The rapid development of workplace health protective and preventive services has been driven by government strategies and recommendations, as well as by the European Union legislation in the areas of health and safety at work and by the European Commission programme in public health. This was also largely due to the new demands and expectations from employers, employees and their representative bodies as they recognize the economic, social and health benefits achieved by providing these services at the workplace, thus providing the available knowledge and evidence necessary for the continuous improvement of workplace health management. Comprehensive workplace health management is a process involving all stakeholders inside and outside any business. It aims at empowering them to take control over their own health and their family’s health considering environmental, lifestyle, occupational and social health determinants and quality of health care. It is based on health promotion principles and it creates a great challenge to health, environment and safety professionals providing services, advice, information and education to social partners at work. It involves also taking care of considerable socioeconomic interest of all involved stakeholders. It has been shown in several instances that the business utilizing a well managed research based occupational health service can gain a competitive advantage by:

Protecting human health against health and safety hazards occurring in the work environment.

Promoting human health workplaces for all ages and healthy aging by appropriate work culture, work organization and support to social cohesion.

Promoting mental health, healthy lifestyle and preventing major non-communicable diseases using specific workplace health policies and management tools.

Maintaining work ability thus also employability throughout working life.

Reducing health care costs caused by employees’ and employers’ injuries, diseases, illnesses and premature retirement resulting from or influenced by occupational, environmental, life style and social health determinants

Using resources effectively, protecting the natural environment and creating a health supportive environment.

Improving social communication and literacy on health, environment and ethics.
This article series describes the author’s observations of various roles undertaken by the occupational health nurse. Whilst recognizing the wide variation that exists in occupational health nursing practice between different industrial and blue collar environments this series reflects the standards that have already been achieved where occupational health nursing is at its most advanced. However it has to be recognized that the level of education, professional skills and the exiting national legislation determines what role can be actually undertaken by occupational health nurses. Even more important is to remember that no one professional out of the exiting workplace health professions is now capable to meeting all health needs of the working population. A multi-disciplinary approach is needed to effectively manage the growing workplace health and safety demands in business today.The workplace health services use the skills of many professionals such as specialist occupational physicians, safety engineers, occupational hygienists, occupational health nurses, ergonomists, physiotherapists, occupational therapists, laboratory technicians, psychologists and other specialists. The role and tasks actually performed for the companies by representatives of different health and safety professions vary greatly depending upon legislative needs, scope of the workplace health concept perceived by directors, enforcement practice, the level of their education, position in the occupational health infrastructure, actions undertaken by insurance institutions and many other factors. Occupational health nurses are the largest single group of health professionals involved in delivering health services at the workplace and have the most important role to play in the workplace health management. They are at the frontline in helping to protect and promote the health of the nations working population.The role of the occupational health nurse in workplace health management is a new and exciting concept that is designed to improve the management of health and health related problems in the workplace. Specialist occupational health nurses can play a major role in protecting and improving the health of the working population as part of this strategy. Occupational health nurses can also make a major contribution to the sustainable development, improved competitiveness, job security and increased profitability of businesses and communities by addressing those factors which are related to the health of the working population. By helping to reduce ill health occupational health nurses can contribute to the increased profitability and performance of organizations and reduce health care costs. Occupational health nurses can also help to reduce the externalization of costs onto the taxpayer, by preventing disability and social exclusion, and by improving rehabilitation services at work. By protecting and promoting the health of the working population, and by promoting social inclusion, occupational health nurses can also make a significant contribution towards building a caring social ethos within the UK. This article provides guidance to employers and employees on establishing workplace health management systems within their own organizations. On how to determine and develop the role and functions of the occupational health nursing specialist within each enterprise and where to go for additional help and advice in relation to occupational health nursing.Changing nature of working life and the new challengesThe world of work has undergone enormous change in the last hundred years. To a large extent the very heavy, dirty and dangerous industries have gone, and the burden of disease, which came with them, in most European countries, has declined. However, the new working environments and conditions of work that have replaced them have given rise to new and different concerns about the health of the working population. Exposure to physical, chemical, biological and psychosocial risk factors at work are now much more clearly linked to health outcomes in the mind of the general public. Expectations of society in regard to health at work have also changed, with increasing demands for better standards of protection at work and for the improvement of the quality of working life. Employers are also recognizing that health-related issues, such as sickness absence, litigation and compensation costs, increasing insurance premiums, are expensive; ignoring them can lead to serious economic consequences. The best employers’ emphasize the important message that good health is good business, and that much can be achieved in this field simply by introducing good management practices.The Need for Workplace ManagementThere are approximately 400 million people who work in the EU Member States. The majority of whom spend more than one half of their waking life at work. However, fatal accidents at work are still common. The standardized incident rates per 100,000 workers in the European Union show that the fatal accident rate varies between 1.6 in the UK to 13.9 in Spain, with Austria, Greece, France, Italy and Portugal all above 5.0%. In the entire European region there are approximately 200 to 7500 non-fatal accidents per 100,000 employees per year, of which around 10% are severe leading to over 60 days absence from work, and up to 5%, per year, lead to permanent disability. It has been estimated that the total cost to society of work related injuries and ill health in the European Union is between 185 billion and 270 billion ECU per year, which represents between 2.6% to 3.8% of Gross National Product (GNP) in member states. The cost of workplace accidents and ill health, in both financial and human terms, remains an enormous, largely unrecognized burden in UK. The majority of those accidents and diseases could have been prevented if appropriate action had been taken at the workplace. Many responsible employers have consistently demonstrated that by paying attention to these issues this type of harm and the subsequent costs can be avoided, to the benefit of everyone concerned. Increasing concern is the growing awareness of occupational stress. Up to 42% of workers in a recent survey complained about the high pace of work. Job insecurity, fear of unemployment, lack of a regular salary and the potential loss of work ability are all additional sources of stress, even for those in employment.The wide ranging social and health effects of occupational stress on the health of the working population are well documented, for example 23% of workers surveyed claimed that they had been absent from work for work related health reasons in the previous twelve months. The resulting cost of sickness absence in United Kingdom is considered to be substantial. In the UK 177 million working days were lost in 1994 as a result of sickness absence; this has been assessed at over 11 billion in lost productivity. HSE statistics are encouraging given in 2009; only 29.3 million days were lost overall, 24.6 million due to work-related ill health and 4.7 million due to workplace injury. Much of this burden of ill health and the resulting sickness absence is caused, or is made worse by working conditions. Even where ill health is not directly caused by work, but by other non-occupational factors such as smoking, lifestyle, diet etc. Interventions designed to improve the health of the working population, delivered at the workplace, may help to reduce still further the burden of ill health. At present the socioeconomic impact of environmental pollution caused by industrial processes on the working population is uncertain, but it is likely to contribute further to the burden of ill health in some communities.

The truth? Email marketing still is incredibly popular today, and may just be the strongest possible online marketing strategy for any business. Depending on 2018 figures, email marketing continues to rank as the fourth most powerful marketing channel, behind search engine optimization, social media, and affiliate programs. These four marketing channels combined account for almost 60% of the content indexed by search engines each month. When used correctly, email marketing can easily meet and exceed the SEO results you’re looking for.Before delving into the email marketing software that will best suit your company’s needs, you first need to define your goals. What do you want to achieve from email marketing? Do you simply want to send new prospects your company’s promotional message or are you seeking to build long-term relationships with current and future clients? Do you need a response straight away or do you like to keep your audience interested in a more subtle approach? Any of these strategies can be met through email marketing, so it’s important to consider which approach will best serve your goals.For those on the hunt for immediate responses, email marketing software such as Roboform’s Aweber could provide a solid solution for immediate follow-ups. Email campaigns generally require follow-up on a very regular basis – at least once a week, but preferably daily. Roboform Aweber includes support for a wide range of email formats and auto-responders, including Aweber, Send Later, and ParetLogic. Autoresponders work as a one-stop solution to sending email messages to potential clients, including information about the company, product, or service being sold. While it’s possible to incorporate Aweber’s live chat function into an email marketing campaign, it may not be the best way to reach clients, since those in need of immediate information might not be ready to talk right away.GetResponse is another extremely easy way to send email messages to potential customers. Users familiar with popular email marketing software will be familiar with this program – GetResponse is often used by many small businesses to send out promotional emails that will bring in new leads, as well as keep older ones interested. This software has been around for a while, so there are plenty of options available to help get rid of that inevitable email marketing plateau. One of the best ways to use GetResponse is to incorporate it into a squeeze page that will be sent out after a lead sign-up occurs. A form for collecting the person’s name and email address goes into the body of the email, so all that’s left for the customer to do is to confirm their registration with a simple click of the “submit” button.The three most popular email marketing platforms all offer some version of a built-in autoresponder, whether for free or for a nominal monthly fee. WordPress is one of the more popular, as its user-friendly interface makes it easy for even a beginner to manage. For less than $5, you can install a WordPress blog and turn it into an effective sales tool. Since WordPress can be used for virtually anything, from simple informational pages to powerful advertising campaigns, it appeals to both businesses looking to stay on top of their competition, as well as individual sellers who need to impress potential buyers. WordPress email marketing services can make your life much easier by helping you take the best of traditional email marketing and turning it into an even more effective online marketing solution.Another popular email marketing strategy these days is using email newsletters as a digital marketing strategy. Newsletters are perfect because they’re both convenient and effective. They don’t have to be broadcast to everyone on your list, which eliminates the possibility of them being overlooked. Newsletters can be sent directly to opt-in email addresses or websites, which means you’ll have an easier time selling to people who aren’t on your list. Because newsletters are also easy to personalize, you can personalize them to fit the interests of the recipient, ensuring that the messages will help them take action.When using email marketing tools such as OptinMonster or a similar builder, the idea is to create as many accounts as possible to increase your conversion rate. OptinMonster can help you by giving you several different options for the name, description, signature, and link to your website. You can use the OptinMonster builder to create an unlimited number of email marketing campaigns for very little cost. With WordPress, you can easily personalize these optin forms to ensure that people who sign up for them to know where they’re going and what they’re signing up for.Another way to effectively incorporate email marketing through your autoresponder series is by using the Convertkit software. Convertkit is not only inexpensive, but it comes with thousands of pre-designed messages that are tailored specifically for every subscriber. This means that you can design separate messages for different categories of your subscribers, ensuring that each group of subscribers has something different to read and respond to. Once you have your list of subscribers, you can use the Convertkit software to help you send out emails at scheduled intervals or automatically based on when your subscribers have read their last message.

The most significant changes implemented by health care reform legislation will come into force on January 1st of 2014. These changes will have at least some impact on all individual and family policy holders and will also effect grandfathered policies that were effective on or before March 23, 2010. The positive changes will be for those who have been rated up or declined for health insurance in the past, for those who are currently or plan to become pregnant, and those whose income is less than 400% of the federal poverty level (I will be developing a worksheet to help you determine whether you are eligible for a subsidy). The negative changes will be for those who have an average or better than average health rating and for those on the younger end of the health insurance spectrum (20s-30s).If You’ve Been Declined or Rated UpIf you have pre-existing conditions, you are now in the sweet spot of health care reform. Starting in October of 2013, health insurance companies will be able to begin accepting applications for policies with a January 1st, 2014 effective date. These policies will not use health status or pre-existing conditions to determine benefits, to decline or charge higher rates. Moving forward, the only factors that will contribute to your health insurance premium is the plan you choose, your age, and tobacco usage. I am not yet aware of how currently effective policies will transition, whether your rating will simply be removed from your existing policy or whether you will need to apply for a new policy to get rid of your rating. I will know more as we get closer to the open enrollment period starting in October 2013.Maternity CoverageIf you are pregnant or are planning a pregnancy, starting on January 1st, 2014, all new health insurance policies will cover maternity automatically. It has not been made explicitly clear whether women who are currently pregnant will be covered. However, given the language of new policies regarding pre-existing conditions, I am comfortable in speculating that there will not be a waiting period for women who are currently pregnant and whose due date falls in 2014 and beyond. I will give updates as I become aware of definite regulations.Health Insurance SubsidiesHealth insurance policies sold through the NC exchange on or after October 2013, with January 1st effective dates, will be eligible for the subsidy. The subsidy amount will be based on your income and you will be eligible if your income is less than 400% of the federal poverty level. Based on income brackets, the premium you owe for your health insurance policy will be calculated as a percentage of your annual income. As previously stated, I will be creating a calculator to help you predict what percentage of your monthly income a health insurance policy will cost you. Health insurance agents will have the ability to assist you in purchasing a policy through the exchange.Young and/or Favorable Health RatingIf you are young and/or have a favorable health insurance rating, in almost all cases, you can expect rate increases in 2014. This rate increase is due to required pre-existing coverage and to rate variance shrinking from young to old subscribers. The purpose of coverage penalties for currently uninsured individuals is an attempt to bring in healthy policy holders and temper this increase. There will be high deductible plans available to those who want to satisfy the health insurance mandate while minimizing monthly premium expenses.There is a danger however, that individuals with low health care expenses will be driven to companies that have high complaint ratios, but offer coverage that fulfills the mandate, because those with poor health are likely to gravitate towards the health insurance companies that most reliably pay claims. If a scenario like this occurs, the reliable health insurance company’s premiums will be driven very high, which may even cause them to go bankrupt if they are unable to attract healthy subscribers. The tragedy of this type of scenario would be that the bargain basement health insurance company would come out on top for the very fact that they don’t do a good job of paying claims.Grandfathered Versus Non-GrandfatheredIf your health insurance policy was effective on or before March 23, 2010, and you have not made changes to your benefit level since then, you have a grandfathered plan. Grandfathered plans are not subject to many of the health care reform requirements, so if you are one of those who expects to see rate increases due to coming changes, it makes sense for you to stick with your current plan for now. If you are in your 20s or 30s, and/or have a very good health rating with your current plan then you probably fall in this category. However, in several years, up to 40% taxes will be applied to grandfathered plans that will cause them to lose their appeal. When these taxes are applied, then in almost all cases it will make sense to roll into a non-grandfathered plan.When to Enroll (Open Enrollment)Starting in October of 2013, you will be eligible to begin applying for a policy that falls under the new health care regulations. The initial open enrollment period will last for 6 months. After this time, there will be an annual open enrollment period at the end of each year (October 15th-December 7th) in which you may switch your benefit level or apply for a policy with a new company. Outside of open enrollment periods, you may change your policy during special enrollment periods created by certain life events such as moving your residence, losing group coverage, getting married, or having a baby.How to EnrollThe enrollment process for policies sold outside the exchange likely remain much the same as they are today with two major exceptions. Medical underwriting will no longer be a part of applications and enrollment periods will be restricted as described above. Policies sold inside the exchange will have the same type of applications as outside except there will be required proof of income if you are eligible for a subsidized policy. It is not yet clear what specific documentation or tax form will be required to substantiate claims of income.Current PoliciesIf you currently have a health insurance policy that you are happy with and plan to keep your policy beyond the open enrollment period, your policy will likely transition on January 1st of 2014 and be automatically modified to accommodate the new regulations coming into force. As previously stated, I am not aware of how ratings on current policies will be handled. They might stay on, in which case you would need to apply for a new policy without a rating to shed your old health rating. The more likely scenario is that non-grandfathered policies will automatically shed their health rating and transition into the new rating pool for that specific policy.What Should You Do?!There’s nothing to do immediately. As October moves closer and the NC health insurance exchange is up and running, I will be able to provide more specific details and directions in navigating the coming changes. I wish you well and invite you to contact me with questions or concerns.