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Historically, the focus of industrial health and safety (H&S) has been on safety and accident avoidance with relatively less attention to long-term occupational health other than via health monitoring and surveillance. The difficulty is the multiple overlapping health consequences that are difficult to separate, measure, and attribute to a source. Furthermore, many health problems occur later, not immediately on exposure, and may be cumulative. Consequently, it is difficult to conclusively identify the cause. Workers may lack knowledge of long-term consequences, and thus not use protective systems effectively. Compounding this is the lack of instruments and methodologies to measure exposure to harm. Historically, the existing risk methodologies for calculating safety risk are based on the construct of consequence and likelihood. However, this may not be appropriate for health, especially for the long-term harm, as both the consequence and likelihood may be indeterminate. This paper develops an instrument to measure the health component of workplace H&S. This is achieved by adapting the established World Health Organization Disability Assessment Schedule (WHODAS) quality of life score to workplace health. Specifically, the method is to identify the likelihood of an exposure incident arising (as estimated by engineering technologists and H&S officers), followed by evaluation of the biological harm consequences. Those consequences are then scored by using the WHODAS 12-item inventory. The result is an assessment of the Diminished Quality of Life (DQL) associated with a workplace hazard. This may then be used to manage the minimization of harm, exposure monitoring, and the design of safe systems of work.

Exposure to chronic harm is difficult to manage and prevent in industry. There is a need to better understand the state of mind when workers disregard safety processes and expose themselves to this type of risk. This paper develops a theoretical model of the reason why workers voluntarily expose themselves to occupational health and safety (OHS) hazards. This Risk, Agency, and Safety & Health (RASH) model proposes that people willingly expose themselves to chronic injuries via a series of risk-taking processes. This causal chain starts with personal motivation and over-alignment with organisational purpose (including impression management). Ideally, that motivation would be moderated by an ability to predict future harm consequences from the task at hand, but that mechanism is weak because it is difficult to predict cause and effect, the consequences are too far in the future, and the opportunities for vicarious learning are few. The motivation then causes misdirected creativity, hence the development of personally novel ways of solving the problem, albeit with greater risk of harm. Perverse agency then sustains actions that exposure the person to harm. Original contributions are the provision of a detailed explanation for risk-taking, and the integration of multiple well-established psychological constructs.

Successful implementation of Health and Safety (H&S) systems requires an effective mechanism to assess risk. Existing methods focus primarily on measuring the safety aspect; the risk of an accident is determined based on the product of severity of consequence and likelihood of the incident arising. The health component, i.e., chronic harm, is more difficult to assess. Partially, this is due to both consequences and the likelihood of health issues, which may be indeterminate. There is a need to develop a quantitative risk measurement for H&S risk management and with better representation for chronic health issues. The present paper has approached this from a different direction, by adopting a public health perspective of quality of life. We have then changed the risk assessment process to accommodate this. This was then applied to a case study. The case study showed that merely including the chronic harm scales appeared to be sufficient to elicit a more detailed consideration of hazards for chronic harm. This suggests that people are not insensitive to chronic harm hazards, but benefit from having a framework in which to communicate them. A method has been devised to harmonize safety and harm risk assessments. The result was a comprehensive risk assessment method with consideration of safety accidents and chronic health issues. This has the potential to benefit industry by making chronic harm more visible and hence more preventable.

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