Category: government

Trained first aiders in “low risk” microbusinesses

WorkSafe contacted me today concerning some issues raised in a previous post concerning their first aid information. Some small tweaks have been made to that post but one point required elaboration.  There is some dispute over whether low risk micro businesses require a trained first aider.   Below is my position.

FIRST AID NEEDS ASSESSMENT

The First Aid Compliance Code discusses a first aid needs assessment.   In our experience of assessing scores of workplaces, large and small, for first aid needs (including over 28 McDonald’s restaurants but that’s another story), we are convinced that a workplace that relies on others to provide an acceptable level of emergency first aid response would expose the employer to avoidable legal issues.   Unless, of course, one relies on “as far as is reasonably practicable” after someone may have been seriously injured or died on your premises.  It is doubtful that the relatives of the deceased would be so forgiving.  (Consider the actions of concerned relatives following the Kerang court case decision.)

Ask yourself, is it better to have a trained first aider on site just in case, or rely on an ambulance being readily available and render no assistance?

Time is crucial in an emergency, with the risk of a person’s condition becoming more serious the longer treatment is delayed.  Emergency ambulances, even in metropolitan areas, can be delayed and, in an emergency, waiting with an unconscious and/or non-breathing person will seem an eternity.  Any delay in rendering appropriate first aid treatment will complicate proving that an appropriate duty of care was applied in the circumstance.

The Australian Resuscitation Council has made its guidelines available online. For those interested in establishing an appropriate level of first aid response for their workplaces, the guidelines are recommended to read.  But more importantly is the need to have suitably trained first aiders on site, particularly after an assessment of the workplace’s  first aid needs has been conducted.  A first aid kit is next to useless if CPR is required.

Of course, the need for first aid is minimised if all the other OHS matters are dealt with first in an orderly safety management system.

Kevin Jones

New Australian OHS statistics

Safe Work Australia released two OHS statistical reports in June 2009 – Mesothelioma in Australia, Incidence 1982 to 2005, Deaths 1997 to 2006 and Notified Fatalities Statistical Report, July 2008 to December 2008.

Both reports are recommended for those statistic junkies out there as the analysis and trends are sadly illustrative, however some of the highlights, if they can be called that, are:

  • In 2005, the age-standardised rate of new cases of mesothelioma was 2.8 per 100 000 population.
  • In 2006, the age-standardised rate of death due to mesothelioma was 2.3 deaths per 100 000 population.

The death rate has remained stable.

MESOTHELIOMA IN AUSTRALIA
INCIDENCE 1982 TO 2005
DEATHS 1997 TO 2006

More detailed information is available in the fatalities report however below are some main findings

There were 88 notified work-related fatalities.

The majority of fatalities were male.

Workers aged 55 years and over accounted for one-fifth (20%) of worker fatalities.

Four industries accounted for over three-quarters of all notified work-related fatalities, in descending order:

  • Agriculture, forestry and fishing,
  • Construction;
  • Transport and storage;
  • Manufacturing

The most common causes of work-related fatalities were, in descending order:

  • Vehicle accident;
  • Being hit by moving objects;
  • Being hit by falling objects;
  • Drowning/immersion; and
  • Falls from a height.

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Worker health continues to get government support

Just because Victoria’s WorkHealth program is not functioning anywhere near its initial intention, it does not mean that the issue of workers’ poor health is being ignored.  In mid-June 2009, Australia’s federal government announced a targeted program called the Tradies Tune-Up.

The funding for this program is very modest in comparison with WorkHealth’s proposed riches.  According to a media statement, the government is allocating $A219,500 to “monitor and check on the health of building and construction workers.”  This sector was chosen because statistics show

“…that men working in manual occupations, like construction, have higher mortality rates, disability and serious chronic disease than other professions.  Statistically, they are also at greater risk of self-harm and suicide.”

This program has a greater opportunity for success as it is coordinated through  OzHelp Foundation, a partnership between the ACT branches of the Master Builders Association and the Construction, Forestry, Mining and Energy Union.  The construction unions, to the knowledge of SafetyAtWorkBlog, have always had strong mental health and wellbeing support programs, often run through chaplaincies, a much neglected form of employee assistance program.

As has occurred elsewhere in Australian workplace services, the program will operate with the support of a mobile assessment vans.  The program will have

“a specially equipped van and accompanying health staff including a registered nurse will set-up ‘pit-stops’ at construction and building sites testing workers in 20 minute sessions on their levels of cholesterol, blood pressure, blood glucose and waist size.”

The government has also committed to develop a National Men’s Health Policy to be finalised later this year.

Health assessment programs that go to the workplace and, importantly, have the support of the union movement have a good chance of success but that success is not just the number of visits.  They must have tangible health improvements to the workers.

Also assessments are not enough to simply inform someone they are fat and unhealthy. There must be a support program for health improvement and the reduction of unhealthy distractions.

OzHelp should not be seen as a Rudd government initiative or only something that can thrive under a sympathetic Labour government.  The foundation has existed for almost five years as can be seen by this media statement.

Such programs also must operate with specific performance benchmarks.  Currently there is no information available about program benchmarks or what timeline is being applied to the program.  As the  program is receiving government funding, it may be necessary to await for department annual reports, if this type of program is reported at all.

Kevin Jones

Flawed first aid information

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 addressing the St John Ambulance 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

Tasers as personal protective equipment

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

2006 interview with Dr Jukka Takala of EU-OSHA

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

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Level crossings and safety management

Regular readers will know that SafetyAWorkBlog believes that there is little justification for road/rail crossings, particularly in metropolitan areas, and that grade separation should be the aim of any crossing upgrades.  Too often governments dismiss grade separation without serious consideration because it is usually the most expensive control option.  Regardless of expense, elimination of hazards must be considered in public safety policy and OHS.  It is only after the elimination of a hazard is seriously considered that lower order control measures are seen to be valid.

At the moment in Victoria, there is community outrage because the truck driver involved in the deaths of 11 train passengers at a level crossing at Kerang has been cleared of any legal responsibility for the deaths.  Several relatives of victims are pursuing civil action against the driver, Mr Christiaan Scholl.

The wisdom of civil action against the driver is debatable as any potential financial “win” will come from the insurance pockets of the Transport Accident Commission and not Mr Scholl.  Compensation may be gained but any hope that the action could be seen as a “penalty” is false.

The Kerang rail crossing illustrates some basic OHS issues:

Worker responsibility

The Kerang level crossing had design deficiencies that had repeatedly identified by a number of government authorities, local companies and the public.  The court case heard that the crossing was known to be dangerous.

In OHS, known hazards are controlled in a number of ways.  Clearly the rail and road traffic was not separated and engineering controls were not introduced at the time of the incident.  The owners of the crossing (and this is debated also) determined that signage was appropriate (or even perhaps “as far as is reasonably practicable”?).

Clearly signage was not adequate but there is also the issue of driver (worker) responsibility.  It was mentioned in court and repeatedly in the media that the level crossing was known to be dangerous.  Why then, would drivers continue to treat the crossing as if it was not?  The legal speed limits remained at 100kph, at the time of the incident.  The road laws clearly state that road traffic must give way to rail traffic and yet drivers have admitted to complacency.

This is perhaps the source of a lot of the community outrage in relation to the Kerang incident.  The findings in favour of the driver place all the responsibility for the incident on the inadequate design of the crossing.

Working environment

As employers have responsibility to ensure a safe and health work environment, so government has a social and legal obligation to make public areas safe.  Victorian governments for decades have neglected the hazards presented by inadequately designed or controlled level crossings.  Governments must take responsibility for inaction just as much as taking credit for action and infrastructure improvements.

Infrastructure spending had started to increase prior to the incident but the need was sharply illustrated through the unnecessary deaths of 11 rail passengers.  Many Australian governments are spending millions of dollars on rail/road crossing upgrades as a result of the Kerang incident.

Road Safety and OHS

Many OHS professionals illustrate OHS by drawing on road safety.  The correlation is very poor but the attempt is understandable – most people drive, they drive within strict laws that were learnt in training (induction), and the road laws are enforced by an external body (police = WorkSafe.  However, this relationship has no corresponding role for employers, who have a workplace responsibility.  The road user has a direct relationship with the regulator. In OHS the role of the employer is crucial.

Perhaps the Kerang incident and other level crossing incidents could be used in brainstorming to illustrate personal accountability, employer accountability and government responsibility.  It would be a worthwhile exercise to discuss whether road safety and workplace safety could share as many educative elements as some of the advocates suggest.

As with most posts on SafetyAtWorkBlog, these thoughts are a work-in-progress and debate and commentary are welcome.

Kevin Jones

Note: SafetyAtWorkBlog is not privy to any of the court evidence and must rely on media reports.  More information will be presented when available.

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