NIOSH logo and tagline

Total Worker Health in Action: March 2012

Volume 1 Number 1 March 2012

Managers’ Buzz

Welcome to the inaugural issue of TWH® in Action!, an electronic newsletter dedicated to bringing you the latest news from the NIOSH Total Worker Health® (TWH®) Program and our partners. In case you’re wondering what happened to the NIOSH WorkLife Program, the Total Worker Health® Program was launched in 2011 (/niosh/enews/enewsV9N2.html) as the next generation of our ongoing commitment to integrating occupational safety and health protection with health promotion and well-being in the workplace.

What exactly do we mean by Total Worker Health®? NIOSH views TWH® as a strategy integrating health protection with health promotion to prevent worker injury and illness and to enhance well-being. As you read through this newsletter you will begin to experience how this idea moves from approach to action. We’ve selected three special articles to highlight the TWH® concept. Read on to find out how sleep influences work, who’s implementing promising TWH® practices, and what’s new at the NIOSH-funded Centers of Excellence.

In between newsletters and for more information about TWH®, please visit our newly redesigned website at We’d love to hear your comments and stories about TWH® in Action! Please e-mail us at

L. Casey Chosewood, MD, Manager

Anita L. Schill, PhD, Manager

Heidi Hudson, MPH, Program Coordinator

Can Enough Zzzz’s Prevent Disease?

man asleep at his desk

By Claire C. Caruso PhD, RN – Research Health Scientist, NIOSH

Scientific evidence is growing that adequate sleep is critical in working safely and maintaining optimal health. The National Sleep Foundation states most adults need 7 to 9 hours of sleep each day. Adequate sleep is associated with a lower risk of obesity, diabetes, high blood pressure, and heart attacks, as well as reduced risk for injuries and errors. A recent study warns that a growing number of Americans are not getting enough sleep. This trend for shorter sleep is likely linked to global competition on businesses, cost of living increases pushing workers to work longer hours, as well as personal choice to spend time on other activities besides sleep because of a lack of knowledge about the importance of sleep.

Inadequate sleep has critical negative impacts on the workplace. The risks from fatigued workers are broad reaching and extend from workers to employers and society. Risks to employers include reduced productivity and increases in worker errors and incidents ranging from medical errors to industrial disasters. Fatigue is a recognized risk factor for vehicle crashes and has been implicated in well-known disasters such as the 2009 Buffalo jet crash and the 2005 BP Texas City explosion.

In December 2010, Healthy People 2020, the US national public health goals for the next 10 years, launched a new chapter for Sleep Health. There are four objectives: 1) increase the proportion of persons with symptoms of obstructive sleep apnea who seek medical evaluation; 2) reduce the rate of vehicular crashes due to drowsy driving; 3) increase the proportion of students in grades 9 through 12 who get 8 or more hours sleep each day; and, 4) increase the proportion of adults who get 7 or more hours sleep each day. NIOSH scientists are working on training programs to improve fatigue and sleep-related issues for workplaces. These will be added to the NIOSH topic page for work schedules as they become available (/niosh/topics/workschedules/). Check out the latest entry on the NIOSH Science Blog related to Sleep and Work

For more tips on improving sleep and to learn what scientists are doing to improve societal well-being through sleep research, check out:

Promising Practices for Total Worker Health®

The TWH® Core Team hit the streets in 2011 to collect real stories from employers who are applying principles of Total Worker Health® in their workplace. In Promising Practices for Total Worker Health®, we will share with you how employers from across the country and from a wide range of industries are effectively addressing both health promotion and health protection in their workplaces. If your organization is proactively integrating health protection and health promotion to prevent injury and illness and advance the well-being of your workers, please email us at Your workplace could be featured next!

BJC Healthcare logo

By Kyle Myers, MS, Public Health Analyst, NIOSH

BJC HealthCare is a nonprofit health care organization that serves residents in the greater St. Louis, southern Illinois and mid-Missouri regions. Long known for providing excellent healthcare services to its patients, BJC’s leadership recognized a need to commit the same level of attention and care to its own employees’ health and well-being. In 2003, the company launched their “Help for Your Health” program to encourage employees to learn about and improve their health by reducing lifestyle-related risk factors. At the same time its occupational health and safety team refocused their efforts and took a proactive stance to prioritize the prevention and control of work related injuries and illness.

Spearheaded by the newly created Health Literacy Advisory Committee, BJC’s new stance on workplace health and safety was developed with input from representatives from all of its affiliated hospitals and business units. The Committee also sought guidance from almost 11,000 of BJC’s 27,000 employees via surveys and focus groups. Thus the ideas, concerns, and goals from individuals throughout the organization were used to help mold and shape the new program.

As a part of BJC’s new comprehensive approach, the company established infection prevention and ergonomic programs to continue to promote health protection in its worksites. Additionally, an annual Health Risk Assessment for all employees was implemented to collect personal health data to help direct wellness interventions. To promote health, BJC’s Help for Your Health program devised a broad range of services including weight management programs, smoking cessation courses, cafeteria initiatives, lunch-n-learns, and annual evidence-based campaigns for breast, colon and prostate health. Recognizing that positive health and safety choices should continue outside of the workplace, the initiatives extended beyond BJC’s facilities to include numerous local health fairs and community awareness programs.

BJC employs a strong communications and marketing strategy to keep program momentum high via: their website, the “BJC Today” employee newspaper, social media campaigns as well as brochures, posters and other promotions throughout the worksite. Creative and healthy incentives are also utilized to encourage and maintain high participation rates.

In order to effectively coordinate and manage the health and safety of its employees, BJC developed an Advisory Board charged with integrating “three buckets” of critical activities: wellness and health promotion; safety and health protection; and the data collection and research of the impact of their programs. The Board ensures a sustained partnership between all of the teams by meeting monthly to establish and discuss strategic goals, provide education on new ideas and topics, promote standardization of efforts, and to share both failures and successes. This system strongly encourages “cross-pollination” as BJC quickly realized the overlap and connectedness of their efforts to promote and protect the health of its employees.

BJC evaluates its program aggressively and systematically with numerous scorecards and dashboards to collect, monitor and study important values including employee biometrics, employees enrolled in smoking cessation efforts and their quit-rates, employee participation in fitness and weight management programs, medical expenditures, pharmacy utilization, and annual audits for compliance with best practices. BJC has also looked to expertise from nearby Washington University in St. Louis to ensure its evaluation methods are rigorous and meaningful.

As a result of this integrated and disciplined approach, actuarial reports have estimated a $6 to $12 million savings since program inception. BJC HealthCare was also recognized in 2009 with the Risk and Insurance magazine’s Theodore Roosevelt Workers’ Compensation and Disability Award based on the goal for its employees “to become healthier than when they started as associates with BJC.” The programs have shown great impact, and are still continuing to evolve as program leaders continue to learn how best to serve BJC employees. BJC strongly believes that “consistency of message and accountability through data is effective,” and that “trust between partners that share both goals and resources is essential.” You may find more information about BJC HealthCare at

Updates from the NIOSH Centers of Excellence to Promote a Healthier Workforce

  • Congratulations to Martin Cherniack, MD — co-director of The Center for the Promotion of Health in the New England Workplace (CHP-NEW) who was one of those recognized by APHA’s Occupational Health and Safety Section for achievements in occupational health and safety. Dr. Cherniack was the recipient of the 2011 Alice Hamilton Award for Lifetime Achievement.
  • Congratulations are also extended to CPH-NEW’s team at the University of Connecticut for being selected as a partner in the National Healthy Worksite Initiative. Led by CDC and funded through the Affordable Care Act’s Prevention and Public Health Fund, the project will launch a $9 million national program to establish and evaluate comprehensive workplace health programs that improve the health of workers and their families. CPH-NEW and other partners will launch up to 100 comprehensive workplace wellness programs over the next two years. To learn more, visit and /nationalhealthyworksite.”

News You Can Use

TWH™ Fast Facts: On an average workday in the US, an estimated 1 million workers are absent due to stress. Find out more at:

Learning Opportunities

Upcoming Webinars provided by the National Safety Council related to Family Safety and Health:

How Ergonomics Can Play A Large Role In the National Prevention Strategy?

SAVE THE DATE!! MAY 16 – 19, 2013
Work, Stress and Heath 2013: Protecting and Promoting Total Worker Health®
10th Conference on Work, Stress, and Health, Los Angeles, CA
Sponsored by NIOSH, the American Psychological Association and the Society for Occupational Health Psychology