Objective The aim of this study was to evaluate the effectiveness of a participatory training program in preventing accidental occupational injuries in factories in Shenzhen, China. Methods We conducted a cluster randomized study with the worker as the unit of analysis, providing 918 workers from 30 factories participatory training. Two control groups received traditional didactic training, including 907 workers from the same 30 factories and 1654 workers in matched control factories. We used generalized estimating equations to compare the before/after person-based injury rate difference in the three groups and binary logistic regression to compare the re-injury rates. Results The person- and event-based incidence rates of accidental injury in the intervention group reduced from 89.3 to 52.1 per 1000 workers (P=0.002) and from 138.3 to 74.5 per 1000 person-years (P<0.001), respectively. The rate reductions in the two control groups were not statistically significant. Compared with the intervention group, the risk of accidental work injury over time was higher in the control groups, with odds ratios (OR) 1.78 (1.04-3.04) and 1.77 (1.13-2.79) for control_1 and control_2 group, respectively. The re-injury rates were 27.1% (13/48) in the intervention group, and 41.7% (15/36) and 52.6% (51/97) in the two control groups respectively, with the latter being significantly higher than the intervention group. Conclusions Our study documented the effectiveness of a participatory approach to occupational health and safety training in reducing accidental work injuries and re-injuries among frontline workers.

As millions of immigrants moved to Hong Kong (HK) from China in the recent decades, large amount of residential housings were built in the early years and a substantial proportion of those buildings used asbestos-containing materials (ACMs). Since the number of new cases of ARDs diagnosed has increased year by year since 1990’s, the remarkable increase of incidences had drawn the attention of the public and most importantly the HK government. It became one of the trigger points leading to asbestos ban in HK history. Comparatively, non-governmental organizations (NGOs), labor unions and patients’ self-help organizations demonstrated a more aggressive and proactive attitude than the HK government and have played a key role in the development of asbestos banning policy in HK. After numerous petitions and meetings with the government representatives by those parties in the past decade, the HK government eventually changed its attitude and started to consider terminating the endless threat from asbestos by amending the policy, and the new clause of legislation for banning of all forms of asbestos was enacted on 4 April 2014. Other than the restriction of asbestos use, the compensation system about ARDs has also made some great moves by the effort of those parties as well. Based on the experience we learnt through the years, efforts from different stakeholders including patients’ self-help organizations, NGOs, legislative councilors, and media power are absolutely essential to the success of progression and development in today’s asbestos banning in HK.

Objectives To assess the relationship between quantitative exposure levels and the development of asbestosis in a Chinese asbestos worker cohort. Method A cohort consisting of 577 male workers from an asbestos products factory in China was followed for 37-years. Personal information was collected, including date of hire, specific job types, duration of exposure, and smoking habits. There were 127 workers (22%) diagnosed as asbestosis by a specialised panel using Chinese radiographic Diagnostic Criteria for Pneumoconioses (GB5908–86). Individual cumulative fibre exposures (f-yrs/ml) were estimated based on periodic dust/fibre measurements from different workshops and years of working at specific workshops, and then categorised into four levels (quartile). The relationship between the exposure levels and cumulative incidence of asbestosis was assessed with Cox Proportional Hazard Model, adjusting for age and smoking. Results Workers at the four exposure levels were comparable in age at entry, exposure duration (around 25 yrs), and smoking rate. However, the proportion of asbestosis cases was grater with exposure levels, accounting for 9%, 27%, 29% and 36% from 1^st quartile to 4^th quartile, respectively. Hazard ratios for cumulative incidence of asbestosis showed a clear trend with the exposure levels, with a nearly three-fold increase (3.42. 95% CI 2.0, 5.9) at the highest exposure level, compared to at the lowest level. Conclusions The study using quantitative estimate of exposures, which was seldom available in China, provides additional evidence for the exposure-response relationship between chrysotile exposure and the development of asbestosis in asbestos workers.