Date of Award


Document Type

Open Access Thesis

Degree Name

Medical Doctor (MD)

First Advisor

Carrie Redlich


Isocyanates are a major cause of occupational asthma. To reduce worker exposure to isocyanates, we conducted a prospective field intervention study of educational and behavioral feedback interventions. 14 auto body shops were randomly assigned to control and intervention groups; 103 workers from these shops consented to study participation. Original surveys of exposure-related Knowledge and Attitudes and Self-Reported Behavior were administered and behaviors were observed at baseline, 6, and 12 months. The intervention group participated in the full intervention with behavioral feedback continued throughout the first 6 months; the control group had no formal interventions until, at 6 months, they received educational training alone. In both study groups, knowledge and attitudes related to personal protective equipment and safe work practices improved substantially. Most improvements were sustained at12 months. The difference in improvement between interventions was borderline significant (p=0.056), indicating that behavioral feedback could be superior to educational training alone for improving knowledge and attitude scores. For self-reported behavior, greater improvement in the intervention group was not significant (p=0.15). At baseline, Self-Reported Behavior score was significantly correlated with Knowledge and Attitudes score and Hispanic ethnicity (p=0.008, and p=0.014), but not with job title, group assignment (intervention vs. control), age, or smoking status. Examining correlations at all study periods, group assignment and Knowledge and Attitudes score were both significant variables affecting self-reported behavior, raising the possibility of greater effectiveness of intervention with behavioral feedback. In conclusion, a multi-faceted intervention including educational training and behavioral feedback improves observed and self-reported safety behavior and related knowledge and attitudes in auto body workers exposed to isocyanates. The addition of behavioral feedback generated improvement in overall knowledge and attitudes that was borderline significant. Scores on the Knowledge and Attitudes Survey were significantly correlated with self-reported behavior, giving this survey great potential for use in characterizing auto body worker exposure risk and readiness for behavior change.


This is an Open Access Thesis.

Open Access

This Article is Open Access