Results of a Cluster Randomized Controlled Trial to Promote the Use of Respiratory Protective Equipment among Migrant Workers Exposed to Organic Solvents in Small and Medium-Sized Enterprises
Abstract
:1. Background
2. Methods
2.1. Trial Design
2.2. Settings and Participants
2.3. Randomization
2.4. Intervention Procedures
2.5. Outcome Measures
2.6. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
Abbreviations
IMWs | Internal Migrant Workers |
PPE | Personal Protective Equipment |
RPE | Respiratory Protective Equipment |
SMEs | Small and Medium-sized Enterprises |
CRCT | Cluster Randomized Controlled Trial |
TDI | Top-down Intervention |
CIG | Comprehensive Intervention Group |
CG | Control Group |
ITT | Intention-to-treat |
ICC | Intra-Class Correlation Coefficient |
SD | Standard Deviation |
OR | Odds Ratio |
aOR | Adjusted Odds Ratio |
CI | Confidence Interval |
GLMMs | Generalized Linear Mixed Models |
RMB | Min Bi |
USD | United States Dollar |
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Intervention | Component | Target Participants | Content | Frequency | Delivered by |
---|---|---|---|---|---|
Top-down intervention | Occupational health education | Managers and occupational health personnel in SMEs |
| One lecture (1 h) The 1st week of the intervention | The principal investigator of the study |
Passive occupational health education and training—lectures | Internal migrant workers |
| One lecture (1 h) The 1st week of the intervention | Trained trainers (3 sessions (1hr each) of training provided by Guangdong Prevention and Treatment Center for Occupational Diseases) | |
Passive occupational health education and training—brochures and posters | Internal migrant workers |
| Brochures delivered twice (baseline and three months), posters posted in the workspace | Trained trainers | |
mHealth | Internal migrant workers |
| Twice per week | Trained trainers via Instant Message Apps | |
Comprehensive intervention | Top-down intervention | As same as the top-down intervention | |||
Peer education | Internal migrant workers |
| Monthly (45–60 min/session) | Trained peer educators (2 sessions (1hr each) of face-to-face training and weekly online assists provided by trained trainers) |
Characteristics | Comprehensive Intervention (20 SMEs, n = 368) | Top-down Intervention (20 SMEs, n = 390) | Control (20 SMEs, n = 453) | Total (60 SMEs, n = 1211) | p * |
---|---|---|---|---|---|
Age (years), mean (SD) | 33.5 (10.8) | 36.3 (9.5) | 34.4 (9.7) | 34.8 (10.0) | 0.386 |
Sex, n (%) | 0.532 | ||||
Male | 245 (66.6) | 291 (74.6) | 335 (74.0) | 871 (71.9) | |
Female | 123 (33.4) | 99 (25.4) | 118 (26.0) | 340 (28.1) | |
Education, n (%) | 0.762 | ||||
Primary School | 50 (13.6) | 43 (11.0) | 39 (8.6) | 132 (10.9) | |
Secondary School | 197 (53.5) | 236 (61.5) | 268 (59.2) | 701 (57.9) | |
High School and above | 121 (32.9) | 111 (28.5) | 146 (32.2) | 378 (31.2) | |
Marital status, n (%) | 0.102 | ||||
Married | 239 (64.9) | 310 (79.5) | 322 (71.1) | 871 (71.9) | |
Single | 129 (35.1) | 80 (20.5) | 131 (28.9) | 340 (28.1) | |
Duration of migration (years), mean (SD) | 10.5 (7.3) | 12.4 (7.0) | 11.6 (6.8) | 11.5 (7.0) | 0.143 |
Employment duration in the current position (months), mean (SD) | 59.0 (56.7) | 67.1 (50.2) | 64.6 (61.2) | 63.6 (56.6) | 0.765 |
Weekly working hours, mean (SD) | 55.2 (8.7) | 55.1 (9.0) | 55.6 (9.7) | 55.3 (9.2) | 0.920 |
Social models for RPE use † (score range: 2–10), mean (SD) | 7.9 (2.5) | 7.8 (2.4) | 7.8 (2.6) | 7.8 (2.5) | 0.813 |
Interpersonal support for RPE use† (score range:3–15), mean (SD) | 9.8 (3.7) | 10.0 (3.3) | 10.0 (3.6) | 9.9 (3.5) | 0.945 |
Group | Baseline | 3-Month Follow-up | 6-Month Follow-up | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
n | Case (%) | n | Case (%) | Our (95%CI) | p | aOR (95%CI) | p | n | Case (%) | Our (95%CI) | p | aOR (95%CI) | p | |
CIG(all) | 368 | 201 (54.6) | 276 | 170 (61.6) | 1.31 (0.84,2.05) | 0.227 | 1.33 (0.81,2.19) | 0.261 | 246 | 184 (74.8) | 2.80 (1.73,4.52) | <0.001 | 2.99 (1.75,5.10) | <0.001 |
CIG(≤3 sessions) | 271 | 148 (54.6) | 179 | 98 (54.7) | 0.94 (0.57,1.55) | 0.800 | 0.86 (0.49,1.51) | 0.594 | 168 | 113 (67.3) | 1.82 (1.08,3.07) | 0.024 | 1.74 (0.96,3.16) | 0.070 |
CIG(≥4 sessions) | 97 | 53 (54.6) | 97 | 72 (74.2) | 2.53 (1.26,5.05) | 0.009 | 2.97 (1.37,6.43) | 0.006 | 78 | 71 (91.0) | 10.73 (4.21,27.36) | <0.001 | 13.72 (4.81,39.14) | <0.001 |
TDI | 390 | 197 (50.5) | 339 | 207 (61.1) | 1.52 (0.99,2.33) | 0.053 | 1.55 (0.96,2.50) | 0.072 | 323 | 202 (62.5) | 1.80 (1.16,2.78) | 0.008 | 1.91 (1.17,3.11) | 0.009 |
Control | 453 | 235 (51.9) | 357 | 191 (53.5) | Reference | - | Reference | - | 332 | 170 (51.2) | Reference | - | Reference | - |
Outcomes | Group | Baseline | 3-Month Follow-up | 6-Month Follow-up | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
n | Mean(SD) | n | Mean(SD) | b (95%CI) | p | bad (95%CI) | p | n | Mean(SD) | b (95%CI) | p | bad (95%CI) | p | ||
Occupational health knowledge | CIG | 368 | 6.6 (1.9) | 241 | 7.2 (1.9) | 0.26 (−0.14,0.67) | 0.203 | 0.15 (−0.25,0.54) | 0.464 | 211 | 7.6 (1.8) | 0.46 (0.04,0.85) | 0.032 | 0.32 (0.01,0.61) | 0.043 |
TDI | 390 | 6.9 (2.0) | 270 | 7.4 (1.7) | 0.20 (−0.20,0.59) | 0.332 | 0.21 (−0.17,0.60) | 0.249 | 297 | 7.3 (1.8) | −0.11 (−0.49,0.27) | 0.570 | −0.09 (−0.46,0.29) | 0.651 | |
CG | 453 | 6.6 (2.0) | 293 | 6.9 (2.0) | Reference | - | Reference | - | 299 | 7.3 (1.7) | Reference | - | Reference | - | |
Attitude towards RPE utilization | CIG | 368 | 36.3 (5.8) | 241 | 38.3 (4.9) | 1.17 (0.07,2.26) | 0.037 | 0.69 (−0.35,1.74) | 0.194 | 211 | 39.4 (5.0) | 2.25 (1.07,3.43) | <0.001 | 1.82 (0.67,2.96) | 0.002 |
TDI | 390 | 37.0 (5.3) | 270 | 38.2 (5.0) | 0.63 (−0.43,1.70) | 0.242 | 0.30 (−0.73,1.32) | 0.571 | 297 | 38.5 (5.6) | 1.03 (−0.07,2.12) | 0.066 | 0.92 (-0.15,1.98) | 0.091 | |
CG | 453 | 37.1 (6.2) | 293 | 37.9 (5.2) | Reference | - | Reference | - | 299 | 37.9 (5.3) | Reference | - | Reference | - | |
n | Case (%) | n | Case (%) | Our (95%CI) | p | aOR (95%CI) | p | n | Case (%) | Our (95%CI) | p | aOR (95%CI) | p | ||
Participation in occupational health check-up | CIG | 365 | 189 (51.8) | 235 | 173 (74.3) | 1.65 (1.00,2.71) | 0.050 | 1.68 (0.98,2.89) | 0.059 | 206 | 163 (79.2) | 2.18 (1.28,3.70) | 0.004 | 2.13 (1.20,3.81) | 0.010 |
TDI | 390 | 235 (60.3) | 269 | 206 (76.4) | 1.38 (0.84,2.28) | 0.206 | 1.38 (0.79,2.38) | 0.256 | 291 | 215 (73.6) | 1.06 (0.65,1.74) | 0.814 | 1.03 (0.63,1.70) | 0.901 | |
CG | 451 | 252 (55.9) | 291 | 192 (66.3) | Reference | - | Reference | - | 299 | 205 (68.3) | Reference | - | Reference | - |
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Chen, W.; Li, T.; Zou, G.; Renzaho, A.M.N.; Li, X.; Shi, L.; Ling, L. Results of a Cluster Randomized Controlled Trial to Promote the Use of Respiratory Protective Equipment among Migrant Workers Exposed to Organic Solvents in Small and Medium-Sized Enterprises. Int. J. Environ. Res. Public Health 2019, 16, 3187. https://doi.org/10.3390/ijerph16173187
Chen W, Li T, Zou G, Renzaho AMN, Li X, Shi L, Ling L. Results of a Cluster Randomized Controlled Trial to Promote the Use of Respiratory Protective Equipment among Migrant Workers Exposed to Organic Solvents in Small and Medium-Sized Enterprises. International Journal of Environmental Research and Public Health. 2019; 16(17):3187. https://doi.org/10.3390/ijerph16173187
Chicago/Turabian StyleChen, Wen, Tongyang Li, Guanyang Zou, Andre M.N. Renzaho, Xudong Li, Leiyu Shi, and Li Ling. 2019. "Results of a Cluster Randomized Controlled Trial to Promote the Use of Respiratory Protective Equipment among Migrant Workers Exposed to Organic Solvents in Small and Medium-Sized Enterprises" International Journal of Environmental Research and Public Health 16, no. 17: 3187. https://doi.org/10.3390/ijerph16173187