Rosemary K. Sokas

An Intervention Effectiveness Study of Hazard Awareness Training in the Construction Building Trades

Objective. We evaluated knowledge, attitudes, and self-reported work practices among apprentice and journeyman trainees in two construction trades at baseline and three months after participation in two training sessions as part of a 10-hour Occupational Safety and Health Administration hazard awareness training program. We developed preliminary assessment of prior and current training impact, accounting for demographics, trade, and construction site safety climate. Methods. Participants were recruited prior to union-delivered safety training, self-completed a baseline survey prior to class, and completed a follow-up interviewer-administered telephone survey three months later. Discrimination (D) testing evaluated knowledge questions, paired t-tests examined differences in pre- and post-intervention knowledge, and attitude responses were tested with the Wilcoxon signed rank test. Linear regression analysis and logistic regression were used to assess the contribution of different categorical responses to specific sub-questions. Results. Of 175 workers completing the baseline survey, 127 were born in the U.S. and 41 were born in Mexico; 40% of those who reported ethnicity were Hispanic. Follow-up surveys were completed by 92 (53%) respondents and documented significant increases in both fall safety and electrical safety knowledge. The most recent safety climate was associated with improvement in fall safety attitudes (slope = 0.49, p<0.005) when adjusted by country of birth (slope = 0.51, p<0.001). Workers born in Mexico had less formal education than U.S.-born workers and lower baseline knowledge scores, but more positive attitude scores at baseline and greater improvements in attitude at follow-up. Conclusion. Knowledge and attitude improvement following a one-hour safety class was measurable at three months in both U.S.-born and Mexican-born construction workers.

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.

Evaluating the association of workplace psychosocial stressors with occupational injury, illness, and assault.

This research project characterizes occupational injuries, illnesses, and assaults (OIIAs) as a negative outcome associated with worker exposure to generalized workplace abuse/harassment, sexual harassment, and job threat and pressure. Data were collected in a nationwide random-digit-dial telephone survey conducted during 2003–2004. There were 2151 study interviews conducted in English and Spanish. Analyses included cross tabulation with Pearsons Chi-Square and logistic regression analyses. Three hundred and fifty-one study participants reported having an OIIA during the 12 months preceding the study. Occurrences of generalized workplace harassment (OR = 1.53; CI = 1.33–1.75, p ⩽ 0.05); sexual harassment (OR = 1. 18; CI = 1.04–.34, p ⩽ 0.05); and job pressure and threat (OR = 1.26; CI = 1.10–1.45, p ⩽ 0.05) were significantly associated with reporting an OIIA. The psychosocial environment is significantly associated with an increased risk of OIIA. Further research is needed to understand causal pathways and to explore potential interventions.

Occupational risk factors for blood and body fluid exposure among home care aides.

This cross-sectional study of home care aides examines self-reported occupational exposure to blood and body fluids to determine if factors that place these workers at risk can be identified. Home care aides working for two agencies in the Chicagoland area were surveyed. A total of 62 (6.3%) of the home care aides reported instances of blood and body fluid exposure either via sharps or mucous membrane contact. Although few aides reported performing health care-related tasks such as colostomy care, caring for a urinary catheter, or bowel stimulation (which were outside their scope of duties), those who did were significantly more likely to experience blood and body fluid exposure (p ≤ .01). Level of assistance needed by clients in tasks such as feeding, laundry, and transportation was also found to be significantly associated with blood and body fluid exposure (p ≤ .01). These data highlight the importance of, and need for, home care aid training in the use of universal precautions.

Community Campaigns, Supply Chains, and Protecting the Health and Well-Being of Workers

The growth of contingent work (also known as precarious employment), the informal sector, and business practices that diffuse employer responsibility for worker health and safety (such as outsourcing and the development of extended national and international contracting networks [supply chains]) pose a serious threat to occupational health and safety that disproportionately affects low-wage, ethnic minority, and immigrant workers. Drawing on cases from the United States and Australia, we examine the role that community-based campaigns can play in meeting these challenges, including several successful campaigns that incorporate supply chain regulation.

Delayed respiratory fatality from trimethylsilyldiazomethane: what do workers need to know about potentially hazardous exposures?

The Occupational Medicine Forum is prepared by the ACOEM Occupational and Environmental Medical Practice Committee and does not necessarily represent an official ACOEM position. The Forum is intended for health professionals and is not intended to provide medical or legal advice, including illness prevention, diagnosis or treatment, or regulatory compliance. Such advice should be obtained directly from a physician and/or attorney.

Occupational Health: Overview

Occupational safety and health has a profound impact on individuals, families, communities, and societies. This article briefly outlines types of hazards and the resulting burden of fatal and nonfatal illness and injury in the context of vulnerable working populations and the changing context of work, including the globalization of work and migration of labor, growth in precarious working arrangements, and specific problems faced by workers at both age extremes. It describes a public health approach anchored in comprehensive programs driven by data and based in management leadership and employee participation. The role of government to provide services and enforce responsibilities is described using examples drawn primarily from the United States, as is the past and potentially future positive role played by labor unions.

What diagnostic tools are available to document death by H2S exposure

The Occupational Medicine Forum is prepared by the ACOEM Occupational and Environmental Medical Practice Committee and does not necessarily represent an official ACOEM position. The Forum is intended for health professionals and is not intended to provide medical or legal advice, including illness prevention, diagnosis or treatment, or regulatory compliance. Such advice should be obtained directly from a physician and/or attorney.

Editorial: Protecting Those Who Serve

ABSTRACTThe May 19 to 21, 2010 symposium “Assessing Potentially Hazardous Environmental Exposures Among Military Populations” brought military and civilian preventive medicine practitioners and scientists together to review the current state of exposure and outcome measurement, prevention, and compensation. Placed in recent historical context, the strides presented are remarkable, yet important challenges remain. Operational as well as ethical imperatives within the military and the growing complexity of civilian disasters demonstrate the need for continued and enhanced collaboration across military and civilian sectors.

OSHA Compliance Issues: Case Referrals to OSHA from an Interfaith Workers' Rights Center

I mmigrant Latino workers have fatal traumatic injury rates that are one-third higher than U.S. workers overall.(1) Nationally, more than 100 workers’ rights centers have formed to provide advocacy and other services to various worker communities, often using a worker-centered, participatory approach. The Chicago Interfaith Workers’ Rights Center (CIWRC) is a center that provides outreach, such as training in labor rights through community venues,(2) and follow-up peer counseling to assist with identified concerns, which are entered systematically into a database that includes complaints, the worker’s decision about the course of action to pursue, and follow-up. It works in concert with the Chicago Area Workers’ Rights Initiative, which is led by the Region V Department of Labor Wage and Hour Division but includes other federal and state entities as well as nongovernmental and advocacy groups. This initiative allows worker centers to triage complaints to the Occupational Safety and Health Administration (OSHA), among other agencies. As part of this initiative, Region V OSHA recognizes CIWRC as the workers’ representative for purposes of reporting a complaint. Previous review of the CIWRC database showed that of the 934 cases recorded for workers who entered the center because of a complaint between March 1, 2001, and February 24, 2005, only 47 resulted in an OSHA referral.(3) These 47 cases formed the basis of this review. According to OSHA’s Inspection Priorities, OSHA prioritizes employee complaints after imminent danger and fatality or catastrophe (an accident that requires hospitalization of three or more workers) investigations.(4)