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

**Authors:** Abas Shkembi, Emma Linhart, Suzanne Chou, Marianna J Coulentianos, Achyuta Adhvaryu, Jesse Austin-Breneman, Kowit Nambunmee, Richard L Neitzel

PMC · DOI: 10.5271/sjweh.4259 · Scandinavian Journal of Work, Environment & Health · 2026-02-28

## TL;DR

A study in Thailand found that co-designed tools for e-waste recycling reduced injuries among informal workers.

## Contribution

The study introduces co-designed tools optimized with stakeholder input to reduce injuries in informal e-waste recycling.

## Key findings

- Workers reported a safer environment with fewer near misses and hand pain using the optimized tool.
- The intervention reduced self-reported injuries by 58% over three months.
- Near misses decreased by 53%, though the result was not statistically significant.

## Abstract

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.

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.

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 statistically significant (-53%, 95% CI -92–173%).

Our study suggests that meaningful reductions in injury risk for specific types of work can be achieved with co-designed tools optimized to consider inputs from multiple stakeholders. This approach can be especially useful in resource-constrained environments, including working conditions in LMIC.

## Full-text entities

- **Diseases:** hand pain (MESH:D010146), worker injuries (MESH:D000382), injuries (MESH:D014947), workplace injuries (MESH:D000073397)

## Full text

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## Figures

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## References

23 references — full list in the complete paper: https://tomesphere.com/paper/PMC12956371/full.md

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Source: https://tomesphere.com/paper/PMC12956371