• John Suter

Understanding Total Worker Health for the Safety Professional


Total Worker Health is often described as a “holistic” approach to occupational safety and health. NIOSH says it “integrates workplace interventions that protect workers’ safety and health with activities that advance their overall well-being”.


These are high-level, conceptual definitions. But what does TWH mean for the safety professional? NIOSH, who pioneered the TWH concept, developed a list of 63 issues that are relevant to TWH, divided into 9 categories:


  • Control of Hazards and Exposures

  • Organization of Work

  • Built Environment Supports

  • Leadership

  • Compensation and Benefits

  • Community Supports

  • Changing Workforce Demographics

  • Policy Issues

  • New Employment Patterns


Hazard Control, Leadership and the Built Environment (such as indoor air quality) are some of the more traditional topics addressed by safety professionals. Other topics, such as Organization of Work, Changing Demographics and New Employment Patterns, have come onto the radar of the safety professional more recently.


Organization of Work in particular has received increasing attention over the past several years, as its considerable effect on occupational safety and health has been recognized. Fatigue, stress, overtime, shiftwork and other aspects of the modern workplace make injury and illness more likely.


Changing Demographics have brought additional challenges from a workforce that is older and more diverse. Safety training may encounter cultural or language barriers. Older workers may be more susceptible to strains and other injuries, and take longer to heal.


New Employment Patterns include arrangements like temporary employees, independent contractors and other contingent workers. These individuals may not have the same level of experience, skill, training and other safety support as traditional employees.


But it is the remaining topics – Compensation and Benefits, Community Supports and Policy Issues – where safety professionals have traditionally not been as involved. They may recognize that these issues affect morale, employee engagement, stress levels, distraction and other factors that make employees more prone to injury and illness. But in larger companies, these topics may be addressed in silos by other departments such as Human Resources. In smaller companies, they may not be addressed at all.


The challenge for safety professionals then, is to help influence these factors that may be outside their direct control, but which affect occupational injuries and illness. For instance, prevention and management of chronic diseases and obesity makes employees less prone to injury and faster to heal. Communities with access to healthy and affordable food choices can make chronic disease prevention more achievable. And policies on reasonable accommodation and return-to-work after injuries can affect the potential for future injuries.


If you are already involved as a safety professional in some of these non-traditional areas – congratulations! – you are well on your way to better protecting the employees in your care through Total Worker Health principles. If not, think about how to reach out to your colleagues in Human Resources, Benefits, Insurance and other departments. Identify areas of common interest as good places to start, such as work-life balance or return-to-work programs.


To review the full list of issues that NIOSH has identified as being relevant to TWH, see this link: https://www.cdc.gov/niosh/twh/totalhealth.html#relevant


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