health promotion

The articles in this series are independently researched and compiled by PSA commissioned authors and peer reviewed.

Occupational health and safety

By Claire Greenway

Introduction
Mary comes into the pharmacy for some pain relief for her headaches. She has been getting headaches quite frequently for the last few months. While you are discussing Marys headaches, you find out that she started a new job four months ago working in an office (she previously worked in a newsagency). When she gets home from work in the evening, her neck muscles are often quite tight. Mary also mentions that her computer keyboard doesnt ever seem to be at the right height and she finds herself raising her shoulders as she types. This tends to create a lot of tension in her neck which appears to be related to her headaches.

How does occupational health and safety relate to health promotion in the pharmacy?
According to the World Health Organisation, health promotion is the process of enabling people to increase control over and to improve their health.1 Pharmacists can assist in enabling people to identify health and safety issues relating to their employment and provide advice on ways to change these factors to improve their health. In Australia, the National Occupational Health and Safety (OHS) Strategy lists five priority areas for OHS improvement which focus on: deducing high severity and high incidence risks improving the management of OHS issues preventing occupational disease eliminating hazards using effective design strengthening the influence of the government in relation to OHS outcomes.2 Commonly reported occupational related diseases in Australia include cancer, cardiovascular disease, respiratory disease, musculoskeletal disorders, infectious and parasitic diseases, mental health disorders, contact dermatitis and noise-induced hearing loss.310 Pharmacy is often the first place for consumers to go when seeking treatment for a range of minor ailments. Pharmacists can make a real difference to a patient who presents with a condition related to workplace hazards by helping to identify the issue and devise

strategies to deal with the workplace hazard.

Continuing Professional Development

Occupational health and safety health promotion

Adequate planning for a health promotion strategy is vital for success. The type of pharmacy health promotion activity for occupational health and safety could be focussed on individuals as opposed to community groups or organisations. In planning this type of health promotion activity, a structured approach can ensure the best outcomes.

Analyse the situation

Occupational health and safety issues are the problem you wish to address. Your target audience includes consumers purchasing products for minor ailments which could be related to workplace hazards. In addition to these consumers, a health promotion activity on occupational health and safety could relate to prevention activities such as advising on sun exposure, manual handling techniques and noise reduction. In analysis of the situation, the use of promotional materials and types of promotional materials available should also be considered.11

Learning objectives
After reading this article, pharmacists should be able to: Discuss prevention or early detection of hazards in the workplace Explain risk management and prevention strategies in the workplace Plan a health promotion activity on occupational health and safety. Competencies addressed: 6.1.1, 6.1.2, 6.3.1, 6.3.2, 6.3.3, 8.2.1, 8.6.2

Set goals and objectives

Defining what you are setting out to achieve will enable you to evaluate the effectiveness of your health promotion activity. It is important to set SMART goals which are Specific, Measurable, Achievable, Realistic and Timely.11 A SMART goal related to an occupational health and safety health promotion activity in the pharmacy

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Claire Greenway is a Project Pharmacist working at PSA National office in Canberra.

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health promotion
The articles in this series are independently researched and compiled by PSA commissioned authors and peer reviewed.

could be to develop and implement a health promotion activity for occupational health and safety in the pharmacy. Pharmacy staff could ask specific questions related to identifying occupational health and safety risk of all consumers making a range of symptom based requests for a two week period.

Capacity building
For any health promotion activity to be effective, the staff involved need to be adequately informed and trained.11 In the case of occupational health and safety, staff members will need information and training about risk identification and common workplace hazards. The SMART goal involves pharmacy staff asking specific questions related to occupational health and safety issues and it will be vital to educate the pharmacy staff on the questions to ensure this goal is achievable. It will be necessary for all staff to know the alarm signs in the answers, and the appropriate steps to take when they are identified.

According to the goals, the pharmacy staff will be asking questions that will allow the identification of occupational health and safety risks that could be implicated as the cause of the minor ailment. For this goal to be achievable, it is important to know the hazards or potential complications to look out for. Some workplace hazards that might commonly cause a consumer to present to the pharmacy are listed in Table 1. After the hazard has been identified, pharmacists can advise people on steps to be taken to reduce the risk associated with the hazard. Office workers who regularly visit the pharmacy for over-the-counter analgesics may require changes to their workstation set up and design to enable them to continue to work productively and effectively. Inappropriate lighting can be identified as a potential cause of problems and steps taken to reduce the impact. Pharmacists can assist patients suffering from contact dermatitis to identify the chemical irritant and provide advice on ways to avoid or manage the irritant in the future. Prevention of workplace hazards and risks can yield significant benefits and reduce the incidence of work related compensation claims.6 Some cases of bodily stress can be avoided by appropriate manual handling procedures. Prevention activities for sun exposure can involve giving advice on the use of sunscreens and protective clothing. Sedentary work practices can be a factor in increasing risk of cardiovascular disease. A simple way to minimise

risk in this area is to encourage regular breaks from sedentary activities. This could involve walking around the office or performing short sequences of activities such as squats and lunges. The message for this activity that you are hoping to promote is the awareness of occupational health and safety issues, how they can impact on health, and ways they can be managed. Safe work Australia can provide further advice on ways to manage and prevent occupational hazards and also provides information about additional workplace hazards (visit: www.safeworkaustralia. gov.au/swa).

Continuing Professional Development

Implementation
Now is the time to put the plan into action. Start by displaying the applicable promotional material in the pharmacy to raise the awareness of the consumers in your pharmacy and set about achieving your goal of asking questions designed for risk identification for occupational health and safety. Use the opportunities presented to assess levels of risk in the consumers and provide advice on minimising risk.

Planning
This stage of the planning process is about getting down to the most basic elements of your health promotion activity to determine how you will raise awareness of this issue and any additional support you may need. You will need to determine the key messages you are hoping to disseminate through your health promotion and ensure it is consistent with the messages consumers may receive from other health professionals.11

Evaluation
It is important to evaluate all health promotion activities in the pharmacy to determine if the set goals have been achieved. This may allow you to refine your plan to achieve better outcomes for your next activity. Ask all involved staff members to evaluate their performance against the set goals to determine the overall success. Some things to consider in your evaluation of this health promotion activity: Were all consumers presenting with symptom based requests asked specific questions aimed at identifying occupational health and safety risk? If not all, what percentages (approximate) of consumers were asked? Were the questions asked appropriate to enable the staff member to identify risk? Were the consumers receptive to the questions being asked? How many consumers were identified as having occupational health and safety risks associated with the condition for which they were seeking treatment/advice?

Table 1. Workplace hazards310

Hazard
Heavy backpacks Sun exposure Sub-optimal office workstations Inappropriate lighting Sedentary work Noise-induced hearing loss Body stressing Chemical exposure

Potential complication
Headaches, back aches Sunburn, skin cancer Headaches, neck and back tension Headaches, seizures Cardiovascular disease, obesity Irreversible hearing loss Muscle strains Contact dermatitis

Who might be affected

School children, students Builders, construction workers, road workers Office workers Office workers, retail, factory workers Office workers Labourers, tradespersons, transport workers Labourers, tradespersons Hairdressers, registered nurses, chefs, mechanics, cleaners

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Submit your answers online at www.psa.org.au and receive automatic feedback

Figure 1. The health promotion planning cycle.

Analyse the situation

Identify the problem Target audience Promotional materials

her headaches with her employer and mention they may be due to her workstation set up. In the meantime, Mary could also consider seeing a physiotherapist to assist with the tension in her neck. Mary comes back in to see you a few weeks later. Her employer has invited an occupational health and safety assessor into the workplace to observe Mary at her workstation and provide advice on improvements that can be made. Following the redesign of her workstation, Mary has not had any further headaches.

Set goals and objectives Evaluation

Determine what worked well Work out how to do it better next time

Specific Measurable Achievable Realistic Timely

References
1. World Health Organisation. Health promotion. [Online, cited 17 Nov 2009]. At: www.wpro.who.int/ health_topics/health_promotion/ 2. Australian Safety and Compensation Council. National OHS Strategy 20022012. Canberra: Commonwealth of Australia; 2002. 3. Australian Safety and Compensation Council. Occupational cancer in Australia. Canberra: Commonwealth of Australia; 2006. 4. Australian Safety and Compensation Council. Work-related cardio-vascular disease in Australia. Canberra: Commonwealth of Australia; 2006. 5. Australian Safety and Compensation Council. Occupational respiratory diseases in Australia. Canberra: Commonwealth of Australia; 2006. 6. Australian Safety and Compensation Council. Work-related musculoskeletal disease in Australia. Canberra: Commonwealth of Australia; 2006. 7. Australian Safety and Compensation Council. Work-related infectious and parasitic diseases in Australia. Canberra: Commonwealth of Australia; 2006. 8. Australian Safety and Compensation Council. Work-related mental disorders in Australia. Canberra: Commonwealth of Australia; 2006. 9. Australian Safety and Compensation Council. Occupational contact dermatitis in Australia. Canberra: Commonwealth of Australia; 2006. 10. Australian Safety and Compensation Council. Work-related noise induced hearing loss in Australia. Canberra: Commonwealth of Australia; 2006. 11. Egger G, Spark R, Donovan R. Health promotion strategies and methods. 2nd ed. Sydney (NSW): McGraw Hill; 2005.

Continuing Professional Development

Capacity building Implementation

Putting the plan into action Display promotional materials Work to achieve goals

Increasing the capacity of the pharmacys workforce to implement a specific health promotion activity Staff training

Planning

Determine the message Getting the message across Achieving the goals Seek additional support

The steps in this cycle can be used in planning a health promotion activity on any topic. Were the consumers identified as having occupational health and safety risks dealt with according to the information and training provided to the staff members? With the answers to these questions in mind, you can now determine what would need to be done to make this activity more effective for next time. As part of your health promotion activity, you have identified that Marys headaches are probably tension headaches due to her sub-optimal office workstation. This is of great relief for Mary as she was getting quite concerned that her headaches had become quite frequent. You advise Mary to discuss

Questions
1. Capacity building in relation to health promotion involves:
a) b) c) d) setting goals. developing promotional materials. identifying the target audience. training staff.

A score of 3 out of 4 attracts three quarters of a credit point.

b) Discuss the workstation set up with your employer. c) Consider changing careers to eliminate the problem. d) See a physiotherapist to address neck tension.

4. Implementation of a health promotion activity involves:

a) setting goals. b) capacity building. c) working towards achieving your goals. d) determining your target audience.

2. What sort of advice is least appropriate to give to a patient suffering from headaches due to workstation set up?
a) Take two paracetamol 500 mg tablets every four hours as necessary (up to 4 g per day maximum).

3. Which of the following is least likely to be an occupational cause of headache?

a) b) c) d) Inappropriate lighting. Sedentary work. Heavy backpacks. Sub-optimal workstations.

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