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Enhancing informal workers' tools to reduce workplace injuries: a quasi-randomized control trial of electronic waste recyclers in Thailand

Shkembi A, Linhart E, Chou S, Coulentianos MJ, Adhvaryu A, Austin-Breneman J, Nambunmee K, Neitzel RL

Scandinavian journal of work, environment & health, 2026

Abstract

Objectives: In low- and middle-income countries (LMIC), there is mixed evidence on the effectiveness of interventions in improving workplace conditions among hazardous industries. In Thailand, a particularly hazardous industry with high injuries is informal electronic waste (e-waste) recycling. We investigated whether developing an optimized tool to dismantle e-waste would reduce injuries.

Methods: We conducted a quasi-randomized control trial to determine the perceptions and efficacy of the optimized tool in reducing worker injuries over three months among 89 workers. The optimized tool for dismantling e-waste was designed following employee and business owner input using conjoint analysis. Workers were quasi-randomized into an intervention (ie, receiving the tool) or control (ie, not receiving) group from an auction. We conducted differences-in-differences Poisson regression to examine differences in self-reported injuries and near misses over three months follow-up between the intervention and control groups.

Results: Among 44 workers who received the tool, workers self-reported that the tool created a safer work environment and reduced near misses, hammer danger, hand vibrations and hand pain. Among 42 workers (21 treatments, 21 controls) with complete information, the intervention reduced self-reported injuries over three months [difference-in-differences: -58%, 95% confidence interval (CI) -19- -79%]. Similar reductions in near misses were observed but not…

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Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design.

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