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Get Behind Total Worker Health

By Rixio Medina, CSP, ASP, CPP, 2018-19 ASSP President
Sep 01, 2018
Rixio Medina-BOD_2018

OSH professionals and a growing number of business leaders understand that to achieve excellence in worker safety and health, and ensure employee satisfaction, an organization must do much more than simply meet minimum regulatory requirements. “Much more” encompasses a wide range of initiatives, including programs that focus on lifestyle changes such as smoking cessation and weight loss, on-site gyms and subsidized fitness center memberships, adjusted work-shift schedules to minimize fatigue, health fairs and vending machines that offer healthy options.

When I first heard about NIOSH’s Total Worker Health (TWH) initiative a few years ago, it sounded similar to programs we were already doing within my corporation, so I didn’t give it too much attention. However, over time and as a result of being involved in ASSP activities, I have come to understand that TWH is a much more comprehensive approach than I initially recognized, one that extends well beyond traditional employee wellness initiatives.

A TWH approach can help organizations integrate their efforts on a wide range of key topics. Specifically, NIOSH defines these five elements of TWH:

  1. Demonstrate leadership commitment to worker safety and health at all levels of the organization.
  2. Design work to eliminate or reduce safety and health hazards and promote worker well-being.
  3. Promote and support worker engagement throughout program design and implementation, addressing hazards and initiatives relevant to safety, health and well-being.
  4. Ensure workers’ confidentiality and privacy.
  5. Integrate relevant organizational systems to advance worker well-being.

Approaching our workforces through the TWH lens requires that we develop organizational policies, programs and practices that focus on promoting workers’ overall safety, health and well-being. These programs benefit not only our employees and their families, but also our employers, our communities and the economy as a whole. By taking a TWH approach, we can holistically address work-related environmental and organizational factors that affect, positively or negatively, our workers’ health and well-being. Also, we need to be more cognizant of mental stressors that occur outside the workplace that can affect employees’ behavior inside the workplace.

I encourage you to learn more about TWH by reading NIOSH’s workbook, “Fundamentals of Total Worker Health Approaches: Essential Elements for Advancing Worker Safety, Health and Well-Being”.


TWH is clearly a next-generation approach to injury and illness prevention. That is why our Council on Professional Affairs has formed a task force to further explore TWH, as well as its implications to and opportunities for our profession. The members of this group represent industry, academia, consulting and affiliated organizations. They will focus on developing recommendations regarding ASSP’s position on TWH and will draft a robust action plan for advancing this approach, including practical tools to help safety professionals further reduce injuries and illnesses in their organizations.

Here are a few examples of targets OSH professionals can help achieve by engaging in this area:

  • Improve the workplace through hazard and exposure control.
  • Increase employment retention by creating a safe workplace.
  • Understand the OSH implications of emerging and flexible employment patterns (e.g., part-time, contingent, remote).
  • Address health and productivity (e.g., fitness for duty, absenteeism, presenteeism), employee compensation and benefit package design/strategies, and disability management.
  • Ensure optimal well-being (e.g., employee engagement, well-being assessments).

Workers today face increasing economic insecurity, they are growing older and many have chronic health issues that their jobs may aggravate. Many people also feel undue stress at work and believe their jobs often place them in harm’s way.

As OSH professionals, we can help employers address these trends and change these perceptions by including in our OSH management systems policies, programs and practices that integrate protection from work-related safety and health hazards with promotion of injury and illness prevention efforts. Through those efforts, we can continue advancing worker well-being.

Joshua Scott
Hello, I'm a "pracademic" faculty member at one of NIOSH's TWH Centers of excellence and involved in our local ASSP chapter.  I'm wondering if there is any room for more participation in the task force mentioned above?  I'd like to contribute. 
Sue Trebswether
Hi Joshua. I've shared your comment and contact information with the staff liaison to this task force. Thanks for your interest in getting involved!
Deborah Nelson

Rixio, I'm now a student in TWH in Dr. Scott's program.  Is there a way to get involved with your TWH task force on an advisory basis?

Deborah Nelson


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