Promoting Safety and Health in the Workplace

- CONTACT CENTER Occupational Safety and Health Center Department of Labor and Employment

Occupational Safety and Health

encompasses the social, mental and physical well-being of workers, that is the whole person

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

The World of Work then

"a foul and poisonous dust [that] flies out from these materials, enters the mouth, then the throat and lungs, makes the workmen cough incessantly, and by degrees brings on asthmatic troubles." "in whom he found heaps of sand that in running the knife through the pulmonary vesicles he thought he was cutting through some sandy body."

Bernardini Ramazzini Father of Occupational Medicine

1713 Published De Morbis Artificum (Diseases of Workers)

Paracelsus (1493-1541) Father of Modern Toxicology

Areolus Phillipus Theophrastus Bombastus von Hohenheim "All substances are poisons; there is none which is not a poison. The right DOSE differentiates a poison from a remedy."

Lesson 2. Know the conditions of work and workplace

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.

Types of Hazards
Chemical hazards
Physical hazards

Ergonomic stresses

Biologic hazards

Types of Hazards
Chemical hazards
Formaldehyde Cigarette smoke Carbon monoxide Carbon dioxide Cleaning Agents

Types of Hazards
Physical hazards
Poor office lighting Noise Dry air Air currents

Types of Hazards
Pollens, allergens and dusts People, plants, mites, pests Condensed water in air conditioners, clogged drains, etc.

Biologic hazards

Types of Hazards
Limited workspace Simplified work Repetitive task Shiftwork (esp. nightwork) Mental and physical workload

Ergonomic stresses

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

Important to characterize exposure

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

Work-Related Musculoskeletal Disorders (WMSDs)

development requires weeks, months or years of exposure to ergonomic risk factors

Repetitive exertions Posture stresses (including static posture) Forceful exertions Contact stresses Job design Work organization Workstation dimension

Lesson 4.

Take active part in keeping yourself safe and healthy.

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.

Total Health Promotion

Smoking cessation Physical activity Nutrition Weight reduction HIV/AIDS Drug Abuse Prevention TB Prevention and Control

Lesson 5. Prevention is better than treatment

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

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

Noise-Induced Hearing Loss

Loss of muscle strength comes with ageing

But muscle strength can be diminished even in young persons

Occupational Safety and Health is Prevention

Many occupational conditions are IRREVERSIBLE
Occupational conditions are PREVENTABLE

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

Occupational Safety and Health Conditions Contact Centers

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)

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)

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.)

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

Occupational Safety and Health Conditions

Contact Centers in the Philippines

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.

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

Results
A Year Established Task 1998 Intensive interactive computer work (chatting) Customer assistance 2002 Voice and computer B 2000 Voice and computer C 1999 Voice and computer D 1999 Voice and computer E

Nature of business

Telemarketing, outbound

Telemarketing (outbound) and customer care services (inbound) 70% female

Telemarketing, mostly outbound

Telemarketing, inbound

Gender

Equal proportion of male and female 20 - 25

Equal proportion of male and female 20 -

80% female

75% female

Age of operators

20 - 35

20 - 25

20 - 25

Results

Hazards Identified Working Posture

A Rapid and repetitive keying, prolonged sitting, static exertions of neck, torso, elbow

B freedom of movement (sit, stand, walk about)

C Prolonged sitting, twisting of upper body and neck to view monitor

D Prolonged sitting, twisting of upper body and neck to view monitor

E Prolonged sitting, twisting of upper body and neck to view monitor

Working Posture of Call Center Agents Company E (n=55)

PARAMETERS Eye position Upper arm position Frequency of Extreme Posture Observed 39 agents with upward gaze Raised upper arms and elevated shoulders in 43 agents Elbow flexed in 28 agents

Results

Lower arm position

Wrist/Hand position

Wrist flexed in 4 agents Wrist extended in 38 agents

Extremely flexed in 5 agents Erect position in 50 agents 38 agents leaning forward

Neck position

Trunk position

Frequency of eye symptoms among call center agents (n=73) Eye symptoms With symptom/s in the last 7 days 22 (29%) 4 (5%) 13 (17%) 15 (20%) With symptom/s in the last 6 months 35 (47%) 8 (11%) 24 (32%) 25 (33%)

Smarting Gritty Itchiness Eye pain

Redness
Tearing

16 (21%)
10 (13%)

29 (39%)
21 (28%)

Dryness
Sensitivity to light

9 (12%)
15 (20%)

15 (20%)
31 (41%)

Frequency of musculoskeletal symptoms among call center agents (n=72) Musculoskeletal symptoms Neck Shoulder Elbow With symptom/s in the last 7 days 4 (6%) 2 (2%) With symptom/s in the last 6 months 36 (50%) 22 (30%) 2 (2%)

Wrist
Upper back Low back Hips or thigh Knee Ankle or feet

4 (5%) 3 (4%) 1 (1%) -

10 (14%)
41 (57%) 33 (46%) 11 (15%) 5 (7%) 7 (10%)

Frequency of hearing and voice disorders among call center agents (n=73)
Hearing and Voice disorders Ear pain With symptom/s in the last 7 days With symptom/s in the last 6 months 12 (16%)

Ringing in the ear Need to raise voice when talking

Hoarseness Tiredness or weakness of voice Exerting more effort to talk Cracking of voice Choking sensation Burning sensation in throat Dry throat

1 (1%)
1 (1%) 3 (4%) 2 (2%) 3 (4%) 2 (2%) 1 (1%)

9 (12%) 15 (20%)
35 (48%) 53 (73%) 37 (51%) 30 (40%) 20 (27%) 17 (23%) 52 (71%)

Complete loss of voice

1 (1%)

4 (5%)

Lesson 6.
Proactive measures are better than reactive efforts

Work Elements and associated Risk factors of voice disorders

Work Environment
a. High intensity of background noise b. Poor room acoustic c. Low temperature and humidity d. Poor workplace air causing irritation

Job Design/ Organization

a. Prolonged heavy use of voice b. Fast paced work brought about by automated call routing or dialing system c. Repetitive reading from long scripts d. Lack of or inadequate breaks

Individual/ Psychosocial Factors

a. Habit of speaking loudly b. Smoking c. Frequent intake of caffeinated beverages d. Infrequent hydration e. Infections involving the throat f. Intake of throat drying medications

Work Elements and associated Risk factors of hearing disorders

Work Environment Job Design/ Organization Individual/ Psychosocial Factors

a. High intensity a. Long duration of a. Poor hygiene background noise work b. Lack of training b. Noise from b. Infrequent breaks on proper headsets c. Inadequate maintenance of c. Poor room number of headsets acoustic headsets

Work Elements and associated Risk factors of visual fatigue

Visual Display
poor image quality, flicker, character size (too small or too big)

Work Environment

Work Position

Job Design/ Organization

a. long duration of work , esp. if without breaks b. high degree of concentration required c. fast pace of work d. repetitive and invariable task

Individual/ Psychosocial Factors

a. uncorrected visual deficiencies b. inadequate training on VDT operation

a. poor illumination, upward gaze excessive contrast in visual direction field, glare, reflections b. high vertical position of the display which may lead to dryness c. inappropriate viewing distance between worker and screen, keyboard, document d. dry air (relative humidity <40%) e. air movement >0.5 m/sec

Work Elements and associated Risk factors of workrelated musculoskeletal disorder

Physical Work Environment Contributing to improper posture a. inadequate lighting b. presence of glare and reflections on the screen Workstation Design a. chair without proper lumbar support b. not height adjustable chair and keyboard c. too high or too low position of monitor or keyboard d. inadequate workspace Work Posture Job Design/ Organization a. long duration of work , esp. if without breaks b. high degree of concentration required c. fast pace of work d. invariable, repetitive task e. high performance quotas Individual/ Psychosocial Factors a. uncorrected visual deficiencies b. inadequate training on computer operation c. lack of job control d. low job satisfaction

a. static posture b. repetitive keying or mouse manipulation c. non-neutral posture (head or body twisted to one side; wrist flexed or extended; elevated shoulders)

Health, Safety and Social Issues

Sleep disorders Gastrointestinal disorders

Risk Factors Associated with Night Work

a. b. c. d. Continued poor quality sleep

Digestive function reduced at night. Intake of coffee and other drinks containing caffeine Increased incidence of smoking to keep awake at night No access to proper meals at night because canteens are closed at night e. irregular meal times and snack

Errors and Accidents

a. Decreased alertness corresponding to trough of circadian rhythm b. Sleep debt c. Cumulative fatigue
a. Alcohol used to overcome fatigue and sleep debt b. Amphetamines and caffeine used to keep awake at night

Substance abuse

Physical attack
Disruption in the pattern of social practices

Walking very late at night or very early in the morning because public transport may not be available at these times

a. Exclusion from events and activities involving the family, friends or community b. Lack of contact with partners, children and friends c. Inability to pursue education, sports etc.

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

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.

Approach in Ensuring Well-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

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

The Link

Prevention of disease/injury Promotion of good health and safety

Improvement of safety and health HEALTHY, SAFE, COMFORTABLE

PRODUCTIVITY

Lesson 7.
Prepare yourself