Safe Work in the 21st Century Education and Training Needs for the Next Decade's Occupational Safety and Health Personnel (2000) / Chapter Skim
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2 Occupational Safety and Health Professionals
2 Occupational Safety and Health Professionals
Pages 32-89
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From page 32... ...
workforce. However, it was possible to assemble a description of the four traditional or core OSH professions (occupational safety, industrial hygiene, occupational medicine, and occupational health nursing)
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However, the committee notes that considerable need exists beyond the current demand for OSH professionals by employers. Doctoral-level safety educators are needed to maintain the supply of practicing safety professionals, and both occupational medicine and occupational health nursing need more specialists with formal training.
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Occupational safety professionals, although they are concerned about all workplace hazards, have traditionally emphasized the prevention of traumatic injuries and workplace fatalities. Similarly, industrial hygienists, although they do not ignore injuries, have been a source of special expertise on the acute and chronic effects of chemical, biological, and physical health hazards.
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Consulting practice presents considerable challenges in influencing internal corporate culture and mounting stable prevention activities from outside the company. Nevertheless, many companies are outsourcing OSH functions, particularly OM and industrial hygiene functions.
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In contrast to the professional practice of occupational safety, industrial hygiene, OM, and occupational health nursing, many researchers who make important contributions to the field have had no OSH training. Scientists investigating the pathophysiology of cancer, or of asthma, for example, may know little about OSH but nevertheless provide information highly relevant for occupational risk assessments.
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In addition to teaching at the college or university level, a number of OSH professionals hold other positions with a significant teaching component, either in continuing education for working professionals or in programs aimed at orienting management personnel or workers themselves to the field. Maintenance of certification in any of the four traditional OSH professions requires participation in continuing education courses, which provides incentives for developing courses and recruiting qualified instructors to meet this demand.
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SAFETY PROFESSIONALS The prevention of injuries, illness, and unexpected death for workers is the basic definition of occupational safety. Although occupational safety has historically focused on the prevention of acute traumatic injury, a broader definition generally includes the control of hazards and the prevention of accidents not only to protect the U.S.
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These early SPs were also known as safety practitioners. Safety Professional Services The American Society of Safety Engineers (ASSE)
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3. Implement, administer, and advise others on hazard controls and hazard control programs.
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. Requirements for a major in safety typically include courses on safety and health program management, design of engineering hazard controls, system safety, industrial hygiene and toxicology, accident investigation, product safety, construction safety, fire protection, ergonomics, educational and training methods, and behavioral aspects of safety.
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Under the sponsorship of ASSE, the American Industrial Hygiene Association (AIHA) , the System Safety Society, the Society of Fire Protection Engineers, the National Safety Council, and the Institute of Industrial Engineers, BCSP evaluates the academic and professional experience qualifications of safety professionals, administers examinations, and issues certificates of qualification to those professionals who meet the Board's criteria and successfully pass its examinations.
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from the American Board of Industrial Hygiene, the Registered Professional Engineer (RPE) from the engineering registration board for any U.S.
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About 10,000 members are designated "professional members" by virtue of certification and 5 years of safety experience or by virtue of a bachelor's degree from an accredited college or university and 10 years of safety experience. A 1997 survey of the membership (American Society of Safety Engineers, 1997)
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Not surprisingly, three-fourths of the respondents indicated that they spent at least 50 percent of their time on safety and healthoriented issues. On average, respondents reported that they spent 59 percent of their time on safety, 10 percent on health issues, 10 percent on industrial hygiene, 9 percent on environmental issues, and 12 percent on other activities.
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Even though the training of management and employees is of the utmost importance, the survey data show that SPs spend less than 5 percent of their time carrying out this responsibility, which involves determining what training is needed, setting the goals and objectives of the training, determining what it will take to carry out the training, conducting or seeing to it that the training takes place, evaluating the effectiveness of the training, and gathering the necessary feedback to improve future training. Ideally, each supervisor would be responsible for the instruction of the workers under his or her direction, but the SP must usually take the initiative to ensure that work is performed without undue risk and that it complies with more than 200 OSHA standards that specifically require employees to be trained in some aspect of occupational safety and health.
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Frequently, an SP in a small or midsize business must assume responsibilities in such areas as industrial hygiene, ergonomics, radiological health, hazardous waste, and the environment. A survey of more than 9,000 CSPs by BCSP provides detailed information about employers (American Society of Safety Engineers and Board of Certified Safety Professionals, 1997~.
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As a consequence, most industrial hygienists come from an educational background in the natural sciences or engineering and have substantial postgraduate training, either in formal degree programs or in continuing education courses. Industrial Hygiene History Appendix C provides a list of events and people who were important in the development of the OSH field as a whole, so this section focuses on some events and people of particular significance for industrial hygiene.
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Industrial Hygienist Services The typical activities carried out by industrial hygienists are summarized by the ABIH (1998) as follows: arcs; · review projects, designs, and purchases to anticipate health haz· critically evaluate work environments, processes, materials inventories, and worker demographics to recognize potential health risks to persons or communities; · assess human exposures to hazards through a combination of qualitative and quantitative methods to determine health risks, regulatory compliance, and legal liabilities; · recommend effective control measures to mitigate risks via engineering, administrative, or personal protective methods; · communicate risks and control measures to workers, management, clients, customers, and communities; · provide specific training to workers about risks and control measures; · perform laboratory analysis of samples taken to assess worker exposure; · conduct research and development on industrial hygiene methods and tools; · interface industrial hygiene programs with related health risk management efforts, including safety, environmental protection, and medic~ne; .
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Most of the research universities that offer master's degree programs in industrial hygiene also offer doctoral degree programs with further training and research opportunities in the field. However, dissertation research directly related to industrial hygiene is also carried out, for example, in engineering departments, chemistry departments, and public health programs that are not identified in their name as supporting advanced education in the field of industrial hygiene.
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In addition to the NIOSH-supported institutions, continuing education courses in industrial hygiene are provided by the extension branches of various universities under the auspices of AIHA and by private firms. Certification of Industrial Hygienists As noted above, ABIH was founded in 1960 to develop and administer certification procedures.
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The allowable credit is 1 year of experience for an acceptable master's degree or 2 years for an acceptable doctoral degree. Upon successful completion of the core and chemical practice or comprehensive practice examinations, candidates become diplomates of ABIH and members of the American Academy of Industrial Hygiene, a professional society whose membership is exclusively composed of certified industrial hygienists.
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. In August 1999 AIHA listed 8,800 full members, that is, graduates of an accredited college with a baccalaureate or graduate degree in industrial hygiene, chemistry, physics, engineering, biology, or related discipline who have been engaged a majority of the time for at least 3 years in industrial hygiene-related activities.
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that these areas will become more integrated with industrial hygiene in institutional planning and management in the future. The implications for industrial hygiene practice are that there will be less technical specialization and more involvement in a broader range of issues, for example, international matters and employee education.
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(1997~. TABLE 2-3 Percentage of Respondents Reporting That They Manage the Indicated Activities Activity Percentage Chemical sampling Industrial hygiene program documentation Asbestos Physical agent monitoring Personal protective equipment evaluation Lead Confined spaces Occupational health 53.7 51.1 50.8 49.2 46.9 46.5 46.4 45.1 SOURCE: Association Research, Inc.
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OCCUPATIONAL MEDICINE OM is the area of preventive medicine that focuses on the relationships among the health of workers, the ability to perform work, the arrangements of work, and the physical, chemical, and social environments of the workplace. Practitioners in this field recognize that work and the environment in which work is performed can have favorable or adverse effects on the health of workers as well as on that of other populations, that the nature or circumstances of work can be arranged to protect worker health, and that health and well-being in the workplace are promoted when workers' physical attributes or limitations are accommodated in job placement (Accreditation Council for Graduate Medical Education, 1999~.
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(Rom, 1992~. Various diseases caused by exposures to agents such as white phosphorus, silica, asbestos, vinyl chloride, and coal dust have caused the most public attention (many of the OM physicians during the first half of this century were also industrial hygienists or health physicists and played important roles in the establishment of those professions)
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Because the field was considered a subspecialty of preventive medicine, most of the 40 training programs are associated with universities with public health schools or specific departments within a medical school. Occupational Medicine Services ACOEM has developed an extensive list of "competencies" describing specific behaviors characteristic of good OM practice (Upfal et al., 1998~.
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evaluate the impacts of such exposures on the health of individual workers, patients, and the public. The physician collaborates with other professionals, such as industrial hygienists, safety engineers, ergonomists, and occupational health nurses, on such efforts.
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In addition to knowledge common to all physicians, the following are distinct knowledge areas within preventive medicine: · biostatistics, · epidemiology, · health services management and administration, · environmental factors, · occupational factors, · clinical preventive medicine activities, and · social, cultural, and behavioral influences on health. Training in the field involves successful completion of a 2-year residency, which generally leads to board certification and which therefore closely follows the educational requirements specified by ABPM, which are as follows:
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· Residents must engage in collaborative work with industrial hygienists, nurses, safety professionals, and others concerned with psycho.
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Physicians who received certification in or after 1998 must take recertification tests every 10 years. Current Status of the OM Physician Workforce ACOEM is the professional organization for physicians interested in occupational medicine.
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Aerospace/general preventive medicine Physical medicine and rehabilitation All others 1,643 1,131 800 779 258 205 159 469 30.2 20.7 14.7 14.3 4.7 3.8 2.9 8.6 SOURCE: Eugene Handley, American College of Occupational and Environmental Medicine, personal communication, April 1999.
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OCCUPATIONAL SAFETY AND HEALTH PROFESSIONALS Other 9% University 7°/r, Corporation 26% Hospital 15% 65 Private practice 43% FIGURE 2-5 Primary practice setting of ACOEM members. SOURCE: American College of Occupational and Environmental Medicine (1999c)
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A possible explanation for the wide variety of settings indicated is provided by the answers to a question about whether the respondent's practice or group was involved in a 24-hour integrated benefits managed care plan (combined group health plan plus workers' compensation)
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society activities, other professional society activities, contributions to scientific meetings and professional literature, continuing education, faculty appointment, board certification. As of July 1999, ACOEM reported a total membership of approximately 7,000.
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Industrial nursing continued to grow, and during the 1920s several colleges and universities offered short courses in industrial hygiene in which nurses participated. By 1930 nearly 3,200 nurses were employed in industry to provide emergency care for ill and injured workers, follow-up, and home visits.
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In 1999, AAOHN membership exceeded 12,000, representing more than 50 percent of the occupational health nurses estimated to be practicing in that area in 1997 (Bureau of Health Professions, 1997~. The 1980s witnessed an expansion of the role of the occupational health nurse, with more involvement in health promotion, management and policy development, cost containment, research, and regulatory issues affecting practice (Babbitz, 1983; Rogers, 1988~.
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Occupational health nurses practice prevention at all levels (primary, secondary, and tertiary) with an emphasis on cost containment while preserving and improving the quality of health care.
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Preplacement examinations also help to establish baseline data for comparison with future health monitoring results. Working with other health care professionals and physicians, the occupational health nurse will want to design programs that identify vulnerable workers who are symptomatic, remove them from the exposure to prevent further insult, observe and sample the work environment to determine the exposure sources, and reduce or eliminate the exposure agent.
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Figure 2-7 shows that only 44 percent of AAOHN members who responded to a recent survey reported an associate degree or diploma as their highest level of formal education (American Association of Occupational Health Nurses, l999b)
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The general course content includes the following: · nursing science, which provides the context for health care delivery, recognizing the needs of individuals, groups, and populations within the framework of prevention, health promotion, and management of care for illness or injury; · medical science specific to treatment and management of occupational health illness and injury integrated with nursing health surveillance activities; · occupational health sciences including , ~ ~ toxicology, to recognize routes of exposure, examine relationships between chemical exposures in the workplace and acute and latent health effects, such as a burn or cancer, and to understand dose-response relationships; industrial hygiene, to identify and evaluate workplace hazards
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At the doctoral level, the emphasis is to prepare occupational health nursing researchers whose work may be specific to such fields of study as nursing, occupational epidemiology, environmental health, and administration of occupational health programs. As of 1998, 722 master's-level and 32 doctoral-level occupational health nurses have been added to the workplace via NIOSH training programs since their initiation in 1977 (Ann Cronin, NIOSH, personal communication, April 23, 1999~.
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This represents about 50 percent of the estimated number of occupational health nurses (Bureau of Health Professions, 1997~. Twenty-seven percent of the AAOHN membership indicated that they were certified in occupational health nursing, 23 percent with the COHN-S certification and 4 percent with the COHN certification (Cox, 1999~.
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The Compensation and Benefits Survey does not provide a comparison of data for certified and noncertified occupational health nurses, but one of the survey questions asks the respondent to select the nearest equivalent to his or her job title from a list. ABOHN asks the same question, with the same list of job titles, of all nurses taking the COHN and COHN-S examinations and provided the committee with the data for all those who
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are currently certified. Table 2-7 compares the AAOHN survey data for a random sample of certified and noncertified occupational health nurses with the ABOHN job title data for all certified occupational health nurses.
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78 SAFE WORK IN THE 21ST CENTURY the individual. Later, in 1957, Americans doing similar work founded the Human Factors Society, which was renamed the Human Factors and Ergonomics Society in 1992.
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, safety professionals (who have an engineering background) , and OM physicians and occupational health nurses (who get involved through workers' compensation cases and who must decide on work restrictions or returnto-work orders)
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The Board of Certified Safety Professionals introduced an ergonomics specialty examination for certified safety professionals in 1999. Current Status of the Ergonomist Workforce The Human Factors and Ergonomics Society has about 5,000 members, of which approximately 700 are students and of which about 600 are from foreign countries.
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Employee Assistance Professionals An employee assistance program (EAP) is a work-site-based program designed to assist in the identification and resolution of productivity problems associated with employees impaired by personal concerns, including, but not limited to, health, marital, family, financial, alcohol abuse, drug abuse, legal, emotional, stress, or other personal concerns that may adversely affect employee job performance.
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Education of Employee Assistance Professionals As might be expected, the individuals who provide employee assistance are typically mental health professionals. A 1998 EAPA member survey reported that 46 percent of respondents were social workers, 27 percent were alcohol or drug abuse counselors, and 12 percent were psychologists (Employee Assistance Professionals Association, 1999~.
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The committee was unable to locate any useful data on current demand for employee assistance professionals. Occupational Health Psychologists Occupational health psychology is an emerging specialty within psychology.
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describes as a convergence of preventive medicine and clinical and health psychology in an industrial-organizational context. The American Psychological Association and NIOSH are partners in a 5-year cooperative agreement to fund the development of graduate-level training in occupational health psychology.
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Table 2-8 summarizes the current OSH professional workforce described in this chapter, that is, safety professionals, industrial hygienists, OM physicians, occupational health nurses, ergonomists, and employee assistance professionals. None of those professional organizations claim to have as members 100 percent of those who are eligible, and it is doubtful that any of TABLE 2-8 Estimated Number of Active OSH Professionals in the United States, 1999 Type of Professional No.
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This survey of more than 25,000 nurses found that 1.0 percent of respondents reported occupational health as their primary employment setting, leading to an estimate of 21,575 nurses working in the field nationwide, about 73 percent higher than the AAOHN membership total. The committee had no way of estimating the undercount for the other OSH professions, but if the proportion is similar to that for occupational health nurses, the total of 76,000 in Table 2-8 might well be as much as 50,000 short as an estimate of the size of the current OSH professional workforce.
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An earlier section of this chapter reports that although 3 percent of safety professionals in the American Society for Safety Engineers have doctorates, only nine U.S. universities offer a doctoral degree in safety, and the committee was able to identify only one dissertation since 1995 that focused on the traditional domain of safety professionals: prevention of sudden traumatic injury.
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workers are employed by firms with less than 100 employees (National Institute for Occupational Safety and Health, 1999~. The majority of the traditional OSH professionals, however, are employed by midsize to large businesses and government agencies.
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OCCUPATIONAL SAFETY AND HEALTH PROFESSIONALS 89 now and will be needed even more in the coming decades, in addition to the traditional OSH professionals, is a new and different model of practice, perhaps one that even uses new categories of OSH personnel created by training managers, supervisors, and workers already employed in these small workplaces.
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