Guest Columnist Chris Goulart Once Again Shakes Up the Status Quo
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OHS, EH&S, SH&E… why do we always find Safety and Health so closely linked. (I won’t touch environmental because the differences are so obvious that most Safety Professionals will only grudgingly take on environmental responsibilities.) However, the linkage with Occupational Health is indelible and inescapable.
Before I proceed to explore this Myth, it might be germane to discuss the origins of how Safety and Health become linked at so many organizations. During the height of manufacturing prowess of the United States (1900-1970) an interesting benefit was added to many large workplaces, the Occupational Nurse.
Originally, the nurse was responsible for providing a first line of treatment for injured workers. It was not unusual for a factory nurse to help try to staunch bleeding from massive wounds or to begin the process of removing items that became embedded in employees as a result of some industrial accident or the other. Over time, and as safety standards within the United States began to improve, the role of the Occupational Nurse became to have functions on both the prevention side of injuries as well as the treatment of injuries once they occurred.
According to the Occupational Safety and Health Administration (OSHA) Occupational Nurses have the following functions1:
- Have special knowledge of workplace hazards and the relationship to the employee health status.
- Understand industrial hygiene principles of engineering controls, administrative controls, and personal protective equipment.
- Have knowledge of toxicology and epidemiology as related to the employee and the work site.
Occupational nurses are also routinely help injured employees return to work, participate in drug testing, ergonomic reviews, job hardening, employee wellness, and a variety of other tasks as well.
Unfortunately, with the decline of major manufacturing facilities in the United States, the existence of the Occupational Nurse has contracted significantly. This is especially true over the last 20 years. The resulting reduction in the numbers of Occupational Health Nurses has necessitated that their responsibilities be delegated to another member of the business support services. This person has typically been the safety coordinator or safety manager.
In the traditional model the safety coordinator was usually educationally trained as an engineer or industrial sciences manager. Rarely would the safety manager have a background in Biology, Medicine, or any other clinical specialty. As a result, they relied heavily on the nurses for health related items.
Today, safety managers are often as likely to be trained in management systems as in any other technical specialty. However, the case remains that they typically have little formal training in health related fields. Some educational institutions with designated safety programs do include classes on Industrial Hygiene and Ergonomics. Some of the more sophisticated programs will also include classes in Biochemistry, Toxicology, Anatomy and Physiology. Unfortunately, this training is still not as in depth as is typically provided in a two year nursing program.
Fast forward to 2009 and we find that a true definition of the responsibility for Occupational Health is generally lacking. Many organizations still expect occupational health to include all of the responsibilities undertaken previously as well as prevention of occupational illnesses, the rehabilitation of injured employees, the administration of claims, and the return to work of previously injured workers.
Upon close inspection, the functions of Occupational Safety and Occupational Health are very different. Safety managers must be concerned with safety training, administration of PPE programs, compliance with OSHA Standards, and Accident Investigation. The few areas of overlap, including risk assessment, workplace safety/health evaluations, and industrial hygiene do not forge as close a bond as might be popularly thought.
It is difficult to expect a safety manager to know the intricacies of blood borne pathogens, Legionnaire’s Disease, Pandemic Flu Management, and other true Occupational Health Issues as well as someone who is a Certified Occupational Health Nurse (COHN).
The COHN designation is one of the few professional certifications with a declining number of persons applying for and earning it. This continues to create additional pressure for safety persons to accept more responsibility for workplace health issues. With an ever increasing demand by companies to abandon traditional workplace safety models and adopt more sophisticated safety management approaches like Behavior Based Safety, TapRoot, System’s Driven Safety, and Integrated Safety Management, it is incumbent upon organizations to explore whether the common addition of Occupational Health into the bailiwick of Safety really makes sense. In the opinion of this author these two disciplines are much better when handled separate, but equal.
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