Health and Safety Executive

Constructing Better HealthFinal Evaluation Report

Prepared by Institute for Employment Studies for the Health and Safety Executive 2007

RR565 Research Report

Health and Safety Executive

Constructing Better HealthFinal Evaluation Report

Claire Tyers BSc, MSc Alice Sinclair BSc, MSc Daniel Lucy BSc, MSc Marc Cowling BA, MSc, PhD Vanessa Gordon­Dseagu BSc, MSc Institute for Employment Studies Mantell Building University of Sussex Campus Brighton BN1 9RF

Dr Jo Rick BA, PhD, CPsychol, AFBPsS Institute of Work Psychology University of Sheffield Sheffield S10 2TN

The Constructing Better Health pilot aimed to raise awareness of occupational health issues within the construction industry, as well as to test out a model of delivery so that learning points could be used in the design of any national scheme. The pilot was carried out in Leicestershire from October 2004 to June 2006.

This report investigates both the process and the impact of the pilot. It considers: 

■ the model of delivery and the reaction amongst employers and workers in the pilot area to the service; ■ levels of take­up of the service and the reactions to different elements of service provision; ■ intermediate outcomes such as awareness of occupational health issues and better health management

procedures; and ■ the ultimate outcome measures including levels of accidents and days lost due to ill­health.

This report and the work it describes were funded by the Health and Safety Executive (HSE). Its contents, including any opinions and/or conclusions expressed, are those of the authors alone and do not necessarily reflect HSE policy.

HSE Books

© Crown copyright 2007

First published 2007

All rights reserved. No part of this publication may bereproduced, stored in a retrieval system, or transmitted inany form or by any means (electronic, mechanical,photocopying, recording or otherwise) without the priorwritten permission of the copyright owner.

Applications for reproduction should be made in writing to:Licensing Division, Her Majesty’s Stationery Office,St Clements House, 2­16 Colegate, Norwich NR3 1BQor by e­mail to hmsolicensing@cabinet­office.x.gsi.gov.uk

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The Institute for Employment Studies

The Institute for Employment Studies is an independent, apolitical, international centre of research and consultancy in human resource issues. It works closely with employers in the manufacturing, service and public sectors, government departments, agencies, and professional and employee bodies. For over 35 years the Institute has been a focus of knowledge and practical experience in employment and training policy, the operation of labour markets and human resource planning and development. IES is a not-for-profit organisation which has over 60 multidisciplinary staff and international associates. IES expertise is available to all organisations through research, consultancy, publications and the Internet.

IES aims to help bring about sustainable improvements in employment policy and human resource management. IES achieves this by increasing the understanding and improving the practice of key decision makers in policy bodies and employing organisations.

Acknowledgements

This work has been guided by an advisory group at the Health and Safety Executive with specific remit for assisting the evaluation and by the broader steering group for Constructing Better Health (CBH) initiative. In particular, Monica Smith and Colleen Bowen have worked closely with the IES team in developing and implementing the evaluation, and Paul Edens, Eleanor Keech, James Noble, Alan Spence and Laura Smethurst have also provided support from within HSE. Additionally, we would like to acknowledge the contribution of staff within CBH, particularly Michelle Aldous and Dulcie Adams, to this evaluation, not least their willingness to reflect on progress to date and share insights gained from their practical experiences. Derek Smallwood and his team within Business Healthcare have also provided valuable information on the healthcheck side of the pilot.

We would also like to acknowledge the role played by a range of stakeholders in Leicestershire and further afield for helping us to understand the broader issues. Additionally, the crucial role of employers and their workers who spoke to the evaluation team needs to be acknowledged and we are very grateful to all those who gave up their time to help us. In addition to the report authors, a number of other IES staff have also had a key role in shaping the evaluation, including Nii Djan Tackey who assisted in collecting employer and worker views, and Gill Howd and Denise Hassany who provided valuable support in the production of this report.

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CONTENTS

EXECUTIVE SUMMARY vii

1. INTRODUCTION 1

1.1 Overview 11.2 Policy context 11.3 Remainder of the report 2

2. THE CONSTRUCTING BETTER HEALTH SERVICE 3

2.1 Overview 32.2 Pilot Aims 32.3 Portfolio of CBH activities 32.4 Pilot targets and delivery design 92.5 Understanding the target users 102.6 Understanding Industry and policy interests 142.7 Summary 14

3. THE CBH EVALUATION 17

3.1 Evaluation design 173.2 Data sources 173.3 Summary 25

4. MARKETING 27

4.1 Introduction 274.2 Types of CBH activity 274.3 Marketing approaches used 274.4 Effectiveness of marketing approaches 304.5 Difficulties in reaching small employers 324.6 Reaching subcontractors on larger sites 344.7 Scale of marketing and sales activities required to ‘convert’ users 354.8 Awareness of the pilot 364.9 Summary 38

5. SERVICE TAKE-UP 39

5.1 Introduction 395.2 Employer patterns 395.3 Take-up by individuals 425.4 Understanding take-up 445.5 Understanding take-up of different service elements 515.6 Summary 54

6. HEALTH CHECK OUTCOMES 57

6.1 Type and scale of testing 576.2 Interpreting the results of the tests 586.3 Test results 596.4 Trends by age and trade 616.5 Referral to General Practitioners 636.6 Summary 64

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7. USER VIEWS ON CBH AND SELF ASSESSED OUTCOMES 65

7.1 User satisfaction 657.2 Self-assessed outcomes 687.3 Summary 78

8. IMPACT OF CBH SERVICES 81

8.1 Overview 818.2 Profile of service use: survey respondents vs. all users 838.3 Changes to core outcomes 838.4 Other data on outcomes 888.5 Service costs and progress against targets 1028.6 Summary 104

9. CONCLUSIONS 105

9.1 This evaluation 1059.2 Learning about the construction industry 1059.3 Messages about occupational health 1069.4 Operational lessons 1079.5 Future of the CBH brand 107

APPENDIX 1: RESPONSE RATES 109

APPENDIX 2: WEIGHTS USED IN ANALYSIS 110

APPENDIX 3: QUESTIONNAIRE USED IN WAVE TWO SURVEY 115

APPENDIX 4: DETAILS OF CASE STUDY PARTICIPANTS 142

APPENDIX 5: DETAILS OF REGRESSIONS USED IN IMPACTANALYSIS 143

APPENDIX 6: ADDITIONAL TABLES TO ACCOMPANY CHAPTER 8 221

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EXECUTIVE SUMMARY

INTRODUCTION

The Health and Safety Commission (HSC) is responsible for health and safety regulation in Great Britain. The Health and Safety Executive (HSE) and local government are the enforcing authorities who work in support of the Commission.

Construction is a key target because of high levels of work-related illness and workplace injuries and fatalities. There are also skills shortages projected for the future, meaning that effective management of ill-health within the industry is a very important, but also a challenging issue.

With the support of sector representatives, activities have been underway since 2000 to establish a comprehensive occupational health support scheme for the construction industry. In order to determine which elements would be most useful in any national initiatives, the HSC’s Construction Industry Advisory Committee (CONIAC) nominated an Action Forum of key industry players who set up a company (Constructing Better Health, or CBH) on a not-for-profit basis to manage a pilot of the same name. The CBH pilot offered a specifically designed occupational health intervention targeted at the construction industry in Leicestershire from October 2004 to June 2006. It was an attempt for policymakers to work closely with the construction industry and the success of the initiative will be judged differently from these two perspectives.

PILOT AIM

The main aim of the CBH pilot was to raise awareness of occupational health issues within the construction industry as well as to test out a model of delivery so that learning points could be used in the design of any national scheme.

In addition, secondary aims were: to help tackle cases of ill-health identified amongst workers, to help employers improve systems dealing with health to promote good risk assessments processes that address health issues and, ultimately, to reduce the incidence of ill-health and associated absence within the pilot area.

PILOT SERVICES

The CBH pilot was jointly run by two specialist providers. Anyone working in the construction industry within Leicestershire was eligible for their support. The actual services on offer were:

■ site visits where occupational health issues were discussed and employer needs determined either for other aspects of the CBH service or for referral onto other providers

■ risk assessments conducted by qualified staff on construction sites

■ document reviews to ensure that employers are operating the most effective health and safety management systems and policies to counter any employee health risks

■ the provision of training in the form of ‘toolbox talks’ designed specifically by CBH staff to cover a range of occupational health issues and information for workers, and two- day management training interventions tailored to individual employer needs

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■ the use of a mobile health testing unit staffed by a qualified occupational health nurse or technician to deliver health surveillance and voluntary health checks

■ case management by trained occupational health professionals for those on sick leave, or identified as in need of support through health testing.

EVALUATION DESIGN

The evaluation was designed to investigate both the process and the impact of the pilot. It therefore considered:

■ the model of delivery and the reaction amongst employers and workers in the pilot area to the service

■ levels of take-up of the service and the reactions to different elements of service provision

■ intermediate outcomes such as awareness of occupational health issues and better health management procedures

■ the ultimate outcome measures including levels of accidents and days lost due to ill-health.

MARKETING

■ As a new initiative working with a hard-to-reach sector, CBH tested a range of marketing and promotional activities. By the end of the pilot, 40 per cent of employers in the pilot area had heard about the service. Getting the messages and approach right has taken time, but there are a number of learning points that have emerged. These included:

■ the need for continued and repeated contacts with employers to generate interest in the pilot, particularly in the first year of operation

■ the difficulties inherent in reaching the smallest contractors, although those who sub-contract to larger companies can be reached via these main contractors

■ the time required to use larger employers as a means of cascading messages and, within each employer, to get to the point of actual service delivery were both significant

■ the proven effectiveness of telemarketing in reaching employers with more than five employees

■ the lack of interest in web-based resources or a telephone helpline. Employers in this sector respond better to proactive approaches by service providers and face-to-face contact.

SERVICE TAKE-UP

After 21 months of operation, the pilot had provided services to 367 different employers. The most popular services were:

■ initial briefings and set-up meetings, with most employers preferring to meet a member of CBH staff prior to setting up actual service delivery on site

■ site visits where occupational health issues were discussed in depth (often following a full site walk round) as well as the other types of services on offer

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■ voluntary health checks, 1,724 of which were provided to workers/employees

■ toolbox talks which were attended by 2,599 individuals.

Take-up of services amongst workers was very high, despite management concerns that worker engagement with the pilot and/or health issues would be low. There was no take-up of case management or health surveillance and only limited take-up of document reviews and risk assessments.

Management were, therefore, happy to offer services targeted at their workers and/or subcontractors. They were less interested in services which targeted managerial and organisational health and safety management directly. This seems driven by a lack of awareness and familiarity with occupational health issues, as well as some fears about opening up to an outside party with regard to any health and safety deficiencies. There was also a lack of interest in ‘doing better’ in relation to occupational health generally, as most employers felt that they were already legally compliant and that this was enough.

Employers tended to opt for the cheap and easy option of voluntary health checks rather than take on a long term and potentially expensive commitment to health surveillance. There were concerns that workers would react badly to being compelled to submit to testing as well as little appreciation of the potential benefits of health surveillance. Some employers having ‘dipped their toe in the water’ with voluntary health checks, however, showed signs that they have, or may become interested in surveillance in the future.

Given the poor performance of construction in terms of worker health, it was initially surprising that there was little interest in case management. However, the complex sub-contractual chains and high level of casual work within the industry means that very often employers do not have to ‘foot the bill’ for sickness absence. The problem can be an invisible one at employer level. In addition, in larger companies with permanent staff, the problems may be difficult for line or site management to understand, as central HR will deal with any sickness absence problems.

HEALTH CHECK RESULTS

■ Approximately one-third of those participating were found to have some form of occupational heath issues, predominantly caused by noise exposure, with some vibration issues. Also, one-third of those participating were found to have general health issues, predominantly related to blood pressure, respiratory and blood, protein and/or sugar in urine. Individuals may have experienced either type of problem or both.

As a result of these abnormal tests, one-third of individuals receiving health checks were referred to their GP following their health check. There were no examples where safety critical workers recorded medical results which failed to meet the acceptable fitness criteria.

REACTIONS TO THE SERVICE

Levels of satisfaction with the pilot were high. The main attractions were that the service was free and convenient, and that it tapped into management and worker interest in their own and their colleagues’ health. Management often stated that CBH helped to reinforce messages that they had already tried to promote to workers or had wanted to raise for some time. Other benefits included greater communication between managers and workers about health and safety as well as other issues. Management felt that offering their workers health-related services helped promote their image as a ‘good’ employer. Overall, therefore, the service was felt by users to be both well designed and fit for purpose.

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SERVICE IMPACT

■ There were five health and safety practice measures (out of 11) against which, using two wave survey data with a matched control group, CBH users demonstrated better performance than non-users and/or the control group. They were significantly more likely to:

■ have a health and safety policy at both time points

■ keep records of health and safety activities at both time points

■ have offered training in the last six or 12 months at both time points (although this is likely to reflect that one-third of CBH users had received training from the pilot)

■ increase the time taken to inform subcontractors by the second survey.

■ There were another two measures (the use of occupational health professionals, and the presence of return-to-work arrangements) where the proportion of CBH users with things in place had decreased between survey waves. Overall, therefore, the use of CBH appears to have helped employers to maintain good practice over time in relation to some but not all indicators of good health and safety management measured by the evaluation. It has also helped communication with subcontractors. There is little quantitative evidence that CBH users have introduced new areas of good practice, however.

Data on ill-health, absence and accident rates was less clear, and CBH users actually reported higher incidence of accidents and absence (in relation to six out of nine outcome measures). CBH users were statistically more likely to report having experienced accidents and absence, and also reported a higher frequency of non-serious injuries. This could be the result of actual higher levels of absence, with CBH users self-selecting into the service to actively deal with this issue. However, it could equally demonstrate that CBH users have better recording procedures, so are better able to monitor and understand accidents and ill-health on site. Given the latency of health outcomes, it is not surprising that there is little quantitative evidence of any CBH impact on these. It will take longer than the period of this evaluation for any hard health outcomes to emerge.

The evidence from the case studies suggests that, in the main, changes on site tended not to reflect changes at managerial level and/or the introduction of new high level risk controls. The changes were, therefore, mostly related to:

■ a greater awareness of health issues and risks amongst employers and individuals, giving individuals better information on which to base their behaviours

■ improved individual health behaviours, including contact with GPs and the implementation of healthy lifestyle changes

■ the use of personal protective equipment (PPE), stimulated by a greater understanding of why this is important.

CONCLUSIONS

■ CBH has been ‘myth busting’ regarding the attitudes of workers towards occupational health issues. Individuals within the sector are interested in their own health and taking steps to protect it, despite what employers might think. The main barriers to change are not at worker level, but actually at managerial level. Managers are the ones who do not want to scrutinise their work practices, and who are unwilling to accept the need for

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organisational-level change. Consultation with both workers and management about the best way forward should therefore be a part of any future initiatives.

■ The view from within the construction sector about its occupational health performance and problems contrasts sharply with the broader view from outside it. Construction employers neither do, nor know, everything that they need to to protect the health of their workers and ultimately their businesses, despite this being the prevailing view of management. Ways of breaking down management resistance, using messages about business and wider benefits, needs to be a priority for moving forward.

■ There is, however, evidence of a deeply embedded reluctance amongst employers to accept that anything could help them improve. Despite this, CBH can demonstrate impacts with many of the employers they worked with. These tend to reflect changes to attitudes and lower level risk management behaviours so far (e.g. the use of PPE or the use of health and safety policies). CBH does appear also to have influenced the way in which employers communicate with subcontractors, and what they expect of subcontractors regarding health issues. There could, therefore, be further impacts in the longer term. Detecting changes to ill-health and absence indicators has not been possible at this stage, but as health outcomes take time to emerge this is as would be expected.

■ Reaching the smallest independent employers and individuals experiencing ill-health will need a different approach to that piloted here. CBH found it hard to engage with micro-businesses, although some were reached on larger sites where they were working as subcontractors. There was also no commitment to case management amongst employers, and offering services on site will only pick up individuals who are healthy enough to be at work. Direct routes to individuals also therefore need to be found.

■ CBH has perhaps been most successful in reference to its primary aim, that of raising awareness of occupational health amongst the industry at a national level. The brand now has the support of a range of industry representatives, and there is greater evidence of a growing momentum in some parts of the sector than there was at the start of the pilot. Elements of a national scheme, which build on the learning points of the pilot are currently being developed.

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1. INTRODUCTION

1.1 OVERVIEW

The Health and Safety Commission (HSC) is responsible for health and safety regulation in Great Britain. The Health and Safety Executive (HSE) and local government are the enforcing authorities who work in support of the Commission. Their mission is to ensure that risks to people’s health and safety from work activities are properly controlled. Construction is a key target for the HSE, due to the particularly high levels of work-related illness and workplace injury experienced by those in the sector. The Constructing Better Health (CBH) pilot was designed to test a model of occupational health support for the construction industry. The evaluation was designed to determine whether demonstrable benefits in terms of changes to health behaviours and, therefore, outcomes could be measured.

The CBH pilot was an occupational health programme designed specifically to meet the needs of employers and workers in the construction industry. It involved the HSE and industry representatives working in partnership to design and manage the initiative as well as act upon the results. The pilot began operation in October 2004 and provided services until June 2006. Since June 2006, further funding has been secured which has been used to support a development and scoping phase for some form of national service. The exact nature of this service is yet to be fully determined but it seems likely that the CBH initiative will continue to provide support to the construction industry in some form in at least the short to medium term.

This report provides an overview of the progress of the pilot to the end of June 2006, and draws together data from a number of sources. This is the final report of the evaluation of this initiative and builds on two previous reports: a baseline report from the first wave of the employer survey1, and an unpublished report to HSE on progress by the CBH pilot to the end of 2005.

1.2 POLICY CONTEXT

The impetus for setting CBH in place began four years before the initiative started operation, in October 2000. The Tackling Health Risks in Construction Conference brought together representatives from across the construction industry, including employers, clients and trade unions. At this conference, all parties indicated a willingness to co-operate in establishing a comprehensive occupational health support scheme. The decision was taken to undertake a pilot scheme to determine what elements would be useful nationally. The HSC’s Construction Industry Advisory Committee (CONIAC) set up a company on a not-for-profit basis (Constructing Better Health) to manage this pilot. The board included representatives from both employer and worker organisations.

Also in 2000, Securing Health Together: A Long-Term Occupational Health Strategy for England, Scotland and Wales2 was launched. One of the five strands of the Securing Health Together strategy was to consider how occupational health support could be improved. The Support Programme Action Group produced a report that outlined a model for how Occupational Health and Safety Support could be delivered for Great Britain3.

1 Tyers C and Sinclair A (2005) Constructing Better Health, Report of the baseline employer survey, HSE Research Report 381.

2 Securing Health Together (HSC, 2000). 3 A Vision for Health, Safety and Rehabilitation Support in Work for GB, (www.ohstrategy.net, October 2003).

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In October 2003, the HSC considered the options for progressing wider access to occupational health and safety support. The Commission agreed that the vision was for a comprehensive service with national coverage and the HSE was asked to develop plans further. More recently, the HSC’s Strategy for Workplace Health and Safety to 2010 and Beyond, published in February 2004, recognised that tackling occupational health and safety in the workplace needed a strategic and partnership-based approach to deliver the level of improvements required. This is being delivered through a number of projects, which prioritise working with partners in a voluntary way to improve access to occupational health support, especially for small firms. CBH is one of these projects.

In May 2003, NHS Scotland launched Safe and Healthy Working, a service similar to the proposed CBH pilot model. HSE is also funding a further pilot which tests different aspects of the model in partnership with Kirklees Metropolitan Council. More recently, February 2006 saw the launch of the Workplace Health Connect pathfinders. This service has been operating in five pilot areas with a nationally available telephone helpline. The service provides occupational health support through workplace visits and referrals to specialist providers, and is targeted at small and medium-sized employers across all sectors. CBH is well placed to offer insights into targeting smaller employers about the kind of messages that employers connect with, and more specifically the kind of measures that are necessary to engage with hard-to-reach sectors such as construction.

1.3 REMAINDER OF THE REPORT

The remainder of the report focuses on the activities of the CBH pilot in more detail and is organised into the following chapters:

■ Chapter 2 provides detail on the CBH pilot, its aims and targets, as well as the range of services on offer and details of the target users and characteristics of the construction industry.

■ Chapter 3 provides a detailed overview of the evaluation aims, outcome measures and data collected to inform the evaluation.

■ Chapter 4 considers the marketing approaches used by the pilot and their relative effectiveness.

■ Chapter 5 looks at service take-up and employer and provider perspectives on the factors affecting take-up.

■ Chapter 6 specifically examines the health check results.

■ Chapter 7 describes user reactions to the service and looks at user views on changes they have made as a result of their involvement with CBH.

■ Chapter 8 considers the impact of the service using statistical analysis of the survey results, and presents descriptive data on a range of outcome measures.

■ Chapter 9 sets out the main conclusions from the evaluation, reflecting on the work of the CBH pilot initiative and highlighting learning points for the future.

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2. THE CONSTRUCTING BETTER HEALTH SERVICE

2.1 OVERVIEW

The broad aim of the CBH pilot was to provide a framework of support for construction employers, workers and sole traders to use best practice occupational health management activities to improve the control and management of occupational health risks and so improve, preserve and protect the health of those working in construction. The CBH pilot was one of a number of evaluation-led programmes which introduced a framework for occupational health support. Anyone working in the construction industry within the Leicestershire area was eligible to take up the services of CBH.

The CBH pilot had a challenging set of objectives specifically tailored to the characteristics of the construction sector. There were a number of issues that would need to be addressed in the design and operation of this type of service from the outset. However, the free and flexible nature of the service was developed to overcome these barriers as far as possible and make the provision attractive to construction workers and employers alike. Despite this, the pilot has faced a number of challenges. In this chapter, we examine in further detail the services that the pilot offered and provide some background about the target industry for the initiative.

2.2 PILOT AIMS

The CBH pilot was established to provide occupational health support, primarily to small and medium-sized employers within construction and, through them, to the construction workforce in Leicestershire. An overriding aim for the project was to raise awareness of occupational health issues within the construction industry as well as to test out a model of delivery for a possible industry-wide scheme.

A number of associated secondary aims were also set for the pilot. These aims included:

■ increasing awareness of occupational health issues and of the pilot

■ taking action to reduce incidences of work-related ill-health with workers who have been involved in the pilot

■ getting systems in place to continually improve health procedures, including sickness absence, amongst construction employers using the services

■ ensuring that risk assessments and control measures address health issues amongst construction employers in partnership with their workers

■ a reduction in the incidence of ill-health within the pilot area and also in the number of workers taking sick leave.

2.3 PORTFOLIO OF CBH ACTIVITIES

The pilot was designed to offer a range of OH services, from initial procedural assessments to full health checks. Take-up of CBH was voluntary, so employers were free to choose from a suite of services on offer. CBH offered a number of different occupational health and safety interventions, some of which proved more popular than others in practice.

2.3.1 Phone line and website

The CBH web site and telephone response line were set up to react to queries and deal with interest generated by marketing activities and the other publicity that CBH received. In addition to the CBH

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website a companion website, using the ‘Fit Builder’ identity, was set up to offer a more accessible, less formal route in to the services.

2.3.2 Initial visits

For most employer contacts, initial contact with the CBH service took the form of an initial visit from CBH staff. This visit was mainly diagnostic in nature, determining the service elements that employers were most interested in and discussing their occupational health needs. The relevant service elements were then taken forward. A significant number of these initial visits took place in offices rather than on-site, at the request of the employer. Some SMEs were difficult to engage, even having reached this stage of contact with CBH.

2.3.3 Site visits/risk assessments

Employers were also offered an on-site visit which included either a walk around the working area by a member of CBH staff to identify any potential occupational health issues that the site could manage more effectively, or a full risk assessment relating to both health and safety issues. The risk assessment approach was based on the HSE generic approach with specialist elements as appropriate (eg Control of Substances Hazardous to Health regulations).

2.3.4 Document reviews

Document reviews were offered to all employers. The service involved employers sharing their health and safety procedures and policies which CBH staff would review. Staff used a template for reviewing these policies which encouraged them to think through the issues according to seven key areas: occupational health and safety management, vibration, musculoskeletal disorders, respiratory issues, stress, dermatitis and noise. The focus was fundamentally and primarily on occupational health issues, although some safety critical issues would also be picked up (eg developing a ‘working at height policy’ for a scaffolding company). All participating employers were provided with a report prioritising the actions required to improve policy.

In relation to each of the priority health topics, reviews covered a range of issues including:

■ organisational control (eg whether or not there was clear allocation of responsibilities)

■ organisational competence (eg whether or not those involved in conducting risk assessments have been adequately trained)

■ organisational communication (eg whether or not arrangements are in place for providing and updating information to site managers and workers)

■ organisational co-operation (eg whether or not health issues are given an appropriate degree of priority)

■ planning and implementation (eg whether or not there are performance standards set to cover risk assessments, workplace control measures, etc.)

■ active monitoring and measurement (eg whether or not monitoring is seen as a line management function)

■ auditing system and review processes (eg whether or not occupational health issues are reviewed alongside other management systems).

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2.3.5 Training

Training was offered to companies at two levels: training for workers and subcontractors who were offered a short training session delivered on-site (toolbox talks), and bespoke training for more senior staff at site management level.

Toolbox talks

These sessions involved a short training talk delivered by CBH staff. Typically the event took between 15 minutes and 45 minutes, depending on the time employers were able to set aside for staff to attend. Typically both subcontractors and workers would attend, and would be encouraged to do so by management. The content of talks was standardised to a CBH designed template. This template included items such as the following:

■ coverage of eight occupational health issues (ie respiration, noise, manual handling, skin, vibration, lead, asbestos, legionella and infections)

■ an overview of each health issue, including when they might be at risk, why they should worry, potential warning signs of problems and what they could do to avoid problems

■ photos of health conditions and preventative measures as well as commentary by CBH staff to help workers identify problems and understand the potential seriousness of these problems if left unchecked

■ an overview of what was included in health checks, to encourage participation.

Management training

This provided specifically designed training programmes. An example two-day course included:

■ a brief overview of legal requirements

■ knowing when and how to report accidents

■ how to investigate accidents and incidents

■ ways of managing health and safety more effectively through risk assessments.

2.3.6 Health checks, surveillance and case management

The CBH pilot also offered free health checks, health surveillance and case management, through the services of an Occupational Health Nurse, an Occupational Health Technician and an Occupational Physician. The health checks took place in a mobile testing unit. The definitions of these services are provided below.

Health surveillance

■ Health surveillance is the statutory, periodic monitoring of an employee’s health which may include administration of a questionnaire, examination or tests of physiological function. It is required as part of the 1992 Managing Health and Safety at Work regulations (MHSW regs) and the 1999 Control of Substances Hazardous to Health regulations (COSHH). The health surveillance service is targeted at those who manage health risks at work and is about putting in place systematic, regular and appropriate procedures to detect early signs of work related ill-health amongst employees exposed to certain health risks. It is seen by the HSE as being integral to the good overall management of health risks within a broader strategy.

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■ The level of health surveillance required depends on the nature of the risk to which individual employees are exposed in the course of their job. The HSE offers the following definition of levels of specific technique:

■ a ‘responsible person’ looking for a clear reaction when someone is working with something that could harm their health (eg checking for skin damage on hands where solvents are being used)

■ a ‘qualified person’ asking, inspecting or examining employees about signs of ill-health (eg an OH nurse carrying out a lung function test where workers regularly use certain paints)

■ medical surveillance by a doctor (eg looking for a reaction to exposure to some chemicals)

■ biological and biological effect monitoring (eg to monitor the effects of exposure to substances such as lead or other chemicals by testing blood, urine or breath samples)

■ keeping individual health records.

■ Health surveillance represents the processes an organisation is required to put in place based on the specific risks its employees encounter in their jobs. The results of health surveillance, therefore, can carry implications for the way an employer manages health and safety.

■ Within the construction industry, health surveillance can often be an appropriate response to the nature of the risks inherent in many jobs on site. Health surveillance is required when employers answer ‘yes’ to all the following questions1:

■ is the work known to damage health in some particular way?

■ are there valid ways to detect the disease or condition?

■ is it reasonably likely that damage to health may occur under the particular conditions at work?

■ is surveillance likely to benefit the employees?

■ We can work through an example pertinent to the construction industry. High noise levels are known to cause hearing loss. A valid technique – hearing tests – can detect the effect of noise on the hearing of individuals who work in noisy conditions. Hearing tests will benefit employees by identifying those at risk so that measures can be taken to protect them and improve working conditions. However, whatever techniques are used, or health issues identified, conducting health tests alone does not constitute good health management. Health surveillance has to be carried out systematically and regularly, and the results have to be acted upon. There is therefore a distinct difference between health surveillance and the use of health checks (described below). Health checks, for example, do not form part of the legal requirements to manage occupational health.

■ In addition, and of particular relevance to construction, people working under the control of employers who are treated as self-employed for tax and National Insurance purposes may be treated as employees for health and safety purposes. Legal duties for such individuals under the Health and Safety at Work Act cannot be passed over by contract.

Health checks

■ The health checks offered as part of the services were a composite voluntary medical assessment designed specifically for the CBH pilot, combining elements of general health

See HSE Books title ‘Health surveillance at work’, Reference HSG61.

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screening and statutory health surveillance. General health screening is non-statutory, periodic monitoring of an employee’s health and may include administration of a general health questionnaire and measurements of height, weight, body mass index, blood pressure and testing urine (urinalysis). It can help to identify lifestyle factors in time to prevent the onset of disease, so encouraging good health and reducing ill-health absence. The main differences between general health screening and the CBH health checks are that the health checks involved a standard battery of tests, regardless of specific risk factors, attendance is voluntary and the results confidential to the employee.

■ The tests included in the health checks are detailed at section 2.4.7.

Case management

■ This describes the ongoing support offered to those individuals who exhibited symptoms, recorded abnormal results in health checks, or were already absent from work with an illness. For work related cases, the occupational health provider could offer this support, dependent on the nature of the medical issue. Individuals could be counselled on the correct use of Personal Protective Equipment (PPE) for some issues, but additional follow-up might be necessary for others (eg vibration or respiratory sensitisation). For non-work related issues the follow-up route was through the individual’s General Practitioner (GP). In the case of other issues (eg bad backs) it might be appropriate to refer the individual onto a third party. The aim of the case management strand of the service was to help employers manage any identified problems effectively.

Fitness to work tests

These tests are used with those identified as safety critical workers (eg crane divers, fork lift truck drivers) using DVLA Group 2 driving standards as fitness indicators. In such cases, workers were made aware that in the case of abnormal results, employers would need to be notified.

2.3.7 Details of health checks conducted

A number of medical tests were offered as part of the voluntary health check designed to specifically target the main health issues facing the industry. In addition, a number of general health checks were included. The tests used are explained in this section. Individuals who were identified as having an occupational health issue were counselled by the Occupational Health Nurse/Technician and then referred onto an Occupational Physician if appropriate. For general health issues individuals were referred directly to their own GP.

Hearing tests

To test for noise-induced hearing loss, hearing tests were carried out in a sound-attenuating booth using an audiometer. Hearing test results were categorised in accordance with HSE’s guidance such that Category 5 is considered to be normal and Categories 2 to 4 are considered abnormal with follow-up by a medical practitioner required. Category 1 is also abnormal but requires access to previous tests in order to measure deterioration. The categories listed here were correct at the time of the pilot, but have now been changed.

Hand-Arm Vibration

The damage caused by exposure to hand-arm transmitted vibration (or HAVS) was assessed using a vibration questionnaire (in line with HSE guidance – HS (G) 88). This questionnaire was only used for those individuals who, when asked, declared symptoms generally associated with the effects of hand-arm vibration syndrome (HAVS), (ie numbness, tingling and whiteness). It should

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be noted that the response from the questionnaire does rely on individuals providing honest responses to a set of questions. There could be some unreliability in results if individuals wish to hide their symptoms for any reason (eg for fear of being found unsuitable to work with vibrating tools). The test is therefore not an objective health test in the same way as the hearing and respiratory tests are, for example.

Respiratory ill-health including sensitisation

The respiratory tests were used to identify any impairment in an individual’s lung capacity. The test was carried out using a Vitalograph. The parameters measured were the Forced Vital Capacity (FVC) and Forced Expiratory Volume 1 second (FEV1). These were compared against predicted values (based on age and height).

Abnormal results were defined as FVC or FEV1 below 80 per cent of predicted values, or where the FEV1/FVD ratio is below 70 per cent. Impairment in lung capacity can be caused by exposure to hazards in the workplace but can also be caused by non-work related conditions, including the effects of smoking.

Dermatitis

The skin assessments were carried out by means of a physical examination where symptoms existed and/or where concerns were raised by individuals. Individuals were counselled, advised and, as necessary, referred for further investigation.

Musculoskeletal ill-health

Data on musculoskeletal disorders (MSDs) was collected only when individuals, when asked, declared symptoms. No formal tests are available to measure the presence of an associated condition, the reporting of which is entirely subjective. Individuals were seen in working time with no adverse effects on job function. All conditions reported could be as a result of work or other activities (eg gardening, DIY).

Vision screening

This test was carried out with a portable vision screening device (Keystone). As there are no specific vision standards for the construction industry, tests were conducted with reference to the standards laid down by the DVLA (Group 2 entitlement, ie HGV/PSV standard) and HSE (HSG6). These are higher standards than those applied to driving cars or light vans. Where an employee’s vision screening result did not reach the appropriate standard he/she was referred to an optician for a detailed eye examination.

Height and weight

This was calculated using the Body Mass Index (BMI) which is the relationship between an individual’s weight (in kilos) and their height (in metres). Abnormal results for BMI were defined where the individual’s BMI is either 30+ or <19.

Blood pressure

The blood pressure assessment was carried out using a sphygmomanometer. Abnormal results for blood pressure were defined where the systolic and diastolic results were greater than 150 or greater than 95 respectively.

Urinalysis

A simple urine test was used to identify the presence of sugar, protein and/or blood in the urine sample as an indicator of a medical condition such as diabetes.

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Smoking

Individuals were asked about their smoking habits and categorised into whether they were current smokers, non-smokers, or ex-smokers (there were some who did not disclose their smoking habits, however).

General versus occupational ill-health

The focus of the CBH pilot was always on occupational health. However, the list of tests provided includes both general and occupational health issues. There are a number of reasons for this. Firstly, general health issues are particularly relevant for an industry such as the construction industry where there are skills shortages and a need to keep skilled operatives at work. Employers are, therefore, unlikely to draw a clear distinction between work-related and other health problems. A primary concern for them is ensuring that they have enough workers to complete their jobs regardless of the nature of their ill-health problem. Secondly, in making the service attractive to workers, offering general health tests was felt to be important. The tests reflect individuals’ concerns about their general health as well as allowing occupational health issues to be raised and tested for. Finally, some jobs in construction (eg crane operation) can be safety critical precisely because of failures in general health. Suffering a heart attack, for example, whilst operating machinery could cause fatalities. Therefore detecting indicators such as high blood pressure are important in an occupational sense, as well as providing information on general health.

Despite this, it is important to have a clear distinction between ill-health which is caused or made worse by work and general health issues which may or may not be work-related. An employer’s responsibility to their staff extends to managing risk and ensuring that staff are fit for work. Basically an employer needs to minimise the extent to which individual workers are put at risk as a result of their work. General health issues are slightly different. If an employer is aware of a general health condition which affects the individual’s ability to work safely, then there is a responsibility to protect the safety of all workers from any potential harm that may result. However, an employer is not expected to manage an employee’s lifestyle or out-of-work activities. This distinction is important when the results of the pilot are discussed in later sections.

2.4 PILOT TARGETS AND DELIVERY DESIGN

In addition to the broad aims to raise awareness of occupational health issues within construction through the application of the services listed, there were a number of numerical targets which the pilot set itself. It was anticipated that these would act as a guide to the scale of activities that could be achieved within the 24 month period of operation, beginning October 2004. However the pilot only actually ran for 21 months, with service delivery ceasing at the end of June 2006. Therefore, whilst it is useful to present the original targets, we also present targets which have been factored down to account for the three month reduction in service delivery.

The CBH pilot had targets to:

■ provide some form of occupational health advice to the 1,360 firms it was anticipated would come forward to take up the service, an estimated 50 per cent of construction employers in the area. This target was based in particular on the assumption that employers would use the free helpline (21 month target: 1,190)

■ provide more in-depth services to 680 firms, an estimated 25 per cent of employers in the area, based on reaching 25 per cent of construction employers in the area (21 month target: 595)

■ reach 5,750 construction workers and workers through visits, health testing, training etc., based on reaching 25 per cent of all workers (21 month target: 5,031)

■ delivering 1,250 health checks to workers (21 month target: 1,094).

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It would be remiss of this evaluation, however, not to set these targets in some form of context. When the pilot was established, the contracted provider determined what they considered to be challenging, but achievable, targets, given their work in other sectors, and based on estimates of the population of construction employers operating in Leicestershire. The assumptions inherent in the setting of the targets did not hold true.

Employers within the construction sector were far more difficult to work with than had been the case in other sectors, requiring greater numbers of approaches by CBH staff to each employer than had been projected. Also, the helpline service was not well used, and neither was the website, therefore the capacity to reach large numbers of employers quickly and cheaply was reduced. It soon became apparent to the steering group and project board, as well as to CBH staff, therefore, that the original targets were going to be unachievable within the timeframe and resources set aside for the pilot. No formal adjustments were made to these targets, but an informal agreement was made that the ‘success’ of the service would not be judged on performance against these alone. The work of the pilot was recognised as challenging and new, and therefore the relevance of setting such tightly defined numerical targets at the outset was questioned. This should be considered when evaluating the progress of the CBH pilot set out in later chapters.

The CBH pilot was jointly run, as a consortium, by two specialist providers. Sypol provided all training, site visits, risk assessments and document review activities, as well as taking responsibility for service marketing and administration. RPS Business Healthcare provided the staff and resources to conduct the health surveillance, health check and case management.

2.5 UNDERSTANDING THE TARGET USERS

CBH was a new and untested service offered to a hard-to-reach industry. However, the underlying messages of CBH about improving health and safety for workers, taking your own occupational health seriously and involving occupational health professionals as advisers, for example, could be taken to any sector. The ways in which the pilot needed to work in order to communicate these messages in construction, and the reasons why a specific pilot for the industry was commissioned, were driven by a number of defining characteristics. In this section we discuss some of the main characteristics of the construction industry which were considered in the design and running of the pilot, and which may have contributed to both the take-up and impacts of the pilot discussed in this report.

2.5.1 Improving but relatively poor performance on health

The construction industry is a priority sector for the HSE. Construction has one of the highest rates of work injuries (an average of 1,790 reportable non-fatal injuries estimated to occur per 100,000 people working in the sector over the period 2003/04 to 2005/06). Whilst there is reliable data available on fatal injuries (there were 71 in 2004/05), non-fatal Reporting of Injuries, Diseases and Dangerous Occurrences Regulations (RIDDOR) reports are subject to significant under-reporting, which currently runs at around 70 per cent for all construction workers (ie only around 30 per cent are reported)1. Reporting levels are particularly low amongst the self-employed (at only around five per cent). The industry also has one of the higher rates of work-related illness (reported at 3,800 per 100,000 people working in the last 12 months)2. It is worth noting that both of these estimates are, however, slightly down on the comparable figures published using 2004/05 data.

1 HSE’s Construction Intelligence Report see http://www.hse.gov.uk/construction/pdf/conintrep0405.pdf. 2 Health and Safety Statistics 2005/06, Health and Safety Commission and Office for National Statistics.

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Recent estimates suggest that the industry continues to pay a high price for these statistics, with 2.9 million working days lost to illness in 2003/04 and a further 1.0 million lost to workplace injury, although whether it bears the full brunt of these costs in terms of paying individuals who are off sick is open to question (see the remainder of this section for details on subcontracting and casual workforce issues which relate to the ‘invisibility’ of absence issues within the industry)1. The main causes of ill-health in the industry have been, and remain, musculoskeletal disorders, asbestosis, mesothelioma, dermatitis and hand-arm vibration, all of which can be prevented with the use of appropriate occupational health controls.

Despite these headline figures, the construction industry itself has made huge progress in tackling the issue of worker safety since the introduction of the Health and Safety at Work Act in 1974 and more recent legislation, such as the Management of Health and Safety at Work Regulations 1992 (MHSW Regs) and the Control of Substances Hazardous to Health Regulations 1999 (COSHH). Until recently, the focus of this activity had mainly been on preventing accidents and improving worker safety, however, the agenda has now moved on to consider occupational health issues such as dermatitis or hand-arm vibration, and it is these which present the greatest business challenges. In an industry with a range of projected skills shortages (discussed in more detail later in this chapter) keeping experienced operatives at work is vital, as is taking steps to ensure that they do not have artificially shortened working lives because of avoidable health problems.

Construction has the second highest proportion of skill shortage vacancies (out of 27 industries) as a proportion of total vacancies (38 per cent against a national average of 20 per cent). The evidence suggests that the number of traditional entrants to the industry (ie males aged 16 to 19) is falling, with a shortfall of recruits into formal training schemes of 17,000 a year. Workforce practices are also changing, increasing the level of skills required from workers2, and contributing to chronic skills shortages. Therefore, ensuring that as few people as possible leave the sector due to ill-health is paramount, as is the need to improve the image of the sector to encourage greater numbers of new recruits to join.

2.5.2 Subcontractual relationships within the construction industry

The construction industry has led the way in the adoption of ‘flexible’ labour practices both in the UK and more widely3. The outsourcing of labour through subcontractors and other intermediaries now means that construction work is increasingly temporary and that employment is dominated by small employers and the self-employed. Construction work is mostly done on a project-by-project basis, whereby contractors assemble teams of people who often work together for a short period of time and then move on to another location, or disperse. At the same time, much of the work is managed by a main contractor who subcontracts parts of it to smaller firms who specialise in a particular aspect of the process. To cope with the fluctuating workload, and in order to reduce overheads, much of the workforce at the site level is hired on a self-employed or casual basis. The result is an extremely complex array of subcontractual arrangements.

This fragmentation is quite clearly present amongst the employers involved in our survey. According to the 2004/05 data (ie wave one of the survey), just five per cent of employers had more than 50 staff on their payroll (Figure 2.1). In addition, 20 per cent of firms mainly work as

1 Jones FJ, Huxtable CS, Hodgson, JT (2005), Self-Reported Work-Related Illness in 2003/4: Results from the Labour Force Survey, Office for National Statistics and the Health and Safety Executive.

2 All figures taken from EOC (2004), Plugging Britain’s skills gaps: Challenging gender segregation in training and work, EOC.

3 International Labour Organization (2001), The construction industry in the 21st century: Its image, employment prospects and skill requirements, Tripartite Meeting on the Construction Industry, International Labour Office, Geneva.

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subcontractors. However, one-third of all firms subcontract work to others, and almost half work as subcontractors at least some of the time (see Figure 2.2 for more details). Research by UMIST suggests that only ten to 20 per cent of the 700,000 self-employed quoted in official figures (out of a total workforce in excess of two million) actually work on their own1, with the rest working with others, but in sub-contractor relationships. There is also an issue regarding how self employment is defined within the industry. Many individuals who declare themselves to be self-employed, do so for tax purposes only, primarily working for one employer throughout most of their working year.

Figure 2.1 Company size of employers surveyed

0

5

10

15

20

25

30

35

40

45

50

Sole trader 1 to 4 5 to 9 10 to 49 50 or more

Number of employees

% o

f sa

mpl

e

Base = 2,011

Source: IES/IPSOS-MORI Survey of Construction Employers 2004/05

Figure 2.2 Subcontractual arrangements within Leicestershire (in per cent)

0

10

20

30

40

50

60

70

80

90

Work independently Get sub-contracted by otherfirms

Sub-contract work to others Don’t know

% o

f fi

rms

How mainly work Ways in which work (at least some of the time)

As this was a multiple response question, the percentages shown sum to greater than 100.

Base: all employers (N = 2,011)

Source: IES/IPSOS-MORI Survey of Construction Employers 2004/05

Cited in HSE’s Construction Intelligence Report, op. cit.

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Size is, perhaps unsurprisingly, a strong predictor of the ‘normal’ working arrangements for construction firms. Larger firms are most likely to engage in some subcontractual arrangements, whilst smaller firms are more likely to work as subcontractors. However, 15 per cent of sole traders used subcontracting arrangements rather than take on permanent or temporary staff. In a survey of construction workers published in 2003, 41 per cent of those in the construction industry had been with their current employer for less than a year and 52 per cent had been working on their current contract for six weeks or less1, demonstrating the short-term nature of many working contracts within construction. This means that often individuals work together on jobs for only a relatively short period of time before moving on to other work. Health and safety cultures on sites, therefore, are likely to be subject to frequent change.

These factors had a number of implications for the CBH pilot in terms of:

■ how it needed to communicate with those working in the industry (supply chains are complex, but also a possible way of cascading messages)

■ where the ultimate responsibility for health and safety decisions lay (often with overall site managers rather than individual contractors)

■ the ‘invisibility’ of some staff (ill-health can simply ‘slip through the cracks’ of these complex relationships as individuals are not paid unless they are actually at work, a point we will return to in later chapters).

2.5.3 The relation of size to health and safety management

Research from Australia has shown that the major factors influencing safety performance were company size, and management and employee commitment to OHS2. Stakeholders interviewed as part of the evaluation (see Chapter 3 for further details) suggested that smaller firms would, on average, be operating to much lower standards due to factors such as a lack of engagement with OH management approaches and less well developed recording systems, processes and paperwork, including risk assessments. This reiterates the necessity of reaching the very smallest of firms in cutting accident and injury rates.

In the baseline employer survey, a number of indicators of health and safety practice were examined. Across all of these, smaller employers were less likely to have procedures or resources in place for managing occupational health (Table 2.1). However, it should be noted that for some small employers, not having paperwork or paper-based systems in place is not necessarily an indication of a lack of good practice. If the employer has a small team of workers who all work exclusively for the company and who are fully briefed (eg on the outcomes of risk assessments), there may not be a need for that employer to write the messages down. In contrast, amongst larger employers, there is a need for effective paperwork to support a broader range of workers.

Despite the well documented skills shortages, a number of stakeholders felt that there was a general lack of commitment to training. This was particularly true amongst the small and micro employers in Leicestershire, despite widespread knowledge of these skills shortages. This can impact further up the supply chain on larger employers who subcontract with these smaller businesses. The evidence from our baseline survey was that size is a major predictor of whether workers have been offered some form of recent health and safety training: 58 per cent of employers with fewer than ten employees had offered training in the last year to their workers, compared with 87 per cent of

1 Figures cited in HSE’s Construction Intelligence Report, op. cit. 2 Lin A, Mill A (2001), Measuring the occupational health and safety performance of construction companies in

Australia, Facilities, Volume: 19 Issue: 3/4, pages 131-139.

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employers with 10 to 49 employees and 94 per cent of employers with 50 or more contracted employees (see Table 2.1).

Table 2.1 Indicators of health and safety practice by employer size (in per cent)

Sole trader

Small (1-9)

Medium (10-49)

Large (50 plus)

Used a health and safety professional in last two years 14 26 60 82

Have a written health and safety policy N/A 70 99 100

Assess possible sources of harm 74 70 88 97

Conduct formal risk assessments 23 56 80 88

Offered training to employees in last 12 months N/A 58 87 94

Base 874 744 289 104

As this was a multiple response question, the percentages shown are greater than 100

Source: IES/IPSOS-MORI Survey of Construction Employers 2004/05

2.6 UNDERSTANDING INDUSTRY AND POLICY INTERESTS

In addition to the characteristics of the industry and how these might affect take-up, there is another important point to make at the start of this evaluation report. The initiative was a joint one between government policy-makers and industry. This means that there are at least two different audiences for the results, each seeking potentially different indicators of ‘success’.

The HSE viewpoint is that the facilitation of changes to management practice should be the primary concern of occupational health interventions. This is driven by the fact that changes at this level are the ones most likely to lead to longer-term changes to the health outcomes of individual workers. The HSE therefore commissioned an in-depth evaluation to furnish them with data which would provide indicators of changes to management practice, as well as other more intermediate (or lower level) measures of change.

The view of industry representatives, however, was more pragmatic. This initiative was seen as a way of raising awareness of occupational health issues from a very low base amongst the industry as a whole. From the industry point of view, one of the main visions for the pilot was that it would stimulate the interest of construction employers in occupational health issues. Positive engagement by employers and workers in the industry, therefore, would be enough in the short term to indicate a successful initiative as this would provide momentum for any future activities.

These two views do not necessarily conflict. The construction industry was focused more on employer and worker take-up and on ways of reaching the sector (ie the process of operating the pilot). On the other hand, the main interests of the HSE lay in the impact of the initiative, particularly in terms of health risk management practices and, therefore, in the implied occupational health outcomes in the longer term. Both parties, however, want to draw out practical learning points for the future. This evaluation report is the first step in doing so.

2.7 SUMMARY

The CBH pilot was set a number of aims, including helping employers to improve their systems and procedures as they relate to occupational health, with the expectation that this would eventually lead to reductions in absence rates and actual ill-health. It was also hoped that the pilot would encourage workers to prioritise health issues and hence reduce the likelihood that they themselves

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would experience work-related ill-health. In addition, the pilot set itself a number of challenging numerical targets for how many employers and individuals they could work with.

In true piloting spirit, CBH was designed to offer a wide range of potential interventions with employers. These ranged from minimal input services (eg responding to a specific OH query over the phone or via the web) to much more comprehensive involvement with an employer (eg providing bespoke manager training or helping develop OH policies). This design enabled the pilot to test the acceptability of different levels of involvement with employers.

The construction industry has led the way in the introduction of flexible labour practices. Small businesses predominate and there is a high degree of subcontracting of work. Teams often work together only briefly before moving on to other jobs. This means that lines of responsibility for health and safety can be unclear and/or there can be little incentive to commit time and resources to health and safety training for staff on short term jobs. The sector also has a relatively poor performance in terms of occupational health, with higher than average rates of days taken off sick, in addition to a high number of work place accidents1. An additional issue for the industry is the skills shortage projected for the future. All of these factors combine to make effective management of ill-health within the industry challenging, but also of vital importance. There is, therefore, an important role for the results of the CBH pilot in helping others to understand how best to work with employers in this sector in the future.

See HSE’s Construction Intelligence Report op. cit.

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3. THE CBH EVALUATION

The evaluation of CBH has been a central component of the pilot activities; the purpose of the evaluation being to inform the development of the pilot as well as to assess measurable outputs. The HSE has required regular feedback from evaluators and CBH staff to inform the development of other services (eg Workplace Health Connect), as well as to enhance the services offered by the CBH pilot itself. There have been a number of activities that have taken place as part of this evaluation, all of which contribute to this report.

■ It was anticipated from the outset that it would only be possible to measure progress against some of the pilot aims during the life of the evaluation as health outcomes are difficult to measure, and take time to emerge. Therefore, as the evaluation was time limited to the two year operation period of the pilot, it was important to consider a range of intermediate, as well as health, outcomes.

3.1 EVALUATION DESIGN

The CBH evaluation was designed to collect and analyse data on whether the objectives of the CBH pilot had been met and whether the model being trialled was sustainable. The measures used were to include data on accident rates and health and safety failures, as well as information collected by the evaluator on attitudes and behaviour relating to occupational health and safety. The evaluation was also tasked to provide information which could be used to inform decision making on the effectiveness of the model within the construction industry and its wider applicability.

The evaluation was required to collect data on:

■ process measures (such as whether the delivery model worked, and whether the model is something that employers in construction actually want)

■ output measures (including what proportion of employers were using various aspects of the service, and levels of usage of the service as a whole)

■ intermediate outputs (including employer awareness of occupational ill-health, whether the service provided something new)

■ ultimate outcome measures (such as changes to the number of accidents and days lost due to ill-health).

■ As such, the evaluation methodology needed to include a matched comparison group and to generate robust data on the impact of the initiative.

3.2 DATA SOURCES

A range of data sources were used in the compilation of this report and to provide evaluation evidence. These are discussed in some detail here.

3.2.1 Management information

In addition to delivering the services, the CBH staff have kept extensive records of their activities with both employers and workers. The format of the database was developed with the evaluation team at the start of the project.

The information which it provides includes details such as:

■ the dates when contacts were made

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■ the type of contacts made (a complex categorisation was used (which has been simplified for the purposes of this report) reflecting whether individuals were contacted by phone, letter or face-to-face, and also the type of information or service provided to individuals)

■ the exact service used by employers (eg whether they took up a toolbox talk, a health check, a risk assessment, etc.)

■ basic details on the type of company (eg number of employees and main type of work undertaken) or characteristics of the individuals involved (eg trade, and size of employer worked for).

■ This database of information is, therefore, an extremely useful source of information about the scale and nature of the activities of the pilot. The evaluation team have conducted detailed analysis of this data for the purposes of this report on all activities between October 2004 and June 2006, ie during the full 21 months of activity during which the pilot was in operation. The results are presented in this report to provide the reader with an overview of the levels of take-up, use of different services, and the scale of marketing and sales activities required to generate this level of interest. Additional information is available on the health checks undertaken and the results of these tests (ie whether individuals had an abnormal reading for the specific test or not, and some breakdowns of these results by age and trade).

3.2.2 Longitudinal survey of employers

In order to measure the impact of the service on users, a longitudinal survey was designed. The survey collected information from employers twice: once before the CBH services were fully operational (the baseline survey), and once towards the end of CBH operations – approximately two years after the initial survey. In addition to conducting interviews in the pilot area (ie Leicestershire and surrounding counties), a control group was also selected. This included construction employers and sole traders operating in an area where CBH would not be offering services. The control area used was the four unitary authorities of Bath and North East Somerset, Bristol City, North Somerset and South Gloucestershire (ie the old county of Avon). The baseline employer survey involved structured telephone interviews with 2,011 construction employers and sole traders across the pilot and control areas. Interviews were conducted from November 2004 to mid-January 2005. The follow-up survey took place from August to October 2006. Both surveys were piloted prior to their use in the field and each lasted an average of 15 minutes.

The purpose of the ‘control’ interviews is to provide a way of comparing any progress made by employers operating in the pilot area with that of similar firms/individuals in an area where there has been no pilot activity. If changes in both areas appear to be similar in scale and/or nature, then the pilot may not have had an identifiable effect. If, however, the changes that employers in Leicestershire make outstrip those made in the control area, this would provide strong evidence that the work of the pilot has been effective. However, whilst the area selected as the control area shares the same broad employer characteristics as the pilot area (in terms of the profile of businesses), there are potentially other, immeasurable, differences between the areas. For example, the type of construction projects running in the area, and the backdrop of the way that HSE inspections and enforcement is carried out.

Sample frame for baseline survey

Participants for the baseline survey were selected from the Business Database, which provides the telephone numbers of all businesses advertising in the Yellow Pages. The database contained 2,369 records for Leicestershire and 3,332 records for the control area. Employers were included in the sample if their records showed that they were operating within the construction industry sector (ie Standard Classification Code (SIC) 45).

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All those listed in the Leicestershire area were contacted, with the aim of achieving 1,000 interviews. However, the number of eligible employers and sole traders in Leicestershire (from the data source concerned) was insufficient, due to the number of construction firms with a Leicestershire address, therefore only 750 interviews were conducted in Leicestershire. A further 252 supplementary interviews were conducted with similar firms and individuals based in the neighbouring county of Nottinghamshire. This had been selected as the ‘reserve’ area at the beginning of fieldwork in case the numbers of achieved interviews in Leicestershire fell behind target. Nottinghamshire was selected as companies based in the county but which work in Leicestershire, were eligible to take up CBH services. This booster sample was designed to increase the number of potential users in the sample, rather than add to the control group. 1,000 interviews were undertaken with construction employers and sole traders operating in the control area. The results of this baseline survey are presented in detail in a published HSE report1.

Wave Two booster sample

The original survey was designed on the basis of the provider targets outlined in Chapter 3, which anticipated that 25 per cent of employers in Leicestershire would receive some advice or other service from the pilot. These targets were not achieved. It was clear from analysis of combined survey and provider records that, for analytical purposes, insufficient numbers of employers who took part in the baseline sample had gone on to use CBH services. Therefore the numbers of employers using the service picked up from the initial population sample was insufficient to allow the evaluation to carry out meaningful analysis of the user group. To better understand employer experiences of the pilot, more users would need to be interviewed.

In order to boost the number of users in the sample, an additional 275 interviews were conducted with companies identified by the CBH management information database as employers that had been contacted by CBH (through sales or service delivery). Of these, 161 had gone on to use the service. These employers therefore only took part in the wave two survey, and no baseline data is available for them. Table 3.1 provides a breakdown of the different sample sources.

Table 3.1 Sample breakdown of Wave Two respondents

Sample area Type of sample % of total Total (N)

Pilot Baseline sample 40.4 595

New sample 18.7 275

Control Baseline sample 40.9 602

Total 100 1,472

Source: IES/MORI Survey of Construction Employers 2004/2005 and 2005/2006

Response rates

Here we present the response rates for the two surveys. We discuss the ‘valid’ response rate, which is calculated by dividing the number of achieved interviews by the total sample (less any ‘bad’ or ineligible numbers, or unused contacts due to the quota having been reached). Full details on the response rates for the two surveys are provided as Appendix 1.

Tyers C and Sinclair A (2005) Constructing Better Health, Report of the baseline employer survey, HSE Research Report 381.

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1

The valid response rates for the baseline survey were:

■ Wave One – 48 per cent overall, broken down as:

□ 47 per cent in Leicestershire

□ 50 per cent in Nottinghamshire

□ 48 per cent in the control area.

■ Wave Two – 72 per cent overall, broken down as:

□ 73 per cent of the baseline pilot sample

□ 65 per cent of the new pilot sample

□ 74 per cent of the control sample.

Cross-referencing to CBH provider records

The survey data was treated prior to analysis by cross-referencing it with the management information collected by the CBH pilot. The latter was used to determine which companies had actually used the CBH pilot services. Respondents were allocated into the user group even where the individual taking part in the survey did not recall their company having used the CBH service.

Table 3.2 shows that a much higher proportion of participants in the second survey were service users than was suggested by the survey results. This discrepancy could reflect a range of factors, including whether or not the interviewer was speaking to the relevant contact within the organisation (eg not the person who actually dealt with CBH), or poor recall. Provider records were felt to be the most accurate source of information on service use.

Table 3.2 Self-classification by CBH records on identity of users

CBH provider records (N)

User Non user N

Survey records User 90 6 96

Non-user 116 146 262

N 206 152 358

Source: IES/MORI Survey of Construction Employers 2005/2006 and IES analysis of CBH management information 2006

Sample characteristics

Details on the size and sectoral breakdown of the achieved survey sample are provided in Table 3.3, along with a range of other organisational and work characteristics. This is the sample data prior to weighting, but with the recoding of users from the provider records complete.

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Table 3.3 Respondent establishment characteristics (per cent)

Characteristic User Non-user pilot area Control Total

Size of workforce*

Sole trader 12.9 39.1 41.0 35.9

1 to 9 25.0 35.8 34.2 33.5

10 to 49 34.4 17.4 17.1 19.9

50 plus 27.7 7.8 7.6 10.7

Total (N) 224 645 602 1,471

Sector*

Building of complete constructions 42.4 30.9 36.4 34.9

Building installation 23.2 32.4 29.6 29.9

Building completion 18.8 24.0 25.0 23.6

Other 15.6 12.6 9.0 11.6

Total (N) 224 641 601 1466

Employ casual workers*

No 80.3 80.9 78.4 79.8

1 to 4 8.1 12.3 14.7 12.6

More than 5 11.7 6.8 6.9 7.6

Total (N) 223 644 598 1,465

Part of larger group*

Yes 27.4 12.8 15.2 16.8

No 72.6 87.2 84.8 83.2

Total (N) 197 391 355 943

Length of operation*

Less than 5 years 15.6 16.6 22.8 19.0

Between 5 and 20 years 39.6 40.8 39.7 40.1

Over 20 years 44.9 42.6 37.5 40.9

Total (N) 225 645 602 1,472

Type of work undertaken*

Domestic 27.1 48.1 49.3 45.4

Commercial 45.8 27.0 27.2 30.0

Evenly split between 17.8 20.9 20.8 20.4 domestic/commercial

Not applicable/other 9.3 4.0 2.7 4.3

Total (N) 225 645 602 1,472

Very short term – one day or less 5.0 6.4 7.0 6.4

Short term – two days to one week 12.2 28.2 27.8 25.5

Between one week and one month 16.3 29.1 28.6 26.9

Several months or longer 45.2 20.2 21.4 24.6

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Characteristic User Non-user pilot area Control Total

Other/it varies 8.1 7.5 6.3 7.1

Not applicable 13.1 7.8 8.7 9.0

Total (N) 221 625 583 1,429

Work independently 40.9 63.9 60.2 58.8

Get subcontracted by other firms 30.9 21.4 23.9 23.9

Subcontract work to others 15.0 8.9 9.7 10.2

Not applicable/other 13.2 5.8 6.2 7.1

Total (N) 220 626 585 1,431

*Indicates a significant difference between the three groups at the five per cent level using the chi-square statistic

Source: IES/MORI Survey of Construction Employers 2006

Just over two-thirds of the sample is made up of micro-businesses with fewer than five employees. Sole traders are well represented and make up about 36 per cent of the total sample. This type of business is a key target group for the pilot so it was important to represent their views in the survey. There is also a fairly high proportion of large employers with over 50 employees in our sample (around 11 per cent).

In terms of industrial sector, the sample represents the three major areas of construction well. These main sectors include: newbuild (construction of buildings, motorways, railways, water projects, civil engineering, roofing); building fit out (electrical work, building insulation, plumbing); and building completion (plastering, painting and decorating, glazing, joinery).

A minority of the employers (around 17 per cent), were part of a larger group of companies or establishments. Organisations in the new booster sample were significantly more likely to be part of a larger group than either the pilot baseline or control groups. There was also a significant difference between the groups in terms of their length of operation; there was a higher proportion of older establishments in the new sample. The majority of employers (around 80 per cent), did not employ casual workers but, where casual workers were employed, the new sample was likely to be employing them in greater numbers. This is likely to reflect the fact that organisations in the new sample were larger.

Matching and weighting

For the purposes of analysis, three groups have been identified: users of CBH services; non-users (ie employers operating in the Leicestershire area who were eligible to receive services but which chose not to do so); and the control group made up of companies operating outside the pilot areas. There were a number of differences in the characteristics of users, non-users and the control group. Given that these differences are highly likely to affect health and safety policies and practices (particularly size) it was necessary to match the samples. By matching the groups on the key observable characteristics in which they differ, greater confidence can be attached to attributions of the impact of the CBH services. It is less likely that any differences in outcomes are due to differences in the make-up of the companies in the different groups with similar groups involved.

The Propensity Score Matching (PSM) technique was used, specifically the Kernal matching approach. A range of variables were used in the matching procedure. These were taken from the second survey due to the lack of baseline data available for many of the ‘users’ (many of whom had come from the top-up sample).

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Constructing a ‘CBH user’ weight

The first matching procedure matched individuals in both the non-user and the control group to the CBH user group and examined the degree of similarity achieved. A weight was then calculated for both control groups to bring them into line with the treatment group. The matching process ensures that there are no statistically significant differences between the control and treatment samples on a range of key variables. An examination of the characteristics separating the groups found that the main difference between CBH users and the other groups was that CBH users were more likely to be larger firms.

The variables used to construct the weight were:

■ type of work conducted (newbuild, fit out, completion or ‘other’)

■ number of employees

■ whether or not the establishment was part of a larger group

■ whether or not the company employed casual workers

■ main way of working (main contractor, subcontractor, work alone or ‘other’)

■ length of time the company had been in operation

■ whether work was mainly commercial/industrial or on domestic premises.

Attitudinal measures were not included in the matching process, as by Wave Two these were less likely to have been affected by the intervention.

Constructing an ‘attrition’ weight

A further weight was compiled to allow for the effects of attrition between the two surveys. Attrition is the tendency to lose certain groups of respondents over successive waves of a longitudinal research design, and as the loss is generally non-random, the representativeness of a sample can diminish over time, producing biased results. The new data captured at Wave Two was weighted to allow for aggregate comparison with the Wave One results – essentially weighting the original sample to look like those who had taken part at both time points. The same variables were entered into the equation as were used to match CBH users to non-users and control groups (listed above), using the information obtained in the first survey. In this case, some baseline attitude questions were also used. An examination of response rates indicated a higher response rate at Wave Two amongst large firms, older firms, those that do not have casual workers and those who disagree that ‘health and safety isn’t a problem in their area of work’.

The matched data was used to produce cross-tabulations, mean score comparisons and to test for statistically significant differences.

The regression equations constructed to develop these weights are provided in Appendix 2.

Gaining participation for Wave Two

All employers participating in the baseline survey were asked whether they would be prepared to speak to evaluators again at a later date. Those who agreed were followed up with a mailed contact letter in March 2006. This provided some basic results from the first survey and encouraged employers to update their contact details. All willing employers were followed up in a second survey from mid-August to the end of September 2006.

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The questions used in the second survey are provided in Appendix 3 (the first survey instrument is not provided as most of the questions are replicated in the second survey.

3.2.3 Stakeholder interviews

As part of the initial evaluative work of the CBH, 11 stakeholders in Leicestershire and across the East Midlands were interviewed during the first half of 2005. These stakeholders were selected to represent a broad range of partner organisations and those with an understanding of the issues involved in working with construction employers. Those involved were recommended by policy and industry representatives from the CBH pilot Steering Group.

The stakeholders involved represented the following organisations:

■ Constructing Excellence Demonstration Project

■ Federation of Master Builders

■ Two major construction employers operating in Leicestershire

■ Health and Safety Executive – Construction Division Wales and South West

■ Health and Safety Executive – Construction Division Midlands

■ Leicestershire Learning and Skills Council – Construction sector adviser, Skills at Work Pilot initiative

■ Leicestershire County Council – Property and Maintenance Divisions

■ Loughborough University – Department of Civil Engineering

■ National House-Building Council

■ Union of Construction, Allied Trades and Technicians – Midlands Region.

Those participating were asked a range of questions including some specific to their organisation to understand the background to the pilot. Questions that were asked of all participants included:

■ How would you describe the construction industry in Leicestershire?

■ What are the generic factors the pilot will need to address?

■ Are there any specific local factors the pilot will need to address?

■ What are going to be the main barriers for the pilot to overcome?

■ What do you think employers see as their needs for support/what would be welcomed by them more widely?

■ What suggestions do you have about how to promote the work of the CBH pilot?

The stakeholder interview data was, therefore, used in two ways. Firstly as an aide to pilot staff in taking forward the CBH initiative; they provided a range of ideas on how best to target the sector based on their own experiences. Secondly, the views of stakeholders on the industry provided a useful backdrop to the survey data, and have been incorporated into this report accordingly. A full outline of the results of the stakeholder interviews was provided to HSE as an unpublished report in

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20051. In addition, CBH staff worked closely with the evaluation team and provided honest insights on their progress throughout the course of the evaluation. All staff who were involved in the CBH pilot were interviewed at least once as part of the evaluation, and most were involved with discussions on a number of occasions with the research team.

3.2.4 In-depth interviews with service users

Qualitative information on the experiences of service users was obtained through in-depth face-to-face interviews. In this case, the users are at two levels: employers and workers. It was therefore important to understand the experiences of both these user groups in relation to their contact with CBH.

The initial strategy was to recruit both employers and individuals listed on the database of CBH users directly, as contact details were collected by the CBH team for all users. However, it proved more difficult to involve individual workers by making direct contact with them. Therefore the decision was taken to use employers as a route to workers. In practice, many of the workers were not directly employed by these companies and therefore represented subcontracting companies who were operating on the site. Within case study employers, members of the evaluation team would interview a range of individuals. The exact people involved differed according to the size and nature of the employer concerned, but generally included some combination of senior management, site management and workers.

A cross-section of employers was included, and the workers involved in the interviews worked for a range of employers, including larger companies responsible for managing construction sites with multiple subcontractors, subcontractors on these sites, and smaller, more domestically focused employers.

IES secured access to sixteen different case study employers. Through these employers a total of 78 interviews were conducted across 21 sites or offices. Employers were visited during both 2005 and 2006. Six of the employers were visited twice to allow us to monitor the longer term impact of the service on these companies. Around half of the interviews (34) were conducted with workers, and the other half (38) with site managers or other more senior staff within the company. Further details of the companies and individuals involved are provided in Appendix 4.

3.3 SUMMARY

The evaluation of CBH was a central component of the pilot. Evaluation and pilot staff worked closely together throughout the life of the pilot.

The evaluation collected a range of data to help the HSE and wider audiences understand both the process of the pilot and early indicators of its impact.

The main activities of the evaluation team were to:

■ analyse management data collected by pilot staff on levels of service use

■ conduct a two-wave survey of employers in the pilot area with a matched control group

■ interview a range of stakeholders in Leicester and nationally

■ engage with users through face-to-face interviews of employers and workers.

This data has been analysed and synthesised to form the basis of this report.

Tyers C, Rick J, Sinclair A and Tackey N (unpublished report to HSE in 2005) Constructing Better Health: Feedback from Stakeholder Interviews.

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4. MARKETING

4.1 INTRODUCTION

CBH undertook a wide range of marketing and sales activities to promote itself to employers. Finding the right message about the CBH pilot and communicating it effectively to the target audience has been one of the most challenging aspects of the pilot, particularly in the early stages of project delivery. Marketing the services on offer has, therefore, been one of the pilot’s core activities. The pilot was designed to specifically target small employers within the construction sector, which are traditionally hard to engage. At various stages, different marketing strategies were used, and in this section we provide an overview of these, along with their respective merits.

4.2 TYPES OF CBH ACTIVITY

The CBH database was designed to provide information for the evaluation, but also allow CBH staff to monitor their progress and act as a record of contact information. The data it contains is very detailed and has captured the degree of complexity involved in delivering a multi-stranded service. For the purposes of this report it has been necessary to condense and process this information.

The huge variety of pilot activities have been broken down, for reporting purposes, into three levels, these are:

■ Marketing activities. These are unsolicited activities designed to generate interest in the service. They range from sending out newsletters and written information to presenting at seminars and cold calls made by a telemarketing company.

■ Sales activities. These represent activities where employers have expressed some interest in the service or approached CBH directly. They therefore included such activities as sending out information which has been requested, and initial meetings with employers.

■ Service delivery. These are core service activities across the suite of services on offer. They also included meetings with employers which took place at their offices or work site.

■ There is relatively incomplete data available for some companies because they had little or no contact with CBH and/or they did not want to share their company information. Throughout this chapter, therefore, there is some information missing from tables for these employers.

4.3 MARKETING APPROACHES USED

The CBH pilot and evaluation were designed to allow learning points to be drawn not only on the impact of the CBH initiative, but also on its processes. What worked well and what did not? An important aspect of this, particularly in understanding how best to work with the construction industry in the future, was understanding how different marketing approaches worked. Various ways of reaching employers were trialled. These are discussed in detail here, before further sections examine how different marketing approaches were received by employers.

4.3.1 Cascading messages

One of the initial strategies for the pilot was to use larger employers and high-profile networks, advocates and events in order to raise the profile of the pilot sufficiently to facilitate their work with smaller employers. Considerable efforts were therefore focused on working with major contractors in the area, as well as generating ‘word on the street’ through a concerted publicity

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campaign targeting local stakeholders. The high-level marketing activities were designed to increase awareness of the CBH brand and generate interest amongst decision maker contacts within larger and more professional employer organisations. This was an approached based on the assumption that major contractors would be an effective conduit to target users, alongside media coverage.

In practice, however, these methods of reaching smaller companies took far longer than anticipated. One reason is the fact that there was actually less activity by major contractors in the area than in many others. There were few large developments run by big companies during the time of pilot. Additionally, this reliance on larger companies or other bodies to cascade messages requires a certain amount of elapsed time for the information to filter down supply chains. Also, reliance on larger employers as a route to smaller firms is limited by the fact that many smaller operators, particularly at the micro-level, do not actually work for larger companies. It was clear that other strategies would also be required in order to reach very small companies.

‘We sat down from very early on and said we’re not going to get to the really small guys by going through the big guys, we’re not going to get it through the marketing because they don’t want to be found.’ (CBH staff member during year one of pilot operation)

4.3.2 Mailings

Initial approaches in the first few months of service operation also used mailshots, sending out details of the CBH service by post to all employers registered with Yellow Pages in the construction sector within the pilot area. The use of mailings was never intended to operate in isolation. The main purpose of these mailings was to generate interest in, and promote the brand, rather than, in itself, stimulate high levels of demand for the service. However, pilot staff assert that even in this respect the use of direct mailings had little impact. Learning points from this approach to marketing were that the mailing should focus on messages pertinent to the audience and include a clear ‘call to action’ (ie give the reader a clear message about what to do next if the content of the mailing interested them). This was lacking in some initial CBH marketing materials.

4.3.3 Proactive approaches to employers

During the first quarter of 2005, in response to lower than anticipated take-up rates, the pilot engaged a professional telemarketing company to help stimulate demand for services. This allowed the CBH team to concentrate on following up rather than generating leads. The move to a more proactive approach, of which the use of telemarketing was a major part, marked a clear change in the take-up rates of the pilot. It has certainly been the most effective way of generating visits for pilot staff.

The main learning points from the telemarketing exercise1 included:

■ the approach has limited effectiveness with small employers (ie those with fewer than five workers)

■ finding the appropriate decision maker within an organisation can be difficult, and they are often on-site and/or extremely busy, necessitating repeated call-backs

■ the use of direct mail in tandem with the telemarketing did not yield higher response rates from employers than telemarketing used alone

As highlighted in the CBH end of pilot report to the HSE, prepared by CBH staff..

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1

■ if an employer had not become involved following the first telephone contact, the extent to which they were likely to be interested following subsequent phone calls was low.

■ Reflecting on this, and on learning points for other initiatives, CBH staff would recommend that telemarketing be introduced at the start of any marketing campaign to raise awareness, but with a focus on larger employers.

In addition, CBH staff themselves dealt with a range of smaller contractors on large sites run by larger employers. This led to an increased awareness amongst smaller firms about the work of the pilot, and achieved word-of-mouth recommendations about the services, although this did take some time to develop.

‘The dynamics are changing in as much as, instead of having to go out there and bang heads against brick walls to get a foot in the door, we now have people phoning us. The word on the street is definitely out there … the message is getting across.’ (CBH staff member, at the start of year two of operation)

4.3.4 Use of events

A number of additional approaches have also been trialled, including the use of events (which varied in approach but generally included a presentation on the CBH pilot and the service on offer) to generate interest, particularly during year one of pilot operations. Examples included:

■ events aimed at employers (eg a launch event attended by the local MP at a local Leisure Centre, to which all major contractors were invited)

■ events aimed at workers and sole traders (eg individuals turning up to a toolbox talk at the Leicester City Football Club ground were given free tickets for the match)

■ operating stands at builders’ merchants

■ leaving information leaflets at these sites and others frequented by workers in the industry.

Whilst there have been some relatively successful events, the degree of interest generated through most of these has not been significant.

CBH also developed strong links with local colleges and training providers, and this was useful in reaching young, apprentice-level staff within the industry. Pilot staff delivered training and health checks to apprentices through their further education providers. Short training sessions – toolbox talks (see description later in this chapter) – were delivered in every college in Leicestershire offering construction courses. These talks were delivered as part of course curricula and colleges also allowed CBH to exhibit at college recruitment events.

4.3.5 Campaign to reach workers

The main marketing collateral of CBH was corporate in style. Materials included CBH branded pens, information packs and a range of postcards and posters highlighting specific health issues. In addition, the website also had a corporate ‘feel’. During the first year of operation, it was recognised that this type of material and style could actually be inappropriate for some of the very small organisations, sole traders and individual workers that form the main target audience for CBH. As a result, a new campaign style was developed, which focused on using the brand ‘Fit Builder’ rather than the more corporate CBH identity.

The campaign adopted a ‘Red Top’ or tabloid style which was felt to be more familiar to workers. The roll-out of the campaign included the creation of marketing materials such as T-shirts, posters, newsletters and vehicle stickers, as well as the development of a new website promoting the ‘Fit

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Builder’ identity. There were some initial misgivings about the appropriateness of the style of this campaign, but research conducted by the pilot suggested that the main contractors appreciated the light-hearted approach of the material. In addition, the Fit Builder newsletters proved popular with a number of suppliers, some of whom provided goods to be offered in prize draws.

These changes to the marketing approach reflected a desire to focus increasingly on the core target group of smaller employers who had proved difficult to reach through telemarketing. The experience of CBH would therefore suggest that any direct approaches to the smaller employers operating in the sector require clear and targeted messages which tap directly into their concerns, and which do so in a non-threatening, familiar style.

4.4 EFFECTIVENESS OF MARKETING APPROACHES

Given the range of marketing and sales approaches used, it is important for future activities to try and determine how well these different methods worked. What techniques proved most useful in reaching employers?

4.4.1 Relative utility of different marketing and sales approaches

Because most employers were contacted on multiple occasions using a variety of contact methods, it is not possible to isolate the effect of different marketing and sales approaches. However, the data collected by CBH staff on their activities does allow us to compare the relative effectiveness of different techniques using conversion rates (ie the number of employers taking up CBH services divided by the number receiving each marketing/sales approach). Table 4.1 provides further details.

CBH mailings were sent out to all employers known to CBH, and the conversion rates for these activities are artificially high as almost everyone who went on to be a service user will have been ‘mailed’ by CBH at some point. Putting aside the direct mail approaches, therefore, it is clear that the most effective type of contact occurs where the employer has signalled a desire to receive a service (ie actively contacted CBH at which point they move on to become a sales contact). However, larger-scale marketing activities are likely to have played a part in generating their interest in the service.

The two most effective forms of sales or marketing contact were ‘telephone sales, helpline call or request call’ and ‘other telephone contact’. These were predominantly telephone calls to make appointments, scheme referrals, and calls requesting help or assistance with specific or general issues. The next most effective group of sales and marketing contacts were those involving face-to-face contact with the employer. This group included ‘face-to-face contact through events and briefings’, and ‘briefing, additional contact from site visit, attended briefing’. By far the most effective ‘cold’ sales and marketing contact was telemarketing, and almost 16 per cent of employers contacted in this way used a CBH service. This technique was also responsible for the greatest actual number of user conversions after mailings (the numbers for which are likely to be artificially high as discussed earlier in this section).

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Table 4.1 Service delivery conversion rate for employers by type or marketing or sales contact

Level of contact Type of approach

Number receiving contact

Number receiving a CBH service

% Conversion rate

Marketing Newsletter/mailing/provision of information 3,880 296 7.6

Telemarketing 906 142 15.7

Other telephone contact 24 10 41.7

Face-to-face contact through events and briefings 129 40 31.0

Sales Information provided as response to request or as follow-up 200 64 32.0

Telephone sales, helpline call or request call 40 20 50.0

Briefing, additional contact from company visit, attended briefing 167 36 21.6

Base (N) 3,944 307

Missing 60 60

Total 4,004 367

As an employer may receive more than one type of contact, the numbers shown do not equal the totals. It is also important to note that the conversion rate gives only an indication of the relative success of a technique as it was not practical to analyse the effectiveness of each technique on its own, or in particular combinations with others. It is only possible to say that out of a certain number receiving a type of contact, a certain number went on to receive a service

The ‘other telephone contact’ conversion rate is high as this included phone calls to make appointments.

Source: IES analysis of CBH Management Information system, June 2006

4.4.2 How employers first heard about CBH

Another indicator of the relative success of different marketing and sales approaches is the extent to which employers can remember them. In the employer survey, CBH users (as self-defined) were asked to state how they recalled first hearing about the pilot (Figure 4.1). The most common response from employers was that they heard through some form of postal information that they had received (18 per cent). It is likely that almost all of those who went on to use the service would have been sent some postal information at some point during the pilot. The next most common response was that they had received a call from a telemarketer (17 per cent), corresponding with the types of activities undertaken by CBH; around half of all employers using the service were approached in this way. The next most well-recalled approach was having seen the Fit Builder newsletter (around 14 per cent). Word of mouth was another important source, 11 per cent had heard about the service through a business associate, and another four per cent from an unspecified contact.

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Figure 4.1 How CBH service users heard about CBH

0 2 4 6 8 10 12 14 16 18 20

Received postal info

Telemarketing

Received Fit Builder newsletter

Business associate

Contacted by CBH

CBH visited worksite

Word of mouth

Builders merchants

Picked up information

Newspaper publicity

Fit Builder Website

From an employee

Attended an event

Picked up a Fit Builder newsletter

Other

How

fir

st h

eard

abo

ut C

BH

%

Base: All CBH users (as self-defined), N = 109

As this was a multiple response question, the percentages shown are greater than 100.

Source: IES/IPSOS-MORI Survey of Construction Employers 2005/2006

4.5 DIFFICULTIES IN REACHING SMALL EMPLOYERS

Given the overall approach to marketing discussed, it is interesting to determine how well the messages put forward by CBH were received by different employers. Considerable efforts were made by the pilot to reach the target group (ie small and medium-sized employers and their workers). The CBH pilot primarily focused its sales and marketing activities on small employers, with over 85 per cent of companies contacted by CBH having fewer than 20 employees (Table 4.2). However, these smaller employers proved relatively difficult to convert into users, as they constituted only around 55 per cent of companies receiving some form of actual service delivery from CBH, were sole traders, or had less than 20 employees. There was therefore a far higher proportion of larger companies in the CBH user group.

There were some differences in take-up of services by companies working on different stages of the building process. However, these also appear to be driven by size, as the building stage with which CBH was most successful was site preparation. There is a larger proportion of larger companies doing this type of work. Employers involved in site preparation, however, make up a relatively small proportion of construction companies operating in Leicestershire.

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Table 4.2 Proportion of employers contacted by and those receiving a service from CBH (by size and business type) (in per cent)

Size of workforce Contacted by CBH Receiving a CBH service

Sole trader 24.7 13.7

1 - 19 62.1 42.3

20 - 49 5.8 12.0

50 - 99 2.3 11.0

100+ 5.1 21.0

Total 100 100

Base (N) 2,555 291

Missing (N) 1,449 76

Business type

Site clearance, groundwork, earth moving and demolition 2.4 4.8

Newbuild (commercial and domestic) and refurbishment 36.5 42.2

Fit out (eg electrical and plumbing work) 19.5 17.0

Completion (eg plastering, joinery, decorating) 28.6 28.9

Other 12.8 7.0

Total 100 100

Base (N) 3,204 353

Missing (N) 800 14

Source: IES analysis of CBH Management Information system, June 2006

It is clear that, for the most part, CBH had difficulties in making any more than a marketing approach to sole traders and small employers (Figure 4.2), as 91 per cent and 84 per cent of these respectively had no further contact with CBH. In contrast, CBH was able to establish better connections with larger employers, particularly those with more than 50 employees. Almost 70 per cent of the larger companies contacted by CBH went on to engage in some of sales activities, and half received a service. This again reflects how difficult it has been for CBH to establish links with companies with less than 20 employees, and in particular with sole traders. The effect of employer type (ie their main activity within construction) was negligible once size had been taken into account.

This is also reflected in the conversion rates (calculated by dividing the number of employers that received a service from CBH by the number of companies approached by CBH) of different types of employers (Figure 4.3). Despite the high number of smaller companies contacted, the conversion rates for these firms were far lower than for larger companies. While just six per cent of sole traders approached by CBH went on to use services, 47 per cent of employers with 100 or more employees and 53 per cent of employers with 50 to 99 staff became service users after being contacted. Therefore workforce size was a key factor determining the likelihood of an employer using CBH services following sales or marketing contact.

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Figure 4.2 Highest level of contact with CBH by size and business type (in per cent)

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Sole Trader

1 - 19

20 - 49

50 - 99

100+

Wor

kfor

ce

size

Marketing Sales Service delivery

Source: IES analysis of CBH Management Information system, June 2006

Figure 4.3 Conversion rate (approaches made: service take-up) by size

0

10

20

30

40

50

60

Sole Trader 1 - 19 20 - 49 50 - 99 100+

Size of workforce

Con

vers

ion

rate

to

CBH

ser

vice

use

rs (

%)

Base: 2,555 employers for whom data was available

Source: IES analysis of CBH Management Information system, June 2006

4.6 REACHING SUBCONTRACTORS ON LARGER SITES

There were sixty companies who used CBH services without receiving any marketing or sales contacts. The individuals working for these companies therefore came into contact with CBH without their management being expressly involved in terms of booking the health check van or having a toolbox talk run solely for their own staff.

These companies came into contact with CBH through their presence on larger sites when toolbox talks or health checks were being conducted. The majority of these companies were small employers or sole traders (Table 4.3). This supports CBH staff views that working through larger employers was an effective way to reach workers within some smaller firms and some self-employed contractors who would otherwise not have got involved.

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Table 4.3 Employers receiving a CBH service and who did not receive any sales or marketing contact from CBH by size

Size of workforce N %

Sole Trader 20 52.6

1 - 19 12 31.6

20 - 49 4 10.5

50 - 99 1 2.6

100+ 1 2.6

Base (N) 38 100

Missing 22

Total 60

Source: IES analysis of CBH Management Information system, June 2006

4.7 SCALE OF MARKETING AND SALES ACTIVITIES REQUIRED TO ‘CONVERT’ USERS

Given the difficulty in successfully marketing to companies, particularly smaller ones, it is also interesting to determine the typical level of commitment (in terms of marketing and sales approaches made to companies) required by CBH in order to actively convert them into service users. There is a clear pattern in that the greater number of marketing and sales contacts made by CBH staff to companies, the better the conversion rate (Table 4.4). Only where four or more contacts have been made with an employer does the conversion rate enter double figures, and still only one in five employers with this number of approaches went on to become service users.

Table 4.4 Service delivery conversion rate for employers by number of marketing and sales approaches made by CBH

Number of marketing and Number receiving sales approaches made Number of employers a CBH service % Conversion rate

0 60 60 100

1 591 28 4.7

2 1,295 48 3.7

3 1,343 91 6.8

4 or more 715 140 19.6

Total 4,004 367 –

Source: IES analysis of CBH Management Information system, June 2006

Although sales contacts appear to be effective in persuading employers to use CBH services, even from the point where employers make proactive contact with CBH it still takes considerable time from this point until actual service delivery. Table 4.5 presents the mean and median number of days taken between first sales contact and first service delivery contact for those firms where date-specific information was available. The mean number of days taken for all companies was 59. The median, which can be a better measure of central tendency when there are some very high numbers which can skew the data (as is the case here) was 16 days. However, employers with 1-19 employees had a far higher mean overall, at 78 days, demonstrating again that this was a particularly hard-to-reach group.

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Table 4.5 Time taken between first sales contact with CBH for an employer and first service delivered to that employer by employer size

Size of workforce N Mean (days) Median (days)

Sole Trader 2 8 8

1 - 19 28 78 15

20 - 49 13 51 14

50 - 99 10 22 16

100+ 22 62 19

All 75 59 16

Missing 20 – –

Total 95 – –

Source: IES analysis of CBH Management Information system, June 2006

When asked about this delay, CBH staff were able to provide a number of reasons for it. Practical issues included the fact that many sites were reluctant to book the mobile health check unit for a Monday or a Friday, as Mondays were used to allocate jobs whilst Fridays often involved an early finish time. Also, for the service to run smoothly, senior management often had to communicate with site management, and a suitable time worked out for visiting the site in question. Another aspect of the service was that the toolbox talks were used to help ‘sell in’ the health checks. Therefore, there was therefore a need to tie in the timing of the toolbox talks with the visit of the health check unit, to ensure that there was sufficient (but not too much) elapsed time between the two.

4.8 AWARENESS OF THE PILOT

The employer survey is another source of information about the success of the marketing techniques used by CBH. All respondents to the second survey from the pilot area were asked whether they had heard about the CBH service. Forty per cent of these employers had done so (Table 4.6). Of those who had heard about the service, 31 per cent had gone on to use it. Of those who had heard about the service but had not become a service user, 32 per cent had considered using it.

There were some differences in awareness according to size and firm type (Figures 4.4 and 4.5). Awareness amongst employers was higher among larger firms (66 per cent of employers with more than 50 employees had heard about the service, compared to just 32 per cent of sole traders), and amongst firms whose main activity was newbuild (48 per cent of these companies had heard about the service, compared to 35 per cent of those involved in fit out).

The majority of employers interviewed through the case study activity had heard about CBH by being contacted directly by the service provider in the area. This usually entailed either a direct telephone call or a letter. A number of other organisations, however, had heard about the scheme through a third party, such as the local safety association.

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Table 4.6 Awareness of CBH

Base % (N) Asked of…

Had heard about CBH service 40.0 869 All employers in pilot area

Had used CBH services 31.3 348 All employers in pilot area who had heard of CBH

Had considered using CBH services 31.8 239 All employers in pilot area who had not used CBH, but who had heard about the service

Source: IES/IPSOS-MORI Survey of Construction Employers 2005/2006

Figure 4.4 Whether or not heard of CBH by size

0

10

20

30

40

50

60

70

Sole Trader Small (1-9) Medium (10-49) Large (50 plus)

Size of workforce*

% h

eard

abo

ut C

BH

Base: 281 sole traders, 287 small, 189 medium and 112 large employers.

* Indicates a significant difference between the groups at the 5 per cent level using the chi square statistic.

Source: IES/IPSOS-MORI Survey of Construction Employers 2005/2006

Figure 4.5 Whether or not heard about CBH by nature of employer

0

10

20

30

40

50

60

Newbuild (commercial and

domestic) and refurbishment

Fit out (eg electrical and

plumbing work)

Completion (eg plastering,

joinery, decorating)

Other

Type of work*

% h

eard

abo

ut C

BH

Base: 293 newbuild, 260 fit out, 196 completion and 116 ‘other’.

* Indicates a significant difference between the groups at the 5 per cent level using the chi square statistic.

Source: IES/IPSOS-MORI Survey of Construction Employers 2005/2006

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4.9 SUMMARY

The target group for this intervention were recognised as hard-to-reach and CBH duly tried out a range of different marketing and engagement strategies in order to develop interest in the service. This broad approach has enabled information about the most effective methods for getting construction companies and individuals working in the sector to take up the service.

The activities of the CBH pilot can be broadly defined as either marketing, sales or service delivery. CBH staff were required to invest heavily in the first two of these in order to generate sufficient interest in the latter. Therefore a great many pilot activities were focused on encouraging employers to meet with CBH staff so that the full range of pilot services could be discussed and an appropriate service plan taken forward on site. Out of around 4,000 employers known to CBH, almost half of these were contacted three or more times by some form of marketing and/or sales activity. It also required tremendous patience and persistence from CBH staff in working with employers. On average, even once an employer had expressed some interest in CBH services, it took 59 days (although the median is lower at 16 days) from this point until CBH staff could engage in actual service delivery with that employer.

Although the pilot focused marketing on smaller employers and sole traders, the conversion rates for these types of employers were very low (less than eight per cent). Take-up rates increase for employers with 20 or more staff: 24 per cent of eligible employers with 20 to 49 employees, 53 per cent of those with 50 to 99 employees, and 47 per cent of those with 100 or more employees, took up CBH services. The original overall target for CBH was that 25 per cent of employers in the pilot area use pilot services. The low take-up rates amongst smaller employers (which make up the majority), were, therefore, a real problem in terms of hitting target numbers. Amongst larger firms, however, these target levels have been hit or exceeded.

The issue in working with smaller employers is that they do not respond well to marketing approaches, even telemarketing which has proven itself as a successful technique for medium and larger firms.

For a small but significant number of smaller employers, the first contact they had with CBH was when they or their staff came into contact with CBH services being delivered on the sites of larger contractors. This suggests that using the supply chain of larger employers can be a good way to reach some smaller employers ‘by the back door’.

There are also learning points about the style of marketing that works within this sector. Proactive approaches are much more effective than the use of mailings or other publicity. Word of mouth is important but does take time to develop. Corporate style marketing does not work well with smaller employers. The use of a tabloid style newsletter, however, did begin to hit this group when it was trialled towards the end of the pilot.

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5. SERVICE TAKE-UP

5.1 INTRODUCTION

Much of the work of CBH, due to the fact that the service was new and different from anything else on offer at the time, was about promoting occupational health services available from the pilot through marketing and other activities. However, it was important for the success of the pilot that employers moved on to take up some form of intervention. In this chapter, we examine actual levels of take-up of the different CBH service elements and how this changed over time. We also consider how different employers reacted, the factors felt to have influenced take-up, and the use of different service elements.

5.2 EMPLOYER PATTERNS

In total, 367 different employers received some form of intervention from CBH staff.

5.2.1 Use of services

A full breakdown of the take-up of different services is presented in Figure 5.1. This shows that, aside from the initial briefing and set-up meetings (which were provided to 87 per cent of employers), the most popular elements of service delivery were site visits and health checks (27 and 29 per cent of CBH users at employer level took up these services). Another popular service was toolbox talks which were used by 22 per cent of employers. In contrast, risk assessments and document reviews were the least-used services. This may be due to employer fears that these assessments would be in some way linked to enforcement (as discussed later in this chapter).

Figure 5.1 Take-up of different CBH services by employers

0 10 20 30 40 50 60 70 80 90 100

Health checks provided

Toolbox talk delivered

Document/system review

Risk assessment

Site Visit

Event, briefing, meeting

Typ

e of

ser

vice

use

d

% of service users

Base: All service users (N = 367)

As each employer can have received multiple services from CBH, the percentage total is greater than 100 for service users.

Source: IES analysis of CBH Management Information system, June 2006

39

5.2.2 Effect of employer size

The data was also examined to determine whether the size of employer bore any relationship to the types of services they selected to take up (Table 5.1). The majority of companies in each size category attended a CBH event, briefing or meeting. The only exception to this was sole traders, only half of whom did so. In general, larger employers appear more likely than smaller companies to use a suite of services. However, none of the employers with more than 100 employees received a risk assessment. Commentary from CBH staff suggests that this may be due to the fact that larger companies with health and safety resources often considered that they were already doing everything they were required to legally, and that they therefore did not see the relevance of the CBH offer. Although take-up of risk assessment was low across employers of different sizes, it is also fairly consistent at roughly three per cent across the other size categories.

Document/system reviews were most popular amongst employers with more than 50 employees but less than 100. This may be due to these employers being aware of the need for good risk assessment and requiring some reassurance in this area. None of the sole traders had a document/system review, but there is no legal requirement for them to have written documentation in place. Many sole traders also work as subcontractors on the sites of larger employers where there is likely to be some form of written policy.

Table 5.1 CBH service use by employers by size (in per cent)

Document/ Event/ Size of Health Toolbox system Risk Site briefing/ workforce checks talks review assessment visit meeting Base (N) Sole Trader 40.0 20.0 – 2.5 12.5 50.0 40

(16) (8) (1) (5) (20) 1-19 22.0 19.5 15.4 3.3 30.1 95.1 123 20-49 34.3 31.4 8.6 2.9 28.6 97.1 35

(12) (11) (3) (1) 10) (34) 50-99 34.4 25.0 21.9 3.1 37.5 87.5 32

(11) (8) (7) (1) (12) (28) 100+ 42.6 45.9 9.8 – 55.7 95.1 61

(26) (28) (6) (34) (58) Missing – – – – – – 76 Total – – – – – – 367

As each employer can receive multiple services from CBH, the percentages shown do not equal 100.

Where figures are presented in brackets next to percentages, these are the actual number of respondents in each cell. These have been presented to reflect the low base size (ie less than 10) for the percentage in question.

Source: IES analysis of CBH Management Information system, June 2006

5.2.3 Take-up over time

Another factor is how service take-up altered, if at all, over time (Figure 5.2). The number of health checks and toolbox talks delivered as a proportion of all CBH services delivered over time is fairly consistent. However, the number of events, briefings and meetings delivered as a proportion of all services delivered increased throughout the duration of the service, reaching a peak in the first quarter of 2006. The quarter with the highest proportion of site visits was the first quarter of operation, with this declining steadily afterwards. This is likely to relate to the concerted efforts

40

undertaken by CBH staff to make contact with employers during the initial stages of the pilot, with the focus shifting to the delivery of core service elements thereafter.

Figure 5.2 Types of CBH services used by employers by quarter (in per cent)

0

10

20

30

40

50

60

70

80

90

Jan-Mar Apr-Jun Jul-Sep Oct-Dec Jan-Mar Apr-Jun

2005 2006

Fre

qu

en

cy

Health checks on-site Toolbox talk delivered Document/system review

Risk assessment Site Visit Event, briefing, meeting

Source: IES analysis of CBH Management Information system, June 2006

5.2.4 Repeat use

There was a high degree of repeat use of CBH services, with almost two-thirds of employers getting involved with more than one incidence of service delivery (Figure 5.3). Almost half of employers used CBH services on four or more occasions. This reflects the fact that larger employers often used services across more than one site. It could also be viewed as an endorsement of the service, given that once employers were engaged with the service they often continued to use the services available.

Figure 5.3 Number of services delivered by CBH to employers

0

5

10

15

20

25

30

35

40

45

50

1 2 3 4 or more

No. of services delivered

% o

f C

BH u

sers

Base: All service users (N = 367)

Source: IES analysis of CBH Management Information system, June 2006

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5.3 TAKE-UP BY INDIVIDUALS

CBH staff also kept records of the job role held by individuals taking up CBH services. For the purposes of analysis, the range of individual job roles has been coded into six main categories:

■ owners are generally the owners of small companies

■ site managers are individuals whose job involves some form of staff management of workers in the trades

■ workers are those who work on sites within the construction industry, normally within one of the core trades or as general labourers

■ management: technical/administration are contracted employees who do not work directly in the construction trades (a wide variety of individuals are listed on the database under this category, but very few actually took up CBH services according to the main CBH management information database)1

■ apprentices are those attending local colleges on day release

■ the self-employed are those who describe themselves as self-employed. These individuals may be sole traders or self-employed for tax purposes only.

The largest single group of users was construction workers, who make up 53 per cent of all those recorded as having used the service, followed by self-employed individuals and apprentices (Figure 5.4). Therefore the bulk of CBH service delivery was to core target users at an individual level.

Figure 5.4 Breakdown of individual CBH users by job role

0

10

20

30

40

50

60

Owner Site manager Worker Management:techical/

administration

Apprentice Self-employed Other

Job role of individual users

% o

f C

BH u

sers

Base: 3,509 users for whom job role is known.

Source: IES analysis of CBH Management Information system, June 2006

The main services used at an individual level were toolbox talks and health checks (Table 5.2). This reflects the fact that these two services were the ones aimed principally at workers and other

There is a huge range of job titles/roles included in this category, each describing only a few individuals. For illustrative purposes, some examples of the kinds of job titles covered by this classification include: Electrical Project Engineer; Health and Safety Advisor; Site Administrator; Training Advisor; Land Surveyor.

42

1

employees. Site managers also received health checks and toolbox talks but, additionally, attended briefings and got involved in site visits. This reflects the broader range of services aimed at them.

Table 5.2 Types of CBH services used by individuals by job title (in per cent)

Manager: Site technical

CBH service Owner management Worker or admin. Apprentice Self-employed Other

Health checks 59.2 61.3 54.0 20.3 9.6 55.7 33.3 (14) (2)

TBT 60.0 48.8 73.2 81.2 97.1 71.3 33.3 (56) (2)

Site Visit 0.8 10.3 0.1 4.3 – – 33.3

Event, briefing, 3.2 14.5 meeting

Base (N) 125 447

(3) (2)

0.2 11.6 – – 33.3 (8) (2)

1875 69 481 506 6

As each individual can receive multiple services from CBH, the percentages shown equal more than 100.

Where figures are presented in brackets next to percentages, these are the actual number of respondents in each cell. These have been presented to reflect the low base size (ie less than 10) for the percentage in question.

Source: IES analysis of CBH Management Information system, June 2006

5.3.1 Take-up over time

At an individual level, healthcheck activity was fairly stable over time, with between 35 and 40 per cent of individual users taking up a healthcheck in most quarters. In the final quarter, however, almost half of all individuals using the service took up a healthcheck. The take-up of toolbox talks rose sharply from just 36 per cent of individuals in the first quarter of 2005 to between 50 and 63 per cent of individuals in the remaining quarters. This is likely to reflect the greater number of employers electing to have toolbox talks delivered on their sites in quarters two and three of 2005 when compared to the first quarter. This data is presented in Figure 5.5.

Figure 5.5 Number of types of CBH services used by individuals by quarter

0

100

200

300

400

500

600

700

Jan-Mar Apr-Jun Jul-Sep Oct-Dec Jan-Mar Apr-Jun

2005 2006Quarter

Fre

qu

en

cy

Healthcheck TBT Site Visit Event, briefing, meeting

Source: IES analysis of CBH Management Information system, June 2006

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5.4 UNDERSTANDING TAKE-UP

Understanding what drives employer take-up is an important part of the learning process of the pilot. The numerical figures tell only part of the story. The reflection of CBH staff, users and other stakeholders in understanding and interpreting some of these findings is explored here.

5.4.1 Lack of any perceived need for change

■ Perhaps the most significant issue affecting take-up was the fact that so many employers did not believe that they had any problems relating to health and/or safety within their own organisation, or were least unwilling to admit to any. Within many companies, therefore there was a lack of commitment to, or interest in, ‘doing better’ with regard to health and safety management.

This is clearly evidenced by results from the employer surveys. Just over two-thirds (69 per cent) of employers who had heard about the CBH pilot, had chosen not to use its services. The most common reasons given were that they did not have any health and safety issues (21 per cent), or a self-expressed lack of interest in the services on offer (19 per cent). A further 16 per cent of employers stated that they were ‘too busy’ to get involved.

Figure 5.6 Why employers in pilot area decided not to use CBH Services

0 5 10 15 20 25

No health and safety issues

Not interested

Too busy

Don’t Know

Already use support from OH providers

Use in-house support for health and safety

Lack of communication/never got back to me

Lack of knowledge

Size of company too small

Other

Rea

son

give

n fo

r no

t ta

king

par

t

% of those who had heard of CBH but chosen not to take part

Base is all employers in pilot area who had heard about CBH but declined to take part (N = 239).

As this was a multiple response question, the percentages shown total greater than 100.

Source: IES/IPSOS-MORI Survey of Construction Employers 2005/2006

Data from the baseline survey clearly showed that the majority of employers already believe that they do enough in this area and that the construction industry already prioritises health and safety issues (Figure 5.7). Additionally, when employers were asked what would help them to improve the way they manage their own and their workers safety, almost one-in-four could not think of anything (Figure 5.8), the clear majority thought that there was nothing they needed to do. This presented CBH with a further challenge in terms of how they communicated the benefits of getting involved with the pilot.

44

‘This is an industry that is improving on its health and safety, but they’ve got a long way to go compared to some industries and they don’t believe that they have a problem.’ (CBH staff member)

Figure 5.7 Attitudes towards health and safety issues

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

I believe that we do enough inthe area of health and safety

Health and safety tends to be apriority in the construction

industry

Strongly agree Tend to agree Neither agree nor disagree Tend to disagree Strongly disagree

Base: All employers, N = 2,011

Source: IES/IPSOS-MORI Survey of Construction Employer 2004/05

Figure 5.8 Most common sources of support that employers would welcome to help improve how they manage their own or worker health and safety

0 5 10 15 20 25 30 35 40 45

Clearer guidance on

legislation

External advice on safety

Help with costs

External advice on health

issues

More time

Nothing

Typ

e of

hel

p

% all employers

Base: All employers, N = 2,011

Source: IES/IPSOS-MORI Survey of Construction Employers 2004/2005

5.4.2 The role of costs

■ Cost is a huge driver in construction, perhaps more so than some other industries. The degree of casual working, and hence limited holiday or sickness benefits for some workers, means that this is not only the case for employers. Individuals, too, are driven by the need to report to work in order to earn their wage.

45

The data from the employer case study interviews identifies cost as the main driver of decision making. It was clear for some employers that the fact that the support on offer was free was central to their involvement. Many of those involved in the interviews actually became involved with CBH for more than one reason, but cost was a recurrent theme.

‘It was offered to me and one thing it was free, which was good, and secondly it was just nice to have a look and see how everybody’s health was really’. (Health and Safety Manager from a CBH user company)

‘Because I believe in keeping up-to-date with these things and I thought it was obviously a free service that was worth taking advantage of.’ (Manager/Owner of a CBH user company)

■ Despite the services being offered to employers for free, the costs of releasing staff to take-up health checks, or the costs of making subsequent changes to work practices could mean that CBH was perceived as a service with a ‘cost burden’. Whilst the CBH service was specifically designed to combat concerns about cost, getting the message across that the service was free, and that it need not have any associated costs (ie past the point of delivery) was not easy.

‘The financial aspects of the scheme need to be spelt out clearly. The construction industry operates on very low margins and will be deterred by an overly costly scheme’. (Construction employer interviewed as a stakeholder)

‘By you coming in and talking to them and doing things, its going to cost them money and it may not be what they’ve got to do as a result that’s going to cost them money, but if they spend an hour with you, they’ve lost an hour’s pay and they won’t do it … They can’t see how spending that time with you is going to benefit them in the long term, if anything it’s just going to cause all sorts of problems. That’s the hardest thing, trying to get it across to the smaller companies that it’s of benefit to them.’ (CBH staff member discussing their impression of the reactions of smaller employers and sole traders)

‘They want something for nothing, they need to know what the benefits will be for them. It has got to be a ‘cashable’ improvement’. (Leicester City Council)

5.4.3 Convenience

A related point, and one raised mainly by individual workers, was how important it was that the toolbox talks and health checks came to them. Users appreciated the convenience of the mobile testing unit which allowed them to be tested with minimal disruption to their working day, and therefore to their earnings. Additionally, all the employers involved in the interviews had arranged for and supported their workers in attending health checks and toolbox talks, and paid wages for the time involved. This was true whether the individuals concerned were direct employees or working as subcontractors.

‘Well the first factor is that it was free, the second factor was the fact that I didn’t have time to take off work to go and see my GP to find out if there was anything wrong with me …’ (General Labourer)

‘This was good because there were certain blokes on this site who hadn’t had a health check in ten years. And because it was free they went and had one. But if it hadn’t have been free they probably wouldn’t have bothered.’ (Forklift Driver)

The experience of using the CBH pilot was contrasted with the difficulties involved in seeing a GP. A number of individuals discussed difficulties in finding the time to make and attend an appointment with their GP, as well as the potential loss of earnings and project delays that could result.

46

‘And they wouldn’t dream of, or have time, to be fair, to go to a doctor. If you’re working five days a week and you’re only home on the weekend, you wouldn’t get a chance until something drastic went wrong.’ (Foreman)

‘The majority of lads, because you don’t get paid, you can’t afford time off so you don’t go to the doctor’s.’ (Site Manager)

‘Obviously difficulties are in this trade we always work to tight deadlines, so it’s obviously having time off work.’ (Manager)

5.4.4 Being seen to be a ‘good’ employer

From the perspective of employers who had used the service, a further attractive feature of the CBH pilot was that it allowed employers to be seen as caring towards their workers, in that they were taking their health seriously and providing support for their staff in effectively managing their health at work. The health of workers was also key to employer involvement with CBH. Looking after the health of their workforce was attractive to at least some of the employers, both as an issue in its own right, but also linked to wider business benefits.

‘I’ve always been really keen on looking after the lads that work for me … Because we’ve not been employing people for so long, I am conscious that I don’t want a claim against me one day to say that, ‘since I’ve been working for COMPANY NAME I’m deaf’, so it’s quite nice to have a base to start with.’ (Manager)

Linked to this employers also felt that health and safety was a reciprocal process, the more information and support that they provided for their workers and the more they were seen to support good health and safety practices, the more their workers would ‘buy into’ health and safety and have a positive attitude towards their employer and the support on offer.

‘I think you get some positive feedback from the guys and they can see that you really genuinely are doing it out of interest for them, rather than some selfish reason. And I think it’s helped the whole sort of feel on the project, definitely.’ (Site Manager)

5.4.5 Real interest by workers in their own health

The primary benefit of the voluntary health tests was viewed by individuals as being the access these offered to information that would allow them to act swiftly on any potential health problems, or be reassured that they were in good health.

‘Just to make sure…there was nothing seriously wrong I suppose, that I didn’t know about, and just to make sure that my health was fine.’ (Gas Engineer)

‘I wanted to obviously see how my health was, my hearing, my breathing, all of that’ (Scaffolder)

In addition, some workers highlighted how they had become involved with CBH because they saw it as an opportunity to deal with a current concern about their own health. It was relatively common for this interest to have been generated by seeing the health of friends or work colleagues deteriorate.

‘I worry about blood pressure and other things like diabetes so I thought it would be a good idea to take part in it.’ (Decorator)

‘I can remember an incident where a friend of mine who was also in the building industry and he had a heart attack … but that was something that could have been avoided if we’d had this sort of thing then.’ (Bricklayer)

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5.4.6 Trust issues

A major construction employer, interviewed at the start of the initiative, was one of a number of stakeholders who expressed a clear view that offering health checks within construction would be problematic, and that trust issues would act as a barrier to take-up.

‘Who do we let see the data? It would be an administrative nightmare, and how far would it (CBH) go in informing people? If site managers are informed there’s a risk that things could get out’. (Construction employer interviewed as a stakeholder)

It was important in practice for the CBH pilot to establish a clear identity as a trustworthy, worthwhile service provider. Employers required a lot of encouragement to open up about any health and safety issues they faced, or which they found difficult to address, as they fear reprisals from ‘officialdom’. There was also an issue in establishing the trust of workers, particularly in assuring them that the results of the tests were confidential. Trust issues could, therefore, act as a barrier to take-up.

‘They don’t want anybody looking at what they have or haven’t got in place, because most of them are worried if they start talking to you, particularly the very small one- and two-man bands, you’re either going to drop them in it with the tax man, the HSE, or whoever else it may be.’ (CBH staff member)

A number of those interviewed felt that in order for the offer of a health check to be taken up by workers it was essential that the service was understood to be both confidential and reliable. It was also mentioned by a number of workers that they felt trepidation about being involved in the service because they feared that it may include tests of their ‘lifestyle’ such as alcohol and drug testing.

5.4.7 Awareness about occupational health

It was generally felt, by both stakeholders and CBH staff, that the service had to work hard to make people understand how it could help them. This included educating employers about occupational health issues, as well as helping them to understand the different service elements on offer and what the benefits were in getting involved in the pilot. These messages took some time to filter through the industry. Employers did not tend to understand or accept that they might need help in effectively managing ill-health issues themselves, or that there was a more general issue within the industry.

‘Quite a lot of the work is changing people’s attitudes, changing the culture of the industry’. (HSE representative)

‘I’ve realised in previous jobs where I’ve been employed to give people advice, people are expecting me to come out, and that’s what I’m there for. [In CBH] I’m actually having to go out and sell what I do to see whether I can get people interested in me giving them free advice.’ (CBH staff member)

‘Two things can change attitudes to health and safety in this industry – a personal experience or seeing success in others and thinking ‘I want a slice of that’’. (Construction employer)

■ CBH was therefore required to start from first principles by ‘selling’ the importance of occupational health within the industry, before they could begin to discuss their own specific services. This also highlights the different philosophies or approaches of the industry and policy partners in the venture. The understanding of employers ‘on the ground’ regarding best practice in occupational health management can fall far short of what policy makers are striving for.

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There was a suggestion amongst some employers that within the industry there had been recent changes to the way that health issues are viewed. Therefore, whilst some managers may have had the will to take forward health issues, CBH was identified as providing them with the means to do so.

‘Health is going to be, and is, an issue. Construction isn’t very good at dealing with health. They’re alright with safety, but health is too hard … So I want to put it on the agenda in our business. And this was the opportunity to put it on the agenda.’ (Manager of CBH user company)

‘I think people’s health is too important to argue about a little time while they go off to do that. It’s not relevant. Health is far more important.’ (Manager of CBH user company)

‘People are aware that historically it’s [the construction industry] had a bad press with long term injuries, and people retiring with back problems and all things like that. And so they’re trying to look at it, I believe objectively as a good employer would.’ (Manager of CBH user company)

‘So we felt that if that helps one person, it’s obviously a good thing.’ (Administrative Manager within CBH user company)

Users of the service often pointed out that having CBH staff on site helped to reinforce messages that they had been trying to communicate to staff for some time. Rather than providing something radically new, CBH was attractive because it provided support for management arguments about what constitutes safe and healthy behaviour. The attraction of the service was precisely because it re-stated what employers were already aware of and had been trying for some time to communicate to their subcontractors and workers. CBH presented managers with the opportunity to give a higher profile to health issues amongst the workforce and, therefore, to pass on their own understanding of what the problems were, which was something that some of them had found difficult to do in the past.

‘I think it was just a general up health and safety consciousness of the whole site to make the lads more aware of what can happen on site and the reason why we make them wear ear and eye protection on jobs … It gives them a better idea of why we push it.’ (Site Manager of CBH user company)

5.4.8 Low levels of existing contact with occupational health or other advisers

Many employers had little or no experience of working with occupational health professionals. Therefore a range of issues, including concerns about cost, lack of trust and understanding what occupational health meant for them could all collide in a distrust of external experts in the field.

Data is available from the baseline employer survey which helps to illustrate this point. Whilst overall, around 28 per cent of employers had used some form of external adviser on health and/or safety in the last two years, very few of these professionals were occupational health specialists (Figure 5.9). In addition, only a limited number of employers surveyed had access to any form of in-house health and safety expertise, and (as would be expected) smaller employers were much less likely to have access to any support at all.

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Figure 5.9 Use of occupational health and safety professionals

0 10 20 30 40 50 60

External health and safety adviser

Occupational health nurse or doctor

HSE inspector or other HSE staff

In-house health and safety adviser

GP

Environmental health

Trade association

Typ

e of

sup

port

% of those using some form of support

Base: All employers who had used some form of health and safety professional in the last two years (N = 545).

Source: IES/IPSOS-MORI Survey of Construction Employer 2004/05

5.4.9 Most appealing aspects of the CBH offer

A useful summary of employer views on take-up is provided by the employer survey. Employers taking part in the survey were asked to state what aspects of the CBH service they found particularly appealing (Figure 5.10). The most popular response was that the services on offer were free of charge. It also appears that the actual range of different services were attractive to employers, as over one-third of the reasons given by employers relate to the actual services on offer (eg training, health checks or site visits). The way in which services were delivered was also an attractive feature, as around 15 per cent of the reasons given related to the confidentiality or professionalism of the service.

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Figure 5.10 Most appealing aspects of CBH services (service users: employers)

0 5 10 15 20 25 30 35

Free service

Health checks available

Training available

Offered a visit

Very informative/knowledgeable

Recommended

Risk assessments available

Marketing appealed

Site visit available

Professional/efficient service

Thought it was a good idea

Confidential service

Provided good advice

Approachable staff

First service I heard about

Other

Don’t know

Mos

t ap

peal

ing

aspe

ct o

f C

BH

% of CBH users

As this was a multiple response question, the percentages shown are greater than 100.

Base for this table was all employers who had used CBH Services (N = 109).

Source: IES/IPSOS-MORI Survey of Construction Employers 2005/2006

5.5 UNDERSTANDING TAKE-UP OF DIFFERENT SERVICE ELEMENTS

Having decided to get involved with the CBH pilot in the first place, employers were then faced with another decision. Which of the different service elements on offer was appealing and/or appropriate for them? Here we discuss some of the issues that emerged during the pilot.

5.5.1 Site visits, risk assessment and document reviews

Site visits were initial briefing visits for the purposes of delivering other elements of the service such as risk assessment or document reviews. The experience of CBH staff was that the initial diagnostic visit tended to identify and confirm a lack of understanding about occupational health issues within the construction industry amongst employers of all sizes. However, it was also true that, in a number of cases, site managers were reluctant to give full access to their site, even where more senior management had given approval for visits. In these cases access could only be obtained to compound and welfare areas, which restricted the type of service that could be offered. In addition to a lack of understanding of the issues, there is evidence from CBH staff that this reflected a certain degree of suspicion or mistrust, as well as fear of enforcement, which was also felt to hinder take-up take of other activities. For example, there was only limited take-up of full risk assessments by employers, as with document review.

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A second reason for low take-up of these managerial-level inputs was felt to be the basic level of employer awareness. Starting with employee health and health checks was more likely to get employers interested. CBH staff reflections on why document review take-up was low indicate that employers often either considered that what they already had in place was sufficient, or were embarrassed by a lack of proper policies and procedures, so that they were reluctant to share this information with outsiders.

There is also anecdotal evidence that where CBH staff were able to get in and deliver a service, this trend was reversed, and that employers became more open to what was on offer and more prepared to take up services over time. Therefore, as word of mouth recommendations increased, the number of employers coming forward may have increased. Additionally, as trust within employers for the CBH brand grew over time, it might have been possible to work in a more in-depth manner with a greater proportion of existing employer contacts (eg moving to health surveillance or case management provision).

It is also worth noting that toolbox talks targeted at employees were extremely popular, in contrast to risk assessments and document reviews which are targeted at management.

5.5.2 Health surveillance

It is clear from the data on take-up that employers were more responsive to health checks than they were to health surveillance. This does have implications for the pilot data, as it is not possible to confidently gross up the figures to a national level. The data on health checks (see Chapter 6) is therefore indicative rather than representative. Without occupational health surveillance it is difficult to accurately gauge the real levels of occupational health problems that exist within the construction workforce tested. This is because the health check testing is reliant on voluntary take-up of tests rather than the use of a standard suite of tests which are administered to all workers.

The provision of health surveillance was also an important aim for the pilot as it is perceived to be integral to good health and safety management and assumed therefore to improve practice with long term benefits to health and business.

CASE STUDY: BARRIERS TO OCCUPATIONAL HEALTH SURVEILLANCE

Only one employer had previously carried out any occupational health surveillance. It is worth discussing how the pilot worked with this employer in more detail, as this was not only the sole employer whose workers had any experience of health surveillance, but also the only employer who expressed any interest in this element of the service.

The employer concerned had around 70 workers. Initially management were keen to take advantage of the offer of free health surveillance, and intended to use CBH to repeat health surveillance they had done previously. However, securing access to the health records of workers, which were kept by another occupational provider, was not possible. The provider in question would not release the data on grounds of confidentiality, although it is likely that this was also driven by commercial concerns. The decision was therefore taken to opt for voluntary health checks instead of starting up a new health surveillance database. To continue the programme of health surveillance would require the comparison with results over time, which would only be possible by going back to the original occupational health provider. However, the technicians involved in delivering the health checks on this site commented that the manager was ‘insistent’ that all workers attended, so the majority of workers did so.

This experience raises issues for new initiatives which seek to take forward health surveillance. Linking with established occupational health providers effectively could be an important factor underpinning successful provision.

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The offer of health surveillance was made to all employers along with health checks. CBH staff are confident that the principle of health surveillance was clearly explained to employers in this study. However, the pilot had a broad range of services on offer, some of which seem to be far more immediately attractive to employers. In amongst a range of other information, employers might not have fully picked up the benefits of health surveillance, and this could have affected initial take-up. Future services that want to promote health surveillance specifically, therefore, could benefit from a simpler approach where health surveillance is the only service on offer.

Further down the line, particularly following the success of the voluntary health checks, it was possible to communicate more effectively with employers about this type of service. By offering larger employers anonymised health check data on their workforce, CBH certainly attempted this dialogue to some degree. However, feedback of this kind was not possible for smaller employers as it would have had the potential to break confidentiality, or may have been seen to do so.

Reflecting on the lack of take-up, CBH staff were able to identify a number of reasons why they believe take-up levels were so low for health surveillance. These included:

■ The presence of subcontractors on sites, and the reliance on self-employed staff – even if these individuals were self-employed for insurance purposes only and did in fact work mainly for their employer. This was felt to complicate the issue for employers. Who should they involve in health surveillance and who could they compel? Employers preferred the simplicity of offering voluntary health checks in many cases.

■ The use of health checks as a way of ‘testing the water’. Some employers may become interested in health surveillance in time, but needed to go through the process of health checks first to gauge the reactions of workers to activities of this type.

■ An unwillingness to commit to ongoing surveillance and the costs that this might involve.

■ Negative perceptions about occupational health providers that they would need to work with in maintaining health surveillance over time. Such providers were viewed as expensive and ‘hit and miss’.

■ Mixed messages from a local insurer who suggested to their policy holders that they would be ‘better off not knowing’ about health problems amongst their workforce in case individuals subsequently made a claim against them. This message was later retracted once proper communication between the pilot and the insurance company involved had been established. However, it did mean that, particularly in the early stages of the pilot, even health checks were felt to be too ‘risky’ by some employers.

5.5.3 Case management

■ In relation to case management, CBH pilot staff always offered and explained this service to employers. However, in all the contact that pilot staff had with employers, not a single employer was able, or prepared, to identify an employee who was on long-term sick leave and/or for whom such a service would have been appropriate. As raised earlier in this report (see Chapter 2), the sickness absence problems that construction faces on an industry level are very difficult to pin down with individual employers. The high degree of subcontracting and self-employment within the industry means that often when individuals do take time off sick, there is no actual cost of this absence to the main contractor or company running the worksite. Employers simply find other individuals to take on the work and are not obliged to provide sick pay or on-going sickness absence management for most of their workforce.

There is also evidence from the case studies on this issue. No employers interviewed as part of the case study activity identified sickness absence as anything more than a fairly minor issue for their company. Very few employers were able to identify workers who were, at that time, not working

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through ill-health. Given the rates of ill-health present in the construction industry, this seems difficult to reconcile. However, as many individuals are not paid for time off work, or receive only the basic statutory sick pay, the perception is that people come to work even when they would be considered too ill to do so in other industries. Additionally, as there is a high level of casual labour, a number of interviewees suggested that there could be a problem with some workers, but because no-one is monitoring their attendance – they don’t show, they don’t get paid – this could mean that many health problems go undetected.

■ Another issue raised by pilot staff was that, for workers for whom sick pay is paid, absence is normally managed by the human resources (HR) function of an organisation. Occupational health support is often only provided for cases of long-term absence or where the company is seeking medical advice to facilitate a capability review or advice under the Disability Discrimination Act (DDA). As the pilot worked mainly with managers outside of HR, or with companies without a HR function, awareness of how the case management element of pilot could benefit employers was not always apparent. In addition, individuals who were off sick at the time of the mobile health checks would have been unable to take part and therefore would have missed the opportunity to self-refer onto the case management side of the pilot.

■ For any initiatives that attempt to take forward case management provision within construction, using employers as the route into work with those who are taking time off sick is clearly problematic. The issue of sickness absence has no resonance for employers and they see no reason to get involved. This raises a question: where are the individuals who are taking time off sick, and how can they be reached?

■ It is difficult to see, given the skills deficiencies that the construction industry currently faces, and will continue to face in the medium to long term, how employers can continue to maintain this position. However, so long as other workers can be easily drafted in to replace those who do fall sick, employers may continue to do so.

5.6 SUMMARY

Service take-up by employers grew steadily over time and there is evidence of extensive repeat use of services, with almost two-thirds of employers receiving more than one service-delivery contact with CBH. We know that many of these will have received a visit from a member of CBH staff to facilitate service provision, but even accounting for this, over half of the employers involved used CBH three times or more.

At an individual level, take-up was fairly consistent over time, from the second quarter of 2005. This suggests that once employers became involved, there were few difficulties in encouraging individuals to participate. This is important because it is in direct contrast with many employers’ preconceived views, and could be important to stress in any future marketing to employers. It is also clear that employers are not always well informed about the needs and interests of their staff. This should be considered in scoping and designing future initiatives.

Low take-up of certain elements of the service was problematic. However, anecdotal evidence suggests that, as employers built a relationship with the CBH team, they became more willing to address the more ‘sensitive’ aspects of their business. Despite this, employer reluctance to take on health surveillance, and to opt instead for health checks which do not form part of the legal requirement to manage OH was disappointing. One learning point from the pilot is that to work effectively with the construction industry, and possibly others, there is a need to tackle management views on occupational health, and on what constitutes good occupational health management, directly.

Amongst survey respondents operating in Leicestershire, 40 per cent had heard about the CBH pilot. Larger firms were most likely to be aware of the services on offer (66 per cent), and sole

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traders the least likely (just 32 per cent). The most attractive feature of the service, and the reason why many employers initially got involved, was that it was offered for free. However, the actual services on offer were also attractive, as was the professionalism of the staff involved. Case study work revealed also that employers feel that getting involved with health issues puts forward a good message to staff about the type of employer they are. This reflects the opinion that health is becoming more important within construction, and that more employers are beginning to understand the importance of maintaining a healthy workforce.

The main reason given by employers for not using CBH services related to the fact that they did not believe that they could be helped, because they already managed health and safety issues well. Other reasons included a lack of interest in the services provided by CBH, existing access to occupational health support or a lack of time.

Amongst individuals, the convenience of the service was the most attractive feature. They did not have to leave work and hence lose time or money. The positive response of workers, and high take-up levels on sites, was a surprise to most employers who, incorrectly, assumed that the prevailing culture on sites and a lack of interest in health issues amongst the workforce would work against the pilot. Satisfaction levels amongst users were high, with 95 per cent of survey respondents satisfied or very satisfied with the services that they had received.

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6. HEALTH CHECK OUTCOMES

The CBH pilot set their own target of delivering 1,250 health checks to individuals. In fact, provider records show that a total of 1,724 construction workers used the mobile testing unit facilities. This represents an average of 11 or more workers for each site visited. Overwhelmingly, those using the service were male, with just 42 women tested (reflecting generally low levels of female employment within the construction industry1). Amongst participants, 1,271 were employed, 127 were self-employed, 177 held a CIS certificate, and 149 declined to disclose their employment status.

The results of the health checks give some insight into the impact of CBH on the early detection of health conditions.

6.1 TYPE AND SCALE OF TESTING

■ The service offered three types of formal medical interventions (voluntary health checks, safety critical checks and health surveillance). However within the pilot, all the participants took part in the voluntary health check programme. No employers took forward any form of health surveillance (see Chapter 5 for further details on lack of take-up).

6.1.1 Health check locations

The majority of the health checks took place on construction sites. In addition, the mobile testing unit was located at a number of central points (for example, Builders Merchants’ premises) to try to engage self-employed and individual construction workers, but with only limited success. The main benefits of operating on sites is that workers can easily be released for the time required to take the test and are able to book themselves in for a specified time slot. In contrast operating in a more ad hoc manner (eg in Builders Merchants) had the problem that individuals were not aware in advance of the presence of the health check van and therefore could often not spare the time at that specific moment. This is a useful learning point for future work with construction employers and workers. The best approach is to take your service to them, as they are unlikely to have time to come to you.

6.1.2 Take-up of different tests

■ The procedure of testing followed a set of standardised tests (as outlined in Chapter 2). Individuals were encouraged to take all the tests, but were free to opt out of any test as the health checks were completely voluntary.

■ Whilst, overall, there was a good take-up of the different testing procedures (between 97 and 98 per cent of those tested elected to have their body mass index measured, or had their blood pressure, hearing or lung function tested), there was a slightly lower take-up of the urinalysis. Pilot staff reflecting on this believe that this is due to some suspicion of the purpose of the tests, and concern that employers were using the service to ‘weed out’ unfit workers or to screen worker drug and alcohol levels, even though this in no way formed part of the urine tests.

6.1.3 Safety critical checks

The monitoring of safety critical workers was another side of the health check activities. This involved examining individuals whose job required them to be medically and physically capable of

See http://www.dti.gov.uk/files/file34487.pdf for a detailed breakdown of construction employment.

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1

safely carrying out their work without endangering themselves or their fellow workers (for example, a mobile plant driver). Where such cases were identified, it was made clear to both employers and to the workers taking up the healthchecks that abnormal test results on safety critical conditions would be shared with the employer. All other test results remained confidential. There was some initial concern by union representatives on the CBH steering group about this approach, with the fear that this may act as a disincentive for individuals to take part. In practice, however, no individual participating in the voluntary health check programme, and who was considered to be a safety critical worker, recorded medical results which failed to meet the acceptable fitness criteria.

It should be noted that fitness for work is not solely determined by occupational health issues. Some duties, for example, machine operation, may be unsafe for individuals with general health issues such as poor eyesight. Also, the issue is not only about the safety of the individual concerned, but also about others working on the site, particularly in the case of driving jobs or crane operation. It was, therefore, challenging for the pilot to work with appropriate safety critical standards, particularly as no specific safety standards exist for the construction industry. Some attempts were made to develop new standards specifically for this pilot, but the process was felt to be too complex to complete within the project parameters. The decision was therefore taken to use existing standards and the ones chosen were the DVLA Group 2 driving standards, which are already widely used by occupational health providers to assess safety critical workers across a range of occupations.

6.1.4 Feedback and referrals

Individuals taking a health check were provided with a results sheet which set out the results of the medical tests in which they participated. They were also counselled about the results and advised as to preventive care and the need to wear personal protective equipment (PPE). Within the pilot, individuals with an occupational health issue were followed up, as necessary, by the Occupational Health Nurse and Occupational Physician. For general health issues, the individuals were referred direct to their own General Practitioner. A small proportion of individuals were referred to their GP with a work related issue after counselling by the Occupational Health practitioner delivering the health check. This occurred where it was considered that the GP was best placed to follow up the case or facilitate onward referral to a non-occupational health specialist (ie an ear, nose and throat specialist for hearing matters or a respiratory specialist for lung function issues).

Once the site visit was complete, site managers of larger sites were provided with a health check report which summarised the overall medical results. This report also included an overview of the medical tests explaining the tests carried out, the procedure adopted and an explanation of the criteria for each medical procedure.

6.2 INTERPRETING THE RESULTS OF THE TESTS

■ It is important, before presenting the results of testing, to note a number of points about how these results should be interpreted. The main issue is that using these test results as the basis for any national estimates (by grossing up from the base numbers) would be incorrect. Even if it was appropriate to gross up figures from the results of the CBH pilot to allow comparison with national estimates, it would be difficult to comment on the rates of health problems detected. Little comparable data on prevalence rates for the construction industry exists.

■ The checks administered were not part of health surveillance, so individuals were able to opt out of testing entirely or opt out of specific, individual tests. Therefore the data presented in this chapter is not actual population data for the workforce of those employers taking part in CBH.

■ There were also some practical difficulties related to conducting healthchecks on some construction sites (although only in a minority of cases) and doing so during normal working

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hours. Offering a convenient service to workers was a key part of the work of the pilot, therefore operating on or close to work sites was critical, as was offering checks throughout the working day. As a result, ideal testing conditions were not always available, but during all tests accepted normal practices for testing were in place (see next section for further details). The extent to which these issues impacted on the test results is unclear. The view of pilot staff is that there is unlikely to be any large scale bias in the results, but this cannot be externally verified as the pilot was not able to access any GP follow-up data or information on the results of other referrals.

6.3 TEST RESULTS

The results of all the testing procedures are presented in Table 6.1, including the numbers of individuals screened for each test and the number of abnormal results recorded for each medical procedure. This data has been provided by RPS Business Healthcare and, due to issues of confidentiality, the raw data was not shared with the evaluators, therefore it has not been possible to conduct any further analysis than that presented here.

The key findings are that the voluntary health check programme identified that:

■ approximately one-third of those participating had occupational health issues, predominantly caused by noise exposure, with some vibration issues

■ approximately one-third of those participating had general health issues, predominantly related to blood pressure, respiratory and blood, protein and/or sugar in urine.

Table 6.1 Test results for voluntary health checks conducted by CBH

Abnormal Number Medical procedure Number screened criteria abnormal % abnormal Hearing test 1,675 HSE Cat 3 83 5.0

HSE Cat 4 416 24.8 Vibration 1,724 Suspected 92 5.4

Confirmed 6 0.3 Skin assessment 1,724 Symptoms 21 1.2 Lung function 1,690 FEV1/FVC <80% 101 6.0 Vision 1,724 Referred to

optician 14 0.8

Body Mass Index (BMI) 1,693 30+ 274 16.2 Blood pressure 1,680 Systolic > 150 163 9.7

Diastolic > 95 164 9.7 Urine 1,311 Glucose 16 1.2

Protein 8 0.6 Blood 104 7.9

Smoking 1,724 Smokers Non Smokers

558 794

32.4 46.1

Ex Smokers 192 11.1 Unknown 180 10.4

Source: CBH End of Project Report 2006, Analysis by RPS Business Healthcare

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6.3.1 Occupational health issues

A range of tests were carried out which dealt with the some of the most common health issues within the construction industry. The results are as follows.

Noise

The largest single work related issue identified by the testing was noise exposure. The categories used to determine hearing loss were current at the time of the pilot, but have now been changed. The ‘old’ categorisation is therefore used to describe the results of tests. Around 30 per cent of those tested for hearing loss fell within the (old) HSE categories three and four.

In some cases, it was necessary to conduct hearing tests close to loud background noise. This could have led, in the cases of some individuals, to a false abnormal result. However, it should also be noted that a number of other factors could equally affect testing, including temporary threshold shift (eg from incorrect use of ear protection on site – although in noise zones workers should have been wearing the necessary hearing protection), and non-work factors such as loud car stereos used on the way to work. It should be stated, however, that very loud sites appear to be the minority of those involved in the pilot. Most sites visited were smaller building sites and housing developments where noise levels are generally lower than on large projects and major commercial developments, for example. Steps were also always taken to locate the testing unit on the quietest part of the site available to reduce ambient background noise as far as possible. If tests were disturbed by outside influences they were re-taken.

Pilot staff are, therefore, confident that despite some practical difficulties the vast majority of tests were accurate. All individuals were referred on to further health provision to determine whether a condition existed or not. However, the pilot does not hold data on the outcomes of these follow-ups. It is therefore not possible to definitively determine the extent to which, if any, overestimation of abnormal results took place.

In some hearing tests, individuals had a pre-existing diagnosis of hearing loss, but in a number of cases this was through previous exposure in industries such as mining or steel. Therefore the attribution of hearing loss to working within the construction industry is difficult for at least some of those tested. Serial data and regular testing would be required to provide suitable historic data. Records which involved a hearing test on entry to the construction industry would be the only way to accurately measure the real effects on hearing loss of working in construction.

Attempting to place these results in the context of national data is also difficult. With audiological conditions, we would expect differences in the levels of abnormality detected between objective test results (such as CBH figures) and self-report assessments (such as the Labour Force Survey which is the main source of comparative data). Often with hearing loss individuals are unaware of problems, they simply attribute any symptoms to ‘getting older’.

Vibration and skin

Six per cent of the sample exhibited ‘damage’ results from vibration exposure, and six cases were considered to be vibration white finger (VWF). Skin assessments were also undertaken, and just over one per cent of individuals tested were identified by CBH as having some form of skin condition.

The nature and extent of symptoms relating to skin conditions and exposure to vibration were determined via self-declaration. A standard, and widely accepted, question and answer approach was employed, which relies on individuals answering a series of questions honestly. In the case of CBH, however, an occupational health professional was also available to look for any visible symptoms. Despite this, it is possible that some under-reporting was present if individuals

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deliberately failed to declare symptoms. This may have been the case for workers who held fears about the effect that a diagnosis would have on their employability. Anecdotally, CBH staff believe that there was a particular concern amongst workers that to disclose vibration symptoms would result in a loss of livelihood. One example was an individual with confirmed VWF who was counselled to avoid further exposure, and to inform his employer about his condition, but who rejected this advice.

6.3.2 General health issues

In addition to the occupational health testing, a number of general health tests were carried out.

Smoking

A simple discussion of smoking habits revealed that almost 80 per cent of workers tested were current or ex-smokers (although further details on the level of smoking involved, eg light to heavy, were not collected). The level of cigarette consumption, however, was not determined in any further detail.

Urinalysis

There were some practical issues with the urine tests, and the proportion of individuals giving urine samples differed from site to site. Reasons for this included: reluctance to give a sample; having washed up before attending the health check unit, including using the toilet; and tests taking place on sites where the unit was too remote from the toilets to make taking the test practical. There was some concern that urine tests were being used to screen for drugs and alcohol which was not actually the case. These concerns did appear to recede over time, however as the service became more established.

Blood pressure and Body Mass Index

Just under ten per cent of workers were identified with a systolic blood pressure of greater than 150 or a diastolic blood pressure of more than 95. However, it should be noted that repeated measurements of blood pressure are important in order to get accurate results. A single high measurement does not necessarily mean that an individual has abnormal blood pressure.

There are several factors which could lead to a false abnormal reading. For example: a psychological reaction to being in a health test environment which raises blood pressure, commonly known as ‘white coat syndrome’; or having recently eaten or drunk caffeine. It is also possible that individuals involved in very physical work immediately prior to the test may have had insufficient rest time to bring their blood pressure down to its normal level. However, checks were administered at the very end of the healthcheck, to control for this as much as possible. The average health check took around 45 minutes, with the blood pressure check taking place approximately 30 to 35 minutes into the check. This should, therefore, have been sufficient resting time prior to the check for the vast majority of participants.

Just over 16 per cent of workers were found to have a Body Mass Index (BMI) of over 30.

6.4 TRENDS BY AGE AND TRADE

To provide a further insight into the medical results of the pilot the abnormal results have been further analysed by job category and by age of the participants (Table 6.2 and 6.3). As the raw data was not provided to the evaluation team, these percentages are based on the total number of individuals in each age group taking any of the tests. Fewer than 100 per cent took some of the tests, therefore these figures are subject to some inaccuracies as not everyone took all the tests.

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However, as discussed earlier in this chapter, take-up of tests was high, therefore the scale of inaccuracy is likely to be negligible for all tests.

There were clear patterns by age, with the likelihood of an abnormal result on the health tests increasing with age for all tests conducted. The greatest shifts by age were in relation to hearing loss, high BMI, and blood pressure, all of which were far higher amongst workers aged 40 or over. In contrast, the likelihood of workers being current smokers actually decreased with age, as more older workers had given up the habit, whilst the proportion of non-smokers (rather than ex-smokers) was also highest amongst the youngest age group. This could suggest that, over time, there will be reductions in the numbers of smokers in this group, as fewer of them will ever have been smokers.

Table 6.2 Analysis of abnormal results by age band

Total (N) Smokers

Audio cat BMI Blood Urine Age band in age band 3&4 30+ pressure Yes No Ex +ve HAVs

Under 25 years 210 15.7 8.1 1.0 43.8 60.5 4.3 3.8 3.8

25-40 years 757 22.3 10.3 6.7 33.7 40.8 7.1 5.3 4.5

Over 40 years 757 39.2 23.6 36.2 27.9 47.3 17.0 10.6 7.4

Total 1,724 28.9 15.9 19.0 32.4 46.1 11.1 13.2 5.7

Base – 29.8 16.2 19.4 36.1 51.4 12.4 9.7 5.6

Source: CBH End of Project Report 2006, Analysis by RPS Business Healthcare

There was a range of differences according to the type of jobs individuals held. In interpreting these, we have considered those trades whose abnormal results levels are above average, and discussed the top five trades in each case. In more detail, the results were that:

■ General operatives (ie those without a skilled trade providing general labour on site) were amongst the top five most likely worker groups to have hearing loss, high BMI, high BP, smoke and have HAVs. This was the group with the most negative overall results, and they actually had the highest levels of positive results for high BMI, BP and smoking levels of all the trades. This group are likely to be the least skilled and most poorly trained within our sample.

■ There were four trades which were in the top five (in terms of abnormal results) for three different tests:

□ bricklayers – for whom abnormal BMI, BP and HAVs levels were all higher than average

□ drivers – for whom hearing loss, BMI and smoking levels were all higher than average

□ painters (although only a small group of these took tests) – BMI, BP and positive urine tests for these workers were all above average

□ steel erectors – for whom hearing loss, urine and HAVs were all higher than average.

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Table 6.3 Analysis of abnormal results by job category

Total (N) Audio BMI Smokers Urine

Job type in cat cat 3&4 30+ BP Yes No Ex +ve HAVs

Bricklayers 130 32.3 20.0 25.4 22.3 56.9 10.8 3.8 6.9

Carpenters/Joiners 174 33.3 6.3 7.5 27.0 52.3 8.6 4.6 4.6

Drivers 45 40.0 22.2 22.2 55.6 20.0 17.8 8.9 0.0

Electricians 130 19.2 13.8 7.7 28.5 48.5 10.0 6.2 4.6

Ground Workers 206 32.0 16.5 16.5 46.1 37.9 7.8 6.8 8.3

Operatives 59 37.3 28.8 28.8 47.5 32.2 10.2 8.5 11.9

Plumbers 71 28.2 8.5 11.3 35.2 50.7 11.3 4.2 5.6

Roofers 38 31.6 18.4 13.2 44.7 34.2 7.9 7.9 2.6

Scaffolders 51 45.1 7.8 7.8 43.1 39.2 3.9 5.9 3.9

Steel Erectors 35 37.1 17.1 17.1 34.3 34.3 22.9 17.1 14.3

Office Staff 343 20.1 23.9 26.5 20.4 58.3 13.1 8.5 2.9

Miscellaneous 380 28.4 11.3 22.4 33.2 38.7 12.9 9.5 7.4

Glaziers/W.Fitters 28 (39.3) (10.7) (7.1) (28.6) (57.1) (7.1) (3.6) (-)

Painters 24 (29.2) (20.8) (25.0) (37.5) (45.8) (8.3) (12.5) (4.2)

Plasterers 11 (45.5) (18.2) (27.3) (72.7) (45.5) (9.1) (-) (-)

Base 1,724 499 274 327 558 794 192 128 98

Total 29.8 16.2 19.4 36.1 51.4 12.4 9.7 5.3

* Miscellaneous includes:-

Air Conditioning Engineer, Asphalter, Assembler, Batching, Catering, Ceiling Fixer, Cleaner, Concrete Finisher, Data technician, Ductor, Fencer, Industrial Cleaner, Landscaper, Lift Engineer, Partition Waller, Punch Operator, Recovery Operator, Recycling, Refrigeration Engineer, Security, Storeman, Tarmacer, Tiler, Tool Hire Manager, Ventilation Engineer, Yard Foreman, etc.

Source: CBH End of Project Report 2006, Analysis by RPS Business Healthcare

6.5 REFERRAL TO GENERAL PRACTITIONERS

The health checks identified that 578 (approximately 30 per cent) of those participating needed to be referred to their General Practitioner for further action and/or follow-up. The reason for referral was predominantly blood pressure, spirometry, and or an adverse urine test (as summarised in Table 6.4). It should be borne in mind that the individual may have been referred for more than one reason and hence the numbers of abnormal test results exceeds the total number of referrals made. A further 14 individuals were referred to an optician for an appropriate eye test following an abnormal eye test result. Within the scope of the pilot it was not possible to conduct a large scale follow-up of those referred onto their GP.

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Table 6.4 Referrals to GP

Total number of tests Reason for referral Abnormal criteria resulting in referrals

Blood pressure Systolic > 150 163 Diastolic > 95 164

Lung function 80

Urine test Glucose 16 Protein 8 Blood 104

Work issues 97

Total 632

Source: CBH End of Project Report 2006, Analysis by RPS Business Healthcare

6.6 SUMMARY

All of the tests carried out by CBH were undertaken on a voluntary basis, despite employers being offered the opportunity to utilise health surveillance. As such, individuals were free to opt in or out of any of the suite of tests on offer, although they were encouraged to take up all tests. In practice, take-up of most of the tests was high, although in some cases if individuals did not self-report symptoms (eg musculoskeletal issues or hand arm vibration), occupational health staff were unable to detect all but the most obvious cases. Therefore it is possible that some underreporting of those tests without objective measures was present. Workers could be motivated not to report symptoms if they feared being identified as unable to continue working. In addition, there were some initial fears around the urine test, with some workers incorrectly assuming that they would be screened for drugs and alcohol. This affected the take-up of urinalysis, which had the lowest recorded take-up (although still comparatively high) of any of the health tests.

The main work-related health issue identified by the pilot was noise exposure, with around 30 per cent of those tested within HSE abnormal categories three and four. In a small minority of cases, conducting hearing tests in optimal conditions was not possible (due to loud background noise on some sites), but in the absence of follow-up data the scale of any bias is unclear. Pilot staff do not feel the bias to have been significant.

Six per cent of the sample exhibited damage results from vibration exposure, although only six actual cases were confirmed as vibration white finger.

The likelihood that individuals would have an abnormal result increased with age, and often the over 40-year-olds were far more likely to have problems. It is worth noting that a number of the tests (eg audio and lung functioning) are age weighted, however. For example, in relation to hearing loss, regulations regarding the use of ear protection were not in place until 1972, so it is likely that this will be a factor for older workers and, in any case, age-related hearing loss will be present. In addition there were certain occupational groups that were more likely to have higher-than-average abnormal test results. These included: operatives, bricklayers, drivers, and steel erectors.

As the health checks were voluntary, the test results do not constitute accurate population data. Individuals could self-select into testing and within this into specific tests. It is possible that some self-selection occurred (eg by those with particularly poor or good health). The results only reflect the results for the population of workers who actually took the test. It would, therefore, be extremely misleading to attempt to estimate the prevalence rates for the industry from the results of this pilot, particularly in the absence of any industry-specific comparative data.

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7. USER VIEWS ON CBH AND SELF ASSESSED OUTCOMES

An important part of any service evaluation is determining the reception that it received from users. Was the offer fit for purpose and well received by its target audience? In this chapter, the views of companies and individuals taking part in the pilot are considered, as well as the views of employers operating in the area who chose not to take up the CBH offer, and their reasons for not doing so. Two main data sources have been used: the Wave Two employer survey, and employer and worker interviews conducted during autumn 2005 and 2006.

7.1 USER SATISFACTION

The employer survey revealed that service users were extremely satisfied with CBH, with the vast majority (93.5 per cent) stating that they were either satisfied or very satisfied with the overall level of service they had received. This is certainly very encouraging. However, case study data and follow-up questions in the employer survey allow us to better understand reactions to the different aspects of service.

Unfortunately, the case study work did not pick up enough employers receiving service elements such as risk assessments and document reviews to allow detailed comments on these. User views, in the main, therefore, reflect reactions to only the two most popular services offered, namely health checks and toolbox talks.

7.1.1 Views on the health checks

The interviews revealed that health checks were regarded as a good idea and were popular among both employers and workers. The level of service was considered to be of a high standard and the tests extensive by the majority of those who received them.

There were, however, some initial reservations amongst both workers and managers. Despite agreeing to the health checks, and encouraging workers to participate, the majority of managers still had concerns about take-up amongst their workforce. The common perception was that workers would be sceptical about the service, and that the prevailing culture on site could prevent people wanting to come forward and identify themselves as having had a check.

However, on some sites whilst bookings could be slow to start, once one or two individuals had signed up, people became more willing to put their names down too. Contrary to stopping people signing up, discussions on site and cultural influences seemed to support the work of the health checks. On a number of sites, the site managers could identify the individuals who had not taken up the checks, and these individuals were seen as outside the norm, rather than those who actually participated.

‘…the health checks – yes, I was actually surprised how well it turned out with the attitudes etc. … I thought they’d not want to do it and think it was a waste of time but that wasn’t the case.’ (Site Manager)

‘It’s a bit like peer pressure – it was very slow at first to get people to go on those health checks but eventually more people did and it was, oh yeah, I’m going to have a health check.’ (Site Manager)

Despite preconceptions that health issues are not of interest to construction workers, there is strong evidence from the popularity of the health testing unit that this is not the case. On most of the sites visited, the available sessions with the mobile testing unit were fully booked. On a couple of the sites the services were so popular that they ran out of time on the first day and were unable to see all those who wished to take part.

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‘We’ve had at least 80 to 90 per cent total (taking the health checks), possibly more.’ (Site Manager)

‘… we had a full appointment sheet and the lads couldn’t get in there…. They were all talking about it and if it just increases their awareness it’s done something.’ (Site Manager)

‘I mean sometimes they’ve come down and left the van here for two days because they’ve had like 30 people to do in one visit.’ (Construction Manager)

Most people who spoke about the health checks were entirely positive. However, one criticism was raised by a number of those interviewed; this was the accuracy of the tests held on work sites (discussed further in relation to the test results in Chapter 6). One organisation found that a surprisingly high percentage of their workforce had hearing problems, but then when they were retested by their GP their results were fine. This problem was attributed to the proximity of the mobile testing unit to very noisy machinery which was drowning out the noises of the test. Similarly with blood pressure testing, a number of workers were informed that they had high blood pressure but when they were retested at their GP their results were normal. This was put down to the stress of being at work and the inaccuracy of electrical blood pressure testing kits. A worker who had already been diagnosed with diabetes before the health check was of the opinion that a urine test was not a good enough way of finding out if workers had diabetes as their blood sugar would have to be very high for this type of test to detect it; he felt that a blood test would have been a more accurate approach.

There were also some instances where managers identified problems with the tests and with the feedback that individuals had received about their own health. Again, the tests identified as problematic were hearing tests and blood pressure checks.

‘The ears one was awkward because there’s always noise on a building site so when you’re in the booth you can always hear things going on.’ (Manager)

‘The only problem was that one of the joiners came to me and said he seemed to have high blood pressure and he went to the doctor’s a few times after and it was because he’d been on site working and didn’t take into account the fact that he’s been hitting nails in all day so he’s obviously going to be ... it’s not from a resting position so that’s ... some of the checks need to take into account that they have been working all day doing manual labour.’ (Site Manager)

Such problems, however, were not common, but they do suggest the need for caution in the interpretation of results in some work environments. This must, of course, also be balanced against the need not to miss health problems or fail to refer where necessary. Good communication about these issues between the practitioner and individual is, therefore, important, as is knowledge of the types of work that individuals have been engaged in, and their work environment, in interpreting test results.

When talking about the health checks, a number of workers brought up chronic health issues. Some of these related to the particular nature of construction work (eg back and joint complaints). It is interesting, therefore, that these are not reflected in the results of the health checks. This could be partially explained by the fact that many workers were of the opinion that these health concerns were part and parcel of working within construction. They may, therefore, not have considered themselves to have a problem, even given evidence of symptoms. They may simply be ‘normalised’ by working with others with similar problems to believe that symptoms of musculoskeletal problems are natural.

‘You do suffer with your back a bit, possibly with the ankles. I’ve pulled the ligaments in both of my ankles. It’s just one of those things.’ (Digger Driver)

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High blood pressure was another commonly mentioned existing health complaint experienced by individuals. This does, however, appear to be reflected in the health check results.

7.1.2 Views on the toolbox talks

The majority of those who received the toolbox talks were also extremely positive. As with the health checks, there was some scepticism amongst managers about whether their workers would actively engage with the messages and delivery. A number of site managers, however, specifically reflected that in fact the sessions worked well, and became far more interactive than they might have imagined. The material and presentational style of the talks were generally very well received.

‘... with the toolbox talks, they’ve ended up being quite interactive at the end. And there’s been quite a buzz around site in terms of what’s been happening… like we’d planned for half an hour, some of them have maybe taken it to an hour.’ (Site Manager)

‘I think when you come onto a building site which is mainly male-orientated, you’ve got to have a certain character to get them to listen and understand … you’ve got to be able to talk to them at their level for them to understand and I think she came across really quite well…’ (Manager)

‘I saw all the material and the material was good …’ (Manager)

Some employers, however, would have welcomed a more tailor-made talk for their staff. A small number felt that the information was too general for their requirements and did not address the health and safety issues specific to their particular trade or work area. There were examples where organisations overcame this issue by arranging for CBH staff to return to their site and give another talk with the information more tailored to their specific needs. This provision was discussed and developed on the suggestion of CBH staff.

‘I think the fact that the course was tailor-made for us was all good.’ (Manager)

Overall, both employers and workers commented that the toolbox talks were useful as they gave them a general overview of the key health and safety issues. In some cases the view was that the information provided precisely met their needs. Managers welcomed the toolbox talks, and supported the training by covering the staff costs, including for subcontractors, involved in releasing staff to attend.

A number of employers commented that they appreciated the importance of providing such talks on an ongoing basis. It was felt that workers would maintain good practice and knowledge for only a relatively short period of time after a talk, so providing continual information was seen as the way to maintain healthy behaviours. The management information shows that, in many cases, following their first training delivery CBH has been successful in securing repeat business from a number of larger employers. Amongst those interviewed this included visiting all the sites that the company operated within the pilot area. For other employers, multiple visits to one site also took place.

Most of the workers interviewed spoke more about the reinforcement of messages through the toolbox talk than new learning. However, they often pointed out that they felt others had benefited from new learning.

‘It was interesting. There were one or two things about the vibration with the white finger, it didn’t tell me too much that I didn’t know already, but if you showed that video and did what we did last week to someone who has been in employment for 18 months to two years, it would make it sink in. But when you’ve done this kind of work for 15 odd years, it’s like they’re refreshing you.’ (Landscape Gardener)

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‘I’ve had training on most of those issues so I was aware of most of it anyway. I always find it helpful because then people who are not aware of those issues are made aware of them. They are vital to make people aware of what’s going on.’ (Forklift Driver)

Looking forward, supporting employers with some form of regular training programme could be a useful way of encouraging good practice. Ideally, however, this should tackle ideas at a managerial as well as a worker level. The experiences of CBH in attempting to market management training (only one company took up the offer of management training – see Chapter 5 for further reflections on the reasons for this), however, shows how hard this can be.

7.2 SELF-ASSESSED OUTCOMES

Given that the main services provided by CBH were well received by their target audience, a further issue is whether the individuals receiving the services believe that they made any difference to them. In this section we consider how CBH users view their progress on health and safety issues since their involvement with the pilot. Chapter 8 provides further analysis of the employer survey to put these views in a more objective context.

All employers who could recall having used CBH services were asked whether they had made any changes to the health and safety practices of their company as a result of their contact with CBH. Thirty-eight per cent of employers had made some change, and a further 15 per cent planned to do so in the future (Figure 7.1). However, a significant minority (43 per cent) had no plans to change. Amongst the 58 employers who had made changes or planned to do so, the most common change discussed was that their own awareness of risks had improved, that they had introduced health checks or that a health and safety policy had been introduced or updated (Figure 7.2).

Reflecting on these results, it is clear that much of the change that has taken place relates to awareness, attitudes and policy. Employers were less likely to identify changes to the way that risks were controlled on site or to report new systems of work being put in place. This contrasts with the approach recommended by HSE where the focus should primarily be on risk removal, with the use of PPE the last line of defence if risks cannot be eliminated or controlled in other ways. The reliance on low-level risk control was a consistent theme amongst employers, as discussed in the remainder of this chapter.

Figure 7.1 Changes to health and safety practice as a result of contact with CBH

0

5

10

15

20

25

30

35

40

45

50

Yes No, but plan to No, and don’t plan to Don’t know

Whether made any changes

% o

f se

lf-i

dent

ifie

d us

ers

( ).Base: all employers who identified themselves as having used CBH services N=109

Source: IES/IPSOS-MORI Survey of Construction Employers, 2005/2006

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Figure 7.2 Most common changes to health and safety made by employers

0 5 10 15 20 25 30 35 40 45 50

Greater awareness of risks

Introducing health checks

H & S Policy introduced/updated

Greater control of risks

Risk assessments conducted

Introduced dedicated health and safety role/committee

Better consultation with staff

Sickness absence policy introduced/updated

Return-to-work/rehabilitation policy introduced/updated

Other

Cha

nges

mad

e to

hea

lth

and

safe

ty p

ract

ice

% of employers

Please note as this was a multiple response question, the percentages shown are greater than 100.

Base: all employers who had used CBH Services, and who said that they had either made, or planned to make, changes to health and safety practice as a result of contact with CBH (N = 58).

Source: IES/IPSOS-MORI Survey of Construction Employers, 2005/2006

The main reason given by employers for not making any changes after contact with CBH included that CBH staff had confirmed the employers’ current approach to health and safety management was appropriate (Table 7.1). A small number of employers indicated that it was either too time-consuming or difficult to make changes, or that they were simply unclear how to do so.

Table 7.1 Why have some CBH service users not made changes to health and safety practice?

Why no changes to health and safety practice? % N Visit confirmed current approach 78.7 37 Unclear how to make changes 6.4 3 Too difficult 4.3 2 Too time-consuming 2.1 1 Other 8.5 4 Don’t know 2.1 1 Base (N) 47 –

Please note as this was a multiple response question, the percentages shown are greater than 100. Note also the small base size for this table. Note: Base for this table was all employers who had used CBH Services, and had indicated that they had not made, and did not plan to make, any changes to their health and safety practice as a result of contact with CBH. Source: IES/IPSOS-MORI Survey of Construction Employers, 2005/2006

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7.2.1 Employer practice

The original design of CBH was that it should tackle both management and worker behaviour through an extensive suite of services. In practice, the majority of time CBH spent on site was with workers. Management were generally reluctant to get involved themselves in training or to accept advice on their practices and procedures. It is, therefore, not surprising that most of the evidence of change as a result of CBH is at the worker level. However, for all impacts to be about worker behaviour, certainly from the policy perspective, is less useful than if widespread change could be evidenced at managerial level. The HSE sees management as the primary force for change within the work environment, and would not therefore expect changes to worker behaviour alone to improve the performance of an industry in terms of occupational health. From an industry perspective, however, it is likely that evidence of any change, at worker level or above, will be welcomed.

The most common reasons given by employers for not making changes at a managerial level following their interactions were that everything was already in place or that there wasn’t a need to change anything. It seems unlikely that this optimal performance in relation to occupational health is actually the case across the board. One of the main learning points from the pilot is, therefore, that future initiatives will need to adopt a different approach to working with management and encouraging them to take a more in-depth look at what they do. Initial perceptions from industry representatives that it would be most difficult to engage individuals at worker level have proved unfounded. It is managers who in fact seem most reluctant to accept advice or to make the changes necessary to move forward.

Despite this, there were a number of examples where employers were keen to discuss changes to the way they operated. At least one employer had used feedback from the health checks as evidence that changes in work practices or the purchase of new equipment were necessary for the future, but had not actually made these changes at the time of the interview.

To illustrate the types of change that have been experienced within employers, three case study examples are provided here.

CASE STUDY 1: OVERCOMING RELUCTANCE AND PUTTING HEALTH ON THE AGENDA

Employer details: 100 or more employees nationally, engaged mainly in newbuild.

The site visited was a large commercial development with 150 staff, but with only three employees of the main contractor on site. Subcontractors were used to carry out the majority of work. CBH staff delivered toolbox talks on two separate occasions offering around six sessions on each visit to accommodate all staff, and two visits from the mobile health check unit.

The site manager admitted to having initial reservations about the CBH service, particularly in relation to how workers would react to it.

‘I was sceptical over it. I thought this was going to be a disaster because you have all macho men and they don’t want to know anything, but the take up from the health check was phenomenal…They were queuing to get in.’

In addition to a high take-up of the services on site, the manager was also able to identify changes that had been introduced to company policy on health testing. He attributed these changes to a combination of the company’s desire to do something in this area, and the momentum that the CBH service had provided to encourage them to do so.

‘We’ve now taken it on board ourselves. [Company name] had always been looking at doing it and whey wanted to move it on…they’re now taking it on themselves full time.’

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Another change was evident at site level.

‘We enquire about people’s health now when we book them into site the first time. We ask them if they’ve got any health problems and all things like that. I still think we could probably make more of it as well. We’re now a lot more aware of what happens through [CBH staff member’s name]’s visits to do the toolbox talks’.

There were also changes at the level of individual workers.

‘When I work with it (cement), you do tend to cover up now whereas I wouldn’t have bothered before. But you don’t realise that it does what it does until you see the pictures the lady shows you…it does make you more careful when you are around any of those items.’

Overall, for this company, the benefits of CBH had been:

■ raising awareness of health issues amongst both management and workers on this particular site

■ the introduction of new policies on site about worker health, specifically discussions at the point where new workers begin to work on the site so that health issues could be monitored

■ an impact on wider company policy, helping the company to move forwards to regular health screening.

CASE STUDY 2: REALISING THE IMPORTANCE OF HEALTH MONITORING AND BETTER COMMUNICATION WITH SUBCONTRACTORS

Employer details: 100 or more employees nationally, engaged mainly in newbuild.

The site visited was a medium-sized commercial build, involving range of subcontactors, around 90 per cent of whom travelled to Leicester from some distance to work on the site. CBH provided multiple toolbox talks and visits from the mobile health check unit.

The site in question is operated by a company that considers itself to have a very good record on health and safety, with good systems in place. However, the services offered by CBH still managed to offer something additional. One manager discussed how working with CBH had made him prioritise health issues more.

‘Whereas probably before the start of the job…it wouldn’t have been the top of my priority list to actually look at doing something like this. Actually having gone through it and seen what benefits there can be, its certainly moved far higher up the list than it would have been.’

The same manager discussed the importance of the training sessions offered by CBH in helping workers to keep their skills up to date.

‘I don’t think the workers are that well informed. Basically they’ll read the method statement, we do try and education them more because of the toolbox talks, but generally they’re not that well informed. I’m probably not that well informed because the industry hasn’t gone that way. A lot of people have been in it for 35 years now, so you leave school, you go onto a construction site and yes, you don’t get much more training, so the toolbox talks are important.’

In addition, the health checks were welcomed because the company, whilst already providing the services of an occupational health nurse on larger sites, did not offer any health testing for sites the size of the one visited. There were also differences in the approach taken by CBH which made the take-up amongst workers higher than the company was used to.

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‘On this sort of job we probably wouldn’t have gone as far as we have with CBH to be fair’.

‘The biggest thing that’s surprised me initially was the amount of people that actually volunteered to go on it. I thought we’d have great difficulty in getting volunteers but it was exactly the opposite. Because we’ve done it. The last job I was on we had a full time nurse and she had to physically go round the canteen trying to get people to come in and have checks. For some reason… I think possibly the way that it was brought out with the toolbox talks, the fact that it was an external body coming on board…everybody just seemed to want to come and do it.’

One of the main issues identified by CBH related to the health of individuals working for a subcontractor. The manager noted how useful it was having the results of the health checks broken down by trade, so that he could identify particular subcontractors as having specific issues and then take steps to tackle these in the future.

‘The trend analysis we got from CBH would indicate particularly the ground workers (as having health problems), where they’ve got a predominantly older workforce. [Subcontractor name] is a company we use here, and a lot of them have worked for the company for 20 years or more…and it was interesting to note that the analysis on their trade did highlight lung function failure…and poor hearing. I’ve let [subcontractor’s name]’s directors have a copy of the results and we would like to sit down with them to look at these issues in the future’.

‘I’d like to see something in place that sort of allows people like sub-contractor’s name to demonstrate to us that they are taking up a scheme similar to this to look after the health of their operatives. I think a lot of the companies we use probably will be very receptive to this because we tend to be very selective about the companies we use.’

Another benefit was felt to be greater communication between workers and management on health issues, but also more widely.

‘It has been absolutely incredible the feedback we’ve had from the workforce. Its not something they’ve just come to do and then forgot about, it has been quite an important talking point on site. It’s stimulated discussion, we’ve probably had a lot more involvement with the workforce on a one to one basis talking to them about things. So it’s stimulated dialogue which has probably knocked on to other things outside of the health issues.’

Overall, therefore, the benefits identified on this site were:

■ the opportunity to offer health checks which the company would not have funded on a site of this size

■ the availability of results which identified specific issues amongst some sections of the workforce (namely within a specific subcontractor)

■ providing management on the site with an impetus and evidence to tackle issues with a specific subcontractor

■ encourage management to set up systems in the future which more formally dealt with the issue of worker health amongst subcontractors

■ encouraged greater dialogue between management and workers on health, but also other, issues.

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CASE STUDY 3: SMALL EMPLOYER TAKES ON HEALTH SURVEILLANCE

Employer details: fewer than five employees, engaged in building completion and landscaping.

The site visited was the main company offices. CBH delivered a toolbox talk and on-site health checks.

Having received the health checks from CBH, this company had become committed to providing ongoing health monitoring. Talking about how the company reflected on the visits from CBH staff, the firm’s owner commented:

‘We’ve sat down and had a chat with the lads and we felt that it would be useful to do it every other year. I think every year would be overkill personally…So we decided that every other year would be great…and would suit our system better. I’ve been trying to expand the business…so I’m trying to build my workforce so we can have a van come here and do all the lads on a health check again.’

The employer had gone so far as to get in touch with the OH provider offering the CBH health checks to set up a meeting to discuss how the service could be offered in the future. This was despite having never worked with an occupational health professional before. When asked why he felt that offering future regular health monitoring would benefit his firm, he replied:

‘It’s really the relationship I have within myself and my workforce, and I don’t think it’s a massive thing to offer. I think it’s good. It’s easier for me to do it than probably them go out and actually get a health check, and I really want my workforce to be fit and healthy…There’s no reason why I can’t ask for certain details of the checks, so the benefit for me could be – other than the fact that the lads know they’re healthy so they feel confident, and I know they’re healthy so they’re able to do certain jobs – the other benefit to me would be that if I was to know things like their hearing, and that when they came to me they were in a fit shape, or when they came to me they had hearing problems, that could potentially help me if I had a dispute with them’.

In addition, this company had received a full risk assessment from CBH. The manager felt that this had helped him formulate a policy for future risk assessments within the company.

‘I do the risk assessments with the lads. I want them to get to the stage where they’re making their own risk assessments and I’ve designed the form that we did here (with CBH)…a risk assessment that they can fill in easily…My plan this year is to implement a system where everybody can do them’.

He also discussed how it had changed his attitude towards working with the HSE.

‘I’ve not spoken to the HSE recently…I think I’m getting to the stage where we’re going to have a meeting and I’ll bring them on site and let them look at all the bad bits and we can sit and talk about it and see how far forward we can go’.

Another outcome was amongst employees.

‘I think it made them aware, gave them a new awareness as well…I hope the risk assessments are also a part of that awareness… Its good to include them in some of the decision-making processes.’

The benefits for this company were, therefore, that:

■ management were hoping to introduce regular health surveillance/screening and to monitor the results

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■ they had contacted an occupational health provider despite never working with this type of professional before

■ the attitude of the employer towards the HSE had changed for the better and to the extent that he was now considering inviting them onto his work premises to get their views on what he could improve

■ risk assessments procedures were being designed that fully involved workers

■ there was a greater awareness of health issues amongst workers, and a commitment from them to engage in future health screening activities.

7.2.2 Accidents and sickness absence management

Employers discussed a number of minor accidents, and these still appeared to be quite a common occurrence on work sites. However, it appeared that the majority of companies believed that they had measures in place to deal with, record and report any accidents that did occur. When asked to describe what these procedures were, employers cited their policies or guidelines on: emergency procedures, ‘back to work’ plans, and the reporting of major incidents to organisations such as the HSE. Few, if any, employers discussed changes to their approach to managing accidents as a result of their involvement with CBH. This is not necessarily a negative finding, however, as CBH kept a tight focus on occupational health throughout its operation. Employers are therefore unlikely to identify the CBH brand strongly with accident reduction, but more with effective health risk management. However, it is possible that if CBH had had the opportunity to work more closely with managers by providing document reviews and risk assessments, there may have been wider evidence of impact of this type.

In terms of sickness absence the majority of organisations and individuals reported very low levels. Organisations felt that they had policies in place to deal with recurrent and regular absenteeism. For most companies, however, the main issues were about getting people back to work rather than preventing absence. Despite this, employers already see themselves as adhering to good practice, even though the evidence from CBH staff is that there were many misconceptions or omissions inherent in the way that employers deal with occupational health issues on site. Breaking down this complacency and over-confidence remains a difficult challenge for those working with the construction industry in this area.

Some individuals (both management and workers) indicated that a certain amount of ill-health was to be expected within construction, caused by the nature of the work (often outdoors and physically demanding). There was little recognition that the job need not involve lots of manual handling tasks if the risks are properly controlled. This provides yet more indications that workers and management need further encouragement to consider higher-level control measures (ie risk removal). Their natural focus tends to be on making existing practices safer, rather than the use of better systems or approaches which reduce the need to come into contact with hazards.

7.2.3 Worker behaviour

There were a number of examples where individuals identified their contact with CBH as having affected the way that work had been carried out on site. Continuing the theme from the preceding section, many of these related to enhanced awareness of, and interest in, personal protective equipment (PPE), both on site and at home. These changes were directly attributed to the increased awareness and a broadened understanding about the reasons for using this PPE gained from the toolbox talks.

‘Even my lads, we go on site and we wear gloves and we ride with the gloves on and stuff, and they’re saying we go home now and we go and do the gardening and we always put

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gloves on. It is just a minor thing but it is being followed through. I am refurbishing the bathroom now. I wear gloves when I am chopping the tiles off. I would never have done that a couple of years ago.’ (Manager)

‘With the noise, with the hearing, they were just stuffing earplugs in their ears and we’re now aware of different sorts of hearing protection. I’m actually going to take the lads up to a big safety warehouse locally where they’ll be able to choose their own equipment that they want to use.’ (Manager)

In addition, there were examples of changed behaviour that were attributed to workers having received health checks.

‘I mean, one guy told me, he said, well, I’ve found out I’m slightly deaf in one ear. So he said, well, I might be paying a bit more attention to whether we meet the right PPE now.’ (Manager)

‘It’s the breathing and the heat and the noise. People don’t know that they can’t hear very well. We tell them to wear protective kit. So it makes me think, or even them think, that they should be wearing a dust mask, they should be wearing ear protection and things like that. And I’ve noticed since they’ve had this screening that they seem to be doing it more. They’re supposed to do it anyway, but you could turn your back and somebody will be doing some fibre glassing without the mask on or even wearing eye protection. I’ve noticed it more, that they are doing it.’ (Site Manager)

‘We knew, really, the dangers, but at times you don’t think it’s going to happen to you. Since we’ve had both the health and safety and the health check, me personally, I do use more equipment. I’m more aware of it.’ (Labourer)

One of the site managers indicated that workers had become more proactive about health and safety issues, taking on the initiative for healthy and safe behaviours themselves.

‘A lot of the guys have become more interactive as well and they do come to you on site …to say, can we do this or can we look at doing this a different way….’ (Site Manager)

In addition, some managers expressed their belief that no matter what interventions were delivered, there would always be some level of unsafe or unhealthy behaviour on site. This is despite their obvious duty to manage risks. Where these attitudes were expressed, CBH was identified as having made workers aware of the risks connected with this behaviour, and therefore as having been helpful in implementing changes at worker level. As a result of CBH’s interventions, at least individuals now had the ability to make a conscious decision about what steps they were prepared to take to protect their health, and also had access to the relevant facts.

‘I’d say they’re more aware of it. I don’t know if they’ve completely changed their behaviour because of it, because if you’ve been doing it that many years it’s hard to change a habit of a lifetime.’ (Manager)

‘I think they’re all aware of the risks and all know how to do it properly, but we’re all human beings and we all take risks every day – and I don’t think you’ll ever get that out of the building site.’ (Manager)

These examples demonstrate again that the way that workers and employers view risk management is through the use of low-level controls rather than risk removal. There is no evidence that management are considering noise control, for example.

The survey also provides some limited data on changes to worker behaviour. Employers were asked to state whether they thought that their workers had made any changes to their work practices as a result of their involvement with CBH, and 45 per cent believed that they had. The most

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commonly reported changes amongst workers were that they now took health issues more seriously and also took risks more seriously (Figure 7.3).

Figure 7.3 Nature of changes in worker practice

0 5 10 15 20 25 30

Take health more seriously

Take risks more seriously

Better use of ear guards

Greater awareness of health risks

Better use of hard hats

Better use of gloves

Better use of procedures for manual handling

Better use of safety guards on equipment

OtherTyp

e of

ch

ange

s no

ted

amon

gst

wor

kers

No. of employers

Please note as this was a multiple response question, the percentages shown are greater than 100.

Note: Base for this table was all employers who had used CBH Services, and had indicated that they had noticed a change in workers’ behaviour, there is therefore a small base size of only 38.

Source: IES/IPSOS-MORI Survey of Construction Employers, 2005/2006

7.2.4 Health and safety knowledge

The prevailing view amongst managers involved in the interviews was that CBH had not added to their knowledge of health and safety in general. They viewed CBH as confirming what they already knew and sometimes raising awareness of specific issues or new legislation. The majority of employers involved in the interviews did not indicate that CBH had independently changed any of their practices, but rather that CBH was one element of a wider trend within the construction sector.

Employers often mentioned that CBH was useful because it gave them a standard to compare their own practices against, and reassurance that their documentation and procedures were fit for purpose. The minority who reported that CBH had changed their attitudes or practices mostly indicated that this was particularly true in their use of PPE and lifestyle issues.

‘It probably brought an awareness. I wouldn’t say it changed my practices, no, but it brought an awareness to one or two things that I probably wasn’t initially aware of.’ (Manager)

Workers were also somewhat unsure as to the long term influence of CBH, although similarly to employers, a number did feel that it had made a difference in terms of awareness of health issues.

Although at a general level there is an apparent reluctance to credit CBH with changes in knowledge or behaviours, there is plenty of evidence from the case studies where CBH is associated with specific changes in the use of PPE and general health behaviours.

7.2.5 General health behaviours

In addition to on-site behaviour, there are multiple examples of the impact of health check results on people’s behaviour outside of work. A number reported visiting their GP having been advised to

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do so after a problem was identified during a health check, whilst others discussed more extensive lifestyle changes such as giving up smoking and changing their diets.

‘Then he said, your blood pressure is up and I advise you to go and see your GP. So that week I went in and he found it was sky high and so I’m on tablets now.’ (Decorator)

‘One of the lads actually was informed that he had some blood in his urine sample and they suggested he go and see the doctor. So that was great.’ (Manager)

‘They did the blood pressure, and they took it twice as it’s quite high. So he advised me to go and have it checked, so I did have it checked. I went to the nurse, our own nurse, and I’ve had it checked three times over three months and they’ve had to put me on blood pressure tablets through this. I’ve gone on a strict diet; over the last month I’ve lost over a stone through this, because the doctor frightens you to death, and I’ve got quite high cholesterol and that’s come down tremendously since I’ve been on this. Well it’s only three weeks really, I lost a stone in three weeks by doing it properly.’ (Site Manager)

‘I do know that one of my guys went to his doctors, they checked out his chest, his breathing and things like that through it. He’s even given up smoking through it as well, so it is quite a good and important thing.’ (Site Manager)

‘One guy came back and apparently his urine sample was extortionate – well over the top. He went to his doctor since and I think it could be diabetes. He’d never have known this so he was over the moon.’ (Site Manager)

The role of regular health checks in actually preventing the escalation of existing conditions was also mentioned by both management and workers.

‘There are a lot of people in the construction industry now that are people who have been in it and are now out of it, that suffer from different things. But if that had been there then, quite a big percentage of those people wouldn’t have some of the illnesses they’ve got.’ (Trade unknown)

7.2.6 Possible future change

Given their involvement in the voluntary health testing as part of CBH, an important question was whether individuals (both employers and workers) would be interested in taking up the same, or similar, services in the future. Most of those interviewed were very positive about getting involved again. However, if the health checks could not be offered on the same free basis, there were concerns about whether employers or individuals would be prepared to cover the costs. Although some workers felt that they would be prepared to cover this themselves, there were concerns that offering health testing on a large scale could become prohibitively expensive at an employer level.

‘I’d like it to be an annual thing …’ (Site manager)

‘If it came around again next year, they’d go.’ (Manager)

‘I think everybody should be screened annually, ideally … we would have them everywhere.’ (Manager)

‘Because it was a free thing we got a lot of people to go. You think of 150 people on the firm, they may all want to do it and it could cost a lot of money … I don’t know on the finance side, I don’t really know what they’d come up with it … It’s the directors and them, they’d let you know on that one.’ (Manager)

‘If there was a charge next time, I would certainly consider paying.’ (Site Manager)

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Some managers expressed an intention to use health checks to screen future potential recruits, or as a guarantee against an employee falsely declaring a positive state of health or claiming damages in the future. Employers welcomed the idea of having better information about the health of workers coming onto their sites.

‘Like I said, they need to protect their own business and if it means that the subcontractors are screened prior so we know they are fit and healthy for working I think that will be a good thing going forward.’ (Manager)

The key reason that employers gave for not continuing to provide services similar to those provided by CBH once the pilot had ended, was cost. Although all of the employers were positive about CBH the majority of them accepted that for them to provide these services for their workers would be unfeasible as it would increase their overheads and make them less competitive than other construction organisations.

‘It’s alright for us to offer it as a business, but that’s coming out of our overhead and not making us as competitive as our competitors, obviously.’ (Manager)

The majority of those involved in the interviews expressed an interest in finding some way of providing the health checks in a cost-effective and timely fashion. Some employers discussed how they were waiting to see what would happen to the CBH initiative after June 2006 (ie the end of pilot operations), before committing themselves to any other provision. A number of them commented that it was a shame that CBH was a short-term pilot, as providing such services in a large scale manner was the most economical. The idea of making it mandatory for companies to carry out such health checks was raised by a number of workers, as this was seen as a way to ‘level out the playing field’ in terms of maintaining competitiveness. A number of the employers also commented that carrying out health checks would save them money in the long run because then they would be less likely to have workers claiming damages or taking time off work.

7.3 SUMMARY

Satisfaction levels with the CBH service were extremely high. A major finding is how well both the training and health checks were received by workers. Despite scepticism amongst managers that CBH would find it hard to effectively engage with workers, the general response to and take-up of services amongst workers was very positive.

The services offered were, overall, felt to be of a very high quality. The toolbox talks sometimes required further refinement to meet the needs of specific employers, but CBH staff were happy to do this, and often returned to employers to offer more tailored training where this was identified. The health checks were also well received in general, although there was some comment on the way in which blood pressure and hearing were tested, and on whether the results were always 100 per cent accurate. The ability for workers to gain access to health professionals without having to leave work was much appreciated.

Just over half of the employers who took part in the survey felt that they had already made changes at work, or planned to do so, as a result of their involvement with CBH. The most common changes identified related to their own awareness of health risks, or to the introduction or improvement of a health and safety policy.

The case study interviews suggested that the main changes were:

■ improved knowledge and awareness amongst both workers and management, allowing individuals to make better-informed choices about their behaviour on and off work sites in relation to their occupational and general health

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■ the work practices of workers, rather than managerial level change. This is likely to reflect that the majority of services involved workers due to a lack of take-up of services aimed at management

■ at the lower end of the risk control hierarchy (ie they were not about risk removal, but more about the use of PPE).

The main reason identified by employers for not making any changes were that, in their opinion, CBH had confirmed that the approaches they were already taking were appropriate.

These results suggest that moving forward from the experiences of CBH in working with the construction industry in the future will require greater focus on breaking down barriers at managerial level. Workers are clearly far more ready to engage with an occupational health service, and to take steps to change their behaviour. This is a significant finding in itself, but also gives a clear indication of where next steps should be. Tackling management resistance to self-examination and improvement will be vital in improving the construction industry’s performance on health.

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8. IMPACT OF CBH SERVICES

The pilot had a number of aims and objectives and in this chapter we discuss the evidence provided by the evaluation about progress towards these. To this end, the evaluation collected data at two time points on a range of different types of outcome. These included intermediate level outcomes (such as changes to health and safety policies or management) and attitudinal change, as well as rates of accidents, ill-health and absence. Identifying health outcomes is notoriously difficult, however. Analysis is provided which considers any early evidence of change to indicators of ill-health and absence. However, it was always anticipated that demonstrating statistically significant effects on these hard outcomes would be difficult within the life of the evaluation.

This chapter draws on data from both waves of the survey to analyse the ways in which the CBH initiative has impacted on workers, management and construction industry in a statistical sense.

8.1 OVERVIEW

Specifically, the chapter follows the following structure:

■ First, survey data is examined. The survey collected data on 27 different outcomes which are grouped into: health and safety practice, ill-health, accidents and absence and attitudes towards health management. The analyses draw comparisons between CBH users, non-users in the Leicestershire area and employers from the control area to identify the unique effects of using pilot services against other factors.

■ Second, descriptive data is presented on these, and on other outcome measures.

■ Third, pilot costs are discussed, along with progress against the initial targets set by the pilot.

Comparing outcomes across the three analytical groups, survey data was analysed by linking data from both survey waves. An analysis was therefore conducted which considered the relative impact of the CBH intervention over a longer period (approximately one-and-a-half years) and which explores the progress of individual organisations over time. This had the benefit of allowing:

■ Analysis of the outcome data from the second survey for the three groups, but which also took account of their starting position. This analysis considered whether, if the starting position of employers was entered into the analysis, any significant differences between CBH users and the other groups remained or emerged. Effectively it determines whether CBH users have made more progress, given their starting point, than the other groups.

■ Change analysis which, for each individual employer surveyed at both waves, considered the actual changes made at this individual level. Did individual employers using CBH make greater changes over time than individual employers who had not done so?

Unfortunately, the user group included in the change analysis was limited to a small number of CBH users (just 61) who had taken part in both surveys. Where this had implications for the extent to which the results can be generalised, this is pointed out.

8.1.1 Statistical analyses used

To identify ‘true’ differences between CBH users and non-users, it was important to control for other characteristics in our analytical process. The set of variables used is listed below:

■ organisation size

■ employer type (ie sub-industrial sector)

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■ length of employer operation

■ whether or not casual workers were employed

■ type of subcontractual arrangements engaged in, and

■ type of work usually conducted (eg domestic, commercial etc).

■ Using the core variables alongside our CBH intervention indicator, we then proceeded to estimate a series of multiple regressions using weighted data (see Chapter 2 and Appendix 3 for further details on the weights used). The precise estimation technique was governed by the nature of the dependent variable.

Three main types of multiple regressions were used to analyse the impact data. These were:

■ dummy probits – these are used when the outcome in question is binary (eg got a health and safety policy or not)

■ ordered probits – this technique is used when the outcome variable can take more than two values, and there is an intrinsic order to these values (eg attitudes to health and safety)

■ multinomial logits – a test used when the outcome variable can take more than two values, but where there is no specific meaning to the ordering of these values.

The latter technique was used for most of the change analyses looking at binary data (eg the acquisition or provision of something over time such as training or a health and safety policy). The technique allows us to look at differences between the groups in relation to the following four groups, the second of which is the most interesting for our purposes:

■ No/No – eg no policy T1 or T2

■ No/Yes – eg no policy T1 but policy by T2

■ Yes/No – eg policy at T1 but no longer at T2

■ Yes/Yes – eg retained policy at both time points.

8.1.2 Interpreting the results

It is worth noting that, despite the best efforts made methodologically by the evaluation and CBH team to include as many users as possible in the evaluation surveys (particularly the use of a user top-up sample in the second survey), there was only a relatively small number of CBH users for whom data is available from both surveys. Multivariate statistics work by identifying patterns of responses in the data. Working with a small number of cases makes it harder to identify such response patterns with confidence. In this instance, working with a small sample of CBH users makes it less likely that patterns relating to the impact of CBH will be detected. On this basis it is likely that the analytical work contained in this chapter has underestimated any impacts, in any direction, particularly changes over time.

Where appropriate, weighting has been imposed to adjust for sample attrition and the different make up of the CBH user group to the other groups (on factors such as employer size). Weighting has ensured that users, non-users and the control group are broadly similar on a range of characteristics, so there are fewer concerns about the results than would be the case if they were fundamentally different. In fact, the groups were already fairly similar across most characteristics (barring size and length of operation) prior to the weighting.

In interpreting the different test results, it is also important to be aware that differences between CBH users and the other groups which are present at the time of the second survey need to be

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considered in relation to baseline results. Just because CBH users have more positive results at the second time point, does not necessarily mean that their use of CBH has led to this – they could have been ‘better’ anyway. This is why analysis has been carried out which provides two different ways of understanding change. Firstly, distance travelled by different groups from their baseline position, and secondly, individual changes made. Both techniques are used here to be as thorough as possible, particularly given the danger of underestimating impact due to small sample sizes involved. In practice, they can be seen as two different statistical methods of investigating the same thing – is there any evidence that use of CBH, rather than other factors, has impacted on employer behaviour?

It is also the case that our outcome measures were defined at a much earlier stage in the project and represent a fairly blunt tool for measuring impacts (this point is also made in the first major evaluation report1 for CBH as far back as 2005). This is compounded by the fact that outcome data relate to ‘rare’ events and are commonly associated with under-reporting.

8.2 PROFILE OF SERVICE USE: SURVEY RESPONDENTS VS. ALL USERS

Before conducting the analysis on outcomes for CBH users, it is first important to understand what types of users are involved in this analysis. If there were any significant differences in the patterns of service take-up between our analysis groups and users as a whole, this would need to be considered in the interpretation of results.

By drawing together the survey responses with provider records it is possible to determine, without the issue of unreliable respondent recall, exactly what level of CBH service had been used. Service use has been compared for those employers who took part in both survey waves (Group one), for the employers who only took part in wave two (Group two), and for all users from the CBH database (Group three, see Table 8.1). The profile of the three groups does vary a little, but there are no significant differences between the groups in relation to their use of any of the services.

8.3 CHANGES TO CORE OUTCOMES

The aim of the analysis was to identify any evidence of the impact of the CBH pilot on 27 outcomes or indicators of good practice. These included: 11 indicators of health and safety practice; nine different measures of ill-health, absence and accidents; and seven attitude statements relating to health management within construction. The results for each group of indicators are summarised in Tables 8.2 to 8.4. For ease of reference to the detailed output tables provided in Appendix 5, each of these outcomes is numbered 1 to 27 in this chapter and A5.1 to A5.27 in the appendix.

Later sections of this chapter present more descriptive analysis of these and other outcomes.

Tyers C and Sinclair A (2005) Constructing Better Health, Report of the baseline employer survey, HSE Research Report 381.

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1

Table 8.1 Level of service use, from CBH provider records (in per cent)

CBH users – Waves One and CBH users – from Wave All users What used Two data (Group one) Two data only (Group two) (Group three)

Mobile testing unit 25.0 29.7 (15) 29.2

Toolbox talks 20.8 24.1 (13) 22.1

Document/system 16.7 12.3 review (10) 9.5

Risk assessments – 2.4 1.9

Site visit 31.3 31.1 (19) 27.2

Initial meeting 93.8 89.6 (57) 86.9

Missing 21.3 5.7 (13) –

Total 61 225 367

As this was a multiple response question, the percentage totals are greater than 100.

Where figures are presented in brackets next to percentages, these are the actual number of respondents in each cell. These have been presented to reflect the low base size (ie less than 100) for the percentage in question.

Source: IES analysis of CBH Management Information system, June 2006

8.3.1 Health and safety practice measures

At the time of the second survey, taking account of the baseline position of users (ie their starting point at the time of the first survey), CBH users were more likely than non-users and/or the control group to:

■ have a health and safety policy and maintain one over time

■ maintain provision of some form of face-to-face training in the last 6 and 12 months for workers

■ increase the time they take to inform subcontractors about risks

■ maintain the recording of health and safety activities (eg risk assessments).

■ There were no differences between CBH users and the other groups on:

■ the perceived importance of being aware of the health and safety practices of subcontractors

■ whether or not they spend time assessing risks

■ whether or not formal risk assessments are conducted.

■ In addition, CBH users were more likely to have stopped having return-to-work arrangements and/or using occupational health professionals over time.

■ A summary of these results is presented in Table 8.2.

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■ Overall, therefore, it seems that CBH users are more likely to continue some good practice over time than non-users or the control group. However, other aspects of good practice have slipped over time, and more so than for the control groups. The role of CBH, therefore, appears to be promoting and reinforcing good practice where it already exists to some degree, rather than instigating examples of ‘new’ good practice, although it has had little effect on return-to-work procedures and/or use of other occupational health professionals (other than CBH). The latter could well be an initial displacement effect, however, where CBH has been used instead of other providers.

Table 8.2 Summary of impact analysis – health and safety practice measures

Reference Analysis 1 (effect at Wave 2 with Wave 1

Analysis 2 (effect on change from Wave 1

No. Outcome measure taken account of ) to Wave 2)

1 Have health and safety policy (CBH more likely than non-user and

(CBH more likely to maintain over time than non-users and

control) control)

2 Face-to-face training in last six months

X (CBH more likely to maintain over time than non-users)

3 Face-to-face training in last 12 months

X (CBH more likely than non-users to maintain over time)

4 Time taken to inform subcontractors

X (CBH more likely than non-users to increase)

5 Importance of being aware of health and safety practices of subcontractors

X X

6 How well informed of health X X and safety risks in areas subcontracted to work on

7 Spend time assessing risks X X

8 Conduct formal risk X X assessments

9 Keep records of health and safety activities (eg risk assessments)

(CBH more likely than non-user and control)

(CBH more likely to maintain over time than non-users and control)

10 Have return-to-work arrangements

X (CBH more likely to have had one at Time 1 and then stopped at Time 2 than non-users)

11 Use of occupational health practitioners

X (CBH more likely to have had used at Time 1 and then stopped at Time 2 than non-users and control)

A ‘’ indicates the variable is statistically significant at the 5% level or below. An ‘X’ indicates the variables was included in the model but was found to be statistically insignificant.

Source: IES analysis of IES/IPSOS-MORI Surveys of Construction Employers, 2004/2005 and 2006

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8.3.2 Ill-health, accidents and absence

The results were not conclusive for this section of the questionnaire, as respondents generally found it difficult to recall levels and types of ill-health and absence with accuracy. Additionally, absence data was recorded in bands (eg 1-5 days, 6-10 days etc), because employers were unable to recall exact figures in the main. Changes in absence levels were, therefore, only measured where there was movement between bands (eg from 1-5 days to 6-10 days). This limits the extent to which positive changes might be expected by effectively making it more difficult to report a substantial enough change in absence.

Overall, CBH users were more likely to report having experienced accidents and ill-health. These findings are, to a degree, counterintuitive. We offer three potential explanations:

1. CBH users actually have higher absence

2. Higher reported absence could be indicative of better reporting and recording practices amongst CBH users (ie employers know more about absence and are therefore more likely to report it)

3. Organisations with historically poor records actively select into CBH to try and remedy their problems.

At the time of the second survey, taking account of the baseline position of employers, CBH users were more likely than non-users, the control group or both, to report:

■ a greater frequency of non-serious injuries in the last two years

■ their organisation having experienced an injury requiring up to three days off work in the last two years

■ having experienced other injuries resulting in three days or more off work

■ experienced fractures or injuries requiring an overnight hospital stay.

■ Considering actual change data, CBH users were more likely to:

■ report in both surveys that they had experienced accidents or injuries in the last two years

■ report in both surveys that they had experienced injuries requiring up to three days off work in the last two years

■ report in both surveys that they had experienced some form of worker absence

■ report in second survey that they had experienced a fracture or overnight stay injury, having not done so in first survey.

This could reflect either a poorer starting point (hence motivation to get involved in CBH) or better internal reporting procedures (hence higher figures).

There were no significant differences between CBH users, non-users and the control group with regard to:

■ whether non-serious injuries had been experienced in the last two years within their workplace

■ the frequency of injuries requiring up to three days off work in the last two years

■ whether ill-health had been experienced which had been caused or made worse by work.

■ A summary of these results is presented in Table 8.3.

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Table 8.3 Summary of impact analysis – accident/illness indicators

Analysis 1 (effect at Wave 2 Reference with Wave 1 taken account of Analysis 2 (effect on change No. Outcome measure ) from Wave 1 to Wave 2)

12 Experienced accidents or X (CBH more likely to injuries in last two years (at maintain over time than work) control)

13 Experienced non-serious X X injuries in last two years (at work)

14 Frequency of non-serious (CBH more likely to report X injuries in last two years higher frequencies than

control, less likely than non-users)

15 Experienced injuries (CBH more likely to report (CBH more likely to requiring up to three days than non-users and control) continue to report over time off work in last two years than non-users and control)

16 Frequency of injuries X X requiring up to three days off work in last two years

17 Experienced other injuries (CBH more likely to report X of three days or more off than control) work

18 Experienced fractures or (CBH more likely to report (CBH more likely to go injuries requiring an than non-users and control) from not reporting at Time 1 to overnight hospital stay reporting at Time 2 than

control)

19 Experienced ill-health X X caused or made worse by work in the last two years

20 Absence in last two years X (regression: more likely to change to having than non-users) (CBH more likely to maintain reporting non-users and control)

A ‘’ indicates the variable is statistically significant at the 5% level or below. An ‘X’ indicates the variables was included in the model but was found to be statistically insignificant.

Source: IES analysis of IES/IPSOS-MORI Surveys of Construction Employers, 2004/2005 and 2006

8.3.3 Attitudes towards health and safety management

At the time of the second survey, CBH users were:

■ more likely to agree that they don’t always have time to deal with health and safety as they would like

■ more likely to disagree with the statement that they do enough in terms of health and safety.

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■ Change analysis showed that CBH users were more likely to agree over time with the statements:

■ health and safety is not a priority within construction

■ we don’t think enough about how the job affects health

■ we don’t always have time to deal with health and safety as we would like.

■ No significant differences were found with regard to how much respondents felt they knew about health and safety legislation.

■ A summary of these results is presented in Table 8.4.

Taken together, these two significant findings suggest that CBH users feel that more can be done on health and safety, but efforts are, in part, constrained by time considerations. By implication, non-CBH users may be happier with the status quo and a relatively low level of engagement.

The descriptive analysis of the attitudinal data is presented in Appendix 6 as Tables A6.1 to A6.7.

Table 8.4 Summary of impact analysis – attitudes towards health and safety

Reference No. Outcome measure

Analysis 1 (effect at Wave 2 with Wave 1 taken account of

Analysis 2 (effect on change from Wave 1 to Wave 2

21 Attitude: in construction industry generally, health and safety doesn’t tend to be a priority

X (CBH more likely to agree over time than non-users)

22 Attitude: in my/our work, health and safety issues aren’t really a problem

X X

23 Attitude: we don’t think enough about how our/my health might be affected by the job

X (CBH more likely to agree over time than non-users)

24 Attitude: we believe that we do enough in the area of health and safety

(CBH more likely to disagree than non-users and control)

X

25 Attitude: we do not always have enough time to deal with health and safety issues in the way we would like

(CBH more likely to agree than non-users and control)

(CBH more likely to agree over time than control)

26 Attitude: we cannot afford to deal with X X every health and safety issue

27 Attitude: we know a lot about health and X X safety legislation

A ‘’ indicates the variable is statistically significant at the 5% level or below. An ‘X’ indicates the variables was included in the model but was found to be statistically insignificant.

Source: IES analysis of IES/IPSOS-MORI Surveys of Construction Employers, 2004/05 and 2006

8.4 OTHER DATA ON OUTCOMES

In addition to the analytical treatment of the 27 core evaluation outcomes, the data behind these analyses also provide a range of other information. This is presented here in a descriptive form to provide a context to the analysis on change.

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8.4.1 Health and safety and return-to-work policies

The vast majority of employers stated that they had a health and safety policy at the time of the first survey (around 93 per cent), and this rose slightly by the time of the second survey (to 95 per cent). Given this very high start position, it is unsurprising that there was little variation over time or by whether employers had used CBH.

8.4.2 Training provision

Employers were asked to discuss their training arrangements for both contracted employees and for casual workers. Well over half of employers and sole traders have provided training delivered by a trainer either to themselves, their contracted employees or their casual workers in the six months prior to the survey (Figure 8.1). By the second survey those from the CBH group were most likely to have provided such with 71 per cent having done so. This is a significantly greater proportion than either the non-user group or the control group, in which 59 per cent and 61 per cent of sole traders and employers had provided such training respectively. Of course, 30 per cent of users in this survey had taken up the offer of CBH provided training, and this result is likely to reflect this. Training in the last 12 months was also considered, and as would be expected, provision at this level is higher, but aside from this the patterns were similar to six month training.

Some additional information on the types of training offered and the length of time since the last training episode are provided in Appendix 6 as Tables A6.8 and A6.9.

Figure 8.1 Whether employers have offered face to face training in the last six months (% offering training)

0

10

20

30

40

50

60

70

80

2004/5 survey 2005/6 survey 2004/5 survey 2005/6 survey 2004/5 survey 2005/6 survey

CBH Non-user Control

%

empl

oyer

s

Base: All employers 2004/05 survey: 77 CBH users, 925 non-users and 1,009 control. 2005/06 survey: 225 CBH users, 645 non-users and 602 control.

Source: IES/MORI Surveys of Construction Employers 2004/2005 and 2005/2006

8.4.3 Subcontracting

Participants were asked in both the first and second survey to what extent they take time to inform subcontractors about the possible health and safety risks in areas they are working on for the company (Table 8.5). In the second survey, most employers and sole traders (62 per cent) stated that they informed their subcontractors all the time, with very few admitting to not informing

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subcontractors at all (just four per cent), which is a slight reduction from the first survey wave (when nine per cent stated they did not inform subcontractors at all). Participants who used subcontractors were also asked how important they feel it is to know about the health and safety practices of subcontractors when deciding which companies to work with. The vast majority, over three-quarters, felt that it was very important, but there was little variation between the user and other groups. The main ways that employers tend to inform their subcontractors about health and safety risks were: informally using a walk round the site; training session before work; through the use of correspondence such as memos; or through literature and manuals (Figure 8.2). CBH users were statistically more likely than both non-users and the control group to issue some form of written information to their subcontractors. Similarly, those working as subcontractors who had used CBH services were more likely to state that they received some form of written guidance.

Table 8.5 How frequently inform subcontractors about work-site risks (in per cent)

CBH Non-user Control All 2004/05 2005/06 2004/05 2005/06 2004/05 2005/06 2004/05 2005/06

Sample survey survey survey survey survey survey survey survey

All the time 63.3 61.8 63 56.8 65.3 65.9 64.2 61.5 (24)

Most of the 20 26.5 14.8 29.5 16.3 24.4 17 26.7 time (8) Some of the 3.3 8.8 14.8 9.1 10.2 4.9 9.4 8 time (1) Not at all 3.3 2.9 7.4 4.5 8.2 4.9 9.4 3.7

(1) Base 34 105 277 213 349 193 664 511 (unweighted)

Source: IES/MORI Surveys of Construction Employers 2004/2005 and 2005/2006

Participants who work as subcontractors were asked how well informed they felt about the possible health and safety risks in work areas they are contracted to work on (Table 8.6). Very few organisations stated that they were not very well or not at all informed. Across all employers, most, 59 per cent, felt that they were fairly well informed whilst a further 39 per cent felt that they were extremely well informed.

Table 8.6 How well informed subcontractors feel (in per cent)

Sample CBH Non-user Control All 2004/05 2005/06 2004/05 2005/06 2004/05 2005/06 2004/05 2005/06 survey survey survey survey survey survey survey survey

Extremely well 23.3 34.2 40.5 43.9 44.8 43.4 38.4 38.8 informed (10) Fairly well 73.3 62.3 59.5 54.4 50 54.7 58.4 58.5 informed (31) Not very well – 2.6 – 1.8 5.2 1.9 2.4 2.2 informed Not at all 3.3 0.9 – – – – 0.8 0.4 informed (1) Base 42 115 411 289 439 267 892 671 (unweighted)

Where figures are presented in brackets next to percentages, these are the actual number of respondents in each cell. These have been presented to reflect the low base size (ie less than 100) for the % in question.

Source: IES/IPSOS-MORI Surveys of Construction Employers 2004/2005 and 2005/2006

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Figure 8.2 Methods used to inform subcontractors

0 10 20 30 40 50 60 70 80

Informally (discussion/walkround)

Written correspondence

Manuals/literature

Formal one-off course

Formal regular trainingprogram

Risk assessments

Method statements

Formal meetings

Other

% employers

User Non-user pilot area Control

Source: IES/IPSOS-MORI Surveys of Construction Employers 2004/2005 and 2005/2006

8.4.4 Risk Identification and management practices

One of the main indicators of good practice in terms of health and safety management is good risk management. However, risk assessment in itself does not deal with risks, it simply identifies where action needs to be taken. Therefore respondents were asked a range of questions in both surveys which aimed to determine how well they identified and dealt with risks.

Identifying health and safety risks

The vast majority of respondents (88 per cent of all employers) felt that they spent time assessing risks in their workplace, and there were no significant differences between CBH users and the other groups in this regard. An even higher proportion of those who asses risks record the outcomes of these assessments (Figure 8.3).

Employers were also asked to identify the risks that ‘in your area of work that could pose a danger to safety or damage to health’. They were prompted to consider risks related to the work site, the materials and equipment used and the way in which work was carried out. They were prompted to include risks even when they felt that these were well controlled. Employers were free to name as many as five different risks. Each risk that they identified was followed up with a further question which asked them to specify how their company had ‘dealt with’ that risk. Employers were free to name as many ways of dealing with risks as they wanted in relation to each risk.

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Figure 8.3 Proportion of employers who risk assess and who keep records (excludes sole traders)

0

10

20

30

40

50

60

70

80

90

100

2004/5 survey 2005/6 survey 2004/5 survey 2005/6 survey 2004/5 survey 2005/6 survey

CBH Non-user Control

% o

f em

ploy

ers

Base: All employers who spend time assessing risks, excluding sole traders.

2004/05 survey – 64 CBH users, 517 non-users and 551 control, 2005/06 survey – 196 CBH users, 389 non-users and 350 control.

Source: IES/IPSOS-IPSOS-MORI Survey of Construction Employers, 2005/2006

The data has been broken by the main risks identified by employers in Table 8.7. This table provides the main ways of dealing with risks identified by the CBH user group, non-users and the control group separately. In the case of each risk, the ways of dealing with it are listed for each of the groups in order of popularity. Caution should be taken in drawing conclusions based on this data, particularly for the CBH user group where the cell sizes are generally smaller. Despite this, there are some interesting indications from the data which are discussed below.

The first point to draw out is that even when asked specifically to discuss dangers to safety and risks to health, employers still focused mainly on safety issues. Table 8.7 is, therefore, primarily populated by safety risks. The most commonly identified risks were: working at height; hazardous or vibrating machinery: and slips, trips and falls. Interestingly, manual handling was not a common response. CBH users, on average, identified a significantly higher number of risks than the other groups (Table 8.8). These results could suggest that CBH users have a greater risk awareness than the other employer groups. However, there are few differences between the control measures used by the CBH user group and the other groups of employers.

There were some health risks discussed, but only by relatively small numbers of employers. Noise, for example, was mentioned as a risk by only six per cent of employers who had used CBH (a statistically equivalent number to the other groups). This is interesting given the results of the health checks which showed that the most common health problem identified amongst those taking tests was hearing loss. Only one employer, a CBH user, identified stressful work situations as a risk, and two CBH users identified high or low temperatures as a risk. No additional health risks were identified by any employers.

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Table 8.7 Most commonly identified risks and main ways of dealing with them given by employers

User Non-user pilot area Control Total

% % % % of all citing Most popular ways of dealing citing Most popular ways of dealing citing Most popular ways of dealing employers risk with risk in order risk with risk in order risk with risk in order citing risk

Working/operating 56.0 Use fall/arrest equipment 52.4 Use fall/arrest equipment 59.0 Use fall/arrest equipment 55.8 at height Provide info/training Provide info/training Provide info/training

Risk assessment Risk assessment Risk assessment Do job differently Do job differently Do job differently

Hazardous/vibrating 29.5 Provide info/training 25.1 Provide info/training 19.6 Provide info/training 26.0 machinery Risk assessments Risk assessments Provide PPE

Provide PPE Provide PPE Risk assessments Introduce new equipment Use safety guards Use safety guards Use safety guards Introduce new equipment Introduce new equipment

Risk of slips, trips 25.0 Provide info/training 18.9 Risk assessments 18.1 Provide info/training 21.8 or falls Keep areas clean Provide info/training Keep areas clean

Risk assessments Keep areas clean Risk assessments Use fall/arrest equipment Use fall/arrest equipment Use fall/arrest equipment

Manual handling 19.5 Provide info/training 16.5 Provide info/training 19.4 Provide info/training 18.7 Risk assessments Introduce new equipment Risk assessments Introduce new equipment Do job differently Introduce new equipment Do job differently Risk assessments Do job differently

Handling/touching 15.0 Provide info/training 12.1 Provide info/training 13.5 Provide info/training 13.9 chemical/ biological Provide PPE Provide PPE Provide PPE substances Risk assessments Risk assessments Risk assessments

Safe storage facilities Safe storage facilities Safe storage facilities

93

User Non-user pilot area Control Total

% % % % of all citing Most popular ways of dealing citing Most popular ways of dealing citing Most popular ways of dealing employers risk with risk in order risk with risk in order risk with risk in order citing risk

Electricity 10.0 Provide info/training 10.6 Enforce controls 13.5 Provide info/training 11.0 Risk assessments Provide info/training Enforce controls Enforce controls Risk assessments Risk assessments

Breathing in dusts, 9.1 Provide PPE 11.6 Provide PPE 12.1 Provide PPE 10.4 aerosols, gases Risk assessment Risk assessments Risk assessments

Movement of fork 10.4 Provide info/training 5.4 Provide info/training 4.7 Provide info/training 7.8 lift vehicles or trucks on site

Risk assessments Reorganise work layout

Reorganise work layout Risk assessments

Risk assessments Reorganise work layout

Noise 5.9 Provide PPE 4.8 Provide PPE 2.5 Provide PPE 4.8 Risk assessments Do job differently Risk assessments Introduce new equipment Provide info/training Introduce new equipment Provide info/training

Base (Unweighted) 226 644 602 1,472

Note: Percentages may equal more than 100 as respondents may give more than one response. The table is based on the most common risks cited by respondents.

Source: IES/IPSOS-IPSOS-MORI Survey of Construction Employers, 2005/2006

94

Dealing with risks

In interpreting the measures used by employers to deal with risks, it is useful to refer to HSE guidance (taken from 5 Steps to Risk Assessment1) on best practice. This suggests a hierarchy of risk evaluation and precaution taking. Broadly, the recommendations are that employers first determine whether the hazard can be removed altogether and, if it cannot, then they should control the risk so that harm is unlikely using steps in the following order:

■ try less risky options (eg by switching to a less hazardous material)

■ prevent access to the hazard (eg by guarding)

■ organise work to reduce exposure to the hazard (eg put barriers between pedestrians and traffic)

■ issue personal protective equipment (eg hearing protection, goggles)

■ provide welfare facilities (eg first aid and washing facilities for decontamination).

■ The data from the employer survey indicates that employers use risk assessments and staff training as their main methods of dealing with risks. There is relatively little evidence of control measures being used which remove risks, or of changed work practices or the use of equipment to reduce exposure to the hazards. Therefore what we see is that employers are more likely to use ways of dealing with risks that are lower down the risk management hierarchy. Rather than introducing new equipment or practices, they tend to focus on training staff about the risks or better understanding the existence of risks through the use of risk assessments. This confirms the evidence from the case studies presented in Chapter 7 that employers are most likely to discuss changes to work practice that involve these lower-level adjustments.

Table 8.8 Mean number of risks identified

CBH status* Mean number of risks Base

User 2.1 226

Non-user pilot area 1.8 644

Control 1.8 602

All 1.9 1,472

* Indicates a significant difference between the groups at the 5 per cent level using an ANOVA test.

Source: IES/IPSOS-IPSOS-MORI Survey of Construction Employers, 2005/2006

8.4.5 Return-to-work arrangements

Just over 40 per cent of employers reported that they had some form of return-to-work arrangements in place in each of the two surveys. The proportion with a return-to-work policy was very similar for CBH users and the control groups, and there were no significant differences between the groups. From what we know from the experiences of pilot staff, however, and the difficulties involved in getting employers to take up case management services for their workers, these estimates could be inflated.

The most common ways of managing return-to-work reported in the second survey (provided in further detail in Table 8.9) were: keeping in contact with off-sick workers (38 per cent of those

See HSE leaflet INDG163(rev2) ‘Five Steps to Risk Assessment’

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1

with some form of return-to-work procedures); identifying workplace controls and adjustments to help returners (32 per cent); and preparing and agreeing a return-to-work plan (27 per cent of employers). There were no significant differences between CBH users and the other groups with regard to the proportions having any of the different procedures in place at the time of the second survey.

Table 8.9 Return-to-work arrangements (in place at the time of both surveys – in per cent)

Non-user pilot User area Control Total

2004/05 2005/06 2004/05 2005/06 2004/05 2005/06 2004/05 2005/06

Keep in contact with 52.4 43.2 44.5 24.2 29.4 39.1 39.3 37.5 off-sick employees (13) (35)

Identify workplace 23.8 31.0 29.2 35.7 40.9 28.6 33.4 31.6 controls and adjustments (6) (25)

Prepare and agree a 38.1 27.1 14.9 29.2 18.9 24.7 22.9 27.1 return-to-work plan (10) (22)

Hold a ‘return-to-work 23.8 20.7 18.4 28.7 21.6 31.4 21.3 25.2 interview’ (6) (6)

Seek professional help 23.8 15.5 10.9 23.5 19.8 22.8 18.5 19.2 and advice when needed (6) (13)

Have a written policy on – 12.9 9.2 12.8 17.7 15.7 10.9 13.5 rehabilitation (10)

Train line managers and – 2.6 4.6 7.7 3.3 4.4 2.8 4.3supervise to manage (2)rehabilitation

Base (Unweighted) 25 81 126 109 159 101 310 291

Where figures are presented in brackets next to percentages, these are the actual number of respondents in each cell. These have been presented to reflect the low base size (ie less than 100) for the percentage in question.

Note: Percentages may equal more than 100 as respondents may give more than one response. Percentages are in brackets where the base for a group is less than 30. Only the most common responses are listed

Source: IES/IPSOS-IPSOS-MORI Surveys of Construction Employers 2004/2005 and 2005/2006

8.4.6 Use of occupational health professionals

All participants were asked whether they had used any occupational health professionals in the last two years. At the second wave under half of employers had used professionals (43 per cent – a slight reduction since the first survey). There were few differences between the CBH user and other groups although CBH users were statistically more likely at Wave One to be using professional services (Figure 8.4). The most commonly used professionals, by all three employer groups were external health and safety consultants (Table 8.10). Very few employers from the pilot area specified staff from the CBH pilot in this category. The most common use for occupational professionals was providing advice on safety or on health issues (Table 8.11).

96

Figure 8.4 Use of occupational health professionals (% using professionals)

0

10

20

30

40

50

60

2004/5 survey 2005/6 survey 2004/5 survey 2005/6 survey 2004/5 survey 2005/6 survey

CBH Non-user Control

% o

f em

ploy

ers

Base: All employers 2004/05 survey: 77 CBH users, 920 non-users and 1,000 control; 2005/06 survey: 221 CBH users, 639 non-users and 590 control. Source: IES/IPSOS-IPSOS-MORI Surveys of Construction Employers 2004/2005 and 2005/2006

Table 8.10 Use of different professionals (%)

User Non-user pilot area Control Total 2004/05 2005/06 2004/05 2005/06 2004/05 2005/06 2004/05 2005/06

External health and safety 63.4 46.2 47.9 42.6 57.9 40.8 56.6 42.7 consultant (58) (42) In-house health and safety 3.5 12.1 8.0 4.7 10.1 11.8 7.8 9.0 officer (1) (11) Occupational health – 6.6 8.6 11.8 11.4 5.3 7.7 8.3 physician (6) GP 3.5 5.5 3.4 4.1 6.5 7.9 4.9 5.8

(1) (5) HSE Inspectors 7.0 9.9 7.1 3.6 0.9 1.3 4.2 4.1

(3) (9) Trade associations 3.5 5.5 3.2 4.1 2.9 2.6 3.1 3.9

(1) (5) Local 3.5 4.4 1.4 1.8 3.6 5.3 3.0 3.6 authority/environmental (1) (4) health officers Occupational health nurse – – 4.3 3.6 3.6 5.3 2.9 3.4

Other HSE representatives 5.0 1.1 2.0 3.0 1.4 2.0 2.5 2.2 2) (1)

Fit Builder/Constructing – 1.1 – – – – – 0.2 Better Health (1) Base (unweighted) 36 91 235 169 274 152 545 412

Where figures are presented in brackets next to percentages, these are the actual number of respondents in each cell. These have been presented to reflect the low base size (ie less than 100) for the percentage in question. Note: Percentages may equal more than 100 as respondents may give more than one response. Only the most common responses are listed. Source: IES/IPSOS-IPSOS-MORI Surveys of Construction Employers 2004/2005 and 2005/2006

97

Table 8.11 Type of work undertaken by health and safety professionals (in per cent)

Wave 2 data

Non-user User pilot area Control Total

Undertake health checks on specific workers 21.1 9.9 17.8 17.4 (19)

Undertake health checks on all workers 10.0 14.4 11.6 11.5 (9)

Monitor sickness absence records 3.3 4.1 2.7 3.4 (3)

Treat ill-health/results of accidents – 5.2 6.4 2.8

Attend health and safety meetings 4.4 3.0 3.3 3.8 (4)

Advise on work-related health issues 25.6 19.8 14.7 21.5 (23)

Advise on general health issues 23.3 23.0 18.1 22.0 (21)

Advise on safety issues 23.3 24.5 25.5 24.1 (21)

Identify risks/hazards 20.0 31.8 25.1 24.3 (18)

Implement health and safety procedures 16.7 18.8 17.6 17.5 (15)

Provide support during back-to-work rehabilitation – 1.8 3.6 1.3

Provide health and safety training 12.2 15.9 16.1 14.1 (11)

Other 11.0 14.1 12.7 12.9 (120

Base (unweighted) 91 170 150 411

Where figures are presented in brackets next to percentages, these are the actual number of respondents in each cell. These have been presented to reflect the low base size (ie less than 100) for the percentage in question.

Note: Percentages may equal more than 100 as respondents may give more than one response. ‘Don’t know’ has not been listed in the above table.

Source: IES/IPSOS-MORI Survey of Construction Employers 2005/2006

8.4.7 Occurrence of accidents

Just under half of respondents had experienced an accident of some kind within their organisation within the last two years (Figure 8.5). This proportion is significantly higher in the CBH group in the second survey than in either the non-user or control groups (51 per cent compared to 43 and 41 per cent respectively). This could, however, just as equally be a reflection of better accident reporting procedures as higher incidence rates. Alternatively it might not necessarily indicate anything substantive – it could simply be ‘luck’, due to the relatively rare nature of work accidents on individual sites.

98

Figure 8.5 Proportion of employers having experienced an accident within the last two years

0

10

20

30

40

50

60

2004/5 survey 2005/6 survey 2004/5 survey 2005/6 survey 2004/5 survey 2005/6 survey

CBH Non-user Control

% h

avin

g ex

peri

ence

d an

acc

iden

t at

wor

k in

las

t tw

o ye

ars

Base: 2004/05 survey – 76 CBH users, 925 non-users and 1,007 control, 2005/06 survey – 222 CBH users, 643 non-users and 600 control.

Source: IES/IPSOS-MORI Survey of Construction Employers, 2005/2006

All participants who stated that they or their workers had experienced injuries were asked what type of injuries these were (see Table 8.12). The majority were non-serious injuries not requiring any time off (71 per cent). There were very few fatalities, with only three organisations in total (unweighted) reporting such accidents. However, around half had experienced injuries requiring up to three days off work and half reported other injuries requiring more than three days off. One in five employers reported that a worker had sustained an injury involving an overnight stay.

Table 8.12 Type of accidents experienced (in per cent)

CBH Non-user Control All

2004/05 2005/06 2004/05 2005/06 2004/05 2005/06 2004/05 2005/06 survey survey survey survey survey survey survey survey

Non-serious injuries

Injuries requiring up to 3 days off

Other injuries – 3 days plus

Fractures/ injuries with overnight hospital stay

Fatal injuries

Base (unweighted)

61.5 (16)

46.2 (12)

38.5 (10)

23.1 (6)

–

26

70.9

52.7

52.7

22.7

0.9

113

71.7

36.9

34.3

19

–

134

68.4

45.9

48.4

18

–

161

71.8

43.1

55.7

23

1.4

255

75.8

46.6

48.7

17.1

2.6

136

69.2

42.1

45.3

21.9

0.7

415

71.3

49.8

50.8

20.4

410

Where figures are presented in brackets next to percentages, these are the actual number of respondents in each cell. These have been presented to reflect the low base size (ie less than 100) for the percentage in question.

Source: IES/IPSOS-MORI Surveys of Construction Employers 2004/2005 and 2005/2006

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1

8.4.8 Levels of work-related ill-health

Employers were asked how many days off their workers had taken due to work-related injuries or work-related ill-health. Two-thirds (67 per cent) of participants in the second survey, claimed that they had experienced no such absence. Respondents, on the whole, found it difficult to indicate with accuracy the amount of time that they or their workers had taken off work. They were therefore given the option of responding using a number of bands, and they were fairly evenly split across these bands, with eight per cent experiencing only up to four days but five per cent claiming to have experienced more than 50 days of such absence (Table 8.13).

Table 8.13 Levels of absence (in per cent)

CBH Non-user Control All

2004/05 2005/06 2004/05 2005/06 2004/05 2005/06 2004/05 2005/06 survey survey survey survey survey survey survey survey

None 70.2 63.4 85.7 71.3 82.4 69.1 80.3 66.8 (51)

1-4 days 19.3 7.2 7.1 7.9 6.9 7.4 10 7.5 (14)

5-9 days – 5.7 1.4 5.9 2 6.4 1.3 5.9

10-19 days 1.8 10.3 1.4 5 3.9 5.3 2.6 7.7 (1)

20-49 days 3.5 7.7 4.3 4 2.9 7.4 3.5 6.7 (3)

50+days 5.3 5.7 - 5.9 2 4.3 2.2 5.4 (4)

Base 73 196 860 620 937 582 1,870 1,398 (unweighted)

Where figures are presented in brackets next to percentages, these are the actual number of respondents in each cell. These have been presented to reflect the low base size (ie less than 100) for the percentage in question.

Source: IES/IPSOS-MORI Surveys of Construction Employers 2004/2005 and 2005/2006

The actual levels of ill-health that employers claim their workers have experienced due to work-related issues are extremely low. Figure 8.6 shows the proportion of each of the three employer groups that reported some incidence of work-related ill-health (ie it does not reflect ill-health rates). We can see that a lower proportion of CBH users had experienced some work-related ill-health at the time of the baseline survey, but that by the time of the second survey, this proportion had risen. Amongst the non-user and control groups this trend was reversed. However, whilst the CBH group were statistically less likely to have experienced work-related ill-health at the time of the baseline survey (at the five per cent level using the chi-square statistic), by the second survey this difference had disappeared.

It is particularly interesting to note how few employers felt that they had workers who had experienced ill-health in the last two years given the statistics on the industry presented in Chapter 2. Construction actually has one of the highest rates of ill-health of any industry as identified by national figures. These low reporting levels within our sample could therefore reflect a low awareness of absence levels, and not necessarily show a lack of actual absence. However, complex subcontractual chains often make it difficult for employers to really understand levels of absence amongst those working on a site.

100

Figure 8.6 Proportion of employers with work related ill-health (themselves or their workers)

0 5 10 15 20 25

2004/5 survey

2005/6 survey

2004/5 survey

2005/6 survey

2004/5 survey

2005/6 survey

CBH

Non

-use

rsC

ontr

ol

Typ

e of

em

ploy

er/t

ime

peri

od

% of employers reporting any staff taking sickness absence

Base – All employers

2004/05 survey: 74 CBH users, 923 non-users and 1,002 control; 2005/06 survey: 219 CBH users, 642 non-users and 600 control.

Source: IES/IPSOS-MORI Surveys of Construction Employers 2004/2005 and 2005/2006

The types of ill-health identified by employers were varied but the most common was back pain or other aches and strains. Table 8.14 presents an outline of the different health conditions identified but, due to small base sizes throughout, the figures provided are numbers rather than percentages.

Table 8.14 Types of work-related ill-health experienced (figures are frequencies rather than percentages due to small base sizes)

CBH Non-user Control All

2004/05 2005/06 2004/05 2005/06 2004/05 2005/06 2004/05 2005/06 survey survey survey survey survey survey survey survey

Back pain

Other aches or strains

Vibration symptoms

Deafness/ringing in ears

Skin probs

Respiratory probs

Stress

Other

Base (unweighted)

6

2

–

–

–

–

–

2

8

6

4

5

3

1

5

–

2

18

38

21

6

11

6

10

19

96

49

16

13

12

27

5

1

7

37

56

21

6

10

10

8

10

111

25

30

35

19

9

1

20

41

53

22

5

3

7

8

4

15

215

24

16

18

8

9

13

0

8

96

Source: IES/IPSOS-MORI Surveys of Construction Employers 2004/05 and 2005/2006

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8.5 SERVICE COSTS AND PROGRESS AGAINST TARGETS

A final consideration is the costs of CBH and the progress of the pilot against targets. The financial data available to the evaluation team came from the CBH pilot records, provided in the form of overall costs, and costs broken down by the following categories: set-up costs, marketing costs, scheme management and occupational health provision.

Setting aside the costs for getting the service running, the overall costs of marketing, broken down by the number of employers taking up the service equates to around £510 per employer successfully reached. The costs of each health check is £116 per check delivered. However, this does not include the full economic costs of providing health checks, such as the costs associated with marketing and CBH staff visiting sites to describe and sell the services.

Taking up CBH services is not identified with any quantifiable hard performance indicators (eg absence or accident rate reductions) at this early stage. We do, however, find evidence that CBH is associated with some softer attitudinal and procedural change. The implication is that any benefits attributable to CBH cannot be measured or quantified in financial terms directly at this point in time. The one area where we do have evidence is the improved identification of ill-health through checks carried out by the mobile testing unit. Using this measure we observe that 1,724 people were tested and of these 632 were found to have a problem which would not otherwise have been identified at such an early stage. There is no data available on the actual number of GP referrals that resulted in a confirmed condition or in some form of treatment, however. If the overall costs of the service, including the costs of marketing and all other service elements, are assessed solely against the incidence of potential health problems, then the costs per potential health problem identified rise to £1,579. This does not, of course, take account of other impacts achieved by the service.

Another way of considering the impact of the CBH pilot is to consider progress against targets (a summary is presented in Table 8.15). The setting of targets for the pilot, where they are expressed in numerical terms, was somewhat arbitrary as there were no existing comparators for guidance (see Chapter 2 for further details on difficulties in setting appropriate targets for the CBH pilot). The pilot not achieving numerical targets therefore should not in itself be seen as a lack of progress. Rather, it is helpful to look at progress against targets as an indicator of the resource input required to achieve a given output.

The pilot has not been able to achieve the levels of take-up amongst employers – and hence workers – that were originally anticipated. However, within employers there has been a greater interest in, and take-up of, services amongst workers than had been envisaged. Therefore the numbers of health checks delivered has exceeded expectations. This indicates that this element of the pilot was easier to implement and more readily received in organisations and amongst workers than predictions would have suggested at the start of the initiative.

The length of pilot activities was also curtailed, and whilst the targets have been reduced to compensate, Chapter 5 presents evidence of a gathering momentum in terms of service delivery, particularly in terms of the numbers of workers getting involved. It is possible, therefore, that, given more time to capitalise on the early months of preparatory activities, greater progress towards these targets could have been achieved. In other words, an intense initial input followed by a longer period of service operation are needed to establish this type of intervention in the construction sector.

There is no evidence of impact on harder outcomes yet (such as absence, ill-health and accident rates). There is, however, some evidence of impact on indicators of good practice in health and safety. These mostly are about encouraging employers to retain existing good practice rather than instigate new practices. There is additional evidence that communication with subcontractors about health issues has also improved.

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Table 8.15 Progress of CBH against targets

Target* Achieved? Comment

Reduction in incidence of ill-health Too early to say – no measurable change at this stage

Levels of ill-health reported by CBH users higher Evidence of better reporting procedures?

Reduction in time taken off by workers due to ill-health

Too early to say – no measurable change at this stage

Low numbers reporting, lack of reliable data

SMEs to have systems in place to continually improve health and safety procedures

Indications that better practice amongst CBH users on some procedures

Indications that CBH has helped encourage employers to retain good practice. Communication with subcontractors has increased

Employers to conduct risk assessment and implement control measures

Risk assessments reportedly conducted by majority Evidence of lower-level control measures

Very high starting point – most firms reported conducting risk assessments at time of first survey, very difficult to measure change from this position

being improved (eg use of PPE)

Workers take action to reduce work related accidents and incidences of ill-health

Positive changes to worker awareness and behaviour

Indicators include referrals to GP, greater reported use of PPE, and greater awareness of health risks

5,031 workers have participated in some form of CBH intervention

Target not reached – 3,509 individuals took up services

Unrealistic target? Still a significant number of users. Take-up levels within participating employers very high

595 employers to have in-depth support Target not reached – 367 employers took part Unrealistic target? Still a significant number of users. Take-up levels within participating employers very high

1,094 health checks conducted Target exceeded, 1,724 checks carried out Health checks seen as very attractive service Worker involvement high

* Where numerical targets are set (rather than proportions) these have been adjusted down from the original 24 month targets to 21 month targets to reflect the shortened operational life of the pilot.

Source: IES analysis of IES/IPSOS-MORI Surveys of Construction Employers, 2004/2005 and 2006

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8.6 SUMMARY

The evaluation collected a wide range of data on outcomes. This was analysed using a range of multivariate techniques (which essentially control for differences in employer characteristics such as size, type of work undertaken, etc.) to allow the unique effects of being involved in CBH to be assessed. There are limitations in the extent to which significant results might be expected though, given that the number of employers responding to both survey waves, and who participated in CBH, was quite small. The impact assessment is therefore more likely to underestimate than overestimate the effect of CBH and should be considered alongside user views and health check results in determining the relative success and impact of the initiative.

In total, data on 27 different outcomes was analysed in the survey data. The greatest difference between CBH users and non-users/the out-of-area control group was that they appeared to have better health and safety policies, deliver more training, to keep better records and to better inform subcontractors, and that they had maintained good practice in these areas over time. Therefore CBH appears to have encouraged the continuation of good practice rather than, so far, to have influenced employers to introduce new measures or systems.

CBH users were more likely to report having experienced accidents and ill-health and to report higher incidence levels on these measures. Given that CBH users also have better recording and reporting procedures, once conclusions could be that this, at least in part, reflects their greater awareness of the types of accidents and ill-health experienced by their staff. However, of course they could also actually experience more accidents/ill-health and/or have become engaged with CBH to help reduced these levels.

CBH users also exhibited attitudinal differences and became less positive over time about the extent to which the construction industry prioritises risks, how much they know about health and safety, and whether they have enough time to deal with health and safety issues properly. These changes would suggest that their engagement with CBH has affected their attitudes towards occupational health issues. Users may now have better information with which to assess their own performance and that of the industry.

Overall, therefore, there was no hard evidence that CBH had reduced accident, ill-health or absence rates at this point in time, although such changes could materialise in the future. Health outcomes are very difficult to measures and can take significant periods of time to emerge sufficiently to be measured. The fact that CBH users are more likely to continue to keep good practice procedures in place over time, however, could suggest that they are more likely to experience positive outcomes in the longer term.

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9. CONCLUSIONS

The CBH pilot tested out new ways of working with the construction industry on occupational health issues. There were many challenges that the pilot needed to overcome in order to successfully engage with employers and workers. In addition, the different services on offer received varying receptions, and the service impacted on some levels of employer and worker practice, but not others. As such, there are a range of learning points that can be drawn out from the work of pilot, and these are discussed here. In addition, since the end of pilot activities in June 2006, the CBH brand has continued to operate, and plans for the future of the service are now available. These too are presented.

9.1 THIS EVALUATION

Understanding the impact of any initiative which has the ultimate aim of reducing incidences of ill-health is difficult. Evaluations are typically constrained by both resources and the need for prompt conclusions. Health outcomes take time to emerge and can be extremely costly to monitor. The scale of changes that can be expected given an intervention of this nature is also difficult to estimate. Ideally, therefore, evaluations would run for a number of years and involve extremely large sample sizes, including large numbers of users. This is rarely possible.

There is therefore a need for evaluative work to accept this limitation from the outset. Focusing solely on statistical or quantifiable impacts can lead to inconclusive results. There is therefore a need to undertake evaluations which attempt to measure change in a range of different ways, as was the case here. Evaluations need to provide evidence across different employers (eg through survey work) and within individual employers (eg through in-depth qualitative work) to truly understand the impact of the intervention in question.

Having said that, the qualitative work discussed in this report has faced an inherent difficulty. There has been a general lack of recognition amongst respondents that CBH has impacted on their knowledge, attitudes and behaviours, despite a range of specific evidence emerging from employers and employees that it has. This typifies what seems to be a persistent, deeply embedded view in the sector that ‘we know about health and safety, and don’t need to know any more’. This is simply unsupported by evidence from the providers involved in delivering services, or from a wider perspective on the performance of the industry as a whole. Both of these sources point to a lack of awareness and/or acceptance amongst employers about the real state of their knowledge of OSH management. Using respondents as the main way of measuring change, therefore, from this base has some disadvantages. Learning from the experiences of the pilot providers about change, and also about the processes of running such an initiative therefore represents an important additional strand in evaluation activities.

9.2 LEARNING ABOUT THE CONSTRUCTION INDUSTRY

CBH has, in some ways, been ‘myth busting’. There was a preconception amongst employers, but also more widely, that, as construction is a ‘macho’ environment, workers in the industry are not interested in health. The massive take-up of health checks and high attendance at toolbox talks by workers clearly contradicts such a view. The other implication of this finding is that consulting with management is not always the best way to assess what individuals at worker level might want. There is therefore a need for to consult with worker representatives too. Policy makers should therefore engage with individuals working in construction at all levels in taking forward future initiatives. Within the construction industry there needs to be a greater recognition that occupational and general health are priorities for employees, and that there is an openness amongst workers to act on them.

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A related misperception amongst management, and again more broadly, is that workers are irresponsible and/or not interested in looking after their own health and safety. There is clear evidence from this evaluation that workers did in fact respond well to the CBH interventions. This was true in terms of individuals improving their general health behaviours, often as a result of the health checks. Also in the way that they changed their working practices with more informed and consistent use of PPE, for example. This contrasts with the fact that organisational change was less evident. Managers were less receptive to messages about change than were their workers.

There is also a paradox in relation to occupational health and safety within construction. On the one hand there is the relatively poor health and safety performance and the high risks present in the industry relative to other sectors when viewed from outside the industry. On the other is the view from inside that ill-health is not an issue and that health and safety are already managed effectively enough.

Complex subcontractual relationships and casual working within construction mean that employers often don’t have to ‘foot the bill’ for sickness absence and therefore don’t record it or see it as a problem. Similarly, workers may feel financial pressures to come to work even when in other sectors they would be considered too ill to do so. Where there are permanent employees, line or site management (who manage health issues on work sites) may not be the ones dealing with individuals who do go off sick. Instead, HR or central management may take things forward with occupational health. Whether this is effectively communicated back to hands-on management who have responsibility for the health and safety standards on site is unclear. There is therefore a total lack of internal confirmation of problems, and a lack of motivation to do anything about them or to recognise that existing practices may not be up to the mark. Tackling these barriers with construction employers therefore needs to be a priority for the future. Only initiatives which directly target managers will be able to really bring about large-scale changes.

9.3 MESSAGES ABOUT OCCUPATIONAL HEALTH

Building on this knowledge of the sector, there is therefore an important question for providers about how best to ‘sell in’ work on occupational health to employers. The CBH initiative focussed on sticking with a message about occupational health rather than safety. This was difficult at first, but actually became a positive for the pilot. CBH had a unique selling point, setting it apart from ‘health and safety’ consultants in taking forward clear messages about the importance of occupational health for both the industry and individual employers.

On a broader scale, any national initiative needs to think carefully about how best to communicate health messages to employers. The projected skills shortages for the construction sector would certainly seem to be one way of encouraging them to see the bigger picture. Another message (which has wider resonance than just construction) is the fact that there can often be unexpected benefits for employers in being seen to tackle occupational health and take the health of their workers seriously. Having a good record on Corporate Social Responsibility is increasingly important in a competitive economy and/or labour market. Therefore being seen to be a ‘good’ and ‘caring’ employer has its own advantages outside of pure financial considerations, although enhanced worker performance can often be another result. Positive changes were clearly in evidence amongst CBH users in the form of better communication between subcontractors, workers and management, for example.

The lack of take-up of health surveillance, in an industry which could clearly benefit from more widespread activities of this kind, is another finding. Employers clearly preferred to take the ‘icing’ of voluntary health checks without the ‘cake’ of a long term commitment to better health monitoring of their workforce. In future, therefore, services which aim to take forward health surveillance could benefit from a greater focus on this one individual element. Having a clear strategy for encouraging employers to see the long-term and business benefits of engaging in health surveillance will be important. This is complicated within construction, however, by a lack of

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industry standards regarding safety critical working, and a lack of industry-specific data which clearly specify the scale of occupational health issues within the workforce. A priority for the future could, therefore, be to address these two major deficiencies.

9.4 OPERATIONAL LESSONS

Working with smaller employers has remained a significant challenge for the pilot. There has been little progress in reaching the very smallest, independent contractors. They seem resistant to a wide range of marketing and sales techniques. Aside from this group, however, there are some learning points about how to effectively engage with the sector.

A multi-stranded marketing approach which operates at at least two levels would seem the best technique. Firstly a concerted focus on getting ‘buy in’ from major contractors, supported by concerted direct marketing techniques used with smaller firms. Micro-businesses and the self-employed were picked up through supply chains, but only if they worked on the sites of larger contractors. Some progress was made in the latter stages of the pilot, however, in using marketing materials and messages that were specifically designed to appeal to this type of company. Telemarketing was the most effective method of reaching small and medium-sized firms.

There were also clear lessons regarding the usefulness and demand for web and telephone-based services for this sector. Neither was subject to high levels of take-up, with employers preferring face-to-face contact, and responding more effectively to direct approaches from the provider. Whilst such services could prove useful with a more established brand, in the early stages of operating a new initiative, particularly one with a regional remit, focusing on the provision of such services would not seem to be a necessary priority.

9.5 FUTURE OF THE CBH BRAND

The primary aim of CBH was to raise awareness at an industry level. There has certainly been progress towards this. A broader range of industry representatives are supportive of an initiative that deals with occupational health than was the case before the project started. The work of the CBH pilot, and the parent company, since the end of pilot activities have influenced the industry to consider some form of national scheme.

The latest proposals for taking forward learning points from the CBH model are that the national scheme will:

■ set industry standards for both work-related health issues and the quality of occupational health provision to deliver health screening

■ build a construction-specific knowledge portal giving consistent advice, guidance and support in the management of health-related risks

■ centralise the collection of work-related health data to develop a ‘benchmark’ for the industry and ensure that future improvements to workforce health are based on valid and reliable data

■ provide a referral route to specialists in the field of return-to-work and rehabilitation.

■ It will therefore be important to monitor the progress of CBH as it now evolves from its initial pilot stage.

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APPENDIX 1: RESPONSE RATES

Table A1.1 Response rates – baseline survey

Leicestershire Nottingham Avon N % N % N %

Total sample drawn 2,369 2,589 3,332 Valid:

Total achieved interviews 750 32 252 10 1,009 30 Refusals 776 33 228 9 966 29 Reached max number of calls 86 4 0 0 99 3

Ineligible/not required: Unable to take part 30 1 21 1 45 1 Number not recognised/out of service/wrong number 264 11 219 8 402 12 No longer at address 108 5 120 5 245 7 Number not required – quotas filled 0 1,707 66 0 0 Other ineligible (ie. Not SIC45) 355 15 42 2 567 17

Total valid sample 1,612 100 501 100 2,118 100 Achieved interviews 750 252 1,009 Valid response rate (%) 47 50 48

Table A1.2 Final sample status

Sample 1: Total sample Baseline Sample 2: Sample 3:

(N) control Baseline pilot New Total Sample 2,409 961 961 487 In scope of study Invalid cases:

Moved/company no longer exists 91 54 29 8 Bad telephone number 242 94 113 35

In scope of fieldwork No contact 53 20 20 13 Refusals:

Respondent refusal 318 105 129 84 Other refusal 30 15 5 10

Other reasons: Not available during fieldwork 152 66 59 27 Others 37 5 11 21

Achieved interviews 1,486 602 595 289 Response rate % in scope of study 62 63 62 59 % in scope of fieldwork 72 74 73 65

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APPENDIX 2: WEIGHTS USED IN ANALYSIS

Table A2.1 CBH weight

Coef. Std. Err. z P>z 95% Conf. Int Type of work: Fit out −0.08112 0.110171 −0.74 0.462 −0.29705 0.134806 Type of work: Completion −0.05471 0.11871 −0.46 0.645 −0.28738 0.177959 Type of work: ‘Other’ −0.12736 0.142681 −0.89 0.372 −0.40701 0.15229 No. of employees: 1 to 9 0.347041 0.121234 2.86 0.004 0.109426 0.584656 No. of employees: 10 to 49 0.849794 0.138047 6.16 0 0.579228 1.120361 No. of employees: 50 or more 1.176991 0.170494 6.9 0 0.84283 1.511152 Establishment part of larger 0.044954 0.13826 0.33 0.745 −0.22603 0.315938 group _IEmploys casual workers_1 −0.02576 0.110411 −0.23 0.816 −0.24216 0.190646 Main way of working: get −0.05038 0.189185 −0.27 0.79 −0.42118 0.320412 subcontracted to others Main way of working: 0.087921 0.194326 0.45 0.651 −0.29295 0.468793 subcontract others Main way of working: ‘Other’ 0.038787 0.215407 0.18 0.857 −0.3834 0.460976 Length of time company in −0.0794 0.123128 −0.64 0.519 −0.32073 0.161923 operation: 5 to 20 yrs Length of time company in −0.1362 0.124576 −1.09 0.274 −0.38037 0.107963 operation: more than 20 yrs Mainly commercial/industrial 0.150608 0.117401 1.28 0.2 −0.07949 0.380709 work Even split between commercial 0.024683 0.12363 0.2 0.842 −0.21763 0.266993 and domestic Mainly ‘Other’ 0.586498 0.269992 2.17 0.03 0.057324 1.115672 Mainly non-construction 0.043462 0.766139 0.06 0.955 −1.45814 1.545068 _cons −1.48448 0.235586 −6.3 0 −1.94622 −1.02274

No. of observations 1,458 Wald chi2(20) 144

Prob >chi2 0 Pseudo R2 0.1161

Log pseudolikelihood −548.285

Source: IES analysis of CBH Management Information system, June 2006

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Table A2.2 Attrition weight

Coef. Std. Err. z P>z 95% Conf. Int Attitude 1: tend to agree 0.020555 0.121664 0.17 0.866 −0.2179 0.259012 Attitude 1: neutral −0.11307 0.153819 −0.74 0.462 −0.41455 0.188407 Attitude 1: tend to disagree −0.06818 0.115362 −0.59 0.555 −0.29428 0.15793 Attitude 1: strongly disagree −0.08134 0.108143 −0.75 0.452 −0.29329 0.130621 Attitude 1: missing/dk −0.29445 0.250208 −1.18 0.239 −0.78485 0.195952 Attitude 2: tend to agree 0.138282 0.091085 1.52 0.129 −0.04024 0.316805 Attitude 2: neutral 0.355419 0.145152 2.45 0.014 0.070927 0.639912 Attitude 2: tend to disagree 0.266636 0.098662 2.7 0.007 0.073263 0.460009 Attitude 2: strongly disagree 0.388109 0.097366 3.99 0 0.197275 0.578943 Attitude 2: missing/dk −0.20726 0.285469 −0.73 0.468 −0.76677 0.35225 Attitude 3: tend to agree 0.061438 0.113663 0.54 0.589 −0.16134 0.284214 Attitude 3: neutral 0.072821 0.158951 0.46 0.647 −0.23872 0.384359 Attitude 3: tend to disagree 0.121251 0.115528 1.05 0.294 −0.10518 0.347683 Attitude 3: strongly disagree 0.107868 0.111394 0.97 0.333 −0.11046 0.326197 Attitude 3: missing/dk −0.5272 0.379615 −1.39 0.165 −1.27123 0.216835 Attitude 4: tend to agree 0.027102 0.071832 0.38 0.706 −0.11369 0.167891 Attitude 4: neutral −0.069 0.145617 −0.47 0.636 −0.3544 0.216403 Attitude 4: tend to disagree 0.077334 0.111084 0.7 0.486 −0.14039 0.295055 Attitude 4: strongly disagree 0.03781 0.228813 0.17 0.869 −0.41066 0.486276 Attitude 4: missing/dk 0.050076 0.565758 0.09 0.929 −1.05879 1.158941 Attitude 5: tend to agree 0.006145 0.109315 0.06 0.955 −0.20811 0.220397 Attitude 5: neutral −0.19629 0.155869 −1.26 0.208 −0.50179 0.109205 Attitude 5: tend to disagree −0.10268 0.1162 −0.88 0.377 −0.33043 0.125069 Attitude 5: strongly disagree 0.050184 0.120916 0.42 0.678 −0.18681 0.287174 Attitude 5: missing/dk 0.24347 0.405543 0.6 0.548 −0.55138 1.03832 Attitude 6: tend to agree 0.067161 0.118999 0.56 0.572 −0.16607 0.300394 Attitude 6: neutral 0.236882 0.158053 1.5 0.134 −0.0729 0.546661 Attitude 6: tend to disagree 0.037132 0.11839 0.31 0.754 −0.19491 0.269173 Attitude 6: strongly disagree 0.076281 0.118399 0.64 0.519 −0.15578 0.308338 Attitude 6: missing/dk −0.26359 0.294431 −0.9 0.371 −0.84067 0.313482 Attitude 7: tend to agree 0.089855 0.090105 1 0.319 −0.08675 0.266457 Attitude 7: neutral 0.234656 0.119222 1.97 0.049 0.000985 0.468327 Attitude 7: tend to disagree 0.125035 0.104013 1.2 0.229 −0.07883 0.328897 Attitude 7: strongly disagree 0.09174 0.141739 0.65 0.517 −0.18606 0.369544 Attitude 7: missing/dk −0.05287 0.361146 −0.15 0.884 −0.7607 0.654962 Mainly commercial 0.076406 0.07201 1.06 0.289 −0.06473 0.217543 Even split between commercial 0.099363 0.071117 1.4 0.162 −0.04002 0.23875 and domestic No. of employees: 1 to 9 0.109063 0.068386 1.59 0.111 −0.02497 0.243096 No. of employees: 10 to 49 0.104681 0.102264 1.02 0.306 −0.09575 0.305115 No. of employees: 50 or more 0.532685 0.182884 2.91 0.004 0.17424 0.891131

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Coef. Std. Err. z P>z 95% Conf. Int Part of larger group 0.062294 0.149331 0.42 0.677 −0.23039 0.354977 Have casual workers −0.1213 0.071602 −1.69 0.09 −0.26164 0.019037 In operation 5 to 20 years 0.123755 0.073758 1.68 0.093 −0.02081 0.268318 In operation 20 years or more 0.260168 0.076232 3.41 0.001 0.110756 0.409579 Type of work: Fit out −0.04724 0.084756 −0.56 0.577 −0.21336 0.118878 Type of work: Completion −0.09363 0.079508 −1.18 0.239 −0.24947 0.0622 Inform subcontractors: most of −0.08055 0.084068 −0.96 0.338 −0.24532 0.084221 time Inform subcontractors: some of 0.116308 0.108324 1.07 0.283 −0.096 0.32862 time Inform subcontractors: not at all 0.1431 0.146614 0.98 0.329 −0.14426 0.430458 _cons −0.36052 0.188486 −1.91 0.056 −0.72995 0.008902

No. of observations 1,973 Wald chi2(20) 85.6 Prob >chi2 0.0009 Pseudo R2 0.0321

Source: IES analysis of CBH Management Information system, June 2006

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Table A2.3 Combined weight (CBH and attrition)

Coef. Std. Err. z P>z 95% Conf. Int Attitude 1: tend to agree 0.020555 0.121664 0.17 0.866 −0.2179 0.259012 Attitude 1: neutral −0.11307 0.153819 −0.74 0.462 −0.41455 0.188407 Attitude 1: tend to disagree −0.06818 0.115362 −0.59 0.555 −0.29428 0.15793 Attitude 1: strongly disagree −0.08134 0.108143 −0.75 0.452 −0.29329 0.130621 Attitude 1: missing/dk −0.29445 0.250208 −1.18 0.239 −0.78485 0.195952 Attitude 2: tend to agree 0.138282 0.091085 1.52 0.129 −0.04024 0.316805 Attitude 2: neutral 0.355419 0.145152 2.45 0.014 0.070927 0.639912 Attitude 2:tend to disagree 0.266636 0.098662 2.7 0.007 0.073263 0.460009 Attitude 2: strongly disagree 0.388109 0.097366 3.99 0 0.197275 0.578943 Attitude 2: missing/dk −0.20726 0.285469 −0.73 0.468 −0.76677 0.35225 Attitude 3: tend to agree 0.061438 0.113663 0.54 0.589 −0.16134 0.284214 Attitude 3: neutral 0.072821 0.158951 0.46 0.647 −0.23872 0.384359 Attitude 3: tend to disagree 0.121251 0.115528 1.05 0.294 −0.10518 0.347683 Attitude 3: strongly disagree 0.107868 0.111394 0.97 0.333 −0.11046 0.326197 Attitude 3: missing/dk −0.5272 0.379615 −1.39 0.165 −1.27123 0.216835 Attitude 4: tend to agree 0.027102 0.071832 0.38 0.706 −0.11369 0.167891 Attitude 4: neutral −0.069 0.145617 −0.47 0.636 −0.3544 0.216403 Attitude 4: tend to disagree 0.077334 0.111084 0.7 0.486 −0.14039 0.295055 Attitude 4: strongly disagree 0.03781 0.228813 0.17 0.869 −0.41066 0.486276 Attitude 4: missing/dk 0.050076 0.565758 0.09 0.929 −1.05879 1.158941 Attitude 5: tend to agree 0.006145 0.109315 0.06 0.955 −0.20811 0.220397 Attitude 5: neutral −0.19629 0.155869 −1.26 0.208 −0.50179 0.109205 Attitude 5: tend to disagree −0.10268 0.1162 −0.88 0.377 −0.33043 0.125069 Attitude 5: strongly disagree 0.050184 0.120916 0.42 0.678 −0.18681 0.287174 Attitude 5: missing/dk 0.24347 0.405543 0.6 0.548 −0.55138 1.03832 Attitude 6: tend to agree 0.067161 0.118999 0.56 0.572 −0.16607 0.300394 Attitude 6: neutral 0.236882 0.158053 1.5 0.134 −0.0729 0.546661 Attitude 6: tend to disagree 0.037132 0.11839 0.31 0.754 −0.19491 0.269173 Attitude 6: strongly disagree 0.076281 0.118399 0.64 0.519 −0.15578 0.308338 Attitude 6: missing/dk −0.26359 0.294431 −0.9 0.371 −0.84067 0.313482 Attitude 7: tend to agree 0.089855 0.090105 1 0.319 −0.08675 0.266457 Attitude 7: neutral 0.234656 0.119222 1.97 0.049 0.000985 0.468327 Attitude 7: tend to disagree 0.125035 0.104013 1.2 0.229 −0.07883 0.328897 Attitude 7: strongly disagree 0.09174 0.141739 0.65 0.517 −0.18606 0.369544 Attitude 7: missing/dk −0.05287 0.361146 −0.15 0.884 −0.7607 0.654962 Mainly commercial 0.076406 0.07201 1.06 0.289 −0.06473 0.217543 Even split between commercial 0.099363 0.071117 1.4 0.162 −0.04002 0.23875 and domestic No. of employees: 1 to 9 0.109063 0.068386 1.59 0.111 −0.02497 0.243096 No. of employees: 10 to 49 0.104681 0.102264 1.02 0.306 −0.09575 0.305115 No. of employees: 50 or more 0.532685 0.182884 2.91 0.004 0.17424 0.891131

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Coef. Std. Err. z P>z 95% Conf. Int Part of larger group 0.062294 0.149331 0.42 0.677 −0.23039 0.354977 Have casual workers −0.1213 0.071602 −1.69 0.09 −0.26164 0.019037 In operation 5 to 20 years 0.123755 0.073758 1.68 0.093 −0.02081 0.268318 In operation 20 years or more 0.260168 0.076232 3.41 0.001 0.110756 0.409579 Main type of work: commercial −0.04724 0.084756 −0.56 0.577 −0.21336 0.118878 Main type of work: domestic −0.09363 0.079508 −1.18 0.239 −0.24947 0.0622 Inform subcontractors: most of −0.08055 0.084068 −0.96 0.338 −0.24532 0.084221 time Inform subcontractors: some of 0.116308 0.108324 1.07 0.283 −0.096 0.32862 time Inform subcontractors: not at all 0.1431 0.146614 0.98 0.329 −0.14426 0.430458 _cons −0.36052 0.188486 −1.91 0.056 −0.72995 0.008902

No. of observations 1,973 Wald chi2(20) 85.6 Prob >chi2 0.0009 Pseudo R2 0.0321 Log pseudolikelihood −1,288.54

Source: IES analysis of CBH Management Information system, June 2006

114

APPENDIX 3: QUESTIONNAIRE USED IN WAVE TWO SURVEY

CONSTRUCTING BETTER HEALTH PILOTS – SECOND SURVEY

FINALISED JUNE 2006 (J28070)

IF HAVE NAMED CONTACT:

Good morning, afternoon, evening. I would like to speak to X (see sample).

IF NO NAMED CONTACT/NAMED CONTACT NO LONGER EMPLOYED:

I would like to speak to the person with overall responsibility for Health and Safety issues for this establishment. Who in your organisation would that be and what is their job title?

QA1: I am calling from Ipsos MORI, an independent research organisation. You may recall taking part in a survey conducted in Winter 2004 on health and safety in the construction industry. We are now doing a second stage of this research. The survey is not about checking compliance and is totally confidential. It should take around 15 minutes and your views are very important. NOW GO TO Q1

TO RELEVANT CONTACT:

READ OUT IF CODE 3 AT QI:

QA2: I am calling from Ipsos MORI, an independent research organisation. We are conducting a survey of the construction industry about health and safety practices prompted by a service that ran in your area called Constructing Better Health/Fit Builder. The survey is not about checking compliance and is totally confidential. It should take around 15 minutes and your views are very important. NOW GO TO Q1

Can I just check, are you the best person to talk about this? IF NOT, ASK TO BE PUT THROUGH TO MOST RELEVANT INDIVIDUAL.

NOTE FOR ALL:

IF SAY NOT RELEVANT/NOT PART OF THE CONSTRUCTION SECTOR check whether organisation has any connection with construction companies/industry, eg provide services to or work with construction companies, eg architects, designers, trade suppliers. If do, say the research is also about construction-related companies and encourage to take part. If insist that not relevant thank and close.

REASSURE IF NECESSARY:

No information that can identify you will be passed on to the HSE, or anyone else including anyone in your organisation. Your views are very important in order to let HSE know how best to support your organisation and others in the future.

We work strictly within the Market Research Society Code of Conduct.

■ (IF Qi = 1 or 2) Establishments have been randomly chosen from Experien Business Database

■ (IF Qi = 3) You have been chosen because you were approached by CBH in the last 2 years and are included in their database of construction companies in the area.

■ IF RESPONDENTS HAVE ANY HEALTH & SAFETY RELATED QUESTIONS, THEY CAN CONTACT THE HELPLINE ON: 08701 545500

115

SECTION 1: ESTABLISHMENT DETAILS:

I’D LIKE TO BEGIN BY ASKING A FEW QUESTIONS ABOUT YOUR ORGANISATION

ASK ALLQ1. SHOWCARD What is the main activity of this establishment? INTERVIEWER PROBE

AS NECESSARY (EG WHAT EXACTLY IS MADE OR DONE AT THISESTABLISHMENT? WHAT MATERIAL OR MACHINERY DOES THAT INVOLVEUSING?) SINGLE CODE ONLY

()Demolition and wrecking of buildings 1

Test drilling and boring

Other (WRITE IN FULLY WHAT THEY DO/MAKE) 18 ()

2

General construction of buildings etc 3

Erection of roof covering and frames 4

Construction of highways, roads etc 5

Construction of water projects 6

Other construction involving special trades 7

Installation: electrical wires/ fittings 8

Insulation work activities 9

Plumbing 10

Other building installation 11

Plastering 12

Joinery Installation 13

Floor and wall covering 14

Painting and glazing 15

Other building completion 16

Renting of construction or demolition equipment with operator 17

SECTION 2: BACKGROUND

FILTER INSTRUCTIONS: ASK SECTION 2 OF ALL

ASK ALL Q2. Are you a ….? READ OUT. SINGLE CODE ONLY

() Sole trader/self employed with NO employees 1 GO TO Q5 Self-employed with employees 2 go to filter at q3 A worker/employer 3 ()

116

Q3. ASK IF Q2 = 2 OR 3, OTHERWISE GO TO FILTER AT Q4 Is this establishment part of a larger group? SINGLE CODE ONLY

() Yes 1 READ OUT Q3B THEN ASK

Q4 No 2 go to Q4 Don’t know 3 ()

READ OUT Q3B ONLY IF CODE 1 AT Q3

Q3b. Please note that in the questions that follow, whilst I will use the word ‘company’, I am only interested in learning what happens at this particular establishment or branch and not what happens in the larger organisation as a whole.

ASK IF Q2 = 2 OR 3, OTHERWISE GO TO Q5 Q4. How many people do you have working for you as employees? By this I mean anyone on Q4

the payroll? ESTIMATE IS OK. ZERO NOT ACCEPTABLE AND SHOULD GO BACK AND CODE 1 AT Q2. IF UNABLE TO RECALL EXACT NUMBER, PROMPT USING BANDS BELOW. SINGLE CODE ONLY

() 1 to 4 1 5 to 9 2 10 to 3 19 20 to 4 49 50 to 5 99 100+ 6 Don’t 7 () know

ASK ALL. Q5. How many people do you have working for you on a (more) casual basis, who are neither

employees nor people who you officially subcontract work to ? NOTE: INCLUDE AGENCY WORKERS ESTIMATE IS OK. ZERO IS ACCEPTABLE. IF UNABLE TO RECALL EXACT NUMBER, PROMPT USING BANDS BELOW. SINGLE CODE ONLY

()0 1

1 to 4 2

5 to 9 3

10 to 419 20 to 549

50 to 6

117

99 100+ 7 Don’t 8 () know

Q6. ASK IF NEW SAMPLE (Qi=3), OTHERWISE (BASELINE) GO TO Q7 IF Q2 = 1 OR 2: How long have you been self-employed? IF Q2 = 3: How long has this establishment been operating? IF UNABLE TO RECALL EXACT NUMBER, PROMPT USING BANDS BELOW. SINGLE CODE ONLY

() Less 1than ayear1 up 2to 2years

2 up 3to 5years

5 up 4to 10years

10 up 5to 20years

20 6yearsormore

Don’t 7 () know

SECTION 3: NATURE OF WORK

FILTER INSTRUCTIONS: ASK SECTION 3 OF ALL

ASK ALL Q7. Which of the following types of work do you/does your company mainly do?

READ OUT. SINGLE CODE ONLY ()

Domestic (ie in or on peoples houses) 1 Commercial/industrial 2 Evenly split between commercial and domestic 3 Other (PLEASE SPECIFY) 4

Not applicable (ie not construction company) 5 ()

Q8. And has the work been mostly…?

118

READ OUT. SINGLE CODE ONLY ()

Very short term – a day or less 1

Short term – 2 days to a week 2

Between one week and one month 3

Several months or longer 4

Other (PLEASE SPECIFY) 5

Don’t know 6

Not applicable (ie not construction company) 7 ()

119

Q9. Do you/does your company work in any of the following ways? READ OUT. MULTICODE OK

() Work independently on a job 1 Work as a subcontractor 2 Subcontract work to others 3 Don’t know 4 Not applicable (ie not construction company) 5 ()

ASK IF TICKED MORE THAN ONE OPTION IN Q9. OTHERS GO TO FILTER AT Q11.

Q10. Do you MOSTLY…? READ OUT. SINGLE CODE ONLY ()

Work independently on a job 1 Work as a subcontractor 2 Subcontract work to others on jobs that you 3 manage Others (PLEASE SPECIFY) 4

Don’t know 5 Not applicable (ie not construction company) 6 ()

SECTION 4: HEALTH AND SAFETY PRACTICE

FILTER INSTRUCTIONS:

ASK SECTION 4 ONLY IF Q2 = 2 OR 3.

IF NEW SOLE TRADER (Qi = 3 AND Q2=1) GO TO FILTER AT Q17,

IF BASELINE SOLE TRADER (Qi = 1 or 2 AND Q2=1) GO TO FILTER AT Q27

I’d like to ask you a few questions about health and safety. I’d like to confirm again that thisconversation is confidential and this is not a test of compliance.

Q11. ASK IF Q2=2 OR 3 Apart from yourself, does anybody else in your organisation get involved in health and safety? SINGLE CODE ONLY

() Yes 1 GO TO Q12 No 2 GO TO Q13 Don’t know 3 ()

120

Q12. ASK IF (CODE 1) AT Q11. OTHERS GO TO Q13. Who is this? DO NOT READ OUT. MULTICODE OK PROBE: Anyone else?

() Trade union representative 1 Health and safety adviser 2 Health and safety committee 3 Occupational health department 4 First Aiders 5 Branch/site managers 6 Employees on the payroll 7 Casual staff 8 Other (PLEASE SPECIFY) 9 ()

Q13. ASK IF (CODES 2 OR 3) AT Q2 Have you/has your company got a written health and safety policy? SINGLE CODE ONLY

() Yes 1 No 2 Don’t know 3 ()

SECTION 5: TRAINING IN HEALTH & SAFETY – NEW SAMPLE

FILTER INSTRUCTIONS: ASK SECTION 5 IF NEW SAMPLE (Qi = 3), OTHERWISE (BASELINE) GO TO Q23

Q14. ASK IF Q2 = 2 OR 3 When was the last time you provided any health and safety training to your employees? RECORD EXACT PERIOD. ESTIMATE IS OK. IF UNABLE, PROMPT USING BANDS BELOW. SINGLE CODE ONLY

() Less than 2 weeks ago 1 GO TO Q15 2 weeks up to but less than 1 month ago 2 1 month up to but less than 3 months ago 3 3 months up to but less than 6 months ago 4 6 months up to but less than 1 year ago 5 1 year up to but less than 2 years ago 6 2 years up to but less than 3 years ago 7 3 years up to but less than 4 years ago 8 4 years up to but less than 5 years ago 9 5 years up to but less than 7 years ago 10 GO TO FILTER AT Q17 7 years or more 11 Don’t know 12 Never 13 ()

121

Q15.

ASK IF (CODES 1−12) AT Q14

Does this training tend to be …? READ OUT. MULTICODE OK

Formal, as part of a regular training program Formal, as part of a one-off course Informal, such as a short discussion or training session before starting work Through the use of manuals, literature Through correspondence (eg memos) sent to workers Others (PLEASE SPECIFY)

Don’t know

() 1 2 3

4 5 6

7 ()

Q16. Which of the following provide health and safety training to your employees …? READ OUT. CODE ALL THAT APPLY

() Your company 1 Constructing Better Health (or Fit Builder) 2 Another external training provider 3 Other (please specify) 4 Don’t know 5 ()

Q17.

ASK IF HAVE CASUAL WORKERS (VALUE GIVEN AT Q5>0 OR ‘NOT’ DON’T KNOW)

When was the last time you provided any health and safety training to your casual workers? RECORD EXACT PERIOD. ESTIMATE IS OK. PROMPT USING BANDS BELOW. SINGLE CODE ONLY

() Less than 2 weeks ago 1 ASK Q18 2 weeks up to but less than 1 month ago 2 1 month up to but less than 3 months ago 3 3 months up to but less than 6 months ago 4 6 months up to but less than 1 year ago 5 1 year up to but less than 2 years ago 6 2 years up to but less than 3 years ago 7 3 years up to but less than 4 years ago 8 4 years up to but less than 5 years ago 9 5 years up to but less than 7 years ago 10 GO TO FILTER AT Q20 7 years or more 11 Don’t know 12 Never 13 ()

122

ASK IF (CODES 1−12) AT Q17

Q18. Does this training tend to be …? READ OUT. MULTICODE OK

()Formal, as part of a regular training program 1

Formal, as part of a one-off course 2

Informal, such as a short discussion or training session 3before starting work

Through the use of manuals, literature 4

Through correspondence (eg memos) sent to workers 5

Other (PLEASE SPECIFY) 6

Don’t know 7 ()

Q19. Which of the following provide health and safety training to your casual workers …? READOUT. CODE ALL THAT APPLY

()Your company 1

Fit Builder/Constructing Better Health 2

Another external training provider 3

Other (please specify) 4

Don’t know 5 ()

ASK SOLE TRADERS (IF Q2 = 1). OTHERS GO TO FILTER AT Q35

Q20. Does this training tend to be …? READ OUT. MULTICODE OK

()Less than 2 weeks ago 1 GO TO Q21

2 weeks up to but less than 1 month ago 2

5 years up to but less than 7 years ago 10 GO TO FILTER AT Q35

Never 13 ()

1 month up to but less than 3 months ago 3

3 months up to but less than 6 months ago 4

6 months up to but less than 1 year ago 5

1 year up to but less than 2 years ago 6

2 years up to but less than 3 years ago 7

3 years up to but less than 4 years ago 8

4 years up to but less than 5 years ago 9

7 years or more 11

Don’t know 12

ASK IF (CODES 1−12) AT Q20. OTHERS GO TO FILTER AT Q35

123

Q21. Does the training you receive tend to be …? READ OUT. MULTICODE OK ()

Formal, as part of a regular training program 1 Formal, as part of a one-off course 2 Informal, such as a short discussion or training session 3 before starting work Through the use of manuals, literature 4 Through correspondence (eg memos) sent to workers 5 Other (PLEASE SPECIFY) 6

Don’t know 7 ()

Q22. Was any of this training provided by Constructing Better Health/Fit Builder? SINGLE CODE ()

Yes 1 GO TO FILTER AT Q35 No 2 Don’t know 3 ()

124

SECTION 6: TRAINING IN HEALTH AND SAFETY - BASELINE

FILTER INSTRUCTIONS: ASK SECTION 6 IF BASELINE SAMPLE (Qi = 1 OR 2), OTHERWISE (NEW SAMPLE: Qi=3) GO TO FILTER AT Q35

Q23. ASK IF Q2 = 2 OR 3 Since we spoke to you in Winter 2004, have you provided your employees with any health and safety training? SINGLE CODE ONLY

() Yes 1 GO TO Q24 No 2 GO TO FILTER AT Q27 Don’t know 3 ()

NEW Q

Q24. ASK IF CODE 1 AT Q23 When was the last time you provided this training? RECORD EXACT PERIOD. ESTIMATE IS OK. IF UNABLE, PROMPT USING BANDS BELOW. SINGLE CODE ONLY

() Less than 2 weeks ago 1 2 weeks up to but less than 4 weeks ago 2 1 month up to but less than 3 months ago 3 3 months up to but less than 6 months ago 4 6 months up to but less than 12 months ago 5 12 months up to but less than 18 months ago 6 Don’t know 7 ()

Q25. Has this training been…? READ OUT. MULTICODE OK

() Formal, as part of a regular training program 1 Formal, as part of a one-off course 2 Informal, such as a short discussion or training session before starting work

3

Through the use of manuals, literature 4 Through correspondence (eg memos) sent to workers 5 Others (PLEASE SPECIFY) 6

Don’t know 7 ()

125

12345

Q26a. ASK IF BASELINE PILOT SAMPLE (Qi = 2 ) AND Q23 = 1 Which of the following have provided this training …? READ OUT. CODE ALL THAT APPLY

() Your company GO TO FILTER AT Q27 Fit Builder/Constructing Better Health Another external training provider Other (please specify Don’t know ()

Q26b. ASK IF CONTROL SAMPLE (Qi = 1) AND Q23 = 1 Which of the following have provided this training…? READ OUT. CODE ALL THAT APPLY

Your company An external training provider Other (please specify) Don’t know

() 1 2 3 4

GO TO FILTER AT Q27

()

Q27. ASK IF HAVE CASUAL WORKERS (VALUE GIVEN AT Q5>0 OR “NOT” DON’T KNOW), OTHERWISE GO TO FILTER AT Q31 Since we spoke to you in Winter 2004, have you provided any casual staff with any health and safety training? SINGLE CODE ONLY

() Yes 1 GO TO Q28 No 2 GO TO FILTER AT Q31 Don’t know 3 ()

Q28. ASK IF Q27 = 1 When was the last time you provided this training? RECORD EXACT PERIOD. ESTIMATE IS OK. IF UNABLE, PROMPT USING BANDS BELOW. SINGLE CODE ONLY

() Less than 2 weeks ago 1 2 weeks up to but less than 4 weeks ago 2 1 month up to but less than 3 months ago 3 3 months up to but less than 6 months ago 4 6 months up to but less than 12 months ago 5 12 months up to but less than 18 months ago 6 Don’t know 7 ()

Q29.

126

Has this training been…? READ OUT. MULTICODE OK ()

Formal, as part of a regular training program 1 Formal, as part of a one-off course 2 Informal, such as a short discussion or training session before starting work

3

Through the use of manuals, literature Through correspondence (eg memos) sent to workers Other (PLEASE SPECIFY) Don’t know

4 5 6 7 ()

Q30a. ASK IF BASELINE PILOT SAMPLE (Qi = 2) AND Q27 = 1 Which of the following have provided this training…? READ OUT. MULTICODE OK

() Your company 1 GO TO FILTER AT Q31 Fit Builder/Constructing Better Health 2 Another external training provider 3 Other (please specify) 4 Don’t know 5 ()

Q30b. ASK IF BASELINE CONTROL SAMPLE (Qi = 1) AND Q27 = 1 Which of the following have provided this training…? READ OUT. CODE ALL THAT APPLY

() Your company 1 GO TO FILTER AT Q31 An external training provider 2 Other (please specify) 3 Both 4 ()

Q31. ASK IF Q2 = 1, OTHERWISE GO TO FILTER AT Q35 Since we spoke to you in Winter 2004, have you received any training in health and safety? SINGLE CODE ONLY

() Yes 1 GO TO Q32 No 2 GO TO FILTER AT Q35 Don’t know 3 ()

Q32. ASK IF Q31=1, OTHERWISE GO TO FILTER AT Q35 When was the last time you received this training? RECORD EXACT PERIOD. ESTIMATE IS OK. IF UNABLE, PROMPT USING BANDS BELOW. SINGLE CODE ONLY

() Less than 2 weeks ago 1 2 weeks up to but less than 4 weeks ago 2 1 month up to but less than 3 months ago 3 3 months up to but less than 6 months ago 4 6 months up to but less than 12 months ago 5 12 months up to but less than 18 months ago 6 Don’t know 7 ()

127

12345

Q33. Has this training been…? READ OUT. MULTICODE OK ()

Formal, as part of a regular training program 1 Formal, as part of a one-off course 2 Informal, such as a short discussion or training session before 3 starting work Through the use of manuals, literature 4 Through correspondence (eg memos) sent to workers 5 Other (PLEASE SPECIFY) 6

Don’t know 7 ()

Q34. ASK IF BASELINE PILOT SAMPLE (Qi = 2) AND Q31 = 1 Was any of it provided by Constructing Better Health/Fit Builder? SINGLE CODE

() Yes 1 No 2 Don’t know 3 ()

SECTION 7: SUBCONTRACTING – BASELINE AND NEW SAMPLE

FILTER INSTRUCTIONS: ASK SECTION 7 OF ALL WHO SUBCONTRACTS OR IS A SUBCONTRACTOR AT Q9.

ASK IF WORK WITH SUBCONTRACTORS (CODE 3) AT Q9, OTHERWISE GO TO FILTER AT Q38

Q35. To what extent do you/does your company take time to inform subcontractors about the possible health and safety risks in work areas they are working on for you? READ OUT. SINGLE CODE ONLY

() All the time ASK Q36 Most of the time Some of the time Not at all GO TO Q37 Don’t know ()

ASK IF (CODES 1−3) AT Q35

Q36. How do you tend to inform subcontractors? DO NOT READ OUT. MULTICODE OK ()

Formally, through a regular training program 1 Formally, through a one-off course 2 Informally, such as a short discussion, walk around site or training 3 session before starting work Through the use of manuals, literature 4 Through correspondence (eg memos) sent to subcontractors 5

128

Other (PLEASE SPECIFY) Don’t know

6 7 ()

Q37.

ASK IF WORK WITH SUBCONTRACTORS (CODE 3) AT Q9

In deciding which subcontractors to work with, how important is it to know about their health and safety practices? READ OUT. SINGLE CODE ONLY

() Very important 1 Quite important 2 Not very important 3 Not important at all 4 Don’t know 5 ()

Q38.

ASK IF WORK AS A SUB-CONTRACTOR (CODE 2) AT Q9, OTHERWISE GO TO Q40

How well informed do you feel you are/your company is about the possible health and safety risks in work areas you are contracted to work on? READ OUT. SINGLE CODE ONLY

() Extremely well informed 1 Fairly well informed 2 Not very well informed 3 Not at all informed 4 Don’t know 5 ()

Q39. How do you tend to get informed by firms you are contracted to work for? DO NOT READ OUT. MULTICODE OK

() Formally, through a regular training program 1 Formally, through a one-off course 2 Informally, such as a short discussion, walk around site or training session before starting work

3

Through the use of manuals, literature 4 Through correspondence (eg memos) sent to subcontractors 5 Other (PLEASE SPECIFY) 6

Don’t know 7 ()

SECTION 8: RISKS AND EXPERIENCE OF ILL-HEALTH/ACCIDENTS

FILTER INSTRUCTIONS: ASK SECTION 8 OF ALL

Q40. Do you/does anyone in your organisation spend time assessing possible sources of harm to you/you and your workers that might be present in your workplace? SINGLE CODE ONLY

() Yes 1 ASK Q41

129

No 2 GO TO FILTER AT Q42 Don’t know 3 ()

Q41.

ASK IF (CODE 1) AT Q40

How do you do this? DO NOT READ OUT. MULTICODE OK ()

Professional experience and/or judgement 1 Advice from consultant 2 Feedback from employees/ employee representative 3 Formal risk assessments 4 Monitoring rates of absenteeism/ sickness 5 Regular checks/monitoring (proactive hazard identification) 6 Incident/accident experience 7 Use HSE or industry codes of practice/guidance 8 Health survey of employees 9 Other (PLEASE SPECIFY) 10

Don’t know 11 ()

ASK IF NOT SOLE-TRADER (CODES 2 OR 3) AT Q2, OTHERWISE GO TO Q44

Q42. Do you keep records of any health and safety activities, such as risk assessments, that you carry out? SINGLE CODE ONLY

() Yes 1 No 2 Don’t know 3 ()

ASK ALL: LOOP Q44−45

Q44. SHOWCARD Generally speaking, what do you consider to be some of the risks in your area of work that could pose a danger to safety or damage to health? These can be to do with the area where you work, the sort of materials and equipment that you use and the way in which work Is carried out. These can also be things that you feel are fairly well controlled. PROBE: Anything else? MULTICODE UP TO 5

() Hazardous machinery or vibrating machinery 1 GO TO Q45 Handling or touching chemical and biological materials and 2 substances Breathing in dusts, aerosols, gases or other substances 3 Noise 4 Movement of fork lift trucks or vehicles on site 5 Driving of vehicles off-site 6 Manual handling (ie lifting/moving of heavy or awkward objects) 7

130

Risk of slips, trips or falls 8 Repetitive actions 9 Potentially dangerous objects accessible to the public 10 Potentially dangerous levels of electricity (eg when working with 11 electrical systems, electrical appliances) UV radiation/working in the sun 12 High or low temperatures 13 Working/operating at heights 14 Awkward working posture/ position, including kneeling 15 Excessive standing 16 Other features of workplace such as steep stairs; blind corners 17 Stressful work situations 18 Harassment or bullying 19 Other workers who do not adhere to health and safety practices 20 Other (PLEASE SPECIFY) 21

None/no answer 22 GO TO Q46 Don’t know 23 ()

ASK FOR EACH MENTION (CODES 1−21) AT Q44. OTHERS GO TO Q46

Q45. SHOWCARD Thinking about each of the risks that you have mentioned in turn, how have you/has your company dealt with them? DO NOT PROMPT. MULTICODE OK

() Provided information and training to staff 1 Introduced new/better equipment or materials 2 Provided workers with personal protective equipment (PPE) 3 Used fall/arrest equipment (eg harnessing, scaffolding) 4 Removed risks by doing job in different way 5 Reorganised work layout 6 Reduced risk by enforcing controls (eg enclosing noisy machines) 7 Ensured regular breaks for staff 8 Substituted hazardous substances/products for less hazardous ones 9 Used safety guards on machinery/ensure equipment is secured 10 Conducted risk assessment/monitoring 11 Kept work areas clean 12 Safe storage of chemicals/ labelling of hazardous substances 13 (COSHH assessments) Removed obstructions 14 Provided washing facilities 15 Provided stress management 16 Avoided working with certain companies/workers/clients 17 Can’t do anything about it 18 Other (PLEASE SPECIFY) 19

131

None/no answer 20 Don’t know 21 ()

ASK ALL

Q46. The following questions are about accidents and injuries in work In the last 2 years, have you/have you or your workers experienced any injuries or accidents at work? SINGLE CODE ONLY NOTE: IF OPERATING LESS THAN 2 YEARS THEN TIME REFERENCE IS WHEN THEIR BUSINESS STARTED

()Yes 1 No 2 Don’t know 3 ()

ASK ALL WHO HAVE OR WHOSE STAFF HAVE EXPERIENCED INJURIES OR ACCIDENTS AT WORK (CODE 1 AT Q46)

Q47. A. Which, if any, of the following type of incidents/accidents were experienced? READ OUT. REVERSE A-F. MULTICODE OK. IF Q2 = 1 AND Q5 = 0. DO NOT READ OUT OPTION E. STATEMENT F: ASK ALLASK ‘B’ FOR EACH MENTION AT ‘A’B. And how many [INSERT RESPONSE AT A] have there been over the last 2 years? TAKE BEST GUESTIMATE IF NOT KNOWN. Would you say it was 1, 2−3, 4−5, 6−10 or more than 10? SINGLE CODE ONLY. ‘DON’T KNOW IS ACCEPTABLE’ ‘DO NOT COLLECT THIS INFORMATION IS ACCEPTABLE’ NOTE: IF OPERATING LESS THAN 2 YEARS THEN TIME REFERENCE IS WHEN THEIR BUSINESS STARTED.

A B C RECORD

NUMERIC IF CAN’T GIVE VALUE ASK YES VALUE USING BANDS

1 2−3 4−5 6−10 10+ () () () () ()

A Non-serious injuries 1 1 2 3 4 5 which did not require any time off

B Injuries requiring up to 2 1 2 3 4 5 three days off work

C Other injuries requiring 3 1 2 3 4 5 more than three days off

D Fractures or injuries 4 1 2 3 4 5 requiring an overnight hospital stay

E Fatal injuries 5 1 2 3 4 5 F ‘Near misses’ (dangerous 6 1 2 3 4 5

occurrences not resulting in injury)

132

ASK ALL

Q48. IF (CODE Q1) AT Q46 ASK In the last 2 years, other than any injuries and accidents you may have already mentioned, have you/have you or your workers experienced any health problems caused or made worse by the work you/they do? IF (CODES 2 OR 3) AT Q46 ASK In the last 2 years, have you/have you or your workers experienced any health problems caused or made worse by the work you/they do? SINGLE CODE ONLY NOTE: IF OPERATING LESS THAN 2 YEARS THEN TIME REFERENCE IS WHEN THEIR BUSINESS STARTED

() Yes 1 GO TO Q49 No 2 GO TO Q50 Don’t know 3 ()

ASK IF (CODE 1) AT Q48. OTHERS GO TO Q50.

Q49. A. What health problems were experienced? PROBE: Anything else? MULTICODE OK IF (CODES 2 OR 3) AT Q2 OR Q5>0: ASK ‘B’ FOR EACH MENTION AT ‘A’ <need to limit number of mentions, say 3> B. How many people were affected? IF UNABLE TO GIVE EXACT NUMERIC VALUE, PLEASE ASK FOR BEST ESTIMATE. PROMPT USING BANDS. DON’T KNOW IS ACCEPTABLE ‘DO NOT COLLECT THIS INFORMATION IS ACCEPTABLE’

A B C IF CAN’T RECALL

RECORD NUMERIC VALUE, CODE Yes VALUE USING BANDS

1 2−3 4−5 6−10 10 +

() () () () () Back pain 1 1 2 3 4 5 Other significant physical 2 1 2 3 4 5 aches or strains (eg muscles or tendons) Problems as a result of 3 1 2 3 4 5 vibration Headaches 4 1 2 3 4 5 Deafness or ringing in the ears 5 1 2 3 4 5 Skin problems (dermatitis) 6 1 2 3 4 5 Respiratory problems (eg 7 1 2 3 4 5 asthma) Other allergies 8 1 2 3 4 5 Infections 9 1 2 3 4 5 Stress 10 1 2 3 4 5 Other (PLEASE SPECIFY) 11 1 2 3 4 5

None 12 1 2 3 4 5 ()

133

Don’t know 13 1 2 3 4 5

ASK ALL

Q50. Over the last 12 months, how many days off work have you/your workers taken due to EITHER work-related injuries OR work-related ill-health? If you can’t recall exactly, please give us your best estimate. RECORD EXACT NUMBER EITHER AS AN AVERAGE OR ABSOLUTE FIGURE (CODE 1 AT Q2, RECORD ABSOLUTE FIGURE ONLY). IF CANNOT RECALL PROMPT TO BANDS BELOW. SINGLE CODE ONLY NOTE: IF OPERATING LESS THAN 12 MONTHS THEN TIME REFERENCE IS WHEN THEIR BUSINESS STARTED. Exact average 0 1 1 to 2 2 3 to 4 3 5 to 6 4 7 to 9 5 10 to 14 6 15 to 19 7 20 to 29 8 30 to 49 9 50 to 99 10 100+ 11 Don’t collect this information 12 Don’t know 13 ()

Q51.

ASK IF CODE (2 OR 3) AT Q2

Do you have arrangements in place to support the return to work of employees on long term sickness absence or to help employees who develop some incapacity to remain at work? SINGLE CODE ONLY

() Yes 1 ASK Q52 No 2 GO TO Q50 Don’t know 3 GO TO Q53 ()

Q52.

ASK IF (CODE 1) AT Q51

What arrangements are in place? PROMPT TO BANDS BELOW. MULTICODE OK ()

Keeping in contact with off sick employees 1 Identify what workplace controls and adjustments are required to help employees return/remain at work

2

Seek professional help and advice when needed 3 Hold a ‘return to work interview’ 4 Prepare and agree a return to work plan 5

134

Have a written policy on rehabilitation 6 Train line managers and supervisors to manage rehabilitation 7 Other (PLEASE SPECIFY) 8 ()

SECTION 9: FIT BUILDER – PILOT SAMPLE

FILTER INSTRUCTIONS:

ASK SECTION 9 ONLY IF IN PILOT SAMPLE (Qi = 2 or 3)

IF CONTROL SAMPLE (Qi=1) GO TO Q66

ASK IF PILOT SAMPLE: (Qi = 2 or 3) AND NOT:

(CODE 2) AT ANY OF THE FOLLOWING Qs: Q16 OR Q19 OR Q26a OR Q30a

OR (CODE 1) AT Q22 OR Q34 <NB: if code 2 or 1 at these Qs, go to Q57.

Q53. Have you ever heard of the Fit Builder/Constructing Better Health occupational health service? If necessary use prompt They offer toolbox talks and have a healthcheck van. SINGLE CODE

() Yes 1 GO TO Q54 No 2 GO TO Q66 Don’t know 3 ()

Q54. ASK IF Q53 = 1 Have you ever used any of the services on offer? SINGLE CODE

Yes No Don’t know

() 1 2 3

GO TO Q57 GO TO Q55

()

Q55. ASK IF Q54=2 OR 3 Have ever considered using the service? SINGLE CODE

Yes No Don’t know

() 1 2 3 ()

Q56. ASK IF Q54=2 OR 3 Why have you not used the service? DO NOT READ OUT. CODE ALL THAT APPLY

Too busy No health and safety issues

() 1 2

135

Already use support from occupational health providers 3 Use in-house support for health and safety 4 Not interested 5 Other (please specify) 6 Don’t know 7 ()

Q57. ASK IF Q54 = 1 OR USED CBH/FIT BUILDER FOR TRAINING (CODE 2 AT ANY OF THESE: Q16/Q19/Q26a/Q30a OR (ODE 1 at Q22 OR Q34), OTHERWISE GO TO Q66 I’m now going to ask a few questions about the fit builder/constructing better health service that you used. By the way, what did you know the service as? REFER TO THIS NAME THROUGHOUT REST OF SURVEY Which features of the service did you use? READ OUT. CODE ALL THAT APPLY

() Health screening 1 Toolbox talks 2 Help with risk assessments 3 Document reviews 4 Site visit/walkaround 5 Adviceline 6 Website 7 Event/briefing 8 Other (please specify) 9 Don’t know 10 ()

Q58. How did you first hear about Fit Builder/Constructing Better Health? DO NOT READ OUT. CODE ALL THAT APPLY

() Received the Fit Builder newsletter through post 1 Received other info through post 2 Picked up a Fit Builder newsletter 3 Picked up other information 4 Newspaper publicity 5 Telemarketing (ie someone called me to set up an appointment) 6 Attended an event 7 Heard through builders’ merchants 8 Heard through education provider 9 Found Fit Builder website (on the internet) 10 Referred by occupational health professional 11 Heard from an employee 12 Heard from a business associate 13 Word of mouth 14 Other (please specify) 15 Don’t know 16 ()

136

Q59. What was it about Fit Builder/Constructing Better Health that appealed to you? DO NOT READ OUT. CODE ALL THAT APPLY

() Free service 1 Confidential service/trusted them 2 Staff were approachable 3 First service I heard about 4 Health checks available 5 Was offered a visit 6 Marketing appealed to me/this business 7 Was recommended to me 8 Toolbox talks (training) available 9 Document review available 10 Risk assessments available 11 Site visit available 12 Other (please specify) 13 Don’t know 14 ()

Q60. How satisfied or dissatisfied were you with the overall service you received? Were you…? READ OUT. SINGLE CODE

() Very satisfied 1 Fairly satisfied 2 Neither satisfied nor dissatisfied 3 Fairly dissatisfied 4 Very dissatisfied 5 Don’t know 6 ()

Q61. Have you made any changes to how you deal with health and safety at work as a result of using Fit Builder/Constructing Better Health? ONE CODE ONLY. IF NO, PROBE: Do you plan to?

() Yes 1 GO TO Q63 No, but plan to 2 No and don’t plan to 3 GO TO Q62 Don’t know 4 GO TO Q64 ()

Q62. Have you made any changes to how you deal with health and safety at work as a result of using Fit Builder/Constructing Better Health? ONE CODE ONLY. IF NO, PROBE: Do you plan to?

() Too costly to implement changes 1 GO TO Q66 Too time-consuming to implement changes 2 Too difficult to implement changes 3 Visit confirmed we were doing the right thing to start with 4

137

Still unclear how best to make changes 5

Other (please specify) 6

Don’t know 7 ()

Q63. ASK IF Q61 = 1 or 2What changes have you made/are you planning to make?DO NOT READ OUT. CODE ALL THAT APPLY.

()H&S policy introduced/updated 1

Risk assessments conducted 2

Sickness absence policy introduced/updated 3

Greater awareness of risks 4

Greater control of risks 5

Return to work/rehabilitation policy introduced/updated 6

Better consultation with staff 7

Introduced dedicated health and safety role/committee 8

Introducing health checks 9

Other (please specify) 10

Don’t know 11 ()

Q64. ASK IF Q54 = 1 OR USED CBH/FIT BUILDER FOR TRAINING (CODE 2 AT ANY OF THESE: Q16/Q19/Q26a/Q30a OR CODE 1 at Q22 OR Q34) AND HAVE WORKERS (CODES 2 OR 3 AT Q2 OR Q5>0), OTHERWISE GO TO Q66 Have you noticed any changes in your workers’ behaviour as a result of using FitBuilder/Constructing Better Health? ONE CODE ONLY.

()Yes 1 GO TO Q65

No 2 GO TO Q66

Don’t know 3 ()

Q65. ASK IF Q64 = 1, OTHERWISE GO TO Q66What changes have you noticed? DO NOT READ OUT. CODE ALL THAT APPLY.

()Better use of hard hats 1 GO TO Q66

Better use of ear guards 2

Better use of gloves 3

Take the risks more seriously 4

Take better care of themselves/take their health more seriously 5

Better use of procedures for manual handling 6

Better use of procedures for use of drills (eg take more regular 7breaks)Better use of safety guards on equipment 8

Other (please specify) 9

Don’t know 10 ()

138

SECTION 10: USE OF HEALTH AND SAFETY PROFESSIONALS

Q66. ASK ALL Have you/your company used the services of any occupational health or medical professionals or talked to anyone with specialist health and safety knowledge over the last 2 years? SINGLE CODE ONLY NOTE: IF OPERATING LESS THAN 2 YEARS THEN TIME REFERENCE IS WHEN THEIR BUSINESS STARTED.

() Yes 1 GO TO Q67 No 2 GO TO Q70 Don’t know 3 ()

Q67. ASK IF (CODE 1) AT Q66. OTHERS GO TO Q70 SHOWCARD Who have you used? DO NOT READ OUT. MULTICODE OK

() Occupational health physician 1 Occupational health nurse 2 GP 3 External Health and safety practitioner/consultant 4 In-house health and safety officer 5 HSE Inspectors 6 Other HSE representatives 7 Local authority/environmental health inspectors 8 Trade associations (eg Construction Industry Training Board) 9 Fit Builder/Constructing Better Health 10 Others (PLEASE SPECIFY) 11

Don’t know 12 ()

Wave 1 =Q32

Q68. ASK IF (CODES 1−11) AT Q67. OTHERS GO TO Q70. Could you give me a description of the work have these professionals undertaken for you? PROBE TO PRECODES. MULTICODE OK

()Undertake health checks on SPECIFIC workers 1

Undertake health checks on ALL workers 2

Monitor sickness absence records 3

Treat ill-health/results of accidents 4

Attend health and safety meetings 5

Advise on work-related health issues 6

Advise on general health issues 7

Advise on safety issues 8

139

Identify risks/hazards 9 Implement health and safety procedures 10 Provide support during back to work rehabilitation 11 Provide health and safety training 12 Others (PLEASE SPECIFY) 13

Don’t know/Can’t remember 14 ()

Wave 1 =Q33

SECTION 11: ATTITUDES TO HEALTH AND SAFETY

Q70. ASK ALL To what extent do you agree or disagree with the following statements? SINGLE CODE ONLY. PROBE: Is that strongly or just ‘tend to’ AGREE/DISAGREE?

Tend Neither No Strongly to agree nor Tend to Strongly opinio

agree agree disagree disagree disagree n A In the construction 1 2 3 4 5 6 ( )

industry generally, health and safety doesn’t tend to be a priority

B In my/our work, health 1 2 3 4 5 6 ( ) and safety issues aren’t really a problem

C I/We don‘t think enough 1 2 3 4 5 6 ( ) about how our/my health might be affected by the job

D I believe I/we do enough 1 2 3 4 5 6 ( ) in the area of health and safety

E I/We don’t always have 1 2 3 4 5 6 ( ) enough time to deal with health and safety issues in the way I/we would like

F I/We cannot afford to deal 1 2 3 4 5 6 ( ) with every health and safety issue

G I/we know a lot about 1 2 3 4 5 6 ( ) health and safety legislation

Q72. We may like to carry out some further research on related issues in the future? Would it be ok for us to contact you again to find out your views? I’d like to reassure you that no-one from the HSE will know you have taken part.

() Yes 1 No 2 ()

140

Q73. ASK IF (CODES 2−3) AT Q2 Can I take your name? RECORD NAME

()Q74. ASK IF (CODES 2 OR 3) AT Q2

Can I take your job title? SINGLE CODE ONLY

()Owner/partner 1

Managing/other Director 2

Outside consultant/adviser 3

Personnel manager 4

Foreman/supervisor 5

Manager/s 6

Health and Safety Manager 7

Others (PLEASE SPECIFY) 8

No 9 ()

THANK RESPONDENT AND CLOSE

141

APPENDIX 4: DETAILS OF CASE STUDY PARTICIPANTS

Sixteen employers were involved in the case study interviews. Seventy-eight interviews were conducted across 21 sites or offices. Employers were visited during both 2005 and 2006, with six of the employers visited involved at both time points and some individuals interviewed twice. Table A4.1 provides details on the size of these companies.

Table A4.1 Details of employers involved in case studies - size

Employer size No. involved in case studies

100 or more 7

20 to 100 4

10 to 19 2

0 to 9 3

Total 16

Source: IES Case study records

Interviews were conducted with individuals working at various levels within these organisations, and also involved individuals working as subcontractors on sites managed by the larger employers.

The individuals interviewed included:

■ eighteen senior managers with responsibility for health and safety within the company

■ eleven site managers, responsible for the safety and health of workers on the specific construction sites visited

■ thirty-four construction workers, including individuals working as: bricklayers; forklift drivers; scaffolders; landscape gardeners; labourers; steel erectors; plumbers, electricians, and decorators.

142

APPENDIX 5: DETAILS OF REGRESSIONS USED IN IMPACT ANALYSIS

A5.1 Whether have a health and safety policy

Table A5.1a Analysis 1 – Effect at Wave 2 with Wave 1 taken account of

Non-user sample Control sample User boost sample No. of employees: 1 to 9 Type of work: Fit out Type of work: Completion Type of work: ‘Other’ Establishment part of larger group Employs casual workers Length of time company in operation: 5 to 20 yrs Length of time company in operation: more than 20 yrs Main way of working: get subcontracted to others Main way of working: subcontract others Main way of working: ‘Other’ Mainly commercial/industrial work Even split between commercial and domestic _cons

No. of observations Wald chi2(20) Prob >chi2 Pseudo R2 Log pseudolikelihood

Coef. Std. Err. z P>z 95% Conf. Int −0.53918 0.242215 −2.23 0.026 −1.01392 −0.06445 −0.59114 0.26808 −2.21 0.027 −1.11657 −0.06571 −0.0994 0.272202 −0.37 0.715 −0.63291 0.434102 −1.74349 0.272072 −6.41 0 −2.27674 −1.21024

0.578021 0.215551 2.68 0.007 0.15555 1.000492 −0.17876 0.236768 −0.76 0.45 −0.64282 0.285293

0.15764 0.360858 0.44 0.662 −0.54963 0.864909 0.75754 0.607228 1.25 0.212 −0.4326 1.947684 0.247243 0.178577 1.38 0.166 −0.10276 0.597246 0.032773 0.255425 0.13 0.898 −0.46785 0.533396

0.050165 0.269987 0.19 0.853 −0.479 0.57933

0.335286 0.257374 1.3 0.193 −0.16916 0.83973

0.524333 0.247211 2.12 0.034 0.039808 1.008858

−0.8866 0.46285 −1.92 0.055 −1.79377 0.020572 0.695646 0.239079 2.91 0.004 0.227059 1.164232

1.10379 0.220443 5.01 0 0.671729 1.535851

2.256633 0.434159 5.2 0 1.405697 3.107569

699 192.41

0 0.3549 −127.511

Source: IES analysis of CBH Management Information system, June 2006

143

Table A5.1b Analysis 2 – Effect on change from Wave 1 to Wave 2

Coef. Std. Err. z P>z 95% Conf. Int Wave 1 no policy, Wave 2 had policy Non-user sample −0.70232 1.359021 −0.52 0.605 −3.36595 1.961316 Control sample −0.50757 1.3354 −0.38 0.704 −3.1249 2.109769 No. of employees: 10 to 49 −33.6856 0.944783 −35.65 0 −35.5373 −31.8338 No. of employees: 50 or more 21.51226 — — — — — Type of work: Fit out 1.428351 0.724548 1.97 0.049 0.008262 2.848439 Type of work: Completion 0.535258 0.88273 0.61 0.544 −1.19486 2.265376 Type of work: ‘Other’ 2.039236 0.94223 2.16 0.03 0.192499 3.885973 Establishment part of larger −1.52659 2.259512 −0.68 0.499 −5.95515 2.901977 group Employs casual workers 0.93922 0.661795 1.42 0.156 −0.35787 2.236314 Length of time company in 0.896237 0.768075 1.17 0.243 −0.60916 2.401636 operation: 5 to 20 yrs Length of time company in 1.162618 0.74117 1.57 0.117 −0.29005 2.615284 operation: more than 20 yrs Main way of working: get 0.135311 0.732175 0.18 0.853 −1.29973 1.570347 subcontracted to others Main way of working: 1.160683 0.847279 1.37 0.171 −0.49995 2.821319 subcontract others Main way of working: ‘Other’ 23.66011 0.96435 24.53 0 21.77002 25.5502 Mainly commercial/industrial 0.898007 0.743497 1.21 0.227 −0.55922 2.355233 work Even split between commercial 0.284545 0.922998 0.31 0.758 −1.5245 2.093588 and domestic Mainly ‘Other’ −22.7178 — — — — — Mainly non-construction 33.42114 1.405699 23.78 0 30.66603 36.17626 _cons −2.26774 1.505437 −1.51 0.132 −5.21834 0.682866

Wave 1 had policy, Wave 2 no policy Non-user sample −0.45266 1.012596 −0.45 0.655 −2.43731 1.53199 Control sample −1.24549 1.14751 −1.09 0.278 −3.49456 1.003591 No. of employees: 10 to 49 0.213555 1.62538 0.13 0.895 −2.97213 3.399242 No. of employees: 50 or more −11.124 0.924092 −12.04 0 −12.9352 −9.31281 Type of work: Fit out 0.019329 0.730633 0.03 0.979 −1.41269 1.451343 Type of work: Completion −0.73117 0.7749 −0.94 0.345 −2.24995 0.787605 Type of work: ‘Other’ −0.89646 1.470888 −0.61 0.542 −3.77935 1.986423 Establishment part of larger −34.2502 2.235391 −15.32 0 −38.6315 −29.8689 group Employs casual workers 0.62336 0.71329 0.87 0.382 −0.77466 2.021383 Length of time company in −0.71138 0.67317 −1.06 0.291 −2.03077 0.608011 operation: 5 to 20 yrs Length of time company in −0.15759 0.7209 −0.22 0.827 −1.57053 1.255347 operation: more than 20 yrs Main way of working: get 0.502316 0.87008 0.58 0.564 −1.20301 2.207641 subcontracted to others

144

Coef. Std. Err. z P>z 95% Conf. Int Main way of working: 0.820249 1.015321 0.81 0.419 −1.16974 2.810242 subcontract others Main way of working: ‘Other’ 24.60281 — — — — — Mainly commercial/industrial −0.35918 1.134938 −0.32 0.752 −2.58361 1.865261 work Even split between commercial 0.116178 0.788812 0.15 0.883 −1.42987 1.662221 and domestic Mainly ‘Other’ −22.5978 1.639178 −13.79 0 −25.8105 −19.385 Mainly non-construction −0.12343 1.979227 −0.06 0.95 −4.00264 3.755788 _cons 0.063396 1.303238 0.05 0.961 −2.4909 2.617695

Wave 1 had policy, Wave 2 had policy Non-user sample −1.96512 0.872599 −2.25 0.024 −3.67538 −0.25486 Control sample −2.18896 0.86763 −2.52 0.012 −3.88949 −0.48844 No. of employees: 10 to 49 2.847528 0.889005 3.2 0.001 1.10511 4.589945 No. of employees: 50 or more 23.63337 0.78332 30.17 0 22.09809 25.16865 Type of work: Fit out 0.379859 0.451618 0.84 0.4 −0.5053 1.265014 Type of work: Completion −1.57579 0.523987 −3.01 0.003 −2.60278 −0.54879 Type of work: ‘Other’ −1.18034 0.747933 −1.58 0.115 −2.64626 0.285584 Establishment part of larger 0.675591 1.594451 0.42 0.672 −2.44948 3.800658 group Employs casual workers 0.733558 0.480882 1.53 0.127 −0.20895 1.67607 Length of time company in −0.04642 0.47763 −0.1 0.923 −0.98255 0.889721 operation: 5 to 20 yrs Length of time company in 1.054769 0.502529 2.1 0.036 0.069829 2.039708 operation: more than 20 yrs Main way of working: get 0.710991 0.499377 1.42 0.155 −0.26777 1.689752 subcontracted to others Main way of working: 0.8398 0.667678 1.26 0.208 −0.46882 2.148424 subcontract others Main way of working: ‘Other’ 21.65019 0.895794 24.17 0 19.89446 23.40591 Mainly commercial/industrial 2.863306 0.537693 5.33 0 1.809447 3.917165 work Even split between commercial 1.958862 0.542138 3.61 0 0.896292 3.021432 and domestic Mainly ‘Other’ 17.31382 1.408912 12.29 0 14.5524 20.07524 Mainly non-construction 36.21545 — — — — — _cons 2.127456 0.934884 2.28 0.023 0.295116 3.959796

No. of observations 579 Wald chi2(20) — Prob >chi2 — Pseudo R2 0.4122 Log pseudolikelihood −128.984

Base category: no change between Waves

Source: IES analysis of CBH Management Information system, June 2006

145

A5.2 Whether given workforce any face to face training in the last six months

Table A5.2a Analysis 1 – Effect at Wave 2 with Wave 1 taken account of

Offered face to face training in thelast 6 months (Wave 1)Non-user sample

Control sample

No. of employees: 1 to 9

No. of employees: 10 to 49

No. of employees: 50 or more

Type of work: Fit outType of work: Completion

Type of work: ‘Other’Establishment part of larger group

Employs casual workers

Length of time company inoperation: 5 to 20 yrs

Length of time company inoperation: more than 20 yrs

Main way of working: getsubcontracted to others

Main way of working: subcontractothers

Main way of working: ‘Other’Mainly commercial/industrial work

Even split between commercial anddomestic

Mainly ‘Other’Mainly non-construction

_cons

No. of observations

Wald chi2(20)Prob >chi2

Pseudo R2

Log pseudolikelihood

Coef. Std. Err. z P>z 95% Conf. Int 0.707785 0.132211 5.35 0 0.448656 0.966914

−0.27198 0.209046 −1.3 0.193 −0.6817 0.13774 −0.10096 0.202181 −0.5 0.618 −0.49723 0.295307

0.832944 0.187462 4.44 0 0.465525 1.200364 1.550356 0.216691 7.15 0 1.125649 1.975063 1.908 0.331632 5.75 0 1.258012 2.557987 −0.27035 0.14871 −1.82 0.069 −0.56181 0.021116 −0.01141 0.186628 −0.06 0.951 −0.37719 0.354372 −0.24431 0.216197 −1.13 0.258 −0.66805 0.179428

0.307931 0.240356 1.28 0.2 −0.16316 0.77902 0.526274 0.15005 3.51 0 0.232182 0.820366 −0.32016 0.163237 −1.96 0.05 −0.64009 −0.00022

−0.48569 0.171499 −2.83 0.005 −0.82182 −0.14956

−0.31621 0.167155 −1.89 0.059 −0.64382 0.01141

−0.2402 0.220858 −1.09 0.277 −0.67307 0.192673

−0.51143 0.316603 −1.62 0.106 −1.13197 0.109096 0.442147 0.167757 2.64 0.008 0.113349 0.770945 0.284965 0.193634 1.47 0.141 −0.09455 0.664481

0.709657 0.443556 1.6 0.11 −0.1597 1.57901 1.028603 0.611747 1.68 0.093 −0.1704 2.227604 −1.06035 0.273839 −3.87 0 −1.59707 −0.52363

1,134 236.17

0 0.31

−534.745

Source: IES analysis of CBH Management Information system, June 2006

146

Table A5.2b Analysis 2 – Effect on change from Wave 1 to Wave 2

Coef. Std. Err. z P>z 95% Conf. Int Wave 1 no training, Wave 2 offered training Non-user sample 0.028227 0.565737 0.05 0.96 −1.0806 1.137051 Control sample 0.042382 0.555531 0.08 0.939 −1.04644 1.131202 No. of employees: 1 to 9 1.747908 0.324579 5.39 0 1.111745 2.384071 No. of employees: 10 to 49 2.575963 0.445575 5.78 0 1.702651 3.449275 No. of employees: 50 or more 4.354026 1.161868 3.75 0 2.076806 6.631247 Type of work: Fit out −0.44508 0.35236 −1.26 0.207 −1.13569 0.245535 Type of work: Completion −0.03842 0.42019 −0.09 0.927 −0.86197 0.78514 Type of work: ‘Other’ −0.68239 0.599953 −1.14 0.255 −1.85828 0.493494 Establishment part of larger group 1.24631 0.693072 1.8 0.072 −0.11209 2.604706 Employs casual workers 1.221796 0.366734 3.33 0.001 0.50301 1.940582 Length of time company in −0.41139 0.430185 −0.96 0.339 −1.25454 0.431755 operation: 5 to 20 yrs Length of time company in −0.76526 0.468367 −1.63 0.102 −1.68325 0.152718 operation: more than 20 yrs Main way of working: get −0.62132 0.407237 −1.53 0.127 −1.41949 0.176852 subcontracted to others Main way of working: subcontract −0.29363 0.509756 −0.58 0.565 −1.29274 0.705469 others Main way of working: ‘Other’ −3.01741 1.261663 −2.39 0.017 −5.49023 −0.5446 Mainly commercial/industrial work 1.160175 0.440475 2.63 0.008 0.296861 2.02349 Even split between commercial and 0.886737 0.416721 2.13 0.033 0.06998 1.703495 domestic Mainly ‘Other’ 4.129125 1.516676 2.72 0.006 1.156496 7.101754 Mainly non-construction 71.89294 — — — — — _cons −2.64223 0.674883 −3.92 0 −3.96498 −1.31948

Wave 1 offered training, Wave 2 no training Non-user sample −0.26133 0.446112 −0.59 0.558 −1.1357 0.613031 Control sample −0.43026 0.452766 −0.95 0.342 −1.31766 0.45715 No. of employees: 1 to 9 0.700766 0.292644 2.39 0.017 0.127195 1.274337 No. of employees: 10 to 49 0.903689 0.408076 2.21 0.027 0.103875 1.703503 No. of employees: 50 or more 3.068447 1.165003 2.63 0.008 0.785083 5.351812 Type of work: Fit out −0.03964 0.307063 −0.13 0.897 −0.64147 0.562192 Type of work: Completion −0.2276 0.359555 −0.63 0.527 −0.93232 0.477111 Type of work: ‘Other’ −0.8079 0.531171 −1.52 0.128 −1.84898 0.233176 Establishment part of larger group 0.894607 0.720826 1.24 0.215 −0.51819 2.3074 Employs casual workers 0.59193 0.293478 2.02 0.044 0.016724 1.167135 Length of time company in 0.281972 0.34305 0.82 0.411 −0.39039 0.954338 operation: 5 to 20 yrs Length of time company in 0.328557 0.338549 0.97 0.332 −0.33499 0.9921 operation: more than 20 yrs Main way of working: get 0.483743 0.354605 1.36 0.173 −0.21127 1.178755 subcontracted to others

147

Coef. Std. Err. z P>z 95% Conf. Int Main way of working: subcontract 0.748248 0.473681 1.58 0.114 −0.18015 1.676646 others Main way of working: ‘Other’ −0.56955 0.707092 −0.81 0.421 −1.95543 0.816325 Mainly commercial/industrial work 0.43395 0.365675 1.19 0.235 −0.28276 1.150659 Even split between commercial and 0.424249 0.379604 1.12 0.264 −0.31976 1.168259 domestic Mainly ‘Other’ 2.456272 0.984167 2.5 0.013 0.527341 4.385203 Mainly non-construction 27.29788 — — — — — _cons −1.66742 0.473256 −3.52 0 −2.59498 −0.73985

Wave 1 offered training, Wave 2 offered training Non-user sample −1.06598 0.458325 −2.33 0.02 −1.96428 −0.16768 Control sample −0.72981 0.452017 −1.61 0.106 −1.61575 0.156129 No. of employees: 1 to 9 1.808647 0.537237 3.37 0.001 0.755681 2.861612 No. of employees: 10 to 49 3.466212 0.58088 5.97 0 2.327707 4.604716 No. of employees: 50 or more 6.068721 1.191136 5.09 0 3.734138 8.403304 Type of work: Fit out −0.50183 0.296633 −1.69 0.091 −1.08322 0.079561 Type of work: Completion −0.19431 0.415877 −0.47 0.64 −1.00941 0.620797 Type of work: ‘Other’ −0.95883 0.502925 −1.91 0.057 −1.94455 0.026882 Establishment part of larger group 1.183758 0.619342 1.91 0.056 −0.03013 2.397647 Employs casual workers 1.230605 0.302929 4.06 0 0.636875 1.824334 Length of time company in −0.30396 0.379098 −0.8 0.423 −1.04698 0.439063 operation: 5 to 20 yrs Length of time company in −0.58783 0.396602 −1.48 0.138 −1.36515 0.189498 operation: more than 20 yrs Main way of working: get −0.08728 0.397055 −0.22 0.826 −0.86549 0.690934 subcontracted to others Main way of working: subcontract 0.36079 0.444084 0.81 0.417 −0.5096 1.231178 others Main way of working: ‘Other’ −0.57603 0.821919 −0.7 0.483 −2.18696 1.034906 Mainly commercial/industrial work 0.838702 0.355882 2.36 0.018 0.141185 1.536219 Even split between commercial and 0.551193 0.400107 1.38 0.168 −0.233 1.335388 domestic Mainly ‘Other’ 2.301923 1.029829 2.24 0.025 0.283495 4.320351 Mainly non-construction −0.10065 — — — — — _cons −1.59837 0.740453 −2.16 0.031 −3.04963 −0.1471

No. of observations 1,134 Wald chi2(20) — Prob >chi2 — Pseudo R2 0.1999 Log pseudolikelihood −1,147.94

Base category: no change between Waves

Source: IES analysis of CBH Management Information system, June 2006

148

A5.3 Whether given workforce any face to face training in the last 12 months

Table A5.3a Analysis 1 – Effect at Wave 2 with Wave 1 taken account of

Offered face to face training in thelast 12 months (Wave 1)Non-user sample

Control sample

No. of employees: 1 to 9

No. of employees: 10 to 49

No. of employees: 50 or more

Type of work: Fit outType of work: Completion

Type of work: ‘Other’Establishment part of larger group

Employs casual workers

Length of time company inoperation: 5 to 20 yrs

Length of time company inoperation: more than 20 yrs

Main way of working: getsubcontracted to others

Main way of working: subcontractothers

Main way of working: ‘Other’Mainly commercial/industrial work

Even split between commercial anddomestic

Mainly ‘Other’Mainly non-construction

_cons

No. of observations

Wald chi2(20)Prob >chi2

Pseudo R2

Log pseudolikelihood

Coef. Std. Err. z P>z 95% Conf. Int 0.521772 0.133695 3.9 0 0.259735 0.78381

−0.01752 0.213051 −0.08 0.934 −0.43509 0.400056 −0.01714 0.213574 −0.08 0.936 −0.43574 0.40146

0.902643 0.166076 5.44 0 0.577139 1.228146 1.595772 0.20979 7.61 0 1.184592 2.006952 1.958055 0.34156 5.73 0 1.288611 2.627499 −0.23017 0.148707 −1.55 0.122 −0.52163 0.061295 −0.07729 0.188494 −0.41 0.682 −0.44673 0.292149 −0.0629 0.253879 −0.25 0.804 −0.56049 0.434694

0.323557 0.265416 1.22 0.223 −0.19665 0.843764 0.408431 0.148768 2.75 0.006 0.116851 0.70001 −0.23963 0.163246 −1.47 0.142 −0.55959 0.080323

−0.385 0.170986 −2.25 0.024 −0.72012 −0.04987

−0.35637 0.177544 −2.01 0.045 −0.70435 −0.00839

−0.25777 0.229954 −1.12 0.262 −0.70847 0.192934

−0.68661 0.326451 −2.1 0.035 −1.32644 −0.04677 0.423363 0.171358 2.47 0.013 0.087507 0.759218 0.390117 0.197571 1.97 0.048 0.002885 0.77735

0.899424 0.423234 2.13 0.034 0.069901 1.728948 0.314997 0.573484 0.55 0.583 −0.80901 1.439005 −0.92695 0.263029 −3.52 0 −1.44247 −0.41142

1,134 244.15

0 0.2954 −516.045

Source: IES analysis of CBH Management Information system, June 2006

149

Table A5.3b Analysis 2 – Effect on change from Wave 1 to Wave 2

Coef. Std. Err. z P>z 95% Conf. Int Wave 1 no training, Wave 2 training Non-user sample −0.16635 0.550248 −0.3 0.762 −1.24482 0.912117 Control sample −0.56318 0.553132 −1.02 0.309 −1.6473 0.520935 No. of employees: 1 to 9 1.663659 0.312151 5.33 0 1.051855 2.275463 No. of employees: 10 to 49 3.489543 0.6036 5.78 0 2.306508 4.672578 No. of employees: 50 or more 2.838674 1.14325 2.48 0.013 0.597945 5.079403 Type of work: Fit out −0.2639 0.362105 −0.73 0.466 −0.97361 0.445815 Type of work: Completion −0.10874 0.430013 −0.25 0.8 −0.95155 0.734068 Type of work: ‘Other’ −0.06733 0.676121 −0.1 0.921 −1.39251 1.257841 Establishment part of larger group 2.219713 1.323227 1.68 0.093 −0.37376 4.81319 Employs casual workers 0.502133 0.409771 1.23 0.22 −0.301 1.30527 Length of time company in −0.31324 0.434319 −0.72 0.471 −1.16449 0.538014 operation: 5 to 20 yrs Length of time company in −0.25331 0.453109 −0.56 0.576 −1.14139 0.63477 operation: more than 20 yrs Main way of working: get −0.66864 0.444957 −1.5 0.133 −1.54074 0.203464 subcontracted to others Main way of working: 0.012564 0.580759 0.02 0.983 −1.1257 1.150831 subcontract others Main way of working: ‘Other’ −3.34467 1.294083 −2.58 0.01 −5.88103 −0.80831 Mainly commercial/industrial wk 1.476494 0.4223 3.5 0 0.648801 2.304187 Even split between commercial 0.782227 0.447706 1.75 0.081 −0.09526 1.659714 and domestic Mainly ‘Other’ 4.4078 1.558488 2.83 0.005 1.35322 7.46238 Mainly non-construction −6.46839 0.952682 −6.79 0 −8.33561 −4.60117 _cons −1.93672 0.648832 −2.98 0.003 −3.2084 −0.66503

Wave 1 training, Wave 2 no training Non-user sample −0.7024 0.460137 −1.53 0.127 −1.60425 0.19945 Control sample −0.95266 0.477258 −2 0.046 −1.88807 −0.01725 No. of employees: 1 to 9 0.791733 0.307638 2.57 0.01 0.188773 1.394693 No. of employees: 10 to 49 2.554504 0.572156 4.46 0 1.433099 3.675909 No. of employees: 50 or more 2.052039 1.180067 1.74 0.082 −0.26085 4.364927 Type of work: Fit out 0.018424 0.325669 0.06 0.955 −0.61987 0.656723 Type of work: Completion −0.14975 0.389638 −0.38 0.701 −0.91343 0.613925 Type of work: ‘Other’ −0.39966 0.597269 −0.67 0.503 −1.57028 0.77097 Establishment part of larger group 1.98658 1.351695 1.47 0.142 −0.66269 4.635854 Employs casual workers 0.235949 0.306742 0.77 0.442 −0.36525 0.837152 Length of time company in 0.342611 0.385607 0.89 0.374 −0.41317 1.098388 operation: 5 to 20 yrs Length of time company in 0.691609 0.36413 1.9 0.058 −0.02207 1.405291 operation: more than 20 yrs Main way of working: get 0.860135 0.414366 2.08 0.038 0.047992 1.672278 subcontracted to others

150

Coef. Std. Err. z P>z 95% Conf. Int Main way of working: 1.198629 0.521397 2.3 0.022 0.17671 2.220548 subcontract others Main way of working: ‘Other’ −0.99442 0.805521 −1.23 0.217 −2.57321 0.584374 Mainly commercial/industrial wk 0.875539 0.374714 2.34 0.019 0.141114 1.609964 Even split between commercial 0.349142 0.415516 0.84 0.401 −0.46526 1.163538 and domestic Mainly ‘Other’ 2.723835 1.091676 2.5 0.013 0.58419 4.86348 Mainly non-construction 23.61641 1.020739 23.14 0 21.61579 25.61702 _cons −1.47297 0.572339 −2.57 0.01 −2.59474 −0.35121

Wave 1 training, Wave 2 training Non-user sample −0.77974 0.496901 −1.57 0.117 −1.75365 0.194164 Control sample −0.84484 0.494992 −1.71 0.088 −1.815 0.125329 No. of employees: 1 to 9 1.994158 0.422122 4.72 0 1.166814 2.821502 No. of employees: 10 to 49 4.825117 0.610923 7.9 0 3.62773 6.022505 No. of employees: 50 or more 5.196584 1.096604 4.74 0 3.04728 7.345888 Type of work: Fit out −0.45482 0.313265 −1.45 0.147 −1.06881 0.159164 Type of work: Completion −0.2387 0.408967 −0.58 0.559 −1.04026 0.56286 Type of work: ‘Other’ −0.5295 0.530657 −1 0.318 −1.56957 0.510569 Establishment part of larger group 2.437108 1.263622 1.93 0.054 −0.03955 4.913762 Employs casual workers 0.955467 0.29511 3.24 0.001 0.377062 1.533872 Length of time company in −0.13912 0.41879 −0.33 0.74 −0.95993 0.681692 operation: 5 to 20 yrs Length of time company in −0.18482 0.415561 −0.44 0.657 −0.9993 0.629666 operation: more than 20 yrs Main way of working: get 0.19142 0.407376 0.47 0.638 −0.60702 0.989862 subcontracted to others Main way of working: 0.574942 0.504465 1.14 0.254 −0.41379 1.563674 subcontract others Main way of working: ‘Other’ −1.35446 0.896391 −1.51 0.131 −3.11135 0.402435 Mainly commercial/industrial wk 1.181685 0.344095 3.43 0.001 0.507272 1.856098 Even split between commercial 0.822299 0.411328 2 0.046 0.016111 1.628487 and domestic Mainly ‘Other’ 2.899178 1.131681 2.56 0.01 0.681125 5.117232 Mainly non-construction 23.71144 — — — — — _cons −1.45123 0.772371 −1.88 0.06 −2.96504 0.062594

No. of observations 1,134 Wald chi2(20) — Prob >chi2 — Pseudo R2 0.2437 Log pseudolikelihood −1,015.51

Base category: no change between Waves

Source: IES analysis of CBH Management Information system, June 2006

151

A5.4 Time taken to inform subcontractors

Table A5.4a Analysis 1 – Effect at Wave 2 with Wave 1 taken account of

Coef. Std. Err. z P>z 95% Conf. Int Inform subcontractors: most of 0.019448 0.273622 0.07 0.943 −0.51684 0.555738 time (Wave 1) Inform subcontractors: some of 0.228799 0.268711 0.85 0.395 −0.29787 0.755463 time (Wave 1) Inform subcontractors: not at all 0.148868 0.513717 0.29 0.772 −0.858 1.155734 (Wave 1) Non-user sample 0.444343 0.28826 1.54 0.123 −0.12064 1.009322 Control sample −0.19338 0.292465 −0.66 0.508 −0.7666 0.379841 No. of employees: 1 to 9 0.069882 0.386059 0.18 0.856 −0.68678 0.826544 No. of employees: 10 to 49 −0.25995 0.419275 −0.62 0.535 −1.08171 0.561818 No. of employees: 50 or more −0.38321 0.429626 −0.89 0.372 −1.22526 0.45884 Type of work: Fit out 0.220203 0.275651 0.8 0.424 −0.32006 0.760469 Type of work: Completion 0.262172 0.331532 0.79 0.429 −0.38762 0.911963 Type of work: ‘Other’ −0.26612 0.398855 −0.67 0.505 −1.04787 0.515617 Establishment part of larger −0.85353 0.309218 −2.76 0.006 −1.45958 −0.24747 group Employs casual workers −0.06098 0.252955 −0.24 0.809 −0.55676 0.434802 Length of time company in 0.065619 0.290081 0.23 0.821 −0.50293 0.634167 operation: 5 to 20 yrs Length of time company in −0.16464 0.272883 −0.6 0.546 −0.69948 0.370202 operation: more than 20 yrs Main way of working: get 0.726052 0.310987 2.33 0.02 0.116529 1.335576 subcontracted to others Main way of working: 0.570485 0.235069 2.43 0.015 0.109758 1.031212 subcontract others Main way of working: ‘Other’ 1.018897 0.284086 3.59 0 0.462098 1.575696 Mainly commercial/industrial −0.30935 0.28524 −1.08 0.278 −0.86841 0.249714 work Even split between commercial −0.22084 0.304979 −0.72 0.469 −0.81859 0.376907 and domestic Mainly non-construction 0.276068 0.502872 0.55 0.583 −0.70954 1.26168

No. of observations 195 Wald chi2(20) 119.17 Prob >chi2 0 Pseudo R2 0.1357 Log pseudolikelihood −155.465

Source: IES analysis of CBH Management Information system, June 2006

152

Table A5.4b Analysis 2 – Effect on change from Wave 1 to Wave 2

Coef. Std. Err. z P>z 95% Conf. Int Take more time at Wave 2 than did at Wave 1 Inform subcontractors: most of 49.59921 1.368534 36.24 0 46.91693 52.28149 time Inform subcontractors: some of 52.54749 1.239368 42.4 0 50.11837 54.97661 time Inform subcontractors: not at all 52.79531 — — — — — Non-user sample −3.05685 1.254829 −2.44 0.015 −5.51627 −0.59743 Control sample −0.45703 1.443049 −0.32 0.751 −3.28536 2.371289 No. of employees: 1 to 9 2.904042 1.369148 2.12 0.034 0.22056 5.587523 No. of employees: 10 to 49 4.122046 1.252809 3.29 0.001 1.666585 6.577506 No. of employees: 50 or more 7.533506 1.880086 4.01 0 3.848606 11.21841 Type of work: Fit out −0.7506 1.007586 −0.74 0.456 −2.72543 1.224235 Type of work: Completion 0.387019 1.149316 0.34 0.736 −1.8656 2.639637 Type of work: ‘Other’ −1.19411 1.491357 −0.8 0.423 −4.11712 1.728894 Establishment part of larger 19.8221 2.064642 9.6 0 15.77548 23.86872 group Employs casual workers −0.42837 0.806914 −0.53 0.596 −2.00989 1.153153 Length of time company in −3.21949 1.959899 −1.64 0.1 −7.06082 0.621841 operation: 5 to 20 yrs Length of time company in −1.08518 1.90043 −0.57 0.568 −4.80995 2.639598 operation: more than 20 yrs Main way of working: get −2.78242 1.250801 −2.22 0.026 −5.23394 −0.33089 subcontracted to others Main way of working: 2.12021 1.411947 1.5 0.133 −0.64716 4.887574 subcontract others Main way of working: ‘Other’ 58.56049 — — — — — Mainly commercial/industrial −1.18689 0.947204 −1.25 0.21 −3.04337 0.669599 work Even split between commercial −0.65343 1.208661 −0.54 0.589 −3.02236 1.715504 and domestic Mainly non-construction 46.75834 2.301429 20.32 0 42.24762 51.26906 _cons −49.7671 2.52412 −19.72 0 −54.7143 −44.8199

Take less time at Wave 2 than did at Wave 1 Inform subcontractors: most of −1.49196 1.091865 −1.37 0.172 −3.63197 0.648058 time Inform subcontractors: some of −2.39171 1.136857 −2.1 0.035 −4.6199 −0.16351 time Inform subcontractors: not at all −40.4244 0.900418 −44.9 0 −42.1892 −38.6596 Non-user sample −0.1446 0.622619 −0.23 0.816 −1.36491 1.075714 Control sample −1.02708 0.694483 −1.48 0.139 −2.38824 0.33408 No. of employees: 1 to 9 1.178311 0.94425 1.25 0.212 −0.67239 3.029007 No. of employees: 10 to 49 1.175158 1.31049 0.9 0.37 −1.39335 3.743671 No. of employees: 50 or more 1.85381 1.269268 1.46 0.144 −0.63391 4.341529

153

Coef. Std. Err. z P>z 95% Conf. Int Type of work: Fit out 1.069772 0.659207 1.62 0.105 −0.22225 2.361793 Type of work: Completion 1.993639 0.81067 2.46 0.014 0.404756 3.582522 Type of work: ‘Other’ 0.150598 0.997563 0.15 0.88 −1.80459 2.105786 Establishment part of larger −1.59818 0.82001 −1.95 0.051 −3.20537 0.009014 group Employs casual workers 0.231604 0.670212 0.35 0.73 −1.08199 1.545196 Length of time company in −0.37687 0.726698 −0.52 0.604 −1.80117 1.047437 operation: 5 to 20 yrs Length of time company in −0.66954 0.757038 −0.88 0.376 −2.1533 0.814229 operation: more than 20 yrs Main way of working: get 0.79314 0.730904 1.09 0.278 −0.6394 2.225685 subcontracted to others Main way of working: 1.884572 0.662917 2.84 0.004 0.585278 3.183866 subcontract others Main way of working: ‘Other’ 38.37498 1.592025 24.1 0 35.25467 41.49529 Mainly commercial/industrial −1.50672 0.732316 −2.06 0.04 −2.94204 −0.07141 work Even split between commercial −1.42321 0.867381 −1.64 0.101 −3.12324 0.276827 and domestic Mainly non-construction 36.34111 — — — — — _cons −1.11328 1.296095 −0.86 0.39 −3.65358 1.427015

No. of observations 195 Wald chi2(20) — Prob >chi2 — Pseudo R2 0.5751 Log pseudolikelihood −84.8003

Base category: no change between Waves

Source: IES analysis of CBH Management Information system, June 2006

154

A5.5 Importance of being aware of health and safety practices of subcontractors

Table A5.5a Analysis 1 – Effect at Wave 2 with Wave 1 taken account of

Coef. Std. Err. z P>z 95% Conf. Int How important to be aware of 0.12773 0.31118 0.41 0.681 −0.48217 0.737631 H&S practices of sub-contractors: quite (Wave 1) How important to be aware of 2.169258 0.501486 4.33 0 1.186364 3.152153 H&S practices of sub-contractors: not very (Wave 1) How important to be aware of 1.077833 1.020964 1.06 0.291 −0.92322 3.078885 H&S practices of sub-contractors: not at all (Wave 1) Non-user sample 0.244886 0.334839 0.73 0.465 −0.41139 0.901158 Control sample −0.14262 0.370224 −0.39 0.7 −0.86825 0.583002 No. of employees: 1 to 9 0.215954 0.396291 0.54 0.586 −0.56076 0.992671 No. of employees: 10 to 49 0.292042 0.459977 0.63 0.525 −0.6095 1.19358 No. of employees: 50 or more −0.37129 0.547036 −0.68 0.497 −1.44346 0.70088 Type of work: Fit out −0.68894 0.326876 −2.11 0.035 −1.32961 −0.04828 Type of work: Completion 0.304614 0.335107 0.91 0.363 −0.35218 0.961412 Type of work: ‘Other’ 0.061548 0.416154 0.15 0.882 −0.7541 0.877195 Establishment part of larger 0.273323 0.470137 0.58 0.561 −0.64813 1.194774 group Employs casual workers −0.07709 0.262052 −0.29 0.769 −0.59071 0.436518 Length of time company in 0.515637 0.350786 1.47 0.142 −0.17189 1.203165 operation: 5 to 20 yrs Length of time company in −0.06888 0.399073 −0.17 0.863 −0.85105 0.713287 operation: more than 20 yrs Main way of working: get 0.536736 0.37312 1.44 0.15 −0.19456 1.268037 subcontracted to others Main way of working: 0.477681 0.279652 1.71 0.088 −0.07043 1.025789 subcontract others Main way of working: ‘Other’ 1.130646 0.478582 2.36 0.018 0.192643 2.06865 Mainly commercial/industrial −1.05995 0.336277 −3.15 0.002 −1.71904 −0.40086 work Even split between commercial −0.93621 0.319282 −2.93 0.003 −1.56199 −0.31043 and domestic Mainly non-construction −8.50854 0.587685 −14.48 0 −9.66038 −7.3567

No. of observations 194 Wald chi2(20) 1,828.3 Prob >chi2 0 Pseudo R2 0.245 Log pseudolikelihood −94.7081

Source: IES analysis of CBH Management Information system, June 2006

155

Table A5.5b Analysis 2 – Effect on change from Wave 1 to Wave 2

Coef. Std. Err. z P>z 95% Conf. Int More important at Wave 2 than at Wave 1 How important to be aware 51.30064 1.174696 43.67 0 48.99828 53.603 of H&S practices of subcontractors: quite How important to be aware 52.88208 — — — — — of H&S practices of subcontractors: not very How important to be aware 93.08385 — — — — — of H&S practices of subcontractors: not at all Non-user sample −0.76084 1.731678 −0.44 0.66 −4.15487 2.633188 Control sample 2.075651 3.140303 0.66 0.509 −4.07923 8.230532 No. of employees: 1 to 9 0.154221 1.239373 0.12 0.901 −2.2749 2.583347 No. of employees: 10 to 49 3.887367 1.897556 2.05 0.04 0.168225 7.606509 No. of employees: 50 or 23.66538 1.719211 13.77 0 20.29579 27.03497 more Type of work: Fit out 4.657799 2.198677 2.12 0.034 0.348472 8.967126 Type of work: Completion 0.480329 1.081683 0.44 0.657 −1.63973 2.600388 Type of work: ‘Other’ −4.34791 2.666531 −1.63 0.103 −9.57421 0.8784 Establishment part of larger −34.394 2.143805 −16.04 0 −38.5958 −30.1922 group Employs casual workers −1.67442 0.989709 −1.69 0.091 −3.61422 0.26537 Length of time company in 1.327347 1.797158 0.74 0.46 −2.19502 4.849713 operation: 5 to 20 yrs Length of time company in 1.95218 2.071008 0.94 0.346 −2.10692 6.011281 operation: more than 20 yrs Main way of working: get 3.293351 2.594627 1.27 0.204 −1.79203 8.378727 subcontracted to others Main way of working: −1.31031 1.222253 −1.07 0.284 −3.70589 1.085258 subcontract others Main way of working: −35.6065 1.795614 −19.83 0 −39.1259 −32.0872 ‘Other’ Mainly −1.10621 1.087414 −1.02 0.309 −3.2375 1.025086 commercial/industrial work Even split between −1.30523 1.164216 −1.12 0.262 −3.58705 0.976591 commercial and domestic Mainly non-construction 12.98447 2.927196 4.44 0 7.24727 18.72167 _cons −53.3762 3.990573 −13.38 0 −61.1976 −45.5548

Less important at Wave 2 than Wave 1 How important to be aware −0.87778 0.848528 −1.03 0.301 −2.54086 0.785309 of H&S practices of subcontractors: quite How important to be aware −1.20957 1.216149 −0.99 0.32 −3.59318 1.174042 of H&S practices of subcontractors: not very

156

Coef. Std. Err. z P>z 95% Conf. Int How important to be aware −0.56137 3.085552 −0.18 0.856 −6.60894 5.486197 of H&S practices of subcontractors: not at all Non-user sample −0.1153 0.957087 −0.12 0.904 −1.99116 1.760552 Control sample −0.35297 0.935713 −0.38 0.706 −2.18693 1.480994 No. of employees: 1 to 9 −0.49963 0.8578 −0.58 0.56 −2.18088 1.18163 No. of employees: 10 to 49 0.769111 0.995425 0.77 0.44 −1.18189 2.720109 No. of employees: 50 or −0.17757 1.175074 −0.15 0.88 −2.48068 2.125529 more Type of work: Fit out −0.8142 0.893981 −0.91 0.362 −2.56637 0.93797 Type of work: Completion 1.189965 0.794902 1.5 0.134 −0.36802 2.747945 Type of work: ‘Other’ −0.21406 1.381506 −0.15 0.877 −2.92176 2.493644 Establishment part of larger 0.316716 1.020682 0.31 0.756 −1.68379 2.317217 group Employs casual workers −1.17122 0.681543 −1.72 0.086 −2.50702 0.16458 Length of time company in 1.264786 0.831186 1.52 0.128 −0.36431 2.893881 operation: 5 to 20 yrs Length of time company in −0.5373 1.047413 −0.51 0.608 −2.59019 1.515593 operation: more than 20 yrs Main way of working: get 1.014767 0.889582 1.14 0.254 −0.72878 2.758316 subcontracted to others Main way of working: 0.943819 0.689163 1.37 0.171 −0.40692 2.294554 subcontract others Main way of working: 1.96774 1.313756 1.5 0.134 −0.60718 4.542655 ‘Other’ Mainly −2.61747 0.785454 −3.33 0.001 −4.15693 −1.07801 commercial/industrial work Even split between −2.08447 0.853376 −2.44 0.015 −3.75706 −0.41189 commercial and domestic Mainly non-construction −38.4646 1.817355 −21.17 0 −42.0266 −34.9027 _cons −0.57297 1.30585 −0.44 0.661 −3.13239 1.986444

No. of observations 194 Wald chi2(20) — Prob >chi2 — Pseudo R2 0.5934 Log pseudolikelihood −65.0611

Base category: no change between Waves

Source: IES analysis of CBH Management Information system, June 2006

157

A5.6 How well informed of health and safety risks subcontractors are

Table A5.6a Analysis 1 – Effect at Wave 2 with Wave 1 taken account of

Coef. Std. Err. z P>z 95% Conf. Int How well informed about 0.647645 0.18064 3.59 0 0.293597 1.001694 H&S risks are you (Wave 1) Non-user sample 0.313314 0.304092 1.03 0.303 −0.2827 0.909324 Control sample 0.139515 0.311191 0.45 0.654 −0.47041 0.749439 No. of employees: 1 to 9 −0.05171 0.278157 −0.19 0.853 −0.59688 0.49347 No. of employees: 10 to 49 −0.64301 0.344818 −1.86 0.062 −1.31885 0.032816 No. of employees: 50+ −0.28883 0.406797 −0.71 0.478 −1.08614 0.508476 Type of work: Fit out −0.12426 0.263705 −0.47 0.637 −0.64112 0.39259 Type of work: Completion −0.31117 0.262716 −1.18 0.236 −0.82608 0.203748 Type of work: ‘Other’ −0.35354 0.325997 −1.08 0.278 −0.99248 0.285401 Establishment part of larger −0.49469 0.331313 −1.49 0.135 −1.14405 0.154673 group Employs casual workers 0.250869 0.246148 1.02 0.308 −0.23157 0.73331 Length of time company in 0.245951 0.287068 0.86 0.392 −0.31669 0.808594 operation: 5 to 20 yrs Length of time company in 0.299848 0.292525 1.03 0.305 −0.27349 0.873186 operation: more than 20 yrs Main way of working: get 0.185633 0.23857 0.78 0.437 −0.28196 0.653221 subcontracted to others Main way of working: 0.20253 0.364321 0.56 0.578 −0.51152 0.916586 subcontract others Main way of working: 0.400772 0.358778 1.12 0.264 −0.30242 1.103963 ‘Other’ Mainly 0.076658 0.308383 0.25 0.804 −0.52776 0.681079 commercial/industrial work Even split between −0.01173 0.310925 −0.04 0.97 −0.62113 0.597673 commercial and domestic Mainly non-construction 1.055332 0.511024 2.07 0.039 0.053742 2.056921

No. of observations 305 Wald chi2(20) 83.14 Prob >chi2 0 Pseudo R2 0.1166 Log pseudolikelihood −204.481

Source: IES analysis of CBH Management Information system, June 2006

158

Table A5.6b Analysis 2 – Effect on change from Wave 1 to Wave 2

Coef. Std. Err. z P>z 95% Conf. Int Better informed at Wave 2 than at Wave 1 How well informed about H&S 26.73155 1.055554 25.32 0 24.66271 28.8004 risks are you: fairly well How well informed about H&S 29.41191 — — — — — risks are you: not very well How well informed about H&S 61.70271 1.321669 46.69 0 59.11229 64.29314 risks are you: not at all Non-user sample −0.35498 0.829432 −0.43 0.669 −1.98064 1.270677 Control sample 0.385063 0.848681 0.45 0.65 −1.27832 2.048447 No. of employees: 1 to 9 −0.57177 0.841633 −0.68 0.497 −2.22134 1.077801 No. of employees: 10 to 49 0.515639 1.058902 0.49 0.626 −1.55977 2.591049 No. of employees: 50 or more 0.989361 1.288226 0.77 0.442 −1.53552 3.514238 Type of work: Fit out 0.67677 0.667803 1.01 0.311 −0.6321 1.985639 Type of work: Completion 0.277138 0.715973 0.39 0.699 −1.12614 1.68042 Type of work: ‘Other’ 1.831125 1.016989 1.8 0.072 −0.16214 3.824386 Establishment part of larger 2.181389 0.80104 2.72 0.006 0.61138 3.751398 group Employs casual workers −1.34281 0.798337 −1.68 0.093 −2.90752 0.221902 Length of time company in −0.30638 0.609697 −0.5 0.615 −1.50137 0.888599 operation: 5 to 20 yrs Length of time company in −0.77321 0.654412 −1.18 0.237 −2.05584 0.509412 operation: more than 20 yrs Main way of working: get −0.76381 0.659355 −1.16 0.247 −2.05612 0.528505 subcontracted to others Main way of working: −3.45148 1.336799 −2.58 0.01 −6.07156 −0.83141 subcontract others Main way of working: ‘Other’ −33.0781 0.719116 −46 0 −34.4875 −31.6686 Mainly commercial/industrial −0.25445 0.684522 −0.37 0.71 −1.59609 1.087186 work Even split between commercial −0.39772 0.715713 −0.56 0.578 −1.80049 1.005053 and domestic Mainly non-construction −33.6447 1.497587 −22.47 0 −36.58 −30.7095 _cons −26.784 1.341677 −19.96 0 −29.4136 −24.1543

Less well informed at Wave 2 than at Wave 1 How well informed about H&S −3.93934 0.61258 −6.43 0 −5.13996 −2.73871 risks are you: fairly well How well informed about H&S −35.1376 1.50082 −23.41 0 −38.0792 −32.1961 risks are you: not very well How well informed about H&S −1.48042 0.91152 −1.62 0.104 −3.26698 0.30613 risks are you: not at all Non-user sample 0.8167 0.81984 1 0.319 −0.79017 2.42357 Control sample 0.51578 0.8055 0.64 0.522 −1.06297 2.09453 No. of employees: 1 to 9 −0.81299 0.69215 −1.17 0.24 −2.16958 0.54359

159

Coef. Std. Err. z P>z 95% Conf. Int No. of employees: 10 to 49 −2.54067 0.8659 −2.93 0.003 −4.23781 −0.84353 No. of employees: 50 or more −0.5326 0.85684 −0.62 0.534 −2.21197 1.14677 Type of work: Fit out 0.28859 0.59626 0.48 0.628 −0.88006 1.45724 Type of work: Completion −1.61273 0.70585 −2.28 0.022 −2.99617 −0.22928 Type of work: ‘Other’ −0.15944 0.73122 −0.22 0.827 −1.59259 1.27372 Establishment part of larger −0.26144 0.69225 −0.38 0.706 −1.61822 1.09533 group Employs casual workers 0.03795 0.67144 0.06 0.955 −1.27806 1.35396 Length of time company in 0.82948 0.76022 1.09 0.275 −0.66052 2.31949 operation: 5 to 20 yrs Length of time company in 0.54873 0.75872 0.72 0.47 −0.93834 2.03579 operation: more than 20 yrs Main way of working: get −0.08869 0.63364 −0.14 0.889 −1.33061 1.15323 subcontracted to others Main way of working: −1.84855 1.05668 −1.75 0.08 −3.9196 0.2225 subcontract others Main way of working: ‘Other’ −0.78178 1.1615 −0.67 0.501 −3.05828 1.49472 Mainly commercial/industrial 0.48865 0.8588 0.57 0.569 −1.19457 2.17187 work Even split between commercial 0.30493 0.95987 0.32 0.751 −1.57639 2.18625 and domestic Mainly non-construction −28.6538 1.82554 −15.7 0 −32.2318 −25.0758 _cons 0.02304 1.08795 0.02 0.983 −2.10931 2.15539

No. of observations 305 Wald chi2(20) — Prob >chi2 — Pseudo R2 0.3971 Log pseudolikelihood −171.668

Base category: no change between Waves

Source: IES analysis of CBH Management Information system, June 2006

160

A5.7 Whether spend time assessing risks

Table A5.7a Analysis 1 – Effect at Wave 2 with Wave 1 taken account of

Coef. Std. Err. z P>z 95% Conf. Int Do you spend time 0.59415 0.15034 3.95 0 0.29948 0.88882 assessing risks (Wave 1) Non-user sample 0.1135 0.22523 0.5 0.614 −0.32795 0.55494 Control sample 0.03028 0.21168 0.14 0.886 −0.38461 0.44518 No. of employees: 1 to 9 0.1945 0.16863 1.15 0.249 −0.13601 0.52501 No. of employees: 10 to 49 0.65063 0.24048 2.71 0.007 0.1793 1.12196 No. of employees: 50 or 1.17656 0.37022 3.18 0.001 0.45094 1.90219 more Type of work: Fit out −0.25815 0.15307 −1.69 0.092 −0.55815 0.04186 Type of work: Completion −0.18971 0.17226 −1.1 0.271 −0.52733 0.14791 Type of work: ‘Other’ 0.25159 0.254 0.99 0.322 −0.24625 0.74942 Establishment part of larger 0.0721 0.31988 0.23 0.822 −0.55485 0.69905 group Employs casual workers 0.24099 0.16364 1.47 0.141 −0.07973 0.56171 Length of time company in −0.25473 0.18184 −1.4 0.161 −0.61113 0.10167 operation: 5 to 20 yrs Length of time company in −0.08444 0.189 −0.45 0.655 −0.45488 0.286 operation: more than 20 yrs Main way of working: get −0.00482 0.17921 −0.03 0.979 −0.35607 0.34643 subcontracted to others Main way of working: −0.13546 0.23626 −0.57 0.566 −0.59851 0.3276 subcontract others Main way of working: −0.26857 0.43918 −0.61 0.541 −1.12934 0.5922 ‘Other’ Mainly 0.29787 0.18465 1.61 0.107 −0.06403 0.65978 commercial/industrial work Even split between 0.16342 0.17713 0.92 0.356 −0.18376 0.51059 commercial and domestic Mainly ‘Other’ 1.09926 0.61703 1.78 0.075 −0.1101 2.30863 Mainly non-construction −2.1013 0.90362 −2.33 0.02 −3.87236 −0.33024 _cons 0.162962 0.30037 0.54 0.587 −0.42575 0.751677

No. of observations 1,123 Wald chi2(20) 106.23 Prob >chi2 0 Pseudo R2 0.171 Log pseudolikelihood −401.875

Source: IES analysis of CBH Management Information system, June 2006

161

Table A47.2b Analysis 2 – Effect on change from Wave 1 to Wave 2

Coef. Std. Err. z P>z 95% Conf. Int Spent time at Wave 1 but do not spend time at Wave 2 Non—user sample 0.05797 0.73545 0.08 0.937 −1.38348 1.49943 Control sample −0.49584 0.73381 −0.68 0.499 −1.93407 0.9424 No. of employees: 1 to 9 −0.01741 0.44571 −0.04 0.969 −0.89099 0.85618 No. of employees: 10 to 49 0.5135 0.64158 0.8 0.423 −0.74397 1.77097 No. of employees: 50+ 21.9415 1.15608 18.98 0 19.6756 24.2073 Type of work: Fit out −0.14166 0.43785 −0.32 0.746 −0.99984 0.71652 Type of work: Completion −0.45302 0.49829 −0.91 0.363 −1.42964 0.5236 Type of work: ‘Other’ −0.19167 0.70116 −0.27 0.785 −1.56592 1.18257 Establishment part of larger group 18.7386 — — — — — Employs casual workers 0.50564 0.48193 1.05 0.294 −0.43892 1.45021 Length of time company in −0.76615 0.53707 −1.43 0.154 −1.81879 0.28649 operation: 5 to 20 yrs Length of time company in −0.75887 0.51823 −1.46 0.143 −1.77459 0.25685 operation: more than 20 yrs Main way of working: get 0.14416 0.44263 0.33 0.745 −0.72339 1.0117 subcontracted to others Main way of working: −0.61336 0.78546 −0.78 0.435 −2.15283 0.92611 subcontract others Main way of working: ‘Other’ 1.39263 1.21333 1.15 0.251 −0.98545 3.77072 Mainly commercial/industrial wk 0.75732 0.4731 1.6 0.109 −0.16993 1.68458 Even split between commercial 0.74488 0.46722 1.59 0.111 −0.17084 1.66061 and domestic Mainly ‘Other’ 1.24068 1.70214 0.73 0.466 −2.09545 4.57681 Mainly non—construction −25.1678 — — — — — _cons 0.89224 0.81453 1.1 0.273 −0.70421 2.48868

Did not spend time at Wave 1 but do spend time at Wave 2 Non—user sample −0.38985 0.74816 −0.52 0.602 −1.85622 1.07651 Control sample −0.49329 0.72589 −0.68 0.497 −1.916 0.92943 No. of employees: 1 to 9 −0.26177 0.50208 −0.52 0.602 −1.24584 0.72229 No. of employees: 10 to 49 0.00516 0.74511 0.01 0.994 −1.45523 1.46554 No. of employees: 50 + 20.489 — — — — — Type of work: Fit out 0.46804 0.44592 1.05 0.294 −0.40596 1.34203 Type of work: Completion −0.73822 0.52145 −1.42 0.157 −1.76024 0.28379 Type of work: ‘Other’ −1.49633 0.98255 −1.52 0.128 −3.42208 0.42943 Establishment part of larger group 20.6827 1.08739 19.02 0 18.5514 22.8139 Employs casual workers 0.1548 0.46159 0.34 0.737 −0.7499 1.0595 Length of time company in −0.3608 0.52011 −0.69 0.488 −1.38019 0.65859 operation: 5 to 20 yrs Length of time company in −0.6121 0.4861 −1.26 0.208 −1.56484 0.34063 operation: more than 20 yrs

162

Coef. Std. Err. z P>z 95% Conf. Int Main way of working: get −0.18108 0.5315 −0.34 0.733 −1.22281 0.86065 subcontracted to others Main way of working: 0.32072 0.71216 0.45 0.652 −1.07508 1.71652 subcontract others Main way of working: ‘Other’ 1.63945 1.2538 1.31 0.191 −0.81795 4.09685 Mainly commercial/industrial wk 0.5131 0.50343 1.02 0.308 −0.4736 1.49981 Even split between commercial 1.07192 0.51131 2.1 0.036 0.06977 2.07408 and domestic Mainly ‘Other’ −0.39869 1.90005 −0.21 0.834 −4.12272 3.32533 Mainly non—construction 29.0496 1.70385 17.05 0 25.7101 32.3891 _cons 0.96199 0.73523 1.31 0.191 −0.47903 2.40301

Spent time at Wave 1 and spend time at Wave 2 Non—user sample 0.00252 0.65265 0 0.997 −1.27666 1.2817 Control sample −0.20057 0.64921 −0.31 0.757 −1.473 1.07185 No. of employees: 1 to 9 0.19941 0.38673 0.52 0.606 −0.55858 0.9574 No. of employees: 10 to 49 1.35886 0.54712 2.48 0.013 0.28652 2.43121 No. of employees: 50 + 22.6804 0.94171 24.08 0 20.8347 24.5262 Type of work: Fit out −0.08067 0.35366 −0.23 0.82 −0.77383 0.61249 Type of work: Completion −0.85687 0.42133 −2.03 0.042 −1.68265 −0.03108 Type of work: ‘Other’ −0.41143 0.59155 −0.7 0.487 −1.57084 0.74798 Establishment part of larger group 20.8743 0.80247 26.01 0 19.3015 22.4471 Employs casual workers 0.60126 0.3645 1.65 0.099 −0.11314 1.31566 Length of time company in −0.67398 0.43419 −1.55 0.121 −1.52497 0.17701 operation: 5 to 20 yrs Length of time company in −0.52551 0.39832 −1.32 0.187 −1.3062 0.25517 operation: more than 20 yrs Main way of working: get −0.30399 0.37997 −0.8 0.424 −1.04872 0.44075 subcontracted to others Main way of working: 0.09497 0.5829 0.16 0.871 −1.04749 1.23744 subcontract others Main way of working: ‘Other’ 0.59444 1.07072 0.56 0.579 −1.50413 2.69301 Mainly commercial/industrial wk 1.03429 0.35506 2.91 0.004 0.33839 1.73019 Even split between commercial 1.15442 0.39173 2.95 0.003 0.38664 1.92221 and domestic Mainly ‘Other’ 1.51997 1.52621 1 0.319 −1.47133 4.51128 Mainly non—construction 24.9086 — — — — — _cons 1.91166 0.6124 3.12 0.002 0.71139 3.11194

No. of observations 1,123 Wald chi2(20) — Prob >chi2 — Pseudo R2 0.1292 Log pseudolikelihood −845.32

Base category: no change between Waves Source: IES analysis of CBH Management Information system, June 2006

163

A5.8 Conduct formal risk assessments

Table A5. 8a Analysis 1 – Effect at Wave 2 with Wave 1 taken account of

Coef. Std. Err. z P>z 95% Conf. Int How do you assess risks 0.428808 0.134382 3.19 0.001 0.165424 0.692192 (Wave 1) Non-user sample −0.0248 0.18933 −0.13 0.896 −0.39588 0.346282 Control sample 0.024712 0.183676 0.13 0.893 −0.33529 0.38471 No. of employees: 1 to 9 0.553256 0.149701 3.7 0 0.259847 0.846665 No. of employees: 10 to 49 1.018992 0.183153 5.56 0 0.660019 1.377965 No. of employees: 50 or 1.729942 0.260875 6.63 0 1.218637 2.241246 more Type of work: Fit out 0.116198 0.143745 0.81 0.419 −0.16554 0.397934 Type of work: Completion 0.010243 0.160117 0.06 0.949 −0.30358 0.324065 Type of work: ‘Other’ 0.028871 0.22116 0.13 0.896 −0.40459 0.462336 Establishment part of −0.18321 0.209801 −0.87 0.383 −0.59441 0.227996 larger group Employs casual workers 0.315301 0.157877 2 0.046 0.005868 0.624735 Length of time company in 0.115562 0.168405 0.69 0.493 −0.21451 0.44563 operation: 5 to 20 yrs Length of time company in 0.046403 0.173852 0.27 0.79 −0.29434 0.387147 operation: more than 20 yrs Main way of working: get 0.303828 0.149666 2.03 0.042 0.010489 0.597167 subcontracted to others Main way of working: 0.097484 0.201917 0.48 0.629 −0.29827 0.493233 subcontract others Main way of working: 0.215346 0.301501 0.71 0.475 −0.37558 0.806277 ‘Other’ Mainly 0.375405 0.160355 2.34 0.019 0.061114 0.689696 commercial/industrial work Even split between 0.184049 0.158615 1.16 0.246 −0.12683 0.494928 commercial and domestic Mainly ‘Other’ 0.746049 0.395363 1.89 0.059 −0.02885 1.520946 Mainly non-construction −0.8254 1.027932 −0.8 0.422 −2.84011 1.189313 _cons −1.57622 0.243614 −6.47 0 −2.05369 −1.09874

No. of observations 1,134 Wald chi2(20) 197.46 Prob >chi2 0 Pseudo R2 0.2134 Log pseudolikelihood −618.251

Source: IES analysis of CBH Management Information system, June 2006

164

Table A5.8b Analysis 2 – Effect on change from Wave 1 to Wave 2

Coef. Std. Err. z P>z 95% Conf. Int Conducted assessments at Wave 1 but not at Wave 2 Non-user sample −0.08058 0.494401 −0.16 0.871 −1.04958 0.888432 Control sample −0.12769 0.485199 −0.26 0.792 −1.07867 0.823277 No. of employees: 1 to 9 1.090063 0.298496 3.65 0 0.505022 1.675104 No. of employees: 10 to 49 2.379417 0.39891 5.96 0 1.597569 3.161266 No. of employees: 50 + 2.8042 0.760484 3.69 0 1.31368 4.294721 Type of work: Fit out −0.00396 0.359587 −0.01 0.991 −0.70874 0.700819 Type of work: Completion −0.56356 0.412369 −1.37 0.172 −1.37179 0.244667 Type of work: ‘Other’ 0.986156 0.441352 2.23 0.025 0.121123 1.851189 Establishment part of larger −0.44178 0.697076 −0.63 0.526 −1.80802 0.924468 group Employs casual workers 0.657423 0.362507 1.81 0.07 −0.05308 1.367923 Length of time company in 0.082439 0.42032 0.2 0.845 −0.74137 0.906251 operation: 5 to 20 yrs Length of time company in −0.13663 0.44808 −0.3 0.76 −1.01485 0.741587 operation: more than 20 yrs Main way of working: get 0.78397 0.363647 2.16 0.031 0.071235 1.496704 subcontracted to others Main way of working: 0.186316 0.53563 0.35 0.728 −0.8635 1.236131 subcontract others Main way of working: 1.49306 0.601148 2.48 0.013 0.314832 2.671289 ‘Other’ Mainly 0.458804 0.415153 1.11 0.269 −0.35488 1.272488 commercial/industrial work Even split between 0.226789 0.400713 0.57 0.571 −0.55859 1.012172 commercial and domestic Mainly ‘Other’ −0.12129 0.901232 −0.13 0.893 −1.88767 1.645095 Mainly non-construction −8.61419 1.336082 −6.45 0 −11.2329 −5.99551 _cons −2.6245 0.591771 −4.43 0 −3.78435 −1.46465

Did not conduct assessments at Wave 1 but do at Wave 2 Non-user sample −0.59599 0.41087 −1.45 0.147 −1.40128 0.209304 Control sample −0.49585 0.399852 −1.24 0.215 −1.27955 0.287843 No. of employees: 1 to 9 1.414899 0.367582 3.85 0 0.694452 2.135347 No. of employees: 10 to 49 2.541297 0.428344 5.93 0 1.701759 3.380836 No. of employees: 50 + 2.023862 0.710461 2.85 0.004 0.631383 3.41634 Type of work: Fit out 0.06125 0.317364 0.19 0.847 −0.56077 0.683273 Type of work: Completion −0.94203 0.362065 −2.6 0.009 −1.65167 −0.2324 Type of work: ‘Other’ 0.888167 0.463345 1.92 0.055 −0.01997 1.796306 Establishment part of larger 0.837783 0.588048 1.42 0.154 −0.31477 1.990335 group Employs casual workers 0.133571 0.345289 0.39 0.699 −0.54318 0.810324 Length of time company in −0.36976 0.356769 −1.04 0.3 −1.06901 0.329497 operation: 5 to 20 yrs

165

Coef. Std. Err. z P>z 95% Conf. Int Length of time company in −0.21775 0.368938 −0.59 0.555 −0.94086 0.505355 operation: more than 20 yrs Main way of working: get 0.060251 0.354608 0.17 0.865 −0.63477 0.755271 subcontracted to others Main way of working: 0.215376 0.473261 0.46 0.649 −0.7122 1.14295 subcontract others Main way of working: 1.03339 0.648633 1.59 0.111 −0.23791 2.304687 ‘Other’ Mainly 0.058623 0.329115 0.18 0.859 −0.58643 0.703677 commercial/industrial work Even split between −0.0796 0.339339 −0.23 0.815 −0.74469 0.585495 commercial and domestic Mainly ‘Other’ −0.85496 0.9718 −0.88 0.379 −2.75966 1.049729 Mainly non-construction 23.62007 1.867268 12.65 0 19.96029 27.27985 _cons −1.28987 0.551565 −2.34 0.019 −2.37092 −0.20882

Conducted assessments at both Waves 1 and 2 Non-user sample −0.61778 0.40616 −1.52 0.128 −1.41384 0.178276 Control sample −0.36855 0.406922 −0.91 0.365 −1.1661 0.429005 No. of employees: 1 to 9 1.854199 0.473778 3.91 0 0.925612 2.782787 No. of employees: 10 to 49 3.440529 0.525871 6.54 0 2.409841 4.471218 No. of employees: 50 + 4.436885 0.742936 5.97 0 2.980757 5.893014 Type of work: Fit out 0.337199 0.311085 1.08 0.278 −0.27252 0.946914 Type of work: Completion −0.38119 0.370426 −1.03 0.303 −1.10721 0.344837 Type of work: ‘Other’ 0.490957 0.43898 1.12 0.263 −0.36943 1.351341 Establishment part of larger 0.58794 0.556085 1.06 0.29 −0.50197 1.677846 group Employs casual workers 0.607197 0.344454 1.76 0.078 −0.06792 1.282314 Length of time company in −0.0739 0.347839 −0.21 0.832 −0.75565 0.607857 operation: 5 to 20 yrs Length of time company in 0.007319 0.366154 0.02 0.984 −0.71033 0.724968 operation: more than 20 yrs Main way of working: get 0.393335 0.340452 1.16 0.248 −0.27394 1.060609 subcontracted to others Main way of working: 0.349167 0.502758 0.69 0.487 −0.63622 1.334555 subcontract others Main way of working: 0.738113 0.555113 1.33 0.184 −0.34989 1.826114 ‘Other’ Mainly 0.742656 0.360272 2.06 0.039 0.036536 1.448776 commercial/industrial work Even split between 0.273444 0.343096 0.8 0.425 −0.39901 0.945899 commercial and domestic Mainly ‘Other’ 1.123429 0.778294 1.44 0.149 −0.402 2.648857 Mainly non-construction 21.58195 — — — — — _cons −2.76753 0.564177 −4.91 0 −3.87329 −1.66176

166

Coef. Std. Err. z P>z 95% Conf. Int No. of observations 1,134 Wald chi2(20) — Prob >chi2 — Pseudo R2 0.1834 Log pseudolikelihood −1228.16

Base category: no change between Waves

Source: IES analysis of CBH Management Information system, June 2006

A5.9 Keep records of health and safety activities

Table A5. 9a Analysis 1 – Effect at Wave 2 with Wave 1 taken account of

Coef. Std. Err. z P>z 95% Conf. Int Do you keep records of 1.012491 0.195781 5.17 0 0.628767 1.396215 H&S activities (Wave 1) Non-user sample −0.70034 0.291205 −2.4 0.016 −1.27109 −0.12959 Control sample −0.67999 0.300963 −2.26 0.024 −1.26987 −0.09012 No. of employees: 10 to 49 0.551176 0.237704 2.32 0.02 0.085284 1.017067 Type of work: Fit out −0.2338 0.210993 −1.11 0.268 −0.64734 0.179737 Type of work: Completion −0.36733 0.290718 −1.26 0.206 −0.93713 0.202468 Type of work: ‘Other’ −0.73524 0.384373 −1.91 0.056 −1.4886 0.018113 Establishment part of 0.96795 0.679209 1.43 0.154 −0.36328 2.299176 larger group Employs casual workers 0.184234 0.261624 0.7 0.481 −0.32854 0.697009 Length of time company in 0.22573 0.266992 0.85 0.398 −0.29756 0.749025 operation: 5 to 20 yrs Length of time company in 0.586847 0.269534 2.18 0.029 0.058571 1.115124 operation: more than 20 yrs Main way of working: get 0.599826 0.224397 2.67 0.008 0.160015 1.039637 subcontracted to others Main way of working: 0.581235 0.27046 2.15 0.032 0.051142 1.111327 subcontract others Main way working: ‘Other’ −0.31213 0.551686 −0.57 0.572 −1.39341 0.76916 Mainly commercial / 1.067809 0.221184 4.83 0 0.634297 1.501322 industrial work Even split between 0.773916 0.269342 2.87 0.004 0.246016 1.301816 commercial and domestic _cons −0.13035 0.440832 −0.3 0.767 −0.99437 0.733665

No. of observations 486 Wald chi2(20) 178.86 Prob >chi2 0 Pseudo R2 0.3951 Log pseudolikelihood −116.699

Source: IES analysis of CBH Management Information system, June 2006

167

Table A5.9b Analysis 2 – Effect on change from Wave 1 to Wave 2

Coef. Std. Err. z P>z 95% Conf. Int No records Wave 1, records Wave 2 Non-user sample −1.57826 0.98599 −1.6 0.109 −3.51077 0.354242 Control sample −1.24091 0.933401 −1.33 0.184 −3.07034 0.588521 No. of employees: 1 to 9 −19.6549 — — — — — No. of employees: 10 to 49 −18.1602 0.773808 −23.47 0 −19.6769 −16.6436 Type of work: Fit out −0.98734 0.686464 −1.44 0.15 −2.33278 0.358105 Type of work: Completion −0.96696 0.728601 −1.33 0.184 −2.39499 0.461074 Type of work: ‘Other’ −1.82781 0.839585 −2.18 0.029 −3.47336 −0.18225 Establishment part of larger −1.93467 2.085252 −0.93 0.354 −6.02169 2.152346 group Employs casual workers 0.872201 0.553298 1.58 0.115 −0.21224 1.956644 Length of time company in −1.55639 0.724989 −2.15 0.032 −2.97734 −0.13544 operation: 5 to 20 yrs Length of time company in −1.11446 0.700201 −1.59 0.111 −2.48683 0.257908 operation: more than 20 yrs Main way of working: get 1.053712 0.628149 1.68 0.093 −0.17744 2.284862 subcontracted to others Main way of working: 0.047638 0.780768 0.06 0.951 −1.48264 1.577915 subcontract others Main way working: ‘Other’ 1.598783 0.992057 1.61 0.107 −0.34561 3.543179 Mainly commercial/indust 1.749116 0.670964 2.61 0.009 0.434052 3.064181 work Even split between 2.251421 0.710411 3.17 0.002 0.859041 3.643801 commercial and domestic Mainly ‘Other’ 23.03308 — — — — — Mainly non-construction −2.70182 1.224486 −2.21 0.027 −5.10177 −0.30187 _cons 21.27493 1.081727 19.67 0 19.15479 23.39508

Records Wave 1, no records Wave 2 Non-user sample −0.4208 0.833228 −0.51 0.614 −2.0539 1.212296 Control sample −0.85121 0.876238 −0.97 0.331 −2.56861 0.866182 No. of employees: 1 to 9 −1.05768 . . . . . No. of employees: 10 to 49 0.819184 0.861079 0.95 0.341 −0.8685 2.506868 Type of work: Fit out 0.069457 0.637415 0.11 0.913 −1.17985 1.318766 Type of work: Completion −1.08111 0.824358 −1.31 0.19 −2.69682 0.534606 Type of work: ‘Other’ −1.01181 0.976156 −1.04 0.3 −2.92504 0.901419 Establishment part larger grp −35.9707 1.487779 −24.18 0 −38.8867 −33.0547 Employs casual workers 0.922383 0.671708 1.37 0.17 −0.39414 2.238906 Length of time company in −2.52234 0.608262 −4.15 0 −3.71452 −1.33017 operation: 5 to 20 yrs Length of time company in −2.77059 0.68965 −4.02 0 −4.12228 −1.4189 operation: more than 20 yrs Main way of working: get 0.390779 0.833917 0.47 0.639 −1.24367 2.025227 subcontracted to others

168

Coef. Std. Err. z P>z 95% Conf. Int Main way of working: −0.1015 0.880322 −0.12 0.908 −1.8269 1.623898 subcontract others Main way working: ‘Other’ 1.548318 1.087793 1.42 0.155 −0.58372 3.680353 Mainly commercial/industrial 1.131689 0.733152 1.54 0.123 −0.30526 2.56864 work Even split between 1.326084 0.695598 1.91 0.057 −0.03726 2.689431 commercial and domestic Mainly ‘Other’ −15.8633 1.475146 −10.75 0 −18.7546 −12.9721 Mainly non-construction −3.06246 1.70115 −1.8 0.072 −6.39665 0.271733 _cons 2.594693 1.067804 2.43 0.015 0.501836 4.68755

Kept records at both Waves 1 and 2 Non-user sample −1.51325 0.77403 −1.96 0.051 −3.03032 0.003824 Control sample −1.95614 0.735554 −2.66 0.008 −3.3978 −0.51447 No. of employees: 1 to 9 −22.1048 1.153326 −19.17 0 −24.3652 −19.8443 No. of employees: 10 to 49 −19.2356 1.301834 −14.78 0 −21.7872 −16.6841 Type of work: Fit out −0.18355 0.490879 −0.37 0.708 −1.14565 0.77856 Type of work: Completion −1.69536 0.580327 −2.92 0.003 −2.83278 −0.55794 Type of work: ‘Other’ −2.33684 0.706577 −3.31 0.001 −3.7217 −0.95197 Establishment part of larger 1.046623 1.548472 0.68 0.499 −1.98833 4.081572 group Employs casual workers 1.158364 0.48146 2.41 0.016 0.21472 2.102007 Length of time company in −1.44847 0.52444 −2.76 0.006 −2.47635 −0.42059 operation: 5 to 20 yrs Length of time company in −0.86073 0.548665 −1.57 0.117 −1.93609 0.214634 operation: more than 20 yrs Main way of working: get 1.640709 0.545346 3.01 0.003 0.57185 2.709568 subcontracted to others Main way of working: 1.283547 0.561774 2.28 0.022 0.182491 2.384604 subcontract others Main way working: ‘Other’ 0.339841 0.900521 0.38 0.706 −1.42515 2.10483 Mainly commercial/industrial 3.219152 0.528245 6.09 0 2.18381 4.254493 work Even split between 2.408287 0.528228 4.56 0 1.37298 3.443594 commercial and domestic Mainly ‘Other’ 25.30959 1.273457 19.87 0 22.81366 27.80552 Mainly non-construction 36.77534 — — — — — _cons 24.56659 1.377235 17.84 0 21.86726 27.26592

No. of observations 573 Wald chi2(20) — Prob >chi2 — Pseudo R2 0.3507 Log pseudolikelihood −222.769

Base category: no change between Waves

Source: IES analysis of CBH Management Information system, June 2006

169

A5.10 Have return to work arrangements

Table A5.10a Analysis 1 – Effect at Wave 2 with Wave 1 taken account of

Coef. Std. Err. z P>z 95% Conf. Int Do you have arrangements 0.58956 0.172266 3.42 0.001 0.251926 0.927195 to support the return to work of employees (Wave 1) Non-user sample −0.12586 0.239349 −0.53 0.599 −0.59497 0.34326 Control sample −0.04474 0.230264 −0.19 0.846 −0.49605 0.406569 No. of employees: 10 to 49 0.414647 0.190417 2.18 0.029 0.041438 0.787857 No. of employees: 50 or 0.852975 0.25191 3.39 0.001 0.359241 1.346709 more Type of work: Fit out 0.243205 0.221057 1.1 0.271 −0.19006 0.676469 Type of work: Completion −0.16855 0.211231 −0.8 0.425 −0.58256 0.245451 Type of work: ‘Other’ 0.215622 0.262101 0.82 0.411 −0.29809 0.729331 Establishment part of larger 0.47078 0.233296 2.02 0.044 0.013527 0.928033 group Employs casual workers 0.126816 0.19867 0.64 0.523 −0.26257 0.516203 Length of time company in 0.035812 0.270528 0.13 0.895 −0.49441 0.566038 operation: 5 to 20 yrs Length of time company in 0.187147 0.277438 0.67 0.5 −0.35662 0.730916 operation: more than 20 yrs Mainly 0.342995 0.231101 1.48 0.138 −0.10995 0.795945 commercial/industrial work Even split between 0.266543 0.25526 1.04 0.296 −0.23376 0.766844 commercial and domestic Mainly ‘Other’ −0.14697 0.516844 −0.28 0.776 −1.15997 0.866025 Main way of working: get −0.05698 0.191618 −0.3 0.766 −0.43254 0.318587 subcontracted to others Main way of working: 0.092404 0.243879 0.38 0.705 −0.38559 0.570399 subcontract others Main way of working: 0.070951 0.314239 0.23 0.821 −0.54495 0.686848 ‘Other’ _cons −1.35655 0.377805 −3.59 0 −2.09704 −0.61607

No. of observations 550 Wald chi2(20) 84.65 Prob >chi2 0 Pseudo R2 0.1889 Log pseudolikelihood −302.252

Source: IES analysis of CBH Management Information system, June 2006

170

Table A5.10b Analysis 2 – Effect on change from Wave 1 to Wave 2

Coef. Std. Err. z P>z 95% Conf. Int No arrangement Wave 1, arrangements Wave 2 Non-user sample −0.77744 0.516937 −1.5 0.133 −1.79062 0.235738 Control sample −0.32213 0.489872 −0.66 0.511 −1.28226 0.638001 No. of employees: 1 to 9 −1.70492 0.582497 −2.93 0.003 −2.84659 −0.56325 No. of employees: 10 to 49 −0.96171 0.562987 −1.71 0.088 −2.06515 0.14172 Type of work: Fit out 1.192282 0.459878 2.59 0.01 0.290936 2.093627 Type of work: Completion −0.1314 0.555385 −0.24 0.813 −1.21993 0.957138 Type of work: ‘Other’ 1.11666 0.637441 1.75 0.08 −0.1327 2.36602 Establishment part of larger 0.569519 0.624939 0.91 0.362 −0.65534 1.794377 group Employs casual workers −0.33448 0.479938 −0.7 0.486 −1.27514 0.606185 Length of time company in 0.064862 0.518614 0.13 0.9 −0.9516 1.081326 operation: 5 to 20 yrs Length of time company in −0.3465 0.537722 −0.64 0.519 −1.40042 0.707417 operation: more than 20 yrs Mainly commercial/industrial 0.495688 0.507253 0.98 0.328 −0.49851 1.489885 work Even split between 0.170724 0.579346 0.29 0.768 −0.96477 1.306221 commercial and domestic Mainly ‘Other’ −0.09886 1.59066 −0.06 0.95 −3.2165 3.018779 Mainly non-construction −29.2433 1.370441 −21.34 0 −31.9293 −26.5572 Main way of working: get −0.10181 0.421647 −0.24 0.809 −0.92822 0.724602 subcontracted to others Main way of working: 0.125952 0.539285 0.23 0.815 −0.93103 1.182932 subcontract others Main way working: ‘Other’ −0.63745 0.979248 −0.65 0.515 −2.55675 1.281836 _cons −0.24545 0.881805 −0.28 0.781 −1.97375 1.482858

Arrangements Wave 1, no arrangements Wave 2 Non-user sample −0.90236 0.48343 −1.87 0.062 −1.84986 0.045149 Control sample −0.61876 0.469432 −1.32 0.187 −1.53883 0.301314 No. of employees: 1 to 9 −1.75078 0.616396 −2.84 0.005 −2.9589 −0.54267 No. of employees: 10 to 49 −0.68196 0.560416 −1.22 0.224 −1.78035 0.416437 Type of work: Fit out 0.963834 0.438183 2.2 0.028 0.105011 1.822656 Type of work: Completion 0.594031 0.492817 1.21 0.228 −0.37187 1.559934 Type of work: ‘Other’ 1.075239 0.503546 2.14 0.033 0.088306 2.062171 Establishment part larger group 0.67454 0.585889 1.15 0.25 −0.47378 1.82286 Employs casual workers 0.034768 0.4453 0.08 0.938 −0.83801 0.907541 Length of time company in 0.134945 0.453508 0.3 0.766 −0.75391 1.023804 operation: 5 to 20 yrs Length of time company in −0.50074 0.477599 −1.05 0.294 −1.43681 0.43534 operation: more than 20 yrs Mainly commercial/industrial 0.213025 0.421173 0.51 0.613 −0.61246 1.038509 work

171

Coef. Std. Err. z P>z 95% Conf. Int Even split between 0.025241 0.508115 0.05 0.96 −0.97065 1.021128 commercial and domestic Mainly ‘Other’ 1.863955 1.224755 1.52 0.128 −0.53652 4.26443 Mainly non-construction −30.6646 1.228359 −24.96 0 −33.0721 −28.2571 Main way of working: get −0.08019 0.422361 −0.19 0.849 −0.908 0.747626 subcontracted to others Main way of working: −0.19334 0.563385 −0.34 0.731 −1.29755 0.910877 subcontract others Main way working: ‘Other’ −0.95397 1.009737 −0.94 0.345 −2.93302 1.025079 _cons 0.000185 0.849127 0 1 −1.66407 1.664443

Had arrangements in both Waves 1 and 2 Non-user sample −0.30258 0.570857 −0.53 0.596 −1.42144 0.816275 Control sample −0.22489 0.516333 −0.44 0.663 −1.23689 0.787101 No. of employees: 1 to 9 −2.85285 0.56558 −5.04 0 −3.96136 −1.74433 No. of employees: 10 to 49 −1.05762 0.484952 −2.18 0.029 −2.00811 −0.10713 Type of work: Fit out 0.196462 0.487645 0.4 0.687 −0.7593 1.152228 Type of work: Completion −0.04253 0.452531 −0.09 0.925 −0.92947 0.844417 Type of work: ‘Other’ 0.506629 0.549951 0.92 0.357 −0.57126 1.584513 Establishment part of larger 1.42354 0.511159 2.78 0.005 0.421686 2.425394 group Employs casual workers 0.841777 0.469045 1.79 0.073 −0.07753 1.761089 Length of time company in 0.301167 0.575407 0.52 0.601 −0.82661 1.428944 operation: 5 to 20 yrs Length of time company in 0.738486 0.559339 1.32 0.187 −0.3578 1.834769 operation: more than 20 yrs Mainly commercial/industrial 0.892527 0.480475 1.86 0.063 −0.04919 1.83424 work Even split between 0.812844 0.602161 1.35 0.177 −0.36737 1.993057 commercial and domestic Mainly ‘Other’ 1.284157 1.064059 1.21 0.227 −0.80136 3.369675 Mainly non-construction −29.9482 1.224209 −24.46 0 −32.3476 −27.5488 Main way of working: get −0.2066 0.399492 −0.52 0.605 −0.98959 0.576392 subcontracted to others Main way of working: 0.191984 0.574797 0.33 0.738 −0.9346 1.318566 subcontract others Main way working: ‘Other’ 0.274994 0.799591 0.34 0.731 −1.29218 1.842163 _cons −0.82496 0.805674 −1.02 0.306 −2.40405 0.754131

No. of observations 551 Wald chi2(20) – Prob >chi2 – Pseudo R2 0.1629 Log pseudolikelihood −598.546

Base category: no change between Waves Source: IES analysis of CBH Management Information system, June 2006

172

A5.11 Use of occupational health practitioners

Table A5. 11a Analysis 1 – Effect at Wave 2 with Wave 1 taken account of

Coef. Std. Err. z P>z 95% Conf. Int Have you used any OH or 0.143811 0.143795 1 0.317 −0.13802 0.425645 medical profs over the last 2 years (Wave 1) Non-user sample 0.175118 0.199834 0.88 0.381 −0.21655 0.566786 Control sample 0.117435 0.199983 0.59 0.557 −0.27452 0.509394 No. of employees: 1 to 9 0.668632 0.131017 5.1 0 0.411845 0.92542 No. of employees: 10 to 49 1.252846 0.176302 7.11 0 0.9073 1.598391 No. of employees: 50 + 1.513265 0.249005 6.08 0 1.025224 2.001305 Type of work: Fit out −0.16967 0.163185 −1.04 0.298 −0.48951 0.150165 Type of work: Completion −0.18517 0.179804 −1.03 0.303 −0.53758 0.167239 Type of work: ‘Other’ 0.35291 0.22423 1.57 0.116 −0.08657 0.792392 Establishment part of larger −0.07516 0.220658 −0.34 0.733 −0.50764 0.357319 group Employs casual workers 0.131662 0.164543 0.8 0.424 −0.19084 0.45416 Length of time company in −0.34499 0.177148 −1.95 0.051 −0.6922 0.002211 operation: 5 to 20 yrs Length of time company in −0.20624 0.181928 −1.13 0.257 −0.56281 0.15033 operation: more than 20 yrs Mainly commercial / 0.271245 0.168614 1.61 0.108 −0.05923 0.601723 industrial work Even split between −0.03579 0.180377 −0.2 0.843 −0.38932 0.317745 commercial and domestic Mainly ‘Other’ −0.12464 0.53221 −0.23 0.815 −1.16775 0.918473 Main way of working: get 0.010484 0.15583 0.07 0.946 −0.29494 0.315905 subcontracted to others Main way of working: 0.189153 0.212965 0.89 0.374 −0.22825 0.606557 subcontract others Main way of working: −0.17478 0.340479 −0.51 0.608 −0.84211 0.492548 ‘Other’ _cons −1.34612 0.256836 −5.24 0 −1.84951 −0.84273

No. of observations 1,113 Wald chi2(20) 176.86 Prob >chi2 0 Pseudo R2 0.1642 Log pseudolikelihood −615.429

Source: IES analysis of CBH Management Information system, June 2006

173

Table A5.11b Analysis 2 – Effect on change from Wave 1 to Wave 2

Coef. Std. Err. z P>z 95% Conf. Int Did not use Wave 1, but do use Wave 2 Non-user sample −0.34795 0.425091 −0.82 0.413 −1.18111 0.485213 Control sample −0.47422 0.433384 −1.09 0.274 −1.32364 0.375196 No. of employees: 1 to 9 0.969275 0.30696 3.16 0.002 0.367644 1.570906 No. of employees: 10 to 49 2.551527 0.36969 6.9 0 1.826947 3.276107 No. of employees: 50 + 2.84987 0.640874 4.45 0 1.59378 4.105959 Type of work: Fit out −0.34065 0.351082 −0.97 0.332 −1.02876 0.347455 Type of work: Completion −0.75357 0.419087 −1.8 0.072 −1.57496 0.067826 Type of work: ‘Other’ −0.1531 0.51087 −0.3 0.764 −1.15439 0.848185 Org. part of larger group −0.436 0.57157 −0.76 0.446 −1.55625 0.684259 Employs casual workers 0.305826 0.354399 0.86 0.388 −0.38878 1.000435 Length of time company in −0.42851 0.37252 −1.15 0.25 −1.15863 0.301621 operation: 5 to 20 yrs Length of time company in −0.40209 0.372796 −1.08 0.281 −1.13276 0.328576 operation: more than 20 yrs Mainly commercial / 0.208047 0.379741 0.55 0.584 −0.53623 0.952325 industrial work Even split between 0.16702 0.374009 0.45 0.655 −0.56602 0.900063 commercial and domestic Mainly ‘Other’ 0.416471 1.061647 0.39 0.695 −1.66432 2.49726 Mainly non-construction −32.7241 0.979765 −33.4 0 −34.6445 −30.8038 Main way of working: get 0.300365 0.364896 0.82 0.41 −0.41482 1.015548 subcontracted to others Main way of working: 0.470995 0.524148 0.9 0.369 −0.55632 1.498306 subcontract others Main way working: ‘Other’ −0.19792 0.748674 −0.26 0.792 −1.6653 1.269452 _cons −1.83246 0.533917 −3.43 0.001 −2.87892 −0.78601

Used Wave 1 but do not use Wave 2 Non-user sample −0.66855 0.379857 −1.76 0.078 −1.41306 0.075957 Control sample −0.81933 0.375044 −2.18 0.029 −1.55441 −0.08426 No. of employees: 1 to 9 0.339254 0.369566 0.92 0.359 −0.38508 1.06359 No. of employees: 10 to 49 1.665962 0.413882 4.03 0 0.854769 2.477155 No. of employees: 50 + 2.844116 0.599652 4.74 0 1.668819 4.019413 Type of work: Fit out −0.07212 0.309923 −0.23 0.816 −0.67956 0.535317 Type of work: Completion −0.94713 0.376503 −2.52 0.012 −1.68506 −0.20919 Type of work: ‘Other’ 0.208045 0.522851 0.4 0.691 −0.81672 1.232814 Org. part of larger group 0.062006 0.512446 0.12 0.904 −0.94237 1.066381 Employs casual workers 0.386278 0.370651 1.04 0.297 −0.34019 1.112741 Length of time company in 0.37738 0.367178 1.03 0.304 −0.34228 1.097036 operation: 5 to 20 yrs Length of time company in 0.181134 0.371315 0.49 0.626 −0.54663 0.908898 operation: more than 20 yrs Mainly commercial/indust. wk 0.336937 0.36873 0.91 0.361 −0.38576 1.059636

174

Coef. Std. Err. z P>z 95% Conf. Int Even split between 0.708933 0.36216 1.96 0.05 −0.00089 1.418753 commercial and domestic Mainly ‘Other’ 0.741788 0.950374 0.78 0.435 −1.12091 2.604487 Mainly non-construction 2.503127 1.319339 1.9 0.058 −0.08273 5.088984 Main way of working: get 0.241413 0.340809 0.71 0.479 −0.42656 0.909387 subcontracted to others Main way of working: 0.488524 0.455453 1.07 0.283 −0.40415 1.381195 subcontract others Main way working: ‘Other’ 0.011445 0.785671 0.01 0.988 −1.52844 1.551332 _cons −1.59647 0.499869 −3.19 0.001 −2.5762 −0.61675

Used at both Waves Non-user sample 0.161799 0.453689 0.36 0.721 −0.72741 1.051012 Control sample −0.09414 0.45125 −0.21 0.835 −0.97858 0.790293 No. of employees: 1 to 9 2.156161 0.425497 5.07 0 1.322201 2.99012 No. of employees: 10 to 49 3.575722 0.471304 7.59 0 2.651984 4.49946 No. of employees: 50 + 5.325688 0.650318 8.19 0 4.051089 6.600288 Type of work: Fit out −0.42786 0.382577 −1.12 0.263 −1.1777 0.321975 Type of work: Completion −0.76352 0.428887 −1.78 0.075 −1.60412 0.077085 Type of work: ‘Other’ 1.208786 0.473292 2.55 0.011 0.281152 2.136421 Org. part of larger group 0.107026 0.510763 0.21 0.834 −0.89405 1.108102 Employs casual workers 0.501006 0.375145 1.34 0.182 −0.23426 1.236276 Length of time company in −0.47242 0.407664 −1.16 0.247 −1.27142 0.32659 operation: 5 to 20 yrs Length of time company in −0.22249 0.422124 −0.53 0.598 −1.04984 0.604855 operation: more than 20 yrs Mainly commercial / 0.882383 0.39203 2.25 0.024 0.114018 1.650747 industrial work Even split between 0.38135 0.421334 0.91 0.365 −0.44445 1.20715 commercial and domestic Mainly ‘Other’ 0.070626 1.588171 0.04 0.965 −3.04213 3.183383 Mainly non-construction −31.8249 1.020464 −31.19 0 −33.825 −29.8248 Main way of working: get −0.01137 0.370221 −0.03 0.975 −0.73699 0.714248 subcontracted to others Main way of working: 0.673857 0.465109 1.45 0.147 −0.23774 1.585454 subcontract others Main way working: ‘Other’ −0.54895 1.12978 −0.49 0.627 −2.76328 1.665379 _cons −3.92126 0.676766 −5.79 0 −5.2477 −2.59482

No. of observations 1,115 Wald chi2(20) – Prob >chi2 – Pseudo R2 0.1841 Log pseudolikelihood −1,202.33

Base category: no change between Waves Source: IES analysis of CBH Management Information system, June 2006

175

A5.12 Experienced accident or injuries in last two years at work

Table A5. 12a Analysis 1 – Effect at Wave 2 with Wave 1 taken account of

Coef. Std. Err. z P>z 95% Conf. Int Have experienced injuries or 0.805576 0.144999 5.56 0 0.521382 1.08977 accidents at work in the last 2 yrs (Wave 1) Non-user sample −0.22846 0.200235 −1.14 0.254 −0.62092 0.163989 Control sample −0.29746 0.192276 −1.55 0.122 −0.67431 0.079399 No. of employees: 1 to 9 0.211196 0.19081 1.11 0.268 −0.16278 0.585177 No. of employees: 10 to 49 0.838401 0.215127 3.9 0 0.416761 1.260041 No. of employees: 50 + 1.699811 0.278046 6.11 0 1.15485 2.244772 Type of work: Fit out 0.122973 0.168498 0.73 0.466 −0.20728 0.453223 Type of work: Completion 0.161392 0.158916 1.02 0.31 −0.15008 0.472861 Type of work: ‘Other’ 0.089133 0.24923 0.36 0.721 −0.39935 0.577614 Establishment part of larger 0.123841 0.220985 0.56 0.575 −0.30928 0.556963 group Employs casual workers 0.428091 0.159954 2.68 0.007 0.114588 0.741595 Length of time company in −0.08754 0.176532 −0.5 0.62 −0.43354 0.258455 operation: 5 to 20 yrs Length of time company in 0.165876 0.187874 0.88 0.377 −0.20235 0.534103 operation: more than 20 yrs Main way of working: get 0.140062 0.166464 0.84 0.4 −0.1862 0.466326 subcontracted to others Main way of working: 0.13889 0.206832 0.67 0.502 −0.26649 0.544274 subcontract others Main way working: ‘Other’ −0.10329 0.357219 −0.29 0.772 −0.80343 0.596842 Mainly commercial / industrial 0.010903 0.180872 0.06 0.952 −0.3436 0.365406 work Even split between commercial −0.29821 0.184376 −1.62 0.106 −0.65958 0.063158 and domestic Mainly ‘Other’ 0.419794 0.483406 0.87 0.385 −0.52767 1.367252 _cons −1.34429 0.317704 −4.23 0 −1.96698 −0.7216

No. of observations 1,128 Wald chi2(20) 194.97 Prob >chi2 0 Pseudo R2 0.3062 Log pseudolikelihood −527.459

Source: IES analysis of CBH Management Information system, June 2006

176

Table A5.12b Analysis 2 – Effect on change from Wave 1 to Wave 2

Coef. Std. Err. z P>z 95% Conf. Int Had accidents Wave 1 but not at Wave 2 Non-user sample −0.00225 0.460855 0 0.996 −0.90551 0.901012 Control sample −0.18397 0.450066 −0.41 0.683 −1.06608 0.698144 No. of employees: 1 to 9 0.476736 0.439952 1.08 0.279 −0.38555 1.339026 No. employees: 10 to 49 1.48854 0.518016 2.87 0.004 0.473247 2.503834 No. of employees: 50 + 2.631518 0.777021 3.39 0.001 1.108585 4.15445 Type of work: Fit out 0.488796 0.400213 1.22 0.222 −0.29561 1.273199 Type of work: Completion 0.351208 0.404203 0.87 0.385 −0.44101 1.14343 Type of work: ‘Other’ 0.706978 0.527533 1.34 0.18 −0.32697 1.740924 Establishment part of 0.666749 0.556628 1.2 0.231 −0.42422 1.757719 larger group Employs casual workers 0.772425 0.341504 2.26 0.024 0.10309 1.441761 Length of time company −0.07902 0.415556 −0.19 0.849 −0.89349 0.735458 in operation: 5 to 20 yrs Company in operation: 0.607807 0.434062 1.4 0.161 −0.24294 1.458552 more than 20 yrs Main way of working: get 0.016092 0.386648 0.04 0.967 −0.74172 0.773907 subcontracted to others Main way of working: −0.02244 0.473189 −0.05 0.962 −0.94987 0.904997 subcontract others Main way of working: −0.80157 0.932713 −0.86 0.39 −2.62965 1.026516 ‘Other’ Mainly commercial / 0.034683 0.409008 0.08 0.932 −0.76696 0.836325 industrial work Even split between −0.48203 0.418234 −1.15 0.249 −1.30175 0.337697 commercial and domestic Mainly ‘Other’ 1.585055 1.122884 1.41 0.158 −0.61576 3.785868 Mainly non-construction −31.032 1.146105 −27.08 0 −33.2784 −28.7857 _cons −2.89392 0.859642 −3.37 0.001 −4.57878 −1.20905

No accidents Wave 1 but accidents at Wave 2 Non-user sample 0.421989 0.513804 0.82 0.411 −0.58505 1.429026 Control sample 0.270712 0.513608 0.53 0.598 −0.73594 1.277365 No. of employees: 1 to 9 0.082366 0.27311 0.3 0.763 −0.45292 0.617653 No. employees: 10 to 49 1.052069 0.359429 2.93 0.003 0.347601 1.756537 No. of employees: 50 + 1.843598 0.704519 2.62 0.009 0.462766 3.22443 Type of work: Fit out 0.199132 0.338536 0.59 0.556 −0.46439 0.86265 Type of work: Completion −0.1778 0.372621 −0.48 0.633 −0.90812 0.552528 Type of work: ‘Other’ 0.713688 0.506865 1.41 0.159 −0.27975 1.707124 Establishment part of 0.870703 0.505521 1.72 0.085 −0.1201 1.861506 larger group Employs casual workers 0.379511 0.376313 1.01 0.313 −0.35805 1.11707 Company in operation: 5 −0.15914 0.384245 −0.41 0.679 −0.91225 0.593964 to 20 yrs

177

Coef. Std. Err. z P>z 95% Conf. Int Company in operation: 0.262453 0.37233 0.7 0.481 −0.4673 0.992206 more than 20 yrs Main way of working: get −0.33036 0.361242 −0.91 0.36 −1.03838 0.377665 subcontracted to others Main way of working: −0.59101 0.481504 −1.23 0.22 −1.53474 0.352722 subcontract others Main way of working: −1.50178 0.860703 −1.74 0.081 −3.18873 0.185169 ‘Other’ Mainly commercial / 0.084241 0.413479 0.2 0.839 −0.72616 0.894645 industrial work Even split between 0.537606 0.389312 1.38 0.167 −0.22543 1.300644 commercial and domestic Mainly ‘Other’ 1.851367 0.975019 1.9 0.058 −0.05964 3.762369 Mainly non-construction −30.6971 1.071457 −28.65 0 −32.7971 −28.5971 _cons −2.40598 0.567059 −4.24 0 −3.5174 −1.29457

Accidents at both waves Non-user sample −0.51219 0.418698 −1.22 0.221 −1.33282 0.308445 Control sample −0.67082 0.389302 −1.72 0.085 −1.43384 0.092193 No. of employees: 1 to 9 0.413538 0.658503 0.63 0.53 −0.8771 1.704179 No. employees: 10 to 49 2.568227 0.637391 4.03 0 1.318963 3.817491 No. of employees: 50 + 4.930971 0.800189 6.16 0 3.36263 6.499312 Type of work: Fit out 0.166614 0.415054 0.4 0.688 −0.64688 0.980105 Type of work: Completion 0.18927 0.378966 0.5 0.617 −0.55349 0.932029 Type of work: ‘Other’ 0.424162 0.496512 0.85 0.393 −0.54898 1.397307 Org. part of larger group 0.864597 0.486413 1.78 0.075 −0.08875 1.817949 Employs casual workers 1.145142 0.388852 2.94 0.003 0.383006 1.907277 Length of time company −0.26739 0.423018 −0.63 0.527 −1.09649 0.56171 in operation: 5 to 20 yrs Company in operation: 0.240626 0.409374 0.59 0.557 −0.56173 1.042984 more than 20 yrs Main way of working: get 0.15348 0.352271 0.44 0.663 −0.53696 0.843919 subcontracted to others Main way of working: 0.042486 0.409049 0.1 0.917 −0.75924 0.844207 subcontract others Main way of working: −0.78023 1.030699 −0.76 0.449 −2.80036 1.239907 ‘Other’ Mainly commercial / 0.007359 0.385888 0.02 0.985 −0.74897 0.763686 industrial work Even split between −0.1369 0.427829 −0.32 0.749 −0.97543 0.701624 commercial and domestic Mainly ‘Other’ 1.17362 1.179546 0.99 0.32 −1.13825 3.485488 Mainly non-construction −30.8357 1.175494 −26.23 0 −33.1396 −28.5318 _cons −2.7926 0.753371 −3.71 0 −4.26918 −1.31602

No. of observations 1,130

178

Coef. Std. Err. z P>z 95% Conf. Int Wald chi2(20) – Prob >chi2 – Pseudo R2 0.2038 Log pseudolikelihood −1,107.03

Base category: no change between Waves

Source: IES analysis of CBH Management Information system, June 2006

A5.13 Experienced non-serious injuries in last two years at work

Table A5. 13a Analysis 1 – Effect at Wave 2 with Wave 1 taken account of

Coef. Std. Err. z P>z 95% Conf. Int Have experienced non-serious 0.785323 0.162032 4.85 0 0.467747 1.102899 injuries in last 2 years (Wave 1) Non-user sample −0.2562 0.214256 −1.2 0.232 −0.67614 0.163731 Control sample −0.2636 0.207382 −1.27 0.204 −0.67006 0.142861 No. of employees: 1 to 9 −0.05601 0.21472 −0.26 0.794 −0.47685 0.364838 No. of employees: 10 to 49 0.693141 0.239532 2.89 0.004 0.223667 1.162615 No. of employees: 50 or more 1.449947 0.283484 5.11 0 0.894329 2.005565 Type of work: Fit out 0.087783 0.179394 0.49 0.625 −0.26382 0.439388 Type of work: Completion 0.0291 0.177953 0.16 0.87 −0.31968 0.377882 Type of work: ‘Other’ 0.138003 0.258235 0.53 0.593 −0.36813 0.644134 Org. part of larger group 0.232804 0.223519 1.04 0.298 −0.20529 0.670893 Employs casual workers 0.463884 0.161625 2.87 0.004 0.147105 0.780663 Length of time company in −0.21849 0.203052 −1.08 0.282 −0.61647 0.17948 operation: 5 to 20 yrs Length of time company in 0.031812 0.215121 0.15 0.882 −0.38982 0.453442 operation: more than 20 yrs Mainly commercial/industrial 0.002934 0.180571 0.02 0.987 −0.35098 0.356847 work Even split between commercial 0.006732 0.187682 0.04 0.971 −0.36112 0.374581 and domestic Mainly ‘Other’ 0.088937 0.478755 0.19 0.853 −0.84941 1.02728 Main way of working: get −0.09309 0.171854 −0.54 0.588 −0.42992 0.243735 subcontracted to others Main way of working: 0.038155 0.23219 0.16 0.869 −0.41693 0.493238 subcontract others Main way of working: ‘Other’ 0.052825 0.380201 0.14 0.889 −0.69236 0.798005 _cons −1.31786 0.343987 −3.83 0 −1.99206 −0.64366

No. of observations 1,132 Wald chi2(20) 155.92 Prob >chi2 0 Pseudo R2 0.2923 Log pseudolikelihood −485.922

Source: IES analysis of CBH Management Information system, June 2006

179

Table A5.13b Analysis 2 – Effect on change from Wave 1 to Wave 2

Coef. Std. Err. z P>z 95% Conf. Int No injuries at Wave 1, injuries at Wave 2 Non-user sample −0.40357 0.451838 −0.89 0.372 −1.28916 0.482018 Control sample −0.30324 0.413417 −0.73 0.463 −1.11352 0.507041 No. of employees: 1 to 9 −0.0339 0.508784 −0.07 0.947 −1.0311 0.963296 No. of employees: 10 to 49 1.435497 0.537697 2.67 0.008 0.381631 2.489363 No. of employees: 50 or more 2.943605 0.644849 4.56 0 1.679724 4.207487 Type of work: Fit out 0.147277 0.421038 0.35 0.726 −0.67794 0.972496 Type of work: Completion −0.15014 0.449431 −0.33 0.738 −1.03101 0.730729 Type of work: ‘Other’ 0.509742 0.531252 0.96 0.337 −0.53149 1.550975 Org. part of larger group −0.12467 0.528718 −0.24 0.814 −1.16094 0.911597 Employs casual workers 0.794371 0.349445 2.27 0.023 0.109472 1.479271 Length of time company in −0.87174 0.419473 −2.08 0.038 −1.69389 −0.04958 operation: 5 to 20 yrs Length of time company in −0.27874 0.422812 −0.66 0.51 −1.10744 0.549955 operation: more than 20 yrs Mainly commercial/industrial wk 0.104764 0.371541 0.28 0.778 −0.62344 0.832971 Even split between commercial −0.25621 0.465829 −0.55 0.582 −1.16921 0.656801 and domestic Mainly ‘Other’ −0.07392 1.410291 −0.05 0.958 −2.83804 2.690201 Mainly non-construction −30.9039 1.150558 −26.86 0 −33.159 −28.6489 Main way of working: get −0.26368 0.384159 −0.69 0.492 −1.01662 0.489253 subcontracted to others Main way of working: 0.231796 0.453676 0.51 0.609 −0.65739 1.120984 subcontract others Main way of working: ‘Other’ −0.27801 0.995348 −0.28 0.78 −2.22885 1.672839 _cons −2.11436 0.771396 −2.74 0.006 −3.62627 −0.60245

Injuries at Wave 1, but no injuries at Wave 2 Non-user sample 0.350952 0.528669 0.66 0.507 −0.68522 1.387125 Control sample 0.386331 0.516197 0.75 0.454 −0.6254 1.398058 No. of employees: 1 to 9 0.520816 0.295729 1.76 0.078 −0.0588 1.100435 No. of employees: 10 to 49 1.24375 0.393343 3.16 0.002 0.472813 2.014688 No. of employees: 50 or more 2.334639 0.549422 4.25 0 1.257791 3.411487 Type of work: Fit out 0.215467 0.347997 0.62 0.536 −0.46659 0.897528 Type of work: Completion −0.1949 0.403531 −0.48 0.629 −0.9858 0.59601 Type of work: ‘Other’ 0.785648 0.529272 1.48 0.138 −0.25171 1.823001 Org. part of larger group −0.18081 0.523752 −0.35 0.73 −1.20735 0.845722 Employs casual workers −0.02536 0.437054 −0.06 0.954 −0.88197 0.831256 Length of time company in −0.29845 0.392233 −0.76 0.447 −1.06721 0.470318 operation: 5 to 20 yrs Length of time company in −0.17158 0.38879 −0.44 0.659 −0.93359 0.590438 operation: more than 20 yrs Mainly commercial/industrial wk −0.18442 0.41184 −0.45 0.654 −0.99161 0.622772

180

Coef. Std. Err. z P>z 95% Conf. Int Even split between commercial 0.132827 0.440739 0.3 0.763 −0.73101 0.99666 and domestic Mainly ‘Other’ −0.38743 1.167471 −0.33 0.74 −2.67563 1.900773 Mainly non-construction −30.9708 1.102058 −28.1 0 −33.1308 −28.8108 Main way of working: get −0.31342 0.341995 −0.92 0.359 −0.98372 0.356878 subcontracted to others Main way of working: 0.269622 0.458366 0.59 0.556 −0.62876 1.168004 subcontract others Main way of working: ‘Other’ −0.9755 0.805625 −1.21 0.226 −2.55449 0.603501 _cons −2.63734 0.560785 −4.7 0 −3.73646 −1.53823

Injuries at both Waves Non-user sample −0.36306 0.493328 −0.74 0.462 −1.32996 0.603846 Control sample −0.48203 0.466403 −1.03 0.301 −1.39616 0.432108 No. of employees: 1 to 9 0.120072 0.881188 0.14 0.892 −1.60703 1.847169 No. of employees: 10 to 49 1.941776 0.80507 2.41 0.016 0.363868 3.519684 No. of employees: 50 or more 4.009912 0.861259 4.66 0 2.321876 5.697948 Type of work: Fit out 0.408623 0.455567 0.9 0.37 −0.48427 1.301518 Type of work: Completion 0.132332 0.443008 0.3 0.765 −0.73595 1.000612 Type of work: ‘Other’ 0.542292 0.568466 0.95 0.34 −0.57188 1.656466 Org. part of larger group 0.755392 0.447823 1.69 0.092 −0.12233 1.63311 Employs casual workers 0.907579 0.423045 2.15 0.032 0.078426 1.736732 Length of time company in 0.372594 0.492424 0.76 0.449 −0.59254 1.337728 operation: 5 to 20 yrs Length of time company in 0.76648 0.465033 1.65 0.099 −0.14497 1.677928 operation: more than 20 yrs Mainly commercial/industrial wk −0.23621 0.407725 −0.58 0.562 −1.03534 0.562915 Even split between commercial 0.444044 0.430842 1.03 0.303 −0.40039 1.288479 and domestic Mainly ‘Other’ 0.494177 1.086035 0.46 0.649 −1.63441 2.622767 Mainly non-construction −31.041 1.166799 −26.6 0 −33.3279 −28.7541 Main way of working: get −0.48924 0.423051 −1.16 0.247 −1.3184 0.339929 subcontracted to others Main way of working: 0.232356 0.458521 0.51 0.612 −0.66633 1.13104 subcontract others Main way of working: ‘Other’ −0.30846 0.863769 −0.36 0.721 −2.00141 1.3845 _cons −3.8085 0.956641 −3.98 0 −5.68349 −1.93352

No. of observations 1,134 Wald chi2(20) – Prob >chi2 – Pseudo R2 0.1834 Log pseudolikelihood −1,030.39

Base category: no change between Waves Source: IES analysis of CBH Management Information system, June 2006

181

A5.14 Frequency of non-serious injuries in the last two years

Table A5. 14a Analysis 1 – Effect at Wave 2 with Wave 1 taken account of

Coef. Std. Err. z P>z 95% Conf. Int How many days off: 6−10 −0.01374 0.102986 −0.13 0.894 −0.21559 0.188106 (Wave 1) How many days off: 10 or more 2.632363 0.13063 20.15 0 2.376333 2.888393 (Wave 1) Non-user sample 0.285813 0.102874 2.78 0.005 0.084185 0.487441 Control sample −0.79336 0.126997 −6.25 0 −1.04227 −0.54445 No. of employees: 1 to 9 0.018712 0.07248 0.26 0.796 −0.12335 0.160769 No. of employees: 10 to 49 0.203308 0.095776 2.12 0.034 0.015591 0.391025 No. of employees: 50 or more 0.906998 0.127598 7.11 0 0.656911 1.157086 Type of work: Fit out −1.31127 0.076321 −17.18 0 −1.46085 −1.16168 Type of work: Completion −0.54995 0.078761 −6.98 0 −0.70431 −0.39558 Type of work: ‘Other’ −0.73234 0.125339 −5.84 0 −0.978 −0.48668 Establishment part of larger 1.109812 0.127609 8.7 0 0.859703 1.359921 group Employs casual workers −1.50792 0.13776 −10.95 0 −1.77793 −1.23792 Length of time company in 0.287017 0.096667 2.97 0.003 0.097552 0.476482 operation: 5 to 20 yrs Length of time company in −0.51214 0.114277 −4.48 0 −0.73612 −0.28817 operation: more than 20 yrs Mainly commercial/industrial 0.91724 0.112522 8.15 0 0.6967 1.13778 work Even split between commercial 0.585754 0.104095 5.63 0 0.381732 0.789776 and domestic Mainly ‘Other’ 8.752833 0.206228 42.44 0 8.348634 9.157033 Main way of working: get 0.098196 0.095976 1.02 0.306 −0.08991 0.286305 subcontracted to others Main way of working: 0.265745 0.111304 2.39 0.017 0.047594 0.483897 subcontract others Main way of working: ‘Other’ −9.69321 0.206228 −47 0 −10.0974 −9.28901 /cut1 0.733609 0.829941 −0.89304 0.236026 /cut2 1.484602 0.844518 1.319079 1.650124

No. of observations 79 Wald chi2(20) 22,7017.3 Prob >chi2 0 Pseudo R2 0.5574 Log pseudolikelihood −34.7924

Source: IES analysis of CBH Management Information system, June 2006

182

Table A5.14b Analysis 2 – Effect on change from Wave 1 to Wave 2

Coef. Std. Err. z P>z 95% Conf. Int Ordered probit Non-user sample 0.185051 0.285814 0.65 0.517 −0.37513 0.745236 Control sample −0.00982 0.249651 −0.04 0.969 −0.49913 0.479486 No. of employees: 1 to 9 0.350692 0.669263 0.52 0.6 −0.96104 1.662422 No. of employees: 10 to 49 0.57421 0.5827 0.99 0.324 −0.56786 1.716282 No. of employees: 50 + 1.865823 0.572698 3.26 0.001 0.743356 2.98829 Type of work: Fit out −0.57814 0.301516 −1.92 0.055 −1.1691 0.012821 Type of work: Completion −0.62104 0.364884 −1.7 0.089 −1.3362 0.094118 Type of work: ‘Other’ −0.17346 0.328639 −0.53 0.598 −0.81758 0.470663 Org. part of larger group 0.179567 0.240422 0.75 0.455 −0.29165 0.650786 Employs casual workers 0.516661 0.25399 2.03 0.042 0.01885 1.014471 Length of time company in −0.10963 0.316634 −0.35 0.729 −0.73022 0.51096 operation: 5 to 20 yrs Length of time company in −0.04253 0.319051 −0.13 0.894 −0.66786 0.582797 operation: more than 20 yrs Mainly commercial / 0.059799 0.285185 0.21 0.834 −0.49915 0.618753 industrial work Even split between −0.14526 0.373562 −0.39 0.697 −0.87743 0.586905 commercial and domestic Mainly ‘Other’ −1.51336 0.765504 −1.98 0.048 −3.01373 −0.013 Main way of working: get −0.3035 0.272949 −1.11 0.266 −0.83847 0.231469 subcontracted to others Main way of working: 0.020757 0.313932 0.07 0.947 −0.59454 0.636052 subcontract others Main way of working: 0.839627 0.61821 1.36 0.174 −0.37204 2.051297 ‘Other’

/cut1 0.299512 0.537108 −0.7532 1.352225 /cut2 1.389336 0.55322 0.305046 2.473627 /cut3 1.77279 0.544881 0.704844 2.840736 /cut4 2.406269 0.552055 1.324261 3.488278

No. of observations 144 Wald chi2(20) 72.67 Prob >chi2 0 Pseudo R2 0.1694 Log pseudolikelihood −185.424

Base category: no change between Waves

Source: IES analysis of CBH Management Information system, June 2006

183

A5.15 Experienced injuries requiring up to three days off work in last two years

Table A5. 15a Analysis 1 – Effect at Wave 2 with Wave 1 taken account of

Coef. Std. Err. z P>z 95% Conf. Int Have experienced injuries 0.906416 0.224004 4.05 0 0.467377 1.345455 requiring up to 3 days off work in last 2 years (Wave 1) Non-user sample −0.53876 0.233522 −2.31 0.021 −0.99646 −0.08107 Control sample −0.61181 0.215107 −2.84 0.004 −1.03341 −0.19021 No. of employees: 1 to 9 0.345423 0.199254 1.73 0.083 −0.04511 0.735953 No. of employees: 10 to 49 0.982173 0.241061 4.07 0 0.509703 1.454643 No. of employees: 50 or more 1.714572 0.288928 5.93 0 1.148285 2.28086 Type of work: Fit out −0.15169 0.221532 −0.68 0.494 −0.58588 0.282506 Type of work: Completion −0.18517 0.217278 −0.85 0.394 −0.61103 0.240687 Type of work: ‘Other’ −0.2629 0.312672 −0.84 0.4 −0.87573 0.349922 Org. part of larger group 0.586259 0.234081 2.5 0.012 0.127469 1.045048 Employs casual workers 0.255871 0.212486 1.2 0.229 −0.16059 0.672335 Length of time company in −0.00298 0.230139 −0.01 0.99 −0.45405 0.44808 operation: 5 to 20 yrs Length of time company in −0.31295 0.248135 −1.26 0.207 −0.79929 0.173381 operation: more than 20 yrs Mainly commercial / −0.12788 0.226134 −0.57 0.572 −0.5711 0.315333 industrial work Even split between −0.19549 0.24983 −0.78 0.434 −0.68515 0.294164 commercial and domestic Mainly ‘Other’ −0.8918 0.614668 −1.45 0.147 −2.09653 0.312922 Main way of working: get 0.275475 0.205015 1.34 0.179 −0.12635 0.677297 subcontracted to others Main way of working: 0.13482 0.252448 0.53 0.593 −0.35997 0.629609 subcontract others Main way of working: ‘Other’ 0.248543 0.362274 0.69 0.493 −0.4615 0.958587 _cons −1.54246 0.287453 −5.37 0 −2.10586 −0.97906

No. of observations 1,128 Wald chi2(20) 175.74 Prob >chi2 0 Pseudo R2 0.3571 Log pseudolikelihood −363.863

Source: IES analysis of CBH Management Information system, June 2006

184

Table A5.15b Analysis 2 – Effect on change from Wave 1 to Wave 2

Coef. Std. Err. z P>z 95% Conf. Int No injuries at Wave 1, injuries at Wave 2 Non-user sample −0.5906 0.546178 −1.08 0.28 −1.66109 0.47989 Control sample −0.50103 0.505504 −0.99 0.322 −1.4918 0.489742 No. of employees: 1 to 9 0.871449 0.478427 1.82 0.069 −0.06625 1.809148 No. of employees: 10 to 49 2.185431 0.568945 3.84 0 1.07032 3.300542 No. of employees: 50 or more 3.917762 0.635805 6.16 0 2.671607 5.163918 Type of work: Fit out −0.16375 0.52343 −0.31 0.754 −1.18965 0.862153 Type of work: Completion −0.31759 0.519574 −0.61 0.541 −1.33593 0.700759 Type of work: ‘Other’ −0.16762 0.657103 −0.26 0.799 −1.45552 1.120273 Org. part of larger group 0.52541 0.533472 0.98 0.325 −0.52018 1.570995 Employs casual workers 0.510982 0.468783 1.09 0.276 −0.40782 1.42978 Length of time company in −0.32539 0.454984 −0.72 0.475 −1.21714 0.566365 operation: 5 to 20 yrs Length of time company in −0.75042 0.49858 −1.51 0.132 −1.72762 0.22678 operation: more than 20 yrs Mainly commercial/industrial wk −0.26082 0.469511 −0.56 0.579 −1.18105 0.659404 Even split between commercial −0.5091 0.523063 −0.97 0.33 −1.53429 0.516082 and domestic Mainly ‘Other’ −31.7521 1.337491 −23.74 0 −34.3735 −29.1306 Mainly non-construction −32.3717 1.287276 −25.15 0 −34.8947 −29.8487 Main way of working: get 0.661558 0.459897 1.44 0.15 −0.23982 1.562939 subcontracted to others Main way of working: 0.251717 0.508601 0.49 0.621 −0.74512 1.248557 subcontract others Main way of working: ‘Other’ −0.28928 1.150233 −0.25 0.801 −2.5437 1.96513 _cons −3.31128 0.635021 −5.21 0 −4.5559 −2.06666

Injuries at Wave 1, but no injuries at Wave 2 Non-user sample 1.414908 1.088019 1.3 0.193 −0.71757 3.547385 Control sample 1.282605 1.0451 1.23 0.22 −0.76575 3.330963 No. of employees: 1 to 9 −0.36745 0.501517 −0.73 0.464 −1.3504 0.615505 No. of employees: 10 to 49 1.283958 0.507257 2.53 0.011 0.289753 2.278163 No. of employees: 50 or more 3.175042 0.611269 5.19 0 1.976977 4.373106 Type of work: Fit out −0.4601 0.479199 −0.96 0.337 −1.39931 0.479114 Type of work: Completion −0.89034 0.580195 −1.53 0.125 −2.0275 0.246823 Type of work: ‘Other’ 0.106096 0.508465 0.21 0.835 −0.89048 1.10267 Org. part of larger group −0.24003 0.558033 −0.43 0.667 −1.33375 0.853699 Employs casual workers 0.315661 0.505203 0.62 0.532 −0.67452 1.305841 Length of time company in −0.2293 0.659998 −0.35 0.728 −1.52288 1.06427 operation: 5 to 20 yrs Length of time company in 0.544051 0.649746 0.84 0.402 −0.72943 1.817531 operation: more than 20 yrs Mainly commercial/industrial wk 0.048203 0.5759 0.08 0.933 −1.08054 1.176947

185

Coef. Std. Err. z P>z 95% Conf. Int Even split between commercial −0.13649 0.757422 −0.18 0.857 −1.62101 1.348029 and domestic Mainly ‘Other’ 2.404252 1.749131 1.37 0.169 −1.02398 5.832485 Mainly non-construction −31.8633 1.174626 −27.13 0 −34.1655 −29.5611 Main way of working: get 0.446818 0.479571 0.93 0.351 −0.49312 1.38676 subcontracted to others Main way of working: −0.4106 0.652275 −0.63 0.529 −1.68903 0.867839 subcontract others Main way of working: ‘Other’ −1.81015 1.43211 −1.26 0.206 −4.61703 0.996737 _cons −4.89098 1.110138 −4.41 0 −7.06682 −2.71515

Injuries at both Waves Non-user sample −1.36113 0.697945 −1.95 0.051 −2.72908 0.006814 Control sample −1.95162 0.630969 −3.09 0.002 −3.1883 −0.71495 No. of employees: 1 to 9 1.742943 1.081061 1.61 0.107 −0.3759 3.861785 No. of employees: 10 to 49 2.933975 0.934457 3.14 0.002 1.102474 4.765476 No. of employees: 50 or more 5.298466 1.001195 5.29 0 3.33616 7.260772 Type of work: Fit out −0.51322 0.729614 −0.7 0.482 −1.94324 0.916793 Type of work: Completion −1.01586 0.603236 −1.68 0.092 −2.19818 0.166456 Type of work: ‘Other’ −1.31963 0.71495 −1.85 0.065 −2.7209 0.081652 Org. part of larger group 1.752387 0.577688 3.03 0.002 0.620139 2.884634 Employs casual workers 0.402832 0.69139 0.58 0.56 −0.95227 1.757931 Length of time company in 1.803291 1.021775 1.76 0.078 −0.19935 3.805934 operation: 5 to 20 yrs Length of time company in 1.58921 0.946735 1.68 0.093 −0.26636 3.444777 operation: more than 20 yrs Mainly commercial/industrial wk 0.160809 0.652582 0.25 0.805 −1.11823 1.439847 Even split between commercial 0.198072 0.659669 0.3 0.764 −1.09486 1.490999 and domestic Mainly ‘Other’ −0.52722 1.13479 −0.46 0.642 −2.75137 1.696923 Mainly non-construction −30.7526 1.516805 −20.27 0 −33.7254 −27.7797 Main way of working: get 0.387013 0.575811 0.67 0.502 −0.74156 1.515582 subcontracted to others Main way of working: 0.118849 0.653838 0.18 0.856 −1.16265 1.400348 subcontract others Main way of working: ‘Other’ 1.396792 0.806271 1.73 0.083 −0.18347 2.977054 _cons −6.20066 1.288894 −4.81 0 −8.72684 −3.67447

No. of observations 1,130 Wald chi2(20) – Prob >chi2 – Pseudo R2 0.2927 Log pseudolikelihood −689.345

Base category: no change between Waves

Source: IES analysis of CBH Management Information system, June 2006

186

A5.16 Frequency of injuries requiring up to three days or more off work

Note: No models available because of insufficient cases to build a model

A5.17 Experienced other injuries requiring three days or more off work

Table A5. 17a Analysis 1 – Effect at Wave 2 with Wave 1 taken account of

Coef. Std. Err. z P>z 95% Conf. Int Have experienced other injuries 0.730342 0.218639 3.34 0.001 0.301817 1.158867 requiring 3 days or more off work (Wave 1) Non-user sample −0.33964 0.250623 −1.36 0.175 −0.83085 0.151574 Control sample −0.51624 0.247612 −2.08 0.037 −1.00155 −0.03093 No. of employees: 1 to 9 0.484293 0.257062 1.88 0.06 −0.01954 0.988125 No. of employees: 10 to 49 1.227488 0.267075 4.6 0 0.70403 1.750945 No. of employees: 50 or more 2.027628 0.299007 6.78 0 1.441585 2.61367 Type of work: Fit out −0.02741 0.245681 −0.11 0.911 −0.50894 0.454114 Type of work: Completion 0.429472 0.216832 1.98 0.048 0.004488 0.854455 Type of work: ‘Other’ −0.27186 0.346507 −0.78 0.433 −0.951 0.407285 Establishment part of larger 0.562823 0.218656 2.57 0.01 0.134265 0.991381 group Employs casual workers 0.245064 0.215649 1.14 0.256 −0.1776 0.667727 Length of time company in −0.35461 0.234408 −1.51 0.13 −0.81404 0.10482 operation: 5 to 20 yrs Length of time company in −0.20961 0.218769 −0.96 0.338 −0.63839 0.219172 operation: more than 20 yrs Mainly commercial/industrial 0.3446 0.226543 1.52 0.128 −0.09942 0.788616 work Even split between commercial 0.15496 0.251592 0.62 0.538 −0.33815 0.648072 and domestic Mainly ‘Other’ 0.565959 0.546568 1.04 0.3 −0.5053 1.637213 Main way of working: get −0.01246 0.230459 −0.05 0.957 −0.46415 0.439235 subcontracted to others Main way of working: 0.03607 0.241779 0.15 0.881 −0.43781 0.509949 subcontract others Main way of working: ‘Other’ 0.218326 0.337591 0.65 0.518 −0.44334 0.879992 _cons −2.22418 0.318148 −6.99 0 −2.84774 −1.60062

No. of observations 1,128 Wald chi2(20) 190.21 Prob >chi2 0 Pseudo R2 0.3876 Log pseudolikelihood −338.765

Source: IES analysis of CBH Management Information system, June 2006

187

Table A5.17b Analysis 2 – Effect on change from Wave 1 to Wave 2

Coef. Std. Err. z P>z 95% Conf. Int No injuries at Wave 1, injuries at Wave 2 Non-user sample −0.63242 0.610733 −1.04 0.3 −1.82943 0.5646 Control sample −0.64767 0.587533 −1.1 0.27 −1.79922 0.50387 No. of employees: 1 to 9 1.232017 0.694749 1.77 0.076 −0.12967 2.593701 No. of employees: 10 to 49 2.535335 0.679029 3.73 0 1.204462 3.866208 No. of employees: 50 + 3.786188 0.703268 5.38 0 2.407807 5.164568 Type of work: Fit out −0.04499 0.597566 −0.08 0.94 −1.2162 1.126214 Type of work: Completion 0.938179 0.480693 1.95 0.051 −0.00396 1.880319 Type of work: ‘Other’ −0.47673 0.925827 −0.51 0.607 −2.29131 1.33786 Org. part of larger group 1.385702 0.511593 2.71 0.007 0.382999 2.388406 Employs casual workers 0.695622 0.465736 1.49 0.135 −0.2172 1.608447 Length of time company in 0.612444 0.687169 0.89 0.373 −0.73438 1.959271 operation: 5 to 20 yrs Length of time company in 0.915872 0.653405 1.4 0.161 −0.36478 2.196523 operation: more than 20 yrs Mainly commercial/industrial 0.346725 0.514634 0.67 0.5 −0.66194 1.355389 Even split between −0.37635 0.595098 −0.63 0.527 −1.54272 0.790021 commercial and domestic Mainly ‘Other’ 2.97662 1.605608 1.85 0.064 −0.17031 6.123554 Mainly non-construction −29.7838 1.314618 −22.66 0 −32.3604 −27.2072 Main way of working: get 0.148681 0.52652 0.28 0.778 −0.88328 1.180642 subcontracted to others Main way of working: 0.170242 0.542434 0.31 0.754 −0.89291 1.233394 subcontract others Main way working: ‘Other’ −1.92728 1.25254 −1.54 0.124 −4.38222 0.527653 _cons −5.4595 1.037712 −5.26 0 −7.49338 −3.42563

Injuries at Wave 1, but no injuries at Wave 2 Non-user sample 0.640875 0.8149 0.79 0.432 −0.9563 2.238049 Control sample 0.996436 0.820747 1.21 0.225 −0.6122 2.605071 No. of employees: 1 to 9 −0.55039 0.41836 −1.32 0.188 −1.37036 0.269583 No. of employees: 10 to 49 0.646118 0.464471 1.39 0.164 −0.26423 1.556464 No. of employees: 50 + 1.99566 0.556681 3.58 0 0.904586 3.086734 Type of work: Fit out −1.52084 0.55612 −2.73 0.006 −2.61082 −0.43087 Type of work: Completion −0.98309 0.502755 −1.96 0.051 −1.96847 0.002292 Type of work: ‘Other’ −0.19443 0.535747 −0.36 0.717 −1.24448 0.855612 Org. part of larger group 0.680572 0.511193 1.33 0.183 −0.32135 1.682491 Employs casual workers 0.537509 0.413256 1.3 0.193 −0.27246 1.347476 Length of time company in 2.302413 0.701557 3.28 0.001 0.927386 3.67744 operation: 5 to 20 yrs Length of time company in 2.326529 0.702671 3.31 0.001 0.949319 3.703739 operation: more than 20 yrs Mainly commercial/industrial −0.04293 0.461562 −0.09 0.926 −0.94757 0.861718

188

Coef. Std. Err. z P>z 95% Conf. Int Even split between −0.9975 0.564408 −1.77 0.077 −2.10372 0.108718 commercial and domestic Mainly ‘Other’ 21.59567 — — — — — Mainly non-construction −29.2133 1.138468 −25.66 0 −31.4447 −26.982 Main way of working: get 0.804006 0.460565 1.75 0.081 −0.09869 1.706697 subcontracted to others Main way of working: 0.785487 0.507331 1.55 0.122 −0.20886 1.779837 subcontract others Main way working: ‘Other’ −21.0478 0.869152 −24.22 0 −22.7513 −19.3443 _cons −5.63997 0.961468 −5.87 0 −7.52442 −3.75553

Injuries at both Waves Non-user sample −0.82209 0.763836 −1.08 0.282 −2.31918 0.675002 Control sample −0.81361 0.676525 −1.2 0.229 −2.13957 0.512357 No. of employees: 1 to 9 −0.19155 1.532686 −0.12 0.901 −3.19556 2.812457 No. of employees: 10 to 49 3.925116 1.217212 3.22 0.001 1.539425 6.310807 No. of employees: 50 + 6.73191 1.312495 5.13 0 4.159466 9.304353 Type of work: Fit out −0.97865 0.886067 −1.1 0.269 −2.71531 0.758012 Type of work: Completion −0.33181 0.637899 −0.52 0.603 −1.58206 0.918452 Type of work: ‘Other’ −1.27022 0.917135 −1.38 0.166 −3.06777 0.527334 Org. part of larger group 1.426375 0.525942 2.71 0.007 0.395547 2.457202 Employs casual workers −0.13408 0.655591 −0.2 0.838 −1.41901 1.150859 Length of time company in −2.33919 0.852189 −2.74 0.006 −4.00945 −0.66893 operation: 5 to 20 yrs Length of time company in −1.74161 0.69634 −2.5 0.012 −3.10641 −0.37681 operation: more than 20 yrs Mainly commercial / 1.431684 0.747098 1.92 0.055 −0.0326 2.895968 industrial work Even split between 0.990266 0.779763 1.27 0.204 −0.53804 2.518574 commercial and domestic Mainly ‘Other’ 1.346629 1.339757 1.01 0.315 −1.27925 3.972505 Mainly non-construction −26.0182 1.760226 −14.78 0 −29.4682 −22.5683 Main way of working: get −0.34173 0.638267 −0.54 0.592 −1.59271 0.909246 subcontracted to others Main way of working: 0.637746 0.636656 1 0.316 −0.61008 1.885568 subcontract others Main way working: ‘Other’ 1.837729 1.021713 1.8 0.072 −0.16479 3.840249 _cons −5.46223 1.360364 −4.02 0 −8.12849 −2.79596

No. of observations 1,130 Wald chi2(20) – Prob >chi2 – Pseudo R2 0.3418 Log pseudolikelihood −651.727

Base category: no change between Waves Source: IES analysis of CBH Management Information system, June 2006

189

A5.18 Experienced fractures or injuries requiring an overnight hospital stay

Table A5. 18a Analysis 1 – Effect at Wave 2 with Wave 1 taken account of

Coef. Std. Err. z P>z 95% Conf. Int Have experienced fractures or 1.041813 0.304734 3.42 0.001 0.444546 1.63908 inquiries requiring overnight hospital stay (Wave 1) Non-user sample −0.56335 0.306398 −1.84 0.066 −1.16388 0.037181 Control sample −0.69859 0.274421 −2.55 0.011 −1.23645 −0.16074 No. of employees: 1 to 9 0.511782 0.352589 1.45 0.147 −0.17928 1.202843 No. of employees: 10 to 49 0.295763 0.403426 0.73 0.463 −0.49494 1.086463 No. of employees: 50 or more 1.100872 0.37532 2.93 0.003 0.365259 1.836486 Type of work: Fit out −0.05593 0.371924 −0.15 0.88 −0.78489 0.673026 Type of work: Completion 0.200609 0.315691 0.64 0.525 −0.41813 0.819353 Type of work: ‘Other’ 0.621939 0.325061 1.91 0.056 −0.01517 1.259046 Establishment part of larger 0.267664 0.309903 0.86 0.388 −0.33973 0.875063 group Employs casual workers −0.08598 0.276498 −0.31 0.756 −0.62791 0.455943 Length of time company in 0.277433 0.434123 0.64 0.523 −0.57343 1.128298 operation: 5 to 20 yrs Length of time company in 0.851701 0.402613 2.12 0.034 0.062594 1.640808 operation: more than 20 yrs Mainly commercial/industrial 0.061115 0.342826 0.18 0.859 −0.61081 0.733041 work Even split between 0.284351 0.341682 0.83 0.405 −0.38533 0.954035 commercial and domestic Main way of working: get −0.09619 0.343291 −0.28 0.779 −0.76903 0.57665 subcontracted to others Main way of working: 0.480104 0.293624 1.64 0.102 −0.09539 1.055596 subcontract others Main way of working: 0.763843 0.46301 1.65 0.099 −0.14364 1.671325 ‘Other’ _cons −2.75175 0.539498 −5.1 0 −3.80915 −1.69436

No. of observations 1,103 Wald chi2(20) 82.07 Prob >chi2 0 Pseudo R2 0.3454 Log pseudolikelihood −202.898

Source: IES analysis of CBH Management Information system, June 2006

190

Table A5.18b Analysis 2 – Effect on change from Wave 1 to Wave 2

Coef. Std. Err. z P>z 95% Conf. Int No injuries at Wave 1, injuries at Wave 2 Non-user sample −1.257 0.780214 −1.61 0.107 −2.78619 0.272192 Control sample −1.30915 0.640675 −2.04 0.041 −2.56485 −0.05345 No. of employees: 1 to 9 1.247354 0.845456 1.48 0.14 −0.40971 2.904417 No. of employees: 10 to 49 0.544714 1.080378 0.5 0.614 −1.57279 2.662215 No. of employees: 50 or more 2.383118 0.827663 2.88 0.004 0.760928 4.005309 Type of work: Fit out −0.08714 0.858427 −0.1 0.919 −1.76962 1.595348 Type of work: Completion −0.05322 0.781125 −0.07 0.946 −1.5842 1.477756 Type of work: ‘Other’ 0.52752 0.813593 0.65 0.517 −1.06709 2.122132 Org. part of larger group 0.613611 0.696732 0.88 0.378 −0.75196 1.97918 Employs casual workers −0.06751 0.68896 −0.1 0.922 −1.41784 1.282831 Length of time company in 0.33357 0.977083 0.34 0.733 −1.58148 2.248618 operation: 5 to 20 yrs Length of time company in 0.898955 0.957619 0.94 0.348 −0.97794 2.775853 operation: more than 20 yrs Mainly commercial/industrial wk 0.96403 1.016425 0.95 0.343 −1.02813 2.956187 Even split between commercial 1.192546 1.051951 1.13 0.257 −0.86924 3.254333 and domestic Mainly ‘Other’ −39.06 1.354943 −28.83 0 −41.7157 −36.4044 Mainly non-construction −36.5873 1.898008 −19.28 0 −40.3074 −32.8673 Main way of working: get −0.46079 0.997695 −0.46 0.644 −2.41624 1.494651 subcontracted to others Main way of working: 0.330391 0.725782 0.46 0.649 −1.09212 1.752897 subcontract others Main way of working: ‘Other’ 1.175179 0.918151 1.28 0.201 −0.62436 2.974722 _cons −5.04067 1.398775 −3.6 0 −7.78222 −2.29912

Injuries at Wave 1, but no injuries at Wave 2 Non-user sample 0.167695 0.703174 0.24 0.812 −1.2105 1.545892 Control sample −0.34369 0.792477 −0.43 0.665 −1.89691 1.209541 No. of employees: 1 to 9 −0.49894 0.682221 −0.73 0.465 −1.83607 0.83819 No. of employees: 10 to 49 1.040685 0.613144 1.7 0.09 −0.16105 2.242425 No. of employees: 50 or more 2.288874 0.763083 3 0.003 0.79326 3.784488 Type of work: Fit out −2.76957 0.626266 −4.42 0 −3.99703 −1.54211 Type of work: Completion −1.0731 0.592943 −1.81 0.07 −2.23525 0.089047 Type of work: ‘Other’ −0.66713 0.80176 −0.83 0.405 −2.23855 0.904294 Org. part of larger group 0.029251 0.595862 0.05 0.961 −1.13862 1.197119 Employs casual workers 0.59389 0.568178 1.05 0.296 −0.51972 1.707499 Length of time company in −0.39386 0.618562 −0.64 0.524 −1.60622 0.8185 operation: 5 to 20 yrs Length of time company in −0.47 0.630322 −0.75 0.456 −1.70541 0.765413 operation: more than 20 yrs Mainly commercial/industrial wk 0.518287 0.699991 0.74 0.459 −0.85367 1.890244

191

Coef. Std. Err. z P>z 95% Conf. Int Even split between commercial −0.54132 0.783805 −0.69 0.49 −2.07755 0.994907 and domestic Mainly ‘Other’ −37.112 1.543012 −24.05 0 −40.1362 −34.0877 Mainly non-construction −38.7221 1.322594 −29.28 0 −41.3144 −36.1299 Main way of working: get 0.831584 0.645418 1.29 0.198 −0.43341 2.096581 subcontracted to others Main way of working: 0.349229 0.742859 0.47 0.638 −1.10675 1.805205 subcontract others Main way of working: ‘Other’ −0.72767 1.557845 −0.47 0.64 −3.78099 2.325652 _cons −3.51873 0.725917 −4.85 0 −4.9415 −2.09596

Injuries at both Waves Non-user sample −0.43014 1.344891 −0.32 0.749 −3.06608 2.205795 Control sample −2.20519 1.346677 −1.64 0.102 −4.84463 0.434251 No. of employees: 1 to 9 −15.8972 1.127512 −14.1 0 −18.1071 −13.6873 No. of employees: 10 to 49 21.54601 1.283603 16.79 0 19.03019 24.06182 No. of employees: 50 or more 24.40081 . . . . . Type of work: Fit out −39.136 1.246129 −31.41 0 −41.5784 −36.6937 Type of work: Completion 0.025618 1.117836 0.02 0.982 −2.1653 2.216536 Type of work: ‘Other’ 2.750354 1.096429 2.51 0.012 0.601393 4.899315 Org. part of larger group −0.48886 0.896256 −0.55 0.585 −2.24549 1.267765 Employs casual workers 0.368633 0.922296 0.4 0.689 −1.43904 2.1763 Length of time company in 21.49057 — — — — — operation: 5 to 20 yrs Length of time company in 24.66202 1.035737 23.81 0 22.63201 26.69203 operation: more than 20 yrs Mainly commercial/industrial wk −1.13177 1.084413 −1.04 0.297 −3.25718 0.993645 Even split between commercial −1.05881 1.121256 −0.94 0.345 −3.25643 1.138816 and domestic Mainly ‘Other’ −37.1126 2.216947 −16.74 0 −41.4578 −32.7675 Mainly non-construction −33.8792 2.957264 −11.46 0 −39.6753 −28.083 Main way of working: get 3.229734 1.17278 2.75 0.006 0.931127 5.528341 subcontracted to others Main way of working: 4.526274 1.400644 3.23 0.001 1.781062 7.271486 subcontract others Main way of working: ‘Other’ 3.009789 1.399141 2.15 0.031 0.267523 5.752056 _cons −50.5373 1.327478 −38.07 0 −53.1391 −47.9355

No. of observations 1,130 Wald chi2(20) — Prob >chi2 — Pseudo R2 0.3249 Log pseudolikelihood −395.933

Base category: no change between Waves Source: IES analysis of CBH Management Information system, June 2006

192

A5.19 Experienced ill-health caused or made worse by work in last two years

Table A5. 19a Analysis 1 – Effect at Wave 2 with Wave 1 taken account of

Coef. Std. Err. z P>z 95% Conf. Int Have experienced health 0.61123 0.253934 2.41 0.016 0.113529 1.108932 problems caused/made worse by work (Wave 1) Non-user sample −0.44915 0.315669 −1.42 0.155 −1.06785 0.16955 Control sample −0.14028 0.280736 −0.5 0.617 −0.69051 0.409953 No. of employees: 1 to 9 −0.59328 0.236578 −2.51 0.012 −1.05696 −0.12959 No. of employees: 10 to 49 −1.532 0.464591 −3.3 0.001 −2.44259 −0.62142 No. of employees: 50 or more −0.52314 0.351229 −1.49 0.136 −1.21153 0.16526 Type of work: Fit out −0.16998 0.209957 −0.81 0.418 −0.58149 0.241532 Type of work: Completion −0.26952 0.24978 −1.08 0.281 −0.75908 0.220038 Type of work: ‘Other’ 0.328069 0.362501 0.91 0.365 −0.38242 1.038558 Org. part of larger group 0.545891 0.428471 1.27 0.203 −0.2939 1.385679 Employs casual workers −0.00234 0.21007 −0.01 0.991 −0.41407 0.409386 Length of time company in 0.328297 0.268653 1.22 0.222 −0.19825 0.854847 operation: 5 to 20 yrs Length of time company in 0.08515 0.23381 0.36 0.716 −0.37311 0.54341 operation: more than 20 yrs Mainly commercial/industrial 0.092683 0.216742 0.43 0.669 −0.33212 0.517489 work Even split between −0.03209 0.200794 −0.16 0.873 −0.42564 0.361461 commercial and domestic Main way of working: get −0.39613 0.270906 −1.46 0.144 −0.92709 0.134839 subcontracted to others Main way of working: −0.50482 0.393155 −1.28 0.199 −1.27539 0.265754 subcontract others Main way of working: ‘Other’ −0.40875 0.491601 −0.83 0.406 −1.37227 0.554768 _cons −0.93542 0.430657 −2.17 0.03 −1.77949 −0.09134

No. of observations 1,094 Wald chi2(20) 52.57 Prob >chi2 0 Pseudo R2 0.1918 Log pseudolikelihood −212.484

Source: IES analysis of CBH Management Information system, June 2006

193

Table A5.19b Analysis 2 – Effect on change from Wave 1 to Wave 2

Coef. Std. Err. z P>z 95% Conf. Int Illness Wave 1, no illness Wave 2 Non-user sample −1.06404 0.828544 −1.28 0.199 −2.68795 0.559878 Control sample −0.40975 0.738536 −0.55 0.579 −1.85725 1.037756 No. of employees: 1 to 9 −1.80872 0.616402 −2.93 0.003 −3.01684 −0.60059 No. of employees: 10 to 49 −3.54151 1.218339 −2.91 0.004 −5.92941 −1.15361 No. of employees: 50 or more −1.02833 0.894764 −1.15 0.25 −2.78204 0.725373 Type of work: Fit out 0.144276 0.580379 0.25 0.804 −0.99325 1.281798 Type of work: Completion −0.5928 0.666694 −0.89 0.374 −1.8995 0.713894 Type of work: ‘Other’ 1.253581 0.791181 1.58 0.113 −0.2971 2.804267 Org. part of larger group 1.119129 1.223949 0.91 0.361 −1.27977 3.518024 Employs casual workers 0.506817 0.501936 1.01 0.313 −0.47696 1.490594 Length of time company in 0.326729 0.667441 0.49 0.624 −0.98143 1.634889 operation: 5 to 20 yrs Length of time company in −0.1297 0.595628 −0.22 0.828 −1.29711 1.037709 operation: more than 20 yrs Mainly commercial/industrial 0.427585 0.494927 0.86 0.388 −0.54245 1.397623 work Even split between commercial 0.273723 0.481995 0.57 0.57 −0.67097 1.218415 and domestic Mainly ‘Other’ 1.540482 0.801065 1.92 0.054 −0.02958 3.110541 Mainly non-construction −35.6046 1.223045 −29.11 0 −38.0017 −33.2075 Main way of working: get −0.75403 0.696051 −1.08 0.279 −2.11826 0.610208 subcontracted to others Main way of working: −1.17273 1.049987 −1.12 0.264 −3.23067 0.885207 subcontract others Main way of working: ‘Other’ −37.9473 0.733786 −51.71 0 −39.3855 −36.5091 _cons −1.51453 1.035607 −1.46 0.144 −3.54428 0.515224

No illness Wave 1, illness Wave 2 Non-user sample 0.111122 0.660775 0.17 0.866 −1.18397 1.406217 Control sample 0.289113 0.641363 0.45 0.652 −0.96794 1.546162 No. of employees: 1 to 9 −0.65672 0.299276 −2.19 0.028 −1.24329 −0.07015 No. of employees: 10 to 49 −0.78178 0.54316 −1.44 0.15 −1.84635 0.282794 No. of employees: 50 or more −0.26105 0.431207 −0.61 0.545 −1.1062 0.584105 Type of work: Fit out 0.262796 0.363034 0.72 0.469 −0.44874 0.974328 Type of work: Completion 0.34004 0.440831 0.77 0.44 −0.52397 1.204052 Type of work: ‘Other’ 1.238462 0.612311 2.02 0.043 0.038354 2.438569 Org. part of larger group 0.817506 0.488911 1.67 0.095 −0.14074 1.775755 Employs casual workers 0.691504 0.396624 1.74 0.081 −0.08586 1.468872 Length of time company in 0.266641 0.431692 0.62 0.537 −0.57946 1.112743 operation: 5 to 20 yrs Length of time company in −0.375 0.478307 −0.78 0.433 −1.31247 0.562462 operation: more than 20 yrs

194

Coef. Std. Err. z P>z 95% Conf. Int Mainly commercial/industrial wk −0.2742 0.494289 −0.55 0.579 −1.24299 0.694589 Even split between commercial 0.39902 0.348079 1.15 0.252 −0.2832 1.081242 and domestic Mainly ‘Other’ −2.80679 1.415522 −1.98 0.047 −5.58117 −0.03242 Mainly non-construction −37.108 0.918984 −40.38 0 −38.9092 −35.3068 Main way of working: get −0.19112 0.42218 −0.45 0.651 −1.01858 0.636339 subcontracted to others Main way of working: −0.9636 0.549447 −1.75 0.079 −2.0405 0.113293 subcontract others Main way of working: ‘Other’ −0.0582 0.777514 −0.07 0.94 −1.5821 1.465704 _cons −2.50657 0.786717 −3.19 0.001 −4.04851 −0.96464

Illness both Waves Non-user sample −0.8933 1.059226 −0.84 0.399 −2.96935 1.182742 Control sample −0.0159 0.989228 −0.02 0.987 −1.95475 1.922952 No. of employees: 1 to 9 −0.35859 0.558284 −0.64 0.521 −1.4528 0.73563 No. of employees: 10 to 49 −36.5817 0.987814 −37.03 0 −38.5178 −34.6456 No. of employees: 50 or more −2.08292 1.140613 −1.83 0.068 −4.31848 0.152637 Type of work: Fit out −0.84617 0.718539 −1.18 0.239 −2.25448 0.562142 Type of work: Completion 0.279481 0.79608 0.35 0.726 −1.28081 1.839769 Type of work: ‘Other’ 0.831027 0.938065 0.89 0.376 −1.00755 2.6696 Org. part of larger group 2.963973 1.122414 2.64 0.008 0.764082 5.163863 Employs casual workers −0.9617 0.668092 −1.44 0.15 −2.27113 0.347739 Length of time company in 2.010134 0.812064 2.48 0.013 0.418517 3.601751 operation: 5 to 20 yrs Length of time company in 1.201036 0.831303 1.44 0.149 −0.42829 2.83036 operation: more than 20 yrs Mainly commercial/industrial wk −0.43046 0.711067 −0.61 0.545 −1.82413 0.963203 Even split between commercial −1.3011 0.699402 −1.86 0.063 −2.6719 0.069706 and domestic Mainly ‘Other’ −38.4251 1.258316 −30.54 0 −40.8913 −35.9588 Mainly non-construction −35.7257 1.343048 −26.6 0 −38.358 −33.0933 Main way of working: get −1.29044 0.682038 −1.89 0.058 −2.62721 0.046326 subcontracted to others Main way of working: −35.947 0.877869 −40.95 0 −37.6676 −34.2264 subcontract others Main way of working: ‘Other’ 0.815167 0.816546 1 0.318 −0.78523 2.415568 _cons −3.61922 0.937773 −3.86 0 −5.45722 −1.78122

No. of observations 1,121 Wald chi2(20) – Prob >chi2 – Pseudo R2 0.1618 Log pseudolikelihood −502.622

Base category: no change between Waves Source: IES analysis of CBH Management Information system, June 2006

195

A5.20 Experienced absence in the last two years

Table A5.20a Analysis 1 – Effect at Wave 2 with Wave 1 taken account of

Coef. Std. Err. z P>z 95% Conf. Int Non-user sample −0.1091 0.197419 −0.55 0.581 −0.49648 0.27829 Control sample 0.026976 0.189414 0.14 0.887 −0.3447 0.398652 No. of employees: 1 to 9 −0.01553 0.085362 −0.18 0.856 −0.18304 0.151968 No. employees: 10 to 49 0.038138 0.163865 0.23 0.816 −0.28341 0.359681 No. of employees: 50 + 1.594639 0.361205 4.41 0 0.885866 2.303412 Type of work: Fit out 0.172936 0.146569 1.18 0.238 −0.11467 0.460541 Type of work: 0.096674 0.18043 0.54 0.592 −0.25737 0.450721 Completion Type of work: ‘Other’ −0.36301 0.198373 −1.83 0.068 −0.75227 0.026249 Employs casual workers 0.354564 0.168735 2.1 0.036 0.023465 0.685664 Main way of working: get 0.280879 0.175206 1.6 0.109 −0.06292 0.624676 subcontracted to others Main way of working: 0.234267 0.186098 1.26 0.208 −0.1309 0.599436 subcontract others Main way of working: 0.306281 0.259694 1.18 0.239 −0.2033 0.815864 ‘Other’ Length of time company −0.00081 0.115353 −0.01 0.994 −0.22716 0.225539 in operation: 5 to 20 yrs Length of time company 0.060093 0.145882 0.41 0.68 −0.22616 0.346349 in operation: more than 20 yrs Mainly commercial / 0.112247 0.159746 0.7 0.482 −0.20121 0.425709 industrial work Even split between −0.18721 0.15246 −1.23 0.22 −0.48637 0.111955 commercial and domestic Mainly ‘Other’ 0.456467 0.37525 1.22 0.224 −0.27987 1.1928 Mainly non-construction −0.32045 0.305125 −1.05 0.294 −0.91918 0.278278 _cons −0.1871 0.258899 −0.72 0.47 −0.69512 0.320926

No. of observations 1,060 Wald chi2(20) 2.26 Prob >chi2 0.002 Pseudo R2 0.2077 Log pseudolikelihood 1.1141

Source: IES analysis of CBH Management Information system, June 2006

196

Table A5.20b Analysis 2 – Effect on change from Wave 1 to Wave 2

Probit regression

Coef. Std. Err. z P>z 95% Conf. Int Non-user sample −0.24379 0.132963 −1.83 0.067 −0.50439 0.016816 Control sample −0.15971 0.133309 −1.2 0.231 −0.42099 0.101571 No. of employees: 1 to 9 −0.25689 0.19961 −1.29 0.198 −0.64811 0.134342 No. of employees: 10 to 49 0.433804 0.190356 2.28 0.023 0.060714 0.806895 No. of employees: 50 + 1.509852 0.221243 6.82 0 1.076223 1.94348 Type of work: Fit out 0.051617 0.151467 0.34 0.733 −0.24525 0.348487 Type of work: Completion −0.16698 0.165329 −1.01 0.313 −0.49102 0.157062 Type of work: ‘Other’ −0.24561 0.198123 −1.24 0.215 −0.63392 0.142704 Employs casual workers 0.282211 0.139789 2.02 0.044 0.008229 0.556193 Length of time company in −0.05451 0.183527 −0.3 0.766 −0.41422 0.305195 operation: 5 to 20 yrs Length of time company in 0.095138 0.177061 0.54 0.591 −0.2519 0.442172 operation: more than 20 yrs Mainly commercial / 0.038998 0.161398 0.24 0.809 −0.27734 0.355332 industrial work Even split between −0.04774 0.176589 −0.27 0.787 −0.39385 0.298369 commercial and domestic Mainly ‘Other’ 0.322674 0.377875 0.85 0.393 −0.41795 1.063296 Mainly non-construction −0.17126 0.827798 −0.21 0.836 −1.79372 1.451192 Main way of working: get 0.002493 0.275894 0.01 0.993 −0.53825 0.543236 subcontracted to others Main way of working: 0.170971 0.27274 0.63 0.531 −0.36359 0.705531 subcontract others Main way of working: −0.06947 0.302161 −0.23 0.818 −0.6617 0.522752 ‘Other’ _cons −0.87 0.379221 −2.29 0.022 −1.61326 −0.12674

No. of observations 1,369 Wald chi2(20) 131.11 Prob >chi2 0 Pseudo R2 0.2013 Log pseudolikelihood −700.386

197

Multinominal logit

Coef. Std. Err. z P>z 95% Conf. Int Absence at Wave 1, no absence Wave 2 Non-user sample −0.31608 0.477756 −0.66 0.508 −1.25246 0.620306 Control sample −0.01222 0.443245 −0.03 0.978 −0.88096 0.856527 No. of employees: 1 to 9 −0.23467 0.40843 −0.57 0.566 −1.03518 0.565841 No. of employees: 10 to 49 0.571465 0.424412 1.35 0.178 −0.26037 1.403298 No. of employees: 50 or more 2.484252 0.599053 4.15 0 1.310129 3.658375 Type of work: Fit out 0.489903 0.362611 1.35 0.177 −0.2208 1.200608 Type of work: Completion 0.27401 0.369315 0.74 0.458 −0.44983 0.997854 Type of work: ‘Other’ 0.18102 0.518823 0.35 0.727 −0.83586 1.197895 Org. part of larger group 1.204505 0.481236 2.5 0.012 0.2613 2.14771 Employs casual workers 0.195288 0.324575 0.6 0.547 −0.44087 0.831444 Length of time company in 0.053863 0.377441 0.14 0.887 −0.68591 0.793633 operation: 5 to 20 yrs Length of time company in 0.192098 0.378894 0.51 0.612 −0.55052 0.934716 operation: more than 20 yrs Main way of working: get −0.04594 0.31331 −0.15 0.883 −0.66002 0.568138 subcontracted to others Main way of working: −0.8821 0.503955 −1.75 0.08 −1.86984 0.105632 subcontract others Main way of working: ‘Other’ −3.03967 1.398352 −2.17 0.03 −5.78039 −0.29895 Mainly commercial/industrial 0.031799 0.376724 0.08 0.933 −0.70657 0.770164 work Even split between commercial −0.41329 0.379538 −1.09 0.276 −1.15717 0.330589 and domestic Mainly ‘Other’ 2.625108 1.59501 1.65 0.1 −0.50105 5.75127 Mainly non-construction −31.6938 1.084335 −29.23 0 −33.819 −29.5685 _cons −1.92296 0.708149 −2.72 0.007 −3.31091 −0.53501

No absence Wave 1, absence Wave 2 Non-user sample −0.58838 0.600279 −0.98 0.327 −1.7649 0.588147 Control sample −0.86121 0.576888 −1.49 0.135 −1.99189 0.269467 No. of employees: 1 to 9 1.91291 0.651267 2.94 0.003 0.636451 3.189369 No. of employees: 10 to 49 3.067501 0.678206 4.52 0 1.738242 4.39676 No. of employees: 50 or more 3.984901 0.831009 4.8 0 2.356154 5.613648 Type of work: Fit out −1.30009 0.684133 −1.9 0.057 −2.64097 0.040783 Type of work: Completion 0.08242 0.487161 0.17 0.866 −0.8724 1.037237 Type of work: ‘Other’ 0.316004 0.530335 0.6 0.551 −0.72343 1.355442 Org. part of larger group 0.837355 0.482869 1.73 0.083 −0.10905 1.783761 Employs casual workers −0.11643 0.62823 −0.19 0.853 −1.34774 1.114875 Length of time company in 0.190603 0.609744 0.31 0.755 −1.00447 1.385679 operation: 5 to 20 yrs Length of time company in −0.01719 0.595902 −0.03 0.977 −1.18513 1.150759 operation: more than 20 yrs

198

Coef. Std. Err. z P>z 95% Conf. Int Main way of working: get −0.05181 0.465084 −0.11 0.911 −0.96336 0.859742 subcontracted to others Main way of working: −0.94721 0.692858 −1.37 0.172 −2.30519 0.410764 subcontract others Main way of working: ‘Other’ 0.522522 0.939063 0.56 0.578 −1.31801 2.363051 Mainly commercial/industrial −0.21797 0.517207 −0.42 0.673 −1.23168 0.795736 work Even split between commercial 0.191588 0.555927 0.34 0.73 −0.89801 1.281184 and domestic Mainly ‘Other’ 0.102073 1.063007 0.1 0.924 −1.98138 2.185528 Mainly non-construction −32.3345 1.280225 −25.26 0 −34.8437 −29.8253 _cons −3.76594 0.815265 −4.62 0 −5.36383 −2.16804 Absence at both waves Non-user sample −2.20483 0.760299 −2.9 0.004 −3.69499 −0.71467 Control sample −1.60384 0.594674 −2.7 0.007 −2.76938 −0.4383 No. of employees: 1 to 9 1.390536 1.209976 1.15 0.25 −0.98097 3.762045 No. of employees: 10 to 49 4.197113 1.22567 3.42 0.001 1.794844 6.599383 No. of employees: 50 or more 6.290986 1.308679 4.81 0 3.726023 8.855949 Type of work: Fit out −1.214 0.938663 −1.29 0.196 −3.05375 0.625748 Type of work: Completion −0.47475 0.650627 −0.73 0.466 −1.74996 0.800454 Type of work: ‘Other’ −0.30374 0.609445 −0.5 0.618 −1.49823 0.890751 Org. part of larger group 1.1974 0.553355 2.16 0.03 0.112844 2.281956 Employs casual workers 0.782737 0.549787 1.42 0.155 −0.29483 1.8603 Length of time company in 0.048768 0.920489 0.05 0.958 −1.75536 1.852893 operation: 5 to 20 yrs Length of time company in 0.508447 0.85725 0.59 0.553 −1.17173 2.188626 operation: more than 20 yrs Main way of working: get −0.42116 0.564655 −0.75 0.456 −1.52787 0.68554 subcontracted to others Main way of working: −1.12272 0.701793 −1.6 0.11 −2.4982 0.252774 subcontract others Main way of working: ‘Other’ −1.21732 1.40831 −0.86 0.387 −3.97756 1.542917 Mainly commercial/industrial 0.799259 0.642006 1.24 0.213 −0.45905 2.057567 work Even split between commercial −0.33265 0.788703 −0.42 0.673 −1.87848 1.213179 and domestic Mainly ‘Other’ 3.41852 1.627048 2.1 0.036 0.229565 6.607475 Mainly non-construction −30.7221 1.412642 −21.75 0 −33.4908 −27.9534 _cons −4.99898 1.493323 −3.35 0.001 −7.92584 −2.07212

Base category: no absence both Waves

Source: IES analysis of CBH Management Information system, June 2006

199

A5.21 Attitude 1: In construction industry generally, health and safety doesn't tend to be a priority

Table A5. 21a Analysis 1 – Effect at Wave 2 with Wave 1 taken account of

Coef. Std. Err. z P>z 95% Conf. Int In construction, H&S 0.109075 0.041037 2.66 0.008 0.028644 0.189506 doesn’t tend to be a priority (Wave 1) Non-user sample 0.242109 0.171088 1.42 0.157 −0.09322 0.577436 Control sample 0.047807 0.171068 0.28 0.78 −0.28748 0.383093 No. of employees: 1 to 9 0.213689 0.134866 1.58 0.113 −0.05064 0.478022 No. of employees: 10 to 49 0.511765 0.163494 3.13 0.002 0.191322 0.832207 No. of employees: 50 + 0.15598 0.224568 0.69 0.487 −0.28416 0.596124 Type of work: Fit out −0.02873 0.129438 −0.22 0.824 −0.28242 0.224966 Type of work: Completion −0.15585 0.168978 −0.92 0.356 −0.48704 0.17534 Type of work: ‘Other’ 0.309657 0.173177 1.79 0.074 −0.02976 0.649077 Org. part of larger group 0.103015 0.20616 0.5 0.617 −0.30105 0.507081 Employs casual workers 0.079063 0.12597 0.63 0.53 −0.16783 0.32596 Length of time company in −0.3204 0.14865 −2.16 0.031 −0.61175 −0.02905 operation: 5 to 20 yrs Company in operation: −0.10503 0.14851 −0.71 0.479 −0.3961 0.186046 more than 20 yrs Main way of working: get −0.09072 0.13923 −0.65 0.515 −0.3636 0.182169 subcontracted to others Main way of working: 0.031617 0.194146 0.16 0.871 −0.3489 0.412136 subcontract others Main way working: ‘Other’ 0.452207 0.303179 1.49 0.136 −0.14201 1.046427 Mainly commercial / 0.208974 0.147072 1.42 0.155 −0.07928 0.49723 industrial work Even split between 0.237999 0.134382 1.77 0.077 −0.02538 0.501383 commercial and domestic Mainly ‘Other’ −0.30005 0.39055 −0.77 0.442 −1.06552 0.465411 Mainly non-construction 7.363746 0.205867 35.77 0 6.960254 7.767238

/cut1 −0.77472 0.265157 −1.29441 −0.25502 /cut2 −0.29443 0.272917 −0.82934 0.240472 /cut3 −0.12812 0.273462 −0.6641 0.407852 /cut4 0.5283 0.278154 −0.01687 1.073472

No. of observations 1,097 Wald chi2(20) 4987.96 Prob >chi2 0 Pseudo R2 0.0405 Log pseudolikelihood −1234.23

Source: IES analysis of CBH Management Information system, June 2006

200

Table A5.21b Analysis 2 – Effect on change from Wave 1 to Wave 2

Coef. Std. Err. z P>z 95% Conf. Int Greater disagreement at Wave 2 In construction, H&S 0.28366 0.14829 1.91 0.056 −0.00698 0.574303 doesn’t tend to be a priority Non-user sample −0.54342 0.372612 −1.46 0.145 −1.27373 0.186886 Control sample −0.50136 0.374592 −1.34 0.181 −1.23555 0.232827 No. of employees: 1 to 9 −0.14687 0.289144 −0.51 0.611 −0.71358 0.419845 No. of employees: 10 to 49 −1.08304 0.377486 −2.87 0.004 −1.8229 −0.34318 No. of employees: 50 + −0.30422 0.467136 −0.65 0.515 −1.21979 0.611346 Type of work: Fit out 0.399221 0.324391 1.23 0.218 −0.23657 1.035016 Type of work: Completion 0.142914 0.334849 0.43 0.67 −0.51338 0.799207 Type of work: ‘Other’ 0.139168 0.484825 0.29 0.774 −0.81107 1.089407 Establishment part of larger 0.587875 0.463459 1.27 0.205 −0.32049 1.496239 group Employs casual workers −0.25206 0.333495 −0.76 0.45 −0.9057 0.401573 Length of time company in 0.957653 0.346815 2.76 0.006 0.277907 1.637398 operation: 5 to 20 yrs Length of time company in 0.404013 0.358374 1.13 0.26 −0.29839 1.106413 operation: more than 20 yrs Main way of working: get 0.820612 0.300254 2.73 0.006 0.232125 1.409099 subcontracted to others Main way of working: −0.26084 0.481671 −0.54 0.588 −1.2049 0.683218 subcontract others Main way of working: −0.28683 0.685811 −0.42 0.676 −1.631 1.057333 ‘Other’ Mainly commercial / −0.79444 0.341992 −2.32 0.02 −1.46473 −0.12415 industrial work Even split between −0.35021 0.345769 −1.01 0.311 −1.0279 0.327487 commercial and domestic Mainly ‘Other’ 0.578512 0.932149 0.62 0.535 −1.24847 2.405491 Mainly non-construction −34.3885 0.811296 −42.39 0 −35.9786 −32.7983 _cons −1.82022 0.79402 −2.29 0.022 −3.37647 −0.26397

Greater agreement at Wave 2 In construction, H&S −1.43933 0.140557 −10.24 0 −1.71481 −1.16384 doesn’t tend to be a priority Non-user sample 0.91797 0.506244 1.81 0.07 −0.07425 1.91019 Control sample 0.647067 0.50308 1.29 0.198 −0.33895 1.633085 No. of employees: 1 to 9 0.426422 0.413333 1.03 0.302 −0.3837 1.236539 No. of employees: 10 to 49 0.240163 0.486654 0.49 0.622 −0.71366 1.193987 No. of employees: 50 + −0.32106 0.698848 −0.46 0.646 −1.69077 1.048659 Type of work: Fit out 0.250523 0.330289 0.76 0.448 −0.39683 0.897878 Type of work: Completion −0.23171 0.388762 −0.6 0.551 −0.99367 0.530253 Type of work: ‘Other’ 0.821089 0.331698 2.48 0.013 0.170973 1.471206 Org. part of larger group 1.24804 0.44025 2.83 0.005 0.385167 2.110914

201

Coef. Std. Err. z P>z 95% Conf. Int Employs casual workers 0.181802 0.304462 0.6 0.55 −0.41493 0.778537 Length of time company in 0.098063 0.371136 0.26 0.792 −0.62935 0.825476 operation: 5 to 20 yrs Length of time company in −0.13729 0.363772 −0.38 0.706 −0.85027 0.575689 operation: more than 20 yrs Main way of working: get 0.409441 0.346797 1.18 0.238 −0.27027 1.08915 subcontracted to others Main way of working: −0.39926 0.47379 −0.84 0.399 −1.32787 0.52935 subcontract others Main way of working: −0.43869 0.57742 −0.76 0.447 −1.57041 0.693031 ‘Other’ Mainly commercial / 0.288854 0.387967 0.74 0.457 −0.47155 1.049256 industrial work Even split between 0.488593 0.390635 1.25 0.211 −0.27704 1.254223 commercial and domestic Mainly ‘Other’ 0.961192 0.756608 1.27 0.204 −0.52173 2.444116 Mainly non-construction −32.565 0.876527 −37.15 0 −34.2829 −30.847 _cons 3.71938 0.840891 4.42 0 2.071264 5.367496

No. of observations 1,097 Wald chi2(20) 2604.8 Prob >chi2 0 Pseudo R2 0.3133 Log pseudolikelihood −797.01

Base category: no change between Waves

Source: IES analysis of CBH Management Information system, June 2006

202

A5.22 Attitude 2: In my/our work, health and safety issues aren't really a problem

Table A5. 22a Analysis 1 – Effect at Wave 2 with Wave 1 taken account of

Coef. Std. Err. z P>z 95% Conf. Int H&S issues aren’t really a 0.171543 0.039651 4.33 0 0.09383 0.249257 problem (Wave 1) Non-user sample −0.0042 0.156516 −0.03 0.979 −0.31097 0.302562 Control sample 0.083142 0.1546 0.54 0.591 −0.21987 0.386151 No. of employees: 1 to 9 0.020237 0.121098 0.17 0.867 −0.21711 0.257583 No. of employees: 10 to 49 0.214437 0.147006 1.46 0.145 −0.07369 0.502563 No. of employees: 50 + 0.458531 0.213057 2.15 0.031 0.040948 0.876115 Type of work: Fit out −0.10208 0.116408 −0.88 0.381 −0.33023 0.126077 Type of work: Completion −0.16655 0.143478 −1.16 0.246 −0.44777 0.114656 Type of work: ‘Other’ −0.10967 0.172549 −0.64 0.525 −0.44786 0.228521 Org. part of larger group −0.13677 0.174283 −0.78 0.433 −0.47836 0.204819 Employs casual workers 0.143519 0.113112 1.27 0.205 −0.07818 0.365216 Length of time company in −0.09351 0.125366 −0.75 0.456 −0.33922 0.152206 operation: 5 to 20 yrs Length of time company in −0.04477 0.13303 −0.34 0.736 −0.30551 0.215962 operation: more than 20 yrs Main way of working: get 0.053731 0.12791 0.42 0.674 −0.19697 0.30443 subcontracted to others Main way of working: −0.09925 0.150768 −0.66 0.51 −0.39475 0.196255 subcontract others Main way of working: 0.131848 0.254658 0.52 0.605 −0.36727 0.630969 ‘Other’ Mainly commercial / 0.114584 0.120146 0.95 0.34 −0.1209 0.350064 industrial work Even split between 0.045343 0.142283 0.32 0.75 −0.23353 0.324213 commercial and domestic Mainly ‘Other’ −0.47713 0.31391 −1.52 0.129 −1.09238 0.138127 Mainly non-construction 1.580929 0.20427 7.74 0 1.180567 1.981291

/cut1 −0.31329 0.244999 −0.79348 0.166895 /cut2 0.320145 0.253207 −0.17613 0.816421 /cut3 0.460184 0.255388 −0.04037 0.960735 /cut4 1.017262 0.264964 0.497942 1.536581

No. of observations 1,124 Wald chi2(20) 177.63 Prob >chi2 0 Pseudo R2 0.0377 Log pseudolikelihood −1,668.34

Source: IES analysis of CBH Management Information system, June 2006

203

Table A5.22b Analysis 2 – Effect on change from Wave 1 to Wave 2

Coef. Std. Err. z P>z 95% Conf. Int Greater disagreement at Wave 2 H&S issues aren’t really a 0.959238 0.099765 9.61 0 0.763701 1.154774 problem Non-user sample −0.13431 0.408915 −0.33 0.743 −0.93577 0.667151 Control sample −0.20323 0.39231 −0.52 0.604 −0.97215 0.565682 No. of employees: 1 to 9 −0.05844 0.347451 −0.17 0.866 −0.73944 0.622548 No. of employees: 10 to 49 −0.52131 0.416161 −1.25 0.21 −1.33697 0.294346 No. of employees: 50 + −0.89649 0.56948 −1.57 0.115 −2.01265 0.219674 Type of work: Fit out 0.447094 0.302943 1.48 0.14 −0.14666 1.040852 Type of work: Completion 0.319473 0.33688 0.95 0.343 −0.3408 0.979745 Type of work: ‘Other’ 0.057712 0.600659 0.1 0.923 −1.11956 1.234983 Establishment part of 0.298816 0.435974 0.69 0.493 −0.55568 1.153308 larger group Employs casual workers −0.48853 0.336019 −1.45 0.146 −1.14711 0.170056 Length of time company 0.133984 0.343397 0.39 0.696 −0.53906 0.80703 in operation: 5 to 20 yrs Company in operation: 0.052532 0.358499 0.15 0.884 −0.65011 0.755177 more than 20 yrs Main way of working: get −0.27588 0.330033 −0.84 0.403 −0.92274 0.370969 subcontracted to others Main way of working: −0.0021 0.468485 0 0.996 −0.92032 0.916111 subcontract others Main way of working: 0.111109 0.621563 0.18 0.858 −1.10713 1.329351 ‘Other’ Mainly commercial / −0.4591 0.35997 −1.28 0.202 −1.16463 0.246432 industrial work Even split between 0.168365 0.379542 0.44 0.657 −0.57552 0.912253 commercial and domestic Mainly ‘Other’ 0.102226 0.805188 0.13 0.899 −1.47591 1.680366 Mainly non-construction −29.514 0.849735 −34.73 0 −31.1795 −27.8486 _cons −2.74924 0.577706 −4.76 0 −3.88152 −1.61696

No change H&S issues aren’t really a 0.751466 0.099081 7.58 0 0.557271 0.94566 problem Non-user sample 0.037129 0.383388 0.1 0.923 −0.7143 0.788555 Control sample −0.00419 0.367794 −0.01 0.991 −0.72506 0.716669 No. of employees: 1 to 9 −0.04812 0.329059 −0.15 0.884 −0.69307 0.596822 No. of employees: 10 to 49 −0.49469 0.376912 −1.31 0.189 −1.23343 0.24404 No. of employees: 50 + −0.50062 0.509618 −0.98 0.326 −1.49945 0.498216 Type of work: Fit out 0.157364 0.286985 0.55 0.583 −0.40512 0.719844 Type of work: Completion −0.17786 0.329112 −0.54 0.589 −0.8229 0.467191 Type of work: ‘Other’ 0.368466 0.475776 0.77 0.439 −0.56404 1.300969 Establishment part of 0.060019 0.42333 0.14 0.887 −0.76969 0.88973

204

Coef. Std. Err. z P>z 95% Conf. Int larger group Employs casual workers −0.68388 0.307083 −2.23 0.026 −1.28575 −0.08201 Length of time company 0.135999 0.310512 0.44 0.661 −0.47259 0.744592 in operation: 5 to 20 yrs Company in operation: 0.005888 0.309858 0.02 0.985 −0.60142 0.613198 more than 20 yrs Main way of working: get −0.07038 0.293423 −0.24 0.81 −0.64548 0.504718 subcontracted to others Main way of working: 0.209401 0.413079 0.51 0.612 −0.60022 1.01902 subcontract others Main way of working: −0.37151 0.66193 −0.56 0.575 −1.66887 0.925848 ‘Other’ Mainly commercial / −0.49494 0.310985 −1.59 0.111 −1.10446 0.114575 industrial work Even split between 0.054098 0.36619 0.15 0.883 −0.66362 0.771818 commercial and domestic Mainly ‘Other’ −0.23796 0.891569 −0.27 0.79 −1.9854 1.509489 Mainly non-construction −0.94405 0.874242 −1.08 0.28 −2.65753 0.76943 _cons −1.82863 0.528968 −3.46 0.001 −2.86539 −0.79187

No. of observations 1,103 Wald chi2(20) 1,871.03 Prob >chi2 0 Pseudo R2 0.1254 Log pseudolikelihood −1,058.67

Base category: greater agreement at Wave 2

Source: IES analysis of CBH Management Information system, June 2006

205

A5.23 Attitude 3: We don't think enough about how our/my health might be affected by the job

Table A5. 23a Analysis 1 – Effect at Wave 2 with Wave 1 taken account of

Coef. Std. Err. z P>z 95% Conf. Int We don‘t think enough 0.122422 0.040018 3.06 0.002 0.043987 0.200856 about how our/my health might be affected by the job (Wave 1) Non-user sample 0.201955 0.170873 1.18 0.237 −0.13295 0.53686 Control sample −0.0402 0.162307 −0.25 0.804 −0.35831 0.277918 No. of employees: 1 to 9 −0.29685 0.13027 −2.28 0.023 −0.55217 −0.04153 No. of employees: 10 to 49 −0.32532 0.153325 −2.12 0.034 −0.62583 −0.02481 No. of employees: 50 + −0.30834 0.214056 −1.44 0.15 −0.72788 0.111205 Type of work: Fit out −0.14233 0.131067 −1.09 0.278 −0.39921 0.11456 Type of work: Completion 0.027702 0.138471 0.2 0.841 −0.2437 0.2991 Type of work: ‘Other’ −0.00975 0.189638 −0.05 0.959 −0.38143 0.361939 Org. part of larger group −0.11776 0.182084 −0.65 0.518 −0.47464 0.239117 Employs casual workers 0.209788 0.132256 1.59 0.113 −0.04943 0.469006 Length of time company in 0.047339 0.156783 0.3 0.763 −0.25995 0.354629 operation: 5 to 20 yrs Length of time company in 0.096029 0.167568 0.57 0.567 −0.2324 0.424456 operation: more than 20 yrs Main way of working: get 0.203659 0.133069 1.53 0.126 −0.05715 0.464468 subcontracted to others Main way of working: −0.11093 0.167305 −0.66 0.507 −0.43884 0.216979 subcontract others Main way working: ‘Other’ −0.17251 0.241409 −0.71 0.475 −0.64566 0.30064 Mainly commercial / 0.216869 0.137552 1.58 0.115 −0.05273 0.486466 industrial work Even split between 0.141981 0.157907 0.9 0.369 −0.16751 0.451474 commercial and domestic Mainly ‘Other’ 0.045509 0.357404 0.13 0.899 −0.65499 0.746009 Mainly non-construction −0.79752 0.388133 −2.05 0.04 −1.55825 −0.03679

/cut1 −0.84465 0.280147 −1.39373 −0.29558 /cut2 0.009547 0.280517 −0.54026 0.559351 /cut3 0.100768 0.28096 −0.4499 0.651438 /cut4 0.590765 0.282247 0.037571 1.143959

No. of observations 1,103 Wald chi2(20) 46.36 Prob >chi2 0.0007 Pseudo R2 0.0275 Log pseudolikelihood −1,482.78

Source: IES analysis of CBH Management Information system, June 2006

206

Table A5.23b Analysis 2 – Effect on change from Wave 1 to Wave 2

Coef. Std. Err. z P>z 95% Conf. Int Greater disagreement at Wave 2 We don‘t think enough 1.087112 0.085265 12.75 0 0.919996 1.254228 about how our/my health might be affected by the job Non-user sample −0.88984 0.399422 −2.23 0.026 −1.67269 −0.10698 Control sample −0.46611 0.390097 −1.19 0.232 −1.23069 0.298465 No. of employees: 1 to 9 1.380888 0.313389 4.41 0 0.766657 1.995118 No. of employees: 10 to 49 0.992286 0.403979 2.46 0.014 0.200501 1.78407 No. of employees: 50 + 0.860159 0.512763 1.68 0.093 −0.14484 1.865156 Type of work: Fit out 0.207361 0.3239 0.64 0.522 −0.42747 0.842193 Type of work: Completion −0.08371 0.345107 −0.24 0.808 −0.76011 0.592686 Type of work: ‘Other’ −0.23977 0.45049 −0.53 0.595 −1.12272 0.64317 Org. part of larger group 0.407819 0.452628 0.9 0.368 −0.47932 1.294952 Employs casual workers −0.72845 0.339838 −2.14 0.032 −1.39452 −0.06238 Length of time company in −0.27819 0.35841 −0.78 0.438 −0.98066 0.424281 operation: 5 to 20 yrs Length of time company in −0.15501 0.379486 −0.41 0.683 −0.89879 0.588771 operation: more than 20 yrs Main way of working: get −0.50238 0.339421 −1.48 0.139 −1.16763 0.162877 subcontracted to others Main way of working: 0.385152 0.405406 0.95 0.342 −0.40943 1.179733 subcontract others Main way working: ‘Other’ 0.325915 0.690854 0.47 0.637 −1.02813 1.679963 Mainly commercial / −0.34157 0.354041 −0.96 0.335 −1.03548 0.352334 industrial work Even split between −0.53131 0.365733 −1.45 0.146 −1.24814 0.185513 commercial and domestic Mainly ‘Other’ −0.269 0.904304 −0.3 0.766 −2.0414 1.503406 Mainly non-construction 22.90745 1.666603 13.74 0 19.64097 26.17394 _cons −3.82803 0.601109 −6.37 0 −5.00618 −2.64988

No change between waves We don‘t think enough 0.780555 0.088744 8.8 0 0.606619 0.95449 about how our/my health might be affected by the job Non-user sample −0.05468 0.399752 −0.14 0.891 −0.83818 0.72882 Control sample −0.11324 0.401583 −0.28 0.778 −0.90033 0.673847 No. of employees: 1 to 9 0.676568 0.299671 2.26 0.024 0.089223 1.263913 No. of employees: 10 to 49 0.473673 0.388156 1.22 0.222 −0.2871 1.234444 No. of employees: 50 + 0.211264 0.496519 0.43 0.67 −0.7619 1.184424 Type of work: Fit out 0.203794 0.299399 0.68 0.496 −0.38302 0.790606 Type of work: Completion 0.072065 0.327862 0.22 0.826 −0.57053 0.714663 Type of work: ‘Other’ 0.05771 0.414803 0.14 0.889 −0.75529 0.87071 Org. part of larger group 0.310644 0.44587 0.7 0.486 −0.56324 1.184533

207

Coef. Std. Err. z P>z 95% Conf. Int Employs casual workers 0.489351 0.308973 1.58 0.113 −0.11622 1.094926 Length of time company in −0.24401 0.334168 −0.73 0.465 −0.89897 0.410949 operation: 5 to 20 yrs Length of time company in 0.358348 0.341545 1.05 0.294 −0.31107 1.027763 operation: more than 20 yrs Main way of working: get 0.023627 0.301184 0.08 0.937 −0.56668 0.613938 subcontracted to others Main way of working: −0.12445 0.441589 −0.28 0.778 −0.98995 0.741047 subcontract others Main way working: ‘Other’ 0.195191 0.701212 0.28 0.781 −1.17916 1.569541 Mainly commercial / −0.28695 0.318493 −0.9 0.368 −0.91119 0.337281 industrial work Even split between −0.09519 0.324819 −0.29 0.769 −0.73182 0.541443 commercial and domestic Mainly ‘Other’ −1.17435 0.988762 −1.19 0.235 −3.11229 0.763586 Mainly non-construction 20.25932 – – – – – _cons −3.07778 0.592499 −5.19 0 −4.23906 −1.91651

No. of observations 1,103 Wald chi2(20) – Prob >chi2 – Pseudo R2 0.1894 Log pseudolikelihood −978.278

Base category: greater agreement at Wave 2

Source: IES analysis of CBH Management Information system, June 2006

208

A5.24 Attitude 4: We believe that we do enough in the area of health and safety

Table A5. 24a Analysis 1 – Effect at Wave 2 with Wave 1 taken account of

Coef. Std. Err. z P>z 95% Conf. Int We believe we do enough in 0.291808 0.048128 6.06 0 0.19748 0.386137 the area of H&S (Wave 1) Non-user sample −0.35326 0.163957 −2.15 0.031 −0.67461 −0.03191 Control sample −0.30539 0.156945 −1.95 0.052 −0.61299 0.002218 No. of employees: 1 to 9 −0.02846 0.137156 −0.21 0.836 −0.29728 0.240363 No. of employees: 10 to 49 0.147083 0.176093 0.84 0.404 −0.19805 0.492219 No. of employees: 50 or more 0.371348 0.201729 1.84 0.066 −0.02403 0.76673 Type of work: Fit out 0.093386 0.131016 0.71 0.476 −0.1634 0.350172 Type of work: Completion −0.19627 0.14088 −1.39 0.164 −0.47239 0.079852 Type of work: ‘Other’ 0.277957 0.174619 1.59 0.111 −0.06429 0.620203 Org. part of larger group −0.01295 0.179207 −0.07 0.942 −0.36419 0.338285 Employs casual workers −0.0498 0.120534 −0.41 0.679 −0.28604 0.186443 Length of time company in −0.09978 0.132098 −0.76 0.45 −0.35869 0.159126 operation: 5 to 20 yrs Length of time company in −0.09749 0.147356 −0.66 0.508 −0.38631 0.191319 operation: more than 20 yrs Main way of working: get 0.038559 0.126071 0.31 0.76 −0.20854 0.285653 subcontracted to others Main way of working: −0.12318 0.170175 −0.72 0.469 −0.45672 0.210359 subcontract others Main way of working: 0.030555 0.196024 0.16 0.876 −0.35365 0.414755 ‘Other’ Mainly commercial / 0.119079 0.124297 0.96 0.338 −0.12454 0.362695 industrial work Even split between 0.218882 0.155645 1.41 0.16 −0.08618 0.523941 commercial and domestic Mainly ‘Other’ −0.39957 0.291382 −1.37 0.17 −0.97066 0.171532 Mainly non-construction 0.933598 0.204697 4.56 0 0.532398 1.334797

/cut1 0.255799 0.241338 −0.21721 0.728813 /cut2 1.229724 0.250805 0.738155 1.721294 /cut3 1.449139 0.256144 0.947106 1.951172 /cut4 2.389081 0.306656 1.788047 2.990114

No. of observations 1,125 Wald chi2(20) 125.6 Prob >chi2 0 Pseudo R2 0.059 Log pseudolikelihood

Source: IES analysis of CBH Management Information system, June 2006

209

Table A5.24b Analysis 2 – Effect on change from Wave 1 to Wave 2

Coef. Std. Err. z P>z 95% Conf. Int Greater disagreement at Wave 2 We believe we do enough in the 0.973108 0.125169 7.77 0 0.727783 1.218434 area of H&S Non-user sample 0.111314 0.414725 0.27 0.788 −0.70153 0.92416 Control sample −0.07321 0.402522 −0.18 0.856 −0.86214 0.715718 No. of employees: 1 to 9 −0.38168 0.311225 −1.23 0.22 −0.99167 0.228313 No. of employees: 10 to 49 −0.21727 0.365553 −0.59 0.552 −0.93374 0.4992 No. of employees: 50 or more −1.12829 0.565806 −1.99 0.046 −2.23725 −0.01933 Type of work: Fit out 0.137239 0.311853 0.44 0.66 −0.47398 0.748459 Type of work: Completion 0.199399 0.32503 0.61 0.54 −0.43765 0.836447 Type of work: ‘Other’ −0.00423 0.487267 −0.01 0.993 −0.95926 0.950795 Org. part of larger group 0.228997 0.491656 0.47 0.641 −0.73463 1.192625 Employs casual workers 0.184792 0.330222 0.56 0.576 −0.46243 0.832014 Length of time company in 0.592868 0.353667 1.68 0.094 −0.10031 1.286043 operation: 5 to 20 yrs Length of time company in 0.72551 0.374388 1.94 0.053 −0.00828 1.459297 operation: more than 20 yrs Main way of working: get 0.046134 0.316096 0.15 0.884 −0.5734 0.66567 subcontracted to others Main way of working: 0.247997 0.435902 0.57 0.569 −0.60635 1.10235 subcontract others Main way of working: ‘Other’ 0.035867 0.550302 0.07 0.948 −1.0427 1.114438 Mainly commercial/industrial −0.33418 0.337286 −0.99 0.322 −0.99525 0.326889 work Even split between commercial 0.541835 0.312105 1.74 0.083 −0.06988 1.153549 and domestic Mainly ‘Other’ 0.94178 0.872693 1.08 0.281 −0.76867 2.652227 Mainly non-construction −30.0565 1.508143 −19.93 0 −33.0124 −27.1006 _cons −2.93898 0.601418 −4.89 0 −4.11774 −1.76022

Great agreement at Wave 2 We believe we do enough in the −0.5802 0.174352 −3.33 0.001 −0.92192 −0.23847 area of H&S Non-user sample −0.40219 0.341157 −1.18 0.238 −1.07084 0.266467 Control sample −0.43738 0.347275 −1.26 0.208 −1.11802 0.243269 No. of employees: 1 to 9 −0.3803 0.293298 −1.3 0.195 −0.95515 0.194557 No. of employees: 10 to 49 0.160384 0.362874 0.44 0.659 −0.55084 0.871603 No. of employees: 50 or more 0.175395 0.488332 0.36 0.719 −0.78172 1.132507 Type of work: Fit out 0.464576 0.29518 1.57 0.116 −0.11397 1.043118 Type of work: Completion 0.054619 0.323587 0.17 0.866 −0.5796 0.688838 Type of work: ‘Other’ 0.914516 0.39987 2.29 0.022 0.130786 1.698246 Org. part of larger group 0.277702 0.42901 0.65 0.517 −0.56314 1.118546 Employs casual workers 0.102997 0.296046 0.35 0.728 −0.47724 0.683237

210

Coef. Std. Err. z P>z 95% Conf. Int Length of time company in 0.040358 0.315698 0.13 0.898 −0.5784 0.659114 operation: 5 to 20 yrs Length of time company in 0.222264 0.327745 0.68 0.498 −0.4201 0.864632 operation: more than 20 yrs Main way of working: get 0.067171 0.28765 0.23 0.815 −0.49661 0.630955 subcontracted to others Main way of working: 0.310175 0.422005 0.74 0.462 −0.51694 1.13729 subcontract others Main way of working: ‘Other’ −0.08343 0.627036 −0.13 0.894 −1.31239 1.145541 Mainly commercial / industrial −0.18763 0.312388 −0.6 0.548 −0.7999 0.42464 work Even split between commercial 0.828142 0.337379 2.45 0.014 0.16689 1.489393 and domestic Mainly ‘Other’ −0.21133 0.943276 −0.22 0.823 −2.06012 1.637453 Mainly non-construction 2.081447 1.363727 1.53 0.127 −0.59141 4.754302 _cons 0.180223 0.544944 0.33 0.741 −0.88785 1.248292

No. of observations 1,125 Wald chi2(20) 2,065.71 Prob >chi2 0 Pseudo R2 0.1625 Log pseudolikelihood −1,011.14

Base category: no change

Source: IES analysis of CBH Management Information system, June 2006

211

A5.25 Attitude 5: We do not always have time to deal with health and safety issues in the way we would like

Table A5. 25a Analysis 1 – Effect at Wave 2 with Wave 1 taken account of

Coef. Std. Err. z P>z 95% Conf. Int We don’t always have as 0.351146 0.036602 9.59 0 0.279407 0.422884 much time to deal with H&S issues as we would like (Wave 1) Non-user sample 0.383348 0.161026 2.38 0.017 0.067743 0.698952 Control sample 0.489656 0.152112 3.22 0.001 0.191522 0.787789 No. of employees: 1 to 9 −0.30023 0.132416 −2.27 0.023 −0.55976 −0.0407 No. of employees: 10 to 49 −0.09746 0.151771 −0.64 0.521 −0.39492 0.20001 No. of employees: 50 + −0.35356 0.197346 −1.79 0.073 −0.74035 0.033229 Type of work: Fit out −0.11256 0.121567 −0.93 0.354 −0.35083 0.125708 Type of work: Completion 0.095124 0.133573 0.71 0.476 −0.16667 0.356921 Type of work: ‘Other’ −0.08914 0.176076 −0.51 0.613 −0.43424 0.255962 Org. part of larger group −0.05614 0.180572 −0.31 0.756 −0.41006 0.297771 Employs casual workers 0.272836 0.123384 2.21 0.027 0.031008 0.514665 Length of time company in −0.17927 0.144114 −1.24 0.214 −0.46173 0.103184 operation: 5 to 20 yrs Length of time company in −0.18333 0.14901 −1.23 0.219 −0.47539 0.10872 operation: more than 20 yrs Main way of working: get 0.061054 0.130192 0.47 0.639 −0.19412 0.316226 subcontracted to others Main way of working: −0.09105 0.158613 −0.57 0.566 −0.40192 0.219827 subcontract others Main way working: ‘Other’ 0.349601 0.287079 1.22 0.223 −0.21306 0.912266 Mainly commercial / 0.030375 0.129331 0.23 0.814 −0.22311 0.283858 industrial work Even split between 0.018061 0.13529 0.13 0.894 −0.2471 0.283224 commercial and domestic Mainly ‘Other’ −0.49468 0.342231 −1.45 0.148 −1.16544 0.176086 Mainly non-construction −1.48226 0.910834 −1.63 0.104 −3.26746 0.302939

/cut1 0.067563 0.254469 −0.43119 0.566313 /cut2 1.124241 0.259996 0.614659 1.633823 /cut3 1.202258 0.261252 0.690213 1.714304 /cut4 1.766721 0.26716 1.243097 2.290344

No. of observations 1,110 Wald chi2(20) 147.67 Prob >chi2 0 Pseudo R2 0.0882 Log pseudolikelihood −1,456.22

Source: IES analysis of CBH Management Information system, June 2006

212

Table A5.25b Analysis 2 – Effect on change from Wave 1 to Wave 2

Coef. Std. Err. z P>z 95% Conf. Int Greater disagreement at Wave 2 We don’t always have enough 0.337301 0.089005 3.79 0 0.162853 0.511748 time to deal with H&S issues as we would like Non-user sample −0.4859 0.360982 −1.35 0.178 −1.19342 0.221609 Control sample −0.75344 0.337322 −2.23 0.026 −1.41458 −0.0923 No. of employees: 1 to 9 0.159313 0.296474 0.54 0.591 −0.42177 0.740392 No. of employees: 10 to 49 −0.14587 0.356 −0.41 0.682 −0.84362 0.551874 No. of employees: 50 or more 0.133767 0.471796 0.28 0.777 −0.79094 1.05847 Type of work: Fit out 0.100011 0.287925 0.35 0.728 −0.46431 0.664332 Type of work: Completion −0.48681 0.323674 −1.5 0.133 −1.1212 0.147581 Type of work: ‘Other’ 0.444204 0.382641 1.16 0.246 −0.30576 1.194166 Establishment part of larger −0.2813 0.402587 −0.7 0.485 −1.07036 0.507752 group Employs casual workers −0.50406 0.326658 −1.54 0.123 −1.1443 0.136173 Length of time company in 0.596624 0.329879 1.81 0.071 −0.04993 1.243175 operation: 5 to 20 yrs Length of time company in 0.444292 0.330084 1.35 0.178 −0.20266 1.091244 operation: more than 20 yrs Main way of working: get −0.2721 0.282366 −0.96 0.335 −0.82552 0.281329 subcontracted to others Main way of working: 0.17431 0.372085 0.47 0.639 −0.55496 0.903582 subcontract others Main way of working: ‘Other’ −0.48892 0.633341 −0.77 0.44 −1.73025 0.752407 Mainly commercial/industrial −0.05565 0.301199 −0.18 0.853 −0.64598 0.534693 work Even split between commercial −0.44263 0.331972 −1.33 0.182 −1.09329 0.20802 and domestic Mainly ‘Other’ 0.731421 0.848496 0.86 0.389 −0.9316 2.394442 Mainly non-construction −31.3087 0.911707 −34.34 0 −33.0956 −29.5218 _cons −1.02293 0.553079 −1.85 0.064 −2.10694 0.061087

Great agreement at Wave 2 We don’t always have enough −0.49951 0.084075 −5.94 0 −0.66429 −0.33472 time to deal with H&S issues as we would like Non-user sample 0.449363 0.402291 1.12 0.264 −0.33911 1.237838 Control sample 0.287992 0.3983 0.72 0.47 −0.49266 1.068646 No. of employees: 1 to 9 −0.32029 0.305171 −1.05 0.294 −0.91842 0.277832 No. of employees: 10 to 49 −0.04731 0.353136 −0.13 0.893 −0.73944 0.644827 No. of employees: 50 or more −0.32923 0.504497 −0.65 0.514 −1.31802 0.659569 Type of work: Fit out −0.40605 0.298497 −1.36 0.174 −0.99109 0.178997 Type of work: Completion −0.00687 0.316043 −0.02 0.983 −0.6263 0.612566 Type of work: ‘Other’ 0.059371 0.427962 0.14 0.89 −0.77942 0.898161

213

Coef. Std. Err. z P>z 95% Conf. Int Establishment part of larger −0.61542 0.413171 −1.49 0.136 −1.42522 0.194385 group Employs casual workers 0.483151 0.306009 1.58 0.114 −0.11662 1.082918 Length of time company in −0.05555 0.31883 −0.17 0.862 −0.68045 0.569342 operation: 5 to 20 yrs Length of time company in −0.05347 0.337552 −0.16 0.874 −0.71506 0.608118 operation: more than 20 yrs Main way of working: get −0.05647 0.282579 −0.2 0.842 −0.61031 0.497377 subcontracted to others Main way of working: −0.15387 0.395419 −0.39 0.697 −0.92888 0.621133 subcontract others Main way of working: ‘Other’ 0.799018 0.604155 1.32 0.186 −0.3851 1.983141 Mainly commercial/industrial −0.16803 0.323334 −0.52 0.603 −0.80175 0.465693 work Even split between commercial −0.53735 0.316848 −1.7 0.09 −1.15836 0.08366 and domestic Mainly ‘Other’ −0.93641 0.851674 −1.1 0.272 −2.60566 0.732845 Mainly non-construction −33.4384 1.092767 −30.6 0 −35.5802 −31.2966 _cons 1.377363 0.609202 2.26 0.024 0.183349 2.571376

No. of observations 1,110 Wald chi2(20) 2,040.4 Prob >chi2 0 Pseudo R2 0.1141 Log pseudolikelihood −1,074.07

Base category: no change between waves

Source: IES analysis of CBH Management Information system, June 2006

214

A5.26 Attitude 6: We cannot afford to deal with every health and safety issue

Table A5. 26a Analysis 1 – Effect at Wave 2 with Wave 1 taken account of

Coef. Std. Err. z P>z 95% Conf. Int We can’t afford to deal with 0.333765 0.036786 9.07 0 0.261666 0.405864 every H&S issue (Wave 1) Non-user sample 0.159383 0.1629 0.98 0.328 −0.1599 0.47866 Control sample 0.134932 0.160344 0.84 0.4 −0.17934 0.4492 No. of employees: 1 to 9 0.158295 0.146028 1.08 0.278 −0.12791 0.444504 No. of employees: 10 to 49 0.225705 0.179493 1.26 0.209 −0.1261 0.577505 No. of employees: 50 or 0.163914 0.212323 0.77 0.44 −0.25223 0.580059 more Type of work: Fit out −0.04429 0.128869 −0.34 0.731 −0.29687 0.208287 Type of work: Completion 0.196261 0.140515 1.4 0.162 −0.07914 0.471665 Type of work: ‘Other’ 0.202114 0.186472 1.08 0.278 −0.16337 0.567593 Org. part of larger group 0.225289 0.191374 1.18 0.239 −0.1498 0.600374 Employs casual workers 0.028389 0.127295 0.22 0.824 −0.22111 0.277884 Length of time company in −0.16594 0.147593 −1.12 0.261 −0.45521 0.12334 operation: 5 to 20 yrs Length of time company in −0.15356 0.155077 −0.99 0.322 −0.45751 0.150386 operation: more than 20 yrs Main way of working: get −0.07094 0.125876 −0.56 0.573 −0.31766 0.175768 subcontracted to others Main way of working: −0.09629 0.154621 −0.62 0.533 −0.39935 0.206756 subcontract others Main way of working: −0.11639 0.202397 −0.58 0.565 −0.51308 0.280299 ‘Other’ Mainly −0.00981 0.14206 −0.07 0.945 −0.28824 0.268623 commercial/industrial work Even split between 0.292643 0.141574 2.07 0.039 0.015163 0.570123 commercial and domestic Mainly ‘Other’ 0.222823 0.405422 0.55 0.583 −0.57179 1.017435 Mainly non-construction 7.293949 0.189986 38.39 0 6.921584 7.666314

/cut1 0.028063 0.305419 −0.57055 0.626673 /cut2 0.717681 0.297826 0.133952 1.301409 /cut3 0.877485 0.298309 0.292811 1.46216 /cut4 1.634468 0.30149 1.043558 2.225379

No. of observations 1,095 Wald chi2(20) 5,331.2 Prob >chi2 0 Pseudo R2 0.0712 Log pseudolikelihood −1,369.04

Source: IES analysis of CBH Management Information system, June 2006

215

Table A5.26b Analysis 2 – Effect on change from Wave 1 to Wave 2

Coef. Std. Err. z P>z 95% Conf. Int Greater disagreement at Wave 2 We can’t afford to deal with −0.0407 0.11864 −0.34 0.732 −0.27323 0.191833 every H&S issue Non-user sample −0.38671 0.351702 −1.1 0.272 −1.07604 0.302611 Control sample −0.4898 0.350452 −1.4 0.162 −1.17667 0.197077 No. of employees: 1 to 9 −0.293 0.289264 −1.01 0.311 −0.85994 0.273949 No. of employees: 10 to 49 −0.27016 0.344855 −0.78 0.433 −0.94606 0.405748 No. of employees: 50 or more −0.58307 0.476797 −1.22 0.221 −1.51758 0.351434 Type of work: Fit out 0.00391 0.28019 0.01 0.989 −0.54525 0.553071 Type of work: Completion −0.12856 0.329937 −0.39 0.697 −0.77522 0.518106 Type of work: ‘Other’ −0.11346 0.395532 −0.29 0.774 −0.88869 0.661766 Establishment part of larger −0.39605 0.437545 −0.91 0.365 −1.25362 0.461525 group Employs casual workers −0.01079 0.283696 −0.04 0.97 −0.56682 0.545242 Length of time company in −0.4366 0.320044 −1.36 0.173 −1.06387 0.190675 operation: 5 to 20 yrs Length of time company in −0.80689 0.322562 −2.5 0.012 −1.4391 −0.17468 operation: more than 20 yrs Main way of working: get 0.006711 0.299038 0.02 0.982 −0.57939 0.592814 subcontracted to others Main way of working: 0.268194 0.380418 0.7 0.481 −0.47741 1.013799 subcontract others Main way of working: ‘Other’ 0.256794 0.567088 0.45 0.651 −0.85468 1.368266 Mainly commercial/industrial 0.422661 0.31307 1.35 0.177 −0.19095 1.036268 work Even split between commercial −0.08021 0.335419 −0.24 0.811 −0.73762 0.577194 and domestic Mainly ‘Other’ −0.0031 0.946775 0 0.997 −1.85874 1.852549 Mainly non-construction −33.4187 0.919349 −36.35 0 −35.2206 −31.6168 _cons 0.808212 0.675095 1.2 0.231 −0.51495 2.131373

Great agreement at Wave 2 We can’t afford to deal with −1.03388 0.101444 −10.19 0 −1.2327 −0.83505 every H&S issue Non-user sample 0.053184 0.397203 0.13 0.893 −0.72532 0.831688 Control sample 0.021971 0.389547 0.06 0.955 −0.74153 0.785468 No. of employees: 1 to 9 −0.23248 0.356988 −0.65 0.515 −0.93217 0.467203 No. of employees: 10 to 49 0.192342 0.418334 0.46 0.646 −0.62758 1.012263 No. of employees: 50 or more −0.83249 0.545613 −1.53 0.127 −1.90188 0.236887 Type of work: Fit out 0.100412 0.320717 0.31 0.754 −0.52818 0.729005 Type of work: Completion 0.497646 0.315374 1.58 0.115 −0.12048 1.115767 Type of work: ‘Other’ 0.565908 0.473297 1.2 0.232 −0.36174 1.493554 Establishment part of larger 0.322187 0.417301 0.77 0.44 −0.49571 1.140082 group

216

Coef. Std. Err. z P>z 95% Conf. Int Employs casual workers 0.005223 0.292146 0.02 0.986 −0.56737 0.577818 Length of time company in −0.88869 0.325004 −2.73 0.006 −1.52568 −0.25169 operation: 5 to 20 yrs Length of time company in −0.98472 0.341421 −2.88 0.004 −1.6539 −0.31555 operation: more than 20 yrs Main way of working: get 0.074164 0.295997 0.25 0.802 −0.50598 0.654308 subcontracted to others Main way of working: 0.056846 0.440993 0.13 0.897 −0.80748 0.921176 subcontract others Main way of working: ‘Other’ 0.159445 0.552422 0.29 0.773 −0.92328 1.242171 Mainly commercial/industrial 0.486691 0.33495 1.45 0.146 −0.1698 1.143182 work Even split between commercial 0.710762 0.355347 2 0.045 0.014295 1.40723 and domestic Mainly ‘Other’ 0.231484 0.842559 0.27 0.784 −1.4199 1.882868 Mainly non-construction −32.1636 0.97803 −32.89 0 −34.0805 −30.2467 _cons 3.58819 0.696548 5.15 0 2.222982 4.953399

No. of observations 1,095 Wald chi2(20) 2,058.6 Prob >chi2 0 Pseudo R2 0.1768 Log pseudolikelihood −976.637

Base category: no change between waves

Source: IES analysis of CBH Management Information system, June 2006

217

A5.27 Attitude 7: We know a lot about legislation

Table A5. 27a Analysis 1 – Effect at Wave 2 with Wave 1 taken account of

Coef. Std. Err. z P>z 95% Conf. Int We know a lot about H&S 0.311245 0.049343 6.31 0 0.214534 0.407955 legislation (Wave 1) Non-user sample 0.022696 0.150444 0.15 0.88 −0.27217 0.317561 Control sample 0.043305 0.145327 0.3 0.766 −0.24153 0.32814 No. of employees: 1 to 9 −0.04048 0.114945 −0.35 0.725 −0.26577 0.184812 No. of employees: 10 to 49 −0.37981 0.132733 −2.86 0.004 −0.63996 −0.11965 No. of employees: 50 or −0.83982 0.202186 −4.15 0 −1.23609 −0.44354 more Type of work: Fit out 0.254704 0.12176 2.09 0.036 0.016059 0.49335 Type of work: Completion 0.172535 0.137783 1.25 0.21 −0.09752 0.442586 Type of work: ‘Other’ 0.249342 0.145099 1.72 0.086 −0.03505 0.533731 Establishment part of larger −0.11686 0.190673 −0.61 0.54 −0.49057 0.256855 group Employs casual workers −0.21043 0.113222 −1.86 0.063 −0.43234 0.011482 Length of time company in 0.165282 0.129033 1.28 0.2 −0.08762 0.418183 operation: 5 to 20 yrs Length of time company in 0.301414 0.135935 2.22 0.027 0.034986 0.567843 operation: more than 20 yrs Main way of working: get −0.03328 0.125101 −0.27 0.79 −0.27848 0.211911 subcontracted to others Main way of working: 0.099462 0.160356 0.62 0.535 −0.21483 0.413753 subcontract others Main way of working: 0.260382 0.211259 1.23 0.218 −0.15368 0.674441 ‘Other’ Mainly −0.10758 0.12438 −0.86 0.387 −0.35136 0.136203 commercial/industrial work Even split between 0.005504 0.140211 0.04 0.969 −0.2693 0.280313 commercial and domestic Mainly ‘Other’ −0.64803 0.310559 −2.09 0.037 −1.25672 −0.03935 Mainly non-construction −1.55366 0.717022 −2.17 0.03 −2.95899 −0.14832

/cut1 −0.17172 0.231099 −0.62467 0.281221 /cut2 0.972946 0.236662 0.509098 1.436795 /cut3 1.366947 0.236126 0.904148 1.829746 /cut4 2.544781 0.27412 2.007517 3.082045

No. of observations 1,113 Wald chi2(20) 156.33 Prob >chi2 0 Pseudo R2 0.0913 Log pseudolikelihood −1,465.05

Source: IES analysis of CBH Management Information system, June 2006

218

Table A5.27b Analysis 2 – Effect on change from Wave 1 to Wave 2

Coef. Std. Err. z P>z 95% Conf. Int Greater disagreement at Wave 2 We know a lot about H&S 1.12381 0.139582 8.05 0 0.850235 1.397385 legislation Non-user sample −0.24675 0.423245 −0.58 0.56 −1.0763 0.582791 Control sample 0.003966 0.400437 0.01 0.992 −0.78088 0.788808 No. of employees: 1 to 9 0.331014 0.305094 1.08 0.278 −0.26696 0.928986 No. of employees: 10 to 49 0.519956 0.410802 1.27 0.206 −0.2852 1.325114 No. of employees: 50 or 1.559562 0.489126 3.19 0.001 0.600894 2.518231 more Type of work: Fit out −0.54009 0.334279 −1.62 0.106 −1.19527 0.115085 Type of work: Completion −0.48145 0.370397 −1.3 0.194 −1.20742 0.244513 Type of work: ‘Other’ −0.31001 0.381737 −0.81 0.417 −1.0582 0.438182 Establishment part of larger 0.012652 0.418897 0.03 0.976 −0.80837 0.833676 group Employs casual workers −0.07464 0.317269 −0.24 0.814 −0.69648 0.547194 Length of time company in −0.93581 0.37812 −2.47 0.013 −1.67691 −0.19471 operation: 5 to 20 yrs Length of time company in −0.40964 0.38218 −1.07 0.284 −1.1587 0.339414 operation: more than 20 yrs Main way of working: get −0.03822 0.326361 −0.12 0.907 −0.67788 0.601434 subcontracted to others Main way of working: −0.74337 0.38859 −1.91 0.056 −1.50499 0.018252 subcontract others Main way of working: −2.35338 0.783825 −3 0.003 −3.88965 −0.81711 ‘Other’ Mainly 0.426126 0.345026 1.24 0.217 −0.25011 1.102364 commercial/industrial work Even split between 0.128688 0.364365 0.35 0.724 −0.58545 0.84283 commercial and domestic Mainly ‘Other’ 2.504447 1.06174 2.36 0.018 0.423476 4.585419 Mainly non-construction 3.438382 1.688524 2.04 0.042 0.128935 6.747829 _cons −3.06601 0.647188 −4.74 0 −4.33447 −1.79754

Great agreement at Wave 2 We know a lot about H&S −0.49533 0.127965 −3.87 0 −0.74614 −0.24453 legislation Non-user sample 0.134754 0.34182 0.39 0.693 −0.5352 0.804709 Control sample 0.232011 0.338174 0.69 0.493 −0.4308 0.89482 No. of employees: 1 to 9 0.112042 0.306225 0.37 0.714 −0.48815 0.712232 No. of employees: 10 to 49 −0.50346 0.360197 −1.4 0.162 −1.20944 0.202511 No. of employees: 50 or −0.76473 0.507969 −1.51 0.132 −1.76033 0.230868 more Type of work: Fit out 0.057678 0.271662 0.21 0.832 −0.47477 0.590125 Type of work: Completion 0.242829 0.30377 0.8 0.424 −0.35255 0.838208

219

Coef. Std. Err. z P>z 95% Conf. Int Type of work: ‘Other’ 0.286337 0.383602 0.75 0.455 −0.46551 1.038183 Establishment part of larger −0.20314 0.401388 −0.51 0.613 −0.98984 0.583571 group Employs casual workers −0.44552 0.279114 −1.6 0.11 −0.99258 0.101532 Length of time company in −0.5182 0.301218 −1.72 0.085 −1.10857 0.072179 operation: 5 to 20 yrs Length of time company in 0.260851 0.311505 0.84 0.402 −0.34969 0.871389 operation: more than 20 yrs Main way of working: get −0.1061 0.290321 −0.37 0.715 −0.67512 0.462918 subcontracted to others Main way of working: −0.05479 0.369561 −0.15 0.882 −0.77912 0.669532 subcontract others Main way of working: −0.69316 0.532057 −1.3 0.193 −1.73597 0.349656 ‘Other’ Mainly 0.122139 0.287647 0.42 0.671 −0.44164 0.685918 commercial/industrial work Even split between 0.005582 0.304468 0.02 0.985 −0.59117 0.602329 commercial and domestic Mainly ‘Other’ 0.044554 0.745574 0.06 0.952 −1.41675 1.505853 Mainly non-construction −27.5102 1.143418 −24.06 0 −29.7513 −25.2692 _cons 1.114542 0.542079 2.06 0.04 0.052085 2.176998

No. of observations 1,113 Wald chi2(20) 1,906.01 Prob >chi2 0 Pseudo R2 0.1658 Log pseudolikelihood −1,005.89

Base category: no change between waves

Source: IES analysis of CBH Management Information system, June 2006

220

APPENDIX 6: ADDITIONAL TABLES TO ACCOMPANY CHAPTER 8

Table A6.1 % Change in responses between waves one and two to attitude statement ‘in the construction industry generally, health and safety doesn’t tend to be a priority’

CBH Non-user Control All 2004/05 2005/06 2004/05 2005/06 2004/05 2005/06 2004/05 2005/06 survey survey survey survey survey survey survey survey

Strongly agree 14.8 8.2 6.7 4.5 6.6 6.7 8.7 6.9 (11)

Tend to agree 18 10 17.3 7.2 14.2 7.6 16.1 8.7 (14)

Neither agree 1.6 4.1 4 3.6 6.6 4.8 4.5 4.1 nor disagree (1) Tend to 14.8 17.3 29.3 17.1 25.5 22.9 24 18.6 disagree (1) Strongly 50.8 58.2 41.3 66.7 46.2 56.2 45.9 59.9 disagree (39) No opinion/ – 2.3 1.3 0.9 0.9 1.9 0.8 1.8 Don’t know Base 77 225 925 645 1,009 602 2,011 1,472 (unweighted)

Where figures are presented in brackets next to percentages, these are the actual number of respondents in each cell. These have been presented to reflect the low base size (ie less than 100) for the % in question.

Source: IES/IPSOS-MORI Surveys of Construction Employers 2004/05 and 2005/2006

Table A6.2 % Change in responses between waves one and two to attitude statement ‘in my/our work, health and safety issues aren’t really a problem’

CBH Non-user Control All 2004/05 2005/06 2004/05 2005/06 2004/05 2005/06 2004/05 2005/06 survey survey survey survey survey survey survey survey

Strongly 4.9 17.7 13.3 16.2 11.2 16.5 10.3 17.1 agree (4) Tend to agree 31.1 20.5 29.3 23.4 21.5 15.5 26.3 20

(24) Neither agree 4.9 8.2 4 4.5 8.4 5.8 6.2 6.7 nor disagree (4) Tend to 31.1 20.5 26.7 23.4 26.2 20.4 27.6 21.2 disagree (24) Strongly 26.2 30.5 25.3 31.5 32.7 37.9 28.8 32.5 disagree (20) No opinion/ 1.6 2.7 1.3 0.9 – 3.9 0.8 2.5 Don’t know (1) Base 77 225 925 645 1,009 602 2,011 1,472 (unweighted)

Where figures are presented in brackets next to percentages, these are the actual number of respondents in each cell. These have been presented to reflect the low base size (ie less than 100) for the % in question.

Source: IES/IPSOS-MORI Surveys of Construction Employers 2004/05 and 2005/2006

221

Table A6.3 % Change in responses between waves one and two to attitude statement ‘I/we don’t think enough about how our/my health might be affected by the job’

CBH Non-user Control All 2004/05 2005/06 2004/05 2005/06 2004/05 2005/06 2004/05 2005/06 survey survey survey survey survey survey survey survey

Strongly 14.8 15 9.5 7.2 10.2 13.5 11.1 12.6 agree (11) Tend to agree 27.9 28.6 21.6 21.6 29.6 21.2 26.7 25.1

(21) Neither agree 3.3 2.3 4.1 2.7 5.6 4.8 4.5 3 nor disagree (3) Tend to 21.3 14.1 31.1 19.8 27.8 21.2 27.2 17.2 disagree 16) Strongly 31.1 37.7 33.8 47.7 26.9 37.5 30 40.2 disagree (24) No opinion/ 1.6 2.3 – 0.9 – 1.9 0.4 1.8 Don’t know (1) Base 77 225 925 645 1,009 602 2,011 1,472 (unweighted)

Where figures are presented in brackets next to percentages, these are the actual number of respondents in each cell. These have been presented to reflect the low base size (ie less than 100) for the percentage in question.

Source: IES/IPSOS-MORI Surveys of Construction Employers 2004/05 and 2005/2006

Table A6.4 % Change in responses between waves one and two to attitude statement ‘I believe we do enough in the area of health and safety’

CBH Non-user Control All 2004/05 2005/06 2004/05 2005/06 2004/05 2005/06 2004/05 2005/06 survey survey survey survey survey survey survey survey

Strongly agree 36.1 36.8 34.7 41.1 35.2 42.3 35.2 39.2 (28)

Tend to agree 42.6 35.9 44 38.4 37 34.6 40.6 36.2 (33)

Neither agree 6.6 3.6 5.3 3.6 8.3 6.7 7 4.4 nor disagree (5) Tend to 13.1 15.9 13.3 12.5 14.8 12.5 13.9 14.2 disagree (10) Strongly 1.6 7.7 2.7 4.5 3.7 2.9 2.9 5.7 disagree (1) No opinion/ – – – – 0.9 1 0.4 0.2 Don’t know Base 77 225 925 645 1,009 602 2,011 1,472 (unweighted)

Where figures are presented in brackets next to percentages, these are the actual number of respondents in each cell. These have been presented to reflect the low base size (ie less than 100) for the percentage in question.

Source: IES/IPSOS-MORI Surveys of Construction Employers 2004/05 and 2005/2006

222

Table A6.5 % Change in responses between waves one and two to attitude statement ‘I/we do not always have enough time to deal with health and safety issues in the way I/we

would like’

CBH Non-user Control All 2004/05 2005/06 2004/05 2005/06 2004/05 2005/06 2004/05 2005/06 survey survey survey survey survey survey survey survey

Strongly agree 11.5 16.4 9.2 15 11.3 13.5 10.7 15.3 (9)

Tend to agree 37.7 37.3 36.8 24.8 32.1 29.8 35 32.8 (29)

Neither agree 9.8 1.8 5.3 2.7 5.7 3.8 6.6 2.5 nor disagree (8) Tend to 21.3 17.3 23.7 24.8 23.6 18.3 23 25.9 disagree (16) Strongly 19.7 25.9 25 31.9 27.4 33.7 24.7 29.3 disagree (15) No opinion/ – 1.4 – 0.9 – 1 – 1.1 Don’t know Base 77 225 925 645 1,009 602 2,011 1,472 (unweighted)

Where figures are presented in brackets next to percentages, these are the actual number of respondents in each cell. These have been presented to reflect the low base size (ie less than 100) for the percentage in question.

Source: IES/IPSOS-MORI Surveys of Construction Employers 2004/05 and 2005/2006

Table A6.6 % Change in responses between waves one and two to attitude statement ‘I/We cannot afford to deal with every health and safety issue’

CBH Non-user Control All 2004/05 2005/06 2004/05 2005/06 2004/05 2005/06 2004/05 2005/06 survey survey survey survey survey survey survey survey

Strongly 8.2 12.7 5.3 7.2 6.5 6.9 6.5 9.9 agree (6)

21.3 10.5 19.7 12.6 18.5 16.7 19.6 12.5 Tend to agree (16) Neither agree 4.9 2.7 3.9 2.7 6.5 3.9 5.3 3 nor disagree (4) Tend to 23 25.9 28.9 22.5 25.9 24.5 26.1 24.7 disagree (18) Strongly 42.6 47.7 40.8 54.1 41.7 47.1 41.6 49.2 disagree (33) No opinion/ – 0.5 1.3 0.9 0.9 1 0.8 0.7 Don’t know Base 77 225 925 645 1,009 602 2,011 1,472 (unweighted)

Where figures are presented in brackets next to percentages, these are the actual number of respondents in each cell. These have been presented to reflect the low base size (ie less than 100) for the % in question.

Source: IES/IPSOS-MORI Surveys of Construction Employers 2004/05 and 2005/2006

223

Table A6.7 % Change in responses between waves one and two to attitude statement ‘I/We know a lot about health and safety legislation’

CBH Non-user Control All 2004/05 2005/06 2004/05 2005/06 2004/05 2005/06 2004/05 2005/06 survey survey survey survey survey survey survey survey

Strongly 19.7 28.6 21.3 25.2 30.8 25.2 25.1 27 agree (15)

52.5 35 49.3 41.4 39.3 38.8 45.7 37.6 Tend to agree (40) Neither agree 13.1 7.7 8 6.3 10.3 11.7 10.3 8.3 nor disagree (10) Tend to 14.8 21.8 17.3 21.6 14 18.4 15.2 21 disagree (11) Strongly – 6.8 4 4.5 4.7 4.9 3.3 5.8 disagree No opinion/ – – – 0.9 0.9 1 0.4 0.5 Don’t know Base 77 225 925 645 1,009 602 2,011 1,472 (unweighted)

Where figures are presented in brackets next to percentages, these are the actual number of respondents in each cell. These have been presented to reflect the low base size (ie less than 100) for the percentage in question.

Source: IES/IPSOS-MORI Surveys of Construction Employers 2004/05 and 2005/2006

224

Table A6.8 Date of last training (in per cent)

Time 2

User Non-user pilot area Control Total

Contracted employees

Last six months 82.7 79.0 84.9 82.3

7–12 months ago 11.2 13.6 9.6 11.4

Over one year ago 6.1 7.4 5.5 6.3

Base (unweighted) 185 286 254 725

Casual Staff

Last six months 85.7 81.8 90.0 85.7 (25) (41) 45)

7–12 months ago 7.1 9.1 10.0 8.2 (2) (5) (5)

Over one year ago 7.1 9.1 - 6.1 (2) (5)

Base (unweighted) 29 50 50 129

Sole traders

Last six months

7–12 months ago

Over one year ago

36.0 (9)

12.0 (3)

52.0 (13)

33.3 17)

33.3 (17)

33.3 (17)

50.0 (22)

25.0 (11)

25.0 11)

37.5

15.6

46.9

Base (unweighted) 25 51 44 120

Where figures are presented in brackets next to percentages, these are the actual number of respondents in each cell. These have been presented to reflect the low base size (ie less than 100) for the percentage in question.

Source: IES/IPSOS-MORI Surveys of Construction Employers 2004/05 and 2005/2006

225

Table A6.9 Way in which training delivered (in per cent)

Non-user User pilot area Control Total

Contracted employees

Formal, as part of regular training program 54.0 51.3 50.7 52.0

Informal, such as a short discussion or training session before 50.4 48.3 41.4 47.9 starting work

Formal, as part of a one-off course 39.7 43.1 41.2 40.9

Through the use of manuals, literature 24.8 25.8 19.8 23.9

Through correspondence (eg memos) sent to workers 14.9 19.0 11.8 15.2

Other 0.6 0.2 0.6 0.5

Don’t know – – – 0.2

Base (unweighted) 187 292 267 746

Casual Staff

Informal, such as a short discussion or training session before starting work

71.4 (21)

Formal, as part of regular training program 42.9 (12)

Through the use of manuals, literature 25.0 (7)

Formal, as part of a one-off course 25.0 (7)

Through correspondence (eg memos) sent to workers 17.9 (5)

Other 7.1 (2)

76.7 39)

59.8 (30)

70.1

36.7 (19)

44.0 (22)

41.8

29.6 (15)

25.8 (13)

26.2

22.6 (12)

18.6 (9)

23.1

7.8 (4)

10.6 (5)

14.1

– – 4.0

Base (unweighted) 29 51 50 130

Sole traders

Formal, as part of a one-off course 60.0 63.7 69.0 61.5 (12) (30) (32)

Informal, such as a short discussion or training session before 25.0 24.2 23.4 24.7 starting work (5) (11) (11)

Formal, as part of regular training program 15.0 19.9 15.8 15.7 (3) (9) (7)

Through the use of manuals, literature 5.0 14.6 16.1 7.5 (1) (7) (7)

Through correspondence (eg memos) sent to workers – 4.5 4.2 1.0 (2) (2)

Base (unweighted) 20 47 46 113

Where figures are presented in brackets next to percentages, these are the actual number of respondents in each cell. These have been presented to reflect the low base size (ie less than 100) for the percentage in question.

Source: IES/IPSOS-MORI Survey of Construction Employers 2005/2006

Published by the Health and Safety Executive  06/07

Health and Safety Executive

Constructing Better HealthFinal Evaluation Report

The Constructing Better Health pilot aimed to raise awareness of occupational health issues within the construction industry, as well as to test out a model of delivery so that learning points could be used in the design of any national scheme. The pilot was carried out in Leicestershire from October 2004 to June 2006.

This report investigates both the process and the impact of the pilot. It considers: 

■ the model of delivery and the reaction amongst employers and workers in the pilot area to the service;

■ levels of take­up of the service and the reactions to different elements of service provision;

■ intermediate outcomes such as awareness of occupational health issues and better health management procedures; and

■ the ultimate outcome measures including levels of accidents and days lost due to ill­health.

This report and the work it describes were funded by the Health and Safety Executive (HSE). Its contents, including any opinions and/or conclusions expressed, are those of the authors alone and do not necessarily reflect HSE policy.

RR565

www.hse.gov.uk