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San Francisco Hotel Worker Study Summary

Niklas Krause 2-4-99


This is a pilot study designed to help in the development of a large-scale research project on the future of work in the hospitality industry. The hospitality industry has experienced a wave of restructuring, consolidation, and new practices to cut costs including lean staffing and greater performance demands on the workforce. The study will explore the impact of these and related changes on the health and quality of life the largest occupational group within the hospitality industry, room cleaners. Jobs in housekeeping (and food and beverage) operations of the hospitality industry represent the future of work in this growing service sector with jobs characterized by increasing repetitive physical workloads, low income, low skill utilization, low job control, and virtually no prospects for training and career advancement. There is compelling evidence that this kind of low-income jobs result in a disproportionate high burden of illness, injury, and disability. Unlike other services, businesses in the hospitality industry, cannot be moved across the borders but will remain a fast growing sector in industrialized countries, creating increasing societal costs including disproportionate workers’ compensation and health care utilization costs. Working conditions in the hospitality industry are representative for a growing number of workers of color, working women, and former welfare recipients. The hospitality industry has become a major target for welfare-to-work and job training programs in cities throughout the country. An aging workforce is faced with increasing job demands in a competitive industry constantly upgrading services. Few studies have been done on this growing workforce and little is known about their specific working conditions and health risks and how they could be addressed.

This study will take a broad view at physical and psychosocial job factors, health, including general self-rated health, musculoskeletal disorders, work-related injury, and health-related quality of life. Further, this study will investigate which innovative organizational strategies can help to reduce the burden of illness and disability in the service sector by comparing hotels in different market segments, different degrees of unionization, and hotels with innovative joint labor management health and safety programs, negotiated child care/elder care benefits, and a multi-employer worker training project.

San Francisco is expected to provide several union and non-union cases for comparison to similar cases in low union density markets and to a selected number of additional cases in other high union density markets that highlight organizational innovations (such as training and career laddering in Las Vegas or work redesign in New York to avoid sub-contracting). The pilot study focuses on housekeeping since it is the largest occupational category in the industry and is the central focus of a larger study including hotels in other cities. The study combines qualitative and quantitative research methods and is participatory in design and implementation thereby laying the groundwork for sustainable efforts in understanding and improving health and safety of service workers.


The pilot study is administered by the director of the Labor and Occupational Health Program (LOHP) at UC Berkeley Robin Baker, in collaboration with Niklas Krause, physician epidemiologist from the School of Public Health at UC Berkeley. Funding is provided by the United Way of the Bay Area and Local 2 of the Hotel Employees and Restaurant Employees International Union (HERE).

The level of union density in San Francisco is among the highest in the country. The largest union is HERE Local 2 which represents 8,000 workers or around 70 % of the industry’s non-supervisory workforce. In San Francisco the multi-employer bargaining agreement with about 50 hotels in the city has taken wages and benefits out of competition. The starting wage for non-tipped jobs is $11 per hour plus comprehensive portable benefits. San Francisco presents a special opportunity for comparisons of work conditions in the industry and for future workplace interventions because of a unique partnership with twelve first class hotels that is designed to improve customer service and job quality in the industry. The San Francisco Hotels Partnership Project has implemented a core-training program throughout much of the industry, and developed pilot projects to resolve conflicts at the lowest possible level within an organization. The parties have also worked to establish joint decision making processes for redesigning work in the food and beverages and housekeeping operations.


The objectives of the proposed study are:
1. To identify key changes in technology and organization in the hospitality industry that affects the future of work for room cleaners.
2. To explore the impact of industry changes on the health, injury rates, and well being of room cleaners.
3. To develop potential strategies for enhancing the future health and well being of room cleaners.
4. To demonstrate the utility of a participatory research methodology that actively involves room cleaners in every aspect of the study, and that results in the ability of participants to effectively advocate for health-promoting changes in their work.
5. To explore the relevance of the findings to similar low wage populations, particularly in the service sector.
6. To widely disseminate study findings and recommendations to encourage further study and action by academic researchers, labor, management, policy makers, and advocacy groups.

The pilot consists of establishing an advisory group of participants, focus groups with room cleaners, the development and administration of a survey instrument, analysis and discussion of results with participants, and dissemination of results in a final report. Although designed for comparisons with other cities, the pilot will allow for comparisons between high quality and low quality (in terms of labor relations and customer service) hotels in San Francisco. In addition, the use of some standardized instruments will enable comparisons of working conditions of housecleaners with jobs in different industries. Finally, future studies are planned to investigate the effects of changes in work conditions and labor-management collaboration on injury incidence, health and functional/quality of life outcomes.


A 30-member advisory group of room cleaners participated in the planning and implementation of this pilot study.
Ten focus groups have been conducted with about 20-25 housecleaners at each meeting recruited from different San Francisco hotels.

A survey instrument has been developed and tested in a focus group of 25 roomcleaners. The revised survey has been translated into Spanish and Chinese languages. The survey includes standard instruments such as Karasek’s Job Content Questionnaire, Siegrist’s effort/reward balance scales including measures of intrinsic and extrinsic effort, SF36 health-related quality of life/functioning, general health status, and specifically developed questions to measure physical workload, musculoskeletal symptoms, work injury, and demographic variables. Depending on reading and language skills it takes 30 to 75 minutes for workers to complete the survey with assistance available from researchers and translators.

139 out of 397 roomcleaners from 4 selected hotels completed the survey during the first wave of data gathering in December 1998.

In summary, specific aims 1 through 15 have been completed (see attached list).


A second wave of data gathering among 258 non-responders is planned for February. Intensive efforts of personal recruitment at the workplace and telephone follow-up is planned for a random 50% sample of 130 non-responders.

Data management and basic analyses limited to descriptive statistics and comparisons between four hotels are planned for March and April. A draft report will be prepared for the union by May 15 and will be available for joint labor management focus groups preparing for upcoming bargaining of five-year contracts. Further analyses including comparisons with national survey data, discussions with participants, and a final report will be completed by December 1999. Publications in peer reviewed scientific journals may be prepared simultaneously or thereafter but no funds have been allocated yet for this purpose.


(0) Establish cooperative relationships between researchers and stakeholders
(1) Select 2-6 hotels (with a total of about 400 employees) representing “good” and “bad” overall work conditions as perceived by union representatives and key senior employees
(2) Conduct a series of focus groups with room cleaners from different hotels which are not selected into the pilot survey, to (a) gain a detailed understanding of their job tasks, workload, working conditions, and work-related health problems, (b) to discuss the scope and goals of the research project, and (c) to invite further participation in design and execution of the study (e.g. development and administration of survey instrument, organization of meetings with roomcleaners at participating hotels)
(3) Develop draft survey instrument
(4) Discuss draft survey instrument with union representatives and other key informants
(5) Pre-test survey instrument in focus group with 25 roomcleaners
(6) Revise survey instrument
(7) Translate survey instrument into Spanish and Chinese languages
(8) Obtain names and addresses of current employees at selected hotels
(9) Invite employees of selected hotels by mail to fill out the survey in off-site meetings
(10) Conduct first wave of survey under supervision of University researchers and with assistance of translators at different times and locations in San Francisco
(11) Create database for data entry using Microsoft Access software
(12) Enter data from questionnaires and check for completeness
(13) Follow-up of workers with incomplete responses by telephone in their first language
(14) Update list of employees and draw random 50% sample from survey non-responders
(15) Obtain contact information including telephone numbers for non-responders
(14) Invite all non-responders by mail to fill out the survey in off-site meetings
(15) Invite 50% random sample of non-responders by telephone and/or personal contact to fill out the survey in off-site meetings
(16) Conduct second wave of survey
(17) Provide follow-up meetings with research team for workers willing to participate but unable to attend the pre-scheduled survey meetings
(18) Enter data into database
(19) Check data for missing information and inconsistencies
(20) Prepare final data set with variable labels for all data fields and create scales for work conditions based on theoretical and/or empirical approaches
(21) Analyze survey data and (a) prepare frequency tables for all questionnaire answers and scales stratified by hotels, (b) compare responses of first wave responders with second wave of responders in 50% sample intensively followed up, (c) compare responses between “good” and “bad” hotels, (d) compare work conditions with reports from studies in other industries, (e) investigate the association between work conditions and self-reported general health, musculoskeletal symptoms, quality of life, and work injury
(22) Gather OSHA 200 logs in selected hotels for 1998 and enter in separate database
(23) Replace employee names by ID code in injury data set and merge with survey data
(24) Analyze merged injury (OSHA 200 log) and survey data, and, specifically (a) compare frequency of self-reported and formally reported work injuries, (b) examine self-reported reasons for not reporting a work-related injury, (c) investigate associations between working conditions and both self-reported and OSHA 200 log based injury frequency
(25) Prepare draft report by May 15, 1999
(26) Present report to stakeholders in joint labor management meetings
(27) Prepare final report by December 1999
(28) Prepare peer-reviewed journal article(s)
(29) Integrate results of pilot study into proposed larger study comparing working conditions and health outcomes across different US cities representing different organizational settings and labor markets in the hotel industry

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