State Surveillance Program

The Occupational Health Branch (OHB) of the California Department of Public Health (CDPHexternal icon) will implement an Expanded Program to reduce the incidence of work-related injury and illness by maintaining and enhancing the capacity for occupational health surveillance and intervention in California. The Expanded Program includes both the required Occupational Health Indicator (OHI) component, as well as three Priority Focus Areas (work-related asthma, fatalities, and pesticide illness) that will build on our 27-year history of continuous NIOSH-funded cooperative agreement for OHS surveillance.

The primary objective of the Connecticut Occupational Health Fundamental-Plus Surveillance Program is to maintain capacity for enhanced occupational illness and injury surveillance at the Connecticut Department of Public Health (CT DPH).  This includes more in-depth data analysis and investigation, and utilizing the results of data collection and analyses to target specific intervention activities.  Established information exchange between CT DPH and our partners within our state, regionally, and nationally is a critical component of the continued success of our program, and will be maintained through this project. The objective above will be achieved through continuation and expansion of longitudinal analysis of occupational illness and injury under-reporting in Connecticut, continuation of population-based surveillance activities through longitudinal analysis of all 21 occupational health indicators for Connecticut, continuation surveillance, investigation, and outreach activities related to adult lead poisonings, in-depth surveillance, investigation, and intervention activities for workplace chemical inhalation exposures and development of indicator methodology for similar examination by other states, and collaboration with the Connecticut Occupational Health Clinics Workgroup and regional occupational health partners from the other Northeast states.  These specific aims have been developed to continue to expand our capacity for occupational illness and injury surveillance and to maintain continuity in our surveillance and intervention programs for the duration of the project period.  These programs and the staff they support provide the basis for the protection of worker health in our state, through surveillance and intervention activities and making our program activities more efficient, effective, and beneficial to the Connecticut workforce. 

The goal of the Occupational Health and Safety Program (OHSP) at the Florida Department of Health (DOH) is to reduce work-related morbidity/mortality in Florida. OHSP will conduct surveillance of occupational injuries, illnesses, and fatalities; disseminate results of findings to stakeholders; increase partnerships within DOH and throughout the state where key issues can be discussed and collaboration can take place; develop prevention and intervention efforts that may increase the safety of Florida workplaces; and enhance and maintain a focus on the construction industry through surveillance, research, and intervention activities with a special emphasis on fatalities. In addition, OHSP will re-establish adult blood lead poisoning outreach, investigation, and intervention support to county health department epidemiologists.

A number of datasets are currently used by OHSP for surveillance activities including hospitalization and emergency department visit records, death certificates, Census of Fatal Occupational Injuries, Florida Trauma Registry, and workers’ compensation. OHSP plans to identify fatality events through media reports, workers’ compensation first report of injuries, and Occupational Safety and Health Administration inspection records. OHSP will contract with a university partner to interview construction workers and contractors to identify risk factors for falls among Hispanic residential construction workers. Results from this project will be used to identify focus areas for interventions.

DOH plans to develop reports, fact sheets, manuscripts, presentations, and outreach and education materials highlighting findings. Partnerships with various private, not-for-profit, and governmental organizations will be leveraged to distribute products to employers and employees.

The Georgia Department of Public Health (DPH) will conduct a Fundamental Surveillance Program for occupational health and safety. The aims of this application are to provide ongoing collection and analysis of the 20 occupational health indicators and to explore existing data sources to identify research and prevention priorities for informing partners, stakeholders, policy makers, and the public about leading causes of morbidity and mortality related to occupational injuries and illnesses in Georgia. The Georgia DPH will maintain surveillance of occupational injuries, illnesses, and hazards in Georgia and to conduct outreach activities on work-related blood lead exposures; establish a comprehensive work-related pesticide poisoning surveillance program in Southwest Georgia; and conduct a statewide Worksite Wellness Survey. The Occupational Health Surveillance project will collect the 20 indicators recommended by the National Institute for Occupational Safety and Health (NIOSH) and the Council of State and Territorial Epidemiologist (CSTE). DPH Occupational Health Surveillance (OH) program will leverage the use of existing and non-traditional data sources, such the Georgia Violent Death Reporting System and the Behavioral Risk Factor Surveillance System. These data sources will contribute to state and local prevention efforts and add to national data regarding the magnitude and trends of occupational health morbidity and mortality

The long-term goal of the Iowa Department of Public Health (IDPHexternal icon) Occupational Health & Safety Surveillance Program (OHSSP) is to promote and protect the health and safety of Iowa’s 1.7 million workers. The objectives are to track and trend occupational data relevant to identified risks and hazards of greatest importance for Iowa workers and to provide the data for the development of technical and lay recommendations that may prevent occupational illness or injury. Surveillance program outputs will include: Calculation and submission of a minimum of 20 Occupational Health Indicators; Development of a new OHI related to motorized roadway fatalities; Collection of adult blood lead test data with follow back and data submission annually to NIOSH; Analysis of the 2014 BRFSS Iowa data involving industry and occupation, and Partnership and reporting of a Midwest Tri-State data project with Minnesota and Wisconsin.

Kentucky ranks as the 7^th-worst state for nonfatal occupational injuries/illnesses, and 14^th-worst state for fatal occupational injury rates. The overall Kentucky Occupational Safety and Health Surveillance (KOSHSexternal icon) expended program (KOSHS fundamental, Occupational Health Indicator [OHI], and Fatality Assessment and Control Evaluation [FACE] component programs) focuses on population-based and case-based surveillance of work-related injuries/illnesses (WII) in Kentucky, a southeastern HHS Region 4 state. Specific aims are to perform population-based WII surveillance using 21 NIOSH-recommended OHI, 6 Kentucky-specific OHI, FACE, and other surveillance data, including new data source evaluation; perform case-based WII surveillance through FACE on-site investigations and high adult blood lead level follow-up investigations; conduct epidemiological analyses of WII surveillance and investigation data; establish and maintain partnerships/collaborations that integrate KOSHS results with partners’ intervention and outreach activities; participate in the KOSHS advisory committee and attend semiannual grantee meetings; disseminate occupational injury/illness data and research results; and perform a process, impact, and outcome evaluation of the overall KOSHS expanded program. Novel industries and occupations targeted in the KOSHS program include highway incident management and truck transportation. KOSHS will also have an innovative emphasis on work-related severe traumatic injuries, traumatic brain injuries, and concussions. Advanced statistical methodologies such as probabilistic data linkage and multiple imputation will be used, and surveillance data quality improvement studies will be performed. Innovative integration of the KOSHS program with NIOSH Total Worker Health®, Safe Communities, CDC-funded Violence and Injury Prevention Programs, and National Safety Council are planned.

New funding will enhance the Louisiana Occupational Health and Injury Surveillance Program’s occupational health surveillance capacity: expanded outreach and prevention activities will occur by leveraging the resources, skills and expertise of its network of partners and stakeholders and its active population surveillance system will be improved through acquisition of new sources of occupational health data and development of targeted surveillance for priority issues impacting Louisiana’s workforce. The program will also continue to play a key public health role in identifying and responding to emerging and emergent occupational hazards and issues.  The overall goal of the surveillance system is to improve worker safety and health through surveillance data that identify high risk occupations and industries, emerging issues, and trends and to promote the use of these data to reduce occupational injuries, diseases, and mortality through targeted prevention actions. Specific proposal aims include: continue to acquire, analyze and interpret occupational health indicator data, including follow-up investigation of elevated blood lead cases; develop and implement targeted surveillance system for occupational heat-related illness, including collection of causes and risk factors; respond to emerging and emergent events that impact Louisiana workers; periodically compile and analyze surveillance data and prepare reports, publications, and presentations; continue to interact regularly with partners and stakeholders to prioritize relevant issues for Louisiana workers, disseminate findings, and develop prevention strategies and interventions based on surveillance findings; participate in the bi-monthly Louisiana Workplace Safety Task Force meetings and conduct quarterly program advisory meetings; evaluate and improve program performance; and participate in NIOSH meetings and other activities.

In partnership with other State agencies and nongovernmental organizations, the Maryland Department of Health and Mental Hygiene (DHMH) seeks to create an expanded Occupational Health and Safety Surveillance Project (OHSSP), focused on three projects:  (1) improving and expanding the occupational health indicators (OHls) reported in the previous project period, with enhancements to the existing data sets, evaluation and addition of new data sources; (2) expanding outreach and education efforts in partnership with stakeholders to effect reductions in work-related illness and injury generally, and in specific priority areas (falls, traumatic brain injuries, and motor vehicle accidents); (3) evaluate the prevalence of prescription opiate use in workers’ compensation cases and conduct an in-depth analysis of the association between use of prescription opiates and return to work and subsequent injury; and (4) conduct an educational intervention with providers focused on the State’s new Prescription Drug Monitoring Program (POMP) in order to increase enrollment in and utilization of the POMP. This project has significant implications for the health of Maryland workers and for the national workforce.  It uses enhanced state surveillance data to improve ongoing education and outreach prevention programs.  Moreover, the focus on prescription pain medication may improve our understanding of the role of pain medication in occupational injuries and fatalities as well as evaluating possible strategies for their control.

Michigan State University in conjunction with the Michigan Department of Health and Human Services and the Michigan Department of Licensing and Regulatory Affairs has been conducting state-based occupational injury and illness surveillance since 1988. The new award from CDC NIOSH will fund activity to generate the occupational indicators and surveillance programs for four specific conditions: (1) occupational lung disease; (2) acute work-related pesticide illness; (3) work-related acute traumatic non-fatal injuries; and 4) work-related acute traumatic fatalities. Major sources of data include reports from hospitals, emergency departments, clinics, individual health care providers, the state’s poison control center, the Michigan Workers’ Compensation Agency and death certificates. Follow-back industrial hygiene inspections will be conducted, and fellow workers interviewed during these inspections. Annual reports for each of the conditions under surveillance will be written. A quarterly newsletter will be prepared and mailed out to approximately 3,300 targeted physicians and health care professionals. The above active outreach to encourage reporting will be continued as well as presentations and display booths at medical meetings and working with other state organizations such as the medical licensing board to publicize Michigan’s occupational disease reporting law. Information about the data collected will also be publishing in the medical literature, via our website, Twitter, Facebook, and the NIOSH Science Blog. Expanded efforts to develop hazard alerts for specific hazards, special populations and industrial sectors will be initiated. Evaluation of the effectiveness of our effort to improve working conditions will be conducted.

A strategic surveillance goal of the National Institute for Occupational Safety and Health is to strengthen the capacity of state health departments to conduct occupational surveillance and related prevention activities. This project will enhance the capacity of the Minnesota Department of Healthexternal icon to promote occupational health and safety through surveillance of a core set of occupational health indicators and dissemination of the findings to appropriate stateholders for use in setting priorities for education and prevention activities. The aims of this program include: (1) Develop a broad profile of occupational health in Minnesota through the assesment of  21 Occupational Health Indicators; (2) Collaborate with agencies, organizations, and individuals who can provide and/or utilize occupational surveillance data; (3) Disseminate and publish surveillance data; (4) Collaborate with the Minnesota Asthma Program to implement strategies for education and prevention of work-related asthma; (5) Establish and maintain an advisory group; (6) Collect, analyze, and evaluate indicators of the rates and costs of serious agricultural injuries in Minnesota; (7) Analyze and evaluate data from the MN BRFSS program to identify relationships between employment in specific industries and occupations and various health behaviors and conditions; and (8) Collaborate with occupational health programs in Iowa and Wisconsin to identify issues, priorities, and potential prevention activities common to the Upper Midwest.

The NMOHSP program will achieve focused surveillance and response by innovative uses of existing data sources already in use for occupational health surveillance and the exploration of new data sources, such as emergency department data; by the formation of new partnerships with industry and nurturing existing partnerships; and through the creative use of electronic technologies and strategic partnerships for outreach. This project is specifically contributing to the establishment of New Mexico’s Fundamental Plus Surveillance, which builds on the previous surveillance system. Outputs and intermediate outcomes will need to be identified (see next section for more details).  However, depending on the data analyzed and the logic model developed, outputs may include:  newsletter/factsheet, magnets for oil and gas company vehicles, an online regional map (surveillance findings: injuries & fatalities) as supplements to existing training/safety programs. The audiences for these outputs will include NM occupational specialists, and oil & gas workers and gas companies/managers.

New York State (NYS) Department of Healthexternal icon continues to conduct occupational health surveillance and intervention in NYS. NYS is the third most populous state, with over 8.9 million full-time employees in 2012. Recognizing that many occupational hazards and adverse health outcomes overlap other public health programs, the Bureau of Occupational Health and Injury Prevention (BOHIP) will work on incorporating occupational health into other public health initiatives. We will continue and enhance our surveillance efforts, and translate past successes into the development and implementation of occupational prevention, intervention and outreach activities. Data collected by BOHIP will be incorporated into other public health tracking systems including the Occupational Health Indicators project, the NYS Prevention Agenda, the NYS Community Data Clearinghouse and the NYS Environmental Public Health Tracking Program. These data will be further evaluated to identify high-risk industries, occupations, and other high-risk populations. BOHIP will continue to collect, follow up and monitor adult blood lead data reported to the Heavy Metals Registry. Collaboration with the NYS Childhood Lead Program will ensure prompt identification of lead poisoned pregnant women and follow-up of their newborns. BOHIP will continue and strengthen its effort in preventing serious and fatal occupational injuries through the NYS Fatality Assessment and Control Evaluation program. BOHIP maintains an Occupational Lung Disease Registry and will use this registry to continue and expand surveillance for occupational lung diseases in NYS by continuing and improving case ascertainment and through the development of education, prevention, and intervention activities.

The goal of the North Carolina Occupational Health and Safety Surveillance Fundamental-Plus Program is to enhance population-based surveillance capacity of work-related injury and illness in North Carolina. The aims of the program are to: assess health risk through the collection and analysis of occupational illness and injury data; promote occupational health policy and program developments through partnerships; and assure the protection of the workforce through intervention and prevention strategies. The objectives to accomplish these aims are to: routinely collect and analyze occupational health injury and illness indicator data using existing federal, state, and case-based datasets related to identified priority areas; identify trends and priority areas needing further investigation; use additional secondary and primary data sources beyond indicator data to study priority areas and help identify injury risk factors; develop reports and communicate findings; maintain and continue developing a committed network of in-state and out-of-state collaborators to help build state surveillance capacity and promote multistate regional collaboration; implement data-driven interventions that focus on high risk groups and conditions; assemble a multidisciplinary team of in-house occupational safety and health professionals to provide investigation and outreach services; and promote enforcement of state regulations by evaluating the effectiveness of regulatory programs designed to reduce workplace injury risks. Major outputs include publications, data summaries and reports; education and outreach materials and targeted outreach campaigns; an increased number of completed chemical exposure case investigations and cases reported; and program status reports and updates. Activities will increase knowledge and awareness of occupational risk factors and prevention strategies among North Carolinians, inform specific efforts to improve regulatory policy and adaptation of risk-reduction behaviors among workers, and ultimately decrease occupational injury, illness, and death in North Carolina.

The Oregon Occupational Public Health Programexternal icon aims to reduce occupational illness and injury through surveillance, analysis and investigation, in addition to developing and disseminating prevention recommendations and interventions. Oregon excels in cultivating partnerships and conducting surveillance and occupational health education/outreach. The Program is a strategic partnership between the Oregon Health Authority and Oregon Health & Science University with guidance from an advisory board of government, industry, and stakeholders. Our model has produced coordination among stakeholders with allied missions, including formal state-level collaborative agreements. In Oregon, work-related illnesses and injuries decreased by 40% between 2000 and 2011. However, occupational injuries continue, with workers’ compensation costs exceeding half-a-billion dollars annually. The program’s innovative research strategy will provide leadership for state-level occupational public health initiatives and programs and strive towards creating action through partnerships, technologies, and novel research methods. Our expanded program includes surveillance and outreach innovations in both Occupational Health Indicators and Oregon Fatality Assessment and Control Evaluation (FACE) projects. The overarching goal is to provide quality data and intervention recommendations to safety professionals who can take action to promote workplace safety and health. We propose an innovative overall strategy to: (1) Implement an expanded vision and strategic plan to advance occupational public health surveillance, research, and outreach in Oregon; (2) Support the success and growth of state-level occupational health initiatives and programs; (3) Invest in innovative areas for future occupational health surveillance research through speaker series and conference panels; and (4) Develop and implement surveillance and outreach innovations in OHI and OR-FACE sub-projects.

The purpose of the project is to build on the existing occupational health and safety surveillance program in Texas by making it more comprehensive. The Texas program surveillance system is intended to provide information essential to protecting workers by determining underlying causes of injuries and illnesses in the workplace, investigating workplace practices, directing intervention strategies, and evaluating the effectiveness of those strategies. Texas DSHS project objectives follow: Conduct population-based occupational health and safety surveillance for all occupational health indicators (OHIs) in order to estimate their magnitude and trends in Texas, as well as conduct more in-depth analyses of occupational health data; Explore new data sources to increase surveillance efforts, strengthen collaborations across agencies, departments, and with private and local partners, and augment outreach and prevention activities within Texas; and, Conduct in-depth investigation activities pertaining to the priority topic of acute occupational pesticide-related illness and injury in Texas. Expected outputs include surveillance research reports, peer and trade publications, education and training materials, OHI data sets for NIOSH and CSTE, and program capacity building.

The human and economic costs of occupational injury and illness (OII) in Washington State are unacceptable. In order to reduce the burden of OII, state occupational health programs need to bring together information from research findings, scientific literature, injury and illness data, worker and company activities, and industry practices to inform and educate stakeholders, government officials, and the general public to ensure evidence-based safety and health prevention programs and public policy. Washington’s OII surveillance program intends to provide timely relevant, accurate public health data and information to those who need to know. To accomplish these ends we propose the following:  1) Identify surveillance, research and prevention opportunities through advisory committee input, occupational injury and illness data, and emerging opportunities for safety and health action; 2) Implement a comprehensive state-based surveillance program addressing traumatic injuries, work-related musculoskeletal disorders, high risk industries for occupational injury and illness, occupational respiratory disease, and hazardous occupational exposures; 3) Develop and use additional data sources for novel approaches to OII surveillance, including the development of an annual measure of worker self-reported OII and continuing to maximize use of Washington’s unique workers compensation data for surveillance; 4) Influence public policy, the safety and health actions of others, and prevent workplace injury and illness through the use of state-based occupational injury and illness data, surveillance and research program outputs; and 5) Grow partnerships with our academic, state and federal partners to reduce OII. The expected outputs from all programs include peer-reviewed papers, state technical reports, enduring materials for prevention and education and news releases. The expected intermediate outcomes are distribution of our outputs by external organizations, use of our research findings to spur additional research, and use of our surveillance data to set standards and guide policy.

Since 2000, with support from National Institute for Occupational Safety and Health (NIOSH) grants, the Wisconsin Department of Health Services (DHS) Occupational Health (OH) Program has been working to collect, analyze and disseminate data on work-related illness, injury and deaths that occur in Wisconsin. Strong collaborations between the Wisconsin DHS OH Program and key stakeholders have already been established and we will continue to cultivate new partnerships to expand current surveillance and capacity. Wisconsin has had a long-term commitment.to extensive, ongoing, data collection systems and we will continue to use these currently existing resources as part of our occupational health surveillance system. Our goal is to continue occupational surveillance activities in order to further reduce injuries and illnesses suffered by Wisconsin workers. Proposed expansion activities for our program include addressing the utility of current data sources, exploring new ones, cultivating new partnerships, developing additional region-specific indicators, seeking new partners, enhancing current processes and conducting a focused  investigation of occupational injuries and illnesses to young workers under the age of 25. By developing and distributing information, we will increase awareness not only of occupational hazards and safety but also of our role in workplace health and safety. Finally, we will enlist current partners and utilize knowledge in order to encourage those new to public health to develop an awareness and understanding of occupational illness, injury and death as a public health issue. It is our aim to provide occupational health leadership in the state of Wisconsin and be a resource for information and interventions that will prevent workplace hazards from occurring.

• Surveillance Program DHHS (NIOSH) Publication No. 2017-164 pdf icon[PDF – 139 KB]
• Center for Workers’ Compensation Studies pdf icon[PDF – 128 KB]