FY 2018 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).
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 give 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, 2017, to September 30, 2018, R01 grant-funded researchers published 117 articles in peer-reviewed journals. The numbers of peer-reviewed publications for the other investigator-initiated research mechanisms are 7 (R03), 31 (R21), and 17 (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
Award-winning Farm Dinner Theater Featured in National Magazine
Project Title: Farm Theater: A Novel Safety Strategy Approach for Agricultural Communities (R01 Grant).
Principal Investigator: D. Reed
Agriculture has an excessive worker injury rate. An estimated 58,385 work-related adult farm injuries (more than six every hour) occurred in 2014. In 2016, 417 farmers and farm workers died from a work-related injury. Additionally, senior farmers and adult farmers in the South experience some of the highest occupational injury and fatality rates in the United States. Reaching farmers with safety and health information can be challenging. They are rarely in the same place and used to working in isolation and taking care of their own safety. Additionally, they have little time to be away from the farm and their work. So what is the best way to break through to this high-risk group with safety and health information? This project at the University of Kentucky developed a new idea—a farm dinner theater.
This program works with established community-based Cooperative Extension Agents in Kentucky, Tennessee, and Mississippi to develop and test a theater intervention aimed at positively changing farm work culture and safety behavior. The theater uses a didactic reader format where participants read from scripts on topics relevant to their communities. Examples include falls, hearing conservation, skin cancer, intergenerational issues of work, equipment operation and reaction time, livestock handling, and virtually any topic related to the farming community. Local actors and farmers put on the plays. So far, each performance has a waiting list. The Oprah Magazine featured the program, along with the study’s principal investigator, Deborah Reed, PhD, in an article. The program has received numerous awards including the American Academy of Nursing’s Edge Runner Award and the Search for Excellence in Farm Health and Safety from the National County Extension Agriculture Agent Organization.
Link Found Between Cancer Risk and Exposure to Viruses in Poultry
Project Title: Case-cohort Study of Cancers in Excess in Poultry Workers (R01 Grant).
Principal Investigator: E. Johnson
Among the viruses that commonly infect chicken and turkeys are oncogenic viruses, which cause cancer. However, there is limited information on how these viruses may influence humans’ risk for cancer. Humans in the general population are widely exposed to these viruses through poultry and their by-products. This lack of knowledge is critical because there have not been enough studies about the cancer risk in exposed individuals.
To address this gap, this unique project studied workers who had been exposed to high levels of oncogenic viruses and other cancer-causing substances in poultry or chicken while working in slaughtering and processing plants. The latter exposure included substances these workers were around while smoking, curing, and wrapping meat on the job or exposed to while off work.
Researchers focused on connections between specific exposures and the development of cancers in varied areas, including the lungs, brain, pancreas, liver, ovary, buccal cavity, and pharynx. Published in the journal Environmental Research, study results showed potential links between lung cancer and oncogenic viruses from poultry, as well as from the other cancer-causing chemicals. In particular, the highest cancer risk was for workers who had job tasks that included washing, cutting, and removing parts of chickens, in addition to having direct contact with their blood. However, scientists did not find an increased cancer risk for office workers and those in the packing area of processing plants. Researchers highlight these and other study limitations in the publication, but do not provide genetic evidence that these oncogenic viruses cause cancer in humans. Because this study has potential public health implications, especially for poultry workers who have high fatality rates from cancer, researchers are continuing to conduct research in this area.
Estimates of Farm Workers’ Physical Activity Could Help Prevent Heat-related Illness
Reducing the Risk of Heat-related Illness in Western Agricultural Workers (R01 Grant).
Principal Investigator: M. Schenker
Farm workers are at high risk for heat-related illness in hot temperatures, especially during summer crop production. Farming is also physically demanding, further increasing the likelihood of developing heat-related illness. An estimated 30%–40% of U.S. farm workers are employed in California. In the past, there was limited research on their physical activity and how it contributes to heat-related illness.
Focusing on this issue, researchers at the University of California, Davis, estimated the physical activity involved in common, strenuous farm tasks that could contribute to heat-related illness among these workers. Study participants included 575 Californian workers on 28 farms in the Central and Imperial Valleys. Researchers used devices called accelerometers, which are clipped onto a hip belt, to measure step counts per minute (cpm) during tasks over the course of a work shift. They then estimated the time spent in light, moderate, or vigorous activity. Researchers found the overall average step count for farm workers was 345 cpm, defined as light activity. Produce carriers had the highest average level of physical activity, with 700 cpm, and ground pruners, who remove or trim plants, had the lowest number at 150 cpm.
The scientists determined a strong link between higher environmental temperature and reduced physical activity. Other factors associated with decreased physical activity included increased age and tasks such as ground pruning, sorting or separating, and harvesting crops. In contrast, doing irrigation work and performing more than one task at the same time were associated with increased physical activity, as well as when pay was based on work completed, rather than on time. These factors could increase the risk for heat-related illness. In FY2018, this study was published in the journal Occupational and Environmental Hygiene.
Thirty-year Study on Exposure to Endotoxin and Respiratory Disease in Textile Workers
Project Title: Lung Disease in Chinese Textile Workers (R01 Grant).
Principal Investigator: D. Christiani
In the United States, at least five million workers across multiple industries are possibly exposed to airborne endotoxin—a dangerous substance released from bacterial cells. However, while research shows short-term exposure leads to respiratory problems like dynamic airflow obstruction, the health effects of chronic or long-term contact with endotoxin remains unknown. Limited studies exist related to this issue, and most of them focus on exposure for less than a decade. As a result, there is little knowledge on how chronic exposure affects the lungs, including the development of lung disease after a person is no longer exposed and the underlying causes for severe cases of the illness.
In a unique study, scientists at the Harvard T.H. Chan School of Public Health evaluated Chinese textile workers’ exposure over three decades to endotoxin and cotton dust. Specifically, they looked into the pulmonary or lung-related impact of chronic exposure and how these workers’ health was impacted after they were no longer around the substances.
This project is the longest running and largest prospective study involving a cohort of textile workers. Study participants included 919 Shanghai residents who were exposed to high levels of cotton dust and endotoxin while employed as cotton workers, and the majority of them having never smoked. Researchers determined the effects of long-term respiratory disease could actually be reversed after workers were no longer on the job and exposed. The scientists also looked into the role that smoking and genetics play related to this topic. The findings of this study are leading to a better understanding of how long-term contact with cotton dust and endotoxin influences chronic respiratory issues.
Bolstering Nighttime Visibility in Roadway Work Zones
Project Title: Warning Beacons for Front Line Service Worker Safety (R01 Grant).
Principal Investigator: M. Rea
Roadway work zones can be dangerous both for motorists and for construction workers who build, repair, and maintain streets, bridges, and highways. In these areas, a variety of complicated road signs, barrels, and lane changes could increase the risk of motor vehicle crashes. To prevent this issue, safety equipment, such as flashing yellow warning beacons, is critical. These lights aim to get motorists’ attention as they approach or drive through work zones and to alert them of potential hazards and nearby workers. However, current standards for warning beacons include a minimum light intensity to ensure risks are seen, but do not identify a maximum degree of light intensity to protect against glare or distraction. The standards also do not differ between daytime and nighttime conditions despite research showing the need for less light intensity at night.
To address this issue, scientists at Rensselaer Polytechnic Institute explored the effect of various light intensities and other factors on motorists’ ability to detect workers while approaching work zones and warning beacons. These other factors included how frequently the warning beacons flashed and whether or not workers wore high-visibility, reflective safety clothing.
Researchers conducted a nighttime field study on a test track with four life-sized, cardboard workers—two with and two without reflective vests—positioned alongside the track lit with warning beacons. Published in Accident Analysis & Prevention, the study showed visibility was greatest at night when the warning beacons had light intensities (max/min) of 25/2.5 candelas (cd) and 150/15 cd, and flash frequencies of either 1 hertz (Hz) or 4 Hz. Furthermore, the reflective vests allowed the drivers to see the simulated workers at the farthest distance tested, regardless of the frequency and intensity of the warning beacons. The findings of this study can help protect workers by increasing visibility in roadway work zones.
Lighting Interventions to Improve Healthcare Workers’ Sleep and Occupational Safety and Health
Project Title: Lighting Interventions to Reduce Circadian Disruption in Rotating Shift Workers (R01 Grant).
Principal Investigator: M. Figueiro
Healthcare workers can sometimes have sleep difficulties because of their circadian rhythm, or the internal biological clock that regulates sleep, being disturbed. Circadian rhythm disturbance is especially evident for those who do rotating or shift work. When individuals are exposed to a natural sunrise and sunset, the circadian rhythm is synchronized to a 24-hour cycle. However, a constant mismatch between a person’s circadian rhythm and environment, including lighting, can disrupt normal sleep patterns, possibly leading to fatigue, injuries, mood changes, and other health problems. Lighting on the job that is either too intense or too low can disrupt healthcare workers’ circadian rhythm, especially for nighttime employees, deceasing their alertness and productivity.
Researchers have been working to increase their understanding of circadian rhythms and how light of varying wavelengths can support or interrupt natural sleep cycles. Specifically, NIOSH-funded scientists at Rensselaer Polytechnic Institute investigated the effectiveness of using a red-frequency light in work settings to help with circadian disruption. As reported in the journal Sleep Review, initial results show the red light increases alertness without stifling melatonin, which can occur when people are exposed to certain light wavelengths. Decreased melatonin can hinder one’s circadian rhythm, causing sleep and other health issues.
This project could significantly benefit shift workers by improving their sleep, as well as their mood and well-being. In FY2018, researchers on this study collaborated with the Light and Health Alliance to develop and disseminate short videos on the science behind lighting and improved human health.
Highlights from R21 Grants
Study Identifies Factors Linked to Healthcare Workers’ Use of Patient Lift Equipment
Project Title: Crossover Study of Factors Associated With Patient Lift Equipment Use (R21 Grant).
Principal Investigator: K. Kucera
Lifting and other patient handling tasks account for more than half of workers’ compensation costs related to musculoskeletal injuries among caregivers, including nurses and other healthcare workers. Patient lift equipment and other support devices designed to move patients have been recommended for safety in the healthcare field. However, according to past research, these equipment and devices are not regularly used despite their increased availability and the implementation of Safe Resident Handling policies, trainings, and programs. So what leads to the use or nonuse of patient lift devices? The answer to this question could result in better approaches, including policies and trainings, which increase their adoption in the workplace.
This study investigated factors that influence the utilization of patient lift equipment. Using a multilevel approach, researchers developed a survey related to lifting and transferring patients that was completed by more than 100 nurses and nursing assistants. The survey collected data on demographics, work experience, training, patient lifting, and lift equipment use, as well as on workers’ exposure to factors possibly linked to lift equipment use. A smaller group of these workers participated in a lift assessment and a case crossover study. The crossover study allowed researchers to measure the relationship between the use of lift equipment and the factors influencing that use, along with the frequency of the use.
According to the study, the nursing staff used equipment to lift or transfer only 21% of patients. The use of equipment differed by the type of movement being performed. Factors influencing lift equipment use included its accessibility, available staff support, the extent to which patients are mobile, and whether equipment is required for the task. Researchers have presented their findings in peer-review journals and at national conferences. In addition, they shared the study results at nurse executive council meetings for hospitals involved in this project.
Highlights from K01 Grants
Associations Between Heat Exposure, Injury, and Productivity in Agricultural Workers
Project Title: Heat Exposure, Injury Risk, and Productivity in Agricultural Workers (K01 Grant).
Principal Investigator: J. Spector
Farm workers die from heat-related illness at an annual rate 20 times that of other workers in the United States. According to past research, exposure to heat could increase the risk of traumatic injuries, but there is limited information on what is behind this association. To address this issue, University of Washington researchers investigated the relationship between the heat stress that agricultural workers experience, their injury risk, and their job productivity. Study participants included more than 12,250 outdoor agricultural workers in Washington State.
Researchers collected various information including workers’ compensation traumatic injury data, measures of workers’ balance and vigilance along with other forms of productivity, and local weather reports. Data on injury and heat conditions for the majority of the workers reflected the period of 2000–2012. Weather and performance data for a smaller sample of 46 workers were collected during August and September 2015.
Through methods of statistical modeling, researchers estimated associations between these data. They found agricultural workers who work in warm temperatures are at risk for heat-related traumatic injuries. However, heat was not linked to decreased vigilance or balance. According to study findings, the relationship between heat exposure and worker productivity is complicated and likely impacted by work factors and economic demands, influencing physical labor and heat exposure.
Researchers partnered with the Pacific Northwest Agricultural Safety and Health Center (Ag Center) to share these findings through the media, community events, conference presentations, educational trainings in English and Spanish, community events, and peer-reviewed publications. As a result, they reached workers, occupational safety and health professionals and researchers, along with stakeholders in the community, industry and government.