Development of leading indicators for the assessment of occupational health performance using Reason's Swiss cheese model

BACKGROUND: The Swiss cheese model of accident causation is a model used in risk analysis and risk management, including aviation safety, engineering, healthcare, and emergency service organizations, and as the principle behind layered security, as used in computer security and defense in-depth. This study aimed to develop and weight the occupational health leading indicators using the Swiss cheese model. MATERIALS AND METHODS: The present study was a descriptive, cross-sectional study; occupational health performance assessment indicators were classified into five main groups of chemical, physical, ergonomic, psychosocial, and biological harmful agents. In addition, potential hazards and their prevention methods were identified using the Swiss cheese model. The leading performance measurement indicators (n = 64) were developed based on preventive methods and were weighted and rated by fuzzy analytic hierarchy process. RESULTS: Thirty-six out of 64 indicators were related to the management measures, 25 indicators were related to exposure to harmful occupational agents, and the remaining indicators were occupational-related illnesses and diseases rate. Considering the importance and frequency of indicators, psychological agents were the most important indicators (40%) and physical agents had the greatest frequency (59%). CONCLUSIONS: Process of indicators' development has demonstrated that the major occupational health prevention measures in the oil and gas industry are concentrated on physical, psychological, and chemical agents, respectively. Thus, to provide protection for employees against occupational diseases and improve health performance indicators, paying special attention to mentioned agents is essential in the oil and gas industry.