MANAGING BEST PRACTICES: So you're at your wits end...
Dear Employee:
I’m writing this article for you, because your employer is worried that if they bring up the subject, their comments may be taken all wrong and the problem may get worse. The problem is that your employer can’t find any workplace cause for your health problems. Investigations have been made, samples have been taken and analyzed, and experts may have been called in to see what they can see. And no one can find anything in the workplace that could be making you sick. But you know you’re not well because of something at work. You feel it. Sometimes taste it. You may even see an unusual rash on your skin.
Your doctor agrees that you have health problems that could be work related. Most importantly, when you’re away from work you begin to feel better, but when you return to work your health problems worsen. And other employees may not feel well, either. You know that work is making you, and maybe other employees, sick. What could be the cause?
The study is titled, “Sham device v. inert pill: randomized controlled trial of two placebo treatments.†In the study, researchers worked with a group of 266 people who had persistent arm pain due to repetitive use. Participants were told that they’d either be receiving capsules of amitriptyline (drug used to treat chronic pain) or acupuncture to see which treatment worked better for reducing pain. They were explicitly told about the adverse side effects from these treatments, which included pain on needle insertion, redness or swelling, skin rash, drowsiness, dry mouth, dizziness, headache, anxiety, frequent urination, and nausea. There really was no treatment during the study. Half of the participants received capsules containing cornstarch, which looked exactly like amitriptyline capsules. And the other half were given fake acupuncture with a needle which looks like it penetrates the skin, but actually the needle has a blunt tip and retracts into a hollow shaft handle.
The study produced two important findings. One, both “treatments†worked at reducing pain, although the fake needle worked better. And, two, a quarter of the participants treated with the fake needle, and one-third using the fake pills, experienced one or more of the adverse side effects that mimicked the information they were given when the study began. Three people even withdrew from the study when reduced “dosage†in the fake pills failed to eliminate the side effects of fatigue and dry mouth. If nothing was really done to these people, how could some get better and how could a quarter to one-third of the people experience adverse side effects?
Employers do care, at least the ones I have worked with. It’s rare for me to find over-exposures to health hazards today. But employers have made mistakes, particularly with hazard communication. Most employers communicate the hazards of chemicals using only material safety data sheets (MSDS), which scare the dickens out of most people. Employers should spend more time explaining risks to employees who work with chemical products in a certain way. Hazard means something could happen. Risk is the probability, or a chance, that something actually happens.
Read any MSDS and what do you find? You find a list of signs and symptoms — adverse side effects — from overexposure. An exposure under established limits, which is normal in most workplaces, is generally not expected to produce these effects. But similar to the study discussed above, some employees may nonetheless experience one or more of the adverse effects that mimic information found in an MSDS. There’s a rational explanation why other employees may not be feeling well, too. In 2001, the New England Journal of Medicine published the study, “The ecology of medical care revisited.†The study found that in an average month, 800 of every 1,000 American men, women and children experience health-related symptoms. Survey any group of employees, and on any given day, there may be many that don’t feel well. This does not necessarily mean that exposures at the workplace are the cause of their ill health.
The point of this article is this: just consider the possibility that the problem could originate in your head. No one is saying you’re crazy or faking it. But admitting this possibility opens up more options to solving health concerns. In next month’s column, I’ll provide suggestions to your employer to help them further address this topic.
Thank you.
I’m writing this article for you, because your employer is worried that if they bring up the subject, their comments may be taken all wrong and the problem may get worse. The problem is that your employer can’t find any workplace cause for your health problems. Investigations have been made, samples have been taken and analyzed, and experts may have been called in to see what they can see. And no one can find anything in the workplace that could be making you sick. But you know you’re not well because of something at work. You feel it. Sometimes taste it. You may even see an unusual rash on your skin.
Your doctor agrees that you have health problems that could be work related. Most importantly, when you’re away from work you begin to feel better, but when you return to work your health problems worsen. And other employees may not feel well, either. You know that work is making you, and maybe other employees, sick. What could be the cause?
Revealing research
Before I get to this point, let me summarize the results of a study published in the February 1, 2006, issue of the British Medical Journal. Don’t worry about the report coming from the Brits, the U.S. National Institutes of Health funded the study to the tune of about $1.6 million. This is just another example of how the world is coming together.The study is titled, “Sham device v. inert pill: randomized controlled trial of two placebo treatments.†In the study, researchers worked with a group of 266 people who had persistent arm pain due to repetitive use. Participants were told that they’d either be receiving capsules of amitriptyline (drug used to treat chronic pain) or acupuncture to see which treatment worked better for reducing pain. They were explicitly told about the adverse side effects from these treatments, which included pain on needle insertion, redness or swelling, skin rash, drowsiness, dry mouth, dizziness, headache, anxiety, frequent urination, and nausea. There really was no treatment during the study. Half of the participants received capsules containing cornstarch, which looked exactly like amitriptyline capsules. And the other half were given fake acupuncture with a needle which looks like it penetrates the skin, but actually the needle has a blunt tip and retracts into a hollow shaft handle.
The study produced two important findings. One, both “treatments†worked at reducing pain, although the fake needle worked better. And, two, a quarter of the participants treated with the fake needle, and one-third using the fake pills, experienced one or more of the adverse side effects that mimicked the information they were given when the study began. Three people even withdrew from the study when reduced “dosage†in the fake pills failed to eliminate the side effects of fatigue and dry mouth. If nothing was really done to these people, how could some get better and how could a quarter to one-third of the people experience adverse side effects?
The power of the mind
The U.S. Surgeon General reports that “...the human brain is the most complex structure ever investigated by our science.†So important is the study of the mind today that the 150 year-old publication, Scientific American, written for the public, launched a sister publication in 2004 called Scientific American Mind. This monthly publication can be found at newsstands. I encourage you to pick up and review a copy. Yes, our “thoughts†can impact our health in both directions. You know this to be true if you’ve ever had to give a presentation in front of a lot of people; just the fear of public speaking can create physical symptoms such as blushing, sweating, palpitations, hyperventilation, and tremors. The power of the mind is phenomenal.Mental health
Awareness of mental health is growing. A 2005 survey by the American Psychological Association finds that 80 percent of Americans say that during the past few years they have become more aware of how their mental health and emotions affect their physical health. And the American Academy of Family Physicians reports that two-thirds of all office visits to family physicians are due to stress-related symptoms.What’s happening in workplaces?
Here’s my take. I’m one of those experts your employer may call in to investigate the workplace for health problems. I’ve got a fancy education and certifications in specialties such as industrial hygiene and safety. But what I value most are my experiences. I’ve conducted more than 500 health and safety investigations in workplaces and have talked about health issues with hundreds, maybe thousands, of employees during the nearly 30 years of doing my job.What am I finding?
Stress is growing. People working in manufacturing for many years are particularly worried about their job. “If this place goes under, how will I survive?†they ask. And even if business is good at their workplace, they have more to do, and if they want to advance, employers are asking employees to obtain more schooling, perhaps get a degree, or another degree. You name it, there’s a lot to be stressed about today.Employers do care, at least the ones I have worked with. It’s rare for me to find over-exposures to health hazards today. But employers have made mistakes, particularly with hazard communication. Most employers communicate the hazards of chemicals using only material safety data sheets (MSDS), which scare the dickens out of most people. Employers should spend more time explaining risks to employees who work with chemical products in a certain way. Hazard means something could happen. Risk is the probability, or a chance, that something actually happens.
Read any MSDS and what do you find? You find a list of signs and symptoms — adverse side effects — from overexposure. An exposure under established limits, which is normal in most workplaces, is generally not expected to produce these effects. But similar to the study discussed above, some employees may nonetheless experience one or more of the adverse effects that mimic information found in an MSDS. There’s a rational explanation why other employees may not be feeling well, too. In 2001, the New England Journal of Medicine published the study, “The ecology of medical care revisited.†The study found that in an average month, 800 of every 1,000 American men, women and children experience health-related symptoms. Survey any group of employees, and on any given day, there may be many that don’t feel well. This does not necessarily mean that exposures at the workplace are the cause of their ill health.
Bottom line
Employers value good health among their employees — if not because of moral values, then because of healthcare cost-containment objectives along with the understanding that a healthy worker is more productive than one who has health problems.The point of this article is this: just consider the possibility that the problem could originate in your head. No one is saying you’re crazy or faking it. But admitting this possibility opens up more options to solving health concerns. In next month’s column, I’ll provide suggestions to your employer to help them further address this topic.
Thank you.
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