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Volume 17, Number 6 (October 2019)

From the Director’s Desk

John Howard, M.D.
Director, NIOSH

Not All Heroes Wear Capes

In 1999, organizations around the world started observing October as Health Literacy Month, a time focused on creating awareness about the importance of using plain language to make health and safety information understandable. This year marks the 20th anniversary of this very important observance that continues to support the theme: “Be a Health Literacy Hero.”

A brief history of how health literacy and plain language got started

  • 1974: The very first mention of the term “health literacy” was in a Health Education as Social Policy monograph by SK Simonds.
  • 1978: Leonard and Cecile Doak, often credited as the founders of health literacy, started studying hospitalized patients.
  • 1985: The Doaks, along with Jane Root, published the classic book on health literacy—Teaching Patients with Low Literacy Skills.
  • 1990s: A number of organizations and individuals from various fields and disciplines started to get involved with health literacy-related issues and initiatives.
  • 2004: The Institute of Medicine published Health Literacy: A Prescription to End Confusion, which received much attention.
  • 2010: The Plain Writing Act was enacted, requiring federal agencies provide clear communication that the public can understand and use. This act defines clear communication or plain language as “Writing that is clear, concise, well-organized, and follows other best practices appropriate to the subject or field and intended audience.”
  • Today: A number of research articles, programs, and tools are available. Additionally, health literacy is a worldwide effort. 

How NIOSH champions plain language

In 2018, NIOSH gave its first Plain Language award to recognize various types of NIOSH communication products that demonstrate excellence in applying plain language principles. Learn more about the award and the 2018 and 2019 winners.

NIOSH also encourages plain language in all of its communication products. To do this, NIOSH scientists and health communicators are encouraged to

  • Attend CDC health literacy and plain language training courses.
  • Use the Clear Communication Index—a research-based tool that helps develop and assess communication materials for the intended audience.
  • Test products with the intended target audience before publication.
  • Submit communication products for the awards that recognize use of plain language principles.

Be a health literacy hero!

Here are a few ways you can make your health and safety information understandable:

We know that whether it is communicating to workers about the importance of wearing personal protective equipment or getting a manufacturer to adopt changes to equipment, plain language plays a role in not only making information understandable, but potentially prompting action. Using plain language is critical to our mission to keep workers safe and healthy.

Research Rounds
Inside NIOSH:
Understanding Injuries to Law Enforcement Officers Is the First Step to Prevention

Law enforcement officers (LEOs) put themselves at risk while working to protect the public. An ongoing NIOSH study is trying to understand how these on-duty injuries occur and how to prevent them, so that LEOs can do their jobs safely.

Previously, NIOSH reported that the rate of nonfatal injury from on-duty assaults had increased among LEOs. In that study—the first national investigation of nonfatal duty-related injuries among LEOs—assault and other violent acts emerged as the leading cause of on-duty injury from 2003 through 2014.

We do not know how many officers get injured on duty each year or how these injuries impact them and their agencies. As community demand for law enforcement services grows and agencies struggle to recruit new officers, keeping current officers safe and healthy is a priority. NIOSH investigators are interviewing LEOs receiving treatment for on-duty injuries in hospital emergency departments across the nation. During these telephone interviews, investigators are asking about the type of injury, the officers’ activities at the time of injury, and the recovery experience. In addition, the telephone interviews include questions about the injured officers’ work experience.

Sharing information about on-duty injuries will help to prevent injuries and inform prevention efforts. All information obtained during the interviews is strictly confidential. Study results will be published in a combined form without personal identifiers, such as officer name or agency information. For more information about the study, please contact Hope Tiesman, study project officer, at

More information is available:

Outside NIOSH:
Work Across Disciplines Common in Occupational Safety and Health

Many occupational safety and health professionals perform tasks outside of their main area of expertise, according to a recent survey on their continuing education needs published in the American Journal of Industrial Hygiene.

The survey built on the 2011 National Assessment of the Occupational Safety and Health Workforce, also called the Westat report, which had similar findings. In 2017, investigators at the NIOSH Education and Research Centers identified new workforce training needs and interests since the 2011 Westat report. They developed a 27-question survey that included similar questions to the Westat report, addressing newer safety and health topics emerging within the last decade. These topics included work across disciplines, or work both within a primary profession and outside of it, and Total Worker Health®, which comprises policies and practices that protect workers and promote health and safety. The survey also asked about preferences for training topics in continuing education.

The investigators distributed the online survey to occupational safety and health and allied, or related, professions across the United States and received 2,064 responses. Most of the respondents worked in private industry and were 50 years of age or older. Their primary professions included safety (28%), occupational health nursing (18%), and industrial hygiene (12%). However, nearly two thirds of respondents reported additional responsibilities in other occupational safety and health-related areas, such as workplace design, or ergonomics, and wellness. Survey respondents expressed the greatest interest in continuing education related to injury prevention, occupational stress, exposure assessment, and safety culture. These survey findings show that interdisciplinary work or work across disciplines continues to grow in occupational safety and health and underscore the need for cross-training in the field.

More information is available:

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NIOSH eNews is Brought to You By:

John Howard, M.D., Director
Christina Spring, Editor in Chief

Managing Editor
Tanya Headley

Section Editors
Anne Blank, Research Rounds
Kiana Harper, Monthly Features

Contributing Editors
Sarah Mitchell
Donjanea Williams

Copy Editor
Cheryl Hamilton

Technical Support
Steve Leonard, Technical Lead
Tonya White, Web Developer

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New NIOSH Virtual Tool Kit to Help First Responders Work Safely Around Illicit Drugs
NIOSH has released a virtual tool kit for First Responders on how to protect themselves from exposure to illicit drugs. The tool kit includes short training videos and sharable infographics that cover protection when illicit drugs may be present and when they are present, what PPE to wear, and how to decontaminate themselves and their equipment. Other resources based on key points from NIOSH recommendations are also included in the virtual took kit. 

New NIOSH Webpage on Suicide and Occupation
NIOSH recently published a webpage on Suicide and Occupation. This page identifies information we know about the suicide problem, factors that are linked to increased risk of suicide among occupations, ways to prevent suicide in the workplace, and a host of other resources.

Feedback Wanted on the 5th Edition of NMAM
The editors of NIOSH Manual of Analytical Methods (NMAM) are collecting feedback about the current edition of NMAM to learn more about how customers use analytical methods in their work and how they use NMAM. Survey results will be used to help focus future method development activities, improve NMAM methods, and identify website content or features in need of improvement. The survey is anonymous, and no individually identifiable data will be collected, published, or released. If you are an NMAM user, we invite you to complete the NMAM Customer Satisfaction Surveyexternal icon. Thank you for your time and your feedback.

NIOSH Center for Motor Vehicle Safety Evaluation 2014–2018
Motor vehicle crashes are the leading cause of work-related deaths in the United States. Since 2014, NIOSH’s Center for Motor Vehicle Safety (CMVS) has followed a 5-year strategic plan for research and prevention, covering all workers who drive on the job. In this new report we evaluated progress toward our strategic goals from 2014 through 2018. Read the Evaluation Report, Performance Measures, and Impact Stories from the five priority worker groups.

NIOSH Announces Recipients of Commercial Fishing Safety Research and Training Grants
NIOSH and the U.S. Coast Guard are pleased to announce the recipients of the 2019 Commercial Fishing Occupational Safety Research Cooperative Agreement and Training Project Grant Program. This year’s program made nine awards totaling $5.25 million. These awards support critical research and training projects to improve the occupational safety of workers in the high-risk commercial fishing industry. The 2019 awards mark the first time the Commercial Fishing Occupational Safety Research Cooperative Agreements and Training Project Grants have been available—a second round of funding is planned for 2020.

Monthly Features

New Communication Products & Reports

FACE Reports

Fact Sheets

Fire Fighter Fatality Investigation and Prevention Program Report

Health Hazard Evaluation Reports


Program Performance One-Pagers (PPOPs)



National Occupational Research Agenda (NORA)

Faces of Work-related Chronic Obstructive Pulmonary Disorder (COPD) Videos Now Available in Spanish
The Faces of Work-related COPD is a video series originally released in English that is now also available in Spanish. The series consists of four short videos that include a physician explaining what COPD is. Also included are interviews with patients diagnosed with work-related COPD who discuss work exposures, their quality of life having the disease, and ways to minimize the risks of getting the disease. This series is part of a NORA Respiratory Health Cross-Sector Council initiative.

Upcoming NORA Construction Sector Council Meeting
The NORA Construction Sector Council meeting is scheduled for November 20–21 in Washington D.C. The Council has three active working groups that are addressing falls, struck-by incidents, and work organization in the construction industry. If you are interested in participating on any of these workgroups please contact Scott Earnest or Liz Garza.

News from Our Partners

DOL Approves New Respirator Fit Testing Protocols to Protect Workers From Airborne Contaminants
The U.S. Department of Labor’s Occupational Safety and Health Administration (OSHA) recently issued a final rule that provides employers with two new fit testing protocols for ensuring that employees’ respirators fit properly. The rule went into effect September 26.

Healthy Workplace Participatory Program Announces NEW Facilitator Manual and Updated Online Toolkit
A NIOSH Center of Excellence for Total Worker Health® (TWH), CPH-NEW, is pleased to announce expanded and upgraded TWH implementation tools for its signature program, the Healthy Workplace Participatory Program Facilitator Manual. Upgrade features include 1) Updated Toolkit at a Glance, 2) NEW Detailed guidance in Get Ready for Program Startup, 3) NEW Design Team Startup meeting guides, 4) NEW Facilitation Skills Video Training Series, and 5) Upgraded Facilitator Manual in Generate Solutions Using the IDEAS Tool.

Upcoming October 23rd Ergonomics Webinar
The NIOSH-funded Education and Research Centers (ERCs) will hold the ninth installment of their 2019 Ergonomics Webinar Series on October 23, from 3–4 p.m. (ET). Dr. Bernard Martin of the University of Michigan will present on “Leg and Neck Muscle Fatigue: Physiological Mechanisms That Can Lead to Musculoskeletal Disorders.” This series offers free monthly webinars on occupational safety and health topics related to human factors and ergonomics. Learn more or register here.

New Publication on Occupational Carbon Monoxide Poisonings
The Wisconsin Department of Health Services reported in a new publication that occupational carbon monoxide (CO) poisonings are likely to be underrepresented in Poison Center records, although they are the second highest source of CO exposure events. Additionally, a new Wisconsin statute makes CO poisoning a reportable condition as of July 2018.

Construction Center Develops New Spanish-Language Resources for Preventing Hearing Loss
The Construction Noise and Hearing Loss Prevention Training Program is now available in Spanish. This program was developed through a collaboration between the NIOSH-funded CPWR—The Center for Construc­tion Research and Training, NIOSH, and the Occupational Safety and Health Administration (OSHA). It offers simple educational modules and activities that be utilized as part of an OSHA training or outside of it. Additionally, CPWR has other resources focused on hearing loss prevention including a new Hazard Alert for Noise and Hearing Loss, offered in English and Spanish.

CPWR Executive Director Contributes to Construction Trade Magazine Article on Aging Workers
Dr. Chris Trahan Cain, Executive Director of CPWR—The Center for Construc­tion Research and Training, recently provided input into an Engineering News-Record magazine article. The story, How Companies Are Adapting to the Needs of an Aging Workforce, was published August 28.

Webinars, Conferences & Events

Call for Abstracts
7th International Conference on the History of Occupational and Environmental Health
Deadline for abstracts is October 30.

XXII World Congress on Safety and Health at Work
Deadline for abstracts is December 15.

Call for Manuscripts
International Journal of Environmental Research and Public Health Special Edition
Deadline for manuscript submission is January 31, 2020.

Upcoming Webinars
2019 NanoEHS Webinar Series: Evaluating Worker and Consumer Exposure to Engineered Nanomaterials
October 8, 12:00 PM–1:00 PM (ET). Register here

Upcoming Conferences
ErgoX 2019
October 28, Seattle, WA

63rd International Annual Meeting of the Human Factors and Ergonomics Society
October 28–November 1, Seattle, WA

Americas Section Technical Conference and Annual General Meeting 2019
October 30, Pittsburgh PA

American Public Health Association Annual Meeting & Expo
November 2–6, Philadelphia, PA

Work, Stress and Health Conference 2019
November 6–9, Philadelphia, PA

30th Annual Art & Science of Health Promotion Conference
April 20–24, 2020, Hilton Head Island, SC

7th International Conference on the History of Occupational and Environmental Health
May 27–29, 2020, Durban, South Africa

XXII World Congress on Safety and Health at Work
October 4–7, 2020, Toronto, Canada

A comprehensive list of upcoming conferences can be found at NIOSH Conferences and Events.