Effect of a Brief Worksite Health Education Workshop on the Fall Prevention Knowledge of Physical Plant Employees

Because laborers are at high-risk for workplace injuries such as those from slips, trips, and falls, employee safety training for prevention of slips, trips, and falls is recommended; physical plant laborers at a small university in Missouri participated in a brief worksite health education workshop on slips, trips, and falls prevention. After completion of the workshop, participants significantly improved their knowledge of identification and reduction of slips, trips, and falls risk. When employers provide safety training programs, and employees practice safe work habits, knowledge of health risks may be increased.

Introduction

Second only to motor vehicle crashes, slips, trips, and falls account for about 15 percent of all accidental deaths at the workplace (Occupational Safety & Health Administration, 2007). A slip is defined as a loss of balance due to lack of friction between a foot and the walking surface. Slips are primarily caused by wet or oily surfaces, inclement weather, loose rugs or other flooring material, and worn walking surfaces (Department of Human Resource Management, n.d.). A trip occurs when workers loses their balance and fall because they encountered an obstacle. Trips are most commonly caused by poor lighting, clutter in the walkway, open doors, uneven walkways, or an obstructed view. Falls occur when workers lose their balance and fall down. Falls can occur when a worker is moving from a ledge, ladder, dock, or other equipment that is raised off the ground. The more environmental risks encountered, the more likely that the worker will experience slips, trips, or falls (Department of Human Resource Management, n.d.).

Slips, trips, and falls are also associated with non-fatal injuries at the workplace, including back injuries, strains, sprains, contusions, and fractures (Occupational Safety & Health Administration, 2007). Injuries from falls are a common cause of missing work (Derk, Marsh, & Jackson, 2007). In addition, the annual direct cost of disabling occupational injuries due to slips, trips, and falls is estimated to exceed $13 billion (Liberty Mutual Workplace Safety Index, 2010). These numbers often account for medical costs alone, and employers need to factor in expenses for potential replacement workers, restricted duty positions, and legal fees as the costs quickly add up (Clean Link, 2010).

In order to reduce the health and economic burdens of slips, trips, and falls at the workplace, employers and employees can focus on prevention programs and personal risk reduction behaviors. Employers can implement prevention programs that may include such interventions as analysis of injury records to identify common causes of slips, trips and falls; on-site hazard assessments; and changes to housekeeping procedures and products. In addition, introduction of preventive products and procedures, general awareness campaigns, programs for external ice and snow removal, flooring changes, and slip-resistant footwear for certain employee subgroups may also be components of falls prevention programs at the workplace (Bell, et al. 2008). Employers can also make tripping and falls hazards a major part of their regular safety inspections, encourage workers to report any slip, trip, and fall hazards that they identify, and especially provide slips, trips, and falls prevention training for all workers (Kilborne, 2009).

Employees can reduce their personal risks by getting a sufficient amount of sleep at night so that they are better able to stay alert in their surroundings. Slips, trips, and falls risk can also be decreased by taking work breaks when appropriate, avoiding drugs and alcohol, and effectively managing stress (American Red Cross, 2009). Employees can also prevent slipping, tripping, or falling by not carrying items that inhibit the ability to see one’s path, adjusting one’s stride to a pace that is appropriate for the walking surface and tasks being carried out, walking with one’s feet pointing slightly outward, and making wide turns when walking around corners (Canadian Centre for Occupational Health and Safety, 2008).

Purpose

Laborers who work in good producing, construction, and manufacturing sectors, account for almost 40 percent of all workplace injuries in Missouri (U.S. Department of Labor, Bureau of Labor Statistics, 2010). Because they are at high-risk for workplace injuries such as those from slips, trips, and falls, an employee safety training program for prevention of slips, trips, and falls is recommended. Physical plant laborers at a small university in Missouri participated in a brief worksite health education workshop. The purpose of this study, therefore, was to assess participants’ change in slips, trips, and falls prevention knowledge after completion of the brief worksite health education workshop.

Methods

Participants

After institutional IRB approval, convenience samples of 110 physical plant employees were solicited to take part in the study. A total of 36 participants (all White, middle-aged, and male) volunteered to participate in the brief worksite health education workshop. Physical plant employees in the university setting are generally responsible for maintaining the aesthetic appeal of a campus as well as housekeeping, moving and repairing equipment, controlling key access, maintaining the recycling program, planning small construction projects, and controlling the boiler system (Truman State University, n.d.).

Instrument

A 10-item, researcher-created, multiple-choice instrument, based on the American Red Cross Preventing Slips, Trips, and Falls text (American Red Cross, 2008) was administered to the participants immediately before and immediately after the brief worksite health education workshop (Figure 1). Voluntary and anonymous, the instrument included questions about the specific topics discussed in the workshop (injury statistics, causes and prevention of slips, trips, and falls, and shoe and ladder safety). The text Preventing Slips, Trips, and Falls (American Red Cross, 2008) was used as a reference to create the questions in the instrument. Each test question consisted of four possible choices with only one choice as the correct answer.

Procedure

Brief worksite health education workshop implementation. During spring 2011, teams of three to four instructors trained and certified in the American Red Cross Workplace Module: Slips, Trips, and Falls Prevention presented four brief (one-hour long) worksite health education workshops at different times of the day to accommodate the work and shift schedules of the participants. The workshops focused on teaching participants to prevent unnecessary injuries in the workplace; how to identify, correct, and report unsafe conditions and behaviors at work; and how to develop a prevention plan to reduce unsafe work areas. Immediately before the workshop started, the pre-test was given by the supervisor to the participants and placed in a folder for the instructors. The instructors then opened the workshops with introductions and icebreaker activities. Participants then completed and discussed with the class the results of a health risk assessment questionnaire to determine their personal risk of injury from slips, trips, and falls.

A slide show with supplementary handouts was used to present causes of injury, risk reduction, and prevention techniques. The focus was on the three main causes for slips, trips, and falls: unsafe conditions, unsafe behaviors, and lack of safety awareness. Brainstorming and discussion sessions using worksheets followed on the topics of ladder safety and choosing the right shoes for different surface conditions.

Brief worksite health education workshop evaluation. Participants were then guided in creating their own written prevention plan using the information covered in the workshop. Personal lifestyle decisions including staying aware and focused at work, managing stress, taking appropriate work breaks, getting plenty of rest, and avoiding alcohol and drug use were emphasized. Participants identified slip, trips, and falls hazards for themselves and others at their work setting and then developed remedies for those situations. Immediately following the workshop, the post-test was administered by the supervisor and placed in a folder for the instructors. Any additional participant questions were answered, and participants received informational booklets to take home and to share with co-workers and family members.

Analysis. Descriptive analyses, including frequencies and percentages, were used to describe individual item results for both the pre- and post-tests. A dependent sample t-test was used to assess differences between the pre- and post-test scores. Significance was set at p< .05.

Results

A dependent sample t-test was conducted to assess changes in slips, trips, and falls prevention knowledge from immediately before to immediately after the brief worksite health education workshop. Participants scored significantly higher in the post-test (M = 8.89, SD = 0.98) compared to the pre-test (M = 7.81, SD = 0.95), t (35) = -5.295, p < .05.

As seen in Table 1, when the percentage of participants who correctly answered each individual test question was compared, those correctly answering the questions about injury percentage from slips, trips, and falls (11.1%-83.3%) as well as the types of shoes to be worn on oily surfaces (22.2%-52.8%) had dramatically increased. On the pre- as well as the post-test, all participants, though, correctly answered the questions about the cause of trips and how to generally prevent slips, trips, and falls. For seven questions on the post-test, at least 90 percent of participants noted the correct answer. For two questions, though, participants’ scores decreased from pre- to post-test. Overall, participants increased their correct responses to five of the 10 test questions from pre- to post-test.

Discussion

The responsibility for reducing the risk for injuries caused by slips, trips, and falls as well as the economic burden it places on an organization falls on both employer and employee (Bell, et al. 2008). When employers provide safety training programs, and employees practice safe work habits, environmental and lifestyle health risks for slips, trips, and falls at the workplace may be minimized (Department of Human Resource Management, n.d.). When physical plant laborers participated in a brief worksite health education workshop on slips, trips, and falls prevention, they significantly improved their knowledge of identification and reduction of slips, trips, and falls risks. All participants seemed to already know the fundamental causes of trips and how to generally prevent slips, trips, and falls before the workshop, but they especially increased their proportion of correct answers from pre- to post-test for questions about injury statistics and proper safety footwear.

Although overall knowledge seemed to be improved, there were still some gaps and topics that may need to be reviewed in any follow-up workshops or emphasized more strongly if the workshops were to be presented again. More emphasis on the content related to questions about personal behaviors that can prevent slips, trips, and falls as well as ladder safety should be provided by instructors as the proportion of correct scores on these questions decreased from pre- to post-test. Unsafe personal lifestyle decisions and lack of safety awareness are two of the three main causes of slips, trips, and falls (American Red Cross, 2009). In order to address these shortcomings, instructors should emphasize common personal behaviors that lead to an increased risk of slips, trips, and falls in the workplace. To increase overall knowledge of ladder safety, it is recommended that instructors conduct hands-on training in proper ladder-safety techniques. In addition, for future workshops, instructors may wish to check more frequently throughout the workshop for participant comprehension using oral quizzes or question and answer sessions to make sure all three main causes of slips, trips, and falls, are equally highlighted.

The results of this study demonstrate that a properly conducted, brief, safety-training workshop can increase participant knowledge regarding various aspects of slips, trips, and falls, however several limitations must be noted. The instrument used for the study, while based on accepted safety standards and possessing face validity, was not pilot-tested, and measures of validity and reliability were not conducted. Future studies should focus on formally assessing the nature of the instrument to determine its true feasibility. Regarding the sample of employees, this study was intended for physical plant laborers at a small, Mid-Western university. It is recommended that further studies be conducted that use a larger, more representative sample to improve generalizability. Further, it is also recommended that a control group be utilized in order to assess the true effectiveness of the program, and follow-up reports on injury statistics could also be conducted to assess any changes in employee behaviors post-intervention.

All in all, injury prevention at the workplace requires teamwork between employees, their co-workers, and their employers to identify and correct unsafe work environments and work habits (American Red Cross, 2008). Providing slips, trips, and falls training for all workers is recommended (Kilborne, 2009), and in this instance the training seemed to help participants better understand risk reduction. Although injury prevention knowledge does not necessarily translate into safer worker behaviors or work conditions, it is a good foundation on which to build a broader culture of safety in the workplace. In addition to regularly scheduled workplace safety trainings such as this one, the addition of a safety committee, if the workplace does not have one, is recommended to increase awareness and commitment to safety of the workers and the organization (American Red Cross, 2008).

References

American Red Cross. (2008). Preventing Slips, Trips, and Falls. St. Paul, MN: The Staywell Company.

American Red Cross. (2009). About the Red Cross. Retrieved September 15, 2011 from http://www.redcross.org

Bell J., Collins J., Wolf L., Gronqvist R., Chiou S., Chang W., Sorock G., Courtney T., Lombardi D., & Evanoff, B. (2008). Evaluation of a comprehensive slip, trip and fall prevention programme for hospital employees. Ergonomics, 51(12), 1906-1925. doi:10.1080/00140130802248092

Canadian Centre for Occupational Health and Safety(2008). Prevention of slips, trips and falls. Retrieved September 15, 2011 from: http://www.ccohs.ca/oshanswers/safety_haz/falls.html

Clean Link. (2010). Preventing slips, trips, and falls. Retrieved September 30, 2011 from http://www.cleanlink.com/hs/article/Preventing-Slips-Trips-And-Falls--8249

Department of Human Resource Management. Slip, trip and fall prevention. Virginia: Department of Human Resource Management. Retrieved September 30, 2011 from: http://www.dhrm.virginia.gov/workerscomp/pptdownloads/STF.ppt

Derk, S., Marsh, S., & Jackson, L. (2007). Nonfatal occupational injuries and illnesses—United States 2004. Journal of the American Medical Association, 298(8), 856-858. doi:10.1001/jama.298.8.856

Kilborne, C. (2009). Slips, trips, falls: boring everyday accidents?. Safety Daily Advisor. Retrieved September 30, 2011 from http://safetydailyadvisor.blr.com/archive/2009/09/14/safety_management_slips_trips_falls.aspx.

Liberty Mutual Research Institute for Safety. (2010). 2010 Liberty Mutual Workplace Safety Index. Retrieved September 15, 2011 from http://www.google.com/url...

Occupational Safety & Health Administration(2007). Slips, trips, and falls. Retrieved September 15, 2011 from http://www.osha.gov/SLTC/etools/poultry/general_hazards/slipstripfalls.html

Truman State University. (n.d.). Physical plant: Services. Retrieved September 30, 2011 from: http://physicalplant.truman.edu/services.asp.

U.S. Department of Labor, Bureau of Labor Statistics. (2007). Numbers of nonfatal occupational injuries and illnesses by industry and case types, 2007. Retrieved September 30, 2011 from: http://www.bls.gov/iif/oshwc/osh/os/pr077mo.pdf.

Acknowledgement: The training portion of this project was funded with a grant from the National Office of Eta Sigma Gamma National Professional Health Education Honorary.

Effect of a Brief Worksite Health Education Workshop on the Fall Prevention
Knowledge of Physical Plant Employees

Justin McDermott
Joan Scacciaferro
Beth Antonacci
Alaina Kramer
Truman State University

Abstract

Introduction

Purpose

Methods

Participants

Instrument

Procedure

Results

Discussion

References

Effect of a Brief Worksite Health Education Workshop on the Fall Prevention Knowledge of Physical Plant Employees

Justin McDermott Joan Scacciaferro Beth Antonacci Alaina KramerTruman State University

Abstract

Introduction

Purpose

Methods

Participants

Instrument

Procedure

Results

Discussion

References

Effect of a Brief Worksite Health Education Workshop on the Fall Prevention
Knowledge of Physical Plant Employees

Justin McDermott
Joan Scacciaferro
Beth Antonacci
Alaina Kramer
Truman State University