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Jane showed up to work late at her appliance manufacturing company. When she arrived her supervisor yelled to run to her spot on the line and get to work since they were behind in production. On her way to her station, Jane slipped on a spot of oil. The oil spot had been growing due to leakage from a part that was caused by a crack. The crack was present because Bob, who was also late, entered the wrong information into the press. What hazards contributed to Jane’s slip? How would you control the different hazards?


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OCCUPATIONAL SAFETY AND HEALTH For Technologists, Engineers, and Managers SEVENTH EDITION DAVID L. GOETSCH President and CEO, The Institute for Organizational Excellence Prentice Hall Boston Columbus Indianapolis New York San Francisco Upper Saddle River Amsterdam Cape Town Dubai London Madrid Milan Munich Paris Montreal Toronto Delhi Mexico City Sao Paulo Sydney Hong Kong Seoul Singapore Taipei Tokyo Vice President and Editor in Chief: Vernon R. Anthony Acquisitions Editor: David Ploskonka Editorial Assistant: Nancy Kesterson Director of Marketing: David Gesell Executive Marketing Manager: Kara Clark Senior Marketing Coordinator: Alicia Wozniak Marketing Assistant: Les Roberts Project Manager: Wanda Rockwell Associate Managing Editor: Alexandrina Benedicto Wolf Senior Managing Editor: JoEllen Gohr Senior Operations Supervisor: Pat Tonneman Cover Design and Art: Aaron Dixon Full-Service Project Management: Jogender Taneja/Aptara®, Inc. Printer/Binder: Edwards Bros. Cover Printer: Lehigh/Phoenix Text Font: Melior Credits and acknowledgments borrowed from other sources and reproduced, with permission, in this textbook appear on the appropriate page within the text. Copyright © 2011, 2008, 2005, 2002, 1999 Pearson Education, Inc., publishing as Prentice Hall, One Lake Street, Upper Saddle River, New Jersey, 07458. All rights reserved. Manufactured in the United States of America. This publication is protected by Copyright, and permission should be obtained from the publisher prior to any prohibited reproduction, storage in a retrieval system, or transmission in any form or by any means, electronic, mechanical, photocopying, recording, or likewise. To obtain permission(s) to use material from this work, please submit a written request to Pearson Education, Inc., Permissions Department, One Lake Street, Upper Saddle River, New Jersey, 07458. Many of the designations by manufacturers and seller to distinguish their products are claimed as trademarks. Where those designations appear in this book, and the publisher was aware of a trademark claim, the designations have been printed in initial caps or all caps. Library of Congress Cataloging-in-Publication Data Goetsch, David L. Occupational safety and health for technologists, engineers, and managers / David L. Goetsch.—7th ed. p. cm. ISBN-13: 978-0-13-700916-9 ISBN-10: 0-13-700916-X 1. Industrial safety—United States. 2. Industrial hygiene—United States. I. Title. T55.G586 2011 658.4'08—dc22 2009041557 10 9 8 7 6 5 4 3 2 1 ISBN 10: 0-13-700916-X ISBN 13: 978-0-13-700916-9 PREFACE BACKGROUND The field of occupational safety and health has undergone significant change over the past three decades. There are many reasons for this. Some of the more prominent reasons include the following: technological changes that have introduced new hazards in the workplace; proliferation of health and safety legislation and corresponding regulations; increased pressure from regulatory agencies; realization by executives that workers in a safe and healthy workplace are typically more productive; health care and workers’ compensation cost increases; increased pressure from environmental groups and the public; a growing interest in ethics and corporate responsibility; professionalization of health and safety occupations; increased pressure from labor organizations and employees in general; rapidly mounting costs associated with product safety and other types of litigation; and increasing incidents of workplace violence. All of these factors, when taken together, have made the job of the modern safety and health professional more challenging and more important than it has ever been. These factors have also created a need for an up-to-date book on workplace safety and health that contains the latest information needed by people who will practice this profession in an age of global competition and rapid technological change. WHY WAS THIS BOOK WRITTEN AND FOR WHOM? This book was written to fulfill the need for an up-to-date, practical teaching resource that focuses on the needs of modern safety and health professionals practicing in the workplace. It is intended for use in universities, colleges, community colleges, and corporate training settings that offer programs, courses, workshops, and seminars in occupational safety and health. Educators in such disciplines as industrial technology, manufacturing technology, industrial engineering, engineering technology, occupational safety, management, and supervision will find this book both valuable and easy to use. The direct, straightforward presentation of material focuses on making the theories and principles of occupational safety and health practical and useful in a real-world setting. Up-to-date research has been integrated throughout in a down-to-earth manner. ORGANIZATION OF THE BOOK The text contains 31 chapters organized into five parts, each focusing on a major area of concern for modern safety and health professionals. The chapters are presented in an order that is compatible with the typical organization of a college-level safety and iii iv PREFACE health course. A standard chapter format is used throughout the book. Each chapter begins with a list of major topics and ends with a comprehensive summary. Following the summary, most chapters include review questions, key terms and concepts, and endnotes. Within each chapter are case studies to promote classroom discussion, as well as at least one safety fact or myth. These materials are provided to encourage review, stimulate additional thought, and provide opportunities for applying what has been learned. SUPPLEMENTS This text is accompanied by a Companion Web site at www.prenhall.com/goetsch. An online Instructor’s Manual is also available to instructors through this title’s catalog page at www.prenhall.com. Instructors can search for a text by author, title, ISBN, or by selecting the appropriate discipline from the pull-down menu at the top of the catalog home page. To access supplementary materials online, instructors need to request an instructor access code. Go to www.prenhall.com, click the Instructor Resource Center link, and then click Register Today for an instructor access code. Within 48 hours of registering you will receive a confirming e-mail, including an instructor access code. Once you have received your code, go to the site and log on for full instructions on downloading the materials that you wish to use. HOW THIS BOOK DIFFERS FROM OTHERS This book was written because in the age of global competition, safety and health in the workplace have changed drastically. Many issues, concerns, and factors relating specifically to modern workplace environments have been given more attention, greater depth of coverage, and more illumination here than other textbooks. Some of the areas receiving more attention and specific occupational examples include • The Occupational Safety and Health Act (OSH Act) and Occupational Safety and Health Administration (OSHA) • Standards and codes • Laws and liability • Stress-related problems • Life safety and fire hazards • The evolving roles of health and safety professionals • Health and safety training • Human factors in safety • Environmental issues and ISO 14000 standards • Computers, robots, and automation • Ethics and safety • Bloodborne pathogens in the workplace • MRSA in the workplace • Product safety and liability • Ergonomics and safety • The relationship between safety and quality • Workplace violence • Workers’ compensation PREFACE • • • • v Repetitive strain injuries (RSIs) Terrorism threats in the workplace Safety-first corporate culture Off-the-job safety NEW TO THIS EDITION This seventh edition of Occupational Safety and Health contains much new and updated material, including the following: • • • • General Revisions All OSHA standards, as well as those of other regulatory agencies, were updated. Research material, related content, and corresponding endnotes were updated throughout. Older content has been retained only to the extent that it is still valid. New photographs were added where appropriate. New or Updated Material in This Edition Chapter 4: Added a new section on the emerging role of safety professionals Chapter 9: Added a new section on the safety professional’s role in product recalls Chapter 15: Added a new section on practical prevention measures for reducing slip and fall hazards and a new checklist for enhancing vision protection Chapter 18: Added a new section on maintenance requirements of NFPA 70E-2009 and OSHA’s training requirements for personnel who face the risk of electric shock Chapter 19: Added a new section on hot work and the necessary components of a hot work program Chapter 20: Added a new section on nanoscale materials and industrial hygiene and global harmonization of OSHA’s Hazard Communication Standard Chapter 24: Expanded the chapter to include hazards relating to Methicillin-resistant Staphylococcus aureus (MRSA) in the workplace Chapter 26: Updated the chapter to include new information on the definition of ethics and ethics tests Chapter 28: Expanded the chapter to include a section on off-the-job safety Chapter 31: Revised the chapter to advocate a safety-first corporate culture as opposed to a safety-friendly culture ABOUT THE AUTHOR David L. Goetsch is Vice President of Northwest Florida Sate College and professor of safety, quality, and environmental management. He also administers the state of Florida’s Center for Manufacturing Competitiveness that is located on this campus. In addition, Dr. Goetsch is president and CEO of the Institute for Organizational Excellence (IOE), a private consulting firm dedicated to the continual improvement of organizational competitiveness, safety, and quality. Dr. Goetsch is cofounder of The Quality Institute, a partnership of the University of West Florida, Northwest Florida State College, and the Okaloosa Economic Development Council. vi PREFACE ACKNOWLEDGMENTS The author acknowledges the invaluable assistance of the following people in developing this book: Dr. Lissa Galbraith, Florida A&M/Florida State University, for the material she contributed on electrical and fire hazards in the first edition; Harvey Martin, health and safety manager of Metric Systems Corporation in Fort Walton Beach, Florida, for providing up-to-date research material; and the following reviewers for their invaluable input: Steven A. Freeman—Iowa State University; JoDell K. Steuver—Purdue University; and Ottis E. Walizer—Minot State University. Special acknowledgment goes to Larry D. Leiman for his contributions in updating all OSHA standards. I N T R O D U C T I O N SAFETY VERSUS HEALTH The title of this book intentionally includes the words safety and health. Throughout the text, the titles “safety and health professional” and “safety and health manager” are used. This, too, is done by design. This approach underscores the point that the field of occupational safety has been broadened to encompass both safety and health. Consequently, managers, technical personnel, and engineers in this field must be knowledgeable about safety and health and be prepared to oversee a corporate program that encompasses both areas of responsibility. Safety and health, although closely related, are not the same. One view is that safety is concerned with injury-causing situations, whereas health is concerned with diseasecausing conditions. Another view is that safety is concerned with hazards to humans that result from sudden severe conditions; health deals with adverse reactions to prolonged exposure to dangerous, but less intense, hazards. Both of these views are generally accurate in portraying the difference between safety and health. However, the line between these two concepts is not always clearly marked. For example, on the one hand, stress is a hazard that can cause both psychological and physiological problems over a prolonged period. In this case, it is a health concern. On the other hand, an overly stressed worker may be more prone to unintentionally forget safety precautions and thus may cause an accident. In this case, stress is a safety concern. Because managers in this evolving profession are likely to be responsible for safety and health, it is important that they have a broad academic background covering both. This book attempts to provide that background. This broadening of the scope of the profession does not mean that specialists in safety and health are not still needed. They are. Chapter 4 shows how today’s safety and health manager is a generalist who often heads a team of specialists such as safety engineers, health physicists, industrial hygienists, occupational nurses, occupational physicians, and risk managers. In order to manage a team of specialists in these various areas, safety and health managers must have the broad and comprehensive background that this book provides. vii This page intentionally left blank BRIEF CONTENTS PART 1 HISTORICAL PERSPECTIVE AND OVERVIEW 1 1 2 3 4 5 Safety and Health Movement, Then and Now 3 Accidents and Their Effects 18 Theories of Accident Causation 32 Roles and Professional Certifications for Safety and Health Professionals 51 Safety, Health, and Competition in the Global Marketplace 77 PART 2 LAWS AND REGULATIONS 87 6 7 8 9 The OSH Act, Standards, and Liability 89 Workers’ Compensation 137 Accident Investigation and Reporting 165 Product Safety and Liability 181 PART 3 THE HUMAN ELEMENT 199 10 Ergonomic Hazards: Musculoskeletal Disorders (MSDs) and Cumulative Trauma Disorders (CTDs) 201 11 Stress and Safety 233 12 Safety and Health Training 244 13 Violence in the Workplace 276 PART 4 HAZARD ASSESSMENT, PREVENTION, AND CONTROL 299 14 15 16 17 18 19 20 21 22 23 24 Mechanical Hazards and Machine Safeguarding 301 Falling, Impact, Acceleration, Lifting, and Vision Hazards 322 Hazards of Temperature Extremes 356 Pressure Hazards 370 Electrical Hazards 383 Fire Hazards and Life Safety 402 Industrial Hygiene and Confined Spaces 429 Radiation Hazards 480 Noise and Vibration Hazards 497 Computers, Automation, and Robots 522 Bloodborne Pathogens and Bacterial Hazards in the Workplace 539 ix x BRIEF CONTENTS PART 5 MANAGEMENT OF SAFETY AND HEALTH 563 25 26 27 28 29 30 31 Preparing for Emergencies and Terrorism 565 Ethics and Safety 593 Hazard Analysis/Prevention and Safety Management 606 Promoting Safety 629 Environmental Safety and ISO 14000 (Environmental Management) 648 TSM: Total Safety Management in a Quality Management Setting 681 Establishing a Safety-First Corporate Culture 694 CONTENTS PART 1 HISTORICAL PERSPECTIVE AND OVERVIEW 1 1 Safety and Health Movement, Then and Now 3 Developments before the Industrial Revolution 3 Milestones in the Safety Movement 4 Tragedies That Have Changed the Safety Movement 6 Role of Organized Labor 9 Role of Specific Health Problems 9 Development of Accident Prevention Programs 11 Development of Safety Organizations 12 Safety and Health Movement Today 14 Integrated Approach to Safety and Health 14 New Materials, New Processes, and New Problems 15 Rapid Growth in the Profession 15 2 Accidents and Their Effects 18 Costs of Accidents 19 Accidental Deaths in the United States 19 Accidents versus Other Causes of Death 20 Work Accident Costs and Rates 21 Time Lost Because of Work Injuries 21 Deaths in Work Accidents 22 Work Injuries by Type of Accident 22 Death Rates by Industry 22 Parts of the Body Injured on the Job 23 Chemical Burn Injuries 24 Heat Burn Injuries 24 Repetitive Strain/Soft-Tissue Injuries 25 Estimating the Cost of Accidents 26 Global Impact of Accidents and Injuries 29 3 Theories of Accident Causation 32 Domino Theory of Accident Causation 32 Human Factors Theory of Accident Causation 34 Accident/Incident Theory of Accident Causation 36 Epidemiological Theory of Accident Causation 38 xi xii CONTENTS Systems Theory of Accident Causation 40 Combination Theory of Accident Causation 42 Behavioral Theory of Accident Causation 44 Drugs and Accident Causation 45 Depression and Accident Causation 45 Management Failures and Accident Causation 47 Obesity and Accident Causation 48 4 Roles and Professional Certifications for Safety and Health Professionals 51 Modern Safety and Health Teams 51 Safety and Health Manager 52 Engineers and Safety 60 Industrial Hygienist 65 Health Physicist 65 Occupational Physician 66 Occupational Health Nurse 67 Risk Manager 68 Certification of Safety and Health Professionals 69 Emerging Role of Safety Professionals 73 5 Safety, Health, and Competition in the Global Marketplace 77 Competitiveness Defined 77 Productivity and Competitiveness 79 Quality and Competitiveness 81 How Safety and Health Can Improve Competitiveness 81 PART 2 LAWS AND REGULATIONS 87 6 The OSH Act, Standards, and Liability 89 Rationale for the OSH Act 89 OSHA’s Mission and Purpose 90 OSH Act Coverage 90 OSHA Standards 91 OSHA’s Record Keeping and Reporting 96 Keeping Employees Informed 102 Workplace Inspections and Enforcement 102 OSHA’s Enhanced Enforcement Policy 103 Citations and Penalties 104 Appeals Process 106 State-Level OSHA Programs 107 Services Available from OSHA 107 Employer Rights and Responsibilities 111 Employee Rights and Responsibilities 112 Keeping Up-to-Date on OSHA 113 Problems with OSHA 113 Other Agencies and Organizations 114 OSHA’s General Industry Standards 119 OSHA’s Maritime Standards 126 OSHA’s Construction Standards 127 CONTENTS Standards and Codes 128 Laws and Liability 130 7 Workers’ Compensation 137 Overview of Workers’ Compensation 137 Historical Perspective 140 Workers’ Compensation Legislation 141 Modern Workers’ Compensation 142 Workers’ Compensation Insurance 144 Resolution of Workers’ Compensation Disputes 145 Injuries and Workers’ Compensation 146 Disabilities and Workers’ Compensation 147 Monetary Benefits of Workers’ Compensation 151 Medical Treatment and Rehabilitation 153 Medical Management of Workplace Injuries 153 Administration and Case Management 154 Cost Allocation 155 Problems with Workers’ Compensation 156 Spotting Workers’ Compensation Fraud and Abuse 156 Future of Workers’ Compensation 157 Cost-Reduction Strategies 159 8 Accident Investigation and Reporting 165 Types of Accident Investigations 165 When to Investigate 166 What to Investigate 166 Who Should Investigate 168 Conducting the Investigation 169 Interviewing Witnesses 171 Reporting Accidents 173 Ten Accident Investigation Mistakes to Avoid 177 9 Product Safety and Liability 181 Product Liability and the Law 181 Developing a Product Safety Program 186 Evaluating the Product Safety Program 187 Role of the Safety and Health Professional 188 Quality Management and Product Safety 189 Product Safety Program Record Keeping 190 User Feedback Collection and Analysis 191 Product Literature and Safety 192 Product Recalls and Safety Professionals 193 PART 3 THE HUMAN ELEMENT 199 10 Ergonomic Hazards: Musculoskeletal Disorders (MSDs) and Cumulative Trauma Disorders (CTDs) 201 Ergonomics Defined 201 Human Factors and Ergonomic Hazards 202 xiii xiv CONTENTS Factors Associated with Physical Stress 203 Ergonomics: A Political Football 205 OSHA’s Voluntary Ergonomics Guidelines 206 Worksite Analysis Program for Ergonomics 208 Hazard Prevention and Control 213 Medical Management Program 214 Training and Education 217 Common Indicators of Problems 217 Identifying Specific Ergonomic Problems 218 Ergonomic Problem-Solving Strategies 220 Economics of Ergonomics 225 Cumulative Trauma Disorders (CTDs) 226 Participatory Ergonomics 230 11 Stress and Safety 233 Workplace Stress Defined 233 Sources of Workplace Stress 234 Human Reactions to Workplace Stress 236 Measurement of Workplace Stress 237 Shift Work, Stress, and Safety 237 Improving Safety by Reducing Workplace Stress 238 Stress in Safety Managers 240 Stress and Workers’ Compensation 241 12 Safety and Health Training 244 Rationale for Safety and Health Training 244 Education and Training Requirements 248 Safety and Health Professionals as Trainers 251 Preparing Safety and Health Instruction 253 Presenting Safety and Health Instruction 254 Applying Safety and Health Instruction 260 Evaluating Safety and Health Instruction 260 Training Supervisors 261 Training New and Transferred Employees 263 Job Safety Analysis as a Training Technique 264 Training Opportunities Available 266 Illiteracy and Safety 268 English as a Second Language Training Issues 270 OSHA Standards and Training 271 13 Violence in the Workplace 276 Occupational Safety and Workplace Violence: The Relationship 276 Workplace Violence: Definitions 277 Workplace Violence: Cases 277 Size of the Problem 279 Legal Considerations 280 Risk-Reduction Strategies 282 Contributing Social and Cultural Factors 284 OSHA’s Voluntary Guidelines 285 CONTENTS Conflict Resolution and Workplace Violence 292 Do’s and Don’ts for Supervisors 295 Emergency Preparedness Plan 296 PART 4 HAZARD ASSESSMENT, PREVENTION, AND CONTROL 299 14 Mechanical Hazards and Machine Safeguarding 301 Common Mechanical Injuries 301 Safeguarding Defined 304 OSHA’s Requirements for Machine Guarding 305 Risk Assessment in Machine Operation 305 Requirements for All Safeguards 307 Point-of-Operation Guards 307 Point-of-Operation Devices 311 Machine Guarding Self-Assessment 311 Feeding and Ejection Systems 312 Robot Safeguards 313 Control of Hazardous Energy (Lockout/Tagout Systems) 313 General Precautions 318 Basic Program Content 318 Taking Corrective Action 319 15 Falling, Impact, Acceleration, Lifting, and Vision Hazards 322 Causes of Falls 322 Kinds of Falls 323 Walking and Slipping 324 Slip and Fall Prevention Programs 326 OSHA Fall Protection Standards 327 Ladder Safety 330 What to Do after a Fall 332 Monitor Fall Protection Equipment and Know Why It Fails 333 Impact and Acceleration Hazards 333 Lifting Hazards 342 Standing Hazards 344 Hand Protection 346 Personal Protective Equipment 349 Forklift Safety (Powered Industrial Trucks) 350 16 Hazards of Temperature Extremes 356 Thermal Comfort 356 Heat Stress and Strain 357 Cold Stress 361 Burns and Their Effects 364 Chemical Burns 366 17 Pressure Hazards 370 Pressure Hazards Defined 370 Sources of Pressure Hazards 371 xv xvi CONTENTS Boilers and Pressure Hazards 372 High-Temperature Water Hazards 372 Hazards of Unfired Pressure Vessels 373 Hazards of High-Pressure Systems 373 Cracking Hazards in Pressure Vessels 373 Nondestructive Testing of Pressure Vessels 375 Pressure Dangers to Humans 376 Decompression Procedures 377 Measurement of Pressure Hazards 378 Reduction of Pressure Hazards 378 18 Electrical Hazards 383 Electrical Hazards Defined 383 Sources of Electrical Hazards 386 Electrical Hazards to Humans 389 Detection of Electrical Hazards 390 Reduction of Electrical Hazards 391 OSHA’s Electrical Standards 394 Electrical Safety Program 395 Electrical Hazards Self-Assessment 395 Prevention of Arc Flash Injuries 396 Training Requirements for Workers 397 19 Fire Hazards and Life Safety 402 Fire Hazards Defined 403 Sources of Fire Hazards 405 Fire Dangers to Humans 408 Detection of Fire Hazards 409 Reduction of Fire Hazards 410 Development of Fire Safety Standards 414 OSHA Fire Standards 415 Life Safety 415 Flame-Resistant Clothing 418 Fire Safety Programs 419 Explosive Hazards 420 OSHA’s Firefighting Options 422 Self-Assessment in Fire Protection 423 Hot Work Program 423 20 Industrial Hygiene and Confined Spaces 429 Overview of Industrial Hygiene 429 Industrial Hygiene Standards 430 OSH Act and Industrial Hygiene 431 Hazards in the Workplace 434 Toxic Substances Defined 436 Entry Points for Toxic Agents 436 Effects of Toxic Substances 438 Relationship of Doses and Responses 439 CONTENTS Airborne Contaminants 440 Effects of Airborne Toxics 441 Effects of Carcinogens 442 Asbestos Hazards 443 Indoor Air Quality and “Sick-Building” Syndrome 445 Toxic Mold and Indoor Air Quality 447 Threshold Limit Values 448 Hazard Recognition and Evaluation 450 Prevention and Control 451 NIOSH and Industrial Hygiene 454 NIOSH Guidelines for Respirators 455 Standards and Regulations 459 General Safety Precautions 461 Nanoscale Materials and Industrial Hygiene 463 Confined Space Hazards 463 OSHA Confined Space Standard 465 Confined Space Management Policy 469 OSHA Standards for Toxic and Hazardous Materials 471 OSHA’s Hazard Communication Standard 472 21 Radiation Hazards 480 Ionizing Radiation: Terms and Concepts 480 Exposure of Employees to Radiation 482 Precautions and Personal Monitoring 482 Caution Signs and Labels 483 Evacuation Warning Signal 484 Instructing and Informing Personnel 484 Storage and Disposal of Radioactive Material 484 Notification of Incidents 485 Reports and Records of Overexposure 485 Notice to Employees 486 Nonionizing Radiation 488 Electromagnetic Fields in the Workplace 490 OSHA Standards for Health and Environmental Controls 493 22 Noise and Vibration Hazards 497 Hearing Loss Prevention Terms 497 Characteristics of Sound 499 Hazard Levels and Risks 500 Standards and Regulations 501 Workers’ Compensation and Noise Hazards 506 Identifying and Assessing Hazardous Noise Conditions 506 Noise Control Strategies 508 Vibration Hazards 512 Other Effects of Noise Hazards 514 Corporate Policy 514 Evaluating Hearing Loss Prevention Programs 516 xvii xviii CONTENTS 23 Computers, Automation, and Robots 522 Impact of Automation on the Workplace 522 VDTs in Offices and Factories 523 Human–Robot Interaction 525 Safety and Health Problems Associated with Robots 526 Safety and Health in Office Automation 528 Industrial Medicine and Robots 529 Technological Alienation in the Automated Workplace 531 Minimizing the Problems of Automation 532 Challenge for the Future 533 24 Bloodborne Pathogens and Bacterial Hazards in the Workplace 539 Facts about AIDS 539 Symptoms of AIDS 540 AIDS in the Workplace 541 Legal Concerns 543 AIDS Education 546 Counseling Infected Employees 547 Easing Employees’ Fears about AIDS 548 Protecting Employees from AIDS 548 Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV) in the Workplace 550 OSHA’s Standard on Occupational Exposure to Bloodborne Pathogens 553 Preventing and Responding to Needlestick Injuries 557 Methicillin-Resistant Staphylococcus Aureus (MRSA) in the Workplace 557 PART 5 MANAGEMENT OF SAFETY AND HEALTH 563 25 Preparing for Emergencies and Terrorism 565 Rationale for Emergency Preparation 565 Emergency Planning and Community Right-to-Know Act 566 Organization and Coordination 567 OSHA Standards 568 First Aid in Emergencies 569 How to Plan for Emergencies 572 Planning for Workers with Disabilities 574 Evacuation Planning 578 Customizing Plans to Meet Local Needs 579 Emergency Response 580 Computers and Emergency Response 581 Dealing with the Psychological Trauma of Emergencies 582 Recovering from Disasters 583 Terrorism in the Workplace 585 Resuming Business after a Disaster 588 26 Ethics and Safety 593 An Ethical Dilemma 593 Ethics Defined 594 Ethical Behavior in Organizations 596 CONTENTS Safety and Health Professionals’ Role in Ethics 596 Company’s Role in Ethics 598 Handling of Ethical Dilemmas 600 Questions to Ask When Making Decisions 601 Ethics and Whistle-Blowing 601 27 Hazard Analysis/Prevention and Safety Management 606 Overview of Hazard Analysis 606 Preliminary Hazard Analysis 607 Detailed Hazard Analysis 609 Hazard Prevention and Deterrence 616 OSHA Process Safety Standard 618 Risk Assessment 620 Safety Management Concerns 622 Best Practices in Safety Management 624 Occupational Health and Safety Management Systems 626 28 Promoting Safety 629 Company Safety Policy 629 Safety Rules and Regulations 630 Employee Participation in Promoting Safety 631 Safety Training 631 Suggestion Programs 632 Visual Awareness 633 Safety Committees 634 Personal Commitment to Workplace Safety 636 Employee-Management Participation 636 Incentives 637 Competition 639 Company-Sponsored Wellness Programs 639 Teamwork Approach to Promoting Safety 640 Persuasion as a Promotional Tool 643 Promoting Off-the-Job Safety 644 29 Environmental Safety and ISO 14000 (Environmental Management) 648 Safety, Health, and the Environment 648 Legislation and Regulation 649 Types of Environments 651 Role of Safety and Health Professionals 652 Hazards of the Environment 653 Hazardous Waste Reduction 657 Environmental Management System (EMS) 661 International Organization for Standardization (ISO) 665 ISO 14000 666 ISO 14000 Series of Standards 666 ISO 14001 Standard 668 ISO 14000 Success Story 676 xix xx CONTENTS 30 TSM: Total Safety Management in a Quality Management Setting 681 What Is QM? 681 How Does QM Relate to Safety? 682 Safety Management in a QM Setting 684 What Is TSM? 684 Translating TSM into Action 685 Fundamental Elements of TSM 686 Rationale for TSM 690 Implementing TSM: The Model 691 31 Establishing a Safety-First Corporate Culture 694 Safety-First Corporate Culture Defined 694 Importance of Having a Safety-First Corporate Culture 695 Globalization of Competition and Safety 696 How Corporate Cultures Are Created 697 What a Safety-First Corporate Culture Looks Like 698 Ten Steps for Establishing a Safety-First Corporate Culture 698 Glossary 707 Index 724 P A R T 1 HISTORICAL PERSPECTIVE AND OVERVIEW 1 2 3 4 5 Safety and Health Movement, Then and Now 3 Accidents and Their Effects 18 Theories of Accident Causation 32 Roles and Professional Certifications for Safety and Health Professionals Safety, Health, and Competition in the Global Marketplace 77 51 1 This page intentionally left blank C H A P T E R SAFETY AND HEALTH MOVEMENT, THEN AND NOW 1 Major Topics ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ Developments before the Industrial Revolution Milestones in the Safety Movement Tragedies That Have Changed the Safety Movement Role of Organized Labor Role of Specific Health Problems Development of Accident Prevention Programs Development of Safety Organizations Safety and Health Movement Today Integrated Approach to Safety and Health New Materials, New Processes, and New Problems Rapid Growth in the Profession The safety movement in the United States has developed steadily since the early 1900s. In that time period, industrial accidents were commonplace in this country; for example, in 1907, more than 3,200 people were killed in mining accidents. Legislation, precedent, and public opinion all favored management. There were few protections for workers’ safety. Working conditions for industrial employees today have improved significantly. The chance of a worker being killed in an industrial accident is less than half of what it was 60 years ago.1 According to the National Safety Council (NSC), the current death rate from work-related injuries is approximately 4 per 100,000, or less than a third of the rate 50 years ago.2 Improvements in safety until now have been the result of pressure for legislation to promote safety and health, the steadily increasing costs associated with accidents and injuries, and the professionalization of safety as an occupation. Improvements in the future are likely to come as a result of greater awareness of the cost-effectiveness and resultant competitiveness gained from a safe and healthy workforce. This chapter examines the history of the safety movement in the United States and how it has developed over the years. Such a perspective will help practicing and prospective safety professionals form a better understanding of both their roots and their future. DEVELOPMENTS BEFORE THE INDUSTRIAL REVOLUTION It is important for students of occupational health and safety to first study the past. Understanding the past can help safety and health professionals examine the present and future with a sense of perspective and continuity. Modern developments in health and 3 4 CHAPTER 1 safety are neither isolated nor independent. Rather, they are part of the long continuum of developments in the safety and health movement. The continuum begins with the days of the ancient Babylonians. During that time, circa 2000 BC, their ruler, Hammurabi, developed his Code of Hammurabi. The code encompassed all the laws of the land at that time, showed Hammurabi to be a just ruler, and set a precedent followed by other Mesopotamian kings. The significance of the code from the perspective of safety and health is that it contained clauses dealing with injuries, allowable fees for physicians, and monetary damages assessed against those who injured others.3 This clause from the code illustrates Hammurabi’s concern for the proper handling of injuries: “If a man has caused the loss of a gentleman’s eye, his own eye shall be caused to be lost.”4 This movement continued and emerged in later Egyptian civilization. As evidenced from the temples and pyramids that still remain, the Egyptians were an industrious people. Much of the labor was provided by slaves, and there is ample evidence that slaves were not treated well—that is, unless it suited the needs of the Egyptian taskmasters. One such case occurred during the reign of Rameses II (circa 1500 BC), who undertook a major construction project, the Ramesseum. To ensure the maintenance of a workforce sufficient to build this huge temple bearing his name, Rameses created an industrial medical service to care for the workers. They were required to bathe daily in the Nile and were given regular medical examinations. Sick workers were isolated.5 The Romans were vitally concerned with safety and health, as can be seen from the remains of their construction projects. The Romans built aqueducts, sewerage systems, public baths, latrines, and well-ventilated houses.6 As civilization progressed, so did safety and health developments. In 1567, Philippus Aureolus produced a treatise on the pulmonary diseases of miners. Titled On the Miners’ Sickness and Other Miners’ Diseases, the treatise covered diseases of smelter workers and metallurgists and diseases associated with the handling of and exposure to mercury. Around the same time, Georgius Agricola published his treatise De Re Metallica, emphasizing the need for ventilation in mines and illustrating various devices that could be used to introduce fresh air into mines.7 The eighteenth century saw the contributions of Bernardino Ramazzini, who wrote Discourse on the Diseases of Workers. Ramazzini drew conclusive parallels between diseases suffered by workers and their occupations. He related occupational diseases to the handling of harmful materials and to irregular or unnatural movements of the body. Much of what Ramazzini wrote is still relevant today.8 The Industrial Revolution changed forever the methods of producing goods. According to J. LaDou, the changes in production brought about by the Industrial Revolution can be summarized as follows: • Introduction of inanimate power (i.e., steam power) to replace people and animal power • Substitution of machines for people • Introduction of new methods for converting raw materials • Organization and specialization of work, resulting in a division of labor9 These changes necessitated a greater focusing of attention on the safety and health of workers. Steam power increased markedly the potential for life-threatening injuries, as did machines. The new methods used for converting raw materials also introduced new risks of injuries and diseases. Specialization, by increasing the likelihood of boredom and inattentiveness, also made the workplace a more dangerous environment. MILESTONES IN THE SAFETY MOVEMENT Just as the United States traces its roots to Great Britain, the safety movement in this country traces its roots to England. During the Industrial Revolution, child labor in factories was common. The hours were long, the work hard, and the conditions often Safety and Health Movement, Then and Now 5 unhealthy and unsafe. Following an outbreak of fever among the children working in their cotton mills, the people of Manchester, England, began demanding better working conditions in the factories. Public pressure eventually forced a government response, and in 1802 the Health and Morals of Apprentices Act was passed. This was a milestone piece of legislation: It marked the beginning of governmental involvement in workplace safety. When the industrial sector began to grow in the United States, hazardous working conditions were commonplace. Following the Civil War, the seeds of the safety movement were sown in this country. Factory inspection was introduced in Massachusetts in 1867. In 1868, the first barrier safeguard was patented. In 1869, the Pennsylvania legislature passed a mine safety law requiring two exits from all mines. The Bureau of Labor Statistics (BLS) was established in 1869 to study industrial accidents and report pertinent information about those accidents. The following decade saw little new progress in the safety movement until 1877, when the Massachusetts legislature passed a law requiring safeguards for hazardous machinery. This year also saw passage of the Employer’s Liability Law, establishing the potential for employer liability in workplace accidents. In 1892, the first recorded safety program was established in a Joliet, Illinois, steel plant in response to a scare caused when a flywheel exploded. Following the explosion, a committee of managers was formed to investigate and make recommendations. The committee’s recommendations were used as the basis for the development of a safety program that is considered to be the first safety program in American industry. Around 1900, Frederick Taylor began studying efficiency in manufacturing. His purpose was to identify the impact of various factors on efficiency, productivity, and profitability. Although safety was not a major focus of his work, Taylor did draw a connection between lost personnel time and management policies and procedures. This connection between safety and management represented a major step toward broadbased safety consciousness. In 1907, the U.S. Department of the Interior created the Bureau of Mines to investigate accidents, examine health hazards, and make recommendations for improvements. Mining workers definitely welcomed this development, since more than 3,200 of their fellow workers were killed in mining accidents in 1907 alone.10 One of the most important developments in the history of the safety movement occurred in 1908 when an early form of workers’ compensation was introduced in the United States. Workers’ compensation actually had its beginnings in Germany. The practice soon spread throughout the rest of Europe. Workers’ compensation as a concept made great strides in the United States when Wisconsin passed the first effective workers’ compensation law in 1911. In the same year, New Jersey passed a workers’ compensation law that withstood a court challenge. The common thread among the various early approaches to workers’ compensation was that they all provided some amount of compensation for on-the-job injuries regardless of who was at fault. When the workers’ compensation concept was first introduced in the United States, it covered a very limited portion of the workforce and provided only minimal benefits. Today, all 50 states have some form of workers’ compensation that requires the payment of a wide range of benefits to a broad base of workers. Workers’ compensation is examined in more depth in Chapter 7. The Association of Iron and Steel Electrical Engineers (AISEE), formed in the early 1900s, pressed for a national conference on safety. As a result of the AISEE’s efforts, the first meeting of the Cooperative Safety Congress (CSC) took place in Milwaukee in 1912. What is particularly significant about this meeting is that it planted the seeds for the eventual establishment of the NSC. A year after the initial meeting of the CSC, the National Council of Industrial Safety (NCIS) was established in Chicago. In 1915, this organization changed its name to the National Safety Council. It is now the premier safety organization in the United States. From the end of World War I (1918) through the 1950s, safety awareness grew steadily. During this period, the federal government encouraged contractors to implement and 6 CHAPTER 1 maintain a safe work environment. Also during this period, industry in the United States arrived at two critical conclusions: (1) there is a definite connection between quality and safety, and (2) off-the-job accidents have a negative impact on productivity. The second conclusion became painfully clear to manufacturers during World War II when the call-up and deployment of troops had employers struggling to meet their labor needs. For these employers, the loss of a skilled worker due to an injury or for any other reason created an excessive hardship.11 The 1960s saw the passage of a flurry of legislation promoting workplace safety. The Service Contract Act of 1965, the Federal Metal and Nonmetallic Mine Safety Act, the Federal Coal Mine and Safety Act, and the Contract Workers and Safety Standards Act all were passed during the 1960s. As their names indicate, these laws applied to a limited audience of workers. According to the Society of Manufacturing Engineers (SME), more significant legislation than that enacted in the 1960s was needed: Generally, the state legislated safety requirements only in specific industries, had inadequate safety and health standards, and had inadequate budgets for enforcement. . . . The injury and death toll due to industrial mishaps was still . . . too high. In the late 1960s, more than 14,000 employees were killed annually in connection with their jobs. . . . Work injury rates were taking an upward swing.12 These were the primary reasons behind passage of the Occupational Safety and Health Act (OSH Act) of 1970 and the Federal Mine Safety Act of 1977. These federal laws, particularly the OSH Act, represent the most significant legislation to date in the history of the safety movement. The Superfund Amendments and Reauthorization Act was passed by Congress in 1986, followed by the Amended Clean Air Act in 1990; both were major pieces of environmental legislation. The concept of Total Safety Management (TSM) was introduced in 1996 to help safety professionals working in organizations that subscribe to the Total Quality Management (TQM) philosophy and/or that pursue ISO 9000 registration. In 2000, U.S. firms began to pursue ISO 14000 registration, and workplace terrorism became an important issue in 2003. In 2007, as more and more older people reentered the workforce, their special safety needs became an issue for safety professionals. In 2010, organizations began to concern themselves with off-the-job safety as a critical part of their overall safety and health plan. Figure 1–1 summarizes some significant milestones in the development of the safety movement in the United States. TRAGEDIES THAT HAVE CHANGED THE SAFETY MOVEMENT Safety and health tragedies in the workplace have greatly accelerated the pace of the safety movement in the United States. Three of the most significant events in the history of the safety and health movement were the Hawk’s Nest tragedy, asbestos menace, and the Bhopal tragedy. This section explains these three milestone events and their lasting effects on the safety and health movement in the United States. Hawk’s Nest Tragedy In the 1930s, the public began to take notice of the health problems suffered by employees who worked in dusty environments. The Great Depression was indirectly responsible for the attention given to an occupational disease that came to be known as silicosis. As the economic crash spread, business after business shut down and laid off its workers. Unemployed miners and foundry workers began to experience problems finding new jobs when physical examinations revealed that they had lung damage from breathing silica. Cautious insurance companies recommended preemployment physicals as a way to prevent future claims based on preexisting conditions. Applicants Safety and Health Movement, Then and Now 1867 Massachusetts introduces factory inspection. 1868 Patent is awarded for first barrier safeguard. 1869 Pennsylvania passes law requiring two exits from all mines, and the Bureau of Labor Statistics is formed. 1877 Massachusetts passes law requiring safeguards on hazardous machines, and the Employer’s Liability Law is passed. 1892 First recorded safety program is established. 1900 Frederick Taylor conducts first systematic studies of efficiency in manufacturing. 1907 Bureau of Mines is created by the U.S. Department of the Interior. 1908 Concept of workers’ compensation is introduced in the United States. 1911 Wisconsin passes the first effective workers’ compensation law in the United States, and New Jersey becomes the first state to uphold a workers’ compensation law. 1912 First Cooperative Safety Congress meets in Milwaukee. 1913 National Council of Industrial Safety is formed. 1915 National Council of Industrial Safety changes its name to National Safety Council. 1916 Concept of negligent manufacture is established (product liability). 1936 National Silicosis Conference convened by the U.S. Secretary of Labor. 1970 Occupational Safety and Health Act passes. 1977 Federal Mine Safety Act passes. 1986 Superfund Amendments and Reauthorization Act pass. 1990 Amended Clean Air Act of 1970 passes. 1996 Total safety management (TSM) concept is introduced. 2000 U.S. firms begin to pursue ISO 14000 registration for environmental safety management. 2003 Workplace terrorism is an ongoing concern of safety and health professionals. 2007 Safety of older people reentering the workplace becomes an issue. 2010 Off-the-job safety becomes an issue. 7 Figure 1–1 Milestones in the safety movement. with silica-damaged lungs were refused employment. Many of them sued. This marked the beginning of industry-wide interest in what would eventually be called the “king” of occupational diseases. Lawsuits and insurance claims generated public interest in silicosis, but it was the Hawk’s Nest tragedy that solidified public opinion in favor of protecting workers from this debilitating disease.13 A company was given a contract to drill a passageway through a mountain located in the Hawk’s Nest region of West Virginia (near the city of Gauley Bridge). Workers spent as many as 10 hours per day breathing the dust created by drilling and blasting. It turned out that this particular mountain had an unusually high silica content. Silicosis is a disease that normally takes 10 to 30 years to show up in exposed workers. At Hawk’s Nest, workers began dying in as little time as a year. By the time the project was completed, hundreds had died. To make matters even worse, the company often buried an employee who died from exposure to silica in a nearby field without notifying the family. Those who inquired were told that their loved one left without saying where he was going. 8 CHAPTER 1 A fictitious account of the Gauley Bridge disaster titled Hawk’s Nest, by Hubert Skidmore, whipped the public outcry into a frenzy, forcing Congress to respond. This tragedy and the public outcry that resulted from it led a group of companies to form the Air Hygiene Foundation to conduct research and develop standards for working in dusty environments. Soon thereafter, the U.S. Department of Labor provided the leadership necessary to make silicosis a compensable disease under workers’ compensation in most states. Today, dust-producing industries use a wide variety of administrative controls, engineering controls, and personal protective equipment to protect workers in dusty environments. However, silicosis is still a problem. Approximately 1 million workers in the United States are still exposed to silica every year, and 250 people die annually from silicosis. Asbestos Menace Asbestos was once considered a “miracle” fiber, but in 1964, Dr. Irving J. Selikoff told 400 scientists at a conference on the biological effects of asbestos that this widely used material was killing workers. This conference changed how Americans viewed not just asbestos, but workplace hazards in general. Selikoff was the first to link asbestos to lung cancer and respiratory diseases.14 At the time of Selikoff’s findings, asbestos was one of the most widely used materials in the United States. It was found in homes, schools, offices, factories, ships, and even in the filters of cigarettes. Selikoff continued to study the effects of asbestos exposure from 1967 to 1986. During this time, he studied the mortality rate of 17,800 workers who had been exposed to asbestos. He found asbestos-related cancer in the lungs, gastrointestinal tract, larynx, pharynx, kidneys, pancreas, gall bladder, and bile ducts of workers. Finally, in the 1970s and 1980s, asbestos became a controlled material. Regulations governing the use of asbestos were developed, and standards for exposure were established. Asbestos-related lawsuits eventually changed how industry dealt with this tragic material. In the 1960s, industry covered up or denied the truth about asbestos. Now, there is an industry-wide effort to protect workers who must remove asbestos from old buildings and ships during remodeling, renovation, or demolition projects. Bhopal Tragedy On the morning of December 3, 1984, over 40 tons of methyl isocyanate (MIC) and other lethal gases, including hydrogen cyanide, leaked into the northern end of Bhopal, killing more than 3,000 people in its aftermath.15 After the accident, it was discovered that the protective equipment that could have halted the impending disaster was not in full working order. The refrigeration system that should have cooled the storage tank was shut down, the scrubbing system that should have absorbed the vapor was not immediately available, and the flare system that would have burned any vapor that got past the scrubbing system was out of order.16 The International Medical Commission visited Bhopal to assess the situation and found that as many as 50,000 other people had been exposed to the poisonous gas and may still suffer disability as a result. This disaster shocked the world. Union Carbide Corporation, the owner of the chemical plant in Bhopal, India, where the incident occurred, was accused of many things, including the following: • Criminal negligence. • Corporate prejudice. Choosing poverty-stricken Bhopal, India, as the location for a hazardous chemical plant on the assumption that few would care if something went wrong. • Avoidance. Putting its chemical plant in Bhopal, India, to avoid the stricter safety and health standards of the United States and the Occupational Safety and Health Administration (OSHA) in particular. Safety and Health Movement, Then and Now 9 In February 1989, India’s Supreme Court ordered Union Carbide India Ltd. to pay $470 million in compensatory damages. The funds were paid to the Indian government to be used to compensate the victims. This disaster provided the impetus for the passage of stricter safety legislation worldwide. In the United States, it led to the passage of the Emergency Planning and Community Right-to-Know Act (EPCRA) of 1986. ROLE OF ORGANIZED LABOR Organized labor has played a crucial role in the development of the safety movement in the United States. From the outset of the Industrial Revolution in this country, organized labor has fought for safer working conditions and appropriate compensation for workers injured on the job. Many of the earliest developments in the safety movement were the result of long and hard-fought battles by organized labor. Although the role of unions in promoting safety is generally acknowledged, one school of thought takes the opposite view. Proponents of this dissenting view hold that union involvement actually slowed the development of the safety movement. Their theory is that unions allowed their demands for safer working conditions to become entangled with their demands for better wages; as a result, they met with resistance from management. Regardless of the point of view, there is no question that working conditions in the earliest years of the safety movement were often reflective of an insensitivity to safety concerns on the part of management. Among the most important contributions of organized labor to the safety movement was their work to overturn antilabor laws relating to safety in the workplace. These laws were the fellow servant rule, the statutes defining contributory negligence, and the concept of assumption of risk.17 The fellow servant rule held that employers were not liable for workplace injuries that resulted from the negligence of other employees. For example, if Worker X slipped and fell, breaking his back in the process, because Worker Y spilled oil on the floor and left it there, the employer’s liability was removed. In addition, if the actions of employees contributed to their own injuries, the employer was absolved of any liability. This was the doctrine of contributory negligence. The concept of assumption of risk was based on the theory that people who accept a job assume the risks that go with it. It says employees who work voluntarily should accept the consequences of their actions on the job rather than blame the employer. Because the overwhelming majority of industrial accidents involve negligence on the part of one or more workers, employers had little to worry about. Therefore, they had little incentive to promote a safe work environment. Organized labor played a crucial role in bringing deplorable working conditions to the attention of the general public. Public awareness and, in some cases, outrage eventually led to these employer-biased laws being overturned in all states except one. In New Hampshire, the fellow servant rule still applies. ROLE OF SPECIFIC HEALTH PROBLEMS Specific health problems that have been tied to workplace hazards have played significant roles in the development of the modern safety and health movement. These health problems contributed to public awareness of dangerous and unhealthy working conditions that, in turn, led to legislation, regulations, better work procedures, and better working conditions. Lung disease in coal miners was a major problem in the 1800s, particularly in Great Britain, where much of the Western world’s coal was mined at the time. Frequent contact 10 CHAPTER 1 Discussion Case What Is Your Opinion? Two safety and health students are debating the issue of corporate responsibility. Tom thinks that industry has clearly demonstrated its unwillingness over the years to provide a safe and healthy work environment for employees. He offers such examples as the Gauley Bridge disaster and the Bhopal gas tragedy as evidence. Janet agrees that industry indeed has a checkered past on safety and health, but she thinks employers have learned that their workforce is a valuable asset that should be protected. Tom’s response is, “Take away federal and state mandates, and industry would return to its old ways in less than a year.” Join this debate. What is your opinion? with coal dust led to a widespread outbreak of anthrocosis among Great Britain’s coal miners. Also known as the black spit, this disease persisted from the early 1800s, when it was first identified, until around 1875, when it was finally eliminated by such safety and health measures as ventilation and decreased work hours. In the 1930s, Great Britain saw a resurgence of lung problems among coal miners. By the early 1940s, British scientists were using the term coal-miner’s pneumoconiosis, or CWP, to describe a disease from which many miners suffered. Great Britain designated CWP a separate and compensable disease in 1943. However, the United States did not immediately follow suit, even though numerous outbreaks of the disease had occurred among miners in this country. The issue was debated in the United States until Congress finally passed the Coal Mine Health and Safety Act in 1969. The events that led up to the passage of this act were tragic. An explosion in a coal mine in West Virginia in 1968 killed 78 miners. This tragedy focused attention on mining health and safety, and Congress responded by passing the Coal Mine Health and Safety Act. The act was amended in 1977 and again in 1978 to broaden the scope of its coverage. Over the years, the diseases suffered by miners were typically lung diseases caused by the inhalation of coal dust particulates. However, health problems were not limited to coal miners. Other types of miners developed a variety of diseases, the most common of which was silicosis. Once again, it took a tragic event—the Gauley Bridge disaster, discussed earlier—to focus attention on a serious workplace problem. Congress held a series of hearings on the matter in 1936. That same year, representatives from business, industry, and government attended the National Silicosis Conference, convened by the U.S. secretary of labor. Among other outcomes of this conference was a finding that silica dust particulates did, in fact, cause silicosis. Mercury poisoning is another health problem that has contributed to the evolution of the safety and health movement by focusing public attention on unsafe conditions in the workplace. The disease was first noticed among the citizens of a Japanese fishing village in the early 1930s. A disease with severe symptoms was common in Minamata, but extremely rare throughout the rest of Japan. After much investigation into the situation, it was determined that a nearby chemical plant periodically dumped methyl mercury into the bay that was the village’s primary source of food. Consequently, the citizens of this small village ingested hazardous dosages of mercury every time they ate fish from the bay. Mercury poisoning became an issue in the United States after a study was conducted in the early 1940s that focused on New York City’s hat-making industry. During that time, many workers in this industry displayed the same types of symptoms as the citizens of Minamata, Japan. Because mercury nitrate was used in the production of hats, enough suspicion was aroused to warrant a study. The study linked the symptoms of workers with the use of mercury nitrate. As a result, the use of this hazardous Safety and Health Movement, Then and Now 11 chemical in the hat-making industry was stopped, and a suitable substitute—hydrogen peroxide—was found. As discussed earlier, asbestos was another important substance in the evolution of the modern safety and health movement. By the time it was determined that asbestos is a hazardous material, the fibers of which can cause asbestosis or lung cancer (mesothelioma), thousands of buildings contained the substance. As these buildings began to age, the asbestos—particularly that used to insulate pipes—began to break down. As asbestos breaks down, it releases dangerous microscopic fibers into the air. These fibers are so hazardous that removing asbestos from old buildings has become a highly specialized task requiring special equipment and training. DEVELOPMENT OF ACCIDENT PREVENTION PROGRAMS In the modern workplace, there are many different types of accident prevention programs ranging from the simple to the complex. Widely used accident prevention techniques include failure minimization, fail-safe designs, isolation, lockouts, screening, personal protective equipment, redundancy, timed replacements, and many others. These techniques are individual components of broader safety programs. Such programs have evolved since the late 1800s. In the early 1800s, employers had little concern for the safety of workers and little incentive to be concerned. Consequently, organized safety programs were nonexistent, a situation that continued for many years. However, between World War I and World War II, industry discovered the connection between quality and safety. Then, during World War II, troop call-ups and deployments created severe labor shortages. Faced with these shortages, employers could not afford to lose workers to accidents or for any other reason. This realization created a greater openness toward giving safety the serious consideration that it deserved. For example, according to the SME, around this time industry began to realize the following: • • • • Improved engineering could prevent accidents. Employees were willing to learn and accept safety rules. Safety rules could be established and enforced. Financial savings from safety improvement could be reaped by savings in compensation and medical bills.18 With these realizations came the long-needed incentive for employers to begin playing an active role in creating and maintaining a safe workplace. This, in turn, led to the development of organized safety programs sponsored by management. Early safety programs were based on the three E’s of safety: engineering, education, and enforcement (see Figure 1–2). The engineering aspects of a safety program involve making design improvements to both Figure 1–2 Three E’s of safety. Enforcement Education Engineering 12 CHAPTER 1 product and process. By altering the design of a product, the processes used to manufacture it can be simplified and, as a result, made less dangerous. In addition, the manufacturing processes for products can be engineered in ways that decrease potential hazards associated with the processes. The education aspect of a safety program ensures that employees know how to work safely, why it is important to do so, and that safety is expected by management. Safety education typically covers the what, when, where, why, and how of safety. The enforcement aspect of a safety program involves making sure that employees abide by safety policies, rules, regulations, practices, and procedures. Supervisors and fellow employees play a key role in the enforcement aspects of modern safety programs. DEVELOPMENT OF SAFETY ORGANIZATIONS Today, numerous organizations are devoted in full, or at least in part, to the promotion of safety and health in the workplace. Figure 1–3 lists organizations with workplace safety as part of their missions. Figure 1–4 lists several governmental agencies and two related organizations concerned with safety and health. These lists are extensive now, but this has not always been the case. Safety organizations in this country had humble beginnings. The grandfather of them all is the NSC. The SME traces the genesis of this organization as follows: The Association of Iron and Steel Electrical Engineers was organized in the first decade of the 20th century and devoted much attention to safety problems in its industry. In 1911, a request came from this association to call a national industrial safety conference. The first Cooperative Safety Congress met in Milwaukee in 1912. A year later, at a meeting in New York City, the National Council of Industrial Safety was formed. It began operation in a small office in Chicago. At its meeting in 1915, the organization’s name was changed to the National Safety Council (NSC).19 Figure 1–3 Organizations concerned with workplace safety. Alliance for American Insurers American Board of Industrial Hygiene American Conference of Government Industrial Hygienists American Industrial Hygiene Association American Insurance Association American National Standards Institute American Occupational Medical Association American Society for Testing and Materials American Society of Mechanical Engineers American Society of Safety Engineers Chemical Transportation Emergency Center Human Factors Society National Fire Protection Association National Safety Council National Safety Management Society Society of Automotive Engineers System Safety Society Underwriters Laboratories Inc. Safety and Health Movement, Then and Now 13 American Public Health Association* Bureau of Labor Statistics Bureau of National Affairs Commerce Clearing House* Environmental Protection Agency National Institute for Standards and Technology (formerly National Bureau of Standards) National Institute for Occupational Safety and Health Occupational Safety and Health Administration Superintendent of Documents, U.S. Government Printing Office U.S. Consumer Product Safety Commission * Not a government agency. Figure 1–4 Government agencies and other organizations concerned with workplace safety. Today, the NSC is the largest organization in the United States devoted solely to safety and health practices and procedures. Its purpose is to prevent the losses, both direct and indirect, arising out of accidents or from exposure to unhealthy environments. Although it is chartered by an act of Congress, the NSC is a nongovernmental, not-for-profit, public service organization. The Occupational Safety and Health Administration (OSHA) is the government’s administrative arm for the Occupational Safety and Health Act (OSH Act). Formed in 1970, OSHA sets and revokes safety and health standards, conducts inspections, investigates problems, issues citations, assesses penalties, petitions the courts to take appropriate action against unsafe employers, provides safety training, provides injury prevention consultation, and maintains a database of health and safety statistics. Another governmental organization is the National Institute for Occupational Safety and Health (NIOSH). This organization is part of the Centers for Disease Control and Prevention (CDC) of the Department of Health and Human Services. NIOSH is required to publish annually a comprehensive list of all known toxic substances. NIOSH will also provide on-site tests of potentially toxic substances so that companies know what they are handling and what precautions to take. Safety Fact Safety Movement and War World War II actually had a positive effect on the modern safety and health movement. During the war, there was a shortage of able-bodied, skilled workers in factories supporting the war effort because most of these workers were in the armed services. Consequently, preserving the safety and health of the relatively few skilled workers still available was paramount. The law of supply and demand suddenly made workplace safety a significant issue, which it still is today. The military war is over, but the economic war still rages. To be competitive in this international conflict, employers today must follow the lead of their predecessors during World War II and protect their employees. 14 CHAPTER 1 SAFETY AND HEALTH MOVEMENT TODAY The safety and health movement has come a long way since the Industrial Revolution. Today, there is widespread understanding of the importance of providing a safe and healthy workplace. The tone was set during and after World War II when all the various practitioners of occupational health and safety began to see the need for cooperative efforts. These practitioners included safety engineers, safety managers, industrial hygienists, occupational health nurses, and physicians. One of the earliest and most vocal proponents of the cooperative or integrated approach was H. G. Dyktor. He proposed the following objectives of integration: • Learn more through sharing knowledge about health problems in the workplace, particularly those caused by toxic substances. • Provide a greater level of expertise in evaluating health and safety problems. • Provide a broad database that can be used to compare health and safety problems experienced by different companies in the same industry. • Encourage accident prevention. • Make employee health and safety a high priority.20 INTEGRATED APPROACH TO SAFETY AND HEALTH The integrated approach has become the norm that typifies the safety and health movement of today. By working together and drawing on their own respective areas of expertise, safety and health professionals are better able to identify, predict, control, and correct safety and health problems. OSHA reinforces the integrated approach by requiring companies to have a plan for doing at least the following: (1) providing appropriate medical treatment for injured or ill workers, (2) regularly examining workers who are exposed to toxic substances, and (3) having a qualified first-aid person available during all working hours. Smaller companies may contract out the fulfillment of these requirements. Larger companies often maintain a staff of safety and health professionals. According to A. Hamilton and H. Hardy, the health and safety staff in a modern industrial company may include the following positions: • Industrial hygiene chemist and/or engineer. Companies that use toxic substances may employ industrial hygiene chemists periodically to test the work environment and the people who work in it. In this way, unsafe conditions or hazardous levels of exposure can be identified early, and corrective or preventive measures can be taken. Dust levels, ventilation, and noise levels are also monitored by individuals serving in this capacity. • Radiation control specialist. Companies that use or produce radioactive materials employ radiation control specialists who are typically electrical engineers or physicists. These specialists monitor the radiation levels to which workers may be exposed, test workers for levels of exposure, respond to radiation accidents, develop company-wide plans for handling radiation accidents, and implement decontamination procedures when necessary. • Industrial safety engineer or manager. Individuals serving as industrial safety engineers or managers are safety and health generalists with specialized education and training. In larger companies, they may be devoted to safety and health matters. In smaller companies, they may have other duties in addition to safety and health. In either case, they are responsible for developing and carrying out the company’s overall safety and health program, including accident prevention, accident investigation, and education and training.21 Other professionals who may be part of a company’s safety and health team include occupational nurses, physicians, psychologists, counselors, educators, and dietitians. Safety and Health Movement, Then and Now 15 NEW MATERIALS, NEW PROCESSES, AND NEW PROBLEMS The job of the safety and health professional is more complex than it has ever been. The materials out of which products are made have become increasingly complex and exotic. Engineering metals now include carbon steels, alloy steels, high-strength low-alloy steels, stainless steels, managing steels, cast steels, cast irons, tungsten, molybdenum, titanium, aluminum, copper, magnesium, lead, tin, zinc, and powdered metals. Each of these metals requires its own specialized processes. Nonmetals are more numerous and have also become more complex. Plastics, plastic alloys and blends, advanced composites, fibrous materials, elastomers, and ceramics also bring their own potential hazards to the workplace. In addition to the more complex materials being used in modern industry and the new safety and health concerns associated with them, modern industrial processes are also becoming more complex. As these processes become automated, the potential hazards associated with them often increase. Computers; lasers; industrial robots; nontraditional processes such as explosive welding, photochemical machining, laser beam machining, ultrasonic machining, and chemical milling; automated material handling; water-jet cutting expert systems; flexible manufacturing cells; and computer-integrated manufacturing have all introduced new safety and health problems in the workplace and new challenges for the safety and health professional. Chapter 23 is devoted to coverage of the special safety and health problems associated with computers, robots, and automation. In addition, coverage of specific aspects of these problems is provided in different chapters throughout this book. RAPID GROWTH IN THE PROFESSION The complexities of the modern workplace have made safety and health a growing profession. Associate and baccalaureate degree programs in industrial technology typically include industrial safety courses. Some engineering degree programs have safety and health tracks. Several colleges and universities offer full degrees in occupational safety and health. The inevitable result of the increased attention given to safety and health is that more large companies are employing safety and health professionals and more small companies are assigning these duties to existing employees. This is a trend that is likely to continue as employers see their responsibilities for safety and health spread beyond the workplace to the environment, the community, the users of their products, and the recipients of their by-products and waste. SUMMARY 1. Safety and health awareness has a long history. There is evidence of occupational safety and health efforts as far back as the time of the Egyptian pharaohs. The Code of Hammurabi, circa 2000 BC, contained clauses that could be interpreted as early attempts at workers’ compensation. There is also evidence of concern for safety and health during the time of the Romans. 2. Milestones in the development of the safety movement in the United States include the following: first recorded safety program in 1892, creation of the Bureau of Mines in 1907, passage of the first effective workers’ compensation law in the United States in 1911, and passage of Occupational Safety and Health Act in 1970. 16 CHAPTER 1 3. Organized labor has played a crucial role in the development of the safety movement in the United States. Particularly important was the work of unions to overturn antilabor laws inhibiting safety in the workplace. 4. Specific health problems associated with the workplace have contributed to the development of the modern safety and health movement. These problems include lung diseases in miners, mercury poisoning, and lung cancer tied to asbestos. 5. Tragedies have changed the face of the safety movement at different times in the United States. The Hawk’s Nest tragedy, asbestos menace, and Bhopal disaster are examples of such tragedies. 6. Widely used accident prevention techniques include failure minimization, fail-safe designs, isolation, lockouts, screening, personal protective equipment, redundancy, and timed replacements. 7. The development of the safety movement in the United States has been helped by the parallel development of safety organizations. Prominent among these are the National Safety Council, the National Safety Management Society, the American Society of Safety Engineers, and the American Industrial Hygiene Association. 8. The safety and health movement today is characterized by professionalization and integration. The safety and health team of a large company may include an industrial chemist or engineer, radiation control specialist, safety engineer or manager, occupational nurse, counselor, psychologist, and dietitian. New materials and processes are introducing new safety and health problems, making the integrated approach a practical necessity and promoting growth in the profession. KEY TERMS AND CONCEPTS Accident prevention Asbestos menace Assumption of risk Bhopal tragedy Code of Hammurabi Contributory negligence Cooperative Safety Congress (CSC) Employer-biased laws Employer liability Fellow servant rule Hawk’s Nest tragedy Inanimate power Industrial hygiene chemists Industrial safety engineer Industrial safety manager National Council of Industrial Safety (NCIS) National Institute for Occupational Safety and Health (NIOSH) Occupational Safety and Health Act (OSH Act) Occupational Safety and Health Administration (OSHA) Organized labor Radiation control specialist Safety movement Three E’s of safety Workers’ compensation REVIEW QUESTIONS 1. To what cause(s) can the improvements in workplace safety made to date be attributed? 2. Explain the significance of the Code of Hammurabi in terms of the safety movement. 3. Describe the circumstances that led to the development of the first organized safety program. Safety and Health Movement, Then and Now 17 4. 5. 6. 7. 8. 9. What is Frederick Taylor’s connection to the safety movement? Explain the development of the National Safety Council. What impact did labor shortages in World War II have on the safety movement? Explain how workplace tragedies have affected the safety movement. Give examples. Explain the primary reasons behind the passage of the OSH Act. Summarize briefly the role that organized labor has played in the advancement of the safety movement. 10. Define the following terms: fellow servant rule, contributory negligence, and assumption of risk. 11. Explain the three E’s of safety. 12. Explain the term integration as it relates to modern safety and health. ENDNOTES 1. S. Minter, “The Birth of OSHA,” Occupational Hazards, July 1998, 59. 2. National Safety Council, Accident Facts (Chicago: National Safety Council, 2008). 3. J. LaDou, ed., Introduction to Occupational Health and Safety (Chicago: National Safety Council, 1997), 28. 4. Ibid., 28. 5. A. Soubiran, “Medical Services under the Pharaohs,” Abbottempo 1: 19–23. 6. LaDou, Occupational Health and Safety, 31. 7. Ibid., 34. 8. Ibid., 35. 9. Ibid., 37. 10. S. Minter and V. Sutcliff, “Fighting Two Wars,” Occupational Hazards, July 1998, 41–42. 11. Ibid., 41. 12. Ibid., 42. 13. Ibid., 41–42. 14. OSHA Fact Sheet: Asbestos. Retrieved from www.osha.gov on January 8, 2009. 15. L. Ted Case Studies: Bhopal Disaster. Retrieved from www.american.edu/ted/bhopal. htm. 16. Ibid., 67. 17. Minter and Sutcliff, “Fighting Two Wars,” 41. 18. Ibid., 41. 19. Ibid., 42. 20. H. G. Dyktor, “Integration of Industrial Hygiene with Industrial Medicine,” Industrial Medicine 9, no. 4 (1940): 193. C H A P T E R ACCIDENTS AND THEIR EFFECTS 2 Major Topics ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ Costs of Accidents Accidental Deaths in the United States Accidents versus Other Causes of Death Work Accident Costs and Rates Time Lost Because of Work Injuries Deaths in Work Accidents Work Injuries by Type of Accident Death Rates by Industry Parts of the Body Injured on the Job Chemical Burn Injuries Heat Burn Injuries Repetitive Strain/Soft Tissue Injuries Estimating the Cost of Accidents Global Impact of Accidents and Injuries There is a long history of debate in this country concerning the effect of accidents on industry (the workers and the companies) and the cost of preventing accidents. Historically, the prevailing view was that accident prevention programs were too costly. The more contemporary view is that accidents are too costly and that accident prevention makes sense economically. As a result, accident prevention, which had been advocated on a moral basis, is now justified in economic terms. Accidents are the fourth leading cause of death in this country after heart disease, cancer, and strokes. This ranking is based on all types of accidents, including motor vehicle accidents, drownings, fires, falls, natural disasters, and work-related accidents. Although deaths from natural disasters tend to be more newsworthy than workplace deaths, their actual impact is substantially less. For example, natural disasters in the United States cause fewer than 100 deaths per year on average. Workplace accidents, on the other hand, cause more than 10,000 deaths every year in the United States.1 The following quote from the National Safety Council (NSC) puts workplace accidents and deaths in the proper perspective, notwithstanding their apparent lack of newsworthiness. While you make a 10-minute speech—2 persons will be killed and about 170 will suffer a disabling injury. Costs will amount to $2,800,000. On the average, there are 11 accidental deaths and about 1,030 disabling injuries every hour during the year.2 This chapter provides prospective and practicing safety and health professionals with the information they need to have a full understanding of workplace accidents and their effect on industry in the United States. Such an understanding will help professionals play a more effective role in keeping both management and labor focused appropriately on safety and health in the workplace. 18 Accidents and Their Effects Figure 2–1 Accident costs by accident type (in billion, in a typical year). Motor vehicle accidents 19 $72 Workplace accidents 48 Home accidents 18 Public accidents 12 COSTS OF ACCIDENTS To gain a proper perspective on the economics of workplace accidents, we must view them in the overall context of all accidents. The overall cost of accidents in the United States is approximately $150 billion. These costs include such factors as lost wages, medical expenses, insurance administration, fire-related losses, motor vehicle property damage, and indirect costs. Figure 2–1 breaks down this overall amount by categories of accidents. Figure 2–2 breaks them down by cost categories. Notice in Figure 2–1 that workplace accidents rank second behind motor vehicle accidents in cost. Figure 2–2 shows that the highest cost category is wages lost by workers who are either injured or killed. The category of indirect losses from work accidents consists of costs associated with responding to accidents (i.e., giving first aid, filling out accident reports, handling production slowdowns). Clearly, accidents on and off the job cost U.S. industry dearly. Every dollar that is spent responding to accidents is a dollar that could have been reinvested in modernization, research and development, facility upgrades, and other competitiveness-enhancing activities. ACCIDENTAL DEATHS IN THE UNITED STATES Accidental deaths in the United States result from a variety of causes, including motor vehicle accidents, falls, poisoning, drowning, fire-related injuries, suffocation (ingested object), firearms, medical complications, air transport accidents, interaction with machinery, mechanical suffocation, and the impact of falling objects. The NSC periodically computes death totals and death rates in each of these categories. The statistics for a typical year are as follows: • Motor vehicle accidents. Motor vehicle accidents are the leading cause of accidental deaths in the United States each year. They include deaths resulting from accidents involving mechanically or electrically powered vehicles (excluding rail vehicles) that occur on or off the road. In a typical year, there are approximately 47,000 such deaths in the United States. • Falls. This category includes all deaths from falls except those associated with transport vehicles. For example, a person who is killed as the result of falling while boarding Figure 2–2 Accident costs by categories (in billions, in a typical year). Wages lost Medical expenses $37 24 Insurance administration 29 Property damage (motor vehicle) 27 Fire losses 10 Indirect losses for work accidents 23 20 CHAPTER 2 • • • • • • a bus or train would not be included in this category. In a typical year, there are approximately 13,000 deaths in the United States from falls. Poisoning. The poisoning category is divided into two subcategories: (1) poisoning by solids and liquids and (2) poisoning by gases and vapors. The first category includes deaths that result from the ingestion of drugs, medicine, widely recognized solid and liquid poisons, mushrooms, and shellfish. It does not include poisoning from spoiled food or salmonella. The second category includes deaths caused by incomplete combustion (for example, gas vapors from an oven or unlit pilot light) or from carbon monoxide (for example, exhaust fumes from an automobile). In a typical year, there are approximately 6,000 deaths in the first category and 1,000 in the second. Drowning. This category includes work-related and non-work-related drownings but excludes those associated with floods or other natural disasters. In a typical year, there are approximately 5,000 deaths from drowning in the United States. Fire-related injuries. This category includes deaths from burns, asphyxiation, falls, and those that result from falling objects in a fire. In a typical year, there are over 4,000 fire-related deaths in the United States. Suffocation (ingested object). This category includes deaths from the ingestion of an object that blocks the air passages. In many such deaths, the ingested object is food. In a typical year, there are approximately 4,000 suffocation deaths in the United States. Firearms. This category includes deaths that result when recreational activities involving firearms or household accidents involving firearms result in death. For example, a person killed in the home while cleaning a firearm would be included in this category. However, a person killed in combat would not be included. In a typical year, there are approximately 2,000 such deaths in the United States. Others. This category includes deaths resulting from medical complications arising out of mistakes made by health care professionals, air transport injuries, interaction with machinery, mechanical suffocation, and the impact of falling objects. In a typical year, there are over 14,000 deaths in these subcategories.3 ACCIDENTS VERSUS OTHER CAUSES OF DEATH Although there are more deaths every year from heart disease, cancer, and strokes than from accidents, these causes tend to be concentrated among people at or near retirement age. Among people 37 years of age or younger—prime working years—accidents are the number one cause of death. Figure 2–3 summarizes the causes of death for persons from 25 to 44 years of age. Notice that the leading cause is accidents. Figure 2–3 shows that accidents represent a serious detriment to productivity, quality, and competitiveness in today’s workplace. Yet accidents are the one cause of death and injury that companies can most easily control. Although it is true that companies Figure 2–3 Causes of accidents (ages 25 to 44 years in a typical year). Accidents 27,500 Cancer 20,300 Motor vehicle 16,500 Heart disease 16,000 Poison (solid, liquid) 2,700 Drowning 1,500 Falls 1,100 Fire related 900 Accidents and Their Effects 21 may have some success in decreasing the incidence of heart disease and stroke among their employees through such activities as corporate wellness programs, their impact in this regard is limited. However, employers can have a significant impact on preventing accidents. WORK ACCIDENT COSTS AND RATES Workplace accidents cost employers millions every year. Consider the following examples from the recent past. Arco Chemical Company was ordered to pay $3.48 million in fines as a result of failing to protect workers from an explosion at its petrochemical plant in Channelview, Texas. The steel-making division of USX paid a $3.25 million fine to settle numerous health and safety violation citations. BASF Corporation agreed to pay a fine of $1.06 million to settle Occupational Safety and Health Administration (OSHA) citations associated with an explosion at a Cincinnati chemical plant that caused two deaths and 17 injuries. These examples show the costs of fines only. In addition to fines, these employers incurred costs for safety corrections, medical treatment, survivor benefits, death and burial costs, and a variety of indirect costs. Clearly, work accidents are expensive. However, the news is not all bad. The trend in the rate of accidents is downward. Work accident rates in this century are evidence of the success of the safety movement in the United States. As the amount of attention given to workplace safety and health has increased, the accident rate has decreased. According to the NSC, Between 1912 and 1998, accidental work deaths per 100,000 population were reduced 81 percent, from 21 to 4. In 1912, an estimated 18,000 to 21,000 workers’ lives were lost. In 1998, in a workforce more than triple in size and producing 11 times the goods and services, there were approximately 10,000 work deaths.4 As Figure 2–1 shows, the cost of these 10,000 work deaths and work injuries was $48.5 billion. This translates into a cost of $420 per worker in the United States, computed as the value-add required per worker to offset the cost of work injuries. It translates further into $6.10,000 per death and $18,000 per disabling injury.5 Although statistics are not available to document the supposition, many safety and health professionals believe that the major cost of accidents and injuries on the job results from damage to morale. Employee morale is a less tangible factor than documentable factors such as lost time and medical costs. However, it is widely accepted among management professionals that few factors affect productivity more than employee morale. Employees with low morale do not produce up to their maximum potential. This is why so much time and money are spent every year to help supervisors and managers learn different ways to help improve employee morale. Because few things are as detrimental to employee morale as seeing a fellow worker injured, accidents can have a devastating effect on morale. Whenever an employee is injured, his or her colleagues silently think, “That could have been me,” in addition to worrying about the employee. Morale is damaged even more if the injured employee is well-liked and other employees know his or her family. TIME LOST BECAUSE OF WORK INJURIES An important consideration when assessing the effect of accidents on industry is the amount of lost time due to work injuries.6 According to the NSC, approximately 35 million hours are lost in a typical year as a result of accidents. This is actual time lost from disabling injuries and does not include additional time lost for medical checkups after the injured employee returns to work. Accidents that occurred in previous years often continue to cause lost time in the current year. 22 CHAPTER 2 Figure 2–4 Work deaths by cause for a typical year. Motor vehicle related 37.2% Falls 12.5 Electric current 3.7 Drowning 3.2 Fire related 3.1 Air transport related 3.0 Poison (solid, liquid) 2.7 Water transport related 1.6 Poison (gas, vapor) Other 1.4 31.6 DEATHS IN WORK ACCIDENTS Deaths on the job have decreased markedly over the years. However, they still occur. For example, in a typical year, there are 10,400 work deaths in the United States. The causes of death in the workplace vary. They include those related to motor vehicles, falls, electric current, drowning, fires, air transport, poisoning, water transport, machinery, falling objects, rail transport, and mechanical suffocation.7 Figure 2–4 gives a complete breakdown of the percentages for the various categories of causes. WORK INJURIES BY TYPE OF ACCIDENT Work injuries can be classified by the type of accident from which they resulted. The most common causes of work injuries are • • • • • • • • • Overexertion Impact accidents Falls Bodily reaction (to chemicals) Compression Motor vehicle accidents Exposure to radiation or caustics Rubbing or abrasions Exposure to extreme temperatures Overexertion, the result of employees working beyond their physical limits, is the leading cause of work injuries. According to the NSC, almost 31 percent of all work injuries are caused by overexertion. Impact accidents involve a worker being struck by or against an object. The next most prominent cause of work injuries is falls.8 The remaining accidents are distributed fairly equally among the other causes listed above. DEATH RATES BY INDUSTRY A variety of agencies and organizations, including the Bureau of Labor Statistics, the National Center for Health Statistics, and the NSC, collect data on death rates within industrial categories.9 Such information can be used in a variety of ways, not the least of which is in assigning workers’ compensation rates. The most widely used industrial categories Accidents and Their Effects 23 Discussion Case What Is Your Opinion? Mack Jones has been a safety engineer at Zumwalt Processing Company for almost 25 years. His son David is a recent college graduate who has been the assistant safety director at another company for just six months. Over supper last night, they had a discussion about work injuries. During the discussion, Mack said he thought back injuries were still the problem that safety professionals should worry about the most. David disagreed. He said repetitive strain/soft tissue injuries such as carpal tunnel syndrome were a bigger problem in the modern computerized workplace. What is your opinion? are agriculture, including farming, forestry, and fishing; mining/quarrying, including oil and gas drilling and extraction; construction; manufacturing; transportation/public utilities; trade, both wholesale and retail; services, including finance, insurance, and real estate; and federal, state, and local government. When death rates are computed on the basis of the number of deaths per 100,000 workers in a given year, the industry categories rank as follows (from highest death rate to lowest): 1. 2. 3. 4. 5. 6. 7. 8. Mining/quarrying Agriculture Construction Transportation/public utilities Government Manufacturing Services Trade The rankings sometimes change slightly from year to year. For example, agriculture and mining/quarrying may exchange the first and second ranking in any given year. This is also true at the low end of the rankings with services and trade. However, generally, the typical ranking is as listed. PARTS OF THE BODY INJURED ON THE JOB To develop and maintain an effective safety and health program, it is necessary to know not only the most common causes of death and injury but also the parts of the body most frequently injured. The NSC stated the following: Disabling work injuries in the entire nation totaled approximately 1.75 million in 1998. Of these, about 10,400 were fatal and 60,000 resulted in some permanent impairment. Injuries to the back occurred most frequently, followed by thumb and finger injuries and leg injuries.10 Typically, the most frequent injuries to specific parts of the body are as follows (from most frequent to least): 1. 2. 3. 4. 5. 6. 7. Back Legs and fingers Arms and multiple parts of the body Trunk Hands Eyes, head, and feet Neck, toes, and body systems 24 CHAPTER 2 The back is the most frequently injured part of the body. Legs and fingers are injured with approximately the same frequency, as are arms and multiple parts of the body; the hands are next in frequency, followed by the eyes, the head, and feet; and neck, toes, and body systems. This ranking shows that one of the most fundamental components of a safety and health program should be instruction on how to lift without hurting the back (see Chapter 15). CHEMICAL BURN INJURIES Chemical burn injuries are a special category with which prospective and practicing safety professionals should be familiar. The greatest incidence of chemical burns (approximately one-third) occurs in manufacturing.11 Other high-incidence industries are services, trade, and construction. The chemicals that most frequently cause chemical burn injuries include acids and alkalies; soaps, detergents, and cleaning compounds; solvents and degreasers; calcium hydroxide (a chemical used in cement and plaster); potassium hydroxide (an ingredient in drain cleaners and other cleaning solutions); and sulfuric acid (battery acid). Almost 46 percent of all chemical burn injuries occur while workers are cleaning equipment, tools, and vehicles.12 What is particularly disturbing about chemical burn injuries is that a high percentage of them occur in spite of the use of personal protective equipment, the provision of safety instruction, and the availability of treatment facilities. In some cases, the personal protective equipment is faulty or inadequate. In others, it is not properly used in spite of instructions. Preventing chemical burn injuries presents a special challenge to safety and health professionals. The following strategies are recommended: • Familiarize yourself, the workers, and their supervisors with the chemicals that will be used and their inherent dangers. • Secure the proper personal protection equipment for each type of chemical that will be used. • Provide instruction on the proper use of personal protection equipment and then make sure that supervisors confirm that the equipment is used properly every time. • Monitor that workers are wearing personal protection equipment and replace it when it begins to show wear. HEAT BURN INJURIES Heat burn injuries present a special challenge to safety and health professionals in the modern workplace. Almost 40 percent of all such injuries occur in manufacturing every year. The most frequent causes are flame (this includes smoke inhalation injuries), molten metal, petroleum asphalts, steam, and water. The most common activities associated with heat burn injuries are welding, cutting with a torch, and handling tar or asphalt.13 Following are several factors that contribute to heat burn injuries in the workplace. Safety and health professionals who understand these factors will be in a better position to prevent heat burn injuries. • Employer has no health and safety policy regarding heat hazards. • Employer fails to enforce safety procedures and practices. • Employees are not familiar with the employer’s safety policy and procedures concerning heat hazards. Accidents and Their Effects • • • • • • 25 Employees fail to use or improperly use personal protection equipment. Employees have inadequate or worn personal protection equipment. Employees work in a limited space. Employees attempt to work too fast. Employees are careless. Employees have poorly maintained tools and equipment.14 These factors should be considered carefully by safety and health professionals when developing accident prevention programs. Employees should be familiar with the hazards, should know the appropriate safety precautions, and should have and use the proper personal protection equipment. Safety professionals should monitor to ensure that safety rules are being followed, that personal protection equipment is being used correctly, and that it is in good condition. REPETITIVE STRAIN/SOFT TISSUE INJURIES Repetitive strain injury (RSI) is a broad and generic term that encompasses a variety of injuries resulting from cumulative trauma to the soft tissues of the body, including tendons, tendon sheaths, muscles, ligaments, joints, and nerves. Such injuries are typically associated with the soft tissues of the hands, arms, neck, and shoulders. Carpal tunnel syndrome (CTS) is the most widely known RSI. There are also several other RSIs to the body’s soft tissues. The carpal tunnel is the area inside the wrist through which the median nerve passes. It is formed by the wrist bones and a ligament. CTS is typically caused by repeated and cumulative stress on the median nerve. Symptoms of CTS include numbness, a tingling sensation, and pain in the fingers, hand, and/ or wrist. Stress placed on the median nerve typically results from repeated motion while the hands and fingers are bent in an unnatural position. However, sometimes the stress results from a single traumatic ev...
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