Kent Jacob Nielsen

Improving safety in small enterprises through an integrated safety management intervention

This study tests the applicability of a participatory behavior-based injury prevention approach integrated with safety culture initiatives. Sixteen small metal industry enterprises (10-19 employees) are randomly assigned to receive the intervention or not. Safety coaching of owners/managers result in the identification of 48 safety tasks, 85% of which are solved at follow-up. Owner/manager led constructive dialogue meetings with workers result in the prioritization of 29 tasks, 79% of which are accomplished at follow-up. Intervention enterprises have significant increases on six of eight safety-perception-survey factors, while comparisons increase on only one factor. Both intervention and comparison enterprises demonstrate significant increases in their safety observation scores. Interview data validate and supplement these results, providing some evidence for behavior change and the initiation of safety culture change. Given that over 95% of enterprises in most countries have less than 20 employees, there is great potential for adapting this integrated approach to other industries.

Physical and psychosocial work environment factors and their association with health outcomes in Danish ambulance personnel – a cross-sectional study

BackgroundReviews of the literature on the health and work environment of ambulance personnel have indicated an increased risk of work-related health problems in this occupation. The aim of this study was to compare health status and exposure to different work environmental factors among ambulance personnel and the core work force in Denmark. In addition, to examine the association between physical and psychosocial work environment factors and different measures of health among ambulance personnel.MethodsData were taken from a nationwide sample of ambulance personnel and fire fighters (n = 1,691) and was compared to reference samples of the Danish work force. The questionnaire contained measures of physical and psychosocial work environment as well as measures of musculoskeletal pain, mental health, self-rated health and sleep quality.ResultsAmbulance personnel have half the prevalence of poor self-rated health compared to the core work force (5% vs. 10%). Levels of mental health were the same across the two samples whereas a substantially higher proportion of the ambulance personnel reported musculoskeletal pain (42% vs. 29%). The ambulance personnel had higher levels of emotional demands and meaningfulness of and commitment to work, and substantially lower levels of quantitative demands and influence at work. Only one out of ten aspects of physical work environment was consistently associated with higher levels of musculoskeletal pain. Emotional demands was the only psychosocial work factor that was associated with both poorer mental health and worse sleep quality.ConclusionsAmbulance personnel have similar levels of mental health but substantially higher levels of musculoskeletal pain than the work force in general. They are more exposed to emotional demands and these demands are associated with higher levels of poor mental health and poor sleep quality. To improve work environment, attention should be paid to musculoskeletal problems and the presence of positive organizational support mechanisms that can prevent negative effects from the high levels of emotional demands.

Work-related stressors and occurrence of adverse events in an ED☆

OBJECTIVE The purpose of this study was to investigate the relationship between 12 work-related stressors and the occurrence of adverse events in an emergency department (ED). METHODS Nurses and physicians, working in an ED at a Danish regional hospital, filled out a questionnaire on occurrence and emotional impact of 12 work-related stressors after each shift during a 4-week period. The questionnaire also instructed the participants to describe any adverse events that they were involved in during the shift. RESULTS Two hundred fourteen adverse events were reported during the 979 studied shifts. During the same period, only 27 adverse events were reported to the mandatory national reporting system, and only 10 of these were duplicates. A high variability of stressors and emotional impact among the different groups of participants was found. Linear regression analysis showed an association between involvement in adverse events and the occurrence and emotional impact of stressors across groups, whereas no significant association was found for age, seniority, shift type, or length. CONCLUSION The study showed an association between the occurrence and impact of 12 work-related stressors and involvement in adverse events across the groups of participants. Furthermore, the study showed that most adverse events were not reported to the mandatory national reporting system.

Patterns of work injuries: cases admitted to emergency room treatment compared to cases reported to the Danish Working Environment Authority during 2003–2010

Objective To compare work injuries treated in an emergency department (ED) and injuries reported to the Danish Working Environment Authority (DWEA). Methods Work injuries of the ED, Odense University Hospital, and injuries from the geographical catchment area reported to the DWEA between 2003 and 2010 were included. The injuries included in both datasets were identified by merging the ED file and the DWEA file using the civil registry number and injury date information as key. Results Approximately 50 000 work injuries occurred in the catchment area of the ED. The intersection between the two injury registration systems was 16%. A major discordance concerned the type of injuries, as some injuries were seen frequently in the ED but not reported to the DWEA to any significant extent, for example ‘eye injuries’ and ‘superficial lacerations or wounds’. On the other hand, some injuries are rarely seen in the ED, but often reported to the DWEA, for example ‘low back pain’. Additionally, younger workers visit the ED more often than older workers, and injuries in the high risk sectors have the lowest reporting proportion. Conclusions Neither the ED nor DWEA injury files alone give a complete picture of work injuries. But merged, they represent a significant number of injuries, taking into account differences in data sources, for example concerning uneven distribution of age, sex, type of injury and type of industry. Obviously, not all serious work related ED injuries resulting in lost work time are reported to the DWEA.

Social identity in the construction industry: implications for safety perception and behaviour

The construction industry has one of the highest frequency levels and rates of work-related injuries, yet the evidence for successful attempts to reduce injuries is generally lacking. The motivational and (safety) behavioural implications of social identification and social categorization among construction labourer work crews were investigated to ascertain how their interactions are affected by the social structure and organization of work. Semi-structured group interviews and mini interviews during work were carried out with 13 concrete work crews (totalling 53 persons) at five large construction sites. The organization of work fosters social identification within a crew, resulting in distancing from and social categorization of site management. Social identification influences safety behaviour in the crews, where worksite safety rules may meet resistance. Future safety initiatives at large construction sites should take into account the dynamics of social identification and categorization in the implementation of safety measures, e.g. by creating an alternative organization of work, thus making it easier for a work crew to identify themselves with the site management. Site/crew managers should consider how safety can become a salient and valued group norm by altering the social structure at the sites and/or fostering dual social identity.

The relationship between macroeconomic and industry-specific business cycle indicators and work-related injuries among Danish construction workers

Objectives The current study examines and compares the relationship between both macroeconomic and industry-specific business cycle indicators, and work-related injuries among construction workers in Denmark using emergency department (ED) injury data and also officially reported injuries to the Danish Working Environment Authority (WEA). Methods The correlations between ED and WEA injury data from the catchment area of Odense University Hospital during the period 1984–2010 were tested separately for variability and trend with two general macroeconomic indicators (gross domestic product and the Danish unemployment rate) and two construction industry-specific indicators (gross value added and the number of employees). Results The results show that injury rates increase during economic booms and decrease during recessions. However, the regression coefficients were generally weak for both the ED (range 0.14–0.20) and WEA injuries (range 0.13–0.36). Furthermore, although there is some variability in the strength of the relationship of the different business cycle indicators, the relationships are generally not stronger for the WEA injuries than for the ED injuries, except for general unemployment. Similarly, no substantial differences in strength of relation between industry-specific and macroeconomic indicators were identified. Conclusions The study shows that there was no difference in the relationship between business cycle indicators, and WEA and ED injury data. This indicates that changes in reporting behaviour do not seem to play a major role in the relation between the business cycle and workplace injuries in a Danish context.

Transient risk factors of acute occupational injuries: a case-crossover study in two Danish emergency departments

Objectives The objectives of this study were to (i) identify transient risk factors of occupational injuries and (ii) determine if the risk varies with age, injury severity, job task, and industry risk level. Method A case-crossover design was used to examine the effect of seven specific transient risk factors (time pressure, disagreement with someone, feeling sick, being distracted by someone, non-routine task, altered surroundings, and broken machinery and materials) for occupational injuries. In the study, 1693 patients with occupational injuries were recruited from a total of 4002 occupational injuries seen in 2013 at two emergency departments in Denmark. Effect estimates were calculated using the matched-pair interval approach. Results Increased risk for an occupational injury was found for time pressure [odds ratio (OR) 1.6, 95% confidence interval (95% CI) 1.3-2.0], feeling sick (OR 2.7, 95% CI 1.9-3.9), being distracted by someone (OR 3.1, 95% CI 2.3-4.1), non-routine task (OR 8.2, 95% CI 5.3-12.5), altered surroundings (OR 20.9, 95% CI 12.2-35.8), and broken machinery or materials (OR 20.6, 95% CI 13.5-31.7). The risk of occupational injury did not vary substantially in relation to sex, age, job task, industry risk level, or injury severity. Conclusion Use of a case-crossover design identified several worker-related transient risk factors (time pressure, feeling sick, being distracted by someone) that led to significantly increased risks for occupational injuries. In particular, equipment (broken machinery or materials) and work-practice-related factors (non-routine task and altered surroundings) increased the risk of an occupational injury. Elaboration of results in relation to hazard period and information bias is warranted.

Integrated Safety Management as a Starting Point for Changing the Working Environment

The effective management of organizational change involves understanding and appreciating the complex interactions of technology, people, organizations, economical factors, legislation, and aspects of cultural, physical, and psychological context. The behavior based and culture based approaches to safety are two seemingly incompatible approaches to creating organizational change in safety performance. However, combined, the two approaches may provide a new perspective on conducting effective and healthy organizational changes. DeJoy has proposed an integrative approach to safety management based on a combination of a behavior-based ‘problem-solving process’ and a ‘culture change process’. The participatory problem-solving process and the culture change process require involvement and commitment from management and workers. The ‘problem-solving process’ and the ‘culture change process’ work in parallel, and strives towards a self-regulatory system where the right messages reach the right people, enabling these to solve the right problems with the right solutions. The problem solving process leads to visible and focused activities, which can be diffused and disseminated throughout the organization and thereby potentially create cultural change. Communication and mutual trust between managers and workers are essential for the process to succeed. The integrated approach to safety management can be operationalized by aiming interventions towards the safety committee, middle managers, and workers using individual and group based coaching, and group workshops. The approach has been tested at 18 small and medium sized Danish enterprises and the chapter will include examples from this study.

Social identity, safety climate and self-reported accidents among construction workers

Abstract The construction industry has one of the highest frequencies of work-related accidents. We examined whether construction workers predominantly identify themselves in terms of their workgroup or in terms of the construction site. In addition, we examined the associations between social identity and safety climate, and how these constructs are associated with work-related accidents. The analyses were based on questionnaire responses from 478 construction workers from two large construction sites, and the methods involved structural equation modeling. Results showed that the workers identified themselves primarily with their workgroup, and to a lesser degree with the construction site. Social identity and safety climate were related both at the workgroup and construction site levels, meaning that social identity may be an antecedent for safety climate. The association between social identity and safety climate was stronger at the workgroup level than at the construction site level. Finally, safety climate at both levels was inversely associated with self-reported accidents, with the strongest association at the workgroup level. A focus on improving safety climate, particularly by integrating initiatives at both the workgroup and management level, may have the potential to improve safety performance and thus decrease the risk of accidents and injuries on construction sites.

Masculinity Ideals in a Contemporary Danish Context

What are the prevailing masculinity ideals among contemporary Danish men? As one of the Nordic welfare states, Denmark has for decades focused on gender equality and changes in the gendered division of labour. Research has suggested a shift in masculinity ideals, but processes of change comprise not only changes but also continuities, as well as ambivalences and contradictions. This article investigates how normative masculinity ideals—the most accepted ways of being a man in a certain context—are expressed and negotiated by contemporary Danish men, and how these ideals are related to overall discourses of gender. The article is based on a mixed methods design, consisting of: (1) a quantitative survey among lower-educated men in two male-dominated occupations, and (2) a qualitative, explorative analysis of data from five focus group interviews with both lower- and higher-educated men. The two occupations in the survey constitute a critical case, based on the argument that if traditional masculinity ideals are rejected here—among lower-educated men, who are likely to be more supportive of traditional gender ideals than the more highly educated—then Danish men in general are likely to reject traditional masculinity ideals. Both the quantitative and qualitative analyses indicate that traditional patriarchal masculinity ideals are not the most legitimate among the men. They seem to subscribe to more gender equality friendly masculinities, although this picture is not clear-cut as we also see negotiations and variations between the men. Thus, the article concludes that in a Danish context we can identify authoritative masculinity ideals that do not reproduce patriarchy or support traditional masculinity ideals in an unambiguous way.