RM-Insight (Vol 7 No 3)

AMERICAN SOCIETY OF SAFETY ENGINEERS www.asse.org
A TECHNICAL PUBLICATION OF ASSE’S RISK MANAGEMENT/INSURANCE PRACTICE SPECIALTY
RM/Insight
This Issue
Beat Your
Competition
3
Joe’s Story
4
A Primer in Risk
Management
7
Information
Technology
10
Catching Up
with AIA
14
Motor Vehicle
Safety
17
Five Costly
Mistakes
19
The Draft ISO
Standard 31000
21
Z359 Fall
Protection Code
22
2008
Vol. 7 • No. 3
It is well known and generally accepted that
fatigue can contribute to accidents. When we con-
sider fatigue as a factor, we usually think of a driv-
er falling asleep at the wheel. But fatigue usually does
not have such a severe result. Inattentiveness, loss of
alertness, carelessness and poor judgment are just
some of the reported accident causes that may have
root in fatigue. Fatigue is most severe with 24-hour-a-
day operations. Operating trucks, cars, forklifts, con-
struction equipment and even plant machinery can be
impacted by operator fatigue. Accidental crashes can
result in loss of driver’s license, property damage,
reduction in company revenues and net profits and
increased insurance costs.
What Is Fatigue?
Fatigue is a state of mind or body resulting from
prolonged activity or lack of sleep. General fatigue is
most often due to inadequate rest, quality and quantity
of sleep, lost or disrupted sleep. Other factors that
impact fatigue include individual physical fitness and
endurance, environmental conditions (heat, humidity,
cold, noise, vibration, altitude, etc.), nature of the work
(sustained, constant attention and monotonous work is
more fatiguing than intermittent, self-paced work),
time of day, individual differences and motivation.
Acute fatigue can be relieved with a couple of
days off with longer sleep periods. Chronic fatigue
results from repeated, cumulative stress (mental
burnout) and may require an extended break or vaca-
tion with longer sleep periods. Adequate quantity
and quality of sleep is the single most important fac-
tor in controlling fatigue.
The National Sleep Foundation, the American
Trucking Association, the U.S. Department of
Transportation (DOT) and other authoritative groups
understand the issue of fatigue. DOT has gone so far
as to promulgate regulations for pilots, truck drivers
and others restricting their hours of service. This arti-
cle will discuss these issues as they relate to drivers
operating commercial motor vehicles.
Some find the driver hours of service rules con-
fusing. Simply stated, the rules for truck drivers are:
•Drivers may drive up to 11 hours in a 14-hour
on-duty window after they have been off duty for 10
hours or more. The 14-hour on-duty window may
not be extended for meal and fuel stops, etc.
•Drivers may not drive after being on duty for 60
hours in 7 consecutive days or 70 hours in 8 consec-
utive days, but drivers can “restart” the 7/8-day peri-
od anytime a driver has 34 hours off duty.
•Drivers using a sleeper berth must take at least 8
consecutive hours in the sleeper berth, plus 2 consec-
utive hours either in the sleeper berth, off duty or any
combination of the two.
Truck Drivers & Fatigue:
Risk & Insurance Costs
By Scot Salzman, CSP, ARM, CPCU, ALCM
continued on page 5
I
Deterioration of vigilance
and alertness
–loss of attention
–slower reactions
–poor response
Diminished ability to
perform work
–impaired judgment
–desire for rest
–loss of motivation
Fatigue

his issue of RM/Insight focuses
on two high-severity-type inci-
dents we address in risk manage-
ment and insurance—driver fatigue
among truck drivers and disaster plan-
ning. Continuing our campaign to provide
members with tools for influencing their
clients and businesses, another install-
ment in disaster response and recovery is
provided. These excellent fact-based arti-
cles contain sound advice.
For some companies, trucking opera-
tions require a degree of management to
which many companies are either unwill-
ing or unable to devote adequate atten-
tion. For manufacturers, moving product
by fleet operations is essential to their
core expertise—making things and ship-
ping them to market. For service busi-
nesses, the focus is more on getting the
job done versus getting to the job. Public
entities, where virtually all jobs require
some form of travel, tend to focus on job
skills, not driving skills. Full-time, over-
the-road motor cargo carriers can better
manage their automobile exposures
because it relates directly to their core
expertise—fleets. CDL requirements also
seem to influence businesses’ attention to
fleet management to the detriment of
autos and light trucks.
However, my experience tells me we
are more exposed to catastrophic loss
from incidental vehicle operations, such
as errands, executives and outside sales
forces, where driver selection, supervision
and training are not well developed. The
safety director of a construction company
leaves a golf tournament and crashes—
alcohol is involved. Two senior executives
of a small company are killed in the same
crash, with the company unable to contin-
ue after the loss. A minor crash turns into
a major claim when a business reason for
the trip is discovered.
Two articles, “Truck Drivers and
Fatigue: Risk and Insurance Costs” by
Scot Salzman and “Motor Vehicle Safety:
Managing Your Company’s Risk Factors”
by Amy Stewart contain tips you can use
immediately. Salzman’s case study in-
cludes examples of results obtained with
attention to driver fatigue. This is the hard
data we need in our jobs.
Although 2007 was one of the quietest
years for weather-related catastrophes,
mini-catastrophes still occur. Atlanta
hotels affected by a March tornado still
require response and recovery planning.
A disaster response and recovery plan
should be part of your strategic business
plan. Appealing to the competitive nature
of the entrepreneur by “beating your
competition” seemed to work well when
this was presented at a business forum
luncheon. After all, we are paid to get
results.
I hope you have responded to the call
for papers for the Risk Management/In-
surance Practice Specialty (RMIPS) loss
control symposium, which will be held
Sept. 18-19, 2008, in Chicago. CNA has
graciously agreed to host this event at its
headquarters in downtown Chicago. We
are excited to develop a professional
development event for broker and carrier
loss control members—the majority of
our membership. And since most safety
and risk management positions in indus-
try are in staff-reporting roles, the sympo-
sium will address influencing
management, emerging technologies and
other topics to help us better identify,
evaluate and control risk.
We will provide you with more infor-
mation on the symposium, including a
final agenda and program, at Safety 2008
in Las Vegas, NV, this June.
RMIPS will sponsor nine sessions at
Safety 2008 and the Training and Com-
munications Branch will sponsor six ses-
sions. They are:
•Safety Heroes and the Actuary’s
Chamber of Secrets—Terrie Norris.
2 Vol. 7 ● No. 3
T
AAddmmiinniissttrraattoorr’’ss
MMeessssaaggee
OFFICERS
ADMINISTRATOR
Mark Oldham
804.273.1508
moldham@ffic.com
ASSISTANT ADMINISTRATOR
Leslie Batterson
312.281.0154
leslie-batterson@ars.aon.com
NEWSLETTER EDITOR
Jim Newberry
808.564.8244
jnewberry@islandinsurance.com
COMMITTEES
AWARDS & HONORS
Dirk Duchscherer
dduchscherer@iwins.com
CONFERENCES & SEMINARS
Steve NyBlom
snyblom@cao.lacounty.gov
MEMBERSHIP DEVELOPMENT
Bob McEldowney
rmceldow@lava.net
NOMINATIONS
Fran Sehn
fran.sehn@HRH.com
WEBSITE CHAIR
Patricia Kagerer
pkagerer@cfjordan.com
STAFF LIAISON
Rennie Heath
847.768.3436
rheath@asse.org
NEWSLETTER DESIGN & PRODUCTION
Susan Carlson
ASSE headquarters staff
scarlson@asse.org
RM/Insight is a publication of the American
Society of Safety Engineers (ASSE) RM/I Practice
Specialty, 1800 E. Oakton St., Des Plaines, IL
60018 and is distributed free of charge to mem-
bers of the RM/I Practice Specialty. The opinions
expressed in articles herein are those of the
author and are not necessarily those of ASSE.
Technical accuracy is the responsibility of the
author. Please send address changes to ASSE at
the address above; fax to (847) 768-3434; or send
via e-mail to customerservice@asse.org.
RRMM//II
PPrraaccttiiccee SSppeecciiaallttyy
RM/Insight
Mark Oldham
continued on page 15

ypically, companies that experi-
ence a disaster, either natural or
man-made, are severely chal-
lenged in not only reopening, but in
remaining in business after reopening. In
cases of localized disaster, like fire or
actions of employees, customers will
become accustomed to trading at other
businesses and without substantial and
costly incentives, reluctant to return to
your business. According to studies,
fewer than half of businesses closed by
fire are still in business 2 years later. In
cases of widespread natural disasters like
Hurricane Katrina, customers relocate
and the business base evaporates until
recovery progresses. However, businesses
with effective planning will be there first
when customers return.
A plan that will identify and minimize
the potential for disaster, mitigate effects,
restore critical operations quickly, recover
remaining operations and drive toward
full restoration of operations can reduce
the timeline from when a disaster is
declared to when it closes.
Companies with plans in place can
progress quickly through these steps.
Without a plan, each step becomes a hur-
dle. Misdirected priorities or attention to
noncritical restoration can slow or prevent
recovery.
Companies in New Orleans, LA,
specifically one bank financial processing
center with flooded offices, saw no inter-
ruption in critical operations. According
to the Atlanta Journal Constitution, some
businesses have prospered by reopening
and responding to community needs.
Others have yet to reopen.
By following a plan focused on pre-
vention, mitigation, critical restoration,
recovery and restoration, any company,
large or small, can be back in operation
before the competition. If your business
comes back up first, your customers will
not be lured away while you are closed
and you will be the first open shop when
your customers come back and need your
services. The key is having a plan estab-
lished in advance and, just as importantly,
clear priorities for first-tier attention to
crucial operations.
Key Elements of a
Disaster Recovery Plan
Identification
This step is the assessment of poten-
tials that could affect your business.
Besides the obvious hazards of wind-
storm, flood and fire, consider man-made
hazards of workplace violence and terror-
ist attacks.
Consider that these may not happen
directly at your business. An attack in the
immediate area will definitely affect and
perhaps place your business and employ-
ees in danger.
Once you have identified hazards,
an assessment of the potentials will
directly impact the amount of resources
you devote to their management. You
must consider the potential frequency
(the chances something may happen)
against the potential impact (the effects
of the hazard). A business in El Paso,
TX, will need to consider windstorms
but in a different context than a business
in Galveston, TX.
Prevention
Although these factors may already be
set in concrete by location of your business
or the type of building you have, controls
can be implemented. Smoke detectors, fire
sprinklers and thorough employee screen-
ing practices can reduce the possibility of a
localized disaster. Employee violence is a
continuing business interruption issue—
limiting prevention efforts to natural disas-
ter potentials can limit the possible benefit
of your planning.
For natural disasters, prevention must
start with location and site protection. If
flooding is a potential, attention to site
grading, landscaping and location of sew-
ers and drains subject to reverse flow is
needed. Storage of stock on floor level
means any flooding will cause stock dam-
age. Placing stock on pallets will give
time to address the flooding or to relocate
stock before it is soaked. A recent roof
leak caused more than $500,000 in dam-
age to a small business when boxes
stacked on floor level became water-
soaked, collapsed and tossed boxes
stacked above into the water.
If your location is susceptible to light-
ning strikes, fixed lightning suppression
on the building and surge suppressors for
crucial equipment may be needed.
Offsite data backup is part of preven-
tion. Duplicate records of crucial data,
such as accounts receivable and engineer-
ing design specifications that cannot be
recovered, must be protected. Systems
that allow remote access, should you be
prevented from operating from your main
location post-disaster, can be vital in
recovery efforts.
You must also consider man-made dis-
asters. Workplace violence continues to
be the leading cause of workplace fatali-
ties for women. For example, if your
business deals with the public in high-risk
situations, like loan collections or expen-
sive jewelry sales, you might want to
develop code words or phrases employees
can use to secretly alert each other of
dangers. One jewelry client with whom I
worked had phrases to use when a sales-
person wanted someone to be with them
to help control the items shown or to call
the police.
Mitigation
These actions are taken during or
immediately after the disaster. Ensuring
adequate emergency response, first aid
and food/water for your employees is the
top priority.
For property, know how to turn off
the fire sprinkler system. Hotel guests
are notorious for using sprinkler heads
for coat hangers and frequently with dis-
astrous results. This happened at one
hotel and the night staff did not know
where the valve to turn off the system
was located. It took the manager 30 min-
utes to drive in; by then, water had flow-
ed down three stories and caused more
than $80,000 in damage. The damage
also included replacing a window that
staff had broken so some of the water
spray could go outside the building.
Most importantly, having a preestab-
lished relationship with contractors for
plumbing, electrical and HVAC can put
your company at the top of the list for
RM/Insight ● 3
Beat Your Competition Back to
Business after Disaster Strikes
By Mark D. Oldham, CSP
T

oe was a good man. His wife and
children loved him. Although he was
educated only through the 11th
grade, as a result of his nurturing and
love, his two children excelled at school.
Joe worked at a plastics additive plant
two miles from his house, a small opera-
tion owned by Baritone Plastics and
Foam Co. Joe joined the company in
1995 as a forklift truck driver.
In 2001, Baritone received its AE 9000
aerospace industry quality manufacturing
system registration. To do that, the company
hired Sheila, a graduate of the management
department at nearby Findlay College.
Sheila had overseen the development of
quality policies, procedures, audits and
records necessary to obtain Baritone’s AE
registration. This registration allowed the
company to qualify as a supplier of plastic
parts and chemical additives for the cockpit
liners used in small aircraft. With that busi-
ness, they invested more time and became
registered against the QS 9000 standard,
which allowed them to make parts for the
auto industry.
But while the company had hired
Sheila, it had not hired any other support
staff during this period. Betty, the human
resources director, found that she was also
director of environment and safety. To be
“qualified” for these additional titles, Betty
was sent to a 40-hour HazWOPER course.
Since Baritone was a small operation, the
Ohio EPA had not yet discovered it and
Ohio’s OSHA would probably never visit
the company, unless it had the misfortune
to kill someone.
The local community hospital, Giffin
County Medical Center, provided support
for cuts, bruises and the occasional falls,
slips and crushed extremities that bedev-
iled Baritone. One or two workers had
developed asthma, which the doctor
claimed was related to the chemicals at
Baritone, but the Giffin doctors were not
board-certified occupational physicians
and were not well-qualified to evaluate
such illnesses.
Working with Danger
The plastics and additives used and
produced at Baritone came with MSDS
and labels that were covered with scien-
tific information. Betty, who had never
had a chemistry, biology, physics or alge-
bra course in her life, had no idea what
any of those words meant, but Betty’s
lack of education and credentials in the
environment and health area were of no
concern to Joe or his coworkers.
Betty called the supplier of Baritone’s
chemical feed stocks and asked them for
some safety training. One bitterly cold
day in February 2001, two members of
the chemical company’s marketing
department with specialties in hazard
communication training arrived. Alan and
Rodney had armloads of training materi-
als and two large boxes of donuts for all
those who attended their show, since they
knew that at such small companies there
was little encouragement by top manage-
ment for such time-wasting activities.
The half-day training program was
well-attended. The plant manager was not
there, but Betty and Sheila were, as was
Lou, the maintenance manager. Since
chemicals were not really of any concern
to Lou, by definition, they were not of
any concern to his crew. Lou had a high-
school education, but had slept through
science class. It did not really matter that
he did not have the educational back-
ground to understand what was taught
that day because he did not care anyway.
He came for the donuts and coffee. At the
end of 4 hours, Lou took a short exam on
“MSDSs and You!” Everyone in the room
chatted about the answers and Lou scored
a passing 80% on the exam.
Betty was very pleased with the
course, although she did not understand
it. She gave Sheila all of the materials
that Alan and Rodney had brought, the
records of attendance and the exam
results. Sheila filed them. Of course, she
had neither the time nor the training to
understand that these documents never
had a prayer of being implemented.
Alan and Rodney had a clear under-
standing of the understaffing of SH&E in
small businesses like Baritone, but they
had neither the responsibility nor the
authority to force Baritone to implement
their suggestions or to take their chemical
hazards seriously. Alan’s and Rodney’s
company worked under the guidance of
the American Chemistry Council’s
Responsible Care Product Stewardship
Code, a voluntary code. Baritone could
take it or leave it, and many times such
small companies left it, much to the cha-
grin of the product stewards.
Joe did not attend the MSDS training
course. He had recently been promoted
from forklift driver to maintenance man
and one of the plastics additives lines that
snaked through the plant had sprung a
leak. This particular line was at about
head height and was in a cramped, dark
space near one of the heating ducts.
Outside it was 12 ºF and the wind was
howling, but near these pipes it was 90 ºF
and the air was still. Joe took his toolbox
and set it down in the chemical puddle
that had formed on the floor.
Since it was hot, he stripped off his
work shirt and stood in his T-shirt, arms
overhead, chemical dripping down his
arms and splashing in his face. He tried to
tighten the pipe fitting that had sprung a
leak. Failing that, he closed the gate valve
for that feed line, much to the dismay of
the supervisor, who did not like his
process stopped, even for maintenance.
Joe then went back to the pipe and
removed the fitting. When he did so, the
remaining liquid in the pipe drained out
and down his arms. He rethreaded the
ends of the pipes and fitted them with a
female-female union. He did all this in a
small, unventilated space, standing in a
puddle of this chemical, with his skin
coated and his hair matted with it.
The chemical did not smell bad and
did not burn his skin or eyes, so he fig-
ured it was not dangerous. After a quick
smoke, which he took in the space where
he had just fixed the pipe, he asked Lou if
he could leave work a little early. He was
not feeling well and it was almost time to
quit anyway.
So what do you think was the outcome
of this story? Did Joe go home, eat dinner
and help his kids do their homework? Or
do you see a picture in your mind of an
ambulance and Joe being wheeled on a
gurney into the back? And do not forget
to visualize Joe’s family watching their
father be taken to an uncertain fate and
their family income plunging and perhaps
never recovering.
4 Vol. 7 ● No. 3
Joe’s Story or How We Could Have Saved Him
By Steven P. Levine, Ph.D., CIH
J

DOT monitors drivers’ hours of service
and reports on the results based through
the trucking company DOT Number. This
information is available at www.safersys
.org. At this website, search for “Company
Snapshot” under the center column
(FMCSA searches). Once you click on
“Company Snapshot,” you will reach a
search page where you can search for a
company by DOT number or company
name. Once you have opened a company
snapshot, you will see a box like that
shown in Table 1 in the Inspections/
Crashes section:
In this example, under the driver col-
umn, the out of service (OOS) rate is
13.2%, almost twice the national average
of 6.8% shown in the last row. When
drivers have serious violations, including
hours of service violations, they are put
“out of service” and cannot continue driv-
ing until adequately rested or until other
issues are addressed.
What are the violations? Near the top
of the snapshot page at the right you will
find a box titled “Other Information for
this Carrier.” Click on SafeStat Results.
You will be taken to a summary page.
Once you click on the driver tab under the
“SafeStat Online” heading, you will see a
driver detail sheet. Go to the dropdown box
toward the middle of the page. Here you
may choose “OOS Violation Summary” or
“OOS Inspections with OOS Violations.”
The “OOS Violation Summary” will give
you a table (Table 2).
The 11-hour rule, 14-hour rule and
60/70-hour rule violations clearly indicate
that drivers may be operating a commercial
motor vehicle while fatigued. Some drivers
will not show their log book or will not pro-
duce the entire record. “No driver’s record
of duty status” and “Driver failing to retain
7 days’ logs” violations also indicate that
the driver may be operating while fatigued.
Do Hours of Service &
Fatigue Really Matter?
Figures 1 through 4 come from an
actual trucking company. Figure 1 is the
driver out-of-service rates over time.
Fatigue can be a major cause of acci-
dents. When you are under the influence
of fatigue, your performance will suffer
much like it would if you were driving
under the influence of alcohol. Some
signs of fatigue are lane drift while driv-
ing, eyes shifting in and out of focus, and
frequent yawning. Figure 2 shows the
increase in the number of motor vehicle
insurance claims over a period of time
parallel to that in Figure 1.
This company instituted comprehen-
sive programs of training and accounta-
bility. Drivers and applicable managment
are held accountable for their out-of-serv-
ice violations, with incentives and disci-
plinary actions applied. Figure 3 shows
the result.
As the out-of-service violation rates
RM/Insight ● 5
Truck Drivers & Fatigue
continued from page 1
Table 1 Inspections
continued on page 6
Rest vs. Sleep
•Rest and sleep are not the same.
•Rest is a break or change of activity.
•Rest can restore energy.
•Rest cannot substitute for sleep.
•Sleep allows both body and brain
to be restored.
Figure 1 Driver OOS Rate
Table 2 Driver OOS Violation Summary (within 30 months)

affects your judgment long before you
fall asleep. The most important factor
affecting fatigue is good, quality sleep.
Most adults need 7 to 8 hours of sleep
per day. People who claim to need less
sleep typically take naps or only think
they get by with less while operating at
reduced performance and making up for
the sleep deficit with longer sleep on days
off. Longer periods of natural sleep on
days off work are a symptom of inade-
quate sleep during the workweek.
•Avoid work schedules that require
more than 8-hour work shifts.
•It is best to schedule driving/working
hours in one long period of 7 to 8 hours,
rather than dividing it into shorter blocks.
•Getting adequate sleep is the only
way a person can overcome periods when
s/he has not had enough sleep.
•The effects of caffeine are short-lived,
but caffeine may be useful in staying alert
when used sparingly.
•Effective ways to avoid fatigue
include scheduling sleep when the body
is ready to sleep and taking naps at the
right times.
•Educate family and friends about the
work schedule and need for quality sleep.
•The body naturally wants to sleep
when it is dark. Ensure that the sleeping
room is dark, quiet and at a comfortable
temperature.
•After a long nap (more than 1.5
hours), it may take several minutes to
feel alert because you may be awakening
from a deep sleep.
•The circadian rhythm is the human
body’s natural biological clock. It is a
cycle that repeats metabolic patterns in
approximately a 24-hour pattern. This
cycle includes periods in the early morn-
ing (2:00 to 4:00 a.m.) and mid-afternoon
(2:00 to 4:00 p.m.) where body tempera-
ture drops, and mood, motivation and
performance degrade. These are the best
times to take sleep breaks, or if not prac-
tical, brief work breaks.
•The following factors affect fatigue
and your driving performance: quality
and quantity of sleep you have gotten
before your trip, time of day and physical
fitness.
•Shift workers experience shift lag,
much like jet lag for travelers crossing time
zones. The body could require 1 to 3
weeks to adjust to shift changes. Living a
different weekend schedule disrupts these
adjustments. Forward shift changes are
easier to adjust to than backward changes.
(Midnight to 8:00 a.m. shift changing to
8:00 a.m. to 4:00 p.m. shift (early morning
to day shift) is easier than the reverse.)
Drowsy drivers are poor judges of
their own performance. Sleepiness
and fatigue are causes of serious
crashes everyday. We must work with
6 Vol. 7 ● No. 3
Figure 3 Driver OOS Rates vs. National Averages
Figure 4 Number of Vehicle Cases by Policy Year
improved, auto insurance claim frequency
decreased (Figure 4).
Controlling Fatigue
By learning about the effects of
fatigue, you can improve safety. Fatigue
Truck Drivers & Fatigue
Figure 2 Number of Claims per Policy Year

he World Book Dictionary pro-
vides several definitions for the
word “primer.” One definition
states that it is a “first book,” i.e., a
primer on arithmetic. Another definition
says it is a “first coat of paint.” This arti-
cle will explore the risk management
process beyond the premise of a first
book but within the context of a first coat
of paint. This primer will help serve as a
foundation in the continuing education of
the SH&E professional.
Anyone who has painted a wall knows
that the primer coat serves as a base or
foundation for the second or finish coat to
the painted wall. This article will attempt
to brush the risk management paint ade-
quately to enhance the future “coats” to
be applied by the SH&E professional.
Business & the
SH&E Professional
The SH&E professional in recent
years has often been asked to take on a
variety of job tasks and functions to con-
trol the cost of doing business within
many organizations. In addition to safety
and health, security has become increas-
ingly more important since the events of
Sept. 11, 2001.
Business strategies may include acquisi-
tions or mergers that require the SH&E
professional to conduct due diligence that
could impact an organization’s business
portfolio. A quality initiative could impact
safety efforts by incorporating safety into
the quality process. This can be done by
developing metrics for safety similar to the
standards used in quality control. An exam-
ple may include a reduction in incidents
through identification of hazards and
developing corrective actions for minimiz-
ing these hazards. The SH&E professional
must be aware of these needs and become
a practice leader within his/her business,
not merely a safety and health technician.
SH&E professionals can no longer
wait for direction; they must become
problem-solvers and develop solutions
to control costs and enhance profitability.
Successfully accomplishing these tasks
may require changes in the organizational
culture.
In Organizational Culture and Leader-
ship, Schein (1985) defines culture as “a
pattern of basic assumptions-invented,
discovered or developed by a given group
as it learns to cope with its problems of
external adaptation and internal integra-
tion-that has worked well enough to be
considered valid and therefore, to be
taught to new members as the correct
way to perceive, think and feel in relation
to those problems.” The SH&E profes-
sional must become a team player in this
culture development as it relates to the
management of risk.
Traditional Risk Management
Risk management has been defined as
a process that uses physical and human
resources to accomplish certain objectives
concerning most pure loss exposures. Both
postloss and preloss objectives must be
considered. Postloss objectives include
1) survival, 2) continuity of operations,
3) earnings stability, 4) continued growth
and 5) good citizenship or social responsi-
bility. Preloss objectives include 1) econo-
my; 2) reduction in anxiety; 3) meeting
externally imposed obligations; and 4) good
citizenship and social responsibility.
The risk management process consists
of four steps:
1) Identify and analyze loss exposures.
2) Select the technique or combination
of techniques to be used to handle each
exposure.
3) Implement the chosen techniques.
4) Monitor the decisions made and im-
plementing changes where appropriate.
(Williams, Head & Glendenning, 1978, 18).
This model has been the foundation of
risk management in organizations for many
years. Small to mid-size companies have
purchased insurance to meet various eco-
nomic/financial needs and may or may not
incorporate an SH&E program to mini-
mize the possibility of loss. Success in
minimizing loss problems is largely a
result of dedicated human capital and
enlightened management. The SH&E pro-
fessional must be a leader in a successful
SH&E process as it relates to risk manage-
ment. To minimize losses, business risk
management is recommended.
A Best Practice Approach
In Best Practices: Building Your
Business with Customer-Focused Solu-
tions, Heilber, Kelly and Ketteman (1998)
note the following three common prac-
tices in the companies they researched:
•constantly search for a better way;
•develop serious, positive, ongoing
relationships with key stakeholders to the
business;
•adopt a strong “process view” of your
business.
The SH&E professional should incorpo-
rate each of these concepts into the daily
activity of controlling losses and maximiz-
ing profits for his/her company. The search
for a better way must include an expanded
business risk management approach, being
part of the risk management team and
understanding the business as a dynamic
entity with opportunities for continual
improvement.
An Enhanced Model for a Business
Risk Management Process
Business risks are numerous and
consist of market risk, credit risk and
operational risks. Operational risk is the
primary focus for this article. The SH&E
professional has the most influence in this
aspect of risk. The business risk manage-
ment process will be discussed in the fol-
lowing six steps:
1) Establish a business risk manage-
ment process with specific goals and
objectives.
2) Assess, identify and analyze busi-
ness risk, including sources used to meas-
ure and assess the risks.
3) Develop business risk management
strategies.
4) Design and implement risk manage-
ment capabilities.
5) Monitor risk management perform-
ance.
6) Continuously improve the risk man-
agement capabilities.
Each step is examined in a case study
setting. A shopping center is used as the
business operation. On the surface, a
shopping center may be considered rather
RM/Insight ● 7
A Primer in Risk Management
for the SH&E Professional
By Francis P. Sehn, M.S., CSP, ARM
continued on page 8
T

simple in exposures (those aspects of the
business that may result in a loss) and
loss (an occurrence for which a business
may or may not be insured) expectancy.
These sometimes small cities can have all
or most of the business concerns that any
manufacturing, construction, institutional
or similar business may encounter.
Typical Exposures
in a Shopping Center
A suburban or urban center will typi-
cally have all of or most of the following:
•one or more structures of various con-
struction features with some type of fire
protection;
•parking lots or garages;
•utility and related equipment;
•center or mall management, mainte-
nance and custodial personnel;
•many storefronts, including food
operations;
•security personnel;
•environmental concerns.
Each loss exposure is discussed within
the framework of a business risk manage-
ment process.
Step 1: Establishing a Business
Risk Management Process
This step may be part of or separated
from the company’s business plan. It
should include specific goals and objectives
for the risk management process in terms
of a common language that all employees
can understand. The goals should be com-
municated regularly throughout the organi-
zation. Mission statements continue to be
used for this purpose in some companies. If
the risk management process’ goal is value-
driv-en instead of priority-driven, it will be
achieved by empowered management and
other personnel. If it is perceived as a prior-
ity, it may or may not receive the focus to
accomplish the goal.
From the SH&E professional’s point
of view, goals are often focused on inci-
dent or injury prevention. These are
appropriate if they can be measured and
impacted by risk management or risk
control techniques. Goals and objectives
like the following are too general to
accomplish meaningful results:
The goal is to reduce injuries to cus-
tomers and to reduce damage to the shop-
ping center to minimize the impact on the
company’s operations.
The objectives are to:
•reduce property losses and the cost of
insurance as it relates to common area
maintenance;
•provide a safe operating environment
to minimize injuries;
•train the entire staff in risk manage-
ment principles and risk control
methods.
While these may be a good start, the
question of how to measure the results is
somewhat of a challenge. Developing a
specific target for improvement, such as a
40% reduction in employee injuries and a
means or method to accomplish that
objective (e.g., train employees in safe
job procedures for material handling and
monitor the activities weekly, is a more
meaningful metric). These goals and
objectives with actionable items for
improvement must be championed by the
risk management team with the SH&E
professional taking a leadership role.
Step 2: Assessment, Identification
& Analysis of the Business Risks
& Sources Used to Measure &
Assess Risks
Many risk management tools accom-
plish these aspects of the process. Assess-
ment and identification tools work in
conjunction to determine the controls or
lack of controls of hazards within any
organization. A large shopping center/real
estate operator’s risk manager has devel-
oped a tool in conjunction with their
insurance broker risk control consultant
to determine the extent of management
controls in place at each of its centers
throughout the U.S. The company em-
ploys custodial, maintenance, security
and management personnel at each loca-
tion. The form asks questions to evaluate
both hazards and controls in each of these
categories:
1) Janitorial services, including janitor-
ial closets, service corridors, freight ele-
vators, fire stairs, service bays, truck
doors, common area stairs, chemicals,
PPE, restrooms, first aid, electrical equip-
ment and cleaning equipment.
2) Security services, including auto-
mobile liability and general liability, and
including crowd control and use of
firearms.
3) Maintenance, including slip and fall
prevention and winter conditions, includ-
ing snow removal, play areas and fire
protection systems.
To adequately analyze the level of
management support for risk manage-
ment, the SH&E professional conducting
the assessment must be knowledgeable of
the technical aspects of these exposures
and the management practices needed to
minimize loss. A more in-depth analysis
may be required for the employee safe-
guards in place and may include (but not
be limited to) the following:
•electrical and machine safeguards;
•PPE;
•lockout/tagout policies and proce-
dures;
•hazardous material handling, storage
and disposal;
•confined space entry procedures;
•emergency action plans.
These are just two examples of assess-
ment and identification tools available to
the SH&E professional. Used properly,
they can lead to corrective actions to min-
imize and eliminate hazards that could
lead to both employee and customer
injuries.
Step 3: Development of Business
Risk Management Strategies
The next step is a team effort based on
the knowledge and skills of the team
members and the level of expertise of the
consulting services provided by the com-
A Primer in Risk Management
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informed. Be sure to
let ASSE know if
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8 Vol. 7 ● No. 3

pany’s insurance broker and insurer.
These strategies can have a significant
impact on any organization’s financial
structure if a poor choice is made in the
risk management strategy. Several possi-
ble strategies used in this step include risk
avoidance, risk retention, risk reduction
and risk transfer.
The SH&E professional can play an
important role in all aspects of the
process. In risk avoidance, the company
may decide that the exposure or the
injury/loss experience presents a financial
burden that can be minimized by avoid-
ing the risk. For example, the custodial
operation of a shopping center may expe-
rience high turnover and have a poor
accident record despite the SH&E profes-
sional’s efforts to train and lead the safety
and health process within that depart-
ment. The cost is minimized by using the
services of a vendor who would be
required to provide insurance for the
employees. There is a contractual fixed
cost with this approach, but the savings
on the insurance impact to the experience
modifier may more than offset the fixed
cost of the service.
Risk retention will require the SH&E
professional to exercise a higher level of
risk control depending on the level of
retention. In these programs, the company
will “retain” or self-insure a level of
insurance. Levels can be in the $250,000
to $500,000 ranges on each injury or inci-
dent. In effect, the company pays the cost
of excess insurance and funds the level
below the retention. Risk control meas-
ures like adherence to safety policies and
procedures becomes a critical part to min-
imize costs in the retention level.
Risk reduction can take several forms
to control costs. The SH&E professional
with expertise in fire protection may look
for ways to reduce the risk through prop-
erly maintained fire protection systems.
Another method includes separating
exposures by placing high-valued stock in
separate fire areas.
Risk transfer typically relies on pur-
chasing standard insurance policies or by
using “hold harmless agreements.” These
are means of transferring the financial
impact to an insurer or to a third party.
Step 4: Designing & Implementing
Risk Management Capabilities
The extent of the step and the SH&E
professional’s input will depend on the
organization’s risk appetite. If a retention
program allows for significant cost sav-
ings, the risk control efforts will typically
be a major part of the process. These
efforts may include employee safety ori-
entation, job safety procedures, electrical,
lockout/tagout, fall protection, driver safe-
ty training and confined space training.
Weekly safety talks and ongoing safety
training will play a key role in communi-
cating the safety message of risk manage-
ment to all levels of employees.
On the other hand, if a guaranteed
insurance program is selected as the strat-
egy, there may be little or no emphasis
placed on safety beyond some minimal
compliance programs. The SH&E profes-
sional can show his/her worth by continu-
ally reviewing risk management data (i.e.,
insurance costs, loss runs, recommenda-
tions from insurance carriers loss control
personnel) to be proactive in leading pro-
grams and processes to minimize loss
producing conditions. One commonly
overlooked area is environmental expo-
sure in large properties. If a shopping
center is required to install retention
ponds for water runoff from the parking
lots, the ponds could accumulate a variety
of wastes that may or not be hazardous.
The pond presents a nuisance to local res-
idents and should be monitored and
fenced with proper signage.
Step 5: Monitoring Risk
Management Performance
Someone once said, “The proof is in
the pudding.” An attendee at one of the
author’s presentations indicated that you
must eat the pudding to taste it. In the
same way, a risk management process is
only as good as team members’ efforts. In
Step 4, the risk management data note
“loss runs.” This information is historical
data based on the payments or anticipated
future payments of claims by the insur-
ance carrier or the administrator. It plays
a role in determining where claim activity
has originated and could continue if
changes are not made to minimize or
eliminate future losses.
A 5-year loss run (2001-2006) for a
single location of a large eastern shop-
ping center operator included the data list
(Table 1).
The highest frequency of incidents
occurred in the interior of the shopping
center, but the sidewalk incidents incurred
the highest cost. The average cost per inci-
dent is also a critical component. The aver-
age cost of an interior incident is less than
$2,000 while the average cost of a food
court incident is more than $6,000. To
attempt meaningful risk control efforts, the
data would need to include the specific
areas of the center where incidents are tak-
ing place. A mall map could be used to
identify problem areas. A large southeast-
ern mall developer and operator have suc-
cessfully used this mapping method to
target problem areas.
Detailed incident reports are also need-
ed to determine incident types. One could
assume that the incidents are all slip, trip
and fall incidents, but that may be an
erroneous assumption. If the security
guards complete the incident reports, the
SH&E professional must ensure that they
are trained in the investigation process
and in handling incident situations to
obtain the maximum data for risk control
corrective actions.
Step 6: Continual Improvement
of Risk Management Capabilities
The SH&E professional’s work is rarely
ever done. The terrorist attacks of 2001
were mentioned earlier in this article. A
recent Rand Corp. report indicated that 60
terrorist attacks against shopping centers in
21 countries have occurred since 1998. A
study was conducted at three shopping
enters to identify and prioritize security
measures that can substantially reduce the
risk of these attacks. A total of 39 meas-
ures were outlined in the report to mini-
mize terrorist attacks, noting that a high
priority set of 6 to 10 measures can cut the
terrorism risk to just one-fifteenth the level
it would otherwise be, based on the three
RM/Insight ● 9
Table 1 Eastern Shopping Center Operator: 5-Year Loss Run (2001-2006)

nformation technology (IT) is one of
the most influential technologies in
today’s business world. It would be
difficult, if not impossible, to imagine
today’s work world without computers,
networking, communication equipment
and software. Effective use of IT has
given enterprises significant market
advantage.
IT has enabled businesses to reduce
costs of operation and to increase produc-
tivity. IT has been adopted extensively in
areas such as finance, human resources,
sales distribution and asset management.
IT has helped businesses capture, store,
process and generate useful information to
help management make strategic decisions.
However, as far as environment, occupa-
tional health and safety management
(EHSM) is concerned, the application of
IT has been slow. This phenomenon is not
confined to India only; the scenario is simi-
lar across the globe.
However, the scenario is changing fast.
Results of a survey conducted by AMR
research group indicate that 40% of
American companies surveyed plan to
address SH&E compliance in their soft-
ware spending this year.
EHSM is one of the major areas of con-
cern in the manufacturing industry. Despite
increased awareness and greater focus
toward SH&E, environmental degradation
and pollution continues and more than
6,000 people die of work-related injuries
and illness everyday. Annual losses result-
ing from work-related accidents amount to
4% of the world GDP or approximately
$1.25 billion.
EHSM’s goal is to:
•provide a clean, safe and healthy
work environment;
•optimize resource use and reduce
waste;
•prevent injuries and illnesses;
•develop safety awareness through
communication and education;
•ensure regulatory compliance and
minimize damage to the environment.
However, success of every program
needs periodic evaluation and control.
More than 50 parameters are used in the
industry for assessing the effectiveness of
an SH&E program. On average, 10 to 15
parameters are used for the purpose. These
parameters include:
•consumption rate of resources such as
water, coal, oil, gas, chemicals, etc.;
•quantity of emission, discharge of
waste;
•percentage of waste recycle, water
recycle;
•number of accidents, incidents, ill-
nesses and noncompliances;
•costs associated with accidents;
•number of fatal accidents;
•level of safety awareness;
•level of regulatory compliance.
The larger the number of parameters
monitored, the better the assessment and
control will be. However, to track and
monitor many parameters effectively, we
need a tool that can capture relevant data,
generate useful information and assist
professionals in making appropriate deci-
sions. This is where IT can play an
important role.
IT will help SH&E professionals cap-
ture data once and use the data repeatedly,
and will help them generate different
reports quickly, accurately and without any
data inconsistency. With this, SH&E pro-
fessionals can be relieved from compiling,
reconciling, retrieving data and generating
reports. IT will help in managing the data
in a systematic manner and facilitate data
access. This will enable SH&E profession-
als to spend more time on value-added jobs
such as planning, data analysis, site inspec-
tion, training and technology upgrades.
IT can use past data effectively and
help raise alarms in time so that appropri-
ate action is taken well before the need
arises.
IT can help improve SH&E statistics
in the following areas:
1) incident tracking;
2) information management;
3) management participation and
commitment;
4) effective communication;
5) risk management;
6) identification and monitoring of
hazards;
7) monitoring health of assets;
8) tracking calibration of measuring
equipment;
9) PPE management;
10) training management;
11) work permit management;
12) medical checkups.
An integrated IT solution can address
the SH&E functionalities at left.
10 Vol. 7 ● No. 3
Information Technology
Plays Vital Role in Environment,
Health & Safety Management
By Santosh Sahoo
I
Figure 1 SH&E Functionalities

How Does IT Assist EHSM?
Incident Tracking
While a portion of work-related dis-
eases has many contributing factors that
are difficult to eliminate, such as genetic
and inherited sensitivities, occupational
accidents are all caused by preventable
factors occurring at the workplace. This is
demonstrated by continuously reduced
accident rates in industrialized countries.
Many companies and some governments
have already adopted zero-accident tar-
gets. This corroborates the hypothesis that
practically all accidents can be eliminated
by a set of known measures.
If all ILO member states used the best
accident prevention strategies and prac-
tices already in place and available, some
300,000 deaths (out of 360,000—83%)
and 200 million accidents (out of 270
million—74%), could be prevented, not
to mention the savings in compensation
payments.
IT can help reduce and prevent inci-
dents by tracking, recording and evaluat-
ing employee injuries and illnesses. This
will help track injury, illness, first aid and
near-hit incidents to meet recordkeeping
and reporting requirements. This can play
a major role in:
•Information management—capture
and manage detailed information on
workplace incidents, investigation, root
cause analysis, corrective action, follow-
up action, injuries, illnesses and near
misses for analysis, reporting and deci-
sion-making.
•Tracking employee and equipment
location—can integrate with GIS applica-
tion to help track the location of employ-
ees, vehicles and equipment.
•Centralized control—enable control
from centralized location in case of
emergency.
•Accurate safety record—maintain
thorough and accurate safety records for
every employee in the organization.
•Accident cost—captures costs associ-
ated with incidents to help lower insur-
ance and workers’ compensation costs.
This also captures lost and restricted days
for impact analysis.
•Reporting—print incident summary
reports, incident logs and incident reports
(such as OSHA 300, 300A and 301) auto-
matically to ensure regulatory compliance.
•EHSM dashboard—dynamically gen-
erate graphs and reports to reveal trends,
statistics and costs to evaluate company
performance and to assist management in
decision-making. Graphs and reports will
be generated based on real-time data.
Information Management
Analysis of workplace incidents found
that many incidents happen for reasons
similar to earlier incidences. This indi-
cates that information management and
dissemination can help prevent recurrence
of incidences. IT can assist in capturing,
organizing, storing, retrieving and dis-
seminating information in a more effec-
tive manner and in the following:
•MSDS creation and management;
•standard operating procedure (SOP)
creation and management;
•workflow-based control on creation,
validation and distribution of documents;
•no need to store physical records/doc-
uments at multiple locations;
•document access from different loca-
tions without sacrificing security;
•updated documents available for use
while retaining older versions for future
reference;
•track training, certifications, positions
and deployments for optimum use of
human resources;
•match job requirements with person-
nel profile for proper fit from skill and
health perspectives;
•data are captured once at the source
and can be used to generate different
types of report to enable management to
make useful decisions;
•no need for manual compilation of data;
•no need for reconciliation;
•accurate report on near real-time
basis;
•provides transparency—the same infor-
mation is available to employees, manage-
ment, safety team and regulatory bodies;
•access control based on the nature of
confidentiality and hierarchy;
•managing acts, regulations, standards
and checklist pertaining to EHMS.
Management Participation
& Commitment
Management participation in EHSM
RM/Insight ● 11
Figure 2 Health Trend
Figure 3 Accident Trend

lends importance to these activities. This
also sends a clear message to employees
and the safety department that manage-
ment is committed to these initiatives.
However, despite its commitment and
willingness to participate, more pressing
needs often keep management busy. When
available for these activities, the compiled
information is either not available or, if
available, has become obsolete. In this
case, IT can provide the following:
•EHSM dashboard generates trends
and statistics in graphical form. This
enables management to easily interpret
the data and arrive at a conclusion. The
graphs and reports will be generated
based on real-time data.
•The dashboard can generate trends for
identified key performance indicators
(KPIs) such as consumption rate of water,
energy, chemicals; quantity of SO2, NOx,
SPM, RSPM emission; percentage of
waste recycled; number of accidents;
number of illnesses reported; cost of acci-
dents and performance against target.
•Provision of drilldown reports at
the click of a button To enable online
analysis.
•Latest information/trends at the click
of a button. No dependence for data.
•Guaranteed accuracy of information
unlike manual reports, which are person-
and time-dependent.
•Asynchronous communication helps
management review the information at
their convenience and record their obser-
vations. Better use of time.
Effective Communication
Timely communication is essential for
EHSM to be effective. IT and communica-
tion technology can help in the following:
•collect, track and report KPIs with
respect to already defined EHS goals;
•display graphical analysis of impor-
tant health and safety metrics through a
digital dashboard;
•enable active communication between
professionals through automated e-mail
and SMS alerts, workflow-based task allo-
cation, progress tracking and completion of
scheduled health and safety activities;
•alerts generation for timely submis-
sion of report to regulatory bodies;
•ease of communication with regulatory
bodies through e-mail. Selective access can
also be given to regulatory bodies, elimi-
nating the need for document submission;
•tracking locations of workers and
equipment through RFID;
•monitor adherence to safety proce-
dures through a web camera;
•remote expert guidance for first aid
and other emergency procedures by use
of a web camera.
Risk Management
Risk management is an essential part of
EHSM. Identifying the risk, assessing the
risk and planning for risk mitigation and
monitoring are important parts of risk man-
agement. This can be achieved two ways.
One is by conducting a regular audit for
adequacy/effectiveness of the system, an
audit for compliance and an inspection of
the workplace for safety and hygiene.
IT can help an organization save time
and money, using point-and-click tech-
nology in the following tasks:
•preparing a checklist for the audit;
•planning for the audit;
•assigning an auditor;
•scheduling the audit;
•capturing audit details and printing a
report;
•follow-up of the audit’s recommenda-
tion;
•raising a request for worksite
inspection;
•approval for worksite inspection;
•scheduling a worksite inspection;
•generating a report of worksites
exceeding the limits;
•follow-up planning, scheduling and
tracking corrective actions;
•managing all data.
Hazard Identification & Monitoring
To ensure a safe and healthy work-
place, one must identify, evaluate and
control occupational exposures to chemi-
cal agents and other physical, biological
or ergonomic hazards in the workplace.
This requires a mechanism to assess
potential risks, plan regular inspection,
interpret sample results and implement
strategies to limit exposure.
IT can help an organization protect
employees from occupational exposures,
evaluate the effectiveness of the safety
program and do it in less time at lower
costs. From planning through reporting,
this can help an organization:
•track workplace conditions through-
out the year;
•collect, document and analyze expo-
sure monitoring results;
•communicate monitoring results to
employees and management;
•identify opportunities to further con-
trol exposures;
•ensure compliance with occupational
health standards.
Monitoring Health of Assets
One cause of accidents is the break-
down of equipment in the middle of an
operation. A breakdown takes workers
by surprise and may lead to accidents
with damage to personnel and property.
Timely equipment maintenance can defi-
nitely reduce, if not eliminate, the
chances of a breakdown.
Some companies use an asset manage-
ment application to track the entire lifecy-
cle of equipment, including preventive,
predictive and breakdown maintenance.
Based on the commissioning date and the
manufacturer’s instructions, maintenance
is planned. An asset management applica-
tion schedules maintenance automatically
and track its status.
IT can help integrate an asset manage-
ment application with EHSM and thereby
enable SH&E professionals to track the
health of assets. If required, it can also
ensure that assets are maintained as per
schedule to prevent incidents/accidents.
Calibration of Measuring Equipment
To control exposure, the actual level of
exposure is to be measured periodically.
For this purpose, measuring equipment
must be accurate. Inaccurate measure-
ment will lead to erroneous results and
unwanted consequences.
IT can help track the measuring equip-
ment and their calibration dates, validity
date, date for recalibration, etc. and help
users manage their work better. This will
help monitor workplace exposure in a more
effective manner. Alerts can be generated to
12 Vol. 7 ● No. 3
Information Technology
IT has proven its worth
in other business
domains. It is time
for SH&E professionals to
realize the utility of IT
and to take advantage
of it to save resources
and lives.

remind officials to take appropriate action
regarding calibration and exposures.
Regular calibration is also required for
other testing equipment and instruments.
IT can help in this area as well.
PPE Management
Industrial hygienists recognize that
engineering, work practices and adminis-
trative controls are the primary means of
reducing employee exposure to occupa-
tional hazards.
However, when effective work prac-
tices or engineering controls are not feasi-
ble or while such controls are instituted,
appropriate PPE must be used.
To be effective, PPE must be individual-
ly selected, properly fitted and periodically
refitted, conscientiously and properly worn,
regularly maintained and replaced as nec-
essary. IT can help in PPE management.
Workflow use will help in automatic
request management:
1) Identify new PPE for usage.
2) Raise requests for PPE.
3) Approval of the request.
4) Check availability status.
5) Check PPE condition.
Training
Knowledge of work procedures, sub-
stances handled, safety procedures and
awareness and communication channels
is important for reducing the number and
impact of incidents. Training and retrain-
ing plays an important role in achieving
this objective. Therefore, training is an
essential part of effective EHSM.
IT can help training by:
•identifying training requirements,
obtaining approval, scheduling and con-
flict-checking;
•assigning training requirements by
job title, department and facility for class
scheduling, conflict-checking and wait-
listing;
•e-training, which enables users to
undergo training through audiovisual mate-
rials on their own time; training material
can be created in multiple languages; this
will also have an inbuilt mechanism to
assess training effectiveness;
•recording actual training details;
•printing certificates;
•tracking recertification dates and
ensuring that recertification is on time.
Work Permit
Many incidents occur in the working
area because of lack of proper communi-
cation and because of work conducted in
prohibited areas without appropriate
authorization. A work permit module is
meant to address these issues through the
following features:
•raising requests for work permits
online;
•approval of work permit requests;
•clearance of requests;
•view status of the request.
Medical Checkup
Employees must have good health
for higher productivity. It is not enough
to just ensure a safe and healthy work
environment and exposure levels within
stipulated limits. Employee health should
be checked at regular intervals, trends
should be analyzed and proactive action,
if any, must be taken to prevent occur-
rence/recurrence of medical conditions.
Medical checkups are required at the
time of recruitment, periodically during
the service period and also during post-
retirement.
IT can assist in the following:
•tests that must be repeated regularly,
such as hearing or general fitness assess-
ments, can be scheduled automatically;
•tracking medical examinations and
reexamination dates;
•raising requests for medical
checkups;
•scheduling medical checkups;
•recording medical checkup results;
•recording injury/ illness details.
Although IT has been adopted exten-
sively in areas such as finance, human
resources, sales distribution and asset
management, its usage is slow as far as
EHSM is concerned. IT can help improve
SH&E statistics by:
1) tracking injuries, illnesses, first aid
and near-miss incidents;
2) better management of waste, dan-
gerous goods transportation, PPE, work
permits, medical checkups, site inspection
and training;
3) generating reports and graphs to
reveal trends, statistics and costs to evalu-
ate company performance;
4) printing incident logs, incident sum-
maries, incident reports (e.g., OSHA 300,
300A, 301 reports) automatically to
ensure compliance;
5) keeping thorough and accurate safe-
ty records for each employee;
6) Recording total costs associated
with each incident to help lower insur-
ance and workers’ compensation cost;
7) Tracking occurrence of lost and
restricted days so as to analyze impact;
8) Storing detailed information along
with cause and conditions at the time of
incident.
The power of IT can be fully har-
nessed provided that EHSM is integrated
with other applications.
The dashboard provides a graphical
view of various key parameters and
enables management to make appropriate
decisions. Management can drill down
and view the details to gain more insight.
These trend reports and drilldowns can be
prepared or customized based on specific
requirements.
Visibility of the program’s effect
enables participation of top management.
This helps ensure that progress is on the
right track and if it is not, it enables the
managers to take action.
IT has proven its worth in other busi-
ness domains. It is time for SH&E pro-
fessionals to realize the utility of IT and
to take advantage of it to save resources
and lives. IT can be used as an effective
tool for EHSM to optimize consumption
of resources, reduce waste, increase waste
recycling, reduce incidents, reduce impact
in the event of incidents, reduce reported
illnesses and reduce costs associated with
accidents, thereby bringing economic
benefit. Ⅲ
Santosh Sahoo is an IT professional with 13
years’experience in the software industry. He
worked in the steel, mining, water utility and
power industries for 6 years before moving to the
software industry. Currently, he works as a prac-
tice head for environment, health and safety prac-
tice for Satyam Computer Services in India. In
this role, he works with customers to identify prob-
lem areas in the manufacturing industry and
provides appropriate solutions to eliminate or mit-
igate the problem. Based on his experience, Sahoo
feels IT implementation has been neglected in
EHSM and believes IT can play a significant role
in improving EHSM in industry. He is leading his
company’s efforts to promote IT in the manufac-
turing industry to improve EHSM statistics. Sahoo
holds a B.Tech degree in mechanical engineering
from the Indian Institute of Technology in Kharag-
pur, India.
RM/Insight ● 13
NAOSH
2008Safety Is Good Business
May4-10,2008
www.asse.org/naosh08

ric Goldberg, associate general
counsel and manager, state pro-
grams, for the American Insurance
Association (AIA), serves as a liaison to
state-based national organizations and
advocates AIA’s policy and positions.
In this interview, Goldberg explains
AIA’s role in advocating for legislation
that helps insurers manage natural catas-
trophe risks and discusses how SH&E
professionals can make the most of insur-
ers’ resources to manage risks and control
losses.
RMI: Provide a brief description of
your role and responsibilities as associate
general counsel and manager, state pro-
grams, for AIA.
EG:I have a dual role that covers both
government affairs and the law department.
Government affairs involves serving as
AIA’s liaison to state-based national organ-
izations such as the National Conference of
Insurance Legislators, the National Confer-
ence of State Legislators and the American
Legislative Exchange Council. I identify
issues these groups are working on and
advocate AIA’s policy and positions related
to those issues. With respect to the law
department, I staff our practice group on
natural catastrophes and property insurance
issues and I also staff committees responsi-
ble for developing policy and positions on
those issues.
RMI: In light of recent events such as
Hurricane Katrina in 2005 and the
Southern California wildfires in 2007,
how is AIA working with states and
Congress to ensure that adequate insur-
ance protection is provided before, during
and after natural disasters?
EG: Insurance is a state-regulated
industry. We are at a pivotal point in his-
tory in terms of how we look at the roles
of the private sector and government with
respect to property protection in the U.S.
The insurance industry is well-posi-
tioned to protect against natural catastro-
phe risk. Lawmakers have taken a more
active role in government to provide
insurance for all natural catastrophe risks.
AIA believes there is a populist, but
flawed, appeal to more government
involvement, for example, in creating
new, state-run catastrophe reinsurance
funds, which is something several states
have considered recently.
We believe one factor that is prevent-
ing the private insurance market from
maximizing its capacity is the current
patchwork quilt of state regulation and
the lack of an optional federal charter for
insurers. Our members write all lines of
property and casualty insurance through-
out the country and the world. To maxi-
mize efficiency and to put us on the same
footing as sectors of the financial services
industry, insurers need the option of one
federal regulator.
Many pieces of legislation are pending
in Congress that address natural catastro-
phe issues. One example is the Klein-
Mahoney bill (H.R. 3355) that would
provide cheap federal loans to state-run
insurance pools that do not manage them-
selves properly.
RMI: What is AIA’s Natural Catastro-
phe Agenda and what initiatives does it
include?
EG: AIA knows that there are no
magic fixes to property insurance avail-
ability issues. We believe steps must
be taken that, over the long run, will
return the catastrophe-prone areas of the
country to a more normalized system of
property insurance. One facet of our
agenda involves loss prevention and miti-
gation—the enactment and enforcement
of modern building codes and smart land
use planning. In addition, market-based
incentives could be put into place to
encourage individuals to take steps to
protect themselves and their homes from
natural catastrophe risk. The other prongs
of our agenda include:
•Land use planning. Much building is
taking place in parts of the country that
are susceptible to natural catastrophes
such as wildfires and earthquakes. State
and local policymakers should look at
where this development takes place and
either prohibit these areas from being
developed or ensure that the people who
choose to live there are prepared to pay
the real costs associated with managing
the risks to which they are susceptible.
•Reforming and modernizing the
national flood insurance program. The
program has not been updated in a mean-
ingful way since 1994. Many changes
must be made to provide protection to
people who live in flood-prone areas
today.
•Regulation reform. Insurers must
operate in a stable environment. Follow-
ing a natural catastrophe, state regulators
and legislators feel like they must “do
something.” It is not uncommon for regu-
lators to change the rules of the game
midstream. It is difficult to underwrite for
such “regulatory risk” because human
factors are involved and it is virtually
impossible to predict how people will act.
We think that more stability in legislative
and regulatory environments is needed to
give capital investors the assurances they
need to invest in a certain market.
•Legal reform. After Hurricane
Katrina, private attorneys and state attor-
neys general sued insurance companies,
challenging the underlying contract lan-
guage—contracts that had been approved
by regulators and in use for decades.
Insurers must know that the contracts
they enter into are upheld and investors
need the certainty and stability that con-
tracts will be upheld to attract capital.
•Tax-based incentives. Many tax
reforms can be implemented that will
have a positive impact on recovery
efforts. For example, South Carolina
enacted legislation last year that allows
individuals to set aside pretax dollars to
pay for mitigation efforts, such as storm
shutters, impact-resistant garage doors
and generators, to protect against the
extent of loss. Florida sometimes holds
sales tax holidays so people can buy
items intended to protect homes from nat-
ural catastrophes.
RMI: With respect to public policy,
what new challenges does AIA expect to
face this year?
EG: This year, we will see many of
the same issues that arose in 2006 and
2007. Natural catastrophe issues will be
on the agenda of state legislators in virtu-
ally all coastal states from Maine to
Texas. Optional federal chartering will
continue to be a major issue too.
We are pleased that Congress passed
an extension of the Terrorism Risk
Insurance Act, which gives insurers a
much-needed backstop to protect against
manmade disasters.
RMI: How does AIA help SH&E pro-
fessionals manage risks and control loss-
es? What resources does AIA have
available for SH&E professionals?
EG: Loss control is a major part of
14 Vol. 7 ● No. 3
Catching Up with AIA
E

property and casualty insurance. AIA has
a loss control committee that is com-
prised of heads of loss control from our
member companies. The committee
focuses on legislation and regulation
impacting the loss control industry. It is
also a forum for loss control professionals
to get together and discuss legislative,
regulatory and compliance challenges.
We think loss control and SH&E pro-
fessionals play a critical role in many
lines of property and casualty insurance,
such as workers’ compensation, commer-
cial property and commercial liability. We
view loss control as twofold—first, as a
part of underwriting. Loss control profes-
sionals can help their company’s under-
writers with underwriting and pricing. In
addition, loss control can help the cus-
tomer reduce the frequency and severity
of its losses but only if the policyholder is
willing to work with loss control and
there is buy-in from top management.
RMI: AIA supports workers’ compen-
sation reform. How do you predict these
reforms will impact occupational safety
and health in the long term?
EG: We believe the insurer can play an
important role in working with customers
to help identify changes that can be made
to reduce injuries. But this only works
when there is a company-wide commit-
ment to safety and health. If management
believes in a culture of safety in the work-
place, an effective partnership can exist
between the insurer and employer.
RMI: How can SH&E professionals
make the most of the insurance mecha-
nism when developing a safety program?
EG: The pricing of insurance product
is related to the expected risk of loss.
For example, workers’ compensation
insurance has a two-step “experience rat-
ing” system. First, the policyholder is
put into a category or categories with
similar employers. Second, the insurer
looks at how this policyholder’s safety
and health record compares with similar
employers. All things being equal, if you
have had fewer losses than other similar
employers, you will generally pay less for
workers’ compensation insurance. If you
have worse-than-average experience, you
pay more.
On the prevention end, many insur-
ance companies have resources available
to help SH&E professionals address caus-
es of loss. These resources range from
pamphlets and videos to on-site surveys
with follow-up recommendations. It
depends on the size and nature of the
employer and the insurance company
with which the employer is working. If
an employer’s SH&E professional is con-
cerned about losses, the employer should
contact the insurance company to learn
what resources are available and may be
able to partner with the insurance compa-
ny to address those losses.
RMI: AIA supports the development
of an optional federal charter, under
which insurers would have the option of
obtaining a federal charter in lieu of the
current state-by-state system of licensing
and regulation. Why is the development
of this charter important and what is its
predicted long-term impact?
EG: We think that the implementation
of an optional federal charter is critical to
the modernization of the insurance indus-
try. The insurance industry is one of the
last outposts of price and product control.
Before you sell a product, a state regula-
tor must approve it. This impedes innova-
tion in the marketplace. Federal oversight
would result in more efficiency and
would help foster innovation.
Banks, investment companies and
other sectors have the option of being
regulated at the federal level, yet insur-
ance companies are subject to regulation
that varies significantly by state. The two
major functions of the regulator—moni-
toring financial solvency and making sure
insurance companies act fairly in the mar-
ketplace—can both be handled more effi-
ciently by a federal regulator.
For example, an insurance company
must file an annual financial statement
every year with state regulators. This is
particularly burdensome because one
insurance group might have 17 different
writing companies in a given state and
each writing company must file its own
financial statement with the state regula-
tor. So hundreds and hundreds of these
statements, which all contain essentially
the same information, are filed each year.
The Gramm-Leach-Bliley Act, which
was enacted in 1999, repealed the De-
pression-era Glass-Steagall Act, which
prohibited banks from selling insurance
and insurance companies from being
banks. However, banks can be regulated
at the federal level, while insurance com-
panies are still regulated by states. The
option of a federal charter for insurers
would help level this playing field.
RMI: What are AIA’s plans and goals
for 2008?
EG: We have a legislative agenda that
ranges from asbestos to workers’ com-
pensation. We will continue to work to
ensure that insurers have the tools avail-
able to manage their risks and to bring
new products to market. We will also
continue to ensure that the role of the
private sector is maximized and to advo-
cate for a modern and effective system
of regulation. Ⅲ
Eric Goldberg is associate general counsel &
manager, State Programs, for the American
Insurance Association (AIA). Among his law
department responsibilities, Goldberg chairs the
AIA property insurance practice group and staffs
its committees responsible for the association’s
legislative and regulatory policy on commercial
and personal property lines. He is a graduate of
the George Washington University and the
Washington University School of Law. He is also
an active member of the Bar of the Common-
wealth of Pennsylvania and the District of
Columbia.
RM/Insight ● 15
•Can We Predict the Future?—Steve
Nyblom and Astra Townley.
•Will Your Substance Abuse Program
Manage the Risk and Defend Your Case?
—Shari Falkenburg and William Judge.
•Enterprise Risk Management Pro-
filing and Benchmarking for Health and
Safety and Fleet Risk Managers—John
Stevens and Lawrence Bamber.
•Start Rolling the D.I.C.E on Your
Safety and Risk Management
Projects—Francis Sehn.
•Evaluating Impact of Training—Chris
Ross.
Our annual RMIPS Advisory Com-
mittee meeting will take place on
Monday, June 9, from 6:00 p.m. to 9:00
p.m. This is one of the few forums where
we can meet face-to-face to discuss direc-
tion and services for the practice specialty
membership. Leslie Batterson, Assistant
Administrator, Jim Newberry, RM/Insight
Editor and all chairs will be there to meet
you. We welcome your attendance and
participation.
See you in Vegas!
Administrator’s Message

both local and regional disasters. Since
most companies today depend on their
computers and databases, having the
resources of a data recovery specialist
may be needed.
Water recovery and board-up contrac-
tors are typically summoned by your car-
rier’s claims department in localized
disasters. However, if your identification
and assessment determines the potential
for large-scale effects of a disaster, your
plans may call for some equipment to
be on site versus relying solely on outside
resources.
Hurricane Katrina expanded the time
when individuals and companies needed
to be self-sufficient. In the past, this was
considered to be no longer than 12 to 24
hours. Today, in widespread disasters by
geography or nature (hurricanes and
avian flu versus computer viruses), a 24-
to 72-hour timeframe must be planned for
before outside resources can be expected.
Your plan may need to include media
relations in the mitigation state. Who is
authorized to make statements to the
media? Have they been trained?
If your identification and assessment
stage found a potential for being unable to
use your present building post-disaster,
where will operations be conducted? This
is not possible for inventory sales and on-
site service industries. However, for some
service industries, the actual location of the
business is immaterial. Inventory sales
could be altered to drop-ship direct from
distributors or manufacturers to maintain
customer commitments or inventory, and
staff could be temporarily shifted from one
location to another.
Many businesses needed cash after
Hurricane Katrina. Banking systems were
interrupted and bank branches limited the
amount of cash that could be withdrawn.
Businesses that needed to relocate staff
and their families soon ran out of petty
cash and needed to rely on staff who had
hard currency. You should consider estab-
lishing a larger-than-normal petty cash
fund as past of your preplanning for
approaching disasters.
As a business owner, it is crucial for
you to manage mitigation. Delegation and
leadership are needed more than your
direct labor in handling the crisis and
working toward resumption.
Resumption
Critical, time-sensitive operations that
must be restored first must be identified
in your planning. Without prioritization,
scarce resources could be devoted by
well-meaning managers to what they con-
sider important for their specific function
versus what is crucial for the enterprise.
This will also permit reallocation of
human and material resources to support
the crucial functions.
Lessons from Hurricane Katrina
included maintaining communication
with staff. With nowhere to live near busi-
nesses, staff could not be expected to
come to work. During the 2004 Florida
hurricanes, employees were reluctant to
return to work for fear of looters coming
to their homes.
Businesses cannot operate without
staff and without landline and cell
phones, contacting employees to come to
work is impossible. Some companies in
Florida dispatched managers to employ-
ees’ homes to first determine their needs
and to find out what could be done to get
the employees back to work. In one case,
this meant establishing temporary hous-
ing in trailers for key staff and their fami-
lies in New Orleans post-Katrina.
Many companies found their company
websites especially useful post-Katrina.
With employees scattered throughout the
southeast, they could post announcements
easily that all employees could access
from any computer. Voicemail systems
can also be used for broadcast messages
to all mailboxes. Since most telephone
systems are now PC-based, including
them in your information technology data
backup and recovery planning should be
considered.
Recovery
The recovery stage is where ancillary
operations are brought back online. These
systems, identified in the planning stage
as less mission-critical, are still needed to
bring the company back into normal
operations. It could be resuming ware-
house operations from drop-shipments to
customers by suppliers or complete call
center operations.
Restoration
The final stage is restoration. This
could involve moving back into the origi-
nal business location or restoring business
hours to those before the disaster. It also
means restoration of prior delivery sched-
ules and hours of operation for a sales
organization.
Conclusion
By first deciding that a disaster
response and recovery plan is needed,
you have likely already done more than
most of your competitors. In my experi-
ence, most business owners do not have a
plan or their plan is to manage through it
like any other daily business dilemma.
The fault in this thinking is that disasters
are not dilemmas—that is why they are
called disasters.
•Identification.
•Prevention.
•Mitigation.
•Resumption.
•Recovery.
•Restoration.
These six steps are the framework for
developing a plan that will bring your
business back into operation quicker and
better than most companies have even
considered.
Many disaster response and recovery
planning resources are available. Your
insurance agent has resources from its
staff and the loss control staff of its carri-
ers. Websites offer tools to develop plans
that can be accessed anywhere with
secured passwords. The Small Business
Administration also has useful tools.
The recommendations in this article do
not identify all possible hazards and we
cannot be responsible on your behalf for
your obligations under any law, rule or
regulation. Continuously identifying and
16 Vol. 7 ● No. 3
Beat Your Competition
By first deciding that a
disaster response and
recovery plan is needed,
you have likely already
done more than most of
your competitors. In
my experience, most
business owners do not
have a plan or their plan
is to manage through it
like any other daily
business dilemma.

guarding against hazards is essential to
the safety of your customers, employees
and property and will lead to improved
business operations. Ⅲ
Sources
Fireman’s Fund Insurance Co., http://
www.firemansfund.com.
iCustomer—a customer-only website
for resources including articles, checklists
and guides for disaster recovery. Vendor
partners such as eVault for secure data
back-up and recovery, Peppercom for cri-
sis management and others.
Sungard (http://sungard.com). Vendor for
systems recovery and crisis management.
Department of Homeland Security
—Disaster Preparedness (http://www
.ready.gov). Tools and resources, including
Disaster Recovery planning checklists.
Agility Recovery Systems (http://
www.agilityrecovery.com)
Vendor for disaster recovery services
and consultation—Peppercom (http://
www .peppercom.com)
Crisis management consulting and
services:
Blindsided—A manager’s guide to cat-
astrophic incidents in the workplace
Bruce T. Blythe, CEO, Crisis
Management International, Penguin
Putnam Inc., New York.
Note: This list is not an endorsement
or recommendation of service providers
and is not all-inclusive of resources avail-
able in disaster response and recovery
service providers. Persons must perform
their own due diligence in selection and
evaluation of service providers.
Mark D. Oldham, CSP, is director of loss control
for Fireman’s Fund Insurance Co. in Midlo-
thian, VA. He is also Administrator of ASSE’s
Risk Management/Insurance Practice Specialty.
Reprinted with permission from The Profe-
ssional Resource, Sept. 12, 2006, Fireman’s
Fund Insurance Co., Novato, CA.
ow safe is the operation of your
company’s motor vehicles? What
are the typical causes of motor
vehicle crashes, incidents and events?
What should be checked to prevent motor
vehicle problems?
Warm-Up Exercise:
Group Discussion
List types of undesirable motor vehicle
events and how you currently compensate
for them or how to improve in these three
categories (sample answers in parentheses).
Category 1: Vehicle Condition
(Preventive maintenance, repairs, vehi-
cle abuse, vehicle assignments, clearance,
collisions, routine maintenance, vehicle
cleanliness, care, pride, policy/procedures/
training, reflective markings, reflectors and
lights, daily, weekly, monthly quarterly or
annual inspection, vandalism, ventilation,
securing loads for transport, radio and
communication devices working.)
Category 2: Driver/Operator Condition
(Self-care: well-rested, well-nourished,
groomed, uniformed, proper training for
the vehicle; route is established/planned in
advance, safety belt use, safe lifting/han-
dling, slips/falls, strains/sprains, speeding,
distractions, fatigue, courteous, abides by
rules of the road as well as by organiza-
tional policies, procedures and protocol,
mindful of traffic: congestion, other driv-
ers, other vehicles, pedestrians, vandalism,
weather. Care for vehicle, from document-
ed inspection and log, to ensure that vehi-
cle is maintained.)
Category 3: Environment
(Traffic density, signs, lights, markings,
parking areas, communications, detours,
construction zones, weather, other drivers
and vehicles, nonmotorized traffic users,
including animals, pedestrians and bicy-
cles, nonlicensed or off-road vehicles such
as yard equipment, forklifts or lift trucks.)
What Can We Do?
Group Discussion 1
(Vehicle Condition)
•What are the leading causes of fatali-
ties for motor vehicles?
Ⅲ(brakes; other vehicles “did not see”;
speed; alcohol; space management).
•What contributing factors lead to
these events and what can be done to pre-
vent them from happening?
Ⅲ(routine inspection; preventive mainte-
nance; following policy and procedure;
education and training; enforcement;
engineering).
•What can we do about our own
responsibilities for vehicle conditions?
Ⅲ(drive vehicles only if they are in
working condition; inspect and main-
tain vehicles; follow through to ensure
repairs; take pride in vehicles from
cleanliness to mint condition).
•Discuss newer designs of vehicles.
Are hazards created with these new
designs or do they contribute to crash
prevention?
Ⅲ(air ride seats; computer feedback;
GPS; new technologies).
Group Discussion 2
(Driver/Operator Condition)
•Describe ways that drivers and opera-
tors can be well-informed in motor vehi-
cle safety (federal, state and local laws,
ANSI/ASSE Z15.1 standard).
•Discuss contributing factors to fatali-
ties from the perspective of the driver’s
condition and how to prevent them
Ⅲ(speed, alcohol and other drugs,
fatigue/distractions, SBU, routing
and scheduling by planning ahead,
defensive driving, blending and
flowing/separating and compromis-
ing with other vehicles and sur-
roundings).
•If there is access to trends in your
organization, share a “typical” motor
vehicle crash scenario and discuss how it
could be prevented. If not, draw real
experiences from the group.
•Discuss the feasibility of having a
crash and injury review team at your
facility, acknowledging both the benefits
and disadvantages.
Group Discussion 3 (Environment)
•Identify ways that communication is
used in the traffic/transportation/motor
vehicle environment.
RM/Insight ● 17
Motor Vehicle Safety: Managing
Your Company’s Risk Factors
By Amy Stewart, CSP
H

Ⅲ(Signage, colors, audible/visual
alarms, signals, markings, traffic
patterns, gestures).
•Examine why environmental factors
contribute to motor vehicle crashes:
Ⅲ(Engineering design, road surface;
lack of warning; road construction;
the human element; weather).
•What can we do as drivers for motor
vehicle safety to survive in the opera-
tional environment, from aggressive or
distracted driving to mobile telephone
usage to impaired drivers?
Ⅲ(Be courteous, take care of self and
vehicle, disengage and keep space
from hazards, follow rules and
regulations)
Checklist/Guidelines for
Motor Vehicle Safety
1) Pretrip
•vehicle conditions are clean, fueled
and maintenance is up-to-date;
•driver conditions are clean, fueled,
maintained and up-to-date.
2) Maintenance schedule is document-
ed for operations and maintenance.
3) Look for damage or vandalism and
report where appropriate.
4) Ensure that employees recognize
their own conditions and strive to be safe.
5) Realize environmental changes are
a part of motor vehicle safety and look
for:
•traffic density;
•nonmotorized highway users;
•signs, lines, markings and lights;
•clues to the environment that can
cause crashes.
Methods & Strategies
for Presentation
Through group discussion, workers
will raise each other’s awareness of motor
vehicle hazards and incorporate hazard
identification in the workplace through
safety committees, peer-to-peer feedback
and employee suggestions. The leader
will offer employee suggestions to upper
management, where appropriate and sup-
port job hazard analysis as well as crash
and injury review, where applicable.
Conclusion
Action
Workers must be mindful of what they
are doing and aware of the actions of
those around them. We may raise aware-
ness of the dangers surrounding motor
vehicles to identify opportunities for
improvement. Plenty of resources are
available internally, locally, statewide and
federally to support the direction of motor
vehicle safety. Time, level of enthusiasm
and energy are the only limitations. De-
termine the greatest exposure to your
organization, search for factual informa-
tion to support solutions and work with
employees to identify what works best for
the organization.
Group Actions
The safety committee should design a
list of improvements that can be made in
the motor vehicle area of the organization
and prioritize, beginning with minimal
cost to “super-size” involving major
upper management investment, instilling
a “not on my watch” attitude.
Tailor an orientation-training program
for all employees who operate motor
vehicles in any capacity and include pro-
cedures, rules and guidelines for keeping
injury/fatality/damage-free. Continue
with refresher and follow-up training and
include analysis and review of incident
rates to give feedback to those on the
frontlines who may benefit from knowl-
edge of risk exposure. Ⅲ
References
49 CFR
ANSI/ASSE Z-15.1-2006, Safe
Practices for Motor Vehicle Operations.
Commercial Driver License Manual—
www.aamva.org.
Digest of Ohio Motor Vehicle Laws—
www.bmv.ohio.gov.
Responsible Driver Handbook—www
.PublicSafety.ohio.gov.
Commercial Vehicle Safety Alliance.
North American Standard Out of Service
Criteria for the Motor Carrier Industry.
Bethesda, MD April 1, 2001.
Federal Transit Administration Office
of Safety & Security. Guidance Docu-
ment Core Element Operator/Employee
Training Draft for Review. Washington,
DC: March 12, 2004.
NIOSH. (2004, March). Work-related
roadway crashes, Who’s at risk? (NIOSH
Publication No. 2004-137). Washington,
DC: Author.
National Safety Council and Center
for Transportation Research and The
University of Tennessee. (2002, April).
International Truck & Bus Safety
Research & Policy Symposium Executive
Summary. Knoxville, TN: Author.
Websites
ASSE—www.asse.org.
American Trucking Associations—
www.truckline.com/index.
Federal Motor Carrier Safety
Administration—www.fmcsa.dot.gov.
Federal Register—www. Access.gpo
.gov/nara.
Federal Transit Administration— http://
www.fta.dot.gov.
National Highway Traffic Safety
Administration—www.nhtsa.dot.gov.
NIOSH—www.cdc.gov/niosh.
National Safety Council—www.nsc.org.
National Transit Institute—www
.ntionline.com.
Substance Abuse and Mental Health
Services Administration—www.samhsa
.gov.
Smith System—www.smith-system
.com.
Transportation Research Board. www
.trb.org
Transportation Safety Institute—www
.tsi.dot.gov.
U.S. Department of Transportation—
www.dot.gov.
Amy Stewart, CSP, is the project director for
Safe Schools/Healthy Students with a federal
grant from the departments of Justice, Education
and Health and Human Services. She is also
involved with the Society of Ohio Safety
Engineers’Patterns for Progress and the Ohio
Trucking Safety Council Board.
18 Vol. 7 ● No. 3
Motor Vehicle Safety
Workers must be mindful
of what they are doing
and aware of the actions
of those around them.
We may raise awareness
of the dangers surround-
ing motor vehicles to
identify opportunities
for improvement.
Learn more about ASSE’s
technical publications
at www.asse.org.

hile workers’ compensation
managed care is widely
viewed as a means of control-
ling expenses, the results are sometimes
quite different from what is expected. In
fact, in many cases, the consequences are
not only unintended but also undesirable
and costly to employers. How can a system
that is developed to manage the use of care
and costs associated with workers’ com-
pensation actually end up costing employ-
ers more than is necessary? Five common
mistakes often made when working with
workers’ compensation managed care
organizations (WCMCOs) include:
1) Employers assume that the
WCMCO’s goals are aligned with their
goal of safely returning the employee to
work as quickly as possible. When em-
ployers select a WCMCO, they believe
they are engaging experts who share their
objectives in the same way they choose an
attorney or accountant. On the surface this
makes sense. When employees are injured,
the employer’s goal is to provide the right
treatment at the right time by the right
physician so that employees can safely
return to work as quickly as possible.
On the other hand, the WCMCO’s
aims are more complex and require an
understanding of how they work. While
they may share the employer’s return-to-
work goals, they also must make a profit.
As a result, when the WCMCO recruits
physicians, it negotiates fees lower than
those mandated by the state, bill at the
mandated price and pay the discounted
fees to the physician. The WCMCO
receives a percentage of the savings and
the balance is reported as a savings to the
employer.
This arrangement has two unintended
and undesirable outcomes. First, top doc-
tors are not attracted to the network.
Second, it encourages more visits and
tests to make up for the loss of income.
The more treatments, the more that is
billed and the more the WCMCO earns.
It is well-documented that utilization is a
prime driver of medical costs in workers’
compensation that are higher than in non-
occupational employee health insurance.
Ironically, the “savings” to the employer
increases as more bills are processed.
2) Employers engage a WCMCO
that does not have physicians who are
properly trained in occupational medi-
cine. Treatment of job-related injuries
requires an expertise that transcends the
medical model followed by physicians
who are trained to treat pathology, disease
and impairments. In workers’ compensa-
tion cases, there must be an understand-
ing of the job’s functional requirements,
care coordination and communication
with the employee and employer, a
knowledge of how the employer can
accommodate an injured worker and a
grasp of the important psychosocial fac-
tors involved in returning to work.
Overworked physicians have little time
or incentive to visit patients’ workplaces
or to explore alternatives with the em-
ployer to maximize functional and voca-
tional recovery. This responsibility falls to
the nurse case manager whose role is to
consult with physicians, assist in review-
ing treatment plans, and help facilitate the
optimal and efficient recovery of the
injured worker.
Again, the system sets the stage for
undesirable outcomes. First, case man-
agement is in effect a rework because the
right work is not being done, adding
another layer and more expense. Second,
doctors do not perceive nurses as peer
reviewers. Lastly, many case managers
are not properly trained nor do they have
the skills to coordinate and guide this
complex process. In the white paper,
“The ‘Management’ in Case Manage-
ment,” Byran Chong, IBM Global Social
Segment, notes, “Between 10% and 50%
of case managers in workers’ compensa-
tion organizations are considered not
fully effective at what they do. These
employees lack knowledge and skills and
many are not motivated to improve.”
The result is episodic care management
with a focus on cases flagged for interven-
tion by the payer rather than a holistic
approach of managing all those involved in
the process to optimize outcomes.
In contrast, a study of Louisiana work-
ers’ compensation claims showed how a
specialized care network of occupational
medicine physicians and other specialists
with experience in treating workers’ com-
pensation patients and expert knowledge
of the physical demands of work, resulted
in significantly fewer lost days and 40%
lower costs of care.
3) Employers do not realize the
importance of evidence-based guide-
lines. When concerns were raised with
WCMCOs regarding over-utilization and
higher-than-expected costs, the compa-
nies developed “utilization reviews”
designed to monitor the care injured
employees receive to ensure that it is
appropriate, necessary and efficient.
It makes sense to have proven medical
protocols for injuries so that the right
treatments can be applied with the right
schedule to get the injured worker back to
work. While these protocols exist, many
WCMCOs do not use them. Since the
present system financially rewards the
networks when a claim goes bad, there is
an understandable reluctance to adopt
these important measures.
The American College of Occupational
and Environmental Medicine (ACOEM)
Practice Guidelines Committee publishes
scientific, evidenced-based occupational
medicine practice guidelines, commonly
referred to as ACOEM Guidelines. ACOEM
Guidelines consider the frequency, duration,
intensity and appropriateness of all modali-
ties and procedures that are most commonly
used in the treatment of injured workers and
establish benchmarks for the return to work.
A Society of Occupational Medicine
study of evidence-based care for low back
pain in workers eligible for compensation
concludes that those workers who had
evidence-based care had less time off
work, spent less time on modified duty
and had fewer reoccurrences compared
with those who had usual care.
RM/Insight ● 19
Five Costly Mistakes Employers
Make with Workers’ Compensation
Managed Care Organizations
By Frank Pennachio, CWCA
W

RM-Insight (Vol 7 No 3)

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