Research and Practice for Fall Injury Control in the Workplace: Proceedings of International Conference on Fall Prevention and Protection. Morgantown, WV: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, DHHS (NIOSH) Publication No. 2012-103, 2011 Nov; :214-215
Approximately four U.S. construction workers are killed each day, and about a third of those are due to fatal falls. Although our understanding of causes and circumstances continues to improve, the overall rate of fatal falls in the construction sector has changed very little since the U.S. Census of Fatal Occupational Injuries was initiated in 1992. The papers in this issue reflect a sea change in the occupational safety and health research agenda over the past decade in which the U.S. has, perhaps, trailed our colleagues in the European Union. This new agenda focuses on moving injury and illness prevention interventions from research to practice (R2P), and allocation of significant research resources to address industry-sectorspecific priorities. The National Institute of Occupational Safety and Health (NIOSH) has established national multi-stakeholder sector councils, including one for construction; has established a small but valuable national construction office within the NIOSH Office of the Director, and has continued support for an extramural national construction center. It further initiated an independent evaluation of its construction programs through the National Academies, which scored this program highly in relevancy and impact. This issue demonstrates the extension beyond the laboratory of this research agenda. Starting with pursuit of epidemiological surveillance for the purpose of guiding and evaluating field R2P interventions (Dong, et al) and economic assessments for the purpose of identifying incentives and overcoming barriers to action (Biddle et al); continuing with development of technologies and evaluation of efficacy (Bobick et al); field evaluation of training and actual work practices (Evanoff, et al); followed by dissemination or technology transfer through codes and standards (Pauls on design of stairway handrails). Post-market case studies on harness suspension trauma (McCurley) illustrate the need for ongoing applied research, even beyond commercial field adoption of innovative technologies and practices. Dissemination of information to the public, technology transfer and the transition from research to practice (R2P) have long been the focus of initiatives in traditional public health practice, but have received little attention in occupational safety and health. Injury and illness prevention in small employer dominated industry sectors like construction demand that we focus on overcoming these barriers to change. A quarter of the U.S. construction workforce is self-employed, and another quarter are employed by the 80% of construction employers with fewer than 10 employees. Dissemination of information and creating incentives to change in such a dispersed and dynamic workforce is difficult. Changes to eliminate fall hazards include: improved design/engineering, site-wide approaches to improve risk communication on multi-employer sites, and major changes in work practices and equipment such as replacing ladders with aerial work platforms, scaffolds and stairways. Management systems increasingly address pre-project and pre-task planning to identify foreseeable hazards and how to control them. NIOSH's Prevention through Design (PtD) initiative encourages changes such as fabrication to facilitate anchorage for fall arrest, adoption of passive fall arrest systems such as guard rails and personnel nets instead of fall arrest harnesses which each worker must properly don and connect to appropriate anchorage points, and redesign of skylights and atriums to support the weight of workers. The list can go on, but adoption of change is challenging. Research to demonstrate feasibility and efficacy in the field, and to help overcome resistance to change is critical. Departure of our rapidly aging workforce and increasingly precarious employment threaten to increase the number of inexperienced workers, which adds to the urgency to reduce fall hazards. Working together, we can prevent many, if not all, fall-related deaths and injuries. To achieve this goal those of us in the research community must recognize and value applied research, field intervention studies, R2P, dissemination of information, and post-market effectiveness studies as planned integral components of our research protocols.
Accident-potential; Accident-prevention; Accidents; Accident-statistics; Biodynamics; Biohazards; Biomechanical-engineering; Biomechanics; Construction; Construction-industry; Construction-workers; Equipment-design; Equipment-reliability; Health-protection; Injuries; Injury-prevention; Psychological-responses; Risk-analysis; Risk-factors; Safety-education; Safety-engineering; Safety-measures; Safety-programs; Safety-research; Statistical-analysis; Training; Work-analysis; Workplace-studies