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Environmental Education and Training: The State of Hazardous Materials Worker Education in the United States

Evaluating Health and Safety Training: A Case Study in Chemical Workers Hazardous Waste Worker Education

Until very recently the effectiveness of training and education in controlling occupational health and safety hazards was largely a matter of faith rather than systematic evaluation (Vojtecky and Berkanovic 1984-85; Wallerstein and Weinger 1992). With the rapid expansion of intensive federally-funded training and education programmes in the past decade in the United States, this has begun to change. Educators and researchers are applying more rigorous approaches to evaluating the actual impact of worker training and education on outcome variables such as accident, illness and injury rates and on intermediate variables such as the ability of workers to identify, handle and resolve hazards in their workplaces. The programme that combines chemical emergency training as well as hazardous waste training of the International Chemical Workers Union Center for Worker Health and Safety Education provides a useful example of a well-designed programme which has incorporated effective evaluation into its mission.

The Center was established in Cincinnati, Ohio, in 1988 under a grant which the International Chemical Workers Union (ICWU) received from the National Institute for Environmental Health Sciences to provide training for hazardous waste and emergency response workers. The Center is a cooperative venture of six industrial unions, a local occupational health centre and a university environmental health department. It adopted an empowerment education approach to training and defines its mission broadly as:

… promoting worker abilities to solve problems and to develop union-based strategies for improving health and safety conditions at the worksite (McQuiston et al. 1994).

To evaluate the programme’s effectiveness in this mission the Center conducted long-term follow-up studies with the workers who went through the programme. This comprehensive evaluation went considerably beyond the typical assessment which is conducted immediately following training, and measures trainees’ short-term retention of information and satisfaction with (or reaction to) the education.

Programme and Audience

The course that was the subject of evaluation is a four or five-day chemical emergency/hazardous waste training programme. Those attending the courses are members of six industrial unions and a smaller number of management personnel from some of the plants represented by the unions. Workers who are exposed to substantial releases of hazardous substances or who work with hazardous waste less proximately are eligible to attend. Each class is limited to 24 students so as to promote discussion. The Center encourages local unions to send three or four workers from each site to the course, believing that a core group of workers is more likely than an individual to work effectively to reduce hazards when they return to the workplace.

The programme has established interrelated long-term and short-term goals:

Long-term goal : for workers to become and remain active participants in determining and improving the health and safety conditions under which they work.

Immediate educational goal : to provide students with relevant tools, problem-solving skills, and the confidence needed to use those tools (McQuiston et al. 1994).

In keeping with these goals, instead of focusing on information recall, the programme takes a “process oriented” training approach which seeks “to build self-reliance that stresses knowing when additional information is needed, where to find it, and how to interpret and use it.” (McQuiston et al. 1994.)

The curriculum includes both classroom and hands-on training. Instructional methods emphasize small group problem-solving activities with the active participation of the workers in the training. The development of the course also employed a participatory process involving rank-and-file safety and health leaders, programme staff and consultants. This group evaluated initial pilot courses and recommended revisions of the curriculum, materials and methods based on extensive discussions with trainees. This formative evaluation is an important step in the evaluation process that takes place during programme development, not at the end of the programme.

The course introduces the participants to a range of reference documents on hazardous materials. Students also develop a “risk chart” for their own facility during the course, which they use to evaluate their plant’s hazards and safety and health programmes. These charts form the basis for action plans which create a bridge between what the students learn at the course and what they decide needs to be implemented back in the workplace.

Evaluation Methodology

The Center conducts anonymous pre-training and post-training knowledge tests of participants to document increased levels of knowledge. However, to determine the long-term effectiveness of the programme the Center uses telephone follow-up interviews of students 12 months after training. One attendee from each local union is interviewed while every manager attendee is interviewed. The survey measures outcomes in five major areas:

• students’ ongoing use of resource and reference materials introduced during training
• the amount of secondary training, that is, training conducted by participants for co-workers back at the worksite following attendance at the Center course
• trainee attempts and successes in obtaining changes in worksite emergency response or hazardous waste programmes, procedures or equipment
• post-training improvements in the way spills are handled at the worksite
• students' perceptions of training programme effectiveness. 

The most recent published results of this evaluation are based on 481 union respondents, each representing a distinct worksite, and 50 management respondents. The response rates to the interviews were 91.9% for union respondents and 61.7% for management.

Results and Implications

Use of resource materials

Of the six major resource materials introduced in the course, all except the risk chart were used by at least 60% of the union and management trainees. The NIOSH Pocket Guide to Chemical Hazards and the Center’s training manual were the most widely used.

Training of co-workers

Almost 80% of the union trainees and 72% of management provided training to co-workers back at the worksite. The average number of co-workers taught (70) and the average length of training (9.7 hours) were substantial. Of special significance was that more than half of the union trainees taught managers at their worksites. Secondary training covered a wide range of topics, including chemical identification, selection and use of personal protective equipment, health effects, emergency response and use of reference materials.

Obtaining worksite improvements

The interviews asked a series of questions related to attempts to improve company programmes, practices and equipment in 11 different areas, including the following seven especially important ones:

• health effects training
• availability of material safety data sheets
• chemical labelling
• respirator availability, testing and training
• gloves and protective clothing
• emergency response
• decontamination procedures.

The questions determined whether respondents felt changes were needed and, if so, whether improvements had been made.

In general, union respondents felt greater need for and attempted more improvements than management, although the degree of difference varied with specific areas. Still fairly high percentages of both unions and management reported attempted improvements in most areas. Success rates over the eleven areas ranged from 44 to 90% for unionists and from 76 to 100% for managers.

Spill response

Questions concerning spills and releases were intended to ascertain whether attendance at the course had changed the way spills were handled. Workers and managers reported a total of 342 serious spills in the year following their training. Around 60% of those reporting spills indicated that the spills were handled differently because of the training. More detailed questions were subsequently added to the survey to collect additional qualitative and quantitative data. The evaluation study provides workers’ comments on specific spills and the role the training played in responding to them. Two examples are quoted below:

Following training the proper equipment was issued. Everything was done by the books. We have come a long way since we formed a team. The training was worthwhile. We don’t have to worry about the company, now we can judge for ourselves what we need.

The training helped by informing the safety committee about the chain of command. We are better prepared and coordination through all departments has improved.

Preparedness

The great majority of union and management respondents felt that they are “much better” or “somewhat better” prepared to handle hazardous chemicals and emergencies as a result of the training.

This case illustrates many of the fundamentals of training and education programme design and evaluation. The goals and objectives of the educational programme are explicitly stated. Social action objectives regarding workers’ ability to think and act for themselves and advocate for systemic changes are prominent along with the more immediate knowledge and behaviour objectives. The training methods are chosen with these objectives in mind. The evaluation methods measure the achievement of these objectives by discovering how the trainees applied the material from the course in their own work environments over the long term. They measure training impact on specific outcomes such as spill response and on intermediate variables such as the extent to which training is passed on to other workers and how course participants use resource materials.

The term environmental education covers a potentially wide range of issues and activities when applied to employees, managers and workplaces. These encompass:

• education for general awareness of environmental concerns
• education and training toward modifying work practices, processes and materials to reduce the environmental impact of industrial processes on local communities
• professional education for engineers and others seeking expertise and careers in environmental fields
• education and training of workers in the growing field of environmental abatement, including hazardous waste cleanup, emergency response to spills, releases and other accidents, and asbestos and lead paint remediation.

This article focuses on the state of worker training and education in the United States in the growing environmental remediation field. It is not an exhaustive treatment of environmental education, but rather an illustration of the link between occupational safety and health and the environment and of the changing nature of work in which technical and scientific knowledge has become increasingly important in such traditional “manual” trades as construction. “Training” refers in this context to shorter-term programmes organized and taught by both academic and non-academic institutions. “Education” refers to programmes of formal study at accredited two-year and four-year institutions. Currently a clear career path does not exist for individuals with interest in this field. The development of more defined career paths is one goal of the National Environmental Education and Training Center, Inc. (NEETC) at Indiana University of Pennsylvania. Meanwhile, a wide range of education and training programmes exist at different levels, offered by a variety of academic and non-academic institutions. A survey of the institutions involved in this type of training and education formed the source material for the original report from which this article was adapted (Madelien and Paulson 1995).

Training Programmes

A 1990 study conducted by Wayne State University (Powitz et al. 1990) identified 675 separate and distinct noncredit short courses for hazardous waste worker training at colleges and universities, offering over 2,000 courses nationwide each year. However, this study did not cover some of the primary providers of training, namely community college programmes, US Occupational Safety and Health Administration training programmes and independent firms or contractors. Thus, the Wayne State number could probably be doubled or tripled to estimate the number of noncredit, noncertification course offerings available in the United States today.

The major government-funded training programme in environmental remediation is that of the National Institute for Environmental Health Sciences (NIEHS). This program, established under the Superfund legislation in 1987, provides grants to non-profit organizations with access to appropriate worker populations. Recipients include labour unions; university programmes in labour education/labour studies and public health, health sciences and engineering; community colleges; and non-profit-making safety and health coalitions, known as COSH groups (Committees on Occupational Safety and Health). Many of these organizations operate in regional consortia. The target audiences include:

• construction trades workers involved in cleanup of hazardous waste sites
• emergency response personnel working for fire and emergency services agencies and industrial plants
• transportation workers involved in transporting hazardous materials
• hazardous waste treatment, storage and disposal facility workers
• wastewater treatment workers.

The NIEHS program has resulted in extensive curriculum and materials development and innovation, which has been characterized by considerable sharing and synergy among grantees. The programme funds a national clearinghouse which maintains a library and curriculum centre and publishes a monthly newsletter.

Other government funded programmes offer short courses targeting hazardous waste industry professionals as opposed to front-line remedial workers. Many of these programmes are housed in university Educational Resource Centers funded by the National Institute for Occupational Safety and Health (NIOSH).

Education Programmes

Community colleges

The broadest change on the hazardous waste education and training landscape in the past few years is the dramatic development of community college programmes and consortia to improve vocational education at the associate’s degree level. Since the 1980s, community colleges have been doing the most organized and extensive curriculum development work in secondary education.

The Department of Energy (DOE) has funded programmes nationwide to provide for a trained workforce at sites where the need has changed from nuclear technicians to hazardous waste clean-up workers. This training is taking place most rigorously at community colleges, many of which have historically provided for personnel needs at specific DOE sites. DOE-funded programmes at community colleges have also given rise to major efforts in curriculum development and consortia for sharing information. Their goals are to establish more consistent and higher standards of training and to provide mobility for the workforce, enabling an individual trained to work at a site in one part of the country to move to another site with minimal retraining requirements.

Several consortia of community colleges are advancing curricula in this area. The Partnership for Environmental Technology Education (PETE) operates in six regions. PETE is working with the University of Northern Iowa to create a world-class network of community college environmental programmes, linked with high schools, that inform and prepare students for entry into these two-year degree programmes. The goals include the development of (1) nationally validated curriculum models, (2) comprehensive professional development programmes and (3) a national clearinghouse for environmental education.

The Hazardous Materials Training and Research Institute (HMTRI) serves the curriculum development, professional development, print and electronic communications needs of 350 colleges with two-year environmental technologies credit programmes. The Institute develops and distributes curricula and materials and implements educational programmes at its own Environmental Training Center at Kirkwood Community College in Iowa, which has extensive classroom, laboratory and simulated field site facilities.

The Center for Occupational Research and Development (CORD) provides national leadership in the US Department of Education’s Tech Prep/Associate Degree initiative. The Tech Prep program requires coordination between secondary and post-secondary institutions to give students a solid foundation for a career pathway and the world of work. This activity has led to the development of several contextual, experiential student texts in basic science and mathematics, which are designed for students to learn new concepts in relationship to existing knowledge and experience.

CORD has also played a significant role in the Clinton administration’s national educational initiative, “Goals 2000: Educate America”. In recognition of the need for qualified entry-level personnel, the initiative provides for the development of occupational skills standards. (“Skills standards” define the knowledge, skills, attitudes and level of ability necessary to successfully function in specific occupations.) Among the 22 skills standards development projects funded under the programme is one for hazardous materials management technology technicians.

Articulation between vocational and baccalaureate programmes

A continuing problem has been the poor linkage between two-year and four-year institutions, which hampers students who wish to enter engineering programmes after completing associate’s (two-year) degrees in hazardous/radioactive waste management. However, a number of community college consortia have begun to address this problem.

The Environmental Technology (ET) consortium is a California community college network that has completed articulation agreements with four four-year colleges. The establishment of a new job classification, “environmental technician”, by the California Environmental Protection Agency provides added incentive for graduates of the ET program to continue their education. An ET certificate represents the entry level requirement for the environmental technician position. Completion of an associate’s degree makes the employee eligible for promotion to the next job level. Further education and work experience allows the worker to progress up the career ladder.

The Waste-management Education and Research Consortium (WERC), a consortium of New Mexico schools, is perhaps the most advanced model which attempts to bridge gaps between vocational and traditional four-year education. Consortium members are the University of New Mexico, the New Mexico Institute of Mining and Technology, New Mexico State University, Navajo Community College, Sandia Laboratory and Los Alamos Laboratories. The approach to curriculum transfer has been an interactive television (ITV) program in distance learning, which takes advantage of the varied strengths of the institutions.

Students enrolled in the environmental programme are required to take 6 hours of courses from the other institutions through distance learning or an offsite semester of coursework. The programme is decidedly inter-disciplinary, combining a minor in hazardous materials/waste management with a major from another department (political science, economics, pre-law, engineering or any of the sciences). The programme is “both broad and narrow” in focus, in that it recognizes a need to develop students with both a broad knowledge base in their field and some specific training in hazardous materials and hazardous waste management. This unique programme couples student participation in realistic applied research and industry-led curriculum development. The courses for the minor are very specific and take advantage of the particularized specialties at each school, but each program, including the associate degree, has a large core requirement in humanities and social sciences.

Another unique feature is the fact that the four-year schools offer two-year associate’s degrees in radioactive and hazardous materials technology. The two-year associate’s degree in environmental science offered at the Navajo Community College includes courses in Navajo history and substantial courses in communications and business, as well as technical courses. A hands-on laboratory has also been developed on the Navajo Community College campus, an unusual feature for a community college and part of the consortium’s commitment to hands-on laboratory learning and technology development/applied research. The WERC member institutions also offer a “non-degree” certificate programme in waste management studies, which seems to be above and beyond the 24-hour and 40-hour courses offered at other colleges. It is for individuals who already have a bachelor’s or graduate degree and who further wish to take advantage of seminars and specialty courses at the universities.

Conclusions

Several significant changes have taken place in the focus of education and training related to the hazardous waste industry in the past few years, in addition to the proliferation of short-course training programmes and traditional engineering programmes. Overall, the Department of Energy seems to have focused education at the community college level on workforce retraining, primarily through the Partnership for Environmental Technology Education (PETE), the Waste-management Education and Research Consortium (WERC) and other consortia like them.

There is a major gap between vocational training and traditional education in the environmental field. Because of this gap, there is not a clear, routine career path for hazardous waste workers, and it is difficult for these workers to advance in industry or government without classic technical degrees. Although inter-departmental options for education at a management level are being established within economics, law and medicine departments which recognize the breadth of the environmental industry, these are still academic-based professional degrees which miss a large part of the available and experienced workforce.

As the environmental clean-up industry matures, the long-term needs of the workforce for more balanced training and education and a well-developed career path become more clear. The large numbers of displaced workers from closed military sites means more people are entering the environmental workforce from other fields, making the demand on union training and placement of displaced workers (both discharged military personnel and displaced civilian personnel) even greater than before. Educational programmes are needed which meet both the needs of personnel entering the industry and of industry itself for a more balanced and better-educated workforce.

Since labour union members are one of the main groups poised to enter the hazardous waste clean-up and environmental remediation field, it would seem that labour studies and industrial relations departments might be logical entities to develop degree programmes that incorporate a hazardous waste/environmental curriculum with development of labour/management skills.

Worker Education and Environmental Improvement

The articles in this chapter have thus far concentrated on training and education regarding workplace hazards. Environmental education serves multiple purposes and is a useful complement to occupational safety and health training. Worker education is a critical and often overlooked aspect of a broad and effective environmental protection strategy. Environmental issues are frequently viewed as purely technological or scientific matters that stand outside the purview of workers. Yet worker knowledge is critical to any effective environmental solutions. Workers are concerned as citizens and as employees about environmental matters because the environment shapes their lives and affects their communities and families. Even when technological solutions are required that use new hardware, software or process approaches, worker commitment and competence are necessary for their effective implementation. This is true for workers whether involved directly in environmental industries and occupations or in other kinds of jobs and industrial sectors.

Worker education can also provide a conceptual foundation to enhance workers’ participation in environmental improvement, health and safety protection, and organizational improvement. The UNEP Industry and Environment Programme notes that “many companies have found that worker involvement in environmental improvement can yield important benefits” (UNEP 1993). The Cornell Work and Environment Initiative (WEI) in a study of US enterprises found that intense worker participation yielded triple the source reduction of technical or external solutions alone and boosted yields of some technological approaches even higher (Bunge et al. 1995).

Worker environmental education comes in a variety of forms. These include trade union awareness and education, occupational training and orientation, connecting environment to workplace health and safety concerns and broad awareness as citizens. Such education occurs in a range of venues including worksites, trade union halls, classrooms and study circles, using both traditional and newer computer-based delivery systems. It is fair to say that workers’ environmental education is an underdeveloped field, especially in comparison with managerial and technical training and school-based environmental education. At the international level, education of front-line workers is often mentioned in passing and is overlooked when it comes to implementation. The European Foundation for the Improvement of Living and Working Conditions has commissioned a series of studies on the educational dimension of environmental protection, and in its next programme of work will directly look at the shop-floor workers and their environmental educational needs.

What follows are several examples gathered through the WEI at Cornell University that illustrate both practice and possibility in worker environmental education.The WEI is a network of managers, trade unionists, environmentalists and government policy officials from 48 countries in all parts of the world, committed to finding ways that workers and the workplace can contribute to environmental solutions. It addresses a wide range of industries from primary extraction to production, service and public-sector enterprises. It provides a means for education and action on environmental matters that seeks to build knowledge at the workplace and in academic institutions that can lead to cleaner and more productive workplaces and better connection between internal and external environments.

Australia: Eco-Skills Modules

The Australian Council of Trade Unions (ACTU) has developed new approaches to workers’ education for the environment that provides both broad social awareness and specific competencies for employment, especially among young workers.

The ACTU has organized an Environment Training Company with a broad mandate to address a variety of sectors but with an initial focus on land management issues. This focus includes teaching ways to handle reclamation work safely and effectively but also ways to assure compatibility with indigenous peoples and natural environments. With input from trade unionists, environmentalists and employers, the training company developed a set of “Eco-Skills” modules to establish basic environmental literacy among workers from an array of industries. These are integrated with a set of skill competencies that are technical, social and safety oriented.

Eco-Skills modules 1 and 2 contain a broad base of environmental information. They are taught alongside other entry-level training programmes. Levels 3 and higher are taught to people who specialize in work focused on reduction of environmental impacts. The first two Eco-Skills modules are composed of two forty-hour sessions. Trainees attain skills through lectures, group problem-solving sessions and practical hands-on techniques. Workers are assessed through written and oral presentations, group work and role plays.

Concepts covered in the sessions include an introduction to the principles of ecologically sustainable development, efficient resource use and cleaner production and environmental management systems. Once Module 1 is completed workers should be able to:

• identify the implications of a given lifestyle for long-term sustainability with specific emphasis placed on the learner’s present and future lifestyle
• identify ways to reduce the environmental impact of human activities
• describe strategies to reduce environmental impacts in a given industry (agriculture, forestry, manufacturing, tourism, leisure, mining)
• describe the main features of an Environmental Management System
• identify the role of stakeholders in reducing environmental pollution and resource depletion.

Module 2 expands upon these initial objectives and prepares workers to begin applying pollution prevention and resource conservation methods.

Some industries are interested in connecting environmental impact skills and knowledge to their industry standards at every level. Awareness of environmental issues would be reflected in the day-to-day work of all industry workers at all skill levels. An incentive for workers lies in the fact that pay rates are linked to industry standards. The Australian experiment is in its infancy, but it is a clear attempt to work with all parties to develop competency-based activities that lead to increased and safer employment while enhancing environmental performance and awareness.

Linking Occupational Health and Safety and Environmental Training

One of the most active unions in the United States in environmental training is the Laborers International Union of North American (LIUNA). US government regulations require that hazardous-waste abatement workers receive 40 hours of training. The union along with participating contractors have developed an intensive 80-hour course designed to provide potential hazardous-waste workers with greater awareness of safety and the industry. In 1995, over 15,000 workers were trained in lead, asbestos and other hazardous-waste abatement and other environmental remediation work. The Laborers–Associated General Contractors programme has developed 14 environmental remediation courses and associated train-the-trainer programmes to assist nationwide efforts at safe and quality remediation. These are conducted at 32 training sites and four mobile units.

In addition to providing safety and technical training, the programme encourages participants to think about larger environmental issues. As part of their classwork, trainees gather materials from local papers on environmental issues and use this local connection as an opening to discuss broader environmental challenges. This joint environmental training fund employs a full-time equivalent staff of 19 at its central office and spends over US$10 million. The materials and training methods meet high quality standards with extensive use of audio-visual and other training aids, specific competency focus, and quality commitment and assessment built in throughout the curricula. A “learn-at-home” video is used to help meet literacy concerns and environmental and basic literacy training are connected. For those who desire it, six of the courses are transferable into college credit. The programme is active in serving minority communities, and over half of the participants come from minority population groups. Additional programmes are developed in partnership with minority consortiums, public housing projects and other training providers.

The union understands that a great deal of its future membership will come in environmentally related businesses and sees the development of worker education programmes as building the foundation for that growth. While both safety and productivity are better on jobs using trained workers, the union also sees the broader impact:

The most interesting impact environmental training has had on members is their increased respect for chemicals and harmful substances in the workplace and at home. … Awareness is also increasing with respect to the consequences of continued pollution and the cost involved with cleaning up the environment. … The true impact is much greater than just preparing people for work (LIUNA 1995).

In the United States, such hazardous-materials training is also conducted by the Operating Engineers; Painters; Carpenters; Oil, Chemical and Atomic Workers; Chemical Workers Union; Machinists; Teamsters; Ironworkers and Steelworkers.

LIUNA is also working internationally with the Mexican Confederation of Workers (CTM), federal and private training groups and employers to develop training methodologies. The focus is on training Mexican workers in environmental remediation work and construction skills. The Inter-American Partnership for Environmental Education and Training (IPEET) held its first training course for Mexican workers during the summer of 1994 in Mexico City. A number of labour leaders and workers from local industries, including paint manufacturing and metal plating, attended the one-week course on environmental safety and health. Other LIUNA partnerships are being developed in Canada with French editions of the materials and “Canadianization” of the content. The European Institute for Environmental Education and Training is also a partner for similar training in Eastern European and CIS countries.

Zambia: Educational Manual on Occupational Health and Safety

In Zambia, too often occupational health and safety is taken seriously only when there is an incident involving injury or damage to company property. Environmental issues are also ignored by industry. The Manual on Occupational Health and Safety was written in an effort to educate employees and employers on the importance of occupational health and safety issues.

The first chapter of this manual outlines the importance of education at all levels in a company. Supervisors are expected to understand their role in creating safe, healthy working conditions. Workers are taught how maintaining a positive, cooperative attitude relates to their own safety and work environment.

The manual specifically addresses environmental issues, noting that all major towns in Zambia face

threats of increasing environmental damage. In specific, the Zambia Congress of Trade Unions (ZCTU) identified environmental hazards in the mining industry through strip mining and air and water pollution that results from poor practices. Many factories are responsible for air and water pollution because they discharge their waste directly into nearby streams and rivers and allow smoke and fumes to escape unchecked into the atmosphere (ZCTU 1994).

Though many African trade unions are interested in further education on the environment, lack of adequate funding for worker education and the need for materials that link environmental, community and workplace hazards are major barriers.

Employer-Based Worker Environmental Education and Training

Employers, especially larger ones, have extensive environmental education activities. In many cases, these are mandated training linked to occupational or environmental safety requirements. However, an increasing number of companies recognize the power of broad worker education that goes well beyond compliance training. The Royal Dutch/Shell Group of companies have made health, safety and environment (HSE) part of their overall approach to training, and environment is an integral part of all management decisions (Bright and van Lamsweerde 1995). This is a global practice and mandate. One of the company’s goals is to define HSE competencies for appropriate jobs. Worker competence is developed through improved awareness, knowledge and skill. Appropriate training will increase worker awareness and knowledge, and skills will develop as new knowledge is applied. A wide range of delivery techniques helps share and reinforce the environmental message and learning.

At Duquesne Light in the United States, all 3,900 employees were successfully trained “on how the company and its employees actually affect the environment.” William DeLeo, Vice-President of Environmental Affairs said:

To develop a training programme that enabled us to meet out strategic objectives we determined that our employees needed a general awareness of the importance of environmental protection as well as specific technical training relative to their job responsibilities. These two points became the guiding strategy for our environmental education program (Cavanaugh 1994).

Worker and Union-Based Environmental Education Programmes

The Workers’ Education Branch of the ILO has developed a six-booklet set of background materials to spark discussion among trade unionists and others. The booklets address workers and the environment, the workplace and the environment, the community and the environment, world environmental issues, the new bargaining agenda, and provide a guide to resources and a glossary of terms. They provide a broad, insightful and easy-to-read approach that can be used in both developing and industrial countries to discuss topics relevant to workers. The materials are based on specific projects in Asia, the Caribbean and Southern Africa, and can be used as a whole text or can be separated in a study circle format to promote general dialogue.

The ILO in a review of training needs pointed out:

Trade unionists must increase their awareness about environmental concerns in general and the impact their employing firms are having on the environment, including the safety and health of their workers, in particular. Trade unions and their members need to understand environmental issues, the consequences that environmental hazards have on their members and the community at large, and be able to develop sustainable solutions in their negotiations with company management and employers’ organizations. (ILO 1991.)

The European Foundation for the Improvement of Living and Working Conditions has observed:

Local trade unions and other employee representatives are in a particularly difficult situation. They will have the relevant knowledge of the local situation and the workplace but will, in most cases, not be sufficiently specialised in complex environmental and strategic issues.

They will, therefore, be unable to exercise their functions unless they received additional and specialised training. (European Foundation for the Improvement of Living and Working Conditions 1993.)

A number of national unions have urged increased workers’ education on the environment. Included among them is the LO in Sweden, whose 1991 Environmental Programme called both for more education and action at the workplace and for additional study circle material on the environment to promote awareness and learning. The Manufacturing Workers Union in Australia has developed a training course and set of materials to assist the union in providing environmental leadership, including how to address environmental issues through collective bargaining.

Good worker-based environmental education provides both conceptual and technical information to workers that assists them in increasing environmental awareness and in learning concrete ways to change work practices that are damaging to the environment. These programmes also learn from workers at the same time to build on their awareness, reflection and insight about workplace environmental practice.

Workplace environmental education is best done when it is connected to community and global environmental challenges so that workers have a clear idea of how the ways they work are connected to the overall environment and how they can contribute to a cleaner workplace and global ecosystem.

Safety and Health Training of Managers

Following a brief review of the development of educational contributions to worker health and safety and of the first attempts to establish the foundations of management education, this article will address curriculum development. The two career paths along which future senior managers develop will be considered as an issue relevant to the educational needs of managers. The curriculum content for managerial issues will be set forth first, to be followed by that pertinent to an understanding of injury causation.

Education for occupational safety and health has been directed, in the main, to people such as safety managers and occupational physicians, and more recently, to occupational health nurses, ergonomists and hygienists—people who have been appointed to specialist staff positions in organizations.

The advisory roles of these specialists have incorporated tasks such as the administration of pre-employment medical examinations, health surveillance, monitoring employee exposures to a range of hazards and environmental examination. Their activities moreover include contributing to job and task design in order to adjust engineering or administrative controls by way of minimizing if not eliminating (for example) the harmful effects of postural demands or of exposure to toxic hazards.

This specialist-oriented educational approach has tended to ignore the central fact that the provision of safe and healthy workplaces requires an extraordinarily broad scope of operational knowledge necessary to make them a reality. It must be borne in mind that managers carry the responsibility for planning, organizing and controlling work activities in public and private enterprises across all industry sectors.

During the decade of the 1970s many initiatives were taken to offer study programmes at the tertiary level to provide a professional education with practical training for the range of specialist engineers, scientists and health care workers entering the field of occupational safety and health.

In the 1980s it was recognized that the people most directly concerned with occupational safety and health, the managers, the workers themselves and their associations, were the most significant entities in the move to reduce workplace injury and ill health. Legislation in many jurisdictions was introduced to provide education for workers serving on safety committees or as elected safety and health representatives. These changes highlighted for the first time the very limited education and training facilities then available to managers.

An early initiative to address management education

Several steps were taken to overcome this problem. The most widely known is Project Minerva, an initiative of the US National Institute for Occupational Safety and Health (NIOSH), which represented an early effort to inculcate that body of specific managerial skills which is necessary to ensure workplace safety and which “generally exceeds that which is offered through courses in the traditional business curriculum” (NIOSH 1985). Teaching materials intended to address the more urgent safety and health concerns were provided for business schools. The resource guide comprised instructional modules, case studies and a book of readings. Module topics are listed in figure 1.

Figure 1. Modular curriculum content, Project Minerva resource guide.

The Canadian Society of Safety Engineers has recommended this structure to business schools seeking to incorporate occupational safety and health materials into their curricula.

Fundamentals of Managing: General Rather Than Specific Needs

Any job responsibility entails the acquisition of relevant knowledge and appropriate skills in order to discharge it. Responsibility for managing occupational safety and health within any organization will be placed increasingly upon line managers at each level in the job hierarchy. Associated with that responsibility ought to be commensurate accountability and the authority to command the necessary resources. The knowledge and skills needed to discharge this responsibility form the curriculum for occupational safety and health management education.

At first sight, it would seem necessary that a curriculum of this sort be developed with the aim of meeting all the special demands of the whole range of management functions as they relate to such a diversity of positions as office administrator, nurse manager, operations director, supplies and purchasing superintendent, fleet coordinator and even ship’s captain. The curricula need also, perhaps, address the whole range of industries and the occupations found within them. However, experience strongly suggests that this is not so. The necessary skills and knowledge are, in fact, common to all management functions and are more fundamental than those of the specialists. They are operative at the level of basic management expertise. However, not all managers arrive at their position of responsibility by taking similar paths.

Managerial Career Paths

The usual path to a managerial career is through either supervisory or specialist functions. In the former case, career development is dependent on work experience and job knowledge and in the latter it ordinarily presupposes off-the-job college education and postgraduate study, for example as an engineer or nurse manager. Both streams need to develop occupational safety and health (OSH) skills. For the latter this may be done in graduate school.

It is usual today for successful managers to acquire the degree of Master of Business Administration (MBA). For this reason the Minerva Project directed its attention to the 600 or more graduate management schools in the United States. By incorporating into MBA curricula such aspects of occupational safety and health as were determined to be critical for successful management of the field, it was believed that this material would be integrated into the formal studies of middle management.

Given the extremely high rate of technological invention and scientific discovery, undergraduate courses, particularly in engineering and scientific disciplines, have only limited opportunities to integrate broadly-based safety theory and practice into design, process and operation studies.

Since managerial roles begin fairly soon after graduation for those with specialist education, there is a need to provide the knowledge and skills that will support the safety and health responsibility of both specialist and generalist managers.

It is important that an awareness of the content of any curriculum devoted to occupational safety and health objectives among management be promoted among other personnel having related responsibilities. Thus, the training of such key employees as safety and health representatives should be designed to keep them current with such curricular developments.

Curriculum for Managing Occupational Safety and Health

There are two broad classes of knowledge into which the discipline of occupational safety and health falls. One is that relating to the functions and principles of management and the other deals with the nature and proactive control of hazards. The model of curriculum development set forth below will follow this division. Both the supervisory path to management and the specialist path will require their own particular coverage of each of these classes.

The question of what level of complexity and technological detail needs to be provided to students may be determined by the purpose of the course, its length and the intention of the providers regarding subsequent education and skills development. These issues will be addressed in a later section.

Specifically, curricula should address machinery and plant safety, noise, radiation, dust, toxic materials, fire, emergency procedures, medical and first aid arrangements, workplace and employee monitoring, ergonomics, environmental hygiene, workplace design and maintenance and, most importantly, the development of standard operating procedures and training. This last is an essential component of managerial understanding. Not only must tasks and processes be the subject of operator training but the requirement for continuous improvement of people and processes makes training and retraining the most critical step in improving the quality of both. Adult learning theory and practice needs to be applied in the development of the curricular materials that guide this continuing training process.

The functions and principles of management

The fundamental purposes of management embrace the planning, organizing and control of workplace activities. They also embrace the incorporation of practices which maximize opportunities for workforce participation in goal setting, team operation and quality improvement. Furthermore, successful management requires the integration of occupational safety and health into all the organization’s activities.

It is rare for undergraduate programmes, outside those of colleges of business, to cover any of this knowledge. However, it is a most essential component for the specialist practitioners to have incorporated into their undergraduate study.

Organizational framework

The mission statement, strategic plan and structure set up to guide and facilitate the attainment of the organization’s objectives must be understood by the managers to be the basis for their individual activities. Each division of the organization whether it is a hospital, trucking business or coal mine, will in turn have its own goals and structure. Each will reflect the need to achieve organizational goals, and, taken together, will drive the organization towards them.

Policies and procedures

The primary embodiment of an organization’s goals are comprised by policy documents, the guides for individual employees on specific topics. (In some jurisdictions, the publication of an organization’s overall policy is required by law.) These documents ought to include reference to the range of occupational safety and health programmes designed with regard to the activities and processes which occupy the working time of employees. A sample of some general policy statements might include documents on emergency evacuation, fire fighting, purchasing procedures, injury reporting and accident and incident investigation. On the other hand, specific hazards will require their own process-specific policy materials concerning, for example, hazardous substances management, ergonomic interventions or entry into confined spaces.

After establishing policy, an activity preferably carried out with worker representative participation and union involvement, detailed procedures would then be put in place to give effect to them. Again, participative practices will contribute to the wholehearted acceptance of them by the workforce as a valuable contribution to their safety and health.

A safety and health management system is schematically illustrated in figure 2.

Figure 2. A health and safety management system.

Organizational structures defining key roles

The next stage in the management process is to define an organizational structure which characterizes the roles of key people—for example, the chief executive—and professional advisors such as safety advisors, occupational hygienists, the occupational health nurse, the physician and the ergonomist. In order to facilitate their roles, the relationships of these people and elected safety and health representatives (required in some jurisdictions) and worker members of safety committees to the organizational structure need to be explicit.

The planning and organizing functions of management will integrate structures, policies and procedures into the operational activities of the enterprise.

Control activities—establishing processes and goals, determining standards of acceptable achievement and measuring performance against those standards—are the operational steps which bring to realization the intentions of the strategic plan. They also need to be established through co-determination. The tools for control are workplace audits, which may be continuous, frequent, random or formal.

An understanding of these activities is an important component of a management education syllabus, and skills should be developed in carrying them out. Such skills are as essential to the success of an integrated safety and health plan as they are to the discharge of any other management function, whether purchasing or fleet operation.

Organizational development and curriculum

Since the introduction of new organizational structures, new equipment and new materials is occurring at a rapid pace, special attention must be given to the processes of change. The employees who will be affected by these changes can have a deciding influence on their effectiveness and on the efficiency of the work group. An understanding of the psychosocial factors influencing the activities of the organization must be acquired and skills must be developed in using this knowledge to reach organizational objectives. Of particular importance is the delegation of the authority and the accountability of the manager to work groups formed into autonomous or semi-autonomous work teams. The management education curriculum must place at the disposal of its students the tools necessary to carry out their obligation to ensure not only process improvement and quality but the development of the multiple skills and quality awareness of personnel with which the issue of safety is so closely involved.

There are two further components of the management curriculum requiring examination. One of these is the activity of incident investigation and the other, on which the whole of this activity rests, is an understanding of the accident phenomenon.

The accident phenomenon

The work of Derek Viner (1991) in clearly expounding the significance of energy sources as the potential hazards in all workplaces has defined half of the accident equation. In conjunction with Viner’s work, the contribution of Dr. Eric Wigglesworth (1972) in identifying human error, the crucial element in managing workplace safety activities, completes its definition. An emphasis on the process of each damaging occurrence has been shown by Benner (1985) when considering accident investigation methods to be the most productive approach to managing worker safety and health.

Wigglesworth’s visualization of the sequence of events which results in injury, damage and loss appears in figure 3. It highlights the role of nonculpable human error, as well as the essential element of loss of energy containment and the potential for the injury outcome where this occurs.

Figure 3. The error/injury process.

The implications of the model for management become clear when planning for work processes takes account of the behavioural inputs which affect those processes. This is so in particular when the role of design is given its rightful place as the initiating mechanism for both equipment and process development. When planning takes account both of the design of plant and equipment and of the human factors influencing work activity, coordination and control mechanisms can then be implemented to assure containment of the identified hazards.

A model may be used to illustrate the significance of the interaction between the worker, the equipment, tools and machines employed to further the task objectives and the environment within which the activity takes place. The model highlights the need to address factors within all three elements which may contribute to damaging events. Within the workstation environment, which encompasses the thermal, aural and lighting components, among others, the worker interacts with the tools and equipment necessary to get the work done (see figure 4).

Figure 4. Representation of workstation elements relevant to injury causation and control.

Accident investigation and analysis

Accident investigation serves a number of important functions. First, it can be a proactive process, being used in situations where an incident occurs which results in no damage or injury but where there is a potential for harm. Studying the sequence of events can uncover features of the work process which could lead to more serious consequences. Second, one may gain an understanding of the process by which the events unfolded and thus can identify the absence of, or weakness in, process or task design, training, supervision or controls over energy sources. Third, many jurisdictions legally require investigations of certain types of incidents, for example, scaffolding and trench collapses, electrocutions and failures of hoisting equipment. The work of Benner (1985) illustrates well the importance of having a clear understanding of the accident phenomenon and an effective protocol for investigating injury and damage events.

The nature and control of hazards

All injury results from some form of energy exchange. The uncontrolled release of physical, chemical, biological, thermal, or other forms of energy is a source of potential harm to a variety of workers. Containment by suitable engineering and administrative mechanisms is one essential aspect of suitable control. Identifying and evaluating these energy sources is a prerequisite for control.

A management education curriculum would thus contain topics covering a range of activities which includes establishing objectives, planning the work, developing policy and procedures, undertaking organizational change and installing controls over work processes (and specifically the energy sources utilized in carrying out that work), all aimed at injury prevention. While curricula designed for the technical areas of operations need address only fundamental principles, organizations that make use of very hazardous materials or processes must have in their employ a senior member of management with sufficient training in the specific modes of handling, storage and transport of such technology to ensure the safety and health of workers and members of the community.

Larger enterprises and small business

Managers who work in larger organizations employing, say, a hundred or more people usually have one or only a few functional responsibilities and report to a senior manager or a board of directors. They have occupational safety and health responsibility for their own subordinates and act within established policy guidelines. Their educational needs may be addressed by the formal programmes offered in business schools at the undergraduate or graduate level.

On the other hand, the sole managers or partners in small enterprises are less likely to have had graduate education, and, if they have, it is more likely to be of a technological than managerial sort, and it is more difficult to address their needs for the management of occupational health and safety.

Small business needs

Providing training programmes for these managers, who often work very long hours, has represented a difficulty of long standing. Although a number of large legislative jurisdictions have produced guidance booklets setting out minimum performance stands, the more promising approaches are being made available through industry associations, such as the Ontario Industrial Accident Prevention Associations funded by levies placed by the Workers’ Compensation Board upon all businesses in the given industrial sector.

Syllabus Content

A body of knowledge and skills which addresses the needs of managers at the first-line supervisory level, middle management and senior executives is outlined in figure 5 by topic. Individual short-form syllabuses follow in figure 6. These have been collated from the syllabuses of a number of university graduate study programmes.

Figure 5. Syllabus for an OSH study programme.

Figure 6. Short form syllabuses for an OSH study programme.

The needs of first-line supervisors will be met through the acquisition of knowledge and skills covered by those topics that relate to operational demands. The training of senior executives will concentrate on such topics as strategic planning, risk management and compliance matters as well as initiating policy proposals. The allocation of hours for each course of study should reflect student needs.

Management education for occupational safety and health demands an eclectic approach to the broadest range of issues. It shares with quality the imperative of being integrated into every management and worker activity, into every employee’s job description and should be a part of the performance appraisal of all.

Training of Health and Safety Professionals

Categories of Occupational Safety and Health Professionals Requiring Training and Education

The delivery of occupational safety and health services requires a highly-trained and multidisciplinary team. In a few less-developed countries, such a team may not exist, but in the vast majority of countries in the world, experts in different aspects of OSH are usually at least available though not necessarily in sufficient numbers.

The question of who belong to the categories of OSH professionals is fraught with controversy. Usually there is no dispute that occupational physicians, occupational nurses, occupational hygienists and safety professionals (sometimes referred to as safety practitioners) are OSH professionals. However, there are also members of many other disciplines who can make a plausible claim to belonging to the OSH professions. They include those ergonomists, toxicologists, psychologists and others who specialize in the occupational aspects of their subjects. For the purpose of this article, nevertheless, the training of these latter types of personnel will not be discussed, as the main focus of their training is often not on OSH.

Historical Perspective

In most countries, specific OSH training is of fairly recent origin. Until the Second World War, most OSH professionals received little or no formal training in their chosen calling. Few schools of public health or universities provided formal OSH courses, though some such institutions offered OSH as a subject in the context of a wider degree course, usually in public health. Segments of OSH were taught at the postgraduate level for physicians training in disciplines such as dermatology or respiratory medicine. Some engineering aspects of safety, such as machine guarding, were taught in technological and engineering schools. In most countries, even training in individual components of occupational hygiene courses were hard to find before the Second World War. The development of occupational nursing training is even more recent.

In the developed countries, OSH training received a boost during the Second World War, just as OSH services did. The mass mobilization of whole nations for the war effort led to greater emphasis on protecting the health of workers (and therefore their fighting capability or productivity with respect to the manufacturing of more munitions, warplanes, tanks and warships). At the same time, however, wartime conditions and the drafting of both university teachers and students into the armed forces made it extremely difficult to set up formal courses of OSH training. After the Second World War, however, many such courses were established, some with the help of the generous study grants for demobilized servicemen awarded by grateful governments.

After the Second World War, most colonies of European empires achieved independence and embarked upon the path of industrialization to a greater or lesser extent as a means to national development. Before long, such developing countries found themselves confronting the ills of the industrial revolution of nineteenth-century Europe, but within a much telescoped time span and on an unprecedented scale. Occupational accidents and diseases and environmental pollution became rampant. This led to the development of OSH training, although even today there are large variations in the availability of such training in these countries.

Review of Current International Initiatives

International Labour Organization (ILO)

There have been several initiatives of the ILO in recent years which relate to OSH training. Many of them relate to practical training for interventive measures at the worksite. Some other initiatives are carried out in collaboration with national governments (Rantanen and Lehtinen 1991).

Other ILO activities since the 1970s have been carried on largely in developing countries throughout the world. Several such activities relate to the upgrading of training of factory inspectors in countries such as Indonesia, Kenya, the Philippines, Tanzania, Thailand, and Zimbabwe.

The ILO, together with other United Nations agencies such as the United Nations Development Programme, has also assisted in the establishment or upgrading of national institutes of OSH, the training functions of which are usually among their top priorities.

The ILO has also produced several practical monographs which are very useful as training materials for OSH courses (Kogi, Phoon and Thurman 1989).

World Health Organization (WHO)

The WHO has held in recent years a number of important international and regional conferences and workshops on OSH training. In 1981, a conference entitled “Training of Occupational Health Personnel” was held under the auspices of the Regional Office for Europe of the WHO. In the same year, the WHO convoked with the ILO a Joint ILO/WHO Committee on Occupational Health which focused on “educational and training in occupational health, safety and ergonomics” (WHO 1981). That meeting assessed the needs for education and training at different levels, developed policies in education and training and advised on methodology and programmes for education and training (WHO 1988).

In 1988 a WHO Study Group published a report entitled Training and Education in Occupational Health to address particularly the new policies on primary health care strategies adopted by the WHO member states, new needs resulting from technological developments and new approaches to health promotion at work (WHO 1988).

International Commission on Occupational Health (ICOH)

In 1985, the ICOH established a Scientific Committee on Education and Training in Occupational Health. This Committee has organized four international conferences as well as mini-symposia on the subject in the International Congresses on Occupational Health (ICOH 1987). Among the conclusions of the second conference, the need to develop training strategies and training methodologies received prominent mention in the list of priority issues (ICOH 1989).

A main feature of the third conference was the methodology of OSH training, including such functions as learning by participation, problem-based learning and evaluation of courses, teaching and students (ICOH 1991).

Regional initiatives

In different parts of the world, regional bodies have organized training activities in OSH. For example, the Asian Association of Occupational Health, established in 1954, has a Technical Committee in Occupational Health Education which conducts surveys on training of medical students and related subjects.

Types of Professional Programmes

Degree-granting and similar programmes

Probably the prototype of degree-granting and similar programmes is the sort which was developed in schools of public health or equivalent establishments. Higher education for public health is a relatively recent development. In the United States, the first school dedicated to this purpose was established in 1916 as the Institute of Hygiene at Johns Hopkins University. At that time, the overriding public health concerns centred around the communicable diseases. As time went on, education about the prevention and control of man-made hazards and about occupational health drew increasing emphasis in the training programmes of schools of public health (Sheps 1976).

Schools of public health offer OSH courses for a postgraduate diploma or for the degree of Master of Public Health, allowing students to concentrate in occupational health. Usually entry requirements include the possession of a tertiary educational qualification. Some schools insist upon relevant prior experience in OSH as well. The duration of training on a full-time basis is usually one year for the diploma and two years for the Master’s course.

Some of the schools train the different OSH personnel together in core courses, with training in the specific OSH disciplines (e.g., occupational medicine, hygiene or nursing) being offered to students specializing in these areas. This common training is probably a great advantage, as trainees of the different OSH disciplines could develop a greater understanding of each other’s functions and a better experience of team work.

Especially in recent years, schools of medicine, nursing and engineering have offered courses similar to those in schools of public health.

A few universities are offering OSH courses at the basic or undergraduate level. Unlike the traditional OSH tertiary courses, admission to which is usually dependent upon the acquisition of a previous degree, these newer courses admit students who have just graduated from high school. Much controversy still surrounds the merits of this development. Proponents of such courses argue that they produce more OSH professionals in less time and at lower cost. Their opponents argue that OSH practitioners are more effective if they build their OSH training on a basic discipline into which they integrate their special OSH practice, such as occupational medicine or nursing. Knowledge of basic sciences may be acquired at the specialization level if they have not been taught as part of undergraduate training.

Training courses in OSH for physicians vary in their clinical component. The conference, mentioned above, on the training of occupational health personnel organized by the WHO/Regional Office for Europe emphasized that “occupational medicine is fundamentally a clinical skill and its practitioners must be fully competent in clinical medicine”. It must also be stressed that the diagnosis of chemical intoxication among workers is largely clinical, as is the differentiation between “occupational disease” and other diseases and their management (Phoon 1986). It has become, therefore, a worldwide trend to insist upon postings to different clinics as part of the training of the occupational physician. In the United States and Canada, for example, trainees undergo a four-year residency programme which includes a substantial clinical component in such subjects as dermatology and respiratory medicine in addition to the curriculum required for the degree of Master of Public Health or its equivalent.

Formal training for occupational nurses probably varies even more in different parts of the world than that for occupational physicians. These differences hinge on the variations of responsibilities and functions of occupational nurses. Some countries define occupational health nursing as “the application of nursing principles in conserving the health of workers in all occupations. It involves prevention, recognition, and treatment of illness and injury and requires special skills and knowledge in the fields of health education and counselling, environmental health, rehabilitation and human relations” (Kono and Nishida 1991).On the other hand, other countries understand occupational nursing as the role of the nurse in an interdisciplinary occupational health team, who is expected to participate in all the fields of general health management, delivery of health services, environmental control, healthy and safe working procedures and OSH education. A survey in Japan showed, however, that not all the graduates from an occupational nursing staff took part in all these activities. This was probably due to a lack of understanding of the nurse’s role in OSH and to inadequate training in some of the fields (Kono and Nishida 1991).

The discipline of occupational hygiene has been defined by the American Industrial Hygiene Association as the science and art devoted to the recognition, evaluation and control of those environmental factors and stresses, arising in or from the workplace, which may cause sickness, impaired health and well-being, or significant discomfort and inefficiency among workers or among the citizens of the community. Speciality training has also emerged within the general field of occupational hygiene, including that in chemistry, engineering, noise, radiation, air pollution and toxicology.

Curricula for Occupational Safety and Health Personnel

The detailed contents of the curricula for the training of occupational physicians, nurses, hygienists and safety personnel, as recommended by the 1981 Joint ILO/WHO Committee an Occupational Health mentioned above will be represented in the pages to follow. As regards the main subject areas to be taught, the Committee recommends:

• organization of occupational safety and health services, their activities, legislation and regulations
• occupational medicine
• occupational hygiene
• occupational safety
• work physiology and ergonomics, dealing particularly with the adaptation of work to man, but also with the readjustment of the handicapped to work
• occupational psychology, sociology and health education.

According to the profile of the personnel, the educational programmes will go more or less deeply into different subjects to meet the demands of the respective professions, as discussed below for several categories.

It is difficult to comment in detail what should go into the curricula of OSH courses. It is generally agreed that such courses should have a greater input of behavioural sciences than is now the case, but such input should be relevant to the sociocultural milieu of a particular country or region for which a course is designed. Moreover, OSH should not be taught in isolation from the general health services and the community health situation in a given country or region. The fundamentals of management science should be included in OSH curricula to improve the understanding of organizational structures and practices in enterprises as well as to enhance administrative skills of OSH professionals. The art of communication and the ability to conduct an investigation of OSH problems scientifically and to formulate solutions were also recommended for inclusion in all OSH curricula (Phoon 1985b).

Physicians and nurses

All medical students should be taught some occupational health. In some countries, there are separate courses; in others, occupational health is dealt with in such courses as physiology, pharmacology and toxicology, public health, social medicine and internal medicine. Nevertheless, medical students do not, as a rule, acquire sufficient knowledge and skill to allow them to practice occupational health independently, and some postgraduate training in occupational health and safety is necessary. For further specialization in occupational health (e.g., occupational diseases, or even more narrow fields, like occupational neurology or dermatology), postgraduate training programmes should be available. For nurses active in occupational health services, both long-term and short-term courses need to be organized, depending on their range of activities.

Figure 1 lists subjects to be included in specialized postgraduate training for physicians and nurses.

Figure 1. Postgraduate training syllabus for physicians and nurses.

Safety and health engineers and safety officers

The practice of occupational safety is concerned with such failures of materials, machines, processes and structures as may give rise to dangerous situations, including the release of harmful agents. The aim of education in this field is to enable students to foresee danger, both at the planning stage of projects and in existing situations, to quantify the danger and to design measures to combat it. Training in occupational safety involves the student in a substantial study of selected topics from engineering and materials science, particularly those related to mechanical, civil, chemical, electrical and structural engineering.

Separate curricular units would be concerned, for example, with the structure and strength of materials, in mechanical engineering; with forces in structures, in civil engineering; with handling and transportation of chemicals, in chemical engineering; with design standards, protective equipment and the theory of preventive maintenance, in electrical engineering; and with the behaviour of strata, in mining engineering.

Safety engineers, in addition to acquiring a basic knowledge, should also undergo a course of specialization. The 1981 Joint ILO/WHO Committee recommendations for a specialized safety engineering course of study are listed in figure 2.

Figure 2. A syllabus for specialization in safety engineering.

Courses can be either full-time, part-time or “sandwich courses”—in the lattermost case, periods of studying are interspersed with periods of practice. The selection of which courses to take is very much a matter of individual circumstances or preference. This is especially true since many safety practitioners have extensive knowledge gained through on-the-job experience in particular industries. However, within a large community or a country, there should preferably be a large range of choices to cater for all these different needs.

The recent enormous advances in communications technology should enable the greater usage of distance-learning courses which can be delivered both to remote areas of a country or even across national frontiers. Unfortunately, such technology is still quite expensive, and countries or areas which need such distance-learning capabilities most may be the very ones least able to afford them.

Primary health care practitioners

There is a severe shortage of OSH professionals in developing countries. In addition, among primary health care practitioners and health professionals as a whole, there is a tendency to direct their main activities to curative services. This should be counterbalanced with the help of appropriate training to emphasize the great value of instituting preventive measures at the workplace in collaboration with other responsible parties such as workers and managers. This would help, to a certain extent, to alleviate the problems caused by the present shortage of OSH personnel in developing countries (Pupo-Nogueira and Radford 1989).

A number of developing countries have recently embarked on short courses of OSH training for primary health care and public health personnel. There is a wide spectrum of organizations which have undertaken such training. They include national productivity boards (Phoon 1985a), farmers’ associations, national safety councils, national institutes of health, and professional bodies such as medical and nurses’ associations (Cordes and Rea 1989).

A scarcity of OSH professionals affects not only developing countries, but many developed ones as well. In the United States, one response to this problem took the form of a joint report by a preventive medicine and internal medicine study group that recommended that training programmes in internal medicine emphasize controls of hazards in the workplace and in the environment, since most patients seen by internists are members of the workforce. Furthermore, the American Academy of Family Physicians and the American Medical Association have published several monographs on occupational health for the family physician. A study by the American Institute of Medicine reaffirmed the role of the primary care physician in occupational health, outlined the basic skills required and emphasized the need to enhance occupational health activity in basic training and continuing education (Ellington and Lowis 1991). In both developed and developing countries, however, there is still an inadequate number of OSH training programmes for primary health care personnel and an insufficient number of trained personnel.

Multidisciplinary training

Training in the multidisciplinary nature of OSH can be enhanced by making sure that everyone who trains is fully familiar with the roles, activities and areas of concern of the other OSH personnel. In an OSH course in Scotland, for example, members of the different OSH professions participate in the teaching programme. The students are also provided with self-instruction packages designed to give them detailed knowledge of and insight into the different OSH professional areas. Extensive use is also made of experiential learning techniques such as role-playing simulations and participative case studies. For example, students are asked to complete personal checklists on how each particular area of occupational health activity is likely to affect them in their own work situations, and on how they can cooperate effectively with other occupational health professionals.

In the running of a multidisciplinary OSH course, a key element is the mix of learners of different professional backgrounds in the same class. The course material, such as group exercises and essays, must be carefully selected without any bias to a particular discipline. Lecturers must also receive training in the setting of multidisciplinary questions and problems (D’Auria, Hawkins and Kenny 1991).

Continuing Education

In professional education as a whole, there is an increasing awareness of the need for continuing education. In the field of OSH, new knowledge concerning old hazards and new problems arising from changes in technology are developing so rapidly that no OSH practitioner could hope to keep up to date without making a systematic and constant effort to do so.

Continuing education in OSH can be formal or informal, voluntary or obligatory in order to maintain certification. It is essential for every OSH practitioner to keep up with reading the key professional journals, at least in his or her own disciplines. When a new hazard is encountered, it would be very useful to mount a literature search on that subject through a library. If such a library is unavailable, the CIS service of the ILO could be asked to undertake that service instead. Moreover, having continual and direct access to at least a few up-to-date texts on OSH is essential to any kind of OSH practice.

More formal kinds of continuing education could take the form of conferences, workshops, lectures, journal clubs or seminars. Usually tertiary institutions of learning or professional organizations can provide the means of delivery of such programmes. Whenever possible, there should be annual events in which a broader range of views or expertise could be canvassed than is usually available within the framework of a small community or town. Regional or international conferences or seminars can provide extremely useful opportunities for participants, not only to take advantage of the formal programme but also to exchange information with other practitioners or researchers outside the formal sessions.

Nowadays, more and more OSH professional organizations require members to attend a minimum number of continuing education activities as a condition for extension of certification or membership. Usually only the fact of attendance at approved functions is required. Attendance by itself is, of course, no guarantee that the participant has benefited from being present. Alternatives such as subjecting OSH professionals to regular examinations are also fraught with problems. Within a single OSH discipline, there is such a wide diversity of practice even within the same country that it is extremely difficult to devise an examination equitable to all the OSH practitioners concerned.

Self-learning

In every OSH training course there should be emphasis on the need for self-learning and its continuing practice. To this end, training in information retrieval and critical analysis of published literature is imperative. Training on the use of computers to facilitate obtaining of information from the many excellent OSH resources around the world would be also beneficial. Several courses have been developed in recent years to promote self-learning and information management through microcomputers (Koh, Aw and Lun 1992).

Curriculum Development

There is an increasing demand on the part of trainees and the community to ensure that curricula are constantly evaluated and improved. Many modern curricula are competency-based. A series of professional competencies required is first compiled. Since competence may be defined by different groups in different ways, extensive consultations on this matter should be held with faculty members and OSH practitioners (Pochyly 1973). In addition, there is a need for consultations with “consumers” (e.g., students, workers and employers), an inbuilt evaluation programme and well-defined but flexible educational objectives (Phoon 1988). Sometimes the establishment of advisory committees on curriculum or teaching programmes, which normally include faculty and student representatives, but sometimes also involve members of the general community, can provide a useful forum for such consultations.

Infrastructure Development

Infrastructure is often ignored in discussions on OSH training and education. Yet supporting facilities and human resources such as computers, libraries, efficient administrative staff and procedures and safe and convenient access are among the host of infrastructure considerations which could be crucial to the success of training courses. Proper monitoring of students’ progress, counselling and assistance of students with problems, health care of students and their families (where indicated), minding of students’ children, canteen and recreational facilities and provision of lockers or cupboards for the storage of personal possessions of trainees are all important details which should receive careful attention.

Faculty Recruitment and Development

The quality and popularity of a training programme are often vital factors in determining the quality of staff applying for a vacant position. Obviously, other factors such as satisfactory service conditions and opportunities for career and intellectual development are also important.

Careful consideration should be given to job specifications and job requirements. Faculty should have the necessary OSH qualifications, though flexibility should be exercised to allow the recruitment of staff from non-OSH disciplines who may be able to make special contributions to teaching or especially promising applicants who may have the capability but not all the qualifications or experience normally required for the job. Whenever possible, faculty should have practical OSH experience.

After recruitment, it is the responsibility of the leadership and senior members of the school or department to make sure that new staff are given as much encouragement and opportunity to develop as possible. New staff should be inducted into the culture of the organization but also encouraged to express themselves and to participate in decision-making processes related to teaching and research programmes. Feedback should be given to them concerning their teaching performance in a sensitive and constructive manner. Whenever necessary, offers of help to remedy identified limitations should be given. Many departments have found the regular holding of teaching or evaluation workshops for staff to be extremely useful. Cross-postings to industries and sabbatical leave are other important measures for staff development. Some extent of consultancy work, which could be either clinical, worksite or laboratory (depending on the discipline and areas of activity of the faculty member) helps to make academic teaching more practical.

Teaching Venues

Classrooms should be designed and furnished according to appropriate ergonomic principles and equipped with audio-visual aid equipment and video projection facilities. The lighting and acoustics should be satisfactory. Access to an exit should be located in such a way as to minimize the disturbance of an ongoing class.

Proper principles of OSH should be applied to the design and construction of laboratories. Such safety equipment as showers, eye washing facilities, first aid supplies and resuscitation equipment and fume cupboards should be installed or made available where indicated, and laboratories should be bright, airy and odourless.

Venues for field visits should be chosen to provide a wide range of OSH experiences for the trainees. If possible, worksites with different levels of OSH standards should be chosen. However, on no account should the safety or health of trainees be compromised.

Locations for clinical work would very much depend on the nature and level of the training course. In some circumstances, bedside teaching may be indicated to demonstrate the appropriate clinical approach to skills in history taking. In some other circumstances, presentation of cases with or without patients could serve the same purpose.

Examinations and Assessment

The recent trend has been to seek alternatives to administering an all-important and single final examination at the end of a course. Some courses have abolished formal examinations altogether and replaced them with assignments or periodic assessments. Some other courses have a combination of such assignments and assessments, open book examinations and closed book examinations as well. It is nowadays increasingly understood that examinations or assessments are as much measures of the quality of courses and teachers as of the trainees.

A feedback of trainees’ opinions concerning the entire course or components thereof through questionnaires or discussions is invaluable in the evaluation or revision of a course. As far as possible, all courses should be constantly evaluated, at least on an annual basis, and revised if necessary.

Insofar as modes of examination are concerned, essay questions can test organization, integrating ability and writing skills. The precision and validity of essay examinations, however, have been found to be weak. Multiple-choice questions (MCQs) are less subjective, but good ones are difficult to formulate and do not allow a display of practical knowledge. Modified essay questions (MEQs) differ from essays or MCQs in that the candidate is presented with a progressive amount of information about a problem. It avoids cueing by requesting short-answer responses rather than presenting candidates with alternatives from which to choose the appropriate answer. Oral examinations can measure problem-solving skills, professional judgement, communication skills and ability to retain composure under stress. The main difficulty with the oral examination is the potential for so-called “lack of objectivity”. The oral examination can be made more reliable by imposing some structure on it (Verma, Sass-Kortsak and Gaylor 1991). Perhaps the best alternative is to use a battery of these different types of examination rather than to rely on one or two of them only.

Certification and Accreditation

The word certification usually refers to the conferment upon a professional of authorization to practise. Such certification could be conferred by a national board or a college or an institution of practitioners of an OSH discipline. Usually, the OSH professional is given certification only after fulfilling a stipulated period of training in connection with an approved course or positions and also upon passing an examination. In general, such “global certification” is valid for life, unless there is proven professional negligence or misconduct. However, there are other forms of accreditation which require periodic renewal. They include such accreditation as that required in some countries to either conduct special statutory medical examinations or to report on radiographs of asbestos-exposed persons.

Accreditation , on the other hand, refers to the recognition of OSH courses by a national board or professional organization or a scholarship-granting body. Such accreditation should be subject to periodic reappraisal to ensure that courses keep to an appropriate level of currency and effectiveness.

A New Approach to Learning and Training: A Case Study by the ILO-FINNIDA African Safety and Health Project

Abuya : What’s the matter? You look worn out.

Mwangi : I am worn out—and disgusted. I was up half the night getting ready for this lecture I just gave and I don’t think it went very well. I couldn’t get anything out of them—no questions, no enthusiasm. For all I know, they didn’t understand a word I said.

Kariuki : I know what you mean. Last week I was having a terrible time trying to explain chemical safety in Swahili.

Abuya : I don’t think it’s the language. You were probably just talking over their heads. How much technical information do these workers really need to know anyway?

Kariuki : Enough to protect themselves. If we can’t get the point across, we’re just wasting our time. Mwangi, why didn’t you try asking them something or tell a story?

Mwangi : I couldn’t figure out what to do. I know there has to be a better way, but I was never trained in how to do these lectures right.

Abuya : Why all the fuss? Just forget about it! With all the inspections we have to do, who’s got time to worry about training?

The above discussion in an African factory inspectorate, which could take place anywhere, highlights a real problem: how to get the message through in a training session. Using a real problem as a discussion starter (or trigger) is an excellent training technique to identify potential obstacles to training, their causes and potential solutions. We have used this discussion as a role play in our Training of Trainers’ workshops in Kenya and Ethiopia.

The ILO-FINNIDA African Safety and Health Project is part of the ILO’s technical cooperation activities aimed to improve occupational safety and health training and information services in 21 African countries where English is commonly spoken. It is sponsored by FINNIDA, the Finnish International Development Agency. The Project took place from 1991 to 1994 with a budget of US$5 million. One of the main concerns in the implementation of the Project was to determine the most appropriate training approach by which to facilitate high quality learning. In the following case study we will describe the practical implementation of the training approach, the Training the Trainers’ (TOT) course (Weinger 1993).

Development of a New Training Approach

In the past, the training approach in most African factory inspectorates, and also in many technical cooperation projects of the ILO, has been based on randomly selected, isolated topics of occupational safety and health (OSH) which were presented mainly by using lecturing methods. The African Safety and Health Project conducted the first pilot course in TOT in 1992 for 16 participating countries. This course was implemented in two parts, the first part dealing with basic principles of adult education (how people learn, how to establish learning objectives and select teaching contents, how to design the curriculum and select instructional methods and learning activities and how to improve personal teaching skills) and the second part with practical training in OSH based on individual assignments which each participant completed during a four month’s time period following the first part of the course.

The main characteristics of this new approach are participation and action orientation. Our training does not reflect the traditional model of classroom learning where participants are passive recipients of information and the lecture is the dominant instructional method. In addition to its action orientation and participatory training methods, this approach is based on the latest research in modern adult education and takes a cognitive and activity-theoretical view of learning and teaching (Engeström 1994).

On the basis of the experience gained during the pilot course, which was extremely successful, a set of detailed course material was prepared, call the Training of Trainers Package , which consists of two parts, a trainer’s manual and a supply of participants’ handout matter. This package was used as a guideline during planning sessions, attended by from 20 to 25 factory inspectors over a period of ten days, and concerned with establishing national TOT courses in Africa. By the spring of 1994, national TOT courses had been implemented in two African countries, Kenya and Ethiopia.

High Quality Learning

There are four key components of high quality learning.

Motivation for learning . Motivation occurs when participants see the “use-value” of what they are learning. It is stimulated when they can perceive the gap that separates what they know and what they need to know to solve a problem.

Organization of subject matter. The content of learning is too commonly thought of as separate facts stored in the brain like items in boxes on a shelf. In reality, people construct models, or mental pictures, of the world while learning. In promoting cognitive learning, teachers try to organize facts into models for better learning and include explanatory principles or concepts (the “but whys” behind a fact or skill).

Advancing through steps in the learning process . In the learning process, the participant is like an investigator looking for a model by which to understand the subject matter. With the help of the teacher, the participant forms this model, practices using it and evaluates its usefulness. This process can be divided into the following six steps:

• orientation
• integrating new knowledge (internalization)
• application
• programme critique
• participant evaluation.

Social interaction . The social interaction between participants in a training session is an essential component of learning. In group activities, participants learn from one another.

Planning training for high quality learning

The kind of education aimed at particular skills and competencies is called training . The goal of training is to facilitate high quality learning and it is a process that takes place in a series of steps. It requires careful planning at each stage and each step is equally important. There are many ways of breaking the training into components but from the point of view of the cognitive conception of learning, the task of planning a training course can be analysed into six steps.

Step 1: Conduct a needs assessment (know your audience).

Step 2: Formulate learning objectives.

Step 3: Develop an orientation basis or “road map” for the course.

Step 4: Develop the curriculum, establishing its contents and associated training methods and using a chart to outline your curriculum.

Step 5: Teach the course.

Step 6: Evaluate the course and follow up on the evaluation.

Practical Implementation of National TOT Courses

Based on the above-mentioned training approach and experience from the first pilot course, two national TOT courses were implemented in Africa, the one in Kenya in 1993 and the other in Ethiopia in 1994.

Training needs were based on the work activity of factory inspectors and were determined by means of a pre-workshop questionnaire and a discussion with the course participants about their everyday work and about the kinds of skills and competencies necessary to carry it out (see figure 1). The course has thus been designed primarily for factory inspectors (in our national TOT courses, usually 20 to 25 inspectors participated), but it could be extended to other personnel who may need to carry out safety and health training, such as shop stewards, foremen, and safety and health officers.

Figure 1. Orientation basis for the factory inspector's work activity.

A compilation of course objectives for the national TOT course was assembled step by step in cooperation with the participants, and is given immediately below.

Objectives of the national TOT course

The aims of the training of trainers (TOT) course are as follows:

• Increase participants’ understanding of the changing role and tasks of factory inspectors from immediate enforcement to long-term advisory service, including training and consultation.
• Increase participants’ understanding of the basic principles of high quality learning and instruction.
• Increase participants’ understanding of the variety of skills involved in planning training programmes: identification of training needs, formulation of learning objectives, development of training curricula and materials, selection of appropriate teaching methods, effective presentation and programme evaluation.
• Enhance participants’ skills in effective communication for application during inspections and consultation, as well as in formal training sessions.
• Facilitate the development of short and long-term training plans in which new instructional practices will be implemented.

Course contents

The key subject areas or curriculum units that guided the implementation of the TOT course in Ethiopia are outlined in figure 2. This outline may also serve as an orientation basis for the whole TOT course.

Figure 2. The key subject areas of the TOT course.

Determining training methods

The external aspect of the teaching method is immediately observable when you step into a classroom. You might observe a lecture, a discussion, group or individual work. However, what you do not see is the most essential aspect of teaching: the kind of mental work being accomplished by the student at any given moment. This is called the internal aspect of the teaching method.

Teaching methods can be divided into three main groups:

• Instructional presentation : participant presentations, lectures, demonstrations, audio-visual presentations
• Independent assignment : tests or exams, small group activities, assigned reading, use of self-guided learning materials, role plays
• Cooperative instruction

Most of the above methods were used in our TOT courses. However, the method one selects depends on the learning objectives one wants to achieve. Each method or learning activity should have a function. These instructional functions , which are the activities of a teacher, correspond with the steps in the learning process described above and can help guide your selection of methods. There follows a list of the nine instructional functions:

• preparation
• transmitting new knowledge
• consolidating what has been taught
• practising (development of knowledge into skills)
• application (solving new problems with the help of new knowledge)

Planning the curriculum: Charting your course

One of the functions of curriculum or course plan is to assist in guiding and monitoring the teaching and learning process. The curriculum can be divided into two parts, the general and the specific.

The general curriculum gives an overall picture of the course: its goals, objectives, contents, participants and guidelines for their selection, the teaching approach (how the course will be conducted) and the organizational arrangements, such as pre-course tasks. This general curriculum would usually be your course description and a draft programme or list of topics.

A specific curriculum provides detailed information on what one will teach and how one plans to teach it. A written curriculum prepared in chart form will serve as a good outline for designing a curriculum specific enough to serve as a guide in the implementation of the training. Such a chart includes the following categories:

Time : the estimated time needed for each learning activity

Curriculum Units : primary subject areas

Topics : themes within each curriculum unit

Instructional function: the function of each learning activity in helping to achieve your learning objectives

Activities : the steps for conducting each learning activity

Materials : the resources and materials needed for each activity

Instructor : the trainer responsible for each activity (when there are several trainers)

To design the curriculum with the aid of the chart format, follow the steps outlined below. Completed charts are illustrated in connection with a completed curriculum in Weinger 1993.

• Specify the primary subject areas of the course (curriculum units) which are based on your objectives and general orientation basis.
• List the topics you will cover in each of those areas.
• Plan to include as many instructional functions as possible in each subject area in order to advance through all the steps of the learning process.
• Choose methods which fulfil each function and estimate the amount of time required. Record the time, topic and function on the chart.
• In the activities column, provide guidelines for the instructor on how to conduct the activity. Entries can also include main points to be covered in this session. This column should offer a clear picture of exactly what will occur in the course during this time period.
• List the materials, such as worksheets, handouts or equipment required for each activity.
• Make sure to include appropriate breaks when designing a cycle of activities.

Evaluating the course and follow-up

The last step in the training process is evaluation and follow-up. Unfortunately, it is a step that is often forgotten, ignored and, sometimes, avoided. Evaluation , or the determination of the degree to which course objectives were met, is an essential component of training. This should include both programme critique (by the course administrators) and participant evaluation .

Participants should have an opportunity to evaluate the external factors of teaching: the instructor’s presentation skills, techniques used, facilities and course organization. The most common evaluation tools are post-course questionnaires and pre- and post-tests.

Follow-up is a necessary support activity in the training process. Follow-up activities should be designed to help the participants apply and transfer what they have learned to their jobs. Examples of follow-up activities for our TOT courses include:

• action plans and projects
• formal follow-up sessions or workshops

Selection of trainers

Trainers were selected who were familiar with the cognitive learning approach and had good communication skills. During the pilot course in 1992 we used international experts who had been involved in development of this learning approach during the 1980s in Finland. In the national courses we have had a mixture of experts: one international expert, one or two regional experts who had participated in the first pilot course and two to three national resource persons who either had responsibility for training in their own countries or who had participated earlier in this training approach. Whenever it was possible, project personnel also participated.

Discussion and Summary

Factory training needs assessment

The factory visit and subsequent practice teaching are a highlight of the workshop. This training activity was used for workplace training needs assessment (curriculum unit VI A, figure 1). The recommendation here would be to complete the background on theory and methods prior to the visit. In Ethiopia, we scheduled the visit prior to addressing ourselves to the question of teaching methods. While two factories were looked at, we could have extended the time for needs assessment by eliminating one of the factory visits. Thus, visiting groups will visit and focus on only that factory where they will be actually training.

The risk mapping component of the workshop (this is also part of curriculum unit VI A) was even more successful in Ethiopia than in Kenya. The risk maps were incorporated in the practice teaching in the factories and were highly motivating for the workers. In future workshops, we would stress that specific hazards be highlighted wherever they occur, rather than, for example, using a single green symbol to represent any of a variety of physical hazards. In this way, the extent of a particular type of hazard is more clearly reflected.

Training methods

The instructional methods focused on audio-visual techniques and the use of discussion starters. Both were quite successful. In a useful addition to the session on transparencies, the participants were asked to work in groups to develop a transparency of their own on the contents of an assigned article.

Flip charts and brainstorming were new teaching methods for participants. In fact, a flip chart was developed especially for the workshop. In addition to being an excellent training aid, the use of flip charts and “magic markers” is a very inexpensive and practical substitute for the overhead projector, which is unavailable to most inspectors in the developing countries.

Videotaped microteaching

“Microteaching”, or instruction in the classroom focusing on particular local problems, made use of videotape and subsequent critique by fellow participants and resource people, and was very successful. In addition to enhancing the working of external teaching methods, the taping was a good opportunity for comment on areas for improvement in content prior to the factory teaching.

A common error, however, was the failure to link discussion starters and brainstorm activities with the content or message of an activity. The method was perfunctorily executed, and its effect ignored. Other common errors were the use of excessively technical terminology and the failure to make the training relevant to the audience’s needs by using specific workplace examples. But the later presentations in the factory were designed to clearly reflect the criticisms that participants had received the day before.

Practice teaching in the factory

In their evaluation of the practice teaching sessions in the factory, participants were extremely impressed with the use of a variety of teaching methods, including audiovisuals, posters that they developed, flip charts, brainstorming, role plays, “buzz groups” and so on. Most groups also made use of an evaluation questionnaire, a new experience for them. Of particular note was their success in engaging their audiences, after having relied solely on the lecture method in the past. Common areas for improvement were time management and the use of overly technical terms and explanations. In the future, the resource persons should also try to ensure that all groups include the application and evaluation steps in the learning process.

Course planning as a training experience

During these two courses it was possible to observe significant changes in the participants’ understanding of the six steps in high quality learning.

In the last course a section on writing objectives, where each participant writes a series of instructional objectives, was added into the programme. Most participants had never written training objectives and this activity was extremely useful.

As for the use of the curriculum chart in planning, we have seen definite progress among all participants and mastery by some. This area could definitely benefit from more time. In future workshops, we would add an activity where participants use the chart to follow one topic through the learning process, using all of the instructional functions. There is still a tendency to pack the training with content material (topics) and to intersperse, without due consideration of their relevance, the various instructional functions throughout a series of topics. It is also necessary that trainers emphasize those activities that are chosen to accomplish the application step in the learning process, and that they acquire more practice in developing learners’ tasks. Application is a new concept for most and difficult to incorporate in the instructional process.

Finally the use of the term curriculum unit was difficult and sometimes confusing. The simple identification and ordering of relevant topic areas is an adequate beginning. It was also obvious that many other concepts of the cognitive learning approach were difficult, such as the concepts of orientation basis, external and internal factors in learning and teaching, instructional functions and some others.

In summary, we would add more time to the theory and curriculum development sections, as outlined above, and to the planning of future curriculum, which affords the opportunity of observing individual ability to apply the theory.

The ILO-FINNIDA African Safety and Health Project has undertaken a particularly challenging and demanding task: to change our ideas and old practices about learning and training. The problem with talking about learning is that learning has lost its central meaning in contemporary usage. Learning has come to be synonymous with taking in information . However, taking in information is only distantly related to real learning. Through real learning we re-create ourselves. Through real learning we become able to do something we were never able to do before (Senge 1990). This is the message in our Project’s new approach on learning and training.

" DISCLAIMER: The ILO does not take responsibility for content presented on this web portal that is presented in any language other than English, which is the language used for the initial production and peer-review of original content. Certain statistics have not been updated since the production of the 4th edition of the Encyclopaedia (1998)."

• Disability and Work
• Worker's Compensation Systems

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Case studies of occupational health management in the engineering construction industry

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D. E. Gyi, R. A. Haslam, A. G. F. Gibb, Case studies of occupational health management in the engineering construction industry, Occupational Medicine , Volume 48, Issue 4, May 1998, Pages 263–271, https://doi.org/10.1093/occmed/48.4.263

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Construction workers are exposed to considerable hazards carrying a health risk, e.g. , dusts, fumes, noise and manual handling, yet there is often poor occupational health service provision particularly for subcontracted labourers. This paper presents seven case studies from large. engineering construction organizations. concerning current practice in occupational health management. The results supported the fact that data and records regarding health-related absence were limited and inconsistent, and that little existed in terms of medicals and health surveillance, particularly in the case of subcontracted workers. The main difficulties envisaged were reported to be the sizeable costs involved; the temporary and mobile work force; demonstrating cost-benefits to top management and a lack of interest amongst workers, perhaps exacerbated by the threat of lost livelihood. Managers also admitted limited health expertise and knowledge of the wider role health professionals could play in health management. Training and further research in this area are indicated.

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Cost-Benefit Analysis of Occupational Health and Safety: A Case Study

• First Online: 21 February 2020

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• Delfina Ramos   ORCID: orcid.org/0000-0003-2862-2883 11 , 12 ,
• Paulo Afonso   ORCID: orcid.org/0000-0003-3882-2491 12 &
• Rosa Costa 13  

Part of the book series: Studies in Systems, Decision and Control ((SSDC,volume 277))

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Top management generally considers occupational safety and health as an extra cost instead of a benefit. The current work presents a case study in a company that produces and installs temporary structures for events, involving two sectors: warehouse and production (assembly and disassembly). The Analysis of the Return on Investment of Preventive Measures clearly proved that the Benefit-Cost (B/C) Ratio is a very valuable instrument for decision making in the context of occupational safety and health. A sensitivity analysis of the B/C ratio was also performed. The proposed measures were proved as efficient for both sectors, with a positive Net Present Value and a B/C ratio higher than 1 in both sectors. Furthermore, the results obtained from the sensitivity analysis allowed us to understand the importance of validating the preventive measures under different situations. Indeed, by varying the scenarios with the introduction of different factors and the level of efficiency of the measures, it became much clearer the conditions of viability of the different preventive measures.

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Toutounchian, S., Abbaspour, M., Dana, T., Abedi, Z.: Design of a safety cost estimation parametric model in oil and gas engineering, procurement and construction contracts. Saf. Sci. 106 , 35–46 (2018)

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Costa, R.: Analysis model of return on investment in preventive measures in occupational safety: conception, application and discussion. Master’s thesis. Published in April (2019)

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Paula Carneiro

Patrício Cordeiro

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Ramos, D., Afonso, P., Costa, R. (2020). Cost-Benefit Analysis of Occupational Health and Safety: A Case Study. In: Arezes, P., et al. Occupational and Environmental Safety and Health II. Studies in Systems, Decision and Control, vol 277. Springer, Cham. https://doi.org/10.1007/978-3-030-41486-3_73

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• Open access
• Published: 25 November 2022

A study on occupational health and safety

• Lídia Maria Costa Araújo Magalhães 1 ,
• Ketyllem Tayanne da Silva Costa   ORCID: orcid.org/0000-0003-0304-2639 2 ,
• Gustavo Nepomuceno Capistrano 2 ,
• Maryanna Damasceno Leal 3 &
• Fábia Barbosa de Andrade 4  

BMC Public Health volume  22 , Article number:  2186 ( 2022 ) Cite this article

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This study aimed to evaluate and describe the indicators of occupational health, with a focus on the medical expertise and periodic medical examination.

This is exploratory-descriptive, cross-sectional, documentary, quantitative, and retrospective research, in the historical series: 2011 to 2015.

The number of lost days of work per worker and the frequency of licenses increased despite the decrease in the Absenteeism Duration Index and stabilization of the Frequency of Medical Workers. As for the adhesion of the workers to the Periodic Medical Examinations, it was decreasing, with a higher percentage in the year 2012 (35.3%). During the analyzed period, 5,186 workers performed the Periodic Medical Examination, and the majority (60.6%) presented non-ideal weight, 41.1% were sedentary, 33.2% had dyslipidemia, 29.0% were alcoholic, 3.2% were smokers, 5.9% had diabetics, and 16.4% reported high noise in the workplace, 27.8% inadequate lighting and 35.9% inadequate work furniture.

Conclusions

The results highlight the need to maintain and strengthen the Worker Health and Safety Policy with emphasis on surveillance, aiming at the promotion and protection of the health of the workers, based on the elaboration of the epidemiological profile of health and, consequently, the implementation of positive impact strategies.

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Introduction

Historically, in Brazil, Occupational Health and Safety (OHS) is strongly associated with the political-social and economic evolution of the country and is presented as the achievement of rights resulting from claims and struggles of the workers. Work is one of the determinants that most impact man’s conditions, quality of life, and health.

Working is essential for human beings since it is the way in which respect, integration, sociability, recognition, and bonds of friendship are obtained. On the other hand, the living conditions of Brazilian workers are aggravated by the alternation of stages of growth and accelerated industrialization with moments of recession, resulting in the government’s adoption of adjustment measures and financial cuts in social policies, such as education, health, safety, transportation, housing, and work, among others [ 1 , 2 ].

Nowadays, the epidemiological profile of workers' morbidity and mortality in Brazil is characterized by the coexistence of diseases that have an intrinsic relationship with working conditions: diseases related to work and typical work accidents, which have their frequency, appearance, and severity modified by the activity. Added to this reality are diseases common to the population as a whole, which have no etiological relationship with work [ 3 ].

Health Promotion and Surveillance refer to the pillar of the Occupational Safety and Health Care Policy (PASS, in Portuguese) that encompasses quality of life and vigilance actions in the environmental and work processes. Standing out among these are the institution of guidelines and programs in the area of mental health and occupational diseases of higher prevalence; the mandatory provision of Periodic Medical Examinations (PME) for all employees; the training in health and safety at work; the creation of an Internal Committee on Health and Safety at Work and a survey of environmental risks, with a stimulus to the active participation of employees in processes involving their health [ 4 , 5 ].

The PME aims, mainly, the prevention, enabling the health surveillance of the employees of a certain company or institution, contributing to the early identification of diseases related or not to work. It is carried out by an occupational doctor and employers must provide examinations for employees at specific times such as dismissal, admission, leaves of absence or change of function, in addition to periodic examinations, which will vary in frequency according to the workers' age (every two years for those between 18 and 45 years old and annually for those outside this age group) [ 6 ].

The PME is performed through clinical examinations, anamnesis, general and specific laboratory tests, according to the function developed by each worker. In addition, the occupational physician must adapt the exams to the particularities of each case, for example, people with disabilities or people who work with noise and may experience deafness caused by this fact. The result of the PME is not given by score or a question of approve or disapprove workers, it is related to the early diagnosis of health problems [ 6 ].

It is noteworthy that the information generated during the expertise act are important indicators of worker's health, privileged instruments for the construction of the morbidity and mortality profile of public servants, which will help to conduct the development of health promotion actions, since the expert databases issue a variety of data on the most prevalent diseases and the professionals who get sick [ 7 ].

It is of great importance to deepen the study in relation to the health of the federal public servant, considering the need to research, know and analyze the determining and conditioning factors of health problems related to processes and work environments. In this way, it is important to analyze workers' health indicators, which are reflections of the real health conditions of the server, with the objective of guiding managers in the planning and control of activities, in addition to allowing deductions regarding the effects of decisions and their results.

From this perspective, this study aimed to evaluate and describe occupational health indicators focusing on the Official Health Expertise and PME of federal public servants, including professors from the institution and administrative technicians from the education sector of the Federal University of Rio Grande do Norte.

Materials and methods

This is a cross-sectional, retrospective study with a quantitative approach, where secondary data were obtained regarding PME and official health expertise, specifically the SIAPE HEALTH module of federal public servants of a public institution of higher education in Brazil.

The information contained in this system is federal level and is entered by the experts who perform the exams, uploading them directly into the system, enabling access to the information by users. For the study, secondary and aggregated data from the SIAPE SAÚDE system database were evaluated, as well as management reports made available by the SIASS Unit (Subsistema Integrado de Atenção à Saúde do Servidor) from UFRN, responsible for storing such data.

The study was carried out at the Federal University of Rio Grande do Norte, Central Campus, especially at the Directorate of Attention to Servant Health (DAS), where the SIASS Unit is located, the latter being responsible for coordinating actions in attention to the health of the institution's servants, specifically, the performance of the Periodic Medical Examination and the Official Health Survey, objects of this study.

The period chosen for the study was from 2011 to 2015. The preference for this time interval was justified by the fact that the year 2011 marks the beginning of the PME through the computerized system SIAPE HEALTH, and the end of the study period in 2015 characterizes five complete years and the historical nature of epidemiological studies.

The population chosen for the study can be divided into levels of education, the teachers, technical-administrative in education, higher level positions are level E, while the technical-administrative in education, middle and basic level positions are levels C and D.

The official health expertise and the PME were used as a dependent variable. For each indicator, independent variables were selected: a) Official Health Expertise: gender, age, position, number of active statutory employees away, number of days of leave and number of days away; and b) PME: Gender, age, position, ethnicity, smoking, physical activity, BMI, hypertension, diabetes mellitus, dyslipidemia, spinal pain, inadequate furniture, inadequate lighting, likes what you do, good relationship with the boss, good relationship with colleagues and fast pace. In addition, the following indicators were observed: Absence Severity Index (IGA), Medical Frequency Leave (FML), Frequency of Workers on Sick Leave (FWML) and Absenteeism Duration Index (IDA), as recommended by the Permanent Commission and International Association on Occupational Health [ 8 ] and the authors Hensing et al. [ 9 ].

The information was obtained from Microsoft Excel spreadsheets, being possible to organize and sort the variables into categories. Then, the data were exported and analyzed in the software Statistical Package for the Social Science (SPSS). Relative and absolute frequency distribution was used for categorical variables, as well as measures of central tendency (average), measures of dispersion (standard deviation), and student's t-test for quantitative variables.

For data analysis, the chi-square test and the calculation of the odds ratio were used for correlation of the indicators, adopting a confidence interval of 95% and a significance level of 5% ( p  < 0.05) for all tests.

Concerning the ethical aspects, the project was submitted to the Research Ethics Committee of Federal University of Rio Grande do Norte where it was appraised and subsequently approved under opinion no. 1.707.691, from the principles of ethical and legal aspects that govern scientific research on human beings, as recommended by Resolution no. 466/12 [ 10 ], and the principles expressed in the Declaration of Helsinki.

The results showed that there were 4,293 (35%) departures from administrative records and 7,946 (65%) absences from work granted by expert examination.

This expert examination is a procedure carried out by a medical expert, whose function is to identify if there is the presence of an illness or to identify if there has been an accident that has made you totally or partially, temporarily, or permanently unable to perform your professional activities [ 11 ]. The magnitude of these absences can be portrayed when we calculate the sum of lost work time over the five years, which generated 179,916 days of absenteeism due to illness.

Data regarding the sociodemographic characteristics of the studied population revealed that 67.9% (8,312) of the departures occurred in female workers and, for males, 32.1% (3,927). Regarding the age group, 34.6% (4,234) of the licenses were approved for workers between 51 and 60 years old, 24.0% (2,934) from 41 to 50 years, 19.2% (2,355) from 31 to 40 years, 11.8% (1,449) from 18 to 30 years, and 10.4% (1,267) over 60 years.

In relation to the post variable, the number of workers occupying the position of administrative technician in education levels C and D predominated, with a prevalence of 62.2% (4,941), while 23.8% (1,889) workers were in higher-level positions.

Figure  1 shows the absence of workers at work due to health care in the period from 2011 to 2015. It is noteworthy that there is an increase between 2011 and 2013, when there is a peak of 7.1 days not worked. The following years show an oscillation, but with a tendency for growth.

Source: Elaborated by the Authors

Indicators of absenteeism, 2011–2015. Natal/RN, Brazel, 2017. Legend IGA = Absenteeism Severity Index; FLM = Frequency of Medical Licence; IDA = Absenteeism Duration Index; FTLM = Frequency of Workers on Medical Licence.

In this sense, it is also relevant to present the individual absence duration, according to the cause of illness, in order to facilitate the adoption of specific measures focused on the pathologies with the greatest impact on lost days of work. Figure  2 shows the IDA according to each International Classification of Diseases (ICD), 10 chapter, and the highest indexes refer to neoplasms (45.64), mental disorders (32.40), congenital malformations (27.00), and diseases of the circulatory system (23.96), respectively. These findings reveal that absences of longer duration were caused by pathologies of a chronic non-transmissible nature, except for causes of absences in chapter XVII of ICD-10.

Source: Elaborated by the author

Distribution of IDA, 2011–2015. Natal/RN, Brazil, 2017. Legend: C = ICD.10 chapter.

Figure  3 presents the results of this study regarding the adherence of the workers to the Periodic Medical Exam (PME), considering the historical series from 2011 to 2015, when an average of 4,362 workers were called.

Source: Elaborated by the authors

Distribution of call, adhesion, non-adhesion, and coverage ratio to PME, 2011–2015. Natal/RN, Brazil, 2017.

The Periodic Medical Exam consists of the periodic clinical and laboratorial evaluation of the worker, due to the existing risks in the work environment and occupational or professional diseases. The PME foresees the adoption of prevention, tracking, and early diagnosis measures for work-related diseases, besides those more prevalent in the general population, such as diabetes mellitus, hypertension, neoplasms, dyslipidemias, and ophthalmologic diseases. Also, the PME will be carried out during working hours, without any burden or need for compensating schedules on the part of the employees. It is important to point out that absenteeism is taken into consideration only due to the worker's personal illness, and this diagnosis cannot be related to someone in the employee's care.

Regarding the operationalization for the PME, it is important to mention that at the moment the server is called for the evaluation of occupational health, through personal e-mail, he/she must fill out the consent form as a way to prove the agreement to participate in periodic medical examinations. Thus, going from the situation "INVITED" to "CONFIRMED". It is worth pointing out the importance and potential of the PME, once it allows the early identification of risk factors for getting sick, as well as the construction of collective diagnoses in the Worker's Health area, which makes this action a health management instrument, for monitoring the health situation and work conditions, and the subsidies for interventions to improve the quality of life of the workers.

It can be observed that the call-up ratio increased by 42.0% from 2011 (0.49) to 2012 (0.91). From the year 2013 (0.84), there were oscillations characterized by drop and growth in the calls.

As for non-adherence, in 2012, there was a decrease, and in 2013 (0.78), 2014 (0.8), and 2015 (0.86), there was an increase in the results, characterizing a relevant increase of 15. 0% between the years of 2011 (0.71) and 2015 (0.86).

About PME membership, it is clear that growth occurred only in 2012 (0.35). Then, the index decreased throughout the series, namely: 2013 (0.22), 2014 (0.2) and 2015 (0.14), which explains the non-adherence data, that comprehends the number of called servers that didn't do the PME in the analyzed year, having as reference the total number of UFRN's servers summoned in the evaluated year as being an unfavorable reality in relation to the PME recommendation. This may be related to factors such as excessive work activities of workers, periodic examinations performed through private health insurance, and to the lack of recognition of the importance of PME by workers.

The coverage ratio of the PME represents the servers that have concluded the PME and those that have an updated Occupational Health Certificate in the analyzed year, with the total number of servers at UFRN in the analyzed period as a reference. This coverage ratio increased significantly in the year 2012 (0.4), showing a growth of 26.0% in relation to 2011. Thereafter, the ratio decreased, with an average of 0.26 between the years of 2013 (0.33), 2014 (0.26) and 2015 (0.2), as shown in Fig.  3 .

In the list of risk factors, health indicators of different epidemiological natures were analyzed. Among them, those related to cardiovascular diseases and occupational risk factors, such as the existence of inadequate work furniture and accelerated work rhythm, are presented in Tables 1 and 2 .

In the list of chronic pathologies covering categories II and III of the Schilling classification, the most common causes of morbidity among workers are: Systemic Arterial Hypertension (SAH), chronic respiratory diseases, diseases of the locomotor system and mental disorders. These are pathologies of multiple etiology in which work is considered a risk factor associated with the increased probability of occurrence of these diseases [ 12 ]. Thus, the present study highlights cardiovascular diseases, especially SAH.

Table 1 shows the distribution of the aforementioned risk factors associated with SAH. It is pointed out that 60.6% (3,143) of the workers that performed the EMP presented non-ideal weight; 58.7% (3,044) practiced some type of physical activity; 70.8% (3,670) denied alcohol use; 96.5% (5.005) did not smoke; 93.9% (4,870) did not have diabetes mellitus (DM); and 66.6% (3,453) did not have dyslipidemia. The association between hypertension and all correlated variables was significant at p  < 0.001. As for the Odds Ratio calculation, we considered the hypertension disease in relation to the following variables: BMI, sedentary lifestyle, alcoholism, smoking, diabetes, and dyslipidemia. The OR calculation does not imply a cause-and-effect relationship, it only suggests that there is an association.

In Table 2 , it is possible to observe that 35.9% of the interviewed workers are not adequate for their activities. In addition, 16.4% report loud noise in the workplace and 27.8% do not have adequate lighting. Social factors were also obtained, noting that 3.7% of the workers surveyed say they do not have a good relationship with their co-workers, while 4.4% do not have a good relationship with their boss and 2.5% show dissatisfaction with what they are doing.

It should be noted that absenteeism is a term used to denote the employee's absence from work [ 13 ]. The International Organization of Work (OIT) defines it as the period of absence of work that is accepted as attributable to an incapacity of the individual, except for that derived from normal pregnancy or prison [ 14 ].

According to the report of the National Audit Office [ 15 ], in the city of Guernsey, United Kingdom, approximately 3.8% of working time was lost due to illness, and civil workers became sick for an average of 8.7 days in 2005. In Chile, health workers belong to the category that has the highest rates of disability due to illness, with 14.3 days of absence per worker per year; unlike the university workers, who present 6 days of work lost per year, similar to the results of this research [ 16 ]. These findings highlight the data shown in Fig.  1 .

Studies found an average of 7.5 lost days of work per year per worker in the nursing area of a university hospital in Brazil [ 17 ]. Santos and Mattos [ 18 ] observed 9.3 days of absenteeism due to disease for each municipal worker of the city of Porto Alegre in 2005. The studies reported 9.1 and 10.3 days of absence due to illness for each public worker of the municipalities of Goiânia and São Paulo, respectively [ 19 , 20 ].

The worker and financial conditions can cause work accidents and environmental conditions, increase work capacity and the market, which may exclude work and consumption capacity. The employee is also hit with productivity, lack of manpower, loss of manpower and/or equipment damage [ 21 ].

The World Health Organization (WHO) estimates about 36 million annual deaths from Chronic Non-Communicable Diseases (NCDs), composed mainly of circulatory diseases, neoplasms, chronic respiratory diseases and Diabetes Mellitus (DM), which have risk factors.—smoking, alcohol, physical inactivity, unhealthy diet and obesity—modifiable in common [ 22 , 23 ].

An important characteristic of epidemiological patterns in Brazil concerns the changes in the composition of morbidity and mortality by groups of causes. Thus, the high prevalence of deaths from infectious and parasitic diseases, present at the beginning of the twentieth century, gave way to NCDs and injuries related to accidents and violence [ 24 ].

In Brazil, according to the Ministry of Health [ 23 ], NCDs are among the main causes of hospital admissions, and the financial cost to the Unified Health System (SUS) represents a growing impact. Estimates for Brazil suggest that the loss of productivity at work and the decrease in family income resulting from chronic pathologies such as diabetes, heart disease and stroke involved spending of US$ 4.18 billion between 2006 and 2015 [ 25 ].

The researchers Moura, Carvalho and Silva (2007) [ 26 ] carried out a study on the repercussion of CNCDs in the granting of social security benefits by the National Institute of Social Security (INSS) and identified musculoskeletal and circulatory system diseases as the main causes for granting sick pay.

This reality is also revealed among public servants in several studies that present the main groups of causes of sick leave for this category of workers, with high rates of absenteeism due to diseases of the musculoskeletal system and connective tissue, mental and behavioral disorders, chronic respiratory diseases and circulatory system diseases [ 7 , 19 , 27 , 28 , 29 , 30 , 31 , 32 , 33 ].

The implementation of strategies to reduce absenteeism is a great challenge for employers, and it is necessary to analyze the events in the workplace to delineate situational diagnoses and guarantee actions to promote worker health. For the authors, the change in the epidemiological profile of illness and the increase in the prevalence of chronic diseases, as shown in Fig.  2 , reveal concern for the global scenario regarding the impact of these diseases on workers' health, due to the growth in the number of lost workdays [ 21 ].

The epidemiological profile of morbidity and mortality in Brazilian workers is characterized by the coexistence of diseases that have an intrinsic relation with working conditions, and in addition, diseases common to the population are observed, which are not etiologically related to the work [ 3 ]. In this reality, it is important to emphasize the importance of the employees performing the Periodic Medical Examination (PME), for the prevention and/or possible early detection of the pathologies that generate the greatest impact on the lost days of work, highlighting the neoplasms [ 22 ].

The importance of performing the PME in the screening of risk factors for chronic non-communicable diseases, such as dyslipidemia, sedentary lifestyle, obesity, arterial hypertension, diabetes mellitus, alcoholism, and smoking is highlighted. In addition, through the PME, the workers will be guided and sent to participate in the various health promotion programs offered by the institution. Through these strategies, it is possible to reduce the prevalence of diseases of the circulatory system, another important cause of absenteeism, as shown in Fig.  2 .

As for Fig.  3 , which shows data on the PME, despite weaknesses, it is evident that the most satisfactory results of PME adherence occurred in the year 2012, a time when workers composed the Integrated Subsystem Unit (SIASS in Portuguese), as well as the constant discussion in forums, national meetings, and events related to the PASS, in a context of articulation in defense of the strengthening of the actions of attention to workers' health, which may have contributed to the results [ 23 , 24 , 25 ].

On the other hand, the situational diagnosis of low PME adherence throughout the historical series was possibly influenced by the recent history of PASS construction and the negative impact of the lack of structuring, planning, and evaluation of the actions. Plus, the largest investments and training, by the Ministry of Planning of Brazil, were related to the expert area which reflects as the main activity of the PASS [ 4 ].

The implementation of actions of health surveillance and promotion are major challenges for the consolidation of SIASS, since it is still a recent practice to promote health in public sector workplaces. It is necessary to elaborate indicators to support the actions and allow the evaluation of the results, considering that the information generated through indicators consolidates the control and planning of the organizational processes, as well as supports the decision making [ 25 , 26 ].

This is a prevention tool that has been implemented in Brazil with workers from federal agencies to identify risk factors associated with future illnesses. This approach in the federal public service has had an impact on the quality of preventive health, avoiding the removal of workers from their workplace for a cause classified as a possible prevention of this disease. Another aspect is the increasing number of absences that have been occurring in recent years, that is, the numbers of absenteeism due to physical and mental illnesses, a fact that occurs at increasingly younger workers' ages, which reveals the need for special attention and protector follow-up in their quality of life.

The results presented in this study deserve attention and can contribute to discussions between the professionals of the technical team and managers of the SIASS Unit and PROGESP/UFRN, as it is believed that the production of knowledge about the subject under study can provide the University with instruments, as well as other institutions at the federal public service level, through the PME as an indicator for planning and evaluating Occupational Health actions.

Thus, continuous investments in health policies aimed at public servants are suggested, which contributes to the reduction of illness and early retirement, resulting from disability. In this sense, investment in research that allows a better understanding of the relationship between health and work in the public service is also recommended.

It should be noted that this study had some limitations, as the use of self-reported data by employees who completed the PME may underestimate or overestimate the results presented.

In order to meet the proposed objective, there was the occurrence of neoplasms, mental disorders, and diseases of the circulatory system in terms of duration of absenteeism (IDA), which were the causes of the absences with a longer duration, which ratifies the epidemiological importance and the impact of non-communicable chronic diseases on workers' health. The gravity index of absenteeism revealed that the number of lost days of work per year per worker increased over the historical series, as well as the frequency of absences.

With regard to the epidemiological profile of the employees who underwent the PME throughout the historical series, it was possible to identify a significant prevalence of overweight in the population. The working conditions were considered satisfactory in the perception of the workers. It should be noted that this study presented some limitations, since the use of self-reported data by the workers may underestimate or overestimate the presented results.

Also observed through this study is the need to maintain and strengthen the PASS with emphasis on surveillance, aiming at the promotion and protection of the health of the workers, based on the elaboration of the epidemiological health profile and, consequently, the implementation of strategies of positive impact for OHS.

Availability of data and materials

The datasets used and/or analysed during the current study available from the corresponding author on reasonable request.

Abbreviations

International Classification of Diseases 

Diabetes mellitus

Frequency of Medical Licence

Frequency of Workers on Medical Licence

Occupational Health and Safety

Absenteeism Duration Index

Absence Severity Index

International Organization of Work

Occupational Safety and Health Care Policy

Periodic Medical Examinations

Systemic Arterial Hypertension

Integrated Subsystem Unit

Statistical Package for Social Science

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This study was partially funded by the Coordination for the Improvement of Higher Education Personnel—Brazil (CAPES)—Financial Code 001. Funders have no role in the study design, data collection and analysis, publication decision or preparation of the manuscript.

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Lídia Maria Costa Araújo Magalhães

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Ketyllem Tayanne da Silva Costa & Gustavo Nepomuceno Capistrano

Nursing Student, Federal University of Rio Grande Do Norte, Natal, Brazil

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L.M.C.A.M. was the principal investigator of the project and responsible for administration, coordination, and funding acquisition. L.M.C.A.M. and F.B.A. were involved in conceptualization and in the study design. L.M.C.A.M. carried out the investigation. L.M.C.A.M., K.T.S.C., G.N.C. and M.D.L. were involved in formal analysis and data curation and wrote the main manuscript text. F.B.A. reviewed and edited the manuscript. All authors reviewed the manuscript. The author(s) read and approved the final manuscript.

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Magalhães, L.M.C.A., Silva Costa, K.T., Capistrano, G.N. et al. A study on occupational health and safety. BMC Public Health 22 , 2186 (2022). https://doi.org/10.1186/s12889-022-14584-w

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Electricity workers are facing significant electrical hazards, preventive actions are important to decrease these hazards. This study Aimed to evaluate the effect of preventive program on electricity workers' awareness regarding occupational health hazards. Design: A quasi experimental design was used. Setting: This study was carried out at two districts of Qalubiya electricity sector. Sample: All electricity workers from the above mentioned settings were included. There were 78workers. Tools: I-structured interviewing questionnaire to determine electricity workers' socio-demographic characteristics, exposure to electricity hazards, knowledge regarding electricity hazards and its prevention and practices of workers regarding precaution to avoid electricity hazards. Results: The current study results revealed that, 35.9% of participants aged from 30 to 39 years old, 57.7% of them were experienced from 1 to 10 years, 43.6% of workers were exposed to injury during their current work, none of workers had good total knowledge scores regarding electricity hazards, and only 2.6% of workers had high satisfactory total practices score preprogram. While, after the program implementation, 89.7% of them had good total knowledge score, and high satisfactory total practices score increased to 88.5%. Conclusion: This study concluded that there were a significant improvement in electricity workers' knowledge and practices regarding prevention of electricity health hazards. Recommendation: ongoing periodic health education programs carried out by the occupational health nurse to raise the awareness of electricity workers about electrical health hazards and periodic training on hazards prevention and electrical safety as well as first aids should be sustained for electricity workers.

Fairuz Romli

Statistics have shown that the number of fatality and permanent disablement cases due to accident at construction sites in Malaysia is one of the highest in comparison to other sectors. Therefore, there is an urgent need to mitigate this problem. In general, there are three basic steps that should be taken to ensure the safe and conducive working conditions: identifying the hazard, assessing the risk and controlling the risk. The implementation of effective hazards control methods may require different approaches due to changing working environment at the construction sites. This project is intended to identify and highlight the common hazards at construction sites today. The data collection was carried out through site investigation using a checklist forms and interview in construction. The study determines fourteen (14) types of work at building construction sites and their common hazards. The works include wood carpenter, bar bender, excavation work, boring rig, hacking and drill, crane work, roof work, bricks installation, scaffolding, electric welding, general activity, mechanical lifting, concreting and electrical equipment usage. The study was conducted at a building construction site and the results showed that the most common hazards for the project around the study area are associated with protective clothing, manual handling and roof work.

Prabir Datta

vivien how , Karmegam Karuppiah

Objective: This is a conceptual paper to describe the arrangements of adequate first aid services in case of injury or illness by integrating the existing guidelines of occupation safety and health, Malaysia. Discussion: The Occupational Safety and Health Act (OSHA) 1994 provide the legislative framework to promote, stimulate and encourage high standards of safety and health at work. Due to the self-regulation schemes applied under this act, OSH relevant guidelines have been introduced to tackle different OSH issues at the workplace. Two of the guidelines discuss in this paper are Guidelines for Hazard Identification, Risk Assessment and Risk Control (HIRARC) (2008) and Guidelines on First-Aid in the Workplace (2004). The gaps exists as how to complementary two existing guidelines to enhance the first aid assessment at the workplace. Conclusion: In summary, this paper recommends on the necessary to conduct a comprehensive workplace first aid assessment and suggests to a detailed curriculum which could help the first aider at the workplace competencies to provide care while considering the workplace hazards

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Advancing social justice, promoting decent work ILO is a specialized agency of the United Nations

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Occupational safety and health

This policy brief is part of the ILO Just Transition Policy Briefs series and is intended to present the linkages between just transition and occupational safety and health (OSH), providing stakeholders with information and recommendations for implementation.

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Local News | What we know about various investigations…

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Local News | What we know about various investigations stemming from Key Bridge collapse

The 984-foot Dali weighed some 112,000 tons loaded with containers when it left the Port of Baltimore early in the morning of March 26. The ship lost all power while approaching the bridge and drifted into one of its support columns, toppling the span .

Here’s what we know about the various investigations:

National Transportation Safety Board

The NTSB’s Office of Marine Safety and Office of Highway Safety are examining what went wrong aboard the Dali and the structural components of the bridge, respectively.

The agency investigates through the lens of safety and with the goal of preventing similar tragedies from occurring, not holding anyone liable.

Investigators have searched the Dali’s engine room for answers about why the vessel lost power. They brought in representatives from the ship’s manufacturer, Hyundai, to help extract data from the electrical system and circuit breakers.

Alarms indicating an inconsistent power supply to refrigerated containers sounded on the Dali before it left the port, according to the City of Baltimore’s lawsuit  against the ship’s Singaporean owner and manager.

NTSB investigators have interviewed members of the Dali’s predominantly Indian crew and the Maryland pilots who boarded the vessel to guide it out of port and under the Key Bridge safely. They also questioned Coast Guard watch standers and took statements from tugboat operators.

Two tugs guided the Dali away from the port’s Seagirt Marine Terminal but cast off once the ship was in the main McHenry shipping channel.

NTSB Chair Jennifer Homendy told senators in April that she expected the agency’s “preliminary report will not be out until the first week of May.” The NTSB is still preparing that report but expects to announce the release date “in the coming weeks,” spokesman Peter C. Knudson said last week.

The preliminary report outlines the agency’s factual findings. A final report, which comes one to two years after an investigation begins, includes conclusions and safety recommendations.

The Coast Guard

Coast Guard officials convened a Marine Board of Investigation, tasking investigators with “thoroughly” examining the ship crash “in accordance with all applicable statutory and regulator mandates,” according to a March 26 memorandum outlining the investigation. The board has to submit a report to the Coast Guard Commandant with its findings, conclusions and recommendations within a year.

Petty Officer Michael Himes described the Marine Board investigation as “complementary” to the NTSB investigation, saying the NTSB was designated as the lead agency. He declined to further comment.

At a news conference the day after the bridge collapse , Homendy credited the Coast Guard with boarding the Dali to download information from its voyage data recorder — a simplified version of an aircraft  “black box” — and providing it to the NTSB for further analysis.

Describing the Coast Guard as “the regulator of U.S. maritime operations,” Knudson said the NTSB relies on the Coast Guard to provide a range of data for its investigation, such as information about mariner licenses and vessel operations, ship inspection and violation history, as well as local knowledge of the port.

“In addition, the USCG provides significant on-scene assistance, such as travel to vessels at anchor or assisting with interviews of crew members, and general coordination of on-scene activities,” Knudson said.

It’s common for those agencies to work together in a maritime accident investigation, said Thomas Roth-Roffy, a former NTSB investigator of almost 20 years.

He said it’s possible the NTSB took the lead in this case because it’s a multimodal investigation involving a bridge, highway and ship.

In a phone interview, Roth-Roffy harked back to investigations he led, such as the NTSB’s probe into the U.S.-flagged cargo vessel SS El Faro, which lost propulsion in the middle of a hurricane in 2015 and sank near the Bahamas along with its 33-person crew

“The Coast Guard was more than just another party in the investigation,” he said. “They were a close partner.”

While the agencies’ investigations may be complementary, Roth-Roffy said, the Coast Guard, unlike the NTSB, can enforce violations of marine regulations or law.

“Conclusions and recommendations concerning commendatory actions or misconduct that would warrant further inquiry shall be referred by separate correspondence to the cognizant District Commander for consideration and action,” the Coast Guard’s investigative memo says.

The FBI was at the scene of the bridge collapse the day it happened, but its involvement escalated April 15, when agents boarded the Dali to serve a search warrant.

The exact scope of the FBI’s investigation into the Key Bridge collapse is unclear. It’s also not known what agents confiscated while aboard.

Before federal agents serve search warrants, they have to articulate in writing their suspicion that a crime occurred. Only if the evidence meets the legal standard of “probable cause” will a judge sign off on a search warrant.

It’s common for the paperwork associated with search warrants to remain under seal in court records long into an investigation and any subsequent criminal case.

The FBI likely is looking at whether a pre-Civil War statute known as “seaman’s manslaughter,” which has been applied in past American maritime disasters, is applicable here.

That law says neglect or misconduct leading to death by the ship officer is punishable by up to 10 years in prison. It also applies to the companies that own and charter vessels when their “fraud, neglect, connivance, misconduct, or violation of law” leads to death.

FBI agents typically do not investigate in a vacuum, but in collaboration with prosecutors from the Maryland U.S. Attorney’s Office or from another branch of the Department of Justice.

“Often in these high-profile matters there would be significant involvement by prosecutors in Washington in addition to the local U.S. attorneys,” former Deputy U.S. Attorney General and Maryland U.S. Attorney Rod Rosenstein said in an April interview after agents raided the ship.

Maryland Occupational Safety and Health

Seven construction workers from Brawner Builders Inc. were on the Key Bridge, taking a break from filling potholes on Interstate 695, when the Dali struck. A state inspector who also was present was able to get to part of the span that didn’t collapse, while one of the construction workers survived by clinging to a piece of debris.

The six others died. Five of their bodies have been recovered .

Maryland Occupational Safety and Health, or MOSH, a branch of the state Department of Labor that investigates workplace injuries and deaths, launched an investigation the same day workers were sent plummeting into the river.

A MOSH spokesperson declined to comment, citing the agency’s ongoing investigation.

William F. Alcarese, a former safety officer with MOSH and its federal counterpart, the Occupational Safety and Health Administration, said such workplace probes look at whether employers abided by regulations designed to keep their workers safe.

He believes investigators will be looking at whether there was an emergency plan in place for the Brawner employees working on the bridge.

“In this case, you had workers on the bridge, was there a communication plan in place? Was there a policy in place for communication?” said Alcarese, noting that bridges are often closed because of inclement weather, such as high winds. “It’s like trenches: Most trenches don’t cave in, but when one does, it can be catastrophic. That’s why there are plans in place.”

Alcarese also pointed to a federal occupational safety regulation that requires employers who put workers over or adjacent to water have a “lifesaving skiff … immediately available.”

Jeffrey Pritzker, executive vice president of Brawner, declined to say whether the company had a rescue boat in the water, citing the MOSH investigation.

“I don’t know that Brawner Builders could’ve taken any more action than that which was taken the evening of the tragedy. Brawner’s safety protocols were consistent with those taken over the last 40 years with similar work,” Pritzker said. “Who would have ever anticipated that a bridge would come down?”

Alcarese expects the workplace investigation to examine the roles of Brawner and the state, which contracted the company.

Officials were quick to praise the work of Maryland transportation police officers who swiftly blocked traffic from going onto the bridge after receiving a mayday call about the drifting ship from the pilot. But attorneys for the families of two victims and one survivor say the workers weren’t notified .

Transportation police, the Maryland Department of Transportation and the Maryland Port Authority declined to say whether they are conducting reviews in response to the collapse, citing the Dali’s owner and manager’s civil court action to clear themselves of liability related to the disaster.

“The pending litigation related to the Key Bridge collapse (limitation of liability action) and anticipated future litigation prevents the Maryland Department of Transportation, the Maryland Transportation Authority, and the Maryland Port Administration from disclosing the existence of investigations or reviews,” the agencies said in a joint statement.

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