Cold Weather Working in the UK: Keeping Staff Safe and Warm

As winter's chill sets in, bringing with it frosty mornings and icy breezes, it's crucial for employers across the UK to turn their attention to the safety and well-being of their workforce. Cold weather isn't just about discomfort; it brings real challenges to the workplace, affecting both health and productivity. In this light, understanding the legal and safety guidelines becomes not just a necessity but a responsibility. This blog post delves into the UK's legal framework and the Health and Safety Executive (HSE) standards, guiding employers on how to navigate the complexities of cold weather working. Whether you're managing an outdoor construction team or an indoor office environment, staying informed and prepared is key to ensuring a safe and comfortable workspace for everyone.

Understanding the HSE Guidelines and What They Mean for Employers

The arrival of cold weather signals more than just a change in wardrobe; for employers, it's a call to action to safeguard their employees' health and safety. The Health and Safety Executive (HSE) of Great Britain plays a pivotal role in this, emphasizing the need for workplaces to adapt to the dipping temperatures. According to the HSE, the onset of cold weather, often marked by warnings from the Met Office, should prompt a reevaluation of working conditions, particularly in jobs that become increasingly challenging in such climates.

Central to this is the adherence to the Workplace (Health, Safety and Welfare) Regulations 1992. These regulations don't dictate exact temperature figures but require employers to maintain what's deemed a "reasonable" temperature in the workplace. While "reasonable" might seem subjective, the HSE provides a guideline suggesting that the minimum indoor temperature should generally be at least 16 degrees Celsius (61 degrees Fahrenheit), or 13 degrees Celsius (55 degrees Fahrenheit) for more physically demanding work.

However, it's important to note that these temperatures are not strict legal limits but rather recommendations that demand a practical approach from employers. What constitutes a reasonable temperature can vary widely depending on the nature of the work and the workplace. For instance, outdoor workers or those in cold storage environments might find themselves outside these temperature ranges.

This means that employers must go beyond just monitoring thermostats. They are tasked with conducting risk assessments to identify if extreme temperatures could pose a health and safety risk. This includes considering potential accident risks due to cold conditions and ensuring basic staff welfare facilities are in place. If these cannot be provided, it may be unsafe for employees to work.

The crux of these guidelines is not in strict adherence to a numerical value but in a broader sense of responsibility. Employers are expected to tailor their approach to the specific circumstances of their workplace, always with the safety and comfort of their employees in mind.

The Real Impact of Cold on Workers: Health, Safety, and Performance

When winter's icy grip tightens, it's not just the outdoor landscape that changes; the cold can significantly impact the health, safety, and performance of workers. The Health and Safety Executive (HSE) warns that cold environments can pose immediate and long-term health risks. For outdoor workers, the challenges are evident: they face the direct brunt of the elements, which can lead to conditions like cold stress, characterized by symptoms such as coughing and body aches.

But it's not just physical health that's at stake. John Rowe, Head of Operational Strategy at the HSE, highlights a crucial yet often overlooked aspect: cold conditions can impair decision-making abilities. Employees working in uncomfortably cold environments are less likely to perform optimally and more prone to unsafe behaviors, as their ability to make good decisions deteriorates.

This dual impact – on both physical health and cognitive function – underscores the importance of a proactive approach to managing workplace temperatures. Whether it's an outdoor construction site or a drafty office space, ensuring that workers are not just physically protected but also mentally sharp is vital. As the temperatures drop, the focus shouldn't just be on thermometers but on the overall well-being of those braving the cold to keep businesses running.

Practical Tips for Employers: Keeping Your Team Warm and Safe

In the face of cold weather, practical steps taken by employers can make a significant difference in ensuring a warm and safe working environment. These measures are not just about compliance with regulations but about demonstrating care and concern for the team's well-being.

  1. Appropriate Personal Protective Equipment (PPE): For outdoor work, providing suitable PPE is crucial. This includes warm clothing, insulated hats, and gloves, which are essential for worker safety in cold outdoor temperatures. The Personal Protective Equipment Regulations 1992 underscore the importance of providing such equipment free of charge when there's a risk to health or safety.

  2. Creating Warm Break Areas: Employers should consider providing mobile facilities for warming up, along with access to hot drinks like soup or tea. This not only helps in maintaining body temperature but also offers a mental break from the cold.

  3. Frequent Rest Breaks: Introducing more frequent rest breaks can be an effective way to manage the impact of cold weather on workers. These breaks allow employees to warm up and reduce the risk of cold stress.

  4. Maintaining Indoor Temperatures: For indoor work environments, it's important to keep the building as warm as possible, ideally around 16°C (61°F) for less active job roles. Ensuring fresh running water and allowing extra breaks for warm drinks can also help.

  5. Regular Check-ins and Weather Monitoring: Keeping an eye on the weather forecast for worsening conditions and checking in on staff regularly to ensure their well-being should be part of the routine.

By implementing these measures, employers can provide a more comfortable and safer working environment, thereby enhancing productivity and morale even during the coldest months.

Success Stories: How UK Businesses Are Adapting to Cold Weather Working

Amid the challenges of cold weather, there are numerous UK businesses that stand as beacons of best practices, showcasing innovative and caring approaches to keep their teams safe and productive. These success stories not only highlight compliance with health and safety regulations but also demonstrate a commitment to employee well-being that goes beyond mere obligations.

One such example is a construction company in Northern England that has set a high standard for outdoor working in the cold. Recognizing the risks posed by freezing temperatures, they have implemented a comprehensive cold-weather strategy. This includes providing high-quality thermal PPE, setting up heated break tents on-site, and scheduling work to minimize exposure during the coldest parts of the day. Their proactive approach has resulted in a notable decrease in cold-related absences and an increase in worker morale.

Another case involves a large office complex in Scotland, where management took steps to combat the challenges posed by a particularly harsh winter. They enhanced their building's insulation, provided additional space heaters in colder areas, and introduced flexible working hours to help staff avoid the chill of early mornings. These measures not only kept the workforce warm but also conveyed a strong message of care and concern for employee comfort.

These stories underscore that adapting to cold weather working is as much about innovation and empathy as it is about adhering to guidelines. They serve as inspiring examples for other businesses looking to navigate the winter months effectively while keeping their teams safe and motivated.

Wrapping Up: Staying Safe and Productive in the Cold

As we've seen, navigating the cold weather at work is about more than just enduring lower temperatures. It's about creating an environment where safety, health, and productivity go hand in hand. Employers who recognize this not only comply with regulations but also foster a workplace culture of care and respect. Whether it's through providing the right equipment, maintaining comfortable temperatures, or simply being attentive to employee needs, the efforts made to combat the cold can have a profound impact. As winter marches on, let's remember that a warm approach to employee well-being is key to thriving through the season.

OSHA Strengthening DOT Whistleblower Protections

The realm of transportation safety is heavily reliant on the vigilant eyes and voices of whistleblowers. These individuals, often employees within the sector, play a crucial role in identifying and reporting safety violations, thereby safeguarding not only their fellow workers but also the general public. Recognizing this critical function, the Occupational Safety and Health Administration (OSHA), in tandem with the National Labor Relations Board (NLRB), has recently undertaken significant steps to bolster whistleblower protections. This move is particularly pertinent in the Department of Transportation (DOT), where ensuring safety is paramount due to the potential for widespread impact. By enhancing the mechanisms for protecting and incentivizing whistleblowers, OSHA aims to create a more secure and transparent transportation sector. This blog post delves into the background of these protections, the recent developments spearheaded by OSHA and NLRB, and the implications for both workers and employers in the transportation industry.

Background of Whistleblower Protections in the DOT

The Department of Transportation (DOT) has long recognized the importance of whistleblower protections as a cornerstone for maintaining safety and compliance in the transportation sector. Historically, these protections have evolved to address the complex and varied risks associated with transportation, ranging from road safety to aviation and maritime operations. Legislation like the Motor Vehicle Safety Whistleblower Act, embedded in the broader Fixing America's Surface Transportation (FAST) Act, underscored the commitment to ensuring that individuals who come forward with critical safety information are protected and potentially rewarded. The Whistleblower Act, in particular, set the stage for incentivizing disclosures of violations, defects, or noncompliance issues that could lead to significant risks. Moreover, the Act facilitated the reporting of safety concerns by offering financial bounties to those providing original information leading to successful enforcement actions. This framework has served as a pivotal element in fostering a culture of safety and accountability within the transportation industry. By enabling employees to report issues without fear of retaliation, these legislative measures have significantly contributed to identifying and rectifying safety hazards, thereby enhancing the overall safety standards in transportation.

Recent Developments by OSHA and NLRB

In a significant advancement for workplace safety, the Occupational Safety and Health Administration (OSHA), in collaboration with the National Labor Relations Board (NLRB), announced a pivotal partnership on October 31st, 2023, aimed at fortifying whistleblower protections. This initiative, marked by the signing of a Memorandum of Understanding (MOU), demonstrates a concerted effort to amplify the impact and effectiveness of federal whistleblower protections.

Under this MOU, OSHA and NLRB have outlined comprehensive procedures for information sharing, referrals, training, and outreach, all focused on interpreting and enforcing federal anti-retaliation protections. This step is vital in ensuring that employees can safely exercise their legal rights within the workplace without fear of retribution. Assistant Secretary for Occupational Safety and Health, Doug Parker, emphasized the importance of this partnership, stating that it is crucial for workers to be able to raise concerns about workplace violations or retaliation without the fear of losing their job or facing other forms of punishment.

Additionally, the collaboration aims to promote awareness of workers' rights and offers enhanced protections for those who report workplace hazards. The ability to report such hazards without fear of retaliation is crucial, especially given that workplace safety can be a matter of life and death. Jennifer A. Abruzzo, NLRB General Counsel, underscored the importance of this MOU, noting that it bolsters protections for workers to speak out about unsafe working conditions by strengthening coordination between OSHA and NLRB in their enforcement efforts.

Furthermore, as part of this joint effort, OSHA and the NLRB created a fact sheet titled “Building Safe & Healthy Workplaces by Promoting Worker Voice”. This resource is designed to help workers better understand their rights and the recourse available when employers violate these rights. The fact sheet aims to empower employees to speak out about violations without fear of retaliation, marking a significant step in safeguarding workplace rights and safety.

NHTSA's Proposed Rule to Formalize its Whistleblower Program

In another stride towards strengthening whistleblower protections, the National Highway Traffic Safety Administration (NHTSA) issued a notice of proposed rulemaking (NPRM) on April 14, 2023. This initiative is aimed at formalizing the NHTSA's Whistleblower Program under the Motor Vehicle Safety Whistleblower Act, a part of the Fixing America’s Surface Transportation (FAST) Act. The proposed regulations are designed to incentivize whistleblowers to provide safety information to NHTSA and ensure their protection.

The Whistleblower Act authorizes NHTSA to reward whistleblowers who disclose original information about potential violations of the National Traffic and Motor Vehicle Safety Act and its regulations. This includes reporting motor vehicle defects, noncompliance, or alleged violations of reporting requirements that could pose an unreasonable risk of death or serious physical injury. Whistleblowers could receive a bounty of 10% to 30% of any civil penalties over $1 million collected from the violating entity.

The NPRM seeks to broadly define "original information" to encourage disclosures. This includes information derived from an individual’s independent knowledge or analysis, not already known to NHTSA or derived from public sources. NHTSA’s proposed rule also includes provisions for waiving the statutory requirement that whistleblowers must first report information internally if they reasonably believe it would lead to retaliation or if the issue is already known or under investigation by the manufacturer.

This proposed rule represents a significant effort to create a more robust framework for whistleblowers within the transportation sector, aiming to enhance safety and compliance through increased transparency and accountability.

Implications and Importance for Workers and Employers

The strengthening of whistleblower protections by OSHA, NLRB, and NHTSA marks a significant shift in the landscape of workplace safety and compliance, especially within the transportation sector. For workers, these developments signal a heightened commitment to protecting those who courageously report safety violations or non-compliance. The enhanced protections and potential financial incentives not only encourage more employees to come forward with crucial information but also serve as a deterrent against employer retaliation.

Employers, on the other hand, are prompted to pay closer attention to their compliance with safety regulations and their response to whistleblower reports. The intensified focus on whistleblower protections underscores the importance of fostering a transparent and responsive workplace culture. For the transportation industry as a whole, these measures are likely to lead to improvements in safety standards and practices, ultimately benefiting public safety and the sector's integrity.

In conclusion, the collaborative efforts of OSHA, NLRB, and NHTSA in strengthening whistleblower protections are a commendable step towards enhancing workplace safety in the transportation sector. These developments not only empower workers but also hold employers accountable, contributing to a safer and more transparent industry.

Navigating the Aftermath of 3M's OSHA Violation: A Call to Action for EHS Compliance

Workplace safety transcends mere compliance—it's a fundamental right for every employee. When the Occupational Safety and Health Administration (OSHA), the sentinel of workplace safety, imposes a significant fine on a company like 3M, it serves as a stark reminder of the gravity of safety protocols. A severe incident at a 3M plant in Wisconsin not only led to a tragic loss of life but also cast a spotlight on the critical role of Environmental Health and Safety (EHS) regulations. Delving into the nuances of this event, we explore the intricate dance between regulation, safety, and corporate accountability.

Background on OSHA and EHS Regulations

OSHA stands as the cornerstone of worker safety in the United States, a role it has robustly filled since 1970. The agency's mission is clear: to mitigate work-related injuries and fatalities by establishing and enforcing standards that promote safe and healthy work environments. Within this mission lies the crux of EHS regulations—a set of directives that span across the management of hazardous materials, operational machinery, and emergency protocols. These guidelines are not set in stone; rather, they evolve in tandem with the changing landscapes of work environments and technological progress, ensuring that safety remains an ever-present priority.

The 3M Incident in Detail

The incident at 3M's Prairie du Chien facility was a sobering wake-up call. According to reports, an employee became entangled in a machine's rotating rollers, a horrifying accident that ultimately proved fatal. OSHA's investigation revealed a startling disregard for established safety protocols, leading to two willful safety violations against the company. The scrutiny brought to light a history of similar equipment-related incidents across 3M's North American plants, underscoring a pattern that could no longer be overlooked. Such an event underlines the urgency for rigorous enforcement of safety measures and a proactive approach to hazard assessment.

Consequences and Fines for 3M

Following the incident, OSHA's response was swift and uncompromising. The fines imposed on 3M totaled over $300,000, a sum that reflects the severity of the violations and serves as a financial deterrent against future lapses. These penalties also serve a broader purpose: to signal to industry peers that non-compliance with safety regulations carries substantial consequences. While fines alone cannot compensate for the loss of life, they play a crucial role in the ecosystem of workplace safety by emphasizing the cost of neglect and the value of human life within the corporate calculus.

Comparison with Previous Incidents

The Prairie du Chien tragedy is not an isolated occurrence in the industrial world; it reflects a concerning trend of safety oversights. Previous incidents, including another fatal accident at a 3M plant in Minnesota earlier that year, echo the recent violation's themes. These incidents collectively highlight a critical need for continual reassessment of safety protocols and the implementation of corrective measures. By examining these events side by side, it becomes evident that systemic changes are necessary to uplift the standards of workplace safety and ensure that such preventable tragedies do not recur.

Role of EHS Compliance Software and Management Solutions

In the digital age, EHS compliance software and management solutions are invaluable tools in the quest to avert workplace accidents. These systems serve as the digital backbone for safety programs, enabling organizations to track compliance, manage data, and identify risks proactively. For a company like 3M, with its extensive range of products and vast operational scale, leveraging such technology is not just beneficial but essential. The integration of compliance calendars, real-time monitoring tools, and safety audits into a unified platform can streamline the management of EHS processes, driving a culture of safety that is both efficient and effective.

Importance of Compliance Audits and Checklists

 Compliance audits and EHS checklists are not just checkboxes to be ticked—they are strategic tools that can drastically reduce workplace hazards. Regular audits are critical for ensuring that safety practices are not only in place but also adhered to and effective. Checklists, such as the International EHS audit checklist, help maintain a high level of diligence and provide a roadmap for continuous improvement. For industries that face a myriad of potential hazards, such as manufacturing, these resources are indispensable for maintaining a safety-first approach and meeting the stringent standards set by OSHA and other regulatory bodies.

Corporate Responsibility and EHS Solutions

Corporate responsibility in the realm of EHS is paramount. Companies like 3M, given their scale and the nature of their operations, bear a significant responsibility to lead with integrity in safety management. It's not only about complying with regulations but also about setting industry standards. Implementing robust EHS solutions, including comprehensive training programs, regular risk assessments, and the adoption of best-in-class safety equipment, can transform the safety landscape of a company. When corporations prioritize the health and safety of their workforce as part of their operational ethos, they set a precedent that resonates across the industrial sector.
The Future of EHS Compliance

The trajectory of EHS compliance is likely to become more stringent, with advances in technology and analytics playing a pivotal role. Incidents like the one at 3M serve as catalysts for change, often accelerating the adoption of stricter regulations and more sophisticated compliance tools. The future will demand greater transparency, accountability, and responsiveness from corporations. As the regulatory landscape evolves, so too must the strategies employed by companies to meet these challenges. Embracing innovative EHS management solutions, fostering a culture of safety, and committing to continuous improvement will be essential for any organization striving to not only meet but exceed the expectations of workplace safety standards.

Global Warming Continues to Threaten Regional Livelihoods

With soaring surface temperatures and new record highs recorded every year for the past 50 years, global warming continues to be one of the biggest threats to various regions around the world. Arizona in particular just recorded the hottest summer in the state’s history, unfortunately coinciding with an increase in heat related deaths across the state. Continued effects from the result of ongoing warming trends in regional environments could pose additional challenges for individuals in the future. 

Record high temperatures can affect the body in a variety of different ways, and create unstable biological conditions that can lead to death. The high surface temperatures also pose threats to infrastructure, technology, and vital installations in urban metropolitan areas. Negative associated effects of heat exposure can be exacerbated when necessary resources are compromised in heat wave events. Officials are still tallying the number of deaths that resulted from the record temperatures in Arizona this year, and many scientists are looking to the future, concerned about new associated risks. 

Record High Summer Temperatures

This summer proved to be a record breaking year for surface temperatures across many regions in the United States, and specifically in Arizona. Record keeping for temperatures began in the state in 1895, and this year experienced three of the highest recorded months on record.

Daily average temperatures this summer holdfast at 97 degrees Fahrenheit which surpassed the three year previous record of 96.7 degrees Fahrenheit. Phoenix also set a record for a 31 day streak of temperatures at or exceeding 110 degrees Fahrenheit. Heat waves like that seen in Phoenix are beginning to happen more frequently as the climate in the region becomes dryer and overall global temperature averages continue to rise. Officials began recording associated deaths in 2005 to identify where policy changes could be applied to lessen the impacts of heat related casualties. They have added several categories to discern the deaths and provide a well rounded investigation into their route cause and resolution.

Heat Related Death Information

  • Sex

  • Age

  • Race

  • Ethnicity

  • Location 

  • Indoors vs Outdoors

  • Air Conditioner present?

    • Working or not working

  • Electricity present?

Collecting vital information like these statistics is vital for researchers when discerning associative risk factors in severe weather events like those of this summer. These electricity statistics are important because findings have influenced power companies to maintain vital electricity powering air conditioners running during heat waves, even if clients have not paid their bills. 

Many of the deaths recorded in previous years happened due to a lapse in power, leaving the affected individuals inside their homes without a working air conditioner. Having the means to cool off is vital during extended periods of record high temperatures, especially when outside averages exceed into the triple digits. 

Counting Heath Related Deaths

Counting and recorded heat related casualties can take an extended amount of time for officials because there are many factors involved in the investigations. There are investigations into the individual's past and present related health conditions, environmental hazards, toxicology reports, autopsies, weather forecasts, and resource assessments. Mariposa county investigates heat deaths including those caused by excessive temperatures, heat stroke, and heart attacks as the result of environmental stress. 

This year's records observed almost 75 percent of the total recorded deaths to have occurred outside exposed to the elements. Almost half of those deaths were homeless people who did not have access to air conditioning, water, or other vital resources. There are an estimated 10,000 people in Mariposa county without access to a home, so the numbers could be potentially much higher if severe conditions persisted even longer. 

Less than 100 of the recorded deaths so far happened indoors in Arizona. Most of these recorded deaths occurred in homes where the in unit air conditioners were turned off or disabled. 

Future of Heat Related Deaths

As global warming continues to impact the world, many regions are experiencing rapid environmental changes. While some regions are experiencing extended winters, rain, and moisture other regions like the southwestern United States have observed quite the opposite. Southern Arizona has just experienced its hottest recorded summer with an extended period of time exceeding triple digit temperatures. These conditions are not atypical for the desert region, however their extended durations and excessively high temperatures are a direct result of the effects of climate change. 

In the future regions like this will continue to see extended periods of extreme temperatures and the cities need to establish enough access to vital resources to prevent increases in heat related deaths. This summer already showed a dramatic increase compared to past years, and hopefully it will lead to improvements in policies controlling the distribution of access to life saving resources like air conditioning, water, and shelter. 

Onsite Treatment to Revolutionize Employee Health Management

Workplace injuries are a constant concern among a variety of industries in the nation. Rising costs and inflation associated with medical care can also negatively impact employers as they respond to injury claims. Businesses also lose money from days of leave taken by injured employees and many additional costs can quickly add up. 

The Occupational Health and Safety Administration (OSHA) has published data suggesting that there are 2.5 injuries for every 100 construction workers in the United States. Statistics for this past year of reported injuries totalled more than 21,000 nonfatal cases caused by falls, slips, and trips. OSHA also publishes extensive safety protocols and education materials each year targeting at limiting these kinds of workplace injuries. American businesses are required to implement many forms of safety education, facilitation, and treatment for their employees. While there are a variety of tools aimed at preventing workplace injuries, they are still likely to occur and additional measures are being developed to further reduce the response time to employee claims. 

Treating Injuries Onsite

Treating injuries onsite is a newer method of response for employee injuries. Onsite clinics are equipped with the facilities, tools, and staff to effectively treat injuries that occur in a work environment. Onsite clinics allow professionals to take the necessary steps to mitigate and identify risks that could lead to accidents that pose additional risks to the company. The thought is that by having these onsite clinics available to employees, there will be improvements in the environment of safety on the job and a reduced response time to effectively treat minor injuries before they become more serious. 

Onsite Clinic Duties

  • Rapid Evaluation of Injury

    • The main role of an onsite clinic will be to rapidly identify and evaluate an employee’s injury. The professional report will determine the extent of the injury, cause, any trends, and lead to a diagnosis of treatment. 

  • Knowledgeable Assessment of First Aid

    • Many workplace injuries can be remedied by simple first aid administered by medical professionals.

    • The official background and experienced staff employed by the onsite clinic will be able to translate their experience to the condition of the affected employee. 

  • Recommend Treatment

    • After identifying and evaluating the employee’s injury the medical staff will be able to address a diagnosis attached to treatment plans. 

    • Having medically trained professionals administer diagnosis and evaluation will prevent minor injuries from getting referred to more serious and expensive practitioners. The professionals will also be able to facilitate many in house treatments that will additionally cut costs for employers and insurance lenders. 

All the nuances of treating onsite injuries without the medical professionals associated with an official clinic can add many complications to effective diagnosis and treatment of an injured employee. These complications result in exponentially higher costs harbored by the company as injury claims and workman’s compensation can be a lingering process. Last year the average worker’s compensation claim cost more than $41,000 according to the National Safety Council. With claim costs averaging such high amounts, it is vital employers and businesses across the nations develop methods to save money and adequately support their employees.

Industry Specific Customizations

By establishing a personal onsite clinic at work sites, employers will be able to customize the kind of specific care and capabilities they provide. Construction sites will be able to attribute more resources devoted toward bodily mobility injuries most commonly faced in their industry. Another feature that could be added to clinics are the ability to effectively respond to specific chemical exposures at different locations, which offers a much higher level of care and efficiency to patients.By allowing specifications to personal onsite clinics, employers will be able to save on injury costs in the future by preventing them before they happen and promptly responding when they do. 

Other Customizations

  • Mobility injuries

  • Bone and soft tissue treatments

  • Respirator fit testing

  • Medical surveillance

  • Hazardous material exposure protocols

  • Drug and alcohol screening

Implementing Prevention Protocols

With the breadth of knowledge and experience that will be associated with establishing an onsite clinic, employees will be able to access vital resources to treat their mental and physical well beings. It is crucial for employers who want to cut costs to not only engage in treatment and evaluation of workplace injuries, but also to invest in prevention programs that can stop injuries from ever occurring. Onsite clinics can design these prevention programs by establishing the knowledge and necessary designs to implement wellness programs that maintain a healthy and productive employee environment. 

Prevention programs will not only work to improve employee education and awareness of potential workplace injuries, but will also provide vital tools they can use to instill responsibility with employees themselves. Providing vital safety tools to employees will help them recognize safety hazards, onsite injuries, and indicators for compromised mental and physical health.