title: Sentinel markers for industrial disasters.
abstract: Workers, managers, and occupational health and safety inspectors can be trained to detect or recognize and promote action to correct sentinel markers for industrial disasters. A sentinel marker is defined as a pre-disaster warning sign of impending failure in prevention. Administrative sentinel markers are: a weak occupational health and safety program; lack of spontaneous access to top management; failure to accept responsibility for subcontractors; the absence of written disaster plans and drills for emergency response in the factory and the adjacent community; noninvestigation of prodromal leaks, exposures, spills or injuries; punishment of "troublesome" individuals reporting such prodromal events; nonuse or misuse of data on illness, injury and absenteeism; and suboptimal work conditions and supervision of shift workers. Information sentinel markers include absence of worker and community right-to-know programs, nonuse of data on earlier mishaps from similar technologies, and failure to provide toxicologic data to hospitals in the pre-disaster phase. Technological sentinel markers are: absence of fail-safe controls, interlocks and automated alarm systems driven by real-time monitoring. Transportation sentinel markers include suboptimal vehicle standards, and drink, drugs and fatigue in drivers. Preventive programs based on identification of all sentinel markers by workers are suggested to be more effective than selective action based on risk assessment analysis.
authors.affiliation: Unit for Occupational and Environmental Medicine, Hebrew University-Hadassah School of Public Health and Community Medicine, Jerusalem, Israel.
authors.forename: P V
authors.initials: PV
authors.lastname: Deutsch
authors.forename: J
authors.initials: J
authors.lastname: Adler
authors.forename: E D
authors.initials: ED
authors.lastname: Richter
mesh_terms: D000062:Accidents, Occupational / Q000517:prevention & control*; D004189:Disaster Planning; D004190:Disasters / Q000517:prevention & control*; D015386:Hazardous Substances; D007557:Israel; D016272:Occupational Health; D012307:Risk Factors; D013672:Technology
chemical_list: D015386:Hazardous Substances