If occupational health is concerned with controlling risks to health which occur at work, health promotion in the workplace is concerned with the overall health of the individual - physical, mental and psychological.

A worker's absence will cost a company money regardless of whether the illness is caused inside or outside the workplace - and one of the best and proven way of reducing this cost is through workplace health promotion.

According to Dr Richard Wynne, occupational psychologist and a director of the Work Research Centre in Dublin, recent Europe-wide research has shown that the traditional ways of managing absenteeism - like tightening up the rules and making sure people report in - don't necessarily work because most absenteeism is actually due to health problems. Moreover, companies operating quality management systems - such as ISO 9000 - are starting to consider health promotion for their workforce as part of overall quality within the company, says Dr Wynne.

Occupational health professionals are beginning to see the benefits of health promotion in the workplace and are increasingly becoming involved in it. For instance, the Health and Safety Executive in Britain is developing a new strategy for occupational health, an element of which will be to work much more closely with health promotion in the workplace.

Traditionally, health promotion at work involves things like exercise programmes, no-smoking policies or healthy eating in the workplace. "These tended to be off-the-shelf programmes which seemed a good idea" but they were not necessarily "a response to a particular problem" in a given company, says Dr Wynne.

The more advanced forms of health promotion look at the actual health problems in a particular company. For instance, "something approaching half of health-related absenteeism is due to back problems of one sort or another", says Dr Wynne. So a programme could be devised not only to prevent people lifting weights in the workplace or to design machines so there's less strain on the back, but physical fitness training, manual handling training or education about backcare could be provided. "It's dealing with the problem in the round rather than just the occupational aspect of it," he says.

It is estimated that 30 to 40 per cent of health-related absenteeism is due to stress. "Obviously we get stress in the workplace but we also get stress from outside work. The problem for the employer is that stress affects health and it doesn't really matter from what source: you'll still get people having health breakdowns as a result of stress - or functioning at a lower level than they should - regardless of whether it's from inside the workplace or outside the workplace." So, many companies are introducing programmes on stress which seek to control stress in and outside the workplace.

The more advanced companies have been providing this kind of training for some time but, according to Dr Wynne, it is often done "in a willy-nilly way, with no particular overall aim in mind. I think one of the distinguishing features of good-class health promotion in the workplace is that it's focused - it's got a problem-solving focus. It's got a beginning, a middle and an end. It's not just a matter of picking different programmes to more or less entertain the troops, which has tended to happen in the past."

Dr Wynne advocates a problem-identification approach. "It needn't be a terribly exhaustive process. It's often as simple as looking at the reasons for absence, longer-term and shorter-term, from the absenteeism data. People routinely get reports that 10 people are absent but they rarely look at the reasons for it. They purely look at it in cost terms and compensation terms rather than the whys and wherefores of it." A health promotion programme should be treated like any other project going on within the company.

It should include setting up schedules for what activities are going to happen and a timescale for implementation.

"I think there are many spin-off benefits to doing this that are not just related to solving the problem. The savings in terms of absenteeism and the cost in absenteeism are real. You do see real benefits in knocking off two or three percentage points off your absenteeism rates. And that has real benefit in terms of productivity and cost savings. The other side benefit is there tends to be a big improvement in workforce morale."

A Manual for Promoting Health Activity at Work is available at £80 from the Work Research Centre, 22 Northumberland Road, Ballsbridge, Dublin 4.