Last data update: Apr 29, 2024. (Total: 46658 publications since 2009)
Records 1-30 (of 35 Records) |
Query Trace: Flynn MA [original query] |
---|
Disparities in COVID-19 vaccine uptake, attitudes, and experiences between food system and non–food system essential workers
Smarsh BL , Yankey D , Hung MC , Blanck HM , Kriss JL , Flynn MA , Lu PJ , McGarry S , Eastlake AC , Lainz AR , Singleton JA , Lincoln JM . J Agric Food Syst Community Dev 2024 13 (2) The COVID-19 pandemic has disproportionately affected the health of food system (FS) essential workers compared with other essential and non-essential workers. Even greater disparity exists for workers in certain FS work settings and for certain FS worker subpopulations. We analyzed essential worker respondents (n = 151,789) in May–Novem-ber 2021 data from the National Immunization Survey Adult COVID Module (NIS-ACM) to assess and characterize COVID-19 vaccination uptake (≥1 dose) and intent (reachable, reluctant), attitudes about COVID-19 and the vaccine, and experiences and difficulties getting the vaccine. We compared rates, overall and by certain characteristics, between workers of the same group, and between FS (n = 17,414) and non–food system (NFS) worker groups (n = 134,375), to determine if differences exist. FS worker groups were classified as “agriculture, forestry, fishing, or hunting” (AFFH; n = 2,730); “food manufacturing facility” (FMF; n = 3,495); and “food and beverage store” (FBS; n = 11,189). Compared with NFS workers, significantly lower percentages of FS workers reported >1 dose of COVID-19 vaccine or vaccine requirements at work or school, but overall vaccine experiences and difficulties among vaccinated FS workers were statistically similar to NFS workers. When we examined intent regarding COVID-19 vaccination among unvaccinated FS workers compared with NFS counterparts, we found a higher percentage of FMF and FBS workers were reachable whereas a higher percentage of AFFH workers were reluctant about vaccination, with differences by sociodemographic characteristics. Overall, results showed differences in uptake, intent, and attitudes between worker groups and by some sociodemographic characteristics. The findings reflect the diversity of FS workers and underscore the importance of collecting occupational data to assess health inequalities and of tailoring efforts to worker groups to improve confidence and uptake of vaccinations for infectious diseases such as COVID-19. The findings can inform future research, adult infectious disease interventions, and emergency management planning. © 2024 by the Authors. |
Assessing the role of social determinants of health in health disparities: The need for data on work
Silver SR , Sweeney MH , Sanderson WT , Pana-Cryan R , Steege AL , Quay B , Carreón T , Flynn MA . Am J Ind Med 2023 BACKGROUND: Work is a key social determinant of health. Without the collection of work-related information in public health data systems, the role of social determinants in creating and reinforcing health disparities cannot be fully assessed. METHODS: The Centers for Disease Control and Prevention (CDC) maintains or supports a number of public health surveillance and health monitoring systems, including surveys, case-based disease and exposure systems, vital status records, and administrative data systems. We evaluated a convenience sample of these systems for inclusion of information in three work-related domains: employment status, industry and occupation, and working conditions. RESULTS: While 12 of 39 data systems were identified as collecting work-related data, this information was often minimal (e.g., only employment status), restricted to a subset of respondents, or only gathered periodically. Information on working conditions was particularly sparse. CONCLUSION: Historically, the limited and inconsistent collection of work-related information in public health data systems has hindered understanding of the role work plays in health disparities. Current CDC data modernization efforts present opportunities to enhance the identification and mitigation of health disparities by prioritizing inclusion of an expanded set of work-related data elements. |
Rural health and rural industries: Opportunities for partnership and action
Scott KA , Elliott KC , Lincoln J , Flynn MA , Hill R , Hall DM . J Rural Health 2023 A recent article in Morbidity and Mortality Weekly Report1 describes the Fatalities in Oil and Gas Extraction (FOG) database—an industry-specific database created to help researchers understand patterns of deaths among US oil and gas extraction (OGE) workers. Among other strengths, the database includes detailed geographic data on fatal incidents–a feature lacking in other systems that track workplace fatalities. It is clear that the majority of OGE worker fatalities occurred in rural micropolitan and noncore counties (Figure 1). This finding may not be surprising to people in the industry. However, it does raise questions about relationships between work, health, and rurality that are rarely explored explicitly or systematically. |
Occupational safety and health equity impacts of artificial intelligence: A scoping review
Fisher E , Flynn MA , Pratap P , Vietas JA . Int J Environ Res Public Health 2023 20 (13) Artificial intelligence (AI) has the potential to either reduce or exacerbate occupational safety and health (OSH) inequities in the workplace, and its impact will be mediated by numerous factors. This paper anticipates challenges to ensuring that the OSH benefits of technological advances are equitably distributed among social groups, industries, job arrangements, and geographical regions. A scoping review was completed to summarize the recent literature on AI's role in promoting OSH equity. The scoping review was designed around three concepts: artificial intelligence, OSH, and health equity. Scoping results revealed 113 articles relevant for inclusion. The ways in which AI presents barriers and facilitators to OSH equity are outlined along with priority focus areas and best practices in reducing OSH disparities and knowledge gaps. The scoping review uncovered priority focus areas. In conclusion, AI's role in OSH equity is vastly understudied. An urgent need exists for multidisciplinary research that addresses where and how AI is being adopted and evaluated and how its use is affecting OSH across industries, wage categories, and sociodemographic groups. OSH professionals can play a significant role in identifying strategies that ensure the benefits of AI in promoting workforce health and wellbeing are equitably distributed. |
Mixed messages and COVID-19 prevention: Why information isn't always enough to protect meat processing workers
Sivén JM , Coburn J , Call TP , Mahoney D , Flores RR , Kaur H , Flynn MA , Menéndez CC . AJPM Focus 2023 100128 INTRODUCTION: The objective of this project was to investigate U.S. meat and poultry processing workers' knowledge of COVID-19, perceived ability to protect themselves from infection, and perspectives on COVID-19 vaccines to inform COVID-19 prevention efforts within this linguistically, racially, and ethnically diverse workforce. METHODS: Qualitative semi-structured in-depth interviews were conducted with Mexican, Central American, Congolese refugee, and Black or African American meat/poultry processing workers from Mississippi, Minnesota, Virginia, and Kentucky (N=40). Data were collected from December 5, 2020, to January 28, 2021. Interview audio was transcribed, and rapid qualitative data analysis was used to analyze transcripts. RESULTS: Most participants expressed receiving mixed messages about COVID-19 protection measures: they were told how to protect themselves (n=38), but workplace policies (such as lack of paid sick leave) often undermined their efforts. Participants who were asked about COVID-19 vaccines (n=31) were aware there were one or more vaccines available to protect them from COVID-19; one-third were eager to get vaccinated. CONCLUSIONS: Community-based efforts may consider supplementing large scale unified information campaigns in order to prevent mixed messages, address worker needs to accurately gauge the threat of illness to their families and communities and empower them to prevent infection. |
Overlapping vulnerabilities in workers of the electronics recycling industry formal sector: A commentary
Ceballos DM , Côté D , Bakhiyi B , Flynn MA , Zayed J , Gravel S , Herrick RF , Labrèche F . Am J Ind Med 2020 63 (11) 955-962 Vulnerabilities in workers performing electronics recycling (e-recycling) in the informal sector worldwide have been well documented. However, the growing e-recycling industry in the formal sector still brings many challenges to protect the health of workers and their environment. This commentary aims to draw attention to the overlooked vulnerabilities faced by the workers of the e-recycling industry formal sector in high-income countries and discuss the potential impact on health inequalities experienced by these workers. Expanding the definition of vulnerability, not limited to the biological susceptibility to chemical and physical exposures, the demographic characteristics of workers in the e-recycling formal sector often reveal social groups known to be disadvantaged regarding occupational exposures and health effects, including young workers, immigrant or ethnic minorities, and workers with mental or physical health issues or disabilities. Overlapping structural vulnerabilities of the e-recycling industry stem from its newness, its working conditions, its conditions of employment, and the sociodemographic characteristics of its workforce. This phenomenon in high-income countries is not restricted to the e-recycling industry alone. It is rather a symptom of more generalized macro socioeconomical phenomena. The present challenges are in line with the new gig and green economies and changes in the global market, and their consequences on the solid waste sector. Continued efforts to strengthen the inclusion of social aspects of health into the complex interaction of the structural vulnerabilities met by e-recycling workers will be essential to anticipate and prevent health issues in this essential but still emerging workforce. |
Flynn et al. Respond
Flynn MA , Cunningham TR , Ahonen EQ , Fujishiro K . Am J Public Health 2018 108 (9) e3-e4 We would like to thank Wegman and Davis for their response to our article and congratulate them and their colleagues on the recent report from the National Academies of Science, Engineering, and Medicine: A Smarter National Surveillance System for Occupational Safety and Health in the 21st Century (NAS report).1 We share Wegman and Davis’s optimism that this moment offers an opportunity for developing systems that generate better, more comprehensive data to improve our understanding of the social determinants that drive health inequities and empower society to eliminate health inequities. Whether arguing for a greater recognition for the influence of work on population health or a greater accounting for the role social structures play in health inequalities manifest in the workplace, the need for a more inclusive, social determinant approach to health inequity2 is a central theme of both documents. |
Updated assessment of occupational safety and health hazards of climate change
Schulte PA , Jacklitsch BL , Bhattacharya A , Chun H , Edwards N , Elliott KC , Flynn MA , Guerin R , Hodson L , Lincoln JM , MacMahon KL , Pendergrass S , Siven J , Vietas J . J Occup Environ Hyg 2023 20 1-36 Workers, particularly outdoor workers, are among the populations most disproportionately affected by climate-related hazards. However, scientific research and control actions to comprehensively address these hazards are notably absent. To assess this absence, a seven-category framework was developed in 2009 to characterize the scientific literature published from 1988 through 2008. Using this framework, a second assessment examined the literature published through 2014, and the current one examines literature from 2014 through 2021. The objectives were to present literature that updates the framework and related topics and increases awareness of the role of climate change in occupational safety and health. In general, there is substantial literature on worker hazards related to ambient temperatures, biological hazards, and extreme weather but less on air pollution, ultraviolet radiation, industrial transitions, and the built environment. There is growing literature on mental health and health equity issues related to climate change, but much more research is needed. The socioeconomic impacts of climate change also require more research. This study illustrates that workers are experiencing increased morbidity and mortality related to climate change. In all areas of climate-related worker risk, including geoengineering, research is needed on the causality and prevalence of hazards, along with surveillance to identify, and interventions for hazard prevention and control. |
Mobile Health and Wellness Project: A binational collaboration of frontline health services to the Latino population in the United States in times of COVID-19
Rosales CB , Dávila Chávez H , Flynn MA , Lara J , Lira Chávez IA , Olivares Marín L , Romero Rangel A , Hirata Okamoto R , Rangel Gómez MG . Front Public Health 2022 10 1022772 Hardly reached communities in the United States greatly benefit from collective efforts and partnerships from Community Based Organizations, Health Institutions and Government Agencies, yet the effort to engage in this collaborative effort is minimal and funding to support these projects is lacking. The COVID-19 Pandemic exacerbated on a national scale what many vulnerable communities experience regularly; difficult access to basic medical care, information and support. In an effort to directly engage with community organizations and curb the infection rate of the COVID-19 virus within vulnerable communities, the US Centers for Disease Control and Prevention (CDC) launched its first targeted effort to partner directly with community based organizations. This article will highlight the first pilot year of activities and key results of COVID-19 education and vaccination efforts by the Mobile Health and Wellness project. This is a fleet of 11 Mobile Health Vehicles managed by the Mexico Section US-Mexico Border Health Commission in partnership with Alianza Americas, Latino Commission on AIDS, and the CDC, targeting Latino, Immigrant and rural communities across the US. |
Occupational safety and health with technological developments in livestock farms: A literature review
Hayden MA , Barim MS , Weaver DL , Elliott KC , Flynn MA , Lincoln JM . Int J Environ Res Public Health 2022 19 (24) In recent decades, there have been considerable technological developments in the agriculture sector to automate manual processes for many factors, including increased production demand and in response to labor shortages/costs. We conducted a review of the literature to summarize the key advances from installing emerging technology and studies on robotics and automation to improve agricultural practices. The main objective of this review was to survey the scientific literature to identify the uses of these new technologies in agricultural practices focusing on new or reduced occupational safety risks affecting agriculture workers. We screened 3248 articles with the following criteria: (1) relevance of the title and abstract with occupational safety and health; (2) agriculture technologies/applications that were available in the United States; (3) written in English; and (4) published 2015-2020. We found 624 articles on crops and harvesting and 80 articles on livestock farming related to robotics and automated systems. Within livestock farming, most (78%) articles identified were related to dairy farms, and 56% of the articles indicated these farms were using robotics routinely. However, our review revealed gaps in how the technology has been evaluated to show the benefits or potential hazards to the safety and well-being of livestock owners/operators and workers. |
Working hours, sleep, and fatigue in the agriculture, forestry, and fishing sector: A scoping review
Elliott KC , Lincoln JM , Flynn MA , Levin JL , Smidt M , Dzugan J , Ramos AK . Am J Ind Med 2022 65 (11) 898-912 INTRODUCTION: Agriculture, forestry, and fishing industry (AgFF) workers often work extremely long hours during peak production seasons, resulting in sleep deprivation and fatigue. The National Occupational Research Agenda has classified fatigue as a "significant safety issue" and area of concern for many industry sectors, including AgFF. This review explores current research and practice in AgFF and proposes next steps. METHODS: We conducted a scoping literature review to examine the extent and nature of research in this area. Article inclusion criteria included peer-reviewed journal articles written in English; published after 1989; covering AgFF workers in high-income countries; with data on working hours/schedules and sleep related to safety and health. RESULTS: Limited research has addressed long hours and sleep deprivation among AgFF workers. We identified 8350 articles for title and abstract review. Among those, 407 underwent full-text review and 96 met all inclusion criteria (67% agriculture, 25% fishing/seafood processing, 8% forestry). The literature provided some evidence fatigue contributes to fatalities, injuries, and illnesses in AgFF. Older, new, young, foreign-born, and female workers, as well as those who work in small organizations or longer hours (40+) may be at higher risk for fatigue-related injury and illness. Few studies have developed or evaluated interventions to control risks. DISCUSSION: Given that fatigue is a factor in injury and illness for this sector, future AgFF surveillance and research should increase efforts to capture fatigue and sleep data, directly investigate the role of long hours and nonstandard work schedules in the sector, and most importantly, create practical interventions to manage fatigue. |
Preventing suicidal behavior among American Indian and Alaska Native adolescents and young adults
Mpofu JJ , Crosby A , Flynn MA , LaFromboise T , Iskander J , Hall JE , Penman-Aguilar A , Thorpe P . Public Health Rep 2022 138 (4) 333549221108986 From 2009 to 2018, overall suicide rates in the United States increased by 20.3% and increased by 43.5% among non-Hispanic American Indian and Alaska Native (AI/AN) communities. Combining years 2009 through 2018, suicide rates per 100 000 population among non-Hispanic AI/AN adolescents and young adults aged 15 to 34 years were 2 to 4 times higher than those of adolescents and young adults of other races and ethnicities. An estimated 14% to 27% of non-Hispanic AI/AN adolescents attempted suicide during that time. The elevated rates of suicidal behavior among non-Hispanic AI/AN adolescents and young adults reflect inequities in the conditions that create health. In this topical review, we describe school-based educational efforts that are driven by local AI/AN communities, such as the American Indian Life Skills curriculum, that teach stress and coping skills and show promise in reducing suicidal ideation attempts and fatalities among AI/AN adolescents. Using a social-determinants-of-health lens, we review the availability and quality of employment as an important influencer of suicidal behavior, as well as the role of the workplace as an environment for suicide prevention in AI/AN communities. Working with tribal, state, local, and federal colleagues, the public health community can implement programs known to be effective and create additional comprehensive strategies to reduce inequities and ultimately reduce suicide rates. |
Health equity and a paradigm shift in occupational safety and health
Flynn MA , Check P , Steege AL , Sivén JM , Syron LN . Int J Environ Res Public Health 2022 19 (1) Despite significant improvements in occupational safety and health (OSH) over the past 50 years, there remain persistent inequities in the burden of injuries and illnesses. In this commen-tary, the authors assert that addressing these inequities, along with challenges associated with the fundamental reorganization of work, will require a more holistic approach that accounts for the social contexts within which occupational injuries and illnesses occur. A biopsychosocial approach explores the dynamic, multidirectional interactions between biological phenomena, psychological factors, and social contexts, and can be a tool for both deeper understanding of the social determinants of health and advancing health equity. This commentary suggests that reducing inequities will require OSH to adopt the biopsychosocial paradigm. Practices in at least three key areas will need to adopt this shift. Research that explicitly examines occupational health inequities should do more to elucidate the effects of social arrangements and the interaction of work with other social determinants on work-related risks, exposures, and outcomes. OSH studies regardless of focus should incorporate inclusive methods for recruitment, data collection, and analysis to reflect societal diversity and account for differing experiences of social conditions. OSH researchers should work across disciplines to integrate work into the broader health equity research agenda. © 2021 by the authors. Licensee MDPI, Basel, Switzerland. |
Public health impacts of underemployment and unemployment in the United States: Exploring perceptions, gaps and opportunities
Pratap P , Dickson A , Love M , Zanoni J , Donato C , Flynn MA , Schulte PA . Int J Environ Res Public Health 2021 18 (19) Background: Unemployment, underemployment, and the quality of work are national occupational health risk factors that drive critical national problems; however, to date, there have been no systematic efforts to document the public health impact of this situation. Methods: An environmental scan was conducted to explore the root causes and health impacts of underemployment and unemployment and highlight multilevel perspectives and factors in the landscape of underemploy-ment and unemployment. Methods: included a review of gray literature and research literature, followed by key informant interviews with nine organizational representatives in employment research and policy, workforce development, and industry to assess perceived needs and gaps in practice. Results: Evidence highlights the complex nature of underemployment and unemployment, with multiple macro-level underlying drivers, including the changing nature of work, a dynamic labor market, inadequate enforcement of labor protection standards, declining unions, wage de-pression, and weak political will interacting with multiple social determinants of health. Empirical literature on unemployment and physical, mental, and psychological well-being, substance abuse, depression in young adults, and suicides is quite extensive; however, there are limited data on the impacts of underemployment on worker health and well-being. Additionally, organizations do not routinely consider health outcomes as they relate to their work in workforce or policy development. Discussion and Conclusions: Several gaps in data and research will need to be addressed in order to assess the full magnitude of the public health burden of underemployment and unemployment. Public health needs to champion a research and practice agenda in partnership with multisector stakeholders to illuminate the role of employment quality and status in closing the gap on health inequities, and to integrate workforce health and well-being into labor and economic development agendas across government agencies and industry. © 2021 by the authors. Licensee MDPI, Basel, Switzerland. |
Reaching "hard to reach" workers: Evaluating approaches to disseminate worker safety information via the Mexican consular network
Flynn MA , Eggerth DE , Keller BM , Check P . J Occup Environ Hyg 2021 18 1-17 Mexican immigrants suffer a disproportionately large number of work-related injuries and deaths given their share of the workforce. Barriers of language, culture, and mistrust are often cited as factors that complicate efforts to reach these workers with occupational safety and health (OSH) interventions. By partnering with the Mexican government and its consulate network in the United States, researchers from the National Institute for Occupational Safety and Health were able to assess the impact of four different information dissemination approaches (posters, passively distributed brochures, actively distributed brochures, and video kiosks) in Spanish in a five-phase study. Exit interviews conducted with Mexicans seeking consular services indicated that while nearly all respondents considered OSH to be of importance, significant differences in impact measures, such as noticing the materials and liking of content, were found when comparing the different approaches. Despite these differences, even the least effective approaches were noticed by large numbers of individuals and significantly increased their stated behavioral intentions regarding OSH. Considering all materials together, significantly more participants reported liking the materials (p < 0.001) than did not, learning something new (p < 0.01), trusting the information (p < 0.05), intending to seek out additional OSH information (p < 0.01), and intending to speak to their bosses about OSH (p < 0.05). These findings contribute to building an evidence base for moving research knowledge into practice, which is an essential, but often overlooked, element of occupational safety and health research, particularly among workers from underserved communities. |
An innovative United States-Mexico community outreach initiative for Hispanic and Latino people in the United States: A collaborative public health network
Flynn MA , Rodriguez Lainz A , Lara J , Rosales C , Feldstein F , Dominguez K , Wolkin A , Sierra Medal IR , Tonda J , Romero-Steiner S , Dicent-Taillepierre J , Rangel Gómez MG . Public Health Rep 2021 136 (3) 287-294 Collaborative partnerships are a useful approach to improve health conditions of disadvantaged populations. The Ventanillas de Salud (VDS) ("Health Windows") and Mobile Health Units (MHUs) are a collaborative initiative of the Mexican government and US public health organizations that use mechanisms such as health fairs and mobile clinics to provide health information, screenings, preventive measures (eg, vaccines), and health services to Mexican people, other Hispanic people, and underserved populations (eg, American Indian/Alaska Native people, geographically isolated people, uninsured people) across the United States. From 2013 through 2019, the VDS served 10.5 million people (an average of 1.5 million people per year) at Mexican consulates in the United States, and MHUs served 115 461 people from 2016 through 2019. We describe 3 community outreach projects and their impact on improving the health of Hispanic people in the United States. The first project is an ongoing collaboration between VDS and the Centers for Disease Control and Prevention (CDC) to address occupational health inequities among Hispanic people. The second project was a collaboration between VDS and CDC to provide Hispanic people with information about Zika virus infection and health education. The third project is a collaboration between MHUs and the University of Arizona to provide basic health services to Hispanic communities in Pima and Maricopa counties, Arizona. The VDS/MHU model uses a collaborative approach that should be further assessed to better understand its impact on both the US-born and non-US-born Hispanic population and the public at large in locations where it is implemented. |
Envisioning the future of work to safeguard the safety, health, and well-being of the workforce: A perspective from the CDC's National Institute for Occupational Safety and Health
Tamers SL , Streit J , Pana-Cryan R , Ray T , Syron L , Flynn MA , Castillo D , Roth G , Geraci C , Guerin R , Schulte P , Henn S , Chang CC , Felknor S , Howard J . Am J Ind Med 2020 63 (12) 1065-1084 The future of work embodies changes to the workplace, work, and workforce, which require additional occupational safety and health (OSH) stakeholder attention. Examples include workplace developments in organizational design, technological job displacement, and work arrangements; work advances in artificial intelligence, robotics, and technologies; and workforce changes in demographics, economic security, and skills. This paper presents the Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health's Future of Work Initiative; suggests an integrated approach to address worker safety, health, and well-being; introduces priority topics and subtopics that confer a framework for upcoming future of work research directions and resultant practical applications; and discusses preliminary next steps. All future of work issues impact one another. Future of work transformations are contingent upon each of the standalone factors discussed in this paper and their combined effects. Occupational safety and health stakeholders are becoming more aware of the significance and necessity of these factors for the workplace, work, and workforce to flourish, merely survive, or disappear altogether as the future evolves. The future of work offers numerous opportunities, while also presenting critical but not clearly understood difficulties, exposures, and hazards. It is the responsibility of OSH researchers and other partners to understand the implications of future of work scenarios to translate effective interventions into practice for employers safeguarding the safety, health, and well-being of their workers. |
Heart attacks, bloody noses, and other "emotional problems": Cultural and conceptual issues with the Spanish translation of self-report emotional health items
Flynn MA , Eggerth DE , Jacobson CJJr , Lyon SM . Fam Community Health 2020 44 (1) 1-9 This article examines how respondents understood items in the Spanish versions of the Short-Form 36 (SF-36v2). Cognitive interviews of the SF-36 were conducted in 2 phases with 46 Spanish speakers living in the United States. Roughly one-third (17/46) of respondents had difficulty understanding the Role Emotional items upon their initial reading, and almost half (21/46) provided examples that were inconsistent with the intended meaning of the items. The findings of this study underscore the importance of conducting cognitive testing to ensure conceptual equivalence of any instrument regardless of how well validated it appears to be. |
Eliminating take-home exposures: Recognizing the role of occupational health and safety in broader community health
Kalweit A , Herrick RF , Flynn MA , Spengler JD , Berko JK , Levy JI , Ceballos DM . Ann Work Expo Health 2020 64 (3) 236-249 Toxic contaminants inadvertently brought from the workplace to the home, known as take-home or paraoccupational exposures, have often been framed as a problem that arises due to unsanitary worker behavior. This review article conceptualizes take-home exposures as a public health hazard by (i) investigating the history of take-home contaminants and how they have been studied, (ii) arguing that an ecosocial view of the problem is essential for effective prevention, (iii) summarizing key structural vulnerabilities that lead populations to be at risk, and (iv) discussing future research and prevention effort needs. This article reframes take-home exposures as one of many chronic pathways that contributes to persistent health disparities among workers, their families, and communities. Including the role of work in community health will increase the comprehensiveness of prevention efforts for contaminants such as lead and pesticides that contribute to environmental disparities. |
Work experiences of Latino building cleaners: An exploratory study
Eggerth DE , Ortiz B , Keller BM , Flynn MA . Am J Ind Med 2019 62 (7) 600-608 BACKGROUND: There are roughly 3.8 million cleaning workers in the United States. The cleaning workforce is largely composed of women, immigrants, and ethnic minorities who receive low wages and have low education levels. They are exposed to physical, chemical, biological, and psychosocial hazards. METHODS: Qualitative methodology was used to investigate how Latino immigrants experience work as building cleaners. A grounded theory coding approach was used to analyze focus group data from 77 participants. RESULTS: Three major themes were identified: economic vulnerability, psychosocial stressors, and health and safety effects. Although workers are aware of the safety hazards associated with their jobs, they believe their immigration status limits employment opportunities leading them to accept poor working conditions. They work through injuries and cope psychologically through minimizing negative health impacts and normalizing work-related injuries and illnesses. CONCLUSIONS: The findings suggest that interventions for these workers should recognize the hostile organizational and psychosocial contexts within which immigrants often work. |
Im/migration, work, and health: Anthropology and the occupational health of labor im/migrants
Flynn MA . Anthropol Work Rev 2018 39 (2) 116-123 From Rudolf Virchow's groundbreaking investigation of typhus among coal miners in 1848 (Brown and Fee 2006) through the World Health Organization's adoption of the social determinants of health (WHO 2008) paradigm in 2008, the relationship between work and health has been fundamental to the development of a social approach to health and well-being found in anthropology today (Abrams 2001; Brown and Fee 2006; Farmer et al, 2006; Singer et al. 1992). Concurrently, the working conditions of im/migrants figured prominently in the early studies and events establishing occupational health as a field in the United States (Abrams 2001). A historic turning point in the effort to securing safer working conditions in the United States occured in New York City in 1911 when im/migrant women made up the majority of workers killed in the fire Triangle Shirtwaist Company. In the same time period, Dr. Alice Hamilton, the founder of occupational medicine in the United States, spent much of her early career studying and treating work-related diseases and conditions of im/migrant workers she met through her association with Jane Addams at the Hull-House in Chicago (Abrams 2001). |
Evaluation of toolbox safety training in construction: The impact of narratives
Eggerth DE , Keller BM , Cunningham TR , Flynn MA . Am J Ind Med 2018 61 (12) 997-1004 BACKGROUND: Construction is a dangerous industry with a large number of small businesses. Because they require minimal resources to deliver, toolbox talks may be an ideal training format for small construction contractors. METHODS: Eight toolbox talks were developed, each with two versions. One version of each toolbox talk was standard and one version included a narrative and discussion questions. Participants were randomly assigned to receive the standard or the narrative version. Pre- and post-intervention surveys measured demographics, workplace safety climate, and knowledge. The post-intervention survey also measured training impact. RESULTS: Including narratives with discussion questions significantly increased knowledge gain and led to increased training impact. Less experienced workers were more likely to gain knowledge and training impact compared to more experienced workers. There were no significant changes in workplace safety climate. CONCLUSIONS: The results suggest that including a narrative and discussion questions increases toolbox talk effectiveness. |
Exploring workplace TB interventions with foreign-born Latino workers
Eggerth DE , Keller BM , Flynn MA . Am J Ind Med 2018 BACKGROUND: Persons born outside the United States are more likely to be diagnosed with tuberculosis disease (TB) than native-born individuals. Foreign-born Latinos at risk of TB may be difficult to reach with public health interventions due to cultural and institutional barriers. Workplaces employing large concentrations of foreign-born Latinos may be useful locations for TB interventions targeting this high-risk population. METHOD: This study used a two-phase approach to investigate the feasibility of workplace TB interventions. The first phase investigated employer knowledge of TB and receptiveness to allowing TB interventions in their businesses through 5 structured interviews. The second phase investigated foreign-born workers' knowledge of TB and their receptiveness to receiving TB interventions in their places of employment through 12 focus groups stratified by gender and education. RESULTS: Phase 1: Only 1 of the 5 employers interviewed had a high level of knowledge about TB, and three had no knowledge other than that TB was a disease that involved coughing. They were receptive to workplace TB interventions, but were concerned about lost productivity and customers finding out if an employee had TB. Phase 2: There was no observed differences in responses between gender and between the bottom two education groups, so the final analysis took place between a gender-combined lower education group and higher education group. The higher education group tended to have knowledge that was more accurate and to view TB as a disease associated with poverty. The lower education group tended to have more misconceptions about TB and more often expressed concern that their employers would not support worksite interventions. CONCLUSIONS: The results from both phases indicate that more TB education is needed among both foreign-born Latino workers and their employers. Obstacles to implementing workplace TB interventions include knowledge, potential productivity loss, employer liability, and perceived customer response. |
Differences in safety training among smaller and larger construction firms with non-native workers: Evidence of overlapping vulnerabilities
Cunningham TR , Guerin RJ , Keller BM , Flynn MA , Salgado C , Hudson D . Saf Sci 2018 103 62-69 Collaborative efforts between the National Institute for Occupational Safety and Health (NIOSH) and the American Society of Safety Engineers (ASSE) led to a report focusing on overlapping occupational vulnerabilities, specifically small construction businesses employing young, non-native workers. Following the report, an online survey was conducted by ASSE with construction business representatives focusing on training experiences of non-native workers. Results were grouped by business size (50 or fewer employees or more than 50 employees). Smaller businesses were less likely to employ a supervisor who speaks the same language as immigrant workers (p <.001). Non-native workers in small businesses received fewer hours of both initial safety training (p =.005) and monthly ongoing safety training (p =.042). Immigrant workers in smaller businesses were less likely to receive every type of safety training identified in the survey (including pre-work safety orientation [p <.001], job-specific training [p <.001], OSHA 10-hour training [p =.001], and federal/state required training [p <.001]). The results highlight some of the challenges a vulnerable worker population faces in a small business, and can be used to better focus intervention efforts. Among businesses represented in this sample, there are deficits in the amount, frequency, and format of workplace safety and health training provided to non-native workers in smaller construction businesses compared to those in larger businesses. The types of training conducted for non-native workers in small business were less likely to take into account the language and literacy issues faced by these workers. The findings suggest the need for a targeted approach in providing occupational safety and health training to non-native workers employed by smaller construction businesses. |
Has the question of e-waste opened a Pandora's box? An overview of unpredictable issues and challenges
Bakhiyi B , Gravel S , Ceballos D , Flynn MA , Zayed J . Environ Int 2018 110 173-192 Despite regulatory efforts and position papers, electrical and electronic waste (e-waste) remains ill-managed as evidenced by the extremely low rates of proper e-waste recycling (e-recycling) worldwide, ongoing illegal shipments to developing countries and constantly reported human health issues and environmental pollution. The objectives of this review are, first, to expose the complexity of e-waste problems, and then to suggest possible upstream and downstream solutions. Exploring e-waste issues is akin to opening a Pandora's box. Thus, a review of prevailing e-waste management practices reveals complex and often intertwined gaps, issues and challenges. These include the absence of any consistent definition of e-waste to date, a prevalent toxic potential still involving already banned or restricted hazardous components such as heavy metals and persistent and bioaccumulative organic compounds, a relentless growth in e-waste volume fueled by planned obsolescence and unsustainable consumption, problematic e-recycling processes, a fragile formal e-recycling sector, sustained and more harmful informal e-recycling practices, and more convoluted and unpredictable patterns of illegal e-waste trade. A close examination of the e-waste legacy contamination reveals critical human health concerns, including significant occupational exposure during both formal and informal e-recycling, and persistent environmental contamination, particularly in some developing countries. However, newly detected e-waste contaminants as well as unexpected sources and environmental fates of contaminants are among the emerging issues that raise concerns. Moreover, scientific knowledge gaps remain regarding the complexity and magnitude of the e-waste legacy contamination, specifically, a comprehensive characterization of e-waste contaminants, information on the scale of legacy contamination in developing countries and on the potential environmental damage in developed countries, and a stronger body of evidence of adverse health effects specifically ascribed to e-waste contaminants. However, the knowledge accumulated to date is sufficient to raise awareness and concern among all stakeholders. Potential solutions to curb e-waste issues should be addressed comprehensively, by focusing on two fronts: upstream and downstream. Potential upstream solutions should focus on more rational and eco-oriented consumer habits in order to decrease e-waste quantities while fostering ethical and sustained commitments from manufacturers, which include a limited usage of hazardous compounds and an optimal increase in e-waste recyclability. At the downstream level, solutions should include suitable and pragmatic actions to progressively reduce the illegal e-waste trade particularly through international cooperation and coordination, better enforcement of domestic laws, and monitoring in both exporting and receiving countries, along with the supervised integration of the informal sector into the recycling system of developing countries and global expansion of formal e-waste collection and recycling activities. Downstream solutions should also introduce stronger reverse logistics, together with upgraded, more affordable, and eco-friendly and worker-friendly e-recycling technologies to ensure that benefits are derived fully and safely from the great economic potential of e-waste. |
Tailoring computer-based training for Latino immigrant workers: Pilot test of the NIOSH mouse tutorial
Flynn MA , DeLaney S , Willeford C . New Solut 2017 28 (1) 1048291117734381 An interactive tutorial on using a mouse for first-time computer users was developed as part of a training CD-ROM tailored for Latino immigrant workers in trenching and excavation. It was designed for Spanish-speaking users with varying levels of formal education. The tutorial was tested in focus groups with workers who had little or no previous experience using a computer. Findings revealed that while users with less than a fourth-grade education and/or low proficiency in Spanish had some difficulties with the tutorial, they still scored above 67 percent on the performance evaluation; participants with at least a fourth-grade education (the majority) completed it with minimal assistance and scored 80%-100% on the performance evaluation. Feedback from participant focus groups following the computer sessions supported these findings. The results of this study suggest that computer-based training may be able to be made accessible for low computer literacy Latino immigrant workers, if it is tailored to their needs. |
Leveraging the domain of work to improve migrant health
Flynn MA , Wickramage K . Int J Environ Res Public Health 2017 14 (10) Work is a principal driver of current international migration, a primary social determinant of health, and a fundamental point of articulation between migrants and their host society. Efforts by international organizations to promote migrant health have traditionally focused on infectious diseases and access to healthcare, while international labor organizations have largely focused on issues of occupational health. The underutilization of the domain of work in addressing the health of migrants is truly a missed opportunity for influencing worker well-being and reducing societal economic burden. Understanding of the relationships among migration, work, and health would facilitate further integration of migrant health concerns into the policy agenda of governments and international agencies that work at the nexus of labor, health and development. The domain of work offers an opportunity to capitalize on the existing health and development infrastructure and leverage technical resources, programs and research to promote migrant health. It also provides the opportunity to advance migrant health through new and innovative approaches and partnerships. |
Promotion of alternative-sized personal protective equipment
Flynn MA , Keller B , DeLaney SC . J Safety Res 2017 63 43-46 Introduction With more diversity in the workforce, companies are producing PPE such as hard hats, safety glasses, coveralls, foot protection, and safety harnesses for a larger range of body shapes and sizes. However, gray literature reports suggest that barriers exist to getting alternate sized PPE from the manufacturer to the workers who need it. The purpose of this study is to determine the extent to which alternative-sized PPE is marketed. Method A web-based review of seven major manufacturers of PPE was conducted to determine: (a) whether or not they offer alternative-sized products, (b) if these products are clearly labeled, and (c) if images used to display PPE are representative of a diverse workforce. Results Of the seven PPE manufacturers investigated, six had at least one product that was marketed as gender and/or size alternatives however, alternative sizes were more common for larger body types. Alternative-sized products rarely included size charts, and the models used to display PPE were overwhelmingly white males of average size. Conclusions Despite the growing availability of alternative-sized PPE, it can be difficult to find these products, which suggests that they are rarely promoted or labeled as alternative-sized. Our study indicates that companies should expand their product lines and more aggressively market and promote these items. Guidance on how to properly fit their products would also be extremely helpful to the end-user. Practical applications Manufacturers could improve the availability of alternative-sized PPE and increase their promotion of these products on their websites and in their catalogs. Individual companies and safety professionals may assist in this process by demonstrating demand for alternative-sized PPE. |
Undocumented status as a social determinant of occupational safety and health: the workers' perspective
Flynn MA , Eggerth DE , Jacobson CJ . Am J Ind Med 2015 58 (11) 1127-37 BACKGROUND: Undocumented immigration to the United States has grown dramatically over the past 25 years. This study explores undocumented status as a social determinant of occupational health by examining its perceived consequences on workplace safety of Latino immigrants. METHODS: Guided by the Theory of Work Adjustment, qualitative analysis was conducted on transcripts from focus groups and individual interviews conducted with a convenience sample of Latino immigrant workers. RESULTS: Participants reported that unauthorized status negatively impacted their safety at work and resulted in a degree of alienation that exceeded the specific proscriptions of the law. Participants overwhelming used a strategy of disengagement to cope with the challenges they face as undocumented immigrants. CONCLUSION: This study describes the complex web of consequences resulting from undocumented status and its impact on occupational health. This study presents a framework connecting the daily work experiences of immigrants, the coping strategy of disengagement, and efforts to minimize the impact of structural violence. |
Immigration, Work, and Health: A Literature Review of Immigration Between Mexico and the United States
Flynn MA , Carreón T , Eggerth DE , Johnson AI . Revista Trab Soc (Santiago) 2014 6 129-149 Understanding the influence someone's job or career has on their health goes beyond the physical, emotional and social hazards, risks and conditions that they face at work. One's job or career also exerts a significant influence over other aspects of life that contribute or detract from their health and that of their family. Work is the major incentive for Latin American migration to the United States. Latino immigrants experience increasingly poorer outcomes for physical health and chronic diseases the longer they remain in the U.S. The strong link between work and immigration suggests that, for many Latin Americans, immigration can be understood as a career path which puts them, and their family members, in situations that can change their physical, emotional, and social health as a condition of their employment. Given the large number of Latin Americans who emigrate for work, it is essential that the unique physical, mental and social impacts of emigration are accounted for when working with clients impacted by emigration at the individual, family and community level as well as those social workers practicing at the system level. This paper is a literature review that explores the impact that emigrating for work has on the health of those that emigrate and their family members that stay behind. |
- Page last reviewed:Feb 1, 2024
- Page last updated:Apr 29, 2024
- Content source:
- Powered by CDC PHGKB Infrastructure