Every working day more than three million Washington State citizens work for one of Washington's 160,000 employers. On average, one Washington worker will die every five days from an occupational injury. Every hour, 100 Washington workers suffer an occupational injury or illness. Workplace illnesses and injuries have very significant direct and indirect costs, to workers, employers, and society at large. In 2008, Washington State paid more than 2.1 billion US dollars in workers' compensation benefits. This five-year NIOSH Cooperative agreement, from July 1, 2005 - June 30, 2010, provided Washington State with the core capacity to track work injuries and illnesses through four main component programs. The systematic, ongoing, collection, and analysis of work injury and illness data allows Washington State citizens, business, and labor groups, and other policy makers to describe the burden of work injuries and illness, perform information based decision making, and assess improvement in the occupational health and safety of the Washington State workforce. 1) The Fundamental program, whose core function is to provide reliable occupational injury and illness data to Washington State citizens, workers, employers and other policymakers through the analysis of public health data sources, had several significant findings: Work-related musculoskeletal disorders (WMSDs) account for 40% of all Washington State workers compensation claims resulting in 3 or more lost workdays and account for 44% of all workers compensation costs. Workers with a hospitalized electrical burn are significantly more likely to have psychiatric sequelae, like post-traumatic stress disorder, than those with non-electrical hospitalized burns. Nearly 40% of all medically treated work injuries reported by workers had a payment source other than workers' compensation, suggesting an underestimation of the burden of occupational injury through use of workers compensation data. Standard methods to identify work-related amputations within administrative databases likely leads to a significant underestimation of the total number of injuries that result in the loss of a body part. 2) The Washington State Fatality Assessment and Control Evaluation (WA FACE) tracks work injury fatalities. Detailed surveillance data are collected on all work-related fatalities in Washington State and used to focus prevention efforts towards high risk work activities and high risk industries. WA FACE documented a decrease in the number of work injury fatalities from 81 to a Washington State low of 64 for calendar years 2005 to 2009, respectively. WA FACE data shows that the top three industry sectors with the highest numbers of work injury fatalities in Washington State are: agriculture, forestry, fishing, and hunting; construction; and transportation and warehousing. WA FACE produced over 80 prevention publications which were directly distributed to over 40,000 individuals, are downloaded from a dedicated WA FACE website, and serve as the foundation for WA FACE personnel onsite trainings. Evaluations of FACE prevention outreach suggest those trained by FACE are likely to initiate change for a safer workplace. 3) The Trucking Injury Reduction Emphasis through Surveillance (TIRES) program focuses on reducing work-related injuries in the Washington State trucking industry, which has some of the highest costs and rates for work-related injuries. Developed and implemented surveillance system with case follow-up interviews of injured workers in the trucking industry. Case follow-up interviews with injured workers led to the identification of four job tasks associated with most work injuries. They are: a) loading/unloading (and other manual handling), b) exit/entry from the cab or trailer, c) securing a load, and d) walking around the job site. The majority of injuries in trucking occur at the customer site. This is another significant finding from the case follow-up interviews. This creates a challenge for outreach training as the employer doesn't have the ability to monitor work processes. The employer may be the cause of the lack of proper equipment or maintenance or may just lack the ability to exert safety controls over their independent workforce. Formed the TIRES steering committee comprised of industry stakeholders including business, labor, insurance, truck driver training schools and independent owner/operators. Suggestions like the collaborative web site and on-line training tools came directly from the steering committee. Developed a collaborative web site, www.KeepTruckingSafe.org
, which is the first consolidated internet safety resource for the US and Washington State trucking industry. TIRES developed over 40 prevention materials through the website and over 85% of site users add the TIRES website to their favorites list. 4) Identifying preventable causes of pesticide-related illness among Agricultural workers. The Pesticide program successfully developed new interview questions to identify risk factors for occupational pesticide-related illness and injury from pesticide drift and personal protective equipment failure. The analysis of contributing factors over a six year period, (2003-2008) found that fifty-three percent (87/167) of pesticide handlers were missing at least one piece of required PPE or had an identified problem with their PPE at the time of their pesticide exposure. Close proximity of workers to power sprayers was more commonly reported as a root cause in pesticide drift than were high winds or other adverse weather conditions. A key factor was lack of communication between spray crews and field crews on the same or on neighboring farms. The findings from these four component programs can all be used in the workplace to help focus prevention efforts on high-risk injuries and industry sectors. Data dissemination efforts of the Washington State surveillance program have led to safer and healthier workplaces. The Washington State Occupational Surveillance program has become a resource for all of Washington workers and employers by maintaining a responsive expert staff, technical expertise in working with public health data sources, and an extensive web catalog of materials. In return, WA benefits from extensive support from the health and safety, employer, and worker communities.