Safety Science 144 (2021) 105446 0925-7535/© 2021 Published by Elsevier Ltd. Developing a novel composite index for monitoring occupational health and wellbeing: A case study in the rail sector in Great Britain Nick Spyropoulos a, * , Victoria Mousteri a , Lisa Regan b , Michelle O’ Sullivan b , Kevin Thompson b , Bridget Juniper c , Liz Davies b a Alma Economics, 24 Stoke Newington Road, N16 7XJ London, UK b RSSB, The Helicon, One South Place, EC2M 2RB London, UK c Work and Wellbeing Ltd, 8 Moreton Ave, Harpenden, AL5 2ET London, UK A R T I C L E INFO Keywords: Occupational health and safety Wellbeing Composite indicator Willingness to Pay Benchmarking Performance indicator ABSTRACT The high economic and social burden of poor physical and mental health among workers calls for strategies to support and protect workforce health. Monitoring occupational health and wellbeing through the consistent and systematic use of data is considered to contribute substantially to designing evidence-based policies that improve outcomes for workers. The purpose of this paper is to expand on current efforts to enhance monitoring practices by introducing a novel approach to developing a composite Health and Wellbeing Index (HWI). HWI can combine a range of areas (for example, sickness absence, exposure to health risks, key health and mental wellbeing) based on valuation methodologies from health economics. The cost of different outcomes to com- panies, individuals and society is identifed using Willingness to Pay (WTP) and Quality Adjusted Life Year (QALY) methods. These costs are compared with estimates of the value society attaches to preventing a fatality to arrive at weightings that refect each HWI component’s monetary equivalence to the cost of a fatality. Based on this method, different components are transformed into comparable units and are added together to calculate a headline metric. A version of HWI that is tailored to the needs of the rail sector in Great Britain was developed in collaboration with the Rail Safety and Standards Board (RSSB) to drive improvements in the sector’s perfor- mance. The new index can be used to track progress over time, benchmark against best practice, identify areas for improvement and develop a robust evidence base for policy design and investment decisions. 1. Introduction Poor health and wellbeing outcomes for people at work pose sig- nifcant challenges to individuals and the economy in the Great Britain and internationally. Based on the most recent evidence by the World Health Organisation (WHO), around 3% of the global disease burden is attributed to work (Wolf et al, 2018). According to recent statistics by the Health and Safety Executive (HSE, 2019a, 2019b), more than 1 million workers suffered from injuries and ill-health as a result of work in each year between 2016/17 and 2018/19 in Great Britain, resulting in high human and economic costs for individuals, employers and the government. The total cost to the economy was estimated at £15 billion in 2017/18. This cost refects the harmful consequences of workers’ poor physical and mental health outcomes in a number of areas including reductions in quality of life, losses in productivity and increased demand for healthcare services. International organisations such as the WHO and the International Labour Organization (ILO), as well as governments and public and in- dustry bodies, acknowledge the importance of maintaining a healthy and productive workforce. Efforts have been made over the last decade to promote health at the workplace, improve outcomes for workers and reduce the burden of disease caused by work. For example, the WHO Health Workplaces strategy identifes the workplace as an important area for health campaigns and policies aiming at protecting workforce health and preventing poor outcomes as a result of both working con- ditions and individual/social factors outside of work (WHO, 2010). Monitoring workers’ health through the use of data in key areas such as sickness absence and illnesses is considered to contribute substantially * Corresponding author. E-mail addresses: nick.spyropoulos@almaeconomics.com (N. Spyropoulos), victoria.mousteri@almaeconomics.com (V. Mousteri), lisa.regan@rssb.co.uk (L. Regan), michelle.osullivan@rssb.co.uk (M. O’ Sullivan), kevin.thompson@rssb.co.uk (K. Thompson), bridget.juniper@workandwellbeing.com (B. Juniper), liz. davies@rssb.co.uk (L. Davies). Contents lists available at ScienceDirect Safety Science journal homepage: www.elsevier.com/locate/safety https://doi.org/10.1016/j.ssci.2021.105446 Received 20 October 2020; Accepted 12 August 2021