Presented by: Dr Justin Ludcke, General Manager of InterSafe, an engineering safety consultancy focused on eliminating serious injury in the workplace.
Run time: 34:44
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Construction work health forum podcast
Presented by: Justin Ludcke
START OF TRANSCRIPT
Welcome. As per the introduction, my name's Justin Ludcke. I work for a company called InterSafe. The introduction there was a little bit of insight into what we do. I guess, as a summary, we investigate incidents. Our point of difference in the health and safety world is that we see a lot and what we then try and go out and help companies prevent. I've got a database of 10,000 to 15,000 incidents involving both fatalities and permanent damage to people. We use that knowledge of what has happened to then go out and try and prevent it happening again. There's a little bit of a difference between what we think might happen and what does happen. A little bit of today is try and give you a little bit of insight into our world. We work, well, around the world in many industries from mining to construction to almost every different industry around the place. But mainly in mining and construction.
What we see, I guess, in terms of the trend – there's always trends that happen in terms of health and safety. I know we've got a forum here today that's dealing specifically with health, but we will deal with the notion of health and safety because it helps set the pattern and the trend a little bit. There's a real trend towards – and this is specifically in the mining industry, but it's moving into the construction industry. Sort of comes as a bit of a wave of oil and gas to mining to construction in terms of how things happen, particularly around health and safety – around the notion of critical risk. Just a quick show of hands. Within your business, is there conversations happening around things like critical risk? Around – what's the other terminology that people use? Material risk. Things like that. Yes? No? Yep. All right.
So in terms of definitions – I actually did a bit of a look see around the place and there's not much – definitions around critical risk management and what that is. But in terms of the actual definition of critical risk; I couldn't find a lot of clear defining principles. The trend that you see is that it's built around the notion that someone could die. All right? Not specifically just that, but that's the general trend of definitions of people's – the defining component of critical risk. Fatal consequences. Single and, obviously, multiple fatality. You know, we get into catastrophic risk and terminologies that simple around multiple fatality, process failures, all those sort of things.
I guess my question today is to give you some insight into our world and what we see and try to answer the question is this sufficient? Okay? Does someone have to die for a risk to be critical? It's easy to say yes or no. But it's harder to put some basis behind why we would say yes or no. For most companies, fatalities get to the point of sovereign risk. Right? It's not longer about, unfortunately, about the person and their families. It's about the business entity and whether it will survive or not. Which is real. Right? Don't get me wrong on that. That's a real component of these type of events. So it's not as simple as just the risk to a person and their family. There's all sorts of other aspects around the business and sovereign risk as well.
So in order to try and give you some insight into answering that question, we need to know a bit about what is happening. So I'm going to take you through our understanding of what we call the size and nature of the personal damage problem in the construction industry. Hopefully, you will have a level of understanding about that. Here's your test to see whether your understanding is the same as what we see from the data. What is the likelihood of different classes? We'll talk about what classes are of personal damage. What are the patterns? Do the patterns change for different classes?
So to help you understand a little bit of the data that I'm about to show you, we look at classification of damage. We use the word damage quite specifically. I know businesses, entities, workplace health and safety, all sorts of entities deal with injury and illness to people and classify them as safety and health. Use the word damage as damage to people, being either safety or health. All right? Because you can go through a whole particular argument about whether a heavy manual handling incident where someone's tried to catch a falling load should be a safety incident or should be a health incident. I don't want to get into that splitting hairs argument. It's an incident that we want to prevent. All right? So we classify damage being safety/health related incidents to people according to three classes. Class 1 permanent, Class 2 temporary, Class 3 minor.
Class 1 permanent. Upper severity of permanent damage is fatality. You can't get any more hurt than dead. Multiple fatality, single fatalities. Everyone's fairly familiar with that notion. Lower severity of permanent damage is what we call non-fatal permanent damage. Not dead, but permanently altered. All right? You do not return to the same level of physical capability, function as you had prior to the incident. Obviously amputation's a pretty simple one to understand there. You had an arm; you no longer have an arm. It doesn't grow back. Subsequently, permanent damage. Back damage can quite often be permanent. The anatomy/physiology behind it is, I'll say, reasonably well known throughout the medical fraternity as to why. We can damage the tissue and function of our body to the point that it will not repair. That's the kind of damage that we are talking about in that category there.
Class 2 temporary, upper severity. Fractures. Now particularly around long bone fractures. So long bone fractures; you might be in a cast for six weeks. It might be six months later. It could be a year later. It could be 18 months later where if you regain your full level of strength, function, capability – you might still have a lump there where the fracture site was. But if it doesn't impair your function in any way then, by definition, that damage was temporary. Lower severity of temporary damage; muscle sprains, lacerations. You know, you get stitches. Again, you might have the scar. But if that scar doesn't impair you in your function, your capability, then by definition, again, only temporary. You can obviously imagine some interesting incident types. Burns start to become an interesting one as to how they step between minor through to temporary through to permanent damage. Obviously minor; simple cuts and bruises.
Now there's a fair bit of information on this slide. This is the culmination or the summation of five sets of research done by government departments. It's probably the same government department called about three or four different things over a period of time. I think it started off as the Productivity Commission, then went to Industry Commission and then went to – I can't even remember the third one. The last couple have been SafeWork Australia. What they're – these are studies to try and estimate the damage to people as a result of workplace incidents.
So in the centre, you can see that the centre of the costs is about the overall estimated cost. We've gone from $20 billion back in 1992/3 data rising up through about $60 billion, $62 billion. This research here was only published about the last couple of months. So $62 billion a year is what the permanent temporary damage cost us in the workplace. It typically sits at around about 5% of GDP. So this is not something that is insignificant in any stretch of the imagination.
When we start to break up by the classes of damage; to understand the costs – again, they are estimates and I can put you towards the research papers for you to get more understanding of them. Class 1 permanent in the red typically sits at sort of 3% to 5%, 6%, 7% of those costs. That's what fatality costs us. Class 1 permanent but non fatal typically sits at around 80% to 90% of the costs. Those costs associated not only directly with the ongoing care and treatment for the person, but also the indirect costs in terms of their loss of income, current income in terms of being invalid pension versus being employed at $80,000 or whatever a year. So these are the costs that are both directly incurred and indirectly incurred by the injured person. Then your Class 2 temporary sits at around that give or take 10%. Now not going to do massive statistical analysis over this, but you can see that we're not dramatically decreasing the cost in terms of cost here. You can see that we're certainly – last three studies have kind of started to plateau out a little bit.
When you start to look at the numbers, it's the same datasets, just giving you slightly different information. We see around about 400 people a year are killed in the Australian workplace from a traumatic fatality. Right? When we throw in occupational disease from a health perspective, it typically adds about another 2,100 a year. So we all know some of the issues around that in terms of asbestosis and how far from the event to the fatality and there's all sorts of other – you know, cancer and heart attack and everything else that goes with that. Okay?
So when we start to look at numbers, you can see the Australia symbol there has – Australia Bureau of Statistics number in terms of the size of our workforce. You can start to get a bit of a feel for the likelihood of these type of incidents. On the next slide, I'll show you what the likelihood looks like.
In terms of non-fatal permanent damage, we're looking at around about – we see a drop off here. It would be interesting to see how that trend goes in the next little while. But 60,000 to 80,000 people a year end up into that non-fatal but permanently injured category. It's in the order of 150 to 250 per day. Per day. Right? Hand on your heart; how many people expected that to be the case? One hundred and fifty to 250 people per day permanently injured in the Australian workforce. All right? That's what the information is telling us. That's what we should be understanding about the likelihood of this particular type of event occurring.
When we look at likelihood based on the number of people in the workforce, you can see you've got around about a one in, give or take, 30,000 chance of being killed in the workforce. Right? One in 30,000. That's a traumatic fatality. Okay? That's the construction industry – the stuff that hits the news pretty regularly, right? That's one event a day in Australia, on average. It works out to be about one in 30,000 chance. Now when we add occupational disease to that, it drops down to about one in 4,500. So 4,500 to 5,000.
[Long pause] when you look at an industry or even a work organisation, if you had a company – what this means is if you had a company that employed 30,000 people and, on average, you'd expect that that company, in Australia, would have one fatality a year. If you have better than that or worse than that, then – you know, no fatalities one year, but two the next; you're still on average. The problem with fatalities in these relatively rare events is that, looking at them year by year, it tends to get fluctuations quite significantly. You can have a bad event and three fatalities at a particular incident or industry and, all of a sudden, it will start skewing the figures. Industries that we see – mining industry, construction industry in states will be skewed quite significantly by one event, eg. Nowra or something like that.
Sorry, just going back to that. So the likelihood of permanent damage but not fatal sits at around about one in 130 to one in 180 people. So for every 180 people – and this is something that often when I sit in front of groups and go out to companies and put this statistic to them, they – well, let's pick a number in the middle. One in every 150 people who work for you will sustain, this year – not just across their working life. This year. Non-fatal but permanent damage. Most people say oh no, no, we haven't had one. I've sat in rooms with companies who said no, no, no, we haven't. I've said well actually, I know you have because a lot of the work we do is actually writing reports for the court, standing up as an expert witness in court where the cases go to common law compensation. I've been contacted by solicitors working on behalf of people who work for you.
So it's an interesting phenomena, because sometimes, you know, not everyone in the company knows about it. Particularly in, say, a construction and mining environment where people coming to a site and not coming back to a site is not an uncommon thing. You don't know whether they've just got a better job somewhere or they've been pushed onto a different site somewhere. They just disappear. It could be because they've sustained some level of significant injury.
So that's just some generic Australian based data. I'm going to take you though into some more data to show you that that's just not a rare, one off concept. Australian construction industry data, again produced by SafeWork Australia, showed that the last 11 years, there have 401 traumatic fatalities. The thing I like to see here is this last little trend here. But I want you to remember this, right? So the fatality rate – and this is, again, traumatic fatalities largely – has dropped off. Almost sort of halved, I guess, in the last two or three years. Just remember that.
When we look at the way in which – and this is where the pattern is. Trying to understand how people get hurt. These traumatic fatalities occur – this is very quick taxonomy that I did. It's probably not a surprise to you to suggest that gravitational energy is the big culprit. Falls from height, hit by falling objects. You can see, as you start to break it down, what it is that people fall from. Buildings and structures, ladders, scaffolding. Obviously more comprehensive data you can get, the better understanding you can get of that sort of story. But that's typically what we see in a lot of the research we do. The pattern around gravity and vehicle is typically what kills people. Collisions, pedestrian impacts, roll overs. You get into electrical, machine, etcetera.
The snapshot out of this particular paper researched by SafeWork Australia – when it got to injuries – so this is all injuries. They had a snapshot from 2009/2010 where they showed that 57,000 construction workers sustained injury throughout that particular year. Sixty-five per cent of them did not apply for workers' compensation. For various reasons; they were not eligible, didn't want to, if you're business owners – all sorts of reasons behind it. But that's just the numbers. But that 57,000 works into about 156 people a day in the construction industry sustaining injury or about 6% of workers.
Now they went on to show that of those 35% that did apply for workers' compensation – this is the kind of trend that we see. So over a period of three years – so they only had data from 2009/10 to 2011/12. You see there's about 37,500 incidents. Now what we commonly see in terms of the number of time off work – trying to equate permanent damage as best we can to the number of days off work. Once you get to about 12 weeks off work, things tend to change in terms of cost and, obviously, typically severity of injury. The pattern's not different in this dataset as well, where 67% of the claim numbers come from that less than 11 – up to 11 weeks off work. But roughly 86% of the cost comes from the greater than – so it's Pareto principle happening in reverse there. Where we know the overall cost – and I'll talk more about cost – comes from the higher severity incidents. And the trend continues there.
We did a fair bit of research into Western Australia construction industry data. We got hold of – it took us five years to get access to this data. We're still – we've got a dataset for the mining industry. We're still working with relevant Queensland authorities to get access to the construction dataset. But we looked at – and the next few slides detail a lot of the Western Australia construction industry. I'll tell you now; they don't things that differently over there. There's a lot of application to what we do in Queensland. This is basically the trend that we see. That from 2003/04 to 2012/13, we've seen about 150% increase in greater than 60 days or 12 week LTI incidents. In terms of 50% increase in the actual numbers through that time.
But the more interesting – you remember that last four years that I spoke about in terms of the fatality trends? Well, the last four years – if we pick up those four numbers there – we've almost doubled the number of incidents and we haven't done much with the number of – so our likelihood of permanent damage or greater than 60 days but non-fatal has almost doubled while our fatality likelihood has halved. Right?
Ultimately, in terms of measures of cost – I'll show you financial cost. People understand dollars. You know, you understand the value of your house. Some of that research shows you that non-fatal or someone sustaining non-fatal, permanent damage who doesn't return to work; average cost of that sort of incident sits well over $1 million. It's a significant cost. But what we see on a day to day basis is that the step difference between minor to temporary to permanent exists across all these types of costs. The physical costs, the ongoing pain, the suffering, dealing with the impairment, dealing with the reduced quality of life.
That then steps into the emotional and psychological costs, the depression and anxiety, pain medication, dealing into harder drugs that deals into suicides and all sorts of other mental health issues. The ongoing costs of the physical injury from a mental perspective cannot be underestimated. Obviously, stretching into social and family costs. There are marriage breakdowns, role changes. It might be the partner that needs to go out to work now and that's not how it's been for the last 20 years. So it's something that we see on a day to day basis. The financial stuff is a number that people tend to understand. The number difference is certainly equivalent in terms of these other measures and costs as well.
Why is this happening? Why are we seeing the fatality rates decrease but this stuff increase? Well, a couple of hypotheses here from a scientific perspective. One; maybe the problem being managed is not appropriately understood. Right? What I mean by that is a couple if are one. Do you guys even look at data from the perspective of non-fatal, permanent damage? Because they tend to – that type of incident is bundled up into our LTI incidents. Your LTI incident set could be whatever, how many – this big. But your non-fatal, permanent damage might only be this much of that pot. Right? What the general pattern looks like compared to that? I will guarantee you it will be different. Okay? the studies that we've done around those different levels of severity – what kills people, multiple fatalities, is a very different pattern to what kills people single fatalities. Which is a different pattern again to what results in non-fatal, but permanent damage down to temporary and minor damage.
How many people are dealing with hand stuff? Yep. How many fatalities have you had with hands? Right? Doesn't necessarily kill people. Right? I'm not saying you don't deal with it, but it's different. It's about the mindset around what we expect to manage by this particular program to deal with hands. If we're expecting to deal with all that higher end stuff, then we probably need a little bit of a wakeup call. The other thing around the hypothesis is maybe the controls being implemented are not all that effective. I'll take you through a bit more around that.
I don't expect you to see the background. The studies in Western Australia – basically, we're looking – you know, it's a four, two and four year period in excess of 5,000, 6,000 incidents. The common trend is human energy or the energy we muster from within – this is how we look at incidents – is prominent in producing those outcomes. When we look at the human energy story and break it down, it's not a Nobel Peace Prize winning research. It's lifting, carrying. It's simple stuff. It's not something that is different to what we used to do. It's just grunt work. Heavy lifting is not necessarily – there's an element of repetitive tasks. There's an element of awkward postures. But still by far and away the most significant mechanism is just the lifting and carrying.
So what we see in that research is that simple lifting and carrying dominates the problem. It's not new to industry. We've done in 100 years ago and we're doing it now. Yeah, things have changed a little bit. But ultimately, the incidents we're getting are still from that same mechanism. And it's saves not created by changes in the industry. I mean, mainly because we were doing it back there and we're still doing it now. Yes, there's been changes in the industry. But based on the injury outcomes, we haven't necessarily dealt with all the stuff we need to in regard to that. So you have to ask the question why do those simple, manual tasks continue to produce serious and permanent outcomes?
Just some quick examples. Obviously, a lot of the cases we deal with are have a very legal nature to them, so I can't tell you too much information. But here's some examples that we see on a day to day basis. A guy – this is not the guy. It's one of my guys. They're moving a 40 tonne concrete tilt panel that's suspended by a crane using a burke bar. Right? You still have to calculate the forces that are required to be applied to that bar in order to move that 40 tonne panel. It's absolutely phenomenal. Not an easy solution to that one, by the way. But unless we want to, we won't find it.
Pushing wheelbarrows. You know a guy pushing a wheelbarrow full of asphalt – 200kg up and down, around and all sorts of places. Even in lifts and elevators. You name it. Right? He'd never seen one of these. Never, ever seen one. I mean, not saying that's the perfect solution, but have you ever seen or talked about a powered wheelbarrow? Nah, never seen it. Right? Until we recognise that there's a problem, we're not going to be able to find reasonable solutions to it. So today is about trying to help define some of these problems.
Core filling concrete block wall using buckets to lift buckets of concrete up and tip them into the top. We do know what a concrete pump is. Right? We do use them regularly. Just we tend to find reasons – and I'll give a bit of insight into that.
One of the eternal problems. Screeding concrete. Now I know this is not an easy one to solve. I'll put a couple of pictures up – I'm not saying they're going to work, but I just did a little bit of research around some of these things that go – while they might not be perfect, it's about the desire to want to do something differently. If you give the right people the encouragement, I will guarantee you they will find it. They will find a solution if there is a market for it. If there's no market, no one will put the dollars in to find the solution. I'd never actually seen one of these before until I just did a search the other day. I thought that's' interesting. I don't know if it works or not, but you can imagine with the civil construction these days and laser guided gear – it has to be possible. It has to be possible.
Even the knowledge around weights of lift. You see lifting chains, all sorts of stuff and you ask someone – you say what does a five tonne lifting block weight? I don't know. It's a little bit hard to see in there, but I think it's in the order of 40kg. Unless we understand the weight of the objects we're lifting, how are we possibly managing the problem? So a couple of things to think about. This will pose some questions, no doubt, but I will get to the questions just in a minute.
Generic or indirect issues, I think, are influencing this pattern that we see. Frequency rates, all injury frequency rate, LTIFRs, TRIFR. There is no weighting for severity of injury. If it's an LTI with a minimum number of days off work or whether the person never returns to work? There is never – it's one and one. All right? So there's no weighting for severity in that context. As a result, you tend to focus on higher frequency, lower consequence incidents.
Zero harm? Again, from a management focus, while this is morally and ethically appropriate – I'm not saying we throw out zero harm. We've got to understand what implications these measures have on what we're seeing. It tends to spread the management focus across all incident severities, which is what it's intended, to a certain degree, to do. But again, priority tends to be placed on those higher frequency, lower consequence incidents. Right? But then we got to the other end of the spectrum. From a critical risk perspective, we tend to focus our attention more on the high consequence – the fatalities by low frequency events. And guess what's left? [Long pause] non fatal permanent damage. Right? It's the bit in the middle that doesn't seem to be well (a) even a whole lot of knowledge about and; (b) the focuses that we're applying, with all great intent, are not meeting in the middle to want to focus on that level of severity of damage.
We then step into – and it's not just a pick on the construction industry. Because the mining industry, a lot of industries are the same – around the egocentric culture. We tend to be fairly blame focussed in our incident investigation. You know, it's a hard and tough industry. You know, teaspoon of cement thing. At the end of the day, we tend to focus on the person at the centre of the incident causation. Which means that it's about what the person does. We do training. Training, signage, procedures, safe work procedures; all that stuff which generally sits in the administrative controls area. Which we know is not as effective as getting engineering controls in place.
More specific or direct issues associated with manual tasks is that we often don't get relevant information to people to help them manage that problem. You know, knees bent, back straight. If you're still doing that, I'll chat with you [laughter]. Because while there is some biomechanical basis for it, if your people are not asking the question first off how much does this weigh? Then you've got a problem. Right? That should be the first thing you should be looking at. Because we all have the strength to damage ourselves. We all have the capability to lift those loads to produce and blow out our back. Right? That is absolutely proven. Until we get to the point of providing the right knowledge and the right approach to this problem, we're going to continue to proliferate what we see up there before.
We know that there's a cumulative effect. It's well known that over years and years – I've done this for the last 20 years. Except this time I did it and blew my back out. There's some reasons for that. Then there's the whole issue of apprentices, right? When you were an apprentice, you got all those jobs, so that's how you learnt. Now we get the new apprentices on and they get those jobs as well because, eh, you can't do it because your back's buggered and the apprentice's back is still okay. For now. Right? Again, the egocentric nature also fits in in terms of the task itself. You make the decision to lift. You make the decision to do it and, therefore, it's easy to go back and say well you didn't do your risk assessment properly or whatever. You didn't do this. Whereas rather than just pointing the finger at the person and say well you did the wrong thing; it should be instigator to say how else can we do this job that doesn't require that person to do that?
Near miss and hazard reporting won't show up your manual task incident. It doesn't. No one wants to dob themselves in saying I lifted that heavy thing over there and I probably shouldn't have. Right? So we need a different approach to that.
So very quickly, I know we're going to run out of time. Don't underestimate planning around this whole notion trying to manage this problem. Now safety and design, I know, to builders and constructors – kind of they say well it's the designers that need to deal with that. Well not necessarily. If you focus on constructability, if you're fortunate enough to be into the game in the process that early on in the project, you need to be managing how we could do it rather than how we are doing it. Does that make sense? Right? And there are always different ways of doing it. Just often we're so far through into the job that you don't have opportunity to put those other things in place. If we can plan back in time, then we have better opportunity.
We need the right people. Now what I mean by that is competent, also experienced, but also willing to change from the same old way. Because if you put the people in charge of doing the stuff and say well I did this 20 years ago, so you're going to be doing the same thing; our opportunity for change is a little bit limited.
We need to have the required resources. We need to be ready to go with the right gear rather than making do with what we've got. Right? Again, it just comes back to that notion of planning. How are we going to do this job and having the right equipment there to be able to do it.
Scheduling. This is another – it would be quite an interesting thing for some. My guess is that it's doing the work when the time is right for the person, for the worker, the person doing the work; not when the project needs it or the client needs it. I know; it's not an easy one for a lot of people to manage. But just because we need to hit a milestone and get that in there by tomorrow with the project doesn't make it the right time to do it if you're going to blow someone's back out to be able to achieve it. Right?
There's a few other things around those matrix; the TRIFR, the AFRs. That's more of an industry focus rather than a specific company focus. It's something that we've been sort of working towards. If we can start – at the end of the day, we end up managing what we measure. Some of those things we're measuring aren't necessarily what we need to manage. Providing relevant factual information to workers can help to start managing the problem.
Trying to change that egocentric approach to a more ergonomic approach, looking at the design of the environment, the equipment they're using and the people and trying to strive for those engineering controls. We've done a lot of good work. Don't get me wrong. Right? The construction industry; there is a lot of stuff that we have done in terms of lifting gear and things like that. But there's still a way to go. Right? There is. I think some of the – well, we'll say the more simple stuff – it's not just about lifting stuff from above that's the solution. Right? There are ways and means around trying to get some very good assisted lift devices in those places that aren't just about lifting from above. And, at the end of the day, in your organisation, promoting those ergonomic conversations, not just the point the finger and say well you did that wrong. You didn't follow this. You didn't do that. Having that conversation about well okay, we understand now that's a problem. How else are we going to do this work?
Thank you very much.
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