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NIOSH Programs > Respiratory Diseases > National Academies Evaluation
Respiratory DiseasesReview & Evaluation: National Academies EvaluationNOTE: Text in this summary was drawn from the National Academies Final Report: Respiratory Diseases Research at NIOSH: Reviews of Research Programs of the National Institute for Occupational Safety and Health. (a link to the full report appears below). The NIOSH RDRP 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 program should adequately fund and engage in high priority occupational respiratory disease surveillance, continue to improve its work in support of its strategic goals, and develop sampling and analytic methods that include exposure assessment scientists as an integral part of the program’s activities. Respiratory diseases caused by exposures to dangerous materials in the workplace have a major adverse effect on worker health, with the NIOSH estimating that deaths from work-related respiratory diseases and cancers account for about 70% of all occupational disease deaths. Respiratory diseases caused by exposures in the workplace include a broad spectrum of adverse health effects, including airway diseases such as asthma, interstitial lung diseases such as silicosis, respiratory infectious diseases such as tuberculosis, and respiratory cancers. These health effects can arise in a wide range of occupational settings and range from mild, reversible conditions to progressive fatal disorders, and can be linked to short-term or long-term exposures. These effects have tremendous implications for worker health and, by extension, the national economy. The mission of the NIOSH RDRP is to provide leadership for the prevention of work-related respiratory diseases, using a scientific approach to gather and synthesize information, create knowledge, provide recommendations, and deliver products and services to those who can effect prevention.The program has five strategic goals: (1) prevent and reduce work-related airway diseases; (2) prevent and reduce work-related interstitial lung diseases; (3) prevent and reduce work-related infectious respiratory diseases; (4) prevent and reduce work-related respiratory malignancies; and (5) prevent respiratory and other diseases potentially resulting from occupational exposures to nanomaterials. This report evaluates the NIOSH RDRP with respect to the relevance of its work to improve occupational safety and health, and the impact of the program’s research in reducing work-related hazardous exposures, illnesses, and injuries. It is one of several independent reviews of NIOSH research programs by the National Academies. All of the reviews were based on the same framework, which was created by a parent committee established by the National Academies. That framework document established a scoring system from 1 to 5 for impact and relevance, with 5 being the highest: Rating of Relevance
Rating of Impact
Assessment of Research Relevance and ImpactThe report assigned the RDRP a score of 5 for relevance because the program’s activities are in the highest-priority subject areas and are highly relevant to improvements in workplace protection. The RDRP is successful in transferring research findings, technologies, and information into workplace practices. This is particularly true for activities related to interstitial lung diseases, airways and infectious diseases, and respiratory cancers. Activities related to some subprograms do not reach this highest level of relevance, but these activities are in important research areas and also make some connections to improvements in workplace protection. Another extremely relevant program focuses on exposure to nanomaterials in the workplace. This program addresses an important need to understand and control engineered nanoparticles and other types of ultrafine particles such as those from welding, diesel engines, and fires. The report assigned the RDRP a score of 4 for impact because while the program has made major contributions to worker health and safety in many of its programs, some have had a smaller impact or the impact is not clearly observed. For example, the documented decrease in the prevalence of latex sensitization, early decreases (pre-2000) in coal workers’ pneumoconiosis, and decreases in silicosis-related deaths in the mining industry are the result of NIOSH intervention and recommendations, and have had a high impact on protecting worker health. In other cases—for example, spread of infectious diseases such as SARS—it is nearly impossible to disentangle the specific contributions NIOSH has made from those of other contributors in limiting the onset or spread of respiratory diseases and resulting decrease in risk or death to exposed workers. However, the program has played a major role in developing respiratory protection systems, guidance documents, and educational materials which have helped to contain what could have been a larger disaster. After much deliberation on how to weigh the assessments of different subprograms, the committee reached a consensus that the program was clearly better than that called for in a score of 4, but not in sum what the committee would rate a 5. If the committee had been given the option of providing non-integer scores, the score for program impact would have been between 4 and 5. Emerging Issues and Future Research OpportunitiesThe report assesses progress by the RDRP in targeting new research relevant to future improvements in workplace protection from occupational respiratory disease and sought to identify significant emerging research areas important to the mission of NIOSH. One general issue that emerged from this analysis is inadequate surveillance for diseases and exposures to toxicants. Surveillance activities are critical to fulfilling the objectives of all the major program goals and assessing the performance of current and future RDRP activities. The report emphasized this as a continuing and emerging issue even though it recognized that the lack of financial and personnel resources and not the lack of awareness or expertise are the major causes of this weakness. The report strongly supports collaborations with industry in disease surveillance and exposure monitoring activities in the workplace, particularly in the face of emerging evidence of a link between exposure and outcome. The report also supports a range of ongoing RDRP activities that proactively address the incidence of future diseases and emerging diseases. These activities include the development and improvement of methods to detect respiratory effects earlier and more accurately, continued research on the molecular mechanisms of workplace-related respiratory diseases, characterization of those agents responsible for respiratory effects, and evaluations of genetic variability that affects worker susceptibility. By reducing and eliminating worker exposure to toxicants and pathogenic organisms, NIOSH research on improving respirators is another essential means to address the threat of respiratory diseases among workers. Recommendations for Program ImprovementThe report makes the following recommendations to help ensure that the RDRP continues to maintain its progress toward protecting workers from respiratory disease. These recommendations are important, despite the high scores given for relevance and impact, which reflect the guidance for ranking established by the framework committee and the committee’s recognition of the financial constraints the RDRP has operated under. The recommendations are prospective and are meant to help support NIOSH in identifying opportunities to improve the relevance and impact of its research portfolio. Strategic Goal 1: Prevent and Reduce Work-Related Airway Diseases Strategic Goal 2: Prevent and Reduce Work-Related Interstitial Lung Diseases Strategic Goal 3: Prevent and Reduce Work-Related Infectious Respiratory Diseases Strategic Goal 4: Prevent and Reduce Work-Related Respiratory Malignancies Strategic Goal 5: Prevent Respiratory and Other Diseases Potentially Resulting from Occupational Exposures to Nanomaterials Cross-Cutting Issues Committee to Review the NIOSH Respiratory Disease Research Program
National Academies Final Report: Respiratory Diseases Research at NIOSH: Reviews of Research Programs of the National Institute for Occupational Safety and Health Evidence Package for the National Academies' Review 2006-2007 Page last updated:
October 2, 2008
Page last reviewed:October 2, 2008 Content Source: National Institute for Occupational Safety and Health (NIOSH) Division of Respiratory Disease Studies |
NIOSH Program:Respiratory Diseases |
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