The United States healthy company model: Total Worker Health

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The WHO has popularized the concept of the Healthy Workplace through their very interesting model published in 2010 which should be on the compulsory reading list in business schools.

The model defines the “healthy workplace ” in the following way: “A healthy workplace is one in which workers and managers collaborate to use a continual improvement process to
protect and promote the health, safety and well-being of
all workers and the sustainability of the workplace by considering the following:

  • Health and safety concerns in the physical work environment.
  • Health, safety and well-being concerns in the psychosocial work environment, including organization of work and workplace culture.
  • Personal health resources in the workplace, and
  • Ways of participating in the community to improve the health of workers, their families and other members of  the community”.

From this initial outline models have emerged regarding the healthy workplace, or management systems for the healthy business: AENORARL SURA, or Total Worker Health, created by NIOSH (National Institute for Occupational Safety and Health) in the United States, among others.

Total Worker Health

Last summer, at the XX World Congress on Safety and Health at Work held in Frankfurt, we had the opportunity to attend the conference given by the head of the project, Dr. L. Casey Chosewood. In the documentation sectionon the world congress website you can access, following registry, one of the videos of Dr. Chosewood’s conferences, together with the powerpoint presentation of the same. If time is short, you can find a short summary and highlights from the presentation here.

What is Total Worker Health™?

It is a strategy which integrates occupational safety with the promotion of health in order to prevent injury and illness in workers and to improve their health and well-being.

How did it come about?

Recent studies have shown that both work-related factors and medical factors unconnected with the workplace jointly impact many of the problems of safety and health faced by workers and their families. Traditionally the programs of safety and health in the workplace have been dealt with separately. Prevention of occupational risk programs have focused essentially on safety; on reducing the exposure of the worker to risk factors originating from the workplace itself. The majority of the programs to promote health in the workplace have focused exclusively on lifestyle factors outside work which place the worker at risk. But both these areas are wholly connected. It is useless to protect the employee from noise in the workplace if on the way home from work AC/DC is coming through the headphones at full volume. That employee has not understood that noise is bad for health; not only the noise from the factory in which s/he works. Nor is it much use working on the promotion of healthy habits in the company, if on leaving work we munch our way through a belly-pork sandwich. The relationship between working life and personal life is closely linked, and there is a growing volume of scientific information backing the effectiveness of combining workplace interventions which integrate health protection programs with health promotion programs.

In the USA there is shocking annual date with respect to illness:


And the main causes of death are the result of bad habits in relation to health: a sedentary lifestyle, stress, poor diet, smoking, etc. The image of a person walking the dog while sitting comfortably in the car is especially significant:


For all these reasons in June 2011 NIOSH launched their Total Health Worker™ program as part of the Steps to a Healthier US initiative. Workforce and WorkLife.

What is it based on?

The following table provides us with a summary of the main themes regarding the integration of occupational safety and health protection with health promotion. The items which appear on it are an example which serves as an illustration of the variety of issues relating to work which have the potential to affect health, and which must be taken into account when devising strategies for activities which integrate protection and promotion of health (translation into Spanish):


Examples of interventions based on the TWH™ program: 

  • The provision of obligatory breathing protection programs which address giving up smoking, and which at the same time support efforts in an integrated way.
  • Integrated ergonomic consultations which include strategies for the protection of joints, and strategies for the prevention and management of arthritis.
  • Periodical meetings between the authorities and safety, occupational health and health promotion personnel which include the combination of the functions of the committees on safety, health and/or sustainability within a single body, either intermittently or permanently.
  • The development of initiatives for the control of stress which in the first place try to reduce stress factors in the workplace, and only as a second step focus on increasing resilience in the workers.
  • The carrying out of programs of training and prevention in order to offset the risks and dangers faced by workers, both in and out of work. Issues could include fall prevention, safety of motor vehicles, first aid, hearing conservation, stretching and flexibility exercises, back care/ safe lifting, eye protection, greater safety in the workplace regarding chemical products, and weight control.
  • The carrying out of integral examinations for detection in the workplace of work and non-work health risks.
  • The exploration of models which combine occupational health services with first aid in the workplace.
  • Achieving the total integration of the traditional safety programs, occupational health clinics, healthy behaviour, health promotion programs, practical training, employee assistance programs (EAP) , diet, disability and compensation for workers through strategic alignment, structures for the presentation of joint reports or common sources of finance.

In this good practice compendium there is further information, together with a new post which this week offers a monograph on the  PrevenControl visit to Harvard.



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