Contrasting Prevalence of Health and Safety Risks and Controls / HealthChoice

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welcome to contrast in prevalence of health and safety risks and controls between residential and commercial construction apprentices this webinar is part of our construction webinar series and we're very happy ur here my name is Joost Robinson goon Administrative Coordinator and projects manager with the work wellness and disability prevention Institute and I'll be Co moderating the webinar today this webinar is made possible through the support of the community gaming grant program through the BC government as

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well as donations and memberships to WW dpi we thank our program partners Canadian Council on rehabilitation and work Education Advisory Committee and speakers who contribute to this webinar series while we're waiting for others to join us I'll go over a few technical points for the webinar you should be able to hear the presentation through your computer speakers or through the conference call line if you dialed in please use the question box to submit any issues you may be experiencing and to ask any questions you have related to

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the presentation we will collect questions submitted throughout the presentation and follow the presentation with a Q&A based on the questions submitted follow in the webinar any questions not answered in the allotted time will be answered and distributed after the event the presentation will be recorded and posted for free on our website within a week along with the slides you will be emailed the direct links for all of these items when they're available today's webinar will be Co moderated by dr. Catherine Berkman

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associate director of knowledge transfer and exchange of the center of research expertise for the prevention of musculoskeletal disorders Catherine will also be moderating our Q&A session and I will let her introduce herself and dr. Ann Marie Dale who will be our presenter today wonderful thank you so much and userid you just want to confirm that you can hear me all right yep perfect wonderful on behalf of dr. Jack Callahan at Cree MSD as we are more commonly

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known it's a pleasure to partner in this construction webinar series and we thank work wellness and disability prevention Institute for this opportunity it's really a pleasure for me to introduce to you today our speaker dr. and Marie Dale and I just want to tell you about a few things about her because I'm sure not all of you have had a chance to read her bio dr. Dale has over 30 years of experience in the clinical treatment of work-related upper extremity conditions and in worksite

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based prevention of Mis musculoskeletal disorders she has used a variety of intervention methods for individuals and groups of workers in many industries including healthcare construction retail grocery automotive manufacturing and other service industries to prevent or reduce the effects of physical exposures from work tasks since joining the O s HR group in 2001 she earned her doctorate in epidemiology with a focus on

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measurement and evaluation of MSDS she is currently exploring safety and ergonomic interventions in the construction industry and participatory health interventions among retail grocery workers both projects focus on reducing physical exposures and improving the health of workers dr. Dale has a passion for helping workers maintain and regain function in order to lead successful and productive lives

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it is a great pressure for me to have dr. Ann Marie Dale present this very compelling presentation today over to you in well thank you very much for the kind words and thank you both for providing me the opportunity to present some of our research this is very new research but conducting research studies in the construction industry is something that our team here at Washington University has been engaged

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in for over 18 years now and I did think it is through those experiences that we are now getting at some of the they're getting to the heart of the issues that these workers are struggling with in the at the worksite and I hope that our listeners today will gain some knowledge as a part of this process so the presentation today I would like to acknowledge a long list of co-authors listed on the screen

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dr. Roman Strickland Kelly and evanov but in addition to that this work is conducted as part of the healthcare workforce center of the Midwest of which Washington University is one of the individuals one of the universities that are running that Center our work is in as one of the centers of excellence for total worker health and NIOSH and they

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are the funders of the research that I'm about to present so without further ado I'd like to proceed to give you a little background to the this particular project so for those of you who may not know construction is an incredibly dangerous industry there they need the number of fatalities and non-fatal injuries in many of the areas compared

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to other industries and there are also some very challenging things to dealing with the construction industry in terms of trying to prevent these injuries the environments given the fact that they are constructing a building is which is often the case or a bridge or a road the environment is constantly changing and therefore the workers must adapt to whatever the tasks are for the day and

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in fact the task may change over the course of a single day in addition there are many specialists that are needed to create the building and as a result many different employers may be working side-by-side to construct a single building many of those employers though might be very small in size construction is often consists of a large number of small sized employers in fact many

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construction workers will form their own company and go out and secure work on projects and so having companies the size of two three ten workers is not uncommon and it is in part due to the these variables with the changing nature of work the size of the employers when we see a high turnover of workers on projects as well as in the industry it

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is it's hard to track these individuals from place to place and over time the other another issue that we deal with in the construction industry is these individuals often suffer from only making low wages bring in workers make higher wages by nature but in general these are not high paid workers much of the work is seasonal for some workers

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particularly if their work is the outside part of construction but even those who can work inside don't always have regular work many of these workers are considered independent contractors they don't actually work for an a single employer and so they oftentimes their job is limited to the length of the project that they are working on the

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growing number of industries that are now hiring and being employed by temporary workers is growing in our US population and that was well described in the fishery workplace book by David David Neil and I think that this is affecting the construction industry more and more as time goes on and workers do not have regular have regular jobs or single employers

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now when we think about health and safety in the construction industry I think we historically have thought about the issues that you see in this depicted in this picture which is a group of hired workers sitting on an i-beam hanging over New York City and of course we're all appalled to think that this is actually our true picture that was taken because back in these days there was no need or no concern for fall safety and

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so these individuals are just sitting out on this Ivy but the truth is today's in today's world many of these individuals are all of these individuals would need to have some sort of fall protection so that they were not at risk of falling because we are concerned about fatal injuries but the truth is more of those workers probably died from the other hazard you see depicted in this picture which is smoking rather

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than fall into their death from this Ivy so historically we have been concerned about safety and the question is what other risks are we not attending to traditional workplace hazards then from the perspective of OSHA have looked at these particular hazards the physical biological chemical biomechanical and safety in the area of construction much of the greatest hazards are in safety

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with regard to machine equipment and slips trips and falls there are some biomechanical exposures with posterior by repetition some biological exposures with asbestos and of course going back to the beginning physical exposures with noise and vibration and then working outdoor foot temperature most of the regulations that are related to the fatalities in particular fall in the area of safety but there are many

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non-traditional workplace hazards that should be considered but are rarely discussed related to construction worker training knowing what they're doing are they trained adequately significant amount of forced overtime in order to complete projects that are not done in a way is the monotony of work in some cases harassment from bosses to keep up with schedules discrimination for workers and

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all of those things also do not consider some other factors that these individuals might be exposed to such as if they have to drive between jobs making sure that the the amount of driving they have just to get to and from work and so we'll talk about a few more of those but there are many non-traditional hazards that we should be concerned about that are not in your addressed in construction so there are

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several factors that are unique to construction one of the things in the upper left picture we see is that construction workers were days away from work and this is particularly true in the middle-aged populations beginning at the age of 35 we can see their days away from work are nearly double those industries and similarly as the aged worker construction worker continues to have higher rates of lost days the upper

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right graph is interesting it shows the seasonality of work and the frequency of unemployment of construction in red compared to all other non-farm related work you can see that there are no there are not significant periods of time that the individual might be unemployed but they certainly would have trouble paying bills on a consistent basis with that type of employment and the bottom picture shows the frequency of smokers

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is much higher than all other industries we're going to talk a little bit more about that issue so most of work related to health and safety focuses on work and safety policy for traditional work outcomes the traditional work safety policies in the upper left hand box show the concern for hearing protection the concern for the physical to the ends of the work using

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assistive devices wearing safety glasses and ventilation controls among others and then those are directly related to the work outcomes we're trying to prevent the number of injuries the number of miss days or to maintain work productivity less common outcomes but certainly outcomes that are discussed related to those traditional workplace safety or in the bottom right and those would be things related to low back symptoms because that might affect work

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productivity Oh more recently here in the u.s. in particular there's a strong concern for the use of pain medication and in particular opioids and the risk of addiction for opioid use which is continuing to play havoc not only with our nation but strongly in our construction industry and then mental health although that's not commonly discussed it is a growing problem I think in all industries and we see the

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same thing happen in its construction but the bottom left box shows some non-traditional health factors that are rarely considered in the construction environment the use of sunscreen despite the fact that they work outdoors or many of them work outdoors all year-round the there's little concern for having access to food to purchase with these individuals that might be working on

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sites where it's challenging for them to walk to their car to go out to get food or even just having a clean place to eat if they bring their food to work furthermore there are there's varying degrees of tobacco and alcohol policies for these for this industry so when we think of construction most people think that all construction work is similar and what I'm here to talk about is a little bit of the differences between

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types of construction and in particular I'm going to talk about carpenters a group that we have been working with and then there's a large difference in some of the rules and policies between the residential and the commercial workers in the left side of your picture of your screen you see two pictures and these are commercial workers you can see the workers are wearing high visibility

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clothing they're working wearing hard hats they should be working very high protection they're wearing sleeve protections and gloves the gentlemen in both the upper and the lower section are tied off or cabled to the the system so if they fall that will catch them and they have on hard steel toed shoes to protect their feet in the event that

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some object falls on them on the right side you see several workers in the residential area you can see there's no high this color there there are individuals in the picture that are wearing tennis shoes they are barehanded with no gloves there's the gentleman in the lower right picture who's up on a pick board on the third floor of a house does not have any fall protection and so he's standing on

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a board about one foot one foot wide and if if he falls there's nothing to catch it so the residential activities and the policies are though that environment in that environment is quite different at the bottom of your screen I point out some of those differences there are fewer safety regulations in residential it's a much less formal organization and there's much less project oversight there are

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fewer foremen for the number of workers or there are a few foreman on the job overall the crews tend to be smaller in residential and though the the leaders tend to have less knowledge in projects it's we're going to show you the data is from apprentice carpenters which are the least skilled of all the trades but it's

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not all the workers in construction or carpenters and yet it's not uncommon for an apprentice carpenter in their later later years of their four-year training to already be running jobs so it doesn't take much to work your way up this system and yet many of these individuals don't really have the necessary experience so the point the presentation today will just compare the safety and

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health risks and supports between residential and commercial apprentice construction workers there has been little out there published on the current programs policies and practices to promote worker health and well-being in construction which is our motivation okay so here's the so what we have done is we've collected surveys in the carpenter apprentice program here this is a single year of data we have 934 surveys that were completed which is a

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response rate of 90% there's a little over a thousand workers carpenters in this group there's a mean age which is quite young as you would expect for apprentices of 28 with a short period of time in the system of only two point six years each on average they report driving 45 minutes or 45 miles one way to work so many of them have long long commutes

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um the majority of this particular population is white or Caucasian which is a union group of apprentices and there are many fewer minorities in this particular group they twenty-eight percent of them are current daily smokers which again is above the national average the ten percent are only ten percent use sunscreen thirty-two percent would be considered

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heavy drinkers where they report drinking more than five drinks for more than five days per month forty-nine percent or almost half say they report they sleep less than seven hours per night on the workplace these same individuals say sixty three percent say there's no limits on the number of hours they work each day fifty-five percent say they are smoking restrictions at the worksite and only four percent say the

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worksite provides sunscreen so I just picked out a few of the items related to both traditional and non-traditional safety safety and health concerns that we would have to for this presentation here are a few more these are predominantly in the safety area so even in safety in this population we can see that the amount of adherence the safety policies and procedures varies across

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these different these workers are recording they vary across the different work on so and these are all carpenters at this point not necessarily residential versus commercial so you can see almost all regardless of residential commercial they're all out nearly all reported receiving drug screens wearing hard hats wearing safety glasses but after those top three we start to see quite a full drop-off of safety with

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quite a few having cell phone use restrictions which is applauded about visible Ivan's clothing and smoking restrictions are somewhat high hearing protection and gloves and then we see very few have a need or require majora respirators hearing tests and radiation testing and some of those things might be just because the nature of the work they're exposed to really does not have some of those risks here I'm presenting those

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same some of those same items but separating them out between residential and commercial so you can see hearing and protection hearing protection and policy for residential is only 35 percent 466 percent our samples fairly split with the 900 individuals with 400 in residential and over isn't a small sample size for residential workers if

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we look down our list for safety glasses that's pretty similar between the two groups ventilation controls is much lower for residential but here there may be less need for ventilation controls this is not to say that they lack policies and there's a need for policies we just they're just reporting there are fewer policies smoking restriction is less common much less common on residential compared to commercial cell phone use is pretty similar which is

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kind of interesting somewhat smaller but they're still pretty similar mandatory overtime is less on residential compared to commercial and daily work our limit is higher on residential compared to commercial so those last two actually are in favor of at the residential worker compared to the commercial worker where the commercial worker is having higher demands on their work time in their work hours but the residential

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worker has fewer policies being put on them for hearing safety go out hearing ventilation and smoking then if we look at the outcomes we see that the number of missed days is higher for residential and the number of low back symptoms is also significantly so the though so here we would think though the number of portables we would be finding

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in the osha logs would be correspondingly higher here we see some non-traditional health factors that I reported before but not splitting them between residential and commercial again using sunscreen doesn't matter there's no difference between the chin grooves and wearing seatbelt there's no difference between the two groups well when we get down to excess of food and having a clean place to eat there's a market difference between residential

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and commercial and this you know is likely due to the fact that commercial has more policies is requiring there's more formal nough students that the contractors make when they enter into the bid where in residential that's not does not seem to be as common in there and their bidding processes for the individual projects each of the workers on residential it appears has to fend

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for themselves quite a bit more here we see the non-traditional health factors separated between residential and commercial remember of individuals who drink alcohol number of days per month is significantly higher among the residential value point 3 compared to their commercial seven-page here we see the number of current smokers and residential is also higher 31 percent

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compared to 25 percent so even the commercial is higher than the national average for all industries but residential is even higher and if you recall going back to our earlier the policies smoking policies on residential was much lower so one would mean there's a connection between smoking policies and smoke coders being able to smoke health problems affecting work productivity the residential workers are saying that's true we saw in

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the previous slide that they're reporting a lot more low back pain they're reporting more in those days of work and here they're reporting that they believe their health problems are affecting their productivity and the last one is a large concern which is those who are receiving prescription medications for pain 15% compared to 10% and remember back at the early slides I told you this as an average population age of 28 who have only been working in

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this work force for 2.6 years on average and yet when you have a large number of these individuals that are already seeking treatment for pain and the prescription are getting prescription that's for that pain here we see each of these are individual models that are looking at three different outcomes the missed days of work as one outcome having a low work ability of just less

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than nine has an outcome and having health productivity that we dichotomize as low one or and what we're seeing here is the prevalence for residential workers in the first row is 75% higher or more more common to have missed days than those that are not working in the residential construction if we look over

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on the far right that for the residential group we see that their health productivity 57% of them are saying their health productivity is less than those who are not working in residential construction similarly we look at the second row of information we can see that those who are reporting poor job security are much more common for low workability 52% are reporting

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will workability and 61% are reporting low productivity if they have poor job security and the last one shows those who based on the jcq have high job strain are twice or three times as often reporting missed days of work so high job strain is associated with a significant number of those who are recording these days of work know

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workability is also associated with high job strain as is low productivity so these individuals are reporting residential is much higher poor job security is a strong predictor and high job strain is a strong predictor of miss day's low workability and loss of productivity here's the relationship between those same three factors and risk taking

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prescription pain medications and here this is similar to the results we saw earlier where what evidential is much higher for those three poor taking pain medication 53% here for job security is 53% related to taking prescription pain meds and then high jobs straight so prescription pain meds which is a big concern we have we have three factors in this population that are our effect are

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related to that taking the payments so this data this cross-sectional data at this point issuing several relationships that are of concern in particular their residential contractors who we know are small size and and they have humor supports for positive health behaviors than commercial our data is showing that these residential carpenters perceive that their health is much poorer than

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their commercial counterparts the residential workers also a reporting greater number missed days lower workability lower work productivity and a fairly much more common usage of pain medication compared to their brothers working in the commercial area work organization also varies within construction and we saw that with the number of work hours being more

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demanding on the commercial side hire more often work overtime as well as yeah overtime so I think we you know as in conclusion I would say there's an urgent need to address not only the problems we have with safety continuing work on safety and construction we have a number of non-traditional health concerns in

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construction at large but in particular a focus on these residential workers who have a greater number of challenges that they face each and every day they go to work it's also though a much more challenging group of workers to access the residential individuals are smaller groups they don't their regularity of them being found at one worksite is in less frequent because the builds are

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smaller and shorter duration workers tend to move around between companies more often and so I think that is part of the reason that where we have a greater challenge for building a culture of health in this particular workforce that's all and I thank you for your thank you so much Emery and yours well I'll just make sure everyone can hear me I know we've had some technical

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difficulties and we apologize for that so I think this is extremely interesting information although it does present a very alarming profile of these residential carpenters and I think I'll kick off your Q&A any suggestions you have and that can address a lot of health and safety and I'm thinking more around how they got information about the survey and is this a potential

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vehicle for them to get information or training on how to look after themselves right so as I mentioned these are union workers so they didn't go back to the Union of their apprenticeship program they they attend of their apprenticeship training four times a year for two weeks and therefore they do receive health and safety training as a part of that apprenticeship this group also has

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mandatory ongoing training of eight hours that they must complete each year and you know we have worked toward infusing this group with more and more information in this area we had originals centered our efforts more around safety and ergonomics for a number of years but with the the growing problem of pain management opioid use

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even in our own workforce here mental health issues are a growing problem we have now started to increase the resources available to these workers and now are encouraging them to take advantage of the various programs that are being offered to them we have a big challenge in all of construction and maybe a bigger Channel in residential and that is that these individuals are primarily male they're Ted this particular group tends to be

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young and so they stuffer from a bit of machoism and overcoming that I think is going to take time for us to break down their culture to give these gentlemen permission to come forth and ask for help we already see that they're going to the doctor to get prescription medications that otherwise they wouldn't have access to them so I think we've made headway on terms of getting them to at least seek treatment now we need to

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take it a little further and try to push upstream not only for seeking treatment earlier but giving them information so that they're empowered to at least help their own control their own health a little bit more thank you and another question that has occurred is do we know how this sample of residential carpenter

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compares to other geographies we have not looked at I don't really know any place else we can get residential data to be honest with you we happen to have the Union environment locally could performs 90% of the residential construction in our area and so we don't know of any other area where people have actually been able to report a fairly

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representative sample of their area and residential workers in their area I also think there there are publications out there that show the difference between construction workers in general compared to non construction workers and we know that the Union I'm sorry that the union construction worker - the non-union construction worker and I think we've seen that in the Union construction worker has more benefits offered to them so if that's the case then I think our

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data is actually more activist unfortunately then it is probably occurs in other regions of the country okay thank you I have a question here in relationship to overtime and the question is is there more overtime in this commercial area and is it possibly due to difference in piece work between

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the two you know I think that it is not driven by the piece work and therefore by the compensation associated with piece work I think it's more driven by the fact that commercial bills are on they they tend to be on tighter schedules and they're it's a much commercial bills in general tend to be more complicated and therefore there's more risk of schedules falling behind products not available when it needs to

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be and so therefore I think there's often a catch-up time where the workers are expecting you know something put them behind the schedule their product wasn't there on time so now everybody's going to have to work this weekend is much more common in the commercial world than it is in the residential world where if there's a delay in residential we just say your house isn't going to be ready on time there's a lot more incentives for completing commercial jobs on time and they are financial

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incentives that are generally realized by the upper management and not by the workers themselves for the workers are expected to perform the work interesting any suggestion as to how to improve the access to access their residential industry to improve their workplace safety as far as just reaching them with information I think that certainly would be one vehicle so you know I think that

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a mobile van kind of a thing particularly in large subdivisions where you know there's a large number of those going up timing you can reach a larger number of workers is one when offering bring you know bring it to them since they don't have the time or the willingness to come to you bring the information to them where they are you know we've tried things like pushing information out

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through newsletters tool box talks toolbox talks are not as common these are safety briefs that are done on a daily basis very common and commercial less common in residential but they still do you occur and that might be a way to give them small bits of the information at a time those are two two things that I would say you know we can focus on we actually this project that I'm presenting this information we're

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actually in the process of using intermediaries to try to do this very thing that you're suggesting which is how do we get information to them an intermediary can be anyone in our system it will generally be a union or a supplier or an insurer who will go out has contact with some natural in some natural way to these workers and so they may be out on the site delivering products and they could deliver other types of information or they could

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deliver program materials or whatever so we're investigating that now as a means to reach these individuals with programs that we think they don't know about or that they would benefit from if they if they knew they were available or to give them information about where to seek those resources that's our current

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project interesting in I recall some interesting similarities between recent webinar related to the trucking industry and there's probably other industries and probably down the road future studies could look at the Henschel interventions that different industries with similar profiles have used that might have worked so I know in the trucking industry there was some

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mobile resources related to dietary support targeted at the the smokers for instance and some incentives for them to eat better and then food was provided almost through that mobile kind of concept so there may be things that some of our participants are aware of or something that we could certainly look at in future is the generalization

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through other industries related to successful interventions for those really hard to reach industries yeah I agree I think that we need to be we need to think out of the box for this one because they're hard to reach and then we have this added cultural issue which I do believe exists also in other industries in the construction industry the Brotherhood is so strong and the

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need for you know proving one's self I've been doing this a long time and I see a change in that culture in a positive way that allows these guys to come forth more today than they ever would have 18 years ago so I think that we've made progress I think all of our attention to this problem and the health of these individuals is is making a difference but I just feel as though it's slow and we're losing a lot of our

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workers in the meantime not only from the baby boomers but also they're just they're just not either willing to stay in the industry or they are physically not surviving and they're leaving the industry for that that's a reason but there's becoming up a bigger a fewer and fewer workers in this area and now the companies are are seeking workers from other areas to come in and do the work because we can't find

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enough workers locally especially with the the pain statistics that you have showin the medication uptake for such a young group already it certainly denotes the the challenge of retention of the worker when they are already experiencing injuries very early on or pain related to their work one of the

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questions also was around any other data sources at the national or state level on some of these health factors in general are we referring to in general for all industries or construction I think in general so you know I actually think for some of the numbers that I'm showing here I don't know if I don't know of statistics that are out there you know sunscreen news I would assume some industries maybe are monitoring the

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that type of thing but I don't know of any you know national numbers I think drinking and smoking those numbers are very well known and construction always needs unfortunately it leads that group so I'm not I'm not familiar with whether you know these non-traditional health issues I don't know that we know the national numbers well for other industries or what we do but we can definitely see a connection between the risks for those

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hazards like sun sun protection and the fact that these individuals are working outdoors you know 100 percent of the time so so there's obviously a need for for better protection than than what we see absolutely and again I think you've addressed some of this but in your opinion what do you believe needs to be done to accelerate the process to address the health and safety of this

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particular worker so you know there's been a lot of discussion around the table of you know we need to mandate this through policies and yet in my experience policies don't always create the change we want I think they can be you know they can be push people to at least talk about it and how some can leverage based on policy but compliance isn't always going to follow I think we really need to get the owners on board

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with a need for this I know with the opioid crisis we have here in the US when we have an owner who has a personal experience with an opioid overdose fatality either among one of their workers or their personal family they are much more ready to talk and address the issue and I think that you know unfortunately the opioid crisis is going on but it actually is starting to bring

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people to the table that I think I'm gonna give us an opportunity to not only talk about pain and medication but some of these other mental health issues and some of the drinking and smoking which are so prevalent in this this workforce and need to be addressed because those are definitely having an effect on the health not only of the worker but the lives of their family members so I think you know bringing getting the owners and

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employers to the table and getting them on board with the need for this I think is very important and that's that's pretty much where we're starting I mean I recall that in Canada in Ontario public health did a very local campaign across the province related to the mental health of new mothers and because it was done at a local provincial level

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there were changes but it had to be addressed locally so that there was community commitment and engagement because again you were dealing with a hard to reach population once they had left the hospital and people were fairly isolated so again if you're dealing with a a carpenter residential worker very

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small business there may be some kind of local initiatives that that could be looked at just a lot potential yeah I think that that's definitely true and and these the construction world tends to be very tight and everybody knows everybody maybe that's were more prevalent here in San Luis where they're in such a strong Union environment but if individuals are seeking work and they have to they have

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to look for seek work for themselves then they probably know the rest of the system around and so you're right that would be a good way to build a campaign from within their own and that would probably grow grow grow stronger and more quickly and here again if we can combine the efforts of not only the individual workers but they're their owners the employers and get them on board

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I think the buy-in here might be the productivity and the cost savings and you know improving the health and we've tried the numbers game and I think we need to continue to to show through the numbers how a productive worker is a healthy worker is more productive and therefore we'll save money to the employer I think we can need to continue that to gather that data so we can can make that take that case I think you've

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summarized it really well and certainly when it's by the numbers if we can show that looking after your health improves productivity and results and cost savings then we're more likely to get an audience from employers and owners of small business I think your passion has certainly come through and and the audience would be really interested in

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what you do next so we have a question related and I think we'll close with this what other areas do you consider in the continuity of your research to be next so we are looking for ways to we're looking to design interventions that we believe the industry is more willing and ready to accept off the shelf I think

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there's a lot of good ideas out there but I don't think many of these small employers in particular have a clue where to start especially instance these are complex systems you know a construction site is complex and so you're saying that handling loads is one of the most important things we need to stop having the workers do and we need to find other means to transport those moves what does

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a company need to have in order to figure that out and most of them know that's what they need to do they don't have a clue how to get started and it seems like such a simple thing but they don't really know where to start so we've created some materials to actually get that process started and we'll skip companies ideas and so I think we need to find those interventions that help solve the problems in a way that can be taken off the shelf by our small workers

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small companies and used right away thank you so much in and I'm just gonna close off this webinar for a plug for that small business group Cree MSD in partnership with the Ministry of Labour in Ontario has just produced new MSD prevention guideline and one of the versions of that guideline is called the QuickStart guide and it is totally

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targeted at the small business operator and I think there's some good information there to kick off intervention planning you know maybe six months from now we'll have some case studies on how that guide has been used to help change some of the practice and we'll look specifically at carpenters and if we've been able to make any

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inroads sounds great so I'd like to thank everyone for joining us today and yura from work wellness for hosting this webinar just a wonderful wonderful a collection of information thank you so much Thank You Catherine a huge thank you to anne-marie for sharing your valuable knowledge with us today and Catherine for a wonderfully moderate in this webinar a special thank you to our audience as well for joining us

Contrasting Prevalence of Health and Safety Risks and Controls

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