title: Survey assessment of worker dermal exposure and underlying behavioral determinants.
abstract: Within the workplace, there is less reliance on engineering controls for dermal exposure protection and more reliance on the worker's motivation and training in use of personal protective equipment. Behavior thus becomes a significant determinant of dermal exposure, and its assessment paramount in examining and understanding factors influencing exposure. The main objectives of this study were to: (i) assess worker knowledge, attitudes, and perceptions (KAP) of workplace dermal hazards using a self-complete questionnaire and to examine KAP associations with behavior and exposure; (ii) compare worker and manager scores to identify potential gaps in KAP between the two groups; (iii) utilize a semiquantitative observational DeRmal Exposure Assessment Methodology (DREAM) to evaluate worker dermal exposure; and (iv) identify potential behavioral factors underlying exposure using DREAM and KAP. Nineteen industries across the Baltimore, Md. and Lancaster, Pa., regions participated in the study including a total of 89 workers and 17 managers. The scales within the KAP questionnaire that served as the outcome measure included knowledge, training, behavior, behavior beliefs, information beliefs, self-efficacy, and overall beliefs. DREAM scores ranged from 0.15 to 545 with a median of 8 and a mean (SD) of 22 (62.5). Whereas worker self-efficacy with respect to PPE use, and the group "workers with 10-20 years of experience" were marginally positively associated with protective behavior (p < 0.08 and p < 0.06, respectively), a question related to barriers to PPE use was negatively associated with precautionary behavior (p < 0.01). Dermal exposure was positively associated with workers in the age group 40-49 years as compared with those less than 40 years of age (OR = 4.86, 95% CI = 0.93, 25.62). There were no statistically significant associations between KAP and DREAM. This is one of the first studies to begin to elucidate worker knowledge, attitudes, and perceptions that underlie behaviors that lead to occupational dermal exposures. Results of the KAP questionnaire can inform strategies to improve awareness and protective practices in the workplace through factors such as increased worker dermal hazard knowledge, well-informed company PPE selection and availability, and improved worker training.
authors.affiliation: Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA. laura.geer@downstate.edu
authors.forename: Laura A
authors.initials: LA
authors.lastname: Geer
authors.forename: Daniel
authors.initials: D
authors.lastname: Anna
authors.forename: Barbara
authors.initials: B
authors.lastname: Curbow
authors.forename: Marie
authors.initials: M
authors.lastname: Diener-West
authors.forename: Berna van Wendel
authors.initials: Bv
authors.lastname: de Joode
authors.forename: Clifford
authors.initials: C
authors.lastname: Mitchell
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Buckley
mesh_terms: D000367:Age Factors; D000395:Air Pollutants, Occupational / Q000032:analysis / Q000633:toxicity*; D003625:Data Collection; D015386:Hazardous Substances / Q000032:analysis / Q000633:toxicity*; D006801:Humans; D016273:Occupational Exposure / Q000009:adverse effects* / Q000706:statistics & numerical data; D018570:Risk Assessment; D012869:Skin Absorption / Q000187:drug effects*; D011795:Surveys and Questionnaires; D017132:Workplace
chemical_list: D000395:Air Pollutants, Occupational; D015386:Hazardous Substances