Vol.:(0123456789) 1 3 Journal of Community Health https://doi.org/10.1007/s10900-019-00777-9 ORIGINAL PAPER Occupational Safety and Health in a Community of Shellfsh Divers: A Community‑Based Participatory Approach Marie A. Garrido 1,2  · Manuel Parra 1,2  · Juana Díaz 3  · Julia Medel 2,4  · Dennis Nowak 5  · Katja Radon 1,6 © Springer Science+Business Media, LLC, part of Springer Nature 2019 Abstract In artisanal fshing communities in Chile, the access to occupational safety and health (OSH) is limited by factors such as the informality of employment. Our objective was to analyze the working and health conditions of workers in a coastal town in Southern Chile, under a community-based participatory approach. We carried out two independent social dialogue workshops within the community. The frst one (N of participants = 25) was aimed to identify the strengths, weaknesses and challenges for preventing decompression sickness among divers. The second workshop (N of participants = 10) was set to identify the work processes and to map the occupational risks during seafood harvesting and processing in the community. Community members’ training for handling and preventing decompression sickness among divers, and the collaboration between a local health representative, stakeholders and authorities, were identifed as contributing factors in reducing fatalities and sequels among divers in the past. Technology and safety on board the vessels, training of healthcare personnel in OSH, and access to health programs, were identifed as remaining challenges. Through risk mapping, the participants identifed the relationship between working and health conditions in the community, reinforcing the necessity of improving access to health and social security. The community participation in identifying and analyzing working and health conditions could be the frst step for a strategy to address OSH through primary health care in rural communities. Community empowerment and involvement in action plans, training on basic OSH for health care workers, and public policies are required. Keywords Community-based participatory research · Diving · Decompression sickness · Informal sector · Occupational health Introduction About half of the working population worldwide works in the informal sector with highest fgures in low and middle income countries [1–3]. Informal work can be defned as employment without legal status and institutional regulation [4]. It is characterized by unstable income, lack of social security coverage, unregulated working hours, poor working conditions and a lack of preventive measures [4–7]. A lack of workplace safety puts the worker at higher risk of occu- pational accidents and work-related diseases increasing the burden caused by non-communicable diseases of the com- munity [8]. The prevalence and incidence of occupational accidents and work-related diseases in the informal sector is largely unknown, as no ofcial statistics for this sector exist. Informal work is especially common in rural areas of many countries around the world. The development of communities depends on exploitation, manufacturing and services around activities such as agricultural, mining and * Marie A. Garrido Marieastrid.garrido@lrz.uni-muenchen.de 1 CIHLMU Center for International Health, Hospital of the Ludwig-Maximilians-University Munich, Munich, Germany 2 Comunidad de Práctica sobre el Enfoque Ecosistémico en Salud Humana, COPEH-LAC, Southern Cone node, Santiago de Chile, Chile 3 Terminal Pesquero de Carelmapu, Maullín, Chile 4 Centro de Estudios de la Mujer, Santiago de Chile, Chile 5 Institute for Occupational, Social and Environmental Medicine, Hospital of the Ludwig-Maximilians-University Munich, Munich, Germany 6 Occupational and Environmental Epidemiology & NetTeaching Unit, Hospital of the Ludwig-Maximilians-University Munich, Munich, Germany