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The NIOSH Surveillance Strategic Plan

Implementation Activities

Objective 1.1 Implementation

Short Term:

1. Promote wide dissemination of the NIOSH Worker Health 2000 Chartbook of occupational surveillance information.
2. Meet annually with Federal surveillance partners (BLS, NCHS, OSHA, and MSHA) to coordinate surveillance activities, including planned analyses, dissemination, and special data collection efforts.
3. Collaborate with the CPSC, NCIPC, and other Federal agencies to expand the National Electronic Injury Surveillance System (NEISS) to capture all traumatic injuries.
4. Increase collaboration with the Environmental Protection Agency (EPA) regarding surveillance of pesticides and other hazards by renewing the Interagency Agreement and sharing aggregated pesticide-related illness and injury data.
5. Increase collaboration with MSHA regarding coal workers' pneumoconiosis surveillance by working with MSHA to increase participation of miners in federally administered health screening programs for miners and by exchanging data to evaluate the effect of any resulting increased participation.

Long Term:

1. Collaborate with NCHS and the PHS Office of Public Health and Science (OPHS) to ensure coordinated tracking of progress towards achievement of all Healthy People 2010 occupational safety and health objectives.
2. Integrate work-relatedness, occupation and industry, International Classification of Diseases (ICD) 10 activity codes, and relevant narrative information into electronic databases.

Objective 1.2 Implementation

Short Term:

1. Improve public access to and utilization of NIOSH and other surveillance information by establishing a "Surveillance sub-site" on the NIOSH Web site (links to relevant sites, publications, current statistical data, etc.).
2. Assess the needs of external and internal surveillance information users as a basis for identifying unmet needs, evaluating the usefulness of NIOSH surveillance products, and developing surveillance information dissemination tools and strategies.
3. Initiate a centralized "clearing house" (a networked surveillance information reporting and retrieval system) for NIOSH, State, and other surveillance reports, alerts, and intelligence.
4. Develop partnerships with other agencies, trade groups, and industry and labor leaders to facilitate the dissemination and use of occupational safety and health surveillance data.

Long Term:

1. Improve access to NIOSH surveillance information by establishing new products, including Internet and Intranet-based surveillance information systems that encourage users to access and analyze NIOSH surveillance data.

Objective 1.3 Implementation

Short Term:

1. Define the specific aims and data components for a proposed ongoing national survey of occupational hazards and occupational safety and health activities.
2. Initiate hazard surveys targeted by industry, occupation, or hazard.

Long Term:

1. Conduct a comprehensive, nationally representative hazard survey.
2. Develop a national occupational exposure surveillance data base.

Objective 1.4 Implementation

Short Term:

1. Support the continued development of software to code occupation and industry narratives and encourage the use of the software in other systems [e.g., death certificate records, CDC National Program of Cancer Registries, Behavioral Risk Factor Surveillance System (BRFSS), NEISS].

Long Term:

1. Participate in standard-setting committees, such as the ANSI Z-16.2 committee that recommends standardized surveillance for occupational injuries and illnesses.
2. Work with health care organizations to encourage the regular use of ICD-10 activity codes for identifying the work-relatedness of injuries and illnesses.
3. Work with vital statistics offices, medical examiner and coroner organizations, and health care organizations to widely disseminate guidelines for determining and recording information on work- related injuries and illnesses.

Objective 1.5 Implementation

Short Term:

1. Evaluate the inclusion of cost variables in existing NIOSH-supported surveillance systems.
2. Evaluate the utility of data from Federal and State workers' compensation systems, BLS, SSA, NCHS, the Census Bureau, the Equal Employment Opportunity Commission (EEOC), and National Council of Compensation Insurers (NCCI) or State rehabilitation programs to advance surveillance of occupationally related disability and impairment.

Long Term:

1. Report on costs of particular illnesses and injuries to workers, employers, and the public at large in NIOSH publications with the data available on the NIOSH website.

Objective 2.1 Implementation

Short Term:

1. Refine, disseminate, periodically review, and update the occupational surveillance profiles developed by the NIOSH-States Surveillance Planning Work Group for selected priority conditions/hazards.
2. Disseminate periodic pneumoconiosis mortality surveillance reports that include State-specific findings and allow for among-State comparisons.

Long Term:

1. Conduct, with States, periodic assessments of their training and technical assistance needs.
2. Conduct analyses of national data systems to produce surveillance reports that are useful for States by providing State-specific surveillance findings.

Objective 2.2 Implementation

Short Term:

1. Develop and support effective mechanisms for providing technical assistance to States for occupational health surveillance core capacity building, for on-going surveillance of selected priority conditions, and for rapid surveillance of emerging problems.

Long Term:

1. Provide States with technical assistance in support of State-based surveillance of all priority conditions on the list generated by the NIOSH-States Surveillance Planning Work Group.

Objective 2.3 Implementation

Short Term:

1. Continue to support State-based surveillance for targeted conditions.
2. Collaborate with States to evaluate the goals of ABLES and SENSOR and to assess the number and characteristics of States needed to accomplish these goals.

Long Term:

1. Periodically evaluate the progress and impact of State-based surveillance of specific occupational conditions and hazards.

Objective 2.4 Implementation

Short Term:

1. In collaboration with States, use the NIOSH-States Surveillance Planning Work Group Report to identify a set of core surveillance activities for implementation in selected States.

Long Term:

1. Evaluate the prevention impact of core surveillance in States and promote adoption of successful models of core surveillance by additional States.

Objective 3.1 Implementation

Short Term:

1. Analyze existing sources of data (such as NTOF, CFOI, FFHHS, NSSPM, TISF, NEISS, and the BLS Annual Survey) and disseminate findings to add to existing knowledge about the magnitude, circumstances, and trends in agricultural illness, injury, and hazards.
2. Pilot new data collection methods to provide data on childhood agricultural hazards and injuries, including collaborative efforts with the Departments of Labor and Agriculture.
3. Continue to collaborate with the Department of Labor to collect occupational illness and injury data in the National Agricultural Workers Survey (NAWS), and evaluate the utility of this survey to fill gaps in agricultural injury and illness surveillance.
4. Collaborate with the EPA and relevant State agencies to capture all acute occupational pesticide- related illnesses and injuries for the purpose of determining the magnitude and trend of this condition, for identifying new and emerging pesticide problems, and for adopting relevant interventions.

Long Term:

1. Promote collection of pesticide use and exposure data and explore using these data as a denominator for identifying pesticides with a high illness-to-use ratio.
2. Propose a system for routine and ongoing childhood agricultural injury surveillance as a component of the NIOSH Childhood Agricultural Injury Prevention Initiative.
3. Evaluate the need and opportunities to develop programs to reduce existing gaps in illness and injury surveillance associated with agriculture, and address under-reporting and under- representation in standard surveillance systems.

Objective 3.2 Implementation

Short Term:

1. Analyze existing sources of data (such as NTOF, CFOI, NEISS, NSSPM, and the BLS Annual Survey) and disseminate findings to add to existing knowledge about the magnitude, circumstances and trends in illness, injury, and hazards in the construction industry.
2. Conduct regional hazard and exposure surveys to describe the magnitude of exposures in the residential home construction industry.
3. Prepare and disseminate a report summarizing targeted surveys of silica hazards associated with highway and other construction operations.

Long Term:

1. Evaluate the need and opportunities to develop programs to reduce existing gaps in illness and injury surveillance associated with construction, and address under-reporting and under- representation in standard surveillance systems.

Objective 3.3 Implementation

Short Term:

1. Develop economic analyses to assess and facilitate the design of short-term in-depth surveillance of specific hazards in mining.
2. Periodically assess and report on CWXSP participation rates and Coal Workers' Pneumoconiosis (CWP) prevalence by mine and other factors using existing data from mine rosters and from MSHA.
3. Increase the use of MSHA illness and injury data narratives for describing patterns and trends.

Long Term:

1. Evaluate the coding and classification of illness and injury data from the MSHA 7001 log and collaborate with MSHA to improve the current data collection form.
2. Expand the CWXSP into a more comprehensive Coal Workers' Health Surveillance Program (CWHSP), to include non-pneumoconiotic airways disease, hearing loss, and other conditions, in addition to CWP.

Objective 3.4 Implementation

Short Term:

1. Assign a NIOSH occupational health and safety expert to work with National Center for Infectious Disease (NCID) to expand the surveillance capacity of the National Surveillance System for Healthcare Workers (NASH) system, to increase the scope of hazard, illness, and injury recording, and to facilitate the use of results gathered by other Federal agencies (BLS, OSHA).
2. Continue to support the evaluation of tools used for screening and surveillance of latex allergies among health care workers.
3. Develop partnerships with trade groups and industry and labor leaders to promote activities and facilitate dissemination and use of surveillance data.

Long Term:

1. Disseminate a surveillance report on occupational hazards, illnesses, and injuries in the health care industry.
2. Develop programs to reduce existing gaps in surveillance information and address under-reporting and under-representation.

Objective 3.5 Implementation

Short Term:

1. Complete NIOSH's report on the magnitude of occupational diseases and injuries.
2. Analyze existing sources of data (such as NTOF, CFOI, TISF, NSSPM, NEISS, and the BLS Annual Survey) and disseminate findings to add to existing knowledge about the magnitude, circumstances, and trends in injuries among special populations at risk.

Long Term:

1. Augment existing surveillance systems to identify and follow-up the occupational problems associated with these traditionally under-served populations.

Objective 4.1 Implementation

Short Term:

1. Identify, facilitate, and encourage model surveillance programs and best practices within industries and occupations. Disseminate information concerning these programs and best practices identified.
2. Identify and report on current employer-based approaches used for medical screening and surveillance of occupational asthma among employees exposed to diisocyanates.

Long Term:

1. In collaboration with industry, trade, labor, clinical, academic, and professional organizations, evaluate and make recommendations for surveillance systems that can be used by companies, unions, and industries.

Objective 4.2 Implementation

Short Term:

1. Develop/evaluate screening and surveillance tools for employer-based occupational respiratory surveillance in high-risk occupational settings (e.g., occupational asthma among employees exposed to diisocyanates; chronic beryllium disease among beryllium workers; coal workers' pneumoconiosis and other dust-related conditions among coal miners; etc.).

Long Term:

1. Support the development of surveillance tools for small business and labor organizations.

Objective 4.3 Implementation

Short Term:

1. Support the evaluation of tools used for screening and surveillance of latex allergies, blood-borne pathogens, and musculoskeletal disorders among health care workers.

Objective 5.1 Implementation

Short Term:

1. Expand extramural research that:
   1. strengthens surveillance of high-risk industries and occupations, such as mining, and of populations at higher risk;
   2. promotes a better understanding of the magnitude and scope of childhood agricultural injuries and illnesses;
   3. develops methods for effective occupational safety and health surveillance conducted by employers, unions, and other non-governmental organizations; and
   4. increases research methods development to improve occupational surveillance.
2. Expand extramural research in surveillance methods in order to reduce the under-recognition and under-reporting of workplace illness and injury. Findings from these projects are intended to advance scientific base of knowledge needed to monitor occupational safety and health hazards, injuries and illnesses.
3. Initiate research to assess participation bias (including barriers to participation) in the CWXSP.

Long Term:

1. Promote research that will facilitate the inclusion of NORA-identified special populations within appropriate surveillance systems.

Objective 5.2 Implementation

Short Term:

1. Evaluate the potential surveillance use of data from the NIOSH Hazard Evaluations and Technical Assistance (HETA) program and make appropriate recommendations to effectively capture, analyze, and report on HETA investigation data.
2. Develop, validate, and promote standardized data collection instruments for assessing hazards.

Long Term:

1. Conduct intervention research to evaluate various ways to increase participation of miners in the CWXSP.

Objective 5.3 Implementation

Short Term:

1. Continue to support the Fatality and Assessment Control Evaluation (FACE) project to supplement surveillance data on selected types of fatalities with in-depth information that can be used to focus prevention recommendations.
2. Continue to conduct follow-back surveys of high risk groups or injury causes through the NEISS.
3. Through the HETA mechanism, conduct individual follow-back investigations of selected sentinel cases of various work-related diseases and provide workplace-specific recommendations for prevention.

Long Term:

1. Coordinate with BLS follow-back studies to be undertaken using cases identified in surveillance systems maintained by each agency (e.g., NIOSH National Electronic Surveillance System and BLS Annual Survey).

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