Vision zero: Developing proactive leading indicators for safety, health and wellbeing at work

The importance of leading occupational safety and health (OSH) indicators in complementing lagging indicators is an emerging topic for the promotion of a prevention culture in organizations. The purpose of this paper is to describe the development process of a set of proactive leading indicators for safety, health and wellbeing (SHW) at work, which was carried out as part of the International Social Security Association’s (ISSA) Vision Zero strategy. Principles of integrated knowledge transfer and exchange between research, policy and practice were followed in both the conception and development phases, and a mixed methods approach was applied across four stages consisting of: a literature review and input from industry; a quantitative evaluation through an online survey; a qualitative evaluation through feedback from organizational representatives and key stakeholders; and a consensus building workshop with the ISSA Steering Committee. A set of fourteen indicators was developed to complement the ISSA Vision Zero strategy, two in relation to each of its seven golden rules for promoting SHW at work. The indicators deal with integrating each aspect of SHW in e.g. visible and competent leadership, procurement, pre-work briefings, evaluating risk management and targeted programmes, learning from unplanned events, innovation and change, work organization, onboarding and refresher training. Results can be presented qualitatively and quantitatively as e.g. ‘yes’ or ‘no’ responses, on a Likert or continuum (five–point) scale, or with frequencies and percentages. The indicators are designed for use by both small and large organizations across all sectors, and can be used for benchmarking and as key performance indicators. They are not only intended to better direct and control SHW processes, but also to support the development of a prevention culture. Recommendations are provided on how the indicators can be refined and improved through future research

Exploring and Expanding the Category of ‘Young Workers’ According to Situated Ways of Doing Risk and Safety—a Case Study in the Retail Industry

Young adult workers aged 18–24 years have the highest risk of accidents at work. Following the work of Bourdieu and Tannock, we demonstrate that young adult workers are a highly differentiated group. Accordingly, safety prevention among young adult workers needs to be nuanced in ways that take into consideration the different positions and conditions under which young adult workers are employed. Based on single and group interviews with 26 young adult workers from six various sized supermarkets, we categorize young adult retail workers into the following five distinct groups: ‘Skilled workers,’ ‘Apprentices,’ ‘Sabbatical year workers,’ ‘Student workers,’ and ‘School dropouts.’ We argue that exposure to accidental risk is not equally distributed among them and offer an insight into the narratives of young adult workers on the subject of risk situations at work. The categorizations are explored and expanded according to the situated ways of ‘doing’ risk and safety in the working practices of the adult workers. We suggest that the understanding of ‘young’ as an age-related biological category might explain why approaches to prevent accidents among young employees first and foremost include individual factors like advice, information, and supervision and to a lesser degree the structural and cultural environment wherein they are embedded. We conclude that age cannot stand alone as the only factor in safety prevention directed at workers aged 18–24 years; if we do so, there is a risk of overemphasizing age-related individual characteristics such as awareness and cognitive limitations before structural, relational, and hierarchical dimensions at the workplace

Participatory organizational intervention for improved use of assistive devices for patient transfer:study protocol for a single-blinded cluster randomized controlled trial

BACKGROUND: Epidemiological studies have shown that patient transfer is a risk factor for back pain, back injuries and long term sickness absence, whereas consistent use of assistive devices during patient transfer seems to be protective. While classical ergonomic interventions based on education and training in lifting and transferring techniques have not proven to be effective in preventing back pain, participatory ergonomics, that is meant to engage and motivate the involved parties while at the same time making the intervention maximally relevant, may represent a better solution. However, these findings are largely based on uncontrolled studies and thus lack to be confirmed by studies with better study designs. In this article, we present the design of a study which aims to evaluate the effect and process of a participatory organizational intervention for improved use of assistive devices. METHODS: The study was performed as a cluster randomized controlled trial. We recruited 27 departments (clusters) from five hospitals in Denmark to participate in the study. Prior to randomization, interviews, observations and questionnaire answers (baseline questionnaire) were collected to gain knowledge of barriers and potential solutions for better use of assistive devices. In April 2016, the 27 departments were randomly allocated using a random numbers table to a participatory intervention (14 clusters, 324 healthcare workers) or a control group (13 clusters, 318 healthcare workers). The participatory intervention will consist of workshops with leaders and selected healthcare workers of each department. Workshop participants will be asked to discuss the identified barriers, develop solutions for increasing the use of assistive devices and implement them in their department. Use of assistive devices (using digital counters -, primary outcome, and accelerometers and questionnaire - secondary outcome), perceived physical exertion during patient transfer, pain intensity in the lower back, occurrence of work-related back injuries during patient transfer, organizational readiness to change, knowledge on how to perform proper patient transfer, social capital and work ability (secondary outcomes) were assessed at baseline and will also be assessed at 1 year follow-up. Process evaluation will be based on qualitative and quantitative data to assess the implementation, the change process, and the impact of context aspects. DISCUSSION: The study will evaluate the effect and process of a participatory intervention on improving the use of assistive devices for patient transfer among hospital healthcare workers. By using cluster-randomization, as well as process- and effect evaluation based on objective measures we will contribute to the evidence base of a promising intervention approach. TRIAL REGISTRATION: ClinicalTrials.gov (NCT02708550). March, 2016

Participatory intervention with objectively measured physical risk factors for musculoskeletal disorders in the construction industry:study protocol for a cluster randomized controlled trial

BACKGROUND: There is high prevalence of back pain and neck-shoulder pain among blue collar workers in Denmark. Excessive physical exposures such as heavy lifting or working with bended or twisted back are risk factors for back pain among workers in the construction industry. Technical evaluation of awkward postures and kinematics of upper/ lower extremities (accelerometry) during work combined with the level of muscular activity (EMG) and video recordings can improve quantification of physical exposure and thereby can facilitate designing preventive strategies. Participatory ergonomics potentially increase the success of interventions aimed at reducing excessive physical exposures. The objectives of this study are to; 1) determine which work-tasks in selected job-groups involve excessive physical load of the back and shoulders during a normal working day (measured with accelerometers, EMG and video recordings). And 2) investigate whether a participatory intervention can reduce the excessive physical workloads, drawing on measurements from phase 1. METHODS/DESIGN: A two-armed parallel-group, single-blind, cluster randomized controlled trial with allocation concealment will be conducted in the Danish construction industry. Approximately 20 construction gangs (≈80 subjects) will be recruited and randomized at the cluster level (gang). We will record in situ physical workload using technical measurements (EMG, accelerometers and video recordings) during a working day before and after the intervention. Based on these measurements a physical load matrix for each worker will be developed. The participatory intervention consist of three workshops: 1) One at baseline, involving presentation of video clips of the work-tasks with excessive physical load customized for each gang, followed by a participatory development of solutions on how to reduce excessive workloads, leading to development of an action plan on how to implement these solutions at the workplace. 2) A second workshop where the implemented solutions will be further developed and qualitatively evaluated during group discussions. 3) A final workshop at follow-up to enhance long-time organizational sustainability of the implemented solutions. DISCUSSION: The results will provide knowledge about the level of physical exposure of the back and shoulders during specific work tasks in the construction industry, and will provide information on options to implement participatory interventions aiming at reducing excessive physical workload. TRIAL REGISTRATION: ClinicalTrials.gov (NCT02498197), registered 29 June 2015