Joe is a 17-year-old who carts heavy boxes from delivery trucks to the basement of the local retail store where he works part-time. Aranja, 57, arrived in Canada three years ago and has found a job as a home-care worker. Henry, 36, takes whatever manual jobs he can get through the temporary work agency he has signed up with.
Each one of these workers is called “vulnerable”—a term being used increasingly in occupational health and safety (OHS) to describe those at a greater risk of work injury. Yet, as the situations of Joe, Aranja and Henry show, the term can refer to very different types of workers.
So what exactly makes these workers vulnerable? Are they the same factors across all groups of workers, or do different groups face different risk factors? Institute for Work & Health (IWH) Scientist Dr. Peter Smith set out to help answer these questions. His research resulted in a new 29-item questionnaire that measures the extent to which workers are at increased risk of work-related injury and illness.
Smith shared the questionnaire and related research findings at a plenary held at the Institute earlier this year, now posted as a slidecast: www.iwh.on.ca/plenaries/2015-jan-20. His study on the development of the questionnaire has since been published in the September 2015 edition of the journal Accident Analysis & Prevention (Vol. 82, pp. 234-243: doi:10.1016/j.aap.2015.06.004). The open-access paper is available to all to read, and offers a link to another, shorter slidecast summarizing his work on the development of the measure.
Using this measure, we can learn more about the patterns of different types of vulnerability across the labour market, which can inform the development of more appropriately tailored primary prevention interventions, says Smith.
Measuring factors that place workers at increased risk of injury is a more proactive approach to injury prevention than waiting for injuries to occur and then taking action.
Four dimensions of vulnerability
Protecting vulnerable workers is a priority within Ontario’s health and safety prevention system. It was a key theme in the December 2010 report of Ontario’s Expert Advisory Panel on Occupational Health and Safety. In the wake of that report, the Ministry of Labour established a Vulnerable Workers Task Group to provide advice on how to better protect vulnerable workers.
The current use of the term “vulnerable workers” brings to mind certain demographics of workers (e.g. new immigrants, young workers) or particular types of work (e.g. work in small business, temporary work). This use is problematic, says Smith. It implies that OHS vulnerability is innate to certain types of work or workers, suggests that OHS vulnerability can’t be changed, and fails to acknowledge that broader factors can play a role.
To address these problems, Smith and his team examined OHS vulnerability through four dimensions that can lead to an increased risk of injury:
- the hazards workers face;
- the workplace- or organizational-level protection they’re offered in the form of policies and practices;
- their awareness of their health and safety rights and responsibilities; and
- the extent to which they’re empowered to take part in work-related injury prevention and to refuse unsafe work.
Finding the right questions
Using these dimensions, the research team defined vulnerability as arising when workers are exposed to hazards in combination with inadequate workplace policies and procedures and/or low OHS awareness and/or a workplace culture that discourages workers’ participation in injury prevention. Turning to the literature, Smith and his team came up with a list of 97 potential questions covering the four dimensions. Then, thanks to feedback from focus groups held in Ontario and in the state of Victoria, Australia (where this study was partly funded), the team further reduced the number of questions to 64.
The team then conducted a pilot survey with 328 respondents in Ontario and British Columbia, as well as a follow-up survey of 62 of these respondents. The process identified questions that did not have a high response rate, a high test-retest reliability (i.e. questions were not answered the same way even though nothing had in fact changed), or high correlation with similar items. These questions were removed, leaving 29 items in the final survey (see below for the full list of questions).
Using this measure, Smith and his team examined whether groups labelled as “vulnerable” are vulnerable in similar ways. They found that, while some groups are vulnerable across all dimensions (e.g. young workers), other groups like workers in small businesses and newcomers are more vulnerable in some dimensions than others.
For example, workers in small businesses are more likely to be exposed to workplace hazards and inadequate workplace policies and procedures. But they are no more likely to be exposed to cultures that discourage worker participation.
A measure like ours can be used both at one point in time to measure vulnerability in the labour force, and over time to measure changes in vulnerability before and after a program is introduced, says Smith. With respect to the latter, Smith recently received a grant to use the measure to examine changes in OHS vulnerability in Ontario associated with the introduction in July 2014 of mandatory awareness training for all workers and supervisors in the province.
Note: The online version of this article was updated in August 2015 to include the link to the open-access article in the journal Accident Analysis & Prevention on the development of the vulnerability measure.