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The authors ask you:
Falls account for much morbidity and mortality in the residential construction industry, yet controlling workplace fall hazards is difficult in this sector. Our research team partnered with an apprenticeship-training program to improve fall prevention training of apprentice carpenters. We utilized focus groups, questionnaires, and worksite audits to measure apprentices’ attitudes, beliefs, work behaviors, training experience, and preferred training methods. Apprentices reported frequent falls from heights, most commonly from ladders. Predictors of falls from heights included greater exposure to residential construction, performance of a larger variety of work tasks, and perceived unsafe crew behavior. The apprentices reported many unsafe work crew behaviors and worksite audits found that fall prevention work practices are performed inconsistently. These data guided redesign of the school-based fall prevention training. Since many of the factors we identified are associated with falls are at the worksite, it is recommended that training interventions also be provided at the workplace. Through collaboration with a broad base of stakeholders, researchers can identify, develop, and measure the impact of training and other types of interventions to improve fall safety in residential construction.
In 2006 the construction industry experienced more fatalities than any other industry1. Falls account for over one-third of all construction fatalities; however, in residential building construction, almost one-half of the fatalities are due to falls. Falls from heights to a lower level rose 39% among residential construction workers in the two-year period between 2003 and 20051. Workers who are inexperienced2, have shorter periods of union membership3, are employed by smaller size contracting companies4 and perform residential construction5 are more likely to experience serious occupational injuries.
Controlling workplace fall hazards is difficult in the residential construction industry, where the work environment is ever changing and the work crews are often small and dispersed. The ratio of experienced to inexperienced workers can be low and there is an increasing immigrant face in residential construction2. On site safety professionals are a rarity and safety innovation has lagged behind commercial construction. New home construction is a competitive sector of the construction industry, with significant time pressures on most jobs. Building practices described in the Construction Standards STD 19266 are not feasible at many residential sites. Home construction methods recommended in Directive STD 3.1A Safety and Health Interim Residential Guidelines7 are more realistic to protect workers from falls from height, but these guidelines do not have the same legal enforcement as regulations, decreasing the incentive for adherence.
Inexperienced workers may be especially vulnerable to falls at residential construction sites as levels of mentorship may be lower than at commercial sites. After a brief classroom training, apprentices become a working member of a crew, which in residential construction, usually consists of another apprentice, a foreman, and a journeyman carpenter. New apprentices “learn by doing” under the mentorship of experienced workers, yet may be vulnerable to falls due to lack of knowledge, inexperience, and risk-taking behaviors. Little is known about the effectiveness of the apprenticeship-training model for fall prevention in residential construction. Our current study focuses on fall prevention education of apprentices in the training school and evaluation of the impact of this training on apprentices’ attitudes, beliefs, and worksite behaviors at residential construction sites.
Given our concern with the fall safety of apprentice carpenters working residential construction, our research team at Washington University in Saint Louis partnered with the local apprenticeship-training program, a collaborative effort between the Carpenters District Council and the Home Builders Association, to improve the fall prevention training of apprentice carpenters. We utilized focus groups, questionnaires, and worksite audits to measure the apprentices’ attitudes, knowledge, risk perceptions, worksite behaviors, training preferences, and identify opportunities for improvement. We used this information to guide the apprentice-training faculty in redesigning the school-based fall prevention training to best address the deficits we uncovered during our baseline assessment. Through a series of planning and development meetings with the faculty, we developed specific learning objectives, lesson plans and training methods for four of the eight training modules in the four-year curriculum. After initiating the revised curriculum, we solicited apprentice evaluation and feedback to guide ongoing curricular improvements. We will re-survey the apprentices and perform another wave of worksite audits to assess the results of our revised training beginning this spring. Through this process it became clear that we must also partner with the contractors to best make an impact on the fall safety of apprentice carpenters at residential worksites. Our team is pursuing additional funding and partnerships to understand the residential contractors’ perspective, develop practical on-the-job training, identify other interventions besides training, and evaluate the effectiveness of these on-site interventions.
Our baseline measures identified many opportunities for improved training both in the apprentice school and at the worksite as well as other interventions. Of the 1,026 apprentices we surveyed, 16% had sustained a fall from height in the past year. Fortunately most of these falls did not result in serious injury or lost time. Most of these falls occurred from ladders, yet ladders were perceived as low risk and ladder training was frequently not performed. When we compared apprentices who fell with those that did not, we found that apprentices who fell had fewer journeymen at their worksite for mentorship, less carpentry work experience, and were 40% more likely to report unsafe co-worker behaviors. In our multivariate model, predictors of falls from heights included greater exposure to residential construction, performance of a larger variety of work tasks, and perceived unsafe crew behavior.
We found that apprentices perceive work on a steeply pitched roof as the most risky task they perform, followed by setting trusses, working on the top plate, and working at unprotected openings and edges. Most of the apprentices knew the height where fall protection is required, but just over half knew that top plate work was not allowed during truss installation and only one-third knew what size of a hole required covering. Most apprentices were confident that they could prevent themselves from falling at work and regarded the safety climate at their workplace as positive. The apprentices reported many unsafe work crew behaviors, which were confirmed through 197 worksite audits. We found that fall prevention work practices were performed inconsistently. Ladders were not set up and used safely and floor openings were left unprotected at many sites. Carpenters were observed standing and balancing on the top plate without a stable surface for support while installing roof trusses. Personal fall arrest was rarely used at the residential construction sites we audited.
Unfortunately, many of the apprentices we spoke to voiced little concern about working near unprotected openings and reported performing dangerous work tasks prior to training. Most of the apprentices receive mentorship from journeymen and fall prevention training at the worksite; however, the quality and quantity of training varies significantly. Apprentices identified barriers at the worksite that prevent them from consistently applying what they learn during training. Time pressures and concerns about job security may prevent apprentices from seeking mentorship on the job. The apprentices overwhelmingly agree that hands-on training is their preferred training method, with on-the-job training preferred over training in the apprenticeship school.
Recognizing the importance of training prior to entering the field, the apprentice school faculty increased the fall prevention content during the first two training sessions. The instructors identified specific learning objectives and lesson plans for four of the eight training sessions to insure that training is consistently delivered and fall prevention is reinforced throughout the four-year program. We used adult learning principles to emphasize hands-on experiences and integration of real-life stories. A portion of a framed structure of a residential construction site was fabricated to allow apprentices to observe and practice fall protection behaviors. Preliminary results show that 96% of early term apprentices agree that the residential prop is an effective training tool and 81% state they will change their stepladder work habits as a result of training. The training appeared to impact many of the apprentices as evidenced by feedback such as, “I will use these safety tactics daily, I had no knowledge of them before”, and “I learned a lot about my own interpretation of risks…risk perception is different than it seems at first.”
Our study to date suggests that apprentice carpenters who spend more time working in residential construction are at increased likelihood of falling from heights compared to those working commercial construction. Fall prevention work practices are performed inconsistently at residential construction sites. Many of the observed risks could be controlled if safe work practices were followed. Ladder use is a priority as we identified frequent unsafe ladder behaviors, exposure to ladders is frequent, and ladders account for a large proportion of falls in national injury statistics. Some apprentices lack knowledge of OSHA fall prevention standards and methods of fall prevention, however apprentices often do not apply safety principles they have been taught in school in the actual work environment. The apprentices’ attitudes and beliefs may drive their risk-taking behaviors; however environmental factors appear to affect the apprentices’ fall safety behaviors, such as work crew behavior and mentorship. Non-unionized workers may be exposed to even greater fall risks as they rarely participate in formal training programs and may lack other workplace protections. Effective training that is based upon identified needs and adult-learning principles can be designed and implemented by apprentice school faculty. It is recommended that training be provided at both the apprentice school and the construction site, however empowering workers through training alone can fall short. Therefore we should collaborate with a broad base of stakeholders to identify other interventions to improve fall safety in residential construction.
The high rates of participation by the apprentices (98.8%) and large sized contractors (100%), and the excitement generated by the apprentice school faculty for this project demonstrate that construction professionals in the St. Louis area are very willing to collaborate with researchers to address the fall problem in residential construction. Our project uncovered many issues that affect the fall safety of apprentices at residential construction sites, some of which can be addressed through in-school training, but many that require intervention at the work crew and contractor level. The in-school fall prevention training program we designed will reach most of the inexperienced residential construction workers in the St. Louis vicinity since approximately 90% of residential contractors employ union carpenters; however, in many areas of the country where home construction is performed by non-union workers, a school-based training program is not feasible. Therefore our research group plans to partner with residential contractors to pursue practical worksite-based training programs and other interventions that will impact fall safety. We envision contractor use of the worksite audit instrument that we developed through this project, the St. Louis Audit of Fall Risks (SAFR), to assess the fall risks at their worksites and plan for hazard management. We are applying for additional funding for our fall prevention research and are looking for researchers interested in similar projects. In order to decrease worker injuries and fatalities, we must identify and employ various methods to protect construction workers from falls.
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