**2. Theoretical framework**

**1. Introduction**

60 Occupational Health

hazards.

lective impact and workstation evaluation.

segments in Brazil [3], just behind the transportation sector.

Ergonomic Design Thinking (EDT) was originally conceived as a project management model used for both organizational design and project management. Thus, it must be understood as an effective tool for project management optimization in general applications, not only design projects. The main idea is the general concept that makes possible the application of creative reasoning and intensive end-user participation in the course of project management just like designers do when solving problems in their during the creative work process. Conventional planning and decision making methods flow in a linear manner, way different from creative thinking. "HSE," short for health safety and environmental management is a fairly new–and crucial–area in operations management [1], especially for those organizations that fall in the category of complex systems, which require a 360° approach to operations management. HSE decision analysis in such environments is definitely a challenge, since prioritizing becomes difficult due to multiple criteria to assess, risks to ponder and level of severity in terms of col-

This chapter outlines the general model for carrying out HSE project management approaches in the workplace. In practical terms, it adds up to existing management systems that are designed to comply with industry and government standards. In order to contextualize the theoretical framework, a case study is employed as a guide for the implementation of a specific HSE Management system for the construction industry. In order to achieve that, the work team used a set of strategies set forth by the EDT modeling, as proposed by Santos and Soares [2]. The choice of this industry segment is due to the fact this particular sector is known by the lack of qualification of its workers. As a consequence, it is acknowledged worldwide as a low performance sector in terms of controlling its operational and environmental risks and

The EDT approach used in the course of the process being described in here was carried out to help the consolidation of a HSE management system for building construction sites. Thus, the complex nature of the work process is dictated not by its operational characteristics or the usual determinants of larger complex systems (i.e., oil refineries, nuclear power plants, medical emergency rooms, construction sites), but because of the difficulties posed by management issues, such as control and enforcement of safety and health practices in this type of work. The building and construction industry struggles to set up and maintain effective action plans and indicators when it comes to health safety and environmental processes, commonly referred to as HSE. In fact, its workers ranks the second most exposed to work accidents of all industrial

The consequence of poor control and management of HSE in construction sites leads to a series of problems ranging from plain inconvenience of mishandling or misinterpretation of data to more serious ones such as poor HSE plans and management systems. The end result of this is converted into an unpleasant workplace, health and safety issues and all sorts of environmental problems. Without the continuous optimization of HSE processes, it becomes virtually impossible to positively improve the work conditions for the workers and all those directly or indirectly affected by the outcomes of bad planning, poor management and actual The concept of EDT derives from the general Design Thinking concept, originally proposed by Brown [4], who defined it as "a discipline that uses the designer's sensibility and methods to match people's needs with what is technologically feasible and what a viable business strategy can convert into customer value and market opportunity." However, the concept has proven to adhere well beyond the design and marketing spectrum. Likewise, ergonomics is not only a tool for improving work conditions but also an effective way for a better design of products and for bringing productivity, therefore economic advantage, for the organizations [5, 6].

The idea behind Design Thinking has been the appropriation of creative thinking and intuitive response actions involved in the design process in a wider range of situations, outside the Design field. With that in mind, Santos and Soares [2], proposed a combination of the Design Thinking "creative based process management" and Ergonomics for Project Management processes in which the interaction between users and those in charge of designing work environments or systems is key to an overall conformity to job design principles and user needs, as well as to the compliance to normative standards and labor legislation (**Figure 1**).

**Figure 1.** General EDT model.

The concept of Ergonomic Design Thinking, hereafter called by its acronym EDT, adheres to the notion of employing formal creative thinking built from within the spectrum of real work actors. Santos et al. [7] points out that nobody knows better about the job than workers themselves. Therefore, it would seem counterproductive not to take in consideration their insights when trying to improve their work conditions, workstations or work systems. Thus, Ergonomic Design Thinking must be seen as a general model for participatory actions in the workplace, which in turns make areas such as Ergonomic Design, product development and, definitely, job design all possible terrain for its dissemination.

All those actions demand sequential steps somewhat flexible to allow creative thinking to flourish. In fact, the model started to be used in setting up HSE management systems in a variety of organizations. Health, safety and even environmental processes are all connected to an important participatory demarche in operational work activities. They should not be dealt with in an insulated manner, without proper integration. Our lives and our health can be affected by poor design choices [8]. By inference, this is true for HSE interventions. Regardless all constraints that may arise in workplace, engineers are mostly responsible for all work environment inadequacies. It is fair to say that companies intuitively use Design Thinking to an extent, even without realizing it. However, organizations resist in taking a human-centered approach because they cannot grasp at the perspective of trying something entirely new. Something that arises out of their control, in the midst of a balance of users' needs, technology and organizational constraints.

The building construction industry is characterized by particularities not present in any other industry. First off, it is entirely a project driven industry, no "final product" is ever alike, due to geographic and geological variations and differences in systems and components (building materials and techniques). Contrary to regular transformation industry, storage and logistics is not a major direct problem, but quality control is as important as in regular manufacturing. Then, we have the construction site issue. It functions as a temporary factory, one in which often times workers share not only tasks but also sleeping rooms with fellow workers. Yet, there is no true attachment to the workplace. It will be used and discharged at the end of every project.

Likewise, teams are not permanent, rarely replicated in the next construction projects. For instance, if a work activity is identified as critical under HSE standpoint, a training program is immediately implemented. However, those trainees will hardly experiment the same constraints in their next construction project. In fact, sometimes they may be even out of the industry all together, since the Building Construction Industry (BCI) is also characterized as a temporary job for many people, employing large amounts of unskilled workers. In order to be successful, a HSE qualification program must take in consideration all of these issues and address them properly. HSE plans and systems need to be pragmatic, safety driven and easily assimilated by everyone. Although every construction site has its own characteristics, it is possible to establish a replicable model that could pass on the essence of prevalent work characteristics that are present in such work environments.

Brazilian Standard NBR 12284 [9] defines a construction site as "a set of areas destined to the execution and support of construction industry Works, divided in operational and living areas." In other words, it is the entire portion of land in which a construction plan will be materialized, plus the storage areas, equipment and machines (concrete mixers, cutters, welding pits, etc.) and also sleeping barracks, restrooms and lunchrooms for the workers. They are inherently hazardous places to work and to "live" and often times workers have no choice but to stay overnight since construction works and construction sites may be located in remote areas.

themselves. Therefore, it would seem counterproductive not to take in consideration their insights when trying to improve their work conditions, workstations or work systems. Thus, Ergonomic Design Thinking must be seen as a general model for participatory actions in the workplace, which in turns make areas such as Ergonomic Design, product development and,

All those actions demand sequential steps somewhat flexible to allow creative thinking to flourish. In fact, the model started to be used in setting up HSE management systems in a variety of organizations. Health, safety and even environmental processes are all connected to an important participatory demarche in operational work activities. They should not be dealt with in an insulated manner, without proper integration. Our lives and our health can be affected by poor design choices [8]. By inference, this is true for HSE interventions. Regardless all constraints that may arise in workplace, engineers are mostly responsible for all work environment inadequacies. It is fair to say that companies intuitively use Design Thinking to an extent, even without realizing it. However, organizations resist in taking a human-centered approach because they cannot grasp at the perspective of trying something entirely new. Something that arises out of their control, in the midst of a balance of users' needs, technol-

The building construction industry is characterized by particularities not present in any other industry. First off, it is entirely a project driven industry, no "final product" is ever alike, due to geographic and geological variations and differences in systems and components (building materials and techniques). Contrary to regular transformation industry, storage and logistics is not a major direct problem, but quality control is as important as in regular manufacturing. Then, we have the construction site issue. It functions as a temporary factory, one in which often times workers share not only tasks but also sleeping rooms with fellow workers. Yet, there is no true attachment to the workplace. It will be used and discharged at

Likewise, teams are not permanent, rarely replicated in the next construction projects. For instance, if a work activity is identified as critical under HSE standpoint, a training program is immediately implemented. However, those trainees will hardly experiment the same constraints in their next construction project. In fact, sometimes they may be even out of the industry all together, since the Building Construction Industry (BCI) is also characterized as a temporary job for many people, employing large amounts of unskilled workers. In order to be successful, a HSE qualification program must take in consideration all of these issues and address them properly. HSE plans and systems need to be pragmatic, safety driven and easily assimilated by everyone. Although every construction site has its own characteristics, it is possible to establish a replicable model that could pass on the essence of prevalent work

Brazilian Standard NBR 12284 [9] defines a construction site as "a set of areas destined to the execution and support of construction industry Works, divided in operational and living areas." In other words, it is the entire portion of land in which a construction plan will be materialized, plus the storage areas, equipment and machines (concrete mixers, cutters,

definitely, job design all possible terrain for its dissemination.

characteristics that are present in such work environments.

ogy and organizational constraints.

62 Occupational Health

the end of every project.

The risk of developing musculoskeletal disorders is very high because in most cases there is no possibility of mechanical material handling. Besides heavy lifting, workers are often exposed to awkward postures, making the BCI the leading industry in ergonomics-related risks and impacts [10]. This is all aggravated by heat stress (especially in some states) and other environmental hazards. Making matters worse, the exposure to job design constraints, issues such as lack of job security and crew rotation, increases the chances of accidents and infirmities [11].

In places with a strong public welfare system, occupational data and epidemiological statistics are usually more precise and credible than in wealthier nations in where private modalities of welfare are more common. In Brazil, the National Institute for Social Security needs a robust database to be able to control multiple benefits it manages, from retirement pensions to temporary disability payments, including indemnity for work accidents and work-related illnesses and disorders. The system operates in an intricate network of information, trying to avoid errors and frauds by individuals and companies, since resources are becoming gradually scarce as population grows older and people live longer.

The cost of liability insurance for example is not a flat rate for generic or specific business categories. It is based on each tax identification number, so that companies with poor occupational health and safety indicators will pay gradually more if they keep neglecting this particular issue. In fact, there is a curiosity that comes from epidemiological data in places with more harsh labor and welfare legislation. More precise data in occupational health and safety data lead to a false perception of low standards. Because it tends to increase reporting of the negative outcomes of HSE management systems, it ends up making them look ineffective when compared to other countries. Often times, countries that are known for having poor health and safety standards may look better in some of those standards. It happens because reporting of occupational health and work accidents in those countries are also very poor.

**Table 1** contains data extracted and combined from various Brazilian government agencies [12, 13], and illustrates epidemiology severity data for the BCI, in terms of frequency.

According to the social security annual statistics report [13], the impact in terms of occupational health and safety figures is exponentially more relevant once the data are further detailed. Out of more than 700.000 work-related accidents, about 121.000 of those involved victims under 29 years old and the building and construction industry is responsible by nearly one third of those figures. Soares [14] sums up the economic impact of work accidents saying that social security agencies alone spends around US\$ 1 billion in wages, benefits and other expenditures, whereas the private sector spends another US\$ four to five billion due to poor work conditions.


**Table 1.** Number of work related accidents in Brazil.

By looking at the data in **Table 1**, it is tempting to infer that the decrease in the number of fatalities and illnesses–despite an increase in number of accidents–is due to the improvement of work conditions and incentives in preventive measures, such as the use of personal protective equipment (PPE) and collective protective systems. However, it is fair to say there has been an overall raise in awareness by workers and consciousness by organizations to employ systematic measures for the improvement of work conditions as a whole, which includes some human factors and ergonomics actions. Another Brazilian government-funded agency, SESI [15], points out a list of prevailing occupational illnesses and injuries in the building construction industry. **Table 2** lists the main causes and preventive measures for each one of those work hazards.


**Table 2.** Prevailing occupational illnesses in the BCI.

The last letter in the HSE acronym represents the environmental aspects of the workplace, its aspects and impacts for the people and surroundings. The BCI is by large the biggest generator of solid urban waste. Considering the entire production chain, the environmental impact varies according to the construction system (steel, wood, concrete and combinations) but it is always high nonetheless. The graph on **Figure 2** shows the distribution of greenhouse gas emissions in Canada per each type of economic sector, placing the BCI, negatively, as a major contributor for another important environmental indicator. The full report makes considerations on the data gathering methodology that raises the numbers for the construction sector even more by adding indirect impact of the entire production chain [16].

**Figure 2.** Distribution of greenhouse gas emissions in Canada.

By looking at the data in **Table 1**, it is tempting to infer that the decrease in the number of fatalities and illnesses–despite an increase in number of accidents–is due to the improvement of work conditions and incentives in preventive measures, such as the use of personal protective equipment (PPE) and collective protective systems. However, it is fair to say there has been an overall raise in awareness by workers and consciousness by organizations to employ systematic measures for the improvement of work conditions as a whole, which includes some human factors and ergonomics actions. Another Brazilian government-funded agency, SESI [15], points out a list of prevailing occupational illnesses and injuries in the building construction industry. **Table 2** lists the main causes and preventive measures for each one of those

**Occupational illnesses Causes Preventive measures**

**Year Accidents Illnesses Deaths** 363.868 19.605 3.094 499.680 33.096 2.766 709.474 17.177 2.753 720.629 16.839 2.038 705.239 14.955 2.731

Silicosis and asbestosis Inhalation of fine particles from asbestos

**Main occupational illnesses in the building construction industry**

**Table 1.** Number of work related accidents in Brazil.

**Number of work related accidents in Brazil**

64 Occupational Health

Air embolism Underwater work or incorrect use of equipment

Contact dermatitis Contact with cement, chemicals or even certain types of PPE

**Table 2.** Prevailing occupational illnesses in the BCI.

and ceramic like materials

Hearing loss Long exposure to noise above 85 dB PPE usage, collective acustic protection RSI/WMD Repetitive tasks for long periods of time Adequate use of rest, work breaks, warm up

Low back pain Inadequate material handling/load lifting Avoidance of heavy lifting/use proper

Heat stress Long exposure to ultraviolet sun rays Proper hydration and avoiding excessive sun

and stretching exercises

procedures

exposure

so on

mechanical aid

Use of appropriate PPE (masks)

Compliance with norms and decompression

Use PPE appropriately, clothing, gloves and

The last letter in the HSE acronym represents the environmental aspects of the workplace, its aspects and impacts for the people and surroundings. The BCI is by large the biggest generator of solid urban waste. Considering the entire production chain, the environmental impact

work hazards.

The BCI's overall environmental impact has to do with processes such as mining (for sand and aggregates), which accounts for great levels of energy consumption, transportation (mostly by diesel trucks) and last, but not least, generation and inadequate disposal of debris and unused materials. In fact, a great deal of the problem is created by the lack of understanding and acknowledge on the part of authorities and society in general regarding the negative impacts of clandestine disposal and the benefits of solid urban waste disposal. Usually, BCI solid waste is considered a minor environmental hazard, which impact is basically due to the volume generated. However, this misconception hides some by-products of those residues, such as the proliferation of undesirable species as rats, cockroaches and insects that may act as vectors for various diseases [17].
