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NIOSH Programs > Health Hazard Evaluations > Outcomes
Health Hazard EvaluationsOutcomesOutcomes are events, occurrences, or conditions that indicate progress in achieving the purpose of the program. Outcomes reflect the results of a program activity compared with its intended purpose; or, outcomes may answer the question "Will these resources result in success or contribute to the success of what we want to accomplish?" Outcomes can be viewed from two different perspectives — ultimate and intermediate. For an occupational safety and health research program like the NIOSH HHE Program, ultimate outcomes are reductions in a particular type of worker injury or illness. Injuries and illnesses have complex causes, and any effect of program activities on rates can take years to be seen. Therefore, outcomes are often measured on an intermediate timeframe. Intermediate outcomes are necessary steps that lead to ultimate outcomes — for example, reductions in the risk of a particular type of injury or illness. For occupational safety and health research programs, achieving intermediate risk reductions is as important as achieving the ultimate outcome of decreasing injury and illness incidence rates. Examples of recent Health Hazard EvaluationsEvaluation of chlorinated compounds and respiratory irritation in the poultry industryThe HHE Program received a request from the Occupational Safety and Health Bureau of a State’s Division of Labor to investigate reported health effects at a turkey processing plant. Employees in the evisceration department of the plant were experiencing symptoms such as eye and respiratory irritation. During two site visits, HHE investigators observed work tasks and processes; evaluated air flow patterns; administered questionnaires regarding medical, job and personal history, and work-related symptoms; did lung function testing of workers; and sampled the air in the plant. The results suggested a link between chlorinated compounds and upper respiratory irritation. HHE investigators recommended improving the plant’s ventilation system. Recommended changes were made and, when HHE investigators returned to the plant, the prevalence of symptoms decreased by 13% to 44%, depending on the specific symptom. The reports of this investigation can be found at:
Disabling lung disease related to flavoringsBronchiolitis obliterans related to artificial butter flavorings inhalation came to the attention of the HHE Program through an August 2000 request from a state health department, which had received medical reports of severe obstructive airways disease among eight former workers of a small microwave popcorn manufacturing facility. Cases of bronchiolitis obliterans have now been recognized in microwave popcorn manufacturing, flavoring manufacturing, other food production, and diacetyl manufacturing facilities. HHE investigators established that workers at the initial microwave popcorn facility had an excess of respiratory disease. They combined results from health and industrial hygiene surveys to determine the cause. Exposure to diacetyl, a major component of artificial butter flavorings, was used as a marker of exposure to the complex artificial butter flavoring mixture. Based on HHE investigators’ recommendations, many changes were made in the plant. Follow-up evaluations showed that disease abnormalities stabilized in those affected and that new workers were at lower risk. Exposures to artificial butter flavoring chemicals declined two to three orders of magnitude. The HHE Program and other researchers at NIOSH have continued to evaluate flavoring exposures and health effects, as well as the effectiveness of measures to control exposures. The reports of this investigation can be found at:
In addition, these investigations have resulted in the NIOSH Alert titled Preventing Lung Disease in Workers Who Use or Make Flavorings and the NIOSH Flavorings-Related Lung Disease Topic page. Page last updated: August 5, 2008
Page last reviewed: August 5, 2008 Content Source: National Institute for Occupational Safety and Health (NIOSH) |
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NIOSH Program:Health Hazard Evaluations |
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