Study: Peer-to-peer training can improve safety, knowledge among Hispanic construction workers

by Kim Krisberg

Eric Rodriguez and his colleagues at the Latino Union of Chicago quite literally meet workers where they're at — on the city's street corners. Many of the day laborers who gather there during the morning hours are hired to work construction at residential housing sites. Work arrangements are hardly formal, to say the least, and day laborers are frequently subjected to unnecessary and illegal dangers on the job. Unfortunately, worker safety is often kicked to the curb in the street corner marketplace.

For years, Rodriguez, who started as an organizer and is now the union's executive director, heard stories about the high rate of injuries among construction day laborers, from the minor to the extreme. And research shows that foreign-born and Hispanic construction workers experience disproportionate rates of injury and death at the workplace. Safety training was desperately needed, Rodriguez said, but providing adequate training to such an informalized network of workers with diverse backgrounds and educational levels was tricky.

When Rodriguez was an organizer in the early 2000s, even reaching out to OSHA for construction safety training was of little help — the agency didn't have instructors fluent in Spanish, had little in the way of Spanish-language materials and wasn't familiar with the Spanish terminology that would resonate with Hispanic day laborers, Rodriguez said. There was an enormous training gap that OSHA simply couldn't fill.

"It was really about taking an old practice that was created decades ago by OSHA and creating something more adaptable to the realities on the ground," Rodriguez told me.

Around the same time the Latino Union was working to improve safety standards, occupational health and safety researchers at the University of Illinois-Chicago wanted to get a better handle on safety and injury statistics among Hispanic construction workers. It was a mutually beneficial relationship and both groups, along with other area worker centers and advocates, came together to develop a safety curriculum that combines leadership development with the complete participation of workers.

They eventually turned to a safety curriculum developed by researchers at Rutgers University Occupational Training and Education Consortium and advocates at New Labor of New Jersey. The Spanish-language curriculum is a modified 10-hour health and safety OSHA training that takes a "popular education" approach, which facilitates the teaching of technical themes to any type of audience regardless of educational backgrounds. According to Rodriguez, the innovative curriculum "respects the actual experience of workers, instead of treating them as if they know nothing...it's no longer just an instructor talking to an audience, it's more of a two-way street."

But before bringing it to Chicago's day laborers, Rodriguez and his colleagues wanted to give it more of a "Chicago flavor." They added more photos and illustrations and made it as interactive as possible.

"It was so interactive and so inclusive of participants, it truly evolved into a great piece of curriculum at the end," he said.

And it worked.

From workers for workers

In a new study, researchers found that the curriculum adapted by Rodriguez and colleagues was indeed effective at improving safety knowledge among low-wage, low-literacy Hispanic construction workers. The study, published online in late March in the American Journal of Industrial Medicine, found that the modified OSHA 10-hour curriculum delivered within a peer-to-peer format — in other words, worker leaders were trained to provide the training to fellow workers — resulted in improved safety knowledge, hazards identification and self-efficacy as well as sustainable health and safety activities.

"Adults learn best from each other and from doing," said study co-author Emily Ahonen, an assistant professor in the Departments of Epidemiology and Environmental Health Science at Indiana University. "It was very hands-on training and involved peers as experts...and that style was very much in line with how worker centers already conduct their activities. It was very synergistic."

Study researchers partnered with eight worker centers in seven cities to train worker leaders to deliver the safety curriculum, eventually resulting in 32 worker leaders training hundreds of fellow construction workers over three years. Training sessions took place on the weekends, were highly participatory in nature, and included the "presence and input" of OSHA-authorized trainers and sometimes an OSHA investigator.

The results? Nearly 450 workers participated in the two-day trainings and earned OSHA's 10-hour certification card, and an additional 17 workers came to only one day of training. Trainees were mostly male and born in Mexico; only one-third reported speaking English well or very well; and 61 percent had less than a high school education. Among 270 participants during year three of the training, nearly 36 percent reported a work-related injury in the prior year. Interestingly, a great number of workers reported having received health and safety training in English, even though they spoke little or no English. Study authors Rodriguez, Ahonen, Linda Forst, Joseph Zanoni, Alfreda Holloway-Beth, Michele Oschner, Louis Kimmel, Carmen Martino, Adam Kader, Elisa Ringholm and Rosemary Sokas wrote:

At one meeting with (worker leaders), one pulled out a billfold with six OSHA 10-hr cards that he had been issued in English courses and reported that his co-workers — non-English speaking roofers — had been required to sit through English language courses and had received OSHA 10-hr cards as well.

Training participants reported significant gains in knowledge on how to prevent falls, the impact of "grounding" to reduce electrical shock risk and how to recognize worksite hazards. The new knowledge stuck as well. In a three-month follow-up call, workers said they "more critically assessed worksites, working more slowly and deliberately, and they reported greater concern for fellow workers. Many also reported having increased confidence to address hazards with supervisors."

Bringing health and safety front and center

The study also found that many worker centers said the experience helped them realize that occupational health and safety is "part of the larger goal of worker/human rights" and that the safety training helped them build leadership among workers, recruit new members and build a broader worker movement.

"It's not that health and safety weren't on their radars...but it was now clearer how safety is central to social justice and worker justice," Ahonen told me. "Quite frankly, health and safety are things that if not right in front of you will often take a back seat to more immediate human needs, like income. Not being paid for work is so immediate that it's a logical place for worker centers to focus their efforts."

Ahonen noted that none of the researchers realized just how far beyond the classroom walls the training would go.

"It was truly multi-layered dissemination in the end," she said. "The amount of workers reached and the levels of empowerment gained from an organizing perspective is more than what we had hoped for. Workers clearly saw what their roles at their worksites could be now — it was incredible to watch."

Ahonen reported that worker centers involved in the study hope to continue such health and safety work, though sustainability can be a challenge.

Study co-author Adam Kader said the trainings had a big impact on confidence and feelings of empowerment among workers at the Arise Chicago Worker Center. Kader, who directs the Arise Worker Center, said that while it's true that occupational health and safety haven't always been at the forefront of the worker center movement, it's a good bet that the same employers who are stealing wages are also forgoing safety. He said health and safety are now a regular part of the conversation at Arise.

"Wage theft can be easier to grasp and sadly, many workers might just think (hazardous work conditions) are part of the job," Kader told me. "But I think we can reach more workers with multiple messages. We're the ones in contact with these workers, so if we're not talking about health and safety, I don't know who will."

Building on the study experience and lessons learned from construction workers, Kader said Arise is now working with a graduate student to develop a mini safety curriculum for car wash workers, who face a number of hazardous conditions and exposures at work.

Rodriguez at Latino Union of Chicago noted that simply the act of putting workers in the role of trainers was "pioneering." And OSHA's taken notice as well, awarding grant funds to the National Day Laborer Organizing Network, of which the Latino Union is a member, to continue the health and safety training model.

Today, Rodriguez said "even the culture on the street corner is changing." Day laborers are now talking about safety on the job, he said, and organizers are bringing aspects of the training curriculum directly to the street corner. The goal doesn't always have to be OSHA certification, Rodriguez noted, because even a little information can prevent an injury on the job.

"It all starts with a conversation," he said.

To request a fully copy of the safety training study, click here.

Kim Krisberg is a freelance public health writer living in Austin, Texas, and has been writing about public health for more than a decade.