NIOSH Respiratory Diseases Research Program

Preface

Executive Summary 

This evidence package presents documentation of the relevance and impact of the Respiratory Diseases Research Program (RDRP) of the National Institute for Occupational Safety and Health (NIOSH). It has been produced within the context of a wider review of NIOSH by the National Academies (NA). The focus of the NA review is to determine the relevance and impact of NIOSH programs to health and safety in the workplace. Reviews of each NIOSH program will be conducted by Evaluation Committees (EC) chosen for relevant expertise. The NA has also appointed a Framework Committee (FC) to specify the issues to be addressed in reviews. The FC has determined that reviews should address the following:

• Assessment of the relevance of the program’s activities to the improvement of occupational safety and health; and evaluation of the impact that NIOSH program's research has had in reducing illnesses and injuries. The EC will rate the performance of the program for relevance, as well as impact of the program in the workplace.  Impact may be assessed directly or, as necessary, using intermediate outcomes to estimate impact. Qualitative narrative evaluations may also be appropriate under certain circumstances.
• The EC will assess the NIOSH program’s targeting of new research areas and identifying emerging issues in occupational safety and health most relevant to future improvements in workplace protection.
• Evaluations will focus primarily on the period since the development of the National Occupational Research Agenda (NORA) in 1996.

In this document, we have tried to provide sufficient information for the EC to conduct its review. If the EC finds that additional information is needed, we will provide it. We look forward to working with the EC as it conducts this review.

The term “RDRP” will likely be unfamiliar even to EC members who are knowledgeable about NIOSH. Throughout this evidence package, the term “RDRP” will be used to describe the broad range of individuals and groups supported by NIOSH to do work that is relevant to occupational respiratory disease. This broad view of all respiratory diseases research supported by the institute is the one most relevant to the institute’s societal impact.

The first two chapters of the evidence package provide introductions to NIOSH and RDRP. The next four chapters are disease-focused and address interstitial lung diseases, airways diseases, respiratory malignancies, and infectious diseases. An exposure-focused chapter addresses nanotechnology research. Finally, five activity-focused chapters address some of the more prominent institute activities needed to reduce work-related respiratory diseases. These activities include surveillance, the Health Hazard Evaluation and Technical Assistance Program, emergency response and disaster preparedness, respirator policy, and sampling and analytical methods activities. A final chapter presents the RDRP vision for the future.

We have tried to minimize overlap in content between disease-focused and activity-focused chapters, but by necessity some does exist. Also, although this evidence package presents a large body of work, those who are familiar with NIOSH will no doubt recognize that it is not comprehensive. RDRP has pursued a vast array of activities and produced a vast array of outputs over the last 10 years. Instead of listing everything RDRP has done, we have tried instead to provide a range of examples that illustrate how RDRP has made a difference.

The reader will encounter the following elements in research chapters. Depending on the maturity and other characteristics of the area, not all sections will report all elements:

• Issue - describes the extent and severity of the problem
• Approach - the steps taken by RDRP to address the problem
• Outputs and Transfer - products of RDRP and the steps taken by NIOSH or others to implement changes leading to solution of the problem
• Intermediate Outcomes - evidence that steps have been taken to implement research results
• Progress Towards End Outcomes - evidence that implementation of research results is at least beginning to have an effect
• Outcomes – evidence that implementation of research results has had an effect
• What’s Ahead - the future course of RDRP in this area

The evidence package is accompanied by a large body of supporting evidence. This supporting evidence is largely in the form of appendix materials provided to members of the EC as electronic files on a portable USB drive. Additional types of supporting evidence include Web links and brief lists of reports of special interest.