Marianne Törner

Safety in construction--a comprehensive description of the characteristics of high safety standards in construction work, from the combined perspective of supervisors and experienced workers.

INTRODUCTION The often applied engineering approach to safety management in the construction industry needs to be supplemented by organizational measures and measures based on how people conceive and react to their social environment. This requires in-depth knowledge of the broad preconditions for high safety standards in construction. The aim of the study was to comprehensively describe the preconditions and components of high safety standards in the construction industry from the perspective of both experienced construction workers and first-line managers. METHOD Five worker safety representatives and 19 first-line managers were interviewed, all strategically selected from within a large Swedish construction project. Phenomenographic methodology was used for data acquisition and analysis and to categorize the information. Nine informants verified the results. RESULTS The study identified four main categories of work safety preconditions and components: (1) Project characteristics and nature of the work, which set the limits of safety management; (2) Organization and structures, with the subcategories planning, work roles, procedures, and resources; (3) Collective values, norms, and behaviors, with the subcategories climate and culture, and interaction and cooperation; and (4) Individual competence and attitudes, with the subcategories knowledge, ability and experience, and individual attitudes. DISCUSSION The results comprehensively describe high safety standards in construction, incorporating organizational, group, individual, and technical aspects. High-quality interaction between different organizational functions and hierarchical levels stood out as important aspects of safety. The results are discussed in relation to previous research into safety and into the social-psychological preconditions for other desired outcomes in occupational settings. IMPACT ON INDUSTRY The results can guide construction companies in planning and executing construction projects to a high safety standard.

Analysis of serious occupational accidents in Swedish fishery

Abstract Occupational accidents present a large problem in fishery. The purpose of the present study was to analyse causes and effects of severe accidents in Swedish fishery during 1986 and 1988–1990, respectively. This information was to serve as a basis for preventive measures at a later stage. Hauling of the trawl stands out as the most accident prone activity followed by shooting of the trawl and repair work/work by the wharf. The most common direct cause of injury was falling. Jamming between part of the ship and the otter boards was also a predominant cause of injury as were pricks and cuts. Getting caught in mechanical equipment, musculo-skeletal over-load, or getting caught in the trawl and pulled up on the trawl drum were other important hazards. Hands and wrists were the most exposed body parts followed by shanks or knees and lower arms or elbows. A predominant primary cause of accidents was the ship motion. Being engaged in unfamiliar work tasks or high noise levels did not seem to have contributed to the accidents to any significant degree. Safety equipment to avoid the accident was usually lacking and this must be identified as a severe problem.

Identifying and analysing hazards in manufacturing industry: a review of selected methods and development of a framework for method applicability

Abstract This study presents the results of a literature review that was performed to identify and evaluate methods suitable for identification and analysis of risks for occupational accidents in manufacturing industry, with special focus on food industry. The studied methods were compiled into two groups, one encompassing ‘morphological’ methods and one encompassing methods for ‘forward’ or ‘backward’ event tracking analysis. The aspects studied in the methods are presented together with a short description of procedures, area of the analysis and relevance to food industry. Also some characteristics of the methods are given, as well as reference to previous key publications on the methods. A methodological framework was developed distinguishing three different approaches of risk analysis based on scope and type of available input data. The different approaches were termed biased reactive, biased proactive and unbiased proactive, respectively. The framework constitutes a guide for, e.g., practitioners in the selection of particular methods of risk analysis depending on prerequisites and context. Relevance to industry The paper presents a review of safety analysis methods based on applicability in manufacturing industry with special focus on food industry. This, together with the presented methodological framework, will serve as an aid to practitioners in the selection of suitable methods, depending on scope of the analysis and type of available input data.

The Counseling, Self-Care, Adherence Approach to Person-Centered Care and Shared Decision Making: Moral Psychology, Executive Autonomy, and Ethics in Multi-Dimensional Care Decisions

ABSTRACT This article argues that standard models of person-centred care (PCC) and shared decision making (SDM) rely on simplistic, often unrealistic assumptions of patient capacities that entail that PCC/SDM might have detrimental effects in many applications. We suggest a complementary PCC/SDM approach to ensure that patients are able to execute rational decisions taken jointly with care professionals when performing self-care. Illustrated by concrete examples from a study of adolescent diabetes care, we suggest a combination of moral and psychological considerations to support the claim that standard PCC/SDM threatens to systematically undermine its own goals. This threat is due to a tension between the ethical requirements of SDM in ideal circumstances and more long-term needs actualized by the context of self-care handled by patients with limited capacities for taking responsibility and adhere to their own rational decisions. To improve this situation, we suggest a counseling, self-care, adherence approach to PCC/SDM, where more attention is given to how treatment goals are internalized by patients, how patients perceive choice situations, and what emotional feedback patients are given. This focus may involve less of a concentration on autonomous and rational clinical decision making otherwise stressed in standard PCC/SDM advocacy.

Participatory analysis of accidents and incidents as a tool for increasing safety behaviour in fishermen. A pilot intervention study

Abstract Although occupational accidents are common in fishery, safety work is often not given priority by the fishermen. The aims of this study were to test a group-based intervention for increased activity in safety work through group discussion of accident/incident experience; to study occurred incidents/accidents and how such events were managed; and to study intervention effects on activity in safety work, risk acceptance and perceived manageability of risks. A sample of men from five crews (11 men) of Swedish fishermen participated. The study had a one group pre-test–post-test design for questionnaire data. The emphasis was on qualitative information collected during the intervention and interviews. The results indicated that accident causes could be appraised as being unmanageable even when technical solutions were possible. Psychological factors may cause incidents not to be documented or discussed. Incident experience seldom leads to preventive measures. Interaction between structural, social and psychological factors seemed to explain this. Questionnaires, observations and interview data suggested that some increase in safety work took place during the intervention. After the discussions the participants perceived risks to be less manageable. The study indicated that, although sensitive to dropout, participative safety interventions in fishery are feasible and may be effective. A longer or more intensive intervention may be necessary in order to progress from problem orientation to action orientation.

Conceptions of Diabetes and Diabetes Care in Young People With Minority Backgrounds

Adolescents with type 1 diabetes (T1DM) need stable self-care routines for good metabolic control to minimize future cardiovascular health complications. These routines are demanding, and might be particularly challenging in underprivileged groups. The aim of this study was to gain in-depth knowledge on the experience of adolescents with T1DM and a non-Swedish background regarding factors that might influence their ability to take care of themselves; in particular, factors that might influence diabetes management routines, their social situation, and the support they receive from caregivers. We interviewed 12 adolescents with T1DM and minority backgrounds. The results indicated resources and constraints in the adolescents’ social context and in the health care organization. The adolescents developed conceptions that helped to explain and excuse their self-care failures, and their successes. These findings highlight the importance of integrating T1DM as part of the individual’s personal prerequisites. We discuss implications for the organization of diabetes care for adolescents.

Relational database as a tool in industrial design. Experience from a human factors engineering analysis of a module for manned space-flight

Abstract A human factors engineering analysis was carried out to verify that the CUPOLA—a module developed by the European Space Agency for the International Space Station—complies with an extensive set of human factors requirements. Analysis was carried out in three steps: task analysis, computer simulation of tasks and empirical test of tasks in a physical mock up. In advance to each step the method of assessment and type of information to be obtained were determined in detail and the way of documentation was established as input forms to a relational database. Advantages and drawbacks of this early formalisation as seen by project members are discussed in the present paper. Relevance to industry The method of early formalisation by a relational database used throughout the project showed to be a suitable tool in this human factors analysis of a working place under design. Early formalisation of the results and documentation served as a quality system supporting a homogeneous high standard of data collection and documentation. In industry, the use of relational databases underlying Product Data Management systems increases. This makes it relevant to try and link human factors work to these methods of documentation in order to promote the integration of human factors work at an early stage of product and production development.

Risk and safety communication in small enterprises : how to support a lasting change towards work safety priority

The frequency of occupational accidents in Swedish farming is high. An intervention methodology aimed at influencing safety attitudes and behaviour was previously tested. The aims of the present study were to evaluate long‐term effects of the intervention and to assess these results in relation to a randomly selected comparison group. The intervention was based on regular group discussions, focusing on dialogue and reflection in networks for social support. Eighty‐eight farmers and farm workers, divided into nine groups, participated. Each group gathered on seven occasions during one year, assisted by a process consultant, supporting safety communication and the change process. A questionnaire was used to evaluate the effects. The long‐term results of the intervention showed that safety activity increased significantly and risk acceptance (fearlessness) and work stress decreased. Measurements were made at T1, T2 and T3, i.e., pre‐, post‐ and long‐term, in the intervention group and at T1 and T3 in the comparison group. The results of the present study showed a long‐term effect of the intervention on safety activity and risk acceptance (fearlessness) in relation to the comparison group. However, the comparison group also showed a decline in work stress, which indicates that the stress reduction may have had other causes than the intervention.

Coping With Paradoxical Demands Through an Organizational Climate of Perceived Organizational Support: An Empirical Study Among Workers in Construction and Mining Industry

Organizational demands on productivity, innovations, and safety may seem paradoxical. How can the organization support employees to cope with such paradox? Based on organizational climate measures of safety, occupational health, innovativeness, and production effectiveness, we explored if a second-order organizational climate could be identified, that was associated with staff safety, health, innovations and team effectiveness, and if such a climate could be represented by an organizational climate of perceived organizational support (POS). Questionnaire data were collected from 137 workgroups in four Swedish companies in construction and mining. Analyses (structural equation modeling) were done at the workgroup level and a split sample technique used to investigate relations between climates and outcomes. A general second-order organizational climate was identified. Also, an organizational climate constructed by items selected to represent POS, was associated with team effectiveness, innovations, and safety. A POS-climate may facilitate employees’ coping with paradoxes, and provide a heuristic for managers in decision making.

Health care to empower self-care in adolescents with type 1 diabetes mellitus and an immigrant minority background:

Background: The pediatric diabetes team aims to support health, quality of life, and normal growth and development among adolescents with type 1 diabetes mellitus. Adolescents with an immigrant background have been found less successful in self-care. Previous research indicated that adolescents who had integrated the disease as a part of their self-image reasoned differently about their self-care to those who had not. Objective: The aim of this study was to identify elements in the patient–pediatrician consultations that might influence such integration of the disease among adolescents with type 1 diabetes mellitus. Methods: A total of 12 pediatrician–adolescent consultations were video-recorded and analyzed. The adolescents all had an immigrant background. Results: Integration of the disease appeared enabled when responsibility was shared; when hope, autonomy, and emotions were confirmed; and when the pediatrician asked probing questions. Letting objective data dominate the adolescent’s experiences, using risk as a motivator, neutralizing emotions in relation to having diabetes, and confirming forgetfulness, may instead inhibit disease integration. Conclusion: An extended person-centered approach with focus on the adolescent’s experiences of everyday life with a chronic disease and less attention on physical parameters in the pediatrician–adolescent consultations may increase integration of the disease.