impact of a worker health study on working conditions, The

Journal of Public Health Policy,  2002  by Lee, Pam Tau,  Krause, Niklas

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BACKGROUND

IN the spring of 1998 the San Francisco-based Hotel Employees/Restaurant Employees Union (HERE) Local 2 began preparations for contract negotiations. For many years room cleaners had complained of high rates of injuries and musculoskeletal disorders. The union was aware that many had undergone surgery and several had become permanently disabled. Believing that these injuries could be job-related, the union leadership felt it was time to tackle this problem and find ways to protect their members' health and safety.

Although the hospitality industry employs roughly 1.7 million workers in 43,000 establishments nationwide, very little health research has been conducted on this sector (1,2). HERE concluded that they needed original research which would look at workload, health, and employee/employer relationship issues.

Traditionally, collaborations between universities and community organizations such as unions arise from the interests and priorities of the academic partners, not the community organizations. In addition, the selection of research methods and design is usually considered within the domain of the academics. This study took a non-traditional path, with the union initiating the partnership and defining the research priorities and methods.

The union looked to UC Berkeley's Labor Occupational Health Program (LOHP) to serve as an intermediary with university-based researchers at UC's School of Public Health (SPH). The union also asked LOHP to direct the project as a whole. This was necessary since the union had no prior experience in working with academic-based researchers. However, union leadership was comfortable with LOHP because of its strong standing with labor and successful track record in facilitating joint labor-management initiatives around issues of health and safety. The union asked LOHP to build a team that included SPH researchers who could apply participatory action research methods and involve workers in all phases of the project.

THEORETICAL FRAMEWORK: PARTICIPATORY ACTION RESEARCH

Participatory action research is "a systematic investigation, with the collaboration of those affected by the issue being studied, for the purpose of education and taking action or effecting social change" (3). This community-driven research begins with the goals and questions of the community, is participatory at every level, is culturally sensitive, and uses a diversity of communication tools and languages. It involves sharing of power and resources with the community, and attempts to build a common language among partners.

A participatory study assembles an appropriate team of research partners, which may include health educators and social scientists, to work in real collaboration with the community. It ensures that ownership of data and methods of dissemination are considered collaboratively, and it includes a collaborative evaluation process that examines the potential and actual impact of the intervention (4). Other objectives include education and empowerment of the community by making resources available for the study of community-defined issues, facilitation of activism, and involvement of both the researchers and community in improving conditions and quality of life (5).

TEAM PARTICIPANTS

HERE Local 2, was the lead community organization. HERE represents approximately 75% of all non-managerial hotel employees in San Francisco. The union membership is more than 8,500 workers; the majority are employed in the 23 major hotels that have contracts with HERE. Local 2 frequently mobilizes its diverse membership to participate in activities such as picket actions, organizing drives, and workplace committees.

Room cleaners typically make up 27% of the workforce in the hotel industry, with food and beverage at 18%, front desk clerks at 9%, and managers at 7% (6). Ninety-nine percent of San Francisco room cleaners are female. Filipinas account for 31%, other Asians 35%, and Latinas 28%. English is not the first language for 95% of the room cleaners (7).

LOHP at UC Berkeley was responsible for direction of the project, coordination between the union and SPH researchers, and facilitation and training of room-cleaner groups involved in the project. Established in 1974, EOHP is a public service arm of the Center for Occupational and Environmental Health at SPH. Its primary purpose is to serve working people and their unions, particularly in Northern California, and assist them in taking an active role in identifying and controlling occupational hazards. Known for its innovative, action-oriented training methods, LOHP also is recognized as a leader in the development of multilingual training materials appropriate for low literacy audiences, for work at the policy level to advance prevention strategies, and its strong record of successful collaborations with community-based organizations.

To facilitate a true community-based participatory research study, LOHP identified as potential collaborators public health researchers who were knowledgeable about and comfortable with the use of this approach. Physician and epidemiologist Niklas Krause, a faculty member in Occupational and Environmental Medicine at the University of California, San Francisco, with extensive experience in collaborating with both unions and management, was the lead public health researcher suggested by LOHP, and joined the project after a meeting with union representatives. Pam Tau Eee, LOHP's Labor Services Program Coordinator, served as co-director, and brought with her professional background her own personal experience years earlier as a room cleaner.