Promoting adoption of fall prevention measures among Latino workers and residential contractors: formative research findings.

BACKGROUND: Falls from heights remain a concern in construction, particularly for foreign-born Latino construction workers employed by small residential contractors. The social ecological model provides a framework to assess the individual and contextual factors influencing the risk for falls. METHODS: Five focus groups and thirteen in-depth interviews with workers, small residential contractors, and key informants were conducted in 2012 in San Francisco and Philadelphia. Data were analyzed with qualitative methods. RESULTS: Economic conditions in residential construction, coupled with a lack of enforcement and vulnerabilities of the foreign-born workforce, are principal contributors to risk for falls. Small contractors perceive strong economic disincentives for implementation of fall protection and foreign-born Latino workers experience a variety of social, cultural and occupational pressures impeding its use. CONCLUSIONS: Increased adoption of fall protection cannot be accomplished solely by targeting Latino construction workers. Research is needed on incentives to influence contractor behavior and facilitate adoption of fall protection measures.

Possibilities and challenges in occupational injury surveillance of day laborers.

BACKGROUND: Day laborers in the US, comprised largely of undocumented immigrants from Mexico and Central America, suffer high rates of occupational injury according to recent estimates. Adequate surveillance methods for this highly transient, largely unregulated group do not currently exist. This study explores chart abstraction of hospital-based trauma registry records as a potential injury surveillance method for contingent workers and day laborers. We sought to determine the degree of completeness of work information in the medical records, and to identify day laborers and contingent workers to the extent possible. METHODS: Work-related injury cases from a hospital-based trauma registry (2001-2006) were divided by ethnicity (Hispanic vs. non-Hispanic origin) and presence of social security number (SSN: yes, no), resulting in four groups of cases. Medical records were abstracted for 40 cases from each group; each case was assigned values for the variables "day labor status" (yes, no, probably not, probable, unknown) and "employment type" (contingent, formal, unknown). RESULTS: Work information was missing for 60% of Hispanic cases lacking SSN, as compared with 33-47% of the other three groups. One "probable" day laborer was identified from the same group. Non-Hispanics with SSN were less frequently identified as contingent workers (5% as compared with 15-19%). CONCLUSIONS: This method revealed severe limitations, including incomplete and inconsistent information in the trauma registry and medical records. Approaches to improve existing resources for use in surveillance systems are identified. The potential of an active surveillance approach at day labor hiring centers is also briefly discussed.

Occupational health and safety experience of day laborers in Seattle, WA.

BACKGROUND: Day Labor is a growing part of the informal economy in the US, and in Seattle, and may entail a high risk of injury and illness at work. METHODS: We surveyed 180-day laborers, at two worker centers and an unregulated "Street" location concerning their job-specific exposures and injury experience. RESULTS: Exposures to both health and safety hazards were common at all three sites. After controlling for type of work, immigrant workers were 1.5-2 times more likely than non-immigrant day laborers to report exposure to hazardous conditions. Among the 180 participants 34 reported injuries were classified as "recordable." We estimated an injury rate of 31 recordable injuries per 100 full time employees. The three hiring locations had differing job experiences and exposures. Those hired through worker centers had a lower risk of exposures, while the Street workers were more likely to refuse hazardous work. CONCLUSIONS: Day laborers are exposed to numerous hazards at work, resulting in high injury rates. Multiple approaches including community based organizations which may provide some employment stability and social support for protection at work are needed to reduce occupational injury and illness risk among these vulnerable populations.