“I didn’t mean for that to happen….”
This is a statement that we have all uttered at one point or another in our lifetimes. For some of us less fortunate people, we have been forced to say this phrase numerous times throughout our lifetime.
Our life is full of purposeful decisions that will correlate with reactions in the world around us. Hopefully, most of the decisions that we make will result in the desired outcome, however, occasionally the outcome we hoped for is not achieved. Moreover, sometimes the outcome we hope for does occur but the system that we operate in is impacted in an unforeseen manner, something that we weren’t expecting as the result of our initial action. This is the definition of unintended consequences, a term that was coined in a 1936 paper written by Robert Merton. In Merton’s thesis he declared that all decisions will create a ripple effect in the system that we live in, sometimes these ripple effects are positive, sometimes they are negative and sometimes they are irrelevant, but at the end of the day all decisions that we make will have a ripple effect.
To give you an example of unintended consequences in popular culture, let’s talk about Barbara Streisand. As a celebrity Barbara Streisand values her privacy. In 2003, prior to the popular rise of social media, a photo was taken from a helicopter of Barbara Streisand’s residnece. The website Pictopia.com published this picture of Ms. Streisand’s home. In an effort to protect her privacy, Ms. Streisand followed the appropriate measures to minimize exposure of her residence to the general population by filing suit against Pictopia.com. While her desired outcome was to limit the number of people with access to the image of her residence, her actions had an entirely different result. Prior to filing suit, the image of Barbara Streisand’s home had been viewed on Pictopia’s website 6 times, and 2 of those were by Streisand’s attorneys. Consequentially, following the media attention surrounding her lawsuit filed against Pictopia.com 420,000 people downloaded the image of her house over the next year. While her desired outcome was to limit exposure of her residence to the general population, her actions actually had the opposite effect. This example is such a strong illustration of negative unintended consequences that sociologists have actually termed this “The Streisand Effect”.
Unintended Consequences in Workplace Safety
As professionals in workplace safety we should be proud of how far workplace safety has come In the last 25 years. The incidence of catastrophic incidents has been reduced exponentially from where they used to be. Overall, workplace safety in the United States is significantly improved. Programs such as Behavior Based Safety, Lean Safety, The Strive for Zero, etc. have been key elements in this improving system. Building off of Robert Merton’s definition & the illustration of “The Streisand Effect” I have been challenging groups of safety professionals to take a minute and think of the unintended consequences in workplace safety. If we are to learn anything from the teaching of Robert Merton, than we should recognize that these dramatic changes in the workplace safety “system” will have correlating unintended consequences. Some of these unintended consequences are having positive impacts. For example, effective integration of ergonomics programs into the Lean analysis of an organization will often correlate in improved efficiency of the productivity of the operation. An unintended consequence that resulted in a positive result.
With that in mind, I believe that for us to continue to improve workplace safety, we need to humbly recognize that some of our actions have had secondary impacts that may not be positive, possibly even negative. For us to apply methods of continuous improvement in our safety programs, we need to address these unintended consequences and implement solutions to rectify the challenges that have been identified. I believe one of these unintended consequences is a huge opportunity for us to impact workplace safety, specifically with respect to musculoskeletal disorders (MSD’s).
For most organizations, MSD injuries account for the highest frequency & most expensive occupational injury claims that they have. These are the sprain or strain type of injuries. Specifically, they are the rotator cuff tendonitis, lumbar strain, degenerative disc disorder type of conditions. If you are reading this, I am sure you can think of 2 or 3 of your most recent claims and it is highly likely that one of them will fall into this category. These are the type of injuries that we all deal with on a regular basis. They are not life-threatening injuries, but they one of the leading causes of disability in the workplace. To identify and learn about risk factors in the workplace, most organizations have implemented programs that focus on zero injuries & immediate reporting procedures. These are great initiatives and I recognize their value in the workplace, however I feel very strongly that they have had an unintended consequence correlating with MSD injuries.
Medical professionals will recognize that most of the aforementioned MSD injuries will have multiple factors leading to the condition. For example, most rotator cuff injuries are not the result of one specific incident, but rather the cumulative impact of long term subacromial impingement – or in laymen’s terms friction between the rotator cuff muscle and the bones of the shoulder joint). It is very common for rotator cuff injuries to begin with an occasional pinch in the shoulder when you get in a compromising posture (think reaching under the barbeque to turn on the propane) but otherwise feel fine. As the cumulative impact of poor shoulder posture continue to rake havoc on your rotator cuff muscles, this occasional discomfort will progress to a constant discomfort every time you reach overhead, but otherwise is fine. As we continue our cumulative aggravating factors the overhead discomfort will then progress to constant discomfort in all planes of movement. If we don’t fix the issue at this point, then it is likely that tissue degeneration will occur leading to rotator cuff tendonitis or even partial thickness rotator cuff tears. As you can see, there was no specific incident that led to this injury, but rather the cumulative trauma of poor posture. It is still possible that there is an incident that will speed this process up, but the more cumulative trauma that has occurred to the tissue, the more easily it will be impacted by outside forces. This is where the unintended consequence lies. At what point does this employee report their shoulder issue to their employer. We all have various aches & pains, but we just write them off as just muscle soreness like we have had before. ”It will go away, just give it a day or two…” As the process progresses & we begin to realize that it is not going away like every other time, these employees often feel the conviction of making up a “cause” for their injury or face the potential penalty for late reporting.
You might be reading this and thinking, “That’s not us! Our folks aren’t sore and when they are, they report it immediately….” Recently I spoke at a large safety conference and in a lecture with approximately 300 various safety professionals & business leaders I had them all stand up and asked them this question, “how many of you in the last year have had back or shoulder pain?” Every single person in that lecture remained standing. I followed that up with “how many of you have had shoulder pain in the last year?” and approximately 70% of the room remained standing. Then for the coup de gras I asked them, “as safety directors, how many of you reported this discomfort to your workplace?” Amongst the smirks, and eye ducking in the room, the point was clear. None of them did. While these issues may not all be work related, there was a percentage of those issues that were impacted by their job duties. As the business leaders and safety champions, they are making the same internal decision that our blue collar workers make on a daily basis….”Is this just muscles soreness that will go away like every other time, or is it something bigger? Should I mention this to someone, or will it just go away with time?” This is the internal dialogue that our workers are making everyday in the workplace. I feel that this has been amplified by our focus on identifying a specific cause & effect for every workplace injury. To do this eliminates the life history, past medical history, hydration levels, etc. that all play a factor in MSD injuries.
So where do we go from here? I believe that this is an opportunity! I believe this is our chance to take the next step in workplace safety. I believe that we need to strive to build an environment that recognizes the impacts of cumulative trauma in the workplace (beyond just the type casted conditions such as carpal tunnel) & recognize that most MSD injuries have a component of life experience impacting them. We need to create cultures that promote people being open and honest about minor issues that likely are not work related, to try and influence the overall health of the worker & in the end reducing the risk for workplace injury down the road. Research tells us that the most accurate predictor of many MSD injuries is a past history of injury to that body part. As we build this proactive culture of workplace wellness, we will in fact be implementing a proactive approach to preventing the future workplace injuries.
In my opinion, this is the next step in workplace safety & merges a proactive approach to wellness with safety. It recognizes that we all have aches & pains, but rather than ducking our heads and hoping that they won’t turn into injuries, it encouraged a proactive approach that strives to prevent injury, rather than waiting for our people to break and paying to fix them. This is not a referendum on safety policies & practices. I think these programs are necessary and valuable. We should be seeking out root causes, but we also need to recognize that not all (possibly not even most) MSD injuries will have a direct incident alone that results in injury. We need to be engaging our people on a more personal level to help them achieve their optimal workplace wellness. This is just the next step & following this step, there will other unintended consequences that we will likely need to address then. It is just like the rock we throw into the lake, it will create ripples regardless of how small the rock we throw. My challenge to all safety professionals is to not think that we have figured it all out, but rather to be striving for continuous improvement within our safety programs. This is an opportunity for improvement that will positively affect our organizations, & also the health and safety of our workforce.