Assessing Occupational Safety and Health Training

[Pages:100]Assessing Occupational Safety and Health Training

A Literature Review

Prepared by: Alexander Cohen, PhD Michael J. Colligan, PhD With Technical Assistance from:

Raymond Sinclair Jerry Newman Ronald Schuler

June 1998

Disclaimer

Mention of company names or products does not constitute endorsement by the National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC).

This document is in the public domain and may be freely copied or reprinted.

Copies of this and other NIOSH documents are available from the National Institute for Occupational Safety and Health Publications Dissemination 4676 Columbia Parkway Cincinnati, Ohio 45226-1998

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DHHS (NIOSH) Publication No. 98-145

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Foreword

Occupational safety and health training remains a fundamental element in workplace hazard control programs. As training objectives, recognition of job hazards, learning safe work practices and appreciating other preventive measures are expected to contribute to the goal of reducing occupational risk of injury and disease. This report reviews data found in the literature reflecting the significance of training in meeting these kinds of objectives and outcomes. As will be seen, there is much positive evidence but the results seem very selective and highly qualified. An analysis to identify factors underlying a successful training experience is also presented and does confirm basic principles of learning. Here too, however, important gaps are noted in the available data. The document proceeds to offer an agenda for addressing outstanding needs and ways for strengthening the role that training can play in improving workplace safety and health. The reader audience concerned with these kinds of issues should find this report to be most informative.

Linda Rosenstock, M.D., M.P.H. Director, NIOSH

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Abstract

M ore than 100 Occupational Safety and Health Administration (OSHA) standards for hazard control in the workplace contain requirements for training aimed at reducing risk factors for injury or disease; others limit certain jobs to persons deemed competent by virtue of special training. A literature review was undertaken to assess the merits of such training rules to achieve this objective and to sort out factors of consequence. The review focussed heavily on published reports, primarily drawn from the period 1980 through 1996, wherein training was used as an intervention effort to reduce risk of work-related injury and disease. Eighty (80) such reports were found and gave overwhelming evidence to show the merits of training in increasing worker knowledge of job hazards, and in effecting safer work practices and other positive actions in a wide array of worksites. Reports from select surveys and investigations of worker injuries and workplace fatalities were also accessed with many implicating lack of training as a contributing factor to the mishaps. In still other studies, workplace training devoted to first aid instruction showed linkage to reduced worker injury rates, suggesting that even this kind of training has benefits to job safety overall.

A critical analysis of the above findings found certain qualifications in viewing training impacts and successes with regard to current workplace standards. For example, most of the reported training intervention studies did not address OSHA training rules per se, and knowledge gain and safe behavior measures were used in many evaluations as opposed to actual injury/disease indicators. Also, in some instances, the training was coupled with other forms of intervention to make attribution difficult. Training deficits noted in some surveys of work injury cases lacked for confirmation and no information was available on the quality of the instruction if given at all.

Despite the above reservations and uncertainties, training's role as a necessary element in developing and maintaining effective hazard control activities remained firmly supported by the available literature. What did emerge from this review and analysis was an appreciation of meaningful training procedures and the recognition of factors both within and beyond the training process that could greatly affect its impact. In this regard, the OSHA voluntary training guidelines were described along with illustrations from the reports to show how the various steps contained within them can be met in realistic ways and have merit in framing an effective program. In addition, factors both within and beyond the training process were assessed for their effects on training outcomes based on data found in the reviewed literature. Variables such as size of training group, length/frequency of training, manner of instruction, and trainer credentials were each shown to be significant determinants to the training process. Equally important were extra-training factors such as goal setting, feedback and motivational incentives along with managerial actions to promote the transfer of learning to the jobsite.

Based on the literature review, follow-on efforts to address outstanding issues and needs regarding effective occupational safety and health training were noted.

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Executive Summary

This review sought evidence from the literature bearing on two questions: Are occupational safety and health training (OS&H) requirements, as cited in many Federal standards governing workplace conditions and operations, effective in reducing work related injury and illness? Does the available evidence show certain training factors or practices to be more important than others in having positive effects on these outcome measures?

The literature search focussed on reports of training intervention efforts designed in whole or in part to enhance worker knowledge of workplace hazards, effect behavior changes to ensure compliance with safe work practices, or prompt other actions aimed at reducing the risk of occupational injury or disease. Eighty (80) such reports met criteria for inclusion. They were products of two literature searches. The first search covered the period up to 1993; the second extended the first search through 1996. The included work came mainly from the period 1980 through 1996 and, by intent, addressed five types of hazardous agents. These were: traumatic injury forces, toxic chemicals/materials, harmful physical factors, ergonomic stressors, and biologic/infectious agents as encountered in an array of work settings. The search also examined data from select surveys and investigative reports where training factors were either implicated in the etiology of workplace injury or disease incidents or, alternatively, were considered a key element to the success of worksite hazard control programs that showed exemplary safety and health records. Still another source for information was reports of worksite training directed to other needs (e.g., first aid) but that had apparent positive effects on worksite safety and health indicators as well.

With regard to answering the first question, the literature accessed and reviewed in this report offered much direct and indirect evidence to show the benefits of training in establishing safe and healthful working conditions. The intervention studies in particular were especially supportive. Findings here were near unanimous in showing how training can attain objectives such as increased hazard awareness among the workers at risk, knowledge of and adoption of safe work practices, and other actions that improve workplace safety and health protection. Data from other types of studies suggested too that lack of required training may have contributed to events where workers were injured or killed.

Although affirming the effectiveness of training to meet hazard control objectives, this review also drew attention to some shortcomings in the supportive data. For example, the training intervention work that offered the most positive evidence did not address OSHA training requirements per se. Rather, the training interventions targeted site-specific problems, and while showing success in resolving such problems, i.e., improving safety performance, their exact relationship to OSHA mandated training rules was unclear. Moreover, where studies reported lower injury rates, reduced lost time or medical costs after training, analyses were lacking to show how the improvements could be accounted for by the positive results from training when measured in terms of knowledge gain or behavior indicators. One study that attempted such an analysis found that the targeted training could only account for 25% of the observed reduction in injury rate. Also, in some instances, the training was coupled to

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other forms of intervention (engineering, ergonomic) so as to make attribution even more difficult. Still another tempering fact was that successful training results appeared greatly influenced by "extratraining" considerations. Management's role/support of safety training and its transfer to the jobsite, setting goals and providing feedback to motivate use of the knowledge gained, and offering incentives or rewards for reinforcing safe performance all seemed crucial to attaining a positive result. These types of factors are not acknowledged in OSHA training requirements. It is noteworthy that a proposed OSHA safety and health program standard does recognize the need for management actions to support OS&H training among other critical components.

Some reports that suggested training deficits as factors contributing to injury/health problems lacked for confirmatory information. In other reports, workers who had received training to protect them against certain job hazards were nevertheless afflicted. Missing in these cases was information about the quality of the training offered; whether it met OSHA requirements, or took note of any of the extra-training factors noted above.

Even with the above reservations and uncertainties, however, the role of training as a necessary element in developing and maintaining effective hazard control activities appeared firm. Indeed, the issue was not so much whether OS&H training could make a difference in reducing risks from workplace hazards. Clearly, it can. But rather ascertaining the conditions for maximizing these training effects. This was the second question posed in this review and two approaches were used to offer a response. One effort focussed on the OSHA voluntary training guidelines wherein examples were extracted from the set of intervention studies to highlight the different steps that had to be taken. Various exhibits in this exercise showed how the steps could be met in realistic ways and could have merit in framing and implementing an effective training program.

A second approach considered factors not covered in the OSHA guidelines but more specific to the training process itself or the attainment of its objectives. Variables included were the size of training group, length and/or frequency of training, manner of instruction, trainer credentials, and training/transfer conditions. Addressed among the latter conditions were extra-training factors such as management/supervisory roles and motivational techniques for reinforcing the learning at the jobsite. The intervention studies were examined for data that could justify statements as to the significance of these factors and/or conditions and where they had the greatest potential for effecting successful training outcomes. A set of statements, tying together evaluative information from the different reports, emerged from this exercise. Some were more supportable than others owing to limitations in the data contained in the reports under review. Most statements about specific factors agreed with concepts in the general learning and motivation literature, i.e., increases in training time per unit group of workers or use of more frequent and shorter sessions suggested more favorable outcomes as did active learning experiences stressing jobsite applications. Some unique extensions or refinements were also noted such as the added benefits of having supervisors or foremen assume a more active trainer role in workplace safety and health training as opposed to others who may have that special responsibility. Particular attention was drawn to the length and frequency of training because of its implications for training schedules, both for initial and for refresher instruction. Needs to develop a decision logic for this purpose were mentioned along with some of the variables to be addressed.

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Suggestions for follow-on work were offered to take account of the gaps in the reviewed literature or other shortcomings in responding to the two questions posed. Among those recommended were:

1) Undertaking studies to ascertain how industry is responding to OSHA training rules and the quality of such efforts. The major data set used in this literature review were researcher directed efforts and, for that reason were not the norm. Focussing the efforts on the most prevalent types of injuries and illnesses and selecting industries or work operations where they are most recurrent would be ideal. Differences in how the mandated training rules were met at the various selected sites and links between the training undertaken and specific injury and disease risk factors would be analyzed. The extent to which the operant practices followed OSHA training guidelines, and the resulting experiences could offer an important reference in gauging their utility. 2) Conducting in-depth studies of training practices and their interrelationship with other elements in an establishment's hazard control program. Directing this effort at companies showing exemplary safety and health records could offer program models for effective training that can best complement or enhance other workplace measures aimed at maximizing risk management. 3) Using case-control or cohort studies to compare differences in the level of training of workers injured or afflicted by occupational disease against those not so affected. The intent here would be to get a better assessment of how training deficits can lead to such problems. Such an analysis would require measures to separate out many nontraining factors that could also be responsible for apparent differences in these cases. 4) Convene workshops to discuss issues concerned with the effectiveness of worksite OS&H training both now and in the future. Invitees would include experts and practitioners conversant with OS&H training, job skills training, health education, organizational behavior and evaluation subject areas. The workshops would seek to pool ideas bearing on the questions posed in this report and added concerns such as the adequacy of current regulatory language in OSHA training rules, future training challenges due to changing workplace technologies, worker demographics, measurement outcomes for assessing the effectiveness of training, the merit of merging different workplace training domains (i.e., OS&H training, job skills training, worksite health promotion), and other issues.

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