“In India, in the past five decades, rates of coronary disease among (the) urban population have risen from 4% to around 10%. In 2000, for example, India has lost more than five times as many years of economically productive life to cardiovascular disease than any other country,” says Anil Saxena, associate director, interventional cardiology, Escorts Heart Institute and Research Centre, New Delhi. By next year, estimates the World Health Organization (WHO), 60% of the world’s cardiac patients will be Indian.
The Delhi government’s Economic Survey, released in June, shows heart disease is the single biggest killer in the capital. It found that heart attacks killed approximately 15,442 people in 2007—that’s more than diabetes, tuberculosis and cancer put together. Clearly, the statistics are intimidating enough to warrant emergency action.
Could the answer lie in your office?
Experts believe prevention should begin early in life, with education in the classrooms. The battle itself needs to be taken to offices, say some experts. This is the thinking behind the WHO message for World Heart Day this year: Work With Heart (the WHO observes World Heart Day every year on the last Sunday of September; this year, it’s on 27 September).
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“There is a lot of sense behind this prevention strategy, as today we spend more than half of our waking hours working—in office,” says K.K. Sethi, senior cardiothoracic surgeon and chairman, Delhi Heart and Lung Institute, New Delhi. “Besides, it is well proven that young Indians are more prone to heart disease—genetically and otherwise—and it is this group of Indians that is facing the scourge of heart attacks today,” says Anshul Jain, senior cardiologist, Maharaja Agrasen Hospital, New Delhi.
Why should the office care about your health? Advocates say that a healthy employee is a bigger asset—the investment is akin to that made in equipment and training. Besides, the employer has to take responsibility for on-the-job factors that influence employee health. “(The) physical, mental, economic and social well-being of the employees is directly influenced by the workplace,” says Peeyush Jain, principal consultant, cardiology, and head, department of preventive cardiology, Escorts Heart Institute and Research Centre, New Delhi. “And the workplace in turn thrives on the optimum working (read: health) of its employees. Thankfully, organizations are now recognizing it and taking steps accordingly.”
When the workplace doesn’t work so well
A 2008 study at University College, London, showed a strong link of work-related stress with heart disease. “People who reported stress at work were at a 68% greater risk of coronary heart disease as compared to those with low-stress jobs,” says Dr Jain. “An unhealthy work environment is characterized by stress, depression, chronic back problems, unhealthy eating habits due to lack of time and decreased opportunity for physical activity, which may lead to heart diseases,” says Dr Saxena. And this in turn provides a definition for a healthy workplace: One where these problems are countered consciously to make your office safer for your health.
“With the current model of work culture we follow (impossible deadlines, killing targets, among others), there is bound to be a lot frustration and negativity in employees,” says H.K. Chopra, senior consultant, medicine and cardiology, Moolchand Heart Hospital, New Delhi, “And this could result in liberation of jittery molecules like epinephrine or non-epinephrine, and can precipitate rupture of vulnerable plaques and massive heart attacks.” Unmanaged stress can also give rise to various emotional, physical and psychological problems that can take an indirect toll on your heart.
Use your office to heal your heart
Dr Saxena lists a few steps to curb stress at the workplace:
Take a break: Stop, take a break and then reassess during stressful tasks or busy days. This will refresh your mind and give you the energy and motivation to take on the next task.
Spread happiness: Begin your day with a smile, compliment at least one person every day and surround yourself with things that make you happy or remind you of happiness...yes, even at your work desk. The cascade of positive chemicals counteracts the chemical response of stress—and that’s sound science.
Make friends: This is an extension of the earlier point, because the happiest people at work are often the ones whose colleagues are their friends. On the other hand, apathy, loneliness, competitive emotions are all sources of stress.
Exercise as if your life depends on it: Because it does. Exercise is non-negotiable, as is learning to relax. Which is why, the more progressive workplaces come equipped with gyms and meditation rooms. “Most of the people who don’t exercise cite the excuse of lack of time. Workplace fitness is the perfect answer to this excuse as employees can exercise before work, during breaks, during lunch or after work,” says Dr Jain. “The convenience factor of doing exercise at (the) workplace is immense, as this way exercise can easily fit into their schedules. Complementary memberships to sports clubs and a 24/7 fitness centre with (the) latest equipment can be a good incentive,” he adds.
Ashutosh Shukla, head of department and senior consultant, internal medicine, Artemis Health Institute, Gurgaon, adds: “A gym in the office premises is a boon and encourages employees to stay physically fit, besides space for a recreation room where yoga or tai chi classes can be organized. Even simple steps like walking around the building during lunch break, taking the steps up instead of the lift go a long way in helping.”
Dr Saxena also suggests “a walking and/or running club (during lunch hour or breaks), a bike rack on premises (so employees can ride to work or during lunch, mind/body classes (yoga, tai chi) initiatives and organizing team sports (volleyball, basketball, softball).”
Management’s health plan
For employers, here’s a ready reckoner to a healthier, and hence more productive, workforce:
1. Having a smoke-free workplace doesn’t help much if the smoke is just fogging up the entry to your lobby. Instead, seek a permanent solution: Conduct tobacco cessation workshops — and ensure adequate follow-up.
2. Advertise a discount on healthy foods (sandwiches, low-fat yoghurt, grilled chicken, fruits, pasta, salads, boiled corn, whole-grain breads and other high-fibre foods) in the office cafeteria. Ban fried food and trans fat rich foods such as bread pakoras, samosas, commercial pizzas, vada, bhaturas, tikki and pastries from the menu. Make fresh fruit, cut up and served hygienically, available within the office premises.
3. Make the staircase accessible. In too many offices, the staircase is synonymous with the fire escape and only the elevator makes any concession to style and comfort. Ensure that the stairwell is not blocked by storage cartons or left dirty and dingy. The idea is for people to find it a pleasure to take the stairs, not consider it a drudgery and punishment.
4. Encourage formation of fitness groups and organize non-competitive sporting activities, preferably involving entire families, for weekends or special days such as running a marathon where the goal, say, is to finish and raise money for charity, not clock in the best time.
5. Organize regular check-ups of all the staff (not just an executive health plan for the upper echelons).
6. Offer support for weight loss and weight management programmes with trainers and nutritionists who can offer one-on-one guidance.
7. Ensure the availability of a counsellor, one who can be seen to be confidential.
8. Educate employees about risk factors such as smoking, blood pressure, cholesterol levels, obesity, lack of exercise and personality types, among others. Encourage a work ethic where competitive spirit does not get out of hand. Periodic interaction with physicians and dieticians in a question-answer session, taking up specific subjects at each meeting (blood pressure, diabetes, cholesterol, genetic interference, among others) also helps remind people of their life beyond work and teaches crucial life skills.
9. Keep noise levels low. If there must be piped music to impress clients, play something soothing (need not be a drone or chant, either).
10. Put appropriate aromatherapy oils in the AC duct to keep the mood of the staff upbeat (cedar wood, basil), soothe stress (lavender) and boost immunity (lemon).
Strategies that have worked
It’s not all theory either. Many have fruitfully put workplace health measures into practice. And help may be as close as your nearest hospital. A physicians’ stress management centre run by Nalin Nag, internal consultant at Apollo Indraprastha Hospital, New Delhi, offers lifestyle and stress management workshops regularly for employees at National Thermal Power Corp. (NTPC), Airtel, Modi Enterprises, Polyplex, Ester industries, Emirates Bank and more.
Gujarat Guardian Ltd has a health guard programme in which it gives points to people who live a healthy lifestyle and give incentives accordingly. Tobacco chewing was common among operators at its glass manufacturing unit in Ankleshwar, so Dr Nag conducted interactive sessions using presentations, films, case studies, among others, for the workers. The result: a zero-tobacco company six months down the line.
The Delhi Heart and Lung Institute has organized public lectures and awareness programmes, including interaction of employees with senior physicians, in many private and public sector undertakings: Mahanagar Telephone Nigam Ltd (MTNL), Delhi Jal Board, Delhi Metro, Oil and Natural Gas Corp. (ONGC), Bharat Sanchar Nigam Ltd (BSNL), Food Corp. of India, State Bank of India and National Textile Corporation, among others.
“At Hero Honda Ltd, our employee health programme has been active since the last 10 years,” says Rakesh Sharma, the company’s chief medical officer (CMO), based at the company’s Daruhera branch. There is a tie-up with the Indraprastha Apollo Hospital, so a team of experts conducts regular health camps, identifies risk groups, examines employees and gives health awareness talks at least seven-eight times a year. Yoga training sessions are held monthly. Bhavna Barmi, a psychologist from Fortis Escorts Heart Institute and Research Centre, Okhla, runs stress management workshops at least four times a year; and Escorts also runs an ongoing substance abuse and smoking cessation programme for employees here. Plus, there’s one-on-one nutritional counselling by a dietician on offer the year round and all the staff up to the level of supervisor are trained in first aid and cardiopulmonary resuscitation (CPR). “Due to our regular blood donation camps, a pool of blood (is) always readily available for all employees,” says Dr Sharma, “and physicians come and do regular and even specific tests (such as doppler for diabetes) regularly in office.”
Moolchand has initiated a preventive heart programme (PHP) for its employees, the first of its kind in the country. Under this programme, psychologists analyse each individual from the personality perspective and their day-to-day capacity to cope with stress, and then advocate some exercises of the mind and relaxation techniques.
At Artemis Health Institute, the human resource (HR) department runs a yoga programme for all employees.
Escorts Heart Institute has several such initiatives for the doctors and other staff, including an in-house gym, table tennis facility, healthy food choices and a tobacco-free environment. They also have tie-ups with several organizations that send executives regularly in batches for physical check-ups, detection of risk factors and stress-reduction counselling.