With workplace deaths an ongoing reality, Michael Quinlan, a professor in Organisation and Management at the Australian School of Business, was surprised to find that, despite a body of research on death and trauma, until recently there has been no investigation into the impact of workplace deaths in Australia. Quinlan and colleagues have now closed that gap with an initial study into the cost of workplace death on families and identified several areas for future inquiry.
Their papers, Traumatic death at work: Consequences for surviving families and The adequacy of institutional responses to death at work: Experiences of surviving families, reveal the significant impact on families, both emotionally and financially. Among this group are some of society's quietest sufferers, says Quinlan. "It's not often recognised that when the primary income earner dies, it places a family in quite a perilous state, their whole life changes and their family just takes a turn," he says.
Co-author Lynda Matthews of the University of Sydney's Work and Health Research Team, says the procedures and processes involved in workplace deaths are hard to navigate and "by the end families are pretty exhausted". "This particular group are a vulnerable and hidden population, [but] they will just continue on and not necessarily jump up and down," she says.
Matthews says the research provides "a baseline" of what the experience is and how best to improve the regulatory systems around workplace deaths. It also shows that institutional responses "are central" to how the families deal with a death.
For the study the researchers interviewed seven families who had lost a relative as a result of a work-related accident in the construction sector. Contacted through the Workplace Tragedy Family Support Group, which campaigns for improved occupational health and safety and workplace laws, the interviewees comments in the report, Traumatic Work-Related Death in the Construction Industry: Experiences of Victims' families, highlight the stark reality of life after a partner or relative had died at work.
"When I had to choose his coffin, I thought to myself... I can't believe I am picking out a coffin. This is horrible ... He was full of life. I should be picking out a holiday not a coffin," said one. Another confided: "There is nothing that anyone can do to make you feel better... He's still gone. He's not coming back. It doesn't matter what you say to me … It's only I who has to find a way to – I don't know – come to terms with it all."
While examining the emotional and financial toll on the families, the researchers also looked at how institutions and regulators had dealt with the families. "[The families] often felt very remote from the process and that there was a lack of closure," says Quinlan. "The family weren't kept in the loop, and often they didn't know that a prosecution or coronial inquest was occurring until almost after the event. Or they felt, and I think justifiably, that not enough investigation had occurred after the incident. There's a sense that justice hasn't been done."
Matthews points out that the formal processes involved in a workplace death can often aggravate grief. Next of kin need to navigate a minefield of bureaucracy that involves state work safety bodies, police, the coroner's court, insurance companies, financial companies and worker's compensation. As one interviewee concluded: "We had the court case and they've all been fined. So, they've been fined. It doesn't bring my son back. You know what I mean?"
There are a lot of legal requirements around workplace death but there are ways of ensuring they do not add to the grieving process, suggests Matthews. For many family members, their exposure to uncertain procedures and a lack of information about the investigations continued for many years and contributed significantly to their sense of isolation and abandonment.
Quinlan believes future research that contributes to the development of protocols for families, and provides insight into the nature and timing of support services, would help minimise the negative impact of traumatic work-related deaths on surviving families.
Matthews points to the experience in the UK where formal arrangements are in place: "In the UK, there is a protocol for communication so everyone involved in the investigations of a workplace accident knows who they have to speak to and at what stage. To our knowledge we don't have a similar protocol in Australia [and] that would be one great step forward to ensure procedures are more streamlined, so [families] get timely and accurate information."
Communication is the linchpin to creating better outcomes for surviving families, the research shows. Quinlan says the human toll on families is often lost in the statistical analysis of workplace deaths. "The people here who've lost a loved one live with that every day of their life … That's something that we need to keep in mind when we talk about the cost burden of occupational health and safety because we're only talking about the financial costs, we're not talking about the costs to people."
One interviewee whose husband had died explained how losing the father of her children had precluded her from making sense of the future: "You are put in a puzzle where you can't find the pieces. There are no pieces to put it back together."
The research also highlights weaknesses in trauma management to meet the needs of families. For instance, Quinlan notes, counsellors often come in straight away, but families say that what they needed was support six or 12 months later. While families acknowledged that support via the workers' compensation system was provided, it was often not valued. By contrast, those who sought their own counselling at a time when they felt they could most benefit reported more satisfactory outcomes.
This finding highlights a further gap in knowledge and the researchers recommend future studies to identify the nature and timing of responses and support best suited to survivors of workplace deaths to ensure service provision is based on actual rather than perceived need.
Although Australia has a strong safety net of workers' compensation payments, there are many workers not covered by the scheme. According to the research, when a death occurs outside of the compensation system, welfare programs must absorb the costs. This makes it difficult to accurately measure the real financial costs of work-related deaths. In 2004, the National Occupational Health and Safety Commission estimated work-related injury and illness cost the Australian community A$34.3 billion or 5% of GDP. However, this figure did not include a detailed breakdown for work-related death or the financial costs for families or dependents of deceased workers. Insight into the economic consequences for these families could directly contribute to enhancing existing support mechanisms, such as workers' compensation, Quinlan believes.
Most often workplace victims are male, and the associated loss of income has greater overall impact on women than men. Previous studies indicate that insufficient income can prolong or intensify grieving and that financial resources help protect against psychiatric morbidity and mortality. Interviews for this study support these views with each family noting changes in health, lifestyle behaviours (such as drug use) and economic expectations. Matthews says the economic and social costs of these negative outcomes are more likely to borne by the community, which further complicates assessment of the real costs of workplace death.
In their interviews with the surviving families, the researchers discovered that grief remained raw many years following a death and impacted through generations. Outcomes closely linked to this included how the families were treated in the immediate aftermath of the accident and the manner in which the family was told about the death. While the majority of those interviewed felt there was little institutional sensitivity, for one participant a failure to notify her of the death for more than eight hours had ongoing repercussions: "There is one thing that will torment me all my life … I was the last one to find out. Therefore, I wasn't ... there to say goodbye to him. I didn't see him. Because it happened at one-thirty and I found out at ten o'clock."
There is little happiness to be found in the pages of Quinlan and his colleagues' work, yet it exposes the need for further investigation to ensure regulators and institutions do not add to the trauma of workplace deaths. The research team is now seeking funding for a more substantial report on this issue.