Making a Difference for Safety: A Case Study

One of my clients recently mentioned that when safety and risk control is practiced in a more forward-thinking way, it can be hard for the uninitiated to understand what that sort of work looks like. There is enough entrenched perception out there of safety as all about rules and requirements, defined exclusively by OSHA, and embodied by inspections and poorly-produced safety training videos, that examples of a better approach are needed. With that in mind, here is a case study of one example of a real-world project for the improvement of the risk and safety picture in an organization. I will periodically offer additional case studies to shed additional light on how safety and risk approaches can be improved in practice.

Situation
A medium-sized light manufacturing operation (400 employees at three locations) with a full-time safety manager and three safety coordinators (one per site, with safety as a collateral responsibility along with human resources and training duties). The operation had a well-structured traditional safety program in place, and good participation on compliance-related matters overall. The major point of concern was an unfavorable trend of injuries related to lifting and manual material handling, with some high-cost claims and a significant number of lost time cases.

Intervention
Because the company had a fairly complete and well-functioning safety program, a targeted accident prevention approach was selected, related to manual material handling issues. Injuries in the selected category included a large number of lower (lumbar) back issues, as well some neck and shoulder injures. A steering team was selected to do some analysis of the numbers, narratives, accident investigations, and ongoing work activities related to the issue. The steering team was charged with working on both the process-related and problem-solving aspects of the issue. In the course of the team’s analysis and information gathering, as well as through joint discussions with senior management, it was decided to implement a practical ergonomics approach to soft tissue injury prevention. This approach was set up to be led by the employee team, with a management liaison assigned to guide the team and be a connection to department heads and facility leadership.

Choosing an Approach for Musculoskeletal Injury Prevention
The team considered a number of systems for ergonomic approaches and musculoskeletal injury prevention. These approaches had different “headlines,” and were variously billed as:
– Back safety
– Back injury prevention
– Soft tissue injury prevention
– Musculoskeletal injury prevention
– Musculoskeletal disorder (MSD) prevention
– Lifting safety
– Manual material handling safety
– Industrial athletics
– Ergonomics, including the variants of “practical ergonomics,” “occupational biomechanics,” and “applied ergonomics”

Some of these names are applied by the providers of the various approaches with great care, and other names are

Types of Approaches Considered
The main types of approaches evaluated included:

– Traditional approaches that focused on classroom training, posters, videos and rules for workplace activity.

– Topic-based grouped packages of video, multimedia, and interactive material, that included material (mostly aimed at safe lifting and back injury prevention) focusing on task setup and lifting techniques.

– Onsite “school” approaches where trainers are brought in to lead the workforce through training experiences related to back injury prevention. Several of these approaches included rather extensive training with a large amount of material and in-depth in-class exercises. Several of the offerings also included a certification or certificate of completion component.

– “System” approaches where a set of techniques (often with proprietary names, slogans, and support materials) were accompanied by consultation with ergonomists or ergonomics specialists

– Ergonomic evaluation instruments that encapsulate a group of factors that impact ergonomic risk and provide for observation and scoring of work activities with numerical scoring

– Holistic approaches based on varied functional disciplines, ranging from martial arts, to yoga, to dance, to athletics.

– Engineering-centered approaches that place primary (or even exclusive) emphasis on facility, equipment, tools, materials, and job design factors.

– Post-incident topic-independent analysis, such as root cause analysis, fault tree, and cause train analysis

Exalted Methodology
One of the interesting results of this examination and selection process was the relatively common contention among solution providers that their particular methodology was distinctively superior to other approaches. After much examination of the relative differences in methodologies and the

A Hybrid Approach
One of the key takeaways we experienced from the solution selection process was that among varied methods, there were various aspects from several different ones that had particular merit given the situation the client group faced, but there were some approach elements from differing methods that were judged to be a better fit. The result of in-depth examination and analysis was a decision to combine elements of several of the approaches, in a customized fashion with consideration of the unique characteristics of the workplaces in question.

Structure and Sequence
Though the details of the approach for this client are worth exploring, those details will require a separate article. Instead, we’ll focus for the moment on the basic structure and implementation steps employed.

– First, claims, first aid, near-miss, accident investigation, and behavioral observation data was compiled and analyzed.

– Second, the existing safety climate and safety management structure was analyzed.

– Third, engineering factors and job design were evaluated.

– Fourth, a physical technique improvement approach was put into place, including baseline techniques, means to establish checkpoints and job aids, and field reinforcement and adjustments

– Fifth, a separate risk factor “quick check” was rolled out, using different underpinnings than the physical technique improvement above. The difference in model concept turned out to be a significant positive benefit to the this overall approach, giving engaged and motivated employees and their managers a chance to confront the idea that there are different ways to approach complex problems, and that deep improvement endeavors fare much better when they are not viewed as rote exercises.

– Sixth, a continuous improvement team was assembled with membership distinct from the steering committee, with the goal of keeping close tabs on how the process elements of the intervention work, and what extended and expanded elements were right to consider implementing

Results
This particular intervention resulted in a very significant drop in associated claims in the affected categories, across all sites. Though the details of the intervention prevent any simplistic summary of how the process worked, one key thread was the coupling of a sense of ownership and participation from the workforce with concrete and sustained reduction of claims frequency and severity. Some of these details will be covered in future articles, but the main takeaway from this high-level view is that selecting a good strategy, getting the right people involved, providing regular guidance, and securing the active support of upper management provide a solid basis for serious safety improvements.

Internet Warnings: Cell Phone Camera Risks

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You may have seen a warning circulating via social media recently about the dangers of taking and posting photos with camera phones.

This particular warning is pretty similar to many that come along regularly, and happens to be pretty much true. (As opposed to the many, many, warning notices that end up being mostly or even completely false. Even though this particular one is based on fact, though, the prevalence and implications of the risk can end up being hard to really discern the way that the threat is presented.

Here are some issues with warnings like this:

1. They may not be timely. The linked video in the circulating warning turns out to be almost four years old. The issue and related facts are still valid, but this sort of warning gives the impression that this is a new threat when it is has been in existence in its current form for at least five years.

2. They exaggerate one aspect of an issue beyond what is realistic. The news stories focus on how camera phones can embed location data in the photo file that could then be used to identify the location where it is taken. But what the news stories neglect to cover is why and under what circumstances such stalking is likely to take place. Certainly it is true that someone could be targeted completely at random, but that is not what is seen in most accounts of the abuses of this type of technology. It is much more common for someone to be targeted specifically, and often this is based on prior relationships.

3. They don’t mention the broader concepts of security online that can add to or reduce online risks far beyond this one issue. In particular, being careful about what you post online in general, and what security settings use use for the various social media sites that you visit. You can take steps to better secure your online presence, and get a better sense of the relative risks online that you need to consider. Stay Safe Online is an organization that provides a good set of tools and information about security online, as well as helping people understand that various dimensions of security online. Google has a pretty good overview of online security as well.  It’s also true that some very popular sites (yes, Facebook!) change things often enough that you need to check and update your settings regularly to ensure that you maintain your desired level of security. By the way, as far as Facebook security goes,  Lifehacker’s guide is regularly updated and a great place to start. Even with good settings, one fact remains: the only way to have something stay absolutely secure is to never post it online in the first place.

So I suggest that the next time you have a warning forwarded to you that implores you to “share it with everyone you know!”, that you check it out first. Snopes is a pioneer in this area and has good references for most of their articles. About.com also has good urban legends and hoax reference pages. There several others, as well. An interesting side note is that there was a forwarded e-mail a few years ago that sought to discredit Snopes, and the email itself ended up discredited by another source.

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If you want to disable location data posting from your phone, here are the steps:

On Android:
Open camera app
Open “Settings”
Scroll down to “GPS” and select “off”

On iPhone:
Go to “Settings”
Under that, Go to “General”
Under that, Go to “Location Services”
Under that, go to “Camera” and select “Off”

On Windows Phone:
Select “Settings”
Under that, select “Applications”
Under that, select “Pictures and Camera”
Turn “Include GPS Data” to “Off”

But more importantly:

1. Check out warnings before you pass them along

2. Know the basic steps to be safer online

3. Consider both the big picture and specific apps and networks you frequent

4. Be careful about what you post and where

5. Limit and supervise your children’s activity online

That approach will be a lot more useful than just chasing the latest warning to get forwarded your way.

Risk Perspective: Foodborne Illness Prevalence

Fresh Fish at a Fish Market

Fresh Fish at a Fish Market

Why Foodborne Illnesses Matter
Foodborne Illness is a significant business hazard risk area affecting restaurants, food service, and food production operations, and many other service, hospitality, and manufacturing industries. It is also an important topic for personal risk control. Because of the importance of the issue, and how many people it touches in one way or another, it deserves repeated coverage from several angles and levels of depth.

The types and categories of foodborne illness, risk factors, signs and symptoms, prevalence, severity levels, and control measures are all worth becoming familiar with to a certain degree. That degree varies, of course, based on your business and personal connection to the issue, but we will begin with some items of near-universal applicability. To that end, let’s take a brief look at what individual foodborne illnesses are the most common and the most dangerous.

Most Common Foodborne Illnesses
(By number of cases in the U.S.)
1. Norovirus
2. Salmonella
3. Clostridium Perfringens
4. Campylobacter spp.
5. Staphylococcus Aureus

Most Dangerous Foodborne Illnesses
(By number of fatalities in the U.S.)
1. Salmonella
2. Toxoplasma Gondii
3. Listeria Monocytogenes
4. Norovirus
5. Campylobacter spp.

Bacteria Under the Mircoscope

Pathogens Under the Microscope

A Question for You

So here’s the question and the issue: If you don’t happen to work directly in the area of food safety, environmental health, or sanitation, how many of those sound familiar to you? How many do you think about related to any particular set of conditions that you see? Many people recognize two or three and have just about no sense of the rest. Did you have any sense, looking at the lists, of what sort of numbers we are talking about? Here are the numbers for 2011:

Number of Cases of Most Common Foodborne Illnesses
(Cases in the U.S., in thousands)
1. Norovirus 5400
2. Salmonella 1000
3. Clostridium Perfringens 965
4. Campylobacter spp. 845
5. Staphylococcus Aureus 241

Most Dangerous Foodborne Illnesses
(By number of fatalities in the U.S.)
1. Salmonella 378
2. Toxoplasma Gondii 327
3. Listeria Monocytogenes 255
4. Norovirus 149
5. Campylobacter spp. 76

Note:  Foodborne Illness Data from Centers for Disease Control, 2000-2008 and 2011 data.

Chef making crepes

Crepe Making

And It Makes What Difference?

Now what do those numbers mean to you? What is the relative level of danger and appropriate response? I’d suggest that most people in general, and many people in affected businesses, don’t have good answers to those two questions. We will cover some of the facts, figures, and approaches to the control of foodborne illnesses in restaurants, food service, food manufacturing, and at home. More importantly, though, is the idea that whatever your business or personal situation, you need to understand the most prominent risks you face, and have a sense of what to do about it.

Set Sail, But Be Smart About It…

“A ship in port is safe, but that’s not what ships are built for,”

The popular quote above is alternately attributed to William Shedd, James Shedd, and Rear Admiral Grace Murray Hopper. The meaning is clear and inspiring, expressing the need to venture out and face the world, and give up (near) absolute safety for the sake of achievement and worthwhile experiences. “You need to be willing to face risks” is a typical encapsulation of the sentiment of the quote, and certainly has applicability on several levels. Accepting the “Nothing ventured, nothing gained.” ethos as valuable and legitimate, let’s consider how the idea is often applied more broadly than any Admiral would support. Let’s examine some aspects of the idea behind this quote and consider the implications.

Take your ship out of port and onto the high seas…
If you have an oceangoing ship.
I recall an occasion when I was about 15, when my older brother and I took out 12 foot aluminum rowboat (with a 3-1/2 horsepower outboard motor) down to the ocean and out around the breakwater. We’d enjoyed many hours on lakes and ponds in that boat, but even 2 foot swells will pound a tiny rowboat pretty soundly.

Take your ship out of port and onto the high seas…
If you have a map and navigation equipment.
The ocean is vast, with rocks and shoals that won’t present themselves to the sailor. You’ve got to know where you are headed, how to get there, and what to avoid along the way. Add to that a way to know your position and you are on your way.

Take your ship out of port and onto the high seas…
If your ship is seaworthy.
My next door neighbor when I was growing up had a beautiful vintage 26 foot Chris Craft boat. He’d carefully refinish the wood hull regularly, maintain the engine and running gear, and keep all the onboard equipment looking and working great. He had a co-worker who wanted a boat, too, and bought an old salvaged boat to “fix up.” Trouble was, he didn’t know how to do the work as well as he thought. He didn’t understand that there was special plywood for marine applications. He’d used regular residential grade plywood to repair the hull, and it was coming apart within weeks of being in the water.

Take your ship out of port and onto the high seas…
With a good crew.
The first time I went sailing, I was the second person on a boat that took one person to handle. What I didn’t realize, though, was that there were many duties to perform, from securing and releasing lines, to dropping the center board and raising it back up, to getting out of the way of the boom when it swung around. Later, when I watched the big America’s Cup racing sailboats in action, I had a new appreciation for all the work (and teamwork) that was absolutely essential for successful sailing. And when a storm comes, the crew better know what to do without any guesswork.

Take your ship out of port and onto the high seas…
With good leadership.
Do you sail through the storm or around it? Do you tack aggressively towards the wind, or take a longer but less intense course? How often and where do you drop anchor along the way? Solid leadership gives you the best shot a successful journey.

So there you have a few examples of the story beyond the story about setting sail. We do need to leave harbor decisively, for sure. But we need to know how to give ourselves the best chance of getting to our destination rapidly and in one piece.

Acceptable Levels of Risk

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Aircraft Carrier Operations (Image courtesy of US Navy)

 

Accepting Risk?
One of the most difficult things to do in the realm of risk management and safety is to establish any sort of concrete framework for what is being deemed an acceptable level of risk overall, or acceptable risk in a particular area. It is not only a structurally and technically daunting concept, it’s also a scary one. After all, any attempt to establish some decided level of acceptable risk (beyond zero risk, which is an impossible concept, as will be discussed in another article) results in certain hazards (and their attendant outcomes) being viewed as “OK” even though those outcomes by their very nature are going to result in some sort of losses over time. The acceptance of exposure to some low level of loss over time is pretty much an absolute, but getting specific about that in terms of quantity or quality is often considered too daunting (or even crass, though the opposite is closer to true) to address, or subject to very lengthy and involved processes when there is an organizational motivation to determine that level.

Decisions Deliberate and Implicit
So here is the hard-to-deal-with truth: every organization (and individual, and family, for that matter…) is making decisions about what is an acceptable level of hazard risk in a given area every day, just not in ways that are always deliberate or obvious.  Some of the same factors that cause reluctance to explicitly accept any particular given level of risk can even work to keep the hazard risk implications out of the mind and discussions of the decision-makers, but those risk decisions are being made either way. The difference is whether the decisions are made in a conscious, deliberate, or programmed way, versus being made by default and without specific attention. Yet for the most part, implicit decisions have the same results as decisions made deliberately.

How is Risk Accepted?
When an organization chooses to set up its business in a particular way, acceptance (or rejection) of all manner of risks is part of the set of decisions that that are made. Note that even if the risk perspective is not explicitly considered, the risk picture is still affected. Some of the particular junctures that greatly affect the risk picture include decisions to:
– Engage (or not engage in) in a certain type of business
– Operate in a certain geographical location
– Build a certain type of facility
– Outfit a facility with certain fixtures, equipment, and tools
– Establish certain work practices
– Hire with certain criteria
– Train in a particular way
– Guide, oversee, and manage workers in a given way
– Engage in formal and informal discipline, incentives, and recognition
– Communicate certain information and results to workers

Risk Acceptance in Practice
Here’s an example: Restaurant chains A and B both offer a similar core menu item. This item requires a certain cut of meat as part of the recipe. Chain A decides to order their meat in the form of a larger, more complete “primal” cut that requires complex knife work by kitchen personnel to break down into final usable form. Chain B decides to get the meat already cut into recipe-ready size and shape from their supplier, so that no cutting is required.

Knife safety and cut prevention in restaurants is certainly a significant issue almost everywhere. It’s clear how the scenario above very significantly affects the risk picture, at least as far as preparation of that core menu item is considered. But it’s also quite possible that both chain A and chain B came to their respective decisions about how to order and prepare the meat with considerations other than safety and risk in mind. In the real-world environment these examples were taken from, the prominent factors actually in play centered on, in the case of chain A:
-Food cost
-Flexibility of regional supply options
-Food quality

…and in the case of chain B:
-Consistency of final product
-Reduced skill level needed for kitchen staff
-Faster prep time

You will note that neither chain had risk or safety as one of their noted criteria. Still, the two approaches have huge risk implications. Another concept in play is the idea that the accepted baseline risk is only half of the equation; the risk controls in place are the other half. It may seem confusing that the first couple of spots on the traditional risk control hierarchy (elimination and substitution) occur up above the level of decided risk consideration mentioned above, so for the purposes of this discussion, it may be easier to consider controls employed to address recognized hazards.

 

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Lighting Striking Skyscrapers (Image by B.W. Townsend)

So, Just What Is An Acceptable Level of Risk?
It should be clear that the answer to this is that there is no one answer. Circumstances and environments vary, as well as organizational “appetite” for risk. Some parts of a framework for boundaries in that regard can be considered, and we’ll talk about that more in other articles.  The more complex the environment and the greater the severity and impact potential of the identified risks, the more likely that quantification would be warranted or even necessary. Less complex environments and operations can’t simply be content to leave risk levels unconsidered.  The key point here is that organizational and business decisions imply acceptance or rejection of hazard risk in many, many cases. If these are identified and analyzed early enough, there is much opportunity for the risk picture to be considered in a constructive way.

Putting This to Use
The risk manager, the safety manager, and the operating manager concerned with hazard risk (which is all operating managers, right?) have an opportunity to be proactive, but it might not be easy. The opportunity is to weigh in earlier in the business planning and decision making process. A few companies have someone in the position of “Chief Risk Officer,” and fewer still have a position of “Chief Safety Officer.” Some of those that do have these positions subordinate them one level from the traditional C-Suite positions, while in the case of the Chief Risk Officer, other types of risk other than hazard risk are often dominant in the role.

So here lies the challenge: Whether the risk manager or head safety position truly has a seat at the senior leadership table, there is an opportunity to insert into business planning discussions earlier and with a more strategic approach. The risk manager or safety professional has the chance to speak to the perspective of greater or lesser risk created by the various business decisions that are being made, and the earlier the better. It is sometimes difficult to do this, and it can be a great test for just how seriously risk and safety is taken by the senior leadership of an organization.

An Example
I had the opportunity to see  the impact of this in an urban beautification project conducted by a municipality, where the development process kept the risk and safety professionals out of the discussion of the project until it was approved, conceptualized, and a fair distance into the design and engineering process. Risks that needed to be controlled or eliminated were identified when the later review did take place, but the budgetary, logistic, and user experience impact of addressing those items at such a late stage led to difficulty. In short, issues that could have been corrected very easily in the conceptual stage became much more daunting once construction was very much underway. Controls were indeed put in place, and some hot-button risks were eliminated, but the time, effort, and resources required were much greater than if earlier intervention were accomplished.