Improving the prevention and control of hazardous substance exposures: a randomised controlled trial in manufacturing worksites.
LaMontagne-AD; Stoddard-AM; Youngstrom-RA; Lewiton-M; Sorensen-G
Occup Environ Med 2004 Nov; 61(11):e26
Background: New measures of exposure prevention activity were used to evaluate the effectiveness of a 16 month management focused intervention addressing hazardous substance exposures in manufacturing work settings. Methods: Exposure prevention efforts were assessed using a previously published rating scheme developed for this study.1 The rating scheme yields a set of measures of exposure potential and protection which are combined into an overall exposure prevention (EP) summary rating. A randomised, controlled design was used to assess intervention effectiveness. Fifteen large manufacturing worksites (mean of 721 employees) completed the 16 month intervention and follow up assessments (seven intervention and eight control sites). Analyses were conducted on the 107 production processes assessed at both baseline and final. Results: Patterns of improvement within the intervention condition were consistent with the intervention emphasis on upstream or source focused intervention, whereas patterns in controls were consistent with prevalent practice (more downstream). A mixed model analysis of variance showed greater improvement in EP ratings in intervention versus controls, but the effect was moderate and statistically nonsignificant. Conclusions: This methods development study has demonstrated that exposure prevention efforts in the manufacturing sector can be systematically assessed across the full range of hazardous substances in use, and that such assessments can serve both needs assessment and effectiveness evaluation functions. Findings suggest that more sustained or intense management focused intervention would significantly improve exposure prevention.
Hazardous-materials; Exposure-assessment; Risk-analysis; Analytical-processes; Occupational-safety-programs; Occupational-health-programs; Epidemiology; Statistical-analysis
Center for Community-Based Research, Dana-Farber Cancer Institute, Boston, MA, USA
Research Tools and Approaches: Intervention Effectiveness Research
Occupational and Environmental Medicine
Dana-Farber Cancer Institute, Boston, Massachusetts