Flawed first aid information Reply

First Aid Complaince CodeSome time ago WorkSafe Victoria issued Compliance Codes on a number of workplace safety issues.  One was concerning First Aid.  The Compliance Codes were intended to replace Codes of Practice which had been around for decades.

The previous major change to workplace first aid was in 1995 when the First Aid Code of Practice was reviewed in Victoria.  Other Australian States vary between prescriptive and non-prescriptive first aid guidelines.

On 31 May 2009, WorkSafe released a factsheet on first aid for low risk micro businesses.  A low risk micro business is explained in the factsheet as those that

  • employ fewer than 10 people
  • are located where medical assistance or ambulance services are readily available
  • are businesses that don’t expose employees to hazards that could result in serious injuries (eg serious head injury, de-gloving, scalping, electric shock, spinal injury) or illnesses that may require immediate medical treatment.

First Aid for Low Risk Micro BusinessesSome examples of low risk micro businesses were included in the factsheet –  “retail shops and outlets, offices, libraries and art galleries” Why a one page information sheet for this sector was deemed to be needed is a mystery?  I asked WorkSafe several questions about this factsheet

  • What was the rationale for the production of this guidance for this sector? Given that the Compliance Code is specifically referenced.
  • Is retail really a low-risk micro-business?
    • What about the use of ladders?
    • Young workers?
    • Working alone or unsupervised?
    • Occupational (customer) violence?
    • Petrol stations?
    • Convenience stores?
    • Night shift security needs?
    • Knife cuts from removing stock from boxes?
    • Manual handling?
  • First aid kits are required but not first aid training. In the case of respiratory failure a first aid kit is next to useless for CPR.
  • Why is only St John Ambulance referenced on the guidance?

The factsheet misunderstands first aid by placing low risk microbusineses into the “paper-cut” sector.  This is doing micro-businesses a dreadful disservice.

TRAINED FIRST AIDER

Shortly after the First Aid Compliance Code was released St John Ambulance broadcast an email about workplace first aid compliance.  In that email St John wrote:

Low risk organisations (office, libraries, retail etc) should have at least one qualified First Aider for 10 to 50 employees…

The May 2009 fact sheet makes no mention of the need for a trained first aider but WorkSafe’s own Compliance Code states this as a compliance element.

A low-risk micro-business may not generate the potential hazards that WorkSafe lists in its definition above but employees in these businesses do have to respond to the injury needs of their customers.  In these times of public liability and the expansion of OHS obligations to include customers, neighbours, and others who are affected by work processes.

WorkSafe itself describes an employee’s duty of care:

“All workers have a duty of care to ensure that they work in a manner that is not harmful to their own health and safety and the health and safety of others.”

The omission of a trained first aider is unforgivable.  What would an employee do if a client collapses in the foyer of a convenience store with a heart attack or chokes on the food that they have just purchased?  What would one do if a stab victim stumbles into the only open retail outlet, perhaps a petrol station, at 2.00am? How would that petrol station attendant  treat someone who has had petrol accidentally splashed in their face?

These matters cannot be treated by a person who is untrained in basic first aid who only has a first aid kit available.  Training for all workers who work alone or in isolation in micro-businesses is a basic element of compliance, one that WorkSafe fails to list in its latest workplace first aid factsheet.

EMERGENCY NUMBER

Almost as unforgivable is that the factsheet makes no reference to the Australian emergency number of 000.  One of the first actions to be performed in a workplace where someone is seriously injured is to call for an emergency ambulance.  While waiting for the medical authorities, and if safe to do so, first aid should be rendered. WorkSafe needs to remember that CPR requires training and that a first aid kit is next to useless in this type of situation.

ST JOHN AMBULANCE

It is curious that only St John  Ambulance is listed on the factsheet for further information.  There are many first aid equipment and training providers in Victoria.  It would have been fairer to either recommend all providers or none at all.

[UPDATE: WorkSafe has advised SafetyAtWorkBlog that they will be addressign the St John Ambulandce and 000 issues raised.]

COMPLIANCE CODES

On 18 September 2008, the WorkSafe website described the First Aid Compliance Code as covering

“…first aid arrangements including first aid needs assessment, first aid training, first aid kits and first aid facilities.”

In a media statement at the time on compliance codes generally WorkSafe Executive Director, John Merritt was quoted:

“The codes were developed after extensive consultation with industry, employers, employees, governmental agencies and the community to provide greater certainty about what constitutes compliance under the OHS Act.”

“The codes include practical guidance, tools and checklists to make it easier for duty-holders to fulfil their legal obligations.”

Mr Merritt added that: “These codes will provide Victorian employers, workers and Health and Safety Representatives with certainty and assistance in meeting their responsibilities.”

The Compliance Codes are aimed at the many dutyholders yet one of the rationales for the new single sheet guidance is that dutyholders (employers) do not read Compliance Codes.  It seems that the Codes are now principally read by OHS professionals and advisers.

(This position may be one of the reasons WorkSafe is pushing so hard for a truly professional OHS structure through its HaSPA program – the establishment of an OHS middleman between the rules and their application in the real world.)

It is a considerable change to the readership the Compliance Codes were aimed at and is a substantial change from the Codes of Practice which, in the case of First Aid, were handed out to all first aid trainees, included in information kits for health & safety reps, and were read by dutyholders and integrated into their OHS management practices.

The significance of Compliance Codes and Codes of Practice at the moment is that these documents are to be part of the Federal Government’s move to harmonisation of OHS laws.  (Some eastern States have already begun joint publication of guidances). Variations in these documents, often the most referred-to OHS documents in workplaces across the country, will undercut the aim of harmonisation – the reduction of business compliance costs through harmonised OHS requirements.  If the practical application of laws are not harmonised, the aims will never be met and the process could be seen as seriously flawed.

Kevin Jones

Integrating climate change impacts into OHS and business management 1

Today the European Policy Centre in Brussels released the report Climate change: Global Risks, Challenges & Decisions. The findings of this report do not directly affect workplace safety but do indicate new ways in which businesses must manage the economic and social hazards that climate change produces.  These new ways of management must be anticipated and understood by OHS professionals.

Synthesis Report Web coverThe report says that

“Linking climate change with broader sustainable consumption and production concerns, human rights issues and democratic values is crucial for shifting societies towards more sustainable development pathways.”

The need for integrated management of business has never been greater.  The common threat of climate change can only be met with a business strategy that embraces the reality of the threat and has this reality on the table of all business discussions – a desire that many professionals have also been pushing for OHS for years.  The boardroom and management tables are becoming full of issues that some see as competing but are in truth complementary.

The report discusses two types of action that can be taken.  Businesses that produce large amounts of carbon should be well involved with mitigation measures and the political policy frameworks.  Other businesses can benefit substantially from adapation, that is

“…whereby society increases its capacity to cope with the impacts of climate change, so far as possible.”

The report gives developing countries a particular focus for adaptation but the concept is equally relevant, and perhaps more easily implemented, in Western countries.

“Adaptation to climate change cannot be successfully implemented if treated as an “add on” and implemented separately from other initiatives aimed at fostering economic and social development and increasing the resilience of societies.”

Climate change is altering the statistical possibilities of worst-case scenarios.  The one-in-a-million is becoming the one-in-a-thousand.  The once-in-a-hundred-years is becoming once-in-a-decade.  The rapidity of change and the greater extremes and fluctuations of these events are changing the way projects are handled, costed and managed.  These fluctuations will challenge the way that safety is managed and are broadening the scope of the profession.

OHS needs to be seen as a discipline that is as multi-faceted as risk management, as human as human resources and as responsible as corporate social responsibility.  The OHS professional will remain focused on the safety of employees but what used to be on the periphery is now moving to the centre – climate change, business continuity, infectious disease pandemics, travel, risk management, shareholder expectations, quality, auditing, governance and accountability, to name a few.

And none of these issues can be dealth with without an integrated and adaptive approach, an approach that can provide more wide-ranging social benefits than ever before.

Kevin Jones

Tasers as personal protective equipment 2

SafetyAtWorkBlog supports the use of tasers, or stun guns, as a control measure that eliminates or reduces the chances of a police officer being seriously injured but concerns continue around the world about the application of tasers. In 2008 the New South Wales government came to a decision of sorts on tasers.   Following the recent death of a man in Queensland from a taser, the focus has shifted to that States.

In an OHS context tasers could almost be considered a piece of active personal protective equipment (PPE), if there can be such a thing.

Recently Dr Jared Strote of the Division of Emergency Medicine at the University of Washington Medical Center said

“It is fairly clear that the use of TASERs on healthy individuals is rarely dangerous (there are hundreds of thousands of uses in the US without serious outcomes). The question is whether there is a subset of people for whom there is a higher risk.

The problem is that the individuals who have died in custody temporally associated to TASER use are the same types who are at higher risk of death during police restraint no matter what type of force is used.”

Dr Strote also illustrates the cost/benefit issue that OHS professionals must deal with constantly

“The issue is probably less whether or not TASERs can cause death (they probably can but very infrequently); the better question is whether their net benefits (potential to avoid using more lethal weapons (like firearms), potential to decrease risk to officers, etc.) outweigh the potential costs.”

Two studies by Dr Strote – “Injuries Associated With Law Enforcement Use Of Conducted Electrical Weapons” and “Injuries Associated With Law Enforcement Use Of Force,” were presented at a forum in New Orleans in mid-May 2009.

A UK expert, Dr Anthony Bleetman, a consultant in emergency medicine says

“Tasers have been used on human subjects probably about a million times, some in training and a lot in operational deployment. With any use of force there is a risk of death. But when you look at the big picture the death rate after Taser is no higher than with other types of force. But what we do know is that there is a certain type of individual who is at greater risk of death after police intervention – the so-called excited delirium state where somebody, usually a male in their 20s or 30s, often with a psychiatric history, often on illicit drugs or psychotropic drugs, has been in a fight or pursuit, physically exhausted, not feeling pain, dehydrated and hypoxic. And then you add on top of that physical restraint by police. These are the ones that die and they die whether you Taser them or don’t Taser them.”

Bleetman explains the role of tasers in comparison with other active PPP:

“Police officers have a whole spectrum of options to use in force from talking to people to laying their hands on people to using capsicum sprays, batons and dogs. And then there’s a gap until you get to firearms when you shoot people. So between batons, dogs, sprays and guns, Tasers sit quite nicely to use against people who are so agitated and so dangerous to themselves and others that the only way to take them down is something as lethal as a gun or as dangerous as a police dog.”

Many American studies and statistics must be treated with caution as tasers are readily available to the general public and therefore operate unregulated. However in 2005 the American Civil Liberties Union undertook a study of law enforcement agencies. According to an Associated Press report from the time written by Kim Curtis:

“The ACLU surveyed 79 law enforcement agencies in Northern and central California, according to spokesman Mark Schlosberg. Of those, 56 use Tasers and 54 agencies provided the ACLU with copies of their training materials and policies regarding stun gun use. Among the organisation’s major concerns was that only four departments regulate the number of times an officer may shoot someone with a Taser gun.”

This last point has been one of the most contentious points of the recent case in Queensland where a police taser was discharged 28 times.

Taser use is a very complex issue, as are most PPE and OHS issues when dealing with emergency services. It may be possible to take some hope from the deterrent effect of tasers identified by the Delaware State Police in some recent budget papers:

“We have encountered numerous incidents where the mere presence of the Taser on the troopers’ belts has discouraged defendants from resisting arrest.”

Kevin Jones

Relocation is always an option for an improved work/life balance Reply

A couple of years ago there was a campaign in Australia to increase the number of general practitioners in rural areas due to a doctor shortage.  One doctor, Nicole Anderson, chose to relocate from tropical Queensland to temperate Tasmania.  She did so for several reasons including improving her work/life balance.

During the campaign in November 2007 I had the chance to talk with Nicole about her experience and her life choices for a SafetyAtWork podcast

As part of the Rural Health Workforce Australia campaign, short videos were produced of which Nicole’s story was one.  Click HERE to see the wonderful countryside Nicole has chosen to practice in.

Kevin Jones

Prophet and Loss – review Reply

I bought tickets to the Jane Woollard play Prophet & Loss in almost totalProphet & Loss 002 ignorance of the play and, as a result, sat in the old church on a cold Winter’s night wondering what I was in for.  The program was detailed but I hadn’t time to read it.  I knew the play was about issues related to workplace death.  That’s the “loss”.  The “prophet” was Isaiah and that was the element that I could not understand without later reflection.

However, finding out about Isaiah could wait till we got home and then we could research a further dimension to what we saw.  The stories that told of the impact of workplace fatalities on families and workmates were compelling although a couple were familiar to me.  They told of bureaucratic confusion, the disinterest of insurance company call centre staff, the psychological legacy of a traumatic death and the inability to understand the survivor experience without having experienced it firsthand.

The venue was small but high and so the actors were close and the pain and grief was well presented.  All of the actors were very good even though I was sure I had seen one of them before somewhere.  It wasn’t till I looked at the program that the actor who looked like Helen Morse was indeed Helen Morse.

The stories’ subjects were frustrating and bleak, there is little opportunity for humour on this topic, but there was opportunity for theatricality and motion.  Fanny Hanusin broke the rhythm with her portrayal of Merpati who was hyperventilating in panic over the lack of understanding of her situation.  As Glynis Angell, the grief counsellor, Merrilyn, began breathing slowly to decrease Merpati’s panic, most of the audience were breath along.

All of the actors interchanged roles, with each taking a turn as an overcoated Isaiah writing on the wall and speaking ancient Hebrew (I later found out).  The role changes worked well on reflection but I could not work out the thematic structure of the play until three-quarters in.  The different outfits, the stories, Isaiah, were all confusing because the pairing of the characters with the stories took too long to establish.  I am not a great wearer of hats but the different characters could have been more readily identified by the audience with hats, as well as the changing of clothing.  Hats are more visible and illustrate different identities more clearly.  It may have shortened my confusion.

What differentiated this play from a series of monologues, given that I didn’t understand the Isaiah context, was the music.  The soloist, Deborah Kayser, the seraphim, sang beautifully and the acoustics of the venue were ideal although the 13th century language was totally lost on me. (A sample of Kayser’s singing can be heard online) I have never heard a double bass played to such beautiful effect as was played by Nick Tsiavos.  The depth of sound from a bow on bass could be felt in one’s chest and how he was able to pluck and stroke those strings at the same time was a mystery until he came into the light in the second half.

Kayser and Tsiavos, the seraphim, were a musical Greek chorus to the tales of grief and frustration.  This role was perhaps emphasized by their wings which were effective but initially confusing.  Kayser introduced the play in character with words that were cryptic but set the tone for the play.

The staging was effective in its industrial appeal and the use of 44-gallon drums as props and seats worked.  Early on the actors slowly rotated these drums to provide a chilling sound which I was hoping for more of throughout the play.

Each character laid out the clothes or uniform of their deceased loved one through the play, providing a useful personal profile that complemented each story.  I recall one character had worn her partner’s clothes for three days in a grieving intimacy.  She would only relinquish the clothes when they no longer smelt of her partner but now of her.

The play was being performed at the Centre for Theology and Ministry near the University of Melbourne for a limited season and as a lead-in to a major theological conference.  The play was supported by the Creative Ministries Network that provides a counselling service for those affected by workplace fatalities.

Prophet & Loss could travel well with its combination of an occupational/social theme, beautiful music and faith.  Please look out for it.

Kevin Jones

New Inventors – scaffold safety – video 4

For several years now the Australian Broadcasting Corporation has run the New Inventors.  This show displays new Australian inventions which increasingly is showing innovations in workplace safety.  In the past many award winning hazard solutions have first come to the attention of the marketplace and OHS regulators through the program.

On 17 June 2009, the show included an innovative scaffold fall protection barrier, HeightGuard. For a limited time only, the video of the invention is available online.  The product should be seen to be best understood.

A media release on HeightGuard is also available in support of the inventors’ appearance at the Queensland Safety Show.

Kevin Jones

Safety At Work podcasts Reply

As many will have noticed, I have been resurrecting some of the podcasts and interviews from several years ago and making them available, alongside new content, on SafetyAtWorkBlog.  Many of the old podcasts were available through iTunes at the time but that was before this blog and the multimedia options it presents.

Just as this blog has an RSS feed so do the podcasts.  If you want to subscribe to the audio through your media player, some of them allow this and the relevant feed is http://safetyatworkblog.wordpress.com/tag/audio/feed

Some of the podcast content may only have historical interest but I believe it is better to have this available universally on line than sitting in my archive.

Kevin Jones

2006 interview with Dr Jukka Takala of EU-OSHA Reply

In October 2006, I interviewed Dr Jukka Takala for the SafetyAtWork podcast.  Jukka had just taken over as director of the European Agency for Safety and Health at Work from Hans-Horst Konkolewsky.

The agency has continued its important work but seems since 2006 to focus more on the EU internal requirements rather than reaching out globally as before.  This is understandable given the influx of new EU member states over that time but it is disappointing when an OHS “regulator’s” website has so many dead links to its former international partners.

The 2006 podcast is available for download.

The transcript of an earlier interview I conducted with Jukka in his ILO days is available by clicking the cover image below.

Kevin Jones

4i18 cover

Panic in disaster planning Reply

Three years ago I had the privilege of arranging for Dr Lee Clarke of Rutgers University to attend the Safety in Action Conference in Australia.  Lee had a book out at the time, Worst Cases, and spoke about the reality of panic.  Lee’s studies have continued and are, sadly, becoming more relevant.

Recently, Rutgers University posted a video interview with Lee on Youtube.

Shortly after the World Trade Center collapse in 2001, I asked Lee to write something about the event from his experience and perspective.  He wrote a piece for a special edition of Safety At Work magazine.  The article has been available through his website for some time and is now available through here by clicking on the image below.

I strongly recommend Lee’s books.  As he says in the video, they’re quite fun, in a sad sort of way.

Kevin Jones

Sept11

Resilience, stress and safety management Reply

The July 25 2007 SafetyAtWork podcast is now available for download.  It includes an interview with Michael Licenblat where we discuss the psychological approach to individuals taking control of their own safety, the benefits of wellbeing programs and the changing workplace.

On listening back to the podcast today, I was struck by several issues he raises:

  • Michael is one of the few wellbeing gurus who directly link the management of stress to the productivity of the worker.  He displays more awareness than many others of the “proactive” OHS context of this approach to human capital.
  • He discusses why it is difficult for all of us to say no to some work tasks, even if  the task is high risk and may injure ourselves and others.
  • He states two core elements of workplace cultures that seem to revolve around the established OHS obligation of consultation.  Perhaps OHS managers can become real agents of change by cranking up consultation.

Kevin Jones