The occurrences of both injury and death that take place on the job are a significant public health problem in the United States, causing a substantial human and economic burden. Traumatic Injury Research at NIOSH is the sixth report in the series Reviews of Research Programs of the National Institute for Occupational Safety and Health. The Committee to Evaluate the NIOSH Traumatic Injury Research Program found the program's research during 1996-2005 (the evaluation period for this review) relevant to reducing the burden of traumatic injury in the workplace and to have contributed to improvements in worker health and safety. To continue to reduce injuries and deaths to workers due to trauma, the committee recommended that the TI Research Program continue setting goals within the program's scope and resources; work with other federal agencies that support injury prevention and control research to outline areas of collaboration; embark on a program to increase the visibility of traumatic injury research; develop a strategic plan for evaluating its research-to-practice efforts and for building the capacity to carry out these efforts; and consider research on the safety impacts of changes in the nature of work as well as intervention research targeting organization policies and practices.
Each year, approximately 5,000 fatal work-related injuries and 4 million non-fatal injuries and illnesses occur in the United States. This number represents both unnecessary human suffering and high economic costs. In order to assist in better evaluating workplace safety and create safer work environments, the Institute of Medicine conducted a series of evaluations of the National Institute for Occupational Safety and Health (NIOSH) research programs, assessing the relevance and impact of NIOSH's work on improving worker safety and health.
The National Institute for Occupational Safety and Health (NIOSH) was established by the Occupational Safety and Health Act of 1970 (U.S. Congress, 1970). Today the agency is part of the Centers for Disease Control and Prevention of the U.S. Department of Health and Human Services. NIOSH is charged with the responsibility to "conduct . . . research, experiments, and demonstrations relating to occupational safety and health" and to develop "innovative methods, techniques, and approaches for dealing with [those] problems" (U.S. Congress, 1970). Its research targets include identifying criteria for use in setting worker exposure standards and exploring new problems that may arise in the workplace. Prevention of occupational hearing loss has been part of the NIOSH research portfolio from the time the agency was established. A principal cause of occupational hearing loss is the cumulative effect of years of exposure to hazardous noise. Exposure to certain chemicals with or without concomitant noise exposure may also contribute to occupational hearing loss. Hearing loss may impede communication in the workplace and contribute to safety hazards. Occupationally acquired hearing loss may also have an adverse effect on workers' lives beyond the workplace. No medical means are currently available to prevent or reverse it, although hearing aids are widely used and research on other treatments is ongoing. Occupational hearing loss is a serious concern, although the number of workers affected is uncertain. In September 2004, NIOSH requested that the National Academies conduct reviews of as many as 15 NIOSH programs with respect to the impact and relevance of their work in reducing workplace injury and illness and to identify future directions that their work might take. The Hearing Loss Research Program was selected by NIOSH as one of the first two programs to be reviewed. Hearing Loss Research at NIOSH examines the following issues for the Hearing Loss Research Program: (1) Progress in reducing workplace illness and injuries through occupational safety and health research, assessed on the basis of an analysis of relevant data about workplace illnesses and injuries and an evaluation of the effect that NIOSH research has had in reducing illness and injuries, (2) Progress in targeting new research to the areas of occupational safety and health most relevant to future improvements in workplace protection, and (3) Significant emerging research areas that appear especially important in terms of their relevance to the mission of NIOSH.
It is the unique mission of the Health Hazard Evaluation Program within the National Institute for Occupational Safety and Health (NIOSH) to respond to requests to investigate potential occupational health hazards. In contrast to other NIOSH programs, the Health Hazard Evaluation Program is not primarily a research program. Rather, it investigates and provides advice to workplaces in response to requests from employers, employees and their representatives, and federal agencies. The National Research Council was charged with evaluating the NIOSH Health Hazard Evaluation Program and determining whether program activities resulted in improvements in workplace practices and decreases in hazardous exposures that cause occupational illnesses. The program was found to play a key role in addressing existing widespread or emerging occupational health issues. This book makes several recommendations that could improve a very strong program including more systematic use of surveillance data to facilitate priority setting, and greater interaction with a broader array of workers, industries, and other government agencies.
The National Institute for Occupational Safety and Health (NIOSH) conducts construction-relevant research activities. From 1996 through 2005, the program focused on four research goals: reducing traumatic injuries and fatalities; reducing exposure to health hazards; reducing major risks associated with musculoskeletal disorders; increasing the understanding of construction industry attributes and factors for improving health and safety outcomes. In this book, the National Research Council evaluates the relevance and impact of the NIOSH Construction Research Program in terms of its research priorities and its connection to improvements in the protection of workers in the workplace. It also assesses the program' s identification and targeting of new research areas, to identify emerging research issues, and to provide advice on ways that the program might be strengthened. The book finds that the efforts of the Construction Research Program have made meaningful contributions to improving construction worker safety and health, and provides overreaching and specific recommendations for continuing progress. While NIOSH cannot set and enforce research-based standards on its own, the program can be expected to help reduce construction workplace fatalities, injuries, and illnesses through its research, its research dissemination, and transfer into practice.
Ever since the United States began producing and testing nuclear weapons during World War II, the effects of ionizing radiation on human health and the environment have been a serious public concern. The Worker and Public Health Activities Program was established more than 20 years ago to study the consequences of exposure to ionizing radiation and other hazardous materials from Department of Energy operations to workers and members of the surrounding communities. In 2005, the National Academies convened an expert committee to conduct a review of the Worker and Public Health Activities Program, which is operated by the Department of Health and Human Services (HHS) at Department of Energy (DOE) nuclear facilities under a Memorandum of Understanding (MOU) with DOE. Review of the Worker and Public Health Activities Program Administered by the Department of Energy and the Department of Health and Human Services concludes that the program has used sound research methods and generally has enhanced public understanding of the risks involved. However, the report recommends that more two-way communication between the agencies and workers and members of the public is needed. The report also explores the ways in which the agencies involved could develop a more coordinated, effective, and thorough evaluation of the public health concerns involved in cleanup and remediation activities at Department of Energy sites.
Coal remains one of the principal sources of energy for the United States, and the nation has been a world leader in coal production for more than 100 years. According to U.S. Energy Information Administration projections to 2050, coal is expected to be an important energy resource for the United States. Additionally, metallurgical coal used in steel production remains an important national commodity. However, coal production, like all other conventional mining activities, creates dust in the workplace. Respirable coal mine dust (RCMD) comprises the size fraction of airborne particles in underground mines that can be inhaled by miners and deposited in the distal airways and gas-exchange region of the lung. Occupational exposure to RCMD has long been associated with lung diseases common to the coal mining industry, including coal workers' pneumoconiosis, also known as "black lung disease." Monitoring and Sampling Approaches to Assess Underground Coal Mine Dust Exposures compares the monitoring technologies and sampling protocols currently used or required by the United States, and in similarly industrialized countries for the control of RCMD exposure in underground coal mines. This report assesses the effects of rock dust mixtures and their application on RCMD measurements, and the efficacy of current monitoring technologies and sampling approaches. It also offers science-based conclusions regarding optimal monitoring and sampling strategies to aid mine operators' decision making related to reducing RCMD exposure to miners in underground coal mines.
Respiratory diseases caused by exposures to dangerous materials in the workplace have tremendous implications for worker health and, by extension, the national economy. The National Institute for Occupational Safety and Health (NIOSH) estimates that deaths from work-related respiratory diseases and cancers account for about 70% of all occupational disease deaths. NIOSH conducts research in order to detect and reduce work-related hazardous exposures, injuries, and diseases; its Respiratory Disease Research Program (RDRP) focuses on respiratory diseases. This National Research Council book reviews the RDRP to evaluate the 1) relevance of its work to improvements in occupational safety and health and 2) the impact of research in reducing workplace respiratory illnesses. The assessment reveals that the program has made essential contributions to preventing occupational respiratory disease. The National Research Council has rated the Program a 5 out of 5 for relevance, and a 4 out of 5 for impact. To further increase its effectiveness, the Respiratory Disease Research Program should continue and expand its current efforts, provide resources for occupational disease surveillance, and include exposure assessment scientists in its activities.
Beginning with the development of the atomic bomb during World War II, the United States continued to build nuclear weapons throughout the Cold War. Thousands of people mined and milled uranium, conducted research on nuclear warfare, or worked in nuclear munitions factories around the country from the 1940s through the 1980s. Such work continues today, albeit to a smaller extent. The Department of Energy (DOE) is now responsible for overseeing those sites and facilities, many of which were, and continue to be, run by government contractors. The materials used at those sites were varied and ranged from the benign to the toxic and highly radioactive. Workers at DOE facilities often did not know the identity of the materials with which they worked and often were unaware of health risks related to their use. In many instances, the work was considered top secret, and employees were cautioned not to reveal any work-related information to family or others. Workers could be exposed to both radioactive and nonradioactive toxic substances for weeks or even years. Consequently, some of the workers have developed health problems and continue to have concerns about potential health effects of their exposures to occupational hazards during their employment in the nuclear weapons industry. In response to the concerns expressed by workers and their representatives, DOL asked the Institute of Medicine (IOM) to review the SEM database and its use of a particular database, Haz-Map, as the source of its toxic substance-occupational disease links. Accordingly, this IOM consensus report reflects careful consideration of its charge by the committee, and describes the strengths and shortcomings of both. To complete its task, IOM formed an ad hoc committee of experts in occupational medicine, toxicology, epidemiology, industrial hygiene, public health, and biostatistics to conduct an 18-month study to review the scientific rigor of the SEM database. The committee held two public meetings at which it heard from DOL Division of Energy Employee Occupational Illness Compensation (DEEOIC) representatives, the DOL contractor that developed the SEM database, the developer of the Haz-Map database, DOE worker advocacy groups, and several individual workers. The committee also submitted written questions to DOL to seek clarification of specific issues and received written responses from DEEOIC. The committee's report considers both the strengths and weaknesses of the SEM and the Haz-Map databases, recognizing that the latter was developed first and for a different purpose. The committee then discusses its findings and recommends improvements that could be made in both databases with a focus on enhancing the usability of SEM for both DOL claims examiners and for former DOE workers and their representatives. Review of the Department of Labor's Site Exposure Matrix Database summarizes the committee's findings.
A new book from the National Research Council recommends changes in how the federal government evaluates the efficiency of research at EPA and other agencies. Assessing efficiency should be considered only one part of gauging a program's quality, relevance, and effectiveness. The efficiency of research processes and that of investments should be evaluated using different approaches. Investment efficiency should examine whether an agency's R&D portfolio, including the budget, is relevant, of high quality, matches the agency's strategic plan. These evaluations require panels of experts. In contrast, process efficiency should focus on "inputs" (the people, funds, and facilities dedicated to research) and "outputs" (the services, grants, publications, monitoring, and new techniques produced by research), as well as their timelines and should be evaluated using quantitative measures. The committee recommends that the efficiency of EPA's research programs be evaluated according to the same standards used at other agencies. To ensure this, OMB should train and oversee its budget examiners so that the PART questionnaire is implemented consistently and equitably across agencies.
The workplace is where 156 million working adults in the United States spend many waking hours, and it has a profound influence on health and well-being. Although some occupations and work-related activities are more hazardous than others and face higher rates of injuries, illness, disease, and fatalities, workers in all occupations face some form of work-related safety and health concerns. Understanding those risks to prevent injury, illness, or even fatal incidents is an important function of society. Occupational safety and health (OSH) surveillance provides the data and analyses needed to understand the relationships between work and injuries and illnesses in order to improve worker safety and health and prevent work-related injuries and illnesses. Information about the circumstances in which workers are injured or made ill on the job and how these patterns change over time is essential to develop effective prevention programs and target future research. The nation needs a robust OSH surveillance system to provide this critical information for informing policy development, guiding educational and regulatory activities, developing safer technologies, and enabling research and prevention strategies that serves and protects all workers. A Smarter National Surveillance System for Occupational Safety and Health in the 21st Century provides a comprehensive assessment of the state of OSH surveillance. This report is intended to be useful to federal and state agencies that have an interest in occupational safety and health, but may also be of interest broadly to employers, labor unions and other worker advocacy organizations, the workers' compensation insurance industry, as well as state epidemiologists, academic researchers, and the broader public health community. The recommendations address the strengths and weaknesses of the envisioned system relative to the status quo and both short- and long-term actions and strategies needed to bring about a progressive evolution of the current system.
Maintaining the health and safety of workers in the United States and globally is accomplished in part by reducing hazardous exposures through the use of personal protective equipment. Personal protective technologies (PPT) include respirators worn by construction workers and miners; protective clothing, respirators, and gloves worn by firefighters and mine rescue workers; and respirators and protective clothing worn by healthcare workers. An estimated 5 million workers are required to wear respirators in 1.3 million U.S. workplaces. For some occupations, such as firefighting, the worker's protective equipment is the only form of protection against life-threatening hazards; for other workers, the PPT is a supplement to ventilation and other environmental, engineering, or administrative hazard controls. In the United States, federal responsibility for civilian worker PPT is integral to the mission of the National Institute for Occupational Safety and Health (NIOSH). This book examines the NIOSH Personal Protective Technology Program (PPT Program) and specifically focuses on the relevance and impact of this program in reducing hazardous exposures and improving worker health and safety.
The National Institute for Occupational Safety and Health (NIOSH) conducts construction-relevant research activities. From 1996 through 2005, the program focused on four research goals: reducing traumatic injuries and fatalities; reducing exposure to health hazards; reducing major risks associated with musculoskeletal disorders; increasing the understanding of construction industry attributes and factors for improving health and safety outcomes. In this book, the National Research Council evaluates the relevance and impact of the NIOSH Construction Research Program in terms of its research priorities and its connection to improvements in the protection of workers in the workplace. It also assesses the program' s identification and targeting of new research areas, to identify emerging research issues, and to provide advice on ways that the program might be strengthened. The book finds that the efforts of the Construction Research Program have made meaningful contributions to improving construction worker safety and health, and provides overreaching and specific recommendations for continuing progress. While NIOSH cannot set and enforce research-based standards on its own, the program can be expected to help reduce construction workplace fatalities, injuries, and illnesses through its research, its research dissemination, and transfer into practice.
Each year, approximately 5,000 fatal work-related injuries and 4 million non-fatal injuries and illnesses occur in the United States. This number represents both unnecessary human suffering and high economic costs. In order to assist in better evaluating workplace safety and create safer work environments, the Institute of Medicine conducted a series of evaluations of the National Institute for Occupational Safety and Health (NIOSH) research programs, assessing the relevance and impact of NIOSH's work on improving worker safety and health.
Respirators are used in a variety of workplaces including emergency response, mining operations, construction, manufacturing, and hospitals. In 2001, National Institute of Occupational Safety and Health (NIOSH) and Bureau of Labor Statistics commissioned a nationwide survey of respirator use in the workplace, the results of which were published in the 2003 report Respirator Usage in Private Sector Firms. The purpose of the survey was to evaluate respirator use and practices, including training practices and the value of respirator manufacturer's instruction, in order to help guide NIOSH respirator certification and research. This National Research Council (NRC) report evaluates the survey in terms of several measures such as the adequacy and appropriateness of the survey instrument, the survey methodology, data analysis, and the conclusions drawn from the data. The NRC report finds that the survey was an important first step in collecting respiratory protection data from a probability sample but that several improvements could be made in survey design and analysis. Based on the review of the survey, the NRC report concludes that data on respirator use would be best provided by employers and employees in the context of the work setting.
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