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Safety is Seguridad: A Workshop Summary
Similar problems exist with task data. Workshop participants could not identify task inventories to compare Hispanic and non-Hispanic workers. For example, it would be of interest to know whether actual work practices are different among Mexican-trained workers who are recent immigrants. Particularly with very-low-wage workers, task inventories may be different with a higher fraction of manual and hand tool work, and fewer capital-intensive processes.
A significant concern raised by the workshop participants was youth employment (under 18 years old) when it places young workers at unacceptable levels of risk and limits their opportunities for education and future employment. Recent NIOSH recommendations on Department of Labor Hazardous Orders define allowable employment for youthful workers in the United States. These may be of particular value to Hispanic youth who may face high-risk work processes with reduced benefit from training and supervision that is often provided only in English.
Other areas where participants identified data gaps included longitudinal data on new immigrants, information on the informal economy, and workers in the cash economy.
SUMMARY OF INTERVENTION PRIORITIES
Participants agreed on several priorities for NIOSH to consider in targeting health education campaigns, public health interventions, and occupational safety and health information to best address the elevated rate of Hispanic occupational fatalities. These priorities include:
workers and employers who speak and write little or no English;
recent immigrants as opposed to established populations;
workers with low literacy levels in both English and Spanish; and
workers with high-risk occupations and industry sectors.
High-risk industry sectors (based on fatality rates) include agriculture, construction, food processing, and health care.
Workshop participants suggested several additional priorities for intervention criteria. Although data resources and workforce characteristics almost certainly vary by state it may be difficult to get state-by-state data. Typically Current Population Survey public datasets can be used only for assessing regional variations due to confidentiality requirements and small datasets in some states. Another priority for intervention is differences by country of origin in popular vocabulary for terms important for worker safety, such as names of equipment or tools, and cultural variations in perceptions of risk and need for protection. Development of strategies for moving toward a more common vocabulary related to safety and health is an important consideration, but the issue was not seen as the primary barrier to preventing injury and illness.
As described in the NIOSH National Occupational Research Agenda priorities related to organization of work, understanding the barriers and context within which public health interventions can be effective should be a priority in targeting Spanish-language materials, as it is in targeting English language public health interventions (NIOSH, 1996). In addition to language differences that can be addressed by translation, recognition of cultural differences may modify the nature of an effective public health intervention, even when addressing the same occupational health hazard in the same industry sector as an English-language counterpart. Effective interventions that extend beyond simple translation are important to address diversity within the Hispanic workforce and differences from the non-Hispanic workforce. Existing data to target, prioritize, and provide metrics for evaluation of the effectiveness of interventions is not currently limiting initial public health interventions but has considerable weaknesses. Workshop participants thought that major long-term initiatives should be developed by NIOSH, the Bureau of Labor Statistics, and OSHA to improve public datasets, and that several high-priority Hispanic target populations can be distinguished with relative confidence using current data.