Empowerment-based health and safety training: evidence of workplace change from four industrial sectors.

BACKGROUND: Empowerment-based health and safety training programs posit that training workers to take action on health and safety issues is key to improving work environments. This article assesses how two union-led, empowerment-based hazardous materials training programs impacted health and safety workplace conditions across four industrial sectors. METHODS: A cross-sectional telephone interview survey was conducted with 362 workers and managers, six to twelve months following training. RESULTS: Participants reported increased attempts and successes in advocating for workplace health and safety changes, as well as individual changes in awareness and work practices. The training also appeared to influence two organizational factors key to worker-initiated changes in the workplace: manager support and union involvement. CONCLUSIONS: Empowerment-based training approaches appear to be effective in fostering workers' ability to initiate change in the workplace. Future evaluations should further refine training evaluation measures of workplace change processes, and consider them in the unique contexts in which they operate.

Empowerment evaluation of worker safety and health education programs.

BACKGROUND: The need to expand the use of evaluation to learn how education programs contribute to workers' occupational safety and health is well documented. Similarly recognized is the need to expand workers' involvement as primary stakeholders in program evaluation. METHODS: Articles for this review were identified through computer database and manual searches related to: intervention research and evaluation; occupational safety, health training, and education; and worker participation and empowerment. RESULTS: After identifying empowerment as a multilevel and multidimensional concept, this review used a theoretical framework of evaluation to show how various participatory and empowering approaches can affect evaluation studies and their use. CONCLUSIONS: The field of occupational safety and health has a unique historical opportunity to further expand workers' involvement in their own education through the use of participatory and empowering approaches to evaluation. Use of these approaches has the potential to strengthen capacities for organizational learning and improve both program theory and practice.

Hazardous waste worker education. Long-term effects.

This study illustrates how a union education center successfully integrated adult empowerment education principles into the teaching methods and curriculum of a health and safety training program. The 12-month follow-up phone survey involved 481 local union respondents each representing a separate plant site and a group of 50 manager trainees. The evaluation shows that the training manual continued to be used by more than 70% of respondents, more than 70% taught coworkers, more than 50% of union trainees went on to train their managers, and more than 90% identified problems at work and sought and obtained changes in programs, training, or equipment. More than 20% reported that major spills had occurred following training. The majority stated that the handling of the spills improved. More than 80% stated that the training better prepared them for their health and safety duties. The managers' data substantially supported union members' reports.

Workplace smoking policies: attitudes of union members in a high-risk industry.

We surveyed members of a medium-size national union representing workers in high-risk industries to assess workers' support for union and company programs to help smokers break the habit and policies that restrict smoking. Two surveys were conducted that involved 690 respondents in 1984 and 593 respondents in 1985. Respondents overwhelmingly (82%) favored restrictions on smoking in the workplace but less than half agreed that companies or unions should be concerned about workers smoking off the job. For both smokers and nonsmokers, beliefs that cancer has specific causes and can be prevented strongly predict support for workplace smoking control policies. Exposure to company occupational health training also influenced smokers and nonsmokers to support selected smoking control policies. These and other findings led to the conclusion that: (1) educating workers about cancer may promote support for smoking control policies, and (2) smoking control policies are more acceptable in the context of a strong company health and safety program.

Lung cancer mortality in workers exposed to sulfuric acid mist and other acid mists.

Mortality patterns were studied in 1,165 workers exposed to sulfuric acid mist and other acid mists (primarily hydrochloric acid mist) in steel-pickling operations. Standardized mortality ratio (SMR) analysis of the full "any acid exposure" cohort (n = 1,165), with the use of U.S. death rates as a standard, showed that lung cancer was significantly elevated, with a mortality ratio of 1.64 [95% confidence interval (CI) = 1.14-2.28, based on 35 observed deaths]. The lung cancer mortality ratio for workers exposed only to sulfuric acid (n = 722) was lower (SMR = 1.39), but further restriction to the time 20 years and more from first employment in a job with probable daily sulfuric acid exposure (approximately equal to 0.2 mg/m3) yielded a mortality ratio of 1.93 (95% CI = 1.10-3.13). An excess lung cancer risk was also seen in workers exposed to acids other than sulfuric acid (SMR = 2.24; 95% CI = 1.02-2.46). When comparison was made to other steel workers (rather than to the U.S. general population) to control for socioeconomic and life-style factors such as smoking, the largest lung cancer excess was again seen in workers exposed to acids other than sulfuric acid (SMR = 2.00; 95% CI = 1.06-3.78). Adjustment for potential differences in smoking habits showed that increased smoking was unlikely to have entirely explained the increased risk. Mortality from causes of death other than lung cancer was unremarkable, with the exception of significantly low rates for deaths due to digestive system diseases.

ICWU cancer control education and evaluation program: research design and needs assessment.

The International Chemical Workers Union is implementing a 3-year nationwide field experiment in cancer prevention education. The educational program includes three stages: generalized cancer control education, education tailored to each local union, and an interactive monitoring system designed to provide ongoing communication and reinforcement for desired cancer control behaviors among local unions and their members. These alternative educational approaches will be systematically evaluated using a randomized factorial study design involving more than 120 local unions. The need for such a program is demonstrated by the results of a needs assessment survey of 690 union members. Respondents expressed strong concern regarding possible carcinogen exposures at the work site, combined with generally low ratings of co-worker knowledge of and adherence to appropriate cancer control behaviors. Engineering controls and personal protective equipment were reported to be inadequate in many work sites.

No demonstrable effect of S-carboxymethylcysteine on clearance of secretions from the human lung.

The mucolytic efficacy of S-carboxymethylcysteine has been assessed in a double-blind crossover trial in 16 patients with chronic obstructive bronchitis. No significant difference was found between drug and placebo after four or seven days' treatment in the rate of clearance of secretions from the lung. This was measured by external counting of previously inhaled polystyrene tracer particles tagged with technetium-99m (99mTc). Lateral scans across the right chest after inhaling the aerosol showed equal penetration of particles towards the periphery of the lung in drug and placebo runs; this indicated that the airways had not been cleared of mucus by the drug. There was no significant difference between drug and placebo runs in the number of coughs or the weight and radioactive content of sputum voided or raised at the end of the run by chest percussion and postural drainage. Ventilatory capacity was not significantly changed nor was there any subjective improvement in the patients as a result of taking the drug.