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Risk Managers Walk a Tightrope
Workplace exposure
hazards often fall under the domain of human resources, safety or risk
managers who may, in turn, seek advice from occupational health
professionals on how to handle them.
Broadly stated, risk
management is the process of reducing negative effects on human health
and ecosystems. In the workplace, the term “acceptable risk” is the
degree to which risk can be tolerated to get a job done. But how do
companies determine whether a risk is tolerable, and at what cost?
In many cases,
applicants who take a job are presumed to tacitly accept any
associated risks. However, conflict can arise when employees and their
employers disagree about whether a hazard warrants abatement.
Health
Hazard Evaluations
In some cases, the
National Institute for Occupational Safety and Health (NIOSH) is asked
to use science to settle such disputes. NIOSH conducts free,
non-punitive health hazard evaluations (HHEs) that can be used to
identify and address suspected workplace exposure risks. Only parties
inside a company (management, individual employees, labor unions) may
request an evaluation.
NIOSH investigators who
perform HHEs consider issues such as:
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Management and
labor’s perceptions of hazards and potential exposure risks in
comparison to actual conditions.
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Obstacles to
effective management-labor communication.
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The rationale behind
each evaluation activity.
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The possible
influence of potentially misleading findings from previously
conducted alternative tests.
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Actions that should
be taken if recommended solutions are not effective.
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Differences between
medical and epidemiological findings.
“It becomes quite
complex, because there are a number of issues at play in any single
evaluation,” said Melody Kawamoto, M.D., a NIOSH medical officer in
the HHE division.
NIOSH investigators are
allowed by law to collect environmental samples, review exposure
records, examine personal and workers’ compensation medical records,
and assess hazard control practices. Employee questionnaires and
private interviews, bio-monitoring (e.g., spirometry, peak-flow
meters), blood and urine analyses and other types of medical screening
exams also may be conducted. While HHE summary reports are published
on NIOSH’s website (www.cdc.gov/niosh) with the company’s name,
personal identifiers are eliminated.
Typically, NIOSH
investigators emphasize the use of a hierarchy of engineering and
administrative controls to address exposure risks, and they encourage
the use of joint labor-employer safety committees.
Best Practices
In industry, best
practices dictate that risk acceptance and avoidance decisions be made
at a senior level prior to the performance of any potentially
dangerous work, said Michael Bell, M.D., medical director of the U.S.
Chemicals Materials Agency, which oversees the destruction of chemical
weapons containing sulfur mustard and other toxic materials.
Dr. Bell spoke on Fitness for Physically Stressful Duties
at the 2006 American Occupational Health Conference, which is
sponsored by the American College of Occupational and Environmental
Medicine.
In the event of an
injury, Chemical Materials Agency policy requires plant closure to
protect workers and allow time for authorities to investigate the
incident, make necessary modifications and re-certify work processes –
at an average down-time cost of about $400,000 a day.
Given the potential
consequences, Dr. Bell said a shift worker under pressure to produce
results should not be expected to be responsible for making an
operational decision on the front lines that has the potential to
result in a work-related injury. In addition, supervising personnel
should take steps to ensure that established controls are consistently
enforced.
To truly appreciate the
nature of risk, it is helpful for employers to understand human
nature. According to research conducted by Baruch Fischhoff, Ph.D., of
Carnegie Mellon University and his colleagues, people tend to be more
willing to tolerate risks they perceive to be under their control,
natural, familiar and fairly distributed than they are to accept risks
they perceive to be imposed, manmade, exotic and unevenly applied.
As part of their
contribution to preparedness, the American College of Occupational and
Environmental Medicine and the American Association of Occupational
Health Nurses are developing the Occupational Health Disaster Expert
Network. The network is a confidential online forum designed to foster
collaboration on issues such as planning, training, best-practice
policies and employee communications.
When developing
a workplace disaster plan, the Red Cross recommends that employers
consider three key areas: human resources, physical resources and
business continuity. FEMA advises employers to use qualified
maintenance staff or professional, licensed contractors to inspect
buildings or utility systems.
Another example
of disaster protection is safe storage of important documents,
electronic files, raw materials and inventory required for continued
business operations. The loss of essential records and inventory
during a disaster is a common contributor to delays in renewed
operations and higher recovery costs.
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