Safety culture

Explicit exhortations to positive attitudes towards safety may reflect a positive safety culture.

Safety culture is the ways in which safety is managed in the workplace, and often reflects "the attitudes, beliefs, perceptions and values that employees share in relation to safety".^[1] In other words, "the way we do safety around here".^[2]

Definition

The Chernobyl disaster highlighted the importance of safety culture and the impact of managerial and human factors on the outcome of safety performance.^[3]^[4] The term ‘safety culture’ was first used in INSAG’s (1988) ‘Summary Report on the Post-Accident Review Meeting on the Chernobyl Accident’ where safety culture was described as:

"That assembly of characteristics and attitudes in organizations and individuals which establishes that, as an overriding priority, nuclear plant safety issues receive the attention warranted by their significance."

Since then, a number of definitions of safety culture have been published. The U.K. Health and Safety Commission developed one of the most commonly used definitions of safety culture: "The product of individual and group values, attitudes, perceptions, competencies, and patterns of behaviour that determine the commitment to, and the style and proficiency of, an organisation’s health and safety management".^[5] "Organisations with a positive safety culture are characterized by communications founded on mutual trust, by shared perceptions of the importance of safety and by confidence in the efficacy of preventive measures."

... doing a job with inadequate safety equipment is a more certain indicator of a poor safety culture ..

The Cullen Report into the Ladbroke Grove rail crash saw safety culture as "the way we typically do things around here"; this would imply that every organisation has a safety culture – just some a better one than others. The concept of 'safety culture' originally arose in connection with major organisational accidents, where it provides a crucial insight into how multiple organisational barriers against such accidents can be simultaneously ineffective; "with each disaster that occurs our knowledge of the factors which make organisations vulnerable to failures has grown. It has become clear that such vulnerability does not originate from just ‘human error’, chance environmental factors or technological failures alone. Rather, it is the ingrained organisational policies and standards which have repeatedly been shown to predate the catastrophe."^[6]

However it is now also applied (with less certain validity) to individual accidents, and hence has come to relate to a full range of safety behaviors from the wearing of PPE (or not), the quality of delivery of a tool box talk, the quality of shopfloor response to fault conditions – or (what is frequently the main concern for major accidents) the extent to which safety considerations influence high level meetings and management decisions. A new starter or recently arrived sub contractor will soon pick up what the local norms are and be heavily influenced by them. If a tipping point of around 90% compliance is observed then these individuals will be highly likely to comply too – but if these individuals observe a 50:50 split then they may feel they have free choice as whatever they do they won't stand out.

The safety culture of an organization and its safety management system are closely related, but the relationship is not simply that the safety culture complies with the formal safety management system The safety culture of an organization cannot be created or changed overnight; it develops over time as a result of history, work environment, the workforce, health and safety practices, and management leadership: “Organizations, like organisms, adapt".^[7] An organization’s safety culture is ultimately reflected in the way in which safety is approached in its workplaces (whether boardroom or shopfloor) . In reality an organization's safety management system is not a set of policies and procedures on a bookshelf, but how those policies and procedures are implemented into the workplace, which will be influenced by the safety culture of the organization or workplace.^[8] The UK HSE notes that safety culture is not just (nor even most significantly) an issue of shopfloor worker attitudes and behaviours "Many companies talk about ‘safety culture’ when referring to the inclination of their employees to comply with rules or act safety or unsafely. However we find that the culture and style of management is even more significant, for example a natural, unconscious bias for production over safety, or a tendency to focussing on the short-term and being highly reactive."^[9]

Since the 1980s there has been a large amount of research into safety culture. However the concept remains largely "ill defined".^[10] Within the literature there are a number of varying definitions of safety culture with arguments for and against the concept. Two of the most prominent and most-commonly used definitions are those given above from the International Atomic Energy Agency (IAEA) andfrom the UK Health and Safety Commission (HSC).^[11] However, there are some common characteristics shared by other definitions. Some characteristics associated with safety culture include the incorporation of beliefs, values and attitudes. A critical feature of safety culture is that it is shared by a group.^[5]^[12]

When defining safety culture some authors focus on attitudes, where others see safety culture being expressed through behaviours and activities.^[13] The safety culture of an organization can be a critical influence on human performance in safety-related tasks and hence on the safety performance of the organization. There are many proprietary and academic methods available which claim to assess safety culture, but very few have been validated against actual safety performance. The vast majority of surveys examine key issues such as leadership, involvement, commitment, communication, and incident reporting. There are also some safety culture maturity tools that are used in focus group exercises, although few of these (even the most popular) have been linked to company incident rates.

Safety culture and major hazards

.. for major hazards, the first obvious sign of a poor safety culture may be a major accident eg the Challenger explosion

Although there is some uncertainty and ambiguity in defining safety culture, there is no uncertainty over the relevance or significance of the concept.^[11] Mearns et al.^[14] stated that "safety culture is an important concept that forms the environment within which individual safety attitudes develop and persist and safety behaviours are promoted". With every major disaster a large amount of resources are set aside in order to identify factors that might have contributed to the outcome of the event. These inquiries pay particular attention to detail and prove to be an invaluable source of information in identifying factors that "make organisations vulnerable to failures" From such inquiries, a pattern emerges; organizational accidents are not a result of randomly coinciding ‘operator error’, chance environmental or technical failures alone. Rather, the disasters are a result of a breakdown in the organization’s policies and procedures that were established to deal with safety, and the breakdown flows from inadequate attention being paid to safety issues. In the UK, investigations into incidents such as the sinking of the MS Herald of Free Enterprise passenger ferry (Sheen, 1987)Kings Cross underground station fire (1987) the Piper Alpha oil platform explosion (1988)^[15] raised awareness of the effect of organisational, managerial and human factors on safety outcomes, and the decisive effect of 'safety culture' on those factors.^[16] In the US , similar issues were found to underlie the Space Shuttle Challenger disaster, subsequent investigation of which identified cultural issues as influencing numerous "flawed" decisions on behalf of NASA and Thiokol management which had contributed to the disaster. The lesson drawn from the UK disasters was that

"it is essential to create a corporate atmosphere or culture in which safety is understood to be and is accepted as, the number one priority".^[15]^:300

Reason^[7]^:294 considers an ideal safety culture to be "the ‘engine’ that drives the system towards the goal of sustaining the maximum resistance towards its operational hazards" regardless of current commercial concerns or leadership style. This requires a constant high level of respect for anything that might defeat safety systems and ‘not forgetting to be afraid’. Complex systems with defence-in-depth (such as would be expected for a major hazard plant) become opaque to most if not all of their managers and operators. Their design should ensure that no single failure will lead to an accident, or even to a revealed near-miss, and there are no timely reminders to be afraid. For such systems, Reason argues, there is an ‘absence of sufficient accidents to steer by’ and the desired state of ‘intelligent and respectful wariness’ will be lost unless sustained by the collection, analysis and dissemination of knowledge from incidents and revealed near misses. It is very dangerous to think that an organization is safe because no information is saying otherwise, but it is also very easy. An organisation that underestimates danger will be insufficiently concerned about poor working conditions, poor working practices, poor equipment reliability, and even identified deficiencies in the defences-in-depth: the plant is still safe ‘by massive margins’, so why rock the boat?^[7] Hence, without conscious efforts to prevent it, complex systems with major hazards are both particularly vulnerable to (and particularly prone to develop) a poor safety culture.

Safety culture and accidents to individuals

Over the years, a lot of attention has focused on the causes of occupational incidents.^[17] When incidents occur in the workplace it is important to understand what factors (human, technical, organizational) may have contributed to the outcome in order to avoid similar incidents in the future. Through developing an understanding of why and how incidents occur, appropriate methods for incident prevention can be developed (Williamson and Feyer 2002). In the past, improvement in workplace safety or in the control of workplace risks has come about through the provision of safer machinery or processes, the better training of employees, and the introduction of formal safety management systems. Consequently (it is argued) in a workplace which has benefitted from these improvements, many of the residual workplace accidents are now the result of operator error; more specifically the error of doing a job a different way from the safe way they have been trained to.^[18] Hence, there is now a move to apply the concept of safety culture at the individual level; worker behaviour is influenced by the safety culture of an organization, so safety culture could affect the worker injury rate.^[13] Although the overall culture of an organization may have an impact on the behaviour of employees, much research has focused on the impact of more localised factors (i.e. supervisors, interpretation of safety policies) in the specific culture of individual workplaces, leading to the concept of a "Local safety climate, which is more susceptible to transition and change".^[13]^:367 This would also suggest that safety climate operates on a different level than safety culture. Mearns et al.^[14] note that although safety culture was a concept originally used to describe the inadequacies of safety management that result in major disasters, that the concept is now being applied to explain accidents at the individual level, although as they emphasize, "The validity of the safety culture concept with regard to individual accidents is yet to be ascertained" (p. 643).

Pidgeon and O’Leary argue "a ‘good’ safety culture might reflect and be promoted by four factors^[12]

“senior management commitment to safety”;
realistic and flexible customs and practices for handling both well-defined and ill-defined hazards;
continuous organisational learning through practices such as feedback systems, monitoring and analysing;
and a care and concern for hazards which is shared across the workforce.

Only two of those factors are within the gift of a management system, and clearly leadership as well as management would be necessary

Several papers (eg - for the UK offshore oil industry -Mearns et al (2000)^[14])have sought to identify specific safety management practices that act as a predictor of (conventional) safety performance. Shannon (1998)^[19] gives details of many reported surveys in Canada and the US and reports the conclusions of Shannon et al (1997).^[20] reviewing them. Variables consistently related to lower injury rates included both those which would be specified by a safety management system: and purely cultural factors :

'Safety Management' factors	Cultural/social factors
delegation of safety activities	(more general)empowerment of the workforce
conduct of safety audits	good relations between management and workers
monitoring of unsafe worker behaviors	encouragement of a long-term commitment of the work force
safety training - initial and continuing	low turnover and longer seniority
good housekeeping	active role of top management

Process safety culture, behavioural safety

Control of major accident hazards requires a specific focus on process safety management over and above conventional safety management, and Anderson(2004) has expressed concern at the implications for management of major hazards of the extension of the 'safety culture' concept to justify behavioural safety initiatives to reduce injury (or lost time accident) rates by improving safety culture.^[21] He argues that 'loss of containment' rates on major hazard sites give a good indication of how well the major accident risks are managed; UK studies show no significant correlation with 'lost time accident' rates. Furthermore, behavioural safety has come to be targetted on reducing the propensity for error of front line staff by getting them to be more careful; UK studies have shown that the vast majority of frontline errors are not free-standing, but are triggered by preceding errors by more senior grades. (In a study of over 700 loss of containment events in the 1990s - of 110 incidents due to maintenance, only 17 were due to a failure to ensure that planned maintenance procedures were followed: 93 were due to a failure by the organisation to provide adequate maintenance procedures. Under 6% of incidents were due to front line personnel deliberately not following procedures.).^[21] There can be no objection to behavioural safety initiatives to to reduce the rate of lost time accidents, provided that they do not divert effort from the management of major hazards and that a low lost time accident rate does not give rise to unwarranted complacency about the major hazard.

References

↑ Cox, S. & Cox, T. (1991) The structure of employee attitudes to safety - a European example Work and Stress, 5, 93 - 106.
↑ ZCBI (1991) Developing a Safety Culture., Confederation of British Industry, London.
↑ Flin, R., Mearns, K., O'Conner, P. & Bryden, R. (2000) Measuring safety Climate: Identifying the common features Safety Science 34, 177 - 192.
↑ IAEA, (1991) Safety Culture (Safety Series No. 75-INSAG-4) International Atomic Energy Agency, Vienna
↑ 5.0 5.1 HSC (Health And Safety Commission), 1993. Third report: organising for safety. ACSNI Study Group on Human Factors. HMSO, London.
↑ Gadd, S; Collins, A M (2002). Safety Culture: A review of the literature HSL/2002/25. Sheffield: Health & Safety Laboratory. p. 3. |accessdate= requires |url= (help)[url=www.hse.gov.uk/research/hsl_pdf/2002/hsl02-25.pdf]
↑ 7.0 7.1 7.2 Reason, J. (1998) Achieving a safe culture: theory and practice Work and Stress, 12, 293-306.
↑ Kennedy, R. & Kirwan, B., (1995) The failure mechanisms of safety culture. In: Carnino, A. and Weimann, G., Editors, 1995. Proceedings of the International Topical Meeting on Safety Culture in Nuclear Installations, American Nuclear Society of Austria, Vienna, pp. 281–290.
↑ "Organisational Culture". Health and Safety Executive. Retrieved 7 April 2015. (see Aberfan disaster, Flixborough disaster, for two notable UK events that may have informed this view)
↑ Guldenmund, F. W. (2000) The nature of safety culture: a review of theory and research Safety Science, 34, 215-257.
↑ 11.0 11.1 Yule, S. (2003) Safety culture and safety climate: a review of the literature. Industrial Psychology Research Centre 1-26.
↑ 12.0 12.1 Pidgeon, N. & O'Leary, M. (2000) Man-Made Disasters: why technology and organizations (sometimes) fail. Safety Science, 34, 15-30
↑ 13.0 13.1 13.2 Glendon, A. I., Clarke, S. G. & McKenna, E. F. (2006) Human Safety and Risk Management, Florida, CRC Press.
↑ 14.0 14.1 14.2 Mearns, K., Whitaker, S. M. & Flin, R. (2003) Safety Climate, safety management practice and safety performance in offshore environments Safety Science, 41, 641-680.
↑ 15.0 15.1 Cullen, W.D., 1990. The Public Inquiry into the Piper Alpha Disaster. HMSO, London.
↑ Reason, J. (1990) The contribution of latent human failures to the breakdown of complex systems. Philosophical Transactions of the Royal Society Series B 327, pp. 475–484.
↑ Haslam, R. A., Hide, S. A., Gibb, A. G. F., Gyi, D. E., Pavitt, T., Atkinson, S. & Duff, A. R. (2004) Contributing factors in construction accidents Applied Ergonomics 36, 401-415.
↑ HSE Human Factors Briefing Note No. 7 Safety Culture at "Organisational Culture". Health And Safety Executive. Retrieved 10 April 2015.
↑ Shannon, Harry (1998). Firm level organizational practices. A report to the Royal Commission on Workers' Compensation in British Columbia. Toronto: Institute for Work and Health. Retrieved 11 April 2015.
↑ Shannon, H. S., Mayr, J. & Haines, T. (1997) Overview of the relationship between organizational and workplace factors and injury rates Safety Science, 26, 201-217.
↑ 21.0 21.1 Anderson, M (2004). Behavioural safety and major accident hazards: Magic bullet or shot in the dark? in Conference Proceedings, Hazards XVIII Symposium, 24 November 2004. (PDF). Manchester: IChemE/UMIST. Retrieved 10 April 2015.