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PSYCHOLOGY OF SAFETY: It won't happen to me

May 31, 2002
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A few weeks ago I received unexpected, grim and shocking news - I have cancer! I tell you this, not for pity or sympathy, but because of the insight I've gained from dealing with this life-threatening diagnosis. The similarities and differences between cancer and occupational injury offer some valuable lessons. I'll give your four:

1) "Accidents" do happen

I was overwhelmed with optimism as I waited for my urologist to reveal the results of the biopsy. The leading indicators gave me a one in five, or 20 percent chance of having prostate cancer. But those statistics were based on the average 60-year-old. I considered myself much less at-risk for cancer than the average person because I don't smoke or consume much alcohol, and I eat very little red meat. I exercise regularly and take antioxidant vitamins daily. Plus, I eat a lot of tomatoes (which contain lycopene - a presumed protector against prostate cancer), and I spend a lot of time in the sun, providing me plenty of vitamin D (another presumed protector against this type of cancer).

I've done everything I know I can do to prevent this relatively common type of cancer. Therefore, my cancer must be an "accident," not only because it was unintentional but because it was unexpected and nonpreventable with my current knowledge, tools and methods.

So what's the connection to safety? Like my cancer, some injuries are not preventable at the time they occur. All of the contributing factors were not known and thus were not controllable. These are accidents. The challenge of safety management is to identify the unknown factors and figure out how to control them. This requires open and candid conversation with everyone involved in the incident, both directly and indirectly.

2) Raise perceptions of risk

Cancer scares more people than any threat of being injured on the job. Why? Cancer is scary because many of its contributing factors are unknown or uncontrollable (as in the genetics that likely contributed to my current plight). But how we talk about workplace "accidents" takes some of the fear out of risk-taking. Many companies include the slogan "all accidents are preventable" in their mission statement. This implies we know enough to eliminate all contributing factors to all injuries and property-damage incidents - that there are no unknown or uncontrollable factors, as there are in cancer.

But there is a lot we don't know about safety management and injury prevention, and so "accidents happen." Through careful analysis of the accident we can define the environmental, behavioral and personal factors that need to change to prevent future mishaps. Then we need to empirically and objectively evaluate corrective action plans designed to effect such change.

Since all of this is easier said than done, there is always the possibility of an "accident." This should raise our perception of personal risk and motivate enthusiastic participation in efforts to reduce the unknown factors contributing to unintentional injury.

3) The power of personal control

Hearing the results of my biopsy was debilitating. At the dinner table I announced, "Well I guess it's just my time. I've lived an active 60 years, and have seen enough of this life." Then my 23-year-old daughter retorted, with tears streaming down her face, "But dad, you haven't seen enough of me."

My daughter's words brought me to my senses. Why am I giving up? I can fight this thing. Famous people like Lance Armstrong, Mayor Rudy Giuliani and General Norman Schwarzkopf have come back strong after a cancer diagnosis - I can too! I began reading books and Internet information about prostate cancer, eventually deciding removal of the prostate is the best therapeutic approach for me. I scheduled surgery with an urologist who has performed more than 350 radical retropubic nerve-sparing prostatectomies.

As soon as I did everything possible to get in control of my problem, I felt much better. Hopefulness took the place of helplessness; motivating stress overcame debilitating distress. We need to make similar transformations in industrial safety.

"It's about being lucky," I hear many workers say. "When it's your time, it's your time." Such apathy is actually supported by certain safety management practices. For example, when companies only measure their safety performance with reactive outcomes like total recordable incidence rates, employees are held accountable for numbers they don't believe they completely control. Offering incentives to keep such group statistics down only makes matters worse. Not wanting to be the "spoiler," many workers won't report minor incidents - hurting overall safety awareness and knowledge in the workplace.

To overcome this common indifference to safety, focus proactively on what people can do each day to prevent injuries. And maintain an open, willing-to-learn perspective whenever an unintentional injury occurs to promote proactive action over reactive inaction.

4) The power of social support

The most important lesson I've learned from my current burden with cancer has been that there is a great amount of social support available when we need it if we are willing to ask for help. As someone once said, "The winds of grace are always blowing, but you have to raise the sail." I raised my sail a few weeks ago with an announcement of being diagnosed with prostate cancer. And since then I've been swept away.

My family reassured me with words like, "We'll help you get through this." My graduate students brought me relevant books and Internet material. My department chairman gave me contact information for reputable urologists. My partners at Safety Performance Solutions offered me encouraging stories of family members who have survived prostate cancer. Students in my university classes expressed appreciation for my teaching and wished me success in overcoming my setback.

Research has shown over and over that social support is critical for overcoming physical illness and emotional conflict. Now I have experienced this firsthand. Through social support I received the information and the inspiration to gain personal control. Indeed, without substantial social support I could not endure the intense and prolonged treatment ordeal required to fight my disease - nor would I want to. Without family, peers and colleagues rooting for me, it's unlikely I'd maintain sufficient motivation and courage to become a long-term cancer survivor.

The relevance to occupational safety is obvious. We need social support to achieve and maintain an injury-free workplace. Personal injury is not preventable without the continual involvement of others. We need coworkers to identify and remove environmental hazards, to give us feedback when we are mindlessly at-risk, to assure us our routine work is worthwhile, to praise us when we go beyond the call of duty for safety, and to help us implement and evaluate safety-improvement methods and interventions.

Unfortunately, we typically don't get the same amount of social support for occupational safety as for fighting cancer. We don't feel vulnerable to a workplace injury, especially with the perception that all injuries are preventable. And we're reluctant to offer safety-related assistance to others unless we get a direct request. Our challenge is to convince people that injury control is more difficult than it looks, and that we need assistance from others in identifying and removing potential contributors to a workplace injury, including environmental hazards and at-risk behaviors.

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