Paula Coleman, Carpenters Health and Safety Fund
MS. STOCK: So with those remarks, I'd like to introduce our first panelist.
Paula Coleman is with the Carpenter's Health and Safety Fund. She's been working for 17 years in the field of occupational safety and health with a number of different unions from ILGWU all the way to the Carpenter's and she has written ergonomic training program and manuals and developed and conduct "Train the Trainer Programs" for union members to encourage interaction and problem solving. She's also written manuals on hazardous waste and protection and confined space. I'd like to introduce Paula Coleman.
MS. COLEMAN: Thank you, Laura. Good afternoon. What I'd like to do this afternoon is just give you a brief overview of the training program that the Carpenter's Union Health and Safety Fund developed with funding from NIOSH. We were given the funding in 1992 to develop a training program and then to evaluate the effectiveness of that training in reducing work related musculoskeletal disorders among carpenters.
Because ergonomists in the program knew nothing about construction, and the carpenters knew about ergonomics, and neither group knew how to teach it, we created a focus group with representatives from labor, management, joint apprenticeship training schools and the safety and health research and assessment program at the Department of Labor and Industries in Washington State. This focus group helped the Health and Safety Fund's ergonomist and the curriculum writer to develop the program.
Despite some wrong turns and some dead ends, the focus group over these four years of the grant was able to accomplish quite a lot. We assessed the musculoskeletal risks of construction carpentry. We developed a four-hour ergonomics awareness training program for apprentices. We chose apprentices, because they're the future of the industry but also they're a captive audience. We produced a student manual and pocket guide on ergonomics and booklets on concrete form work and drywall. And we evaluated some various tools that are being market as ergonomically designed. Finally, we conducted post-training interviews with apprentices and contractors who had participated in the awareness program.
We wanted to find out what the training impact had been and also what suggestions apprentices had for making construction carpentry easier and safer.
The original study plan that we developed for calls for three study groups. Group I would receive ergonomics awareness training. Group II would receive ergonomics awareness training and what we called without really knowing what we meant, integrated ergonomics training. And the third group would not get any ergonomics training at all. To evaluate the effectiveness, we would then compare cumulative trauma disorder claims among the three groups. This data, when analyzed, will be helpful. But as an indication of the effectiveness of this training, I believe that this scientific model is flawed.
It's not clear that the effectiveness of training in reducing CTD's can be measured by looking at workers' comp and health and welfare claims. How can four hours of training affect the development of CTD's when the conditions to which carpenters are exposed remain the same? Training apprentices to recognize risk factors does not translate into the significant work site changes that are needed to reduce work related CTD's. Unless conditions on construction sites change conditions which include tools, equipment, organization, layout, specialization, storage of materials, delivery of materials, housekeeping and bidding procedures, trained carpenters, especially apprentices, are not going to be able to adopt the risk reducing behaviors they've learned.
Though the funding was for development, implementation and training evaluation only, we first needed to understand what the risk factors were for construction carpenters. Is there risk? Is their work repetitive enough to produce CTD's? Is hammering the problem? Are CTD's even an issue when compared to falls and being struck by objects. To find out, we asked carpenters to self report their musculoskeletal symptoms. Seventy-one percent reported pain in at least one body part.
Developing the curriculum (I was the curriculum writer), I wanted to make sure that we did not have a four hour lecture on bio-mechanics and the NIOSH lifting formula. I actually didn't want any kind of a lecture at all. We wanted students to become involved in the training. We wanted them to be active in the classroom and then active on the job site in protecting their own bodies. We wanted apprentices to recognize the risk factors of any job they were given. To recognize the signs and symptoms of CTD's and to understand the long term consequences of lack of treatment and prevention.
Mainly, we wanted participants to think about how to change their work to reduce the risk of developing CTD's.
MS. COLEMAN: Here's a quick example of one way to teach about risk factors. This is something you're all going to do. You have to work with the person sitting next to you.
MS. COLEMAN: Okay. What you need to do. And, Laura, maybe you can do this with me. Okay. Somebody holds a pen straight out in front of you in your hand in sort of a neutral power grip. The person sitting next to you has to try and pull that pen out of your hand. Okay. Now, bend your wrist all the way down, all the way down and now try and pull that pen ---
If you want, you can reverse roles so you see what it feels like.
MS. COLEMAN: So what risk factor does that teach? Awkward posture. That's the kind of posture carpenters are in all day long. It is enormously fatiguing. Although our training also includes many physical activities, the most valuable aspect of the training has students working together in small groups to evaluate their own activities in terms of CTD risks. They develop alternative work practices which, without reducing productivity, reduce the risks to which they are exposed. Students working in small groups select one tool which they believe requires redesigning in order to reduce their risks.
These designs have produced everything from a nailer with the comfort of a golf cart to realistic easily implemented improvements which would reduce external contact stress, overhead work, repetitive large motions of the arm and shoulder, relieve trigger finger, redistribute weight and balance and allows ground level work to be done from a standing position. A few of those tool designs are over there on the wall. You'll see that the first one there is a sandblaster's helmet. And although it does have a nicotine patch in it, it also has an inflatable collar which keeps the toxins out and relieves stress upon the neck and shoulder muscles.
MS. COLEMAN: The painter sander which is the second one looks very much like the sanders being used now, but by using grip stoppers and a cable, that tool allows painters to sand ceilings with a one arm motion instead of forcefully reaching this way (indicating) with back, shoulders and both arms. One of my favorites is this painter's idea of an ergonomically enhanced tool for carpenters.
MS. COLEMAN: The truth is that many of the improvements the students have designed could be incorporated into tool production right now. It requires the commitment of tool manufacturers and major consumers. Using the focus group model, tools could be designed by engineers and users.
Tool evaluations became an unanticipated undertaking of that project. To be useful, the training had to include realistic suggestions for ways to reduce musculoskeletal stress. These suggestions needed to provide apprentices with actions that would be under their extremely limited control and which would also serve to demonstrate new technology and equipment to contractors and owners.
Because ergonomics is a buzz word of the mid-90's with everything from $70 martini glasses to $400 handbags marketed as economically designed, we decided to evaluate some ergonomic construction tools for ourselves. On site, but also in the lab with heart and muscle monitors, we tested three different kinds of equipment for carrying drywall. We also tested hydraulic drywall lifts. We tried the two-wheel wheel barrow and an adjustable shovel. Unfortunately, most of these tools were inadequately designed or constructed. The point is that tools and equipment cannot be adequately designed or evaluated without the participation of the skilled users of those tools.
Our training program is taught by skilled crafts people. I believe that's the key. That's what makes it work. In 1994, OSHA funded us to take the training we had developed under the NIOSH grant nationwide. We used the funding to train trainers. We now have over 150 skilled carpenters, millwrights and piledrivers teaching ergonomics awareness to their respective apprentices and journeymen. And we've begun to train trainers from other trades, painters, sheet metal workers and asbestos insulators.
To date, about 5,000 carpenters, mainly apprentices, have taken this ergonomics awareness course. We've just completed a series of interviews with the apprentices in Seattle who have taken the training. In a minute, I'd like to close with some of their responses. In the future, we're going to increase mixed trades training so that it provides a unique opportunity to look at construction organizations and planning issues. It encourages cross-fertilization of ideas. We're improving the integration of skills and ergonomics instruction for apprentices. We'd like to see the focus group model expanded to include owners, architects and engineers - people who have the authority to change structures and worksite culture. Their participation would enable us to design and engineer-out many hazards.
This program worked, because it is immediately relevant to construction carpenters. It builds upon the knowledge and experience of skilled craftsmen who have bad backs, bad shoulders, bad arms, bad hands but who now know how to work safer and smarter. It's effective because these injured carpenters want to make sure that those just starting out in the trade do not suffer the same life-and livelihood-diminishing injuries.
I'd like to end with the apprentices' assessment of how effective this training has been for them. When we asked them if they were able to put what they had learned to use on the job, 88 percent said that they were more aware of all of their work activities and how they might change them. Eighty-five percent said they lifted differently. Fifty-three percent said they used micro-breaks at work either by varying their tasks or by taking a 10 to 20 second stretch. Thirty-six percent said it changed the way they carried materials, and eighteen percent said it helped them select better tools. Ten percent said their foremen prevented them from working safer.
We asked the apprentices how to change the awareness and behavior of co-workers, foremen, superintendents and contractors. Seventy-six percent said mandatory training for carpenters, foremen and superintendents. Finally, when we asked if they were interested in an advanced or a refresher course which would be on their own time, 89 percent said, yes, they would. Thank you.
MS. STOCK: Thank you, Paula. We're going to actually hold questions till the end in order to give all of our speakers an opportunity to speak, but we're really very committed to leaving 20 to 25 minutes at the end for a general discussion.
