In This Issue
- Director’s Desk
- NIOSH-Morgantown Hosts Department of Labor Announcement
- NIOSH Announces Free Screenings for Coal Workers’ Pneumoconiosis for Coal Miners
- NIOSH Funding Opps
- Morbidity and Mortality Weekly Report: Workers Memorial Day, April 28
- New NIOSH Topic Page Promotes Healthy Aging
- Remembrance Quilt Unveiling
- NIOSH Releases New Web Page for Poultry Processing Workers
- International Publication, The Economist, Features NIOSH Research
- Center for Motor Vehicle Safety Launches Strategic Plan
- NIOSH Congratulates…
- Face Reports
- Fire Fighter Fatality Investigation Program Reports
- News From Our Partners
- r2p Corner
- Health Hazard Evaluations (HHE)
- New on the NIOSH Science Blog
- Federal Register Notices
- New Communication Products
- Call for Abstracts and Presentations
- Upcoming Conferences & Workshops
- Did you know?
Volume 12 Number 1 May 2014
From the Director’s Desk
John Howard, M.D.
Annual Scientific Award Ceremony Honors NIOSH Researchers
On May 1, observing a tradition that began in 1988, NIOSH held its annual Scientific Awards Ceremony to honor our researchers for excellence in science. This year I presented the awards live from our Pittsburgh location. The awards presented included the Alice Hamilton Award, for scientific excellence of technical and instructional materials by NIOSH scientists and engineers; the James P. Keogh Award, for outstanding service by a current or former NIOSH employee; and the Bullard-Sherwood Research-to-Practice Award, for exceptional efforts by NIOSH researchers and partners in applying occupational safety and health research to the prevention of workplace fatalities, illnesses, or injuries. In addition, the Director’s Award for Extraordinary Intramural Science was also presented.
Named after Dr. Alice Hamilton, a pioneering researcher and occupational physician, the Alice Hamilton Award is given for outstanding NIOSH contributions in the areas of biological sciences, engineering and physical sciences, human studies, and educational materials. The submissions go through a rigorous review by panels of scientific experts, including peers from both outside and inside NIOSH. The awardees for 2014 have contributed to an array of sectors, highlighting the broad range of occupational safety and health. This year’s awardees have contributed to the fields of workplace violence prevention, ladder safety, taxicab security, occupational exposures to respirable crystalline silica, and nanotechnology.
The James P. Keogh Award for Outstanding Service in Occupational Safety and Health recognizes a current or former employee of NIOSH whose career “exhibits respect and compassion for individual workers, with tireless leadership, courage, and a fierce determination to put knowledge into practice to enhance their well-being.” For 2014, NIOSH honored Dr. Albert E. Munson, a pioneer in toxicology, one of the founding fathers of immunotoxicology, and the first director of NIOSH’s Health Effects Laboratory Division, which has grown into an organization of over 200 staff dedicated to interpreting the causes and mechanisms of occupational disease. Dr. Munson contributed to the science that supported a clean and safe environment under the Clean Water Act and Superfund. He developed standard approaches to assessing the adverse effects of chemicals on the immune system, and served on eminent expert panels that produced authoritative scientific reports on immunotoxicology and the effects of dioxin. Dr. Munson is also a leader in nurturing new generations of young scientists. At NIOSH, he has set a high standard in training and encouraging talented students and post-doctoral fellows.
The Bullard-Sherwood Research-to-Practice Award—named for Edward W. Bullard, the inventor of the hard hat, and R. Jeremy Sherwood, the inventor of the personal industrial hygiene sampling pump—recognizes recipients for outstanding contributions in three categories: Knowledge, Interventions, and Technology. This year, the awards went to
- a project that used 3-D body scans to update specifications for seat belts, fire truck cabs, and personal protective equipment to better fit today’s firefighters;
- research that examined the potentially explosive environment of underground coal mines and lithium battery safety;
- and an innovative ladder app that provides employers and workers with a convenient, real-time tool for positioning ladders safely and preventing serious falls on the job.
The awards were presented by Jed Bullard, grandson of Edward W. Bullard.
The Director’s Award for Extraordinary Intramural Science recognizes outstanding collective contributions to science excellence at NIOSH by individual intramural scientists and support staff. The award in the category of Distinguished Career Scientist was presented to Mark Stephenson, senior research audiologist in the Division of Applied Research and Technology and the coordinator of the NIOSH Hearing Loss Prevention Program. Dr. Stephenson is a recognized leader in work-related hearing loss. In his capacity at NIOSH, Dr. Stephenson was one of the first practitioners to apply health communication theory to hearing conservation. He spearheaded the development of two NIOSH numbered publications that continue to serve as standard references in hearing conservation. In recognition of Dr. Stephenson’s leadership, the American Academy of Audiology has asked Dr. Stephenson to develop recommendations to update audiometric monitoring procedures for the first time in more than 50 years.
The award in the category of Early Career Scientist was presented to Mike Flynn, social scientist in the Education and Information Division. Mr. Flynn is a leader in innovative research that seeks to improve the occupational health of immigrant workers, a growing segment of the U.S. workforce. He serves as the NIOSH assistant coordinator for the Priority Populations and Health Disparities Program, the principle investigator for several major field studies, and a member of the National Advisory Committee for the Ventanillas de Salud health promotion program operating in Mexican consulates across the United States. His research and participation recognizes the role of work as a critical health determinant for Mexican workers and their families in the United States and incorporates that dimension into effective strategies for preventive care. Mr. Flynn is co-editor of a forthcoming book from the American Psychological Association on research needs and directions for addressing occupational health disparities. He has widely presented at professional meetings and published numerous journal articles and book chapters in this area of research and outreach and is increasingly recognized as a leader in research translation.
Congratulations once again to our NIOSH researchers and award recipients. I am honored to work alongside such men and women.
For a full list of all awards and award recipients, please visit /niosh/awards/.
NIOSH-Morgantown Hosts Department of Labor Announcement
On April 23, the NIOSH Morgantown Facility hosted U.S. Secretary of Labor Thomas E. Perez, Assistant Secretary of Labor for Mine Safety and Health Joseph A. Main, Senator Jay Rockefeller (D-WV), and other distinguished visitors as the U.S. Department of Labor announced a final rule to lower miners’ exposure to respirable coal mine dust in all underground and surface coal mines. Learn more on the U.S. Department of Labor web page at http://www.dol.gov/opa/media/press/msha/MSHA20140669.htmExternal.
NIOSH Announces Free Screenings for Coal Workers’ Pneumoconiosis for Coal Miners
Beginning in April, NIOSH will offer a series of free, confidential health screenings to coal miners throughout Oklahoma, Louisiana, Texas, New Mexico, Arizona, Southern Utah, and Southern Colorado. The screenings are intended to provide early detection of coal workers’ pneumoconiosis, also known as black lung, a serious but preventable occupational lung disease in coal miners caused by breathing respirable coal mine dust. Learn more at /niosh/updates/upd-04-07-14.html.
NIOSH Funding Opps
The NIOSH Office of Mine Safety and Health Research has three funding opportunities currently available: two broad agency announcements (BAA) and a request for proposals (RFP).
- BAA: Development and Demonstration of Robotics Technologies and Systems to Support Self-Escape or Rescue Efforts
- BAA: Mine Ventilation and Safety Research and Capacity Building
- RFP: Mining Industry Surveillance System
Learn more at /niosh/mining/omshr4u/fundingseekers.html.
Morbidity and Mortality Weekly Report: Workers Memorial Day, April 28
Each year, NIOSH collaborates with the staff of CDC’s Mortality and Morbidity Weekly Report (MMWR) to publish the most recent annual statistics, NIOSH analyses of occupational illness and injuries, and investigations of occupational hazards. For a summary of the key findings from this year’s Workers Memorial Day issue of the MMWR, go to http://blogs.cdc.gov/niosh-science-blog/2014/04/25/mmwr-wmd2014/.
New NIOSH Topic Page Promotes Healthy Aging
NIOSH recently released a new topic page that offers a worker-focused perspective on health and safety and chronic disease issues related to aging. This is one of the first NIOSH topic pages to co-align with the existing Total Worker HealthTM webpage. Read more at /niosh/updates/upd-04-01-14.html.
Remembrance Quilt Unveiling
On April 8, NIOSH Director John Howard, M.D., attended the unveiling of a Remembrance Quilt, currently exhibited in the Russell Senate Office building in Washington, DC. Sponsored by the organization Cold War Patriots, the handcrafted quilt was created in the image of the American flag to honor the thousands of workers who served this nation by building its nuclear defense programs. The ceremony was attended by several other federal agency representatives who carry out duties under the Energy Employees Occupational Illness Compensation Program Act, alongside Senator Mark Udall (D-CO), who spoke in support of worker’s families.
NIOSH Releases New Web Page for Poultry Processing Workers
A new topic page focused on NIOSH research and recommendations to prevent work-related injury and illness among poultry processing workers is now available. The page provides resources to help employers and workers identify risk factors and take effective measures to prevent work-related injuries and illnesses in poultry processing. To view the new page, visit /niosh/topics/poultry/.
International Publication, The Economist, Features NIOSH Research
Research by Dr. Robert Park of NIOSH is cited prominently in an article in the April 26 edition of The Economist. The article reports on current scientific evidence suggesting a link between occupational exposure to manganese at levels below current permissible limits, and risk for Parkinson’s-like nervous system impairments. Risks presented by manganese in welding fumes are the focus of a current NIOSH scientific investigation. Read The Economist article at http://www.economist.com/news/science-and-technology/21601233-exploring-link-between-manganese-and-parkinsons-disease-subtle-effectsExternal or the full research review article at http://dx.doi.org/10.1016/j.shaw.2013.07.003External.
Center for Motor Vehicle Safety Launches Strategic Plan
On May 1, NIOSH released the strategic plan for its Center for Motor Vehicle Safety, a blueprint for paving the way to reduce the burden of work-related crashes. The Strategic Plan for Research and Prevention, 2014–2018 describes the vision, mission, and scope for the NIOSH Center for Motor Vehicle Safety, placing the Center’s work in the context of complementary work of other U.S. federal agencies, non-governmental organizations, and international partners. Read more at /niosh/updates/upd-05-01-14.html.
Cincinnati Federal Executive Board Recognizes NIOSH Researcher
Every year the Cincinnati Federal Executive Board (FEB) recognizes the hard work of public service employees. This year NIOSH researcher Scott Dotson was recognized as the winner of the Professional/Scientific Award at the FEB Recognition of Federal Excellence Awards Program. Congratulations to Scott and to all the NIOSH employees who were nominated for these awards.
Researchers Win Best Aerosol-related Paper Award
On March 24, NIOSH researchers John Snawder, Mike Breitenstein, Eric Esswein, Max Kiefer, and William Sieber were informed that their paper, “Occupational Exposures to Respirable Crystalline Silica During Hydraulic Fracturing,” published in the Journal of Occupational and Environmental Health, won the American Industrial Hygiene Association’s (AIHA) Aerosol Technology Committee’s David L. Swift Award for best aerosol-related paper published in 2013. The award will be presented at AIHA’s annual conference in June. The full article is available at http://dx.doi.org/10.1080/15459624.2013.788352External.
NIOSH Researcher Receives SOT Award for Best Paper
At the annual meeting of the Society of Toxicology, John Snawder of NIOSH and coauthors from the U.S. Environmental Protection Agency and the University of Cincinnati were notified that their paper titled “Application of an Updated Physiologically Based Pharmacokinetic Model for Chloroform to Evaluate CYP2E1-mediated Renal Toxicity in Rats and Mice” was awarded Best Paper of 2013 by the Society of Toxicology Risk Assessment Specialty Section. The full article is available at http://dx.doi.org/10.1093/toxsci/kfs320External.
Reducing Injuries from Nail Guns
Reducing injuries from nail guns is a goal of the NORA Construction Sector Council to reduce “struck by” injuries. Nail guns are a leading cause of injury among residential carpenters and responsible for an estimated 37,000 emergency room visits each year, of which 60% are occupationally related. NIOSH researchers have developed nail gun safety recommendations to prevent the hazards. A new NIOSH topic page (/niosh/topics/nailgun/) highlights the extent of the problem, discusses what can be done to prevent the injuries, and provides links to recent key NIOSH publications (such as Straight Talk About Nail Gun Safety and Nail Gun Safety: A Guide for Construction Contractors) and journal articles on the subject.
Pipefitter Dies When Excavation Wall Collapses, Causing Water Tank to Rotate and Pin Him Against Excavation Wall—Michigan
Land Owner Pinned by Tractor Bucket When Working in Ditch—Michigan
Handyman Died When Tree He Was Felling Split Vertically and Struck Him—Michigan
Farm Laborer Died When Struck By Front End Loader Bucket—Michigan
Day Care Monitor Dies After Crash of 15-Passenger Van—Kentucky
A Tree Trimmer Dies from Asphyxia When Compressed by Palm Fronds—California
A Tree Trimmer Dies When He Falls From a Tree—California
A Day Laborer Dies When He is Pinned Between a Loading Dock and a Backing Truck—California
Arborist Dies in Fall from a Tree after Being Hoisted by a Crane to the Tree—Massachusetts
Two Laborers Die from Hydrogen Sulfide Exposure in a Confined Space at an Organic Waste Recycling Facility—California
Orchard Tractor Operator Dies When Run Over by Trailer-mounted Water Tank Towed by Tractor—Washington
Roofing Contractor Falls 35 Feet from Roof—Washington
Orchard Tractor Operator Run Over by Trailer-mounted Water Tank—Washington
Temporary Worker Died While Cleaning a Double Auger Screw Conveyor Machine—Massachusetts
Painter/Rigger Falls 200 Feet from Bridge into River—Washington
Fire Fighter Fatality Investigation Program Reports
Volunteer Fire Fighter Electrocuted by Downed Power Line Following Severe Weather—North Carolina
An energized power line contacting a metal building, pooling water and runoff from a recent rain storm, not wearing any personal protective clothing or non-conductive boots, the lack of situational awareness and not recognizing electrical hazards, and the lack of other first responders in the area at the time of the incident were some of the factors that led to the death of the fire fighter. /niosh/fire/pdfs/face201319.pdfCdc-pdf
Volunteer Lieutenant Suffers Sudden Cardiac Death at Fire Station While Doing Fitness Training—New York
The lack of an annual medical evaluation consistent with NFPA 1582 (Standard on Comprehensive Occupational Medical Program for Fire Departments), not ensuring fire fighters are cleared for duty by a physician knowledgeable of the physical demands and personal protective equipment of firefighting, the lack of an annual physical ability evaluation, and not having mandatory comprehensive wellness and fitness programs were some of the factors that led to the death of the fire fighter. /niosh/fire/reports/face201328.html
News from Our Partners
Minnesota Adds Occupational Health Indicator for Work-related Low Back Disorder Hospitalizations
The Minnesota Department of Health’s Occupational Health and Safety Surveillance Program has posted on its web site an additional occupational health indicator (OHI) for hospitalizations for work-related low back disorders. Data are available for the years 2000–2011. The OHIs, developed and pilot-tested by NIOSH and the Council of State and Territorial Epidemiologists, represent measures of the occupational health status of a state’s population that can be used to monitor trends and prioritize prevention efforts. All 20 Minnesota OHIs can be found at http://www.health.state.mn.us/occhealthExternal .
North Carolina Occupational Health Surveillance to Tackle CO Poisoning of Workers in the Agricultural Industry
The Occupational Health Surveillance Program (OHSP) of the North Carolina Division of Public Health, Occupational Environmental Epidemiology Branch, in collaboration with East Carolina University’s Agromedicine Institute, are working to address the hazard of carbon monoxide (CO) poisoning of farm workers throughout the state of North Carolina. North Carolina possesses a very robust agricultural economy, which results in many workers being engaged in crop production, the state program said. Concerns over prevention of future accidents prompted OHSP to raise awareness in the agricultural community about CO poisoning prevention. OHSP has developed educational materials—an online factsheet, a radio public service announcement, and a video posted on YouTube—for distribution to farm operators and workers in early to mid-June. These materials will be posted at http://epi.publichealth.nc.govExternal.
National Safety Council Celebrates 100 Years
As part of the National Safety Council’s 100 year anniversary celebration, theorganization has developed a special issue of the Journal of Safety Research showcasing a sample of research that has made an impact in the safety arena since the journal’s inception in 1969. Articles in the special issue include successful occupational safety programs and committees, among other accomplishments. To view the issue, go to http://www.journals.elsevier.com/journal-of-safety-research/virtual-special-issues/100th-anniversary-of-the-national-safety-council/External. The issue will be available through September 2014.
OSHA Seeks Nominations for Two Committees
The Occupational Safety and Health Administration (OSHA) is accepting nominations for members to serve on the Whistleblower Protection Advisory Committee. OSHA seeks to fill 12 committee positions that will become vacant January 1, 2015. See the Federal Register notice for submission details at http://www.gpo.gov/fdsys/pkg/FR-2014-03-13/html/2014-05438.htmExternal. Nominations must be submitted by May 12.
OSHA is also accepting nominations for members to serve on the National Advisory Committee on Occupational Safety and Health. OSHA seeks to fill all 12 committee positions, which consist of four public representatives and two representatives each for labor, management, and professionals in occupational safety and in occupational health. See the Federal Register notice for submission details (http://www.gpo.gov/fdsys/pkg/FR-2014-03-26/html/2014-06696.htmExternal). Nominations must be submitted by May 27.
Save the Date! Graduate Summer Institute in Environmental Health Sciences at Johns Hopkins School of Public Heath
The Department of Environmental Health Sciences at Johns Hopkins School of Public Health will be hosting a 2-week Summer Institute from June 9–21. Nine full courses and three 1-day short courses will be offered over the 2-week period. Courses are designed for practicing public health professionals with responsibilities for health, safety, and environmental matters in government agencies, non-government organizations, and industry and for students who are interested in learning more about environmental health sciences concepts. For more information go to http://www.jhsph.edu/departments/environmental-health-sciences/summer-institute/External.
UC Davis Study Finds Significant Federal Undercounting of Ag Injuries, Illnesses
Federal agencies responsible for tracking workplace hazards fail to report 77 percent of the injuries and illnesses of U.S. agricultural workers and farmers, new research from the University of California at Davis has found. The lack of complete data greatly reduces the chances that safety and health risks for the nation’s food suppliers will be corrected, the researchers said. An abstract of the study, which was funded by NIOSH, can be found at http://www.annalsofepidemiology.org/article/S1047-2797(14)00012-X/abstractExternal.
NIOSH and OSHA Sign Partnership Agreement
On April 22, NIOSH and the Occupational Safety and Health Administration (OSHA) signed a memorandum of understanding that formalizes their collaborative partnership to improve occupational safety and health conditions throughout the United States. Their collaboration will seek to further strengthen their partnership to advance the protection of workers and promote best practices using effective prevention strategies and technologies. For more information, contact Frank Hearl at (202) 245-0652 or FHearl@cdc.gov.
Health Hazard Evaluation (HHE) Program Update
Exposures of Helicopter Pilots and Gunners to Firearm Noise and Lead During Gunnery Target Training Exercises
The HHE Program received a request for technical assistance concerning helicopter crews’ exposures to gunshot noise and lead during airborne offshore and ground range gunnery training exercises. The helicopter crews assist in intercepting and disabling drug- and contraband-running watercraft. NIOSH investigators found that helicopter pilots and gunners were exposed to loud noise during gunnery target training; peak noise levels corresponded to levels that can damage hearing. Airborne lead exposures were below occupational exposure limits, but surface lead was found inside helicopter cabins. HHE Program investigators recommended
- Installing a partial noise barrier in the helicopters between the pilots and gunner
- Continuing to require double hearing protection for everyone in the helicopter cabin when they shoot weapons
- Cleaning the inside of the helicopter cabins to help remove surface lead accumulation
A link to this final report is available at /niosh/hhe/whats_new.html.
Evaluation of Chemotherapy Drug Exposure in an Outpatient Infusion Center
The HHE Program was asked by managers of a regional hospital to evaluate health symptoms among outpatient cancer and infusion center employees working with or around chemotherapy drugs. Although the investigation could not definitively link employee symptoms to chemotherapy drug exposures, many were consistent with what is reported in the literature and in other settings where chemotherapy drugs are handled. HHE Program investigators recommended
- Requiring employees to wear chemotherapy gowns and gloves whenever handling chemotherapy drugs
- Updating procedures for handling hazardous drugs safely
- Starting a medical surveillance program for employees who handle chemotherapy drugs
A link to this final report is available at /niosh/hhe/whats_new.html.
What’s New on the NIOSH Science Blog? Join the Discussion Today!
- Do We Need to Challenge Respirator Filters with Biological Aerosols?
- So How Accurate Are These Smartphone Sound Measurement Apps?
- Occupations with High Obesity Prevalence in Washington State
- The History and Future of NIOSH Morgantown
- Semi-autonomous Motor Vehicles: What Are the Implications for Work-related Road Safety? http://blogs.cdc.gov/niosh-science-blog/2014/04/22/semi-autonomous-vehicles/
- Coccidioidomycosis: An Enduring Work-related Disease http://blogs.cdc.gov/niosh-science-blog/2014/04/23/coccidioidomycosis/
- Workers Memorial Day 2014 http://blogs.cdc.gov/niosh-science-blog/2014/04/24/wmd-2014/
- Morbidity and Mortality Weekly Report: Workers’ Memorial Day, April 28, 2014 http://blogs.cdc.gov/niosh-science-blog/2014/04/25/mmwr-wmd2014/
Federal Register Notices of Public Meetings and Public Comment
Respiratory Protective Devices 42 CFR Part 84—Revision
The notice was posted on April 7. Written comments should be received within 60 days.
Health Hazard Evaluation and Technical Assistance Requests and Emerging Problems—Revision
The notice was posted on April 8. Written comments should be received within 60 days.
Application of a Web-based Health Survey Tool in Schools—New
The notice was posted on April 11. Written comments should be received within 30 days.
NIOSH Manual of Analytical Methods (NMAM) Entitled: Method 8324:3—Bromopropionic acid in urine; a metabolite of 1-bromopropane—Draft Document
The notice was posted on April 11. Comments must be received by June 10.
For a listing of NIOSH official publications for rules, proposed rules, and notices, go to www.cdc.gov/niosh/fedreg.html.
New NIOSH Communication Products
- Bibliography of Communication and Research Products
- Preventing Deaths and Injuries to Fire Fighters by Establishing Collapse Zones at Structure Fires
- NIOSH Center for Motor Vehicle Safety: Strategic Plan for Research and Prevention, 2014–2018
Presentations and Abstracts
American Association of Textile Chemists and Colorists
Oral presentations must be submitted by July 21. Poster presentations must be submitted by November 7. http://www.aatcc.org/ic/gen_info2015.cfmExternal
FDIC International 2015
Presentations must be submitted by June 30. http://s36.a2zinc.net/clients/pennwell/FDIC2015/Public/Content.aspx?ID=42695External
Upcoming Conferences and Workshops
May 31–June 5, San Antonio, TX
Safety 2014 ASSE Professional Development Conference & Exposition
June 8–11, Orlando, FL
2014 NFPA Conference and Expo
June 9–12, Las Vegas, NV
7th International Conference on Environmental Science and Technology 2014
June 9–13, Houston, TX
23rd Annual Social Marketing Conference
June 20–21, Clearwater, FL
International Society for Agricultural Safety and Health 2014 Annual Conference: Cultivating Ag Safety and Health
June 22–26, Omaha, NE
8th Annual National Conference on Health Communication, Marketing and Media
August 19–21, Atlanta, GA
1stInternational Conference Work and Spirituality
September 9–11, Lausanne, Switzerland
2014 National Safety Council Congress & Expo
September 13–19, San Diego, CA
National Symposium to Advance Total Worker HealthTM
October 6–8, Bethesda, MD
24th Annual Meeting of the International Society of Exposure Science
October 12–16, Cincinnati, OH
62nd International Association of Emergency Managers Annual Conference
November 14–19, San Antonio, TX
American Association of Textile Chemists and Colorists
March 24–26, 2015, Savannah, GA
FDIC 2015 Conference
April 20–25, 2015, Indianapolis, IN
A comprehensive list of upcoming conferences can be found at www.cdc.gov/niosh/exhibits.html.
Did You Know?
Did you know that April 28 was Workers Memorial Day? Every year on April 28, NIOSH and the nation observe Workers Memorial Day to honor men and women who have suffered job-related injury, illness, and death, and to renew our efforts for safe workplaces. To read a statement from NIOSH Director John Howard, M.D., for Workers Memorial Day, go to /niosh/updates/upd-04-24-14.html. To learn more about Workers Memorial Day, go to http://www.aflcio.org/Issues/Job-Safety/WorkersMemorialDayExternal.
Please send your comments and suggestions to us by visiting /niosh/contact/.
This newsletter is published monthly via email by the National Institute for Occupational Safety and Health to inform members of the public health community as well as interested members of the general public of Institute-related news, new publications, and updates on existing programs and initiatives.