About the Comments and Categories
Starting in May, 2005, NORA requested comments from stakeholders to identify important occupational safety and health issues, such as: diseases, injuries, exposures, populations at risk, and needs of the occupational safety and health system. Input was also requested on the types of research and partners needed to make a difference. Comments were received through this website, by E-mail and on paper. A court reporter provided transcripts of comments received during NORA Town Hall meetings.
Approximately 800 individuals submitted information through the website and the Town Hall meetings. Each submittal could include up to ten comments, since the comment form includes ten input boxes. Each comment was given a unique identification number, which is displayed in the search results. Approximately 1000 comments have been categorized and can be searched. Stakeholders may benefit from the problems identified, solutions suggested and partners recommended in these comments.
Each submittal was analyzed to determine if the text could be separated into distinct parts. Each ‘unit comment’ was then determined to be a “Comment on the NORA process” or a recommendation of a research priority. As a result, the database contains 1600 categorized records.
Each comment recommending a research priority was indexed by the terms listed below using the approach that such a comment could be characterized by a sentence of the form:
“I recommend as a priority these 'sectors' having these 'populations' experiencing these 'health effects' due to these 'exposures' where these 'approaches' will be most useful in reducing the problem and these organizations/people should be engaged as 'partners'."
Each of the words in single quotes is a category. For each comment, none or some of the items in each category were selected as search terms. The search terms are not exhaustive but were selected primarily to reflect the programs in the NIOSH Program Portfolio. Where additional terms were needed to capture the range of comments offered, terms were taken from the 21 priority areas of the first decade of NORA. A few more terms were added to cover large gaps; these tended to be broad terms, for example, exposures to "chemicals/liquids/particles/vapors".
Non-obvious aspects of the categorization criteria are indicated below:
The eight NORA sector groups are defined in terms of the Census Bureau’s North American Classification System (NAICS) codes. Click here for more information.
- Agriculture, forestry, and fishing
- Construction
- Healthcare and social assistance
- Mining
- Manufacturing
- Services
- Transportation, warehousing and utilities
- Wholesale and retail trade
- Unspecified – This term was chosen when a comment recommending a research priority did not specify any sector(s).
A term describing a population was selected when a comment described a group of workers that could not be characterized by their employers’ sector or sub-sector or their occupation.
- Youth – Typically, teenage or younger.
- Older – Typically, workers were described as aging or older. >
- Language/culture/ethnicity – Typically, workers were described as immigrants, minority, Hispanic, Black, etc., or were characterized as having a distinguishing culture.
- Disability – Physical or mental.
- Small business
- Other – Some examples are: women, workers who live in rural areas, pregnant workers, diabetics, part-time workers, workers in the informal sector, Generation X workers, shorter stature workers, and low wage workers.
Health outcomes; diseases/injuries
These terms were selected using their “common” definitions rather than strict medical definitions.
- Cancer – Includes mutagenicity and other pre-cancer indicators.
- Reproductive – Defined broadly as effects on the reproductive health of prospective parents as well as effects on fetuses leading to the birth of an unhealthy or deformed baby.
- Cardiovascular disease – Typically, hypertension.
- Neurological effect/mental health – Includes effects on nerves, headaches, pain, effects on nerves (including white-finger syndrome), depression and other mental health issues.
- Renal disease – Any kidney or urological effect
- Hearing loss – Includes noise exposures that might lead to hearing loss.
- Immune disease – Includes any mention of the immune system. Does not include asthma.
- Dermal disease – Typically, skin disease or chemical exposures of the skin.
- Infectious diseases – Includes exposures to infectious agents that might lead to an infectious disease.
- Musculoskeletal disorders – Soft tissue and joint disorders, most often caused by repetitive motions, especially repeated heavy lifting.
- Respiratory disease – Includes asthma and other lung diseases as well as other conditions of the respiratory tract, for example, rhinitis.
- Traumatic injuries
- Mortality
- Infectious agents – Selected only when the exposure to the infectious agent was implicated in some other disease than an infectious disease, for example, cancer.
- Chemicals/liquids/particles/vapors – Includes pharmaceuticals.
- Work organization/stress
- Heat/cold
- Noise/Vibration – This term was not selected when noise exposure was a risk factor for hearing loss. It was selected when a noise exposure was a risk factor for some other effect, for example, injuries due to difficulty in communicating. Vibrations include all frequencies.
- Radiation (ionizing and non-ionizing) – Includes sun and UV exposures of skin, radioactivity, and electromagnetic radiation of any frequency.
- Indoor environment – Typically, exposures associated with office buildings described as sick-building, mold, ventilation system effectiveness or vapors released from materials.
- Motor vehicles – Any mobile, motorized machine, including forklifts, farm tractors and other self-propelled farm machinery and ATV’s.
- Violence – Physical or verbal.
- Work-life issues – Selected when issues originating outside work were mentioned as risk factors, including obesity, physical conditioning, and stress due to family relationships. Also selected when work exposures could harm family members or communities.
Approaches
These terms reflect answers to the question “What types of research will make a difference” and broadly reflect the public health model.
“Research” is taken very loosely and includes any types of studies, better understanding and improved implementation.
- Surveillance – Typically, surveillance systems, but also includes worksite surveillance of risk factors. Does not include worksite medical surveillance to identify early disease; that was categorized as “Health service delivery.”
- Hazard identification – Narrowly defined as laboratory studies to determine what health effects exposure to a chemical (or a physical hazard) is capable of producing, without necessarily obtaining any dose response data relevant to worker exposures.
- Etiological research – Field or laboratory studies relating health effects to worker exposures.
- Exposure assessment – Includes worksite measurements as well as improved analytical methods and instrumentation.
- Risk assessment methods – Narrowly defined as formal risk assessment (usually quantitative).
- Engineering and administrative control/banding – Any engineering solutions, e.g., better design of machinery and buildings, engineering controls, process improvement, and substitution (with less hazardous chemicals). Also includes specification of allowable worksite procedures to reduce hazards (administrative controls) as well as control banding (relatively new administrative procedures to achieve worksite hazard identification, exposure assessment and control without measurements at the worksite).
- Personal protective equipment
- Training – Selected when improvements in training workers, supervisors, employers, engineers, architects and others were recommended. Improved education of occupational safety and health specialists and professionals was categorized as “Capacity building.”
- Intervention effectiveness research – Broadly defined to include laboratory or field studies of the effectiveness of a workplace intervention designed to reduce risk.
- Work-site implementation/demonstration – Selected when employers/workers control the adoption of interventions or programs and researchers have, at most, a facilitation and evaluation role. Typically, the comment recommends assistance in implementing a proven intervention within a population of worksites or recommends community-based, participatory research.
- Economics – Selected when a comment cites financial, profit, or productivity issues as factors in worker safety and health. Includes issues of the business case for occupational safety and health and return-on-investment.
- Authoritative recommendation – Includes policies, recommendations, standards and regulations applicable to a population of worksites, typically generated by corporate occupational safety and health professionals, NIOSH, consensus standards groups and government agencies.
- Marketing/dissemination – Making information widely available.
- Capacity building – Education of occupational safety and health specialists and professionals
- Health service delivery – Occupational health medical services, including medical monitoring, diagnosis, and treatment as well as the payment for such services, especially workers’ compensation systems. Includes return-to-work issues following a disabling injury or illness.
- International interaction – Selected when the comment recommends collaborating with, learning from or sharing solutions with other countries.
- Emergency preparedness and response – Includes natural disasters, terrorism and single-person emergencies.
- Work-site occupational safety health system/record keeping – Selected when a comment recommends improvements in work-sites’ occupational safety and health system or the safety culture. Also selected when a comment recommends improvements in governmental systems at the local, state or national level including improvements in the handling of information or records.
Partners
When a comment explicitly recommends future work with a named partner or a class of partners, the partner’s name or class description was placed in a “partner” field. Select “Partner recommended” in the search criteria to find only those comments for which an entry was made in the “partner” field.