Summaries of some of Monday's conference sessions follow. For more articles, visit http://safety.blr.com/nsc2004

A Huge Disconnect: Healthcare Safety

The healthcare industry suffers from a huge disconnect between what they know and what they do, according to Jim Ramsay, Assistant Professor at the University of Wisconsin, Stevens Point. The healthcare field knows that 7 out of 10 injuries in the medical facilities happen to nurses--and that 1 out of every 3 employees will be exposed to workplace violence--and that the bloodborne pathogens requirement is the highest cited OSHA citation in the healthcare field. Yet, healthcare job descriptions more often than not fail to address safety requirements. Similarly, the core accreditation process doesn't require demonstration of competency in known risk areas. Nor do nursing school programs properly train and prepare nursing students for these safety competencies.

Some developments which should help in these areas include:

• At VA hospitals, Kara Szirotnvak, is working toward a limited lifting or zero lifting environment to reduce ergonomic issues, reduce risk of patient injuries, increase job satisfaction among nursing staff by instituting engineering changes to prevent the need for nurses to have to lift patients.
• OSHA has entered an alliance with Joint Commission on Accreditation of Healthcare Organizations to develop best practices, resources, workshops, seminars, lectures, and so forth on healthcare issues
• OSHA has entered other alliances with healthcare industry groups, including the Association of Occupational Health Professionals and the New Jersey Association of Hospitals for similar development of reference materials and additional training resources.

Ramsey recommended employers use a job safety analysis (JSA) or job hazard analysis (JHA) as an effective administrative control.

Ramsay is working with a group that will be publishing a report in NSC's Journal of Safety Research in 2005 regarding accreditation in the health care field and degree to which it adequately addresses risks in the workforce.

-- Peggy Carter-Ward

Critic Cites Problems with Traditional Metrics for Safety Performance

The traditional measurements of safety performance used by safety managers and regulators "suck," according to Peter Furst, the director of contracting for the Liberty Mutual Group. Furst made his assessment Monday at the National Safety Conference' s Congress and Expo in New Orleans, LA. Traditionally, the safety process is managed in isolation from other organizational systems within a company, and the methods for measuring and therefore changing safety performance are incompatible with the modern business approaches. According to Furst, injury and illness statistics and accident reports don't' tell us what causes injuries or other safety-related losses.

Management often responds to high injury rates with more training and worker rewards and punishments for acting in certain ways. These methods do not usually result in long-term or permanent changes in safety performance because the root cause of the injury rates was never determined.

Furst outlined the elements of an organizational scorecard for aligning safety goals with the business values that drive the company's core functions and decisions. Businesses general measure the value of their activities through profit/loss and price/earnings ratios, return on investment (ROI), productivity, and efficiency. He urges safety managers create an organizational scorecard that takes in to account 5 primary factors:

• Mission--a statement of why the company exists
• Guiding principles--values that drive the company toward its mission (profit, productivity, customer satisfaction, employee loyalty, and others)
• Vision--how to carry out the mission (factors that distinguish your company)
• How we are doing--criteria for measuring progress
• Targets--desired performance and results

He compared the business practices at Southwest Airlines and United Airlines. United had copied the practices employed at Southwest, according to Furst, yet Southwest is making money and United is facing bankruptcy. The single greatest difference between the 2 companies was that Southwest has an employee culture that harmonizes very well with the company's business values, and United does not, according to Furst.

Measurements of safety performance must be closely linked to the mission and vision of the company. Safety managers should measure whether or not workers are doing the right things to carry out the company's mission. For example, it may be better to measure a potential employee's commitment or attitude toward safety during the hiring process than measuring how often he or she attends training. A measurement of the employee's commitment to safety (doing things right) will is better than counting the number of times training sessions attended.

The organizational scorecard will help safety managers set goals and develop safety strategies in balance with other organizational needs such as productivity, product quality, timeliness, use of resources (equipment, space), and cost. Setting goals that can only be attained by using resources in a way that defeat another business goal are doomed to failure. Recognize that optimum business performance may allow for an injury rate above zero.

-- David Galt

Breaking the Pattern

A session by Robert Russell, consultant from Strategic Safety Associates, titled Breaking the Pattern of Accident Repetition, focused on how to respond effectively to accident repeaters. Russell has helped companies in more than 60 countries develop more effective safety practices, with clients such as American Airlines, Amtrak, Kodak, Xerox, and others.

According to a recent Canadian study, the average "repeat offender," that is, a person who has five or more accidents in five years, is an average of 53 years of age and is male. If the person was injured younger in life, more accidents are bound to happen over time. And, the cost of each lost-time work accident was found to be about $14,000--which means there is a huge potential to save organizations significantly by identifying and correcting accident repetition.

Here is an 8-step approach that Russell recommends to combat accident repetition:

1. Develop a system and a policy for accident prevention--be sure it is a positive approach and include a written plan
2. Secure leadership support--management, supervisors, and the union.
3. Publish a clear statement to everyone--so everyone understands the policy
4. Develop ways to flag problems
5. Evaluate factors and patterns
6. Orient and coach leadership
7. Intervene with repeaters--avoid lecture and blame
8. Follow up and adjust--so the accidents don't happen again
With these interventions, accident repetition can be reduced, saving your company valuable time and money.

-- Peggy Cretella

The Hispanic Workforce: It's not Just Language, It's Cultural!

With the continuing increase in Hispanic workers in the U.S. workforce, employers face the challenge of incorporating this growing workforce into existing safety programs. Robert Ramirez, of Ramirez Associates, led an engaging and interactive session to help safety professionals more effectively manage their Hispanic employees.

Ramirez attempted to debunk the several common myths about the Hispanic workforce:

• Simply because you have one or more foremen who identify themselves as a Hispanic, does not mean they will be able to deal with all other Hispanics in a culturally competent way.
• Simply the fact that you have a member of the Hispanic community who works in a mainstream agency, does not mean he or she is able to communicate in Spanish.
• A single member of the Hispanic community cannot represent the entire Hispanic community.
• The belief that, because there are so many ethnic communities, it is not feasible or cost effective to have working relationships with them, is not valid.
• Cultural competence is not something we can simply pick up with time by working with Hispanics
• Collecting information from a Hispanic community needs to be relationship-based rather than task-based.

Ramirez further offered the following tips for creating and maintaining Hispanic employee loyalty:

• Provide training and workplace communication in Spanish
• Take extra efforts to explain concepts that are culturally new (ESOP, HMO, 401k, flextime, co-pay, etc). Don't accept an "I don't need it" answer? press them, that they DO need it. Help them get a checking account.
• Assure them that they will not be punished for requesting clarification.
• Understand that 'yes" may not mean "yes" and "right now" might mean "later"
• Encourage initiative
• Respect the tradition of family comes first
• El respeto--respect! For Hispanics, respect is more internal, (that is, how others treat you), according to Ramirez.

In conclusion, Ramirez stressed that the differences aren't simply language but are more cultural. Having sensitivity to the cultural differences will allow you to have a more effective relationship with your Hispanic employee.

--Peggy Carter-Ward

Employee-Driven Ergonomics Programs

Stephen Jones, CIE, AMP ergonomist from Alcoa Mills Products delivered a session on Employee-Driven Ergonomics Programs. The focus of this session was how these programs function and types of improvements made.

Jones has been working in the area of ergonomics since 1990. His work at Davenport Works, which is the largest aluminum rolling plant in the world, employing 2400 workers, contributed to a significant decrease in musculoskeletal disorders. Ergonomics programs implemented there have taken ergonomic injuries from 9 or 10 per year down to zero.

What contributes to an ergonomic injury? Jones attributes the causes to an aging, deconditioned workforce and aging, and deconditioned equipment. The average age of employees who received ergonomics-related injuries is 30 to 40 years, and new employees are injured more frequently than veteran employees.

How has Alcoa worked to decrease ergonomic injuries? To start, they have not waited on OSHA to come out with another standard. Instead, they modeled an ergonomic program after OSHA's initial ergonomics standard, which was later repealed. Next, they create an "EHS Balanced Scorecard" which consists of:

• Identifying the top ten ergonomic risks
• Creating departmental ergonomics committees to identify risk factors
• Creating a plant-wide steering committee with representatives from each department
• Creating a nontraditional work assignment that focuses on only ergonomic issues and is filled by an internal employee
• Delivering "discomfort surveys" which are given to at-risk employees. Questions on the survey help to identify problem areas and elicit employee ideas for solutions
• Entering information into an ergonomic database which measures risks, and weights and ranks risk factors
• Allocating a budget to fix the most significant ergonomic problems.

In addition, employee incentives are offered to engage employees in this important injury reduction initiative. Jones attributes the success of this program to:

1. Employees are the key problem identifiers and were involved in all steps
2. Employees developed new solutions that were user-friendly
3. Employees were enthused and empowered.

-- Peggy Cretella

Changes in ANSI Safety Eyewear Standard

Under a new, more stringent ANSI standard for safety eyewear, there are two levels of prescription lens performance: basic impact and high impact, according to Francine Jones, manager of professional relations at Titmus.

Plano (non-prescription) lenses have two levels of impact performance under the new standard as well.

The new ANSI standard was released in August 2003, but OSHA has yet do adopt it by reference.

Under the new ANSI standard, "Practice for Occupational and Educational Personal Eye and Face Protective Devices" (Z87.1-2003), prescription lenses are allowed to be as thin as 2.0 mm if they meet the high impact testing requirements, Jones noted. Only certain materials, such as polycarbonate, are capable of passing the high impact velocity test. If lenses have a coating, such as a tint, they must be tested with the coating.

Frames are required to hold a 2.0 mm high-impact lens when exposed to high impact under the new standard, according to Jones.

Manufacturers label lenses with high-impact protection with a "+" sign.

For eyewear that meets only the basic-impact requirements, the new ANSI standard requires a warning label that can only be removed by the user of the eyewear.

Jones recommended that a hazard assessment to determine exposure to high impact include a checklist of possible hazards, including impact, heat, dust, chemicals, and optical radiation.

Even in a low-impact environment, high-impact eyewear may be a better practice, according to Jones.

-- Sean Dean

OSHA Year-End Enforcement Targets Met

OSHA expects to have issued a total 78,613 serious or willful violations by September 30, the end of the fiscal year, a slight increase over last year's total. Richard Fairfax, Director of OSHA's Enforcement Division, gave a preliminary end of the fiscal year enforcement report Monday at the National Safety Council's Congress and Expo in New Orleans, LA. He added that only 8 percent of those violations were contested by the violators, down from 9 percent contested in 2003.

He reported several other enforcement statistics of interest to the regulated community:

• Through OSHA's National Emphasis program, warning letters to businesses resulted in a 5 percent reduction in illness and injury rates at those businesses over a 3-year period
• Inspections yielded a over 13 percent reduction in illness and injury rates at those companies inspected
• OSHA completed actions against 16 violators of the General Duty Clause for ergonomics violations, and issued 325 hazard alert letters concerning ergonomics hazards.

OSHA completed enhanced enforcement program (EEP) actions at 245 companies with death-related or willful and repeat violations. EEP-related actions mean the company's violations were egregious enough to be subject to follow-up inspections, inspections of other worksites owned or operated by the violator (whether or not they had reported violations), and visits by OSHA representatives to corporate management.

Fairfax said his office plans the following initiatives for the coming fiscal year:

• An asbestos directive update (last one done in 1994)
• Process safety management initiative
• Pulp digesters initiative
• Lockout/tagout directive
• Permit-required confined space directive
• Fatality directive
• MSDS initiative tied to the agency's new hazard communication guidance documents.

Fairfax said the agency would identify inadequate MSDSs and send letters to the manufacturers to correct the deficiencies and follow-up the letters with inspections.

-- David Galt

Lockout/Tagout and Verify

Performing lockout without bringing a machine to a zero-energy state is like locking out a gun with the bullets in it, according to Jeff Holland, UAW safety representative at John Deere Cylinder & Seeding.

In a high-energy technical session, Holland stressed the importance of lockout/tagout in safety operations because small mistakes can have deadly results. In particular, he emphasized the importance of bringing equipment to a zero energy state to avoid the unexpected release of stored energy, which could cause injury.

"We cannot just lock it out with the bullets in it," said Holland.

Holland said there are four major elements to a lockout program: conditions (state of equipment), awareness (accomplished through training), attitude which includes positive reinforcement (reward employees for doing the right thing), and design (engineering controls).

Holland said lockout procedures must be clearly defined and communicated. He said his company's program uses placards with step-by-step lockout procedures for specific equipment. In addition, he said parameters must be set for when lockout must be used.

Holland described the particular safety concerns of troubleshooting on machines (for example, verifying service was conducted properly) when the power is on. Holland said many injuries occur during troubleshooting. When troubleshooting, it's important to stay out of all hazardous areas--not just the most obvious ones--by anticipating, identifying, and evaluating all of the potential hazards. After the troubleshooting is completed, conduct lockout of equipment, Holland said.

-- Sean Dean