Healthcare and Commercial Construction: The Role of Inspections Within Health and Safety Interventions in Dynamic Workplaces and Associations With Safety Climate
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CitationGrant, Michael Patrick. 2016. Healthcare and Commercial Construction: The Role of Inspections Within Health and Safety Interventions in Dynamic Workplaces and Associations With Safety Climate. Doctoral dissertation, Harvard T.H. Chan School of Public Health.
AbstractStatement of problem: Dynamic work environments and physically demanding jobs in the healthcare and commercial construction industries present workers with a constantly changing suite of hazards, and hence the changing need for controls. Workers in these industries experience high rates of MSDs and other illnesses and injuries. Hazard recognition and control are essential and inspections are essential elements used to identify and anticipate hazards and to implement corrective action as part of a systems-level approach to tackle the dynamic worksite.
Methods: Because there is a dearth of practical resources for evaluating ergonomic risk factors in healthcare environments the first step in this dissertation was to explore the development of a tool and process for identifying modifiable aspects of acute care hospital patient care units to prevent work-related MSDs. To address a lack of systems-level approaches to worksite-based interventions in construction, an ergonomics program that relies heavily on inspections was developed and evaluated on five pairs of commercial construction sites. To examine associations between physical working conditions and safety climate, the relationship between weekly safety inspections and weekly safety climate scores was examined on six commercial construction sites.
Results: The inspection process provided a structured method for recognizing hazards in dynamic and physically demanding work environments and reporting both observations and recommendations to decision makers. There were no significant intervention effects, however key challenges to intervention implementation were competing safety and production priorities and break practices leading to inconsistencies delivering the intervention and key resources to workers. Variations in week-to-week safety inspections were highly correlated with variations in week-to-week safety climate.
Conclusions: Inspection tools and processes were useful in a systems-approach to workplace interventions in the dynamic industries of healthcare and commercial construction. Worksite-based ergonomics interventions focusing efforts on hazard identification, recommendations for solutions, and reinforcing both positive and negative feedback to safety management and workers can have a major impact on worker wellbeing. In addition, physical working conditions (as identified through weekly safety inspections) are an important aspect of the week to week changes of safety climate in the dynamic commercial construction environment.
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