title: "Decision-critical" work: a conceptual framework.
abstract: "Safety-sensitive" workers, also termed "safety-critical" workers, have been subject to fitness to work assessments due to concerns that a performance error may result in worker injury, injury to coworkers or the general public, and/or disruption of equipment, production or the environment. However, there exists an additional category of "decision-critical" workers, distinct from "safety-sensitive" workers, in whom impairment may impact workplace performance, relationships, attendance, reliability and quality. Adverse consequences in these latter areas may not be immediately apparent, but a potential "orbit of harm" nevertheless exists. Workplace consequences arising from impairment in "decision-critical" workers differ from those in "safety-sensitive" personnel. Despite their importance in the occupational context, "decision-critical" workers have not previously been differentiated from other workers in the published literature, and we now outline an approach to fitness to work assessment in this group.
authors.affiliation: Division of Preventive Medicine, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, 5-30F University Terrace, 8303-112 Street, Edmonton, AB T6G 2T4 Canada.
authors.forename: Xiangning
authors.initials: X
authors.lastname: Fan
authors.affiliation: Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB Canada.
authors.forename: Charl
authors.initials: C
authors.lastname: Els
authors.affiliation: Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB Canada.
authors.forename: Kenneth J
authors.initials: KJ
authors.lastname: Corbet
authors.affiliation: Division of Preventive Medicine, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, 5-30F University Terrace, 8303-112 Street, Edmonton, AB T6G 2T4 Canada.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Straube
keywords: Accidents; Decision-critical work; Fitness to work; Occupational safety; Safety-sensitive work