Saf Health Work 2011;2:105-21 | DOI:10.5491/SHAW.2011.2.2.

105
pISSN : 2093-7911
eISSN : 2093-7997

Review
Review of Qualitative Approaches
for the Construction Industry: Designing a Risk
Management Toolbox
David M. ZALK1, Ton SPEE2, Matt GILLEN3, Thomas J. LENTZ4,
Andrew GARROD5, Paul EVANS5 and Paul SWUSTE6
1
Environment, Safety, and Health Directorate, Lawrence Livermore National Laboratory, Livermore, CA, USA, 2Research and Development
Arbouw, Harderwijk, The Netherlands, 3Construction Program, National Institute for Occupational Health and Safety, Washington, DC, USA
4
Education and Information Division, National Institute for Occupational Safety and Health, Cincinnati, OH, USA, 5Chemical Risk Management
Unit, Health and Safety Executive, Bootle, Merseyside, UK, 6Safety Science Group, Delft University of Technology, Delft, The Netherlands

Objectives: This paper presents the framework and protocol design for a construction industry risk management toolbox. The
construction industry needs a comprehensive, systematic approach to assess and control occupational risks. These risks span
several professional health and safety disciplines, emphasized by multiple international occupational research agenda projects
including: falls, electrocution, noise, silica, welding fumes, and musculoskeletal disorders. Yet, the International Social Security As-
sociation says, “whereas progress has been made in safety and health, the construction industry is still a high risk sector.”
Methods: Small- and medium-sized enterprises (SMEs) employ about 80% of the world’s construction workers. In recent years
a strategy for qualitative occupational risk management, known as Control Banding (CB) has gained international attention as a
simplified approach for reducing work-related risks. CB groups hazards into stratified risk ‘bands’, identifying commensurate con-
trols to reduce the level of risk and promote worker health and safety. We review these qualitative solutions-based approaches
and identify strengths and weaknesses toward designing a simplified CB ‘toolbox’ approach for use by SMEs in construction
trades.
Results: This toolbox design proposal includes international input on multidisciplinary approaches for performing a qualitative
risk assessment determining a risk ‘band’ for a given project. Risk bands are used to identify the appropriate level of training to
oversee construction work, leading to commensurate and appropriate control methods to perform the work safely.
Conclusion: The Construction Toolbox presents a review-generated format to harness multiple solutions-based national pro-
grams and publications for controlling construction-related risks with simplified approaches across the occupational safety, health
and hygiene professions.

Key Words: Control banding, Qualitative risk management, Construction toolbox, Risk level based management system, Barrier
banding

Introduction
Received: February 28, 2011, Accepted: May 4, 2011 The construction industry is serviced by a collection of trades,
Correspondence to: David M. ZALK many of which have attendant hazards, a high risk of injury
Environment, Safety, and Health Directorate or illness, and involve working in a changing environment.
Lawrence Livermore National Laboratory Despite the existence of recognized and effective solutions and
PO Box 808 L-871, Livermore, CA 94551, USA
guidance for reducing risks from these hazards too frequently
Tel: +1-925-422-8904, Fax: +1-925-422-9974
they are poorly implemented. Control Banding (CB) is a sim-
E-mail: [email protected]
Copyright © 2011 by Safety and Health at Work (SH@W)
This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted
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plified approach for reducing work-related risks that uses a despite near-identical hazards.
qualitative risk assessment method leading directly to solutions
and, therefore, may be very useful to address this construction Construction industry needs
industry issue. The consequences of construction hazards can The construction industry is dominated by small- and medium-
be severe in terms of morbidity and mortality. Analysis of these sized enterprises (SMEs) who lack full time safety and health
incidence data calculated an average cost of US$27,000 per staff. In the US and NL for instance, about 80% of the con-
incident in construction, almost double the US$15,000 cost per struction companies are SMEs with fewer than 10 employees
case for all industry [1]. [12,13] and in Great Britain (GB) they account for 73% of the
An estimated 7% to 10% of the global workforce works industry’s fatalities [14]. As is true with general industry, the
in the construction industry. But the sector accounts for 30% to accident and occupational disease rates are often twice as high
40% of occupational fatal accidents worldwide: at least 60,000 among SMEs, compared with large enterprises [15]. The con-
per year [2,3]. The risks are similar worldwide, and are in many struction industry is highly competitive and work is typically
cases safety-related [4]. Falls from heights can cause significant awarded to the lowest bidder. Construction worksites are by
injuries, are often fatal, and the fundamental approach neces- their nature temporary, and typically involve multiple contrac-
sary to prevent this accident outcome was described over 3300 tors and subcontractors each present for only a portion of the
years ago (Deuteronomy 22:8). Even so, the numbers for con- project. These and other attributes contribute to hazards and
struction fatalities, injuries, and related costs are generally flat complicate national safety and health enforcement efforts. The
or continue to rise in the US, New Zealand, Taiwan, and The end result is that poor occupational safety, health and hygiene
Netherlands (NL) [5-8]. (OSHH) protection and enforcement shift disproportionate
In addition to injury risks, construction workers are also human and economic costs to the construction worker, their
exposed to a variety of health hazards. Potential hazardous families and communities [16]. Globally, construction employ-
substance exposures include: ers commonly utilize immigrant workers. These employees
·Solvent vapors from glues and paints typically speak non-native languages, may have low literacy
·Acids and alkalis used for cleaning skills resulting in many languages being spoken on a worksite,
·Reactive compounds such as epoxy resins and may have general communication issues between employ-
·Insulation materials, e.g. mineral wool ers and employees that go beyond language and literacy [17].
·‘Natural’ products e.g. quartz (from stone, concrete or Small employers often do the same job as their employees and
brick cutting), wood dust are without time to search for prevention, risk assessment, and
·Fume from heating or burning, e.g. torch cutting, weld- control information. As construction industry management is
ing, diesel exhaust, bitumen often output-oriented, as long as quality, time, and cost criteria
Many construction tasks also present physical hazards, e.g. are met, little thought is given to ensure protective measures
noise, vibration, and handling loads. Occupational hearing loss are used and followed. Often employees decide how the job
in the construction sector remains significant, even in nations is done. Therefore, ‘solutions initiatives’ are best aimed at em-
with strong regulations [9]. An estimated 30% of construc- ployee and employer [16].
tion workers have musculoskeletal disorders (MSD) and back It is unrealistic to expect most SME employers to dis-
pain, even though basic solutions have been available for 100 tinguish among separate OSHH fields. Small construction
years [3,10]. Industry recognition of health hazards is lower employers have been shown to view OSHH risks as the respon-
than that for injury hazards. The casual nature of employment sibility of employees instead of something integrated into their
in construction is likely to conceal disorders and diseases. For company management systems [4]. Few understand accident
example, MSDs could cause the worker to leave construction, prevention or detailed hazard awareness, often with controls
or respiratory disease might not develop until later in life. Com- unavailable or opting for the cheapest control measure [18,19].
plaint data from NL indicate construction workers generally Regulatory enforcement of control measure use is weakest with
do not complain about hazardous substances, with the excep- construction SMEs, and nearly non-existent in most countries
tion of a few specific jobs. However, over 50% of all construc- for accident and MSD prevention [16,19,20]. Effective enforce-
tion laborers complain about dust, apparently without being ment as a means of promoting control solutions use requires
aware that virtually all construction dust contains hazardous intense and sustained efforts that is unlikely to occur given
substances like silica and wood [11]. Even when implemented limited resources and expertise. Consequently, more effective
nationally, control solutions are rarely known or used widely, approaches will involve better mechanisms for reaching SMEs

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with holistic solutions to industry challenges, rather than a reli- measures properly [30,31]. To significantly affect injury and
ance on enforcement and punitive strategies. illness rates in the construction industry, a consistent and coor-
dinated message must present a simplified method for ensur-
Health and safety perspectives ing risk assessment, risk prioritization, and workable solutions
Construction hazards have received considerable attention readily available to workers. Given the similarity of construc-
over the last two decades. Researchers internationally have tion hazards and control implementation problems across dif-
examined hazards, consequences, and costs and developed nu- ferent countries, a strong case can be made for increased global
merous interventions and tailored controls [6,11,16,19,21,22]. collaboration and better utilization of limited resources.
Construction has also grown as a specialty practice area for
OSHH professionals. Although injury and fatality rates have Objective
become relatively flat over the last two decades for larger firms,
injury rates remain high for SME construction firms. Nu- Several initiatives have been presented to overcome the variety
merous research needs remain and transfer of research from of hazards in the construction industry that are multidisci-
peer-reviewed journals to construction practice, and between plinary and multinational. The National Institute for Occu-
countries, has been slow. There is increasing recognition that pational Safety and Health (NIOSH) National Occupational
implementation of evidence-based public health interventions Research Agenda identifies priority construction challenges
of all types is hampered by the near total absence of systems and related goals for seven specific hazards: falls, electrocution,
and infrastructure for marketing and distributing information struck-by hazards, noise, silica, welding fumes, and MSDs [32].
to end users [23]. Many countries are getting more involved The International Social Security Association has created a
with transfer, ranging from developing “Research to Practice” construction-based declaration stating “whereas progress has
programs in the US, to improved packaging of technical guid- been made in safety and health, the construction industry is still
ance in GB, to industry in NL. Increasingly, research programs a high risk sector with respect to accidents and occupational
are attempting to develop more comprehensive approaches to diseases, often resulting in premature death or disability retire-
transfer research findings to practice. ment” [33]. The declaration resolves to “all nations” that “mas-
Respirable quartz dust (silica) provides an excellent ex- sive action must be taken” to address this situation and “the
ample of these gaps and challenges. Silicosis in construction main focus should be risk prevention.” A NIOSH resource also
has been an issue for decades and preventative methods are notes “construction work is an important example for showing
well known to OSHH professionals [24]. Awareness of silica how an application moving directly to exposure controls based
hazards among SME contractors has lagged behind awareness on the task performed is the best use of the Control Banding
of injury hazards. Silica as a recognized hazard in NL began strategy” [31]. The purpose here is exploring possibilities for a
getting attention in the early 1990s [25]. Despite several initia- multidisciplinary approach addressing these initiatives utilizing
tives taken to reduce silica exposure in construction, inconsis- international input. The goal of this paper is investigating the
tent application of control measures has led to early signs of feasibility of utilizing CB strategies to develop a toolbox model
silicosis in newer construction workers [26,27]. Since then, the that addresses risk prevention for the hazards that threat the
Dutch government and the sector jointly invested approximate- construction worker.
ly 16 million euro for developing and implementing measures
to reduce silica exposure [28]. In 2007, however, Dutch Labor Methods
Inspectorate inspections showed only 30% of the construction
companies take measures against dust at high exposure levels This analysis is divided into two parts: (i) overview of solutions-
[22], a figure which is exactly the same as it was before this based models to derive multidisciplinary elements necessary for
investment [26]. In NL, therefore, one can conclude that the the construction industry and (ii) designing a toolbox frame-
investment has not led to implementation of more control mea- work to develop risk ‘bands’ for construction projects and iden-
sures, so far. tify commensurate control methods to perform comparable
Increasingly important is focusing on preventive and con- work safely. The overview provides a presentation of available
trol methods for common work-related hazards [29]. In shift- solutions-based models and analyzing them according to their
ing the focus to ‘prevention’, it is vital to transfer information strengths and limitations. Emphasis is given to research find-
comprehensibly, so workers and employers can understand the ings that can be standardized into usable information products
hazards and risks, how they apply, and how to use the control for contractors and workers ensuring solutions generated can be

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transferred between countries. An original toolbox framework ance and regulations.

is then designed from both existing and new elements that are The US Occupational Safety and Health Administration
necessary and practical for multidisciplinary application based (OSHA) appear to concur with universal precaution terminol-
on research for organizing and delivering solution options for ogy in a “Quick Card” for construction PPE. The single-page
construction SMEs. Quick Card also covers very basic information on selection,
use, and care for prescribed PPE. Construction universal pre-
Solutions-Based Models cautions listed are PPE for the: eye, face, foot, hand, head, and
hearing protection. Simple guidance from the GB Health and
Solutions-based OSHH research for controlling risk or expo- Safety Executive (HSE) expands on this model: “The absolute-
sure is currently divided by hazard: ly essential health and safety toolkit for the smaller construction
·Chemical risks - silica, solvents, welding fumes, asbes- contractor”. This sets out checklists for many of construction
tos, and lead. hazards, presenting short, simplified, and standardized controls
·Physical risks - ergonomics risks, noise, vibration, heat, by industry sector.
and cold. A universal precautions model represents a simple binary
·Safety risks - working at heights, with energized equip- approach: when or wherever the hazard is present the same
ment/machinery, unstable structures. control approach is used. The simplicity of this approach is a
Various governmental, professional, and industry groups major strength. It is the easiest to communicate to employers
have developed guidance, recommendations, and solutions for and employees. It serves to create a baseline of holistic con-
use by construction employers. There are a number of ways struction rules that every employee should be trained on and
to organize solutions-based information. We have divided aware of, before entering a construction site. It works well with
up solution approaches into three models that reflect relative easily recognized hazards. Disadvantages of universal precau-
complexity of evaluation and control. This provides a helpful tions may arise when this approach is applied to complex
perspective given that the most straightforward low complexity hazards because the approach may result in overprotection and
solutions are most likely to be successfully communicated to, perceived burden in some cases and under-protection in others.
and implemented by, SMEs. These three risk approaches are: While this may not be a significant issue for low cost controls
·Low complexity - Universal Precautions such as hard hats, it is more challenging for more costly con-
·Medium complexity - CBs, subdivided as trols. While universal precaution approaches should always be
- Task-to-Control considered, they may not be suitable for complex hazards rang-
- Risk-to-Control, and ing in severity based on site-specific factors.
·High complexity - Expert Driven
Control banding model
Universal precautions model CB is a medium-complexity approach to evaluation and control
We describe the least complex approach as ‘universal precau- of hazards. It involves a structured evaluation of tasks, opera-
tions’ because it involves using a basic control in every situa- tions, or work settings. It does not involve quantitative exposure
tion involving a particular hazard. The term is commonly used assessment, utilizing operation-specific objective information
in occupational health to describe the use of hand and face such as quantities of materials used, exposure properties of
personal protective equipment (PPE) in health care with all substances handled, and nature or duration of tasks. CB origi-
patients to avoid contacting bloodborne pathogens and other nated in the pharmaceutical industry for use as an alternative
bodily fluids. An example of a common universal precaution approach for controlling chemical exposures in the absence of
in construction is the use of hardhats and steel-toed shoes by occupational exposure limits and from European systems link-
all site workers. These precautions are universal because they ing exposure to control systems [31]. It relies on decision rules
are implemented on every worksite regardless of work scope or derived from prior quantitative studies of various exposure
tasks performed. Universal precautions also include other types factors. CB allows users to make meaningful inferences about
of measures higher in the control hierarchy, such as machinery likely exposures and controls needed to reduce them. Thus it
guarding, requirements for ladders, prohibited activities, safe represents qualitative risk assessment and risk management ap-
traffic routes, equipment maintenance, residual current devices, proaches. CB groups workplace hazards into four or five strati-
and requirements for extracted or emission-suppressed tools. fied risk ‘bands’, identifying commensurate control measures.
The approach is widely used for safety hazards, both in guid- Such risk assessment is necessarily generic, so the bands used

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should apply precautionary assumptions. While OSHH profes- Task-to-control model

sionals have viewed CB and simplification as a lesser option to The T2C approach organizes control recommendations by
quantitative methods, recent application of CB to nanomaterial task, rather than by level of risk. PPE may also be recom-
exposure control has altered that view significantly [31,34,35]. mended for those controls not sufficiently reducing exposures.
An important application for CB is where uncertainty is high, Standardizing tasks afford multidisciplinary perspectives across
such as when exposure limits do not exist but substances can the OSHH professions. Although standardizing construction
be reliably grouped based on similarity to better studied sub- industry tasks is a substantial challenge, there are both common
stances. Or when tasks vary in nature, setting and duration, as tasks and task components that can meet this expectation. In
is often the case in the construction industry. GB, the Control of Substances Hazardous to Health (COSHH)
Development and validation of CB has accelerated inter- Regulations were not well understood by SME employers who
nationally, resulting in occupational risk management models lacked OSHH expertise, prompting requests for simplified ap-
being built upon CB principles [31,36,37]. Most CB ‘toolkits’ proaches to compliance. This led to ‘COSHH essentials’, a
are national initiatives to control SME employees’ exposures to CB toolkit combining hazards of chemicals or products, and
chemicals, especially substances without exposure limits. CB potential exposure, to identify appropriate control measures via
strategies have also expanded recently to ergonomics and injury ‘Control Guidance Sheets’ (CGS). Strengths of the T2C model
prevention [31]. CB publications have helped increase control include addressing risks, for a variety of hazards, by identifying
use by providing an evidence-based alternative to quantitative established standardized control solutions for individual tasks.
exposure assessment. CB efforts have helped emphasize the Limitations include potential for excessive or insufficient con-
need to increase control implementation for SMEs. Although trol that standard approaches present. This is particularly true
researchers and OSHH practitioners have long worked hard to for construction tasks with substantial variability and a heavy
communicate solutions, even through the late 1990s literature reliance on PPE rather than the well-established hierarchy of
was inconsistent in reporting intervention effectiveness and controls.
good practice [38].
Increasing global need has expanded the popular defini- Silica and asbestos
tion of CB as a risk assessment-banding-control model to in- In 2005, new evidence for risk to health at the existing GB
clude “task-to-control” approaches focused on controls needed silica exposure limit, (0.3 mg/m3 as an 8-hour Time Weighted
for specific tasks. Since 2000, national and international col- Average) emerged [39]. This created needs for task-related
laborations facilitated through the World Health Organization guidance describing a precautionary degree of good control
(WHO) and the International Labor Organization (ILO) have practice the new limit at 0.1 mg/m3. This guidance, ‘Silica es-
been a major driver. These global organizations have provided sentials’, is identified by industry: here ‘COSHH essentials for
significant impetus to CB, backing an array of initiatives to pre- construction’. ‘Silica essentials’ is a good example of using 33
vent work-related injury and illness wherever OSHH expertise construction-related CGS for point-source hazards generated at
is lacking [30]. US NIOSH highlights construction sector at- worksites, with good exposure assessment and controls estab-
tributes, such as pre-job planning for preventing and managing lished. Also, a series of HSE CGS for ‘non-licensed’ asbestos
construction hazards, suggesting that CB approaches could fit work applies to lower risk asbestos work in the construction
well [31]. Researchers commonly use construction task-based sector. These present the T2C approach in a similar manner as
exposure models to evaluate and understand the episodic, high- ‘Silica essentials’, with commensurate approaches to reducing
ly variable exposures associated with construction activities, exposures.
and develop work practice and control solutions. While con- This T2C approach to the CB model is effective for SMEs.
struction is a definitive multidisciplinary activity, such research It gives imperative advice on control measures for defined tasks.
and solutions tend to not be easily accessible for the worker. It utilizes research findings on exposures associated with tasks
OSHH expertise available to SMEs is lacking: meanwhile, reg- along with research on effectiveness of controls. The advice re-
ulatory standards and guidance call specific practices and con- flects expert consensus, tested by SMEs for usability, acceptabil-
trol measures for defined tasks. To date, no set of tools has been ity and comprehensibility. Advice is accessed by selecting the
developed for construction contractors; although many “task- appropriate task, such as rock drilling, tile pressing, or abrasive
based” control measures exist and align with CB concepts. To blasting, and downloading the CGS [40], with ancillary guid-
address variability needs, the CB model divides into two sub- ance (e.g. appropriate respirator selection; health surveillance
categories: task-to-control (T2C) and risk assessment. for silicosis). Strengths include field application and evaluation,

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with the ‘Silica essentials’ CGS being implemented in Southern Noise

Africa and Latin America, often adapting the CGS to local Noise-induced hearing loss remains common and exposure to
conditions and resources. Many have been translated to Span- high noise levels remains a major issue for construction work-
ish and Portuguese [41]. In addition, the US Center for Con- ers globally [9]. Noise and hearing protection belong both to
struction Research and Training (CPWR) targets silica control T2C and universal precautions. Although the potential for ap-
advice directly to workers, in a manner comparable with HSE plication of noise reduction and barrier solutions in construc-
CGSs. These are in two formats: Construction Solutions Work tion have been around for decades, they are viewed as cost-
Practices, and Hazard Alerts [42]. Other national studies also prohibitive even though there are few data to substantiate this
identify limitations of relying on respirators alone for silica ex- perception [51,52]. Both US and GB research indicates that
posure control in Worksafe Victoria (Australia) and Worksafe the least expensive and most beneficial noise control practice is
BC (Canada). NIOSH has developed a number of task-based to ensure that construction equipment is working and is main-
“Workplace Solutions” for grinding concrete, tuckpointing, tained appropriately [53]. However, the construction industry
breaking concrete with a jackhammer, and rock drilling. will always have to use hearing protection and its use in US
construction worksites is common. But a study of construc-
Ergonomics tion workers in their first three years of apprenticeship found
Currently the limitation is that there are no true CB toolkits for measurable hearing loss, even though average noise exposures
ergonomics; however, recognizing that a number of approaches were measured below 90 dB(A) [54]. Research has produced
and supportive research fit ‘T2C’ can be seen as a strength. For substantial information, but correlating elevated noise levels to
example, tiling and plastering involve a significant amount of either trade-based or task-based construction activities is diffi-
removing and installing materials, overhead and at floor level, cult for prioritizing intervention resources [55-57].
with extensive heavy lifting, twisting and carrying. Construc- Despite the investment to develop a quantitative task-
tion Solutions Work Practices (developed by CPWR) is a based solution, University of Washington found that a quali-
‘Construction Solutions’ database and an excellent source of tative evaluation provided a better exposure prediction [55].
information for controlling MSD risks. CPWR offers control Recent research by Neitzel focused on methods to increase the
solutions in a quasi-CGS format for carrying heavy materials, actual use of abundantly available hearing protection by de-
stooped postures for floor level work, and stressed hand and ploying a semi-quantitative noise level indicator with an alert.
wrist activities. CPWR solutions for lifting and carrying include The device, worn by a construction worker, lit up at elevated
using lightweight concrete materials, tool extension devices noise levels as a reminder to use hearing protection. This ap-
for work at floor level, and ergonomically designed hand tools proach created an effective, low-cost individual worker’s T2C
to mitigate wrist and arm MSDs ‘NIOSH Simple Solutions’ that fits noise variability and construction SME needs. Wearing
for construction ergonomics offers a solutions-based approach the device for just two months ensured significant increases
for floor level or overhead lifting, and for handling, and hand- in workers’ hearing protection use another two months later.
intensive work in the form of Tip Sheets [43]. Acknowledging Combining this approach with HSE control solutions can lead
that sharing worker-developed ergonomic solutions remains to a CB toolkit.
limited, the CPWR Construction Solutions database affords
an opportunity for posting to share trade-based ergonomic risk Safety risks
reduction solutions. Simplified solutions to reduce MSDs for There is a limitation in that there are no existing CB strategies
work at height and floor level can also be found in Ergonom- for ‘Safety’. Research is working in this direction, however,
ics Checkpoints [44]. These might form an appropriate basis and T2C resources to prevent construction injuries continue to
for the development of CB ergonomic toolkits, because such appear. A CB-like approach for safety risks, known as Barrier
practical approaches aim specifically at SMEs internationally Banding, aims to simplify injury prevention [58,59]. Rather
and have been updated and improved [45,46]. Task-based ergo- than ‘control measures’, safety identifies ‘barriers’ such as
nomics solutions are effective, but ‘participatory ergonomics’ machinery guarding or fall protection to prevent injury. Such
has the most sustainable effect. ‘Participatory methods’ means barriers are related strongly to safety management systems.
developing solutions that, in collaboration with workers and The technique involves check-phrases that describe potential
SME managers, include construction SME strategies [46-48]. accident scenarios, which guide the user towards appropriate
These methods led to a measured risk reduction of up to 34% precautions against injury [58,60]. This comprises:
for lifting and carrying materials [49,50]. ·An innovative look at construction site safety risks

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·Identifying preventative measures necessary to reduce Risk-to-control model

these risks, and A limited selection of CB toolkits are available that could help
·Having control measures and barriers in place before the construction sector. The Risk-to-Control model utilizes a
work starts. Risk Level (RL) matrix approach, utilizing qualitative risk as-
There are a number of solutions-based initiatives that fol- sessment techniques. Parameters for defined tasks determine
low this approach, with downloadable information for both the RL. This RL approach assists in ensuring control measures
construction workers and employers. For example, NIOSH are sufficient to control risks. Strengths of this approach are
funded CPWR development of an electronic Library of Con- that controls are stratified commensurate to risk, it follows the
struction Occupational Safety and Health (eLCOSH ) identify- hierarchy of control, and it promotes the potential for substitu-
ing appropriate risk reduction methods for common construc- tion. The strengths and limitations of CB toolkits, as well as
tion injuries. In 1997 four stakeholder focus groups began an the different types of toolkits from various countries, have been
evaluation of eLCOSH to ensure organization of existing well described [31,36,61].
available construction OSHH materials. The website has since While ‘COSHH essentials’ could be utilized as a construc-
grown to 836 documents, with 150 in Spanish. The Construc- tion RL approach, its applications are limited because the focus
tion Solutions database is another internet-based resource from is the fixed workplace. ‘COSHH essentials’ and the comparable
CPWR and NIOSH, referred-to under ‘noise’, above. It was Einfaches Massnahmenkonzept Gefahrstoffe (EMKG) tool-
developed in response to needs of contractors, supervisors and kit from Bundesanstalt für Arbeitsschutz und Arbeitsmedizin
workers in the field who want immediate and accurate infor- (BAuA) have been evaluated for adequacy of its recommended
mation when confronted with problems. The database provides control for tasks in SMEs requiring solvent-based components
control solutions to construction industry hazards by identify- and may also be useful for tasks using large quantities of dry
ing interventions and control measures demonstrated as effec- materials, such as construction-related powders and dusts [62-
tive. Content is created from peer-reviewed literature and other 64]. Previous evaluation of the ‘COSHH essentials’ determined
available information. The Construction Solutions database strengths of the toolkit for solid substances such as powder and
describes T2C measures in practical, end-user terms, organized dusts, however there was a potential for exposure underestima-
by hazard and task. The success and value of the database for tion for small quantities of volatile liquids over large surfaces
users will depend on having sufficient coverage for hazards and such as glue in a carpenter shop [62]. Recent evaluation of CB
controls for a given task or trade. It will be launched in phases against quantitative data sets with solvents and in carpentry-
as various sections are completed. It can support, and encour- related production show excellent control of exposures below
ages, construction user feedback and suggestions for other solu- established limits, however a probabilistic model shows CB
tions. This T2C approach for safety solutions is growing with does not guarantee compliance except for volatile liquids in
a NIOSH group developing a general Solutions Database for closed systems and solids with local exhaust ventilation [63].
SMEs and other countries working on similar databases (Aus- In addition, CB limitations in construction could include some
tralia, GB, NL). A task-based prototype for hazards and control many hot processes, gases, and spray applications.
measures for “Masonry, Cement, and Plaster” is being tested The premier RL approach is ‘Stoffenmanager Construc-
on focus groups. tion’, developed as a pilot to control silica dust exposures for
Excellent standard implementation guides are offered plasterers and tilers [65]. Its concept is that risk assessment and
in Australia through Worksafe Victoria in booklet format. advice should be based on quantitative exposure assessments
The T2C measures presented for concrete cutting and drilling wherever possible and modeled calculation should only be
include a step-by-step approach to address electrical safety, applied when there were no exposure data. Stoffenmanager
working at heights, barriers necessary for safe work with equip- for control of exposure to silica dust has three risk assessment
ment, and PPE necessary for specific tasks - an expansion of routes, depending on the data available. The program deter-
universal precautions. The booklet also provides a checklist for mines which route to use:
site and equipment safety, and site-specific Job Safety Analysis ·Route 1 uses quantitative exposure data as well as quan-
worksheets. These ensure that prior to starting, comprehensive titative data about the effectiveness of control measures.
safety measures are in place, commensurate control measures It calculates an exposure factor (EF), a reduction factor
are implemented, and responsible person identified. (RF) and a remaining exposure factor for each task
·Route 2 uses a database of about 4000 building materi-
als and products (developed for the Product Group In-

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formation System Arbouw) to locate workplace instruc- Expert-driven model

tion sheets The expert model approach represents the traditional approach
·Route 3 deals with products that are not in the database. whereby an employer utilizes an OSHH professional to evalu-
As in chemical control version of Stoffenmanager, the ate site specific hazards, recommend controls, and manage a
assessor must enter data. safety and health program or system to insure effective imple-
mentation. This conventional approach is commonly seen as
Factors the ‘gold standard’. Strengths are obvious as expert derived
‘Stoffenmanager Construction’ uses exposure and reduction prescriptive solutions effectively follow the established hierar-
factors. This is a useful technique to assess the control require- chy of controls and are the standard of OSHH professions.
ment for a task, through the degree to which an exposure limit This approach provides the highest confidence that hazards
is exceeded. According to the European Standard 689, a situa- are properly evaluated and controlled, especially for highly
tion is adequately controlled if the probability of exceeding the complex hazards. OSHH professionals are expected to know
limit is 5% or less. Therefore, the 95th percentile (95th %) value about research describing exposures and control effectiveness
of exposure data sets is used as the measure of exposure for the from professional journals and learning about developments
task. via professional conferences. OSHH professional employment
·EF is calculated by dividing the measured exposure by by construction employers also helps to institutionalize and
the applicable limit value, whether this limit is health- integrate OSHH at the organization level and into other key
based or performance-based. business areas such as design and procurement. The major
·RF shows to what extent a defined control measure is limitation of this approach is that most SMEs do not employ
capable of reducing an exposure. It is calculated by di- OSHH professionals as they are expensive and in many parts
viding the exposure concentration with no control mea- of the world are rare or non-existent. OSHH professionals also
sure by that with a defined control measure. The RF is tend to specialize, thus requiring multiple consultants. While
also calculated as the 95th % with and without control. the expert-driven model will always be critical for large employ-
Where there is more than one control measure, the RFs ers and complex hazards, limitations of this approach have
for each separate measure are multiplied, e.g. RFLEV × fuelled interest by governments and international organizations
RFwater suppression in developing CB approaches that provide meaningful alterna-
·Divide EF by RF. The remaining value is the EF after tives for SMEs.
control measures have been applied. If the remaining
EF is greater than 1, additional control measures are Framework for a Construction
necessary. Toolbox Model
In summary, CB utilizes existing researcher data on ex-
posures and control effectiveness. It packages this information Banding of risk
into decision rules that allow the selection of controls to be Over the last few years CB has expanded into wider OSHH
tailored to either specific tasks (T2C) or the most common sce- fields, beyond substances and chemical products. These are
narios and control options (Risk-to-Control or RL Approach). termed ‘toolkits’: a ‘toolbox’ may contain several toolkits [31].
The advantage of CB is that it offers flexibility to accommodate Toolkits use the CB approach of ‘banding’ for assigning the
workplace variation and increases likelihood that appropriate risk of a given hazard to one of several - typically four - levels.
controls are used. CB can be considered more complex for em- Expert models use quantitative risk assessment methods to
ployers to use than T2C, therefore reliability can increase when stratify the risk and define the boundaries between strata. They
employers have had some basic CB training [37]. It lends itself use data to assign the efficacy of control measures into bands.
to a “competent person” approach, where a trained individual International collaborations are developing toolkits as ‘preven-
employed by the contractor has the knowledge and authority tive’ measures for OSHH experts and non-experts alike. Tool-
to implement controls. Disadvantages of CB approaches are kits should guide non-professionals, and inform professionals.
the lack of quantitative exposure assessment and direct involve- International CB workshops have promoted CB expansion,
ment of an OSHH professional. Therefore, overexposures research, and publications. They have been a focal point for
could occur if controls are not implemented correctly or main- original applications of simplified risk banding and control
tained over time. approaches for silica exposure, ergonomics, and safety [31,36]
and have led to this international collaborative opportunity.

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Construction industry risk banding requires identifying the Level of risk

right safety solutions across OSHH disciplines to achieve injury Safety science has qualitative and semi-quantitative tools to as-
and illness prevention. Assigning a band to a project, just as for sess risks [68,69]. Risk is seen as a numeric variable. Simplisti-
tasks, is a practical approach to identify and reduce risks relat- cally, it combines an adverse effect (or its severity) with a prob-
ing to work-related accidents and disease. ability of that consequence. Probabilities and consequences
Construction stakeholders under NIOSH assembled a Na- are classified into groups and provided with a value. Simple
tional Construction Agenda. The agenda provides a framework multiplication of values for probability and consequence pro-
upon which to develop and promote a construction toolbox, duce a risk score, used to compare one risk with another for
including intermediate goals that build upon task-based con- prioritization. An exposure/frequency estimate of hazard
trol measures, and moves towards pre-job planning, awareness and probability of specified consequences for scenarios are
training, competent person training, and CB use. However, compared [69]. Other variations of these tools can include the
interest of US researchers and practitioners in CB construction numbers exposed or the degree to which risk can be controlled
applications has not led to the development of a toolbox for via ‘relative ranking’. The RL model most often used is divided
use by ‘duty holders’ - employers, designers and contractors. into four categories, with determination by frequency and se-
A variety of applications, generally falling under the rubric of verity of hazard. This RL approach has been used recently for
“task-based” approaches or toolkits, align with CB risk band- an occupational hygiene qualitative risk assessment to control
ing concepts. For example, construction researchers recognized nanoparticle material exposure [35] and as part of a Risk Level
early on that “task-based sampling” was most appropriate for Based Management System (RLBMS). The RLBMS is a risk-
understanding and controlling exposures with construction based occupational risk management model, designed to focus
activities [21,66,67]. Multiple opportunities to utilize risk-based OSHH resources on the highest workplace risks. This model is
CB strategies in the construction industry exist. also auditable, so it fits OSHH management systems and na-
tional regulatory oversight [37].
Examples The RLBMS model is an appropriate framework for
Two major OSHA health standards for construction -for lead bringing together the control-focused research and solutions-
(1926.62) and asbestos (1926.1101) - include task-based alterna- based approaches [37]. RLBMS has shown consistency in
tives that reinforce regulatory applicability. integrating multiple solutions across the OSHH professions
·The lead standard required that specific precautions be utilizing an RL delineation of hazards and commensurate con-
used for identified tasks, ranging from work involving trols. Strengths include the use of qualitative risk assessment to
lead based paints (e.g., manual scraping, manual sand- achieve regulatory compliance and standardizing a wide variety
ing, heat gun applications) to welding, cutting, and of tasks. Trades and tasks of the construction industry are more
torch burning (1926.62(d)(2)). limited, especially for SMEs. RLBMS and solutions-based
·The asbestos standard created four classes of work, toolkits offer simple identification and control measures that
delineated by risk, with tailored specific precautions for can fit into a single toolbox. It requires identifying OSHH risks
each. It incorporates provisions to treat suspect mate- and risk reduction steps for each project phase. The RLBMS
rial as “presumed asbestos-containing materials” as an approach provides a step-by-step mechanism for creating this
alternative to bulk analysis testing. toolbox. It takes control solutions from research and good
Preliminary versions of an OSHA proposal for silica in practice, organized within simple project-based and task-based
construction also included an option for employers to follow formats. This simple format requires a toolkit structure layered
specified controls for 8 listed tasks as an alternative to expo- by level of complexity of control solutions. Also necessary is
sure assessment and competent person provisions. Each stan- addressing the National Construction Agenda (stakeholders’
dard utilizes the concept of a “competent person” capable of consensus) to secure pre-job planning to ensure the appropriate
identifying hazards, selecting the appropriate control strategy, level of worksite supervisor training to identify controls match-
and with authority to take prompt remedial measures. A GB ing task-related OSHH risks. This requires a project-specific
asbestos decision tool leads to comparable banding decisions RL. Therefore, within this framework design proposal we first
whether or not the job is licensed. If licensed, the full provi- provide a method to obtain a project specific RL and then pres-
sions of the Control of Asbestos Regulations 2006 apply. If ‘not ent the layered toolkit structure by control levels (CL).
licensed’, there are CGS for common, low risk tasks.

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Table 1. Pre-Job Hazard Analysis checklist concept

Severity - Answer reflects hazard potential without controls in place (Yes = 4 points each)

Chemical

Is there a possibility that asbestos-containing materials will be encountered? Yes□ No□

Is there a possibility that lead-containing materials will be encountered? Yes□ No□

Will there be jack hammering, roto-hammering or similar concrete work Yes□ No□

Will there be breaking or cutting of tiles, masonry or other silica dust work Yes□ No□

Will the job involve welding, soldering, or torch cutting? Yes□ No□

Will there be engines running on the worksite? Yes□ No□

Will work involve chemicals, solvents, painting, brazing or grit blasting? Yes□ No□

Will work be within vaults, manholes, trenches, or tanks >4 feet deep? Yes□ No□

Will the workers require personal protective clothing? Yes□ No□

Will the job involve materials or processes requiring respiratory protection? Yes□ No□

Physical

Is there a potential for manual material-handling of items over 40 pounds? Yes□ No□

Is there a potential for repetitive tasks for more than 30 minutes a workshift? Yes□ No□

Is there a potential for repetitive transfer of materials less than 40 pounds? Yes□ No□

Will workers be exposed to elevated noise levels on this job? Yes□ No□

Is there high (e.g. jackhammer) or low vibration (e.g. manned cab vehicles) activity? Yes□ No□

Safety

Will work be performed on or near energized equipment, lines, or circuits? Yes□ No□

Will there be overhead power lines or potential underground or hidden utilities? Yes□ No□

Will workers be working above 6 feet from ground level? Yes□ No□

Will scaffolding or ladders be used and worker access be provided? Yes□ No□

Will there be work cutting, grinding, or breaking of concrete or masonry? Yes□ No□

Will the job involve steel and/or scaffolding erection? Yes□ No□

Will floor, wall, and/or roof openings be created during this job? Yes□ No□

Will crane(s), forklift(s), manlift(s), or other lifting equipment be used? Yes□ No□

Will there be excavation or trenching in excess of 4 feet? Yes□ No□

Will the subcontractor be using motor vehicles or heavy equipment on-site? Yes□ No□

Probability (Highest = 20 pts, Mid = 10 pts, Lower = 5 pts, Lowest = 0 pts)

Number of workers on the jobsite? More than 10□ 6-10□ 3-5□ 1-2□

Length of project in 8-hour days? 10 or more□ 6-9□ 2-5□ 1□

Dustiness on the jobsite (no controls in place). High (clouds)□ Moderate (visible)□ Low (puff)□ None□

Fuel-, electrical-, & manual- based energy on jobsite? High□ Moderate□ Low□ None□

Will the work be performed indoors? Mostly□ Sometimes□ Rarely□ None□

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Fig. 1. RL matrix for determi­nation of job­

site training requirements. RL: risk level .

Pre-Job Hazard Analysis (PJHA) curing the appropriate control measures per task is performed
In addressing the need for a project specific RL, Table 1 pres- using the solutions-based models identified above prior to work
ents a concept for a PJHA checklist establishing a project- commencement. The PJHA RL outcome assists in identifying
specific band by RL. The table is based on the research-derived when control measures for specific tasks require higher exper-
hazards inherent to construction trades. Its purpose is to score tise then the project lead possesses. As the RL is determined
the hazards within a given construction project. The ‘sever- independently from tasks, higher expertise must be obtained for
ity checklist’ contains common chemical, physical and safety the task or a substitution for a lower risk task approach can be
hazards determined independently from specific tasks. The made.
‘probability checklist’ determines ‘exposure’: the project scale,
duration, number of workers, overall dustiness, and overall ‘po- Training and expertise
tential energy’ estimate for project completion. This estimate The ‘toolbox approach’ takes into account the ‘mentoring re-
is based on the concept: higher inherent potential energy yield lationship’ that is (or should be) present in construction trades.
higher adverse outcome risk from its release. Silica exposures An inexperienced apprentice is teamed with an experienced
are higher from grinding versus manual breaking; metal fume craftsman as mentor, to develop the skills - the knowledge base
exposures are higher from torch cutting than mechanical cut- - of the craft. This process can ensure both competence and
ting. More energy can lead to more noise; more energy is used an understanding of the craft’s OSHH dimensions. Skilled
in manual handling then with dollies, than utilizing machinery. workers are differentiated from apprentices by ‘card-carrying’
Higher energy equipment has more severe consequences in status, certifying ‘skill-of-the-craft’. Many European countries
the event of electric shock, or heavy equipment failure. Work and US states require, or are working to require, card-carrying
at height or in trenches implies a potential energy released construction trade workers on jobsites, ensuring they possess
through a fall. Responses to ‘severity’ and ‘probability’ should the skill-of-the-craft to perform their work to codes and regula-
avoid consideration of control measures. tions. In GB, the Sector Skills Council promotes OSHH skills
Scores for PJHA severity and probability are each indi- for construction employees. Defining ‘levels of training’ in the
vidually added. Each score is then found, within a given range, Construction Toolbox meets this concept. An apprentice may
based on a 4 × 4 matrix (Fig. 1). Their intersection determines attain ‘Basic Craft Skills’ with a minimum of training under a
the RL for the construction project and is the first step in this mentor, working to skill-based ‘Hazard Awareness’ by trade at
Construction Toolbox design. The RL identifies the level of the card-carrying level. In the US, OSHA regulations require
training and expertise to match the inherent project’s risk at the higher level training to become ‘Competent Persons’, to over-
earliest stage [4]. The RL also indicates the degree of expertise see specific activities with inherently higher risk, fitting regula-
needed for project pre-planning. The next step for the project tory requirements discussed above. RL4 work requires ‘Expert
lead is to identify each of the tasks performed on the jobsite. Se- Training’, to assist in understanding and controlling multiple

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Construction. At this level the construction company

can assess hazards and get guidance to control for spe-
cific situations.
·CL 4 is specialist advice. This level is for complicated
and/or very hazardous situations such as on large
asbestos projects, major construction at heights, and ex-
tensive concrete demolition, or work involving biohaz-
ards, radioactivity, carcinogens, or a vast array of highly
hazardous chemicals.
Planning the project prior to initiating work will require
the determination of appropriate CLs for each standardized
task. Task-related control measures are selected from available
options at the specified CL. As indicated above, these are re-
search and solutions-based resources. The advantage of such a
layered model is that CL1 and probably CL2 can be filled on a
Fig. 2. Task-by-Task CL approach. CL: control level, IH: industrial worldwide uniform scale. Knowledge, instruments, factsheets
hygiene. and checklists are all available at these levels. When tasks are
at higher levels of risk, such control measures normally need
risks. tailoring to project tasks. The CL helps identify the degree of
The key boundary is between RL2 and RL3 - workers will tailoring and type of help necessary for complex situations.
need to be able recognize: Designations CL3 and CL4 mean that workers need help with
·When work is, and is not , within their skill-of-the-craft control measures from a Competent Person or an OSHH spe-
and cialist. CL3 and CL4 are intentionally aligned in this manner
·When they meet the ‘Assistance Required’ band; need- to ensure the provision of effective control measures, and their
ing a certified Competent Person to verify that appro- sustained and correct use.
priate control measures are evaluated in place.
Discussion
Control Level (CL)
With a project specific RL determined, the final step is to assist The review and analysis of the solutions-based models presents
the jobsite manager in accessing control solutions utilizing a a wealth of potential tools available across the construction
layered toolkit structure (Fig. 2). industry. The toolbox framework design presented delivers
Each layer reflects a CL in this manner: a banding of project risk that also accomplishes pre-project
·CL1 is the universal precautions model. This level deals planning. The primary limitation of the Construction Toolbox
with the general hazards at the workplace such as trip- is it not being field-tested. The PJHA checklist (Table 1) is a
ping and falling as well as head, foot, hand, ear, and proposal based on expert advice and may require refinement.
body protection. These hazards apply worldwide to The scores, and expansion or reduction of the checklist need
everybody at the construction site and everybody at the consideration on national, regional, and cultural bases. The
construction site must have knowledge of these and fol- Construction Toolbox will, of course, need evaluation and
low worksite controls identified. validation, as a whole and of its parts. The critical issue is the
·CL 2 is the T2C model. This level deals with general effectiveness and sustainability of control implementation.
hazards with basic projects in construction and demoli- In theory, the Construction Toolbox approach is well placed
tion and include simpler tasks involving hazards such to assist the development of mentor-apprentice relationships
as silica, asbestos, noise, awkward postures, and heavy through standardized OSHH information for construction
lifting as well as electrical, machinery, and work at trades. Also in theory, it would be a tool for appropriate, con-
height risks. sistent training of qualified workers, competent persons, the
·CL 3 is the CB Model. This level requires the collection development of OSHH experts in construction, in risk control,
of simple input parameters to use existing online tool- and risk management.
kits such as COSHH Essentials and Stoffenmanager In practice, the endpoint of this Construction Toolbox

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model cannot simply be the identification of an RL, CLs, the website, require CGSs that include:
production of control advice, and the barriers and control ·Checklists for control measures and barriers, and
measures in place. Rather, Construction Toolbox use should ·A ‘Work-site Hazard Analysis’ worksheet.
continue through the project, to assist adaptation as the work- The utility of CB toolkits to deliver effective control ad-
site changes. The correct level of expertise can be identified and vice to SMEs through CGSs has been shown through existing
risks controlled at all stages. The more common and easily con- review and critique publications, however the gaps in field
trolled hazards are prioritized as such, represented in the lower studies remain and further research is necessary for the issues
RL categories (RL1 and RL2). It is poor practice to control specific to the construction industry [36,74,75]. These toolkits
lower risks and milder outcomes before higher risks and more also require testing of formats to optimize, for users, ‘drill-down’
severe outcomes. Therefore, a tool for managers’ systematic ap- for access to control advice based on tasks that they recognize.
proach to barriers and controls focuses resources on higher RL Tasks should include variables such as those in Table 1, e.g.
events and CL requirements. Focusing expert OSHH profes- duration, other workers’ proximity, the variety of controls that
sional availability, management-related ‘culpability’ in accident might be available. ‘Drill-downs’ produce CGSs that include
scenarios can also receive appropriate attention. CB is not - task summary and generic control measures and/or barriers,
yet - a banding of risk management. Good risk management or specific CGSs as necessary for tasks. Web-based ‘drill-down’
means reducing high frequency, more severe outcomes from actively linked to the Construction Toolbox have potential for
construction hazards. currency, updating and real-time translations. This would en-
An important point for the use of CB toolkits is the poten- hance the risk management aspect, communicate hazard-to-
tial to identify the appropriate control measures in the absence control to the worker, and offer field-based advice to others in
of expertise. At a training level, simplification and uniformity a participatory format. The PJHA can also be similarly useful.
reinforce retention, implementation and the sustainability of For SMEs, each question can be linked to a brief explana-
prevention. The design of the Construction Toolbox also af- tion and additional resources links as they determine the CL,
fords the opportunity to consider these OSHH prevention task-by-task. The SME manager can begin to consider all op-
concepts at the planning, design, and engineering stages of portunities for hazard or task substitution, and selecting task
construction projects [70]. Such ‘prevention through design’ parameters to reduce the overall expertise required. Users and
approaches are now available in many countries [70-73]. Some experts can score online resources such as CGSs and CL-based
hazards are simply not anticipated. Unnecessary risks may not solutions for utility, simplicity, and effectiveness as feedback, for
appear until workers encounter them during the construction evaluation. SMEs can also get Construction Toolboxes on CD
process. Therefore, additional risk prevention methods can be by trade, having ‘drill-down’ format, but no web-based benefits.
found within NIOSH supported research to gather case studies In seeking to address these issues, the intent is to remain
and to provide a conceptual framework for addressing safety global in scope. However, many of the current control solutions
and health at the project design phase [73]. Banding a project’s are skewed toward a few countries [74]. The United Nations’
RL in pre-project planning therefore offers a complementary Globally Harmonized System of Classification and Labelling
prevention through design within the Construction Toolbox of Chemicals (GHS) is well suited for offering a needed global
framework. consistency in the international identification of chemicals.
The GHS is a system for standardizing and harmonizing the
Requirements classification and labeling of chemicals which would be benefi-
The availability and usefulness of a Construction Toolbox will cial in addressing chemical exposures in construction as there
require: is a clear correspondence between European risk phrases and
·A web-based format for standardized tasks and related GHS classifications for use in CB toolkits [31,36,74,75]. There
CLs that is continually updated, are often national research gaps, so international research and
·Free and readily accessible control guidance that is ac- literature requires locating and consideration. In economically
ceptable, comprehensible and usable, developing countries the number of OSHH professionals and
·Free and readily available web access to existing solu- technicians need substantial growth [74,75]. The Construction
tions-based resources, and Toolbox can become a foundation for training OSHH experts
·A web-based format to share successes and lessons and technicians in construction in university programs, and
learned by both task and trade. spreading expertise through train-the-trainer campaigns. De-
Sharing control solutions and lessons learned, e.g. post on veloped countries can also use such campaigns, with exchange

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of successful control information where language barriers ex- ·Identifies the appropriate level of training to oversee the
ist [75]. The process can work best internationally when key work, and
aspects of the CL approaches in the CGS are communicated ·Enables identification and implementation of suitable
largely through pictorial formats, to minimize the need for control measures for safe working.
translation and standardizing the control expectations [74]. For Such a strategy has long been sought, but never presented
example, the HSE is developing a short series of simple icons in this format. Critical elements of the work remain to be
as an ‘employee checklist’. But this whole context is reliant on done on the research side are:
a Construction Toolbox existence, acceptance, dissemination, ·The validation and verification of this toolbox ap-
and use. Therefore, the authors would advocate that ILO or proach,
WHO set up an international working group to collect and ·Implementation and further evaluation of the PJHA
order existing information and to make this readily available checklist,
(e.g., internet or booklets). In this manner, as experts are lack- ·Practicality of integrating enforcement and national
ing in many developing countries, an initial goal to ‘pick the regulatory compliance,
low-hanging fruit’ would be a solid step in right direction [74]. ·A movement back toward solutions-based practical,
If all countries implemented simple, practical strategies to pre- field research, and
vent accidents, it would be possible to eliminate 83% of safety- ·Multidisciplinary collaborations at local, national, and
related deaths and 74% of accidents annually [76]. international levels.
To appropriately develop the Construction Toolbox com-
Conclusion ponents, the needs in practice are:
·Development of centralized databases at the T2C level
A constant throughout this discussion is recognition that work- expanded across the professions,
ers in the construction industry are involved in a dangerous ·Creation of training packages for SMEs and train-the-
trade. Construction work-related risks are well understood, trainer packages for experts,
but it remains a leader for raised injury, illness and fatality ·Scaling to the Construction Toolbox model to economi-
rates; and associated costs to business, society and families. It cally developing countries, and
is unconscionable that construction remains hazardous, while ·Sharing of successes and limitations as well as field-
resources over decades - statistics, causal factors, and control based feedback and improvement.
measures to reduce risk - are known to OSHH professionals. Further, the creation of the necessary centralized web-
Construction Toolbox development seeks to change the percep- based system to unify an international implementation will
tion that work-related risks in this sector are just safety-related require funding, development, and maintenance ensuring the
and inevitable; rather it emphasizes that chemical and physical Construction Toolbox availability to the world’s construction
exposures abound and are preventable. The concept is a com- SMEs. Delivering such an essential product to SME managers
prehensive tool for the construction industry, to assess and con- is the first, but most important, step. However, without further
trol occupational risks that currently are segmented between analysis and field implementation it will remain just another
OSHH professions. The Construction Toolbox presents a for- publication seeking to reduce the constant stream of work-re-
mat to harness multiple solutions-based national programs and lated injuries and illnesses, an abhorrent mark on the construc-
publications for controlling construction-related risks across the tion industry worldwide.
OSHH professions. CB and Barrier Banding have been united
in this RLBMS format using simplified risk assessment and risk Construction Solutions-Based
management strategies. Multiple OSHH professional expertise Internet Resources
unite in this framework to organize, communicate, and imple-
ment risk reduction programs at a construction jobsite. Our HSE Construction Silica Essentials
intent was to propose a simplified risk banding approach for OSHA Construction Industry assistance
the SMEs that employ over 80% of the world’s construction University of Washington silica solutions
workers. University of Washington noise hearing loss, construction
This occupational risk management toolbox strategy: NIOSH Construction Health and Safety solutions
·Uses a qualitative risk assessment approach to deter- NIOSH Respirator resource
mine an RL ‘band’ for a given project, The Center for Construction Research and Training

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(CPWR) tion measures for fatal occupational falls in the construction

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