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Embracing Total Worker Health

Deborah R. Roy, M.P.H., R.N., CSP, COHN-S, CIT, FASSP, FAAOHN, 2020-2021 ASSP President
Oct 01, 2020

ASSP President Deb RoyOur profession is evolving faster than ever. Over my career in OSH, we have moved from a compliance focus to best practices to advocating for safety management systems, assessing risk and understanding human performance. In the past decade, some organizations have begun to embrace another emerging method, Total Worker Health (TWH). In fact, according to a 2019 ASSP survey, 56% of members said their organizations had incorporated some aspects of TWH concepts and practices into their safety and health program or management systems.

TWH provides an opportunity for us to advance our profession as well as the safety and well-being of the people in our organizations. NIOSH defines TWH as a system of policies, programs and practices that integrates protection from work-related safety and health hazards with the promotion of injury and illness prevention to advance worker well-being.

Implementing and using TWH strategies can help our organizations address evolving business conditions, create a sustainable benefit to worker safety and health, and improve our organizations’ financial health. TWH also represents an opportunity to demonstrate how we contribute to our organizations’ goals. Beyond providing technical expertise, we must show leaders that we understand our business and its risks and that we can help identify ways to improve systems to enhance worker well-being.

To do this, we must be prepared to mitigate the effects of an aging workforce; recognize changing employment relationships, such as virtual and gig work arrangements; develop awareness of work-related stress disorders, psychosocial risks and chronic diseases; and adapt to shifting cultural norms. Achieving this takes a broad, collaborative approach and requires leadership commitment, a dedicated team educated in the concepts, a gap analysis that identifies the organization’s needs and an action plan.

If your organization is not yet ready for that level of implementation, consider piloting a TWH program. For example, smoking is a known risk factor for back injury. If your workforce has a high number of work-related back injuries and a high rate of smoking or tobacco use, have you correlated the data and considered strategies that could reduce the broader risk?

One option is to consider tobacco use in the work environment. If smoking or tobacco use is prohibited on the property, then more workers will have incentive to reduce smoking or quit. You can further support employees (and, better yet, their spouses or partners) with no-cost tobacco-cessation programs, and quit-assist methods such as patches or medications. In addition, if your health plan offers free smoking-cessation resources and education, make sure your workers know how to access them. The key is to promote the behavioral change, alter the environment and support (not blame) employees. 

In this example, in addition to reducing the risk of back injury by addressing job risks as we would traditionally do, reducing smoking or tobacco use will reduce healthcare costs. In the U.S., annual healthcare cost per smoker ranges from $2,500 to $5,000 depending on the state (view by-state statistics). Showing a positive return on investment by reducing risks and costs through a collaborative TWH approach will demonstrate the value of such initiatives. It will also show how we can apply our skills to reduce broader organizational risks. If you do not have access to aggregate health risk data, this is great opportunity to collaborate with leaders in human resources and other areas.

Just as many of us have worked collaboratively in our organizations or with clients to successfully address COVID-19 risks, TWH is an opportunity for us to be more visible and to use a scientific approach to reduce risk, support leadership and protect employees. Consider this another chance for OSH professionals to shine! 


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