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ciences at th

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nd evaluate a

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truction sites

ust reeducat

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n addition, a

f exposure w

eractive com

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e University

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14 to June 2

a constructio

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at one week p

a significantly

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mponent of o

Caban-Martinez, A

Page 1

y was a res

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on worksite-b

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three sites

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our intervent

Alberto

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talk showed

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ance the cu

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ed of a diver

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whom only

hallenge duri

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tudies of So

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st one of the s

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mpletion ch

nt sites. Our

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are outlined in

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in Toxic crystallin

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d promising

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speakers; th

y spoke Cr

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outh Florida

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study group m

ent protocol w

hallenges fac

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cations to the

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t all workers

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results in c

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and subsequ

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he first two su

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construction

be culturally

, Creole, and

e first recruitm

owed us to

uently carried

the recomme

urvey time p

urveys togeth

pal Investigator:

alth behavio

ve adult-learn

as provide e

METHODS

not without

n sites in Mi

y and linguis

d English. O

ment site. Th

modify the

d out succes

ended modifi

oints and att

her only afte

Caban-Martinez, A

Page 2

or change. F

ning compo

evaluation o

S

slight challe

iami require

stically comp

Our team inc

he recruitmen

protocol fo

ssfully by the

fications for f

ended the too

r the toolbox

Alberto

2 of 15

Future

onents

of the

enges.

d our

petent.

cluded

nt and

or the

e fifth

future

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The first

second su

completio

Half of th

collection

surveys w

worked a

the lesson

Florida is

D

they were

survey co

60 partici

A

Safety Of

upational Lessons i

econd Delivera

survey was

urvey was ha

on. The follo

he study staf

n in English

were filled ou

around the w

ns learned is

s after 4:30 P

Due to the lar

e allowed for

ollection proc

ipants in clos

A very import

fficers. The S

in Toxic crystallin

ble Report

handed out

anded out aft

ow-up data co

ff conducted

. A majority

ut by the stu

workers’ sche

s that the be

PM, once thei

rge number o

r study comp

o

e

a

a

in

th

m

in

IR

cess and allo

se to 30 minu

tant factor th

Safety Office

ne Silica (BOLTS)

either the da

ter the toolbo

ollection was

data collectio

y of participa

udy staff acco

edules and m

est time to c

ir shift is ove

of workers p

pletion by th

of survey col

fficient as po

assembly-line

nd mov ed

ncluded two

he completio

member distr

ncluded two

RB petty cas

owed us to c

utes.

hat led to our

ers had reserv

Pilot Study

ay before or

ox talk, and w

s conducted o

on in Spanis

ants preferre

ording to the

made sure to

contact const

er and before

participating

heir managers

llection and

ossible. We u

e-like system

through diff

study team

on of both su

ributing par

study mem

sh reconcilia

omplete the

r recruitment

ved blocks o

Princip

the morning

was, therefor

over the phon

sh, while the

ed to comple

e oral respon

call back ev

truction work

they get hom

at each site,

s, we had to

participant i

used a foldab

m, in which

fferent proce

members co

urveys. The

rticipant ince

mbers collect

ation purpose

toolbox talk

success was

of time with t

pal Investigator:

g before the

re, immediat

ne, a week af

other half w

ete the study

nses of each

very single p

kers over th

me.

and the sho

streamline th

incentive dis

ble, portable

workers form

essing stages

ollecting and

second stage

entives, and

ting participa

es. This syste

k and data co

s the collabor

the entire con

Caban-Martinez, A

Page 3

toolbox talk

tely collected

fter each site

worked on the

y in Spanish

worker. The

articipant. O

e phone in S

rt amount of

he on-site pr

stribution to

table to crea

med a single

s. The first

d double che

e included a

d the third

ant signature

em quickene

ollection for

ration with o

nstruction cr

Alberto

3 of 15

k. The

d after

e visit.

e data

h. The

e staff

One of

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f time

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be as

ate an

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about

on-site

rew in

Building Occupational Lessons in Toxic crystalline Silica (BOLTS) Pilot Study Principal Investigator: Caban-Martinez, Alberto

BOLTS | Second Deliverable Report Page 4 of 15

the mornings that allowed us to address and deliver the toolbox talk at once in one place. This

allowed us to recruit many more workers per site, as well as provided us with enough time to conduct

toolbox talks and data collection without taking much of the company’s work time. This aspect is

very important as the construction managers do not like to see their workers participating in the study

during scheduled working time.

During our site visits, a few questions were raised by workers and Safety managers that we

would like to highlight in this report. Workers seemed interested in knowing more about the

combined effects of smoking and dust exposure.

Additionally, certain workers complained about not being provided with the right type of

PPE masks. Finally, some workers were interested in receiving health screenings on site, as most did

not have health insurance coverage. Safety managers were eager to collaborate in further studies,

including other topics of construction site health and safety.

Recommendations

We would recommend the study timeline to be modified in the following manner:

Recruitment of participants should be done through collaboration with the Safety Officer

during stand-down meetings one day prior to the toolbox talk. This provides participants with ample

Baselin

e Assessment

Post Toolbox Talk

Assessment

1‐W

eek Follo

w‐Up

Assessment

Toolbox Talk

Toolbox Talk & Air

Sampling Demo

Control

Experimental

1 –Day Prior Stand‐Down Meeting Phone

Building Occu

BOLTS | Se

time to co

fact that

interventi

T

focus and

one day p

during th

utmost im

should be

and Creo

The on

weekends

up until a

language

B. DATA

upational Lessons i

econd Delivera

omplete the l

only particip

ion survey an

The toolbox t

d attention if

prior to the

he experimen

mportance to

e carrying ou

le.

ne-week foll

s. Workers g

around 7 pm.

s.

A COLLEC

Figure

in Toxic crystallin

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lengthy basel

pants who b

nd will be ab

talk should b

f the talk is t

toolbox talk

ntal toolbox t

the interacti

ut the toolbox

low-up shou

get out of wor

Staff should

TED

1. Socio‐dem

worke

ne Silica (BOLTS)

line survey o

bring back th

le to receive

be conducted

too lengthy.

so printouts

talk. Having

ive compone

x talk, taking

uld be condu

rk at 4:30 an

d be available

mographic cha

ers participati

Pilot Study

overnight. At

heir filled o

the correspo

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Moreover, th

s of the expo

this pictogra

ent of the int

g turns to tran

ucted after w

d are usually

e to conduct

aracteristics o

ng in the BOL

Princip

t this point, it

out baseline

onding incent

e than 5 min

the air sampl

osure data ca

aphic represe

tervention. If

nslate the info

work on week

y willing to p

this part of th

of commercia

LTS pilot stud

pal Investigator:

t is imperativ

survey will

tives.

nutes, as part

ling should a

an be provid

entation of th

f possible, tw

formation pre

kdays, or in

participate in

he study in d

al constructio

y

Caban-Martinez, A

Page 5

ve to underlin

receive the

ticipants wil

also be cond

ded to partici

heir exposure

wo or three p

esented to Sp

the afternoo

the follow-u

different nece

on

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ne the

post-

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e is of

people

panish

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up call

essary

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follow-up

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aseline demo

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ective demog

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ion would le

cipants skipp

nal question

cipants miss

smoking rela

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n, many partic

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articipants, of

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Workers’ Smoking Status

Smoking status for workers, defined as current smokers, former smokers, and never smokers,

was determined by combining information regarding current smoking habits and whether they have

consumed 100 cigarettes in their life time. Smoking rates in this sample is slightly elevated

compared to Florida (22.8% vs 19.3%). Smoking was more prevalent in the control group than the

intervention group (28.0 vs 16.5%, p=.039, respectively). Overall, the intervention group had less

smoking history. No other differences were detected among other control variables, including union

status, OSHA training, education, or medical history.

A multivariable least squares regression was set up to assess any associations between the

intervention and personal protective equipment use and knowledge about silica after one week.

These models controlled for possible confounders such as safety training, smoking status, and

membership of a union. As shown in [Tables 1 and 2], the only factors that significantly predicted the

behavior and knowledge of workers one week after the intervention were the intervention itself and

exposure to dust.

Source DF Type III SS

Mean Square

F Value

Pr > F

DustContactFromTask_ 4 170.588 42.6471 1.62 0.1778 UnionMember 1 60.9381 60.9381 2.32 0.1322

OSHA10 1 0.0011 0.0011 0 0.9948 EducationLevel 5 87.9428 17.5886 0.67 0.6478 AsthmaHistory 1 0.01655 0.01655 0 0.98 COPDHistory 0 0 . . .

SilicosisHistory 0 0 . . . LungCancerHistory 0 0 . . .

Control 1 253.643 253.643 9.66 0.0027 smoking 2 79.3437 39.6719 1.51 0.2279

Table 1. Multivariable Regression of Behavior After One Week



In a separate analysis of the repeated measures of knowledge and behavior throughout the

different survey time-points of the study, an association surfaced with smoking status [Tables 3].

Multiple repeated measure ANOVAS were run, analyzing the relationship of smoking status on each

behavior outcome and knowledge question. Smoking status was only significantly associated with

use of PPE to prevent dust exposure in a model controlling for OSHA 10 and 30 training, education

level, union status, dust exposure from their work tasks. Former smokers exhibited worse behavior

patterns related to PPE use when compared to current or never smokers (Pr>|t| =.0081, .0069

respectively).

Type 3 Tests of Fixed EffectsEffect Num DF Den DF F Value Pr > F trial 1 88 0.39 0.5338 Site 4 157 0.28 0.8903 trial*Site 4 88 5.17 0.0009 smoking 2 157 4.29 0.0154 OSHA10 1 157 0.43 0.5129 EducationLevel 5 157 0.76 0.5771 UnionMember 1 157 0.30 0.5853 dusty 4 55 1.37 0.2563 OSHA30 1 157 0.49 0.4865

Source DF Type III SS

Mean Square

F Value

Pr > F

DustContactFromTask_ 4 141.08 35.27 3.18 0.0183 UnionMember 1 34.1191 34.1191 3.08 0.0836

OSHA10 1 39.429 39.429 3.56 0.0633 EducationLevel 5 32.3427 6.46855 0.58 0.7123 AsthmaHistory 1 5.39084 5.39084 0.49 0.4878 COPDHistory 0 0 . . .

SilicosisHistory 0 0 . . . LungCancerHistory 0 0 . . .

Control 1 421.73 421.73 38.06 <.0001 smoking 2 21.9135 10.9567 0.99 0.3771

Table 2. Multivariable Regression of Knowledge After One Week

Table 3. Use of PPE to prevent Dust contact and Smoking Repeated Measures



smoking _smoking Estimate Standard Error

DF t Value Pr > |t|

Current Former -0.8686 0.3238 157 -2.68 0.0081 Current Never -0.0636 0.2348 157 -0.27 0.787 Former Never 0.8051 0.294 157 2.74 0.0069

D. FUTURE IMPLICATIONS

Data collected in the BOLTS pilot project suggest that commercial construction workers exposed

to interactive toolbox talk on workplace silica and dust exposures are more likely to increase their use

of personal protective equipment (i.e. face mask) and identify greater relevant workplace sources of

dust/silica when compared to workers participating in a regular toolbox talk. Elements of adult

learning theory that incorporates facts and tangible, hands-on activities (i.e., air sampling exposures

levels) appears to improve worker safety behaviors and knowledge at least in the 1-week follow up

period. Future studies should consider moving from ambient air sampling at the worksite to

individual worker air sampling to provide a more personalized individual exposure level.

Furthermore, the follow up time period should be increased to 3-4 weeks post intervention in order to

ascertain the longer-term impact of the interactive toolbox talk on worker behavior. The BOLTS data

supports the idea the flat lecture-based toolbox talks may limit the impact the message has on worker

knowledge and behavior, although more rigorous study design and follow up periods are needed.

E. PUBLICATIONS AND STUDENT TRAINING As of the date of this second deliverable report, the BOLTS research team has presented preliminary

findings of the pilot project at two venues that include research study, governmental and construction

industry partners:

1. Olano H, Chen C, Sznol J, Kling H, Arheart KL, Watkins S, Chalmers J, Harduar-Morano L,

Cavicchia P, and Caban-Martinez AJ. Preliminary findings from the Building Occupational

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F. APPENDICES

A. Manuscript draft – For submission at AJPH

B. Final Data set

C. Baseline Survey

D. Post-Intervention Survey

E. Follow-up Survey

second final deliverable report · final f miami, ... oolbox talk at the sites. talk on si talk on...

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