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Safety Interventions for the Prevention of Accidents in the Work Place. Safety Interventions for the prevention of Accidents in the Work Place
Abstract
The objective of this review is to assess the effectiveness of Safety Interventions in Preventing Accidents at Work (SIPAW):
Compare safety interventions to no treatment, treatment as usual or alternative intervention.
If possible examine (constituent) components of safety interventions which appear to enhance the effectiveness of Safety interventions in preventing accidents at the work place
Point out needs for future safety intervention research
... Also the effect of improvements of safety management systems on the effectiveness of these systems. The effectiveness of safety interventions, or the organisational/safety culture are more or less a blind eye in safety research (Dyreborg et al., 2010). The fragmented approach focussing on different aspects of safety management simply does not offer sufficient proof to support that there is are causal relationships. ...
... A safety intervention programme can be initiated at the workplace by the employer or the employees, or initiated from outside the workplace by public authorities, social partners or other stakeholders. However, the intervention must take place and aimed at improving safety in the workplace or during work (Dyreborg, et al., 2011). Accordingly, European Agency for Safety and Health at Work (2014) outlined that employers have clear procedures and responsibilities for health and safety and that everyone be made aware of their own and others' responsibilities to safety. ...
According to the results of this review, structural safety measures and integrated safety measures
could be the most relevant to reduce accidents at work. But safety measures focusing on safety climate
and culture may be relevant as well, although there is a need for more scientific studies of the
underlying mechanisms influencing accidents as the pathways might be rather complex.
With regard to the structural approaches, there are quite good evidence for moderate to large effects
of classical engineering approaches, such as substitution of dangerous technologies with less
dangerous technology. This effect is found across industries as diverse as work in the social and
health sector, forestry and paper industry.
Regarding the integrated safety measures, they are often more complex and diverse, precisely because
they combine and integrate different types of safety measures. It does not look as if the integrated
safety measures have less effect, although they only integrate actions at the individual level compared
to the organisational level. Thus, it appears that when you integrate a number of safety measures, it
will overall give a big boost to safety, compared to one-off measures.
This paper presents a model of how three groups of accident prevention measures: modification of attitudes, behaviour, and structural conditions, are influencing two broad categories of risk factors: (a) behaviour, and (b) physical and organisational environment; and two process factors: (c) attitudes and beliefs, and (d) social norms and culture. Some of the hypothesised paths in the model seem to be weak: Attitude modification→Attitude→Behaviour→Accidents and injuries (the KAP-model), while others seem strong: Structural modification→Physical and organisational environment→Behaviour→Accidents and injuries. When various preventive measures are used in combination, and to the extent that they influence social norms and cultural factors, they are probably more effective than interventions affecting individuals (modifying factors such as attitudes and beliefs) only. Although attitude change measures seem to have little direct impact on behaviour, they may still have an important role in accident prevention. Important challenges remain to develop interventions that influence social norms and safety-related aspects of culture and to identify optimal combinations of preventive measures.
Work-related falls from roofs remain a significant problem for workers in the construction industry. Knowledge about the main causative or initiating factors leading to fall incidents is desperately needed for fall prevention intervention. From biomechanical and psychophysiological perspectives the majority of occupational falls, including falls from roofs, can be regarded as loss-of-balance incidents. The primary objective of this paper is to summarize the current knowledge from multiple fields about factors that are related to the control of balance during roofing work. An extensive literature review identified a number of environmental, task-related and personal factors that degrade the control of balance and could be associated with the initiation of falls from roofs. These factors include visual exposure to elevation; unstable visual cues and inadequate visual information in the work environment; 'confined' and inclined support surfaces; unexpected changes in roof surface properties; load handling; physical exertion; fatigue; task complexity that diverts workers' attention; individual differences; work experience and training; and personal protective equipment. Current measures to reduce falls from roofs focus mainly on fall protection procedures, such as the use of covers, guardrails, safety nets, and personal fall-arrest systems, or the application of warning-line systems, safety monitoring systems, and fall protection plans. In many instances, these procedures are not practical for the industry and current regulations allow the use of alternative means of fall protection, such as slide guards. Future research on preventing falls from roofs should consider the main effects and interactions of the environmental, task-related and personal factors that affect the balance control of workers. Research-supported improvements in the visual and physical characteristics of the roof work environment, the construction materials and methods, and work procedures and practices may result in improved workers' balance control as well as overall safety performance, and would ultimately reduce incidents of falling from a roof.
The management of uncertainties is discussed as a key challenge for organizations and two approaches to handling uncertainties are introduced, i.e. minimizing uncertainties versus coping with uncertainties. The analysis of rules as for instance laid out in standard operating procedures is suggested as one method for identifying the approach to uncertainty management chosen in a particular organization. Given advantages and disadvantages of both approaches to uncertainty management, loose coupling is discussed as a way of balancing the two approaches and a conceptualization of safety culture as a means for loose coupling is proposed. One of the central controversies underlying discussions on designing organizations for safety, i.e. the relationship between autonomy and safety, is expanded upon in order to deepend the understanding of different design strategies within the framework of uncertainty management. Finally, it is argued that the role and importance of safety culture differs depending on the chosen approach to uncertainty management, requiring that any safety culture assessment is preceeded by an assessment of the fit between the uncertainties an organization is confronted with and the chosen forms of handling these uncertainties. Methods for carrying out these assessments are suggested.
This paper compares and contrasts two prominent and seemingly antagonistic safety management rubrics: the behavior change and culture change approaches to safety. The two perspectives are analyzed in terms of their conceptual and theoretical foundations, defining characteristics, and apparent strengths and weaknesses. The level of empirical support for each approach is also assessed. The argument is advanced that the two approaches are essentially complementary and that their respective strengths can be merged into a more balanced and comprehensive approach for managing workplace safety. This integrated approach has two key features: (1) a data-based and participatory problem-solving process that emulates some of the inherent strengths of behavior change technology, and (2) a more explicit culture change process that can be systematically monitored and assessed.
This article summarizes evaluation data for ten types of accident prevention program drawn from 53 program evaluations: personnel selection variables, technological interventions, behavior modification programs, poster campaigns, quality circles, exercise and stress management, near-miss accident reporting, comprehensive ergonomics, the International Safety Rating System (ISRS), and the Finnish national control program. Standard measures of effect size were computed for source studies which described the effectiveness of programs in terms of the percentage reduction in accidents attributable to the program. By this standard, personnel selection techniques were the least effective (3.8%), and comprehensive ergonomics programs (49.5%) were the most effective. Some methodological issues in safety program evaluation are discussed in conjunction with some further thoughts on a previously published review of ISRS evaluation results (in 1991).
A review and synthesis of behavioural safety literature identified three behaviour change perspectives: cognitive (goal setting); behaviourist (behaviour modification); and eclectic (social learning). Bandura's social learning theory usefully integrates the divergent philosophies of Locke's goal setting and Luthan's behaviour modification. Social learning theory assumes that behaviour is controlled by internal processes and environmental stimuli, and so human action can be explained by the combined effect of goals and feedback. The effectiveness of behavioural safety has been demonstrated consistently, but, despite some success, token reward programmes are controversial because they are close to 'paying for safety'. Researchers have overwhelmingly favoured initiatives based on goals and performance feedback without material reward. Goals and feedback produced good results in the varying cultures of North American, European and Middle-East manufacturing environments, including mines, chemical plants, laboratories, paper mills and shipyards. Goals and feedback, aimed principally at operatives, have been used to improve safety in Finnish, British and Hong Kong construction industries. It is also clear that their effectiveness is strongly related to management commitment; and that they must be supported by a developed safety infrastructure. This suggests that goals should also embrace management safety behaviours, in order to improve management commitment.
The objective of this study was to evaluate interventions that reduce or prevent needlestick injuries in health care occupations.
Cochrane Collaboration search strategies to locate studies that evaluated interventions to reduce needlestick injuries in health care occupations were used. Studies were selected if they met the following criteria: (1) interventions were evaluated in the defined population; (2) interventions were randomized, with a comparison group(s); (3) outcomes were objectively measured and had interpretable data. Eleven studies met inclusion criteria. The main outcomes of interest were changes in the number of glove or skin perforations and changes in amount of skin contamination.
Three studies found a decrease in glove or skin perforations when double gloves or combinations of gloves were used by surgeons and their assistants. One study found an increase in glove perforations but a decrease in hand contamination. Three studies evaluated the effectiveness of specialized needles in reducing needlestick injuries during surgical wound closure with decreases in glove or skin perforations reported. Protective devices were evaluated in three studies and significant reductions in glove perforations were found with the use of a needleless intravenous system and surgical assist device. One study evaluated a "no-touch" technique used by surgeons during wound closure and found a significant decrease in the number of glove perforations compared to the traditional "hand-in" method of closure.
Few randomized controlled trials have been employed to evaluate the effectiveness of interventions to reduce needlestick injuries in health care occupations. The majority of the studies evaluated interventions during surgical procedures, rather than during patient care on nursing units, probably because the latter is more difficult to observe.
The main objective of this study was to systematically review the existing evidence for the effectiveness of farm injury prevention interventions.
We used a systematic approach to search the following electronic databases: MEDLINE, EMBASE, ERIC, PsycInfo, Sociofile, NTIS, Agricola, Expanded Academic Index, Dissertation Abstracts, and Occupational Safety and Health (NIOSHTIC). Proceedings and technical papers of the National Institute for Farm Safety were reviewed. We also checked the references of potentially eligible studies and consulted with experts in the field to identify other relevant information sources.
Papers had to involve a farm safety intervention to be included in the review. To best characterize the current state of farm safety research, all study designs were accepted, including those without comparison groups and those with absent or inadequate evaluation methods.
We identified 25 studies for the review. Eleven of the studies involved farm safety education programs, five consisted of multifaceted interventions that included environmental revisions, a farm visit, or both; nine papers described farm safety interventions but did not report results from an evaluation. Farm safety education interventions included safety fairs, day camps; certification programs; workshops; and courses for farm families, youth, and agricultural workers. Multifaceted interventions were targeted to farm operators and generally involved farm safety audits, followed by environmental or equipment changes and/or safety education. Program evaluations assessed changes in safety attitudes, knowledge, and/or behaviors and generally involved pre- and post-test methodology. Only three studies examined changes in the incidence of farm injuries. Of the studies evaluated, most reported positive changes following the interventions. However, limitations in the design of evaluations make the results of many of the studies difficult to interpret.
There is a need for more rigorous evaluations of farm safety intervention programs. Suggested study design improvements include randomization of study subjects when appropriate, use of control groups and the objective measurement of outcomes such as behavior change and injury incidence.
The objective of this review was to describe the effectiveness of interventions designed to prevent work-related eye injuries in construction, manufacturing, and agricultural industries. Two types of interventions were of interest: (1) effectiveness of different types of eye protection and/or environmental controls in the workplace, and (2) evaluation of behavioral interventions focused on increasing the use of eye protection among at-risk workers.
Cochrane Collaboration search strategies were used to identify reports of the effectiveness of interventions designed to prevent eye injuries. To be included, a measurable outcome (change in eye injury rates, use of eye protection or costs for eye injury care) had to be reported. Studies that focused on exposures to lasers, radiation or microwaves were not included.
Seven reports met inclusion criteria-all from industrial settings. None of the studies was a controlled trial and only one involved a comparison group.
Although there is some evidence that policy changes are effective in changing behaviors and reducing eye injuries in manufacturing settings either in conjunction with a broader program focused on eye safety or by policy alone, there is limited scientific literature about the effectiveness of eye injury prevention interventions. There is a need for systematic evaluation of interventions designed to prevent eye injuries and to change the overall safety culture.