Engaging expert contractors: The work health and safety obligations of the business or undertaking

This article examines the legal principles governing the statutory work health and safety general duties of principals who engage expert contractors to carry out work beyond the expertise of the principal. The article examines recent case law in which superior courts accepted the principal’s argument that the engagement of the expert contractor was sufficient to discharge the principal’s statutory work health and safety general duty. It then reframes the debate within the principles of systematic work health and safety management, and key provisions in the harmonised Work Health and Safety Acts—the primary duty of care; the key underpinning principles; the positive and proactive officer’s duty; and the horizontal duty of consultation, cooperation and coordination. It argues that it is likely that courts examining the issue of the principal’s work health and safety obligations under the harmonised Work Health and Safety Acts will require principals to do more to actively manage the work of expert contractors to ensure the health and safety of all workers and others potentially affected by the work.

Toward a model for forming psychological safety climate in construction project management

The nature of construction projects and their delivery exposes participants to accidents and dangers. Safety climate serves as a frame of reference for employees to make sense of safety measures in the workplace and adapt their behaviors. Though safety climate research abounds, fewer efforts are made to investigate the formation of a safety climate. An effort to explore forming psychological safety climate, an operationalization of safety climate at the individual level, is an appropriate starting point. Taking the view that projects are social processes, this paper develops a conceptual framework of forming the psychological safety climate, and provides a preliminary validation. The model suggests that management can create the desired psychological safety climate by efforts from structural, perceptual, interactive, and cultural perspectives. Future empirical research can be built on the model to provide a more comprehensive and coherent picture of the determinants of safety climate.

Antimicrobial stewardship activities : a survey of Queensland hospitals

Objective: In 2011, the Australian Commission on Safety and Quality in Health Care (ACSQHC) recommended that all hospitals in Australia must have an Antimicrobial Stewardship (AMS) program by 2013. Nevertheless, little is known about current AMS activities. This study aimed to determine the AMS activities currently undertaken, and to identify gaps, barriers to implementation and opportunities for improvement in Queensland hospitals. Methods: The AMS activities of 26 facilities from 15 hospital and health services in Queensland were surveyed during June 2012 to address strategies for effective AMS: implementing clinical guidelines, formulary restriction, reviewing antimicrobial prescribing, auditing antimicrobial use and selective reporting of susceptibility results. Results: The response rate was 62%. Nineteen percent had an AMS team (a dedicated multidisciplinary team consisting of a medically trained staff member and a pharmacist). All facilities had access to an electronic version of Therapeutic Guidelines: Antibiotic, with a further 50% developing local guidelines for antimicrobials. One-third of facilities had additional restrictions. Eighty-eight percent had advice for restricted antimicrobials from in-house infectious disease physicians or clinical microbiologists. Antimicrobials were monitored with feedback given to prescribers at point of care by 76% of facilities. Deficiencies reported as barriers to establishing AMS programs included: pharmacy resources, financial support by hospital management, and training and education in antimicrobial use. Conclusions: Several areas for improvement were identified: reviewing antimicrobial prescribing with feedback to the prescriber, auditing, and training and education in antimicrobial use. There also appears to be a lack of resources to support AMS programs in some facilities. What is known about the topic? The ACSQHC has recommended that all hospitals implement an AMS program by 2013 as a requirement of Standard 3 (Preventing and Controlling Healthcare-Associated Infections) of the National Safety and Quality Health Service Standards. The intent of AMS is to ensure appropriate prescribing of antimicrobials as part of the broader systems within a health service organisation to prevent and manage healthcare-associated infections, and improve patient safety and quality of care. This criterion also aligns closely with Standard 4: Medication Safety. Despite this recommendation, little is known about what AMS activities are undertaken in these facilities and what additional resources would be required in order to meet these national standards. What does the paper add? This is the first survey that has been conducted of public hospital and health services in Queensland, a large decentralised state in Australia. This paper describes what AMS activities are currently being undertaken, identifies practice gaps, barriers to implementation and opportunities for improvement in Queensland hospitals. What are the implications for practitioners? Several areas for improvement such as reviewing antimicrobial prescribing with feedback to the prescriber, auditing, and training and education in antimicrobial use have been identified. In addition, there appears to be a lack of resources to support AMS programs in some facilities.

Transformerless PV inverters - recent test results and a discussion of DC current injection and safety issues

With the variety of PV inverter types and the number of transformerless PV inverters on the Australian market increasing, we revisit some of the issues associated with these topologies. A recent electric shock incident in Queensland (luckily without serious outcome) associated with a transformerless PV system, highlights the need for earthing PV array structures and PV module frames to prevent capacitive leakage currents causing electric shock. The presented test results of the relevant voltages associated with leakage currents of five transformerless PV inverters stress this requirement, which is currently being addressed by both the Clean Energy Council and Standards Australia. DC current injection tests were performed on the same five inverters and were used to develop preliminary recommendations for a more meaningful DC current test procedure for AS4777 Part 2. The test circuit, methodology and results are presented and discussed. A notable temperature dependency of DC current injections with three of the five inverters suggests that DC current injection should be tested at high and low internal inverter temperatures whereas the power dependency noted only for one inverter does not seem to justify recommendations for a (rather involved) standard test procedure at different power levels.

Individual differences in the processing of punishment and reward cues : an application to road safety messages

This thesis examined the extent to which individual differences, as conceptualised by the revised Reinforcement Sensitivity Theory, influenced young drivers' information processing and subsequent acceptance of anti-speeding messages. Using a multi-method approach, the findings highlighted the utility of combining objective measures (a cognitive response time task and electroencephalography) with self-report measures to assess message processing and message acceptance, respectively. This body of research indicated that responses to anti-speeding messages may differ depending on an individual's personality disposition. Overall, the research provided further insight into the development of message strategies to target high risk drivers.

Better health outcomes for people with physical disabilities in China through audits of mobility related access : a research and implementation need

China has 85 million people with disabilities, 30% of whom have a physical disability(1). Up to 2006, overall disability rates increased by 0.5% per year, more for males and in rural areas, and rates of physical disability increased by 11.2% per year(2). With population ageing the proportion of people with disability will increase even faster. In May 2014 the 67th World Health Assembly adopted a resolution endorsing the WHO Global Disability Action Plan 2014–2021. One of its three objectives is “to remove barriers and improve access to health services and programmes”. Access to transport contributes to positive health outcomes both directly and indirectly (e.g. access to economic opportunities, which is associated with better health)(3). However, once people with physical disabilities leave their dwellings they are confronted with physical barriers to their mobility, ranging from the condition/provision of paths to the cost/availability of transport and access to buildings. In addition, their mobility restrictions increase their vulnerability as road users, exposing them to a higher risk of injury through road crashes. QUT's School of Public Health and Social Work (PHSW) and and Centre for Accident Research and Road Safety-Queensland (CARRS-Q) CARRS-Q have been collaborating on development of a combined disability audit and road safety access tool that can identify transport barriers and safety issues along the routes taken by people with disabilities, to enable prioritisation of actions to address these issues. There are also spin-off benefits for other road users from addressing the rising toll of disability through road crashes in China(4). The tool has undergone initial proof-of-concept testing in India and Viet Nam, and is currently being assessed in Cambodia and Laos. Given the rapid development of China, increases in rates of physical disability and the impacts of an ageing population, it is proposed to establish collaborative research through the Australia-China Centre for Public Health to (1) tailor the combined road safety audit and disability access tool for use in China; (2) evaluate its use on a sample of routes; (3) develop plans for changes to the routes in consultation with local authorities; (4) evaluate the effectiveness of implemented changes in terms of access and health. 1. Zheng, Q, et al, 2014. Health and Quality of Life Outcomes, 12:25. 2. Zheng, X, et al, 2011. Bull World Health Org, 89:788–797. 3. Götschi, T & Kahlmeier, S, 2011. Integrated Transport, Health, and Sustainability Assessment (INTHESA): Final Report. Institute of Social and Preventive Medicine, University of Zurich. 4. Lin, T, et al, 2013. J Public Health, 35:541–547.

The role of university research centres in building road safety capacity : implications for China

In recent decades, highly motorised countries, such as Australia, have witnessed significant improvements in population health through reductions in fatalities and injuries from road traffic crashes. In Australia, concerted efforts have been made to reduce the road trauma burden since road fatalities reached their highest level in in the early 1970s. Since that time, many improvements have been made drawing on various disciplines to reduce the trauma burden (e.g., road and vehicle design, road user education, traffic law enforcement practices and enforcement technologies). While road fatalities have declined significantly since the mid-1970s, road trauma remains a serious public health concern in Australia. China has recently become the largest car market in the world (Ma, Li, Zhou, Duan, & Bishai, 2012). This rapid motorisation has been accompanied by substantial expansion of the road network as well as a large road trauma burden. Road traffic injuries are a major cause of death in China, reported as accounting for one third of all injury-deaths between 2002 and 2006 (Ma et al., 2012). In common with Australia, China has experienced a reported decline in fatalities since 2002 (see Hu, Wen & Baker, 2008). However, there remains a strong need for action in this area as rates of motorisation continue to climb in China. In Australia, a wide range of organisations have contributed to the improvements in road safety including government agencies, professional organisations, advocacy groups and research centres. In particular, Australia has several highly regarded and multi-disciplinary, university-based research centres that work across a range of road safety fields, including engineering, intelligent transportation systems, the psychology of road user behaviour, and traffic law enforcement. Besides conducting high-quality research, these centres fulfil an important advocacy role in promoting safer road use and facilitating collaborations with government and other agencies, at both the national and international level. To illustrate the role of these centres, an overview will be provided of the Centre for Accident Research and Road Safety-Queensland (CARRS-Q), which was established in 1996 and has gone on to become a recognised world-leader in road safety and injury prevention research. The Centre’s research findings are used to provide evidence-based recommendations to government and have directly contributed to promoting safer road use in Australia. Since 2006, CARRS-Q has also developed strong collaborative links with various universities and organisations in China to assist in building understanding, connections and capacity to assist in reducing the road trauma burden. References Hu, G., Wen, M., Baker, T. D., & Baker, S. P. (2008). Road-traffic deaths in China, 1985–2005: threat and opportunity. Injury Prevention, 14, 149-153. Ma, S., Li, Q., Zhou, M., Duan, L., & Bishai, D. (2012). Road Traffic Injury in China: A Review of National Data Sources. Traffic Injury Prevention, 13(S1), 57-63.

Incorporation of road safety into road management systems

Road collisions negatively affect the lives of hundreds of Canadians per year. Unfortunately, safety has been typically neglected from management systems. It is common to find that a great deal of effort has been devoted to develop and implement systems capable of achieving and sustaining good levels of condition. It is relatively recent that road safety has become an important objective. Managing a network of roads is not an easy task; it requires long, medium and short term plans to maintain, rehabilitate and upgrade aging assets, reduce and mitigate accident exposure, likelihood and severity. This thesis presents a basis for incorporating road safety into road management systems; two case studies were developed; one limited by available data and another from sufficient information. A long term analysis was used to allocate improvements for condition and safety of roads and bridges, at the network level. It was confirmed that a safety index could be used to obtain a first cut model; meanwhile potential for improvement which is a difference between observed and predicted number of accidents was capable of capturing the degree of safety of individual segments. It was found that the completeness of the system resulted in savings because of the economies obtained from trade-off optimization. It was observed that safety improvements were allocated at the beginning of the analysis in order to reduce the extent of issues, which translated into a systematic reduction of potential for improvement up to a point of near constant levels, which were hypothesized to relate to those unavoidable collisions from human error or vehicle failure.

The application of social network analysis in the construction industry of Hong Kong

The Hong Kong construction industry is currently facing ageing problem and labour shortage. There are opportunities for employing ethnic minority construction workers to join this hazardous industry. These ethnic minority workers are prone to accidents due to communication barriers. Safety communication is playing an important role for avoiding the accidents on construction sites. However, the ethnic minority workers are not very fluent in the local language and facing safety communication problems while working with local workers. Social network analysis (SNA), being an effective tool to identify the safety communication flow on the construction site, is used to attain the measures of safety communication like centrality, density and betweenness within the ethnic minorities and local workers, and to generate sociograms that visually represent communication pattern within the effective and ineffective safety networks. The aim of this paper is to present the application of SNA for improving the safety communication of ethnic minorities in the construction industry of Hong Kong. The paper provides the theoretical background of SNA approaches for the data collection and analysis using the software UCINET and NetDraw, to determine the predominant safety communication network structure and pattern of ethnic minorities on site.

Competitive advantage through safety compliance : smaller firm responses to changes in the Australian occupational health and safety regulatory context

Smaller firms are often viewed as resistant to regulation due to cost burdens. However, evidence indicates that for some compliance is beneficial under certain conditions. Drawing on data on attitudes and responses of smaller firm owner-managers to changes in Australia’s harmonising work health and safety context we report on smaller firms’ responses to these changes. Despite uncertainty due to incomplete harmonisation, many owner-managers viewed safety compliance as important and necessary to do business. Those with negative views still linked positive safety performance to business outcomes. We categorise smaller firms’ responses and in this sample most are Positive Responders. We suggest ways forward for policy-makers to support smaller firms in complying with occupational health and safety regulation.

Bridging the gap: Exploring the barriers to using economic evidence in healthcare decision making and strategies for improving uptake

Evidence from economic evaluations is often not used to inform healthcare policy despite being well regarded by policy makers and physicians. This article employs the accessibility and acceptability framework to review the barriers to using evidence from economic evaluation in healthcare policy and the strategies used to overcome these barriers. Economic evaluations are often inaccessible to policymakers due to the absence of relevant economic evaluations, the time and cost required to conduct and interpret economic evaluations, and lack of expertise to evaluate quality and interpret results. Consistently reported factors that limit the translation of findings from economic evaluations into healthcare policy include poor quality of research informing economic evaluations, assumptions used in economic modelling, conflicts of interest, difficulties in transferring resources between sectors, negative attitudes to healthcare rationing, and the absence of equity considerations. Strategies to overcome these barriers have been suggested in the literature, including training, structured abstract databases, rapid evaluation, reporting checklists for journals, and considering factors other than cost effectiveness in economic evaluations, such as equity or budget impact. The factors that prevent or encourage decision makers to use evidence from economic evaluations have been identified, but the relative importance of these factors to decision makers is uncertain.

Perceived barriers and facilitators to increasing physical activity among people with musculoskeletal disorders : a qualitative investigation to inform intervention development

Purpose Musculoskeletal conditions can impair people’s ability to undertake physical activity as they age. The purpose of this qualitative study was to investigate perceived barriers and facilitators to undertaking physical activity reported by patients accessing ambulatory hospital clinics for musculoskeletal disorders. Patients and methods A questionnaire with open-ended items was administered to patients (n=217, 73.3% of 296 eligible) from three clinics providing ambulatory services for nonsurgical treatment of musculoskeletal disorders. The survey included questions to capture the clinical and demographic characteristics of the sample. It also comprised two open-ended questions requiring qualitative responses. The first asked the participant to describe factors that made physical activity more difficult, and the second asked which factors made it easier for them to be physically active. Participants’ responses to the two open-ended questions were read, coded, and thematically analyzed independently by two researchers, with a third researcher available to arbitrate any unresolved disagreement. Results The mean (standard deviation) age of participants was 53 (15) years; n=113 (52.1%) were male. A total of 112 (51.6%) participants reported having three or more health conditions; n=140 (64.5%) were classified as overweight or obese. Five overarching themes describing perceived barriers for undertaking physical activity were "health conditions", "time restrictions", "poor physical condition", "emotional, social, and psychological barriers", and "access to exercise opportunities". Perceived physical activity facilitators were also aligned under five themes, namely "improved health state", "social, emotional, and behavioral supports", "access to exercise environment", "opportunities for physical activities", and "time availability". Conclusion It was clear from the breadth of the data that meaningful supports and interventions must be multidimensional. They should have the capacity to address a variety of physical, functional, social, psychological, motivational, environmental, lifestyle, and other perceived barriers. It would appear that for such interventions to be effective, they should be flexible enough to address a variety of specific concerns.

Traffic safety at road-rail level crossings using a driving simulator and traffic simulation

A number of Intelligent Transportation Systems (ITS) were used with an advanced driving simulator to assess its influence on driving behavior. Three types of ITS interventions namely, Video in-vehicle (ITS1), Audio in-vehicle (ITS2), and On-road flashing marker (ITS3) were tested. Then, the results from the driving simulator were used as inputs for a developed model using a traffic micro-simulation (Vissim 5.4) in order to assess the safety interventions. Using a driving simulator, 58 participants were required to drive through a number of active and passive crossings with and without an ITS device and in the presence or absence of an approaching train. The effect of driver behavior changing in terms of speed and compliance rate was greater at passive crossings than at active crossings. The difference in speed of drivers approaching ITS devices was very small which indicates that ITS helps drivers encounter the crossings in a safer way. Since the current traffic simulation was not able to replicate a dynamic speed change or a probability of stopping that varies based on different ITS safety devices, some modifications of the current traffic simulation were conducted. The results showed that exposure to ITS devices at active crossings did not influence the drivers’ behavior significantly according to the traffic performance indicators used, such as delay time, number of stops, speed, and stopped delay. On the other hand, the results of traffic simulation for passive crossings, where low traffic volumes and low train headway normally occur, showed that ITS devices improved overall traffic performance.

Keeping international visitors safe on Australian beaches : informing the content of surf safety messages

In Australia, international tourists/visitors are one of the highest risk groups for drowning at beaches. Swimming in patrolled areas, between the flags, reduces the risk of drowning with most drownings occuring outside these areas. There is a need to understand beliefs which influence the extent to which international tourists/visitors intend to swim between the flags. The theory of planned behaviour (TPB) and, in particular, the indirect beliefs which underpin constructs in the model, represent a means of determining what factors influence this intention. The current study compared international visitors/tourists as having either low or high intentions to swim between the flags on a range of behavioural, normative, and control beliefs. A series of MANOVAs revealed significant differences between the groups in all three of the beliefs. The findings provide insight into potential foci for message content for use in educational campaigns aimed at keeping international visitors safe on Australian beaches.