For more than 20 years women in northeastern North Carolina have been organizing to address social, economic, and health issues arising from industrial work in an area with few employment opportunities. Although the impacts of racial discrimination and fast paced assembly line production have been described by government inspectors, journalists, and women advocating on their own behalf, research has not quantified the occurrence of specific health outcomes or their risk factors. Through collaboration of investigators at Duke University, University of North Carolina, and the Center for Women's Economic Alternatives, the investigators propose to evaluate occupational roots of health disparities among women in a five-county region of northeastern North Carolina. An intensive prospective cohort study of women newly employed in assembly line work in the area is planned to define the incidence of musculoskeletal disorders and acute injuries under different work conditions and exposures, document high-risk groups, and allow the exploration of etiologic factors. To facilitate analyses, a multidimensional exposure assessment will be conducted documenting work processes, exposures, and conditions of women employed in the target industries. This will be accomplished through collaboration with workers, serving as key informants, and the use of participant-action and risk-mapping techniques. The exposure matrix will be used in etiologic analyses but will also serve as an educational tool for workers and providers of healthcare. This process will include not only traditional (physical, chemical, and ergonomic) work exposures but also psychosocial aspects including level of control and demand. In addition to providing high-quality data on an unstudied high-risk population, this work will employ a blend of qualitative and quantitative methodologies to help document and quantify health-related quality of life and social consequences of employment for women in rural North Carolina and the relationship of these consequences to different types of work exposures. Community outreach will be integrated at all stages of the research design to foster empowerment of women employed in this industry through risk factor education, medical information on disease and treatment, ergonomic training, and legal rights. Education will also be targeted to medical providers in this geographic area on work exposures and conditions, exposure response, prevention, basic epidemiology, and ergonomics.
