EHS Today National Safety Survey 2015 Question Title * 1. What is your title? Question Title * 2. How long have you worked in the environmental, health and safety (EHS) field or had safety responsibilities? Less than 5 years 5-10 years 11-15 years 16-20 years More than 20 years Question Title * 3. How many people report to you? 0 1 to 9 10 to 19 20 to 49 50 to 99 100 to 249 250 to 499 500 to 999 1000 to 2499 2500+ Question Title * 4. What is your current salary? Less than $35,000 $35,000-$44,000 $45,000-$54,000 $55,000-$64,000 $65,000-$74,000 $75,000-$84,000 $85,000-$94,000 $95,000-$104,000 More than $105,000 Question Title * 5. For which of the areas do you have responsibility? (Check all that apply.) Emergency management Environmental compliance Ergonomics Fire Protection Industrial hygiene Occupational health Risk management Safety Security Wellness Workers’ Compensation Question Title * 6. What is your educational background? (Choose highest attained.) Attended high school High school graduate Attended college Baccalaureate degree Master’s degree Doctorate degree Question Title * 7. Check any of the certifications you currently hold: Certified safety professional Certified industrial hygienist Certified occupational health nurse Qualified environmental professional Question Title * 8. Describe your work environment: Corporate staff Division staff Government office/laboratory Plant/facility Worksite/construction site Educational institution Question Title * 9. How many EHS professional events did you attend last year? 0 1 2 3 4 5 or more Question Title * 10. How would you describe the EHS program in your facility/organization? World-class Very good Good Average Fair Poor Not applicable Question Title * 11. What is your top EHS goal this year? Addressing a specific safety issue (e.g., fall protection, lockout/tagout, etc.) Complying with new/existing regulations Getting employees fully engaged in safety Lowering our injury/illness rate Reducing our environmental footprint Winning an award for EHS performance None of the above Question Title * 12. Does top management in your organization provide active and visible support for occupational safety and health? Yes No Question Title * 13. Does your organization prioritize safety over production and/or other business demands? Yes No Question Title * 14. Do you use leading indicators to measure safety performance? Yes No Question Title * 15. If you answered “yes” to Question 14, please check all leading indicators that you track: Employee audits/observations Equipment/machinery maintenance Facility housekeeping Near-misses Overall employee engagement in safety Participation in safety committees Safety meetings Training Question Title * 16. Which of the following types of injuries/illnesses are you actively targeting in your organization/facility? (Check all that apply.) Back injuries Caught-in-between injuries Chemical burns/exposures Cuts, lacerations and punctures Fractures Repetitive-stress/musculoskeletal injuries Slips, trips and falls Sprains, strains and tears Struck-by injuries Question Title * 17. Compared to the previous year, did the budget for occupational safety and health in your organization in 2014-2015: Increase more than 10% Increase 1-10% Stay the same Decrease 1-10% Decrease more than 10% Not sure Question Title * 18. Which of the following programs are conducted in your facility/organization? (Check all that apply.) Eye, face and head protection Fall protection Foot protection Hand protection Hearing protection Respiratory protection Question Title * 19. Does your organization/facility have or make use of the following? (Check all that apply.) Distracted-driving policy Formal ergonomics program Formal safety communications (newsletter, intranet, etc.) Formal safety training/mentoring program Safety committees Safety motivation/incentives/recognition Workplace bullying policy Workplace violence policy Question Title * 20. Does your organization have a formal workplace wellness program in place? Yes No Question Title * 21. If you answered “yes” to Question 20, which of the following wellness components do you offer? (Check all that apply.) A gym or fitness facility Healthy on-site food options Nutrition education On-site medical checkups Weight-loss competitions Wellness incentives Question Title * 22. Do you regularly follow the news, updates, regulatory decisions, announcements and/or publications from any of the following agencies? (Check all that apply.) CSB EPA FMCSA MSHA OSHA NIOSH Question Title * 23. How would you rate David Michaels’ performance as OSHA administrator? Excellent Good Average Fair Poor Not Sure Excellent Good Average Fair Poor Not Sure Question Title * 24. In what area would you most like to see improvement in your organization/facility’s EHS program? Question Title * 25. What is the most frequent complaint that you hear from employees about your organization’s EHS program? Question Title * 26. What is the most common type of injury or illness you see within your organization? Question Title * 27. Can you share an example of a workplace EHS-related challenge that your company solved or improved in the last year? Question Title * 28. May we contact you for more information for our feature report on the National Safety Survey? Yes No Question Title * 29. If you answered “yes” to Question 28, please provide your contact information below: Name: Company: Email: Phone Number: Submit Survey