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Total Worker Health in Action: March 2015

Volume 4 Number 1 March 2015

Managers’ Buzz


Spring is a time of renewal. For those of us committed to Total Worker Health®, it’s a time to renew our dedication to the mandate put forth by the Occupational Safety and Health Act of 1970 – to create safe and healthful workplaces for all working men and women and to preserve our nation’s human resources. It’s a time to sharpen our focus on protecting, preserving and promoting the well-being of all workers.

In this issue of TWHTM in Action! you will find the latest evidence and resources to help advance safety, health and well-being for the workers you serve. In our Total Worker Health Exclusive, gain a better understanding of the link between Total Worker Health and Global Sustainability — the perfect prelude to Work, Stress, and Health 2015: Sustainable Work, Sustainable Health, Sustainable Organizations, where you will be able to engage on the topic in-person with experts from around the globe, including scientists from NIOSH and the NIOSH Centers of Excellence to Promote a Healthier Workforce. Read the latest research and evidence on Total Worker Health, such as a systematic review of Effectiveness of Total Worker Health Interventions, in New Publications and Resources. In case you missed the recent live webinar on “Preserving Lung Health: At Work and Beyond,” the recording is now available. Be sure to check it out and learn more about the many upcoming events happening across the globe in our Conferences, Webinars and Trainings section. There may be something close to home that captures your attention!

The Total Worker Health Affiliate Program is growing faster than we ever imagined. We are pleased to welcome four new Affiliates:International Brotherhood of Boilermakers, Iron Ship Builders, Blacksmiths, Forgers, and Helpers (IBB);Nebraska Safety Council; SAIF; and, the Health Management Research Center in the University of Michigan (UM-HMRC) School of Kinesiology.

Last but not least, you are invited to join us (physically or virtually) on Wednesday, April 1 as we celebrate National Walking Day in collaboration with the Office of the Surgeon General’s Everybody Walk! Initiative. Learn more in the Healthier Feds section.

As always, we hope this newsletter inspires you to become a Total Worker Health advocate. Share your comments and stories about TWH® in Action! with us on Twitter (@NIOSH_TWH), on the NIOSH Total Worker Health® LinkedIn Group, or by email at


Total Worker HealthTM and Global Sustainability: What’s the Link?

Jessica MK Streit, MS, Research Psychologist, National Institute for Occupational Safety and Health

How might your actions today affect the lives of future generations? For many, reflections provoked by this question center on the impact our choices have on the surrounding natural environment. Contemporary scientific models, however, suggest that the concept of sustainability comprises three critical dimensions: environmental, economic, and social.1 Of these, social sustainability is historically underrepresented or neglected in research and reporting because of the complex nature of the topics it encompasses (see Table 1).1

Global Efforts to Address Social Sustainability

Table 1. Components of Social Sustainability
  • Human rights
  • Livability
  • Community development
  • Social responsibility
  • Social support
  • Social justice
  • Labor rights
  • Health equity

Recent years have seen several multinational efforts to rectify this disparity, including the International Organization for Standardization’s issuance of ISO 26000Social Responsibility; the establishment of the Center for Safety & Health Sustainability; and the Global Reporting Initiative’s revisions to the G4 Sustainability Reporting Guidelines (GRI G4).2, 3, 4, 5

Although these accomplishments have moved us in the right direction, there is still more work to be done. As NIOSH Director Dr. John Howard highlighted in a 2014 blog on safety sustainability, for example, there is a need for increased transparency in annual organizational reporting on non-economic performance indicators. 6

In an effort to further international social sustainability dialogue and action, NIOSH will cohost Work, Stress, and Health 2015: Sustainable Work, Sustainable Health, Sustainable Organizations with the American Psychological Association and the Society for Occupational Health Psychology. This 11th International Conference on Occupational Stress and Health will be held May 6–9 in Atlanta, Georgia, and will feature presentations by social sustainability and corporate social responsibility experts from around the world.

Expert Opinions: Pursuing Sustainable Work, Health, and Organizations

While learning more about the conference theme in preparation for May, I have been wondering about the relationship between sustainability science and the core principles of Total Worker HealthTM. I was fortunate to have a recent discussion of this very topic with two of the conference’s keynote speakers: Dr. Aditya Jain (Assistant Professor in Human Resource Management and Deputy Director of the Centre for Organizational Health and Development, University of Nottingham, United Kingdom) and Dr. Bengt Arnetz (Vice Chair for International Affairs and the Deputy Director for Wayne State University’s Institute of Environmental Health Sciences, Detroit, Michigan, United States).

Table 2. Work-related Aspects of Sustainability
  • Employment conditions
  • Healthcare system
  • Organizational climate
  • Organizational safety systems
  • Training and development
  • Implications for safety and health

I learned from Dr. Jain and Dr. Arnetz it is important to acknowledge and explore the interrelatedness of many concepts in order to continue advancing sustainability science and practice. When we think about how to build a sustainable world, researchers and practitioners will benefit from considering the impact of work on the economy, the environment and society. Collaboratively, Dr. Jain and Dr. Arnetz identify six work-related aspects that are part of a holistic view of sustainability (see Table 2). Unfortunately, organizations typically limit the focus of their sustainability efforts to the impact they have on the external environment and surrounding community. An organization’s internal sustainability, say Dr. Jain and Dr. Arnetz, is rarely considered and assessed.

Taking Action: Advice from the Experts

Dr. Jain and Dr. Arnetz both believe programs and practices that target worker safety, health, and well-being are essential elements for achieving internal organizational sustainability. According to Dr. Jain, integrating participatory management strategies into such programs and practices should further enhance their benefits. “The more you get the workforce to design the organization’s road to sustainability, the more sustainable the organization will eventually be,” he notes. Participatory management increases the likelihood that workers will be healthier and more invested in the workplace. They will be more able and more willing to contribute to the operations that render the organization sustainable over time.

It is also critical to investigate and evaluate both economic and noneconomic organizational performance. While it may seem attractive to develop a set of custom-tailored metrics for every organization, Dr. Jain cautions against “reinventing the ‘sustainability wheel’” in future work. Implementing or adapting sustainability definitions and indicators that are widely understood and accepted by science and industry promotes a standardized system for gauging the sustainability of work and the impacts of work in the larger sustainability context. Credible, validated organizational sustainability resources are available for researchers and practitioners from the World Health Organization, the International Labour Organization, the Organisation for Economic Cooperation and Development, the ISO, and the GRI, for example.2, 4, 5, 9, 10, 11, 12

Drawing Conclusions: Total Worker HealthTM and Internal Sustainability

After speaking with Dr. Jain and Dr. Arnetz, I believe that Total Worker HealthTM holds the potential to fill a major void in the current pursuit of global sustainability. According to the experts, sustainability activities require comprehensive science and action. Total Worker Health TM, which calls for the design and implementation of integrative research and best practices, directly supports this need. I also feel it cannot be mere coincidence that every one of the six work topics identified by the experts as essential to sustainability is cited among the Issues Relevant to a Total Worker HealthTM Perspective.

At its core, Total Worker HealthTM challenges us to think comprehensively about the integrated and reciprocal health effects of work and nonwork experiences. Well-designed jobs and workplaces protect and promote worker safety, health, and well-being. Healthy workers are essential for achieving internal sustainability for organizations. Internally stable, viable organizations are an undeniably critical element for a sustainable economy, society, and world.














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Updates from NIOSH Centers of Excellence to Promote a Healthier Workforce

The Center for the Promotion of Health in the New England Workplace (CPH-NEW)

Laura Punnett, CPH-NEW Co-Director, recently was interviewed for an NPR broadcast series on nursing injuries. In this broadcast, NPR investigates the high number of Massachusetts nursing injuries from lifting and moving patients, as well as the advocacy around safe patient handling protocols. To view the NPR interview and learn more about Dr. Punnett’s role in protecting and promoting healthcare worker safety, visit NPR Investigation on Injured Nurses.

Harvard Center for Work, Health and Well-being

Dr. Glorian Sorensen, Principal Investigator for the Harvard T.H. Chan School of Public Health Center for Work, Health and Wellbeing, will participate in the highly competitive Rockefeller Foundation’s Academic Writing Residency in Bellagio, Italy, in April. The objective of this writing residency is to prepare a manuscript that will identify the unique and shared challenges of implementing integrated approaches to worker health, safety, and well-being across settings; highlight strategies used to address these challenges; and identify benefits resulting from these policies, programs, and practices for workers and their families, as well as for employers and communities. Dr. Sorensen will synthesize findings across her research studies, focusing particularly on healthcare in the United States and manufacturing in India.

University of Iowa Healthier Workforce Center for Excellence (HWCE)

The University of Iowa’s Healthier Workforce Center congratulates its partner, the Nebraska Safety Council, for becoming a Total Worker Health® Affiliate. Building on a successful partnership, the Nebraska Safety Council and the HWCE will work together on a community-based pilot project to help small Nebraskan businesses (with <100 employees) initiate Total Worker Health programs and policies.

Oregon Healthy Workforce Center (OHWC)

OHWC welcomed its new center manager, Anjali Rameshbabu, who has a PhD in Psychology (Health & Social emphasis) from the University of Wisconsin–Milwaukee. She will help coordinate activities of the OHWC research groups and work closely with the Center’s outreach and education team to communicate research findings to the community.

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News from our Affiliates and Partners

We are pleased to announce four new Total Worker Health Affiliates!

International Brotherhood of Boilermakers, Iron Ship Builders, Blacksmiths, Forgers, and Helpers (IBB): The IBB developed Boilermaker Total Health (BtH), a strategy integrating OH&S protection and health promotion to further protect and improve health both on and off the job. The BtH program has two components: HealthBenchmark, designed to set meaningful standards for functional abilities and medical assessment for pre-apprentices entering the trade, and HealthArc, a comprehensive health and wellness program designed to promote member health 24/7, on and off the job.

Nebraska Safety Council : The Nebraska Safety Council/WorkWell is committed to providing leadership and resources that promote safe and healthy environments in the workplace, on the roads, and in our homes and communities. The Council promotes the Total Worker Health through (1) worksite implementation (Community Based Pilot Grant from the University of Iowa Healthier Workforce Center for Excellence); (2) worksite consultation; (3) state awards at an annual conference; (4) trainings, networking meetings, and regional and national presentations; and (5) promotional and educational materials. The purpose is to meet organizations where they are; help determine the current state of their programs, data, and organizational culture; and provide support and guidance to further advance their workplace initiatives through integration and evidenced-based practices.

SAIF: SAIF is Oregon’s not-for-profit, state-chartered workers’ compensation company. Its vision is to be an industry innovator that makes Oregon the safest place to work. Its goal is to serve and protect the Oregon workforce, meet the needs of workers and employers, and strengthen Oregon’s economy. As an affiliate, SAIF aims to improve the well-being of its employees, as well as nearly 50,000 policyholders and 600,000 covered workers. SAIF is committed to focusing on actions at the organizational level that improve health and support a zero-injury work environment.

University of Michigan: The Health Management Research Center in the University of Michigan (UM-HMRC) School of Kinesiology has been a leader in establishing the scientific foundation linking modifiable health risks to health care costs, disability, workers’ compensation, absenteeism, and presenteeism. UM-HMRC has a growing interest in Total Worker Health, recognizing that providing a safe work environment is a prerequisite for establishing trust and that programs protecting worker safety and health have the same individual and outcome goals as programs promoting health. Interests of UM-HMRC include developing the business case for Total Worker Health; identifying the most effective strategies to integrate health promotion and health protection within organizations; and articulating the mechanism through which an organization’s culture influences individual behavior and the most effective strategies to leverage that culture to improve health.

To view all of the current TWH Affiliates, please visit /niosh/TWH/affiliate.html. Participation in the Affiliate Program is voluntary and intended for academic institutions, labor organizations, public sector entities, and nonprofit associations that align with the principles of a Total Worker Health approach. If your organization is interested in becoming a NIOSH TWH Affiliate, please visit the NIOSH Total Worker Health website at /niosh/twh/affiliate.html or contact the NIOSH Office for Total Worker Health via email at

Mark Your Calendars! International Experts Discuss Total Worker HealthTM at Work, Stress, and Health 2015

Work, Stress, Health 2015 conference information image

The 2012 NIOSH Total Worker HealthTM Research Compendium contains seminal papers highlighting the need for designing and implementing sustainable programs to protect and advance worker safety, health, and well-being. Program longevity is essential for achieving lasting, positive impacts on workforce health—a key to the growth, prosperity, and staying power of individual organizations and the broader global economy.

But how do we do it? How do we design and execute sustainable workplace health- and safety-enhancing programs? How do we evaluate the impact these programs have on the vitality of workers, organizations, and the world?

Join with global experts to explore the answers to questions such as these at Work, Stress, and Health 2015: Sustainable Work, Sustainable Health, Sustainable Organizations. The American Psychological Association, NIOSH, and the Society for Occupational Health Psychology will convene this 11th International Conference on Occupational Stress and Health from May 6 through May 9, 2015, at the Westin Peachtree Plaza in Atlanta, Georgia.

The conference will feature a track on Total Worker Health and include several presentations from NIOSH scientists and NIOSH-funded Centers of Excellence to Promote a Healthier Workforce. Sustainability-relevant topics and preconference workshops to be addressed include:

  • Methods for developing sustainable organizational interventions
  • Metrics and processes for evaluating organizational program sustainability
  • The antecedents and consequences of sustainable occupational safety and health programming
  • The economics of sustainability
  • Work as a resource for health and well-being
  • Tools for creating well workplaces
  • Occupational health management
  • Developing and sustaining the organizational safety climate

Editor’s note: For more on sustainability, don’t miss this issue’s Total Worker Health Exclusive!

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Healthier Feds

Celebrate National Walking Day with NIOSH and the HHS Office of the Surgeon General on Wednesday, April 1!

Dr. Howard walking the stairs at work

In the spirit of National Walking Day, the NIOSH Office for Total Worker Health and the Office of the Surgeon General’s Every Body Walk! Initiative are partnering again this year to promote walking during the work day. Join NIOSH, the Office of the Surgeon General, and others across the country to get America walking!

We invite you to walk a minimum of 30 minutes during your work day on Wednesday, April 1st! There are several ways you may choose to do this.

  1. Change one of your routine sit-down meetings to a walking meeting.
  2. Walk to a peaceful break location or hike to a pleasant picnic spot for lunch.
  3. Walk to see co-workers for a face-to-face exchange rather than simply using email all day to communicate.
  4. Take the stairs in/out of your building and to/from all meetings throughout the day.
  5. Create or join local walking groups.

However you choose to do it, please join NIOSH and share pictures of you and your colleagues, your friends, your pets, and your family walking on Twitter and Instagram using #NIOSHwalks #EveryBodyWalk.

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New Publications and Resources

Two New Publications from Centers of Excellence to Promote a Healthier Workforce

A systematic review of Effectiveness of Total Worker Health Interventions was recently published in the Journal of Occupational Health Psychology, one of the NIOSH-funded Centers of Excellence to Promote a Healthier Workforce. In this systematic review, Dr. Kent Anger and coauthors from The Oregon Healthy Workforce Center reviewed 17 different interventions that had at least some elements of health protection and/or health promotion. The team of investigators found that integrated health protection and health promotion interventions that address injuries and chronic diseases simultaneously can improve workforce health effectively and more rapidly than those employing a limited focus. This article is freely available online.

A study on Physical activity levels at work and outside of work among commercial construction workers was recently published in JOEM from researchers at the Harvard School of Public Health’s Center for Work, Health and Well-being. Researchers found that among commercial construction workers, physical activity related to work contributed about two-thirds of the workers’ total weekly amount of moderate physical activity.

2014 National Symposium on Corrections Worker Health—Summary Report Now Available

In February, the 2014 National Symposium on Corrections Worker Health Summary Report was released. NIOSH representatives served as members of the planning committee and presented at the symposium, which was sponsored by two of the NIOSH-funded Centers of Excellence to Promote a Healthier Workforce and several of their partners. The report highlights recognition of the serious risks to corrections workers’ health and safety and the appreciation for resolving a national consensus on the timeliness of research and practice for interventions. The report and other relevant information from the symposium can be found on the conference website.

In addition to this report, read the latest CPH-News and Views column on correctional workforce health risks, challenges, and opportunities for prevention.

New OSHA Report on the Contribution of Work Injuries and Illnesses to Income Inequality

OSHA recently issued a report entitled “Adding Inequality to Injury: The Costs of Failing to Protect Workers on the Job.” The report details how work-related injuries and illnesses force thousands of working families out of the middle class and prevent many low-wage workers from getting out of poverty. Simply put, work injuries and illnesses hamper the ability of many working families to realize the American Dream.

Recording of the March 12th Total Worker Health Webinar: “Preserving Lung Health: At Work and Beyond” Now Available!

NIOSH Total Worker Health Webinar Series banner

On Thursday, March 12, the Office for Total Worker Health kicked off the 2015 NIOSH Total Worker Health Webinar Series with a special presentation cohosted by NIOSH’s Division of Respiratory Disease Studies (DRDS), titled “Preserving Lung Health: At Work and Beyond.” In case you missed the live webinar, the recording is now available. Continuing education opportunities are still available for the recording.

The presentation provided participants of diverse professional backgrounds with a common understanding of the different avenues and angles through which to protect and promote the respiratory health of workers—from health surveillance (triggering an intervention), to best practices for promoting respiratory health both on and off the job, to practical considerations for how best to implement evidence-based programs.

Video Series for Small Employers Launched by the Healthier Workforce Center at the University of Iowa

Tips for small employers

The Healthier Workforce Center at the University of Iowa is pleased to launch a new video series to promote total worker health to small employers. In the first video, Total Worker Health® Tips from Small Employers, industry leaders from small businesses in the Midwest share their tips and experiences with Total Worker Health. To view the video and learn more about upcoming videos, visit the HWCE website.

CDC Releases New Guidance for Healthy Food Service in the Workplace

CDC’s Division of Nutrition, Physical Activity, and Obesity has launched a new website on Healthy Food Service Guidelines. Every day, millions of Americans buy or are served food and beverages at their workplaces or in other community settings such as hospitals, parks, and recreation areas. Food service guidelines are used to create a food environment in which healthier choices are more available for consumers. Featured resources include

Tips for offering healthier options

Tips For Offering Healthier Options and Physical Activity at Workplace Meetings and Events:

Tips and resources for increasing healthier food and beverage options at worksite meetings, parties, conferences, and events and for offering physical activity opportunities for employees throughout the work day.



Smart Food Choices: How to Implement Food Service Guidelines in Public Facilities

Smart Food Choices: How to Implement Food Service Guidelines in Public Facilities:

Action steps to implement food service guidelines in government work sites or other public facilities, in order to increase the availability of healthier food and beverage options at food service venues such as cafeterias, concession stands, snack bars, and vending machines.



Guidance to promote and support healthy food, beverage, and physical activity options in hospitals

Healthy Hospital Environments Toolkit

Guidance to promote and support healthy food, beverage, and physical activity options in hospitals. Includes information about engaging stakeholders and assessing needs as well as food, beverage, and physical activity environments.



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Conferences, Webinars, and Trainings in Support of NIOSH Total Worker HealthTM

The Oregon Healthy Workforce Center recently hosted multiple technical sessions at the 2015 Oregon Governor’s Occupational Safety and Health Conference, where the Center exhibited along with its home organization, the Oregon Institute of Occupational Health Sciences, a Gold Sponsor for the event.

CPH-NEW Outreach Director, Suzanne Nobrega, hosted a 2.5-day intensive training workshop on implementing the Healthy Workplace Participatory Program at the American Association of Occupational Health Nurses 2015 National Conference on March 21–26, in Boston, MA.

On April 9, Kellie Pierson and Michelle Lee of the NIOSH Office for Total Worker Health will present “Total Worker Health: How to Prevent Injury and Advance Well-Being” at the Spring Conference of the Vermont School Boards Insurance Trust in Stowe, VT.

The 17th Annual Occupational Health and Safety Symposium will be held April 16 and 17 at the Kirkwood Hotel in Cedar Rapids, IA. Hosted by the University of Iowa’s Healthier Workforce Center in partnership with the Heartland Center for Occupational Safety and Health, the event will feature presenters and panelists that will cover issues relevant to building the case for and implementing Total Worker Health®. Dr. L. Casey Chosewood, MD, MPH, Director of the Office for Total Worker Health®, will present the keynote address, “Making the Business Case for Total Worker Health®: Exploring Value, Engagement, and Productivity.”

On April 29, L. Casey Chosewood, MD, MPH will present “Road Map to a Healthier Workplace: Total Worker Health” at the 2015 KY Worksite Wellness Summit at the Corvette Museum in Bowling Green, KY.

The Eleventh International Conference on Occupational Stress and Health, “Work, Stress, and Health 2015: Sustainable Work, Sustainable Health, Sustainable Organizations,” will be held at the Westin Peachtree Plaza on May 6–9, 2015 with preconference workshops and opening events on May 6. Several Scientists from NIOSH and Centers of Excellence to Promote a Healthier Workforce will be presenting and the conference includes a track dedicated to Total Worker Health. To learn more, visit

On May 13, L. Casey Chosewood, MD, MPH will present the Keynote Address: Advancing Worker Well-being through Total Worker Health at the North Dakota Worksite Wellness Symposium in Bismarck, ND.

On June 4, L. Casey Chosewood, MD, MPH will present a Semi-plenary: Advancing Global Total Worker Health: Bridging Health Promotion and Health Protection at the 31st International Congress on Occupational Health in Seoul, Korea.

Dr. Anita L. Schill will be presenting the poster, “Advancing Well-Being Through Total Worker Health®” at the Fourth World Congress on Positive Psychology, June 25-28, in Lake Buena Vista, Florida.

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