Worker participation in change processes in a Danish industrial setting.

Background: Improving the design, management and organization of work may be an important step in improving occupational health. An intervention, guided by the principles of participatory action research (PAR), is directed at traditional work environment problems in the epoxy plastic industry, that is, eczema and accident- related injuries. Methods: The study population consisted of employees at two wind turbine-manufacturing plants. A quasi-experimental design was employed with before and after measurements and a comparison group with a 3 1/2 year-follow-up period. Results: The role of employee elected safety representatives was changed from one of controlling and "policing" to that of safety advisors. The attitudes of employees also changed, from an individualistic understanding of safety as the responsibility of the single employee, to a more collective understanding of safety as being everyone's shared responsibility. Structural changes led to a less hierarchical management system. This process led eventually to the establishment of self-governing work groups in which each member had a well-defined area of responsibility. The change process was associated with improvements in the psychosocial work environment and safety climate, a 66% reduction in the incidence of eczema, and a 48.6% reduction in the incidence of occupational accidents. In the comparison population, a twin factory under the same company, similar but delayed and less dramatic changes also occurred. Conclusions: Implementation of a comprehensive intervention was followed by improved employee perceptions of the company's safety standards and the psychosocial work environment, as well as by substantial reductions in the incidence of eczema and occupational accidents.