Research Collaborators

• Washington University School of Medicine
• Duke University
• Carpenters District Council
  • Currently 900 apprentice members, was 2,400
  • 90% of residential workforce in STL is unionized
    
• Carpenters’ Joint Apprenticeship Program
  • Apprentices work residential, commercial or both
  • Jointly supported by the union and local contractors
  • Instructors are journeymen with college degree
  • 4-year on-the-job training program
  • Attend 2-week training sessions every 6 months
  • Facilities include classrooms and large shops

Background

• Construction is a dangerous industry
• 1,178 fatal work injuries in 2007 (BLS 2007)
• 35% fatalities due to falls
• Residential construction
  • 43% fatalities due to falls (BLS 2007)
  • Challenges in residential construction
    • Small work crews, fast-paced
    • No permanent job sites, geographically dispersed, rapidly changing environment
      
      
• Falls remain a leading cause of morbidity and mortality in construction

Fall Prevention Project

Use the results from comprehensive needs assessment to improve the fall prevention curriculum at carpenters' apprenticeship training program.

Methods-Phase I

Needs Assessment

• 5 focus group of apprentices at different stages of training
  • 36 total participants
    
    
• 197 worksite audits
  • 510 brief worker surveys
  • 95.5% of those asked for interviews agreed
    
    
• 1,025 questionnaires
  • 98.8% response rate

Results - Focus Groups

• Work at heights early in career
• Apprentices perform many tasks prior to training, including tasks at elevations
• Frequently assigned high risk tasks
• Crewmembers frequently perform tasks unsafely & instruct them to do the same
• Are hesitant to ask for instruction or to question methods that appear unsafe
• Fear layoff if refuse to do a task they don’t know how to do or they think is too risky

Worksite Audits

• 52-item observational audit – St. Louis Audit of Fall Risks (SAFR)
  • General Safety (3)
  • Floor Joist & Sub-floor (3)
  • Floor Opening (6)
  • Wall Opening (2)
  • Truss Setting (6)
  • Roof Sheathing (7)
  • Ladders (10)
  • Scaffolds (13)
  • Personal Fall Arrest (2)
    
    
• Brief worker interview
• Trained carpenters perform audit
• All or none scoring
  • Meets safety criteria
  • Does not meet criteria
  • Not observed during audit
    
    
• Mean domain scores computed
• Electronic Library of Construction Safety & Health
• http://www.elcosh.org/

Percent of Time Observed Behaviors Met Audit Safety Criteria

Percent of Time Observed Behaviors Met Audit Safety Criteria

Percent of Time Apprentices Reported Safe Crew Behaviors

Questionnaire Results: Fall Statistics

• Falls
  • 16% fell from height in previous year
  • 51% knew someone who had fell from height in last year
  • 29% of all falls were from ladders, 18% truss/top plate, 17% floor openings
    
    
• Those who fell
  • Fewer journeymen on site for mentorship
  • 40% more likely to report unsafe crew behaviors
  • Twice as likely to work residential construction

Questionnaire Results

• Risk perceptions by task
  • Steep pitch roofs
  • Setting trusses
  • Working on the top plate
  • Unprotected openings
  • Ladders perceived as low risk
    
    
• Confidence is high
  • Feel they can prevent themselves from falling
  • Feel they can perform work tasks safely

Percent of Apprentices who Knew OSHA Standard

Percent of Apprentices Reporting Trained at School Prior to Performing Task at Work

Training Preferences

• Apprentices like
  • Learning by doing
  • Practicing tasks and skills in shop
  • Real world examples and stories
    
    
• Apprentices dislike
  • Reading the OSHA regulation book
  • Listening to long lectures
  • Sitting in a classroom

Needs assessment results for ladders

• Most falls occur from ladders
• Ladders used frequently at the worksite
• Most apprentices not trained to use ladders
• Ladder knowledge is lacking
• Ladders perceived least risky work task
• Many unsafe ladder behaviors reported
• Many unsafe ladder behaviors observed

Methods-Phase II

Training Priorities - Phase II

• Frequently performed tasks
  • Tasks performed early in career
  • Tasks performed prior to receiving training
  • Tasks reported/observed as unsafe during audits
    
    
• Priority tasks include:
  • Ladder use – 9 objectives
  • Floor openings – 6 objectives
  • Truss setting – 8 objectives
  • Scaffold use – 5 objectives

Training Methods

• Use participatory, hands-on learning
• Practice tasks in real-world setting
• Limit lecture & reading OSHA standards
• Present in classroom 1st, then perform in shop
• Share fall stories to personalize
• Use small group discussion to problem-solve
• Focus on attitudes, beliefs, risk perceptions
• Use repetition & reinforcement
• Empower apprentices to identify safe work methods & consistently use them on the job

Target Curriculum Areas

• New apprentices (Introduction)
  • 18 training objectives
    
    
• 6 month apprentices (Health & Safety)
  • 8 training objectives
    
    
• 1^st year apprentices (Residential Framing)
  • 6 training objectives
    
    
• 3^rd year apprentices (Scaffolding & Rigging)
  • 9 training objectives

New Apprentice Training

New Apprentice Training

New Apprentice Training

6 Month Apprentice Training

6 Month Apprentice Training

1st Year Apprentice Training

• Sub-floor framing: discuss leading edges & covering stairwell opening
• Wall framing: discuss guarding window/door openings, covering HVAC holes & not walking ladder blocks
• Roof framing: 20-minute discussion of fall prevention methods, fall story shared, show pictures of correct way to set truss, brace & install stay lap, discourage top plate standing
• In shop: inform students of safety rules and deduct points from shop grade for all violations

3rd Year Apprentice Training

• Scaffolding
  • Use of ladders, guard rails & PFAS as they relate to scaffolding standards are presented
  • Students choose correct size ladder, set, & climb while erecting scaffolding
  • While erecting scaffold proper fall practices are used
  • Students identify violations in scaffold pictures, discuss what led to the violation, and how to abate the violation
• Rigging
  • Use of crane, hoists & chain falls practiced in the shop
  • Crane setup and truss hook up procedures shown
  • Discuss the hook-up, moving & landing of trusses

Monitoring Results - Phase II

• Monitor curriculum delivery
  • Note variations in training each time delivered
  • If change improved training integrate into lesson plans for future sessions
• Monitor objective achievement
  • Initially only 73% in Term 2
  • Modified objectives to be more realistic
  • Overall 90% objective achievement rate
• Continue to modify delivery method and objectives to best meet needs of apprentices and instructors
• Focus groups for apprenticeship feedback:
  • 96% felt that the prop is an effective training tool
  • 81% stated they will change their work habits
• Quotes from apprentices:
  • “I will use these safety tactics daily, I had no knowledge of them before.”
  • “I learned a lot about my own interpretation of risks.”
  • “You scared the heck out of me by telling me all the ways I’m going to die!”

Phase III

Percent Reporting Trained at CJAP Prior to Task Performance at Work

* p < .05, ** p < .01

Percent Knowing OSHA Regulation

* p < .05, ** p < .01

Percent Reporting Safe Crew Behavior

* p < .05, ** p < .01

Percent Safe Behaviors Observed by Audit

* p < .05, ** p < .01

Percent Safe Behaviors Observed by Audit

* p < .05, ** p < .01

Percent Reporting Fall from Height

* p < .05, ** p < .01

Conclusions

• Falls from heights are common in construction
• Despite training & mentorship apprentice carpenters lack fall prevention knowledge
• Unsafe behaviors at heights are common
• Instructors can develop training to address knowledge gaps & change behaviors
• Training can result in improved safety when working at heights
• Using needs assessment to drive intervention was an effective method to drive training
• Methods can be replicated

What’s next?

• Monitor long-term effects of curriculum
• Develop worksite based fall prevention training & foreman mentorship program to decrease falls
  • Use needs assessment to identify current state
  • Develop 1-day foremen training
  • Measure effects of training on fall behaviors
• Increase use of fall prevention technology
  • Measure current use of residential fall technology
  • Pilot fall prevention devices
  • Measure effects
• Disseminate our methods, tools, and results
  • SAFR on the eLCOSH website www.cdc.gov/elcosh/

Discussion