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dc.rights.licenseCreative Commons Attribution (CC BY) license
dc.contributor.authorChen, Wenen
dc.contributor.authorLi, Tongyangen
dc.contributor.authorZou, Guanyangen
dc.contributor.authorRenzaho, Andre M. N.en
dc.contributor.authorLi, Xudongen
dc.contributor.authorShi, Leiyuen
dc.contributor.authorLing, Lien
dc.identifier.citationChen, W., Li, T., Zou, G., Renzaho, A.M.N., Li, X., Shi, L. and Ling, L. (2019) ‘Results of a cluster randomized controlled trial to promote the use of respiratory protective equipment among migrant workers exposed to organic solvents in small and medium-sized enterprises’, International Journal of Environmental Research and Public Health, 16(17), p. 3187. Available at:
dc.description.abstractBackground: Existing evidence shows an urgent need to improve respiratory protective equipment (RPE) use, and more so among migrant workers in small and medium-sized enterprises (SMEs). The study aimed to assess the effectiveness of a behavioral intervention in promoting the appropriate use of RPE among internal migrant workers (IMWs) exposed to organic solvents in SMEs. Methods: A cluster randomized controlled trial was conducted among 1211 IMWs from 60 SMEs in Baiyun district in Guangzhou, China. SMEs were deemed eligible if organic solvents were constantly used in the production process and provided workers with RPE. There were 60 SMEs randomized to three interventions on a 1:1:1 ratio, namely a top-down intervention (TDI), a comprehensive intervention, and a control group which did not receive any intervention. IMWs in the comprehensive intervention received a module encompassing three intervention activities: An occupational health education and training component (lectures and leaflets/posters), an mHealth component in the form of messages illustrative pictures and short videos, and a peer education component. The TDI incorporated two intervention activities, namely the mHealth and occupational health education and training components. The primary outcome was the self-reported appropriate RPE use among IMWs, defined as using an appropriate RPE against organic solvents at all times during the last week before measurement. Secondary outcomes included IMWs’ occupational health knowledge, attitude towards RPE use, and participation in occupational health check-ups. Data were collected and assessed at baseline, and three and six months of the intervention. Generalized linear mixed models were performed to evaluate the effectiveness of the trial. Results: Between 3 August 2015 and 29 January 2016, 20 SMEs with 368 IMWs, 20 SMEs with 390 IMWs, and 20 SMEs with 453 IMWs were assigned to the comprehensive intervention, the TDI, and the control group, respectively. At three months, there were no significant differences in the primary and secondary outcomes among the three groups. At six months, IMWs in both intervention groups were more likely to appropriately use RPE than the control group (comprehensive intervention: Adjusted odds ratio: 2.99, 95% CI: 1.75–5.10, p < 0.001; TDI: 1.91, 95% CI: 1.17–3.11, and p = 0.009). Additionally, compared with the control group, the comprehensive intervention also improved all three secondary outcomes. Conclusions: Both comprehensive and top-down interventions were effective in promoting the appropriate use of RPE among IMWs in SMEs. The comprehensive intervention also enhanced IMWs’ occupational health knowledge, attitude, and practice. Trial registration: ChiCTR-IOR-15006929. Registered on 15 August 2015.en
dc.description.sponsorshipThe study was funded by National Science Foundation of China (81402767), the Medical Science and Technology Research Fund of Guangdong Province (WSTJJ20140116510124198504200421), China Medical Board (13-175) and Sun Yat-sen University (15ykpy08). The sponsors are not involved in study design; in the collection, analysis, and interpretation of data; in the writing of the report and in the decision to submit the paper for publication.en
dc.relation.ispartofInternational Journal of Environmental Research and Public Healthen
dc.rights© 2019 by the authors
dc.subjectRespiratory Protective Equipmenten
dc.subjectSmall And Medium-Sized Enterprisesen
dc.subjectCluster Randomized Controlled Trialen
dc.titleResults of a cluster randomized controlled trial to promote the use of respiratory protective equipment among migrant workers exposed to organic solvents in small and medium-sized enterprisesen
rioxxterms.typeJournal Article/Reviewen
qmu.authorZou, Guanyangen
qmu.centreInstitute for Global Health and Developmenten

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