Roger Alesbury and Steve Bailey look at the steps that occupational hygiene professionals have taken over the last three years to grow indigenous skills in the discipline in parts of the world where there is currently a limited inherent capability, and discuss the likely common challenges and the lessons learnt for anyone planning to set up international training schemes.
Recent decades have seen a decline in manufacturing in much of the developed world, and increasing production and mineral extraction in other countries. With the change in this industrial base comes a shift in geographical patterns of demand for occupational health services and professionals. The distribution of occupational hygienists, for example, is highly skewed toward the OECD and English-speaking countries and, in particular, the USA. However, the potential for growth is greatest in non-OECD countries, and this picture is likely to be similar for other occupational health and safety professions.
In many developing countries, occupational illness is burgeoning because of rapid industrialisation,1 yet there is a low level of basic health and safety awareness and a shortage of competent staff to provide basic occupational-health services. The problems are compounded by the limited range of training and development options where they are needed. Few courses are available, and those that are often do not meet the same standards as in developed countries. Mentoring is not generally a viable option because there are limited numbers of specialist practitioners able to provide support. Remote learning via the Internet offers a useful approach for raising awareness and teaching theory but cannot address the practical training and experience required to produce competent practitioners.
A traditional approach in multinational corporations has been to use expatriates. Another option has been to send trainees to the US or UK for university training, but this is expensive and can only be done on a very limited scale. It generates a small cadre of people with skills that are highly marketable and mobile, so employers are increasingly reluctant to invest large sums when it may not be possible to retain the people trained.
A shared vision and partnership
No single organisation could overcome the scale and complexity of the issues and develop a workable international training solution to balance supply and demand. So, from a small beginning with a few interested professionals producing a discussion document in 2006, a collaborative effort has evolved to make it possible. Funded initially by multinational companies such as BP and GlaxoSmithKline, this has matured into a far-reaching international initiative between companies, universities, training providers, and professional associations.
The British Occupational Hygiene Society (BOHS) worked with the Australian Institute of Occupational Hygienists (AIOH) to engage other national organisations through the International Occupational Hygiene Association (IOHA), and this partnership has now expanded to include the American, Irish, South African, and Hong Kong associations. Other countries are also actively considering joining.
The collaboration has led to a shared vision, based on:
For the model to be sustainable it is essential that all the participants derive benefits from the system so that they have an interest in its long-term continuation. Their interests in becoming involved will vary from altruism to generating an ongoing income stream.
Turning the vision into practice has required a commitment to true partnership from each of the organisations involved. Reaching consensus on decisions has not been easy. Individual participants often had limited understanding of the issues, as well as established interests to protect. It has taken diplomacy and persistence to get this far, and the following ground rules have now emerged to guide the decision-making process:
Above all, flexibility and the “art of the possible” have been the keys to progress.
Meeting customer needs
Different levels of training meet the different needs of managers, non-specialist employees, technicians and professionals. The system of training and development has been designed to allow students to build their skills from a low base in a structured way. Students can supplement their knowledge in a spiral learning fashion to achieve higher qualifications. Topics can be re-visited at each level, but with growing background knowledge and experience that allows for deeper insights. Learning at the lower levels is never wasted or repeated.
Our first priority has been to develop training at the intermediate level of skill (Practical Modules) — technicians with the practical occupational-hygiene skills to identify, assess and control risk — in order to meet the most immediate needs of industry. We have chosen a modular format, based on five-day teaching units, to provide flexibility to meet the needs of business and students. The latter study as many modules as they need, when they need, and further modules will be developed over time.
The training has to be delivered locally, and be both accessible and affordable to the local market. That means finding suitable venues and, of course, trainers. Sending trainers from the UK might give more control over quality, but costs are going to be considerably higher and therefore not sustainable beyond a pilot programme. With indigenous training providers, assessment and approval becomes more difficult; minimum standards must be specified, and a way to devolve the approval role to local partner organisations developed.
Accessibility will also mean that translation and delivery in local languages will be necessary in many countries where students do not wish to, or cannot, study in English.
Ultimately, the students benefit from local provision of quality-assured, affordable training courses and, consequently, enhanced career prospects. They achieve a globally-recognised qualification with minimal barriers to entry, the opportunity to progress to a professional level, and the potential for international mobility.
Learning by teaching
The courses have been piloted for more than two years, and many lessons have been learnt along the way about the teaching and course materials.
There are no entry qualifications for the courses but those students who lack a strong scientific or technical education do find the intermediate modules very challenging. They benefit from having taken a ‘Fundamental Principles’ course first, and this is strongly encouraged.
‘Chalk and talk’ teaching in large classes is not effective in many countries, given both language and cultural barriers. For example, students are sometimes not willing to ask questions, or to admit when they do not understand a topic. Thus, ‘formative’ assessment has become the normal way of delivering the courses, and competency is developed through practical, hands-on sessions.
Working in small groups on case studies helps students develop their knowledge while at the same time allowing tutors to assess their progress. ‘Overnight’ study exercises leading to student presentations have similar benefits. The final multiple-choice exam has been replaced by an open-book assessment, which is part of the students’ learning process. Each course is supported by a comprehensive student manual so that students have a reference point, and teaching materials closely match the flow of the manual.
This style of teaching puts a considerable responsibility on the tutors, so delivery is restricted to approved training providers. Class sizes are limited to around 20 pupils with two trainers, which allows for some individual coaching where there are cultural differences and difficulties
Student assessment and certification
Successful completion requires attendance for the whole course, passing the open-book test, and completing practical exercises and a project to the satisfaction of the course director.
Students completing a module receive an Award of Satisfactory Course Completion, which recognises their understanding of the subject taught and the ability to apply their knowledge to answer questions. To demonstrate competence in the subject area, students must also complete a Personal Learning Programme and submit a portfolio of their project work after completing the course. Successful students are awarded an intermediate certificate of competence in that subject. Satisfactory awarding of six such certificates will entitle the student to progress to the full Intermediate International Certificate of Competence in Occupational Hygiene.
The open-book examination, practical assessment, and an oral examination process have been developed and are currently managed by BOHS. It is proposed that certificates and awards will be made through national organisations, where they exist, and (subject to final agreement) will include the IOHA logo. Where there is no national association, or the national association does not wish to make awards, the BOHS Faculty of Occupational Hygiene, or other IOHA-recognised examining boards, may offer student assessment and awards provision directly.
The examination boards have a crucial role to play. They set the syllabuses for the examinations, determine how the assessment and certification processes will work, source the exam questions, appoint the examiners, and quality-assure the whole system. If we are to achieve a truly global system of qualifications, they will also have to reconcile differences in national practice. And there must be a long-term aim that all national certification bodies will accept the international qualifications emerging from the scheme.
Conclusion
There is still a considerable way to go but a global system of training and qualifications for occupational hygiene is now available, and principles on which it will operate have been established.
Collaboration and engagement with stakeholders were essential as starting points but, for the longer term, there has to be agreement about overall management of the scheme. In all likelihood this will mean establishing a central body. It may well be a representative body with no resource of its own, which draws on the resources of the contributing partners. It will have legal status and will set the framework and responsibilities for the oversight of assessment standards, as well as the provision, maintenance, updating of, and access to training materials.
Success in expanding the system will depend on international collaboration, open transfer of information, an inclusive approach, a focus on customer needs, and determination — tempered by flexibility and pragmatism.
References
1 World Health Organisation (2008): WHO Occupational Health Programme, available at www.who.int/occupational_health/en
Steve Bailey is vice-president of EH&S strategic projects for GlaxoSmithKline, and Roger Alesbury is head of occupational hygiene for BP.
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