OSH research

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Klaus Kuhl (Cooperation Centre, Kooperationsstelle Hamburg IFE GmbH)


Introduction

OSH research combines a range of approaches. The public health and safety analysis approach involves epidemiology, toxicology, microbiology, health education etc. There are also physical, chemical, technical, economic and organisational approaches, such as developing engineering controls, non-hazardous chemicals, exhaust systems, or stress-free work processes. Both approaches are necessary for OSH, where research is application-oriented. Interdisciplinary methods, coordination and stakeholder participation are extremely important.

OSH research, definition, relation to research in other disciplines

OSH research is a systematic investigation to acquire new knowledge in the field of occupational safety and health. Developed in reaction to practical problems, namely workplace injuries, this applied research looks into incidences, characteristics, causes and prevention [1].

OSH research is closely related to research on ergonomics, originally developed in the 1850s to improve the quality, effectiveness and efficiency of work processes. The experience gained during the extensive restructuring processes demonstrated that, in the long-term, these goals could only be achieved by healthy workers and well-designed machines. The aim of modern ergonomics is, therefore, to optimise the resource “human work” by adapting work to humans. It studies the interactions between humans and other system elements, in order to optimise human well-being and overall system performance. A large overlap between the two scientific fields has developed [2] [3].

OSH research needs to address a wide range of problems [4] [5] :

OSH research needs to combine the public health approach because of the injury focus and the safety analysis approach because of the prevention focus. I.e. researchers have to employ on the one hand epidemiology, microbiology, toxicology, health education etc. and on the other hand physical, chemical, technical and organisational approaches, such as the development of engineering controls, of non-hazardous chemicals, of exhaust systems and stress-free work processes. Both approaches are needed in occupational health as well as in occupational safety [1] although to a different extent.

Methods and instruments in use

The methods and instruments may be complex, involving many disciplines, depending on the specific problems. There is an increased need to identify and involve all necessary expertise and to coordinate the efforts. This is illustrated by the following table.

Table 1: Disciplines and methods for selected OSH issues

Problems Disciplines Objectives / methods Typical institutes
Slips, trips Accident research Identify hazardous conditions (design statistics and reporting systems, data gathering and analyses) Institutes of accident insurance associations
Labour inspection
Medicine Develop cures, rehabilitation Medical universities
Medical engineering Develop prosthesis Specialised institutes
Accident research Develop preventive measures by a systematic examination of the structure and functions of a system aimed at identifying accident contributors, modelling potential accidents, and finding risk-reducing measures [1] (lab and technical centre). Institutes of accident insurance associations

Other institutes (e.g. ergonomics)
Engineering departments of universities

Measuring technology Develop measuring methods (lab and technical centre) Institutes of accident insurance associations
Chemical engineering Identify safe alternatives, e.g. non-slippery floor-lining, dry cleaning (lab and technical centre) Technical universities
Process engineering / Ergonomics Identify technical and organisational alternatives, e.g. processes that avoid complicated moves (technical centre) Technical colleges
Equipment development / Ergonomics Develop PPE – personal protective equipment - e.g. non-slippery safety boots R&D – research and development - departments of private companies
Psychology Develop communication methods,
Develop methods to change unsafe behaviour
Universities
Consultants
Education, communication Develop training and instruction methods Colleges
IT Develop tools for risk assessment and identification of preventive and control measures Institutes,
Institutes of accident insurance associations
Economy Develop methods to calculate the costs of accidents and preventive measures,

Design incentive systems

University institutes
Institutes of accident insurance associations
Policy Design control systems, e.g. rules/standards for staircases, floor lining etc. Multidisciplinary work groups
Jurisprudence Design legal systems Universities
Sociology Evaluate methods (statistics, surveys, questionnaires)

Develop methods of participation

Universities
Consultants
Work related chronic or acute diseases caused by hazardous substances Epidemiology Identify harmful substances (surveillance, data gathering and analyses) Medical universities
Medicine Develop cures, rehabilitation Medical universities
Toxicology Identify harmful substances (lab)

Identify mechanisms, pathways (lab)
Identify OELs – occupational exposure levels - (lab)

Universities
Develop measuring methods (lab and technical centre) Institutes of accident insurance associations
Hygiene Develop preventive measures (lab and technical centre)

< Medical universities, Institutes of accident insurance associations

Chemical engineering Identify safe alternatives (lab and technical centre) Technical universities
Process engineering / Ergonomics Identify technical and organisational alternatives, e.g. processes that do not need chemicals (technical centre) Technical colleges
Equipment development / Ergonomics Develop PPE, e.g. gloves, masks and filters R&D departments of private companies
Psychology Develop communication methods,
Develop methods to change unsafe behaviour
Universities
Consultants
Education, communication Develop training and instruction methods Colleges
IT Develop tools for risk assessment and identification of preventive and control measures Technical colleges Institutes of accident insurance associations
Economy Develop methods to calculate the costs of diseases and preventive measures,

Design incentive systems

University institutes
Institutes of accident insurance associations
Policy Design control systems, e.g. OEL systems Multidisciplinary workgroups
Jurisprudence Design legal systems Universities
Consultants
Sociology Evaluate methods (statistics, surveys, questionnaires)

Develop methods of participation

Universities
Consultants

Source: Overview by the author

A full research cycle could start with epidemiological surveillance, i.e. a systematic collection, analysis and interpretation of health data (see also: Reporting and monitoring occupational accidents and diseases in Europe and Learning from incidents and accidents). As major problems become apparent, researchers may design studies to answer detailed questions. This is followed by the development of intervention / prevention strategies and finally by an evaluation of these strategies [1]. As can be seen from the table above, there is a difference regarding data collection for work-related diseases and for accidents; the former is done by medical experts often from university institutes, and the latter by experts from accident insurance association institutes (see also: Accident investigation and analysis). Regarding study design researchers focus more on health measures, whereas regarding intervention strategies, researchers focus more on engineering controls. However, prevention of e.g. MSD – musculoskeletal diseases requires not only lifting devices but also continuous individual exercises and improvements in work organisation [6], thus stressing the need to look beyond discipline borders.

There are many barriers between the disciplines. One such example is safety and health research: it is easier to obtain information on accidents in companies than on work-related diseases, making evaluations in this field very difficult [7]. These divisions as well as the great number of involved disciplines illustrate that interdisciplinary methods, exchange and coordination are very important. The development of safe machines would greatly benefit from the involvement of OSH researchers already at the design stage, rather than trying to improve a machine that has already caused accidents [1]. The same applies (though less obvious) to work processes/organisation which may cause accidents, MSD and stress related diseases. Stakeholders should also be included, e.g. machine operators or workers that could be affected by inefficient design and implementation procedures. Not only do such stakeholders know the specific requirements, they are also more likely to ‘buy in’ to measures which they have helped develop (see also Methods and effects of worker participation).

Well designed engineering control measures are often put in place, only to realise that workers do not respond as desired or even try to outwit or manipulate the appliances [8]. Developing preventive measures or controlled experimental research is generally not sufficient; behaviour must also be addressed. Especially on safety management and OSH policy, several research projects use a system perspective, as opposed to the analytical perspective, because of the many factors that may influence the results. This analysis focuses primarily on the complete system, and tries to understand its functioning [9].

There is, therefore, a need for further development of expertise, exchange, networking and coordination in OSH research. Coordination has two major aspects: cross-disciplinary/institutional and cross-national. The first is often carried out by large governmental institutes (FIOH in Finland or BAuA in Germany). However, this is also an obligation of institutes and organisations involved in OSH research. EU-OSHA notes: 'research organisations should coordinate their respective programmes, target them to address practical problems arising at the workplace, and make preparations for the research findings to be transferred to firms, and especially to SMEs' [10].

At cross-national the partnership for European Research in Occupational Safety and Health - PEROSH and the European agency EU-OSHA 'encourage national OSH research institutes to set joint priorities, exchange results and include occupational health and safety requirements in research programmes' [11] . To combine both approaches the national agencies often serve as Focal Points for the European agency.

Evaluation, results

Evaluation has many aspects and levels. In general, the evaluation of OSH research projects must consider the human factor, which usually requires an evaluation in a company setting. The ultimate test is whether an approach really improves the situation in a company. There is wide scope for various projects, so identifying the most promising approach is beneficial. Apart from the usual problems associated with methodological evaluation (e.g. sample size, selection bias), OSH project evaluation is complicated by other factors of influence:

  • Behaviour of employees, which depends on culture (e.g. macho behaviour), age, peer pressure, company culture, example of management and supervisors
  • Condition of buildings and machines; design and quality, maintenance
  • Situation and history of the company; e.g. relation of newcomers and experienced staff, danger of closing down, number of contract workers, etc.
  • Duration of project; OSH projects are often short term activities, due to company time schedules, although, long term projects are preferable for improved results.

This can lead to similar projects in similar companies producing results that are quite different, or even questionable or irreproducible.

The EU-OSHA demands that projects should produce evidence-based results. This is their hierarchy of criteria [12]:

  1. Systematic reviews and meta analyses
  2. Randomised controlled trials
  3. Cohort studies
  4. Case control studies
  5. Cross sectional surveys
  6. Case reports
  7. Expert opinion

Some scientists (especially in the medical area but also in OSH research) claim the randomised controlled trial approach needs a redesign, as the announcement of intervention can already lead to OSH improvements [13] [14].

The hierarchy of criteria does not consider contextual factors, i.e. factors mentioned above that could nevertheless influence the results of the research projects. Therefore, the ‘realistic evaluation method’ has been developed to take these factors into account [15].

While the reduction in numbers and/or severity of accidents and work related diseases remains the litmus test, the evaluation of project design and implementation is important for analysing the factors of success and failure. Careful documentation is therefore necessary to enable such evaluations [14].

To produce sound results would also require finding a sufficient number of comparable companies. However, finding a viable number of companies (especially SMEs) that will commit themselves to such long term studies is very difficult. Therefore many research projects rather conduct short term studies and compare the situation in the same company before the onset of the project and after a given period of often one or two years. This may well yield useful results provided the situation in the company and the general economic and cultural situation does not change much.

Examples

A typical example for the evaluation of larger OSH projects is provided by the Dutch Working Conditions Act covenant on working conditions in the cleaning and window cleaning sectors. The project was evaluated by an external institute producing a report on its effects [16]. Data was obtained from a questionnaire filled in by 10,000 employees from the sector, and telephone interviews conducted with 2,600 employers. The response rate among the employees was 23% and among the employers 13%. The results showed improvements in some areas, with no changes in others.

In their 2009 analysis Hartmann and Spallek suggest that work related MSDs are still on the increase, despite many studies, projects and efforts to combat them [6]. Some projects used video documentation to track work movements of specially equipped test persons. Some used virtual reality. Many projects developed or implemented preventive back pain training others concentrated on lifting aids or ergonomically designed chairs. The authors see the need for a more coordinated approach involving medicine, psychology, technology and socio-political institutions. They stress the need to identify and consider the individually optimal balance of strain and relief.

Pedersen and colleagues noted in a 2012 report [17]: 'A revised realistic evaluation model is provided which includes factors such as role behaviour, leader and worker motivation, underreporting of accidents/injuries, production pressure, unplanned organisational change and accounting for multilayer effects. These can be attained through qualitative and/or quantitative methods, allowing for the use of realistic evaluation in both large and small scale studies, as well as in systematic reviews'.

Expert forecasts, new and emerging risks

OSH research is not only trying to solve problems but to prevent, so early risk identification is important. Researchers describe methods for establishing new and emerging risks. EU-OSHA has contracted its Topic Centre Risk Observatory to conduct expert forecast studies covering: physical, chemical, biological and psychosocial risks; see e.g. [18]. The researchers applied the so-called Delphi method, which they describe as ‘a widely used methodology to create foresight information on topics for which only uncertain or incomplete knowledge is available. There are several variations of the Delphi method but all of them are based on an iteration process with at least two survey rounds in which the results of the previous rounds are fed back and submitted again to the experts for new evaluation. The feedback process ensures that the experts are aware of the views of other experts and gives them the possibility to revise their first evaluation accordingly. At the same time, it avoids group pressures, which could have the experts not dare giving their real opinion and would lead to distorted results’. The team used three survey rounds and had a number of responses in the range of 50-70 experts.

SSome experts have pointed out limitations of the Delphi method, as it is seen as a method for evaluating already identified trends [19]. Scientists have therefore expanded and complemented the methodology into a so-called 'foresight system' [20] [21] . This includes analyses of scientific publications, database searches and virtual tours to a possible future. The authors postulate the following cycles:

  1. Preliminary stage: setting up the objectives, scaling the exercise, defining the organisational design and members of the panels, preparing the input data and information,
  2. Central stage (a): determining the key-parameters (‘drivers’) and issues,
  3. Central stage (b): identifying the relevant perspectives and scenarios,
  4. Finalisation stage: strategic analysis, dissemination of the results and recommendations.

In order to improve the validity of the emerging risks findings, EU-OSHA established a Europe-wide survey on health and safety at the workplace: the European Survey of Enterprises on New and Emerging Risks (ESENER) [22]. It involved approximately 36,000 interviews across 31 countries (27 European Union Member States, Norway, Switzerland, Croatia and Turkey). Through separate telephone interviews, ESENER asked managers and workers’ health and safety representatives about OSH risk management at their workplace, with a particular focus on psychosocial risks. Following this, four in-depth (multivariate) secondary analysis projects were carried out in 2011, aiming at amongst others identifying the extent to which ESENER is able to confirm practices from other studies and drawing on scientific knowledge and information on the regulatory and business environment [23].

Priorities for OSH research in the EU

EU-OSHA has drawn conclusions regarding research priorities. A report presented in 2005 was declared a working paper as it was based on a limited number of expert opinions [20]. In short, the research priorities were: psychosocial issues, musculoskeletal disorders, dangerous substances, knowledge of reproductive risks, OSH management, and risks associated with cross-factors.

EU-OSHA has continuously adapted the priorities, based on the above mentioned studies [23]. The findings included:

  • Effective preventive action across all sectors is needed to tackle increasing MSDs, stress, violence and harassment.
  • Research is needed into how worker representation can effectively address psychosocial and other emerging risks.
  • A systematic approach to psychosocial risk prevention is recommended, and establishments should implement a broad range of preventive actions.
  • A lack of technical support and guidance is the most important barrier to managing psychosocial risks, followed by a lack of resources.
  • Awareness of psychosocial risks needs to be increased, as does the provision of support and guidance. Further research is needed to support the ‘business case’ for psychosocial risks management at workplace level.

Conclusions and outlook

The wide variety of disciplines and methods mean that OSH research is complex. More cooperation is required at all levels and disciplines. The barriers between safety research and health research must be lowered, and both must consider the human factor and the behaviour issue.

Closer cooperation and coordination must include ergonomics research. The European Ergonomics Societies (FEES) among others look into “elderly workers”, which is also a big issue in OSH research [24].

Many research results are not yet applied in practice, for example pschosocial risk assessment is still not implemented in many companies. Among the reasons for this (e.g. methodological problems in producing transferable results) Luczak and colleagues have identified insufficient efforts to design multidisciplinary projects. They demand a new culture in OSH research [9].


References

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Links for further reading

EU-OSHA – European Agency for Safety and Health at Work, Topics (2012). Retrieved 15 June 2012, from: http://osha.europa.eu/en/topics.

Brueggmann, M., Roetting, Luczak, H. ‘International Comparison of Occupational Safety and Health Research—A Review Based on Published Articles‘, International Journal of Occupational Safety and Ergonomics, 2001, Vol. 7, No. 4, pp. 387–401. Available at: www.ciop.pl/814.

Adèr, H.J., Mellenbergh, G.J., Hand, D.J., Advising on research methods: A consultant's companion, Huizen, The Netherlands: Johannes van Kessel Publishing, 2008.

Ornstein, M.D. ‘Survey Research’, Current Sociology, 1998, 46(4): iii-136.

Ørbaek, P., Working environment challenges of the future: Output of the Copenhagen Seminar, Lecture at a PEROSH conference in Finland, 2011. Retrieved 7 March 2012, from: http://www.perosh.eu/p/DCDCB0AAC9F4E629C12578B7003745FD.

Iavicoli S., How to identify research priorities in OSH, Lecture at a PEROSH conference in Finland, 2011. Retrieved 7 March 2012, from: http://www.perosh.eu/p/DCDCB0AAC9F4E629C12578B7003745FD.

Iavicoli S., Rondinone B., Marinaccio A., Fingerhut M., ‘Research priorities in occupational safety and health’, Industrial Health, 2006, 44:169-178.

Iavicoli S., Rondinone B., Marinaccio A., Fingerhut M., ‘Identification of research priorities in occupational health’, Occup Environ Med, 2005, 62:71-72.

Rondinone B., Boccuni F., Iavicoli S. ‘Trends and priorities in occupational health research and knowledge transfer in Italy’, Scand J Work Environ Health, 2010, 36:339-348.