SAFETY & HEALTH
LERC
Occupational Safety & Health Programs
LERC conducts an active research, education, and technical assistance program in occupational safety and health. General open enrollment safety and health classes are available as part of LERC’s Leadership School classes offered around the state each year. Specialized classes and courses tailored for individual unions and organizations are available by special arrangement as is technical assistance. Current and recent specialized research and training projects are described below. Click a link to learn more.
Research
Air Quality and Health in Commercial Aviation
Construction Ergonomics and Safety
Health Care Ergonomics and Patient HandlingEducation and Training
Young Workers
Home Care Workers
Fire Fighter and Emergency Medical Services Ergonomics Training Curriculum
The Right to Know: An Employee Guide to Information About Work Hazards
Pulp and Paper Industry Health Hazard Training Modules
Dental Hygiene Ergonomics CurriculumAIR QUALITY & HEALTH IN COMMERCIAL AVIATION
Cabin Air Quality Incident Monitoring and Reporting
Funded by: Federal Aviation Administration
Steven Hecker, Project Director, Senior Lecturer and Director, Continuing Education and Outreach, Department of Environmental and Occupational Health Sciences, University of Washington.
LERC Faculty
Research Partners:
Description:
This project began in May 2005. LERC is participating in this research as a member of the Occupational Health Research Consortium in Aviation (OHRCA). The research plan responds to the National Research Council report, The Airliner Cabin Environment and the Health of Passengers and Crew (2002), and subsequent Congressional mandate to develop a health surveillance system and exposure data in relation to air quality incidents on commercial aircraft. Specific activities include:
The anticipated products of this project include a design for a future full-scale study, which is necessary to determine association between bleed air exposure and health effects. The larger study would produce the scientific rigor necessary to determine possible relationships between exposures and subsequent symptom reports and confounding circumstances.
CONSTRUCTION ERGONOMICS & SAFETY
Since 1995 LERC has been a member of the research consortium on construction safety and health organized through The Center to Protect Workers Rights and funded through a NIOSH cooperative agreement. LERC researchers have carried out a series of distinct but related projects under this research program. Ergonomics in construction has been and continues to be a main focus of these activities. The following sections describe some of these specific projects.
Diffusing Ergonomic Innovations in Construction
Funded by: Center to Protect Workers Rights
LERC Faculty:
Description:
This project, funded in 2004 and renewable annually for 5 years, builds on earlier work by LERC and other CPWR grantees. Prior research has clearly demonstrated the high risk of musculoskeletal injury (MSD) faced by construction workers of many trades. Attempts to modify tools, equipment, and work practices to reduce MSD risk are challenging in construction because of certain industry characteristics. These include the constantly changing worksite, the transience of the workforce, the fragmentation of the industry, and similar factors. As a result the dramatic improvements we have seen in many manufacturing operations through redesign of tools and the work environment have not penetrated nearly as far in construction.
The diffusion project applies the Roger’s diffusion of innovations model, widely used in public health studies, to the study of ergonomic innovations in construction. The model postulates that the effective diffusion of innovations depend both on characteristics of the innovation itself and the current level of penetration of the target audience. In other words, an innovation that is currently being used by only a very small number of firms (innovators) should be diffused by techniques that are different from something that is used by 20 percent of the target group (early adopters). Among the characteristics of the innovation that affect its diffusion are:
We will assess a number of ergonomic innovations according to this model in order to better understand factors that facilitate and interfere with their adoption of, for instance, the self-feeding extended-handled screw gun for carpenters. Currently, the research team is assessing a number of innovations in masonry.
Publications:
Weinstein, M., Hecker, S., Hess, JA., Kincl, L. "A Roadmap to Diffuse Ergonomic Innovations in the Construction Industry: There is nothing so practical a good theory," Int J Occup Environ Health 2007; 13: 46-55.
Weinstein, M., Hecker, S., & Hess, JA. "An Action Research Plan to Diffuse Ergonomic Innovations in the Construction Industry." in Proceedings from the International Ergonomics Association (IEA) 2006 Congress, Maastricht, Netherlands.
Best Practices in Ergonomics of Masonry
Funded by: Center to Protect Workers Rights
LERC Faculty:
- Jennifer Hess, DC, PhD, Principal Investigator
- Laurel Kincl, PhD, Co-Investigator
Research Partners:
Description:
LERC has subcontracted to the University of Iowa to work on a Center to Protect Workers Rights project led by Dr. Daniel Anton.
Work-related musculoskeletal disorders (MSD) are common among construction workers and masons are among the most affected by these problems. The masonry industry accounts for the second highest incidence rate of all construction trades for injuries with lost workdays due to overexertion involving lifting (Bureau of Labor Statistics, 2002). The majority of overexertion injuries among masons involve the low back and the upper extremities where musculoskeletal disorders have been associated with exposure to physical risk factors such as repetitive, heavy lifting and awkward postures.
Although engineering, administrative, and work practice solutions exist for reducing exposure to MSD risk factors, many innovations available to masonry are not commonly used. To explore the reasons for low levels of utilization, the Center to Protect Workers Rights held the “Best Practices in Masonry Conference” in 2004 to discuss strategies for reducing MSDs. Commercial masonry contractors, masonry workers, union representatives, safety representatives, and researchers developed a list of currently available engineering, administrative, and work practice solutions. This meeting identified three primary issues related to adoption of ergonomic solutions in masonry: 10 regional differences in use, 2) current utilization levels are largely unknown, and 3) the effectiveness of some masonry innovations for reducing injury risk is unclear. Therefore, the barriers to and acceptability of masonry innovations require additional study and clarification.
Several innovations were identified during the Best Practices conference as most promising. They are 1) equipment: maastclimbing scaffolding, adjustable tower scaffolding, mortar silos, grout hogs, 2) materials: lightweight block, J-block or other open ended block, and 3) work practices: half weight bags of cement, reduced sized pallets, and lift teams when using 12” block.
Investigators at the University of Oregon and University of Iowa are conducting telephone surveys and field audits of masonry construction sites in four U.S. regions: the West Coast (WC), Midwest (MW), Southeast (SE), and the Northeast (NE), to better understand regional differences in use and current utilization levels of these innovations, in order to develop strategies to better disseminate these innovations throughout the masonry industry. The table below demonstrates initial telephone survey findings for regional use of innovations. Most masonry contractors employ 0 to 2 innovations and the Northeast region of the U.S. uses significantly fewer innovations than the other three regions.
Preliminary Telephone Survey Results of Masonry Innovation Use
Innovation (n=156-180)
WC
MW
SE
NE
Total
Use on most/all jobs
%
%
%
%
%
Mortar silo
35.8
31.1
37.8
4.4
27.2
Grout hog
4.0
26.3
39.4
0
16.0
Scaffolding (hydraulic/mechanical)
26.4
35.6
23.7
14.0
25.1
Light-weight block
40.4
36.4
47.4
22.2
36.3
H-block
37.7
11.4
10.5
11.1
18.9
AAC
1.9
2.3
2.6
0
1.7
Reduced size pallets
1.9
7.1
13.9
20
10.3
Half-weight cement bags
3.8
4.7
0
0
2.2
2-person lift for 12” block
18.0
35.7
13.2
28.9
24.0
Publications:
Hess, JA., Weinstein, M. "Innovations Reduce Injuries: Equipment, materials, and work practices are available to protect masons," Masonry Construction, October, 2007.
Designing for Construction Safety
Safety through design is a familiar concept in occupational safety and health generally, but it has had limited application to the prevention of hazardous exposures to construction workers. Architects and engineers clearly consider safety in their designs, but the target of their efforts has traditionally been the end user of the facility rather than those who will construct it. This is slowly beginning to change. Research suggests that addressing safety and health hazards in the design and planning phases of construction projects can yield significant improvements in safety and health outcomes for construction workers. LERC’s investigation of a safety in design process called Life Cycle Safety applied on a major semiconductor fab construction project was part of an effort to expand the knowledge base in this field.
This project was a collaborative effort involving the following organizations: Intel Corporation, Hoffman Construction, Industrial Design and Construction, DGI Ergonomics and Safety Leadership Services, the University of Oregon, and Oregon State University’s Department of Civil, Construction and Environmental Engineering. In 2000 Intel initiated an expanded effort to apply safety-in-design practices in the design and construction of its latest semiconductor research and production facility (D1D) to be constructed in Hillsboro, Oregon. Prior Intel projects had brought lessons learned forward in a continuous improvement effort. For the D1D project this effort was magnified. Intel’s factory group established safety through all life cycles of the facility as one of its major goals for the project, along with cost, schedule, quality, and other more traditional goals. Intel’s construction services group particularly wanted greater involvement from trade contractors with prior experience building other Intel factories in the upfront programming and design phases. This, they felt, would enhance safety and health during construction and subsequent phases by identifying issues that could be resolved upstream based on past experience.
As this was a pioneering experience, development of tools to implement it and documentation of implementation and outcomes was an important component of the project. The University of Oregon and Oregon Stat University joined the project to bring broader knowledge of safety-in-design research and practice to the group and to conduct intervention research to assess implementation and outcome of the D1D safety-in-design effort.
As an outgrowth of this research LERC hosted an international symposium in September 2003 called “Designing for Safety and Health in Construction” in Portland, Oregon.
Publications:
M. Weinstein, J. Gabatese, S. Hecker. 2005. Can design improve construction safety: Assessing the impact of a collaborative safety-in-design process. Journal of Construction Engineering and Management 131(10): 1125-1134.
S. Hecker, J. Gambatese, M. Weinstein. September 2005. Designing for construction worker safety: Moving the construction safety process upstream. Professional Safety 50(9): 32-44.
S. Hecker, John Gambatese. 2003. Safety in Design: A Proactive Approach to Construction Worker Safety and Health. Applied Occupational and Environmental Hygiene 18(5): 339-342.
The proceedings of the symposium are also available for purchase:
S. Hecker, J. Gambatese, M. Weinstein. 2004. Designing for Safety and Health in Construction. Eugene, OR, UO Press, ISBN 087114154x
Please contact Marc Weinstein for information about ordering copies of the proceedings.
Fitness at Work – Stretching and other Aspects of Worker Health
Pre-work stretching programs appear to be increasing in popularity, in construction and other industries. Anecdotally many claims are made as to the effectiveness of these programs in reducing the incidence of work-related musculoskeletal injuries, but very little systematic research has been published to document these claims. We published a review of the literature on this topic and an article written for practitioners who treat work related musculoskeletal injuries. We continue to explore ways to keep workers healthy. Jennifer Hess presented an update on stretching and fitness at the 2003 Governor’s Occupational Safety and Health Conference in Portland, Oregon. Copies of the PowerPoint presentation and handouts are available by request.
Publications:
J. Hess, S. Hecker. 2003. Stretching at Work for Injury Prevention: Issues, Evidence and Recommendations. Applied Occupational and Environmental Hygiene 18(5): 331-338
J. Hess, S. Hecker. 2004. Danger: Men at Work, How Ergonomics Can Make Construction Sites Safer. Biomechanics 11(3): 22-35.
HEALTH CARE ERGONOMICS & PATIENT HANDLING
Determining Manual Patient Transfer Best Practices to Improve Training of Community-Based Health Care Providers
Funded by: Collins Medical Trust and SAIF Corporation
LERC Faculty:
Three manual patient transfer techniques for bed to wheelchair transfers by a single provider:
There are over 1,200,000 home care workers or ‘caregivers’ in the US and this occupation is expected to grow more than 27% by 2114 (BLS 2005). This group of workers included home care workers, certified nursing assistants (CNAs), physical therapists, occupational therapists, and home health nurses, all of whom may be called upon to assist in patient transfers. Even though hospitals and long term care facilities are moving toward safe patient handling policies that include the use of powered mechanical lifting devices, in most home care settings use of such devices continues to be prohibitive and single-person manual handling of patients is common. Several factors account for this. In some states the patient is the employer. These patient-employers may not be able to afford the cost of renting or purchasing mechanized lift equipment and most private insurance carriers and Medicare do not cover the cost of patient handling aids. Transfer boards, slide sheets, transfer belts are expensive and the purchase of mechanical lift equipment can cost as much as $6000. Home environments may also be too small or crowded to allow use of mechanized equipment.
Until mechanized lift and transfer equipment becomes practical and affordable those working in the home setting will continue to manually lift and transfer patients and safer methods of manually transferring people between surfaces are needed. The purpose of this study was to compare three single person manual patient transfer methods to assess which method carries the least risk to home care caregivers.
Two ‘mock patients’ one ‘light’ patient (125 lbs) and one ‘moderate’ weight patient (160 lbs) were transferred from a bed to a wheelchair. Low back stresses and caregiver perceptions were measured. The three single-person manual transfer techniques were chosen because they are frequently used or have the potential for being less risky for both caregivers and patients; the modified standing pivot; and transfer board; and the scoot transfer. The modified standing pivot (pivot) is a variation on the traditional ‘hug’ technique. Typically, transfer boards (slides) are used when a patient is sufficiently independent so that they can slide themselves from one surface to another with minimal assistance from caregiver. In this study, we rained caregivers to transfer a moderately dependent patient using a slide board. The scoot transfer (scoot) uses a series of small scoots to move the patient and has been suggested to be less physically demanding than other patient transfer technique. For each testing scenario the patient was moved from a ‘bed’ surface to a wheelchair that was of similar height. The wheelchair was angled toward the bed to decrease the transfer distance, rather than set at 90 degrees to the bed. The arm and footrest of the wheelchair closest to the bed were removed. A 2-inch wide transfer belt was used for all transfers.
While we do not recommend any of these techniques as ‘safe’ for dependent patients, based on the combination of clinician and ‘patient’ perceptions, exposure duration, and biomechanical evaluation, the slide board technique appears to be the safest and most comfortable. The scoot and the pivot each have elements that make them more risky and they should be avoided.
Our evaluation should not be mistaken for promotion of manual patient handling. We advocate use of mechanical and other patient handling equipment, in addition to slide boards. Powered portable lifts, stand assist devices, lateral transfer devices (slide sheets)., and other equipment are necessary to significantly reduce the risk of musculoskeletal injury in clinicians working in the home environment.
Long Term Care Facility Safe Resident Handling Program
LERC Faculty:
- Jennifer Hess, DC, PhD, Principal Investigator
It has been established that there is no safe way to manually lift or handle residents. Nonetheless, nurses and nursing assistants (CNAs) ar frequently called upon to lift, transfer and reposition dependent and semi-dependent residents in most health care facilities. These tasks place them at high risk for sprains, strains, and other musculoskeletal injuries. Data show that musculoskeletal injuries to nurses and CNAs are a serious problems in Oregon, which results in costly and disabling injuries to workers and to the residents being handled. Long-term care facilities (LTC) such as skilled nursing homes and assisted living facilities lag behind acute care in the need to adopt safe patient handling (SRH) practices that rely on the use of motorized mechanical equipment and that engage management and staff in an ongoing ergonomics process.
The goal of the current project, funded by an Oregon OSHA training grant, is to develop a dynamic SRH program for LTC facilities and the appropriate training materials. The program will include a step-by-step guide for acquiring funding assistance for motorized patient handling equipment and for implementing a sustainable joint labor-management program. These materials will be made available to LTC facilities in Oregon and used by Occupational Safety and Health (OSH) personnel at OR OSHA, SAIF, Liberty Mutual and others, to facilitate the transition to SRH in these facilities. This project is being carried out with the help of the Oregon Coalition on Healthcare Ergonomics (OCHE) subcommittee comprised of volunteers from the LTC industry, unions (Oregon Nurses Association (ONA), Service Employees International union (SEIU)), researchers, the Oregon Healthcare Association (industry group for long-term care), OR OSHA, and workers compensation insurers.
Publications:
Hess, JA., Kincl, L., Mandeville, DS. "Comparison of Three Single Person Manual Patient Transfer Techniques for Bed to Wheelchair Transfers," Home Health Nursing, 2007, 25(9), 572-579.
HOMECARE WORKERS
Homecare workers are a fast-growing part of the workforce in Oregon and this growth will continue as the baby-boom generation ages. The continued expansion of the homecare industry has created an urgent need to support homecare workers by providing opportunities for basic training and continued professional development. Better training and support for homecare workers will naturally lead to improved care for the elderly and disabled who are their clients.
Long Term Care Workers Website
A new website for long-term care workers, their clients, trainers, and researchers are being sponsored through the partnership of LERC/OLSHEP and SEIU 503: www.ltcworkers.com. The website lists training opportunities by region and has links to many resources.
Safety Manual for Homecare Workers
OLSHEP, SAIF and the Home Care Commission Training committee have created a Health and Safety manual for both workers and clients. The manuals will soon be available on the Long Term Care Workers Website.
Inventory of Training Resources for Homecare Worker
LERC is working to create a comprehensive inventory of relevant training courses, resources, and materials available to homecare workers in Oregon. This inventory would be accessible on the long-term care training resource website and will be promoted in newsletters and in various materials.
New Training for Homecare Workers
LERC faculty have participated in a stakeholders group that is developing a systematic training program for homecare workers. This increased training,, which prioritizes health and safety, will raise quality of care and promote homecare career advancement and core competencies. Partnering with the Better Jobs/Better Care grant, LERC faculty also worked to create a standard group of competencies for caregivers in a variety of community-based settings.
Communication Skills Workshops
LERC faculty partnered with SEIU 503 and the Better Jobs/Better Care homecare training grant steering committee to present a series of workshops on “Communication Skills and Problem-Solving for Homecare Workers.” Improved communication skills can lead to better, safer, person-centered care for the client, and a safer, more satisfying job for the HCW. Participants who completed the Communication and Problem-solving Skills workshop were admitted to a First Aid/CPR class for free. CPR is a “skill-building” class that is a high priority for all stakeholders.
If you are interested in additional information about training programs for homecare workers, please contact Helen Moss.
TRAINING PRODUCTS
Fire Fighter and Emergency Medical Services Ergonomics Training Curriculum
- Laurel Kincl, PhD
- Jennifer Hess, DC, PhD
Eight hour ergonomic curriculum for fire and emergency medical personnel that include curriculum, instructor guide, DVD with video and PowerPoint slides, and transparency masters.
Download the curriculum manual's PDF here
[ includes guides, handouts & slides ]
Five Power Point training modules are part of the curriculum.
Download the modules here:
Module 1: Introduction
Module 2: Hazard Analysis
Module 3: Solutions
Module 4: Body Mechanics
Module 5: Command StaffDevelopment funded by Oregon Occupational Safety and Health Administration Training Grants Program and SAIF Corporation.
THE RIGHT TO KNOW: AN EMPLOYEE GUIDE TO INFORMATION ABOUT WORK HAZARDS
- Steven Hecker
- Braxton Chambers
Printed copies available. Single copies free, $3 each thereafter. Discount for bulk orders.
Contact: Helen Moss
Download the PDF here.
PULP & PAPER INDUSTRY HEALTH HAZARD TRAINING MODULES
In cooperation with the Association of Western Pulp and Paper Workers and with funding from the Oregon Occupational Safely and Health Division, LERC developed a sequence of five training modules to address chemical and noise hazards in the pulp and paper industry. The curriculum was pilot tested in two training workshops attended by pulp and paper workers in 1996 and revised and published in a loose-leaf format in July 1997. The full package includes an instructor guide and the following five modules:
Each module contains an appendix with overhead transparency masters and other supporting materials. While the modules are targeted at the pulp and paper industry, much of the material is easily adaptable for use in a variety of manufacturing and industrial environments where these hazards are present. The modules are available at no cost to Oregon pulp and paper industry personnel while supplies last. For others the cost is $15 plus postage.
Contact:
Marc Weinstein
DENTAL HYGIENE ERGONOMICS CURRICULUM
Dental hygienists are at high risk of musculoskeletal disorders from the physical stresses that are part of their job tasks. In cooperation with the Oregon Federation of Nurses and Health Professionals and Kaiser Permanente Dental Care Program, LERC produced a training curriculum to address these problems, entitled “Preventing Musculoskeletal disorders: A Dental Hygiene Ergonomics Curriculum.” The curriculum covers topics including:
Copies of the curriculum are available for $15 plus postage.
Contact:
Laurel Kincl