OCCUPATIONAL HEALTH DISPARITIES

Outcomes

Outcomes are events, occurrences, or conditions that indicate progress in achieving the purpose of the program. Outcomes reflect the results of a program activity compared with its intended purpose or outcomes may answer the question "Will these resources result in success or contribute to the success of what we want to accomplish?"

Outcomes can be viewed from two different perspectives -- ultimate and intermediate. For an occupational safety and health research program like the NIOSH Occupational Health Disparities Program, ultimate outcomes are reductions in a particular type of worker injury or illness. Injuries and illnesses have complex causes, and any effect of program activities on rates can take years to be seen. Therefore, outcomes are often measured on an intermediate timeframe. Intermediate outcomes are necessary steps that lead to ultimate outcomes -- for example, reductions in the risk of a particular type of injury or illness. For occupational safety and health research programs, achieving intermediate risk reductions is as important as achieving the ultimate outcome of decreasing injury and illness incidence rates.

Dry Cleaners Health Study

Over half of all dry-cleaning workers are women, and over half of these women belong to minority and/or immigrant groups. In “mom-and-pop” family-staffed shops, children may be on site all day.

NIOSH has documented the causes of death in a cohort of dry cleaners, including an increased risk of death from cervical cancer¹² and dry-cleaning chemical, fire, and ergonomic risks.¹³ NIOSH has also shown how those risks might be reduced by upgrading equipment^{14, 15, 16} and explored the attitudes of dry-cleaning workers and owners toward the risks.¹⁷

Simple Solutions: Ergonomics for Farm Workers

Most ergonomic research has focused on manufacturing or office settings. Focusing on agriculture, this document offers solutions for a variety of agricultural settings and raises awareness that musculoskeletal disorders are preventable in agriculture -- not just part of farm life. In addition to giving specific solutions, the publication also inspires people to devise their own solutions through guidelines, resources, and a "how-to build ergonomic teams" section. Since many farmers are small employers with limited resources, it focuses on low-cost solutions and even includes diagrams for building them on the farm. Simple Solutions takes research and puts it into the hands of those who can use it.

This document has become a new model for other NIOSH publications. Because of the success of this document, NIOSH plans to develop another similar publication for construction workers. Other NIOSH researchers have voiced their desire to use the same format for additional health problems among other worker populations, e.g., Simple Solutions: Lead Avoidance for Constructions Workers.

References

12. Ruder AM, Ward EM, Brown DP. 2001. Mortality in dry-cleaning workers: an update. Am J Ind Med 39:121–32.
13. National Institute for Occupational Safety and Health. 1997. Control of Health and Safety Hazards in Commercial Dry cleaners. DHHS/PHS/CDC, Cincinnati, Ohio. NIOSH Worker Health Chartbook, 2004. DHHS (NIOSH) Publication No. 2004-146
14. Burroughs GE, Ewers LM, Taylor L, Marlow D. 1999. Evaluation of eight dry cleaning shops with state-of-the-art control equipment. Evaluation of eight dry cleaning shops with state-of-the-art control equipment.
15. Earnest GS, Ewers LM, Ruder AM, Petersen MR, Kovein RJ. 2002. An evaluation of retrofit engineering control interventions to reduce perchloroethylene exposures in commercial dry-cleaning shops. Appl Occup Environ Hyg 17: 104–11.
16. Ewers LM, Ruder AM, Petersen MR, Earnest GS, Goldenhar LM. 2002. Effects of retrofit emission controls and work practices on perchloroethylene exposures in small dry-cleaning shops. Appl Occup Environ Hyg 17:112–20.
17. Goldenhar LM, Ruder AM, Ewers LM, Earnest S, Haag WM, Petersen MR. 1999. Concerns of the dry-cleaning industry: a qualitative investigation of labor and management. Am J Ind Med 35:112–23.