Thirty years of safety climate research: reflections and future directions

How the interplay of monitoring-enabled digital technologies and human factors facilitates or hinders metro systems' resilient response to operational disruptions

The metro is susceptible to disruption risks and requires a system response capability to build resilience to manage disruptions. Achieving such resilient response state requires readiness in both the technology side, e.g., utilizing digital technologies (DTs) to monitor system components, and the human factors side, e.g., fostering positive human coping capabilities; however, these two sides are usually considered independently, without sufficient integration. This paper aims to develop and empirically test a model in which monitoring-enabled DTs, employees' reactions, and their positive capabilities are simultaneously considered in terms of their interplay and impact on system response capability. The results showed that while DTs for monitoring physical components enhanced perceived management commitment and fostered collective efficacy, DTs for monitoring human components increased psychological strain and inhibited improvisation capability, creating a "double-edged sword" effect on system response capability. Additionally, explicit management commitment buffered the adverse effect of DTs-induced psychological strain on individual improvisation.

Who do you ask? predicting injury rates from survey responses

BACKGROUND

Few studies have addressed whether using manager or worker perceptions of safety policies and practices alone predict reported injury rates less accurately than using both.

OBJECTIVE

This study provides an example and describes a method that can be used to address this issue with survey instruments designed to measure safety climate, policies, or practices.

METHODS

Using multilevel logistic regression, we estimated the relationship between worker and manager perceptions of a given exposure and the odds of worker injury during the post-survey year for three safety scales. We tested whether surveying both workers and managers provides additional predictive value compared with surveying just one group.

RESULTS

Injury in the year following the survey was significantly associated with worker scores on two of the three scales. Manager responses were not significantly associated with injury and did not significantly improve injury rate prediction when added to a model with only worker survey responses.

CONCLUSIONS

The capacity of manager-only or worker-only perceptions of safety policies and practices to predict worker injuries should be established before choosing to survey just one or the other. The approach and findings in this paper can be applied to other survey instruments and in other settings to help make this choice.

Safety climate and seat belt use in the fire service

OBJECTIVE

Motor vehicle incidents or apparatus crashes are a leading cause of firefighter fatalities in the United States. Nonuse of seat belts has been linked to some of these fatalities. This research seeks to understand the relationship between safety climate and seat belt use among firefighters, as findings will provide insights into factors that may bolster seat belt use and protect firefighters.

METHODS

Data were collected from 208 career firefighters working for a city fire department in the southeastern United States. Structural equation modeling was used to test a hypothesized model and to assess the relationships between organizational safety climate, work group safety climate and seat belt use.

RESULTS

It was determined that positive perceptions of workgroup safety climate, as a higher order factor, comprised of supervisor support, horizontal cohesion, and vertical cohesion, was positively associated with seat belt use within a sample of firefighters. Organizational level safety climate did not have a significant relationship with seat belt use but did positively influence workgroup safety climate perceptions.

CONCLUSIONS

Safety climate has been associated with safety compliance and participation behaviors, but more research was needed to specifically examine the impact of safety climate on seat belt use in firefighters. The findings point to the importance of safety climate as a leading indicator and predictor of seat belt use. Bolstering safety climate through safety programs, commitment to safety, effective communication, supportive supervisors and cohesion should ultimately aid in bolstering seat belt use among firefighters, which is important to curtailing firefighter injuries and fatalities.

Mapping Strategies for Strengthening Safety Culture: A Scoping Review

BACKGROUND

Twenty years after the "To Err Is Human" report, one in ten patients still suffer harm in hospitals in high-income countries, highlighting the need to strengthen the culture of safety in healthcare. This scoping review aims to map patient safety culture strengthening strategies described in the literature.

METHOD

This scoping review follows the JBI methodology. It adhered to all scoping review checklist items (PRISMA-ScR) with searches in the Lilacs, MedLine, IBECS, and PubMed databases and on the official websites of Brazilian and North American patient safety organizations. The research took place during the year 2023.

RESULTS

In total, 58 studies comprising 52 articles and 6 documents from health organizations were included. Various strategies were identified and grouped into seven categories based on similarity, highlighting the need for a comprehensive organizational approach to improve patient care. The most described strategies were communication (69%), followed by teamwork (58.6%) and active leadership (56.9%).

CONCLUSION

The identified strategies can promote the development of a culture in which an organization can achieve patient safety, involving practices and attitudes that reduce risks and errors in healthcare. However, the identification of strategies is limited because it is restricted to certain databases and websites of international organizations and does not cover a broader spectrum of sources. Furthermore, the effectiveness of these strategies in improving patient safety culture has not yet been evaluated.

Relationship Between Companies' Responses to Near-Miss Reports and Turnover Intentions of Workers: A Nationwide Cross-Sectional Study

Background

Effective near-miss management is important in preventing workplace accidents. A company's inadequate response to near-miss reports can lead workers to feel insecure and dissatisfied with the company. We investigated the relationship between companies' responses to near-miss reports and turnover intentions of workers.

Methods

We conducted a cross-sectional study using online self-administered questionnaire survey to workers aged ≥20 years in Japan in March 2022. The analysis included 5,071 participants who had near-miss experiences and reported them to their companies. The independent variable was companies' responses to near-miss reports, classified into three categories: adequate response group, inadequate response group, and no response group. The dependent variable was turnover intentions. We calculated the odds ratio and 95% confidential interval (CI) using multilevel logistic regression analyses nested for industries and adjusted for covariates.

Results

Of the 5,071 participants, 3,058 (60.3%) were adequate response group, 1,484 (29.3%) were inadequate response group, and 529 (10.4%) were no response group. In multivariable adjusted model, compared with adequate response group, the odds ratio of inadequate response group and no response group were 1.80 (95% CI: 1.56-2.08) and 2.63 (95% CI: 2.15-3.22), respectively.

Conclusion

Our results suggested that there was a relationship between companies' responses to the near-miss reports and turnover intentions of workers. It is important not only to collect near-misses but also to respond appropriately to the reports and provide feedback to workers.

The impact of safety behavior, perceived risk, and workplace resources on COVID outcomes for U.S. Aircraft Rescue and Firefighting personnel

BACKGROUND

Aircraft rescue and firefighting (ARFF) personnel are first responders located at airports in the United States who provide emergency response, mitigation, evacuation, and rescue of passengers and crew of aircraft at airports. The nature of their work puts ARFF personnel in close contact with travelers on a regular basis and at elevated risk for COVID-19 exposure.

OBJECTIVE

In this study, we focused on safety behavior, perceived risk, and workplace resources to understand COVID-19 outcomes in the early pandemic among the overlooked worker population of ARFF personnel. The goal of this study was to examine how a self-reported positive COVID test were associated with safety behavior, perceived risk, and workplace resources.

METHODS

Cross-sectional survey data were collected among ARFF personnel a year into the COVID-19 pandemic.

RESULTS

Regression results showed that each additional unit increase in perceived susceptibility to COVID-19 was associated with a 133% increase in the odds of testing positive for COVID-19 (OR = 2.33, p <  0.05), and with each additional unit increase in perceived severity level, the odds of getting COVID-19 decreased by 47% (OR = 0.53, p <  0.05).

CONCLUSIONS

Infection control among first responders may be improved by providing relevant information physical and emotional resources, and support that help shape perceptions of risk and adoption of prevention behaviors.

Systematic Review of Workplace Interventions to Support Young Workers' Safety, Work Environment and Health

PURPOSE

This systematic review investigates the effectiveness of workplace interventions to support young workers' work environment, safety and health.

METHODS

A systematic search was conducted in bibliographic databases including PubMed, Web of Science Core Collection and PsycInfo for English or Scandinavian articles published from 2007 to 2022. The PICO strategy guided the assessment of study relevance and the bibliographical search for randomized controlled trials (RCTs) and non-RCTs in which (1) participants were young workers (mean age: 15-29), (2) interventions were initiated and/or carried out at the workplace, (3) a comparison group was included, and (4) an outcome measure related to work environment, safety and health was reported. We categorized each included study using the intervention classification framework. The quality assessment and evidence synthesis adhered to the guidelines developed by the Institute for Work & Health (Toronto, Canada).

RESULTS

A total of 33 high and medium quality studies showed a moderate level of evidence for no benefit of 'Mental training' on stress. We found limited evidence of a positive effect of the following intervention types: 'Attitude and belief' on mental health problems, 'Behavior based' on anxiety, and 'Multifaceted' on hand eczema. We found limited evidence for no benefit of the following intervention types: 'Mental training' on mental health problems, and 'Physiological modifications' on musculoskeletal disorders. The remaining intervention types showed mixed or insufficient evidence.

CONCLUSIONS

Except for a moderate level of evidence for no benefit of 'Mental training' on stress, the evidence synthesis recommends, that there is not enough evidence from the scientific literature to guide current practices. The results emphasizes a strong need for high quality interventions specifically aiming at increasing or maintaining young workers' work environment, safety and health. Included studies focused mainly on individual measures, highlighting the need for studies investigating possible preventive measures at the group or organizational level.

The association between safety climate and noncombat injury events among United States Air Force workers

INTRODUCTION

Work-related injuries are a common lagging safety indicator whereas safety climate assessments can help identify constructs serving as leading indicators. The National Institute for Occupational Safety and Health (NIOSH) partnered with the U.S. Department of the Air Force (DAF) Safety Center to examine the association between perceptions of safety climate survey constructs and the number of injury events within the DAF workforce.

METHODS

The DAF administers voluntary, anonymous, occupation-specific safety climate surveys to DAF workers using the internal Air Force Combined Mishap Reduction System (AFCMRS). Survey responses from 2014 to 2018 provided by DAF workers and injury events in maintenance, support, and operations occupations were shared with NIOSH. Exploratory Factor Analysis revealed five constructs: Leadership and Communication; Organizational Safety Priority; Error Management; Resource Adequacy; and Deployment/Official Travel Impact. Squadron-level analysis included bivariate correlations and estimated Rate Ratios (RRs).

RESULTS

1,547 squadrons administered the survey, averaging 144 workers and 15.8 reportable injuries per squadron. Higher (more favorable) squadron-level construct scores were consistently correlated with fewer reported injuries (p < 0.001). Controlling for the number of workers, RRs revealed significant reductions in injury rates with each one-unit increase in responses: Leadership and Communication RR = 0.40 (95%CI: 0.32-0.48); Organizational Safety Priority RR = 0.50 (95%CI: 0.40-0.64); Error Management RR = 0.37 (95%CI: 0.30-0.47); Deployment/Official Travel Impact RR = 0.36 (95%CI: 0.29-0.45). Resource Adequacy revealed a non-significant lower injury rate RR = 0.87 (95%CI: 0.73-1.04).

CONCLUSIONS

This unique study quantified safety climate and the association with injuries across a multi-year period. While safety climate measurements may be limited by frequent turnover and the self-reported, voluntary, anonymous nature of AFCMRS, the strength of this study is in the census of injuries.

PRACTICAL APPLICATIONS

Future research should include longitudinal analyses to examine the impact on injuries when squadron leaders are provided feedback on safety climate survey results.

Safety climate and safety behaviors: Adapting and validating a positively worded safety climate scale through the time-lagged approach

BACKGROUND

Contemporary literature raises serious questions about the inclusion of negatively worded items in the safety climate scale. Despite these reservations, limited efforts have been made to address this shortcoming.

OBJECTIVE

The present study aims to adapt and empirically validate the ten-items group-level safety climate scale with the purpose of replacing negatively worded items with positively worded ones after a thorough validation process. The present study is one of the first to propose an empirically validated group-level safety climate scale that uses positive items to measure the safety climate construct.

METHODS

Study 1 was conducted using a sample of 135 participants. Study 2 used a time-lagged approach to validate the scale, with a sample of 173 production workers from six oil and gas organizations in Malaysia. The Partial Least Squares Structural Equation Modeling (PLS-SEM) method was used to test the hypothesized relationships.

RESULTS

In Study 1, the results of the exploratory factor analysis showed good reliability for the revised scale. In Study 2, the results of the PLS-SEM analysis demonstrated a positive relationship between safety climate and safety behaviors, thereby validating the revised and translated scale of safety climate.

CONCLUSION

The revised safety climate scale will not only improve data quality, but it will also increase response rates. Additionally, the revised scale will assist managers in understanding the true perceptions of safety climate in their organization, regardless of the cultural context in which the scale is used.

Support for safety in the fire service: a test of reciprocal causality for safety motivation

Much research has identified safety motivation as an essential individual-level antecedent of safety performance. Recently, scholars have shown interest in workplace support as an essential factor of safety motivation. While support from different sources is theoretically distinct, each is argued to be not just an antecedent, but also an outcome of the other. A similar reciprocal relationship is also expected between support and safety motivation. Our research utilised the Self-Determination Theory (Deci & Ryan, 1985) and Social Cognitive Theory (Bandura, 1988) to examine the role of each source of support on safety motivation; and investigate their reciprocal relationships. We used structural equation modelling to analyse three-wave longitudinal data (three months apart) from 314 firefighters throughout Malaysia. The result confirmed direct relationships and interestingly, denied that reciprocal relationships exist between organisational support, social support, and safety motivation over time. Our study recommends that the fire department should encourage support from all sources, primarily from senior management since it is the catalyst that activates support from other sources.

The cross-level effect of team safety-specific transformational leadership on workplace safety behavior: The serial mediating role of team safety climate and team safety motivation

INTRODUCTION

Workplace safety not only impairs individual health but also affects economic and social development.

METHOD

Based on social learning theory, collective social learning theory, and expectancy-valence theory, using cluster random sampling method, 630 employees from 66 different work teams out of around 800 employees in a domestic petroleum enterprise were selected to participate in the research. The safety-specific transformational leadership, safety climate, safety motivation and workplace safety behavior scales were used. Data were collected in two stages. SPSS22.0 and Mplus7.0 were used to analyze the data to explore the relationship between team safety-specific transformational leadership and workplace safety behavior, as well as the serial mediating effect of team safety climate and team safety motivation.

RESULTS

The results showed that: (a) team safety-specific transformational leadership can positively influence safety compliance and safety participation; (b) team safety climate mediates the relationship between team safety-specific transformational leadership and safety compliance and safety participation; (c) team safety motivation mediates the relationship between team safety-specific transformational leadership and safety compliance and safety participation; and (d) team safety climate and team safety motivation play a serial mediating role between team safety-specific transformational leadership and safety compliance and safety participation.

PRACTICAL APPLICATIONS

This research has both theoretical and practical significance.

The association between workplace physical environment and nurses' safety compliance: A serial mediation of psychological and behavioral factors

Aim

This study describes Jordanian intensive care unit nurses' satisfaction with their physical environment and investigates the association between workplace physical environment and nurses' safety compliance. Additionally, the study offers serial mediation analyses of psychological and behavioral factors between satisfaction with the workplace physical environment and nurses' safety compliance.

Introduction

Compliance with safety measures is a vital indicator of safety performance, as less compliance directly reflects undesirable safety outcomes among nurses, like occupational accidents, injuries, and fatalities. Social cognitive theory and the safety triad model contribute to understanding safety compliance behaviors to safety procedures. Thus, enhancing safety compliance in healthcare organizations remains a challenge and concern.

Methods

A quantitative research method was used based on cross-sectional and descriptive data from eight governmental hospitals in Jordan. The population included all intensive care unit nurses in the Ministry of Health's hospitals (n = 1104). A cluster sampling technique selected 285 nurses to participate. Empirical results were obtained through structural equation modeling (i.e., Smart PLS-SEM), which has become popular in this kind of research.

Results

The mean of Jordanian ICU nurses' satisfaction with the workplace physical environment was 3.36, which is moderate. Although the Smart PLS findings did not support the direct association between the workplace physical environment and nurses' safety compliance, serial mediation of safety participation in the workplace physical environment and nurses' safety compliance and perceived safety management commitment confirm the indirect association in the study model.

Conclusion

This study fills a gap in available safety and nursing literature, especially when considering the scarce studies that investigated the physical elements in the workplace and both safety compliance and safety participation. The findings are valuable for academicians, health providers, and policymakers and may trigger creative ideas and interventional solutions to improve nurses' safety compliance in healthcare organizations.

Factors determining safety culture in hospitals: a scoping review

OBJECTIVE

To evaluate and synthesise the factors determining patient safety culture in hospitals.

METHODS

The scoping review protocol was based on the criteria of the Joanna Briggs Institute. Eligibility criteria were as follows: (1) empirical study published in a peer-reviewed journal; (2) used methods or tools to assess, study or measure safety culture or climate; (3) data collected in the hospital setting and (4) studies published in English. Relevant literature was located using PubMed, CINAHL, Web of Science and PsycINFO databases. Quantitative and qualitative analyses were performed using RStudio and the R interface for multidimensional analysis of texts and questionnaires (IRaMuTeQ).

RESULTS

A total of 248 primary studies were included. The most used instruments for assessing safety culture were the Hospital Survey on Patient Safety Culture (n=104) and the Safety Attitudes Questionnaire (n=63). The Maslach Burnout Inventory (n=13) and Culture Assessment Scales based on patient perception (n=9) were used in association with cultural instruments. Sixty-six articles were included in the qualitative analysis. In word cloud and similarity analyses, the words 'communication' and 'leadership' were most prominent. Regarding the descending hierarchical classification analysis, the content was categorised into two main classes, one of which was subdivided into five subclasses: class 1a: job satisfaction and leadership (15.56%), class 1b: error response (22.22%), class 1c: psychological and empowerment nurses (20.00%), class 1d: trust culture (22.22%) and class 2: innovation worker (20.00%).

CONCLUSION

The instruments presented elements that remained indispensable for assessing the safety culture, such as leadership commitment, open communication and learning from mistakes. There was also a tendency for research to assess patient and family engagement, psychological safety, nurses' engagement in decision-making and innovation.

Safety voice climate: A psychometric evaluation and validation

INTRODUCTION

Speaking up about safety issues, termed "safety voice," is a proactive response where people across all levels of the organization express their concerns to prevent physical hazards. An understanding of safety voice requires insight into its antecedents. A perceived need to fit in with the organization and fear of consequences can trump the courage to speak out about safety concerns. Safety voice climate can be seen as a manifestation of the social exchanges in an organization and functions as a roadmap of which speaking out behaviors are encouraged and which behaviors are not. This study conceptualizes safety voice climate, presents the Safety Voice Climate Scale (SVCS) as a measurement tool, and gathers initial evidence for its validity. The study also assesses the associations between the SVCS and safety voice behavior.

METHOD

The SVCS and the measurement of safety voice behavior were derived from the Trends in Risk Level in the Norwegian Petroleum Activity questionnaire. The SVCS includes the two theoretical dimensions Work colleagues' encouragement of safety voice and Leaders' attitudes towards safety voice. Psychometric properties were tested with a representative sample from the Norwegian petroleum sector (n = 7,624).

RESULTS

Confirmatory factor analyses supported the proposed two-factor model, and the internal consistency of the factors was good. Furthermore, a structural equation model including the SVCS as predictors of safety voice behavior showed a good fit, indicating acceptable criterion validity, although only the Work colleagues' encouragement of safety voice variable was significantly associated with safety voice behavior. Conclusion and practical application: The SVCS can be used as a tool to detect some of the barriers and supporting elements relating to safety voice and guidance on the efforts needed to foster work climates that promote communication of safety issues.

Violence Prevention Climate and Health-Oriented Leadership in German Emergency Departments

Emergency departments (EDs) are high-risk environments for workplace violence. Research into techniques to prevent violence has less frequently explored the influence of leadership. This study aims to analyze the association of leadership with the prevention of violence using the concepts of health-oriented leadership (HoL) and the violence prevention climate (VPC). This quantitative cross-sectional study was conducted through online surveys between November 2021 and March 2022 across Germany. A sample of 370 doctors and nurses working in German EDs were recruited. Perceptions towards VPC and HoL were compared between groups divided according to profession and position using independent t-tests or Mann-Whitney U tests. Separate multiple linear regression models for supervisors and employees analyzed the association between different profiles of HoL with VPC. Supervisors and employees showed significant differences in supervisor staff-care and VPC. Regression analysis demonstrated that supervisors' self-care and employees' assessment of supervisor's staff-care positively predicted all dimensions of VPC. This empirical study provides insights into the variable perceptions of different groups and the association of leadership profiles with the perceptivity of VPC. The results of this study can be used to emphasize the importance of HoL training for both employees and supervisors to improve communication and health-promoting behavior.

Improvement of short-term outcomes with VR-based safety training for work at heights

Serious games and virtual reality offer engaging learning opportunities and a cost-effective solution within an immersive and safe environment for safety training in construction. However, there have been few examples of safety training for work at heights developed using these technologies, especially commercial training. To fill this literature gap, a new VR-based safety training was developed and compared with lecture-based training across time. We conducted a quasi-experiment with a non-equivalent group design with 102 workers from six construction sites in Colombia. Learning objectives, observations from training centers, and national regulations were considered during the design of the training methods. Training outcomes were assessed using Kirkpatrick's model. We found that both training approaches were effective in improving knowledge test results and self-reported attitudes in the short-term; and risk-perception, self-reported behavior and safety climate in the long-term. In particular, participants of the VR-based training got significantly higher results in knowledge and reported higher attitudes (commitment and motivation) than participants of the lecture-based training. We suggest that safety managers and practitioners should invest in VR using serious games as an alternative to training programs based on short-term outcomes. Future work is needed to test VR for long-term outcomes.

Organizational health climate as a precondition for health-oriented leadership: expanding the link between leadership and employee well-being

The link between leadership and employee well-being is long established. In particular, health-oriented leadership is discussed as a leadership style specifically promoting employee well-being. However, the preconditions of health-oriented leadership remain largely unexplored. From the perspective of conservation of resources theory, leaders can only provide resources when receiving some themselves. We propose that organizational health climate (OHC) is an important organization-based resource for a health-oriented leadership style. More specifically, we hypothesize that the relationship between OHC and employee job satisfaction and emotional exhaustion is mediated by health-oriented leadership. We thereby differentiate two levels of analysis: a within-team level and a between-team level. We examined 74 teams with 423 employees of childcare centers at three time points, each 6 months apart. By means of multilevel structural equation modeling, we found OHC to be a significant antecedent of health-oriented leadership at the between-team level. The relationship between OHC and employee job satisfaction was mediated by health-oriented leadership at the between-team level, but not at the within-team level. The relationship between OHC and employee exhaustion showed another pattern of relationships at the different levels of analysis, while it was not significantly mediated by health-oriented leadership. This indicates the value of differentiating between levels of analysis. We discuss the implications for theory and practice that can be drawn from our findings.

Constructs of leading indicators: A synthesis of safety literature

INTRODUCTION

Leading indicators represent an invaluable tool that offer organizations the capability to: track health and safety performance, not just failures and accidents; measure effectiveness of safety efforts adopted; and focus on undesired precursors, rather than undesired occurred events. Despite these palpable advantages associated with their adoption, leading indicator's definition, application, and function are mostly ambiguous and inconsistent within literature. Therefore, this study systematically reviews pertinent literature to identify the constructs of leading indicators and generates guidance for leading indicator implementation (as a conceptual model).

METHOD

The overarching epistemological design adopted interpretivism and critical realism philosophical stances together with inductive reasoning to analyze 80 articles retrieved from the Scopus database, plus 13 more publications supplemented by the snowballing technique. Analysis of the safety discourse within literature (as secondary data) was undertaken in two stages, namely: (1) a cross-componential analysis identified the main features of leading indicators in comparison to lagging indicators; and (2) content analysis revealed prominent constructs of leading indicators.

RESULTS AND CONCLUSION

Analysis results identify that the definition, types, and development methods represent the main constructs for understanding the concept of leading indicators. The study identifies that ambiguity around the definition and function of leading indicators is due to the lack of differentiation of its types, namely passive leading indicators and active leading indicators.

PRACTICAL APPLICATION

As a practical contribution, the conceptual model, which introduces continuous learning through a perpetual loop of development and application of leading indicators, will help adopters create a knowledge repository of leading indicators and to continuously learn and improve their safety and safety performance. Specifically, the work clarifies their difference in terms of the timeframe passive leading indicators and active leading indicators take to measure different safety aspects, the functions they serve, the target they measure and their stage of development.

How can proactive personality affect cabin attendants' safety behaviors? The moderating roles of social support and safety climate

Cabin attendants are mainly responsible for maintaining in-flight safety, and they are crucial to enhance air travel safety and alleviate passenger concerns. The objective of this study is to explore relationships between proactive personality, social support, safety climate and safety behaviors among cabin attendants. A self-assessment questionnaire was used to investigate a sample of 560 cabin attendants from China Southern Airlines Ltd. The results show that proactive personality and safety climate positively influence cabin attendants' safety behaviors. Social support was found to weaken the positive effect of proactive personality on safety behaviors. Furthermore, social support and safety climate jointly moderate the relationship between proactive personality and safety behaviors, suggesting that this relationship is the strongest when the levels of social support and safety climate are both high. Theoretical and practical implications for researchers and practitioners in designing interventions and strategies to promote safety behaviors in an airline context are discussed.

Preventing Surgical Site Infections: Are Safety Climate Level and Its Strength Associated With Self-reported Commitment To, Subjective Norms Toward, and Knowledge About Preventive Measures?

OBJECTIVES

Surgical site infections (SSIs) represent a major source of preventable patient harm. Safety climate in the operating room personnel is assumed to be an important factor, with scattered supporting evidence for the association between safety climate and infection outcome so far. This study investigated perceptions and knowledge specific to infection prevention measures and their associations with general assessments of safety climate level and strength.

METHODS

We invited operating room personnel of hospitals participating in the Swiss SSI surveillance program to take a survey (response rate, 38%). A total of 2769 responses from 54 hospitals were analyzed. Two regression analyses were performed to identify associations between subjective norms toward, commitment to, as well as knowledge about prevention measures and safety climate level and strength, taking into account professional background and number of responses per hospital.

RESULTS

Commitment to perform prevention measures even when situational pressures exist, as well as subjective norm of perceiving the expectation of others to perform prevention measures were significantly (P < 0.05) related to safety climate level, while for knowledge about preventative measures this was not the case. None of the assessed factors was significantly associated with safety climate strength.

CONCLUSIONS

While pertinent knowledge did not have a significant impact, the commitment and the social norms to maintain SSI prevention activities even in the face of other situational demands showed a strong influence on safety climate. Assessing the knowledge about measures to prevent SSIs in operating room personnel opens up opportunities for designing intervention efforts in reducing SSIs.

Reconciling general transformational leadership and safety-specific transformational leadership: A paradox perspective

INTRODUCTION

Research exploring the relationship between transformational leadership and safety has used transformational leadership in context-free (e.g., "general transformational leadership," or GTL) and context-specific forms (e.g., "safety-specific transformational leadership," or SSTL), assuming these constructs are theoretically and empirically equivalent. In this paper, a paradox theory is drawn on (Schad, Lewis, Raisch, & Smith, 2016; Smith & Lewis, 2011) to reconcile the relationship between these two forms of transformational leadership and safety.

METHOD

This is done by: (a) investigating whether GTL and SSTL are empirically distinguishable; (b) testing the relative importance of GTL and SSTL in explaining variance in context-free work outcomes (i.e., in-role performance, organizational citizenship behaviors) and context-specific (i.e., safety compliance, safety participation); and (c) examining the extent to which perceived safety concern in the work environment renders GTL and SSTL distinguishable.

RESULTS

Two studies (one cross-sectional, one short-term longitudinal) show that GTL and SSTL are psychometrically distinct albeit highly correlated. Furthermore, SSTL explained statistically more variance than GTL in both safety participation and organizational citizenship behaviors, whereas GTL explained more variance in in-role performance than did SSTL. However, GTL and SSTL were only distinguishable in low-concern contexts but not high-concern contexts.

CONCLUSIONS AND PRACTICAL APPLICATIONS

These findings challenge the "either-or" (vs "both-and") approach to considering safety and performance, cautioning researchers to consider nuanced differences in context-free and context-specific forms of leadership and to avoid further proliferation of often redundant context-specific operationalizations of leadership.

Safety not guaranteed: Investigating employees' safety performance during a global pandemic

The COVID-19 pandemic threatened employees' health and safety more than any event in recent years. Although millions of employees transitioned to working from home to mitigate infectious disease exposure, many worksites re-opened amid the pandemic as high infection rates persisted longer than expected. Safety guidelines were issued by the Centers for Disease Control and Prevention, the World Health Organization, and other national initiatives to improve the health and safety of employees returning to on-site work. The current work addresses predictors of infection control safety behaviors in a general working population that largely lacks infection control training and expertise. Drawing from Neal and Griffin's model of safety behavior, we investigated organizational factors (i.e., perceived safety climate, safety-related organizational constraints, occupational risk of COVID-19 exposure) and individual factors (i.e., infection control safety attitudes, conscientiousness, and risk aversion) associated with employees' infection control safety behaviors shortly after returning to on-site work during the pandemic. Survey results from 89 full-time employees across industries demonstrated that the organizational and individual factors accounted for 51.19 percent of the variance in employees' infection control safety behaviors. Organizational factors accounted for 49.02 percent of the explained variance, and individual factors accounted for 50.98 percent of the explained variance. Conscientiousness, perceived safety climate, safety-related organizational constraints, and infection control safety attitudes explained significant variance in employees' infection control safety behaviors, while the occupational risk of COVID-19 exposure and risk aversion did not. Organizations may benefit from considering employees' conscientiousness and safety attitudes during employee selection as well as enhancing their organization's safety climate and mitigating safety-related organizational constraints.

Comparison of management and workers' perception, attitudes and beliefs toward health and safety in the Ontario manufacturing sector

INTRODUCTION

The Ontario manufacturing sector is over-represented when it comes to workers' compensation claims in the province. A previous study suggested that this may be the result of compliance gaps with respect to the province's occupational health and safety (OHS) legislation. These gaps may be, in part, due to differences in perceptions, attitudes, and beliefs toward OHS between workers and management. This is noteworthy as these two cohorts, when working well together, can foster a healthy and safe work environment. Therefore, this study sought to ascertain the perceptions, attitudes, and beliefs of workers and management with respect to OHS in the Ontario manufacturing sector and to identify differences between the groups, if any.

METHODS

A survey was created and disseminated online to get the widest reach across the province as possible. Descriptive statistics were used to present the data and chi-square analyses were performed to determine if there were any statistically significant differences in responses between workers and managers.

RESULTS

In total, 3,963 surveys were included in the analysis, which consisted of 2,401 (60.6%) workers and 1,562 (39.4%) managers. Overall, workers were more likely to state that their workplace was 'a bit unsafe' relative to managers and this difference was statistically significant. There were also statistically significant differences between the two cohorts with respect to health and safety communication matters, the perception of safety as a high priority, whether people work safely when unsupervised, and whether control measures are adequate.

CONCLUSIONS

In summary, there were differences in perception, attitudes, and beliefs toward OHS between workers and managers in Ontario manufacturing and these differences must be addressed in order to improve the sector's health and safety performance.

PRACTICAL APPLICATIONS

Manufacturing workplaces can improve their health and safety performance by strengthening labor-management relationships, including having routine health and safety communication.

Musculoskeletal Health Climate Is a Prognostic Determinant of Sickness Absence Among Female Eldercare Workers: A Prospective Cohort Study

OBJECTIVES

The present study investigated the association between musculoskeletal health climate, that is, the shared perceptions among workers concerning musculoskeletal health, and sickness absence.

METHODS

Questionnaire data on two domains of musculoskeletal health climate, perceived management priority (PMP) and pain acceptance at work (PAW), were collected at baseline. Data on sickness absence were extracted at 1-year follow-up. Data were analyzed using negative binomial multivariable regression.

RESULTS

The final study population comprised 390 female eldercare workers. Compared with participants with low PMP scores, participants with high PMP scores had lower risk of sickness absence (incidence rate ratio, 0.6; 95% confidence interval, 0.4-0.9). Participants with high PAW scores had higher risk of sickness absence than participants with low PAW scores (incidence rate ratio, 1.4; 95% confidence interval, 0.9-2.2).

CONCLUSIONS

The results showed an association between the musculoskeletal health climate and sickness absence.

Analyzing the impact of psychological capital and work pressure on employee job engagement and safety behavior

Introduction

Buildings and infrastructure are the primary focus of the construction industry, which also includes related activities such as design, planning, demolition, renovation, maintenance, and repair. Safety performance is crucial to the industry's ability to work effectively in spite of hazardous conditions on the job site during any given project. Improving construction workers' safety performance in Malaysia requires an in-depth examination of the interplay between workers' psychological capital, work pressure, employee engagement, and safety participation.

Methods

Administrative and field workers from different divisions across Malaysia's six regions were randomly sampled to collect data for this study. The workers were given a total of 500 questionnaires, of which 345 were returned to the team of researchers. Based on the data analysis, there is an effective interaction between the factors tested toward safety performance.

Results

According to findings, psychological capital positively and significantly affected workers' work engagement. Also, work engagement greatly impacted both workers' safety performance outcomes. Also, as expected, worker pressure significantly and negatively affected workers' safety performance.

Discussion

Insights gained from this research have helped us better organize work and involve employees in safety activities/policies to boost workplace safety performance. The study also suggested that firms should reduce their employees' workloads because doing so would not lower their Psychological Capital but would instead fortify them to better carry out their duties in a risk-free manner.

Occupational physicians dealing with mental health: between employee and company interests: a qualitative study

BACKGROUND

Occupational health physicians are increasingly confronted with mental health issues at their workplace. Facing them, most of them feel insecure and not sufficiently trained. Employee's mental well-being depends at the same time on individual and significantly on organizational variables. This complicates the physician's position, since they have to serve many interests. The focus of the present study is to investigate what difficulties occupational health physicians face and how organizational culture and management influence their work.

METHODS

Interviews were conducted with N = 25 physicians as part of a training for basic mental health care. Interviews were interpreted using qualitative content analysis.

RESULTS

Working with mentally ill employees was difficult for the physicians interviewed. Many felt insecure managing and preventing mental health issues. A need for further education was observed. Environmental factors (organizational culture, management) have a strong impact on the work of an occupational health physician and highlight its systemic dimension. Even though many of our participants report a meanwhile more open attitude towards mental disorders at their workplace, on the level of direct contact to the management prevail descriptions of little acceptance and a high priority of economic outcomes.

CONCLUSIONS

More education on topics of mental health is needed for occupational health physicians. Future trainings should consider the intertwined nature of their work and enable them in dealing consciously with other actors in the company. For enhancing employee's mental well-being occupational health physicians could be granted a strengthened position in companies or be supported through more exchange with colleagues in other companies.

Development and Validation of an Integrated Healthy Workplace Management Model in Taiwan

Background

Impacts of exposure are generally monitored and recorded after injuries or illness occur. Yet, absence of conventional after-the-effect impacts (i.e., lagging indicators), tend to focus on physical health and injuries, and fail to inform if workers are not exposed to safety and health hazards. In contrast to lagging indicators, leading indicators are proactive, preventive, and predictive indexes that offer insights how effective safety and health. The present study is to validate an extended Voluntary Protection Programs (VPP) that consists of six leading indicators.

Methods

Questionnaires were distributed to 13 organizations (response rate = 93.1%, 1,439 responses) in Taiwan. Cronbach α, multiple linear regression and canonical correlation were used to test the reliability of the extended Voluntary Protection Programs (VPP) which consists of six leading indicators (safe climate, transformational leadership, organizational justice, organizational support, hazard prevention and control, and training). Criteria-related validation strategy was applied to examine relationships of six leading indicators with six criteria (perceived health, burnout, depression, job satisfaction, job performance, and life satisfaction).

Results

The results showed that the Cronbach's α of six leading indicators ranged from 0.87 to 0.92. The canonical correlation analysis indicated a positive correlation between the six leading indicators and criteria (1st canonical function: correlation = 0.647, square correlation = 0.419, p < 0.001).

Conclusions

The present study validates the extended VPP framework that focuses on promoting safety and physical and mental health. Results further provides applications of the extended VPP framework to promote workers' safety and health.

The path toward successful safety performance measurement

INTRODUCTION

Safety management is widely seen as a key contributor to occupational health and safety (OHS) performance. Performance measurement is an important tool for management in reaching its goals. Safety performance measurement has gained increasing attention in the literature. However, little is known so far of the path towards successful safety performance measurement resulting in better OHS performance.

METHODS

This study analyzes the maturity of safety performance measurement in relation to OHS performance and the role of employee commitment and practices of using performance information in facilitating the performance benefits. The empirical data were gathered with a survey that received 270 responses from five industrial organizations. Partial least squares structural equation modeling (PLS-SEM) was used to analyze the data obtained.

RESULTS

It is found that commitment to performance measurement is the strongest explaining factor of both supervisor and employee OHS performance, while the maturity of performance measurement has a direct effect on supervisor safety performance only.

PRACTICAL APPLICATIONS

The results show how safety performance measurement can be implemented to derive the potential benefits. While managers may benefit directly from advanced performance measures, the wider performance benefits among employees materialize only by using performance measurement properly and committing employees to it.

The relationship between safety climate and safety performance: A review

INTRODUCTION

Since its inception more than four decades ago, research on safety climate has been conducted in many industries. Subsequently, a plethora of systematic literature reviews on safety climate in various work environments has focused on research trends and measurement scales. Yet, despite these reviews, the overall picture of how safety climate influences performance is still not well understood. The current study reviews existing literature on safety climate, specifically how it affects safety performance.

METHOD

Literature searches were conducted using EBSCOhost and Web of Science databases in March 2021. We included English-language, peer-reviewed studies that reported the results of research done on safety climate and safety performance. We extracted data (contextual, theoretical, methodological and definition of safety performance) from these studies and were deductively analyzed and categorized into common themes.

RESULTS

One hundred and sixty-two safety climate studies were identified. We found that studies on safety climate-performance were conducted in 16 types of industries while 23 different theories explained the safety climate-performance relationship. The quantity and quality of variables and methods used varied considerably across the surveys. Safety climate is predominantly used as a predictor while safety-related behavior is the most common definition of safety performance among the articles we reviewed. Few papers from the current review were methodologically strong, suggesting that current evidence on the link between safety climate and safety performance still suffers from common method bias.

CONCLUSIONS

Although literature has provided evidence for the positive effect on safety performance via a strong safety climate, strong and convincing methods are still lacking and the causality of an improved safety climate still needs to be demonstrated.

PRACTICAL APPLICATIONS

The findings of the current review offer a better understanding of how employers can improve safety climate in the workplace in various settings.

Inclusive leadership and workers' safety behaviour during Covid-19 pandemic

Purpose

COVID-19 pandemic underlines the need for effective leadership to resolve the crisis. This study aims to examine the impact of inclusive leadership on safety behaviours via the mediating role of the safety climate.

Design/methodology/approach

This research studied and compared two of the industries most affected by the pandemic, specifically banking and education. The questionnaire was undertaken among 111 from the education sector and 159 from the banking sector. Structural equation modelling – partial least square (SEM – PLS) was used to analyse the results.

Findings

The study suggested that inclusive behaviour shaped the safety behaviours among employees through the safety climate. However, the influence of inclusive leadership on the safety environment and safety behaviours of education staff in the company was not as powerful as in the banking sector.

Practical implications

There's a connection between inclusive leadership and worker protection. Besides, inclusive leadership and its effect on safety behaviour are culturally based. High levels of collectivism encourage leaders to care deeply for their employees' well-being, as demonstrated in this study by the promotion of a healthy working atmosphere, especially in times of crisis.

Originality/value

This research potentially adds to the current literature on leadership and safety behaviour and offers valuable management recommendations.

The influence of pandemic-related workplace safety practices on frontline service employee wellbeing outcomes

The COVID-19 pandemic has exposed the vulnerability of frontline employee (FLEs) to infections and other hazards and highlighted the importance of workplace safety practices (WSP) for service organizations. In response to the critical issue of service safety, we developed and empirically tested a model proposing that WSPs negatively influence FLE perceptions of pandemic related threats and positively influence their perceptions of organizational supportiveness (POS). In turn, these perceptions have time-lagged effects on two aspects of FLE wellbeing-reduced emotional exhaustion and increased work engagement. Utilizing data from a two-wave (separated by a month) survey panel consisting of 310 FLEs across the United States, we found evidence for all hypothesized relationships. We discuss the practical and theoretical implications of our findings and provide suggestions for future research on service safety on the organizational frontlines.

Radiography Managers’ Perspectives on the Strategies to Mitigate Disruptive Behaviours: A Qualitative Exploratory Study

Disruptive behaviours (DBs) are not normally in the scope of legal sanctions, notwithstanding their undesirable effects. Hence, many healthcare organizations still have difficulty in dealing with them in an effective manner. Several studies suggest that few organizations have tailor-made policies or procedures for evaluating, proving and mitigating these behaviours. However, evidence shows that mitigating DBs is critical to empowering healthcare workers to focus on providing superior, affordable and safe patient care. The aim of this study was to explore radiography managers’ perspectives on the strategies to mitigate DBs involving radiographers. An exploratory qualitative study employing one-on-one semi-structured in-depth interviews was carried out between March and April 2021. Eleven radiography managers at central hospitals in Harare Metropolitan Province were selected by criterion-purposive sampling. The interview data were analyzed using Tesch’s method of qualitative analysis. The data were first manually coded and then entered into Nvivo (QSR International Version 11) for further analysis. Three themes emerged from the interview data including awareness of DBs, willingness to address DBs, and conflict resolution. Context-specific strategies to mitigate DBs should be identified and implemented to guarantee a healthy work environment for radiographers so that they focus on providing excellent and safe patient care.

Differences in employment, job characteristics, and work-related perceptions by sociodemographic factors among registered nurses of diverse race/ethnicity

BACKGROUND

Available research on registered nurses (RNs) indicates that RNs with diverse race/ethnicity are more likely to work in disadvantaged workplaces.

PURPOSE

To examine differences in employment, job characteristics and perceptions about work among RNs by sociodemographic characteristics.

METHODS

We analyzed data from statewide random samples of California RNs (N=895).

FINDINGS

Increased age was associated with increased likelihoods of working part-time, day-shift, and in non-hospital settings and having managerial positions. Asian and Black nurses were more likely to work in urban areas than White nurses. The levels of job demand, job control, job satisfaction, perceived organizational culture, and safety climate were significantly different by sociodemographic characteristics. Greater intention to leave the job was associated with younger age and working in non-hospital settings.

DISCUSSION

The findings suggest that differences exist in nurses' employment, job characteristics, and perceptions about their work and work environment by sociodemographic characteristics among RNs of diverse race/ethnicity.

A tale of six climates: Reflections and learnings after the development of six industry-specific safety climate scales

INTRODUCTION

Researchers are finding merits in utilizing industry-specific safety climate scales that capture the nuances of context, and tend to show stronger associations with safety behavior and outcomes like incidents. Yet, to date, guidance around the practicalities of developing and validating such industry-specific scales is lacking in the safety science literature.

METHOD

In this paper we outline our experiences developing six industry-specific safety climate scales and highlight strengths and limitations of our approach. We also briefly review the industry-specific safety climate literature and offer highlights for consideration when developing such scales. Our method to develop industry-specific safety climate scales followed an established best practice structure: literature review of existing published industry scales, collation and review of existing scale items, consultation interviews with industry experts, item drafting, exploratory and confirmatory statistical analyses, and finally, a real-world ecological validity test.

RESULTS

Our research highlighted the diversity of safety climate dimensions (both the conceptual and content domains of each dimension) when it is considered at an industry level. Also, the literature reviews revealed a dearth of industry-specific safety climate scales in the areas we engaged with, so our project filled a glaring gap in research and practice. Best practice safety climate scale development methods are provided to stimulate further research.

CONCLUSIONS

We conclude with reflections on the nature of safety climate within and across industries, and offer suggestions for future lines of research across other contexts (e.g., national culture, geography, and regulatory settings). We suggest that industry-specific safety climate scales have a specific use case, such as identifying specific areas to improve and evaluating the impact of safety interventions.

PRACTICAL APPLICATIONS

This article provides applications for both applied researchers (to improve capabilities in safety climate scale development) and practitioners who wish to measure organisational safety climate and design effective interventions. Engaging with regulators to build safety climate scales is powerful because their personnel have rich experiences to share across multiple workplaces. Organisational researchers can engage with survey panels to build robust scales. Finally, industry-specific nuances can lead to richer insights into an organisation's safety climate.

Adapting, adopting, and advancing change: A framework for future research in the psychology of occupational safety

INTRODUCTION

While there are numerous reviews of the research on the psychology of occupational safety, these studies provide weak guidance on where the research should go next. Accordingly, we introduce a simple framework for thinking about future research in this area: the adapting, adopting, and advancing change framework. This framework summarizes how external, technological, and theoretical developments have driven research in the psychology of occupational safety and uses these observations as evidence to imagine ways in which they may continue to do so.

METHOD

We critically reviewed seminal research in the psychology of occupational safety using the adapting, adopting, and advancing change framework. Adapting to change means considering external changes such as the fluctuating nature of work and the labor market. Adopting change refers to incorporating the latest technological and technical advances to facilitate more robust research methods and analyses. Finally, advancing change refers to theoretical advances and how they will push psychology of occupational safety research forward.

RESULTS

We highlight several avenues for future research that emerge at the convergence of the framework's three themes, including developing the safety skill construct, assessing variation in demand appraisals on safety outcomes, distinguishing safety climate from related constructs, and examining safety constructs that are usually considered as outcomes (e.g., injuries) as predictors instead.

CONCLUSIONS

In doing so, we provide a clear structure to help researchers better identify the most effective directions for future research on the psychology of occupational safety.

Investigation of occupational fatigue and safety climate among nurses using the structural equation model

BACKGROUND

Nursing is associated with many stressful situations that can lead to fatigue, reduced efficiency, and physical and mental illness. Safety climate is one of the most important indicators of safety management performance assessment that assesses employees' attitudes towards safety issues.

OBJECTIVE

The purpose of this study was to investigate the relationship between safety climate and occupational fatigue in nurses.

METHOD

This descriptive-analytical study was performed on nurses working in hospitals affiliated to Zabol University of Medical Sciences in 2019. 143 nurses were selected by the proportional sampling method and entered the study. Demographic questionnaires, Occupational Fatigue Inventory (SOFI), and Nurses' Safety Assessment Questionnaire were used for data collection. Statistical tests, including Independent T-Test, ANOVA, Mann-Whitney U, Kruskal-Wallis, and multivariate analysis of variance (MANOVA) were used to analyze the results using SPSS software version 21, and the multivariate structural equation was used for modeling.

RESULTS

The mean scores of safety climate and occupational fatigue were 67.15±12.73 and 85.09±41.49, respectively. Job and demographic variables except for the second job (P-value = 0.065) had a significant effect on the variables of safety climate and occupational fatigue. There were also higher scores for occupational fatigue and all of its subscales in the group of women compared to the group of men.

CONCLUSION

The results showed that occupational and demographic variables have significant effects on safety climate and occupational fatigue. There was a significant relationship between demographic variables of age, work experience, and education level with safety climate. There was also a significant relationship between education level, job satisfaction, satisfaction with colleagues and work experience with occupational fatigue. Therefore, paying attention to fatigue and safety climate of nurses in workplaces is recommended.

A bidirectional examination of mental health symptoms and perceptions of leader support: Which comes first?

Leader support for psychological health (LSPH) has been identified as an important factor in the prediction of mental health symptoms among warfighters. Although research has examined the relationship between LSPH and mental health symptoms, the extent to which this relationship is bidirectional has been underexplored. Consequently, the present study examined the longitudinal relationships between perceived LSPH and mental health symptoms (depression and PTSD) among military personnel over a 5-month period. We found that perceived LSPH at Time 1 (T1) was associated with fewer mental health symptoms at Time 2 (T2); however, mental health symptoms at T1 were also associated with lower perceptions of LSPH at T2. The results differed slightly based on the type of symptoms experienced, but the relationships between perceived LSPH and symptoms did not vary based on whether soldiers had been exposed to combat. However, it is important to note that the overall sample had low combat experience. Despite this, these findings may suggest that the assumption that leader support can enhance soldier mental health may fail to consider that the symptoms themselves may also affect how leaders are perceived. Therefore, organizations such as the military should consider both directions to optimally understand the relationship between leaders and subordinate mental health.

The role of union health and safety representatives during the COVID‐19 pandemic: A case study of the UK food processing, distribution, and retail sectors

This article highlights the weakness of the UK's occupational health and safety infrastructure exposed by the COVID‐19 pandemic. Utilising a political economy perspective, it captures the critical role of workplace union safety representatives in mitigating risk and contesting the expropriation of health and recommodification of labour, specifically inadequate sick pay.

Safety interventions for the prevention of accidents at work: A systematic review

Background

Limited knowledge regarding the relative effectiveness of workplace accident prevention approaches creates barriers to informed decision-making by policy makers, public health practitioners, workplace, and worker advocates.

Objectives

The objective of this review was to assess the effectiveness of broad categories of safety interventions in preventing accidents at work. The review aims to compare effects of safety interventions to no intervention, usual activities, or alternative intervention, and if possible, to examine which constituent components of safety intervention programs contribute more strongly to preventing accidents at work in a given setting or context.

Date Sources

Studies were identified through electronic bibliographic searches, government policy databanks, and Internet search engines. The last search was carried out on July 9, 2015. Gray literature were identified by searching OSH ROM and Google. No language or date restrictions were applied. Searches done between February and July of 2015 included PubMed (1966), Embase (1980), CINAHL (1981), OSH ROM (NIOSHTIC 1977, HSELINE 1977, CIS-DOC 1974), PsycINFO (1806), EconLit (1969), Web of Science (1969), and ProQuest (1861); dates represent initial availability of each database. Websites of pertinent institutions (NIOSH, Perosh) were also searched.

Study Eligibility Criteria Participants and Interventions

Included studies had to focus on accidents at work, include an evaluation of a safety intervention, and have used injuries at work, or a relevant proxy, as an outcome measure. Experimental, quasi-experimental, and observational study designs were utilized, including randomized controlled trials (RCTs), controlled before and after (CBA) studies, and observational designs using serial measures (interrupted time series, retrospective cohort designs, and before and after studies using multiple measures). Interventions were classified by approach at the individual or group level, and broad categories based on the prevention approach including modification of: Attitudes (through information and persuasive campaign messaging).Behaviors (through training, incentives, goal setting, feedback/coaching).Physiological condition (by physical training).Climate/norms/culture (by coaching, feedback, modification of safety management/leadership).Structural conditions (including physical environment, engineering, legislation and enforcement, sectorial-level norms). When combined approaches were used, interventions were termed "multifaceted," and when an approach(es) is applied to more than one organizational level (e.g., individual, group, and/or organization), it is termed "across levels."

Study Appraisal and Synthesis Methods

Narrative report review captured industry (NACE), work setting, participant characteristics, theoretical basis for approach, intervention fidelity, research design, risk of bias, contextual detail, outcomes measures and results. Additional items were extracted for studies with serial measures including approaches to improve internal validity, assessments of reasonable statistical approaches (Effective Practice of Organization of Care [EPOC] criteria) and overall inference. Random-effects inverse variance weighted meta-analytic methods were used to synthesize odds ratios, rate ratios, or standardized mean differences for the outcomes for RCT and CBA studies with low or moderate levels of heterogeneity. For studies with greater heterogeneity and those using serial measures, we relied on narrative analyses to synthesize findings.

Results

In total 100 original studies were included for synthesis analysis, including 16 RCT study designs, 30 CBA study designs, and 54 studies using serial measures (ITS study designs). These studies represented 120 cases of safety interventions. The number of participants included 31,971,908 individuals in 59 safety interventions, 417,693 groups/firms in 35 safety interventions, and 15,505 injuries in 17 safety interventions. Out of the 59 safety interventions, two were evaluating national prevention measures, which alone accounted for 31,667,110 individuals. The remaining nine safety interventions used other types of measures, such as safety exposure, safety observations, gloves or claim rates. Strong evidence supports greater effects being achieved with safety interventions directed toward the group or organization level rather than individual behavior change. Engineering controls are more effective at reducing injuries than other approaches, particularly when engineered changes can be introduced without requiring "decision-to-use" by workplaces. Multifaceted approaches combining intervention elements on the organizational level, or across levels, provided moderate to strong effects, in particular when engineering controls were included. Interventions based on firm epidemiologic evidence of causality and a strong conceptual approach were more effective. Effects that are more modest were observed (in short follow-up) for safety climate interventions, using techniques such as feedback or leadership training to improve safety communication. There was limited evidence for a strong effect at medium-term with more intense counseling approaches. Evidence supports regulation/legislation as contributing to the prevention of accidents at work, but with lower effect sizes. Enforcement appears to work more consistently, but with smaller effects. In general, the results were consistent with previous systematic reviews of specific types of safety interventions, although the effectiveness of economic incentives to prevent accidents at work was not consistent with our results, and effectiveness of physiological safety intervention was only consistent to some extent.

Limitations

Acute musculoskeletal injuries and injuries from more long-time workplace exposures were not always clearly distinguished in research reports. In some studies acute and chronic exposures were mixed, resulting in inevitable misclassification. Of note, the classification of these events also remains problematic in clinical medicine. It was not possible to conduct meta-analyses on all types of interventions (due to variability in approach, context, and participants). The findings presented for most intervention types are from limited sources, and assessment of publication bias was not possible. These issues are not surprising, given the breadth of the field of occupational safety. To incorporate studies using serial measures, which provide the only source of information for some safety interventions such as legislation, we took a systematic, grounded approach to their review. Rather than requiring more stringent, specific criteria for inclusion of ITS studies, we chose to assess how investigators justified their approach to design and analyses, based on the context in which they were working. We sought to identify measures taken to improve external validity of studies, reasonable statistical inference, as well as an overall appropriate inferential process. We found the process useful and enlightening. Given the new approach, we may have failed to extract points others may find relevant. Similarly, to facilitate the broad nature of this review, we used a novel categorization of safety interventions, which is likely to evolve with additional use. The broad scope of this review and the time and resources available did not allow for contacting authors of original papers or seeking translation of non-English manuscripts, resulting in a few cases where we did not have sufficient information that may have been possible to obtain from the authors.

Conclusions and Implications of Key Findings

Our synthesis of the relative effectiveness of workplace safety interventions is in accordance with the Public Health Hierarchy of Hazard Control. Specifically, more effective interventions eliminate risk at the source of the hazard through engineering solutions or the separation of workers from hazards; effects were greater when these control measures worked independently of worker "decision-to-use" at the worksite. Interventions based on firm epidemiological evidence of causality and clear theoretical bases for the intervention approach were more effective in preventing injuries. Less effective behavioral approaches were often directed at the prevention of all workplace injuries through a common pathway, such as introducing safety training, without explicitly addressing specific hazards. We caution that this does not mean that training does not play an essential function in worker safety, but rather that it is not effective in the absence of other efforts. Due to the potential to reach large groups of workers through regulation and enforcement, these interventions with relatively modest effects, could have large population-based effects.

A Maturity Model for Resilient Safety Culture Development in Construction Companies

A resilient safety culture is characterized by the capability of addressing the changing and unforeseen safety risks associated with the increasingly complex nature of sociotechnical systems, and creating an ultrasafe organization. An assessment of the maturation of resilient safety culture helps organizations to evaluate their capabilities of managing safety risks and achieving a consistently high safety performance. This study aims to present a maturity model developed to measure and improve resilient safety culture in the construction environment. The research was conducted in two stages. The first stage consisted of a review of the literature on the concepts of a resilient safety culture and the capability maturity model for the development of a maturity model. In the second stage, the developed model was evaluated using the Delphi technique. The model defines five maturity levels that can be used to measure resilient safety culture of a construction organization. It presents a set of descriptions of 19 aspects of resilient safety culture at each maturity level. The assessment procedure and the way of using the model are further discussed. Theoretically, this study provides insights into the maturity characteristics of a resilient safety culture. In practical terms, it offers guidance for benchmarking and encouraging the enhancement of organizations’ capabilities to manage safety risks.

When and for Whom Organizational Identification is More Effective in Eliciting Safety Voice: An Empirical Study from Construction Industry Perspective

Safety voice (SV) is a form of voice in which employees express opinions or concerns about organizational safety. It plays an important role in preventing accidents and promoting safety performance. The purpose of this study is to reveal the emotional factors and boundary conditions behind employee engagement in SV, especially in the construction context. This study, therefore, investigated how organizational identification (OID) drove construction project participants' SV using a three-way interaction model of perceived insider status (PIS) as an individual difference and safety climate (SC) as an organizational contextual difference. The proposed model was tested using a sample of 357 participants in different construction projects. The results showed that OID was positively correlated with SV. The interaction effect of OID and PIS on SV depended on the SC, with PIS enhancing the identification-voice relationship at a low level of SC and weakening it at a high level of SC.

Safety Climate in the Indonesian Construction Industry: Strengths, Weaknesses, and Influential Demographic Characteristics

The Indonesian construction industry is a significant contributor to economic growth in Indonesia. However, poor safety performance limits its contributions due to the negative impacts of poor safety on project performance. This research aims to assess the level of the safety climate in the Indonesian construction industry, identify its strengths and weaknesses, and understand the influence of individual demographic characteristics on the safety climate. Data were collected using a questionnaire survey from 1757 respondents working in six large state-owned construction companies in Indonesia. Results indicate that the overall safety climate level is fairly good. However, the safety climate scores of individual safety climate items are observed to vary widely. The scores reveal that construction employees understand the importance of safety and management demonstrates a degree of safety commitment, particularly by having regular safety communications. In contrast, the implementation of safety is limited in reality because safety is not considered a priority at work. Lack of safety resources and limited enforcement of safety rules further hinder the implementation of safety at the project level. Large state-owned construction companies such as those where data were collected should take the lead in changing the work practices in the Indonesian construction industry to improve safety performance. Level of education, length of work experience, position, permanency of job status, work location (project or office-based), and type of project are individual demographic characteristics that influence the level of the safety climate. Understanding the influence of these characteristics on the safety climate allows specific intervention strategies to be used to improve safety.

Caring for yourself and for others: team health climate and self-care explain the relationship between health-oriented leadership and exhaustion

Purpose

Health-oriented leadership is an emerging concept that is promising for better understanding how leaders can support employee well-being. However, there is uncertainty about the process through which health-oriented leadership relates to employee well-being. Advancing health-oriented leadership research, this study aims to examine employee self-care and the perceived team health climate as mediating mechanisms.

Design/methodology/approach

The authors conducted a time-lagged study with three measurement points (NT1 = 335, NT2 = 134, NT2 = 113) to test these mechanisms.

Findings

The results show that health-oriented leadership at Time 1 positively relates to employee self-care and perceived team health climate at Time 2, which, in turn, are negatively associated with employee exhaustion at Time 3.

Originality/value

The indirect associations suggest that health-oriented leadership relates to employee well-being via the perceived team health climate and the individuals' self-care. By revealing an important mediating mechanism, this study contributes to the health-oriented leadership literature and can help organizations and leaders improve health promotion in organizations.

Safety-Management Practices and the Occurrence of Occupational Accidents: Assessing the Mediating Role of Safety Compliance

This study examines the impact of critical safety-management practices on the occurrence of occupational accidents by means of safety compliance in Malaysia’s oil and gas industry. This study employed a cross-sectional design, in which data were collected from oil and gas downstream operations in five states within Malaysia using the convenience-sampling technique. The valid data of 280 responses were analyzed with Smart-PLS, and the structural-equation-modeling technique was applied. The study’s outcome revealed that safety-management practices (i.e., safety training, workers’ involvement, safety communication and feedback, management commitment to safety, safety-promotion policies, and safety rules and procedures) were significantly associated with occupational accidents via safety compliance. Thus, this study is helpful for practitioners and researchers to understand the importance of safety-management practices in reducing occupational accidents.

Musculoskeletal health climate is associated with musculoskeletal pain and sickness absence among workers: a cross-sectional study

OBJECTIVES

This study aimed to investigate whether a musculoskeletal health climate, expressing the shared perceptions among workers concerning musculoskeletal health, is associated with number of musculoskeletal pain sites and sickness absence.

DESIGN

Cross-sectional study.

SETTING

Six slaughterhouses from 2 companies in Denmark and 6 home-nursing units and 12 nursing homes from 1 municipality in Jutland, Denmark.

PARTICIPANTS

A total of 1092 slaughter house workers and 410 care workers completed an online questionnaire from February to October 2019.

OUTCOME MEASURES

The exposure variable was musculoskeletal health climate assessed by two domains; (1) perceived management priority of musculoskeletal health measured by a modified subscale from the Nordic Safety Climate Questionnaire and (2) work group pain acceptance which was a modified version of the activity engagement subscale of the chronic pain acceptance scale. Outcomes variables were number of musculoskeletal pain sites (0-6) and days with sickness absence.

RESULTS

The associations between the two subscales, number of musculoskeletal pain sites and sickness absence were calculated using mixed linear and generalised estimating equation regression models. Higher perceived management priority scores were associated with a lower number of musculoskeletal pain sites across both job groups: β=-.57 (95% CI -0.91 to -0.23) and sickness absence (>5 days) due to musculoskeletal pain prevalence ratio (PR) 0.79 (95% CI 0.57 to 1.08). In contrast higher work group pain acceptance scores were associated with higher number of musculoskeletal pain sites: β=0.38 (0.11 to 0.66), whereas associations with sickness absences seemed to be modified by job groups; PR 1.59 care workers and PR 0.86 slaughterhouse workers.

CONCLUSION

The observed relationship between musculoskeletal health climate, musculoskeletal pain sites and sickness absence indicate that cultural factors should receive increased attention in work place preventive interventions.

The Abysmal Organization of Work and Work Safety Culture Experienced by North Carolina Latinx Women in Farmworker Families

The occupational health of immigrant workers in the United States is a major concern. This analysis describes two domains, organization of work and work safety culture, important to the occupational health of Latinx women in farmworker families. Sixty-seven Latinx women in North Carolina farmworker families completed a baseline and five follow-up questionnaires in 2019 through 2021. Fifty-nine of the women were employed in the year prior to the Follow-Up 5 Questionnaire. These women experienced an abysmal organization of work and work safety culture. They experienced significant job churn, with most changing employment several times during the 18-month period. Most of their jobs were seasonal, paid less than $10.00 per hour, piece-rate, and almost all without benefits. The women's jobs had little skill variety (mean 1.5) or decision latitude (mean 1.1), but had high psychological demands (mean 2.0). Work safety climate was very low (mean 13.7), with 76.3% of women noting that their supervisors were "only interested in doing the job fast and cheaply" rather than safely. Women employed as farmworkers versus those in other jobs had few differences. Further research and intervention are needed on the organization of work and work safety culture of Latinx women manual workers.