Less than one workplace fatality per 100,000 workers in 10 years' time - that was the target Prime Minister Lee Hsien Loong set for Singapore in a recent address to this year's World Congress on Safety and Health at Work.
Singapore successfully achieved its previous target of less than 1.8 fatalities per 100,000 workers in 2014, but the rate has risen to 1.9 in the past two years. What more can be done to bring down the current rate of 1.9 to less than one?
The way forward to hit and sustain the target is the Vision Zero approach, launched in 2015 by the National Workplace Safety and Health Campaign to develop a mindset that all injuries and ill health arising from work are preventable, and ultimately zero harm is possible.
Since then, the Workplace Safety and Health Council has worked with businesses to implement it in their organisations.
Building on this momentum, the campaign this year reiterates the critical importance of keeping safe and healthy in the workplace with the call to "Prevent all injuries. Go home safe and healthy".
And in recent years, there has been growing global support for the Vision Zero movement. Countries such as Australia, Canada, Finland, South Korea and New Zealand have developed policies based on Vision Zero values and principles.
In October 2015, the Group of Seven (G-7) created a Vision Zero Fund to work towards zero fatal and severe work-related injuries and diseases in sectors that link to global supply chains as well as to strengthen institutional structures such as employment insurance and inspection frameworks.
To many, the Vision Zero approach appears to focus predominantly on tackling workplace safety hazards, and, at most, also occupational and work-related diseases.
It is imperative for Singapore to adopt a complementary wider perspective beyond meeting zero accident targets or preventing occupational diseases, one which recognises that the prevention and management of non-communicable diseases like diabetes and hypertension are equally important. This is because they affect a worker's safety, as well as capacity to work. This calls for the Total Workplace Safety and Health (Total WSH) approach.
Conceptualised by the National University of Singapore Saw Swee Hock School of Public Health in collaboration with the Manpower Ministry in 2012, the Total WSH paradigm is one which emphasises the interconnection across work, safety and health to better protect and promote workers' health and safety.
We must first understand its underlying three-way work-safety-health framework, and how these components interact.
The work-safety connection is the one most obvious to many, with frequent reports on workplace injuries and fatalities that result from poor work practices or dangerous work conditions, and the impact on productivity and profit margins. For instance, long-term exposure to excessive noise will result in noise-induced hearing loss - a common notifiable occupational disease - in a worker and could put him and his colleagues at greater safety risk.
It is also easy to see the work-health connection. Elements which we are exposed to at the workplace can affect our health - for instance, exposure to compounds such as wood dust, grain dust or certain chemicals can cause occupational asthma.
Ill health in turn affects productivity. The economic cost of work-related injury and illness to Singapore in 2011 was estimated to constitute 3.2 per cent of gross domestic product, or $10.5 billion.
What is often overlooked is the impact of health on safety risks. PM Lee noted: "Ill health is a key contributory factor in more than one-third of our work-related fatalities in Singapore."
Research has proven that workers with certain adverse health risks and chronic diseases like diabetes and hypertension are not only less productive, but are also at higher risk of safety lapses.
An unwell worker who experiences frequent giddy spells is more prone to falls, which result in injuries or even death. Diseases such as diabetes, hypertension and high cholesterol pose significant economic burdens in healthcare costs and productivity losses. The Saw Swee Hock School estimated the annual economic cost of diabetes in the working population to exceed $2.5 billion by 2050.
The risks of chronic diseases grow with age. With Singapore's ageing population and increasing life expectancy, individuals look set to stay in the workforce for longer periods. The number of workers who suffer from chronic diseases will rise, and poorly managed chronic diseases will further compromise safety and productivity.
The recently published US-based Rand Wellness Programme Study found that the returns to employers from the disease management component of workplace wellness programmes were more than three times the amount put into them, with the return on investment being US$3.80 (S$5.10) for every dollar spent. It makes long-term investment sense for employers to add the disease management component to their workplace safety and health efforts.
The Total WSH addresses the health-safety gap by providing an integrated approach to managing occupational safety and health issues holistically.
In this approach, a comprehensive assessment takes the safety and health status of an organisation into consideration, recommends customised intervention programmes, followed by the monitoring and review of these programmes. The Total WSH service can help equip employers with the means to tackle chronic diseases at the workplace, including diabetes, hypertension and high cholesterol.
Intervention programmes for disease screening, treatment and management - such as the Chronic Disease Management Programme - can be incorporated into safety and health efforts at workplaces.
Workplace safety and workplace health are not isolated issues. Risks at the workplace clearly affect health, and the health condition of an individual may modify the risks at the workplace.
Adopting both Vision Zero and Total WSH will help bring down accident rates and help Singapore reach its target by 2028, or perhaps earlier, and ultimately enable individuals to enjoy long, healthy and productive lives, beyond productivity and bottom lines.
•The writer is associate professor at the Saw Swee Hock School of Public Health, National University of Singapore.
