Examining the Impact of Narrative

Case Studies in Toolbox Talks for

Building Construction

Terri Heidotting, Ed.D.

Education and Information Division
NIOSH
Best Practices in Occupational Safety and Health,
Education, Training, and Communication: Ideas That Sizzle
Baltimore, Md - October 2002
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 Injury and Fatality Incidence Rates
Fatal Occuptional Injuries by Industry (2001) Nonfatal Occupational Injury / Illness by Industry
(2000)

Government 3.1
Services/Other 6.8
Services/Other 3.9
Retail 5.9
Retail 2.4
Wholesale 5.8
Wholesale 4.3

Transportation 6.9
Transportation 12.9

Manufacturing 9
Manufacturing 3.2

Construction 8.3
Construction 13.3

Mining 30 Mining 4.7

Agriculture 22.8 Agriculture 7.1

Sources: BLS Census of Fatal Occuptional Injuries and Employment by Industry, 2001 2
(http://www.bls.gov/news.release/cfoi.t04.htm); BLS Incidence Rates of Nonfatal Occuptional Injuries and Illnesses by
Industry Division and Selected Case Types, 1998-2000, Table 7 (http://www.bls.gov/news.release/osh.t07.htm )
 What are “Toolbox Talks”
• Also called “tailgate”
talks used in wide range
of industries –
construction, mining,
agriculture
• Brief (10-15 minute)
weekly safety training
sessions (“talks”)
• Safety talks conducted
on the work site
• Safety talk conducted by
the site supervisor,
foreman, safety
supervisor, or senior
employee 3
 Background
• Previous focus groups on improving toolbox
talks - Role of narratives / stories
• Need for quality training materials that are:
– Inexpensive and easily accessible
– Have a wide variety of safety topics
– Evaluated for their effectiveness
• Safety training materials developed with
input from the industry
• Instructional design of materials grounded in
accepted learning theories
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Training Intervention T I
ER
Effectiveness Research (TIER)
• Formative Evaluation:
– Determination of training needs
– Conceptualization of goals and objectives to meet the needs
• Process Evaluation:
– Development of draft training materials
– Field testing of data collection instruments
• Outcome Evaluation:
– Controlled study to determine if intended outcomes are obtained
and sustained
– Identification if critical elements
• Impact Assessment:
– Longitudinal study - Did training met the educational needs identified
in Stage 1
– Examination of the impact of training on the learner and learner’s
environment

NIOSH Publication Number: 99-142

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Website: http://www.cdc.gov/niosh/99-142.html
Pilot Study
• Draft toolbox lessons
– Treatment – with story
(narrative)
– Control – without story
(company’s own lessons)
• Data collection and analyses
– Focus groups
– Interviews
– Observations of training
sessions
• Participants
– Electricians, carpenters,
laborers with 4 to 38 years
of experience
• Feedback from instructors and
employees 6
 Toolbox Talks – Meeting the Needs
of Instructors and Employees
• Instructors
– Uncomfortable presenting materials in front of others
– Want to present quality materials that will keep the employees
interest and encourage their participation
• “Typical toolbox materials are “pretty lame”
• “It just goes in one ear and out the other”
• Employees “aren’t paying attention…don’t care to be
there…they want to sign their name and leave.”
– Want materials that are easy to use
• Don’t have pre-training preparation time
• Employees
– Want quality materials that are interesting
• “Sometimes it seems like it never happened”
• Ineffective toolbox talks are “rushed for time…you’re going
to lose your interest right off the bat”
– Want topics that reflect work being done
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– “Get to the point!”
 Pilot Versions of NIOSH Toolbox
Talks for Construction
Building Preventing Falls From Extension Ladders:
Probably the biggest risk in the use of portable ladders is that the ladder will
Construction slip from its position and cause a worker to fall. Incorrect use of ladders may
#2 result in the bottom of ladders slipping outward, or ladders that fall to one side
or another. In the case described above there were several factors that
contributed to the fatal fall. For instance, the sections of extension ladders
Preventing Falls From Extension Ladders should never be separated for individual use. The upper sections rarely have
proper feet. These sections can slip out if used like other portable ladders with
In building construction, falls from ladders occur frequently, and for a variety of feet. It is usually very risky to attempt to carry tools or materials while climbing
reasons. Here are the details of a fatal fall from a section of an extension up or down a ladder. The three-point-contact rule should be followed: two feet
ladder:
and a hand, or two hands and a foot, should always be in contact with the
A two man crew was finishing up on a jobsite after replacing the roofing ladder. Finally, it is usually a good idea to secure the ladder at both top and
material on a bank building. The two workers decided to use the two halves of bottom, using equipment such as ladder spurs; this makes good sense
an extension ladder separately. They placed the lower section of the especially if the ladder will be used in one position for a while. This may seem
extension ladder (with proper feet attached) against a roof over top the drive- like a freak accident because the fatal injury occurred when the worker struck
in banking lanes. One worker took the upper section of the ladder (with his head on the handle end of a broom, but the circumstances of this fall are
rounded end caps, but no feet) to finish some work on a small section of roof very common. Any time a ladder slips or is dislodged from its position while a
over a bank entrance. After completing this task, the same worker placed the worker is on it, that worker is in danger of falling and striking the ground,
upper section against the roof beside the lower section. After retrieving tools, equipment or materials, parts of the building or the ladder itself, causing
including a bristle-head broom, he began to climb the upper section of the serious even fatal injury.
ladder. He was nearly to the roof, when the ladder slid outward at the bottom.
The worker fell with the ladder. The broom, which was being carried with the Other tips for safe ladder use:
bristles down, struck the pavement, and then the victim’s head struck the
handle end of the broom stick. A bank employee heard the fall, looked out a  Non-self-supporting portable ladders should be placed at a horizontal-to-
window, and saw the victim on the ground. The injured worker was semi- vertical angle of no more than 1:4. This simply means that the base
conscious when the emergency squad arrived and transported him to a local should not extend out from the supporting vertical wall more than 1/4 the
hospital for treatment. Shortly after arriving at the hospital, he was taken to a overall height of the ladder.
regional trauma center by air ambulance, where he died the following day.  The side rails of portable ladders should extend at least 3 feet above the
landing. (When this is not possible, secure the side rails at the top to a
Discussion: rigid support and use a grab device.)
Based on this brief description, what do you think went wrong?  Make sure that the weight on the ladder will not cause it to slip off its
support.
Do you think carrying tools, materials and a broom up the ladder contributed
to this fatal fall? What else might have contributed?  Before each use inspect ladders for cracked or broken parts such as
rungs, steps, side rails, feet and locking components.
Have you ever fallen, or nearly fallen from a ladder? Do any of you know  Do not apply more weight on the ladder than it is designed to support 8
anyone who has fallen from a ladder? (Tell us what happened.) How could a Use only ladders that comply with OSHA design standards
fall like this have been prevented? [1926.1053(a)(1)]
 NIOSH Narrative Toolbox Talks
What Worked

• Real-life stories would “get

my attention”
• Stories that reflect incidents Real Life Incident—
in the employees’ A carpenter and his co-worker were
geographical area more overcome by carbon monoxide (CO)
interesting when they entered a basement area
• Discussion questions where a gasoline-powered generator
pertaining to the story was lowered into the basement to
facilitated participation and serve as the source of power. The
interest first worker used a ladder to climb
• Stories made the information down into the basement to check the
easier to understand and generator and was overcome by
remember carbon monoxide. The second
worker, who probably entered the
• Employees and instructors
basement to assist the downed
reported they could “relate
worker, was also overcome. The
to” the person in the story
workers were dead when
• Safety topics reflected work they were found and the
done at the site basement was…….
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 NIOSH Narrative Toolbox Talks
Changes Made

…the emergency squad arrived and transported • Don’t include unnecessary

him to a local hospital for treatment. Shortly details
after arriving at the hospital, he was taken to a
regional trauma center by air ambulance, where • Need variety --“Everybody
he died the following day. dies”
Story Discussion Questions:
Based on this brief description, what do you • Bullet additional information
think went wrong? for easier manipulation by
Preventing Falls From Extension Ladders:
instructor
Probably the biggest risk in the use of portable • Present story discussion
ladders is that the ladder will slip from its questions immediately
position and cause a worker to fall. Incorrect
use of ladders may result in the bottom of afterwards
ladders slipping outward, or ladders that fall to
one side or another. In the case described
• Vocabulary level of text
above there were several factors that should be simple
contributed to the fatal fall. For instance, the
sections of extension ladders should never be
• Text structured to be read
separated for individual use. The upper sections verbatim
rarely have proper feet. These sections can slip
out if used like other portable ladders with feet.
• Pictures added
 The three-point-contact rule should be
followed: two feet and a hand, or two hands
and a foot, should always be in contact with
the ladder. 10
 Revised NIOSH Toolbox Talks
for Construction
Preventing Electrocutions: Overhead
Powerlines and Boom Crane

 Overhead power lines at construction sites can be an

electrocution hazard for construction workers, especially
when construction equipment like cranes, cherry pickers
and hi-lifts are used at the site.
 Overhead powerlines are not insulated, and cranes,
including the boom and cables, are generally made of
conductive materials. Anyone touching the body, cable, or
tagline on a crane when it contacts an overhead powerline
could be electrocuted.

A construction electrocution:
A laborer was part of a crew that was installing steel roof joists using a
boom crane. The laborer was standing by the joists, waiting to hook the
joists to the choker cable, when the crane operator swung the cable
toward him. He grabbed the choker, then grabbed a steel post with his
other hand, to balance himself as the cable kept swinging. The cable
swung out and touched the powerline, became energized, and sent
electricity through the laborer, electrocuting him. They took him to the
hospital, where he was pronounced dead on arrival.

1. How would you prevent an electrocution like this?

2. Do you know anyone who was injured or electrocuted when a 11

crane contacted an overhead powerline? What happened?
 Next Steps...
• Formal study – treatment and control groups
– Impact of real life cases
• Pre-training versus post-training changes in:
– Knowledge gains
– Safety attitudes
– Site observations
– Satisfaction with training
– Potential differences in injury rates
– Instructor feedback
• Ongoing improvements in training lessons
• Development of public domain materials
accessible to all
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For more information please contact:

Terri Heidotting, Ed.D.

National Institute for Occupational Safety and Health
Education and Information Division
4676 Columbia Parkway, C-10
Cincinnati, Oh. 45226
513/533-8325
1-800-35-NIOSH
1-800-356-4674
[email protected]

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