Prevention at heart of multifaceted program

Offerings range from hygiene to wellness

With a truly comprehensive occupational health program, it is sometimes difficult to focus on one specific aspect when recognizing it for excellence. That wasn’t necessary, however, in the case of the selection committee of the American College of Occupational and Environmental Medicine (ACOEM) that bestowed a 2003 Corporate Health Achievement Award jointly on Houston’s Mara-thon Oil Co. (MOC) and Marathon Ashland Petroleum LLC (MAP), based in Findlay, OH. In ACOEM’s words, the firms were recognized for their "exemplary programs and practices that protect the health and safety of employees and communities in which they work."

MOC is an integrated energy business and a top-five U.S. oil company, specializing in exploration and development activities in 10 countries. MAP was formed on Jan. 1, 1998, from the downstream operations of its parent companies, Marathon Oil Corp., a 62% interest owner, and Ashland Inc., a 38% interest owner.

The wide range of MOC and MAP offerings fall into three major categories:

  • Healthy People, which incorporates programs such as absence management and international medicine;
  • Health Environment, epitomized by Mara-thon’s workplace and community exposure risk mitigation programs;
  • Health Company, which includes the corporate wellness program, Well ALL Ways.

While the programs and services are almost too numerous to mention, they are linked by a unifying theme: prevention. "We are committed to being leaders in prevention," asserts Brian J. Linder, MD, MPH, medical director for both companies.

Interestingly, this dedication to prevention is foundational in Marathon’s employee wellness programming, a departure from a common tendency at many companies to have the most visible health initiatives focus on those employees who have already developed disease states.

From mediocrity to excellence

In fact, the commitment to prevention has an especially high profile at Marathon through the wellness program, where participation rates in the health risk appraisal (HRA) screening, the cornerstone of a reinvigorated program, have dramatically improved in recent years.

HRAs are critical to wellness efforts because they establish baseline data that wellness professionals can later use to evaluate program effectiveness, and because they can identify at-risk employees. Therefore, achieving high participation rates enhances the validity of the data and improves chances for success.

"Two years ago, participation rates were mediocre," Linder concedes, noting that only about 15% of the employees were completing HRAs at the time.

The company determined that a culture change was the only way to achieve long-term improvement. "People come to the table at different stages [of readiness to change]," he observes. "We planned an aggressive incentive program to encourage participation."

Why target participation before behavioral change? "Most of the literature says it’s difficult to change behavior using incentives," Linder explains. "However, if you focus on participation you’ll get better results." In addition, he notes, the literature also shows a correlation between participation and cost savings.

As people participate in the HRAs and are touched by wellness staff and programs, they can be brought along through the progressive stages of change, he continues.

The vehicle that was used to boost HRA participation was a wellness bank. The company provided a bank of $250 for every employee and spouse (a $500 total), to be used for health and wellness activities. Completing the HRA fills the individual wellness account for the following year. "The bank basically covers anything that gets you out and active," says Linder. "For example, the bank can be used for such things as golf green fees or even Little League membership fees. In fact, last year the program was expanded so bank dollars could be used to purchase exercise equipment."

How have the incentives worked? "They have been highly successful," says Linder. "We’ve been in the 75% to 80% range for participation."

Integration is critical

While targeted strategies like the HRA incentives can help boost the effectiveness of specific programs, overall success at Marathon also is enhanced by the integration of the various health-related departments and services, which range from occupational hygiene to toxicology and product safety, from occupational health nursing to disease management.

"We’re a very heavily regulated industry," Linder notes, "So we must be dedicated to industrial hygiene and toxicology to meet OSHA and EPA standards. But we’re also focused on international health issues, medical surveillance, epidemiologic concerns and studies, and absence and care management. Unless you have a very integrated effort, you are not going to be successful." So, for example, occupational health will regularly interact with the safety department, and with human resources (benefits), and so on.

The credit for successful integration, Linder says, goes to the companies’ "talented and experienced staff." And, of course, the ongoing dedication to prevention.

This dedication literally spans the globe, and includes the international communities where Marathon is active. "We have public health and preventive medicine experts in both companies who are concerned about sustainable development and our social obligation to the community," notes Linder. So, for example, the company is currently involved in a project to combat malaria in Equatorial Guinea.

Bringing things full circle back home, Marathon brings that commitment to prevention to bear in its occupational hygiene program as well. "Everyone knows you can’t have disease without exposure, so we take a proactive approach," says Linder.

Summing up the overriding philosophy that drives occupational health success at MOC and MAP, he notes that "keeping people healthy is the most cost-effective approach."

[For more information, contact:

Brian J. Linder, MD, MPH, Medical Director, Marathon Oil Co./Marathon Ashland Petroleum LLC, 539 S. Main St., Findlay, OH 45840-3295. Telephone: (419) 421-2062. Fax: (419) 421-4559. E-mail:]