Work that's done without regular supervision or contact with coworkers obviously carries extra risks. Consider self-employed workers: they make up just 7.4 percent of the U.S. civilian workforce, yet experience almost 20 percent of workplace fatalities, according to the BLS.

Cal/OSHA this month fined a psychiatric hospital $54,000 for safety violations in connection with a physician's slaying last November — including a citation for not enforcing an unwritten policy prohibiting staff from being alone with patients. A staff physician had met a newly admitted bipolar patient alone in an exam room on an isolated hallway. Ninety minutes later a custodian found her lying unconscious when he entered the room to empty the trash. Attempts to revive her were unsuccessful.

In this issue of ISHN's e-newsletter, we offer tips for ensuring the safety of your lone workers.

EVERYONE DOES IT

First, let's not limit our sense of lone rangers.

Sure, we're talking about those home health aides — 30,000 in New York City alone — who cook, clean, shop and sometimes bathe patients. And also delivery men and women, lab workers, field technicians, sales people, roofers, landscapers, taxi drivers, truckers, farmers, fishermen, loggers, maintenance workers, meter readers, mail carriers, animal keepers, cleaners, doctors, nurses, teachers, security guards, painters, and an estimated 40 million Americans working from home.

But even in factories, refineries, warehouses and large construction sites, most employees will work on their own at some point — out of sight or sound of others.

And in every workplace, someone has to be the first to arrive and someone is the last to leave and turn out the lights.

Despite the growing prevalence of people working in mobile, isolated or unfamiliar environments without regular supervision, safety and health resources for these circumstances are scarce. Maybe it's our pride in rugged individualism.

Search OSHA's Web site for "unsupervised safety" and you'll get references from construction safety committee meetings or various standards, but no specific guidance. A search of the American Society of Safety Engineers' Web site produces zero documents.

And truth be told, a search of ISHN's Web site produces zero articles on solo safety. But you will find a column by psychologist Dr. E. Scott Geller on "self-talk" — how to write a mental script for monitoring and evaluating our own actions.

NO DIFFERENCE

Thanks to the Internet, you can find quite a few guidelines on lone worker safety from sources outside the U.S. — particularly in the United Kingdom. The UK's Health and Safety Executive (HSE) published a 12-page primer on "Controlling the Risks of Solitary Work" in 1998 — www.hse.gov.uk/pubns/indg73.pdf

"Establishing safe working for lone workers is no different from organizing the safety of other employees," states the HSE. The basics remain the same: identifying hazards, coming up with controls, educating employees about the risks they face and holding them accountable, communicating regularly, and tracking performance.

Assessing the risks faced by lone workers is the first step. Here are some items from a checklist compiled by the Facilities Management Directorate of the University of Sheffield in the U.K.:

• Does the solitary work present a special hazard (such as lifting an object too heavy for one person)?
• Is lighting and ventilation sufficient?
• Is equipment safe and regularly maintained?
• What are the risks if the equipment fails (say a delivery van breaks down at night)?
• What does the worker do in an emergency (such fire, illness, violence or an accident)?
• What first aid provision is required?
• How will you communicate with the worker to ensure his or her safety on a regular basis?
• Is the worker known to be reliable and to seek help when they reach the limit of their knowledge or experience?
• Is the worker medically fit for the task?
• Has the worker been trained for the task, and have they demonstrated their competence?
• Does the worker have appropriate PPE, chemical safety data sheets, and other information about the job, equipment or substances?

The HSE also offers these risk considerations: Does the solitary work present special hazards to women, and young or old workers? Does the work require special training in first aid, or the use of automatic warning devices that sound an alert if specific signals are not received? Are there some tasks that simply cannot be performed alone?

EXTENDING THE CULTURE

Your safety training for solo workers will be based in part on the findings of your risk assessment.

Depending on risks, training might emphasize driving safety and seat belt use; lifting and material handling; ladder safety; slips, trips and fall prevention; tool safety; chemical safety; PPE use; electrical safety; weather observations; recognizing signs of personal fatigue and heat stress; and knowing signs of potential violence — from a stranger, a customer, a patient, or a backyard dog.

One of the basics is to make sure lone workers understand the limits to what can and cannot be done while working on their own. As the HSE states, it should not be left to individuals to decide when they need help. Set the ground rules in your initial training. Employees should know how to deal with job circumstances that are new, unusual or beyond the scope of training — when to stop work and seek advice from a supervisor.

As with any safety orientation training, solo workers should be schooled in company policies, procedures and values.

Employees who spend most of their hours away from the hub of work — on the road, in solitary outposts, in home offices or working off-hours or odd shifts — are not natural constituents of a corporate culture. It takes extra effort to instill core values (including safety and health) in an extended, fragmented workforce.

Consider the challenge facing FedEx, with 200,000 employees — many spending their days in the confines of a van. For FedEx to succeed as a service business, its employees must present consistent attitudes and a positive image to customers. The company's "Custom Critical" culture requires all "team members" to demonstrate core competencies every day: trust (accountability), team spirit (active participation and contributions), zeal (positive attitude and commitment to goals), and innovation (creative problem-solving).

All easily can be adapted to safety goals.

FOLLOW THE SCRIPT

You might also want to consider training solo workers to talk to themselves — nothing wrong with that, says Scott Geller.

The last thing you want is employees who fly solo, without supervision or coworker cooperation, to operate on automatic pilot, says Dr. Geller. Instead of mindless, routine behavior, your goal is for employees to talk to themselves before, during and after their safe behavior. It's called mindful fluency, he says.

Help employees write a mental script to follow when they're out on their own. The script should draw on their training about specific risks and procedures. And it can include reminders, pep talks, pats on the back, and red flags that signal the need to call for help.

"We might give ourselves a mental reminder that a particular job calls for a certain safe behavior before we start," says Dr. Geller. "Then we might describe our actions while doing the work. Afterward, we might look back and evaluate our actions.

"We should give ourselves mental credit when we do something safely, especially if it was inconvenient, uncomfortable or inefficient. We should also look for improvements, giving ourselves specific suggestions. Your positive self-talk should also be combined with actual rewards such as exercise, eating a favorite food, or spending money. While you're enjoying your reward, remind yourself that you deserve it. That you avoided a shortcut or the easy way out."

MAINTAINING CONTACT

Finally, following risk assessments and training, here are suggestions for how managers and solo workers can maintain safety in lonely assignments on an on-going basis, courtesy of Sheffield University.

For managers:

• Make regular, informal visits to monitor the safety of lone workers. Ask yourself how you would feel working there — would you feel safe?
• Make sure risk assessments are available for workers to refer to, and that safe work procedures are available.
• Talk to those who work alone. Ask questions. Listen. Do they have any concerns? Make sure they know you do not want them to put themselves at risk. Ask how their job could be made safer.
• Make sure you have a reliable system for contacting lone workers and establishing their safety and security. This could be a call-in system, a tracking device, a mobile phone, etc.

For employees:

• Make sure someone knows where you are, and set up a contact system so you can tell someone you're at work and when you're leaving.
• Don't do anything that you feel might put yourself in danger. Report any dangerous incident or situation to your supervisor and ask for advice.
• If you start to feel tired or sick either stop for a short break, take a walk outside, or go home after contacting your supervisor.
• Make sure you know, and follow, relevant safe working procedures and guidelines for operating equipment and handling substances.
• If you don't know how to do something — don't do it. Leave it until someone is around to help you.

CORRECTION

In last week's newsletter, we stated that the American Industrial Hygiene Association's distance learning courses attracted more participants than professional attendance at the annual conference. Actually, the courses have attracted more attendance than the conference's weekend Professional Development Courses. The conference attracted 4,100 to 4,300 (numbers have not been confirmed) this year.

Dave Johnson is the ISHN E-News editor. He can be reached at djsafe@bellatlantic.net, (610) 666-0261; fax (610) 666-1906.

WHERE IS THE NEAREST AED IN YOUR WORKPLACE?