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17. Disability and Work

17. Disability and Work (10)

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17. Disability and Work

Chapter Editors: Willi Momm and Robert Ransom


Table of Contents


Disability: Concepts and Definitions
Willi Momm and Otto Geiecker

Case Study: Legal Classification of Disabled People in France
Marie-Louise Cros-Courtial and Marc Vericel

Social Policy and Human Rights: Concepts of Disability
Carl Raskin

International Labour Standards and National Employment Legislation in Favour of Disabled Persons
Willi Momm and Masaaki Iuchi

Vocational Rehabilitation and Employment Support Services
Erwin Seyfried

Disability Management at the Workplace: Overview and Future Trends
Donald E. Shrey

Rehabilitation and Noise-induced Hearing Loss
Raymond Hétu

Rights and Duties: An Employer’s Perspective
Susan Scott-Parker

     Case Study: Best Practices Examples

Rights and Duties: Workers’ Perspective
Angela Traiforos and Debra A. Perry


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18. Education and Training

18. Education and Training (9)

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18. Education and Training

Chapter Editor: Steven Hecker

Table of Contents

Figures and Tables

Introduction and Overview
Steven Hecker

Principles of Training
Gordon Atherley and Dilys Robertson

Worker Education and Training
Robin Baker and Nina Wallerstein

Case Studies

Evaluating Health and Safety Training: A Case Study in Chemical Workers Hazardous Waste Worker Education
Thomas H. McQuiston, Paula Coleman, Nina Wallerstein, A.C. Marcus, J.S. Morawetz, David W. Ortlieb and Steven Hecker

Environmental Education and Training: The State of Hazardous Materials Worker Education in the United States
Glenn Paulson, Michelle Madelien, Susan Sink and Steven Hecker

Worker Education and Environmental Improvement
Edward Cohen-Rosenthal

Safety and Health Training of Managers
John Rudge

Training of Health and Safety Professionals
Wai-On Phoon

A New Approach to Learning and Training:A Case Study by the ILO-FINNIDA African Safety and Health Project

Antero Vahapassi and Merri Weinger


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1. Teaching methods chart


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22. Resources: Information and OSH

22. Resources: Information and OSH (5)

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22. Resources: Information and OSH

Chapter Editor:  Jukka Takala



Table of Contents

Figures and Tables

Information: A Precondition for Action
Jukka Takala

Finding and Using Information
P.K. Abeytunga, Emmert Clevenstine, Vivian Morgan and Sheila Pantry

Information Management
Gordon Atherley

Case study: Malaysian Information Service on Pesticide Toxicity
D.A. Razak, A.A. Latiff, M.I. A. Majid and R. Awang

Case Study: A Successful Information Experience in Thailand
Chaiyuth Chavalitnitikul


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1. Some core periodicals in occupational health & safety
2. Standard search form
3. Information required in occupational health & safety


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23. Resources, Institutional, Structural and Legal

23. Resources, Institutional, Structural and Legal (20)

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23. Resources, Institutional, Structural and Legal

Chapter Editors:  Rachael F. Taylor and Simon Pickvance


Table of Contents 

Figures and Tables

Institutional, Structural and Legal Resources: Introduction
Simon Pickvance

Labour Inspection
Wolfgang von Richthofen

Civil and Criminal Liability in Relation to Occupational Safety and Health
Felice Morgenstern (adapted)

Occupational Health as a Human Right
Ilise Levy Feitshans

Community Level

Community-Based Organizations
Simon Pickvance

Right to Know: The Role of Community-Based Organizations
Carolyn Needleman

The COSH Movement and Right to Know
Joel Shufro

Regional and National Examples

Occupational Health and Safety: The European Union
Frank B. Wright

Legislation Guaranteeing Benefits for Workers in China
Su Zhi

Case Study: Exposure Standards in Russia
Nikolai F. Izmerov

International Governmental and Non-Governmental Organizations

International Cooperation in Occupational Health: The Role of International Organizations
Georges H. Coppée

The United Nations and Specialized Agencies

     Contact Information for the United Nations Organization

International Labour Organization

Georg R. Kliesch   

     Case Study: ILO Conventions--Enforcement Procedures
     Anne Trebilcock

International Organization for Standardization (ISO)
Lawrence D. Eicher

International Social Security Association (ISSA)
Dick J. Meertens

     Addresses of the ISSA International Sections

International Commission on Occupational Health (ICOH)
Jerry Jeyaratnam

International Association of Labour Inspection (IALI)
David Snowball


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1. Bases for Russian vs. American standards
2. ISO technical committees for OHS
3. Venues of triennial congresses since 1906
4. ICOH committees & working groups, 1996


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24. Work and Workers

24. Work and Workers (6)

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24. Work and Workers

Chapter Editors:  Jeanne Mager Stellman and Leon J. Warshaw 


Table of Contents 


Work and Workers
Freda L. Paltiel

Shifting Paradigms and Policies
Freda L. Paltiel

Health, Safety and Equity in the Workplace
Joan Bertin

Precarious Employment and Child Labour
Leon J. Warshaw

Transformations in Markets and Labour
Pat Armstrong

Globalizing Technologies and the Decimation/Transformation of Work
Heather Menzies


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25. Worker's Compensation Systems

25. Worker's Compensation Systems (1)

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25. Worker's Compensation Systems

Chapter Editor: Terence G. Ison


Table of Contents 

Terence G. Ison

Part One: Workers' Compensation

Organization, Administration and Adjudication
Eligibility for Benefits
Multiple Causes of Disability
Subsequent Consequential Disabilities    
Compensable Losses    
Multiple Disabilities    
Objections to Claims    
Employer Misconduct    
Medical Aid    
Money Payments    
Rehabilitation and Care    
Obligations to Continue the Employment    
Vicarious Liability    
Health and Safety    
Claims against Third Parties    
Social Insurance and Social Security

Part Two: Other Systems

Accident Compensation    
Sick Pay    
Disability Insurance    
Employers’ Liability

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Abuya: What’s the matter? You look worn out.

Mwangi: I am worn out—and disgusted. I was up half the night getting ready for this lecture I just gave and I don’t think it went very well. I couldn’t get anything out of them—no questions, no enthusiasm. For all I know, they didn’t understand a word I said.

Kariuki: I know what you mean. Last week I was having a terrible time trying to explain chemical safety in Swahili.

Abuya: I don’t think it’s the language. You were probably just talking over their heads. How much technical information do these workers really need to know anyway?

Kariuki: Enough to protect themselves. If we can’t get the point across, we’re just wasting our time. Mwangi, why didn’t you try asking them something or tell a story?

Mwangi: I couldn’t figure out what to do. I know there has to be a better way, but I was never trained in how to do these lectures right.

Abuya: Why all the fuss? Just forget about it! With all the inspections we have to do, who’s got time to worry about training?

The above discussion in an African factory inspectorate, which could take place anywhere, highlights a real problem: how to get the message through in a training session. Using a real problem as a discussion starter (or trigger) is an excellent training technique to identify potential obstacles to training, their causes and potential solutions. We have used this discussion as a role play in our Training of Trainers’ workshops in Kenya and Ethiopia.

The ILO-FINNIDA African Safety and Health Project is part of the ILO’s technical cooperation activities aimed to improve occupational safety and health training and information services in 21 African countries where English is commonly spoken. It is sponsored by FINNIDA, the Finnish International Development Agency. The Project took place from 1991 to 1994 with a budget of US$5 million. One of the main concerns in the implementation of the Project was to determine the most appropriate training approach by which to facilitate high quality learning. In the following case study we will describe the practical implementation of the training approach, the Training the Trainers’ (TOT) course (Weinger 1993).


Development of a New Training Approach

In the past, the training approach in most African factory inspectorates, and also in many technical cooperation projects of the ILO, has been based on randomly selected, isolated topics of occupational safety and health (OSH) which were presented mainly by using lecturing methods. The African Safety and Health Project conducted the first pilot course in TOT in 1992 for 16 participating countries. This course was implemented in two parts, the first part dealing with basic principles of adult education (how people learn, how to establish learning objectives and select teaching contents, how to design the curriculum and select instructional methods and learning activities and how to improve personal teaching skills) and the second part with practical training in OSH based on individual assignments which each participant completed during a four month’s time period following the first part of the course.

The main characteristics of this new approach are participation and action orientation. Our training does not reflect the traditional model of classroom learning where participants are passive recipients of information and the lecture is the dominant instructional method. In addition to its action orientation and participatory training methods, this approach is based on the latest research in modern adult education and takes a cognitive and activity-theoretical view of learning and teaching (Engeström 1994).

On the basis of the experience gained during the pilot course, which was extremely successful, a set of detailed course material was prepared, call the Training of Trainers Package, which consists of two parts, a trainer’s manual and a supply of participants’ handout matter. This package was used as a guideline during planning sessions, attended by from 20 to 25 factory inspectors over a period of ten days, and concerned with establishing national TOT courses in Africa. By the spring of 1994, national TOT courses had been implemented in two African countries, Kenya and Ethiopia.


High Quality Learning

There are four key components of high quality learning.

Motivation for learning. Motivation occurs when participants see the “use-value” of what they are learning. It is stimulated when they can perceive the gap that separates what they know and what they need to know to solve a problem.

Organization of subject matter. The content of learning is too commonly thought of as separate facts stored in the brain like items in boxes on a shelf. In reality, people construct models, or mental pictures, of the world while learning. In promoting cognitive learning, teachers try to organize facts into models for better learning and include explanatory principles or concepts (the “but whys” behind a fact or skill).

Advancing through steps in the learning process. In the learning process, the participant is like an investigator looking for a model by which to understand the subject matter. With the help of the teacher, the participant forms this model, practices using it and evaluates its usefulness. This process can be divided into the following six steps:

  • motivation
  • orientation
  • integrating new knowledge (internalization)
  • application
  • programme critique
  • participant evaluation.


Social interaction. The social interaction between participants in a training session is an essential component of learning. In group activities, participants learn from one another.


Planning training for high quality learning

The kind of education aimed at particular skills and competencies is called training. The goal of training is to facilitate high quality learning and it is a process that takes place in a series of steps. It requires careful planning at each stage and each step is equally important. There are many ways of breaking the training into components but from the point of view of the cognitive conception of learning, the task of planning a training course can be analysed into six steps.

Step 1: Conduct a needs assessment (know your audience).

Step 2: Formulate learning objectives.

Step 3: Develop an orientation basis or “road map” for the course.

Step 4: Develop the curriculum, establishing its contents and associated training methods and using a chart to outline your curriculum.

Step 5: Teach the course.

Step 6: Evaluate the course and follow up on the evaluation.


Practical Implementation of National TOT Courses

Based on the above-mentioned training approach and experience from the first pilot course, two national TOT courses were implemented in Africa, the one in Kenya in 1993 and the other in Ethiopia in 1994.

Training needs were based on the work activity of factory inspectors and were determined by means of a pre-workshop questionnaire and a discussion with the course participants about their everyday work and about the kinds of skills and competencies necessary to carry it out (see figure 1). The course has thus been designed primarily for factory inspectors (in our national TOT courses, usually 20 to 25 inspectors participated), but it could be extended to other personnel who may need to carry out safety and health training, such as shop stewards, foremen, and safety and health officers.

Figure 1. Orientation basis for the factory inspector's work activity.


A compilation of course objectives for the national TOT course was assembled step by step in cooperation with the participants, and is given immediately below.


Objectives of the national TOT course

The aims of the training of trainers (TOT) course are as follows:

  • Increase participants’ understanding of the changing role and tasks of factory inspectors from immediate enforcement to long-term advisory service, including training and consultation.
  • Increase participants’ understanding of the basic principles of high quality learning and instruction.
  • Increase participants’ understanding of the variety of skills involved in planning training programmes: identification of training needs, formulation of learning objectives, development of training curricula and materials, selection of appropriate teaching methods, effective presentation and programme evaluation.
  • Enhance participants’ skills in effective communication for application during inspections and consultation, as well as in formal training sessions.
  • Facilitate the development of short and long-term training plans in which new instructional practices will be implemented.


    Course contents

    The key subject areas or curriculum units that guided the implementation of the TOT course in Ethiopia are outlined in figure 2. This outline may also serve as an orientation basis for the whole TOT course.

    Figure 2. The key subject areas of the TOT course.


    Determining training methods

    The external aspect of the teaching method is immediately observable when you step into a classroom. You might observe a lecture, a discussion, group or individual work. However, what you do not see is the most essential aspect of teaching: the kind of mental work being accomplished by the student at any given moment. This is called the internal aspect of the teaching method.

    Teaching methods can be divided into three main groups:

    • Instructional presentation: participant presentations, lectures, demonstrations, audio-visual presentations
    • Independent assignment: tests or exams, small group activities, assigned reading, use of self-guided learning materials, role plays
    • Cooperative instruction


    Most of the above methods were used in our TOT courses. However, the method one selects depends on the learning objectives one wants to achieve. Each method or learning activity should have a function. These instructional functions, which are the activities of a teacher, correspond with the steps in the learning process described above and can help guide your selection of methods. There follows a list of the nine instructional functions:


      1. preparation
      2. motivation
      3. orientation
      4. transmitting new knowledge
      5. consolidating what has been taught
      6. practising (development of knowledge into skills)
      7. application (solving new problems with the help of new knowledge)
      8. programme critique
      9. participant evaluation.



                  Planning the curriculum: Charting your course

                  One of the functions of curriculum or course plan is to assist in guiding and monitoring the teaching and learning process. The curriculum can be divided into two parts, the general and the specific.

                  The general curriculum gives an overall picture of the course: its goals, objectives, contents, participants and guidelines for their selection, the teaching approach (how the course will be conducted) and the organizational arrangements, such as pre-course tasks. This general curriculum would usually be your course description and a draft programme or list of topics.

                  A specific curriculum provides detailed information on what one will teach and how one plans to teach it. A written curriculum prepared in chart form will serve as a good outline for designing a curriculum specific enough to serve as a guide in the implementation of the training. Such a chart includes the following categories:

                  Time: the estimated time needed for each learning activity

                  Curriculum Units: primary subject areas

                  Topics: themes within each curriculum unit

                  Instructional function: the function of each learning activity in helping to achieve your learning objectives

                  Activities: the steps for conducting each learning activity

                  Materials: the resources and materials needed for each activity

                  Instructor: the trainer responsible for each activity (when there are several trainers)

                  To design the curriculum with the aid of the chart format, follow the steps outlined below. Completed charts are illustrated in connection with a completed curriculum in Weinger 1993.

                  1. Specify the primary subject areas of the course (curriculum units) which are based on your objectives and general orientation basis.
                  2. List the topics you will cover in each of those areas.
                  3. Plan to include as many instructional functions as possible in each subject area in order to advance through all the steps of the learning process.
                  4. Choose methods which fulfil each function and estimate the amount of time required. Record the time, topic and function on the chart.
                  5. In the activities column, provide guidelines for the instructor on how to conduct the activity. Entries can also include main points to be covered in this session. This column should offer a clear picture of exactly what will occur in the course during this time period.
                  6. List the materials, such as worksheets, handouts or equipment required for each activity.
                  7. Make sure to include appropriate breaks when designing a cycle of activities.


                  Evaluating the course and follow-up

                  The last step in the training process is evaluation and follow-up. Unfortunately, it is a step that is often forgotten, ignored and, sometimes, avoided. Evaluation, or the determination of the degree to which course objectives were met, is an essential component of training. This should include both programme critique (by the course administrators) and participant evaluation.

                  Participants should have an opportunity to evaluate the external factors of teaching: the instructor’s presentation skills, techniques used, facilities and course organization. The most common evaluation tools are post-course questionnaires and pre- and post-tests.

                  Follow-up is a necessary support activity in the training process. Follow-up activities should be designed to help the participants apply and transfer what they have learned to their jobs. Examples of follow-up activities for our TOT courses include:

                  • action plans and projects
                  • formal follow-up sessions or workshops

                  Selection of trainers

                  Trainers were selected who were familiar with the cognitive learning approach and had good communication skills. During the pilot course in 1992 we used international experts who had been involved in development of this learning approach during the 1980s in Finland. In the national courses we have had a mixture of experts: one international expert, one or two regional experts who had participated in the first pilot course and two to three national resource persons who either had responsibility for training in their own countries or who had participated earlier in this training approach. Whenever it was possible, project personnel also participated.


                  Discussion and Summary


                  Factory training needs assessment

                  The factory visit and subsequent practice teaching are a highlight of the workshop. This training activity was used for workplace training needs assessment (curriculum unit VI A, figure 1). The recommendation here would be to complete the background on theory and methods prior to the visit. In Ethiopia, we scheduled the visit prior to addressing ourselves to the question of teaching methods. While two factories were looked at, we could have extended the time for needs assessment by eliminating one of the factory visits. Thus, visiting groups will visit and focus on only that factory where they will be actually training.

                  The risk mapping component of the workshop (this is also part of curriculum unit VI A) was even more successful in Ethiopia than in Kenya. The risk maps were incorporated in the practice teaching in the factories and were highly motivating for the workers. In future workshops, we would stress that specific hazards be highlighted wherever they occur, rather than, for example, using a single green symbol to represent any of a variety of physical hazards. In this way, the extent of a particular type of hazard is more clearly reflected.


                  Training methods

                  The instructional methods focused on audio-visual techniques and the use of discussion starters. Both were quite successful. In a useful addition to the session on transparencies, the participants were asked to work in groups to develop a transparency of their own on the contents of an assigned article.

                  Flip charts and brainstorming were new teaching methods for participants. In fact, a flip chart was developed especially for the workshop. In addition to being an excellent training aid, the use of flip charts and “magic markers” is a very inexpensive and practical substitute for the overhead projector, which is unavailable to most inspectors in the developing countries.


                  Videotaped microteaching

                  “Microteaching”, or instruction in the classroom focusing on particular local problems, made use of videotape and subsequent critique by fellow participants and resource people, and was very successful. In addition to enhancing the working of external teaching methods, the taping was a good opportunity for comment on areas for improvement in content prior to the factory teaching.

                  A common error, however, was the failure to link discussion starters and brainstorm activities with the content or message of an activity. The method was perfunctorily executed, and its effect ignored. Other common errors were the use of excessively technical terminology and the failure to make the training relevant to the audience’s needs by using specific workplace examples. But the later presentations in the factory were designed to clearly reflect the criticisms that participants had received the day before.


                  Practice teaching in the factory

                  In their evaluation of the practice teaching sessions in the factory, participants were extremely impressed with the use of a variety of teaching methods, including audiovisuals, posters that they developed, flip charts, brainstorming, role plays, “buzz groups” and so on. Most groups also made use of an evaluation questionnaire, a new experience for them. Of particular note was their success in engaging their audiences, after having relied solely on the lecture method in the past. Common areas for improvement were time management and the use of overly technical terms and explanations. In the future, the resource persons should also try to ensure that all groups include the application and evaluation steps in the learning process.


                  Course planning as a training experience

                  During these two courses it was possible to observe significant changes in the participants’ understanding of the six steps in high quality learning.

                  In the last course a section on writing objectives, where each participant writes a series of instructional objectives, was added into the programme. Most participants had never written training objectives and this activity was extremely useful.

                  As for the use of the curriculum chart in planning, we have seen definite progress among all participants and mastery by some. This area could definitely benefit from more time. In future workshops, we would add an activity where participants use the chart to follow one topic through the learning process, using all of the instructional functions. There is still a tendency to pack the training with content material (topics) and to intersperse, without due consideration of their relevance, the various instructional functions throughout a series of topics. It is also necessary that trainers emphasize those activities that are chosen to accomplish the application step in the learning process, and that they acquire more practice in developing learners’ tasks. Application is a new concept for most and difficult to incorporate in the instructional process.

                  Finally the use of the term curriculum unit was difficult and sometimes confusing. The simple identification and ordering of relevant topic areas is an adequate beginning. It was also obvious that many other concepts of the cognitive learning approach were difficult, such as the concepts of orientation basis, external and internal factors in learning and teaching, instructional functions and some others.

                  In summary, we would add more time to the theory and curriculum development sections, as outlined above, and to the planning of future curriculum, which affords the opportunity of observing individual ability to apply the theory.



                  The ILO-FINNIDA African Safety and Health Project has undertaken a particularly challenging and demanding task: to change our ideas and old practices about learning and training. The problem with talking about learning is that learning has lost its central meaning in contemporary usage. Learning has come to be synonymous with taking in information. However, taking in information is only distantly related to real learning. Through real learning we re-create ourselves. Through real learning we become able to do something we were never able to do before (Senge 1990). This is the message in our Project’s new approach on learning and training.



                  Raymond Hétu

                  * This article was written by Dr. Hétu shortly before his untimely death. His colleagues and friends consider it one memoriam to him.

                  Although this article deals with disability due to noise-exposure and hearing loss, it is included here because it also contains fundamental principles applicable to rehabilitation from disabilities arising from other hazardous exposures.

                  Psychosocial Aspects of Occupationally Induced Hearing Loss

                  Like all human experience, hearing loss caused by exposure to workplace noise is given meaning—it is qualitatively experienced and evaluated—by those whom it affects and by their social group. This meaning can, however, be a powerful obstacle to the rehabilitation of individuals suffering from occupationally induced hearing loss (Hétu and Getty 1991b). The chief reasons, as discussed below, are that the victims of hearing loss experience perceptual barriers related to the signs and effects of their deficiency and that the manifestation of overt signs of hearing loss is highly stigmatizing.

                  Communication problems due to the distorted perception of hearing

                  Difficulties in hearing and communication resulting from occupationally induced hearing loss are usually attributed to other causes, for example unfavourable conditions for hearing or communication or a lack of attention or interest. This erroneous attribution is observed in both the affected individual and among his or her associates and has multiple, although converging, causes.

                    1. Internal ear injuries are invisible, and victims of this type of injury do not see themselves as physically injured by noise.
                    2. Hearing loss per se progresses very insidiously. The virtually daily auditory fatigue due to workplace noise suffered by exposed workers makes the timely detection of irreversible alterations in hearing function a matter of the greatest difficulty. Individuals exposed to noise are never aware of tangible deteriorations of hearing capacity. In fact, in most workers exposed daily to harmful levels of noise, the increase in the auditory threshold is of the order of one decibel per year of exposure (Hétu, Tran Quoc and Duguay 1990). When hearing loss is symmetric and progressive, the victim has no internal reference against which to judge the induced hearing deficit. As a result of this insidious evolution of hearing loss, individuals undergo a very progressive change of habits, avoiding situations which place them at a disadvantage—without however explicitly associating this change with their hearing problems.
                    3. The signs of hearing loss are very ambiguous and usually take the form of a loss of frequency discrimination, that is, a diminished ability to discriminate between two or more simultaneous acoustic signals, with the more intense signal masking the other(s). Concretely, this takes the form of varying degrees of difficulty in following conversations where reverberation is high or where background noise due to other conversations, televisions, fans, vehicle motors, and so forth, is present. In other words, the hearing capacity of individuals suffering from impaired frequency discrimination is a direct function of the ambient conditions at any given moment. Those with whom the victim comes into daily contact experience this variation in hearing capacity as inconsistent behaviour on the part of the affected individual and reproach him or her in terms like, “You can understand well enough when it suits your purpose”. The affected individual, on the other hand, considers his or her hearing and communication problems to be the result of background noise, inadequate articulation by those addressing him or her, or a lack of attention on their part. In this way, the most characteristic sign of noise-induced hearing loss fails to be recognized for what it is.
                    4. The effects of hearing loss are usually experienced outside of the workplace, within the confines of family life. Consequently, problems are not associated with occupational exposure to noise and are not discussed with work colleagues suffering similar difficulties.
                    5. Acknowledgement of hearing problems is usually triggered by reproaches from the victim’s family and social circles (Hétu, Jones and Getty 1993). Affected individuals violate certain implicit social norms, for example by speaking too loudly, frequently asking others to repeat themselves and turning the volume of televisions or radios up too high. These behaviours elicit the spontaneous—and usually derogatory—question, “Are you deaf?” from those around. The defensive behaviours that this triggers do not favour the acknowledgement of partial deafness.


                            As a result of the convergence of these five factors, individuals suffering from occupationally induced hearing loss do not recognize the effects of their affliction on their daily lives until the loss is well advanced. Typically, this occurs when they find themselves frequently asking people to repeat themselves (Hétu, Lalonde and Getty 1987). Even at this point, however, victims of occupationally induced hearing loss are very unwilling to acknowledge their hearing loss on account of the stigma associated with deafness.

                            Stigmatization of the signs of deafness

                            The reproaches elicited by the signs of hearing loss are a reflection of the extremely negative value construct typically associated with deafness. Workers exhibiting signs of deafness risk being perceived as abnormal, incapable, prematurely old, or handicapped—in short, they risk becoming socially marginalized in the workplace (Hétu, Getty and Waridel 1994). These workers’ negative self-image thus intensifies as their hearing loss progresses. They are obviously reluctant to embrace this image, and by extension, to acknowledge the signs of hearing loss. This leads them to attribute their hearing and communication problems to other factors and to become passive in the face of these factors.

                            The combined effect of the stigma of deafness and the distorted perception of the signs and effects of hearing loss on rehabilitation is illustrated in figure 1.

                            Figure 1. Conceptual framework for incapacity from handicap


                            When hearing problems progress to the point that it is no longer possible to deny or minimize them, individuals attempt to hide the problem. This invariably leads to social withdrawal on the part of the worker and exclusion on the part of the worker’s social group, which ascribes the withdrawal to a lack of interest in communicating rather than to hearing loss. The result of these two reactions is that the affected individual is not offered help or informed of coping strategies. Workers’ dissimulation of their problems may be so successful that family members and colleagues may not even realize the offensive nature of their jokes elicited by the signs of deafness. This situation only exacerbates the stigmatization and its resultant negative effects. As Figure 1 illustrates, the distorted perceptions of the signs and effects of hearing loss and the stigmatization which results from these perceptions are barriers to the resolution of hearing problems. Because affected individuals are already stigmatized, they initially refuse to use hearing aids, which unmistakably advertise deafness and so promote further stigmatization.

                            The model presented in Figure 1 accounts for the fact that most people suffering occupationally induced hearing loss do not consult audiology clinics, do not request modification of their workstations and do not negotiate enabling strategies with their families and social groups. In other words, they endure their problems passively and avoid situations which advertise their auditory deficit.

                            Conceptual Framework of Rehabilitation

                            For rehabilitation to be effective, it is necessary to overcome the obstacles outlined above. Rehabilitative interventions should therefore not be limited to attempts to restore hearing capacity, but should also address issues related to the way hearing problems are perceived by affected individuals and their associates. Because stigmatization of deafness is the greatest obstacle to rehabilitation (Hétu and Getty 1991b; Hétu, Getty and Waridel 1994), it should be the primary focus of any intervention. Effective interventions should  therefore  include  both  stigmatized  workers  and  their circles of family, friends, colleagues and others with whom they come into contact, since it is they who stigmatize them and who, out of ignorance, impose impossible expectations on them. Concretely, it is necessary to create an environment which allows affected individuals to break out of their cycle of passivity and isolation and actively seek out solutions to their hearing problems. This must be accompanied by a sensitization of the entourage to the specific needs of affected individuals. This process is grounded in the ecological approach to incapacity and handicap illustrated in figure 2.

                            Figure 2. Model of restrictions due to hearing loss


                            In the ecological model, hearing loss is experienced as an incompatibility between an individual’s residual capacity and the physical and social demands of his or her environment. For example, workers suffering from a loss of frequency discrimination associated with noise-induced hearing loss will have difficulty detecting acoustic alarms in noisy workplaces. If the alarms required at workstations cannot be adjusted to levels significantly louder than those appropriate for people with normal hearing, the workers will be placed in a handicapped position (Hétu 1994b). As a result of this handicap, workers may be at the obvious disadvantage of being deprived of a means to protect themselves. Yet, simply acknowledging hearing loss puts the worker at risk of being considered “abnormal” by his or her colleagues, and when labelled disabled he or she will fear being seen as incompetent by colleagues or superiors. In either case, workers will attempt to hide their handicap or deny the                                                                                                                             existence of any problems, placing themselves at a functional                                                                                                                         disadvantage at work.

                            As figure 2 illustrates, disability is a complex state of affairs with several interrelated restrictions. In such a network of relationships, prevention or minimization of disadvantages or restrictions of activity require simultaneous interventions on many fronts. For example, hearing aids, while partially restoring hearing capacity (component 2), do not prevent either the development of a negative self-image or stigmatization by the worker’s entourage (components 5 and 6), both of which are responsible for isolation and avoidance of communication (component 7). Further, auditory supplementation is incapable of completely restoring hearing capacity; this is particularly true with regard to frequency discrimination. Amplification may improve the perception of acoustic alarms and of conversations but is incapable of improving the resolution of competing signals required for the detection of warning signals in the presence of significant background noise. The prevention of disability-related restrictions therefore necessitates the modification of the social and physical demands of the workplace (component 3). It should be superfluous to note that although interventions designed to modify perceptions (components 5 and 6) are essential and do prevent disability from arising, they do not palliate the immediate consequences of these situations.

                            Situation-specific Approaches to Rehabilitation

                            The application of the model presented in Figure 2 will vary depending on the specific circumstances encountered. According to surveys and qualitative studies (Hétu and Getty 1991b; Hétu, Jones and Getty 1993; Hétu, Lalonde and Getty 1987; Hétu, Getty and Waridel 1994; Hétu 1994b), the effects of disability suffered by victims of occupationally induced hearing loss are particularly felt: (1) at the workplace; (2) at the level of social activities; and (3) at the family level. Specific intervention approaches have been proposed for each of these situations.

                            The workplace

                            In industrial workplaces, it is possible to identify the following four restrictions or disadvantages requiring specific interventions:

                              1. accident hazards related to the failure to detect warning signals
                              2. efforts, stress and anxiety resulting from hearing and com-munication problems
                              3. obstacles to social integration
                              4. obstacles to professional advancement.


                                    Accident hazards

                                    Acoustic warning alarms are frequently used in industrial workplaces. Occupationally induced hearing loss may considerably diminish workers’ ability to detect, recognize or locate such alarms, particularly in noisy workplaces with high levels of reverberation. The loss of frequency discrimination which inevitably accompanies hearing loss may in fact be so pronounced as to require warning alarms to be 30 to 40db louder than background levels to be heard and recognized by affected individuals (Hétu 1994b); for individuals with normal hearing, the corresponding value is approximately 12 to 15db. Currently, it is rare that warning alarms are adjusted to compensate for background noise levels, workers’ hearing capacity or the use of hearing protection equipment. This puts affected workers at a serious disadvantage, especially as far as their safety is concerned.

                                    Given these constraints, rehabilitation must be based on a rigorous analysis of the compatibility of auditory perception requirements with residual auditory capacities of affected workers. A clinical examination capable of characterizing an individual’s ability to detect acoustic signals in the presence of background noise, such as the DetectsoundTM software package (Tran Quoc, Hétu and Laroche 1992), has been developed, and is available to determine the characteristics of acoustic signals compatible with workers’ hearing capacity. These devices simulate normal or impaired auditory detection and take into account the characteristics of the noise at the workstation and the effect of hearing protection equipment. Of course, any intervention aimed at reducing the noise level will facilitate the detection of acoustic alarms. It is nevertheless necessary to adjust the alarms’ level as a function of the residual hearing capacity of affected workers.

                                    In some cases of relatively severe hearing loss, it may be necessary to resort to other types of warning, or to supplement hearing capacity. For example, it is possible to transmit warning alarms over FM bandwidths and receive them with a portable unit connected directly to a hearing aid. This arrangement is very effective as long as: (1) the tip of the hearing aid fits perfectly (in order to attenuate background noise); and (2) the response curve of the hearing aid is adjusted to compensate for the masking effect of background noise attenuated by the hearing aid tip and the worker’s hearing capacity (Hétu, Tran Quoc and Tougas 1993). The hearing aid may be adjusted to integrate the effects of the full spectrum of background noise, the attenuation produced by the hearing aid’s tip, and the worker’s hearing threshold. Optimal results will be obtained if the frequency discrimination of the worker is also measured. The hearing aid-FM receptor may also be used to facilitate verbal communication with work colleagues when this is essential for worker safety.

                                    In some cases, the workstation itself must be redesigned in order to ensure worker safety.

                                    Hearing and communication problems

                                    Acoustic warning alarms are usually used to inform workers of the state of a production process and as a means of inter operator communication. In workplaces where such alarms are used, individuals with hearing loss must rely upon other sources of information to perform their work. These may involve intense visual surveillance and discreet help offered by work colleagues. Verbal communication, whether over the telephone, in committee meetings or with superiors in noisy workshops, requires great effort on the part of affected individuals and is also highly problematic for affected individuals in industrial workplaces. Because these individuals feel the need to hide their hearing problems, they are also plagued by the fear of being unable to cope with a situation or of committing costly errors. Often, this may cause extremely high anxiety (Hétu and Getty 1993).

                                    Under these circumstances, rehabilitation must first focus on eliciting explicit acknowledgement by the company and its representatives of the fact that some of their workers suffer from hearing difficulties caused by noise exposure. The legitimization of these difficulties helps affected individuals to communicate about them and to avail themselves of appropriate palliative means. However, these means must in fact be available. In this regard, it is astonishing to note that telephone receivers in the workplace are rarely equipped with amplifiers designed for individuals suffering from hearing loss and that conference rooms are not equipped with appropriate systems (FM or infrared transmitters and receptors, for example). Finally, a campaign to increase awareness of the needs of individuals suffering from hearing loss should be undertaken. By publicizing strategies which facilitate communication with affected individuals, communication-related stress will be greatly reduced. These strategies consist of the following phases:

                                    • approaching the affected individual and facing him or her
                                    • articulating without exaggeration
                                    • repeating misunderstood phrases, using different words
                                    • keeping as far away from sources of noise as possible


                                    Clearly, any control measures that lead to lower noise and reverberation levels in the workplace also facilitate communication with individuals suffering from hearing loss.

                                    Obstacles to social integration

                                    Noise and reverberation in the workplace render communication so difficult that it is often limited to the strict minimum required by the tasks to be accomplished. Informal communication, a very important determinant of the quality of working life, is thus greatly impaired (Hétu 1994a). For individuals suffering from hearing loss, the situation is extremely difficult. Workers suffering from occupationally induced hearing loss are isolated from their work colleagues, not only at their workstation but even during breaks and meals. This is a clear example of the convergence of excessive work requirements and the fear of ridicule suffered by affected individuals.

                                    The solutions to this problem lie in the implementation of the measures already described, such as the lowering of overall noise levels, particularly in rest areas, and the sensitization of work colleagues to the needs of affected individuals. Again, recognition by the employer of affected individuals’ specific needs itself constitutes a form of psychosocial support capable of limiting the stigma associated with hearing problems.

                                    Obstacles to professional advancement

                                    One of the reasons individuals suffering from occupationally induced hearing loss take such pains to hide their problem is the explicit fear of being disadvantaged professionally (Hétu and Getty 1993): some workers even fear losing their jobs should they reveal their hearing loss. The immediate consequence of this is a self-restriction with regard to professional advancement, for example, failure to apply for a promotion to shift supervisor, supervisor or foreman. This is also true of professional mobility outside the company, with experienced workers failing to take advantage of their accumulated skills since they feel that pre-employment audiometric examinations would block their access to better jobs. Self-restriction is not the only obstacle to professional advancement caused by hearing loss. Workers suffering from occupationally induced hearing loss have in fact reported instances of employer bias when positions requiring frequent verbal communication have become available.

                                    As with the other aspects of disability already described, explicit acknowledgement of affected workers’ specific needs by employers greatly eliminates obstacles to professional advancement. From the standpoint of human rights (Hétu and Getty 1993), affected individuals have the same right to be considered for advancement as do other workers, and appropriate workplace modifications can facilitate their access to higher-level jobs.

                                    In summary, the prevention of disability in the workplace requires sensitization of employers and work colleagues to the specific needs of individuals suffering from occupationally induced hearing loss. This can be accomplished by information campaigns on the signs and effects of noise-induced hearing loss aimed at dissipating the view of hearing loss as an improbable abnormality of little import. The use of technological aids is possible only if the need to use them has been legitimized in the workplace by colleagues, superiors and affected individuals themselves.

                                    Social activities

                                    Individuals suffering from occupationally induced hearing loss are at a disadvantage in any non-ideal hearing situation, for instance, in the presence of background noise, in situations requiring communication at a distance, in environments where reverberation is high and on the telephone. In practice, this greatly curtails their social life by limiting their access to cultural activities and public services, thus hindering their social integration (Hétu and Getty 1991b).

                                    Access to cultural activities and public services

                                    In accordance with the model in Figure 2, restrictions related to cultural activities involve four components (components 2, 3, 5 and 6) and their elimination relies on multiple interventions. Thus concert halls, auditoriums and places of worship can be made accessible to persons suffering from hearing loss by equipping them with appropriate listening systems, such as FM or infrared transmission systems (component 3) and by informing those responsible for these institutions of the needs of affected individuals (component 6). However, affected individuals will request hearing equipment only if they are aware of its availability, know how to use it (component 2) and have received the necessary psychosocial support to recognize and communicate their need for such equipment (component 5).

                                    Effective communication, training and psychosocial support channels for hearing-impaired workers have been developed in an experimental rehabilitation programme (Getty and Hétu 1991, Hétu and Getty 1991a), discussed in “Family life”, below.

                                    As regards the hearing-impaired, access to public services such as banks, stores, government services and health services is hindered primarily by a lack of knowledge on the part of the institutions. In banks, for example, glass screens may separate clients from tellers, who may be occupied in entering data or filling out forms while talking to clients. The resulting lack of face-to-face visual contact, coupled with unfavourable acoustic conditions and a context in which misunderstanding can have very serious consequences, render this an extremely difficult situation for affected individuals. In health service facilities, patients wait in relatively noisy rooms where their names are called by an employee located at a distance or via a public address system that may be difficult to comprehend. While individuals with hearing loss worry a great deal about being unable to react at the correct time, they generally neglect to inform staff of their hearing problems. There are numerous examples of this type of behaviour.

                                    In most cases, it is possible to prevent these handicap situations by informing staff of the signs and effects of partial deafness and of ways to facilitate communication with affected individuals. A number of public services have already undertaken initiatives aimed at facilitating communication with individuals suffering from occupationally induced hearing loss (Hétu, Getty and Bédard 1994) with results as follows. The use of appropriate graphical or audio visual material allowed the necessary information to be communicated in less than 30 minutes and the effects of such initiatives were still apparent six months after the information sessions. These strategies greatly facilitated communication with the personnel of the services involved. Very tangible benefits were reported not only by clients with hearing loss but also by the staff, who saw their tasks simplified and difficult situations with this type of client prevented.

                                    Social integration

                                    Avoidance of group encounters is one of the most severe consequences of occupationally induced hearing loss (Hétu and Getty 1991b). Group discussions are extremely demanding situations for affected individuals, In this case, the burden of accommodation rests with the affected individual, as he or she can rarely expect the entire group to adopt a favourable rhythm of conversation and mode of expression. Affected individuals have three strategies available to them in these situations:

                                    • reading facial expressions
                                    • using specific communication strategies
                                    • using a hearing aid.


                                    The reading of facial expressions (and lip-reading) can certainly facilitate comprehension of conversations, but requires considerable attention and concentration and cannot be sustained over long periods. This strategy can, however, be usefully combined with requests for repetition, reformulation and summary. Nevertheless, group discussions occur at such a rapid rhythm that it is often difficult to rely upon these strategies. Finally, the use of a hearing aid may improve the ability to follow conversation. However, current amplification techniques do not allow the restoration of frequency discrimination. In other words, both signal and noise are amplified. This often worsens rather than improves the situation for individuals with serious frequency discrimination deficits.

                                    The use of a hearing aid as well as the request for accommodation by the group presupposes that the affected individual feels comfortable revealing his or her condition. As discussed below, interventions aimed at strengthening self-esteem are therefore prerequisites for attempts to supplement auditory capacity.

                                    Family life

                                    The family is the prime locus of the expression of hearing problems caused by occupational hearing loss (Hétu, Jones and Getty 1993). A negative self-image is the essence of the experience of hearing loss, and affected individuals attempt to hide their hearing loss in social interactions by listening more intently or by avoiding overly demanding situations. These efforts, and the anxiety which accompanies them, create a need for release in the family setting, where the need to hide the condition is less strongly felt. Consequently, affected individuals tend to impose their problems on their families and coerce them to adapt to their hearing problems. This takes a toll on spouses and others and causes irritation at having to repeat oneself frequently, tolerate high television volumes and “always be the one to answer the telephone”. Spouses must also deal with serious restrictions in the couples’ social life and with other major changes in family life. Hearing loss limits companionship and intimacy, creates tension, misunderstandings and arguments and disturbs relations with children.

                                    Not only does hearing and communication impairment affect intimacy, but its perception by affected individuals and their family (components 5 and 6 of figure 2) tends to feed frustration, anger and resentment (Hétu, Jones and Getty 1993). Affected individuals frequently do not recognize their impairment and do not attribute their communications problems to a hearing deficit. As a result, they may impose their problems on their families rather than negotiate mutually satisfactory adaptations. Spouses, on the other hand, tend to interpret the problems as a refusal to communicate and as a change in the affected individual’s temperament. This state of affairs may lead to mutual reproaches and accusations, and ultimately to isolation, loneliness and sadness, particularly on the part of the unaffected spouse.

                                    The solution of this interpersonal dilemma requires the participation of both partners. In fact, both require:

                                    • information on the auditory basis of their problems.
                                    • psychosocial support
                                    • training in the use of appropriate supplemental means of communication.


                                    With this in mind, a rehabilitation programme for affected individuals and their spouses has been developed (Getty and Hétu 1991, Hétu and Getty 1991a). The goal of the programme is to stimulate research on the resolution of problems caused by hearing loss, taking into account the passivity and social withdrawal that characterize occupationally induced hearing loss.

                                    Since the stigma associated with deafness is the principal source of these behaviours, it was essential to create a setting in which self-esteem could be restored so as to induce affected individuals to seek out actively solutions to their hearing-related problems. The effects of stigmatization can be overcome only when one is perceived by others as normal regardless of any hearing deficit. The most effective way to achieve this consists of meeting other people in the same situation, as was suggested by workers asked about the most appropriate aid to offer their hearing-impaired colleagues. However, it is essential that these meetings take place outside the workplace, precisely to avoid the risk of further stigmatization (Hétu, Getty and Waridel 1994).

                                    The rehabilitation programme mentioned above was developed with this in mind, the group encounters taking place in a community health department (Getty and Hétu 1991). Recruitment of participants was an essential component of the programme, given the withdrawal and passivity of the target population. Accordingly, occupational health nurses first met with 48 workers suffering from hearing loss and their spouses at their homes. Following an interview on hearing problems and their effects, every couple was invited to a series of four weekly meetings lasting two hours each, held in the evening. These meetings followed a precise schedule aimed at meeting the objectives of information, support and training defined in the programme. Individual follow-up was provided to participants in order to facilitate their access to audio-logical and audioprosthetic services. Individuals suffering from tinnitus were referred to the appropriate services. A further group meeting was held three months after the last weekly meeting.

                                    The results of the programme, collected at the end of the experimental phase, demonstrated that participants and their spouses were more aware of their hearing problems, and were also more confident of resolving them. Workers had undertaken various steps, including technical aids, revealing their impairment to their social group, and expressing their needs in an attempt to improve communication.

                                    A follow-up study, performed with this same group five years after their participation in the programme, demonstrated that the programme was effective in stimulating participants to seek solutions. It also showed that rehabilitation is a complex process requiring several years of work before affected individuals are able to avail themselves of all the means at their disposal to regain their social integration. In most cases, this type of rehabilitation process requires periodic follow-up.


                                    As figure 2 indicates, the meaning that individuals suffering from occupationally induced hearing loss and their associates give to their condition is a key factor in handicap situations. The approaches to rehabilitation proposed in this article explicitly take this factor into account. However, the manner in which these approaches are applied concretely will depend on the specific sociocultural context, since the perception of these phenomena may vary from one context to another. Even within the sociocultural context in which the intervention strategies described above were developed, significant modifications may be necessary. For example, the programme developed for individuals suffering from occupationally induced hearing loss and their spouses (Getty and Hétu 1991) was tested in a population of affected males. Different strategies would probably be necessary in a population of affected females, especially when one considers the different social roles men and women occupy in conjugal and parental relations (Hétu, Jones and Getty 1993). Modifications would be necessary a fortiori when dealing with cultures which differ from that of North America from which the approaches emerged. The conceptual framework proposed (figure 2) can nevertheless be used effectively to orient any intervention aimed at rehabilitating individuals suffering from occupationally induced hearing loss.

                                    Furthermore, this type of intervention, if applied on a large scale, will have important preventive effects on hearing loss itself. The psychosocial aspects of occupationally induced hearing loss hinder both rehabilitation (figure 1) and prevention. The distorted perception of hearing problems delays their recognition, and their dissimulation by severely affected individuals fosters the general perception that these problem are rare and relatively innocuous, even in noisy workplaces. This being so, noise-induced hearing loss is not perceived by workers at risk or by their employers as an important health problem, and the need for prevention is thus not strongly felt in noisy workplaces. On the other hand, individuals already suffering from hearing loss who reveal their problems are eloquent examples of the severity of the problem. Rehabilitation can thus be seen as the first step of a prevention strategy.



                                    Friday, 11 February 2011 21:22

                                    Rights and Duties: An Employer's Perspective

                                    The traditional approach to helping disabled people into work has had little success, and it is evident that something fundamental needs to be changed. For example, the official unemployment rates for disabled people are always at least twice that of their non-disabled peers—often higher. The numbers of disabled people not working often approach 70% (in the United States, United Kingdom, Canada). Disabled people are more likely than their non-disabled peers to live in poverty; for example, in the United Kingdom two-thirds of the 6.2 million disabled citizens have only state benefits as income.

                                    These problems are compounded by the fact that rehabilitation services are often unable to meet employer demand for qualified applicants.

                                    In many countries, disability is not generally defined as an equal opportunities or rights issue. It is thus difficult to encourage corporate best practice which positions disability firmly alongside race and gender as an equal opportunities or diversity priority. Proliferation of quotas or the complete absence of relevant legislation reinforces employer assumptions that disability is primarily a medical or charity issue.

                                    Evidence of the frustrations created by inadequacies inherent in the present system can be seen in growing pressure from disabled people themselves for legislation based on civil rights and/or employment rights, such as exists in the United States, Australia, and, from 1996, in the United Kingdom. It was the failure of the rehabilitation system to meet the needs and expectations of enlightened employers which prompted the UK business community to establish the Employers Forum on Disability.

                                    Employers’ attitudes unfortunately reflect those of the wider society—although this fact is often overlooked by rehabilitation practitioners. Employers share with many others widespread confusion regarding such issues as:

                                    • What is a disability? Who is and who is not disabled?
                                    • Where do I get advice and services to help me recruit and retain disabled people?
                                    • How do I change my organization’s culture and working practices?
                                    • What benefit will best practice on disability bring my business—and the economy in general?


                                    The failure to meet the information and service needs of the employer community constitutes a major hurdle for disabled people wanting work, yet it is rarely addressed adequately by government policy makers or rehabilitation practitioners.

                                    Deep-Rooted Myths that Disadvantage Disabled People in the Labour Market

                                    Non-governmental organizations (NGOs), governments, indeed all those involved in the medical and employment rehabilitation of persons with disabilities, tend to share a set of deep-rooted, often unspoken assumptions which only further disadvantage the disabled individuals these organizations seek to help:

                                    • “The employer is the problem—indeed, often the adversary.” It is employer attitudes which are often blamed for the failure of disabled people to find jobs, despite the evidence that numerous other factors may well have been highly significant.
                                    • “The employer is not treated either as a client or a customer.” Rehabilitation services do not measure their success by the extent to which they make it easier for the employer to recruit and retain disabled employees. As a result, the unreasonable difficulties created by suppliers of rehabilitation services make it difficult for the well-intentioned and enlightened employer to justify the time, cost and effort required to effect change. The not-so-enlightened employer has his or her reluctance to effect change more than justified by the lack of cooperation from rehabilitation services..
                                    • “Disabled people really cannot compete on merit.” Many service providers have low expectations of disabled people and their potential to work. They find it difficult to promote the “business case” to employers because they themselves doubt that employing people with disability brings genuine mutual benefit. Instead the tone and underlying ethos of their communication with employers stresses the moral and perhaps (occasional) legal obligation in a way which only further stigmatizes disabled people.
                                    • “Disability is not a mainstream economic or business issue. It is best left in the hands of the experts, doctors, rehabilitation providers and charities.” The fact that disability is portrayed in the media and through fund-raising activities as a charity issue, and that disabled people are portrayed as the natural and passive recipients of charity, is a fundamental barrier to the employment of disabled people. It also creates tension in organizations that are trying to find jobs for people, while on the other hand using images which tug at the heartstrings.


                                    The consequence of these assumptions is that:

                                    • Employers and disabled people remain separated by a maze of well-meaning but often uncoordinated and fragmented services which only rarely define success in terms of employer satisfaction.
                                    • Employers and disabled people alike remain excluded from real influence over policy development; only rarely is either party asked to evaluate services from its own perspective and to propose improvements.


                                    We are beginning to see an international trend, typified by the development of “job coach” services, towards acknowledging that successful rehabilitation of disabled people depends upon the quality of service and support available to the employer.

                                    The statement “Better services for employers equals better services for disabled people” must surely come to be much more widely accepted as economic pressures build on rehabilitation agencies everywhere in the light of governments’ retrenchment and restructuring. It is nonetheless very revealing that a recent report by Helios (1994), which summarizes the competencies required by vocational or rehabilitation specialists, fail to make any reference to the need for skills which relate to the employers as customer.

                                    While there is a growing awareness of the need to work with employers as partners, our experience shows that it is difficult to develop and sustain a partnership until the rehabilitation practitioners first meet the needs of the employer as customer and begin to value that “employer as customer” relationship.

                                    Employers’ Roles

                                    At various times and in various situations the system and services position the employer in one or more of the following roles—though only rarely is it articulated. Thus we have the employer as:

                                    • the Problem—“you require enlightenment”
                                    • the Target—“you need education, information, or consciousness raising”
                                    • the Customer—“the employer is encouraged to use us in order to recruit and retain disabled employees”
                                    • the Partner—the employer is encouraged to “enter into a long term, mutually beneficial relationship”.


                                    And at any time during the relationship the employer may be called upon—indeed is typically called upon—to be a funder or philanthropist.

                                    The key to successful practice lies in approaching the employer as “The Customer”. Systems which regard the employer as only “The Problem”, or “The Target”, find themselves in a self-perpetuating dysfunctional cycle.

                                    Factors outside the Employer’s Control

                                    Reliance on perceived employer negative attitudes as the key insight into why disabled people experience high unemployment rates, consistently reinforces the failure to address other highly significant issues which must also be tackled before real change can be brought about.

                                    For example:

                                    • In the United Kingdom, in a recent survey 80% of employers were not aware they had ever had a disabled applicant.
                                    • Benefits and social welfare systems often create financial disincentives for disabled people moving into work.
                                    • Transport and housing systems are notoriously inaccessible; people can look for work successfully only when basic housing, transport and subsistence needs have been met.
                                    • In a recent UK survey, 59% of disabled job seekers were unskilled compared to 23% of their peers. Disabled people, in general, are simply not able to compete in the labour market unless their skill levels are competitive.
                                    • Medical professionals frequently underestimate the extent to which a disabled person can perform in work and are often unable to advise on adaptations and adjustments which might make that person employable.
                                    • Disabled people often find it difficult to obtain high quality career guidance and throughout their lives are subject to the lower expectations of teachers and advisers.
                                    • Quotas and other inappropriate legislation actively undermine the message that disability is an equal opportunities issue.


                                    A legislative system that creates an adversarial or litigious environment can further undermine the job prospects of disabled people because bringing a disabled person into the company could expose the employer to risk.

                                    Rehabilitation practitioners often find it difficult to access expert training and accreditation and are themselves rarely funded to deliver relevant services and products to employers.

                                    Policy Implications

                                    It is vital for service providers to understand that before the employer can effect organizational and cultural change, similar changes are required on the part of the rehabilitation provider. Providers approaching employers as customers need to recognize that actively listening to the employers will almost inevitably trigger the need to change the design and delivery of services.

                                    For example, service providers will find themselves asked to make it easier for the employer to:

                                    • find qualified applicants
                                    • obtain high quality employer-oriented services and advice
                                    • meet disabled people as applicants and colleagues
                                    • understand not just the need for policy change but how to make such change come about
                                    • promote attitude change across their organizations
                                    • understand the business as well as the social case for employing disabled people


                                    Attempts at significant social policy reforms related to disability are undermined by the failure to take into account the needs, expectations and legitimate requirements of the people who will largely determine success—that is, the employers. Thus, for example, the move to ensure that people currently in sheltered workshops obtain mainstream work frequently fails to acknowledge that it is only employers who are able to offer that employment. Success therefore is limited, not only because it is unnecessarily difficult for the employers to make opportunities available but also because of the missed added value resulting from active collaboration between employers and policy makers.

                                    Potential for Employer Involvement

                                    Employers can be encouraged to contribute in numerous ways to making a systematic shift from sheltered employment to supported or competitive employment. Employers can:

                                    • advise on policy—that is, on what needs to be done which would make it easier for employers to offer work to disabled candidates.
                                    • offer advice on the competencies required by disabled individ-uals if they are to be successful in obtaining work.
                                    • advise on the competencies required by service providers if they are to meet employer expectations of quality provision.
                                    • evaluate sheltered workshops and offer practical advice on how to manage a service that is most likely to enable people to move into mainstream work.
                                    • offer work experience to rehabilitation practitioners, who thus gain an understanding of a particular industry or sector and are better able to prepare their disabled clients.
                                    • offer on-the-job assessments and training to disabled individuals.
                                    • offer mock interviews and be mentors to disabled job seekers.
                                    • loan their own staff to work inside the system and/or its institutions.
                                    • help to market rehabilitation agencies and promote policies, organizations and disabled job seekers to other employers.
                                    • offer customized training whereby they become directly involved  in  helping  disabled  individuals  to  acquire  specific job-related skills.
                                    • participate on management boards of rehabilitation agencies or set themselves up in an informal advisory capacity to national policy makers or suppliers.
                                    • lobby alongside rehabilitation providers and disabled people for better government policies and programmes.
                                    • advise on the services and products they require in order to deliver best practice.


                                    Employer as Customer

                                    It is impossible for rehabilitation practitioners to build partnerships with employers without first acknowledging the need to deliver efficient services.

                                    Services should emphasize the theme of mutual benefit. Those who do not passionately believe that their disabled clients have something of real benefit to contribute to the employer are unlikely to be able to influence the employer community.

                                    Improving the quality of service to employers will quickly—and inevitably—improve services for disabled job-seekers. The following represents a useful audit for services wishing to improve the quality of service to the employer.

                                    Does the service offer employers:

                                    1. information and consultancy regarding:

                                      • business benefits which result from employing disabled persons
                                      • possible applicants
                                      • access to the services and the nature of services offered
                                      • models of policy and procedures proven successful by other employers
                                      • legal obligations


                                      2. recruitment services, including access to:

                                      • suitable applicants
                                      • job coaches


                                      3. pre-screening of applicants as per employer expectations

                                      4. professional job analysis and job modification services, able to advise on job restructuring and the use of technical aids and adaptations in the workplace, both for existing and potential employees

                                      5. financial support programmes which are well marketed, appropriate to employer requirements, easy to access, efficiently delivered

                                      6. information and practical help so that employers can make the worksite more physically accessible

                                      7. training for employers and employees regarding the benefits of employing people with disabilities generally, and when specific individuals have been employed

                                      8. work-experience services which provide the employer with relevant support

                                      9. work habituation or employee-orientation services to include job coaches and job-sharing schemes

                                      10. post–job offer support for employers to include advice on best practice in the management of absenteeism and presentation of work-related impairments

                                      11. advice for employers on career development of disabled employees and on meeting the needs of underemployed disabled employees.


                                                        Practical Steps: Making it Easier for the Employer

                                                        Any system of services which aims to help disabled people into training and work will inevitably be more successful if the needs and expectations of the employer are adequately addressed. (Note: It is difficult to find a term which adequately encompasses all those agencies and organizations—governmental, NGOs, not for profit—which are involved in policy making and service delivery to disabled people seeking work. For the sake of brevity, the term service or service provider is used to encompass all those involved in this entire complex system.)

                                                        Close consultation over time with employers will in all likelihood produce recommendations similar to the following.

                                                        Codes of practice are needed which describe the high quality of service employers should receive from employment-related agencies. Such codes should, in consultation with employers, set standards which relate both to the efficiency of the existing services and to the nature of services offered—This code should be monitored via regular surveys of employer satisfaction.

                                                        Specific training and accreditation for rehabilitation practition-ers in how to meet the needs of employers is required and should be a high priority.

                                                        Services should recruit people who have direct experience of the world of industry and commerce and who are skilled in bridging the communication gap between the not-for-profit and profit-making sectors.

                                                        Services themselves should employ significantly more disabled people, thus minimizing the numbers of non-disabled intermediaries dealing with employers. They should ensure that disabled people in various capacities have a high profile in the employer community.

                                                        Services should minimize the fragmentation of education, marketing and campaigning activities. It is particularly counterproductive to create a milieu characterized by messages, posters and advertising which reinforces the medical model of disability and the stigma attached to particular impairments, rather than focusing on the employability of individuals and the need for employers to respond with appropriate policy and practice.

                                                        Services should collaborate to simplify access, to services and support, for both the employer and for the disabled person. Considerable attention should be given to analysing the client journey (with both employer and disabled person as client) in a way that minimizes assessments and moves the individual speedily, step by step, into employment. Services should build on mainstream business initiatives to ensure that disabled people are given priority.

                                                        Services should bring employers together routinely and ask their expert advice regarding what has to be done to make services and job candidates more successful.


                                                        In many countries, the services designed to help disabled people into work are complex, cumbersome and resistant to change, despite the evidence decade after decade that change is required.

                                                        A fresh approach to employers offers enormous potential to transform this situation significantly by radically altering the position of one key protagonist—the employer.

                                                        We see business and government engaged in a wide-ranging debate regarding the way in which relationships between stakeholders or social partners must inevitably change over the next 20 years. Thus employers launch the European Business against Social Exclusion Initiative in Europe, major companies join together to re-think their relationship with society in the UK in “Tomorrow’s Company”, and the Employers Forum on Disability becomes only one of various UK employer initiatives aimed at addressing issues of equality and diversity.

                                                        Employers have much to do if the issue of disability is to take its rightful place as a business and ethical imperative; the rehabilitation community in turn needs to take a fresh approach which redefines working relationships between all stakeholders in a way that makes it easier for employers to make equal opportunities a reality.



                                                        Friday, 11 February 2011 21:25

                                                        Rights and Duties: Workers' Perspective

                                                        Historically, people with disabilities have had tremendous barriers to entering the workforce, and those who became injured and disabled on the job have often faced job loss and its negative psychological, social and financial ramifications. Today, people with disabilities are still underrepresented in the workforce, even in countries with the most progressive civil rights and employment promotion legislation, and in spite of international efforts to address their situation.

                                                        Awareness has increased of the rights and needs of workers with disabilities and the concept of managing disability in the workplace. Workers’ compensation and social insurance programmes that protect income are common in industrialized countries. The increased costs related to operating such programmes have provided an economic basis for promoting the employment of people with disabilities and the rehabilitation of injured workers. At the same time, people with disabilities have become organized to demand their rights and integration into all aspects of community life, including the workforce.

                                                        Labour unions in many countries have been among those who have supported such efforts. Enlightened companies are recognizing the need to treat workers with disabilities equitably and are learning the importance of maintaining a healthy workplace. The concept of managing disability or dealing with disability issues in the workplace has emerged. Organized labour has been partly responsible for this emergence and continues to play an active role.

                                                        According to ILO Recommendation No. 168 concerning the vocational rehabilitation and employment of disabled persons, “workers’ organizations should adopt a policy for the promotion of training and suitable employment of disabled persons on an equal footing with other workers”. The recommendation further suggests that workers’ organizations become involved in formulating national policies, cooperate with rehabilitation specialists and organizations, and foster the integration and vocational rehabilitation of disabled workers.

                                                        The purpose of this article is to explore the issue of disability in the workplace from the perspective of the rights and duties of workers and to describe the specific role that labour unions play in facilitating the on-the-job integration of people with disabilities.

                                                        In a healthy work environment, both the employer and the worker care about the quality of work, health and safety, and the fair treatment of all workers. Workers are hired on the basis of their abilities. Both workers and employers contribute to maintaining health and safety and, when an injury or disability does occur, they have the rights and duties to minimize the impact of the disability on the individual and the workplace. Although workers and employers may have different perspectives, by working in partnership they can effectively achieve goals related to maintaining a healthy, safe and fair workplace.

                                                        The term rights is often associated with legal rights determined by legislation. Many European countries, Japan and others have enacted quota systems requiring that a certain percentage of employees be persons with disabilities. Fines may be levied on employers who fail to meet the prescribed quota. In the United States, the Americans with Disabilities Act (ADA) prohibits discrimination against people with disabilities in work and community life. Health and safety laws exist in most countries to protect workers from unsafe working conditions and practices. Workers’ compensation and social insurance programmes have been legislated to provide a variety of medical, social, and, in some instances, vocational rehabilitation services. Specific workers’ rights may also become part of negotiated labour agreements and therefore legally mandated.

                                                        A worker’s legal rights (and duties) related to disability and work will depend on the complexity of this legislative mix, which varies from country to country. For purposes of this article, workers’ rights are simply those legal or moral entitlements considered to be in the workers’ interest as they relate to productive activity in a safe and non-discriminating work environment. Duties refer to those obligations that workers have to themselves, other workers and their employers to contribute effectively to the productivity and safety of the workplace.

                                                        This article organizes worker rights and duties within the context of four key disability issues: (1) recruitment and hiring; (2) health, safety and the prevention of disability; (3) what happens when a worker becomes disabled, including rehabilitation and the return to work after injury; and (4) the total integration of the worker into the workplace and the community. Labour union activities related to these issues include: organizing and advocating for the rights of workers with disabilities through national legislation and other vehicles; ensuring and protecting rights by including them in negotiated labour agreements; educating union members and employers on disability issues and rights and responsibilities related to disability management; collaborating with management to further the rights and duties related to disability management; providing services to workers with disabilities to assist them in becoming integrated or more integrated into the workforce; and, when all else fails, engaging in resolving or litigating disputes, or fighting for legislative changes to protect rights.

                                                        Issue 1: Recruitment, Hiring and Employment Practices

                                                        While the legal obligations of labour unions may relate specifically to their members, unions traditionally helped to improve the working lives of all workers, including those with disabilities. This is a tradition that is as old as the labour movement itself. However, fair and equitable practices related to recruitment, hiring and employment practices take on special significance when the worker has a disability. Because of negative stereotypes as well as architectural, communication and other barriers related to disability, disabled job seekers and workers are often denied their rights or face discriminatory practices.

                                                        The following basic lists of rights (figure 1 to 4), although simply stated, have profound implications for equal access to employment opportunities by disabled workers. Disabled workers also have certain duties, as do all workers, to present themselves, including their interests, abilities, skills and workplace requirements, in an open and forthright manner.

                                                        Figure 1. Rights and duties: recruitment, hiring and employment practices


                                                        In the hiring process, applicants should be judged on their abilities and qualifications (figure 1). They need to have a full understanding of the job to evaluate their interest and ability to do the job. Further, once hired, all workers should be judged and evaluated according to their job performance, without bias based on factors not related to the job. They should have equal access to employment benefits and opportunities for advancement. When necessary, reasonable accommodations should be made so that an individual with a disability can perform the requisite job tasks. Job accommodations can be as                                                                                                                     simple as raising a workstation, making a chair available or                                                                                                                             adding a foot pedal.

                                                        In the United States, the Americans with Disabilities Act not only prohibits discrimination against qualified workers (a qualified worker is one who has the qualifications and abilities to perform the essential functions of the job) based on disability, but also requires that employers make reasonable accommodation—that is, the employer provides a piece of equipment, changes non-essential job functions or makes some other adjustment that does not cause the employer undue hardship, so that the person with a disability can perform the essential functions of the job. This approach is designed to protect workers’ rights and make it “safe” to request accommodations. According to the US experience, most accommodations are relatively low in cost (less than US$50).

                                                        Rights and duties go hand in hand. Workers have a responsibility to notify their employer of a condition that may affect their ability to do the job, or that may affect their safety or that of others. Workers have a duty to represent themselves and their abilities in an honest manner. They should request a reasonable accommodation, if necessary, and accept that which is most appropriate for the situation, cost-effective and least intrusive to the workplace while still meeting their needs.

                                                        ILO Convention No. 159 concerning the vocational rehabilitation and employment of disabled persons, and Recommendation No. 168 address these very rights and duties and their implications for workers’ organizations. Convention No.159 suggests that special positive measures may sometimes be necessary to ensure “effective equality of opportunity and treatment between disabled workers and other workers”. It adds that such measures “shall not be regarded as discriminating against other workers”. Recommendation No. 168 encourages the implementation of specific measures to create job opportunities, such as providing financial support to employers to make reasonable accommodations, and encourages labour organizations to promote such measures and provide advice about making such accommodations.

                                                        What labour unions can do

                                                        Union leaders typically have deep roots within the communities in which they operate and can be valuable allies in promoting the recruitment, hiring and continued employment of persons with disabilities. One of the first things they can do is to develop a policy statement on the employment rights of people with disabilities. Education of members and a plan of action to support the policy should follow. Labour unions can advocate rights for workers with disabilities on a broad scale by promoting, monitoring and supporting relevant legislative initiatives. In the workplace they should encourage management to develop policies and actions that remove barriers to employment for disabled workers. They can assist in developing appropriate job accommodations and, through negotiated labour agreements, protect and further the rights of disabled workers in all employment practices.

                                                        Organized labour can initiate programmes or cooperative efforts with employers, government ministries, non-governmental organizations, and companies to develop programmes that will result in increased recruitment and hiring of, and fair practices towards, people with disabilities. Representatives can sit on boards and lend their expertise to community-based organizations that work with people with disabilities. They can promote awareness among union members, and, in their role as employers, labour unions can set an example of fair and equitable hiring practices.

                                                        Examples of what labour unions are doing

                                                        In England, the Trades Union Congress (TUC) has taken an active role in promoting equal rights in employment for persons with disabilities, through published policy statements and active advocacy. It regards the employment of disabled people as an equal opportunities issue, and the experiences of disabled persons as not unlike those of other groups that have been discriminated against or excluded. The TUC supports existing quota legislation and advocates for levies (fines) on employers who fail to comply with the law.

                                                        It has published several related guides to support its activities and educate its members, including TUC Guidance: Trade Unions and Disabled Members, Employment of Disabled People, Disability Leave and Deaf People and Their Rights. Trade Unions and Disabled Members includes guidance about basic points that unions should consider when negotiating for disabled members. The Irish Congress of Trade Unions has produced a guide with similar intent, Disability and Discrimination in the Workplace: Guidelines for Negotiators. It provides practical steps to tackle workplace discrimination and to promote equality and access through negotiated labour agreements.

                                                        The Federation of German Trade Unions also has developed a comprehensive position paper stating its policy for integrative employment, its stance against discrimination and its commitment to use its influence to further its positions. It supports broad employment training and access to apprenticeships for disabled persons, addresses the double discrimination faced by disabled women, and advocates for union activities that support access to public transportation and integration into all aspects of society.

                                                        The Screen Actors Guild in the United States has approximately 500 members with disabilities. A statement on non-discrimination and affirmative action appears in its collective bargaining agreements. In a cooperative venture with the American Federation of Television and Radio Artists, the Guild has met with national advocacy groups to develop strategies to increase the representation of people with disabilities in their respective industries. The International Union of United Automobile, Aerospace and Agricultural Implement Workers of America is another labour union that includes language in its collective bargaining agreements prohibiting discrimination based on disability. It also fights for reasonable accommodations for its members and provides regular training on disability and work issues. The United Steel Workers of America has included for years non-discrimination clauses in its collective bargaining agreements, and resolves disability discrimination complaints through a grievance process and other procedures.

                                                        In the United States, the passage and implementation of the Americans with Disabilities Act (ADA) was, and continues to be, promoted by US-based labour unions. Even before passage of the ADA, many AFL-CIO member unions were actively involved in training their memberships on disability rights and awareness (AFL-CIO 1994). The AFL-CIO and other labour union representatives are carefully monitoring the implementation of the law, including litigation and alternative dispute resolution processes, to support the rights of workers with disabilities under the ADA and to ensure that their interests and the rights of all workers are fairly considered.

                                                        With passage of the ADA, labour unions have produced scores of publications and videos and organized training programmes and workshops to further educate their members. The Civil Rights Department of the AFL-CIO produced brochures and held workshops for their affiliated unions. The International Association of Machinists and Aerospace Workers Center for Administering Rehabilitation and Education Services (IAM CARES), with support from the federal government, produced two videos and ten booklets for employers, people with disabilities and union personnel to inform them of their rights and responsibilities under the ADA. The American Federation of State, County and Municipal Employees (AFSCME) has a long-standing history of protecting the rights of workers with disabilities. With passage of the ADA, AFSCME updated its publications and other efforts and trained thousands of members and AFSCME staff on the ADA and workers with disabilities.

                                                        Although Japan has a quota and levy system in place, one Japanese labour union recognized that individuals who are mentally disabled are the most likely to be underrepresented in the labour force, especially among larger employers. It has been taking action. The Kanagawa Regional Council of the Japanese Electrical, Electronic and Information Union is working with the city of Yokohama to develop an employment support center. Its purpose will include training individuals who are mentally disabled and providing services to facilitate their placement and that of other disabled persons. Further, the union plans to establish a training centre that will provide disability awareness and sign-language training to union members, personnel managers, production supervisors and others. It will capitalize on good labour-employer relationships and engage business people in the management and activities of the centre. Initiated by the labour union, the project promises to be a model of collaboration between business, labour and government.

                                                        In the United States and Canada, labour unions have been working cooperatively and creatively with government and employers to facilitate the employment of people with disabilities through a programme called Projects with Industry (PWI). By matching labour union resources with government funding, IAM CARES and the Human Resources Development Institute (HRDI) of the AFL-CIO have been operating training and job placement programmes for individuals with disabilities regardless of their union affiliation. In 1968, HRDI began to function as the AFL-CIO’s employment and training arm by providing assistance to diverse ethnic groups, women and people with disabilities. In 1972, it began a programme with a specific focus on people with disabilities, to place them with employers who had labour agreements with national and international labour unions. As of 1995, more than 5,000 people with disabilities have been employed as a result of this activity. Since 1981, the IAM CARES programme, which operates in the Canadian and US labour markets, has enabled more than 14,000 individuals, most of whom are severely disabled, to find jobs. Both programmes provide professional assessment, counselling and job placement assistance through linkages with businesses and with government and labour union support.

                                                        In addition to providing direct services to workers with disabilities, these PWI programmes engage in activities that enhance public awareness of people with disabilities, promote cooperative labour-management action to foster employment and job retention, and provide training and consulting services to local unions and employers.

                                                        These are only some examples from around the world of activities that labour unions have taken to facilitate fairness in employment for workers with disabilities. It is fully in line with their broad goal to facilitate worker solidarity and to end all forms of discrimination.

                                                        Issue 2: Disability Prevention, Health and Safety

                                                        While securing safe working conditions is a hallmark of labour union activity in many countries, maintaining health and safety in the workplace has traditionally been an employer function. Typically, management has control over job design, tool selection, and decisions about processes and the work environment that affect safety and prevention. Yet, only someone who performs the tasks and procedures on a regular basis, under specific work conditions and demands, can fully appreciate the implications of procedures, conditions and hazards on safety and productivity.

                                                        Fortunately, enlightened employers recognize the importance of worker feedback, and as the organizational structure of the workplace is changing to increase worker autonomy, such feedback is more readily invited. Safety and prevention research also supports the need to involve the worker in job design, policy formulation and the implementation of programmes on health, safety and disability prevention.

                                                        Another trend, the sharp increase in workers’ compensation and other costs of job-related injury and disability, has led employers to examine prevention as a key component of the disability management effort. Prevention programmes should focus on the full range of stressors, including those of a psychological, sensory, chemical or physical nature, as well as on trauma, accidents and exposure to obvious hazards. Disability can result from repeated exposure to mild stressors or agents, rather than from a single incident. For example, some agents can cause or activate asthma; repeated or loud noises can lead to hearing loss; production pressure, such as piece-rate demands, can cause symptoms of psychological stress; and repetitive motions can lead to cumulative stress disorders (e.g., carpal tunnel syndrome). Exposure to such stressors can exacerbate disabilities that already exist and make them more debilitating.

                                                        From a worker’s perspective, the benefits of prevention can never be overshadowed by compensation. Figure 2 lists some of the rights and responsibilities that workers have in relation to disability prevention in the workplace.

                                                        Figure 2. Rights and duties - health and safety


                                                        Workers have a right to the safest work environment possible and to the complete disclosure about risks and working conditions. Such knowledge is especially important to workers with disabilities who may need knowledge of certain conditions to determine whether they can perform the job functions without jeopardizing their health and safety or that of others.

                                                        Many jobs involve risks or dangers that cannot be fully removed. For example, construction jobs or those that deal with exposure to toxic substances have obvious, inherent risks. Other jobs, like data entry or sewing machine operation, seem relatively safe; however, repetitive motions or improper body mechanics can lead to disabilities. These risks can also be reduced.

                                                        All workers should be provided with necessary safety equipment and information on practices and procedures that reduce risk of injury or illness due to exposure to hazardous conditions, repetitive motions or other stressors. Workers must feel free to report/complain about safety practices, or to make suggestions to improve working conditions, without fear of losing their jobs. Workers should be encouraged to report an illness or disability, especially one that is caused or could be exacerbated by the work task or environment.

                                                        With regard to duties, workers have a responsibility to practice safety procedures that reduce risks to themselves and others. They must report unsafe conditions, advocate for health and safety issues, and be responsible regarding their health. For example, if a disability or illness places a worker or others at risk, the worker should remove him- or herself from the situation.

                                                        The field of ergonomics is emerging, with effective approaches to reducing disabilities incurred as a result of the manner in which the work is organized or performed. Ergonomics is basically the study of work. It involves fitting the job or task to the worker rather than vice versa (AFL-CIO 1992). Ergonomic applications have been used successfully to prevent disability in fields as diverse as agriculture and computers. Some ergonomic applications include flexible workstations that can be adapted to an individual’s height or other physical characteristics (e.g., adjustable office chairs), tools with handles to fit hand differences and simple changes in work routines to reduce repetitive motions or stress to certain parts of the body.

                                                        Increasingly, labour unions and employers recognize the need to extend health and safety programmes beyond the workplace. Even when disability or illness is not work-related, employers incur the costs of absenteeism, health insurance and perhaps rehiring and retraining. Further, some illnesses, such as alcoholism, drug addiction and psychological problems, can result in decreased worker productivity or increased vulnerability to on-the-job accidents and stress. For these and other reasons, many enlightened employers are engaging in education about health, safety and disability prevention on and off the job. Wellness programmes that address issues such as stress reduction, good nutrition, smoking cessation and AIDS prevention are being provided in the workplace by unions, management and through joint partnership efforts that may include the government as well.

                                                        Some employers provide wellness and employee assistance (counselling and referral) programmes to address these concerns. All of these prevention and health programmes are in the worker’s and employer’s best interests. For example, figures typically show savings-to-investment ratios between 3:1 and 15:1 for some health promotion and employee assistance programmes.

                                                        What can labour unions do?

                                                        Labour unions are in a unique position to use their leverage as representatives of workers to facilitate health, safety, disability prevention or ergonomics programmes in the workplace. Most prevention and ergonomics experts agree that worker participation and involvement in prevention policies and prescriptions increases the likelihood of their implementation and effectiveness (LaBar 1995; Westlander et al. 1995; AFL-CIO 1992). Labour unions can play a key role in establishing labour-management health and safety councils and ergonomics committees. They can lobby to promote legislation on workplace safety and work with management to establish joint safety committees, which can result in a substantial reduction in job-related accidents (Fletcher et al. 1992).

                                                        Labour unions need to educate their members about their rights, regulations and safe practices related to workplace safety and disability prevention on and off the job. Such programmes can become part of the negotiated labour agreement or union-based health and safety committees.

                                                        Further, in policy statements and labour agreements and through other mechanisms, labour unions can negotiate disability prevention measures and special conditions for those with disabilities. When a worker becomes disabled, especially if the disability is work-related, the union should support that worker’s right to accommodations, tools or reassignment to prevent exposure to stress or hazardous conditions that can increase the limitation. For example, those with occupationally induced hearing loss must be prevented from continued exposure to certain types of noise.

                                                        Examples of what labour unions are doing

                                                        The policy statement of the Federation of German Trade Unions concerning employees with disabilities specifically identifies the need to avoid health risks for workers with disabilities and to take measures to prevent them from incurring additional injury.

                                                        Under a negotiated labour agreement between the Boeing Aircraft Corporation and the International Association of Machinists and Aerospace Workers (IAMAW), the IAM/Boeing Health and Safety Institute authorizes funding, develops pilot programmes and makes recommendations for improvements related to worker health and safety issues, and manages the return to work of industrially impaired workers. The Institute was established in 1989 and funded by a four cent per hour health and safety trust fund. It is operated by a Board of Directors that is composed of 50% management and 50% union representation.

                                                        The Disabled Forestry Workers Foundation of Canada is another example of a joint labour-management project. It evolved from a group of 26 employers, unions and other organizations that collaborated to produce a video (Every Twelve Seconds) to draw attention to the high accident rate among forestry workers in Canada. Now the Foundation focuses on health, safety, accident prevention and workplace models for reintegrating injured workers.

                                                        IAM CARES is engaged in an active programme of educating its members on safety issues, particularly in high-risk and hazardous jobs in the chemical industries, the construction trades and the steel industry. It conducts training for shop stewards and line workers, and encourages the formation of safety and health committees that are union-operated and independent of management.

                                                        The George Meany Center of the AFL-CIO, with a grant from the US Department of Labor, is developing educational materials on substance abuse to help union members and their families deal with alcohol and drug addictions.

                                                        The Association of Flight Attendants (AFA) has done some remarkable work in the area of AIDS and AIDS prevention. Volunteer members have developed the AIDS, Critical and Terminal Illness Awareness Project, which is educating members on AIDS and other life-threatening illnesses. Thirty-three of its locals have educated a total of 10,000 members about AIDS. It has established a foundation to administer funds to members who are also coping with a life-threatening disease.

                                                        Issue 3: When a Worker Becomes Disabled—Support, Rehabilitation, Compensation

                                                        In many countries, labour unions have fought for workers’ compensation, disability and other benefits related to on-the-job injury. Since one purpose of disability management programmes is to decrease the costs related to these benefits, it may be assumed that labour unions are not in favour of such programmes. In fact, this is not the case. Labour unions support rights related to job protection, early intervention in the provision of rehabilitation services and aspects of sound disability management practice. Disability management programmes that focus on reducing the worker’s suffering, address concerns about work loss, including its financial implications, and try to prevent short- and long-term disability are welcomed. Such programmes should return the worker to his or her job, if feasible, and provide accommodations when necessary. When it is not feasible, alternatives such as reassignment and retraining should be provided. As a last resort, long-term compensation and wage replacement should be guaranteed.

                                                        Fortunately, data suggest that disability management programmes can be structured to meet the needs and rights of the workers and still be cost effective for employers. As workers’ compensation costs have skyrocketed in industrialized countries, effective models that incorporate rehabilitation services have been developed and are being evaluated. Unions have a definitive role to play in developing such programmes. They need to promote and protect the rights listed in Figure 3 and educate workers about their duties.

                                                        Figure 3. Rights and duties: support, rehabilitation and compensation.


                                                        Most of the workers’ rights listed are part of standard return-to-work services for injured workers according to state-of-the-art rehabilitation techniques (Perlman and Hanson 1993). Workers have a right to prompt medical attention and to the assurance that their wages and jobs will be protected. Swift attention and early intervention are found to reduce the time away from work. Withholding benefits can result in refocusing efforts away from rehabilitation and returning to work, and into litigation and animosity towards the employer and the system. Workers need to understand what will happen if they become injured or disabled, and should have a clear understanding of company policy and legal protections. Unfortunately, some systems related to prevention, workers’ compensation and rehabilitation have been fragmented, open to abuse and confusing for those who depend on these systems at a vulnerable time.

                                                        Most trade unionists would agree that workers who become disabled gain little if they lose their jobs and their ability to work. Rehabilitation is a desired response to injury or disability and should include early intervention, comprehensive assessment and individualized planning with worker involvement and choice. Return-to-work plans may include returning to work gradually, with accommodation, at reduced hours or in reassigned positions until the worker is ready to return to optimal functioning.

                                                        Such accommodations, however, can interfere with the protected rights of workers in general, including those related to seniority. While trade unionists support and protect the rights of disabled workers to return to work, they seek solutions that do not interfere with negotiated seniority clauses or require restructuring of jobs in such a way that other workers are expected to assume new tasks or responsibilities for which they are not responsible or compensated. Collaboration and union involvement are necessary to resolve these issues when they arise, and such circumstances further illustrate the need for labour union involvement in the design and implementation of legislation, disability management and rehabilitation policies and programmes.

                                                        What labour unions can do

                                                        Labour unions need to be involved in national legislative planning committees related to disability, and in task forces which deal with such issues. Within corporate structures and the workplace, labour unions should help organize joint labour-management committees engaged in developing company-level disability management programmes, and should monitor individual outcomes. Unions can assist with return to work by suggesting accommodations, engaging the assistance of co-workers, and providing assurance to the injured worker.

                                                        Labour unions can work cooperatively with employers to develop model disability management programmes that assist workers and meet cost-containment goals. They can engage in research of worker needs, best practices and other activities to determine and protect worker interests. Worker education rights and responsibilities and needed actions are also critical to ensuring the best responses to injury and disability.

                                                        Examples of what labour unions have done

                                                        Some unions have been active in helping governments address the inadequacies of their systems related to on-the-job injuries and workers’ compensation. In 1988, responding to cost concerns related to injury compensation and to labour union concern over a lack of effective rehabilitation programmes, Australia passed the Commonwealth Employees Rehabilitation and Compensation Act, which provided a new coordination system for managing and preventing workplace illness and injuries of federal workers. The revised system is based on the premise that effective rehabilitation and return to work, if possible, is the most beneficial outcome for the worker and the employer. It incorporates prevention, rehabilitation and compensation into the system. Benefits and jobs are protected while the individual undergoes rehabilitation. Compensation includes wage replacement, medical and related expenses, and in certain instances limited lump sum payments. When individuals are unable to return to work they are adequately remunerated. Early results are demonstrating an 87% return-to-work rate. Success is attributed to many factors, including the collaborative involvement of all stakeholders, including labour unions, in the process.

                                                        The IAM/Boeing Health and Safety Institute, already mentioned, provides an example of a labour-management programme that was developed in one corporate setting. The model return-to-work programme was one of the first initiatives taken by the Institute because the needs of industrially injured workers were being neglected by fragmented service-delivery systems administered by federal, state, local and private rehabilitation agencies and programmes. After analysing data and conducting interviews, the union and the corporation set up a model programme that is felt to be in the best interests of both. The programme involves many of the rights already listed: early intervention; quick response with services and compensation requirements; intensive case management focused on return to work with accommodation, if needed; and regular evaluation of the programme’s outcomes and workers’ satisfaction.

                                                        Current satisfaction surveys indicate that management and injured workers have found the joint labour-management Return-to-Work Programme an improvement over existing services. The previous programme has been replicated at four additional Boeing plants and the joint programme is expected to become standard practice throughout the company. To date, more than 100,000 injured workers have received rehabilitation services through the programme.

                                                        The AFL-CIO’s HRDI programme also offers return-to-work rehabilitation services for workers injured on the job at companies with affiliated union representation. In partnership with Columbia University’s Workplace Center, it administered a demonstration programme called the Early Intervention Program, which sought to determine if early intervention can speed the process of getting workers, who are out of work because of short-term disability, back to the job. The programme returned 65% of participants to work and isolated several factors critical to success. Two findings are of particular significance to this discussion: (1)workers almost universally experience distress related to financial concerns; and (2) the programme’s union affiliation reduced suspicion and hostility.

                                                        The Disabled Forestry Workers Foundation of Canada developed a programme it calls the Case Management Model for Workplace Integration. Also using the joint union-management initiative, the programme rehabilitates and reintegrates disabled workers. It has published Industrial Disability Management: An Effective Economic and Human Resource Strategy to assist in the implementation of the model, built on partnership between employers, unions, government and consumers. Further, it has developed the National Institute of Occupational Disability and Research, involving labour, management, educators and rehabilitation professionals. The Institute is developing training programmes for human resource and union representatives that will lead to further implementation of its model.

                                                        Issue 4: Inclusion and Integration in the Community and the Workplace

                                                        In order for people with disabilities to become fully integrated in the workplace, they must first have equal access to all community resources that predispose and assist people to work (education and training opportunities, social services, etc.) and that give them access to the work environment (accessible housing, transportation, information, etc.). Many labour unions have recognized that people with disabilities are not able to participate in the workplace if they are excluded from full participation in community life. Further, once employed, people with disabilities may need special services and accommodations to be fully integrated or to maintain job performance. Equality in community life is a precursor to employment equity, and to fully address the issue of disability and work, the broader issue of human or civil rights must be considered.

                                                        Labour unions have also recognized that to ensure employment equity, sometimes special services or accommodations may be required for job maintenance, and in the spirit of solidarity, may provide such services to their members or promote the provision of such accommodations and services. Figure 4 lists the rights and duties that recognize the need for full access to community life.

                                                        Figure 4. Rights and duties: inclusion and integration in the community and the workplace.


                                                        What unions can do

                                                        Labour unions can be direct agents of change in their communities by encouraging the total integration of people with disabilities in the workplace and community. Labour unions can reach out to workers with disabilities and the organizations that represent them, and collaborate to take positive action. The opportunities to exert political leverage and affect legislative change have been noted throughout this article, and they are fully in keeping with ILO Recommendation No. 168 and ILO Convention No. 159. Both stress the role of employers’ and workers’ organizations in the formulation of policies related to vocational rehabilitation, and their involvement in the implementation of policy and services.

                                                        Labour unions have a responsibility to represent the needs of all their workers. They should provide model services, programmes and representation within the labour union structure to include, accommodate and engage members with disabilities in all aspects of the organization. As some of the following examples will demonstrate, labour unions have used their members as a resource for raising funds, to serve as volunteers or to engage in direct services on the job and in the community to ensure that people with disabilities are fully included in community life and the workplace.

                                                        What unions have done

                                                        In Germany, a type of advocacy is legally mandated. According to the Severely Disabled Persons Act, any enterprise, including labour unions, that has five or more permanent employees, must have a person who is elected to the staff council as a representative of disabled employees. This representative ensures that the rights and concerns of disabled employees are addressed. Management is required to consult this representative in matters related to general recruitment as well as policy. As a result of this law, labour unions have become actively involved in disability issues.

                                                        The Irish Congress of Trade Unions (ICTU) has published and disseminated a Charter of Rights of People with Disabilities (1990), which is a list of 18 fundamental rights considered essential to the full equality of people with disabilities in the workplace and the community at large. It includes the rights to a barrier-free environment, housing, quality health care, education, training, employment and accessible transportation.

                                                        In 1946, the IAMAW began to help people with disabilities by establishing the International Guiding Eyes. This programme provides guide dogs and training in how to use them to blind and visually impaired individuals so that they can lead more independent and satisfying lives. Approximately 3,000 individuals from many countries have been helped. Part of the costs to operate the programme are borne by the contributions of union members.

                                                        The work of one Japanese labour union has been previously described. Its work was a natural evolution from the work of the Assembly of Trade Unions begun in the 1970s when a union member who had an autistic child requested labour union support to focus on the needs of children with disabilities. The Assembly established a foundation that was supported by the sale of matches and, later, boxes of tissues, by union members. The foundation started a counselling service and a telephone hotline to help parents cope with the challenges of raising a disabled child in a segregated society. As a result, parents became organized and lobbied the government to address accessibility (railways were pressured to improve accessibility, a process that continues today) and to provide educational training and upgrade other services. Summer activities and festivals were sponsored, as well as national and international tours, to foster understanding of disability issues.

                                                        After twenty years, when the children grew up, their needs for recreation and education became needs for vocational skills and employment. A vocational experience programme for youth with disabilities was developed and has been in effect for several years. The unions requested companies to provide work experiences for second-year high school students with disabilities. It was out of this programme that the need for the Employment Support Center, noted under Issue 1, became apparent.

                                                        Many unions provide extra support services to people with disabilities on the job to assist them in maintaining employment. The Japanese labour unions use on-the-job volunteers to support young people in work-experience programmes with companies that have union representation. IAM CARES in the United States and Canada uses a buddy system to match new employees who have disabilities with a union member who serves as a mentor. IAM CARES also has sponsored supported employment programmes with Boeing and other companies. Supported employment programmes provide job coaches to assist those with the most severe disabilities in learning their jobs and maintaining their performance at productive levels.

                                                        Some labour unions have established subcommittees or task forces composed of disabled workers, to ensure that the rights and needs of disabled members are fully represented within the union structure. The American Postal Workers Union is an excellent example of such a task force and the wide implications it can have. In the 1970s, the first deaf shop steward was appointed. Since 1985, several conferences have been held just for hearing-impaired members. These members also serve on negotiating teams to resolve job accommodation and disability management issues. In 1990, the task force worked with the postal service to develop an official stamp depicting the words “I love you” in a hand sign.


                                                        Unions, at their most basic level, are about people and their needs. Since the earliest days of labour union activity, unions have done more than fight for fair wages and optimal working conditions. They have sought to improve the quality of life and to maximize opportunities for all workers, including those with disabilities. Although the union perspective emanates from the workplace, the union influence is not limited to enterprises where negotiated labour agreements exist. As many examples in this article demonstrate, labour unions can also affect the larger social environment through a variety of activities and initiatives that are aimed at eliminating discrimination and inequities towards people with disabilities.

                                                        While unions, employers, government entities, vocational rehabilitation representatives and men and women with disabilities may have different perspectives, they should share the desire for a healthy and productive workplace. Unions are in a unique position to bring these groups together on common ground, and thereby play a key role in improving the lives of people with disabilities.



                                                        Saturday, 22 October 2011 18:57

                                                        Case Study: Best Practices Examples

                                                        SABRE Employment (UK)

                                                        Mission Statement:

                                                        To communicate overall objectives/business goals which not only embrace the provision of quality service to applicants, but clearly reflect the desire to provide an efficient recruitment service to employers and which assist employers to improve their capacity to employ people with disabilities. Emphasis should be placed on the primary aim to achieve customer satisfaction. “All of Sabre’s activities begin with our customers. Our goals are to provide recruitment solutions through effective job matching, reliable training and support and to offer expertise in the recruitment and employment of people with disabilities.”

                                                        A job fair was recently held to give people a chance to meet employers and learn about different jobs. McDonald’s Restaurants Ltd. ran a workshop on interview skills and also sponsored the job fair event along with Shell and Pizza Hut. There were employer displays which provided an opportunity for employers and prospective employees with learning difficulties to meet in an informal way.

                                                        The Coverdale Bursary Programme (UK)

                                                        For five years, Coverdale, a small (70 people) management consultancy has offered bursaries to the value of £10,000 per person to disabled individuals seeking high quality management training. These individuals then go into companies like Barclays Bank, the Post Office and Midland Bank for additional training, in a process which promotes long-term attitude change across participating companies. This programme is now being expanded. It has been adapted by The Canadian Council for Rehabilitation and Work.

                                                        Brook Street and FYD (UK)

                                                        A commercial recruitment agency, Brook Street, and a charity for young deaf people, Friends for the Young Deaf (FYD), have worked in partnership for some years. Brook Street offers work experience and assessment to the young deaf graduates completing the FYD leadership training programme; Brook Street then places appropriate candidates into jobs, charging the same commercial fee they would charge for any candidate.

                                                        Employers’ Forum on Disability (UK)

                                                        Companies involved in the Employers’ Forum on Disability, an employer-funded association that promotes the integration of disabled persons in the labour market and provides advisory services for interested enterprises, helped disabled entrepreneur Stephen Duckworth to establish his business, Disability Matters, which now offers high quality consultancy and awareness-raising on disability to companies across the UK. Its philosophy encompasses the following:

                                                        • to understand and define the business case for employing disabled people
                                                        • an authoritative employers’ voice on disability
                                                        • employment- and training-related services which are more market led
                                                        • to develop new ways to attract qualified disabled applicants and to retain disabled employees
                                                        • The key to influencing employers and mobilizing their involvement is to network in a way that:
                                                        • promotes the business case through business-to-business communication
                                                        • promotes personal contact between employers and disabled individuals
                                                        • promotes employer ownership of the issue and an awareness on the part of rehabilitation providers that the employer should be valued as stakeholder, customer and potential partner
                                                        • positions disability as part of the wider debate regarding economic and social regeneration, long-term unemployment, poverty and micro and macroeconomic policies


                                                        Other examples in the UK: The Employer Forum on Disabilities

                                                        Leading UK companies drafted a highly influential policy framework called the “Employers Agenda on Disability, a Ten Point Plan”. This was launched by the Prime Minister and is now publicly supported by more than 100 major firms. It has proven a powerful force for change because it was drafted by the employers themselves in consultation with disability experts. It is now a key tool in helping employers to comply with discrimination legislation.

                                                        Supporters of the Agenda are publicly committed to structuring their corporate policy on disability using a 10-point framework addressing the following issues: Equal Opportunities Policy and Procedures Statement; Staff Training and Disability Awareness; The Working Environment; Recruitment; Career Development; Retention, Retraining and Redeployment; Training and Work Experience; People with Disabilities in the Wider Community; Involvement of Disabled People; Monitoring Performance.

                                                        The Action File on Disability, a unique manual which provides practical information on how to implement the Agenda, has been produced by the Employers’ Forum on Disability.

                                                        Graduate Recruitment:

                                                        More than 20 companies are involved in a consortium working with “Workable”, which brokers work-experience opportunities to disabled students in a planned and structured manner.

                                                        Twenty-five companies jointly fund an initiative making annual Career Fairs for students accessible for disabled students. The Career Fairs are now wheelchair accessible, and interpreters for the deaf are available, as well as large-print brochures and other support. Employers had experienced such difficulty attracting disabled graduates to apply for jobs using traditional intermediaries that they are now pioneering recruitment methods which speak directly to the disabled students.

                                                        HIRED (US)

                                                        The project HIRED in San Francisco embodies this new employer orientation. The acronym stands for Helping Industry Recruit Employees with Disabilities. Their literature highlights the services they offer employers:

                                                        “Project HIRED is a private, not for profit organization serving the San Francisco Bay area. Our purpose is to assist individuals with disabilities to secure jobs appropriate to their qualifications and career goals. Our services to employers include:

                                                        • free referrals, pre-screened, qualified candidates matched to a company’s job openings
                                                        • quality temporary employment services at competitive rates
                                                        • customized, on site seminars on the technical, legal and interpersonal aspects of disability in the workplace, and
                                                        • consultation on all topics related to disabilities in the workplace.


                                                        In addition to less formal corporate partnerships, Project HIRED has a corporate membership programme involving approximately 50 Bay Area companies. As corporate members, these companies are entitled to free consulting and a discount on seminars. We are currently exploring additional services, such as library of video resources, to further assist corporate members successfully incorporate people with disabilities in their workforce.”

                                                        ASPHI (Italy)

                                                        The origins of ASPHI (Associazione per lo Sviluppo di Progetti Informatici per gli Handicappati) go back to the late 1970s when IBM Italy organized courses in computer programming for the visually impaired. A number of companies which had subsequently employed the trainees, together with specialist partner agencies from the non-profit sector, created ASPHI for the physically disabled and the hearing and mentally impaired. The Association involves more than 40 companies which provide financial support, staff and volunteer helpers, advice as well as employment opportunities for ASPHI’s graduates. ASPHI’s objective is to harness information technologies for the social and vocational integration of disadvantaged groups. Its activities include: job training, research and development of new products (mainly software) which facilitate alternative methods of communication, personal autonomy and rehabilitation, and community education, thus breaking down prejudices and discrimination against disabled people. Each year, some 60 young people are qualified by ASPHI. With about 85% of its graduates finding a permanent job, ASPHI’s success has brought it national and international recognition.

                                                        Swedish Employers’ Federation Initiative

                                                        The Swedish Employers’ Federation Initiative, “Persons with Disabilities in Companies”, positions disability firmly in the labour market debate in the country and conveys the message that disability is an issue of importance to the Swedish Employers Confederation and its members. The Federation states: “The path to employment for persons with disabilities must be made smoother. Requirements for this include:

                                                        • clear signals to employers concerning responsibility and costs
                                                        • financial compensation for extra costs, if any, incurred by employers who appoint persons with disabilities
                                                        • more knowledge of disabilities and the scope of persons with disabilities for changing attitudes and values
                                                        • improved cooperation between companies, authorities and individuals to create a dynamic and flexible labour market.”



                                                        Friday, 21 January 2011 20:29

                                                        Introduction and Overview

                                                        A 1981 study of worker safety and health training in the industrial nations begins by quoting the French writer Victor Hugo: “No cause can succeed without first making education its ally” (Heath 1981). This observation surely still applies to occupational safety and health in the late twentieth century, and is relevant to organization personnel at all levels.

                                                        As the workplace becomes increasingly complex, new demands have arisen for greater understanding of the causes and means of prevention of accidents, injuries and illnesses. Government officials, academics, management and labour all have important roles to play in conducting the research that furthers this understanding. The critical next step is the effective transmission of this information to workers, supervisors, managers, government inspectors and safety and health professionals. Although education for occupational physicians and hygienists differs in many respects from the training of workers on the shop floor, there are also common principles that apply to all.

                                                        National education and training policies and practices will of course vary according to the economic, political, social, cultural and technological background of the country. In general, industrially advanced nations have proportionally more specialized occupational safety and health practitioners at their disposal than do the developing nations, and more sophisticated education and training programmes are available to these trained workers. More rural and less industrialized nations tend to rely more on “primary health care workers”, who may be worker representatives in factories or fields or health personnel in district health centres. Clearly, training needs and available resources will vary greatly in these situations. However, they all have in common the need for trained practitioners.

                                                        This article provides an overview of the most significant issues concerning education and training, including target audiences and their needs, the format and content of effective training and important current trends in the field.

                                                        Target Audiences

                                                        In 1981, the Joint ILO/WHO Committee on Occupational Health identified the three levels of education required in occupational health, safety and ergonomics as (1) awareness, (2) training for specific needs and (3) specialization. These components are not separate, but rather are part of a continuum; any person may require information on all three levels. The main target groups for basic awareness are legislators, policy makers, managers and workers. Within these categories, many people require additional training in more specific tasks. For example, while all managers should have a basic understanding of the safety and health problems within their areas of responsibility and should know where to go for expert assistance, managers with specific responsibility for safety and health and compliance with regulations may need more intensive training. Similarly, workers who serve as safety delegates or members of safety and health committees need more than awareness training alone, as do government administrators involved in factory inspection and public health functions related to the workplace.

                                                        Those doctors, nurses and (especially in rural and developing areas) nonphysician primary health care workers whose primary training or practice does not include occupational medicine will need occupational health education in some depth in order to serve workers, for example by being able to recognize work-related illnesses. Finally, certain professions (for example, engineers, chemists, architects and designers) whose work has considerable impact on workers’ safety and health need much more specific education and training in these areas than they traditionally receive.

                                                        Specialists require the most intensive education and training, most often of the kind received in undergraduate and postgraduate programmes of study. Physicians, nurses, occupational hygienists, safety engineers and, more recently, ergonomists come under this category. With the rapid ongoing developments in all of these fields, continuing education and on-the-job experience are important components of the education of these professionals.

                                                        It is important to emphasize that increasing specialization in the fields of occupational hygiene and safety has taken place without a commensurate emphasis on the interdisciplinary aspects of these endeavours. A nurse or physician who suspects that a patient’s disease is work-related may well need the assistance of an occupational hygienist to identify the toxic exposure (for example) in the workplace that is causing the health problem. Given limited resources, many companies and governments often employ a safety specialist but not a hygienist, requiring that the safety specialist address health as well as safety concerns. The interdependence of safety and health issues should be addressed by offering interdisciplinary training and education to safety and health professionals.

                                                        Why Training and Education?

                                                        The primary tools needed to achieve the goals of reducing occupational injuries and illnesses and promoting occupational safety and health have been characterized as the “three E’s”—engineering, enforcement and education. The three are interdependent and receive varying levels of emphasis within different national systems. The overall rationale for training and education is to improve awareness of safety and health hazards, to expand knowledge of the causes of occupational illness and injury and to promote the implementation of effective preventive measures. The specific purpose and impetus for training will, however, vary for different target audiences.

                                                        Middle and upper level managers

                                                        The need for managers who are knowledgeable about the safety and health aspects of the operations for which they are responsible is more widely acknowledged today than heretofore. Employers increasingly recognize the considerable direct and indirect costs of serious accidents and the civil, and in some jurisdictions, criminal liability to which companies and individuals may be exposed. Although belief in the “careless worker” explanation for accidents and injuries remains prevalent, there is increasing recognition that “careless management” can be cited for conditions under its control that contribute to accidents and disease. Finally, firms also realize that poor safety performance is poor public relations; major disasters like the one in the Union Carbide plant in Bhopal (India) can offset years of effort to build a good name for a company.

                                                        Most managers are trained in economics, business or engineering and receive little or no instruction during their formal education in occupational health or safety matters. Yet daily management decisions have a critical impact on employee safety and health, both directly and indirectly. To remedy this state of affairs, safety and health concerns have begun to be introduced into management and engineering curricula and into continuing education programmes in many countries. Further efforts to make safety and health information more widespread is clearly necessary.

                                                        First-line supervisors

                                                        Research has demonstrated the central role played by first-line supervisors in the accident experience of construction employers (Samelson 1977). Supervisors who are knowledgeable about the safety and health hazards of their operations, who effectively train their crew members (especially new employees) and who are held accountable for their crew’s performance hold the key to improving conditions. They are the critical link between workers and the firm’s safety and health policies.


                                                        Law, custom and current workplace trends all contribute to the spread of employee education and training. Increasingly, employee safety and health training is being required by government regulations. Some apply to general practice, while in others the training requirements are related to specific industries, occupations or hazards. Although valid evaluation data on the effectiveness of such training as a countermeasure to work-related injuries and illnesses are surprisingly sparse (Vojtecky and Berkanovic 1984-85); nevertheless the acceptance of training and education for improving safety and health performance in many areas of work is becoming widespread in many countries and companies.

                                                        The growth of employee participation programmes, self-directed work teams and shop floor responsibility for decision-making has affected the way in which safety and health approaches are taken as well. Education and training are widely used to enhance knowledge and skills at the level of the line worker, who is now recognized as essential for the effectiveness of these new trends in work organization. A beneficial action employers can take is to involve employees early on (for example, in the planning and design stages when new technologies are introduced into a worksite) to minimize and to anticipate adverse effects on the work environment.

                                                        Trade unions have been a moving force both in advocating more and better training for employees and in developing and delivering curricula and materials to their members. In many countries, safety committee members, safety delegates and works council representatives have assumed a growing role in the resolution of hazard problems at the worksite and in inspection and advocacy as well. Persons holding these positions all require training that is more complete and sophisticated than that given to an employee performing a particular job.

                                                        Safety and health professionals

                                                        The duties of safety and health personnel comprise a broad range of activities that differ widely from one country to another and even within a single profession. Included in this group are physicians, nurses, hygienists and safety engineers either engaged in independent practice or employed by individual worksites, large corporations, government health or labour inspectorates and academic institutions. The demand for trained professionals in the area of occupational safety and health has grown rapidly since the 1970s with the proliferation of government laws and regulations paralleling the growth of corporate safety and health departments and academic research in this field.

                                                        Scope and Objectives of Training and Education

                                                        This ILO Encyclopaedia itself presents the multitude of issues and hazards that must be addressed and the range of personnel required in a comprehensive safety and health programme. Taking the large view, we can consider the objectives of training and education for safety and health in a number of ways. In 1981, the Joint ILO/WHO Committee on Occupational Health offered the following categories of educational objectives which apply in some degree to all of the groups discussed thus far: (1) cognitive (knowledge), (2) psychomotor (professional skills) and (3) affective (attitude and values). Another framework describes the “information–education–training” continuum, roughly corresponding to the “what”, the “why” and the “how” of hazards and their control. And the “empowerment education” model, to be discussed below, puts great emphasis on the distinction between training—the teaching of competency-based skills with predictable behavioural outcomes—and education—the development of independent critical thinking and decision-making skills leading to effective group action (Wallerstein and Weinger 1992).

                                                        Workers need to understand and apply the safety procedures, proper tools and protective equipment for performing specific tasks as part of their job skills training. They also require training in how to rectify hazards that they observe and to be familiar with internal company procedures, in accordance with the safety and health laws and regulations which apply to their area of work. Similarly, supervisors and managers must be aware of the physical, chemical and psychosocial hazards present in their workplaces as well as the social, organizational and industrial relations factors that may be involved in the creation of these hazards and in their correction. Thus, gaining knowledge and skills of a technical nature as well as organizational, communication and problem-solving skills are all necessary objectives in education and training.

                                                        In recent years, safety and health education has been influenced by developments in education theory, particularly theories of adult learning. There are different aspects of these developments, such as empowerment education, cooperative learning and participative learning. All share the principle that adults learn best when they are actively involved in problem-solving exercises. Beyond the transmission of specific bits of knowledge or skills, effective education requires the development of critical thinking and an understanding of the context of behaviours and ways of linking what is learned in the classroom to action in the workplace. These principles seem especially appropriate to workplace safety and health, where the causes of hazardous conditions and illnesses and injuries are often a combination of environmental and physical factors, human behaviour and the social context.

                                                        In translating these principles into an education programme four categories of objectives must be included:

                                                        Information objectives: the specific knowledge that trainees will acquire. For example, knowledge of the effects of organic solvents on the skin and on the central nervous system.

                                                        Behavioural objectives: the competencies and skills that workers will learn. For example, the ability to interpret chemical data sheets or to lift a heavy object safely.

                                                        Attitude objectives: the beliefs that interfere with safe performance or with response to training that must be addressed. The belief that accidents are not preventable or that “solvents can’t hurt me because I’ve worked with them for years and I’m fine” are examples.

                                                        Social action objectives: the ability to analyse a specific problem, identify its causes, propose solutions and plan and take action steps to resolve it. For example, the task of analysing a particular job where several people have sustained back injuries, and of proposing ergonomic modifications, requires the social action of changing the organization of work through labour-management cooperation.

                                                        Technological and Demographic Change

                                                        Training for awareness and management of specific safety and health hazards obviously depends on the nature of the workplace. While some hazards remain relatively constant, the changes that take place in the nature of jobs and technologies require continuous updating of training needs. Falls from heights, falling objects and noise, for example, have always been and will continue to be prominent hazards in the construction industry, but the introduction of many kinds of new synthetic building materials necessitates additional knowledge and awareness concerning their potential for adverse health effects. Similarly, unguarded belts, blades and other danger points on machinery remain common safety hazards but the introduction of industrial robots and other computer-controlled devices requires training in new types of machinery hazards.

                                                        With rapid global economic integration and the mobility of multinational corporations, old and new occupational hazards frequently exist side-by-side in both highly industrialized and developing countries. In an industrializing country sophisticated electronics manufacturing operations may be located next door to a metal foundry that still relies on low technology and the heavy use of manual labour. Meanwhile, in industrialized countries, garment sweatshops with miserable safety and health conditions, or lead battery recycling operations (with its threat of lead toxicity) continue to exist alongside highly automated state-of-the-art industries.

                                                        The need for continual updating of information applies as much to workers and managers as it does to occupational health professionals. Inadequacies in the training even of the latter is evidenced by the fact that most occupational hygienists educated in the 1970s received scant training in ergonomics; and even though they received extensive training in air monitoring, it was applied almost exclusively to industrial worksites. But the single largest technological innovation affecting millions of workers since that time is the widespread introduction of computer terminals with visual display units (VDUs). Ergonomic evaluation and intervention to prevent musculoskeletal and vision problems among VDU users was unheard of in the 1970s; by the mid-nineties, VDU hazards have become a major concern of occupational hygiene. Similarly, the application of occupational hygiene principles to indoor air quality problems (to remedy “tight/sick building syndrome”, for example) has required a great deal of continuing education for hygienists accustomed only to evaluating factories. Psychosocial factors, also largely unrecognized as occupational health hazards before the 1980s, play an important role in the treatment of VDU and indoor air hazards, and of many others as well. All parties investigating such health problems need education and training in order to understand the complex interactions among environment, the individual and social organization in these settings.

                                                        The changing demographics of the workforce must also be considered in safety and health training. Women make up an increasing proportion of the workforce in both developed and developing nations; their health needs in and out of the workplace must be addressed. The concerns of immigrant workers raise numerous new training questions, including those to do with language, although language and literacy issues are certainly not limited to immigrant workers: varying literacy levels among native-born workers must also be considered in the design and delivery of training. Older workers are another group whose needs must be studied and incorporated into education programmes as their numbers increase in the working population of many nations.

                                                        Training Venues and Providers

                                                        The location of training and education programmes is determined by the audience, the purpose, the content, the duration of the programme and, to be realistic, the resources available in the country or region. The audience for safety and health education starts with schoolchildren, trainees and apprentices, and extends to workers, supervisors, managers and safety and health professionals.

                                                        Training in schools

                                                        Incorporation of safety and health education into elementary and secondary education, and especially in vocational and technical training schools, is a growing and very positive trend. The teaching of hazard recognition and control as a regular part of skills training for particular occupations or trades is far more effective than trying to impart such knowledge later, when the worker has been in the trade for a period of years, and has already developed set practices and behaviours. Such programmes, of course, necessitate that the teachers in these schools also be trained to recognize hazards and apply preventive measures.

                                                        On-the-job training

                                                        On-the-job training at the worksite is appropriate for workers and supervisors facing specific hazards found onsite. If the training is of significant length, a comfortable classroom facility within the worksite is strongly recommended. In cases where locating the training at the workplace may intimidate workers or otherwise discourage their full participation in the class, an offsite venue is preferable. Workers may feel more comfortable in a union setting where the union plays a major role in designing and delivering the programme. However, field visits to actual work locations which illustrate the hazards in question are always a positive addition to the course.

                                                        Training of safety delegates and committee members

                                                        The longer and more sophisticated training recommended for safety delegates and committee representatives is often delivered at specialized training centres, universities or commercial facilities. More and more efforts are being made to implement regulatory requirements for training and certification of workers who are to perform in certain hazardous fields such as asbestos abatement and hazardous waste handling. These courses usually include both classroom and hands-on sessions, where actual performance is simulated and specialized equipment and facilities are required.

                                                        Providers of onsite and offsite programmes for workers and safety representatives include government agencies, tripartite organizations like the ILO or analogous national or sub-national bodies, business associations and labour unions, universities, professional associations and private training consultants. Many governments provide funds for the development of safety and health training and education programmes targeted at specific industries or hazards.

                                                        Academic and professional training

                                                        The training of safety and health professionals varies widely among countries, depending on the needs of the working population and the country’s resources and structures. Professional training is centred in undergraduate and postgraduate university programmes, but these vary in availability in different parts of the world. Degree programmes may be offered for specialists in occupational medicine and nursing and occupational health may be incorporated into the training of general practitioners and of primary care and public health nurses. The number of degree-granting programmes for occupational hygienists has increased dramatically. However, there remains a strong demand for short courses and less comprehensive training for hygiene technicians, many of whom have received their basic training on the job in particular industries.

                                                        There is an acute need for more trained safety and health personnel in the developing world. While more university-trained and credentialed physicians, nurses and hygienists will undoubtedly be welcomed in these countries, it is nonetheless realistic to expect that many health services will continue to be delivered by primary health care workers. These people need training in the relationship between work and health, in the recognition of the major safety and health risks associated with the type of work carried on in their region, in basic survey and sampling techniques, in the use of the referral network available in their region for suspected cases of occupational illness and in health education and risk communication techniques (WHO1988).

                                                        Alternatives to university-based degree programmes are critically important to professional training in both developing and industrialized nations, and would include continuing education, distance education, on-the-job training and self-training, among others.


                                                        Education and training cannot solve all occupational safety and health problems, and care must be taken that the techniques learned in such programmes are in fact applied appropriately to the identified needs. They are, however, critical components of an effective safety and health programme when employed in conjunction with engineering and technical solutions. Cumulative, interactive and continuous learning is essential to prepare our rapidly changing work environments to meet the needs of workers, especially as regards the prevention of debilitating injuries and illnesses. Those who labour in the workplace as well as those who provide support from the outside need the most up-to-date information available and the skills to put this information to use in order to protect and promote worker health and safety.


                                                        The European Union (EU) today exercises a major influence on worldwide health and safety law and policy. In 1995, the Union comprised the following Member States: Austria, Belgium, Denmark, Finland, France, Germany, Greece, Ireland, Italy, Luxembourg, Netherlands, Portugal, Spain, Sweden and the United Kingdom. It will probably expand in years to come.

                                                        The forerunner of the Union, the European Community, was created in the 1950s by three treaties: The European Coal and Steel Community Treaty (ECSC) signed in Paris in 1951, and the European Economic Community (EEC) and European Atomic Energy Community (EAEC) Treaties signed in Rome in 1957. The European Union was formed with the entry into force of the Maastricht Treaty (concluded in 1989) on 1 January 1992.

                                                        The Community has four institutions, namely, the Commission, the Council, the Parliament and the European Court of Justice. They derive their powers from the treaties.

                                                        The Structures

                                                        The Commission

                                                        The Commission is the Community’s executive body. It is responsible for initiating, proposing and implementing Community policy, and if a Member State fails to fulfil its obligations under the treaties, the Commission can take proceedings against that Member State in the European Court of Justice.

                                                        It is composed of seventeen members appointed by the governments of Member States for a renewable four-year period. Each Commissioner is responsible for a portfolio and has authority over one or more Directorates General. One such Directorate General, DG V, is concerned with Employment, Industrial Relations and Social Affairs, and it is from within this Directorate General (DG V/F) that health and safety and public health policies are both initiated and proposed. The Commission is assisted in its health and safety law and policy-making role by the Advisory Committee on Safety, Hygiene and Health Protection at Work and the European Foundation for the Improvement of Living and Working Conditions.

                                                        Advisory Committee on Safety, Hygiene and Health Protection at Work

                                                        The Advisory Committee was established in 1974 and is chaired by the Commissioner responsible for the Directorate-General for Employment, Industrial Relations and Social Affairs. It consists of 96 full members: two representatives each of government, trade unions, and employers’ organizations from each Member State.

                                                        The role of the Advisory Committee is to “assist the Commission in the preparation and implementation of activities in the fields of safety, hygiene and health protection at work”. Because of its constitution and membership, the Advisory Committee is much more important and pro-active than its title suggests, so that, over the years, it has had a significant influence on strategic policy development, acting alongside the European Parliament and the Economic and Social Committee. More specifically, the Committee is responsible for the following matters within its general frame of reference:

                                                        • conducting exchanges of views and experience regarding existing or planned regulations
                                                        • contributing towards the development of a common approach to problems existing in the fields of safety, hygiene and health protection at work and towards the choice of Community priorities as well as measures necessary for implementing them
                                                        • drawing the Commission’s attention to areas in which there is an apparent need for the acquisition of new knowledge and for the implementation of appropriate educational and research projects
                                                        • defining, within the framework of Community action programmes, and in cooperation with the Mines Safety and Health Commission, (i) the criteria and aims of the campaign against the risk of accidents at work and health hazards within the undertaking; and (ii) methods enabling undertakings and their employees to evaluate and to improve the level of protection
                                                        • contributing towards keeping national administrations, trade unions and employers’ organizations informed of Community measures in order to facilitate their cooperation and to encourage initiatives promoted by them aiming at exchanges of experience and at laying down codes of practice
                                                        • submitting opinions on proposals for directives and on all measures proposed by the Commission which are of relevance to health and safety at work.


                                                        In addition to these functions, the Committee prepares an annual report, which the Commission then forwards to the Council, the Parliament and the Economic and Social Committee.

                                                        The Dublin Foundation

                                                        The European Foundation for the Improvement of Living and Working Conditions, located in Dublin, was established in 1975 as a specialized, autonomous Community body. The Foundation is primarily engaged in applied research in the areas of social policy, the application of new technologies, and the improvement and protection of the environment, in an effort to identify, cope with and forestall problems in the working environment.

                                                        European Agency for Health and Safety at the Workplace

                                                        The European Council has recently established the European Agency for Health and Safety at the Workplace in Bilbao, Spain, which is responsible for collating and disseminating information in its sector of activities. It will also organize training courses, supply technical and scientific support to the Commission and forge close links with specialized national bodies. The agency will also organize a network system with a view to exchanging information and experiences between Member States.

                                                        The European Parliament

                                                        The European Parliament exercises an increasingly important consultative role during the Community’s legislative process, controls a part of the Community’s budget jointly with the Council, approves Community Association agreements with non-member countries and treaties for the accession of new Member States, and is the Community’s supervisory body.

                                                        The Economic and Social Committee

                                                        The Economic and Social Committee is an advisory and consultative body which is required to give its opinion on a range of social and vocational issues, including health and safety at work. The Committee draws its membership from three main groups: employers, workers and an independant group comprising members with a wide spectrum of interests including professional, business, farming, the cooperative movement and consumer affairs.

                                                        Legal Instruments

                                                        There are four main instruments available to the Community legislator. Article 189 of the EEC Treaty as amended provides that “In order to carry out their task and in accordance with the provisions of this Treaty, the European Parliament acting jointly with the Council and the Commission shall make regulations and issue directives, take decisions, make recommendations or deliver opinions.”


                                                        It  is  stated  that  “A  regulation  shall  have  general  application. It shall be binding in its entirety and directly applicable in all Member States.” Regulations are directly enforceable in Member States. There is no need for further implementation. Indeed, it is not permissible for legislatures to consider them with a view to that  end.  In  the  field  of  health  and  safety  at  work,  regulations are rare and those that have been made are administrative in nature.

                                                        Directives and decisions

                                                        It is stated that “A directive shall be binding, as to the result to be achieved, upon each Member State to which it is addressed, but shall leave to the national authorities the choice of form and methods.” Directives are instructions to Member States to enact laws to achieve an end result. In practice, directives are used mainly to bring about the harmonization or approximation of national laws in accordance with Article 100. They are therefore the most appropriate and commonly used instruments for occupational health and safety matters. In relation to decisions, it is stated that “A decision shall be binding in its entirety upon those to whom it is addressed.”

                                                        Recommendations and opinions

                                                        Recommendations and opinions have no binding force but are indicative of policy stances.


                                                        The European Communities made a decision in the mid-1980s to press ahead strongly with harmonization measures in the field of health and safety. Various reasons have been put forward to explain the developing importance of this area, of which four may be considered to be significant.

                                                        First, it is said that common health and safety standards assist economic integration, since products cannot circulate freely within the Community if prices for similar items differ in various Member States because of variable health and safety costs imposed on business. Second, 10 million people a year are the victims of, and 8,000 people a year die from, workplace accidents (out of a workforce which numbered 138 million people in 1994). These grim statistics give rise to an estimated bill of ECU 26,000 million paid in compensation for occupational accidents and diseases annually, whilst in Britain alone the National Audit Office in their Report Enforcing Health and Safety in the Workplace estimated that the cost of accidents to industry and the taxpayer is £10 billion per year. It is argued that a reduction of the human, social and economic costs of accidents and ill-health borne by this workforce will not only bring about a huge financial saving but will also bring about a significant increase in the quality of life for the whole Community. Third, the introduction of more efficient work practices is said to bring with it increased productivity, lower operational costs and better industrial relations.

                                                        Finally, it is argued that the regulation of certain risks, such as those arising from massive explosions, should be harmonized at a supranational level because of the scale of resource costs and (an echo of the first reason canvassed above) because any disparity in the substance and application of such provisions produces distortions of competition and affects product prices.

                                                        Much impetus was given to this programme by the campaign organized by the Commission in collaboration with the twelve Member States in the European Year of Health and Safety, which took place during the 12-month period commencing 1 March 1992. This campaign sought to reach the whole of the Community’s working population, particularly targeting high-risk industries and small and medium-sized enterprises.

                                                        Each of the founding treaties laid the basis for new health and safety laws. The EEC Treaty, for example, contains two provisions which are, in part at least, devoted to the promotion of health and safety, namely articles 117 and 118.

                                                        Community Charter of the Fundamental Social Rights of Workers

                                                        To meet the challenge, a comprehensive programme of measures was proposed by the Commission in 1987 and adopted by the Council in the following year. This programme contained a series of health and safety measures grouped under the headings of safety and ergonomics, health and hygiene, information and training, initiatives concerning small and medium enterprises, and social dialogue. Added impetus to these policies was provided by the Community Charter of the Fundamental Social Rights of Workers, adopted in Strasbourg in December 1989 by 11 of the 12 Member States (the United Kingdom abstained).

                                                        The Social Charter, as agreed in December 1989, covers 12 categories of “fundamental social rights” among them are several of practical relevance here:

                                                        • Improvement of living and working conditions. There should be improvement in working conditions, particularly in terms of limits on working time. particular mention is made of the need for improved conditions for workers on part-time or seasonal contracts and so on.
                                                        • Social protection. Workers, including the unemployed, should receive adequate social protection and social security benefits.
                                                        • Information, consultation and participation for workers. This should apply especially in multinational companies and in particular at times of restructuring, redundancies or the introduction of new technology.
                                                        • Health protection and safety at the workplace.
                                                        • Protection of children and adolescents. The minimum employment age should be no lower than the minimum school-leaving age, and in any case not lower than 15 years. The hours which those aged under 18 can work should be limited, and they should not generally work at night.
                                                        • Elderly persons. Workers should be assured of resources providing a decent standard of living upon retirement. Others should have sufficient resources and appropriate medical and social assistance.
                                                        • Disabled people. All disabled people should have additional help towards social and professional integration.


                                                        Member States are given responsibility in accordance with national practices for guaranteeing the rights in the Charter and implementing the necessary measures, and the Commission is asked to submit proposals on areas within its competence.

                                                        Since 1989, it has become clear that within the Community as a whole there is much support for the Social Charter. Undoubtedly, Member States are anxious to show that workers, children and older workers should benefit from the Community as well as shareholders and managers.

                                                        The 1989 Framework Directive

                                                        The principles in the Commission’s health and safety programme were set out in another “Framework Directive” (89/391/EEC) on the introduction of measures to encourage improvements in the safety and health of workers at work. This makes a significant step forward from the approach witnessed in the earlier “Framework Directive” of 1980. In particular, the 1989 Directive, while endorsing and adopting the approach of “self-assessment”, also sought to establish a variety of basic duties, especially for the employer. Furthermore, the promotion of “social dialogue” in the field of health and safety at work was explicitly incorporated into detailed provisions in the 1989 Directive, introducing significant requirements for information, consultation and participation for workers and their representatives at the workplace. This 1989 Directive required compliance by 31 December 1992.

                                                        The Directive contains re-stated general principles concerning, in particular, the prevention of occupational risks, the protection of safety and health and the informing, consultation and training of workers and their representatives, as well as principles concerning the implementation of such measures. This measure constituted a first attempt to provide an overall complement to the technical harmonization directives designed to complete the internal market. The 1989 Directive also brought within its scope the provisions of the 1980 Framework Directive on risks arising from use at work of chemical, physical and biological agents. It parallels the ILO Convention concerning Occupational Safety and Health, 1981 (No. 155) and its accompanying Recommendation (No. 161).

                                                        The overall objectives of the 1989 Directive may be summarized as being:

                                                        • humanization of the working environment
                                                        • accident prevention and health protection at the workplace
                                                        • to encourage information, dialogue and balanced participation on safety and health by means of procedures and instruments
                                                        • to promote throughout the Community, the harmonious development of economic activities, a continuous and balanced expansion and an accelerated rise in the standard of living
                                                        • to encourage the increasing participation of management and labour in decisions and initiatives
                                                        • to establish the same level of health protection for workers in all undertakings, including small and medium-sized enterprises, and to fulfil the single market requirements of the Single European Act 1986; and
                                                        • the gradual replacement of national legislation by Community legislation.


                                                        General duties placed upon the employer include duties of awareness, duties to take direct action to ensure safety and health, duties of strategic planning to avoid risks to safety and health, duties to train and direct the workforce, duties to inform, consult and involve the workforce, and duties of recording and notification.

                                                        The Directive provided similar safeguards for small and medium-sized enterprises. It is stated, for example, that the size of the undertaking and/or establishment is a relevant matter in relation to determining the sufficiency of resources for dealing with the organization of protective and preventive measures. It is also a factor to be considered in relation to obligations concerning first aid, fire fighting and evacuation of workers. Furthermore, the Directive included a power for differential requirements to be imposed upon varying sizes of undertakings as regards documentation to be provided. Finally, in relation to the provision of information, it is stated that national measures “may take account, inter alia, of the size of the undertaking and/or establishment”.

                                                        Under the umbrella of the 1989 Directive, a number of individual directives have also been adopted. In particular, “daughter” directives have been adopted on minimum safety and health requirements for the workplace, for the use of work equipment, for the use of personal protective equipment, for the manual handling of loads, and for work with display screen equipment.

                                                        The following Directives have also been adopted:

                                                        • Council Directive of 20 December 1993 concerning the minimum safety and health requirements for work on board fishing vessels (93/103/EEC)
                                                        • Council Directive of 12 October 1993 amending Directive 90/679/EEC on the protection of workers from risks related to exposure to biological agents at work (93/88/EEC)
                                                        • Council Directive of 3 December 1992 on the minimum requirements for improving the safety and health protection of workers in surface and underground mineral-extracting industries (92/104/EEC)
                                                        • Council Directive of 3 November 1992 on the minimum requirements for improving the safety and health protection of workers in mineral-extracting industries that involve drilling (92/91/EEC)
                                                        • Council Directive of 19 October 1992 on the introduction of measures to encourage improvements in the safety and health at work of pregnant workers and workers who have recently given birth or who are breast-feeding (92/85/EEC)
                                                        • Council Directive of 24 June 1992 on the minimum requirements for the provision of safety and/or health signs at work (92/58/EEC)
                                                        • Council Directive of 24 June 1992 on the implementation of minimum safety and health requirements at temporary or mobile construction sites (92/57/EEC)
                                                        • Council Directive of 31 March 1992 on the minimum safety and health requirements for improved medical treatment on board vessels (92/29/EEC)
                                                        • Council Directive of 23 April 1990 on the contained use of genetically modified micro-organisms. (90/219/ EEC)


                                                        Since the passage of the Maastricht Treaty, further measures have been passed, namely: a Recommendation on a European schedule of industrial diseases; a directive on asbestos; a directive on safety and health signs at the workplace; a directive on medical assistance on board vessels; directives on health and safety protection in the extractive industries; and a directive introducing measures to promote improvements in the travel conditions of workers with motor disabilities.

                                                        The Single Market

                                                        The original Article 100 has been replaced by a new provision in the Treaty of European Union. The new Article 100 ensures that the European Parliament and the Economic and Social Committee must be consulted in all cases and not simply when the implementation of a directive would involve the amendment of legislation in one or more Member States.



                                                        Sunday, 23 January 2011 21:48

                                                        Principles of Training

                                                        Training can and will produce positive results if it is based on clearly defined needs specific to the workplace and if it is delivered with a view to those needs and the ways in which adults learn. This is, of course, true for safety and health training as well. The principles of safety and health training are no different from those which apply to any form of industrial training. Indeed, a good case can be made for the integration of skill training along with safety training wherever possible. Safety and health training which fails to produce positive results because it is not based on sound analysis is, at best, a waste of time and money. At worst, such training may result in false confidence, thus increasing the risk of accidents.

                                                        Needs Assessment

                                                        The first step in safety and health training design is to identify the problems which need to be addressed. This may be done for the entire organization, for a particular location or for a particular job. Alternatively, the analysis of training needs may have a specific focus, for example, compliance with safety and health legislation or the performance of the joint safety and health committee. However, not all problems can be solved by training; in some cases, other action is needed to supplement it. A simple example of this is the case where the problem identified is a low level of compliance with the rule obliging workers to wear personal protective equipment. While part of the problem may be due to the fact that employees do not understand why the equipment is needed or how to use it correctly, it is equally possible that some or all of the problem may be caused by the fact that there is consistent failure to replace broken or missing equipment.

                                                        The existence of problems may surface in the form of a high rate of accidents, refusal-to-work situations or government inspectors' orders or citations. However, it is the problems which underlie such outward signs of trouble that need to be clearly identified. A training needs assessment may be defined as the process of identifying problems that are signalled by deficiencies in compliance with standards or external requirements and that can be resolved wholly or partly by training. A systems approach to training needs analysis involves a number of logical steps: problem identification, analysis, identification of training needs, the ranking of needs in order of urgency and the setting of training goals or objectives.

                                                        Problem identification

                                                        The sorts of problems that lend themselves to solution by means of training include the following:

                                                        Those that are identified after accidents have already happened. In this case, problems may be identified through review of accident statistics, accident investigation reports or, more broadly, through the failure to meet organizational goals for safety and health.

                                                        Problems that can be anticipated. Dangers can be identified before actual harm is done—for example, hazards can be foreseen when new machinery, substances or processes are introduced into the workplace, where there exist processes that have never been thoroughly analysed or where existing practice conflicts with known safe procedures .

                                                        The existence of external requirements. New legal requirements which either impose specific safety and health training duties or other requirements suggesting the need for training are examples of external requirements. The development of new industry codes of practice or national or international standards affecting safety and health are other examples.

                                                        Problem analysis

                                                        The next step is to analyse the problems so that necessary training may be identified. Problem analysis involves collecting information about the problem so that its causes can be determined. It also requires determining an appropriate standard which should be met. If, for example, the problem identified relates to a lack of effectiveness of the joint safety and health committee, analysis seeks to answer several questions. First, what is the committee supposed to be doing? Second, how well is the committee performing each of its required tasks? (This question requires the analyst to determine appropriate performance standards which should apply.) Third, why is the committee not performing particular tasks effectively?

                                                        Determining solutions

                                                        Once the problem has been analysed, the next step is to determine suitable solutions. If training is the solution or part of the solution, the particular training needs must be identified. What combination of skills and knowledge is required and by whom?

                                                        A critical part of the investigation of training needs is the assessment of the people involved. The purpose of this is threefold: first, people are likely to be more committed to training (and thus more likely to learn) if they have played a part in identifying the needs themselves; second, it is often necessary to assess the current level of required skill and knowledge among the target group of employees (for example, one might investigate whether joint safety and health committee members actually know what it is they are supposed to be doing); third, basic educational levels and literacy and language skills must be known so that appropriate instructional methods are applied. Surveys can be used to assess a number of these variables. If they are used, however, care should be taken to ensure individual confidentiality.

                                                        Setting priorities and goals

                                                        Once training needs have been clearly identified, the next step is to set priorities and objectives. Consideration must be given to the relative urgency of various training needs, taking into account factors such as the relative severity of consequences should accidents occur, the frequency with which problems are likely to occur, the number of people affected and legal compliance.

                                                        Training objectives must be specific because, if they are not, evaluating whether the training has been successful will prove difficult. Specifically defined objectives also help determine appropriate training content and delivery method. Training objectives or goals establish the results that training should achieve. Examples of specific training objectives might include (a) to ensure that every manager and supervisor knows and understands legal safety and health duties and rights applying to themselves and to all workers, (b) to ensure that all welders know and understand the hazards of welding and the required control procedures or (c) to provide fork-lift truck operators with the skill to operate their vehicles safely according to required procedures

                                                        Needs Assessment Methods

                                                        Methods for analysing training needs depend on the scope of the assessment and on available resources. All or some of the following methods may be used:

                                                        • Documentation review. For example, written statements of safe working practices, legal requirements, company policies and procedures, accident statistics and workplace inspection reports can be examined to determine their bearing on training needs.
                                                        • Specific analysis. Accident statistics, joint committee minutes, accident investigation reports and job and task hazard analyses may be examined for their specific relevance to the problem in question.
                                                        • Interviews and observation. Interviews with representative samples of supervisors, workers and others may be used to assess attitudes and perceived problem areas; observations can be made of representative jobs to assess compliance with safe working practices.
                                                        • Surveys. A survey can be used for relatively large groups to gain information about current skills and knowledge levels and about perceived training needs and problem areas as well.


                                                        Choosing Appropriate Instructional Methods

                                                        Instructional methods include a number of techniques such as lectures, problem-solving exercises, small group discussion and role-playing.The methods chosen must be appropriate to what is being learned (whether knowledge, skills or concepts) and the training objectives. If, for example, the training objective is to impart knowledge about basic safety rules in the workplace, then a short lecture may be appropriate. However, there are different levels of learning in adults. The lowest level of learning is listening to information; the next level is acquiring knowledge; then, developing understanding; and finally, at the highest level, the ability to apply what is learned to different situations. In most training situations, participants will need to learn at more than one level and so a variety of instructional techniques will be required. Instructional methods must also be based upon sound principles of how adults learn best.

                                                        Principles of Adult Learning

                                                        The way in which adults learn differs from the way children learn in several important respects. Adults approach the task of learning in possession of life experiences and a developed concept of self. The process of learning is an individual experience which takes place within the learner and depends on the learner's willingness to learn, the ability to relate his or her own experiences to what is being learned and the perceived value of what is being learned to the learner. In many cases, adults make a free choice to learn and so, unlike school children, they are voluntary participants. However, when safety and health training is provided in the workplace, workers and managers may be required to attend training sessions, with little room for individual choice. Where this is so, particular attention needs to be paid to involving learners both in the process of identifying training needs and in the design of the programme itself. Addressing the perceived training needs of workers may be as important as the identification of needs in other areas. Above all, adult training involves change. As with any change, acceptance is dependent on the learners’ belief that they have some control over the change and that the change is not perceived as threatening.

                                                        Research has identified a number of factors which facilitate learning in adults:

                                                        • Motivation. Since learning is an individual experience, adults must want to learn and must perceive the relevance of what they learn to their personal interest.
                                                        • Seeing and hearing. Adults tend to learn best when they can see as well as hear what is being taught. This means that lectures should include accompanying visual material such as overhead transparencies or slides.
                                                        • Practice. The opportunity to practise what is being taught facilitates learning. When a skill is being taught (for example, the correct fitting of self-contained breathing apparatus) learners should be allowed to exercise it for themselves. Where the objective is applied knowledge, problem-solving exercises can be used. “Experiential” exercises whereby learners actually experience the application of abstract concepts such as teamwork are valuable instructional tools.
                                                        • Relationship to practical experience. Learning is facilitated when the training material can easily be related to the practical experience of the learners. This suggests that examples used should, as far as possible, relate to the industry processes familiar to the learners.
                                                        • Participation in the learning process. Adults should know from the start what the learning objectives are and be given the opportunity to test the lesson content against these objectives.
                                                        • Feedback. Adults need feedback on their own results (how well they are doing) and positive reinforcement.
                                                        • Trying out ideas. The opportunity to try out and develop ideas is part of the individual process of internalizing new information and its application. This can be achieved through small peer group discussions.
                                                        • Physical environment. The training facility and equipment should be sympathetic to the learners, allowing them, for example, to see visual material and to work effectively in small groups.


                                                        Training Implementation

                                                        Careful consideration should be given to the selection of trainers, the scheduling of training and pilot testing. In selecting trainers, two equally important abilities must be sought: knowledge of the subject and teaching ability. Not everyone who has the required safety and health knowledge will necessarily have teaching ability. On the whole, it is easier for people to acquire knowledge than it is to acquire teaching ability. In most workplaces, including the shop floor, there will be a number of people who have a natural teaching ability, and they will have the advantage of knowing the workplace and being able to understand practical examples. In small group learning, a “group learning facilitator” may be used in place of a trainer. In this case, the facilitator is learning along with the group but has responsibilities for the process of learning.

                                                        The scheduling of training involves several important considerations. For example, it should be arranged at a time convenient for the learners and when interruptions can be minimized. Training can also be packaged in self-contained modules so that it can be spread out over time—perhaps a three hour module once a week could be scheduled. Not only does this approach sometimes cause less interference with production, it also allows time between sessions for learners to try to apply what has been learned.

                                                        Every training programme should be pilot tested before initial use. This allows the programme to be tested against training objectives. Pilot testing should involve not only the trainers but a representative sample of the prospective learners as well.

                                                        Training Evaluation

                                                        The purpose of evaluating training is quite simply to establish whether the training objectives have been met and, if so, whether this has resulted in solving the problem addressed by those objectives. Preparation for training evaluation should begin at the training design stage. In other words, the problem to be addressed by training must be clear, the training objectives must be specific and the status quo prior to training must be known. For example, if the problem to be addressed is poor observance of safe working practices in material handling operations, and training has been designed to address part of this problem by providing information and skills to, say, fork-lift operators, then a successful outcome in this case would be high observance of correct safe working practices.

                                                        Evaluation of training can be done at various levels. At the first level, the aim is simply to assess student reactions to the training programme. Did they like the programme, the instructor and the course material, were they bored, did they feel that they had learned something? This approach may be useful in assessing whether or not the programme was perceived to be of value by the students. Such evaluations are most usefully conducted through an attitude survey and should not generally be administered by the course instructor. Participants are unlikely to provide candid answers at this point even if the questionnaires are anonymous. As an aid to this type of evaluation, students can be allowed to test themselves on the training content.

                                                        The next level of evaluation is the assessment of whether or not the learning objectives have been met. Learning objectives are related to the content of the training and they define what the student should be able to do or know when training is completed. Learning objectives are usually developed for each part of the course content and are shared with students so that they know what they should expect to learn. Evaluation at this level is designed to assess whether or not students have learned what is defined in the learning objectives. This can be done by testing participants at the end of the course. Knowledge, concepts and abstract skills can be assessed in written tests whereas practical skills can be assessed by direct observation of students demonstrating the skill. Where this level of evaluation is used, it is absolutely necessary to have prior knowledge of the knowledge or skill baseline of the students before training begins.

                                                        The third level of evaluation is the assessment of whether or not the knowledge and skills learned in the training are actually being applied on the job. Such assessment can be made through direct observation at specified intervals of time following training. Evaluation of application on the day following training may produce a result quite different from that based on an evaluation some three months later. It is important to note, however, that if the evaluation shows a lack of application after three months, it may not be the training itself which is defective; it may be due to a lack of reinforcement in the workplace itself.

                                                        Finally, the highest level of evaluation is the determination of whether or not the problem addressed by the training has been resolved. If the problem identified was a high rate of musculoskeletal injuries in the shipping and receiving area, is there evidence of the desired drop in the injury rate? Here again, timing is important. In this case, it may take time for the training to become effective. The rate may not drop for a number of months because such injuries are often cumulative; and so the rate for some time may reflect conditions prior to training. Furthermore, the training may result in greater awareness of the problem leading to increased reporting soon after training.

                                                        Ideally, all four levels of training evaluation should be built into the training design and implementation. However, if only one level is used, its limitations should be clearly understood by all concerned.

                                                        Where training is designed and provided by an external agency, the organization can and should nevertheless evaluate its potential usefulness by applying criteria based on the principles outlined in this article.

                                                        Training Reinforcement

                                                        No matter how successful training is in meeting objectives, its effect will decline with time if reinforcement is not provided in the workplace on a regular and consistent basis. Such reinforcement should be the routine responsibility of supervisors, managers and joint safety and health committees. It can be provided through regular monitoring of performance on the job, recognition of proper performance and routine reminders through the use of short meetings, notices and posters.


                                                        The occupational safety and health of workers has been an important aspect of legislation laid down in the form of the Labour Law promulgated in July 1994. To urge enterprises into the market system, and in the meantime to protect the rights of labourers, in-depth reforms in the system of labour contracts and wage distribution and in social security have been major priorities in the government agenda. Establishing a uniform welfare umbrella for all workers regardless of the ownership of the enterprises is one of the goals, which also include unemployment coverage, retirement pension systems, and occupational disease and injuries compensation insurance. The Labour Law requires that all employers pay a social security contribution for their workers. Part of the legislation, the draft of the Occupational Disease Prevention and Control Law, will be an area of the Labour Law to which major attention has been devoted in order to regulate the behaviour and define the responsibilities of employers in controlling occupational hazards, while at the same time giving more rights to workers in protecting their own health.

                                                        Cooperation Between Governmental Agencies and the All-China Federation of Trade Unions in Policy Making and Legislation Enforcement

                                                        The Ministry of Public Health (MOPH), the Ministry of Labour (MOL), and the All-China Federation of Trade Unions (ACFTU) have a long history of cooperation. Many important policies and activities have resulted from their joint efforts.

                                                        The current division of responsibility between the MOPH and the MOL in occupational safety and health is as follows:

                                                        • From the preventive medical point of view, the MOPH oversees industrial hygiene and occupational health, enforcing national health inspection.
                                                        • The focus of the MOL is on engineering the control of occupational hazards and on the organization of labour, as well as overseeing occupational safety and health and enforcing national labour inspection (figure 1) (MOPH and MOL 1986).


                                                        Figure 1. Governmental organization and division of responsibility for occupational health and safety


                                                        It is difficult to draw a line between the responsibilities of the MOPH and the MOL. It is expected that further cooperation will focus on enhancing enforcement of occupational safety and health regulations.

                                                        The ACFTU has been increasingly involved in safeguarding workers’ rights. One of the important tasks of the ACFTU is to promote the establishment of trade unions in foreign-funded enterprises. Only 12% of overseas-funded enterprises have established unions.



                                                        Sunday, 23 January 2011 21:53

                                                        Worker Education and Training

                                                        Worker training in occupational safety and health may serve many different purposes. Too often, worker training is viewed only as a way to comply with governmental regulations or to reduce insurance costs by encouraging individual workers to follow narrowly defined safe work behaviours. Worker education serves a far broader purpose when it seeks to empower workers to take an active part in making the workplace safe, rather than simply to encourage worker compliance with management safety rules.

                                                        Over the past two decades, there has been a move in many countries toward the concept of broad worker involvement in safety and health. New regulatory approaches rely less on government inspectors alone to enforce safety and health on the job. Labour unions and management are increasingly encouraged to collaborate in promoting safety and health, through joint committees or other mechanisms. This approach requires a skilled and well-informed workforce that can interact directly with management on issues of safety and health.

                                                        Fortunately, there are many international models for training workers in the full range of skills necessary to participate broadly in workplace health and safety efforts. These models have been developed by a combination of labour unions, university-based labour education programmes and community-based non-governmental organizations. Many innovative worker training programmes were developed originally with financing from special government grant programmes, union funds or employer contributions to collectively bargained safety and health funds.

                                                        These participatory worker training programmes, designed in a variety of national settings for diverse worker populations, share a general approach to training. The educational philosophy is based on sound adult education principles and draws upon the empowerment philosophy of “popular education”. This article describes the educational approach and its implications for designing effective worker training.

                                                        Educational Approach

                                                        Two disciplines have influenced the development of labour-oriented safety and health education programmes: the field of labour education and, more recently, the field of “popular” or empowerment education.

                                                        Labour education began simultaneously with the trade union movement in the 1800s. Its early goals were directed towards social change, that is, to promote union strength and the integration of working people into political and union organizing. Labour education has been defined as a “specialized branch of adult education that attempts to meet the educational needs and interests arising out of workers’ participation in the union movement”. Labour education has proceeded according to well-recognized principles of adult learning theory, including the following:

                                                        • Adults are self-motivated, especially with information that has immediate application to their lives and work. They expect, for example, practical tools to help them solve problems in the workplace.
                                                        • Adults learn best by building on what they already know so that they can incorporate new ideas into their existing, vast reservoir of learning. Adults wish to be respected for their experience in life. Therefore, effective methods draw on participants' own knowledge and encourage reflection on their knowledge base.
                                                        • Adults learn in different ways. Each person has a particular learning style. An educational session will work best if participants have the opportunity to engage in multiple learning modalities: to listen, look at visuals, ask questions, simulate situations, read, write, practice with equipment and discuss critical issues. Variety not only ensures that each cognitive style is addressed but also provides repetition to reinforce learning and, of course, combats boredom.
                                                        • Adults learn best when they are actively engaged, when they “learn by doing”. They are more responsive to active, participatory methods than to passive measures. Lectures and written materials have their place in a full repertoire of methods. But case studies, role plays, hands-on simulations and other small-group activities that allow each individual to be involved are more likely to result in the retention and application of new learning. Ideally, each session involves interaction between participants and includes occasions for learning new information, for applying new skills and for discussing causes of problems and barriers to solving them. Participatory methods require more time, smaller groups and perhaps different instructional skills than those that many trainers currently possess. But to increase the impact of education, active participation is essential.


                                                        Since the beginning of the 1980s, worker safety and health training has also been influenced by the perspective of “popular” or “empowerment” education. Popular education since the 1960s has developed largely from the philosophy of Brazilian educator Paulo Freire. It is an approach to learning that is participatory and is based on the reality of student/worker experiences in their worksites. It fosters dialogue between educators and workers; critically analyses the barriers to change, such as organizational or structural causes of problems; and has worker action and empowerment as its goals. These tenets of popular education incorporate the basic principles of adult education, yet stress the role of worker action in the educational process, both as a goal to improve worksite conditions and as a mechanism for learning.

                                                        Participatory education in an empowerment context is more than small group activities that involve students/workers in active learning within the classroom. Participatory popular education means students/workers have the opportunity to acquire analytic and critical thinking skills, practice social action skills and develop the confidence to develop strategies for the improvement of the work environment long after the education sessions end.

                                                        Design of Education Programmes

                                                        It is important to realize that education is a continuing process, not a one-time event. It is a process that requires careful and skilful planning though each major stage. To implement a participatory education process that is based on sound adult education principles and that empowers workers, certain steps must be taken for planning and implementing participatory worker education which are similar to those used in other training programmes (see “Principles of Training”), but require special attention to meeting the goal of worker empowerment:

                                                        Step one: Assess needs

                                                        Needs assessment forms the foundation for the entire planning process. A thorough needs assessment for worker training includes three components: a hazards assessment, a profile of the target population and background on the social context of training. The hazards assessment is aimed at identifying high-priority problems to be addressed. The target population profile attempts to answer a broad set of questions about the workforce: Who can most benefit from training? What training has the target population already received? What knowledge and experience will the trainees bring to the process? What is the ethnic and gender makeup of the workforce? What is the literacy level of the workers and what languages do they speak? Whom do they respect and whom do they mistrust? Finally, gathering information on the social context of training allows the trainer to maximize the impact of training by looking at the forces that may support improved safety and health conditions (such as strong union protection that allow workers to speak out freely about hazards) and those that may pose barriers (such as productivity pressures or lack of job security).

                                                        Needs assessment can be based on questionnaires, review of documents, observations made in the workplace and interviews with workers, their union representatives and others. The popular education approach utilizes an ongoing “listening” process to gather information about the social context of training, including people's concerns and the obstacles that might inhibit change.

                                                        Step two: Gain support

                                                        Successful worker education programmes rely on identifying and involving key actors. The target population must be involved in the planning process; it is difficult to gain their trust without having sought their input. In a popular education model, the educator attempts to develop a participatory planning team from the union or shop floor who can provide ongoing advice, support, networking and a check on the validity of the needs assessment findings.

                                                        Labour unions, management and community-based groups are all potential providers of worker safety and health education. Even if not sponsoring the training directly, each of these groups may have a key role to play in supporting the educational effort. The union can provide access to the workforce and back up the efforts for change that hopefully will emerge from the training. Union activists who are respected for their knowledge or commitment can assist in outreach and help ensure a successful training outcome. Management is able to provide paid released time for training and may more readily support efforts to improve safety and health that grow out of a training process they have “bought into”. Some employers understand the importance and cost-effectiveness of comprehensive worker training in safety and health, while others will not participate without government-mandated training requirements or a collectively bargained right to paid educational leave for safety and health training.

                                                        Community-based non-governmental organizations can provide training resources, support or follow-up activities. For non-union workers, who may be especially vulnerable to retaliation for safety and health advocacy on the job, it is particularly important to identify community support resources (such as religious groups, environmentalist organizations, disabled worker support groups or minority workers’ rights projects). Whoever has a significant role to play must be involved in the process through co-sponsorship, participation on an advisory committee, personal contact or other means.

                                                        Step three: Establish education objectives and content

                                                        Using information from the needs assessment, the planning team can identify specific learning objectives. A common mistake is to assume that the objective of workshops is simply to present information. What is presented matters less than what the target population receives. Objectives should be stated in terms of what workers will know, believe, be able to do or accomplish as a result of the training. The majority of traditional training programmes focus on objectives to change the individuals' knowledge or behaviours. The goal of popular worker education is to create an activist workforce that will advocate effectively for a healthier work environment. Popular education objectives may include learning new information and skills, changing attitudes and adopting safe behaviours. However, the ultimate goal is not individual change, but collective empowerment and workplace change. The objectives leading to this goal include the following:

                                                        • Information objectives are geared towards the specific knowledge the learner will receive, for example, information about the health hazards of solvents.
                                                        • Skill objectives are intended to ensure that participants can do specific tasks that they will need to be able to perform back on the job. These can range from individual, technical skills (such as how to lift properly) to group action skills (such as how to advocate for ergonomic redesign of the workplace). Empowerment-oriented education emphasizes social action skills over mastery of individual tasks.
                                                        • Attitude objectives aim to have an impact on what the worker believes. They are important for ensuring that people move beyond their own barriers to change so that they are able to actually put their new-found knowledge and skills to use. Examples of attitudes that may be addressed include beliefs that accidents are caused by the careless worker, that workers are apathetic and do not care about safety and health or that things never change and nothing one can do will make a difference.
                                                        • Individual behavioural objectives aim to affect not just what a worker can do, but what a worker actually does back on the job as a result of training. For example, a training programme with behavioural objectives would aim to have a positive impact on respirator use on the job, not just to convey information in the classroom as to how to use a respirator properly. The problem with individual behaviour change as an objective is that workplace safety and health improvements rarely take place on an individual level. One can use a respirator properly only if the right respirator is provided and if there is time allowed for taking all necessary precautions, regardless of production pressures.
                                                        • Social action objectives also aim to have an effect on what the worker will do back on the job but address the goal of collective action for change in the work environment, rather than individual behaviour change. Actions that result from such training can range from small steps, such as investigating one specific hazard, to large undertakings, such as starting an active safety and health committee or campaigning to redesign a dangerous work process.


                                                        There is a hierarchy of these objectives (figure 1). Compared with the other training objectives, knowledge objectives are the easiest to achieve (but they are by no means easy to attain in an absolute sense); skill objectives require more hands-on training to ensure mastery; attitude objectives are more difficult because they may involve challenging deeply held beliefs; individual behaviour objectives are achievable only if attitude barriers are addressed and if performance, practice and on-the-job follow-up are built into the training; and social action objectives are most challenging of all, because training must also prepare participants for collective action in order to achieve more than they can on an individual basis.

                                                        Figure 1. Hierarchy of training objectives.


                                                        For example, it is a reasonably straightforward task to communicate the risks that asbestos poses to workers. The next step is to ensure that they have the technical skills to follow all safety procedures on the job. It is more difficult still to change what workers believe (e.g., to convince them that they and their fellow workers are at risk and that something can and should be done about it). Even armed with the right skills and attitudes, it may be difficult for workers to actually follow safe work practices on the job, especially since they may lack the proper equipment or management support. The ultimate challenge is to promote social action, so that workers may gain the skills, confidence and willingness to insist on using less hazardous substitute materials or to demand that all necessary environmental controls be used when they are working with asbestos.

                                                        Empowerment-oriented labour education always aims to have an impact on the highest level—social action. This requires that workers develop critical thinking and strategic planning skills that will allow them to set achievable goals, constantly respond to barriers and reshape their plans as they go. These are complex skills that require the most intensive, hands-on approach to training, as well as strong on-going support that the workers will need in order to sustain their efforts.




                                                        The specific content of educational programmes will depend on the needs assessment, regulatory mandates and time considerations. Subject areas that are commonly addressed in worker training include the following:

                                                        • health hazards of relevant exposures (such as noise, chemicals, vibration, heat, stress, infectious diseases and safety hazards)
                                                        • hazard identification methods, including means of obtaining and interpreting data regarding workplace conditions
                                                        •   control technologies, including engineering and work organization changes, as well as safe work practices and personal protective equipment
                                                        • legal rights, including those relating to regulatory structures, the worker’s right to know about job hazards, the right to file a complaint and the right to compensation for injured workers
                                                        • union safety and health provisions, including collectively bargained agreements giving members the right to a safe environment, the right to information and the right to refuse to perform under hazardous conditions
                                                        • union, management, government and community resources
                                                        • the roles and responsibilities of safety and health committee members
                                                        •  prioritizing hazards and developing strategies to improve the worksite, including analysis of possible structural or organizational barriers and design of action plans


                                                        Step four: Select education methods

                                                        It is important to select the right methods for the chosen objectives and content areas. In general, the more ambitious the objectives, the more intensive the methods must be. Whatever methods are selected, the profile of the workforce must be considered. For example, educators need to respond to workers’ language and literacy levels. If literacy is low, the trainer should use oral methods and highly graphic visuals. If a variety of languages is in use among the target population the trainer should use a multilingual approach.

                                                        Because of time limitations, it may not be possible to present all of the relevant information. It is more important to provide a good mix of methods to enable workers to acquire research skills and to develop social action strategies so that they can pursue their own knowledge, rather than attempt to condense too much information into a short period of time.

                                                        The teaching methods chart (see table 1) provides a summary of different methods and the objectives which each might fulfil. Some methods, such as lectures or informational films, primarily fulfil knowledge objectives. Worksheets or brainstorming exercises can fulfil information or attitude objectives. Other more comprehensive methods, such as case studies, role-plays or short videotapes that trigger discussion may be aimed at social action objectives, but may also contain new information and may present opportunities to explore attitudes.

                                                        Table 1. Teaching methods chart

                                                        Teaching methods Strengths                                                      Limitations Objectives achieved
                                                        Lecture Presents factual material in direct and logical manner. Contains experiences which inspire.
                                                        Stimulates thinking to open a discussion.
                                                        For large audiences.
                                                        Experts may not always be good teachers.
                                                        Audience is passive. Learning difficult to gauge.
                                                        Needs clear introduction and summary.
                                                        Worksheets and questionnaires Allow people to think for themselves without being influenced by others in discussion.
                                                        Individual thoughts can then be shared in small or large groups.
                                                        Can be used only for short period of time. Handout requires preparation time. Requires literacy. Knowledge Attitudes/emotions
                                                        Brainstorming Listening exercise that allows creative thinking for new ideas. Encourages full participation because all ideas equally recorded. Can become unfocused.
                                                        Needs to be limited to 10 to 15 minutes.
                                                        Knowledge Attitudes/emotions
                                                        Planning deck Can be used to quickly catalogue information.
                                                        Allows students to learn a procedure by ordering its component parts.
                                                        Group planning experience.
                                                        Requires planning and creation of multiple planning decks. Knowledge
                                                        Risk mapping Group can create visual map of hazards, controls, and plans for action.
                                                        Useful as follow-up tool.
                                                        Requires workers from same or similar workplace.
                                                        May require outside research.
                                                        Knowledge Skills/social action
                                                        Audiovisual materials (films, slide shows, etc.) Entertaining way of teaching content and raising issues.
                                                        Keeps audience’s attention.
                                                        Effective for large groups.
                                                        Too many issues often presented at one time.
                                                        Too passive if not combined with discussion.
                                                        Audiovisuals as triggers Develops analytic skills.
                                                        Allows for exploration of solutions.
                                                        Discussion may not have full participation. Social action Attitudes/emotions
                                                        Case studies as triggers Develops analytic and problem-solving skills.
                                                        Allows for exploration of solutions.
                                                        Allows students to apply new knowledge and skills.
                                                        People may not see relevance to own situation.
                                                        Cases and tasks for small groups must be clearlydefined to be effective.
                                                        Social action Attitudes/emotions
                                                        Role playing session (trigger) Introduces problem-situation dramatically.
                                                        Develops analytic skills.
                                                        Provides opportunity for people to assume roles of others.
                                                        Allows for exploration of solutions.
                                                        People may be too self-conscious.
                                                        Not appropriate for large groups.
                                                        Social action Attitudes/emotions
                                                        Report back session Allows for large group discussion of role plays, case studies, and small group exercise. Gives people a chance to reflect on experience. Can be repetitive if each small group says the same thing. Instructors need to prepare focused questions to avoid repetitiveness. Social action skills Information
                                                        Prioritizing and planning activity Ensures participation by students. Provides experience in analysing and prioritizing problems. Allows for active discussion and debate. Requires a large wall or blackboard for posting. Posting activity should proceed at a lively pace to be effective. Social action
                                                        Hands-on practice Provides classroom practise of learned behaviour. Requires sufficient time, appropriate physical space, and equipment. Behaviours

                                                        Adapted from: Wallerstein and Rubenstein 1993. By permission. 

                                                        Step five: Implementing an education session

                                                        Actually conducting a well-designed education session becomes the easiest part of the process; the educator simply carries out the plan. The educator is a facilitator who takes the learners through a series of activities designed to (a) learn and explore new ideas or skills, (b) share their own thoughts and abilities and (c) combine the two.

                                                        For popular education programmes, based on active participation and sharing of worker’s own experiences, it is critical that workshops establish a tone of trust, safety in discussion and ease of communication. Both physical and social environments need to be well planned to allow for maximum interaction, small group movement and confidence that there is a shared group norm of listening and willingness to participate. For some educators, this role of learning facilitator may require some “retooling”. It is a role that relies less on a talent for effective public speaking, the traditional centrepiece of training skills, and more on an ability to foster cooperative learning.

                                                        The use of peer trainers is gaining in popularity. Training workers to train their peers has two major advantages: (1) worker trainers have the practical knowledge of the workplace to make training relevant and (2) peer trainers remain in the workplace to provide on-going safety and health consultation. The success of peer trainer programmes is dependent on providing a solid foundation for worker trainers through comprehensive “training of trainer” programmes and access to technical experts when needed.

                                                        Step six: Evaluate and follow up

                                                        Though often overlooked in worker education, evaluation is essential and serves several purposes. It allows the learner to judge his or her progress toward new knowledge, skills, attitudes or actions; it allows the educator to judge the effectiveness of the training and to decide what has been accomplished; and it can document the success of training to justify future expenditures of resources. Evaluation protocols should be set up in concert with the education objectives. An evaluation effort should tell you whether or not you have achieved your training objectives.

                                                        The majority of evaluations to date have assessed immediate impact, such as knowledge learned or degree of satisfaction with the workshop. Behaviour-specific evaluations have used observations at the worksite to assess performance.

                                                        Evaluations that look at workplace outcomes, particularly injury and illness incidence rates, can be deceptive. For example, management safety promotion efforts often include incentives for keeping accident rates low (e.g., by offering a prize to the crew with the least accidents in a year). These promotional efforts result in under-reporting of accidents and often do not represent actual safety and health conditions on the job. Conversely, empowerment-oriented training encourages workers to recognize and report safety and health problems and may result, at first, in an increase in reported injuries and illnesses, even when safety and health conditions are actually improving.

                                                        Recently, as safety and health training programmes have begun to adopt empowerment and popular education goals and methods, evaluation protocols have been broadened to include assessment of worker actions back at the worksite as well as actual worksite changes. Social action objectives require long-term evaluation that assesses changes on both the individual level and on the environmental and organization level, and the interaction between individual and environmental change. Follow-up is critical for this long-term evaluation. Follow-up phone calls, surveys or even new sessions may be used not only to assess change, but also to support the students/workers in applying their new knowledge, skills, inspiration or social action resulting from training.

                                                        Several programmatic components have been identified as important for promoting actual behavioural and worksite changes: union support structures; equal union participation with management; full access to training, information and expert resources for workers and their unions; conducting training within the context of a structure for comprehensive changes; programme development based on worker and workplace needs assessments; use of worker-produced materials; and integration of small group interactive methods with worker empowerment and social action goals.


                                                        In this article, the growing need for preparing workers for broad participation in workplace injury and illness prevention efforts has been depicted as well as the critical role of workers as advocates for safety and health. The distinct role of labour empowerment training in responding to these needs and the educational principles and traditions that contribute to a labour empowerment approach to education were addressed. Finally, a step-by-step educational process that is required to achieve the goals of worker involvement and empowerment was described.

                                                        This learner-centred approach to education implies a new relationship between occupational safety and health professionals and workers. Learning can no longer be a one-way street with an “expert” imparting knowledge to the “students”. The educational process, instead, is a partnership. It is a dynamic process of communication that taps the skills and knowledge of workers. Learning occurs in all directions: workers learn from the instructors; instructors learn from workers; and workers learn from one another (see figure 2).

                                                        Figure 2. Learning is a three-way process.


                                                        For a successful partnership, workers must be involved in every stage of the educational process, not just in the classroom. Workers must participate in the who, what, where, when and how of training: Who will design and deliver the training? What will be taught? Who will pay for it? Who will have access to it? Where and when will training take place? Whose needs will be met and how will success be measured?



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