Professional Documents
Culture Documents
Proceedings of
the International Symposium on
Culture of Prevention Future Approaches
Helsinki 2014
Contents
Foreword
- Harri Vainio, Markku Aaltonen 5
Symposium opening speech
- Leo Suomaa 9
Opening speech for the International Symposium on a Culture of Prevention
- Hun-ki Baek 12
Opening speech
- Philippe Jandrot 14
Opening remarks
- Hans-Horst Konkolewsky 15
Opening Speech for International Symposium on Culture of Prevention
- Korean Embassy in Finland 19
Keynote speeches
Prevention culture as culture: Can we achieve it, and is it enough?
- Schulte PA, Guerin RJ, Okun AH 21
Evidence of the benefits of a culture of prevention
- Gerard I.J.M. Zwetsloot 30
Challenges and Barriers to Promoting Safety Culture
- Marianne Levitsky 36
Future approaches to a culture of prevention
- Walter Eichendorf, Ulrike Bollmann 43
Selected articles
Taking prevention beyond the workplace
the role of social security institutions
- Bernd Treichel 54
The health, safety and health promotion needs of older workers
- Jane White 59
Industry-specific Development Programme for improving well-being at work
- Marika Lehtola et al 65
A European Guide on Economic Incentives for Prevention
- Dietmar Elsler 68
National working life development strategy to 2020 in Finland
- Ismo Suksi 74
Vocational education providers network promoting occupationalsafety
during on-the-job learning
- Sari Tappura 78
Contributors111
Foreword
Markku Aaltonen, Harri Vainio
Finnish Institute of Occupational Health
Fortunately, many statistics indicate that workplace health and safety
has improved over time. Occupational injury rates in the European Union, the United States and elsewhere have shown a steady decline over
the past 100 years, and exposure to chemical agents in the United States
and Europe has also decreased considerably in the past forty years or so.
However, uncertainty about what specific preventive interventions led
to these improvements makes it difficult to select appropriate interventions in countries in which high rates persist. Moreover, some occupational health statistics remain unfavorable. Noise-induced hearing loss,
work-related musculoskeletal disorders, stress-related complaints and
skin disorders continue to be prevalent. Other less predominant conditions (for example HIV and HBV) have serious consequences, and so
protecting workers from these communicable hazards remains a high
priority.
The well-being of a nation is dependent on the work of its people and on
the health of its population. For this purpose, national health and safety
policies are required to support and promote sustainable development
in society. Prevention is better than cure; this has been a well-accepted
notion for centuries, and it remains at the core of the future emphasis
on prevention culture.
On 29 June 2008, at the XVIII World Congress on Safety and Health at
Work, the Seoul Declaration on Safety and Health at Work was signed.
The declaration included statements concerning national governments
responsibility for perpetuating a national preventative safety and health
culture, for systematically improving their national safe workplace performance, and for providing a health standard with appropriate enforcement to protect workers. International co-operation continued in
the area of prevention culture when the ISSA International Section for a
Culture of Prevention was launched in 2011 in Istanbul, Turkey, and will
continue in the XX World Congress in Frankfurt, Germany 2014.
Artefacts comprise the visible and verbally identifiable elements at workplaces. Examples are safety posters, messages
and slogans, documents and reports related to safety (audits,
accidents, etc.), work procedures and instructions, dress codes
(wearing of personal protective equipment), etc.
Adopted values include the aspects stated or aspired to by
the organization. These are the written or spoken statements
made by the employer or business manager. Values also include
workers safety attitudes towards behaviour, people and issues
related to safety practices.
Basic assumptions are the underlying, shared convictions
regarding safety among the members of an organization. These
assumptions are implicit and invisible, but evident to the members.
These could be about what is safe and what is not.
On the basis of this common concept, the theoretical framework for the
Symposium (Helsinki Onion) was developed (see Figure 1). The Symposium programme consisted of presentations about these different levels.
The Symposium opened up viewpoints to these different aspects related
to the culture of prevention.
Conclusions
The Symposium proved to be a useful forum for the exchange of ideas,
generating research and collaboration, networking, and social interaction. This Proceedings of the International Symposium includes the key
presentations and selected papers of the programme. The publication is
freely available on the website of the Finnish Institute of Occupational
Health.
References
International Symposium on Culture of Prevention Future Approaches. www.ttl.fi/cultureofprevention2013
Seoul Declaration on Safety and Health at Work. www.seouldeclaration.org/en/
Schein, E. H. (2004) Organizational culture and leadership, 3d Ed. San Francisco: Jossey-Bass.
EU-OSHA European Agency for Safety and Health at Work (2011). Occupational Safety and
Health culture assessment - A review of main approaches and selected tools.
11
Good morning!
I am Hun-ki Baek, President of the Korea Occupational Safety and Health
Agency. As the president of KOSHA and chairperson of the ISSA International Section for a Culture of Prevention, I am extremely glad to be here
with you on this special occasion of the International Symposium on a
Culture of Prevention.
Honorable Director Leo Suomaa of the Finnish Ministry of Social Affairs
and Health, Director Seiji Machida of the ILOs Program on Safety and
Health at Work and the Environment (SafeWork), Secretary General
Hans-Horst Konkolewsky of the ISSA, Director General Harri Vainio of
the Finnish Institute of Occupational Health, Director Philippe Jandrot
of the INRS (Institut National de Recherche et de Scurite, National Research and Safety Institute) of France, Deputy Director General Dr. Walter Eichendorf of the DGUV (Deutsche Gesetzliche Unfallversicherung,
German Social Accident Insurance) of Germany, Korean Ambassador to
Finland Dong-hee Jang, and distinguished representatives and experts
from safety and health organizations!
I am truly happy to see you all in this beautiful city of Helsinki, the center
of the Baltic Sea and Scandinavia.
As you know, the Safety and Health Summit held in Seoul, Korea on
June 29, 2008 on the occasion of the 18th World Congress on Safety and
Health at Work adopted the Seoul Declaration.
The declaration, which was adopted by 46 representatives of workers,
employers and governments is the first in history to declare safety and
health a fundamental human right and a means of economic development.
The Seoul Declaration is the basis for the Istanbul Declaration, which was
adopted in the Labor Ministerial Meeting at the 19th World Congress on
Safety and Health at Work in Istanbul, Turkey in 2011. This declaration
reaffirmed governments commitment to occupational safety and health.
Thanks to these efforts, the ISSA International Section for a Culture of
Prevention was established on the basis of active support and cooperation with the ILO and the ISSA.
Since its inauguration, the Section has been engaged in various activities including successfully hosting the Inaugural General Assembly at
12
13
Opening speech
Philippe Jandrot, Director
Institut National de Recherche et de Scurit (INRS)
The concept of a culture of prevention is fairly new in the field of occupational health and safety. Twenty years ago, in France, social partners did
not accept any kind of reference to a culture of prevention. The reasons
for rejecting this term were quite different among employers and workers unions, but there was a very strong common opposition.
We can now see that the idea of a culture of prevention has rapidly become widely accepted, through a few important dates:
11 March, 2003 Communication of European Commission - Community strategy on health and safety at work (2002-2006) set the principle of A real culture of prevention
29 June, 2008 Seoul Declaration The summit participants commit
to taking lead in promoting a preventative safety and health culture,
placing safety and health high on national agenda.
September 2011 ISSA created Prevention culture section
Today everyone uses the concept of a culture of prevention. Each of us
has developed our own understanding of this concept, but how common are these understandings?
Should we understand that there is only one culture of prevention or
that there are several, depending on regional cultures or other factors?
What are the components of a culture of prevention? Knowledge? Beliefs? Behavior? Ethic rules? Moral values? Competencies? Concepts?
Does a prevention culture have tools?
How do we create a culture of prevention? Education and training are
natural ways to do this. Can the implementation of a management system also be a way to implement or develop a culture of prevention?
How do we evaluate the level of a culture of prevention?
All these questions have to be addressed. The objective of this symposium was to start answering some of these questions and to prepare for
the ISSA XX world congress in Frankfurt on 24 - 27 August 2014.
I believe that the good quality of the work and discussion during the
symposium in Helsinki will make September 2013 an important date in
the development of a common understanding of the Culture of prevention.
14
Opening remarks
Hans-Horst Konkolewsky, Secretary General
International Social Security Association (ISSA)
due to work-related accidents and diseases which account for the major
part of fatalities. This means that more people are killed due to their
work than due to conflicts and wars.
Positively, a trend towards lower incidents of fatal work accidents can be
observed both in Europe and globally, while fatal occupational diseases
incidents however continue to increase.
Besides the unacceptable human losses, there are huge economic consequences which have been estimated at 4 % of global GDP as millions
of workdays are lost and billions have to be paid by workers compensation boards, pension systems and society at large.
The nature of occupational health problems is changing too: According
to European and national surveys the ranking of reported health problems is headed by ergonomic and psychosocial conditions. It is therefore
not surprising that, according to the OECD, between 40 and 50 % of new
invalidity cases amongst member countries are caused by mental health
problems.
This adds another element to the previously mentioned complexity of
prevention, as the causes of mental health problems can be both workand non-work related.
Ladies and gentlemen,
This is why, in the view of the ISSA, a new prevention approach is needed
where traditional collective prevention measures at the workplace are
supplemented by measures that focus on the individual and that also
take into account a persons social setting and resources.
This holistic prevention concept not only requires new competencies,
tools and collaboration structures for those involved, but it also calls
for an increased focus on health and health promotion at work, and for
workers who have suffered an accident or disease, systematic return-towork programmes.
As a consequence, prevention systems and actors find themselves at a
critical crossroads:
If authorities, organisations and professionals in charge of prevention at
the workplace do not react to these evident developments in workers
health and embrace a more holistic and integrated prevention approach,
they risk being criticised for not being able to manage and reduce the
increasing negative health impacts and the related economic consequences.
They also risk that the positive recognition in society of the added value
of investing in work- related prevention structures and efforts might be
weakened severely.
However, if the same actors decide to embark on the development of
new, supplementary prevention concepts, tools and the related competencies and collaborative structures, the value of prevention and the
important role of the workplace in achieving more inclusive labour mar16
kets and productive societies will become even more evident and thus
contribute to the development of a prevention culture at the workplace
and in society.
For the ISSA there is no doubt about the choice of strategic direction
to be taken. In our view, the introduction of supplementary holistic and
person-centred prevention approaches is both an obvious necessity in
view of the dramatically changing nature of workplace health challenges
and an historic opportunity to further strengthen prevention and to turn
the development of a genuine workplace prevention culture into an economic and social development strategy for our societies.
This is why we, over the past two years and in line with our initial commitment as co-initiators and signatories of the Seoul Declaration for
Safety and Health at Work - which has identified the involvement of all
actors in society as a key condition for the development of a prevention
culture - have developed three sets of Prevention Guidelines for social
security administrations. Our objective is strengthening the role of social
security both as regards workplace risk prevention, health promotion
and return-to-work measures.
These Guidelines will, together with good practices and reference literature, be presented in November 2013 at the ISSAs World Social Security
Forum in Doha, Qatar.
A new Centre for Excellence will be established in 2014 to offer member
organisations expert advice and practical support, training and recognition related to the successful implementation of these Guidelines.
The ISSA and its global membership are committed to developing proactive and preventive social security and look forward to collaborating
closely with other actors in the workplace and beyond in the formation
of national and global prevention cultures.
Ladies and gentlemen,
I have in my opening remarks briefly outlined,
(1) that the development of a prevention culture has become more necessary than ever due to the increasing complexity of safety and health
challenges at work, with a strong growth in health conditions that can be
both work- and non-work related,
(2) that in order to develop supplementary individual and holistic prevention approaches, traditional barriers between the workplace and society need to be overcome, and new concepts, tools and collaborative
structures between relevant actors in both domains need to be developed, and
(3) that this offers an historic opportunity for prevention to be even
more highly valued and recognised as a prerequisite for inclusive labour
markets and productive economies, and consequently for prevention
culture to form a key element in the social and economic development
strategy of countries and regions.
17
During the coming 2 days we have an excellent opportunity to further advance our thinking as regards future approaches for a prevention
culture.
I look forward to a very interesting programme with many exceptional
speakers and to fruitful exchanges about the different dimensions that
should be reflected in a definition of a prevention culture, and how this
strategic concept can be made operational both at the workplace and
beyond, which will be one of the key topics of the World Congress for
Safety and Health at Work that will take place in August 2014 in Frankfurt, Germany.
I wish you a successful meeting and very much look forward to the results of the symposium.
Thank you for your kind attention.
18
tinents, countries, regions, and enterprises, show great disparities, depending on the degree of economic and social development.
Furthermore, many workers are still in the blind-spots of occupational
safety and health.
Now your achievements enable us to minimize the blind-spots of safety
and health and help employers and workers fulfill their responsibilities in
order to improve safety at work.
Honorable Occupational Safety and Health representatives!
Ensuring the safety and health of workers translates into upholding the
noble value of human respect. Occupational safety and health is the
most essential means to ensure workers welfare, and it should take priority over everything else.
We cannot emphasize too much the importance of prevention in occupational safety and health, as prevention is not only more effective but
also less costly than treatment and rehabilitation.
The statement by ILO Director-General Guy Ryder on the World day for
Safety and Health last April eloquently attests to this: Occupational disease impoverishes workers and their families and may undermine whole
communities when they lose their most productive workers. Meanwhile,
the productivity of enterprises is reduced and the financial burden on
the State increases as the cost burden of health care rises.
Let us remind ourselves once again that, as stated in the Seoul Declaration on Safety and Health at Work adopted in 2008, safety and health
is the basic right of workers as well as a means with which to achieve
economic development.
I would like to ask all of you to show your insights into and commitment
toward safety and health, so that the principles and basic ideas of the
Seoul Declaration can have far-reaching effects in industrial sites around
the world.
Before I finish, I would like to express my sincere appreciation to the
Finnish Ministry of Social Affairs and Health, and the Finnish Institute of
Occupational Health for providing this excellent venue at which distinguished representatives can gather together.
I hope this Symposium bears fruitful results and contributes to improving our workplaces.
Thank you very much.
20
Disclaimer: The findings and conclusions in this report are those of the author(s) and do not necessarily represent the views of the National Institute for Occupational Safety and Health.
Central to the SSRWI competencies are the understanding and application of the concepts of hazard, risk, and control to all areas of a persons
work, home, school, and community life.
ic growth. As populations age and the incidence of chronic disease increases, so does its prevalence. Socio-cultural determinants of health
have an impact onand are impacted bychronic disease, and these
interrelations are varied and complex (50, 51). There is a pressing need
to intervene in this trend by moving from a palliative medical model
to a prevention-based approach (52). Preventing chronic diseases can
provide better quality of life, reduce unnecessary medical costs and lost
productivity, strengthen national economies, and advance a culture of
well-being.
moting well-being and a robust evidence base related to the determinants of well-being are required for the concept to be more forcefully
addressed in various policy areas (56). At the organizational level, contemporary practice calls for a paradigm shift in occupational health
from a treatment orientation to a holistic approach focused on mitigation of the causes of ill health and the promotion of well-being (57).
How to do this is the question. There is a need for public health and
occupational health intervention strategies to come together to create
a holistic approach to workforce well-being. Both the U.S. Total Worker
Health (TWH) initiative and the European Healthy Workplaces initiative, have begun to build up the linkages between work and non-work,
while helping to tear down the artificial divide between them. These approaches promote a culture of prevention in the workplace but also advance the well-being of the workforce. However, more etiologic research
is needed to investigate the interaction of occupational and personal risk
factors (ORFs and PRFs) (5). At the societal level, promoting the health
(in all of its facets) of every person who works is vital to the welfare of all
people, both in and out of the workforce. Creating and sustaining a culture of well-being ensures that the social fabric that binds us promotes
the highest possible quality of life for every individual.
http://www.cdc.gov/niosh/TWH/
http://www.healthy-workplaces.eu/en
26
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30
Gerard Zwetsloot is senior research scientist at the Netherlands Organisation for Applied Scientific Research, TNO (NL), and honorary professor at the University of Nottingham (UK).
31
Practical evidence
e. g. Case studies
Theory based
Practice based
For evidence of the benefits of a culture of prevention, smart combinations of scientific and practical evidence are most useful. Table 1 gives
an overview of the characteristics thereof.
32
Prevention through proactive risk assessment and participatory action-oriented approaches (11)
In small-scale and informal workplaces step-wise participatory approaches are effective for primary prevention. The steps are: 1) learn
good local practices; 2) identify significant risks and effective measures;
3) jointly plan locally feasible improvements; 4) implement prioritised
measures and record the achievements; 5) review the performance and
sustain step-by-step progress. Locally feasible, low-cost options, as well
as the design and use of locally adjusted action tool-kits, were shown to
be effective in many sectors and by several intervention studies. In the
local context, a networks of trainers are essential for sustaining improvement activities.
2) Prevention through occupational health and safety training (12)
In this comprehensive systematic review of the effectiveness of OSH
training, strong evidence was found for the effectiveness of training on
worker OSH behaviours, positively affecting worker practices and primary prevention. However, there was insufficient evidence of effects on
health (i.e. illnesses, injuries, health symptoms).
The prevention of work-related cancer, dust-related diseases, asthma, chronic pulmonary diseases, noise, and injuries in low and middle income countries (13)
This systematic review clarified that incentives, regulation, and enforcement of regulation are effective in stimulating implementation of the
available effective (technical) tools. Feedback and rewards help to prevent occupational injuries. Personal protective equipment has potential,
but its use is difficult to put into effect, while no conclusive evidence was
found that education and training, preventive drugs or health examinations are effective.
4) Core values that support a prevention culture (14)
While health, safety and well-being at work (HSW) represent values in
themselves, other values can support them. In a literature overview of
values and value-laden factors that support HSW, seven core values were
identified and grouped into three value clusters. The first value cluster comprises the values of interconnectedness, participation and trust.
The second cluster comprises justice and responsibility. The third value
cluster comprises the values of growth and resilience. These core values
can be regarded as basic value assumptions that underlie a culture of
prevention.
5) Networking, zero accidents vision and accident prevention (15)
Increasingly companies feel their identity and reputation do not allow
for accidents and work-related diseases, and that zero (accidents, harm)
is the only ethically sustainable goal for health and safety (16). Membership of the Finnish Zero Accident Forum, where companies share best
practices and inspiration with each other and with FIOH, was associated
with significant improvements in their accident rates in the period 200533
2008, while those in the national statistics levelled off, even-though the
member companies already performed much better than the national
average.
6) Accident prevention through safety leadership (17)
In a comprehensive literature review it was shown that transactional and
transformational leadership does make a change for safety. The main
effective elements were: (a) having and disseminating a clear vision; (b)
acting as role models and showing concern; (c) motivating employees,
encouraging worker involvement; (d) communicating consistent safety
messages; (e) setting clear goals and standards; (f) monitoring and recognising positive safety behaviours; and (g) providing resources.
7) Accident prevention through a good safety climate (18)
This meta-analysis demonstrated that (a good) safety climate has a positive, but weak, effect on safety compliance (adherence to procedures)
and a somewhat stronger effect on participation (employee commitment and involvement in safety). The latter, however, will vary across
occupational settings and work environments.
8) Prevention of fatal accidents through life saving rules (19)
In 2009 Shell introduced twelve life-saving rules as part of pursuing
goal zero world-wide. The twelve rules were not new, but were now especially promoted, emphasising that compliance was mandatory for all
Shell employees and contractors while on Shell business or sites. An important principle, communicated explicitly, was: If you choose to break
these rules, you choose not to work for Shell. The fatal incident rate in
Shell was reduced by 71% between 2008 (baseline) and 2011 (last year
of the evaluation) implying around 21 lives saved in 2.5 years, while the
average for the sector was a reduction of 39%. The lost time incidents
frequency rate dropped by 40%, compared to 21% in the sector.
Conclusions
A prevention culture is dynamic and complex, which makes it difficult to
generate hard scientific evidence of the benefits through traditional research methodologies. Innovative types of research, combining practical
evidence with rigorous scientific methods are key. It cannot be a surprise
that evidence of the effectiveness of the internalisation of prevention
into the mind-sets, the values as well as behaviour and actions of policy
makers, managers and employees, is very limited. The majority of available evidence is for the effectiveness of the implementation of preventive and promotional activities. There is evidence of the effectiveness of
regulation, enforcement of regulation and incentives, participatory stepwise approaches, leadership and genuine management commitment,
OSH, training, networking for zero accidents and harm, safety climate,
and organisational enforcement of compliance to essential rules or principles (life saving rules).
34
References
1.
IAEA. Summary Report on the Post-Accident Review on the Chernobyl Accident. Safety
Series No. 75, International Nuclear Safety Advisory Group. Vienna: IAEA; 1986.
2.
Cullen WD. The public inquiry into the Piper Alpha disaster, 2 volumes. London: H.M. Stationery Office; 1990.
3.
Cox SJ, Flin R. Safety culture: philosophers stone or man of straw? Work and Stress. 1998,
12 (3): 189-201.
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Guldenmund FW. Understanding and Exploring Safety Culture. Oisterwijk (NL): Box Press;
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Reason JT. Managing the risks of organisational accidents. Aldershot: Ashgate; 1997.
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Schein E. A conceptual model for managed culture change. In: Schein E, editor. Organisational culture and leadership. 2nd ed. San Francisco: Jossey-Bass; 1997.
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Snowden D. Cynefin: a sense of time and space - the social ecology of knowledge management. In: Despres C and Chauvel D, editors. Knowledge Horizons: The Present and the
Promise of Knowledge Management. Oxford: Butterworth-Heinemann; 2000: 237-266.
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Hollnagel E, Woods D, Leveson N. Resilience engineering concepts and precepts, Hampshire. Burlington: Ashgate Publishers; 2006.
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Weick KE, Sutcliffe K. Managing the unexpected. San Francisco: Jossey-Bass; 2007.
10. Huber M, Knottnerus JA, Green L, van der Horst H, Jadad AR, Kromhout D, et al. How
should we define health? BMJ 2011; 343: d4163.
11. Kogi K. Essential Occupational Safety and health Interventions for Low- and Middle-income Countries: an overview of the evidence. SH@W 2012: 3, (3): 155-165.
12. Robson LS, Stephenson CM, Amick BC III, Eggerth DE, Chan S, Bielecky AR, et al. A systematic review of the effectiveness of occupational health and safety training. Scand J Work
Environ Health 2012, 38, (3): 193-232.
13. Verbeek J, Ivanov I. Essential Safety and Health Interventions for Low- and Middle-income
countries, An overview of the Evidence, SH@W, 2013, 4 (2): 77-83.
14. Zwetsloot GIJM, van Scheppingen AR, Bos EH, Dijkman A, Starren A. The Core Values that
support Health, Safety and Well-being at Work. SH@W, 2013: 4: 187-196.
15. Virta H, Liisanantti E, Aaltonen M. Nolla tapaturmaa -foorumin vaikutukset ja kokemukset.
Loppuraportti Tysuojelurahastolle. Helsinki: Tyterveyslaitos; 2009.
16. Zwetsloot GIJM, Aaltonen M, Wybo JL, Saari J, Kines P an, Op De Beeck R. The case for
research into the zero accident vision, Safe Science 2013, 58: 41-48.
17. Lekka C, Healley N, editors. A review of the literature on effective leadership behaviours for
safety. Buxton: Health and Safety Executive, RR952: 2012.
18. Clarke S. The relationship between Safety Climate and Safety Performance: a meta-analytic
review, J of OHP 2006; 11 (4): 315-327.
19. Peuscher W, Groeneweg J. A big oil companys approach to significantly reduce fatal
accidents. SPE 2012: 157465-MS.
35
36
This presentation is a personal view and does not necessarily represent the opinions of Workplace Health
Without Borders.
Can culture surveys and the safety culture maturity concept be applied
to influencing safety culture at the societal level? Just as a safety culture
survey in a workplace can provide a baseline on which to judge the success of an intervention, can we design a social survey to benchmark societal safety culture? There is limited experience in this area for example,
the Ontario, Canada Workplace Safety and Insurance Board conducted
public surveys before and after its social marketing campaigns (4) and
the UK Health and Safety Executive (HSE) (5) conducted a survey of public attitudes to safety. Responses to such surveys may point the way to
priority audiences for building a public safety culture. For example, the
HSE survey found that employers were slightly less likely than workers
and the general public to agree with the statement, health and safety
requirements are a cornerstone of a civilized society. Such results may
suggest that safety culture promotion efforts may need to start with
efforts to influence employer buy-in and responsibility.
Much effort has gone into validating and standardizing safety culture
and climate surveys at the workplace level. Similar efforts to develop
valid social surveys indicative of safety culture at the society level could
prove a valuable contribution to building national safety cultures.
Establishing a baseline measure of culture and prioritizing audiences are
good first steps in planning a strategy to build safety culture. Deciding
how to influence the audience can prove even more challenging.
Social marketing campaigns and motivational messages have been used
in efforts to influence social attitudes and behaviours with respect to
other public health and environmental goals. (Social marketing is the
use of marketing and advertising techniques to promote socially beneficial objectives.) Occupational health and safety (OHS) practitioners may
be able to learn from research on social marketing, motivation, influencing and decision-making related to other social objectives.
Much of this research emerges from the sphere of behavioural economics a deviation from classical economics that, in the words of leading
theorists (6) represents the combination of psychology and economics
that investigates what happens in markets in which some of the agents
display human limitations and complications. Behavioural economics contradicts classical economics in showing that people dont always
make decisions based on rational cost-benefit considerations. It teaches
us that we need to take into account the very human quirks and tendencies that influence everyones choices and actions.
Compilers and popularizers of research on behavioural economics, social marketing, motivation, influence and decision-making (7, 8,9,10,11)
point to a number of findings that may be useful in developing strategies for building safety culture. Five areas of research with promising
implications for safety culture are outlined below.
1. Framing: Kahneman and Tversky (12) have demonstrated the importance of how an issue is presented -- showing that framing the same
problem as a loss rather than a gain can significantly change the out37
come. They further articulated this as a principle of loss aversion quantifying it in the formulation that the pain of losing something is two
times greater than the pleasure of gaining it.
Framing has been invoked in health promotion endeavours, with experiments measuring the effectiveness of health promotion messages
framed in positive or negative ways. (13) According to this research,
negatively framed messages e.g. you could permanently lose your
hearing are more effective in promoting detection behavior such as
taking a screening test, while positively framed messages, e.g. you can
guard against permanent hearing damage are more effective in promoting prevention behavior such as wearing protective equipment. The
UK HSE (13) reported on a test of positively and negatively framed messages in informational brochures. Results indicated that the previous
history of the audience affected the potency of positively versus negatively framed messages. For example, those who knew someone with
hearing damage or had regularly used hearing protection were more
likely to be influenced by a positive message, while the converse was
trued for negative messages.
The HSE study also suggested that negative, i.e. fear-based messages
had more emotional impact than positive messages, but are not necessarily more successful in eliciting desired behaviour. In a British Columbia
study of OHS social marketing campaigns aimed at young people, Lavack
(14) found that more than half of the campaigns were fear-based. Her
team analyzed the factors that influenced the success of the campaigns,
applying the Extended Parallel Process model that has been developed
in the context of other health promotion campaigns. According to this
model, four components of a fear-based health promotion message are
key to motivating desired behaviour to avoid an unwanted outcome:
susceptibility (the audience must believe that the outcome could happen to them), severity (the outcome must be severe enough that the
audience wants to avoid it) self-efficacy (the audience must believe they
can perform the desired behaviour) and response efficacy (the audience
must believe that the desired behaviour will be effective in preventing
the outcome).
Lavacks results indicated that a combination of self-efficacy, susceptibility, and severity in a campaign greatly increased its effectiveness.
The HSE and Lavack results suggest that framing does matter but must
be applied in conjunction with other message features, and take audience characteristics into account. The best approach may be to use
different messages, some positive, some negative to be effective with
different audience segments.
2. Present Bias Preference: Behavioral economics also points to an
abundance of research illustrating that future outcomes are less potent
than more immediate outcomes in influencing behaviour. Present-bias
preference is especially germaine to occupational health, in view of the
many hazards such as those causing chronic disease, that exert their effects at some uncertain point in the future. Zohar (15) suggests that immediate feedback is a tactic that can counteract present bias preference
38
making them safer on the job. As Lavack stated, there are often environmental elements that preclude the individual from performing safety
behaviours. This brings us back to a main challenge in promoting workplace safety culture: it is not something that can be achieved through
individual changes alone, but is a product of the surrounding social environment and shared values and attitudes that foster safety. That is why a
key goal in changing safety culture must be to bring societys leadership
on board in demonstrating commitment to safety.
Recent tragedies that have taken place on the world stage have served
to elevate workplace health and safety on the international social agenda. This is exemplified by comments in a 2013 Toronto Globe and Mail
article (26)following a factory collapse in Bangladesh: In 1997, in response to reports about horrendous working conditions in Vietnam, a
Nike spokeswoman was quoted saying What is Nikes responsibility?
These are not our factories.Over the course of that year, the public reaction became scathing enough to warrant a stronger reaction. Companies quickly realized that they would be held directly accountable even
for conditions at sub-contracted facilities.
In his drama All My Sons, playwright Arthur Miller created the character of a factory owner who manufactured substandard equipment and
realizes at the plays end that those who died as a result were all my
sons - that he was as responsible for their safety as he was for the safety of his own children. Similarly, people around the world are realizing
that those to whom we outsource production of our goods, who make
the clothes we wear and the food we eat, are all our sons, daughters,
siblings and workers. The dawning of this awareness will help build a
society, in the words of the Seoul Declaration (1), in which the right to
a safe and healthy working environment is respected at all levels, where
governments, employers and workers actively participate in securing
a safe and healthy working environment through a system of defined
rights, responsibilities and duties, and where the principle of prevention
is accorded the highest priority.
References
1.
2.
Fleming M. Safety culture maturity model [monograph online].UK Health and Safety Executive; 2000. [cited September 2013].
3.
Occupational safety and health culture assessment a review of main approaches and
selected tools [monograph online]. European Agency for Safety and Health at Work; 2011.
[cited September 2013].
4.
Road to Zero: a prevention strategy for workplace health and safety in Ontario [monograph online] Ontario Workplace Safety and Insurance Board; 2008. [cited September
2013]
5.
Elgood J, Gilby N, Pearson H, , Attitudes towards health and safety: a quantitative survey
of stakeholder opinion [monograph online].Mori Social Research Institute. UK Health and
Safety Executive; 2004. [cited September 2013]
41
6.
7.
Kahneman D. Thinking fast and slow. New York: Farrar Straus and Giroux; 2011
8.
9.
42
44
Detect minor mistakes and errors, and take them seriously (preoccupation with failure)
Resist sweeping simplification complex systems are not simple
(reluctance to simplify interpretations)
Closely monitor internal processes nothing can be taken for
granted (sensitivity to operations)
Promote willingness to be flexible, thus ensuring that system
functionality is quickly restored after error and the system emerges
stronger from crises (commitment to resilience)
Prioritize expertise over hierarchy: respect specialist knowledge
and ability (underspecified structuring).
46
49
at an organizational level:
Explicit commitment to the health and safety of all, e.g. active
adherence to Vision Zero;
A strategy of pro-active behaviour at organizational level, e.g. prevention as a principle applied throughout all phases of the value
chain (22);
Employee participation in decisions concerning health and safety
within the company, e.g. the endowment effect (23);
The frequency and density of communication between manager
and employee as well as amongst employees on the subject
of safety and health, e.g. how a manager looks after the mental
well-being of an employee (5);
50
at a societal level:
Impact of issues of public and work-related health on the
company, e.g. workplace health promotion, rehabilitation (13);
Health capabilities, e.g. basic capabilities such as the availability
of a doctor and clean water (24);
Number and size of companies and institutions certified as
family friendly;
Implementation of guidelines, here: ISSA guidelines on prevention, workplace health promotion and return-to-work activities;
Integration of health and safety into general and vocational education (nursery school, school, initial vocational training, higher
education, continuing vocational education and training), e.g.
the Good, healthy school initiative, the smoothing of the transition between school and working life or the integration into
higher education content;
Integration of health and safety into (public) media, e.g. articles
in daily newspapers, news reports, films;
51
References
1.
Seoul Declaration on Safety and Health at Work. Seoul: 2008 [Homepage on the Internet;
cited 2014 Feb 17]. Available from: www.seouldeclaration.org.
2.
3.
Schein E H. Organizational Culture and Leadership. 3rd ed. San Francisco: Jossey-Bass;
2004.
4.
International Safety Advisory Group (INSAG). Safety Culture. Safety Series No 75-INSAG-4.
Vienna: IAEA; 1986.
5.
Zohar D. Thirty years of safety climate research: Reflections and future directions. Accident
Analysis and Prevention. 2010; 42: 1517-1522.
6.
Ruhloff J. Health and safety: a neglected topic in the realm of education. ENETOSH Workshop OSH and education: Approaches to a successful cooperation. 5 November 2009,
A+A Duesseldorf, Germany [Homepage on the Internet; cited 2014 Feb 17]. Available from:
http://www.enetosh.net/webcom/show_article.php/_c-196/_nr-4/i.html.
7.
Health & Safety Laboratory (HSE). Measuring the safety climate in organisations. Reduce
injuries and costs through cultural change. Derbyshire: 2013.
8.
Zwetsloot G, Aaltonen M, Wybo J-L, Saari J, Kines P, Beeck, R Op De. The case for research
into the zero accident vision. Safety Science 2013; 58: 41-48.
9.
Zwetsloot G, Scheppingen A R van, Bos E H, Dijkman A. The Core Values that Support
Health, Safety, and Well-being at Work. Safety and Health at Work 2013; 4: 187-196.
10. Antonovsky A. Unravelling the mystery of health How people manage stress and stay
well. San Francisco: Josey-Bass; 1987.
11. Weick K E, Sutcliffe K M. Managing the Unexpected: Resilient Performance in an Age of Uncertainity. 2nd ed. San Francisco: Jossey-Bass; 2007.
12. Jehn A. Geschftsprozessmanagement im Broadcast Wissen Sie, was Sie tun? In: Kundenorientierung in der Broadcast-Industrie; 2008.
13. Zwetsloot G, Scheppingen, A R van, Dijkman A J, Heinrich J, Besten H den. The organizational benefits of investing in workplace health. International Journal of Workplace Health
Management. 2010; 3 (2); 143-159.
14. Weick K E. Sensemaking in Organizations. Foundations for Organizational Science. London:
Sage Publications; 1995.
15. Giebel D. Integrierte Sicherheitskommunikation. Zur Herausbildung von Unsicherheitsbewltigungskompetenzen durch und in Sicherheitskommunikation, Berlin: 2012
16. Rickert H. Vom Begriff der Philosophie. Logos 1910/11; 1.
17. Dame Black C. Working for a healthier tomorrow. Dame Carol Blacks Review of the health
of Britains working age population. Presented to the Secretary of State for Health and the
Secretary of State for Work and Pensions. London: 17th March 2008.
18. Marianetti O, Passmore J. Mindfulness at Work: Paying Attention to Enhance Well-Being
and Performance. Oxford Handbook of Positive Psychology and Work. 2010; 189-200.
19. Guldenmund F W. Understanding and Exploring Safety Culture. Oisterwijk: Box Press; 2010.
20. Bourdieu P. Entwurf einer Theorie der Praxis auf der ethnologischen Grundlage der kabylischen Gesellschaft. 3rd ed. Suhrkamp: Frankfurt; 2012.
52
21. Boden L. Experience rating: Take your medicine or find a new prescription? International
Symposium on the Challenges of Workplace Injury Prevention through Financial Incentives,
29 - 30 November 2012, Toronto, Canada [Homepage on the Internet; cited 2014 Feb 17].
Available from: www.iwh.on.ca/prevention-incentives-2012/proceedings/boden.
22. National Institute for Occupational Safety and Health (NIOSH). Prevention through Design.
Plan for the National Initiative. Cincinnati/Ohio: 2010.
23. Levitsky M. Influencing Safety Culture at the Society and Workplace Levels. Newsletter of
the ISSA Section for a Culture of Prevention. 2012; 1: 11-12.
24. Nussbaum M C. Creating Capabilities. The Human Development Approach. Cambridge,
Massachusetts, and London: 2011.
53
en.wikipedia.org/wiki/File:Lunch-atop-a-skyscraper-c1932.jpg).
They were admired for their courage and therefore heroic. Over the
years, the heroes have lost quite some of their glory because they were
careless enough to risk their lives over a sandwich. The picture beautifully portrays how times and values have changed, safety technology has
changed, culture has changed and prevention culture has changed, too.
Along with the technical progress, our knowledge, our skills, our behaviors and habits have also changed over the years. Today, we rarely
discuss safety hazards, because solutions are available. But we discuss
well-being at work instead. We try to identify the sources for our stressful lives and get stressed thinking about it. Psycho-social issues at the
workplace were not even considered a source of ill-health or a potential
source for accidents in 1932. And to top it all off, today, we may be faced
with new safety and health threats that we might not even know yet.
We explore new production methods of outsourcing or insourcing, new
forms of work organization, such as tele- and flexi-work, and new technologies, such as nano- or biotech. We have 24 hour work-connectivity
on our smart phones and welcome wifi and phone radiation, while trying
to eliminate old health hazards, such as smoking. Who knows, maybe
we are still sitting on that steel joist, without realizing it.
of shared values, attitudes and beliefs that shape health and safety practice (2). Also the original definition for a prevention culture as stated in
ILO Convention No 187 focused on the risks at the workplace; and the
role of the tripartite partners, but the Seoul Declaration (3) then extended the term prevention culture beyond the workplace, by stating that
workers health [was] the responsibility of society as a whole (4).
With the Seoul Declaration, the focus in prevention had been widened
from the traditional work safety approach to a broader prevention approach where health and safety is seen as an integral part of work and
lifestyle. The steady increase in mental health issues and musculo-skeletal diseases is an example, indicating that the borders between workers
health and public health are dissolving and the links between work life
and private life become more fluid.
What is Prevention?
Different professions have a different understanding of prevention. Preventive medicine, risk prevention, crime prevention, prevention of social
injustice, prevention in social security, etc. The list is endless. The word
prevention was probably used first in the context of medicine, but already in 1894, the Permanent International Committee on Social Insurance (CPIAS), which operated on a permanent basis in Europe between
1891 and 1914, had an item on the agenda at its Congress in Milan, Italy
on the prevention of occupational risks (5).
Over the years, different definitions of prevention have been proposed.
Commonly, these definitions stem from varying expectations with regard to the role that prevention should play in society. Prevention in the
world of work can have a considerable variety of meanings, depending
on what particular area one looks at: working conditions, industrial relations, occupational safety and health; or even employment (6). It also
links to pension and disability pension schemes, or - since the 2010 financial crisis- even to the financial risks that can be encountered at the
workplace. Prevention in the most general meaning of the word can be
understood as a measure to avoid an undesired event through early
intervention (4).
McKinnon, who reviewed various definitions of prevention in social security argues with Hjort that a modern concept of prevention includes
both prevention of diseases, accidents, risks and risk factors and promotion of health and well-being (7). His statement is supported by an Sinfield, who distinguishes at least three different levels of prevention (8):
Primary prevention limits the incidence of disease by controlling causes
and risk factors; secondary prevention aims to cure patients and reduce
the more serious consequences of disease through early diagnosis and
treatment; and tertiary prevention aims to prevent complications, reduce
disabilities and minimize pain. The ISSA has adapted Sinfields approach
by classifying it into three dimensions (and not levels) of prevention, as
all of them must be given the same priority; that is risk management,
health promotion/maintenance and return to work /rehabilitation.
55
These three dimensions clearly illustrate that at the center of all prevention related activities is the health of the individual and that for each
dimension, a proactive effort is required in order to protect, maintain or
restore the health of the worker.
57
References
1.
2.
Levitsky M. Influencing Safety Culture at the Society and Workplace Levels. ISSA Section for a Culture of Prevention Newsletter June 2012, page 11. http://www.issa.int/
documents/10192/378586/Newsletter+Vol+I+-+June+2012/4a822d49-4917-4b24-a53121f896b6fa96. [cited 2014 January 31]
3.
4.
5.
ISSA. In the service of social security: The history of the International Social Security Association 1927-1987. Geneva: International Social Security Association, 1986.
6.
7.
McKinnon R. Promoting the concept of prevention in social security: issues and challenges
for the International Social Security Association. International Journal of Social Welfare;
2009, page 2.
8.
Sinfield A. Preventing poverty in the European Union. European Journal of Social Security.
2007; 9(1): 11-28.
9.
10. HSC, ACSNI Study Group on Human Factors. 3rd Report: Organising for Safety. London:
Health and Safety Commission; 1993.
11. Uttal B. The corporate culture vultures. Fortune magazine. 1983 October 17
58
terms. To help them decide which publications were relevant, they initially screened each abstract before ordering the full publication. The
researchers next reviewed the publications of each research study. The
team looked at how the research was carried out and they also assessed
the quality of the research papers using the following star rating system:
*** Strong evidence, provided by consistent findings in multiple, high
quality scientific studies
** Moderate evidence, provided by generally consistent findings in fewer, smaller or lower quality scientific studies
* Limited or contradictory evidence, produced by one scientific study
or inconsistent findings in multiple scientific studies No scientific evidence
Finally, our researchers summarised the information collected, including
a description of the research, evidence statements and the quality of
evidence. The review looked at research that covered:
60
Peoples reactions get slower with age but this is offset by increased accuracy, accumulated knowledge and experience. Even
though certain cognitive processes ie perception, memory, reasoning and judgement can slow down, the impact on individuals
varies and workers can make up for this in other ways.
Regular intellectual stimulation and cognitive exercise, among
other things, are linked to the maintenance and improvement of
intellectual ability.
In one large study, the vast majority of participants over the age of
65 showed no sign of cognitive impairment.
There is limited research on mental wellbeing in older workers, but
social support and risk reduction strategies for stress and improving coping strategies are important issues.
Older workers want to maintain and update their skills and have
access to training, just as workers in general do.
Psychological and
psychosocial factors
Workplace organisational
factors
Sensory abilities
- Vision
- Hearing
61
There was limited evidence to show that working excessive overtime in physically demanding jobs has an adverse effect on older
workers.
Limited evidence also showed that work ability reduced sooner
in female healthcare workers carrying out shiftwork than in male
healthcare workers this could be due to the dual role women in
the survey had at home and at work.
Older male workers were less of an accident risk but females over
55 were found to have the highest estimated incident rate. This
could be because the occupations this group of female workers
were involved in were more physical.
The risk of non-fatal serious injury was lowest in the older worker
group but the injuries sustained eg sprains, strains, fractures
and dislocations were more severe and recovery took longer.
Employer engagement was vital in the recovery process. There is
an increased risk of developing chronic diseases with age, but this
doesnt necessarily mean that work shouldnt be allowed. Diseases
such as diabetes or heart disease can be controlled and workplace
adjustments can be.
Short-term non-certified absence is the largest recorded category
of sickness absence. Workers over 55 take more days off through
self-reported ill health relating to work. The health issues they
report include musculoskeletal problems and stress, anxiety or
depression.
Intervention studies
The second stage of the review evaluated studies on interventions in
safety, occupational health and health promotion. However, these types
of study were limited in both number and quality. The team established
that:
62
Dont forget
Like most studies, this one had some limitations, including the lack of
good research on which to base guidance. In particular, areas for further
research could include:
63
Whats next?
This project is the first in a research series commissioned by IOSH to
look at a diverse working population, focusing on age as a particular
subgroup. A second report in the series, from Brunel University, will investigate the experiences and views of workers over retirement age on
safety risks and practices.
* United Nations. The world at six billion. www.un.org/esa/population/
publications/sixbillion/sixbilpart1.pdf.
United Nations. Population ageing and development 2009. www.un.org/
esa/population/publications/ageing/ageing2009chart.pdf.
Zhan Y, Wang M, Liu S, Shultz K. Bridge employment and retirees
health: a longitudinal investigation. Journal of Occupational Health Psychology 2009; 14 (4): 374389; Waddell G, Burton AK. Is work good for
your health and well being? The Stationery Office, 2006.
64
The next aim is to get people in the field to use the gathered information, to develop their well-being together, and make this a permanent
mindset and part of their everyday life. How does the Program succeed
in this? First of all, the forestry field is of a suitable size not too large
and not too small. It is important that there is a well-known and respected instigator for the cause, i.e. the Metsmiesten Sti Foundation. In
addition, the Finnish Institute of Occupational Health has provided the
field with a great deal of objective know-how concerning well-being at
work. The Programme also provides networking possibilities. Forestry
66
workers were already involved in the Preproject; since then, they have
represented the needs and suggested project proposals. The steering
group is active and knowledgeable, and is willing to change things.
Moreover, the atmosphere during the Programme has been enthusiastic;
people are eager to learn, constructive and think of the common good.
Finally, all the result have been and will be shared with everyone, even
beyond the field itself.
(1) Strandstrm M. Timber Harvesting and Long-distance Transportation of Roundwood 2011 (Background Information and Long Term
Trends of Finnish Wood Supply). Metstehon tuloskalvosarja [serial on
the Internet]. 2012; 3b [cited 2014 Jan 30]. Available from: http://www.
metsateho.fi/files/metsateho/ Tuloskalvosarja/Tuloskalvosarja_2012_3b_
Timber_harvesting_and_long-distance_transportation_of_roundwood_
2011_ms.pdf
(2) Metsmiesten Sti Foundation. Taustatietoja Stist [Background Information on the Foundation] [homepage on the Internet].
[cited 2014 Jan 30]. Available from: http://www.mmsaatio.fi/www/fi/
taustatietoja_saatiosta/index.php
(3) Ala-Laurinaho A, editor. Metstalouden tyhyvinvoinnin T&K-ohjelma: Metsmiesten Stin hankevalmistelu. [Research and Development
Program for Improving Well-being at Work in Forestry: preliminary program plan of Metsmiesten Sti Foundation]. Metstehon raportti
219. Helsinki: Metsteho Oy; 2011.
(4) Pkknen R. Models for well-being at work. List of accepted oral
presentations. International Symposium on Culture of Prevention Future approaches 25-27 September 2013 [homepage of the internet].
[cited 2014 Jan 30]. Available from: http://www.ttl.fi/en/international/
conferences/culture_of_prevention/Documents/cupre_orals.pdf
67
A European Guide on
Economic Incentives for Prevention
Dietmar Elsler
European Agency for Safety and Health at Work, Bilbao, Spain
European countries could benefit from introducing more economic incentives to promote workplace health and safety, rewarding those organisations that work hardest to protect their employees. That is the
message of the economic incentive project, undertaken by the European
Agency for Safety and Health at Work (EU-OSHA). Some EU Member
States already offer various kinds of financial rewards for businesses that
invest in keeping their employees safe. These rewards range from state
subsidies and grants, through to tax breaks, preferential terms for bank
loans, and lower insurance premiums for the best-performing businesses. A practical guide based on the findings of the economic incentives
project has been developed by EU-OSHA and is intended to serve as a
practical and user-friendly tool to help incentive providers to create or
optimise their own economic incentive schemes.
Keywords: economic incentives, cost-benefit analysis, prevention
Introduction
Research has shown that external economic incentives can motivate further investments in prevention in all organisations and thus lead to lower
accident rates (1) (2).
The EU-OSHA project on economic incentives gives the clearest indication yet that these types of incentives are effective, encouraging organisations to improve their occupational health and safety. According to
Elsler (2), for every euro spent through incentive schemes, up to 4.81 is
saved at societal level through reduced accident and disease rates, and
lower rates of absenteeism as working conditions improve.
Besides this business case for the incentive-providing organisations,
there are further arguments to introduce an economic incentive scheme,
especially for private or state-run insurance companies:
practice in designing incentive schemes. All in all, the project shows that
economic incentives can be effective in nearly all countries, despite the
wide differences in their social security and accident insurance systems.
The project and its results have been presented at conferences and
workshops in numerous European countries, including Bulgaria, Cyprus,
the Czech Republic, Germany, Italy, Sweden, Slovenia and the UK. Some
practical consequences have already been observed. For example, the
Italian workers compensation authority INAIL has developed a new
incentive scheme which takes into account the experiences and good
practice of other countries and is therefore based on the best available international knowledge. In Italy INAIL is responsible for the workers compensation of 3.8 Mio enterprises and 17.8 Mio workers. With a
budget of over 850 million the INAIL scheme is targeting small and
medium-sized enterprises in particular. Experts estimate that it could
lead to benefits worth 2.55 billion at society level.
Types of incentives
The following economic incentives to promote occupational safety and
health can be found in European countries (3):
Many common incentive schemes in Europe are based on insurance
premium reductions. If the premium reductions are simply calculated
according to the risk of the company, taking into account past accident
insurance and disease rates, this so-called experience rating process is
very easy to apply. In addition a large number of companies can take
part in this incentive scheme, as it applies to all insured companies. Research about the effectiveness of experience rating found evidence (1)
that a lower rate of accidents is achieved. The effect of experience rating
is analysed in depth in the incentive scheme of the Finnish agriculture
sector. Using administrative data, Rautiainen et al. (4) conducted interrupted time series analyses which showed that the premium discount
reduced the overall claim rate by 10.2%, meaning the reduction of more
than 5000 accidents. However, the authors do not exclude the possibility that under-reporting could have contributed partly to the claim
reduction, although actually no farmer would benefit economically from
such a practice. The possible bonus in the insurance premium would
70
always be much lower than the cost of an accident which would not be
reimbursed if it was not reported. Under-reporting is often discussed
as a possible negative side effect of experience rating. As the Finnish
example shows, such a practice hardly ever leads to a positive economic
benefit for the under-reporting company, if the incentive scheme is designed in the right way.
Kohstall et al. (5) propose that both positive and negative incentives
should be used in an incentive system. Through negative incentives (or
disbenefits), companies that remain significantly above the sectors average accident rate can be obliged to pay an augmented insurance premium. This would increase the visibility of bad OSH performance and
therefore raise awareness in the enterprises concerned. The normal insurance premiums are usually planned into the budget of companies. A
positive variation is of course welcomed, but only a negative variation
will force companies to adapt their budget planning and therefore make
them think more deeply about taking preventive measures. Further negative deviation in insurance premiums can serve as a psychological foot
in the door for labour inspectors or safety representatives trying to persuade an enterprise to put more effort into OSH.
Overall, research literature provides convincing evidence for the positive
effects of experience rating, i.e. accident insurance premiums depending
on the individual accident record of a company, but nevertheless there
are some potential shortcomings connected with this method. Small and
medium-sized enterprises (SMEs) in particular rarely profit from such incentive schemes and therefore the insurance schemes of FBG (Germany)
and INAIL (Italy) combine an experience rating system with a funding
system that rewards specific prevention activities as well. The statistical
evaluations of both case studies have proven the effectiveness of such an
approach, leading to significantly lower accident rates and better health
outcomes among participating enterprises. For SMEs it is important to
create a direct link between OSH activities and a reward, such as an insurance premium reduction. Therefore, effort-based incentive schemes
are more effective for SMEs than pure experience rating approaches.
Possible adaptations of this type of incentive scheme could be a start,
with high premiums that are reduced annually if no accidents occur (as
in car insurance). Another idea could be to reward increased reporting in
order to receive more detailed information on accidents/diseases.
Example:
Incentive scheme of the German Butchery Sector Accident Insurance (3)
Premiums are reduced in participating companies for preventive measures, for example those concerning knife accidents, falls and slips, machines and traffic safety. The economic incentive can reach up to 5% reduction of the insurance rate. An OSH audit is also offered, which checks
the proper implementation of an OSH managemen system and in which
more than 40 companies participated in 2008. During the period evaluated (2001 to 2007) target fulfilment of the participating companies
improved continually. Starting at a similar accident rate in 2001 (92 per
71
Subsidy systems
tax incentives
non-financial incentives
72
References
1.
Tompa, E., Trevithick, S., McLeod, C. (2007), A systematic review of the prevention incentives of insurance and regulatory mechanisms for occupational health and safety, Scandinavian Journal of Work, Environment and Health, 33(2): 8595.
2.
Elsler, D., Treutlein, D., Rydlewska, I., Frusteri, L., Krger, H., Veerman, T., Eeckelaert, L.,
Roskams, N., Van Den Broek, K., Taylor, T.N. (2010), A review of case studies evaluating
economic incentives to promote occupational safety and health, Scandinavian Journal of
Work, Environment & Health, 36(4): 289298. Available from http://osha.europa.eu/en/topics/economic-incentives/review-case-studies-econ-incentives.pdf
3.
EU-OSHA European Agency for Safetz and Health at Work (2010), Economic incentives to
improve occupational safety and health: A review from the European perspective. European
Agency for Safety and Health at Work, Bilbao, Spain. Available from
http://osha.europa.eu/en/publications/reports/economic_incentives_TE3109255ENC/view
4.
Rautiainen, R.H., Ledolter, J., Sprince, N.L., Donham, K.J., Burmeister, L.F., Ohsfeldt, R.,
Reynolds, S.J., Phillips, K., Zwerling, C. (2005), Effects of premium discount on workers
compensation claims in agriculture in Finland, Am J Ind Med, 48(2): 100109.
5.
6.
Elsler, D., Eeckelaert, L. (2010), Factors influencing the transferability of occupational safety
and health economic incentive schemes between different countries, Scandinavian Journal
of Work, Environment & Health, 36(4): 325331. Available from http://osha.europa.eu/en/
topics/economic-incentives/transferability-econ-incentives.pdf
73
74
the basics in order, everyday work and attending to the duties run
smoothly;
development efforts at first carried out through separate projects,
then through a versatile and systematic approach;
excellent or world-class products, services, operational concepts
and workplace communities, and their continuous development.
The categories are defined more specifically at the end of the strategy
paper (1).
The strategys dream or vision is that in future all workplaces will have
achieved at least a good basic level. Successful workplaces will invest in
the quality of working life and have a well-functioning workplace community, and competitive and productive enterprises will generate new
employment.
In the autumn of 2012 the Working Life 2020 action plan (project) was
launched for implementation of the strategy. Its home base is in the
Ministry of Employment and the Economy but it is cooperating broadly
with the Ministry of Social Affairs and Health, the Ministry of Education
and Culture and the Ministry of Finance. The key actors also include
all social partners and some main expert organizations, nineteen actors
altogether.
During the year 2013 we were building the project organization and the
networks. In the years 2014 and 2015 we will be intensifying cooperation
between the key actors and starting several kinds of measures.
The goals of the Working life 2020 project are:
coordinating, steering and monitoring the working life actors
development operations;
strengthening the working life actors opportunities for reaching
ever more workplaces and for finding out their needs to move
from one development phase to another;
encouraging and inspiring the actors to develop working life quality and productivity at the same time;
creating and ensuring operational preconditions for the project.
The projects implementation has five paths. The main path consists of
the promises of cooperation made by the key actors and other organizations. In those promises the actors have given answers to the question
75
Which are such solutions for improving the working life in Finland that
workplaces need and where your organization, by this promise of cooperation, can have the greatest influence? Every actor has given 2 - 5 key
objectives which, when achieved by them, will contribute to reaching
the goals of the national working life development strategy. By defining
the key objectives the actors crystallize their operations in the project
in only a few issues that aim at improving the working life quality and
productivity. This brings out the critical functions/special areas that help
the workplace get from the present working life level to the target level.
The key objective may be targeted farther in the future than the annual
action plans made for achieving to it. It is also advisable, as far as possible, to place the target group workplaces on development levels in
accordance with the working life strategy (basic level, developers and
forerunners). The means of achieving the key objectives are thus only a
small part of each actors normal service and/or product selection and
strategy. When defining the means, it is also advisable to consider how
to best reach the target group workplaces.
The second implementation path consists of cooperation networks. The
most important of these are the regional networks. Within this project
we have built up fifteen networks. These networks are composed of the
regional authorities and the key actors regional organizations. Not less
important than the regional network is the Unions and sectoral network.
The aim of those two networks is to develop measures at the regional
and the Union level. The project also has a science and an international
network. Their goal is to find new methods and measures for improving
the quality of working life.
At the governmental programmer We have two governmental development programmes: Forum for Well-being at Work and Leadership
development network. The objective of the first one is to distribute information and good practices, to strengthen cooperation, to promote
access to services and their visibility, to promote development work at
workplaces and to disseminate information on well-being at work.
The objective of the Leadership development network is to identify,
compile and distribute good management practices, to create quality
standards for good management in the public sector, to improve age
management and to develop the quality of and equal access to management training.
Tekes the Finnish Funding Agency for Technology and Innovation
(Tekes) has its own project: Liideri programme for business operations,
productivity and joy at work. (2) The objective is to help companies renew their business operations by developing leadership, new forms of
working and employee competence.
By the Working life 2020 project we aim at finding a lot of new best
practices and good examples. To distribute these we have a knowledge
management system. It is supported by communication. Its main goals
are to create a dialogue and achieve understanding of the needs for
76
Conclucions
The project had its kick off in April 2013. We are still in the very beginning. It is too early to say anything about the results. The strategy paper
provides a solid foundation for us to succeed . It is also clear that we
now have broader cooperation in the field of working life development.
We have never before had so many key actors and other collaborators
working for shared goals.
Reference list:
1.
National Working Life Development Strategy to 2020, link to the strategy paper:
http://www.tem.fi/files/35434/Tyoelaman_kehittamisstrategia2020_A4_eng.pdf
2.
http://www.tekes.fi/en/programmes-and-services/tekes-programmes/liideri/
77
Abstract
Occupational Safety and Health (OSH) regulations prescribe the essential occupational safety requirements in Finland. The regulations are also
applied to students work in connection with vocational education. The
Finnish National Board of Education (FNBE) funds OSH development
projects in vocational education annually. Several vocational education
providers (VEPs) received funding for OSH development projects in
20092013. The Finnish Ministry of Social Affairs and Health (FMSAH) initiated cooperation between these subprojects by providing funding for
their coordination and networking. This paper introduces a networking
project that aims to promote OSH awareness, competence, and practices in vocational education. The subprojects results have been presented
and discussed in seminars and workshops.
Keywords: Vocational education, Vocational education provider, Occupational safety, OSH, On-the-job learning
Introduction
Vocational education provides students with the necessary knowledge
and skills to gain vocational expertise, and the capabilities to find employment or become self-employed (1). In Finland, vocational education
requires three years of full-time study, and it includes theoretical education and a supervised on-the-job learning period. During on-the-job
learning, students familiarise themselves with the practical requirements
of an occupation and achieve the core objectives of the occupation. (2)
Vocational education providers (VEPs) are responsible for organising education in their respective regions. There are over 80 VEPs in Finland,
involving thousands of students and several educational branches (2).
VEPs operate under occupational safety and health (OSH) regulations,
since the Finnish OSH Act (3) also applies to work done by students in
connection with their education. According to the Vocational Education
Act (1), students have the right to a safe learning environment, which
also applies to on-the-job learning.
However, the OSH requirements are quite demanding for vocational
78
Objectives
The aim of this study is to present the networking project as an example of how VEPs and teachers are informed and guided with respect to
the OSH requirements. The objectives of the networking project were to
coordinate the VEPs OSH development projects, to discuss and learn
from the good OSH practices developed and to promote their application within on-the-job learning, and to increase OSH awareness and
the competence of different parties responsible for on-the-job learning
(VEPs, teachers, students, and supervisors in work places).
Methods
To commence the networking project, the FMSAH granted funding for
coordination to Tampere University of Technology (TUT), and nominated
the author to work as an OSH specialist and coordinator of the project.
The networking project was directed in cooperation with the FNBE and
FMSAH. At the beginning of the project, the network of subprojects was
established, and the objectives of the network were set. During the project, OSH procedures were developed within the subprojects. The subprojects were presented and discussed in workshops, wiki pages (6), and
seminars. Feedback on the networking project was collected from the
participants.
Results
In 20092010, the networking project started with four VEPs and their
subprojects. As part of the network project, new VEPs were activated to
apply to the FNBE for annual funding for their projects. In 20122013,
as many as 10 large VEPs got funding and participated in the network.
During 20092013, nine workshops and two large outcome seminars
were arranged at different VEPs estates. In all, more than a hundred vocational education professionals participated in the workshops and seminars. In the subprojects of 20092010, the OSH guidelines were developed, especially related to social and health, construction, and heating,
plumbing, and air-conditioning sectors. Moreover, the risk assessment
procedures in a large vocational training organisation were developed.
In 20112013, the subproject dealt, for example, with the on-the-job
learning agreements, statutory reporting on the young students working with dangerous conditions, orientation, training of the on-the-job
79
Discussion
In Finland, the regulations state the essential OSH requirements for VEPs
with respect to students work in connection with education (1, 3). These
requirements are quite demanding for the VEPs and teachers supervising on-the-job learning, because they have almost all the fields of business under their operation. The VEPs and teachers need information and
guidance on OSH issues in order to ensure the occupational safety of
students. The networking project provided them assistance and support
from experts and each other in developing their OSH procedures.
The network participants did not have the sufficient resources or competence necessary to continue with the OSH issues all alone, and thus
they hoped that the networking project and cooperation between VEPs
would continue in the future. The long-term development of OSH issues
was seen as a very important aspect of vocational education, not merely
a topic for annual seminars and separate development projects.
In addition to the networking project, the FNBE actuated a compilation
project of 15 brand-specific OSH guidebooks for VEPs and teachers supervising and directing on-the-job learning in vocational education (4).
The OSH guidebooks project also actively promotes OSH awareness and
competence of the VEPs and teachers involved in vocational education.
The networking among the 10 VEPs started to work independently, and
currently, it does not need to be pushed further. However, new VEPs
should be persuaded to participate in the network and to further apply
funding for OSH development. Recruiting new VEPs into the network
would still improve the awareness of occupational safety issues in the
whole vocational education sector. In the future, the VEPs also need
more focused consultation related to their projects.
80
References
1.
Finlex Data Bank. Vocational Education Act 630/1998 [homepage on the Internet]. [cited
2014 Jan 13]. Available from: http://www.finlex.fi/fi/laki/ajantasa/1998/19980630. (in Finnish)
2.
Finnish National Board of Education. Performance indicator for initial vocational education
and training in Finland 2011 [homepage on the Internet]. [cited 2014 Jan 13]. Available
from: http://www.oph.fi/download/132466_Performance_Indicator_for_initial_vocational_education_and_training_in_Finland_2011.pdf.
3.
Finlex Data Bank. Occupational Safety and Health Act 738/2002 [homepage on the Internet]. [cited 2014 Jan 13]. Available from: http://www.finlex.fi/en/laki/kaannokset/2002/
en20020738.pdf. (Unofficial translation)
4.
5.
6.
Vaaka-networking project [wiki pages on the Internet]. [cited 2014 Jan 13]. Available from:
http://vaaka.wikispaces.com/. (in Finnish)
81
Introduction
Occupational safety culture has been mainly discussed and analysed at
the corporate level. The main approaches utilized are the psychological
and the engineering approaches (1). The first focuses on how workers
feel about and perceive the safety and health management system, and
on their attitudes towards and behaviour regarding safety. The latter is
more concerned with the managerial aspects, systems, and procedures
that may have an influence on safety. The same approaches can be used
when safety culture is analysed at the national level.
European legislation on occupational safety and health (2) sets certain
safety management requirements for all member countries. The main
mandatory management procedures are: 1) performing a systematic risk
assessment at the workplace including risk identification, worker participation, and adequate safety measures; 2) developing a prevention policy
3) informing workers about the risks and training them on work safely;
4) ensuring the right of the workers and their representative to take part
in any measures that may substantially affect safety and health at the
workplace in an equal manner; and 5) providing health surveillance for
workers. The occurrence of occupational accidents should be minimized,
when these safety management procedures are properly implemented
at the workplace.
EU-OSHAs European survey of enterprises on new and emerging risks
(ESENER) explores the views of managers and workers representatives
on how health and safety risks are managed at their workplace. The
Pan-European opinion poll on OSH investigated the opinions of the
general public on contemporary workplace issues in 2011-2012. In this
study, the national results of these surveys as well as the national statistics on occupational accidents published by the statistical office of the
European Union (Eurostat) are utilized.
The purpose is to determine whether the national implementation rate
of various safety management procedures correlate with the national
rate of occupational accidents. A high negative correlation may indicate
the procedure to be effective in safety work, while a high positive correlation may suggest the procedure to be relatively ineffective.
1
82
Heikki Laitinen is Senior Advisor at 3T Results Ltd and Adjunct Professor at Lappeenranta University of
Technology
Materials
Implemented in 2009, ESENER is a European telephone survey that explored the views of company managers and workers representatives on
how health and safety risks are managed at their workplace. The survey
includes 36,000 interviews that were carried out in 31 countries.
ESENER dataset is available free of charge on the Internet (3). The results
of 28 questions concerning OSH management activities were used in
this analysis.
The Pan-European opinion poll on OSH was EU-OSHAs survey on the
views of the general public on occupational health and safety. 35,540
interviews were carried out in 36 European countries in 2011-2012. Two
of the questions were used in this study.
European statistics on occupational accidents cover non-fatal accidents
at work resulting to over 3 days of absence from work as well as fatal accidents. There is wide variation in under-reporting of non-fatal accidents
in different countries, which reduces the reliability of the accident rates.
Thus, only the rates of fatal accidents were used in this study. The data
was available on the Internet (4), and the average accident rate of three
years (2005-2007) in each country was used in the analysis.
Results
Ten out of 30 questions showed a statistically significant negative correlation with the fatal accident rate, which means that these practices
are more common in countries with a low accident rate (Table 1). The
question concerning OSH issues in high level corporate management
meetings showed the highest correlation; they are regularly addressed
in meetings in countries with a low fatal accident rate. The involvement
of the line management in OSH was more common in safe countries
also, as was the use of ergonomics and psychological consultation services, and the existence of procedures to deal with OSH problems within
the company.
83
Table 1. OSH management questions with a significant negative correlation with the fatal accident
rate, n=28 countries.
Average %
StDev.
Correlation
with fatal
accident
rate
39,3
13,00
-0,592***
23,5
19,51
-0,487**
The workplace takes actions if individual employees work excessively long or irregular hours
37,4
15,02
-0,465**
57,5
20,25
-0,460**
28,4
19,05
-0,446**
68,9
13,43
-0,428*
26,4
15,56
-0,408*
19,8
8,90
-0,395*
37,2
16,05
-0,380*
19,6
15,52
-0,356*
Pearsons correlation
*** p<0.001
** p<0.01
* p<0.05
The dots in Fig. 1 show the fatal accident rate and the average percentage of companies with a positive answer to the ten most relevant questions (Table 1) in each of the 28 countries. In the Nordic countries (Sweden, Finland, Norway, and Denmark), United Kingdom, Ireland, and the
Netherlands at least 50% of companies on average have implemented
these OSH practices. These countries have a low fatal accident rate also.
Figure 1. The average implementation percentage of the ten most relevant OSH management activities and the rate of fatal occupational
accidents by country, N=28 countries.
84
Table 2. OSH management questions with a not significant or significant positive correlation with
the fatal accident rate, n=28 countries
Average
%
StDev.
Correlation
with fatal
accident
rate
People are very well informed about safety and health risks at
workplace (POLL)
25,8
11,01
-0,313
47,9
16,20
-0,213
34,2
14,72
-0,143
76,6
16,02
-0,124
27,7
8,81
-0,118
63,1
29,39
-0,111
24,1
8,38
-0,093
29,3
17,25
-0,051
40,4
10,58
0,037
58,1
23,24
0,062
54,6
12,56
0,112
The workplace uses a general health and safety consultancy (inhouse or external)
59,8
17,38
0,174
85,9
10,45
0,178
33,6
15,50
0,214
29,3
21,43
0,242
53,4
12,66
0,358*
67,2
29,95
0,395*
39,2
12,10
0,428*
55,7
12,86
0,435*
Pearsons correlation
*** p<0.001
** p<0.01 * p<0.05
85
Discussion
Many management practices that are obligatory in EU countries seem to
have no relation with their safety level. Typical examples include an OSH
policy, risk assessment, and medical examinations. They are relatively
commonly implemented in all countries but do not separate low fatal
accident rate countries from high accident rate countries.
Rather than to the obligatory procedures, the issues that separate the
low and high accident risk countries are linked to the participation and
motivation of the companys top and line management.
The explanation for the results may be that the motivation of the management to enforce OSH at the workplace has a major impact on the
effectiveness of all procedures including the obligatory ones. If the motivation is weak, the workers representatives have no real influence, and
risk assessments are carried out only as a matter of form. In countries
where the motivation of the managers is high, also the general public
is more confident in taking safety actions when problems arise. This is
further indication of a good safety culture.
Safety inspectors visit companies more actively in high accident rate
countries, which may have several explanations. These countries may
have directed more resources to combatting safety problems. Hopefully
the inspections will have the desired outcome and the safety situation
will improve in future.
References
86
1.
Antonsen, S., Safety culture: theory, method and improvement, Ashgate Pub Co, UK, 2009,
172 pp.
2.
The European Framework Directive on Safety and Health at Work (Directive 89/391 EEC)
3.
4.
http://epp.eurostat.ec.europa.eu/portal/page/portal/health/health_safety_work/data/
main_tables (cited 2013 Sept 10)
Abstract
CSR is based on the integration of economic, social, ethical and environmental concerns in business operations. Commitment to CSR by organisations may be demonstrated by the participation in publicly available
CSR frameworks or performance indicators. This paper explores a number of these frameworks. The specific health and safety indicators, which
vary for each framework, are outlined and the contribution these frameworks make to health and safety management is discussed.
Introduction
Corporate Social Responsibility (CSR) is an instrument of positive change
taking place in organizations. Fidderman (1) notes that it reflects an increasing interest in issues such as globalization and large-scale industrial change, environmental damage from economic activity and social
criteria affecting investment decisions of individuals and institutions.
CSR sets the framework and defines the method with which organizations must operate to be able to meet the ethical, legal, commercial and
public expectations that a society has of any enterprise. The European
Agency for Health and Safety at Work (2) defines CSR as: A concept
whereby companies integrate social and environmental concerns in their
business operations and in their interactions with their stakeholders on a
voluntary basis European Agency for Safety and Health at Work. The UK
Health and Safety Commission (3) suggest that CSR can be seen, as an
approach to good business, which takes into account the social impact
an organization has on the community both locally and globally. IEER (4)
notes that the principles of CSR and Sustainable Development overlap
in many areas. At a practical level both CSR and Sustainability involve an
organizations operational values, policies and practices, management
of environmental, social and softer issues and voluntary contributions to
community development.
There is a growing movement in larger organisations in particular, to
demonstrate their commitment to CSR and Sustainability. An indication
of this commitment may involve the participation in publicly available
CSR or Sustainability frameworks and performance indicators. A number
of these frameworks exist, each focusing on different aspects of reporting depending on the needs of the community they serve, Montero, (5).
This paper reviews a selection of these frameworks including the Glob87
Responsible Care
This is a voluntary global initiative of the International Council of Chemical Associations (ICCA) (8). The aim is to drive continuous improvement
in health, safety and environmental (HSE) performance across the chemical sector, and to encourage open and transparent communication with
stakeholders. The initiative operates in nearly 60 countries through Na88
Discussion
The health and safety indicators described in these frameworks fall into
two main categories; reactive indicators which include fatalities, lost time
injury rates and ill health data; and proactive indicators which demonstrate effective management and include certification of management
systems, evidence of strategic commitment, education and training and
consultation. There is some variation for example the focus of Dow Jones
Index may be reactive indicators, as the investment market may be specifically interested in headline data. Difficulties rise in making such data
meaningful across a range of countries with varying reporting systems.
89
90
References
1.
Fidderman. H CHaSPI: the Corporate Health and Safety Performance Index. Health and
Safety Bulletin 327 13-23 2004
2.
European Agency for Safety and Health at Work Corporate Social Responsibility and
Health and Safety at Work. Luxembourg: Office for Official Publications of the European
Communities 2004
3. HSC, Corporate responsibility and accountability for occupational health and safety. A
progress report on HSC/E initiatives and measures.2003
4.
Institute for Ecological Economy Research.Significance of the CSR debate for Sustainability
and the requirement for companies. IOEW, Berlin 2004
5.
Montero, M., Araque, R. and Rey, J. Occupational health and safety in the framework of
corporate social responsibility. Safety Science 47 1440-1445 2009
6.
Global reporting Initiative [homepage on the Internet] available from https://www.globalreporting.org accessed 21/2/2014
7.
Dow Jones Sustainability Indices. [homepage on the Internet] available from http://www.
sustainability-indices.com accessed 21/2/2014
8.
9.
ICCA, Responsible Care Progress Report: Growing Our Future, 2012, International Council
of Chemical Associations, Brussels, Belgium 2012
91
Background
The Finnish system where tax-funded municipal health services co-exist with private services and with occupational health services (OHS)
is unique. This multi-channel system may lead to inefficiencies and to
sub-optimization between organizers and providers and to high regional variation. Data on health spending conceal these variations.
Employers are required (under the Occupational Health Act) to arrange
at their own expense OHS for employees in order to prevent work-related health risks. They also have the possibility to arrange medical care on
a voluntary basis. Employers can purchase OHS from a municipal health
centre or other organizations offering OHS, such as private medical centres, or operate OHS themselves or in co-operation with others. By filing
a claim with the Social Insurance Institution (Kela), employers can have
part of their OHS expenses reimbursed. The reimbursement is equal to
60% of the costs of preventive services provided in the form of workplace assessments and check-ups, and 50% of the costs of necessary and
reasonable medical care offered as general practitioner-level treatment.
In Finland, regional comparisons of health care costs are possible. The
only exception to this are occupational health services, utilization data
for which are scattered across many different employer registers. As OHS
costs are not identified by region and employers have responsibility for
arranging the services (whereas municipalities mainly arrange tax-funded local health care), OHS is invariably left outside the scope of structural
and financial reforms in health care.
92
Results
Looking at the average costs of preventive OHS we see a fairly even distribution among the municipalities (Figure 1).
93
94
Health centres provide services at a cost that is 1/3 lower than that of
other providers. Small employers (> 20 employee.) spent 1/3 less on
health care than bigger employers.
Conclusions
Metropolitan and urban areas, where employers have the greatest ability
to pay for OHS, will benefit the most and may have no need to provide
the same level of outpatient primary care for residents as municipalities
where OHS presence is modest.
The results of this study can be used to evaluate the regional allocation
of resources and the significance of OHS in the primary health care.
Reference
Hujanen T, Mikkola H. Tyterveyshuollon palvelujen kustannusten alueelliset erot. [Regional
differences in the costs for occupational health services]. Helsinki: Kela, Nettitypapereita
42; 2013. Available from: http://hdl.handle.net/10138/38194
96
Background
Historically, workplace fires have been a significant cause of death, injury, disability and severe economic losses.
Location
Deaths
25 February 2010
Gazipur, Bangladesh
21
24 December 2010
Dhaka, Bangladesh
26
11 September 2012
Karachi, Pakistan
289
24 November 2012
Dhaka, Bangladesh
112
26 January 2013
Dhaka, Bangladesh
27 February 2013
Kolkata, India
19
8 May 2013
Dhaka, Bangladesh
3 June 2013
Mishazi, China
119
In the last few years, a number of fires with significant fatalities have
occurred in Asia. Table1 shows some of the more disastrous recent fires.
Although not a fire, another noteworthy accident is the factory collapse
in Dhaka, Bangladesh on 24 April 2013, which caused 1,126 deaths.
98
The impact of many of these accidents could have been minimised had
there been a promotion of prevention and safety culture. Unfortunately,
many resources are still going towards inspection and enforcement and
few towards prevention. In South Asia today, one of two scenarios are
frequently seen.
Aim
The aim of the ongoing project by the Fair Labor Association (FLA) is to
develop and implement a collaborative approach between management
and workers through a fire safety initiative to address basic fire safety.
The ultimate goal of the project is for factories to have a workplace fire
safety culture in place where all workers share a common set of knowledge, attitudes, perceptions and beliefs about workplace fire safety.
Definitions
Fire safety is defined in the project as both fire protection and fire prevention.
Fire prevention is ensuring that the elements that are required for combustionheat, fuel and oxygendo not come together. This is done by
eliminating one or more of the elements. For example, measures such
as restricting open flames, prohibiting smoking in the workplace, or
ensuring appropriate storage of flammable materials.
Fire protection translates into material, equipment, resources and procedures to evacuate personnel and extinguish or mitigate the effects of
the fire. For example, every workplace should have:
100
Fire protection also provides a means for dealing with emergencies including:
Methods
The FLA designed and is implementing a project that:
In this programme, guidelines, lesson plans and materials are standardised. There are robust training infrastructures and fixed evaluation
mechanisms which included pre-tests, post-tests, and assessments of
presentations and reports.
Results
The Workplace Fire Safety Facilitator Course
The five-day Workplace Fire Safety Facilitator course was finalized, accredited and implemented for the first time in November 2013 in Sri
Lanka for 17 participants representing four countries and four major
garment brands. The course consisted of an initial 3 days during which
the participants actively addressed:
[http://www.fairlabor.org/sites/default/files/foundationalcompetencies.pdf]
[http://www.fairlabor.org/sites/default/files/fla_fire_safety_self-assessment_may_2013.pdf]
[http://www.fairlabor.org/sites/default/files/workplace_fire_safety_facilitator_training_syllabus.pdf]
[http://www.fairlabor.org/sites/default/files/workplace_fire_safety_facilitator_train-the-trainer_syllabus.pdf
101
The candidate trainers were required to complete the same gap assignment as the Workplace Fire Safety Facilitators as well as to prepare to
present a course module during the sessions after the gap.
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The mean score of the pre-test of the Train-the-Trainer course was 59%,
which rose to a post-test mean score of 90%.
Upon completion of the Train-the-Trainer course, the trainers are required to complete the (UK) National Examination Board for Occupational Safety and Health International Fire Safety and Risk Management
Course as well as successfully instruct the Workplace Fire Safety Facilitator course under the observation and evaluation of a master trainer.
National master trainers have been trained in three countries, Bangladesh, India, and Sri Lanka. Four widely-known international garment
brands have trained two master trainers each. The cascading effect has
started regionally and will quickly reach factories and workplace in the
targeted countries and brands.
Evidence of the cascading effect is apparent. The first national course
where two candidate national master trainers are being evaluated and
additional brand trainers are being trained was be held in Bangladesh in
February and March 2014.
Conclusion
The programme is building capacity and prompting prevention based
on identified competencies. The gap exercise of the Workplace Fire Safety Facilitator course in Sri Lanka on its own promoted fire safety messages in 17 different enterprises, located in six countries, delivered in seven
different languages, impacting over 200 workers.
Acknowledgements
The authors would like to acknowledge the enthusiastic support from
the Fair Labor Association, the (UK) Institution of Occupational Safety
and Health, and the (US) National Fire Protection Association.
Works Cited
Fair Labor Association, n.d. Fire Safety Competency Assessment. [Online]
Available at: http://www.fairlabor.org/sites/default/files/fla_fire_safety_self-assessment_
may_2013.pdf
[Accessed February 2014].
Fair Labor Association, n.d. FLAs Fire Safety Initiative. [Online]
Available at: http://www.fairlabor.org/sites/default/files/foundationalcompetencies.pdf
[Accessed February 2014].
The Institution of Occupational Safety and Health, n.d. Workplace Fire Safety Facilitator Training
Programme. [Online]
Available at: http://www.fairlabor.org/sites/default/files/workplace_fire_safety_facilitator_training_syllabus.pdf
[Accessed February 2014].
The Institution of Occupational Safety and Health, n.d. Workplace Fire Safety Facilitator Trainthe-Trainer Course. [Online]
Available at: http://www.fairlabor.org/sites/default/files/workplace_fire_safety_facilitator_
train-the-trainer_syllabus.pdf
[Accessed February 2014].
103
Vision Zero
The New Global Strategy for Safe Mining
Helmut Ehnes, Secretary General
ISSA Mining Director Prevention BG RCI
And, most of all, it means human suffering, families losing their loved
ones and their suppliers!
Mining operations go along with a variety of hazards. Not only in large
operations, as they first come to mind, but also in the manifold small
scale mines, with an estimated 13 million labourers worldwide exposed
to substances such as dust, mercury and other chemicals, while also
dealing with poor ventilation, inadequate space and overexertion. But
is the number of severe accidents and diseases inevitable, or can we
change this situation?
gy, and we should learn from the way the best are doing. In doing so, we
will notice that a high potential lies in Vision Zero.
Firstly defined as early as in the 19th century by Eleuthre Irne du Pont,
its very successful elements were adopted by many European countries
first aiming at road safety, then extended to safety and health at work.
Du Pont established E. I. du Pont de Nemours and Company, a gunpowder mill in Delaware/U.S.A. in 1802. A number of severe accidents caused
by explosions, including three wagonloads of explosives detonating in
the city centre leaving several people dead and numerous buildings destroyed, showed du Pont the need for prevention. In 1811, he established safety rules and transferred responsibility to his managers, now
required to live on the site premises together with their families. The
decision to document and analyze all accidents and near-misses properly; the credo that every accident is avoidable; and the creation of an
error-forgiving work environment led to vast improvements in safety. To
this day, the DuPont group is a global leader in occupational safety and
health. The findings and groundbreaking success of DuPonts measures
are today a vital element of Vision Zero.
Vision Zero is a prevention strategy for a safe future without fatal or serious accidents. By focussing on severe and fatal accidents, its application
increases the level of safety and health overall.
This aim is neither unrealistic, nor over ambitioned. High-risk industries
such as chemical plants or airlines deal with significant risks, but show
that they are controllable. Large and economically successful mining
corporations prove that even operations in difficult environments, such
as large depths, can be run safely and without endangering the health of
miners. Vision Zero in mining can be achieved it requires knowledge of
the tried and tested tools and the motivation to act on all management
and operational levels.
The promising approach has been implemented in respects to road safety by several European countries, beginning with Sweden in 1990 with
remarkable success! Countries applying the Vision Zero strategy to improve safety in traffic achieve significant better results in the accidents
statistics measured against the number of inhabitants.
Ethics: Human life and health are paramount and take priority over
all other objectives
Responsibility: providers and regulators of the mining sector share
responsibility with users;
Safety: mining processes should take account of human fallibility
and minimize both the opportunities for errors and the harm done
when they occur; and
Mechanisms for change: providers and regulators must do their utmost to guarantee the safety of all stakeholder in mining, including
105
Rules:
Workplace:
People:
Only covering each field adequately brings the chance to work without
any accident or incident.
This set, labelled Seven Golden Rules for Safe and Economic Mining, has been filled with hands-on advice for each one of the seven
aspects, explaining the underlying principles, arguments for adaption, advice on operational implementation, models of good practice as found in the industry, and a list of checkpoints for managers.
CHECKPOINTS
2 3 4 5 6 7
107
Conclusion
No one should get severely hurt, let alone be killed in mining. To change
the current situation, there is no better way than to apply Vision Zero
for the mining industry, by utilizing well proven prevention tools and
methods systematically and throughout. The key to success is a set of
practical tools to support managers in implementation, suitable for both
large corporations and small-scale mines as given by the Seven Golden Rules.
Efficient prevention will increase productivity beyond the investment.
But first and foremost: Life and health can never be exchanged for any
other benefits within society!
108
109
Conclusions
The Learning Caf method proved to be a successful way to involve participants in collecting and exchanging ideas on various culture of prevention themes.
110
Contributors
Proceedings of the International Symposium on Culture of Prevention
Future Approaches
Aaltonen, Markku
Finnish Institute of Occupational Health
Topeliuksenkatu 41 a A
00250 Helsinki
Finland
markku.aaltonen@ttl.fi
Bollmann, Ulrike
Institute for Work and Health of the
German Social Accident Insurance
Koenigsbruecker Landstr. 2
D - 01109 Dresden
Germany
ulrike.bollmann@dguv.de
Ehnes, Helmut
ISSA Mining
Theodor-Heuss-Str. 160
30853 Langenhagen
Germany
helmut.ehnes@bgrci.de
Eichendorf, Walter
German Social Accident Insurance
(DGUV)
Alte Heerstr. 111
53757 Sankt Augustin
Germany
walter.eichendorf@dguv.de
Elsler, Dietmar
EU-OSHA
Gran Via 33
48009 Bilbao
Spain
elsler@osha.europa.eu
Gold, David
Gold-Knecht Associates
Chemin des Cerfs, 4
1272 Genolier
Switzerland
david.gold@gold-knecht.com
bklemmer@fairlabor.org
rlevy@fairlabor.org
Guerin, Rebecca J. MA
Project Officer
Safe-Skilled-Ready Workforce Initiative
National Institute for Occupational
Safety and Health (NIOSH)
Centers for Disease Control and
Prevention (CDC)
4676 Columbia Parkway MS # C-10
Cincinnati, OH 45226
RGuerin@cdc.gov
Hujanen, Timo
The Social Insurance Institution of
Finland
Nordenskildinkatu 12 /PO Box 450
00101 Helsinki
Finland
timo.hujanen@kela.fi
Juntunen, Eeva
KPMG Oy Ab
Tlnlahdenkatu 3 A
00100 Helsinki
Finland
www.kpmg.fi
Eeva.Juntunen@kpmg.fi
Laitinen, Heikki
3T Results Ltd
Ainontie 12 B
04230 Kerava
Finland
heikki.laitinen@3tratkaisut.fi
Lehtola, Marika
Finnish Institute of Occupational Health,
FIOH
P.O.Box 310
70101 Kuopio
Finland
marika.lehtola@ttl.fi
111
Levitsky, Marianne
Workplace Health Without Borders
6130 Tomken Road
L5T 1X7 Mississauga, ON
Canada
m.levitsky@whwb.org
Tappura, Sari
Tampere University of Technology
P.O. Box 541
FI-33101 Tampere
Finland
sari.tappura@tut.fi
Mikkola, Hennamari
The Social Insurance Institution of
Finland
Nordenskildinkatu 12 /PO Box 450
00101 Helsinki
Finland
hennamari.mikkola@kela.fi
Treichel, Bernd
International Social Security Association
Post Box 1
1211 Geneva
Switzerland
treichel@ilo.org
112
Tuominen-Thuesen, Minna
KPMG Oy Ab
Tlnlahdenkatu 3 A
00100 Helsinki
Finland
KPMG Oy Ab
minna.tuominen-thuesen@kpmg.fi
Walker, Deborah
Loughborough University
School of Business and Economics
LE11 3TU Loughborough
United Kingdom
d.walker@lboro.ac.uk
White, Jane
IOSH Institution of Occupational Safety
and Health
The Grange, Wigston
LE18 1NN Leicester
United Kingdom
jane.white@iosh.co.uk
Zwetsloot, Gerard
TNO Safe & Healthy Business
Postbus 718
2130 AS Hoofddorp
Netherlands
gerard.zwetsloot@tno.nl