Management of safety climate and the psychosocial work environment – new challenges for occupational health and safety professionals?

Introduction: The work environment and Occupational Health and Safety (OHS) practice have changed over the last number of years. A holistic OHS approach has been recommended by the authorities in this field (e.g. World Health Organisation (WHO), European Agency for Safety and Health at Work (EU-OSHA) and the International Labour Organisation (ILO)). This involves a unified action engaging elements of the physical and psychosocial workplace with greater focus on prevention and promotion of health and wellbeing. The health and safety practitioner (HSP) has been recognised as one of the main agents for implementation of OHS. Within an organisation they act as a leader of change and a professional who shapes health and safety while safeguarding the wellbeing of individuals at work. Additionally, safety climate (SC) has been developed as an essential concept for OHS of an organisation, its productivity and the wellbeing of its workforce. Scholars and practitioners have recognised the great need for further empirical evidence on the HSP’s role in a changing work environment that increasingly requires the use of preventative measures and the assessment and management of psychosocial work-related risks. This doctoral research brings together the different concepts used in OHS and Public Health including SC, Psychosocial workplace risks, Health Promotion and OHS performance. The associations between these concepts are analysed bearing in mind the WHO Healthy Workplace Framework and three of its main components (physical and psychosocial work environment and health resources). This thesis aims to establish a deeper understanding of the practice and management of OHS in Ireland and the UK, exploring the role of HSPs (employed in diverse sectors of activity) and of SC in the OHS of organisations. Methods: One systematic review and three cross-sectional research studies were performed. The systematic review focussed on the evidence compiled for the association of SC with accidents and injuries at work, clarifying this concept’s definition and its most relevant dimensions. The second article (chapter 3) explored the association of SC with accidents and injuries in a sample of workers (n=367) from a pharmaceutical industry and compared permanent with non-permanent workers. Associations of safety climate with employment status and with self-reported occupational accidents/injuries were studied through logistic regression modelling. The third and fourth papers in this thesis investigated the main tasks performed by HSPs, their perceptions of SC, health climate (HC), psychosocial risk factors and health outcomes as well as work efficacy. Validated questionnaires were applied to a sample of HSPs in Ireland and UK, members of the Institute of Occupational Safety and Health (n=1444). Chi-square analysis and logistic regression were used to assess the association between HSPs work characteristics and their involvement in the management of Psychosocial Risk Factors, Safety Culture and Health Promotion (paper 3). Multiple linear regression analysis was used to determine the association between SC, HC, psychosocial risk factors and health outcomes (general health and mental wellbeing) and self-efficacy. Results: As shown in the systematic review, scientific evidence is unable to establish the widely assumed causal link between SC and accidents and injuries. Nevertheless, the current results suggested that, particularly, the organisational dimensions of SC were associated with accidents and injuries and that SC is linked to health, wellbeing and safety performance in the organisation. According to the present research, contingent workers had lower SC perceptions but showed a lower accident/injury rate than their permanent colleagues. The associations of safety climate with accidents/injuries had opposite directions for the two types of workers as for permanent employees it showed an inverse relationship while for temporary workers, although not significant, a positive association was found. This thesis’ findings showed that HSPs are, to a very small degree, included in activities related to psychosocial risk management and assessment, to a moderate degree, involved in HP activities and, to a large degree, engaged in the management of safety culture in organisations. In the final research study, SC and HC were linked to job demands-control-support (JDCS), health, wellbeing and efficacy. JDCS were also associated with all three outcomes under study. Results also showed the contribution of psychosocial risk factors to the association of SC and HC with all the studied outcomes. These associations had rarely been recorded previously. Discussion & Conclusions: Health and safety climate showed a significant association with health, wellbeing and efficacy - a relationship which affects working conditions and the health and wellbeing of the workforce. This demonstrates the link of both SC and HC with the OHS and the general strength or viability of organisations. A division was noticed between the area of “health” and “safety” in the workplace and in the approach to the physical and psychosocial work environment. These findings highlighted the current challenge in ensuring a holistic and multidisciplinary approach for prevention of hazards and for an integrated OHS management. HSPs have shown to be a pivotal agent in the shaping and development of OHS in organisations. However, as observed in this thesis, the role of these professionals is still far from the recommended involvement in the management of psychosocial risk factors and could have a more complete engagement in other areas of OHS such as health promotion. Additionally, a strong culture of health and safety with supportive management and buy-in from all stakeholders is essential to achieve the ideal unified and prevention-focussed approach to OHS as recommended by the WHO, EU-OSHA and ILO.

Drivers' ratings of different components of their own driving skill: A greater illusion of superiority for skills that relate to accident involvement

Different components of driving skill relate to accident involvement in different ways. For instance, while hazard-perception skill has been found to predict accident involvement, vehicle-control skill has not. We found that drivers rated themselves superior to both their peers and the average driver on 18 components of driving skill (N = 181 respondents). These biases were greater for hazard-perception skills than for either vehicle-control skills or driving skill in general. Also, ratings of hazard-perception skill related to self-perceived safety after overall skill was controlled for. We suggest that although drivers appear to appreciate the role of hazard perception in safe driving, any safety benefit to be derived from this appreciation may be undermined by drivers' inflated opinions of their own hazard-perception skill. We also tested the relationship between illusory beliefs about driving skill and risk taking and looked at ways of manipulating drivers' illusory beliefs.

Análisis de la percepción de seguridad en puentes peatonales: una aproximación mediante modelación híbrida

Este artículo de investigación científica y tecnológica estudia la percepción de seguridad en el uso de puentes peatonales, empleando un enfoque sustentado en dos campos principales: el microeconómico y el psicológico. El trabajo hace la estimación simultánea de un modelo híbrido de elección y variables latentes con datos de una encuesta de preferencias declaradas, encontrando mejor ajuste que un modelo mixto de referencia, lo que indica que la percepción de seguridad determina el comportamiento de los peatones cuando se enfrentan a la decisión de usar o no un puente peatonal. Se encontró que el sexo, la edad y el nivel de estudios son atributos que inciden en la percepción de seguridad. El modelo calibrado sugiere varias estrategias para aumentar el uso de puentes peatonales que son discutidas, encontrando que el uso de barreras ocasiona una pérdida de utilidad, en los peatones, que debería ser estudiada como extensión del presente trabajo.

Transport safety for older people: A study of their experiences, perceptions and management needs

With evidence of increasing accident risk due to age-related declines in health and cognition affecting driver performance, there is a need for research promoting safe mobility of older people. The present study aimed to identify transport options and licensing issues for a group of older people in an Australian community. Ninety-five participants aged 75 and over were interviewed about their driving status and accident record and tested for cognitive ability. After stratification on cognitive level and driver status (current, ex-driver or non-driver), 30 were selected for further in-depth interviews concerning demographics, licence status and impact of change, travel options available and used, and travel characteristics. Considerable reliance on the motor vehicle as the mode of transport and the decision to cease driving were major quality-of-life issues. There was little evidence of planning and support in making the decision to stop driving. Some differences in transport decisions on the basis of cognitive level were evident; however, people with severely compromised cognitive ability (and, therefore, unable to give informed consent) had been excluded. The study suggested the need for resources to assist older people/carers/health professionals to plan for the transition from driver to non-driver and to manage alternative transport options more effectively

Domestically produced food: Consumer perceptions of origin, safety and the issue of trust

It is becoming increasingly difficult for the public to attempt to assess risks using traditional methods such as smell, taste or other physical attributes of food. The existence of extrinsic cues such as the country of origin (COO) of food can help to make food purchase decisions easier for consumers. However, the use of extrinsic cues depends heavily on the extent to which consumers trust such signals to be indicative of quality or safety, which in turn depends on the credibility behind that cue. This paper aims to examine consumers association of domestically produced food with increased food safety standards and the association of COO and food safety information with socio-demographics and other aspects of consumer psychology such as attitudes, risk perception and trust. Using an ordered probit model, domestic production is examined as an extrinsic cue for food safety by looking at the relationship with trust in food safety information provided by national food standards agencies (NFSAs) and other socio-demographic characteristics, based on nationally representative data from 2725 face-to-face interviews across five European countries. Results suggest that domestic production of food is an extrinsic cue for food safety and as consumers place increasing importance on food safety they are more interested in food produced in their own country. This, coupled with consumer trust in a strong, and independent national food standards agency, suggests the potential exists for the increased consumption of domestically produced foods.

Perceptions of informal safety nets: a case study from a South African informal settlement

The relevance and importance of informal safety nets that buffer poor households from livelihood hardships have been given little attention in South Africa’s development programmes to date. This article contributes to the understanding of informal safety nets by investigating local perceptions in a South African informal settlement. The main findings of the study are that families perform an important safety net function, but that these sources of assistance can be susceptible to social isolation. Immediate neighbours and friends also play an important safety net role, but these reciprocal-based sources of assistance may be difficult to secure. Community-wide threats can have a severe impact on people’s ability to engage in safety net transfers. Many of these difficulties stem from South Africa’s structural unemployment crisis. This factor is the greatest danger to the future of the informal safety net system in the informal settlement.

Chemotherapy patients' perceptions of drug administration safety

To explore chemotherapy patients' experiences of drug administration safety and to investigate the relationship between perceptions of risk and harm from error, staff safety practices, and patients' engagement in error prevention strategies.

'New perspectives on well-known issues': patients' experiences and perceptions of safety in Swiss hospitals

Patients' reports of safety-related events and perceptions of safety can be a valuable source for hospitals. Patients of eight acute care hospitals in Switzerland were surveyed for safety-related events and concerns for safety. In workshops with hospitals areas for improvement were analyzed and priorities for change identified. To evaluate the benefit of the approach, semi-structured interviews were conducted with hospital risk managers. 3,983 patients returned the survey (55% response rate). 21.4% reported at least one definite safety event, and the mean number of 'definite' incidents per patient was 0.31 (95% CI=0.29 to 0.34). 3.2% were very concerned and 14.7% were somewhat concerned about medical errors and safety. Having experienced a safety-related event, younger age, length of stay, poor health and a poor education increased the probability of reporting concerns. With some exceptions, results confirmed the hospitals' a priori expectations regarding the strengths and weaknesses of their institutions. Risk managers emphasized the usability of results for their work and the special value of referring to the patient's perspective at their home institutions. A considerable fraction of patients subjectively experiences safety-related events and is concerned about safety. Patient-generated data introduced a new quality into the discussion of safety issues within hospitals, and some expected that patients' experiences and concerns could affect patient volumes. Though the study is limited by the short time horizon and the lack of follow-up, the results suggest that the described approach is feasible and can serve as a supplemental tool for risk identification and management.

Patients' and healthcare workers' perceptions of a patient safety advisory

To assess patients' and healthcare workers' (hcw) attitudes and experiences with a patient safety advisory, to investigate predictors for patients' safety-related behaviors and determinants for staff support for the advisory.

A qualitative cross-level investigation of safety climate perceptions

ver the last few decades occupational health and safety research has shifted its focus away from engineering and ergonomics as a means of improving workplace safety, and has given greater attention to examining the role played by organisational factors, such as safety climate. One factor constraining the advancement of our understanding of the safety climate construct is the tendency of researchers to remain steadfastly bound to the notion that safety climate is measured via a quantative measurement tool. Researchers in the area (e.g., Frone & Barling, 2004; Zohar, 2003) are now arguing for better triangulation of methodologies, in particular better qualitative research, to advance our knowledge and understanding. The present study extends the present body of safety climate literature in two ways; firstly, it addresses this methodological issue via the utilisation of a semi-structured interview methodology and secondly it examines the qualitative structure of safety climate perceptions across different levels (organisation, supervisor and co-worker) and different groups (managers vs. employees). Examination of the interview transcripts revealed qualitative differences and similarities between the different safety climate levels (organisational, supervisor and co-worker) and between manager and employee safety climate perceptions. Implications of these findings for safety climate theory and measurement are discussed.