BACKGROUND Occupational safety and health (OSH) programs are a strategy for protecting workers' health, yet there are few peer-reviewed reports on methods for assessing them, or on the prevalent characteristics of OSH programs, especially in small businesses. METHODS We adapted an occupational safety and health administration (OSHA) survey instrument to assess: management commitment and employee participation, workplace analysis, hazard prevention and control, and education and training. This was supplemented by a series of open-ended questions. We administered the survey in 25 small worksites. RESULTS Scores for each element ranged widely, with distribution of most scores being positively skewed. Barriers to addressing OSH included lack of time and in-house expertise, and production pressures. External agents, including corporate parents, liability insurers, and OSHA, played an important role in motivating OSH programs. CONCLUSIONS Small businesses were able to mount comprehensive programs, however, they may rely on outside resources for this task. Being small may not be a barrier to meeting the requirements of an OSHA program management rule.

An action-oriented conference, Organized Labor, Public Health, and Tobacco Control Policy, was held in September 2000 in Boston, Massachusetts. Labor union leaders, tobacco control and public health activists, researchers, and practitioners met for two days to: 1) learn about existing labor-based tobacco control initiatives; 2) educate one another about resources, barriers, and opportunities for labor-public health joint action on tobacco policy; 3) and identify where agendas overlap and form the basis for specific next steps in collaborative efforts in tobacco-related research, training, and advocacy. This report summarizes presentations and participant discussions to inform readers of the information exchanged and of the enthusiasm shared by conference participants translated into a set of joint recommendations for increased labor-based and joint labor-public health action to reduce the burden of tobacco on working people.

Objectives. This study determined the level of insurance coverage for smoking cessation treatment and factors associated with coverage among health and welfare funds affiliated with a large labor union.Methods. A self-administered written survey was mailed to fund and union officials. Analyses were conducted by chi (2) tests.Results. Twenty-nine percent of funds provided coverage for some type of smoking cessation treatment,with the odds of coverage significantly increased among funds whose administrators reported having received members' requests for smoking cessation treatment in the past year (odds ratio = 4.9, P = .05).Conclusions. Coverage for smoking cessation services is low, comparable to coverage offered by other health insurers. Interventions with union members and fund officials are needed to provide union members with access to affordable and effective smoking cessation treatments.

Objectives. This report describes local unions' positions on tobacco control initiatives and factors related to these positions., Methods. A national random-sample of local union leaders was surveyed by telephone. Results. Forty-eight percent of local unions supported worksite smoking bans or restrictions, and only 8% opposed both a ban and a restriction. Conclusions. Support for tobacco control initiatives among local unions was higher than might be expected on the basis of previous evidence. Engaging unions in smoking policy formation is likely to contribute to the larger public health goal of reducing smoking and exposure to secondhand smoke among workers.

According to prior reports, blue-collar workers are less likely to participate in worksite health promotion programs than are white-collar workers, This study examined worker participation in the WellWorks worksite cancer prevention intervention, which integrated health promotion and health protection Analyses were conducted to assess relationships among participation in health promotion and health protection programs, and workers' perceptions of management changes to reduce potential occupational exposures. Results indicate that blue-collar workers were less likely to report participating in health promotion activities than white-collar workers. A significant association was observed between participation in nutrition- and exposure-related activities, suggesting that participation in programs to reduce exposures to occupational hazards might contribute to blue-collar workers' participation in health promotion activities, Furthermore, when workers were aware of changes their employer had made to reduce exposures to occupational hazards, they were more likely to participate in both smoking control and nutrition activities, even when controlling for job category. These findings have clear implications for future worksite cancer prevention efforts.

Objectives. To describe a theoretic approach and rationale for the integration of health protection and health promotion in worksite cancer prevention programs and to describe an intervention study designed to implement this integration. Methods. Twenty-four worksites were recruited to participate in this randomized, controlled study. The theoretically based intervention model integrates health promotion and health protection through (1) joint worker-management participation in program planning and implementation, (2) consultation on worksite changes, and (3) educational programs targeting health behavior change. Results. Although the primary purpose of this paper is to describe a theoretic approach to the integration of health promotion and health protection, preliminary results are also noted. In these predominantly manufacturing worksites, many workers faced the double jeopardy of exposures to occupational carcinogens and personal risks such as smoking or poor dietary habits. Production workers' job responsibilities frequently limited their full participation. Barriers to participation were identified early in the project, and strategies were developed to facilitate maximal worker involvement and worksite changes. Conclusions. Lifestyle changes such as smoking cessation or dietary changes may be more effectively promoted among blue collar audiences when programs also encourage management actions to reduce occupational exposures. Public health professionals trained in health promotion and health protection must work together to effectively address the health concerns of this population.