title: Effectiveness of a Multidimensional Randomized Control Intervention to Reduce Quartz Exposure Among Construction Workers.
abstract: There is little evidence with respect to the effectiveness of intervention programs that focus on the reduction of occupational quartz exposure in the construction industry. This article evaluates the effectiveness of a multidimensional intervention which was aimed at reducing occupational quartz exposure among construction workers by increasing the use of technical control measures. Eight companies participating in the cluster randomized controlled trial were randomly allocated to the intervention (four companies) or control condition (four companies). The multidimensional intervention included engineering, organizational, and behavioural elements at both organizational and individual level. Full-shift personal quartz exposure measurements and detailed observations were conducted before and after the intervention among bricklayers, carpenters, concrete drillers, demolishers, and tuck pointers (n = 282). About 59% of these workers measured at baseline were reassessed during follow-up. Bayesian hierarchical models were used to evaluate the intervention effect on exposure levels. Concrete drillers in the intervention group used technical control measures, particularly water suppression, for a significantly greater proportion of the time spent on abrasive tasks during follow-up compared to baseline (93 versus 62%; P < 0.05). A similar effect, although not statistically significant, was observed among demolishers. A substantial overall reduction in quartz exposure (73 versus 40% in the intervention and control group respectively; P < 0.001) was observed for concrete drillers, demolishers, and tuck pointers. The decrease in exposure in the intervention group compared to controls was significantly larger for demolishers and tuck pointers, but not for concrete drillers. The observed effect could at least partly be explained by the introduced interventions; the statistically significant increased use of control measures among concrete drillers explains the observed effect to some extent in this job category only. Sensitivity analyses indicated that the observed decrease in exposure may also partly be attributable to changes in work location and abrasiveness of the tasks performed. Despite the difficulties in assessing the exact magnitude of the intervention, this study showed that the structured intervention approach at least partly contributed to a substantial reduction in quartz exposure among high exposed construction workers.
authors.affiliation: Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands Netherlands Organization for Applied Scientific Research TNO, Zeist, The Netherlands erik.vandeurssen@tno.nl.
authors.forename: Erik
authors.initials: E
authors.lastname: van Deurssen
authors.affiliation: Shell International B.V., Shell Health, Risk Science Team, The Hague, The Netherlands.
authors.forename: Tim
authors.initials: T
authors.lastname: Meijster
authors.affiliation: Netherlands Organization for Applied Scientific Research TNO, Leiden, The Netherlands.
authors.forename: Karen M
authors.initials: KM
authors.lastname: Oude Hengel
authors.affiliation: Netherlands Organization for Applied Scientific Research TNO, Zeist, The Netherlands.
authors.forename: Ruud
authors.initials: R
authors.lastname: Boessen
authors.affiliation: Netherlands Organization for Applied Scientific Research TNO, Zeist, The Netherlands.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Spaan
authors.affiliation: Netherlands Organization for Applied Scientific Research TNO, Zeist, The Netherlands.
authors.forename: Erik
authors.initials: E
authors.lastname: Tielemans
authors.affiliation: Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands.
authors.forename: Dick
authors.initials: D
authors.lastname: Heederik
authors.affiliation: Netherlands Organization for Applied Scientific Research TNO, Zeist, The Netherlands.
authors.forename: Anjoeka
authors.initials: A
authors.lastname: Pronk
mesh_terms: D000328:Adult; D001499:Bayes Theorem; D060389:Construction Industry; D003252:Construction Materials; D004391:Dust / Q000032:analysis; D004784:Environmental Monitoring / Q000379:methods; D006801:Humans; D019570:Inhalation Exposure / Q000032:analysis; D016273:Occupational Exposure / Q000032:analysis / Q000517:prevention & control*; D011791:Quartz / Q000032:analysis*; D017132:Workplace
chemical_list: D004391:Dust; D011791:Quartz
keywords: cluster randomized controlled trial; construction industry; exposure assessment; intervention study; quartz; technical control measures