Employers can positively impact worker health and well-being through ongoing job-related health, fitness, and injury-prevention initiatives.

Virginia Marshall (Halling), PT

Work Life Influence on Total Worker Health

Quality of work life (QWL) can be defined as the total quality of an employee’s work life at an organization. There are clear benefits to both employees and employers when work supports a healthy and safe lifestyle: Employees are more focused, productivity increases, and error rates and absenteeism are reduced.

More than before, especially notable with today’s tight labor market, full-time employees are spending upwards of 40 hours per week in the workplace—and many spend more time than that. Employees working in areas such as healthcare, distribution, and manufacturing are often pulling double shifts. This impacts an employee’s ability to get adequate rest, proper nutrition, and adequate stress relief, all of which can have a negative impact on health and well-being.

The relationship between job satisfaction and life satisfaction has been extensively reported on in the literature. Higher job satisfaction has been shown to predict higher life satisfaction. On the flipside, work dissatisfaction and job dissatisfaction are similarly positively correlated. Decades of research point to this fact.

Since employees spend such significant amounts of time in their workplaces, positive influences in the workplace should directly benefit employees in terms of overall health and stress reduction, and employers should directly benefit as well. The positive influence should be evident in performance, attendance, and workforce stability, as well as reduced medical and workers’ compensation costs.

Investments in employees in the form of comfortable break areas, providing adequate nutritious food, and work schedules that allow for adequate worker recovery can go a long way toward maintaining workers’ health and maintaining a stable workforce. Employers that strive to positively influence their workforce during working hours benefit directly and have a substantial impact on the quality of life of their employees’ family members and even on their communities.

A Proper Work “Fit”

An important factor to be considered is ensuring that employees are being “well matched” to the work and work environment in order to enhance an employee’s ability to be successful, productive, and safe. Determining if someone is “well matched” requires considering a combination of factors including education, training, tools, equipment, and even the physical capacity needed to be safe and successful. A subset of this factor, as it relates to physically demanding work, is for an employee to be provided with all of the resources necessary to maintain the ability to sustain work over time.

Applying Maintenance Concepts to a Workforce

Employers are very familiar with what it takes to maintain the tools and equipment necessary to produce their products and deliver their services. There are even entire departments dedicated to this, such as housekeeping and maintenance. Applying maintenance concepts to human beings is not an easy task, but it can provide substantial results.

Product Resources

The following companies offer products and services that can be helpful for industrial rehabilitation and work injury assessment:

DSI Work Solutions Inc

KEY Functional Assessments Network

WorkWell Prevention & Care

Preventive Maintenance in Worker Health

Preventive maintenence involves monitoring key parameters and implementing the necessary corrective steps to anticipate and be in front of any failure or malfunction.

Simple examples of this include changing the oil and adding fuel before a vehicle or machine ceases to operate. When we speak of employees, we are talking about illness and injury prevention. This should be based on scientific study and understanding as it relates to rest, recovery, and nutrition.

Nutrition: In many US companies, for example, there exists a real possibility to improve the health of workers by focusing on healthy nutrition options at work. Educating employees about healthy food choices and fueling strategies for the type of work the employee does as well as providing nutritional meals and snacks during their work shift could prove to be a worthwhile investment.

Training: Ongoing training related to the use of proper technique and tool use reinforces the benefit to the employee as well as the importance to work quality and productivity.

Exercise: Warm-ups in the workplace and education about good types of activities and exercises help to counterbalance work.

Edifying Example of Preventive Maintenance

As an example of how an employer can provide comprehensive preventive maintenance, I’d like to share my experience while spending a week working with a company in the South American country Colombia. I was both surprised and inspired by what was learned. The principles of rest, stress reduction, nutrition, and ongoing training were present and firmly in place.

The employees were doing highly physically demanding work in a tropical environment, which included high levels of heat and humidity. Taking this into account, the employer provided many resources to foster the health and well-being of its workforce.

This included a small but nutritious snack as well as water at every break. Breaks were taken in a cooler room. It was not a very big area, but it contained adequate seating for the group of employees taking their break.

The employer provided the main meal of the day in a cool and comfortable cafeteria, where simple fare was prepared on-site. The highly nutritious offerings included a protein such as chicken, a starch such as rice, a green salad with fresh limes to squeeze along with herbs for seasoning, and a small dessert (just two or three bites at most). There was definitely certain etiquette associated with the main meal. It was taboo to talk about work while eating, as this time was also part of de-stressing. Employees talked about sports and current events, but work conversation was not tolerated.

A physical therapist was a routine presence in the facility—present for the better part of two days a week. This therapist served primarily as a work coach, helping workers refine techniques to improve performance and reduce physical expenditure and risk of injury, and also to answer questions.

Employees overall appeared fit, at a healthy weight with good energy, were friendly, and the work atmosphere was a comfortable one.

Corrective Maintenance (Minimally Disruptive)

Another type of maintenance commonly found in the workplace is that of an immediate response to the earliest indications of impending trouble or malfunction. This is corrective action that has minimal cost and disruption. Today in business and industry we see this service for workers often referred to as an “OSHA First Aid” level of injury prevention or early intervention. Providing this level of service to employees with seemingly minor concerns and questions requires careful triage to assure that this “minimally disruptive” level of intervention is the appropriate response. It also requires careful monitoring during and after the intervention to be sure that the condition does not reoccur or worsen.

Many employees benefit tremendously from this level of support, as it keeps minor situations from escalating. It is human nature to ignore minor discomforts until they become an interference to the ability to work, which often leads to more major problems. Often seen in industry providing this level of service is the occupational health nurse (OHN). Increasingly, therapists, athletic trainers, and exercise physiologists are providing these services as they relate to musculoskeletal concerns—which remains a high cost driver for work-related injuries.

Corrective Maintenance (Substantially Disruptive)

This is the level that is most costly, both in terms of “repair” costs and lost productivity. The intention is that preventive maintenance avoids this—or at least it significantly reduces the likelihood of such occurrences. However, immediate corrective action with the intention of resuming normal operations as soon as possible becomes the goal.

Substantially disruptive corrective maintenance is unplanned or unscheduled preventive maintenance or curative maintenance.

As it relates to employees, this is when an illness or injury results in needing to be restricted in work activity or even needing to stay out of work altogether. Physicians commonly write restrictions or excuse the individual through a doctor’s note. If the employee’s condition is such that it requires even as little as 6 weeks out of work, the likelihood that the individual will have to be replaced (or not be able to return) increases substantially.

In order to efficiently and effectively facilitate an employee’s recovery and return to work in this situation, effective communication is essential. Otherwise, the length of the “disruption” will cause significant and perhaps irreparable damage to both employee and employer. Easy-to-understand documentation of the essential job requirements (essential functions) and physical demands to which the employee must return can facilitate the communication process greatly. Well-documented information can lay the foundation for work performance testing, to assure all parties with a need to know as to the current safe performance level of the employee. It is often a lack of such information that leads to major disruptions and the potential for the employee to lose or leave the job.


Workforce management—indeed, workforce maintenance—would benefit from a stronger emphasis on worker health, fitness, injury prevention, and even an injury management systems approach. Although occupational health nurses are the most prevalent in this space, physical and occupational therapists as well as other rehab professionals are playing an increasing role in assisting employers on the musculoskeletal side of the equation. However, there is much room for improvement across the board.

Science will hopefully assist us as research and outcomes guide us toward more predictive maintenance types of approaches, thereby making it increasingly possible to improve quality of work life and therefore quality of life over all for employees. PTP

Virginia “Ginnie” Marshall (Halling), PT, is chief executive officer of DSI Work Solutions Inc. For more information, contact [email protected].