Cincinnati, OH: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control, National Institute for Occupational Safety and Health, Purchase Order 900110, 1990 Jan; :1-126
High-risk worker notification -- the process of informing workers at risk that past exposure to work hazards has given them increased chances of developing occupational disease -- has emerged during the 1980s as a pivotal issue in United States occupational health policy. In the space of little more than a decade, worker notification has progressed from abstract ethical debate to active programming, in the process generating a sizeable body of literature. Much of this literature is prescriptive in nature, offering moral commentary, sensitizing concepts, and recommendations. Increasingly, however, empirical studies are appearing that describe specific programs of worker notification, in some cases including at least partial evaluation of the intervention's impact. These mark a welcome trend because many vital questions regarding the effects of notification still remain unanswered. The need for better evaluation is recognized by the National Institute for Occupational Safety and Health (NIOSH), which has played a central role in developing programs for worker notification. The agency is currently devising plans-for systematic evaluation of its own notification activities, both ongoing and retrospective. As part of NIOSH's evaluation planning, this paper critically analyzes presently available scientific studies on worker notification, along with other material related to program design and evaluation in risk communication. The empirical studies reviewed here were located through a search of NIOSH's bibliographic database, supplemented by a number of unpublished documents and personal communications concerning completed or ongoing worker notification projects. Where relevant, theoretical and methodological literature has been included from a number of academic disciplines and professional fields -- sociology, anthropology, psychology, communications, social work, public health, and public administration. The purpose of the analysis is to identify important issues and current gaps in knowledge concerning worker notification, showing how these might be addressed and clarified through evaluation research. This literature review, representing the first stage of a two-phase project, covers: (I) an overview of worker notification policy and programs, (II) examples of notification, (III) critical issues, and (IV) implications for evaluation. The second phase of the project, available separately I consists of a fuller discussion of the evaluation issues involved and detailed designs for several evaluation studies that NIOSH might undertake for its high-risk worker notification activities.
Carolyn Needleman, Ph.D, Bryn Mawr College, Bryn Mawr, PA 19010