Promoting Safety and Health in the Workplace CONTACT

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 Ergonomic stresses Physical hazards 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) n 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 B C D E Year Established 1998 2002 2000 1999 Task Intensive interactive computer work (chatting) Voice and computer Nature of business Customer assistance Telemarketing, outbound Telemarketing (outbound) and customer care services (inbound) Telemarketing, mostly outbound Telemarketing, inbound Gender Equal proportion of male and female 70% female 80% female 75% female Age of operators 20 - 25 20 - 35 20 - 25

Results Hazards Identified A B C D E Working Posture Rapid and repetitive keying, prolonged sitting, static exertions of neck, torso, elbow freedom of movement (sit, stand, walk about) Prolonged sitting, twisting of upper body and neck to view monitor

Results Working Posture of Call Center Agents Company E (n=55) PARAMETERS Frequency of Extreme Posture Observed Eye position 39 agents with upward gaze Upper arm position Raised upper arms and elevated shoulders in 43 agents Lower arm position Elbow flexed in 28 agents Wrist/Hand position Wrist flexed in 4 agents Wrist extended in 38 agents Neck position Extremely flexed in 5 agents Erect position in 50 agents Trunk position 38 agents leaning forward

Frequency of eye symptoms among call center agents (n=73) Eye symptoms With symptom/s in the last 7 days the last 6 months Smarting 22 (29%) 35 (47%) Gritty 4 (5%) 8 (11%) Itchiness 13 (17%) 24 (32%) Eye pain 15 (20%) 25 (33%) Redness 16 (21%) 29 (39%) Tearing 10 (13%) 21 (28%) Dryness 9 (12%) 15 (20%) Sensitivity to light 15 (20%) 31 (41%)

Frequency of musculoskeletal symptoms among call center agents (n=72) Musculos With keletal symptom/ symptoms s in the last 7 last 6 days months Neck 4 (6%) 36 (50%) Shoulder 2 (2%) 22 (30%) Elbow - 2 (2%) Wrist - 10 (14%) Upper back 4 (5%) 41 (57%) Low back 3 (4%) 33 (46%) Hips or thigh 1 (1%) 11 (15%) - 5 (7%) Knee

Frequency of hearing and voice disorders among call center agents (n=73) Hearing and Voice disorders With symptom/s in the last 7 days With symptom/s in the last 6 months Ear pain - 12 (16%) Ringing in the ear - 9 (12%) Need to raise voice when talking 1 (1%) 15 (20%) Hoarseness 1 (1%) 35 (48%) Tiredness or weakness of voice 3 (4%) 53 (73%) Exerting more effort to talk 2 (2%) 37 (51%) Cracking of voice 3 (4%) 30 (40%) Choking sensation 2 (2%) 20 (27%) - 17 (23%) Dry throat 1 (1%) 52 (71%) Complete loss of voice 1 (1%) 4 (5%) Burning sensation in throat

Lesson 6. Proactive measures are better than reactive efforts

Work Elements and associated Risk factors of voice disorders Work Environment Job Design/ Organization a. High intensity of a. Prolonged heavy use background noise of voice b. Poor room acoustic b. Fast paced work c. Low temperature and brought about by humidity automated call d. Poor workplace air routing or dialing causing irritation 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 a. poor illumination, upward excessive contrast in gaze visual field, glare, direction 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 Job Design/ Organization Individual/ Psychosocial Factors 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 a. uncorrected visual deficiencies b. inadequate training on VDT operation

Work Elements and associated Risk factors of workrelated musculoskeletal disorder Physical Work Environment Workstation Design Work Posture Job Design/ Organization Contributing to improper posture a. inadequate lighting b. presence of glare and reflections on the screen 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 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) 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 Individual/ Psychosocial Factors a. uncorrected visual deficiencies b. inadequate training on computer operation c. lack of job control d. low job satisfaction

Health, Safety and Social Issues Risk Factors Associated with Night Work Sleep disorders Gastrointestinal disorders a. b. c. d. Errors and Accidents a. Decreased alertness corresponding to trough of circadian rhythm b. Sleep debt c. Cumulative fatigue Substance abuse a. Alcohol used to overcome fatigue and sleep debt b. Amphetamines and caffeine used to keep awake at night Physical attack Disruption in the a. Exclusion from events and activities involving the family, 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 Walking very late at night or very early in the morning because public transport may not be available at these times

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