Last reviewed 7 June 2016

Workplace health continues to move up the business agenda in the UK and while the core role of health and safety managers must be to protect the organisation’s workers from workplace hazards, they are increasingly being asked to take on wider responsibilities. Vicky Powell examines the BOHS Workplace Health Triangle and discusses how managers can use this to navigate the various aspects of their job.

Good health is good for business

Health and safety managers are beginning to tackle health risks in the workplace with the same commitment that has historically applied to managing safety at work. This is undoubtedly good news for employees and employers, given the obvious advantages of good health to workers and a number of studies proving the business benefits of healthy workplaces.

Tackling ill health and, in particular, highlighting and tackling the costs of work-related ill health has been strongly emphasised within the new five-year strategy recently unveiled by the Health and Safety Executive (HSE), entitled Helping Great Britain Work Well.

At the same time, the concept of worker wellbeing is also achieving greater prominence, with the Government urging employers to assist employees in this regard, eg by encouraging staff to be more active during the working day and offering healthier food choices in canteens to tackle rising national obesity levels.

Indeed, it is common for health and safety managers to collaborate both with human resources managers and occupational nurses and doctors, with the potential focus on topics such as employee wellbeing, anxiety and depression, sickness absence and occupational health surveillance. However, at times it can be difficult to distinguish exactly where one department’s responsibility ends and another’s begins.

Navigating these multiple functions can present challenges for the professionals involved in worker’s health and as a result, the British Occupational Hygiene Society (BOHS), the Chartered Society for Worker Health Protection, has designed a Workplace Health Triangle to help managers more effectively balance their various roles.

The BOHS Workplace Health Triangle

The BOHS Workplace Health Triangle defines health in the workplace as comprising three intersecting spheres of:

  • occupational hygiene — protecting people from workplace health risks

  • occupational health — caring for and managing the health of workers

  • wellbeing — promoting healthy lifestyle choices among workers.

Workplace Health Triangle

Steve Perkins, the CEO of BOHS, explains that occupational hygiene is largely about prevention of work-related ill health.

He says, “As occupational hygienists, we are on the preventative side, focused on stopping people getting ill from workplace risks. Occupational hygienists are not involved in the clinical disciplines of managing existing health conditions. Essentially, the job of an occupational hygienist is to investigate and control health hazards in the workplace, using science and engineering principles, in order to protect workers from serious and fatal illnesses caused by work-related activities.”

In contrast, the occupational health sphere has a clinical focus.

Steve Perkins says, “Clinical occupational health is the province of occupational health nurses and doctors. In the workplace they are actively engaged in helping workers who are sick or injured and this is where the path of occupational hygiene diverges from occupational health. As hygienists, our sole focus is on prevention, rather than cure. That’s why we are scientists and engineers rather than clinicians.”

Some common responsibilities of occupational health nurses and doctors might include:

  • undertaking medical checks and health surveillance

  • recommending appropriate adjustments in the workplace to help people stay in work

  • providing rehabilitation to help people return to work

  • giving advice on alternative suitable work for people with health problems

  • advising on ill health retirement.

Finally, there is the third area of wellbeing. Increasingly, employers are being urged to support the health and wellbeing of their employees. Examples of corporate wellbeing initiatives, often put in place by the organisation’s human resources personnel, have included:

  • programmes to encourage greater levels of activity among employees, eg by providing subsidised gym membership, sit–stand desks or shower and changing facilities to encourage cycling or running to work

  • provision of healthier food in canteens and vending machines to encourage better eating

  • smoking cessation programmes for staff.

“Interestingly, the wellbeing agenda has been embraced by large corporations and has a lot of traction in the media,” says Steve Perkins. This is a good thing of course, as it puts the responsibility back on individuals for maintaining their own general health. However, the danger associated with wellbeing is that it can be easier to focus on aspects such as healthy eating and exercise programmes at the expense of the control of serious — even deadly — workplace health risks that the employer has created and has a legal duty to manage.”

Collaboration is key

Of course, as the above illustration indicates, the three spheres intersect significantly, creating areas of commonality and collaboration.

Steve Perkins says, “In practice, boundaries can overlap and there are areas of mutual interest. For example, while the focus of occupational hygiene is on the prevention rather than the cure of occupational ill health, occupational nurses and doctors will be in a position to offer advice and signposting to employees and employers to help prevent occupational ill health. Similarly, hygienists may be involved in occupational health surveillance and HR personnel in display screen equipment checks, depending on how the organisation is structured. Certainly, to achieve the optimum health outcomes for workers, all the professionals involved in the Workplace Health Triangle will always collaborate, with an understanding and respect for each other’s roles.”

Unfortunately, managing workplace health risks is an area which historically has been overlooked.

“I don’t think people consciously side-lined health,” continues Steve Perkins. “We have this phrase ‘health and safety’ and we say it as if it’s one thing, but it came to mean something in common usage that in practice it didn’t stand for. For many years, ‘health and safety’ really meant ‘safety’, but health is different from safety. A fall from a ladder is an obvious risk that has an immediate, sometimes tragic, effect. In contrast, work-related health hazards are often invisible and silent while the long latency of their ill effects means that diseases emerge only years later.”

Managing work-related health risks can be complex and the BOHS Workplace Health Triangle forms part of the Society’s efforts to demystify and highlight this important area.


The latest available figures show that in 2013/14, work-related injuries and new cases of occupational ill health cost the UK an estimated £14.3 billion and the majority of this — £9.4 billion — was the result of occupational illness.

Proof, indeed, of the high price of failing to address work-related ill health in Britain.