The paper identifies frequent accident types in the construction industry, characterises the accident sequence, and identifies barrier failures for the most frequent accident types. 176 accidents in ...the Norwegian construction industry investigated by the Norwegian Labour Inspection Authority in 2015 are analysed. The most frequent accident types include: fall from roof, floor or platform; contact with falling objects; fall from scaffold; and contact with moving parts of a machine. A comparison of the study sample to other injury samples, showed that the distribution of accident types varied regarding severity and different construction types. This can be explained by differences in work type, hazard, and energy type and energy amount. An analysis of barrier failures showed that many accidents are explained by the lack of physical barrier elements. The results indicate that there is significant potential for accident prevention in the construction industry by systematic barrier management.
•Using the ConAC framework, 1.039 causal factors were identified in 176 construction accidents.•Factors most identified were worker actions, risk management and immediate supervision.•Worker actions ...is the outcome of many other causal factors.•Immediate supervision is a key causal factor connecting management and worker actions.•Risk management is a key causal factor and strongly connected to immediate supervision and worker actions.
The aim of this study was to add to the relatively sparse literature on accident causality in the construction industry by identifying frequent causal factors and connections between causal factors. Using the Construction Accident Causation (ConAC) framework, 176 relatively severe construction accidents investigated by the Labour Inspection Authority in 2015 were analysed. The seven factors most identified were (in rank order): (1) worker actions, (2) risk management, (3) immediate supervision, (4) usability of materials or equipment, (5) local hazards, (6) worker capabilities, and (7) project management. A set theoretic approach was used to identify causal connections between causal factors. Risk management, immediate supervision and worker actions were found to be key causal factors and strongly connected. The analyses identified seven causal factors consistently connected to worker actions, for example immediate supervision and local hazards. Immediate supervision was found to be strongly connected to both worker actions and risk management, underlining the importance of the supervisor controlling unsafe conditions/acts and planning the work to reduce risk. Strong connections were also found between risk management and immediate supervision, and between risk management and worker actions. Risk management and immediate supervision is to a large degree about planning and risk control at different levels, underlining the importance of risk being addressed at different levels and by different actors in construction projects.
Safety management in construction is complicated due to the complex “nature” of the construction industry. The aim of this research was to identify safety management factors (e.g., risk management ...and site management), contextual factors (e.g., organisational complexity) and combinations of such factors connected to safety performance. Method: Twelve construction projects were selected to compare their safety management and safety performance. An analytical framework was developed based on previous research, regulations, and standards where each management factor was defined. We employed qualitative comparative analysis (QCA) to produce case knowledge, compare the cases, and identify connections between the factors and safety performance. The material collected and analyzed included, for example, construction planning documents, reports from OHS-inspections, safety indicators, and interviews with project leaders and OHS experts. Results and conclusions: The research showed that: (a) the average score on 12 safety management factors was higher among projects with high safety performance compared to projects with low safety performance; (b) high safety performance can be achieved with both high and low construction complexity and organizational complexity, but these factors complicate coordination of actors and operations; (c) it is possible to achieve high safety performance despite relatively poor performance on many safety management factors; (d) eight safety management factors were found to be “necessary” for high safety performance, namely roles and responsibilities, project management, OHS management and integration, safety climate, learning, site management, staff management, and operative risk management. Site management, operative risk management, and staff management were the three factors most strongly connected to safety performance. Practical implications: Construction stakeholders should understand that the ability to achieve high safety performance in construction projects is connected to key safety management factors, contextual factors, and combinations of such factors.
Objective
To examine the prevalence of advanced frailty, comorbidity, and age among sepsis-related deaths in an adult hospital population.
Methods
Retrospective chart reviews of deceased adults ...within a Norwegian hospital trust, with a diagnosis of infection, over 2 years (2018–2019). The likelihood of sepsis-related death was evaluated by clinicians as sepsis-related, possibly sepsis-related, or not sepsis-related.
Results
Of 633 hospital deaths, 179 (28%) were sepsis-related, and 136 (21%) were possibly sepsis-related. Among these 315 patients whose deaths were sepsis-related or possibly sepsis-related, close to three in four patients (73%) were either 85 years or older, living with severe frailty (Clinical Frailty Scale, CFS, score of 7 or more), or an end-stage condition prior to the admission. Among the remaining 27%, 15% were either 80–84 years old, living with frailty corresponding to a CFS score of 6, or severe comorbidity, defined as 5 points or more on the Charlson Comorbidity Index (CCI). The last 12% constituted the presumably healthiest cluster, but in this group as well, the majority died with limitations of care due to their premorbid functional status and/ or comorbidity. Findings remained stable if the population was limited to sepsis-related deaths on clinicians’ reviews or those fulfilling the Sepsis-3 criteria.
Conclusions
Advanced frailty, comorbidity, and age were predominant in hospital fatalities where infection contributed to death, with or without sepsis. This is of importance when considering sepsis-related mortality in similar populations, the applicability of study results to everyday clinical work, and future study designs.
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