The growing presence of Spanish-speaking workers and employers in the United States and the unprecedented 12-percent increase in the overall rate of workplace fatalities among Hispanic workers in 2000 highlights the need to better communicate occupational safety and health information in Spanish to both employees and employers. To address this need, the National Institute for Occupational Safety and Health (NIOSH) is preparing a strategy for developing and disseminating Spanish-language occupational safety and health educational and technical material. To gather information necessary to create this strategic plan, the National Research Council (NRC) was asked to host a workshop to
identify the most pressing occupational safety and health issues faced by Spanish-speaking workers and employers in the United States;
examine how NIOSH can best meet the informational needs of the occupational safety and health community to address effectively the safety and health issues faced by Spanish-speaking workers and employers in the United States; and
identify potential partnerships for NIOSH in reaching Spanish-speaking workers, their employers, and others.
To address the charge, the NRC established a committee and commissioned five white papers to set the stage for a workshop that was held on May 29–30, 2002, in San Diego, California. This workshop summary is a synopsis of the presentations and discussions at the workshop and is intended as input to the NIOSH strategic planning in this area. It does not contain any conclusions and recommendations. The conclusions and recommendations in the white papers represent the views of the authors and not necessarily those of the committee or the NRC.
Workshop participants discussed 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 occupational injuries and fatalities among Hispanics. These priorities include:
workers and employers who speak and write little or no English;
recent immigrants rather than established populations;
workers with low literacy levels in both English and Spanish; and
workers with high-risk occupations and industry sectors.
Based on fatality rates, these high-risk industry sectors include agriculture, construction, food processing, and health care.
As described in the NIOSH National Occupational Research Agenda (NIOSH, 1996) 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. 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. The National Occupational Research Agenda noted that effective interventions should extend beyond simple translation 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 the data have considerable weaknesses. Workshop participants thought that NIOSH, the Bureau of Labor Statistics, and the Occupational Safety and Health Administration (OSHA) should develop major long-term initiatives to improve public datasets, but that several high-priority Hispanic target populations can be distinguished with relative confidence using current data.
While it is clear from workshop discussions that occupational safety and health resources for Spanish-speaking workers are needed, it is less whether that there are adequate materials that fit these needs. Many different domestic and international sources of Spanish-language materials were identified. Workshop participants identified a variety of problems regarding existing materials. There was general agreement that there is a need to collect, evaluate, and disseminate Spanish-language resources on an ongoing basis. Workshop participants agreed that the quality of existing material is varied and some of it is often poor. To address the issue of quality of material, workshop participants urged that evaluation standards for materials be implemented, including an evaluation of existing materials. They suggested that a national clearinghouse (ideally, web based) of materials judged to be of good quality be established with some information on best situations for use practices.
The participants did not think that it was adequate to simply collect, evaluate, and disseminate existing materials. Development of new materials to fill current gaps would also be of great value. The language must be appropriate to the educational level of the target audience. The material should pinpoint behaviors that are key to safety, and focus on these. It is essential to develop both content and delivery modes for messages with consumer input.
With respect to delivery mode and approaches, the workshop participants agreed that multiple modes of delivery should be considered, not just print media. Workshop participants agreed that communication materials and strategies must be in Spanish, but that language alone is not enough for adequate communication. It is essential that messages be delivered in culturally appropriate ways both in terms of content and approaches. Discussion during the workshop focused on providing resources for those who are best able to access high-risk Spanish-speaking workers and to support their efforts.
There was also considerable discussion and varied opinions about the best approach to translating material into Spanish. There was agreement that direct translation of materials, warning labels, signs, etc. usually does not convey the correct meaning, and that adaptation is essential at the very least.
The workshop participants discussed how to prioritize which information gaps to fill and believed that the priority should not be on translation of technical health and safety documents. Rather, emphasis would be better placed on developing materials as part of a strategic initiative to reach Spanish-speaking workers, their employers, and their communities with practical information that can assist in preventing workplace injury and illness. Well-developed educational materials by themselves do not always assure that the intended audience will be reached. It is important that materials be used in the context of a well-planned educational intervention. Workshop participants thought that it would be important to have a solid evaluation process.
The workshop participants appreciated the opportunity provided by NIOSH for them to come together to discuss these issues. The diversity of the participants was noted. Participants included representatives from government agencies, community organizations, academic research centers, employers, outreach workers, and union members. Discussions were open, honest, and
productive. There was agreement on the importance of the problem, particularly in relation to the numbers of workers affected, the risks inherent both in common occupations for Latinos, in workers with little or no command of English, and in the lack of power to affect change or ask for their rights (e.g., workers’ compensation, OSHA and immigration rights). The power differential between workers and employers is particularly strong because of the lack of legal status of many workers, even when employers recruit from across the border. The need to protect all workers, as reflected in the initiative of NIOSH in convening this conference, was acknowledged by the participants.