The importance of near miss reporting to further improve safety performance

Dealing with accidents implies that such events have in common the potential to affect people and the environment in a significant way. Therefore, all parties involved in industrial risk management processes, i.e. industry, regulatory authorities, public as well as scientific and technical institutions, are well aware of the importance of considering and analysing such type of events for the purposes of accident prevention. Also, the methods of Quantitative Risk Assessment (QRA) have large experience in numerically expressing the various degrees of risk related to accidents. On the other hand, the topic of including `near misses' (i.e. any event which could have escalated to an accident) in safety management systems with the aim to prevent major accidents and the occurrence of similar events in the future is relatively new. Although its importance has more and more been recognised in the last few years, it is not yet a commonly accepted fact that near miss reporting and investigation of near misses should be an integral part of a safety management system in industrial facilities. In the European Council's new `Seveso II Directive' 96/82/EC, there is—in addition to the mandatory requirements of major accident reporting—an explicit recommendation to report near misses to the Commission's Major Accident Reporting System (MARS) on a voluntary basis. In this paper, examples of current experience in the chemical industry with the collection and analysis of data on near misses are presented and discussed with regard to industry-wide conclusions. In addition to this more qualitative discussion, quantitative arguments are put forward regarding the impact of near misses on risk estimates derived from QRA.     

Safety management systems under Seveso II: Implementation and assessment

The `Seveso II Directive' (96/82/EC) requires certain establishments holding hazardous substances to implement a Safety Management System (SMS). The first part of the paper discusses the origin of this requirement, the guidance drawn up to help companies fulfil it, and the results of preliminary testing of this guidance. One important element in implementing and inspecting SMS is the identification of SMS weaknesses, the safety culture that effects SMS and finally the evaluation of safety performance. The second part of this paper examines some principles underlying industrial practice in evaluating SMS. Audit-related activities, involving proactive performance indicators for monitoring compliance with standards, are used nowadays to identify weaknesses of the SMS. Preventive actions to control risks and policy updating within the company through strategic plans are found to be sensitive to the number and type of SMS elements taken into account as indicators. The value of quantifying performance using simple rating systems in audits may be limited to the single installation. The guidelines and evaluation methods could thus produce useful results only when safety aspects and system elements are identified and evaluated separately for each installation; the value of quantification is limited to the individual elements after considering their functional relation with the rest of the elements in the SMS environment and the local safety culture into which they are developed.     

Technical note on the contribution of sociotechnical factors to accidents notified to MARS

Not least due to the new `Seveso II Directive', Safety Management Systems (SMS) have become a hot topic in the `safety business'. To reveal in a structured way how organisations manage safety at their plants, classification schemes can be applied to identify plant-specific precautions on different hierarchical levels, e.g. from `top level' equipment reliability to `bottom level' safety climate. In this paper, such a model is used to classify the accidents reported to the European Commission's Major Accident Reporting System (MARS) according to the levels on which failures resulting in actual accidents did occur, and to cross-compare the levels of causation with the overall `severity' of the accidents. It is analytically shown that ∼66% of the accidents are caused by latent SMS failures, and that especially those accidents which are caused by failures in the `deepest layers of latency' have significantly higher `severities' than accidents caused by more `immediate' failures. In other words, it is quite likely that the deeper the underlying causes of an accident, the more `severe' its consequences. Implementing SMS is thus worth the effort.     

The functioning and status of the EC's major accident reporting system on industrial accidents

This paper describes the functioning and current status of the European Commission's Major Accident Reporting System (MARS), dedicated to collect in a consistent way data on major industrial accidents involving dangerous substances from the Member States of the European Union under the requirements of the `Seveso Directives', to analyse and statistically process them, and to distribute all non-confidential accidents data and analysis results to the Member States. This modern information exchange and analysis tool is made up of two connected parts: one for each local unit (i.e. for the Competent Authority of each Member State), and one central part for the European Commission. The local as well as the central parts of this network can serve both as data logging systems and, on different levels of complexity, as data analysis tools. The central database allows complex pattern analysis, identifying and analysing the succession of disruptive factors leading to an accident. On this basis, “lessons learned” can be formulated for the industry or regulatory bodies for further accident prevention. Results of various overall analyses of the contents of MARS are given. The availability of MARS data and analysis results is described.     

Results of Finnish national survey in the chemical industry on EU legislation concerned with risk assessment and safety compliance climate

A questionnaire study about the Finnish chemical industry was devised to explore the implementation of the risk assessment obligations of the EU Chemical Agents Directive (98/24/EC), and the role of risk assessment activities as a part of OSH management. The quantitative method involved an assessment of online questionnaire. The respondents were employers' (N = 49) and workers' (N = 105) OSH representatives from different companies'. The regression analysis of the responses indicated that prioritizations in the risk assessment had a highly significant (p < 0.001) effect both on the prevention measures in the management and on the safe use of chemicals. The present results showed that development measures have to be directed at the most important problems ensuring that sub-contractors carry out hazard identification and arranging their on-the-job training so that it matches the chemical plant enterprise's own workers. Furthermore, the results of risk assessment should be used in the planning and management of the work, in the development of the supervisors' leadership skills as well as when following up the improvements.     

Task type as a moderator of positive/negative feedback effects on motivation and performance: A regulatory focus perspective

Applying Higgins' regulatory focus theory, we hypothesized that the effect of positive/negative feedback on motivation and performance is moderated by task type, which is argued to be an antecedent to situational regulatory focus (promotion or prevention). Thus, first we demonstrated that some tasks (e.g., tasks requiring creativity) are perceived as promotion tasks, whereas others (e.g., those requiring vigilance and attention to detail) are perceived as prevention tasks. Second, as expected, our tests in two studies of the moderation hypothesis showed that positive feedback increased self‐reported motivation (meta‐analysis across samples: N = 315, d = 0.43) and actual performance (N = 55, d = 0.67) among people working on promotion tasks, relative to negative feedback. Positive feedback, however, decreased motivation (N = 318, d = ?0.33) and performance (N = 55, d = ?0.37) among individuals working on prevention tasks, relative to negative feedback. These findings suggest that (a) performance of different tasks can affect regulatory focus and (b) variability in positive/negative feedback effects can be partially explained by regulatory focus and task type. Copyright © 2010 John Wiley & Sons, Ltd.     

Self‐protective reactions to peer abusive supervision: The moderating role of prevention focus and the mediating role of performance instrumentality

Across 3 studies, we apply a self‐protection perspective of observed mistreatment to examine a moderated mediation model on “when” and “why” third parties are motivated by peer abusive supervision. We hypothesize that prevention‐focused third parties will increase their performance effort as a response to peer abusive supervision, and this effect is mediated by performance instrumentality. In a field study of working adults (Study 1) and an experimental study that manipulated peer abusive supervision (Study 2), we found that peer abusive supervision interacted with third parties' prevention focus to predict their performance effort such that peer abuse was positively related to third parties' performance effort only for those high on prevention focus. Results were replicated in a second field study of working adults (Study 3). Further, we found support for the mediating effect of performance instrumentality. The theoretical and practical implications of our results are discussed.     

Closing the gap: a research agenda to accelerate the adoption and effective use of proven older adult fall prevention strategies

IntroductionTo make an impact on the public's health, evidence-based interventions must be disseminated broadly, supported by training and technical assistance, adopted widely, and implemented as designed. Many effective older adult fall prevention interventions have been identified, but too few have gained wide community acceptance and little is known about the best ways to encourage their broader use. Therefore, as in many other fields, fall prevention suffers from a wide gap between scientific discoveries and their everyday use.MethodThis article articulates the key activities embedded in Step 4 of the public health model—specifically translation and dissemination to ensure widespread adoption and use—in order to illuminate critical research needs in older adult fall prevention.ConclusionsThese needs, if addressed, will help close the gap between research and practice.     

Validation of a questionnaire about the perception of occupational biohazard in Spanish companies

Objectives. The aim of this work was to develop, validate and test a new questionnaire to assess the biological risk in workers with intentional or unintentional exposure to biological agents. Methods. A questionnaire including 34 questions was developed to study the perception of workers against occupational biohazard. Content Validity Index (CVI) and Content Validity Ratio (CVR) were calculated for the analysis of content validity. A pilot study was carried out with 60 workers from 17 companies performing analysis of Cronbach's α to assess the internal consistency or reliability. Results. A total of 518 workers from 51 Spanish companies in which there is exposure to biological agents participated in the study yielding a response rate of 90%. The final questionnaire obtained a Cronbach's α > 0.759 with a stable test–retest result. The questionnaire validation demonstrates that it could be used to evaluate the biological risks and help the prevention of occupational accidents and diseases. Discussion. This study has validated the need to evaluate worker's perception against occupational risks, as well as the application of prevention methods and protective equipment. It is a first step towards developing an occupational biohazards assessment method including all the requirements set by the European Health and Safety Strategy 2013–2020.     

Beyond the mean: Understanding firm‐level consequences of variability in diversity climate perceptions

We develop and test an organizational‐level model of the consequences of diversity climate for company performance. Drawing from affective events theory and the organizational climate literature, we highlight the role of idiosyncrasies in employees' diversity climate perceptions. Specifically, we consider diversity climate strength (i.e., agreement in employees' climate perceptions) as a boundary condition of diversity climate's organizational‐level effects and expect high climate strength to be particularly beneficial in demographically diverse organizations. Moreover, we introduce collective positive affect as an underlying mechanism of diversity climate's conditional effects on company performance. Hypotheses are tested in a study of 82 German small‐and‐medium‐sized companies with 13,695 surveyed employees. Results show a moderated mediation relationship where diversity climate is only positively related to organizational performance (via collective positive affect) at relatively high diversity climate strength. Although this finding holds for both demographically diverse and homogeneous organizations, post hoc analyses provide initial evidence that a strong climate only helps to realize the effects of diversity climate on collective positive affect when members of age‐ and gender‐related demographic subgroups converge in their climate perceptions. Our study contributes to a better understanding of diversity climate as an effective lever for managing diversity.     

Investigation of ammonium nitrate based emulsion ignition characteristic

This paper presents an analysis of the observed ignition behaviors of ammonium nitrate (AN) and emulsion explosives (EE). Pure AN and EE locally ignited by a heat source do not undergo sustained combustion when the pressure is lower than some threshold value usually called the Minimum Burning Pressure (MBP). A reason for pure AN's and EE's incapable of burning was suggested, and the roles of sample water, inorganic salts, oil phase, and sensitizer were discussed. Accelerating rate calorimeter (ARC) was used to study the thermal stability of EE and AN. The results also showed that MBP is of vital importance and useful for the manufacture and application of AN and EE in terms of accident prevention.     

Environmental and eco-costs life cycle assessment of an acrylonitrile process by capacity enlargement in Mexico

Life cycle assessment and marginal prevention costs (eco-costs method) for an acrylonitrile plant were carried out estimating the environmental impact and the eco-costs, due to the increment in the production capacity. This study compares the old plant's operative performance (old design) at 50,000 ton/year where the by-products were incinerated, with the current operation at 60,000 ton/year where those by-products in the waste stream will be treated to take advantage of its substance content, to generate profitable products. In addition, the effect of a wastewater flow rate with cyanide was evaluated on the biological wastewater treatment process.The redesign showed a high reduction percentage in eleven of eighteen midpoint impact categories. The reduction of 36% in the global impacts in the redesign was obtained when these ones were calculated based on the impacts of the year of 2005. The CO₂ emissions equivalents (CO₂eq) had a reduction of 46% (from 6.55 to 3.50 kg CO₂eq/kg of acrylonitrile). The total of marginal prevention costs (eco-costs) are 1.28 USD/kg for acrylonitrile old design and the 0.735 USD/kg for acrylonitrile redesign, i.e. 42.5% lower than the old design. This means that 94.5% are costs for pollution and the use of energy and 5.4% by depletions of material resources.This study proved that the redesign is environmentally most favorable and economically affordable method.Eco-costs method should be incorporated as part of the financial indicators of a project, but with the respective adaptation to the environmental and economic conditions of a region.     

Workers' compensation loss prevention representative contact and risk of lost-time injury in construction policyholders

IntroductionInsurance loss prevention (LP) representatives have access and contact with businesses and employees to provide targeted safety and health resources. Construction firms, especially those smaller in size, are a high-risk population. This research evaluated the association between LP rep contact and risk for lost-time injuries in construction policyholders.MethodsWorkers' compensation data were utilized to track LP rep contact with policyholders and incidence of lost-time injury over time. Survival analysis with repeated events modeling calculated hazard ratios (HR) and 95% confidence intervals (CI).ResultsCompared no LP contact, one contact was associated with a 27% reduction of risk (HR = 0.73, CI = 0.65–0.82), two with a 41% (HR = 0.59, CI = 0.51–0.68), and three or more contacts with a 28% reduction of risk (HR = 0.72, CI = 0.65–0.81).ConclusionsLP reps appear to be a valuable partner in efforts to reduce injury burden. Their presence or contact with policyholders is consistent with reduction in overall incidence of lost-time injuries.Practical applicationsReduction in lost-time injuries, resulting in reduced workers' compensation costs for policyholders and insurance companies, builds a business-case for safety and injury prevention. LP reps are often a low or no-cost benefit for insurance policyholders and may be an important injury prevention resource for small firms and/or those with lack of safety resources and staff.     

A socio-cognitive strategy to address farmers' tolerance of high risk work: Disrupting the effects of apprenticeship of observation

IntroductionWhy do generations of farmers tolerate the high-risk work of agricultural work and resist safe farm practices? This study presents an analysis inspired by empirical data from studies conducted from 1993 to 2012 on the differing effects of farm safety interventions between participants who live or work on farms and those who don't, when both were learning to be farm safety advocates. Both groups show statistically significant gains in knowledge and behavioral change proxy measures. However, non-farm participants' gains consistently outstripped their live/work farm counterparts.MethodDrawing on socio-cultural perspectives, a grounded theory qualitative analysis focused on identifying useful constructs to understand the farmers' resistance to adopt safety practices.FindingsUnderstanding apprenticeships of observation and its relation to experiential learning over time can expose sources of deeply anchored beliefs and how they operate insidiously to promote familiar, albeit unsafe farming practices. The challenge for intervention-prevention programs becomes how to disrupt what has been learned during these apprenticeships of observation and to address what has been obscured during this powerful socialization process.Practical applicationsImplications focus on the design and implementation of farm safety prevention and education programs. First, farm safety advocates and prevention researchers need to attend to demographics and explicitly explore the prior experiences and background of safety program participants. Second, farm youth in particular need to explore, explicitly, their own apprenticeships of observations, preferably through the use of new social media and or digital forms of expression, resulting in a story repair process. Third, careful study of the organization of work and farm experiences and practices need to provide the foundations for intervention programs. Finally, it is crucial that farm safety programs understand apprenticeships of observation are generational and ongoing over time, and interventions prevention programs need to be ‘in it’ for the long haul.     

STEADI: CDC's approach to make older adult fall prevention part of every primary care practice

IntroductionPrimary care providers play a critical role in protecting older adult patients from one of the biggest threats to their health and independence—falls. A fall among an older adult patient cannot only be fatal or cause a devastating injury, but can also lead to problems that can effect a patient's overall quality of life.MethodsIn response, the Centers for Disease Control and Prevention (CDC) developed the STEADI initiative to give health care providers the tools they need to help reduce their older adult patient's risk of a fall.ResultsCDC's STEADI resources have been distributed widely and include practical materials and tools for health care providers and their patients that are designed to be integrated into every primary care practice.ConclusionAs the population ages, the need for fall prevention efforts, such as CDC's STEADI, will become increasingly critical to safeguard the health of Americans.Practical applicationsSTEADI's electronic health records (EHRs), online trainings, assessment tools, and patient education materials are available at no-cost and can be downloaded online at www.cdc.gov/STEADI. Health care providers should look for opportunities to integrate STEADI materials into their practice, using a team-based approach, to help protect their older patients.     

An epidemiologic comparison of injuries presenting to a pediatric emergency department and local urgent care facilities

Problem

The objective of this study was to compare the epidemiology of injuries presenting to emergency department (ED) and urgent care (UC) facilities of a single, NEISS-affiliated hospital.

Method

Patient medical records (n = 36,811) were used to compare injury incidence, injury characteristics, and demographic characteristics between the ED, on-site UC, and off-site UC during 2006.

Results

ED presentations were more likely to be open wounds and motor vehicle-related compared to on-site UC presentations. ED presentations were more likely to be system wide/late effects, be made by an African American, or be paid through Medicaid compared to off-site UC presentations. On-site UC presentations were more likely to be made by an African American or be paid through Medicaid compared to off-site UC presentations.

Discussion

ED and UC injury characteristics and patient demographics differ. With no nationally-representative UC injury surveillance, current research likely underestimates injury incidence and presents skewed profiles. Impact on Industry: This article adds insight into the generalizability of ED-based injury surveillance to UC injuries.     

International co-operation in hazardous materials accident prevention

Accident prevention relies on a proper understanding of relevant hazards so that appropriate controls can be put in place to safeguard those who are potentially endangered. Setting deaths from war, natural events and domestic accidents to one side, industrial chemicals in their manufacture, transport, storage and use arguably contribute significantly to society's accident toll. National and international regimes have been developed over the years to characterise the properties of these hazardous materials so that risks to society and workforces handling such `dangerous goods' are reduced. Sometimes it has taken a disaster to show that a hazard formerly unrecognised did in fact exist; sometimes the closer scrutiny of test methods has shown that a dangerous property may have gone unrecognised; sometimes misuse of materials precipitated controls. However, in all the deliberations surrounding hazardous materials characterisation, accident investigation and prevention, and development of controls, suitable exchange of information and viewpoints between experts is necessary to promote development and adoption of international conventions. These international protocols are normally agreed by policy makers who have technical advisers to support their negotiations. These technical advisers need to meet in an appropriate forum to develop an understanding of all the relevant factors and to test ideas; often such group discussions pave the way to agreements being reached at formal policy negotiations, to solutions being provided for certain disasters, to better methods of testing. The International Group of Experts on the Explosion Risks of Unstable Substances (OECD-IGUS) created by the OECD is one such group. It first met in 1962.Set up initially to harmonise test methods used by countries to identify and quantify the explosive properties of unstable materials, it has continued over the years to offer scientists who are advisers to their governments (and others) a forum to exchange data and information primarily in support of the development of classifications regimes to protect society from the hazards of unstable substances and remove barriers to international trade but also in understanding and quantifying the resulting effects—such as explosion—from accidents involving these and other `dangerous goods'. This paper describes some of the accidents which show the need for international controls for `dangerous goods' and some of the contributions made by OECD-IGUS (often referred to as `IGUS') to their developments.     

Violence‐prevention climate,exposure to violence and aggression,and prevention behavior: A mediation model

This study explored mechanisms underlying employees' behaviors targeted at preventing workplace physical violence and verbal aggression. Poor psychological violence‐prevention climate perceptions and previous exposure to violence and aggression represent stressors that were associated with increased strains and reduced motivation. Strains and motivation, in turn, were related to prevention behaviors. We collected data from employee and coworker dyads, and structural equation modeling results supported that clear organizational policies, prompt management responses to assaults, and putting safety as a priority contributed positively to prevention behaviors through reduced strains and increased motivation. On the other hand, prior experiences of being attacked were related to more strains and lower motivation, which were related to lower prevention compliance. Our results inform future interventions for violence prevention. Copyright © 2011 John Wiley & Sons, Ltd.     

Comparison of recidivism rates for a teenage trauma prevention program after the addition of high-fidelity patient simulation

Objectives: We evaluated the benefits of adding high-fidelity simulation to a teenage trauma prevention program to decrease recidivism rates and encourage teens to discuss actionable steps toward safe driving.

Methods: A simulated pediatric trauma scenario was integrated into an established trauma prevention program. Participants were recruited because they were court-ordered to attend this program after misdemeanor convictions for moving violations. The teenage participants viewed this simulation from the emergency medical services (EMS) handoff to complete trauma care. Participants completed a postsimulation knowledge assessment and care evaluation, which included narrative data about the experience. Qualitative analysis of color-coded responses identified common themes and experiences in participants' answers. Court records were reviewed 6 years after course completion to determine short- and long-term recidivism rates, which were then compared to our program's historical rate.

Results: One hundred twenty-four students aged 16–20 years participated over a 2-year study period. Narrative responses included general reflection, impressions, and thoughts about what they might change as a result of the course. Participants reported that they would decrease speed (30%), wear seat belts (15%), decrease cell phone use (11%), and increase caution (28%). The recidivism rate was 55% within 6 years. At 6 months it was 8.4%, at 1 year it was 20%, and it increased approximately 5–8% per year after the first year. Compared with our programs, for historical 6-month and 2-year recidivism rates, no significant difference was seen with or without simulation.

Conclusions: Adding simulation is well received by participants and leads to positive reflections regarding changes in risk-taking behaviors but resulted in no changes to the high recidivism rates This may be due to the often ineffectiveness of fear appeals.