Exploratory Study for the Adaptability of Trust Leading Indicator and Proactive Leading Indicator Based on Prevention Culture

Abstract

Background

This study explored the applicability of the Trust Leading Indicator (TLI) and Proactive Leading Indicator (PLI), developed as part of the Vision Zero, a global campaign for the dissemination of prevention culture, in Korean industries. The relationship between these indicators and safety culture-related variables were compared, such as safety climate, safety behavior, risk perception, and accident experience.

Methods

The study sample comprised 630 workers from 12 subcontractors affiliated with the Republic of Korea's large manufacturing plant. Correlations among the main variables were examined, including group differences in TLI and PLI based on subjective accident experience.

Results

The TLI and PLI had significant positive correlations with the sub-factors of safety climate and safety behavior and negative correlations with risk perception, indicating their potential utility as extensions of existing safety culture indicators. A significant difference in TLI and PLI was observed across accident experience levels.

Conclusion

Despite limitations, such as the predominance of male workers in the study owing to the nature of the industry and use of subjective accident experience rather than official industrial accident data, this study is significant as it explores the applicability of the two leading indicators of prevention culture in Korean industries, confirming the potential utility of these indicators across various cultural contexts and contributing to global efforts to disseminate a prevention culture.

1. Introduction

The Republic of Korea's enactment of the Serious Accident Penalties Act (January 2021) and announcement of a roadmap to reduce serious industrial accidents (November 2022) are national efforts to prevent industrial accidents. However, the Republic of Korea's industrial accident fatality rate remains very high among the Organization for Economic Cooperation and Development countries (5th out of 38 countries), with the rate stagnating at 0.4–0.5‱ in recent years [1]. This indicates the need for changes in the Republic of Korea's occupational safety and health management system. Accordingly, the Korean government's roadmap for reducing fatal accidents has included a nationwide campaign to internalize safety culture, emphasizing a Korean-style safety-culture evaluation index. Safety culture refers to the underlying assumptions, values, and norms about safety in the workplace that are embodied in an organization's policies, procedures, and practices, and influence employees' attitudes toward safety and related behaviors [2,3]. This is consistent with growing interest in a new safety and health paradigm, as companies strive to establish and comply with safety regulations and procedures but are questioning why accidents occur and recognizing that the decision-making climate and risk-taking behaviors are the main causes of accidents [4].

With the Republic of Korea's growing interest in promoting a safety culture in the workplace, research on prevention culture at the international level has been conducted since the Seoul Declaration of 2008 World Congress on Safety and Health at Work. In a prevention culture, which is a more comprehensive approach than a safety culture, safety and health target all stages and areas of life, including traditional risk prevention, workplace health promotion, and reintegration care. Prevention culture is based on a common understanding of the value of safety and health and prescribed laws and guidelines so that it can be integrated into individuals' daily lives [5]. The International Social Security Association (ISSA) launched the Vision Zero (VZ) campaign, a holistic campaign that integrates safety, health, and well-being, under the premise that all accidents, losses, and illnesses are preventable [6]. The VZ campaign emphasizes prevention, integrating leading indicators such as leadership, worker engagement and empowerment, learning, and organizational culture as a long-term process to create a safe and an excellent working environment. It proposes 7 golden rules (Appendix 1) for implementation [7].

White [8], who conducted initial research on VZ's leading indicators, identified 10 such indicators, such as management commitment, visibility, and communication, including feedback loops et al In this context, two proactive studies are noteworthy: a Korean-German joint study to develop a Trust Leading Indicator (TLI) in the field of occupational safety and health from 2018 to 2020 [9,10] and a Proactive Leading Indicator (PLI) study to develop a common leading indicator to organize mutual learning based on the needs of companies and organizations worldwide for developing indicators in the context of ISSA's VZ Strategy [11]. A core activity of VZ is developing these leading indicators because the relationship between safety culture, occupational health, and safety outcomes in each country is not sufficiently clear [12]. Since the Seoul Declaration in 2008 [13], ongoing global efforts are discussing the leading indicators of prevention culture and related factors through the establishment of the International Section on Prevention Culture and the Global Forum of the 19th, 20th, and 21st World Congress on Safety and Health at Work.

Meanwhile, the International Strategy Conference on Occupational Safety and Health in Europe proposed a plan to develop a prevention culture in 2013 and identified leadership, participation, empowerment, and trust as key elements of prevention culture in 2016 [9]. A follow-up study on White's work was jointly commissioned by the Republic of Korea and Germany to develop TLI centered on the trust factor in a three-year international collaboration [10]. Trust is a leading indicator of a prevention culture. In occupational safety and health, trust is positively related to safety commitment [14], safety leadership [15], and safety culture [16]. Traditional attitude theory suggests that trust reflects intentionality that is manifested by a belief in the trustworthiness of others [17]. Intentionality may encourage an increase in related behaviors, such as facilitating the provision of sensitive information, because trust factors can shape behaviors that are difficult to develop through normal procedures [18].

Research has been conducted in the Republic of Korea on the development of trust indicators for certain occupations, such as for teachers (openness, competence, integrity, caring, trust, and closeness) [19]. In industrial workplaces, Jeong et al [20] studied the moderating effect of trust on leaders in relation to the influence of safety climate on safety behaviors, and the effect of safety leadership on organizational trust in construction sites was recently verified [21]. Studies of trust in industrial workplaces have primarily used research items from previous studies on general supervisors (three items) or organizational trust (nine items). To develop a leading indicator to measure trust in occupational safety and health beyond the occupation and object of trust in previous studies, a TLI was constructed using a preliminary questionnaire based on interpersonal and organizational trust, using Schein's organizational culture model and the seven golden rules of VZ (12 factors and 77 items). A preliminary survey of 353 workers and an additional main survey of 841 workers were conducted in the Republic of Korea. Through reliability testing, and exploratory and confirmatory factor analysis, a 20-item tool was developed, which included the four dimensions of competence, justice, care, and cooperation, reflecting the perspectives of occupational safety and health [10]. It was published in 2023 in the Republic of Korea to spread prevention culture as a global occupational safety and health activity [22]. In Germany, Trust Practice-Tools was also published based on Korean results [23].

The PLI was developed as a set of 14 leading indicators covering safety, health, and well-being through a multistage mixed-methods approach that included a literature review and industry inputs; qualitative evaluation of draft indicators through an online survey; quantitative evaluation through feedback from organizational representatives and key stakeholders; and a consensus-building process through an ISSA Steering Committee workshop [11]. The developed indicators satisfied Sinelnikov et al’s [24] criteria and were meaningful, transparent, easily communicable, valid, useful, timely, and actionable. The seven golden rules of VZ comprise two items each, and the indicators are organized to enable selection and utilization of a yes/no checklist (option 1), frequency estimation (option 2), or quantitative measurement methods (option 3), depending on the workplace size and capacity. An appropriate Likert-type frequency-estimation method is useful for international benchmarking across workplaces. The ISSA has developed and distributed a guidebook to facilitate developing PLI as a leading indicator [7] and introduced it recently in the VZHandbook, covering the comprehensive theory, technology, and management of VZ [25].

Although both indicators were developed based on the seven Golden Rules of VZ, further research is needed to verify if they are implementable across various industries in different cultures and their correlation with safety behavior and accidents at industrial sites. Clarke [26] found that a positive safety climate is associated with safety engagement and compliance and fewer accidents of reduced severity. A high level of risk perception is known to increase physical and mental fatigue, cause burnout, and decrease job engagement among workers [27]; this could increase the tendency to engage in risky behaviors and decrease safety motivation and behaviors. This pathway between safety climate and behaviors was significant among manufacturing industry workers with high levels of risk [28]. Additionally, risk perception had a significantly negative influence on workers' overall well-being, including job attitudes, engagement, and satisfaction [29].

As research on the antecedents of prevention culture in the fields of occupational safety and health in the Republic of Korea is unavailable, it is important to assess the applicability of these two indicators to Korean industrial sites as a strategy for spreading safety culture, thereby providing reference for future studies. Therefore, the purpose of this study assessed the feasibility of implementing the TLI and PLI and their relationship with existing safety culture measures through an exploratory comparison among Korean industrial workers.

2. Methods

2.1. Hypothesis

To promote a prevention culture, the following hypotheses were proposed to explore the applicability of TLI and PLI in Korean industrial sites:

H1

TLI and PLI will be positively related to safety climate and behavior.

H2

TLI and PLI will be negatively related to risk perception.

H3

TLI and PLI will differ by subjective accident experience.

2.2. Participants and measures

A survey was conducted in September 2020 among subcontracted workers at a large manufacturing plant in the Republic of Korea. The survey's purpose was explained to the workers before the survey, and printed questionnaires including a voluntary participation agreement were distributed and collected by the researcher with the assistance of the health manager.

In total, 630 workers from 12 subcontracted sites participated. A priori power analysis was conducted applying G∗Power version 3.1.9.7 [30] to determine the minimum sample size required to test the hypothesis. Results indicated the required sample size to achieve 95% power for detecting a small correlation (r = 0.20) conservatively, at a significance criterion of α = 0.05, was N = 319. In addition, Comrey and Lee [31] suggest sample sizes for scale development: 300 = good, 500 = very good, ≥1,000 = excellent. Therefore, the 630 participants in this study are a sufficient sample size to test our hypotheses.

Based on the demographic analysis (Table 1), 621 (98.7%) were male; the age distribution was 67 (10.7%) in their 20s, 185 (29.4%) in their 30s, 180 (28.6%) in their 40s, and 195 (31%) in their 50s and above. Among the participants, 300 (47.6%) had 10 or fewer years of work experience, 165 (26.2%) had 11–20 years, and 161 (25.6%) had 21 or more years; 189 (30%) were managers, 423 (67.2%) general workers, and 13 (2.1%) were either executives or above. Given the feature of medium and small size workplace, the 189 managers may also engage in office work.

Table 1.

Participants' demographic characteristics

Characteristics	Sub-group	Frequency	Ratio (%)
Sex	Male	621	98.7
	Female	7	1.1
Age	20s	67	10.7
	30s	185	29.4
	40s	180	28.6
	50s and over	195	31
Work tenure	Under 5y	154	24.5
	5∼10	146	23.2
	11∼15	97	15.4
	16∼20	68	10.8
	21∼25	55	8.7
	Over 25y	106	16.9
Position	Executive	13	2.1
	Manager	189	30
	Worker	423	67.2
Accident experience	None	387	61.4
	1∼2	139	22.1
	3 and over	99	15.7

To test H3, the participants were categorized according to the frequency of their subjective accident experiences. Based on the mean (1.34) frequency of subjective accident experiences, the zero-accident group had 387 participants, the low-frequency group had 139 (1–2 accidents), and the high-frequency group had 99 (3 or more accidents). Seven companies were below average in accident experience, and five were above.

The TLI comprises 20 items, with competence, justice, care, and cooperation as sub-factors [9,10]. The PLI comprises 14 items centered on the VZ core principles, with two questions for each principle [11]. A separate translation process was conducted to use the PLI in the Republic of Korea. Experts in psychology, safety, and health translated the items, and English experts reviewed the contents of the translated items. Finally, a member working in occupational safety and health verified the face validity. The PLI utilized the items presented in the guidebook's frequency estimation method (see Appendix 1 on TLI and PLI items).

To test H1 and H2, items for safety climate, safety behavior, and risk perception were used. Safety climate assessment comprises 22 items measuring management value, safety leadership, communication, education and training, and safety regulation and system. Safety behavior is divided into participation and compliance behaviors and includes eight items [28]. Risk perception encompasses cognitive and emotional risk perception and is assessed via six items [32]. All items were rated using a 5-point Likert scale.

In addition, demographic characteristics and the frequency of accident experience during the year prior to the survey were measured. The scales had adequate internal consistency, as evidenced by Cronbach's α values of 0.972 for TLI and 0.966 for PLI. Adequate reliability was demonstrated by the scales for safety climate (0.952), safety behavior (0.935), and risk perception (0.900).

2.3. Analytic method

The mean and standard deviation of the main variables were analyzed across the 12 workplaces. To test H1 and H2, the correlations between TLI and PLI and the sub-factors of safety climate, safety behavior, and risk perception were assessed. To test H3, mean differences between groups according to the level of accident experience as the dependent variables were tested using one-way analysis of variance (ANOVA) with TLI and PLI. Scheffé post-hoc tests were performed. The data were analyzed using IBM SPSS version 19.

3. Results

3.1. Descriptive statistics across workplaces

The means and standard deviations of the TLI, PLI, sub-factors of safety climate, safety behaviors, and risk perception were analyzed to determine upper and lower workplace groups (Table 2). To categorize the groups, we used the mean values of TLI and PLI, the main variables in this study, and categorized them as “low (Group 2)” if both mean values were lower than the mean. Group 2 consisted of three sites that had consistently lower means for TLI, PLI, safety climate, and safety behaviors, and relatively higher means for risk perception.

Table 2.

Means and standard deviations of the TLI, PLI, sub-factors of safety climate, safety behaviors, and risk perception

Group	M	TLI	PLI	Safety climate					Safety behavior		Risk perception
(n)	SD			Value	Comm.	Train.	Syst.	Leader.	Comp.	Parti.	Cog.	Emo.
Group 1	M	91.49	63.19	19.47	22.98	18.02	13.67	26.57	18.42	18.04	9.09	8.39
(470)	SD	9.55	6.73	1.99	2.78	2.32	1.81	3.44	2.03	2.29	3.26	2.59
Group 2	M	79.89	54.32	16.93	20.53	15.54	11.66	23.74	17.18	16.94	10.44	9.47
(160)	SD	15.01	10.13	3.07	3.84	3.28	2.53	4.29	2.55	2.50	3.27	2.54
Total	M	88.51	60.91	18.82	22.35	17.38	13.16	25.84	18.10	17.76	9.45	8.68
(630)	SD	12.58	8.86	3.08	3.32	2.87	2.24	4.01	2.33	2.47	3.55	2.83

Note. Value, management value; Comm., communication; train., education and training; Syst., safety regulation and system; Leader., safety leadership; Comp, safety compliance; Parti., safety participation; Cog., cognitive; Emo., emotional; TLI, trust leading indicator; PLI, proactive leading indicator.

3.2. Correlation among main variables

Correlation coefficients were calculated between safety climate, safety behavior, and risk perception, and the total scores of TLI and PLI (Table 3). A positive correlation was found between TLI and the sub-factors of safety climate, management value (r = 0.578), safety leadership (r = 0.655), communication (r = 0.741), education and training (r = 0.789), and safety regulation and system (r = 0.765). Positive correlations were also found between PLI and management value (r = 0.540), safety leadership (r = 0.621), communication (r = 0.704), education and training (r = 0.767), and safety regulation and system (r = 0.759). These two indices were also positively correlated with the sub-factors of safety behavior: compliance behavior (TLI: 0.543, PLI: 0.525) and participation behavior (TLI: 602, PLI: 0.598).

Table 3.

Correlations among TLI, PLI, sub-factors of safety climate, safety behaviors, and risk perception

Variable	Sub-factor	TLI	PLI
Safety climate	Management value	0.578	0.540
	Safety leadership	0.655	0.621
	Communication	0.741	0.704
	Education and training	0.789	0.767
	Safety regulation and system	0.765	0.759
Safety behavior	Compliance	0.543	0.525
	Participation	0.602	0.598
Risk perception	Cognitive	-0.228	-0.229
	Emotional	-0.330	-0.321

TLI, trust leading indicator; PLI, proactive leading indicator.

Both indices were negatively correlated with the sub-factors of risk perception (cognitive risk perception: TLI: -0.228, PLI: -0.229; emotional risk perception: TLI: -0.330, PLI: -0.321), indicating that higher levels of TLI and PLI were associated with lower levels of risk perception. Finally, a significant, strong correlation was observed between TLI and PLI (r = 0.816).

3.3. Differences between TLI and PLI according to accident experience

We tested for differences in TLI and PLI scores using the subjective accident experience level as an independent variable (Table 4). Levene's test was nonsignificant (TLI, p > 0.05; PLI, p > 0.05), signifying group homogeneity.

Table 4.

Analysis of variance for TLI and PLI by accident experience

DV	IV (Group)	M	SD	F	p	Eta2	Post-hoc test (Scheffé)
TLI	(1)None	88.75	12.52	6.857	0.001	0.028	(1) > (2)∗∗
	(2)Low	83.92	12.28
	(3)High	84.67	13.62
PLI	(1)None	61.41	8.66	12.470	0.000	0.050	(1) > (2)∗∗ (1) > (3)∗∗∗
	(2)Low	57.78	9.03
	(3)High	55.94	10.02

∗∗p < 0.01, ∗∗∗p < 0.001.

TLI, trust leading indicator; PLI, proactive leading indicator.

A significant difference was observed between groups on the TLI (F = 6.857, p < 0.001). Post hoc analysis confirmed a significant difference between groups 1 and 2 (p < 0.01). A significant difference was also observed between groups in PLI (F = 12.470, p < 0.001), with post-hoc analysis revealing noteworthy differences between groups 1 and 2 (p < 0.01) and groups 1 and 3 (p < 0.001).

4. Discussion

This study explored the applicability of TLI and PLI, which are leading indicators that were recently developed as part of a strategy to spread the prevention culture in Korean industrial sites. The study results are as follows:

First, the correlations between the TLI and PLI and previously used indicators were significant for all of the indicators, supporting hypotheses (1) and (2). This finding is consistent with Cox et al [16] and confirms the applicability of both TLI and PLI as an extension of the safety culture indicators across cultures and industries. A significant negative correlation was observed between risk perception and TLI and PLI. The correlation strength was lower than that of the safety-climate sub-factors. According to Oah et al [33], if risk perception is very low, people are more likely to engage in unsafe behaviors; however, if it is overly high, people are also more likely to engage in unsafe behaviors because of tension and fatigue. These risk perception characteristics may have led to the relatively weak correlations.

In particular, it is important to address not only the relationship between these indicators but also how TLI and PLI are distinguished from existing indicators in terms of discriminant validity. In regression analysis with safety climate sub-factors and TLI and PLI as dependent variables, variance inflation factor (VIF) values were all below 5 (VIF: 1.4–3.8), confirming the independence of indicators. Future studies should assess more diverse causal relationships between safety culture indicators and prevention culture indicators. These results are because the two indicators reflect the conceptual differences between safety culture and preventive culture. For example, the items of leadership in safety culture refers to praise, simple discussion, and autonomy. However, TLI and PLI refer to whether a leader is in the perspective of workers, whether a leader has honesty, or a will of a leader. This is because the concept of prevention culture reflects unconscious perceptions and basic assumptions such as values, attitudes, and self-esteem. In addition, while previous safety culture measurement tools have been developed for each country or industry, the TLI and PLI are based on national surveys. For example, the PLI utilizes data from companies in more than 20 countries and 20 sectors. Furthermore, while safety culture is specialized for preventing occupational accidents, the TLI and PLI are tools that also promote health and well-being. Therefore, the relative influence of each country and company's safety or health policies and support programs on safety culture and TLI or PLI may vary. For example, the impact of a company's health policy on TLI and PLI may be greater than its impact on safety culture. However, there is a lack of research on this, and comparative studies at the country or company level are needed.

Second, the analysis of group differences in TLI and PLI according to the level of subjective accident experience found that the accident-free group had significantly higher levels of both TLI and PLI, supporting hypothesis (3). This provides empirical evidence for the relationship between safety culture, occupational health, and safety outcomes as the leading indicator of VZ core activity. However, as Guldenmund [12] noted, the relationships remain somewhat unclear because accident data have a subjective component. Therefore, the implications of both indicators for occupational accident preventive activities are of interest.

This study has the following limitations. First, the study sample was statistically sufficient to test the hypotheses, but the demographic variables were limited by the fact that male workers accounted for 98.7% of the study population, a fact attributable to the nature of steel manufacturing workplaces. Future studies should consider industrial fields in which all genders are present in sufficient numbers.

Second, to identify the causal relationship between the two indicators and occupational accidents, we used the subjective frequency of accidents reported by workers as a criterion for categorizing the accident experience groups; however, these are not objective occupational accident data. This limitation may apply to other cultures, in which it is still difficult to obtain official accident data, even for research purposes. Nevertheless, these efforts must continue.

Third, although TLI and PLI are conceptually organized around the seven golden rules of VZ, an attempt to identify an exploratory factor structure for both indicators did not yield statistically significant results. There are several reasons for this, but the most important is that the 630 workers in the study were recruited from 12 different worksites, indicating that although they are part of the same contractor, there may be differences in the safety and health culture of each worksite. Therefore, future studies should go a step further than correlations and examine the factor structure of these two indicators in a single plant.

Despite these limitations, this is the first study to apply the two leading indicators, developed within the context of a globally encouraged prevention culture, to Korean industrial sites to confirm their utility. The practical significance of this study is that it confirms the potential applicability of these two indicators for companies to support the Korean government's recent national strategy to promote a safety culture. In addition, both TLI and PLI indicators have been identified as applicable in various cultures and industries, such as in Korean workplaces, as mentioned in the development process of each indicator. This means that the two indicators can be utilized to promote prevention culture, such as by comparing many workplaces, including those in the Republic of Korea and elsewhere in Asia. The participating workplace showed considerable interest because they expected the study to facilitate approaching existing variables such as safety climate, safety behavior, and safety perception in a new way, by focusing on the concept of trust and leading indicators of occupational safety and health. As mentioned in the introduction, it is clear that there is interest and demand for a new safety and health paradigm in workplaces at a practical level. Therefore, the two leading indicators are expected to be used voluntarily to diagnose and improve prevention culture in workplaces.

The Republic of Korea's prevention culture continues to require sufficient consideration, research, and practical application. Most importantly, it will require participation from workers and workplace safety and health professionals. The leading indicators, which are part of international efforts to promote a prevention culture will likely advance interest in occupational safety and health.

CRediT authorship contribution statement

Kyung Woo Kim: Writing – original draft, Formal analysis. Kwangsu Moon: Writing – review & editing, Writing – original draft, Data curation. Ji Dong Lee: Validation, Resources, Methodology.

Conflicts of interest

Authors declare that there are no conflicts of interest.

Appendix 1. The comparison of TLI and PLI centered on 7 golden rules

Vision Zero 7 golden rules	Items of TLI	Items of PLI
1. Take leadership (demonstrate commitment)	-Managers of our workplace carries out safety and health work from an employees' point of view. -Managers of our workplace make a safety and health decisions with their employees. -Managers of our workplace are open and honest to their employees.	-How often do leaders visibly demonstrate their commitment to integrating SHW in their work processes and behavior? -How often are new leaders selected based on their intrinsic motivation or proven record in SHW?
2. Identify hazards (control risks)	-Our workplace has its own competencies to ensure safety and health from hazardous and harmful work environment. -Members of our workplace consult with the manager about any difficulties or problems related to safety and health work, even though it could be disadvantageous to individuals. -Members of our workplace listen attentively to suggestions or issues about safety and health.	-How often are SHW risk reduction measures evaluated? -How often are reported unplanned SHW events followed-up by leaders for investigation, SHW learning/improvement, and feedback to those directly involved?
3. Define targets (develop programmes)	-Our workplace has a system to agree on and implement safety and health issues. -A system and processes related to safety and health at our workplace are fair. -Members of our workplace listen attentively to suggestions or issues about safety and health.	-How often are SHW an integrated part of induction processes? -How often are targeted programs and their SHW improvement goals evaluated?
4. Ensure a safe and healthy system (be well-organized)	-Our workplace has a process for giving feedback for safety and health. -Members of our workplace share a goal of ensuring safety and health at the workplace is a top priority.	-How often are SHW an integrated part of discussion in prework meetings? -How often are SHW systematically considered when planning and organizing work?
5. Ensure safety and health in machines, equipment and workplaces	-Safety and health policies and practices of our workplace follow a universal standard such as Occupational Safety and Health Act. -Members of our workplace sincerely take care of each other's safety and health.	-How often are technological or organizational innovations used to reduce SHW hazards and risks in the design stage? -How often is the promotion of SHW included in procurement processes?
6. Improve qualifications (develop competence)	-Our workplace provides systematic training and education to work safely and healthily. -Members of our workplace believe and support colleagues' efforts and behaviors on the safety and health. -Members of our workplace continually learn how to prevent accidents through the similar industry accidents case. -Our workplace considers building competencies for safety and health as an important value.	-How often are SHW covered in initial training? -How often are SHW covered in refresher training?
7. Invest in people (motivate by participation)	-Managers of our workplace understand and respect the pursuit of work-life balance for employee. -Members of our workplace do not discriminate based on age, gender, or origin. -A goals, regulations, and rules of our workplace related to safety and health fully reflect an ethical aspect such as a respect for the lives of employees. -Our workplace takes safety and health measures fairly, regardless of the type of employment such as subcontracting or nonregular employees.	-How often are worker suggestions for improving SHW followed up adequately? -How often are workers given recognition for excellent SHW performance?