Health and Safety – Summary

Topic	Study	Details	Evaluation	Application
Government data	(Cataldo et al., 1986; Haggerty, 1986; WaIler, 1987).	Government data reveal that accidental injury is: 1. · the fourth most frequent cause of death in the American population as a whole. 2. · The leading cause of death of individuals under age 45. 3. · Responsible for over half of all deaths of children and adolescents
Definition	Pheasant (1991)	defines an accident as “ an unplanned unforeseen or uncontrolled event – generally one that has unhappy consequences”.
Road Accidents	(DETR, 1999).	During 1999 there were just over 235,000 accidents causing personal injury, which caused 320,000 casualties including 3,600 deaths. This actually shows a marked improvement over the last twenty years, as deaths and serious injuries have reduced by 36 per cent and 48 per cent respectively since 1981
Home Accidents		Around 4,300 people are killed each year in home and garden accidents, and about 170,000 suffered serious injuries that required inpatient treatment in hospital. Home accidents also led to 2.84 million visits to accident and emergency departments.
Work Accidents	(R0SPA, 2001 a).	Surveys indicate that about 1.5 million people each year are hurt at work and treated in casualty departments. In 1998/9 there were just under 53,000 major injuries reported, of which 24,000 were to members of the public	Many of the injuries are minor and so are not reported.
Person and system approaches	Reason (2000)	person approach, and the system approach	Notice these terms seem to be almost synonymous: Unsafe behaviours or unsafe systems Individual and organisational errors
Unsafe behaviours or unsafe systems	Roberts and Holly (1996)	Accidents are caused by either: 1. Unsafe behaviours or 2. Unsafe systems Roberts and Holly (1996) list the basic causes of accidents in hospital settings: 1. Inadequate work standards: through a lack of training and supervision. 2. Inadequate equipment or maintenance of equipment 3. Abuse or misuse of equipment, or failure to check equipment. 4. Lack of knowledge (for example in not being able to use equipment correctly. 5. Inadequate physical or mental capacity to do the required job. 6. Mental or physical stress 7. Improper motivation (e.g. Dr Shipman)
Deskilling	Bainbridge (1987)	A source of error in the relationship between operators and machines is the deskilling of the workers. Bainbridge (1987) referred to this as the irony of automation. She pointed out that designers view human operators as unreliable and inefficient, and try to replace them wherever possible with automated devices. Yet this policy often leads directly to an increased number of errors and accidents. There are two ironies here: the first is that many mistakes come from the designer’s initial errors — systems are introduced which have not been properly worked out and which are actually unable to do what is required of them. Second, as Bainbridge points out, designers still leave people to do the difficult tasks, which cannot be automated so easily.
Cognitive overload	Barber (1988)	The study of selective attention highlights some limitations on our ability to process information. An example of this problem was reported by Barber (1988), in a description of an aircraft accident in the area of Zagreb, which was then part of Yugoslavia. A British Airways Trident collided with a DC-9 of Inex Adria Airways, resulting in the loss of 176 lives. One of the factors identified as leading to the collision was the cognitive overload of the air traffic controller responsible for the sector the planes were flying in.
Equipment design		An illustration of the problem of equipment design occurred during World War 11(1939—45), and it came about because the US air force had concentrated on training pilots to fly aircraft rather than designing aircraft that could be flown by pilots.
Individual and organisational errors	Reason (1990),	Most accidents have multiple causes, though we can divide many of them into two basic categories: 1. Individual errors (unsafe behaviours) 2. Organisational errors (unsafe systems) Reason (1990), in his discussion of human error presented a series of case studies of major disasters. In each disaster, a situation was created over a number of months or years, where the systems introduced or neglected by management finally produced a major incident. The incident itself was triggered by the action of one or two individuals and it was these individuals who inevitably got the public blame while the organisation remained relatively unscathed.
Types of error	Riggio (1990)	identified four types of error that can lead to accidents: · 1 Errors of omission: failing to carry out a task; for example, not closing the bow doors on the ferry in Zeebrugge harbour · 2 Errors of commission: making an incorrect action, for example, a health worker giving someone the wrong medicine · 3 Timing errors: working too quickly, working too slowly · 4 Sequence errors: doing things in the wrong order
Reasons for not reporting		· · time lost · · feeling guilty · · admitting mistakes · · possible disciplinary action · · possible lost confidence of colleagues · · making a mountain out of molehill.
The problems for management of receiving an accident report include:		· · having a written record of the event which increases the danger of litigation · · increased need for action by management · · increased need for investment in people Or equipment · · responsibility is shifted from the worker to the organisation.
Factors affecting individual error		· Substance and alcohol abuse · Lack of sleep · Accident proneness · recent stressful life events · fear of mistakes.
Factors affecting organisational error		1. · the selection of inappropriate staff 2. · poor working procedure 3. · duty rotas that lead to fatigue 4. · an organisational climate that creates poor morale 5. · inadequate equipment for the task 6. · inadequate levels of training.
Drink driving	· Department of Transport, 1992 · Williams et al. (1994)	In 1996 there were 10,850 drink-drive accidents including 540 deaths . In an earlier report it was estimated that about half of pedestrians aged between 16 and 60 killed in road accidents had more alcohol in their bloodstream than the legal drink-drive limit Williams et al. (1994) reported that 50% of adults admitted to a hospital surgery unit with a head injury were obviously drunk
Sleep Related Vehicle Accident (SRVA)	Horne and Reyner (2001)	SRVAs peak around 2-6 am and 2-4 pm when sleepiness is naturally higher. It is noted that non-sleeping "rest" is no substitute for sleep. Sleep does not occur spontaneously without warning, and is preceded by feelings of increased sleepiness of which the driver is quite aware.
	Horne, J.A. & Baulk, S.D. (2004).	Awareness of sleepiness when driving.