Feature

Working for healthy workplaces

Black and ethnic minority workers are at particular risk of work-related ill health, says Allan Swann

As an occupational health worker it continually amazes me how many health workers underestimate the degree to which people’s health is damaged by their work. Doctors, for instance, spend a laughably insignificant portion of their long training on occupational health.

This ‘blindness’ extends to the question of ill health among ethnic minority populations. It is generally accepted that these communities’ disadvantage extends to their health and that resources should be targeted to counteract this. Health problems to which these groups may be genetically predisposed, or which arise from diet or from poverty, have all become proper issues for concern. But work rarely gets a mention.

Four years ago Sheffield Occupational Health Project workers became convinced that black workers in Sheffield were having their health damaged by their working conditions to an even greater degree than indigenous white workers. They set up the Black and Ethnic Minority Occupational Health Initiative (BEMOHI) in 1989-90, to address this neglected area of need.

They were first alerted to the issue by the very high numbers of Yemeni and Pakistani steelworkers and ex-steelworkers with noise-induced deafness (97 per cent of 2,000 surveyed had more than 10 decibel loss). The explanation lay with the fact that they had been recruited to noisy jobs, were less likely to be promoted out of them, and were rarely given advice and training in their own languages. It seemed likely that this disadvantage would disproportionately expose them to many other risks at work. And so it has turned out.

BEMOHI now has five workers (two Pakistani, one Afro-Caribbean, one Arab and one white). We run several community-based occupational health advice clinics and work in many of the surgery-based clinics run by Sheffield Occupational Health Project in areas where there are a significant number of ethnic minority patients.

Thousands of workers have won compensation awards for occupationally-induced ill health or disability with our help and there have been some successes in improving workplace conditions. An important aspect of our work is education: informing workers of their rights, warning them about hazards, and persuading people that they do not have to accept damage as their lot.

We still meet many workers with deafness problems, but also with various lung diseases and respiratory illnesses caused or worsened by their exposure to dusts and fumes at work. Effects of exposure to chemicals, repetitive strain injuries, and stress-related illnesses are also common among ethnic minority workers.

An illustrative example of how disadvantage works is the prevalence of musculo-skeletal problems among Afro-Caribbean female health workers. Back injuries are a common problem for all nurses and domestics but the problem is often compounded for black workers, many of whom were recruited to the unpopular night shifts, where they have remained ever since. These shifts are more likely to be run with very few staff and so the risk of night shift staff damaging their backs while struggling alone to help a distressed patient is all the greater. The move into so-called care in the community also seems to have affected Afro-Caribbean workers disproportionately, as it has led to much more single working and a decrease in trade union protection.

The logic behind setting up BEMOHI was not just that there was an area of special need, but also that special advice techniques and facilities would be needed. This has been amply confirmed by the Asian women’s survey, which BEMOHI was heavily involved in developing. It has shown that many Asian women work, few are given health and safety advice, and many want advice and help from an Asian woman. Language skills are an obvious need, but it is also necessary to recognise and overcome the understandable distrust these communities have of official or mainstream institutions.

BEMOHI has already won respect for its work. Much remains to be done in informing and empowering communities, but even more is to be done in persuading the central institutions of the health service, the law and the benefit agencies, among others, to recognise occupationally-induced ill health as a significant aspect of ethnic minority disadvantage.

BEMOHI is concerned to gear its work to changing employment patterns in ethnic minority communities. For example, we have produced advice leaflets in Cantonese for catering workers. We will develop the leaflets and translate them for Pakistani and Bengali workers. Similarly we are developing a questionnaire for taxi drivers on occupational health, which will provide a basis for advice material.

But as a result of pressure on the budget of the family health services authority, a principal funder of BEMOHI and SOHP — both voluntary sector charitable bodies — there is a very real threat of our grant income being drastically reduced in the near future. As well as the threat to our own jobs, yet another short-term decision could result in continuing and unrecognised damage being inflicted on black and white working people.

BEMOHI and SOHP are based at Mudford Building, 37 Exchange Street, Sheffield S2 5TR. Tel: 0742-755760/765694.