| Course | NR 518 Population Health and Epidemiology in Nursing Practice |
|---|---|
| Week | 6 |
| Paper type | Risk factor analysis |
| Length | About 1,120 words, 2 pages |
| Format | APA 7 student paper |
| School | Chamberlain University |
| Program | MSN |
| Updated | September 2026 |
Free sample paper for NR 518 Week 6
Risk Factor Analysis: Nine Factors for Silicosis in Engineered Stone Workers Sorted by Whether They Can Be Changed, Who Would Have to Change Them and How Many Workers Carry Them
Student Name
College of Nursing, Chamberlain University
NR 518: Population Health and Epidemiology in Nursing Practice
Instructor Name
Month Day, Year
Risk Factor Analysis: Nine Factors for Silicosis in Engineered Stone Workers Sorted by Whether They Can Be Changed, Who Would Have to Change Them and How Many Workers Carry Them
Why Sort Instead of List
A list of risk factors for silicosis among engineered stone countertop workers would include age, a job, a material, a cutting method, a missing mask, a shop, an immigration status and a lack of insurance. Placed in one table, they look equal. They are not. Some cause disease and can be removed; some make disease worse by delaying its discovery; some only mark who is at risk. A program has limited money and must act where action changes something. This analysis sorts nine factors by three questions: can it be changed, who would have to change it, and how many workers carry it. The figures on how common each factor is come from two California studies: a clinical case series of 52 workers with silicosis (Fazio et al., 2023) and interviews with 20 fabrication workers in Los Angeles (Fazio et al., 2025).
The Sorted Table
Table 1 sorts the factors into three groups.
Table 1
Risk Factors Sorted for Action
| Factor | Changeable? | Who would have to change it | How common (source) |
|---|---|---|---|
| Cutting engineered stone rather than lower-silica material | Yes, by substitution | Manufacturers, buyers, regulators | Defines the exposed group |
| Dry cutting, no water at the blade | Yes | Shop owners, with enforcement | 68% of interviewed workers regularly dry cut (Fazio et al., 2025) |
| No local exhaust ventilation | Yes | Shop owners, with funding or enforcement | Not measured in either study |
| Respirators not provided, not fitted or not worn | Yes | Shop owners; workers | Half of interviewed workers said employers did not reliably provide them (Fazio et al., 2025) |
| Years in the industry | Only going forward | Workers; job-transition programs | Median 15 years among cases (Fazio et al., 2023) |
| Fear of job loss for raising safety concerns | Yes, slowly | Regulators, workers' centers, employers | A main theme in worker interviews (Fazio et al., 2025) |
| Uninsured or limited-scope coverage | Yes, by policy | State and county health programs | 19% uninsured and 39% restricted-scope Medi-Cal among cases (Fazio et al., 2023) |
| Continuing to cut stone after diagnosis | Yes, with income support | Workers; programs for disability and retraining | 48% of cases (Fazio et al., 2023) |
| Male sex, age 30s to 50s, Latino immigrant | No | Not applicable; these mark the group | 51 of 52 cases were Latino immigrant men (Fazio et al., 2023) |
Group 1: Causes That Can Be Removed
The first four factors act on exposure itself. The material itself is mostly quartz, often above nine parts in ten crystalline silica (Rose et al., 2019), and cutting it dry, without exhaust ventilation or respiratory protection, puts that dust into workers' lungs. These are the factors a prevention program can remove, and they share a feature: the person who must change is usually the shop owner, not the worker. Workers cannot fit their own saws with water feeds or install exhaust hoods. These shops already fall under the federal silica limit, an eight-hour average of 50 micrograms in each cubic meter of air (Occupational Safety and Health Administration, 2016). What is missing is not a rule but compliance in small shops and someone to verify it.
These factors are also the most common. Dry cutting was reported by more than two thirds of interviewed workers, and half described unreliable respirator provision. A program that changed nothing but these would reach most of the exposed group.
Group 2: Factors That Make Disease Worse by Delaying Its Discovery
Lack of insurance, fear of losing work and continuing to cut after diagnosis do not cause silicosis. They make it more severe by keeping workers exposed and undiagnosed longer. In the case series, 58% of workers had a delayed diagnosis, often after being treated for pneumonia or tuberculosis, and 38% were first diagnosed at an advanced stage (Fazio et al., 2023). Nearly half kept working with stone afterward, which is understandable when the alternative is no income. These factors are changeable, but not by shop owners. Health coverage is a matter for state and county programs; income support and retraining for diagnosed workers require disability systems and workforce programs; fear of retaliation shrinks only when enforcement protects workers who speak up and when workers' centers can raise concerns on their behalf.
Group 3: Markers of Who Is at Risk
Age, sex and national origin describe who does this work; they do not cause silicosis. They matter to a program for a different reason: they tell the program whom to reach and how. Outreach must be in Spanish, through trusted community organizations, and designed for men who may avoid government contact. Years in the industry sits between groups: it cannot be undone, but it tells screening programs whom to prioritize, since risk rises with cumulative exposure.
Factors Considered and Left Out
Two factors were considered and left out of the table on purpose. Smoking harms the lungs and worsens breathlessness in workers who already have silicosis, and a program should offer help to quit, but smoking does not cause silicosis and removing it would not prevent a single case; placing it in the table would invite a program to spend its effort on a factor that feels familiar rather than one that matters. Tuberculosis was also left out as a risk factor because it runs the other way: silicosis raises the risk of tuberculosis, so tuberculosis testing belongs in the program's care of workers, not in its list of causes. Leaving factors out, and saying why, keeps the table focused on the decisions the program must make. A reader who disagrees can add them back knowing what was weighed.
What the Sorting Shows
Sorted this way, the analysis points to a two-part program. The first part removes exposure and must be aimed at shop owners, with enforcement and help paying for equipment. The second part shortens the time between disease and diagnosis and supports diagnosed workers to leave exposure, and must be aimed at health and social programs. Neither part is aimed mainly at changing workers' own behavior, which is where many prevention plans start. The analysis also shows a gap in the evidence: neither California study measured ventilation directly, so the county does not know how many shops lack it. Air sampling in a sample of shops would fill that gap before a program sets its targets.
References
Fazio, J. C., Gandhi, S. A., Flattery, J., Heinzerling, A., Kamangar, N., Afif, N., Cummings, K. J., & Harrison, R. J. (2023). Silicosis among immigrant engineered stone (quartz) countertop fabrication workers in California. JAMA Internal Medicine, 183(9), 991-998. https://doi.org/10.1001/jamainternmed.2023.3295
Fazio, J. C., Garcia, S. R., Torres, I. R., Gandhi, S. A., Cummings, K. J., Buhr, R. G., Riley, K., Ponce, N., Bustamante, A. V., & Glenn, B. (2025). Silica hazards in engineered stone countertop production: Worker experiences and challenges in Los Angeles. American Journal of Industrial Medicine, 68(10), 867-880. https://doi.org/10.1002/ajim.70010
Occupational Safety and Health Administration. (2016, March 25). Occupational exposure to respirable crystalline silica. Federal Register, 81, 16286-16890. https://www.federalregister.gov/documents/2016/03/25/2016-04800/occupational-exposure-to-respirable-crystalline-silica
Rose, C., Heinzerling, A., Patel, K., Sack, C., Wolff, J., Zell-Baran, L., Weissman, D., Hall, E., Sooriash, R., McCarthy, R. B., Bojes, H., Korotzer, B., Flattery, J., Weinberg, J. L., Potocko, J., Jones, K. D., Reeb-Whitaker, C. K., Reul, N. K., LaSee, C. R., . . . Harrison, R. (2019). Severe silicosis in engineered stone fabrication workers: California, Colorado, Texas, and Washington, 2017-2019. MMWR. Morbidity and Mortality Weekly Report, 68(38), 813-818. https://doi.org/10.15585/mmwr.mm6838a1
NR 518 Week 6 instructions, in plain terms
For the Week 6 analysis, students identify risk factors for a health problem in a population and analyze them. Prompts often ask which factors are modifiable, how strong the evidence is, and which should be targeted by intervention. Some name a framework to apply, for instance the epidemiologic triangle or social determinants of health. A list of factors earns little on its own; the analysis lies in sorting them. Ask who would have to change each factor and how many people carry it, so the result points toward a program. Use published data for frequencies where possible, citing each figure. Page length and required frameworks vary by section.
How the NR 518 Week 6 example is put together
The example explains why sorting beats listing, then presents a table of nine factors with four columns, citing each frequency. The first group, causes that can be removed, shows that the person who must change is usually the shop owner, and notes that a federal exposure limit already applies. The second group explains how lack of insurance and fear of retaliation worsen disease through delayed diagnosis and continued exposure. The third group treats age, sex and origin as markers that guide outreach. A section explains why smoking and tuberculosis were left out. The conclusion outlines a two-part program and names a gap: no data on ventilation.
Reading the NR 518 Week 6 grading rubric
Rubrics for this analysis usually reward accurate identification of risk factors, correct classification as modifiable or not, strength of supporting evidence, and implications for intervention. Graders look for sorting that leads somewhere, such as identifying who must act. Citing frequencies from credible sources strengthens the evidence criterion. Distinguishing causes from markers and from factors that affect severity often earns credit under critical thinking. Use of a named framework, when required, should be applied rather than described. Tables should be clear and consistent with the text, and citations should follow APA 7 throughout, including within table cells where figures are drawn from studies. A column naming who would have to act is the single addition most likely to move an analysis from adequate to strong.
Common NR 518 Week 6 mistakes, and how to avoid them
The weakest analyses list many factors with no sorting, or treat demographic markers as if they were causes. Another common problem is aiming every intervention at individual behavior when the modifiable factors sit with employers or systems. Students also cite frequencies without sources or mix figures from different populations without saying so. Explain factors you considered and excluded. Watch for reverse relationships, such as a disease that raises the risk of another condition. Finally, end with what the sorting implies for a program. A risk factor analysis that does not point toward action has done half the work the assignment asks for. Keep the table and prose in agreement.
Get a NR 518 Week 6 example written to your instructions
Send the prompt and the population your section named, and a custom NR 518 Week 6 analysis is written to them and returned inside 24 to 48 hours, the first one free. If a grid with fixed columns came with the assignment, send the grid and the analysis is built inside its rows rather than beside them.
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NR 518 Week 6 questions, answered
How many factors should the analysis carry?
Four or five taken properly beats nine named. Each one needs a paragraph to establish that it can be changed, that somebody could change it and that enough people carry it to matter, and a list of nine leaves a sentence apiece. Where the prompt sets a number, meet it and put the depth into the two you rank highest.
Is a behavior a risk factor or an outcome of something else?
Often both, and saying so is usually worth marks. Smoking is a factor for the disease and an outcome of price, advertising and where the shops are, so a program can aim at the behavior or at whatever produces it. Naming which of those two you are aiming at keeps the analysis from drifting into blame, which is where these papers most often lose their footing.
My factor is the same one for three different outcomes. Does that help?
It helps a great deal and it belongs in the ranking rather than in a footnote. A factor feeding several outcomes at once buys more per person reached than one feeding a single condition, and a program aimed at it can be defended on grounds no single disease supplies. Say which outcomes travel with it and how sure you are about each.
Where can I find a free NR 518 Week 6 sample paper?
The nine-factor silicosis analysis printed above is the whole NR 518 Week 6 sample, free to read. For an analysis of a different condition, send your focus through the request form and a sorted version is written.
Is a behavior a risk factor or an outcome in NR 518 Week 6?
It can be both. Continuing to work after diagnosis, in the sample, is a behavior that worsens disease but is itself driven by income and job security, so the analysis treats it as changeable only through income support.