Occupational health among Latino workers: a needs assessment and recommended interventions.
Safety is seguridad: a workshop summary - communicating occupational safety and health information to Spanish speaking workers, May 29-30, 2002, San Diego, California. Washington, DC: National Academies Press, 2003 Jan; :129-150
The occupational health of Latino workers in the United States is increasingly being recognized as an important area for study as well as for public health and clinical intervention. From a public health perspective, this is an important issue to address for several reasons. The Latino population in the U.S. is sizeable (Table 1) and growing rapidly, especially in urban areas. Work-related diseases cause substantial morbidity and mortality and are amenable to public health primary prevention interventions, such as the elimination or reduction of the exposures that cause them. Secondary prevention interventions, in the form of surveillance and clinical services, are also an essential part of the public health approach to occupational health. Although occupational diseases can affect members of all racial/ethnic groups and socioeconomic classes, available evidence suggests that Latino workers, along with other minority workers as well as low-income workers, are at higher risk for occupational disease than other workers in the general population. This excess risk is probably due to over representation of Latino workers in the more hazardous occupations and industries. The resources allocated by the Government for workers' health are modest. NIOSH, OSHA, and BLS have budgets that are smaller by one order of magnitude than the budgets allocated to U.S. Federal agencies with comparable missions, such as the Environmental Protection Agency (EPA), and the Food and Drug Administration (FDA). These allocations have consistently proved inadequate to serve the needs of the U.S. workforce in general. Consequently, the occupational health needs of minority workers, e.g., African-Americans and Latinos, have been largely unmet with regard to targeted surveillance or primary prevention interventions. Primary Prevention is achieved by the elimination or substantial reduction of risk factors that are known to cause workplace death and disease. These interventions can only be successful with the full participation and cooperation of the groups affected by the hazards -- the workers and the companies. A first step is to quantify the dimensions of the problem through hazard surveillance, or collection of systematic data on the prevalence of workplace hazards and populations at risk, followed by specific recommendations for engineering interventions at the point of production to control risk factors. Hazard surveillance should precede disease surveillance for the purposes of primary prevention. Secondary Prevention involves the early medical diagnosis and treatment of injury or illness that is successful in achieving recovery and return to work. The data on specific types of morbidity caused by the work environment in the Latino population are very limited, and many Latino workers lack access to available clinical occupational health services. As a result of this lack of epidemiological and surveillance data, programs providing clinical occupational health services to Latino working populations have not been developed adequately. This vicious cycle of no services > no data > no services can be broken by simultaneously developing epidemiological research and surveillance methods that will effectively include Latino workers and providing clinical occupational health services accessible and targeted to Latino working populations. A related topic of growing interest in public health for the Latino population is Environmental Justice (sometimes considered from the perspective of "Environmental "Injustice"). Environmental Justice has focused on the observation that air pollution; hazardous worksites; hazardous waste dumps and other sources of environmental pollution are likely to be sited in close proximity to communities of color (Frumkin et al., 1999). There are no systematic, reliable sources of data on occupational diseases in the U.S. working population (Herbert et al., 2000). Recent peer-reviewed estimates of occupational morbidity and mortality experience for the general U.S. population (1992), not differentiated by race, are substantial (Leigh et al., 1997). Based on the best available denominator data for the U.S. working population, we developed an estimate of the numbers of occupational disease deaths and new cases among Latino workers in the U.S. Next, using U.S. and New York City aggregate data, we will see that Latino workers are disproportionately employed in the more hazardous occupational categories and under-represented in the less hazardous categories.
Occupational-hazards; Racial-factors; Demographic-characteristics; Worker-health; Surveillance-programs; Health-care; Risk-factors; Data-processing; Information-systems; Occupational-health-programs; Occupational-safety-programs; Training
Rafael Moure-Eraso Professor, Department of Work Environment University of Massachusetts, Lowell One University Avenue Kitson 200 Lowell, MA 01854-2867
Safety is seguridad: a workshop summary - communicating occupational safety and health information to Spanish speaking workers, May 29-30, 2002, San Diego, California
National Academy of Sciences, Washington, DC