Australian & NZ Society of Occupational Medicine

Associate Labour Minister Ruth Dyson
Address to the joint annual conference of the Australian & NZ Society of Occupational medicine and the Aviation Medical Society of Australia & NZ
Millenium Hotel, Christchurch
8.00am, Friday, 24 September 2004

Rau rangatira maa,
tenei te mihi ki a koutou i runga i te kaupapa o te ra.
Tena koutou, tena koutou, tena koutou katoa.

[Distinguished guests, greetings to you gathered here for this purpose today. Greetings once, twice, three times to you all.]

Thank you for the invitation to speak to you today. Greetings to you all – and particularly warm greetings to our overseas guests. It is a pleasure to have you in New Zealand. I want to also acknowledge the many other speakers who are presenting at your conference.

I value this opportunity to discuss with you the Government’s increased focus on occupational health, some of the key issues developments.

Having responsibility for ACC as well as OSH, I am very aware that when it comes to occupational safety and health, the emphasis in New Zealand has long been on safety. We are not alone in this: the focus on occupational safety ahead of occupational health is an international phenomenon.
Those responsible for workplace health and safety are inclined to focus their resources on occupational injury because the effects are more immediate and obvious than occupational disease. Given the suddenness of injury events, their link to work activity is generally clear-cut. The sequence of events can be investigated and action to prevent a recurrence is much easier to establish.
Occupational health issues, however, often present greater challenges. The link to work may be less obvious or harder to prove. The effects might not be felt until after the person has moved on to a different job, or they may only show up after people have retired from paid work. But this difficulty in addressing the issues should not stop us from facing up to the challenge of occupational health.

National Occupational Health and Safety Advisory Committee (NOHSAC)
Recognising that occupational health needs to be made a higher priority, this Government established the National Occupational Health and Safety Advisory Committee. NOHSAC is an independent committee responsible for providing independent advice directly to the Minister of Labour on major occupational health and safety issues in New Zealand.
NOHSAC will increasingly play a key role in providing an independent assessment of the measures that will deliver the greatest benefit for the prevention of occupational injury and disease. It will also work to develop an evidence-based approach to occupational health and safety issues. $3.1 million dollars was announced in funding for NOHSAC in the 2004 Budget to enable this research.
The first report from NOHSAC, into the burden of occupational injury and illness in New Zealand, is due for release next month. Those like yourselves who know the field well expect the report will show that the burden of occupational illness is many times greater than the burden of injury.

Around 110 to 120 workplace deaths resulting from injury are recorded each year. Many commentators have suggested the entire figure for work-related illness fatalities is around 400-500 per year, and I suspect that the estimates in the NOHSAC report may exceed even this figure.
The good news about the NOHSAC report is that for the first time we will have a credible fix on the size of the problem. Unfortunately I also expect that this will be news that will be hard for New Zealand society to come to grips with. It may be, after all, a burden far greater than the annual road toll.
One thing the NOHSAC report will certainly make very clear is that the vast majority of work-related deaths in New Zealand are due to occupational disease rather than injury.
The fact that credible data on such a serious issue is not readily available is another issue the committee is to address. The second report from NOHSAC will be a thorough and critical review of methods and systems used to measure and monitor occupational disease and injury in New Zealand.
Health Outcomes International have been contracted to produce the report and the work is well underway. It is due for release in March next year.
NOHSAC’s reports should help drive a greater focus on occupational health outcomes, with particular emphasis on better policy development and information provision.
UK experience
Some of the issues New Zealand faces in occupational health are parallel to overseas experience. A July 2004 report by the UK House of Commons Work and Pensions Committee noted five challenges in relation to the occupational health work of the Health and Safety Commission (HSC) and Health and Safety Executive (HSE).
ØInadequacies in the data on the extent and nature of occupational ill-health.
ØThe need to tackle emerging risks such as those associated with passive smoking and occupational stress.
ØReductions in the government agency’s in-house expertise in occupational ill-health, thus raising questions about its capacity to show leadership on the issue.
ØLack of proactive enforcement action with regard to occupational health issues.
ØInadequate resourcing for occupational health work.
This report noted that health issues are more difficult than safety issues to deal with through legislation or compliance action. Partly as a result of this, the European Union is exploring the use of non-regulatory mechanisms as a means of making progress on workplace health and safety in the future.
Non-regulatory mechanisms include awareness raising and social dialogue, voluntary partnership agreements, development of health and safety skills, financial incentives and procurement policies.
These are exactly the type of initiatives that New Zealand needs to take to address our own occupational health issues. It is hoped that the work of NOHSAC, by showing the heavy toll exacted by occupational ill health, will help motivate all sectors of society to address workplace health issues more effectively.
The Government in general, and the Department of Labour in particular, will be leading this move to more effectively address the issue of occupational health.
Workplace Health and Safety Strategy
One way that the government will address these matters is to focus New Zealand’s collective efforts more strategically. The Workplace Health and Safety Strategy for New Zealand to 2015 provides a common vision for everyone with an interest in the wellbeing of workers: from specialists like the members of your societies, to government agencies, employers and members of the workforce.
A draft of the strategy, which is now undergoing public consultation, includes the long-term goals of developing stronger:
ØWorkplace quality culture
ØIndustry and community engagement; and
ØGovernment leadership and practice
There are also medium-term aims towards meeting those objectives.
The medium-term aims in developing a Workplace Quality Culture are that business owners and managers recognise the value of health and safety, managers are committed to the systematic management of risks, and workers participate in improving health and safety.
To achieve Industry and Community Engagement in the medium term will involve industry partnerships and networks sharing best practice, greater community awareness of the human impact of health and safety issues, and leaders promoting health and safety to their networks and communities.
Achieving the best possible Government Leadership and Practice will depend on agencies and different levels of government coordinating their activities, setting high expectations as an employer and purchaser, and demonstrating improvements in their own health and safety practices.
As well as identifying the strategic approaches that will achieve the greatest gains, the strategy also identifies the key occupational health issues facing New Zealand. These priorities are:
ØAirborne substances
ØManual handling, and
ØPsychosocial factors.
Airborne substances include fumes, dusts, gases, mists and vapours that cause cancers, respiratory diseases including occupational asthma, and other illnesses. Specific examples in the workplace include asbestos, wood dust, solvents and environmental tobacco smoke.
Manual handling work accounts for a large proportion of ACC claims for work-related injury and illness.
Psychosocial factors can affect a worker’s psychological response to their work and workplace conditions. Issues that need to be addressed include high workloads, bullying and violence at work. These can lead to stress-related disorders and drug dependence. They are likely to need priority attention, given changing patterns in labour participation, work organisation and technology.
In safety-critical industries such as transport, the safety implications of impairment caused by psychosocial factors extend beyond the workforce to impact on the travelling public as well.
The three priorities of the Workplace Health and Safety Strategy represent a mix of “traditional” and “emerging” health issues which require different intervention approaches.
For example, airborne substances can be addressed through the elimination and substitution of substances and the use of respiratory protective equipment. Manual handling is best dealt with through work design and engineering controls. Psychosocial factors will need to be addressed through a range of measures including more socially-based interventions.
The transport industry in general, and the aviation industry in particular, have been leaders in assessing and managing the risks of impairment, whether it is caused by psychosocial factors, physical ill health, or the effect of drugs, alcohol, or medication. As New Zealand looks to address these issues in a wide range of industries, the transport industry will be able to provide leadership and pass on its knowledge, experience, and international networks.
This strategy is part of the New Zealand Injury Prevention Strategy, released by the Government last year, and will make a valuable contribution to the broader strategy’s vision of a “safer New Zealand, becoming injury free”.

The strategy also contributes to wider government goals, particularly for:
Øreducing inequalities in health, education, employment and housing; and
Ø the development of an inclusive, innovative economy for the benefit of all.
OSH’s fatigue and shiftwork guidelines
Earlier this year, OSH released for comment two draft guidelines: Healthy Work: A systematic framework for managing shiftwork and Healthy Work: Basic information for employers and employees about sleep and fatigue – and the consequences for managing shiftwork.
The feedback on these documents is being incorporated into final guidelines, which are expected to be published early next year.
Since the amendment of the Health and Safety Act in May 2003, the Civil Aviation Authority has been designated to administer the Health and Safety in Employment Act for work on board aircraft, and for aircraft as places of work while in operation. The Maritime Safety Authority has a similar designation for vessels at sea.
As the impacts of shiftwork are particularly relevant to the transport sector, it is appropriate that these guidelines will be jointly published by OSH, the Maritime Safety Authority, and the Civil Aviation Authority.
The future of occupational health
The higher profile for occupational health that will result from the work of NOHSAC is an opportunity for everyone to ensure that occupational health issues get more attention, both now and in the future.
I know that there is some unease about the current restructuring of the Department of Labour, particularly around how this might weaken the identity of OSH. I can assure you, however, that as Minister I want to see occupational health and safety services strengthened, not diminished. And I want to see more occupational health practitioners employed in the field.
The sense of urgency that the NOHSAC report is likely to foster should provide extra impetus for the aviation industry to build on the good work you’ve already done.
The issues of fatigue, stress, shiftwork, and the effects of impairment have been familiar to you for many years, as general safety issues as much as issues of occupational health.
An industry that is “ahead of the game” like aviation will clearly be a valuable resource for those employers and agencies who may only be beginning to look at these questions.

As government agencies increase the focus on – and funding for – occupational health research, they will be looking to work alongside industry leaders and specialists like yourselves, to undertake research and identify emerging issues.
While the impact of workplace injury may grab the headlines and capture the imagination of the public, specialists in occupational medicine will view the findings of NOHSAC’s report as no surprise. An increasing emphasis on research and monitoring of occupational health should help practitioners like yourselves validate with data the trends you have observed in your professional practice.
The impact of occupational disease will never be simple to quantify, nor the responsibility easy to sheet home, but with more funding for research, and more commitment to acting on the results, New Zealand should be able to reduce the ill health caused by work.
In closing, I would like to congratulate your two societies for organising a highly informative programme over the next three days, with the opportunity to discuss international research developments, raise relevant issues, engage in networking and to be stimulated and inspired.

I am sure that through events such as this, and through your continuing efforts throughout the year, your partnerships and opportunities for developing skills and services will grow from strength to strength for the great benefit of the entire workforce.