Promoting Safety and Health in the Workplace

1. PromotingSafety and Healthin the Workplace - CONTACT CENTER -

2. Occupational Safety and Health encompasses the social, mental and physical well-being of workers, that is the �whole person�

3. Lesson 1. Learn from the past and prepare for a better future

4. The World of Work then �

5. Bernardini RamazziniFather of Occupational Medicine

6. Paracelsus (1493-1541)Father of Modern Toxicology

7. Lesson 2. Know the conditions of work and workplace

8. Occupational and Work-Related Diseases and Injuries History of exposure to hazardous workplace factors becomes indispensable in determining whether an illness is because of workplace factors or not.

9. Types of Hazards

10. Types of Hazards

11. Types of Hazards

12. Types of Hazards

13. Types of Hazards

14. Lesson 3. Mere exposure to hazard does not cause harm to safety or health

15. Hazards in the workplace can cause harm if there is undue exposure such as through elevated workplace concentration without proper control measures. Important to characterize exposure

16. Work-Related Musculoskeletal Disorders (WMSDs) development requires weeks, months or years of exposure to ergonomic risk factors

17. Lesson 4. Take active part in keeping yourself safe and healthy.

18. Diseases of Workers Many diseases of occupational cause are multifactorial,with non-occupational factors playing a role. Personal characteristics, other environmental and socio-cultural factors usually play a role as risk factors for these diseases.

19. Total Health Promotion Smoking cessation Physical activity Nutrition Weight reduction HIV/AIDS Drug Abuse Prevention TB Prevention and Control

20. Lesson 5. Prevention is better than treatment

21. HARMFUL EXPOSURES EARLY IN WORKING LIFE MODIFY NORMAL COURSE OF PHYSIOLOGICAL CHANGES DUE TO AGEING ALONE

22. Hearing loss comes with ageing But hearing loss can occur much earlier due to occupational exposure

23. Noise-Induced Hearing Loss

24. Loss of muscle strength comes with ageing But muscle strength can be diminished even in young persons

25. Occupational Safety and Health is Prevention Many occupational conditions are IRREVERSIBLE Occupational conditions are PREVENTABLE

26. ENSURING WORKER WELL-BEING �The choice of a starting age for attention should be selected as �young� enough that intervention efforts can be expected to make a difference during the working life.� Committee on the Health and Safety Needs of Older Workers National Research Council and Institute of Medicine

27. Occupational Safety and Health ConditionsContact Centers The Occupational Safety and Health Center, through its technical divisions, has embarked on a research project that will look into the occupational safety and health conditions in call centers in the Philippines. This project addresses a relatively recent phenomenon in the work environment that employs thousands of Filipino young workers.The Occupational Safety and Health Center, through its technical divisions, has embarked on a research project that will look into the occupational safety and health conditions in call centers in the Philippines. This project addresses a relatively recent phenomenon in the work environment that employs thousands of Filipino young workers.

28. Occupational Safety and Health in Call Centers(Secondary Data) Musculoskeletal disorders Linked to poorly designed workstations (Hoekstra et. al. 1995). Associated with longer shift duration (Ferreira M and Saldiva PH, 2002) Long uninterrupted hours of work with the computer Invariable and sedentary work (Norman K et. al. 2001) Low job satisfaction (Most IG, 1999) A search of secondary data or published reports yielded only a few studies concerning occupational safety and health conditions in call centers. Among the identified health problems in call center employees were pains in the neck/shoulder, wrist and back areas. These problems were associated with poor workstation design such as computer monitors placed above eye level, work surfaces that were too high, non-adjustable chair. Other factors mentioned that contribute to the development of muscle and joint pains were long uninterrupted hours of work with the computer, invariable and sedentary work and low job satisfaction.A search of secondary data or published reports yielded only a few studies concerning occupational safety and health conditions in call centers. Among the identified health problems in call center employees were pains in the neck/shoulder, wrist and back areas. These problems were associated with poor workstation design such as computer monitors placed above eye level, work surfaces that were too high, non-adjustable chair. Other factors mentioned that contribute to the development of muscle and joint pains were long uninterrupted hours of work with the computer, invariable and sedentary work and low job satisfaction.

29. Occupational Safety and Health in Call Centers (Secondary Data) Voice disorders Intensive verbal interaction with clients one of the contributing factors (Jones K et. al., 2002) Eyestrain Poor lighting conditions and intensive computer use (Putnam C et. al., 2000) Another health issue that affect call center operators is the risk of having voice problems. Telemarketers are twice more likely to have voice problems compared to the general population as shown by the study of Jones. Symptoms noted were dry itchy throat, hoarseness, frequent clearing of throat. One of the factors identified to contribute to the problem is the high demand on the vocal system because of the interactive nature of the task of call center operators. Workers also reported eye strain associated with the physical environment such as poor lighting conditions and uninterrupted use of computers. Another health issue that affect call center operators is the risk of having voice problems. Telemarketers are twice more likely to have voice problems compared to the general population as shown by the study of Jones. Symptoms noted were dry itchy throat, hoarseness, frequent clearing of throat. One of the factors identified to contribute to the problem is the high demand on the vocal system because of the interactive nature of the task of call center operators. Workers also reported eye strain associated with the physical environment such as poor lighting conditions and uninterrupted use of computers.

30. Occupational Safety and Health in Call Centers (Secondary Data) Problems due to psychosocial and work organization stressors (Putnam C et. al., 2000) Increased reporting of health disorders Negative work attitude (boredom, job dissatisfaction, anger, etc.) The major psychosocial and work organization stressors identified by participants include Very little job security fearing that their call centre might close suddenly Dealing with rude clients Unrealistic performance quotas assessed in terms call rates, call times, sales quotas; constant electronic performance monitoring; random taping of phone conversations. Work Schedules that interfere with family and social life. Very early or late shifts created transportation problems and concerns for safety Performing simplified, highly fragmented repetitive, fast paced workloads The interaction of psychosocial factors and other work factors have been related to injury and other health issues in the workplace The major psychosocial and work organization stressors identified by participants include Very little job security fearing that their call centre might close suddenly Dealing with rude clients Unrealistic performance quotas assessed in terms call rates, call times, sales quotas; constant electronic performance monitoring; random taping of phone conversations. Work Schedules that interfere with family and social life. Very early or late shifts created transportation problems and concerns for safety Performing simplified, highly fragmented repetitive, fast paced workloads The interaction of psychosocial factors and other work factors have been related to injury and other health issues in the workplace

31. Occupational Safety and Health in Call Centers(Secondary Data) Concern over potential hearing problems (Patel J and Broughton K, 2002) Exposure to high intensity sound coming from the headsets high sound levels in the room from the simultaneous talking of the employees Call center workers have been documented to have occasional exposure to higher noise levels is possible, for example from fax tones, holding tones, and high pitched tones from mobile telephones. High sound levels in the room may also occur from the simultaneous talking of the employees. Though it is recognized that in general the levels of noise transmitted through the headsets or levels present in the call centers are incapable of damaging the ear directly, a large number of workers studied were concerned that their hearing was being damaged as a result of exposure to noise at work. Call center workers have been documented to have occasional exposure to higher noise levels is possible, for example from fax tones, holding tones, and high pitched tones from mobile telephones. High sound levels in the room may also occur from the simultaneous talking of the employees. Though it is recognized that in general the levels of noise transmitted through the headsets or levels present in the call centers are incapable of damaging the ear directly, a large number of workers studied were concerned that their hearing was being damaged as a result of exposure to noise at work.

32. Occupational Safety and Health Conditions Contact Centers in the Philippines The Occupational Safety and Health Center, through its technical divisions, has embarked on a research project that will look into the occupational safety and health conditions in call centers in the Philippines. This project addresses a relatively recent phenomenon in the work environment that employs thousands of Filipino young workers.The Occupational Safety and Health Center, through its technical divisions, has embarked on a research project that will look into the occupational safety and health conditions in call centers in the Philippines. This project addresses a relatively recent phenomenon in the work environment that employs thousands of Filipino young workers.

33. Methods Case study of 5 call centers Purposively selected employees from one (1) company Questionnaire to collect data about personal circumstances, occupational profile, medical and psychosocial conditions Company profile Data will be collected regarding the organization in terms of size, tasks, type of clients, work organization, working hours, etc. Information on incentive system will also be gathered. A cross-sectional study is being planned in 5 call centers covering various nature and complexity of tasks. About 50 employees from each company selected by purposive sampling will be asked to answer a questionnaire. Data about personal circumstances, occupational profile, medical and psychosocial conditions will be collected. Data that will be collected by interviewing the management of the company will include the following: History of the company, nature of the business, size, type of clients, tasks of workers, etc. Incentives and benefits as well as performance monitoring scheme implemented in the company Policy on work schedules such as rest and breaks, overtime, and shift rotation Components of occupational safety and health program A cross-sectional study is being planned in 5 call centers covering various nature and complexity of tasks. About 50 employees from each company selected by purposive sampling will be asked to answer a questionnaire. Data about personal circumstances, occupational profile, medical and psychosocial conditions will be collected. Data that will be collected by interviewing the management of the company will include the following: History of the company, nature of the business, size, type of clients, tasks of workers, etc. Incentives and benefits as well as performance monitoring scheme implemented in the company Policy on work schedules such as rest and breaks, overtime, and shift rotation Components of occupational safety and health program

34. Results 5 call centers Varying tasks of operators 1 call center with only interactive computer task (internet online communication) 4 call centers both voice and computer Five call centers were visited. The operators of these call centers perform a wide array of tasks. The employees in one call center are engaged in internet real-time or online communication or chatting for the duration of the work shift. The task involves intensive interactive computer work. There is no verbal interaction with the customers. The employees of the other 4 call center visited have direct interaction with customers both inbound and outbound via telephone. The computers are used to process transactions (retrieve and/or input information).Five call centers were visited. The operators of these call centers perform a wide array of tasks. The employees in one call center are engaged in internet real-time or online communication or chatting for the duration of the work shift. The task involves intensive interactive computer work. There is no verbal interaction with the customers. The employees of the other 4 call center visited have direct interaction with customers both inbound and outbound via telephone. The computers are used to process transactions (retrieve and/or input information).

35. Results The next few slides will show the results of the preliminary survey. The companies visited have operated between less than a year to 5 years. All of the companies cater primarily to clients in the US. As mentioned earlier, the tasks performed by the operators differed in terms of extensiveness of computer use and vocal load. The tasks of the operators in 4 companies involve talking on the telephone and computer use. On the other, the task of operators in one company only involve computer use. The nature of the business also varied. All except for 1 are engaged in telemarketing. Predominantly female workforce was noted in 3 companies. The other 2 boasts of equal proportion of male and female. All the call centers visited employ young workers.The next few slides will show the results of the preliminary survey. The companies visited have operated between less than a year to 5 years. All of the companies cater primarily to clients in the US. As mentioned earlier, the tasks performed by the operators differed in terms of extensiveness of computer use and vocal load. The tasks of the operators in 4 companies involve talking on the telephone and computer use. On the other, the task of operators in one company only involve computer use. The nature of the business also varied. All except for 1 are engaged in telemarketing. Predominantly female workforce was noted in 3 companies. The other 2 boasts of equal proportion of male and female. All the call centers visited employ young workers.

36. Results Static posture from prolonged sitting, postural fixation when viewing the computer monitor and repetitive movements are common occurrences in computer-based tasks. And these we saw in 4 out 5 companies visited. In the long run, these working posture may lead to muscle and joint pains. Interestingly, in one company, the operators were allowed to assume different body postures and positions. They can walk about because they use wireless headsets and because of minimal human-computer interaction.Static posture from prolonged sitting, postural fixation when viewing the computer monitor and repetitive movements are common occurrences in computer-based tasks. And these we saw in 4 out 5 companies visited. In the long run, these working posture may lead to muscle and joint pains. Interestingly, in one company, the operators were allowed to assume different body postures and positions. They can walk about because they use wireless headsets and because of minimal human-computer interaction.

37. Results Postures of 55 agents were directly observed and evaluated using the Rapid Upper Limb Assessment checklist. Noted predominant postures are as follows (Table 9). The agents had upward gaze. When working with monitor height settings above eye level (seen in 39 out of 55 workstations), Twisting of the head and the trunk to either side in all agents was brought about by monitors placed either to the left or to the right of the agents. The upper arms and shoulders were elevated in 43 agents because of the relatively high keyboard height. Also, 28 agents assumed extremely flexed elbows. The agents assumed awkward and sustained reaching position when using the mouse. Because of inadequate workspace, the mouse were positioned relatively distant to the agents, Non-neutral* wrist position was noted in 42 out of 55 agents during keyboard use. 38 of them had extended wrists while another 4 had flexed wrists. Only 11 agents had neutral wrist positions. Forward leaning posture was noted in 38 agents. The other 17 were seen to assume backward leaning position.Postures of 55 agents were directly observed and evaluated using the Rapid Upper Limb Assessment checklist. Noted predominant postures are as follows (Table 9). The agents had upward gaze. When working with monitor height settings above eye level (seen in 39 out of 55 workstations), Twisting of the head and the trunk to either side in all agents was brought about by monitors placed either to the left or to the right of the agents. The upper arms and shoulders were elevated in 43 agents because of the relatively high keyboard height. Also, 28 agents assumed extremely flexed elbows. The agents assumed awkward and sustained reaching position when using the mouse. Because of inadequate workspace, the mouse were positioned relatively distant to the agents, Non-neutral* wrist position was noted in 42 out of 55 agents during keyboard use. 38 of them had extended wrists while another 4 had flexed wrists. Only 11 agents had neutral wrist positions. Forward leaning posture was noted in 38 agents. The other 17 were seen to assume backward leaning position.

38. A self-administered questionnaire was given to the 75 participants a week before the actual survey. Three agents returned the symptom survey for the musculoskeletal disorders unanswered; 2 agents did not answer the eye, hearing and voice symptom survey. Of the 72 who completely answered the forms, 5 females and 4 male agents reported no symptom referable to the eyes, ears, voice and musculoskeletal system. At least 1 symptom was reported by 63 agents. The distribution of complaints according to the affected organ systems is given in the following slides. The recent symptoms (experienced in the last 7 days) commonly noted by the respondents involved the eyes. Four to 22% of the surveyed agents reported having any one of the 8 eye strain symptoms - smarting and eye redness being manifested most frequently. Higher incidences were seen in the past 6 months. A self-administered questionnaire was given to the 75 participants a week before the actual survey. Three agents returned the symptom survey for the musculoskeletal disorders unanswered; 2 agents did not answer the eye, hearing and voice symptom survey. Of the 72 who completely answered the forms, 5 females and 4 male agents reported no symptom referable to the eyes, ears, voice and musculoskeletal system. At least 1 symptom was reported by 63 agents. The distribution of complaints according to the affected organ systems is given in the following slides. The recent symptoms (experienced in the last 7 days) commonly noted by the respondents involved the eyes. Four to 22% of the surveyed agents reported having any one of the 8 eye strain symptoms - smarting and eye redness being manifested most frequently. Higher incidences were seen in the past 6 months.

39. Among the musculoskeletal disorders reported by the subjects, the highest frequencies were seen for the upper back, neck and lower back, in descending order. Around 4 agents were unable to perform their usual work during the last 7 days because of pains in the mentioned areas.Among the musculoskeletal disorders reported by the subjects, the highest frequencies were seen for the upper back, neck and lower back, in descending order. Around 4 agents were unable to perform their usual work during the last 7 days because of pains in the mentioned areas.

40. None of the agents surveyed complained of recent symptoms of hearing disorders. However, in the past 6 months, the complaints of ear pain and ringing in the ear were reported. Of the 73 agents, up to 53 (73%) responded to have at least one symptom of voice disorder in the last 6 months. Those who have voice disorder symptoms in the last 7 days also complained that their work was adversely affected.None of the agents surveyed complained of recent symptoms of hearing disorders. However, in the past 6 months, the complaints of ear pain and ringing in the ear were reported. Of the 73 agents, up to 53 (73%) responded to have at least one symptom of voice disorder in the last 6 months. Those who have voice disorder symptoms in the last 7 days also complained that their work was adversely affected.

41. Lesson 6. Proactive measures are better than reactive efforts

42. Work Elements and associated Risk factors of voice disorders

43. Work Elements and associated Risk factors of hearing disorders

44. Work Elements and associated Risk factors of visual fatigue

45. Work Elements and associated Risk factors of work-related musculoskeletal disorder

47. Implications of the Study Knowledge gained to be used to improve working conditions In existing and prospective new call centers Address the OSH problems at an early stage Policy/Program Implications needs of women, mothers, young workers policies concerning work shifts, esp. prolonged night work adequate, on-site medical and health promotion facilities The Occupational Safety and Health Center is supporting the development of the call center industry and we believe that through this study Knowledge will be gained to improve working conditions In existing and prospective new call centers Address the OSH problems at an early stage to avoid an upsurge of safety and health-related issues From our findings, we will be able to assist in the formulation of policy and programs that will address the needs of women include working mothers and young workers Health and safety issues concerning work shifts, esp. prolonged night work And the need for adequate, on-site medical and health promotion facilities The Occupational Safety and Health Center is supporting the development of the call center industry and we believe that through this study Knowledge will be gained to improve working conditions In existing and prospective new call centers Address the OSH problems at an early stage to avoid an upsurge of safety and health-related issues From our findings, we will be able to assist in the formulation of policy and programs that will address the needs of women include working mothers and young workers Health and safety issues concerning work shifts, esp. prolonged night work And the need for adequate, on-site medical and health promotion facilities

48. Implications of the Study Recognition of complex nature of safety and health issues in call centers Interaction of psychosocial factors with other work factors Unique work organization because of electronic monitoring High performance standards Issues on job security Compensation implications Recognition of problems of workers in call centers Associated with air quality, ambient noise, noise from headset, human-computer interaction, shift work, etc. Occupational safety and health concerns of non-industrial workers are often times overlooked. Through this project, the complex nature of health issues in call centers as an example of non-industrial workplace is presented. The health problems of workers in call centers associated with air quality, ambient noise, noise from headset, human-computer interaction, shift work are brought into light and may aid in clarifying issues in compensation. Occupational safety and health concerns of non-industrial workers are often times overlooked. Through this project, the complex nature of health issues in call centers as an example of non-industrial workplace is presented. The health problems of workers in call centers associated with air quality, ambient noise, noise from headset, human-computer interaction, shift work are brought into light and may aid in clarifying issues in compensation.

49. Approach in EnsuringWell-Being of Workers Looking at regulatory requirements Relevant laws, standards, issuances and guidelines Enforcement Implementation Inspection Evaluation Looking at developmental strategies Information Education Training Campaigns Good practices Successful cases Competitions Demonstrations Interventions

50. Participatory approach Participation and involvement from stakeholders Coordinated intervention Learning from specifications/guidelines, scientific data best practice

52. Lesson 7. Prepare yourself