Joseph Zanoni

Barriers and benefits of protective eyewear use by Latino farm workers

Abstract Agricultural work is one of the riskiest occupations for the eyes. Protective eyewear can prevent eye injuries in upward of 90% of cases. Latino migrant and seasonal farm workers (LFWs) are at particular risk of eye injury because of economic, social, and cultural barriers to safe employment. The goal of this project was to determine the perceived benefits and barriers to use of protective eyewear during agricultural work among LFWs. In the year 2000, 55 workers who spent at least part of their time working in Illinois and Michigan as seasonal, hired farm workers were interviewed either individually (9) or in six focus groups (46) regarding their perceptions of eye hazards and the factors that encourage or discourage the use of protective eyewear. Subsequently, safety glasses and training on eye safety were delivered by promotores de salud to LFWs from the same cohort over two summer seasons. During the second season, the promotores observed the use of safety eyewear by farm workers at least once per week on 17 farms over a three-month period. At each point of observation, the promotores asked those wearing the glasses why they chose to wear them and those who were not wearing them, why not. At both points of the study (pre-intervention interviews and post-intervention observations), the reasons for use fell into the following categories: protection from hazards, appearance, whether it was mandated/provided by the employer, and whether others used it. The reasons for non-use include perceived lack of protection, discomfort, undesirable appearance, interference with visual acuity, slowing down the work pace, and no mandate from employers. Since eliminating the eye injury hazard is not possible in most agricultural settings, administrative strategies and use of personal protective equipment are critical. Perceptions of the target audience, LFWs, should be used to develop a comprehensive eye safety program; this should include allowing LFWs to select a style from effective prototypes, providing eyewear and promoting/mandating its use in hazardous job tasks, and implementing a comprehensive PPE program for eye safety. In addition, addressing functional problemsfalling off, fogging, loss and forgetting glasses, the pace slowdown that reduces production and leads to lower wages for workersshould be addressed.

An interfaith workers' center approach to workplace rights: implications for workplace safety and health.

Background: Over the past decade, fatal occupational injury rates for immigrant workers have increased disproportionately, as have informal and precarious working arrangements. Workers’ rights centers have emerged as a response. Objective: This descriptive report characterizes an innovative approach to encourage immigrant workers to access federal and state occupational safety and health programs through an interfaith workers’ center. Methods: Existing data obtained by volunteers at time of intake were redacted and imported into a SAS database for secondary analysis. Statistical methods used to evaluate associations between outcome of interest and various characteristics included the &khgr;2 test of association, Fisher exact test of association, and multivariate logistic regression. Results: A total of 934 individual records were reviewed, although for any given item, missing data was a limitation. Among 780 persons reporting their primary language, 75% spoke Spanish, 19% Polish, 4% English, and 1% Other. The following total numbers of formal complaints were filed with each of the following agencies: 110 referred to the state Department of Labor (DOL), 123 to the federal Equal Employment Opportunity Commission (EEOC), 65 concerning federal violations of wages and hours, and 47 complaints with the Occupational Safety and Health Administration (OSHA). Approximately 37% of the OSHA complaints resulted in a measurable outcome, exceeding the average for all complaints. Conclusion: Workers’ most frequent concerns focus on pay and discrimination. Recasting occupational safety and health hazards as threats to income and as forms of discrimination may help identify hazards.

More than training: Community-based participatory research to reduce injuries among hispanic construction workers

BACKGROUND Workplace mortality and severe injury are disproportionately distributed among foreign born and Hispanic construction workers. Worker Centers (WCs) provide services and advocacy for low-wage workers and a way for investigators to reach them. The goal of this project is to prevent occupational injuries by increasing awareness of hazards and self-efficacy among foreign born, Hispanic construction workers and by expanding the agenda of WCs to include occupational health and safety (H&S). METHODS Investigators partnered with eight WCs in seven cities to train worker leaders to deliver a modified OSHA 10-hr curriculum to their peers. RESULTS Thirty-two worker leaders trained 446 workers over 3 years. There was a demonstrated improvement in knowledge, hazard identification, self-efficacy, and sustainable H&S activities. CONCLUSIONS This study provides evidence for successful implementation of a training intervention for low wage, low literacy Hispanic construction workers using a community-based participatory research approach.

Personal Care Assistants and Blood Exposure in the Home Environment: Focus Group Findings

Abstract Background: Exposure to blood and bodily fluids continues to be an important and life-threatening risk facing health care workers employed in traditional health care workplaces. Little is known about how blood exposure risk impacts personal care assistants (PCAs) who provide care in homes. Objectives: A National Institute for Occupational Safety and Health (NIOSH)-funded community based participatory research project between Service Employees International Union (SEIU), PCAs, and university-based researchers was conducted to increase the understanding of the risk of exposure to blood among PCAs. Methods: Six focus groups were conducted to assess the relationship between the context of work, blood exposure, and Results: Findings indicate that PCAs are exposed to blood even though they do not provide health care or treatment. Training and barrier protection may be available, but the quality of each was highly variable if available. Conclusions: Focus group findings will be used to implement a union-based participatory primary prevention intervention for the reduction of blood exposure among PCAs.

Co-Learning With Home Care Aides and Their Clients: Collaboratively Increasing Individual and Organizational Capacities

Changes in health care provide unprecedented opportunities for collaboration across research, education, and practice for the common goal of enhancing the well-being of older adults and their caregivers. This article describes how a pilot project, Promoting Seniors’ Health with Home Care Aides, has synergistic education, research, and practice effects that enhance individual and organizational capacities. This pilot is an innovative partnership with home care aides to deliver a safe physical activity program appropriate for frail seniors in a real-life public home care program. The intervention and research occur in older adults’ homes and thus provide rare opportunities for the research team and partners to learn from each other about dynamics of home care in older adults’ life contexts. Co-learning is essential for continuous quality improvement in education, research and practice. The authors propose to establish “teaching home care” to ensure ongoing co-learning in gerontology and geriatrics.

Implementation and Evaluation of Interventions for Home Care Aides on Blood and Body Fluid Exposure in Large-Group Settings

Participatory research conducted with academic, union and management cooperation resulted in the development, implementation, and process evaluation of interventions designed to reduce occupational blood and body fluid exposure among home care aides. Home care aides working for a large urban home care agency took part in the design and implementation of an interactive participatory training program conducted in large-group settings, and the development and evaluation of two training tools: an information card for home care aides and a sharps safety magnet for their clients. A process evaluation conducted immediately following the interactive training program found that 72 percent of the home care aides preferred it to lecture-style trainings typically offered, while only 9 percent preferred typical trainings. Home care aides were able to effectively articulate information learned during the interactive training program, with less than 2 percent providing inaccurate information about what was taught during the training. Home care aides overall responded positively to the information card and the magnet, with aides caring for clients who used sharps rating the tools as more useful. Participatory training programs can be effectively implemented in a large-group setting.

Latina/o Community Funds of Knowledge for Health and Curriculum

Community organizing brings Latina/o families together to enhance repertoires of culturally relevant practices to promote health and curriculum. The Healthy Schools Campaign, a 4-year environmental justice partnership between public health researchers and Latina/o organizations in 2 neighborhoods of Chicago, was formed to confront the epidemics of asthma and obesity in children that result in premature death. The partnership supported diverse organizing and addressed health inequity through inquiry with parents who created knowledge, took action, and reflected on outcomes in schools and in the community. Community funds of knowledge were created and exchanged through the processes of compromiso, confianza, and colaboración.

An Approach to Assessing Data Quality in an Area Probability Survey Using CBPR

Community-based participatory research (CBPR) approaches attempt to engage community members in all aspects of research conducted in the community. Proponents of CBPR suggest that among the many advantages to using CBPR is higher acceptance of and cooperation in research endeavors than is usually achieved through more traditional research approaches. Using secondary analysis of sample disposition data from two area probability surveys of the same community areas, one involving community interviewers in a fully collegial CBPR study and the other using professional interviewers, this study finds that data collected using CBPR techniques may lead to higher cooperation and lower refusal rates than data collected by professional interviewers. However, when compared to external population indicators such as census data, the sample produced by CBPR interviewers overrepresents certain population groups whereas the survey data produced by professional interviewers may underrepresent key population groups.

“Then They Trust You …”: Managing Ergonomics in Home Care

The home care workforce, already at 2.7 million caregivers, will become the nation’s fastest growing occupation by 2024 as the senior boom generation accelerates the demand for in home services to meet its long-term care needs. The physically challenging work of assisting clients with intimate, essential acts of daily living places home care workers (HCWs) at risk for musculoskeletal disorders (MSDs); yet, HCWs typically receive little formal job training and may lack appropriate assistive devices. In this qualitative pilot study, HCW focus groups described workplace MSD risk factors and identified problem-solving strategies to improve ergonomic conditions. The results revealed that HCWs rely on their behavioral insights, self-styled communications skills and caring demeanor to navigate MSD risks to themselves and increase clients’ physical independence of movement. We suggest changes in employer and government policies to acknowledge HCWs as valued team members in long-term care and to enhance their effectiveness as caregivers.

Evaluating goals in worker health protection using a participatory design and an evaluation checklist

Spanish-speaking immigrant workers in construction are considered hard to reach and at high risk for work-related injury and fatality. This evaluation study describes the use of participatory methods and an evaluation checklist to consider a health and safety (H&S) training program for these workers. A previously developed training manual and model were disseminated to eight worker centers (WCs) through participatory research collaboration. It incorporated H&S training for workers while strengthening the role of WCs as sources for leadership development and worker empowerment. Design, delivery, reaction, application, and extension were assessed through individual interviews with participants, trained trainers, and center staff and through observation of training sessions and partner debriefs; pre- and post-training tests assessed participant learning. Results indicate moderate learning and application by participants and strong evidence for structural gains in and among WCs. We conclude that such partnerships and models are valuable tools for collaborating with hard-to-reach workers.