Health & Safety: Recovery—or Relapse?
By Lee Schaller
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| A safety-outfitted Dick Pacific crew sets concrete at the Honolulu Airport parking structure. |
Last year at this time, the overall consensus was that the industry was striving to comply with health and safety standards, be more pro-active and above all, work to keep employees safe and healthy on the job. In other words, the industry, for the most part, was taking care of business. But the system, especially workers’ comp, was in serious need of healing.
A year has passed. Some things have changed—a new DLIR (Department of Labor and Industrial Relations) director, for example.
What about the industry’s health and safety record? Is it still showing improvement? Or have we suffered a relapse? Take two pills and read on.
Let’s be Careful Out There
The past year has seen a number of serious and even fatal accidents. Is this as bad as it appears in media coverage or is the perception due in part to the high-profile nature of the accidents and projects involved?
“The tragic accidents that occurred this past year had an impact throughout the community,” says Daniel Vasilash, GCA (General Contractors Association of Hawaii) safety committee chair. “We build relationships at work, and through the years our ‘ohana’ grows. (So) These events have a greater impact because they involve people we know.”
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Vasilash, who also is safety director for Watts Constructors, LLC, speaks about what his own company is doing in the health and safety field. “Safety and health in our business must be part of every operation. Without question, it is every employee’s responsibility at all levels. The personal safety and health of each employee of Watts Constructors is of primary importance.
Prevention of an occupationally induced injury or illness will be given precedence over operating productivity. Our objective is a program that will reduce the number of injuries and illnesses to an absolute minimum. Our goal is zero accidents and injuries.”
“The industry has seen too many losses of life and limb,” says Joaquin Diaz, CSP, regional safety manager for Dick Pacific Construction Co., Ltd.
“Our industry leaders need to understand the value of a strong safety program. They need to view safety as another element of business versus a hindrance. Although safety is not a profit center, it should be considered as a cost savings center.”
“There have been some very significant accidents in 2007,” agrees Tracy Lawson, CSP, CHST, CSHP, principal, risk control services, with Risk Solutions Partners. “The final statistics are not out yet but I expect to see the same or higher rates as 2006. I think one of the concerns is that many of the companies experiencing accidents do have safety programs. The question is are they doing what they said they would do—are people working their plans or are they just working? When we see a higher occurrence of fatalities and serious incidents, theoretically this means we are having a significant increase in reportable and near miss incidents. Attention to detail and getting back to basics seems to be the first step in the right direction. Companies should conduct a gap analysis to see whether or not their programs are being implemented according to policy and expectation; and where there are shortfalls or gaps, action plans to make corrections need to be put into place.”
Symptoms and Solutions
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There was just about universal agreement as to the most worrisome problem
for the industry in the safety arena. “Fall protection,”
says Clifford Higa of Safety Systems Hawaii, Inc., “is the biggest
challenge.” And his company is doing something about it. In addition
to conducting fall protection certification classes, Safety Systems
Hawaii has a new “safe-t-ladder rail extension system” that
allows workers to walk through the ladder instead of around it. The
design allows for safer entry on and off the top of the ladder even
for workers wearing a “loaded-up” tool belt.
“The HIOSH ‘Tie-Off, It’s Your Life’ campaign
served as a reminder to the people involved in our industry,”
says the GCA’s Vasilash. “Falls are among the leading causes
of fatalities in construction and this focus, including the playing
of the TV commercials when the family is at home together, continues
to serve as a reminder of exactly who is impacted by unsafe acts. The
HIOSH advisory committee comprised of members from general industry
as well as construction and the trades meets regularly to discuss concerns
and potential solutions. Committee members have the opportunity to address
any concerns relative to their activities and to establish communication
with others who may offer solutions or insight.”
| Are You SHARP? SHARP (the HIOSH Safety and Health Achievement Recognition Program) allows qualifying companies exemption from routine or programmed HIOSH inspections for up to two years. For information, visit the HIOSH web site and click on the quick link for SHARP. Current SHARP construction-related companies are: |
“I am seeing a high incidence of fall protection, trenching, scaffolding, and crane and rigging infractions,” says Lawson. “These are symptoms of a deeper problem and translate into substandard acts or conditions on the site. It seems as though many organizations are so busy they think they don’t have time for safety, when, in fact, the busiest time is the most at risk time and that is when safety is most critical. There seems to be a tendency to separate safety from productivity. This is a false line of thinking; the real answer is that in order to have a truly productive environment, safety needs to be integrated into every aspect of operations.”
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VPP Hawaii Members OSHA’s VPP program (Voluntary Protection Program) extends official recognition of the outstanding efforts of companies that have achieved exemplary occupational safety and health. For more information, visit www.osha.gov and click on the VPP link. Current VPP member companies in Hawaii are: |
“Most people fail to realize that construction is a high risk business,” says Clark “Skip” Morgan, president of Alakai Mechanical Corporation. “They constantly have to be reminded to always think about the things that could happen. People need to be aware of their surroundings as they do their work—aware and sensitive to what could happen. Don’t take chances. Don’t do anything stupid. Complacency is one of the evils we fight. Almost every accident is preventable.”
“I don’t know if there has been an actual increase in accidents—several of them involved high profile projects, so they may have received more media coverage than usual,” points out Joe Ferrara, safety chair for the ABC (Associated Builders and Contractors, Hawaii Chapter) and general manager of Consolidated Painting LLC. “The HIOSH ‘Tie-Off’ campaign created more awareness among workers. Companies seem to have a better hold on safety.”
Serious Side Effects
In addition to continuing concerns about specific areas such as fall protection, there are other challenges facing the industry, which impact the entire issue of health and safety. “A major challenge,” says ABC’s Ferrara, “is the need to develop skilled personnel and safety-trained people.” And he’s speaking from the top down.
Dick Pacific’s Diaz agrees, mentioning as the main challenges currently facing the industry, “Effective leadership in safety—creating an awareness about the economics of safety management; also globalization of the labor workforce—the workforce demographics have changed and the industry needs to better prepare for this shift.” Speaking of the importance of risk aversion, he says, “The industry needs to apply better risk decisions when pursuing work, entering new markets and employing a new workforce.” Diaz also cites the need for aggressive safety program management—modeling the program to fit the company’s profile. “Many organizations rely on boiler plate safety programs.”
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The importance of effective leadership and expert safety management are underscored by Vasilash, who points out, “The days of a long time progression in moving up in position as skills and experience are developed are gone. It used to take years for a journeyman to become foreman and a foreman to become superintendent. This is no longer the case. As we promote good workers to higher levels of responsibility, we don’t necessarily train them to become good leaders. As an older seasoned person leaves the industry, he or she often is replaced by someone with limited prior experience or training. This shortage of experienced qualified people creates challenges in managing our projects and our workers. We must supplement this inconsistency with training to ensure that we provide hazard awareness and recognition.”
In the light of our extremely tight labor market, several industry members see accidents and infractions as a direct result of the desperate rush to hire and get employees on the job—at times, without adequate safety training. (Editor’s note: See our story on Education and Apprenticeship in this issue.)
“You don’t send your troops into combat without them having knowledge about warfare and being equipped to fight,” says Diaz. “That’s how I would compare the training deficit in our industry. It is unfortunate for employers not to invest in the training of their employees. That investment will reap greater benefits for their employees in the long run.”
“This indirectly becomes a safety topic,” says Rick Heltzel, president of Healy Tibbitts Builders, Inc. “The workforce peak in our industry results in fewer available workers. It’s hard to find qualified people, so a company may bring in some who are not properly trained.”
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Most Cited Standards by HIOSH Oct. 1, 2006 – Sept. 30, 2007 |
“With our tight labor force,” Ferrara concurs, “some non construction-oriented people are coming into the industry, but most companies are training their people—they know it’s beneficial to them.”
“I would say anytime you are putting any worker into a situation where he or she is not properly trained, experienced and supervised, accidents will occur,” says Lawson. “But it is not just doing training to comply with the requirements; it is doing training that is effective and that is followed up in the field so that the concepts and strategies in the training are translated into everyday work. I see training being done and workers going back to do the same thing they always did, and the employer is wondering why he/she is not getting different results. The answer is simple. Train for a substantial change in behavior and follow up with reinforcement and accountability in the workplace. If I give you a class on how to lift properly, I need to relate it to your workplace, relate it to why it is a benefit to you as an individual (and to the employer) and then it needs to be reinforced the minute you return to the workplace.”
Tell Me There’s a Cure
“Even though workers do not intend to get hurt,” says the GCA’s Vasilash, “they sometimes conduct themselves in an unsafe manner. The causes of unsafe behaviors are often the result of loss of focus, fatigue or distractions. Individuals also can develop a false sense of security regarding their ability to control or protect themselves as they perform their work.”
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What can be done to alter these dangerous habits and/or attitudes? “Changes in behavior can be affected by addressing beliefs, attitudes and counterproductive circumstances at the worksite,” says Vasilash. “To ensure continual improvement, constant attention to safety and health issues must be ongoing.”
“I think the biggest thing employers can understand,” adds Lawson, “is that they have a responsibility for everything that takes place in their workplace. They also need to realize the fiscal value of having an efficient safety program. Employers need to ensure that there is competent person supervision—competent as OSHA (Occupational Safety and Health Organization) defines it and that means having training and experience in a particular area such as fall protection and having the authority to take prompt corrective action. Employers need to ensure that their supervision is as strong in safety as in getting the job done. Also, companies should make sure the right system is used in a particular exposure and that the system is used properly and maintained according to the manufacturer’s requirements. Most companies measure success by everyone being ‘tied off’ or wearing safety glasses. Safety is NOT common sense. It is a science and it is learned.”
Awareness also gets top marks in helping to “make things right.” For example, the aforementioned HIOSH “Tie-Off” campaign. “The ‘Tie-Off’ campaign created great awareness about fall protection in the community,” says Diaz. “The purposeful targeting of the community, family and friends was very forward thinking by HIOSH. We saw and heard of family members encouraging their loved ones to ‘tie-off’ at work. Our industry needs to remember that workers will do only what is expected of them. If there are numerous issues with employee fall protection on site, for example, then that project has an issue with project leadership. Employer leadership has to step up if real change is to be long term.”
“The number one thing to do,” says Healy Tibbitts’ Heltzel, “is from the top down, assign the highest priority to safety. It is the most important aspect of what we do.”
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| A Hawaiian Dredging safety meeting at the Plantation Town Apartments jobsite |
Also impressed with the HIOSH “Tie-Off” campaign is Cheryl Arii, acting safety director for Hawaiian Dredging Construction Company, Inc. “I believe any program to promote safety, such as HIOSH’s ‘Tie-Off’ campaign, is effective because it puts safety into the minds of people not only on the jobsite but at home. As shown in the commercial, when families reinforce the message, it makes it more meaningful.”
Need a Doctor?
“A survey done by HMA (Hawaii Medical Association) showed that 60 percent of doctors who used to accept workers’ comp (cases) no longer will consider doing so,” says Ronald Kienitz, DO, medical director of Concentra Medical Centers. “I see this every day and document it in my medical records when the patients find their way to Concentra, where they still can get care.” What’s the problem here? Why are doctors opting not to handle workers’ comp cases? As Dr. Cynthia Jean Goto, president of the HMA has noted in detail, “…the main problem our physicians face in Hawaii is the declining reimbursements from insurance companies.” She also cites HMSA, the primary private healthcare insurance company in Hawaii, as uncontested in determining its premiums and its payment to physicians.
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| Dr. Kienitz of Concentra Medical Centers examines a truck driver patient. |
Dr. Kienitz, a longtime advocate of healthcare and workers’ comp reform, is passionate about the problem. “It takes significant and long term abuse for physicians to refuse to care for their own patients injured on the job,” he says. “Therefore, it was quite a while after July 1, 1995 (when legislators reduced reimbursements to physicians treating workers’ comp cases by more than 54 percent) before anyone would admit that the drastic, thick-headed approach of our legislature and former governor was having a negative effect. That effect, however, has been insidious and steady and no one argues anymore that it has happened.”
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| Ronald Kienitz, DO, medical director of Concentra Medical Centers, works with a patient in physical therapy. |
Kienitz underscores once again, as in the past several years we have spoken with him, “HMA has petitioned for approximately 100 specifically-targeted codes that we were able to show were not significant cost drivers and if increased sufficiently, would be a major help in attracting the right doctors back to accepting the care of injured workers. Unfortunately, the DLIR director (according to the way in which Act 234 is written) is significantly limited in the increases he can give petitioned codes. The average increase of these codes by about 18 percent (implemented on Jan. 1, 2007) simply has not been enough to reverse the trend and doctors stay away from workers’ comp (cases) in droves.” Commenting on a current administrative bill which proposes to raise physicians’ reimbursement fees with stepped increases in the entire fee schedule in 2008 and 2009 to ultimately achieve approximately 130 percent of Medicare rates, Kienitz says, “Although we appreciate the thought behind the administration’s bill, we are concerned about two things: first, whether the increases will be enough to provide unfettered access to primary case management by skilled doctors and to specialty care—orthopedic and neurosurgeons, reconstructive and general surgeons, ENT (Ear Nose Throat), psychologists and psychiatrists.
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| Kienitz and staff members (l to r) Jaclyn Gutierrez-Martinez, Lyn Gante, and Summer Houchin. |
Secondly, we are concerned that any blanket increase in the entire fee schedule again will result in significant, predictable increases in overall cost. The greater the increase, the more negative attention raised from employers. We therefore have suggested that a better approach would be to target increases to specific workers’ comp procedure codes at a level that would bring doctors back so that care is not delayed. Because of improvements in care efficiency, the overall result will be far less that the actuarially-calculated increases and may actually be a paradoxical decrease in overall costs. One way to achieve this would be to rewrite the language in Act 234 to allow the DLIR director more latitude in setting reimbursements of specific, targeted codes and to allow him to make regular cost of living adjustments without going through another lengthy petition process. Also, what really needs to be done is to have the legislature understand that it was and is a mistake to base workers’ comp and NF (nursing facility) reimbursement on Medicare for many reasons.”
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| Eddy Ragasa (standing) and Jackfrey Manuel of T & T Electric install cross-arms on a high-voltage pole for T & T’s primary power project at the Pohakuloa Training area Base Camp on the Big Island. |
Regarding the impact of Hawaii’s tight labor market on health and safety issues, Kienitz says in his role as a part time independent medical examiner and permanent partial impairment rating physician, “I do see that the tight labor market has had an effect on the quality of workers available to employers and workers sometimes are assigned tasks that they are not fully familiar with. In many cases, there also seems to be a much higher tolerance to positive drug tests.”
Preventative Medicine
Most industry companies, by all reports, take health and safety very seriously and are committed to constantly improving the working environment. What exactly are they doing?
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New Director, New Direction? But there’s more to the story. In an address to ABC members at the association’s recent Construction Preview dinner presentation and in an interview with B.I., Ching, with a background as an educator and deputy prosecuting attorney, outlined his overview in more detail. “A primary goal,” he says, “is preventative education and partnering with the industry.” In addition, Ching emphasizes, “We will be focusing on egregious violators, going after the really bad guys, the ones who repeatedly violate the law and take advantage of everyone.” He also speaks of a second goal: “We need to do something to help small businesses. I asked my people to put together a program addressing this and to think long-term.” The resulting program, a partnership of HIOSH, Dick Pacific, Risk Solution Partners, Island Insurance and the Veterans of Safety (VOS) now has taken form as a training system which Risk Solution’s Lawson explains, “is aimed at helping businesses, especially small business, get a handle on the basics of why safety is economically important to them and how to get started. It also puts them in touch with a mentor through the VOS.” Called Pathway to Success, the program kicked off Feb. 6 with an introductory meeting. Dick Pacific’s Diaz reports that classes incorporating nine basic modules of two hours each will be offered in March, June and September. (For more information, contact: jennifer.k.shisido@hawaii.gov) “The long-term vision,” says Ching, “is to practice safety continuously—it’s good business, it helps your workers and it increases the bottom line. In her state of the state address, the governor said, ‘The future is all of our responsibility.’ That’s what I am working toward—more education, more collaboration, helping your businesses.” We asked Ching what he feels about the accident (and fatality) rate during the past year. “Falls are a constant battle,” he says, “but the recent spike in safety incidents was related to heavy equipment. And they were mainly due to things that could have been avoided such as not wearing a seat belt or not following the equipment manufacturer’s guidelines.” Ching mentions another contentious point: “Some people are playing games. They don’t turn in or they falsify their records.” As to how the industry is doing overall, he says, “My gut feeling is that people understand the long-term vision. They realize the importance of building good health and safety programs into the cost of doing business.” |
Darwin
L.D. Ching, the newly-appointed director of the DLIR views his
role as “fostering collaborative working relationships with
labor unions, the state legislature, businesses and the community.”• Dick Pacific – “Dick Pacific has departed from using incident rates as indicators of the success or failure of our program,” explains regional safety manager Diaz. “We changed and now model our program to measure the efforts of project leaders on site. These measurements involve pro-active and failure-based assessments. Pro-active measurements include cultural and performance assessments, safety culture surveys and foreman accountability scorecards, which have lowered our incidence rate by 68 percent and lost time rate by 66 percent in the past three years while still maintaining a large volume of work. The failure-based measurements include trend analysis of daily inspections, tracking incidence causes for trending, requiring measurable corrective planning for incidents and action planning for projects with low assessment scores. This has infused a greater level of accountability by executives to project leaders by ensuring, ‘We say what we mean.’”
• Kaikor Construction – “We constantly emphasize the importance of safety being a personal responsibility,” says CEO Garrett Sullivan. “We make safety the first topic of every company meeting and newsletter. We recently hired a personal fitness trainer for our field employees and have found this to be a tremendous benefit in helping employees’ health and safety agility in the workplace. As far as major health and safety challenges, Kaikor continuously emphasizes to our field employees the four hazards which account for 90 percent of all construction fatalities: falls, struck by an object, caught in-between and electrical shock.”
Healy-Tibbitts – “The first topic at our monthly operational meetings is safety,” says company president Heltzel. “It’s always at the top of the list of things to discuss. There are site safety officers at all projects and we have a Hawaii area safety manager who coordinates and oversees the management of safety programs. We follow the Army Corps and Navy safety manuals which add even more discipline to our programs. We do an accident hazard analysis (AHA) for every construction activity, analyzing the operation and identifying any safety hazard in a written document which we discuss with our operations people as a further preventative measure.”
Hawaiian Dredging – “Hawaiian Dredging has a very comprehensive safety program,” reports acting safety manager Arii, “which includes site specific orientations for all of our employees and subcontractor employees, plus training, regular inspections and a disciplinary program. Our safety administrators play a key role in preventing injuries and eliminating hazards. And they strive to continue their professional development by attending regular training and obtaining their OHST, CHST or STS certifications. This year we will try something new—online training. We think this will be a time-saving and economical way to train a large group with little or no disruption to operations.”
Alakai Mechanical – “We emphasize safety in every way,” says company president Morgan, “from pre-job planning to extensive in-house training. We spend a lot of time teaching and we have a generous incentive program for employees with unblemished safety records, with rewards given quarterly.”
Actus Lend Lease – “Actus Lend Lease conducts safety orientations and task-specific training for all workers before they are allowed to work at our sites,” says Steven Goraczkowski, operations manager-construction, RME Hawaii. “A four-hour incident and injury free (IIF) training for all workers and their managers currently is under way. Over 500 of our Hawaii workers have received this training, including 100 percent of Actus employees. IIF must be part of the culture of Actus and the subcontractors who work for us. We hold daily internal field-level staff meetings and weekly contractor supervisor meetings to communicate production and safety issues. We also conduct monthly mandatory ‘all hands’ safety meetings to address specific high-risk activities on the project and their safety concerns. We hold crew leaders and foremen equally responsible for the safety of their workers. If a worker is sent home for unsafe work activities or an unsafe attitude, there’s a good chance his or her foreman also will be sent home. It may sound heavy-handed but we really do care. We want all workers to act safely for themselves, their co-workers and their families.”
Consolidated Painting – “We conduct in-house training regularly,” says general manager Ferrara. “We update constantly and currently are revising our written program. It takes everyone to make an effective safety environment a reality—HIOSH, the industry, individual companies. The bottom line is to keep people safe. I think overall, the industry is doing a good job. Companies have safety directors, are participating in HIOSH recognition programs, and generally are committed to keeping their workers safe and healthy.”
T & T Electric, Inc. – “T&T personalizes its safety
culture,” says health and safety officer Tom Laffipiy, “a
safety culture which derives from the company mission statement which
embodies the owners’ (Leonard and Suellen Tanaka) personal feelings
toward their employees—‘to provide opportunities for our
employees to grow and improve their quality of life as individuals and
families.’ Establishing and maintaining a positive safety culture
requires the involvement and commitment of all levels of management,
including the owners, plus empowering employees with the same level
of responsibility and accountability as supervisors, for a safe and
healthful work environment. Every employee is a safety officer and has
the right to halt operations if an unsafe act is observed. It is everyone’s
kuleana and that is not negotiable. Personalizing the safety program
is the most critical element of maintaining the positive safety culture
of the company. We end all safety meetings, toolbox or company-wide,
with the personal message, ‘We want you to come to work each day
to make a living for your family and be able to go back home to be with
them at the end of the day.’ Continuous reminders that their actions
at work directly affect the lives of their loved ones at home always
gets everyone’s attention. That is the key.”
And it’s also a perfect way to end this report.