The L&I Blog

December 12, 2017

A prescription for success;
How UW focused on workplace safety and made it work

by Debra Milek, MD, Ph.D., MPH
Part 1 of 2

Cleaning crews are the unsung heroes of our office buildings. Long after we’ve gone home for the day, they go about the task of cleaning up the messes that we’ve left behind. Unfortunately, these workers are vulnerable to a wide range of injuries. In fact, according to the Bureau of Labor Statistics, janitors/custodians suffer more on-the-job injuries than construction laborers. Why is that? Consider the type of job duties that janitors and custodians perform. During their workday, they repetitively lift and move heavy objects, empty trash containers, carry buckets, sweep and mop, vacuum, dust high places, unlock and lock many doors and scrub floors and counters. Over time, the body movements involved in performing these tasks can take a physical toll on a worker, which can translate into workers’ comp claims and disability.  Happy Crew

In addition to being Medical Director of the Occupational and Environmental Medicine practice at Harborview Medical Center and its COHE, I am also a Medical Consultant to our UW Environmental Health and Safety/Campus Preventive Health Division.  We noticed that custodians were the third most often injured group of workers at the University of Washington exceeded only by patient care providers in the medical centers. While we have considerable experience in addressing the injuries of janitors and custodians from a treatment standpoint, we needed to do more to prevent their injuries from happening in the first place.

Tackling the problem

Our Safety and Health Investment Project grant from L&I, allowed us to begin to address potential work hazards, beginning with the premise, “Discomfort may predict future injury.” With collaboration between the UW Environmental Health and Safety and Facilities Building Services Division, we developed a participatory ergonomics approach which included developing a survey to learn from the custodians which tasks caused them discomfort. It turned out that vacuum backpacks were a very significant source. We then shadowed small groups of the custodial workers and discovered that there is a lot more complexity to proper backpack use than meets the eye. To remedy this problem, we conducted in-depth training sessions ordered harnesses that were more comfortable, and ended the practice of shared equipment amongst the custodial staff. Importantly, for each custodian, we fit-to-size a proper vacuum backpack and  allow them to demonstrate back to us the recommended method for more comfortable and safer use.    

Information from the survey and our engagement with custodial staff created positive feedback from the custodians, and it paved the way for other safety improvements. For example, we identified job duties that involved our custodial staff repetitively to bend at the waist for long periods. Since this type of body movement increases the chance of back injury, we provided them with the proper tools (and training) to decrease the amount of time they spent bending.

For example:

  • Grabbers (for picking up small items)
  • Long-handled toilet brushes (good for those who are very tall)
  • Long and adjustable handled scrapers for removing various things that stick firmly to surfaces
  • Magnets installed on bathroom stall doors and partitions, which gets rid of the need for the custodian to swing out a hip to hold the door open while bending forward for cleaning (my favorite!)

A continued payoff

Since the original project ended, I have continued to work with Facilities and our safety efforts continue to pay off for the benefit to the custodians. For example, we initially tackled 4 of our 16 scheduled projects during the grant period. And, we’ve subsequently addressed several more discomfort causing tasks from the survey with a focus on the shoulder and other areas. Additionally, the small group safety teams that formed during the project’s initial phase have coalesced into one large safety team made up of custodians, supervisors, managers, safety staff, occupational medicine physician and the director of building services. These team members commit themselves to weekly safety meetings.

Our continued focus on safety allowed us to address several other areas of work discomfort that custodians reported in our earlier survey.

Here’s what we did:

  • To limit the use of raised shoulders when working overhead, we purchased telescoping surface wipers to clean high (and low) surfaces.
  • To eliminate one-hand lifting of dumpster lids, we purchased props to hold them open.
  • We purchased lightweight key rings to replace uncomfortable heavy key rings.
  • To help decrease the risk of slips, trips, and falls in poorly lit areas, we purchased mini key ring flashlights.
  • Group members also have developed slip, trip and fall prevention education which they will present to each of the custodian work groups.
  • And more

Lessons for business owners and safety managers

If you are an employer or safety manager, what should you take away from UW’s experience? Here are a few things for you to consider.

1. Injuries are lurking at your jobsite. Even if you don’t have custodial employees at your business, I can speak from professional experience that your employees, regardless of industry, are subject to workplace hazards. And, it’s your job as an employer to keep your employees safe!

2. Communication is key. Don’t live by the motto, “No complaints, no problems.” I guarantee you that your employees are already talking amongst themselves about workplace safety issues.  As we addressed their concerns, we had feedback from some employees who agreed the ergonomic changes were great ideas and the sooner we employ these into action – the better.  Engage your employees and let them know that they can speak up.

3. Develop your process. You can’t simply hand a new tool to an employee and walk away. Any new tool or process requires input, evaluation, training, and assessment so that employees and supervisors will have total “buy in.”  We discovered that nobody learns by watching. Hands on individually for each new tool is our approach. And new tools/processes require follow up because change is not a simple process.

Here is the process that we use before we roll out a new tool:


4. Customize your approach. One size doesn’t fit all. Not every tool or method will work for every employee. Ergonomics is about finding the right fit. That’s why you should engage your employees and their immediate supervisors to see how they like (or don’t like) the tool. If you don’t pay attention to this area, your employees will revert back to their old ways of doing things.

5. Keep it up! You won’t change your company’s safety culture overnight – it’s an ongoing process that requires engagement. Don’t start one safety initiative and then walk away when it’s done. After our initial project ended, we continue to engage our custodians at weekly safety meetings and solicit their input.  And, in the interests of transparency and engagement, we make the content of the meetings available to all custodial staff.

6. Leadership engagement and support is crucial to success. In EHS we are looking at other areas beyond the custodians for proactive measures to reduce injuries while in Facilities we continue and expand the work that we began.

Closing thoughts

We believe attention to diminishing risk factors for injury will pay off in a reduction of injuries, disability, workers compensation costs and increase employee satisfaction. We encourage you to look at injuries in your workplace and how they might be prevented. We are grateful to L&I for awarding us the SHIP grant which enabled us to begin these efforts. We are happy to share our training and products with other employers.

Dr. Milek is also an Associate Professor in the division of General Internal Medicine at Harborview  and is an adjunct faculty member of the Department of Environmental and Occupational Safety and Health in the UW School of Public Health.

We would like to express our gratitude to Dr. Debra Milek who took time out of her busy schedule to serve as a guest author. This article represents the second in a series of articles submitted by providers who participate in the COHE program.

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