Amputations, a serious form of work-related trauma, affect between 15,000 and 20,000 Americans each year. Minnesota Sentinel Event Notification System for Occupational Risk (MN SENSOR) data indicates that primary and fabricated metal industries have the fourth highest rate of work-related amputations. The number of potentially affected workers in these industries is several folds greater than other high-risk industries. In addition, amputations represent only a fraction of the cases of upper extremity trauma. In spite of the fact that many companies provide services to assist in the development of work-related safety programs, the effectiveness of such programs has not been evaluated in a controlled intervention study. In addition, there has been little research with regard to hazard control within small (4-50 employees) industrial establishments. The specific objectives of this research are to: (1) evaluate small machining and metal stamping shops with regard to the availability, functionality, and use of machine guarding; (2) identify critical factors for implementing and conducting effective machine guarding programs, including the identification and elimination of barriers to program success; and (3) implement and assess the effectiveness of an intervention that uses a combination of control technology, regulatory guidelines, and worker/owner training in a randomized controlled trial. The intervention will be designed using a health promotion model. We will work with an advisory board of industry leaders and workers throughout the proposed research study. A randomized controlled trial consisting of two groups will be conducted. These groups will consist of: (1) control group (minimal intervention); (2) owner and worker intervention. A technical and peer-based intervention will be conducted by peer educators. Shops in each intervention group will be evaluated at the time they are enrolled and one year after their initial evaluation. Two measurements will be developed for this purpose: (1) self-administered worker and owner surveys grounded in health promotion models; and (2) an evaluation performed by industrial hygienists of frequency of machine use and machine guarding availability, functionality and utilization for targeted machines. Our primary outcome is a change in shop score which measures machine use and machine guarding availability and functionality. Regression analysis will be used to compare change in shop scores from base-line and follow-up evaluations between the treatment groups. Data from worker and owner surveys will be summarized using basic descriptive statistics and used as both outcome and process measures. Data will be disseminated to the scientific and industrial communities.
