people being able to note the very things they can do personally and in the organisation to increase alertness on site. The number of times where I've put some technology on individuals to wear for a month or two weeks, it's staggering how many will come back and say 'Gee Jen, I didn't realise that I was as sleepy or as fatigued as I actually was.' So now when they engage in training around fatigue it is so much more meaningful to them.

Of course this data can also inform and update our existing policies and procedures. Nothing is written in stone.

Here's this word again – 'culture'. Despite the best protocols it will be culture and leadership that will determine the ultimate success of any fatigue control or intervention.

But what do we mean by 'culture'? To answer this question I refer to the work of Dr Dan Petersen. Through his work across a variety of industries in the Northern Hemisphere he arrived at six criteria that must be present to bring about a culture of safety excellence, to bring about a culture where people look out for each other around fatigue and actively manage it.

In his criteria you'll notice that the first two involve leadership to be visibly and actively involved. This isn't simply writing a policy, signing it and sticking it on a wall. This is about leaders actively in the workplace engaging with individuals and showing them how fatigue should be managed and it should be managed and responded to. This is about top leadership turning up to work at reasonable hours and leaving for home at reasonable hours and not sending emails in the middle of the night.

Frontline supervision is performance focused and this isn't just about employees looking at KPIs around how many people are fit for work. This is about frontline supervision actively engaging in conversations with each individual asking them how are they feeling, performing a fatigue risk assessment, looking at someone's eyeballs to notice whether they're fatigued, emotionally distressed or whatever else might be contributing to their fatigue.

Naturally for a culture to be an engaged safety excellence kind of culture, we have employees that are actively participating. What this means is not simply employees turning up and doing what they're there to do. This means employees being invited to contribute to how training, education, shift scheduling, rosters and other things are done on site. Naturally for that to occur the system has to be flexible to accommodate what the requirements of the workers are. Every site, every team on a site will have slightly different requirements. So it's important that the system is able to be flexible to accommodate this and finally, any system, be it a risk management system, a fatigue policy, a safety excellence system, for it to be actively worked and embraced it needs to be positively perceived by the workforce.

But criteria on their own won't work if there's no accountability. For true accountability each layer of the organisation needs to know what to do, needs to be trained how to do it, to do the right things, measure the right things and ask the right questions to ensure fatigue management stays on the radar. Recognition is one of the biggest things that many of our organisations here in Australia really struggle with and I'm not referring to your typical recognition program. I'm genuinely referring to the basic conversations that a supervisor, a leading hand, a frontline person can have with another around noticing someone and giving them genuine feedback around what they're doing well or where they need improvement.

To help you reflect on how well your organisation reflects the six criteria and the model of accountability to which I've just talked to, a PDF of this questionnaire will shortly be made available for you to use in your business. Simply print it out and invite a variety of people in your business to complete it. Once done the data will give you a sense of what you might need to do next in relation to managing your fatigue.

Now interestingly at the start of the webinar I invited you to respond to a question, 'What are your attitudes towards someone suffering from fatigue?' and overwhelmingly the response was 'Fatigue seems to be part and parcel of today's world.'

That's quite disappointing but it's the reality we're always on. I certainly know for myself, I travel a lot for my work and when I'm not with a customer, I then go back to my hotel room or my donga or wherever else I'm staying and I catch up on my day job. If I'm working from home or working at home in Brisbane, I will come home to two kids and a husband that need to be attended to as well. Once they're attended to and in bed, guess what? The laptop, the phone, something comes up.

We work in a very busy world where our attention is being demanded from every single angle. So busyness and tiredness seems to be real. It's time for our organisations to recognise this, genuinely recognise and not simply through education and policies and procedures, but genuinely engaging in conversations with their employees as to what we can do better.

Burning the candle at both ends just to get through life is not the answer. In fact as we know, doing so just makes us perform even worse.

There is absolutely no shame in needing sleep. After all we're not embarrassed to take a break, to use the bathroom, drink some water, get some food, even go for a walk. Why should we be ashamed to ask for a break to get some sleep?

Q&A Session

Deidre Rutherford:

Thank you Jenny and thank you all for the questions that have been coming in through the presentation. We will attempt to get through as many as we can in the time we have left.

Q: Jenny, when we think about work related fatigue, high physical and/or mental demands, shift work, long hours etc, how do we get companies to focus controls at the top of the hierarchy, that is, through the design of the work?

Jenny Krasny:

That's a really great question. If it was simple we'd all be doing it of course and what one of the responses to this question is we really need to be going to the workers themselves and asking them how are they finding the work, how are they finding the schedule, 'Is the work itself not only demanding on a mental or physical perspective but is it also dull?', 'Is it monotonous?' We know that boredom can certainly trigger fatigue and distraction.

It's about engaging with the employees, seeing what they're doing, understanding how they're managing their life and only then asking them what do they believe could be done to not only control for but also manage fatigue more effectively? This can be through anything from doing a very simple risk analysis to identify 'What are the things that are contributing to fatigue?', 'What are the barriers that are currently in place?' and 'Could there be something done more effectively or different to manage it?'

Deidre Rutherford:

Thank you. Another question Jenny.

Q: Do you think workers would be more comfortable about reporting the outside work fatigue if their managers had demonstrated true commitment to managing fatigue at work?

Jenny Krasny:

Absolutely. I found recently I went to a conference where there were safety and health innovation awards. One organisation particularly stands out for me that one, was an organisation that took mental health, not only fatigue but all issues to do with emotional and psychological stress, and created a context where conversations are had around how people are feeling. This goes beyond the typical 'Are you okay?'

These conversations were about taking a genuine interest in every employee, seeing them as people and not simply workers. This was about individuals engaging with these people and asking them how do they spend their time, what do they do when they're on R&R and how are things going for them, not only from a fatigue but also an emotional perspective. That organisation themselves then found the morale, the commitment, the engagement in the work was far greater.

Interestingly they also reported incidents went down and the number of near misses reported also down because people had the morale and the alertness to want to speak up and call each other out. So I think certainly workers would be more comfortable about reporting outside work fatigue if their managers, their organisations, their leading hands and their peers took an active interest and then responded positively to this kind of feedback.

Deidre Rutherford:

Thank you. So a key message is about that positive engagement.

We have another question Jenny.

Q: How do we influence useful conversations with workers about their fatigue levels if there is an overtime financial driver?

Jenny Krasny:

That's a tricky one. We sometimes as organisations completely shoot ourselves in the foot. On one hand there is the desire to get a project completed in time, under budget and on the other hand we're also told we have a duty of care to look after our employees. It's a very difficult balance between trying to manage production needs with the wellbeing of workers.

However certainly conversations with workers can be simply as sitting and working alongside each of your workers, driving in the vehicle to and from the project site, the construction site or simply engaging in crib huts and other conversations in prestarts around things that are beyond production, things that are beyond financial, things that are beyond targets around timelines but now having targets around wellbeing metrics.

Some of the organisations with which I work once wellbeing, safety and fatigue metrics are defined and clearly talked about, you find that overtime and other financial drivers seem to be less of an issue. As the engagement increases people are more willing to do what's required and performance increases strangely enough.

Deidre Rutherford:

Thanks Jenny. I have a question for you.

Q: Do you feel that there is merit in identifying some specific performance measures, lead measures that organisations could follow and have you seen any organisations actually put some lead performance measures in that are working to help their management of fatigue?

Jenny Krasny:

Absolutely. I mean unfortunately most things around fatigue is measured after an event, no different to how safety is measured. Usually after an event, lost time injuries and reportable injuries and so forth. But more and more organisations and some of my customers I've seen implement ideas whereby they measure how many times are leaders having conversations with individuals, but not only how many times or what the frequency of it is, but actually capturing the quality of those conversations around wellbeing, around emotional stress, physical stress, even psychological stress and therefore fatigue. Measuring the quality of that and then going to the employees themselves and asking them to comment on how effective those conversations are being, and does the organisation actively care.

So we're trying to make something that possibly sounds really convoluted quite simple around 'Let's just ask a genuine question of wellbeing that can encompass anything from mental health through to fatigue.' Then in that conversation engage in true, wholehearted dialogue with the employee as a person and that certainly is making a difference in many organisations with which I work.

Deidre Rutherford:

Wonderful. Thank you. Another question.

Q: You mentioned it costs the economy $3 billion a year. Does this figure include the lack of productivity if a fatigued worker is at work?

Jenny Krasny:

No.

Unfortunately not and I mentioned the $3 billion cost in economy. The reality is that that's even just an arbitrary figure. We don't 100 per cent know what is the real fatigue risk that we carry in organisations and therefore the impact of things like presenteeism and absenteeism and everything else that happens in between.

The figure was simply calculated based on some exit interviews and other such results that could be tangibly measured, but nothing at this point that I've come across at least looks at the impact of fatigue on presenteeism and the lack of productivity.

Deidre Rutherford:

Thank you Jenny. We don't appear to have anymore questions. So we might finalise this webinar.

Thank you for taking the time out of your busy schedule Jenny to present again for us. We sincerely thank you for doing so. I'm sure everyone would agree that your presentation was insightful and gave us all a lot to think about.

Thank you all once again for participating in this webinar and we remind you to register as soon as you can for the final webinar in this Construction Work Health Series. Your feedback is always valuable for us, so please take 30 seconds to complete the survey that will pop up once the webinar is over.

Thank you and goodbye.

[End of Transcript]

Office of Industrial Relations

Sedentary work
Who is at risk of too much sitting in construction?

Presented on: 23 August 2016

Presented by: Deidre Rutherford, Principal Advisor – Ergonomics, Workplace Health and Safety Queensland

Presenter: Nicholas Gilson, Centre for Research on Exercise, Physical Activity and Health, University of Queensland

Deidre Rutherford:

Hello. Welcome to the Construction Work Health Webinar Series. My name is Deidre Rutherford and I am the Facilitator for today's webinar. I am a Principal Advisor with the Ergonomics Unit here at WHSQ.

The inaugural Construction Work Health Forum was held in March earlier this year. The forum was well attended and more importantly, very well received by industry. We have created this webinar series based on some of the most popular presentations and workshops on the day so that they may be shared with a broader audience than those who were able to attend the forum. However, if you were able to attend on the day I'm sure you will enjoy seeing the presentation again.

We are fortunate that a number of presenters from the forum have kindly made themselves available to present their presentation from the forum and we thank them all very much for doing so.

This five part webinar series covers a range of topic areas.

These are Good Better Best - applying good work design principles to maximise health and wellbeing presented by Dr Rebecca Loudoun, Engaging your workforce presented by Daniel Hummerdal, Silica – Managing the risk, presented by our own Brad Geinitz, Alert at work – a practical approach to identifying and managing workplace fatigue risks, presented by Jenny Krasny and finally, Who is at risk of too much sitting in construction presented by Dr Nick Gilson.

We anticipate that today's session will take approximately 45 minutes. This is the last webinar in our Construction Work Health Forum Encore Series. If you missed out on any of the previous webinars in this series, recordings of the webinars including this one will be available on the work safe website in the next few weeks. We encourage you to share this with your colleagues and networks.

The presentation itself should take about 30 minutes and will be followed by a short question and answer session. If you have any questions during the presentation please enter them into the chat box and select 'send to all panellists'. Or type your question through the Q&A chat box. We will try and get through as many questions as possible at the end of the presentation.

Today's presentation is entitled 'Who is at risk of too much sitting in construction?' and I would now like to introduce you to today's presenter, Dr Nick Gilson.

Nick is a Senior Lecturer at the School of Human Movement and Nutrition Science at the University of Queensland. His research focuses on designing, implementing and evaluating innovative interventions that target physical activity, sedentary behaviour and health in the workplace. Dr Gilson regularly publishes and presents the findings of his research and advises and provides consultancy services to industry and regulatory bodies. He also contributes to policy documents that are defining future approaches to occupational health at the population level.

I'll now hand you over to Nick to get us started on today's webinar.

Nick Gilson:

Thank you for that introduction Deidre and hello all. It's a pleasure to be chatting with you today via this webinar link on sedentary work and it's implications for construction.

When I was asked to do this talk I thought I'd present it in four different sections or areas.

The different sections are there on the right hand side which I'm going to talk a little bit about first of all, the definition of sedentary exposure. I think that's really important for us to understand what it's all about so you can understand some of the evidence and the research around the behaviour. Then I'm going to talk a little bit about our exposure, how much sitting and sedentary behaviour we do especially in the occupational space. Then a little bit about the health impact which is probably one of the strongest research areas that we have at the moment and I'm also going to introduce a little bit of information there on productivity which is a really interesting, emerging area. Then I thought I'd finish off by talking about the possibility of doing some intervention work and trying to change the behaviour itself.

Now the studies and the evidence that I'll be pulling on is focused on chronic disease outcomes. This has really been an exploding area of research over the last 10 years as you can see from that top figure there and that represents the number of papers that have been published in that particular area over that time period.

That corresponds or complements quite well the more established area of research in the area of musculoskeletal issues and ergonomics which I'm sure you're very familiar with. But my particular focus today will be on chronic disease risks, health outcomes and productivity.

So if I move first of all to the definition and this is my working definition that I use a lot in my research. It's from the Sedentary Behaviour Research Network and the blue text there highlights the key points in that definition that we need to be aware of. First of all when we're talking about sedentary behaviour in my context we talk about waking behaviour. We think about sedentary behaviour in terms of energy expenditure and that energy expenditure is very low. It's below 1.5 METs.

To give you some context walking briskly will expend about 3 METs of energy. That's three times resting metabolic rate. So that 1.5 is indeed very low for energy expenditure. Along with that we also talk about posture which is important and really if we want to talk about sedentary behaviour to sitting. So that's a good way to start and to think about what sedentary behaviour is.

Now the next slide here is important. I thought I'd show this to you just to highlight that we can be highly exposed to sedentary behaviour but still be physically active.

Now these two traces are from devices called accelerometers which we use to map movement and sedentary behaviour across the day. They're from two different individuals.

The one on the top there highlights an active individual. You can see that hump there right at the start of the day is when somebody's getting their morning run in. There's about 40 minutes of moderate to vigorous physical activity. We can then see from the rest of the day there's a high level of sedentary exposure. So this person is hitting the physical activity guidelines but is still sitting for long periods of the day.

Then if you look at the bottom figure that's quite opposite. You see this person is inactive by physical activity guidelines. They're not getting that 30 minutes in of moderate to vigorous physical activity but they are exposed to less sedentary behaviour because they have a lot of incidental movement and that's generated by the spikes across the day.

So it's important to bear those different patterns in mind when you think about the impact of sedentary exposure and it's not just about the total amount of sitting time that you have, but it's also about the pattern across the day, how many breaks, how many interruptions you have.

Okay so now I'm going to move on to a little bit about exposure. Of course we know that sedentary behaviour is ubiquitous in society and our day to day lives in the modern day. The figure on the left there gives you a nice kind of time flow chart around where sedentary behaviour occurs and we often think of this as three distinct domains. One is in leisure time, the second is travel, when we're in the car typically and the third one which tends to dominate sedentary exposure is work, our occupational context.

The figures on the right are very nice data from the US which show the impact that reductions in occupational energy expenditure have had on total energy expenditure across time. As we become more office based, as work becomes more sedentary, we've had a reduction in occupational energy expenditure, total energy expenditure which I think underpins a lot of the chronic disease problems that we have today.

Now how much sitting does the typical Australian do? Well some of our work and colleagues' work from around Australia using objective measures, those accelerometers, suggest that people sit from anything to eight to 10 hours of their working day. Around about half to three quarters of that is spent sitting at work. Now again I'm talking about office based work here and we're talking about prolonged sitting usually at desks. Really there is not that much evidence or data coming through for occupational sedentary exposure outside of the office based context.

I've had a good hunt around and these are the only data that I can find from Safe Work Australia which has a look at different types of occupations outside of office work – manufacturing, transport, construction, agriculture and health and community services. You can see here the percentage of exposure risk for males and females in those different industries and it's still quite high.

Now the big question for us is what is the pattern or the total amount of sitting that occurs in that exposure? The answer is we really don't know for the Australian population and the Australian industries that are presented there in that figure.

I've gone abroad and looked at some international studies and only really came up with three. One was a Danish study which looked at manufacturing workers, construction and mobile plant operators. That study was suggesting that construction workers sit for about three and a half hours a day. Colleagues in the Netherlands are doing some work here as well and they kindly gave me some of their data which indicated that about 44 per cent of the workday was sedentary in male construction workers which is lower than office workers but still quite high. Importantly seven per cent of that work time was in prolonged sitting, greater than 30 minutes which is important for health and productivity outcomes.

Then the third bullet there was also fascinating. This was data from the US, a very large study, self reported which suggested there may be a compensation effect. So even if we have vigorous physical labour in some construction areas, long work days may compensate and we get more sedentary behaviour outside of work which I think is very important to consider.

So if we move on and think about how much sedentary exposure we have in construction in Australia the answer is we really don't know. We're getting an indication that it is significant but we're unsure about the patterns and also the different patterns relative to the different sub occupations in construction work.

So I thought it would be a good idea now to get your views on this. So what I'd like to do is pose a question for you and to take a poll which should pop up on your screen now and ask you to identify which of these different sub occupations you think sedentary exposure is highest? Then we'll come back to this data in a couple of minutes to see what the poll results are.

So while you're answering that poll I'll move onto my next slide. Just bear with me while I click through here.

This is my first take away message. I've got three take away messages for you. The first take away message is we desperately need measurement based studies and objective measurement based studies where we can really get a handle on how much sedentary exposure is occurring in those different sub occupations.

If I was to take a guess I would suggest that perhaps these occupations sit the least. We're talking about manual labouring, trades people on site and perhaps also construction managers and supervisors although a colleague I was chatting to the other day in construction suggested that these people might also sit a lot because they're driving between sites.

Then also areas where prolonged sitting might most occur are tower crane operators. You can understand these people spend a lot of time above buildings during the day operating machinery, mobile crane operators, not just driving but operating that machinery, earthmoving and diggers and also of course we have an increasing amount I think of office based work that construction workers participate in.

So coming back to your poll it's interesting that many of you have identified – do we have the results of that poll? It's coming through. We'll come back that in a second.

Then we'll move on and have a look at the results of that poll as it comes through.

Okay so I'm going to come back to that at the end of the next section and what I'd like to do now is move on to the next area of my talk which considers impact.

Now I'm thinking that many of you have seen the media filtering through from the research we've done around sitting and chair disease. You may have seen the 60 Minutes program which I think was on about a year or so ago which is a great thing to watch if you haven't watched that. The link is there for you to have a look at. You may have seen these newspaper articles, the one on the top right there has linked sitting to be the new smoking which I think is not quite helpful because some sitting is healthy and beneficial for us of course. We need to break up sitting with standing and moving but we don't want to eliminate all sitting whereas smoking is very different. There's zero tolerance there with health outcomes.

Then at the bottom there you may have seen these types of headlines coming through around 'Each hour of sitting increases chance of heart disease by 14 per cent.' So there's a strong evidence base coming through for the health impact of sitting.

But you may have also seen these articles coming through from the local press in Australia. This is one I picked up while of course I was standing on the train through the Metro. 'Sitting does not shorten your life.' This was from a large UK based study which is suggesting that it's actually physical activity and mediating sitting which is important. The one on the right there was reported from The Australian that 'Sitting is okay as long as you keep moving.'

So if I was to look at the evidence base for impact and you'll excuse the pun, but we as researchers are beginning to construct the epidemiological evidence base about the interaction between physical activity and sitting.

But I really want to leave you with this slide which I think is for me the most powerful piece of evidence to highlight why sitting is bad for us in terms of chronic disease. This is a very large study from Canada which followed around about 17,000 men and women for 12 years, mapped out how long they were sitting for and then calculated their cumulative survival rate. So basically how many people were not dying during those 12 years.

You can see there at the bottom here that the cumulative survival rate is much better for people who are actually sitting almost none of the time compared to the people who are almost sitting all of the time. So that's a really powerful piece of evidence which really brings forward the importance of dealing with sedentary exposure.

Now if I was to quickly introduce and talk a little bit about why that is the case, the epidemiological evidence is telling us that sitting and prolonged sitting without breaks is linked to premature mortality as that previous figure highlights, cardio-metabolic outcomes and some cancers, specifically bowel cancer and breast cancer in women.

The physiological mechanisms linked to this is all to do with muscle activation or activity. The middle figure in the slide shows what we call an EMG which is basically tracking the electrical activity of muscle as it contracts and relaxes. Clearly you can see the muscle contracting using energy expenditure and stepping and also getting out of the chair and also during standing interesting enough. Then there's very little activation during sitting.

Now when we get muscle activation we use metabolites in the bloodstream, particularly a protein called lipoprotein lipase which is a key enzyme which regulates blood glucose and lipid metabolism. We also of course use energy rather than storing it as fat and there's a new area around gravitational resistance which comes from space science which suggests that we have various physiological effects which when we stand we counter blood pooling in the lower legs. So there's some energy and some physiological effects which are used to maintaining the arterial blood pressure there.

Now they are the issues around health and that's a very quick summary of why perhaps we have good health outcomes, but something that's fascinating me more and more is to do with the impact that sedentary exposure has on business and whether high levels of sedentary behaviour are linked to productivity.

Now I've kind of conceptualised this for you as a carrot and stick approach. If I think about the stick approach first of all, there is perhaps a duty of care for employers around sedentary exposure and chronic disease outcomes. I've highlighted here the first legal action by a worker claiming compensation linked to prolonged sitting in Australia, the Schodde vs Comcare case.

Comcare judged that compensation was not due here and that was upheld at appeals. But it's interesting to highlight that these types of claims are emerging. If we think about accountability we can think about workplaces being responsible for providing good systems that do not require excessive sedentary behaviour, the importance of providing information and training to employees to help break up sitting and also the importance of measuring and monitoring sedentary behaviour in the workplace so we can react.

But if I move to the carrot approach and think about the link between sedentary exposure and productivity, we know that productivity losses linked to illness and absenteeism are very large. It's a particular statistic there I pulled off the ABS around $24 billion a year. We can also link productivity to presenteeism - being at work but not being focused and not completing tasks.

Now my question for research and for business and for practitioners, can we link high levels of sedentary exposure to productivity and presenteeism issues? If we look at the research that's been done so far the relationship is limited and moderate at best. That's because I think we have few studies, they tend to be cross sectional rather than interventional with a comparative or control group, we tend to use self report measures which are not the best way of picking up productivity and presenteeism, and also we get poor variability in those studies. So the people we tend to recruit and get involved are those people who feel the most productive.

[00:21:45] so beginning to look at this in detail. We've done a really great experimental study which have used standing desks and walking desks to replicate standing and moving in workplaces. We've measured brain activation in the frontal lobes which are responsible for decision making.

So we've got people to come into our lab, do different work jobs using these different stations and then measured their frontal lobe activation at the end of the day. We're beginning to find this, that if you think about what you have during a day as a cognitive resource and you energise the workplace, so you get standing and moving into the workplace more than just simply sitting, participants in that study are focusing better on urgent tasks. They're delegating non urgent tasks to another day or another time when they can do them and they're avoiding inhibitory tasks. So really that cognitive resource is being allocated much better to different work tasks through standing and moving.

So my second take away message then is that we do have a good evidence base for minimising the risk of prolonged occupational sitting for health, for chronic disease outcomes and we're beginning to find that sedentary exposure is linked to work performance. If you take that [00:23:16] construction you can think about the importance of fatigue and maintaining focus and concentration in driving for example, or power crane operating where mistakes can be very hazardous.

Okay so I'm about to move onto my last piece but I'll come back to the poll here and our responses are as follows.

It's looking as though tower crane operators are the job occupation where you think most sedentary exposure is occurring. So that I think reinforces the idea that we need to get in and measure these patterns in exposure to identify who is at most need for intervention.

Okay so onto my final bit of the presentation, what can we do around intervention? Well a good place to start is thinking what would the intervention need to be like? I'll be honest with you the evidence base is not at the point where we have specific guidelines for chronic disease reduction in terms of sedentary behaviour at the moment. The key question that we're bringing forward and the key guidance is that we need to sit less, move more and stand more whenever we can. But if you look at the evidence colleagues in Sydney have suggested that if we reduce every hour spent over seven hours sitting we reduce mortality risk by five per cent.

If we interrupt sitting every 20 to 30 minutes for two to five minutes colleagues from Melbourne and Curtin in Western Australia suggested that we have an impact on metabolic health. There's a group in the UK who've tried to put forward consensus guidelines around building up standing and incidental movement in the workplace, suggesting that we should accumulate a minimum of two hours increasing to an ideal of four hours of standing time.

Now this is a really nice figure from a colleague of mine which conceptualises how that pattern might look. If we look at the top bar there that's typically I guess what people mostly do if they get some movement in during their lunch break or their coffee break in the morning, with large blocks of sitting in the red zone there.

The bottom bar is ideally what we'd like. So lots of changes of posture, moving through sitting, standing and walking. It may be within the construction industry we have different models which fit different types of workers.

The next slide identifies the different sectors and areas that we need to target if we really want to bring about sustained change through an intervention model. We need to consider socioecological policy as the top layer, the organisational approach, the environment and of course the individual around education and knowledge.

Now from my work which really focuses a lot on intervention we're really lacking anything around policy in organisation at the moment. Our work is solely focused on trying to adapt, tweak the environment and also provide education and knowledge to the individual.

I really just want to finish off in the last few slides by talking to you a little bit about an intervention program we've done with truck drivers which partly focuses on sedentary behaviour and the role of the individual and the environment in changing that.

It's termed 'Shifting Gears'. It also focuses on diet but through this program we're trying to implement more movement and less sitting during driving breaks.

It was all about healthy choices. We particularly focused on local delivery drivers. We found it very difficult to recruit long haul drivers and all of them were men. That great picture on the right hand side there highlights what a difficult and hard to reach group this population is.

Now a little bit about the time scale. It ran from July 2013 to December 2014 and those blue boxes there highlight when we went through recruitment. We did some baseline measures on our key outcomes. Very importantly we ran workshops for drivers where we chatted around some of the challenges and barriers that they faced around healthy choices and we targeted as well very importantly there, the opportunities to break sitting and get more moving into the work day. We then did the intervention and then we did a follow up. One of the key aims here as you can see in that text at the bottom was to map sedentary behaviour and physical activity changes that end intervention and follow up.

Now very quickly for the intervention process we gave drivers an activity tracker and got them to download a smartphone application called the Jawbone Up. This allowed drivers to map out their choices and self regulate and self monitor. I'm not going to dwell a lot on the different areas of the application but I just want you to focus on this orange bar in the middle which is basically a movement goal.

So what drivers are able to do is to reduce their sedentary exposure, focus on movement and then self regulate that in terms of the goals that they set each and every day. We were linked in socially to the application as well as the other drivers as well. So you got a lot of social support there.

Now I could talk really for hours and hours about the outcomes from Shifting Gears, but really this is the key finding for this presentation about how the project, the intervention, was able to reduce sedentary exposure in what is a very sedentary group who have to drive a lot during their day.

Now this was sedentary exposure during the day at baseline. So this is not driving time. This is the time they're spending during work time where they are sitting but they have a choice to stand and move. You can see there that at end intervention and follow up through the workshop and self monitoring approach we were reducing choice sedentary exposure by about 40 or so minutes at both end and follow up.

So that leads me nicely to my third and final take away message, that I think if we use participatory approaches we can reduce prolonged occupational sitting in highly sedentary work that has good implications and messages for construction.

So how do we move forward and I'll be happy to take any of the questions that you have around this in the next bit. But for me as a researcher in construction around sedentary exposure first of all we have to measure. We have to map out the patterns and the differences of occupations that we need to target.

We need to consult with all the key stakeholders. So that's not just employees, but also managers and also the professional bodies and affiliations. Then we have to pilot test. We have to see what works and why, and what doesn't work.

All that has to occur through support and importantly funding because we need good, quality research which can provide good evidence which can then show us the way forward.

So with that I'd like to really thank you for listening. I hope you found the presentation useful and took away some important points. Those are my contact details should anybody after the presentation wish to talk to me and I'd be very keen on talking to any of you out there who are interested in taking this work forward.

Thank you very much.

Deidre Rutherford:

Thank you Nick for taking the time out of your busy schedule to present again for us. We sincerely thank you for doing so. I'm sure everyone would agree that your presentation was insightful and gave us a lot to think about.

Q&A Session

Thank you for the questions that have been coming through in the presentation. We will attempt to get through as many as we can in the time we have left.

The first question is Nick,

Q: How do we persuade managers to take action about reducing prolonged sedentary work when the intervention research is still in its infancy?

Nick Gilson:

That's a really good question to start with Deidre. I think first of all we recognise that the work is in its infancy but I think now we're pretty sure that sedentary exposure for chronic disease outcomes is a strong case to make. So we do need interventions.

We need to pilot test those interventions now in the workplace to see what works and doesn't work. To do that we need professional affiliation support. So my key suggestion for those out there who are managers who want to move this forward is to lobby the professional affiliations to try and get support for this work so we can move it forward. Then we look at this as a team effort where we bring research teams together with companies, managers and professional affiliations to explore the issues in a quality way.

Deidre Rutherford:

Thanks Nick.

Q: Would you encourage companies to tackle small pilot interventions for their at risk occupations such as mobile plant operators, tower crane operators and the like?

Nick Gilson:

Yes I would but we need to do that in a systematic way. As I mentioned in my slides the first step in that is to do good measurement work so we're very clear on where the issues are.

The next step is to then talk and consult with people in that workplace to try and drive a participatory approach because we have to get buy in from workers and we have to fit it into their busy lives to make it meaningful. Those are my key suggestions around doing pilot work and moving to pilot work.

Pilot work fulfils a role. From the analysis and the feedback we get from those types of studies we're able then to develop an evidence base which can really inform good practice and we need to try and gain that momentum towards really sustainable translations. So the pilot work is very important in that systematic approach.

Deidre Rutherford:

Thanks Nick. That's very encouraging.

Another question,

Q: You referred to the app in your Shifting Gears research. Are there apps out and available now that workplaces can use to assist them in this journey?

Nick Gilson:

Yes there are a range of commercially available apps and also apps that are free of charge for both android and Apple phones.

The role of apps can be very helpful to empower workers towards healthy choices particularly around physical activity and sedentary exposure. But what we need to consider is that the role of technology and applications are not a magic pill. It needs to be an holistic approach where we get organisational buy in, that we're also talking and touching base with workers around their environments and the knowledge and awareness of why change is important.

Also the groups that we tend to deal with especially in the truck driving community are not incredibly switched on to the role of this technology sometimes. So while we had good success with the truck drivers we involved in our work and who were fantastic and helped us a lot, we also had a number of drivers who dropped out of the study because that technology wasn't appropriate for them.

So it really is important to recognise and it's especially important for companies and professional affiliations that simply throwing the ball to workers and saying that 'It's your responsibility for change' will not work entirely.

Deidre Rutherford:

Thanks Nick. That's very interesting insight.

I don't believe we have any more questions at this stage.

So with that I will thank you once again for participating in this webinar. The recording for this webinar and the previous ones in this series will be available on the work safe website in the next few weeks.

Once again thank you Nick. Thank you to all for participating and goodbye.

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