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Program Description

NIOSH Total Worker Health™ Website

Total Worker Health™ integrates occupational safety and health protection with workplace policies, programs and practices that promote health and prevent disease to advance worker safety, health and well-being.

Today, emerging evidence recognizes that both work-related factors and health factors beyond the workplace jointly contribute to many safety and health problems that confront today’s workers and their families. Traditionally, workplace safety and health programs have been compartmentalized. Health protection programs have focused squarely on safety, reducing worker exposures to risk factors arising in the work environment itself. And most workplace health promotion programs have focused exclusively on lifestyle factors off-the-job that place workers at risk. A growing body of science supports the effectiveness of combining these efforts through workplace interventions that integrate health protection and health promotion programs.

In June 2011, NIOSH launched the Total Worker Health™ (TWH™) Program as an evolution of the NIOSH Steps to a Healthier U.S. Workforce and the NIOSH WorkLife Initiatives. The TWH™ Program supports the development and adoption of ground-breaking research and best practices of integrative approaches that address health risk from both the work environment (physical and organizational) and individual behavior. The original scientific rationale for expanding research on the benefits of integrated programs to improve worker health and workplace safety was published in a research compendium of three seminal papers on the science and practice of integrating health protection and health promotion, The NIOSH Total Worker Health™ Program: Seminal Research Papers 2012 .

The TWH™ Program includes an intramural component and an extramural component, comprised of four Centers of Excellence to Promote a Healthier Workforce . Both of these components conduct research on the integration of health protection and health promotion; communication of current knowledge, successful approaches, and challenges, and advocacy of the concepts and practices of total worker health to our partners and stakeholders.

In November 2012, further evidence was presented by the four NIOSH-funded Centers of Excellence to Promote a Healthier Workforce at the first Symposium on Total Worker Health™ sponsored by the University of Iowa's Healthier Workforce Center of Excellence .

The "Issues Relevant to Total Worker Health™" graphic below is an at-a-glance visual of issues relevant to integrating occupational safety and health protection with health promotion. The lists below are not meant to be exhaustive, but, rather they illustrate the breadth of issues related to work that has the potential to impact health and should be considered as strategies are developed for the integration of health protection and health promotion activities.

*Issues in these lists are for illustrative purposes, are not meant to be exhaustive nor do they necessarily reflect equivalent importance.

†Health Insurance Portability and Accountability Act

Updated: August 2013

Interventions consistent with TWH™ include but are not limited to:

  • Provision of mandated respiratory protection programs that simultaneously and comprehensively address and provide supports for tobacco cessation.
  • Integrated ergonomic consultations that also discuss joint health, arthritis prevention, and management strategies.
  • Regularly scheduled, joint meetings of safety, occupational health and health promotion leadership and staff to include combining the functions of safety, health, and/or sustainability committees into one entity, either intermittently or permanently.
  • Development of stress management efforts that first seek to diminish workplace stressors, and only then work on building worker resiliency.
  • Implementation of training and prevention programs that counter hazards and risks faced by workers both on and off the job. Topics could include falls prevention, motor vehicle safety, first aid, hearing conservation, stretching/flexibility, back safety/lifting safety, eye protection, safer work with chemicals, and weight management.
  • Provision of onsite, comprehensive workplace screenings for work and non-work related health risks.
  • Exploration of models that combine occupational health services with workplace primary care.
  • Full integration of: traditional safety programs, occupational health clinics, behavioral health, health promotion programs, coaching, Employee Assistance Programs (EAP), nutrition, disability and workers compensation through strategic alignment, joint reporting structures or common funding streams.


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  • Page last reviewed: April 16, 2013
  • Page last updated: July 17, 2015 The U.S. Government's Official Web PortalDepartment of Health and Human Services
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