Worldwide, workplace cancer prevention has a significantly lower profile than workplace injury prevention despite a real and present need to elevate the profile of workplace cancer prevention globally. Many organizations worldwide attest to the high number of annual work-related cancers and cancer deaths, but then say that workplace cancer statistics are underestimated, that the problem is worse than statistics bear out, and that the profile of workplace cancer prevention must be elevated. This apparent consensus begs a few questions. Supported by reputable resources from around the globe, this article explores several questions:
What Is Cancer & How Prevalent Is It?
According to the U.S. Department of Health and Human Services’ 14th Report on Carcinogens, cancer affects almost everyone’s life, either directly or indirectly; approximately one out of two men and one out of three women living in the U.S. will develop cancer at some point in his/her lifetime (NTP, 2016). According to American Cancer Society (ACS, 2017a), cancer is the second most common cause of death in the U.S. and accounts for nearly one of every four deaths. World Health Organization (WHO, 2017) estimates that worldwide in 2012 (the most recent data), 14 million new cancer cases and 8.2 million cancer-related deaths occurred, and that the number of new cancer cases is expected to rise by about 70% over the next 20 years.
Imagine it is a hot summer day and David the field technician receives an electronic text for a service call in the middle of his morning schedule. David adjusts his schedule to accomplish an assigned urgent task: the repair or replacement of a cooling fan for a natural-gas-fired HVAC unit atop the roof of a customer’s correctional facility.
Arriving at the work site 30 minutes later via a company vehicle, David positions an extension ladder to gain access to the client’s roof. He troubleshoots the HVAC unit and determines the malfunction to be a faulty bearing set. David climbs down to his vehicle to obtain the replacement part and returns to the roof with an extension cord and a reciprocating saw to complete the work. He locates a rooftop electrical outlet to power his saw and begins to disassemble the unit. When the repair is completed, David intends to return to ground level, lower and stow the ladder and proceed to a nearby fast food establishment to take his lunch break and cool off.
OSH professionals will quickly grasp the serious injury and fatality (SIF) hazard potentials that this worker encountered while working alone, remotely or in isolation. Consider the motor vehicle operation, ladder ascent/descent, fall from an elevated working surface, flammable gas under pressure, electrical contact through a power tool and extension cord, energized electrical HVAC components, unexpected HVAC start-up, workplace violence potential and heat stress exposure due to elevated temperature extremes.
The risk appetite of U.S. employers is maturing to recognize and respond to the hazards of lone work. Old business paradigms of minimal staffing to achieve maximum profits are being countered with wise risk management decisions to produce quality service and products in a safe manner.
An estimated 53 million people are lone workers in the U.S., Canada and Europe (Myers, 2015). Once OSH professionals begin pondering the topic, work environments and tasks for which lone work has been accepted in the past, despite the related SIF potentials, are easily identified and countered.
Contractor prequalification is a “pre-tender process used to investigate and assess the capabilities of contractors to carry out a contract satisfactorily if it is awarded to them” (Hatush & Skitmore, 1997; Truitt, 2012). Written safety program submission is frequently required of contractors for review by hiring organizations or their third-party service providers as a condition of contractor prequalification. Consider a recent study of safety professionals in which more than 57% of respondents rated the evaluation of contractor written safety programs as being very or extremely important during contractor safety prequalification (Figure 1; Wilbanks, 2017). Programs required by hiring organizations regularly include evidence of contractor employee orientation, training and prejob task and risk assessment (Inouye, 2015).
Petersen (2001) might have ascribed the affinity for program submission as stemming from the “OSHA Era” of 20th century safety management evolution. He complained that overemphasis to programs with inadequate emphasis given to the humans who are subject to them inevitably results in workers not caring about safety. “And we wonder why our programs don’t fly! (p. 120).” Programs are not safety, Petersen (2000) retorts, they are “islands of safety,” normally in answer to the dictates of OSHA but not integrated into the overall management system. Petersen (2001) challenges the effectiveness of programs, asking: “Are they effective? Do they change attitudes or behavior? Do they motivate or even communicate?” (p. 117).
A present-day answering of Petersen’s questions in the context of contractor prequalification is aided by the observations of Philips and Waitzman (2013), who offer that requiring program submission may have some value (Table 1).
Trucks with cargo tanks used in the service industry need routine maintenance to ensure their safety and keep product flowing. But such turnarounds are a source of concern for the industry. As production mounts and traffic increases, truck congestion at service facilities causes delays, impacting worker safety (Chakraborty, Kumar & Malguri, 2016). Several potentially deadly hazards such as falls exist in such operations. But a largely unrecognized and often fatal hazard is confined spaces in truck tanks.
In the allied service trade where tank truck maintenance is outsourced to specialized vendors, work has many potential hazards. Specialty trades conduct inspection, sanitation, maintenance and repair. To get the job done, employees frequently enter confined spaces and work at height. Productivity often means balancing personal safety, health and performance.
Truck drivers and service technicians frequently climb onto tank vehicles using side ladders, stairs, walkways, catwalks and caged work platforms. Additionally, service workers frequently use compressed air, steam and high-pressure water to conduct tank clean-out operations. Employees commonly access tank cargo holds by entering manways, hatches and portals at the dome or top of a tank container. In these activities, employees may be exposed to toxic, flammable, oxygen-deficient and chemically asphyxiating atmospheres (Harle, 2017). These hazards call for a new paradigm in OSH regarding truck tanks.
Improving Production & Morale
Addressing these issues can produce quantifiable benefits, including improved production and enhanced employee morale. Establishing an effective safety and health program at a job site is one of the best ways of protecting the company’s most valuable asset, its workers. Losing workers to injury or illness, even for a short time, can cause significant disruption and cost. It can also damage workforce stability and a company’s reputation (OSHA, 2016).
Organizations may experience unintended negative side effects when productivity and profitability are pursued regardless of the consequences. Unfortunately, safety training may be perceived as a non-value-adding activity at best, or a waste of employee time and organizational resources at worst.
Conversely, when safety training is treated as an investment in human capital, the importance is highlighted for management. When employees are properly trained in safety, the benefits to their physical well-being can also be simultaneously borne by the machines, equipment or production materials they are working on and around. Effective training reduces the potential for unnecessary loss.
Whether the workplace is the factory floor of a manufacturing plant, on the ground at a building or development site, in the transportation infrastructure or any other sector of the economy involving a working association between humans and machines, knowledge of safety practices continues to be a relevant and integral part of employee training and growth.
A challenge often cited in the evaluation of safety training programs (Conklin, 2012; Cullen, 2007) is how to certify that the training actually sticks. When organizations prepare and deliver safety training that is lucid, comprehensive and compelling, the likelihood of retention increases. Well-designed and meticulously implemented training may reduce employee resistance and enhance engagement in safety efforts.
Fall protection equipment is the most visible aspect of a fall protection program and it can be the most costly. Unfortunately, these investments can be nullified due to equipment misuse or cheating (i.e., using the equipment outside its intended use).
Common fall protection equipment misuse issues are well documented in equipment literature, through standards boards and in safety-related publications. The following 10 examples of misuse were selected based on the authors’ personal experience and more than 30 years of observation in their roles as fall protection consultants. Each misuse is explained followed by recommendations for how to rectify it.
1) Rebar Snap Hooks
Rebar snap hooks, also referred to as pelican hooks, large gates or form hooks, are frequently used because they are large and can connect to many objects. Just as with other components, rebar snap hooks are tested and approved for use only in specific configurations. When used outside those configurations a risk of failure exists.
Rebar snap hooks are not tested in the same way they are used. For example, the larger snap hooks are not tested for bending and some manufacturers are now marking certain parts of the hook with “Do Not Load” to illustrate when loading is outside the equipment’s intended use. When these snap hooks are attached to vertical members, such as guardrail and scaffolding posts, the potential exists for bending and loading of the area marked as not to be loaded.
OSH professionals can find the following sentence in OSHA standards for general industry (29 CFR Part 1910.6), construction (29 CFR 1926.6), shipyard employment (29 CFR Part 1915.5) and marine terminals (29 CFR Part 1917.3): “The standards of agencies of the U.S. government, and organizations which are not agencies of the U.S. government which are incorporated by reference in this part, have the same force and effect as other standards in this part.” What does this mean?
The noted paragraphs are a list of the consensus standards written primarily by industry that OSHA has adopted as the law, officially called incorporation by reference (IBR). The OSH Act was signed into law Dec. 29, 1970, by President Richard Nixon. At Section 6(a), the OSH Act authorized the U.S. Secretary of Labor to adopt other federal standards and national consensus standards for a period of 2 years without having to go through the official rulemaking process.
Congress decided that since national consensus standards were written by highly knowledgeable, experienced professionals and had gone through a comprehensive review process, adopting these standards would simplify standards promulgation and provide immediate protection for America’s workforce.
This new agency (OSHA) chose to adopt several hundred of these other standards, and those adopted standards are incorporated into the law by means of a specific OSHA standard referring to that adopted standard.
Emery, Robert J. (University of Texas Health Science Center at Houston and School of Public Health) | Patlovich, Scott J. (University of Texas Health Science Center at Houston and School of Public Health) | Jannace, Kalyn C. (University of Texas Health Science Center at Houston and School of Public Health)
A variety of safety and health risks exist on college and university campuses based on the types of teaching and research activities conducted. OSH programs are typically implemented to help identify and control these risks to keep students, faculty, staff and visitors safe. A significant challenge for decision makers at these institutions is how to determine appropriate staffing and resourcing levels for such programs. A further challenge to staffing is ensuring that the job description and duties accurately represent those activities that truly fall under the purview of the position.
Existing methods of measuring efforts often include some level of intense observation or surveillance, which staff may consider to be intrusive and cumbersome (Sewell, Barker & Nyberg, 2012). As a result, the Hawthorne Effect, described in other time and motion studies, may alter the way a staff member conducts his/her routine activities leading to an observed effect further from the normal (Fernald, Coombs, DeAlleaume, et al., 2012). Brown, Emery, Delclos, et al.’s (2015), recently developed predictive models provide the ability to estimate staffing and resourcing needs in academic settings using institutional drivers such as total net assignable square footage, but the models do not account for staff productivity.
In this pilot study the authors utilized the ecological momentary assessment (EMA) research technique to record the work activities being undertaken by OSH personnel during a typical 8-hour work day in an effort to augment the Brown, et al., models by addressing worker productivity. Practicing OSH professionals were evaluated 1 day per week over a 5-week period (for a total of 5 work days, all weekdays) to determine the type of work conducted during the normal 8-hour work shift.
Marcham, Cheryl L. (Embry-Riddle Aeronautical University) | Turnbeaugh, Treasa M. (Board of Certified Safety Professionals) | Gould, Susan (Board of Certified Safety Professionals) | Nadler, Joel T. (Board of Certified Safety Professionals)
For more than 40 years, the multiple-choice examination has been the standardized assessment tool used in the certification process of OSH professionals (Wright, Turnbeaugh, Weldon, et al., 2015). The use of a multiple-choice exam to award a credential, however, has been criticized by many OSH professionals. This may be primarily due to a perception that relates to their previous academic experience with multiple-choice exams and a misunderstanding of the science behind the development of such exams.
The use of standardized tests clearly ensures a consistent and rapid method of scoring, but the use of such tests is legally defensible only if the test is developed through a systematic, psychometric process that objectively measures the relevant skills and knowledge of the individuals being assessed (Wright, et al., 2015). These exams are not, as many perceive, developed solely by individual certificants intending to make the test questions as hard or as trivial as possible.
Components of High-Quality Certification Examinations
The process of establishing and delivering a high-quality certification examination involves several steps and many subject matter experts (SMEs), as well as extensive statistical evaluation. The process must generate an examination that is valid, reliable, fair and practical. Each component plays a role in the development of a high-quality examination for the certification process (Figure 1, p. 46).
Consider the following descriptions of three incidents in which work zone intrusions resulted in injuries and fatalities of construction and transportation workers.
Case 1: On March 13, 2017, two construction workers were killed in a work zone by a hit-and-run driver. A third was severely injured. The workers were conducting a ditch inspection when a car veered off the lane and crashed into the work zone (Johnson, 2017).
Case 2: On April 7, 2017, at approximately 3:00 a.m., a vehicle drove into a cut-off emergency lane and struck four DOT employees who were sanding and painting metal structures beneath an overpass. One worker was declared dead at the scene of the crash while two workers were severely injured (Park & Clark, 2017).
Case 3: Following some erratic driving upstream, a vehicle entered into a highway work zone and hit a company vehicle parked in the work zone, then ran over several barrels before coming to rest. Prior to crashing into the stationary company vehicle, a worker was hit and killed (Reese, 2016).
A consistent undertone in the three cases is the cause of the fatality: a motorist intruding into a predetermined and closed-off work zone. To keep the roadway open to the public during construction, highway construction workers are often exposed to the hazards of working in close proximity to live traffic. According to CDC (2016), 1,435 workers died on duty between 2003 and 2014, averaging about 115 fatalities per year. Vehicles intruding into a work zone are considered a primary source of worker fatalities. In addition, CDC (2016) reports that approximately 50% of fatalities recorded between 2011 and 2014 were attributed to vehicles hitting a worker in a work zone. The results from a survey conducted by Associated General Contractors of America (AGC, 2015) indicate that approximately 50% of all U.S. roadway contractors witnessed a work zone intrusion in 2014.