This summer’s Prevention through Design (PtD) Workshop – convened July 9–11th in Washington by the National Institute for Occupational Safety and Health (NISOH) – was the broadest and most aggressive effort in more than a decade to push American occupational safety and health to the next level. In tackling this goal, however, the conference also revealed some significant obstacles that remain.

The basic purpose of the conference was the development of a strategic plan to promote PtD. Also known as Design for Safety, the PtD concept maintains that safety in the construction, maintenance, use and eventual disposal of most productive equipment and facilities can be greatly enhanced if more practical attention is paid to safety at the design stage. Data show that about a third of all workplace injuries are design-related.

A corollary of PtD is that facilities designed with safety in mind, in addition to being safer, are also less expensive to build, operate, maintain and demolish.

After a first day of PtD overviews by prominent advocates, the conference divided participants by industrial sector for more in-depth examinations on day two. Construction was one focus, as was AFF (agriculture, forestry and fishing), manufacturing, mining, services, health care/social assistance, transportation/warehousing and wholesale/retail trade. In each sector, participants looked into the state of PtD practice, policy, research and education and set up committees to continue the investigation and dialogue after the Workshop’s conclusion. On the third day, results of the sector discussions were shared in a general session.

Though no dramatic program or action agenda emerged from the conference, significant new ground was broken. For the first time, NIOSH brought all the larger key players together, revealing that most of them share a recognition that PtD works, not only for workers but also for companies. The conference also showed that the knowledge of how to implement effective PtD programs in every sector of the economy already exists.

“The question isn’t how to do safer design,” says LHSFNA Occupational Safety and Health Division Director Scott Schneider, who addressed the conference on its opening day, “but how to spread that knowledge and develop it into an accepted standard for the nation as a whole.”

Despite the apparent success of design for safety programs in, for example, Britain and Australia, PtD has not “taken off” in America. In Europe and other places where new projects are now consistently designed with PtD in mind, the advance was led by national governments that established and enforced design standards across all industry. However, it is unlikely that a regulatory agenda will lead the effort in the U.S. In the absence of such government initiative, market forces and promotion by OSH professionals will have to drive the transformation.

“Market forces” come down to the economic interests of the vast expanse of entities across all sectors of American industry. Among these are many of the nation’s largest companies that already incorporate PtD in their production. At the conference, for instance, the CEO of Kaiser-Permanente, a health care provider, spoke of the importance of designing hospitals with built-in supports above each bed so that nurses can use hoists instead of their backs to lift patients. Similarly, a vice president from Sikorsky Aircraft explained that all its helicopters and manufacturing facilities are now designed so that aircraft construction workers can easily attach themselves to fall protection supports. In another example, a corporate officer from Alcan reported that the company has achieved an 86 percent drop in fatalities and an 87 percent cut in lost time incidents since it implemented PtD principles in its warehouse facility construction.

More directly relevant to Laborers and LIUNA signatory contractors is the application of PtD principles in the construction industry. Remarks by officials from such companies as Bechtel and Washington Group International demonstrated that the world’s largest construction companies already find PtD fundamental to their entire corporate culture. Indeed, design-build firms – companies that both design and build facilities – have the incentive and the ready control necessary to spur design for safety, and they are national leaders in PtD. Also, for very large companies, whether in construction or otherwise, that self-insure their operations, PtD helps keep long-range losses to a minimum. In addition, companies that plan to operate, maintain and someday demolish and reconstruct their own facilities see the value of using designs that will help ensure safety at every stage in their ownership.

Thus, in general, workers, large owners and large builders have the most to gain from PtD and are already the most “on board” with its development and use. On the other hand, smaller companies and owners, along with the design and engineering professions, have yet to embrace the concept.

For the most part, American architects and engineers remain unaware that workplace safety might even be enhanced by their attention to PtD. Indeed, as the testimony of the architects and engineers who participated in the conference made clear, both professions rarely address the topic of workplace safety at any point in their training. Even after graduation and employment, they seldom visit actual worksites. Revealing just how poorly his profession understands PtD, one architect suggested that his peers might pit their artistry against safety. “PtD threatens to engage us in an area in which we are not trained,” he said. “It pushes our limits and raises the value judgment: is great safety more important than great design?”

Engineers also spoke of “unsophisticated clients” (e.g., smaller owners) who, themselves, know little if anything about safety and do not or cannot impose safety requirements on their requests for design or engineering bids. Moreover, the architect pointed out that architectural firm attorneys, as a matter of standard practice, coach the profession not to accept responsibility for safety, saying it is the sole responsibility of builders and contractors. And, since under present American law, architects and engineers are virtually immune from liability for worker injuries, no direct benefit encourages either profession to take safety more seriously.

For safety professionals – notably led by NIOSH, which convened the Workshop – the key to long-range success seems to rest in marshalling the experience, resources and outlook of big corporate and other institutional players to influence those who do not now embrace PtD.

“Over the last 25 years, we’ve made significant progress in reducing occupational injuries and deaths in the United States, but we seem to have reached a plateau,” says Schneider. “To get to the next level, we have to make PtD a core element of our national effort. If we do that, we take a large percentage of today’s hazards right out of the equation.”

[Steve Clark]