Guest blog by Dr Drushca Lalloo, lead author of The Value of Occupational Health Research report
As a follow-on from the Society of Occupational Medicine’s (SOM) 2017 report Occupational health: the value proposition and its 2018 report Occupational Health: The Global Evidence and Value, a new report The Value of Occupational Health Research was published on 26th June 2019, through a formal launch at the House of Lords hosted by SOM Patron, Lord David Blunkett.
The report was prepared by a University of Glasgow team led by Professor Ewan Macdonald, Head of the Healthy Working Lives Group, with Dr Drushca Lalloo as lead author, Dr Sergio Vargas-Prada Figuero, and from HEHTA, Dr Evi Germeni and Professor Emma McIntosh and sponsored by the Society of Occupational Medicine and the Health and Safety Executive. Its summary points are as follows:
Why are three ‘value’ reports thought to be necessary in OH?
The report postulates that this is because OH provision in most countries sits outside mainstream medical services. Employers have to purchase it; it is therefore an overhead cost; and because many OH conditions are chronic, with long latency, the perceived value appears to be low. This has been reflected in the significant decline of academic OH resources in the UK over the past 3 decades, at a time when recognition of the interaction between work and health has never been higher. Worldwide the costs of work-related health issues are an estimated 4% of global GDP and equivalent to the entire GDP of the UK. This figure refers to work injuries and illnesses only, with the burden likely to be considerably higher when accounting for the impact of health on work, and going forward, the ageing working population with multiple morbidity and longer occupational exposures.
Key report findings
Although a persisting lack of good quality evidence to support the economic value of OH research is identified from the report, it concludes that there is a strong case to support the OH societal and public health value of OH research. It provides striking examples of the benefits in these areas namely early epidemiological studies of large scale occupational diseases and discovery of carcinogens and occupational cancers that consequently, have been substantially reduced (or even eliminated). It describes Waddell and Burton’s pioneering evidence review on the Management of Low Back Pain marking the the first national OH guidelines in the UK and bringing to the forefront the biopsychosocial model of health. It also highlights one of the most valuable contributions of OH research in current times i.e demonstration of the health benefits of ‘good work’ and the adverse health impact of being away from work empowering all those in workplace health to confidently promote the benefits of being in work.
The report envisions that modern day OH research has scope to be even broader in its role, not just targeting ‘occupational diseases’ but also accessing a wide range of the population to ‘prevent’ and ‘manage’ broader population health issues. It warns however that commitment and action are required to continue to innovate and drive the OH research agenda and to actively ‘market’ this value to key stakeholders (e.g. OH clinicians, employers, the HR community, employees, employee representative organisations and Government). Further, the future maintenance of this potentially ‘valuable’ contribution can only be secured through retention and growth of the OH academic base and attracting research funding.
The report has 11 recommendations predominantly pertaining to OH research but also other related OH issues. The first calls for the development of a new coordinating Centre for Health and Work, independent of, but working with regulators, to coordinate research and advice, academic training and promoting the agenda. Other recommendations were that; occupational health advice should be available to all of the working age population; this should be underpinned by increased training and recruitment of OH clinicians and, there should be a national co-ordinated OH research strategy that should include robust health economic evaluation. It highlights that OH remains a poorly understood and publicised specialty and that work is still needed to increase its profile and to ‘market’ careers in OH.
Since its launch, the report has received overwhelming support from key stakeholders, for the development of a Centre for Work and Health but also OH as a speciality. There has been much concerned discussion for at least a decade around the diminishing OH clinician numbers and training posts and the declining academic base. Various efforts over the years have largely been fruitless and the trajectory for progress and any meaningful outcome has remained unchanged.
Through these 3 evidence-based reports, the strength of the OH value case appears finally to have met the threshold of attracting the necessary attention in order to bring about the urgent actions required. This is fundamental for the survival of the specialty and ensuring healthy working lives for the UK working age population. We need to work together to seize this valuable opportunity. Our time is now.