Worker Safety Outcomes Research Articles

Is another public health crisis brewing beneath the COVID-19 pandemic?

Evidence indicates associations between exposure to mass traumatic events and increased alcohol consumption and related harms following the crises. However, there is limited evidence available to inform alcohol policies during such events. In this commentary, we present the range of government actions to control public access to alcohol during the novel coronavirus disease 2019 pandemic in provinces and territories across Canada. Liquor retailers, including both private and government-run retailers, have been designated as essential services in all jurisdictions, operating under an evolving set of rules. From a public health perspective, keeping liquor retailers open during pandemic-related lockdown restrictions is a delicate decision which poses new risks and considerations about the best strategy for minimizing alcohol-related harms. We discuss the need to strike a balance between supplying public access to alcohol, particularly to those living with dependence, and unintentionally sending the message that alcohol is essential in our lives and encouraging consumption. Given the far-reaching effects of alcohol on health, social, psychological, economic, and work safety outcomes, we describe international guidance for minimizing alcohol-related harms and suggest that a nuanced and evidence-informed discussion about the considerations and impacts of alcohol control measures during a public health emergency should be undertaken.

The Dangerous Middle: Situational Awareness and Worker Perception of Beetle Kill

ABSTRACTForest workers, including loggers, foresters, and wildland firefighters, are regularly exposed to some of the most fatal occupational environments in the United States. These hazardous work environments may become even more complex and dynamic when subject to bark beetle outbreaks that have resulted in significant tree mortality. The impacts of tree death from bark beetles are significant, with the cumulative 17-year (2000–2016) footprint for bark beetle caused tree mortality estimated at 54 million acres. However, how workers think about and act in these environments is understudied. This study, therefore, approaches the issue of beetle kill and forest worker safety by examining the perspectives or workers themselves. Its contribution is to leverage ethnographic research to provide insights that can generate new research questions, better inform outreach, and ultimately improve worker safety outcomes. The resulting insights show that beetle kill was understood by workers as a hazard that increased the complexity and dynamism of the work environment, making situational awareness both more necessary and more difficult to maintain. While much research about situational awareness focuses on hazardous situations, it is suggested that building adequate situational awareness should also include broader considerations of organizational communication, as well as training and experience considered over the course of entire careers.

The Influence of Religious Consciousness on Construction Health and Safety Practices and Performance

The potential of religiousness to influence health and safety (H&S) practices and attitudes, which will in turn determine H&S performance, is an area that remains highly under-examined. Hence, using the Nigerian construction industry as a case study, this study evaluates the impact of religious consciousness on H&S practices, H&S attitudes and H&S performance, and explains how it is practiced to influence H&S. It also identifies, evaluates and explains the ways in which religion is instrumental in improving H&S. The study employs a mixed method research approach involving the use of survey questionnaires and interviews in collecting relevant data. The data collected was analysed thematically and using descriptive and inferential statistics including the Kendall's tau-b test. The findings show strong evidence of elements of religion, for example, the belief in the supernatural and religious underpinned activities in construction organisations. It also shows correlations between H&S lagging indicators, such as rituals, alteration of works and elements of religion, being afraid or respecting the supernatural. There is a correlation between the element of religion, membership of a religious organisation and the leading H&S indicators such as conducting H&S audit. Additionally, it emerged that elements of religion, such as observed belief in the supernatural, correlate with the attitudes of the contractors towards H&S such as ensuring the safety of the public and preserving the environment. Furthermore, a significant number of the respondents perceived that the promotion of H&S practices through religious underpinned teachings could be an effective way of improving H&S practices in Nigeria. This study is a first step in exploring the potentials of religiousness in H&S improvement. It is also beneficial to academics, policymakers and religious teachers, in promoting improved H&S performance on construction projectsPoor safety culture is a systemic issue for construction workers in Nigeria. Evidence suggests workers’ rights to safe work and dignity are abused frequently. Although extant Nigerian laws compel contractors to maximise work safety, media reports are rife with incidents of collapse of structures, site accidents and hazards. Fatalities, and consequential losses from these, are significant. In context, the Nigerian procurement law requires contractors to be pre-qualified before receiving contract awards. Through a systematic literature review (SLR), this study examines pre-award assessment processes and standards relating to contractors’ compliance with workers’ health and safety. In addition, pre-award assessment objectives are compared with normative objectives of health and safety standards during construction. A significant gap is found between the two: pre-award assessment is incapable of translating into considerable safety outcomes for workers and projects. As a result, a new framework for assessing contractors’ safety capability is proposed. The study also argues the significance of the proposed framework to extant pre-qualification frameworks used in Nigeria. Rather than being prescriptive, the framework can measure health and safety capabilities quantitatively. Conclusions are elicited from these on how to reform the Nigerian procurement landscape in terms of health and safety standards, and the cost benefits therefrom.

Effect of Mindfulness-Based Stress Reduction Training on Health Care Worker Safety: A Randomized Waitlist Controlled Trial.

The study assessed the impact of mindfulness training on occupational safety of hospital health care workers. The study used a randomized waitlist-controlled trial design to test the effect of an 8-week mindfulness-based stress reduction (MBSR) course on self-reported health care worker safety outcomes, measured at baseline, postintervention, and 6 months later. Twenty-three hospital health care workers participated in the study (11 in immediate intervention group; 12 in waitlist control group). The MBSR training decreased workplace cognitive failures (F [1, 20] = 7.44, P = 0.013, (Equation is included in full-text article.)) and increased safety compliance behaviors (F [1, 20] = 7.79, P = 0.011, (Equation is included in full-text article.)) among hospital health care workers. Effects were stable 6 months following the training. The MBSR intervention did not significantly affect participants' promotion of safety in the workplace (F [1, 20] = 0.40, P = 0.54, (Equation is included in full-text article.)). Mindfulness training may potentially decrease occupational injuries of health care workers.

Recognizing and Responding to the "Toxic" Work Environment: Worker Safety, Patient Safety, and Abuse/Neglect in Nursing Homes.

This grounded theory study examined how the certified nursing assistant (CNA) understands and responds to bullying in the workplace. Constant comparative analysis was used to analyze data from in-depth telephone interviews with CNAs ( N = 22) who experienced bullying while employed in a nursing home. The result of the analysis is a multistep model describing CNA perceptions of how, over time, they recognized and responded to the "toxic" work environment. The strategies used in responding to the "toxic" environment affected their care provision and were attributed to the development of several resident and worker safety outcomes. The data suggest that the etiology of abuse and neglect in nursing homes may be better explained by institutional cultures rather than individual traits of CNAs. Findings highlight the relationship between worker and patient safety, and suggest worker safety outcomes may be an indicator of quality in nursing homes.

Risk shifting and disorganization in multi-tier contracting chains: The implications for public safety

Organizational responses to financial crises have contributed to workplace changes, including a reliance on multi-tier sub-contracting chains. An extensive research literature discusses the adverse impact of these trends on worker health and safety. Research has shown that economic pressures leading to unsafe practices by contractors, hazardous forms of disorganization in contracting chains and regulatory failure contribute to adverse health and safety outcomes for workers. Less research has addressed the impact of sub-contracting chains on the potential for complex catastrophic incidents in which the public could be impacted. We contribute to a growing body of work on this subject by examining excavation work around high pressure natural gas pipelines in Australia. We draw on past research complemented with concepts from the economics literature to highlight the impact of ‘risk shifting’ as contractors seek to cope with financial pressure in highly competitive sectors. Contract terms incentivize contractors to work as quickly as possible while also prioritizing compliance with safety-related rules. Using qualitative data from 36 face-to-face interviews we discuss the way that supply chains characterized by these types of contracts can lead to situations where the pressure to work quickly means that contractors might trade off safe work practices in order to meet project deadlines and make a profit. We argue that in times of acute financial pressure, safety can become fungible with an associated increase in risk to the public. The findings of this research may have broader implications for other public risk situations in sectors with similar structures and organizational arrangements.

Is an Efficacious Operation a Safe Operation: The Role of Operational Practices in Worker Safety Outcomes

One of the most fundamental indicators of a facility's social sustainability is the health and safety of its workers. Yet the literature provides little guidance for engineering managers, workers or researchers trying to understand how practices designed to enhance productivity will impact the safety of operational workers. The present research addresses that gap by simultaneously examining operational “best” practices such as quality management and just-in-time and performance outcomes such as productivity and worker safety. To control for the myriad of potential problems with self-reports of worker safety performance, we match secondary data provided by the state of Oregon with managers' self-reported responses to operational practices. The results show that the relationship between operational practices and safety outcomes is nuanced with just-in-time harming worker safety, an impact that can be mitigated by the adoption of team-based work up to a point, as the relationship between JIT and team-based work is U-shaped.

Patient safety climate and worker safety behaviours in acute hospitals in Scotland

ObjectivesTo obtain a measure of hospital safety climate from a sample of National Health Service (NHS) acute hospitals in Scotland and to test whether these scores were associated with worker safety behaviors, and patient and worker injuries. MethodsData were from 1,866 NHS clinical staff in six Scottish acute hospitals. A Scottish Hospital Safety Questionnaire measured hospital safety climate (Hospital Survey on Patient Safety Culture), worker safety behaviors, and worker and patient injuries. The associations between the hospital safety climate scores and the outcome measures (safety behaviors, worker and patient injury rates) were examined. ResultsHospital safety climate scores were significantly correlated with clinical workers’ safety behavior and patient and worker injury measures, although the effect sizes were smaller for the latter. Regression analyses revealed that perceptions of staffing levels and managerial commitment were significant predictors for all the safety outcome measures. Both patient-specific and more generic safety climate items were found to have significant impacts on safety outcome measures. ConclusionThis study demonstrated the influences of different aspects of hospital safety climate on both patient and worker safety outcomes. Moreover, it has been shown that in a hospital setting, a safety climate supporting safer patient care would also help to ensure worker safety. Impact on industryThe Scottish Hospital Safety Questionnaire has proved to be a usable method of measuring both hospital safety climate as well as patient and worker safety outcomes.

Association Between Poor Sleep, Fatigue, and Safety Outcomes in Emergency Medical Services Providers

Objective. To determine the association between poor sleep quality, fatigue, and self-reported safety outcomes among emergency medical services (EMS) workers. Methods. We used convenience sampling of EMS agencies and a cross-sectional survey design. We administered the 19-item Pittsburgh Sleep Quality Index (PSQI), 11-item Chalder Fatigue Questionnaire (CFQ), and 44-item EMS Safety Inventory (EMS-SI) to measure sleep quality, fatigue, and safety outcomes, respectively. We used a consensus process to develop the EMS-SI, which was designed to capture three composite measurements of EMS worker injury, medical errors and adverse events (AEs), and safety-compromising behaviors. We used hierarchical logistic regression to test the association between poor sleep quality, fatigue, and three composite measures of EMS worker safety outcomes. Results. We received 547 surveys from 30 EMS agencies (a 35.6% mean agency response rate). The mean PSQI score exceeded the benchmark for poor sleep (6.9, 95% confidence interval [CI] 6.6, 7.2). More than half of the respondents were classified as fatigued (55%, 95% CI 50.7, 59.3). Eighteen percent of the respondents reported an injury (17.8%, 95% CI 13.5, 22.1), 41% reported a medical error or AE (41.1%, 95% CI 36.8, 45.4), and 90% reported a safety-compromising behavior (89.6%, 95% CI 87, 92). After controlling for confounding, we identified 1.9 greater odds of injury (95% CI 1.1, 3.3), 2.2 greater odds of medical error or AE (95% CI 1.4, 3.3), and 3.6 greater odds of safety-compromising behavior (95% CI 1.5, 8.3) among fatigued respondents versus nonfatigued respondents. Conclusions. In this sample of EMS workers, poor sleep quality and fatigue are common. We provide preliminary evidence of an association between sleep quality, fatigue, and safety outcomes.