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

项目摘要 该项目旨在减少主要雇用高风险员工的小企业的负面健康结果。 拉丁裔工人通过描述他们接触危险化学品的特征，并评估社区健康状况， 工人（CHW）的干预是有效的，在减少这些暴露。虽然从定义上讲是可以预防的， 职业病和伤害是美国死亡的主要原因， 拉丁美洲人面临的挑战小企业面临着特殊的风险。他们更有可能雇用低工资的人， 拉丁裔工人，经常使用危险溶剂，包括挥发性有机化学品，可导致哮喘， 癌症、心血管和神经系统疾病;但他们的工人缺乏文化和语言上的接触。 适当的职业健康和污染预防信息，由于经济，物理和社会 隔栏. CHW在拉丁裔社区领导的干预和外联活动记录了获得 卫生保健和健康教育以及减少农场工人在工作场所的接触。CHW是一个 创新的方法，以弥合这些小企业界和其他利益攸关方之间的差距。的 拟议中的项目将利用亚利桑那大学、索诺拉大学 环境研究所和埃尔里奥社区健康中心社区参与 研究框架将用于完成以下具体目标：1）量化和识别暴露于 在我们的目标地区常见的两个高风险小企业部门中的危险化学品（即，汽车修理 商店和美容院）; 2）与企业主、贸易团体、工人和社区卫生工作者合作， 为每个小企业部门量身定制工业卫生强化CHW干预措施;以及3） 进行一项整群随机试验，以评估CHW干预措施在减少工作场所 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 男性和女性占主导地位的企业的控制策略。企业将被随机分配到 干预或延迟干预组，这两个组都将获得参与的激励措施，包括工作场所 健康检查。CHW将与企业主和员工密切合作， 确保战略适合他们的工地使用菜单的互补战略的变化 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的干预，超越提供职业健康教育。干预将 通过帮助边缘化的拉丁裔工人和小企业主克服目前的障碍， 有限的教育，识字和计算机技能，以了解与他们的工作相关的危险， 使他们能够更好地控制其职业暴露，最终目标是防止 职业病和减少健康差距。

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.