Category: continuity

A shaky start leads to a terrific book on incident investigation by Michael Tooma

There is one word that should not be used as an adjective in relation to workplace fatalities – impacted. Workers fall from roofs and the concrete floor has an impact on them. Workers hit by mobile plant or crushed in machines die from the impact. An impact results from the transfer of energy and this transfer of energy in workplaces can kill.

“Impacted” is used by those who do not feel comfortable differentiating between “affect” and “effect” and it is surprising to find the term used in the opening chapter of Michael Tooma’s latest book, Due Diligence: Incident Notification, Management and Investigation.

“Unless you have been involved in a serious incident, you don’t really appreciate how an incident will affect you. For every worker killed at work, there is a grieving mother, father, spouse and/or child. Their co-workers are impacted. Their friends are impacted. Management, guilt-ridden as they are in the aftermath of an incident, sometimes for good reason, sometimes not, are also personally and emotionally impacted. The tragedy touches everyone. In the midst of it all, a group of people are tasked with managing through the chaos and trying to get answers for all those impacted by the tragedy. This book is for them.”

The sentiment is correct and true but read the paragraph aloud and it sounds absurd. And why the overuse of “impacted” when a perfectly suitable word, “affect”, was used in the first sentence?

And this clumsy opening does the book a disservice. Tooma has repeatedly stated that this is a safety book written by a lawyer and not a legal book written about safety. This is a major change from a major Australian OHS publisher. It is a recognition that the readership is not lawyers feeding on lawyers but people wanting to understand workplace safety. Continue reading “A shaky start leads to a terrific book on incident investigation by Michael Tooma”

NSW inquiry into workers’ compensation illustrates short-termism

UnionsNSW are campaigning strongly on OHS issues during an inquiry by Joint Select Committee on the NSW Workers’ Compensation Scheme into workers compensation.  They make the point that a focus on the reduction of injury is the most effective way of rendering a workers compensation scheme “profitable”.  By neglecting worker safety, injuries increase and there is a higher demand on compensation and rehabilitation resources.

A major concern in the campaign is that the government is focussing on reducing costs and, in workers’ compensation schemes, that often results in fewer resources for injured workers and their families.

Tim Ayres, Secretary of the Australian Manufacturing Workers Union, was quoted in the Sydney Morning Herald:

“If NSW employers want to save money on workers’ comp premiums, they should focus on reducing their premiums by providing safer workplaces where workers don’t get injured and killed.”

But a draft submission, seen by SafetyAtWorkBlog, by the International Governance and Performance Research Centre (IGPRC) of Macquarie University provides some balance into the rhetoric. Continue reading “NSW inquiry into workers’ compensation illustrates short-termism”

Is capitalism anti-safety? Systemic failures in oil industry

The Wall Street Journal and other media around the world have reported on systemic failures of the global oil industry and government regulators identified by the National Commission on the BP Deepwater Horizon Oil Spill and Offshore Drilling.  These articles are based on the release of a single chapter, Chapter 4, of the final report due for release on 11 January 2011.

A media release from the Commission includes the following findings from Chapter 4

“The well blew out because a number of separate risk factors, oversights, and outright mistakes combined to overwhelm the safeguards meant to prevent just such an event from happening.  But most of the mistakes and oversights at Macondo can be traced back to a single overarching failure—a failure of management.  Better management by BP, Halliburton, and Transocean would almost certainly have prevented the blowout by improving the ability of individuals involved to identify the risks they faced, and to properly evaluate, communicate, and address them.”

“. . .the Macondo blowout was the product of several individual missteps and oversights by BP, Halliburton, and Transocean, which government regulators lacked the authority, the necessary resources, and the technical expertise to prevent.”

“The blowout was not the product of a series of aberrational decisions made by rogue industry or government officials that could not have been anticipated or expected to occur again. Rather, the root causes are systemic and, absent significant reform in both industry practices and government policies, might well recur.”

“What we. . .know is considerable and significant:

  1. each of the mistakes made on the rig and onshore by industry and government increased the risk of a well blowout;
  2. the cumulative risk that resulted from these decisions and actions was both unreasonably large and avoidable; and
  3. the risk of a catastrophic blowout was ultimately realized on April 20 and several of the mistakes were contributing causes of the blowout.”
The significance of these quotes is that the Commission is critical of an industry and not just a single company.   Continue reading “Is capitalism anti-safety? Systemic failures in oil industry”

Telling is better than being exposed

Many OHS laws place obligations on employers to notify regulators (   )  of any particularly serious (often defined) incidents.  In many jurisdictions regulators are sometimes informed of work-related hospital admissions, for instance, even if employers do not notify.  But there is substantial benefit in notifying the regulators early.

Anecdotal evidence shows that by facing up to the reality that an incident has occurred is less costly in the long term as this shows that one is aware of one’s OHS obligations and willing to apply them.

The wisdom of reporting incidents in a timely manner is perhaps illustrated by a 17 December 2010 article in The Age newspaper.  It is rumoured that incidents involving apprentice tiler Kane Ammerlaan may not have been reported to the OHS regulator in Victoria, WorkSafe.

Prompt reporting may not have been able to improve Ammerlaan’s situation relating to the fall but investigations into this possibly life-changing incident could have begun much earlier, and when evidence was easier to collate.

Ammerlaan also alleges that:

‘Through my six weeks I was constantly abused. There was a lot of verbal abuse; they’d throw stuff at me; I was shot with a nail gun on a few occasions.”

This may raise, yet again, the safety issue of the treatment of young workers and apprentices; an issue on which the community seems to require regular reminding.

Kevin Jones

Neglect by company directors found to have contributed to death of worker

It is always fascinating to hear of directors of companies being found personally guilty for workplace health and safety breaches because it seem to happen so rarely.

The latest instance in Australia occurred on 3 December 2010 following a 2007 death of a 22-year-old rigger named Luke Aaron Murrie.  Below is WorkSafe Western Australia‘s media release on the case.

“A Malaga hoist and crane company has been found guilty of failing to provide and maintain a safe workplace and, by that failure, causing the death of a worker.

Two Directors of the company were also found guilty of breaching a section of the Occupational Safety and Health Act dealing with offences that occur with the consent or connivance of a Director or are attributable to the neglect of the Director. Continue reading “Neglect by company directors found to have contributed to death of worker”

Safety Cases must become a reality in the US

Some of the media, over the weekend, was critical of BP for not applying a Safety Case to the BP/Deepwater horizon oil rig.  The Safety Case is an established method of assessing risk in high-hazard organisations and should have been applied.  Whether such a technique would have made any difference is debatable as it is hypothetical.

Safety Case regimes have proven effective and are used as a default risk setting in many corporations but the story is not only one of a specific Safety Case missed opportunity.  BP is an example of corporate hypocrisy that supports the cynicism of the community to large corporations whose actions do not reflect their commitment. Continue reading “Safety Cases must become a reality in the US”

An executive decision leads to over six deaths

“Don’t put all your eggs in the one basket”.  The first time we hear such a saying is likely to be from our parents or our grandparents but it could equally apply to all the applications of risk management.  Clearly someone at Sundance Resources forgot this wisdom when its board members boarded a plane in Africa to visit a mining site.  The plane crashed and all on board died.

The remaining Sundance executives quickly acknowledged the error in media conferences shortly after the incident even though the decision was understandable.  In safety and workplace parlance, the board took a “shortcut” in safety, an act that would have been soundly disciplined for most workers.

Everybody takes shortcuts at work and sometimes these shortcuts lead to injury or death.  It is easy to say that the cause of an incident is a specific decision, the shortcut but it was not only the Sundance executive’s decision that contributed to the death.  In this instance the board entered a plane that later fell from the sky.  If they had made the same shortcut but on a different plane the outcome would have been very different.

Deaths always have a context to them and present a variety of “what-ifs” when we investigate.  A specific combination of events/decisions/actions/shortcuts lead to a death.  The Sundance shortcut was clearly the wrong decision, at the wrong time, in the wrong place and with the wrong mode of transport but there are more contributory factors that will become evident when the wreckage is fully recovered. Continue reading “An executive decision leads to over six deaths”

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