Abstract

There is a long and continuing legacy of epidemiologists from high income countries conducting occupational health research in low and middle income countries. Opportunities to investigate occupational hazards in relatively high exposure settings and to develop multi-country research partnerships that can lead to disease prevention globally are the main motivations for this type of research. However, it should be appreciated that changes in the cultural, economic, and political environment of the country where the research is conducted can have profound influences on the likelihood of research success. Our research groups have long histories of conducting epidemiologic investigations among textile workers in Shanghai, China. The research includes studies of multiple different cancers and parkinsonism (HC) and respiratory disorders (DCC) in relation to exposures to textile industry dusts and chemicals. Several gene/environment investigations have also been conducted. We present the historical background leading to the research, and the logistical challenges that have emerged over time as political, social, and economic conditions in Shanghai have changed. These challenges include reduced access to workplaces, reduced worker participation rates, and governmentally imposed restrictions on transporting bio-specimens outside of China. Based on our experiences, we can offer some recommendations that occupational epidemiologists in high and low/middle income countries might consider to facilitate collaborative research: being cognizant of national and regional political, social, and economic policy changes; maintaining flexibility in research protocols and budgetary allocations during the course of study conduct; and, keeping lines of communication open throughout the research design and implementation.