Every year on April 28, Workers Memorial Day, we honor those who have suffered injury, illness, and death on the job. Great strides have been made in workplace safety and health since Dr. Alice Hamilton and her colleagues began their historic investigation of occupationally related illnesses, as chronicled in her book, Exploring the Dangerous Trades. However, as long as the cost of any job is an injury, illness, or death that results in physical, financial, or emotional hardship for a worker or a worker's family, we fall short as a nation. There is no doubt that workplace hazards such as asbestos, coal-mine dust, and industrial chemicals still exist as in the days of Dr. Hamilton, despite great advancements in controlling exposures and reducing the toll of job-related impairment, disability, and death. However, the National Institute for Occupational Safety and Health (NIOSH) and its partners must not only deal with these legacy hazards, but also recognize new challenges resulting from the evolving nature of work as we move toward 2020 and beyond. Increased research is needed to explore the impacts of a changing workforce and workplace, while not abandoning the ongoing task of controlling or eliminating many of the historical but persistent hazards Dr. Hamilton and her colleagues began investigating years ago. NIOSH, along with its extramural partners, has embarked on one strategy to develop a more comprehensive approach to the evolving workplace "Total Worker Health(TM) [TWH(TM)]. Instead of the traditional approach of addressing occupational health and personal health as separate imperatives, TWH(TM) attempts to recognize the synergies between the two and to truly meld traditional workplace health and safety programs with health promotion programs to build and maintain a healthier workforce. Safer, healthier, and happier workers are essential for achieving increased productivity, lower medical costs, and other benefits to families, communities, the U.S. economy, and society as we look ahead to the next decade.
Margaret Kitt, MD, MPH, National Institute for Occupational Safety and Health, 1600 Clifton Rd. NE, MS E-20, Atlanta, GA 30333