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Promoting Health at Work in Switzerland: the Friendly Work Space Project
MATTIG, Thomas, CHASTONAY, Philippe
MATTIG, Thomas, CHASTONAY, Philippe. Promoting Health at Work in Switzerland: the
Friendly Work Space Project. Primary Health Care Research & Development , 2016, vol. 1, no. 3, p. 1017
Available at:
http://archive-ouverte.unige.ch/unige:89226
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*Corresponding author
Thomas Mattig, Health Promotion Switzerland, Ave de la Gare 52, 1003 Lausanne, Switzerland, Tel: 41-21-345-15- 15; Email:
Submitted: 26 September 2016 Accepted: 18 October 2016 Published: 20 October 2016 Copyright
© 2016 Mattig et al.
OPEN ACCESS Keywords
• Work health promotion
• Prevention
• Corporate health management
Case Report
Promoting Health at Work in Switzerland: The Friendly Work Space Project
Thomas Mattig1* and Philippe Chastonay2
1Institute of Global Health, University of Geneva, Switzerland
2Department of Medicine, University of Fribourg, Switzerland
Abstract
The working environment as a potential generator of disease has been well documented over time. Despite national programs in many countries, it still remains a problem worldwide. This has urged the World Health Organization to call for urgent global action.
In Switzerland, a federal State of 26 mostly independent cantons in health and education matters, a national foundation devoted to health promotion and its coordination nationwide, has been established by law in the late 1990ies: Health Promotion Switzerland. One of the major projects of the Foundation is the “Label Friendly Work Space” Project. The aim of the project is to incite companies to implement successful corporate health management for the health benefit of their employees and possibly increased productivity.
In order to obtain the label companies have to go first through a self-assessment responding to a series of quality criteria. Second, external independent experts evaluate whether the company meets those criteria and has adopted a work health management approach.
The attribution of the label will ensure both that employees will benefit from health promotion programs (fitness, stress management, etc.) and that the company considers the reorganization of the working processes and conditions, in order to allow better personal development and job control of the employees, thus contributing to their mental and physical health. This is in correspondence with the Luxembourg Declaration on Workplace Health Promotion.
At present, 61companies, mostly major companies, have obtained the label Friendly Work Space. This represents 200,000 employees, who enjoy optimized working conditions hopefully with a beneficial effect on their health.
A future challenge will be the development of partnerships with SMEs, since SMEs are the biggest employers in the country.
INTRODUCTION
For the World Health Organization (WHO) the workplace is a “priority setting for health promotion” [1]. Indeed, it is well established that the workplace directly influences the physical and mental health of workers, which in turn affects the well- being of their families and communities at large [2-5]. Health promotion in the workplace, as the International Labour Office (ILO) has suggested, “Complements occupational safety and health measures” and should be a “combined effort of employers, workers and national authorities” [6]. ILO has developed an interactive educational program (SOLVE) which focuses on integrating health promotion into occupational health and safety policies. The program is based on “the relationship between psychosocial factors and other health related behaviours and their underlying causes in the workplace, such as work organization, working conditions and labour relations” [7]. The SOLVE package
includes at present several topics (stress, violence, tobacco, alcohol and drugs, nutrition, physical activity, healthy sleep and HIV/AIDS) and has been adopted throughout the world [7].
The concept of the health promoting workplace can represent a win-win approach for employers, employees and health authorities: indeed, it can respond to health needs of workers and to organisational targets of companies, thus contributing to the social and economic development of communities [6].
In Europe the Luxembourg Declaration has set the stage regarding health promotion at the workplace: “Workplace Health Promotion (WHP) is the combined efforts of employers, employees and society to improve the health and well-being of people at work. This can be achieved through a combination of improving the work organisation and the working environment, promoting active participation and encouraging personal development” [8].
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In Switzerland, a federal State of 26 mostly independent cantons in health and education matters, a national foundation devoted to health promotion and its coordination nationwide, has been established by law in the late 1990ies: Health Promotion Switzerland [9]. One of the major projects of the Foundation is the “Label Friendly Work Space” Project. The aim of the project is to incite companies to implement successful health management in their enterprise for the health benefit their employees and possibly increased productivity [10]. Our paper presents the project how it was conceived and how it is implemented.
METHODS
In order to obtain the label Friendly Work Space companies have to take different steps, ultimately adopting a corporate health management approach according to Quality Criteria of the European Network of Work Health Promotion[11], slightly adapted to the Swiss Context by Health Promotion Switzerland in collaboration with partners companies[12]:
• Step 1: Internal evaluation (self-assessment) according to
the above mentioned quality criteria: Table 1 summarizes those criteria.
• Furthermore the tool “Check-WHP” supports companies in identifying their strengths and potential for improvement [13]. In the process employees also have the opportunity to test their own level of stress using a specific stress measuring tool, the S-tool [14], allowing the companies to establish a Job Stress Index [15] providing them with information on work related stress and its impact on health and productivity.
• Step 2: External evaluation: External and independent experts evaluate whether the company meets those criteria and has adopted a work health management approach as well at the strategic level of the company as on a daily basis.
• Step 3: Attribution of the label “Friendly Work Space”:
After a positive assessment, the company will be awarded the Friendly Work Space label. Companies that do not obtain the required average may obtain the intermediate
Table 1: Quality Criteria of Work Health Management.
Criterion 1:
Workplace Health Management and Corporate Policy
Corporate philosophy: WHM has been integrated into the corporate strategy Resources: Resources are available for WHM
Management review: Top management checks on a regular basis the implementation of WHM Continuing education: Health topics are integrated into training modules for employees and top management
Health-related infrastructure: Employees have access to health relevant infrastructure and offers Criterion 2:
Aspects of Human Resources and Work
Organisation
Skills of employees and health conditions: Employees have the opportunity to acquire the needed work and health skills Quantitative or qualitative over- and under-load: Tasks are organized in a way there is no under- nor overload
Development opportunities: Specific organizational measures allow personal development of employees Participation: Employees have the opportunity to contribute actively to solve identified health challenges at the workplace Support of employees and promotion of an appropriate work environment: the top management makes sure there is a good
work environment
Dealing with absenteeism and reintegration measures: the company cares about sick and injured employees and is supportive of their reintegration
Family-friendly work and organizational structures: the company supports measures insuring compatibility between work and family life
Prevention: the company supports preventive interventions in various fields, such as alcohol, tobacco, drugs, mobbing, sexual harassment
Criterion 3:
Planning of Work Health Management
(WHM)
WHM :a WHM coordination structure has to be put in place including persons in charge of health issues in the company WHM goals: WHM targets contribute to the strategic an operational goals of the company
WHM communication: employees are informed of the WHM goals Criterion 4:
Social Responsibility Employees with a handicap: the company offers working opportunities to people living with a handicap Community involvement: the company supports social, cultural and health promoting initiatives in the community
Environmental protection: the company takes measures to avoid harmful effects on humans and the environment Criterion 5:
�Implementation of Work Health Management (WHM)
Survey of actual situation: WHM measures are based on relevant health data collected periodically Analysis of actual situation: WHM priorities are set on the basis of the collected data
Objectives and Target Groups: each WHM measure fixes precise objectives and identifies specific target groups Action implementation: the implementation of measures is checked on a regular basis
Criterion 6:
Overall Evaluation of Work Health Management (WHM)
Evaluation data: The effect of WHM must be assessed based on evaluation parameters from the following fields: Health related indicators and dimensions; Occupational Health and Safety precautions; economic factors such as productivity, cost-
effectiveness, customer satisfaction
Evaluation Procedure: Evaluation procedures and time frame have to be clearly defined; Results must be documented;
Consequences should be drawn from the evaluation
label “Committed to Friendly Work Space”. Continuous training modules on WHP are proposed by the Foundation to the companies. A re-evaluation (and possibly renewal of the label) is scheduled every three years.
RESULTS AND DISCUSSION
The Friendly Work Space label is awarded to companies that implement the WHM with success. The online analysis tool S-Tool provides companies with a detailed overview of resources and constraints experienced by employees; it allows the companies to plan targeted measures and implement them. The tool Check WHP supports companies in identifying their strengths and potential for improvement. The Job Stress Index provides them with key figures that highlight the impact of stress related to work on health and productivity of employees. Incidentally, the yearly Job Stress Index Survey realized in 2016 in Switzerland showed that every fourth employee (25.4%) experiences stress at work i.e. is confronted to more workload than available resources at work.
Continuous training modules allow specialists and managers to acquire practical knowledge of WHP. At present, 61 companies, mostly major companies, have obtained the label Friendly Work Space. This represents 200,000 employees that enjoy optimized working conditions, hopefully with a beneficial effect on their health. In 2015 for example 40 companies have used the S-Tool in order to better understand the working conditions increasing the stress level of employees and to improve the situation. A recent study among 8 companies gone through the process and representing 3000 employees showed that 25% of employees reported to be less stressed at work, a reduction of missing days of employees (2.6 days/year/employee), less productivity loss (approximately 8’000 USD/year/employee) [16]. Furthermore it has been reported that the cost / benefit is in a 1: 5 ration, which means that 1 invested dollar yields a profit of 5 dollars [17].
That working conditions affect the health of workers is hardly contested. Indeed robust data exist showing the negative effect on health (and productivity) of deleterious working conditions:
one might for example mention the early work of Siegrist [18]
underlining the importance of adverse health effects of high- effort/low-reward working conditions on cardio-vascular risk factors and cardio-vascular disease. One might also mention the work of numerous other researchers, such as Fletcher’s et al., work on the cumulative effects of job characteristics on health [19], especially affecting women and older workers. It has also been reported that unsatisfactory working conditions negatively affect productivity [20], poor health of employees represent 2.6%
of the total human capital costs of a company [21], whereas a 10%
increase in well-being score is associated with a 4% higher self- reported job performance [21]. ILO has estimated that the costs related to injury, illness and death at the workplace represents 4% of the annual global GDP [22].
Health promotion interventions at the workplace often suffer from lack of appropriate evaluation. Yet in a recent systematic review of randomized intervention trials Groeneveld et al., report that there is “strong evidence for the effectiveness of workplace lifestyle-based interventions on body fat and, in populations at risk for CVD, body weight” [23]. However, in a review of meta- analysis, systematic reviews and peer-reviewed articles Goldberg and Ahrens come to the conclusion that “singular interventions
showed limited effectiveness; greatest results are achievable through comprehensive multimodal (or systemic) programs including relational and behavioural elements” [24].
When considering more specifically stress reduction programs to be implemented at the workplace, there is some debate: indeed, while McCraty et al., report “brief workplace stress management intervention can produce clinically significant reductions in BP and improve emotional health among hypertensive employees” [25], Murphy, in a literature review back in 1996,considers that “the large number of different stress-management techniques coupled with the wide range of health outcome measures used in stress intervention studies makes it difficult to draw firm conclusions about the efficacy of each technique and each outcome” and calls for a combination of approaches [26]. At present, the importance of inappropriate job organization appears as a crucial risk factor of the workers’
health [27]: indeed, long and irregular working hours for example have been associated with increased health problems [26]; so has downsizing of the company [29] or low job control of the workers[30]. Goh et al., in a recent meta-analysis of 228 studies assessing the effect of work stressors on health outcomes reported “that job insecurity increases the odds of reporting poor health by about 50%, high job demands raise the odds of having a physician-diagnosed illness by 35%, and long work hours increase mortality by almost 20%”[31].
CONCLUSIONS
The attribution of the label Friendly Work Space will ensure both that employees will benefit from health promotion programs (fitness, stress management, etc.) and that the company considers the reorganization of the working processes and conditions, in order to allow better personal development and job control of the employees, thus contributing to their mental and physical health.
This is in correspondence with the Luxembourg Declaration on Workplace Health Promotion. Such an approach of occupational health and safety is closely linked to the notion of sustainability, as argued by some authors [32].
Since Small and Middle Enterprises (SMEs)s are the biggest employers in the country, a future challenge will be the development of partnerships with SMEs, as already seen in some countries [33], despite some difficulties related to their smaller size [34].
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Mattig T, Chastonay P (2016) Promoting Health at Work in Switzerland: The Friendly Work Space Project. JSM Health Educ Prim Health Care 1(3): 1017.
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