neurotoxicity after exposure to chemicals in his
workplace. As a result of his illness,
had to give up his job. Since that time he has
suffered ongoing anger, irritability and depression. His
illness also contributed to the temporary breakdown
of his marriage. His wife Jane had difficulties
coming to terms with his illness.
The sequence of
events.
appliances.
necessary, and then returning them. The repairs
involved the use of an epoxy resin, and the area to be
repaired was cleaned with solvents.
for the boat and a smaller room for mixing the
chemicals needed for the process.
The amount of health and safety equipment
that was available was, in
the glue room there was a small extractor fan
and to mix the glue he used kitchen gloves. A breathing
mask with air supply was available but frequently
in use in other parts of the company.
himself did not know, for the majority of the time
he worked at the boat repairers, of the dangers of
the chemical he was using.
Due to previous concerns an
inspector, having previously worked in the printing
industry, noticed a distinct smell of solvents.
There was little ventilation and the
extractor fan in the mixing room was actually drawing
contaminated air from the wider factory to the room. The
inspector made a number of suggestions.
He suggested that monitoring for vapour
levels be done. Further, he asked that procedures be put in
place to minimise any vapour that was there. The
inspector also checked the extractor fan. He was
concerned that it was both not adequate for the job
and could possibly spark igniting any vapour that
was present. In checking the breathing equipment
it. Two months later he came back to the
inspector saying that the equipment was not available and
not used.
The inspector, concerned that
levels at the workplace. The results of the tests
showed that vapour levels were actually below the
exposure standards. The inspector had some doubts
over the results as they were taken in winter and
levels would be higher in the heat of summer. Also,
less repair work was being done at the time of the
check. Nevertheless, there was not enough evidence
for prosecution. At the time
pleased with the result, and felt that the company
was not made accountable.
Medical treatment
Initially, there was a long delay before
there was medical help for
visits to his local doctor and to a clinical
psychologist.
possible concerns over adverse effects on his
illness.
Impact on
Initially the symptoms were not severe. They
included pins and needles in his fingertips to rashes on
his face and bad circulation. Often in the
morning he would awaken smelling a glue residue. Murray
remarked:
It was probably about 18 months
before, because my daughter used to come running in and give me a kiss
before she went to school or I went to work
in the morning sort of thing. She goes ‘gees it stinks’, my sheets,
because I used to sweat at night. Even in the
middle of the night in winter down here. And I don’t have
electric blankets on. It used to stink so much
and [I’d] think ‘what’s going on here’. I didn’t put it down to
anything. (
As time went on
problems with his breathing. This culminated in what
he and staff at his local hospital thought was a
heart attack. At the same time he began to notice
changes in his personality and memory.
Increasingly, he became angry and irritable
and experienced frequent mood swings. He found that his
short-term memory suffered and he had to make notes to
remind himself of what had occurred. He
remarked:
Initially, what I noticed mostly was
short-term memory was going pretty bad… When my day planner was
starting to get full of scribbles and things
like that and clients were ringing up saying ‘you didn’t get back to
me yesterday. Do you still want this or
do you still want that?’ And [I said] ‘gee what was it? Who are you
again?’ Um sort of thing.
Things like this. (
There were further changes in concentration
and motivation. In his spare time
studying for a Bachelor of Commerce degree.
to decline, his grades dropping from As to Cs:
It’s been a big thing because I’ve
never failed anything before in my life. (
These changes in
without his family. Within in the family he found he
could no longer cope with his step-children. The
marriage itself began to come under strain. Despite
seeing a marriage counsellor for several months,
Murray and Jane eventually separated.
townhouse. More generally, he became increasingly
anti-social, giving up hobbies and sports. Having
both played and then coached in several sports,
this. His circle of friends declined. Social
situations became difficult for
isolating himself from others:
I feel safer, I feel like if I’m by
myself and nobody is coming in to my world or something then nothing can go
wrong. I can’t get angry,
I don’t feel threatened or intimidated, all these sorts of things. (
solvent neurotoxicity.
qualification system and a database for using chemicals in
the workplace. However,
concerns for his future, particularly when his ACC
rehabilitation plan ended.
Yeah that’s about, so I don’t really
know what the future brings or anything. Umm, probably the shit will hit
the fan early next year. That’s when
rehab plan finishes, I dunno. (
He was concerned about his future employment
prospects, in terms of both his ability to get and
keep a job, and the likelihood that others would
hire him:
Who wants to hire a crazy? (
Although he was coming to terms with his
illness, he still struggled with it on a daily basis:
I just hate living like this, eh. I
really do. The main focus I’ve got in life is with most of the guys in
relationships is to make sure that their partner is
well-catered for when they die sort of thing. That’s my focus,
I want to make sure that [the]
mortgage is paid and everything like this, then I
don’t mind doing something,
disappearing or whatever... But that’s not the way
to solve things. (
42
The family
Initially, when
Over the time that he worked there she began
to notice changes in him. This began with physical
symptoms like a recurrent rash. Then
And then he started to get really
moody and lazy and yeah. He just changed from this placid person to this big
monster. (Jane)
She observed that
changes in
problems to laziness. Jane noted that
friends no longer visited. As a result, they did
very little as a couple. Jane still kept up her visits to
friends and to the gym.
Of further concern to Jane was
that he could receive more money through
compensation than she did working full time. Nor did she
feel that he made up for this by doing chores
around the house. Overall, she was not interested in his
illness. She had her own problems, including two
nervous breakdowns.
All these pressures affected their relationship.
Although they reconciled in June and July of 2000 after
a separation, Jane was doubtful about the
future of their marriage. She commented that they are more
like flatmates now:
Hmmm, yeah, we just sorta like, its not a marriage,
we’re sort of like in a flatmate y’know, we’re just
flatting
together. That’s what it’s like. Yeah, half
the time we don’t even talk (Jane)
Jane’s doubts extended to
lasting employment. Although
sustain working there.
The
workplace
The workplace was a small business offering a
variety of services which, at the time of the illness,
included life raft survey and repair. The manager
noted that
work he did.
competence and provided him with opportunities for
extra training and certification.
When
manager. They immediately decided to send
about this and did not want anything to be done.
Management insisted that if there was a problem
then it had to be dealt with. The result of the
from the workplace for his own health.
For
could not understand how
the first worker to become affected by the
chemical. The problem the company faced with
was that the job could not be done without the
chemical. It was not something that they could have
worked around. The company changed to a new
solvent.
to the job. Even though the new chemical was less
reactive there was still the possibility that
would be intolerant to it.
not seem to be clear-cut and there was no
resolution resulting from the diagnosis. The manager
thought it would have been much simpler if could be
diagnosed with a single blood test. This lack of
clarity made
general morale of the other workers, in his belief,
did not suffer from
increase in the ACC levy. There were no increased
costs from changing the chemicals they used in
repair work.
Context
In the machinery and equipment manufacturing
sector of the manufacturing industry in the year
2000/2001 there were
700 new and 886 ongoing paid work-related entitlement claims. These cost
ACC $1,821,000 and
$8,507,000 respectively.
Amongst building trades workers in the year
2000/2001 there were 1,892 new and 2,263 ongoing
paid work-related entitlement claims. These cost
ACC $5,593,000 and $25,054,000.
Amongst men in the 30-34-year-old age group
in 2000/2001 there were 5,525 new and ongoing
work-related paid entitlement claims, costing ACC
$7,313,000.
171
CONCLUSION
The effects of workplace injuries and illness
are complex and inter-related. In addition, because many
of these effects are specific to individual
situations, not one person sees or experiences them all.
Large-scale ‘macro’ studies have used data
analysis or survey methods to provide a total, aggregated
economic cost; calculated as ongoing or for a
particular period in time. However, using these ‘blunt’
methodologies to calculate economic costs means the
uncounted economic costs and many social
consequences, what Dembe terms
‘the social effects’, of workplace injury and illness, remain hidden,
and thus not part of any economic calculation.61
This study aimed to extend knowledge of
‘costs’ to include ‘non-economic’ costs; in particular to
explore the emotional, physical and social impact on
the lives and daily activities of injured and ill
employees and those around them. Most organisations
know how much and what types of insurance
cover they have, what their machinery and
equipment is worth, and the amount paid out in wages.
But our understanding of the enormous, varied,
and dispersed effects of workplace injury and illness
remains limited.
Other research into the social and economic
consequences of workplace injury and illness has
identified the complex interplay of personal, social,
organisational and environmental factors. The
outcomes for the individual of injury and illness are
subject to a range of influences from the
workplace, community, medical profession, workers
compensation and social security systems, and
broader society.62 These
studies have discussed the mutual dependence of these factors, which create
a ripple effect in spreading the effects of
workplace injury and illness out beyond the injured or ill
employee to reach wider society, and which act to
increase or mitigate the resulting consequences.
One study termed these factors ‘cost
determinants’.63
This research provides a useful framework for
our findings. The Conclusion briefly repeats some
examples of direct and indirect costs from the
Findings chapters, and discusses how certain
determinants act to cause or prevent, alleviate or
exacerbate the outcomes of injury or illness across
all, or selected, areas. For ease of
understanding, the cost determinant discussion first outlines those
determinants which influence outcomes across all groups.
This discussion is followed by how other
determinants influence outcomes in particular areas:
individual, family and friends; workplace; and
government and medical. Finally, six overarching
themes, which are subject to, and have influence
over all areas and parties involved, are briefly
discussed.
Identifying the consequences
We found examples of direct and indirect
costs, which affected the employee, employer and
community. A considerable proportion of the indirect
costs was borne by the injured or ill employee
or their family. For example, the effects on
their relationships were considerable. Loss of intimacy,
increased distance between spouses or parents and
children, employer to employee, between
workmates, were common in the participants. Feeling
isolated or self-imposed isolation put
relationships under pressure – some broke down while
others emerged from the difficult period
strengthened through shared experiences. Other costs
involved loss of future earnings and medical
costs.64
61 A Dembe (2001). p403. Please refer to the
Literature Review Part I: Macro Studies.
62 A
Dembe (2001). p413. Also see for example Kiel et al (2000); Coulton et al
(1995); Boden et al (1999).
63 Kiel
et al (2000). p110.
64 This conclusion is supported by previous research findings. For example
see Australian Industry Commission
(1995), for a discussion
on consequences to different areas of society.
172
For the family and friends of the injured or
ill employee, one of the most considerable indirect costs
observed was separation, both physical and emotional.
This led to strain on relationships: in three
cases, relationships were broken, with a further
two cases losing their pre-injury relationships
permanently. In addition, there were major lifestyle
changes for many of the families, with many
participants changing their careers, beginning or
stopping study and giving up hobbies to care for the
family member. Friends of the individual were also
affected – from the loss of a close friend, to
helping them through their illness and injury with
support – often at their own cost. This may have
meant less time with their own families, or
financial cost.
For the employer, costs included lost
production, negative impacts on staff morale, bad publicity, and
the costs of replacing employees or equipment;
and in some cases, legal costs. For the workplace,
costs included the loss of a friend and colleague,
possibly animosity towards the injured or ill
employee and even the immeasurable impact of feeling
responsible for an injury or fatality.
For the government sector, the impact on
officials carrying out statutory functions was observed,
including the psychological impact of investigating
fatalities, dealing with recalcitrant employers and
comforting bereaved or confused families. Other hidden
costs included costs of medical retirement
for government employees, as well as education,
injury prevention; and costs of investigation and
appeals. Many costs are non-recoverable; for
example, lost taxes, lost labour, voluntary and unpaid
work, casual work (while this was also a loss to
the individual, because it was not taxed, it was also
not compensated), and social capital. For the
medical community, indirect costs observed included
time, equipment and drugs, and rehabilitation
costs.
These costs and their impacts were discussed
fully in the Findings chapters. However, based on the
results of these fifteen case studies, conclusions
may be drawn about the nature of these costs: what
causes or prevents them; and what factors may
mitigate or increase them.
Key results: determinants that influenced
outcomes across all
areas
We found one of the major relationships
between social and economic consequences revolved
around socio-economic status. One of the protective factors that prevented or
alleviated adverse social or
economic outcomes, was being in a higher
socio-economic profession. Usually related to this was
having a higher level of education, with ample
social and/or workplace support.65 If not, the
participant had less choices and support following their
injury or illness to prevent the economic
consequences reaching into and affecting their home and
family life. Compare Philip and Paul to
Thomas and Barbara. The latter lived in small towns, with
limited employment opportunities and an
unskilled, insecure job. Their choices were a lot less
than that of Paul and Philip’s – who, although
they did not receive much (if at all) workplace
support, still had the unstinting support of their family
and the financial reserves to change careers.
The labour market status of other participants affected their behaviour
following their illness or injury.
The fact that some participants indicated
they did not feel secure in their current job and were finding
it difficult to secure alternative employment
(such as Grant, Thomas, and Mark) has meant staying in
their former occupation instead of moving on.
Others, like Peter and Paul, have chosen to leave the
profession and retrain in another career, while others
(Julia, Philip) were forced to leave their
profession and have not yet found an alternative. This
has no doubt exacerbated the economic
consequences for them and their families.
The visibility and invisibility of injury or illness was a major factor in
many of our cases, with influences
acting from all areas. With an obvious, demonstrable
link to the workplace, we found that the injured
participants received more support. Diagnosis and
treatment was accurate and prompt when medical
providers were dealing with an injury associated with
a specific event. There was (largely) more
65 This conclusion is supported by previous research findings. For example
see Keogh et al (2000).
173
support provided by the workplace. Examples included
Mark (provided income support by
company), Grant (structured rehabilitation and
support programme, transport), and Brian (a gift of
money, use of cell phone).
Conversely, for the ill participants, establishing the work-relatedness of
the illness was a major
barrier to
effective and timely support. Delays in diagnosis,
and/or debates over the nature of exposure, had
serious implications for treatment and recovery.
Murray and John, Barbara and Julia all experienced
this. Fast and appropriate treatment and
acknowledgement by others of the condition would have
helped speedy recovery and return to work, such as in
the case of Martin.66 It would have also helped
alleviate the financial costs for these participants.
This injury and illness discrepancy also had
implications for acknowledgement, from all parties involved.
The more obvious and visible the injury, the greater
the sympathy and recognition it received. In its
own way, this acknowledgement often served in
assisting recovery and learning. Acknowledgement
and support included appropriate treatment and
compensation, thus lessening the burden on family
and friends. One additional method of
acknowledgement was participation in this study. Some
participants commented that this was validation for them,
because although it meant revisiting
difficult memories and experiences, it also served as
an acknowledgement of the seriousness of what
had happened to them, and the impact it had on
their lives. Participants were able to reflect on their
experiences and understand some of their actions and
reactions. Participants also commented they
hoped others would benefit from their experience.
Finally, a further determinant that was
observed that impacted across all areas was the level of health and
safety awareness by the employer and their
employees. The case studies
showed this influenced the attitude of
the employees themselves, and had a considerable
impact on the outcomes for the injured or ill
employee, and their family, as well as how they were
treated by others.67 Whether health and safety
was regarded as integral to the business, an
afterthought, or was not even considered, this attitude and
its resultant behaviour had major consequences
for the injured or ill employee. As a result of Ian’s
death, his employer instigated an extensive health
and safety compliance team. The support given to
Grant was in stark contrast to the complete
lack of acknowledgement or support given to John. The
ignorance shown by Barbara’s employer contrasts with
the successful case managing Lisa’s supervisor
and health and safety officer. These cases
showed that having an effective health and safety system in
place prevented or helped alleviate such adverse
outcomes for the participants and their families.
Further results: determinants that
influenced outcomes in particular
areas
Individual and their friends and
family
For the individual and their friends and
family around them, certain characteristics affected the
presence, or absence, of social and economic
consequences.68
The personality of the participants had an observed effect on the
presence of certain social
consequences, and changes and feeling more positive as a
result were of benefit for Paul and Lisa.
Other whether these were severe or minor.
Conscientious, perfectionist, high achievers were present
(these included
Philip, Julia, and Lisa). Other employees showed initiative based on experience,
were
problem solvers, choosing to take responsibility
(such as Thomas and Ian). Taking charge of their
situation, making personality traits impacted
negatively on consequences. Some participants became
66 This conclusion is supported by previous research findings. For example
see Wood et al (1993), quoted in
al (2000).
67 This conclusion is supported by previous research findings. For example
see Australian Industry Commission
(1995), and
68 It is interesting to note that many of the following findings are
supported by previous research. For example see
the discussion of consequences by A
174
withdrawn, internalising their problems and worries
(such as Martin and Peter). This led to pressure
within the relationship. Becoming suicidal,
depressed or violent had adverse effects on relationships
(John, Peter, and
Murray). Eventually
these relationships did not survive.
While the cases were not selected on the
basis of ethnicity, a range was still represented. However, it
was felt that only one case warranted comment on
the basis of ethnicity. The fact that Philip came
from an Asian cultural background may have
accounted for a number of consequences of his
condition. Philip (and his family) had very high
expectations for him, and this was reflected in the
amount of worry and support observed following his
breakdown. His father blamed himself for
Philip’s condition and the family did all
they could to assist his recovery (financially and emotionally).
However, this may be an individual reaction.
The family status of participants – particularly having dependants –
affected the way they reacted and
the subsequent consequences faced after their
injury or illness. Wanting to provide for the family
pushed Thomas to cultivating cannabis, getting
caught, and then facing the consequences of his
employers continuing to blame the injury on this.
However, in Thomas’ case the strength of his
relationship with his partner bonded them even more
strongly together, whereas in Peter’s case this
worked in the reverse and the relationship broke
down. Lisa had no dependants whereas Julia did
(including her
elderly father), and the consequences for the two were distinctly different.
Ian’s family
were completely devastated and continue to suffer
after their loss of a father, provider and husband.
Related to family status, the age of the individual had an important impact in that it
affected the social
and familial responsibilities of the individual.
Younger participants may have been caring for young
children, while older participants were caring for
elderly relatives.
Geographic location had some effect on the support structures
that were available to the families of the
individual. Often couples were separated for a time
while the injured or ill employee received
treatment elsewhere, such as Brian’s wife while he was
in Burwood, or Thomas’ partner when he was
undergoing surgery. Sarah did not have the same access
to physiotherapy as other participants due to
her geographical isolation.
Their job roles also affected outcomes. Some participants were
involved in activities other than their set
tasks, which may have contributed to their injury
or illness, and in other cases made a difference to
subsequent consequences. For example, Brian was doing
maintenance work that was not part of his
usual job description when he fell through the
skylight, while Thomas had been told to ‘find
something useful to do’ and was cutting cardboard
corners that normally would have cost the
company about ten cents to purchase.
The cases did not show any consequences based
on gender alone sufficient for comment.
Workplace and colleagues
Some of the factors that influenced outcomes
for the participants emerged from the workplace.
If the injured or ill employee was able to return or remain within the workplace, they experienced better
rehabilitation outcomes. The prime example of this was
Lisa, but Grant was also encouraged to
return to work quickly as part of his
rehabilitation. However, he indicated he was not comfortable
there. Conversely, some participants felt they
were forced to return to work too early, thus
exacerbating the outcomes for them. Martin felt he had
not recovered sufficiently from his
leptospirosis and Thomas was forced to return to the
sawmill.
We found that some larger firms have more resources to support the
affected person, and also
institute
comprehensive health and safety improvements. But we also
found that bigger companies did not
necessarily mean more developed health and safety
systems, for example, the rapidly expanding boat
building workplaces of John and Peter had either
woefully inadequate systems in place, or none
whatsoever.
175
The role of the supervisor impacted on the recovery outcomes for the workplace
and the attitude that the
workplace took to the injury . When the employer could
and was able to assist (for example Lisa),
there were better results.
Government
The various roles and functions of the
government, including the medical community, helped
determine the consequences for participants.
The involvement of an outside advocate, such as a union, was important in mediating
with employers or
supporting the affected person and the workplace. In
Ian, Julia, and Lisa’s cases they provided
assistance and understanding of the systems involved in
and around injury and illness.
Related to this finding is the fact that some
participants saw
Workplaces and employers wanted direction and
response from
Multiple case managers and lack of contact
about the individual’s case, information about
entitlements, and seemingly endless paperwork exacerbated
what was an already stressful time for
participants.
However, on a positive note, some
participants noted the particular support from
went beyond the usual role of the inspector –
telling them about the legal process, or providing
information on their condition. In difficult
circumstances the professionalism and support of
staff and ACC staff lessened the negative aspects
of the injury experience.
When receiving medical treatment, multiple treatment providers increased negative outcomes for
participants due to long-term, ongoing and often
expensive treatment and rehabilitation. Delayed
diagnosis resulting in delayed treatment and therefore
recovery time and an increased chance of
complications which may delay or prevent return to usual
work activities has already been discussed.
Discussion: the links between social
consequences and economic
costs
The social and economic costs of workplace
injury and illness are inextricably linked. For our fifteen
participants and their families, friends, workplaces and
various officials, social consequences had
economic costs, and vice versa. These inter-related
determinants and outcomes are difficult to
explain, and previous studies have chosen different
methods to illustrate the pattern of outcomes.69
Six overarching themes that we observed acted
to influence the outcomes for participants and those
around them, but which are also determinants of
consequences in themselves. These six themes
mitigate or exacerbate both short- and long-term
outcomes for all involved. They are generated from
all areas; the individuals themselves, the home,
workplace, and wider society.
Isolation: self-imposed or forced isolation had a
negative impact on family and work relationships. For
others to offer support, they needed to understand
the condition and the effect it had on the
individual. Likewise, the individual received better
support when they sought out contact and did not
withdraw, isolating themselves and others. Cases
showed examples of both physical and emotional
isolation.
Blame: many of those involved in the cases were either blamed
by others, took the blame, or avoided
the consequences. Injured or ill employees
blamed their employer, felt they were blamed by other
employees or their employer. Families suffered
emotional consequences from both being blamed or
blaming others. People – and government services –
denied their responsibility and culpability for
consequences or shifted this responsibility onto others.
69 For a discussion of various models, please see Literature Review.
176
Responsibility: accepting responsibility has been shown to
alleviate or even prevent adverse social and
economic consequences for all parties involved. Some
participants were forced to make choices and
changes in their lives or careers, while others took
responsibility and made the necessary changes, to
alleviate negative outcomes. Others have felt the
immeasurable weight of responsibility for not
preventing an injury or illness.
Suffering: physical and mental suffering was an enormous
factor in all the cases. There were also
indications of considerable suffering in cases where
another party felt responsible for someone’s
misfortune. The sense of helplessness at a situation,
in turn, led to increased negative social effects,
whether it was the injured or ill employee, or
another person associated with their situation.
Acknowledgement of the progress they have
made (either physically or emotionally) was important
for understanding their condition and enabling
some recovery.
Understanding: a lack of knowledge about their situation on
the part of the employee, their workplace,
and medical staff increased the suffering,
isolation, and confusion for all involved. Conversely,
knowledge and information, timely and appropriate
support and treatment greatly alleviated the
negative consequences of the injury or illness.
Power: taking charge of their situation, understanding their
actions and reactions, and making changes
alleviated or even prevented negative outcomes for the
participants and those around them. The
usual power relationship in a workplace leaves the
employee subject to the decisions of the employer,
however, negative consequences are avoided when the
employee is supported by the employer and
others, and understanding is shown by those
involved.
Final remarks
Consequences from workplace injury and
illness extend out from the injured or ill employee to reach
all of us. These consequences are both visible
and invisible, including the loss of life and a marriage,
the loss of a taxpayer, another person on a
benefit, loss of social capital, productivity and retraining,
or morale costs. They may be temporary or
permanent, or even final. However, the costs and
consequences described here represent the ‘tip of the
iceberg’.
No one person in any of the ‘areas’ that has
been discussed (the individual, their friends and family,
their workplace and colleagues, the government,
the medical community) sees or experiences the full
extent of the direct and indirect social and
economic consequences of injuries or illness in
workplaces. The nature of the
consequences are such that it is rare all the costs are combined to
provide an overall picture of the magnitude and
complexity of outcomes.
Therefore, to understand the total
consequences requires measures that go beyond just counting
cases or calculating dollar figures. To provide
insight and understanding into specific impacts, and to
gain a human perspective, the definition of costs
must be widened beyond compensated costs to
include ‘non-economic’ costs – the unquantifiable
consequences of injury and illness that are both
multiple and complex.
These fifteen case studies, totalling
sixty-eight interviews with the employee and the people
surrounding them, illustrated common experiences that
happened to ordinary people. They also
showed how certain factors may alter the outcomes
for those harmed in a positive or a negative way.
Seemingly minor gaps in systems or practices
that appeared insignificant on their own created huge
far-reaching consequences for a range of people and the
government agencies that were affected.
This is why, as
the costs are, as a direct motivation for
action.
pays must specify ‘for whom?’.70 It must be clearly communicated to employers, employees, the
Government and the community that believing
it is cheaper to take an unnecessary risk than to
70 A
177
prevent it, is fundamentally flawed. The costs and
consequences of workplace injury and illness will
still exist – except they will be borne by the
workplace, employee and the community.
Shifting the costs - from those who create
the risks to those groups who bear the majority of the
hidden, non-compensated costs - lessens or removes
the incentive to control them. Conversely, the
benefits from controlling and minimising these risks,
for the employee, the community, government
and medical community, are increased when
adverse outcomes are minimised or removed.
Research has shown that these indirect, unquantified costs are many times the amount of the direct,
known costs, estimated as at least 4 percent of
cost should be seen as an investment; that the
long-term benefits of improved employee health and
well-being, and innovation, can happen simultaneously.71 How to create the right incentives to
encourage a commitment to health and safety, and thus
alleviate the devastating impact of injuries
and illness, must continue to be explored.
Increasing our understanding of how these
costs arise; what alleviates and exacerbates, causes or
prevents them, will also increase our understanding
of the consequences to ordinary people of the
impact of government policies and legislation. It
also contributes to our understanding of how to
minimise the aftermath for all those affected, as
well as plan and provide appropriate support and
prevention. This study aimed, and achieved, its purpose
of highlighting and raising awareness of the
debilitating effect of not preventing workplace injury
and illness for the injured or ill employee, their
friends and family, workplace, and the costs to
government.
For our fifteen participants and thousands
more just like them, they are counting the human costs
every day.
71 P Dorman (2000). Introduction.
Dorman concludes that economic incentives will be become more sophisticated
and enjoy greater use, but that they will be
seen as only one leg of the OHS tripod. There will
continue, Dorman
redicts, to be key roles for regulation and
self-regulation to improve working conditions. (p12).
178
EPILOGUE
Grant
Grant feels alright now but he as well as his
family is keen that he change his workplace. He has
attended a couple of interviews but has not been
successful in finding other employment, he feels,
because of the condition of his hand. Meanwhile, he
continues to work at the same place he was at
when he had his injury and is now doing a
full-time job. He feels ‘trapped’ and much as he wants to,
does not think he will be able to change careers.
wife have separated again) and he is still not
working. He describes himself as ‘the loneliest man in
the world’.
He thinks that his employer believes that his
problem is associated with alcohol and drugs use and he
has not heard from them since
of his condition and is concerned about the
problem of solvent-induced neurotoxicity in New
Mark
Mark still has moments of pain and immobility
and is frustrated by that and the fact that he is still
unable to take part in sport. Though he is no
longer in the same company he is in the same industry,
and so often sees his old colleagues who he says
are still sympathetic and show interest. He is now
more involved with indoor tasks which are
computer based. However, he feels that his lack of
mobility restricts what he can do in an office job –
he has always had jobs that were largely outdoors
based. This year he was turned down for a job
because the prospective employer felt Mark would not
be able to cope with working indoors all the
time.
As far as his personal life is concerned, he
feels he is a very honest person and the lack of honesty
following his injury was unpleasant. He realises how
easily he could have died in the injury and how
very lucky he was, and that has ‘turned his life
around’. He now enjoys each moment of each day.
Julia
Julia’s symptoms have not completely gone.
She still experiences stabs of pain when driving or
bending (which medication reduces) and gets numbness
down her left side to her legs. She has not
returned to her workplace because of her on-going
discomfort and spends her time caring for her
elderly and sick father. This mainly involves
getting his meals. Because of her
not being able to return
to work, there has been additional financial
strain of the family. Julia sees her future as a receptionist
without the pressure of computer work.
Although specialists’ opinion remained
divided, ACC did not provide cover for Julia’s claim because the
specialist medical advice provided to ACC determined
that her injuries were not caused by activities in the
workplace. Julia appealed this decision at the
District Court but the appeal was dismissed.
179
Philip
Philip feels better now and is only working
part time – 20 to 30 hours a week – as he feels he cannot
cope with a full-time job yet because he still
gets anxious and depressed. His family, he feels, are sad
for what he has and is going through as well as
at the loss of the potential they feel he had. Philip
admits that they bear the brunt of his illness and
its symptoms.
Philip is now working in a GP clinic. He
comments that though the different work is helpful, it can
be just as demanding. He has learned to ‘let go
and relax’. Overall, however, things are, he says, better
as he now has more free time and is treated
better by staff and colleagues.
Brian
Brian has not improved since the interview
but is no worse and better settled.
adjusted and confident – she was able to take a short
vacation overseas with her friend, Rose and
thought Brian was fine with the care he received in
their absence.
given her the confidence that she can do it again
in the future and take breaks from caregiving as
required.
and friends who, she feels, have let Brian down
badly as they have stopped visiting. The same is true
of his former colleagues and workplace – they
have never phoned or visited to ask about Brian and
Barbara
Barbara’s condition has worsened since the
interview. She has been back in the hospital twice - the
second time she was in ICU for six days. She is on
oxygen sixteen hours a day and her family are very
concerned about her condition. She is no longer able
to work (and feels she is unlikely to ever again).
ACC did not in the end accept her claim for
cover, because specialist medical advice provided to
ACC concluded that her incapacity was
primarily a result of smoking and not occupational asthma.
She is now receiving an Invalid’s Benefit.
Barbara has doubts over
during its investigation. In her opinion, the
employer should have been prosecuted. However, despite
these problems, Barbara seems quite positive about
her situation, commenting, ‘yeah, you’ve just got
to get on with it’.
John
John comments that he feels seventy percent
better now than when he was interviewed. He has
changed careers and has, because of advice from his
doctors, removed himself from the environment
that caused him the problem. He has not heard
from his employers at all – not even to find out how
he is doing. His family too, is doing better
and they believe the credit for this goes to the
inspector who gave them the initial direction to help
John.
Peter
Peter is still sensitive and fragile, which
affects his mobility. He and his wife are getting divorced but
Peter comments that his immediate family and
siblings are now in much closer contact with him.
Peter feels that he is more accepting of his
situation, and he is less self-conscious about his scars
around others. He is not currently employed and has
heard nothing from his previous employers.
Peter had joined an Honours programme at the
university and is due to finish in November. He is
looking forward to his financial independence once
he has finished. However, he took out a student
loan as he received no financial assistance for
retraining after his injury , either from his employers or
from ACC. He believes ACC has only continued his
weekly compensation, as they themselves had
not undertaken any retraining measures on his
behalf. This, he feels, is now going to apply other
180
pressures to his life along with the ongoing ones
suffered as a result of the injury . ACC cannot
provide retraining unless Peter’s skills are inadequate
for him to return to work. ACC is required to
provide weekly compensation until such time as Peter
regains an ability to work.
But overall, Peter is feeling positive about
the fact that his retraining and additional qualifications will
help his put his unpleasant experiences behind
him and he will be once again able to enjoy life to the
best of his abilities.
Sarah
Although Sarah still has aches in her thumbs
and hands and feels her wrists are weak, she feels a lot
more positive now than she was at the time of her
injury . She is completely rehabilitated and
independent, and so is able to work full time on the
farm. She is still is self-employed, with the same
staff member who was there at the time of her
injury , along with a new person she took on just after
the injury . It took her staff time to adjust to
her being back full time after being in an advisory role
for six months – she still feels excluded at
times.
Sarah’s children are doing fine and have
chosen their careers. But they are now extremely aware of
how quickly and suddenly injuries and death can
happen, and their worry for Sarah remains high, to
the extent of their checking on her regularly.
Paul
Paul is coping better and is feeling less
stressed. He says that dealing with customers is becoming
easier as there is now less noise than in his
former panel beating business. His family is also dealing
with the situation much better now with stress
levels for all of them being lower.
Ian
Jenny, Ian’s widow, still feels lost without
Ian and although she is planning her own future, she
wishes she did not have to. The family has been
getting on with their lives but still miss Ian terribly
and talk about him a lot when they get together.
The children still have many questions they would
have liked to ask him.
She began an intensive six-month computer
course, knowing that she would have to start working
from the following year in order to support the
household and realising that many jobs now require
computer skills. She also realises that at her age
jobs are not that easy to come by. However, the
training has given her confidence and has made her
more hopeful of the future.
Recent fatalities reminded Jenny and her
children of what they went through when Ian died, and it
has taken them several weeks to recover. People
have been suggesting Jenny re-marries, but the
thought upsets her as she feels it is disloyal.
Paradoxically, however, she questions herself in that she
feels she is living in the past. Overall though,
Jenny is hopeful of the future and is glad that the
children are doing alright.
Lisa
Lisa’s condition continues though the
severity has reduced considerably. She continues to have
acupuncture up to twice a week to maintain the
improvement and to provide relief. She has recently
returned to the gym and has not experienced any
problems. She uses this as an opportunity to keep
up with the stretching exercises.
Lisa wanted a challenging career in the IT
field and had been studying for an IT certificate. She began
a new job earlier this year in which data
entry makes up fifty to sixty percent of her daily tasks, writing
about thirty percent, and the rest is reading and
phone discussions. Since the data entry work is not as
intense or repetitive now as it was in her previous
job and she has more freedom and control of her
time and tasks, she can better manage her tasks
and thereby, her condition. Her current employer was
told of her OOS
condition at the outset and has been very supportive of her, as well as taking
health
and safety very seriously. Things are, she
feels, definitely better now.
Thomas
Although Thomas is still with the same
employer, his relationship with them is, in his words,
‘tolerable, only
just’. This is because he feels that they still blame him and are trying to use
his prior
drug conviction as the cause of the injury.
Thomas is looking for other employment which, ‘pays
better and treats the workers better’. On a
positive note, his family is doing well – his relationship
with his partner is strong and the girls are
doing well, are healthy and enjoying town life.
Martin
Martin is doing better and his family is
fine. He has returned to the same workplace, and is still
working on the pig chain.