OTGV #39 - Work Health

Broadcast Date: 13/10/03

Is the slightest increase of body warmth a raging fever in the morning of a workday?

Is going to work each day feeling like going back to school after a long holiday?

And after work, do you come home grouchy and fight with your family?

A yes answer to any of these questions and you may be suffering from job-related stress.

Hi Welcome to On the Grapevine with me Chong Ching Liang.

Last week the Health Promotion Board handed out its kudos to employers who actively work to encourage their employees to adopt healthy lifestyles.

However, as the cliché goes, it is a changed world.

There's no longer lifetime employment, in fact retrenchments always seem to hover round the corner, and workers can't even expect annual wage increments anymore.

This seems like a New Economy concoction that's guaranteed to affect workers' emotional and psychological well being.

Yet this issue is not entirely looked into.

The Health Promotion Board has a whole department dedicated to Work Health Promotion or W-H-P.

It has done sterling work in getting private and public sector companies to start health promotion activities at the work place.

However, W-H-P still hasn't moved into the area of looking into promoting better psychological health for workers.

And it is something that will need time to develop says W-H-P's manager, Mabel Chia-Yarrall.

"I think that will be evolving because as with Work Place Health, it started way back in the late 80s, so it is now in the 2000, it’s evolved and it has come a long way."

In Singapore, sometimes there's an assumption that a physically healthy person is BEST able to deal with stress.

Is this true though?

U-S's National Institute for Occupational Safety and Health or NIOSH tries to explain how stress can have a direct link to physical illness in its web-site.

NIOSH explains that stress creates something called the fight-or-flight syndrome in us.

This means an alarm is set off in the brain, which then responds by releasing various hormones preparing the body for defensive action.

Prolonged stress means that the body is placed constantly on the edge resulting in symptoms such as clenched teeth, an accelerated heart rate or blood pressure.

This may ultimately result in more wear-and-tear leading to chronic illnesses and lower resistance against infections.

The Journal of Occupational and Environmental Medicine reported that health care expenditures are nearly 50% greater for workers who report high levels of stress.

Mabel Chia-Yarrall says a recent international study suggests this may be true.

"Over 40 percent of workers feel they can't cope at their work. The ones who have no control at their work. They are more likely to have heart disease. It's not a cause-and-effect kind of thing but it contributes to the likelihood of having heart disease."

Singapore employers lag far behind their European or North American counterparts in looking after their employees' psychological health.

President of Motorola Singapore, Jeffrey Tan, suggests maybe the Asian culture is to be blamed.
"Within an Asian culture sometimes Asians tends to be a little more reticent and unwilling to speak up. But I think as a corporation we have been very successful in that regard; in terms of getting people to come out and say well, there really is no repercussion in this. We just want to be able to understand what are the challenges you face and to collectively work together in that regard."

Motorola like many of the western multi-national companies, have set in place an Employee Assistance Programme, or E-A-P.

An E-A-P uses a psychologist outside the company hierarchy who'll hear out an employee's personal or work-related problem.

The beauty of this process is it's conducted under strict confidentiality so there's no fear of repercussion when a worker seeks help.

This additional "listening ear" is sometimes an unavoidable alternative says Jeffrey Tan.

"Sometimes there are issues that will require a professional counsellor and we do have an Employee Assistance Programme which is part and parcel of the overall human resource support. And when necessary, we will get people to come in to help."

HPB's Mabel Chia Yarrall on the need to provide such a service.

"It's an important area to address and the EAP is an excellent programme to look at that because staff can go and confide to other people. But if you don't have a formal programme you could also identify some mentors. Not necessary their supervisors. It could be the canteen lady, it could be someone, you know who is not holding an official status. And someone whom staffs feel they can go to talk about family, their health or their workplace."

NISOH says a recent survey found that 77% of employers using EAPs experienced improved work productivity and reduced MCs by between 25% and 50%.

The local companies do try.

Changi General Hospital has an internal helpline though it doesn't have external counselors to ensure confidentiality says C-E-O T. K. Udairam.

"We have stress management programme ran by our psychologists and therapists. We have also got another programme for managing stressful situations that they have. So we have a whole group of 60-70 in the hospital, we have trained them and they basically have become buddies to people who are under stress."

Any move to enhance workers health must take a holistic approach.

Singaporean employers have done very well in the promotion of physical health.

But in this age of retrenchment paranoia and pay reduction frustration,

should more be done?

This is Chong Ching Liang for Newsradio 938.


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Related Links:

Newsradio 938 (now 938Live)
http://www.938live.sg/

Health Promotion Board
http://www.hpb.gov.sg/

National Institute for Occupational Safety and Health
http://www.cdc.gov/niosh/homepage.html

Journal of Occupational and Environmental Medicine
http://www.joem.org/

OTGV #38 - EHI-SARS

Broadcast Date: 29/09/03

Singapore was rocked by a SARS scare this month as a researcher was found to have the SARS coronavirus in his body.

The researcher is a post-doctoral student who worked at both the National University of Singapore and the Environment Health Institute laboratories.

The Health Ministry convened a review panel of overseas and local expert to audit the bio-safety practices of the labs working with the SARS virus.

Chong Ching Liang looks at what was uncovered in this week's On The Grapevine.

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The Environment Health Institute or EHI laboratories are rated at bio-safety level 3 or BSL-3.

This means that it can handle highly infectious diseases.

Yet a visiting researcher from the NUS caught something there and ended being the latest addition to Singapore's health statistics.

Hi, welcome to On the Grapevine with me Chong Ching Liang.

It is a huge bullet dodged.

Singapore could have the misfortune of accidentally starting another SARS outbreak through EHI's contaminated virus samples.

Acting Health Minister Khaw Boon Wan considers Singapore lucky that only one person is infected and that he didn't infect anyone else.

"And in this instance, I think luckily it is a minor trip. It is like a small earthquake. Richter scale 2.0. It alerts us to the possible fault lines. Important thing is to learn from this and tighten up procedures so that in future we can one prevent possibility of a real serious earthquake of Richter scale 7.1 or if bad luck something happen, we know how to respond to that. On hindsight looking at this development of the incident I would consider ourselves lucky."

And the incident revealed the fault-lines well.

The first fault lay with the researcher and his supervisor says the Head of the review panel, Dr Antony Della Porta of the World Health Organisation.

"He was working with someone who supervised him and I think the situation was that they rushed and they didn't put the appropriate protective equipment on."

But it extends further.

When the SARS outbreak happened, the EHI was recruited to join in the fight against SARS.

This generated certain complications says the Institute's head, Dr Ooi Eng Eong.

"On hindsight of course we could have put in better system in place. We anticipated the volume of the work would be low and the bulk of the work will be on dengue. We never anticipated to have to deal with SARS. And so on hindsight, yeah we could have done certain things better. And so we are going to take the opportunity and from here on to take stock of our situation, review our procedures, do our protocols, put in system in place and prevent this from ever happening again."

Dr Della Porta says Singapore and its public sector labs have varying standards making safety practices confusing to visiting researchers.

He says the fault-line extends from the individual to the laboratory, and to the lack of appropriate governing public policies on bio-safety.

"It's obvious that the lab put in enormous efforts and put in fantastic efforts during the SARS outbreak but it led to some inconsistencies where the lab was not really prepared to handle organisms at that level. And so to some extent, this incident occurred because of that. But it also occurs because Singapore doesn't have a set of legislative standards for biological safety, and that was one of our strongest recommendations, that that be introduced."

Dr Della Porta explained how the SARS bug may have contaminated the other virus samples.

"We can come up with many hypotheses. Obviously they are working in the same biologically safety cabinet. In theory they have decontaminated between handling the different viruses. If for example a plate or something to contaminated, say some weeks or months before hand, and you were to use that to grow the next stocks, that stock will have a low level of contamination. The next time you use that stocks, it will actually grow up more viruses."

He also took pains to explain that it wasn't the entire EHI laboratory being infectious.

One reason why the latest patient got infected was that he failed to wear the appropriate safety attire while he handled the SARS-contaminated West Nile virus.

In theory even if the researcher didn't catch the SARS bug, he could also come down with the West Nile virus.

Dr Della Porta says there may be new infection if appropriate actions aren't taken.

"I don't think it happen just at the one time. And that's why we are not sure which stocks could have the virus in and which of them might not so we suggest that the prudent and safe to do was to get rid of all stocks and start fresh."

Dr Ooi says his Institute accepts the review panel's call.

"First thing that we are going to do now is to go back and destroy all the virus. We are going to clean the BSL-3 lab and resume work in the BSL-2 lab. Fortunately, a lot of the important projects like the diagnostic test all that have been completed. We know at what level of the virus it can pick up and we know the anti-body tests how well it can perform. So a lot of the critical information on the diagnosis and patient information is already there. So in that sense I don't think it will affect the way we respond to outbreaks. Hopefully we will never see one more."

Analyst with GK Goh Research, Mr Song Seng Wun says this incident isn't likely to impede Singapore's aspiration to be a biomedical hub.

"The point to bear in mind really is that the biomedical clusters here are endowed mainly by the big MNCs from all over the world and some of the biggest names like for instance Schering-Plough who has an integrated society up in Tuas, runs their own labs for instance. They are an international company I would argue, I would even suggest that the standards that they maintain in the Singapore labs will be no different from what they maintained elsewhere as well. So I don't think this latest incident in the government-run labs will have any implications as far as these companies are concerned."

Mr Khaw Boon Wan has assured that existing gaps in bio-safety measures will be plugged.

The research on SARS may have encountered a small hiccup but it will continue.

Until the EHI has upgraded its safety practices, the research center won't be able to continue to grow the SARS virus.

But the Singapore General Hospital's laboratory still can.

No expert thinks Singapore is less capable to deal with the next SARS outbreak.

The fight goes on.

This is Chong Ching Liang for Newsradio 938.

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Related Links:

Newsradio 938 (now 938Live)
http://www.938live.sg/

National University of Singapore
http://nus.edu.sg

Ministry for the Environment's Environment Health Institute web-page
http://app.nea.gov.sg/cms/htdocs/category_sub.asp?cid=130

World Health Organisation
http://who.int/

GK Goh and Associates
http://www.gkgoh.com.sg/

OTGV #37 - Balaji's Concerns

Broadcast Date: 22/09/03

In a recent talk to tertiary students, Minister of State for Health and Transport Balaji Sadasivan spoke about the various threats to Singapore’s security.

Chong Ching Liang, who was at the Singapore Institute of International Affairs-organised event, brings you the highlights.

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It was a student seminar on international affairs.

But perhaps in current times, the focus of the day was on the negative aspects of international affairs.

The students were exposed to the pessimism of a world re-shaped by globalization.

Hi welcome to On the Grapevine with me Chong Ching Liang.

The Guest of Honour for the seminar was Dr Balaji Sadasivan the Minister of State for Health and Transport.

He started off by highlighting how globalization might have changed the world for the worse.

"This seminar title "borderless threats, boundless enemies" aptly describes the security challenges of today. In the past, the threat to a country came across its borders. Your borders are finite and you only have a limited number of neighbours. But today with globalisation, with air travel, international communications, every country in the world is your neighbour. And every country where there is a conflict, that conflict can come over and affect the security of your country. A good example is the Middle-east conflict and the terrorism it generates has an impact on us and the security in Singapore today."

Globalization and the Internet may have benefited research and communications but this benefit also extends to people seeking to topple the current world order.

But while terrorism using conventional bombs may be on everyone's mind, Dr Balaji touched on what he considered the more lethal threats facing the world today.

"I consider the most lethal forms of borderless threats: infectious disease and bio-terrorism. A single atypical pneumonia carrier in the province of Guang Dong was all it took to spark off the outbreak of SARS worldwide. The SARS incident has also brought to the foreground the need to adequately prepared against the threat of bio-terrorism. Defence against bio-terrorism has been on the top agenda since the anthrax attacks following 911. But the SARS outbreak and its impact on such a global scale has been a rude awakening for many countries and exposed the inadequacies of their emergency preparedness."

SARS is a disease that evolved from nature and as a result the outbreak had an idiosyncratic behaviour that epidemiologists worldwide could detect and subsequently subvert its spread.

Dr Balaji told the students that a bio-terrorist attack may come with synchronized attacks in different parts of the world or in a country.

This makes policing and containment ever more challenging.

The current New Economy has also been called the Age of Biotechnology.

Biotech firms are supposed to provide the push for the next phase of the global economic evolution.

But the proliferation of biotechnological research also has its downside said Dr Balaji.

"The possibility of bio-terrorism attacks is more probable than what is commonly believed. Biological weapons are sometimes called the "poor man's atom bomb" because it is relatively cheaper to administer than conventional or nuclear weapons. Some experts have estimated it to costs only about one dollar per square kilometer of disruption. With bio-technology on the rise, discoveries in life sciences may further increase the potency and diversity of bio-weapons. It is also becoming difficult to distinguish between legitimate research in biotechnology and ill-intended research in bio-weapons."

Half of Dr Balaji's 20-minute speech was on infectious diseases and bio-terrorism, the other half was on conventional terrorism.

No wonder when it came to the turn of the students to speak most asked him about threats and challenges posed by terrorism and regional conflicts.

The first question asked.

"I am Kelvin from Anderson JC. Sir you have pointed out the bio-terrorism can inflict more damage as it can be synchronized. However during the infection outbreaks of SARS we have lives lost so how can we keep the damage low when an unexpected virus attacks synchronized by terrorists have occurred?"

Dr Balaji's answer to Kelvin's worry.

"You must have sufficient intelligence to pre-empt it to make sure they don't even cross the border into Singapore. And second you must have adequate surveillance we have put into place. System to monitor what is happening so that if there is some unusual pattern then you immediately know something is wrong and investigate because it is easier to contain an outbreak when it is small than when it becomes widespread."

But this answer doesn't seem to assuage the students’ worries.

All who spoke seem fixated on the issue of violent conflict.

The last question of the day to Dr Balaji was on what he considered to be his main concerns.

His reply wasn't anywhere near terrorism at all, which might have surprised the students though it shouldn't have.

"Empower youth to deal with the current situation. If I were a young person today in the current situation, my biggest concern would be employment and career prospects. And how you empower young people to deal with that."

That was the only time economic challenges was raised in the half an hour that students had in their question and answer with the Minister of State.

Globalisation - seen in its most violent and sensational incarnation.

Ironic, in world made so much smaller by air-travel and the Internet, the ties that bind are seen as ties that constrict and force conflict, and not a forger of friendship.

This is Chong Ching Liang for Newsradio 938.

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Related Links:

Newsradio 938 (now 938Live)
http://www.938live.sg/

Singapore Institute of International Affairs
http://www.siiaonline.org/