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This essay aims to provide an overview of how health can be influenced by work and the work environment. The essay will explore the main trends and issues related to working conditions, identify knowledge and information gaps. Recommendations for the future of an identified group of workers and the general workforce as a whole will be suggested.
The writer chose to focus on a group of workers in the cleaning industry. The identified workers work for XYZ Cleaning Services Limited in Partnership with ABC Shopping Mall based in Birmingham City Centre. The workforce comprises of ten workers who work between 2000 hours and 0500 hours. The minimum number of workers per shift is three staff and up to a maximum of five per shift. The workers are contracted to work 40 hours per week, an equivalent of five nights per week with two nights off.
The workers are responsible for overall sweeping of the mall floor using scrub driver machines. This includes sweeping and mopping of mall stairs, cleaning escalators, windows and sweeping shop fronts on the busy main street.
Out of the ten workers, all are male migrant workers. There are five Afro-Carribeans, three Africans and two East Europeans. It can be argued that half of these men can hardly read and write but they handle the chemicals that can be hazardous to health. The workers are distanced from the company's administrative office which is open during the day outside their working hours. The workers are solemnly dependant on their supervisors who control what type of work they do.
The cleaning industry employs very large numbers of people in all sectors of the economy. The range of work covers all cleaning activities in offices, factories, shop malls and hospitals etc (Health and Safety Executive (HSE), 2005). The industry ranges from large contract cleaning companies to small-medium enterprises. As stated by the HSE (2005) 83.1 percent of cleaning companies employ between 1 to 10 employees under a different range of contracts. In England and Wales,it can be noted that most people who work in this industry are from ethnic minorities. 37% of these workers are immigrants (HSE, 2007).
The cleaning service represents one of the most dynamic areas of cooperate services worldwide (World Health Organisation (WHO), 1998). The fact that the industry faces stiff competition and struggles with high staff turnover increases the opportunities for illegal working. Cleaning companies sometimes have to accept contracts knowing that they will not meet the health and safety requirements or they will lose contracts. This means that the customer dictates the workers' working conditions sometimes compromising workers' health and safety. HSE (2007) highlights that often, health and safety matters are not included in the customers' procument, and instead they are discussed after the contract has been signed.
In 2005-2006, 3500 work related accidents were reported to the HSE and Local Authorities. Almost over 700 of these were serious major accidents (www.hse.gov.uk).
Cleaning is a basic service occupation carried out in all industry and workplaces. In ABC Shopping Mall, the cleaners' health and safety conditions depend on the environment that they work in which is usually poor in general. Most of the work is performed as contract cleaning and cleaners are employed by XYZ who are responsible for the health and safety of these workers but do not control the environment in which the workers work in. As a result of the nature of the cleaning job, cleaners are potentially exposed to a wide range of chemical, biological, physical and physiological risks. (www.osha.europa.eu).
Despite being hardly able to read and write, some of these male workers handle chemical and biological substances that can be potentially hazardous to their health such as dirt, dust etc. These dangerous substances to which the cleaners are exposed include chemical and biological substances contained in the work environment. Workers are exposed to microorganisms such as bacteria, viruses, fungal secretions and soot particles generated during the cleaning process. Workers are also at an increased risk of suffering from upper respiratory tract infections. The risk of getting contaminated by bodily fluids, blood and other related dirt that can be hazardous to the workers' health is high (European Council Directive, 2006).
Mechanical hazards in cleaning work include hazards linked to poor built of work equipment and work environment that can bring awkward working positions in lifting and handling (Woods et al, 1999). The workers at XYZ Company work on elevated platforms, wet and slippery floors using rotating cleaning machinery that can potentially harm their body posture. One has to push the machine putting strain on their backs.
Musculoskeletal problems are also rife in this particular workplace. The company however provides rider cleaning machines that workers operate whilst sitting and driving in them. Some of these machines used to scrub the floors affect workers' health. One has to push the machine straining their backs. The mall covers a large surface area and the workers face a high work load due to intensification of work and increased demand.
The company provides recommended safety shoes to reduce injuries from heavy objects falling on workers feet. There is also an oversupply of visibility vests for workers to use when working on the streets. Workers are also provided with goggles and gloves when working in dusty and dirty environments.
During winter, the workers get exposed to extreme cold resulting in them suffering from colds and flu on and off. This workplace is right in the middle of a big vibrant city open to the public. It can be very dangerous for the workers on the streets as they are subjected to verbal and physical abuse from drunks walking about the city centre.
A United Kingdom (UK) study shows that the prevalence of health problems such as musculoskeletal complains, skin problems and psychological disorders are high among cleaners than other professions (International Labour Organisation (ILO), 2000). Also according to a Finnish study in 1999, cleaners are most affected by a declining workability, frequent medical consultations and periods of absenteeism than other workers. There is little knowledge in most self employed and often undeclared workers on their occupational health and safety, or their working and employment conditions. Migrant workers are often not aware of their rights, hardly speak English and are often desperate to get a job (European Agency for Safety, 2007). The fact that they are unrecognised, migrant workers exposes them to an increased risk for exploitation, low wages and unfavourable working conditions (HSE, 2007).
At XYZ, workers are paid fortnightly and only the minimum wage. This is barely enough to cover basic living. The workers end up getting extra jobs to cover for the deficit resulting in increased risk to their health. XYZ Company pays the workers double rate on public and bank holidays but recently the company wants to change the contractual agreement to this arrangement. The workers are not happy but there is no workers' union to represent them on such matters.
According to EU-OSHA (2008) cleaning companies are under immense pressure to deliver cheaper services. As a result there is an increased demand for flexibility resulting in compromised health and safety of workers in order to respond quickly and accurately to the customers' demands. Woods et al (1999) highlight that cleaners will end up having to work unsocial hours, disrupted work-social life balance, fatigue and being victims of violence. Although, social partners strive to promote daytime cleaning, most cleaning workers work at night in general. As stated by ILO (2000) cleaning workers suffer from ineffective social functioning which contributes to work-life conflicts. Their interrupted rotas do not improve their work-life balance.
Health and safety is a big part in the work environment. According to Walton (1994) as cited in Naidoo and Willis (2000) work plays a significant role in human lives and influences people's well being. It requires considerable demands on time and energy. People are increasingly influenced by both positive and negative aspects of their work.
Work stressors may lead to personal negative aspects such as anxiety, general mental distress, heart disease and other chronic illness (Chiang et al, 2003). In order to understand the influence of work conditions and ill health, factors such as nature of work, the environment, age of workers, gender, income, level of education, personality and marital status need to be considered. The workers' well being is affected by such harmful effects and the physical environment and psychosocial factors of employment. Orme et al (2003) suggest that individuals will try to combine occupational and family demands resulting in ill health.
However as argued by Chiang et al (2003) some quantities of stress or pressure are necessary in order to meet targets. Moderate levels of stress are a significant motivational factor that can be effective in achieving a dynamic equilibrium. No health can exist without cooperation with other people and their environment (Health and Safety Commission, 2004). Social interactions that characterise a given environment will impact on successful maintenance of health at work. Pressures from significant others, notably family, friends and co-workers may all exert considerable pressure on health at work. As highlighted by Westwood and Low (2003) both environmental and cultural factors influence occupational performance. The impact of the environment and culture involve transactional relationships with the individual and occupational variables.
Westwood and Low (2003) further argue that cultural factors do impinge on the ability and renovation of the worker and that, individual differences in learnt custom, beliefs and values can easily facilitate or hamper performance. Unlike in medical clinical settings where the patients' culture is frequently viewed as the problem and recommendations are attributed to patients and not to the clinician. In the cleaning industry, the workers' culture is viewed as the problem and recommendations are not attributed to workers. Work culture is an internal environment that encapsulates the mind, body and soul, space and time issues (Chiang et al, 2003).
In UK, the average British citizen works longer hours than their European counterparts. A great number of factors make it difficult to achieve harmony between work and family, resulting in more stress on workers. Many people find it difficult to suit their work requirements to their family life. This may result in conflicts concerning family roles (Wainright and Calnan, 2002). People from the low socioeconomic class suffer greater adversity in their social environments and hence have greater life stresses. Goodman (2005) further argues that adverse expenses at work may lead to more serious psychological and physical health problems and these appear to depend on a range of factors like personal, social and cultural influences.
The idea that people should work for a living is very nearly universally accepted. Work purports to advance the common good while disregarding the common man especially his health (Wainright and Calnan, 2002). It can be argued that it promises financial freedom but in turn delivers captive chains. By willingly participating, working beyond their potential people are selling their freedom to the merchants of greed who are belting their own self interested enrichment from workers quest to survive.
Finlay et al (2005) highlight that it is impractical not to work for the sake of principle. But people are, however, aware of the real reasons why they work hard, the real nature of freedom and the difference of the two. In order to keep people coming to work willingly and cheerfully they need to be convinced that there are benefits. Consumerism then comes into play. Blaxter (1990) suggests that by promoting the idea that personal status and worthy are determined by ownership of property, employers can ensure a sufficient supply of willing workers despite their health suffering in the process.
A well defined workplace benefits everyone. Work stations and job tasks that are matched to the needs of individual employees are always best. Different workers have different needs hence require different working conditions. In cleaning and other industries, workplace injuries are the result of doing the same thing over and over again (HSE, 2005). The cleaning job requires a person to use all strength and lack of recognition and the feeling of being undervalued, high stress in the job and a lack of support from supervisors may result in poor performance and productivity.
A major paradigm shift towards an integrated, proactive and prevention-oriented approach is essential, to address these problems (World Health Organisation (WHO), 2002). At organisational level, a comprehensive policy should be put in place. An organisational policy that focuses on health and safety, needs of workers, including psychosocial problems. This will reduce the negative impact of workplace psychosocial problems.
Through improved psychosocial working conditions, workers are healthier with a higher morale and employers will see increase in productivity. Policy analysis helps the employers to understand the multiple and sometimes conflicting facets of work policy that contribute to multiple outcomes, some intended and some unintended (HSE, 2007).
Workers' health means individual and holistic well being at work. Occupational health is identified as the key driver in promoting health of workers in the workplace. Health examinations, workplace visits, counselling and advising services are essential preventive occupational health measures.
Better health, well being and quality of life, healthier living habits and safer healthier work environments are an improved image of the workplace. According to WHO (1998) workers and supervisors should undertake health promotion at work. Individual's needs should be taken into account, shift patterns, shortening of work shift hours and use of special equipment should make work task meaningful and balance with a person's life.
The Government White Paper, Saving Lives: Our healthier nation by the Department of Health (DOH) (1998) identifies accidents as a major public health priority and set targets to reduce deaths and injuries from accidents by October 2010. The Accidental Task Force (2000) coordinates cross Government action and identifies appropriate evidence based practice to prevent deaths and long term debilitating injury from accidents.
This incorporates the Departments of Transport, Trade and Industry, HSE and the Office of the Deputy Prime Minister. Under the Health and Safety at Work Act 1974, it is the responsibility of management to take into account as far as practicable the health and safety and welfare of its employees (HSE, 2005).
As the discussion above indicates, health and safety issues in the workplace are complex. Perceptions might differ from reality and solutions might be less evident than they first appear. Innovative policies must be advised in the workplace to protect workers from hazards. Willingness by companies to approve and enforce mandatory rules on health and safety at work is of paramount importance.
The Government has worked tirelessly to attempt to address health and safety issues in the workplace both at national and local levels. The Control of Substances Hazardous to Health Regulations (COSHH) (2002) stipulates employers' duty to protect employees and other persons from hazardous substances used at work.
As highlighted by the HSE, employers have a legal obligation to report injuries, diseases and dangerous occurrences to the HSE and local authorities to enable them to identify where and how risks arise and investigate serious accidents (RIDDOR, 1995).
A healthy workforce is a happier, more productive workforce. Dame Carol Black's Review of the Health of the Working Age Population (2008) highlights the need for employers to create workplaces that are accommodating and safe. It also recommends that everyone enjoys the benefits of health and fulfilling work (Working for a Healthier tomorrow, 2008).
The changing lifestyles and multiculturalism in the UK has resulted in a number of Government actions that are controversial for their perceived threat to civil liberties but such restrictions are necessary to prevent significant harm to the public at large.
Government paternalism may be justifiable when it is fact based but the Government is never justified in promoting a position that is scientifically incorrect. Political community does not have a clear sense of the concept of Public Health apart from the discourse around health care reform. According to the DOH (2004) Public Health regulation is designed to monitor health threats and intervene to reduce risk to the population. It can, however, violate fundamental Civil Liberties such as the right to privacy, bodily integrity, data protection and freedom of movement.
The risk to self is usually the least politically accepted reason for regulation. Paternalistic policies can be effective in preventing harm in the workplace. Neglect of the needs of the vulnerable predictably harms the whole community by eroding public trust and undermining social cohesion (House of Commons, 2006).
In the UK, improvements of health have been seen within the number of reportable injuries in the workplace being reduced by 52% in 2006 following a new health and safety campaign. The Acheson Report (1998) identifies health inequalities and factors that affect health creating problems for public health professionals and policy makers. The main determinants of health as identified by Dahlgren and Whitehead (1991) schematic overview of the range of factors that can contribute casually or in modifying forms of the variation in peoples' health were highlighted (www.whatispublichealth.org.uk).
The goals of Public Health are closely aligned with those of WHO (2000) which offer strategies that work towards developing healthy public policies, working with communities to identify their own needs.
The Liberals stress on the importance of individual autonomy and that people are given choice. Any intervention that may expose an individual to risk is morally unacceptable unless the person agrees to being exposed in legal terms. Public health interventions may interfere to different degrees with peoples' choices or liberties. A greater more explicit justification is needed for the state to interfere in a situation where the individual consent would otherwise be required due to considerable health and other risks involved (DOH, 2007).
Combined effects of physiological factors have considerable negative ramifications for workers, employers, workers' families and the society in general. For the individual, these can result in isolation, stigmatisation, injury, illness or even death. To the organisation, this could result in increased absenteeism, accidents, reduced productivity and reduced profits. Also to the family, there would be perceived loss of income, reduced welfare, missed opportunities for children, psychological trauma and eventually family breakdown. Lastly, the society at large will be negatively affected through increased costs, high unemployment and crime rates and consumer spending and reduced productivity.
The essay has shown that the work environment has a significant influence on people's health and well being. There is a wealth of evidence that individuals harbour feelings of isolation in the workplace in our culture. Whilst awaiting the Cultural Revolution in management and the workforce, the nation must embark on specific reform measures to mitigate the problems inherent on the health of the workers and the measures that might increase awareness of the importance of influence of work on health.
In conclusion, developing sound knowledge on the risk factors and health and safety outcomes will address challenges and develop preventive measures to the specifities of the cleaning and other industries in general. There is also need for further studies on migrant workers in the cleaning sector in order to address some of the inequalities as highlighted in this essay.
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