Atlanta, GA: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, U60-OH-008338, 2006 Dec; :1-66
Under NIOSH-funded SENSOR grants, NJDHSS conducted surveillance and intervention activities for silicosis and work-related asthma (WRA), which are among the 13 priority health conditions identified for surveillance by the NIOSH-States Surveillance Planning Work Group (NIOSH, 2001). Selection by the work group was based on the criteria of magnitude, severity, intervention potential, effectiveness/preventability, emergent conditions, public concern, economic impact, and feasibility of surveillance. Nationally, a total of 16,131 silicosis-associated deaths were recorded during 1968-2001 (CDC, 2003). Statistics show that more than 250 workers die each year from silicosis in the U.S. (Mahoney, 1999). However, due to underreporting and under recognition, these numbers may actually be higher. A 1995 study found that the potential average years of life lost associated with silicosis was 22.1 years and the potential cumulative years of work lost due to silicosis was983,185 years (Zhong, 1995). The American Thoracic Society estimates that 15% of adults with asthma have acquired asthma from a workplace exposure, and applying this estimate to New Jersey BRFSS data (450,000 adults with asthma) suggests that there are approximately 67,500 adults in New Jersey who may have asthma caused or aggravated by their job (NJDHSS, 2003).These data can also be used to assess the burden of WRA to plan and target diverse intervention activities at the state level. During the course of conducting occupational health surveillance projects, NJDHSS investigators: 1) Identified, evaluated, and utilized various available sources of data on occupational diseases. Data sources appropriate to the condition under surveillance were selected and developed. 2) Designed timely, simple, and acceptable surveillance systems for accurately collecting occupational health data. Staff created registries and database systems for tracking and following up on reports silicosis and work-related asthma. Databases were also developed for managing information from case-based interventions, as well as industry-wide hazard surveillance studies. 3) Conducted analysis of data to estimate the burden of occupational disease in New Jersey and described the epidemiology of specific diseases, implemented strategies for intervention, and targeted specific industries for educational outreach, exposure characterization, and exposure reduction. 4)Developed and carried out industry-wide interventions for silicosis in foundries, potteries, sand mines, highway construction, dental laboratories, and monument builders; and for work-related asthma in health care facilities, funeral homes, and dialysis centers. On-site industrial hygiene evaluations of specific workplaces identified through surveillance were conducted and reports were issued with recommendations for controlling exposure to the causal agent of the targeted condition. Voluntary participation and cooperation from employers and employees was obtained to help achieve surveillance project goals. 5) Issued alerts and educational bulletins to specific industries as a result of surveillance project findings. Published surveillance findings in annual newsletters, special reports, and articles in the peer-reviewed literature. Educational materials for employers, employees, and their physicians were developed. A complete list of educational materials on occupational health developed by the NJDHSS is included in the Appendix. NJDHSS developed and gave presentations on general surveillance activities, specific occupational health conditions, specific workplace evaluations, and industry-wide studies at national public health, industrial hygiene, and epidemiology meetings. 6)Evaluated the effectiveness of surveillance and intervention activities by comparing completeness of data sources used to identify cases, and by performing follow-up industrial hygiene evaluations at previously inspected workplaces to assess compliance with original recommendations. NJDHSS accomplished increased recognition of occupational asthma and silicosis; increased numbers and reporting of identified cases; improved case processing; and conducted more effective interventions, information dissemination, and evaluation. Collection, management, and analysis of occupational health surveillance data following the SENSOR model is vital to directing interventions aimed at reducing the morbidity associated with the occupational diseases, work-related asthma and silicosis. The New Jersey Occupational Health Surveillance System is structured in such a way as to be adoptable by other states interested in establishing occupational health surveillance.
David Valiante, New Jersey Department of Health and Senior Services, Division of Epidemiology, Environmental, and Occupational Health, Occupational Health Surveillance Program, P.O.Box 360, Trenton, New Jersey 08625