Improving occupational health risk management in SMEs: the role of major projects - Research report

Project background Although the management of occupational safety and health (OSH) in construction has been problematic historically, there have been improvements in recent years. Health, however, is typically more difficult to manage than safety, and is often the poor relation, despite the evidence that the human costs of work-related ill-health far exceed those of accidents in construction. Improving practices in small and medium enterprises (SMEs) can be particularly difficult but there is evidence that, for safety at least, good practices ‘trickle’ from major projects and companies to smaller organisations and to those who work in them. This research assessed the impact that large projects can have specifically on the way SMEs manage occupational health (OH) risks: it used in-depth interviews with workers, managers and OSH professionals. The research was conducted on the Defence and National Rehabilitation Centre (DNRC), a major construction project which sought to drive good practice in its supply chain. By focussing in detail on eleven of these ‘mid-level’ companies – which sit between the well-resourced main contractors and very small, typically family-run, micro-organisations – it was possible to explore the specific barriers to good practice becoming embedded and consider the interventions necessary to overcome these. Key findings Many of those working on the project considered that the general arrangements for health risk management were similar to the way they usually worked, and particularly were in line with the way that they would work on other high-profile projects. This reduced the likelihood of those companies learning new practices specifically from this project. Nevertheless, there were some cases where subcontractors had purchased new equipment or adopted new habits to meet the requirements in relation to the management of dust or manual handling. This had given them an insight into the usefulness and benefits of such tools or measures and increased their commitment to use them elsewhere. The main area where interviewees reported requirements on this project to be substantially different to their usual practices was for health assessments. This was an area where the client/main contractor had set out to achieve high standards, by bringing an OH provider onto site and requiring that all contractors arranged health checks for their workers. It was also an area where many of the subcontractors were currently falling below recognised good practice. Some companies which had not done health assessments previously said they would now continue with them; and those who were already doing them to a limited degree had used the project to drive the process forward internally. Some had also learnt about risk assessing and supporting individuals with health conditions, largely as a result of discussions with the occupational health adviser (OHA) on site. Many operational workers interviewed were well informed about risk; they were also highly motivated to take care of their health. There was substantial evidence of ‘trickle-down’, that these workers learnt from large projects such as this and carried this knowledge with them. Those in more senior or professional roles also learnt and transferred good practice between jobs. The subcontractors which adopted good practices most willingly were those which were already working hard to improve their OSH. This typically reflected a growing recognition of their responsibility and duty of care towards their workforce and also an organisational desire to do more work on prestigious projects (which were likely to pay the subcontractors enough to be able to work to these higher standards). One of the biggest barriers to good practice in relation to occupational health risks was a lack of knowledge – individuals at all levels made decisions based on an incorrect understanding of either the risks involved or the legal requirements. For example, the legal requirements relating to health surveillance were widely misunderstood; also, many workers believed masks to be the best solution to dust exposure but underestimated the importance of being clean shaven. Many interviewees commented that their main exposure to health hazards, particularly noise and dust, arose from the activities of others. Typically, they relied on PPE to protect them in these situations. A third barrier to good practice was the relatively high proportion of subcontract, self-employed or agency workers. This reflects common working practice in the industry, and the high turnover of workers on site was reported to influence training, safety culture and the costs and provision of health assessments. However, there were examples of contractors working hard to overcome this, by using the same subcontractors or self-employed workers regularly, or actively increasing the number of workers employed directly. Cost was also identified as a potential barrier to good practice: not necessarily for those working on this project, but, in their opinion, for others on less prestigious projects and those running smaller businesses. Conclusions and Recommendations This research has confirmed the impact that major projects can have on driving good practice along the supply chain and that this applies to health as much as it does to safety. It is therefore important that the clients on such projects: • Set and enforce consistently high standards, to expose the supply chain and its workforce to good practices and encourage them to rise to these expectations • Set expectations for the provision of health assessments, so that companies are motivated and supported to put mechanisms in place • Make such expectations very clear at the tender stage to ensure that work is priced and planned appropriately • Employ suitable occupational health specialists such as OH advisers and occupational hygienists to raise standards and support and educate managers and OSH practitioners • Actively develop knowledge in the supply chain by sharing the expertise of in-house specialists • Manage the interactions between contractors to minimise worker exposures from trades other than their own Additionally, industry wide commitment is required relating to: • Consistency within the industry, and ensuring that prequalification and accreditation schemes set high standards for health alongside those for safety • Training for managers, supervisors and OSH professionals to ensure they are as knowledgeable about health as they are about safety • Improved materials for workforce training so that they fully understand the impact of work related ill-health and know how to avoid it • Increased education regarding OH/medical obligations so that senior managers and others in small companies understand what sensitive data they should and should not collect • Processes for managing OH data at an industry level to ensure that records can follow a worker from one project or employer to another, and that all are working to the same minimum standard; such a process could then operate alongside the current requirement for each worker to have a CSCS card. • Increasing the availability of specialist resource such as OH advisers, OH physicians and occupational hygienists, as there is a shortage of all disciplines across the UK Ongoing efforts will be required to achieve widespread change. Clients on major projects need to focus on setting high standards and clear expectations; and ongoing engagement from major contractors and from bodies such as the Health in Construction Leadership Group, Build UK, and Working Well Together are important to propagate good practice through the supply chain. At the same time, wider industry interventions and continued technological advancements will be needed to enable and build on this; alongside legal intervention where necessary to support the minimum acceptable standard

Improving occupational health risk management in SMEs: the role of major projects - Summary report

Improving occupational health risk management in SMEs: the role of major projects - Summary repor

Modern Erosion Rates and Loss of Coastal Features and Sites, Beaufort Sea Coastline, Alaska

This study presents modern erosion rate measurements based upon vertical aerial photography captured in 1955, 1979, and 2002 for a 100 km segment of the Beaufort Sea coastline. Annual erosion rates from 1955 to 2002 averaged 5.6 m a-1. However, mean erosion rates increased from 5.0 m a-1 in 1955–79 to 6.2 m a-1 in 1979–2002. Furthermore, from the first period to the second, erosion rates increased at 60% (598) of the 992 sites analyzed, decreased at 31% (307), and changed less than ± 30 cm at 9% (87). Historical observations and quantitative studies over the past 175 years allowed us to place our erosion rate measurements into a longer-term context. Several of the coastal features along this stretch of coastline received Western place names during the Dease and Simpson expedition in 1837, and the majority of those features had been lost by the early 1900s as a result of coastline erosion, suggesting that erosion has been active over at least the historical record. Incorporation of historical and modern observations also allowed us to detect the loss of both cultural and historical sites and modern infrastructure. U.S. Geological Survey topographic maps reveal a number of known cultural and historical sites, as well as sites with modern infrastructure constructed as recently as the 1950s, that had disappeared by the early 2000s as a result of coastal erosion. We were also able to identify sites that are currently being threatened by an encroaching coastline. Our modern erosion rate measurements can potentially be used to predict when a historical site or modern infrastructure will be affected if such erosion rates persist.Cette étude présente les mesures de taux d’érosion contemporains établies en fonction de photographies aériennes verticales prises en 1955, en 1979 et en 2002 sur un segment de 100 km du littoral de la mer de Beaufort. Entre 1955 et 2002, les taux d’érosion annuels ont atteint 5,6 m a-1 en moyenne. Cependant, les taux d’érosion moyens se sont accrus pour passer de 5,0 m a-1 pendant les années 1955- 1979 à 6,2 m a-1 dans les années 1979 - 2002. Par ailleurs, de la première période à la deuxième période, les taux d’érosion ont augmenté à 60 % (598) des 992 sites analysés, ont diminué dans le cas de 31 % (307) des sites, et changé de moins de ± 30 cm à 9 % (87) des sites. Les observations historiques et les études quantitatives recueillies au cours des 175 dernières années nous ont permis de placer nos mesures des taux d’érosion dans un contexte à plus long terme. Plusieurs des caractéristiques côtières le long de cette étendue du littoral ont reçu des noms d’endroits typiques de l’Ouest dans le cadre de l’expédition de Dease et Simpson en 1837, et la majorité de ces caractéristiques avaient disparu vers le début des années 1900 en raison de l’érosion côtière. Cela laisse donc entendre que l’érosion s’est à tout le moins manifestée pendant la période visée par les données historiques. Grâce à l’utilisation d’observations historiques et d’observations contemporaines, nous avons pu déceler la perte de sites culturels et historiques de même que d’infrastructures modernes. Les cartes topographiques de l’U.S. Geological Survey révèlent un certain nombre de sites culturels et historiques connus, ainsi que des sites dotés d’infrastructures modernes datant des années 1950, sites et infrastructures qui avaient disparu vers le début des années 2000 en raison de l’érosion côtière. Nous avons également été en mesure de cerner des sites qui sont présentement menacés par un littoral qui empiète sur le terrain. Nos mesures des taux d’érosion contemporains pourraient éventuellement servir à déterminer à quel moment un site historique ou une infrastructure moderne sera touché advenant que des taux d’érosion similaires persistent

Connections: A Journal of Public Education Advocacy - Fall 2003, Vol. 10, No. 1

President's Message - As the 50th anniversary of Brown v. Board of Education approaches, and state budget shortfalls continue, Wendy D. Puriefoy calls for "no child left behind" to become a sacred national commitment.Senator Kennedy on the Vision of Public Education - Sen. Edward M. Kennedy argues that the funding made available for school reform must be aligned with the goals set by NCLB.Making It Happen - Legal Defense Fund President Elaine R. Jones says courts must advance the cause of equity in schools to banish remnants of segregation that linger long after Brown.Viewpoint - Jack Jennings, director of the Center on Education Policy, played a role in implementing the Elementary and Secondary Education Act in the 1960s. Today he examines the policy and funding parallels between the original act and NCLB.Conversations - Peter McWalters, president-elect of the Council of Chief State School Officers; Angela Z. Monson, Oklahoma state senator; and Ted Sanders, president of the Education Commission of the States, discuss the many challenges states face in meeting NCLB requirements.End Notes - Richard Navarro, UNICEF's education chief, encourages international support to help Afghanistan rebuild its education system

Advancing Diversity, Equity, and Inclusion in Developmental Disabilities: The Essential Role of Leadership for Cultural and Linguistic Competence

ABSTRACT There is a clear and compelling need to approach equity, diversity, and inclusion not as problems to be solved,but rather as opportunities to be realized. The Developmental Disabilities Bill of Rights and Assistance Act of 2000,states the need for cultural competence, specifically to ensure that supports and services “are provided in a manner that assure maximum participation and benefit for persons with IDD.” Cultural and linguistic competence (CLC) are evidence-based or proven practices that reduce disparities, advance diversity, and promote equity. Achieving CLC requires strong and informed leadership to spark the necessary changes within systems, organizations, and practice. It requires responding effectively to race, ethnicity, culture, and other intersecting identities in leadership development and opportunities. There is a need for leaders with the commitment, energy, knowledge, and skills to do the hard work of advancing and sustaining CLC in systems, organizations, and programs that develop policy, provide supports and services, conduct research, and advocate with persons with IDD and their families. It is important that leaders have the insight, courage, and skill to step out in the forefront of this complex set of dynamics and be the force to gather the collective will to make change. There are two distinct yet related challenges that continue to confront the IDD network: 1) the lack of capacity across all aspects of the network to develop, nurture, and support people who are prepared to lead efforts that advance and sustain CLC; and 2) there are few members of racial, ethnic, and cultural groups, including people with disabilities from these groups, presently occupying or being groomed to become leaders and assume leadership positions network-wide

Nanotechnology in construction and demolition: What we know, what we don’t

Self-cleaning windows, very high strength concrete and thin, super-efficient insulation are just three examples of new building materials promised by nanotechnology, which manipulates matter at the atomic level. But for all their purported benefits, little is known about the risks posed by very small, engineered particles and fibres. Some long and very thin strands might act like asbestos if they are inhaled, for instance. To begin addressing this knowledge gap, the Institution of Occupational Safety and Health (IOSH) sponsored a research team at Loughborough University, led by Professor Alistair Gibb and Dr Wendy Jones, to investigate where these materials are used, how widespread this use is, what the potential risks are and how workers in construction and demolition might manage them. The executive summary of that report, released in January, is reproduced here with IOSH’s permission

Feasibility of low-intensity psychological interventions for emotional and behavioural difficulties in children and young people with genetic conditions: a case series

Background: Children with genetic conditions may experience significant mental health difficulties such as anxiety and challenging behaviour. However, understanding of the feasibility and effectiveness of psychological interventions for emotional and behavioural problems in the context of genetic conditions is limited. Low-intensity psychological interventions have demonstrated promise in paediatric populations and may be able to address their mental health difficulties. / Method: A case series design was used to assess the feasibility of low-intensity interventions for emotional and behavioural difficulties in children and young people with genetic conditions recruited from a mental health drop-in centre at a tertiary hospital. Participants received seven weekly sessions with a trained practitioner. The intervention was based on existing modular treatments and evidence-based self-help materials. Feasibility and treatment satisfaction were assessed, as well as measures of symptoms of anxiety and challenging behaviour, treatment goals, and quality of life, at baseline, during treatment, and six-month follow-up. / Results: Five participants received treatment for challenging behaviour, one for anxiety, and one for obsessive compulsive disorder. All participants completed treatment. Clinically significant change in the SDQ Total score was found in three participants. All participants demonstrated progress in goals and symptoms of emotional and behavioural difficulties over the course of treatment. / Conclusions: Low-intensity psychological interventions for emotional and behavioural difficulties in children and young people with genetic conditions is feasible, acceptable, and potentially beneficial. Further research is warranted to examine the effectiveness of the intervention and its use in clinical paediatric settings

Challenging Perceptions of Disability through Performance Poetry Methods: The "Seen but Seldom Heard" Project.

This paper considers performance poetry as a method to explore lived experiences of disability. We discuss how poetic inquiry used within a participatory arts-based research framework can enable young people to collectively question society’s attitudes and actions towards disability. Poetry will be considered as a means to develop a more accessible and effective arena in which young people with direct experience of disability can be empowered to develop new skills that enable them to tell their own stories. Discussion of how this can challenge audiences to critically reflect upon their own perceptions of disability will also be developed

‘What are you going to do, confiscate their passports?’ Professional perspectives on cross-border reproductive travel

Objective: This article reports findings from a UK-based study which explored the phenomenon of overseas travel for fertility treatment. The first phase of this project aimed to explore how infertility clinicians and others professionally involved in fertility treatment understand the nature and consequences of cross-border reproductive travel. Background: There are indications that, for a variety of reasons, people from the UK are increasingly travelling across national borders to access assisted reproductive technologies. While research with patients is growing, little is known about how ‘fertility tourism’ is perceived by health professionals and others with a close association with infertility patients. Methods: Using an interpretivist approach, this exploratory research included focussed discussions with 20 people professionally knowledgeable about patients who had either been abroad or were considering having treatment outside the UK. Semi-structured interviews were recorded, transcribed verbatim and subjected to a thematic analysis. Results: Three conceptual categories are developed from the data: ‘the autonomous patient’; ‘cross-border travel as risk’, and ‘professional responsibilities in harm minimisation’. Professionals construct nuanced, complex and sometimes contradictory narratives of the ‘fertility traveller’, as vulnerable and knowledgeable; as engaged in risky behaviour and in its active minimisation. Conclusions: There is little support for the suggestion that states should seek to prevent cross-border treatment. Rather, an argument is made for less direct strategies to safeguard patient interests. Further research is required to assess the impact of professional views and actions on patient choices and patient experiences of treatment, before, during and after travelling abroad