Paulo Roberto Zétola1,2,3
THE ROLE OF MANGERS IN OCCUPATIONAL HEALTH
Protecting the health of the economically active population of a country is the noblest mission of health and safety at work (HSW) management, precisely because it provides care to those who create wealth for society. This assertion might serve to ground several of the issues addressed in this semi-plenary session: what is the role of managers in HSW service leadership? Should they do just what is necessary to comply with the law or should their actions go beyond? What do international agencies (such as the International Labor Organization) recommend? What good practice guidelines and health programs should be used? What are the means to control risks/hazards and thus save lives?
These questions are our focus, together with the methods to manage absenteeism, improving the working conditions and the so-called "health equation," which two main components — health behavior and safe behavior — have direct impact on the rates of work-related diseases and accidents. One further relevant aspect is reinforcing the HSW culture in organizations. In this case, the role of managers, together with the upper management and employees, is to promote and enhance healthy and safe behaviors. These goals should be based on the specific health profile of the target population, as revealed by epidemiological data analysis, to plan health promotion and disease prevention actions.
Concepts in management concern specific technical aspects to enable managers organize their activities. What are their responsibilities? What is the scope of their work? What (legal and technical) documents are indispensable for management, including planning, organization, objectives, goals and indicators, financial and quality management, among others? Within this context, managers need tools widely used in business administration, but still scarcely applied to health, such as formulating health policies with the corresponding mission, vision and values.
THE CASE OF RENAULT
What does a company need to improve HSW? In this lecture I will describe the success story of the HSW department of a multinational automobile manufacturer, in which effective organization enabled perceptible changes and improvements in HSW indicators.
Some of the topics to be addressed are: infrastructure of the onsite medical center; relevance of appropriate management conditions to improve HSW; highest-level National Accreditation Organization (ONA) certification — this level of accreditation is rare among healthcare services and a considerably distinguishing aspect of health management in this particular company; and the physical training center, which plays a central role at the "beginning" and "along" the working day and includes physical therapists who monitor activities in the health center and workstations.
In regard to the implemented HSW programs, there is one called "Workplace Well-being Program," which is developed along three axes — psychosocial, nutrition and physical activity — by duly trained professionals, and a custom-tailored 24-hour call service to give orientation on health issues, laboratory tests, medical visits and diseases.
Further initiatives include a "benefits club," with focus on enhancing self-care. In addition to representing a significant preventive resource, it also affords opportunities to potentiate active care and thus avoid diseases and improve the quality of life of workers through actions aiming at achieving healthy longevity. Finally, there is the "Health Management Medical Program," which provides care to workers and their dependents, including internal vaccination campaigns.
Still within this context, I will describe the HSW challenges met by a large company. Through examples of successful initiatives to improve the quality of work life, I will discuss the major current challenge in Brazil, namely, that of maintaining the productive longevity of workers.
1. ILO Guidelines on occupational safety and health management systems, ILO-OSH 2001 Geneva, International Labour Office, 2001
2. British Standards Institution. ISO 45001 - Sistemas de Gestão para Saúde e Segurança Ocupacional. Available at: https://www.bsigroup.com/pt-BR/saude-e-seguranca-ocupacional-iso-45001. Cited 14 Feb 2019.
3. Zétola P [org.]. Tratado de Gestão em Saúde do Trabalhador. Minas Gerais: Editora Ergoltda, 2019.