Introduction Artisanal shellfish divers in southern Chile are vulnerable workers lacking social security, working in dangerous conditions in the sea. For several years serious and fatal accidents affected them. Measures implemented by local authorities and fishermen have improved this situation. However, long-term effects are the current concern; in 2012–2014, a study about working and health conditions of divers was carried out. Main results showed high prevalence of sensorineural hearing loss and attention deficits associated with long-term exposure. Intervention activities are needed for prevention.

Objective To develop an intervention program to prevent long-term effects on health of shellfish divers in southern Chile through an ecohealth approach.

Methods Based on the pillars of ecohealth approach for solving health problems (community participation, gender equality and transdisciplinary), workshops for social dialogue are being implemented since 2015 to obtain a participative diagnosis and to identify the resources for management with community leaders, workers, governmental and nongovernmental organisations.

Results Twenty-five people participated in the first workshop (response: 29%; women: 20%). The main strengths identified were the active participation of fishermen’s unions, the intersectoral support network and research applied for solving problems. Weaknesses were low participation of women and experienced divers and environmental factors. The main challenges are to improve access to social security, improve environmental and working conditions and following rise awareness about long-term effects based on research.

Conclusions Interventions in occupational health, using the ecohealth approach allows the participation of the community in diagnosing and solving their health problems.

Acknowledgments We thank EKOSANTÉ, a Latin American, Caribbean and Canadian collaboration in ecohealth, for the grant for this intervention project and the Centre for International Health CIHLMU funded by the German Academic Exchange Service (DAAD) via its exceed program financed by the German Federal Ministry for Cooperation and Development (BMZ) for funding the initial research project.