THE FOLLOWING LECTURE HAS BEEN APPROVED FOR ALL STUDENTS BY BIRMINGHAM CITY UNIVERSITY

1. THE FOLLOWING LECTUREHAS BEEN APPROVED FOR ALL STUDENTS BY BIRMINGHAM CITY UNIVERSITY health.bcu.ac.uk/craigjackson This lecture may contain information, ideas, concepts and discursive anecdotes that may be thought provoking and challenging Any issues raised in the lecture may require the viewer to engage in further thought, insight, reflection or critical evaluation

2. Occupational ill-health People are made sick by the work they do Dr. Craig Jackson Prof of Occupational Health Psychology Education Law & Social Sciences BCU www.health.uce.ac.uk/craigjackson

3. The Godfather of Occupational Disease “When you come to a patient’s house, you should ask him what sort of pains he has, what caused them, how many days he has been ill, whether the bowels are working and what sort of food he eats. So says Hippocrates. I may venture to add one more question: what occupation does he follow? ” Bernard Ramazinni (1633-1714)

4. 10 20 30 40 50 60 70 80 90 100 % returning to work <1 2 4 6 8 10 12 14 16 18 20 22 24 months not working • Return to Work • Longer off work = Less likely to return to work Waddell, 1994

5. Regional Picture • Self-reporting? • Who’s best off? • Who’s worse off?

6. Work Related Ill-Health in the UK 33 Million days lost per year Males lose more working days than females Days lost increase with age Low managerial / professionals had highest rate of absence Most sickly occupations are health & social welfare, construction, teaching, and research

7. Work Related Ill-Health in the UK Bakers appear highly with occupational asthma Metal workers appear highly with upper limb problems Mesothelioma deaths high in shipbuilders and asbestos workers Stress, depression and anxiety highest in: Public admin. Defence Education Health work Social work

8. China & Egypt

9. History of Occupational Illness Stone-age was first age of occupational risk Iron-age and smelting worsened this Mining in Egyptian period: worse job going Bernardino Ramazzini (1633-1714). DeMorbis Artificium Industrial Revolution UK. Factory Act. 1802 Annie Bessant. Matchworkers Sir Thomas Legge (1863 – 1932) 1st Inspector of Factories

10. 1848 – Factory act

11. 1848 – Factory act

12. 1848 – Factory act

13. England

14. England: Black Country

15. England: Black Country

16. England: Black Country Photo courtesy of Institute of Rural Health

17. England: Black Country Photo courtesy of Institute of Rural Health

18. England: Black Country Photo courtesy of Institute of Rural Health

19. England: Black Country – environmentally friendly? Photo courtesy of Laurie Leeming-Latham of MOHS

20. England: Black Country – environmentally friendly? Photo courtesy of Alastair Robertson

21. Mystery Health Problems ?

22. Mystery Health Problems ?

23. Economics of Scale - Solway Harvester Photo courtesy of Dr Gordon Baird

24. Solway Harvester Equivalent to 7 people from Wigtownshire Equivalent to 120,000 people from London

25. Not just the crappy jobs. . .

26. Pleural thickening

27. Pleural thickening

28. Testing Workers’ Lung Function

29. Core Occupational Diseases (EU) Chemical Chemical Biological Physical Physical Inorganic Organic Dusts Others Cadmium CS5 Zoonoses Asbestos Radiation Chromium Benzene Hepatitis Silica(te) NIHL Mercury Chlorine TB Mesothelioma Cataract Manganese Aromatics Vibration Nickel P.aromatics Dermatitis Lead Isocyanates

30. 21st Century Workplaces • Global companies and operations • Leaner & Meaner managers • Gender issues • Disability issues • Migrant issues • Longer & less fixed working hours • Shorter contracts • Dirty jobs out-sourced

31. 21st Century Workplaces

32. The World of Work and People • More complex • Illness + Disease Focused • Health & Safety Obsessed • Market-forces Dominated • Quality Management Driven • SMEs Predominant • Mass production • Low Skills or Training required = low pay

33. 21st Century Workplaces

34. Current Sources of Occupational Ill-Health Chemicals Gasses Dusts Particles Light Heat Noise Vibration Stress Radiation Slips, trips, falls Working hours Ergonomics

35. Troublesome Occupations

36. Top 5 Modern Day Occupational Health Problems Hearing Loss (NIHL, TTS) Industry, Drivers, Emergency work Respiratory Problems Asbestos, Industry, Recycling Skin Problems Nurse, Hairdressers, Industry Mental Health / Stress / Anxiety Office workers Musculoskeletal problems Office, Drivers, Industry, Construction

37. Work Related Ill-Health in the UK MSDs and Stress show little change since 2002 Mesothelioma deaths and Asbestosis slowly rise Asthma and Contact Dermatitis show little change Occupational infections high in 2002 – diarrhoeal disease Occupational Deafness slowly declining

38. Who is susceptible to stress ? “Veal – Fattening Crate” “Small, cramped office workstations built of fabric covered disassemblable wall partitions and inhabited by junior staff members. Named after the small pre-slaughter cubicles used by the cattle industry” Douglas Coupland

39. The New Millennium – The Existential Age • Stress • Post Traumatic Stress Disorder • Chronic Fatigue Syndrome • Multiple Chemical Sensitivity • Diffuse Pain Syndromes (RSI, MSD, WI) • Non-Specific Effect Modifiers • Psycho-Immunology

40. Professional Meddling

42. Non-Specific Symptoms Often missed in assessment

43. Modern day complaints Multiple Chemical Sensitivity Chronic Fatigue Syndrome Sick Building Syndrome Gulf War Syndrome Low-level Chemical Exposure Electrical Sensitivity Historical complaints Railway Spine Neurasthenia Combat Syndrome Symptom Prevalence % Stuffy nose 46.2 Headaches 33.0 Tiredness 29.8 Cough 25.9 Itchy eyes 24.7 Sore throat 22.4 Skin rash 12.0 Wheezing 10.1 Respiratory 10.0 Nausea 9.0 Diarrhoea 5.7 Vomiting 4.0 Heyworth & McCaul, 2001 Prevalence of Non-Specific Symptoms

44. Potential Health Risks 3x Cardiovascular problems 2x Substance abuse High Effort Low Reward + High Demand Low Control 3x Back pain STRESS! 2-3x Injuries 5x Certain cancers 2-3x Conflicts 2-3x Infections 2-3x Mental health problems Shain 2001

45. What kids think of stress • Stress • Looks like a flaming deamon Sounds like an eagle squaking • Tastes like a burnt sausage Smells like sour milk Feels like stroking a hedgchog Stress is when mum says NO!!!!! • by Andrew (aged 10)Year 5Potley Hill Primary School

46. Stress Golden Age of Stress Everyone is Stressed BBCi - “Stress” = 16,000 finds More people experiencing more stress Greater demands from employers People working longer hours 24 / 7 society World Wars I and II Where was stress? Possible evidence from dud shells

47. Karasek’s demand-control model of stress development Productive, Motivated low strain active job control low high passive high strain Risk of psychological strain and increased illness low high job demands Karasek 1979

48. job demands low high low strain active job control low high passive high strain Karasek 1979

49. So what of Birmingham. . . ? • Local Industries • Local populations • Biggest Local Health Problems • Any Complicating / Confounding Factors? • What is Birmingham famous for? • What has Birmingham achieved? • Occ Ill-Health in your family?

50. Occupational Alveolitis