Objective To address the risk factors for coronary heart disease (CHD) and back pain in workplaces employing less than 50 people in the Merthyr/Cynon area of South Wales.
Design A comparative study of small workplaces randomly allocated into either CHD or musculo-skeletal intervention groups.
Setting Small workplaces, employing 50 staff or less.
Method Following random allocation into CHD or musculo-skeletal groups, participating workplaces received a dual approach consisting of organisational health promotion policy advice and support with individual employee health screening, advice and limited intervention.
Results Stress was the most commonly reported CHD risk factor amongst respondents and was more prevalent amongst women, although there was also an important differentiation identified between 'workplace' and 'domestic' stress. Advice about stress was twice as often reported in the private than in the public sector, although the prevalence of'current stress' was slightly higher among the public than the private workers. Most smokers wanted to stop. Over 50 per cent of respondents reported some form of musculo-skeletal problem and physical inactivity was generally high across all sectors. There appeared to be an increased awareness of health messages following the interventions but no statistically significant changes in behaviour were evident. Nearly all workplaces (97 per cent) had smoking policies. The commonest obstacle to health promotion was lack of obvious benefit as perceived by the employer.
Conclusions Overall, there appeared to be a resistance to workplace health promotion, which was viewed as not benefiting the business, requiring too much time, and not the employer's responsibility. Most small businesses do not have the resources available to larger employers to address the health needs of their workforce and alternative ways of helping these workplaces needs to be explored. The major issue that needs to be addressed is stress, which may originate in the workplace or at home. Other important health related matters include exercise, diet, smoking and spinal pain.