Safety Science Research Articles

A Themed Issue to Advance the Science of Quality and Safety in Obstetric Anesthesiology

A Themed Issue to Advance the Science of Quality and Safety in Obstetric Anesthesiology

Specific road safety issues in LMICs: an overview and some illustrative examples

This paper gives an overview of the work of PIARC Working Group 3.1.1 ‘Specific road safety issues for LMICs’. The working group performed its activities in the period 2019–2023. We prepared two deliverables: (a) a literature review, and (b) an overview of illustrative examples. The review started from the notion that the road safety problem requires a multi-disciplinary approach. The safe system approach is generally considered as the central concept for this purpose and this starting point is also taken in this study. However new directions are needed to make the safe system concept work in LMICs. The period of the first UN Decade of Action for Road Safety has brought us a series of valuable problem analysis and overview articles prepared by a variety of institutions and institutes. As a PIARC working group we did not repeat this effort, but used it as a starting point to indicate which specific issues do require a boost in LMICs for the coming period up to 2030. We concluded that the following 12 issues deserve special attention. Strategical: (i) Sustainable Development Goals integral approach, (ii) safety culture, (iii) road safety management and leadership, (iv) building road safety expertise and science; Tactical: (v) transportation system as a whole, (vi) city design, architecture, land use, rural planning, (vii) cost effectiveness, (viii) legislation and enforcement; Operational: (ix) speed, (x) sustainable safe roads, (xi) vehicles as a safe system component, (xii) post-crash health care. As a result of our discussions and analyses we also concluded that it is worthwhile and necessary to make a distinction between the issues in terms of levels of approach. Making roads and vehicles safe may be considered as operational safety measures on a component level, whereas city design and transport system issues do represent a more tactical approach. On top of that, organisational and cultural aspects do have a more strategical nature. As in many managerial and planning tasks the distinction between strategical, tactical and operational levels of approach is needed in the road safety field. It illustrates that the Safe System concept asks for a multi-level vision, thus preventing a silo approach with a limited focus on human behaviour, safe roads or vehicle safety. A further analysis for each of the selected issues resulted in priority areas, i.e. topics that deserve special attention in the LMIC context. In a similar line of reasoning we also described illustrative examples, i.e. LMIC related before-after studies that show the perspective of certain measures on an evidence basis. Although we found some illustrative cases for each of these issues, our search for evidence based cases confirmed the findings from recent overview articles indicating the lack of LMIC related road safety research. A more widespread implementation of effective road safety measures in LMICs would require a stronger national commitment and leadership from the road safety agencies point of view in the first place. Moreover an evidence based policy asks for a strong national and regional knowledge infrastructure. Ultimately road safety policies and road safety research programs are to be considered as inseparable. A strong local knowledge infrastructure may thus become the basis for an effective national road safety policy.

Fire safety science: Proceedings of the 14th international symposium

Fire safety science: Proceedings of the 14th international symposium

A comprehensive framework for examining the influence of tower crane safe operations on sustainable practices in modular integrated construction

PurposeThis study aims to explore the tower crane safety factors (TCSFs) that influence tower crane safe operations (TCSOs) in modular integrated construction (MiC). It evaluates how the adoption of these factors contributes to achieving TCSOs and promoting sustainable practices (SPs) within MiC.Design/methodology/approachTo achieve this aim, the study employed a systematic search to ensure a comprehensive collection of variables. Additionally, it conducted a questionnaire survey involving professionals and utilized a brainstorming technique to categorize the different variables. Finally, partial least squares structural equation modeling (PLS-SEM) was employed to test the relationship between TCSOs and SPs.FindingsThe results of measurement models indicated strong convergent and discriminant validity, with each observed variable correlating well with its latent variable. Moreover, a significant positive correlation between TCSOs and SPs was evidenced by a path coefficient (β = 0.755) and a p-value of <0.05. Lastly, the structural model revealed that the independent variables strongly influence the dependent variable (i.e. SPs) by 57%, underscoring safety's pivotal role in advancing sustainability within MiC projects. These findings provide empirical evidence that improving tower crane safety can directly enhance sustainable practices, offering a dual benefit of increased safety and sustainability for the construction sector.Originality/valueThis study makes a unique and previously undiscovered contribution to the field by identifying the TCSFs in MiC and employing a novel approach by utilizing PLS-SEM to create a unique mathematical model. It offers valuable insights into the relationship between TCSFs, TCSOs and SPs, thus contributing to methodological advancements within Safety Science and providing a foundation for future research and practical implementation in the construction industry.

CFD-based analysis of deviations between thermocouple measurements and local gas temperatures during the cooling phase of compartment fires

Data from thermocouple (TC) measurements play a pivotal role in fire safety science and engineering studies. It is well-known that there are deviations from the actual local gas temperature and many studies have led to the development of correction factors. The present study focuses on these deviations inside compartments through a systematic series of CFD simulations, performed with Fire Dynamics Simulator (FDS), version 6.8.0. A canonical cubic box is used as geometry. This allows for the demonstration of the impact of the presence of smoke, with variable optical thickness, on the TC data as retrieved from FDS. Significant differences are observed between TC measurements and local gas temperatures. Corrections as developed for TC measurements in open atmospheres cannot be readily applied in compartment configurations, where smoke properties change both spatially and temporally.

Mode 2 critical systems practice for complex safety decisions: Reflections from New Zealand's dairy industry

AbstractPoor decision‐making contributes to disasters in complex industrial systems. Improving group decision‐making practices for safety‐critical interventions is crucial yet hindered by a fragmented safety science literature. Our study applies Jackson's critical systems practice (CSP) to a complex safety problem at a New Zealand dairy manufacturing facility. Reflective practice, employed in the study and writing this article, underlines CSP's usefulness in navigating complex emergent safety challenges. Key insights include clarifying cognitive complexity amongst participants early in an intervention, focusing more sharply on crucial safety outcomes by using critical facilitation and enhancing CSP's ‘Check’ stage using reflective practice. We conclude by calling on scholars to prioritise the application of CSP in real‐world contexts to deepen our understanding of systemic praxis and generate actionable improvements.

The Effect of Occupational Safety and Health Counseling on the Use of Personal Protective Equipment at the Special UPTD of the Medan Hajj Hospital

The development of occupational safety and health science in the work environment can be seen with the development of advanced science and technology as well as the emergence of new innovations in the work environment and encouraging companies to improve the knowledge and skills of their human resources. The purpose of this study is to determine the Influence of Occupational Safety and Health Education (K3) on the Behavior of Using Personal Protective Equipment at the Special UPTD of Haji Medan Hospital. This research includes quasi-experimental research. This study uses a one group pretest and pottest design. The population in this study is emergency room nurses at the Special UPTD of Haji Medan Hospital which totals 50 nurses in June-August 2024. The sampling technique in this study is total sampling. The measuring tool in this study uses a univariate and bivariate distribution of non-parametric data with the Wilcoxon test. The results of the Wilcoxon statistical test of both knowledge and attitude obtained a P-value of 0.000. This means that at alpha 5% there is a significant difference in median score between before and after counseling. Meanwhile, in the aspect of action, there was an increase in the number of PPE users between before and after counseling. Because the results of Asymp.Sig of knowledge, attitudes and actions are less than 0.05, H0 is rejected so that there is an influence of occupational health and safety counseling (K3) on the behavior of using PPE. In conclusion, there is an influence of Occupational Safety and Health Counseling (K3) on the behavior of using personal protective equipment at the Special UPTD of Haji Medan Hospital. The suggestions are expected to increase the frequency of counseling and provide information on the importance of using personal protective equipment in the workplace, provide strict sanctions against nurses who do not use personal protective equipment at work, increase the frequency.

Perspectives on Anesthesia and Perioperative Patient Safety: Past, Present, and Future.

During the past 70 years, patient safety science has evolved through four organizational frameworks known as Safety-0, Safety -1, Safety-2, and Safety-3. Their evolution reflects the realization over time that blaming people, chasing errors, fixing one-offs, and regulation would not create the desired patient safety. In Safety-0, the oldest framework, harm events arise from clinician failure; event prevention relies on better staffing, education, and basic standards. In Safety-1, used by hospitals, harm events arise from individual and/or system failures. Safety is improved through analytics, workplace culture, high reliability principles, technology, and quality improvement. Safety-2 emphasizes clinicians' adaptability to prevent harm events in an everchanging environment, using resilience engineering principles. Safety-3, used by aviation, adds system design and control elements to Safety-1 and Safety-2, deploying human factors, design-thinking, and operational control or feedback to prevent and respond to harm events. Safety-3 represents a potential way for anesthesia and perioperative care to become safer.

Biomimetic 3D-printed Composites: Ballistic Impact Resistance with Nacre-Inspired and Tubulane Structures

This research delves into nature-inspired designs for creating materials with exceptional impact resistance, leveraging cutting-edge 3D printing techniques. Our composite design features a nacre-like outer layer combined with a tubulane-resembling core, aiming to enhance energy dissipation significantly. By emulating the dense aragonite structure found in natural nacre and the unique porosity of tubulane, to enhance ballistic impact resistance. To validate its effectiveness, we conducted ballistics tests using a 40-grain lead-tipped .22 LR bullet at an initial velocity of 330.7 m/s, with a specialized chronograph setup to measure both initial and post-penetration bullet velocities, quantifying energy absorption precisely. This study opens new frontiers in aviation safety, structural engineering, and personal protective equipment, showcasing the transformative potential of biomimicry and additive manufacturing in advancing public safety and material science.

Simulated fire video collection for advancing understanding of human behavior in building fires.

The goal of the present research was to develop a video collection of simulated fires to investigate how people perceive growing building fires. In fire safety science, a critical factor to occupant responses to building fires is the pre-movement period, determined by how long it takes an individual to initiate taking protective action with an incipient fire. Key to studying the psychological processes that contribute to the duration of the pre-movement period is presenting human subjects with building fires. One approach used in previous research is to present videos of building fires to individuals via scenarios. The numerical simulations used to model fire dynamics can be used to render videos for these scenarios. However, such simulations have predominantly been used in fire protection engineering to design buildings and are relatively inaccessible to social scientists. The present study documents a collection of videos, based on numerical simulations, which can be used by researchers to study human behavior in fire. These videos display developing fires in different types of rooms, growing at different rates, different smoke thickness, among other characteristics. As part of a validation study, participants were presented with subsets of the video clips and were asked to rate the perceived risk posed by the simulated fire. We observed that ratings varied by the intensity and growth rate of the fires, smoke opacity, type of room, and where the viewpoint was located from the fire. These effects aligned with those observed in previous fire science research, providing evidence that the videos could elicit perceived risk using fire simulations. The present research indicates that future studies can utilize the video library of fire simulations to study human perceptions of developing building fires as situational factors are systematically manipulated.

The Veterinary Student Survey on Patient Safety Culture (VSSPSC): A Quantitative and Qualitative Exploration of American Veterinary Students' Perceptions of Patient Safety Culture.

Patient safety culture (PSC) is a multidimensional construct that reflects the way healthcare organizations promote safe patient care. Veterinary students are explicitly and implicitly indoctrinated into organizational cultures and will carry these attitudes and behaviors into their future work. In this study, we evaluated the psychometric properties of a PSC survey among veterinary students in the United States and investigated their attitudes toward PSC. Exploratory factor analysis identified factors that explained portions of the variance in responses. Importantly, the measures derived from those factors predicted the likelihood of a student mentioning a negative experience/opinion regarding error reporting. Most students reported receiving explicit training in communication, but coursework in other areas, such as human factors and safety culture, was uncommon. Veterinary students generally reported high levels of agreement with the tenets of patient safety science, though some items demonstrated wide variation in responses, underscoring the need for more uniform incorporation of education in veterinary PSC.

Atezolizumab Before and After Chemoradiation for Unresectable Stage III Non–Small Cell Lung Cancer

Outcomes for patients with unresectable stage III non-small cell lung cancer (NSCLC) treated with chemoradiation therapy (CRT) have improved with adjuvant immune checkpoint inhibitors, with a reported 5-year overall survival benefit of approximately 10% for adjuvant durvalumab vs placebo after completion of CRT without progression and with preserved performance status. Starting atezolizumab prior to CRT may allow more patients to benefit from immunotherapy. To evaluate clinical outcomes of patients treated with atezolizumab before and after CRT for unresectable stage III NSCLC. This single-cohort, phase II, nonrandomized controlled trial was conducted at 11 US sites. Patients with pathologically confirmed, unresectable stage III NSCLC who were treatment naive and had good performance status were enrolled between January 3, 2018, and July 24, 2019. Data were locked on March 21, 2023. Patients received four 21-day cycles of atezolizumab, 1200 mg intravenously, with therapy administered on day 1 of each cycle. Patients not experiencing tumor progression continued to CRT (60 Gy to involved fields) concurrent with weekly carboplatin area under the curve of 2 and paclitaxel, 50 mg/m2, followed by planned consolidation carboplatin area under the curve of 6 and paclitaxel, 200 mg/m2, for two 21-day cycles. Patients not experiencing progression continued atezolizumab, 1200 mg, every 21 days to complete 1 year of therapy. The primary end point was the disease control rate at 12 weeks. Secondary end points were progression-free survival, overall survival, overall response rate, safety, and translational science end points. A total of 62 patients (median [range] age, 63.9 [38.1-86.5] years; 32 female [51.6%]) were enrolled and received at least 1 dose of atezolizumab. The disease control rate at 12 weeks was 74.2% (80% CI, 65.7%-81.4%). Median progression-free survival was 30.0 months (95% CI, 15.8 to not evaluable), and the median overall survival was not reached. The overall survival rate at 24 months was 73.7% (95% CI, 63.4%-85.7%), and the overall response rate was 66.2%. Seventeen patients (27.4%) experienced grade 3 or higher immune-related adverse events, including 1 with grade 5 pneumonitis and 1 with grade 4 Guillain-Barré syndrome. Thirty patients (48.4%) experienced grade 3 or higher treatment-related adverse events. These findings suggest that neoadjuvant atezolizumab merits further study based on safety and encouraging outcomes. ClinicalTrials.gov Identifier: NCT03102242.

Large Outdoor Fires and the Built Environment (LOF&BE): Summary of Workshops at 14th International Symposium on Fire Safety Science

Large Outdoor Fires and the Built Environment (LOF&BE): Summary of Workshops at 14th International Symposium on Fire Safety Science

Understanding of causality and its mathematical representation in accident modeling

Accident models are a critical element of safety science as they provide a profound understanding of accident causality, which helps develop accident prevention and control strategies. The evolving accident situations and complex engineering systems offer significant challenges in understanding causality. This limits the realistic representation of causality in the accident model, impacting its usefulness. This paper presents a framework to demystify the understanding of causality and its mathematical representation in accident modeling. The framework uses the theory of causality, understanding interdependencies, constructing these elements in mathematical representations to formulate a mathematical accident model, and subsequently utilizing advanced probability theory and machine learning for accident analysis. The methodology is demonstrated in the case of the Champlain Tower South collapse. The ultimate objective of this work is that readers can use this framework for any engineering system accident modeling (i.e., construction, road, or process systems). The framework will help develop accident preventive and control strategies.

A THEORETICAL SUGGESTION FOR THE DEVELOPMENT OF A SAFETY CULTURE: CIVIL AVIATION CONTEXT

Purpose - This paper aims to place aviation safety culture on three pillars theoretically, and by doing so, to distill findings. By more clear words, It tries to give a more detailed explanation of the concept of safety and safety sciences. Regardless of the business branches, safety should be an important branch, depending on its clear importance in aviation, maritime, health and engineering and more technical sciences to give a clear insight into safety another purpose. Methodology - Methodologically, the differences between the communities of Gemeinschaft and Gesellschaft of Tönnies and epistêmê and technê discrimination of Greek philosophy pave the way for Habermas’s Communicative Action Theory to create a cultural form that is exemplified as safety culture in civil aviation depending on the increasing impacts of the communication and communication networks. In the end, it concludes that the safety culture of civil aviation can be explained with this type of theoretical background and this methodology can be utilised in other industrial branches and sciences. Findings- The main findings of this research can be collected in two groups. One of them is directly related to the creation of a cultural form (safety culture) and its main features by theoretical means, the other one is the evaluation of these theoretical means to the specific ends in a specific business branch, so civil aviation. Conclusion- Through these ways, the importance of communication, sociological heritage and knowledge forms in aviation safety culture will be more theoretically understandable which is a complementary recipe of the research gap. On the other side, and in clearer words, safety is one of the great problems of humankind and business life. Like many other concepts such as security, the importance of heritage, culture, transmission and transportation of knowledge will be more understandable with these kinds of papers or works.

Safety education at research facilities with radiation sources and short-term facility users – Current design and practice and possibilities for improvement

Research facilities such as spallation sources and synchrotrons generate radiation for use in atomic-level or molecular-scale experiments. These facilities can be viewed as complex safety-critical systems. An important aspect of the safety management of such systems is the short safety education and training programme the users are required to undergo in order to gain facility access. As research on the topic is limited, this study aimed to increase the knowledge about current education design and practice using the perspectives of safety science and pedagogy. Study objectives were to identify preconditions that impact the safety education design, to describe current design and practice of the safety education, and to identify weaknesses and possibilities for improvement. Site visits with a total of 20 interviews were performed at three research facilities. The results show the need for sufficient resources to maintain learning activities for users, provide pedagogical continuing education for educators, and maintain safety culture-enhancing activities to meet the challenges of having large numbers of short-term facility users. Increased focus should be placed on safety-related competence needs and the mapping of these to match the competence of individual users. New thinking and innovation can benefit the design and provision of such education activities, based on both socio-technical system and system safety perspectives.

Safety of Human–Artificial Intelligence Systems: Applying Safety Science to Analyze Loopholes in Interactions between Human Organizations, Artificial Intelligence, and Individual People

Loopholes involve misalignments between rules about what should be done and what is actually done in practice. The focus of this paper is loopholes in interactions between human organizations’ implementations of task-specific artificial intelligence and individual people. The importance of identifying and addressing loopholes is recognized in safety science and in applications of AI. Here, an examination is provided of loophole sources in interactions between human organizations and individual people. Then, it is explained how the introduction of task-specific AI applications can introduce new sources of loopholes. Next, an analytical framework, which is well-established in safety science, is applied to analyses of loopholes in interactions between human organizations, artificial intelligence, and individual people. The example used in the analysis is human–artificial intelligence systems in gig economy delivery driving work.

What is diagnostic safety? A review of safety science paradigms and rethinking paths to improving diagnosis.

Diagnostic errors in health care are a global threat to patient safety. Researchers have traditionally focused diagnostic safety efforts on identifying errors and their causes with the goal of reducing diagnostic error rates. More recently, complementary approaches to diagnostic errors have focused on improving diagnostic performance drawn from the safety sciences. These approaches have beencalled Safety-II and Safety-III, which apply resilience engineering and system safety principles, respectively. This review explores the safety science paradigms andtheir implications for analyzing diagnostic errors, highlighting their distinct yet complementary perspectives. The integration of Safety-I, Safety-II, and Safety-III paradigms presents a promising pathway for improving diagnosis. Diagnostic researchers not yet familiar with the various approaches and potential paradigm shift in diagnostic safetyresearch may use this review as a starting point for considering Safety-I, Safety-II, and Safety-III in their efforts toboth reduce diagnostic errors and improve diagnostic performance.

A new measure of feeling safe: Developing psychometric properties of the Neuroception of Psychological Safety Scale (NPSS).

The study comprised of 3 stages: (a) item generation, (b) item reduction, and (c) assessment of factor structure and internal consistency. Exploratory and confirmatory factor analysis was conducted from 2 samples who completed a survey online (exploratory n = 342, confirmatory n = 455). Initially, 107 items were generated. Item reduction and exploratory factor analysis resulted in a 29-item NPSS with subscales of compassion, social engagement and body sensations. The NPSS was found to have a consistent factor structure and internal consistency. The NPSS is a novel measure of psychological safety which can be used across a range of health and social care settings. This research provides a platform for further work to support and enhance understandings of the science of safety through the measurement of psychological, relational and physiological components of safety. The NPSS will help shape new approaches to evaluating trauma treatments, relational issues and mental health concerns. Research to establish the convergent, discriminant and concurrent validity of the NPSS and to explore its use with diverse community and clinical populations is underway. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

From the Journal Editor

Haere mai! Welcome to volume 1, edition 1 of the New Zealand Journal of Health and Safety Practice! The Journal is open access and online and subscriptions are free. Although published in New Zealand we hope it will be read by workers everywhere who work in the field of health, safety and wellbeing. This edition is published at the time of International Workers' Memorial Day and the 29th anniversary of the New Zealand Cave Creek tragedy. I hope the Journal will grow to share practical, research-based knowledge that will help every worker (and visitors to workplaces) to go home physically and mentally unharmed. Much work went into the development of the Journal and I thank: the authors who spent time writing and revising the articles our anonymous reviewers who spent their time reading the submissions and making comments: you have helped set the standard for the Journal. Nik Crombie and Max Sullivan in the Victoria University of Wellington Library who helped with the backroom work and technology making the Journal free to publish. The editorial team also thanks HASANZ, Engineering New Zealand, Faculty of Asbestos Management of Australia & New Zealand, Human Factors and Ergonomics Society of New Zealand, Institute of Organisational Psychology, New Zealand Institute of Safety Management, New Zealand Occupational Health Nurses Association, New Zealand Occupational Hygiene Society, New Zealand Safety Council, AVID Plus Limited and Risk Management Ltd for financial and other support to help establish the Journal. Terje Aven, a Norwegian academic, wrote that “safety science is multidisciplinary. Its contributors and its audience range from psychologists to chemical engineers”; that safety science “covers the physics and engineering of safety; its social, policy and organisational aspects; the management of risks; the effectiveness of control techniques for safety; standardization, legislation, inspection, insurance, costing aspects, human behaviour and safety and the like.” The founding organisations of NZJHSP are similarly drawn from those disciplines. A call for papers for the July 2024 edition will go out shortly. I look forward to submissions for future editions of this Journal those focused on the practice of workplace health and safety through implementing the broad subject area of safety science to help protect workers and others and achieve good work conditions. References Aven, T. (2014). What is safety science? Safety Science, 67, 15-20. https://doi.org/10.1016/j.ssci.2013.07.026