Fatal occupational injuries continue to be a significant public health problem in Massachusetts as they are throughout the United States. Each year in Massachusetts approximately 70 workers are fatally injured at work. Information about the work settings and the specific circumstances in which these deaths occur is essential to develop effective prevention measures at the state and national levels. Since 1990, the Massachusetts Department of Public Health (MDPH) has participated in the NIOSH Fatality Evaluation and Control Evaluation (FACE) program. This program has allowed MDPH to build the Massachusetts surveillance system for fatal occupational injuries, to increase understanding of risk factors leading to fatal events through investigations of targeted fatalities, and to undertake activities to prevent fatal occupational injuries in the Commonwealth. This Cooperative Agreement enabled MDPH to continue and enhance the Massachusetts FACE project from 9/1/01 through 10131/06. The long range goal of the project was to reduce the incidence and accompanying human and economic burden of work-related fatalities in the Commonwealth. Specific aims were to: 1) maintain the current case ascertainment system for timely identification and collection of data on all fatal occupational injuries to identify high risk workplaces and populations; 2) conduct onsite investigations of targeted fatalities using FACE investigative methods to identify risk factors and develop recommended countermeasures to control or eliminate identified risks; 3) disseminate surveillance findings, FACE reports, NIOSH Hazard Alerts, FACE Facts and other injury prevention information to workers, employers and health and safety professionals and advocates who can intervene in the workplace to prevent workplace deaths; and 4) develop, implement and evaluate prevention projects targeting specific industries, groups of workers or hazards to reduce the incidence of fatal occupational injuries in Massachusetts. During the project period, Massachusetts FACE collaborated with the Massachusetts Census of Fatal Occupational Injuries to identify and document 327 fatalities, conducted 40 in-depth field investigations, and prepared and disseminated 32 FACE reports (additional reports in progress.) New efforts were undertaken to document deaths involving immigrant workers. Massachusetts FACE developed a data collection supplement to collect information on immigrant worker deaths, subsequently adapted for use by NIOSH and other states, and completed 19 investigations of immigrant worker deaths. As part of this effort, Massachusetts FACE developed new working relationships with community organizations serving immigrant groups that assisted in both data gathering and outreach. Greater emphasis was also placed on development of user friendly materials. Eight short, user friendly safety alerts - FACE Facts - were developed and thousand of copies were disseminated to stakeholders across the state. The feasibility of conducting investigations of deaths of public sector workers, who are not covered by OSHA in Massachusetts, was also explored. Increased emphasis was also placed on translation of data into public health action. Massachusetts FACE expanded its ongoing Fall Prevention project, establishing a working group of government and community stakeholders to address falls in residential construction. Massachusetts FACE also provided technical assistance to a community initiated task force on floor finishing safety that has led to changes in local practices, new efforts to educate the industry and consumers, and proposed state policies to regulate the floor finishing industry and use of flammable lacquer sealers. FACE activities also helped focus local attention on workplace violence hazards faced by teens contributing to changes in state child labor laws to require adult supervision of young workers after 8 pm. In addition, FACE collaboration with the Massachusetts Department of Education helped bring a new health and safety focus to vocational education in the Commonwealth. The experience over the project period has led to several new initiatives in the ongoing Massachusetts FACE project. These include the addition of public sector deaths as a target for investigation, increased collaboration with community partners to document and prevent immigrant worker deaths, and continued coordination of stakeholders in a prevention project to address falls in residential construction.
Letitia Davis, ScD, Director, Occupational Health Surveillance Program, Massachusetts Department of Public Health, 250 Washington Street, Boston, Massachusetts 02108