A 1981 study of worker safety and health training in the industrial nations begins by quoting the French writer Victor Hugo: “No cause can succeed without first making education its ally” (Heath 1981). This observation surely still applies to occupational safety and health in the late twentieth century, and is relevant to organization personnel at all levels.
As the workplace becomes increasingly complex, new demands have arisen for greater understanding of the causes and means of prevention of accidents, injuries and illnesses. Government officials, academics, management and labour all have important roles to play in conducting the research that furthers this understanding. The critical next step is the effective transmission of this information to workers, supervisors, managers, government inspectors and safety and health professionals. Although education for occupational physicians and hygienists differs in many respects from the training of workers on the shop floor, there are also common principles that apply to all.
National education and training policies and practices will of course vary according to the economic, political, social, cultural and technological background of the country. In general, industrially advanced nations have proportionally more specialized occupational safety and health practitioners at their disposal than do the developing nations, and more sophisticated education and training programmes are available to these trained workers. More rural and less industrialized nations tend to rely more on “primary health care workers”, who may be worker representatives in factories or fields or health personnel in district health centres. Clearly, training needs and available resources will vary greatly in these situations. However, they all have in common the need for trained practitioners.
This article provides an overview of the most significant issues concerning education and training, including target audiences and their needs, the format and content of effective training and important current trends in the field.
In 1981, the Joint ILO/WHO Committee on Occupational Health identified the three levels of education required in occupational health, safety and ergonomics as (1) awareness, (2) training for specific needs and (3) specialization. These components are not separate, but rather are part of a continuum; any person may require information on all three levels. The main target groups for basic awareness are legislators, policy makers, managers and workers. Within these categories, many people require additional training in more specific tasks. For example, while all managers should have a basic understanding of the safety and health problems within their areas of responsibility and should know where to go for expert assistance, managers with specific responsibility for safety and health and compliance with regulations may need more intensive training. Similarly, workers who serve as safety delegates or members of safety and health committees need more than awareness training alone, as do government administrators involved in factory inspection and public health functions related to the workplace.
Those doctors, nurses and (especially in rural and developing areas) nonphysician primary health care workers whose primary training or practice does not include occupational medicine will need occupational health education in some depth in order to serve workers, for example by being able to recognize work-related illnesses. Finally, certain professions (for example, engineers, chemists, architects and designers) whose work has considerable impact on workers’ safety and health need much more specific education and training in these areas than they traditionally receive.
Specialists require the most intensive education and training, most often of the kind received in undergraduate and postgraduate programmes of study. Physicians, nurses, occupational hygienists, safety engineers and, more recently, ergonomists come under this category. With the rapid ongoing developments in all of these fields, continuing education and on-the-job experience are important components of the education of these professionals.
It is important to emphasize that increasing specialization in the fields of occupational hygiene and safety has taken place without a commensurate emphasis on the interdisciplinary aspects of these endeavours. A nurse or physician who suspects that a patient’s disease is work-related may well need the assistance of an occupational hygienist to identify the toxic exposure (for example) in the workplace that is causing the health problem. Given limited resources, many companies and governments often employ a safety specialist but not a hygienist, requiring that the safety specialist address health as well as safety concerns. The interdependence of safety and health issues should be addressed by offering interdisciplinary training and education to safety and health professionals.
Why Training and Education?
The primary tools needed to achieve the goals of reducing occupational injuries and illnesses and promoting occupational safety and health have been characterized as the “three E’s”—engineering, enforcement and education. The three are interdependent and receive varying levels of emphasis within different national systems. The overall rationale for training and education is to improve awareness of safety and health hazards, to expand knowledge of the causes of occupational illness and injury and to promote the implementation of effective preventive measures. The specific purpose and impetus for training will, however, vary for different target audiences.
Middle and upper level managers
The need for managers who are knowledgeable about the safety and health aspects of the operations for which they are responsible is more widely acknowledged today than heretofore. Employers increasingly recognize the considerable direct and indirect costs of serious accidents and the civil, and in some jurisdictions, criminal liability to which companies and individuals may be exposed. Although belief in the “careless worker” explanation for accidents and injuries remains prevalent, there is increasing recognition that “careless management” can be cited for conditions under its control that contribute to accidents and disease. Finally, firms also realize that poor safety performance is poor public relations; major disasters like the one in the Union Carbide plant in Bhopal (India) can offset years of effort to build a good name for a company.
Most managers are trained in economics, business or engineering and receive little or no instruction during their formal education in occupational health or safety matters. Yet daily management decisions have a critical impact on employee safety and health, both directly and indirectly. To remedy this state of affairs, safety and health concerns have begun to be introduced into management and engineering curricula and into continuing education programmes in many countries. Further efforts to make safety and health information more widespread is clearly necessary.
Research has demonstrated the central role played by first-line supervisors in the accident experience of construction employers (Samelson 1977). Supervisors who are knowledgeable about the safety and health hazards of their operations, who effectively train their crew members (especially new employees) and who are held accountable for their crew’s performance hold the key to improving conditions. They are the critical link between workers and the firm’s safety and health policies.
Law, custom and current workplace trends all contribute to the spread of employee education and training. Increasingly, employee safety and health training is being required by government regulations. Some apply to general practice, while in others the training requirements are related to specific industries, occupations or hazards. Although valid evaluation data on the effectiveness of such training as a countermeasure to work-related injuries and illnesses are surprisingly sparse (Vojtecky and Berkanovic 1984-85); nevertheless the acceptance of training and education for improving safety and health performance in many areas of work is becoming widespread in many countries and companies.
The growth of employee participation programmes, self-directed work teams and shop floor responsibility for decision-making has affected the way in which safety and health approaches are taken as well. Education and training are widely used to enhance knowledge and skills at the level of the line worker, who is now recognized as essential for the effectiveness of these new trends in work organization. A beneficial action employers can take is to involve employees early on (for example, in the planning and design stages when new technologies are introduced into a worksite) to minimize and to anticipate adverse effects on the work environment.
Trade unions have been a moving force both in advocating more and better training for employees and in developing and delivering curricula and materials to their members. In many countries, safety committee members, safety delegates and works council representatives have assumed a growing role in the resolution of hazard problems at the worksite and in inspection and advocacy as well. Persons holding these positions all require training that is more complete and sophisticated than that given to an employee performing a particular job.
Safety and health professionals
The duties of safety and health personnel comprise a broad range of activities that differ widely from one country to another and even within a single profession. Included in this group are physicians, nurses, hygienists and safety engineers either engaged in independent practice or employed by individual worksites, large corporations, government health or labour inspectorates and academic institutions. The demand for trained professionals in the area of occupational safety and health has grown rapidly since the 1970s with the proliferation of government laws and regulations paralleling the growth of corporate safety and health departments and academic research in this field.
Scope and Objectives of Training and Education
This ILO Encyclopaedia itself presents the multitude of issues and hazards that must be addressed and the range of personnel required in a comprehensive safety and health programme. Taking the large view, we can consider the objectives of training and education for safety and health in a number of ways. In 1981, the Joint ILO/WHO Committee on Occupational Health offered the following categories of educational objectives which apply in some degree to all of the groups discussed thus far: (1) cognitive (knowledge), (2) psychomotor (professional skills) and (3) affective (attitude and values). Another framework describes the “information–education–training” continuum, roughly corresponding to the “what”, the “why” and the “how” of hazards and their control. And the “empowerment education” model, to be discussed below, puts great emphasis on the distinction between training—the teaching of competency-based skills with predictable behavioural outcomes—and education—the development of independent critical thinking and decision-making skills leading to effective group action (Wallerstein and Weinger 1992).
Workers need to understand and apply the safety procedures, proper tools and protective equipment for performing specific tasks as part of their job skills training. They also require training in how to rectify hazards that they observe and to be familiar with internal company procedures, in accordance with the safety and health laws and regulations which apply to their area of work. Similarly, supervisors and managers must be aware of the physical, chemical and psychosocial hazards present in their workplaces as well as the social, organizational and industrial relations factors that may be involved in the creation of these hazards and in their correction. Thus, gaining knowledge and skills of a technical nature as well as organizational, communication and problem-solving skills are all necessary objectives in education and training.
In recent years, safety and health education has been influenced by developments in education theory, particularly theories of adult learning. There are different aspects of these developments, such as empowerment education, cooperative learning and participative learning. All share the principle that adults learn best when they are actively involved in problem-solving exercises. Beyond the transmission of specific bits of knowledge or skills, effective education requires the development of critical thinking and an understanding of the context of behaviours and ways of linking what is learned in the classroom to action in the workplace. These principles seem especially appropriate to workplace safety and health, where the causes of hazardous conditions and illnesses and injuries are often a combination of environmental and physical factors, human behaviour and the social context.
In translating these principles into an education programme four categories of objectives must be included:
Information objectives: the specific knowledge that trainees will acquire. For example, knowledge of the effects of organic solvents on the skin and on the central nervous system.
Behavioural objectives: the competencies and skills that workers will learn. For example, the ability to interpret chemical data sheets or to lift a heavy object safely.
Attitude objectives: the beliefs that interfere with safe performance or with response to training that must be addressed. The belief that accidents are not preventable or that “solvents can’t hurt me because I’ve worked with them for years and I’m fine” are examples.
Social action objectives: the ability to analyse a specific problem, identify its causes, propose solutions and plan and take action steps to resolve it. For example, the task of analysing a particular job where several people have sustained back injuries, and of proposing ergonomic modifications, requires the social action of changing the organization of work through labour-management cooperation.
Technological and Demographic Change
Training for awareness and management of specific safety and health hazards obviously depends on the nature of the workplace. While some hazards remain relatively constant, the changes that take place in the nature of jobs and technologies require continuous updating of training needs. Falls from heights, falling objects and noise, for example, have always been and will continue to be prominent hazards in the construction industry, but the introduction of many kinds of new synthetic building materials necessitates additional knowledge and awareness concerning their potential for adverse health effects. Similarly, unguarded belts, blades and other danger points on machinery remain common safety hazards but the introduction of industrial robots and other computer-controlled devices requires training in new types of machinery hazards.
With rapid global economic integration and the mobility of multinational corporations, old and new occupational hazards frequently exist side-by-side in both highly industrialized and developing countries. In an industrializing country sophisticated electronics manufacturing operations may be located next door to a metal foundry that still relies on low technology and the heavy use of manual labour. Meanwhile, in industrialized countries, garment sweatshops with miserable safety and health conditions, or lead battery recycling operations (with its threat of lead toxicity) continue to exist alongside highly automated state-of-the-art industries.
The need for continual updating of information applies as much to workers and managers as it does to occupational health professionals. Inadequacies in the training even of the latter is evidenced by the fact that most occupational hygienists educated in the 1970s received scant training in ergonomics; and even though they received extensive training in air monitoring, it was applied almost exclusively to industrial worksites. But the single largest technological innovation affecting millions of workers since that time is the widespread introduction of computer terminals with visual display units (VDUs). Ergonomic evaluation and intervention to prevent musculoskeletal and vision problems among VDU users was unheard of in the 1970s; by the mid-nineties, VDU hazards have become a major concern of occupational hygiene. Similarly, the application of occupational hygiene principles to indoor air quality problems (to remedy “tight/sick building syndrome”, for example) has required a great deal of continuing education for hygienists accustomed only to evaluating factories. Psychosocial factors, also largely unrecognized as occupational health hazards before the 1980s, play an important role in the treatment of VDU and indoor air hazards, and of many others as well. All parties investigating such health problems need education and training in order to understand the complex interactions among environment, the individual and social organization in these settings.
The changing demographics of the workforce must also be considered in safety and health training. Women make up an increasing proportion of the workforce in both developed and developing nations; their health needs in and out of the workplace must be addressed. The concerns of immigrant workers raise numerous new training questions, including those to do with language, although language and literacy issues are certainly not limited to immigrant workers: varying literacy levels among native-born workers must also be considered in the design and delivery of training. Older workers are another group whose needs must be studied and incorporated into education programmes as their numbers increase in the working population of many nations.
Training Venues and Providers
The location of training and education programmes is determined by the audience, the purpose, the content, the duration of the programme and, to be realistic, the resources available in the country or region. The audience for safety and health education starts with schoolchildren, trainees and apprentices, and extends to workers, supervisors, managers and safety and health professionals.
Training in schools
Incorporation of safety and health education into elementary and secondary education, and especially in vocational and technical training schools, is a growing and very positive trend. The teaching of hazard recognition and control as a regular part of skills training for particular occupations or trades is far more effective than trying to impart such knowledge later, when the worker has been in the trade for a period of years, and has already developed set practices and behaviours. Such programmes, of course, necessitate that the teachers in these schools also be trained to recognize hazards and apply preventive measures.
On-the-job training at the worksite is appropriate for workers and supervisors facing specific hazards found onsite. If the training is of significant length, a comfortable classroom facility within the worksite is strongly recommended. In cases where locating the training at the workplace may intimidate workers or otherwise discourage their full participation in the class, an offsite venue is preferable. Workers may feel more comfortable in a union setting where the union plays a major role in designing and delivering the programme. However, field visits to actual work locations which illustrate the hazards in question are always a positive addition to the course.
Training of safety delegates and committee members
The longer and more sophisticated training recommended for safety delegates and committee representatives is often delivered at specialized training centres, universities or commercial facilities. More and more efforts are being made to implement regulatory requirements for training and certification of workers who are to perform in certain hazardous fields such as asbestos abatement and hazardous waste handling. These courses usually include both classroom and hands-on sessions, where actual performance is simulated and specialized equipment and facilities are required.
Providers of onsite and offsite programmes for workers and safety representatives include government agencies, tripartite organizations like the ILO or analogous national or sub-national bodies, business associations and labour unions, universities, professional associations and private training consultants. Many governments provide funds for the development of safety and health training and education programmes targeted at specific industries or hazards.
Academic and professional training
The training of safety and health professionals varies widely among countries, depending on the needs of the working population and the country’s resources and structures. Professional training is centred in undergraduate and postgraduate university programmes, but these vary in availability in different parts of the world. Degree programmes may be offered for specialists in occupational medicine and nursing and occupational health may be incorporated into the training of general practitioners and of primary care and public health nurses. The number of degree-granting programmes for occupational hygienists has increased dramatically. However, there remains a strong demand for short courses and less comprehensive training for hygiene technicians, many of whom have received their basic training on the job in particular industries.
There is an acute need for more trained safety and health personnel in the developing world. While more university-trained and credentialed physicians, nurses and hygienists will undoubtedly be welcomed in these countries, it is nonetheless realistic to expect that many health services will continue to be delivered by primary health care workers. These people need training in the relationship between work and health, in the recognition of the major safety and health risks associated with the type of work carried on in their region, in basic survey and sampling techniques, in the use of the referral network available in their region for suspected cases of occupational illness and in health education and risk communication techniques (WHO1988).
Alternatives to university-based degree programmes are critically important to professional training in both developing and industrialized nations, and would include continuing education, distance education, on-the-job training and self-training, among others.
Education and training cannot solve all occupational safety and health problems, and care must be taken that the techniques learned in such programmes are in fact applied appropriately to the identified needs. They are, however, critical components of an effective safety and health programme when employed in conjunction with engineering and technical solutions. Cumulative, interactive and continuous learning is essential to prepare our rapidly changing work environments to meet the needs of workers, especially as regards the prevention of debilitating injuries and illnesses. Those who labour in the workplace as well as those who provide support from the outside need the most up-to-date information available and the skills to put this information to use in order to protect and promote worker health and safety.