Occupational Health Disparities
Activities: NIOSH Research Projects
The research dollars invested in projects related to special populations topics are shown in Figure 1. Based on this graph, other than a large upsurge following the initiation of NORA and a spike in funding following the 1999 NORA solicitation, there has been a steady increase in extramural funding of about 3 to 4 million dollars per year and in intramural funding of 2 to 3 million dollars per year over the pre-NORA funding levels. This increase does not include the 2 to 3 million dollars of funding for extramural projects funded by NIH focusing on occupational exposures under the partnered Environmental Justice and Health Disparities programs.
Intramural Projects
A Participatory Intervention Program for Homecare Workers
This is a 5-year community-based participatory research project that will develop and evaluate a model intervention program for one large population of predominately female low-income, minority and immigrant home care workers (HCWS) in Alameda County, California. The focus of the intervention will be the development of an interactive checklist and accompanying educational materials aimed at improving awareness and knowledge about safety and health risk factors and improving the ability of HCWs, their consumers, social workers, and others to identify simple, available interventions. The target population is multilingual (English, Spanish, and Chinese) and of low literacy level. The project will use a combination of qualitative and quantitative methods to gather information about HCW safety and health needs and available materials and resources to address those needs. NIOSH investigators will construct a prototype of a checklist using information from focus groups, key informant interviews, and observational site visits. Community outreach workers using peer education techniques will field test the efficacy of the intervention materials with other HCWs and consumers. The completed checklist will be evaluated using a randomized experimental design to examine the HCWs’ and their consumers’ improvement in safety and health awareness and ability to identify and change hazards in the work environment utilizing the checklist materials.
Contact: Sherry Baron
Division of Surveillance, Hazard Evaluation, and Field Studies
(513) 458-7159
Occupational and Health Disparities
Numerous large-scale prospective population-based epidemiologic studies have been established to examine a broad array of social, behavioral, physiologic, and genetic determinants of health disparities for several potentially work-related diseases such as cardiovascular disease, mental illness, arthritis, and chronic back conditions. Although these studies are well suited to the examination of population-based health disparities due to the racial, ethnic, gender, and socio-economic diversity of the study populations, occupational information obtained from participants is generally confined to job title. This lack of occupational information limits our ability to examine empirically the role of occupational factors on racial and ethnic disparities in health and impedes our ability to identify modifiable workplace factors that could be targeted for health prevention activities.
To better understand current practices in the measurement and analytic treatment of occupational variables in population-based health research, NIOSH is conducting a systematic review of federally funded population-based cardiovascular epidemiology studies. To identify studies for this review, a search was conducted of the biomedical database CRISP (Computer Retrieval of Information on Scientific Projects). The search criteria were study dates (current or recently completed as of 1/1/2000), health end-points (cardiovascular disease), and study design (population-based epidemiology study). For each study identified for review, we retrieved data dictionaries or comparable information sources from the selected studies to identify current practices used to measure occupation. Study publication lists were obtained and journal articles were selected for review if work-related issues were examined. A manuscript was prepared (in review) for publication that presents a review of the state of the science concerning the measurement and analytic treatment of occupation-related variables in population-based cardiovascular disease studies.
During FY06, we finalized the study manuscript and initiated manuscript peer review. An abstract of this work was presented at the Society of Epidemiologic Research (SER) Conference in June, 2006. Due to the interest of external partners (NIH/OBSSR, NHLBI, CDC SES Measures Work Group) in our review and the review findings, we envision involving these partners in the manuscript review process (post-peer review) and engaging them in ongoing discussions via conference calls about “best practices” for the measure of occupation in population-based studies, as well as barriers and opportunities to their implementation. We hope that involving these partners will encourage the development of new funding initiatives in future years that may focus on convening experts from public health and occupational health to guide the measures of occupation used in population-based studies and/or focus on providing supplemental funding for one or more ongoing population studies to include a module of occupational measures in one or more rounds of future data collection.
Contact: Leslie MacDonald
Division of Surveillance, Hazard Evaluation, and Field Studies
(513) 841-4529
Mortality, Cancer Incidence, and Biomarker Studies
These studies are being conducted to elucidate exposure-outcome relationships, especially dose-response relationships for risk assessment, and to examine relationships between biomarkers (of exposure, susceptibility, and oncogene expression) and cancer outcomes. More than half of all dry-cleaning workers are women, and more than half of these women belong to minority and/or immigrant groups. In “mom-and-pop” family-staffed shops, children may be on site all day. NIOSH has documented the causes of death in a cohort of dry cleaners, including an increased risk of death from cervical cancer and dry cleaning chemical, fire, and ergonomic risks. NIOSH has also shown how those risks might be reduced by upgrading equipment and explored the attitudes of dry-cleaning workers and owners toward the risks. (Other studies are also being done through this project that do not involve priority populations.)
Contact: Avima Ruder
Division of Surveillance, Hazard Evaluation, and Field Studies
(513) 841-4440
Overcoming Barriers to Occupational Safety and Health in Priority Populations
This project is the coordination project for a NORA research program on Overcoming Barriers to Occupational Safety and Health in Priority Populations, including low-income, minority, immigrant and/or older workers. This project will provide the coordination and integration of quantitative and qualitative data collected across four research projects. It will examine the role of multilevel factors in creating barriers to effective safety and health programs including 1) individual-level factors such as language, literacy, previous knowledge and experience regarding occupational safety and health; 2) workplace-level factors including provision of tools and training, management commitment to safety and health, and supervisor and coworker social support; and 3) societal-level factors such as discrimination, policies regarding undocumented immigrants, and the overall economic prospects that allow workers to find alternative employment. The project will also analyze a variety of existing surveillance data sources to better describe the work and health of priority working populations. Finally, the project will improve coordination and dissemination of project outcomes as well as consultation with outside experts, promotion of improved training on research methodology for priority populations among internal NIOSH staff, and dissemination of findings through national workshops and NIOSH and peer-reviewed publications.
Contact: Sherry Baron
Division of Surveillance, Hazard Evaluation, and Field Studies
(513) 458-7159
Health Survey of Minority Farm Operators
This project is interdivisional and involves collaboration with another federal partner. The farm operator survey was conducted through an interagency agreement between NIOSH and the USDA National Agricultural Statistics Service (NASS), and in collaboration with DSR. As this is a surveillance project, no specific hypotheses were proposed; however, the goal of describing the occupational health problems of farm operators was planned. Data were collected in 2000 and FY2006. Planned data collection includes telephone interviews with approximately 25,000 farm operators that will include several questions on hazardous exposures, barriers to using hearing protection, and pesticide-related illness. The 2000 Minority Farm Operator Occupational Health Survey was conducted by USDA/NASS on behalf of NIOSH. A stratified simple random sample of farm operators from 50 U.S. states was selected for telephone interviews via USDA’s Computer Assisted Telephone Instrument (CATI) system. Stratification was based on gender, race, and ethnicity. Hispanic/Latino, minority, and female farm operators were oversampled to increase the corresponding sample size. Because of a low response rate, an additional sample of Latino farm operators from California, Arizona, New Mexico, and Texas were selected for face-to-face interviews to further increase the sample size. Weight was calculated for each stratum from observed sample size and USDA/NASS 1997 Census of Agriculture.
Activities during FY06 have concentrated on data analysis and preparation of the primary paper. Data analyses conducted thus far include calculations of estimated national prevalence of general health conditions, hearing loss, and mental health symptoms by gender, race, and ethnicity. Investigators have been working with Dr. Carles Muntaner from the University of Toronto on analyses and discussion of health disparities. Papers for publication include a general summary of survey results with an emphasis on health disparities and several papers focused on key health issues such as mental health and hearing loss. The primary paper presenting estimated national prevalence of health conditions by racial and ethnic group was completed and submitted for review to the branch, a statistical colleague in DSR, and to our collaborators at the USDA/NASS. The paper is being revised based upon recommendations received and will be submitted for clearance and external review shortly.
In collaboration with NASS, a summary will be written and information may be placed in the NIOSH Chartbook and on the USDA/NASS website. Two faculty members from the University of Texas Center for Health Promotion and Prevention Research are working on applying the process of Intervention Mapping (a theory- and evidence-based method for planning, implementing, and disseminating health promotion interventions) based on results of this study. The consultants selected barriers to the use of hearing protection as a primary example due to the high percentage of self-reported hearing loss by farm operators in this survey (34%). The consultants have the opportunity to analyze questions on barriers to the use of hearing protection included in focus groups held by the National Center for Farmworker Health. Findings will be disseminated to USDA/NASS constituents and through scientific publications. Translations will be done to disseminate information to Spanish-speaking groups who represent the populations surveyed. Data analysis and writing of papers will continue in FY06-FY08. New data collected in FY06 may not be available from NASS for analysis and dissemination until FY07-FY08.
Contact: Toni Alterman
Division of Surveillance, Hazard Evaluation, and Field Studies
(513) 841-4210
National Agricultural Workers Survey (NAWS) Health Surveillance
This project provides ongoing occupational health surveillance of hired farmworkers. As this is a surveillance activity, there are no specific hypotheses. Rather, this is a continuation of efforts to collect descriptive information on the working conditions and health of hired farmworkers, with a shift in focus to psychosocial factors and mental health. The National Agricultural Workers Survey (NAWS) is a national survey of farmworkers in crop agriculture conducted by the Department of Labor (DOL). The NAWS collects data on demographics, legal status, education, family size, wages and working conditions, and participation in the U.S. labor force. In 1999, NIOSH funded an occupational health supplement to the NAWS. Data collection has been reduced in subsequent years. This project is conducted through an interagency agreement with the Employment and Training Administration (ETA) at the Department of Labor. Mental disorders account for approximately 25% of all disabilities in the United States and are a leading cause of premature death. They represent not only an immense psychological, social, and economic burden to society, but also increase the risk of physical illnesses. Based upon previous research and recommendations from a meeting of national and international experts held in 2004, an occupational health supplement was piloted in FY2006. A revised supplement may be added to the National Agricultural Workers Survey (NAWS) for FY07-FY08. This study will be the first to provide prevalence estimates of mental health problems in a nationally representative sample of hired farmworkers, along with descriptive information on work organization and psychosocial factors experienced. Results can be used for monitoring farmworker health and targeting farmworkers most at risk for poor health because of their work. Prevalence data can also be used to measure the impact of interventions or changes in policy. The supplement includes questions on job insecurity, working conditions, structure of work and job stress (demand/control), work-family concerns, mental health, general health, and work limitations. In FY06, items were selected, translated, and tested with hired farmworkers. Revisions were made and piloting of the new questions began in March 2006. Pilot data was provided by DOL in August 2006. External partners with expertise in occupational and social epidemiology, health disparities, Latino culture, and farmworker health and migration include Dr. Joseph Grzywacz, Wake Forest University School of Medicine; Dr. Carles Muntaner, Chair, Department of Psychiatry University of Toronto; and Jorge Nakamoto, cultural anthropologist, Aguirre International. Our partner at the DOL is Daniel Carroll, Senior Policy Advisor in the Education and Training Administration.
Surveillance data from this project will be included in the next NIOSH Worker Health Chartbook. In FY2006, a surveillance document containing national prevalence estimates of health symptoms, working conditions, exposures, field sanitation, use of personal protective equipment, and pesticide training was sent for formal external review. Analyses were conducted on hired farmworker women. A paper was published in FY2006 in the Journal of Agricultural Safety and Health (May 2006), Occupational Health Survey of Farm Workers by Camp Health Aides. The finalized supplement may be administered in FY07-FY08. Once a data set is received, additional papers for publication will be written. In FY07-FY09, DOL will work with NIOSH to prepare a public use data set that will be made available to researchers.
Contact: Toni Alterman
Division of Surveillance, Hazard Evaluation, and Field Studies
(513) 841-4210
Childhood Agricultural Injury Surveillance
In fiscal year 1997, Congress provided funding for NIOSH to implement the Childhood Agricultural Injury Prevention Initiative. The goal of the initiative is to reduce the risk of fatal and nonfatal injuries to children who live on, work on, or visit farms. Since inception of the NIOSH Childhood Agricultural Injury Prevention Initiative, NIOSH has applied a triad approach of surveillance, research, and information dissemination. This project is designed to encompass the nonsurveillance components of the initiative. Activities within this project include (1) assuming a leadership role in federal efforts to prevent childhood agricultural injuries; (2) assisting in the development of a grant/cooperative agreement program to stimulate research and the use of empirical data to reduce agricultural injuries to children; (3) eliciting feedback from stakeholders on progress of the Initiative and strategies or ideas for improving research and prevention efforts; (4) providing technical and programmatic assistance to the National Children's Center for Rural and Agricultural Health and Safety; and (5) serving as a liaison for NIOSH research activities in order to achieve wide dissemination of research results to childhood agricultural safety and health practitioners.
The research component is primarily conducted through an extramural grant program. To date, NIOSH has funded 31 extramural research projects under the initiative, encompassing a range of areas identified as priorities by external constituents and partners. These research areas include examining injury etiology, rigorous evaluations of commonly available childhood educational or training programs to determine effectiveness in influencing safety and health behaviors to prevent agricultural injuries and illnesses among children and adolescents; developing new or enhancing existing control technologies to reduce injury to youth exposed to agricultural production hazards; promoting a better understanding of the magnitude and scope of childhood agricultural injuries and illnesses; evaluating the effectiveness of community-based interventions in reducing childhood agricultural injury and disease; evaluating incentives that encourage adults to protect youth from farm hazards; and identifying the economic and social consequences of youth working on farms.
In the first year of the Initiative, NIOSH funded the National Children’s Center for Rural Agricultural Health and Safety (NCCRAHS). The Center is designed to help translate research into commonly understood concepts or terms for parents and practitioners, and to provide the latest up-to-date information on childhood agricultural injury prevention to stakeholders. Examples include posting the latest NIOSH/USDA surveillance information on the Center’s website,, disseminating promising research findings, and translating research findings into plain and easy to understand language for practitioners and farm families. This has resulted in development of the North American Guidelines for Children’s Agricultural Tasks (a developmental-based guide for work tasks for youth), an action plan for addressing Migrant and Seasonal Adolescent Farmworkers, Creating Safe Play Areas on Farms (to address the majority of youth who are injured on farms while not working), and the promotion of promising research interventions for agricultural youth injury prevention. A public awareness campaign is being developed for youth in agriculture. This Childhood Agricultural Safety Public Awareness campaign is being led by the NCCRAHS with support of the Childhood Agriculture Safety Network (CASN). Three topics selected to be presented in an ongoing public awareness campaign were 1) youth and tractors, 2) ATVs and youth, and 3) safe play areas. The NCCRAHS also seeks to work with internal and external partners and stakeholders to address and implement the recommendations from the 2001 Childhood Agricultural Injury Prevention Summit and the 1996 National Action Plan. The ultimate goal of the project is to facilitate and enhance federal efforts to reduce childhood agricultural injuries.
Contact: John Myers
Division of Safety Research
(304) 285-6005
Childhood Agricultural Injury Prevention
NIOSH has developed a surveillance system that is centered on relationships with the National Agricultural Statistics Service (NASS) and the U.S. Department of Labor (USDOL). NIOSH has to date conducted six farm operator surveys with NASS to estimate injuries to children living, working on, or visiting farms: Childhood Agricultural Injury Surveys (CAIS), covering all farming operations, were conducted for 1998, 2001, and 2004; Minority Farm Operator Childhood Agricultural Injury Surveys (MCAIS), covering racial and ethnic minority farms, were conducted for 2000 and 2003; and a farm hazard survey covering all farming operations was conducted in FY2006. The 1998 CAIS results were released in FY2001. The preliminary results from the 2001 CAIS were released by NASS in FY2004. A NIOSH brochure highlighting results of the 2001 CAIS was released in FY2005. Complete results will be release in FY2007. For the 2004 CAIS, a brochure highlighting results was released in FY2006. The CAIS will be conducted in years ending in 0 and 5. For the 2000 M-CAIS, four brochures highlighting results were released in FY2004 and two volumes of a statistical abstract were released in FY2006. The final two volumes will be released in FY2007. Data collection for the 2003 M-CAIS occurred in FY2004, with results scheduled for release in FY2007. The M-CAIS will be conducted in the years ending in 4 and 9. A Web-based data retrieval system (Ag-RISQS) for the CAIS and M-CAIS should be available in FY2007. Data from the farm hazard survey, conducted in FY2006, are scheduled for release in FY2008. NIOSH continues collaborating with the USDOL on the National Agricultural Workers Survey (NAWS) youth farm worker injury module to assess farm injuries to workers under 20 years old. NAWS data collected from fiscal years 2001 through 2004 were analyzed in FY2006. NIOSH plans to continue exploring collaborative opportunities with USDOL for future NAWS efforts. NIOSH will also continue reporting childhood agricultural injury data available from other surveillance systems. An analysis of data from the Consumer Products Safety Commission's National Electronic Injury Surveillance System (NEISS) for the years 2000-2003 will be published in FY2007. An analysis of youth farm fatalities in the Bureau of Labor Statistics' Census of Fatal Occupational Injuries (CFOI) surveillance system was accepted for publication in FY2006. As of FY2006, this project has produced 40 publications, with 11 more expected in FY2007. The 40 completed publications include: eight NIOSH brochures directed at farm operators; three NASS fact sheets directed at the news media and general public; seven NIOSH surveillance documents containing results targeted at researchers and other health professionals; and 22 peer-reviewed journal articles or conference papers directed at researchers and health professionals. Surveillance data from this project are being used by extramural researchers to assess issues such as the impact of proposed changes to Child Labor Hazardous Orders, the possible impact of guidelines for assigning work to household youth on farms, and the assessment of farm tractor use by youth on farms. Furthermore, these surveillance data are being reported by nationally recognized youth injury prevention groups as the best measure of childhood agricultural injury burden in the United States. NIOSH will continue to provide increased access to these surveillance data to extramural partners in FY2007.
Contact: David Hard
Division of Safety Research
(304) 285-6068
A Faith - Based Stress Interventions for African Americans
The goals of this project are to: (1) Design a culturally tailored occupational
stress intervention for working African Americans in partnership with a local
faith-based organization (FBO) and to (2) Test the intervention with members
of the target audience to evaluate the extent to which it improves OSH knowledge,
impacts behavioral intentions, and increases efficacy in preventing and/or
managing work-related stress.
In Phase 1 of the project (FY06), NIOSH is designing a culturally innovative
occupational stress intervention for working African Americans in partnership
with a local faith-based organization (FBO) in consultation with the University
of Cincinnati experts. In Phase 2 (FY07), the FBO will deliver and test the
intervention with members of the target audience to evaluate the extent to
which the intervention improves OSH knowledge, impacts behavioral intentions
and increases efficacy in managing work-related stress. Participants are
expected to report pre- to post-intervention gains in OSH knowledge, in behavioral
intentions related to use of new knowledge and skills, and perceptions in
efficacy to address work-related stress.
This 2-year pilot project brings together NIOSH and University of Cincinnati
researchers and members of an FBO to develop and test a culturally tailored
occupational stress intervention. Formal expertise in stress management and
African American health together with the FBO’s local knowledge of
the cultural communication, beliefs, preferences, and understandings of its
community will ensure that such a product is successfully developed and tested.
Further, the project will generate an effective partnership model for working
collaboratively with FBOs, an identification of effective strategies for
reaching African American workers, and strengthened FBO capacity to provide
OSH or other health interventions to its community.
Contact: Rashaun Roberts
Division of Applied Research and Technology
513-533-8346
Assessing the TB Education
Needs for Hispanic Immigrant Workers
This proposal will build upon previous work by the investigators that
established the feasibility of the proposed recruitment strategies
and qualitative data collection methods with Hispanic immigrant workers.
This project will interview Hispanic immigrant workers and their employers
to accomplish the following specific goals: 1) To better understand
the factors that would motivate the employers of Hispanic immigrant
workers to provide TB-related training for their workers. 2) To better
understand how to meet the training needs specific to the many small
businesses that employ Hispanic immigrant workers. Both goals will
be met by interviewing employers of Hispanic immigrant workers (half
from small businesses) regarding their willingness to provide TB education
for their workers and about their training needs and preferences. 3)
To better understand Hispanic Immigrant Workers’ knowledge of
and attitude toward TB. Focus groups will be conducted with HIW from
a broad range of industries. Participants will discuss their levels
of knowledge, health beliefs, attitudes and cultural practices related
to TB. The participants will be recruited through the Coalition for
the Dignity and Rights of Immigrants, an advocacy group serving the
local Hispanic community. 4) To better understand the factors contributing
to TB test seeking and treatment adherence among Hispanic immigrant
workers. The increasing incidence of multi-drug resistant tuberculosis
(MDR-TB) presents a significant public health concern. MDR-TB results
when individuals who are infected with tuberculosist begin but do not
complete the course of treatment. Preliminary interviews with the Hamilton
County TB Control Program indicated that there were significant numbers
of HIW in the area who have tested positive on TB skin testing, but
who did not return for follow-up tests. Working with the Hamilton County
TB Control Program and other agencies/groups serving the local Hispanic
community, we hope to identify three cohorts of individuals (1) Hispanic
immigrant workers who had an initial positive skin test reaction (PPD+)
and did not seek further tests, 2) Hispanic immigrant workers who started
treatment for TB (active or latent) but did not complete treatment,
and 3) Hispanic immigrant workers who completed treatment TB (active
or latent)] to identify factors, which if addressed, could increase
treatment follow through. 5) To develop recommendations for the development
of TB educational materials for Hispanic immigrant workers and their
employers.
The findings from the informational interviews with employers conducted
for Specific Goals 1 & 2, the focus groups conducted for Specific
Goal 3, and the interviews with individuals who tested positive for
TB that were conducted for Specific Goal 4 will be reviewed by a panel
comprised of the researchers, other NIOSH subject matter experts, the
project consultants, and representatives from our community partners
to generate recommendations for the development of the following:
• TB educational materials targeted at the employers of Hispanic
immigrant workers, • Strategies to meet the training needs of
small businesses that employ Hispanic immigrant workers, • Spanish-language
TB education materials tailored to meet the needs of Hispanic immigrant
workers.
The actual development and evaluation of the TB education materials
for both employers and Hispanic immigrant workers is beyond the scope
of the current study. Project timeline: Year 1 – Clearance; Year
2 – Complete clearance and data collection for Specific Goals
1, 2, 3 & 4; Year 3 – Specific Goal 5, dissemination of results.
Contact: Donald Eggerth
Education and Information Division
513-533-8505
Biomechanical and Physiological Study
of Firefighter Boots
This project is a laboratory study which will be conducted over a
two-and-one-half-year period. Twenty-five female and 25 male career
or volunteer firefighters will be recruited and tested for physiological
and biomechanical responses while performing several simulated firefighting
tasks (e.g., climbing a ladder, carrying a charged hose line, and dragging
a 165-lb dummy) in the laboratory. Subjects’ physiological responses
will be determined by metabolic and respiratory variables including
energy expenditure, minute ventilation, and peak flow. Standard anthropometric
measurements will be recorded of the lower extremity and foot for both
genders. Subjects’ biomechanical responses in performing simulated
fire fighting tasks will be determined by examining their whole-body
center-of-mass movements as well as joint loadings (e.g., joint forces
and moments). The Human Factors Laboratory of the Protective Technology
Branch, Division of Safety Research is considered to be a state-of-the-art
motion analysis facility, and the DSR staff involved is uniquely qualified
to conduct this research.
This laboratory-based study will provide important outcomes which
are expected to impact emergency response and fire department workers,
emergency response and firefighter boot manufacturers, and the US national
standards setting body responsible for oversight of structural fire
fighting policy (NFPA). The long-term goal is to provide much needed
biomechanical and physiological data to the NFPA 1971 standards committee
so they may revise and update their standards for protective ensembles
for structural fire fighting.
Contact: Shiowyi Chiou
Division of Safety Research
304-285-6029
Community Partners for Healthy Farming Intervention Research
The Community Partners for Healthy Farming Intervention Research (CPHF-IR)
program provides substantial technical input from multiple NIOSH Divisions
to evaluate new or adapted interventions for reduction of farm-related
injuries, hazards, and illnesses. These projects are selected from
proposals submitted in response to a RFA’s. A total of 13 projects
were funded in the prior two series (1996-1999 and 1999-2003). As required
in the RFA, each extramural project has a strong evaluation component
and has formed partnerships between researchers, local communities,
workers, managers, agricultural organizations, agribusinesses, and
other stakeholders who provide unique resources and collaborate in
every aspect from inception through evaluation and dissemination. NIOSH
technical liaisons and advisors provide selected technical expertise
and consultation on project development, electronic formatting of educational
materials, human subjects compliance, implementation, dissemination
and evaluation with individual awardees. In FY2003 a new, third series
of 4-year projects (2004-2007) were selected. Funded activities involve
nine states (CA, IA, IL, IN, MN, MI, OH, OR, WI). The Certified Safe
Farm (CSF) project is utilizing health insurance claims data (not workers’ compensation)
of Iowa Farm Bureau members to evaluate the impact of the CSF program,
a unique access to data for all industries. Two ergonomic interventions
projects are expected to enhance production in nursery operations in
Midwest and significantly reduce identified ergonomic risk factors
among hand-harvesters of tree-fruit crops in California. The fourth
project is evaluating the effectiveness of specially-designed, computer-based
safety training in Hispanic vineyard workers with no prior English
or computer use expertise. The first three are outgrowths of prior
series of CPHF-IR projects and a fourth builds of educational tools
previously piloted among Hispanic nursery workers with limited education.
This c- TRAIN system replaces the keyboard with a 9-button input device
and is expected to enhance training while reducing costs for small
operations and be transferable to other industries. In collaboration
with partners, researchers have collected baseline data, assessed needs,
and piloted selected interventions. In FY2007, the final year of this
series, the projects will continue implementing selected interventions,
collect post-intervention data, analyze results and begin disseminating
findings and products. In 2005 a compendium of 40 formally evaluated
training curriculums, promotional programs, and publications as well
as outcomes of completed Community Partners projects was published
(Ehlers and Palermo). Simple Solutions: Ergonomic Solutions for Farm
Workers, NIOSH pub. No. 2001-111, an outgrowth of Community Partners
and other NIOSH agricultural initiatives continues in demand with over
80,000 copies disseminated in collaboration with current and prior
Community Partners projects. Cooperative agreement funding enhances
collaborative learning and resource utilization, between NIOSH and
awardees, and intradivisional collaboration of technical advisors.
NIOSH promotes collaboration between the CPHF projects, other NIOSH-funded
intramural and extramural projects, e.g. Agricultural Centers, and
with appropriate stakeholders. NIOSH organized meetings of Community
Partners extramural partners at the annual conference of the National
Institute for Farm Safety in British Columbia, Canada; maintains a
list-serve; updates and distributes tables describing the projects
with contact information; provides multimedia expertise via consultations,
and maintains a CPHF website with links to the extramural project websites.
At the NORA Symposium (2006), the evaluation method for their social
marketing project was presented by the extramural principal investigator
at a plenary session and a poster over viewing the Community Partners
program by the NIOSH liaison. In FY 2007, (1) small purchase order
contracts will be used to further the dissemination of Simple Solutions
to selected audiences, (2) staff will collaborate to evaluate and disseminate
NIOSH documents on noise-induced hearing loss among farmers 15-30 years
of age, and (3) summarize information from the NIOSH-funded surveillance
activities under the Occupational Health Nurses in Agricultural Communities
cooperative agreement program.
Contact: Janet Ehlers
Division of Surveillance, Hazard Evaluations, and Field Studies
513-841-4205
Core OSH Training for New/Young Workers
In FY 2003, NIOSH convened a multidisciplinary working group to select
and refine the best of the existing OSH curricula and methods for use
as a national foundation curriculum for youth. This curriculum currently
consists of six modules: 1) understanding new and young worker risk
of workplace injuries; 2) recognizing and finding hazards; 3) controlling
workplace hazards by making jobs safer and working safety; 4) your
roles in dealing with emergencies at work; 5) know your rights; and
6) taking action: getting the information you need and communicating
with your boss and co-workers. All modules contain guidance for teachers
as well as a variety of activities that are designed to be used in
a participatory, interactive manner within classrooms. The curriculum
was evaluated during 2005/6 in 16 schools across 10 states through
a partnership with the National Association of State Directors of Career
Technical Education (NASDCTE). The evaluation determined the effectiveness
of the curriculum in improving health and safety knowledge, skills,
and work practices. During 2006/7, the foundation OSH curriculum was
modified as appropriate for all 50 states and Puerto Rico. It is now
being prepared for dissemination via website and CD-ROM to other states,
schools, training programs, junior colleges, or appropriate training
venues. This intervention effectiveness study employs quasi-experimental
methods. States self-selected to participate and stratification was
used to ensure that representative schools participated with varying
demographics including urban and rural environments, considerations
of ethnic and cultural diversity, and various socioeconomic strata
associated with school districts. The curriculum was taught by existing
high school teachers within their current career clusters programs.
A contracted coordinator arranged for teacher training and served as
a support person and quality control evaluator to school districts
utilizing the curriculum. Students participated as part of their existing
career exploration or vocational programs, thus no special permissions
were needed. The research protocol qualified for exempted NIOSH approval
because all data collection occurred in existing educational settings
according to established school procedures. Assessments included routine
tests and quizzes to assess knowledge gain, demonstrations of skills,
critical thinking, and problem solving, and scores on other assignments
as given by the teachers. Longitudinal follow-up of students' workplace
experiences is desirable and the feasibility of doing this through
collaborations with teachers and guidance counselors is being explored.
A representative sample of teachers was invited to participate in a
qualitative process assessment of the program through a focus group.
Contact: Carol Stephenson
Education and Information Division
513-533-8581
Development of Epidemiologic Research Methods
The goal of this project is to develop appropriate methods and computer
programs to analyze epidemiologic studies and update cohort master
files, and to create incidence and mortality rate files for use in
epidemiologic analyses. These methods, programs and rates are used
by researchers worldwide in the conduct of etiologic epidemiology research.
This methods development project realizes outcomes that indirectly
benefit worker health, by providing tools for the evaluation of health
hazards. The elucidation of these hazards may lead to changes in the
workplace, for example, in reducing worker exposures or in providing
incentive for the development of new control technologies.
NIOSH LIFE TABLE COMPUTER PROGRAM. The NIOSH Life Table Analysis System
(LTAS) is used by hundreds of researchers within and outside of NIOSH
to analyze occupational cohort studies. Half the registered users of
LTAS reside outside the U.S. A conversion of LTAS to a Windows-based
platform has been nearly completed and will be made available to users
within and outside of NIOSH.
RATE FILE DEVELOPMENT. NIOSH maintains a number of mortality rate
files stratified by age, race, sex, and calendar time. These files
must be continually updated with new mortality and population data.
These files include county-, state-, and nationallevel mortality rate
files made publicly available through CDC. In addition, special rate
files for mortality and cancer incidence must be updated continually.
New International Classification of Diseases (ICD) codes must be incorporated
when appropriate, such as when new ICD revisions occur, or when old
ones are modified (e.g., use of the ICD-10 revision beginning in 1999).
EPIDEMIOLOGIC DATABASE MANAGEMENT SYSTEM (EDMS) AND AUTOMATED UPDATE
OF COHORT FILES. EDMS was created to provide a relational database
platform for epidemiologic study data. This system allows more-detailed
information to be stored with increased accessibility to researchers
than has been previously possible. Vital status of cohorts is determined
via several national sources. Information from these sources needs
to be electronically, rather than manually, applied to cohort files.
Furthermore, demographic information such as names, addresses and dates
of birth need to be incorporated automatically. Such programs have
been developed and are continually being revised as new databases and
technologies become available.
In FY06: 1) LTAS.NET: Methods used to develop LTAS.NET were presented
at a statistical conference. A user manual was written, and the program
algorithms were extensively validated in SAS and beta-tested by internal
and external users. 2) Rate files with data through 2003 were updated,
and a manuscript was published on ICD-10 rates. Special rate files
were created as requested by researchers. 3) EDMS continued as the
production system for IWSB mortality and incidence studies and for
worker notification, with 17 current studies, including the extensive
updates of the Beryllium cohort. Ongoing maintenance included upgrading
the data entry system to the current software version, improving the
reporting system, and training additional IT staff to use the system.
For FY07: 1) LTAS.NET: A manuscript will be drafted for submission
to a journal for publication. A dissemination plan for the rollout
of LTAS.NET will be implemented. Training for NIOSH users will be provided.
Ongoing support of the program will be provided given changing security
environments as the software is rolled out. 2) Rates will continue
to be created, adding 2004 data to all rate files. 3) EDMS will continue
as the production system for IWSB mortality and incidence studies and
for worker notification. Maintenance includes completing the data entry
conversion, completing reporting improvements, and creating turnkey
programs for importing data.
Contact: Mary Schubauer-Berigan
Division of Surveillance, Hazard Evaluations, and Field Studies
513-841-4251
Emerging Issues in Injury Surveillance
The goals of
this project are to explore new or previously under-recognized
occupational injury problems, and evaluate new sources of traumatic
occupational injury data; to develop and publish new recommendations
to prevent occupational injury; and to develop and disseminate these
data, including the use of new formats and in association with appropriate
partners. This emerging issues project will thus address a variety
of topics that will include new (or newly appreciated significant)
occupational injury problems; new ways to obtain, process, evaluate
and disseminate occupational injury data; and responses to the continual
presentation of new recommended safety guidelines or standards. Specific
activities include providing expert advice and assistance to developers
and end-users of injury surveillance systems and communicating NIOSH
data to the public. The project will thus involve a variety of research
and service efforts directed at occupational injury surveillance
issues. This project has spawned new surveillance and research, including
a FY04 NORA research program to fill data gaps on worker injuries
and illnesses associated with transportation and a FY05 project to
examine the potential of federal workers’ compensation data
to guide injury and illness prevention efforts among federal workers.
This project has contributed to NIOSH comments to regulatory agencies,
principally analyzing and interpreting relevant injury surveillance
data. It is anticipated that identification of information or research
gaps, and new surveillance projects, as well as better injury prevention
recommendations, will be important outcomes of the project. Specific
efforts in fiscal year 07 include contributing to the implementation
of the NIOSH surveillance program, working with partners seeking
to utilize available data to guide prevention efforts focused on
young workers including youth working in agriculture, and filling
gaps in information on injuries sustained by emergency responders
at the World Trade Center terrorism site.
Contact: Dawn Castillo
Division of Safety Research
304-285-5916
Evaluation of Safety Training for Spanish Speaking
Roadway Workers
If it is possible for a supervisor that does not speak fluent Spanish
to effectively transmit OSH information to Spanish speaking workers
using materials, they may serve as a template for additional training
efforts with other ESL workers. Specifically, foreman's use of a set
of English language safety training materials will be compared to the
way in which they attempt to use Spanish language safety training materials.
Different patterns of use (or non-use of certain materials) may be
associated with differences in employees' gains in workplace safety
knowledge, attitudes and skills. This project will first utilize interviews
with supervisors regarding their current practices and problems they
are experiencing training non-English speaking workers. This will be
followed by direct observation of worksite training and a pilot intervention
assessing the usefulness of one set of bilingual materials. The study
will provide information on how instructors, supervisors, and employers
can more effectively meet the learning needs of Spanish speaking workers.
Such information is needed so that more effective safety training can
be provided for Spanish speaking workers, a workforce population that
is rapidly increasing in the U.S. The Laborer's Health and Safety Fund
of North America developed bilingual training materials that will be
used in this study. Participants will be recruited with the assistance
of this union and their associated contractors who are involved in
road and bridge construction, thus performing tasks relevant to the
training materials of interest. This study involves a formative data
gathering phase and a quasi-experimental design phase to evaluate the
existing training materials. Brief pre and post-training hands-on demonstrations
performed by the participants will be used to collect data regarding
participant skill competency after training. Data will also be collected,
as needed, through onsite observations of the training, assessment
of the safety climate of the overall worksite, targeted interviews,
and focus groups. A multivariate analysis method will be used.
Contact: Carol Stephenson
Education and Information Division
513-533-8581
Fatality Assessment and Control Evaluation (FACE) Project
The goals/objectives of this project are to
prevent fatal work injuries by identifying work situations at high
risk of fatal injury and developing prevention strategies for those
who can intervene in the workplace.
NIOSH is voluntarily notified of selected occupational fatalities
(currently machine-related, workers under 18 years of age, highway
construction work zones, and Hispanic workers) by the Departments of
Labor in the states of Maryland, North Carolina, South Carolina, Tennessee,
and Virginia, Federal OSHA Area Offices in Ohio and Pennsylvania, and
the Allegheny County Coroner’s Office in Pittsburgh, Pennsylvania.
NIOSH is notified of work-related deaths of youth under 18 years of
age across the nation by the Wage and Hour Division, U.S. Department
of Labor. Through on-site fatality investigations, FACE personnel collect
agent, host, and environmental information from the pre-event, event,
and post-event phases of the fatal incident via a case series design
to facilitate descriptive analysis of the incidents. These investigations
are not conducted to find fault or place blame, but to better understand
the chain of events and contributing factors and develop recommendations
for preventing similar deaths. Findings from FACE investigations are
frequently combined with surveillance data to describe specific injury
problems and develop broad-based prevention recommendations. The results
of FACE investigations are disseminated through narrative reports for
each fatality, NIOSH Alerts, Workplace Solutions, technical reports,
targeted mass mailings, journal articles, MMWRs, and presentations.
NIOSH Alerts and Hazard IDs have covered the topics of forklifts, skid
steer loaders, telecommunication towers, skylights, moving large hay
bales, and wood chippers among others. The results of the FACE program
have the unique capability to reach workers at risk and provide timely
intervention strategies to targeted areas.
All FACE products are available on the internet. Additionally, NIOSH
frequently undertakes targeted dissemination efforts to provide prevention
information to specific audiences. For example, in FY04 NIOSH mailed
a packet documenting crane-related injury risks and steps that can
be taken to prevent worker death and injury to approximately 4,600
crane rental and crane service establishments across the nation.
NIOSH also partners with other federal agencies and private sector
groups to communicate prevention information from the FACE program.
For example, NIOSH has worked for several years with OSHA and the National
Association of Tower Erectors (NATE) to reduce extremely high fatality
rates for workers who erect and maintain telecommunication towers.
NIOSH data analysis, information from FACE investigations, and recommendations
are used by OSHA and NATE as training materials. To address shared
concerns about the incidence of young workers being fatally injured
while operating forklifts, NIOSH and the Department of Labor’s
Wage and Hour Division (WHD) collaborated in December 2002 to send
an information packet on forklift safety and young workers to more
than 10,000 retail warehouses and storage facilities. NIOSH, WHD, and
OSHA all participated in additional outreach efforts in January 2004
to distribute 5,000 copies of this same packet, along with an OSHA
bulletin, in a broader mailing that included OSHA alliance partners
such as the Industrial Truck Association (ITA).
Contact: Virgil Casini Jr
Division of Safety Research
304-285-6020
Flight Crew Studies
MENSTRUAL CYCLE BIOMONITORING STUDY OF FEMALE FLIGHT ATTENDANTS: This
biomonitoring feasibility study enrolled 71 flight attendants and teachers
(comparison group). Sleep measures and urinary melatonin monitored
circadian disruption, and urinary hormone assays monitored hormonal
changes. An analysis plan for salivary cortisol has been developed
and laboratory analyses are underway. In FY06, a manuscript describing
sleep quality was prepared. In FY07, primary study outcomes will be
analyzed.
REPRODUCTIVE HEALTH STUDY OF FLIGHT ATTENDANTS: This study used a
telephone questionnaire to collect information on reproductive outcomes
and risk factors from flight attendants and teachers (referents). Outcomes
of interest include spontaneous abortion, menstrual disorders, and
time-to-pregnancy. By the end of FY07, programming for work histories
was completed, exposure variables were created and data acquisition
was completed. In FY07, analyses of the spontaneous abortion and menstrual
cycle data will begin.
EXPOSURE ASSESSMENT FOR REPRODUCTIVE HEALTH STUDIES OF FLIGHT ATTENDANTS: Study
objectives are to characterize cosmic radiation and cabin air quality
exposures for a variety of aircraft and flight routes, and to compare
cosmic radiation exposure dose with predicted dose from an FAA model.
Radiation exposure data will be used to develop exposure guidelines
and health risk education for flight crew. In FY06, two papers on flight
crew radiation exposure measurement were drafted. In FY07, three cosmic
radiation and one indoor environmental quality manuscripts will be
completed and submitted.
BIO-AEROSOL MONITORING STUDY: This study will establish a baseline
of bio-aerosol measurements on a wide-body, twin aisle passenger aircraft.
Samples monitoring on a total of 16 flight segments included viable
airborne bacteria/fungi, surface viable bacteria/fungi, fungal spore
counts, and bulk allergen dust samples. Temperature, relative humidity,
and carbon dioxide measurements were also collected. As of FY06, three
manuscripts were written and in review. In FY07, one manuscript was
published and the carbon dioxide analysis and the bulk allergen dust
manuscript will be initiated.
COHORT MORTALITY STUDY OF FORMER PAN AM FLIGHT ATTENDANTS: This
study will examine the mortality experience of over 10,000 former Pan
Am flight attendants to determine whether they are at increased risk
of mortality from breast and other cancers. A cancer incidence study
(Breast Cancer Incidence Among Former Pan Am Flight Attendants - CAN
7124) is being conducted concurrently in the same cohort. In FY07,
the data analysis will be completed and a draft manuscript will be
prepared.
COHORT MORTALITY STUDY OF FORMER PAN AM PILOTS: This study
will examine the mortality experience of 6,000 former Pan Am pilots
to determine whether they are at increased risk of mortality from cancers
thought to be associated with exposure to ionizing radiation. As of
FY06, the protocol was peer reviewed and HSRB approval was obtained,
editing of the data abstracted/entered from the Pan Am records was
initiated, and the data abstracted/entered from several Pan Am records
continue to be edited. In FY07, the editing of the data from all records
will be completed, and the editing of the merged data will be initiated.
CYTOGENETIC STUDY OF MARKERS OF COSMIC RADIATION EXPOSURE AND EFFECTS
AMONG PILOTS: This study will quantify chromosomal aberrations (CA)
detected by fluorescence in situ hybridization (FISH) assay as a marker
of damage due to ionizing radiation exposure in 83 long-haul pilots
and 51 university faculty (referents). In FY06, participants were notified
of individual dietary results; questionnaire and laboratory data were
merged and edited; pilot flight segment data were edited, and flight
plans were obtained for the dose estimation algorithm. In FY07, questionnaire
data were analyzed and an abstract and manuscript were prepared; genotyping
analysis of DNA repair and other polymorphic genes will be performed;
cosmic radiation dose estimates will be completed; and the flight records
and additional stored blood samples will be anonymized.
Contact: Barbara Grajewski
Division of Surveillance, Hazard Evaluations, and Field Studies
513-841-4429
Improving the Health and Safety of Minority Workers
This 5- year project will join a team of NIOSH researchers,
University of Illinois at Chicago and other external researchers, industry
experts and community-based organizations (CBOS). The first phase of
the project will involve the conduct of a mixed methods study in the
Chicagoland area designed to investigate the relationship between psychosocial
stressors at work, stress, and stress-related problems and factors
that moderate these relationships among minority and White workers.
In subsequent phases of the project, a web-based survey will be administered
to Chicago-based companies and CBOs to gauge awareness and the prevalence
of psychosocial factors found by the study to be the most salient to
minority health and to assess current practices and policies that may
be intended to address diverse OSH needs, if any. The web-based survey
will also evaluate perceptions of what workplaces and CBOs need (i.e.
in terms of information, assessment tools, etc.) to build more responsive
OSH practices, programs and policies. The results of the web-based
survey and the mixed methods study will inform the development of toolkits
for reducing psychosocial risks in diverse workforces. The toolkits
will be disseminated to employers and community-based organizations
and subsequently evaluated.
Contact: Rashaun Roberts
Division of Applied Research and Technology
513-533-8346
Minority Health and Work Organization: Research to Practice
Although the psychosocial work environment is known to affect physical
and mental health, little is known about how this relationship contributes
to racial/ethnic health disparities. This project will develop, evaluate
and utilize methods to detect workplace risk factors contributing to
stress and stress-related problems among minority workers and to gauge
the effectiveness of occupational safety and health (OSH) programs
and services available through employers and community organizations.
The work will be done in three phases. Phase 1 will involve developing,
finalizing and evaluating the validity and reliability of a survey
instrument designed to detect organization of work risk factors for
disease and illness in a multiracial/multiethnic sample of workers.
One of the first of its kind, the instrument will be designed to evaluate
the potential impact of both race-based and traditional stressors on
safety and health. Phase 2 will entail conducting a cross-sectional
study in which the aforementioned survey instrument is utilized to
detect workplace risk factors to minority health. Additional survey
items to evaluate the extent to which workplace OSH programs and policies
are used and or perceived as effective by minority workers will be
administered as part of the survey. The survey will also assess availability
of OSH information and programs through community-based organizations
(CBOs). The cross-sectional survey will be telephonically administered
to a random sample of workers of diverse racial/ethnic backgrounds.
Finally, in Phase 3, a participatory approach to product development
will be used to create 2 different sets of informational products (e.g.,
web links to relevant information for CBOs and work organizations,
fact sheets, booklets/pamphlets, guidelines for addressing psychosocial
risk) designed to build knowledge about workplace psychosocial risk
factors to minority health. Materials will be customized for, and distributed
to CBOs and to work organizations employing a diversity of workers.
Follow-on email and/or telephone contacts 3-6 months after distribution
will assess the utility and impact of the information.
Project work in FY06 is focusing on survey and development of the
survey methodology. Work in FY07 expected to focus on cognitively testing
the survey instrument, completing the survey pilot, refining the survey
and sampling methodologies based on the pilot results and preparing
for the formal administration of the survey.
Contact: W Stephen Brightwell
Division of Applied Research and Technology
513-533-8173
NIOSH Information Dissemination Strategy: Spanish
NIOSH is expanding its ability to disseminate occupational safety
and health (OSH) information to Spanish-speaking workers and their
employers. The purpose of this project is to disseminate Spanish-language
OSH communication products and identify audiences and partners that
may use these materials. This dissemination strategy is based on a
study report commissioned by NIOSH and authored by the National Academies
of Science as well as input from all NIOSH divisions and from external
partners and audiences.
Information is currently being disseminated through emails, the NIOSH
800-number, and translated NIOSH publications on the Internet. Beginning
in FY2007, this project will focus more on developing easy-to-read
materials (e.g., brochures with photos and diagrams demonstrating processes
such as putting on PPE) that are based on technical NIOSH documents.
Presenting material in this format will be more useful to workers who
may have difficulty with written language.
Contact: Susan Afanuh
Education and Information Division
513-533-8345
Silica & Noise Exposure Control for Tile Roof Installers
A series of recent NIOSH Health Hazard Evaluations has highlighted
a newly recognized hazard that results from the use of concrete tiles
in the residential roofing industry. Roofers, who cut tiles, are exposed
to high concentrations of respirable dust, quartz, and noise. Because
of the intrinsically hazardous nature of work on pitched roofs and
the characteristics of the material, traditional engineering control
solutions such as local exhaust ventilation or water suppression are
not viewed favorably due to potential slipping and tripping hazards.
In addition, because of the nature of the tools and the material cut,
noise is a hazard.
Utilizing a systems approach to address exposures to silica and noise,
a series of laboratory and field studies will be performed in collaboration
with the Hazard Evaluations and Technical Assistance Branch, DSHEFS,
and in partnership with roofers, roofing contractors, tile manufacturers,
trade unions, and OSHA. The goal is to develop practical, effective
measures to protect this group of workers from noise and silica exposures.
Roofing tile is typically cut without the use of controls for reducing
exposures to crystalline silica. Data characterizing these “uncontrolled” exposures
have been collected through HHEs. To evaluate control effectiveness,
additional data must be gathered, including information about tool
and control design and performance, operating parameters, and environmental
conditions. For this project, effective controls are those that maintain
exposures below the occupational exposure limit (in this case the NIOSH
recommended exposure limit or the OSHA permissible exposure limit)
or those that reduce exposure by 70 to 95% or better. The suite of
silica and dust control options to be investigated in this project
include hand-held tools with local exhaust ventilation; the use of
wet methods including the application of water while cutting with hand-held
and stationary tools; amending the water with a surfactant to improve
wetting and investigate the ability of the surfactant (e.g., detergent)
to prevent staining said to occur when water is used when cutting these
tiles; the addition of a retarder to the water to slow down the curing
of the water-concrete dust mixture and preclude staining (Roofers told
NIOSH investigators that when cutting concrete roofing tiles water
reacts with the concrete tile resulting in stained tiles); and the
use of local exhaust ventilation with stationary masonry saws. Several
hand-held tools with local exhaust ventilation are commercially available.
In addition, at least one tool has been developed by a roofer specifically
to address the current exposure issue. This study will assess the effectiveness
of commercially available and emerging tool designs in the field in
collaboration with the roofing partnership; laboratory evaluations
as a screening of these designs will also be performed.
EPHB researchers are conducting a laboratory assessment of a stationary
saw using both water suppression and local exhaust ventilation to control
dust emissions. In addition, low-cost hood designs for stationary masonry
saws will be developed and tested by EPHB engineers. This effort will
build on EPHB’s success in developing low-cost ventilation control
products (e.g., reducing lead exposures in radiator repair shops.)
Contact: Alberto Garcia
Division of Applied Research and Technology
513-841-4596
State-Based Fatality Surveillance Using FACE Model
State-based FACE is a continuing extramural program of identification
and epidemiologic investigation of selected occupational fatalities.
The objective of the State-based FACE project is to prevent fatal work-related
injuries through an integrated program of surveillance, on-site investigation,
and dissemination and prevention activities. The project is implemented
through cooperative agreements with State health and labor departments.
State-based FACE identifies cases through active surveillance of all
external causes of occupational death occurring within the funded state,
and collects general epidemiological data on each case. In-depth field
investigations are conducted for selected cases in targeted categories
of fatal injuries. These targets are determined according to national
and state priorities. Current national targets include: youth less
than 18 years of age, Hispanic workers, machine-related deaths, and
deaths of highway/street construction zone workers. States select their
own targets based on fatal injury patterns and prevention priorities
within their states. Emphasis is placed on occupational fatalities
in the agricultural and construction industries.
Detailed epidemiologic data are collected on the circumstances of
selected fatalities through on-site investigations using a standardized
investigation procedure. Agent, victim, and environmental information
are evaluated in relation to the pre-event, event, and post-event phases
of the incident. The project's ability to couple case identification
with surveillance data yields detailed information beyond that normally
available for developing prevention strategies. Because the project
is state-based, the resulting prevention recommendations will be readily
adaptable to state-specific and regional needs and can be rapidly disseminated
to the audiences best suited to implement workplace controls.
Since the project start date in FY89, 22 states have actively participated
in the project identifying over 18,000 work-related fatalities, and
conducting over 1,500 fatality investigations. Recommended interventions
have been broadly disseminated at the state level through presentations,
journal articles, news media, videos, safety brochures, fact sheets,
and training guides. State fatality data and case reports have also
significantly contributed to NIOSH documents, journal articles and
presentations. Through these dissemination methods, what is learned
through the State-based FACE project's surveillance and investigation
activity is quickly translated into prevention actions.
Contact: Doloris Higgins
Division of Safety Research
304-285-6276
Tailoring OSH Training for Hispanic
Immigrant Workers
This study will collect information from recent (<2 years in U.S.)
Hispanic immigrant workers (HIW) regarding occupational safety and
health (OSH) training histories, risk perception, risk acceptance and
adjustment strategies and use it to tailor OSH training interventions
HIW working in construction. Specific Aim 1- Understanding differences
in prior OSH knowledge, risk perception, risk acceptance and adjustment
strategies. 24 focus groups [5 with HIW, 5 with NHIW and 5 with NHW)
with workers from a broad range of industries will be conducted to
identify the unique aspects of the HIW experience. The Hispanic participants
will be recruited through agencies serving the Cincinnati, OH and Santa
Fe, NM Hispanic immigrant communities. Content analyses of the focus
group data will be used to guide development of a research questionnaire
that will be used to further assess differences in OSH training histories,
risk perception, risk acceptance and adjustment strategies between
HIW, NRH and ABW. This questionnaire will be validated on a sample
of approximately 600 workers (200 HIW, 200 NRHW and 200 ABW) from a
broad range of industries. Specific Aim 2 - Develop culturally sensitive
OSH training modules. The questionnaire developed in Specific Aim 1
will be administered to approximately 100 HIW employed in the construction
industry. The survey responses will be used to tailor an existing OSH
training intervention for construction workers. Specific Aim 3 - Evaluate
the effectiveness of the culturally tailored OSH training modules.
The training intervention developed in Specific Aim 2 will be administered
to approximately 200 HIW employed in the construction industry. The
workers will be randomly assigned to receive either tailored or untailored
safety training. The participants will be assessed both prior to training
and afterwards regarding their OSH knowledge, safety attitudes, and
self-reported workplace safety behaviors. To overcome literacy and
language barriers, much of this assessment will use worksite simulation
demonstrations, video clips and individually administered questionnaires.
It is expected that HIW receiving the tailored interventions will show
greater gains in OSH knowledge and more improved OSH attitudes than
those receiving the untailored training. In addition, the HIW who participate
in this training will be asked to share the OSH knowledge they received
with fellow workers. The participants will be contacted at 1 and 3
months following training and assessed regarding OSH knowledge, safety
attitudes, and self-reported OSH behaviors. In addition, they will
be interviewed regarding the frequency and quality of any interactions
in which they shared OSH information with a fellow worker. It is expected
that the HIW who received the tailored training will retain more OSH
information, maintain greater attitude changes, have higher levels
of self-reported OSH behavior, and report more frequent and more successful
instances of serving as a training resource for other HIW than those
who received the untailored training. Project timeline: Year 1 -- Clearance
and Aim 1; Year 2 – Aims 1 & 2; Year 3 – Aim 2; Year
4 -- Aim 4; Year 5 -- Aim 4 & dissemination of results.
Contact: Donald Eggerth
Education and Information Division
513-533-8505
Understanding and Promoting OSH in Low Income Older Workers
The proposed study involves two complementary research components.
In the first component, a study will be conducted of a federally funded
employment program for low income older workers called the Senior Community
Service Employment Program (SCSEP). SCSEP is funded by the U.S. Department
of Labor (DOL) and run by several national non-profit organizations
(e.g., Experience Works, AARP, National Council on the Aging, Easter
Seals) and state-based agencies. SCSEP participants must be at least
55 years of age and cannot have a household income more than 25% above
the poverty level. They are placed in jobs at community and government
agencies (e.g., nurse’s aides, librarians, clerical workers)
and receive specialized training related to their job. The ultimate
goal of SCSEP is for participants to transition to unsubsidized employment
that is not supported with federal funds. In the second component,
archival data will be analyzed from the Health and Retirement Study
(HRS), a nationally representative longitudinal survey of approximately
10,000 older adults that began in 1992 and is currently on-going. The
HRS contains a wealth of information concerning each respondent’s
work history, current occupation, job characteristics, health status
and conditions, and economic assets. Analysis of HRS data will focus
on identifying a group of low income older workers that are roughly
comparable to SCSEP participants, and then tracking them over a ten
year period with regard to their occupation and health. Together, the
analysis of HRS and SCSEP data will provide a more complete picture
of low income older workers than either data source can alone. In FY06,
the project will begin by using a qualitative approach, in terms of
focus groups and key informant interviews, that will identify workplace
factors associated with successful safety and health outcomes in low
income older workers.
Contact: James Grosch
Division of Applied Research and Technology
513-533-8167
Work Organization Predictors of Depression in Women
This is an interdivisional prospective study examining the relationship
between non-traditional work organization stressors (e.g., work-family
conflicts, harassment, discrimination), traditional work organization
stressors (e.g., demands, control), and depression in working women.
It is hypothesized that these stressors are related to depression in
women. It is also hypothesized that workplace policies which prohibit
discriminatory practices, and programs which promote career progression
and work-family balance may attenuate the effects of work organization
stressors on depression. A contract research firm will collect telephone
survey data on non-traditional and traditional work organization stressors
and depression from approximately 2000 women and men working in administrative
support positions (e.g., accounting, bookkeeping, clerical). Subjects
will be drawn from companies expected to vary with regard to work organization
stressors (particularly non-traditional) and organizational policies,
practices and programs. A Human Resources representative from each
company will also provide information about specific HR policies and
programs within their companies. Data will be collected on an annual
basis for three years.
During the first year, a draft survey was developed which was reviewed
by a focus group of administrative support workers and revised per
their comments. In FY02, the revised survey was reviewed by a second
focus group, and finalized. A Title 42 Fellow was hired to assist with
the project and a contract was awarded to a research firm to identify
collaborating companies and conduct telephone surveys. In FY03, HSRB
clearance was obtained, and an OMB package was sent to OMB for clearance.
In FY04, OMB clearance was obtained, and company and participant recruitment
was begun. Recruitment continued into FY06, and the first (baseline)
wave of data will be delivered to NIOSH at the end of FY06. The second
wave of data collection will occur
between August of 2006 and August of 2007.
Contact: Naomi Swanson
Division of Applied Research and Technology
513-533-8165
Workplace Violence Initiative: Research and Implementation
The primary objective of this project is to support and coordinate
the conduct of new research in the area of workplace violence prevention.
The specific FY07 aims include: (1) Publish manuscripts in peer reviewed
journals, based on the data collected from the survey that used the
BLS Survey of Occupational Injuries and Illnesses as a sampling frame
for a survey of employers regarding policies, procedures, training,
and incidence of workplace violence; (2) Analyze data from the enhanced
National Crime Victimization Survey (NCVS) as well as the Workplace
Risk Supplement to further identify risk factors and characteristics
of workplace violence victims; (3) Continue meetings of the Federal
Interagency Task Force on Workplace Violence Research and Prevention;
(4) Fund extramural research related to analysis of workplace violence
interventions.
Workplace violence has been recognized as a significant public health
and occupational safety and health issue, but gaps remain in our knowledge
of specific risk factors and the effectiveness of particular intervention
strategies. This project will utilize the capacity of broad-based survey
systems to incorporate supplements and enhancements in order to fill
some of the most pressing data knowledge gaps.
The Federal Interagency Task Force on Workplace Violence Research
and Prevention will continue to provide a forum for the sharing of
information and identification of potential collaborative efforts among
the diverse Federal agencies that fund and/or conduct research or prevention
activities related to workplace violence.
Information from the stakeholder meetings have been incorporated into
conference presentations and stakeholder newsletters. An educational
workplace violence prevention DVD was completed and distribution started
in June of 2004 and reprinted in 2005 to meet the large demand. Information
from this DVD provides businesses with clear strategies that can be
adopted regarding prevention activities.
A new project will be developed for the evaluation of an intervention
to prevent work-related homicides and assaults in retail establishments.
The objective will be to evaluate models for the delivery of a Crime
Prevention Through Environmental Design Program (CPTED). By the First
quarter, a protocol will be completed including enrollment of partners,
development of a management team, identification of contractual resources,
and completion of study design and methodology, development of a management
team, a project plan and budget. By the second quarter, FY07, the protocol
will be submitted to HSRB and OMB for approvals, and support contracts
scope of works initiated with contracts. By the fourth quarter, FY07,
support contracts will be awarded. By the first quarter, FY08, site
visit teams will be selected and trained. Field site visits are targeted
to begin in FY08, follow-up site visits in FY09, and data analysis
and publications in FY09-FY10).
Contact: Daniel Hartley
Division of Safety Research
304-285-5812