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Rising Th rough the 4 Soft -Tissue Safety Cultures
Safety culture?” At least to some extent I partially agree.
Have you heard someone expound “there’s no such thing as
Let me explain: Safety culture doesn’t exist on its
own. Rather, Safety is a microcosm of a company’s over-
all culture; a complex compound of both the espoused as well as
the unwritten and unspoken rules and ways “we actually do things
around here.” Th e messages that we convey weigh heavily, and can
either benefi t or detract from Safety planning and performance.
You can see this in an issue that is an ongoing, pernicious prob-
lem for many organizations: soft -tissue injuries and sprains-and-
strains. When any problem persists, it’s not by coincidence. Rather,
there are underlying mindsets, forces, actions and inactions that
contribute to any tenacious issue.
The Four Levels of Safety Culture
About two decades ago, I fi rst wrote about seeing four levels of
Safety Culture:
1. To, where Safety is “pushed” or applied onto others.
2. For, where Safety is led more benevolently but still predomi-
nantly driven by “experts” for others.
3. With, where there is leaders and workers partner.
4. By, where Safety is mostly internalized by people, and they
increasingly believe in it and act for themselves.
(Note that there are actually more than just four clearly defi ned
levels, and most companies fall between two of these.)
Soft-tissue Safety Culture
We can apply this to soft -tissue injuries and sprains-and-strains.
From our global work over the past four decades, here are the char-
acteristics of the 4 levels of “Soft -tissue Safety Culture”:
1. Forced (“To”). In this scenario, workers adopt an “out of
sight, out of mind” approach and do as little as is required to stay
out of trouble. A frequent default here is leaders assuming strains
and sprains (S&S) are likely faked, not real, or occurring off -work.
Out of frustration, leaders oft en resort to blaming workers for not
paying attention, or for disregarding policies and procedures.
Th ere can be pressure to not report these injuries (“suck it up,”
“man up”, etc.). S&S are oft en disregarded as being inevitable. Th e
company might provide only the minimal “required” prevention
information. Posters and reminders generally emphasize strength-
ening “will power” with messaging such as “lift safe,” or “think be-
fore you act.” Th is culture’s focus is forced compliance.
2. Protective (“For”). Experts believe they know what’s best for
workers, and tend to distrust employees to act for their own best
Safety. So, they “benevolently” take the initiative to design out (of-
ten termed “idiot-proofi ng”) potential S&S exposures.
Messaging is simplistic but well-intentioned (“be careful!”
“bend your knees,” “don’t twist,” “lift with your legs,” “keep your
back straight”). Th e focus tends to be on only at-work exposures,
with better “awareness” being encouraged. Th ere can be a reliance
on “carrot and stick” reinforcers (incentives and discipline.) Atten-
dance at traditional “back schools” that emphasize imparting rudi-
mentary physiology might be required for those who were injured.
Many such cultures attempt to in-
corporate pre-hire selection processes
to somehow screen out those who
might be S&S-prone. Th ere’s an over-
riding emphasis on “quick fi xes,” such
as one-exposure education and equip-
ment such as back belts, scissors lift s,
and tool/weight suspensions.
3. Involved (“With”). Ergonomic redesign, adjustments and pro-
spective equipment purchasing is done on another level, with strong
input from those doing the work, including piloting new designs.
Training is also stepped up towards better understanding and dis-
covery vs. “just do as you’re told.” Th ere’s greater attention fi xed upon
the specifi c tasks associated with higher risk of cumulative trauma
(not just “heavy” loads.) Positive personal motivation is encouraged,
rather than “do it for the company” or “to stay out of trouble.” Th ese
companies oft en use external or clipboard monitoring.
Th e culture initially considers psychosocial contributors in S&S
and begins to encourage thinking cumulatively. Training is more
hands-on, sometimes with “traditional”-but-limited methods. Off -
work S&S risks begin to be considered. Overall, workers are seen as
potential internal Safety agents, involved in training and in trans-
mitting and reinforcing messaging.
4. Internalized (“By” workers for themselves). Here the de-
fault mindset moves towards personal control. People realize
they’re their own ultimate Safety resource (“I make the biggest dif-
ference in my own life”). Th ere’s greater talk and understanding
that small repetitive motions and tasks can be an “invisible” con-
tributor to S&S, and that, conversely, small positive decisions and
actions can lead to greater Safety.
Th is culture tends to not rest on its laurels, assuming they aren’t
perfect and must continue to hone their approaches. Th ese compa-
nies see S&S connections to other injuries, such as slips/trips/falls,
drops on foot, bodily reaction, and hand injuries. Understanding
of S&S contributors and prevention dynamics is elevated, and this
his level focuses on spreading protective principles that readily
port to off -work activities, grounded in concrete practical appli-
cations. Energizing soft -tissue Safety is paramount, as is helping
place workers in greater control of their own Safety.
Rising to the Next Level
If you fi nd yourself mired on an S&S plateau, fi rst identify your
company’s level of “Soft -Tissue Safety Culture.” Th en look towards
incorporating elements of those on the “next step up” to move to-
wards higher soft -tissue Safety. Better yet, this can in turn elevate
your overall Safety culture and performance.
Robert Pater is the Managing Director and creator of the
MoveSMART® system for preventing strains/sprains, slips/trips/falls,
hand injuries implemented in over 60 countries. Th eir emphasis is
on “Energizing, Engaging Expertise” to simultaneously elevate safety
per formance, leadership and culture.
50 Occupational Health & Safety | FEBRUARY/MARCH 2025 www.ohsonline.com