Addressing Severe Injury Potential

In Chapter 7, Heinrich Revisited Tmisins or Myths, comments are made on Heinrich s often expressed premise that the predominant causes of no-injury accidents are identical to the predominant causes of accidents resulting in major injuries. I said that I found the premise to be invalid. Furthermore, I made the case that a large proportion of the incidents resulting in serious injuries are singular and unique events, that their causal factors are multifaceted and complex, and that descriptions of similar accidents are seldom found in the historical body of incident data. 

Some safety practitioners presume that efforts concentrated on the types of accidents that occur frequently will also encompass the types of accidents that result in severe injury or damage. That often results in the severity potential being overlooked, along with a misdirection in the application of resources. 

Kriebel, in Occupational Injuries Factors Associated with Frequency and Severity, makes these interesting observations about the relation between injury frequency and severity. 

A Model of Injury Severity Safety researchers have generally ignored severity, perhaps because for many years it was believed that the seriousness of the consequences of an accident was essentially randomly determined 

William G. Johnson, in MORT Safety Assurance Systems, also implies that severity potential needs greater emphasis. He writes  

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But, seldom do safety management systems specifically address severe injury potential. Thus, to properly address that potential and to give it the priority consideration needed, safety practitioners must add an element within their safety management systems to undertake distinct activities to seek those hazards that present severe injury or damage potential. 

Chapter 8 is devoted to addressing severe injury potential. It makes the case that safety professionals must undertake separate and distinct activity to seek those hazards that present the most severe injury or damage potential so that they can be given priority consideration. To do that effectively, they must be capable of making hazards analyses and risk assessments. 

Why make so much of the idea on which the Critical Incident Technique is based A system that seeks to identify causal factors before their potentials are reahzed would serve well in attempting to avoid low prob-abihty-severe consequence events. Chapter 9, Addressing Severe Injury Potential, is devoted to that subject. In that chapter, in support of the premises I put forth, I quoted from Dan Petersen who said the following in his book Safety Management, 2nd edition ... 

Unfortunately, many safety practitioners continue to act on the premise that if efforts are concentrated on the types of accidents that occur frequently, the potential for severe injury will also be addressed. That results in the severe injury potential being overlooked, since the t)q)es of accidents resulting in severe injury or fatality are rarely represented in the data pertaining to the types of accidents that occur frequently. A sound case can be made that many accidents resulting in severe injury or fatality are unique and singular events. 

But, having listened to presentations on leading indicators and having had discussions with safety directors, I am concerned that the leading indicators chosen may not address the real needs, particularly with respect to severe injury potential. Consider these two situations ... 

In selecting leading indicators, methods to identify severe injury potentials must be addressed, particularly the potential for low probability-high consequence events. 

Causal factors for low-probability/high-consequence events are rarely represented in the analytical data on incidents that occur frequently, and the uniqueness of serious injury potential must be adequately addressed. However, accidents that occur frequently may be predictors of severity potential if a high-energy source was present (e.g., operation of powered mobile equipment, electrical contacts). 

However, the question for many safety and health professionals today is whether simply complying with the OSHA standards is sufficient to safeguard all employees in the workplace Compliance with the OSHA standards may address most of the major hazards in many workplaces (and is required) however, is the achievement of a sufficient compliance level with the appropriate OSHA standards sufficient to effectively and efficiently safeguard the workplace and reduce the number and severity of potential occupational injuries and illnesses (and the correlating workers compensation cost) Are safety and health professionals being employed by companies and organizations to achieve compliance (and avoid potential OSHA penalties), or is there an expectation of a minimization or elimination of all hazards and the correlating reduction in losses and costs ... 

Placing too much emphasis on injury-producing events but not focusing on potentially serious close call incidents can result in unreliable effective assessments. Rather than relying solely on injury rates or other postevent assessments, organizations could use a broader hazard control audit process. This management style audit would address several key components of the accident prevention process. The audit forms would help evaluators rate each component against prepublished... 

Planning During planning activities, leaders identify natural hazards, technological hazards, and terrorist threats, or workplace violence situations. Planning addresses the risks of each hazard or threat, including the likelihood of occurrence and the potential severity. Severity considers loss of life, loss or damage to property, injuries, business interruption, and other factors. 

OSHA has concluded that effective management of employee safety and health is a decisive factor in reducing the extent and severity of work-related injuries and illnesses. An effective management program addresses work-related hazards, including those potential hazards that could result from a change in workplace conditions or practices. In addition, it addresses hazards that are not regulatory driven [2]. 

The potential health benefits of plant polyphenols, such as the flavonoids, have been addressed over the years in the framework of the oxidative stress concept. Oxidative stress, as initially formulated by Sies (1985), refers to an imbalance in the dynamic equilibrium between oxidants and antioxidants that favors the formers, potentially leading to damage. As several diseases are supposed to mechanistically involve oxidative stress, such as atherosclerosis, ischemia-reperfusion injury, cancer, and neurodegenerative disorders (Halliwell Gutteridge, 1999), an impressive number of studies on the in vitro antioxidant activity of polyphenols have spotted these compounds as putatively useful to counteract the deleterious oxidant imbalance associated with disease. However, as will be discussed later, because of limited bioavailability and recent updated concept of oxidative stress, the putative activity of polyphenols as global antioxidants is a limited and simplistic view of polyphenol activity in vivo that can be scarcely supported by experimental data. 

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