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INTRODUCTION: Outsourcing is a commonly occurring organizational activity, but one associated with negative occupational safety outcomes. Improving the management of safety in workplaces where contractors are employed is vital, but under-researched in the service sectors. The aims of this paper were to investigate both the practices and challenges of safety management in outsourced facility management (FM), an important global service sector. METHOD: Twenty-three semi-structured interviews were conducted with clients and contractors in three different FM outsourcing arrangements between large corporations in the UK. Data were thematically coded against frameworks derived from existing literature to identify deployed safety management practices and reveal challenges associated with safety management in these outsourced relationships. RESULTS: Safety management practices in outsourced FM conformed to known practices clustering into four previously identified categories (planning, selecting, on-site working, and checking). A fifth category (reviewing) was not observed. Operating across national boundaries, applying national contracts locally, working with mandated KPIs, and contract specifications all created new challenges for safety management not previously reported. Other known challenges associated with economic pressure and disorganization were observed. CONCLUSION: Safety management practices observed in safety critical industries also apply in FM. However, the challenges of safety management in these three cases included regulatory failures that have not been routinely identified in other empirical studies of safety in outsourcing arrangements. PRACTICAL APPLICATION: Adopting widely accepted safety management practices support safer working in outsourced FM and encourage cross-sector learning. New challenges for safety management noted here encourage consideration of unintended consequences of contract terms and conditions, require corporate agreement on how to ensure safety compliance when working transnationally, and a review of decision-making and processes and procedures to enable effective and safe working locally.

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INTRODUCTION: Despite growing concerns over safety risks associated with on-site contractors in high-risk industries, little research has examined how host organizations affect their safety. Drawing from the open systems perspective, this study investigated the influence of host organizations' safety climates on on-site contractor employees' safety and job attitudes. METHOD: The study used multi-level structural equation modeling (MSEM) to test hypothesized relationships among variables with survey data collected from 1,720 employees of 68 on-site contractor organizations and 3,205 employees of six host organizations. RESULTS: At the organization-level, host organizations' safety climates were associated with their on-site contractor employees' safety behaviors, job attitudes, and injuries, and these effects were mediated by the safety climate of the on-site contractor organizations. CONCLUSIONS: This study demonstrates that the safety climates of host organizations can extend to their on-site contractor organizations. Therefore, fostering a positive safety climate not only benefits the host organizations themselves but also creates a crucial environmental cue that shapes the safety climate and outcomes of on-site contractors. PRACTICAL APPLICATIONS: Leading by example and fostering a positive safety climate within the organization are effective ways for a host organization to ensure the safety of its on-site contractors.

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OBJECTIVE: This article introduces a novel approach called Digital Weighted Multi Criteria Decision Making (DWMCDM) that employs interval valued fuzzy sets to select the best contractor for building projects. The contractor is chosen based on the pre-qualification and bid evaluation phases. In the first phase, the distance between the actual and required skills of the significant criteria is determined, and it is then converted into digital weighted distances to identify the maximum number of criteria related to the specific project of each contractor. The second step ranks the best contractor based on the bid price and digital weighted distances. RESULTS: The suggested technique integrates the pre-qualification and bid review phases to address project award delays and other restrictions. Finally, a real-world application is addressed to demonstrate the applicability of the proposed approach to any type of interval valued fuzzy inputs.

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BACKGROUND: In recent decades, there has been a significant transformation in the world of work that is characterized by a shift from traditional manufacturing and managerial capitalism, which offered stable full-time employment, to new forms of entrepreneurial capitalism. This new paradigm involves various forms of insecure, contingent, and non-standard work arrangements. Within this context, there has been a noticeable rise in Self-Employed individuals, exhibiting a wide range of -working arrangements. Despite numerous investigations into the factors driving individuals towards Self-Employment and the associated uncertainties and insecurities impacting their lives and job prospects, studies have specifically delved into the connection between the precarious identity of Self-Employed workers and their overall health and well-being. This exploratory study drew on a 'precarity' lens to make contributions to knowledge about Self-Employed workers, aiming to explore how their vulnerable social position might have detrimental effects on their health and well-being. METHODS: Drawing on in-depth interviews with 24 solo Self-Employed people in Ontario (January - July 2021), narrative thematic analysis was conducted based on participants' narratives of their work experiences. The dataset was analyzed with the support of NVIVO qualitative data analysis software to elicit narratives and themes. FINDINGS: The findings showed that people opt into Self-Employment because they prefer flexibility and autonomy in their working life. However, moving forward, in the guise of flexibility, they encounter a life of precarity, in terms of job unsustainability, uncertainties, insecurities, unstable working hours and income, and exclusion from social benefits. As a result, the health and well-being of Self-Employed workers are adversely affected by anger, anomie, and anxiety, bringing forward potential risks for a growing population. CONCLUSION AND IMPLICATIONS: Neoliberalism fabricates a 'precariat' Self-Employed class. This is a social position that is vague, volatile, and contingent, that foreshadows potential threats of the health and wellbeing of a growing population in the changing workforce. The findings in this research facilitate some policy implications and practices at the federal or provincial government level to better support the health and wellbeing of SE'd workers.

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The abundant generation of construction and demolition waste (CDW) poses a threat to the sustainable development in China and recycling plays a vital role in complying with circular economy zero-waste goal. In this study, we first investigate the determinants of contractor's intention to recycle CDW by establishing an integrative model of the theory of planned behavior (TPB) and the norm activation model (NAM) with rational and moral considerations. Based on the questionnaire data of 210 valid responses, structural equation modeling is employed to test the proposed hypotheses and analyze the integrative structural model. The results show that the integrative model with adequate reliability and validity fits the empirical data well and the explanation power is superior to that of initial TPB model and NAM model, demonstrating the appropriateness of merging TPB and NAM in the area of CDW recycling research. Moreover, it is found that personal norms are the most critical determinant enhancing the CDW recycling intention, followed by perceived behavioral control. Although subjective norms fail to directly affect the CDW recycling intention, they can significantly strengthen personal norms and perceived behavioral control. These findings provide useful insights for government to develop effective management strategies to motivate CDW recycling intention of contractors.

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To promote the green development of the construction industry, improve resource utilization, and mitigate the environmental pollution caused by engineering projects, this study identifies the key paths and influencing factors of behavioral diffusion through the analysis of green behavior diffusion among contractors based on the behavioral decisions of the main participants. The study aims to improve positive influences among contractors with respect to the sustainable development of construction. Using the SIR (susceptible-infected-removed) model, we reconsider contractors of different states; construct state transformation paths for potential adopters, adopters, and abandoners of green behaviors among contractors; and analyze the factors that influence the diffusion of green behaviors among contractors to simulate the effects of different paths of behavior diffusion. The results show that two paths, adoption and recovery rates, have a positive influence on the diffusion of green behavior, while three other paths have a negative influence. The identified factors exhibit two types of influence, promotion and hindrance, involving both intra-firm and government regulations, and are associated with other stakeholders. This study promotes the diffusion of green behavior among contractors, which allows contractors to gain a competitive advantage in advance and has positive implications for the implementation of environmentally friendly concepts in the construction industry.

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Most illnesses and deaths in industry workers are associated with occupational diseases (ODs). In recent years, mining has grown rapidly into a major driver of the Mongolian economy. In this study, the organization-based registry data on OD incidence and mortality from the archival data of the 'Erdenet' Copper and Molybdenum Concentrator Plant in Mongolia were used. We estimated the ODs burden in disability-adjusted life years (DALYs) loss between 1999 and 2019. A total of 72,802 DALYs were lost over 20 years, of which 97.5% were due to years lived with disability and 2.5% for years of life lost. The disease burden was high in men, accounting for 76.8% of total DALY. In terms of age groups, among people aged 46-55, DALY accounted for the largest percentage of losses. We found that workplace dust, noise, ergonomics, and vibration were the main factors attributed to the DALYs during the past two decades.

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The dataset indicates the problem factors which may influence the development of partnering relationship between two key project parties - the main contractor and the subcontractor. A total of 53 problem factors were identified and were clustered into five categories. An online questionnaire was used to elicit the viewpoints of these key parties with regards to the extent to which the factors have an impact on the partnering relationship in the Malaysian construction industry. The target respondents were managers and engineers of various construction companies in Malaysia with the main contractors or subcontractors who have projects in Kuala Lumpur, Shanghai and New Delhi. Both descriptive and quantitative analysis approaches were used to present the data. Relative Importance Index method was used to determine the top challenges to building favourable partnering relationships; and Partial Least Squares Structural-Equation Modelling (PLS-SEM) analysis was conducted to examine the role played by each cluster of factors in explaining the quality of partnering relationship between the main contractors and subcontractors. This data set would assist practitioners to work on the major problem factors to improve the quality of partnering relationship between the key participants in their present and future construction projects. By eliminating or minimizing these problem factors, practitioners will contribute significantly to effective supply chain management in the construction industry. The data would be of value to academics and industry professionals involved in the construction business domestically and internationally.

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This study aimed to develop the accident mechanism of fatal accidents taking place in multiple processes at the workplace. Multiple processes were defined as the existence of multiple work types and work processes in the same workspace. Recently, various processes are frequently conducted simultaneously in one workplace with the participation of several companies, and more workers are increasingly experiencing industrial accidents while working in multiple processes. To prevent accidents in the multiple processes caused by the sameness of work period and space, the accident process was investigated by analyzing the investigation reports on serious industrial accidents in South Korea, and then the accident mechanism model was developed. By utilizing the developed model, the major safety measures to be taken by the contractor for each of the 8 types of accidents caused by the multiple processes were drawn. The roles and responsibilities of the contractor to be implemented in order to prevent accident occurrence in multiple processes were proposed through the accident mechanism of each type of fatal accident. It is expected that the accidents taking place in the multiple processes can be prevented with the drawn results.

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Background: Recently, there has been a call to improve the holistic welfare of dependent contractors (DCs). Thus, our study examined the relationship between DCs and mental health symptoms and how this relationship was modified by age, sex, and income status of workers. Methods: A total of 27,980 workers from the Fifth Korean Working Conditions Survey are included in our study. The participants who reported having depression or anxiety over the last 12 months are defined those who had mental health symptoms. We performed exact matching for age group and sex, followed by conditional logistic regression with survey weights. Finally, stratified analyses by age, sex and income level were conducted. Results: DCs were found to be at increased risk of depression/anxiety compared to other workers. The odds ratio (OR) is 1.52 (95% confidence interval [CI]: 1.06-2.17). In the stratified analyses, vulnerable groups were middle-aged (OR [95% CI]: 1.68 [1.10-2.54]), female (OR [95% CI]: 1.85 [1.20-2.84]), and low-income (OR [95% CI]: 3.18 [1.77-5.73]) workers. Conclusions: Our study's results reinforce those of other studies that show that DCs are at greater risk of experiencing mental health issues than other workers and that and this risk is greater for middle-aged, female, and low-income workers. These results suggest that appropriate policy efforts should be made to improve the psychological well-being of DCs.

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PURPOSE: External cardiac assist devices are based on a promising and simple concept for treating heart failure, but they are surprisingly difficult to design. Thus, a structured approach combining experiments with computer-based optimization is essential. The latter provides the motivation for the work presented in this paper. METHODS: We present a computational modeling framework for realistic representation of the heart's tissue structure, electrophysiology and actuation. The passive heart tissue is described by a nonlinear anisotropic material law, considering fiber and sheetlet directions. For muscle contraction, an orthotropic active-strain model is employed, initiated by a periodically propagating electrical potential. The model allows for boundary conditions at the epicardium accounting for external assist devices, and it is coupled to a circulation network providing appropriate pressure boundary conditions inside the ventricles. RESULTS: Simulated results from an unsupported healthy and a pathological heart model are presented and reproduce accurate deformations compared to phenomenological measurements. Moreover, cardiac output and ventricular pressure signals are in good agreement too. By investigating the impact of applying an exemplary external actuation to the pathological heart model, it shows that cardiac patches can restore a healthy blood flow. CONCLUSION: We demonstrate that the devised computational modeling framework is capable of predicting characteristic trends (e.g. apex shortening, wall thickening and apex twisting) of a healthy heart, and that it can be used to study pathological hearts and external activation thereof.

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Adoption of prefabrication is essential for improving the urban built environment. However, the existing prefabrication market in China is far from mature. As the stakeholder who conducts construction activities, the contractor is facing a dilemma of lacking steady prefabricated components supply. In this circumstance, a potential solution is that contractors open their own prefabrication factories to guarantee stable component supply. The aim of this research is exploring the key factors for contractors to open prefabrication factories. Firstly, a total of 28 influencing factors were identified from literature. Then, the identified factors were divided into four categories: policy environment, market environment, technological environment, and enterprise internal environment. Through interviews with experienced professionals, a total of 19 factors were selected for future analysis. Based on the 19 factors, a questionnaire was designed and distributed to the experts to rate the degree of mutual influences. The collected data were analyzed using Ucinet6.0 software, and the adjacency matrix and the visual models were established. Finally, through the analysis of node centrality, betweenness centrality, and closeness centrality, the four key influencing factors were determined including mandatory implementation policy, precast concrete component's price, market demand, and contractor's strategic objectives. The results of this study could assist contractors in making decisions of opening their own prefabrication factories toward more sustainable environment.

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The construction industry has been recognized as one of the crucial industries of a country. In large-scale public projects, it is frequently observed that the client, who serves the public, seeks the services of several sub-contractors (project outsourcing firms) to execute projects. It also seeks the consulting firms' services to monitor the progress and performance of these sub-contractors. However, performance evaluation of a large number of sub-contractors is not only a challenging phase but also a source of conflict and mistrust between the evaluators and evaluatees because of the subjectivity in the evaluation process. The current study classifies perceived organizational performance into two streams, arguing that the one involving the opinions from the independent evaluators is more objective than the self-evaluation one. The study also makes a pioneering attempt in post-qualification performance evaluation of sub-contractors through the Ordinal Priority Approach (OPA), a promising multi-attribute decision-making methodology. The deployment of the OPA allows the decision-makers to estimate the weights of the evaluation criteria, the sub-contractors to be evaluated, and the experts who evaluated them simultaneously. Thus, the methodology can minimize the causes of mistrust by uncovering unreliable experts and inappropriate criteria. Also, a novel Relative Performance Index (RPI) has been proposed to standardize the performance evaluation system. The results show that evaluation of the firms does not end at their evaluation as without evaluating the evaluators, such an evaluation is only partially effective.

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Objectives. This research intends to investigate the responsibilities of the parties engaged in the implementation phase of the infrastructure projects in occupational health and safety, i.e., the consultant and contractor. Methods. A questionnaire was developed through the selection and modification of the responsibilities from the literature review. Results. The statistical analysis results show that the consultants and contractors both ranked the item 'The owner requires the contractor to implement the occupational safety standards within the bid' first in the owner responsibilities, having 0.67 relative importance index (RII). In the responsibilities of the consultant, the first ranked item was 'The consultant has a role in adopting occupational safety plans and contingency plans', having 0.66 RII. In the responsibilities of the contractor, the first ranked item was 'The contractor shall provide the insurance cover for all project crews', having 0.71 RII. In the responsibilities of the workers, the first ranked item was 'Workers know the handling of tools and equipment within the project', having 0.59 RII. Conclusion. Overall, there was general agreement between consultants and contractors to classify and arrange items because both face the same conditions and have the same working environment.

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Based on primary data collected from the households of Dangs district in South Gujarat, India, the paper shows that every year a third of young adults migrate to Surat district and neighbouring areas for half a year to work as sugarcane harvesters. The data show that they live in temporary shelters in harsh conditions with bare minimum necessities and amenities. A large share of their earnings, much lower than the minimum wage rate for agricultural labour, is used to pay the labour contractors who provide cash advances during the lean post-monsoon months. Paying back the principal amount with hefty interest on it traps generations of migrant workers in the vicious cycle of poverty and indebtedness.

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Waste recycling is a critical method to effectively address environmental issues raised by construction and demolition waste (C&DW). As highlighted in previous studies, the contractor is considered the primary purchaser for recycled C&DW products. However, there is a limited understanding of the factors affecting the contractor's purchase willingness towards C&DW recycling products. This study investigated these key drivers using the Exploratory Sequential Mixed Approach. Firstly, a hypothetical model was developed based on the theory of planned behavior (TPB). Secondly, a questionnaire survey was then employed in data collection. Thirdly, structural equation modeling (SEM) was adopted for data analysis. It is revealed that multiple factors directly affect the contractor's purchase willingness towards C&DW recycling products. These factors include government measures, the contractor's attitude, perceived behavioral control, perceived consumer effectiveness, and subjective norms. Besides, recycling product information indirectly affects the contractor's purchase willingness. Based on the findings, the study provides strategies for the government, contractors, recycling enterprises, and public buyers to increase C&DW recycling products' purchase willingness. Findings derived from the empirical study can be used as a theoretical reference for government departments to develop related promotion policies. Moreover, the suggestions provided are helpful to guide recycling enterprises to promote their products.

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A retrospective analysis of worker blood lead levels (BLL) was conducted using blood lead data collected by four bridge painting contractors before and after lead exposure. The objective of the study was to evaluate the effectiveness of exposure controls in preventing elevated blood lead levels (>25 µg/dl) during bridge painting projects. The contractors selected for the study submitted BLL data for 289 workers representing ten work tasks and 11 bridge painting projects. In total, 713 blood lead levels results were evaluated. The mean blood lead level for all work classifications combined was 10.9 µg/dl at baseline compared with 14.9 µg/dl after two months of exposure and 15.0 µg/dl after four months of exposure. Two months after initial exposure, 29% of the painters and 35% of the laborers had a 10 µg/dl incremental increase or greater in blood lead level. Likewise, 18% of the painters and 26% of the laborers had a blood lead level greater than 25 µg/dl during the same time. The blood lead levels that exceeded the 25 µg/dL threshold ranged from 30µg/dL-63 µg/dL for painters and 26 µg-56 µg/dL for laborers. All work tasks with high-intensity exposure (abrasive blaster/painter, abrasive blaster, painter & laborer) experienced an average blood lead level increase that ranged from 0.2 µg/dl to 8.9 µg/dl two months after initial exposure. Blood lead testing conducted after modified exposure controls (two months after the initial follow-up blood testing) were implemented showed a decrease in average blood lead levels (range -0.14 µg/dl to -2.7 µg/dl) for two high-intensity exposure work tasks. In comparison, the other two high-intensity work tasks had moderate increases (range 1 µg/dl to 2.4 µg/dl). The modified exposure controls included an increase in the air velocity inside of the work containment and an administrative control in the form of additional worker training on lead exposure prevention. The reduction in the 95th percentile (point estimate) BLL exposure profile for each exposure group at the 4-month follow-up blood testing period is associated with modified exposure controls. Ineffective exposure controls were identified through the analysis of worker BLLs. We found two exposure groups (laborer and painter) whose 95th percentile (point estimate) exposure profile was greater than the OSHA construction lead standard's targeted BLL goal (25 µg/dl) during the first two months of exposure. Our research findings provide support for monthly blood lead testing after baseline until blood lead levels are controlled to an acceptable concentration.

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BACKGROUND: In November 2017, CMS finalized the 2018 Medicare Outpatient Prospective Payment System rule that removed TKA from the Medicare inpatient-only (IPO) list. This action had significant and unexpected consequences. METHODS: We looked at 3 levels of the IPO rule impact on TKA for Medicare beneficiaries: a national comparison of FFS inpatient and outpatient classification for 2017 vs 2018; a survey of AAHKS surgeons completed in April 2019; and an in-depth analysis of a large academic medical center experience. An analysis of change in admission classification of patients with TKA over time, number of QIO audits, compliance solutions for the new rule, and cost implications of those compliance solutions were evaluated. RESULTS: Hospital reimbursement averages $10,122 in an outpatient facility but does not include the physician payment. Average hospital reimbursement in the inpatient setting is $11,760. The difference in hospital reimbursement varies widely (90th percentile decrease, $6725 vs 10th percentile $2048). Physician payments are the same in both settings (avg $1403). Patients with TKA not designated for inpatient admissions are not eligible for bundle payment programs. Patients designated as outpatients are subjected to higher out-of-pocket expenses. Patients may have an annual Medicare Part B Deductible ($185) and a 20% copay as well as prescription and durable medical equipment costs. An AAHKS survey demonstrated that 45.08% were with inpatient designation only, 17.62% were with outpatient designation only, 25.39% were designated as necessary, and 10.1% were designated by the hospital. This survey showed that 66 of 374 (17.65%) patients had undergone a QIO audit as a result of issues with the IPO rule. An evaluation of an AMC demonstrated that since January 1, 2018, 470 of 690 (68.1%) of CMS patients with TKA left in less than 2 midnights. The institution was subjected to 2 QIO audits. CONCLUSIONS: There are many unintended consequences to the IPO rule application to TKA.

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As a major participant of the construction industry, small contractors have been increasingly involved in green building construction projects in recent years. However, existing literature indicates that little research has been done to investigate the critical success factors for small contractors to conduct green building construction projects. As a result, this study aims to fill up the gap by identifying the most critical success factors of small contractors and comparing them against large contractors. To achieve these goals, a comprehensive literature review and pilot interviews with experienced industry experts were conducted first, followed by a questionnaire survey administered to 30 small contractors from the construction industry of Singapore. Non-parametric statistical tests were used to analyze the data. Results reported that "laborers with experience in conducting green building construction projects," "incentives/subsidies provided by government," "support of senior management," "return on investment," "commit to changing behavior," "effective communication between stakeholders on goals for sustainable construction," "early contractor involvement," "engaging experts with sound knowledge of green building construction," "cost control," and "competency of project manager" were the top ten critical success factors for small contractors to conduct green building construction projects. Additionally, the comparison results between small and large contractors revealed that eight factors were statistically different assessed by industry practitioners. These factors are "procurement process," "cost control," "commit to changing behavior," "educating clients on benefits in sustainable construction," "laborers with experience in conducting green building construction projects," "hefty levy and tax on unsustainable construction practices," and "public demand for green building construction" and "industrial culture." This study enriches the knowledge by exploring the critical success factors for small contractors to conduct green building construction projects. Furthermore, this study is informative to industry practitioners as well, especially to those small contractors who plan to conduct green building construction projects in the future.

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BACKGROUND: Health care facilities require frequent renovations to maintain or enhance their service, and to meet the dynamic demands of their patients. Construction activities in active health care facilities are a significant contributor to various challenges that range from infection to death. It is therefore essential to minimize the adverse impacts of construction activities on health care units as well as their adjacent sites. METHODS: A questionnaire was developed to study current training modules to prepare construction crews to work in health care environments. The survey was disseminated among professionals of the top 15 health care contractors. A total of 129 individuals participated, and their responses were analyzed using descriptive and categorical statistics. RESULTS: This study investigates current training practices regarding (1) the level of training, (2) the frequency of training, and (3) the impact that the sensitivity of the project has on the training. To effectively prepare construction crews, special training must be provided to them. CONCLUSIONS: There are uncertainties about the sufficiency and impact of the existing training. Existing trainings are tailored for upper management positions, and the amount/frequency of training for construction crews are substantially low. Findings of this study contribute to characterizing the activities and conditions pertaining to training of construction crews.

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