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Safety is Seguridad: A Workshop Summary 6 Overarching Issues This section summarizes the material presented in the earlier chapters and discusses several overarching issues that came up repeatedly during the workshop. At the workshop, discussion often centered on the underreporting of incidents and severity and the non-reporting of violations. Spanish-speaking workers often are less aware of regulations and are less likely to report violations than other workers, as some may be concerned about deportation (and sometimes are threatened with this). Hispanics are often aware that they are easily replaceable, so are less likely to report violations and are reluctant to miss work because they might lose their pay or their job. Spanish-speaking workers may be less likely to use a company health service department if their injuries or other harms are noted and reported. Occupational safety and health information in Spanish is necessary but not currently sufficient to resolve these issues. 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 (see Appendix E and Chapter 3 of this report for details). Workshop participants also agreed that the quality of existing material is mixed, with some of it very 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, on the Internet) of good-quality materials be established with information on best practices. Workshop participants also identified best practices with respect to the content of occupational safety and health material in Spanish. The language must be appropriate to the educational level of the target audience. When several Spanish terms exist, it may be necessary to include more than one. Messages must be simple, brief, and clear. It may be necessary to use spanglish8 if that is what workers use (e.g., sheetrockero, for a person who works with sheetrock). It may be important to communicate some basic safety English (e.g., “duck” and “run”). It is important to use participant observation at worksites to develop materials, and to understand barriers and incentives tied to workers’ beliefs and experiences. Participant observation is a tool developed by anthropology that involves the researcher spending time in the community (or worksite) alongside the workers. It allows the researcher or evaluator to experience the conditions, difficulties, facilitators, language, and so on at the worksite (Scrimshaw and Hurtado, 1987). 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 worker input. The workshop participants agreed that multiple modes of delivery should be considered, not just print media. Preferred delivery modes include photonovelas,9 radio, TV (talk shows as well as ads and announcements), websites, community sites (e.g., schools, churches), and 8 A mixture of Spanish and English in words or sentences. 9 Photonovelas are essentially expanded comic books, or simple, short highly illustrated dramatic stories. For example, a protagonist in the story might get injured on the job, and readers would learn how injuries occur and how to prevent them.
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Safety is Seguridad: A Workshop Summary worksite training sessions. Again, it is essential to develop these with worker input. In several areas, workshop participants had differing views of how to proceed. There was much discussion on the issue of whether to use a clearinghouse or local groups for development of materials. Some participants thought that a national clearinghouse, which developed and recommended materials, is most effective. Others thought that local development by those close to the culture and the worksite would result in more appropriate and innovative approaches. A combination of local and national approaches might make the most sense. 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, including warning labels and signs, usually does not convey the correct meaning, and that adaptation is essential at the very least. Adaptation involves working with the materials to convey the correct meaning in culturally, educationally, and linguistically acceptable language. Some workshop participants thought that adapting would carry too much English or U.S. cultural and linguistic “baggage,” and that it was essential to create materials in Spanish, with user participation. Workshop participants debated the extent to which various government agencies involved in worker safety had worked together effectively in the past. There was agreement that working together is important, and that the dialogue during the workshop between representatives of various agencies and with other workshop participants was useful in furthering such collaborations. It was noted that partnerships of industry, OSHA, NIOSH, and worker groups provide models for successful training programs. Audiences for improved worker safety communication materials and for the methods for developing and improving these include: owners and employers; controlling contractors; frontline supervisors; trainers, safety personnel; workers, including day laborers (There is great variety in type of work, risks, level of training, literacy.); families; unions, trade associations; federal agencies (e.g., NIOSH, OSHA, Environmental Protection Agency); local and state health departments and clinics; community organizations; insurers, bonding agencies, financial organizations; media; and policy makers (local, state, national, international). Safety for workers involves behavior changes to ensure safe habits and safe conditions. The workshop participants discussed the need to change employer, supervisor, and worker behaviors. It was noted that workers seldom have the power to change working conditions. This power lies with owners, employers, contractors, supervisors, etc., and communication with these groups regarding their responsibilities for worker safety is essential. Intermediaries (e.g., plant supervisors, contractors) can play an important role ensuring safety and delivering informational materials. Often, the solution to high-risk situations lies in changing the environment rather than, or more than, changing the worker behavior. Workshop participants discussed in detail the role of the government at federal, state, and local levels and agreed that key roles include:
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Safety is Seguridad: A Workshop Summary setting goals and priorities for worker safety (e.g., Healthy People 2010, surgeon general’s reports); establishment of regulations; monitoring and enforcement of compliance with regulations; considering goals in resource allocation for research, surveillance, enforcement, and materials development; development and communication of essential content of worker safety notices and information; remedying the lack of legal requirement to communicate with workers in their own language (states are not consistent on this, nor are industries); and clearinghouse function for materials and rating of materials. The range of agencies involved is broader than many would think (e.g., Health and Human Services, NIOSH, National Institutes of Health, CDC, Environmental Protection Agency, Department of Transportation, Food and Drug Administration, Department of Labor, OSHA, U.S. Department of Agriculture); Workshop participants also discussed research needs for developing occupational health and safety information in Spanish. There was consensus that the top two research needs were funding to develop and test materials (intervention studies) at local universities, community organizations, and others and funding for better documentation of risky behaviors and exposures for Spanish-speaking workers. There was also a discussion regarding the need for a multi-national approach. Workshop, participants thought that the United States could work with representatives of Spanish-speaking countries to assess, develop, and improve materials in the context of home countries. The United States could also work with Mexico in particular (and with Mexico’s Secretary for Health) to develop materials for use with workers in both countries, and for training workers who will immigrate or who move back and forth across the border. It may be useful for the United States to work with the U.S.-Mexico Border Health Association, the U.S.-Mexico Foundation for Science, the Pan American Health Organization and similar organizations. And finally the United States should work with maquiladora health and safety support networks (American Public Health Association, American Industrial Hygiene Association, Mexican Industrial Hygiene Association). The workshop participants were greatly appreciative of 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. Together 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 and in workers with little or no command of English, and in the lack of power to affect change or ask for their rights. The power differential between workers and employers is particularly great because of the lack of legal status of many workers, even when employers recruit across the border. The need to protect all workers, as reflected in the NIOSH initiative in convening this conference, was praised by the participants.
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Representative terms from entire chapter: