Manufacturing Worksites Research Articles

Evaluation of a workplace suicide prevention program in the Australian manufacturing industry: protocol for a cluster-randomised trial of MATES in manufacturing

Males are at higher risk of death by suicide than females in Australia, and among men, blue-collar males are at higher risk compared to other working males. In response, MATES in Construction developed a workplace suicide prevention program for the construction sector in 2007 that has been widely implemented in Australia. In the current project, this program is being adapted and trialled in the manufacturing sector. The common aims of MATES programs are to improve suicide prevention literacy, help-seeking intentions, and helping behaviours. The program will be evaluated using a cluster randomised-controlled trial design with waitlist controls across up to 12 manufacturing worksites in Australia. We hypothesise that after 8 months of the MATES in Manufacturing program, there will be significantly greater improvements in help-seeking intentions (primary outcome) compared to waitlist controls. The project is led by Deakin University in collaboration with the University of Melbourne, and in partnership with MATES in Construction and a joint labour-management Steering Group.Trial registration: The trial was registered retrospectively with the Australian New Zealand Clinical Trials Registry on 25 January 2022 (ACTRN12622000122752).Protocol version: 2.0, November 2022.

Lost in translation: The challenge of adapting integrated approaches for worker health and safety for low- and middle-income countries.

ObjectivesTo describe the process of adapting an intervention integrating occupational safety and health (OSH) and health promotion for manufacturing worksites in India and the challenges faced in implementing it; and explore how globalization trends may influence the implementation of these integrated approaches in India and other low- and middle-income countries (LMICs).MethodsThis study—conducted in 22 manufacturing worksites in Mumbai, India—adapted and implemented an evidence-based intervention tested in the U.S. that integrated OSH and tobacco control. The systematic adaptation process included formative research and pilot testing, to ensure that the tested intervention was tailored to the local setting. We used qualitative methods and process evaluation to assess the extent to which this intervention was implemented, and to explore barriers to implementation.ResultsWhile participating worksites agreed to implement this intervention, not all components of the adapted intervention were implemented fully in the 10 worksites assigned to the intervention condition. We found that the OSH infrastructure in India focused predominantly on regulatory compliance, medical screening (secondary prevention) and the treatment of injuries. We observed generally low levels of leadership support and commitment to OSH, evidenced by minimal management participation in the intervention, reluctance to discuss OSH issues with the study team or workers, and little receptivity to recommendations resulting from the industrial hygienist’s reports.ConclusionIndia presents one example of a LMIC with a rising burden of non-communicable diseases and intensified exposures to both physical and organizational hazards on the job. Our experiences highlight the importance of national and global trends that shape workers’ experiences on the job and their related health outcomes. Beyond a singular focus on prevention of non-communicable diseases, coordinated national and international efforts are needed to address worker health outcomes in the context of the conditions of work that clearly shape them.

The Prevalence of Tobacco Use among Manufacturing Workers: Findings from the Baseline Survey of the Mumbai Worksite Tobacco Control Study

Objectives: To explore the potential role of the work context associated with tobacco use patterns among manufacturing workers in India Methods: We used cross-sectional survey data from the Mumbai Worksite Tobacco Control Study. Workers from manufacturing worksites in the greater Mumbai region were surveyed from 20 worksites that were recruited between July 2012 and July 2013 on rolling basis for a randomized controlled trial. Results: A total of 6880 workers out of 7633 that employed in 20 manufacturing worksites were surveyed. Current tobacco use was higher among production (23.5%) than non-production (19.2%) workers. In contrast, past tobacco use was somewhat lower among production (6.2%) than non-production (8.4%) workers. Production workers who used smokeless tobacco were twice as likely to report their workplaces did not have a policy or rule prohibiting tobacco use as compared to smokers or non-tobacco users. The prevalence of past tobacco use - compared to current use - was associated with workers’ education, economic index and number of co-workers using tobacco. Conclusions: The current study underscores the important role of co-workers and worksite tobacco control policies (that cover both smoking and smokeless forms) to support reductions in tobacco use among manufacturing workers.

A Substance Abuse Intervention Program at a Large Russian Manufacturing Worksite

Motivating alcohol abusers to enter treatment, comply with recommendations, and make significant changes in their behavior is no easy task. In the West, professionals learned the importance of motivation early on, and they learned it first from those recovering in Alcoholics Anonymous. Early occupational alcoholism programs used job performance and disciplinary steps to motivate problem drinkers to take action. The threat of job loss proved significant in breaking through denial and in motivating clients to begin a recovery process. This approach was incorporated into the Employee Assistance Program (EAP) and EAP professionals have used job performance and disciplinary steps to motivate those with many types of personal issues. In the Russian Federation, no such history exists. This workplace-based alcohol intervention program is a first for Russia, and it uses the work performance approach successfully deployed in the West for many decades.

Safety Management in Multiemployer Worksites in the Manufacturing Industry: Opinions on Co-Operation and Problems Encountered

Co-operation between different parties and effective safety management play an important role in ensuring safety in multiemployer worksites. This article reviews safety co-operation and factors complicating safety management in Finnish multiemployer manufacturing worksites. The paper focuses on the service providers’ opinions; however, a comparison of the customers’ views is also presented. The results show that safety-related co-operation between providers and customers is generally considered as successful but strongly dependent on the partner. Safety co-operation is provided through, e.g., training, orientation and risk analysis. Problems encountered include ensuring adequate communication, identifying hazards, co-ordinating work tasks and determining responsibilities. The providers and the customers encounter similar safety management problems. The results presented in this article can help companies to focus their efforts on the most problematic points of safety management and to avoid common pitfalls.

Typology of ROII Patterns on Cluster Analysis in Korean Enterprises

ObjectivesAuthors investigated the pattern of the rate of occupational injuries and illnesses (ROII) at the level of enterprises in order to build a network for exchange of experience and knowledge, which would contribute to workers' safety and health through safety climate of workplace.MethodsOccupational accidents were analyzed at the manufacturing work site unit. A two step clustering process for the past patterns regarding the ROII from 2001 to 2009 was investigated. The ROII patterns were categorized based on regression analysis and the patterns were further divided according to the subtle changes with Mahalanobis distance and Ward's linkage.ResultsThe first clustering of ROII through regression analysis showed 5 different functions; 29 work sites of the linear function, 50 sites of the quadratic function, 95 sites of the logarithm function, 62 sites of the exponential function, and 54 sites of the sine function. Fourteen clusters were created in the second clustering. There were 3 clusters in each function categorized in the first clustering except for sine function. Each cluster consisted of the work sites with similar ROII patterns, which had unique characteristics.ConclusionThe five different patterns of ROII suggest that tailored management activities should be applied to every work site. Based on these differences, the authors selected exemplary work sites and built a network to help the work sites to share information on safety climate and accident prevention measures. The causes of different patterns of ROII, building network and evaluation of this management model should be evaluated as future researches.

Promoting contraceptive use among female rural-to-urban migrants in Qingdao, China: A comparative impact study of worksite-based interventions

ABSTRACTBackground We conducted a comparative study in worksites to assess the impact of sexual health promoting interventions on contraceptive use among female rural-to-urban migrants.Study design In Qingdao ten manufacturing worksites were randomly allocated to a standard package of interventions (SPI) and an intensive package of interventions (IPI). The interventions ran from July 2008 to January 2009. Cross-sectional surveys at baseline and end line assessed the sexual behaviour of young female migrants. To evaluate the impact of the interventions we assessed pre- and post-time trends.Results From the SPI group 721 (baseline) and 615 (end line) respondents were considered. Out of the IPI group we included 684 and 603 migrants. Among childless migrants, self-reported contraceptive use increased significantly after SPI and IPI (adjusted odds ratio [aOR] = 3.23; 95% confidence interval [CI] = 1.52−6.84; p < 0.01 and aOR = 5.81; 95% CI = 2.63−12.80; p < 0.001, respectively). Childless migrants older than 22 years reported a greater use after IPI than after SPI.Conclusion Implementing current Chinese sexual health promotion programmes at worksites is likely to have a positive impact on migrant women working in the manufacturing industry of Qingdao. More comprehensive interventions seem to have an added value if they are well targeted to specific groups.

A hazardous substance exposure prevention rating method for intervention needs assessment and effectiveness evaluation: the Small Business Exposure Index

AimsThis paper describes the refinement and adaptation to small business of a previously developed method for systematically prioritizing needs for intervention on hazardous substance exposures in manufacturing worksites, and evaluating intervention effectiveness.MethodsWe developed a checklist containing six unique sets of yes/no variables organized in a 2 × 3 matrix of exposure potential versus exposure protection at three levels corresponding to a simplified hierarchy of controls: materials, processes, and human interface. Each of the six sets of indicator variables was reduced to a high/moderate/low rating. Ratings from the matrix were then combined to generate an exposure prevention 'Small Business Exposure Index' (SBEI) Summary score for each area. Reflecting the hierarchy of controls, material factors were weighted highest, followed by process, and then human interface. The checklist administered by an industrial hygienist during walk-through inspection (N = 149 manufacturing processes/areas in 25 small to medium-sized manufacturing worksites). One area or process per manufacturing department was assessed and rated. A second hygienist independently assessed 36 areas to evaluate inter-rater reliability.ResultsThe SBEI Summary scores indicated that exposures were well controlled in the majority of areas assessed (58% with rating of 1 or 2 on a 6-point scale), that there was some room for improvement in roughly one-third of areas (31% of areas rated 3 or 4), and that roughly 10% of the areas assessed were urgently in need of intervention (rated as 5 or 6). Inter-rater reliability of EP ratings was good to excellent (e.g., for SBEI Summary scores, weighted kappa = 0.73, 95% CI 0.52–0.93).ConclusionThe SBEI exposure prevention rating method is suitable for use in small/medium enterprises, has good discriminatory power and reliability, offers an inexpensive method for intervention needs assessment and effectiveness evaluation, and complements quantitative exposure assessment with an upstream prevention focus.

Rates and Determinants of Uptake and Use of an Internet Physical Activity and Weight Management Program in Office and Manufacturing Work Sites in England: Cohort Study

Background Internet-based physical activity (PA) and weight management programs have the potential to improve employees’ health in large occupational health settings. To be successful, the program must engage a wide range of employees, especially those at risk of weight gain or ill health.Objective The aim of the study was to assess the use and nonuse (user attrition) of a Web-based and monitoring device–based PA and weight management program in a range of employees and to determine if engagement with the program was related to the employees’ baseline characteristics or measured outcomes.MethodsLongitudinal observational study of a cohort of employees having access to the MiLife Web-based automated behavior change system. Employees were recruited from manufacturing and office sites in the North West and the South of England. Baseline health data were collected, and participants were given devices to monitor their weight and PA via data upload to the website. Website use, PA, and weight data were collected throughout the 12-week program.Results Overall, 12% of employees at the four sites (265/2302) agreed to participate in the program, with 130 men (49%) and 135 women (51%), and of these, 233 went on to start the program. During the program, the dropout rate was 5% (11/233). Of the remaining 222 Web program users, 173 (78%) were using the program at the end of the 12 weeks, with 69% (153/222) continuing after this period. Engagement with the program varied by site but was not significantly different between the office and factory sites. During the first 2 weeks, participants used the website, on average, 6 times per week, suggesting an initial learning period after which the frequency of website log-in was typically 2 visits per week and 7 minutes per visit. Employees who uploaded weight data had a significant reduction in weight (−2.6 kg, SD 3.2, P< .001). The reduction in weight was largest for employees using the program’s weight loss mode (−3.4 kg, SD 3.5). Mean PA level recorded throughout the program was 173 minutes (SE 12.8) of moderate/high intensity PA per week. Website interaction time was higher and attrition rates were lower (OR 1.38, P= .03) in those individuals with the greatest weight loss.Conclusions This Web-based PA and weight management program showed high levels of engagement across a wide range of employees, including overweight or obese workers, shift workers, and those who do not work with computers. Weight loss was observed at both office and manufacturing sites. The use of monitoring devices to capture and send data to the automated Web-based coaching program may have influenced the high levels of engagement observed in this study. When combined with objective monitoring devices for PA and weight, both use of the website and outcomes can be tracked, allowing the online coaching program to become more personalized to the individual.

Characteristics of Participants in a Cancer Prevention Intervention Designed for Multiethnic Workers in Small Manufacturing Worksites

To examine worker characteristics explicated in our social-contextual intervention model that might be associated with participation in a cancer prevention intervention. These characteristics included sociodemographic variables, mediating mechanisms, and modifying conditions. Randomized, controlled study in 24 small multiethnic manufacturing worksites. Analyses were conducted on an embedded cohort of 456 employees in the intervention condition, incorporating the clustering of respondents in worksites using generalized linear mixed modeling methods. The intervention was based on an inclusive, comprehensive social-contextual model targeting fruit, vegetable, and red meat consumption, multivitamin use, and physical activity. Gender (p = .02) and self-efficacy (p < .01) were associated with participation. There were no differences in participation by race/ethnicity or occupational status. We observed no associations between participation of individual workers in intervention activities and health behavior change. The intervention attracted workers across racial/ethnic and occupational groups. The combination of a comprehensive intervention with wide diffusion of program messages may have been more powerful in influencing participation and behavior change than characteristics of individual employees.

“Una Mujer Trabaja Doble Aquí”: Vignette-Based Focus Groups on Stress and Work for Latina Blue-Collar Women in Eastern North Carolina

Latina women are a growing percentage of the working population, and very little is known about their health needs and interests. The purpose of this article is to share qualitative research results gathered from Latina women with a particular focus on exploring stress and health. This project was a substudy of Health Works in the Community, a 5-year CDC-funded multiple risk-factor reduction trial using participatory action research approaches to address smoking, healthy eating, stress, and physical activity among blue-collar women from 12 manufacturing work sites in rural, eastern North Carolina. Five focus groups were conducted with trained, bilingual facilitators using a vignette-based moderator guide that appeared particularly effective with this population. Results from the focus groups are used to make recommendations for future research with Latinas and for developing effective work-site-based interventions to address issues of stress and health within this population.

Norms and Their Relationship to Behavior in Worksite Settings: An Application of the Jackson Return Potential Model

To measure health norms and assess their influence on behavior among 2541 employees in 16 manufacturing worksites using an adapted Jackson's Return Potential Model (RPM). Worksite-level norm intensity, crystallization, and normative power were calculated for several behaviors; linear regression analyses tested whether normative power was related to each health behavior. Norms about safe work practices and smoking were most intense; norms about safe work practices were most crystallized. Safe work practices and smoking held the highest normative power; healthy eating held the least normative power. Comparing norm characteristics across health behaviors leads to important leverage points for intervening to influence norms and improve worker health.

Assessing and intervening on OSH programmes: effectiveness evaluation of the Wellworks-2 intervention in 15 manufacturing worksites

Aims: (1) To develop a transparent and broadly applicable method for assessing occupational safety and health (OSH) programmes or management systems; (2) to assess OSH programmes in a sample of...

A Comprehensive Worksite Cancer Prevention Intervention: Behavior Change Results from a Randomized Controlled Trial (United States)

Workplace cancer prevention initiatives have been least successful with blue-collar workers. This study assesses whether an intervention integrating health promotion with occupational health and safety results in significant and meaningful increases in smoking cessation and consumption of fruits and vegetables, compared to a standard health promotion intervention, for workers overall and for blue-collar workers in particular. A randomized controlled design was used, with 15 manufacturing worksites assigned to a health promotion (HP) or a health promotion plus occupational health and safety intervention (HP/OHS), and compared from baseline (1997) to final (1999). The response rates to the survey were 80% at baseline (n = 9019) and 65% at final (n = 7327). Both groups targeted smoking and diet; the HP/OHS condition additionally incorporated reduction of occupational exposures. Smoking quit rates among blue-collar workers in the HP/OHS condition more than doubled relative to those in the HP condition (OR = 2.13, p = 0.04), and were comparable to quit rates of white-collar workers. No statistically significant differences between groups were found for mean changes in fruits and vegetables. Integration of occupational health and safety and health promotion may be an essential means of enhancing the effectiveness of worksite tobacco control initiatives with blue-collar workers.

Influence of participation in a worksite health-promotion program on disability days.

This study assessed the impact of health-promotion program participation on short-term and long-term disability absence days during a 6-year period in a manufacturing company. Male, hourly, active employees (n = 4189) were analyzed from 1995 to 2000. Disability absences were compared for program participants and nonparticipants from baseline (1995) through 5 years of the program. The percentage of nonparticipants absent on any given day was greater than that of participants. Moreover, the average number of disability absence days incurred by nonparticipants significantly increased from baseline to program year 5 compared with participants. The total amount saved each year in disability absence days for the 2596 program participants was $623,040, which resulted in a savings-to-cost ratio of 2.3 per year. Participation in worksite health-promotion programs may lead to reduced disability days in a manufacturing worksite population.

Can community organization strategies be used to implement smoking and dietary changes in a rural manufacturing work site?

A one-year intervention project was developed and implemented to demonstrate the utility of using community organization methods to mobilize a rural, predominantly minority work site community toward smoking and dietary change. This intervention for smoking and dietary change was conducted in a rural work site (n = 235 at baseline) and guided by employees. It involved activities to change the work site environment and the behaviors of individuals. A community advisory board (n = 15) made up of members of the work site was established, and it met monthly with members from the research team to design and implement nine cancer prevention activities that were targeted to the needs of this community. Activities and information were disseminated to the employees during a nine-month period. Surveys were administered prior to and following the delivery of the intervention. This project was successful in engaging a rural manufacturing work site community in thinking about cancer prevention strategies. Results of this intervention demonstrated significant increases in numbers of smoking cessation attempts, reported fruit and vegetable consumption, self-efficacy for dietary change and perceived risk for cancer. Work site social norms changed as evidenced by employee perceptions of co-worker support of dietary and smoking change (all ts > 1.95, all Ps < 0.05). Other results with marginal statistical significance (P < .015) but potentially useful for future studies include increased intentions to reduce the fat in the diet. In light of the low-intensity and time-limited nature of this community organization intervention, the observed changes in dietary and smoking behaviors are encouraging and support the use of these strategies in rural, culturally diverse work sites.

Do processes of change predict smoking stage movements? A prospective analysis of the transtheoretical model.

The transtheoretical model (TTM) posits that processes of change and the pros and cons of smoking predict progressive movement through the stages of change. This study provides both a cross-sectional replication and a prospective test of this hypothesis. As part of a larger study of worksite cancer prevention (the Working Well Trial), employees of 26 manufacturing worksites completed a baseline and 2 annual follow-up surveys. Of the 63% of employees completing baseline surveys, 27.7% were smokers (N = 1,535), and a cohort of these smokers completed the 2-year follow-up. Cross-sectional results replicated previous studies with virtually all the processes of change and the cons of smoking increasing in linear fashion from precontemplation to preparation (all ps < .00001), and the pros of smoking decreasing (p < .01). However, contrary to the hypothesis, the baseline processes of change and the pros and cons of smoking failed to predict progressive stage movements at either the 1- or the 2-year follow-ups. Possible explanations for these findings and concerns about the conceptual internal consistency of the TTM are discussed.

Do processes of change predict smoking stage movements? A prospective analysis of the transtheoretical model.

The transtheoretical model (TTM) posits that processes of change and the pros and cons of smoking predict progressive movement through the stages of change. This study provides both a cross-sectional replication and a prospective test of this hypothesis. As part of a larger study of worksite cancer prevention (the Working Well Trial), employees of 26 manufacturing worksites completed a baseline and 2 annual follow-up surveys. Of the 63% of employees completing baseline surveys, 27.7% were smokers (N = 1,535), and a cohort of these smokers completed the 2-year follow-up. Cross-sectional results replicated previous studies with virtually all the processes of change and the cons of smoking increasing in linear fashion from precontemplation to preparation (all ps < .00001), and the pros of smoking decreasing (p < .01). However, contrary to the hypothesis, the baseline processes of change and the pros and cons of smoking failed to predict progressive stage movements at either the 1- or the 2-year follow-ups. Possible explanations for these findings and concerns about the conceptual internal consistency of the TTM are discussed.

Mental health, absenteeism and earnings at a large manufacturing worksite.

BACKGROUND: A few recent studies have examined the relationship between mental illness and labor market variables. The findings are inconsistent, however, and leave unanswered many questions concerning both the nature and magnitude of the relationship. AIMS OF THE STUDY: A recently available worksite-based data set is analyzed to explore the relationship between symptoms of emotional and psychological problems and employee absenteeism and earnings among employees at a large US worksite. METHODS: The analysis was based on data collected through a random and anonymous survey of workers at a large US manufacturing worksite. Two measures of absenteeism are combined - days absent during the past 30 days due to sickness or injury and days absent during the past 30 days because the employee did not want to be at work - to create both a dichotomous (i.e., ever absent) and a continuous (i.e., number of days absent) absenteeism variable. Annual earnings were measured as personal earnings from the primary job. Various statistical models were tested to determine the independent and joint (with alcohol and illicit drug use) relationship between symptoms of emotional problems and labor market variables. RESULTS: The analysis consistently finds that workers who report symptoms of emotional/psychological problems have higher absenteeism and lower earnings than otherwise similar coworkers. This finding is robust to model specification and to the inclusion of comorbid conditions such as alcohol and illicit drug use. DISCUSSION: This study contributes new information to the literature in this area by estimating the effects of emotional/psychological symptoms on two important labor market variables: absenteeism and earnings. Several specifications of the absenteeism and earnings equations were estimated to test the independent effect of emotional symptoms and the joint effects of emotional symptoms and other comorbid conditions. The results suggest that employers should consider the productivity losses associated with workers' mental health when designing worksite-based programs such as employee assistance programs (EAPs). LIMITATIONS: Unlike national surveys of households or individuals, the sample does not include unemployed individuals or those outside the labor force. Therefore, the decision to participate in the labor market can not be modeled. In addition, the study relies on voluntary self-reported survey data that may suffer from underreporting of substance use and emotional symptoms. Although respondents were repeatedly assured about confidentiality, if underreporting does exist, it may be more acute than in household surveys because respondents may be more worried about job loss if they self-report drug or alcohol use at the worksite. CONCLUSIONS: All four measures of emotional symptoms had a positive and statistically significant relationship with absenteeism and a negative and statistically significant relationship with personal earnings. These findings were robust across all specifications, even when the effects of other potentially confounding factors (i.e., alcohol and drug use variables) are included. In addition, the number of days intoxicated and cigarette use in the past year appear to be significantly related to earnings even after controlling for emotional symptoms. Finally, the explanatory power of the models is relatively high for cross-sectional data, especially for the earnings regressions. IMPLICATIONS FOR HEALTH CARE PROVISION AND USE: The findings from this worksite suggest that employers might do well to reassess the priorities of their EAPs and consider directing more of their resources to diagnosing and assisting employees with emotional and psychological distress. IMPLICATIONS FOR HEALTH POLICY FORMULATION: It is strongly suggestive that mental health status is related to absenteeism and earnings for employees at this worksite. However, most employer-based programs and policies are designed to dissuade the use of alcohol and illicit drugs by workers (e.g., employee drug and alcohol testing) rather than addressing other employee behaviors and problems. IMPLICATIONS FOR FURTHER RESEARCH: Numerous opportunities are present to collect similar data from other worksites and settings to determine whether these models and results are robust.