It was determined that saturation was reached after three focus groups, totalling 15 participants. The qualitative data resulted in six themes. The quantitative data captured key demographic characteristics as well as knowledge, attitudes and behaviors information secured from the 43-question survey. The data reported here includes a subset of nine participants who provided this additional information, as those in the first focus group experienced challenges with survey participation and literacy barriers that were addressed in focus groups 2 and 3.

The qualitative and quantitative results of this convergent mixed methods study were analyzed separately, and then discussed together as suggested by Fetters, Curry and Creswell [36]. Quantitative survey data is presented first, followed by the qualitative data.

Quantitative survey dataSocial/demographic characteristics of participants

Participants’ country of origin included five countries: Ecuador (n = 4, 44.4%), Dominican Republic (n = 2, 22.2%), Mexico (n = 1, 11.1%), Peru (n = 1, 11.1%), and El Salvador (n = 1, 11.1%). Ages ranged from 41 to 61, with a median of 46.0 and a mean of 48.78 (standard deviation 6.72).

The number of years that participants lived in the U.S. varied from 8 to 31. The most frequent answer was 10–20 years (n = 4, 44.4%). The median was 17.0 years and the mean was 18.78 with a standard deviation of 7.85 years. All nine survey respondents were first generation immigrants to the U.S., meaning that they were born outside the U.S. Total household income (before taxes) were reported as n = 2 (22.2%) for each of the categories $10,000-19,000, $20,000–29,000 and $30,000–39,000 and n = 1 (11.1%) for each of the responses $50,000-59,000, $60,000–69,000 and $80,000 or more.

Lastly, the Social/Demographic section asked participants about their preferred language in a variety of communication scenarios, as summarized in Table 1. These six questions were included in order to determine the most appropriate language for designing a future intervention for this population. The response choices for each were: only Spanish, more Spanish than English, both equally, more English than Spanish, and only English.

When asked “How long have you been in the cleaning profession?” (n = 9), five participants (55.6%) responded ten years or more, suggesting a high level of experience gained on the job. One participant each (11.1%) responded less than one year, 1–3 years, 4–6 years and 7–9 years. When asked “What type of job training would be helpful to learn new skills?” (N = 5) three participants (60.0%) preferred “Text messages to phone with tips and links to website resources.” One (20.0%) chose “Someone training me at my workplace” and two (40.0%) answered “Someone training me at a community center.” For Focus Group 3, the question was revised to gather more detail: “How would you like to receive training about health and safety practices related to your cleaning job?” The response options were increased to seven, which were answered according to the following (N = 4): Training provided through email = 1 (25.0%), Training provided through text messaging to your phone = 3 (75.0%), Onsite in-person training at workplace = 2 (50.0%), Onsite in-person training at community center = 2 (50.0%). The responses Not sure, Not interested in learning new skills at this time and Other (please explain) all received zero (0.0%). Cleaning locations and hours per week are summarized in Table 2.

Table 2 Cleaning location and hours per week

All participants conducted a variety of cleaning operations within their occupational role, as shown in Table 3, with most participants spending 1–2 h per task category. Participants were also asked to specify the products used, which provides information regarding potential environmental exposures.

Table 3 Occupational cleaning activity, number of hours per week and products used

Most participants had worked outside the cleaning industry. Six respondents indicated: Dunkin Donuts®; industrial machine handling classes, sewing and fashion design; Dunkin Donuts® (cashier), manufacturing [factory worker], printing office; taking care of kids; electronics [factory] - welding; plastic factory. Most participants (n = 9) were currently employed by a company either full time (n = 3) or part-time (n = 3) or were self-employed full time (n = 2) or part-time (n = 1), while one was employed seasonally.

When asked “How are you paid?” and for what location, seven participants (87.5%) responded by the hour (one indicating location was a school), one (12.5%) indicated being paid by the week, and zero chose by the day. One participant, not counted in the statistics, created her own response by writing in “by the house.” For the two respondents who also had second jobs, one reported being paid by the hour for cleaning apartments and another participant indicated being paid by the week. Additional characteristics of occupational cleaning activities are summarized in Table 4.

Table 4 Characteristics of occupational cleaning activities

The participants use a variety of PPE. Most often, gloves were worn (88.9% of participants), followed by masks (66.7%), knee pads (33.3%), uniform (33.3%), special shoes or shoe covers (22.2%), and goggles or protective glasses (11.1%).

When asked “How long do you see yourself staying in this occupation?” four participants (44.4%) responded 1–3 years, and five (55.6%) indicated ten years or more. None indicated less than 1 year, 4–6 years or 7–9 years.

The survey responses regarding cleaning at home are summarized in Table 5.

Table 5 Characteristics of home cleaning activities

The focus group participants were asked to “Please write a list of five products you use at home (all-purpose cleaner, toilet cleaner, tub and tile cleaner, window cleaner, etc.).” The responses are organized by room, in Table 6.

Table 6 Products used at homeQualitative dataTheme 1: knowledge of cleaning procedures via training experiences

A total of 15 participants participated in the focus groups and were included in qualitative analysis. Participants reported that their knowledge was gained through training experiences, starting at young ages by tradition, typically at home (“since I was a girl,” “at three years old”, “around seven years old” and “at thirteen”). Participants also reported knowledge was typically learned through observation (“she never taught me, I would watch them,” and “we Latinos learn to do things...without being taught”). There were also several comments about the lack of job training found in their professional careers. Two women in Focus Group 3 spoke about not being given any job training. One woman did say that “20 years ago when I started...some type of health person would come...they taught us how to take off the gloves...” This participant “liked that because...someone was concerned about us, who was interested in us.” Another participant commented that all she received were instructions on paper for her training: “the bosses only gave a paper when we started...and it says ‘training’ such and such product, and the instructions.” One participant pointed out the language barrier inherent with English instructions, that the paper that the boss read was in English, and were told, “that’s what it says, and sign here.” Another participant remarked that she has worked at her job for “19 years but they never gave me training.” Conversely, one participant was a trainer at her job where she had the opportunity to “teach them how to take care of themselves, how to protect themselves.” The dangers of working with chemicals was also discussed, “sometimes we don’t know how to use the products, and we mix them too.”

The predominant codes were: Started cleaning young, Tradition, Learned by observation. The category was: Experience drives knowledge, and the thematic analysis was: Knowledge gained through training experiences starts young by tradition and is typically learned through observation.

Theme 2: attitudes regarding the presence of chemicals in cleaning products

For attitudes, participants reported that product performance matters when making sure a space looks clean (“use some strong liquids, and it’s for the people,” and “smells good”). Preferred products include those that are more natural (“practically try to avoid everything … that’s why I use without air, without water … and bleach”) while another participant expressed doubts about natural products (“all organic things have chemicals too”). Preferred products come from reading about what works and word-of-mouth recommendations. Several participants reported not reading labels (“we don’t look [at labels]”) due to lack of time, already knowing what product to use, and most product labels being in English and difficult to read (“and they’re all miniscule … you’ve got to use a magnifying glass.”).

The predominant codes were: Looks & smells good, Word of mouth, Rarely read labels. The category was: Product performance matters and the thematic analysis was: Chemicals aren’t typically a consideration; Need to use what’s necessary to perform the job well.

Theme 3: cleaning routines (behaviors)

For behaviors, participants reported cleaning their own homes daily (“every day”) with an emphasis on regular cleaning routines. The importance of certain spaces was also expressed (“kitchen and bathroom are the main thing”) and two participants expressed that the kitchen is of prime importance, for when visitors are over. Occupational cleaning was heavy duty and may occur in a variety of locations (“apartments, houses, offices, and apartments after construction”). It includes tasks such as daily sweeping, mopping and cleaning windows as well as elevator doors, kitchens, student rooms (dorms), small cafeterias and offices at a university. The work is physically intense (“men’s work, the women do it,” “force ourselves to do the work,” “using heavy machines, the shampoo machine,” and “she does heavy duty work.”)

The predominant codes were: Clean daily, Flexibility, Heavy duty. The category was: Home and work routines and the thematic analysis was: Occupational cleaning involves physically intense work that extends from the job to home.

Theme 4: cleaning products used

For Cleaning Products Used, participants reported price as a key factor (buying products “at Costco®,” “at the supermarket … Costco® when there’s coupons,” “buy what’s more or less at a price that we can afford.”) Other Latinas reported being given products by their employer including several homeowners, a school and a university. Product names discussed included Fabuloso®, Windex®, Clorox®, dish soap, Easy Off® and Mr. Muscle®. For laundry, one participant reported “Tide® or Gain® laundry soap … fabric softener” while another mentioned “Suavitel®.” Sustainable options such as vinegar and water as well as bleach alternatives were also mentioned.

The predominant codes were: Price, what works, what’s provided.

The category was: Decisions on products used and the thematic analysis was: Use of cleaning products is driven by price and efficacy when given a choice.

Themes 5 & 6: home country & cultural identity

The topics of home country and cultural identity were discussed in response to an ice breaker question and carried through in some instances to the formal focus group discussions. Participants reported pride in being Latino (“Latino, something to be proud of!” and “my roots, my culture” as well as “we have that human warmth, full of love,” “we’re different”). The struggles of immigration and life both in participants’ country of origin and in the U.S. was also discussed (“we came to struggle … to this country,” “very hard working,” “I picked peanuts, peeled peanuts, tied tobacco”). Several participants discussed childhood conditions such as working in agriculture (“tend to the animals”) and growing up in a large family (“I have seven brothers,” “we’re a poor family,”) including one participant who was the first of 11 siblings and as a child went to school from 8 am to noon and then worked, including cooking for agricultural workers. Perceptions of Latinos in the workforce that were voiced in FG#3 included discussion of “people who don’t value work of Hispanic people” and in the U.S. “[it’s] all Hispanics working as cleaners.”

The predominant codes were: Proud, Large family, Loyal to roots back home, Worked hard. The category was: Home country & cultural identity and the thematic analysis was: Life in home country was hard and grounded by family ties.