NEW SOLUTIONS, Vol. 23(3) 485-503, 2013
Features TRAINING FOR AN EFFECTIVE HEALTH AND SAFETY COMMITTEE IN A SMALL BUSINESS SETTING ALLISON CROLLARD RICHARD L. NEITZEL CARLOS F. DOMINGUEZ NOAH S. SEIXAS
ABSTRACT
Health and safety committees are often heralded as a key element of successful health and safety programs, and are thought to represent a means of engaging workers in health and safety efforts. While the understanding of the factors that make these committees effective is growing, there are few resources for how to assist committees in developing these characteristics. This paper describes one approach to creating and implementing a training intervention aimed at improving health and safety committee function at one multilingual worksite. Short-term impacts were evaluated via questionnaire and qualitative observations of committee function. Results indicated high satisfaction with the training as well as modest increases in participation, cooperation, role clarity, and comfort with health and safety skills among committee members. The committee also made considerable achievements in establishing new processes for effective function. Similar interventions may be useful in other workplaces to increase health and safety committee success. Keywords: safety training, training evaluation, health and safety committee
Employee participation has been identified as a key element to the success of occupational health and safety programs [1-5]. Workers often have a good understanding of their work and its hazards, so valuable information can be 485 Ó 2013, Baywood Publishing Co., Inc. doi: http://dx.doi.org/10.2190/NS.23.3.d http://baywood.com
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gained about the type of hazards in the workplace and potential control methods by fostering their participation in health and safety activities [6, 7]. One common method for engaging workers in health and safety is through the use of joint labor-management health and safety committees (HSCs) in which worker representatives act as liaisons between the workforce and management, and members work together to identify and address health and safety issues. As a result, HSCs have been widely adopted as a key mechanism for increasing worker involvement in health and safety. However, simply having an HSC does not ensure that a company’s workers will be sufficiently engaged, or that the workplace will be healthy and safe. Rather, the HSC must be effective to realize these benefits. Despite a variety of resources providing best practice guidelines for HSC effectiveness, little empirical evidence exists on the characteristics that make committees successful [8]. Studies that have been carried out often use disparate measures of HSC effectiveness, and have taken place in a variety of different countries and jurisdictions, each with a distinct regulatory environment, making it even more difficult to find commonalities in determinants of HSC success. Researchers measuring effectiveness in terms of injury rates have found that sites with lower injury rates are more likely to have larger committees in relation to workforce size, committees with higher ratios of worker-members to management-members, committees that reviewed more worker health and safety complaints at meetings, committees that recorded and reviewed health and safety issues from previous meetings, and committees with increased scope and executive authority [4, 9-11]. Perceived HSC effectiveness has also been associated with increased executive authority and worker-member involvement, as well as increased training of HSC members [9, 12, 13]. Qualitative studies and reviews have also suggested that key characteristics of HSCs include recordkeeping measures such as agendas and meeting minutes, and tracking of health and safety issues; mechanisms for the workforce to report issues; written recommendations to management for addressing issues; HSC member participation in additional training, inspections, and accident investigations; and clearly defined roles and responsibilities of HSC members and of the HSC itself [14-17]. Researchers and industry experts also describe external factors that influence committee effectiveness. Often, particularly in the United States, HSCs take on an advisory role as employers are ultimately responsible for ensuring a healthy and safe workplace. Therefore, the level of management support for health and safety in general, as well as its support for the HSC, can affect a committee’s ability to address health and safety issues regardless of internal HSC factors [10, 12]. Union involvement and positive labor-management relations may also help facilitate HSC effectiveness through provision of resources and support of worker engagement in health and safety matters [12, 15]. Adding to the complexity of committee effectiveness is the increasing diversity of workforces, particularly in the United States. If a primary goal of HSCs is to foster worker involvement, it is important that workers are adequately
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represented on committees, not only in terms of departments and shifts, but also language and cultural groups. Immigrant workers or workers with limited English proficiency may be difficult to engage due to language and cultural differences, and may have difficulties communicating about health and safety issues [17-19]. This may prevent these workers from serving on HSCs or being reached by HSC members. Minimal guidance exists for how to best engage immigrant workers or workers with limited English proficiency in health and safety activities, particularly in the context of HSCs. There are also significant gaps in knowledge from the literature in understanding how to develop an effective health and safety committee in the workplace, multilingual or otherwise. Despite the efforts of researchers to identify characteristics associated with effective HSCs, little information is available on methods that focus on developing and implementing such characteristics to improve HSC function. Two Canadian studies describe efforts in this area, and specifically focus on training interventions for HSC members to improve committee function [20, 21]. Ostry and Yassi [20] conducted a study in which selected labor and management representatives of various health and safety committees from health-care facilities in British Columbia, Canada, attended one-day workshop trainings on HSC issues. The authors describe statistically significant post-training increases in attendee reports of cooperation among HSC members, comprehension of the committee role, and ability to identify health and safety hazards. Similarly, SPR Associates Inc. [21] conducted a survey of HSC members who had completed a 40-hour certification training that was required of at least one management and one labor representative of a committee by the Ontario Occupational Health and Safety Act. Results revealed increased worker and management perceptions of worker contributions to committee activities, effectiveness of inspections, and improvements in health and safety. While the results of these studies suggest that training may offer some benefits to HSC function, details on training content and technique are not provided. In an effort to improve understanding in these areas, a small-scale intervention study was conducted with an HSC in a small business setting with a multicultural and multilingual workforce. As a case study, the focus was to elucidate the complex role of committees in the health and safety environment of a workplace, and to develop a training approach to build capacity for improved committee function. Long-term impact of the training intervention was assessed by measuring changes in HSC effectiveness in terms of injury rates, presence and severity of hazards and exposures, and perceptions of HSC effectiveness, and are reported elsewhere [22]. However, it was hypothesized that a host of shorter-term conditions would need to be met in order for the committee to effect any change in health and safety conditions. Figure 1 shows a conceptual model of the intervention’s theorized effect. This paper describes the context and approach to developing and implementing a training intervention for a multilingual HSC, and evaluating its short-term impacts.
Figure 1. Conceptual model of training effect.
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METHODS Development and implementation of the HSC training took place in the context of an 18-month-long intervention study at a small scrap metal recycling business in Washington state, where health and safety committees are required for companies with more than 10 employees. The company buys metalcontaining objects from companies and individuals, breaks them down into small pieces by hand and by large mechanical shredding and shearing processes, and sorts the metals by type to be resold. The nature of the work poses a variety of health and safety hazards for its 50 production employees, as described elsewhere [23]. The majority of yard workers are represented by one union, and a handful of others—truck drivers and crane operators—are represented by two additional unions. Immigrant workers comprise approximately 70 percent of the workforce, most from Mexico or Central America. Only 45 percent of workers reported that they were comfortable reading and speaking English. The site was selected for the study after a concerned worker approached a consultant, employed by the University of Washington (UW), who was conducting industrial hygiene monitoring at the scrap yard. The worker expressed frustration that many health and safety issues remained unaddressed by the site’s management, and that health and safety communications were not meeting the needs of the site’s culturally and linguistically diverse workforce. Study staff contacted the concerned worker’s union about the potential for collaborating on an intervention study that would empower workers to address health and safety issues. With their support, input was solicited from the site’s health and safety director and it was determined that the health and safety committee, while meeting state requirements, was not functioning optimally, but with additional support could potentially be a useful forum for worker involvement. The idea for the study was presented at a meeting with study staff, the union organizer, and the site’s upper management, who then granted permission to conduct the study. The study consisted of an assessment of health and safety conditions both before and after the training for the health and safety committee. The assessments included semi-quantitative observations of hazards and use of controls throughout the site; a questionnaire administered to all employees asking about hazards, safety climate, and experiences with the HSC; a questionnaire administered to HSC members with items on HSC function and effectiveness; and industrial hygiene measurements of noise, particulates and metals, and carbon monoxide. In addition, study staff attended all HSC meetings, had individual meetings with the site’s health and safety director, who chaired the HSC, and conversed frequently with committee members and other employees throughout the duration of the study. These informal interactions and observations provided critical additional insight into the function of the HSC, the interactions and relationships both within the HSC and between HSC members and
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the workforce, and the underlying health and safety environment at the site. All research activities were reviewed and approved by the UW Institutional Review Board. Health and Safety Context Prior to the involvement of the research team, the company had established a health and safety program that included a variety of written programs, a health and safety director hired shortly before the study, and a health and safety committee. However, the management demonstrated inconsistent support for its health and safety program, including HSC activities. At the time, the union representing the majority of the site’s workers and most of the immigrant workers did not appear to be actively involved in health and safety issues, and a shop steward—who might have been an important liaison for workers to express health and safety concerns—had not been appointed. Despite this, most workers, particularly immigrant workers, viewed the union as an important source of support. The pre-intervention health and safety assessment provided further insight into the site’s workers’ perceptions of and experiences with health and safety. In the questionnaire, employees assigned only moderate scores for overall safety climate [22]. Qualitatively, workers expressed that they perceived management to be more concerned with production than with safety. For instance, they mentioned that the production manager, also an HSC member, was often seen in the scrapyard without appropriate personal protective equipment (PPE) or doing work in very unsafe situations. In addition, many discussions observed on-site involved blaming individuals for health or safety incidents or problems. Most workers also expressed frustration with communication barriers as a result of the multilingual workforce. In the questionnaire, most immigrant workers reported that language was a barrier to effective health and safety communication, and that their language and/or ethnicity affected how they were treated at work. Informally, these workers explained that they were hesitant to raise health and safety issues for fear of being treated as “difficult” by management and supervisors. The HSC at Baseline The existing HSC was composed of mostly worker-elected representatives, a couple of supervisors, the vice president of operations, one of the company’s owners, and its chair, the health and safety director. Not all work areas were represented in the committee, and few Spanish speakers participated in the HSC, despite the large proportion of Spanish-speaking employees in the workforce. As the site was preparing to have elections for new committee members just after the beginning of the study, the UW research team recommended that an effort be made to recruit members from all departments, as well as
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Spanish-speaking employees, and that the owner sitting on the committee no longer participate. These recommendations were intended to increase comfort and collaboration, particularly for worker-members, and were well received and eventually implemented. The site’s union organizer was also invited to attend committee meetings in efforts to promote worker-member participation. Observations of committee meetings prior to the training intervention revealed that the safety director did the bulk of the committee work, including preparing agendas, recording minutes, chairing committee meetings, acting as liaison with management and the workforce, and responding to any health or safety issues raised. It did not appear that committee members, particularly worker-members, were involved in health and safety activities outside of the meeting setting such as inspections, incident investigations, or worker health and safety trainings. Although various health and safety issues were raised by both management- and worker-members during meetings, it was unclear how and by whom the issues would be addressed. Meetings were conducted in English, and all materials were available only in English. Study staff also observed limited collaboration between members both in and out of HSC meetings, particularly between English- and Spanish-speaking members and between worker- and management-members. Via the questionnaire, differences were found between worker-members and management-members in perceived HSC effectiveness [22]. Managementmembers reported lower effectiveness in HSC hazard identification than workermembers, while worker-members were more likely to report that the HSC was not effective in its communication with workers, that there was not enough worker influence on committee activities, and that language was a barrier to participation on the committee. Anecdotally, most HSC members seemed skeptical that the committee had much impact on health and safety, and many expressed doubt that there was potential to have any influence on health and safety due to lack of support from upper management. For instance, members had expressed concerns to management on multiple occasions that a propane tank was in dangerous proximity to torch-cutting operations, but managers refused to remediate the situation. In addition to lack of management support, most members mentioned a lack of support from their co-workers. They explained that much of the workforce had little faith in the HSC, and that members were not regarded as having any authority or influence in health and safety matters. Employee perceptions of HSC function and effectiveness were also assessed in the pre-intervention questionnaire [22]. Only 35 of the 42 production workers were aware of the existence of the committee, with fewer than half able to correctly name their HSC representative. Very few workers had ever reported a health or safety problem to the HSC, and more than half of those who had said it was not corrected. Many workers also stated that they did not feel they were adequately represented on the committee.
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Training Intervention One of the major themes arising from questionnaire results and the qualitative data was that there were divisions among workers at the site, resulting in distinct perceptions and attitudes among different groups about the health and safety environment at the worksite. As previously described, immigrant workers viewed the worksite as less accommodating for working safely, had difficulties effectively communicating health and safety concerns, and reported discrimination based on their ethnicity. This highlighted the need to consider these differences between employees when developing the training curriculum for the HSC. If an effective committee is one that involves workers in health and safety, approaches that garnered buy-in and facilitated involvement of all workers in a meaningful way were vital to training success. In particular, it was important to engage immigrant workers on the HSC, as they would be liaisons for a significant portion of the workforce. Similarly, differences in perspectives were seen within the committee. Worker members and management members had differing opinions on the HSC’s effectiveness, as well as the role and level of worker involvement related to committee function. The apparently limited level of collaboration was also an indication that members perhaps had different views of the situation, and different agendas. Thus, it was concluded that furthering cooperation and group cohesion would also be important issues to address through the training intervention, as they were felt to be essential to the committee’s function, effectiveness, and sustainability. In addition to the need to increase workforce involvement and collaboration among committee members, needs for improved committee processes and activities were identified. HSC members required additional health and safety training and became involved in health and safety activities outside of meetings. Organized procedures for soliciting worker input on health and safety matters were insufficient. In addition, the HSC needed to discuss the roles and responsibilities of individual committee members, as well as their role in the context of the on-site general health and safety program. The HSC needed to prepare agendas in advance of its meetings and make meeting notes available to members and to the workers. To raise awareness of these HSC needs, it was thought that providing instruction on general health and safety principles and information on activities typically done by effective HSCs might be useful activities for the training intervention. It became clear that there was a need for training methods that would engage all parties, and promote collaboration and communication both within the HSC and between the HSC and the greater workforce. As a result, activities were chosen to promote group development and teamwork, and incorporated adult education, participatory training, and empowerment education principles to maximize engagement and meaningful learning [6, 24, 25]. A skilled bilingual
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and bicultural facilitator was utilized to ensure comprehension and promote participation, as about half of members spoke Spanish as a first language and had varying English language abilities. All presentations, handouts, and materials were translated into Spanish by a native Spanish speaker on the research team and were available to all HSC members. In addition to its focus on group development and communication, the training would also provide basic skills and techniques for effective HSC processes such as hazard identification and soliciting worker input on health and safety issues as described below. Intervention Implementation
After negotiating time and duration, management and study staff agreed on two four-hour training sessions taking place at the worksite, with two weeks between sessions. The facilitator served as an emcee and led the majority of discussions during the training, while University staff presented health-andsafety–specific content and helped facilitate small group activities. Training activities and content are summarized below and are available in detail on the study’s website [26]: Session 1: • icebreaker exercise and introduction to training staff, purpose of the training, and ground rules of the sessions; • brief discussion of the context and causes of health and safety incidents; • team-building exercises including small group discussions of health and safety roles specific to management-members and worker-members; and a related role-play activity; • overview of hazard recognition and control theory including hazard identification practice using site-specific photos; and • assignment of a “homework” activity in which committee members were to engage coworkers in discussion about health and safety hazards in their work areas, along with potential solutions. Session 2: • icebreaker exercise and discussion of communication styles, language and cultural differences, and techniques for facilitating communication around the worksite; • discussion of current committee function and effectiveness and presentation of characteristics and activities of effective HSCs as described in the research literature; • brief overview of pre-intervention health and safety assessment findings and issues arising in the “homework” activity; • small-group discussions of potential next steps for improving committee function and effectiveness; and • priority-setting activity to identify key areas for committee improvement.
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At the start of the sessions, HSC members tended to sit in segregated groups: supervisors at one table, English-speaking workers at another, and Spanishspeaking workers at a third. During small-group activities, committee members were moved and regrouped by the facilitator for some activities to foster collaboration among members who were perhaps less accustomed to working together. The facilitator also made considerable efforts to engage all committee members, giving each the opportunity to voice his or her opinions and encouraging participation of those who tended to be reserved during the trainings. The icebreaker games at the beginning of each session also seemed to promote participation and collaboration by forcing the group to work closely and communicate in potentially uncomfortable situations that were ultimately light-hearted and fun. Overall, the committee members seemed to take the training sessions seriously, and were willing to participate in activities and contribute to discussions. In efforts to foster and sustain any changes in committee function from the training, study staff continued their involvement with HSC activities for one year. Staff attended committee meetings, and also met individually with the safety director, union members, and the union organizer. Translation and interpretation services were provided by study staff, and the committee was encouraged and coached to make changes in policies and processes to improve its effectiveness. In addition, support was provided for the HSC to address two priority health and safety issues, which resulted in a study of traffic patterns at the worksite and recommendations for addressing traffic safety, as well as training and materials for HSC members to facilitate department safety meetings, as detailed elsewhere [22]. Training Evaluation
While an evaluation of the longer-term impacts of the intervention was planned for one year post-intervention, it was decided that an evaluation of the short-term and intermediate outcomes as seen on the conceptual model (Figure 1) would also be useful in understanding the training intervention’s impact. A brief pretest-posttest evaluation was conducted to assess the short-term outcomes of the training. The 13 HSC members completed a short written questionnaire in either English or Spanish one week before the first training session as well as at the completion of the second training session. The seven pre- and postintervention items were developed to assess any change in comfort participating in committee activities, perceptions of committee cooperation, clarity of committee roles, and individual comfort with health and safety skills. The postintervention questionnaire also had items to assess HSC members’ satisfaction with the training. Questionnaire items primarily utilized a Likert scale format, with the addition of a few open-ended items on the post-intervention questionnaire. The training was also evaluated qualitatively, through observations of
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committee function and informal interviews with committee members before, during, and after the training intervention. RESULTS Study findings included both questionnaire results and qualitative observations of the HSC’s functioning post-intervention. Questionnaire Results As seen in Table 1, initial scoring of the evaluation items was moderately high, with mean responses of 3.77 or higher (on a 1-5 scale) for all items. Nonetheless, average increases in scoring by all members were seen for all factors—particularly in comfort speaking up in the committee setting (mean
Table 1. Evaluation of HSC Function Before and After Training Pre-training mean (SD) scorea
Post-training change
Total (n = 13)
Total (n = 13)
Managementmembers (n = 4)
Workermembers (n = 9)
Comfort interacting in HSC setting
4.31 (0.75)
0.38 (0.87)
–0.25 (0.50)
0.67 (0.87)
Comfort speaking up in HSC setting
4.15 (1.07)
0.46 (0.78)
0.00 (0.00)
0.67 (0.87)
Level of cooperation among HSC members
4.23 (0.60)
0.23 (0.83)
0.41 (0.82)
0.33 (0.87)
Individual role clarity
4.00 (0.85)
0.42 (0.67)
0.50 (0.58)
0.38 (0.74)
HSC role clarity
3.77 (1.01)
0.54 (0.97)
0.50 (1.29)
0.56 (0.88)
Comfort with hazard identification
4.15 (1.28)
0.38 (0.77)
0.00 (0.00)
0.56 (0.88)
Comfort developing solutions to hazards
4.23 (0.83)
0.31 (0.75)
0.25 (0.50)
0.33 (0.87)
Questionnaire item
aScale:
1 (strongly disagree) to 5 (strongly agree).
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change of 0.46), clarity of the individual members’ roles (change of 0.42), and clarity of the committee’s role in health and safety (change of 0.54). Interestingly, results stratified by management status show that management-members’ rating of their comfort with interacting in the committee setting decreased, while worker-members’ rating of their comfort showed a substantial increase. The decrease may be due to very high scoring of this item initially (4.31), and a regression to the mean on the post-training questionnaire. Similarly, there was no increase in reported comfort speaking up in the committee setting among management-members, although there was a fair increase among worker-members. On average, committee members reported being satisfied with the training on the post-training questionnaire (Table 2). They indicated that the facilitator was clear and encouraged participation from all members and that the information presented and handed out was useful. Overall HSC members rated satisfaction at 4.69 out of 5. Satisfaction with training elements was very similar between management- and worker-members. The responses to the open-ended items on the post-training questionnaire also revealed that committee members were generally satisfied with the training intervention. When asked which elements of the training were the most useful, many members cited the integration, collaboration, and participation of all committee members, particularly between workers and management, and between English speakers and Spanish speakers.
Table 2. HSC Member Satisfaction with Training Intervention Mean (SD) scorea Total (n = 13)
Managementmembers (n = 4)
Workermembers (n = 9)
Ability of facilitator to encourage participation
4.77 (0.60)
5.00 (0.00)
4.67 (0.71)
Clarity of facilitator
4.69 (0.48)
5.00 (0.00)
4.56 (0.53)
Usefulness of information
4.62 (0.51)
4.50 (0.58)
4.67 (0.50)
Usefulness of handouts
4.50 (0.90)
4.67 (0.58)
4.44 (1.01)
Future use of handouts
4.45 (0.69)
4.67 (0.58)
4.38 (0.74)
Overall satisfaction
4.69 (0.48)
4.75 (0.50)
4.67 (0.50)
Questionnaire item
aScale:
1 (strongly disagree) to 5 (strongly agree).
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Qualitative Observations of Post-Intervention HSC Function Changes in committee structure and function can be seen in Table 3. Several procedural changes were made after the training, including the development of a mission statement for the HSC, outlining of roles and responsibilities of members, implementation of a new hazard reporting system, and initiation of writing recommendations to management. After the training intervention, committee activities continued to be led primarily by the safety director/ committee chair, although efforts were made to involve the HSC as a whole in health and safety initiatives. For instance, all members participated in training to do walk-through inspections and accident investigations, and there were reports of members responding to near-miss incidents and facilitating use of the hazard reporting system. Study staff also observed considerably more participation of worker-members during HSC meetings, particularly Spanish-speaking members. Both Spanish-speaking and English-speaking members commented that interpretation during meetings helped to facilitate this increased participation, ultimately resulting in better collaboration and communications within the entire group. Union organizers, some immigrants and native Spanish-speakers, occasionally attended HSC meetings and provided support for participation and communication for the group as well. HSC member complaints about the lack of credibility of the committee among the workforce persisted, although the majority of worker-members commented that the new work area safety meetings led by members had helped garner respect and engage workers in health and safety issues. DISCUSSION Results from the evaluation of the training intervention indicated that HSC members were satisfied with the training, and that some change in participation, cooperation, role clarity and comfort with health and safety skills as measured by the questionnaire may have resulted from the intervention. These positive effects are modest, however, and coupled with the very small sample size, do not provide clear indication of the actual effect of the training. As is often the case with applied intervention work, the complicated nature of health and safety conditions makes it difficult to identify the exact causes of such changes. In this dynamic worksite, a variety of health and safety activities and large fluctuation in production demands occurred concurrently with the study. For instance, around the time of the pre-intervention health and safety assessment, efforts were being made to complete safety recommendations following a consultative visit made by the state occupational health regulatory agency. Various near-miss incidents and accidents also occurred throughout the study period, which often resulted in a reactive emphasis on certain safety measures by upper management.
Post-intervention HSC activities • All work areas represented on HSC, more than half of HSC made up of workermembers • Hour-long HSC meetings scheduled monthly, sometimes cancelled or rescheduled • Creation of a mission statement and charter outlining roles and responsibilities within the committee • Spanish-English interpretation during meetings (by study staff) • Translation of agendas and minutes in both Spanish and English (by study staff), made available to all workers • Development of an anonymous hazard reporting system (suggestion box style) • Walk-through inspection training for all HSC members • Solicitation of a traffic safety study for the worksite followed by a written recommendation for changes to upper management • Development and implementation of industry-specific health and safety “toolbox trainings” delivered to the workforce by HSC members
Pre-intervention HSC activities
• Elections held for worker representatives, which made up more than half of HSC members • Health and safety director elected as HSC chair • Many, but not all work areas represented • Hour-long HSC meetings scheduled monthly, but often cancelled or rescheduled • Agendas and minutes used at meetings • Health and safety issues raised via round robin exercise at meetings
• Establishing processes for making decisions and setting priorities • Identifying and monitoring goals for the committee • Setting aside more time for committee business • Having a worker-member co-chair the committee
Recommended activities not adopted
Table 3. Accomplishments of the Committee Pre- and Post-Intervention
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There was also an occasion when workers did not receive notification letters of their periodic blood lead testing results, leading to increased discussion of health-related effects of their work exposures among employees. As these events unfolded, study staff attempted to coach the committee in becoming involved in and addressing such issues. The continued presence and support of study staff may also have influenced training outcomes. Rather than providing the training and leaving the HSC to be independent and self-sustaining, it was decided that the committee would most benefit from continued support and resources. In the context of the apparent lack of upper management support for health and safety from the beginning of the study, it was unclear that momentum from the training intervention and subsequent committee growth would be sustained. Indeed, HSC meetings were frequently cancelled or rescheduled due to production pressures, and it was only with persistent pressure from the study staff that the committee continued to meet regularly and undertook many of the recommended projects. The study staff was also instrumental in promoting teamwork and participation after the training by providing Spanish-English interpretation and facilitating some meeting activities. Without the ongoing assistance of the research team, it was unclear if the committee would have made the achievements it did with the intervention alone. Furthermore, it was uncertain whether the magnitude of change that did occur was sufficient to have lasting and significant impact on overall health and safety. CONCLUSION Despite the challenges of implementing the intervention in such a dynamic, complex setting, the training for development of a model HSC gave rise to several positive changes. It was promising that HSC members were satisfied with the training intervention, and that they reported overall positive changes in group dynamics within the committee. Shortly after the intervention, the committee made several notable accomplishments, such as developing a mission statement and charter, writing formal recommendations to management, and establishing an approach to regularly engage the workforce through the departmental safety meetings. We believe these successes can be attributed to a variety of factors incorporated into the training, including a focus on capacity building, use of a facilitator, attention to language needs, and use of site-specific examples and materials via a variety of training activities. A similar approach may be useful in conducting trainings for HSCs at other worksites, particularly in small companies with diverse workforces. Over the course of the study, it became obvious that the existence of the state mandate requiring HSCs was not sufficient to ensure an effective committee. On the other hand, it is unlikely that the company would have established
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a committee had it not been required, so the mandate was an important first step in increasing awareness of the utility of committees and their role in fostering worker involvement in health and safety issues. Mandating training for health and safety committee members would seem appropriate, given the positive effects observed here, although the effectiveness of such training would, of course, be dependent on how it was implemented. Regulatory mandates could have the potential to foster improved HSC success by requiring policies and procedures associated with committee effectiveness, and providing resources for companies and their committees to establish these policies and procedures, be it via training or other methods. In addition, labor unions and trade associations could also play an important role in advocating for and supporting training in effective HSC function for worker and management members. Regardless, further studies at additional worksites and in different industries are warranted to better understand the impact of intervention work on HSC effectiveness and any subsequent implications for occupational health and safety policy. ACKNOWLEDGMENTS This study was funded by the Washington State Department of Labor and Industries Safety and Health Investment Projects program, grant number 2009ZH00115. The authors are indebted to the participating facility and workers, without whom this research would not have been possible. AUTHORS’ BIOGRAPHIES ALLISON CROLLARD is a research coordinator at the University of Washington’s Department of Environmental and Occupational Health Sciences. Her interests in the field include policy and programmatic interventions for occupational health disparities. Her email address is [email protected] RICHARD L. NEITZEL is an Assistant Professor of occupational hygiene at the University of Michigan Department of Environmental Health Sciences and Risk Science Center. He is interested in quantitative and subjective exposure assessment in occupational and non-occupational settings and development and evaluation of effective occupational and community health interventions and controls. He is also interested in incorporating new methodologies and technologies into risk assessment efforts. His email address is [email protected] CARLOS F. DOMINGUEZ is a research coordinator at the University of Washington’s Department of Environmental and Occupational Health Sciences. His interests include workers’ protection and safety in the workplace through effective research to practice interventions and the advancement of best practices
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aimed at reducing occupational health disparities among immigrant workers. His email address is [email protected] NOAH S. SEIXAS is Professor of occupational hygiene at the University of Washington, and a certified industrial hygienist with an emphasis on the quantification of exposure for occupational epidemiology. In addition to teaching industrial hygiene courses and maintaining an active research program, Dr. Seixas is the Director of the NIOSH-sponsored Northwest Center for Occupational Health and Safety and Editor in Chief of the Annals of Occupational Hygiene. Current research interests include characterization of exposures and intervention strategies to control exposures to noise in construction and welding fume in shipyards. Dr. Seixas is also interested in organizational factors that may contribute to disparities in occupational health experience, especially among immigrant workers. His email address is [email protected] NOTES 1. E. Barbeau et al., “Assessment of Occupational Safety and Health Programs in Small Businesses,” American Journal of Industrial Medicine 45 (2004): 371-379, doi: 10.1002/ajim.10336. 2. A. D. LaMontagne et al., “Assessing and Intervening on OSH Programmes: Effectiveness Evaluation of the Wellworks-2 Intervention in 15 Manufacturing Worksites,” Occupational and Environmental Medicine 61 (2004): 651-660, doi: 10.1136/ oem.2003.011718. 3. H. S. Shannon et al., Health and Safety Approaches in the Workplace: A Report Prepared by the Interdisciplinary Health and Safety Research Group of McMaster University in Hamilton Ontario (Toronto: Industrial Accident Prevention Association, 1992). 4. H. S. Shannon et al., “Workplace Organizational Correlates of Lost-Time Accident Rates in Manufacturing,” American Journal of Industrial Medicine 29 (1996): 258-268, doi: 10.1002/(SICI)1097-0274(199603)29:33.3.CO;2-Y. 5. U.S. Department of Labor Occupational Safety and Health Administration, Injury and Illness Prevention Programs White Paper, January 2012, http://www.osha.gov/ dsg/InjuryIllnessPreventionProgramsWhitePaper.html (accessed June 2, 2013). 6. C. C. Gjessing, T. F. Schoenborn, and A. Cohen, Participatory Ergonomic Interventions in Meatpacking Plants (NIOSH Publication No. 92-124), 1994, http://www. cdc.gov/niosh/pdfs/94-124.pdf (accessed June 2, 2013). 7. T. T. Khai et al., Participatory Action-Oriented Training, 2011, http://www.ilo.org/ wcmsp5/groups/public/—asia/—ro-bangkok/—sro-bangkok/documents/publication/ wcms_169357.pdf (accessed September 6, 2012). 8. A. Yassi et al., “Effectiveness of Joint Health and Safety Committees: A Realist Review,” American Journal of Industrial Medicine 56 (2013): 424-438, doi: 10.1002/ ajim.22143. 9. A. Eaton and T. Nocerino, “The Effectiveness of Health and Safety Committees. Results of a Survey of Public-Sector Workplaces,” Industrial Relations 39 (2000): 265-290, doi: 10.1111/0019-8676.00166.
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10. S. Geldhart S, H. S. Shannon, and L. Lohfeld, “Have Companies Improved Their Health and Safety Approaches over the Last Decade? A Longitudinal Study,” American Journal of Industrial Medicine 47 (2005): 227-236, doi: 10.1002/ ajim.20131. 11. T. Morse et al., “Characteristics of Effective Job Health and Safety Committees,” New Solutions: A Journal of Environmental and Occupational Health Policy 18(4) (2008): 441-457, doi: 10.2190/NS.18.4.c. 12. L. Boden et al., “The Impact of Health and Safety Committees,” Journal of Occupational Medicine 26(11) (1984): 829-834, doi: 10.1097/00043764-19841100000013. 13. Thomas A. Kochan, Lee Dyer, and David B. Lipsky, The Effectiveness of UnionManagement Safety and Health Committees, (Kalamazoo: WE Upjohn Institute for Employment Research, 1977). 14. G. K. Bryce and P. Manga, “The Effectiveness of Health and Safety Committees,” Relations Industrielles 40(2) (1985): 257- 282, doi: 10.7202/050133ar. 15. N. Milgate, E. Innes, and K. O’Loughlin, “Examining the Effectiveness of Health and Safety Committees and Representatives: A Review,” Work 19 (2002): 281-290. 16. T. Morse and A. Bracker, Characteristics of Effective Health and Safety Committees: Preliminary Results from Interviews, 2010, http://oehc.uchc.edu/healthywork/images/ Summary_HSC_effectiveness_interviews.pdf (accessed June 2, 2013). 17. L. A. McCauley, “Immigrant Workers in the United States—Recent Trends, Vulnerable Populations, and Challenges for Occupational Health,” AAOHN Journal 53(7) (2005): 313-319. 18. D. Parker et al., “A Comparison of the Perceptions and Beliefs of Workers and Owners with Regard to Workplace Safety in Small Metal Fabrication Businesses,” American Journal of Industrial Medicine 50 (2007): 999-1009, doi: 10.1002/ajim. 20508. 19. Q. Williams et al., “The Impact of a Peer-Led Participatory Health and Safety Training Program for Latino Day Laborers in Construction,” Journal of Safety Research 41 (2010): 253-261, doi: 10.1016/j.jsr.2010.02.009. 20. A. Ostry and A. Yassi, “The Design and Evaluation of a Joint Health and Safety Committee Education Programme in the Healthcare Sector in Western Canada,” Just Labour 4 (2004): 23-32. 21. John O’Grady, “Joint Health and Safety Committees: Finding a Balance,” in Injury and the New World of Work, ed. Terrence Sullivan (Vancouver: UBC Press, 2000), 162-197. 22. N. S. Seixas et al., ”Intervening at the Bottom: Can a Health and Safety Committee Intervention Influence Management Commitment?” Policy and Practice in Health and Safety 11(1) (2013): 61-78. 23. R. L. Neitzel et al., “A Mixed Methods Evaluation of Health and Safety Hazards at a Scrap Metal Recycling Facility,” Safety Science 51(1) (2013): 432-440, doi: 10.1016/j.jssci.2012.08.012. 24. E. Rosskam, “Participatory/Problem-Based Methods and Techniques for Training in Health and Safety,” New Solutions: A Journal of Environmental and Occupational Health Policy 11(3) (2001): 215-227, doi: 10.2190/FYD8-UJHG-DYXC-P3L2.
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25. N. Wallerstein and M. Weinger, “Health and Safety Education for Worker Empowerment,” American Journal of Industrial Medicine 22 (1992): 619-635, doi: 10.1002/ ajim.4700220502. 26. Seixas Laboratory, “Health and Safety Committee Project 2010-2011,” February 2, 2012, http://blogs.uw.edu/uwseixas/health-and-safety-committee-project-2010-2011/ (accessed June 13, 2013).
Direct reprint requests to: Allison Crollard Department of Environmental and Occupational Health Sciences University of Washington School of Public Health and Community Medicine 4225 Roosevelt Way NE, Suite 100 Seattle, WA 98105 e-mail: [email protected]
Features TRAINING FOR AN EFFECTIVE HEALTH AND SAFETY COMMITTEE IN A SMALL BUSINESS SETTING ALLISON CROLLARD RICHARD L. NEITZEL CARLOS F. DOMINGUEZ NOAH S. SEIXAS
ABSTRACT
Health and safety committees are often heralded as a key element of successful health and safety programs, and are thought to represent a means of engaging workers in health and safety efforts. While the understanding of the factors that make these committees effective is growing, there are few resources for how to assist committees in developing these characteristics. This paper describes one approach to creating and implementing a training intervention aimed at improving health and safety committee function at one multilingual worksite. Short-term impacts were evaluated via questionnaire and qualitative observations of committee function. Results indicated high satisfaction with the training as well as modest increases in participation, cooperation, role clarity, and comfort with health and safety skills among committee members. The committee also made considerable achievements in establishing new processes for effective function. Similar interventions may be useful in other workplaces to increase health and safety committee success. Keywords: safety training, training evaluation, health and safety committee
Employee participation has been identified as a key element to the success of occupational health and safety programs [1-5]. Workers often have a good understanding of their work and its hazards, so valuable information can be 485 Ó 2013, Baywood Publishing Co., Inc. doi: http://dx.doi.org/10.2190/NS.23.3.d http://baywood.com
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gained about the type of hazards in the workplace and potential control methods by fostering their participation in health and safety activities [6, 7]. One common method for engaging workers in health and safety is through the use of joint labor-management health and safety committees (HSCs) in which worker representatives act as liaisons between the workforce and management, and members work together to identify and address health and safety issues. As a result, HSCs have been widely adopted as a key mechanism for increasing worker involvement in health and safety. However, simply having an HSC does not ensure that a company’s workers will be sufficiently engaged, or that the workplace will be healthy and safe. Rather, the HSC must be effective to realize these benefits. Despite a variety of resources providing best practice guidelines for HSC effectiveness, little empirical evidence exists on the characteristics that make committees successful [8]. Studies that have been carried out often use disparate measures of HSC effectiveness, and have taken place in a variety of different countries and jurisdictions, each with a distinct regulatory environment, making it even more difficult to find commonalities in determinants of HSC success. Researchers measuring effectiveness in terms of injury rates have found that sites with lower injury rates are more likely to have larger committees in relation to workforce size, committees with higher ratios of worker-members to management-members, committees that reviewed more worker health and safety complaints at meetings, committees that recorded and reviewed health and safety issues from previous meetings, and committees with increased scope and executive authority [4, 9-11]. Perceived HSC effectiveness has also been associated with increased executive authority and worker-member involvement, as well as increased training of HSC members [9, 12, 13]. Qualitative studies and reviews have also suggested that key characteristics of HSCs include recordkeeping measures such as agendas and meeting minutes, and tracking of health and safety issues; mechanisms for the workforce to report issues; written recommendations to management for addressing issues; HSC member participation in additional training, inspections, and accident investigations; and clearly defined roles and responsibilities of HSC members and of the HSC itself [14-17]. Researchers and industry experts also describe external factors that influence committee effectiveness. Often, particularly in the United States, HSCs take on an advisory role as employers are ultimately responsible for ensuring a healthy and safe workplace. Therefore, the level of management support for health and safety in general, as well as its support for the HSC, can affect a committee’s ability to address health and safety issues regardless of internal HSC factors [10, 12]. Union involvement and positive labor-management relations may also help facilitate HSC effectiveness through provision of resources and support of worker engagement in health and safety matters [12, 15]. Adding to the complexity of committee effectiveness is the increasing diversity of workforces, particularly in the United States. If a primary goal of HSCs is to foster worker involvement, it is important that workers are adequately
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represented on committees, not only in terms of departments and shifts, but also language and cultural groups. Immigrant workers or workers with limited English proficiency may be difficult to engage due to language and cultural differences, and may have difficulties communicating about health and safety issues [17-19]. This may prevent these workers from serving on HSCs or being reached by HSC members. Minimal guidance exists for how to best engage immigrant workers or workers with limited English proficiency in health and safety activities, particularly in the context of HSCs. There are also significant gaps in knowledge from the literature in understanding how to develop an effective health and safety committee in the workplace, multilingual or otherwise. Despite the efforts of researchers to identify characteristics associated with effective HSCs, little information is available on methods that focus on developing and implementing such characteristics to improve HSC function. Two Canadian studies describe efforts in this area, and specifically focus on training interventions for HSC members to improve committee function [20, 21]. Ostry and Yassi [20] conducted a study in which selected labor and management representatives of various health and safety committees from health-care facilities in British Columbia, Canada, attended one-day workshop trainings on HSC issues. The authors describe statistically significant post-training increases in attendee reports of cooperation among HSC members, comprehension of the committee role, and ability to identify health and safety hazards. Similarly, SPR Associates Inc. [21] conducted a survey of HSC members who had completed a 40-hour certification training that was required of at least one management and one labor representative of a committee by the Ontario Occupational Health and Safety Act. Results revealed increased worker and management perceptions of worker contributions to committee activities, effectiveness of inspections, and improvements in health and safety. While the results of these studies suggest that training may offer some benefits to HSC function, details on training content and technique are not provided. In an effort to improve understanding in these areas, a small-scale intervention study was conducted with an HSC in a small business setting with a multicultural and multilingual workforce. As a case study, the focus was to elucidate the complex role of committees in the health and safety environment of a workplace, and to develop a training approach to build capacity for improved committee function. Long-term impact of the training intervention was assessed by measuring changes in HSC effectiveness in terms of injury rates, presence and severity of hazards and exposures, and perceptions of HSC effectiveness, and are reported elsewhere [22]. However, it was hypothesized that a host of shorter-term conditions would need to be met in order for the committee to effect any change in health and safety conditions. Figure 1 shows a conceptual model of the intervention’s theorized effect. This paper describes the context and approach to developing and implementing a training intervention for a multilingual HSC, and evaluating its short-term impacts.
Figure 1. Conceptual model of training effect.
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METHODS Development and implementation of the HSC training took place in the context of an 18-month-long intervention study at a small scrap metal recycling business in Washington state, where health and safety committees are required for companies with more than 10 employees. The company buys metalcontaining objects from companies and individuals, breaks them down into small pieces by hand and by large mechanical shredding and shearing processes, and sorts the metals by type to be resold. The nature of the work poses a variety of health and safety hazards for its 50 production employees, as described elsewhere [23]. The majority of yard workers are represented by one union, and a handful of others—truck drivers and crane operators—are represented by two additional unions. Immigrant workers comprise approximately 70 percent of the workforce, most from Mexico or Central America. Only 45 percent of workers reported that they were comfortable reading and speaking English. The site was selected for the study after a concerned worker approached a consultant, employed by the University of Washington (UW), who was conducting industrial hygiene monitoring at the scrap yard. The worker expressed frustration that many health and safety issues remained unaddressed by the site’s management, and that health and safety communications were not meeting the needs of the site’s culturally and linguistically diverse workforce. Study staff contacted the concerned worker’s union about the potential for collaborating on an intervention study that would empower workers to address health and safety issues. With their support, input was solicited from the site’s health and safety director and it was determined that the health and safety committee, while meeting state requirements, was not functioning optimally, but with additional support could potentially be a useful forum for worker involvement. The idea for the study was presented at a meeting with study staff, the union organizer, and the site’s upper management, who then granted permission to conduct the study. The study consisted of an assessment of health and safety conditions both before and after the training for the health and safety committee. The assessments included semi-quantitative observations of hazards and use of controls throughout the site; a questionnaire administered to all employees asking about hazards, safety climate, and experiences with the HSC; a questionnaire administered to HSC members with items on HSC function and effectiveness; and industrial hygiene measurements of noise, particulates and metals, and carbon monoxide. In addition, study staff attended all HSC meetings, had individual meetings with the site’s health and safety director, who chaired the HSC, and conversed frequently with committee members and other employees throughout the duration of the study. These informal interactions and observations provided critical additional insight into the function of the HSC, the interactions and relationships both within the HSC and between HSC members and
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the workforce, and the underlying health and safety environment at the site. All research activities were reviewed and approved by the UW Institutional Review Board. Health and Safety Context Prior to the involvement of the research team, the company had established a health and safety program that included a variety of written programs, a health and safety director hired shortly before the study, and a health and safety committee. However, the management demonstrated inconsistent support for its health and safety program, including HSC activities. At the time, the union representing the majority of the site’s workers and most of the immigrant workers did not appear to be actively involved in health and safety issues, and a shop steward—who might have been an important liaison for workers to express health and safety concerns—had not been appointed. Despite this, most workers, particularly immigrant workers, viewed the union as an important source of support. The pre-intervention health and safety assessment provided further insight into the site’s workers’ perceptions of and experiences with health and safety. In the questionnaire, employees assigned only moderate scores for overall safety climate [22]. Qualitatively, workers expressed that they perceived management to be more concerned with production than with safety. For instance, they mentioned that the production manager, also an HSC member, was often seen in the scrapyard without appropriate personal protective equipment (PPE) or doing work in very unsafe situations. In addition, many discussions observed on-site involved blaming individuals for health or safety incidents or problems. Most workers also expressed frustration with communication barriers as a result of the multilingual workforce. In the questionnaire, most immigrant workers reported that language was a barrier to effective health and safety communication, and that their language and/or ethnicity affected how they were treated at work. Informally, these workers explained that they were hesitant to raise health and safety issues for fear of being treated as “difficult” by management and supervisors. The HSC at Baseline The existing HSC was composed of mostly worker-elected representatives, a couple of supervisors, the vice president of operations, one of the company’s owners, and its chair, the health and safety director. Not all work areas were represented in the committee, and few Spanish speakers participated in the HSC, despite the large proportion of Spanish-speaking employees in the workforce. As the site was preparing to have elections for new committee members just after the beginning of the study, the UW research team recommended that an effort be made to recruit members from all departments, as well as
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Spanish-speaking employees, and that the owner sitting on the committee no longer participate. These recommendations were intended to increase comfort and collaboration, particularly for worker-members, and were well received and eventually implemented. The site’s union organizer was also invited to attend committee meetings in efforts to promote worker-member participation. Observations of committee meetings prior to the training intervention revealed that the safety director did the bulk of the committee work, including preparing agendas, recording minutes, chairing committee meetings, acting as liaison with management and the workforce, and responding to any health or safety issues raised. It did not appear that committee members, particularly worker-members, were involved in health and safety activities outside of the meeting setting such as inspections, incident investigations, or worker health and safety trainings. Although various health and safety issues were raised by both management- and worker-members during meetings, it was unclear how and by whom the issues would be addressed. Meetings were conducted in English, and all materials were available only in English. Study staff also observed limited collaboration between members both in and out of HSC meetings, particularly between English- and Spanish-speaking members and between worker- and management-members. Via the questionnaire, differences were found between worker-members and management-members in perceived HSC effectiveness [22]. Managementmembers reported lower effectiveness in HSC hazard identification than workermembers, while worker-members were more likely to report that the HSC was not effective in its communication with workers, that there was not enough worker influence on committee activities, and that language was a barrier to participation on the committee. Anecdotally, most HSC members seemed skeptical that the committee had much impact on health and safety, and many expressed doubt that there was potential to have any influence on health and safety due to lack of support from upper management. For instance, members had expressed concerns to management on multiple occasions that a propane tank was in dangerous proximity to torch-cutting operations, but managers refused to remediate the situation. In addition to lack of management support, most members mentioned a lack of support from their co-workers. They explained that much of the workforce had little faith in the HSC, and that members were not regarded as having any authority or influence in health and safety matters. Employee perceptions of HSC function and effectiveness were also assessed in the pre-intervention questionnaire [22]. Only 35 of the 42 production workers were aware of the existence of the committee, with fewer than half able to correctly name their HSC representative. Very few workers had ever reported a health or safety problem to the HSC, and more than half of those who had said it was not corrected. Many workers also stated that they did not feel they were adequately represented on the committee.
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Training Intervention One of the major themes arising from questionnaire results and the qualitative data was that there were divisions among workers at the site, resulting in distinct perceptions and attitudes among different groups about the health and safety environment at the worksite. As previously described, immigrant workers viewed the worksite as less accommodating for working safely, had difficulties effectively communicating health and safety concerns, and reported discrimination based on their ethnicity. This highlighted the need to consider these differences between employees when developing the training curriculum for the HSC. If an effective committee is one that involves workers in health and safety, approaches that garnered buy-in and facilitated involvement of all workers in a meaningful way were vital to training success. In particular, it was important to engage immigrant workers on the HSC, as they would be liaisons for a significant portion of the workforce. Similarly, differences in perspectives were seen within the committee. Worker members and management members had differing opinions on the HSC’s effectiveness, as well as the role and level of worker involvement related to committee function. The apparently limited level of collaboration was also an indication that members perhaps had different views of the situation, and different agendas. Thus, it was concluded that furthering cooperation and group cohesion would also be important issues to address through the training intervention, as they were felt to be essential to the committee’s function, effectiveness, and sustainability. In addition to the need to increase workforce involvement and collaboration among committee members, needs for improved committee processes and activities were identified. HSC members required additional health and safety training and became involved in health and safety activities outside of meetings. Organized procedures for soliciting worker input on health and safety matters were insufficient. In addition, the HSC needed to discuss the roles and responsibilities of individual committee members, as well as their role in the context of the on-site general health and safety program. The HSC needed to prepare agendas in advance of its meetings and make meeting notes available to members and to the workers. To raise awareness of these HSC needs, it was thought that providing instruction on general health and safety principles and information on activities typically done by effective HSCs might be useful activities for the training intervention. It became clear that there was a need for training methods that would engage all parties, and promote collaboration and communication both within the HSC and between the HSC and the greater workforce. As a result, activities were chosen to promote group development and teamwork, and incorporated adult education, participatory training, and empowerment education principles to maximize engagement and meaningful learning [6, 24, 25]. A skilled bilingual
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and bicultural facilitator was utilized to ensure comprehension and promote participation, as about half of members spoke Spanish as a first language and had varying English language abilities. All presentations, handouts, and materials were translated into Spanish by a native Spanish speaker on the research team and were available to all HSC members. In addition to its focus on group development and communication, the training would also provide basic skills and techniques for effective HSC processes such as hazard identification and soliciting worker input on health and safety issues as described below. Intervention Implementation
After negotiating time and duration, management and study staff agreed on two four-hour training sessions taking place at the worksite, with two weeks between sessions. The facilitator served as an emcee and led the majority of discussions during the training, while University staff presented health-andsafety–specific content and helped facilitate small group activities. Training activities and content are summarized below and are available in detail on the study’s website [26]: Session 1: • icebreaker exercise and introduction to training staff, purpose of the training, and ground rules of the sessions; • brief discussion of the context and causes of health and safety incidents; • team-building exercises including small group discussions of health and safety roles specific to management-members and worker-members; and a related role-play activity; • overview of hazard recognition and control theory including hazard identification practice using site-specific photos; and • assignment of a “homework” activity in which committee members were to engage coworkers in discussion about health and safety hazards in their work areas, along with potential solutions. Session 2: • icebreaker exercise and discussion of communication styles, language and cultural differences, and techniques for facilitating communication around the worksite; • discussion of current committee function and effectiveness and presentation of characteristics and activities of effective HSCs as described in the research literature; • brief overview of pre-intervention health and safety assessment findings and issues arising in the “homework” activity; • small-group discussions of potential next steps for improving committee function and effectiveness; and • priority-setting activity to identify key areas for committee improvement.
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At the start of the sessions, HSC members tended to sit in segregated groups: supervisors at one table, English-speaking workers at another, and Spanishspeaking workers at a third. During small-group activities, committee members were moved and regrouped by the facilitator for some activities to foster collaboration among members who were perhaps less accustomed to working together. The facilitator also made considerable efforts to engage all committee members, giving each the opportunity to voice his or her opinions and encouraging participation of those who tended to be reserved during the trainings. The icebreaker games at the beginning of each session also seemed to promote participation and collaboration by forcing the group to work closely and communicate in potentially uncomfortable situations that were ultimately light-hearted and fun. Overall, the committee members seemed to take the training sessions seriously, and were willing to participate in activities and contribute to discussions. In efforts to foster and sustain any changes in committee function from the training, study staff continued their involvement with HSC activities for one year. Staff attended committee meetings, and also met individually with the safety director, union members, and the union organizer. Translation and interpretation services were provided by study staff, and the committee was encouraged and coached to make changes in policies and processes to improve its effectiveness. In addition, support was provided for the HSC to address two priority health and safety issues, which resulted in a study of traffic patterns at the worksite and recommendations for addressing traffic safety, as well as training and materials for HSC members to facilitate department safety meetings, as detailed elsewhere [22]. Training Evaluation
While an evaluation of the longer-term impacts of the intervention was planned for one year post-intervention, it was decided that an evaluation of the short-term and intermediate outcomes as seen on the conceptual model (Figure 1) would also be useful in understanding the training intervention’s impact. A brief pretest-posttest evaluation was conducted to assess the short-term outcomes of the training. The 13 HSC members completed a short written questionnaire in either English or Spanish one week before the first training session as well as at the completion of the second training session. The seven pre- and postintervention items were developed to assess any change in comfort participating in committee activities, perceptions of committee cooperation, clarity of committee roles, and individual comfort with health and safety skills. The postintervention questionnaire also had items to assess HSC members’ satisfaction with the training. Questionnaire items primarily utilized a Likert scale format, with the addition of a few open-ended items on the post-intervention questionnaire. The training was also evaluated qualitatively, through observations of
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committee function and informal interviews with committee members before, during, and after the training intervention. RESULTS Study findings included both questionnaire results and qualitative observations of the HSC’s functioning post-intervention. Questionnaire Results As seen in Table 1, initial scoring of the evaluation items was moderately high, with mean responses of 3.77 or higher (on a 1-5 scale) for all items. Nonetheless, average increases in scoring by all members were seen for all factors—particularly in comfort speaking up in the committee setting (mean
Table 1. Evaluation of HSC Function Before and After Training Pre-training mean (SD) scorea
Post-training change
Total (n = 13)
Total (n = 13)
Managementmembers (n = 4)
Workermembers (n = 9)
Comfort interacting in HSC setting
4.31 (0.75)
0.38 (0.87)
–0.25 (0.50)
0.67 (0.87)
Comfort speaking up in HSC setting
4.15 (1.07)
0.46 (0.78)
0.00 (0.00)
0.67 (0.87)
Level of cooperation among HSC members
4.23 (0.60)
0.23 (0.83)
0.41 (0.82)
0.33 (0.87)
Individual role clarity
4.00 (0.85)
0.42 (0.67)
0.50 (0.58)
0.38 (0.74)
HSC role clarity
3.77 (1.01)
0.54 (0.97)
0.50 (1.29)
0.56 (0.88)
Comfort with hazard identification
4.15 (1.28)
0.38 (0.77)
0.00 (0.00)
0.56 (0.88)
Comfort developing solutions to hazards
4.23 (0.83)
0.31 (0.75)
0.25 (0.50)
0.33 (0.87)
Questionnaire item
aScale:
1 (strongly disagree) to 5 (strongly agree).
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change of 0.46), clarity of the individual members’ roles (change of 0.42), and clarity of the committee’s role in health and safety (change of 0.54). Interestingly, results stratified by management status show that management-members’ rating of their comfort with interacting in the committee setting decreased, while worker-members’ rating of their comfort showed a substantial increase. The decrease may be due to very high scoring of this item initially (4.31), and a regression to the mean on the post-training questionnaire. Similarly, there was no increase in reported comfort speaking up in the committee setting among management-members, although there was a fair increase among worker-members. On average, committee members reported being satisfied with the training on the post-training questionnaire (Table 2). They indicated that the facilitator was clear and encouraged participation from all members and that the information presented and handed out was useful. Overall HSC members rated satisfaction at 4.69 out of 5. Satisfaction with training elements was very similar between management- and worker-members. The responses to the open-ended items on the post-training questionnaire also revealed that committee members were generally satisfied with the training intervention. When asked which elements of the training were the most useful, many members cited the integration, collaboration, and participation of all committee members, particularly between workers and management, and between English speakers and Spanish speakers.
Table 2. HSC Member Satisfaction with Training Intervention Mean (SD) scorea Total (n = 13)
Managementmembers (n = 4)
Workermembers (n = 9)
Ability of facilitator to encourage participation
4.77 (0.60)
5.00 (0.00)
4.67 (0.71)
Clarity of facilitator
4.69 (0.48)
5.00 (0.00)
4.56 (0.53)
Usefulness of information
4.62 (0.51)
4.50 (0.58)
4.67 (0.50)
Usefulness of handouts
4.50 (0.90)
4.67 (0.58)
4.44 (1.01)
Future use of handouts
4.45 (0.69)
4.67 (0.58)
4.38 (0.74)
Overall satisfaction
4.69 (0.48)
4.75 (0.50)
4.67 (0.50)
Questionnaire item
aScale:
1 (strongly disagree) to 5 (strongly agree).
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Qualitative Observations of Post-Intervention HSC Function Changes in committee structure and function can be seen in Table 3. Several procedural changes were made after the training, including the development of a mission statement for the HSC, outlining of roles and responsibilities of members, implementation of a new hazard reporting system, and initiation of writing recommendations to management. After the training intervention, committee activities continued to be led primarily by the safety director/ committee chair, although efforts were made to involve the HSC as a whole in health and safety initiatives. For instance, all members participated in training to do walk-through inspections and accident investigations, and there were reports of members responding to near-miss incidents and facilitating use of the hazard reporting system. Study staff also observed considerably more participation of worker-members during HSC meetings, particularly Spanish-speaking members. Both Spanish-speaking and English-speaking members commented that interpretation during meetings helped to facilitate this increased participation, ultimately resulting in better collaboration and communications within the entire group. Union organizers, some immigrants and native Spanish-speakers, occasionally attended HSC meetings and provided support for participation and communication for the group as well. HSC member complaints about the lack of credibility of the committee among the workforce persisted, although the majority of worker-members commented that the new work area safety meetings led by members had helped garner respect and engage workers in health and safety issues. DISCUSSION Results from the evaluation of the training intervention indicated that HSC members were satisfied with the training, and that some change in participation, cooperation, role clarity and comfort with health and safety skills as measured by the questionnaire may have resulted from the intervention. These positive effects are modest, however, and coupled with the very small sample size, do not provide clear indication of the actual effect of the training. As is often the case with applied intervention work, the complicated nature of health and safety conditions makes it difficult to identify the exact causes of such changes. In this dynamic worksite, a variety of health and safety activities and large fluctuation in production demands occurred concurrently with the study. For instance, around the time of the pre-intervention health and safety assessment, efforts were being made to complete safety recommendations following a consultative visit made by the state occupational health regulatory agency. Various near-miss incidents and accidents also occurred throughout the study period, which often resulted in a reactive emphasis on certain safety measures by upper management.
Post-intervention HSC activities • All work areas represented on HSC, more than half of HSC made up of workermembers • Hour-long HSC meetings scheduled monthly, sometimes cancelled or rescheduled • Creation of a mission statement and charter outlining roles and responsibilities within the committee • Spanish-English interpretation during meetings (by study staff) • Translation of agendas and minutes in both Spanish and English (by study staff), made available to all workers • Development of an anonymous hazard reporting system (suggestion box style) • Walk-through inspection training for all HSC members • Solicitation of a traffic safety study for the worksite followed by a written recommendation for changes to upper management • Development and implementation of industry-specific health and safety “toolbox trainings” delivered to the workforce by HSC members
Pre-intervention HSC activities
• Elections held for worker representatives, which made up more than half of HSC members • Health and safety director elected as HSC chair • Many, but not all work areas represented • Hour-long HSC meetings scheduled monthly, but often cancelled or rescheduled • Agendas and minutes used at meetings • Health and safety issues raised via round robin exercise at meetings
• Establishing processes for making decisions and setting priorities • Identifying and monitoring goals for the committee • Setting aside more time for committee business • Having a worker-member co-chair the committee
Recommended activities not adopted
Table 3. Accomplishments of the Committee Pre- and Post-Intervention
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There was also an occasion when workers did not receive notification letters of their periodic blood lead testing results, leading to increased discussion of health-related effects of their work exposures among employees. As these events unfolded, study staff attempted to coach the committee in becoming involved in and addressing such issues. The continued presence and support of study staff may also have influenced training outcomes. Rather than providing the training and leaving the HSC to be independent and self-sustaining, it was decided that the committee would most benefit from continued support and resources. In the context of the apparent lack of upper management support for health and safety from the beginning of the study, it was unclear that momentum from the training intervention and subsequent committee growth would be sustained. Indeed, HSC meetings were frequently cancelled or rescheduled due to production pressures, and it was only with persistent pressure from the study staff that the committee continued to meet regularly and undertook many of the recommended projects. The study staff was also instrumental in promoting teamwork and participation after the training by providing Spanish-English interpretation and facilitating some meeting activities. Without the ongoing assistance of the research team, it was unclear if the committee would have made the achievements it did with the intervention alone. Furthermore, it was uncertain whether the magnitude of change that did occur was sufficient to have lasting and significant impact on overall health and safety. CONCLUSION Despite the challenges of implementing the intervention in such a dynamic, complex setting, the training for development of a model HSC gave rise to several positive changes. It was promising that HSC members were satisfied with the training intervention, and that they reported overall positive changes in group dynamics within the committee. Shortly after the intervention, the committee made several notable accomplishments, such as developing a mission statement and charter, writing formal recommendations to management, and establishing an approach to regularly engage the workforce through the departmental safety meetings. We believe these successes can be attributed to a variety of factors incorporated into the training, including a focus on capacity building, use of a facilitator, attention to language needs, and use of site-specific examples and materials via a variety of training activities. A similar approach may be useful in conducting trainings for HSCs at other worksites, particularly in small companies with diverse workforces. Over the course of the study, it became obvious that the existence of the state mandate requiring HSCs was not sufficient to ensure an effective committee. On the other hand, it is unlikely that the company would have established
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a committee had it not been required, so the mandate was an important first step in increasing awareness of the utility of committees and their role in fostering worker involvement in health and safety issues. Mandating training for health and safety committee members would seem appropriate, given the positive effects observed here, although the effectiveness of such training would, of course, be dependent on how it was implemented. Regulatory mandates could have the potential to foster improved HSC success by requiring policies and procedures associated with committee effectiveness, and providing resources for companies and their committees to establish these policies and procedures, be it via training or other methods. In addition, labor unions and trade associations could also play an important role in advocating for and supporting training in effective HSC function for worker and management members. Regardless, further studies at additional worksites and in different industries are warranted to better understand the impact of intervention work on HSC effectiveness and any subsequent implications for occupational health and safety policy. ACKNOWLEDGMENTS This study was funded by the Washington State Department of Labor and Industries Safety and Health Investment Projects program, grant number 2009ZH00115. The authors are indebted to the participating facility and workers, without whom this research would not have been possible. AUTHORS’ BIOGRAPHIES ALLISON CROLLARD is a research coordinator at the University of Washington’s Department of Environmental and Occupational Health Sciences. Her interests in the field include policy and programmatic interventions for occupational health disparities. Her email address is [email protected] RICHARD L. NEITZEL is an Assistant Professor of occupational hygiene at the University of Michigan Department of Environmental Health Sciences and Risk Science Center. He is interested in quantitative and subjective exposure assessment in occupational and non-occupational settings and development and evaluation of effective occupational and community health interventions and controls. He is also interested in incorporating new methodologies and technologies into risk assessment efforts. His email address is [email protected] CARLOS F. DOMINGUEZ is a research coordinator at the University of Washington’s Department of Environmental and Occupational Health Sciences. His interests include workers’ protection and safety in the workplace through effective research to practice interventions and the advancement of best practices
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aimed at reducing occupational health disparities among immigrant workers. His email address is [email protected] NOAH S. SEIXAS is Professor of occupational hygiene at the University of Washington, and a certified industrial hygienist with an emphasis on the quantification of exposure for occupational epidemiology. In addition to teaching industrial hygiene courses and maintaining an active research program, Dr. Seixas is the Director of the NIOSH-sponsored Northwest Center for Occupational Health and Safety and Editor in Chief of the Annals of Occupational Hygiene. Current research interests include characterization of exposures and intervention strategies to control exposures to noise in construction and welding fume in shipyards. Dr. Seixas is also interested in organizational factors that may contribute to disparities in occupational health experience, especially among immigrant workers. His email address is [email protected] NOTES 1. E. Barbeau et al., “Assessment of Occupational Safety and Health Programs in Small Businesses,” American Journal of Industrial Medicine 45 (2004): 371-379, doi: 10.1002/ajim.10336. 2. A. D. LaMontagne et al., “Assessing and Intervening on OSH Programmes: Effectiveness Evaluation of the Wellworks-2 Intervention in 15 Manufacturing Worksites,” Occupational and Environmental Medicine 61 (2004): 651-660, doi: 10.1136/ oem.2003.011718. 3. H. S. Shannon et al., Health and Safety Approaches in the Workplace: A Report Prepared by the Interdisciplinary Health and Safety Research Group of McMaster University in Hamilton Ontario (Toronto: Industrial Accident Prevention Association, 1992). 4. H. S. Shannon et al., “Workplace Organizational Correlates of Lost-Time Accident Rates in Manufacturing,” American Journal of Industrial Medicine 29 (1996): 258-268, doi: 10.1002/(SICI)1097-0274(199603)29:33.3.CO;2-Y. 5. U.S. Department of Labor Occupational Safety and Health Administration, Injury and Illness Prevention Programs White Paper, January 2012, http://www.osha.gov/ dsg/InjuryIllnessPreventionProgramsWhitePaper.html (accessed June 2, 2013). 6. C. C. Gjessing, T. F. Schoenborn, and A. Cohen, Participatory Ergonomic Interventions in Meatpacking Plants (NIOSH Publication No. 92-124), 1994, http://www. cdc.gov/niosh/pdfs/94-124.pdf (accessed June 2, 2013). 7. T. T. Khai et al., Participatory Action-Oriented Training, 2011, http://www.ilo.org/ wcmsp5/groups/public/—asia/—ro-bangkok/—sro-bangkok/documents/publication/ wcms_169357.pdf (accessed September 6, 2012). 8. A. Yassi et al., “Effectiveness of Joint Health and Safety Committees: A Realist Review,” American Journal of Industrial Medicine 56 (2013): 424-438, doi: 10.1002/ ajim.22143. 9. A. Eaton and T. Nocerino, “The Effectiveness of Health and Safety Committees. Results of a Survey of Public-Sector Workplaces,” Industrial Relations 39 (2000): 265-290, doi: 10.1111/0019-8676.00166.
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