Development of an HTO-based framework for occupational health management in high-risk environments

The modern work environment continuously presents new demands on employees, often resulting in health-related impacts. Consequently, occupational health management (OHM) is gaining increasing importance (Zanko & Dawson, 2012; Sorensen et al., 2021). High-risk environments (HREs) such as aviation, healthcare, or the military, represent unique work settings. These environments are characterized by higher levels of stress and strain for personnel, and other challenges especially for their mental health. Additionally, due to their specific working conditions, it is more challenging to implement conventional OHM measures into the daily routines within HREs. This creates a need to develop an OHM concept tailored for HREs that can meet their specific requirements. Given the particular complexity of these work environments, a holistic model like the human-technology-organization-approach (HTO-approach, Strohm & Ulich, 1997), which maps the interdependencies of these elements, is suitable to explain and account for the multitude of influencing factors. Complex models in health science are typically used to describe and categorize stress factors, their interrelationships, and their effects. The framework presented here follows a preventive approach and aims to illustrate supportive and protective measures along with their interactions. To develop a practical and effective OHM framework suitable as a template for HREs such as aviation, the following approach was taken: Systematic literature reviews on OHM and HREs were conducted as part of several academic studies. A definition of "HRE" from an ergonomic or occupational science perspective was created, including a characterization using evaluation criteria for HREs that were developed in a subsequent study. Additionally, an analysis was conducted to identify the specific demands of the modern work environment and particularly those of HREs on their employees and their health. To assess existing approaches and their implementation in relevant work environments, expert interviews were conducted with OHM managers from the fields of aviation, military, emergency services, air rescue, and railways. Based on this, a holistic framework of OHM was developed for the operational area of an airline, grounded in the human-technology-organization-approach, designed to meet the specific demands of HREs in the modern work environment.