Poplin Gerald S, Pollack Keshia M, Griffin Stephanie, Day-Nash Virginia, Peate Wayne F, Nied Ed, Gulotta John, Burgess Jefferey L
Center for Applied Biomechanics, University of Virginia, Charlottesville, USA.
Mel & Enid Zuckerman College of Public Health, University of Arizona, Tucson, USA.
BMC Public Health. 2015 Apr 19;15:407. doi: 10.1186/s12889-015-1675-8.
Formalized risk management (RM) is an internationally accepted process for reducing hazards in the workplace, with defined steps including hazard scoping, risk assessment, and implementation of controls, all within an iterative process. While required for all industry in the European Union and widely used elsewhere, the United States maintains a compliance-based regulatory structure, rather than one based on systematic, risk-based methodologies. Firefighting is a hazardous profession, with high injury, illness, and fatality rates compared with other occupations, and implementation of RM programs has the potential to greatly improve firefighter safety and health; however, no descriptions of RM implementation are in the peer-reviewed literature for the North American fire service.
In this paper we describe the steps used to design and implement the RM process in a moderately-sized fire department, with particular focus on prioritizing and managing injury hazards during patient transport, fireground, and physical exercise procedures. Hazard scoping and formalized risk assessments are described, in addition to the identification of participatory-led injury control strategies. Process evaluation methods were conducted to primarily assess the feasibility of voluntarily instituting the RM approach within the fire service setting.
The RM process was well accepted by the fire department and led to development of 45 hazard specific-interventions. Qualitative data documenting the implementation of the RM process revealed that participants emphasized the: value of the RM process, especially the participatory bottom-up approach; usefulness of the RM process for breaking down tasks to identify potential risks; and potential of RM for reducing firefighter injury.
As implemented, this risk-based approach used to identify and manage occupational hazards and risks was successful and is deemed feasible for U.S. (and other) fire services. While several barriers and challenges do exist in the implementation of any intervention such as this, recommendations for adopting the process are provided. Additional work will be performed to determine the effectiveness of select controls strategies that were implemented; however participants throughout the organizational structure perceived the RM process to be of high utility while researchers also found the process improved the awareness and engagement in actively enhancing worker safety and health.
规范化风险管理（RM）是一种国际公认的减少工作场所危害的流程，其定义步骤包括危害界定、风险评估以及控制措施的实施，所有这些都在一个迭代过程中进行。虽然欧盟所有行业都有此要求且在其他地方广泛使用，但美国维持基于合规的监管结构，而非基于系统的、基于风险的方法。与其他职业相比，消防是一项危险的职业，受伤、患病和死亡率都很高，实施风险管理计划有可能极大地改善消防员的安全与健康；然而，北美消防部门的同行评审文献中没有关于风险管理实施情况的描述。
在本文中，我们描述了在一个中等规模的消防部门设计和实施风险管理流程所采用的步骤，特别关注在患者转运、火场和体育锻炼程序中对伤害风险进行优先级排序和管理。除了确定参与式主导的伤害控制策略外，还描述了危害界定和正式的风险评估。进行了过程评估方法，主要是为了评估在消防服务环境中自愿采用风险管理方法的可行性。
风险管理流程得到了消防部门的广泛认可，并促成了45项针对特定危害的干预措施的制定。记录风险管理流程实施情况的定性数据显示，参与者强调了：风险管理流程的价值，特别是参与式自下而上的方法；风险管理流程对于分解任务以识别潜在风险的有用性；以及风险管理在减少消防员受伤方面的潜力。
如此实施的这种基于风险的方法用于识别和管理职业危害与风险是成功的，并且被认为对美国（及其他）消防服务是可行的。虽然实施任何此类干预措施确实存在一些障碍和挑战，但提供了采用该流程的建议。将开展更多工作以确定所实施的选定控制策略的有效性；然而，整个组织结构中的参与者都认为风险管理流程非常有用，同时研究人员也发现该流程提高了积极加强工人安全与健康的意识和参与度。
