SURVEILLANCE
Monitoring Fatal Injuries
NIOSH conducts Fatality Assessment and Control Evaluation (FACE) investigations to understand factors that contribute to or cause deaths from work injuries. During FY 1997, the FACE program conducted field investigations of work-related fatalities in three primary targeted areas: falls from elevations, machine-related injuries, and logging injuries. The goal of the NIOSH FACE program is to prevent fatal work injuries by identifying work situations at high risk for fatal injury and to formulate prevention strategies. During FY 1997, NIOSH conducted 20 FACE investigations in nine states (Indiana, Kentucky, North Carolina, New York, Pennsylvania, South Carolina, Texas, Virginia, West Virginia). Through scientific research and analyses, recommendations are developed based on FACE investigations to alert employers, workers, safety and health professionals, and other government agencies to potentially hazardous situations that could lead to fatal injury.
A second surveillance system, the National Traumatic Occupational Fatalities (NTOF) surveillance system, allows NIOSH to determine the causes and nature of workplace deaths occurring from traumatic injury. NTOF data analyzed in FY 1997 indicate that during the 14-year period from 1980 to 1993, 82,696 workers died as a result of injuries sustained at work, a reduction, over this time period, of 45% in the annual rate of work-related deaths.
NTOF data further indicate that for the most recent ten years of data, 1984-1993, the states with the greatest number (rather than rate) of fatal occupational injuries were California, Texas, Florida, Illinois, and Pennsylvania respectively. The states with the highest rates include: Alaska, Idaho, Montana, Mississippi, West Virginia, and Wyoming.
Workers Still at High Risk for Lead Exposures
Lead exposure has been recognized as an occupational problem since ancient times. Although there have been indications of a decreasing trend among adults since 1993, elevated blood lead levels (BLLs) continued to be a significant problem for workers in 1997. Elevated BLLs can cause anemia, nervous system, gastrointestinal, and reproductive disorders, and may also affect children and spouses if lead is carried home on clothing or other articles from the workplace. NIOSH directs the Adult Blood Lead Epidemiology and Surveillance (ABLES) Program as a means of identifying and preventing cases of elevated BLLs (those above 25 µg/dL).
In FY 1997, ABLES programs were operating in 27 States and an additional 10 States not involved with the ABLES program either had adult lead surveillance capability or were in the process of developing that capability. During 1996, 25 States reported 12,672 adults with blood lead levels equal to or greater than 25 µg/dL through this surveillance system. Of these individuals, 751 (5.9%) had BLLs above 50 µg/dL, the level at which OSHA requires medical removal from the workplace. Surveillance activities enable States to target intervention efforts to workplaces in need of control technology, education, or other intervention activities, including the prevention of take-home lead exposures to children and spouses.
Monitoring States for Worker Health and Safety
NIOSH supports a network of surveillance systems (referred to as SENSOR--Sentinel Event Notification for Occupational Risks) that are operated by thirteen state agencies across the country. Through cooperative agreements with NIOSH, these state agencies conduct surveillance of targeted occupational safety and health conditions and provide follow-up investigations, technical assistance, or intervention demonstrations at work sites where problems are identified. During FY 1997, NIOSH awarded $2.1 million to 13 States for surveillance of the following nine conditions: amputations, asthma, burns, carpal tunnel syndrome, dermatitis, injuries in children, noise-induced hearing loss, the health effects of pesticide exposure, and silicosis.
In FY 1997 SENSOR data on carbon monoxide (CO) poisonings resulted in the publication of a NIOSH CO Alert. The Alert, addressing CO poisonings from small gasoline-powered engines, was a collaborative effort of NIOSH, OSHA, USEPA, and the Consumer Product Safety Commission (CPSC).
Tracking Nonfatal Injuries in Hospital Emergency Rooms
Using the National Electronic Injury Surveillance System (NEISS), NIOSH collaborates with the Consumer Product Safety Commission to conduct national surveillance of nonfatal occupational injuries. This surveillance system provides national data for all nonfatal occupational injuries for workers treated in hospital emergency departments. NIOSH estimated that during the 2-year period, from October 1995 through September 1997, 6.7 million workers came to hospital emergency departments for medical care due to an occupational injury. According to a separate database, the National Hospital Ambulatory Medical Care Survey (NHAMCS) of 1996, it was estimated that 12% of all injury visits to hospital emergency departments were work-related. This is considered to be a conservative estimate, however, because the occupational status of more than one-quarter of the cases was unknown.
