Why should we care about OH&S for Migrant Workers in China?

Migrant labour, temporary foreign workers and in-country migration of workers are becoming more common to many economies. While the “newness” of a worker to any jobsite increases the risk of injury [see Institute for Work and Health, “Newness” and the risk of occupational injury, Issue Briefings, May 2009], a worker in any of these categories faces greater risk if language, education, training, experience are at the low end of the spectrum.

I was in Chongqing China last week as a technical advisor to a project reducing risks to workers. The Canada-China Migrant Labour Occupational Health and Safety project seeks to increase health and safety among the 1.3 million migrant workers concentrated in the coal mining, construction and textile industries in the Chongqing municipality—an administrative jurisdiction serving a population of about 33 million.

Whatever your political views, the simple reality of China’s modernization coupled with the demographic, economic and environmental realities of a billion-plus people create significant challenges. Whether you are in China, Canada or California, you can’t sustain economic growth in sectors like construction without an adequate, safe and healthy labour force. Increasingly, that labour force demand cannot be met through natural population growth and traditional educational streams. For Canada, this means a growing reliance on temporary foreign workers and immigration to meet labour requirements; for places like Chongqing, it’s a matter of temporarily filling demand through migrant labour.

WorkSafeBC’s contribution of training materials, videos and expertise is making a difference. We produce materials for our multicultural labour force in British Columbia so the marginal cost of sending a Chinese translation of a safety brochure in a pdf file or a subtitled two-minute instructional video clip attached to an email is insignificant. The impact on the lives of migrant workers in China (and elsewhere in the world) can be life changing for the better.

At a symposium I attended in Chongqing, I heard first hand (through an interpreter) from migrant workers how many of the safety precautions, work procedures and protective equipment we take for granted are just being implemented in the project’s demonstration sites. More importantly, I heard these worker representatives—not just officials—speak proudly of their advancements in occupational health and safety.

In one of the most humbling moments, I was told how more than 2 million migrant and resident workers in Chongqing have heard about WorkSafeBC and benefitted directly from the materials we produced. That number is almost equivalent to the total labour force in British Columbia.

What happens in China is no longer something that simply occurs far off on the other side of the world. In a global economy, we are all linked; the health and safety of workers who are part of that world-wide supply chain ought to be a concern for all of us. In Chongqing, we drove in German cars, used Dutch translating devices, and watched American software present Canadian knowledge through Japanese projectors.

In a world where there are growing concerns about an “averaging down” of worker health and safety, WorkSafeBC is proudly playing its part in raising OH&S standards for workers in B.C. and elsewhere in our shrinking and interdependent world.

Have Occupational Injury Rates Stopped Falling?

For most of the last twenty years, we have seen time-loss injury rates decline across a broad spectrum of industries and in jurisdictions around the world. This has been welcome news on all fronts. The human loss and suffering avoided alone is one thing, and the financial costs are yet another reason for celebrating this remarkable improvement.

On the downside, the rate of decline has slowed and may have actually begun to climb. NCCI reports injury frequency has risen for the first time since 1997. In fact, the decline has been going on for even longer than that. If you discount two minor blips in 1997 and 1994, injury rates have declined for 18 of the last 20 years in the study (1991-2009).

Recent data shows 2010 and 2011 have seen increases in overall injury rates. One interesting point made by the analysis is the impact of the length in hours of the work week. Few systems actually measure hours of exposure to work (Washington State being the only North American workers’ comp system I know of), but the NCCI points out that fewer hours of exposure per week (month, quarter, twelve-month moving average) will likely mean fewer injuries if the denominator is week, month or year. As weekly hours increase, so will injuries.

Another factor relates to claim behaviour. The report suggests:

•Some insurance experts have suggested that workers, fearful of losing their jobs, may have postponed filing workers compensation claims, but now appear less hesitant to file claims as the economy has shown signs of modest improvement. While the extent to which this phenomenon occurred is unclear, it may have contributed to the observed increase in claim frequency in 2010.

•There is evidence of an influx of small lost-time claims in 2010, which may have been medical-only claims in previous years. A lack of available light duty jobs for injured workers to return to might have contributed.

Are injury rates declining elsewhere? At WorkSafeBC and other Canadian workers’ compensation systems, we have heard reports of the same sort of flattening of the injury rate. This chart shows some selected provinces’ data up to 2009 and the generally falling injury rates. Since then, we have seen a flattening out of the injury frequency and some evidence of an uptick.

Is this something to worry about? I think so. No injury is acceptable and the only acceptable injury rate is zero: that has to remain the target. I believe we are making progress toward that end. I also believe we have harvested much of the proverbial “low hanging fruit.” We have taken a bit of free ride on technology as well, (you get few trips and falls over power cords when you are using cordless devices). New designs and innovations have further reduced injury (as you will see in the Saw Stop video). We are even beginning to use technology to organize important research, and to deliver key messages to where they are needed, when they are needed (see the Joint Prevention of Workplace Violence: Creating an Innovative Web-based Tool report, and Prevention of Violence website).

Yes, we have made progress but fundamental change takes time. The next step towards a zero injury rate means fundamental changes in a societal shift in beliefs and attitudes. Until we in the workers’ compensation industry begin to believe that work-related injuries are not inevitable, we have little hope of achieving that fundamental societal change.

What happened at the IAIABC Convention – Part 2

Celebrating the centenary of workers’ compensation in the U.S. was the major theme at IAIABC Convention. The opening session was a specially commissioned play depicting the events running up to the establishment of the first workers’ compensation system in the U.S. In Wisconsin, as elsewhere, the need for greater certainty for workers and employers was high on the list of features both sides wanted.  Just as important was the idea that workers’ compensation would act as a major driver of safety changes. 

It is also important to recognize the context of the times. By 1911, modern workers’ compensation law was already part of the landscape in Germany, so it had a track record that was beneficial to understanding the value proposition of the proposed new legislation. It was also a time of great tension between labour and capital.

As depicted by the play, the new legislation was not universally praised. As with most compromises, there were those who wanted more out of the deal. That tension has always been present, and there are few signs that the future will see that tension disappear. Retiring Executive Director, Greg Krohm, of the IAIABC made this point in his opening remarks. While generally positive about workers’ compensation, Greg believes some workers still fall through the cracks. He also points to broader changes in society that are forcing workers’ compensation systems to adapt. As he put it in his opening remarks, it would be odd if workers’ compensation did not change to adapt to trends such as a declining unionized workforce, aging population, and growing medical costs. On this point, Greg quoted NCCI as saying the “Medical/Indemnity pie” that describes workers’ compensation expenditures now registers more than 60 percent on the medical side. 

Greg’s remarks highlighted a belief that recent changes in workers’ compensation law do not really change anything for the large central population of injured workers. He noted a troubling trend in some states where claims are made that lack any likely work-relatedness, yet are pursued to try and reach a settlement. This drives up costs, and creates an impetus for restrictive legislation for these marginal cases. 

While Greg could see no definite pattern of “take-aways” from labour in recent workers’ compensation reform, Professor John F. Burton had a very different view. He noted that workers’ compensation premium costs are often raised as an issue, and pointed out that in the workers’ compensation context declining premiums may or may not be a good thing. In a bid to drive down premium rates, benefits have been cut in his view. He noted that replacement rates on permanent partial disability claims in several states are well below the 50 percent level in states such as California, Oregon, Washington, and even the host state of Wisconsin (among others). He also pointed to the issue of apportionment [apportioning causation in part to work and in part to other causes] in California, and the rise in large deductible policies as being further changes that undermine the system. 

Apportionment of permanent disability on the basis of causation in California terms, accepts the principle that an injured worker has a right to be compensated for a disability that is work-related, but limits the employer’s obligation to compensate an injured worker for a disability that is not work-related.

[Under California Labor Code Section 4663, “(a) Apportionment of permanent disability shall be based on causation. (b) Any physician who prepares a report addressing the issue of permanent disability due to a claimed industrial injury shall in that report address the issue of causation of the permanent disability.”] 

Professor Burton felt strongly that the apportionment issue was a significant shift from the dictum of “taking the worker as you find him.” Greg felt the shift was less pronounced, and noted the “as the employer finds him” position was more related to Arthur Larson’s influence, which he characterized as “very liberal”, than any fundamental principle of workers’ compensation itself. 

The debate over large deductibles included one point of view that suggested firms with such large deductible policies are really self-insured for part of their loss. Some argued that this provides greater incentives to invest in safety. On the other hand, many administrators pointed out that such policies may result in unintended consequences including under-reporting of injuries [why report if there is no insurance to be paid?]. 

Others suggested greater numbers of large deductible policies make funding of oversight, appeal, inspection and prevention initiatives more difficult. These functions are typically funded through assessments on the premiums paid (large deductibles mean lower premiums paid, therefore, lower assessment income to fund other programs). 

There were many more issues discussed at this event and I will raise some of these in future posts to this blog.

What happened at the IAIABC’s Convention-Part 1?

A few weeks ago I attended the International Association of Industrial Accident Boards and Commission’s 97th annual convention in Madison, Wisconsin. Wisconsin was the first state to have a constitutional worker's compensation law and that centenary was a central theme of the convention. While other states in the U.S. have some claim to concurrent or even earlier laws, Wisconsin probably wins by virtue of the first fatality claim being paid under legislation declared valid by the state’s Supreme Court.   

As a speaker, I was honoured to receive a commemorative coin specially minted for the centennial. The antique bronze medallion bears the image of the Wisconsin capital building and the state’s motto, “Forward” on one side. On the obverse, a stylized “W” and character illustrate the compromise that was reached a century ago. The presentation case included a card stating I would also receive a printed commemorative volume of the “reflections” on the history and development of workers’ compensation in the U.S., but you can read the content of those reflections online. By the way, the placement of the apostrophe on the coin is correct. Wisconsin’s system is the “worker’s compensation” system; all others in Canada and the U.S. use the plural possessive “workers’ compensation.” (More trivia: another exception to the plural-possessive rule is the title of the legislation in British Columbia, which omits the apostrophe altogether).   [gallery]

The importance of workers’ compensation as social legislation as opposed to pure insurance, was also underscored in part by reference to the 50th anniversary celebrations held in 1961. While in the present environment it may not be possible to garner the same attention, for that anniversary the U.S. Post Office issued a stamp, and President Kennedy gave an address in recognition of the half century milestone.

What was fascinating about the various sessions exploring the development of workers’ compensation in the U.S. was the focus on its nature as a compromise, and its intent as mechanism to improve the health and safety of workers. I was impressed how often the theme of occupational health and safety was presented both in its historical sense and as the present and yet undiscovered land (after all, we have been at it for 100 years and we have yet to achieve safe workplaces free of work-related injury, illness and death). Several presenters made reference to the 1972 Report on National Commission on Workmen’s Compensation. The commission was chaired by John F. Burton, Jr. who was an honoured guest at the convention. It is interesting to note the commission’s view on prevention: 

"We recommend that insurance carriers be required to provide loss prevention services, and that the workmen's compensation agency carefully audit these services. State-operated workmen's compensation funds should provide similar accident prevention services under independent audit procedures where practicable."

A hundred years on, one has to wonder how much of a priority prevention services really are.

On a similar note, OSHA in the U.S. appears to be evaluating if state OSHA programs are living up to their requirements to offer occupational safety and health programs at the state level that are of equivalent effectiveness as those offered by the national agency. The enhanced Federal Annual Monitoring and Evaluation (FAME) reports make interesting reading for any agency that has a prevention mandate. Timeliness of reports, what’s included in databases, and how enforcement is being done are all included. In the ones I’ve read, there are also responses from the state agencies with concrete actions and commitments.   

I’ll have more from this event in a later post.

A few weeks ago I attended the International Association of Industrial Accident Boards and Commission’s 97th annual convention in Madison, Wisconsin. Wisconsin was the first state to have a constitutional worker's compensation law and that centenary was a central theme of the convention. While other states in the U.S. have some claim to concurrent or even earlier laws, Wisconsin probably wins by virtue of the first fatality claim being paid under legislation declared valid by the state’s Supreme Court.   

As a speaker, I was honoured to receive a commemorative coin specially minted for the centennial. The antique bronze medallion bears the image of the Wisconsin capital building and the state’s motto, “Forward” on one side. On the obverse, a stylized “W” and character illustrate the compromise that was reached a century ago. The presentation case included a card stating I would also receive a printed commemorative volume of the “reflections” on the history and development of workers’ compensation in the U.S., but you can read the content of those reflections online. By the way, the placement of the apostrophe on the coin is correct. Wisconsin’s system is the “worker’s compensation” system; all others in Canada and the U.S. use the plural possessive “workers’ compensation.” (More trivia: another exception to the plural-possessive rule is the title of the legislation in British Columbia, which omits the apostrophe altogether). 

The importance of workers’ compensation as social legislation as opposed to pure insurance, was also underscored in part by reference to the 50th anniversary celebrations held in 1961. While in the present environment it may not be possible to garner the same attention, for that anniversary the U.S. Post Office issued a stamp, and President Kennedy gave an address in recognition of the half century milestone.

What was fascinating about the various sessions exploring the development of workers’ compensation in the U.S. was the focus on its nature as a compromise, and its intent as mechanism to improve the health and safety of workers. I was impressed how often the theme of occupational health and safety was presented both in its historical sense and as the present and yet undiscovered land (after all, we have been at it for 100 years and we have yet to achieve safe workplaces free of work-related injury, illness and death). Several presenters made reference to the 1972 Report on National Commission on Workmen’s Compensation. The commission was chaired by John F. Burton, Jr. who was an honoured guest at the convention. It is interesting to note the commission’s view on prevention: 

"We recommend that insurance carriers be required to provide loss prevention services, and that the workmen's compensation agency carefully audit these services. State-operated workmen's compensation funds should provide similar accident prevention services under independent audit procedures where practicable."

A hundred years on, one has to wonder how much of a priority prevention services really are.

On a similar note, OSHA in the U.S. appears to be evaluating if state OSHA programs are living up to their requirements to offer occupational safety and health programs at the state level that are of equivalent effectiveness as those offered by the national agency. The enhanced Federal Annual Monitoring and Evaluation (FAME) reports make interesting reading for any agency that has a prevention mandate. Timeliness of reports, what’s included in databases, and how enforcement is being done are all included. In the ones I’ve read, there are also responses from the state agencies with concrete actions and commitments.   

I’ll have more from this event in a later post.

What can you learn from an old name tag?

I was cleaning out a drawer the other day and came across an old name tag. Time has yellowed its face a little and the pin clip has separated from the back, but the old logo and print are still very readable.  

When I started at WorkSafeBC as a vocational rehabilitation consultant (VRC), this was an essential part of my kit. Before lanyards, swipe cards, and security gates became the norm in industry and at WorkSafeBC, this little name tag was something I wore when I went to visit injured workers in hospitals, schools, and jobsites. 

Back then VRCs were expected to make at least two presentations every quarter. I took this requirement as a challenge. I would arrange to speak to employer groups, chambers of commerce, and rotary luncheons (not as easy as it sounds). My presentations focused on rehabilitation and return-to-work outcomes but the questions always strayed into areas of assessments, experience rating, claims policy and prevention/regulation. I usually wore my own name tag to such events. It was my introduction and it drew a little more attention than those sticky “Hello, my name is” labels ubiquitous at such events.    

You will note the name tag doesn’t say “Vocational Rehabilitation Consultant.” Even if it did, I am certain every audience I spoke to considered me “that guy from WCB.” I think this reaction was cunningly intentional on the part of the vocational rehabilitation leadership of the day.  I learned very quickly that in order to have credibility with these audiences, I had to live up to that billing — I had to know more about every aspect of our business. 

As anyone who has tried presenting or teaching something knows, the process of preparation and delivery deepens your knowledge. I read and could quote from George Nelson Wright’s Total Rehabilitation — the vocational rehabilitation bible of its day. I prepared examples from my own experience of successful training-on-the-job initiatives. I  also learned to anticipate the questions that would be asked including those outside my own role. 

When I could, I would co-present. I would bring along others to answer the tough questions and I would learn from them. My credibility depended on giving correct answers and on delivering on any commitments for further information I would make; more importantly, that credibility would make a difference in creating return-to-work opportunities and fostering a safety culture that ultimately protects workers.    

Finding that name tag reminded me that regardless of my role, I am the face of WorkSafeBC to every employer, service provider, worker or representative I meet. The lesson, however, is not specific to me. If you work in the world of workers’ compensation, you need to know about primary prevention, walk the talk when it comes to safety, understand how insurance works, and believe in rehabilitation/return-to-work. No one can know all the answers but every time you facilitate an answer from another part of the worker's compensation system and listen to the answer, your understanding and potential to make a difference increases.  

Not a bad reminder from an old name tag.

Is the centenary of workers' comp worth celebrating?

Workers’ compensation in its present form is a concept that is about 100 years old in North America.  Germany celebrated the 125^th anniversary of its workers’ compensation last year.  Wisconsin and Ohio are celebrating their century of workers’ compensation in 2011.  In Canada, Ontario will reach the 100 year mark in 2014 while WorkSafeBC’s next hundred years will begin on January 1, 2017.

Is there really something to celebrate?  In one sense, celebration is hardly the word one ought to use for a system that exists because of the injury, disease and death imposed on workers as a consequence of their employment.  Those of us working in worker’s compensation, occupational health and safety, and prevention are keenly aware that our careers flow from failures to secure the safety and health of workers.  On the other hand, it is the sincere belief that we can make a difference that draws us to this work.  There is something positive about having that privilege.

Looking at the past 100 years another way, there are clearly some grounds for celebration.  The establishment of workers’ compensation has certainly provided an alternative to fault systems that often involve lengthy legal battles.  Employers today may not fully comprehend the value proposition contained in the historic compromise that is the basis for workers’ compensation.  No CEO, owner or manager alive today can recall the world before worker’s compensation became the exclusive remedy, barring the injured worker from suing his employer or fellow workers for work-related injury.  Aside from the odd case of non-workers taking action against an employer that gets widely reported in the media, workers have no frame of reference for considering the legal costs and delays that are inherent in most suits.

Workers’ compensation systems have other advantages for employers and workers that are worthy of celebration.  The pooling and mutualization of risks and claims costs by sector provides employers with more predictable costs in the form of relatively stable premiums.  The structure and design of experience rating and discount systems such as COR for employer prevention and disability management programs may also provide incentives for employers to invest in safety and disability management/return-to-work programs.  Safer workplaces and safe, durable return to work for workers are worth celebrating.

The exclusive state fund model is also one worth celebrating.  The German DGUV page for their 125^th gives a great little history of the evolution of their system.  The Ohio Bureau of Workers’ Compensation flash slide show celebrating its 100 years  is engaging and speaks to the future as well as the past. 

The US Workers’ Compensation Centennial Commission website is another great resource for reflecting on how far workers’ compensation has come.  This distinguished group of business, labour and government leaders  (mostly based in Wisconsin where the centenary celebrations will be held), includes the AFL-CIO, National Association of Manufacturers, former governors and current workers’ compensation administrators.  Sponsors include the AMA, NCCI, ISO and other private insurers, industry services organizations. 

A century of workers’ compensation is worth celebrating.  If workers’ compensation did not exist, I am certain there would be pressure from workers and employers to create it. And despite the wide range of arrangements by which it is achieved, workers’ compensation promises to be a vital and important part of the public policy for many years to come.