Participatory research on workers' health

Rethinking the Paradigm and Practice of Occupational Health in a World Without Decent Work: A Perspective From East and Southern Africa

The global political economy is generating new forms and growing shares of informal, insecure, and precarious labor, adding to histories of insecure work and an externalization of social costs. The COVID-19 pandemic has highlighted the consequences of ignoring such signals in terms of the increased risk and vulnerability of insecure labor. This paper explores how such trends are generating intersecting adverse health outcomes for workers, communities, and environments and the implications for breaking siloes and building links between the paradigms, science, practice, and tools for occupational health, public health, and eco-health. Applying the principle of controlling hazards at the source is argued in this context to call for an understanding of the upstream production and socio-political factors that are jointly affecting the nature of work and employment and their impact on the health of workers, the public, and the planet.

Psychology and the Workers’ Health Movement in the State of São Paulo (Brazil)

This article discusses the ways in which psychology has contributed to a new range of public health services concerned with the health of working people in the State of São Paulo, Brazil. It begins by discussing the political, institutional and theoretical bases from which the Workers’ Health Movement emerged in the early 1980s as a replacement for previous approaches to occupational health. It provides examples of some of the different actions and practices that were developed and which had a key role in the battle for better working conditions and for an enhanced role for workpeople in organizational change. Finally it shows how the dialogue between the field of Workers’ Health and psychology was crucial for the construction of psychology’s social agenda.

From Theory to Practice: A Determinants Approach to Workplace Health Promotion in Small Businesses

A determinants approach to workplace health promotion focuses on the sources of health and ill health in the workplace itself. Key practice requirements of such an approach include the capacity to shift focus beyond the individual to the work environment, to cross disciplinary and jurisdictional boundaries in identifying problems and solutions, to foster health promotion self-sufficiency within the workplace, to enable worker participation in the process, and to adapt practice strategies to a business setting. This article identifies the challenges of such practice by reference to the experiences of health promoters in a Canadian public health department who attempted a determinants-centered stress reduction program for small-sized businesses. Findings under-score the significance for workplace health promotion of the broader structural context in which the workplace and the intervention are located, of differing perspectives between health professionals and workplace parties, and of conflicting professional accountabilities. Possibilities for addressing these challenges are considered.

Participatory Mapping of Occupational Hazards and Disease among Asbestos-exposed Workers from a Foundry and Insulation Complex in Canada

A study of former asbestos-exposed foundry and insulation workers was carried out in Sarnia, Ontario, home to Canada's petrochemical industry, using participatory mapping to document past exposures and subsequent diseases. Before it closed, government inspectors had monitored the use of asbestos at the facility, documenting levels that were thousands of times above the current legal limit. The study was undertaken by the Occupational Health Clinics for Ontario Workers (OHCOW) and Canadian Auto Workers (CAW) to provide evidence for worker compensation claims. Using facilitated hazard mapping, former Holmes workers graphically reconstructed their workplaces and detailed their exposures. Using facilitated body mapping, workers recorded and displayed their health problems. The study uncovered a grim pattern of occupational diseases. Following the release of the results, coupled with clinically confirmed diagnoses and corroborating evidence of exposure, hundreds of former Holmes employees and their families received compensation for occupational diseases that had previously gone unrecognized.

Exploring occupational and health behavioral causes of firefighter obesity: a qualitative study

BACKGROUND

Firefighters, as an occupational group, have one of the highest prevalence rates of obesity. A qualitative study investigated occupational and health behavioral determinants of obesity among firefighters.

METHODS

Four focus groups were conducted with firefighters of every rank as Phase I of the FORWARD study which was designed to assess health behavioral and occupational characteristics related to obesity in firefighters.

RESULTS

Analysis revealed five main themes of central importance to firefighters: (1) fire station eating culture; (2) night calls and sleep interruption; (3) supervisor leadership and physical fitness; (4) sedentary work; and (5) age and generational influences.

CONCLUSION

The results showed a strong interrelationship between occupational and health behavioral causes of obesity in firefighters. The relevance of these qualitative findings are discussed along with the implications for future obesity interventions with firefighters.

Exploring occupational and behavioral risk factors for obesity in firefighters: a theoretical framework and study design

Firefighters and police officers have the third highest prevalence of obesity among 41 male occupational groups in the United States (US). However, few studies have examined the relationship of firefighter working conditions and health behaviors with obesity. This paper presents a theoretical framework describing the relationship between working conditions, health behaviors, and obesity in firefighters. In addition, the paper describes a detailed study plan for exploring the role of occupational and behavioral risk factors in the development of obesity in firefighters enrolled in the Orange County Fire Authority Wellness Fitness Program. The study plan will be described with emphasis on its methodological merits: adopting a participatory action research approach, developing a firefighter-specific work and health questionnaire, conducting both a cross-sectional epidemiological study using the questionnaire and a sub-study to assess the validity of the questionnaire with dietary intake and physical activity measures, and evaluating the strengths and weaknesses of the body mass index as an obesity measure in comparison to skinfold-based percent body fat. The study plan based on a theoretical framework can be an essential first step for establishing effective intervention programs for obesity among professional and voluntary firefighters.

The Good, the Bad, and the Ugly of Partnered Research: Revisiting the Sequestration Thesis and the Role of Universities in Promoting Social Justice

As universities increasingly rely on external sources of research funding, researchers worldwide are realizing that if their work is financially supported by organizations with distinct political or financial interests, they risk their careers if their results deviate from the interests of their funding partners. This article presents a case that illustrates how ugly this situation can become. Reviewing the literature on the advantages and dangers of partnered research, the historical role of universities, funding trends, and university mission statements, the authors contend that universities must engage in service learning and participatory action research, but must ensure that faculty members engaging in academic activity with partners—whether industry, hospitals, governments, nongovernmental organizations, or communities—have their professional integrity protected. If doubt exists about whether the partner can or will honor these principles or the mission of universities for social good, universities should avoid granting joint or affiliate appointments or accepting funds or favors of any kind. Universities also need formal structures to ensure ethical application of innovation and principled partnership engagement. In becoming servants of government or corporatism, universities have become less vital to society and are failing in their mission to promote social justice and sustainability. Strong measures are needed to restore public trust.

Building a strong foundation for occupational health and safety: Action research in the workplace

BACKGROUND

Action research (AR) holds promise as a method to improve occupational health and safety.

METHODS

This case study explores the challenges and accomplishments during the first 6 months of an AR occupational health and safety committee at a manufacturing facility.

RESULTS

Critical steps in the formative phase of the AR project included: (1) addressing differing power levels and perceived ownership of management and production committee members; (2) developing a collaborative approach to communication and problem solving; and (3) transitioning from dependence on university leadership to shared leadership among the committee.

CONCLUSIONS

AR can lead to greater empowerment to address occupational health and safety issues, and to improved dialog between labor and management. AR can increase the likelihood that the problem will be understood, and effective solutions will be developed and their application supported and used throughout the organization.

Psicologia e saúde do trabalhador: práticas e investigações na Saúde Pública de São Paulo

Este artigo tem por objetivo situar o momento histórico da emergência do campo da Saúde do Trabalhador na Saúde Pública e resgatar experiências que exemplificam diferentes tipos de inserção da Psicologia na saúde do trabalhador. Focaliza a descrição no Estado de São Paulo, que presencia um contexto político e institucional fecundo para o desenvolvimento desse campo a partir de meados dos anos 1980. Recorre-se à apresentação de atividades desenvolvidas pela Psicologia nos serviços de saúde pública que marcam algumas de suas contribuições para a saúde do trabalhador.

The Latin American Social Medicine database

Background

Public health practitioners and researchers for many years have been attempting to understand more clearly the links between social conditions and the health of populations. Until recently, most public health professionals in English-speaking countries were unaware that their colleagues in Latin America had developed an entire field of inquiry and practice devoted to making these links more clearly understood. The Latin American Social Medicine (LASM) database finally bridges this previous gap.

Description

This public health informatics case study describes the key features of a unique information resource intended to improve access to LASM literature and to augment understanding about the social determinants of health. This case study includes both quantitative and qualitative evaluation data. Currently the LASM database at The University of New Mexico brings important information, originally known mostly within professional networks located in Latin American countries to public health professionals worldwide via the Internet. The LASM database uses Spanish, Portuguese, and English language trilingual, structured abstracts to summarize classic and contemporary works.

Conclusion

This database provides helpful information for public health professionals on the social determinants of health and expands access to LASM.

Involving street youth in peer harm reduction education. The challenges of evaluation

OBJECTIVES

To describe and discuss the challenges in evaluation of a participatory action research with street-involved youth.

METHODS

A combination of quantitative and qualitative methods were utilized for both process and outcome evaluations. Process evaluation methods included in-depth individual interviews, focus groups, participant observation, and session debriefing forms. Summative evaluation research included focus testing of the harm reduction video and a survey of video users.

FINDINGS

Members of the youth team reported favourably on the experience, citing friendship, skills development, fun, and pride of accomplishment among the key benefits of participation. Political tensions arose because of the focus on reducing harm from drug use rather than encouraging abstension. The heavy demands of participatory research and development, resource constraints and the priority given to product development in these kinds of projects necessarily precludes extensive youth participation in the design, implementation and analysis of additional evaluation research. Even when resources are directed towards evaluation, there is a tendency to focus on data collection, which may limit time and resources for data analysis. Finally, there is an inclination to focus on the product development rather than dissemination and impact of the product.

INTERPRETATION

Despite the challenges inherent in participatory action research and its evaluation, this project was regarded as an empowering experience by the street youth who participated in it. It is worthwhile to direct resources to evaluation which optimally gives proportional attention to data collection as well as data analysis, and focusses not only on product development but also on its dissemination and impact.

Women workers confront one-eyed science: building alliances to improve women's occupational health

Women suffer many health problems related to their work, but attempts to improve their situation face obstacles at two levels: recognition of their problems and ability to organize to prevent them. Recognition by occupational health specialists has been delayed due in part to: A perception that women's issues have been included in research focussed on male workers; pressure to deal with more visible issues of mortality and well-established illness; ignorance of women's working conditions; methodological biases and inadequacies. Recognition by unions is slowed when women and their concerns are absent from union membership and/or governing structures. Feminist health advocates have not often participated in these struggles, due to social class differences and difficulties in linking with some male-dominated unions. Also, due to the wide variety of hazardous working conditions, they do not emerge from population-based analyses of health determinants in the same way as do domestic violence, tobacco or poverty. The authors describe three alliances necessary for successful research, policy and practice in women's occupational health: between feminist and working-class organizations; between feminists and occupational health scientists; between researchers and women workers.

Social medicine in Latin America: productivity and dangers facing the major national groups

There is little knowledge about Latin American social medicine in the English-speaking world. Social medicine groups exist in Argentina, Brazil, Chile, Colombia, Cuba, Ecuador, and Mexico. Dictatorships have created political and economic conditions which are more adverse in some countries than others; in certain instances, practitioners of social medicine have faced unemployment, arrest, torture, exile, and death. Social medicine groups have focused on the social determinants of illness and early death, the effects of social policies such as privatisation and public sector cutbacks, occupational and environmental causes of illness, critical epidemiology, mental health effects of political trauma, the impact of gender, and collaborations with local communities, labour organisations, and indigenous people. The groups' achievements and financial survival have varied, depending partly on the national context. Active professional associations have developed, both nationally and internationally. Several groups have achieved publication in journals and books, despite financial and technical difficulties that might be lessened through a new initiative sponsored by the US National Library of Medicine. The conceptual orientation and research efforts of these groups have tended to challenge current relations of economic and political power. Despite its dangers, Latin American social medicine has emerged as a productive field of work, whose findings have become pertinent throughout the world.

Identifying and prioritizing gaming workers' health and safety concerns using mapping for data collection

BACKGROUND

This research was prompted by the clinical presentation of workers from a variety of gaming occupations with injuries and illnesses and multiple health and safety concerns.

METHODS

Using participatory action research principles, 51 gaming workers in Ontario and 20 gaming workers in Manitoba were consulted during a series of focus group sessions. Mapping exercises were used to survey the participants about their health concerns, perceived occupational hazards and the impact of working conditions on their personal lives. Participants were then asked to prioritize their concerns and make recommendations for improvements.

RESULTS

Gaming workers from both provinces identified similar health, hazard and psycho-social concerns. They prioritized the issues of stress, ergonomics, indoor air quality (including second-hand smoke and temperature), biological hazards, physical hazards and noise.

CONCLUSIONS

This study points to a need to more fully investigate and address health and safety issues in the gaming industry. It also demonstrates the effectiveness of a worker-driven, participatory consultation.

The health and safety concerns of immigrant women workers in the Toronto sportswear industry

Immigrant women's conditions of work have worsened with new government and managerial strategies to restructure the Canadian apparel industry. Changes in occupational health and safety legislation have both given and taken away tools that immigrant women workers could use to improve the quality of their working lives. The author outlines a methodology for eliciting the health and safety concerns of immigrant women workers.

[Health promotion and education: a diagnosis of sanitation conditions using participatory research and community education (São João dos Queiróz - Quixadá/Ceará, Brazil)]

This study was conducted in a rural community, São João dos Queiróz, a township in the county of Quixadá, Ceará, Brazil, using a combination of participatory research and community education in compliance with the health promotion reference and principles of the 1986 Ottawa Charter. The project was joined by representatives of several local government institutions and organizations from the grassroots community movement. The theme generating the research, as defined by an assembly meeting of the community association, was a diagnosis of sanitation conditions in the community. The starting point was the assessment of local conditions. Results showed adverse local conditions in sanitation, literacy, income, and employment. Suggestions for solving the problems were organized so as to be included in the planning agenda for local health policies. Evaluation was procedural and enriched with daily research activities. The problem-solving pedagogical approach developed during the educational process contributed to a critical reconstruction, appropriation, and sharing of the resulting knowledge.