Safety Culture and Climate: Construction Worker Safety and Health

Transcription

1 Safety Culture and Climate: Construction Worker Safety and Health Men at lunch, RCA Building NYC 29 September Jack Dennerlein 1 November

2 Safety Culture Outline It s everywhere Regresses to the individual Organizational policies, programs & practices Safety Culture and Climate in Construction Safety climate and physical working conditions Improving safety climate intervention studies Improving worker health (Health Culture) 2

3 Between 2000 and 2007, academic literature and popular media exploded with references to safety culture. Over 2250 articles in newspapers, magazines, scholarly journals, and law reviews in an eight-year period included references to safety culture, whereas only 570 references were found in the prior decade. The concept of safety culture has become a hot topic within safety research, with scientific journals like Work and Stress and Safety Science both special entire issues to the topic1. Stian Antonsen (2009) Safety culture and the issue of power. Safety Science 47: Susan S. Silbey (2009) Taming Prometheus: Talk About Safety and Culture. Annu. Rev. Sociol. 35:

4 2015 4

5 2010 5

6 2015 6

7 2003 7

8 Displaying affinities with individualist and reductionist epistemologies, safety culture is frequently operationalized in terms of the attitudes and behaviors of individual actors, often the lowest-level actors, with the least authority, in the organizational hierarchy. Susan S. Silbey (2009) Taming Prometheus: Talk About Safety and Culture. Annu. Rev. Sociol. 35:

9 Worker Outcomes Injury Illness Wellbeing Worker Proximal Outcomes Health & Safety Behaviors Engagement in Programs Beliefs Knowledge Skills Enterprise Outcomes Productivity & Quality Turnover & Absence Health Care Costs Sorensen et al. Prev Med Aug 12;91:

10 2011 "Air-traffic controllers have notoriously difficult schedules that are prone to inducing profound levels of impairment associated with sleep deficiency," says Chuck Czeisler, a Harvard University Medical School professor who specializes in sleep research. 10

11 Sociological critiques claim that culture is emergent and indeterminate and cannot be instrumentalized to prevent technological accidents. Rather; Research should explore the features of complex systems that have been elided in the talk of safety culture: normative heterogeneity and conflict, inequalities in power and authority, and competing sets of legitimate interests within organizations. Susan S. Silbey (2009) Taming Prometheus: Talk About Safety and Culture. Annu. Rev. Sociol. 35:

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13 Safety Climate Safety Climate is based on the functional construct of organizational climate where workers understand what is being rewarded (and penalized) within complex and ambivalent organization. Organizations are complex and ambivalent Climate perceptions require detection from multiple cues in the presence of competing demand and inconsistent policies Zohar D. Accid Anal Prev. 2010;42(5):

14 Worker Outcomes Injury Illness Wellbeing Worker Proximal Outcomes Health & Safety Behaviors Engagement in Programs Beliefs Knowledge Skills Enterprise Outcomes Productivity & Quality Turnover & Absence Health Care Costs Sorensen et al. Prev Med Aug 12;91:

15 Enterprise Characteristics Workplace Policies, Programs, & Practices Degree of integration Indicators of integration Worker / Work Force Characteristics Conditions of work Physical Environment Organization of Work Psychosocial Factors Job Tasks & Demands Worker Proximal Outcomes Health & Safety Behaviors Engagement in Programs Beliefs Knowledge Skills Worker Outcomes Injury Illness Wellbeing Enterprise Outcomes Productivity & Quality Turnover & Absence Health Care Costs Sorensen et al. Prev Med Aug 12;91:

16 Safety Climate and Conditions of Work Grant et al Harvard Chan School Doctoral Thesis,

17 Safety Climate and Conditions of Work Table 2.2. Results of repeated measures analysis. Effect Estimate N Standard Error p-value Climate/Safety Inspection < * Lagged one week

18 Transience of the industry Subcontracting Work organization ( cultural unit?) Induction / acculturation process (training through the trades) 18

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20 Workers come and go on construction sites Number of new workers who completed baseline survey and those syll on-site for follow up Number of workers who lex site B B B=baseline (new workers) F#=follow up number (returning workers) B F1 B F1 F1 F2 F2 B B F1 F2 F2 F3 B B F1 F1 F2 F3 F Month of the study on the worksites Sparer et al, Amer. J. Ind. Medicine, (9):

21 Innovation can overcome challenges Components that improve culture include: Communications Incentives Leadership Integrating Adapting

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23 Communication: Safety Performance Feedback Inspection (Identifying Controls and Hazards) Superintendent mitigates hazard Site and subs Scores to workers Hazards Reported Super/SM/PM Controls & Hazards Foremen Reports Sparer et al, New Solutions, 2015 May;25(1):

24 Incentive: Lunch and Raffle Sparer et al., 2013, Safety Science 51: Sparer et al., 2015, New Solutions 25(1):

25 A u g S e p t O c t N o v D e c J a n F e b M a r A p r M a y J u n J u l A u g S e p t O c t N o v D e c J a n F e b M a r A p r M a y J u n J u l A u g S e p t O c t N o v D e c J a n F e b M a r A p r M a y J u n J u l A u g S e p t O c t N o v D e c D R P I P C A B C D E F G H Evaluated Cluster Randomized Trial on 8 (4 pairs) sites Key: DR = Dry run of intervenyon PI = Pilot of intervenyon PC = Pilot of control A-H = Full scale RCT sites A-H Each color represents a matched pair IntervenYon Control IntervenYon Control IntervenYon Control IntervenYon Control Dry Run Pilot IntervenYon Pilot Control Data collecyon methods & control Sparer et al, Scand J Work Environ Health, Accepted!

26 Safety Climate Improved! Amount of improvement varied across pairs Effect estimate SE Effect Size P-value Model 1 Simple % 0.06 Model 2 Adjusted for pair/block % 0.01 Model 3 Adjusted for baseline differences % Change in safety climate score IntervenYon Control -4 Pair 1 Pair 2 Pair 3 Pair 4 Mean Sparer et al, Scand J Work Environ Health, (4):

27 Qualitative Results Safety communication: "It helped safety wise definitely, to be cautious of other people and what s around you, and that's huge. Communication is key between the trades.. Teambuilding: The trades were working together with the program, and other trades were watching out for everyone else. Normally they would never do that, but now I see talking amongst the trades this came from the program. Positive reinforcement of safe work practices:(intervention) "It felt good to finally get a report in a meeting to say I did something right" Sparer et al, Scand J Work Environ Health, (4):329-37

28 Incorporating hazards into the Sociotechnical systems Climate perceptions require detection from multiple cues in the presence of competing demand and inconsistent policies Hazards and Controls Physical, Psychosocial Grant, M. PhD Thesis Marin, Luz PhD. Thesis Sparer et alscand J Work Environ Health, (4): Sorensen et al,

29 Innovation can overcome challenges Components that improve culture include: Communications Incentives Leadership Integrating Adapting

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31 The Center for ConstrucYon Research 31 and Training (CPWR) Project PI: Linda Goldenhar CPWR Co-PI: Stephanie Johnson University of Colorado Natalie Schwatka University of Denver John Rosecrance Colorado State Jack Dennerlein Northeastern University NaYonal evaluayon Colorado Georgia Ohio Kentucky West Virginia Massachusejs

32 Foreman are required to take 30 OSHA Safety Training Developed and adding a Safety Leadership Module/elecYve OSHA Has approved adding the developed curriculum 5 LEADERship Skills Leads by example Engages and empowers team members AcYvely listens and pracyces threeway communicayon DEvelops team members through teaching, coaching, & feedback Recognizes team members for a job well done 32

33 33 Who are Safety Leaders? Foremen frontline managers Experienced workers Trainees/apprenYces Superintendents Owners Anyone.Everyone

34 Innovation can overcome challenges Components that improve culture include: Communications Incentives Leadership Integrating Adapting

35 All the Right Moves Aim 1: Develop a worksite-based, multi-component, and integrated musculoskeletal disorders prevention and health promotion intervention for workers in commercial construction Aim 2: Complete a feasibility study of the developed worksite based intervention on six sites, randomly assigned to either intervention (five sites) or controls (five sites) with workers measured at baseline and at one and sixmonth follow up

36 Lessons learned: What works? Collaborative engagement in planning and vetting of ideas/components of integrated programs Customization to setting, population and needs Okechukwu 2014 Total Worker Health Symposium Augmentation of existing program should occur as much as possible 36

37 Soft-tissue Injury Prevention(StIPP) Feedback SIPP InspecYons Pre-task plans Work Tasks Built from safety programs (Z10) and matching our own implementation guidelines 37

38 38 Health week Education & engagement & health coaching

39 Cluster Randomized Controlled Trial 10 Construction Sites 5 Pairs ( ) Matched and randomized within GC Concurrent treatment/reference Intervention Treatment Sites StIPP Six Weeks Offered 4 telephone health coaching sessions Data Collection Treatment & Reference Baseline N =

40 Treatment reduced new incidence of worker pain and improved selfreported health behaviors. Workers loved Health Week Change psychosocial factors? Co-worker and supervisor support? No change in work environment Did not measure psychosocial factors, but qualitative data supports. Not sensitive enough to measure physical StIPP program had limitations Needed more upstream changes and planning including the bidding process

41 Table 2: Effects of intervention on changes in worker health from baseline to follow-up 2 Outcome Measure (units) N Β-Coefficient (95% CI) P-Value Recreational physical activity (16.46, 62.02) (minutes/day) Healthy diet (0.02, 1.80) Unhealthy diet (-0.78, 0.27) Dietary balance (0.04, 2.36) Categorical outcome variables 12-month pain (increase compared to no change) 12-month pain (decrease compared to no change) Follow Up 2 (six months) Mailed survey Dennerlein et al., Work, Stress, and Health, Minneapolis, MN N OR (95% CI) P-Value (0.15, 0.72) (0.27, 2.23)

42 Innovation can overcome challenges Components that improve culture include: Communications Incentives Leadership Integrating Adapting Still a lot to do! Model for other industries

43 Safety Culture Outline It s everywhere Regresses to the individual Organizational policies, programs & practices Safety Culture and Climate in Construction Safety climate and physical working conditions Improving safety climate intervention studies Improving worker health (Health Culture) 43

44 Thank you! hjp:// Funding sources include but are not limited to grants from the NaYonal InsYtute for OccupaYonal Safety and Health (R01 OH003997, R01 OH008373, R01 OH008781, R01 OH01009, T42 OH008416, U19 OH008861, U60 OH009762). 44