OHSMS Survey Instrument

Survey of Facilities with a Certified Occupational Safety and Health Management System (OHSMS)

Note: Questions in black were taken from OSHA’s 2011 National Survey of Safety and Health Practices Baseline Survey, a statistical survey of occupational safety and health policies and practices among private sector establishments in non-agricultural industries. These questions have been vetted and asked in a prior approved OMB survey (OMB Approval 1218-0263). Asking these questions will allow us to compare the responses of establishments with a certified OHSMS in place to responses from a statistical sample of all establishments.

Questions on blue are new and were developed for this project specifically.

General Information

This survey is intended for organizations that have implemented an occupational safety and health management system (or OHSMS) and have had that system certified under a voluntary consensus standards such as OHSAS 18001, ISO 45001 or ANSI/ASSP Z10.

1. Are you responsible for implementing or overseeing the certified OHSMS where you work?

___YES

___NO {Ask respondent to forward to another person}

[If you answered NO because you are not the person responsible for implementing the OHSMS, please forward the survey link to that individual.]

2. Has your organization’s OHSMS been certified by an accredited certification body?

___ YES

___ NO {Exit Survey}

___ Don’t Know {Exit Survey}

3. Which of the following standards have you been certified to?

Standard	NO, we have never been certified to this	YES, we have been certified to this	Certification Period
			Initial Certification (Month/Year)	To (Month/Year)
ISO 45001	□	□	___ / _____	___ / _____	□ Not sure when
OHSAS 18001	□	□	___ / _____	___ / _____	□ Not sure when
ANSI/ASSP Z10	□	□	___ / _____	___ / _____	□ Not sure when
Responsible Care	□	□	___ / _____	___ / _____	□ Not sure when
OSHA VPP	□	□	___ / _____	___ / _____	□ Not sure when
CSA Z1000-06 (Canada)	□	□	___ / _____	___ / _____	□ Not sure when
Other: [list] _______________	□	□	___ / _____	___ / _____	□ Not sure when

4. What does the scope of your OHSMS certificate cover? (Select the one that best describes your OHSMS.)

__ The single and only location owned by my organization

__ A single location that is part of a larger organization

__ Multiple locations as part of a larger organization

__ All locations owned by a larger organization

5. Is your organization owned domestically (U.S.) or by a foreign organization?

___ Domestic

___ Foreign

6. How many full-time employees are covered by the scope of the OHSMS certificate?

__ 2 to 10 employees

__ 11 to 49 employees

__ 50 to 100 employees

__ 101 to 249 employees

__ 250 to 500 employees

__ more than 500 employees

__ Don’t Know/Not Sure

7. Which of the following industrial sectors best corresponds to the operations covered by your OHSMS certificate?

(Please Select One)

_____ Mining, Quarrying, and Oil and Gas Extraction

_____ Utilities

_____ Construction

_____ Manufacturing

_____ Wholesale Trade

_____ Retail Trade

_____ Transportation and Warehousing

_____ Information Technology and Services

_____ Finance and Insurance

_____ Real Estate and Rental and Leasing

_____ Professional, Scientific, and Technical Services

_____ Management of Companies and Enterprises

_____ Administrative and Support Services

_____ Waste Management and Remediation Services

_____ Educational Services

_____ Health Care and Social Assistance

_____ Arts, Entertainment, and Recreation

_____ Accommodation and Food Services

_____ Other Services (except Public Administration)

_____ Public Administration

8. If you know the 5- or 6-digit NAICS code that corresponds to the operations covered by your OHSMS certificate, please provide it. If not, please provide a description of these operations so we can assign an appropriate NAICS code.

_______ NAICS Code

__________________________________________ Description of operations

Hazards

9. Below is a list of possible sources of workplace injury or illness. Please read through the list and check off any hazard that is a potential safety or health issue at your organization or that has been addressed through your safety and health rules or policies.

__ Use of, or malfunction of, equipment or machines

__ Falls from elevation

__ Falls on the same level—trips or slips

__ Exposure to toxic substances, hazardous waste, radioactive substances, or toxic gases

__ Excessive noise

__ Motor vehicle accidents

__ Exposure to extreme heat or cold

__ Exposure to viruses, microbes or other infectious substances [Do NOT check if exposure is limited to coworkers or customers with colds, influenza, coronavirus (COVID-19), or other such illnesses.]

__ Increased risk of exposure to coronavirus (COVID-19)

__ Lifting heavy loads

__ Repetitive stress injuries or musculoskeletal disorders

__ Fires or explosions

__ Workplace violence, either by employees or nonemployees

__ Work in permit-required confined spaces (such as tanks, vessels, silos, storage bins, hoppers, vaults, pits, manholes, tunnels, equipment housings, ductwork, pipelines)

__ Work with explosives

__ Flying particles or debris

__ Electric shock

__ Lockout/tagout hazards [CHECK IF YOU HAVE A LO/TO PROGRAM]

__ Materials handling hazards

__ Hazardous materials (combustible or flammable liquids or gases)

__ Compressed gases

__ Hazardous waste handling

__ Biological hazards or needlesticks

__ Combustible dust

__ None of the above

__ Other

__ Don’t Know/Not Sure

Questions on Certification

As we mentioned at the start of this survey, we are interested in your responses because your organization implemented a certified Occupational Safety and Health Management System, or OHSMS. The next few questions ask about your OHSMS.

10. What was the initial motivation for your organization to implement an OHSMS? PLEASE CHECK ALL THAT APPLY.

__ To improve health and safety in our workplace

__ In response to a serious incident or close call

__ To facilitate compliance with federal or state regulations

__ OSHA or state citation and/or fine

__ To be eligible for a program providing worker’s compensation premium reductions.

__ To keep other expenses low (e.g., health insurance, liability)

__ Required by a corporate parent (domestic)

__ Required by a corporate parent (international)

__ Required by one or more clients/customers

__ Required by one or more host employers

__ Required by one or more investors

__ To gain public recognition by OSHA, a state OSH agency, an industry group, etc.

__ To help integrate safety and health into overall business operations

__ To help manage a multi-establishment corporation

__ Other

__ Don’t Know/Not Sure

11. Does your OHSMS cover employees of temporary agencies that work on site at your organization?

___ Yes

___ No

___ Not sure

12. Does your OHSMS cover contractor employees that work on site at your organization?

___ Yes

___ No

___ Not sure

13. What elements does your OHSMS cover? PLEASE CHECK ALL THAT APPLY.

__ Management commitment and resources 

__ Employee participation 

__ Occupational health and safety policy 

__ Goals and objectives 

__ Performance measures 

__ System planning and development 

__ OHSMS manual and procedures 

__ Training system 

__ Hazard control system 

__ Rewards or incentives for reduced injury/illness cases or rates

__ Preventive and corrective action system 

__ Post-incident drug testing

__ Procurement and contracting 

__ Communication system 

__ Evaluation system 

__ Continual improvement 

__ Integration of safety and health into the organization’s business practices

__ Management review 

14. In what year did your organization first begin work implementing your OHSMS? (Note: this should be before you were certified)

______ (Year)

__ Not sure

15. Did any of the following resources help you put your OHSMS in place and, if so, how helpful were those resources?

Resource	We did not use this	We did use it and it was…
		Not helpful	Somewhat helpful	Very helpful	Not sure
OSHA Consultation	□	□	□	□	□
Private consultant	□	□	□	□	□
Formal training	□	□	□	□	□
Guidance document (non-OSHA)	□	□	□	□	□
Insurance company	□	□	□	□	□
Professional association	□	□	□	□	□
Other: [Describe] ________________ ________________ ________________		□	□	□	□

16. Based on your best estimate, what was the total effort spent implementing your OHSMS (excluding the of certification itself)?

__ < $5,000

__ $5,000 to $10,000

__ $10,000 to $25,000

__ $25,000 to $50,000

__ $50,000 to $100,000

__ $100,000 to $250,000

__ >$250,000

___ Not sure

17. Based on your best estimate, what was the total initial cost to certify your OHSMS?

__ < $5,000

__ $5,000 to $10,000

__ $10,000 to $25,000

__ $25,000 to $50,000

__ $50,000 to $100,000

__ $100,000 to $250,000

__ >$250,000

___ Not sure

18. Did you hire consultants to assist in implementing your OHSMS?

___ Yes [Go to Q19]

___ No [Skip to Q20]

___ Not sure [Skip to Q20]

19. What was the cost incurred to hire the consultants?

__ < $5,000

__ $5,000 to $10,000

__ $10,000 to $25,000

__ $25,000 to $50,000

__ $50,000 to $100,000

__ $100,000 to $250,000

__ >$250,000

___ Not sure

20. To what extent do you agree with the following statements?

Statement	Strongly Disagree	Disagree	Neither agree nor disagree	Agree	Strongly Agree	Not sure
The process of implementing an OHSMS was easy
The process of obtaining certification of our OHSMS was easy
I would recommend that other companies obtain certification of their OHSMS

If respondent indicates “agree” or “strongly agree” to “I would recommend that other companies obtain certification of their OHSMS”, ask this question:

You indicated that you would recommend obtaining certification to other companies. Are there specific reasons why?

{open-ended}

If respondent indicates “disagree” or “strongly disagree” to “I would recommend that other companies obtain certification of their OHSMS”, ask this question:

You indicated that you would not recommend obtaining certification to other companies. Are there specific reasons why?

{open-ended}

Resources

21. How many individuals in your organization have primary responsibility for employee safety and health?

___ employees

22. Is there a separate line item in the operational budget of your organization for safety and health?

___ Yes

___ No

___ Not sure

Other Certifications

23. Does your company hold any of the following other management system certifications?

Standard	NO, we don’t have this	YES, we have this	We obtained initial certification in:
Quality (ISO 9001)	□	□	Year:	□ Not sure when
Environment (ISO 14001)	□	□	Year:	□ Not sure when
Other: {list} ____________	□	□	Year:	□ Not sure when
Other: {list} ____________	□	□	Year:	□ Not sure when
Other: {list} ____________	□	□	Year:	□ Not sure when

Safety Practices

Now we would like to find out about safety and health policies and practices at your organization.

24. Please check each statement below that applies to your company.

__ Employee safety is mainly provided by initial and annual refresher training.

__ New hires work with experienced employees who train them in safe practices.

__ Our employees perform administrative (white collar) and managerial work; we don’t really provide safety and health training.

__ Supervisors hold regular safety meetings with employees.

__ Managers, supervisors and/or workers receive incentives (I.e. cash bonuses, non-cash awards, recognition, or celebrations) based on injury/incident rates.

__ We have an injury, illness, incident and near miss reporting system.

__ We encourage reporting and take steps to ensure employee reports of injuries and incidents do not result in retaliation or discipline or are otherwise discouraged.

__ We investigate all incidents to determine root causes.

__ We administer post-incident drug tests after injuries, illnesses or near misses.

__ We regularly inspect all workstations to detect/identify hazards.

__ We have a safety and health committee.

__ We have consultants, safety experts, or industrial hygienists assess safety and health conditions at our workplace(s).

__ Our insurance company helps provide safety and health expertise.

__ None of the above.

25. How does your organization approach correcting hazards?

PLEASE CHECK ALL THAT APPLY.

__ Hazards are corrected in response to an incident.

__ Hazards are corrected when there is a near miss or an event that could result in injury.

__ Hazards are corrected when work methods seem inadequate or employee training seems inadequate.

__ Hazards are corrected when an employee reports observing them.

__ Hazards are corrected as the need arises or as a hazard comes to our attention.

__ Hazards are corrected as part of our reviews of production processes or work activities.

__ We have a budget for correcting hazards each year, which depends on priorities and the hazards identified.

__ Other

__ Don’t Know/Not Sure

26. Who is involved in conducting investigations of safety-related incidents or near misses?

DO NOT CHECK IF THE PERSON’S INVOLVEMENT IS LIMITED TO BEING INTERVIEWED OR ASKED FOR INFORMATION, AS WITH A WITNESS TO THE EVENT.

PLEASE CHECK ALL THAT APPLY.

__ The manager responsible for safety and health

__ The supervisor responsible for the area where the incident occurred

__ Workers in the area where the incident occurred

__ The safety committee

__ Top management

__ Other ____________________

27. Do you have regular safety meetings, such as when a new job is begun, lunch box meetings, or monthly sessions?

__ Yes

__ No

__ Don’t Know/Not Sure

28. Below are examples of strategies that some organizations use to address workplace safety and health issues. For each activity, please which, if any, are used at your organization.

Does your company…	Yes	No	Don’t Know
Designate one individual with authority over the safety and health program?
Assign and communicate safety program-related roles, responsibilities, and authority to all managers, supervisors, and employees?
Provide information, training, and resources so that all employees understand and can fulfill their program-related responsibilities?
Have drills for emergency situations?
Investigate incidents (injuries, illnesses, fatalities)?
Involve employees in conducting incident investigations?
Investigate near-misses?
Perform regular workplace hazard inspections at least annually?
Identify and assess hazards associated with changes in processes or equipment before the changes or new equipment are introduced?
Identify hazards associated with emergency situations?
Have a system for prioritizing hazards for control based on the likelihood of the incident and severity of the impairment?
Perform regular job hazard analysis?
Have a written employee safety and health reporting system with follow-up investigations?
Have a procedure for addressing hazards reported by employees?
Perform regular written reviews of your organization’s safety and health performance (e.g., review performance over the past year, evaluation of injury and illness performance on a regular basis, etc.)
Have a joint employee and management safety and health committee?
Have safety and health meetings (other than training and committee meetings) with employees?
Regularly review or audit the operation of your safety and health system to ensure that your program is working the way it was intended?

Safety Training

29. How do workers receive safety and health training?

(PLEASE CHECK ALL THAT APPLY.)

__ On the job training by a coworker

__ On the job training by a supervisor

__ Regular training in groups

__ Lectures, seminars, or other presentations led by safety personnel

__ Self-directed training via handouts, videos, pamphlets

__ Computer-based training

__ Other—PLEASE DESCRIBE_____________

Assessing Certification Outcomes

30. With regards to your certified OHSMS, to what extent do you agree with the following statements?

Our certified OHSMS has…

Statement	Strongly disagree	Disagree	Neither agree nor disagree	Agree	Strongly agree	Not sure
Improved safety
Reduced the number of injuries or illnesses
Reduced workers compensation costs
Increased productivity
Reduced production/operational costs
Increased profits
Increased reporting of hazards and concerns by employees
Reduced the number of “near misses”
Improved employee morale
Reduced employee turnover or improved retention
Reduced employee absences
Improved management-employee relations
Improved safety culture
Opened new business opportunities
Improved our competitiveness
Improved the quality of our product/service
Greater integration of safety/health into business decisions and operations
Expanded “ownership” of safety and health
Improved our reputation in the community
Improved our reputation in our industry

[For each item where the respondent indicated they “Strongly Agree” with the statement in Question 30, they following type of question will appear]

The following set of questions ask you to elaborate on items in the previous question you “strongly agreed” with. If you can, please provide additional information or anecdotes that elaborate on how you feel for some or all of these. This type of information will assist us in better understanding real-world success stories.

31. You indicated that you strongly agree that your OHSMS resulted in {item from Question 30}, please provide additional details if you can.

{Open-Ended}

The following set of questions ask you to elaborate on items in the previous question you “strongly disagreed” with. If you can, please provide additional information or anecdotes that elaborate on how you feel for some or all of these. This type of information will assist us in better understanding real-world issues and concerns.

32. You indicated that you strongly disagree that your OHSMS resulted in {item from Question 30}, please provide additional details if you can.

{Open-Ended}

Impact of OHSMS on Coronavirus Pandemic Response

33. To what extent do you agree or disagree with the following statements on whether your OHSMS helped your organization respond to the pandemic?

Statement	Strongly disagree	Disagree	Neither agree nor disagree	Agree	Strongly agree	Not sure
Our OHSMS identified infectious diseases and external public health issues as a risk to our business.
Our OHSMS included specific plans for responding to a pandemic
Our OHSMS helped us identify and access resources we needed to respond to the pandemic
Our OHSMS helped us decide whether to continue some or all of our operations during the pandemic
Our OHSMS helped us monitor and respond to worker concerns about the impact of the pandemic in the workplace
Our OHSMS helped us monitor and respond to worker concerns about the broader impact of the pandemic (e.g., on their family)
Worker input improved our ability to respond to the pandemic.
Our OHSMS helped us communicate throughout our organization during the pandemic.
Our OHSMS helped operate more safely during the pandemic
Our OHSMS helped us operate more safely when our facilities re-opened.

34. To what extend was your organization’s OHSMS helpful in anticipating and responding to the pandemic?

___ We did not use it

___ Not helpful

___ Somewhat helpful

___ Very helpful

___ Not sure

35. Are there any specific aspects of your OHSMS that assisted your organization in responding to the pandemic?

{Open-Ended}

36. Does your organization require contractors/suppliers to provide information on their safety and health program and performance (e.g., injury and illness rates) when submitting bids or quotes?

___ Yes [Go to Q37]

___ No [Go to Q38]

37. If yes, are you more likely to engage a contractor/supplier who has a certified OHSMS?

___ Yes

___ No

We are also interested in understanding how having a certified OHSMS affects injuries and illnesses. To do this, we need information from your OSHA 300 log that is required to be filled out each year. We recognize this will take some time but having this information would be valuable to DOL in understanding the effect that OHSMS’s have on injury and illness rates.

38. In the table below, please provide as many years of data as possible. To assist you, we have referred to areas of the OSHA Form 300A form that contains the necessary information.

Year	Total Hours Worked by All Employees (Under “Employment Information” on your 300A)	Total Number of Deaths (Line G on your 300A)	Total Number of Cases with Days Away from Work (Line H)	Total Number of Cases with Job Transfer or Restriction (Line I)	Total Number of Other Recordable Cases (Line J)
2012
2013
2014
2015
2016
2017
2018
2019

In addition to understanding your injury and illness history, we also would like information on your workers’ compensation experience.

39. In the table below, please provide as many years of workers’ compensation data as possible.

Year	Number of Claims	Value of Claims ($1,000s)	Experience Modification Rate (EMR)
2012
2013
2014
2015
2016
2017
2018
2019

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