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Work Should Not Hurt You: Reduction of Hazardous Exposures in Small Businesses Through a Community Health Worker Intervention

Work Should Not Hurt You: Reduction of Hazardous Exposures in Small Businesses Through a Community Health Worker Intervention

Status
Completed
Phases
NA
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT03455530
Enrollment
268
Registered
2018-03-06
Start date
2020-02-21
Completion date
2024-01-22
Last updated
2025-07-10

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Community Health Aides, Industrial Hygiene, Volatile Organic Compounds

Brief summary

This project aims to reduce negative health outcomes in small businesses that primarily employ high-risk Latino workers by characterizing their exposures to hazardous chemicals and assessing if a community health worker (CHW) intervention is effective at decreasing these exposures. Although preventable by definition, occupational disease and injuries are leading causes of death in the United States, with a disproportionate burden faced by Latinos. Small businesses pose a particular risk. They are more likely to employ low-wage Latino workers, and often use hazardous solvents including volatile organic chemicals that can cause asthma, cancer, cardiovascular, and neurological disease; yet their workers lack access to culturally and linguistically appropriate occupational health and pollution prevention information due to economic, physical, and social barriers. CHW-led interventions and outreach in Latino communities have documented increased access to health care and health education and reduced workplace exposures among farmworkers. CHWs are an innovative method to bridge the gap between these small business communities and other stakeholders. The proposed project will capitalize on established partnerships between the University of Arizona, the Sonora Environmental Research Institute, Inc. and the El Rio Community Health Center. A community-engaged research framework will be used to complete the following specific aims: 1) quantify and identify exposures to hazardous chemicals in the two high risk small business sectors common in our target area (i.e., auto repair shops and beauty salons); 2) work collaboratively with business owners, trade groups, workers and CHWs to design an industrial hygiene - enhanced CHW intervention tailored for each small business sector; and 3) conduct a cluster randomized trial to evaluate the effectiveness of the CHW intervention at reducing workplace exposures to volatile organic compounds and assess which factors led to successful utilization of exposure control strategies in both male and female-dominated businesses. Businesses will be randomized to either an intervention or delayed intervention group, both of which will receive incentives to participate including worksite health screenings. CHWs will work closely with business owners and employees to select and implement exposure-strategies appropriate for their worksite using a menu of complementary strategies of varying complexity and cost. This innovative project has the potential to directly reduce occupational health disparities through a CHW intervention that moves beyond providing occupational health education. The intervention will overcome current barriers by helping marginalized Latino workers and small business owners who may have limited education, literacy, and computer skills to understand the hazards associated with their work, and will empower them to have greater control over their occupational exposures, with the ultimate goal of preventing occupational disease and reducing health disparities.

Interventions

OTHERIndustrial Hygiene-Enhance Community Health Worker Intervention

The intervention will be derived from audits and exposure assessments and focus groups with workers and owners in the same business types (excluded from the trial) conducted in an earlier part of the study, as well as a community advisory group (e.g., Hispanic Chamber of Commerce) . From this, we will generate educational materials specific for each small business sector. We will provide the CHWs with a list of industry-specific control options along with potential cost savings and benefits. For example, EPA estimates a cost saving of $13,000 per year for auto body shops that switch to the high-velocity low-pressure spray guns. Each list will be a comprehensive menu of options that contain multiple control measures including simple controls, such as keeping the lids on the solvent containers.

Sponsors

Sonora Environmental Research Institute, Inc.
CollaboratorUNKNOWN
El Rio Community Health Center
CollaboratorOTHER
National Institute of Environmental Health Sciences (NIEHS)
CollaboratorNIH
University of Arizona
Lead SponsorOTHER

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)

Masking description

Data collection will be conducted by research staff blinded to the intervention condition. CHWs will only be present at the first baseline-assessment prior to data collection.

Intervention model description

Both groups will receive a baseline exposure assessment and health screenings from El Rio Community Health Center. Then, the intervention group will receive the industrial hygiene (IH)-enhanced community health worker (CHW) intervention. After the second exposure assessment, the delayed group will receive the intervention. A third exposure assessment will be obtained to determine if exposure levels and controls are maintained in the intervention group, and to assess the intervention in the delayed group. This will help us assess sustainability of the intervention. CHWs will accompany evaluators during the first assessment but leave before data collection begins. We anticipate that the CHW intervention will be completed over a 60-day time period (range: 30-90 days).

Eligibility

Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes

Inclusion criteria

* workers or owners of small businesses in select sectors (e.g., beauty salons, auto shops) in target zip codes in southern metropolitan Tucson, Arizona

Exclusion criteria

* age less than 18 years or people not employed in targeted sectors

Design outcomes

Primary

MeasureTime frameDescription
Change in Volatile Organic Chemical Concentrations From Pre- to Post-Intervention6 monthsThe primary outcome is the change in average total volatile organic chemical exposures for each business from pre- to post- intervention.

Countries

United States

Participant flow

Participants by arm

ArmCount
Intervention Group - Beauty Salon
The intervention group will receive the IH-enhanced CHW intervention before (\ 3 months) the other arm (Delayed Intervention Group). Industrial Hygiene-Enhance Community Health Worker Intervention: The intervention will be derived from audits and exposure assessments and focus groups with workers and owners in the same business types (excluded from the trial) conducted in an earlier part of the study, as well as a community advisory group (e.g., Hispanic Chamber of Commerce) . From this, we will generate educational materials specific for each small business sector. We will provide the CHWs with a list of industry-specific control options along with potential cost savings and benefits. For example, EPA estimates a cost saving of $13,000 per year for auto body shops that switch to the high-velocity low-pressure spray guns. Each list will be a comprehensive menu of options that contain multiple control measures including simple controls, such as keeping the lids on the solvent containers.
77
Delayed Intervention Group - Beauty Salon
The delayed intervention group will receive the IH-enhanced CHW intervention after (\ 3 months) the other arm (Intervention Group). Industrial Hygiene-Enhance Community Health Worker Intervention: The intervention will be derived from audits and exposure assessments and focus groups with workers and owners in the same business types (excluded from the trial) conducted in an earlier part of the study, as well as a community advisory group (e.g., Hispanic Chamber of Commerce) . From this, we will generate educational materials specific for each small business sector. We will provide the CHWs with a list of industry-specific control options along with potential cost savings and benefits. For example, EPA estimates a cost saving of $13,000 per year for auto body shops that switch to the high-velocity low-pressure spray guns. Each list will be a comprehensive menu of options that contain multiple control measures including simple controls, such as keeping the lids on the solvent containers.
70
Intervention Group - Auto Shop
The intervention group will receive the IH-enhanced CHW intervention before (\ 3 months) the other arm (Delayed Intervention Group). Industrial Hygiene-Enhance Community Health Worker Intervention: The intervention will be derived from audits and exposure assessments and focus groups with workers and owners in the same business types (excluded from the trial) conducted in an earlier part of the study, as well as a community advisory group (e.g., Hispanic Chamber of Commerce) . From this, we will generate educational materials specific for each small business sector. We will provide the CHWs with a list of industry-specific control options along with potential cost savings and benefits. For example, EPA estimates a cost saving of $13,000 per year for auto body shops that switch to the high-velocity low-pressure spray guns. Each list will be a comprehensive menu of options that contain multiple control measures including simple controls, such as keeping the lids on the solvent containers.
69
Delayed Intervention Group - Auto Shop
The delayed intervention group will receive the IH-enhanced CHW intervention after (\ 3 months) the other arm (Intervention Group). Industrial Hygiene-Enhance Community Health Worker Intervention: The intervention will be derived from audits and exposure assessments and focus groups with workers and owners in the same business types (excluded from the trial) conducted in an earlier part of the study, as well as a community advisory group (e.g., Hispanic Chamber of Commerce) . From this, we will generate educational materials specific for each small business sector. We will provide the CHWs with a list of industry-specific control options along with potential cost savings and benefits. For example, EPA estimates a cost saving of $13,000 per year for auto body shops that switch to the high-velocity low-pressure spray guns. Each list will be a comprehensive menu of options that contain multiple control measures including simple controls, such as keeping the lids on the solvent containers.
52
Total268

Withdrawals & dropouts

PeriodReasonFG000FG001FG002FG003
Overall StudyWithdrawal by Subject9133

Baseline characteristics

CharacteristicIntervention Group - Beauty SalonDelayed Intervention Group - Beauty SalonIntervention Group - Auto ShopDelayed Intervention Group - Auto ShopTotal
Age, Continuous44 years
STANDARD_DEVIATION 12
47 years
STANDARD_DEVIATION 14
40 years
STANDARD_DEVIATION 12
38 years
STANDARD_DEVIATION 11
42.4 years
STANDARD_DEVIATION 12.4
Ethnicity (NIH/OMB)
Hispanic or Latino
54 Participants52 Participants47 Participants37 Participants190 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
21 Participants15 Participants21 Participants14 Participants71 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
2 Participants3 Participants1 Participants1 Participants7 Participants
Region of Enrollment
United States
77 participants70 participants69 participants52 participants268 participants
Sex/Gender, Customized
Female
68 Participants62 Participants4 Participants3 Participants137 Participants
Sex/Gender, Customized
Male
7 Participants7 Participants64 Participants48 Participants126 Participants
Sex/Gender, Customized
Unknown
2 Participants1 Participants1 Participants1 Participants5 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
EG002
affected / at risk
EG003
affected / at risk
deaths
Total, all-cause mortality
0 / 770 / 700 / 690 / 52
other
Total, other adverse events
0 / 770 / 700 / 690 / 52
serious
Total, serious adverse events
0 / 770 / 700 / 690 / 52

Outcome results

Primary

Change in Volatile Organic Chemical Concentrations From Pre- to Post-Intervention

The primary outcome is the change in average total volatile organic chemical exposures for each business from pre- to post- intervention.

Time frame: 6 months

Population: This is a cluster-randomized trial where the clusters were small businesses. There were 1-4 workers at each shop per assessment. The unit of analysis here is the average total volatile organic chemicals exposures for each business at each analysis.

ArmMeasureValue (GEOMETRIC_MEAN)
Intervention Group - Beauty SalonChange in Volatile Organic Chemical Concentrations From Pre- to Post-Intervention2738 ppb
Delayed Intervention Group - Beauty SalonChange in Volatile Organic Chemical Concentrations From Pre- to Post-Intervention3875 ppb
Intervention Group - Auto ShopsChange in Volatile Organic Chemical Concentrations From Pre- to Post-Intervention523 ppb
Delayed Intervention - Auto ShopsChange in Volatile Organic Chemical Concentrations From Pre- to Post-Intervention225 ppb
95% CI: [0.45, 1.19]Mixed Models Analysis
95% CI: [0.55, 3.24]Mixed Models Analysis

Source: ClinicalTrials.gov · Data processed: Apr 28, 2026