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The authors ask you:
The goals of public occupational health surveillance are to collect, analyze, and interpret occupational health data to improve occupational health and safety. The National Occupational Mortality Surveillance II (NOMS II) system proposes to address the occupational surveillance information gap by using death certificate data to identify increased risks for acute and chronic disease and injury. NOMS II is based on death certificate data which includes coded usual industry and occupation, and will refine the existing analysis system by incorporating data from seven U.S. states for 2001-2006, 2008 and 2010. The NOMS II data system will have the flexibility to look at various categories of causes of death and categories of industries or occupations, and to examine all causes mentioned on death certificates. In addition, the system provides an economical data source that is readily available and that has relatively representative data. Reporting on national mortality for industry sectors will provide information to internal and external partners who use the information to set priorities.
In 2006 about 150 million U.S. workers were potentially exposed to injury- and illness-causing substances and situations in the workplace. Investigators often try to analyze mortality due to occupational disease and illness. Although various approaches exist for occupational health surveillance, there is no comprehensive system that can identify elevated mortality due to chronic disease. One way to document occupational sources of injury and illness is to identify occupations and industries associated with specific causes of death. The NOMS II project will allow national surveillance using death certificate records to identify potential occupational disease problems to target for research and intervention.
To identify elevated occupational mortality among workers, it is proposed to add 2000-2010 data to an existing 1984-1998 mortality database and statistically analyze mortality by industry and occupation for each of the eight NORA industry sectors for the current decade. NIOSH supports states in providing death certificate industry and occupation data in collaboration with the National Center for Health Statistics. The new NOMS II database will use updated methodology, including the Census 2000 and NAICS coding systems for industry and occupation, and the Tenth Revision of the International Classification of Disease (ICD), that took effect in 1999. The NOMS I project statistically analyzed mortality in 28 US states for the period 1984-1998 and resulted in the identification of elevated disease and injury mortality and high risk occupations; these findings were further evaluated in many follow-up studies described in published reports. Building on the NOMS I study design and methods, the proposed NOMS II project will evaluate mortality by industry and occupation for each of the eight NORA industry sectors for the period 2000-2010. Improvements in analyses and dissemination will include sector-specific multiple cause analyses of age-adjusted mortality for disease by usual occupations. The results of the project will include the identification of elevated mortality due to previously recognized causes or hazards as well as newly recognized risks for disease among workers whose lifetime or usual occupation was in one of the eight sectors. Besides data for 2003-2004 already on hand, this proposal would add data for 2001, 2006, 2008, and 2010 from seven states: Hawaii, Indiana, Kansas, Kentucky, Nevada, New Jersey, and West Virginia. It is estimated that about 3,000,000 deaths will be available for analysis by sector.
| NORA Industry Sectors |
|---|
| Agriculture, Forestry, and Fishing |
| Mining |
| Construction |
| Manufacturing |
| Wholesale and Retail Trade |
| Transportation, Warehousing, and Utilities |
| Services |
| Healthcare and Social Assistance |
An updated NOMS II surveillance system is needed by internal and external customers who analyze the occupational mortality data and use it to help set priorities. Investigators have used NOMS I data as the source for many conference presentations, posters, and publications, and will likely use NOMS II similarly in the future. NOMS data makes possible analyses for workers that are difficult to assemble into a study cohort, e.g. auto mechanics, farmers, or workers in particular geographic areas. Reports have used NOMS data to check for consistency across geographic areas, states, and race/gender groups; to generate hypotheses; to provide background information for more specific studies; and to monitor time trends. Investigators have linked NOMS mortality data to exposures using job exposure matrices, have generated rates for selected groups, and have identified candidate populations for health promotion programs. 122 publications have been produced from NOMS I. States currently coding are: Hawaii, Indiana, Kansas, Kentucky, Nebraska, Nevada, New Jersey, New Mexico, North Dakota, South Dakota, Utah, West Virginia.
Occupation- and industry-specific surveillance of injury and illness mortality is essential for surveillance of the workplace. NOMS II will address these surveillance needs. It allows quick analysis of death certificate-based occupational mortality data for in-home and external inquiries on specific mortality outcomes as they relate to occupation or industry. Although occupational injuries and illnesses have multiple potential causes, other features such as lifestyle and long latency periods make it difficult to establish that an outcome is work-related. A surveillance system for workrelated injury and illness mortality is helpful to inform decision-making on allocating public health resources to occupational health and safety research and intervention, and to prioritize, target and evaluate public health activity to investigate and reduce work-related injury and illness.
Sector specific reports from NOMS II will occur after consulting with sectors to ensure that requests for data will meet information needs. Additional funds will assist with the acquisition of more coding states, especially states with large minority populations or that provide better geographic representation. NOMS II data may also be used to help in the development of an automated industry and occupation coding system, which is another ongoing NIOSH project.
U.S. Bureau of the Census. 2000 Alphabetical Index of Industries and Occupations. See Internet site http://www.census.gov/hhes/www/ioindex/ioindex.html
U.S. Bureau of Labor Statistics, Bulletin 2307; and Employment and Earnings, monthly, January 2007 issue. See Internet site http://www.bls.gov/cps/home.htm
W.H.O. International Statistical Classification of Diseases and Health Related Problems (The) ICD-10 Second Edition. Geneva: World Health Organization,
The findings and conclusions in this poster are those of the author(s) and do not necessarily represent the views of the National Institute for Occupational Safety and Health. Citations to Web sites external to NIOSH do not constitute NIOSH endorsement of the sponsoring organizations or their programs or products. Furthermore, NIOSH is not responsible for the content of these Web sites.
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