FY 2019 Extramural Research Program Highlights: Multidisciplinary Centers
- Multidisciplinary Centers
- Investigator-Initiated Research
- Cooperative Research Agreements
- Specialty Training Programs
Multidisciplinary Centers
NIOSH funds multidisciplinary centers that focus on industries with an excessive share of job-related injury and illness. Various grant mechanisms, including cooperative research agreements and center training grants, fund these centers.
On this page, you will find research highlights for our:
- Centers for Agricultural Safety and Health
- National Center for Construction Safety and Health Research and Translation
- Centers of Excellence for Total Worker Health®
- Education and Research Centers
You can also find the information on this page in the NIOSH Extramural Research and Training Program: Annual Report of Fiscal Year 2019.
Centers for Agricultural Safety and Health
The Centers for Agricultural Safety and Health (Ag Centers), established as part of the NIOSH Agricultural Safety and Health Initiative through a cooperative agreement, represent a major NIOSH effort to protect the safety and health of farm workers and their families. These centers conduct research, education, and prevention projects to respond to the nation’s pressing agricultural safety and health problems. Currently, 10 regional Ag Centers throughout the country work on regional safety and health issues unique to each area. NIOSH also supports the National Children’s Center for Rural and Agricultural Safety and Health (Child Ag Center)external icon within the National Farm Medicine Center in Marshfield, Wisconsin. With a national focus, the Child Ag Center strives to enhance the safety of all children exposed to hazards associated with agricultural work.
NIOSH Centers for Agricultural Safety and Health
In 1990, Congress established a national initiative in agricultural safety and health under Public Law 101-517. The intention of this initiative, “… when sustained over a period of time, would result in a significant and measurable impact on … health effects among rural Americans.” In response, NIOSH began funding Ag Centers in 1991. These centers strive to improve worker safety and health in the agriculture, forestry, and fishing industries—jobs that consistently ranked among the most dangerous in the United States. Although they still rank as some of the most dangerous, in the 25 years since the initiative took effect, there have been significant decreases in injuries, illnesses, and fatalities among farm workers. The work of the Ag Centers has contributed to this decline in injuries and deaths.
The Ag Centers’ work spans the full research-to-practice continuum. First, they conduct basic science to evaluate and quantify an issue. Researchers then transfer the results into engineering controls, educational outreach efforts, or policy changes aimed at preventing or mitigating the problem. The Ag Centers’ research helps create and validate evidence-based approaches. However, the real impact occurs by application of these approaches through practical education, outreach, and prevention projects within their regions. Geographic diversity in agriculture, forestry, and fishing activities drives the need for regional engagement by the centers.
The Ag Centers made significant contributions to public health in FY 2019:
- Integrating skill and know-how from multiple disciplines, institutions, and community partners to solve complex problems.
- Providing a continuum of basic research through translation and outreach activities that turn findings into evidence-based prevention programs.
- Responding to the many cultural, ethnic, educational, and language differences that are significant barriers to safety and health for many laborers in this workforce.
- Contributing knowledge to agricultural industries in the fields of medicine, nursing, industrial hygiene, epidemiology, engineering, and education.
Ag Center 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, 2018, through September 30, 2019, Ag Centers published 74 articles in peer-reviewed journals. Find a searchable database of NIOSH publications, which includes grantee final reports and publications, by using the NIOSHTIC-2 publications search.
Surveillance and Research to Prevent Biological Exposures and Potential Zoonotic Diseases
Zoonotic diseases, also known as zoonoses, are caused by the spread of infectious agents between animals and people, including bacteria, fungi, viruses, and parasites. Workers involved with animal husbandry during their daily activities have an elevated exposure risk to zoonoses. Multiple NIOSH-supported Ag Center projects are involved with these efforts, including the examples below. By protecting workers and minimizing their exposure risks, our society at large benefits. Mitigation efforts to protect populations from this type of cross-species transmission and the associated public health impacts may include (1) viral sampling and assessment for worker exposures and (2) studying the microbiome or the genetic material of bacteria, fungi, protozoa, and viruses in workers and their environments to better understand their exposures and associated risks.
Colorado: Antimicrobial Exposures Within Livestock Operations
Antibiotics have been in use for almost a century to stop or slow down bacterial infections. Their use in production agriculture closely parallels that in human populations during this span. However, heavy reliance on antibiotics, for both people and animals, inevitably leads to a small fraction of bacteria surviving and becoming resistant, which is known as antimicrobial resistance. The World Health Organization identified this issue as one of the most urgent health threats of our time.
This project aimed to identify and measure the level of antimicrobial-resistant bacteria within agricultural environments where workers handle, manage, and apply liquid manure slurry. Samples from fecal-amended crop fields of fresh manure, stored dairy and swine manure slurry, and soil cores indicated a rich bacterial microbiome. Researchers focused on the diverse microbiome and found manure contained a significant number of species reflecting what might be found inside the guts of cattle. They also noted a change in the microbiome composition or makeup between fresh manure and the manures stored in on-farm holding structures. Scientists found high rates of tetracycline resistant genes present in both manure and soil samples although the latter group had comparatively lower rates. Based on DNA sequencing, these genes seem identical to those found in common human pathogens or disease-causing organisms in people.
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Minnesota: Optimizing the Assessment of Virus-containing Particles in Animal Agriculture
Workers in animal agriculture face the risk of airborne exposure to infectious viruses, like zoonotic influenza viruses. Measuring the concentrations and sizes of particles with which these infectious airborne viruses are associated is essential to assess exposures to viral aerosols and manage them effectively. However, only a few studies have investigated airborne levels of viral ribonucleic acid, or RNA, in terms of particle diameter, and almost no data exist on the sizes of particles that contain infectious viruses.
Past research showed that large volumes of air must be sampled for enough live virus to be picked up for detection and quantification in workplaces, and that sampling methods (e.g., filters, impingers, impactors, cyclones, and electrostatic precipitators) have different strengths and weaknesses. To address this issue, researchers at the University of Minnesota focused on developing a viral-aerosol sampler that is high volume, field portable, and size differentiating to measure worker exposures to live airborne influenza viruses in animal agriculture facilities.
These scientists evaluated current sampling approaches by testing a range of samplers side-by-side to find the best combination of sampler properties for airborne viruses in animal agriculture. Using these comparisons, they established the essential design parameters and are now determining the specific sampler design based on computational fluid dynamics modeling. Results show that a two-stage sampling strategy could be optimal during investigations of zoonotic influenza outbreaks in animal agriculture facilities. The initial use of a high flow, non-sizing sampler may be best for detecting viruses at low concentrations. If detected, a medium flow, size-separating sampler may then be most appropriate. Researchers are currently evaluating this two-staged approach. The tests will demonstrate how data from the new sampler and strategy can assess and manage risks of airborne virus transmission in animal agriculture workplaces.
Details:
Upper Midwest Agricultural Safety and Health Center (UMASH)external icon
Minnesota: Long-term Study of Infectious Disease Risks at the Human-swine Interface
The role of human interactions with animals as a source of emerging infectious diseases is universally recognized. People having regular animal contact are at the front line for exposure to known and emerging pathogens or disease-causing organisms, therefore, veterinarians provide a unique window into occupational risks for emerging zoonotic diseases. This 5-year longitudinal or long-term study of a cohort of U.S. swine veterinarians will aid in understanding the exposure and health risks related to pigs for three widespread emerging zoonotic pathogens in the U.S. swine industry: (1) livestock associated Staphylococcus aureus (including Methicillin-resistant S. aureus [MRSA] and multidrug resistant S. aureus), (2) influenza A viruses, and (3) hepatitis E virus.
The study compared a group of companion animal veterinarians without contact with swine or pigs with veterinarians who interact with swine or pigs to look at pathogen exposure and health risks. University of Minnesota researchers aimed to determine the exposure risk of these groups to the following and associated health effects: (1) MRSA and multiple drug resistant S. aureus, (2) influenza A virus exposure and disease, and bidirectional transmission of the virus between humans and pigs, and (3) hepatitis E exposure and seroconversion. Researchers found a substantial increase in exposure to livestock associated S. aureus and MRSA in swine veterinarians. Preliminary findings also suggest elevated exposure to hepatitis E virus, which is like other study findings focused on veterinarians.
Washington: The Healthy Dairy Worker Study
While workers on dairy farms have multiple occupational exposures, including allergens like dust, microbes, and endotoxin or toxins inside of bacterial cells, some studies report low rates of certain health issues among people living and working on farms associated with these exposures, like asthma, atopy, and symptomatic diarrhea. The “hygiene hypothesis” or “farm effect” suggests exposures to microbes and allergens on farms may result in individuals becoming immune to them and could be a critical determinant of whether farmworkers stay healthy or develop issues like infection and airway inflammation. This study explores the “hygiene hypothesis” by recruiting new hires on a dairy farm, along with existing workers and individuals from the community, and observed changes in their gut and nasal microbiome and health for two years.
University of Washington researchers want to better understand particular exposures in the dairy work environment and whether certain individuals have immunity to them. This knowledge could lead to more effective interventions like early detection of those at risk of developing health problems. Investigators also hope to prioritize preventive interventions, including infection control practices, and to understand vulnerable worker populations with a research to practice approach.
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National Center for Construction Safety and Health Research and Translation
CPWR—The Center for Construction Research and Training received a NIOSH cooperative agreement for 2014–2019 through an extramural competition and has been funded for the past 25 years through a series of competitive NIOSH funding announcements. The center, with its diverse construction community, leads in applied construction research, making effective interventions available to the construction industry. Along with its consortium of six academic partners, CPWR researches safety and health risks that construction workers face on the job, including their causes and solutions. Their research projectsexternal icon support Construction Sector Program research goals as well as emerging issues.
CPWR’s work has included applied research for hazards and health conditions, emerging issues research in nanomaterials, construction industry data and tracking, and the distribution and transfer of research. Research projects also responded to the National Academy of Sciences’ recommendations for the NIOSH construction research program, including distributing research-to-practice solutions. CPWR has cultivated and optimized external partnerships for prevention, protections, research, and research translation for protecting U.S. construction workers.
CPWR 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, 2018, through September 30, 2019, CPWR published 15 articles in peer-reviewed journals. Find a searchable database of NIOSH publications, which includes grantee final reports and publications, by using the NIOSHTIC-2 publications search.
New Technologies for Safer Concrete Drilling
Commercial construction workers frequently drill holes into concrete to insert anchor bolts for hanging pipes, conduit, or equipment, and for structural upgrades. This concrete drilling can produce respirable silica dust at concentration levels that can harm the lungs. Some drills also vibrate so intensely that they can damage the small nerves and blood vessels in the fingers, leading to permanent hand injuries. Two new drilling technologies, evaluated by CPWR in the past 10 years, have been shown to protect workers from these dangerous exposures while maintaining or improving workplace productivity. CPWR evaluated new bit designs with hollow cores that remove dust through the drill bits’ center. These drill bits can control dust exposure while drilling concrete and also can reduce the time required to clean out the drilled hole. The center also evaluated new powerful electric rotary hammer drills that can reduce vibration compared with older pneumatic or air-powered technology. All major drill manufacturers now sell these new technologies, and they are being adopted by mid- and large-sized construction contractors.
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Reducing Musculoskeletal Disorders by Moving Ergonomics Research into Practice
At the top of the list of disabling injuries in construction are musculoskeletal disorders (MSDs). MSDs, also called soft tissue injuries, are caused by the body being overexerted from working in awkward postures, or lifting, pushing, and pulling objects. While there is significant research on ways to prevent these injuries, adoption of safer practices has been slow in the construction industry. To address this issue, CPWR established an Ergonomics Community of Practice (ECoP) to explore ways to increase awareness and use of ergonomic research findings and interventions in construction that could reduce the risk for MSDs. Consisting of researchers and representatives from the construction and insurance industries, the ECoP conducted formative research from 2015 through 2019 on common materials handling practices in the construction industry and related barriers and motivators to engaging in safer practices. The group used a social marketing approach to identify and then create resources to help construction employers and workers overcome these barriers and increase the use of ergonomic research findings and interventions. These activities led to the development of Best Built Plans—a comprehensive program focused on reducing MSDs caused by manual materials handling.
Best Built Plans provides construction contractors and workers with free, practical, online tools and resources to help plan for safe materials handling while remaining productive on the job. The program can be accessed online, downloaded to a computer, or accessed through a mobile app. It includes a planning tool tailored for each stage of a project, along with training and coaching resources like smartphone games and a toolbox talk. A recent pilot test of this program led to the Best Built Plans Ergonomics Training Program—a new labor-management driven, comprehensive training component. This program includes modules for workers and their employers and covers topics such as the connection between soft tissue injuries and opioid use.
Best Built Plans launched in July 2018, and by September 2019, the online website had recorded more than 10,700-page views, and more than 600 users had downloaded the entire program or used the mobile app. In addition, the toolbox talk was accessed more than 14,600 times, the smart phone games more than 2,600 times, the planning worksheets more than 900 times, and over 20,000 copies of a related hazard alert card had been distributed both electronically and in print.
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Partnerships to Advance Research to Practice (r2p)
Partnerships play a critical role in moving research findings into practice on construction job sites. This is why the CPWR Research to Practice (r2p) initiative has made significant progress in building industry collaborations. Since its launch in 2010, the r2p program has established partnerships positioned to support research and to disseminate findings or outputs to target audiences. These partnerships also support communities of practice that link researchers and construction industry stakeholders with a shared focus on certain occupational hazards and that also connect interagency working groups and alliances with government agencies to enhance the impact of priority activities.
CPWR has also developed networks, including the Trainers & Researchers United Network (TRU-Net)external icon and the Construction Safety and Health Networkexternal icon, which allow participants to find new research partners, engage a broader audience of industry stakeholders in identifying research needs, start new joint initiatives, and promote safer workplace practices. A recent evaluation of the NIOSH Construction Program recognized CPWR for the value of its r2p focused partnerships.
In FY 2019, CPWR used its partnerships to engage the construction industry in NIOSH and CPWR research projects focused on these objectives: reducing silica exposure during masonry restoration, improving recognition of ergonomic hazards, and developing labor-management driven r2p products, including a ladder safety video. Through interagency workgroups, CPWR played a lead role in national campaigns with the Occupational Safety and Health Administration (OSHA) and NIOSH, such as the National Fall Prevention campaign, the My Safe Summer Jobs campaign, and the Safe + Sound campaign.
CPWR also used its partnerships to share research findings with other sectors, such as the Oil and Gas Extraction Sector. In addition, through the CPWR-OSHA Alliance, manufacturers, OSHA staff, and researchers in the NIOSH Construction Program and NIOSH Mining Program joined together to fill gaps in the awareness and use of select silica controls. Ongoing collaborations with OSHA’s Construction Directorate and NIOSH’s Construction Program also supported the development of a survey that will inform future research and dissemination efforts on OSHA’s priority to reduce trench incidents and fatalities.
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Centers of Excellence for Total Worker Health®
In FY 2019, NIOSH funded six Centers of Excellence for Total Worker Health (TWH), located throughout the United States, to explore and research the concepts of TWH. NIOSH defines TWH as policies, programs, and practices that integrate protection from work-related safety and health hazards with the promotion of injury and illness prevention efforts to advance worker well-being. TWH principles aim to broadly integrate workplace systems to control hazards and exposures, organization of work, compensation and benefits, work-life balance, and organizational change management. Their approach works toward a hazard-free workplace for all workers.
The centers made important efforts toward TWH:
- Pilot testing of promising workplace policies and programs.
- Developing and distributing best practices and tool kits.
- Creating strategies to overcome barriers for adoption of work-based interventions to protect and promote health.
- Investigating costs and benefits associated with integrated programs.
- Promoting increased development and application of biological markers of stress, sleep, and depression to protect workers and improve worker health.
- Examining the relationships between workplace policies and practices and worker health outcomes.
Centers of Excellence for Total Worker Health®
The Centers of Excellence develop and evaluate interventions to improve safety, health, and well-being—TWH approaches— in high-risk industries that can reduce healthcare costs when adopted on a broad scale. The centers engage in the following:
- Multidisciplinary research on the effects and outcomes of policies, program, and practices that integrate protection from work-related safety and health hazards with promotion of injury and illness prevention efforts to advance worker well-being;
- Development and dissemination of evidence-based research and recommendations for workplace programs, policies, and practices;
- Production of audience-specific educational materials, outreach, and capacity-building resources for optimizing their uptake or adoption or adaptation for protecting workers and improving worker well-being; and
- Evaluation of results to determine the impact on occupational safety and health and reduction in burden.
The Centers’ 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, 2018, through September 30, 2019, the Centers of Excellence for TWH published 34 articles in peer-reviewed journals. Find a searchable database of NIOSH publications, which includes grantee final reports and publications, by using the NIOSHTIC-2 publications search.
Reaching Hundreds in Healthcare: New Ergonomics Training for Nursing Professionals
In FY 2019, more than 800 nurses and other healthcare professionals participated a new online training called Ergonomics in Healthcare. This free program for nurses, which offers five continuing education (CE) hours, was developed by the Center for the Promotion of Health in the New England Workplace. The program aims to prevent soft tissue injuries and MSDs caused by sudden or frequent exposure to force, vibration, repetitive motion, and awkward bodily positions. Preventing soft tissue injuries is important for nurses because, in 2017, nursing ranked among the top three occupations with the highest rates of MSDs. The National Safety Council featured the training in its Safety+Health magazine. The program was also highlighted by the Hospital Employee Health magazine and the Massachusetts Association of Occupational Health Nurses. In addition, two major healthcare organizations in Massachusetts— the Massachusetts Hospital Association and University of Massachusetts Memorial Healthcare system—hosted the Ergonomics in Healthcare program on their CE portals.
Details:
- Center for the Promotion of Health in the New England Workplace (CPH-NEW)external icon
- New for Nurses: Online Continuing Education on Preventing MSDsexternal icon
- Massachusetts Association of Occupational Health Nurses Free CNE: Ergonomics in Healthcareexternal icon
Veterinarians and the Opioid Epidemic
Many current initiatives related to the opioid crisis focus on the pharmaceutical industry and healthcare providers for human patients. Veterinarians are generally overlooked although many can legally prescribe, distribute, carry, and store narcotics, which include opioids. While these drugs are prescribed to treat animals, they have the potential to be diverted or used illegally and abused by people.
To understand this issue, the Center for Health, Work & Environment partnered with a Colorado veterinary society to administer an online survey to 189 of their veterinarians. The survey focused on animal owners’ abuse and misuse of opioids. In particular, the survey asked about the role of veterinarians in preventing diversion, their use of Colorado’s prescription drug monitoring program, their awareness of abuse and misuse in their clinic, and about their need for resources. Researchers found that 13% of surveyed veterinarians knew an animal owner had injured or intentionally made an animal sick or even made the animal seem ill or hurt to get opioid medications. In addition, 44% of the veterinarians were aware of opioid abuse or misuse by either a client or a veterinary staff member.
The Center for Health, Work & Environment staff presented these findings to the American Veterinary Medical Association, the Colorado Department of Regulatory Agencies–Veterinary Medicine, and more than 300 Colorado veterinarians via a townhall. In addition, presentations were given to the Centers for Disease Control and Prevention’s One Health program, and the study findings were highlighted in the American Journal of Public Health.
Details:
- Prescription Opioid Epidemic: Do Veterinarians Have a Dog in the Fight?external icon
- NIOSH Science Blog: The Role of Veterinarians in the Opioid Crisis
- Opioids in the Workplace: NIOSH Extramural Research
- Colorado School for Public Health: Center for Health, Work & Environmentexternal icon
Understanding Occurrences of PTSD in Correctional Officers
Workers in the Public Safety Sector, like correctional officers, often face situations that are stressful, potentially unpredictable, and traumatic. These incidents can lead to mental health issues like substance use disorders, depression, and even posttraumatic stress disorders (PTSD). Funded through a pilot grant from the Healthier Workforce Center of the Midwest, a St. Louis University researcher looked at the occurrence of PTSD among jail correctional officers in the Midwestern United States and any associated health characteristics. The study found a relationship between PTSD and an anxiety or depression-related diagnosis, burnout, and emotional labor.
The Journal of Occupational and Environmental Medicine and other academic publications highlighted these research findings in FY 2019. The investigator on this project also presented at the American Correctional Association conference and is using partnerships to increase awareness of the study and develop other initiatives to support well-being within the correctional system. These includes collaborations with the American Occupational Therapy Association, community organizations like the St. Louis Alliance for Reentry, and other programs at St. Louis University like the Health Criminology Research Consortium and Transformative Justice Initiative.
Details:
- Posttraumatic Stress Disorder and Job Burnout Among Jail Officersexternal icon
- Healthier Workforce Center of the Midwestexternal icon
Increasing Workplace Physical Activity Among Call Center Workers
Call center workers are among the most sedentary, or inactive, workers in the United States. On average, call center workers spend a higher percentage of their time sitting than any other occupational group.
Sedentary behavior is related to an increased risk of obesity, diabetes, heart disease, and musculoskeletal or muscle and bone injury. Sedentary behavior is also linked to a greater risk of death from any cause. Prior research found that standing desks and walking workstations reduce back pain, musculoskeletal complaints, and overall sedentary time, which relates positively to improved mood, job satisfaction, and general well-being.
Researchers at the Oregon Healthy Workforce Center are evaluating interventions, both organizational and individual, to decrease sedentary work and improve health in call center workers. Organizational interventions include physical workplace alterations and changes in the way supervisors interact with employees. Individual interventions include changing employee health and safety behaviors through training, monthly safety and health activities, and active workstations. Preliminary results from the self-reports of call center workers linked more musculoskeletal pain and lower life satisfaction to time spent sitting at work.
Workers in other occupations and industries could benefit from the findings of this research as the number of sedentary workers continues to rise in the United States. This study was mentioned in The Society for Occupational Health Psychology newsletter, in addition to the researchers’ other projects related to sedentary behavior and work.
Details:
- Hold the Phone: Increasing Physical Activity at Work
- Society for Occupational Health Psychology Newsletter Summer 2019 (Vol. 21)pdf iconexternal icon
- Oregon Healthy Workforce Center: Active Workplace Studyexternal icon
Effectiveness of Safety Interventions for Low-wage Healthcare Workers
A safe patient-handling intervention decreased injuries among nurses, but not among lower-wage workers employed as patient care associates, according to a recent study in the American Journal of Public Health.
Researchers at the Harvard T.H. Chan School of Public Health compared self-reports of safe patient-handling practices and hospital injury rates at two large Boston area hospitals from 2012 through 2014. The purpose of the study was to investigate how results at the population level may not show the full picture.
In 2013, nurses and patient care associates at one hospital received the same safe patient-handling intervention while workers at the other hospital did not. The intervention included initial and ongoing training on using new equipment to help move patients safely, such as slings and special devices. Study participants involved 482 nurses and 96 patient care associates at the intervention hospital and 915 nurses and 94 patient care associates at the comparison hospital.
After the intervention, lifting and exertion injuries among nurses decreased by about a third, however, no decrease in injuries occurred among patient care associates. At the same time, both groups reported similar improvements in their own safe handling of patients. These findings are an example of the “inequality paradox,” which is the tendency of some interventions to unintentionally widen the gap between less and more advantaged workers. Subsequently, the results highlight the importance of accounting for differences among workers when designing and evaluating health and safety interventions.
Details:
- Paradoxical Impact of a Patient-Handling Intervention on Injury Rate Disparity Among Hospital Workersexternal icon
- Safety Intervention Less Effective for Low-wage Workers
- Harvard T.H. Chan, School of Public Health: Center for Work, Health & Well-beingexternal icon
Developing Safer and Healthier Work Through Communities
The University of Illinois at Chicago (UIC) Center for Healthy Work continues to explore how to implement safer and healthier approaches to work that extend into the community through the Greater Lawndale Healthy Work Project. UIC researchers are collecting data from two Chicago neighborhoods with high levels of unemployment and/or residents in precarious work, to find ways to improve worker health at the community level. They are using existing neighborhood data, a community health survey, focus groups, interviews, and an approach called concept mapping to identify what works. Concept mapping is a way to understand data, collected from qualitative sources, where ideas are put into a picture or map.
To date, scientists have used the neighborhood level data to create a community health profile on work. They found that, compared with the city of Chicago overall, the residents in their study are younger, mostly racial and ethnic minorities, less likely to have a high school education, and have higher rates of unemployment. For working residents, there is a greater likelihood of employment in low-skill and low-wage jobs and with higher rates of poverty even when working year-around. Furthermore, these residents are less likely to have health insurance, but work in occupational industries with high injury rates.
Investigators also looked at workplaces within these communities and found that of 1,127 employers, more than half were in the retail, food, and service industries. The researchers used these data findings to develop a theory of change and identify three strategic areas to direct the project’s focus: (1) community norms that support healthy work (people and networks), (2) strong system of community resources that support healthy work (community capacity), and (3) equitable opportunity for work exists (policy and systems).
Investigators also plan to analyze community health survey data collected from 488 residents of the neighborhoods in the study. By engaging directly with communities and their workers, researchers aim to raise awareness of the relationship between communities, work, and health, as well as develop new TWH interventions.
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Education and Research Centers
NIOSH supports professional training in occupational safety and health (OSH) through training programs in Education and Research Centers (ERCs). ERCs are university-based multidisciplinary centers that offer graduate, post-graduate, and research training in the core and allied fields of occupational safety and health. ERCs also supply continuing education and outreach to the OSH community throughout the federal health region they serve. ERCs are interdisciplinary programs and a major part of a network of training grants that help ensure an adequate supply of qualified professional practitioners and researchers. Essential ERC components are outreach and research-to-practice activities with other institutions, businesses, community groups, and agencies within their region, as well as academic programs. Programs respond to area needs and carry out new strategies and initiatives to meet those needs, with a focus on worker health and safety.
NIOSH Education and Research Centers
The Occupational Safety and Health Act of 1970 (Public Law 91-596external icon) directs NIOSH to ensure an adequate supply of qualified occupational safety and health personnel. NIOSH responded to this mandate by funding training programs to provide the nation with a competent, highly skilled occupational safety and health workforce. NIOSH-funded ERCs serve a vital role in protecting the health and safety of the nation’s workforce. Aligning with the goals of Healthy People 2020—to prevent diseases, injuries, and deaths due to working conditions—ERCs improve occupational safety and health through education, research, and collaboration. They serve as regional, national, and global resources for business, labor, government, and the public.
ERCs meet the critical need to produce researchers and practitioners—vital to maintaining workplace health and safety— and reduce the burden of preventable work-related injury, illness, and death by performing the following actions:
- Providing the necessary knowledge to the U.S. workforce to reduce the burden of work-related injury, illness, and death.
- Developing the major research advances needed to prevent occupational injuries, illnesses, and fatalities in the United States.
- Providing regional and industry-specific outreach and consultation to more than 5,000 small-, medium-, and large-sized U.S. businesses annually.
- Serving as the primary knowledge source for public and government leaders for job-related safety issues without duplicating other government programs.
ERC 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, 2018, through September 30, 2019, ERCs published 253 articles in peer-reviewed journals. Find a searchable database of NIOSH publications, which includes grantee final reports and publications, by using the NIOSHTIC-2 publications search.
Trainees, Graduates, and Employment of Graduates
In academic year 2018–2019, more than 340 students graduated from ERC programs with specialized training in disciplines including industrial hygiene, occupational health nursing, occupational medicine, occupational safety, and other closely related occupational safety and health fields. The number of students enrolled decreased slightly from 993 in FY 2018 to 978 in FY 2019. The table below shows the number of students enrolled, graduates, and employment status during FY 2019.
Table. ERC Trainees, Graduates, and Employment, FY 2019
| Program Area | Enrolled | Graduates | Employed or seeking occupational safety and health employment (%) |
|---|---|---|---|
| Industrial Hygiene | 312 | 115 | 114 (99) |
| Occupational Health Nursing | 117 | 41 | 38 (93) |
| Occupational Medicine | 134 | 64 | 64 (100) |
| Occupational Safety | 150 | 61 | 56 (92) |
| Other Related Disciplines | 265 | 64 | 59 (71) |
| Total | 978 | 345 | 331 (96) |
The table below shows the placement of FY 2019 graduates by program area and work setting. We consider graduates looking for occupational safety and health employment and not working outside their field as remaining in the field.
Table. ERC Graduate Employment by Work Setting, FY 2019
| Work Setting/ Program Area |
Industrial Hygiene |
Occupational Health Nursing |
Occupational Medicine |
Occupational Safety |
Other |
Total |
|---|---|---|---|---|---|---|
| Private Industry | 73 | 4 | 4 | 35 | 22 | 126 |
| Federal/ State/Local Government |
14 | 5 | 4 | 7 | 10 | 40 |
| Academic Institution |
12 | 2 | 5 | 5 | 11 | 37 |
| Clinic/Hospital | 0 | 14 | 40 | 1 | 2 | 54 |
| Other OSH Employment |
4 | 0 | 0 | 1 | 5 | 10 |
| Seeking Advanced OSH Degree |
3 | 0 | 5 | 3 | 6 | 17 |
| Seeking OSH Employment |
6 | 13 | 6 | 4 | 3 | 32 |
| Total | 114 | 38 | 64 | 56 | 59 | 331 |
Continuing Education Outputs
Continuing education of occupational safety and health professionals is a required part of ERC funding. Each year, NIOSH ERCs train thousands of these professionals around the United States through course offerings in the occupational safety and health core and related disciplines. The following table shows the continuing education activity by discipline. In FY 2019, ERCs provided 348,390 person hours of training to 51,153 occupational safety and health professionals who took 1,562 courses.
Table. Continuing Education Courses by Discipline, FY 2019
| Discipline | Number of Courses |
Number of Trainees |
Person-Hours of Training |
|---|---|---|---|
| Industrial Hygiene | 199 | 4,579 | 39,137 |
| Occupational Health Nursing | 235 | 9,758 | 36,322 |
| Occupational Medicine | 209 | 7,864 | 24,921 |
| Occupational Safety | 715 | 21,632 | 170,650 |
| Ag Safety and Health | 21 | 1,413 | 2,459 |
| Other | 183 | 6,087 | 72,901 |
| Total | 1,562 | 51,153 | 348,390 |
ERC Program Achievements
Speaking on the Future of Work: The Centennial Celebration of the International Labour Organization
For the 100th anniversary of the International Labour Organization, the UN recognized its agency with a panel discussion on the future of work and the role of safety and health. The event addressed challenges related to the future of work including technology, changing demographics, and work organization. Among the featured panel of experts were two faculty from the New York and New Jersey ERC. They spoke to the UN audience about key issues facing vulnerable and migrant workers, including precarious, unhealthy, and unsafe working conditions characterized by low wages and few or no benefits. They ended the panel session with a discussion on why occupational safety and health is critical to the future of work and how the International Commission on Occupational Health impacts work, the workforce, and the workplace. The panel session took place in May 2019 at the UN Headquarters in New York City.
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Development of TWH Graduate Certificate Program
The North Carolina Occupational Safety and Health ERC developed a graduate certificate course in TWH. The goal of the TWH program is to prepare trainees to respond to the changing nature of work, including technology shifts, globalization, alternative work arrangements, and shifting workforce demographics. The nine-credit hour certificate program addresses these issues through the interdisciplinary and comprehensive approach of TWH. The program offers three courses focused on (1) critical issues in work, worker, and workplace health, (2) essential methods for evaluating worker and workplace health, and (3) planning and evaluating TWH interventions. In FY 2019, eight students from multiple academic disciplines completed TWH coursework, while two students earned a TWH graduate certificate. The ERC plans to offer the courses online in FY 2020. This move will open the certificate program beyond degree-seeking students to working professionals across the United States and internationally.
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- Graduate Certificate in Total Worker Health®external icon
- North Carolina Occupational Safety and Health Education and Research Centerexternal icon
Return to Work Predicators for Stroke Survivors
Nearly 800,000 Americans have either a first-time or a repeated stroke annually, with many of them experiencing mental, emotional, and physical injuries despite improvements in treatment. In fact, stroke is a leading cause of long-term disability and failure to return to work for employees.
Researchers at the University of Alabama at Birmingham ERC reviewed 2,586 journal articles and selected 19 relevant studies to identify factors that affect stroke survivors’ return to the job. These factors included stroke severity, disability, race and ethnicity, occupation, level of education, and the existence of mood disorders like anxiety and depression. Workers were more likely to work again after a mild or moderate stroke than a severe stroke. They also were more likely to be Caucasian and of higher socioeconomic status than those who did not return to work. Other findings showed that occupational health nurses can help stroke survivors who return to work by monitoring their health history related to stroke and ensuring the availability of necessary resources, like support for anxiety and depression and the opportunity for rest breaks. African Americans are much more likely to have a stroke than other racial and ethnic groups, yet few of the studies focused on them.
These results show the importance of future research looking into factors that predict return to work for African American stroke survivors. The research findings were published in the journal Workplace Health & Safety.
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- Return to Work Among Stroke Survivorsexternal icon
- Stroke Severity, Race, and Socioeconomic Status Predict Return to Work for Stroke Survivor
Addressing Critical Mental Health Issues in Agriculture
The University of Iowa ERC focuses on research and training that target critical issues in agricultural safety and health, including increasing suicide rates. Farm workers are employed in a high-risk industry where they deal with stressors including financial challenges like market prices and physical risks like heat-related illness. In addition, they face stigma along with limited access to mental health treatment.
To address these problems, an ERC trainee studied the relationship between health insurance and healthcare-seeking behaviors among Midwestern farmers. The study identified a lack of health insurance as a stressor for farmers and the type of insurance influenced when they would visit a healthcare provider. In addition, another trainee investigated the association between farmer suicides in Iowa and access to certified mental health centers. These research findings showed that counties with certified mental health centers had an increased risk of having one or more farmer suicides. This suggests that access to care, alone, is not enough for prevention. Both studies demonstrate the need to better understand barriers to farmers receiving mental health services to improve their well-being and minimize suicide rates.
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