28-30 June 2006 Beijing China

Proceedings of CIB W99 International Conf6rence on

Global Unity for ealth in Construction

Edited by

Dongping Fang Rafiq M. Choudhry

Jimmie W. Hinze

;$%AY~RE+i Am

Tsinghua University Press

Beijing

SCIENTIFIC AND TECHNICAL COMMITTEE

Coordinators: Dr Dongping Fang, Tsinghua University, China Dr Jimmie W. Hinze, University of Florida, USA

Members: Dr A A Talukhaba, University of Witwatersrand, RSA Dr Adnan Enshassi, The Islamic University of Gaza, Palestine Mr Albert W.K. KWOK, The HK Polytechnic University, Hong Kong, China Mr Albert0 Lopez-Valcarcel, SafeWork Program, ILO Dr Alistair Gibb, Loughborough University, UK Dr Ainarjit Siiigh, University of Hawaii, Honolulu, USA Dr Andrew R, Hale, Delft University of Technology, Netherlands Dr Arie Gottfried, Politecnico di Milano, Italy Dr Basliir Almed Memon, QUEST, Pakistan Dr Bonaventura Hadikusumo, Asian Institute of Technology, Thailand Dr Chansik Park, Chung-Ang University, Korea Dr Chen Chuan, Tsingliua University, China Ms Chunfang Qin, China Association of Construction Industry, China Dr Churning Shang, Ministry of Construction, China Mr Derek V, Smyth, Gammon Consiruction Limited, I-Iong Kong, China Dr Eimo “Ed” Koeim, Lamar University, USA Dr Edward Jaselskis, Iowa State University, USA Dr Francis Wong, The I-Iong Kong Polytechnic University, I-Iong Kong, China Dr Florence Yean Yng Ling, National University of Singapore, Singapore Dr George Ofori, National University of Singapore, Singapore Dr Helen Lingard, RMIT University, City Campus Melbourne, Australia Dr Jeffrey Lew, Purdue University, USA Dr Jill Wells, CIB, TG59, UK Dr John A. Garnbatese, Oregon State University, USA Dr John Smallwood, Nelson Mandela Metropolitan University, RSA Mr Kevin Berg, Bechtel, USA Dr Luis Alves Dim, Technical University of Lisbon, Portugal Dr Martin Loosemore, The University of New South Wales, Australia Dr Marton Marosszeky, The University of New South Wales, Australia Dr Masahiko Kunishima, University of Tokyo, Japan Dr Michael H. Faber, Swiss Federal Institute of Technology, Switzerland Dr Miquel Casals, Universitat Politecnica de Catalunys, Spain Dr Nicholas Chileshe, Sheffield Hallam University, UK Dr Osama A Jannadi, King Fahd University of Petroleum & Minerals, Saudi Arabia Dr Patrick G Dempsey, Liberty Mutual Research Institute for Safety, USA Dr Patrick Zou, The University of New South Wales, Australia Mr Philco Wong, Gammon Construction Limited, Hong Kong, China

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Dr Peter Barrett, University of Salford, UK Dr Satyanaray ana Kalidindi, Indian Institute of Technology Madras, India Dr Shengli Niu, ILO Dr Sherif Mohamed, GriKilh University, Australia Dr Shizhao Ding, Tongi i University, China Dr Shouqing Wang, Tsinghua University, China Dr Silvio Melhado, Escola Polit6cnica, University of SBo Paulo, Brazil Dr S iu-lam Tang, Hong Kong Polytechnic University, I-long Kong, China Dr Steve Rowlinsoii, University of Hong Kong, China Dr Suzanne Wilkinson, University of Auckland, New Zealand Dr Syed M. Ahmed, Florida International University, USA Dr TEO Ai-Lin Evelyn, National University oC Singapore, Singapore Dr Theo C . I-Iaupl, Cape Peninsula University of Technology, South Africa Mr Wei Tang, Beijing Construction Engineering Group, China Dr Wim Bakens, CTB, Netherlands Dr Xiaoming Wang, CSIRO, Australia Dr Xinyu I-Iuang, Intel Products (Shanghai), China Dr Xueqing Wang, Tianjin University, China Dr Yaowi Wang, Harbin Institute of Technology, China Dr Yong Bai, The University of Kansas, USA Dr Zongzhi Wu, Associalion of Occupational Safety and Health, China

ORGANIZING COMMITTEE

Prof. Dongping Fang, Tsinghwa University - Chair Mr. Rafiq Miiliainmad Choudhry - Conference Secretary Dr. Shouqing Wang Dr. Chum Chen Mr. Yang Shu Ms. Zhou Ying Mr. Zhu Difei MI-. Huang Jixin Mr. SunYu Mr. Zhou Quan Mr. Xi Haifeng M i Luo Xiaowei Mr. Zhang Xin Mr. Qi Xiao Ms. Wang Qing

IV

3rgonomics in Construction: Indian Perspectives Tohn J. Smallwood and Theo C. Hatipt

An Investigation into Worker Consultation & Engagement Approaches Silly Hare, BiEL Maloney, Iain Cameron and A . Roy Duff

Organizational Health Management Interventions in the Australian Construction Industry: An Evaluation of One Case Study Project Helen Lingnrd, Lisa Bradley, Keriy Brown, Caroline Bailey and Keith Townsend

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600

609

The Silent Ergonomics of the South African Construction Industry: Observations in the Western Cape William M Samuels, The0 C. Hut@ and Winston M. Slmkantu

619

15 FUTURE DEVELOPMENT TRENDS

Culture Change Towards Construction Safety Risks, Incidences and Injuries: Literature Review and Case Study Patrick X FY Z024 Steve Windon and Syainstil H. Mslhrmd

Implementation of Safety Auditing Systems in World FamousLarge Public Works Proj ecls in I-Iong Kong Steve Rowlinson and Raglan Hei-Choi Lam

A Review of Global Safety Performance Factors Syed Id Alzmed, Lincoln H. Forbes and Salman Azhar

The Risk-Accident Cycle: Trends in Research Applied to the Construction Industry Gloria I. Cawajai and Eugenio Pellicer

629

640

647

652

663 AUTHOR INDEX

XI1

Organizational Health Management Interventions in the Australian Construction Industry: An Evaluation of One Case Study Project

Helen Lingard’, Lisa Bradley, Kerry Brown, Caroline Bailey and Keith Townsend2

I , N I T University, Melbourne, Australia 2. Queensland University of Tccluiology, Brisbane, Australia Correspond to: helen.ling~rd@rmit.edii.au

Abstract: Work conditions in the constniction industry are notoriously demanding. In Australia, construction workers are rcquircd to work long hours, typically over six days. Project-based workers work significantly longcr hours and experience higher levels of work-life conflict, job stress and burnout than their counterparts in the corporate offices of construction firms. Problems of job dissatisfaclioil, increased turnover intention, lack of general well-being, substance abuse and, psychological and psychiatric problems have all been associated with a lack of balance betwecn work atid non-work life. This paper presents a post hoc cvaluation of a three-pronged employee healthy lifestyle promotion intervention which was introduced at a large Australian infrastructure consttuction project. The results highlight the benefits associated with the adoption o f an integrated approach to the management of employees’ work-life balance, health and wellbeing. The authors argue that construction organisations should broaden the scopc of their occupational Iicalth and safety (OFI&S) management nctivities to address issues of work-life balance and general employee wellness.”

Keywords: PVork-l$e balance, workers ’health, work hours, f i ~ e s s , lifestyle, health mnnagernent, wellbeing, productivity

1 INTRODUCTION

1.1 The Relevance of Employee “Wellness” Hillier, Fewell, Cann and Shepherd (2005) write of an ‘endemic un-wellness’ that is affecling employees’

behaviour within organizations, suggesting that a large number of employces and, by logical inference, organizational cultures are unwell. This is a concern because the health of a workrorce is essential to national productivity. While it has long been recognized that workplaces expose workers to physical and chemical hazards, researchers have only recently begun to expose the health impact of long hours and psycho-social stressors. Another recent development has been the blurring of the distinction between occupational and non-occupational health effects (Drennan et a1 2006). While it is considerably harder to identify tlie work-related causes of many chronic health conditions, there is a growing recognition that employee health and wellness are influenced by a complex interaction or factors in the work and non-work domains. This paper describes a qualitative post-hoc evaluation of a health promotion intervention introduced during the constniction of a large infrastructure project in tlie Australian constniction industry.

1.2 Workforce Health A report published by Pfizer Inc in 2001, titled “The Health Status ojthe UnitedStrrtes Workforce’ identifies a

prevaIence of behavioural risk €actors associated with workers” health, including smoking, sedentary lifestyle and obesity (Peregrin, 2005). In the United States, NOSH has introduced a campaign called “Steps to a I-Iealthier US Workforce.” Hillier et a1 (2005) describe a similar initiative called the ‘‘Healthy Workforce Iiiitiative” in the UK. This initiative is jointly sponsored by the Department of Health and the principal OH&S regulatory body (tlie Health and Safety Executive) thereby bringing workforce health issues into the mainstream OH&S arena.

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1.3 State of Health of the Australian Workforce In Australia, comprehensive workforce health statistics are not ‘routinely collected. However, a national

telephone survey of 16,304 Australian workers conducted between 1998-2001 revealed that a large proportioll of Australian workers rate their health to be sub-optimal (Korda et a1 2002). In the Australian sample, male, blue-collar workers rated their health particularly poorly compared to other groups. Almost two thirds of the Australian workers sampled reported a current long term health condition, such as asthma, arthritis, hay fever, back pain, cardiovascular disease or other long term health conditions. The analysis suggests that health is a serious problem in the Australian workforce.

Unfortunately Korda et a1 (2002) did not analyse workers’ health by industry. However evidence in international studies suggests that construction workers’ health is relatively poor. For example, King and I-Iudson (1985) analysed the Standard Mortality Ratios (SMXs) for various construction trades and report that, in the majority of cases, SMRs [or various diseases, including neoplasms (tumours), circulatory diseases and respiratoly diseases were higher than that for the population as a whole in the same age group. They conclude that constructioll workers are comparatively unhealthy, acknowledging that the causes of these elevated SMRs are likely lo include exposure to workplace hazards, such as chemicals, radiation or dusts, as well as non-work lifestyle factors.

1.4 Work Hours, Work-Life Balance and Psychological Health One recurrent issue believed to impact upon the health of construction workers in Australia is the requirement

to work long hours and participate in regular weekend work. Previous Canadian research has linked weekend work with higher emotional exhaustion, job stress and psychosomatic health problem (Jaind, 2004). Also, I-hang and Hinze (2006) report that US construction sites that work a 5 day week have lower injury frequency rates than those working a 6 or 7 day week.

The length of work hours and a six day week present particular issues for project based workers. In one study, the average number of hours worked each week was 62.5 among site-based respondents in direct construction activity, 56.1 among respondents who work mostly in a site office and 49.0 among respondents in the head or regional office (Lingard & Francis, 2004). Long work hours are known to increase negative work-to-home spillover (i.e. the extent to which work is perceived to impact on employees’ home life in a negative way) (White, I-Iill, McGovern, Mills and Smeaton 2003). Work interference with family life has been associated with job dissatisfaction, life dissatisfaction, intention to turnover, general well-being, psychological strain, psychiatric disorders, substance abuse and problem drinking (Allen et a1 2000; Netemeyer, Boles, & McMurrian, 1996; Boyar, Maertz, Pearson, & Keough, 2003; O’Driscoll et al, 1992; O’Driscoll et al, 2003; Grant-Vallone & Donalclson, 2001; Hammer, Saksvik, Nytr0, Torvatn, & Bayazit, 2004; Frone 2000; Grzywacz & Marks, 2000).

Perhaps unsuirprisingly, given their longer work hours, construction site-based employees report significantly higher work interference with family life and suffered significantly higher levels of burnout than employees who worked in the head or regional office. Burnout, itself a form of diminished psychological wellbeing, has also been associated with the experience of distress, anxiety, depression, reduced self-esteem and substance abuse (Maslach., Schaufeli & Leiter, 2001). Some studies also identify a link between burnout and coronary heart disease (Appels & Schouten 1991; Tennant, 1996).

1.5 Rising Stress Claims Compensation claims for work-related stress are rising dramatically in Australia. For example, in Victoria, in

2003/4, there were 2,912 new stress claims (VWA 2004). The number of stress claims has grown steadily in absolute numbers since the mid 1990s. Moreover, the proportion of total claims accounted for by stress has also grown steadily fiom 4.1% in 1994/95 to 9.1% in 2003/04. Work-related stress is clearly a major workforce health issue for the future.

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One of the most often cited models of job stress and strain is Karasek’s (1979) ‘job demands-control model’. @is model holds that jobs characterized by high demands (e.g. long hours) and low control produce the greatest stress reactions. Butler, Grzywacz, Bass, and Linney (2005) report that jobs characterized by higher demands and less control at work are related to greater work-to-family conflict. In the construction context, Lingard & Francis (2005) report that hours of work and job schedule demands similarly produce work-to-family conflict which, in turn, gives rise to chronic stress responses including employee burnout.

1.6 The Link Between Stress and Musculo-Skeletal Disorders Stressfill work conditions are serious risk factors for employees’ mental health but it is now known that stress

js also a risk factor in musculo-skeletal disorders (MSDs). This relationship is strong both in relation to the fveqziency and duration of MSD claims. For example, stressors or sozirces ofstress play an important role in the development, exacerbation and maintenance of work related upper extremity disorders (Bongers et a1 2002) and back pain (Linton 2001). Indeed, Linton (2001) suggests that eliminating stress risk factors could reduce the number of cases of back pain by up to 40%. The pathways by which work stress contribute to MSDs are not Cully ,understood but Bongers et a1 (2002) suggest that stressful work conditions: have a direct effect upon the speed of movements, applied force and/or poshire; cause physiological changes leading to MSD problems; lead to a di€ferent appraisal of MSD problems; and influence the transition kom acute to sub-acute to chronic MSD pain.

Like stress claims MSDs are a rapidly growing categoiy of compensation claim in Australia. For example, in 2003104, MSDs were the most prevalent type of occupational injury in Victoria. In 2003/04, there were 18,567 new MSD claims, accounting for 57.9% of claims and amounting Lo a total of $10.046.5 million dollars. Furthermore, construction is known to be a high risk industry for MSDs (McWilliams et a1 2001; Niskanen and Lauflalamni, 1989).

1.7 Health Promotion Interventions An increasing number of organizations have initiated programmes designed to improve the physical and mental

health of their employees on a general level (DeGroot & Kiker 2003). DeGroot & Kiker (2003) distinguish between reactive employee health management programmes and those focused on more positive health pronzotion. Reactive programmes are those in which assistance is only provided once a particular health problem, €or example alcoholism, is identified and help is sought. In contrast, occupational health promotion programmes focus on changing behaviours, both at work and outside work before adverse health outcomes occur. These programmes are designed to promote behaviours that will improve employees’ fitness, health and general wellness. Typical component parts of such programmes include:

0 The provision of nutritious options in cafeterias and vending machines and/or employer subsidies for the purchase of healthy foods (which are often more expensive than non-healthy foods);

Encouraging exercise by subsidising memberships o f fitness centres and by demonstrating management commitment to exercise; and/or Offering on-site health education and screening for issues like high blood pressure or cholesterol (White 2005).

Smoking cessation interventions; e

1.8 Aim of This Paper Despite the growth in employee health management initiatives in recent years, few attempts have been made to

rigorously evaluate the effects of these programmes, Further, in the construction industry, the implementation of occupational health promotion programmes is not widespread. Most OH&S effort focuses on the prevention of acute trauma incidents, such as falls, collisions, stnictural collapses etc.

This paper describes a qualitative post-hoc evaluation of a health promotion intervention introduced during the

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construction of a large infrastructure project in the Australian construction industry. The paper does not purport to

describe a rigorous attempt to evaluate the effect of the health promotion intervention. Owing to the fact aat researchers became involved in the evaluation after the health promotion interventions had been implemented, it was impossible to evaluate the effects of the intervention by means of a robust experimental design. No pre- a d post- comparisons could be made and it is impossible to ascertain the true efect of the health promotion intervention Nowithstanding this unavoidable methodological limitation, the data provide insight into employees' responses to

the introduction of the health promotion intervention at the case study construction project.

1.9 Context of the Research The case study construction project involved upgrading the existing Wivenhoe Dam in Queensland,

Australia, to ensure the dam is able to safely inanage extreme rainfall events and "any conceivable flood" in tile future. The existing dam was construcled approximately 20 years ago. It comprises a 2.3 kilometre long earth and rock embankment, with a concrete spillway section. Five radial gates, measuring 12 metres wide and 16.5 liletres high are installed on this spillway section. In response Lo increased rainfall forecasts, the project SpOIIsor,

SEQWater, decided to undertake a comprehensive upgrade of the dam. The case study construction project was delivered by means of a 'project alliance', providing an ideal opportunity to experiment with innovative work practices.

Construction of the first stage of the upgrade coinmenced in April 2004. The major tasks involved in the project were building an additional spillway for the dam and Strengthening the existing concrete spillway by undertaking post tensioning works. Over 425,000 cubic metres of material were cxcavated for the new spillway. The project also entailed the construction of a five-span traffic bridge and placement of embankment materials within the additional spillway slnicture (MacDowall 2005). The Wivenhoe Dam upgrade was officially completed on 22"d September 2005, several months ahead of the scheduled completion date. The project also cost less to construct than originally estimated.

1.10 The Health Promotion Intervention Three complementary iniliatives were introduced simultaneously as par1 of a health promotion intervention

during the construction stage of case study project. One of these (the compressed work week) was imposed upon the whole project. Participalion in this initiative was not voluntary and the intervention was available to both salaried and wages workers on the project. The other two interventions (the Energy 4 Life and LNA - Effective Personal Productivity Programmes) were voluntary and available only to salaried employees at the site. The interventions are briefly described below. 1.10.1 Compressed work week

The cornpressed work week involved reducing the length of the working week, but increasing the length of the working day. This initiative was introduced part-way through the construction stage of the project. At the commencement of the construction project, the site was operating on (approximately) a 58 hour week, spread over six days. This coinprised five ten hour days (Monday to Friday) plus an eight hour day on Saturday. Shortly before data collection commenced in March 2005, the site moved to a five day week, with working hours extended to 11.5 hour per day on week days. Weekend work was no longer required, By May 2005, the site was operating on winter hours, reducing work hours firther to 10.5 hours per day. 1.10.2 Energy 4 Life

The Energy 4 Life programme involved the provision of training (on a voluntary basis) in the importance of maintaining healthy eating practices, getting sufficient rest and participating in regular exercise, The programme was delivered by an independent provider, but paid for by the project organization, i.e. the Alliance, Participants were required to review their current lifestyle and commit to a personal exercise plan. This involved committing to

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undertaking a minimum of 35 minutes of physical exercise three times each week. Participants were supported by The provision of self-help tapes. 1.10.3 Leadership Management Australia -Effective Personal Productivity

The LMA - Effective Personal Productivity programme is a proprietary training programme designed to assist with managerial or supervisory responsibility lo increase their personal productivity (See

h~://www.leadershipmanagement.com.au/Portals/ 57ad7180-~5e7-49f5-b282-~647Scdb7ee7/EPP,pdf) for more information. The LMA - Effective Personal Productivity programme explores the issue of productivity and provides

&a[ setting and time management skills. The programme encourages participants to set priorities in both their work end non-work lives and provides training in teamwork and coiniiiunication. One key learning objective is learning me ability to say “no” and feel comfortable about leaving work at the end ofthe work day.

METHODS

2.1 Interviews Interviews were conducted with project-based employees ( ~ 1 6 ) in March and early April 2005. These

interviews were conducted after the introduction of the compressed work week and the commencement of the ‘Energy 4 Life” (E4L) and LNIA, Effective Personal Productivity programmes. The interviews explored employees’ Rerceptions about tlie following issues:

0 Work hours and the effects of weekend work; The perceived benefit of the compressed work week; The impact of the Lh4A- Effective Personal Productivity programme; and The impact ofthe Energy 4 Life programme.

3 Results

3.1 Work Schedule Demands The majority of interviewees commented unfavourably about upon the long hours required in the

construction industry (before moving to the compressed work week). They commented upon the negative impact of long hours upon their home life, their physical and psychological well-being, quality and productivity on site. One common theme in the interviews was the difficulty experienced in performing everyday chores outside of work and the development of fatigue when working these hours for extended periods of time. For example one interviewee commented: “[Yoal] work 7.30 to hloocly 5...So you have no time ajier hours to do any ylzone calls or talk to people. Have to do it all during work. Because we work such long hours,..that does get tiring. The long hours does get tiring ... and because we are here ... when you need to get to a bank or something ... not open Saturday ”

Another common theme was the negative impact of work hours on family hnctionhg. One interviewee said of their relationship with their spouselpaxtner: “[Before the introduction of the compressed work week] we weren ’t spending enough time together -actually as a result of working here because my hours are longer, and I have to travel to work ’’

The constant and unrelenting pressure associated with the schedule demands imposed in the coiistruction industry as a whole was expressed by another interviewee as follows: “You feel obliged to push as hard as you

can ... by meeting deadlines ... then next job they push even more ... compromise safe ty...q trality I think gets compromised a little hit. ”

I

3.2 Weekend Work The negative impact of weekend work on employees’ work-life balance and well-being was also a prominent

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theme in the interview data. In particular, interviewees commented on the negative impact of weekend work on home life, energy levels and motivation. The negative impact of weekend work on family and leisure time was also a common theme. The following comment was typical:

“FJ%en you know you are coming in Saturday morning ... there’s not a lot yoti can do then. Yozi’ve really onb got one day to go and do things at yozrr leisure. And it ties you down over n longperiod.”

The impact of weekend work on family functioning (as opposed to time) was also an important theme in the interview data. One interviewee commented of IiisAier experiences:

“I had only been recently married. The impact oj‘that increased work time vas really felt at home. yol, do

Several interviewees suggested that “presenteeism” was endemic i n the construction industry in that, although employees were obliged to attend work on Saturdays, productivity was often sub-optimal. One interviewee stated tgis in the following words: “You get zised to it @er a while but the biggest part of the frustration is that 110 one wants to be here on a Satzrrrlay so that you get in and you jnd people oren ‘t effective. You ‘ve got certain people whinging out on ihe site -sometimes not as prodierive as it might befioni i\/ionday to Friday.” 3.2.1 Compressed work week

The compressed work week was the only one of the three healtli promotion initiatives available to both salaried and waged workers. This means it was available to office-based professional and inanagerial employees as well as

site-based blue-collar workers. The compressed work week received almost unaniinous support. The interview [lata indicate that the change was regarded very positively by salaried and waged employees alike. Stated benetits associated with the compressed work week included: improved productivily; increased involvement with home and famiIy; decreased work-family conflict; increased opportunity for resthecuperation from the long working week; and increased organisational commitment.

A common theme raised during the interviews was the increased leisure opportunities available when working over five days. For example, one interviewee Commented: “Having a weekend 08 you can go somewhere, even if it is onlyfor a night -go Saturduy, cunie backSunday. And you are refieshed to go back to work on Monday”

The advantage of the compressed work week for employees with family responsibilities was also a common theme. For example, one interviewee said: “TheJive day week has just made it incredible. I’ve talked to the workers out on site. I mean, !hey get to spend a whole weekend with their kids and their families now, not jzist one day”

Lastly, a number of interviewees linked the introduction of the compressed work week with feelings about future involvement with the organization and even participation in the industry. One interviewee expressed this as follows: “I was actzially contenzplating whether the construction indtrstry was not for me. And I was becoming active in seeking orher roles. And then the elr’mincriion of the Saturday work - really saved that. So if it wasn’t for that, probably wozildn ’t be here at the moment. And, not only had Ifelt the change, and the hilge beneJt - niy tv@

has as well. She imnecliately saw a totally diSferent person on the weekend. So that was really positive, Bait now 1 ani nzarch happier, much more energetic at work. So I concentrate for longer - well, for the entire tiine I an? here. Whereas before there were times there‘that were non-productive. ”

The interviews also suggested that the compressed work week was appreciated by both office and sitc-based employees at the case study project. For example, one interviewce commented: “TheJive day week has jz ist made it incredible. I’ve talked tu the workers out on site. I mean, they get to spend a whole weekend with [heir kids and their families now, not just one day” 3.2,2 Energy 4 Life

The Energy 4 Life programme was only available to salaried workers (i.e. those engaged in supei-viso“, managerial or professional roles) at the case shidy project. In total, six interviewees indicated they were

Satzrrilays, and you get home Saturday affernoon - jzist tired -you coirldn ’t do anything that afternoon”

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participating in the Energy 4 Life programme, These interviewees were all salaried staff, All of the interviewees with experience of the Energy 4 Life programme spoke favourably of the programme. In particular, they commented upon the fact that the Energy 4 Life programme motivated them to exercise more regularly and eat more heallhib. All interviewees who were participating in the programme indicated they had changed their behaviour as a result. For example, one participant commented “I am eating differently -just trying to eat more healthy food. Trying to eat salads for lunch - generally didn’t used to pay much attention, just whatever food to fill up. But now, r am paying more attention to eating healthier lunches and breawasts and things like that.”

Several interviewees said that the Energy 4 Life programme had improved their energy levels overall, which impacted on their work and home activities. For example, one interviewee said of the programme “Generally it works well and I know when I do exercise it gives me a lot more energy anyway, through the day. I f ind if I’m getting bogged down and not exercising, it aflects my energy levels at work and at home.”

The only negative comment made about the Energy 4 Li€e programme related to the difficulty with which Energy For Life exercise objectives could be balanced with work and family. For example, one interviewee commented “I definitely want to do [exercise]. But ...So r me to find hayan how 3 times a week - when my child is not going mum, mum - is hard. ” 3.2.3 LMA (Effective Personal Productivity)

Like the Energy 4 Life programme, the LMA - Effective Personal Productivity programme was ody available to salaried employees at thc case study project. This is, in part, due to the fact that the LMA - Effective Personal Productivity programme is aimed at people with managerial responsibilities. In total, seven interviewees indicated they were participating (or had previously participated) in the LMA - EfFective Personal Productivity programme. All of the interviewees with experience of the LMA. programme spoke favourably of the programme. In particular, they commented upon the fact that the LMA programme helped them to prioritise their activities and work more efficiently. One interviewee expressly commented that his stress levels had been reduced by participation in the LMA programme, commenting “I’ve learnt a lot of dgerent techniques - to make myselfinore productive, SO that I can get more done in each day. Just organising fasks andprioritising. When I do that, it reduces my stress becazrse I am not worried about all the different things.”

Several of the interviewees commented indirectly upon the LMA programme’s impact upon their work-life balance. One interviewee said of the programme, “It’s helped in the fact that it opened my eyes up with my partner and myself- not spending enough time together. That’s when we made the decision to spend more time - real time together. We did make that change as a result of LMA. Because we were doing things on priorities - and our little family & apriority,”

Other interviewees commented upon the fact that the LMA programme helped them to plan and manage their work in such a way that they were able to restrict time spent at work to formal work hours. For example, one interviewee commented “Basically it has helped in that I am setting my priorities now ... I used to procrastinate a lot and leave everything until the last minute. Whereas, ifpossible, [I now] stay at work only in work hours and then get ozlt of here. I found I have improved now - got myself a whiteboard, I am writing all my stqf down - tasks I need to get done, the important ones. So at least I can worvy about them and leave others that aren’t important tinti1 tomorrow. I’

The only negative comment made about the LMA programme was that, while the prograinme helped participants to be more productive, it required a considerable commitment of time, which impeded their ability to

Participate in other out of work activities. For example, one interviewee commented “I am doing an LM course on Effective Personal Productivity. So that tokes zp time as well at the moment. The diflculty in that is if1 ani feeling a

bit snowedunder ... So until these courses are finished ... I am having less of a lifestyle.”

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4 DISCUSSION

4.1 Perceived Impact of the Health Promotion Intervention Comments made by employees interviewed following the introduction of the three-pronged health promotion

intervention suggest that this intervention had a positive impact upon employees’ work-life balance and wellbeing at the case study project. Owing to the fact that three components of the health promotion intervention were introduced simultaneously, it is impossible lo determine whether these components would be similarly well received if introduced in isolation.

However, the interview results suggest that there were some synergies between the three initiatives implemented. For example, the interview data suggest that the LMA - Effective Personal Productivity programine, the Energy 4 Life programme and the compressed work week complemented one anolher by providing access to

more uninterrupted time €or non-work pursuits, including physical exercise and family activities. One objective of the LMA - Effective Personal Productivity programme was to enable participants to priorilise and plan their non-work and family time, which would have been made easier by the work schedule permitting a two day wcekend. Further, in providing a full two day weekend during which employees could rest, recuperate, exercise and speild lime with family, the compressed work week is Ikely to have supported the ob.jectives of the Energy 4 Life programme.

Within the LMA - Effective Personal Productivity programme, employees were also instructed in tinie management with an emphasis upon the efficient use of work hours. The message conveyed was that leaving work at the elid of “official” work day was expected and legitimate and that working back late was neither expected nor necessary. As such, the LMA - Effective Personal Productivity appears to have helped to overcome the problem of “presenteeism” and helped employees reel more comfortable when placing boundaries around the hours they spent at work. As such, the LMA - Effective Personal Produclivity was supportive of the Energy 4 Life programme in de-stigmatising practices such as leaving work on time to participate in sporting or physical exercise activities.

In combination, these initiatives appear to have worked in a complementary way to improve einployces’ sense of work-life balance as well as their perception of physical and mental wellbeing- both at work and outside work. 4.1.1 Need for changes to the work environment

One important distinction to make is that the compressed work week involved changing the way that at the case study project was actually organized. As such it was designed to eliminate or reduce stressfill aspects of the work environment at the case study construction site, i.e. eliminate the requirement for weekend work and rcduce overall work hours. In contrast, the LMA - Effective Personal Productivity and Energy 4 Life programmes were essentially training interventions designed to change the behaviour of employees at the case study project. This is an important distinction because interventions designed to combat occupational stress fall into two categories: those that act upon the individual; and those that act on the work environment (Giga, Cooper & Paragher 2003). Kenney & Cooper (2003) suggest that which type of approach is adopted depends, lo some extent, on whether occupational stress is viewed as a “personal trou6le” (related to personality characteristics) or as a “public concern” (related primarily to work characteristics). Arguably, health promotion interventions designed to alleviate occupational stress by changing employee behaviour, such as the LMA - Effective Personal Productivity and Energy 4 Lire programmes are unlikely to maintain employee health and well-being in the long term without organizational interventions designed to eliminate or reduce stressors in the work environment (Kenney & Cooper 2003). This is because characteristics of the work environment can prevent employees from exercising coping or lifestyle behaviours learned in training programmes, like the LMA - Effective Personal Productivity and Energy 4 Life programmes.

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In introducing the compressed work week alongside the LMA - Effective Personal Productivity and Energy 4 Life programmes, the project management team at the case study project made a significant change t o the work environment, challenging the entrenched assumptions concerning the work conditions required to achieve productivity and perfonnance in the Australian construction industry. As such, the interventions implemented at the case study construction project represent a genuine attempt to address workers’ health as a ‘public concern.’ However, the issue of extending working hours could also present other significant OHS risks, For example long hours and insufficient time for rest and recuperation is associated with fatigue and the occurrence of injury (Lilley et a1 2002; Goldenhar et a1 2003). While adverse safety outcomes were not observed on the case study project described in this paper, any future interventions that involve re-organizing work hours must be rigorously evaluated in terms ofthe impact upon OHS risk more broadly. 4.1.2 Equity in availability of health promotion iiiitiatives

One issue raised during the interviews was the fact that blue collar, site workers were not able to participate in lhe Energy 4 Life programme, with one interviewee commenting “the boys out there work very long days. A lot of then1 smoke heavily, don ‘t eat salads at lzinch time. I ain not stire whether some of them shozild be on Energy 4 Life, or have some guidance about changing their lfesiyle so that when they Jiaish work they can enjoy enjoyable nclivities instead of at the pub drinking.”

It is important that future health promotion interventions target not blue collar, site-based personnel in addition to white collar managerial and pro€essional employees. These two employee groups are known to have different health profiles but could both undoubtedly benefit from health promotion programmes.

5 CONCLUSIONS

In conclusion, the interview data suggest that construction industry employees’ experienced work- and non-work lives, can be positively influenced by organizational health promotion interventions. Further, not only do these interventions appear to improve employees’ subjective sense of well-being but they may also influelice employees’ feelings towards both their work and employing organization. While our research design does not allow us to state conclusively that the health promotion initiatives implemented at the case study project were the cause of the positive feelings people had toward their workplace, the comments made by interviewees indicate that the heal111 promotion interventions were positively received. On the whole, employees were very positive about their health, work-life balance and well-being. The implementation of health promotion interventions in the construction industry is not commonplace, however, taken together, these interview findings suggest that constiuction organizations that do implement such programmes can expect positive results.

6 LIMITATIONS AND FUTURE RESEARCH

The research presented In this paper is limited in a number of important respects. Firstly, the evaluation was a post-hoc evaluation and no attributions of cause and effect can therefore be made. While the formative evaluation of the health promotion intervention via employees’ subjective comments is valid, fiirther research is needed using a robust experimental design. A more rigorous experimental evaluation of health promotion interventions is being undertaken in several additional case study projects.

Secondly, the results are based on the experiences of employees at one case study construction project and no claims to generalisability of the frndings are therefore being made.

Finally, the data presented is indicative of employees’ perceptions of the health promotion initiatives implemented at the case study project. No objective measures of health or health outcomes were used in this evaluation. Future

617

studies (using more robust experimental methods) will incorporate objective measures of health and health outcomes),

ACKNOWLEDGEMENTS

This research was fbnded by the Australian Research Council with support from the Construction Induslry Institute (Australia). The authors would like to acknowledge the assistance of Leighton Contractors Pty Ltd in providing access to personnel for data collection.

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PREFACE

The CIB W99 International Conference on Global Unity for Safety and Health in Construction, organized under the patronage of the International Council for Research and Innovation in Building and Construction (CIB) and CIB Working Commission 99 in partnership with (Tsinghua - Gammon) Construction Safety Research Center and the Institute of International Engineering Project Management at Tsinghua University, provides an international forum for researchers, engineers, practitioners, and safety & health professionals to address current issues that affect the successful achievement of safety and health in construction. The primary objective of the conference is to communicate information, expertise, and research results on construction safety and health in order to assist all nations, especially developing and underdeveloped nations around the world, to make improvements in the health and well being of the construction workforce. The conference provides a single fonim to bring together researchers, academics, administrators, and practitioners representing educational institutions, government agencies, contracting organizations, consulting fiqs, and other construction related organizations, officers, experts, and specialists &om all over the world. *

The conference provides an exchange of experience in new developments and in practical applications to improve safety and health on construction sites. In addressing universal challenges in construction safety & health, the papers presented at the conference have been organized within the following categories:

0 Law, strategy and planning 0 Application of IT and automation 0 Standards and guidelines 0 Roles of stakeholders 0 Culture and its influence 0 Issues in developing countries

Education, training and continuous learning 0 Behavior based safety and productivity 0 Risk analysis and decision-making 0 Environment impact assessment and noise control 0 Investments and benefits Workers’ working conditions and quality of life

Measurement and quantitative analysis 0 Future development trends In response to the “call-for-papers”, 107 abstracts were received from 26 countries. After abstract review and

full paper review, 75 papers from 21 countries were approved by the Scientific and Technical Committee for inclusion in the conference proceedings. Among them, 6 authors, 1 from government, 2 from industry and 3 lrom academic were selected as speakers to present the highlights of most of the above topics through six keynote addresses. These peer reviewed and edited proceedings are aimed at contributing significantly to the body of knowledge relative to improving construction safety and health in construction.

We would like to express our thanks to the CIB, Tsinghua University, Conference sponsors and supporting organizations, all members of the S&T Committee, as well as the authors, participants and supporting staff members who have contributed to the success of the conference.

Dongping Fang Rafiq M. Choudhry

Jimmie W. Hinze

Beijing, China June, 2006

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International Conference on Global Unity for Safety & Health in Construction (2006 : Being, China) Proceedings of CIB W99 international conference on global unity for safety & health in construction / ed. by Dongping Fang, Rafiq M. Choudhry and Jimmie W. Hinze. Beijing : Tsinghua University Press, 2006. Imprint

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Choudhry, Rafif M. Hinze, Jimmie W. CIB W99 international conference on global unity for safety & health in construction International conference on global unity for safety & health in construction Global unity for safety & health in construction

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