January 6, 2018

Horizon Scanning and the Management of Workplace Health and Wellbeing

Assessed Coursework for Applied Psychology Postgraduate Courses

Module Title: The Management of Workplace Health 

Module Code: C84MWH

Grade Awarded: Merit

Definition of Horizon Scanning

The purpose of utilising horizon scanning techniques for identifying a business’s prospects cannot be overstated as they reveal emerging issues and opportunities for change. The Health and Safety Executive (HSE) has defined horizon scanning as providing the opportunity “to systematically anticipate, identify and prepare for new or changing risks in the workplace and to consider the implications that new and emerging issues will have on the distribution of resources, existing priorities and delivery for work related health and safety” (HSE, n.d., p1). This summarises the value of horizon scanning in areas such as strategic decision making, business intelligence, resilience, operations, recruitment, and safety (Schultz, 2017).

Horizon scanning enables businesses to keep abreast of the current and emerging economic, technological, and social trends, which are likely to impact their objectives. For example, advances in technology, virtual work, globalisation, and the ageing workforce (Schaufeli, 2004).

Horizon scanning facilitates investigative processes which allow companies to prepare for organisational change, react more rapidly and effectively to shifting economic environment, while providing the opportunity to identify new products and services which stimulate innovation. Horizon scans are often organised around frameworks, with the PESTLE analysis being a common example which collects information on trends/driving forces using a mixture of headings, i.e. political, economic, social, technological, legal and regulatory, and environmental (Brown, 2007).

Consequently, it is imperative that companies keep abreast of emerging risks, to implement necessary interventions which will help to maintain a healthy and productive workforce.

Miles and Saritas (2012) described a systematic appraisal process for horizon scanning:

  • Dredging: Researching, recognising, and classifying the issues
  • Selection: Selecting the most relevant issues which including current and emerging issues
  • Analysis: Risk analysis and scenario building and drivers of change
  • Application: Effective communication of results to key stakeholders including incorporating the recommendations into future planning

The HSE has a more in-depth approach with three required processes and outputs. The first of these is scenario building, which incorporates a review of data, interviews, and workshops, horizon scanning conference participation, wind tunnelling, and an ongoing engagement with metrics. Secondly, it is necessary to engage key stakeholders and staff in the activities of scenario building and foresight. Thirdly, effective knowledge management is used which incorporates education and training of staff and key stakeholders in the value and importance of utilising horizon scanning techniques (Schultz, 2007).

Emerging Physical, Chemical & Biological Risks to the Health of the Working Population


The European Agency for Safety and Health at Work (EU-OSHA) commissioned three projects relating to the emerging physical, chemical, and biological risks in the workplace. To forecast emerging risks, the same methodology was used in each project with experts who were required to have no less than 5 years of experience in their respective fields. Questionnaires were run in three consecutive rounds based on the Delphi method, to gain subjective perspectives, and scientifically-based opinions (EU-OSHA, 2010/2013/2011).

EU-OSHA (2009) defined an emerging occupational safety and health risk as “any occupational risk that is both new and increasing”. This includes previously unknown risks which may be caused by new processes, technologies, workplaces, or social and organisational change, changes in public or social perceptions that re-classify the risk and newly-emerging scientific knowledge which identifies inherent issues as a risk. Additionally, there are risks that are increasing if the hazards are growing, the likelihood of exposure is increasing, and the effect of the hazard on the person’s health is worsening.

Emerging Physical Risks to the Health of the Working Population

Experts who participated in the project were required to have in-depth knowledge and a minimum of 5 years experience, in their respective fields. They identified the following top 10 risks as emerging:

Lack of physical activity (MV=4.57): Prolonged periods of static sitting or standing as well as non-neutral trunk positions can be found in occupations such as call centre agents, crane operators, and truck drivers. This can lead to high blood pressure, cardiovascular disease, obesity, and musculoskeletal disorders.

Combined exposure to vibration and awkward postures (MV=4.56): Symptoms of vibroacoustic diseases are caused by long-term exposure to hand-arm vibration and noise. These conditions are exacerbated by poor ergonomic design of equipment, which results in musculoskeletal disorders.  

Poor awareness of thermal risks among low income workers (MV=4.50): High-risk groups such as illegal workers in the agriculture and construction sectors, who lack adequate health and safety knowledge, are often exposed to thermal discomfort in either hot or cold environments, which negatively impacts performance and wellbeing.

A combination of musculoskeletal and psychosocial risk factors (MV=4.43): Healthcare, cashiers, VDU and call centre workers are primarily affected. Musculoskeletal risk refers to stress caused by poor ergonomic design of work stations and equipment that is not designed correctly for the physiology of workers. In this context, psychosocial risk factors are a good example of the Job Demand Control theory, since “the combination of low decision latitude and heavy job demands is associated with mental strain” (Karasek, 1979, p1).

Additionally, Siegrist’s Effort Reward Imbalance model is fitting, which emphasises reward rather than control, whereby an equilibrium must be struck between the costs invested by the individual and the gains received, since “all major contracts in social life, including the work contract, are based on the principle of reciprocity” (Siegrist, 2002, p1).

Multi-factorial risks (MV=4.42): Call centre agents can experience heightened levels of stress when exposed to multiple factors such as maintaining static positions for long periods, inadequate acoustics and headsets, background noise, inferior lighting, poor work station designs, low job control, and high emotional demands.

Thermal discomfort (MV=4.40): Primarily in industrial environments, this affects the overall performance, health, and wellbeing of workers who do not have adequate protection against the extremes of the weather.

Vibration and muscular work (MV=4.38): Constant exposure to vibration can cause work-related injuries and cumulative trauma disorders, such as carpal tunnel.

Human – machine interfaces leading to emotional strain (MV=4.35): Particularly in the air industry and healthcare sectors, the handling of computer-aided devices poses considerable risks because of the interfaces’ poor ergonomic design. This leads to mental and emotional strain and a higher probability of accidents and errors. ‘Cobots’, or intelligent robots, should be adapted for the worker’s skills rather than the other way around, which is usually the case.

Inadequate protection of high risk groups against long standing ergonomic risks (MV=4.21): Low income workers exposed to poor working conditions receive inadequate training and information regarding high task repetition, forceful exertions, and awkward postures.

Increased exposure to UV radiation (MV=4.17): Outdoor workplace exposure to sun radiation can cause cataracts and numerous types of cancers. Additionally, workers who are exposed to UV-based technologies in sectors such as printing workshops, the food industry, or the health care sector, are also at risk.

Emerging Chemical Risks to the Health of the Working Population

Experts who participated in the project were required to have in-depth knowledge and a minimum of 5 years experience in their respective fields. The following 10 risks were identified by them:

Nanoparticles and ultra-fine particles (MV=4.6): These have been identified as one of the main priorities by expert stakeholders who were included (by EU-OSHA) in the broader consultation process.  Little research has been conducted in this area since nanoparticles have unique properties which are not consistent with conventional materials. The accumulation of these particles may cause cancers, but this is not yet proven.

Poor control of risks in SMEs (MV=4.39): Small to medium enterprises, which employ approximately 66% of workers in the private sector, often lack the resources and knowledge to implement appropriate risk controls, which results in non-compliance with the EU framework directives on chemical agents.

Outsourcing (MV=4.34): In activities such as cleaning and maintenance, outsourced low income workers often have little control over high risk work, while they are denied adequate training and knowledge in assessing hazards and managing risks.

Epoxy resins (MV=4.14): Products such as paint, adhesives, inks, and varnishes are the main cause of allergic contact dermatitis. There is an increasing demand worldwide for these products, while personal protective equipment is not being used extensively. Adequate training in the safe use of these products is insufficient.

Dangerous substances in waste treatment (MV=4.11): The processing of waste is considered one of the most dangerous occupations, as approximately 110 volatile organic compounds have been discovered at landfills, composting, and recovery plants. Workers in this industry are susceptible to illness rates 50% higher than other workers, with infectious disease rates being six times higher.

Dermal exposure (MV=4.11): The cumulative effects of dermal exposure to dangerous substances, especially epoxy resins and isocyanates, is underestimated and of particular concern for the construction sector, small- to medium-size enterprises, and self-employed people.

Diesel exhaust (MV=4.02): More research is needed in this area, however it is generally agreed that its major components are carcinogenic. Consistent exposure to the diesel exhaust of trucks in the mining industry is especially hazardous to workers.

Isocyanates (MV=4.02): These allergenic and sensitising substances can be found in construction products. Exposure occurs not only at the production stage, but also during processing such as spraying, welding, and grinding.

Man-made mineral fibres (MV=3.96): These are either siliceous or non-siliceous respirable machine-made mineral fibres which are a source of occupational exposure and defined by the HSE as “fibre which is a particle with a diameter less than or equal to 3µm, a length greater than or equal to 5µm and a length/diameter ratio greater than or equal to 3”. They can be found in materials such as fibre glass, mineral wools, and ceramic fibres. Activities such as furnace wrecking and loft insulation expose workers to these hazards (HSE, 2014, p1).

Dangerous substances in the construction sector (MV=3.96): Multiple exposure to chemical agents in this sector is not well assessed, and is very difficult to control, for example paints, carcinogenic agents, solvents, and epoxy resins. It includes activities where workers are exposed to dangerous substances in jobs such as electroplating, vulcanising, and rubber processing.

Emerging Biological Risks to the Health of the Working Population

Experts who participated in the project were required to have in-depth knowledge and a minimum of 5 years experience, in their respective fields. They identified the following top 10 risks as emerging:

Global epidemics resulting from occupational risks (MV=4.51): This risk was identified as ‘strongly emerging’ and primarily affects health care employees, drivers of public transport, aircrews, and border controls staff who are continually exposed to people, some of whom may be infected with diseases such as malaria, dengue fever, and meningococcal disease. It also includes coming into close contact in confined spaces with animal livestock.

Difficult assessment of biological risks (MV=4.06): Another ‘strongly emerging’ risk is a lack of knowledge pertaining to the proper and effective assessments of biological agents, which includes identification and measurement. Consequently, this means they are not being managed safely in the workplace and are often an unintentional consequence of work activities. This area needs developing and further research.

Worker exposure to drug-resistant microorganisms (MV=3.97): Misuse of antibiotics has caused an increase in bacterial resistance in human healthcare whereby organisms develop a resistance to medication. This includes antibiotic use in livestock factory farming and animal breeding.

Lack of information on biological risks (MV=3.97): This occurs particularly in relation to exposure assessment methods and dose-effect associations. This makes risk assessments more difficult and occurs predominantly in workplace offices and the agricultural sector.

Lack of planned preventative maintenance on air conditioning and water systems (MV=3.92): Exposure to legionella bacteria poses a risk when workers are exposed to manmade water systems which are not correctly maintained.

Inadequate occupational safety and health training of local authority staff (MV=3.92): Adequate, relevant, information and training is not being provided to workers regarding the risks of being exposed to biological hazards such as sewage treatment and waste collection.

Biohazards in waste treatment plants (MV=3.89): The handling of solid waste exposes workers to pulmonary, gastrointestinal, and dermal problems because of exposure to the bioaerosols which become airborne during collection, sorting, and recycling of materials. Municipal waste which is composed of large amounts of organic material is particularly harmful.

Combine exposure to bioaerosols and chemicals (MV=3.81): A lack of knowledge still prevails regarding the effects of being exposed to more than 1 hazard, which is a common occurrence in workplaces, e.g. endotoxins, moulds in indoor workplaces, and mycotoxins. Consequently, it difficult to diagnose what is the cause of the health issues.

Endotoxins (MV=3.81): These are “toxins built of polysaccharide and phospholipid substances that are integral parts of the outer wall of bacteria” (EU-OSHA, 2007, p53) and are mainly found in workers’ environments where organic dust is prevalent, for example agriculture and forestry, textile industry, sewage, waste, and recycling, paper industry, metal industry, and food production and processing.

Moulds in indoor workplaces (MV=3.78): Exposure to mould through inhalation or dermal contact can result in various ailments such as respiratory infections and diseases, allergic reactions, nose, throat or eye irritations, and flu like symptoms. If left untreated, a sick building syndrome can manifest (EU-OSHAa, 2007).

Emerging Psychosocial Risks to the Health of the Working Population

“In 2002, the annual economic cost of work-related stress in the EU-15 was an estimated EUR 20 000 million” (EU-OSHA, 2007, p.4). This illustrates the seriousness of the problem and highlights the importance of the role of employers in creating working environments that are conducive for the health and wellbeing of their workers.

In order to identify and prioritise the risks, EU-OSHA invited 62 experts in the first survey round, 79 experts in the second, and 79 experts in the third round. Response rates were 45%, 27%, and 21% respectively (EU-OSHA, 2007). The following most important 10 risks were recognised and identified as closely interrelated.

Precarious contracts in unstable labour markets: MV- 4.56 / SD – 0.51. Businesses exist in rapidly changing times which requires a level of competitiveness that is unprecedented. Globalisation is forcing companies to achieve more with less, and this impacts directly on the workforce. Consequently, businesses are required to offer contracts to employees which offer little security and long-term stability, e.g. zero hours, short-term, or temporary contracts. This is defined as precarious work, which provides a low level of certainty about future prospects for the employee, minimal control over working conditions (including hours to be worked), and values such as equality, diversity, and inclusion not being considered in terms of the worker’s wellbeing (EU-OSHA, 2007).

Impact of globalisation: MV – 4.38 / SD – 0.72. The growth of globalisation exacerbates workforce inequalities as companies come under pressure to compete with multi-national corporations that have the resources and capabilities to dominate the markets. Consequently, companies move abroad to countries where there are cheaper labour markets and this business model frequently exploits workers who are demographically disadvantaged (EU-OSHA, 2007).

New forms of employment contracts: MV – 4.25 / SD – 0.68. As businesses constantly seek higher profits in an extremely competitive environment, it is advantageous to utilise a business model that offers workers temporary employment contracts, zero hours contracts, and short-term contracts. This approach alleviates the financial risks of offering permanent contracts which require the provision of annual leave pay, sickness absence pay, pensions, and additional benefits for the employee.

Feeling of job insecurity: MV – 4.25 / SD – 0.68. “Job insecurity reduces psychological well-being and job satisfaction, and increases psychosomatic complaints and physical strain” (Witte, 1999, p.1). Some of the causes of insecurity have been identified by EU-OSHA (2007), for example; globalisation, unstable labour markets, outsourcing, and lean production. These factors lead to employees feeling they have little control and independence over prospects, and this is a prominent cause of stress and illness.

Ageing workforce: MV – 4.19 / SD – 0.54. In this demographic, some abilities decline, such as physical strength, while others increase, for example experience and sense of responsibility. This paradox is further illustrated by Silverstein (2008, p.1): “In some ways, these workers will be our most skilled and productive employees but in others the most vulnerable.” As ageing workers continue to pursue a higher retirement age, they become more vulnerable to poor working conditions, while employers are more likely to exploit them compared to younger workers. Additionally, they are less likely to be given lifelong learning opportunities, which is likely to negatively affect their health and increase the likelihood of work-related accidents (EU-OSHA, 2007).

Long working hours: MV – 4.13 / SD – 0.62. Higher demands are being placed upon workers by employers that are driven by rising costs in highly competitive environments. Workers who feel apprehensive and insecure about future employment prospects are choosing to work longer hours without adequate compensation, in the hope that their loyalty will be looked upon favourably by the employer. Additionally, workers are given higher workloads without adequate support and sufficient resources. New technologies have also given rise to employees working longer hours, often in isolation and the experts consulted on this project agree that this can lead to genuine work overload. This is not sustainable and will eventually negatively impact the worker’s health and psychological wellbeing (EU-OSHA, 2007).

Work intensification: MV – 4.07 / SD – 1.03. “According to the European Working Conditions Survey (2000), the higher the pace constraints, the more probably is workers’ perception that their health is threatened” (EU-OSHA, 2007, p61). Work intensification can be linked to various factors, but researchers have been unable to reach a definitive conclusion on the chain of causalities. However, it is agreed that a more efficient and effective use of time has become the primary objective in shaping the way employees work, for example having to work faster but with less control. Technological developments have resulted in just-in-time production, where workers’ errors or delays can lead to high costs. Utilising computers to develop monitoring and evaluation measures ensures that the worker’s performance is perpetually scrutinised (EU-OSHA, 2007).

Lean production and outsourcing: MV – 4.06 / SD – 0.68. Landsbergis, Cahill, and Schnall (1999) found that the effects of lean production on workers’ health have suggested high levels of stress, fatigue, and tension, which is because of highly repetitive work and having to work faster for longer periods. Outsourcing leads to job elimination which has a negative effect on the worker’s morale and sense of self-worth, while “studies indicate the relationship between job insecurity, stress, and poorer mental health” (EU-OSHA, 2007, p53).

High emotional demands at work: MV – 4.00 / SD – 0.52. Within the context of the EU-OSHA (2007) report, because this topic covers such a wide range of factors, the experts decided to focus on bullying and harassment, which is more prevalent in the healthcare and service sectors. Workers often tend not to disclose their emotional trauma for fear of losing their jobs, which is a source of considerable stress. There are far reaching consequences for workers that are treated in this way, for example sleep disorders, irritable bowel syndrome, post-traumatic stress disorder, and musculoskeletal disorders (EU-OSHA, 2007).

Poor work-life balance: MV – 4.00 / SD – 0.73: Irregular and non-standard working hours prevents a clear distinction between working and private lives. Adverse effects may include unhealthy eating, failure to establish a balanced daily routine, and poor sleeping habits (EU-OSHA, 2007).

Current and Emerging Risks in the Public Sector

In June 2016, 5.3 million people were employed in the United Kingdom’s public sector, which encompasses public corporations and local and central government, in areas such as health and social care, police, fire and rescue, and education. This comprises 20% of all workers in the country. Prothero (2016) observed that “within England, there doesn’t appear to be any clear north-south divide in terms of public sector employment rates. There are plenty of local authorities in the southern half of England with above average public sector employment rates and plenty of local authorities in the northern half of England with below average public sector employment” (p.26).

In 2012/13, the age profiles for the public sector were: under 20 years of age: 1%; 20 to 29 years: 15%; 30 to 39 years: 22%; 40 to 49 years: 30%; 50 to 59 years: 25%; 60 years or older: 7%. (Cribb, Disney, & Sibieta, 2014). This indicates that more than 50% of the workforce are aged 40 to 59 years where musculoskeletal disorders, cardio-vascular disease, diabetes, and cancer is more prevalent (Podro & Dix, 2012). Additionally, Lack (2011) highlighted a current and emerging issue with respect to older workers as they struggle to maintain optimum health and productivity, while cognitive abilities will begin to deteriorate and dysfunctional sleep patterns can emerge which can lead to mental health problems.

In 2015 Q2, of 5.3 million employees, 1.7 million were male and 3.6 million were female which calculates to 32% and 68% respectively (Office for National Statistics, 2016).

Consequently, consideration must be given to the current risk/issue of gender inequalities which has been highlighted by the European Risk Observatory: “Work-related risks to women’s safety and health have been underestimated and neglected compared to men’s, regarding research and prevention. This imbalance should be addressed in research, awareness-raising and prevention activities” (Flaspöler et al., 2013).

Plimmer (2015) highlighted the risks of outsourcing contracts which exposes the public sector to companies that lack the required knowledge and professionalism to ensure that the workforce’s health and wellbeing is fully considered: “The amount of government money spent on outsourced public services has almost doubled from £64bn to £120bn in 5 years since the coalition came to power” (Plimmer, 2015, p1.) This will also lead to an increase in temporary workers since the government estimates that there are between 1.1 million and 1.3 million people on fixed term or temporary contracts with approximately half working in the public sector (Unison, n.d.). Thus, such precarious employment conditions where a large portion of the workforce is not guaranteed a job for life, can lead to feelings of insecurity and uncertainty, which leads to stress.

The public sector has experienced high levels of staff reduction because of budgetary cuts by central government, resulting in austerity policies and increasing work intensification for staff who retained their jobs, leading to high levels of stress (Malloch & Haque, 2015). This has direct consequences for staff who have physical contact with users of services such as health and social care, education, and security services, and is one of the fundamental current causes of stress which can lead to burn out and mental health issues (Pavanelli, 2016),

Strategic decision making, which often defines new business models, also often fails to consider the implications at operational levels which results in workers having to meet deadlines with fewer resources. This issue has been highlighted by Morse (2016) from the National Audit Office: “Departments have significantly cut their staff numbers and costs in the last five years but not enough planning has gone into making sure that, over the longer term, the reductions already made and any required in future are sustainable and do not damage the delivery of public services” (p1).

The issues of obesity and musculoskeletal disorders are current risks, but will become more prevalent in the millennial generation because of unhealthy diets and sedentary lifestyles, and this will have far reaching consequences for employers. “The lifetime medical expenditure that is attributable to obesity for an obese 20-year-old varies from $5,340 to $29,460, increasing proportionally with rising weight” (Barkin, Heerman, Warren, Rennhoff, 2001, p240) with 30 US states reporting that 30% of children between the ages of 10 and 17 are classified as either overweight or obese.

Technological advances, which allow for remote working, has given rise to significant risks, for example psychosocial risks whereby workers feel isolated from colleagues which decreases engagement. This issue will become more prevalent as the trend continues and gains momentum. Additionally, these advances give workers the resources to continue working outside their paid hours, resulting in no clear ‘recovery’ period from work and ultimately this will lead to ill health (Podro & Dix, 2012).

Presenteeism exists whereby a worker attends work while being ill because of uncertainty about job security and this directly affects productivity. This risk has not been given the consideration it merits, and the trend is likely to worsen if economic downturns continue and workers are threatened with job losses as a result of austerity measures being adopted by public sector organisations (Podro & Dix, 2012).

It is generally agreed by experts that the UK economy will suffer the effects of the UK leaving the European Union (EU) – known as Brexit – resulting in a reduction in trade and foreign direct investment in the short-term. Consequently, this will reduce national income and weaken public finances (Emmerson, Johnson, Mitchell, & Phillips, 2016).

Managing Current and Emerging Health Risks in the Public Services Sector

It is generally agreed that there is no such thing as risk-free activity in organisations, whether it is internal, external, strategic, financial, or operational. Consequently, it is imperative that a formalised and systematic approach to risk assessments is adopted by public sector organisations.

The timely, appropriate, and effective use of risk management tools within the context of worker health and wellbeing is imperative in ensuring that public sector organisations make informed decisions based on tangible data and valid information. Additionally, compliance with the Health and Safety at Work (HSW) Act is paramount to ensure the health, safety, and welfare of workers, since recognition of their rights is the first step to a stress-free working environment and organisations have a moral and legal obligation to ensure the safety and health of their workers.

Effective, reliable, and robust horizon scanning (scenario building) techniques must be utilised to develop policy, establish sound operational and tactical objectives, improve resilience, and decrease risk exposure. This approach must be embedded into the policy making process and organisational culture and public sector managers have the unique opportunity to contribute to the solution. Additionally, they must adopt positive leadership styles that promote employee engagement, engender supportive relationships, encourage creativity, and develop worker potential.

Accelerated public sector funding cuts have had a drastic effect on workers’ health and wellbeing, particularly in relation to work-related stress (WRS) and psychosocial risks, the effect of which has been estimated to cost the UK economy 6.5 billion a year.

It is impossible to entirely eradicate WRS, consequently the priority is to reduce the impact it has on workers. The financial benefits of this approach have far reaching consequences for improved performance and productivity, reduced presenteeism, and fewer absences. WRS is undoubtedly a current risk, however consideration must be given to emerging issues which are likely to exacerbate this problem, such as the likelihood of another financial crisis which will invoke additional austerity measures, leading to further job losses and outsourced contracts. Moreover, the reduction of staff numbers puts more pressure on those left behind, which invariably results in precarious employment conditions for workers, which is a leading cause of stress. This is not often a long-term solution, so managers have the responsibility to develop operating models which ensures that reductions are sustainable.

Musculoskeletal disorders (MSDs) are one of the primary current issues in the workplace. A systematic and consistent strategy focused on alleviating the stressors which give rise to the disorders is essential. Additionally, this is an emerging problem with respect to the millennial generation, who have already started to experience the negative consequences associated with sedentary lifestyles. This includes health issues that are caused by obesity such as high blood pressure, high cholesterol, and diabetes. The excessive financial costs of presenteeism and absences caused by these problems, will have to be absorbed by employers.

Emerging risks pertaining to workers who are choosing higher retirement ages for financial reasons will ultimately have financial consequences for the public sector. Workers who continue to work beyond 60 years of age will be more susceptible to MSDs, while cognitive abilities will start to deteriorate, which will impact on productivity.

In order to alleviate the above-mentioned risks, public sector managers must implement appropriate and timely interventions (e.g. wellness programmes) to moderate, reduce, or remove the stressors which lead to ill health. It is recommended that focus is given to primary level interventions which focus on the cause of stressors and which are aimed at changing organisational, role, or task characteristics, e.g. conducive management styles, encouraging worker participation in the design of work (which allows for job control), ergonomically-designed work stations, offering flexible working, and implementation of effective performance reviews. Secondary interventions are designed to provide workers with the knowledge and resources to alleviate the effects of stressors such as cognitive behavioural therapies, mindfulness courses, exercise, and healthy eating. Tertiary interventions are essential but ‘too late’ as such, since they provide medical or psychological treatment of health and mental disorder issues by occupational health providers. Promoting the value of good interpersonal relationships is another mechanism which is essential to the wellbeing of staff.

In the UK, uncertainty associated with Brexit will have an impact on investment, growth, and public finances which is likely to put further pressure on public sector budgets. Additionally, Brexit will result in an end to EU regulations and this will have monumental consequences for public sector organisations who will need to review short, medium, and long-term health and safety strategic objectives, including the designing of new health and safety regulations. These consequences highlight the urgency for public sector managers to seize the opportunity and start conducting horizon scanning exercises in order to determine the impact that Brexit will have on the health and wellbeing of workers.

Since two-thirds of employers cite the poor health habits of their employees as the biggest challenge to managing healthcare costs, the potential of workplace health promotion interventions must not be overlooked because the majority of workers spend most of their life at work.


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