Canadian Safety Reporter

3 Canadian HR Reporter, a Thomson Reuters business 2018 News | February 2018 | CSR Reducing the risk of impaired employees with Occupational Health Nurses Occupational Health Nurses on staff can help employers deal effectively with legal and safety issues caused by impairment, regardless of its cause BY DIANNE DYCK "MANY EMPLOYEES are hard-pressed to swear that they have never been at work and im- paired." No doubt, this statement will raise eyebrows, but think about it: Impairment is experi- encing a diminished, reduced, or damaged state of being. It stems from a disease state, injury, or substance-related condition. Yet, there are more sources. Impairment is a problem in body function or structure. The World Health Organization terms it an activity-limitation — a difficulty encountered when executing a task or action — while a participation-restriction is a problem in life situations. This broader definition encom- passes traditional sources of impairment along with other sources such as fatigue, shift- work, medication, medication interactions, and aging. Disease state Illness/injury can result in em- ployee disability and manifest as activity-impairment or partic- ipation-restriction. Employees absent from the workplace, or functioning in a reduced capac- ity, offer reduced productivity. Presenteeism denotes em- ployee presence at work, but reduced productivity due to fa- tigue, illness, injury or psycho- logical disturbances. Presentee- ism has been reported to cost nine times the cost of employee absenteeism (Aldana, 2009). Substance-induced state Employees can be working but still be functionally incapaci- tated. Impairment varies with substance properties, dosage, user gender and age, length and time since use, tolerance level, or the nature of the activity. Ac- tivities involving concentration, fine motor skills, information processing, deductive reason- ing, quick response time, and memory are the most impacted. Many people work two or more jobs. Our society is sleep- deprived: "Canada is the third- most sleep-deprived country, with nearly a third (31 per cent) of Canadians feeling like they don't sleep enough" (Avia, 2016). This is a problem, as fatigue is associated with functional and cognitive impairment such as vigilance, cognitive perfor- mance, memory, problem- solving, planning, and verbal fluency deficits which can cause workplace incidents. Employee productivity, attention to de- tail, learning, and creativity are reduced. Shiftwork alters work- ers' circadian rhythm and sleep, negatively impacting alertness, decision-making, recall, and re- sponse time. Diminished capacity state With 20 per cent of full-time workers over 60, employers are witnessing the effects of aging: • Increased morbidity due to sleep deprivation, chronic health conditions, increased use of medication • Functional inability to undertake previous job tasks. Older workers are likely to experience vision, hearing, mus- cle-strength, mobility, motor- performance, fine-motor-skill, perceptual-ability, and response- time changes, along with sleep changes and cognitive declines. Risk management: Risk management involves mak- ing and implementing decisions to minimize adverse effects of accidental and business losses. It is the systematic application of planning, organizing, leading, and controlling functions to: • Anticipate and identify accidental loss exposures • Evaluate the related risk • Work to avoid or eliminate hazards • Attain acceptable level of risk. Risk is a state in which losses are possible. In disability man- agement, the risks to Cana- dian employers include high employee-absence rates, legal obligations, financial losses, and thwarted societal expectations. The legislation impacting and influencing disability manage- ment are human rights legisla- tion, workers' compensation acts, privacy legislation, occu- pational health and safety (OHS) legislation, employment Stan- dards, and labour law. Permanent disability puts em- ployees at risk for withdrawal from the workforce and pre- mature death (Scott-Marshall, 2015). This is a human capital loss. Financial risks stem from losses the employer faces when an employee is medically absent – lost productivity, business in- terruption costs, disability claim costs, supplementary healthcare costs, worker replacement costs, time lost in rearranging work schedules, and increased insur- ance premium rates. Each year, full-time Canadian employees miss, on average, 7.8 workdays due to medical reasons and 1.7 days due to family reasons. Those 9.5 days cost employers $2,117.36 per employee. Societal expectations ema- nate from Canada's strong "so- cial conscience." Employers are expected to "do the right thing" for employees; if perceived to fail, their corporate image and reputation suffers. Risk management is the re- sponsibility of organizational leaders. They decide their "risk appetite," preferred system for risk control, and how to enact stakeholder accountability. Occupational health nurses (OHNs) are involved in risk management situations and dai- ly provide risk communications. Occupational health (OH) pro- grams and disability manage- ment programs (DMPs) are risk management tools: they are hu- man resource "risk management approaches" aimed at promot- ing employee well-being, pre- venting illness and injury, and mitigating medical costs. They preserve human capital. OH nursing is risk manage- ment operationalized. Synony- mous with every aspect of an Occupational Health and Safety Management System, OH nurs- ing minimizes the costs of risk. It is an administrative, manage- rial function like standard OHS hazard identification and loss- control, but more sophisticated and focused on potential risk. A DMP serves a risk manage- ment function; it controls the human and economic costs of injury and illness, conveys a mes- sage that employees are valued, and demonstrates legislative compliance. It is a risk manage- ment and risk-communication approach designed to integrate corporate resources, minimize associated losses and costs, and prevent future occurrences. Managing employee impairment Employee impairment is con- cerning. Organizations should combine risk management ap- proaches – uphold the legal duty of providing a safe and healthy workplace while meeting busi- ness strategies and obligations. Employers must have policies and procedures to address im- pairment situations – an OHS policy and program; safe work procedures; and enforcement. Employers need to ensure the health impacts of work condi- tions like work hours, demands, pace, shiftwork, and travel re- quirements, are evaluated. If deemed hazardous, employers must remedy the situation and adequate resources and exper- tise must exist to identify and manage employee impairment. OHNs can help, as they are qualified to undertake the man- agement of employee impair- ment by: • Ensuring employees are fit to work OHNs > pg. 7

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