El Trabajo no te Debe Danar: Reduction of Hazardous Exposures in Small Businesses through a Community Health Worker Intervention

项目总结 该项目旨在减少主要雇用高风险的小企业的负面健康后果。 拉美裔工人通过描述他们接触危险化学品的特征并评估社区健康 工人(CHW)干预在减少这些暴露方面是有效的。虽然从定义上讲是可以预防的， 职业病和伤害是美国的主要死亡原因，其中不成比例的 拉丁裔面临的负担。小企业构成了一个特别的风险。他们更有可能雇佣低薪 拉丁裔工人，经常使用危险的溶剂，包括可能导致哮喘的挥发性有机化学品， 癌症、心血管疾病和神经疾病；然而，他们的工人在文化和语言上缺乏接触 因经济、物质和社会原因而获得适当的职业健康和污染防治信息 障碍。CHW领导的干预措施和在拉丁裔社区的外联活动记录了更多获得 卫生保健和健康教育，以及减少农场工人的工作场所暴露。CHW是一种 以创新的方法弥合这些小企业界与其他利益攸关方之间的差距。这个 拟议的项目将利用亚利桑那大学、索诺拉大学和索诺拉大学 环境研究所，Inc.和埃尔里奥社区卫生中心。参与社区活动的人 研究框架将用来完成以下具体目标：1)量化和确定暴露于 在我们的目标领域中常见的两个高风险小企业部门(即汽车维修)的危险化学品 商店和美容院)；2)与企业主、行业团体、工人和CHW合作 设计针对每个小企业部门的工业卫生强化卫生保健工作干预措施；以及3) 进行整群随机试验，评估CHW干预措施在减少工作场所方面的有效性 暴露于挥发性有机化合物，并评估哪些因素导致成功利用暴露 在男性和女性主导的企业中的控制策略。企业将被随机分配到 干预或延迟干预小组，这两个小组都将获得包括工作现场在内的参与奖励 健康检查。CHWS将与企业主和员工密切合作，选择和实施 曝光-适用于其工作场所的策略，使用各种不同的补充策略菜单 复杂性和成本。这一创新项目有可能直接减少职业健康差距。 通过CHW干预，超越了提供职业健康教育。这项干预将 通过帮助边缘化的拉丁裔工人和小企业主克服当前的障碍 受教育程度、识字能力和计算机技能有限，无法理解与其工作相关的危险，并将 使他们能够更好地控制自己的职业暴露，最终目标是防止 减少职业病和缩小健康差距。

PROJECT SUMMARY This project aims to reduce negative health outcomes in small businesses that primarily employ high-risk Latino workers by characterizing their exposures to hazardous chemicals and assessing if a community health worker (CHW) intervention is effective at decreasing these exposures. Although preventable by definition, occupational disease and injuries are leading causes of death in the United States, with a disproportionate burden faced by Latinos. Small businesses pose a particular risk. They are more likely to employ low-wage Latino workers, and often use hazardous solvents including volatile organic chemicals that can cause asthma, cancer, cardiovascular, and neurological disease; yet their workers lack access to culturally and linguistically appropriate occupational health and pollution prevention information due to economic, physical, and social barriers. CHW-led interventions and outreach in Latino communities have documented increased access to health care and health education and reduced workplace exposures among farmworkers. CHWs are an innovative method to bridge the gap between these small business communities and other stakeholders. The proposed project will capitalize on established partnerships between the University of Arizona, the Sonora Environmental Research Institute, Inc. and the El Rio Community Health Center. A community-engaged research framework will be used to complete the following specific aims: 1) quantify and identify exposures to hazardous chemicals in the two high risk small business sectors common in our target area (i.e., auto repair shops and beauty salons); 2) work collaboratively with business owners, trade groups, workers and CHWs to design an industrial hygiene – enhanced CHW intervention tailored for each small business sector; and 3) conduct a cluster randomized trial to evaluate the effectiveness of the CHW intervention at reducing workplace exposures to volatile organic compounds and assess which factors led to successful utilization of exposure control strategies in both male and female-dominated businesses. Businesses will be randomized to either an intervention or delayed intervention group, both of which will receive incentives to participate including worksite health screenings. CHWs will work closely with business owners and employees to select and implement exposure-strategies appropriate for their worksite using a menu of complementary strategies of varying complexity and cost. This innovative project has the potential to directly reduce occupational health disparities through a CHW intervention that moves beyond providing occupational health education. The intervention will overcome current barriers by helping marginalized Latino workers and small business owners who may have limited education, literacy, and computer skills to understand the hazards associated with their work, and will empower them to have greater control over their occupational exposures, with the ultimate goal of preventing occupational disease and reducing health disparities.