Workplace Health in the Andes A Mixed Methods Study of Chilean Copper Miners

High-altitude exposure is a recognised occupational risk for Chilean mine workers, a unique cohort who commute between low-altitude residences and high-altitude mine sites to work demanding, 12-hour rotating shifts. This unique work pattern, commonly termed the ‘Chilean miner model’, creates a distinct cycle of chronic intermittent hypobaric hypoxia (CIHH), a multisystem stressor leading to accelerated cardiovascular pathology, impaired aerobic capacity, and profound neurocognitive deficits. This physiological strain is significantly compounded by noncommunicable metabolic and cardiovascular diseases, resulting in accelerated physiological decline and a disproportionate burden of poor health outcomes.Obesity is the most prevalent chronic disease in the Chilean population, and its combination with hypoxic exposure creates a powerful synergistic effect that exponentially increases the risk of acute cardiac events. Recognising this risk, the Chilean government amended the occupational health and safety regulations to protect CIHH-exposed workers, explicitly mandating the implementation of health promotion programs targeting chronic diseases prevalent among the Chilean population. Despite this regulatory effort, prevailing organisational health promotion programs remain ineffective, anchored in a reductionist, pathogenic paradigm that inappropriately focuses on individual-level behavioural interventions. This approach overlooks the systemic constraints governing worker health, which has resulted in a failure to adequately protect the workforce, emphasising the imperative that traditional occupational hygiene methods must be extended to systematically protect worker health.This thesis rigorously addressed this empirical and theoretical failure by moving beyond microlevel pathogenic models, toward a comprehensive, macro-level analytical framework. The research employed a mixed-methods approach grounded in a conceptual systems model to systematically characterise Chilean copper miners (Mineros de Cobre) and establish the causal pathways through which the health of Chilean copper mine workers is harmed. The primary aim was to identify and prioritise the environmental, social, and individual health determinants that exert the greatest influence on worker nutrition, physical activity, and overall health status, thereby establishing an evidence base for effective, systems-integrated health promotion.The findings establish that worker health status is a direct and quantifiable function of long-term exposure to modifiable organisational and environmental determinants. The research identified profound structural constraints, including long commute times, demanding labour, and job design, which collectively enforce a "present bias" where the imperative for immediate safety and job stability compels workers to neglect long-term health outcomes. Crucially, the analysis established a statistically significant correlation between employment duration and the deterioration of health behaviours, in particular inadequate sleep, nutrition, and physical activity.These results confirm that the failure of health initiatives lies not with individual non-compliance, but with systemic organisational factors, such as fragmented program integration, roster pattern design, and union-negotiated high-calorie food provision, that actively operate as inherent health hazards undermining personal responsibility.