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Examining the Impact of Narrative Case Studies in Toolbox Talks for

Building Construction

Terri Heidotting, Ed.D.Education and Information Division

NIOSH

Best Practices in Occupational Safety and Health,

Education, Training, and Communication: Ideas That Sizzle

Baltimore, Md - October 2002

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Injury and Fatality Incidence Rates

Fatal Occuptional Injuries by Industry (2001)

22.8

30

13.3

3.2

12.9

4.3

2.4

3.9

3.1

Agriculture

Mining

Construction

Manufacturing

Transportation

Wholesale

Retail

Services/Other

Government

Sources: BLS Census of Fatal Occuptional Injuries and Employment by Industry, 2001 (http://www.bls.gov/news.release/cfoi.t04.htm); BLS Incidence Rates of Nonfatal Occuptional Injuries and Illnesses by Industry Division and Selected Case Types, 1998-2000, Table 7 (http://www.bls.gov/news.release/osh.t07.htm )

Nonfatal Occupational Injury / Illness by Industry (2000)

7.1

4.7

8.3

9

6.9

5.8

5.9

6.8

Agriculture

Mining

Construction

Manufacturing

Transportation

Wholesale

Retail

Services/Other

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What are “Toolbox Talks”• Also called “tailgate” talks

used in wide range of industries – construction, mining, agriculture

• Brief (10-15 minute) weekly safety training sessions (“talks”)

• Safety talks conducted on the work site

• Safety talk conducted by the site supervisor, foreman, safety supervisor, or senior employee

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Background

• Previous focus groups on improving toolbox talks - Role of narratives / stories

• Need for quality training materials that are:– Inexpensive and easily accessible– Have a wide variety of safety topics– Evaluated for their effectiveness

• Safety training materials developed with input from the industry

• Instructional design of materials grounded in accepted learning theories

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Training Intervention Effectiveness Research (TIER)

• Formative Evaluation: – Determination of training needs– Conceptualization of goals and objectives to meet the needs

• Process Evaluation: – Development of draft training materials– Field testing of data collection instruments

• Outcome Evaluation: – Controlled study to determine if intended outcomes are obtained and

sustained – Identification if critical elements

• Impact Assessment: – Longitudinal study - Did training met the educational needs identified

in Stage 1– Examination of the impact of training on the learner and learner’s

environment

NIOSH Publication Number: 99-142 Website: http://www.cdc.gov/niosh/99-142.html

T IE R

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Pilot Study

• Draft toolbox lessons– Treatment – with story

(narrative)– Control – without story

(company’s own lessons)• Data collection and analyses

– Focus groups– Interviews– Observations of training

sessions• Participants

– Electricians, carpenters, laborers with 4 to 38 years of experience

• Feedback from instructors and employees

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Toolbox Talks – Meeting the Needs of Instructors and Employees

• Instructors– Uncomfortable presenting materials in front of others– Want to present quality materials that will keep the employees interest

and encourage their participation• “Typical toolbox materials are “pretty lame” • “It just goes in one ear and out the other” • Employees “aren’t paying attention…don’t care to be there…they

want to sign their name and leave.”– Want materials that are easy to use

• Don’t have pre-training preparation time• Employees

– Want quality materials that are interesting• “Sometimes it seems like it never happened”• Ineffective toolbox talks are “rushed for time…you’re going to lose

your interest right off the bat”– Want topics that reflect work being done– “Get to the point!”

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Pilot Versions of NIOSH Toolbox Talks for Construction

Building Construction

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Preventing Falls From Extension Ladders In building construction, falls from ladders occur frequently, and for a variety of reasons. Here are the details of a fatal fall from a section of an extension ladder: A two man crew was finishing up on a jobsite after replacing the roofing material on a bank building. The two workers decided to use the two halves of an extension ladder separately. They placed the lower section of the extension ladder (with proper feet attached) against a roof over top the drive-in banking lanes. One worker took the upper section of the ladder (with rounded end caps, but no feet) to finish some work on a small section of roof over a bank entrance. After completing this task, the same worker placed the upper section against the roof beside the lower section. After retrieving tools, including a bristle-head broom, he began to climb the upper section of the ladder. He was nearly to the roof, when the ladder slid outward at the bottom. The worker fell with the ladder. The broom, which was being carried with the bristles down, struck the pavement, and then the victim’s head struck the handle end of the broom stick. A bank employee heard the fall, looked out a window, and saw the victim on the ground. The injured worker was semi-conscious when the emergency squad arrived and transported him to a local hospital for treatment. Shortly after arriving at the hospital, he was taken to a regional trauma center by air ambulance, where he died the following day. Discussion: Based on this brief description, what do you think went wrong? Do you think carrying tools, materials and a broom up the ladder contributed to this fatal fall? What else might have contributed? Have you ever fallen, or nearly fallen from a ladder? Do any of you know anyone who has fallen from a ladder? (Tell us what happened.) How could a fall like this have been prevented?

Preventing Falls From Extension Ladders: Probably the biggest risk in the use of portable ladders is that the ladder will slip from its position and cause a worker to fall. Incorrect use of ladders may result in the bottom of ladders slipping outward, or ladders that fall to one side or another. In the case described above there were several factors that contributed to the fatal fall. For instance, the sections of extension ladders should never be separated for individual use. The upper sections rarely have proper feet. These sections can slip out if used like other portable ladders with feet. It is usually very risky to attempt to carry tools or materials while climbing up or down a ladder. The three-point-contact rule should be followed: two feet and a hand, or two hands and a foot, should always be in contact with the ladder. Finally, it is usually a good idea to secure the ladder at both top and bottom, using equipment such as ladder spurs; this makes good sense especially if the ladder will be used in one position for a while. This may seem like a freak accident because the fatal injury occurred when the worker struck his head on the handle end of a broom, but the circumstances of this fall are very common. Any time a ladder slips or is dislodged from its position while a worker is on it, that worker is in danger of falling and striking the ground, equipment or materials, parts of the building or the ladder itself, causing serious even fatal injury. Other tips for safe ladder use:

Non-self-supporting portable ladders should be placed at a horizontal-to-vertical angle of no more than 1:4. This simply means that the base should not extend out from the supporting vertical wall more than 1/4 the overall height of the ladder.

The side rails of portable ladders should extend at least 3 feet above the landing. (When this is not possible, secure the side rails at the top to a rigid support and use a grab device.)

Make sure that the weight on the ladder will not cause it to slip off its support.

Before each use inspect ladders for cracked or broken parts such as rungs, steps, side rails, feet and locking components.

Do not apply more weight on the ladder than it is designed to support Use only ladders that comply with OSHA design standards [1926.1053(a)(1)]

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NIOSH Narrative Toolbox TalksWhat Worked

• Real-life stories would “get my attention”

• Stories that reflect incidents in the employees’ geographical area more interesting

• Discussion questions pertaining to the story facilitated participation and interest

• Stories made the information easier to understand and remember

• Employees and instructors reported they could “relate to” the person in the story

• Safety topics reflected work done at the site

Real Life Incident—A carpenter and his co-worker were overcome by carbon monoxide (CO) when they entered a basement area where a gasoline-powered generator was lowered into the basement to serve as the source of power. The first worker used a ladder to climb down into the basement to check the generator and was overcome by carbon monoxide. The second worker, who probably entered the basement to assist the downed worker, was also overcome. The

workers were dead when they were found and the basement was…….

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NIOSH Narrative Toolbox TalksChanges Made

• Don’t include unnecessary details

• Need variety --“Everybody dies”

• Bullet additional information for easier manipulation by instructor

• Present story discussion questions immediately afterwards

• Vocabulary level of text should be simple

• Text structured to be read verbatim

• Pictures added

…the emergency squad arrived and transported him to a local hospital for treatment. Shortly after arriving at the hospital, he was taken to a regional trauma center by air ambulance, where he died the following day. Story Discussion Questions: Based on this brief description, what do you think went wrong? Preventing Falls From Extension Ladders: Probably the biggest risk in the use of portable ladders is that the ladder will slip from its position and cause a worker to fall. Incorrect use of ladders may result in the bottom of ladders slipping outward, or ladders that fall to one side or another. In the case described above there were several factors that contributed to the fatal fall. For instance, the sections of extension ladders should never be separated for individual use. The upper sections rarely have proper feet. These sections can slip out if used like other portable ladders with feet. The three-point-contact rule should be

followed: two feet and a hand, or two hands and a foot, should always be in contact with the ladder.

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Revised NIOSH Toolbox Talks for Construction

Preventing Electrocutions: Overhead

Powerlines and Boom Crane

Overhead power lines at construction sites can be an electrocution hazard for construction workers, especially when construction equipment like cranes, cherry pickers and hi-lifts are used at the site.

Overhead powerlines are not insulated, and cranes, including the boom and cables, are generally made of conductive materials. Anyone touching the body, cable, or tagline on a crane when it contacts an overhead powerline could be electrocuted.

A construction electrocution: A laborer was part of a crew that was installing steel roof joists using a boom crane. The laborer was standing by the joists, waiting to hook the joists to the choker cable, when the crane operator swung the cable toward him. He grabbed the choker, then grabbed a steel post with his other hand, to balance himself as the cable kept swinging. The cable swung out and touched the powerline, became energized, and sent electricity through the laborer, electrocuting him. They took him to the hospital, where he was pronounced dead on arrival.

1. How would you prevent an electrocution like this? 2. Do you know anyone who was injured or electrocuted when a crane contacted an overhead powerline? What happened?

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Next Steps...

• Formal study – treatment and control groups– Impact of real life cases

• Pre-training versus post-training changes in:– Knowledge gains– Safety attitudes– Site observations– Satisfaction with training– Potential differences in injury rates– Instructor feedback

• Ongoing improvements in training lessons• Development of public domain materials

accessible to all

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For more information please contact:

Terri Heidotting, Ed.D.National Institute for Occupational Safety and Health

Education and Information Division4676 Columbia Parkway, C-10

Cincinnati, Oh. 45226513/533-8325

1-800-35-NIOSH1-800-356-4674toh8@cdc.gov