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continuous improvement topics. 30-minute podcasts on PPE, software,
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Industry leader interviews covering safety, 5S, Lean, Six Sigma and continuous improvement topics. 30-minute podcasts on PPE, software, tools, GHS labeling and more. Rich library of safety-related content.

Total Worker Health – Explained

Total Worker Health. Dr. Bud Harris says it’s safety goggles and an apple. It’s occupational safety and health protection plus workplace health promotion.

An out-of-shape worker is more likely to be injured. Dr. Bud urges companies to follow NIOSH’s Total Worker Health initiative, adding stretching, walking meetings and healthy foods in the lunchroom machines. And more.

Dr. Bud is a Certified Wellness Coach and Certified Personal Trainer. He led EHS at Con-way Freight, Intel, Tyco Electronics, and is now owner of FitnessWork, LLC.


Brandon Nys: Welcome to Safety Experts Talk. Visit our website at

(intro music)

Dr. Bud Harris: The statistics are very clear. Employees spend more time at work than doing anything else next to sleep. It’s just a no-brainer to integrate some health promotion alongside health protection.

Dan Clark: Companies, traditionally, have dealt with worker health and safety in distinctly separate ways. The safety manager says “Wear goggles.” HR urges you to “Eat an apple.” Those two approaches are blending in something called Total Worker Health.

Hi, I’m Dan Clark. Today we’re talking with Dr. Bud Harris, safety and health expert, Certified Wellness Coach, Certified Personal Trainer, and owner of FitnessWork, LLC, from his office in Hillsboro Oregon. Hello Dr. Bud!

Dr. Bud: Hello, Dan.

Dan: I love your diverse rise to success. You were a helicopter logger, an electrician, you’ve been an EHS leader at Intel, Tyco and Con-way Freight and now you’re America’s Wellness Sergeant.

Dr. Bud: Yes (laughs)

Dan: That’s a great title.

Dr. Bud: I’m getting ready to take my dog for a walk and then go hit the swimming pool for a few laps.

Dan: Good. Sounds like a great career.

Dr. Bud: (laughs) Yeah!

Dan: Total Worker Health began in 2011 developed by NIOSH, The National Institute For Occupational Safety And Health. In a nutshell just tell us what it is.

Dr. Bud: Well, simply put, Total Worker Health integrates occupational safety and health protection with workplace health promotion.

Dan: Oh! OK, so if you’re healthy you’re more apt to be safe. Is that it?

Dr. Bud: Correct, and you’re able to respond to risky things you encounter in the workplace.

Dan: Oh, so you have a faster reaction time.

Dr. Bud: Correct.

Dan: Well, let’s get into the nuts and bolts. What should a company do to start a Total Worker Health program?

Dr. Bud: Well, it really starts very slowly because, again, it’s not mainstream. It’s something that NIOSH has been talking about for a long time.

The way that Con-way did it — Con-way Freight, where I was injury prevention health coach for almost 6 years — is kicking off simple little “Choose To Lose” programs. “Know Your Numbers.” You either go see your primary health care provider or you bring in a contracted nurse to take blood pressure, glucose, cholesterol.

So, what you’re doing is you’re actually just sort of giving them a snapshot of themselves. Where their health lies. Their blood numbers, those kinds of things. And then it crosses over, for example, to their body mass index. So, are they overweight or are they obese or are they morbidly obese? So, those are some of the first steps. It’s just know where you are.

And then move into simple things like hydration and what you talked about earlier about eating apple. So it just slowly moves in.

And then at Con-way I put together the “Essential Eight” stretch program. When the dispatcher would be dispatching the drivers in the morning and they had their safety meetings, I would be talking to them as well about something health related — whether it was safe lifting or back health — while we had a certified stretch leader leading the drivers through the “Essential Eight.”

Dan: I’d like to see photos of this. (laughs) This is great.

Dr. Bud: Yeah. We had an entire … three different locations doing pre-shift stretching while the dispatcher was going to their daily routine of dispatching the drivers. So, it would be all the drivers. It was voluntary, but they would all do it. And we were building on something I was a part of Intel Corporation, what’s called a Certified Stretch Leader. Somebody that’s gone through a very simple program to answer questions about what muscles are we stretching, why are we stretching so we can do it safely. And they end up getting in the middle of a circle of the drivers and leading a stretch while the dispatcher is talking to them about what they’re going to be doing that day.

Dan: So, it’s down time anyway. The would just be standing there listening to someone talk.

Dr. Bud: Yeah. Very successful and it was implemented in a lot of the larger terminals across the Con-way Freight system.

It definitely showed that it lowered the soft tissue injuries and just nagging things. I mean, a driver would get up, get out of bed, get in the car, get out of the car, go in the office, jump in the truck and start throwing boxes around. It behooves them to take the joints through their full range of motion before they embark on their day.

Dan: Yeah, it’s a great warm-up. Well, this program began with NIOSH, The National Institute For Occupational Safety And Health. What do they offer to a company to begin a program other than a list of things to do? Do they offer any kind of incentive for companies?

Dr. Bud: Not this time. That has been thrown out by a lot of different companies. Again, this can be quantified on a lot of different fronts. Healthcare providers, for example.
Out-of-pocket — as you know with the Affordable Care Act — has got a lot of press, both good and bad.

Dan: Mm-hm.

Dr. Bud: What a lot of companies are doing now is they’re giving the employees a lower out-of-pocket cost if they participate in different events.

For example, I did some work at Rite-Aid here in Portland. I came in and did what was called “The Lunch And Learn” where the employees would bring their sack lunches to the break room and I would present 45 minutes on a topic.

Dan: Oh, I see.

Dr. Bud: And one of them was nutrition and one of them was starting a walking program and being more active. So, they would receive a discount if they did two “The Lunch And Learns” and two active events like 5K walk and maybe another event. So, their out-of-pocket would be substantially less if they basically did those four activities and did their annual health risk assessments.

So, what you do is you utilize the resources that are available to you. Total Worker Health, as far as the NIOSH website, does have what’s called “Issues Relevant To A Total Worker Health Perspective” and it lists out all the elements that would be considered Total Worker Health.

SAIF Corporation, the state workers’ comp program here has just recently been certified as a Total Worker Health. And on their website,, they have a lot of resources as well.

Dan: And that’s S-A-I-F-dot-com.

Dr. Bud: Correct.

Dan: OK, great.

Dr. Bud: When I was a Tyco Electronics back in 2005 I subscribed to Wellness Councils of America.

Dan: OK.

Dr. Bud: That acronym is WELCOA. []

Dan: Mm-hm.

Dr. Bud: And there for a small fee you can have all different kinds of bulletins, newsletters, quizzes, PowerPoints, interviews. It’s just a huge resource of how to get started, even working with executive management, how to get the initiative going and I’ve been using them for 20 years. I became a faculty member for Welcoa about two years ago.

So, there’s just a lot of resources out there now, but getting started, Dan, slow. Starting a hydration campaign, getting an apple-a-day campaign, starting a walking program, looking into your healthcare providers what they offer. A lot of the healthcare providers actually have a consultant on staff that is dedicated to the employer that’s obligated to provide these type of resources but the HR department, it’s is so overwhelmed that they just don’t reach out and get that person on site and get those free seminars coming in.

Dan: Oh, I see.

Dr. Bud: To the facility.

Dan: Well, with Total Worker Health, does the safety manager — the traditional safety manager — do they now need to have training on how to advise workers on a healthy lifestyle?

Dr. Bud: It’s moving that direction and it’s starting… it usually starts with ergonomics.

Dan: Mm-hm.

Dr. Bud: Stretch routines is nothing new. A lot of the bigger companies — Johnson & Johnson, Safeway Corporation — they have been doing ergonomics consultation to discuss work design, joint health and arthritis prevention.

So, that’s been going on for years and years, and I have a background as a safety engineer. It wasn’t really a bulk of our training but as we see over 60 percent of injury types now are becoming soft tissue.

When I was at Intel Corporation, one month Tony Brace, the ergonomist, said nine out of the 12 injuries was related to people just being out of shape.

Dan: (laughs)

Dr. Bud: Slip, trip and not even falling.

Dan: Wow!

Dr. Bud: Or using the mouse all day and then getting, sort of, a wrist injury. More and more people are just de-conditioned. Low back pain, it’s easier to slip a disk just bending over doing your day-to-day job. I mean, “industrial athlete.” That was a term coined about 20 years ago when we’re out there working. For example, a truck driver jumps in the back of a trailer with the pallet jack. They move around heavy, heavy loads. They’re asked to down-stack pallet after pallet just like an athlete would work during the day. So, there’s got to be some proper prep and a little bit of tension. But yeah, the safety manager now has to, sort of, look down that road.

Dan: They also still have to continue with the traditional risk assessment, root cause analysis, monitoring leading and lagging indicators. How is a safety manager going to have time to do the additional soft touch stuff?

Dr. Bud: It’s going to be a challenge. It definitely is, but what I did is look to the free resources that are available. The healthcare provider, the local YMCA. For example, New Seasons offers nutrition classes for free. There’s so many different personal trainers out there that want to come on site and do free presentations and hope they would secure some kind of work.

I did a “Lunch and Learn” series for a large container company. I came in once a month during shift change. It was reasonably priced but I gave them a menu of things that I could talk about. They chose off the menu and I would come in for 45 minutes when two shifts were in the break room and with the handout and a demonstration and discussion. And the safety manager, all he had to do was pick up the phone and call me.

Dan: Right.

Dr. Bud: So, there’s just so much out there, it’s just … I think the biggest inroad to Total Worker Health is the safety manager has to accept that it needs to be done. They don’t necessarily need to do it. They just need to organize it.

Dan: Well, it’s because of the benefit because a healthy worker who’s not overweight is going to be a more efficient, safer worker. Right? I think you were telling me that earlier. Somebody who is not overweight is going to be able to do physical labor much more efficiently, of course. They’re going to be less likely to get injured because their muscles are built up better and that they can actually get more work done at the end of the shift.

Dr. Bud: Correct, exactly. There’s a new term out there. Most people have heard of absenteeism, but they haven’t really heard of the term presenteeism, which is a metric from the productivity management world where a person comes to work and they’re expected to perform as a 1.0 FTE full-time employee. But — due to chronic illnesses like obesity, diabetes, low back injuries — they’re not able to perform up to what they did earlier. And maybe they’re making more money because they had been there a while. But they’re doing less work than they did they did before, yet they’re making more money.

So, they’re starting to quantify that and they’re saying that presenteeism is the largest cost in the human productivity management cycle. You’ve got your direct costs when somebody pulls their low back, for example. Then you’ve got your indirect costs, when somebody has to come in and work overtime to replace that person. But you also have the presenteeism cost where a person comes back to work. And now they’re on limited duty for a period of time because they put on a hundred pounds.

I have used the example when I speak at safety conferences, Dan, where you get hired at $15 an hour pulling boxes off one conveyor belt and putting them on another, for example, at a freight terminal. Then you gain a hundred pounds and you get paid five dollars more an hour. Now you’re making $20 an hour but you’re actually doing less work than you did before. And now that’s called presenteeism. Presenteeism also is coming to work and surfing the Internet or getting on your Facebook or playing fantasy football. That’s also considered being at work and not actually participating.

Dan: So, be more disciplined as a worker. But, also, be disciplined with your health because it could also save your job. Is that what you’re saying? (laughs)

Dr. Bud: (laughs) Well, yeah. I’m not sure that one could be let go because they’re doing less work due to medical issues. Surfing the Internet, probably.

The way SAIF Corporation tries to straddle the aisle of health promotion and health protection is they promote health at the organizational level by helping employees identify and control issues that work against alertness, productivity and safety. These can be simplified into three categories:

— What to do.
— What to avoid.
— What to eat.

In those three realms, they work on:

— Moving more.
— Getting better sleep.
— Healthful foods.
— Drinking the right kind of water.

And often:

— Dealing with chronic stress.
— Eliminating tobacco and nicotine.

Dan: Oh, OK. So you’ve got:

— What to do. Be physically active, get sleep.
— What to eat. Eat healthy food, drink a lot of water.
— What to avoid. The chronic stress and cigarettes or tobacco. Any kind of nicotine input.

Dr. Bud: Correct. And that’s how they break it down simple. They also have ideas:

— Organized walking meetings.
— Compete as work team in community events.
— Serve fruits and veggies for snacks.
— Organize a volunteer activity for the organization.

A lot of different things, a lot of different challenges, a lot of different free resources that are out there. The YMCA, as I mentioned, the parks and rec, community fitness events. There’s just a whole host of things that are free or almost free that a safety manager can reach out to and organize. It usually ends up in the lap of the HR department, as you said earlier.

Dan: Mm-hm.

Dr. Bud: What I did at Tyco Electronics when I arrived … the HR department was six and it was three when I showed up. The wellness program sat on the shelf. So, after about two to three months, I asked if I could pick it up and run with it. I was able to do that. I was able to get gym membership up from 200 to 500. Started a stretching program giving people extra time to stretch in the gym, embedding it in their job safety analysis that if they had a job, for example, in shipping and receiving they’re expected to stretch, and were given time to stretch.

Dan: Right.

Dr. Bud: And the ErgoWell program that I developed was nominated for the North American Tyco EHS Excellence Award.

Dan: Oh, that’s great. But it sounds like you couldn’t have done any of that without check off from management. This is got a start from the top down.

Dr. Bud: Yes. The old saying “Walk Your Talk.” Management not only has to support it, they have to convey they’re going to buy into it and they also have to be seen about doing the things.

So, when we started a walking program with the city of Wilsonville, when they came in and gave pedometers to all the employees, the managers upstairs had to be seen wearing their pedometers.

Dan: Ahh.

Dr. Bud: When we started inter-plant flag football and softball teams they had to be part of those as well.

Dan: Oh. Well, I’m a horrible football player so I guess if I were manager I’d have to get out there and humiliate myself. But I guess that’s part of it, isn’t it?

Dr. Bud: You can block, right Dan?

Dan: (laughs) Well, if we had a Total Worker Health program that’s going to start at company X, say it’s a construction company or something. You want to get the safety manager together with the HR department or even if you don’t have an HR department, you’re a small company. What’s the first thing that you want to do to be be able to make a plan — to write it down or to type it up?

Dr. Bud: The first thing I would do is you want to get it to the safety committee. So, we change the name from “safety committee” to “safety and health committee.”

Dan: Ahh.

Dr. Bud: And then from there we start documenting in our minutes. We get some proactive champions on the safety and health committee. There’s no shortage of people out there that want to help other people get healthy. Or there’s no shortage of people that are already healthy and active. And, believe it or not, they want to fly the flag if given the opportunity. And if you get enough of those on the safety committee then it becomes, sort of, a safety and health promotion committee. And then from there things can be added to the safety committee agenda, like filtered water would be one.

At Tyco, for example, that’s one of the first things that went on the agenda. Filtered water. After that it was a designated walking route where people could walk around the plant without having to put on their safety gear.

Dan: Ahh.

Dr. Bud: So, it’s just one step at a time. Like you alluded to earlier, management has to buy into it. They have to communicate down through the organization that this is something they’re going to do. It becomes part of the charge, the normal business of the safety committee. It’s just business as usual and then more and more aggressive things start being added to the agenda.

For example a 5K. That’s what we did it at Con-way. We ended up getting 45 truck drivers and their family members out to a 5K walk-run. Many of those ended up becoming a runner on one of my Truckers to Triathletes team. And then they start getting bikes and they start biking with their families. Then they want to be a runner and a biker. Then they’d go to the gym and start swimming and they become full triathletes. So …

Dan: Amazing.

Dr. Bud: The statistics are very clear that employees spend more time at work than doing anything else next to sleep.

Dan: Wow.

Dr. Bud: And it’s a good place for social support. It’s a good place to promote healthy messages. The employer reaps the benefit of a healthier worker. It’s just a no-brainer integrating some health promotion alongside health protection.

Somebody that injures there shoulder is usually a $75,000 issue, and the low back $50,000. Where somebody that smashes a finger, for example, could be $2,000 or $3,000 when it’s all said and done. So the soft tissue injuries are the costly ones.

In the safety world we spent a lot more time on making sure people have safety glasses, hard hats, safety toes and gloves on than people lifting correctly and drinking enough water and getting enough sleep.

Dan: And having the right muscle tone to be able to lift correctly.

Dr. Bud: Correct. All of those things. I believe that we’re moving down that road and I think the SAIF Corporation out here on the West Coast being the first certified Total Worker Health, a lot more safety managers are getting their workforces to stretch. A lot more HR managers are bringing in contract nurses to do blood draws so the employees will know their biometrics, their glucose numbers, their cholesterol, their triglycerides, those kinds of things that you need to know to sort of take a snapshot of where you’re at.

Dan: Right, so you can have a baseline and have goals.

Dr. Bud: Correct. Knowing where you’re at and then knowing where you need to go and then let’s bring that delta together.

Dan: So we have the safety committee. Does the safety manager and the HR manager sit on this committee and do they lead it?

Dr. Bud: They’re part of it.

Dan: I see.

Dr. Bud: But yeah. In all organizations I’ve worked in I’ve been part of the safety committee.

Dan: OK.

Dr. Bud: In an intra-survey — that’s another big step one in starting health promotion/wellness program — is we need to know what the employees want. Maybe some of employees just want more light. They want a nicer staircase because just getting people to take the stairs is a big one.

Dan: Oh, instead of the elevator.

Dr. Bud: Yeah, some people are having artists come in for free and making their staircase really pretty with beautiful art.

Dan: (laughs)

Dr. Bud: And then employees will want it. Just simple things like that. You know, getting your 10,000 steps a day. Getting a pedometer and starting to track it and doing little competitions with your coworkers. You know, “Hey, how many steps do you have today?” “Oh, I’m at 7,000.” “Well, we need to go out for a quick 10 minute meeting and walk around the campus and get our 3,000 so we can end the day with our recommended 10,000 steps.”

Dan: 10,000 steps. See, that’s something I didn’t know. So, I can see how it’s really difficult for a truck driver. Stretching is one thing to be able to begin that program but you got them into the Truckers To Triathletes program. I assume it’s more than 10,000 steps (laughs) so …

Dr. Bud: (laughs) Yeah, well, that’s getting them to walk around what’s called a long box. That’s the really long trailer you’ll see on a tractor. Walking around that 38 times is one mile.

Dan: Oh, really? OK.

Dr. Bud: 10,000 steps in general terms is 5 miles. It’s 2,000 steps per mile.

Dan: OK.

Dr. Bud: And you burn about a hundred calories per mile walking and 200 calories running per mile. So, that’s how we get people started is while they’re waiting. A lot of the truck drivers have to wait when they pull into a terminal for the trucks in front of them to process. So, they have time.

Dan: Mm-hm.

Dr. Bud: So, just getting them motivated enough — you mentioned goals earlier — some of my goals to the hundreds of truck drivers that I worked with was “I just need you to get out of your truck and walk around while you’re waiting for the customer to download you.”

Dan: Right.

Dr. Bud: “Pushing the bird out of the nest” is usually the hardest part.

Dan: “Wait! I can’t unload right now. I’ve got three more laps to make 38 around my truck!” (laughs)

Dr. Bud: (laughs) That’s true, though.

Dan: That’s dedication.

Dr. Bud: It starts feeding on itself …

Dan: Mm-hm.

Dr. Bud: … after somebody starts feeling better and their low back pain starts to ease. And they’re eating better. And they’re drinking more water and …

Also, it’s a mental outlook too, Dan. The famous law of attraction: If you focus on negative things — you know, the traffic, the weather — if you focus on it day-in and day-out you’re going to attract more of it into your life.

Dan: Hm.

Dr. Bud: So we get truckers to say “This too shall pass.” Somebody cutting them off or road closures. Start focusing on all the positive things in your life as opposed to all the crap going on.

Dan: There’s certainly no shortage of that, is there?

Dr. Bud: Yes (laughs).

Dan: Truckers To Triathletes. We’ve talked about this a little bit here and there but how did you start that at Con-way Freight?

Dr. Bud: Right. So, what we did is I met a truck driver who was working what’s called line-haul. We were doing a “biggest loser” competition and he was really frustrated that he wasn’t able to make any gains. Frustrated to the point that he went on a super-duper cleanse program, which I actually didn’t recommend. But he did it anyway. And then when he was done and he did lose some weight I challenged them to do a triathlon.

Dan: Oh!

Dr. Bud: At that point he went ahead and trained — after he worked 12 to 14 hours a day — doing spin classes and swimming. He inspired a couple of other drivers and we ended up with three drivers doing their first full triathlons. Then it spread to three teams and now we’re up over a hundred trucker-athletes and the family members doing triathlon events around the country.

Dan: And it’s in your seventh year.

Dr. Bud: Seventh year was this year. Yeah, exactly.

Dan: Wow.

Dr. Bud: We’ve got a couple truck drivers. One that’s lost a hundred pounds and another trucker who’s on his way to losing a hundred pounds in a couple weeks.

Dan: Mm-hm. And that’s a great program because, let’s face it, your typical blue-collar worker is tough to get off the dime and into a gym.

Dr. Bud: Yeah (laughs).

Dan: Maybe it’s a cultural thing. And this gets us back around to Total Worker Health. Does Joe Six-Pack just roll his eyes when he hears a phrase like Total Worker Health?

Dr. Bud: Yeah, it is a challenge to get your traditional blue-collar employee to get into gym. A lot of their — I wouldn’t call them excuses — but their explanation is “Hey, I work 10 to 14 hours a day. I get my exercise. I don’t need to go to a gym.”

Dan: Uh-huh.

Dr. Bud: But their health metrics screening shows otherwise.

Dan: And they’re not getting the aerobic workout that they would, no matter how hard they work. Right?

Dr. Bud: Correct. Yeah, they’re not getting their heart rate up for extended periods of time. Tight hamstrings create the low back pain that 80 percent of Americans will have. There’s just a whole host of things that functional training really helps with.

Dan: Right. Well, we’re close to the end Dr. Bud. Any final thoughts on starting a program of Total Worker Health?

Dr. Bud: Yes. Just decide to do anything consistently. That means an apple. Changing out some of the snacks that come into the facility. Having water bottles out of a job sites. Just pick something and make it consistent and then pick something else. Get the safety committee engaged.

After listening to this interview go right back to engage HR and their supervisor say “Hey, what can we do the just do anything and get this started?” ’Cause it’s not going to happen overnight but if you start it today and pick one thing, in five years you’ll see a huge difference in not only productivity but morale, absenteeism as well as presenteeism.

Dan: Overcome inertia.

Dr. Bud: Yes, exactly. That ball of mass is sitting there just vibrating, not doing anything.

Dan: Well, Dr. Bud, I’m sure people will want to check you out on Twitter and Facebook and those are linked on your website. What is that?

Dr. Bud: I’m at WellSgt-dot-com [] Its abbreviation for AmericasWellnessSergeant-dot-com. That’s my speaker website. I do a lot of speaking and that’s where you can locate me if you would like me to speak at an event.

Dan: It sounds like you’re always on the keyboard there. You better get out and do something!

Dr. Bud: I plan on it! (laughs) I’ve got to stay busy and I’ve got to stay active. I’ve got to “walk the talk.” Right, Dan?

Dan: That’s right.

Dr. Bud: (laughs) Yeah.

Dan: Very good. Thank you, Dr. Bud. Our guest has been Dr. Bud Harris, cWC, CPT and owner of FitnessWork, LLC, from his office in Hillsboro, Oregon. I appreciate you listening to the podcast. I’m Dan Clark

(outro music with voice over)

Brandon: Thank you for joining us on Safety Experts Talk. If you have suggestions for future podcasts, send them to For more safety experts talking about safety news, OSHA regulations, PPE, lean, 5S, or Continuous Improvement, go to


TOTAL WORKER HEALTH ® is a registered trademark of the US Department of Health and Human Services

Dr. Bud Harris photos © ℗ 2015 FitnessWork, LLC.; Men in yellow shirts photo by U.S. Navy / Tim D. Godbee

Additional Resources