Translation research in occupational safety and health: A proposed framework.

Translation research in occupational safety and health is the application of scientific investigative approaches to study how the outputs of basic and applied research can be effectively translated into practice and have an impact. This includes the study of the ways in which useful knowledge and interventions are disseminated, adopted, implemented, and institutionalized. In this paper, a 4-stage framework (Development, Testing, Institutionalization, and Evaluation) is presented. Translation research can be used to enhance the use and impact of occupational safety and health knowledge and interventions to protect workers. This type of research has not received much attention in the occupational safety and health field. However, in contemporary society, it is critical to know how to make an impact with the findings and outputs of basic and applied research. This paper provides a novel framework for consideration of how to advance and prioritize translation research for occupational safety and health.

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.

Efficacy of an outdoor air pollution education program in a community at risk for asthma morbidity.

BACKGROUND: Asthma management guidelines recommend avoiding exposure to indoor and outdoor air pollutants. A limitation of such recommendations is that they do not provide information about how the public should obtain and act on air quality information. Although the Air Quality Index (AQI) provides simplified outdoor air quality forecasts, communities with high rates of asthma morbidity tend to have low rates of internet access due to factors such as low socioeconomic status. Assessments of knowledge about air quality among low-income minority communities are lacking, as are community-based programs to educate the public about using the AQI. METHODS: An air quality education program and system for disseminating air quality information were developed to promote pollutant avoidance during the reconstruction of a major highway in a low-income minority community on Chicago's South Side. The program, which centered on workshops run by community asthma educators, was evaluated using a pre-test, post-test, and 1-year follow-up questionnaire. RESULTS: A total of 120 community workshop participants completed at least a portion of the evaluation process. At baseline, knowledge about air quality was limited. Following the workshops, substantial increases were noted in rates of correct answers to questions about health effects of air pollution, the availability of air quality information, and the color code for an AQI category. Approximately 1 year after the workshops were held, few participants could recall elements of the training. Few participants have internet access, and alternative means of distributing air quality information were suggested by study participants. CONCLUSIONS: Baseline knowledge of air quality information was limited in the community studied. Air quality education workshops conducted by community educators can increase knowledge about outdoor air quality and its impact on health over the short term. Refresher workshops or other efforts to sustain the knowledge increase may be useful. Given the known short-term and long-term effects of air quality on morbidity and mortality, air quality education efforts should be further developed, evaluated, and promoted for the general public, for people with underlying cardiopulmonary disease, and given the documented health disparities within the general population, for low-income and minority communities.

Trainer evaluation of a union-based ten-hour safety and health hazard-awareness program for U.S. construction workers.

A web-based survey of union-based outreach instructors evaluated training materials developed to teach OSHA ten-hour hazard-awareness courses to members of the construction trades. Respondents taught an average of five ten-hour hazard-awareness courses per year. When asked about hazards commonly encountered by their trainees, 83% identified falls from ladders, with a range of 1-22 hazards identified. Over one third of the trainers taught individuals whose primary languages were not English. Increased interaction with trainees through subsequent phone calls may be a marker of differential training impact.

The Great Lakes Center's health hazard evaluation program: promoting community environmental health through partnerships between academic and public health departments.

The Great Lakes Center of Excellence in Environmental Health (GLCEEH), an innovative capacity-building component of the University of Illinois, performs health hazard evaluations in collaboration with the Illinois Department of Public Health and local health departments. GLCEEH has provided state and local health departments with faculty, industrial-hygiene expertise, and research expertise to help them investigate a variety of environmental health issues. This article describes health hazard evaluations performed with support from the National Center for Environmental Health, lessons learned, and recommendations for successful collaboration between academic and public health departments. From the academic perspective, health hazard evaluations are beneficial because they provide faculty and students with the opportunity to engage in public health practice and encounter new issues that advance the science of environmental health through research. From the perspective of a public health department, health hazard evaluations are beneficial because they address priority environmental health concerns and build the capacity of department personnel to conduct health hazard evaluations with internal resources. A collaborative health hazard evaluation program increases public health capacity by developing new approaches to environmental health problems and by sharing limited resources.

Aortic dissection and thrombosis diagnosed by emergency ultrasound in a patient with leg pain and paralysis.

The authors present a case of aortic dissection and abdominal aortic aneurysm thrombosis in a 78-year-old male who presented to the emergency department (ED) complaining of lower extremity and paralysis for the past 1.5 hours. The initial vital signs in the ED were as follows: blood pressure (BP) 132/88 mmHg, heart rate (HR) 96, respiratory rate (RR) 14, and an oxygen saturation of 94% at room air. Physical exam was notable for pale and cold left leg. The ED physician was unable to palpate or detect a Doppler signal in the left femoral artery. Bedside ultrasound was performed which showed non-pulsatile left femoral artery and limited flow on color Doppler. Abdominal aortic aneurysm screening ultrasound was performed showing a 4.99 cm infrarenal abdominal aortic aneurysm and an intra-aortic thrombus with an intimal flap. Vascular surgery was promptly contacted and the patient underwent emergent aorto-bi-femoral bypass, bilateral four compartment fasciotomy, right common femoral artery endarterectomy with profundoplasty, and subsequent left leg amputation. Emergency physicians should utilize bedside ultrasound in patients who present with risk factors or threatening signs and symptoms that may suggest aortic dissection or aneurysm. Bedside ultrasound decreases time to definitive treatment and the mortality of the patients.

Implementation and evaluation of interventions for home care aides on blood and body fluid exposure in large-group settings.

Participatory research conducted with academic, union and management cooperation resulted in the development, implementation, and process evaluation of interventions designed to reduce occupational blood and body fluid exposure among home care aides. Home care aides working for a large urban home care agency took part in the design and implementation of an interactive participatory training program conducted in large-group settings, and the development and evaluation of two training tools: an information card for home care aides and a sharps safety magnet for their clients. A process evaluation conducted immediately following the interactive training program found that 72 percent of the home care aides preferred it to lecture-style trainings typically offered, while only 9 percent preferred typical trainings. Home care aides were able to effectively articulate information learned during the interactive training program, with less than 2 percent providing inaccurate information about what was taught during the training. Home care aides overall responded positively to the information card and the magnet, with aides caring for clients who used sharps rating the tools as more useful. Participatory training programs can be effectively implemented in a large-group setting.

Ultrasound diagnosis of bilateral quadriceps tendon rupture after statin use.

Simultaneous bilateral quadriceps tendon rupture is a rare injury. We report the case of bilateral quadriceps tendon rupture sustained with minimal force while refereeing a football game. The injury was suspected to be associated with statin use as the patient had no other identifiable risk factors. The diagnosis was confirmed using bedside ultrasound.

An English/Spanish safety climate scale for construction workers.

BACKGROUND: Workers in the construction trades experience high rates of traumatic injury. An increasing number of workers in this industry speak only Spanish, including members of construction trade unions. This brief communication reports a dual language safety climate scale developed during a larger training intervention study. METHODS: Construction workers in two unions self-completed a previously validated 6-item safety climate scale modified for the construction trades. A seventh item was developed midway through the study and incorporated into the version completed by half of the respondents. For one union with a sizeable number of Spanish-speaking members, a dual-language (Spanish/English) version was administered. Follow-up telephone interviews conducted 3 months after the self-completed survey also included the safety climate scale. RESULTS: Cronbach's coefficient alpha was 0.85 for the 6-item scale and 0.85 for the 7-item scale. Similar coefficient alpha scores were found for the subgroup of Spanish-speakers on the 6- and 7-item scales. Spanish speakers with low education were less likely to respond to the scale when self-completing but not when it was administered by telephone in Spanish. CONCLUSION: This safety climate scale elicits consistent and reliable response from unionized construction workers when administered in English or in Spanish. Spanish literacy may be a consideration for the use of this scale among foreign-born Hispanic workers.

Personal care assistants and blood exposure in the home environment: focus group findings.

BACKGROUND: Exposure to blood and bodily fluids continues to be an important and life-threatening risk facing health care workers employed in traditional health care workplaces. Little is known about how blood exposure risk impacts personal care assistants (PCAs) who provide care in homes. OBJECTIVES: A National Institute for Occupational Safety and Health (NIOSH)-funded community based participatory research project between Service Employees International Union (SEIU), PCAs, and university-based researchers was conducted to increase the understanding of the risk of exposure to blood among PCAs. METHODS: Six focus groups were conducted to assess the relationship between the context of work, blood exposure, and use of available hazard controls in home care workplaces. RESULTS: Findings indicate that PCAs are exposed to blood even though they do not provide health care or treatment. Training and barrier protection may be available, but the quality of each was highly variable if available. CONCLUSIONS: Focus group findings will be used to implement a union-based participatory primary prevention intervention for the reduction of blood exposure among PCAs.

Occupational health among Chicago day laborers: an exploratory study.

The authors report on the results of an exploratory investigation of the occupational safety experience among day laborers at one street-corner hiring site in Chicago. The authors' goals were to pilot street-corner surveillance methods, including those that would facilitate access to the workers, and to obtain information on the day laborers' occupational safety experience, including the types of jobs and tasks performed, the hazardous conditions encountered, and the frequency of occupational injuries. The authors held interviews at one street corner in Chicago; 21 day laborers participated. All were male, and 90% were Latino. Construction jobs were common. Roofing and demolition were 2 of the most hazardous jobs. Of the respondents, 52% had been injured in the previous year. This exploratory study was a successful first step in occupational injury research among street-corner day laborers and suggests that these workers are frequently exposed to hazardous working conditions without safety training or equipment.

Effectiveness of community health workers for promoting use of safety eyewear by Latino farm workers.

BACKGROUND: To evaluate The Community Health Worker "promotor de salud" (CHW) model is evaluated as a tool for reducing eye injuries in Latino farm workers. METHODS: In 2001, 786 workers on 34 farms were divided into three intervention blocks: (A) CHWs provided protective eyewear and training to farm workers; (B) CHWs provided eyewear but no training to farm workers; (C) eyewear was distributed to farm workers with no CHW present and no training. RESULTS: Pre- and post-intervention questionnaires demonstrated greater self-reported use of eyewear in all blocks after the intervention (P < 0.0001), with Block A showing the greatest change compared to B (P < 0.0001) and C (P = 0.03); this was supported by field observations. Block A showed the greatest improvement in knowledge on questions related to training content. CONCLUSION: CHWs were an effective tool to train farm workers in eye health and safety, improving the use of personal protective equipment and knowledge.