Though its zero-harm programme was reducing accidents and illness, Johnson Matthey's group environment, health and safety team took time out to draw up new procedures for the company's tasks which, however infrequent, risked the severest injury. The team then audited the group's plants worldwide to check they were upholding the revised standards.
The drinks maker Diageo went through a similar process when it rea lised its zero-accidents initiative, which, like Johnson Matthey's was bringing down the injury total, had made no dent in its fatality rate.
As Diageo's governance manager, Aidan O'Donnell, put it: "The saying that if you look after the pennies the pounds look after themselves is not true in this case."
Its response was to develop a "severe and fatal incident prevention programme" with new rules controlling high-hazard activities such as work at height and workplace transport. These instructions were supported by increased funding for controls, including access equipment for work at heights over 2 m. They were also strictly enforced, without the "hearts and minds" approach often used to encourage safe behaviour when the stakes are lower.
The positive effect of the intervention on the major and fatal injury rate was almost immediate.
But it's easy to see how so many organisations have come to concentrate on counting the pennies.
Almost 100 years ago Herbert William Heinrich proposed the theory that for every 330 incidents involving workplace hazards, 300 will result in no harm, 29 will produce minor injuries and one a major injury or death.
There have been variants and refinements by other academics to this ratio -- often represented a s a triangle with the near-misses at the base and the single serious injury a t the apex -- proposing ratios that vary by industry or by hazard. Some have questioned whether the theory has any validity (the source of Heinrich's data is obscure), but it has stuck in the minds of many OSH practitioners.
It seems sensible that "sweating the small stuff", driving down minor accidents and near-misses, should not only cut total injury rates but should also drain the reservoir of hazardous acts that allows the worst to happen occasiona lly when all the gaps in an organisation's protective measures align.
But the experience of Diageo and others is that it's an approach that fails to deliver results where they are most critical.
Work to minimise low-level incidents is no bad thing but, if you make major hazard controls wait on it, you might be living on borrowed time.