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The character international joint ventures of the large construction projects in Denmark and common EU guidelines for occupational safety suggests that the conclusions and recommendations also apply to large construction projects in other EU countries. Injury prevention is a multi-disciplinary area and may involve interaction among many cognate disciplines, including safety engineering, statistics, epidemiology, occupational medicine, ergonomics, toxicology, public health, public policy, sociology and psychology.
The present study is primarily based on quantitative methods from safety engineering, statistics and epidemiology in combination with socio-cultural methods from the third age of safety Hale and Hovden, involving both personal attitude and behaviour and contextual physical and organizational environment, social norms and culture injury prevention factors Lund, The increasing complexity of construction projects creates the need for engineers and other professionals trained in all phases of the project's life cycle.
Construction engineering is a discipline that attempts to meet this new challenge.
The CDIO syllabus objective is to create rational, complete and universal goals for engineering education. A large construction project consists in general of all four project phases: conceive, design, construction and operate. Research and practice has shown that many injuries could be avoided if the occupational risks had been foreseen during conceive and design phases Behm, ; Spangenberg et al, a ; Gambatese et al, This research provides an argument for including all project phases in an injury prevention model targeted at large construction projects. According to the European Union's statistical unit, Eurostat, approximately construction workers are killed each year in the EU Eurostat's homepage.
Accurate figures are hard to obtain due to unregistered employees and unregistered accidents. The NWEA has estimated the underreporting of injuries to approximately 50 per cent.
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This corresponds to an average injury rate for construction workers in Denmark of approximately 35 injuries per million working hours taking into account the underreporting. The number of fatalities is 10 per year in average — The overall injury rate has been falling for some years, but the decline seems to have stopped and been replaced by a new upward tendency The Danish Working Environment Authority, The Danish part of the trans-European transport network has been under continuous development during the last two decades.
The Danish construction industry has been involved in the completion of three large and complex bridge and tunnel traffic links, the first being the Great Belt Link — During the construction of the Great Belt Link, it became clear that the injury rate was almost twice the average injury rate for construction workers in Denmark. Major challenges were the international character of the contract holders the contractors were organized in joint ventures and the fact that a client-led health and safety organization had not yet been introduced.
As a result of the experience from the Great Belt Link, a client-led health and safety organization was implemented during construction of the subsequent part of the transportation network. The call for tenders contained occupational safety and health as an integral part of the construction work. A special safety and health committee was established with the client as chairman and with the participation of relevant stakeholders including the Danish Working Environment Authority.
At the beginning of the construction period the injury rates were high, whereupon the client-led safety and health organization successfully implemented various occupational safety and health measures as described in Chapter 4. The injury rate fell to 20 injuries per million working hours, which was approximately one-third compared to the Great Belt Link The Danish Working Environment Authority, The number of fatal accidents was reduced but not eliminated, as three workers lost their lives.
The third large construction project is the Copenhagen Metro an ongoing project which began in , where experience from the earlier projects was utilized again. Significant injury preventive results were obtained, sometimes under very difficult working conditions. Part of the Metro system was built under an existing commuter train which was in operation during the tunnel boring.
The injury rate of the Metro project was approximately 30 injuries per million working hours during the first two stages — The injury rates at the large construction projects in Denmark have decreased significantly during the last years. Behind the improvements had been concerted efforts among the different stakeholders.
Major public or semi-public contracting clients, The Danish Working Environment Authority, labour inspection authorities, the occupational health services, the unions, consultancies, contractors and their association worked together to reduce injuries during construction work. Several injury prevention measures were introduced at the projects and the preventive lessons of the large construction projects are evaluated further in Chapter 4. Injury prevention models have developed from focusing on technical causes to focusing on dynamic interactions between man, machine, environment, organization and society Reason, ; Glendon and McKenna, ; Hale and Hovden, The first age of safety was concerned with the technical measures to guard machinery, prevent fire and explosions, and prevent structures from collapsing.
It was then realized that technical risk assessment and technical prevention measures alone could not prevent injuries from occurring. The dominance of the technical view of safety in risk analysis and prevention was broken and the study of human error and human recovery came on the agenda. The second age of safety was concerned with the interaction between man and machine: the socio-technical injury prevention concept.
This led to the third age of safety, concerned with the interaction between man, machine, environment, organization and society, and where management systems are the focus point of injury prevention methods and involvement of the employees has become a key issue together with norms and values of the society Hale and Hovden, The safety management methods started in high risk enterprises, that is, nuclear power plants and the aviation industry, but have spread to other industries, including the construction industry.
This concept is a holistically approach to injury prevention, where the enterprises are viewed as social and cultural systems. In socio-cultural injury prevention models both personal factors, like attitude and behaviour, and contextual factors, like structural and cultural factors and social norms, govern the outcome of injury risk exposure Lund, Attitude is a hypothetical construct that represents an individual's like or dislike for an item, that is, a person, a behaviour or an event. Attitudes are composed from various forms of judgments.
Attitudes may develop on the ABC model affect, behavioural change and cognition Olson and Zanna, The affective response is a physiological response that expresses an individual's preference for an entity. The behavioural intention is a verbal indication of the intention of an individual. The cognitive response is a cognitive evaluation of the entity to form an attitude.
Most attitudes in individuals are a result of observational learning from their environment.
Behaviour refers to the actions or reactions of an individual, usually in relation to the environment. Behaviour may develop on the KAP model knowledge, attitude, practice or behaviour Olson and Zanna, The assumption is that increased knowledge will modify attitudes with regard to, for example, injury prevention and as a consequence behaviour will change, and injuries may be avoided. Behaviour can be conscious or unconscious, overt or covert, and voluntary or involuntary.
Human behaviour can be common, unusual, acceptable or unacceptable. Humans evaluate the acceptability of behaviour using social norms and regulate behaviour by means of social control. The structural factors consist of the physical environment, that is, the physical conditions at the construction site, and the organizational environment, that is, the political and economic organization of the construction company and the construction industry Lund, The contextual factors include cultural factors and social norms.
Culture generally refers to patterns of human activity and the symbolic structures that give such activities significance and importance. A social norm is an assessment by the collective, while attitude is an assessment of the individual. In sociology a social norm is a rule that is socially enforced. Social sanctioning is what distinguishes norms from other cultural dimensions or social constructions such as beliefs and values.
Interventions to reduce injuries in construction workers
Norms are thought to affect a wide variety of human behaviour. Social norms can also be viewed as statements that regulate behaviour and act as informal social controls. They are usually based on some degree of consensus and are enforced through social sanctions. The interventions were divided into four main categories with regard to the type of prevention measures utilized: attitude, behaviour or structural modification measures, and one category where measures from two or three of the main categories were used in combination orchestration. Based on the review they find that some of the hypothesized paths in the injury risk factor model seem to be weak, for example, the KAP model, whereas others seem to be strong, for example, modification of physical and organizational environment followed by behavioural change.
They conclude that when various preventive measures are used in combination, that is, orchestration, and the measures succeed in influencing social norms and public opinion, they are probably more effective than safety intervention targeting individuals only. The safety intervention reviews provide an argument for including both personal factors and contextual factors in a socio-cultural injury prevention model for large construction projects.
Construction engineering is a phased process. A large construction project consists in general of four project phases: conceive, design, implement construction and operate — CDIO Crawley, These main phases may be divided into sub-phases. In the conceive phase the owner produces a list of requirements for a project, giving an overall view of the project's goals.
Owners of these large projects are usually government agencies, either at the national or local level. Construction procurement describes the merging of activities undertaken by the owner client to obtain a building or a construction. There are many different methods of construction procurement; however the three most common types of procurement are: traditional design-bid-build, design and build, and management contracting.
Interventions to reduce injuries in construction workers | Cochrane
In the design-bid-build contract, the project is completely designed by the owner and his consultancies, then bid on by contractors, and then completed. Under this system, once the design is completed by the design team, construction companies are asked to make a bid for the work, either based directly on the design, or on the basis of drawings and a bill of quantities provided by the owner and his consultancy.
Following evaluation of bids, the owner will typically award a contract to the lowest responsible bidder. At the large construction projects, it is often not just one contractor, but a consortium of several contractors working together.
In the design and build approach turn-key contract the contractor is given a performance specification by the client, and must undertake the project from design to construction to produce a completed fully functional construction or building, while adhering to the performance specifications. The contractor's ability to influence the construction process is limited by this method.
In the management contracting arrangement the client plays an active role in the procurement system by entering into separate contracts with the design consultancy and individual trade contractors. This approach is often used to speed up the procurement processes, allow the client greater flexibility in design variation throughout the contract, keep the ability to appoint individual trade contractors, separate contractual responsibility on each individual contractor, and to provide greater client control.
The contracting methods provide an argument for letting the client be responsible for establishing an overview of injury prevention measures to be implemented during all the project phases of a large construction project. The safety and health obligations of the designer are determined by the Danish legislation Executive order No. The main obligations are: not to prescribe a substance or material that could be dangerous; point out the specific risks and other special circumstances involved with the specific project; indicate if there are specific conditions of the surroundings of the construction site, which may pose a particular risk to the workers for example, stray ships ; indicate how individual work or work processes must be organized in relation to each other.
Furthermore, the design team should, as part of project material, provide a description of the characteristics of the construction to the extent they are relevant to safety and health during maintenance or repair of the structures. The description should include a list of the specific conditions to be observed in relation to safety and health of such future work.