Fiscal Year 2017 Extramural Research Program Highlights

Investigator-Initiated Research

The NIOSH extramural research program supports relevant, high-quality scientific investigations that help reduce work-related injuries, illnesses, and fatalities. These awards include funding for large projects (R01) as well as small projects (R03) and exploratory research grants (R21).

Research Grants

The R01 funding opportunity focuses on developing an understanding of the risks and conditions associated with job-related injuries, illnesses, and fatalities. These projects also explore methods to reduce risks and prevent or lessen exposure to hazardous workplace conditions. The R03 funding mechanism supports research projects that can be completed in 2 years with limited resources, including pilot and feasibility studies, secondary analysis of existing data, and small, self-contained research projects. The R21 mechanism encourages research to explore novel scientific ideas or develop new techniques, methods, model systems, tools, or other applications with the potential for significant impact on work-related safety and health.

The extramural research portfolio also includes mentored research scientist development (K01) awards that offer postdoctoral training for the next generation of occupational safety and health scientists. These highly competitive K01 awards provide up to 3 years of funding and a scientific research focus designed to develop the skills and productivity of new research scientists as they transition between postdoctoral training and independent research careers.

NIOSH awards conference and scientific meeting grants under two research grant mechanisms, R13 and U13. Both grants support high quality, scientific conferences/meetings relevant to the safety and health of workers, including symposia, seminars, and workshops.

The mission of NIOSH is to develop new knowledge in the field of occupational safety and health and then transfer it to practice. The extramural research program advances this mission through its research. This work helps in identifying workers at risk, developing methods for measuring hazard exposures, and detecting adverse health effects. The program also helps in determining the frequency of job-related hazards, increasing understanding of the causes of work-related diseases and injuries, and reducing or eliminating hazard exposures. Grantees share research results through diverse communication channels, including scientific meetings, conferences, and workshops.

Investigator-initiated research outputs are the products of research activities and include publications. We collected publications by NIOSH-funded extramural researchers from principal investigator reports to NIOSH, the NIH Reporter database, the NIOSHTIC-2 database, and the PubMed database. From October 1, 2016, to September 30, 2017, R01 grant-funded researchers published 127 arti­cles in peer-reviewed journals. The numbers of peer-reviewed publications for the other investigator-initiated research mechanisms are 13 (R03), 34 (R21), and 19 (K01). Find a searchable database of NIOSH publications, which includes grantee final reports and publications, by using the NIOSHTIC-2 publications search.

Highlights from R01 Grants


Global Impact of Novel Interventions to Protect Workers from Airborne Diseases

Project Title: Testing Novel Interventions to Protect Workers from Airborne Infections. Principal Investigator: E. Nardell

Tuberculosis (TB) is one of the world’s dead­liest diseases. One-fourth of the global population is infected with this airborne spread illness. Concerns about the transmis­sion of airborne infections, like SARS (severe acute respiratory syndrome), pandemic influenza, bioterrorism agents, TB, and other diseases in the workplace led to this study. While this project initially focused on interventions to reduce the risk of airborne infections to workers, significant findings and outcomes emerged related to TB.

Researchers tested several methods to reduce the contagion of patients with multidrug-re­sistant TB. The methods included wearing a surgical mask and using upper-room germi­cidal ultraviolet (GUV) air disinfection. Through human-to-guinea pig transmission studies, researchers discovered long-sought evidence for upper room GUV efficacy. They found that upper room GUV (254 nm) resulted in patients with multidrug-resistant TB becoming more than 80% less infectious. Investigators found surgical masks 53% effective in reducing patient contagion.

Researchers also developed and tested a new, more efficient approach to the upper room GUV, called the “eggcrate ceiling” GUV. This study also led to new dosing guidance for GUV application, including new guidelines issued in South Africa. The World Health Organiza­tion is also considering data from the study in its upcoming revised TB infection control guidelines.

Furthermore, scientists developed a new approach to the TB transmission control strategy named Find cases Actively, Separate temporarily, and Treat effectively or FAST. The FAST method rapidly diagnoses TB via molec­ular diagnostic testing. It also tests to see if a person has a drug resistant form of TB. FAST has been tested and implemented in hospital settings globally, including in Bangladesh, Russia, and Vietnam. The World Health Orga­nization also included information on FAST in its publication, Implementing the End TB Strat­egy: the Essentialsexternal icon.

Tuberculosis: Data and Statistics
Grantome: Testing Novel Interventions to Protect Workers from Airborne Infectionsexternal icon

New Guidelines Developed for the Design of Hospital Patient Rooms to Reduce Musculoskeletal Disorders in Healthcare Workers

Project Title: A Participatory Design Process Addressing Ergonomics in Hospital Patient Rooms. Principal Investigator: S. Lavender

Musculoskeletal disorders are soft-tissue injuries caused by sudden or sustained expo­sure to repeated motion, force, vibration, and awkward positions. They are a major source of injury to healthcare workers. According to the Occupational Safety and Health Adminis­tration (OSHA), nursing aides, orderlies, and attendants had the highest rates of muscu­loskeletal disorders in 2010. The awkward postures and motions of healthcare workers, along with the physical effort required to complete their tasks, are often related to the structure of their workspace. For many health­care workers, the hospital patient room is a common work setting that leads to significant physical demands for employees due to room design.

This study aimed to reduce healthcare work­ers’ musculoskeletal injuries in the patient room setting. Using a design process that actively involves users, researchers obtained information from employees working in patient rooms to develop an improved room design. Researchers conducted interviews and focus groups with these workers across multiple occupations. They gathered details on the workers’ job tasks and challenges faced because of patient room design, collecting worker input on ideal designs for patient rooms. Scientists also received feedback from hospital patients and visitors on multiple room design layouts. The findings from this study led to 66 new guidelines that define the design needs of patient rooms. These rec­ommendations will allow building designers, hospital administrators, and others interested in patient room design to make informed deci­sions when building or remodeling hospitals.

Grantome: A participatory Design Process Addressing Ergonomics of Hospital Patient Rooms external icon
OSHA: Healthcare, Safe Patient Handlingexternal icon

The Revised Strain Index: An Enhanced Job Exposure Assessment Method for Musculoskeletal Issues

Project Title: Exposure Response Relationships for CTS and Epicondylitis from Pooled Data. Principal Investigator: A. Garg

As shown by 2014 National Safety Council data, work-related sprains, strains, and tears were twice as likely to result in workers’ compensation claims as fractures, cuts, lac­erations, amputations, bruises, contusions, burns, and chemical burns altogether. These musculoskeletal injuries negatively impact both workers and employers. This NIOSH-funded project focused on the relationship between biomechanical stressors—physical job demands like frequent bending, heavy lifting, and lengthy standing—and upper limb injuries—carpal tunnel syndrome (CTS), tennis elbow (lateral epicondylitis), and golfer’s elbow (medial epicondylitis).

To measure biomechanical stressors, researchers used analytical methods to find which physical factors on the job exposed workers to increased risk of musculoskeletal disorders. These methods include a new risk assessment model, developed during this study, called the Revised Strain Index. This index quantifies physical exposures to mus­culoskeletal problems that impact the upper body. The Revised Strain Index builds on the 1995 Strain Index—one of the most common methods in North America to measure distal upper extremity exposures on the job.

The Revised Strain Index focuses on each physical exertion in a task and each task within the overall job. Its calculations are also sensitive to minor improvements in tasks over time. Researchers think that the Revised Strain Index will supply more reliable data than established surveillance based assessment models: the 1995 Strain Index and Ameri­can Conference of Governmental Industrial Hygienists (ACGIH®) Threshold Limit Value for Hand-Activity Level.

Grantome: Exposure Response Relationships for CTS and Epicondylitis from Pooled Dataexternal icon
The Revised Strain Index: An Improved Upper Extremity Exposure Assessment Modelexternal icon
NIOSH Musculoskeletal Health Program

Highlights from R21 Grants


Novel Blood Test Quickly and Accurately Detects Pesticide Exposure

Project Title: Integrated Approach for Environmental Health Monitoring: Exposure Signatures of Pesticides. Principal Investigator: D. Du

Pesticides are a common agricultural tool to increase harvests. But over-exposure to some pesticides leads to serious health problems, including nerve damage. So worker protection, including exposure monitoring, is critical. At NIOSH, the Pesticide Surveillance Program monitors work-related illness and injury from exposure to pesticides. Tests available right now for exposure monitoring are expensive, time-consuming, and involve special equip­ment and trained personnel.

Researchers at Washington State Univer­sity collaborated with the NIOSH-funded Ag Center, Pacific Northwest Agricultural Safety and Health Center, on a study to work on this issue. They developed a simple, fast, and inexpensive blood test that accurately detects the level of exposure to potentially harmful pesticides among farm workers. The so-called sandwich ELISA (enzyme-linked immuno­sorbent assay) test is unique in its ability to measure the level of immune response-trig­gering molecules, or antigens.

Much like commercially available pregnancy tests, this test consists of a treated strip that reacts in the presence of specific protein mol­ecules, or enzymes. The treated strip changes color in the presence of enzymes produced by the liver after exposure to phosphorus-based pesticides. To verify the test’s accuracy, scien­tists measured the level of pesticide exposure in 124 blood samples from study participants who worked with pesticides in orchards or on cotton farms in Washington State or Pakistan. They found that the test accurately and quickly measured pesticide exposure by detecting pesticide-related enzyme activity and the total amount of enzyme in the blood. This study appeared in the journal, Biosensors and Bioelectronics. With the goal of making the test commercially available, scientists are now verifying its accuracy and developing software to enable its use in the field.

Grantome: Integrated Approach for Environmental Health Monitoring: Exposure Signatures of Pesticidesexternal icon
Simultaneous detection Of Dual Biomarkers From Humans Exposed To Organophosphorus Pesticides By Combination Of Immunochromatographic Test Strip And Ellman Assay external icon
Research Rounds: Novel Blood Test Quickly and Accurately Detects Pesticide Exposure
NIOSH Pesticide Illness & Injury Surveillance

Highlights from K01 Grants


Maker of PURELL® Sanitizer Brand Produces Video Featuring NIOSH-funded Healthcare Infection Prevention Study

Project Title: Impact of Patient Safety Climate on Infection Prevention Practices and Healthcare Worker and Patient Outcomes. Principal Investigator: A. Hessels

During FY2017, the inventor of the PURELL® sanitizer product brand, GOJO Industries Inc., developed a video featuring the work of NIOSH-funded researcher Amanda Hes­sels, PhD, MPH, RN. Her study focused on understanding whether healthcare workers’ perceptions of a positive job safety climate relate to improved adherence to standard precautions, resulting in lower levels of health­care worker exposures and hospital patient infections. GOJO Industries Inc. posted the video on their YouTube channel and shared it with their staff and 900 others who work to prevent infection nationwide.

Hessels also conducted a webinar on her study as part of a Teleclass Education pro­gram by Webber Training Inc. More than 1,000 people attended the webinar and more than 6,000 accessed the webinar recording.

YouTube: the Relationship between Patient Safety Climate and Adherence to Standard Precautions
Grantome: Impact of Patient Safety Climate on Infection Prevention Practices and Healthcare Worker and Patient Outcomesexternal icon

Preventing Respiratory Infections in Healthcare Workers Using Math Models

Project Title: Preventing Occupational Infections in Healthcare Professionals Using Risk Models. Principal Investigator: L. Casanova

Healthcare workers face a high risk of devel­oping infectious diseases, such as respiratory infections. This is because of their job tasks and their high likelihood of coming in contact with bacteria and viruses. This study strives to reduce the spread of respiratory illnesses in healthcare settings. Researchers are devel­oping complex mathematical models that describe how respiratory infections spread from patients to healthcare professionals. The models aim to find the various ways that healthcare workers face exposure to these illnesses and calculate their risks of becoming infected in multiple settings. Researchers plan to use the study findings to develop strategies to lessen healthcare workers’ risk of contract­ing respiratory illnesses.

Grantome: Preventing Occupational Infections in Healthcare Professionals Using Risk Modelsexternal icon
NIOSH Healthcare Workers

Page last reviewed: August 1, 2019