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Industrial hygiene recommendations as interventions: a collaborative model within occupational medicine.

The authors conducted a cross-sectional telephone survey of patients and employers to evaluate the effectiveness of conducting industrial hygiene work site visits as part of the medical management of clinic patients with suspected occupational disease. Industrial hygiene interventions were intended to keep the index patient from ongoing exposure while simultaneously protecting co-workers from future disease. The demographics of the 76 work sites and patients are summarized. According to the employers, 78 percent had implemented at least one recommended intervention, and 52 percent of the employers had implemented the priority intervention. The factors associated with the employers' implementation of the recommended industrial hygiene controls are presented. Employers were 3.7 times more likely to implement the priority intervention (p = .04) if they believed a worker's illness was work-related. Employers with joint labor-management health and safety committees were 3.8 times as likely to implement the priority intervention (p = 0.04). The factors associated with changes in the patients' self-reported disease status are explored and the social and economic implications of this model, are discussed. Patients who reported an improvement in disease status were 5.5 times more likely to have maintained or increased their salary (p = 0.03). Patients were 10.4 times more likely to be working if the employer had implemented any intervention (p = 0.02) and 13.3 times more likely if the priority intervention (p = 0.01) had been adopted. Those patients who left their original employer suffered a median decrease in salary of 35 percent if they found work with a different employer and a 90 percent decrease when they failed to find a new job.