Within Tunnelling and Trenching industries, unique hazards are inherent to each process that differ from other types of heavy civil construction. Unstable ground conditions, large-scale machinery, hazardous atmospheres, equipment traffic, and chemicals are just a few of the risks our crews are exposed to on a daily basis. Assessing these risk factors, initiating mitigation measures and maintaining a safe work environment are crucial.

Safety in and of itself is dynamic in nature. Each person may define safety just as uniquely as any company or organization. This can be observed in employee behaviors and employer safety program mission statements. Equally diverse is the approach taken to ensure that everyone goes home safety at the end of the day. In consideration of such diversity, the approach to ensuring a workforce can safely function on the job should be well defined, yet able to adapt to each employee’s individualities.

This paper will discuss safety and risk mitigation specific to tunnel construction as well as various approaches in determining:

  • Fitness for duty
  • Baseline level of cognitive ability
  • Quality of decision-making skills
  • Retention of training and skillsets

Employee Drug testing and fit-for-duty

The Occupational Safety and Health Administration (OSHA) defines “fit-for-duty” as an individual who is in a healthy state mentally, physically, and emotionally and therefore can perform the tasks essential in their specified role or position. In being fit-for-duty, this employee poses no threat to the safety and health of themselves, fellow employees, members of the public, or any affected property. Fit-for- duty is an official diagnosis afforded by a physician, chiropractor, physical therapist, or other qualified medical practitioner.

Physical requirements for tunnel workers are considerably more demanding than other mainstream modes of infrastructure construction. The working environments are not necessarily classified as confined spaces but are considered limited, to say the least. Ergonomics, noise, air contaminants, and shifts lasting longer than eight hours all contribute to an increased risk for injury and illness.

Mechanisms of injury generally result from five risk factors, all of which are found in tunnelling construction (Queensland Government, 2007):

  • Forceful actions – where a one-time exposure or event results in an acute injury;
  • Awkward and stationary positioning for extended periods
  • Vibration
  • Repetition of tasks and movements over an extended period
  • Duration of shifts and tasks

In a proactive approach to risk mitigation, it is important to consider specific tasks that fall under the mechanisms of injury then utilize the hierarchy of controls to achieve the most effective control or elimination of a hazard.

Current approaches

Approaches to ensuring fitness for duty have evolved with time as have approaches to treatment for workrelated illnesses and injuries. In high-risk industries like construction, tunnelling and mining, fit-for-duty examinations are extremely important in ensuring a safe and healthy working environment. Examinations are conducted upon hiring, as conditions change, and at the end of employment. Doing so protects the worker by identifying illnesses and potential for injuries. The employer is protected by documenting the employee’s current health status and baseline results.

The physical examinations differ with location, job description, employer requests, and physician, but generally address respiratory, heart, vision, hearing, and flexibility. Typically, in the tunnelling industry, baseline evaluations are conducted for sight, hearing, and lung health. Exposures to silica can be widespread and are thus if exposures meet the exposure minimums, employers are required to facilitate a baseline examination and with a follow-up every three years. Employees also need to be flexible enough to work in limited spaces and be able to lift 50lbs or more without risking an injury.

Examinations are conducted by licensed physicians. Results are forwarded to either human resources, safety, or other designated members of management. Results and information therein are confidential and shall be stored in secure locations. Parameters for these examinations are determined at the start of a project and adjusted as roles change. Countries, states, and provinces also have specific legislative requirements that must be met.

Pre-employment evaluations

In the United States, the protocol for establishing fitness for duty differs from most other countries. Preemployment drug testing and fit-for-duty examinations are a cornerstone of the hiring process. In the eyes of many employers, this is a key factor in a potential employee’s ability to safely perform their assigned duties on a daily basis. This process can only begin once an offer of employment has been rendered and accepted. The examination shall also take place prior to active work commencing by the individual.

In the United States and Canada, however examining one’s physical ability to perform a specific job function must strongly adhere to laws passed to protect people with disabilities. A safety factor under consideration within the job description must include only functions that are essential to the business operation (DHS, 2011). Therefore, the employee must have a clear understanding of the mental, physical, and procedural job requirements prior to accepting the position.

More specifically, if the employee agrees to submit to regular or random drug testing as a condition of employment, then he/she may not elect to deny future testing. The same goes with physical examinations such as lifting tolerances, hearing, vision, and respiratory health. On average, the physical demands on a laborer in construction tunnel industry exceed those of other industries.

Drug testing in the USA

A drug-free workplace policy is an element that can be found in most safety programs throughout the United States. This includes pre-employment, post-accident, for- cause and random drug testing of employees.

Nearly 75 per cent of American worksites employ some form of preemployment drug testing (Fortner, N., et al, 2011). A greater number of employers have active Workplace Drug and Alcohol Policies as they are required by either their insurance company, line of work, or as negotiated by the formal collective bargaining process.

Is the prevalence of testing programs due to their effectiveness or can they simply be attributed to the status- quo? It depends on who you ask. What most people do agree on is that the origin of random drug testing can primarily be attributed to the Regan era. President Ronald Regan’s Drug Commission on Organized Crime issued a report in 1986 recommending drug testing for public sector employees (Rothstein, 1991). As a result, the Drug-Free Workplace Act of 1988 was put into effect. The act was initially designed to target government employees and contractors (including all branches of military).

Random drug testing maintains its position as a hot topic throughout the construction industry as professionals within the safety and health industry debate the benefits and cost effectiveness of sustaining such a comprehensive program.

States and provinces that have passed laws that allow recreational use of marijuana. This has complicated the implications of a safe work environment for both employees and employers.

Post-accident drug testing has been used for decades by employers. However, in January 2017, new regulations were passed by OSHA that prohibits the retaliation towards employees. Conversely, employers are also prohibited from basing incentive programs on incidents reported. Take the example of an incentive program which declares that employees will be issued a safety award upon reaching 90 days without a lost time incident. Should a lost time incident occur, none of the employees will receive the award. This practice is in direct violation of OSHA’s section 1904.35(b) (1)(iv).

Drug testing in Canada

The subject of the employer’s right to drug test employees in Canada is a very contentious one to say the least. In a union environment, it is even more so. In the end, it all boils down to human rights. Approximately 10 pre cent of Canadian worksites have active drug testing programs in place (MacDonald, S. et al., 2006).

The laws strongly favor the employee in Canada. To test an employee an employer must have reasonable cause as well as a strong program to support the justification of such cause.

The Ontario Human Rights Commission states that employers must go to great lengths to establish the necessity for random drug testing based on specific risks within the workplace. Even still, the argument for human rights presents itself based on the employee’s interpretation of The Code.

Rationality of testing approaches

The justification for testing approaches varies among industries. Strong proponents will support the prevention aspect of pre-employment and random drug testing in that it could possibly prevent a catastrophic accident or even fatality. In addition to the value of life, therein lies the potential for a significant cost savings associated with injury claims management. Workers’ compensation carriers offer significant discounts for policy holders.

The opposition to testing approaches poses arguments that may be interpreted as more subjective in nature. Cost effectiveness, legitimacy of testing science, and human rights are among the leading positions. Legalization of marijuana in limited locations of the United States and Canada has prompted this argument to the forefront of legal, ethical, and safety discussions.

Human rights activists pose that the lack of accurate time-sensitive testing that would prove an employee was directly affected on the job denotes the legitimacy of any testing protocol.

Cognitive function

Fitness for duty is contingent upon a negative test for the presence of drugs and or alcohol and is an expected way of doing business in the United States as well as some limited business models in Canada. The validity of such testing is strongly contended by both sides of the argument. The real question is, “Is there a better way to ensure an employee is fit-for-duty on every day?” The answer for this author is, “Yes, there absolutely is. And the answer lies with cognitive function.”

Impacts of cognitive function

Cognitive function simply encompasses one’s ability to acquire information. The way we make decisions, react to stressors, use language, retain information, and utilize knowledge summarizes the level of cognitive response level at any given time. Our ability to have effective cognitive function is infinitely affected by genetics, our environment, and how we take care of our bodies. Simply put (outside of genetic predisposition), some of the following triggers can significantly affect a person’s level of cognitive function:

  • Sleep deprivation
  • Drugs and alcohol
  • Stress

Sleep deprivation

Leading the list of triggers of cognitive impairment is sleep deprivation. A regular and quality sleeping schedule is rare to most adults. Equally so, is the ability to get to sleep and stay asleep. Sleep deprivation has both short and long- term effects on health and cognitive response even in the healthiest of adults.

Studies have concluded that a lack of sleep is equal to or even more dangerous than drinking alcohol. In fact, a wake period of 17-19 hours can equate to a blood alcohol level of 0.05 per cent (Williamson, A. and Feyer, A., 2000). This is equivalent to waking at 6am and staying awake until 11pm or later. Results increase exponentially as deprivation continues to a level equal to a blood alcohol content of 0.1 per cent. Even at the 19-hour mark, this impairment would exceed the Canadian blood alcohol content limit.

If a mining shift starts at 6am with a one-hour commute, consider the following for a 12-hour shift:

  • Employee wakes at 3:30am
  • Employee ends shift at 6:00pm
  • Employee cleans-up and leaves site by 6:30pm
  • Employee arrives home at 7:30pm
  • Employee goes to sleep at 9:30pm

The total hours an employee is awake every day could be as much as 19 hours. By the time the employee is leaving work, they are already at 15 hours and arriving home at 17 hours of awake time. One crucial point to consider is that the awake time is spent doing arduous labor, thus increasing the amount of fatigue and decreasing the level cognitive function.

Drugs and alcohol

Drug use and alcoholism have long histories associated with illness, cognitive impairment, and life expectancy. The immediate cognitive implications of inebriation present significant evidence for workplace safety concerns. Delays in response time, decision-making, and days away from work all impact an employee’s ability to function safely on the job. Depressive symptoms are also more prevalent for people within this group.

An additional factor to be considered for this group is recurring detoxification. The act of repeatedly detoxing from drug and alcohol use leaves long-lasting impairments of prefrontal brain function (Loeber, S. et al, 2009). These deficiencies may be discovered with standardized screening techniques currently in use by mainstream employers.

Stress

Stress can present itself in many ways. As adults we are placed in situations to deal with stress every day. How we handle the stressors, whether physical or emotional, can deeply impact the efficacy of cognitive function. Inadvertent stress on the body induced by heat or cold can have devastating effects on the body as well as its cognitive functioning ability.

Hydration alone can have significant effects on cognitive function. A study concluded that dehydration impaired cognitive abilities of participants as demonstrated in tests of memory and perception. For this study, unacclimated participants were subjected to heat under conditions of hydration and dehydration. Both groups experienced a temporary reduction in cognitive function (Cian, C. et al, 2001).

Approaching fitness for duty with Cognitive response

A new approach in securing employee fitness for duty on a daily basis is long overdue. What if this contemporary method was not only objective in nature, but also specifically focused on the employee being evaluated? By approaching fitness for duty from a holistic point of view, the employer can assess employee alertness and response times in their current state, and at the moment of task performance. They are scored against themselves by using a baseline created from previous evaluations.

Even in a non-scientific approach, it is possible to implement a proactive cognitive awareness program. A simple stretch-and-flex program has been proven to not only reduce the number of musculoskeletal injuries, but also improve cognitive function by increasing oxygen intake and blood flow. In addition to the physical benefits of stretch-and-flex, supervisors are able to identify crew members who may be experiencing physical limitations due to illness or injury.

Scientific approaches

When assessing cognitive response in a controlled scientific setting, there are myriad testing methods that are generally acceptable. Each method is designed to assess specific areas of motor response, speech, tactile function, visual function, as well as processes for intellectual function. Select tests, can evaluate multiple domains of cognitive function. Generally, they include memory challenges, simple mathematics, perception of shapes and space, as well as identification of patterns and images.

Real world applications

Implementing cognitive assessment protocol in the workplace is not only effective for risk management purposes but can also significantly affect the mental and physical wellbeing of the included employees. The assessment process is now striving to establish the employee’s level of alertness rather than a standard program that simply tries to identify an impairment. Over time, there is a shift in safety culture where a tangible value is placed on human life and fitness for duty. This is a striking comparison to the stigma of “drug testing” in the workplace.

Implementation

Although available products differ slightly in their approaches for implementation and maintenance of a fit- for-duty program, the goal is universal. A unique baseline of response data is collected from each employee. This means that each employee is only compared to themselves, resulting in much more accurate identification of fatigue and or impairment.

A Fit-for-Duty program would be written and implemented like any other safety program in the workplace. Employees would need to be introduced to the new program and trained on its goal, attributes, and benefits. A change in any culture should be paced with re- training and meaningful interaction maintained.

Data collection is administered at the employer’s discretion. Ideally, sampling is completed at the beginning of each shift as well as following prolonged breaks in active work like lunch or training. Electronic tablets can be securely mounted wherever employees enter their workplaces or work stations. Employees can also access the testing program on their personal mobile devices.

After an employee clocks-in, they will each participate in the brief testing window of one to three minutes. A passing score will release them to enter their workstation.

Results

Because the sampling is electronic, results are provided instantaneously to both the employee and the designated member(s) of management. At this point, the protocol established in the program will be engaged.

The program would need to identify a specific protocol to address employees who are flagged with a deviation in score. A confidential meeting could be conducted with the employee and safety or human resources manager to discuss the test results. It is at this point where a management decision would be made to determine a plan of action. Some countermeasures could include, but would not be limited to:

  • Alternative work duties outside of safety sensitive areas
  • Employee sent home (in cases of flu or illness)
  • Employee referred for drug screening protocol
  • Employee offered resources for counseling Following any type of deviation, a passing test would be required prior to resuming normal work duties.

Benefits

For any new program to be successful, there must be a solid buy-in from upper management. Everyone needs to participate in the program, just like any other company program. The benefits for implementation of a daily fit-for- duty program are multifaceted.

The safety culture is enriched with an environment of respect and understanding. Employees are no longer suspected of wrong-doing but are rather cared for in a fundamental approach. Alternatives rather than punishments are designed to ensure a truly safe and healthy working environment.

Employee self-awareness is enriched. Employees will become familiar with the testing protocol and approaches. They will also be aware of the triggers which will result is a failing score. Once employees become comfortable with the guidelines and expectations, they will begin to understand their limits and engage management accordingly for guidance, prior to experiencing a score deviation.

Employers will gain a deeper understanding of their employees needs and abilities. Patterns will begin to surface with shifts, seasons and events within the workplace. This will provide valuable information that can instigate further operational change.

Conclusion

Inherent hazards associated with tunnelling and trenching construction can take a toll on the human body and psyche. Crews are working long hours in conditions that likely expose them to noise, vibration, chemicals, moving machinery, and possible hazardous atmospheres. Every employer strives to provide a safe and healthy working environment for their employees. Opinions on how to achieve this can vary with each safety professional.

Considering the dynamic nature of safety and the individuals we work with every day; an equally diverse approach should be taken to ensure fitness for duty and workplace safety. Past approaches in establishing a one time or limited fitness for duty are valued by employers, insurers and certainly the clinical agencies. However, employees are left functioning on the defensive. In addition to a lack of employee buy-in, a large facet of workplace safety is being completely overlooked.

Singularly identifying deficiencies in worker cognitive function on a regular basis casts a wider glance than generalized identifiers like drug and alcohol use. Additionally, meaningful triggers like fatigue, illness, stress, and working environment can also be identified and mitigated prior to the occurrence of an incident, injury, or even fatality. Additional benefits include employee self- awareness, reduction in sick days, and improved safety culture. A program that monitors daily cognitive efficacy has the potential to compliment an already existing and effectively functioning health and safety program.