Presented by: Helen Lingard, RMIT University Distinguished Professor and Director of the Centre for Construction Work Health and Safety Research.
Run time: 42:29
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Construction work health forum podcast
Presented by: Professor Helen Lingard
START OF TRANSCRIPT
Professor Helen Lingard:
Thank you very much, Nigel, for that introduction and thank you for inviting me to be here today. As Nigel said, today I want to talk about improving workers' health and safety and, in particular, talking about the organisation and the design of construction work. Because design is a work health and safety policy imperative. It's been well recognised in the Australian Work Health and Safety Strategy 2012-2022, which talks about the importance of health and safety by design. It specifically talks about hazards being eliminated and minimised by design. It talks about designing for safety and health in relation to the design of structures, plant, substances and things that the construction industry concerns itself with on a regular basis.
Now in my view, in construction, there's an awful lot of emphasis on safety and design practices as they relate to structures and plant. We do a lot of work in that. We have a lot of safety and design reviews of standard practice and project management protocols. We have chair reviews. So there's a lot of emphasis on safe design in relation to structures and plant. But what there is less of an emphasis on is safe design in relation to the design of work itself. The design of the way that work is done, the systems of design and the way that we design and manage work to eliminate hazards and risks. I think this is where there's an awful lot of work that the construction industry could do. Indeed, we're starting to do some research in this space.
Now moving towards some of the demographic shifts and changing social attitudes which Mark introduced very well to us already. We've got a completely changing landscape in terms of our workforce. We've got dual earner couples where both partners in a family are the predominant family form. Which means that the breadwinner/homemaker model no longer applies to our workforce.
So we've got to look at the design of work to support and enable people to work within these new family forms. Or not new family forms, but dominant and important family forms. We've got an aging population and elder care is now a real responsibility for many Australian workers. We talk about the sandwich generation, which is a generation of workers in which people have responsibility for elder family members as well as children simultaneously creating new challenges. We've got a situation where Australian women are delaying childbirth. This also plays out to caring responsibilities and how they are experienced by families. We've got young men now demanding a more active role in family life. They want to spend time with their children and see them grow up and participate. They don't want to be at work all the time and miss out. The changes in relation to generational changes – Gen Y, Gen Z and, as we move forward, more recent generations will have a different relationship with work to that of the Baby Boomers. They want a life. They're demanding a life. So there's a need to rethink and redesign work that works for all of these different groups. That has some real challenges for the traditional way that work is organised in the construction industry.
Now a few years ago, we did some research to look at work hours in construction. We looked at the – we did a big survey with a number of large construction companies. This is some of our data that shows that the average number of hours worked per week is very, very high in construction. But it's particularly high amongst workers who work on site in construction roles. Slightly lower in the site office and lower again in the company office, but still it's a long hours industry.
In the changing nature of the work/family interface where we've moved to this model here, which is a model which reflects the fact that family work is now shared between partners in a household. It's no longer the case that you would have a breadwinner who went out and made the money and a homemaker who stayed home fulfilling family care, which was this model here. We've now got this working family model as our predominant family form. We need to think about how we design work to support people who are in those arrangements. I don't think, at the moment, the construction industry does it very well.
It's also a gendered issue. If you look here – we actually collected data about the extent to which construction workers' spouses or partners were in paid employment. You see here that the white is the female respondents; so this is females who work in the construction industry telling us about their partners' paid employment activity. You can see for the women in construction, they're much more likely to have partners who work somewhere between 35 and 50 plus hours per week. This is a real problem for women in our industry. They don't have, as many of the men do, partners at home who have scaled back to work part time. So we have a real problem. If we're looking at sustainability and the ability for the industry to attract talented, effective, skilled workers; already, we've got an industry structure that makes it very hard for 50% of the workforce to cope with the demands of construction.
We also measured work/family conflict. Now this is a phenomenon – and there's two different facets to it. There's time based conflict and strain based conflict. This is the extent to which you simply feel that work takes too much of your time; that you can't function at home effectively. Or in the case of strain based conflict, work causes so much stress and tension that when you do go home and you're in the family domain, you can't function effectively because you carry over those strains and stressors into that domain.
We collected this data from construction workers in our companies who participated in this research. We had a very large sample. We actually compared this data using a standard measurement method to data that's published from other countries. So we've got MBA graduates in the US, hospital workers in the US, teleworkers generally in the US, we've got some data from the Netherlands. We looked at others as well. But generally speaking, amongst all the groups in all the published literature we could find around the world, the construction industry in Australia had higher levels of work interference with family than anywhere else.
Now the reason that this is a concern is that work interference with family, particularly time and strain based, has a very, very well established and proven consequences for health. Indeed, the academic literature, again from all around the world, shows that this work/family conflict is associated with increased stress and anxiety, depression, lower job satisfaction, high cholesterol, heart disease, burnout, strained family relationships, absenteeism and turnover and then behavioural facets like poor diet, low levels of exercise and sleep problems. So if we're working people in this way, we need to expect that there will be serious health consequences. I think these are the sorts of things which really need to be understood and addressed in the design of work.
Because what we're going to see, if we're not careful, is this downward spiral effect where the more conflicted people are, the more people's work disrupts their family life, the more they're going to be burnt out. The more burnt out they get, the less resilient they are and the less able to cope with work demands. Then the more negatively work will impact upon family life. So if we don't actually break this cycle, we're actually heading for a very, very damaging and unsustainable situation for many of our workers. I think we are seeing some evidence in our research of that downward spiral effect.
Here's some of the data that I think is particularly telling in relation to that. So what we did in one of our Australian Research Council funded research projects was we actually collected data every week from workers working on a large infrastructure construction project in Melbourne. I have to disagree with Mark about Melbourne. It's a wonderful place to live. But anyway, this is the data that we collected. These workers filled out these little diaries every week to just tell us – we asked three or four really simple questions. How many hours did you work this week? How satisfied are you with your work/life balance? How able were you to complete the tasks that you needed to complete at home? How able were you to complete your work at work? So we asked five or six questions and then we gave people the opportunity to give us comments if they wanted to explain any of the results that they were giving us. So it was a really quick and easy thing that people did.
This is the data that we got back from one of the projects. Now what's really interesting here to us is that hours of work, which is this solid black line here, shot up quite dramatically in this period here. What this coincided with was here, when work hours were at their peak, there was a scheduled milestone to be completed. This was a big road infrastructure project and the minister was going to come. They were opening a new ramp. The media were coming. It had to be done. It had to be finished. It was a big, big deal. So you can see that, prior to that, people's hours of work escalated dramatically.
But what's actually really interesting is that this is their hours of work, which went up in that period. But if you look at these lines here that fell dramatically in almost exact mirror image; that's their satisfaction with work/life balance. It's their capacity to complete tasks at home and their capacity to complete tasks at work. What's more important, I guess, is this dotted line here which really shows their capacity to complete tasks at home, which fell below the other lines. When people are working that hard, that long to achieve a milestone, it's home life that suffers more than anything.
I think this data really tells a really important story about the rhythms of project life. You know, the fact that over the life of a project, people don't experience these things in a consistent way. What goes on in a project impacts and it impacts over time. When we start to understand these ebbs and flows and peaks and troughs, then we can start to think about how we design work differently.
One of the things that we used to try and explain that research was this notion of effort recovery model. Basically, if people go to work and they expend a lot of psychological or physical energy to complete work, but they don't then have enough recovery between work periods, then eventually that creates a very, very unhealthy scenario. Indeed, in the explanatory data that the workers at this project shared with us, they indicated that they weren't getting enough time to recover. This is a quote that somebody gave us during that intense period. As usual, I've got too much to do. There aren't enough hours in the week. Time flies by. You look at what you're meant to achieve at the end of the day and you end up carrying it over to the next day. So I came into work at 4:00am to try and get ahead.
Now that's just not sustainable. This was a young project engineer. So if we're working people like this, we can't expect to get good results from them in the long term. It will result in long term health and, I would suggest, also serious safety consequences.
So my question to the industry, I guess, is if we use sophisticated project planning and scheduling techniques to manage our construction projects– which we do. We use very sophisticated software techniques and modelling to actually manage the targets in our projects and manage our resources. Why can't we use these same tools to design project work to mitigate some of these negative impacts? Because if we know that working people in this way – we know when the major project milestones are going to be. We know when people are going to be working really, really super hard to get things done. Is it possible to design in in project schedules appropriate recovery opportunities? Actually program them in so we don't damage people to a great extent.
So these are the sorts of things which, I think, as construction project managers and planners, we need to start questioning about the industry. Because we measure health and safety matrix routinely. What we don't measure is the impact that project events have on health and safety experiences as they play out. We need to perhaps go back and understand the project data in its relation to the health and safety impacts that we're seeing.
So the second bit of research I'd like to talk to you about – sorry, I've strung together a series of case studies here because, ultimately, I think they all tell the same story. Or the same sort of story around the design of work. This piece of work was an 18 month project investigating health promotion strategies in Queensland. It was funded by the Queensland Government Department of Justice and Attorney-General as part of their Healthy, Happy Workplaces Program. We partnered with Lendlease in the delivery of this particular piece of research.
So the aims and objectives were to do some participatory action research. So actually go out onto construction sites, work with participants on those sites to design, implement and evaluate some strategies to address workers' health. The specific target of this research activity was on these five health factors of smoking, poor nutrition, hazardous alcohol intake, physical inactivity and overweight/obesity. So we had these five factors that were the focus. We collected our data using various different ways. We did some surveys to understand how people were currently living. We did some workshops to consult with people about what sorts of programs they might like around improving these SNAPO factors. Finally, we went back and we evaluated whether these programs had had an impact and undertook some focus groups to talk to workers who'd experienced them to really understand how health promotion was experienced by these groups.
Now just one of the interesting bits of data, because it's probably worth reflecting on. I don't really understand the reasons for this. I think it raises more questions than answers. But we used a method of measurement called the SF36. It's a standard, short form survey that measures health. It's used by the Australia Bureau of Statistics. So because we used it, we were able to compare our data with the standard data produced by the ABS.
So this is our data in relation to the ABS data. Down here are all the different aspects of health that this index measures. It measures everything from physical functioning, bodily pain, vitality, social functioning, emotional health and mental health. So it looks at a whole heap of things. The age group is along the top. The bold figures are the ones in which the health scores that we got in construction were lower than the equivalent Australian population data.
This tells an interesting story. I don't actually know why the data looks like this, but it actually, I think, warrants further research. The under 30s and 30 to 39 group have bold for almost all of those health indicators. That suggests that these groups, younger workers in the construction industry, have poorer health as measured by the SF36 than their population equivalents for their age. These are things which should be of concern and possibly warrant further investigation. What's really interesting, as well, is that for some groups, vitality – or for some health dimensions, rather, vitality and social functioning, which are sort of the more of sort of mental, emotional, psychological [long pause] dimensions of this SF36; the scores are low across the bracket of age groups.
So this data's telling us something. I think it's worth noting. I think these things need to be understood a little bit more. We need to understand, for example, why, irrespective of age, social functioning and role emotional are poor in construction. Also, we need to understand what's going on with these younger workers, relative to workers in other industries. Because they certainly seem to be poorer in health for their age.
So some of the health interventions that were introduced on our construction sites that participated in this program were smoking cessation programs, healthy food information, fresh fruit pop up stalls, yoga and stretching exercises; all sorts of things that were really positive and really important things to do. Indeed, when we went back and asked the workers who were on these sites how they'd experienced these things, they felt very valued and made comments that we've never been on a site before where the principal contractor has done these sorts of things for us. We feel really valued in that. That's really positive.
However, the data that we collected, which was this diary data over a period of time, showed, really, there was no sustained, continuous improvement in any of the variables that we looked at – any of the things or behaviours. So for example, this shows days of week that people reported they'd eaten junk food, daily serves of fruit and daily serves of vegetables. You can see it kind of went up and down. But unfortunately, it didn't do what we had hoped; which would go along to a point where they introduced some interventions and go up. We didn't see improvements here. Junk food would have gone, obviously. But the other two should have gone up. But, in fact, it's up and down, up and down and there isn't really a sustained improvement. So this was disappointing to us and, indeed, to our partners.
So we then went back and interviewed people about why this could be, what was going on? We talked to people about the barriers that they were experiencing to health and wellbeing. Some of those barriers were about the fact that they just simply worked such long hours and they were making trade offs. One guy said you get into a cycle. There's just not enough time. It's hard to step back and make a change. You get into a pattern of eating, smoking, drinking, sleeping. You wake up and do it all again and, before you know it, you've put on 20kg. You know, simply time poverty meant it was really difficult.
Job insecurity and stress. They talked about drinking in relation to concerns about job security. Particularly prevalent at one particular site at which we were collecting data. The masculine work culture played a part. It was only 400 blokes here. Call it pride, but there's no way you're getting me to be involved with yoga. I've deleted the expletives from that quote. [Laughter] but there was peer pressure to behave in certain ways. These are things which, I think, it's really important to understand if we're going to design work that works. That keeps people healthy and promotes healthy behaviour.
So our key recommendations from this piece of work were look, we need to understand workers' health in the context of the organisation of work. So rather than simply introduce health promotion programs without looking at the way people work, we need to actually understand the way people work and design health promotion programs that respond to some of those more structural and organisational challenges. We need to look at the quality of work. We need to look at a more holistic approach. We need to look at people's work and family interactions and health, their job stressors, the links between their mental health and health related behaviours.
I know that there's a lot of talk now about creating mentally healthy workplaces. I think all of our results support the need to do that. It's quite important. This is consistent with an understanding of health that says we can't treat health as something that can be understood in isolation of what the social ecology of people's experiences at work and at home and in life more generally. Because we don't exist in a vacuum. It's the holistic interactions between work, family and individual behaviours that create this health behaviour and health outcomes. If we try and address changing behaviour without addressing the way that work is organised, the research suggests that we'll produce very limited or short lived results.
So the practical outcomes from this – and I guess one of the things that I'd like to share is that there were some positive learnings. Lendlease has taken this on board. We were working through the Lendlease Foundation and they really took these results on board. They said right, we're going to be really careful in future not to deliver one off health and wellbeing interventions, but look at programs more holistically over time. One of their initiatives which grew from this research was creating a calendar of events that was delivered in the road services division. They had a 12 months calendar of events, as opposed to one off, individual, ad hoc programs. They decided that they were going to address things that were of concern to workers more holistically. They ran some facilitated workshops about financial literacy. Things which we wouldn't think of as being related to health, but they'd actually addressed some of the workers' key pressure points that were impacting on their health. So, in fact, understanding that some of these broader, lifestyle experiences have a health impact allows us to design programs that can be more sustaining and beneficial. So that was some practical learnings that came out of that work.
Indeed, the workers who participated in those new holistic programs were really, really positive about them. These are some quotes that the Lendlease Foundation kindly let me use. But they're talking about how the benefits associated with these programs flow to outside of work. So I live the second one from the bottom. Yeah, I really benefited from these and I told the old man to go to the doctor's for a prostate cancer awareness check. So they're actually talking about yeah, we learnt this at work; but now we're going back and we're actually sharing that information with our family members because it's actually broadening and helping us to be better and more healthy in our outside lives as well. Every morning, instead of eating a pie, I'm having cereal at home. So they were benefiting or they felt they were
I think the interesting thing about those findings, just going back to them, is that looking at things more holistically, looking at the design of work can produce substantial benefits. Until we actually start looking at the root causes of poor health and poor healthy behaviours or undesirably healthy behaviours and actually going back to how is work and the way that we design work actually creating this situation, then I think we need to – we're going to have a fairly limited ability to address it.
Now one of the interesting things that Mark McCrindle mentioned this morning, and I'm really pleased that he did, was looking at engaging workers and the expectation of participatory ways of working. Because again, another case study that I'd like to share with you is around looking at ways to engage and get workers to participate in the design of better work. One of the things that we've seen in our research is that a lot of the health and safety management systems that are implemented within organisations have a very top-down focus. They create a culture of enforcement where we write a lot of detailed procedures and rules. Which are obviously important documents, but they're intended to control workers' behaviour and then we try and monitor and enforce compliance with those procedures and rules.
Now the challenge is in that and it's a tension; because rules and procedures obviously have an important role to play in defining the boundaries of what's acceptable behaviour. But what they don't do is recognise workers' tacit knowledge and, in fact, the informal work practices that they use on a daily basis. So what we're seeing is – and this is well documented and I've heard other people speak about this. We're seeing gaps between procedures or what some people call work as imagined and practices, which is the way work is actually done.
Now this case study emanated from some participatory video work that I did with a very small company in Victoria; a company called CodeSafe Solutions. Now CodeSafe Solutions have a really innovative approach. We were interested, initially, in how they were using visual, digital, mobile and social technologies to actually communicate health and safety information to construction workers. But what we didn't realise until we actually spent time on site working with them; that what they were doing was far more powerful than that. They were actually unlocking workers' knowledge and using that workers' knowledge to redesign the way that work was done. In doing so, they were empowering and engaging workers in completely new ways that produced a whole range of different benefits and outcomes.
So this participatory video is an interesting phenomenon. We've actually studied it a little bit. This what the participatory video process looks like in practice. I'll explain a little bit in a moment. So these top-down management systems which attempt to create these cultures of enforcement don't recognise, as I said, workers tacit knowledge or informal work practices. Arguably, there's a need to better understand work from the perspective of the people who do it. If we're going to design work that works, we need to understand, from the people who do it, what works for them and what doesn't and how they experience it. This guy here is actually the founder of CodeSafe Solutions. This is just a shot of him actually on site with a group of insulation installation workers, listening to them and hearing from them about how they actually work. We studied this as ethnographic researchers. So we went in and we watched them do their thing. We learnt from watching them. So it was a really interesting kind of research experience. In fact, we're making a documentary about it at the moment because what we found, we feel, is so interesting and important.
So participatory video; it was a term I'd never heard of, but I've become really interested in it as a concept. It's a set of techniques that involves a group or community in creating their own films. So it's not like documentary where people don't have a say in shaping the content of the film. What it does, it allows people to shape issues according to their own sense of what's important and decide how they want to be portrayed. So construction workers themselves make films about their own work. They decide what should be in the films. They decide what they want to say. They're in control of making these films. So this approach has been used to provide insight into and share experiences of daily realities of marginalised and disadvantaged groups of people all around the world. Our research, I guess, was intended to look at the opportunities to use this participatory video technique to engage workers in a discussion about health and safety and the design of their work.
I've got a couple of little examples here, because they're really telling. I think they really reveal the power of participatory video. Because one of the things that the company we were working with or CodeSafe was working with was an organisation that installs insulation in buildings. One of the things that they wanted to do initially was to make a film about how to access ceiling spaces in domestic, residential houses and show how to do that safely. So when the film crew got to site to film this film, they found this fellow here who was really cross. He just said look, you want to make this film? I'm telling you this is not going to work because we can't follow the standard operating procedure that this company has in place. So the standard operating procedure required a straight ladder to be placed at a 1:4 ratio and extend 900mm beyond the step off point. [Long pause] he said it's just – it's practically impossible. In the context of this physical work environment, that is practically impossible.
Indeed, in the making of the video, these quotes here were made by the health and safety manager of the company who had accepted this standard operating procedure for as long as she'd been with the company. But she said look, shooting it and viewing it through the camera's eye; we had to stop. The camera just doesn't lie. To place a straight ladder at the required ratio, you can't get a body in there. It blocks off the access. You have to contort yourself. It's just physically impossible. Not only was it impossible to do with a straight ladder, but it was also not possible to do it with a standard A frame ladder that was provided to them because they had to stand on the top rung and haul themselves physically into the ceiling space.
Now this standard operating procedure had been in existence for a long time. It was only when this film was being made and people visually realised this is just – this is not how we work. So in fact, what this did was show a clear gap between the procedure and the practice. Flowing from this, this company has now found a new access system that resolves this particular problem. Again, the visualisation of it was really important.
Now here's another example of a scaffold erection process where [long pause] they were making a film about how they work to erect a scaffold. The original erection process involved these unprotected edges during the erection activities. Indeed, the guys who were viewing the video reflexively with the workers said well, you know, this isn't really a good way of doing it. Is there a better way of doing it? The workers themselves came up with an alternative which uses midplatforms and horizontal members to provide edge protection during the erection process. This indicates – this video unlocked this opportunity to learn in practice. So as the manager involved in that particular film making process said, there was one phase for 30 seconds where they were unprotected and I said I'm sure we can do something different. So we went back out to the worksite with the crew and the supplier and showed the crew the issues and said how do you reckon we fix it? They spent several hours and, in the end, they did. So in the end, they found a way to fix it.
Again, it was the process of using the video to learn about the practical reality of doing the work. It allowed managers to understand work from the perspective of the people who did the work, which they previously hadn't understood. It ultimately led to the redesign of work processes, practices or equipment to actually make work practically safer in the environment in which it was performed.
We interviewed workers about this process and what was really, really good was that the workers talked about how important it was for them to have an input into the design of their work and to learn from their peers about what could actually be done better. Until they sat down and watched the videos, they hadn't really, in some cases, understood or recognised that there may be a better way of doing it. It was actually the reflection, collectively, of the workers saying well we can do that better. We can think of a different way of doing it. Unlocking that important knowledge and that creativity was a really key thing in this participatory video process.
The workers talked as well about how procedures were inherently limited because sometimes you just can't write things down. They talked about some knowledge is knowledge that you know how rather know what. The procedures are quite good at telling you what to do. They're not always so good at telling you how to do things. So this know how versus know what was really also important for the workers. The visual way of understanding health and safety in practice was very, very powerful. So I think this participatory video also says something about engaging workers in the design of work. They do this job on a daily basis. If we want to design work that works, actually talking to workers, listening to them and using visual ways to understand work is very, very powerful.
So how does this work in the bigger construction project picture? I've just completed, with a group of my colleagues at RMIT, a five year international benchmarking study funded by the US Federal Government and undertaken in collaboration with Virginia Tech. One of the things that we did was we wanted to look at the relationship between the way people communicate with one another in construction project networks and the quality of health and safety outcomes that are realised. We collected data from 23 construction projects, ten in Australia, 13 in the US, and we undertook 288 interviews. So we actually talked to a lot of people over this five year period. I'll explain what this means in a moment.
One of the things that wanted to know was what creates the conditions for really effective risk control outcomes? So we wanted to know what project characteristics produce the types of hierarchy of control outcomes we all aspire to? What produces the eliminations, the engineering solutions and the substitution type solutions? So what we did was, across these projects, many in the US, some in Australia; we actually asked people how they communicated with other project stakeholders throughout the life cycle of the projects. We wanted to know how many times they gave information and received information to different parties. So we wanted to know where people sat in the social networks of the projects. We then tried to statistically relate that to hierarchy of control outcomes.
So we took a bunch of building features in our projects and we looked at the way that health and safety was dealt with and we scored them all in accordance with the hierarchy of control. So a higher score meant that you got better outcomes in terms of elimination, substitution and engineering and a lower score meant that you were relying on procedures and rules and administrative type measures. So the higher score outcomes were the things we were interested in seeing.
Across all of our projects, we then looked at who was talking to who when key decisions were made. We were able to map these in little social network diagrams to actually really understand project networks and where people sat. Now here's an example where the constructor, here, was very central to the decisions that were being made. So on the right hand side of this network, we've got here the architect, the client's engineer, the client and the rail authority. So these guys were all what we would call demand side stakeholders. They were people demanding something of the project. On the left hand side here, we've got the supply side. So we've got another group of stakeholders here. But the construction contractor is central to this. The centrality is shown by his position and also the fact that these bold lines show the frequency of communication.
Now what we found across all the projects we looked at was that when the construction contractor's position in the decision networks was higher, we got higher quality HOC outcomes. Higher quality risk control outcomes. Basically, we got more examples of elimination, substitution and engineering controls implemented when the construction contractor was central in these networks. We looked at this statistically and found that this was a statistically significant finding. We can safely say that if you design construction project networks with a construction contractor able to have a key role in decisions that are made, particularly during the pre-construction stages of work, you are much more likely, statistically, to get higher quality health and safety risk control outcomes.
So the learning from this, I guess, in relation to the design of work is that it's not just about designing work that works actually in the field. It's about designing project delivery scenarios that facilitate this. You know, that facilitate good decisions being made because the right people are at the table at the time when those decisions are being made. I think that's actually an important lesson from this international benchmarking study.
To go back to some work that I was involved with with a number of other universities, including Queensland University of Technology some years ago. We worked with a group of clients, designers and constructors and, indeed, government agencies and peak industry bodies to develop a set of documents that was designed and tended to facilitate a collaborative lifecycle approach to construction workers' health and safety. I think some of the principles – while it's a little old now, some of the principles in this set of documents that talk about clients, designers and constructors working together and they talk about the integration of health and safety considerations into upstream design and planning decision making are still very, very relevant to the work today that needs to be done. Indeed, in particular to creating networks that look like this. Because in order to create a network that looks like this with the constructor in a nice central position, there needs to be a consideration of the way that projects are ultimately structured and they way that commercial arrangements in projects play out.
So what do these findings all mean? To some it all up, I think there are three – from all of these little bits of research, there are three key messages. The first one is to consider health and safety issues early and make sure that when you're considering them, you have the right knowledge in the decisions that are made. Including workers' knowledge and acknowledging their tacit knowledge is really important. But also making sure that you have people who understand construction in making decisions about projects – the way that projects should be scheduled, planned, designed, ultimately delivered.
The second thing is to engage people in meaningful ways. I think the use of technology, digital, mobile, visual technologies can really help here. But simply just talking to the people who do the work. They practice the work on a daily basis. Understanding what shapes the way they work and how they can contribute to better work design is really important.
Lastly, understanding the issues of what really impacts health. Because it's not always about providing a fruit box in the site office or some of the things that are nice to do, but aren't really addressing the key issues about hours, rosters, the underlying cultures within which people work. Because there's more fundamental things that we need to fully understand in order to really address health.
I'd just like to acknowledge the funding agencies for the three case studies I've presented. The first one was funded by the Queensland Government under the workplaces for wellness – Healthy, Happier Workplaces Imitative, the second one by the Victorian Department of Business and Innovation and the third one by the National Institute of Occupational Safety and Health in the US. Thank you.
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