Is the office out to get you?

Feeling sick and tired? If the thought of entering the office fills you with nausea, you’re not alone. Chances are if you’re sick, so is your office. 
THEY’VE solved a lot of today’s problems in those sci-fi shows on the telly. Deep sea travel, deep space travel, intergalactic peace mere trifles, really. What today’s earthlings really need to know is: How do the crews of these futuristic ships manage to live for months without fresh air or sunlight, while staying as fit and cheerful as a winning team of football jocks? No one in Star Trek or Seaquest DSV ever has sore eyes, a rasping cough and lethargy after a tough day on the control console. They never find their sleeping quarters are sickeningly hot, while those working near the floor-to-ceiling windows catch endless colds and must wear scarves to ward off the draughts. And despite all the high-tech gizmos, no one ever seems to develop an allergy to the chemical fumes from computers, desks, carpets, and room fittings.

In short, there is no resemblance to real life in the average high-rise office building of today. Somewhere along the way to warp drive, scientists must have sorted out the problems of sick building syndrome.

We should be so lucky. Many of Australia’s two and a half million office workers now spend more than 90 per cent of their waking lives in artificially controlled environments that are potentially hazardous to the health. The result, for a few human occupants, is a severe illness such as an allergic reaction or asthma attacks.
Many more suffer frequent respiratory infections and a low-grade malaise in worktime that disappears when they leave the office, a pattern known as sick building syndrome or building-related illness.

Add to this the computer-age problem of injuries to hands, arms and shoulders from overuse of keyboards, and the health consequences of a sedentary lifestyle (absenteeism from illness due to poor eating and exercise patterns is estimated to cost Australian industry more than $6 billion a year), and you begin to wonder: Is life in the office bad for your health? The answer is more likely to be “Yes” if you work in a new building, one that is 12 to 18 months old, or a recently refurbished one. The World Health Organisation says that up to 30 per cent of such offices will be affected by sick building syndrome, leaving occupants with symptoms such as wheezing, coughs, headaches, undue fatigue, sore eyes, noses and throats, and nausea and dizziness.
It is not known how many people are affected, and it is suspected that many problems go unreported.

This makes it hard to tell how serious the problem is. Cynics dismiss the syndrome as the product of neurotic people making up symptoms, and they are the kinds of symptoms easily faked or imagined.
Some overseas research does indicate that psychological factors are at play; workers who have boring jobs and little control over their environment are more likely to complain. The Welsh School of Architecture surveyed 2000 office workers and found some direct links between buildings and ill-health but also discovered, says the school’s Nigel Vaughan, that “You can be working in a sod of an office with all the classic signs of a sick building and still feel fantastic as long as your bosses respect you and there’s no threat of being thrown on the dole.” But consultants, such as the team from the National Occupational Health and Safety Commission’s Worksafe Australia, say they nearly always find a physical cause for health problems in buildings that they are called in to investigate. It is true that some people are affected by low levels of contaminants and others not, they say, but that is because they are more sensitive to them, just as some people are affected by cat hair or pollen and others are not.

The major culprit, in many cases, is poor air-conditioning. Peter Williams, a senior lecturer in the faculty of architecture, building and planning at Melbourne University, has surveyed nearly 600 Melbourne office buildings in the past six years and found few came up to scratch. “It’s staggering how much of the building stock is affected, ” Williams says.

Nearly half the air-conditioning systems did not allow access to areas that needed to be kept clean and dry to prevent them becoming a breeding ground for fungi and bacteria, including the potentially fatal legionella. Eighty-two per cent failed the current Australian standards for fresh air. Many recirculated too much stale air because the building managers believed it was cheaper than having to heat or cool fresh air, Williams says.

In 63 per cent of the buildings, the fresh air intake itself was contaminated, often because it was stupidly situated and affected by car emissions from the basement carpark, or by the system’s outflow vent (drawing back the stale air the system was trying to expel). Some buildings had no fresh air intake at all.

Such faults are exacerbated in new or newly refurbished buildings because much of today’s furniture, carpets, curtains and fittings give off gases, known as “volatile organic compounds”, when new.
The vapors come from substances such as glues, solvents, fire retardants, and the foam in upholstery; new computers can emit gases when the plastic and wiring inside them heats up.

It is an invisible plague, and the toll on health is much harder to see or understand than, say, the problem of the manual worker who does his back when a crate falls on him. That makes sick building syndrome a natural target for critics, who dismiss it as a fantasy of the workshy. But the last time cynics tried to brush aside a new-fangled occupational health problem, they were proved badly wrong.

In the mid-1980s repetitive strain injury was nicknamed “kangaroo paw” and derided as a form of hypochondria unique to Australians.
Now overuse injuries account for 60 per cent of all workplace illnesses in America, making them the fastest-growing occupational ailment in that country.

In contrast Mark Towler, health and safety officer with the Victorian Trades Hall Council says overuse injuries in Australian offices have plummetted over the past decade due to changing attitudes by employers, who now take the problem seriously, and
to design changes in computer equipment and office furniture. Multi-skilling of employees as companies downsize also means that fewer people are now tied to keying at high speed for eight hours a day, he says.

Victoria’s WorkCover figures show that RSI claims by workers in a group of office-based industries have fallen from 922 in 1985- 86 to 186 in 1993-94.

But the jury is still out on other potential computer health hazards, such as radiation exposure and eyestrain, Towler says.
It is possible that staring for hours a day at a screen damages the eye’s ability to adjust focal length, which would impair the ability to drive and other tasks.

What is clear is that sitting in an office day after day, with little or no vigorous physical exercise, takes its toll on health.
Regardless of the population of an organisation, the most common and costly health problems are always consistent: high blood pressure, high cholesterol, smoking, obesity and poor physical fitness.

Says Julie Bond, programs manager for Life. Be in It: “People sit down from the time they get in until morning tea, except to get up to walk a short distance to the coffee machine, where they have a coffee which accelerates their blood pressure. Then they sit until lunchtime when they walk to the canteen . . . More and more research confirms that your body can’t cope as well with stress when you’re run down and inactive.” This, at least, would seem to be under the individual’s control.
Bond says that 30 minutes’ exercise a day, the equivalent of a brisk walk at lunchtime, would be enough to improve fitness. But even that time might be hard to find, as unpaid overtime increases in the struggle to hold on to jobs while unemployment is high.

The cost of all this is not only measured by the toll on worker health and well-being. It has a significant impact on the company bottom line as well. Professor Wai-on Phoon, head of Worksafe Australia’s occupational medicine unit, says that sick building syndrome “does affect productivity; some people just feel so tired”.

David Rowe, senior lecturer in building services with the University of Sydney, set out to find the monetary cost of an uncomfortable office environment. “One hypothesis is that if people were feeling unhappy about the place they work in and decided
they were sick enough to take time off from work, it’s quite possible that they might take more time than they would if they had an attractive workplace. If each of Australia’s 2.5 million office workers took an extra half a day of sick leave per year, it would cost industry about $130 million a year.” At least one case has made it to court. In March the Sydney solicitors Lane and Lane sued the developer of their building, over alleged fundamental design shortcomings in the air-conditioning of its city offices. The case was settled out of court, but not before it had eaten up the not-inexpensive time of six barristers, five solicitors and a Federal Court judge.

Generally, though, the current economic climate militates against solving many sick building problems. Buildings will continue to be built on the cheap by developers who cut corners; to be managed by companies that cut maintenance costs by failing to do maintenance; to be fitted out by tenants who have no idea about what their floor- to-ceiling partitioning is doing to the air flow, or about the consequences of cramming too many people into too small a space.
The problems are fixable, Williams says, “But they cost. They certainly do cost.” That’s the thing about sci-fi, of course. In its fantasy world, no one has to deal with the realities of stumbling economies, cut-throat competition, the need for organsations to be lean and mean. You don’t find Star Fleet Command cutting corners because the budget is tight this year. In real life it is different; who needs the challenge of sci-fi’s windswept planets and roaring beasties when our own buildings are out to get us? Beam us up, Scottie.

First published in The Age.

Falling through a larger net

Mandatory reporting of child abuse has led to more detected cases. But will the system be able to protect these children? 

SHE HAD four children and post-natal depression. As part of her hospital’s treatment program, she and her family were interviewed by a social worker who asked her eldest, a 12-year-old boy, how his mother’s depression affected him. The boy said that sometimes his mother got angry and slapped him.

The social worker, feeling she had to report child abuse, notified a child protection agency; the case was substantiated but no action was taken. The mother was devastated by the report and never returned to the clinic. “For the boy, the pain of betraying his mother will probably last longer than the pain of her hand,” says Dorothy Scott, a senior lecturer in social work at Melbourne University. “For the baby, the risk from the mother’s untreated depression is probably greater than it was before . . . It will probably be a long time before (the mother) will ask for help again.”
Stories like this confirm some of the fears of those who had opposed the introduction of mandatory reporting of child abuse. Many professionals believed it would lead to “defensive practice”, with anxious workers overreacting and families being more hurt than helped.

They argued that money would be poured into investigating child abuse at the cost of services to help prevent it, and that the system would become so overloaded that it would be even harder to pinpoint the cases that could end in serious injury or death. How do you pick the Daniel Valerios out of the 31,000 notifications predicted for this year?
But mandatory reporting or at least, the publicity surrounding its arrival has also done what the public hoped it would, picking up thousands of abused children who might otherwise have gone undetected.

Reports of suspected abuse have risen by more than 60 per cent, from 76 a day to 120 a day, in the 18 months since mandatory reporting was introduced.

Notifications by mandated professionals, such as doctors, nurses, teachers and police, have risen only by an expected 9 per cent. The welter of new reports has come from ordinary people, concerned relatives, friends and neighbors of children. The substantiation rate the number of reports found, on investigation, to have been justified has remained stable at about 23 per cent, so it is clear that more genuine cases are being picked up. This is despite the fact that reports from ordinary people are the ones least likely to be substantiated.

There are many more children in the safety net; the question is, can the net keep them safe?
Dorothy Scott fears that the flood of notifications will impair the system’s ability to handle them. “In America, mandatory reporting actually led to more children being killed. The system gets so overloaded that looking for the dangerous case becomes even more like looking for the needle in the haystack. Response times become delayed, so that rather than getting to an urgent case in 24 hours, it becomes 48 hours.

“There will be cases that mandatory reporting flushes out that we would otherwise not hear about. The question is, on balance, does it do more good than harm?” Carol Russell, chief executive officer of the Children’s Welfare Association of Victoria, says the response to mandatory reporting overloaded both the state child protection service and voluntary agencies.

“The level of bureaucratisation in Health and Community Services understandable with a government department that is under scrutiny all the time because of the difficult decisions it makes can mean that action isn’t taken quickly enough,” Russell

“You make a call, but the case worker, who is a junior officer, has to check it out with a senior officer, and it can be a week or maybe two weeks before you hear anything back. Obviously they have to make a decision about how urgent a case is, but our experience has been that it takes a long time just to make that decision.”
Agencies that offer family support services now have long waiting lists and a clientele that consists mainly of families about which there has been a notification, Russell says. This means the services are unable to help families in crisis who have not yet been driven to abuse and preventive work has had to be cast aside.

Russell says: “If you were to go to a service and say, `I think I’m in trouble, please help’, the service would say, `We can’t help you.

Our waiting list is six weeks long, and most of those people have been referred to us by the department and so have priority’. There have been situations where people have gone in and asked for help and been refused, and six weeks later been referred again, this time through the child protection system after abuse has occurred.”
In August 1993, Australia saw what could happen in an extreme case of a parent refused help. Reports of a six-year-old boy savagely bashed to death on the NSW coast by a gang of teenagers in a park ended with the arrest of the boy’s mother and her lover, who admitted having beaten the child for hours. Three weeks before his death, the mother had gone to authorities begging that her five children later found to be covered in old bruises and burns be placed in foster care. Her plea was refused.

In Victoria, the child protection system was recently attacked by a parliamentary inquiry into child sexual assault. The Crime Prevention Committee, chaired by Liberal MLC Ken Smith, accused protective services of trying to “deflect” notifications to cut down on those requiring further action and said many of its investigations were “most inadequate”.

The report, Combating Child Sexual Assault, said that protective workers’ guidelines encouraged them to assess cases initially according to how they view the notifier, and to visit the family only if phone calls to other professionals failed to assure them of the child’s safety.

“A child protection system which has the underlying philosophy of deflecting as many cases away from itself as possible, and where a visit to the family is seen as a last resort, even where the abuse is substantiated, . . . can in no way meet the protection needs of children,” the report said. “In many cases, this one notification may be the only chance that a child has of coming to the notice of protective workers.”
The committee discovered many cases where workers suspected that the child concerned had been assaulted but were unable, in their early attempts, to gain either a disclosure from the child or supporting forensic evidence. “Budgetary and staffing limitations meant that they were unable to devote any additional time to the case and the offending was left to continue,” the report said.

This sounds dangerously close to Dorothy Scott’s description of the situation in the United States where, she says, mandatory reporting overload has led to a legalistic approach to assessing children’s risk. Says Scott, “There, the question being asked is no longer `How is the child?’ but `Do we have a legal case?”‘ Committee chairman Smith acknowledges that it would be impossible to investigate 30,000 cases a year, “But it’s got to be more than just phone calls, more than a worker just deciding the mum on the other end of the line is a bit upset, or deciding not to investigate because there were no witnesses and therefore no proof.”
With suspected sexual abuse, he says, several personal visits might be necessary if the investigation is to be adequate: “You won’t always get a child to disclose at the first discussion. They need to build a rapport with somebody.”
Penny Armytage, assistant director of protection and care with the Department of Health and Community Services, says there was a crunch after the introduction of mandatory reporting. But the Government has since poured extra money and people into the system, and case loads and response times have returned to previous levels, she says.

An extra $19.3 million in recurrent funding has paid for 109 new protection workers and extra administrative staff; $4.5 million of it will go to family support services. More than 90 per cent of investigations this year began within five days of notification, Armytage says, and 57 per cent of notifications in 1993-4 were investigated with personal visits.

Armytage says it is important that workers filter notifications, partly to ensure that the cases they investigate involve the potential of significant harm to the child and justify intervening in a family’s private life. “We believe that our screening is appropriate and necessary. We have learnt from international research and professional literature that . . . more and more resources are being directed to investigating cases that are not substantiated at the cost of services provided for children and families who have clearly
been identified as at risk.”
Armytage and others say that child abuse is becoming more prevalent as a new generation of social problems hit children. An increasing number of substantiated cases involve parents who are drug-dependent or alcoholic, who have chronic psychiatric illnesses or who are intellectually disabled. Armytage says workers are also seeing younger children who have been exposed to “horrendous” sexual abuse.

But although battering and sexual abuse cases generate the most publicity, neglect is the most common form of substantiated abuse.

Scott argues that it is wrong to allow the most extreme cases to drive policy.

She says society must move past the voyeurism and vengeance generated by cases such as Daniel Valerio’s, past the simple urge to rescue children from evil parents, to address the broader issues of problems in families. She emphasises the importance of services such as maternal and child health nurses and school guidance counsellors, access to both of which has been limited by the Kennett Government, in helping families avoid abuse.

Russell says ordinary people have a role in this, too. “It’s very important that we acknowledge that we wouldn’t have picked up some of the cases of abuse if we hadn’t had such community interest in the mandatory reporting debate. (The flood of notifications) is about the community being more aware and wanting to make sure that our kids are safe.

“On the other hand, it’s too easy to pick up the phone and think that someone else will fix it, that someone in the government will take over for you, and you won’t have to do anything about it any more. You have to sheet a little bit of it back to the community: What can you do to help the situation?
“If you see people in distress, if you have neighbors where the kids are really difficult and the mum needs time out, give them a hand. Do a bit of babysitting; join a voluntary agency; offer foster care. This is what you, Mrs X and Mr Y, can actually do to help prevent child abuse.”

First published in The Age.