What does good health look like? Development of leading occupational health performance indicators

Occupational Health and Safety (OHS) performance indicators are important to ensure effective management and contribute to organizational decision-making processes regarding health risk mitigation strategies. Recently, the resurgence of "black lung" and silicosis have increased awareness of work-related health impacts on workers and industry. Occupational health impacts are often under-reported compared to occupational safety impacts. Where they are addressed, the emphasis is typically on lagging indicators such as illness and disease rates. The inadequacy of lagging indicators such as workplace compensation statistics in revealing the full extent of worker illness and disease is widely acknowledged. A framework of leading indicators could provide workplaces with tools that can measure occupational health outcomes more effectively, allowing for early intervention and risk mitigation.

This study aims to identify reliable leading health indicators that can support workplaces to identify and manage risk factors that impact worker health, using a mixed-method review approach. Initially, a literature review to identify and rate the quality of key occupational health indicators was conducted, followed by a qualitative survey to collect stakeholder feedback. Indicators were stratified for quality and type (leading or lagging), in the categories of leadership, strategy, organization, employees, and partnership. The survey results were collated to reflect categories and sub-categories of Occupational Health and Safety (OHS) management system areas.

Of the 153 leading health performance indicators that were identified through the literature, 28 (18%) were evaluated as high quality, 80 (52%) as medium quality, and 45 (29%) as low quality. A total of 106 lagging indicators were extracted, 42 rated as high quality (40%), 39 (37%) as medium quality, and 25 (24%) as low quality. Results of the data review indicated that occupational health performance indicators centred on risk control systems (n = 7; 25%) and communication (n = 4; 14%) were rated as higher quality leading indicators. High-quality performance indicators pertaining to employees (competence, awareness, and involvement) were lacking (n = 2; 7%). A framework of leading indicators that can be used by companies to evaluate and ensure health risks are controlled is proposed.

To effectively address occupational health risks, including injuries and illnesses that develop over time due to hazardous exposures, it is essential to integrate OHS metrics as a core component of health and safety management systems. This research established a baseline framework to assist the industry in establishing key occupational health performance objectives enabling them to achieve their duty of care to protect the health of workers.