Driver safety
We recognise that our sales representatives can be at risk especially from road traffic accidents, and ergonomic stressors such as manual handling. With the number of sales representatives GSK has employed around the world, and with the wide range of countries in which we operate, there may at times be unfortunate accidents or fatalities.

The lost time injury and illness rate for our commercial organisation of 0.41 is greater than that of our manufacturing organisation. The main cause of these lost time injuries in commercial is motor vehicle accidents. In total 21% of lost time injuries resulted from motor vehicles. In addition, two of the three fatalities that occurred in GSK in 2002 were from motor vehicle accidents. Therefore, reducing the number of motor vehicle accidents in commercial operations is a key priority for GSK.

In 2002 we worked on reviewing current programmes and developing a programme for commercial operations focused on driver safety, office safety and on improving reporting of incidents. Rollout of these programmes for commercial operations will be a major focus in 2003. We will be working with a few pilot locations to test the programmes and will in the future focus driver safety training on areas of the world with the highest number of road traffic incidents. The main elements of the programme being developed include:

• Educating drivers and their managers on roles and responsibilities.
• Improving investigation and reporting of work-related vehicle accidents.
• Developing driver check lists for use by line managers.
• Making available defensive driving courses and training.
• Assessing driver profiles to identify individuals needing additional training.
• Advising on car selection including safety, security, environmental and ergonomic advice.
• Promoting safe driver behaviours.
• Providing guidance on mobile phone use.

Ergonomics
Ergonomic-related illnesses remain the most frequent illnesses at GSK. In 2002, 43% of all illnesses and 65% of all lost time illnesses were musculoskeletal in nature and resulted in 1,450 lost days. Office and production tasks caused 75% of these illnesses. While the impact on GSK remains substantial, these figures represent reductions from 2001 when ergonomic-related illness was 53% of total illness, causing 193 cases and 1,023 lost days. In addition to illness, 18% of all occupational injuries and 19% of lost time injuries were due to overexertion and strains. These injuries resulted in 2,231 lost days. Taken together, ergonomic-related injury and illness account for 23% of all injury and illness and 23% of all lost time days. Sustained improvements in ergonomics will help GSK operations meet the objective of a 15% annual reduction in lost time injury and illness rate.

Reducing ergonomic illness and injury has been a key focus for 2002. Current and past data, programmes and initiatives were reviewed. An EHS guideline and supporting tools were developed, providing a preferred approach to prevent and manage the health and safety aspects of ergonomic risks. GSK sites progressed successful local initiatives. Continued rollout of these programmes will be a major focus in 2003, supported by joint Corporate and GMS business objectives, local consultation, site audits, and global training. One key objective is to use operational excellence processes and tools to establish an ergonomic improvement process that reduces ergonomic injuries and illnesses and improves productivity and quality. Collectively, these efforts have combined to reduce the impact of ergonomic illness and will form the focus of our continued efforts.

Occupational Hygiene and Control of Chemical Agents
The pharmaceutical industry discovers and manufacturers compounds that are designed to have biological effects on the body. As a result, safe handling precautions are required to protect our employees in R&D and manufacturing. At GSK we try to create a work environment that relies on engineering controls and technology to maintain exposures below the Occupational Exposure Limit (OEL) and comply with both GSK and legislative requirements.

In 2002, many of our occupational illnesses and injuries resulted from chemical exposures. For example, the second most common category of occupational illness was non-allergic dermatitis which includes irritant dermatitis and steroid withdrawal rash. There were 154 and 64 cases reported in 2002 and 2001, respectively. The large increase was principally due to improvements in reporting recurrent cases of steroid withdrawal rash. While the number of cases increased dramatically, the number of lost days in 2002 decreased to 13 from over 290 in 2001. Two additional categories of chemical exposure-related illness merit special notice: allergic dermatitis and allergic respiratory disease, which together account for eight percent of all occupational illness. These illnesses remain a special area of focus as they result in life long health effects that can be life threatening. The primary causes of allergic dermatitis and respiratory disease continued to be chemicals, laboratory animals, and latex. There were some individual successes in 2002, such as a 54% reduction in latex allergy as compared to 2001 experience. Sustained improvements in chemical agent control will help GSK operations meet the objective of a 15% annual reduction in the lost time injury and illness rate. Work-related mental illness is not included in these statistics but is discussed below.

Managing Chemical Exposures has been identified as a key theme for GSK for 2003. To support this theme, GSK has set objectives, established a Chemical Agents Steering Committee (CASC) and made tools available. The objectives include assessing worker exposures to high hazard compounds at primary and secondary manufacturing facilities. Corporate Environment, Health and Safety and Employee Health Management, in conjunction with Engineering, Technology and Capital Management, R&D and Global Manufacturing and Supply have launched several tools to provide assistance with assessing risk and designing controls. These tools include guidelines, technical information documents, exposure control matrix and exposure control engineering design solutions.

Work-related Mental Health
Work-related mental illness is evaluated separately from other work-related illnesses and is not included in rates or numbers in this report unless specifically noted. As compared to 2001, work-related mental illness dropped to the third most common cause of occupational illness, accounting for 20% of all illness cases, 53% of all lost time illnesses and 3,133 lost days of productivity. In addition, persons with mental illness had the highest case severity, with a mean of 51 days absence per case vs. 36 days for all other illness. Of course, the impact of mental illness extends beyond the number of days lost to directly affect both productivity and quality of life.

While many of the immediate stressors of the merger have passed, the focus for GSK continues to be protecting and enhancing the mental health of employees by fully implementing the requirements of the Global EHS Resilience and Mental Well Being Standard. This effort includes:

• Ongoing identification and assessment of job related risks to mental well-being through such tools as the Global Leadership and Organisational survey, numerous business initiatives, and the launch of an intranet-based team assessment tool for managers.
• Reductions in risks and promotion of the general mental well-being of employees through such programmes as wellness initiatives and mental health care support systems.
• Confidential investigation, reporting and corrective actions to prevent recurrences.

During 2002, progress was made in establishing globally consistent diagnosis, investigation, reporting, and management of work-related mental illness cases. The number of cases increased as did the geographic and business distribution of reporting. Because the data lacked consistency for the entire year, details of mental ill-health cases will again be reported separately from key injury and illness measures as in 2001. However, given the past years' progress, it is intended to review these illnesses for inclusion in the GSK lost time and other performance measures in 2003 and 2004.

Read about our Health and Safety Performance

Human Immunodeficiency Virus (HIV)
GSK provides HIV/AIDS healthcare programmes for employees. While arrangements differ depending on local circumstances, all the programmes are based upon a set of principles that reflect current best practice and draw upon Guidelines agreed jointly by the International Organisation of Employers and UNAIDS. Included in the principles:

• GSK does not discriminate against any employee based on HIV status.
• GSK provides information and training to staff on HIV and AIDS prevention appropriate to their needs.
• GSK ensures appropriate provision for the care of HIV positive regular employees, their long term partners and immediate families, including access to voluntary testing with counselling, and provision of anti-retroviral medicines.
• GSK maintains medical confidentiality at all times.

Process safety
Controlling process hazards is a continuing programme in GSK with a goal of minimising risk through the use of expert engineering design and good manufacturing processes. Many GSK products begin with the formulation and processing of hazardous materials such as flammable solvents and combustible powders. Through GSK's Green Chemistry and Green Technology programmes scientists look for opportunities to eliminate the use of these hazardous materials.

Where this substitution is not feasible our Process Safety Programme ensures that safety is built into the process. GSK EHS Standards require all hazardous operations to complete Process Hazard Analysis (PHA) studies that include the identification of hazards, the evaluation of risk and the development and implementation of corrective action where needed. The Process Safety Programme is a continuing management system that is in-place for the life cycle of every process ensuring that the highest level of safety is maintained as the process is operated, refined and finally decommissioned.

During 2002 several major projects were initiated to improve the Process Safety Management Programme at GSK. Corporate Environment, Health and Safety developed technical guides specific to process safety that provide details of the risk assessment process as well as recommended best practice. These guides were distributed to GSK manufacturing and R&D facilities. PHA assessment tools including the intranet-based Process Safety aspect of the Control Matrix, and Hazard and Operability (HAZOP) PHA systems were launched.

GSK R&D and manufacturing sites continue to implement robust Process Safety Management Systems based on GSK's Standards and on global and local regulatory requirements. Using the GSK tools and best practice, research and production facilities continue to ensure that GSK's processes are designed, installed and operated at the highest level of safety and environmental control.

In 2003 GSK will continue to enhance the Process Safety Programme through the launch of additional PHA tools, engineering guides and training seminars.

Safety engineering
GSK's safety engineering programme focuses on construction, plant safety and emergency response activities to ensure that our employees, contractors, visitors and the community are protected from the operational hazards within our facilities. Through innovative programmes such as the Risk Assessment and Control Processes, Construction Contractor Safety Programme, Capital Project EHS Review Process and our Emergency Response Programmes we ensure that safety is built into and maintained at our sites worldwide. The reward for such actions can be seen at sites such as Sonepat, India where a major construction project spanning three years involving 1,700 construction workers recorded 6 million hours worked without a lost time injury. During 2002 and continuing into 2003 the GSK safety engineering community initiated site improvements and awareness campaigns to protect our UK sites and employees' homes during the UK's Fire Brigade Union strikes. In addition, fire safety awareness campaigns were launched in other countries to reinforce fire safety in the workplace and at home.

A continuing process within our Safety Engineering Programme is the development and distribution of safety engineering guides and safety alerts. These intranet-based tools provide engineered solutions to fire, explosion, electrical, machine guarding and other operational risks. These guides provide a standardised GSK global approach to difficult safety risks.

For 2003 we will be expanding our globally standardised approaches to manufacturing hazards by developing safety engineering design guides and by implementing process safety risk analysis programmes for manufacturing operations that are traditionally not covered by government-regulated process safety programmes.