„It should be possible to even out differences in standards“

Occupational Health in Novartis International

Von A. Edward Smith

Occupational Health is far more than merely protecting workers from the effects of hazardous chemicals. This is particularly so in a global company like Novartis which operates in both the richest and the poorest countries of the world.

In 1950, the World Health Organisation pronounced the aims of an Occupational Health Service to be “the promotion and maintenance of the highest degree of physical, mental and social wellbeing of workers of all occupations“. This would certainly represent the highest ideal in terms of employees but is somewhat narrow in scope by today‘s requirements. Nowadays we would see occupational health extending to both our customers and our neighbours.
Health at the Workplace...

The Novartis Health, Safety and Environment policy places emphasis on both health protection and health promotion. An Occupational Health Guideline is currently being drafted which will spell out the measures necessary to carry out the policy. Both the policy and the guideline apply to Novartis worldwide. The implementation will however vary from one country to another depending on local culture, legal framework, healthcare structure and basic standard of living.

Employee health care is the traditional area of occupational health activity and is concerned with prevention of work-related disorders, treatment activities and some health promotion initiatives. Work related ill health may arise from chemical, biological, physical, ergonomic or mental hazards. Prevention is best achieved through a process of hazard identification, risk assessment and risk management. Risk management involves good communication with the workers and management, medical/biological surveillance, and risk reduction measures in the workplace. This brings benefits to the employees of health protection, and to the employers of less lost work time, reduced compensation payments (and thereby lower insurance premiums) and even increased productivity.

Additional value can be obtained through epidemiological analysis of health surveillance data, and the design and conduct of targeted employee health studies. These activities can help to identify primary prevention possibilities as well as to document improvements in employee health, and can help to reassure employees, customers and neighbours alike that their own health is not being compromised by our activities or our products.

General health promotion is a variable activity and it can bring considerable benefits; however it should be regarded as a medium to long term investment. Programmes may include Health Club activities at one end of the spectrum to employee assistance schemes such as drug and alcohol counselling, at the other. This can ultimately lead to a healthier life style in the employee thereby providing the employer with a healthier workforce in which there is less absenteeism and fewer accidents.

...and beyond

Occupational health activities extend beyond the workplace, into the community through our customers and our neighbours. Activity with customers is often seen as an extension of the product stewardship activities. However, it can, and should be, much more than this. It can, for example, be a fully operating advisory service involving audit, education, policy setting and advocacy issues, as well as registration-based services, involving the expertise of various specialists working within a team. The service may be provided through risk assessment, field trials or toxicology response and will involve a multidisciplinary approach. Such activity can lead to better knowledge of adverse reactions, litigation claims and poisoning incidents. Through extending activities and building on relationships, it should be possible to impact and reduce these negative aspects.

We have also sought to bring about increased awareness within the communities surrounding our chemical industrial sites. Occupational health and safety professionals have become involved not only when incidents have occurred but also in proactive community initiatives. By means of risk communication they have helped to influence the risk perception within the neighbouring community.

In order to ensure that standards are being met, Novartis will have a system of reporting of performance measures. These will include the rate of occurrence of occupational illness, sickness absenteeism, and measurement of changes in levels of hazardous substances both in the workplace and workers. Appropriate performance measures and hence targets may differ from one location to another. This is because of the variable nature of the activities in one country compared to another. Most of the Novartis major manufacturing sites are in the more developed countries, whereas in the poorer countries there may only be office and customer based activities. This means one is not comparing like with like when judging standards and this must be taken into account in the final evaluation. For example in a poor country in may be more important to provide the employees with heavily subsidised meals rather than support a highly sophisticated health centre.

Generally speaking however it should be possible to develop targets for improvement to even out possible differences in standards from place to place. By this means management can demonstrate its responsibility for occupational health and create a culture of continuous improvement and added value.

*A. Edward Smith is Corporate Occupational Physician of Novartis International AG, Basel, Switzerland