Thomas R. Cunningham

Better understanding the small business construct to advance research on delivering workplace health and safety

Abstract A critical step toward advancing research for achieving greater impact on occupational safety and health in small businesses is to have a better understanding of what is meant by the term ‘small business’. The term needs to reflect not only the number of people employed and the financial resources of an enterprise, but also the psychosocial experience of the people that are represented in small businesses. In this article we discuss the role of several dimensions in differentially defining the small business construct, including: number of employees, business age, structure, workforce, manager centricity, and culture. As greater consensus on the small business label is reached, more focused frameworks for small business occupational safety and health research, policy and practice may be developed.

Translation research in occupational safety and health: A proposed framework

Translation research in occupational safety and health is the application of scientific investigative approaches to study how the outputs of basic and applied research can be effectively translated into practice and have an impact. This includes the study of the ways in which useful knowledge and interventions are disseminated, adopted, implemented, and institutionalized. In this paper, a 4-stage framework (Development, Testing, Institutionalization, and Evaluation) is presented. Translation research can be used to enhance the use and impact of occupational safety and health knowledge and interventions to protect workers. This type of research has not received much attention in the occupational safety and health field. However, in contemporary society, it is critical to know how to make an impact with the findings and outputs of basic and applied research. This paper provides a novel framework for consideration of how to advance and prioritize translation research for occupational safety and health.

Work as an Inclusive Part of Population Health Inequities Research and Prevention

Despite its inclusion in models of social and ecological determinants of health, work has not been explored in most health inequity research in the United States. Leaving work out of public health inequities research creates a blind spot in our understanding of how inequities are created and impedes our progress toward health equity. We first describe why work is vital to our understanding of observed societal-level health inequities. Next, we outline challenges to incorporating work in the study of health inequities, including (1) the complexity of work as a concept; (2) work’s overlap with socioeconomic position, race, ethnicity, and gender; (3) the development of a parallel line of inquiry into occupational health inequities; and (4) the dearth of precise data with which to explore the relationships between work and health status. Finally, we summarize opportunities for advancing health equity and monitoring progress that could be achieved if researchers and practitioners more robustly include work in their efforts to understand and address health inequities.

“Check” This Out: A Review of Gawande's The Checklist Manifesto

Our ability to make a positive impact on people and society has increased exponentially with the advancement of science and technology. We can build towering skyscrapers, send massive amounts of information across the world in seconds, and bring people without heartbeats back to life. This rapid advancement has resulted in jobs that are much more complex and demanding than they were even 20 years ago. In medicine, physicians must apply an exponentially increasing body of knowledge. For example, the number of new medications approved for use increased dramatically from the early 1980s to 2001, with 311 new drugs approved in the 1990s alone (Corrigan, Donaldson, & Kohn, 2001). Along with more complexity comes the increased challenge of employing knowledge consistently, accurately, and safely. This requires highly specialized health care employees to correctly apply this vast knowledge and work together flawlessly with other specialties, both introducing opportunities for errors. Gawande (2009) explains,

Differences in safety training among smaller and larger construction firms with non-native workers: Evidence of overlapping vulnerabilities

Collaborative efforts between the National Institute for Occupational Safety and Health (NIOSH) and the American Society of Safety Engineers (ASSE) led to a report focusing on overlapping occupational vulnerabilities, specifically small construction businesses employing young, non-native workers. Following the report, an online survey was conducted by ASSE with construction business representatives focusing on training experiences of non-native workers. Results were grouped by business size (50 or fewer employees or more than 50 employees). Smaller businesses were less likely to employ a supervisor who speaks the same language as immigrant workers (p < .001). Non-native workers in small businesses received fewer hours of both initial safety training (p = .005) and monthly ongoing safety training (p = .042). Immigrant workers in smaller businesses were less likely to receive every type of safety training identified in the survey (including pre-work safety orientation [p < .001], job-specific training [p < .001], OSHA 10-hour training [p = .001], and federal/state required training [p < .001]). The results highlight some of the challenges a vulnerable worker population faces in a small business, and can be used to better focus intervention efforts. Among businesses represented in this sample, there are deflcits in the amount, frequency, and format of workplace safety and health training provided to non-native workers in smaller construction businesses compared to those in larger businesses. The types of training conducted for non-native workers in small business were less likely to take into account the language and literacy issues faced by these workers. The findings suggest the need for a targeted approach in providing occupational safety and health training to non-native workers employed by smaller construction businesses.

A safety information campaign to reduce sharps injuries: Results from the Stop Sticks campaign

Abstract Injuries from medical sharps devices and blood-borne pathogen (BBP) exposure are a significant risk to many healthcare workers. Risk awareness communications and sharps safety strategies are key components of BBP exposure prevention efforts. The research reported here includes an evaluation of a large-scale communication intervention aimed at raising awareness among healthcare workers regarding the risks of sharps injuries and BBP exposure, as well as methods of prevention. The Stop Sticks campaign was a multi-media communication intervention targeted at multiple healthcare facilities in Columbia, South Carolina. Following a comprehensive needs assessment in each facility, tailored communications were delivered via several channels. Samples included individual hospital departments, an entire hospital, and a nursing home. Results indicate high levels of knowledge and communication channel recall, minimal attitude and behavior change, and a strong association between sharps-related safety behavior and safety climate. Overall, this research suggests the blitz approach is viable for raising awareness of occupational safety and health issues. Based on these findings, several recommendations are offered for conducting safety campaigns in healthcare facilities.

Conference Summary Understanding Small Enterprises Conference, 25–27 October 2017

Objectives The specific objectives of the 2017 Understanding Small Enterprises Conference were to: (i) identify successful strategies for overcoming occupational safety and health (OS&H) barriers in small and medium-sized enterprises (SMEs); (ii) disseminate best practices to research and business communities; (iii) build collaborations between different stakeholders including researchers, insurers, small enterprises, government agencies; and (iv) better inform OS&H research relevant to SMEs. Methods A two and a half day international conference was organized, building upon three previously successful iterations. This conference brought together researchers, practitioners, and other stakeholders from 16 countries to share best practices and emerging strategies for improving OS&H in SMEs. Findings Cross-cutting themes that emerged at the conference centered around: 1) stakeholder and intermediary involvement; 2) what occupational health and safety looks like across different industries; 3) intervention programs (tools and resources); 4) precarious and vulnerable work and the informal sector; and 5) Total Worker Health® in SMEs. Conclusion A number of innovative initiatives were shared at the conference. Researchers must build collaborations involving a variety of stakeholder groups to ensure that OS&H solutions are successful in SMEs. Future OS&H research should continue to build upon the successful work of the 2017 Understanding Small Enterprises Conference.