Lipscomb Hester J, Dale Ann Marie, Kaskutas Vicki, Sherman-Voellinger Roslyn, Evanoff Bradley
Division of Occupational and Environmental Medicine, Department of Community and Family Medicine, Duke University Medical Center, Durham, North Carolina 27710, USA.
Am J Ind Med. 2008 Jan;51(1):60-8. doi: 10.1002/ajim.20544.
Falls remain a serious source of morbidity and mortality in residential construction despite considerable knowledge of risk factors and prevention strategies. While training is universally viewed as positive, we know little about its effectiveness in preventing residential falls.
A series of focus groups were conducted with union apprentice carpenters (n = 36) at varied levels of training to elicit input on factors that might influence the effectiveness of residential fall prevention training, including hazard awareness, timing of elements of formal instruction, jobsite mentoring, and workplace norms.
While apprentices identified many residential fall hazards, they voiced little concern about work near unprotected vertical or horizontal openings such as stairwells, window openings or leading edges. On residential jobs, apprentices worked at heights immediately and were often exposed to hazards they had not yet been trained to handle. The quality of mentoring varied tremendously, and things they had been taught in school were often not the norm on these small worksites. Use of fall arrest equipment was uncommon. Job insecurity in this fast-paced work environment influenced behaviors even when apprentices reported knowledge of safe procedures; this was more of a problem for less experienced apprentices.
These data provide compelling evidence that apprentices often do not apply safety principles they have been taught in school in the actual work environment, illuminating how attempts to empower workers through training alone can fall short. The findings have policy implications and demonstrate the importance of measuring more than knowledge when evaluating effectiveness of training.
尽管对危险因素和预防策略有相当多的了解，但跌倒仍是住宅建设中发病和死亡的严重来源。虽然培训被普遍视为有益的，但我们对其预防住宅跌倒的效果知之甚少。
对不同培训水平的工会学徒木匠（n = 36）进行了一系列焦点小组讨论，以获取有关可能影响住宅跌倒预防培训效果的因素的意见，包括危险意识、正规教学内容的时机、现场指导和工作场所规范。
虽然学徒们识别出许多住宅跌倒危险，但他们对在无防护的垂直或水平开口（如楼梯间、窗户开口或前沿）附近工作几乎没有担忧。在住宅工地，学徒们立即在高处作业，经常接触到他们尚未接受过处理培训的危险。指导的质量差异很大，他们在学校学到的东西在这些小工地往往不符合规范。使用防坠落设备并不常见。在这种快节奏的工作环境中，工作不安全感影响了行为，即使学徒们报告了解安全程序；对于经验较少的学徒来说，这更是一个问题。
这些数据提供了令人信服的证据，表明学徒们在实际工作环境中往往不应用他们在学校学到的安全原则，揭示了仅通过培训来增强工人能力的尝试可能如何不足。这些发现具有政策意义，并表明在评估培训效果时，衡量的不仅仅是知识的重要性。
