The SOBANE risk management strategy and the Déparis method for the participatory screening of the risks
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- Malchaire, J.B. Int Arch Occup Environ Health (2004) 77: 443. doi:10.1007/s00420-004-0524-3
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The first section of the document describes a risk-prevention strategy, called SOBANE, in four levels: screening, observation, analysis and expertise. The aim is to make risk prevention faster, more cost effective, and more effective in coordinating the contributions of the workers themselves, their management, the internal and external occupational health (OH) practitioners and the experts. These four levels are: screening, where the risk factors are detected by the workers and their management, and obvious solutions are implemented; observation, where the remaining problems are studied in more detail, one by one, and the reasons and the solutions are discussed in detail; analysis, where, when necessary, an OH practitioner is called upon to carry out appropriate measurements to develop specific solutions; expertise, where, in very sophisticated and rare cases, the assistance of an expert is called upon to solve a particular problem.
The method for the participatory screening of the risks (in French: Dépistage Participatif des Risques), Déparis, is proposed for the first level screening of the SOBANE strategy. The work situation is systematically reviewed and all the aspects conditioning the easiness, the effectiveness and the satisfaction at work are discussed, in search of practical prevention measures. The points to be studied more in detail at level 2, observation, are identified. The method is carried out during a meeting of key workers and technical staff.
The method proves to be simple, sparing in time and means and playing a significant role in the development of a dynamic plan of risk management and of a culture of dialogue in the company.
KeywordsPrevention strategyRisk analysisScreening method
The framework European Directive (European Communities 1989) requires that the employer ensure the safety and health of the workers in all aspects related to work by implementing the general prevention principles: avoid the risks; evaluate the risks which cannot be avoided; fight the risks at the source; adapt the work to workers.
The application of these principles in the field raises many problems. One of them is the coordination between occupational health (OH) practitioners (occupational physicians, safety engineers, ergonomists, psychologists...) and the industry, in particular in small and medium enterprises (SMEs).
After a short review of some concepts, a strategy is presented that makes it possible to avoid, solve or minimise the problems and organise, effectively and economically, the cooperation for a greater efficiency of the prevention.
This document is addressed not only to OH practitioners but also to the employers that are responsible for the implementation of prevention programmes and to the workers who abide by this prevention.
Workplaces or work situations
By “workstation”, one generally understands, in a restrictive way, the place and conditions (noise, heat, dimensions, spaces...) in which an operator performs a stereotyped task. This concept is obsolete, owing to the fact that, in the new forms of work organisation, operators no longer work at a specific worksite day after day, but in a “work situation”, where they interact with workers from a set of workplaces. The expression “work situation” refers to all the physical, organisational, psychological and social aspects of life at work, which can influence the behaviour and well being of the worker and the efficiency at work.
Occupational health practitioners and experts
We will designate, by OH practitioners, the persons, such as safety officers, occupational physicians, industrial hygienists, and ergonomists, who are trained in safety and health at work to recognise, prevent, evaluate and reduce the risks. The training and competence of these people can be variable, but no distinction will be made here between the different types of practitioners.
We will call experts the people, coming in general from specialised laboratories, with qualifications and the methodological and technical means to look further into a particular problem. In general, however, these competences and means are limited to a particular aspect: electricity, toxicology, acoustics, mental effects, relational problems....
Small and medium-sized enterprises
Large companies usually have well-trained internal OH practitioners, and the social dialogue works rather well. The situation is clearly different in the SMEs, where 60% to 80% of the workforce labour and the rates of accidents and occupational diseases are approximately twice as large. A part-time internal OH practitioner is sometimes present but is often isolated. These SMEs must rely on external prevention services to fulfil the missions that they cannot effectively accomplish in-house.
The methods of risk assessment and, furthermore, of risk prevention must be developed primarily for these SMEs, taking account of their limited means and qualifications in occupational health and safety.
Quantification vs qualification of the risks: measurement vs evaluation
A great number of methods is available to “assess” the different occupational risks. Many of them were developed by researchers whose responsibility and interest lay in the establishment of general relations between constraints and effects, rather than in the solutions of problems in a particular work situation.
That is particularly the case for environmental factors and musculoskeletal problems (ISO 79331991; Rappaport 1991; Radwin et al. 1994; Wells et al. 1994; Malchaire and Piette 1997; Occhipinti 1998). Those methods are, most of the time, badly used, because they are difficult, complex and expensive.
From experience in the field, it should be concluded that the representative and correct quantification of the exposure and of the risk is very difficult and expensive and that the majority of measurements performed in industry have little value.
It is thus necessary to encourage the OH practitioners who are measuring systematically and the employers who are asking for such quantitative data, to think about the real interest of those measurements, their validity and their cost and to encourage them to “quantify” better and more validly, but advisedly, according to explicit objectives.
This conclusion is much the same as the standpoint of Goelzer in her Yant lecture in 1996, who said “It is not unusual to see more attention given to exposure assessment and monitoring than to hazard prevention and control. The fascination exerted by sophisticated equipments and numbers is, for some reason, greater than the interest in designing pragmatic solutions to prevent exposure” (Goelzer 1996). It is also similar to the point of view of the participants in the control banding workshop held in London in November 2002 (Anon). As underlined by Oldershaw (2002), “A single simple personal sample may cost more than $400: three quarters of the member states of WHO spend less than this per capita and per year in their health systems.”
SOBANE strategy of risk management
The number of risk factors and the number of work situations are so large that it is impossible to study them all in detail. In fact, it would be useless since, in the majority of the cases, prevention measures can be taken right away on the basis of simple “observation” by the people directly concerned and who know in detail the work situations day after day.
A detailed analysis can prove to be necessary when the work situation remains unacceptable, once the obvious solutions have been implemented, and the participation of experts become essential only in some particularly complex cases.
This procedure is adopted spontaneously and logically in most cases. Following a complaint, a visit (screening) of the work situation is made, and obvious problems are corrected. If this is not the case, a meeting (observation) is organised to discuss it more in detail and to identify solutions. If it cannot be solved directly, an OH practitioner is called in to help (analysis) and, in cases particularly difficult to solve, one has recourse to an expert (expertise).
This spontaneous procedure remains, however, non-systematic and, in general, not very effective, due, mainly, to the lack of efficient tools to guide these screenings and observations and the fact that, frequently, the problems are transferred by the people in the field (workers and their management) to the OH practitioners and the experts and that these specialists take full responsibility of the studies and recommendations.
It is, therefore, necessary to develop screening and observation tools for the people in the field and ensure the complementarity of the partners.
That is the objective of the risk management strategy described below.
Characteristics of the four levels of the SOBANE strategy
In difficult cases
In complex cases
Ten minutes per factor
People of the company
People of the company
People of the company + OH practitioners
People of the company + OH practitioners + experts
Health at work
Level 1, screening
The objective at this level is only to identify the main problems and solve immediately the simple ones, such as a hole in the ground, a container containing a solvent and left abandoned, or a computer screen turned towards a window.
This identification must be carried out internally, by people in the company who know perfectly the work situation, even if they have little qualification in safety, physiology or ergonomics. These people are the workers themselves, their immediate technical management, the employer itself in the small companies, with an internal OH practitioner, if available, in a medium-sized or large company. The tools must be simple and quick to understand and use and must be adapted to their industrial sector.
The method at this level 1, screening, must seek to identify the problems in all work circumstances, and not at a given moment.
Level 2, observation
A problem unsolved at level 1, screening, must be studied more in detail. The method must still be simple to understand and implement, and quick and inexpensive, so as to be used as systematically as possible by the workers and their technical staff, with the cooperation of an internal OH practitioner when available.
The objective is again to lead these people to discuss the problem in order to identify prevention solutions as soon as possible. As at level 1, the observation requires an intimate knowledge of the work situation in its various aspects, its options, and the normal and abnormal operations. The depth of the study at this level 2, observation, will vary according to the risk factor and according to the company and the qualifications of the participants.
The method should not require any quantification and, therefore, any measurements, so as to remain applicable even when these qualifications and techniques are not available.
Level 3, analysis
When the screening and observation levels did not allow the risk to be brought to an acceptable value, or when a doubt remains, it is necessary to go further in the analysis of its components and in the search for solutions.
This stage requires the assistance of OH practitioners who have the necessary qualification, tools and techniques. They will often be external OH practitioners, intervening in close cooperation with those who conducted stage 2, observation, (and not in their place), to bring to them the necessary qualification and means.
The method can use more sophisticated terms and concepts. It can require simple measurements with common instruments, measurements, however made, with explicitly defined objectives of confirmation of the problems, investigation of the causes and optimisation of the solutions.
Level 4, expertise
In particularly complex situations, a study at level 4, expertise, might be required, with the additional assistance of an expert. Sophisticated or specific measurements will sometimes be necessary to optimise appropriate solutions.
The Déparis method presented here is intended to fulfil the needs for the screening level. The methods for the observation, analysis and expertise levels were developed and validated with regard to noise (Malchaire et al. 1998a, Malchaire 2000), thermal environments of work (Malchaire et al. 1998b, 1999), lighting (Malchaire et al. 1998c), whole-body vibration (Malchaire et al. 1998d), hand–arm vibration (Malchaire et al. 1998e; Malchaire and Piette 2001) and musculoskeletal constraints (Malchaire et al. 2002; Malchaire and Piette 2002). Additional methods are being developed in the context of a European research project for the following aspects: chemical agents; biological agents; safety (falls, slips...); fire and explosion hazards; electric safety; machine safety and work on VDUs.
Criteria of a tool for a comprehensive screening of the risks in a work situation
To be usable directly by the workers and their technical management, with, if available but not necessarily, the assistance of an OH practitioner. Therefore the method must be simple to understand, must use the usual vocabulary, take little time and not require any measurement.
To require no special knowledge in health or safety, but to be based only on the intimate knowledge of the work situation by the workers and their management.
To approach, quickly, as many aspects of the work situation as possible.
To avoid rating scales that divert the attention from the search for solutions and be directed towards the calling into question of the work situation and towards the search for improvements.
To be directed, not necessarily towards the elimination of the “legal health and safety problems”, but rather towards the search for a flexible, pleasant and technically efficient work situation and towards the research of the best technical, human and economic condition for the workers and the company.
To make it possible to determine when the intervention of an OH practitioner is required.
To lead to action plans in the short, medium and long terms
To constitute the first level of the general strategy of prevention SOBANE.
The Déparis method
Description of the method
The tool of participative screening of the risks Déparis (in French, dépistage participatif des risques) follows, strictly, these criteria. It consists of 18 tables dealing with 18 aspects of the work situation: 1. Operating areas; 2. Technical organisation between workplaces; 3. Work sites; 4. Risks of accident; 5. Controls and signals; 6. Tools and work material; 7. Repetitive work; 8. Handling operations; 9. Mental load; 10. Lighting; 11. Noise; 12. Thermal environment; 13. Chemical and biological agents; 14. Vibration; 15. Work relationships between workers; 16. Local and general social environment; 17. Work content; 18. Psychosocial environment.
The order of the tables corresponds as much as possible to the way one physically approaches a work situation, going from the general aspects to the more specific ones, considering the general organisation (nos. 1 and 2), the work sites (no. 3), safety (no. 4) and aspects of work (nos. 5 to 9). The environmental factors (nos. 10 to 14) are deliberately pushed back. The psycho-organisational factors (nos. 15 to 18) are dealt with at the end of the discussion, when the best climate of cooperation has developed.
Smiling face, green light: satisfactory situation.
Neutral face, amber light: average and ordinary situation, to be improved if possible.
Unhappy face, red light: situation unsatisfactory, likely to be dangerous and must be improved.
At the end of the 18 tables, the actions and complementary studies proposed during the discussion are summarised in a table that determines “who” does “what” and “when”. This table will lead to the action plan in the short, medium and long terms.
A partial redundancy does exist between various tables. This was avoided as much as possible in order to arrive at rather complementary headings. However, total separation is neither possible nor desirable, as the work situation is experienced by the workers as a whole, where the various aspects interfere with, reinforce or neutralise each other.
Procedure for use of the Déparis method
- 1.The process can be profitable only if it is developed in a climate of sincere cooperation. Certain conditions must be fulfilled so that this is the case, namely:
The clear and unambiguous position of the employer, declaring its objectives of safety and health and committing itself to take account of the results.
The scrupulous respect of the committees where labour and management discuss the health and safety problems of the company. When it exists, the health and safety committee must keep and fully play its role, more specifically here by promoting the development of the local actions and the follow-up.
The work situation is identified, made up of a coherent set of interacting workplaces. The number of workers concerned may vary, but should rarely exceed 10 (by team in the event of shift work) under penalty of considering a set of workplaces too heterogeneous.
The employer designates a coordinator, with the agreement of the workers. The coordinator will have to organise the meetings, lead them and report the results. He or she must know the work situation perfectly and could be a supervisor, the section head or a local OH practitioner when available. This coordinator is the main actor in the procedure whom all parties must accept unreservedly.
The coordinator adapts the Déparis tables to the particular work situation by modifying terms, eliminating irrelevant aspects, transforming others or adding new ones.
A working group is formed with key workers of the work situation, designated by their colleagues and their representatives and with some technical supervisory staff, designated by the employer.
The choice and the representativeness of the participants must also be accepted unreservedly by the workers and the hierarchy.
The number of people taking part in the meeting should be approximately 3 to 7, neither too large—on pain of being too expensive—nor too small—on pain of being not very representative. In a small enterprise, it can be a group of two or three people. In a larger company, the group might include two or three workers, a supervisor, a production engineer, a person from the engineering and design department, another one from the purchase or maintenance department, an OH practitioner....
These participating workers must be key persons in the work situation, knowing particularly well the activities and physical and social work conditions. They should not speak in their own name, but be able to express, as much as possible, the opinions and expectations of the group of workers. In mixed-gender work situations, the participation of at least a woman and a man is essential.
A meeting of the working group is organised in a quiet room, close to the workplaces. The meeting must be held in close proximity to the workplaces in order for the group to be able to go there, if necessary, to discuss possible changes. Experience shows that it is very difficult to hold a meeting while the participants are working and must also supervise and intervene in the process.
The coordinator leads the meeting. He or she clearly explains the framework, the objectives and the procedure and then proposes, one by one, the points to discuss from the 18 tables. The tables can be projected by a transparency onto a wall or distributed to the participants. The discussion is launched and tries to concentrate on the aspects included in the table, not to give a score but to determine, on the one hand, what can be done simply, directly and in practical terms to make the situation more flexible, more effective and more pleasant and, on the other hand, to decide what should be discussed further (level 2, observation) to identify adequate solutions. The group is, at the same time, invited to suggest who could implement each solution, how and when.
After the meeting, the coordinator writes a synthesis. A fair copy of the result is prepared, with the tables used and the detailed information arising from the meeting, the list of proposed solutions, with the indication of “who does what and when”, and the list of the aspects that need to be studied more in detail. Ideally, this synthesis is presented to the participants individually or, preferably, during a second meeting. This proves to be rich in confirmation and additions. It also demonstrates the educational effect of Déparis, namely that some participants looked at their work situation more thoroughly, with different eyes, in search of more permanent control measures.
The synthesis is presented to the employer and the consultative committee.
The methods of level 2, observation, are used for the items requiring it to search for more specific solutions or to give shape to the proposals made on the level of Déparis.
Action plans at the short, medium and long terms are decided and implemented. The table summarising who does what when makes it easier to determine what can be implemented immediately, what must be planned, what must be budgeted for. It also makes it possible to follow the evolution of the actions and to evaluate the results.
Periodically, and after an appropriate lapse of time, the Déparis study is repeated and the action plans are updated, as improvement of the work situation cannot be made at once and is never final.
Role of the OH practitioner
Make the social partners—employers and unions—aware of the possibilities that Déparis offers to structure their approach to the working situations in a comprehensive way.
Adapt the Déparis tool to the characteristics of the work situation, by re-examining the terminology (ex: workshop or office) and/or the aspects taken into consideration (ex: vibration, work on VDU...).
Follow closely, or even take the lead in, the first use of Déparis so as to avoid ambiguities and take care that the process of discussion, decision and implementation develops harmoniously.
Periodically, take care that the process is renewed and is maintained in the company.
The OH practitioner thus plays, literally, the role of an “engine”, starting the process, bringing the fuel necessary (the Déparis method) and maintaining the movement, then overcoming the inertia and the friction forces.
In some cases, and especially for a first use, a meeting can prove to be premature or impossible. OH practitioners who wish to introduce Déparis into companies must then use it themselves, while trying to collect the opinions and the ideas of the operators. This use is still participative but in the more traditional meaning: the worker takes part in the study conducted by the OH practitioner.
The Déparis method was tested in 40 companies, including 13 with fewer than 50 workers, 14 with 50 to 200 workers and 13 with 200 to 500 workers. These 40 companies were selected from five branches of industry: the tertiary sector (offices, etc., 6); chemical (e.g. painting, printing works, 8); metal (workshop, garages, etc., 8); repetitive work (e.g. pharmaceutical, packing, 8); self-employed (bakers, butchers, etc., 4) and health care (hospitals 6).
A possible bias exists in the selection, as one can assume that the companies that agreed to take part were already aware of the safety and health problems: an ergonomic study had previously been done in 18 of the 40 companies, but only seven had led to prevention actions.
The methodology of validation included a questionnaire concerning the preliminary contacts; the course of the meeting (who, where, how long, how, order of the headings, who does what and when); the results (number of solutions, nature, etc.) and the opinions of the participants and of the coordinator on the method and the documents provided (contents, length, time and degree of comprehension).
One hundred and twenty-three persons (38% women) took an active part in the 40 meetings, that is, 2 to 11 persons per meeting, in the majority designated by the management in order not to interfere with the work process. These work situations concerned, on the whole, 456 men and 378 women.
The coordinator was the internal OH practitioner in 51% of the cases, the employer itself in 28% and an external OH practitioner in the other cases.
The meetings were organised most of the time (62%) away from the work, but the group went to the workplaces in 44% of the cases in order to consider certain practical details.
The 18 tables were dealt with in approximately two hours, as planned (116±28 min, from 54 min to 180 min).
Aside from the “vibration” table, which was concerned only in 50% of the cases, all the tables were found to be extremely relevant by more than half of the participants, and for the last four headings (relations and psychosocial environment) by more than 70%.
A total of 417 measures of prevention was proposed, that is, more than ten per meeting: 33% only had already been proposed; 45% were specific to the work situations and 49% were very practical solutions.
The research of who does what and when hardly took any time and appeared interesting (77%) and reliable (87%). It played a role in the search for solutions in 32% of the cases. It was the same for the evaluation by the three smiles: little time (100%), very interesting (94%) and reliable (77%). Fears about a different use of the data were expressed in 19% of the meetings.
The procedure to use the method appeared sufficiently explained (92%), easy to understand and use (81%), guiding to solutions (96%) and to allow one to determine if the situation at work was acceptable or was to be studied in more detail (96%).
For 81% of the people, the method was sufficiently simple and practicable to be used by people in the field.
In terms of cost and time necessary, the preparation of the intervention takes time to convince the employer and the hierarchy to take this route and to gain the cooperation of the workers. The technical preparation of the Déparis meeting also takes some time. The meeting lasts approximately two hours for three to seven people. After the meeting, the time to write the report is approximately two hours. The cost of the procedure is thus not nil, but appears reasonable and definitely lower than the cost of intervention by consultants.
In terms of results, the results of Déparis might vary greatly, according to the way the coordinator leads the meeting and to the existing “culture” of the company (culture that Déparis tries to improve).
In some cases, the participants limit themselves to report the problems, discussing primarily whether a given aspect is satisfactory or not. In other cases, the discussion really concerns the roots of the problems, but the solutions remained general “it would be necessary”, “one could”, “one should”... “reorganise the work”, “re-examine the work cycles”....
In many cases, however, the goal was reached: practical solutions were formulated, such as plans to reshape a workspace, relocate stocks or machines, re-distribute the tasks between workers, modify the work process. The final table of who does what when then makes it possible to determine the priorities and define action plans in the short, medium and long terms.
During a later use, the effectiveness becomes more significant, the participation of the workers more practical, demonstrating that the previous meetings taught them to look better at their work situation.
The solutions are practical and proposed by the people directly concerned. Therefore, they are accepted and implemented more spontaneously.
An action plan, a “dynamic plan of risk management”, is set up, in the short, medium and long terms, in particular, thanks to the table of who does what and when.
The method allows the self-training of the workers, by leading them to seek information according to their needs, instead of passively receiving stereotyped training programmes decided by OH practitioners.
A complete version of the Déparis method can be downloaded from the website of the author.
Prevention requires one not only to understand the work situation, but also to know it, and the people who really know the situation are the workers themselves. The strategy thus rests on the knowledge of the work situation by the workers and their management, rather than on the understanding of this situation by an OH practitioner. Consequently, the person at the centre of the prevention strategy is not the OH practitioner, but the workers and their technical management, assisted, when necessary, by the OH practitioners. The approach is, therefore, an approach of risk management by the people directly concerned.
Is it not utopian to count on the workers and their technical management to manage the risk prevention process?
If it is not completely utopian, how is the process of screening started in a small company?
If this process is started, is it not likely, by these observation methods, that specific technical aspects will be favoured, without a more global approach to the work situation?
In this same case, is there not the risk that the OH practitioners will never be called for assistance, the actors at levels 1 and 2 considering that they can solve all the problems by themselves?
Lastly, how can it be ensured that the problems are adequately dealt with in the short and long terms?
Indeed, the concern about safety and health remains small in SMEs, and few actions are carried out directly by the employers and the workers themselves. However, it should also be admitted that the existing methods do not encourage them to undertake any action. Most of them are too long, not adapted to their situations, difficult to understand, directed towards quantification and do not suggest preventive measures. Consequently, it appears too early to conclude that self-management of the problems cannot work: the experiments were badly carried out, they are not conclusive.
In the current state of the organisation of safety and health at work, in Belgium as well as in other countries, the only systematic contact with health and safety in SMEs is the annual visit by the occupational physician and the annual inspection of the workplaces.
These inspections are, and remain, essential to detect some significant safety and health aspects, such as biological risks, fire, or electrical risks, which might escape the awareness of the workers because they do not interfere directly with their behaviour at work. However, in many cases, these inspections are carried out in accordance with a standard and stereotyped protocol, and the information collected concerns mainly what can be seen, heard, felt or smelled at the time of the inspection. Their impact on the improvement of the work situation might then remain limited.
The strategy presented here wants to be pragmatic. It offers to the company a tool (level 1, Déparis) complementary to these inspections, more adapted to its working situation, giving more information and allowing the determination of aspects of the work situation that really need further investigation.
In the current situation and for SMEs, the occupational physician and the people in charge of the annual inspections will remain the best people to introduce these tools to the company, to make the employers and the employees aware of the benefits that they can derive from their use and thus start the process of education. Any other way of initiating the process must, of course, be used: trade unions, employers’ associations, newsletters, posters, and so on.
be as comprehensive as possible, by not taking into account only the technical factors (heights, positions, forces) but also the organisational, relational, and personal factors.
be sufficiently detailed and rich in information to lead the users to appropriate solutions.
be instructive in explaining what the potential safety and health damages are.
be cautious, by clearly indicating when recourse to an OH practitioner is essential—because the consequences are serious, the problem is difficult to apprehend or the solutions are difficult to develop.
The quality of the solutions depends upon the quality of the methods. It was therefore essential that these level 1 and 2 methods be written by OH practitioners and experts capable of ensuring this quality. Then, the difficulty consisted of translating the documents into words comprehensible in the field.
The last question relates to the follow-up of the actions. This depends on the employer, who has the whole responsibility for the work situation. It is clear, however, that solutions found and finalised by the workers and their management have a much greater chance of becoming effective thereafter than those described at the end of a 10 to 50-page report prepared by an OH practitioner who has taken charge of the problem. The approach centred on the people concerned has a greater probability of leading to successful actions.
The discussion above is based upon the way prevention is organised and is functioning at the present time, at least in Belgium. Can this situation change with time? It is hoped that this will be the case and that the strategy of SOBANE will contribute to this evolution.
Another element could also accelerate the evolution. It is the obligation for companies to behave, with regard to the work situation, as they do with regard to their products and to guarantee the quality of their health and safety programmes. A standard (BS 8800 1996) exists in the United Kingdom, and the International Labour Office published a recommendation on this matter (International Labour Office 2001). Audit systems are already imposed in some countries. These quality systems will require that cooperation between the company and OH practitioners be organised. The SOBANE strategy could be the basis of this cooperation.
The Déparis method was developed and validated with the financial support of the European Social Fund and of the Belgian Federal Public Service Employment, Labour and Social Dialogue.