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Safety Science 74 (2015) 184–194

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Safety Science
journal homepage: www.elsevier.com/locate/ssci

Risk-based management of occupational safety and health


in the construction industry – Part 2: Quantitative model
Vitor Sousa ⇑, Nuno M. Almeida, Luís A. Dias
Department of Civil Engineering, Architecture and GeoResources, Technical University of Lisbon – IST, Av. Rovisco Pais, 1049-001 Lisbon, Portugal

a r t i c l e i n f o a b s t r a c t

Article history: During the last decades, there has been a growing awareness about occupational safety and health risks
Received 6 February 2014 by the various interested parties in the construction industry. However, despite the substantial improve-
Received in revised form 1 July 2014 ments achieved, the rate of accidents is still significantly higher than in most of the other industries. Two
Accepted 2 January 2015
major reasons have been used to explain this high rate of accidents in the construction industry: (i) the
Available online 29 January 2015
intrinsic riskiness due to the nature of the activities and the particular characteristics of constructions
projects and organizations; and (ii) the financial and economic issues regarding the implementation of
Keywords:
additional safety measures in a growing competitive market.
Occupational safety and health
Quantitative risk assessment
This companion paper is presented in two parts. The present document refers to Part 2 and makes use
Construction industry of the background knowledge and existing initiatives reviewed in Part 1 to propose and detail the Occu-
Monte Carlo Simulation pational Safety and Health Potential Risk Model (OSH-PRM). The proposed model was conceived to assist
in conducting cost-benefit analysis for occupational safety and health risk management. The OSH-PRM
enables an enhanced management of the resources available to improve safety and health conditions
in the various activities and for different groups of workers involved in the execution stage of a construc-
tion project.
Ó 2015 Elsevier Ltd. All rights reserved.

1. Introduction within the risk assessment activity defined in the ISO


31000:2009, there is no tool to quantify safety and health costs
Some generic aspects common to construction projects that considering the underlying uncertainty. The model presented
contribute to explain the performance in terms of safety and health herein is intended to provide a basis to perform stochastic cost-
are (Peláez, 2008): (i) the construction projects as unique products; benefit analysis of occupational safety and health risk in construc-
(ii) the dispersion and variability of work conditions and locations; tion, taking into consideration the planning and scheduling of the
(iii) the diversified and multicultural labor structure; (iv) the type projects. In the present study it is assumed that within the scope
of contract established with the workers; (v) the variability/insta- of occupational safety and health in general, and in the construc-
bility of the jobs and the work teams; and (vi) the lack of training tion industry in particular, the risks involved are mostly individual
and information. Although safety and health concerns are transver- and depend on the nature and conditions in which the tasks or
sal to all stages of the life cycle of construction projects, it assumes activities are performed and not on the nature of the project. How-
a greater importance in the execution stage. In fact, construction ever, a note must be made to the concept of ‘‘safety climate’’
sites are workplaces capable of presenting innumerable hazards (Zohar, 1980), used to describe the shared perceptions of the work-
to the workers safety and health and the activities developed often ers on how safety management is being operationalized in the
place the workers in potentially dangerous situations. workplace at a particular moment in time (Byrom and Corbridge,
The review presented in the first part of this companion paper 1997). This concept is considered to be a sub-component of the
illustrates that there is already a significant research on occupa- ‘‘safety culture’’ construct (IAEA, 1988) by some (e.g., Cooper,
tional safety and health risk in general, and in the construction 2000; Glendon and Stanton, 2000; Neal et al., 2000; Zohar, 2000;
industry in particular, covering most of the risk management pro- Silva et al., 2004; Choudhry et al., 2007) or a reflection of the actual
cess activities defined in the ISO 31000:2009 standard. However, safety culture by others (e.g., Williamson et al., 1997; Cabrera and
Isla, 1998; Cox and Flin, 1998; Guldenmund, 2000; Lee and
Harrison, 2000; Fuller and Vassie, 2001; O’Toole, 2002;
⇑ Corresponding author. Vredenburgh, 2002; Arboleda et al., 2003). Safety climate deals,
E-mail address: vitor.sousa@tecnico.ulisboa.pt (V. Sousa). in part, with the ‘‘societal’’ dimension of the occupational safety

http://dx.doi.org/10.1016/j.ssci.2015.01.003
0925-7535/Ó 2015 Elsevier Ltd. All rights reserved.
V. Sousa et al. / Safety Science 74 (2015) 184–194 185

and health risks and has been extensively explored by several


authors in four major direction (Cooper and Phillips, 2004): (i)
Occupaonal safety
designing psychometric measurement instruments and ascertain- Construcon acvity
ing their underlying factor structures (e.g., Zohar, 1980; Brown ∑ or task (Act.)
and health hazards
(Haz.)
and Holmes, 1986; Coyle et al., 1995; Garavan and O’Brien,
2001); (ii) developing and testing theoretical models of safety cli-
mate to ascertain determinants of safety behavior and accidents ∑n Act. 01 - (OP x NW x D) Haz. 01 - (SP x RI x TC)
(e.g., Cheyne et al., 1998; Thompson et al., 1998; Neal et al., Haz. 02
∑n Act. 02
2000; Prussia et al., 2003; Yule, 2003; Yule et al., 2007); (iii) exam-
...
ining the relationship between safety climate perceptions and ... ...
actual safety performance (e.g., Zohar, 2000); and (iv) exploring ...
the links between safety climate and organizational climate (Neal ... ... ...
et al., 2000; Cooper and Phillips, 2004; Silva et al., 2004; Zohar,
...
2008). Several authors have also studied the safety climate specif- ... ...
ically in the construction industry (e.g., Dedobbeleer and Béland, ...
... ...
1991; Niskanen, 1994; Glendon and Litherland, 2001; Gillen ...
et al., 2002; Mohamed, 2002; Fang et al., 2006; Zhou et al., 2011). ∑n Act. m Haz. r

2. Safety and Health Potential Risk Model


Fig. 1. Occupational Safety and Health Potential Risk Model (OSH-PRM).
There have been significant improvements in terms of occupa-
tional safety and health in the construction industry since the
workers of the group of workers j in activity i (–); D is the duration
1970s. This was largely due to regulatory and legal measures that
of the group of worker j in activity i (hour); SP is the severity param-
have been implemented (Hallowell and Gambatese, 2009). The
eter of the hazard k to the group of worker j in activity i (–); TC is
development of formal safety and health plans and the widespread
the total accident cost of hazard k for the group of workers j in activ-
implementation of safety and health risk assessment in construc-
ity i (USD/accident); IR is the incidence rate of hazard k for the
tion projects greatly contributed to the improvements. Despite all
group of workers j in activity i (number of accidents/hour); i is
the studies conducted and improvements made, even organizations
the activity and n the number of activities (–); j is the workers group
with good performance in terms of occupational safety and health,
and m the number of workers groups in the activity i (–); and k is
according to the present standards, can improve through the imple-
the hazard and r is the number of hazards for the workers group j
mentation of additional measures to reduce the likelihood or/and
in the activity i (–). The number of workers (NW) involved and
the severity of hazards to the safety and health of workers and
the duration (D) of the construction activities are detailed in the
the general public (Hinze and Wilson, 2000). Furthermore, this
project plan and schedule, providing the total number of work
improvement does not, necessarily, need to compromise productiv-
hours of all workers per activity and per professional category. Pro-
ity. Already in the 1970s, Levitt and Parker (1976) observed that the
jects having notoriously distinct periods for the completion of work,
safest organizations established links between productivity and
as is the case of work done in night shifts, it may be advisable to
safety, using this relationship to set salaries and promotions of
split the total hours worked by activity and by professional catego-
employees. Hinze and Parker (1978) also found that the construc-
ries in subgroups. On the other hand, the definition of the activities
tion managers with the best records in meeting cost and time objec-
to be considered should take into account the spatial distribution of
tives also had the best occupational safety and health results.
workers in each moment. It may be convenient to group different
Salminen and Saari (1995) examined the effectiveness of 26 mea-
activities taking place at the same time whenever the hazards affect
sures in terms of productivity and safety, concluding that most con-
all workers present due to spatial overlap issues in the execution of
tributed to the improvement of the performance in both aspects.
the tasks. The model was presented in summation form for simplic-
ity, but it can assume an integral form and account not only for the
2.1. General structure
average statistical values but also for the complete distribution of
values.
Based on the safety equilibrium model developed by Hallowell
and Gambatese (2007) and the demand-capacity model proposed
2.2. Operational parameter (OP)
by Mitropoulos et al. (2009), the Occupational Safety and Health
Potential Risk Model (OSH-PRM) is proposed (Fig. 1).
During the construction stage, workers’ exposure to hazards
The model was designed to allow estimating the stastistical cost
varies significantly with several operating factors, such as age
of workplace accidents by activity and detailed for groups of
and occupation of workers or the size, type and internal organiza-
workers, providing a basis for cost-benefit analysis of additional
tion of the companies. In the U.S., older workers have higher rates
safety measures for the project as a whole. Mathematically, the
of fatal accidents while younger workers experience higher rates of
OSH-PRM can be translated into the following expression:
non-fatal accidents (CPWR, 2010). Hinze and Harrison (1981) and
2
Hinze and Raboud (1988) concluded that the largest construction
X
n
6X
m
SC ¼ 4 OP NWj Dj companies in the U.S. and Canada have more formal occupational
i¼1 j¼1
|fflfflfflfflfflfflfflffl{zfflfflfflfflfflfflfflffl} safety and health management systems implemented and lower
Exposure of the workers group
0 13 incidence rates records. The same is reported by CPWR (2010) for
fatal accidents in the construction industry in the U.S. For non-fatal
BX
r
C7
@ SPk TCk IRk A5 ð1Þ accidents, companies with 11–249 employees have higher inci-
|fflfflfflffl{zfflfflfflffl} |{z}
k¼1
Severity of the consequences Possibility of occurrence dence rates than firms with fewer than 10 employees (CPWR,
j i
2010). However, Hinze and Gambatese (2003) observed no safety
where SC is the safety cost (USD); OP is the operational parameter improvements with the size of the company for specialty contrac-
of the group of workers j in activity i (–); NW is the number of tors in the U.S. On the other hand, the presence of safety and health
186 V. Sousa et al. / Safety Science 74 (2015) 184–194

technicians, the existence of safety and health managers and the light injury) (Green and Brown, 1977). For the management of indi-
management support, contribute to improving occupational safety vidual risks in dam projects and based on indications from the HSE,
and health (Hinze and Harrison, 1981; Hinze and Raboud, 1988). Bowles (2004) proposes the relationship between the SP and the
The study carried out by Sawacha et al. (1999) suggests that vari- annual probability of life loss shown in Fig. 2. In this regard, the
ables related to organizational policy of the companies are the HSE limit of tolerability for individual risks to the general public
group of factors that most influence occupational safety and health is also adopted as a maximum.
in the construction industry in the UK. Indirectly, for fatal accidents, this parameter allows to value dif-
The OP included in the OSH-PRM is intended to take into ferently human life. This is a tricky and controversial issue that
account the workers exposure to hazards in a specific project con- exceeds the scope of the present paper. According to Smith
sidering intrinsic variables, such as the age and experience of the (2004), the HSE considers the following ranges of values for human
workers, and extrinsic variables, such as the weather conditions, life: (i) £ 1 000 000 for individual risks where exposure is voluntary
the proximity of workers engaged in different activities, the safety and there is a sense of control by individuals; (ii) £ 2 000 000 to
and health management system implemented in the organization £ 4 000 000 when dealing with individual risks where exposure is
and the safety and health plan implemented in the project or the not voluntary and, therefore, is not in the control of the individu-
particular conditions in the workplace. Primarily, this parameter als; and (iii) £ 5 000 000 to £ 15 000 000 when dealing with socie-
takes into account the implications of working conditions and tal risks, usually situations involving a large number of victims,
occupation of workers involved in performing each task on their many uncertainties regarding the likelihood and no control by
exposure to hazards. Accordingly, within the OSH-PRM, the OP the individuals. This represents a SP ranging from 1 to 15.
adapts the approach proposed by Mitropoulos et al. (2009), aggre- In practice, the severity parameter is a correction of the total
gating: (i) job requirements issues (factors associated with the cost of a given type of accidents reflecting different levels of will-
task, the environment and the work habits); and (ii) workers ingness to avoid that type of accidents. It accounts also for strate-
related issues (factors associated with the competence, attention gic/political options and to ensure coherence it should be set at a
and error). The OP is a positive value that will depend on the rela- company level, industry level or country level and not at a project
tion between the exposure of a group of workers performing a task level.
in a specific project and the average exposure of workers while
performing the same task in the construction industry in general. 2.4. Incidence rate (IR)
Its default value is one and its definition should be based on expert
evaluation for each specific case. The experts need to evaluate if According to the resolution of Sixteenth International Confer-
the specific conditions of the construction project increase or ence of the Labor Statisticians (ILO, 1998) the main indicators used
decrease the risk (probability and/or severity) of accident in rela- in the statistics of work accidents are the ratio between the num-
tion to the average values defined by the severity parameter and ber of accidents and the number of workers exposed (per 1000
incidence rate. workers – Incidence Rate) or the number of hours worked (per
1 000 000 h worked – Frequency Rate), the ratio between the num-
2.3. Severity parameter (SP) ber of work days lost and the number of hours worked (per
1 000 000 h worked – Severity Rate) and the median of the ratio
In order to address the difference between the acceptable cost between the number of lost worked days and the number of acci-
to avoid an accident and the cost of the accident occurring dents (Days Lost). For the statistical analysis of occupational acci-
(http://www.hse.gov.uk/risk/theory/alarpcheck.htm, accessed 23/ dents a year is usually used as the reference time unit. In the
02/2011), the SP allows the assignment of different valuations to present study the definition of the U.S. Bureau of Labor Statistics
the hazards. The SP is necessarily greater than one and the dispro- (BLS) for the incidence is adopted:
portion between the total cost of the accident occurring and the IR ¼ N=HW ð2Þ
amount that is deemed acceptable to eliminate the underlying haz-
ard may derive from objective or subjective values. For example, where IR is the incidence rate of the hazard (number of accidents/
hazards resulting in accidents involving, usually, multiple workers hour); N is the number of accidents in a determined period – usu-
and, frequently, very severe consequences (e.g., fatalities) should ally one year (–); and HW is the number of hours worked in one
adopt a higher SP when compared to hazards resulting in accidents year (hour). As a form of reporting, the BLS reports incidence rates
involving isolated workers and less serious consequences (e.g., referenced to equivalent workers, with an equivalent full-time
worker (EFTW) corresponding to 40 h a week for 50 weeks in a year
(2000 h per year). This convention was adopted in the present
study, instead of the fixed value of one million hours worked. The
10
determination of the incidence rates was made based on the records
9 available on the BLS website (http://www.bls.gov/home.htm), using
8 data for the years 2003 to 2010. Only the private sector was ana-
Severity parameter [-]

7 lyzed, considering separately: (i) the construction sector in general


(CS); (ii) the building sub-sector (BS); and (iii) the heavy engineer-
6
ing sub-sector (ES).
5
In the analysis performed, the incidence rate was analyzed
4 solely in terms of the construction sector globally and some of its
3 subsectors. However, the incidence rate varies significantly with
2
several other factors, including the tasks (e.g., nature of the task,
materials and equipment involved), the workers (e.g., age, experi-
1
ence, role) and the organization characteristics (e.g., size, occupa-
0 tional safety and health policy) (e.g., see CPWR, 2010). Thus,
1.00E-07 1.00E-06 1.00E-05 1.00E-04
Annual probability of one fatality [-] although this aggregate analysis is a first approximation, possible
within the limitations of the information available, an additional
Fig. 2. Severity parameter (adapted from Bowles, 2004). breakdown detailing of the incidence rate for each of the previously
V. Sousa et al. / Safety Science 74 (2015) 184–194 187

mentioned class of factors would provide additional accuracy to the the workers’ compensations, and the health system of the country
model. In practice, only the fact that the hours worked in activities (Larsson and Betts, 1996).
not related to production, where the number of accidents is consid- In the U.S., the National Safety Council (NSC) estimated an aver-
erably less, are taken into account does reduce the incidence rates age cost of $ 1 150 000 for fatal accidents in the construction
in an artificial way. Ideally, the OSH-PRM should use incidence rates industry in 2004 (NSC, 2006), very similar to the $ 1.33  106 esti-
reported to professional categories by subsector. Even if the mated in 2009 for the average cost of fatal occupational accidents
detailed IR were available they would represent average values in general (NSC, 2011). Conversely, the National Institute for Occu-
for the industry and the SP would still be required to characterize pational Safety and Health (NIOSH) estimated an average cost of
the specific conditions of each project. $ 864 000 per fatal accident in the construction industry between
1992 and 2002 (NIOSH, 2006). For new non-residential develop-
ments, the costs associated with construction accidents represent
2.5. Total costs (TC) between 7.9% and 15% of the total value of the project (Everett
and Frank, 1996). Coble and Hinze (2000) estimated the cost of
The TC associated with (the lack of) occupational safety and compensations to workers in approximately 3.5% of the overall
health are high. The National Audit (NAO, 2004) reports that, in value of the organizations. In the U.K., the HSE indicates a value
1995/96, the (lack of) safety and health costs in the U.K. for the soci- of £ 1 336 800, in 2003, to quantify the fatalities in cost-benefit
ety as a whole were estimated at £ 18.1  109. This amount corre- analyzes. In 1997 the European Statistics on Accidents at Work
sponds to 2.6% of the Gross Domestic Product (GDP). Similar (ESAW) estimated that the cost of accidents to insurers repre-
value, of roughly 3% of the GDP, was estimated by Leigh et al. sented about 0.6% of wages in Europe, amounting to
(1997) for the U.S. in 1992, which corresponds to approximately € 16 000  106. Of these, approximately 66% was spent on high-
$ 170.9  109. From this amount, more than $ 1.7  109 are associ- risk sectors such as agriculture, manufacturing, construction,
ated with the civil engineering sub-sector (Leigh et al., 2004). In transport and communication (EASHW, 2002).
Norway, in 1990, the costs of occupational accidents and diseases The majority of the studies to determine costs related to occu-
were estimated at NOK 40  109, about 6% of the corresponding pational safety and health in construction concentrated in fatal
GDP, of which 10% were supported by private companies, 10% by accidents. However, fortunately, these are not the most common
individuals and the remaining 80% by the public sector (Rognstad, accidents. In 1993, non-fatal accidents accounted for 78.9% of the
1994). total costs related to accidents in the U.S. (Leigh et al., 2006). Ana-
The most common criteria for classifying the costs of occupa- lyzing only the state of California, U.S., Leigh et al. (2001) estimated
tional safety and health in general are (Peláez, 2008): (i) according that occupational diseases account for roughly 14% of the total cost
to imputation (direct costs and indirect costs); (ii) according to with occupational safety and health, with the remainder relating to
their nature (costs of materials, services, personnel, depreciation, accidents. Hinze and Appelgate (1991) analyzed some 600 reports
opportunity, etc.); and (iii) according to the activity level (fixed of serious and slight injuries, having obtained an average total cost
costs and variable costs). Traditionally, the burden of occupational per accident of $ 24 655 and $ 1226, respectively. Hinze et al.
safety and health has been mostly expressed in terms of direct and (2006) analyzed medical records of 135 998 workers with injuries
indirect costs (e.g., Heinrich, 1930; Brody et al., 1990; Klen, 1989). from accidents occurred between 2001 and 2003 that did not
The most current view according to this concept is the comparison require days of absence from work, obtaining an average cost of
to an iceberg, where the direct (or visible) costs represent the vis- $ 565.30 for the hospital treatment charges. Depending on the nat-
ible portion of the iceberg (above the surface) and the largest por- ure of the injury, average costs ranged from $ 253.57, for eye inju-
tion is invisible and corresponds to indirect costs, also called ries, and $ 933.78, for injuries in the shoulder/upper arm, with the
hidden or invisible cost (e.g., Naquin, 1975; Godfrey, 1996; maximum unit costs exceeding $ 10 000. The authors also
Hassam, 1997). Other conceptual approaches use different termi- observed that the nature of the injuries varied significantly with
nology, such as insurable and non-insurable costs (Simonds and the age and the gender of the workers. For the construction indus-
Grimaldi, 1956) or controllable and uncontrollable costs (Laufer, try in the state of Oregon, U.S., Horwitz and McCall (2004) analyzed
1987). These different definitions have not always obtained total the claims relating to fatal accidents and non-fatal accidents
receptivity, but helped to change the definitions of what are direct resulting in disability between 1990 and 1997, noting that the val-
and indirect costs. Indirect costs may contain various components, ues vary significantly with the part of the body injured, the nature
such as those enumerated by Hinze (1992). Numerous studies have and the event causing the injury, the occupation, the age, the salary
been carried out following these conceptual approaches (e.g., and the experience in the role of the worker, and the year in which
Rinefort, 1977; Collinson, 1980), suggesting ratios between direct the accident occurred.
and indirect costs of 1:11 (HSE, 1993), 1:6 (Levitt, 1975; Mangan, Table 1 present some values published for the cost of occupa-
1993), 1:4 (Heinrich, 1930; Pillay and Haupt, 2008), 1:2.3 tional safety and health in the U.K. and in the U.S. The majority
(Shalowitz, 1990), 1:2 (Simonds and Grimaldi, 1956), 1:1 of the details of the models used to determine the costs are not
(Rinefort, 1977) 1:0.33 (Laufer, 1987) to 1:0.22 (Leopold and very clear, except for the model used by the NIOSH which is
Leonard, 1987). Sawacha et al. (1999) reported that for every detailed in Biddle (2004). No currency conversion was done on
pound paid directly by insurers, contractors may incur from £ 5 the grounds that this would constitute a misrepresentation of the
to £ 50 of overhead costs and Hinze and Appelgate (1991) obtained values. The exchange rate variations are a result of several factors
ratios between direct and indirect costs varying according to the not related to occupational safety and health and may lead to mis-
total cost of the accident, with average ratios 1:4.2, for minor acci- leading results. For instance the variation of the U.S. dollar and the
dents, to 1:20.3, for serious accidents. In contrast, Pillay and Haupt sterling pound exchange rate against the euro that has occurred in
(2008) obtained ratios inversely proportional to the severity of recent years originates substantial differences depending whether
accidents and varying depending on the origin and consequences the conversion is done using the exchange rate of the year in which
of the accident. It has been shown that the relationship between the studies were done, and then updating the value to the present
direct and indirect costs varies considerably, depending on factors year (using a discount factor), or updating the value first and then
such as the industry analyzed, the severity of the consequences, performing the currency conversion using the current exchange
the definition of each class of costs, the research method used, rate. Therefore, the values shown are valid only for the particular
the dominant structure of insurance against accidents at work, context in which they were determined, considering that their
188 V. Sousa et al. / Safety Science 74 (2015) 184–194

Table 1
Occupational accidents and illnesses costs.

Safety and health HSEa NSC NIOSH NIOSH Hinze and Miller and Horwitz and Hinze et al.
(2006)b (2006)c (2009)d Appelgate (1991) Galbraith (1995)e Mccall (2004)f (2006)g
Accidents
Fatal £1 336 800 $1 150 000 $864 000 $852 000 $2 500 000 $10 433
Non-fatal
Permanent disability £207 200 $34 000
Serious £20 500 $24 655 $46 000
Slight £300 $1226 $650 $565
Illnesses
Permanent disability £193,100
Temporary absence £2300 + £180 per
(over 1 week) day absent
Minor £530
a
2003 values, for any industry.
b
2004 values.
c
2003 values.
d
2001 values.
e
For any industry.
f
Only compensations.
g
Only medical expenses.

use in another context must be made based on indicators such as Weahrer was also the author of the DHHS (NIOSH) Publication
average earnings or average hospital costs, since there is a much No. 2009–154 (NIOSH, 2009), were the mean and median total
stronger correlation with remuneration losses, compensation val- costs of accidents in the U.S. construction industry are presented.
ues and treatment costs, which are some of the key components In this publication the total cost only includes direct and indirect
in determining the total cost of accidents. costs. In the present study, the values published in NIOSH (2009)
The total costs presented in Table 1 do not include all costs for the construction industry in general, and the building and the
associated with the (lack of) occupational safety and health. They civil engineering sub-sectors, by type of accident, were prorated
include only portions relating to wages, lost productivity and med- by the values obtained by Waehrer et al. (2007) to establish the
ical and administrative expenses. However, the financial implica- total cost of fatal accidents. Instead of using deterministic values,
tions of occupational safety and health extend far beyond the the total costs of fatal accidents were approximated by a probabi-
individuals and organizations involved, affecting the society in listic distribution considering that: (i) the total costs follow an uni-
general. Workers suffer loss of income and additional expenses, modal normal distribution; (ii) the mode can be estimated by the
just to name a few of the objective/quantitative consequences. following relation – Mode = 3  Median – 2  Average; and (iii)
Employers are responsible for the burden with injured workers the standard deviation corresponds to maximum possible accord-
who cannot work, including administrative costs and the expenses ing to the relations proposed by Basu and Dasgupta (1992) and
with the recruitment and training of potential substitutes, and may Bottomley (2004), derived from the Chebyshev inequality.
incur in a wide range of charges, including fines, aggravation of
insurance premiums, legal fees, and/or compensation amounts.
Society as a whole still has to bear with costs resulting from the 3. Model implementation
increased expenditure of health services and social security, the
loss of production in the economy and the investigation of the acci- The proposed model is intended to assist decision making only
dents, to name a few. Therefore, there is a line of research that has when the level of risk is acceptable or tolerable. While the OSH-
considered, in addition to the direct and indirect costs, the costs of PRM contemplates the influence of operational factors that affect
quality of life. The theoretical concepts that support the definition the incidence and severity of accidents, these are not reflected in
of the quality of life costs associated with non-fatal accidents were the statistical analyzes presented below. Furthermore, the model
established by Cohen (1988), Viscusi (1988) and Rodgers (1993). is intended to perform analysis based on average values and cannot
Its estimation is frequently made based on the difference between be applied to a specific group of workers because of the set of rea-
the compensations awarded in court and the amounts claimed by sons enumerated by Cuny and Lejeune (2003), namely that the
the victims. From the literature survey conducted, it is considered likelihood of a worker having an accident depends on the number
that Waehrer et al. (2007) presented the most detailed study incor- of accidents that he had in the past.
porating direct, indirect and quality of life costs for fatal and non- The OSH-PRM does not a substitute the need to develop and
fatal accidents by subsectors of the construction industry, workers’ effectively implement safety and health plans and apply adequate
characteristics and type of accident (Table 2). procedures to identify occupational safety and health hazards (e.g.,
see Mohamed, 1999). Note that the model was developed based on
the assumption that, even for acceptable or tolerable levels of risk,
Table 2 there are still margins for financial gain in increasing the level of
Total cost of construction accidents in the U.S. (Weahrer et al., 2007). safety. Potential savings were estimated between $ 4–8 for every
dollar invested in preventive measures, in the U.S. (Barrie and
Sector Accident costa
Paulson, 1992), and of £ 3 for every pound invested in preventive
Fatal Non-fatal with lost days
measures, in the U.K. (Ikpe et al., 2012). The amount of savings
Construction (CS) $3 954 669 $42 093 depends largely on the size of the project, since the cost percentage
Building (BS) $3 864 501 $44 105 of implementing occupational safety and health measures is inver-
Heavy engineering (ES) $4 100 056 $40 987
sely proportional to the value of the project, ranging from around
a
2002 values. 0.3% to 3.7% and of its total cost (Baxendale and Jones, 2000).
V. Sousa et al. / Safety Science 74 (2015) 184–194 189

Day (2009) refers that studies conducted in Europe indicate costs determine the cost of the residual risk associated with the mea-
with accidents at work of the order of the double of the costs that sures. Having determined the base level of risk in the project, it
would be needed to avoid them. Incidentally, according to the is possible to evaluate the efficiency and effectiveness of possible
study by Harper and Koehn (1998), only the savings in insurance measures to prevent occupational safety and health hazards by
premiums offset by more than twice the investments in specific repeating the previous steps and reflecting the changes of those
occupational safety and health programs implemented in the con- measures in terms of incidence rate, the total costs of accidents/
struction industry in the southeastern state of Texas, U.S., during incidents and/or the workers exposure to hazards. The new
the years 1992 to 1996. Additionally, beyond the performance in amount of the total risk cost of the project must be added to the
terms of safety and health, investment in safety and health man- cost of implementing the measures. For each hazard, an appropri-
agement systems in construction contributes to enhance the com- ate measure is one whose sum of the cost of implementation with
petitivity of the organizations, particularly through the effects on the cost of the residual risk is lower than the base level, as pro-
productivity and innovation, image, reputation, and economic- posed in the model developed by Gibson (1976).
financial performance (Fernández-Muñiz et al., 2009). Rechenthin The description of the OSH-PRM presented presupposes the use
(2004) asserts that improved safety in projects constitutes a sus- of average values. However, safety and health related issues are
tainable competitive advantage for construction related compa- anything but absolute or deterministic. So, whenever possible, it
nies, being a reflection of a well-run organization. is preferable to use probabilistic distributions for the costs, the
incidence rates, and even the number of workers and the exposure
3.1. Procedure durations, explicitly considering the stochastic nature of the vari-
ables. In this case, the use of Monte Carlo Simulation will yield a
The OSH-PRM was designed to be implemented over the work final result that is also a distribution, thus providing information
schedule. Thus, the model presupposes the existence of a work not only regarding the average expected value, but also the range
breakdown structure of the project with the activities character- of values and the variability associated.
ized temporally (beginning and ending moments), spatially (local-
ization where the tasks are performed) and operationally (labor, 3.2. Fatal accidents
materials and equipment required), for which there is a need to:
(i) identify the hazards associated with each activity, grouping Accidents where an immediate fatality occurs are clearly
the common ones; (ii) organize the groups of workers exposed to defined situations and tend to be known by the relevant authori-
each hazard and the exposure time, estimating an adequate value ties and, often, exploited by the media. Consequently, the situa-
for the operational parameter given the particular conditions of the tions of incomplete records are reduced in developed countries.
project; (iii) quantify the incidence rate and the cost related to each Thus, despite the difficulties that may exist in finding the origins,
combination of hazard/exposed workers, defining the value of the causes are generally known and quantification is possible with
severity parameter to use; (iv) estimate the risk to each combina- some ease and accuracy. In the case of accidents where death is not
tion of hazard/exposed workers; and (v) determine the total risk, immediate, it may be more difficult to establish the relationship
adding the risk of each combination of hazard/exposed workers. between the causal agent and death. In this case, the results can
After identifying the hazards to safety and health in every activity be substantially different, depending largely on the criterion
and grouping those that are common, a list of hazards in the pro- adopted by the authorities for the period to consider a fatality as
ject and the respective connection with the activities is obtained. a result of an accident. A period of one year is recommended by
It is recommended to use standardized designations for the haz- the International Labour Organization (ILO), which was adopted
ards, such as those used by the Bureau of Labor Statistics and Occu- by most countries in Europe and used in the information collected
pational Safety and Health Administration’s Occupational Injury by the Eurostat, but the criterion is not universal (e.g. see
and Illness Classification System (OIICS) in the U.S., the Reporting EUROSTAT, 2001; CPWR, 2007). Analyzing fatalities from falls in
of Injuries, Diseases and Dangerous Occurrences Regulations (RID- construction, Cattledge et al. (1996) found that death occurred
DOR) in the U.K., or the Resolution III of the Sixteenth International on the day in 65% of the cases, but approximately 15% occurred
Conference of the Labour Statisticians (ILO, 1998). Based on the after a week and roughly 5% took place after more than 90 days,
work planning and schedule, it is possible to determine the num- which illustrates the relevance that the time criterion used may
ber and occupation of the workers exposed to each hazard, as well have in the results. Another source of differences between the
as the corresponding duration of exposure. Special attention available statistical data is that some countries consider all work-
should be given to the existence of workers who, although not ers (e.g., Australia, Germany, Italy, Norway, Sweden, USA) while
directly associated with a particular activity, may be exposed to others exclude self-employed (e.g., Finland; Spain; Switzerland)
hazards associated with the activity due to temporal and spatial (CPWR, 2007). In the European Union, the publication of the Com-
overlap. For each of the hazards of the activities, it is necessary mission Regulation (EU) No. 349/2011, of 11 April 2011, represents
to determine the incidence rate and the cost of the consequences an important step for harmonizing statistical data on occupational
in each group of workers exposed. Also, the severity and opera- safety and health and defines a one year period to consider an acci-
tional parameters must be established accordingly to the safety dent as the cause of death. Despite these definition details, in most
level deemed suitable and the particular conditions in which the developed countries, the institutions responsible for collecting
tasks are performed. Finally, the risk for each of the different information on fatal accidents have confidence in the dada avail-
groups of workers identified in each of the hazards of the activities able (e.g., see NAO, 2004).
is estimated and summed to determine the total risk of the project. According to the accidents categorization adopted by the BLS,
Based on a cost-benefit logic, this total amount represents the the main events or exposures associated with fatal accidents in
value that should be expended, in average, to completely eliminate the construction industry in the U.S. are: (i) A – Contact with
the risk of occupational safety and health accidents associated with objects and equipment; (ii) B – Falls; (iii) C – Exposure to harmful
the hazards identified. substances or environments; (iv) D – Transportation incidents; (v)
Since eliminating occupational safety and health accidents E – Fires and explosions; and (vi) F – Assaults and violent acts.
completely is virtually impossible, in practice this amount can be Fig. 3 presents the incidence rates of fatal accidents in the con-
used as a basis for evaluating the cost-benefit of implementing struction industry in the U.S. between 2006 and 2010 by each main
additional safety measures, with the model being used also to source. The importance of falls as the main cause for fatal accidents
190 V. Sousa et al. / Safety Science 74 (2015) 184–194

Incidence rate [per 100 000 EFTW]

Incidence rate [per 100 000 EFTW]


10 10

1 1

2010

2010
2009

2009
2008

2008
2007

2007
0.1 0.1

2006

2006
A B C D E F Year [-] A B C D E F Year [-]
Event or exposure [-] Event or exposure [-]
(A) (B)
Incidence rate [per 100 000 EFTW]

10

2010
2009
2008
2007
0.1
2006

A B C D E F Year [-]
Event or exposure [-]
(C)
Fig. 3. Incidence rate by the main causes of fatal accidents in the U.S. in the (A) construction industry in general and in the (B) building and (C) heavy engineering subsectors
(BLS, 2007, 2008, 2009, 2010, 2011).

in the construction industry is noticeable, but its relevance is evolution of the incidence rate of fatal accidents in the U.S. since
higher in the building sub-sector than in the heavy engineering 2003, where the downward trend can be observed.
sub-sector. In the heavy engineering sub-sector, accidents related To allow a statistical analysis, it was assumed that the incidence
to material and equipment handling and involving mobile equip- rates can be adjusted by normal distributions. In estimating the
ment and vehicles are the most frequent. statistical parameters of the distributions, the average was deter-
Considering all workers involved in the construction industry in mined considering only the fatal accidents incidence rates from
the U.S. (private and public), it is observed that the incidence rate 2006 to 2010 and the standard deviation was estimated using
has shown a slightly downward trend over the past two decades. two approaches (ALT – alternative): (i) ALT1 – considering only
However, in spite of observing a decrease of around 20% over the the years 2006–2010 and assuming that the trend in the evolution
past 20 years, annual change has been slight and subjected, some- of the incidence rate is negligible in this period (i.e., differences
times, to positive variations (CPWR, 2010). Considering only the between each year are of stochastic nature); and (ii) ALT2 – assum-
private sector of the construction industry, Fig. 4 presents the ing that variability is given by the difference between a second
degree polynomial regression curve, adjusted to the incidence rate
from 2003 to 2010, and the observed incidence rates in each year.
35.0 The selected criteria for both approaches aimed at ensuring that
the estimated mean value in both approaches is the same and
Incidence rate [per 100 000 EFTW]

30.0 sought to capture extreme scenarios in terms of variability. The


sample used to determine the incidence rate distributions repre-
25.0 sents the number of accidents given in Table 3.
In Fig. 5, the distributions of the incidence rates obtained for
20.0
CS each approach are shown by subsector of the construction industry.
15.0
BS
10.0 ES

Table 3
5.0
Fatal accidents by subsector in the sample used (2003–2010).

0.0 Sub-sector Fatal accidents


2003 2004 2005 2006 2007 2008 2009 2010
Construction in general (CS) 8583
Year [-] Building construction (BS) 1666
Heavy engineering (ES) 1660
Fig. 4. Evolution of the incidence rate of fatal accidents in the U.S.
V. Sousa et al. / Safety Science 74 (2015) 184–194 191

1.0 1.0

0.9 0.9

0.8 0.8

0.7 0.7

Probability [-]
Probability [-]
0.6 0.6
0.5 0.5
0.4 0.4
0.3 0.3
0.2 0.2
0.1 0.1
0.0 0.0
8.0 13.0 18.0 23.0 28.0 8.0 13.0 18.0 23.0 28.0
Incidence Rate [per 100 000 EFTW] Incidence Rate [per 100 000 EFTW]
CS BS ES
(A) (B)
Fig. 5. Incidence rate of fatal accidents distributions estimated according to (A) ALT1 and (B) ALT2.

The differences in terms of variability are noticeable, especially in Fig. 9 allows differentiating the statistical potential risk unit
the heavy engineering sub-sector cost for a specific construction project using expert opinion. For
The same approach was applied to determine the distribution of example, the potential risk unit cost of high risk heavy engineering
incidence rates by sub-sector for each of the main causes of the project could be defined as the 90% value, which corresponds to
accidents. For simplicity, Fig. 6 presents only average values, which $5.35/Men.hour. The level of risk of the project could simply be
are identical in both alternatives. defined by expert evaluation.
Figs. 7 and 8 present the statistical distributions of the costs Based on distributions of the potential risk unit cost estimated,
associated with fatal accidents in the U.S. construction industry the following average costs of fatal accidents per hour worked by
by sub-sector and main cause of the accident, respectively. The val- each worker are obtained:
ues were updated to 2010 values.
Validation of the ranges of costs is difficult without analyzing – $3.55/Men.hour in the construction industry in general;
the original data, which are inaccessible for confidentiality reasons. – $2.98/Men.hour in the building sub-sector;
However, it was observed that the variability estimates are within – $5.21/Men.hour in the heavy engineering sub-sector.
the ranges obtained by Rognstad (1994), in Norway, and Hassam
(1997), in Portugal. The values above represent the average statistical value that is
Making use of the Monte Carlo technique and assuming a cost- cost-effective to invest in additional measures in order to eliminate
benefit logic, it is possible to estimate the distribution of the all fatal accidents. In a more practical sense, since eliminating acci-
amount to invest in safety and health in order to prevent fatal acci- dents completely is rather utopic, evaluating the cost-effectiveness
dents, per person-hour of work, for each sub-sector and origin of of a specific safety measure would require the implementation of
the accident. Fig. 9 shows the distributions of the potential risk the model again estimating the incidence rate and/or severity of
unit cost estimated for each sub-sector. For the Monte Carlo Simu- the consequences values due to the implementation of the mea-
lation, the Latin hypercube sampling algorithm and Mersenne sure. The difference between the potential risk unit cost presented
Twister random number generator were used to perform 5000 above and the potential risk unit cost with the additional safety
simulations. measure would represent the limit mean statistical value that
the measure could cost to be cost-effective.

1.0

0.9
10
Incidence Rate [per 100 000 EFTW]

0.8

0.7
Probability [-]

0.6

0.5 CS
1
0.4 BS
0.3 ES
0.2
ES
0.1
0.1 BS
A B C D E F CS Sub-sector [-] 0.0
Event or Exposure [-] 4000 4250 4500 4750 5000 5250 5500
Cost [$1 000]
Fig. 6. Average value of fatal accidents incidence rates in the U.S. by sub-sector for
each of the main causes. Fig. 7. Cost of fatal accidents by sub-sector of the U.S. construction industry.
192 V. Sousa et al. / Safety Science 74 (2015) 184–194

1.0 1.0
0.9 0.9
0.8 0.8
0.7 0.7

Probability [-]
Probability [-] 0.6 0.6
0.5 0.5
0.4 0.4
0.3 0.3
0.2 0.2
0.1 0.1
0.0 0.0
3000 3500 4000 4500 5000 5500 6000 3000 3500 4000 4500 5000 5500 6000
Cost [$1 000] Cost [$1 000]
(A) (B)
1.0
0.9
0.8
0.7
Probability [-]

A
0.6
B
0.5
C
0.4
D
0.3
E
0.2
F
0.1
0.0
3000 3500 4000 4500 5000 5500 6000
Cost [$1 000]
(C)
Fig. 8. Cost of fatal accidents by event or exposure in the U.S. (A) construction sector in general, (B) building sub-sector and (C) heavy engineering sub-sector.

1.0 1.0
0.9 0.9
0.8 0.8
0.7 0.7
Probability [-]

Probability [-]

0.6 0.6
0.5 0.5
0.4 0.4
0.3 0.3
0.2 0.2
0.1 0.1
0.0 0.0
0 2 4 6 8 0 2 4 6 8
Unit Cost [$/Men.hour] Unit Cost [$/Men.hour]
(A) (B)
CS BS ES

Fig. 9. Potential risk unit cost of fatal accidents for each sub-sector of the U.S. construction industry estimated according to (A) ALT1 and (B) ALT2.

4. Concluding remarks cost-benefit of occupational safety and health risk mitigation


options available for implementation in construction projects.
The OSH-PRM was proposed to enhance the application of the The implementation to the US construction industry demonstrates
ALARP principle by providing a means to quantify the risk in each the potential use of the model to estimate probabilistic costs of
construction activity in monetary terms. The model was developed occupational safety and health. For the practical implementation
to quantify the uncertainty in all components explicitly, following of the model at a construction project scale it is important to define
the spirit of the international standard ISO 31000:2009. The the statistical range of values for the operational parameter to pro-
objective of the OSH-PRM is to assist in the evaluation of the vide the experts some quantitative guidance.
V. Sousa et al. / Safety Science 74 (2015) 184–194 193

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