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OCCUPATIONAL HEALTH DISPARITIES

different populations

Activities: NIOSH Funded Research Grants

NIOSH sponsors research and training through its extramural programs, which complement the Institute's intramural programs. More information is available from the NIOSH Office of Extramural Programs. Our Research Portfolio includes the following NIOSH-funded research grants:

Adapting the North American Guidelines for Children’s Agricultural Tasks (NAGCAT) for Ethnic Communities: A Research Model

Hmong children work or play alongside their parents in the field and at the market. Current English-language safety materials do not include many tasks Hmong children are doing and are in a format not understood by non-literate Hmong parents. The purpose of this research project was to investigate culture-specific health behavior patterns and develop culturally appropriate health promotion methods for Hmong farming families. Through field observations and other methods, the research team learned that the three primary hazards encountered by Hmong children include (1) rototiller operation, (2) use of knives and other sharp handtools, and (3) marketing activities (including money handling, lifting, and customer interaction). This research resulted in the development of three culturally and ethnically appropriate guidelines. Methods and procedures were documented and shaped into an algorithm useful in adapting safety guidelines on ANY topic for ANY age and ethnic group with slight modifications in ANY part of the world.

Contact: John M. Shutske, Ph.D.
University of Minnesota
shutske@umn.edu
Project Period: 2000–2004

Assessing and Controlling Occupational Health Risks to Immigrant Workers

Tufts University, in concert with its partners, the Immigrant Service Providers Group (ISPG) as the community-based organization and the Cambridge Health Alliance as the healthcare provider, will implement a 4-year, three-part program to address occupational health risks to immigrant workers in Somerville, MA. Somerville, known as a "gateway" community due to the diverse variety of immigrant populations and community organizations, as well as remarkable temporal shifts in its immigrant population, represents a unique laboratory for this activity. For example, this project leverages existing peer youth and adult educational training and advocacy programs for immigrants. These programs have been successfully implemented by members of the ISPG (Haitian Coalition, Latino Coalition, and the Community Action Agency of Somerville) on issues ranging from tobacco use to ambient environmental hazards. The proposal is to extend the impact of these successes in designing a sustainable, community-based capability to assess, characterize, and reduce occupational health risks in immigrant populations. Further, it is believed that the very structure and organization of work influences such key issues as immigrant empowerment and the sustainability of interventions aimed at lessening the impact of occupational injury, illness, and mortality. As a result, a pilot Green Cleaning Cooperative, to address occupational risks encountered by female immigrant workers engaged in domestic services, will be launched. This aspect of the project will leverage work of the Collaboration for Better Work Environment for Brazilians (COBWEB) project based at the University of Massachusetts Lowell and at the Brazilian Immigrant Center in Boston. Also, the Massachusetts Coalition for Occupational Safety and Health (MassCOSH) will be a key partner by contributing occupational content, materials, and training to this grant. The MassCOSH partnership establishes a link to another work and environment project based in Dorchester, MA. This proposed project builds upon past successes of the partners (peer leadership) and leverages investments made in nearby projects. An annual immigrant occupational assessment will be employed to identify needs and best practices in Somerville and actively pursued to disseminate this information to other cities and towns with substantial immigrant populations in concert with the Massachusetts Executive Office of Environmental Affairs and the Boston Public Health Commission.

Contact: David M. Gute
TUFTS University Medford Massachusetts
david.gute@tufts.edu
Project period: 2005-2009

Biomechanical Stability of Pregnant Women

Over 70% of pregnant women are employed. Pregnant women fall at a rate similar to that of women over the age of 70. The factors that contribute to this increased risk of falling are unknown, as little research has been performed to study gait and postural stability biomechanics during pregnancy. The purpose of the proposed research study is to investigate the changes to dynamic stability during level walking, stair ascent and descent, and perturbed stance in pregnant women. We hypothesize that, with advancing pregnancy, the following parameters will increase: the anterior position of the center of mass with respect to the base of support, the trial to trial intra-subject variability of selected gait parameters, the required joint torques, and the reaction time and response amplitude in response to a mild postural perturbation. Fifty pregnant women will be recruited to participate in this study. Data will be collected during each of the trimesters (2, 5, and 8 months). Fifty non-pregnant age and weight matched healthy women will serve as a control group, Women in the control group will participate in a single data collection session. An 8-camera video system interfaced with a force plate will be utilized to collect three-dimensional Kinematic and kinetic data of 10 trials of each subject during level walking, stair ascent and stair descent. A dynamic posturography system will be used to measure the subject's neuromuscular control in response to a mild perturbation during static standing balance. For the pregnancy group, a one-way repeated measures MANOVA will be performed for each dependent variable. A Tukey post-hoc analysis will be performed the significant values are present between visits. Additionally, to compare biomechanical stability of the pregnant women to the control subjects, a paired t-test will be performed on each dependent variable. Statistical significance will be considered at the probability level of p < 0.05.

Contact: Jean L. McCrory, PhD
University of Pittsburgh
jmccrory@pitt.edu Project Period: 2005 – 2008

Casa y Campo: Pesticide Safety for Farmworker Families

An estimated 4.2 million seasonal and migrant farmworkers and their dependents work across the United States. This population is largely minority (90% Hispanic), medically underserved, and at risk for a variety of environmental health problems. Casa y Campo is a community-university partnership of the North Carolina Farmworkers Project, Student Action with Farmworkers, and Wake Forest University School of Medicine that is working to reduce the environmental health risks of pesticide exposure among farmworkers in North Carolina. The Casa y Campo partnership has (1) conducted research to document knowledge and beliefs about pesticide exposure, to document exposure of farmworker children, and to document other environmental health concerns of farmworker families; (2) developed culturally appropriate materials and programs to reduce pesticide exposure among these families; and (3) developed materials and programs to better prepare healthcare providers to recognize, treat, and prevent pesticide exposure of farmworker families.

Contact: Thomas A. Arcury, Ph.D.
Wake Forest University School of Medicine
tarcury@wfubmc.edu
Project period: 2001–2005

Challenges to Farmworkers' Health at the US-Mexico Border

Challenges to Farmworkers' Health at the US-Mexico Border Broad, long term objectives are to establish community-based interventions to reduce these risks. Specific aims are to create a risk profile, disseminate results to the community, generate hypotheses on the relationship between border residence and health risks and formulate a ROI intervention. Health relatedness of project/relevance to mission of agency: The UA's Project EXPORT Center or Health Equality addresses health disparities through CBPR and works in a Hispanic community near the border. Our community partners are dedicated to improving farmworker health and protecting the human rights of all border residents. Research design/methods promote direct community participation in decision-making. The partner organizations, UA, Campesinos Sin Fronteras and Derechos Humanos, will join in problem definition, development of the research instruments, data collection, analysis and interpretation with broad community participation. A cross-sectional survey will be used to interview a randomized household cluster sample of farmworkers in three communities in south Yuma County. Another survey will be conducted at specific pick-up points for farmworkers who are not living in local households but may be commuting from a distance, living in their automobiles, living across the border or living in "colonias" not yet mapped. These surveys will collect descriptive data on farmworkers' health risks and order conditions that will be compared with national data available from the National Agricultural Workers Survey and the California Agricultural Workers Health Study. Results will be disseminated to the community as a basis for generating hypotheses on the relationship between border residence, work sites and the health risks of farmworkers. Rationale and techniques for pursuing goals: The border region experiencing increasing migration, the threat of terrorism and, consequently, intensive surveillance, Anecdotal evidence indicates that these conditions affect the health of farmworkers. Study techniques will engage the community in an analysis and dialogue on these issues, leading to innovative strategies for reducing health risks. Relevance of research to public health: Farmworkers at the border are overwhelmingly Hispanic, suffer from many health disparities compared with other Hispanics and non-Hispanics in the United States and live in families of varying residence status. The border environment may affect their health and their ability to obtain health care. This study will identify aspects of border residence that affect health and that can be addressed through educational and policy- related programs.

Contact: Joel Meister
University of Arizona
jmeister@u.arizona.edu
Project Period: 2006 – 2008

Effects of Aging on the Biomechanics of Slips and Falls

Injuries associated with slip and fall accidents pose a significant problem to industry, both in terms of human suffering and economic losses. Existing evidence has identified several aging effects related to slip and fall accidents, yet does not explain determining causes of older individuals’ higher likelihood of slip and fall accidents. In this study, intrinsic changes associated with aging (e.g., gait adaptation, musculoskeletal and sensory degradation) and their effect on the initiation, detection, and recovery processes of slips and falls were evaluated to answer the question of why older adults were exposed to a higher likelihood of slip-induced falls. The aim of the study was to investigate changes in walking and the ability to recover from slips associated with increasing age. The present study measured how deterioration of lower extremity muscular strength/ activation rate and sensory functions among older individuals affect several biomechanical parameters under normal and abnormal conditions.

Contact: Thurmon Lockhart, Ph.D.
Virginia Polytechnic Institute and State University
Lockhart@vt.edu
Project period: 2001–2004

Ergonomic Aspects of Older Workers' Postural Balance

The main purpose of this project was to investigate elderly (45-75 years) workers’ abilities and limitations with regard to the work-related demands and associated task and environmental risk factors. The risk factors investigated were task type performed (static and dynamic), environmental lighting, standing/walking surface slipperiness and inclination, and footwear hardness. The choice of risk factors and worker age groups was based on published epidemiological literature. Each worker’s postural stability was quantitated using both kinetic and kinematic measurement systems in a laboratory where he/she was randomly presented with the above-mentioned risk factors. In addition, each worker’s perceived sense of postural balance was measured and compared to that obtained by the objective measurements.

Contact: Amit Bhattacharya, Ph.D.
University of Cincinnati Medical College
bhattaat@uc.edu
Project period: 1999–2003

Etiology and Consequences of Injuries among Children in Farm Households: A Regional Rural Injury Study – 1999

The objectives for this study were (1) to identify risk factors for agricultural operation-related injuries to persons less than 20 years of age, using a case-control study design; and (2) to determine the incidence and initial consequences of injuries, for all persons, using an injury data collection system to serve as a basis for surveillance. Among 16,538 persons followed through 1999, approximately half were less than 20 years of age. Data for all types of injury events and demographics were collected for the two 6-month periods of 1999 by computer-assisted telephone interviews from a cohort of agricultural operation household members in a five-state Midwest region. Exposure data were collected simultaneously through a nested case-control study. Injury rates were adjusted for within-household correlation. Adjustment analyses addressed potential biases. Case-control data were analyzed using multivariate methods. Identification of the total injury burden for agricultural operations and risk factors for agriculture-related injuries suggest opportunities for interventions and further research.

Contact: Susan Goodwin Gerberich, Ph.D.
Regional Injury Prevention Research Center (RIPRC) and Center for Violence Prevention and Control (CVPC), Division of Environmental Health Sciences (EHS), School of Public Health (SPH), University of Minnesota (U of M)
gerbe001@umn.edu
Project period: 1998–2002

Evaluating Teen Farmworker Education: An Evaluation of a High School ESL Health and Safety Curriculum

The Teens Working in Agriculture English as a Second Language (ESL) curriculum is designed to provide teen agricultural workers with the knowledge and tools to protect their health and safety in the fields. The aims of this study were to assess whether high school students who participated in the curriculum would demonstrate increased knowledge and improved attitudes and behaviors regarding health and safety, and to assess whether a community-based intervention would increase outcomes even further. Using a quasi-experimental design, the research consisted of two intervention groups and a comparison group, and included more than 2,000 students from some of California’s key agricultural communities. Pre- and post-tests, focus groups, and interviews were used to evaluate the results among students, teachers, and parents. The study found that a school-based ESL curriculum is an effective intervention to reach and educate teen farmworkers. ESL classes can serve as a much needed access point for young farmworkers.

Contacts: Robin Baker, M.P.H., Labor Occupational Health Program, UC Berkeley and
James Meyers, Ed.D., Center for Occupational and Environmental Health, UC Berkeley
rbaker@berkeley.edu
Project period: 2000–2003

Evaluation of a School-Based Agricultural Health and Safety Curriculum: Work Safe Work Smart

Rural adolescents may be employed in both agricultural and nonagricultural jobs. The Work Safe Work Smart curriculum was designed to address the wide spectrum of occupational hazards experienced by rural youths. The goals of this study were to evaluate the effectiveness of the Work Safe Work Smart curriculum by measuring changes in knowledge, attitudes, and beliefs related to preventative behaviors and to promote dissemination and utilization of the curriculum in rural schools. A group-randomized study design was used to evaluate the curriculum in a sample of 38 rural Minnesota high schools. A pre-test and two post-tests were used to evaluate outcomes. Adolescents exposed to the curriculum showed significant changes in five of the seven outcome categories at the first post-test and one outcome at the second post-test. More than 12,000 copies of the curriculum (whole or parts) have been distributed on CD-ROM and via download from the Minnesota Dept. of Health website.

Contact: Allan N. Williams, Ph.D.
Minnesota Department of Health
allan.williams@health.state.mn.us
Project period: 2000–2004

Factors Affecting the Health of Employed Pregnant Women

Pregnant employed women may be at an increased risk for poor pregnancy outcomes and poorer postpartum emotional and physical health if they are exposed to high levels of prenatal occupational and home stressors. In this three-wave prospective panel study, 197 women employed full-time in nonprofessional occupations were interviewed at 28 to 40 weeks gestation, then again at 4-6 weeks (N=142) and 4-6 months (N=115) after their return to work postnatally. Data were analyzed via multiple regression with backward elimination. The findings have implications for changes in the organization of work for pregnant and postpartum nonprofessional women. Postpartum mental and physical health problems can lead to lost work time, low productivity, and increased use of health and community social services. Recognizing and trying to mitigate the effects of home and work stressors may reduce the drain on those resources, and, more important, improve the well-being of working mothers.

Contacts: Kathryn J. Luchok, University of South Carolina Arnold School of Public Health and
Lynne A. Hall, University of Kentucky College of Nursing (Co-PI)
kluchok@sc.edu
Project period: 2001–2004

Health Disparities Among Healthcare Workers

This study uses multidisciplinary methods to examine the work environment as a primary mediator of the effect of socioeconomic position on health. We will estimate the degree and frequency of exposure to health and safety hazards in a large population of healthcare workers in Northeastern Massachusetts and describe the context of these exposures within the organization and climate of the workplace. We will describe the general physical and mental health of participating healthcare workers and estimate frequency of musculoskeletal disorders, acute injuries (including interpersonal assaults), and symptoms of anxiety and depression. The persistence of health problems and a range of employment outcomes will also be assessed. Facility case studies will provide insights into the consequences of these health outcomes. By comparing multiple facilities and job groups, we seek to explain how the political economy of the work environment determines workers’ health.

Contacts: Craig Slatin, Sc.D., MPH, University of Massachusetts, Lowell and
Laura Punnett, Sc.D., University of Massachusetts, Lowell
Craig_Slatin@uml.edu
Project period: 2000–2006

Hispanic Construction Workers: Medical Expenditures, Fatalities, Injuries

In light of demographic changes in the United States, the construction industry is characterized by a large, young, and quickly growing Hispanic workforce, coupled with a sizeable and persistent difference in occupational fatalities between Hispanic and non-Hispanic construction workers. Protecting the safety and health of Hispanic workers is a critical challenge facing the construction industry. To address the NIOSH research priorities and examine this important focus area in construction safety and health research, we propose to conduct targeted research on this special at-risk population in our next 5-year plan. The specific aims of this project include (1) examining the safety and health status of Hispanic construction workers, (2) identifying disparities in safety and health and utilization of health services among Hispanic construction workers, (3) identifying major socioeconomic and work organization factors contributing to the disparities, and (4) developing intervention strategies. Four large national population-based survey databases will be used for the study, including the March Supplement to the Current Population Survey, the National Health Interview Survey, the Medical Expenditure Panel Study, and the Annual Survey of Occupational Injuries and Illnesses. The data analyses will be conducted in two parts, descriptive and analytic. In the first part, statistics will be calculated to illustrate the extent and nature of the problems and to test the hypotheses. In the second part, multivariate analyses will be conducted to determine how the independent variables interact and contribute to occupational health and utilization of health services among Hispanic construction workers. This study will provide important information about Hispanic safety and health, help people better understand this issue, and promote the development of interventions to improve safety and health for this subpopulation group.

Contact: Xiuwen (Sue) Dong
Center to Protect Workers Rights (CPWR)
(301)578-8500

IMHOTEP

The purpose of Project IMHOTEP is to increase knowledge, skills and research training of under-represented minority students in the areas of biostatistics, epidemiology and occupational safety and health. For the purposes of this program, under-represented minority students are African American/Black American, Hispanic/Latino, or American Indian/Alaska Native students. Students who are selected for the program participate in 11 weeks of intense research and data analysis with experts at the Centers of Disease Control and Prevention (CDC)/Agency for Toxic Substances and Disease Registry (ATSDR). At the outset of the program, students participate in two weeks of classroom training that includes introductory courses in epidemiology, biostatistics, and occupational safety and health, as well as an epidemiology home study course, computer based training, and hands on field experiences with CDC professionals. In the remainder of the program, students gain valuable work experience in processing, analysis, and presentation of data through the study of existing data sets from divisions of CDC, including the National Institute for Occupational Safety and Health (NIOSH). In 2000, OMH and Morehouse have a new cooperative agreement which the cost/intern increased from $7,500 to $10,050.

Office of Extramural Programs
404-498-2530

Jornaleros Unidos con el Pueblo (Day Laborers United)

Day laborers represent a socially marginalized community that endures a disproportionate burden of avoidable workplace hazards. The informal, temporary nature of their work and their limited social and economic resources increase the laborers' exposure to hazards and their sensitivity to the consequences of injury and illness. The field of environmental justice recognizes such affected populations have limited opportunities to name problems and inform decisions that affect their lives. This project aims to improve the day laborers' working conditions by increasing their social and economic resources and by influencing changes in the social and structural contexts that contribute to hazardous working conditions. The project builds upon an existing partnership involving San Francisco immigrant day laborers, community organizations, and governmental institutions responsible for immigrant worker welfare. The project used assessments conducted and strategies identified by this partnership. More specifically, through adapting a model process of communication for social change, the project will (1) will convene a community council as a space for dialogue among day laborers, their employers, community organizations, and participating research and governmental institutions based on mutual interests, equitable participation, and the goal for collective action; (2) prioritize, plan, and implement integrated and culturally relevant interventions to reduce workplace hazards; and (3) evaluate the changes in the collective capacity of day laborers, employers, and participating institutions resulting from the process. The proposed community council broadens the stakeholders represented in the existing partnership to employers and laborers. The project applies resources and structure to a participatory process of assessment, planning, intervention, dissemination, and evaluation conducted by the council. Interventions will be implemented that aim to address hazards faced by day laborers as well as the social factors and institutional structures that influence those hazards. The participatory evaluation will be in place from the beginning of the project implementation, recognizing a distinction between the capacity for achieving change and the actual achievement of change. Outcome indicators will be formulated to reflect changes in hazardous work conditions and their social and structural context and changes in the collective capacity of the community.

Contact: Rajiv Bhatia
San Francisco Department of Public Health
Rajiv.bhatia@sfdph.org
Project period: 2003-2007

JUSTA: Justice and Health for Poultry Workers

The overall goal of this project is to address the health disparities faced by immigrant Latino poultry workers in rural Western North Carolina (NC), through a partnership (JUSTA-Justice and Health for Poultry Workers) of community advocates, environmental health sciences, and healthcare providers. Workers in the poultry industry in the United States experience a disproportionate share of occupation-attributed musculoskeletal, skin, and respiratory disorders. Recent trends in this industry have concentrated the injuries in a worker population that is poor, minority, and comprised predominantly of immigrants. These workers are purposively recruited into jobs rejected by the local population, and lack the means to protect themselves from hazards. The exposures of workers also affect their families. To bring about greater social and environmental justice for these workers, the proposed work will have two loci: helping individual workers and their families to be more resilient to stressors and strengthening community-based organizations so that they can move toward social and regulatory change and justice. Community advocates, healthcare providers, and environmental health researchers will work together in this project to address five specific aims: 1) to encourage social action by Latino community-based advocacy groups in Western NC to effect policies that reduce the burden of occupational and environmental health disparities due to employment in the poultry industry; 2) to construct the foundation on which to base educational materials and communication strategies designed to prevent or reduce exposure to physical and social occupational stressors and their effects among Latino poultry worker families; 3) to develop culturally and linguistically appropriate educational materials and implement programs that will promote ways to prevent or reduce exposure to physical and social occupational stressors and their effects among Latino poultry worker families; 4) to develop educational materials and implement programs that will better prepare healthcare providers to recognize and treat with cultural competence illnesses related to poultry production and processing among immigrant families, and counsel families on ways to prevent or reduce exposure; and 5) to evaluate the process and outcomes of community participation in this project so that it can be used by other community-based organizations to engage community residents in efforts to reduce environmental and occupational risks in their own communities.

Contact: Sara A. Quandt
Wake Forest University Health Sciences
squandt@wfubmc.ed
Project period: 2004-2008

Nail Salon Hazards and Health Effects

Nail salon employees are potentially exposed to dozens of recognized chemical hazards including acrylates, solvents, and biocides in dust and vapor form, yet little is known of salon workers' total exposure or work environment conditions. Even less is known about prevalence of health effects in this population of mostly Asian immigrant women workers. We do know that exposure to the chemicals with which they work has been linked to asthma, dermatitis, cognitive dysfunction, and reproductive health hazards. Special barriers confront investigators in studying the nail work environment, including the small size of nail salon businesses and potential language and cultural differences between investigators and salon owners and workers. The proposed study, by a new investigator, aims to develop methods for a community-based, comprehensive investigation of both the technical and social issues related to the nail salon work environment and health hazard prevalence in salon workers. Through consultation with a research advisory group, site visits to salons, and in-depth and relationship-building interviews with stakeholders, the investigator will 1) design an exposure assessment strategy appropriate to the evaluation of nail salon work environments; 2) design a survey to assess occupationally-related health effects in nail salon workers; 3) pilot the exposure assessment strategy and health effects survey to evaluate feasibility and validity; 4) assess the social context of occupational health issues as they relate to nail salon work; 5) determine access strategies and build relationships to facilitate this project and a larger-scale study.

Contact: Cora R. Roelofs
University of Massachusetts, Lowell
Cora_roelofs@uml.edu
Project period: 2003-2006

New York Restaurant Worker Health & Safety Project

The mission of the New York Restaurant Worker Health & Safety Project is to improve working conditions of immigrant restaurant workers in New York City in order to reduce occupational injuries and illnesses. This mission requires fulfilling the following long-term objectives: 1) documenting existing job hazards, injuries, and illness in the restaurant industry; 2) developing feasible and effective model practices in ergonomics and work organization for restaurants; 3) creating a new understanding and leadership in occupational safety and health among immigrant restaurant workers; and 4) engaging restaurant owners, public health officials, and other decision makers in developing policies and practices that will foster restaurant occupational safety and health. To achieve these objectives, a set of interdependent activities is proposed, including: A) creation of a restaurant safety & health task force to govern the project; B) design and test of a set of improved ergonomic and work organizational conditions in a model cooperatively-owned restaurant; C) creation and training of occupational health promoters among interested restaurant workers and their subsequent use as teachers; D) quantitative, quantitative, and clinical assessment of the nature and extent of work-related hazards, injuries, and illnesses among restaurant workers; and E) a set of specific dissemination methods, including an employer technical assistance service, a restaurant industry summit, and publication of industry-specific health service and workplace guidelines. The consortium that proposes this work has essential elements that make program success likely— a restaurant workers' center (Restaurant Opportunities Center of New York), a community-based immigrant services organization (Latin American Integration Center), a university-based occupational health research institute (Queens College Center for the Biology of Natural Systems), and a public hospital (Elmhurst Hospital). A unique feature of this project is the opportunity (heretofore rare in occupational health) to design, evaluate, and modify a model commercial kitchen and restaurant to identify features that can minimize risk of injury and illness. Additional strengths include the prominence of the targeted population in the design, governance, implementation, and budget of the project and a dynamic, experienced, and highly complementary consortium.

Contact: Saru Jayaraman
ROC of New York
saru@rocny.org
Project period: 2005-2009

Occupational Health of Immigrants Working in Restaurants

The eating and drinking (E&D) industry is the third largest employment sector in the United States,and restaurant workers make up the largest proportion of E&D workers. It is estimated that E&D workers sustain more than 5% of reported nonfatal injuries nationwide. Washington State reports even higher rates with a 7.6% injury rate in 1999. The E&D industry, and in particular the restaurant industry, is one of the most common workplaces for Chinese immigrants. The primary purpose of this feasibility study is to explore and analyze the occupational experiences of Chinese immigrants who work in restaurants, with specific emphasis on work-related injuries and illnesses. The specific aims are to: (1) identify and describe the types of occupational injuries and illnesses that occur among Chinese immigrant workers; (2) describe Chinese immigrant restaurant workers' perceptions about work-related hazards and risks; (3) examine these workers' occupational health and safety knowledge related to such things as regulatory requirements, worker protection, and safe work practices; (4) identify individual and contextual factors influencing the occupational experiences of these workers; and (5) determine the optimal way to collect valid and reliable data about occupational hazards and risks among Chinese immigrant workers. The participants for this study will consist of a purposive sample of 20 Chinese immigrants whose primary employment is in the restaurant industry. Inclusion criteria include: (1) born in China, Taiwan, or Hong Kong; (2) over 18 years of age; (3) speak Chinese, Taiwanese, or English; and (4) have been working in restaurants for at least 6 months. An ethnographic approach that includes semi-structured interviews and participant observation will be used. The interviews will be used to learn about the participants' work-related experiences and to explore their knowledge and perceptions about occupational hazards and risks. The participant observation will be used to generate new questions and to supplement the information collected during the interviews. Additionally, a Demographic and Immigration Questionnaire will be used to collect demographic and immigration data, and a Demands of Immigration Scale will assess distress associated with the demands of immigration. A qualitative software program (Hyper RESEARCH) will be used for data management. An ecological framework will guide interview questions and analysis for this study; this framework provides a means to identify the full range of factors that affect the participants' occupational experiences.

Contact: Jenny H. Tsai
University of Washington
Project period: 2003-2006

Promoting Occupational Health Among Indigenous Farmworkers in Oregon

Promoting Occupational Health of Indigenous Farmworkers in Oregon: This proposal is detailing an issue that seeks to address a growing number of farmworkers in the United States that are coming from indigenous communities in Mexico. In addition to speaking languages other than Spanish, these workers have distinct cultural traditions, not shared by other farmworkers. This project aims to develop community-based strategies to address the health disparities of this vulnerable working population. A multidisciplinary project is proposed which includes partners with expertise in community advocacy, environmental science, provision of health services, and worker education. The investigators propose to develop greatly needed and innovative methods to improve the capacity of migrant farmworkers who speak indigenous languages to understand the hazards associated with agricultural work and practical ways to protect themselves, and to increase their access to health and social services. Specifically, this project aims to, 1) identify priorities for workplace safety education, interventions, and policy change for farmworkers speaking indigenous languages, health providers serving this community, and other community stakeholders; 2) build leadership and problem-solving capacity among persons speaking indigenous languages; 3) collaborate with community agencies, activists, and advocates serving indigenous workers to develop strategies to increase the workers' knowledge and use of resources on priority issues; 4) develop educational materials relevant to the health and safety of indigenous farmworkers and disseminate these materials via multiple mechanisms; 5) increase the agricultural community's knowledge of the needs of indigenous farmworkers; 6) develop sustainable programs to improve the health of this population and to create effective changes to address identified priorities; and 7) develop a successful partnership including representatives from the farmworker communities, health providers, and environmental scientists through this project.

Contact: Nargess Shadbeh
Oregon Law Center
nshadbeh@yahoo.com
Project Period: 2004 – 2008

Research in Training and Education in OHS

This application, from the Association of Occupational and Environmental Health Clinics (AOEC), proposes to continue and expand upon various OHS educational, informational, and surveillance activities undertaken for NIOSH over the past decade under cooperative agreements. These activities are a significant contribution to OHS in the United States. The investigator has been with the organization for 15 years and has overseen $11 million in grants. She and staff are all well-qualified to carry out the proposed work. The application is concise and clearly presented. The major strengths of the application are the applicant's record of conducting the proposed activities, the inclusion of an evaluation component for all activities, the production of educational materials and readily accessible OHS information, and the network of member clinics that serves both as a source of data and a source of OHS professionals to carry out the proposed current activities of AOEC including the OEM exposure coding system, the surveillance database, and the educational outreach to underserved populations is considered by the Committee to be relevant and innovative. The major weaknesses are the declining clinic participation in the surveillance database (being addressed) and the issue of assent and consent for children who are eligible to be included in the database. There also appears to be limited outcome and impact evaluation and lack of discussion about barriers to surveillance program implementation. The proposal describes a number of other OEHC activities that appear to be very beneficial to OEHC members. The Committee concluded that human subjects are involved and that the application fails to address the four criteria or provide justification for an exemption. Inclusion plans for women, children and minorities are acceptable. Overall, the application's strengths substantially outweigh its weaknesses.

Project Period: 2006 – 2008

Rutgers University Occupational Training and Education Consortium (OTEC) Latino Construction Worker Safety and Health Project

The Rutgers University OTEC in collaboration with the N. J. International Laborers Union (LIUNA) and New Labor (NL), a nonprofit membership-based organization of immigrant Hispanic workers, will conduct a 3-year study to evaluate the effectiveness of an innovative Spanish language safety and health education and training program for non-union Hispanic day laborers in construction.

This project will leverage the skills and resources of each of these organizations including the particular expertise in construction safety and health offered by LIUNA, OTEC's skills in developing and evaluating worker-facilitated, participatory safety and health training programs, and New Labor's experiences in pioneering interactive Spanish language training to develop and mobilize safety and health activists. Specific aims include the following:

  • Adding to the knowledge base about the safety and health needs of Hispanic day laborers through a baseline evaluation that compares union and non-union cohorts of Hispanic construction laborers.
  • Developing and delivering an industry recognized intervention (a Spanish language version of the OSHA 10-hour construction safety and health training program) to a minimum of 200 nonunion Hispanic day laborers over a 2-year period.
  • Evaluating the impact of the intervention.
  • Integrating the safety and health training program with OTEC and New Labor's ongoing safety and health and safety training activities with the targeted population.
  • Widely disseminating the training curriculum, evaluation data, and descriptions of the intervention.

Contact: Michele Ochsner
Rutgers/CPWR
(732)392-3780

Sustained Work Indicators of Older Farmers

This prospective panel study focuses on the family farmer, the most rapidly aging workforce in the United States. This special population suffers one of the highest rates of occupational injury and mortality. Specific aims are to (1) identify factors that influence the sustained work of farmers over age 50, (2) develop health profiles of older male and female farmers, (3) develop exposure profiles of agricultural tasks performed by older farmers, and (4) explore the sociocultural, family, and economic factors that influence the work practices and health of older farmers. Farmers in Kentucky and South Carolina (N=1,423) were enrolled in the study. Measures on sociocultural, health and behavioral, and work environment factors are being collected through five seasonal waves of surveys and annual focus groups. Findings from the study will be used to design occupational counseling appropriate to age, gender, race, and health and safety programs for aging farmers.

Contact: Deborah B. Reed
University of Kentucky College of Nursing
dbreed01@uky.edu
Project period: 2001–2006

Teaching Kids Safety on the Farm: What Works

The Teaching Kids Safety on the Farm: What Works study measured the impact on the rates of childhood agricultural injury of the active dissemination of the North American Guidelines for Childhood Agricultural Tasks (NAGCAT) to farm families. These guidelines were developed to help parents select age-appropriate farm tasks for their children and promote farm safety for children through increased awareness, simple behavioral changes, and increased adult supervision. In central New York State, 845 farm households with resident or working children were randomized to a NAGCAT intervention group or to a control group. Outreach educators visited each intervention farm household to explain, review, and leave a copy of the NAGCAT guidelines with the parent or adult employer. Control farms received a farm visit to collect baseline data only. Telephone surveillance was conducted every 3 months for both intervention and control farms for 21 months.

Contact: Anne Gadomski, M.D., M.P.H.
Bassett Research Institute, Cooperstown, NY
anne.gadomski@bassett.org
Project period: 2000–2003

Utilization of Health Services among Hispanic Construction Workers

In light of demographic changes in the United States, the construction industry is characterized by a large, young, and quickly growing Hispanic workforce, coupled with a sizable and persistent difference in occupational fatalities between Hispanic and non-Hispanic construction workers. Protecting the safety and health of Hispanic workers is a critical challenge facing the construction industry. To address the NIOSH research priorities and examine this important focus area in construction safety and health research, we propose to conduct targeted research on this special at-risk population in our next 5-year plan. The specific aims of this project include (1) examine the safety and health status of Hispanic construction workers, (2) identify disparities in safety and health and utilization of health services among Hispanic construction workers, (3) identify major socioeconomic and work organization factors contributing to the disparities, and (4) develop intervention strategies to reduce/eliminate the disparities and improve the safety and health of Hispanic construction workers overall. Four large national population-based survey databases will be used for the study, including the March Supplement to the Current Population Survey, the National Health Interview Survey, the Medical Expenditure Panel Study, and the Annual Survey of Occupational Injuries and Illnesses. The data analyses will be conducted in two parts, one descriptive and one analytic. In the first part, statistics will be calculated to illustrate the extent and nature of the problems and to test the hypotheses. In the second part, we will conduct multivariate analyses to determine how the independent variables interact and contribute to occupational health and utilization of health services among Hispanic construction workers. This study will provide important information about Hispanic safety and health, help people better understand this issue, and promote the development of interventions to improve safety and health for this subpopulation group.

Contact: Xiuwen (Sue) Dong
CPWR
(301)578-8500 ext.128

Wisconsin Childhood Agricultural Safety and Health Intervention

This project accomplished four specific objectives: (1) to learn about the work in the dairy and fresh vegetable market sectors in Wisconsin that children and adolescents typically performed and the musculoskeletal and traumatic injury hazards they faced; (2) to learn what has already been done to improve safety and health among working children and adolescents; (3) to evaluate practices that simultaneously increased profits and safety; and (4) to share the results with other state dairy producers and vegetable growers in an information dissemination intervention and evaluation effort. This research was adaptable on a wider scale and especially relevant to the "traditional agriculture" areas as well as elsewhere in the United States. The practices are easy for farmers to adopt because they can be both safer and more profitable.

Contact: Larry J. Chapman, Ph.D.
University of Wisconsin Biological Systems Engineering Department
ljchapma@facstaff.wisc.edu
Project period: 1997–2000

Work and Social Environments: Urban Youth and CVD Risk

This project accomplished four specific objectives: (1) to learn about the work in the dairy and fresh vegetable market sectors in Wisconsin that children and adolescents typically performed and the musculoskeletal and traumatic injury hazards they faced; (2) to learn what has already been done to improve safety and health among working children and adolescents; (3) to evaluate practices that simultaneously increased profits and safety; and (4) to share the results with other state dairy producers and vegetable growers in an information dissemination intervention and evaluation effort. This research was adaptable on a wider scale and especially relevant to the "traditional agriculture" areas as well as elsewhere in the United States. The practices are easy for farmers to adopt because they can be both safer and more profitable.

Contact: Sheila T. Fitzgerald
Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
sfitzger@jhsph.edu
Project period: 1998–2002

Worker Susceptibility to Mutagenic Risk

Special populations at risk for workplace-related health effects include workers with genetic susceptibility to the mutagenic effects of occupational exposures due to inherited variants of metabolism and repair enzymes. We have demonstrated that workers exposed to vinyl chloride (VC) experience an increased frequency of biomarkers of mutagenic damage (mutant ras-p21 or mutant p53) in a dose-dependent fashion. At any given dose, however, workers can experience none, one, or both of these biomarkers, suggesting that inherited differences may exist that account for these differences in effect from similar exposures. Restriction fragment length polymorphism techniques were used to analyze DNA from subgroups of VC-exposed workers with none, one, or both biomarkers of mutagenic damage for genetic polymorphisms in VC metabolism and repair enzymes. Workers with the polymorphisms would be anticipated to be more likely to have the biomarkers than similarly exposed workers without the polymorphisms and thus would be more likely to suffer from subsequent carcinogenic and other health effects of VC exposure. These workers could be targeted for more aggressive interventions to prevent these adverse effects.

Contact: Paul Brandt-Rauf, M.D., Sc.D., Dr. P.H.
Columbia University
pwb1@columbia.edu
Project period: 2001–2005

Work-related Injuries Among Immigrant Workers

Many foreign-born persons are employed in the most hazardous sectors of the U.S. workforce, including the agriculture, construction, and service industries. However, despite the fact that there are millions of foreign-born workers in the United States, research on work-related injuries and interventions to improve working conditions for foreign-born workers is limited. Several national surveys have been used to study a variety of health issues among immigrants in the United States; however, these national databases have not been fully utilized to study work-related injuries among foreign-born workers. Our long-term research goal is to study work-related injuries among foreign-born persons in the U.S. workforce. In this study, a large cohort of foreign-born adults aged 18-64 years will be constructed using data collected in the 1997-2002 National Health Interview Survey (NHIS) to study nonfatal work-related injuries among foreign-born workers. In addition, the NHIS data will be linked with data collected in the 1998-2003 Medical Expenditure Panel Survey (MEPS) to study medical care expenditures and sources of payments for treating nonfatal work-related injuries among foreign-born workers in the United States. The specific aims of this study are: (1) to compare the nature, frequency, and risk factors of nonfatal work-related injuries between foreign-born and native-born workers in the United States; (2) to examine the medical expenditures associated with nonfatal work-related injuries among foreign-born and native-born workers in the United States; and (3) to describe the sources of payments for the medical treatment of nonfatal work-related injuries among foreign-born and native-born workers by size of employer and type of industry. The proposed study is based on our previous research analyzing NHIS and MEPS data for injury research and its benefits from the team's extensive complementary experience in work-related injury prevention research and in the field of health outcomes research. Accomplishing the specific aims outlined in this proposal will ensure that foreign-born workers, industry, academia, and national public health professional organizations have current information about nonfatal work-related injuries among foreign-born workers in the United States. By expanding the knowledge base on work-related injuries among foreign-born workers, appropriate injury prevention programs can be developed and we move closer to achieving the NIOSH mission of promoting safety and health at work for all people.

Contact: Huiyun Xiang
Children Research Institute
xiangh@pediatrics.ohio-state.edu
Project period: 2006-2009

 

 
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