Atlanta, GA: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, R03-OH-007840, 2009 Mar; :1-11
Background and Purpose: 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 percent 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; however, little is known about the specific work experiences of Chinese immigrant workers. This study used an ecological model to examine the experiences of Chinese immigrant restaurant workers and to identify factors that affect these workers' occupational health and safety. The ecological framework that guided this study consisted of four levels of influence: microenvironment, organizational, socio-community and macroenvironment. Methods: The ethnographic approach used for this study consisted of individual interviews, participant observations in full-service restaurants, and questionnaires. Eighteen Chinese immigrant workers in the Greater Seattle area of Washington State meeting the following criteria were interviewed: (1) foreign-born Chinese, (2) age 18 or over, (3) Mandarin (Chinese) or English speaking, and (4) had at least 6 months work experience in restaurants at the time of interview. Half of the participants were from China, four from Hong Kong, and five from Taiwan. The mean age was 48.8 years (SD=13.5). The years of working in restaurants at the time of the interview ranged from 10 months to 25 years (Mean=6.3 years, SD=7.6). Their roles included busperson, waitperson, cashier, dishwasher, food preparation assistant, cook, and restaurant owner. Each participant was interviewed individually. Questionnaires were collected to obtain demographic and immigration information, health status, and perceived stress levels from demands of immigration. The principles of ethnographic content analysis guided qualitative data analysis. Means and frequency were used to summarize the questionnaire data. Results: Adjustment to occupation and to language was the most stressful demands of immigration to the participants. Non-fatal injuries (e.g., cuts, small oil burns) or noticeable physical or psychological discomfort (e.g., pain in fingers, wrists, shoulders or knees; sore legs or back; sleep problems) were the primary occupation injury and illness experiences of the participants. Business volume, hierarchical worker structure, and needing to use English for communication with customers (psychosocial); extreme temperature, broken glasses or dishes, and noise from kitchen hoods (physical); slippery floor and repetitive motions from operating equipment (environmechanical); and bleach (chemical) were hazards emerged from the data. Psychosocial hazards were their biggest concern. No participant was aware of the material safety data sheets; neither did they receive formal safety training when they started the job. Factors influencing these workers' occupational safety and health included attitude towards the use of protective devices and attitudes about self-care (individual); nature of interactions with co-workers (microenvironment); level of management support and worker's roles (organizational); location of restaurant and existence of Chinese communities (socio-community) and racism and barriers to choice (macroenvironment). Implications: Chinese immigrant restaurant workers face multiple hazards at work and experience an array of psychosocial and physical health problems as a result of their exposure to these hazards. Multiple factors, ranging from individual to macroenvironment, influence these workers' exposure to hazards and health outcomes. To effectively address the occupational safety and health of Chinese immigrant restaurant workers, multi-level approach is recommended. For instance, public health should work with policy makers to ensure that work safety training is provided to these workers and the employers and also work with the employers and workers to ensure that health and safety measures are always properly used in restaurants. Chinese communities and advocacy groups should also be invited to be part of the problem-solving process. The latter, or the community-partnered approach, is particularly critical to the worker populations, such as Chinese immigrant restaurant workers, who are unusually vulnerable to exposures to hazards.
Injuries; Injury-prevention; Accident-prevention; Accidents; Accident-rates; Accident-statistics; Food-handlers; Racial-factors; Epidemiology; Statistical-analysis; Quantitative-analysis; Questionnaires; Demographic-characteristics; Sociological-factors; Age-factors; Stress; Musculoskeletal-system; Musculoskeletal-system-disorders
Jenny Hsin-Chun Tsai, PhD, ARNP, Department of Psychosocial and Community Health, School of Nursing, University of Washington, Box 357263, Seattle, WA 98195