Are they having a laugh?

“Stay on the job longer”. “All the best pick up tips here”. The liberal sprinkling of innuendo and use of the fairer sex on these leaflets feels like a 1970s throwback.

In fact, they have been produced in the last year in an attempt to get the message about workplace health across to workers. But is this really the best way to convey the message?

Yes, says Julie Clay, marketing manager for Constructing Better Health, a two-year pilot scheme launched in 2004. Based in Leicestershire, it aimed to show how a nationwide advice and support service for occupational health might work.

“We tried with the corporate style and it just didn’t work,” says Clay. “It looks like blah blah blah and goes in the bin.” So they switched from “The Times” to “The Sun” and people started reading them.

This lesson in communication is one of the things to emerge from the study. The formal findings won’t be ready until early next year, but CM has gleaned an insight into some of the findings so far.

Construction can be bad for your health, no news there. But what has changed is people’s attitude towards occupational health. It would be nice to believe that the industry has collectively become more caring. To a certain extent, in the light of corporate social responsibility, it has. But perhaps more pressing are the commercial and political pressures. Noise-induced hearing loss is the largest source of compensation claims. And then there’s the looming spectre of hand arm vibration (HAV).

“They say HAV is the new asbestos,” says Vaughan Burnand, Shepherd chief executive and chair of the Major Contract Group’s (MCG) health and safety working group. “If you believe that, there will be huge payouts for HAV.” Place this in the context of rising insurance premiums and you can see the emergence of a business case for investing in occupational health.

Politically, the story goes something like this: the population is ageing, so we need people to work longer, not go on the sick before retirement age. This message has been coming through the HSE, most recently with the toughened-up rules on noise and on vibration.

Who made them ill?

Legally, of course, construction firms should already be taking occupational health problems seriously: the Management of Health and Safety at Work Regulations 1999 say you should be keeping your eye on any employees who might be damaged by work. But while training and prevention are pretty well understood, the issue of surveillance and working out how to handle workers with health issues is more complex.

The problem with occupational health in the construction industry is the sheer size of the workforce involved. There are thousands of workers, many of them moving from firm to firm and many with existing health problems, occupational or otherwise. But if they’re not monitored soon the lawyers will be asking: “Who made them ill?”

Most main contractors are already getting their house in order in relation to occupational health. MCG has had an occupational health strategy in place for its direct employees for four years (www.mcg.org.uk) and it is now putting together a policy to cover the supply chain.

But it’s the SMEs who employ the majority of people in the industry and it is these firms that CBH has tried to reach.

There were plenty of services up for grabs during the pilot period, including on-site assessments and training for managers and workers, advice on legislation, free health checks in a mobile unit which came to site and help in setting up management systems.

Did the contractors of Leicestershire jump at the chance? They did not. Despite publicity and a website, people weren’t calling the helplines as had been hoped.

“We thought the larger contractors would have bought into it earlier on and they did not,” says CBH project manager Michelle Aldous. “But then the ones that came on board really came on board.”

Among these is Old House Holdings, a group of four companies. “We had been looking into occupational health and how we could best approach it for a while,” says group health and safety manager Mike Webb. “CBH came along and offered an easy route in.”

Aldous had to employ a firm of telemarketers to target smaller firms. This was successful for firms with between five and 50 employees but no good for micro-firms and sole traders whose wives and partners tended to answer the phones at home.

It was not until Summer 2005 that CBH adopted its more “chatty” approach, a move that did not sit comfortably with the CBH board. “It took a hell of a lot to convince them,” recalls Aldous.

Persuading macho construction workers to go through a health check was not as difficult as it seemed. “Men are interested in their health if they are given the opportunity,” says Aldous. “We had some very cynical site managers who said: ‘They will never go for a health check, I don’t know why you are wasting your time and ours.’ But the amount of interest from the blokes turned the site manager’s views around completely.”

The trick was to let workers know what they were in for. Mention a health check and many men will think of stripping off and being asked to cough, not to mention drugs and alcohol tests. So the first step was a tool box talk to raise awareness, with a follow up from the mobile health unit between two days and a week later.

Old House made the tool box talks mandatory. After that workers had the chance to sign up for health checks if they wanted to, except in the case of AW which made them mandatory too. Webb was surprised by the response. “We expected quite a cautious response but as soon as one person put their name down, away it went.”

They didn’t test for drugs and alcohol. Aldous estimates that at least 40% of construction workers have issues with drugs and/or alcohol, so including such a test could have really scuppered the scheme.

Once in the van, workers were asked a series of questions which then determined which tests they would undergo, including tests on vision, urine, lung function, hearing, symptoms of HAV, blood pressure and body mass index.

The most common problem was hearing loss. The second was high blood pressure. That’s a lifestyle issue rather than an occupational one, but it’s still going to impact on someone’s efficiency and if they’re driving the tower crane, for example, its even more of a problem.

From there, workers with health issues were referred to a the relevant healthcare provider. Results remain confidential and are held with the occupational health provider. Only in situations where a worker is “safety critical”, such as a crane driver, will health problems be revealed.

CBH carried out 1,724 health checks. The only trades that couldn’t be coaxed to the talks or checks were the brickies because they are paid on piece work. At 40 minutes for the talks and an hour for the check, that’s a lot of bricks.

National database

It will be next year before the details of a nationwide scheme are announced, along with the formal results of the pilot which the Institute of Employment Studies in Brighton is evaluating.

Two things are clear, however. The first is that standards need to be established. For example, if you’ve got a scaffolder working at height, what should you test him for and how often? The second is that an industry database of health information would be a huge benefit. Accessible by all occupational health providers, workers’ health could be better managed as they moved between projects and employers.

Less clear is whether the provision of health checks will become part of a national scheme.

Concept Development Solutions, one of Old House Holdings’ four firms, has decided to provide regular health checks for all the subcontractors’ employees. Concept will charge £15 per person towards the cost, which will be nearer £75.

“Concept partner with a lot of the small contractors all the time,” says Webb. “We feel it’s the right thing to do.”