BCRSP Health and Wellness Study Guide - 2014 Edition

Canadian
Registered
Safety
Professional
Health and Wellness
Study Guide
Board of Canadian Registered Safety Professionals
6700 Century Avenue Suite 100, Mississauga, ON L5N 6A4
Tel: (905) 567-7198

Toll free: 1-888-279-2777
E-Mail: info@bcrsp.ca
Web: www.bcrsp.ca
Last Revision: 2014

BCRSP Guide to Registration © Page 1
Health and Wellness (HW)
Health and Wellness (HW)

This domain was originally developed by Sheila Miller, RN MSc(A)OH, COHN(C), CRSP and Brenda
Greenslade, RN, MSc(A)OH, COHN(C), CRSP, St John’s, NL; and subsequently revised in 2006, 2013
and 2014 by Dianne E.G. Dyck, RN, DPHN, BN, MSc, COHN(C), CRSP, Calgary, AB.
Originally Developed: 2002 Last Revision Completed: 2014
Table of Contents
Domain ...................................................................................................................................................... 2
Scope ...................................................................................................................................................... 3
Suggested Reading ..................................................................................................................................... 3
Additional Resources ................................................................................................................................. 4
Learning Objectives for the Competencies .............................................................................................. 7
HW1: Demonstrate an Understanding of Workplace Health Promotion................................................. 7
HW2: Demonstrate an Understanding of Injury, Illness, and Disease Prevention Programs .............. 17
HW3: Demonstrate an Understanding of Employee Assistance Programs ......................................... 21
HW4: Demonstrate an Understanding of Wellness Programs ............................................................. 25
HW5: Demonstrate an Understanding of Disability Management Programs ....................................... 32
HW6: Demonstrate an Understanding of Addiction Control ................................................................. 37
HW7: Demonstrate an Understanding of the Factors that Impact Health and Wellness ..................... 41
HW8: Demonstrate an Understanding of How Factors in the Workplace Impact Worker Wellbeing ... 43
HW9: Demonstrate an Understanding of the Effects of Fatigue on Worker Health and Performance 49
HW10: Demonstrate an Understanding of the Influence of the Psychosocial Work Environment
Influences Worker Health and Wellness ..................................................................................... 53
HW11: Demonstrate an Understanding of the Influence of Work/life Balance on Worker Health and
Wellness ..................................................................................................................................... 54
Health and Wellness
Domain
The BCRSP’s Examination Blueprint of 2015 sets out 11 competencies in workplace health and wellness
that the prospective CRSP must demonstrate. The 2015 Examination Blueprint is the basis for this study
guide.
The OHS professional will have a clear understanding of the relationship between the worker’s physical
and social environment at work, the worker’s home environment, and the worker’s personal health
practices and resources, and how these contribute to the worker’s sense of health and well-being. As
well, the OHS professional will become aware of how worker health and well-being impacts the
organization. In essence, worker health and well-being are directly related to organizational health and
productivity. 1
Health promotion is defined as the science and art of helping people change their lifestyle to move
toward a state of optimal health. Optimal health is a balance of physical, emotional, social, spiritual, and
intellectual health 2. It is more than a lifestyle change; it is about changing environments so that they are
supportive of individuals and groups making healthy decisions. Lifestyle change can be facilitated through
a combination of efforts to:
1. enhance awareness;
2. change behaviour; and
3. create environments that support good health practices.
Health researchers and advocates stress the importance of community development and facilitating a
process whereby communities use their “voice” to define and make their health concerns known. The
workplace, in addition to being a community, is an important venue for promoting health because workers
spend at least one third of their day at work.
Workplace health promotion programs, commonly known as workplace wellness programs, provide
workers with the ability to increase their control over, and to improve, their physical and psychological
health needs. They consist of activities directed toward increasing the level of well-being and actualizing
of the health potential of workers, their families, and the company.
The theory and operational content for the Health and Wellness Domain identified in the Blueprint for
the Canadian Registered Safety Professional Examination provides the OHS professional with a
general overview of worker health and well-being. It also introduces employee support services such as
workplace wellness, attendance support, employee assistance, addiction control, and disability
management programs. The BCRSP’s Health and Wellness Domain has eleven sub-domains. The topic
of health and wellness is vast in nature and is not limited by the competencies identified in this domain.
The term “worker” will be used within this study guide, except when referring to employee support
services that apply only to employees.
1 Towers Watson. (2012). Pathway to Health and Productivity: 2011/2012 Staying@Work Report. Atlanta, GA: Watson Wyatt
Worldwide. Available online at: www.watsonwyatt.com.
2
O’Donnell, M. (1989). American Journal of Health Promotion, Vol. 3 (3), p. 5.
Health and Wellness
Scope
The Health and Wellness (HW) domain provides a general overview of worker health and wellness, as it
applies to the field of occupational health and safety:
Competency HW1: Demonstrate an understanding of workplace health promotion.
Competency HW2: Demonstrate an understanding of injury, illness, and disease prevention programs
(e.g., immunizations, personal protective equipment, hand hygiene, medical
screening, etc.).
Competency HW3: Demonstrate an understanding of employee assistance programs.
Competency HW4: Demonstrate an understanding of wellness programs (e.g., stress management,

physical fitness, and weight management).
Competency HW5: Demonstrate an understanding of disability management programs (e.g., modified

work, rehabilitation, return to work, etc.).
Competency HW6: Demonstrate an understanding of addiction control programs (e.g., tobacco, alcohol,
drugs, gambling, etc.).
Competency HW7: Demonstrate an understanding of disability management programs (e.g., modified

work, rehabilitation, return to work, etc.).
Competency HW8: Demonstrate an understanding of the factors that lead to health and wellness (e.g.,
environmental, social, economic, physiological, lifestyle, etc.).
Competency HW9: Demonstrate an understanding of the effects of fatigue on worker health and
performance (e.g., shift work, fitness for work, overtime, etc.).
CompetencyHW10: Demonstrate an understanding of the influence of the psychosocial work

environment on worker health and wellness (e.g., leadership, expectations, civility,
respect, etc.).
Competency HW11: Demonstrate an understanding of the influence of work/life balance influences on

worker health and wellness.
Suggested Reading
The primary reference texts for the Health and Wellness Domain are:
Dyck, Dianne E. (2013). Disability management: Theory, strategy and industry practice, 5th
edition. Markham, ON: LexisNexis. Available through
http://www.lexisnexis.ca/bookstore/bookinfo.php?pid=494
Dyck, Dianne E. (2011). Occupational health & safety: Theory, strategy and industry
practice, 2nd edition. Markham, ON: LexisNexis. Available through
http://www.lexisnexis.ca/bookstore/bookinfo.php?pid=494
O’Donnell, Michael & Associates (2002). Health promotion in the workplace, 3rd edition.
Toronto, ON: Delmar Thomson Learning. Available through www.amazon.ca
Health and Wellness
O’Donnell, 2002, provides a comprehensive review of many of the dimensions of health promotion
activities within the workplace. Dyck, 2013 offers insight and guidance into the various areas of disability
management and has been written to provide some general guidelines required for creating and
managing a quality disability management program. The author examines the sub-domains of workplace
wellness, management theories, occupational health and safety programs, employee assistance
programs, graduated return-to-work programs, as well as Workers’ Compensation, attendance support,
and disability management programs. Dyck, 2011 addresses the impact that corporate culture,
organizational systems, and work design has on worker health and well-being.
Additional Resources
Additional recommended readings and available internet resources are provided below. Please Note:
The internet URLs provided are home site addresses. Once there, use the site’s search function to
access the desired article.
Resources marked with an ** can also be located on the BCRSP website in the applicant's only section.
**Alberta Health Services. (2009). It’s our business: Dealing with the troubled employee.
Available through Alberta Health Services online at: http://www.albertahealthservices.ca/
**Alberta Health Services. (2010). It’s our business: The basics: Alcohol, other drugs and
gambling. Available through Alberta Health Services online at:
http://www.albertahealthservices.ca/
**Alberta Health Services. (2010). It’s our business: An addiction in the family: What it means for
the workplace. Available through Alberta Health Services online at:
**Alberta Health Services. (2010). Alcohol/drug policy development and employee testing.
Available through Alberta Health Services available online at:
**Alberta Health Services. (2010). It’s our business: Workplace peer support. Available through
Alberta Health Services available online at: http://www.albertahealthservices.ca/
**Alberta Health Services. (2010). It’s our business: Does someone I work with have a problem?
Available through Alberta Health Services online at: http://www.albertahealthservices.ca/
Addictions Foundation of Manitoba. (2005). Available online at: www.afm.mb.ca . Select Alcohol
& Drugs from the home page. This website discuses Methadone use and provides links to all
relevant substances. For example, The Basics:
• Alcohol
• Binge Drinking
• Cannabis
• Cocaine & Crack
• Ecstasy
• Inhalants
• LSD
• Magic Mushrooms
• Methamphetamine
• PCP
• Rohypnol
• Smokeless Tobacco
• Tobacco
Health and Wellness
Addictions Foundation of Manitoba. Workplace Services: Gambling. Available online at:

www.afm.mb.ca
Butler, B. (2006). Brief analysis of current workplace substance abuse issues and activities in
Canada, March 2004 issue. Revised 2012. Available online at: http://www.ccsa.ca
Butler, B. (2006). Current legal context: Employee testing, May 2004 issue. Revised 2012.
Available online at: http://www.ccsa.ca
Canadian Centre for Occupational Health and Safety (CCOHS). Available online at:
www.ccohs.ca - OSH answers:
• Employee assistance programs (EAP) (2009)
• Psychosocial/Workplace stress – general (2012)
• Rotational shiftwork (2010)
• Substance use in the workplace (2008)
• Violence in the workplace (2012)
• Violence in the workplace – negative interactions (2006)
• Violence in the workplace – warning signs (2006)
• Work/Life balance (2008)
Canadian Public Health Association, (2001). ROI One Life Immunization. Available online at:
http://www.benefitscanada.com/wp-content/uploads/2013/09/roiOneLife_immunization.pdf
Duxbury, L., and Higgins, C. (2001). Work/life balance in the new millennium: Where are we?
Where do we need to go? Available at Canadian Policy and Research Networks online at:
www.cprn.org
Duxbury, L. & Higgins, C. (2012). Reducing Work–Life Conflict: What Works? What Doesn’t?
Available online at: http://www.hc-sc.gc.ca/ewh-semt/alt_formats/hecs-sesc/pdf/pubs/occup-
travail/balancing-equilibre/full_report-rapport_complet-eng.pdf
Dyck, D. (2014). Integrated workplace health management course. Prepared for the University of
Fredericton and University of Calgary. Access available through
http://www.ufred.ca/w_certificate_in_disability_management.aspx? or degdyck@yahoo.ca
Government of Ontario (2014). Play, live, be tobacco free. Available online at:
http://www.playlivebetobaccofree.ca/
Health Canada. (2008). Chapter 4, Social and Economic Factors that Influence Our Health and
Contribute to Health Inequities, Report on the State of Public Health in Canada, Cat. No. HP2-
10/2008E. Available online at: www.phac-aspc.gc.ca
Health Canada. (2004). What determines health? Available online at: www.phac-aspc.gc.ca
HelpGuide. (2012). Stress management: How to reduce, prevent, and cope with stress. Available
online at: www.helpguide.org
Kansas Workforce Initiative (2010). Work-Family Conflict and Family-Work Conflict, available
online at http://www.kwi.ku.edu/research/WorkforceEvidenceReviews/ER%20Work-
Family%20Conflict.pdf
Labour Canada. (2010). Guide to Prevention of Violence in the Work Place, Cat. No. HS24-
85/2010. Gatineau, PQ: Human Resources and Skills Development Canada. Available online at:
http://www.hrsdc.gc.ca/eng/home.shtml
Health and Wellness
National Institute of Disability Management (NIDMAR). (1995). Disability management in the

workplace. Port Alberni, BC: Author.
**NIOSH. (1997). Plain language about shift work. Cincinnati, OH: US Department of Health
and Human Services. Available online at: www.niosh.com
**Non-Smokers Rights Association (2014). Cigarette prices in Canada, June 2014. NSRA-ADNF,
Ottawa. Available online at: http://www.nsra-adnf.ca/cms/file/files/140605_map_and_table.pdf
**Occupational Health Clinics for Ontario Workers Inc. – OHCOW. (2005). Shiftwork health
effects & solutions. Hamilton, ON: OHCOW. Available online at: http://www.ohcow.on.ca
Pender, N., Murdaugh, C., & Parsons, M. A. (2011). Health promotion in nursing practice, 6th
edition. Upper Saddle River, NJ: Pearson Education Inc.
Public Health Agency of Canada (2014). Canada Immunization Guide, 2014. Available online
at: http://www.phac-aspc.gc.ca/publicat/cig-gci/assets/pdf/p01-eng.pdf
**Reid J.L., Hammond, D., Burkhalter, R., & Ahmed, R. (2014). Tobacco use in Canada:
Patterns and trends, 2014 edition. Waterloo, ON: Propel Centre for Population Health Impact,
University of Waterloo. Available online at: http://www.tobaccoreport.ca/2014/
Statistics Canada (2012). Smoking, 2010. Available online at: http://www.statcan.gc.ca/pub/82-

625-x/2012001/article/11668-eng.htm
Statistics Canada (2013). Smoking. Available online at: http://www.statcan.gc.ca/search-

recherche/bb/info/3000018-eng.htm
Towers Watson (2014). 2013/2014 Staying@work report: Canada summary. Available online at:
http://www.towerswatson.com/en-CA/Insights/IC-Types/Survey-Research-Results/2014/02/2013-
2014-staying-at-work-report-canada-summary
Towers Watson. (2012). Pathway to health and productivity: 2011/2012 Staying@work report.
Atlanta, GA: Watson Wyatt Worldwide. Available online at: www.watsonwyatt.com
Watson Wyatt Worldwide. (2010). The health and productivity advantage: 2009/2010 North
American staying@work report. Atlanta, GA: Watson Wyatt Worldwide. Available online at:
www.watsonwyatt.com
WSIB. (2000). Business results through health & safety. Toronto, ON: WSIB. Available online
through
http://www.ryerson.ca/content/dam/irm/pdfs/training/ISS_MGR/WSIB_BusinessResultsThroughH
S.pdf
Yang, H., Schnall, P. Jourequi, M. Su, T, and Baker, D. (2006). Work hours and self-reported
hypertension among working people in California, Hypertension, 48(4): pages 744-50.
Health and Wellness
Learning Objectives for the Competencies
The following summarizes the objectives for the Health and Wellness (HW) Competencies as set out in
the 2015 BCRSP Examination Blueprint.
HW1: Demonstrate an Understanding of Workplace Health Promotion

Although the terms health promotion and health protection (disease prevention) tend to be used
interchangeably, they differ in terms of their motivational mechanisms and goal orientations. Health
promotion is defined as the science and art of helping people change their lifestyle to move toward a
state of optimal health. Optimal health is defined as the balance of physical, emotional, social, spiritual,
and intellectual health. 3 Health promotion is not a disease- or condition-specific approach; rather it seeks
to expand positive potential for health in a dynamic way. Health promotion is behaviour motivated by the
desire to increase well-being and actualize human health potential. 4 In the workplace, blood pressure
screening, weight management programs, vaccination programs, health and wellness education, etc., are
examples of health promotion efforts.
Health protection, also termed illness/injury or disease prevention, is any behaviour performed by a
person, regardless of his/her perceived or actual health status, in order to protect, promote or maintain his
or her health, whether or not such behaviour is objectively effective toward that end. 5 The focus is to
prevent a specific disease or condition by avoiding the occurrence of pathogenic insults to health and
well-being.
For workplace wellness programs to reach their optimal impact, they must appeal to, and reach, as many
workers as possible through three levels of effort, namely:
1. Primary prevention which consists of activities directed toward decreasing the probability of
specific illnesses, injuries, or dysfunctions in individuals, families, and communities, including
active protection against unnecessary stressors. 6 Some examples of primary prevention activities
include general health education, routine immunization, routine medical examinations, annual eye
examinations, general fitness awareness, psychological health awareness programs, provision of
specific-pathogen vaccines (e.g., tetanus, rabies, flu, and H1N1 vaccination), etc.
2. Secondary prevention which emphasizes early diagnosis and treatment for health conditions
thereby shortening their severity and duration, enabling individuals to regain normal functioning in
a timely manner. 7 Some examples of secondary prevention activities include blood pressure
screening, cholesterol screening, hearing testing, visual screening, weight loss programs,
screening for specific illnesses (Mantoux testing for tuberculosis, AIDS testing, Pap Smears for
cervical cancer, colonoscopy for colon disease, etc.)
3. Tertiary prevention occurs once a health condition or disability becomes stable or is irreversible.
The goal is to assist the individual to regain an optimal level of functioning within the constraints
of the condition or disability.
3
O’Donnell, M. (2002). Health promotion on the workplace, 3rd edition. Toronto, ON: Delmar Thomson Learning, p. 49.
4
Pender, N., et al. (2011). Health promotion in nursing practice, 6th edition. Boston, MA: Pearson Education, p. 5.
5
6
7
Health and Wellness
Using a wellness continuum (Figure 1), the relationship of the three levels of prevention are explained.
Figure 1: Wellness Continuum 8
Wellness Continuum 8
Wellness Illness
Well Signs & Disease Disability Death

Moderately Neutral High
Well Symptoms
Primary Secondary Tertiary

Prevention Prevention Prevention
• Health Promotion • Health Protection • Disability Case
• Wellness Incentives • Medical Monitoring Management
• Routine Immunization • Workplace Screening • Weight Management
• EAP Counselling
General Health Education

Many organizations offer general health education to workers in the form of brown bag lunch sessions,
safety meeting talks, health and wellness fairs, newsletter briefs, and posters. These are often delivered
in the form of the “disease or condition of the month”, e.g., Heart Health Month, Cancer Month, Diabetes
Month, etc.
Blood Pressure Screening

Blood pressure is the force of blood pushing against the walls of arteries. Each time the heart beats, it
pumps out blood into the arteries. Blood pressure is highest when the heart contracts, pumping the blood
through the arteries. This is called systolic pressure. When the heart is at rest, between beats, blood
pressure falls. This is the diastolic pressure. A blood pressure reading uses these two numbers, the
systolic and diastolic pressures. Usually, they are written one above or before the other. Readings are
interpreted as follows:
• 120 (systolic)/80 (diastolic) or lower indicates normal blood pressure;

• 140/90 or higher is high blood pressure (hypertension); and
• 120-139 for the top number, or 80-89 for the bottom number, is pre-hypertension.
8 Adapted from: Chenoweth, D. (2007). Worksite health promotion, 2nd ed.. Windsor, ON: Human Kinetics.
Health and Wellness
High blood pressure usually has no symptoms, except rarely, headaches might occur. High blood
pressure can cause serious problems such as stroke, heart failure, heart attack, and kidney failure. High
blood pressure can be controlled through healthy lifestyle habits and the use of prescription medications.
A diagnosis of hypertension (a chronic medical condition where blood pressure readings are consistently
elevated) can only be made after a number of high blood pressure readings have been recorded.
An estimated 900 million people in developing countries have high blood pressure (hypertension), but a
mere one-third are aware of their condition. Further, only 100 million of these people receive treatment,
while only 5% of the total cases are controlled. Gaziano 9 and colleagues report that a 25% increase in
high blood pressure screening in 19 developing countries would reduce the number of cardiovascular
disease events and deaths that occur each year by up to 3% in these countries. Furthermore, the
incremental cost-effectiveness ratios of these screening programs were found to be well below one times
GDP per capita in the 19 developing countries assessed. 10
Cholesterol Screening
Blood cholesterol levels are an important indication of current and future health. High cholesterol levels
put the individual “at risk” for a variety of health conditions, including heart disease. As blood cholesterol
levels rise, the likelihood of suffering a heart attack increases exponentially. Cholesterol screenings can
help determine if blood levels are within the safe range and can indicate if lifestyle or dietary changes are
warranted to prevent the development of cardiovascular disease. Many companies offer periodic
cholesterol screening as a means of health protection.
Weight Management Programs

Organizations worldwide recognize that worker obesity is among the top three lifestyle risk factors that
can negatively impact employee health, leading to rising medical and benefit costs and lost productivity. 11
Hence, workplace health and weight loss programs are instituted in corporate environments to help
workers manage their body weight and to adopt a healthy lifestyle. While it may seem like an expensive
perk for workers, employers know that weight-loss programs can actually help their bottom line when it
comes to disability and health care costs. Luckily, most communities have agencies that specialize in
weight management programming, which can provide assistance.
Routine Immunization
A vaccine is a biological preparation that improves immunity to a particular pathogen or disease. A
vaccine typically contains an agent that resembles the disease-causing microorganism (pathogen), and is
often made from weakened or killed forms of the microbe, its toxins, or one of its surface proteins. The
agent stimulates the body's immune system to recognize the agent as foreign, destroy it, and "remember"
it, so that the person’s immune system can more easily recognize and destroy any of these
microorganisms in the future. Vaccines can be prophylactic (for example, to prevent or ameliorate the
effects of a future infection by any natural or "wild" pathogen), or therapeutic (for example, vaccines
against cancer).
Typically, Canadian workers enter the workplace immunized against childhood diseases, tetanus, and
diphtheria. Depending on the anticipated work exposures, workers may need additional immunization
against hepatitis, typhoid, rabies, etc. Of course, annual flu vaccinations are highly recommended.
In the course of their work, the OHS professional will spend time on health protection (disease
prevention) activities. However, it is important to recognize that although health promotion and health
protection activities differ, they are complementary processes.
9 Gaziano, T., et al. (2012). Presentation at World Congress of Cardiology, on 21, April 2012.
10 Gaziano, T., et al. (2012). Presentation at World Congress of Cardiology, on 21, April 2012.
11 Towers Watson (2014). 2013/2014 Staying@work report: Canada summary. Available online at:
http://www.towerswatson.com/en-CA/Insights/IC-Types/Survey-Research-Results/2014/02/2013-2014-staying-at-work-report-
canada-summary
Health and Wellness
Integrated Workplace Health Management 12

The ultimate approach to primary prevention is the Integrated Workplace Health Management (IWHM)
approach -- a management approach in which organizational resources are positioned in an integrated
manner to promote workplace health, safety, and well-being for the employee and the organization. The
components of the IWHM program are linked so that they can optimize their program effectiveness as
well as support the functions of all the other IWHM components. The result is an enhanced approach to
promote and manage workplace health, safety, and well-being.
The components of an IWHM program (Figure 2) function to promote workplace health, safety, and
wellness; protect employees and the organization from workplace hazards; and support employees and
the workplace to successfully overcome various health and safety challenges that stem from a variety of
sources.
Figure 2: Integrated Workplace Health Management (IWHM) Approach 13
IWHM: Components and Functions
OH&S
Program Employee
Attendance Assistance
Control Program
(EAP)
Human Disability
Resources Management
Program Program
Employee
Workplace
Recruitment,
Selection & IWHM Wellness
Program
Retention
© Dyck, D., 2014
These IWHM components operate on various levels: a systems level, organization level, management
level, and individual level 14. The intent is to use an integrated and upstream approach 15 so that workplace
health, safety, and well-being can be realized with the least possible risk of loss, and in a cost-effective
manner.
12 Dyck, D. (2014). Integrated workplace health management course. Prepared for the University of Fredericton and University of
Calgary. degdyck@yahoo.ca .
13 Dyck, D. (2014). Integrated workplace health management course Prepared for the University of Fredericton and University of
Calgary. degdyck@yahoo.ca .
14 System Level – an approach in which the path of maximizing workplace health, safety and well-being is the path of least
resistance – the “easiest/natural way to proceed”.
Organizational Level – the creation of an organization in which leadership, culture, work environment, and employee supports
are aimed at workplace health, safety and well-being.
Management Level – the management practices used to address workplace health, safety and well-being.
Individual Level – the efforts that employees make towards promoting workplace health, safety and well-being for themselves
and their co-workers
15 Upstream approach refers to the organizational design, leadership, research, development, and production activities within an
organization. In terms of the workplace, it is the actions/activities designed to promote, protect, and enhance workplace health,
safety and well-being.
Health and Wellness
IWHM Explanation
A healthy organization is one whose culture, work environment, and people-management practices are
integrated and aligned to create a climate that engages, energizes, and enables employees to produce
sustainable business results. Unfortunately, Canadian organizations tend to position their employee
support programs and services to operate as “silos”. That is, they function independently with little to no
interface with each other. Their program outcomes and performance data are not combined with the
intent of understanding the true and total picture of the organization’s status of workplace health, safety,
and well-being.
To create a healthy workplace, the organization has to set the stage (an upstream approach). Through
enlightened leadership and the creation of a supportive work culture, Management can attain operational
excellence in workplace health, safety, and well-being. By understanding the value offered and the
benefits afforded through the linkage of the various workplace support programs and services,
Management can position the workplace to function effectively and to be highly productive. Part of the
integration would be the development and implementation of a measurement strategy to collect and
combine key data variables that indicate the status of the organization’s health, safety, and well-being.
IWHM Components: Linkages

The components of an IWHM program interface so that they can optimize their effectiveness as well as
support the function of all the other components. This concept (Figure 3), in essence, demonstrates how
the contributions of each component can be used to support workplace health, safety, and well-being of
the employee and the organization.
By way of examples, consider the following:

• Employee recruitment, selection, and retention should be linked with the Human Resources (HR)
Program, Attendance Control, OHS Program, and Disability Management Program (DMP) in a
reciprocal manner. When seeking to hire new employees, knowing the job demands is essential.
The OHS Program can play a major role in providing this type of information to HR personnel;
• The Human Resources (HR) Program should be linked with Attendance Control, OHS Program,
Disability Management Program (DMP), and Workplace Wellness Program (WWP) in a reciprocal
manner. If HR notes that prescription drug costs are elevated due to increased use of lifestyle-
factor medications, they can work with the WWP to offer health education and other promotional
initiatives that encourage the adoption of positive employee lifestyle practices;
• Attendance Control should be linked with the employee recruitment, selection, and retention;
Human Resources (HR) Program; Employee Assistance Program (EAP); Disability Management
Program (DMP); and Workplace Wellness Program (WWP) in a reciprocal manner. By way of an
industry example, Dyck, 2011, describes the operation of an Attendance Support and Assistance
Program, as well as how links with a Disability Management Program; 16
16
Dyck, D. (2013). Disability management: Theory, strategy & industry practice, 5th ed. Markham, ON: LexisNexis Canada
Inc., Chapter 9.
Health and Wellness
Figure 3: Integrated Workplace Health Management Approach 17
IWHM: Components and Functions

Linkages
Employee recruitment,
selection and retention
OH&S
should be linked with the Program
HR Program, Attendance Employee
Attendance
Assistance
Control, OH&S Program & Control
Program (EAP)
Disability Management
Program in a reciprocal
manner Disability
Human
Management
Resources
Program
Program (HR)
(DMP)
Employee Workplace
IWHM
Recruitment, Wellness
Selection & Program
Retention (WWP)
Source: Dyck, 2011
• The OHS Program should be linked with employee, recruitment, selection, and retention; Human
Resources (HR) Program; Attendance Control; Employee Assistance Program (EAP); Disability
Management Program (DMP); and Workplace Wellness Program (WWP) in a reciprocal manner.
Post-incident occurrence, the OHS team may arrange for Critical Incident Stress Debriefing
offered by the EAP. This psychological first-aid measure can prevent the serious consequences
of exposure to a life-threatening event;
• The Disability Management Program (DMP) should be linked with employee, recruitment,
selection, and retention; Human Resources (HR) Program; Attendance Control; OHS Program;
Employee Assistance Program (EAP); and Workplace Wellness Program (WWP) in a reciprocal
manner. The DMP outcome data may indicate that the prime reason for employee short-term
medical absences is psychological disorders. As such, the organization would be encouraged to
enhance its management practices (an HR mandate) and its EAP services. However, if the
primary reason for employee work absence is due to musculoskeletal disorders, health protection
measures through the OHS Program would be recommended;
• The Workplace Wellness Program (WWP) should be linked with employee, recruitment, selection
and retention; Human Resources (HR) Program; Attendance Control; OHS Program; Employee
Assistance Program (EAP); and Disability Management Program (DMP) in a reciprocal manner.
In the course of offering WWP initiatives, the existence of ergonomic issues may be noted. As
such, the OHS and DMP may be called upon to address the current musculoskeletal injuries and
to seek ways to remedy the situation.
Although many Canadian organizations have these employee support programs and services in place,
the above suggested linkages are rarely evident.
Benefits of Linkages
There are numerous benefits that organizations can realize through IWHM integration, such as the
occurrence of:
17 Dyck, D. (2014). Integrated workplace health management course. Prepared for the University of Fredericton and University of
Calgary. Access is available through http://www.ufred.ca/w_certificate_in_disability_management.aspx? or degdyck@yahoo.ca
Health and Wellness
• Human Resources Program, Workplace Wellness Program, Employee Assistance Program,

Occupational Health & Safety Program, Absence Control Program, and Disability Management
Program and service utilization and data integration;
• A comprehensive view of the status of workplace health, safety, and wellness;
• An understanding of program savings, return on investment, and impact;
• Linkages between workplace performance metrics, and employee absence and medical rates
and costs;
• Benchmarking of organizational data to national norms and other benchmarking indices; and
• Informed decisions to be made in regards to workplace health, safety, and wellness programs
and services.
Companies that use their entire corporate leverage in an integrated way, have been known to:
• Retain employee talent;
• Generate highly-engaged workforces positioning them to do well in the marketplace;
• Deliver higher-quality products and services;
• Realize greater productivity and profitability;
• Deliver the greatest business value;
• Enjoy stronger financial performance; and
• Generate superior ROI to shareholders.
In terms of quantifiable financial returns, these organizations that integrate their health and productivity
have been shown to realize:
• Higher market premiums – market premiums that are 18 points higher that the market premiums
of low-effectiveness organizations;
• Average revenues per employee that are 40% higher – the difference per employee is $132K;
• An annual health care differential of $551 per employee;
• Lower casual absence days;
• Fewer disability days;
• Lower voluntary staff turnover rates;
• Reduction in employee health risks; and
• Fewer disability days. 18
These are the drivers for adopting an integrated approach to workplace health management.
In essence, there is a link between highly effective health and productivity strategies, and strong business
and financial results. By linking an organization’s OHS efforts with its Employee Assistance Program,
Disability Management Program, and Workplace Wellness Program; and by recognizing the impact that
management and human resources management theories can have on a workforce and workplace
wellness, the opportunity to significantly reduce illness/injury incidence and impact exists. The challenge
then, becomes one of acting on that knowledge in a proactive manner – an organizational primary health
prevention (health promotion) manner.
18 Towers Watson (2013). Pathway to health and productivity: 2011/2012 Staying@work survey report. Available online at
http://www.towerswatson.com/en-CA/Insights/IC-Types/Survey-Research-Results/2011/12/20112012-StayingWork-Survey-
Report--A-Pathway-to-Employee-Health-and-Workplace-Productivity , pg. 2.
Health and Wellness
A: OBJECTIVES:
General Objectives:
The OHS professional will:
• be knowledgeable about health promotion and health protection (disease prevention).

• recognize their respective role in promoting worker health and well-being.
Specific Objectives:
The OHS professional will be able to:
• define the terms health promotion, optimal health, and health protection (disease
prevention);
• identify the differences between health promotion and health protection;
• define the three levels of health protection;
• identify workplace examples of health promotion (e.g., general health education, routine
immunization, routine medical examinations, annual eye examinations, general fitness
awareness, psychological health awareness programs, provision of specific pathogen vaccine,
etc.), and health protection (e.g., occupational health and safety programs, hearing conservation
programs, ergonomic programs, health surveillance, medical monitoring, respiratory protection
programs, and international travel programs, etc.), including the three levels of prevention;
• describe the motivational base for the adoption and sustainability of health behaviours;
• define health and be knowledgeable about how health is viewed from a number of contexts;
• understand the Health Belief Model;
• explain the design of workplace health promotion programs;
• describe the program management of health promotion programs; and
• understand the contribution that an OHS professional can make towards health promotion and
health protection (disease prevention).
B. ACTIVITIES:
1. Suggested Reading:
Dyck, D.E. (2013). Disability management: Theory, strategy and industry practice,
5th edition. Markham, ON: LexisNexis.
Chapter 7: The role of employee assistance programs in disability management,
pp. 239-268.
Chapter 12: Prevention of workplace illness and injury, pp. 411-460.
O’Donnell, M., & Associates. (2002). Health promotion in the workplace, 3rd edition.
Toronto, ON: Delmar Thomson Learning.
Chapter 1: The health effects of health promotion by J. Harris and J. Fries, pp. 1-
20.
Chapter 3: Design of workplace health promotion programs by M. O’Donnell, pp.
49-73.
Chapter 4: Program management of workplace health promotion programs by W.
Baun, pp. 78-113.
Chapter 7: Theoretically-based strategies for health behavior change by K.
Wallston and C. Armstrong, pp. 182-199.
Pender, N., Murdaugh, C., & Parsons, M. A. (2011). Health promotion in nursing
practice, 6th edition. Upper Saddle River, NJ: Pearson Education Inc.
Health and Wellness
Introduction: Global health promotion: Challenges of the 21st century, pp. 1-9.
Chapter 1: Toward a definition of health, pp. 14–31.
Chapter 2: Individual models to promote health behavior, pp. 35-62.
Chapter 3: The PRECEDE-PROCEED model, pp. 74-76.
Chapter 14: Health promotion at the worksite, pp. 308-310.
Towers Watson (2014). 2013/2014 Staying@work report: Canada summary. Available

online at: http://www.towerswatson.com/en-CA/Insights/IC-Types/Survey-Research-
Results/2014/02/2013-2014-staying-at-work-report-canada-summary
Towers Watson. (2012). Pathway to health and productivity: 2011/2012 Staying@work

report. Atlanta, GA: Watson Wyatt Worldwide. Available online at: www.watsonwyatt.com
2. The terms health promotion, optimal health, and health protection (disease prevention) are
described by Pender on pages 5-6. The differences between promotion and health protection
(disease prevention) are also covered. O’Donnell defines health promotion and optimal health on
page 49 and goes on to discuss the unique needs of health promotion programs serving workers
in industrial settings, pages 70-73.
3. Refer to Pender, pages 36 for definitions of the levels of health protection (disease prevention)
along with some workplace examples. Additional examples are provided by Dyck, pages 256-
258.
4. Motivation plays a key role in the initiation and maintenance of health-protecting (disease
prevention) and health-promoting behaviours. Pender describes the motivational base for health
behaviours on pages 5-6.
5. The meaning of health is viewed in many contexts: historic and cultural, social and personal,
scientific, and philosophic. These meanings can be contradictory and overlapping. It is important
for OHS professionals to share a common understanding of what health is so they can work
together to promote health. Health is defined as “a state of complete physical, psychological, and
social well-being and not merely the absence of disease and infirmity” by the World Health
Organization (WHO). 19 Refer to Pender, Chapter 1 (pages 14-31) for a discussion on the
definition of health. As well, O’Donnell provides the meaning of health on pages 1-2.
6. Understanding the determinants of health-protecting (disease-prevention) behaviour is critical for
the OHS professional to develop effective interventions that promote and facilitate lifestyle
changes by employees. The Health Belief Model is a framework for exploring why some people
who are free of illness take actions to avoid illness while others do not. Refer to O’Donnell, pages
183-184 for a detailed explanation of the Health Belief Model.
7. The design of workplace health promotion programs is explained by O’Donnell, Chapter 3, pages
49-69. Additionally, the Seven Steps to Better Health Promotion suggested by Health Canada
(1987) 20 are valuable to know and still hold true today:
Step 1: Set your communication goals

Precisely state the overall intent of your communication activities. The goal of your
communications program may not necessarily be the same as your overall project. For
example, the program goal may be encourage people to adopt a more active lifestyle,
and the communications goal is to inform them of various active living programs.
Step 2: Identify your target audience

The rule of thumb is to direct your message to the group of people who are the most
directly affected by the health issue of concern.
19
World Health Organization – WHO. (1996). Basic document (36th edition). Geneva, Switzerland: WHO.
20
Health Promotion Directorate. (1987). 7 Steps to better health promotion, Cat. No. H39-126/1988E, ISBN No. 0-662-16226-9,
Ottawa, ON: Minister of Supply and Services Canada.
Health and Wellness
Step 3: Decide what you are going to communicate – your strategy

Take what you need/want to say and condense it down to one or two sentences.
Step 4: Tell your target audience how you can help them – benefits
Ensure that your message is positive and that it provides some direct or indirect solutions
for your target group. In essence, make sure that your target audience is aware of “what
is in it for them” to participate in the program.
Step 5: Tell your target audience why you can help them
Make sure your target audience knows WHY you can help them.
Step 6: Decide how to reach your target audience – tactics

Determine what message medium works the best for your target audience. Some
possible avenues include:
• company announcements or news releases;
• pamphlets or brochures;
• audio-visual presentations;
• posters;
• workshops or seminars;
• bulletin board displays;
• pay cheque flyers;
• presentations at safety meetings or tailboard meetings; and/or
• use of websites, Facebook pages, blogs, Twitter, etc.
Then, find out where to reach your target audience and how much information they can
comfortably absorb at once. Finally determine what can realistically be done given your
time and budget.
Step 7: Evaluate the effectiveness of your communication program

Before starting your program, establish realistic program performance goals that are
measurable. Ensure that you have performance targets established. Once the program is
running, monitor how it is functioning as compared to the set targets. Make program
adjustments as you go along. This is called Formative Evaluation.
To measure the program success, conduct a program evaluation at the end of a pre-
determined time-period comparing the program outcomes against the pre-set desired
program objectives and targets.
8. The program management of workplace health promotion programs is discussed by W. Baun in
O’Donnell, Chapter 4, pages 78-113.
9. Health protection is directed towards decreasing the probability of experiencing illness by working
to protect the body against pathological stressors or detection of illness in the asymptomatic
stage. The Health Promotion Model is complementary to the models of health protection. Health
promotion is directed toward increasing the level of well-being and self-actualization of an
individual. Health promotion focuses on movement toward enhanced health and well-being.
Illness and disease tend not to be motivators for health-promoting behaviour. Pender, pages 44-
51, describes The Health Promotion Model (revised).
10. The OHS professional can make a significant contribution towards health promotion and health
protection because they have the unique opportunity to interact with numerous adults on a daily
basis. Refer to Pender, pages 8-9 for ideas on possible outcomes.
Health and Wellness
HW2: Demonstrate an Understanding of Injury, Illness, and Disease

Prevention Programs
Health protection (disease prevention) programs such as occupational health and safety programs,
hearing conservation programs, medical monitoring, and respiratory protection programs tend to be
introduced into the workplace by virtue of compliance with the various provincial/federal/territorial pieces
of legislation. Others, like pre-placement health screening programs, ergonomic assessments, vision
screening, immunization, and return-to-work fitness assessments, and international travel programs, exist
because they make sound business sense.
From a business perspective, the Towers Watson 2011-2012 Staying@Work Report: Pathway to
Health and Productivity, indicates “a strong link between highly effective health and productivity
strategies and strong human capital and financial results” (p. 2). For example, market premiums that are
18 percentage points higher, 40% higher average revenues per employee, lower annual health care
costs, fewer lost workdays due to absenteeism and disability, reduced staff turnover, and fewer employee
health risks (p. 2).
The Ontario Workplace Safety and Insurance Board (WSIB) guidebook, Business Results Through
Health & Safety (2000), was written to help organizations understand why occupational health and safety
programs (health protection programs) provide shareholder value, improved operations, and better
bottom-line results. This resource is very useful in helping stakeholders understand the financial and
business benefits of health promotion programs like occupational health and safety programs.
Effective marketing is critical to communicating the value of health promotion and health protecting
programs throughout an organization. Marketing is defined as a social and managerial process through
which individuals and groups obtain what they need and want by creating and exchanging products or
services and value with others. 21 Effective marketing can be equated to effective marketing management.
Marketing management involves managing customer demand which, in turn, involves managing customer
relationships. OHS professionals can promote their health promotion or health-protecting (prevention)
programs by nurturing strong relationships with program champions and those workers who support the
services offered. Union leaders, line managers, and human resources personnel can be valuable allies.
They are well positioned to help market the program and its services.
To operationalize the concept of health protection, the following terms are defined:
• Occupational Health and Safety Program - a complete system that ensures high safety
standards throughout the company’s operations and:
 reflects a strong commitment from management towards workplace health and safety;
 encourages worker commitment towards workplace health and safety;
 helps workers understand their responsibility for preventing workplace incidents;
 implements a work environment that provides the elements required to work safely, namely
know how to work safely, able to work safely, equipped to work safely and motivated to work
safely;
 provides workers with safe work tools/equipment, and personal protective equipment;
 promotes strong worker personal hygiene practices, such as hand washing, avoidance of
eating/drinking in work areas, and removal of contaminated clothing at the end of a shift; and
 enables program evaluation and continuous improvement.
It is a defined action plan designed to prevent incidents and occupational diseases.
21
Dyck, D.E. (2011). Occupational health & safety: Theory, strategy and industry practice, 2nd edition. Markham, ON:
LexisNexis, p. 591.
Health and Wellness
• Hearing Conservation Programs – are designed to prevent noise induced hearing loss, that is,
hearing loss due to noise exposure greater than 85dB 22. A hearing conservation program is
comprised of:
 identification, assessment and control of noise hazards;
 management and worker education on noise, the potential ill effects, and effective control
measures;
 provision of hearing protection;
 medical monitoring through regular hearing tests; and
 regular program evaluation and continuous improvement of noise abatement measures to
prevent hearing loss.
• Ergonomic Programs – are aimed at preventing work-related musculoskeletal disorders

(WMSDs). Management commitment, worker involvement, program management, worksite
analysis, ergonomic prevention and control measures, stakeholder education and training, and
medical management of injuries are the key components.
• Health Surveillance – the systematic collection and evaluation of worker data to identify
instances of illness or health trends suggesting adverse workplace exposures coupled with
actions to reduce hazardous workplace exposures. It includes job-specific immunizations such as
tetanus, polio, hepatitis, typhoid, etc. immunizations.
• Medical Monitoring – monitoring is the evaluation of a disease/condition over time. It can be

performed by continuously measuring certain parameters (for example, respiratory capabilities,
lung changes, etc.), and/or by repeatedly performing medical tests (such as blood or urine tests
for certain markers like the presence of mercury, lead, or other chemicals).
• Respiratory Protection Program – establishes acceptable practices for respirator selection and
use; for individual fit testing; for the care of respirators in accordance with the regulatory
requirements; and for the maintenance of respiratory equipment. In addition to having such a
program, the employer must also be able to demonstrate that the program is enforced and
updated as necessary.
• International Travel Program – addresses the preparation of international workers for work in
foreign environments, either on a temporary assignment, or on a long-term basis. Employee
fitness to travel assessment; preparation for regular healthcare; provisions for emergency
treatment and evacuation; orientation to social and cultural norms; and security briefings are all
part of an International Travel Program.
When adopting and/or maintaining a workplace health promotion program, OHS professionals need to
develop measurable program performance objectives which are endorsed and supported by senior
management.
22
The criterion level, often abbreviated as Lc, is the steady noise level permitted for a full eight-hour work shift. This is 85 dB(A) in
most jurisdictions. The exceptions are 90 db(A) in Quebec and 87 dB(A) in the Canadian federal noise regulations. Source:
CCOHS (2012) Noise - Occupational Exposure Limits in Canada. Available on line at www.ccohs.ca .
Health and Wellness
A: OBJECTIVES:
General Objectives:
• The OHS professional will understand the value of health protection (disease prevention)
programs, e.g., occupational health and safety programs, hearing conservation programs, health
surveillance, medical monitoring, respiratory protection, international travel programs, etc.
• The OHS professional will be able to demonstrate the value that health promotion and health
protection (disease prevention) programs can offer to an organization.
• The OHS professional will know how to effectively market health promotion and health protection
(disease prevention) programs.
• define the term effective program marketing;

• understand the core marketing concepts;
• understand the term – key marketing concept, and how it can be operationalized;
• describe how to build a business case for a health promotion and health protection (disease
prevention) program;
• understand why employers invest in health promotion programs;
• understand why employers invest in health protection programs;
• describe how to develop a communication plan for a health promotion and health protection
(disease prevention) program;
• understand the contribution that an OHS professional can make towards the marketing of a
health promotion and health protection (prevention) program; and
• appreciate the role that the various health and safety protection programs play in protecting the
worker.
B. ACTIVITIES:
Canadian Public Health Association, (2001). ROI One Life Immunization. Available online
at: http://www.benefitscanada.com/wp-
content/uploads/2013/09/roiOneLife_immunization.pdf
Dyck, D.E. (2011). Occupational health & safety: Theory, strategy and industry
practice, 2nd edition. Markham, ON: LexisNexis.
Chapter 14: Marketing occupational health & safety programs, pages 591-617.
O’Donnell, M., & Associates (2002). Health promotion in the workplace, 3rd edition.
Chapter 1: The health effects of health promotion by J. Harris and J. Fries, pages
1-20.
Pender, N., Murdaugh, C., & Parsons, M. A. (2011) Health promotion in nursing
practice, 6th edition. Upper Saddle River, NJ: Pearson Education Inc.
Chapter 14: Health promotion at the worksite, pages 325-327.
Public Health Agency of Canada (2014). Canada Immunization Guide, 2014. Available
online at: http://www.phac-aspc.gc.ca/publicat/cig-gci/assets/pdf/p01-eng.pdf
Health and Wellness

WSIB. (2000). Business results through health & safety. Toronto, ON: WSIB.
Available online through
http://www.ryerson.ca/content/dam/irm/pdfs/training/ISS_MGR/WSIB_BusinessResultsTh
roughHS.pdf
Part 1: Business case introduction, pages 2-11.
 The term effective program marketing involves:
• marketing Disability Management services, internally and externally, through the use of:
 Disability Management Program educational sessions;
 Disability Management Program brochures/posters;
 Disability Management Program educational presentations;
 media boards (e.g., bulletin boards, electronic information boards, computer
message boards, etc.); and/or
 articles in the company newsletter.
• use of Disability Management Program web pages;
• provision of one-on-one coaching on sound disability management practices for workers
and management;
• use of recognition/rewards for a performance of the desired disability management
practices by line management;
• provision of regular Disability Management Program reporting to all levels; and
• use of disability trend analysis data to identify issues and reinforce the message(s)
presented.
Refer to Dyck on page 681 for more details.
2. The core marketing concepts are discussed by Dyck on pages 665-668.

3. Marketing management is explained by Dyck: Effective marketing can be equated to effective
marketing management. Marketing management involves managing customer demand which, in
turn, involves managing customer relationships. Refer to Dyck, page 667 for details on marketing
management using the marketing of a disability management program as an industry example.
4. Communication about the program, its goals, features and outcomes, is pivotal to a successful
program. A sample communication plan and communication tools for a disability management
program are provided by Dyck on pages 677-690.
5. Health promotion occurs in many settings. Over the years, Canadian employers have become
interested in providing health promotion programs in the workplace. The assumptions are that
health promotion programs can result in:
• improved employee morale;

• increased productivity;
• decreased medical absenteeism rates and costs;
• fewer disability claims and costs;
• lower supplementary health care costs; and/or
• reduced staff turnover.
For more information on the benefits of health promotion programs, refer to Pender, pages 308-
310; O’Donnell, pages 1-20; and the Towers Watson Staying@Work Report (2011-2012).
6. Health protection programs are valued by employers because of the many loss control savings
that can be realized. The Ontario Workplace Safety and Insurance Board (WSIB) guidebook,
Health and Wellness
Business Results Through Health & Safety, was written to help organizations understand why
Health and Safety (Health Protection Programs) provide shareholder value, improved operations
and better bottom-line results. Part 1: The Business Case for Health & Safety, lists the
following outcomes as the business justification for Health and Safety Programs:
• Compliance with the law;

• Cost reduction;
• Business interruption protection;
• Employee relations improvement;
• Reliability and productivity improvement;
• Building public trust;
• Building organizational capability.
7. Based on the information provided, determine what role the OHS professional could play in the
marketing of a health promotion and health protection (disease prevention) program.
8. Job-specific immunization protects workers from airborne and bloodborne pathogens. Workers
employed in positions where direct exposure to these pathogens or needlestick punctures could
occur, should be immunized. For more information, refer to the Canada Immunization Guide,
2014 and the ROI One Life.
9. Worker protection includes hazard management. The ideal approach is to eliminate, substitute, or
enclose work hazards using engineering approaches. When that is not possible, then control
hazards through administrative means, such as the use of safe work practices, work scheduling,
work information systems, ventilation assessments, equipment safeguarding, worker education/
training, adequate supervision, good housekeeping, worksite inspections, hazard reporting and
investigation, compliance enforcement, and hazard control evaluations. The last line of worker
protection is personal protective equipment (PPE) – eye, head, hand, hearing, respiratory, foot, or
full-body protection. PPE should be used as “back-up” protection for the worker against work
hazards. For more details, refer to Dyck, Chapter 7.
10. Medical monitoring/screening is a means of secondary prevention in the workplace. Because
screening is administered on asymptomatic persons who are at risk for certain diseases or
adverse health outcomes, disease or dysfunction can be detected before medical care would
normally be sought. Its purpose is early diagnosis and treatment of the worker. It can also detect
new occupational injury/illness, assess worker fitness to work, and evaluate the efficacy of
personal protective measures.
HW3: Demonstrate an Understanding of Employee Assistance Programs
Employee assistance programs (EAPs) exist in the workplace to provide confidential, short-term,
professional counselling assistance to employees and their families to help them overcome personal and
family problems that undermine work performance. Historically, they were designed to address alcohol
and drug abuse in the workplace; however over time, EAPs have expanded their counselling services to
encompass:
• crisis management;
• financial counselling;
• legal counselling;
• career/vocational counselling;
• stress management counselling/seminars;
• time management counselling/seminars;
• change management counselling/seminars;
• divorce counselling;
• childcare and eldercare support;
Health and Wellness
• alternative therapies (behaviour modification, nutrition counselling, eating disorder counselling,

etc.);
• wellness programs;
• disability management, especially when psychological barriers to a successful return to work
exist; and
• advice to managers/supervisors on how to deal with difficult people situations at work.
Key to a successful EAP is respecting and upholding the confidentiality aspect of the service. The
provision of confidential counselling services is the cornerstone of any EAP. If jeopardized, employees
and family members will not use the EAP.
Employee assistance programs can be linked to disability management as employee assistance

counselors may be involved in providing services before disability occurs, during the disability period, in
the return-to-work process and as part of the follow-up process. It is important for the OHS professional to
be knowledgeable about the scope and function of EAPs, as well as the importance of protecting the
confidentiality of EAP services.
A: OBJECTIVES
General Objectives:
• be able to gain an understanding of the scope and function of an EAP;

• recognize the value of having linkages between the EAP and other programs such as
occupational health and safety programs, workplace wellness programs, attendance support
programs, addiction control programs, disability management programs, change management
programs, smoking cessation programs, and weight management programs.
• understand that changing workplace dynamics can have damaging effects on employee and
family health, and well-being;
• identify drivers that contribute to stress related claims;
• describe what an EAP is and how it adds value to an organization;
• list the scope of EAP services;
• identify reasons for an EAP referral;
• describe the procedures for an EAP referral;
• describe the steps of EAP counselling;
• understand the importance of the provision of confidential EAP services;
• explain how EAPs integrate with workplace wellness models;
• recognize the role that EAPs can play in the disability management and return-to-work processes;
• describe the best practices in linking disability management program with an EAP;
• identify if EAPs work or not; and
• recognize the future challenges facing workplaces that can be addressed by EAPs.
Health and Wellness
B. ACTIVITIES:
Alberta Health Services. (2010). It’s our business: Dealing with the troubled employee.
Alberta: Alberta Health Services. Available on http://www.albertahealthservices.ca/
CCOHS. (2009). OSH answers: Employee assistance programs (EAP). Available on

www.ccohs.ca
Dyck, D.E. (2013). Disability management: Theory, strategy and industry practice, 5th
edition. Markham, ON: LexisNexis.
Chapter 7: The role of employee assistance programs in disability management,
pages 239–268.
Chapter 9: Workplace attendance support and assistance, pages 289-324.
Chapter 10: Disability management practice standards, pages 325 -394.
Chapter 11: Prevention of workplace illness and injury, pages 411-46.
O’Donnell, M., & Associates. (2002). Health promotion in the workplace, 3rd edition.
Chapter 16: Employee assistance programs by R.P. Maiden and D.B. Levitt,
pages 415-456.
2. Absenteeism costs are often symptomatic of serious workplace problems. For discussion on how
changing dynamics in the modern workforce have been linked with numerous health problems, refer
to Dyck, pages 240–243. Additional insight is available in O’Donnell, pages 415-416 and Alberta
Health Services, It’s Our Business: Dealing with the Troubled Employee.
3. There are three main drivers for the increase in the number of stress-related claims: work-related
drivers, societal drivers, and the medicalization of social and/or employment problems. These drivers
are described by Dyck on pages 243-247.
4. An EAP provides confidential, professional assistance to employees and their families to help them
resolve problems affecting their personal lives and, in some cases, their job performance. Historically,
EAP Programs were introduced to deal with employee alcohol and drug abuse; however over time,
the services provided by EAP programs have expanded. These services are outlined by Dyck on
pages 251-253. O’Donnell, pages 415-420 further discusses the history and role of EAPs, as does
the CCOHS fact sheet, OSH Answers: Employee Assistance Programs (EAP).
5. EAP programs are broad in scope, providing services in a number of areas. Their scope of practice is
described by Dyck on pages 252, and some real-life examples of how EAPs provide support in
disability situations are outlined on pages 255-256. O’Donnell, pages 416-420, describes the basic
principles of EAPs. The CCOHS fact sheet, OSH Answers: Employee Assistance Programs
(EAP), expands on this aspect by explaining what happens when the employee calls the EAP.
6. EAPs offer value to organizations by assisting employees and family members to address personal
problems. This is generally measured in terms of increased work productivity. O’Donnell, pages 432-
439 discusses whether EAPs work or not, and provides some typical program costs.
7. Dyck, pages 253-255, describes the value that an EAP can provide in the disability management
arena. As well, EAPs can assist employees to reduce their work absenteeism. Dyck, pages 290-291
describes some employee absenteeism costs that can be reduced with the help of EAP services. The
role of EAPs in the prevention of workplace illness and injury is also discussed by Dyck on pages
411-412.
Health and Wellness
8. The reason for EAP referrals is discussed in the CCOHS fact sheet, OSH Answers: Employee
Assistance Programs (EAP). The Alberta Health Services fact sheet, Dealing with the Troubled
Employee, also discusses the management of troubled employees.
9. Refer to Dyck, pages 94-95 for graphic presentations depicting the management of an employee with
a health concern, and the management of an employee with a personal issue or problem. Each of
these flow charts denotes the appropriate times for initiating referrals. O’Donnell, page 422, discusses
three types of EAP referrals. They include self-referral, job performance, and/or medical referral, and
peer referral.
10. The steps of EAP counselling include assessment, motivational counselling, short-term problem
solving, treatment matching, follow-up, return to work and aftercare. These steps are explained by
O’Donnell, pages 422-425.
11. Confidentiality is defined as “the maintenance of trust and the avoidance of invasion of privacy
through accurate reporting and authorized communication”. 23 Refer to Dyck, pages 359-368 for a
description of a Standard of Practice on Confidentiality. O’Donnell, page 425, explains the importance
of confidentiality.
12. In many workplaces, the occupational health and safety program, EAP, attendance support and
assistance program, disability management program, and workplace wellness program operate
independently, focusing solely on their respective goals. Dyck describes this disjointed approach as a
“silo effect” because each program functions in isolation. A Workplace Wellness Model that integrates
all aspects of workplace health by linking occupational health, attendance support, disability
management, occupational safety, industrial hygiene, EAP, workers’ compensation claims, and
human resources practices is described by Dyck, pages 415-425. This is the ideal situation.
13. EAPs have a significant role to play in the disability management process. This is described by Dyck
on pages 257-260.
14. A number of best practices associated with linking EAPs with disability management programs are
discussed by Dyck on pages 1133-1134. They include:
• Ensure that the proposed Integrated Disability Management Program model includes a formal
linkage with company or organization’s Employee Assistance Program. Effective linkage can
be achieved before, during or after the disability occurs;
• Ensure that all the service providers attain a mutual understanding of and respect for the
individual program goals and objectives, as well as for the overall Integrated Disability
Management Program goals and objectives;
• Promote a partnership approach that allows for multi-disciplinary interventions;
• Examine the outcome measures on the cases served jointly by the Employee Assistance
Program and Integrated Disability Management Program personnel. Knowledge of utilization
rates, types of cases served, trend analyses and success or failure rates, and anticipatory
guidance for illness and injury prevention can be provided using aggregate data.
15. The intent is to be able to assess the value of the linkage and its contribution to the overall process.
This outcome data can also be compared to those cases that were not co-managed to determine the
value of the Disability Management Program-Employee Assistance Program linkage.
16. O’Donnell, page 437, discusses whether or not EAPs work.
17. EAP costs range from $18 to $36 per employee per year. O’Donnell discusses EAP costs on page
437.
23
Dyck, D.E. (2013). Disability management: Theory, strategy and industry practice, 5th edition. Markham, ON: LexisNexis, p.
360.
Health and Wellness
18. The CCOHS fact sheet, OSH Answers: Employee Assistance Programs (EAP), addresses what
organizations should be looking for when contracting/hiring an EAP provider.
19. The five issues that will challenge future workplaces are described by Dyck on pages 260–263. EAPs
have a role to play in helping companies to address these issues.
HW4: Demonstrate an Understanding of Wellness Programs
Workplace Wellness Programs are operationalized as programs designed to manage both the
psychological and physical issues in response to environmental stressors, including one’s work
environment. 24 They include programs like:
1. Stress Management
Stress is defined as the nonspecific response of the body to any demand made on it. 25 Another way of
defining stress is that it is “the result produced when a structure, system, or organism is acted upon by
forces that disrupt equilibrium or produce strain”. 26 In our dynamic and busy industrial world, stress which
tends to be cumulative in nature, is something that everyone faces.
Stress is necessary to life: The body’s stress response is a key psycho-physiological adaptive
mechanism. Hans Selye breaks the stress response down into eustress and distress. Eustress or
positive stress is an agreeable and healthy experience which is associated with positive health, increased
performance, human growth, and learning. Distress or negative stress is a disagreeable and pathogenic
state in which health and performance deteriorates. It is associated with almost every common illness
from flu to heart disease.
Stress has been a major concern for businesses because the effects of stress impact all aspects of the
workplace and the organization. In the workplace, stress can originate from excessive workloads, lack of
work/life balance, inadequate staffing 27, the nature of the job, the pace and design of the work, the work
environment, and the structure and the style of the employee-employer relationship. Generally a worker’s
stress level rises when the individual faces multiple demands but perceives few avenues to take control
over those demands. When stress occurs in amounts that an individual cannot handle, both psychological
and physical changes can occur. 28
High levels of work stress have been found to be associated with lack of mental alertness, forgetfulness,
substandard work performance, workplace accidents, reduced productivity, frequent health problems,
workplace violence, and increased workplace losses.
Workplace stress is defined as “the harmful physical and emotional responses that can happen when
there is a conflict between job demands on the employee and the amount of control an employee has
over meeting those demands. In general, the combination of high job demands and a low degree of
control over the work situation can lead to distress and disease. 29, 30
24
LexisNexis, p. 1403.
25
Selye, H. (1977). Introduction in D. Wheatley (ed.), Stress and the heart. New York: Raven Press.
26
Taber’s Cyclopedia Medical Dictionary reported in CCOHS (2008). Health Promotion/Wellness/Psychological: Workplace stress –
general. Available through CCOHS online at: http://www.ccohs.ca
27 Towers Watson. (2012). Pathway to health and productivity: 2011/2012 Staying@work report. Atlanta, GA: Watson Wyatt
29
CCOHS. (2008). Health promotion/wellness/psychological: Workplace stress - general. Available on the CCOHS website online
at: http://www.ccohs.ca
Health and Wellness
Many organizations have implemented stress management programs. The assumption being that if
workers can be assisted to better manage their stress levels, savings can be realized through the cost-
avoidance associated with fewer accidents, lowered medical and absenteeism costs, and increased
productivity. Stress management programs have a basic premise: The worker does not have to be the
victim of stress. The belief is that there are many ways in which the worker can make a difference in
his/her health and well-being. In essence, personal/organizational stress can be managed and effectively
controlled.
Using this approach, stress management programs tend to be one of five types:
1. Education/awareness building;
2. Assessment-focused;
3. Skill-building;
4. Therapeutic/counselling; or
5. Organizational/environmental change.
The first three types of stress management programs tend to identify people with particular performance
issues and to teach them how to better cope with stressful situations. These approaches are preventative
in nature. The therapeutic or counselling stress management programs are aimed at individuals who
demonstrate particular symptoms and who need help to self-manage the distress they are experiencing.
Organizational or environmental change is the least frequently implemented stress management
program; yet, it can have the greatest impact on reducing workplace stress levels.
Based on the Towers Watson report, 2011-2012, organizations are having limited success at addressing
the high levels of workplace stress. It appears as if there is a discrepancy between what workers report
as the sources of workplace stress (namely inadequate staffing, unclear or conflicting job expectations
and organizational culture), and what organizations view as the sources of work stress (namely excessive
workload/long work hours and lack of work/life balance). This finding indicates that if organizations want
to effectively manage work stress, they need to recognize and assess the stressors within their own work
environment. 31
Stress management programs can be delivered as workshops, self-learning tools or through personal
coaching. Key to implementing a stress management program is to involve workers in the design of the
program; set agreed-upon performance objectives for the program; and evaluate the program outcomes
against those objectives. The ultimate goal is to create working environments that allow people to work
together in ways that optimize their health and well-being.
The OHS professional will have an understanding of workplace stress, how it can negatively impact the
workplace in terms of worker illness, accidents, and related costs, and how stress management programs
can be effectively implemented.
2. Physical Fitness Programs
Employee participation in worksite physical fitness programs can enhance employee health-related
fitness, reduce cardiac risk factors, decrease illness/injury rates, reduce the rate of employee
absenteeism, and lessen risk-taking behaviours. 32
Pender defines physical activity as any bodily movement produced by skeletal muscles that results in
expenditure of energy and includes a broad range of occupational, leisure-time, and routine daily
32
Shepard, R. (1996). Worksite fitness and exercise programs: A review of methodology and health impact, American journal of
health promotion, Vol. 10(6), pp. 436-52.
Health and Wellness
activities. 33 Exercise is leisure-time physical activity conducted with the intention of developing physical
fitness. 34 Physical fitness is a measure of a person’s ability to perform physical activities that require
endurance, strength, or flexibility, and is determined by a combination of physical activity and genetically
inherited physical characteristics. 35
OHS professionals should encourage the development and implementation of workplace physical fitness
programs for large and small companies and then, promote employee participation.
3. Smoking Cessation
Tobacco use is a leading cause of death in both Canada and the United States. The health problems
caused by smoking include:
• Cancer of the lung, bladder, mouth, voice box, throat, kidney, cervix and bowel;
• Heart attack, circulatory problems, and stroke;
• Lung disease including chronic obstructive pulmonary disease, emphysema, chronic bronchitis;
and
• Flu, pneumonia, colds, peptic ulcer, Crohn's disease, tooth loss, gum disease, osteoporosis,
sleep problems, cataracts, thyroid disease, and menstrual problems. 36
Smoking is also related to infertility, sudden infant death syndrome, and infant health problems.
Although smoking rates have decreased over the years, about 17% of Canadians still smoke. 37 According
to the Conference Board of Canada, most smokers work. 38 The average annual cost of a smoker to
Canadian employers is estimated to be $4,256 in decreased productivity and increased absenteeism. 39 In
2010, the cost of smoking to Canadians was an estimated $7.1 billion in lost productivity because of
medical absences; and an additional $3.4 billion in long-term economic losses as a result of premature
deaths due to smoking.
As for the cost to smokers, smokers pay higher life insurance premiums and billions of dollars in tobacco
taxes. Smokers pay the costs of burn holes in furniture, clothes, car interiors, and, sometimes, the cost of
fires. Then, there's the cigarettes themselves. According to the Non-Smokers Rights Association, Ottawa,
the average cost of a carton of cigarettes (200 cigarettes) in Canada (2014) was $102.82 (with taxes). 40
Hence, a smoker who smokes a pack a day (20 cigarettes per pack) spends almost $3,753 each year on
cigarettes. The Conference Board of Canada estimates that effective workplace cessation programs can
result in a 35% reduction in the prevalence rate of daily smokers by 2025.30
33
Pender, N., et al. (2011). Chapter 6: Physical activity and health promotion, Health promotion in nursing practice, 6th edition.
Upper Saddle River, NJ: Pearson Education Inc., page 141.
34
U.S. Department of Health and Human Services (2008a). Reported in Pender, N., et al. (2011). Health promotion in nursing
practice, 6th. edition. Upper Saddle River, NJ: Pearson Education Inc., p. 141.
35
U.S. Department of Health and Human Services (2008a). Pender, N., et al. (2011). Health promotion in nursing practice, 6th
edition. Upper Saddle River, NJ: Pearson Education Inc., p. 141.
36
Health Canada. (2005). What does smoking cost you? Healthy living. Available at: http://www.hc-sc.gc.ca
37
Health Canada. (2011). Canadian ttobacco use monitoring survey (CTUMS) 2010. September 7, 2011. Available at
http://www.hc-sc.gc.ca
38 Conference Board of Canada (2013). Smoking cessation and the workplace: Briefing 1 - Profile of tobacco smokers in
Canada. Ottawa, ON: Conference Board of Canada. Available at
http://www.projecthealth.ca/sites/default/files/Smokingcessation-brief.pdf
39 Conference Board of Canada (2013). Smoking cessation and the workplace: Briefing 3 –Benefits of workplace programs.
Ottawa, ON: Conference Board of Canada. Available at http://www.newswire.ca/en/story/1250657/up-in-smoke-smokers-cost-
their-employers-more-than-4-000-each-per-year
40 Non-Smokers Rights Association (2014). Cigarette prices in Canada, June 2014. NSRA-ADNF, Ottawa. Available at:
http://www.nsra-adnf.ca/cms/file/files/140605_map_and_table.pdf
Health and Wellness
OHS professionals should encourage the development and implementation of smoking cessation
programs for large and small companies, and then, promote employee participation. As well, there are
many pieces of Canadian legislation that have resulted in smoke-free public places.
4. Weight Management Programs
Eating patterns have a significant impact on an individual’s health and quality of life. Obesity is a medical
condition characterized by an excess of body fat and usually, but not always, as an excess of body
weight. 41 Clinically, it is defined as having a body mass index rating of 30 and above. The Body Mass
Index (BMI) is defined as weight in kilograms divided by the square of the individual’s height in meters
and is highly correlated with the total body fat. 42 In Canada, obesity is recognized as one of the major
public health problems. It is associated with many health problems such as high blood pressure, heart
disease, diabetes, and stroke. Since a significant number of workers are obese or overweight, the
workplace is an ideal venue for offering weight management programs. Such programs offer benefits for
both the worker and the organization.
Over 60% of Canadian organizations offer diet/exercise programs, and 44% offer weight management
programs. As well, at least an additional 10% of organizations plan to introduce both programs in 2014. 43
OHS professionals should encourage the development and implementation of workplace weight
management programs and then, promote employee participation.
A: OBJECTIVES
General Objectives:
• be able to define the term, workplace wellness program;

• have an understanding of workplace stress and how it impacts safe work practices;
• understand the impact and cost of workplace stress to the organization;
• have an understanding of the negative impact of a sedentary lifestyle and how it impacts safe
work practices;
• understand the features of and the positive impact that workplace physical fitness programs can
offer an organization;
• have an understanding of the negative impact of smoking on worker health and the organization.
• understand the features of and the positive impact that workplace smoking cessation programs
can offer;
• have an understanding of the negative impact of obesity and how it impacts health;
• understand the features of and the positive impact that workplace weight management programs
can offer an organization.
41
Kaplan, G., Brinkman-Kaplan, V., & Framer, E. (2002). in O’Donnell, M. (2002). Chapter 10: Physical activity in the workplace,
Health promotion in the workplace, 3rd edition. Toronto, ON: Delmar Thomson Learning, p. 293.
42
Anderson, D. (2002), in O’Donnell, M. (2002). Chapter 10: Physical activity in the workplace, Health promotion in the
workplace, 3rd edition. Toronto, ON: Delmar Thomson Learning, p. 230.
43 Towers Watson (2014). 2013/2014 Staying@work report: Canada summary. Available online at:
http://www.towerswatson.com/en-CA/Insights/IC-Types/Survey-Research-Results/2014/02/2013-2014-staying-at-work-report-
canada-summary
Health and Wellness
In regards to stress management,
• define stress and the two types of stress – eustress and distress;
• define workplace stress;
• recognize the sources of stress in the workplace;
• list the health effects that stress can have on individuals;
• explain the various stages of stress;
• identify ways for dealing with workplace stress;
• explain organizational sources of stress;
• discuss the implications of organizational stress;
• identify the basic premise of stress management programs; and
• identify key features of a stress management program.
In regards to physical fitness,
• define physical activity, exercise and physical fitness;

• understand the negative effects of a sedentary lifestyle;
• evoke physical activity bahavioural change;
• identify key features of a workplace physical fitness program; and
• explain the benefits of a physical fitness program to an organization.
In regards to smoking cessation,
• describe the negative health effects of smoking to the individual and family members;
• explain the benefits of smoking cessation and smoking cessation programs;
• explain the smoking rates in Canada;
• discuss the costs of smoking in Canada;
• describe the ecological approach to smoking cessation; and
• identify the components of a workplace smoking cessation program.
In regards to weight management,
• define obesity and Body Mass Index;

• understand the negative effects of obesity;
• identify the health benefits of weight loss;
• identify key features of a workplace weight management program; and
• explain the benefits of a weight management program to an organization.
B: ACTIVITIES:
CCOHS. (2008). Health promotion/ wellness/ psychosocial: Workplace stress –

general. Available through the CCOHS website at: www.ccohs.ca
Conference Board of Canada (2013). Smoking cessation and the workplace: Briefing
1 - Profile of tobacco smokers in Canada. Ottawa, ON: Conference Board of Canada.
Available online at: http://www.projecthealth.ca/sites/default/files/Smokingcessation-
brief.pdf
Health and Wellness
Conference Board of Canada (2013). Smoking cessation and the workplace: Briefing 3 –
Benefits of workplace programs. Ottawa, ON: Conference Board of Canada. Available
online at: http://www.newswire.ca/en/story/1250657/up-in-smoke-smokers-cost-their-
employers-more-than-4-000-each-per-year
Chapter 12: “Prevention of workplace illness and injury”, pages 411-444.
Chapter 13: “Toxic work environments: Impact on employee illness/injury”, pages
461-484.
Chapter 14: “Psychological health and safety in the workplace”, pages 485-504.
Gottlieb, N., (2002), in O’Donnell, M. (2002). Chapter 13: Tobacco control and cessation,
Health promotion in the workplace, 3rd edition. Toronto, ON: Delmar Thomson
Learning, pages 338-358.
HelpGuide. (2012). Stress management: How to reduce, prevent, and cope with stress.
Online resource available online at: www.helpguide.org
Kaplan, G., Brinkman-Kaplan, V., & Framer, E., in O’Donnell, M. (2002). Chapter 12:
Worksite weight management, Health promotion in the workplace, 3rd edition.
Toronto, ON: Delmar Thomson Learning, pages 293-328.
Murphy, L. (2002), in O’Donnell, M. (2002). Chapter 15: Stress management, Health

promotion in the workplace, 3rd edition. Toronto, ON: Delmar Thomson Learning,
pages 389-409.
Non-Smokers Rights Association (2014). Cigarette prices in Canada, June 2014. NSRA-
ADNF, Ottawa. Available online at: http://www.nsra-
adnf.ca/cms/file/files/140605_map_and_table.pdf
Pender, N., et al. (2011). Chapter 8: Stress management and health promotion, Health
promotion in nursing practice, 6th edition. Upper Saddle River, NJ: Pearson
Educational Inc., pages 194-212.
Reid J.L., Hammond, D., Burkhalter, R., & Ahmed, R. (2014). Tobacco use in Canada:
Patterns and trends, 2014 edition. Waterloo, ON: Propel Centre for Population Health
Impact, University of Waterloo. Available online at: http://www.tobaccoreport.ca/2014/
Towers Watson (2014). 2013/2014 Staying@work report: Canada summary. Available

online at: http://www.towerswatson.com/en-CA/Insights/IC-Types/Survey-Research-
Results/2014/02/2013-2014-staying-at-work-report-canada-summary
Towers Watson. (2012). Pathway to Health and Productivity: 2011/2012 Staying@Work

Report. Atlanta, GA: Watson Wyatt Worldwide. Available online at:
www.watsonwyatt.com
Wilson, M., & DeJoy, D. (2002), in O’Donnell, M. (2002). Chapter 10: Physical activity in
the workplace, Health promotion in the workplace, 3rd edition. Toronto, ON: Delmar
Thomson Learning, pages 244-268.
Health and Wellness
Stress Management Program:

2. Refer to the above information for a definition of stress, eustress, and distress. O’Donnell
explains stress on page 391-393.
3. Refer to CCOHS 2008, pages 1–2, for a definition of workplace stress and some workplace
stressors. O’Donnell, page 399 also lists a number of organizational stressors.
4. Refer to CCOHS 2008, pages 2-3, and the Towers Watson Staying@Work Report (2012) for
the health effects associated with high levels of stress. O’Donnell explains the relationship
between job stress and health on pages 391-393. Stress can be good and is often seen as a
normal response. However, too much stress can have a negative impact on the individual. There
are a number of signs and symptoms that can indicate when an employee is experiencing too
much stress. CCOHS 2008, page 3, provides an overview of the signs and symptoms of distress.
5. Refer to CCOHS 2008, pages 3-4, for a detailed description of the various phases of stress and
possible action to take to deal with the stages of stress. For additional information, refer to
HelpGuide (2012), Stress Management: How to Reduce, Prevent, and Cope with Stress.
6. The types of interventions available for dealing with the negative effects of stress are explained
by O’Donnell, pages 393-402, and in the Towers Watson Staying@Work Report.
7. For the most part, stress management usually falls under the umbrella of the EAP. Refer to
Pender, pages 201-203, for ways to counter distress. CCOHS 2008, pages 5–6, provides some
general tips for dealing with stress at work and at home. O’Donnell, pages 399 and 400 lists
some actions to manage the negative effects of stress at the individual level and at the
organizational level. In contrast, the Towers Watson Staying@Work Report (2014) offers a more
organizational approach to health and productivity. It proposes the development of a supportive
work culture and environment, as well as the adoption of people-friendly management practices.
8. Job-related stress results from human interactions in the workplace. Every worker has basic
psychological health needs. There are numerous factors in any workplace that can impact the
psychological health of workers, namely too many and conflicting demands and priorities; lack of
understanding of how work performance is measured; poor communication practices; little or no
feedback and recognition for the work done; etc. Refer to Dyck, pages 465-472, for a detailed
discussion about sources of organizational stressors. O’Donnell, page 399, lists a number of
organizational stressors, as do the two Towers Watson Staying@Work Reports (2012 and
2014).
9. High levels of stress negatively impact workers as well as the organization in which they work.
There are always some choices about the way in which work can be done. The implications of
organizational stress are presented in Dyck, pages 436-443, 462-464.
10. The basic premise of stress management programs is provided above.
11. The key features of a stress management program are provided above. O’Donnell expands on
this concept by discussing the elements of a stress management intervention (pages 397-403)
and the specific element of a stress management program (page 403-404).
Physical Fitness:
12. The definitions of physical activity, exercise, and physical fitness are provided above and
discussed further in Pender, pages 141.
13. Refer to Pender, pages 141-143 and Wilson, pages 244-245 for a description of the benefits of
physical activity.
14. Refer to Pender, pages 151-157 for a discussion on physical activity in adults.
15. The various approaches to promoting physical activity behavior change are discussed in Wilson,
pages 249-263.
16. The features of a workplace physical fitness program are provided by Wilson, pages 265-268.
Health and Wellness
17. Organizations implement physical fitness programs based on the assumption that healthy
workers result in savings for the organization. Refer to Wilson, pages 246-249 for a discussion of
the related organizational benefits, as well as the Towers Watson Staying@Work Report.
Smoking Cessation:
18. The negative health effects due to smoking are discussed above, as well as in Gottlieb, pages
338-342.
19. The benefits of smoking cessation are explained by Gottlieb, page 341.
20. The smoking rates in Canada are provided above, as well as in Reid, J., et al. (2014). Tobacco
Use in Canada: Patterns and Trends, 2014 edition.
21. The costs of smoking in Canada are provided above.
22. The ecological approach to smoking cessation is explained by Gottlieb, pages 355-359.
23. The components of a workplace smoking cessation program are discussed by Gottlieb on pages
349-359.
Weight Management:
24. Refer to Kaplan, pages 293-295, for a definition of obesity and its prevalence.
25. The definition for Body Mass Index is provided.
26. There is a number of negative health effects associated with obesity, namely heart disease, high
blood pressure, diabetes, liver disease, and such. These negative health effects are further
described in Kaplan, pages 298-299, as well as the health benefits of weight loss, pages 299-
300.
27. A review of workplace Weight Management Programs is provided in Kaplan, pages 305-317.
An industry example of an effective workplace Weight Management Program, along with the
organizational benefits of a Weight Management Program can be found in Kaplan on pages 319-
322.
HW5: Demonstrate an Understanding of Disability Management Programs
Disability management, in its entirety, can be defined as the process of preventing and managing
absence from work. Operationally, it is an active process directed towards promoting and supporting
regular workplace attendance and minimizing the impact of impairment on the ill or injured employee’s
ability to compete in the workplace. 44
A disability management program is a management tool aimed at managing the real and potential
losses associated with employee illness and injury. An integrated disability management program
manages both occupational and non-occupational disabilities on a short- and long-term basis and
contains the following elements:
• Joint union-labour-management endorsement, commitment and involvement;

• Supportive policies, procedures and systems;
• A system that ensures accountability by all parties;
• Absenteeism and disability data collection for analysis and evaluation;
• Claims management and adjudication;
• Case management and coordination;
• Multi-disciplinary interventions — occupational health and safety, human resource, EAP, medical,
vocational or occupational rehabilitation professionals;
44
1123.
Health and Wellness
• Early intervention and a graduated return-to-work program; and

• Attendance support and disability prevention strategies. 45
The advantage of integration is that this approach provides a comprehensive approach to disability
management and according to Watson Wyatt Worldwide, employers who have integrated disability
management programs experience an average reduction of 19-25% in their total disability costs. 46
A disability management program is part of the business system functioning within a company. It operates
with, and is affected by, other system components such as employee pension and compensation,
employee benefits, workers’ compensation claims management, human resources support, labour
union/association support, business operations, employee assistance program, employee physical fitness
facilities, occupational health and safety programs, corporate counsel support, etc. The disability
management program needs to be aligned with these business systems and operate according to the
general system rules in place within the organization. 47
Implementation of a graduated return-to-work program can be an effective method of systematically

returning employees to health and work as well as contributing to cost-containment. 48 Graduated return-
to-work programs through the use of modified work, support the importance of early intervention in
returning the recovering employee to the workplace in a safe and timely manner. The recommended
components of a graduated return-to-work program include:
• Employee and supervisor submission of all the necessary claim forms;

• Active involvement by the employee and supervisor;
• Early intervention;
• Communication with the employee and attending physician regarding the availability of
modified/alternate work;
• Regular follow-up with the employee and physician regarding employee fitness to work;
• Availability of modified/alternate work for the recovering employee;
• Documented return-to-work plans;
• Placement of the employee into suitable modified/alternate work;
• Monitoring of the employee’s progress and fitness to work;
• A gradual return to full-time duties;
• Evaluation of the claim management practices and outcomes;
• Evaluation of the case management practices and outcomes; and
• Data collection and management. 49
They involve interim measures which are offered to recovering employees and may include:
1. Changing their existing “own” occupation conditions such as hours of work, duties and
responsibilities
2. Accommodating workplace restrictions like lifting, transitional work, providing different duties
within another occupation or worksite;
3. Providing training opportunities; or
4. A combination of those listed.
45
Dyck, D.E. (2013). Disability management: Theory, strategy and industry practice, 5th edition. Markham, ON: LexisNexis, pp.
12-17.
46
Watson Wyatt Worldwide (1998), News Release, Employers that measure results from integrated disability management
programs report big savings (15 October 1998), www.watsonwyatt.com .
47
102.
48
Lyons, D.E. (2004) Integrated Disability Management: Assessing Its Fit for Your Company, Ideas at Work, Winter 2004,
www.libertymutual.com .
49
181--184.
Health and Wellness
Companies that have implemented graduated return-to-work programs have realized significant success at
returning employees to work, and at containing their disability rates and costs. As well, they are able to
demonstrate compliance with the Canadian “duty to accommodate” legislation.
From a mitigation perspective, OHS professionals have the expertise and can be given the responsibility
to provide a planned approach that minimizes barriers, so that employees can safely return to work.
In terms of prevention, the OHS professional has an important role to play in the prevention and
management of occupational and non-occupational illnesses/injuries.
A: OBJECTIVES
General Objectives:
• gain an understanding of the negative impact of employee illness/injury on an organization;

• understand the features of and the positive impact that disability management programs can offer
an organization;
• be able to understand the role they play in the prevention and management of occupational and
non-occupational injuries and illnesses;
• be able to understand the framework required for successful graduated return-to-work programs;
• be able to understand the role they play in supporting a graduated return-to-work program.
• define disability management;

• explain the various disability management models;
• define key terms such as managed rehabilitative care, early intervention, occupational bond,
advocacy, accommodation, rehabilitation, person-job fit, case management and claims
management, short term disability, long term disability, and workers’ compensation;
• explain the key elements of a disability management program;
• describe the key concept of confidentiality as it relates to the disability management process;
• understand the concept of an integrated disability management program and its elements;
• explain the Canadian workers’ compensation system as it relates to disability management;
• describe the types of benefits provided in both the workers’ compensation system and disability
management program;
• describe the roles of the key stakeholders in the disability management program;
• explain the management of health care and personal problems;
• understand the process of managed rehabilitative care (claims and case management);
• describe the graduated return-to-work process – the objectives, principles and outcome
measures;
• define terms such as modified work, alternate work, fitness to work, functional capacity
evaluation, independent medical examinations and job demand analysis;
• articulate the benefits of graduated return-to-work programs;
• identify the barriers to graduated return-to-work programs;
• discuss why joint labour-management support is necessary for successful modified work and
graduated return-to-work programs;
• describe how successful relations between labour and management can be achieved;
• list the functions of joint labour/management in graduated return-to-work programs;
• outline the steps in graduated return-to-work programs; and
Health and Wellness
• identify the roles of key people involved in graduated return-to-work programs, namely the:
 Injured employee;
 Supervisor;
 Disability Management Coordinator;
 Disability Case Manager;
 Disability Claims Administrator;
 Workers’ Compensation Claims Administrator;
 Vocational Rehabilitation Specialist; and
 Return-to-work Coordinator;
• explain how workplace-based disability management programs can be successful.
B. ACTIVITIES:
Chapter 1: Disability management: Overview, pp. 11-46.
Chapter 2: Joint labour-management support and involvement, pp. 47-82.
Chapter 3: The supportive infrastructure for an integrated disability management
program, pages 83-120.
Chapter 4: An integrated disability management: Stakeholder roles, pp. 121-150.
Chapter 5: An integrated disability management: Operationalized, pp. 151-192.
Chapter 10: Disability management practice standards, pp. 325-394.
Chapter 31: Disability management best practices, pp. 1123-1162.
Chapter 26: Occupational health & safety: Legal aspects, pp. 1024-1026, and
p.1057.
National Institute of Disability Management (NIDMAR) (1995). Disability management

in the workplace. Port Alberni, BC: Author.
2. Refer to Dyck (2013), pages 11-12, and 1245 for practical definitions of disability management.
3. The various disability management models are described by Dyck (2013), pages 21-22. They
include:
a. Traditional Model — This is a model in which the care plan, authorized leave, and return-to-
work process are medically directed. The employer relies on the treating practitioners
(primarily the employee’s attending physician) to validate the illness and to help the employee
to return to work. This model is often the starting point in disability management for many
organizations, as well as for insurer disability management models.
b. Job Matching Model — This is a model which involves a fitness assessment of the injured or ill
employee and an analysis of the physical/psychological demands of the employee’s job. The
intent is to determine if there is a “match” or “mismatch” in terms of a safe return to work for the
employee.
c. Managed Care Model — In a managed care model, the employee’s diagnosis is referenced
against standardized care plans, procedures and diagnostic testing guidelines to determine if
treatment and the physician’s suggested leave duration are appropriate. This model, like the
traditional model, tends to be medically driven.
Health and Wellness
d. Direct Case Management Model — This employee-employer approach to dealing with the
employee’s reduced work capacity and the employer’s business needs/resources uses some of
the elements of the first three models. However, it is the employee and employer who decide,
based on their respective needs, the terms of the medical absence and the return-to-work plan.
4. Key terms are defined by Dyck (2013) - early intervention (p. 19); occupational bond (p. 20);
managed rehabilitative care, advocacy, accommodation, rehabilitation, case management
and claims management, person-job fit (Chapter 5); short term disability, long term
disability, and workers’ compensation (Chapter 3), as well as in the Glossary.
5. The key elements of a disability management program are discussed by Dyck (2009) on pages
12-17.
6. The concept of confidentiality, as it relates to the disability management process, is explained in
a practice standard presented by Dyck (2013) on pages 359-368. Under the privacy legislation,
Canadian employers are legally required to maintain employee personal health information
secure and confidential (refer to Chapters 22 and 23 for additional details).
7. The description of an integrated disability management program and its elements is provided by
Dyck (2013) on page 12, and pages 445-448.
8. The Canadian workers’ compensation system operates a “no fault” insurance agreement between
employers and employees that requires employers to be responsible for costs associated with
occupational injuries and illnesses. A description of the Canadian workers’ compensation system
is available in the text by Dyck (2013), pages 100-101 and page 1265. Additional information is
available in Dyck (2011), pages 1024-1026, and 1057.
9. Descriptions of the types of benefits provided in workers’ compensation and disability
management programs are outlined by Dyck (2013) on pages 100-101.
10. The clarity of stakeholder roles is an essential element in ensuring successful disability
management. The role and function of key stakeholders involved in an integrated disability
management program is described by Dyck (2013) on pages 163-167 and in Chapters 4 and 12.
11. The management of employee health care and personal problems is described by Dyck (2013)
on pages 94 and 95. Additional information is provided on pages 167-179.
12. There are a number of activities and tasks in the process of Managed Rehabilitative Care (claims
and case management). A detailed description of this process can be found in Dyck (2013) on
pages 326-335, and 335-351.
13. The objectives, principles, and outcome measures associated with the graduated return-to-work
process are provided by Dyck (2013) on pages 179-185.
14. The evidence that disability management programs are successful is provided in Dyck (2013),
pages 28-32 and in NIDMAR, pages 5-7.
15. Definitions for terms such as modified work, alternate work, fitness to work, functional
capacity evaluation, independent medical examinations, and job demand analysis are
provided by Dyck (2013), in Chapter 5 and in the Glossary. NIDMAR, pages 65-66, also defines
these terms.
16. The aim of graduated return-to-work programs is to return the injured employee back to work in a
safe and timely manner. There are several benefits to successful graduated return-to-work
programs outlined by Dyck (2013) on page 112.
17. Barriers to successful modified work and graduated return-to-work plans exist at the
organizational and individuals levels. These are outlined by Dyck (2013) on pages 159-160, and
341-342.
18. Successful modified work and graduated return-to-work programs are founded on trust and
mutual respect for all stakeholders and require the support of labour and management. The
importance of this support is discussed by Dyck (2013) on pages 53-61.
19. Successful relations by labour and management are possible through the development of a
positive working relationship which is based on mutual respect, trust, as well as a willingness to
Health and Wellness
work together. A number of ways that this can be achieved can be found in Dyck (2013) on page
61-62.
20. It is important to have joint involvement of labour and management in the development of a
disability management program design, infrastructure development, implementation, and
evaluation. Refer to Dyck, page 62-63 for a list of the functions of labour/management in
graduated return-to-work programs.
21. Dyck (2013), pages 181-185 outline the objectives and principles of graduated return-to-work
plans and practices. An explanation of an individual graduated return-to-work plan for an
employee is provided on pages 114-115.
22. Clarity of stakeholder roles is vital to the success of the disability management processes and the
graduated return-to-work plans. These roles are outlined by Dyck (2013) Chapter 4, and Chapter
5, pages 163-167.
23. Dyck (2013), pages 113-116, outlines the steps in developing graduated return-to-work programs.
24. Clarity of stakeholder roles is vital to the success of graduated return-to-work programs. These
roles are outlined by Dyck (2013), Chapter 4 and Chapter 5.
HW6: Demonstrate an Understanding of Addiction Control
Tobacco is an addictive substance because it contains the chemical nicotine, a stimulant. Like heroin or
cocaine, nicotine alters brain functions, causing nicotine cravings. This addiction to nicotine is what
makes it so difficult for individuals to quit smoking or to stop using some smokeless tobacco products.
Workplace smoking cessation programs have proven effective at supporting employees to stop smoking.
But to be effective, these programs require the following elements:
• a workplace non-smoking policy;

• an ecological approach to smoking cessation;
• a needs assessment of each level of the ecological levels;
• program planning;
• implementation of the program; and
• evaluation of the program.
As well, there are many pieces of Canadian legislation that have resulted in smoke-free public places.
The abuse of alcohol and other drugs leads to impairment which in turn, causes accidents and injuries,
and negatively impacts workplace health and safety. The adverse effects of substance abuse on work
attendance, production, reliability, costs, and employee morale, directly concern employers.
Substance abuse/excessive gambling occurs when an individual continues to drink alcohol, use drugs,
or gamble heavily even when this behaviour causes trouble in their work and personal lives. 50 The
Canadian Centre on Substance Abuse (CCSA) defines workplace substance abuse as the use of a
potentially impairing substance to the point that it adversely affects performance or safety at work, either
directly through intoxication or hangover, or indirectly through social or health problems. Generally
speaking, substance abuse is considered to occur when a drug is taken without medical reasons, or if a
substance impairs or jeopardizes the health or safety of oneself or others. Abuse can occur by using a
substance too much, too often, for the wrong reasons, at the wrong time, or at the wrong place. 51
50
Alberta Health Services. (2006). It’s our business: The basics: Alcohol, other drugs and gambling. Available on
www.albertaheatlhservices.com
51
CCOHS. (2008). OSH answers: Substance abuse in the workplace. Available on www.ccohs.ca
Health and Wellness
A: OBJECTIVES
General Objectives:
• recognize the dangers of tobacco addiction;

• understand how substance abuse/excessive gambling impacts the individual, family and
workplace;
• be knowledgeable about the design and implementation of an Addiction Control Program.
• explain the etiology of tobacco addiction;

• describe the elements of an effective smoking cessation program;
• define substance abuse/excessive gambling;
• define workplace substance abuse;
• describe the general effects of various types of substances on the body;
• identify the signs that indicate an employee is possibly abusing substances;
• discuss how substance abuse can cause problems at work;
• discuss how substance abuse/excessive gambling can affect family members;
• list the costs associated with substance abuse for business;
• identify work elements that may contribute to substance abuse;
• identify the elements of a substance abuse policy/program;
• define and explain workplace peer support; and
• discuss the issues surrounding alcohol and drug testing.
B. ACTIVITIES:
Alberta Health Services. (2010). It’s our business: The basics: Alcohol, other drugs and
gambling. Available online at: www.albertahealthservices.com
Alberta Health Services. (2010).It’s our business: An addiction in the family: What it
means for the workplace. Available online at: www.albertahealthservices.com
Alberta Health Services. (2010). Alcohol/Drug policy development and employee testing.
Available online at: www.albertahealthservices.com
Alberta Health Services. (2010). It’s our business: Workplace peer support. Available
online at: www.albertahealthservices.com
Alberta Health Services. (2010). It’s our business: Does someone I work with have a
problem? Available online at: www.albertahealthservices.com
Addictions Foundation of Manitoba (2005). Available online at: www.afm.mb.ca . Select

Alcohol & Drugs. Alcohol & Other Drugs discusses Methadone use and provides links
to all relevant substances. For example, The Basics:
• Alcohol
• Binge Drinking
• Cannabis
Health and Wellness
• Cocaine and Crack

• Ecstasy
• Inhalants
• LSD
• Magic Mushrooms
• Methamphetamine
• PCP
• Rohypnol
• Smokeless Tobacco
• Tobacco
Addictions Foundation of Manitoba, Workplace Services: Gambling. Available online at:

http://www.afm.mb.ca
Butler, B. (2006). Brief analysis of current workplace substance abuse issue and activities
in Canada, March 2004 issue. Revised 2011. Available online at:
http://www.ccsa.ca/CCSA
Butler, B. (2006). Current legal context: Employee testing, May 2004 issue. Revised
2011. Available online at: www.ccsa.ca
CCOHS. (2008). OSH answers: Substance abuse in the workplace. Available online at:
www.ccohs.ca
CNW (2013). Smoking still prevalent in segments of Canadian society. Available online
at: http://www.newswire.ca/en/story/1144449/smoking-still-prevalent-in-segments-of-
canadian-society
Government of Ontario (2014). Play, live, be tobacco free. Available online at:
http://www.playlivebetobaccofree.ca/
Reid, J.L., Hammond, D., et al. (2014). Tobacco use in Canada: Patterns and trends,
2014 edition. Waterloo, ON: Propel Centre for Population Health and Impact, University
of Waterloo. Available online at: http://www.tobaccoreport.ca/2014/
Statistics Canada (2012). Smoking, 2010. Available online at:

http://www.statcan.gc.ca/pub/82-625-x/2012001/article/11668-eng.htm
Statistics Canada (2013). Smoking. Available online at: http://www.statcan.gc.ca/search-

recherche/bb/info/3000018-eng.htm
2. The etiology of tobacco addiction is provided above.

3. Tobacco facts and figures are available from Statistics Canada and the Conference Board of
Canada. Other statistical sources are the Propel Centre for Population Health and Impact, and
Play, Live, Be Tobacco Free (Government of Ontario) at http://www.playlivebetobaccofree.ca/
4. The definition of substance abuse/excessive gambling is provided above. More detail is
available in the Alberta Health Services fact sheet, The Basics: Alcohol, Other Drugs and
Gambling, page 2.
5. Refer to CCOHS, page 2 for the definition of substance abuse in the workplace. Substance
abuse can lead to serious workplace problems, for example:
Health and Wellness
• Many aspects of the workplace today require alertness, and accurate and quick reflexes. An
impairment to these qualities can cause serious accidents, and interfere with the accuracy
and efficiency of work.
• The after-effects of substance use (hangover, withdrawal) have been shown to negatively
affect job performance.
• Absenteeism, illness, and/or reduced work productivity are associated with substance abuse.
• Preoccupation with obtaining and using substances while at work, interferes with employee
attention and concentration on the work being done.
• Illegal activities at work including selling illicit drugs to other workers, is part of this problem.
• The psychological or stress-related effects due to substance abuse by a family member,
friend or co-worker tend to negatively affect another person's job performance.
6. The CCSA article, page 1, discusses four possible types of substance abuse in the workplace
and their related costs to the Canadian economy.
7. The table in CCOHS, page 2, identifies the category of substances, gives examples of the
product, and lists possible general effects. This table is not an all-inclusive list.
8. Employees who have an addiction problem may experience a variety of signs. Refer to Addictions
Foundation of Manitoba for a listing of these signs for the various types of substances. The signs
and symptoms of excessive gambling are provided by Addictions Foundation of Manitoba, How
Gambling Works. The Alberta Health Services fact sheet, The Basics: Alcohol, Other Drugs
and Gambling, page 2, offers a problem identification checklist that is useful.
9. Refer to CCOHS, page 1, for a list of how substance abuse can cause problems at work. The
effects of substance abuse/excessive gambling are also discussed in the Alberta Health Services
fact sheet – An Addiction in the Family: What it Means for the Workplace.
10. Both of the above Alberta Health Services fact sheets explain how family members are affected
by substance abuse/excessive gambling.
11. The costs of substance abuse/excessive gambling for business may be both direct and indirect.
Review pages 2-3, CCOHS for a listing of the costs to a business.
12. There are many work factors within the workplace that can contribute to substance
abuse/excessive gambling. It is important to note that a variety of personal and social factors may
also play a role. CCOHS, page 4 gives a list of these work elements.
13. The workplace is an important venue for addressing substance abuse/excessive gambling issues.
There are a number of ways employers can address the problem. An overview of ways
employers can deal with substance abuse in the workplace is provided in the CCOHS fact sheet,
page 4. The Alberta Health Services fact sheet, The Basics: Alcohol, Other Drugs and
Gambling, page 3, discusses what a workplace can do. The Alberta Health Services fact sheet,
An Addiction in the Family: What it Means for the Workplace, pages 3 and 4, provides
suggestions for effective ways to work together to address substance abuse/excessive gambling.
As for the development of a substance abuse policy, the Alberta Health Services fact sheet,
Alcohol/Drug Policy Development and Employee Testing, pages 1-3, explains the process.
Additionally, Dyck, page 686 discusses substance abuse as a disability.
14. Workplace Peer Support is advocated as an effective approach to addressing substance
abuse/excessive gambling problems, job performance issues and other personal problems
affecting employees. To learn about Workplace Peer Support, how it operates and the benefits it
provides, refer to Alberta Health Services: Workplace Peer Support. Likewise, the Alberta
Health Services: Does someone I work with have a problem? is a valuable resource for co-
employees and is available online.
15. In Canada, the use of workplace drug and alcohol testing programs remains controversial. There
is no specific legislation in Canada which deals with testing. It tends to fall under the Human
Rights Legislation. For research on alcohol and drug abuse patterns, government initiatives,
trends in policy development, legal climate in 2004, and the current legal status of worker
drug/alcohol testing in Canada, refer to the two articles by Barbara Butler, as well as Dyck, page
686.
Health and Wellness
HW7: Demonstrate an Understanding of the Factors that Impact Health and

Wellness
Health and wellness are much more than the absence of disease and illness. Health, an essential life
ingredient, is influenced daily by the cultural, social, economic, and physical environments in which an
individual exists. When looking at the health of Canadians, it is important to consider non-medical factors
- the social determinants of health - that affect well-being. The determinants intersect and interact with
each other, so that the health of any individual is a complex summation of factors. There is considerable
evidence that these socioeconomic circumstances of individuals and groups are equally, or more,
important to health status than medical care and personal health behaviours.
The following are examples of the Social Determinants of Health (SDOHs):
• Environmental conditions;
• Income and social status;
• Social support networks;
• Lifestyle;
• Education;
• Employment and working conditions;
• Social environments
• Geography;
• Physical environments;
• Healthy child development;
• Health services;
• Gender; and
• Culture.
Environmental Conditions
The environmental factors include the work, home, community and environmental conditions to which
people are exposed. They include work and work conditions, home and home conditions, weather, air
quality, water quality, soil quality, etc.
Income and Social Status

Health status improves at each step up the income and social hierarchy. High income promotes living
conditions such as safe housing and ability to buy sufficient good food. The healthiest populations are
those in societies which are prosperous and have an equitable distribution of wealth.
Social Support Networks

Support from families, friends, and communities is associated with better health. Effective responses to
stress and the support of family and friends seem to act as a buffer against health problems.
Lifestyle
Choices in eating, sleeping, exercising, alcohol consumption, drug use, weight control and risk taking are
all lifestyle factors. They can either work towards or against healthy living.
Education
Health status improves with each level of education attained. Education increases opportunities for
income and job security, and gives people a sense of control over life circumstances - key factors that
influence health.
Health and Wellness
Employment and Working Condition

Unemployment is associated with poorer health. People who have more control over their work
circumstances and fewer stressful job demands are healthier and often live longer than those who are
involved in more stressful or riskier work and other activities.
Social Environments
Social stability and strong communities can help reduce health risks. Studies have shown a link between
low availability of emotional support, low social participation, and mortality (whatever the cause).
Geography
Whether workers live in remote, rural communities, or urban centres, the services available can have an
impact on their health.
In addition to having a direct impact on the health of individuals and population, SDOHs interact with each
other. They are the best predictors of individual and population health and tend to impact personal
lifestyle choices. 52
A: OBJECTIVES
General Objective:
• The OHS professional will have knowledge of the factors that influence physical and
psychological health and well-being.
• list the key determinants of health;

• discuss the underlying evidence that supports the health determinants;
• identify the underlying premise for each determinant; and
• understand how each determinant impacts worker health.
B: ACTIVITIES
Health Canada. (2004). What determines health? Available online at: www.phac-
aspc.gc.ca
Health Canada. (2008). Chapter 4, Social and Economic Factors that Influence Our
Health and Contribute to Health Inequities, Report on the state of public health in
Canada, Cat. No. HP2-10/2008E. Available online at: www.phac-aspc.gc.ca
2. A list of the key determinants of health is provided above and is presented in Health Canada,
What Determines Health?
3. Much has been learned over the past several decades about what determines health. The
research tells us to examine factors both inside and outside the health care system. We need to
look at the “bigger picture”. There is a growing body of evidence about what makes people
52
Raphael, D. (2003). Addressing the social determinants of health in Canada: Bridging the gap between research findings and
public policy. Reported in Health Canada (2004). The social determinants of health: An overview of the implications for policy and
the role of the health sector, p. 2. Available online at: www.phac-aspc.gc.ca
Health and Wellness
healthy and this evidence is presented in Health Canada, Chapter 4, Social and Economic
Factors that Influence Our Health and Contribute to Health Inequities, Report on the State of
Public Health in Canada.
4. The underlying premise for each determinant is provided in Health Canada, What Determines
Health?
5. The relationship between work and health is believed to have a biological basis, whereby the
stress created in “bad job situations” affects the nervous systems which influences the immune
system, making it harder for individuals to fight disease. Refer to Health Canada, What
Determines Health? to understand how each determinant impacts worker health.
HW8: Demonstrate an Understanding of How Factors in the Workplace

Impact Worker Wellbeing
In the workplace, there are many factors like corporate culture, four generations in the workplace,
diversity and an aging workforce that impact worker well-being. Corporate culture is defined as the
system of shared beliefs and values that develops within an organization and guides behaviour of its
members. It is the way things are done within the organization. Just as no two individuals or families are
the same, neither are two corporate cultures the same. Each is unique and has a profound impact on the
performance of the organization and the quality of work life experience of workers. In essence, a
corporate culture can either support, or negatively impact, worker health and wellness.
According to Ryan (2004), “The corporate culture is dictated by what management does; what
management pays attention to: what management condones or ignores; and what management
measures. (Add to that,) management controls the resources necessary to effect change.” 53
All organizations have cultures, whether they know it or not. 54 Culture is to an organization what memory
is to a person. 55 The corporate culture conveys management’s beliefs, attitudes, values, and approaches
to workers. It lets workers know whether or not they are trusted, valued, or respected. In addition, workers
learn the priorities that senior management holds dear; which procedures to follow; and which workplace
rules can be ignored. They learn who is really in charge; how decisions get made; how problems are
handled; how conflicts are resolved; how much support exists for workers; and who shares
responsibility/accountability for what. Corporate culture helps workers figure out how to get around
workplace challenges or barriers — officially and unofficially — and which values, attitudes, and
behaviours will or will not be tolerated. 56
Although corporate culture is the “man-made” part of the work environment, 57 it is not a conscious
element, even for senior management. Corporate culture includes formal policies that are laid out in black
and white, but it is much more than that. It is the “personality” that differentiates one organization from
another.
53
Ryan, D. (2004). Moving off your OH&S plateau: Cutting edge strategies for fostering and measuring a dynamic OH&S culture.
(Presented at the Occupational Health & Safety Amendment Act, 2002 — What’s New, What’s Changing and What You Need to
Do to Comply, Insight Conference, May 27-28, 2003, Edmonton, AB.).
54
Rutledge, T. (2007). Culture – Not just a plaque on the wall, Canadian occupational safety, April/May 2007 Issue, p. 14.
55
International Atomic Energy Agency. (2002). Safety culture in nuclear installations: Guidance for use in enhancement of safety
culture (December), available online at: www-pub.iaea.org
56
Roithmayr, T., & Dyck, D.E. (2011). Chapter 5, Occupational health and safety: Leadership and commitment, Occupational
health & safety: Theory, strategy & industry practice, 2nd edition, Markham, ON: LexisNexis Canada Inc., pp. 258-259.
57
International Atomic Energy Agency. (2002). Safety culture in nuclear installations: Guidance for use in enhancement of safety
culture (December), available online at: www-pub.iaea.org
Health and Wellness
Management Theories and Practices

Management practices and human resource management theories have a significant impact on
occupational health and safety programs, and worker health and well-being. According to researchers like
Dr. M. Shain, job-related stress results from human interactions in the workplace. It needs to be managed
like production and operational activity. It is up to management to address job stress at the source
(Eliminate Risk) instead of dealing solely with the symptoms of job stress through the occupational health
and safety, EAP, attendance support, and disability management programs (Tolerate Risk). Prevention is
key, as opposed to mitigation.
A management team that recognizes the importance of supporting good mental health and safety in the
workplace, of acknowledging the importance of work/life balance, of providing family-friendly workplace
programs, and of supporting and assisting workers to attend work on a regular basis and be productive,
net a healthy organization that is productive and profitable. Research indicates that leading companies
recognize this link between worker health and worker effectiveness. Companies with strong commitment
to worker health and well-being, enjoy:
• increased worker effectiveness;

• reduced work stress;
• lower health care costs;
• lower levels of presenteeism;
• fewer work absence days;
• lower staff-turnover rates; 58
• superior financial outcomes – 40% higher revenues per employee, and 18% higher market
premiums. 59
Hence, leadership matters….. “Companies with the most effective health and productivity programs have
a strong commitment from senior management who regularly communicate the importance of a healthy
lifestyle, volunteer to be health champions, and provide adequate budgets to support health and
productivity programs.” 60
Labour Relations
Joint labour-management support and involvement is needed for the development of a trusting and
positive work environment in which workers can successfully function and grow. As such, labour and
management must work together to address the corporate cultural issues that impact worker beliefs,
attitudes and behaviours. Organizations that achieve positive labour relationships are able to reach
greater business and financial heights.
Multiple Generations
For the first time in history, there are four generations working in today’s workplaces. With four
generations in the workplace, each with their own beliefs, values, wants and needs, employers face the
daunting challenge of trying to meet worker expectations. For example, meetings tend to be viewed by
older workers as “busy work”. They prefer short meetings, speedy decisions, and only want to meet when
there is an urgent need. Younger workers on the other hand, tend to value this type of social interaction
and to view meetings as a way to reach a solution to an identified problem. 61
Older workers have demonstrated that they value rules and regulations. Younger workers have been
known to ignore rules, policies, and chain-of-command. Younger workers live in a world of advanced
58
Watson Wyatt Worldwide. (2010). The health and productivity advantage: 2009/2010 North American staying@work report.
Atlanta, GA: Watson Wyatt Worldwide, pp.2-4.
60
Watson Wyatt Worldwide. (2010). The health and productivity advantage: 2009/2010 North American staying@work report.
Atlanta, GA: Watson Wyatt Worldwide. p. 3.
61
Health and Wellness
technology. They are techno-wizards who embrace technology as a normal element of their lives. Older
workers had to learn to adapt to technology and for some, there remains a healthy “distrust of these new
tools”. 62 These are about a few of the many identified differences observed in relation to the four
generations in the workplace.
Workplace Diversity
“Today’s workforce is very diverse. It ranges from single men and women of various cultural backgrounds
with no dependents, to those who are married with children and caring for elderly parents.” 63 Each has
different values, beliefs, needs, and expectations on life and work. By effectively managing diversity,
organizations can enhance their competitive advantage in the Canadian labour market.
Cultural diversity is defined as the learned, shared way of doing things relative to a specific group of
people. Culture is learned and is taught by members of the particular societal group. It is what defines the
“boundaries” of different groups of people. 64
Some of the cultural dimensions that impact the workplace include:
1. Language
Language reflects a group’s culture and the vocabulary reveals the history of the society and the
aspects that are important to it. The structure of the language used can influence how one
understands the surrounding environment. 65
2. Time Orientation
Different cultures hold different attitudes about time. A traditional view of time is that it is circular,
suggesting repetition. If something doesn’t happen today, that is okay, because the opportunity
will return tomorrow. A modern viewpoint is that time is linear. The past is gone; the present is
here and future is almost upon us. Rather than measuring time with recurring natural events, time
is measured with precise movement of a clock. 66
Another aspect is the difference between monochronic (do one thing at a time) and polychronic
(do many things at once) cultures. Monochronic cultures separate work and rest: polychronic
cultures do not. 67
3. Use of Space
Personal space is that “distance of comfort” to which we have adapted. We feel uncomfortable if
others invade that space or if they are too far away for ready communication. The size of the
personal space zone varies with cultures. For example, South Americans and Arabs are
comfortable at closer distances than are North Americans. 68
62
63
Buller, T. A flexible combination, Benefits Canada, November 2004. Available online at: www.benefitscanada.ca , p.99.
64
Schermerhorn, J., Hunt, J., & Osborn, R. (1991). Managing organizational behavior, 4th edition. Toronto, ON: John Wiley &
Sons, p. 79.
65
Sons, pp. 79-80.
66
Sons, p. 80.
67
Sons, p. 80.
68
Sons, pp. 80-81.
Health and Wellness
Organization of space also differs. Spanish and Italian towns are set up around central squares,
whereas North American towns are structured linearly along Main Street. In the workplace, North
Americans prefer individual offices, whereas the Japanese choose an open floor plan. 69
4. Religion
Religion is a major component of culture. Rituals, religious days, icons, and foods are some of the
visual manifestations. Religion also influences codes of ethics and moral behaviour.
5. Values and Attitude Foundations

Values/attitudes regarding achievement and work, wealth and material gain, risk and change vary
by culture and impact how people view employment and organizations. Four main
values/attitudes that are worth consideration are:
a) Power Distance – The degree to which a society accepts a hierarchical or unequal

distribution of power within organizations. An organization with a small power distance is
characterized by superiors viewing subordinates as “people like me”. Superiors are
accessible and the general belief is that all the organizational members have equal rights.
b) Uncertainty Avoidance – The degree to which a society perceives unequal and ambiguous
situations as threatening and to be avoided. An organization with strong uncertainty
avoidance is characterized by the belief that time is money, security is paramount, and
documented rules and regulations are critical.
c) Individualism-Collectivism – The degree to which a society focuses on individuals or

groups as resources for work and social problem solving. Collectivism holds a “we”
consciousness: a socialistic outlook, and that decision-making is a group responsibility.
d) Masculinity-Femininity – The degree to which a society emphasizes the so-called

“masculine” traits such as assertiveness, independence, and insensitivity to human feelings.
A masculine-oriented society has sex roles clearly differentiated, values independence; and
perceives the big and fast as beautiful. 70
The Aging Workforce

The Industrial World is facing a situation where its workforce is older than it has ever been before. Older
workers have many work qualities that make them a valuable asset to any workplace. They are described
as experienced, loyal, possessing strong work ethics, and willing to try a variety of roles.
Society as a whole tends to be gerontophobic: that is, fear of the aging process, and as such, tends to
be prejudiced against older workers. 71 Some of this is perpetuated by the media, and some by older
workers themselves. For example, many older workers view themselves as being too old to start a new
career or to tackle a new business endeavour. Having spent their entire career in one line of work, many
believe that they could not do anything else. And some view themselves as being overqualified to do a
less demanding job. 72
69
Sons, p. 81.
70
Hofstede, G. (1980). Motivation, leadership, and organization: Do Americans theories apply abroad? Organizational dynamics,
Vol. 9, Summer issue, pp. 46-49.
71
72
Health and Wellness
In terms of hiring the older worker, employers question the required training and development investment
given that the older worker may not be with the company all that long. Employers also view these workers
as being physically slower, less physically able, less productive, more set in their ways, unable to adapt to
new technology, and more likely to get hurt.
Older workers do face a number of challenges that comes with the aging process. For example, 23% of
Canadian workers experience illness/injuries that negatively impact their ability to function in the
workplace. By aged, 65 years, the prevalence of disability increases to 42%. 73 Some other noted
conditions that are associated with aging are hearing loss, visual deficits, slower reaction times, problems
with shift work, increased susceptibility to lengthy absences if injured and increased prevalence of chronic
health conditions. However, these can be mitigated by a supportive lifestyle and being realistic with the
work assignments. 74
In terms of work-personal life conflict, older workers are often involved in providing care for an older,
dependent relative. Working and shouldering this type of responsibility can lead to caregiver strain – the
stress of caring for an elderly dependent. Older women are particularly susceptible, especially when they
have additional care giving responsibilities for grandchildren. 75
Today, many older workers are holding down a variety of jobs that range from entry-level to key
knowledge positions. Employers appreciate the dedication and expertise that they bring, and therefore,
are willing to shoulder any associated risks and costs.
A: OBJECTIVES
General Objective:
• The OHS professional will have an understanding of a number of workplace and social factors
that can adversely affect worker well-being.
• define corporate culture;

• explain how corporate culture impacts the workplace;
• discuss the impact of management practices and human resource management theories on
worker health and wellness, as well as organizational success;
• describe the impact that labour relations has on worker health and wellness;
• explain the phenomenon of four generations in the workplace;
• describe the traits of the four generational groups;
• explain the impacts that the presence of four generations is having on the workplace;
• define cultural diversity;
• define culture;
• explain the five cultural dimensions that impact the workplace;
• define gerontophobia; and
• explain the impact that an aging workforce is having on the workplace.
73
Williams, K. (2003) Returning to work after disability: What goes wrong? (Presented at Canadian Human Resource Planners
event, May 15, Calgary, Alberta).
74
75
Health and Wellness
B. ACTIVITIES:
1. Suggested Reading
Chapter 5: Occupational health & safety: Leadership and commitment, pages
257-300.
Chapter 6: Safe workplace = great workplace: Building a sustainable culture of
safety, pages 307-352.
Chapter 31: Occupational health & safety: Diversity considerations, pages 1205-
1244.
Chapter 32: Impact of four generations in the workplace on Occupational health
& safety, pages 1249-1296.

Watson Wyatt Worldwide. (2010). The health and productivity advantage: 2009/2010
North American staying@work report. Atlanta, GA: Watson Wyatt Worldwide. Available
online at: www.watsonwyatt.com
2. Corporate culture is defined on the previous pages.

3. How the corporate culture impacts the workplace, is explained on the previous pages. For
additional information, refer to Dyck, Chapters 5 and 6; the Towers Watson, 2011/2012
Staying@Work Report; and the Towers Watson, 2013/2014 Staying@Work Report.
4. The impact of management practices and human resource management theories on worker
health and wellness, as well as organizational success is briefly described above. For more
details, refer to Watson Wyatt, 2009-2010.
5. The nature of the labour-management relations impacts worker health and wellness, as well as
organizational business success. Refer to Chapter 2, Dyck, 2009, for more details.
6. The phenomenon of four generations in the workplace and their respective traits are described in
detail by Dyck, pages 454-462.
7. The impacts that the presence of four generations is having on the workplace is explained by
Dyck, pages 458-462.
8. The definition of cultural diversity is provided on the previous pages.
9. The definition of culture is provided on the previous pages.
10. The five cultural dimensions that impact the workplace are discussed on the previous pages.
11. The definition of gerontophobia is provided on the previous pages, and explained in greater
detail in Dyck, page 463.
12. The impact that an aging workforce is having on the workplace, is discussed in Dyck, page 463.
Health and Wellness
HW9: Demonstrate an Understanding of the Effects of Fatigue on Worker

Health and Performance
Fatigue is the state of extreme weariness or exhaustion from work, overexertion, or stress. It can be
physical or psychological in nature, and result in reduced alertness, capabilities, and performance.
Fatigue is a very common complaint and it is important to remember that it is a symptom and not a
disease. Many illnesses can result in the complaint of fatigue and they can be physical, psychological, or
a combination of the two.
Shiftwork is any work conducted outside of normal daytime work hours (7 a.m.-6 p.m.), and which is
done on a regular or rotating-shift basis. 76 Almost 25% of Canadian workers work non-standard work
hours. 77 As the Canadian economy becomes more service oriented, this percentage of shift workers will
increase. Unfortunately, up to about 20% of workers are unable to tolerate shiftwork. 78 As well, a larger
percentage of shift workers are at increased risk for negative health effects. 79,80 As such, the OHS
professional must be cognizant of the impact of shift work on workers, and what can be done through
scheduling and other approaches to mitigate the effects of shift work on productivity, morale, safety, and
health.
Circadian rhythms are physical, mental, and behavioral changes that follow a roughly 24-hour cycle,
responding primarily to light and darkness in an organism’s environment. They are found in most living
things, including animals, plants, and many tiny microbes. 81 Shiftwork can be opposed to the worker’s
biological rhythms and disruptive to the circadian system. This relationship is depicted in Figure 4.
76
Zenz, C. (1994). Occupational medicine, 3rd edition. Toronto, ON: Mosby, pp. 960, 963.
77
Public Health Agency of Canada. (2005). Shift work and health eating: Education & awareness raising, Canada health network,
p. 169. Available online at: http://www.gov.ns.ca/
78
Zenz, C. (1994). Occupational medicine, 3rd edition. Toronto, ON: Mosby, p. 960.
79
80
Rosenstock, L., Cullen, M., Bordkin, C., & Redlich, C. (2005). Textbook of clinical occupational and environmental medicine,
2nd edition. Toronto, ON: Elsevier Saunders, p. 231, 557-558, 604, 632, 688, 691, and 934
81
National Institutes of Health. (2012). Circadian rhythms. Bethesda, MD: U.S. Department of Health and Human Services
Health and Wellness
Figure 4: How Shiftwork Impacts Human Health and Well-being 82
Relationship between Shiftwork and Human Health & Well-being
Shiftwork
Mismatch Disturbed social
of circadian patterns
rhythms
Sleep-wake Social
disturbances deficits
Illness/injury Lifestyle Changes Personal &

vulnerability (diet, smoking, exercise, social stress
activities)
Biological
desynchronization
Disease
As such, the following negative health effects have been noted:
• disrupted sleep patterns; 83

• reduced health and general wellness;
• gastrointestinal disorders 84 and disease (peptic ulcers, 85 pancreatitis, 86 heart disease 87,88);
• exacerbation of existing chronic health conditions like epilepsy, 89 diabetes, 90 asthma; 91
• female reproductive problems (lowered fertility; 92 spontaneous abortions 93);
• greater alcohol and substance abuse; 94
82 Adapted from Knutsson, A. (1989). Shift work and coronary heart disease, Scandanavian journal of social medicine
supplement, 44, pp. 1-36.anavian.
83
Zenz, C. (1994). Occupational medicine, 3rd edition. Toronto, ON: Mosby, p. 964-968.
84
85
2nd edition. Toronto, ON: Elsevier Saunders, p. 604.
86
87
2nd edition. Toronto, ON: Elsevier Saunders, p. 557-558.
88
89
90
91
92
93
Health and Wellness
• depression, mood disturbances, and personality changes; 95

• reduced performance quality; 96
• increased incident rates and injuries; 97 and/or
• increased medical absences from work. 98
Shiftwork Scheduling
The scheduling of shift work impacts human health to differing degrees:
• Fixed shifts – always working the same shift – low birth weights; 99
• Rotating shifts – moving regularly between day, evening, and night shifts – associated with pre-
term births 100, and low birth weights 101;
• Oscillating shifts – alternating between two shifts on a weekly basis – undetermined effects;
• Split shifts – a shift that is broken up by a period of off work time; and
• Alternate shifts – a 4-day workweek comprised of 10-hour days, nights, or evening and weekends
off; or an 8-day workweek of 4 10-hour shifts followed by 4 days off. 102
Research has shown that work schedules that slowly rotate clockwise, that is, day to evening to night to
day, are the least problematic. 103 OHS professionals should assist employers to understand the hazards
of shiftwork, and how to mitigate and/or prevent the potential ill effects of shiftwork.
Overtime
In Canada, 2011, worker overtime as a percentage of payroll, increased to 3.5%, from 2.8% in 2009. As
well, the cost of replacement workers doubled in that two-year period. Overtime translates into longer
work time which in turn is associated with worker fatigue, sleeping problems, injuries, accidents, high
blood pressure, psychological and behavioural disorders, musculoskeletal problems, cardiovascular
disease, and disability.
A: OBJECTIVES
General Objectives:
• understand the negative impact of shiftwork on worker health and well-being;

• appreciate which shift schedules are less hazardous to worker health and well-being;
• understand how to improve shiftwork practices within an organization;
• learn effective coping strategies for shift workers;
• appreciate the health effects of overtime.
94
95
96
97
98
99
100
101
102
Zenz, C. (1994). Occupational medicine, 3rd edition. Toronto, ON: Mosby, pp. 963-964.
103
Health and Wellness
• define shiftwork and circadian rhythms;

• identify the various shiftwork schedules that are the most problematic to worker health and well-
being;
• discuss circadian rhythms and its effect on physical and psychological performance, and on
women’s health;
• identify the health and social effects of shiftwork;
• discuss the related recommendations;
• outline the health and wellness tips for shift workers;
• identify the negative health effects of overtime; and
• explain some strategies for improvement by the organization.
B: ACTIVITIES:
CCOHS. (2010). Rotational shiftwork. Available online at: www.ccohs.ca
NIOSH. (1997). Plain language about shift work. Cincinnati, OH: US Department of
Health and Human Services. Available online at: www.niosh.com
Occupational Health Clinics for Ontario Workers Inc. – OHCOW. (2005). Shiftwork health
effects & solutions. Hamilton, ON: OHCOW. Available online at: http://www.ohcow.on.ca
Yang, H., Schnall, P. Jourequi, M. Su, T, and Baker, D. (2006). Work hours and self-
reported hypertension among working people in California, Hypertension, 48(4): pages
744-50.
2. Definitions of shiftwork and circadian rhythms are provided above, and on page 1 of each of
the CCOHS, NIOSH, and OHCOW documents.
3. Refer above, and to the NIOSH (pages 5-12), and OHCOW (page 1) documents, for examples of
the various shiftwork schedules that are the most problematic to worker health and well-being.
4. The CCOHS (pages 2-3), NIOSH (pages 13-18) and OHCOW (pages 1-2) documents provide
explanations on circadian rhythms and their effect on physical and psychological performance,
and on women’s health.
5. The OHCOW document identified the health and social effects of shiftwork and provides
recommendations to mitigate or prevent these effects (pages 2-3). Refer to the CCOHS and
NIOSH for additional related information.
6. Review the OHCOW document for health and wellness tips for shift workers (page 4). As well,
CCOHS, pages 6-7, addresses what the individual can do to cope with shiftwork.
7. Strategies for improvement by the organization are provided in CCOHS, pages 4-6.
8. Assist organizations to understand the negative effects of excessive overtime, and how to
address that practice.
Health and Wellness
HW10: Demonstrate an Understanding of the Influence of the Psychosocial

Work Environment Influence On Worker Health and Wellness
Physical and social environments have major influences on a person’s health, both at home and at work.
In the physical environment, noise levels, toxic substances, air quality, and workplace design can directly
affect people. The social environment through such factors as work schedules, coordinating home and
work responsibilities, deadlines, work organization and available training and support impact worker
wellness. Interpersonal relationships including supervisor communication, feedback from co-workers, and
family relationships are affected by the social environment.
Some of the recognized organizational stressors that can negatively impact workers include:
• Inadequate staffing;
• Lack of clear or conflicting job expectations;
• No/limited line of sight;
• Lack of development;
• Lack of coaching;
• Lack of autonomy, discretion;
• Little opportunity for participation;
• Poor working conditions;
• Ineffective policies, processes or procedures;
• Poor communications;
• Ambiguity or conflict in roles;
• Lack of performance information;
• Unclear performance measures;
• Lack of meaningful work;
• Lack of effective feedback;
• Lack of recognition or reinforcement;
• Workplace harassment.
By implementing a supportive and people-oriented work culture, and transformational leadership at every
level of management, organizations can counter the influence of a negative psychosocial work
environment.
A Supportive and Sustainable Work Culture is a system of shared beliefs and values developed by
management that produces a work environment in which workers know how to perform their jobs, are
able to perform their jobs, are equipped to perform their jobs, and are motivated to perform their jobs
competently. It defines management expectations, workplace civility, worker respect, and the anticipated
level of trust. In essence, it is the way management wants things to be done.
Transformational leadership is inspired leadership that influences the beliefs, values and goals of
workers so that they can perform in an extraordinary manner.
Health and Wellness
A: OBJECTIVES
General Objective:
• appreciate the physical and social factors that can impact worker and organizational health;
• learn how to address workplace stressors;
• understand the value of a Supportive and Sustainable Work Culture and transformational
leadership.
• identify factors within the workplace that can negatively impact worker health;
• identify factors within the workplace that can negatively impact organizational health;
• explain the Toxic Cycle;
• discuss The Performance Maximizer; and
• describe how good performance management practices can result in positive performance and
financial results.
B. ACTIVITIES:
Roithmayr, T. (2011), in Dyck, D.E. (2011). Chapter 18: Toxic work environment: Impact
on employee illness/injury, Occupational health & safety: Theory, strategy and
industry practice, 2nd edition. Markham, ON: LexisNexis, pages 739-758.
2. The factors within the workplace that can negatively impact worker health are described by
Roithmayr, pages 369-384.
3. The factors within the workplace that can negatively impact organizational health are described
by Roithmayr, pages 369-384. It is important to recognize that the factors that affect organization
health are the same factors that affect worker health. These two health states are interrelated.
4. The Toxic Cycle Model and its concepts are presented by Roithmayr, pages 373-378.
5. The The Performance Maximizerand its components are described by Roithmayr, page 372.
6. Roithmayr describes how good performance management practices can result in performance
and financial results on pages 378-379.
7. Transformational leadership is explained in Dyck, pages 319-320.
HW11: Demonstrate an Understanding of the Influence of Work/life Balance

on Worker Health and Wellness
Canadians play many different societal roles in their lives. They are sons, daughters, siblings, spouses,
parents, students, workers, friends, caregivers of elderly relatives, and volunteers in their communities.
They must also make room in their lives for taking care of their own physical, emotional, spiritual,
intellectual, and psychological well-being. Not surprisingly, achieving balance among all these competing
priorities and demands can be difficult. Hence, achieving a sound work/life balance is critical to worker
health and well-being.
Health and Wellness
Work/Life balance is a broad and dynamic concept that encompasses the prioritizing and balancing of
"work" (job, career, and ambition) on the one hand, with "life" (personal health, well-being, pleasure,
leisure, family time/responsibilities, social responsibilities, intellectual growth, and spiritual development)
on the other. 104 Related, though broader, other terms for work/life balance include "lifestyle balance" and
"life balance". To achieve work/life balance, individuals are encouraged to:
• separate work time, and family or leisure time;

• develop a “top priority” list for both work and home;
• schedule work and non-work activities in the same day planner or calendar;
• delegate some tasks to others;
• take on only what can be accomplished within the respective work or family time; and
• listen to one’s body - take time to exercise, eat well, relax, and sleep. 105
Employers are encouraged to promote work/life balance. The rationale is that organizations can benefit
by having:
• employees who attend work regularly, thereby reducing work absenteeism;

• increased work productivity;
• improved employee morale and working relationships;
• decreased presenteeism and related costs;
• decreased worker stress; and
• better employee attraction and retention.
Organizations that offer employees support and assistance when needed, net greater worker loyalty.
Through a workplace Attendance Support and Assistance Program, the organization is able to help
employees deal with their personal, home, and/or workplace issues in a responsible and constructive
manner.
A: OBJECTIVES
General Objective:
• have an understanding of issues that adversely influence work/life balance;

• understand the negative impacts of employee absenteeism;
• learn what employers can do to support workers.
• define work/life balance and work/life conflict;

• describe the four broad categories associated with work/life balance;
• identify factors that lead to work/life conflict;
• discuss why work/life balance has become more difficult;
• describe why work/life balance is important to all stakeholders;
• describe the trends that have adversely influenced work/life psychological health has declined;
• describe those employees who are “at risk” of experiencing work/life conflict and identify the
reasons why;
104
Dyck, D. (2012). Work/Life Balance. Unpublished work. Calgary, AB.
105
Government of Canada. (2010). Work smarter - Find your work-life balance, Canada business network, October 21, 2010.
Health and Wellness
• review the cost of work/life imbalance to employees and their families;

• suggest approaches that may be taken by the employee, family, and employer to reduce work/life
balance conflict;
• understand the value and functioning of a workplace Attendance Support and Assistance
Program; and
• identify ways in which the employer can support employees through “troubled times”.
B. ACTIVITIES:
CCOHS. (2008). OSH answers: Work/life balance. Available online at: www.CCOHS.com
Duxbury, L. (2001). Work/life balance in the new millennium: Where are we? Where do
we need to go? Available at Canadian policy and research networks www.cprn.org
Duxbury, L. & Higgins, C. (2012). Reducing Work–Life Conflict: What Works? What
Doesn’t? Available online at: http://www.hc-sc.gc.ca/ewh-semt/alt_formats/hecs-
sesc/pdf/pubs/occup-travail/balancing-equilibre/full_report-rapport_complet-eng.pdf
Chapter 9: Attendance Support and Assistance Program, pages 289-324.
Kansas Workforce Initiative (2010). Work-Family Conflict and Family-Work Conflict,

available online at
http://www.kwi.ku.edu/research/WorkforceEvidenceReviews/ER%20Work-
Family%20Conflict.pdf

2. The definition of work/life balance is provided on the previous pages, as well as in the Duxbury
reports and the Kansas Workforce Initiative.
3. The four broad categories associated with work/life balance are addressed in the CCOHS fact
sheet. They include:
• Role overload: This form of work/life conflict occurs when the total demands on time and
energy associated with the prescribed activities of multiple roles are too great to perform the
roles adequately or comfortably.
• Work-to-family interference: This type of role conflict occurs when work demands and
responsibilities make it more difficult to fulfill family-role responsibilities (e.g., long hours in
paid work prevent attendance at a child's sporting event, preoccupation with the work role
prevents an active enjoyment of family life, work stresses spill over into the home
environment and increase conflict with the family).
• Family-to-work interference: This type of role conflict occurs when family demands and
responsibilities make it more difficult to fulfill work-role responsibilities (e.g., a child's illness
prevents attendance at work, conflict at home makes concentration at work difficult).
• Caregiver strain: Caregiver strain is a multi-dimensional construct defined in terms of
"burdens" in the caregivers' day-to-day lives, which can be attributed to the need to provide
care or assistance to someone else who needs it.
Health and Wellness
4. In our lives, we all play many roles: employee, spouse, child, parent, etc. However, each of these
roles imposes demands on us that require time, energy, and commitment. Refer to Duxbury,
2001, page 3 for a definition of work/life conflict.
5. Refer to the Duxbury reports, 2001 and 2012, to identify the factors that may lead to increased
work/life balance.
6. An increase in the number of women working, single parent families, dual earners, eldercare, and
childcare responsibilities began in the 1990’s. These and other factors can be linked to increased
work/life conflict. Refer to Duxbury, 2001, pages 6-10 for complete details.
7. Review Duxbury, 2001, pages 12-21 to identify the trends that have adversely influenced work/life
balance during the last decade.
8. According to Duxbury, 2012, work and personal life are no longer separate domains – the
boundaries have disappeared. Over 50% of workers report regularly taking work home. Role
overload is systemic.
9. Work/life conflict affects individuals in a variety of ways. For example, the worker experiences
increased workload, an inability to set boundaries between work and home life; problems
balancing the two lives; string that leads to stress and illness; and deteriorated psychological and
physical health. The organization ends up with a stressed workforce; decreased employee
morale; higher staff turnover rates; reduced productivity due to employee presenteeism and high
absenteeism; business interruptions; problems attracting new talents; and problems with
succession planning, knowledge transfer, and change management.
10. Both the Duxbury reports review why work/life conflict has increased and why psychological
health has declined.
11. Refer to Duxbury, 2001, pages 21-39 to identify those workers “at risk” of experiencing work/life
conflict and why these groups are at risk.
12. The cost of work/life imbalance has been significant for everyone. Duxbury, pages 39-49, reviews
these costs as it relates to the employer, worker, and the worker’s family. As well refer to the
Towers Watson, 2011/2012 Staying@Work Report for more cost details.
13. Most employers feel that helping workers to balance their competing work and non-work
demands is not their responsibility. However, the inability to balance work and family is
everyone’s problem, especially with the increased interference of personal time by technology.
The Duxbury reports discuss the importance of work/life balance to all stakeholders. As well, the
CCOHS fact sheet provides information on Work/Life Initiatives and why organizations should
consider offering these employee supports. The Towers Watson, 2011/2012 Staying@Work
Report clearly demonstrates the advantages of employer-employee accountability in achieving a
healthy work/life balance.
14. Work/life balance can be re-established by:
• providing organizational support for work/life balance;

• creating supportive work-family corporate culture;
• educating supervisors on value of work/life balance;
• empowering supervisors to buffer work pressures;
• providing family-friendly benefits and programs; and
• offering programs that facilitate psychological detachment such as leisure activities, and
workshops about time management and relaxation can help employees dealing with potential
work and family conflicts.
Review Duxbury, 2001, pages 49-64 to identify approaches that can be taken to reduce work/life
conflict.
15. The CCOHS fact sheet explains how an organization can implement work/life balance initiatives.
Work/life balance initiatives are any benefits, policies, or programs that help create a better
Health and Wellness
balance between the demands of the job and the healthy management (and enjoyment) of life
outside work. They include:
• on-site childcare;
• emergency childcare assistance;
• seasonal childcare programs (such as during March Break or Christmas);
• eldercare initiatives (may range from referral program, eldercare assessment, case
management, a list of local organizations or businesses that can help with information or
products, or seminars and support groups);
• referral program to care services, local organizations, etc.;
• flexible working arrangements;
• parental leave for adoptive parents;
• family leave policies;
• other leaves of absence policies such as educational leave, community service leaves, self-
funded leave or sabbaticals;
• employee assistance programs;
• on-site seminars and workshops (on such topics as stress, nutrition, smoking, communication
etc.);
• internal and/or external educational or training opportunities; or
• fitness facilities or fitness membership assistance (financial).
16. An attendance support and assistance program is a pro-active approach to promoting and
supporting employee attendance at work. Although an attendance program can be called many
different things, like attendance management, attendance support, employee wellness, workplace
wellness, etc., the terms attendance support and assistance program is one that can be used by
management and trade unions to address employee unscheduled absenteeism. To be
successful, an attendance support and assistance program must be custom-made to fit the
organization and the attendance problems identified. Although there is no such thing as a
“standard” program, there are many common features of a successful attendance support
program, namely:
• identifying the importance to the organization of worker dependability and responsibility, as
demonstrated through good attendance;
• indicating the concern of the organization regarding excessive absenteeism for any reason;
• identifying the relationship between absence and performance management;
• defining culpable or “blameworthy” absences and non-culpable or “innocent” absences, and
the measure for dealing with these separately, that is, progressive discipline for culpable
absence and counselling or resource assistance for non-culpable absence;
• clearly outlining the rules of the organization on reporting absences, for example:
(a) the frequency and direction of reporting;
(b) when and if a medical certificate is required; and
(c) the nature and frequency of any additional information required by the employer
during a period of absence from work.
• being consistently enforced, while at the same time flexible enough to allow for some
discretion on the part of the employer in the case of emergencies or unusual circumstances;
• providing guidance to managers on what information is required from the absent worker, and
what type of information is necessary for tracking purposes; and
• ensuring that there is a method for documentation and follow-up in the management of
absenteeism.
Health and Wellness
For additional details, review Chapter 9, Dyck (2013), on the functioning of a workplace
attendance support and assistance program.
17. Using the readings provided above, identify the ways in which the employer can support workers
through “troubled times”.

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Health and Wellness

Tel: (905) 567-7198

Last Revision: 2014

Health and Wellness (HW)

Originally Developed: 2002 Last Revision Completed: 2014

Competency HW1: Demonstrate an understanding of workplace health promotion.

Competency HW3: Demonstrate an understanding of employee assistance programs.

Competency HW4: Demonstrate an understanding of wellness programs (e.g., stress management,

Competency HW5: Demonstrate an understanding of disability management programs (e.g., modified

Competency HW7: Demonstrate an understanding of disability management programs (e.g., modified

CompetencyHW10: Demonstrate an understanding of the influence of the psychosocial work

Competency HW11: Demonstrate an understanding of the influence of work/life balance influences on

Addictions Foundation of Manitoba. Workplace Services: Gambling. Available online at:

National Institute of Disability Management (NIDMAR). (1995). Disability management in the

Statistics Canada (2012). Smoking, 2010. Available online at: http://www.statcan.gc.ca/pub/82-

Statistics Canada (2013). Smoking. Available online at: http://www.statcan.gc.ca/search-

Learning Objectives for the Competencies

HW1: Demonstrate an Understanding of Workplace Health Promotion

Figure 1: Wellness Continuum 8

Well Signs & Disease Disability Death

Primary Secondary Tertiary

General Health Education

Blood Pressure Screening

• 120 (systolic)/80 (diastolic) or lower indicates normal blood pressure;

Weight Management Programs

Integrated Workplace Health Management 12

Figure 2: Integrated Workplace Health Management (IWHM) Approach 13

IWHM: Components and Functions

© Dyck, D., 2014

IWHM Components: Linkages

By way of examples, consider the following:

Figure 3: Integrated Workplace Health Management Approach 17

IWHM: Components and Functions

Source: Dyck, 2011

• Human Resources Program, Workplace Wellness Program, Employee Assistance Program,

The OHS professional will:

• be knowledgeable about health promotion and health protection (disease prevention).

The OHS professional will be able to:

Towers Watson (2014). 2013/2014 Staying@work report: Canada summary. Available

Towers Watson. (2012). Pathway to health and productivity: 2011/2012 Staying@work

Step 1: Set your communication goals

Step 2: Identify your target audience

Step 3: Decide what you are going to communicate – your strategy

Step 6: Decide how to reach your target audience – tactics

Step 7: Evaluate the effectiveness of your communication program

HW2: Demonstrate an Understanding of Injury, Illness, and Disease

It is a defined action plan designed to prevent incidents and occupational diseases.

• Ergonomic Programs – are aimed at preventing work-related musculoskeletal disorders

• Medical Monitoring – monitoring is the evaluation of a disease/condition over time. It can be

The OHS professional will be able to:

• define the term effective program marketing;

Towers Watson. (2012). Pathway to health and productivity: 2011/2012 Staying@work

 The term effective program marketing involves:

2. The core marketing concepts are discussed by Dyck on pages 665-668.

• improved employee morale;

• Compliance with the law;

HW3: Demonstrate an Understanding of Employee Assistance Programs

• alternative therapies (behaviour modification, nutrition counselling, eating disorder counselling,

Employee assistance programs can be linked to disability management as employee assistance

The OHS professional will:

• be able to gain an understanding of the scope and function of an EAP;

The OHS professional will be able to:

CCOHS. (2009). OSH answers: Employee assistance programs (EAP). Available on