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Workplace Safety

UNDERSTAND THE UNDERLYING CAUSES OF INJURY TO IMPROVE RISK MANAGEMENT

By Workplace Safety

According to the U.S. Occupational Safety and Health Administration, 969 construction workers suffered fatal injuries while on the job in 2008, almost one-fifth of all U.S. workplace fatalities that year. Another 314,000 workers suffered non-fatal injuries. When four construction workers die every weekday, it is clear that the industry needs to improve its safety practices. Too often, however, companies take measures that treat the symptoms of the problem but not the problem itself.

Suppose a particular company is having frequent job site injuries. Management decides that workers need additional training on safe work practices. After the training, their loss experience improves, causing management to shift its attention elsewhere. Gradually, though, the losses begin to mount again. This time, management decides to invest in better tools. Loss frequency declines again, and again management focuses on other things, but eventually the injury rate climbs back up.

Management is baffled, so they decide that the problem is sloppy, inattentive work, and they lay down the law. Managers will make unannounced spot checks on job sites and discipline employees caught performing work unsafely. This puts the fear of God in the workforce, but it produces results: Injury rates dip again, though a few skilled workers pay for transgressions with their jobs. Satisfied that a firm hand has fixed the problem, management moves on. Sure enough, the injury rate bumps back up.

Managers are livid. “Maybe, they snarl, we should do away with your bonuses so we can pay for the higher Workers Compensation bills we’re getting.” Management instituted these bonuses to encourage workers to increase profits by doing more jobs in less time and spending less on each individual job. Now the workers are angry because they’ve busted their tails to finish as many jobs as possible but have failed to satisfy management. Management is angry because training, equipment, and threats did not solve the problem. What none of them see is that the bonuses are the problem.

The bonuses give workers a financial incentive to work as quickly as possible. If they finish early and move onto the next job, they get nice checks every quarter. However, speed, power tools, ladders, and a group of human beings are often not a combination conducive to safe work. When workers rush, they cut corners, lose focus on the task at hand, and get careless. The guy working on the roof who will get an extra $1,000 in the fall if the company finishes two jobs in July will knock himself out (sometimes literally) to finish the roof on Wednesday instead of Friday. This can lead to him hammering his fingers instead of the roofing nails. Management can buy him a nicer hammer and give him weeks of safety training, but if that extra $1,000 will cover the college tuition bill, none of those things will stop him from rushing through a job.

When confronted with risk management problems, construction firms need to look beyond the symptoms — banged up hands, sprained ankles — and look for the underlying cause driving the behavior that leads to these injuries. When they treat the problem (perhaps by creating new financial incentives for loss prevention), they will see lasting improvement.

CAUTION ON THE ROAD: HOW TO DEAL WITH AN AGGRESSIVE DRIVER

By Workplace Safety

Every driver needs to adhere to the rules of the road, and when driving is part of your job, there is added importance to the task. Driving for a living increases the amount of time you spend on the road each day which increases your likelihood of having to handle aggressive drivers.

What defines an aggressive driver?

Aggressive drivers are some of the most dangerous and reckless drivers on the road. They don’t just drive fast; they make aggressive maneuvers in their vehicles that put all other drivers and pedestrians at risk. Below are some examples of aggressive driving behavior:

  • Attempting to bully the person in front of them by tailgating and trying to get them to change lanes.
  • Passing that results in cutting other people off, as well as passing on the right or on the shoulder of the road.
  • Showing a blatant disregard for red lights, stop signs, yield signs, and crossing zones.
  • Displaying a general disregard and contempt for the safety and personal space of other cars and drivers.

When you observe an aggressive driver, the sharp and abusive way they operate their vehicle suggests that an angry person is behind the wheel. To further enhance this notion, most aggressive drivers yell, flash their lights excessively, make volatile and aggressive hand gestures and honk their horns at other drivers. Make no mistake that an aggressive driver is a dangerous driver whose behavior is completely unpredictable.

How do you handle aggressive drivers effectively?

The first thing to remember when facing an aggressive driver is not to turn into an aggressive driver in response. Never attempt to teach the aggressive driver a lesson or punish them by thwarting their efforts to pass you or by increasing your speed. Similarly, do not try to keep them penned in behind you or beside you. Instead, make safety your first priority and let them pass you by. You are better off behind an aggressive driver than you are in front of one.

As an aggressive driver passes you by, they might make certain offensive hand gestures or yell things to which you feel compelled to respond. Resist the temptation to respond. Always act in a professional manner and treat all other drivers, even the aggressive ones, as you would any company customer. Remember that aggressive drivers are irrational (at least, while they are aggressive) and responding to them, even politely, can escalate the situation. Simply ignore what they are doing, and refuse to make eye contact.

Be sure to take note of the make and model of an aggressive driver’s car, as well as their license plate number, if you are able. When you are in a safe location and no longer driving, call your local authorities and report the driver. If the driver is acting especially dangerous and erratic, you might want to pull over into a safe, public area and call the authorities immediately.

Remember, vigilante justice does not pay. Your primary goal should be on your safety, and the safety of other cars around you. Let the local authorities deal with the aggressive driver and keep your focus on remaining safe and productive.

CONDUCT INSPECTIONS AND TRAIN EMPLOYEES TO PROMOTE SAFETY WHEN USING HEAVY EQUIPMENT

By Workplace Safety

Safety is a concern in every workplace. It might come as a surprise to some employees that their own safety, as well as the safety of their coworkers, is not reliant on the mechanical health of company equipment alone. In fact, the way you handle the training your company provides to you, as well as the safety guidelines of the workplace, go just as far to ensure safety as properly working equipment does. Let’s examine the three main components of workplace safety and the conservative guidelines that should be followed in each.

Safety Component One: Equipment Safety

  • Make sure that equipment is inspected each day before it is used. Some of the items to look for include:
    • Are the headlights and taillights functioning properly?
    • Do the reverse lights and sounds work?
    • Do the brakes (including the emergency brake) work?
    • Is the windshield free from any obstruction?
  • Ensure that the equipment is maintained on a regular schedule. Your company should have a routine maintenance schedule for all heavy equipment. Be certain to adhere to the schedule.
  • Be aware of new problems. If you are the normal operator of a piece of equipment and notice that it is not behaving as efficiently or it’s in a state of disrepair, bring your concerns to the attention of your supervisor immediately.
  • Always use the equipment as you were trained to and in a manner consistent with what the equipment was developed for.

Safety Component Two: Training

  • If you use heavy equipment, make sure you fully understand how to use it and inspect it. If you believe your prior training is insufficient, make sure to mention that and ask for additional resources.
  • Stay up-to-date with the various hand signals that OSHA requires crane operators and signal men to utilize. Realizing that you’ve forgotten some of the signals right as you need to use them is extremely dangerous. If you were to communicate the wrong message, you could be putting yourself and others at serious risk.
  • Take all workplace training seriously and always pay attention to the task at hand.

CLEAN AND TIDY WORKPLACE MAY BE MORE CRITICAL THAN YOU THINK

By Workplace Safety

Good housekeeping is the first step to a safe workplace. Although vehicular maintenance and equipment safety are important issues, it is also necessary to pay attention to the little things that are often overlooked, like general workplace cleanliness. General cleanliness encompasses the day-to-day duties that every employee handles during the work hours — from keeping the sink clear of sharp knives to putting away materials that are no longer in use. Although you might chalk up many of these actions as common sense, you would be surprised by how many accidents are caused by a general lack of cleanliness.

Step 1: Pay Attention to the Floors

Employee trips and falls are painful, expensive and can result in a loss of mobility that impacts the employee’s life both on and off the job. Basic guidelines should be followed for workplace cleanliness and organization, to minimize the possibility of accidents:

  • Keep floors clean so that they do not become slippery. Make sure to clean up tracked in water and mud, spilled chemicals and oil.
  • Place “Wet Floor”� signs on the floors when necessary. And when you observe these signs, avoid walking in that area by taking another route.
  • Clear all debris or piles from paths in your workplace. Stacks of paper, piles of loose tools, and anything that does not belong in a walkway should not be in a walkway.
  • Make sure equipment and materials used in your workplace have safe and proper storage places. The storage areas should not block walkways or impede travel throughout the building.
  • If you notice any loose floor tiles or carpeting, or protruding nails and screws, notify your maintenance department.
  • Walk in designated walkways. In factories, machine shops and other workplaces, taking shortcuts by walking in between machines and assembly lines can be perilous. Instead, use the designated walkways in your area.

Step 2: Prevent Potential Hazards

From chemical spills to falling objects, the potential hazards in any workplace are staggering. Safety is everyone’s responsibility. Keep these simple tips in mind each day, and you can help reduce the likelihood of injuries.

  • Do not stack or put away objects and materials so they overhang or stick out of the place in which they are kept.
  • Never pile papers or stack other objects so high that they become unstable.
  • Make sure pallets are always stacked in a neat pile with no pallets sticking out.
  • Keep a clear route to sprinklers, lights, electrical equipment, vents, fire alarms, and fire extinguishers.
  • Make certain hazardous chemicals are stored properly and in the correct, clearly labeled containers. Always keep them sealed according to factory instructions, and never leave them out where they can be tripped over or accidentally spilled.
  • Be sure to keep oil away from other debris.
  • Dispose of all chemicals and trash properly.

By practicing these good habits on a daily basis, you not only reduce the likelihood of an accident or injury, but you also create a cleaner, more efficient workplace that improves the attitude and energy level of everyone at the job site.

LEARN TO DRIVE SAFELY ON RAIN-SOAKED ROADS

By Workplace Safety

As a truck driver, there are many things you can control. You can control your steering and where you stop for the night. One thing that is out of your hands is the weather. Rain, sleet, hail and wind will all present themselves on different days to make your job more hazardous. The most often encountered adverse weather condition is rain, so learning how to drive safely in it, and prepare your vehicle for it, is vital.

Take Preventative Measures before the Rain

Your vehicle should be prepared for all kinds of weather, before you actually encounter that weather.

Here are some tips for readying your vehicle for rain:

  • Keep your windshield wipers in good working condition. Old windshield wipers do not provide you with a clean windshield that you can safely see through.
  • Make sure your tires are properly maintained. Tires that are properly filled and have deep tread will make rainy day driving much safer.
  • Test your headlights, turn signals and brake lights, and make certain all are working as they should. A non-functioning headlight is dangerous both at night and when it rains. The same applies to your brake lights and turn signals.

How to Drive Safely in the Rain

At the onset of rainy conditions, you should immediately change your driving style. Follow these guidelines to keep yourself and those around you safe:

  • Slow down and follow the three-second rule. Wet roads can impair the speed with which your vehicle comes to a stop. Take the extra time to slow down, and don’t follow the car ahead of you too closely. To begin slowing down, try taking your foot off the gas pedal rather than braking.
  • Choose the middle lane to avoid puddles in the left and right lanes.
  • Never drive through a puddle unless you can see the ground beneath it. If you have no choice but to go through a puddle without knowing how deep it is, make sure you go slowly and never go through a puddle deeper than the bottom of your doors. After driving through the puddle check your brakes before you begin traveling at faster speeds to make sure they were not adversely affected by the water.
  • If the rain becomes heavy and your visibility is severely limited, pull over and wait until conditions are better.
  • Try to drive in the tracks of the vehicle in front of you.
  • Always use your headlights and windshield wipers. If your visibility is restricted due to windows fogging inside the cab, turn up your defroster. You should also open your windows to improve the air circulation.
  • Use extra caution when driving through oil patches in the road since these can be especially slick.

How to React to Hydroplaning

There are times when the amount of water on the road accumulates and your vehicle can’ push it away from the tires. When this occurs, you lose connection with the pavement and end up riding on top of the water. This dangerous situation is called hydroplaning. Since you are driving on water there is no traction to be gained and you are simply gliding. This is extremely hazardous and requires immediate action:

  • Slow down by taking your foot off the gas. If you are driving slowly enough, the chance of hydroplaning is reduced. If you end up hydroplaning, further speed reduction is necessary.
  • Avoid using your brakes when hydroplaning since that could force your vehicle to skid and possibly jackknife.
  • Avoid turning your steering wheel. This too can cause a skid.
  • As you begin to slow down, your vehicle should come back into contact with the road. When this happens, you will feel more firmness in the steering wheel. At that point you can start pumping your brakes gently to slow down and you can also begin steering your vehicle to gain control.

TAKE A STAND AGAINST ALCOHOL AND DRUGS IN THE WORKPLACE

By Workplace Safety

Everyone is well aware that drinking and driving is a dangerous combination, but we also need to recognize that drinking and/or using drugs in the workplace is equally hazardous. Impaired workers might not be able to concentrate on the task at hand. Depending on your job function, an error could cause injury or even death to yourself or a co-worker.

All employees need to share the responsibility of workplace safety. If you know that a co-worker is impaired on the job, then you must report his or her condition to a supervisor immediately. If you choose to close your eyes to the situation, you could be putting yourself or others at risk of an accident or injury. Your supervisor will be able to assist the employee in finding a company-sponsored or community-based treatment plan. The critical thing to remember is that the workplace is no place for drugs and alcohol.

Key Points to Consider:

  • Difficulty in job performance can be caused by unrecognized personal problems, including addiction to alcohol or other drugs.
  • Help is always available to any employee who is struggling with substance abuse.
  • It is an employee’s responsibility to decide whether or not to seek help.
  • Addiction is both treatable and reversible.
  • An employee’s decision to seek help is private and will not be made public.

If your company offers an Employee Assistance Plan (EAP) and you or a co-worker seeks help through the plan, you can be assured that:

  • Conversations with an EAP professional — or other referral agent — are private and will be protected.
  • All information related to performance issues will be maintained in his/her personnel file, but data relating to treatment referrals will be kept separately.
  • Information about treatment for mental illness or addiction is not a matter of public record and cannot be shared without a release signed by the employee.
  • If an employee chooses to tell co-workers about his/her private concerns, that is his/her decision.
  • When an employee tells his/her supervisor something in confidence, supervisors are required to protect that disclosure.

TAKE PRECAUTIONS TO PREVENT HEAT-RELATED ILLNESS DURING THE LONG, HOT SUMMER

By Workplace Safety

Although the human body naturally cools itself, continuous exposure to extreme heat can overwhelm those mechanisms, leading to illness and even death.

The following are four types of heat-related ailments listed in order of severity (four being the most severe). Even a less severe condition can become more severe unless steps are taken to remedy the problem as early as possible.

  1. Heat Cramps – painful muscles spasms in the arms, legs, or abdomen, often with dizziness, weakness, and profuse sweating. Such cramps actually occur more often in well-conditioned people after prolonged heat exertion and are caused by the loss of sodium through sweating. Increasing daily sodium intake slightly during hot weather exertion can help prevent cramping.
  2. Heat Syncope – fainting caused when the body compensates for too much heat by diverting blood from the brain to the skin.
  3. Heat Exhaustion – extreme fatigue with muscle aches, nausea, and fever. Additional symptoms can include clammy skin, diarrhea, rapid pulse, vomiting, and weakness.
  4. Heat Stroke – failure of the body’s temperature control systems. Symptoms can include disorientation, agitation, hyperventilation, racing pulse, lethargy, convulsions, and eventually loss of consciousness. The body temperature rises to extremely high levels, sometimes above 110 F.

Helping a victim of heat-related illness:

  • Take the person out of the heat.
  • Loosen their clothing.
  • Apply cool, wet cloths (not freezing or cold) and/or soak the victim’s clothing with water.
  • Elevate the feet eight to 10 inches.
  • And, if the person is conscious and not vomiting, offer plenty of fluids.

Preventing heat-related illness:

  • Wear loose-fitting, lightweight, light-colored clothing.
  • Use sunscreen to prevent sunburn, which can hinder the skin’s ability to cool itself.
  • Wear a hat that provides shade and allows ventilation.
  • Limit vigorous activity during hot, humid weather.
  • Drink plenty of water — even more than you need to satisfy your thirst — before, during, and after exercise. Drinks with sugar and/or caffeine will not help; they actually rob your body of fluids. Alcohol causes you to lose more fluid than you consume.
  • Avoid hot, confined places. If you can’t, then work in shifts. Work a while, and then rest in a cooler place for a few minutes.
    Electric fans might provide comfort, but when the temperature is in the high 90s, fans will not prevent heat-related illness.
  • Some prescription and over-the-counter drugs can interfere with the body’s ability to regulate temperature. Discuss with your doctor whether any of your medications might have this effect and, if so, be especially careful to limit your exertion and drink plenty of water.

At the first sign of heat illness such as cramps, nausea, dizziness, or severe headaches, get away from the heat. Find a cool spot and rest for a few minutes and get some fresh air. Remember, it is easier to prevent heat illness than to treat it once symptoms develop. And always seek immediate medical help if you or a co-worker develops any of the symptoms described above.

STEER CLEAR OF DANGER WHEN OPERATING HEAVY EQUIPMENT

By Workplace Safety

Bulldozers, scrapers, and tractors, oh my! A jobsite crawling with heavy equipment can sometimes feel like a danger zone. However, with the proper heavy equipment safety guidelines in place, you can reduce risk on your jobsite and ensure your workers head home unscathed each and every day. There are three main ingredients to safe heavy equipment operation: Safe equipment, proper training and a safe attitude, and constant awareness of all jobsite activities. If heavy equipment operators are armed with these three tools, they’ll have no problem playing it safe. Read on to learn more about these and other essential safety factors for operating heavy equipment on the jobsite.

Play it safe with dependable equipment

The Occupational Safety & Health Administration (OSHA) puts a lot of emphasis on the safety features of heavy equipment. However, there’s much more to keeping equipment safe than just inspecting the machine’s safety features. After all, countless things can go wrong with this complex equipment, and these problems can lead to some major risks on the jobsite.

Therefore, it’s extremely important to create customized inspection checklists for each unique piece of equipment. Safety experts recommend that heavy equipment operators conduct a pre-operational walk around and pre-start up (in cab) inspection each and every day before they crank up.

During this inspection, the worker should ensure that service, emergency, and parking brakes are all functioning; headlights, taillights, and backup lights are operating properly; and that the horn is working. Of course, these are just a few of the items that should be included on the checklist. Employers should create customized checklists for each piece of equipment based on both OSHA guidelines and the information provided in the equipment operating manual.

Steer clear of jobsite dangers

Heavy equipment operators should be well aware of all jobsite activities so they can avoid any potential dangers. That’s why it’s critical for equipment operators to walk through site activity checklists daily. Here are a few obstacles and activities operators should stay on the lookout for:

  • Overhead lines: Many fatal occupational injuries occur each year in the U.S. due to contact between large jobsite equipment and overhead lines. That’s why equipment operators must exercise extreme caution when working anywhere near overhead power lines. Workers should assume that all overhead lines are energized, unless electrical utility authorities have indicated otherwise, and that they’re grounded visibly and marked appropriately. OSHA provides specific requirements for the safe use of equipment near overhead lines.
  • Barricades: Barricades must be used on any jobsite where heavy equipment is in operation. These barricades help to notify workers where equipment is in use so that they can stay out of the area and avoid serious injury.
  • Hand Signals: If a crane is operating on a jobsite, the crane operator and the signaler must know the hand signals that are required by OSHA. These hand signals can be used for other types of equipment, as well.

Ensure safety with well-trained workers

Of course, a jobsite is only as safe as its workers. That’ why it’s so important to employ only well-trained, safety-conscious workers for a heavy equipment jobsite. According to OSHA requirements, jobsites, materials, and equipment should undergo frequent and regular inspections only by “competent persons”� designated by the employer. It takes training to be a competent worker.

It’s extremely important to train your employees on proper equipment inspection and operation safety. After all, your workers’ lives could depend on it. For more information, visit the OSHA website at www.osha.gov.

STRESS THE SIGNIFICANCE OF SAFE DRIVING TO YOUR EMPLOYEES

By Workplace Safety

You most likely learned to drive many years ago, and haven’t looked back since you were sixteen. In fact, you probably haven’t thought a whole lot about your driving skills since you first learned to drive. What is important to realize is that your driving abilities, or lack thereof, can have a tremendous impact on your safety at work.

The No. 1 cause of death on the job is highway accidents, according to a 2007 Bureau of Labor Statistics study. Of the approximately 5,600 on-the-job fatalities in 2007, more than 2,300 were transportation-related incidents. In fact, many of the fatalities were salespeople headed to sales calls or someone out for an occasional trip in the company vehicle. Because of these grim facts, many employers are taking steps to reduce accidents by organizing driver’s training for some or all of their employees.

Not only do car accidents carry a heavy price tag in terms of dollars, but they also take an emotional toll on employees. Although offering a driving course to employees is an expense for an employer, the training might pay off in the long run. For example, some insurance companies offer discounts to companies who participate in driver’s training programs, which might offset those costs. Programs range from videos and workbooks to online classes, some of which are available directly from the National Safety Council. With the National Safety Council program, for example, employer’s can track which employees signed up for the online course. This way, an employer can individually reward an employee for participating in the program.

Teaching safe driving techniques is by no means a new concept. In the 1940s, Harold L. Smith marketed the Smith System to help prevent accidents before they happen. More than half a century later, the five basics of The Smith System are still taught to help drivers make good choices behind the wheel. The five basic tenets of The Smith System are:

1. Look ahead at least 15 seconds, giving you an opportunity to see a problem and make a decision before it’s too late.
2. Keep a 360-degree view of what is going on around your vehicle. Check mirrors every five to eight seconds to update yourself on what is happening.
3. Keep your eyes moving! Avoid staring straight ahead by looking around and maintaining your involvement in the road conditions.
4. Maintain space around your vehicle to provide an alternate way out in the event of a dangerous situation.
5. Seek eye contact with other drivers and pedestrians to make sure that you are seen in your vehicle.

Even if a formal driver’s safety course is not offered in the workplace, some common sense tips on being a safe driver can still be emphasized. Fatigue and technology are both potentially fatal when combined with drivers on the road. If you feel yourself getting tired, pull over – plain and simple. Don’t hesitate to ask someone else to drive or to locate a highway rest stop for a short break. In addition to fatigue, technology, cellular phones, mp3 players, PDAs can be deadly. Don’t make that important business call from the road, and don’t try to jot down notes from a meeting. Stop and get off the road to attend to business. It could be the most important stop you make all day.

Employers should also take the time to highlight the benefits of safe driving to the employees themselves. Although safe driving skills obviously benefit the employer, they also benefit the employee personally through reduced speeding tickets and fewer accidents and injuries. The costs associated with emphasizing safe driving are quickly outweighed by the benefits to everyone involved.

LEARN AND PRACTICE THE GUIDELINES FOR SAFE LIFTING TECHNIQUES

By Workplace Safety

According to the Bureau of Labor Statistics, more than 1 million workers suffer back injuries each year. In many cases, these injuries could have been prevented if the workers learned and practiced the proper lifting of heavy objects.

Learning safe methods of lifting and handling heavy objects can protect against injury and make work labor easier. Although these methods might take a while to get used to, over time, safe lifting practices will become second nature.

Guidelines for Safe Lifting

Ask yourself the following questions before you attempt to lift an object:

  • Can I safely lift this object by myself?
  • Is the load too awkward or too large to handle alone?
  • Does the load have good grips or handles?
  • Is there anything present to obstruct proper lifting?
  • Might the contents of the load shift while being lifted?
  • Is there enough space in the work area for easy movement?

Practice the following heavy lifting techniques to protect yourself from injury:

  1. Place your feet at least shoulder width apart to maintain good balance. Keep your feet firmly planted, and try to distribute weight evenly throughout the soles of both feet.
  2. Utilize your abdominal muscles. You will reduce stress and strain on your back by tightening abdominal muscles before starting the lift.
  3. Bend from your knees. This will ensure that weight comes into the thighs and hips first, rather than the spine. Never lift with your knees locked because the hamstrings will tighten and lock the pelvis into an unbalanced position. Never bend from the waist. This improper practice puts tremendous pressure on the back. During the lift, keep your back straight, but not vertical.
  4. Tuck in your chin. Tucking your chin will help keep your back straight.
  5. Grip with your palms, not with your fingers. You are less likely to drop an object by gripping with your palms, as opposed to gripping with only the fingers.
  6. To start the load moving, use your body weight, and then lift by pushing up with the legs. By using your legs, you will fully utilize the strongest muscles in your body.
  7. To avoid strain on your upper back, keep the arms and elbows close to the body while lifting.
  8. Keep the load close to your body. Use your feet to change direction.
  9. Make sure you can see where you are going!
  10. To lower the object, bend the knees. Never stoop. Place the load on a shelf or bench and push it into position. Make certain your hands and feet are clear when placing the load.

Make a point to practice the above steps when lifting anything, even a relatively light object.

Don’t be afraid to ask for help. If the weight, size, or shape of an object is too much for one person, don’t take the risk. Instead, ask for assistance from one of your co-workers. Ideally, workers should be approximately the same size for team lifting. Designate one lifter to be responsible for control of the action to ensure proper coordination. If efforts are not coordinated among lifters, the risk of injury can increase.