Cincinnati, OH: 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. 2014-123, 2014 May; :1-27
The national initiative on Prevention through Design (PtD) was launched in 2007 with the goal of designing out occupational hazards to protect workers. PtD involves all of the efforts to anticipate and design out hazards to workers in facilities, work methods and operations, processes, equipment, tools, products, materials, new technologies, and the organization of work [Schulte et al. 2008]. PtD utilizes the traditional hierarchy of controls by focusing on hazard elimination and substitution followed by risk minimization through the application of engineering controls and warning systems applied during design, re-design, and retrofit activities. In addition to reducing the risk of serious injury and illness, significant business costs savings are associated with hazard elimination and the application of engineering controls to minimize risks. As businesses adopt hazard control measures higher in the "hierarchy of controls," i.e., designing-out hazards and minimizing risks, business value increases. These improvements in business value are related not only to lower worker compensation rates and health care costs to care for injured workers but also to achieving faster time to market, improved operational efficiency, improved employee morale, decreased employee absenteeism and turnover, higher product quality, and increased market share. PtD also supports the application of administrative controls and personal protective equipment when they supplement or compliment an overall risk minimization strategy and include the appropriate program development, implementation, employee training and surveillance. The ultimate objective of the PtD initiative is to achieve a cultural change so that designing out occupational hazards is the norm. Progress has been made the last six years in research, education, practice, and policy outcomes. Research outcomes highlighted include a project initiated by NIOSH in partnership with ORCHSE Strategies, LLC (formerly Mercer, ORC WorldwideTM) to determine the extent to which the policies of large US-based multinational corporations stipulate that safety and health preventive measures be designed and built in, rather than added after a process has been put into operation. A survey was administered to ORC Fortune 200 member organizations to gather information on the extent to which PtD policy or practice is integrated into product design, machine design, plant layout, condition of premises, selection and specification of materials, production planning, and duties of managers and employees. The survey specifically captured information on company policies and management practices that address worker safety and health issues in the design or redesign of equipment, processes, or tools. Responses on the survey indicated that a majority (80%) of companies were aware of PtD and 77% included PtD principles in their operations. Moreover, 40% of those responding indicated that they required their suppliers and contractors to have internal PtD programs [Biddle 2011; Newell and Biddle 2011]. Education outcomes of note include the inclusion of PtD principles in 10 safety management and engineering textbooks as well as the completion of four self-contained education modules targeting students majoring in Architectural, Civil, or Construction Engineering. Each module consists of a presentation file in an Adobe format, a PowerPoint presentation, and an instructor's manual. These have been completed for Architectural Design and Construction, Reinforced Concrete, Structural Steel Design and Mechanical-Electrical Systems. Practice outcomes include 93 peer-reviewed journal articles cited over 720 times in the peer-reviewed scientific literature; the creation of a wiki to disseminate successful PtD concepts; and an outreach to industry that includes making the business case for PtD. One success story is the Construction Industry Institute research report, (RR101-11) Addressing Construction Worker Safety in the Project Design. The research effort identified and developed over 400 design suggestions that are available free to members of the Construction Industry Institute. The accumulated suggestions reflect all types of design disciplines, jobsite hazards, and construction components and systems. A computer program, titled "Design for Construction Safety ToolBox," was developed which incorporates the design suggestions accumulated. The program alerts the user to project-specific construction safety hazards and provides suggestions to eliminate or reduce those hazards during the design phase. Policy outcomes have been numerous. PtD concepts have been added to over 25 consensus standards including those by American National Standards Institute (ANSI), American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE), American Society of Safety Engineers (ASSE), American Industrial Hygiene Association (AIHA), Underwriters Laboratory (UL), Semiconductor Equipment and Materials International (SEMI), and the International Organization for Standardization (ISO). One highlight is that in 2011, the ASSE obtained approval from ANSI for ANSI/ASSE standard Z590.3, "Prevention through Design: Guidelines for Addressing Occupational Risks in Design and Redesign Processes". This standard provides guidance on including PtD concepts within an occupational safety and health (OSH) management system, and can be applied in any occupational setting. Critical to making progress in institutionalizing PtD is to continue to influence educational systems in response to demands from industry and employees. NIOSH will assess the output of educational systems in terms of trained engineers, architects, designers, and purchasers. Additionally, the practice of OSH needs to include PtD principles in risk management systems. Until PtD is central to risk management, efforts to prevent occupational illness, injury, and death will be impaired and the cost of not implementing PtD will be significant. The progress made to date is a good foundation, but more progress is needed to ensure worker protection.