Occupational safety and health performance indicators in SMEs: A literature review

Abstract

BACKGROUND:

Small and medium-sized enterprises (SMEs) face greatest difficulty in managing occupational risks compared to large enterprises. Limited resources, little knowledge about risk management process and deficiencies in organizational processes are often pointed in the literature as important obstacles to occupational safety and health (OSH) performance in SMEs. However, external factors can also be of paramount importance, such as the economic crisis. Because under specific scenarios OSH conditions may deteriorate in SMEs, is important to establish effective indicators.

OBJECTIVE:

This study aims to identify OSH performance indicators within the context of SMEs.

METHODS:

To identify the indicators, a literature review was carried out on different studies published in scientific journals in the OSH field between 2008 and October 2018 using the Scopus, ScienceDirect, Web of Science and PubMed databases.

RESULTS:

As a result, 14 management and organization OSH indicators applied to SMEs were identified, along with 5 at individual OSH indicators.

CONCLUSION:

The indicators were discussed in relation to its applicability to assess OSH performance, as well as their reliability. Future research should be done to assess the identified indicators in SMEs.

Keywords

Indicators risk level occupational safety & health SMEs OSH conditions OSH performance

1 Introduction

Small and medium-sized enterprises (SMEs) play a key role in national economic development of any country in terms of value added and employment. According data from 2017 provided by the European Commission [1], SMEs accounted for two thirds of overall employment and 56.8% of overall value added, and expectations point to an increase as was observed in the last years. However, despite the importance of these companies for the country’s economy, concerns relate to OSH has been growing along the last decade. SMEs face several difficulties in complying with Occupational Health & Safety (OSH) regulations [2]. Rodrigues et al. [3], in their literature review, also recognized that risk assessment and control are particularly challenging for these companies, due to limited resources, little knowledge about the enterprise’s risks by the owner and deficiencies in organizational processes. This is reflected in the high prevalence of accidents among them. According to a Eurostat report, in the European Union [4], SMEs account for 60% of all occupational injuries and for about 72% of fatal accidents.

To reverse this scenario, SMEs, governments and authorities need to make a great effort to improve OSH management. The importance of an effective strategy to protect workers from work-related accidents and diseases in SMEs, in particular the ones with smaller sized, is emphasized in the EU OSH Strategic Framework 2014–2020, where one of its major challenges is to empower of micro and small enterprises to put in place effective and efficient risk prevention strategies. Is of paramount importance to identify the principal sources of accidents and occupational diseases, monitoring their OSH performance and identify critical areas of intervention [5].

Representative indicators should be selected that reflect the work environment safety and health performance, and such indicators should be measurable. These indicators should warning of problems related to safety and health, preferably before injuries or diseases occur, and allowing for safety interventions and management programs to be designed [5 –7]. However, unlike process industries where OSH performance indicator issues are clear and well documented in terms of the description and use thereof, this issue is still unclear with respect to SMEs. This study’s aim is, therefore, to identify the OSH performance indicators applicable to SMEs by way of a systematic literature review.

1.1 Safety performance in SMEs

SMEs are frequently described as a single group of companies. However, it is important to realize that they have unmatched features [3, 8]. According to European Commission (2003) [9] SMEs can be categorized into three groups: micro (<10 workers; ≤\euro 2 m turnover; ≤\euro 2 m balance sheet), small (<50 workers; ≤\euro 10 m turnover; ≤\euro 10 m balance sheet) and medium-sized enterprises (<250 workers; ≤\euro 50 m turnover; ≤\euro 43 m balance sheet). The company’s size is one factor that is considerably related to OSH performance. Smaller sized enterprises have fewer economic, human and technological resources compared to the large ones [8 , 10–14]. In these enterprises, resources are frequently allocated to the business priorities and matters related to OSH are put aside. Additionally, OSH is, in some cases, seen as a cost by the owner/managers and not an investment. Other factors also vary according the enterprise size and can have influence in OSH performance, such as organizational structure and routines, management commitment, knowledge and competence, which are frequently poorer in smaller sized firms [15].

SMEs demonstrates greater difficulties in evaluating and controlling risks effectively [14 , 16–19]. In fact, the smaller the company, the worse the OSH management practices [15]. In addition, due to the low number of accidents at small organizations and due to the low number of workers in each one, risk perception may be low and this can have implications for risk control, causing management priorities to be reviewed [20]. It should also be highlighted that at SMEs, the company’s employer is also in most cases responsible for OSH issues [20]. This is also a factor contributing to that such issues are placed in the background by the employer, particularly when the employer believes that OSH is the workers’ responsibility [16]. Other aspects as the low investment in safety training, the low involvement and commitment with OSH matters by both the owner and the employees and the lack or ineffective communication and information among the different actors has been also referred in the literature as limitative factors for SMEs OSH performance [11–14 , 22]. As a consequence, smaller sized enterprises usually have higher accident rates and worse consequences when compared to larger enterprises [17 , 24].

Deterioration in working conditions and reversals in OSH matters can be explained not only by internal factors, but also due to the influence of external factors, such the economic crisis [25]. In fact, a risk of neglecting workers’ protection during periods of economic crisis, since economic difficulties tend to lead to considerable delays in prevention strategies [24]. This neglect of OSH brings with it negative consequences for both the worker and the organization [26]. Organizations’ lack of investment in OSH may have taken place in areas including: worker training, acquisition of new work equipment, particularly personal protective equipment (PPE) and also innovation [27]. It is also important to note that economic pressures, principally during the recession period, encourage the pace of work to become more intense and the number of hours spent working to increase, which creates conditions for workers to have less rest time [22]. It should be noted that this pressure is greater in smaller organizations [22]. Therefore, with an increase and worsening in the number of workers in poor working conditions at SMEs in a context of crisis, when the priority is focused on the organization’s survival and not on OSH, there may be an increased risk of accidents at work and occupational diseases [25].

1.2 Occupational safety and health performance indicators

In the world of industry and business, indicators are used as a measure to assess performance in areas that include: finance, effectiveness and efficiency, customers, satisfaction and safety [28]. An indicator can be defined as any measure, whether qualitative or quantitative, that aims to obtain information about a certain topic being studied [29].

The lack of effective proactive indicators is one of the problems currently faced in the OSH field [30]. OSH performance indicators can be defined as a resource that makes it possible to assess changes that may have taken place regarding organizations’ safety and health [31]. They provide necessary information about where and how to act [32]. A good indicator should be stable, replicable, sensitive to change and low in cost [33], and the choice of indicators to be used should take into account SMART criteria, i.e. indicators should be specific, measurable, achievable, relevant and time-bound [34]. The use of indicators results in decision-making that allows for prevention and the preparation of an effective response to occupational accidents [31].

OSH performance indicators can be categorized into two large groups: ‘personal safety’ and ‘process safety’ versus ‘leading indicators’ and ‘lagging indicators’ [35]. These can deal with different fields: the nature and particular features of dangers, technical characteristics and changes in safety and health levels, issues related to formal and informal safety, communication and cooperation problems, and changes to forecast results in light of economic difficulties [36]. Choosing a good indicator is sometimes made more difficult due to the fact that different names are given to the same concept [37]. For example, ‘process safety indicators’ are described as indicators related to processing activities, including process disturbances, barrier quality, root causes and precursors of loss of containment [34, 35]. For bodies such as the UK’s Health and Safety Executive, however, these kinds of indicators are called ‘activities indicators’ [38]. ‘Personal safety indicators’, on the other hand, can be defined as indicators that make it possible to assess the effectiveness of measures to enable workers to avoid, for example, cuts and falls, which are not included in the management of process-related dangers [39].

‘Leading indicators’ can easily be defined through their relationship with ‘lagging indicators’ [37]. Lagging indicators, also known as outcome indicators, provide necessary information about OSH performance related to accidents and injuries [29]. They therefore work as direct measuring instruments for undesirable events or failures and the harm caused in adverse events [35], which may serve as a motivation for employers and workers to improve the organization’s OSH performance [29]. Leading indicators, also known as inputs or activities indicators, make it possible to remove or control possible situations that may lead to adverse events and can also provide early warning signs, therefore enabling the organization to take timely measures to avoid an accident [37]. Use of these types of indicators is mostly related to bureaucratic management practices [30]. However, at today’s organizations, the focus should be on results so that workers can use their own creativity and ability to innovate and reach objectives [30]. Outcome indicators are therefore needed that make it possible to assess and improve the effectiveness of OSH actions in real time [30]. Leading indicators therefore refer to the prevention of adverse events by providing workers with OSH training, while lagging indicators deal with the consequences of an adverse event. This highlights the importance of using performance indicators when it comes to OSH [33].

2 Materials and methods

2.1 Research strategy

This study was based on a systematic review study founded on the guidelines of the PRISMA method [40] and the guidelines provided by the Centre for Reviews and Dissimination (2009) [41]. There was a search for articles identifying factors related to SMEs’ OSH performance. The search for scientific articles was carried out using the Scopus, ScienceDirect, Web of Science and PubMed databases.

The search focused on identifying articles that included keywords under the following general categories: Small and Medium Sized Enterprises, Occupational Safety and Health, Performance. The keywords used for the search are described in Table 1. The search for different combinations of keywords was restricted to the article’s title, abstract and keywords.

Table 1
Keywords used for the search

General Specific search terms

Small and Medium Sized Enterprises “Small and Medium Sized Enterprise*”

AND

Occupational Safety and Health “Occupational Safety and Health” OR “Occupational Health and Safety” OR “Occupational Safety” OR “Occupational Health” OR “Safety”

AND

Performance “Performance” OR “Safety Level” OR “Safety Conditions” OR “Risk Level”

General	Specific search terms
Small and Medium Sized Enterprises	“Small and Medium Sized Enterprise*”
	AND
Occupational Safety and Health	“Occupational Safety and Health” OR “Occupational Health and Safety” OR “Occupational Safety” OR “Occupational Health” OR “Safety”
	AND
Performance	“Performance” OR “Safety Level” OR “Safety Conditions” OR “Risk Level”

2.2 Eligibility criteria

Inclusion and exclusion criteria were defined and used to determine the eligibility of studies. The search was limited to studies that focused on manufacturing industries included within the concept of SMEs and that examined at least one factor related to companies’ OSH performance. Studies that compared factors related to OSH performance between companies with different sizes were also considered. Only research articles written in English and published between the year 2008 and October 2018 were included, and the choice was made to limit the study to Europe. Review articles, studies focusing on sectors of activity other than manufacturing industries, studies based on process industries, studies focusing on theoretical models and studies that did not indicate the way the factor was measured were not included.

2.3 Screening criteria

Search results were exported to the bibliographic software package Mendeley and duplicates were removed. Articles were screened for eligibility against the specified inclusion and exclusion criteria using a three-step systematic approach. Initially, article’ titles were examined for relevance. Secondly, abstracts were screened giving particular importance to the study aims and methodology. Finally, full text articles were retrieved for those studies appearing to meet the eligibility criteria, and for those where the information in the title and abstract was insufficient for exclusion.

3 Results

The results presented in this section are the result of the literature review. Based on the eligibility criteria, only 19 studies were included in the qualitative synthesis. All the studies’ scope was an analysis of manufacturing industry SMEs.

This literature review made it possible to identify different OSH performance indicators. These were grouped into 2 categories: 14 management and organization OSH indicators (Table 2) and 5 personal OSH indicators (Table 3).

Table 2
Management and organization OSH indicators

Indicator Measures Form of measurement References

Personnel management policies Identification of the number of part-time, subcontracted and temporary workers; determination of staff turnover as the number of leavers over a period of time in relation to the total staff. Information provided by the organization [42]

Safety climate Determination of the safety climate level by applying validated tools. Questionnaire administered to workers [42 –45]

OSHMS, certification Identification of the existence of an OSHMS; identification of the number of years the OSHMS has existed; description of OSH management practices, routines and procedures; identification of the level of motivation for certification. Questionnaire administered to the companies [46];

Interviews with safety engineers [47]

OSH policies Identification of the existence of a safety policy; Level of perceptions about OSH policies. Questionnaire administered to employers and workers [18, 44]

Risk communication and information Analysis of existing programs and policies for risk communication; Management’s willingness to improve information activities and risk communication channels; Availability of OSH information; Existence of channels for communicating OSH information. Questionnaire administered to the companies, safety officers or workers [8 , 49]

Organizational commitment Determination of the organizational commitment level by applying validated tools. Questionnaire administered to workers [22, 44]

Workers’ involvement Analysis of workers’ involvement and participation in safety management activities. Questionnaire administered to employers or workers [18, 22]

Management’ involvement Analysis of the amount of top-level management’s involvement in OSH activities; time dedicated to OSH issues. Analysis of the level of perceived employer interest in safety. Questionnaire administered to companies [48]

Interviews with top-level management and workers [10]

Investment/Resources Analysis of the management’s willingness to invest in OSH; Analysis of sustainability of investing in OHS; Identification of financial resources provided to promote OSH; Level of risk in creditworthiness. Questionnaire administered to companies [8 , 15]

Credit bureau database

Risk assessment Analysis of the frequency of risk assessment activities. Questionnaire administered to employers or workers [8, 18]

Accident analysis Identification of the existence of a system for recording and analyzing accidents and incidents; Analysis of use of the data from records of accidents and incidents in the development of policies. Questionnaire administered to companies [8]

Risk control Identification of the existence of a risk control plan; Measures and practices to control risk. Questionnaire administered to employers or workers [8 , 18]

Training, program and frequency The existence of training for workers on OSH and the content thereof is analyzed; % of workers who received training; number of hours of training per worker. Questionnaire administered to companies, employers or workers [8 , 49]

Occupational accidents, diseases and absenteeism Analysis of the numbers of accidents occurred; determination of accident rates; analysis of the number of days lost; analysis of occupational diseases occurred and number thereof. Questionnaire administered to employers, OSH practitioners or workers [18 , 53]

Accident databases and absenteeism [8 , 51]

Indicator	Measures	Form of measurement	References
Personnel management policies	Identification of the number of part-time, subcontracted and temporary workers; determination of staff turnover as the number of leavers over a period of time in relation to the total staff.	Information provided by the organization	[42]
Safety climate	Determination of the safety climate level by applying validated tools.	Questionnaire administered to workers	[42 –45]
OSHMS, certification	Identification of the existence of an OSHMS; identification of the number of years the OSHMS has existed; description of OSH management practices, routines and procedures; identification of the level of motivation for certification.	Questionnaire administered to the companies	[46];
		Interviews with safety engineers	[47]
OSH policies	Identification of the existence of a safety policy; Level of perceptions about OSH policies.	Questionnaire administered to employers and workers	[18, 44]
Risk communication and information	Analysis of existing programs and policies for risk communication; Management’s willingness to improve information activities and risk communication channels; Availability of OSH information; Existence of channels for communicating OSH information.	Questionnaire administered to the companies, safety officers or workers	[8 , 49]
Organizational commitment	Determination of the organizational commitment level by applying validated tools.	Questionnaire administered to workers	[22, 44]
Workers’ involvement	Analysis of workers’ involvement and participation in safety management activities.	Questionnaire administered to employers or workers	[18, 22]
Management’ involvement	Analysis of the amount of top-level management’s involvement in OSH activities; time dedicated to OSH issues. Analysis of the level of perceived employer interest in safety.	Questionnaire administered to companies	[48]
		Interviews with top-level management and workers	[10]
Investment/Resources	Analysis of the management’s willingness to invest in OSH; Analysis of sustainability of investing in OHS; Identification of financial resources provided to promote OSH; Level of risk in creditworthiness.	Questionnaire administered to companies	[8 , 15]
		Credit bureau database
Risk assessment	Analysis of the frequency of risk assessment activities.	Questionnaire administered to employers or workers	[8, 18]
Accident analysis	Identification of the existence of a system for recording and analyzing accidents and incidents; Analysis of use of the data from records of accidents and incidents in the development of policies.	Questionnaire administered to companies	[8]
Risk control	Identification of the existence of a risk control plan; Measures and practices to control risk.	Questionnaire administered to employers or workers	[8 , 18]
Training, program and frequency	The existence of training for workers on OSH and the content thereof is analyzed; % of workers who received training; number of hours of training per worker.	Questionnaire administered to companies, employers or workers	[8 , 49]
Occupational accidents, diseases and absenteeism	Analysis of the numbers of accidents occurred; determination of accident rates; analysis of the number of days lost; analysis of occupational diseases occurred and number thereof.	Questionnaire administered to employers, OSH practitioners or workers	[18 , 53]
		Accident databases and absenteeism	[8 , 51]

Table 3

Individual OSH indicators

Indicator	Measures	Form of measurement	References
Risk perception	Identification of hazard awareness and the importance of safety measures and hierarchy of controls.	Interviews with top-level management and workers	[10]
Unsafe behaviors	Identification of at-risk behavior regarding the use of PPE and CPE; quantification of the % of unsafe behaviors.	Questionnaire administered to employers and employees	[18, 53]
		Interviews with top-level management and workers	[10]
		Direct observation	[30, 52]
Attitudes	Identification of workers’ attitudes that may jeopardize their safety and health or encourage a safe and healthy working environment; identification of the level of perception of employers’ safety attitudes by workers.	Interviews with top-level managers and other stakeholders	[42]
		Questionnaire administered to workers	[22 , 44]
Workers’ motivation regarding OSH issues and satisfaction at work	Extent to which workers state their work is significant and important; level of importance assigned to OSH issues. Positive workers attitude towards work.	Questionnaire administered to OSH practitioners or workers	[22 , 48]
		Interviews with top-level managers and other stakeholders	[42]
Age	Correlation between age and safety performance	Questionnaire administered to the companies	[22]

The management and organization OSH indicators identified were: personnel management policies; safety climate; certification in Occupational Safety and Health Management Systems (OSHMS); OSH policies; risk communication and information; organizational commitment; workers’ involvement; management’ involvement; investment/resources; risk assessment; accidents analysis; risk control; training (program and frequency); occupational accidents, diseases and absenteeism. The following individual indicators of OSH level were identified: risk perception; unsafe behaviors; attitudes; workers’ motivation regarding OSH issues and satisfaction at work; age.

During the analysis of the articles, the way each indicator was measured was also identified. The main means of measuring each indicator were the use of questionnaires and then performance of interviews with employers, workers, OSH practitioners and other stakeholders regarding management and organization indicators. Organizations’ databases and reports were also used for some indicators. For individual OSH indicators, the measurement method focused on interviews and questionnaires. Direct observation was also used. It is noteworthy that analyzing organizations’ databases, reports and direct observation makes it possible to identify indicators based on more objective data, such as determining accident rates, analysis of the number of days lost, identifying and determining the percentage of non-compliance and quantification of the percentage of unsafe behaviors.

4 Discussion

In this literature review, only indicators that dealt with the analysis of SMEs have been identified. In the analysis of the articles, the measures used by the authors related to OSH performance were identified and they were combined into the relevant indicators, which were categorized as either management and organization or individual indicators.

The management and organization indicators were seen as those connected to organization and safety management, as well as labor-related organization factors that may have implications for OSH performance [29]. One of the indicators identified dealt with personnel management policies, such as the number of part-time, subcontracted and temporary workers, as well as establishing organizations’ personnel turnover [18 , 54–56]. Although this indicator includes different labor aspects, turnover was the only one analyzed in the studies included in the qualitative synthesis [42]. Turnover as an objective measure indicates the cycle of new staff or replacement of workers [54]. A low turnover rate is therefore a factor of stability for workers and has a positive impact on workers’ safety in the workplace since it avoids knowledge being lost [54]. However, it should be noted that organizations with more proactive OSH management, even if they have higher turnover rates [42], which can be a factor of instability for workers [54], tend to have better OSH performance than those that are not yet entirely involved in OSH management [42]. Personnel management policies therefore reveal themselves to be an important indicator, not only because of the influence in the enterprise OSH performance, but also for the importance of external factors, such as the economic recession where turnover tend to increase considerably [55]. It is to be expected that the number of temporary and part-time workers goes up in periods of economic recession [25 , 56]. Furthermore, it is important to note that analysis of this indicator is often based on information provided by the organizations [42], so a retrospective analysis is feasible.

In turn, safety climate can be understood as the range of molar perceptions shared among workers regarding their working environment [57]. The safety climate therefore has fleeting and unstable characteristics with a propensity to change in accordance with the organization’s specific characteristics, referring to a shared perception as a specific time and in a certain place [58]. The existence of a positive safety climate has been linked to a lower occupational accidents rate [59], enhanced physical and mental health for workers [42], positive work attitudes and greater organizational commitment [44], and better the working conditions [45]. Therefore, the greater the safety climate, the better organizations’ OSH performance will be. Although safety climate is a good indicator of OSH performance to be applied to SMEs [42–45 , 60], its application has focused on large companies [61, 62].

Regarding organizations’ certification, particularly by OSHMS, studies show that certified companies appear to include OSH in the other functions of the organization and that workers appear to be more involved and seem to comply with OSH policies and procedures willingly and not because of any kind of reward or punishment they could receive [47, 48]. Certification of organizations by OSHMS therefore enables employers to deal with the challenges and reduce at-risk behavior and attitudes and, consequently, reduce problems with the working environment [63]. Furthermore, it works as a kind of regulation, requiring organizations to comply with legal obligations and participate in organization processes that encourage the constant improvement of OSH conditions [34, 63]. Nevertheless, certification does not necessarily mean solving all problems in the working environment, and important aspects such as psychosocial risk factors may be excluded [64]. Additionally, it is important to remember that although certification is not an obstacle to organizational learning, this learning and constant improvement in OSH at advanced levels is achieved through overall organization processes, and is not an intrinsic characteristic of OSHMS [63]. Despite the importance that certification connected to OSHMS can have for companies’ OSH performance, many SMEs are still not aware of the importance of OSH and many have economic difficulties, reasons that are associated with non-certification [46]. OSH performance also appears to be lower in non-certified organizations [46]. Certification, then, particularly by way of OSHMS, may be a good indicator for SMEs OSH performance. Nevertheless, it should be used together with other indicators to ensure more reliable results because many employers tend to look at OSH simply as a legal obligation and an economic burden [8, 14].

Actions connected to OSH management are also important indicators of OSH performance. Companies should establish clear safety policies that include training and worker involvement in OSH [44] and develop working procedures and safety instructions that maintain and improve OSH [10]. Safety policies and procedures make it possible to improve organizations’ OSH performance [18, 44]. They are therefore fundamental parts of an organization’s social responsibility and have a positive impact on the organization itself because they can improve OSH performance and prevent accidents, improve attitudes and increase workers’ motivation, as well as deepening commitment to safety and, indirectly, improve financial performance [44]. However, Reinhold et al. [10], in a study on SMEs in Estonia, found that OSH management, particularly regarding occupational risks, is not in most cases included in organizations’ strategy and policy, and these data were obtained in interviews with top-level management and workers. Compliance with safety rules and standards is another important aspect, and greater knowledge about OSH issues among workers means more effective use will be made of safety equipment [48].

Worker involvement in organizations’ OSH decisions about the risks that workers face, as well as the way they are eliminated and minimized and the procedures to be borne in mind, was identified as having a direct, positive effect on workers’ safe behavior at SMEs, with important implications for OSH performance [18, 22].

Management involvement with OSH has been linked to satisfaction at work and organizational commitment [42]. Management commitment has a negative effect on occupational pressure and a positive effect on incentives and communication [48]. Organizational commitment, in turn, has a positive impact on organizations’ OSH performance [22, 44]. Workers’ perception regarding the organization’s positive attitude towards protecting their OSH interests means that they tend to reciprocate by complying with safety policies and procedures, safe behavior and greater organizational commitment [22]. However, managers of smaller companies often do not have the time or knowledge for interventions connected to safety performance in order to maximize the usefulness of implementing OSH measures [18]. Yet, workers at smaller organizations tend to feel that safety rules and procedures are more important and/or necessary and feel more involved in the OSH management process, identifying safety as a higher priority than workers at larger organizations [42]. Involvement of management and organizational commitment therefore form a good indicator of OSH performance.

Investment and the enterprises’ resources were also pointed out as important indicators to apply to SMEs. The smaller the size of the company, the less investment there is in OSH [8], mostly because of the lower resources available [8 , 23]. Investment in OSH should take place in terms of structural measures and PPE as well as in training [8].

Risk assessment, accident analysis and risk control were also pointed out in several studies as being important OSH performance indicators [8 , 44]. In one study carried out by Bonafede et al. (2016) [16], significant differences were found between SMEs and large organizations regarding the perception of OSH-related activities, with large organizations demonstrating a much more active attitude to the implementation of measures and confidence in their positive impact on OSH. However, in the workers’ understanding, lack of resources is one of the main obstacles to risk assessment, accident analysis and risk control [16]. Larger companies tend to carry out deeper, better quality risk assessments than smaller companies [8 , 16]. In the study carried out by Reinhold et al. [10], most SMEs involved demonstrated stances and procedures that contributed to OSH, specifically the existence of written working procedures and safety instructions, investigations of accidents at work, availability of PPE for workers and supervision of workers’ health. In another study involving only microenterprises, carried out by Boustras et al. [18], a significant relationship between the use of PPE and safety performance was found. Perception of the employer’s interest in OSH conditions and the development of policies and procedures for assessing and controlling risks demonstrates a positive impact on organizations’ OSH performance [18 , 44].

Risk communication and information were previous identified to be related to OSH performance [8 , 48]. Communication between managers and workers regarding OSH issues is an effective way of improving OSH [48]. Managers of smaller organizations demonstrate less willingness to improve OSH communication than managers at larger organizations [8]. Fernández-Muñiz et al. [48] found that communication positively influences the adoption of safe behavior and therefore has a positive impact on OSH performance [22].

Training is also seen in several studies as having a positive effect on OSH and on the existence of a safety culture at organizations [8 , 45]. Smaller organizations have less management involvement in worker training and less desire to improve training than larger organizations [8]. Worker training is, according to the Portuguese Labor Code (Article 131 of Law no. 7/2009 of 12 February 2009, amended by Law no. 8/2016 of 1 April 2016) an obligation for employers. However, SMEs have more restrictions on implementing training because of a lack of economic resources [14], and so measures such as the existence of worker training on OSH and the content thereof should be analyzed, together with the percentage of workers who have received training and the number of hours of training per worker.

The most commonly used indicators for SMEs are outcome indicators, based on occupational accidents and diseases, and there are several studies focusing on them [8 , 53]. Micheli and Cagno [8] found that the frequency and magnitude of occupational accidents tended to be greater in smaller sized companies in comparison with larger ones. Haslam et al. [42] showed that absenteeism tended to go in the opposite direction, with a higher absenteeism rate in larger organizations. This fact can be explained by smaller organizations’ tendency not to provide sick pay, which means that absenteeism rates due to illness are lower and workers work even if they are ill, which in the long term can lead to an increase in the number of occupational diseases [42]. Finally, one variable that cannot be excluded from the analysis of occupational accidents at and absenteeism is worker satisfaction, since it is conditioned by the absence of accidents and occupational diseases [48]. Additionally, albeit indirectly, safety performance, through worker satisfaction, has a positive effect on an organization’s competitiveness [48]. Nonetheless, quantifying this indicator retrospectively depends on the form of measurement used, since certain studies use organizations’ records [8 , 51] to make this analysis possible. Other studies use questionnaires instead [18 , 53], which makes retrospective analysis more difficult.

As well as the management and organization indicators already discussed, individual OSH indicators were also identified.

Risk perception has been also related to OSH performance [10], having influence in several other previously identified indicators such as safety training, risk communication, safety resources, risk assessment and risk control [65, 66]. As stated by Rodrigues et al. [3], misperceptions from both employers and employees may adversely affect OSH. Decision making about risk control measures can be dependent from the employers risk perceptions, leading them to spend their scarce resources on risks that may not be a priority. The lower frequency of occupational accidents in SMEs, due to its small size, can lead the employers to believe that risk in their own companies is under control [10, 42]. Risk perception was also found to have influence on employees’ behaviors, and consequently, the accident rates and the risk of developing an occupational disease [60 , 67–69].

Unsafe behaviors can also be considered a situation leading to future incidents, and detecting and correcting them in a timely way is essential. It is therefore a fundamental indicator for improving OSH [52]. Whenever necessary, employers should supply suitable PPE and collective protective equipment (CPE), as well as also inform workers about how they are used suitably and motivate them to do so [10]. Providing and using PPE and CPE has a positive influence on OSH performance, since higher usage rates tends to mean lower levels of risk to which workers are exposed, and so lower likelihood of workers suffering an accident at work or developing an occupational disease [10, 53]. There are several studies based on questionnaires and interviews with top-level management and workers, as well as direct observation, to quantify this measure [10 , 53]. Some care must be taken, because when interpreting it, opinions from the two groups may be contradictory [18]. This fact has been demonstrated by Boustras et al. [18] when finding that most employers at microenterprises involved in the study reported that they provided PPE to their workers and from their point of view the workers were willing to use the equipment. However, the workers in fact reported that they mostly did not use PPE [18].

Attitudes are also an important OSH indicator that has been analyzed in some studies [22 , 44]. Hadjimanolis et al. [22] found that workers with positive attitudes tended to reveal safe behavior by complying with OSH policies and procedures. The impact of positive work attitudes can translate into positive implications for employers and workers, such as the absence of accidents at work or occupational diseases [42].

Motivation and satisfaction at work have a positive effect on OSH performance [22 , 44]. Improving an organization’s OSH performance can therefore increase worker satisfaction and, furthermore, the company’s competitiveness [48]. In addition, safe behavior by workers and involvement in the company’s OSH management also improve worker satisfaction and help reduce absenteeism and the occupational accidents rate, since the workers feel like an important part of the organization and that their opinions and contributions are valued [48].

Age was negatively correlated with safety performance by Hadjimanolis et al. [22], i.e., the older the workers, the lower safety performance level. Because older workers consider that they have more experience and knowledge about occupational risks, tend not comply with safety procedures leading to lower safety performance. Additionally, older workers may have a decrease in cognitive system, health state, physical capacity and recovery capacity [70, 71].

5 Conclusions

This study made it possible to identify and discuss several OSH performance indicators applicable to SMEs regarding management and organization and regarding individual OSH. Regarding management and organization indicators, 14 were identified as indicators to assess OSH performance: personnel management policies; safety climate; certification in OSHMS; OSH policies; risk communication and information; organizational commitment; workers’ involvement; management’ involvement; investment/resources; risk assessment; accidents analysis; risk control; training (program and frequency); occupational accidents, diseases and absenteeism. In respect to individual OSH indicators, the following ones were identifies: risk perception; unsafe behaviors; attitudes; workers’ motivation regarding OSH issues and satisfaction at work; age. Indicators were discussed in relation to their reliability, being the ones that resulted from questionnaires and interviews found to be more subjective and more prone to bias. Indicators that resulted from observations, databases and other reports were discussed as more reliable. So, despite some limitations, the objectives initially set out for the study were met.

This study was limited by the fact that the search for scientific articles focused on papers that included SMEs from manufacturing sector, and so indicators potentially analyzed in existing studies found in other sectors may be lacking. It was also difficult to establish the connection between factors and their use as OSH performance indicators. Due to the limited number of studies focused into assess OSH performance in PMEs, studies that compared OSH among enterprises with different sizes of considering specific indicators were also included. It is therefore necessary to be cautious when generalizing them.

In terms of future work, it is important, based on the OSH performance indicators identified and discussed here, to carry out a study that makes it possible assess the real impact different factors, such as the economic factors on OSH performance at SMEs, so that measures can be found to practically help manage OSH performance at such organizations.

Conflict of interest

None to report.

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