Has anyone seen an eyeball?

We had a bit of a crisis here last week. One of our employees, in the microbiology team, got sick. No one knew it was coming because he’s such a quiet chap by normal standards, a bit of a loner really. I’ve walked past him several times without even realising he’s there. It was awful. There was no warning, he just projectile vomited, like a scene from The Exorcist. It was all over the floor and up the walls. What’s worse, the poor guy vomited with such force that he lost an eyeball.  We’re still looking for it.  It’s not the first time he’s been sick at work either but he’s a good sport and hasn’t complained so we aren’t inclined to record it in our sickness data because we see him as a bit of an outlier and not representative of the healthy workforce we have here at HSL.

Meet Larry.

Larry has had an interesting career. He worked for many years as a successful resuscitation dummy in first aid training. He was a hard worker too. He’s been jumped on, had his mouth probed with dirty fingers, his chest cavity has been crushed by overenthusiastic and overweight first-aiders, and he’s nearly been suffocated several times by people who blew into his mouth AND his nose at the same. No doubt he has helped save many lives. Larry thought he was settling down for a nice retirement, albeit an inactive one, given that he has no legs.

And then he met Cat Makison-Booth. He should have known better. 

Cat, seen here filming for a BBC documentary on her work, is one of our microbiologists at HSL and is leading our innovative work around Norovirus.

Cat needed to be able to replicate the way that human beings vomit when infected with Norovirus and was looking around for a suitable dummy to help. Unfortunately for Larry, he didn’t move out of the way quick enough (difficult, with no legs).

A bit like Robocop, Larry found himself strapped to a gurney while surgery took place. His chest was removed and replaced with an artificial stomach, all secured with a wooden frame that held him firmly in place. When he woke from surgery, something was sloshing around his insides and the next thing he knows, he’s projectile vomiting and has been doing it ever since. The poor guy:  he spent his working career on his back pretending to be unconcious, and now he spends his semi-retirement wishing that he was. It’s a tough life.

He should be proud though, the work he is helping with is important. Norovirus is nasty. Picked up by eating the wrong thing (I didn’t know that oysters are a potential source of Norovirus as well as pearls) or by touching a contaminated surface. Symptoms typically last at least 48 hours and include projectile vomiting and diarrhoea (we’ve asked Larry if he’d like to have a bottom half attached but he just looked at us with suspicion).  

Norovirus is incredibly infectious. There are around one million virus particles in just 1 ml of vomit. When you think that the average person can vomit up to 1.35 litres and that it takes just 10-20 particles to cause an infection, you begin to understand why it causes such problems across industries. Healthcare is the most publicised. In addition to the patient safety issues an outbreak of Norovirus can cripple bed capacity in a hospital through ward closures. Other industries also suffer though. In fact, anywhere there is a confined space such as oil rigs, schools, conferences, submarines and cruise ships, there is the potential for infection to spread. The financial burden to the economy is huge and around £100m per annum in healthcare alone. It’s so infectious, that some governments deem it a potential bio-weapon.

It’s hardy stuff too. It can survive up to twelve days in the environment and many disinfectant products, such as alcohol-based hand gels are not effective in killing it.  You also shed the virus for 48 hours after your symptoms have stopped, which is why it spreads so quickly because people come back to work when they are feeling better and infect colleagues. Oh, and unlike, say, chicken pox, you can get re-infected with norovirus and there is no vaccine. So, all in all, something to avoid.

All of which is why the work that Cat is doing is so important, because it fills a gap in the science which is: When someone infected with Norovirus vomits, how much of the physical environment is contaminated?  The answer, as it turns out, is a lot. Here’s a link to video of Cat explaining how Larry works, and then him doing his thing.

Don’t feel sorry for him, he’s got a holiday coming up. The spread of virus is up to 7.8 square metres. What’s more, the naked eye can’t see the smaller particles of vomit. You can only see them in the video because Cat uses a fluorescent marker when filling poor Larry’s stomach. This light or the marker isn’t available to people decontaminating the environment, so you tend to find that the main spillage is cleaned – the bits you can see – but that there are significant levels of virus left in the environment.

So, Cat’s work goes on, developing the science underpinning decontamination of the Norovirus environment and has applications for most industries in the UK.  And as for Larry, well, it’s not so bad for him. He made it onto the Letterman show, which was exciting for him. Also we do feel terrible that he lost an eyeball as part of his routine work.  So we’ve booked him a nice two week holiday.

On a cruise ship.

Flip flops, apples and mops

I’ve made a self-diagnosis: I’m mildly stressed. In the week I chose to go camping in the New Forest, the glorious dry spell that led me to eat more sausages and burgers than is healthy broke, and was replaced by violent thunderstorms and localised flooding.  I had planned to spend my days lounging around the campsite, playing cricket with the neighbours, using empty beer bottles for stumps, but instead spent it mopping out the tent in my flip flops, while flood water lapped dangerously close to my electric hook-up.

It could be worse though. Much worse. My line manager doesn’t bully me, I have an interesting job and a great view from the office (right now I am looking out at Solomon’s temple and a selection of slightly neurotic sheep who are probably wondering where all the big explosions keep coming from – more on that in a later blog).

Work-related stress is debilitating, both for the individuals that suffer from it, and the businesses for whom they work. It’s easy to visualise the circle: workplace doesn’t promote health and wellbeing, people get stressed, people go on sick leave, business loses money, business has less money to invest in people. And so on.  

Many organisations do show a commitment to the wellbeing of their employees, but their efforts are misguided, and end up failing to make a tangible difference. I had a conversation with a senior director in a large public sector company recently, one that employs thousands of people.  Wellbeing was high on the agenda: people were encouraged to cycle to work, and healthy food and fresh fruit was available in the canteen.  It made little difference to stress-levels. They found that people who like apples, eat more apples, and the people who cycle to work do so with slightly more vigour: if you are being bullied by your line manager and made to wait in line to be let in to the office, apples aren’t going to help, at least not in the way they were intended.  That’s not to say healthy eating and exercise aren’t important: far from it. Having a healthy body is part of the solution, something I tell myself every time I walk past an Indian takeaway. But it is only a part of the solution.

Work-related stress isn’t an easy problem to address. Most people work to live, rather than the other way around. Put your hands up if you’d come into work next week if your Euromillions numbers came up this Friday? Thought so.  Work can be tough, and at times stressful. If it wasn’t, we’d all be dancing round and whistling like Mary Poppins and having group hugs. Some pressure is okay, and when the pressure build into stress, most people can cope for a short time (mopping the tent out the first time was okay but by day three, I was a seething mass of anger). When it gets too much it can have a massive impact on business productivity.

According to PriceWaterHouseCooper, the overall annual cost of sickness absence to UK businesses is nearly £29billion per annum, a rise of £1billion over the last two years. This increase is the result of average sickness absence rates rising to 9.1days per employee, up 5% since 2011. Even more worrying, Government reports suggest that it’s the longer-term absences caused by stress and anxiety that have gone up, whereas short-term absences (‘Yeah, feeling much better thanks. Must have been a 24-hour thing. Huh, what tan?’) have gone down. Work-related stress accounts for about a third of this figure: £10bn a year. Reducing stress-related sickness absence by as little as 10% could save UK businesses by as much as £1billion every year. That’s a one and seven zeroes.  That’s a number worth having a go at. 

It can be done.

Our team of work psychologists worked with one of the UK’s leading oil and gas supplier to reduce sickness absence throughout their call-centre workforce. Okay, confession time: I’ve lost my patience with call-centre staff many times, although not the company above, thankfully. Usually when I’ve been put on hold and subjected to the psychological warfare of Vivaldi’s four seasons on endless loop, only to be interrupted before the good bits, to be told I’ve moved up in the queue and they’ll-get-to-me-just-as-soon-as-they-jolly-well-can-you-delicious-and-valued customer-you (but what number am I?!). I’ve ranted. I’ve been rude. I’ve put the phone down in utter shame when they tell me the reason it’s not working is because I haven’t got my internet router switched on (yes, it really did happen). It’s easy to forget that the person on the other end of the phone is human (even if reading from a script to weed out the idiots like me) and they have feelings. Multiply a call like mine by eight hours in the job, and it’s not a surprise to understand why they had issues.

We like a challenge at HSL.  It makes our scientists smile in a strange way. It’s one of the reasons the Government keep us on top of a hill in Buxton. We were asked to help reduce the levels of absenteeism in the call centre. And we did. How? We talked to people: managers, workers, and everyone in between. We found out what it was really like, not what the policies said. We looked at how work-related mental health was managed, and we made suggestions. People got excited. Someone was actually taking their individual health and wellbeing seriously. 

And it worked. Using a systematic and pragmatic approach, the company has reported an 11% reduction in stress-related sickness absence rates with not a green apple or a free lunchtime head massage in sight.

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 If you want more information on the management of stress in the workplace, you can access various toolkits at HSEs website here: http://www.hse.gov.uk/stress/standards/