Business Cases: Supporting PTD Solutions

In 1970, the OSH Act was promulgated with the intent focus “to assure so far as possible every working man and woman in the Nation safe and healthful working conditions” (29 U.S. Code 671). The question of how to accomplish that goal has been the subject of discussions throughout the SHE NIOSH, 2006, 2010; Schulte, Rinehart, Okun, et al., 2008). Looking at early efforts beginning in the 1800s, this belief was typified by the widespread implementation of machine guards, boiler safety practices and controls for elevators, followed by more efforts such as lockout/tagout controls and improved ventilation. Following passage of the OSH Act, many efforts, including the Safety and Health Awareness for Preventive Engineering (SHAPE) program (www.cdc.gov/niosh/topics/SHAPE), the issuance of the Process Safety Management of Highly Hazardous Chemicals Standard (29 CFR 1910.119), the OSHA Alliance Roundtable on Design for Construction Safety (www.designforconstructioninsafety.org), and NSC’s Integrating Safety Through Design Symposium and its Institute for Safety Through Design were all undertaken to encourage prevention during the design process (Schulte, et al., 2008). Despite this level of activity, a need for a national comprehensive approach to address worker safety and health issues by designing out potential hazards at the beginning phases of a project remained. In July 2007, NIOSH launched the Prevention Through Design (PTD) national initiative to establish such a comprehensive approach (NIOSH, 2012). The initiative’s broad mission is “to prevent or reduce occupationally related injuries, illnesses, fatalities and exposures by including prevention considerations in all designs that affect individuals in the occupational environment” (NIOSH, 2010). With the assistance of diverse stakeholders spanning the industrial sectors and educational disciplines, PTD was defined as: The practice of anticipating and “designing out” potential occupational safety and health hazards and risks associated with new processes, structures, equipment or tools, and organizing work, such that it takes into consideration the construction, maintenance, decommissioning and disposal/recycling of waste material, and recognizing the business and social benefits of doing so. (NIOSH, 2010) PTD addresses SH&E needs by “eliminating hazards and minimizing risks to workers throughout the life cycle of work premises, tools, equipment, machinery, substances and work processes, including their construction, manufacture, use, maintenance, and ultimate disposal or reuse” (NIOSH, 2010). As NIOSH moved forward, researchers found that too many promising control technologies (engineering design solutions)—those grounded in PTD—were not transferred from research into practice. Although proof of preventing occupational injury, illness or fatality alone often drives industry to change, the lack of adoption of these effective solutions demonstrated that there were others reasons behind SH&E business decisions. Understanding the reasons for businesses to use programs and practices grounded in PTD became the objective of a NIOSH study. Although the research team selected several controls to examine more closely, this article presents information on only three—safe patient lifting and handling, ergonomic wine grape picking tub and chemical substitution in professional garment cleaning. The NIOSH team selected the business case as the method to determine why these three solutions were adopted. Business case is a term used frequently but often misunderstood. Querying Google returns several definitions or functions: Business case captures the reasoning for initiating a project or task. Business case is part of a project’s mandate, produced before a project is initiated. Business case is a type of decision-making tool used to determine how a particular decision will affect profitability. Business case is a structured proposal for business improvement that functions as a decision package for decision makers. In reality, the business case answers the question, What’s in it for the company? Or in this instance, Why would the company implement practices grounded in PTD? Many methods and tools are available to develop a business case based on economics, finance and business management. To determine the business case for the three PTD engineering controls in this study, the value strategy was selected. This method was initially designed by an ORC Networks and NIOSH team under the sponsorship of AIHA and American Board of Industrial Hygiene (AIHA, 2009; Biddle, Carande-Kulis, Woodhull, et al., 2011; Brandt, Doganier, Downs, et al., 2010). The seven-step strategy culminates with the financial and nonfinancial value of a program, activity or intervention (Table 1). For this study, the purpose of each step has been expanded beyond industrial hygiene to include all SH&E activities associated with the three engineering controls being studied. Table 1 Value Strategy Information for each step can be obtained directly from company records, through discussions with affected workers and management, from prior studies conducted on similar programs, activities or interventions, or a combination of all three. As shown in this study, the value strategy can also be used to create the business case using various assumptions and parameters. A single firm evaluated a lifting program calculating the return on investment (ROI) based on workers’ compensation savings only. Collecting company records and conducting personal interviews was the method used to determine the costs and benefits associated with wine grape tubs. Finally, the business case for the garment wet-cleaning technology was created by using prior studies that covered multiple establishments using differing methods and parameters. This study demonstrated that the business case developer should never lose sight of the need to capture information that is meaningful to the final investment decision maker. When important, explore the changes in health outcomes, SH&E risk management and in business processes. The developer should also consider the effects on achieving business objectives that cover a wide range of topics including sustainable business, SH&E excellence, employee retention, increased profits, increased market share and excellence in corporate social responsibility. The following sections review the business cases developed for each of the three PTD controls.