Approaches for assessing the efficacy of occupational health and safety standards.
Stayner L; Kuempel E; Rice F; Prince M; Althouse R
Am J Ind Med 1996 Apr; 29(4):353-357
Approaches for evaluating the effectiveness of occupational health and safety standards were reviewed. Three approaches for evaluating the effectiveness of occupational health and safety standards have been used: exposure surveillance, disease surveillance, and prospective studies. The exposure surveillance approach was illustrated using data obtained by OSHA and Mine Safety and Health Administration (MSHA) inspections that evaluated compliance with the standards for asbestos (1332214), coal mine, and quartz (14808607) dust in US mines. The data showed that there appeared to be problems complying with the quartz standard. Approximately 30 to 40% of the compliance standards were found to exceed the OSHA standard for respirable quartz. A NIOSH study showed that exposures to coal dust have decreased sharply since around 1969 to 1972 when the 2mg/m3 standard went into effect. Average exposures for all jobs in the coal industry are currently around 1mg/m3. The disease surveillance approach was illustrated by citing a study in which changes in mortality from silicosis, coal workers pneumoconiosis (CWP), and asbestosis were examined based on an analysis of National Center for Health Statistics data for the period 1968 to 1990. The analysis indicated a decreasing trend for silicosis, an increasing trend for asbestosis, and essentially no change for CWP mortality. It was noted that the increasing trend in asbestosis mortality may be an artifact reflecting increased awareness of the disease by physicians or biases related to compensation or the long latency period of the disease. The prospective study approach was illustrated using data obtained in studies of the silicosis risk in Canadian hardrock miners and CWP among US coal miners. The silicosis risk estimates which were based on evaluations of chest X- rays appeared to be influenced by the reader who examined the films. The study of CWP showed that the prevalence of the disease has decreased since the MSHA coal dust standard went into effect in 1977. The most recent round of a chest X-ray study showed that approximately 10% of the miners with more than 25 years of coal mining experience had CWP.
NIOSH-Author; Occupational-health; Epidemiology; Health-standards; Disease-prevention; Occupational-exposure; Asbestos-dust; Coal-workers-pneumoconiosis; Surveillance-programs; Quartz-dust; Mortality-data; Risk-analysis;
Author Keywords: intervention research; occupational health; disease prevention
American Journal of Industrial Medicine