March 29, 2018 / Lee Newman

Why OHS Professionals Are Turning Toward Total Worker Health

Editor’s note: AIHA is one of several organizations partnering with NIOSH on the 2nd International Total Worker Health Symposium.

As the nature of work changes, and public health issues change, our approach to worker health and safety must change too. That’s one reason why, twelve years ago, I decided to shift my own OHS career toward public health and start two academic centers—the Center for Health, Work & Environment (CHWE) at the Colorado School of Public Health and the Mountain & Plains Education and Research Center, a NIOSH ERC, housed in CHWE.

In our training programs, our research, and our practice, we’re trying a new, more integrated approach to advancing worker health, safety, and well-being, in the paradigm called Total Worker Health. NIOSH defines TWH as “policies, programs, and practices that integrate protection from work-related safety and health hazards with promotion of injury and illness prevention efforts to advance worker well-being.” To me, this means we prioritize safety first and foremost, while also striving to improve overall worker health.

The approach resonated with me personally and professionally. After 20 years of diagnosing and treating workers who had developed occupational lung disorders—from asbestosis and asthma to chronic beryllium disease and silicosis—it was clear that the overall well-being of these people was affected both by textbook hazardous exposures to dusts and fumes as well as other factors ranging from workplace stress to tobacco and nutrition. A “worksite wellness” agnostic, I began to see data emerging to support the use of a more integrated approach to improving safety, health, and productivity.

If you look back at a national survey conducted by Westat for NIOSH that was published in 2011, it would be hard to imagine that the concept of TWH would gain so much traction so quickly. That survey found that industrial hygiene and occupational safety professors as well as working OHS professionals had little or no interest in the health promotion side of worker health and safety.

Here’s the shift: In a 2017 survey of OHS continuing education needs, conducted by our CE director Josh Scott along with the other 17 ERCs, we found that 53 percent of the 820 IH, occupational safety, and ergonomics professionals who completed the survey were now interested in receiving continuing education on TWH. Anecdotally, my friends in IH and safety tell me that they are increasingly expected to have knowledge and skills outside of their core disciplines. In response, our center, and a number of other ERCs, have begun to integrate TWH electives into the curriculum.

To address the need for more advanced training in TWH, last year our Center’s Deputy Director Liliana Tenney and I launched the nation’s first graduate-level Certificate in Total Worker Health, based in the Department of Environmental and Occupational Health at the Colorado School of Public Health. We’ve been impressed with the range of professionals attracted to the certificate program. In our first wave, applicants have included a practicing industrial hygienist, an architect who does workplace design, a planning professional who designs public spaces, public health students, an occupational health nurse, and an occupational medicine resident. We are attracting people from nontraditional disciplines. I’m encouraged that this brings more, and diverse, perspectives to the challenges we continue to face in OHS.

And the movement toward TWH approaches is not just limited to the classroom. This spring, I’m excited to join colleagues from the research, business, and labor communities to discuss how healthier, safer work can improve worker well-being at the 2nd International Total Worker Health Symposium. This conference will bring together many different stakeholders and will be a great way for OHS professionals to gauge (and come up to speed on) this emerging field. The event will take place May 8–11 on the National Institutes of Health Campus in Bethesda, Md. If you’re interested in attending the meeting, you can register online.

Lee Newman

Lee Newman, MD, MA, FACOEM, FCCP, is a researcher, physician, public health practitioner, and educator. He is a professor in the Departments of Environmental and Occupational Health and Epidemiology at the Colorado School of Public Health and in the Division of Pulmonary Sciences and Critical Care Medicine at the University of Colorado Anschutz Medical Campus. He is the founding director of both the Center for Health, Work & Environment (CHWE) and the Mountain & Plains Education and Research Center (MAP ERC). The CHWE is one of six Centers of Excellence for Total Worker Health supported by NIOSH, and the MAP ERC is one of eighteen centers of its kind supported by NIOSH.


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