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Worker participation and autonomy: a multilevel approach to democracy at the workplace.

The article describes a process toward democracy at the workplace in a Swedish middle-sized manufacturing company producing for the export market. The change process was initiated and engineered by the trade union local in close cooperation with management. Within an overall strategy for increased worker control, the democratized work organization combines co-determination for the local trade union board in strategic management decisions with a system of autonomous production groups, where supervisors have been replaced by "contact people" elected by and responsible to the groups. Through the autonomous groups, all workers participate in decisions about production. The groups decide on all matters related to work performance and take collective responsibility for production results. As an introduction to the case, the paper puts this trade union model for democracy at the workplace in the perspective of a 50-year development of productivity and worker participation in Scandinavia. The case report deals both with the change process (why and how it came about) and with the outcome of the new work organization for the workers, the union, and the company. It is shown that the new work organization has meant a richer job content, increased dignity for workers, increased solidarity among workers, increased trade union activity and strength, as well as a more effective use of productive resources in the company. Despite local peculiarities, it is concluded that the experiences gained from this case can be transferred to other workplaces where workers are interested in having more say, more security, and a more meaningful work situation.

Democracy↗

Deaths from trench cave-in in the construction industry.

At least 70 US construction workers die each year in trench cave-ins, and Occupational Safety and Health Administration (OSHA) standards for work in trenches have been criticized as hard to understand and inadequate. This study examined 306 fatal cases, obtained mainly from OSHA investigations, from 1974 to 1986. Most of the deaths occurred in shallow trenches while digging sewer lines, and were caused by failing to shore or brace the walls of the trench. The risk of cave-in death was higher in young workers and those in small firms; only 12% of the deaths were in unionized companies. OSHA issued citations in 94% of the cases, with fines ranging up to $58,400; the average fine was $1,991 per death. Death due to cave-in is a significant risk for construction workers, and can be prevented by proper protective measures.

Accidents, Occupational↗

Renewing the model employer. Changing employment relations and "partnership" in the health and private sectors.

Drawing from original empirical data this paper compares the changing nature of employment relations in the health and private sectors. A key concern is to assess the extent to which the emergence of partnership-type arrangements between employers and trade unions lays the basis for the "renewal" of the traditional public sector concept of the model employer. Empirically, the paper draws on a survey of trade union representatives from 238 workplaces and a case study of a hospital trust. The data reveal that employment relations in the NHS are more collectivist when compared with the private sector. However, the development of partnership in the NHS is hamstrung by ongoing training and involvement gaps and widespread work intensification.

Employment↗

Hazards in the hospital: educating the workforce through its union.

The hospital workforce is exposed to many occupational hazards of which most hospital workers are unaware. The author and another health educator, both employed with the California State Department of Health, conducted occupational health and safety educational sessions for the membership of a hospital workers' union. These sessions taught nonprofessional workers how to recognize hospital hazards, how to eliminate or minimize these hazards, and informed workers of their legal rights under the California Occupational Safety and Health Act. We first had to convince the union health and safety officer that we had skills and information which would be of benefit to the union. Once that hurdle was crossed, we encountered some difficulty conducting an adequate needs assessment and including the target population in the planning of the educationals. Two series of educational sessions for rank-and-file members were conducted and were enthusiastically received by those attending, with a request for more sessions.

Accidents, Occupational↗

Reform in higher education for nurses: comparative comments from Canada.

This article compares the move of basic nursing education in Australia into the university sector with the status of higher education for nursing in Canada. The influence of nursing unions and nursing associations in nursing education, and the role of human resource planning and development in nursing are addressed. Four major issues confronting university-based education are explored: essential qualities of nursing education, content versus process curricula, transition of faculty into academia, and relationships with other disciplines, especially medicine.

Australia↗

The role of union democracy in the struggle for workers' health in Mexico.

In this article, the author analyzes the struggle for workers' health in Mexico, emphasizing the importance of the general and specific political context. In an overview of the legislation on industrial health and safety, the state institutions involved in the issue, and the characteristics of union organization in Mexico, the author shows that the limited activities related to workers' health have more to do with the relative political weakness of the Mexican working class than with the formal structures of legislation, state institutions, and unions. The second part of the article deals with the four most important struggles for health and safety in Mexico during the last ten years, which show some similarities. These struggles are consistently linked to processes of union democratization and tend to decline when union democracy is lost. The strategies of the companies show a common pattern: removing health issues from collective bargaining and putting them in the hands of state institutions. When workers have opposed this solution, management has used selective repression to solve the conflict. The state institutions subordinate their position to the companies' by postponing action or by doing a technically poor job. Changing the existing situation involves the social legitimation of the workers' health issue, since this would have an impact on the political processes involved, i.e., corporate control over workers, authoritarian labor relations and professionalism, and resources of the state institutions.

Collective Bargaining↗

The rise and fall of the asylum worker's association: the history of a 'company union'.

In the nineteenth century, the only method open to asylum nurses and attendants to air a grievance, apart from resigning from their employment, was to present a petition to their employing authorities. In fact they were still making use of the petition as late as 1899, when a petition was presented in London, by attendants in favour of shorter hours. (This was turned down for reasons of expense.)

Employee Grievances↗

Comparison of perceived occupational health needs among managers, employee representatives and occupational physicians.

The aim of this study was to assess how occupational health providers view the importance of different occupational health functions compared with their customers (managers and union representatives). A postal survey was undertaken requesting that managers of medium and large companies, union representatives and occupational physicians rank in order of importance 13 listed functions of an occupational health service which have appeared in the published literature. The results were analysed and tabulated to allow comparison of the responses among the four groups. The two functions ranked as most important by all four groups were advice on the work environment and advice on medical retirement. Dental services as an occupational health service function were ranked as least important by all four groups, with provision of physiotherapy services by occupational health departments also perceived as relatively unimportant by managers of medium and large companies. A wide discrepancy of views was revealed between physicians, managers and unions over the importance of immunization for travel and work and the rehabilitation and resettlement of sick and injured workers. The physicians ranked these functions as more important than the managers or union representatives. Managers of medium-sized companies also ranked counselling in the workplace much higher than the other respondents. The study shows the dilemma that occupational health services may face in deciding what functions should be provided compared to what their customers wish to be provided.

Administrative Personnel↗

Recognition. When the music stops.

Trade unions can no longer expect NHS employers automatically to recognise their role in negotiating employment terms and conditions on behalf of their members. NHS self-governing trusts are now free to set their own terms and conditions of employment--and to choose with whom they wish to negotiate. Roger Kline outlines the importance of recognition agreements.

Collective Bargaining↗

Gut issue.

Unions are willing to strike over it, and companies are ready to draw the line, too. Now both sides are turning to Congress to fix the health insurance mess. This is the first of two articles on responses to the growing health care crisis. A report on state efforts begins on p. 708.

Cost Control↗

The new union strategy. Turning the community against you.

They're called corporate campaigns, and unlike traditional union organizing efforts, their aim is to tarnish a hospital's relationship with its community by questioning its mission, tax-exempt status and quality of care. The campaigns can be brutal and relentless, and as hospital executives from Connecticut to California will attest, they can even get personal.

Anomie↗

[Health risk in workers at fuel stations: posture of the fuel union].

The risk assessment of exposure to benzene of filling attendants in petrol stations is a main goal for Italian companies. Changes in the organisation of the service station, in gasoline composition and improvement in good working practices have been performed. To assess the implementation of these activities environmental investigation have been carried out over the last years. The results show that exposure to benzene in petrol stations is now below the limits stated by regulations in force.

Humans↗

Union Carbide and the community surrounding it: the case of a community in Puerto Rico.

Based on fieldwork in Puerto Rico, this article examines the views on health hazards of residents in a semi-rural community in relation to the influx of industrial development since the early 1970s. It is suggested that "folk" terminology and particular aspects of Puerto Rican culture are less significant in this instance than many studies in medical anthropology suggest. The focus is on the emergence of a protest movement concerned with health problems which community residents and workers attribute to a nearby Union Carbide factory. Residents of El Ingenio, Yabucoa, Puerto Rico, have brought a law suit against Union Carbide and, the management of the plant has attempted to dispel the conflict. The article argues that health concerns of residents, industrial workers, and plant management cannot be interpreted without taking into account problems of unemployment, political affiliations, and company policies and their impact over time.

Adolescent↗

Tip-toeing over the minefield of union rivalry.

Time off for voluntary union officials, the role of Acas, solving inter-union rivalry by sole negotiating responsibility: these are topics looked at in the second part of our summary of the Dyson review of industrial relations at Westminster Hospital. Professor Dyson calls for the underresourced and badly deployed district personnel department to be moved urgently to the main hospital site and for its staff to be strengthened.

Conflict, Psychological↗

Union Health Service celebrates 50th year managing capitated patients.

Union Health Services is celebrating its 50th year managing capitated patients. One measure of its success is the staff model HMO's ability to hold down premium hikes to 3.4% compared with the national average of 11.5%. Read about how the Chicago-based non-profit does it.

Capitation Fee↗

The relationship of unions to prevalence and claim filing for work-related upper-extremity musculoskeletal disorders.

BACKGROUND: Unionization has been found to be related to higher filing of workers' compensation (WC) claims, but the extent of the relationship and the relationships to other variables have not been previously reported. METHODS: Telephone interviews were conducted with both a population-based and WC-based samples of musculoskeletal disorder (MSD) cases. RESULTS: Workers at unionized facilities were 5.7 times (95% CI 2.5-13.1) more likely to file a claim for WC, despite a comparable rate of MSD cases. Higher filing was also associated with several measures of MSD severity (1.8-14.1 odds ratios), economic sector (OR = 10.1 for manufacturing), hourly (vs. salary) wages (OR = 2.6), and for having a personal physician (OR = 2.5). Unions appeared to have a protective effect on social effects of work-related MSD. CONCLUSIONS: Unions appear to improve filing of work-related MSD, particularly for less severe conditions. The higher filing does not appear to be a case of "moral hazard," but rather improved and earlier reporting, as is advocated by early intervention approaches to reducing MSD.

Case-Control Studies↗

SPATTER! SPATTER! SPATTER! Workers' health and the spray machine debate.

A conflict between industrialization and worker health developed in the painting industry during the early 1900s with the introduction of the spray machine. This technological innovation allowed the application of paint at greater speed and lower cost than hand painting and increased the rate at which painters were exposed to lead and other toxins contained in paint. From roughly 1919 to 1931, the painters' trade union clashed with employers, paint manufacturers, and legislatures over the impact of the spray machine on the health of workers and the need to enact legislation to regulate its use. While painters made gains on local, state, and national levels during the 1920s to prevent the use of the spray machine, their efforts ultimately failed.

Air Pollutants, Occupational↗

[Challenges facing nurses' associations and unions: a global perspective].

Nurses are at the heart of every country's health care system. What sort of problems do they face at work? What are the coping strategies that they and their organizations pursue? Drawing on the findings of a unique global survey of nurses' associations and unions, the authors provide clear answers to these and related questions at a time when population ageing, epidemics, privatization and understaffing are putting heightened pressures on health care systems around the world. Interestingly, the priority concerns of nurses' organizations the world over have much in common despite the widely differing national contexts in which they operate.

Data Collection↗